Equipment for hearing loss, speech and speech replacement


Introduction

The aim of this information sheet is to provide basic information on a range of communication products available that are designed to make life easier for people with disabilities and older people. It gives details about the main features to consider and it compares alternative equipment solutions.

Equipment for people with hearing loss

If you have hearing loss, there is a wide range of assistive listening devices available to help enable people with hearing loss to hear in many different types of environments such as at school or college, when you're out and about, socialising with friends, attending meetings/conferences, public information counters, or just watching TV at home.

Whatever type of hearing loss you have, there are products that can help you in everyday situations, even if you already have hearing aids. Listening devices use microphones to pick up and amplify sound, making it clearer and easier to understand. Some listening devices have additional features that reduce the effect of background noise and boost speech.

More detailed information on these and many other products and technologies is available from DeafHear (formerly the National Association for Deaf People), and on their website www.deafhear.ie.

Personal listeners

If you have difficulty catching everything that is said in conversation you may benefit from using a personal listener device which amplify the sounds you want to hear and bring them closer to your ears. A personal listener provides clear, sharp sound reproduction leading to relaxed, stress free listening. There are many uses for these versatile products, including connecting directly to various types of audio-visual equipment.

You can use a personal listener during the day for conversation with friends or at work where you may find listening in a group or noisy situation to be difficult or stressful. You can also use them to listen to TV, radio, music device or your computer.

You choose the way you want to listen, for instance, with headphones or earphones, or by using your hearing aid on the “T” setting, or using a loop program with a neck loop or ear hook. Your hearing aid may have the “T” (loop) facility. With this you can enhance your listening by making more of your hearing aid. Sounds will be transmitted directly to your hearing aid, significantly reducing background noise.

Wireless TV/Radio systems

TV listeners mean you can enjoy television without turning up the TV too loudly for others in the room. Choose the neckloop type if you have hearing aids or the stethoset version with headphones if you don't.

If you have difficulty catching everything that is said on TV or radio, you may benefit from using a TV and audio systems which amplify the sounds you want to hear and bring them directly to your ears. Radio Frequency (RF) Wireless TV systems allow you the freedom to move around without the need to have wires between you and the item you want to listen to. However, they all need to be connected to your TV, radio or music etc to pick up the sound using the leads provided.

Your hearing aid may have the “T” (loop) facility. With this you can enhance your listening by making more of your hearing aid when you choose a wireless listener product with a “T” symbol. Sounds will be transmitted directly to your hearing aid’s loop facility increasing intelligibility and significantly reducing background noise. Wireless listeners are designed to enable quick connection to your TV, radio or music device. They all require you to wear a receiver whether or not you use a hearing aid. Radio Frequency (RF) TV listeners have a longer range, meaning you can even leave the room during an ad break and hear when your programme is coming back on. Infrared (IR) TV listeners require direct line of sight so can't do this, but they are often a bit cheaper.

Home induction loop systems

Induction loop systems transmit the sound directly to your hearing aid’s “T” (loop) facility that is built into most hearing aids. The main advantage of using the loop facility is that it can minimise the distracting effect of background noise and so enhance the sounds you want to hear making them easier to understand. Because the loop receiver facility is built into your hearing aid you will not need to wear an additional receiver.

The principle of a loop system is bit like radio. A transmitter sends the sound direct to your hearing aid which has a built-in receiver known as the loop facility. Hearing aids with this facility are often referred to as having a telecoil fitted in them.

Public induction loop systems

Audio-frequency induction loop systems (AFILS) allow hearing impaired people to hear more clearly. Most hearing aids have a ‘T’ or ‘MT’ switch which allows them to pick up the electromagnetic field generated by an induction loop system. The hearing aid converts this signal into a sound suited to its user’s specific hearing requirements. Any person with a hearing aid positioned within or near the loop can hear the loop signal by switching their hearing aid to the correct position, allowing them to participate more effectively in general conversation, ordering goods or services, listening to public performances, etc.

Wireless listening systems

These systems are designed to be used in conjunction with hearing aids, cochlear implants or headphones, and in various environments such as educational/training and conference settings etc.

They consist of a microphone transmitter that is worn by a person talking (directional mode) or laid on a flat surface (omni-directional/conference mode) and a receiver which is worn by the person who is hard of hearing.

Sound is amplified by the receiver using either a neck loop or integrated receiver (Direct Audio Input) into the hearing aid or cochlear implant processor. The system helps the listener to hear the speaker's voice without unwanted background interference.

Equipment for speech and speech replacement

This section includes information on some basic communication aids and strategies that may help you if you have difficulty speaking. Sometimes known as Augmentative and Alternative Communication (AAC), these technologies can supplement or replace spoken communication. Complex or hi-tech solutions are not covered in any depth here.

Types of equipment used for speech and speech replacement include:

  • letter, word, picture charts, folders and/or books
  • eye pointer boards
  • rotary pointer boards
  • scanning communication boards
  • specialist switches for communication aids
  • communication strategies

Letter, word, picture charts, folders and/or books

These items offer a simple solution for basic communication if you have little or no speech. They can also be particularly useful if you are unable to write things down easily. Letters, words, or pictures are shown to you in a folder, book or on a chart. You can then select individual letters, words, pictures or symbols to convey your respective needs to another person.

