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Practical Suggestions for Persons
with a Hearing Impairment
FUNCTION OF THE NORMAL EAR
The ear is divided into three parts: an external ear, a middle
ear and an inner ear. Each part performs an important function
in the process of hearing.
The external ear consists of the auricle (pinna) and ear canal.
These structures gather the sound and direct it down the ear
canal, towards the ear drum membrane.
The middle ear chamber lies between the external and the inner
ear and consists of an ear drum membrane and three small ear
bones (ossicles): malleus (hammer), incus (anvil) and stapes
(stirrup). These structures transmit the sound vibration to
the inner ear. In so doing they act as a transformer, converting
the sound vibrations in the external ear canal into fluid
waves in the inner ear.
The inner ear chamber contains the microscopic hearing and
balance nerve endings (hair cells) bathed in fluid. Fluid
waves initiated by movement of the stapes bone stimulate the
delicate hearing nerve endings, which in turn transmit an
electric impulse to the brain where it is interpreted as sound.
TYPES OF HEARING IMPAIRMENT
The external ear and the middle ear conduct and transform
sound; the inner ear receives it. When there is some problem
in the external or middle ear, a conductive hearing impairment
occurs. When the trouble lies in the inner ear, a sensori-neural
or hair cell loss is the result. Difficulty in both the middle
and inner ear results in a mixed hearing loss (i.e. conductive
and a sensori-neural impairment).
CONDUCTIVE IMPAIRMENT
A conductive type of hearing impairment occurs when sound
is not conducted efficiently through the ear canal, ear drum,
or tiny bones of the middle ear. Conductive losses reduce
the loudness of sound that is heard. A conductive impairment
may result from blockage of the external ear canal, from a
perforation (hole) in the ear drum membrane, from middle ear
infection or from disease any of the three middle ear bones.
This type of hearing impairment is usually correctable.
A person with a conductive hearing loss may notice that his
ears may seem to be full or plugged. He usually speaks softly,
with a well modulated voice, because he hears his own voice
quite loudly. In general, he hears better in noise than in
quiet. Crunchy foods, such as celery, sound very loud and
he may have to stop chewing to be able to hear what is being
said. With this type of impairment one hears quite well over
the telephone.
Fortunately, the patient with a conductive hearing impairment
will never go deaf. He will always be able to hear, with reconstructive
ear surgery or by use of a properly fitted hearing aid.
SENSORI-NEURAL IMPAIRMENT
A sensori-neural hearing impairment may result from disturbance
of inner ear circulation, increased inner fluid pressure or
from disturbances of nerve transmission. The most common cause
of sensori-neural impairment is an aging change in the nerve
endings (hair cells in the cochlea). This type of impairment
is not able to be corrected by surgery, but rarely leads to
deafness.
The person with a sensori-neural impairment may state that
he can hear people talking, but he cannot understand what
they are saying. An increase in the loudness of speech may
only add to his confusion. Speech is audible, but not often
understandable. He usually hears better in quiet places and
he may have difficulty understanding what is being said over
the telephone. He will probably hear low tones better than
high tones and, therefore, may find a man's voice more understandable
than a woman's higher pitched voice. Often the patient with
this type of hearing impairment may not hear a door bell or
the telephone ringing in another room.
CENTRAL IMPAIRMENT
A central type of hearing impairment occurs when auditory
centers of the brain are affected by injury, disease, tumor,
heredity, or unknown causes. Loudness of sound is not affected
necessarily, but understanding speech is.
HEARING IMPAIRMENT IN ONE EAR
A hearing impairment that is confined to one ear prevents
a person from distinguishing the direction of sound. He will
also have difficulty hearing from the involved side and may
find it difficult to understand words in a noisy background
or where the acoustics are poor.
When this impairment is secondary to a middle ear problem
(i.e. conductive), surgery will usually be possible to restore
the hearing, giving a better auditory balance. When the impairment
is sensori-neural (i.e. hair cell loss), it is often possible
to restore some of this hearing balance through the use of
a hearing aid.
