Assistive Technology for Students who are Deaf or Hard of Hearing

Definitions and Foundations of Hearing Differences

  • Audiometric vs. Functional Descriptors:

    • Hearing loss severity is clinically classified by audiologists using decibel thresholds across frequencies into four broad categories: mild, moderate, severe, and profound.
    • Single-word audiometric terms do not accurately predict functional abilities across complex tasks such as speech perception, language comprehension, listening in noise, or preferred communication mode.
    • Medical Model: Classifies individuals strictly based on measured decibel loss and auditory threshold limits.
    • Cultural Model: Identity is defined by cultural affiliation, preferred communication mode (e.g., American Sign Language), and self-identity. An individual clinically diagnosed with moderate or severe hearing loss may culturally identify as Deaf.
    • Many individuals within the deaf and hard of hearing community reject deficit-based terminology such as hearing impairment, loss, or disability.

  • Wisconsin Department of Public Instruction Eligibility Guidelines Definitions:

    • Deaf: Refers culturally to individuals affiliated with the Deaf community who use American Sign Language (ASL) as their primary mode of communication. Deaf students may display speech or speech-reading capabilities depending on the environment.
    • Deafness: A physical hearing condition so severe that the processing of linguistic information through sound alone—with or without hearing aids or amplification—is severely limited. Students with cochlear implants remain physically deaf regardless of functional auditory performance. Deafness is independent of speech ability or sign language usage.
    • Hard of Hearing: A degree of hearing loss that permits the processing of acoustic information for auditory-verbal communication, supplemented by hearing aids or Assistive Listening Devices (ALDs) as needed. Audiometric tests do not reliably predict auditory comprehension; functional performance ranges from full auditory access with amplification to requiring sign language support in complex or noisy settings.

WATI Assistive Technology Decision Making Guide

WATI Assistive Technology Decision Making Guide

  • Student Abilities and Difficulties:

    • Evaluates how a student utilizes residual hearing and responds to technology across diverse educational settings.
    • Key evaluation parameters:
    • Current and past usage of hearing technology or personal amplification.
    • Reliance on sign language and sign language interpreters.
    • Ability to access direct teacher instruction from the front of the room, while the teacher moves around, or when the teacher's back is turned to write on the board.
    • Ability to access peer contributions during class discussions, group work, or unstructured activities.
    • Access to school safety alarms (fire, tornado) and public address system announcements.
    • Availability of emergency communication tools to contact family or community support services.
    • Ability to access closed captioning on instructional video media.
    • Communication methods across family, peer, and community environments.
    • Capacity to take notes while maintaining direct line-of-sight visual contact with a speaker or interpreter.
    • Participation and information access during group events, assemblies, and lectures.

  • Environmental Considerations:

    • Background Noise: Generated by internal sources (students, computer cooling fans, overhead projectors, HVAC systems) and external sources (hallways, adjacent classrooms, playgrounds, street traffic). Noise masks speech sounds, creating severe communication barriers.
    • Room Acoustics: Physical surfaces (tile floors, glass windows, hard walls) create sound reverberation (echoes), smearing speech clarity. High-reverberation environments include gymnasiums, cafeterias, auditoriums, and music rooms. Low-reverberation environments feature carpeting, acoustic ceiling tiles, and smaller room dimensions.
    • Distance: Sound intensity decreases significantly over distance. Traditional preferential seating placing the student in the front row reduces distance to the teacher's primary instruction point, but teacher movement during instruction varies this distance dynamically. Distance severely limits acoustic access to peer responses across the classroom.
    • Visual Access: Sightlines are vital for visual information gathering. Seating students in the second or third row offers improved visual access to peer interactions without requiring complete head turns. "U"-shaped or circular seating arrangements provide optimal visual access. Lip-reading requires an uninterrupted line-of-sight; looking down to take notes or a teacher turning to write on a board breaks visual access. Visual fire/tornado alarms and printed copies of daily public address announcements ensure equitable information access.
    • Lighting: Fluorescent lighting introduces acoustic hums. Dim lighting or strong backlighting from windows places speakers and interpreters in shadow, obscuring facial expressions, lip movements, and signs.
    • Available Technology: Interactive whiteboards, computers, broadcast announcements, and sound field amplification systems enhance access when properly integrated.

