INCLUSIVE TECHNOLOGY FOR THE SPECIALLY ABLED

 Hearing impairment is the inability of an individual to hear sounds adequately. This may be due to improper development, damage or disease to any part of the hearing mechanism.  

The Four Types of Hearing Loss

• Sensorineural Hearing Loss.
  • In a sensorineural hearing loss, a person is having issues in the inner ear (cochlea) or acoustic nerve. Damage to these structures can occur due to exposure to loud noises, illness (meningitis), ototoxic medications, or it can happen simply due to genetics or the aging process. Sensorineural hearing loss is permanent, and treatments include the use of hearing aids and cochlear implants. 
• Conductive Hearing Loss 
  • This occurs when something prevents sound from passing through the outer or middle ear and into the inner ear. This can occur when earwax or fluid builds up in the ear canal, or when there is damage to the eardrum or bones in the middle ear (ossicles). There may also be a birth defect that prevents sound waves from entering the ear to stimulate the acoustic nerve, such as atresia or microtia. A person dealing with conductive hearing loss has multiple options for treatment, depending on the specific issue. Treatments may include surgery to repair structural abnormalities, a procedure to remove blockages, or the implementation of a hearing aid, cochlear implant or bone-anchored hearing aid (BAHA). 
• Mixed Hearing Loss.
  • In some cases, a person may be suffering from both a sensorineural and conductive hearing loss. In this instance, the issue is classified as a mixed hearing loss. Mixed hearing loss affects both the inner ear and outer or middle ear, and as such, it can lead to a more profound hearing loss. Treatments will vary depending on the severity of the hearing loss, but in addition to a surgical procedure, hearing aids and cochlear implants may be necessary. 
• Auditory Neuropathy Spectrum Disorder.
  • Sometimes sound is able to enter an ear normally and reach the acoustic nerve, but there is a problem when the sound is transmitted to the brain. This hearing loss is known as auditory neuropathy spectrum disorder (ANSD). 
  • ANSD can occur for a variety of reasons. In some cases, the hair cells of the inner ear are damaged and are unable to properly transmit sound information to the brain. Sometimes a genetic mutation is the cause of this hearing loss, and other times damage that occurs to the auditory nerve can lead to ANSD. People with ANSD may seem to have normal hearing sensitivity on a hearing test, but they may struggle to understand spoken words. In some cases, a hearing aid or cochlear implant paired with a hearing-assistive technology (HAT) system can help mitigate the negative effects of this hearing loss. However, more severe cases, in which the person has great difficulty understanding speech, may require the use of a visual communication technique, like sign language or a picture exchange communication system (PECS). 

 With limited opportunities for communication and expression, many people with hearing loss may be lacking in emotional support and comfort. They are unable to talk about their worries and anxieties in daily life and are more likely to develop negative emotions such as nervousness, fear, and loneliness. While digital technology might be a virtual bridge for hearing people to maintain interpersonal communication especially n times of social isolation like during the Covid-19 pandemic, for deaf and hard-of-hearing people, digital technology may not only be the cause of emotional impairment but also does not provide the functionality it should. 

Phone screens are small and not adaptive, instant messaging software is not assistive and thus video calls are not helpful in communication. Similarly, lack of adaptive technologies in many of the daily use apps or websites makes day to day living like online shopping, online medical consultations and educational e-learning into significant challenges for the hearing impaired.

In this way, it appears that digital technology becomes an enabler of reverse social isolation in the case of the hearing impaired population in the world. 

  People with hearing loss have difficulty hearing and understanding speech. Despite significant advances in hearing aids and cochlear implants, these devices are frequently not enough to enable users to hear and understand what is being communicated in different settings.

Why? Because, for many of us, turning up the volume isn’t enough. Even with the latest technology, hearing aids have a limited effective range, basically amplify almost all sound, and usually can’t separate the background noise from the voices and sounds you want to hear.  

In addition to noise, distance and environment affect hearing ability. The farther hearing aid microphones are from what you want to hear, the less likely you will be able to hear and understand. Similarly, open areas, bare walls and floors, high ceilings, and floors and walls with many angles all contribute to poor acoustic conditions and what is called reverberation.

The good news is that there are hearing assistive technologies (HAT) that can readily enable communities to become more hearing friendly.