REHABILITATIVE MEASURES
A complete audiologic/otologic examination by a competent
ear specialist is necessary to determine what type of hearing
impairment is present, its probable cause and its treatment.
The treatment of choice may be remedial, preventive, medical,
surgical or a combination of these. Each person with impaired
hearing should have the benefit of adequate auditory rehabilitation.
A well rounded program of rehabilitation for persons with
a hearing loss may include speech reading, auditory training,
speech strategy techniques, instruction in the use of a hearing
aid and guidance in social adjustment. All aspects of the
program do not necessarily apply to each individual with impairment,
but each individual may be helped through some of these methods.
HINTS FOR FRIENDS AND RELATIVES OF THE HARD OF HEARING
The individual with a hearing impairment must stop, look and
listen in order to understand speech.
There are a number of factors that can significantly influence
the communicating ability of the hearing handicapped. An understanding
of some of these factors will prepare you to communicate more
effectively with such persons.
Persons with a mild hearing loss may have trouble hearing
only certain sounds such as f, s, and t, h, or hearing in
certain situations. Hearing problems may also occur when the
sound source is far away or when there is a lot of background
noise. Persons with moderate or severe hearing losses have
trouble in many situations, and persons with profound hearing
loss hear little or nothing around them.
Speech Reading (lip reading). It is not uncommon for the person
with impaired hearing to say, "I can't hear a thing without
my glasses." This expression is a sure indication that
he relies heavily on speech reading (lip reading). Many use
speech reading without being aware that they have developed
the skill. Over the years, the listener unconsciously compensates
for his auditory impairment by obtaining visual clues of speech
from the lips and facial expressions of the speaker.
Many take formal training from tutors who are especially prepared
in this area. Whatever the means of acquiring the skill, it
is helpful to all hearing handicapped to be able to view the
face of the speaker. The speaker who absentmindedly covers
his mouth, chews gum, or does not face the patient with a
hearing loss during a conversation deprives the handicapped
listener of valuable visual information that could enhance
this understanding. Poor speech habits not only limit the
lip reading skill of the listener, but also introduce distorted
speech sounds. On the other hand, overly precise lip movements
are to be avoided because exaggerated mouthings also result
in speech distortion. Lip readers have learned to interpret
normal speech movement.
Attention. Relatives of the hard of hearing have been heard
to say, "Oh, he hears what he wants to hear." Sometimes
a person is able to hear and understand without apparent difficulty.
However, his "good hearing" is often the result
of an ideal listening situation in which he was communicating
at a short distance, with an articulate speaker, in the absence
of noise. Attempts to communicate in noise or with poor articulation
or from another room in the house will often end in failure.
The hearing handicapped expend an enormous amount of energy
in an effort to determine the important clues of speech. Their
attention to the task of hearing requires concentration.
Modulated Voice. A very loud voice that is further amplified
by a hearing aid becomes distressing and sometimes painful
to the hearing aid user. If a person seems to hear but not
understand, shouting will not benefit the listener. It is
also wise to remember not to drop the loudness of your voice
at the end of a sentence.
Speaking clearly. One must speak with care while at the same
time not exaggerating the words. Overdoing one's enunciation
also leads to distorted speech. Remember that the listener
will not understand all the sounds even when they are properly
articulated. Faulty enunciation will further reduce his understanding.
Rate. Rapid speech is very difficult for the hard of hearing
to understand. Spoken words last only a fraction of a moment.
The brain must quickly identify each group of sounds in a
word and assign a meaning. If groups of sounds (words) are
run together or any single word is distorted or omitted by
fast speaking, then the listener's understanding is affected.
Because spoken language is so brief, the listener only has
a short time to identify each word. Frequently, the hard of
hearing give the wrong answer to a question, not because they
don't know the answer, but because they have misinterpreted
the question.
Speech Clues. Poor speech discrimination (inability to understand
words) is the major handicapping aspect of a hearing impairment.
Because the meaning of many words is lost or misinterpreted
by the hearing impaired patient, the speaker can help by offering
as many clues as possible to establish the meaning of conversation.