  • Sensory Considerations:

    • Co-occurring visual, auditory, or tactile challenges must be evaluated. Students with dual sensory impairments (deaf-blindness) or co-occurring cognitive disabilities require specialized multi-sensory accommodations.

  • Tasks and Narrowing the Focus:

    • Premise: Provide access to identical information available to hearing peers across all environments.
    • Tasks must be defined using specific, measurable objectives (e.g., "complete and deliver social studies presentation", "identify plot and characters in a story", "organize daily assignments") rather than vague goals like "participate in class".

  • Solution Generation and Selection:

    • Brainstorming potential tools without immediate selection, followed by reviewing the assistive technology continuum.
    • Applying a feature match process to align device features with student capabilities, tasks, and environmental demands.
    • Categorizing options into immediate implementations, short-term additions, and long-term targets requiring training.

  • Implementation and Follow-Up Plan:

    • Establishing trial periods with defined start dates, trial lengths, assigned responsible personnel, and success metrics.
    • Collecting systematic feedback from the student, family, and educational team.
    • Setting explicit, scheduled follow-up meeting dates.

Hearing Technology

  • Overview: Hearing technology encompasses systems designed to improve sound accessibility, divided into Assistive Listening Devices (ALDs) and Personal Amplification.

  • Assistive Listening Devices (ALDs):

    • Designed to optimize the signal-to-noise ratio by picking up sound directly at the source and transmitting it directly to the listener, bypassing distance, background noise, and room reverberation.
    • Frequency Modulation (FM) Systems:
    • Transmits sound via radio waves across specific frequencies reserved by the Federal Communications Commission (FCC).
    • Deployed as whole-room sound field systems (installed or portable) or personal units.
    • Personal FM receivers connect to earphones, headphones, or directly to hearing aids via Direct Audio Input (DAI) boots or integrated ear-level receivers programmed by an audiologist.
    • Channel cross-over interference can occur if adjacent rooms use matching FM frequencies.
    • Infrared Systems:
    • Transmits audio using invisible light waves to light-sensitive receivers connected to speakers or personal headsets.
    • Requires an unobstructed line-of-sight between the transmitter and receiver.
    • Light signals are contained within room walls, eliminating cross-room channel interference, but signals are susceptible to interference from bright sunlight or external light sources.
    • Induction Loop Systems:
    • Transmits electromagnetic signals through wire loops installed around room perimeters (under carpets, inside walls, or ceiling tiles).
    • Requires the listener's hearing aid or receiver to be equipped with a Telecoil (t-coil).
    • One-to-One (1:1) Communicators:
    • Hardwired system connecting a microphone transmitter directly to a receiver/headset via a physical cord.
    • Features user-adjustable volume control for direct conversation, television listening, or vehicle travel.

  • Personal Amplification:

    • Individually selected, fitted, and programmed by an audiologist based on audiometric profile and ear anatomy.
    • Hearing Aids:
    • Primary body styles: Behind-The-Ear (BTE), In-The-Ear (ITE), and In-The-Canal (ITC).
    • Legacy Analog: Amplified all incoming acoustic frequencies linearly in equal ratios.
    • Digital Programmable: Features digital signal processing custom-tuned to specific frequency losses, offering speech enhancement, background noise reduction, directional microphones, internal telecoils (t-coils), and integrated FM capabilities without external DAI hardware.

  • Non-AT Medical Implants (IDEA Context):

    • Cochlear Implant (CI):
    • Surgically implanted electronic device that bypasses damaged sensory hair cells in the cochlea to stimulate the auditory nerve directly.
    • Primary manufacturers: Advanced Bionics, Cochlear Americas, and Med-El.
    • Features body-worn or ear-level speech processors compatible with ALD direct inputs.
    • Individuals with CIs remain physically deaf despite functioning auditorily as hard of hearing.
    • Bone Anchored Hearing Aid (BAHA™):
    • Surgically implanted bone-conduction device manufactured by Cochlear Americas.
    • Indicated for severe conductive hearing loss, ear malformations, chronic middle ear disease, or Single Sided Deafness™.
    • Children under 5 years5\,\text{years} of age utilize a soft elastic headband mount prior to surgical implantation.

