1
Q
What is HAT?
A
Hearing Assitive Technology is any piece if equipiment, software, program or product system that is used to increase, maintain or improve the functinal capabilties of persons with hearing impairments
2
Q
What are ALD’s
A
Assistive Listening Device is another name for Hearing Assistive Technology
* but, typically refers to personal listening systems
3
Q
Why should you use HAT?
A
- Increase awareness & recognition of enviromental sounds & situtaions
- Improve 1 on 1 or group Communication
- Improve phone communication
- Increase engagement in social activities
4
Q
Name Communication Obstacles
***
A
- Distance
- Backgrond Noise
- Reverberation
5
Q
What is my role as an audiologist when it comes to HAT?
A
- Educating the public on what HI is, the needs of those w/ HI & Benefit/outcome of HAT
- Educating the hearing impaired on federal access laws & their rights, HAT & expected benefits.
- Educating employers, businesses, and public facilities. appropriate HAT selection, installing & maintaing devices
- Fitting hearing aids and HAT Fit optimized HA’s or CI’s, ensure compatibility of HAT & versatility
The Process of Selecting appropriate HAT device
6
Q
What are the Considerations When Recommending Hearing Assistive Technology
A
- Degree of HL
- Auditory & Cognitive function
- Dexterity
- Device Key Features
* Cost
* Compatibility
* Cosmetics
* Versatility
* Durability
* Reliability
7
Q
The Process of Selecting appropriate HAT device.
A
What to consider when recommending HAT
* Amplification
* Lifestyle
* Features
* Components
Consider The Problem
* Acoustic Enviorment
* Functional Limitations
* Social Emotional Aspects
* Participation Restictions
Provide a Solution
* HAT (PLD’s, LAS, Tele, etc)
* Support (Fed Law, $ resources, Support groups)
8
Q
What is the goal of hearing management?
A
- Increase the probability that successful communication will occur
- Find a suitable solution based on individual hearing need
- Provide equitable access relative to normal hearing people
- Teach communication strategies
- Use multiple types of assistive technology
9
Q
*****
What are the Modes of Hearing Assistive Technology?
A
Visual
* Flashing lights, Text display
Vibro-tactile
* Bed shaker, wristband, smartwatch/phone
Audio
* Amplified sound
* Sent directly to ears
Services
* Dogs
* ASL interpreters
* CART
10
Q
What are the main Hearing Assistive Technology categories?
A
- Alerting/Signaling Devices & Support Services
- Personal Listening Devices/Assistive Listening Devices
- Telecommunications Access
- Large Area Systems
- Advanced Computing/Artificial Intelligence
- Text-Based Systems
- Google Search & Smartphone Applications
11
Q
What are the Modes of Hearing Assistive Technology?
A
Visual
* Flashing lights, Text display
Vibro-tactile
* Bed shaker, wristband, smartwatch/phone
Audio
* Amplified sound
* Sent directly to ears
Services
* Dogs
* ASL interpreters
* CART
12
Q
Alerting & Signaling Devices
* What are they for
* Examples
* when to use them
A
- Signal and alerting devices give the patients the ability to understand what is happening around them. It connects them to the environment, it makes them feel safe and secure.
- Alarm Clock, Multi Alert System, Service Dogs
- Should be considered to maintain independence and ensure safety. - Perform daily activities, identify changes in enviorment, feel connected to surrounding, manage safety.
13
Q
Personal Listening Systems/Devices
* What are they for
* Types
* Examples
* when to use them
A
- They Provide enhanced listening in noise, Ear-level RM devices in the classroom and Provide enhanced listening from a distance (wireless)
Two Types: Hard wired personal amplifier or Wireless personal listening device
* Pocket Talker, Roger, FM TV streamers
* Consider these when additonal amplification, clarity or additonal seperation from noise is needed.
14
Q
What are the components of wireless transmission?
A
- Audio source is received by the Microphone
- Transmitter, encodes the signal for transfer
- Receiver, recover the signal
- Delivery system, audio signal is delivered to headphones or hearing aids.
15
Q
Large Area System
* What are they for
* Examples
* When to use them
A
- Large area systems are used in public places like museums, movie theaters, or religious services.
- Wireless → Infrared, CADS, Radio Frequency (FM or DM)
- Direct Connect Transmission → Electromagnetic Induction/ Hearing Loop.
- Eliminates issues of distance and improves Speech clarity in background noise. & reduce confusion of reverberation in the room.
16
Q
Large Area System
* What are they for
* Examples
* When to use them
A
- Telecommunications provide Access to visual cues, Access to captions, Bilateral streaming, Improved speech recognition, Remote care and Telehealth services.
- Relay services, Video conferencing, Online content, TV streamers, Real-time captioning, Smartphone or Smart Devices
- Amplified volume, adjustable amplification and frequency shaping, Signaling lights & Captioning
Transcriptions.
17
Q
Hearing Technology in Hearing care
A
Needs Assessment
* Diagnosis of HL & Hearing Ability
* Mesure Speech Understanding
* Pre treat questionaires
* Patient perception of HL & function
* Patient Expectations
ALD Demonstration Center
* To encourage use & understanding, helps with connectivity and use, troubleshooting & training, Try before you buy.
Verification of Function
* HA’s, CI’s or HAT Optimized & Verified
Validation of Effectiveness/ Improvement
* HAT must be verified
* Questionnaires & Behavioral Tests
Ongoing Rehabilitation & Assessment
* Ongoing process to adress the changes in life or if patient is not receving
18
Q
What is included in a Needs Assessment.
A
Assessing patient need includes but is not limited to:
* Diagnosis of hearing loss and characterization of hearing ability
* Measurement of speech understanding ability
* Pretreatment subjective questionnaires
* Patient perception of their own function
* Patient expectations
19
Q
HAT Follow Up Care
A
- Ensure the device is being used properly and the desired benefit is being achieved
- Verify device function
- Validation of patient benefit should be an on-going process
- Address patient’s communication situation during each office visit
- Ask questions to probe for areas of difficulty and offer solutions
- Administer speech perception tests
20
Q
Types of Signal Transmission
A
- Near Field Magnetic Induction (NFMI)
- Frequency Modulated
- Digitally Modulated (BT or Proprietary)
- Infrared
21
Q
Near Field Magnetic Induction (NFMI)
* how does the system work?