By using several different words to express the same thought,
the hard-of-hearing listener is provided with additional clues
as to the context of the speech. For example, instead of saying,
"Would you like to see the paper?" you might say,
"The Gazette; would you like to read the newspaper?"
You will notice that the loss of some of the more important
words is less critical when there are others to indicate the
same idea. However, the misinterpretation of the single work,
"paper" in the first sentence results in a complete
breakdown of communicating that particular idea.
Hearing impairment is a complex handicap. The task of adjusting
to one's handicap can be eased by remembering a few simple
rules. Get the hard of hearing person's attention, enunciated
clearly and speak loudly enough. Don't speak rapidly. Above
all, be patient.
SPEECH READING
Speech reading is a skill that enables a person with impaired
hearing to better understand conversation by attentively observing
the speaker.
All of us, whether we have hearing impairment or not, employ
the sense of sight as well as the sense of hearing in ordinary
conversation. We find it easier to comprehend if we can watch
the speaker's facial expression, lip movements and gestures.
A study of the fundamentals of speech reading will make conversation
less of an effort and therefore more pleasant for both the
speaker and the listener.
It is important that the person who has a hearing loss inform
his family, close friends, and associates with his problem
so that they may avoid needlessly increasing the difficulty
of speech reading. He speech reader must, so to speak, "stop,
look and listen", in order to understand what he hears.
It is helpful to point this out to family and associates so
that they will get the patient's attention before speaking.
The patient with the hearing impairment must recognize characteristics
of the English language. Many sounds and many words look the
same on the lips. Look into your mirror and say the following
pairs of groups of sounds and works: f, v, p, b, m; beet,
meet, meat, shoe, chew; few, view. Each pair or group of letters
and words looks the same on the lips.
The speech reader must determine from the context of the sentence
which word is being used, just as the normal hearing person
must depend upon the context to tell which of two or more
words that sound the same are being used.
The hard-of-hearing person should be aware that it is impossible
to see certain words on the lips and therefore he will continuously
need to fill in "gaps" in words and in sentences.
Look in the mirror again and say the following sounds: k,
g, n, l, and t. It is impossible to see these sounds on the
lips because they are formed in the throat and in back of
the mouth. Two-thirds of all sounds in the English language
are not visible on the lips. Because of the difficulties presented
by sounds, the speech reader is encouraged to follow the context
or thought of what is being said, rather than to try to lip
read each word.
The hard-of-hearing person can also help himself by being
keenly aware of the rhythm of conversation. A change in the
rhythm is a definite aid to understanding what is being said.
Pauses between words and sentences, stress and inflection,
all effect what the speech reader sees and should convey different
meanings to him.
To master speech reading, one must acquaint himself with the
"setting" of a given situation. For instances, if
the hard-of-hearing person is invited to a gathering, he should
find out as much as possible about the occasion to give himself
a background for speech reading. Who will be present? What
are the names of some of the persons who are likely to attend?
What are the interests of this particular group? What are
they most likely to discuss as a group or individually?
The person, who is learning to speech read, learning to use
a hearing aid, or both, should have the help of a professional
person trained to teach these skills. There are many books
on the subject of speech reading. Recognizing spoken words
by watching the speaker's lips, face and gestures is a daily
challenge for all deaf persons. Speech reading is the least
consistently visible of all the communication choices available
to deaf people; only about 30 percent of English sounds are
visible on the lips and 50 percent are homophonous, that is,
they look like something else.
HEARING AIDS
If the hearing level has dropped below the point of serviceable
hearing, perhaps the greatest assistance to effective speech
reading is a carefully selected hearing aid. Much of the strain,
fatigue and tension accompanying speech reading can be reduced,
and perception and understanding can be enhanced, by a properly
fitted hearing instrument. It is most important for the person
with impaired hearing to avail himself of this opportunity
for maximum understanding. It can mean the difference between
constantly straining to "get" what is being said
and understanding conversation with relative ease and comfort.
Hearing aids may be worn as ear level instruments or as body
type aids. Ear level aids may be placed deep in the ear canal,
in the outer ear opening, or may be worn in back of the ear.
