Emergency 911 is still inaccessible for many New Yorkers. How long do we have to wait?

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In New York City, where I live, the deaf and hard of hearing are out of luck when it comes to calling 911 for help.
Text 911 (or Text-to-911) is available in thousands of municipalities and counties across the United States. It can be life-saving not only for those who cannot hear but also for people with speech impediments, for those in hostage situations, in domestic violence disputes, or in active shooter scenarios, among others.

So where is New York City’s long-promised 911 texting system?

In June 2017 New York City’s Department of Information & Technology (DoITT) announced a plan for a fully digital 911 system that could handle texts, photos and videos as well as phone calls. That system, Next-Generation 911, was scheduled to launch in the first quarter of 2022. In the interim, the city would offer a more modest 911 texting service, expected to go into service by early 2018, according to the June 2017 announcement.

As a headline in the local online newspaper The City put it, “Text-to-911 Caught in Life-or-Death Battle Between NYPD and Tech Agency.” Here’s a link to the article, which also fills in the background of New York’s dispute.

This week (Nov. 12), the City Council’s Committee on Technology held a joint hearing with the Committee on Fire and Emergency and the Committee on Public Safety to see why New York still lacks a basic Text 911 system. A panel of members of the Deaf community were the first to testify. Speaking through interpreters, one after another described harrowing experiences with 911. On a later panel, a man overcame his stutter to eloquently describe the insulting treatment he’d received from impatient 911 operators. Another speaker recalled being stranded at a highway bus stop at night with no way to communicate her whereabouts.
Representatives of DoITT and the police and fire departments testified next. One official begged off under sharp questioning by the committee chair, saying he’d only been in the job since the previous summer. As soon as the city officials were finished their testimony, they got up and left, despite the fact that further panels of those affected had not yet spoken.
I testified on behalf of those with hearing loss and explained that even with a hearing aid and a cochlear implant I cannot hear well enough to respond to a 911 operator’s questions, especially on the street or almost anywhere outside of my apartment. I pointed out that the inability to report an emergency endangers not only the individual trying to make the call but others in the area. A deaf friend recently told me about encountering a dangerously disturbed man on the subway, who was agitated and aggressive to other passengers. She got off the train and looked in vain for a transit official or police officer. New York’s subways have Wifi, but she wouldn’t have been able to communicate with the 911 operator. Finally, feeling “irresponsible and guilty for not following through,” she gave up.  It’s the city that should feel irresponsible and guilty.

Don’t hold your breath waiting for NextGen, which officials said is at least four years away. The city has yet to select a contractor for the system. Nor is the interim system anywhere in sight. Current estimates for the interim system are for the summer of 2020.
A few years ago when I wrote about Text 911, a representative from the city’s office of emergency management told me about two services that provide the equivalent of Text 911: Smart 911 and Rapid SOS. But learning about and installing those apps requires training and forethought. We’re taught from the time we can speak to call 911 in an emergency. Who stops to think of alternatives when danger threatens?
For more information about Text 911, go to the FCC’s Text-to-911: Quick Facts and FAQs. The FCC also maintains a frequently updated master list of areas that have Text 911.
Readers, if you’ve had difficult or dangerous experiences with 911, please comment. If you live in an area with Text 911, please share what that experience is like.

 

For more about living with hearing loss, read my books, available at Amazon.com. (If you want to buy the paperback of Smart Hearing, wait. Amazon has it listed at $18.25 for some reason. It should be $10.99.)

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Captions: Better and Better!

I don’t like to write about apps and products that I don’t use myself, because the first-person experience is very important when dealing with hearing devices. But when I find one I like, I want to share it.

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In the past few months, I’ve been using a transcription app called Otter.ai. Otter has been around since early 2018 and is intended to be a transcription tool for business and other meetings. But it’s great for the deaf and hard of hearing. Otter is available for iPhone or Android. It’s free for the first 600 minutes a month, which is more than enough for me. Upgrading to 6000 minutes costs $9.99 per month or $79.99 per year for business, $2.99 per month for students and teachers.