A
- The voice or signal is picked up by a microphone.
- Signal is sent to an amplifer → strengthens the electrical signal so it can drive through the loop wire
- A copper wire is installed around the area
- Amplified current flows through the loop & creates an electromagnetic filed within the looped area
- The current produces electromagnetic lines of flux that rise up perpendicular to the loop wire & radiate toward the center of the looped area.
- Receiver/T-coil: The T-coil Inside HA, CI, or headloop detects these fluctuations in the magnetic field & converts the electromagnetic energy back into an electrical signal.
- Delivery System: The hearing device processes the electrical signal according to the listener’s hearing loss prescription and delivers it as amplified sound to the ear
22
Q
A hearing loop (also called an induction loop) system takes sound from a source and delivers it directly to a listener’s hearing aid or cochlear implant telecoil through __ _ .
A
A hearing loop (also called an induction loop) system takes sound from a source and delivers it directly to a listener’s hearing aid or cochlear implant telecoil through magnetic induction.
23
Q
Which components are necessary for NFMI?
A
- Microphone,
- amplifier with power supply,
- looped enviorment,
- telecoil
- Delivery system
24
Q
Near Field Magnetic Induction (NFMI)
* How is sound transmitted?
A
- The loop creates the magnetic field, but the telecoil is the part that receives and decodes it inside the hearing aid or CI.
- The audio signal is transmitted as electromagnetic fluctuations in a magnetic field.
- direct transmission, analog signal, no carrier frequency is used
Microphone → electrical signal → amplifier → loop wire → magnetic field Telecoil detects the modulated magnetic lines of flux → converts them back into sound.
25
Near Field Magnetic Induction (NFMI)
* Are there limitations to this technology?
* **Null Points** - sound quality
* Potential for **electromagnetic inference**
* **Spillover** - privacy issue
* Marginal sound quality
* Large areas require additional loops
* Must be **within looped area**
* Range of transmission depends on the strength of the electromagnetic signal
* **Costly** to instal
26
Near Field Magnetic Induction (NFMI)
* frequency
Frequency: 10-14 MHz
27
Frequency Modulated
* How does the system work?
Input signal varies with **frequency**, & impose to carrier signal = Frequency modulation, the signal will change based on input frequency → uses changes in frequency to carry speech information
28
Frequency Modulated
Which components are necessary?
* Microphone,
* transmitter,
* receiver,
* hearing aids (headphones)
29
Frequency Modulated
* How is sound transmitted?
* Mic picks up audio signal from the talker (6 inches from the mouth, direct connect to a sound source)
* Transmitter encodes and sends signal via radio waves
* Channel specific, transmitter/receiver on the same frequency channel to transmit
* Receive decodes the audio signal from the carrier wave
* Signal received by the listener
* Headphones, HA, CI
30
Frequency Modulated
Are there limitations to this technology?
* Transmission range depends on power of transmitter
* Required user to wear a receiver with headset or neckloop
* Radio frequency interference
* **Spill over**
* **Channel specific**
* **Signal hacking**
31
Frequency Modulated
Frequency
Frequency: 216-217 MHz
32
Digitally Modulated (BT or Proprietary)
How does the system work?
* Microphone – picks up the signal
* Transmitter: encodes it into a digital bit stream (2.4 GHz)
* Receiver: receives digital modulation signal and decodes the DM bit stream back into an audio waveform.
* Delivery system: The decoded audio is processed by the hearing aid, CI, headphone etc. & delivered to the ear as sound.
33
Digitally Modulated (BT or Proprietary)
Which components are necessary?
* Microphone
* Transmitter
* Receiver
* Delivery System
34
Digitally Modulated (BT or Proprietary)
How is sound transmitted?
* Sound is sent as a digitally modulated signal (not analog like FM/IR).
* The digital packets are transmitted securely over radio frequency (RF), usually around 2.4 GHz for BT or a proprietary band for DM.
* At the receiver, packets are reassembled into an audio waveform, amplified, and delivered through the hearing aid/CI.
35
Digitally Modulated (BT or Proprietary)
What are the best applications of this technology?
* Enhanced security (channel hoping, 79 channels)
* Enhanced connectivity (pairing)
* Cleaner & clearer signal
36
Digitally Modulated (BT or Proprietary)Are there limitations to this technology?
* Can be expensive
* Limited device compatibility
* Connectivity can be tricky
* Short range (50) ft
37
# **
Digitally Modulated
Frequency:
Frequency: 2.4 GHz
38
Infrared
How does the system work?
* **Microphone** – picks up the signal
* Transmitter **(IR LED emitter)** – converts that audio into a modulated infrared light signal and emits it.
* Receiver **(diode)** – picks up the infrared light signal. & converts light back into audio signal and goes to listening device.
* Delivery system, the audio signal is sent to the **listening devices**. (headphone, neckloop, HA’s etc)
w/HA the patient has to have an intermediary device (neckloop) with IR receiver
39
Infrared
Which components are necessary?
* Microphone,
* transmitter of IR light,
* specialized receiver,
* w/headset or neckloop
40
Infrared
How is sound transmitted?
Uses invisible light waves (infrared) to carry the audio signal.
41
Infrared
What are the best applications of this technology?
* Enhanced security, will not bleed over, no cross contamination.
* Smaller rooms, dark rooms
42
Infrared
Are there limitations to this technology?
