Brooks
Hearing & Speech Clinic
Paris, TX (903)
737-8800 Sulphur
Springs, TX (903) 438-1600
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Hearing Tips & Terms
Captions For Deaf and Hard-of-Hearing Viewers
Do all hearing aids work the same way?
Facts on Assistive Listening Devices (ALDs)
How can I find out if I have hearing loss?
How common is hearing loss and what causes it?
Make hearing easier - things you & your family can do
Problems Associated with Hearing Loss
What can I expect from my hearing aids?
What are the different kinds of hearing aids?
What problems might I experience while adjusting to my hearing aids?
What questions should I ask before buying hearing aids?
Captions For Deaf and Hard-of-Hearing Viewers
What are captions? Open and closed captions Digital closed captioning Real-time captioning Electronic newsroom captions Edited and verbatim captions Rear window captioning Current research The law Captions and the FCC· Who is required to provide closed captions?
When will I see more closed-captioned programming? What programs are exempt? Other resources
On August 5, 1972, Julia Child, "The French Chef," in a program televised from WGBH studios in Boston, taught viewers how to make one of her prized chicken recipes. The significance of that day stretched far beyond the details of the entrée to have a profound and lasting impact on human communication. It was the first time Americans who are deaf and hard-of-hearing could enjoy the audio portion of a national television program through the use of captions.
Since then, captions have opened the world of television to people who are deaf and hard-of-hearing. At first, special broadcasts of some of the more popular programs were made accessible through the Public Broadcasting Service. Now, more than 2,000 hours of entertainment, news, public affairs, and sports programming are captioned each week on network, public, and cable television. Captions are no longer a novelty: they have become a necessity.
Captions are words displayed on a television screen that describe the audio or sound portion of a program. Captions allow viewers who are deaf or hard of hearing to follow the dialogue and the action of a program simultaneously. They can also provide information about who is speaking or about sound effects that may be important to understanding a news story, a political event, or the plot of a program.
Captions are created from the transcript of a program. A captioner separates the dialogue into captions and makes sure the words appear in sync with the audio they describe. A specially designed computer software program encodes the captioning information and combines it with the audio and video to create a new master tape or digital file of the program.
Captions may be "open" or "closed." To view closed captions, viewers need a set-top decoder or a television with built-in decoder circuitry. Open captions appear on all television sets and can be viewed without a decoder. In the past, some news bulletins, presidential addresses, or programming created by or for deaf and hard-of-hearing audiences were open captioned. With the widespread availability of closed-caption technology, open captions are rarely used.
Closed captioning has become available for digital television sets, such as high-definition television (HDTV) sets, manufactured after July 1, 2002.1 Digital captioning provides greater flexibility by enabling the viewer to control the caption display, including font style, text size and color, and background color.
1 Zenith Electronics Corporation, July 1, 2002
Real-time captions are created as an event takes place. A captioner (often trained as a court reporter or stenographer) uses a stenotype machine with a phonetic keyboard and special software. A computer translates the phonetic symbols into English captions almost instantaneously. The slight delay is based on the captioner's need to hear the word and on the computer processing time. Real-time captioning can be used for programs that have no script; live events, including congressional proceedings; news programs; and nonbroadcast meetings, such as the national meetings of professional associations.
Although most real-time captioning is more than 98 percent accurate, the audience will see occasional errors. The captioner may mishear a word, hear an unfamiliar word, or have an error in the software dictionary. Often, real-time captions are produced at a different location from the programming and are transmitted by phone lines. In addition to live, real-time captioning, captions are being put on prerecorded video, rental movies on tape and DVD, and educational and training tapes using a similar process but enabling error correction.
Electronic newsroom captions (ENR) are created from a news script computer or teleprompter and are commonly used for live newscasts. Only material that is scripted can be captioned using this technique. Therefore, spontaneous commentary, live field reports, breaking news, and sports and weather updates may not be captioned using ENR, and real-time captioning is needed.
Captions can be produced as either edited or verbatim captions. Edited captions summarize ideas and shorten phrases. Verbatim captions include all of what is said. Although there are situations in which edited captions have been preferred for ease in reading (such as for children's programs), most people who are deaf or hard-of-hearing prefer the full access provided by verbatim texts.
More and more movie theaters across the country are offering this type of captioning system. An adjustable Lucite panel attaches to the viewer's seat and reflects the captions from a light-emitting diode (LED) panel on the back of the theatre.
Researchers are studying caption features, speeds, and the effects of visual impairments on reading captions. This research will help the broadcast television industry understand which caption features should be retained and which new features should be adopted to better serve consumers. Other research is examining the potential for captions as a learning tool for acquiring English-language and reading skills. These studies are looking at how captions can reinforce vocabulary, improve literacy, and help people learn the expressions and speech patterns of spoken English.
The Americans with Disabilities Act (ADA) of 1990 requires that businesses and public accommodations ensure that disabled individuals are not excluded from or denied services because of the absence of auxiliary aids. Captions are considered one type of auxiliary aid. Since the passage of the ADA, the use of captioning has expanded. Entertainment, educational, informational, and training materials are captioned for deaf and hard-of-hearing audiences at the time they are produced and distributed.
The Television Decoder Circuitry Act of 1990 requires that all televisions larger than 13 inches sold in the United States after July 1993 have a special built-in decoder that enables viewers to watch closed-captioned programming. The Telecommunications Act of 1996 directs the Federal Communications Commission (FCC) to adopt rules requiring closed captioning of most television programming.
The FCC rules on closed captioning became effective January 1, 1998. They require people or companies that distribute television programs directly to home viewers to make sure those programs are captioned. Under the rules, 100 percent of nonexempt programs shown on or after January 1, 1998, must be closed captioned by January 1, 2006. Also, 75 percent of nonexempt programs shown before January 1, 1998, must be closed captioned by January 1, 2008. The rules do not apply to videotapes, laser disks, digital video disks, or video game cartridges.
Who is required to provide closed captions?
The rules apply to people or companies that distribute television programs directly to home viewers (video program distributors). Some examples are local broadcast television stations, satellite television services, and local cable television operators. In some situations, video program providers are responsible for captioning programs. A video program provider can be a television program network (for example, ABC, NBC, UPN, Lifetime, A&E) or other company that makes a particular television program. However, since networks do not distribute television programs directly to home viewers, they are not responsible for complying with the captioning rules and are not required to respond to complaints from viewers. However, broadcast and cable networks and program producers pay close attention to captioning issues and, along with the U.S. Department of Education, are the primary source for funding of captioning.