It’s very simple to use. Once you’ve downloaded it you tap the microphone icon and start talking. Otter recognizes different voices and starts new paragraphs with each new speaker. It also punctuates fairly accurately. You can adjust the size of the type. Although I haven’t tried this, I believe it can identify each speaker.

The transcript takes a while to show up, which can be confusing if you are using this to hear. The first few times this happened to me, I thought Otter was not connected to the internet via Wifi or cell. Now I know I just have to be patient. One way around the problem is to start talking into the app before the important part of the conversation begins. When the transcription finally appears, start your meeting. From here on the transcription will be close to real time. Be sure to read the privacy policy if you are concerned about confidential material.

I have increasingly found, however, that although Otter is recording the conversation it is not providing captions — or at least live captions. It seems to be related to wifi access. Since I — and my readers — are much more interested in Otter as a captioning device than as a recording device, it’s important to understand whether or not the app can work on cell service or if it requires Wifi. I didn’t realize how much of an issue this was when I wrote the post. I’ll research it and amend the post as needed.

Also, as noted in the comments below, if you are also using your telecoil to access a hearing loop or other assistive device, Otter turns your telecoil off. Not good. Otter is not intended as a captioning device — it’s meant for transcription. So maybe we’re asking more of it than it is offering.

Nevertheless, if all goes well, the conversation is saved and can be accessed from your computer for editing. For a fuller description of what Otter can do, read this review from PC Magazine.

Some of you may have read “Captions Wherever You Go,” a post I did on Google Live Transcribe last spring. Once I discovered Otter I stopped using Google because it was much easier to have one phone for all functions. But Android users may find Google Transcribe more to their taste than Otter.

My other favorite app is Innocaption, which is meant specifically for the deaf and hard of hearing. I’ve been using this app on my iPhone 8 for the past year or so, and it is also available for Android. Previously, the only way I could talk on the phone was with my landline captioned phone.

After you register with Innocaption and download the free app, you’re ready to go. Innocaption will assign you a phone number, but if you’ve been using another mobile phone number and don’t want to change, you can have the Innocaption number forward to that number for both incoming and outgoing calls. If you have a Made for iPhone or Android hearing aid, the sound will go wirelessly to your hearing aid or cochlear implant. The captions appear on your phone screen. If you don’t have a Made for iPhone or Android device, you can use a streamer to transmit the audio.

You can transfer your contact list as well as your favorites list. Innocaption also keeps a record of recent calls. To make a call, you click on the Innocaption icon. You can make a call much the way you always have, either by clicking on a favorite number or by inputting the number on the keypad. To answer an incoming call, click on the Innocaption icon on your smartphone screen. Innocaption also provides captioned voice mail. An icon of what looks like a pair of glasses appears on the icon. Tap once and takes you to the keypad. Tap once on the hashtag. it will automatically dial your voice mail. Just follow the prompts to get messages and to save or delete. Innocaption, for the most part, uses human transcribers, which improves accuracy. If no humans are available, it offers a voice-recognition transcription. I find that if I hang up and try again in a few minutes, a human often is then available.

Most smartphones have other dictation apps as well. On the iPhone, any text app also has a microphone app that will provide a live transcription. Here’s a link to various tricks you can use with dictation apps to save time and increase accuracy. If you want explicit directions for using a dictation app, check out this article from Business Insider.

Please share your experiences with these or other apps in the comment section.

For more about living with hearing loss, read my books, available at Amazon.com and Barnes and Noble, and maybe at your favorite bookstore or library. If it’s not there, ask for it!

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Would You Cure Your Hearing Loss?

Would you cure your hearing loss?

At the moment, that’s a hypothetical question. A cure for hearing loss does not exist. But as Dr. Tom Friedman of the National Institutes of Health told an audience at the Hearing Loss Association of America’s annual convention in June, a cure for at least one type of hearing loss may be around the corner.