* Direct line of sight is required
Cannot penetrate obstacles
* External light sources can influence transmission
* Short Distance
But you can use multiple emitters to reach larger distances
* Low light needed
43
Infrared
Frequency
Frequency: 2.3 or 2.8 MHz
44
Telephone relay service (TRS)
* Free text based service
* Keyboard for typing for the hearing impaired person side of the conversation and an LCD screen on which the other person’s responses appear
TRS User dials 711→ Communication Assistant (CA) answers → HI Caller provides phone number →
CA dials the number → CA relays conversation (HI types → CA voices | Hearing person speaks → CA types/signs | STS/VRS if needed) →
Real-time back-and-forth communication →
Conversation ends → CA disconnects and logs the call
45
Voice Carry Over (VCO)
Available for people who can communicate clearly by talking but have difficulty hearing on the phone
* VCO user dials 711 (or TRS number) and requests a VCO call.
* CA connects the call to the hearing person.
* VCO user speaks directly to the hearing person.
* Hearing person responds verbally → CA types the response.
* VCO user reads the typed message on their device.
* Steps 3–5 repeat until the conversation ends.
46
Hearing Carry Over (HCO)
Impaired speech, cerebral palsy or other speech disorder
* Speech impaired dials 711
* CA connects call
* SI types massage
* CA voices typed massage to listener
* Listener responds verbally directly to SI individual.
47
Internet protocol relay service (IP)
Connects telephone conversations using an internet-connected device
* User logs into the IP Relay website or app & enters phone #
* (CA) connects to the hearing person.
* HI types their message on the device → CA voices it to the hearing person.
* Listener responds verbally → CA types it back to the HI screen.
* Conversation continues in real-time typed ↔ spoken exchange.
* Either party ends the call when finished.
48
Video relay service (VSR)
Subscriber-based service for those who use ASL and have videophones, smartphones, tablets, or computers that are set up for video communication
* Deaf/HOH User connects with a Video Interpreter (VI).
* Deaf/HOH signs in ASL to the VI.
* VI voices the message in spoken English to the hearing person.
* Hearing person responds verbally.
* VI signs the spoken response back in ASL to the deaf user.
* This real-time back-and-forth continues until the call ends.
49
Video remote interpreting (VRI)
**Remote Interpreter for in-person conversations**
* Deaf/HOH person and hearing person are in the same room. & connect to VRI for remote interpreter
50
Real-time sign language translation
* Face-to-face conversation between ASL and speaking person
* Artificial intelligence-driven video machine translation technology
51
Speech-to-text technologies
* Automatic speech recognition (ASR)
* Voice Recognition
* Notetaking
* Computer assisted note taking
* Computer access Real-time translation (CART)
* Captioning
* Relay Conference Captioning
* Motion Picture Access
* Smartphone Speech-to-text applications
52
Automatic speech recognition (ASR)
**Converts spoken words into a written format**
**Artificial intelligence and machine learning**
* Analyzes the acoustic properties of speech
* Evaluates which word might logically follow another, using syntax or linguistic clues
* Applies linguistic rules of the language
**Uses**:
* Transcription services
* Voice assistants
* Captioning
* Dictation software
53
Name the service
will automatically detect speech and convert it into written text it uses linguistics and it is machine learning to be able to put in the correct words based on what it hearing within the speech spectrum identifying the sounds and then identifying what word is likely to go into the sentence,
Automatic Speech Recognition
54
Voice Recognition
* Speaker recognition or voice biometrics
* Identifies and verifies a specific person’s voice
* Determines who is speaking
* Analyzes unique vocal characteristics: Pitch, Tone & Rhythm
Uses:
* Security
* Customer service
* Personalization
55
ASR VS. HUMAN TRANSCRIPTION:
* ASR is faster but creates more errors which require editing.
* The most notable difference between the two is accuracy.
* For dictation with only one speaker ASR may work well enough.
* Transcription services offer superior accuracy and more flexibility in content or verbatim transcription from multiple audio sources, but you need to factor in the cost.
56
Voice Recognition
* Speaker recognition or voice biometrics
* **Identifies and verifies a specific person’s voice**
* Determines who is speaking
* Analyzes unique vocal characteristics (pitch, tone, rhythm)
* Used for security, customer service, personalization
57
Voice Recognition
Analyzes unique vocal characteristics of what?
Pitch
Tone
Rhythm
58
Determines **who** is speaking →
Transcribe **what** is said →
Determines **who** is speaking → Voice Recognition
Transcribe **what** is said → Automatic speech recognition (ASR)
59
What is the goal of VR & ASR?
Goal is to use VR and ASR to create a more accurate transcription of what's going on
* Voice recognition is using automatic speech recognition in conjunction.
60
Key Applications of ASR
Automatic Speech Recognition
* **Transcription services:** Converting audio or video recordings into text.
* **Voice assistants:** Understanding commands like "Hey Siri, set a timer."
* **Captioning**: Generating real-time captions for live broadcasts or online videos.
* **Dictation software**: Allowing a user to speak to a computer to write emails, documents, or notes
61
Voice Recognition
Key applications:
Voice Recognition
* **Security**: Authenticating a user's identity for a banking app or unlocking a phone with a voice command.
* **Customer service:** Verifying a customer's identity over the phone without requiring a password or PIN.
* **Personalization:** Allowing a smart speaker to distinguish between different family members to provide personalized responses.
62
What is Notetaking service?
Volunteers, who take notes written or computer
* not word for word, misspellings, based off what listener thinks is important
* They willl attend class, meeting & provide notes
63
What is Computer assisted note taking
Near perfect accuracy when combined with human intelligence
* Uses ASR
64
what is Computer access Real-time translation (CART)
* Human transcription, stenographer, instant, verbatim, preferred captioning method for deafness and hard of hearing, very accurate.
* Live captioning, transcribers may not know all the jargon, displayed on an individual's computer monitor or wall screen
65
Types of captioning
* Verbatim:
* Edited:
* Online captioning: “
* Offline captioning:
* Open captioning
* Closed captioning
66
# Name the Captioning Type
subtitles or closed captions, scripted and synched to a pre-recorded video file, researched and verified for accuracy
Offline captioning
67
# Name the Captioning Type
always in view, no need for decoding, embedded in video.