When will I see more closed-captioned programming?
The FCC rules can create transition periods during which the amount of closed-captioned programming will gradually increase. During 2000 and 2001, video program distributors must provide captioning for 450 hours per channel per calendar quarter of new programs (programs shown on or after January 1, 1998). In 2002 and 2003, distributors must increase the hours per channel of captioned programming to 900 per calendar quarter for new programs. In 2004 and 2005, 1,350 hours per channel per calendar quarter of new programs must be captioned.
If a video program distributor is already providing more than the required hours per channel during a specific calendar quarter, that distributor must continue to provide captioned programming at substantially the same level as the average level it provided during the first 6 months of 1997.
For programming shown before January 1, 1998, at least 30 percent of a channel's programming during each calendar quarter must be captioned starting January 1, 2003.
Some advertisements, public service announcements, non-English-language programs (with the exception of Spanish programs), locally produced and distributed non-news programming, textual programs, early-morning programs, and nonvocal musical programs are exempt from captioning. The FCC plans to review the program exemptions later to determine whether any changes are necessary.2
2 The Caption Center
To find out more about the FCC rules and captions, including information on the complaint process, call
Voice: 1-888-CALL-FCC (1-888-225-5322)
TTY: 1-888-TELL-FCC (1-888-835-5322)
Locally at (202) 418-7096
TTY: (202) 418-7172
Internet: www.fcc.gov/cgb/dro/caption.html
Media Access Group at WGBH
125 Western Avenue
Boston, MA, 02134
Voice: (617) 300-3400
TTY: (617) 300-2489
Fax: (617) 300-1035
E-mail: access@wgbh.org
Internet: access.wgbh.org
Gallaudet University (GU) and National Deaf Education Network and
Clearinghouse/Laurent Clerc National Deaf Education Center
800 Florida Avenue, NE
Washington, DC, 20002-3695
Voice: (202) 651-5000, 8:30 a.m. - 5 p.m., Eastern time
TTY: (202) 651-5000, 8:30 a.m. - 5 p.m., Eastern time
Fax: (202) 651-5704
E-mail: public.relations@gallaudet.edu
Internet: www.gallaudet.edu
League for the Hard of Hearing (LHH), New York
50 Broadway
New York, NY, 10004
Voice: (917) 305-7700, 9 a.m. - 5 p.m., Eastern time
TTY: (917) 305-7999
Fax: (917) 305-7888
E-mail: postmaster@lhh.org
Internet: www.lhh.org
National Association of the Deaf (NAD)
814 Thayer Avenue, Suite 250
Silver Spring, MD, 20910-4500
Voice: (301) 587-1788, 9 a.m. - 5 p.m., Eastern time
TTY: (301) 587-1789
Fax: (301) 587-1791
E-mail: nadinfo@nad.org
Internet: www.nad.org
National Center for Accessible Media
125 Western Avenue
Boston, MA 02134
Voice: (617) 300-3400
TTY: (617) 300-2489
E-mail: ncam@wgbh.org
Internet: ncam.wgbh.org/index.html
National Shorthand Reporters Association
118 Park Street S.E.
Vienna, VA 22180
Voice: (703) 281-4677
Note: Many commercial vendors and some specialized software will allow individuals, groups, and schools to create captions.
Ask yourself the following questions. If you answer "yes" to three or more of these questions, you could have a hearing problem and may need to have your hearing checked by a doctor.
Do I have a problem hearing on the telephone?
Do I have trouble hearing when there is noise in the background?
Is it hard for me to follow a conversation when two or more people talk at once?
Do I have to strain to understand a conversation?
Do many people I talk to seem to mumble (or not speak clearly)?
Do I misunderstand what others are saying and respond inappropriately?
Do I often ask people to repeat themselves?
Do I have trouble understanding the speech of women and children?
Do people complain that I turn the TV volume up too high?
Do I hear a ringing, roaring, or hissing sound a lot?
Do some sounds seem too loud?
Facts on Assistive Listening Devices (ALDs)
ALDs are “binoculars for the ears” and may benefit many people with residual hearing. They are intended to augment standard public address and audio systems by providing signals that can be received directly by persons with special receivers or their own hearing aids.
ALDs “stretch” the performance of a hearing aid by increasing the signal to noise ratio (SNR). This is significant as SNR has to be higher for many people with hearing loss for them to hear speech over background noise.
ALDs reduce the effect of distance between the person with hearing loss and the sound source; override poor acoustics; and minimize background noise.
There are hard-wired ALDs and three types of wireless ALDs (audioloop, FM, and Infrared). All three types can be used with or without hearing aids, and can be used with an array of receiver attachments for consumers with varying needs and preferences. This includes neck loops, silhouette inductors, headphones, direct audio input and other linkages. Hard-wired ALDs include hand-held amplifiers with microphones, direct audio input microphones, and hard-wired systems.
ALDs may be installed in large areas, portable for personal use, or in the case of FM systems, built into a hearing aid.
1. Types of hearing aids include: conventional analog hearing aids, analog programmable hearing aids, and digital processing hearing aids.
2. Lower-end technology allows limited flexibility in programming the hearing aid for the individual’s hearing loss characteristics and environmental characteristics.
3. Mid-level technology allows greater flexibility in meeting individual needs and can produce a hearing aid that is fully automatic. This level of technology may include noise reduction which may make listeners more comfortable in noisy backgrounds.
4. The highest level of technology can be completely automatic or user controlled. This level of technology provides the greatest flexibility and many custom features are available to meet the individual listener’s needs.
A hearing aid is an electronic, battery-operated device that amplifies and changes sound to allow for improved communication. Hearing aids receive sound through a microphone, which then converts the sound waves to electrical signals. The amplifier increases the loudness of the signals and then sends the sound to the ear through a speaker.
How common is hearing loss and what causes it?
Approximately 28 million Americans have a hearing impairment. Hearing loss is one of the most prevalent chronic health conditions in the United States, affecting people of all ages, in all segments of the population, and across all socioeconomic levels. Hearing loss affects approximately 17 in 1,000 children under age 18. Incidence increases with age: approximately 314 in 1,000 people over age 65 have hearing loss. Hearing loss can be hereditary, or it can result from disease, trauma, or long-term exposure to damaging noise or medications. Hearing loss can vary from a mild but important loss of sensitivity, to a total loss of hearing.
