No Wheelchair Ramp for the Deaf

Getting hearing access for those who are deaf or hard of hearing is a little more complicated.

No Wheelchair for the Deaf

One accommodation for the hard of hearing is an American Sign Language interpreter. But only a small minority of those who need it, use it. — Getty Images

 

 

Trying to get accommodations for those of us who are hard of hearing or deaf can be a long, tough slog.

Two years ago, the U.S. Equal Employment Opportunity Commission (EEOC) filed a lawsuit against shipping giant FedEx Ground, charging it with discriminating against its deaf and hard-of-hearing employees and job applicants for years.

The EEOC alleged that the company violated federal law by failing to provide needed accommodations, such as closed-caption training videos, scanners that vibrate instead of beep, flashing safety lights and American Sign Language (ASL) interpretation.

FedEx filed a motion to dismiss the suit, but this year a federal judge denied the motion. The case is still under litigation.

All of which brings me to the sticky issue of accommodations — namely, that no one type works for all. There is no wheelchair ramp equivalent when it comes to hearing loss.

Although the FedEx case involves the specific needs of a particular workplace, the problems of hearing access challenge all of us and make asking for hearing access — even for something as simple as a better-equipped lecture hall — complicated. Which access do you ask for?

One accommodation that is routinely offered is an ASL interpreter. The problem is that only a small minority of those with hearing loss (less than 5 percent) use ASL. It’s no more helpful to most than an interpreter speaking Hungarian would be.

Among the most widely used accommodations, found in theaters, houses of worship and public gathering places, are infrared or FM headsets. The person with hearing loss borrows a headset from the venue. Sound, which travels through the regular sound system and then wirelessly to the headset, is amplified. Sometimes these systems work well. More often they are helpful to those with milder losses but not for anyone else. They also work only as well as the microphone. It the microphone is badly positioned, the headsets won’t deliver clear sound.

The technology that gets people most excited is induction looping. (Here’s a short video about it.) This, too, works through the venue’s regular sound system, and the sound quality is often excellent. It consists of a wire run around the perimeter of a room that transmits a signal, again wirelessly, to the audience member’s own hearing aid or cochlear implant, set to the telecoil setting. If a hearing aid does not have a telecoil, or the user doesn’t have hearing aids, headsets similar to those used for FM devices can be worn. Sometimes hearing people use them, just to hear better.

For some, the best option is captioning. This can be open captioning on a shared screen, similar to the captions on your television or subtitles on a movie. Or it can be closed captioning, sent to your personal device (an iPhone or iPad) or one provided by a theater. Generally this kind of captioning, called CART, which I described in some detail a few months ago, is live.

Scripts can also be scanned or typed into a new device being tested by Globetitles. It sends prescreened captions to personal devices, including computer and television screens, tablets and smartphones. The captions appear as red type on a black background, so they don’t bother others. You can see a sample by clicking on the Globetitles link.

Unfortunately, no single system fits all needs. Some think captioning serves the largest number of people. Others like looping because you don’t have to do anything except change the program on your hearing aid. Live captioning could be adapted to the kind of Sony glasses used in Regal Cinemas, or something like Google Glass could put captions right before your eyes.

Most venues will probably continue to offer one form of listening assistance (or none). But if that assistance does not serve a person with a hearing disability when another type of assistance would, that person can bring a lawsuit under the ADA.

As Lise Hamlin, the Hearing Loss of America Association’s director of public policy and state development, emailed me in a discussion about accessibility: “You might be able to make a case for both a listening system and captioning under the ADA. The relevant phrase is ‘effective communication.’ The key is providing effective communication to each person who needs it. If even one person is denied effective communication, they can file a claim.”

Most of us don’t want to get involved in a lengthy lawsuit — we just want to understand the play or the sermon or the mayor’s announcement or the community meeting or the visiting candidate. Is that so much to ask?

This post first appeared on AARP Health on August 10, 2016.