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Genetic, or hereditary, hearing loss is responsible for about 60 percent of hearing loss present at birth or developing in early childhood. It is also responsible for some adult-onset hearing loss, either on its own or in combination with exposure to noise or other toxins, including some medications like streptomycin or aminoglycoside antibiotics.

Hereditary hearing loss is caused by one or more mutations on a specific gene or genes. As of May 2019, scientists have identified 129 different genes causally associated with hearing loss. (“Causally” is the important word here.) Others are still being investigated. Gene sequencing can show which specific genes carry a mutation.

Hela Azaiez, PhD at the University of Iowa, who also spoke, noted that there are over 7000 possible mutations in those genes. She also said that an expert can sometimes predict which gene is responsible for the loss by the pattern on an audiogram. The more a person knows about the pattern of loss in the family, the easier it is to find the defective genes that are causing the loss, so a large family tree is helpful.

Autosomal recessive genes are the cause of hearing loss in 59 percent of cases. When the gene is recessive, the effect — in this case hearing loss — may skip generations and a pattern may not be apparent. Thirty-six percent of the genes that cause hearing loss are autosomal dominant, which means they always cause hearing loss. That leaves five percent, of which four percent are linked on the x chromosome and 1 percent in mitrochondrial DNA.

Two-thirds of those with hereditary hearing loss have no other related symptoms. But the remaining third have what is called syndromic deafness, with symptoms in addition to hearing loss. These include Usher syndrome (the disorder that Rebecca Alexander, subject of my previous post, has), Alport syndrome, and Perrault syndrome.

The next step for researchers is developing a way to correct those mutations. Several laboratories are moving ahead quickly with research.

Dr. Friedman is chief of the Laboratory of Molecular Genetics at the National Institute on Deafness and Other Communication. Dr. Hela Azaiez focuses on autosomal dominant genes at the Molecular Otolaryngology and Renal Laboratory at the University of Iowa. In the afternoon Dr. Azaiez gave a workshop with former HLAA Executive Director Brenda Battat and her family, who have hereditary hearing loss. Brenda Battat wrote about her family’s genetic search in an article for the January-February issue of Hearing Life Magazine called “Caught Up in a Whirlwind of Genetic Hearing Loss . They have been working with Dr. Azaiez.

To return to the question in my title: Would You Cure Your Hearing Loss? Many in the culturally Deaf community would answer with an emphatic No. Hearing loss/deafness/sign language are what makes them a community. As for me, with many years of hearing loss behind me, I would also probably say no, because the speech pathways in my brain are attuned to the way I hear now with a hearing aid and a cochlear implant.

But there are good reasons for determining the cause of hereditary hearing loss even if you don’t plan to treat it. Families may decide to correct the mutation in future generations. If it is too late to correct in younger family members, or if the family does not want to correct it, finding out what the mutation is and which family members have it allows them to plan ahead for future health care and other decisions.

The research symposium at Convention is always fascinating. This year’s panel included other researchers and much more information than I have room for here. Don’t miss next year’s symposium at the HLAA Convention in New Orleans.

For more about living with hearing loss, read my books, available at Amazon.com and Barnes and Noble, and maybe at your favorite bookstore or library. If it’s not there, ask for it!

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Captions Wherever You Go

It’s rare that a new app or product comes on the hearing device market that seems revolutionary. But Google has come out with a voice to text app that is potentially game-changing for those of us with severe hearing loss.

Although I have an excellent hearing aid and a state of the art cochlear implant, I still have trouble understanding speech in a group or in a noisy environment. Existing voice to text apps like AVA and Dragon Dictation help in those situations, but Google Transcribe far out performs them.

Google Transcribe is a free app that is currently available only for Android devices. I’ve been using it for the past month or so and didn’t want to write about it till I understood the pros and cons.