Open captioning:
68
# Name the Captioning Type
word for word, unfiltered
**Verbatim**: word for word, unfiltered
69
# Name the Captioning Type
corrects errors, considers the audience
**Edited**: corrects errors, considers the audience
70
# Name the Captioning Type
“real-time”, simultaneous with the program, no script preparation
**Online** captioning: “real-time”, simultaneous with the program, no script preparation
71
# Name the Captioning Type
subtitles or closed captions, scripted and synched to a pre-recorded video file, researched and verified for accuracy
**Offline captioning:** subtitles or closed captions, scripted and synched to a pre-recorded video file, researched and verified for accuracy
72
# Name the Captioning Type
can be turned on and off, displayed using a built-in decoder, separate text stream
**Closed captioning:** can be turned on and off, displayed using a built-in decoder, separate text stream
73
# Name the Caption
always in view, no need for decoding, embedded in video.
**Open captioning:** always in view, no need for decoding, embedded in video.
74
Closed captioning:
Closed captioning: can be turned on and off, displayed using a built-in decoder, separate text stream
75
Open captioning:
Open captioning: always in view, no need for decoding, embedded in video.
76
Offline captioning:
Offline captioning: subtitles or closed captions, scripted and synched to a pre-recorded video file, researched and verified for accuracy
77
Online captioning
Online captioning: “real-time”, simultaneous with the program, no script preparation
78
Edited
Edited: corrects errors, considers the audience
79
Verbatim
Verbatim: word for word, unfiltered
80
Motion Picture Access
* Theaters must supply assistive technology; Infrared systems to ensure no spill-over into adjacent theaters, Induction loop available in some theaters is designed to work with personal amplification, Fm systems may be used with specific channels assigned for each theater room
81
Motion Picture Access
Examples
* **Captiview**: transmits to the receiver via RF
Receiver secures in cup hold or seat and a displays text
* **Sony Entertainment Access glasses**
**Small projector** on glasses projects **captions** ~ 10 ft in front of the user
* **Rear Window**
Reversed captions, LED panel mounted at rear of theatre
Acrylic panels attached to the seat reflect captions
* Open captions
82
# Summary
AM
AM → Amplitude
* Input signal varies with loudness/amplitude & imposed onto carrier signal = Amplitude modulation, the signal will change based on input loudness, amplitude → Carry information.
83
# Summary
FM
FM → Frequency
* Input signal varies with frequency, & impose to carrier signal = Frequency modulation, the signal will change based on input frequency → uses changes in frequency to carry speech information
84
# Summary
DM
DM → Bit Stream
* Voice is Sampled & converted into a bit stream (0’s &1’s) bit stream is turned into a wave & superimposed on carrier signal = Digital Modulation uses changes in bit stream to carry speech information
85
Modulation
Modulation: Inputting and a input signal on to a carrier wave is called modulation
* Modulation is changing the shape of the carrier wave to encode the desired information.
86
Carrier wave
Carrier wave: A carrier wave is a pure wave of constant frequency
* Without an input signal it does not carry weight/information.
* To be able to relate it to speech or data you have to impose an input signal on top of the carrier wave.
87
Bi directional VS Unidirectional
* Unidirectional system: Transmits sound in one direction only (transmitter → receiver)
* Bidirectional system: Transmits sound in both directions (transmitter ↔ receiver).
88
# Name the Law
* People with disabilities using modern communications tech
* Equal access to: closed captioning, relay services, video description, telephone compatibility, VoIP/text/video conferencing, emergency services
| ****
21st Century Communications and Video Accessibility Act (2010)
89
# Name the Law
Expectations / requirements
* Telecommunications Relay Services (TRS) must be available
* Hearing aid compatibility & volume control
* No individual qualification proof required to use accessibility features.
| ***
21st Century Communications and Video Accessibility Act (2010)
90
# Name the Law
21st Century Communications and Video Accessibility Act (2010)
* exclusions
* Some video programming: private videos may be exempt unless broadcast/posted on TV/online.
* Device size: screens < 13″ may be exempt.
* Specialized equipment: if accessibility truly cannot be achieved.
* Waivers: manufacturers can request if they demonstrate undue burden.
91
# Name the Law
* Telephones manufactured in the U.S.; essential telephones compatibility
* Essential phones must be hearing-aid compatible (telecoil/“T” coupling) to reduce interference and allow use with HAs/CIs; volume control access.
Hearing Aid Compatibility (HAC) Act (1988)
92
# Name the Law
Expectations / requirements
Public-use and emergency phones are HAC; educate users on M/T ratings for wireless devices:
* M-rating: interference reduction with HAs.
* T-rating: telecoil coupling capability.
Hearing Aid Compatibility (HAC) Act (1988)
93
# Name the Law
Hearing Aid Compatibility (HAC) Act (1988)
Exclusions
Public mobile or private radio services, certain cordless phones, and secure telephones.
94
# Name the Law
* Individuals with disabilities; covered entities: private employers, state/local governments, employment agencies, labor organizations, labor-management committees.
* Equal employment opportunity, no discrimination by public entitiies, public accommodation- reasonable modifications, Telecommunications & Relay,
Americans with Disabilities Act (ADA) (1990; ADAAA 2008)
95
# Name the Law
* Equal employment opportunity;
* No discrimination by public entities in programs/services/activities.
* No discrimination by private places of public accommodation and commercial facilities.
* Telephone companies must provide interstate/intrastate TRS 24/7 & Closed captioning of federally funded PSAs required.
* provisions; includes conditions not considered disabilities.
Americans with Disabilities Act (ADA) (1990; ADAAA 2008)
96
# Name the Law
Americans with Disabilities Act (ADA) (1990; ADAAA 2008)
Qualifying definition
Physical/mental impairment substantially limiting ≥1 major life activity; record of; or regarded as such.