Body worn hearings aids as a general rule have a greater amplifying
potential and are used in severe or profound hearing impairment.
The CROS hearing aid is available for persons with a one-sided
hearing loss. This aid picks up sounds which originate on
the poor hearing side and routes the sound to the better ear.
A CROS hearing aid may be worn behind the ear or in the ear.
In using a hearing aid, remember that hearing loss involves
two factors: volume and clarity. A hearing aid amplifies speech
to help you hear what people say. It also amplified most of
the sounds around you. However, the amplification of other
sounds, such as clattering dinnerware or a plane flying overhead
may be distracting. For this reason, it often takes several
weeks to become accustomed to wearing a hearing aid.
Some hearing aids have a "T" switch which enables
them to hear on the telephone. In addition to acting as an
amplifier, the "T" switch helps to eliminate background
noises.
If you have a hearing loss but you do not want a hearing aid,
you might still benefit from an amplifier for your telephone.
Several kinds are available. One type comes built into the
receiver and is available from phone companies. Another type
is portable, can be attached to any telephone, and is small
enough to be carried in a purse or a pocket. There are numerous
different styles of hearing aids: all in the ear, behind the
ear, body aid, canal aid, and deep insert canal aid.
THE USE OF A HEARING AID
Individuals react differently to the use of a hearing aid.
One's age, the severity of the hearing impairment, and the
acceptance of the need for the aid may strongly influence
one's reaction to supplementing his own hearing with amplified
sound. The type and degree of hearing impairment may limit
the benefit to be gained from a hearing aid. Generally speaking,
the hearing impaired patient has a dual problem. He experiences
a reduction in the intensity of sound in which every day environmental
noises, including speech, are not perceived in their normal
loudness. In addition, there is often an accompanied reduction
in what is called discrimination. An impairment of one's ability
to distinguish among the sounds of speech leads to a reduction
of understanding.
If a person has an impairment of a conductive type, he can
expect maximum benefits from a hearing aid because discrimination
ability is not greatly affected. Most persons with this type
of impairment become adjusted to using a hearing aid with
very little difficulty.
If the hearing impairment is of the sensorineural or sensory
type (loss of hair cells), the difficulty of adjusting satisfactorily
to a hearing aid may be greatly increased. Very often, persons
who have this type of loss can hear speech sounds if they
are loud enough, but cannot always understand what is being
said. It is true that the speech must be loud enough to permit
the listener to understand to his full capability. But making
speech increasingly louder will not necessarily lead to a
correspondent improvement in discrimination because the hair
cells have become less sensitive to the acoustic differences
of speech sounds. A hearing impaired person will often say,
"I hear but I cannot always understand what I hear."
Because the prime function of an aid is to amplify sounds,
many users of these instruments continue to experience difficulty
in understanding. Although the hearing aid does not correct
the discrimination impairment through amplification, many
sounds of speech can be heard and understood with greater
ease. A hearing aid offers the user hearing that is short
of normal acuity but more satisfactory than the uncompensated
impairment. The major problem for a new hearing aid user is
to adjust the hearing aid in noise. There have been many innovations
in hearing aid fitting that have helped new users to learn
to live with noise. Changes in circuitry of the hearing aid
have greatly eased the initial learning process for many patients.
STEPS IN LEARNING TO USE A HEARING AID
Whatever the type of hearing impairment, it is important to
follow a planned program of "learning to use the hearing
aid." The ease or difficulty of hearing will vary depending
on the loudness of background noises, the distance of the
listener from the source of the sounds, the clarity of speech
or of music, and the lighting (which may enhance or may interfere
with lipreading). Practice exercises will help to prepare
the wearer to use his hearing aid in a variety of different
situations. Recommendations for learning to use a hearing
aid for maximum benefit are described in the following paragraphs.
1. Use the Aid at First in Your Own Home Environment.
Your hearing aid amplifies noise as well as it amplifies music
or speech and you may be disturbed temporarily by background
noise. Concentrate on listening for all of the normal household
sounds and try to identify each sound that you hear. Once
you identify background noises, such as the hum of the refrigerator,
the roar of an electric fan, the clinking of dishes, or the
slamming of doors, these noises will tend to be less annoying
and distracting to you.