There are cons, as a glance at the photo illustrates. It starts out fine and then deteriorates.Google Transcribe IMG_0495

This transcript was made during a discussion with three other people. Looking at the transcript now, a day after the conversation took place, the text seems pretty garbled. It seemed perfectly clear at the time, probably because I can also hear enough to provide context. My book club was discussing Geraldine Brooks’ novel “March,” which imagines Louisa May Alcott’s “Little Women” from the perspective of the father who goes off to the Civil War. “Marmion” in this text refers to Marmee. I’m not sure what the word “Reversible” was supposed to be, but the rest of it seems clear enough.

Using the device at my book club, the discussion at first appeared in Spanish. Google Transcribe is also a translation app and has dozens of languages to choose from. I must have clicked on Spanish by mistake.

If you have an Android phone, all you need to do is download the Google Transcribe app. If, like me, you are a loyal Apple user, you’re out of luck unless you buy an Android device. Fellow blogger Shari Eberts, who wrote about Google Transcribe a few weeks ago, suggested buying an inexpensive Android device and not registering for phone service.

I bought this device. Since I’m not an Android user it took me a few tries to figure how to turn it on and navigate around it. I should have had the sales person show me how it works. It’s a nice slim phone and it charges quickly. As long as it’s connected to WiFi, it gets Internet access. I recently used this phone for GalaPro (see earlier post), because the type is clearer and larger than that on my iPhone. It even has a nice camera.

Live Transcribe also provides live captioning for any video, including podcasts, Skype calls and others. You can read more about this on Hearingtracker.com in an article by David Copithorne.

Live Transcribe is an artificial-intelligence based technology, which means that it learns how to hear speech. Your own voice will quickly be the most accurate, because it’s the one the app is most often exposed to. Other speakers will also transcribe more or less accurately depending on background noise, how clearly the speaker articulates and so on. It may take longer for Live Transcribe to recognize and accurately translate heavily accented speech.

Copithorne also wrote about Google’s Project Euphonia, which learns to recognize diverse speech patterns, for instance speech impediments. In partnership with the ALS Therapy Development Institute, Google Transcribe’s algorithms will enable it to learn to follow the speech patterns of people with ALS.

I haven’t tried Google Transcribe yet in a restaurant but I have successfully used it in environments that were previously very difficult. One is at our HLAA New York City chapter monthly meeting. The presentations are looped and captions are provided by CART. But I’ve always found it difficult to hear people who want to talk to me before or after the program. I used it this past week and it changed the whole experience. I could actually understand what people were saying. (CART, at least for now, is a superior caption provider, but since you can’t take your CART provider with you most of the time, Google Transcribe is a good substitute.)

Last week Apple stores were holding workshops for people with disabilities to demonstrate ways that Apple products could be of help. I had asked for CART captioning for the workshop, but Apple was unable to provide it. The workshop was held in a typically loud Apple Store. Apple had provided a portable hearing loop, which helped. But the only way I followed the presentation was on my Android phone using Google Translate.

It seems like heresy to use an Android phone in an Apple Store, but the presenters were impressed. Let’s hope Apple follows Google’s lead in this promising new technology.

 

UPDATE, MONDAY May 27:

Android’s Live Transcribe will let you save transcriptions and show ‘sound events’.

Click to read the article.

 

 

 

 

 

 

Hearing Mom

Sunday is Mother’s Day. I miss my mom. But I especially miss all the things I didn’t hear her say.Mom and me 2013

In her 80s, my mother’s mind and body succumbed to aging. She developed dementia, she had frequent falls and she often needed a wheelchair. But her hearing remained acute. Mine did not.

After my father died, when Mom was 85, she wanted to stay in the house they’d lived in together. It was far away from any of her children, and she had 24-hour-a-day nurses’ aides. Despite this attention, she often fell or had other physical issues that would send her to the hospital, then into rehab to recover, then home again with an aide, only to fall or suffer heart problems or infections once again, and start the cycle over.