Alerting Devices

  • Functional Overview:

    • Alerting devices convert auditory signals into high-decibel amplified sounds, flashing visual light strobes, or physical tactile vibrations to capture attention.
    • Configurations exist in stationary tabletop models and portable travel units.

  • Alerting Applications:

    • Baby monitors
    • Alarm clocks and wristwatches
    • Computer notifications
    • Doorbell and door knock sensors
    • Fire and Carbon Monoxide smoke detectors
    • Telephone and cell phone ring indicators
    • Severe weather warning alerts

Communication Supports

  • Telecommunications:

    • Cell Phones, Pagers, and Text Devices:
    • Commercial mobile hardware rated for Hearing Aid Compatibility (HAC) to connect via t-coil circuits.
    • Supports SMS text messaging, instant messaging (IM), and email communication.
    • Amplified Telephones and Inline Amplifiers:
    • Telephones with internal decibel gain controls or inline external adapter modules to boost acoustic output.
    • TDD / TTY (Telecommunication Device for the Deaf / Teletypewriter):
    • Hardware incorporating a physical keyboard and display screen to transmit text across standard telephone lines.
    • Requires communication with another TTY or connection to a relay service. Advanced units feature integrated printers, answering machines, and text storage.
    • Captioned Telephones:
    • Displays real-time transcriptions of incoming spoken conversation on an integrated screen via specialized relay connections.
    • Telecommunications Relay Service (TRS):
    • Operator-mediated telephone service. A relay agent reads typed TTY text aloud to a hearing recipient and types spoken responses back to the TTY user.
    • Voice Carry Over (VCO):
    • TRS option for deaf or hard of hearing individuals who speak verbally. The user speaks directly to the hearing recipient, and the relay operator types the recipient's spoken responses for the user to read.
    • Computer Web Cameras:
    • Webcams paired with broadband internet enable visual sign language communication.
    • Internet Protocol Relay (IP Relay):
    • Web-based relay system allowing users to initiate relay calls through personal computers via internet connections rather than analog telephone lines.
    • Video Phone:
    • Dedicated video monitor and camera unit facilitating direct visual sign language calls over high-speed broadband.
    • Video Relay Service (VRS):
    • High-speed internet relay service. A qualified Video Interpreter (VI) provides real-time sign-to-voice and voice-to-sign interpretation between a signing video phone user and a hearing telephone user.

  • Closed Captioning:

    • FCC Mandates:
    • Federal Communications Commission regulations mandated internal caption decoder chips in all analog televisions with screen sizes greater than 13 inches13\,\text{inches} manufactured after 1993.
    • Expanded in 2002 to require captioning display capabilities across all digital television (DTV) receivers.
    • Standalone decoders display captions on non-captioned monitors; encoders add captions to live or recorded media.
    • Described and Captioned Media Program (DCMP):
    • Free-loan educational clearinghouse offering thousands of captioned instructional video titles via online streaming or DVD delivery.

  • Person-to-Person Communication:

    • Pen and Paper: Written message exchanges.
    • Texting Devices & Webcams: Mobile messaging and direct video streaming.
    • Commercial Communicators:
    • UbiDuo Face to Face Communicator™: Standalone dual-keyboard device featuring wireless connection and real-time dual display screens, allowing direct, real-time typed dialogue without third-party internet or cellular networks.

  • Group Activities and Classroom Supports:

    • Note-Taking Options:
    • Copies: Providing copies of instructor outlines or peer notes using duplication paper or photocopiers.
    • Electronic Note-Taking: Trained note-takers type real-time summarized lecture notes into a computer or portable word processor.
    • Digital Pen™: Smart pen hardware recording handwriting on specialized dot-pattern paper, converting strokes into digital computer text via recognition software.
    • Interactive Whiteboards (SMART Board™): Touch-sensitive display connected to a computer and digital projector, allowing instructors to manipulate applications, write in digital ink, and export saved whiteboard files.
    • Voice-to-Text and Voice-to-Sign Technologies:
    • Caption Mic™: Speech recognition setup where a trained re-speaker repeats classroom dialogue into a microphone system that generates live text captions.
    • Dragon Naturally Speaking™: Speech recognition software dictating spoken audio directly into text documents.
    • iCommunicator™: Real-time software translating spoken voice into text, computer-generated sign language video, or synthetic speech.
    • Video Remote Interpreting (VRI): Online service providing sign language interpretation via high-speed internet and webcams when an interpreter cannot be physically present.
    • Real-Time Captioning Services:
    • CART (Communication Access Realtime Translation): Verbatim, word-for-word live transcription performed by a trained captionist using a stenotype machine, computer, and real-time translation software.
    • CPrint: Meaning-for-meaning condensed speech-to-text translation system developed at the National Technical Institute for the Deaf (NTID) at Rochester Institute of Technology (RIT).
    • Remote Captioning: Live captioning delivered by an offsite captionist receiving classroom audio via phone or internet microphone and streaming text back via data connection.