Katherine Bouton is the author of “Living Better With Hearing Loss: A Guide to Health, Happiness, Love, Sex, Work, Friends … and Hearing Aids,” and a memoir, “Shouting Won’t Help: Why I — and 5o Million Other Americans — Can’t Hear You”. Both available on Amazon.com.

 

Relief from the High Cost of Hearing Aids?

Last month the prestigious National Academies of Sciences, Engineering and Medicine issued a report with a series of recommendations that, if adopted, could revolutionize the way consumers receive and pay for hearing health care in the United States.images

Unfortunately, this report was not widely covered in the mainstream press, and although I wrote about this at the time, I’m also addressing it here, for those who may have missed this important development.

About 30 million Americans have hearing loss, but 67 to 86 percent of those who could benefit from hearing aids do not use them. The report called hearing loss “a significant public-health concern.” It is of course also of significant personal concern for those with hearing loss.

The June 2 report by the Committee on Accessible and Affordable Hearing Health Care for Adults represented input from experts in hearing research, public health, geriatrics and audiology, as well as from industry and consumer groups.

Consumers hope the recommendations will ultimately result in relief from the high cost of hearing aids, little insurance coverage and the limited availability of hearing professionals.

The committee listed 12 recommendations, but here are the four I consider most important.

  • Make buying a hearing aid easier by removing the Food and Drug Administration’s regulation requiring a medical evaluation or a waiver before a hearing aid can be purchased.

    It’s not difficult for consumers to waive the medical evaluation, but many people feel they are required to see a doctor before buying a hearing aid. This is a stumbling block for many. As the report pointed out, the only time a medical visit is essential is if you display “red flag” conditions, including sudden or rapidly progressing hearing loss within the previous 90 days, acute or chronic dizziness, pain or discomfort in the ear, or a visible ear deformity.

  • Promote hearing screening in wellness and medical visits.

    Most primary care doctors do not conduct even a cursory screening for hearing loss, even among the elderly. Failure to recognize hearing loss can be a threat to quality health care. A patient may not hear the doctor clearly, for instance.

  • Make lower-cost, over-the-counter hearing devices more widely available by implementing a new FDA category for them.

    This refers to personal sound amplification products, or PSAPs, and other less costly over-the-counter hearing devices.

  • Improve the compatibility of hearing technologies with other communications systems.

    This refers not only to compatibility of hearing aids with other hearing assistive devices and technologies, but also to developing “open platform” hearing aid programming. This would allow health care professionals — or, eventually, the device owner — to be able to program the settings on any device from any manufacturer, which is currently not the case.

In many ways, the report echoes the highly critical findings of a White House advisory group’s report last October. The group, as reported in the New York Times , said that industry concentration and overregulation meant that hearing aids had “not experienced the dramatic reductions in price and increases in features that have been routinely seen across consumer electronics.”

“When compared in complexity to today’s smartphones costing a few hundred dollars each,” the report said, “even premium-model hearing aids are simple devices but can cost several thousand dollars.”

The response to the White House report, as well as to these new recommendations, has varied widely among industry, consumer and health care groups — “hailed by some groups and denounced by others,” noted audiologist Barbara Weinstein, writing on the website Hearing Health & Technology Matters.

But she urged all parties to work toward common goals. “It is a win-win for all stakeholders to close the gap between the proportion of persons with untreated age-related hearing loss and the proportion of those who enjoy a measurably high quality of life as the result of hearing health care interventions purchased through audiologists.

“We are part of the problem and part of the solution. Let’s change that balance and remain essential,” she said.

One group supporting the recommendations was the Hearing Loss Association of America HLAA, the largest consumer group in the United States representing people with hearing loss. You can read HLAA’s statement here.  Many of the recommendations in the report echo earlier HLAA policy recommendations.

You can read a summary of the report here. The full report — “Hearing Health Care for Adults: Priorities for Improving Access and Affordability” — is available from the National Academies Press online or by calling 202-334-3313 or 800-624-6242.

Click on the link to read.  New Report Pushes for Cheaper, Easier Hearing Aids.

 

This post first appeared on AARP Health, June 10, 2016

Katherine Bouton is the author of “Living Better With Hearing Loss: A Guide to Health, Happiness, Love, Sex, Work, Friends … and Hearing Aids,” and a memoir, “Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You”. Both available on Amazon.com.