Eventually, against her wishes, my siblings and I decided she would be better in the long-term nursing care facility at the community where they lived. She ended up thriving there.

But while she was still living at home, my hearing was a significant obstacle. It was difficult for me to hear her on the phone — and frustrating for us both — so I visited as often as I could. Even when I visited her, though, her soft voice and increasing dementia made it hard for me to understand her. My hearing loss also created some potentially dangerous situations. If I had to call her doctor or even 911, I couldn’t hear their responses. I’d hand the phone to my mother to listen for me and hope she was correctly repeating whatever the doctor said. I didn’t know about captioned phones then, or I’d surely have ordered one. If Text 911 had existed, that would have removed another barrier to communication.

Once she was in the nursing facility, there were fewer crises. But as she became less clear mentally, and as her voice weakened, I not only couldn’t understand what she was saying, but I was never sure she was saying what I thought she was saying. It’s hard enough for a fully hearing person to converse with someone with dementia. Imagine what it’s like when you aren’t sure you’ve understood correctly.

My mother died in 2014. Every mother’s Day I think about all that I missed in those last years of her life. Despite hearing aids and a cochlear implant, and hearing-assistive devices galore, my hearing and her dementia still created an enormous gap. The only way across it was with smiles and hugs and just being there — for her and for me.

Most people’s hearing problems are not as severe as mine. But if you’re having trouble hearing an elderly parent with a whispery voice — or if the parent is having trouble hearing you — don’t let that happen. If you are not ready for hearing aids, buy yourself a handheld device such as a pocket talker.

But whatever solution you come up with, don’t let those words be lost forever.

(A version of this post was first published in 2015 in AARP online.)

Photo courtesy of Katherine Bouton

For more about hearing health, my book “Smart Hearing.” will tell you everything I know about hearing loss, hearing aids, and hearing health.Smart Hearing_Cover_highres

You can get it online at Amazon or Barnes & Noble, in paperback or ebook for Kindle or Nook. You can also ask your library or favorite independent bookstore to order it.

Crowdsourcing Hearing Info

The Mayo Clinic, in collaboration with the Hearing Loss Association of America (#HLAA) and the Ida Institute, an independent non-profit organization that promotes hearing health, has established an online forum where you can find support, answers to specific questions, share experiences and even gripe if you feel like it.

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The forum is monitored by Mayo Clinic staff as well as volunteer mentors, and this oversight should help keep the discussions civil and the information credible. I’ve been following it for the past couple of weeks and I’ve found a lot of interesting information, and a lot of people whose hearing-loss experiences help put my own in perspective.

To join the group:

Go to https://connect.mayoclinic.org/group/hearing-loss/.Click on the “Join” button at the top, create a user name (you can use a nickname or a first name plus @ — for instance Katherine@), enter your email address and follow the prompts.

Anyone can read the discussions, whether or not you join, but if you want to initiate a topic or comment on an existing discussion, you’ll need to fill in information in the section titled “Introduce Yourself.”

An online forum is not a substitute for an in-person support group. Whether you are new to hearing loss or a veteran of hearing loss, you might benefit from joining an HLAA or ALDA (Association of Late Deafened Adults) chapter near you. But I also recommend joining this forum. You can learn from the discussions and also contribute to others’ knowledge.

(If you think you’ve already read this post, you’re right! It was published in a longer form a few weeks ago. Now that I’ve had a chance to read the discussions over a few weeks, I thought it was worth another post. Please share your experiences.)