Hearing depends on the following series of events that change sound waves in the air into electrical impulses that the auditory (hearing) nerve carries to the brain. The ear has three major parts, described as the outer ear, middle ear, and inner ear.
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Sound waves enter the outer ear (pinna) and travel through a narrow tube (ear canal) that leads inside the ear to the eardrum (tympanic membrane). The eardrum vibrates from the incoming sound waves and transmits these vibrations through three tiny bones called the ossicles (the malleus, incus, and stapes) in the middle ear. They amplify the sound and send it through the entrance to the inner ear (oval window) and into the fluid-filled hearing organ (cochlea).·
The vibrations create ripples in the fluid that bend projections from tiny hair cells in the cochlea, causing electrical impulses that the auditory nerve, or eighth cranial nerve, sends to the brain.·
The brain translates these impulses into what we experience as sound.Image of the inner ear
Types of Hearing Loss - There are different types of hearing loss. Conductive hearing loss occurs when sound waves are prevented from passing to the inner ear. This can be caused by a variety of problems including buildup of earwax (cerumen), infection, fluid in the middle ear (ear infection or otitis media), or a punctured eardrum. Sensorineural (nerve) hearing loss develops when the auditory nerve or hair cells in the inner ear are damaged by aging, noise, illness, injury, infection, head trauma, toxic medications, or an inherited condition. Mixed hearing loss is a combination of both conductive and sensorineural hearing loss. A conductive hearing loss can often be corrected with medical or surgical treatment, while sensorineural hearing loss usually cannot be reversed.
People with hearing loss may experience some or all of the following problems:
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Difficulty hearing conversations, especially when there is background noise.·
Hissing, roaring, or ringing in the ears (tinnitus).·
Difficulty hearing the television or radio at a normal volume.·
Fatigue and irritation caused by the effort to hear.·
Dizziness or problems with balance.
How can I find out if I have hearing loss?
If you think you might have hearing loss, visit your physician, who may refer you to an otolaryngologist or audiologist. An otolaryngologist is a physician who specializes in ear, nose, and throat disorders, and will investigate the cause of the hearing loss. An audiologist is a hearing health professional who identifies and measures hearing loss and will perform a hearing test to assess the type and degree of loss.
On the basis of the hearing test results, the audiologist can determine whether hearing aids will help. Hearing aids are particularly useful in improving the hearing and speech comprehension of people with sensorineural hearing loss. When choosing a hearing aid, the audiologist will consider your hearing ability, work and home activities, physical limitations, medical conditions, and cosmetic preferences. For many people, cost is also an important factor. You and your audiologist must decide whether one or two hearing aids will be best for you. Wearing two hearing aids may help balance sounds, improve your understanding of words in noisy situations, and make it easier to locate the source of sounds.
What are the different kinds of hearing aids?
There are several types of hearing aids. Each type offers different advantages, depending on its design, levels of amplification, and size. Before purchasing any hearing aid, ask whether it has a warranty that will allow you to try it out. Most manufacturers allow a 30- to 60-day trial period during which aids can be returned for a refund.
There are four basic styles of hearing aids for people with sensorineural hearing loss:
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In-the-Ear (ITE) hearing aids fit completely in the outer ear and are used for mild to severe hearing loss. The case, which holds the components, is made of hard plastic. ITE aids can accommodate added technical mechanisms such as a telecoil, a small magnetic coil contained in the hearing aid that improves sound transmission during telephone calls. ITE aids can be damaged by earwax and ear drainage, and their small size can cause adjustment problems and feedback. They are not usually worn by children because the casings need to be replaced as the ear grows.·
Behind-the-Ear (BTE) hearing aids are worn behind the ear and are connected to a plastic earmold that fits inside the outer ear. The components are held in a case behind the ear. Sound travels through the earmold into the ear. BTE aids are used by people of all ages for mild to profound hearing loss. Poorly fitting BTE earmolds may cause feedback, a whistle sound caused by the fit of the hearing aid or by buildup of earwax or fluid.·
Canal Aids fit into the ear canal and are available in two sizes. The In-the-Canal (ITC) hearing aid is customized to fit the size and shape of the ear canal and is used for mild or moderately severe hearing loss. A Completely-in-Canal (CIC) hearing aid is largely concealed in the ear canal and is used for mild to moderately severe hearing loss. Because of their small size, canal aids may be difficult for the user to adjust and remove, and may not be able to hold additional devices, such as a telecoil. Canal aids can also be damaged by earwax and ear drainage. They are not typically recommended for children.·
Body Aids are used by people with profound hearing loss. The aid is attached to a belt or a pocket and connected to the ear by a wire. Because of its large size, it is able to incorporate many signal processing options, but it is usually used only when other types of aids cannot be used.Do all hearing aids work the same way?
The inside mechanisms of hearing aids vary among devices, even if they are the same style. Three types of circuitry, or electronics, are used:
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Analog/Adjustable: The audiologist determines the volume and other specifications you need in your hearing aid, and then a laboratory builds the aid to meet those specifications. The audiologist retains some flexibility to make adjustments. This type of circuitry is generally the least expensive.·
Analog/Programmable: The audiologist uses a computer to program your hearing aid. The circuitry of analog/programmable hearing aids will accommodate more than one program or setting. If the aid is equipped with a remote control device, the wearer can change the program to accommodate a given listening environment. Analog/programmable circuitry can be used in all types of hearing aids.·
Digital/Programmable: The audiologist programs the hearing aid with a computer and can adjust the sound quality and response time on an individual basis. Digital hearing aids use a microphone, receiver, battery, and computer chip. Digital circuitry provides the most flexibility for the audiologist to make adjustments for the hearing aid. Digital circuitry can be used in all types of hearing aids and is typically the most expensive.What can I expect from my hearing aids?
Using hearing aids successfully takes time and patience. Hearing aids will not restore normal hearing or eliminate background noise. Adjusting to a hearing aid is a gradual process that involves learning to listen in a variety of environments and becoming accustomed to hearing different sounds. Try to become familiar with hearing aids under nonstressful circumstances a few hours at a time. Programs are available to help users master new listening techniques and develop skills to manage hearing loss. Contact your audiologist for further information about programs that may suit your individual needs.