2. Wear the Aid Only as Long as You Are Comfortable
With It.
Do no attempt to set an endurance record or to wear the aid
at first during all of your waking hours. If you are tired
and fatigued after using the aid for an hour or two, take
it off. Let the way you feel be your guide. You can, over
a period of several weeks, gradually lengthen the amount of
time that you wear the aid.
3. Accustom Yourself to the Use of the Aid by Listening
to Just One Other Person - husband or wife, neighbor or friend.
Talk about familiar topics; use common expressions, names,
or a series of numbers for practical purposes. After a few
day of practice with one person in a quiet environment try
a different listening exercise. Turn on the radio or television
and with this auditory distraction try to understand your
companion's speech.
4. Do Not Strain to Catch Every Word
The importance of listening carefully and of concentrating
on what is being said cannot be overemphasized, but do not
worry if you miss an occasional word. Normal hearing persons
miss individual words or parts of sentences and unconsciously
"fill in" with the thought expressed. (Keep your
eyes on the face of the speaker. Speech reading is a very
great help as a supplement to the hearing aid.)
5. Do Not Be Discouraged by the Interference of Background
Noises.
If your initial experience with the aid is unsatisfactory,
remember that you are learning new habits, or rather, relearning
old habits in a new setting. Normal hearing persons are aware
of background noises too, but have learned to push them out
of conscious awareness. As you learn to discriminate between
noise and speech and to identify various background sounds,
you will also be able to ignore extraneous noises just as
persons with normal hearing do.
6. Practice Locating the Source of Sound by Listening
Only.
Localization of sound (the determination of the direction
from which the sound comes) often presents a special problem
to wearers of hearing aids. One exercise that helps to develop
directional perception is to relax in a chair, keep your eyes
closed, and have someone speak to you from different places
in the room. Each time your helper changes his position, attempt
to locate him through the sound of his voice alone.
7. Increase Your Tolerance for Loud Sounds.
At first, hearing aid users tend to set the volume control
at a level too low for efficient listening. Louder sounds
need not cause discomfort. By a very simple procedure you
may, over a period of time, increase your tolerance for sound.
While you are listening to one speaker or to your radio or
television in your home, gradually turn up the volume control
of your hearing aid until the sound is very loud. When the
loudness is uncomfortable, very slowly turn the volume down
to a more comfortable level. After a period of practice you
will find that your comfort level has increased considerably.
8. Practice Learning to Discriminate Different Speech
Sounds.
Prepare a list of words which differ in one sound only. For
example:
Food-mood ball-all
see-she feel-peel
could-good gown-down
Have your helper pronounce these words slowly and distinctly.
Watch the lip movements closely while you carefully listen
for the differences in similar pairs of words. Then try to
discriminate the words by listening alone.
9. Listen to Something Read Aloud.
A good exercise in listening is to have your companion read
aloud from a magazine or a newspaper while you follow along
with your own copy of the reading material. At irregular intervals
your reader should stop and have you repeat the last word
read.
10. Gradually Extend the Number of Persons with Whom
You Talk, Still Within Your own Home Environment.
You will find that it is more difficult to carry on a conversation
with three or four persons than it is to talk to one. Concentrate
mainly on the individual who is talking the most.
11. Gradually Increase the Number of Situations in
which you use Your Hearing Aid.
After you have adjusted fairly well in your own home to background
noise and to conversation with several people at once, you
will be ready to extend the use of your aid to the supermarket,
church, theater, and other public places. Turn the volume
low to reduce the impact of unfamiliar background noise; do
not sit under balconies; move about in different areas of
the auditorium or theater until you find a section or a seat
where you can hear well. Dining out may present special problems
to the hearing aid user, so eat your first meals in public
in a quiet restaurant with carpeted floors and draped windows.
Avoid noisy cafeterias. Sit away from the kitchen area. As
your tolerance for noise increases, you will find it easier
to experiment with increasingly noisy environments.