The Language of Disability: It Can Be Hard to Get It Right

Last week I went to a panel discussion organized by the New York Museum Access Consortium. There were four panelists representing different disabilities and a moderator from MAC. The audience was made up mostly of people from disability rights organizations and museum personnel.images

The evening’s topic was “Mindful Communication.” Avoiding hurtful or offensive language when talking about disability isn’t as easy as it sounds. “People first” is a generally accepted standard. To use hearing loss as an example, a person is not “hearing impaired,” because that suggests that the way he or she hears defines who he or she is. We prefer “people with hearing loss.” (For more on parsing terms for hearing loss see my post “Deaf, Hard of Hearing, Hearing Impaired? Be Careful What You Call Us.”) It took me a long time to realize that “hearing impaired” is a distasteful term to many with hearing loss – and I have hearing loss! So I’m relatively easy on others who slip up on the politically correct terms.

After the panelists introduced themselves, with visual descriptions for the blind in the audience, the moderator led the discussion with a variety of questions. I can’t do justice to the full hour’s discussion but a couple of comments stuck with me.

The panelists were asked what kind of language they found offensive. I expected to hear them say that casual ignorant slurs were hurtful. Instead, the answers were much more complicated.

Ansel, who has visible disabilities and uses a wheelchair, said he dislikes it when someone trying to be kind says: “God bless you.” He doesn’t feel the need to be blessed, and finds it condescending. But he doesn’t get angry. “If it makes them feel good, it’s okay.”

Nefertiti, who is blind, dislikes being called “amazing.” When she was growing up, people were always saying how amazing she was. “I was such an amazing kid just for getting up in the morning! It gave me a little bit of an ego.” She prefers to think of herself as “just a human being doing what I do. It doesn’t mean I’m amazing just because I’m blind.” Of the term “disabled” she said cheerfully, “I feel pretty abled.”

In the question and answer period, one museum employee spoke about the difficulty of using correct and acceptable language in written literature like museum guides. “We’re working with a staff with a fear around language,” she said, to nods of agreement from others in the audience. Another of the panelists, Madison, suggested that staff take their lead from the community in question. Nefertiti similarly suggested listening to the person or group and then mirroring the language they use.

This brought the conversation back around to the panel’s topic: Mindful Listening. Mindful Listening is always important, as Nefertiti pointed out. If, for instance, a sighted person offers to help a blind person cross the street, and doesn’t listen to a polite “No thanks,” nobody wins: “The blind person is offended and the sighted person is baffled.”

Some of the more digressive responses were also insightful. One of the challenges Nefertiti faces as a blind woman was something I’d never considered. Being blind, she said, means that she misses the culture of body language. Someone will say “She’s a nice girl but….” Think of all the ways you could end that sentence without saying another word:  With a shrug (suggesting “… she’s not very effective at her job”), with a roll of the eyes (“…. the clothes she wears make her look like a slut”), with a shake of the head (“… not for me!”), with raised eyebrows accompanied by a shoulder hitch (“… who knows what she’ll get into next”). Etc.

A full transcript of the discussion can be found here. 

Coincidentally, this week Major League Baseball announced that it would discontinue use of the term “Disabled List” for players who were injured. The change came about after advocates for people with disabilities complained, according to the New York Times. The Times quoted Jay Ruderman, president of the Ruderman Family Foundation, which encourages greater inclusion of people with disabilities in society: “The disability community identifies with the term ‘disabled,’” he said “When it’s used incorrectly, when someone is injured, not disabled, that’s offensive.” He went on: “People with disabilities do not consider themselves injured….Someone who tears an A.C.L. is not permanently disabled.”

It’s true (usually) that they are not permanently disabled, but should they happen to use a wheelchair for a period of time, they are entitled to the same rights under the Americans with Disabilities Act as people with more permanent disabilities. Nobody ever said the ADA was restricted to those with permanent injuries. In any case, goodbye to the DL and welcome the “Injured.”

Most of my readers have hearing loss. I’d love to hear your comments about terms and comments that offend you.

For more about hearing health, my book “SMART HEARING.” will tell you everything I know about hearing loss, hearing aids, and hearing health. Available online at Amazon or Barnes & Noble, in paperback or ebook for Kindle or NOOK.

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