What questions should I ask before buying hearing aids?
Before you buy a hearing aid, ask your audiologist these important questions:
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Are there any medical or surgical considerations or corrections for my hearing loss?·
Which design is best for my hearing loss?·
What is the total cost of the hearing aid?·
Is there a trial period to test the hearing aids? What fees are nonrefundable if they are returned after the trial period?·
How long is the warranty? Can it be extended?·
Does the warranty cover future maintenance and repairs?·
Can the audiologist make adjustments and provide servicing and minor repairs? Will loaner aids be provided when repairs are needed?·
What instruction does the audiologist provide?·
Can assistive devices such as a telecoil be used with the hearing aids?What problems might I experience while adjusting to my hearing aids?
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Become familiar with your hearing aid. Your audiologist will teach you to use and care for your hearing aids. Also, be sure to practice putting in and taking out the aids, adjusting volume control, cleaning, identifying right and left aids, and replacing the batteries with the audiologist present.·
The hearing aids may be uncomfortable. Ask the audiologist how long you should wear your hearing aids during the adjustment period. Also, ask how to test them in situations where you have problems hearing, and how to adjust the volume and/or program for sounds that are too loud or too soft.·
Your own voice may sound too loud. This is called the occlusion effect and is very common for new hearing aid users. Your audiologist may or may not be able to correct this problem; however, most people get used to it over time.·
Your hearing aid may "whistle." When this happens, you are experiencing feedback, which is caused by the fit of the hearing aid or by the buildup of earwax or fluid. See your audiologist for adjustments.·
You may hear background noise. Keep in mind that a hearing aid does not completely separate the sounds you want to hear from the ones you do not want to hear, but there may also be a problem with the hearing aid. Discuss this with your audiologist.What are some tips for taking care of my hearing aids?
The following suggestions will help you care for your hearing aids:
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Keep hearing aids away from heat and moisture.·
Replace dead batteries immediately.·
Clean hearing aids as instructed.·
Do not use hairspray or other hair care products while wearing hearing aids.·
Turn off hearing aids when they are not in use.·
Keep replacement batteries and small aids away from children and pets.What research is being done on hearing aids?
The National Institute on Deafness and Other Communication Disorders (NIDCD) supports more than 30 grants for scientists to conduct studies on hearing aid research and development. These studies cover areas such as the application of new signal processing strategies and ways to improve sound transmission and reduce noise interference, as well as psychophysical studies of the impact of abnormal hearing function on speech recognition. Other studies focus on the best way to select and fit hearing aids in children and other difficult-to-test populations, and on reducing bothersome aspects such as feedback and the occlusion effect. Further research will determine the best ways to manipulate speech signals in order to enhance understanding.
To improve hearing aid performance, especially in noisy situations, NIDCD has entered into two collaborative ventures. The first was formed between NIDCD and the Department of Veterans Affairs (VA) to expand and intensify hearing aid research and development. The program includes a contract for the development of hearing aids as well as clinical trials. The knowledge gained will be used to help people choose the best hearing aid for their particular type of hearing impairment.
In the second collaboration, the National Aeronautics and Space Administration (NASA) and the VA have joined NIDCD in surveying all Federal laboratories for acoustic and electronic technologies that might improve hearing aids. The most promising technologies have been presented to auditory scientists and hearing aid manufacturers in the hope of forming research partnerships that will lead to commercial application of these technologies.
Do I have a hearing problem?
Ask yourself the following questions. If you answer "yes" to three or more of these questions, you could have a hearing problem and may need to have your hearing checked by a doctor.
Do I have a problem hearing on the telephone?
Do I have trouble hearing when there is noise in the background? Is it hard for me to follow a conversation when two or more people talk at once? Do I have to strain to understand a conversation? Do many people I talk to seem to mumble (or not speak clearly)? Do I misunderstand what others are saying and respond inappropriately? Do I often ask people to repeat themselves? Do I have trouble understanding the speech of women and children? Do people complain that I turn the TV volume up too high? Do I hear a ringing, roaring, or hissing sound a lot? Do some sounds seem too loud?
What should I do?
Hearing problems are serious. The most important thing you can do if you think you have a hearing problem is to go see a doctor. Your doctor may refer you to an otolaryngologist (oh-toe-lair-in-GAH-luh-jist), a doctor who specializes in the ear, nose, and throat. An otolaryngologist will try to find out why you have a hearing loss and offer treatment options. He or she may also refer you to another hearing professional, an audiologist (aw-dee-AH-luh-jist). An audiologist can measure your hearing. Sometimes otolaryngologists and audiologists work together to find the treatment that is right for you. If you need a hearing aid, an audiologist can help you find the right one. Although children must be seen by a physician before they can be fitted for a hearing aid, adults do not always see a physician. Adults who do not see a physician before getting a hearing aid must sign a waiver.
Why am I losing my hearing?
Hearing loss happens for many reasons. Some people lose their hearing slowly as they age. This condition is known as presbycusis (prez-buh-KYOO-sis). Doctors do not know why presbycusis happens, but it seems to run in families. Another reason for hearing loss may be exposure to too much loud noise. This condition is known as noise-induced hearing loss. Many construction workers, farmers, musicians, airport workers, tree cutters, and people in the armed forces have hearing problems because of too much exposure to loud noise. Sometimes loud noise can cause a ringing, hissing, or roaring sound in the ears, called tinnitus (tin-NY-tus).
Hearing loss can also be caused by a virus or bacteria, heart conditions or stroke, head injuries, tumors, and certain medicines.
What treatments and devices can help?
Your treatment will depend on your hearing problem, so some treatments will work better for you than others. Here are the most common ones:
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Hearing aids are tiny instruments you wear in or behind your ear. They make sounds louder. Things sound different when you wear a hearing aid, but an audiologist can help you get used to it.To find the hearing aid that works best for you, you may have to try more than one. Ask your audiologist whether you can have a trial period with a few different hearing aids. You and your audiologist can work together until you are comfortable.
