Let’s talk about Accessibility!
Lidia Best, President European Federation of Hard Of Hearing, Chair, National Association of Deafened People writes:
When we are fitted with our hearing aids or cochlear implants do we discuss different accessibility aspects with our audiologists or technicians? How well are we prepared for the world after the CI and the confusing information we receive?
Unfortunately, the accessibility aspects of using hearing technologies are rarely part of the rehabilitation and counselling and I’m not sure why? Is this because audiologist often are not themselves someone with hearing loss or maybe because it is not part of their curriculum, or because it is hard to keep up with all changes brought in from manufacturers? Most likely it is a combination of all different reasons.
While growing up, as a hard of hearing young person, I was not fully aware of what accessibility means to me and others with hearing loss. For me, accessibility was simply sitting in the first row in the class or in school assemblies, and this may still be valid for many people ?
I had analogue hearing aids with simple switches 0, T, M. Zero meant, the aid was switched off, M- was switched on with mic on but I had no clue what the T was for? Telephone? Maybe. I wore my aids since I was 12 years old and it took a chance encounter during International Hard of Hearing Young People Summer Camp in Denmark, when I was twenty-three to discover what the “T” meant.
T-coil of course! I sat at the board meeting of IFHOHYP [link to IFHOHYP site]and listen to instructions “turn your aid to T, the magic suddenly happened. No background noise, just someone speaking directly to my ear. For me this was the Eureka moment. Since then, I have used my hearing aids and later CI with t-coil function in public places with room fitted hearing loops and with portable FM systems.
Now, you would think that this is the old story, we are now in the different times, but not really! So many people with hearing aids and cochlear implants are still not fully aware of the possibilities for accessibility within their own devices. Our hearing technology has evolved and now we also have possibilities with Bluetooth, direct streaming to mobile devices. Once set up, and it works as a seamless experience.
Unlike with t-coil, with a simple switch and you can hear clearly, Bluetooth requires a bit of technology knowledge and familiarity with different gadgets. Imagine elderly CI or HA user or someone with sight problems tasked with the job of pairing many different devices!
For some people , they need additional support in managing all complicated technology and Bluetooth is complicated . Then, not all devices at home , school or workplace can be connected directly, and streamers – in form of neck loops or hand held devices- do the job of a go between.
One barrier in hearing accessibility can be audiologists themselves, not all, but some assumptions seem to be repeated. Below are the examples:
“No one needs hearing loops; it is Bluetooth now “ – using hearing loops in public places and Bluetooth in personal use are not mutually exclusive. They complement different situations and lifestyle.
“CI users are hearing, they have amazing scores in testing” Indeed, there are CI users who are doing exceptionally well in audiologist booth. There is only one but…those tests are done in the ideal conditions, the world outside is noisy and lots of people struggle hearing in noise.
“ There are no hearing loops in my country, so my patients do not need t-coil” While this might be the case, the patients should have the knowledge of them. CI users travel all over the world, chances are, they will attend gathering of hard of hearing associations at some point or visit public places where hearing loops are fitted as standard practice such as churches, theatres and museums. Without the t-coil, they will not be able to experience full inclusion and participation.
Audiologists are the gate keepers, the first point of contact for so many people who are experiencing hearing loss for the first time, and it can be bewildering at first. So, the question is, should an accessibility discussion and sign posting to the relevant organisation be part of the audiology appointments?
Should audiologists spend more time discussing the lifestyle of their patients and explain and demonstrate the benefits of the assistive listening technology as well as the other support available?
From my personal experience and from the user’s survey which National Association of the Deafened People did in 2018, I would say yes. The need for such support was clear from our survey and such support can help with dealing with isolation and anxiety among patients.
Of course, audiologists may not be able to be up to date with all the new technology and it changes constantly, as do our phones, TVs and computers. Associations such as ours and others exist to provide much needed peer support and lived experience knowledge. What other aspects of accessibility do you struggle with?
Thanks Lidia! Do send us your comments to add…. firstname.lastname@example.org
15 November 2021