12. Take Part in an Organized Course in Lipreading.
Lipreading will help you in general communication with others;
consider it an important supplement to the use of the hearing
aid. Although lipreading has many limitations, some words
cannot be seen on the lips and some words cannot be distinguished
from each other, lipreading combined with a hearing aid is
often more satisfactory than is either alone.
13. The Telephone and the Hearing Aid.
If your hearing loss is not especially severe, you will probably
be able, with a little practice, to use your hearing aid with
the telephone. Place the receiver end of the telephone next
to the microphone of the hearing aid. In some hearing aids
an induction coil is an integral part of the aid, and the
cordless portion of the telephone is placed in contact with
the case of the aid. Getting used to the placement of the
telephone and getting used to listening in this manner requires
practice. It is suggested that you arrange to have a friend
telephone you at a certain time each day for several days
to help you become accustomed to the telephone procedure with
the hearing aid.
The prime objective in wearing a hearing aid is to give you
more normal communications in every day life. For maximum
benefits, lipreading rehabilitation should accompany the practice
training in using the hearing aid.
SPECIAL DEVICES
You may have certain communications that cannot be solved
by the use of a hearing aid or by speech reading. These problems
may involve the use of the telephone, radio, and television,
and the inability to hear the door chime, telephone bell,
and alarm clock.
Special instruments have been developed to solve these problems.
They are listed in journals such as Shhh and Voice.
TELEPHONE COMMUNICATION
The telephone represents an important avenue of communication
and one that offers the hearing handicapped considerable difficulty.
Many hearing aids provide a telephone switch. Moving the switch
turns off the aid's microphone and activates what is called
an "induction coil." The telephone receiver is placed
in contact with the case of the hearing aid to amplify the
conversation without picking up distracting noises.
Volume control handset. This telephone handset is equipped
with a thumb-operated wheel with which to adjust the loudness
of an incoming message.
Telephone amplifier. This unit is a pocket size battery operated
amplifier that is useful to the hearing impaired person who
uses different telephones. It can be carried in a purse or
pocket and simply clips on to most telephone receivers.
Auxiliary receiver. Many severely handicapped people rarely
rely solely on speech reading which, of course, cannot be
used on the telephone. A procedure using the assistance of
a third person is helpful. The "third person' listens
to the incoming message through the auxiliary receiver attached
to a conventional telephone. He repeats the message so that
the hard-of-hearing "listener" can lip read and
speak his answer directly into the telephone. In this way,
the profoundly handicapped can actively participate in the
telephone conversation.
Code-Com telephone set. This telephone instrument converts
incoming sounds into light and vibratory signals. By using
a prearranged code of dots and dashes, the profoundly deaf
can enjoy telephone communication by watching the flashing
light --TDD/TTY (Telephone Device for the Deaf) systems.
Teletypewriters. The telephone-teletype system is another
method of communication for the profoundly deaf that permits
the two-way transmission of typewritten messages over telephone
lines. The deaf person who wishes to make a telephone call
to someone with similar teletype equipment places the handset
in a special cradle and dials the number. A monitor light
flashes to signal when the phone at the other end is busy,
ringing, or when someone answers. After contact is made, a
conversation can be typed back and forth between the two parties,
offering a printed record of the messages. A large national
telephone-teletype network for the deaf has been made possible,
in part, by the generosity of organizations that donate repairable
teletype machines to the deaf. A number of these different
devices can be seen in the Hearing Journal.
Dataphone data set. Dataphone service can link telephone facilities
to teletypewriters, facsimile and telewriting devices, and
other equipment used by persons with physical impairments.
Graphic Communicator. The telephone can also be used to transmit
and receive written messages. Messages and diagrams written
on the paper surface of the unit are reproduced simultaneously
at any phone location that is equipped with a similar apparatus.
Either written or oral material can be seen over the same
telephone so that the hearing members of the family can use
the same handset.
Switchboard amplifier. The telephone operator who has a hearing
impairment will encounter difficulty. However, the requirements
of her job may be satisfied through the use of a small transistorized
amplifier which has a volume control. The operator simply
adjusts the loudness of the incoming calls to suit her needs.