97
# Name the Law
Americans with Disabilities Act (ADA) (1990; ADAAA 2008)
Exclusions
Illegal drug use; certain behavioral/sexual disorders; social/economic disadvantage; temporary/non-chronic conditions; minor impairments not “substantially” limiting.
98
# Name the Law
Federal agencies, programs receiving federal financial assistance, federal employment, and federal contractors; individuals with disabilities
Rehabilitation Act (1973)
99
# Name the Law
* No harassment based on disability; provide reasonable accommodations for known limitations for Federal Employment & Federal Contractors
* No discrimination in any program/service receiving federal funds; equal access required. (eduction)
* Federal agencies must make websites/digital content/IT accessible.
Rehabilitation Act (1973)
100
# Name the Law
* Accessible facilities/technology; academic adjustments (extended test time, notetakers); workplace accommodations (modified equipment, flexible schedules); auxiliary aids; accessible web/digital content(per §508).
* Must be reasonable and not impose undue hardship.
Rehabilitation Act (1973)
101
# Name the Law
Qualification
Rehabilitation Act (1973)
Documented disability substantially limiting a major life activity **and** otherwise qualified for the program/service/job.
102
# Name the Law
Rehabilitation Act (1973)
Individuals with Disabilities Education Improvement Act (IDEA) (1975)
103
# Name the Law
Children with disabilities and their families; guarantees Free Appropriate Public Education (FAPE) with specially designed instruction at no cost.
Individuals with Disabilities Education Improvement Act (IDEA) (1975)
104
# Name the Law
* Ages 3–21
* Focus: special education & related services in school.
* Delivered via IEP; ensures FAPE in the Least Restrictive Environment (LRE).
* Covers 13 disability categories (includes the categories above).
Individuals with Disabilities Education Improvement Act (IDEA) (1975)
Part B
105
# Name the Law
* Birth to 3 (Infants & Toddlers)
* Early Intervention system with a service coordinator and IFSP (Individualized Family Service Plan).
* Services listed in the doc include: assistive tech; audiology; family counseling; health/medical/nursing/nutrition; OT/PT; psychological services; social work; special instruction; vision services.
IDEA 1975
Part C
106
# Name the Law
Improves special education via funding, training, and research across states/programs.
Individuals with Disabilities Education Improvement Act (IDEA) (1975)
Part D
107
Another name for Hearing Assistive Technology may be what?
Assistive listening device
108
A 75-year-old male presents for an audiological evaluation. His audiogram shows a moderate-to-severe sensorineural hearing loss in both ears. He reports difficulty hearing the doorbell and smoke detector alarms. Which of the following patient characteristics is LEAST likely to indicate that he would benefit from an alerting device?
* The patient has a history of falls and limited mobility
* The patient has a tactile sensitivity
* The patient's hearing loss is progressive
* The patient lives alone
**The patient has a tactile sensitivity**
* Alerting devices often use vibrotactile alerts, so a patient with tactile sensitivity may not tolerate or benefit from this type of device. The other options (living alone, progressive hearing loss, and limited mobility) are all indicators that an alerting device could be beneficial for safety and communication.
109
You are setting up a private practice and trying to decide whether or not to include an HAT display. What do you see as the advantages and disadvantages of such a display?
Pros:
* Opportunity to try before buy
* Pt's demo different devices - compare
* additonal revenue
Cons:
* Cost of demo/display items
* additonal time to discuss HAT
* Cost of staff to maintain
110
Define Hearing Assistive Technology:
Any item, piece of equipment, software program or product system that is used to increase, maintain or improve the functional capabilities of persons with hearing impairment.
111
Captions may be open or closed. Which of the following statements most accurately describes the difference between open and closed captions?
* Open captions are only visible to viewers with hearing loss, while closed captions are accessible to all viewers.
* Closed captions are a newer technology used for online streaming, while open captions are used primarily for broadcast television.
* Closed captions can be turned on or off by the viewer, whereas open captions are permanently burned into the video and cannot be disabled.
* Open captions are stored in a separate file, while closed captions are embedded directly into the video stream.
**Closed captions can be turned on or off by the viewer, whereas open captions are permanently burned into the video and cannot be disabled.**
* The key difference lies in viewer control. Closed captions are an optional feature that the viewer can activate or deactivate, while open captions are a permanent part of the video and are always visible.
112
Compare and contrast digital modulation transmission and traditional frequency modulation transmission (what are the similarities and differences). What is the advantage of digital modulation?
Both systems use wireless technology to transmit a signal across a distance. Both devices overcome the three obstacles to communication: background noise, distance and reverberation. Both devices can be used with or without hearing aids. Differences in the system are related to security (signal hacking by tuning into the frequency channel for FM), interference (FM) or connectivity issues (DM), and sound quality (better with DM). Nowadays, battery drain is less of an issue with Bluetooth Low Energy protocols.
113
Transmission of a signal has challenges. Match the challenges with the correct type of signal transmission.
Transmission:
* Induction Loop
* Frequency Modulation
* Digital Modulation
* Infrared
Challenges:
* Radio frequency interference and not secure
* Connectivity issues and can consume more power
* Spill over and limited frequency range
* Direct line of sight required and limited range
* Induction Loop → Spill over and limited frequency range
* Frequency Modulation → Radio frequency interference and not secure
* Digital Modulation → Connectivity issues and can consume more power
* Infrared → Direct line of sight required and limited range
114
What are the modes of HAT.
Vibrotactile, visual, Amplified audio, services
115
There are 3 obstacles to communication. Describe each obstacle and how HAT can overcome these obstacles.
**Distance:**
* The further we are from the sound source the more difficulty we will have hearing due to the inverse square law. Hearing assisitve technology bridges the gap by delivering sound directly to the ear or providing an alternate form of signaling.
**Background noise:**
* Background noise makes it harder to hear, especially for individuals with hearing loss. Hearing assistive technology improves the signal to noise ratio or provides additional visual or tactile information to support understanding.