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Personal listening systems help you hear what you want to hear while eliminating or lowering other noises around you. Some, called auditory training systems and loop systems, make it easier for you to hear someone in a crowded room or group setting. Others, such as FM systems and personal amplifiers, are better for one-on-one conversations.·
TV listening systems help you listen to the television or the radio without being bothered by other noises around you. These systems can be used with or without hearing aids and do not require you to use a very high volume.·
Direct audio input hearing aids are hearing aids that can be plugged into TVs, stereos, microphones, auditory trainers, and personal FM systems to help you hear better.·
Telephone amplifying devices. Some telephones are made to work with certain hearing aids. If your hearing aid has a "T" switch, you can ask your telephone company about getting a phone with an amplifying coil (T-coil). If your hearing aid is in the "T" position, this coil is activated when you pick up the phone. It allows you to listen at a comfortable volume and helps lessen background noise. You can also buy a special type of telephone receiver and other devices to make sounds louder on the phone.·
Mobile phone amplifying devices. To help people who use a T-coil hear better on mobile phones, an amplifying device called a loopset is available. The wire loop goes around your neck and connects to the mobile phone. The loop transmits speech from the phone to the hearing aid in your ear. It also helps get rid of background noise to make it easier to talk in a noisy environment.·
Auditorium-type assistive listening systems. Many auditoriums, movie theaters, churches, synagogues, and other public places are equipped with special sound systems for people with hearing loss. These systems send sounds directly to your ears to help you hear better. Some can be used with a hearing aid and others without.·
Cochlear (COKE-lee-ur) implants have three parts: a headpiece, a speech processor, and a receiver. The headpiece includes a microphone and a transmitter. It is worn just behind the ear where it picks up sound and sends it to the speech processor, a beeper-sized device that can fit in your pocket or on a belt. The speech processor converts the sound into a special signal that is sent to the receiver. The receiver, a small round disc about the size of a quarter that a surgeon places under the skin behind one ear, sends a sound signal to the brain. Cochlear implants are most often used with young children born with hearing loss. However, older adults with profound or severe hearing loss are beginning to receive these implants more often.·
Lip reading or speech reading is another option. People who do this pay close attention to others when they talk. They watch how the mouth and the body move when someone is talking. Special trainers can help you learn how to lip read or speech read.Can my friends and family help me?
Yes. You and your family can work together to make hearing easier. Here are some things you can do:
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Tell your friends and family about your hearing loss. They need to know that hearing is hard for you. The more you tell the people you spend time with, the more they can help you.·
Ask your friends and family to face you when they talk so that you can see their faces. If you watch their faces move and see their expressions, it may help you to understand them better.·
Ask people to speak louder, but not shout. Tell them they do not have to talk slowly, just more clearly.·
Turn off the TV or the radio if it does not have to be on.·
Be aware of noise around you that can make hearing more difficult. When you go to a restaurant, do not sit near the kitchen or near a band playing music. Background noise makes it hard to hear people talk.Working together to hear better may be tough on everyone for a while. It will take time for you to get used to watching people as they talk and for people to get used to speaking louder and more clearly. Be patient and continue to work together. Hearing better is worth the effort.
The Noise in Your Ears: Facts About Tinnitus
Do you hear a ringing, roaring, clicking, or hissing sound in your ears? Do you hear this sound often or all the time? Does the sound bother you a lot? If you answer yes to these questions, you may have tinnitus (tin-NY-tus).
Tinnitus is a symptom associated with many forms of hearing loss. It can also be a symptom of other health problems. According to estimates by the American Tinnitus Association, at least 12 million Americans have tinnitus. Of these, at least 1 million experience it so severely that it interferes with their daily activities. People with severe cases of tinnitus may find it difficult to hear, work, or even sleep.
What causes tinnitus?
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Hearing loss. Doctors and scientists have discovered that people with different kinds of hearing loss also have tinnitus.·
Loud noise. Too much exposure to loud noise can cause noise-induced hearing loss and tinnitus.·
Medicine. More than 200 medicines can cause tinnitus. If you have tinnitus and you take medicine, ask your doctor or pharmacist whether your medicine could be involved.·
Other health problems. Allergies, tumors, and problems in the heart and blood vessels, jaws, and neck can cause tinnitus.What should I do if I have tinnitus?
The most important thing you can do is to go see your doctor. Your doctor can try to determine what is causing your tinnitus. He or she can check to see if it is related to blood pressure, kidney function, diet, or allergies. Your doctor can also determine whether your tinnitus is related to any medicine you are taking.
To learn more about what is causing your tinnitus, your doctor may refer you to an otolaryngologist (oh-toe-lair-in-GAH-luh-jist), an ear, nose, and throat doctor. He or she will examine your ears and your hearing to try to find out why you have tinnitus. Another hearing professional, an audiologist (aw-dee-AH-luh-jist), can measure your hearing. If you need a hearing aid, an audiologist can fit you with one that meets your needs.
How will hearing experts treat my tinnitus?
Although there is no cure for tinnitus, scientists and doctors have discovered several treatments that may give you some relief. Not every treatment works for everyone, so you may need to try several to find the ones that help.
Treatments can include
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Hearing aids. Many people with tinnitus also have a hearing loss. Wearing a hearing aid makes it easier for some people to hear the sounds they need to hear by making them louder. The better you hear other people talking or the music you like, the less you notice your tinnitus.·
Maskers. Maskers are small electronic devices that use sound to make tinnitus less noticeable. Maskers do not make tinnitus go away, but they make the ringing or roaring seem softer. For some people, maskers hide their tinnitus so well that they can barely hear it.
Some people sleep better when they use maskers. Listening to static at a low volume on the radio or using bedside maskers can help. These are devices you can put by your bed instead of behind your ear. They can help you ignore your tinnitus and fall asleep.·
Medicine or drug therapy. Some medicines may ease tinnitus. If your doctor prescribes medicine to treat your tinnitus, he or she can tell you whether the medicine has any side effects.·
Tinnitus retraining therapy. This treatment uses a combination of counseling and maskers. Otolaryngologists and audiologists help you learn how to deal with your tinnitus better. You may also use maskers to make your tinnitus less noticeable. After a while, some people learn how to avoid thinking about their tinnitus. It takes time for this treatment to work, but it can be very helpful.·
Counseling. People with tinnitus may become depressed. Talking with a counselor or people in tinnitus support groups may be helpful.·
Relaxing. Learning how to relax is very helpful if the noise in your ears frustrates you. Stress makes tinnitus seem worse. By relaxing, you have a chance to rest and better deal with the sound.What can I do to help myself?