Selection, Implementation, and Resource Directory

  • Selection Process:

    • Utilize a feature match process to align device features with student needs, task demands, and classroom environments. Prioritize immediate accessibility solutions while planning for items requiring specialized training or funding.

  • Implementation Plan:

    • Execute systematic device trial periods to measure effectiveness using concrete performance criteria. Gather direct user feedback from the student, family, and educational staff.

  • Organizations and Information Resources:

    • American Speech Language Hearing Association: www.asha.org
    • Hearing Loss Association of America: www.hearingloss.org
    • National Association of the Deaf: www.nad.org
    • Office of the Deaf and Hard of Hearing (ODHH): http://dhs.wisconsin.gov/sensory
    • WI Department of Public Instruction: www.dpi.wi.gov
    • Students who are Deaf or Hard of Hearing: Eligibility Criteria Guidelines (2003): http://www.dpi.wi.gov/sped/pdf/dhhguide.pdf
    • WI Educational Services Program for the Deaf and Hard of Hearing (WESP-DHH): www.wesp-dhh.wi.gov

  • Product and Vendor Directory:

    • Assistive Listening Devices: Audio Enhancement (www.audioenhancement.com), LightSPEED Technologies (www.lightspeed-tek.com), Lifeline (www.lifelineamp.com), Oticon (www.oticonus.com), Phonak (www.phonak.com), Sonovation (www.avrsono.com), Williams Sound (www.williamssound.com).
    • Captioning: CART Info (www.cartinfo.org), C-Print at NTID/RIT (www.ntid.rit.edu/CPrint), Described and Captioned Media Program (www.dcmp.org), Federal Communications Commission (www.fcc.gov/cgb/consumerfacts/closedcaption.html).
    • Cochlear Implants / BAHA: Advanced Bionics (www.bionicear.com), Cochlear Americas (www.cochlear.com), Med-El (www.medel.com).
    • Hearing Aid Manufacturers: GN ReSound (www.gnresound.com), Micro-Tech (www.hearing-aid.com), Rexton (www.rexton-online.com), Siemens (www.usa.siemens.com), Starkey (www.starkey.com), Unitron (www.unitronhearing.com), Widex (www.widexPro.com).
    • Signaling and Product Distributors: ADCO Hearing Products (www.adco.com), Harris Communications (www.harriscomm.com), Hear More (www.hearmore.com), HiTec Group, Inc (www.hitec.com), Sonic Alert (www.sonicalert.com), Ultratec Inc. (www.ultraatec.com).
    • Specific Educational Software & Hardware: Caption Mic (www.captionmic.com), Digital Pen - Logitech (www.logitech.com), Dragon Naturally Speaking - Nuance (www.nuance.com/naturallyspeaking), iCommunicator (www.myicommunicator.com), SMART Board (www.smarttech.com), UbiDuo Face to Face Communicator (www.scommonline.com).
    • Telecommunications Relay Services: Communication Service for the Deaf - CSD-VRS (www.c-s-d.org), Hamilton Relay Inc. (www.hamiltonrelay.com/states/wi.htm), Hands-On Video Relay Service - HOVRS (www.hovrs.com), Sorenson Communications (www.sorenson.com).
    • Wisconsin AT Demonstration Sites: Assistive Technology Resource Center (www.wiatrc.org), Independence First (www.independencefirst.org), Stout Vocational Rehabilitation Institute (www.svri.uwstout.edu), UniversaLink (www.cdhh.org), WATI Lending Library (www.wati.org).