**Reverberation:**
* It is harder to hear in a room with poor sound quality, or acoustics. Sound waves reflect off solid surfaces such as exposed walls, tabletops, and flooring. This causes echoes, called reverberation. Sound absorbing objects like carpets and couches reduce reverberation and are considered a form of assistive technology. Remote microphones also support better hearing by reducing the effects of echo.
116
You have a patient for whom you have recommended an Assistive Listening Device. This patient has very limited financial resources. Describe some potential sources of funding where this patient may obtain assistance.
* **Arizona Technology Access Program** offers loaner equipment and low-interest loans for the purchase of equipment.
* **Care Credit** and **small bank loans** offer a credit line for the purchase of assistive technology.
* Resources like **vocational rehabilitation** services may also be able to support disability needs.
117
A 68-year-old patient with a bilateral sensorineural hearing loss is considering discontinuing their landline telephone service and relying solely on their cell phone. As their audiologist, which of the following is the LEAST relevant consideration you would urge them to make prior to finalizing their decision?
* The reliability of 911 emergency services and the accuracy of location data from a cell phone.
* The ability of their cell phone to function during a power outage compared to a landline.
* The compatibility of their current hearing aids with the cell phone's telecoil or Bluetooth features.
* The need to purchase an unlimited data plan for their cell phone to ensure call quality.
**The need to purchase an unlimited data plan for their cell phone to ensure call quality.**
* While a patient's cell phone plan is a financial consideration, it is not a primary clinical or safety-related consideration for the audiologist. Call quality is more dependent on the cellular signal strength and phone hardware than the data plan itself. The other options (A, B, and D are critical audiological and safety-related factors that directly impact the patient's ability to communicate effectively and securely.
118
You are counseling a patient on buying a new cell phone that has better compatibility with her hearing aids. What M/T rating are you going to recommend? And what does the M/T rating mean? Which Federal Regulation/Law governs this rating?
* Mobile phones are required by the Federal Communications Commission to indicate the compatibility rating (1-4) of the microphone and telecoil.
* Higher numbers indicate better compatibility and less interference.
* **M3. M4 and T3, T4 ratings are recommended.**
* **The Hearing Aid Compatibility Act of 1988** and Twenty-First Century Communications and Video Accessibility Act are the primary laws that control the rating of hearing aid compatibility with all landline and cellular phones.
* Clarification- T is a rating of the telecoil strength within the phone not the HA/CI
119
# True or false
Eligibility for a telephone through CaptionCall is determined by a medical professional.
FALSE
* There are several individuals and organizations that can recommend and assist people with getting a captioning phone; any health professional, telecommunications companies, and state distribution programs.
120
# True or false
CaptionCall allows users to turn On/Off captioning, increase the phone volume and increase ringer volume.
True
121
A 72-year-old male with a severe bilateral hearing loss since childhood is a good hearing aid user but reports specific difficulties hearing his wife in the car and at restaurants. Which of the following is the most appropriate Hearing Assistive Technology (HAT) recommendation for this patient, and why?
1. A personal sound amplification product (PSAP), because it provides a general volume boost that is effective in any listening environment.
2. An FM/DM system or a remote microphone, because it overcomes the effects of distance and background noise by sending the speaker's voice directly to his hearing aids.
3. A captioned telephone, because it provides a visual text representation of conversations, which is ideal for a patient with severe hearing loss.
4. A vibrating alerting system, because it can alert him to his wife's presence even when he cannot hear her voice.
**2. An FM/DM system or a remote microphone, because it overcomes the effects of distance and background noise by sending the speaker's voice directly to his hearing aids.**
* The patient's primary complaints are difficulties with hearing at a distance and in background noise. An FM/DM system or a remote microphone is specifically designed to address these challenges by placing a microphone near the desired speaker (in this case, his wife), thereby improving the signal-to-noise ratio and bypassing the negative effects of distance. The other options do not address the patient's specific situational difficulties.
122
A 60-year-old male with a high-frequency sensorineural hearing loss refuses to consider hearing aids. His spouse complains that he turns the TV volume up to an uncomfortably loud level. Compare the three different wireless system options to resolve his concern. Describe the primary advantages and disadvantages of each type of transmission in terms the patient can understand.
* The patient's primary problem is hearing the TV. A TV listening system with headphones directly addresses this by allowing the patient to set his own volume without affecting the room's volume, thereby resolving the conflict with his spouse.
* A TV listening system using infrared (IR) or radio frequency (RF) or electromagnetic induction is appropriate.
* A potential disadvantage of IR is that it requires a clear line-of-sight to the transmitter, and radio frequency/FM may experience some interference from other devices.
* The disadvantage for a hearing loop may be that the installation process directly impacts the clarity of the signal and may be complicated for a patient to install unless they use a portable unit.
123
Which of the following statements best describes ASR and its primary benefit for patients who are hard of hearing or deaf?
* ASR is a technology that uses sound wave analysis to enhance a speaker's voice and reduce background noise; it is helpful for patients who have trouble hearing in a noisy environment.
* ASR is a technology that provides a visual text representation of spoken information in real-time; it is helpful for patients who have difficulty understanding speech, particularly on the phone or in group settings.
* ASR is a technology that automatically adjusts the volume and pitch of a speaker's voice to match a listener's hearing loss profile; it is helpful for patients who have varying degrees of hearing loss.
* ASR is a technology that uses vibrations and haptics to alert a patient to specific sounds; it is helpful for patients who need to be aware of environmental alerts like a fire alarm or a doorbell.
**ASR is a technology that provides a visual text representation of spoken information in real-time; it is helpful for patients who have difficulty understanding speech, particularly on the phone or in group settings.**
(2)
124
What is ASR/automatic speech recognition?
Automatic Speech Recognition is the **conversion of speech to text.**
* The primary benefit for patients with hearing loss is the provision of a visual, real-time caption of spoken information, which aids in comprehension when auditory information is incomplete or distorted.