 

 

 

Would You Ask for Help With Hearing Problems at Work?

Accommodations for Hearing Loss at Work Dealing with the stigma of both hearing loss and aging at work can keep some employees from asking for accommodations — Thomas Barwick/Getty Images

Older workers with hearing problems face a double whammy: They’re dealing with the stigma not only of hearing loss but also of age. If they ask for accommodations on the job for hearing loss, they fear attention will be drawn to their age as well.

The Americans with Disabilities Act protects the rights of workers to ask for accommodations at work to help them hear more easily. However, research out of Oregon State University has found that older workers are less likely to feel there’s support for them to ask for that kind of help, because of worries they’ll be perceived as old by coworkers and managers.

Other research has shown that people with disabilitiesrefrain from requesting accommodations if they think coworkers would find the request “normatively inappropriate” — meaning not in keeping with the office culture. For instance, an office environment with a focus on maximizing profits like that in The Big Short or The Social Network is perceived as being much less likely to understand and tolerate a disability than would a nonprofit that prides itself on a more inclusive culture.

Research by David C. Baldridge and Michele L. Swift of Oregon State University’s College of Business, published in the journal Human Resources Management, studied the effect of age on such requests. Workers’ fear of seeming old, they found, may trump their fear of seeming to have a disability. Their findings were based on an email survey of 242 workers ages 18 to 69. Most had moderate to severe hearing loss.

Age itself has a negative stereotype in many workplaces, including the perception of “lower productivity, resistance to change, reduced ability to learn, and greater cost,” the authors wrote. “These stereotypes are often associated with fewer promotions, less training, lower performance ratings, and lower retention.”

But add disability to age and the stereotypes multiply. The older the person with a disability, the more likely they are to fear that others will attribute the request not to the disability, but to their age.

“Simply put,” the authors wrote, “people with disabilities appear to face a straightforward yet troubling question, ‘If I ask for a needed accommodation, will I be better or worse off?'”

In their discussion, the researchers advised managers and human resources personnel to realize that while many older employees may be eligible for and would benefit from disability accommodation, “these employees might also be particularly reluctant to make requests,” especially if they work in for-profit organizations or if the organization appears not to have others with disabilities.

When the disability is hearing loss, managers should make sure telephones have adjustable volume (and, I would add, be telecoil compatible). Large meetings should routinely include open captioning, which can also help employees with normal hearing follow what’s being said.

In an email interview, Baldridge said managers should think about the inclusion of persons with disabilities as “a normal aspect of diversity management.”

As the workforce ages, disability increases. The Bureau of Labor Statistics reports that about 26 percent of those ages 65 to 74 are in the workforce, and the majority are full-time workers. It’s in a company’s interest to have employees working at full capacity. If people are reluctant to ask for accommodations for a disability, their output and effectiveness are likely to suffer.

Please share your workplace experiences in the “reply” section below.

For more information about David Baldridge’s studies of disability and the workplace, email him at David.Baldridge@bus.oregonstate.edu.

For suggestions on workplace accommodations for hearing loss see HLAA’s Employment Toolkit. 

 

This post first appeared on AARP Health on June 3, 2016

Living Better jpegshoutingwonthelp

Katherine Bouton is the author of “Living Better With Hearing Loss: A Guide to Health, Happiness, Love, Sex, Work, Friends … and Hearing Aids,” and a memoir, “Shouting Won’t Help: Why I — and 50 Million Other Americans — Can’t Hear You”. Both available on Amazon.com.

Dogs, Debates and Doorbells

My dog is trained to respond to the doorbell when it rings. During last night’s Republican debate, the candidates repeatedly went over their tiIMG_0834me limit.

The timer signal sounded just like our doorbell.

Thus he barked through most of the debate, no doubt also agitated by the shouting and buffoonery on stage.

He looks kind of presidential, don’t you think?

For information about trained service dogs for the deaf and heard of hearing, go to Canine Companions for Independence. 