SIGNAL DETECTION
Signal bells. Some hard-of-hearing persons have difficulty
hearing the door chime or the telephone bell. The problem
of hearing a particular signal may be solved by either amplifying
the signal or by substituting it with another sound that can
be easily heard. For example, one may find help by substituting
a lower pitched buzzer for the door bell. Similarly, the local
telephone company supplies eight signal bells with different
pitch characteristics ranging for 800 to 4000 Hz. You may
request to listen to the different telephone bells in order
to select the one you hear most easily. Generally, an "800
Hz bell" is the most rewarding.
Tone ringer. The telephone ringer concentrates the acoustic
signal within a range (580-1500 Hz) easily heard by many of
the hard-of-hearing patients.
Buzzer. This telephone signal substitutes a buzzer-like sound
for the usual ringer. It is preferred by many hearing impaired
persons who have adequate hearing acuity for low frequencies.
Extra strength signals. In addition to bells of different
pitch, are alarms of extra-loudness, such as gongs, bells,
and horns to signal the ringing of the telephone.
Auxiliary control device (Signalman). This unit signals the
ringing telephone by activating a flashing lamp. Substituting
a visual clue for the auditory signal is particularly helpful
to the severely hearing impaired.
Electronic switch. The inability to hear a sound originating
in another part of one's home poses another problem for the
hearing impaired. One can solve his reception of a specific
sound such as a door chime or the cry of a baby by installing
this special switch. The switch converts sound into either
visual or vibratory impulses. Lamps or vibrators are wired
from the sound sensing apparatus to various rooms throughout
the house.
Automatic waking devices. This device consists of an electric
clock into which is build or plugged into a bedside lamp,
buzzer, or vibrator, depending on the preference of the user.
The buzzer can be placed under the pillow while the vibrator
is attached to the bed frame. At a preset time, the clock
activates the alarm signal. It is the light and the vibrations
that awaken the sleeper.
Electronic stethoscope. This instrument consists of a standard
stethoscope to which a modified hearing aid amplifier is attached.
The user adjusts the volume control and frequency response
to his requirements. In this way, the hard-of-hearing physician
and nurse can hear faint body signals that otherwise would
go undetected.
RADIO AND TELEVISION LISTENING
Amplified earphone. This device permits the
whole family to enjoy radio and television. Remote headsets
allow the hearing impaired patient to adjust volume while
situated at his chair.
Loudspeaker. This unit is also connected
to the television and the speaker placed conveniently next
to the hearing impaired listener's chair. Your radio and television
repairman can provide and install a suitable amplifier and
when coupled to a loudspeaker or headset will provide adequate
amplification.
Desk model amplifier. Some persons prefer
to use a small transistorized auditory trainer that is equipped
with earphones. This type of amplifier offers greater fidelity
than the average hearing aid. These devices permit other household
members to listen in comfort while the sound is amplified
for the hearing impaired listener.
Induction coil apparatus. Frequently, the
hearing impaired person complains that he is distracted from
radio and television listening by household sounds amplified
by the hearing aid. If the aid is equipped with a telephone
switch, he can use an inexpensive induction coil that is connected
to the loudspeaker of the television. This coil creates a
magnetic field from which the hearing aid picks up and amplifies
the radio and television signals. The television sound is
placed on a plate containing the special coil. A small induction
coil plate is also available that can be used with an ear-level
aid.
Induction loop system. This is a variation
of the coil apparatus in which a magnetic field is produced
by a wire loop running from the television set around the
baseboard of the viewing room. A switching device permits
the user to receive the sound through his hearing aid from
either or both the television loudspeaker and the induction
loop system. In this way, hearing impaired and normal hearing
viewers can enjoy a television program together.
Hearing Ear Dog. A new program for the profoundly
hard-of-hearing and totally deaf individual is the use of
dogs to hear for their masters. A group in Denver, Colorado,
has pioneered the first hearing ear dogs to aid deaf persons.