They may also provide an aid to basic two-way communication if you are deaf or hard of hearing. If the product contains a page of alphabet letters and numbers, you can construct words and sentences by pointing at one letter or digit at a time.

Larger systems may contain over 300 picture cards to represent words, food and drink, people or feelings. They may be categorised using colour codes or be arranged in a pocked-sized presentation folder to make them easy to use.

It may also be possible for you to create a folder of your own using a photograph album. This could include pictures of everyday objects such as a clock face or cup of tea with corresponding words or phrases written underneath. This can have the added advantage of being personalised to meet your own specific requirements and photos can be of known and familiar objects or people which will make it more meaningful to the user.

Eye pointer boards

These boards are communication displays that are designed for access by 'eye gaze'.

Your communication partner is positioned facing you on the other side of the board and will be able to see where your eyes are focused. This is because the board is either transparent or made with a square cut out in the centre.

At a basic level the user indicates/builds up a message by gazing at the appropriate item (letter, word, symbol, picture) on the display. At a more complex level, colour coding allows more items to be displayed.

Rotary pointer boards

These products are battery powered pointer boards that can help you to communicate a message. They work by using a switch to rotate a pointer. As it turns, you stop its movement as it points to a chosen picture, word or symbol, to indicate the required message.

If you have difficulty using a standard switch, several alternatives are available to suit your individual requirements.

Scanning communication boards

These products assist in facilitating communication for users who struggle to point at letters with a finger, a pointer or a laser, via blinking, nodding or other small movements.

They contain a number of squares which can be lit sequentially or, in some instances, in programmable patterns, to facilitate communication.

Symbols, real or miniature objects can be placed on the areas to be illuminated and you can stop the light when the required object or symbol is illuminated. They can be either mains or battery powered and are operated by switches chosen to suit your specific needs.

Some of these products may be further enhanced with sounds or speech selection. Speech based communication boards may have press keys that operate spoken words or phrases.

Specialist switches for communication aids

If you have limited dexterity or motor function and find it difficult to operate conventional switches, you may need an alternative type of switch to enable you to control your communication equipment.

Before buying a device ensure that you can operate any switches easily. If you require an alternative style of switch, check it is compatible with the product you are buying.

Alternative types of switches include:

  • Suck or blow switches - These are simple switches that you operate using your mouth with a suck or blow action. The switch can be stand mounted on a bed or wheelchair, or to a wall or floor stand
  • Plate switches - These devices consist of a large active plate area and a low operating pressure which enable you to easily activate a communication aid using your hand, knee, chin, elbow and head. They can be mounted on a flexible bracket stand for use in a wheelchair, bed or chair. Some models can be fitted with guards to prevent accidental activation.
  • Foot switches - These are strongly made switches that are operated by moving your foot.
  • Micro switches - These are easy-to-use, light-to-the-touch switches mounted on a flexible stand, which you can activate by using your hand, head or chin. The flexible stand makes it easy to position and move them on a bed, chair or wheelchair, using a clamp.
  • Chin switch - This is a single switch mounted on a tube that you can operate simply using your chin.

Communication strategies

These techniques are designed to help you overcome communication difficulties. Some are published resources which are useful for developing alternative or augmentative communication skills, but not necessarily tied to any specific equipment. They may include vocabulary selection and sets of signs or symbols.

Lámh

Lámh is a manual sign system used by children and adults with intellectual disability and communication needs in Ireland. Lámh signs are used to support communication. Lámh was developed in order to have a standardised, Irish-based manual sign system for those with intellectual disabilities and communication needs. Many children and adults with communication needs can understand much more than they can express verbally. Signing can provide a means of taking part in conversation. With Lámh, speech is always used with signs and only key words in a sentence are signed. The person can see as well as hear what is being communicated and it encourages eye contact and attention to movement; skills that are important for speech development.

Multi-fit hook and loop wrist bands

These are a simple inexpensive low cost solution designed for basic communication. The bands are in three colours: GREEN for ‘Yes’, RED for ‘No’ and BLACK for ‘Mixed’. Self-adhesive symbols can also be attached to the bands using a hook so that the basic message is enhanced. They are mainly used in environments where symbol books or VOCA (Voice Output Communication Aids) cannot be used, such as in a swimming pool, or on a bus. One advantage of this system is that it can be easily understood by an unfamiliar communication partner.

Irish Sign Language

Irish Sign Language (ISL) is a visual language and it is the term used to describe the sign language used in the Republic of Ireland. ISL is the primary and/or preferred mode of communication of the Deaf community in Ireland. Under the Irish Sign Language Act 2017, the State recognises the right of users to name ISL as their native language. This Act has not yet been commenced but this must be done within three years from 24 December 2017. Grants are currently available for families of deaf or hard of hearing children for ISL tuition. ISL courses are offered by several organisations including the Irish Deaf Society (Deaf Adult Literacy Services) www.irishdeafsociety.ie, IrishDeaf.com IrishDeaf.com, the Centre for Sign Language Studies in Galway, the Cork Deaf Association www.corkdeaf.ie, and the Deaf Community Centre in Limerick. Courses are also offered by several colleges of further education.

Using objects of reference

It may be possible to devise your own basic communication language or strategy using everyday objects when communicating with someone you know. For example, you could pick up a fork to indicate that you are hungry or that it is time to eat or perhaps a towel to say that you want to go swimming.

Useful addresses

Last updated: 5 October 2018