Think about things that will help you cope. Many people find listening to music very helpful. Focusing on music might help you forget about your tinnitus for a while. It can also help mask the sound. Other people like to listen to recorded nature sounds, like ocean waves, the wind, or even crickets.
Avoid anything that can make your tinnitus worse. This includes smoking, alcohol, and loud noise. If you are a construction worker, an airport worker, or a hunter, or if you are regularly exposed to loud noise at home or at work, wear ear plugs or special earmuffs to protect your hearing and keep your tinnitus from getting worse.
If it is hard for you to hear over your tinnitus, ask your friends and family to face you when they talk so you can see their faces. Seeing their expressions may help you understand them better. Ask people to speak louder, but not shout. Also, tell them they do not have to talk slowly, just more clearly.
Noise-Induced Hearing Loss
Every day we experience sound in our environment such as the television, radio, washing machine, automobiles, buses, and trucks. But when an individual is exposed to harmful sounds--sounds that are too loud or loud sounds over a long time--sensitive structures of the inner ear can be damaged, causing noise-induced hearing loss (NIHL).
How do we hear?
Hearing is a series of events in which the ear converts sound waves into electrical signals that are sent to the brain and interpreted as sound. The ear has three main parts: the outer, middle, and inner ear. Sound waves enter through the outer ear and reach the middle ear where they cause the eardrum to vibrate.
The inner ear.
The vibrations are transmitted through three tiny bones in the middle ear, called the ossicles. These three bones are named the malleus, incus, and stapes (and are also known as the hammer, anvil, and stirrup). The eardrum and ossicles amplify the vibrations and carry them to the inner ear. The stirrup transmits the amplified vibrations through the oval window and into the fluid that fills the inner ear. The vibrations move through fluid in the snail-shaped hearing part of the inner ear (cochlea) that contains the hair cells. The fluid in the cochlea moves the top portion of the hair cells, called the hair bundle, which initiates the changes that lead to the production of nerve impulses. These nerve impulses are carried to the brain, where they are interpreted as sound. Different sounds move the hair bundles in different ways, thus allowing the brain to distinguish one sound from another, such as vowels from consonants.
What sounds cause NIHL?
NIHL can be caused by a one-time exposure to loud sound as well as by repeated exposure to sounds at various loudness levels over an extended period of time. The loudness of sound is measured in units called decibels. For example, normal conversation is approximately 60 decibels, the humming of a refrigerator is 40 decibels, and city traffic noise can be 80 decibels. Examples of sources of loud noises that cause NIHL are motorcycles, firecrackers, and firearms, all emitting sounds from 120 to 140 decibels. Sounds of less than 80 decibels, even after long exposure, are unlikely to cause hearing loss.
Exposure to harmful sounds causes damage to the sensitive hair cells of the inner ear as well as the hearing nerve. These structures can be injured by two kinds of noise: loud impulse noise, such as an explosion, or loud continuous noise, such as that generated in a woodworking shop.
What are the effects of NIHL?
Impulse sound can result in immediate hearing loss that may be permanent. The structures of the inner ear may be severely damaged. This kind of hearing loss may be accompanied by tinnitus, a ringing, buzzing, or roaring in the ears or head, which may subside over time. Hearing loss and tinnitus may be experienced in one or both ears, and tinnitus may continue constantly or occasionally throughout a lifetime.
Continuous exposure to loud noise also can damage the structure of the hair cells, resulting in hearing loss and tinnitus. Exposure to impulse and continuous noise may cause only a temporary hearing loss. If the hearing recovers, the temporary hearing loss is called a temporary threshold shift. The temporary threshold shift largely disappears 16 to 48 hours after exposure to loud noise.
Both forms of NIHL can be prevented by the regular use of hearing protectors such as earplugs or earmuffs.
What are the symptoms of NIHL?
The symptoms of NIHL increase gradually over a period of continuous exposure. Sounds may become distorted or muffled, and it may be difficult for the person to understand speech. The individual may not be aware of the loss, but it can be detected with a hearing test.
Who is affected by NIHL?
More than 30 million Americans are exposed to hazardous sound levels on a regular basis. Individuals of all ages, including children, adolescents, young adults, and older people, can develop NIHL. Exposure occurs in the workplace, in recreational settings, and at home. Noisy recreational activities include target shooting and hunting, snowmobiling, riding go-carts, woodworking and other noisy hobbies, and playing with power horns, cap guns, and model airplanes. Harmful noises at home include vacuum cleaners, garbage disposals, gas-powered lawn mowers, leaf blowers, and shop tools. And it makes no difference where a person lives--both urban and rural settings offer their own brands of noisy devices on a daily basis. Of the 28 million Americans who have some degree of hearing loss, about one-third can attribute their hearing loss, at least in part, to noise.
Can NIHL be prevented?
NIHL is preventable. All individuals should understand the hazards of noise and how to practice good health in everyday life.
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Know which noises can cause damage (those above 90 decibels).·
Wear earplugs or other hearing protective devices when involved in a loud activity (special earplugs and earmuffs are available at hardware stores and sporting good stores).·
Be alert to hazardous noise in the environment.·
Protect children who are too young to protect themselves.·
Make family, friends, and colleagues aware of the hazards of noise.·
Have a medical examination by an otolaryngologist, a physician who specializes in diseases of the ears, nose, throat, head, and neck, and a hearing test by an audiologist, a health professional trained to identify and measure hearing loss and to rehabilitate persons with hearing impairments.What research is being done for NIHL?
Scientists are studying the internal workings of the ear and the mechanisms that cause NIHL so that better prevention and treatment strategies can be developed. For example, scientists have discovered that damage to the structure of the hair bundle is related to temporary and permanent loss of hearing. When the hair bundle is exposed to prolonged periods of damaging sound, the basic structure of the hair bundle is destroyed and the important connections among hair cells are disrupted. These structural changes lead directly to hearing loss.
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Recent NIDCD research
Recent findings by NIDCD researchers show that hair bundles are capable of rebuilding their structure from top to bottom over a 48-hour period (the common duration of temporary hearing loss). Researchers suggest that permanent hearing loss may occur when damage is so severe that it overwhelms the self-repair mechanism. 11 Schneider M.E., Belyantseva I.A., Azevedo R.B., Kachar B. Rapid renewal of auditory hair bundles. Nature. 22 Aug 2002. 418(6900): 837-838.