Boomers, Hearing Loss and the Workplace

Americans are working longer than ever, whether by choice or necessity. It’s created a problem the workplace has tried to ignore: hearing loss among the millions of boomers still on the jobolder_1645590c

It’s 2016, which means that the first of the baby boomers turn 70 this year. 2.5 million of them. Having survived to 70, their life expectancy is now 85. That’s just the start. Ten thousand baby boomers will turn sixty-five every single day between 2011 and 2029, according the Pew Research Center, with similarly long life expectancies.

Many of them plan to continue working and many others will be involved in volunteer work. As of today, more than half of boomers are still on the job – that’s about 45 million baby boomers, ranging in age from 51 to 70. The total figure for boomers, according to the Census Bureau is 76 million.

By 2022, the Bureau of Labor Statistics predicts, nearly one-third of those 65 to 74 will be in the work force.One half of those 65 and over have hearing loss. Two-thirds of those 75 and over have hearing loss.

How is the workplace going to cope with this? So far, by ignoring it.

Very few workplaces offer accommodations for those with hearing loss. For instance, company wide meetings might be held in rooms equipped with hearing loops or with both an ASL interpreter and CART captions. Few businesses provide those accommodations. Audiologist Juliette Sterkens, who is HLAA’s Hearing Loop Advocate, thinks the omission is not deliberate on the part of employers: in an email she wrote that she was “convinced that most are unaware that their employees’ struggle.” Echoing a familiar comment about the invisibility of hearing loss, she added, “they may realize something is not right but they cannot put their finger on it.

For now, it falls on you – the hearing-diminished boomer – to hold your own.

Here are some tips.

*Get hearing aids. Unfortunately, corporate America drops the ball on this one too. Most company insurance plans do not pay for hearing aids, nor does Medicare.

*If you can’t afford hearing aids, try a PSAP. If you’re not sure what a PSAP is, start with this New York Times article: “Just Don’t Call Them Hearing Aids.” At one-tenth the average price of a hearing aid, they are very effective for those with mild to moderate hearing loss. Only 20% of those who could benefit from hearing aids use them. That number holds firm well into old age. Hearing aids work. So do PSAP’s. For most employees, either of these devices can correct hearing to nearly normal.

*If you are still having trouble despite hearing aids, tell your supervisor and your colleagues. And then tell them again and again. Hearing loss is invisible, and they’ll quickly forget they need to look at you when they talk, refrain from yelling on the phone, not expect you to hear them from across the room.

*Make sure your hearing aids have telecoils. By law all landline telephones must be hearing-aid compatible, which means that the inner workings won’t cause your hearing aid to buzz. If you flip to telecoil mode when making or receiving a call the reception will be far clearer. And if you happen to work in one of those rare places where meeting rooms are looped, you’ll be able to hear as clearly from the back row as you would from the front.

*If necessary, ask for accommodations. The easiest and most effective of these is a captioned telephone. A captioned phone won’t work for a trader on the floor of the stock exchange – the captions are too slow – but it will help a majority of those with hearing loss to follow a business conversation.

*If you work at an information counter or a cash register, or anyplace where you regularly interact with people, ask for a portable hearing loop. These are usually thought of as accommodations for customers with hearing loss, but they are equally effective for an employee with a loss.

*Use personal assistive-listening devices. If you need to regularly hear one or more speakers – at a daily meeting for instance, look into FM systems or Phonak’s Roger system. The FM systems work best for one on one conversations, but the Roger can be used with several microphones around a table, allowing you to hear all the speakers.

*If you feel you are being discriminated against because of your hearing loss, keep a record of incidents. These can turn out to be invaluable in retaining your job, or in getting a decent settlement if you are told you’re no longer needed.

*Check out HLAA’s Employment Toolkit, which offers a wealth of information.

No company will tell you they’re firing you because you can’t hear, but there are plenty of pretexts – the job is being eliminated, you’re “not a team player,” etc. – and you may be able to expose them for just that if you have kept a written record.

No one wants to get into a lawsuit, and the big guys usually win. So optimize your workplace experience, and keep your job.