125
According to our discussion in class on alerting and signaling devices, which of the following BEST describes the psychological benefit of using visual or vibratory alerting systems for a person with hearing impairment?
* The use of such systems can instill a connection with one's surroundings and a sense of confidence in being informed of events that require a response.
* The technology is less fatiguing than straining to hear auditory signals in a world designed for hearing individuals.
* The technology helps the user better interpret visual and vibratory cues in the absence of auditory signals.
* The technology can provide a greater sense of privacy by notifying the user of alerts without disturbing others.
The use of such systems can instill a connection with one's surroundings and a sense of confidence in being informed of events that require a response.
126
Based on the information provided, what is the primary reason some programs use edited captioning strategies instead of verbatim (word-for-word) captioning?
* To incorporate multiple languages simultaneously and cater to a more diverse audience.
* To save time and resources by using a streamlined, pre-written script instead of real-time transcription.
* To make the captions more visually appealing and easier to read in a single glance.
* To simplify the language for the primary audience, as viewers only have one chance to read the captions.
**To simplify the language for the primary audience, as viewers only have one chance to read the captions**.
* Verbatim is word for word captioning in real time. Edited captioning uses strategies like simplifying the language to accommodate different language levels of the primary audience. This is important because viewers have only one chance to view the captions.
127
Match the type of captioning with the correct description. Not all descriptions apply.
Type:
* Online captions
* Off-line captions
* Open captions
* Closed captions
Descriptions:
* a separate, scripted text file
* permanent part of the media
* a transcript that appears on the screen at the same moment as the corresponding speech, closed captioning for videos and other media
* readily accessible, separate than the audio
Online captions→ a transcript that appears on the ….
Off-line captions→a separate, scripted text
Open captions→ permanent part of the media
Closed captions → readily accessible, separate than the audio
128
You are responsible for equipping one of your local courtrooms with assistive listening for the hearing-impaired. Would you choose a loop, FM or Infrared. List the advantages and disadvantages of your choice.
* I would choose an IR system for a local courtroom.
* Advantages: There is no-spill-over outside of the room which is important specifically in this situation as these meetings are very personal, connectivity is very simple as well.
* Disadvantages: You need a direct line of sight to the transmitter to be able to pick up the signal, if someone walks in front of the signal it can get cut off. You need a specific receiver to get the signal and decode it back into an acoustic signal so you can hear it.
129
Describe the circumstances under which you might recommend a personal amplifier, such as a pocketalker, for your client instead of a hearing aid.
* financial concerns
* in denial and not ready for HA
130
Match each of the following with the provided characteristic
Service:
* Computer assisted notetaking
* Communication access realtime
* Voice recognition
* Automatic speech recognition
Description:
* Done by a trained operator using a stenographic keyboard and special computer software, offers immediate voice to text translation of what is being said in a meeting or lecture.
* Analyzed behavioral characteristics of a person’s voice and creates a profile
* Software that converts spoken words into text, making content more accessible.
* Uses a computer with word processing software to type summary notes of a meeting or lecture
* Uses a computer with word processing software to type summary notes of a meeting or lecture.→ **Computer Assisted Notetaking (CAN)**
* Done by a trained operator using a stenographic keyboard and special computer software, offers immediate voice to text translation of what is being said in a meeting or lecture→ **Communication Access Realtime Translation (CART)**
* Analyzes behavioral characteristics of a person's voice and creates a profile→ **Voice Recognition**
* Software that converts spoken words into text, making content more accessible→ **Automated Speech REcognition**
131
In the article Connectivity is the Future of Hearing Technology, we learned about emerging technology. Which emerging technology is designed to enable a person attending a lecture in an auditorium to bilaterally stream a high-quality audio signal directly from the public address system?
* Auracast
* Artificial Intelligence (Al)
* Binaural processing
* Proprietary technology
Auracast
132
# Fill in the blank
According to the inverse square law, as the distance from a sound source ______the intensity of the sound______
According to the inverse square law, as the distance from a sound source increases, the intensity of the sound decreases.
133
YOU ALWAYS NEED TO EDUCATE the patient on the ___ not only the ___
YOU ALWAYS NEED TO EDUCATE the patient on the **LIMITATIONS** not only the **benefits**
134
___ is the prolongation of sound by multiple reflections.
Reverberation/echo
135
Understanding speech is more challenging with telecommunication devices due to
* the distance that must be overcome wirelessly
* the reduced frequency range inherent in these devices
* degradation of the auditory signals
* infiltration of background noise
degradation of the auditory signals
136
People with significant hearing loss are more vulnerable to missed auditory alerts while sleeping because why?
* They do not sleep with amplification OR
* they remove their hearing aids
137
# True or false
The most important consideration for a remote microphone system is to provide consistent auditory access to speech sounds without noticeable interference.
TRUE
138
# True or false
The quality of a transmitted signal cannot be verified for proprietary remote microphones.
FALSE
* Audiologists verify the quality of the transmitted sound by performing a listen check, using a transparency method of verification, and performing behavioral speech in noise tests.
139
# True or false
Hearing aid accessories use direct transmission.
TRUE
* ex: roger
140
# True or false
Hearing aids that do not have internal receivers can be coupled using an adapter and direct audio input.
TRUE
141
# True or false
Personal amplification products and over-the-counter hearing aids can provide the same individualized solution as prescriptive hearing aids and cochlear implants.
FALSE
* Hearing assistive technology is NOT a substitute for an appropriately fit hearing aid or cochlear implant.
142
# True or false
According to the Changing Role of the Audiologist from Hearing Healthcare Provider to Hearing Loss Mitigation Counselor, younger patients are not attracted to hearing assistive technology and their hearing loss remains untreated.
FALSE
* "In addition to providing connections to safety features and prolonging independence in older patients, technology may also serve as a bridge to attract younger patients with untreated hearing loss by providing multi-functional tools designed to make their lives easier and better."