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Drug therapies
Other studies involve potential drug therapies for NIHL. For example, scientists are studying how changes in blood flow in the cochlea affect hair cells. When a person is exposed to loud noise, blood flow in the cochlea drops. However, a drug that is used to treat peripheral vascular disease (any abnormal condition in blood vessels outside the heart) maintains circulation in the cochlea during exposure to noise. These findings may lead to the development of treatment strategies to reduce NIHL.Continuing efforts will provide opportunities that can aid research on NIHL as well as other diseases and disorders that cause hearing loss.
Sudden Deafness
Description
Sudden Sensorineural Hearing Loss (SSHL), or sudden deafness, is a rapid loss of hearing. SSHL can happen to a person all at once or over a period of up to 3 days. It should be considered a medical emergency. A person who experiences SSHL should visit a doctor immediately.
A doctor can determine whether a person has experienced SSHL by conducting a normal hearing test. If a loss of at least 30 decibels in three connected frequencies is discovered, it is diagnosed as SSHL. A decibel is a measure of sound. A decibel level of 30 is half as loud as a normal conversation. A frequency is another way of measuring sound. Frequencies measure sound waves and help to determine what makes one sound different from another sound.
Hearing loss affects only one ear in 9 out of 10 people who experience SSHL. Many people notice it when they wake up in the morning. Others first notice it when they try to use the deafened ear, such as when they make a phone call. Still others notice a loud, alarming "pop" just before their hearing disappears. People with SSHL often experience dizziness or a ringing in their ears (tinnitus), or both.
Some patients recover completely without medical intervention, often within the first 3 days. This is called a spontaneous recovery. Others get better slowly over a 1 or 2 week period. Although a good to excellent recovery is likely, 15 percent of those with SSHL experience a hearing loss that gets worse over time.
Approximately 4,000 new cases of SSHL occur each year in the United States. It can affect anyone, but for unknown reasons it happens most often to people between the ages of 30 and 60.
Causes/Diagnosis
Though there are more than 100 possible causes of sudden deafness, it is rare for a specific cause to be precisely identified. Only 10 to 15 percent of patients with SSHL know what caused their loss. Normally, diagnosis is based on the patient's medical history. Possible causes include the following:
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Infectious diseases.·
Trauma, such as a head injury.·
Abnormal tissue growth.·
Immunologic diseases such as Cogan's syndrome.·
Toxic causes, such as snake bites.·
Ototoxic drugs (drugs that harm the ear).·
Circulatory problems.·
Neurologic causes such as multiple sclerosis.·
Relation to disorders such as Ménière's disease.Treatment
People who experience SSHL should see a physician immediately. Doctors believe that finding medical help fast increases the chances for recovery. Several treatments are used for SSHL, but researchers are not yet certain which is the best for any one cause. If a specific cause is identified, a doctor may prescribe antibiotics for the patient. Or, a doctor may advise a patient to stop taking any medicine that can irritate or damage the ear.
The most common therapy for SSHL, especially in cases with an unknown cause, is treatment with steroids. Steroids are used to treat many different disorders and usually work to reduce inflammation, decrease swelling, and help the body fight illness. Steroid treatment helps some SSHL patients who also have conditions that affect the immune system, which is the body's defense against disease.
Another common method that may help some patients is a diet low in salt. Researchers believe that this method aids people with SSHL who also have Ménière's disease, a hearing and balance disorder.
Research
Two factors that help hearing function properly are good air and blood flow inside the ear. Many researchers now think that SSHL happens when important parts of the inner ear do not receive enough oxygen. A common treatment for this possible cause is called carbogen inhalation. Carbogen is a mixture of oxygen and carbon dioxide that seems to help air and blood flow better inside the ear. Like steroid therapy, carbogen inhalation does not help every patient, but some SSHL patients taking carbogen have recovered over a period of time.
Customer Satisfaction and Usage Trends
In the 2004 MarkeTrak survey we found interesting trends over time. If we consider hearing instruments 4years of age or less (the effective life of a hearing instrument),the overall customer satisfaction rating is 73.1%;the dissatisfied rating remained virtually the same despite the change in scaling. Customer satisfaction with new hearing instruments less than or equal to one year is 77.5%which puts it in the top-third of products and services in the United States. When considering the large percentage of new digital (eg,programmable) directional hearing instruments available, the 77.5% customer satisfaction rating is consistent with a previous historical MarkeTrak analysis that showed programmable directional aids had an 81% satisfaction rating and programmable omni-directional aids had a 72% rating. Hearing instrument owners who do not use their hear-ing instruments increased to 1.2 million.(Author’s Note: A user is defined as an individual reporting they wear and use their hearing instrument. Usage is accept-ed even if it is only occasional—even if less than a half-hour per day).Part of this is due to the fact that 36% of the hearing instruments owned are 5 years or older; nearly 6 out of 10 hearing instruments in the drawer are at least 5 years old. The average age of hearing instruments increased from 3.8 in 2000 to 4.5 in 2004.Customer Satisfaction and Usage Trends Digital Cell Phones and Hearing Aids Digital Cell Phones and Hearing Aids Have you ever wondered why you cannot hear very well on your digital cell phone when you are wearing your hearing aid(s)? It is because most digital cellular phones are not hearing aid compatible. Cell phones give off radio waves called radio frequency emissions. These emissions create an electromagnetic field around your phone’s antenna. The degree of buzzing sounds you may hear will depend on how much radio frequency emissions are emitted by your particular cell phone. Cell phones using CDMA and IDEN transmission technologies seem to work better than those using GSM technology for hearing aid users. The following website lists the wireless service providers found in your zip code and the technology each company uses. It is www.wirelessadvisor.com. On July 10,2003,the Federal Communications Commission (FCC) ruled that digital cell phone manu-facturers must make two handsets available to users with reduced interference and with telecoil compatibility within the next two years. Currently, telecoils are not compatible with digital cell phones. This does not mean that every cell phone will be compatible with hearing aids but that most companies will have one or two models that will be compatible with hearing aids. This includes companies such as Verizon, Sprint, Nextel and Cingular. There is a website that lists hearing aid compatible phones by manufacturer. That website is: www.accesswireless.org US overall customer satisfaction trends for hearing instruments that are 1-4 years old. Are your hearing aids sitting in the drawer? Call me so we can make sure your hearing aids are working to their top efficiency. (903)868-2650
The National Council on Aging study finds …
A survey completed by NCOA of 2069 hearing-impaired individuals and 1710 of their family members reveals that hearing instrument users are likely to report improvements in their physical, emotional, mental and social well being. Users of hearing instruments on average are more socially active and avoid extended periods of depression, worry, paranoia and insecurity compared to non-users with hearing loss. Additionally, family members and friends are more likely to notice these benefits than the actual users themselves. If you or a family member would like a copy of this study, feel free to call us. We would be happy to send you one! The best compliment you can pay our practice is to refer a friend or family member!