Similar to the Seeing Eye program, these dogs are trained
to look out for their masters by using their ears. For example,
if the deaf individual's house catches on fire, the hearing
ear dog is trained to awaken his master in order that he may
save himself. In a similar manner, the hearing dog alerts
his master to the doorbell, telephone, etc. The Ear Foundation
can help answer your questions about this program.
Vibrotactile devices. This is composed of
an electronic case which can be carried in the pocket and
the vibrator is worn on the chest or with a wrist harness.
Many users find the tactile aid of significant help in speech
reading as a safety device for being aware of traffic and
other warning sounds and generally as a help in feeling more
"contacted".
Closed captioning. This is a process by which
the audio portion of a television program is translated into
captions (sub-titles) that appear on the TV screen. Hearing
impaired viewers can then read what they cannot hear. Closed
captions can be seen when a telecaption adapter is connected
to a television set.
Computers. Computers (Personal computers)
can offer a significant advantage to the hearing impaired
child to reach the same level of scholastic development that
is achieved by hearing children
Concerts and Auditoriums. Many public facilities
such as churches, theaters, and concert halls have special
facilities for hearing impaired attendees. These FM or infrared
systems are headsets which allow for control of background
noise as well as amplification of the "main event."
Contact facilities you are interested in attending to determine
whether such assistance is available and if advance reservation
is required.
Special surgical devices-cochlear implants.
Cochlear implants are surgically implanted devices which enable
the deaf or profoundly hearing impaired to hear by electrically
stimulating the inner ear or cochlea. Components of the system
include a microphone, signal processor, external transmitter,
and implanted receiver.
SUMMARY
A complete audiologic/otologic examination is necessary to
determine what type of hearing impairment is present, its
probable cause and recommended treatment.
Hearing is a natural and a normal way to understand speech.
If your hearing can be improved by medical or by surgical
means, or through the use of a hearing aid, this should be
done.
Whatever the type of treatment carried out, rehabilitation
is essential if you are to gain maximum benefits from treatment.
Be determined to master speech reading - make a hobby of it.
It will help in every conversation.
Make every effort to relax. Do not strain either to hear or
to see speech. Strain causes tension and makes lip reading
much more difficult. A combination of seeing and hearing,
under relaxed conditions, enables persons with impaired hearing
to hear most speakers quite well.
Do not expect to understand every word in a conversation,
but follow along with the speaker. As you become familiar
with the speech, key words will emerge and you will be able
to understand the complete thought.
Try to stage-manage the situation to your advantage. Lighting
is important. Avoid facing a bright light and avoid having
a shadow on the speaker's face. Six feet is an ideal separation
from the speaker; from this distance his lip movements, facial
expressions and gestures can be readily observed.
Maintain an active interest in people and events. Keep abreast
of national affairs and events in your community and intimate
social circles. You will be able to follow discussions more
easily.
Remember that conversation is a two-way affair. Do not monopolize
the conversation in an attempt to direct and control it. On
the other hand, do not let it pass by without participating.
Take an active and interested part whenever possible.
Be particular about your speech. A hearing impairment of long
duration may bring changes in volume as well as in articulation
and voice quality. These changes must be prevented when possible
and corrected where indicated. A pleasant, well-modulated
voice is a great asset.
A friendly, sympathetic interest in other people and in their
problems can do much to smooth one's own path.
The education of the public is your responsibility and ours
alike. You cannot help others to understand your problem if
you conceal it from them. Do not hide the fact that you wear
a hearing aid, or that you depend on speech reading to understand
conversation. By letting others know about your problem, you
can make communications easier for you. It is only through
mutual acceptance and understanding of the problems of persons
with impaired hearing that the "outsider" can be
expected to adjust to needs of the speech reader. Without
this understanding the "outsider" may unintentionally
add to the problems of the speech reader.
Always keep in mind that the success of your auditory rehabilitation
is largely dependent on you, your attitude and your acceptance
of the problem.
Try to find a quiet place to talk. Cutting down on background
noise will make it easier to understand the speaker.
Ask people to repeat or rephrase things that are not clear.
Pretending to understand when you do not will only cause problems
later.
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