  There are five general types of assistive listening devices: audio induction (also called a hearing) loop, FM system, infrared system, personal amplified system and Bluetooth systems

• Hearing Loops, also known as Induction Loops or Audio  Frequency Induction Loop Systems (AFILS), consist of a copper wire placed within a room, theater, or counter which is connected via a special loop “driver” to a public address or sound system. An electromagnetic field is created that connects to a telecoil in hearing aids, cochlear implants, or telecoil receivers. Loops are the most user-friendly of  assistive listening options. Hearing loops are simple, discreet, and      effective. Users simply switch their devices to the telecoil program and  automatically receive clear, customized sound directly to their ears. People who do not have hearing aids or who do not have access to telecoils in their hearing aids or streamer need to use a hearing loop receiver and headphone to connect to the system.  Watch this video to understand how they work - https://youtu.be/WifPN-8NF_0?si=U259eXqHkV2BClfV
• Infrared Systems (IR) work like TV remote controls. A transmitter sends speech or music from a public address or sound system to an IR receiver using invisible infrared light waves. This technology is line-of-sight and cannot be used outdoors during the daytime due to being affected by light. Because IR signals are sent and received in a straight line, users are encouraged to sit as centrally as possible; those sitting in balconies or other areas with poor sight lines may experience interference or receive no sound signal at all. Everyone using the IR system needs a receiver and either a headphone or a neck loop. For those  who have telecoil-equipped hearing aids and cochlear implants, neck loops  eliminate the need for headphones.
• FM Systems, or Radio Frequency Assistive Listening Systems, transmit wireless, low power FM frequency radio transmission from a sound system to FM receivers. An advantage of this system over an infrared system: FM is not affected by direct sunlight. Everyone using the system needs a receiver and either a headphone or a neck loop.  For those who have telecoil-equipped hearing aids and cochlear implants, neck loops eliminate the need for headphones.

Assistive Listening Devices (ALDs) are personal technologies that can help you communicate in one-to-one conversations. They are hand-held amplifiers with microphones that bring the sound you wish to hear closer to your ears. These small devices capture the sound you want to hear and may filter some background noise.

Bluetooth is a relatively short range wireless technology frequently used to connect cell phones, televisions, computers, tablets and, recently, hearing aids and cochlear implants.  Hearing device Bluetooth technology is sometimes proprietary—that is, designed for a specific brand and/or model of device. While this technology is evolving, it is still generally not suited for long range transmission in a large venue like an auditorium or theater.    

Captioning is the text of the audio portion of a video or film displayed directly on the video or film, often on the bottom of the screen. This may include not only the words, but the sounds that are important to understand and the source of the sound. Open captions cannot be turned off; closed captions are not visible unless they are decoded and turned on for display.

CART ( Communication Access Realtime Translation ) is verbatim text of spoken presentations provided for live events. Only the text is provided on a computer screen or projected for display on a larger screen. CART may be provided in the classroom, at meetings, workshops and other presentations including live theater – anywhere that someone with a hearing loss needs to hear in a group setting.

 'CART' is available to deaf and hard-of-hearing people who seek an alternative to American Sign Language interpreting - or ASL - or reliance on assistive listening devices. Audio description: A CART machine hooked to a laptop. 

Understanding speech may require using more than one technology; sometimes people with hearing loss need CART in addition to an assistive listening system. Combining assistive technology with CART can provide the best experience—improving both sound clarity and understanding.

CART is an auxiliary service that can be provided, on location or remotely, in which spoken words are converted to text by specially trained providers. The text can be projected onto a screen, displayed on a computer monitor or laptop, or transmitted via the internet. Event and venue managers and people who need CART should be aware that CART can be combined with a PowerPoint or other presentation content—enabling people to view all content on one screen.

Effective CART depends on the skill of the provider and their ability to hear what is said by every speaker. Special attention must be paid to the meeting site, the location of the provider in the room, the size and positioning of the screen on which captions will appear, and the behavior of the speakers. In the case of remote CART, a designated person onsite during the meeting should be available to troubleshoot technical difficulties if they arise.

Hearing Loops

https://www.amplifiedtelephones.co.uk/news/which-hearing-loop-do-i-need.html

Infrared Technologies

https://www.newtechsouthern.co.uk/assistive-hearing/infrared-hearing-systems/

https://hearingassistivetech.com/products/infrared-hearing-systems/

https://www.listentech.com/listenir/

FM Systems

https://www.hearingaidaccessory.com/product-category/fm-hearing-sysytems/

https://www.hearinglink.org/technology/fm-systems/

CART( Communication Access Realtime Translation ) & Captioning Software

https://www.aarp.org/health/conditions-treatments/info-2016/captions-hearing-loss-cart.html

Bluetooth devices

https://www.bluetooth.com/auracast/

https://www.hear.com/in/hearing-aids/bluetooth/

https://www.hearingtracker.com/bluetooth-hearing-aids

ALD- Assisted Learning Devices and Personal Devices

https://adcohearing.com/

https://www.hearingaidaccessory.com/

https://designwanted.com/deaf-technology-products-empowered-design/

https://www.hearmore.com/store/default.asp

https://dailycaring.com/10-helpful-products-for-hearing-impaired-seniors-increase-independence-and-safety/