143
# True or false
Beyond the critical distance, the listener can clearly understand speech since they are exposed to more reflected energy, which amplifies the desired signal.
FALSE
* Reverberation causes distortion in the speech signal.
144
# True or false
Audio over Wi-Fi technology systems allow people to use personal smart devices as personal receivers. By downloading a free application to their smart device and selecting a preferred channel on the network, a person can listen to the preferred audio through personal headphones or hearing aids connected to the device.
TRUE
* Teens and children can access information through RF systems, infrared systems, portable listening systems, audio over Wi-Fi, and hearing loops. Audio over Wi-Fi is especially appealing since it uses personal devices (e.g., smartphones), offering privacy and reducing self-consciousness.
145
An FM/DM system can transmit to a specialized receiver with headphones or a neckloop attached. The neckloop receiver then uses ____ to transmit the signal to the hearing aid via the ____
An FM/DM system can transmit to a specialized receiver with headphones or a neckloop attached. The neckloop receiver then uses **NFMI** to transmit the signal to the hearing aid via the **telecoil**
146
Smart devices that offer a Bluetooth Low Energy protocol can transmit signals directly to a hearing aid that utilizes the same protocol. This protocol for Android devices is called ______.
* ASHA
* Audio Signal for Hearing Aids
147
An example of a hard-wired amplifier is ____.
Pockettalker
148
A large area assistive listening system that uses traditional frequency modulation (FM) to transmit sound from a microphone to a listener's receiver operates on multiple frequency bands. Which of the following frequency bands might an FM system use to transmit audio information?
* 2.4 GHz
* 2.3-3.8 MHZ
* 50-60 Hz
* 72-76 MHz
72-76 MHz
* Traditional FM systems typically use **72-76 MHz, 216-217 MHz, and 900 MHz** frequency bands to transmit an audio signal. In class we used the 72 MHz frequency band.
149
Which of the following statements accurately describes how the Wireless Emergency Alerts (WEA) system functions?
* The alerts are broadcast to all WEA-enabled mobile devices within a targeted geographic area.
* The system requires users to opt-in by signing up for a subscription service.
* The system constantly tracks a user's specific location in case they need to send a personalized warning.
* Alerts are sent as standard text messages (SMS) to every phone in a state.
**The alerts are broadcast to all WEA-enabled mobile devices within a targeted geographic area.**
* Wireless Emergency Alerts (WEA) are alert messages sent to your mobile phone during an emergency. No sign-up is required. WEA messages are relevant to your location- you only receive WEA messages when you and your cell phone are in the area of the emergency. If you visit another city, you will only receive alerts for that location and not your hometown. National Weather Service weather.gov/wrn/wea
150
Implementation Considerations
* Are there any contraindications to HAT?
* Acoustic Environment
* Social Emotional issues
* Functional Difficulties
* Available Support
151
Understanding the ADA and Employment Rights
* What is the primary purpose of Title 1 ADA?
* To protect people with disabilities from discrimination in employment
* Private employers with 15 or more employees
* Federal entities must comply with the Rehabilitation Act of 1973
152
Define Disability
1. a person who has a physical or mental impairment that substantially limits one or more major life activities
2. a person with a record of a physical or mental impairment that substantially limits one or more major life activities
3. a person who is regarded as having a physical or mental impairment that substantially limits one or more major life activities
153
Major Life Activities and Bodily Functions
Basically anything
* Major life activities include, but are not limited to: caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, sitting, reaching, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, interacting with others, and working.
* Major bodily functions include functions of the immune system, special sense organs and skin; normal cell growth; and digestive, genitourinary, bowel, bladder, neurological, brain, respiratory, circulatory, cardiovascular, endocrine, hemic, lymphatic, musculoskeletal, and reproductive functions.
* The operation of a major bodily function includes the operation of an individual organ within a body system.
154
Limitations
Of ADA
* Episodic or remissive conditions (e.g., epilepsy, MS, cancer, diabetes, asthma, depression, bipolar disorder, schizophrenia) still qualify if they substantially limit major life activities.
* No minimum duration required—impairments can count as disabilities regardless of how long they last.
155
# ADA
Condition, Manner, or Duration
Consider the individual as compared to most people in the general population.
* Difficulty performing the activity
* Effort required to perform the activity
* Time required to perform a major life activity
* Pain experienced when performing a major life activity
* Length of time the major life activity can be performed
* The way an impairment affects the operation of a major bodily function
156
When to request an accommodation:
When you **identify a workplace barrier** due to a disability that is
* prevents the person from competing for the job
* Prevents the person from performing a job
* Prevents equal access to a benefit of employment
157
How to request accommodation
* Employee must disclose condition and request **(verbal or written).**
* Employer must provide **reasonable, timely accommodation** if agreed.
* Employer may **request medical documentation** to verify ADA disability.
158
Reasonable Accommodation
* making existing facilities accessible
* job restructuring
* part-time or modified work schedules
* acquiring or modifying equipment
* changing tests, training materials, or policies
* providing qualified readers or interpreters
* reassignment to a vacant position
* medical leave
* work at home
159
Job Accommodations Network (JAN)
* Grant, funded from US Department of Labor
* Free
* Provides ADA info and accommodation solutions for employees (negotiate) & employers.(process)
* Provides resources, not legal advice.
160
What are the phone streaming protocols available?
Made for Iphone- Iphone
ASHA Protocol - Android
161
___ = gold standard for improving SNR in real-world settings.
**Remote Microphone Systems (RMS)** = gold standard for improving SNR in real-world settings.
Comprehensive Exam 3
flashcards
Decks in class (14)
# Cards
-
Tinnitus Hyperacusis & Misophonia62
-
Research methods57
-
Statistics25
-
Practice Development 1 & 259
-
Early Intervention and Educational Audiology0
-
HAT161
-
Vestibular Assessment & Treatment II265
-
Advances in Audiologic Care.0
-
Occupational and Environmental65
-
Medical Imaging67
-
Ethics In Audiology0