Digital Cell Phones and Hearing Aids
Have you ever wondered why you cannot hear very well on your digital cell phone when you are wearing your hearing aid(s)?It is because most digital cellular phones are not hearing aid compatible. Cell phones give off radio waves called radio frequency emissions. These emissions create an electromagnetic field around your phone's antenna. The degree of buzzing sounds you may hear will depend on how much radio frequency emissions are emitted by your particular cell phone. Cell phones using CDMA and IDEN transmission technologies seem to work better than those using GSM technology for hearing aid users. The following website lists the wireless service providers found in your zip code and the technology each company uses. It is www.wirelessadvisor.com. On July 10,2003, the Federal Communications Commission (FCC) ruled that digital cell phone manufacturers must make two handsets available to users with reduced interference and with telecoil compatibility within the next two years. Currently, telecoils are not compatible with digital cell phones. This does not mean that every cell phone will be compatible with hearing aids but that most companies will have one or two models that will be compatible with hearing aids. This includes companies such as Verizon, Sprint, Nextel and Cingular. There is a website that lists hearing aid compatible phones by manufacturer. That website is: www.accesswireless.org
Summer Hearing Aid Care
With the arrival of summer and hot humid days comes an increase in hearing aid problems. Moisture is a common source of hearing aid dysfunction for users of both in-the-ear and behind-the-ear hearing aids. Excessive moisture due to humidity and perspiration can cause distortion, static, and a myriad of other problems. Perspiration, high humidity, and spontaneous leaps into the lake are all contributors to an increase in moisture related hearing aid problems. To help avoid the time and expense of a manufacturer repair, follow these simple preventive maintenance techniques: Open the battery door at night to allow air to circulate and dry. Consider the purchase of a hearing aid dehumidifier, a Dri-Aid Kit or a Dry and Store Box. These products are inexpensive, simple to use, and provide a handy storage spot for your hearing aids. Drying time and sophistication of the products will vary. Ask us to recommend a product to fit your needs. If you perspire heavily during summer activities, take a moment to remove your hearing aids and wipe off excess moisture with a tissue. If you wear behind-the-ear hearing aids, consider wearing a moisture guard. Do not leave your hearing aids in direct heat or sunlight. Avoid storage in glove compartments or similar environments where excessive heat can build up. If your hearing aid is not working, and a moisture problem is suspected, open the battery door, remove the battery, and allow it to dry in an area with good air circulation. Do not attempt to dry it in the microwave or with a hair dryer. Many times moisture will evaporate on its own, and after several hours the instrument will be functional again. These simple tips can help you enjoy your hearing aids this summer and throughout the year!
Lower the volume on portable stereos and televisions. When you are involved in a loud activity, wear earplugs or other hearing protective devices. Be sure to protect children as well.
If earwax blockage is a problem for you, ear, nose, and throat doctors recommend using mild treatments such as mineral oil, baby oil, glycerin, or commercial ear drops to soften earwax.
The ear infection otitis media is most common in children, but adults can get it, too. You can help prevent otitis media by washing your hands frequently. Also, get a flu shot every year to stave off respiratory infections. If you still get an ear infection, see a doctor immediately before it becomes more serious.
Do you take medication? If so, ask your doctor if your medicine is ototoxic, or damaging to the ear. Ask if other drugs can be used instead. If not, ask if the dose can be safely reduced. Sometimes it cannot. However, your doctor will help you get the medicine you need while trying to reduce unwanted side effects.
The follow is a chart of sounds often heard in everyday life.
Normal conversation at 3-5 feet 60-70 dB
Dial tone of a telephone 80 dB
OSHA monitoring requirement begin 90 dB
Subway train at 200 feet 95 dB
Regular sustained exposure may cause permanent damage 90-95 dB
Power mower 107 dB
Pain begins 125 dB
Jet engine at 100 feet 140 dB
Loudest sound that can occur 194 dB
Here are some things you and your family can do to make hearing easier:
• Ask your family members to speak louder, but not shout.
• Turn off the TV or the radio if it does not have to be on.
• Be aware of noise around you that can make hearing more difficult. When you go to a restaurant, do not sit near the kitchen or near a band playing music.
If you’ve followed the steps above, but are still having difficulty hearing, call (903) 737-8800 to schedule a FREE hearing screening.
Some forms of hearing loss can be inherited. Not all inherited forms of hearing loss take place at birth, however. Some forms can show up later in life. In otosclerosis, which is thought to be a hereditary disease, an abnormal growth of bone prevents structures within the ear from working properly.
Summer brings with it warm weather and lazy days on the beach – as well as an increase in hearing aid troubles.
Moisture is the culprit for many hearing aid related problems. Excessive moisture due to high humidity and sweat can cause distortion, static and a host of other problems. To help avoid the time, and expense, of a manufacturer repair, follow these preventative maintenance techniques.
Open the battery door at night to allow air to circulate and dry.
Consider the purchase of a hearing aid dehumidifier, a Dri-Aid Kit or a Dry and Store Box. These products are inexpensive, simple to use, and provide a handy storage spot for your hearing aids.
If you perspire heavily during summer activities, take a moment to remove your hearing aids and wipe off excess moisture with a tissue.
If you wear behind-the-ear hearing aids, consider wearing a moisture guard.
Do not leave your hearing aids in direct sunlight.
Avoid storing your hearing aids in glove compartments or similar environments where excessive heat can build up.
If your hearing aid isn’t working and you suspect it’s due to a moisture problem, open the battery door, remove the battery and allow it to dry in an area with good circulation. Do not attempt to dry it in the microwave or with a hair dryer. Moisture will often evaporate on its own.