Reflections on Hearing Loss

KB in Seattle copyInterview with Stu Nunnery, After hearing loss, Katherine Bouton finds new purpose in life. This paragraph about HLAA is just one part. Click on the link to read the whole interview.

Stu: Hearing loss has many side effects short and long term and most troubling to many of us is the isolation, depression, and other long term health issues.

Katherine: This is why I advocate for HLAA. Joining your local chapter of HLAA is the best way you can find others like you. It doesn’t mean you give up your hearing friends or your hearing life, but you meet new friends. And because many HLAA meetings have Communication Access Real Time (CART) capability, you can actually comfortably “hear” in these meetings.  I’ve learned a huge amount in casual conversation with my HLAA friends, and even more from the structured programs we sponsor. That said, in contrast to the very culturally vibrant deaf community, outside of HLAA (and maybe ALDA) there isn’t a hearing-loss community at all, much less a vibrant one. I think active HLAA members do have a vibrant community, but it’s hard to get people interested.

 

Source: After hearing loss, Katherine Bouton finds new purpose in life

The Elusive Sound of Music

Hearing aids and cochlear implants are designed to maximize speech comprehension, which is as it should be. But for many of us, this means compromising on one of life’s joys, music.music-notes-on-staff-clipart-dT6XGz8T9

As Natalie Angier wrote in an article in Science Times last week, “In international surveys, people consistently rank music as one of life’s supreme sources of pleasure and emotional power. We marry to music, graduate to music, mourn to music.”

She also noted that Americans listen to music four hours a day.

The inability to hear and appreciate music is one of the most frustrating aspects of hearing loss. While hearing aids and cochlear implants are designed to maximize our speech comprehension, they are inadequate to the task of reproducing the fidelity of the human ear when it comes to music.

Part of this has to do with digital versus analog hearing aids. Audiologist and author Marshall Chasin, director of auditory research at the Musicians’ Clinics of Canada, has explained that the old-fashioned analog hearing aid was nowhere near as good as the newer digital hearing aids for speech, but it was better for music listening.

It also has to do with the wide range of sound in music. “Human speech is generally between 30 decibels and 85 decibels, giving it a range of about 50 decibels,” says Lisa Packer, a staff writer for Healthy Hearing. “Music, however, has a range of about 100 decibels. Hearing aids simply aren’t designed to efficiently process such a wide range of sound.”

So what can you do? Chasin has this practical advice for hearing aid users:

  • For recorded music, turn down the volume on the source and turn up your hearing aid. Turning up the volume on, say, a car radio just causes distortion of the incoming signal.

  • Use an FM system, and plug it into the direct audio input jack. This also helps reduce the distortion that results from turning up the source of the sound.

  • In a live-music venue, muffle the microphone on your hearing aid. Try a scarf or earmuffs over your hearing aid or wear a hat, or you can try Chasin’s trick: Scotch tape. He tells his patients to take several layers of tape and place it over the microphone. This decreases the distortion. “It is low-tech, but it works really well,” he says.

  • Take off the hearing aid. Music is inherently louder than speech, and if you have moderate hearing loss, you may be able to hear without amplification and without distortion.

  • For those with cochlear implants, some of these suggestions might work, although not the last one. Most people have little to no residual hearing after a cochlear implant, so simply taking the device off would leave you with no sound.

From my own experience, a visual component always improves the musical listening experience. For example

  • Vocal music with captions (whether live opera or YouTube) will help you to “hear” the sung words in a way that you can’t without that visual clue.

  • Reading lips is not a solution because singing distorts the mouth, but watching a singer can help with comprehension simply because of body language and facial expression.

  • With orchestral music, the kind most difficult for me to follow live — and impossible to follow as recorded music — I find that if I focus on a key player it helps to make the music a bit more comprehensible. This is easier with an instrument where you can see the player’s hands and body movements — a piano or cello, for instance. I can’t follow the fingering of a flute or piccolo in any useful way.

I refuse to give up on music, so I accept it even with compromises. It’s far better than no music at all.