The Use (or underuse) of Hearing Aids

Hearing loss is more common than many people think. An estimated 500 million experience hearing loss worldwide.
How many people use hearing aids? In the US (with a population of over 316 million in 2013), where nearly 10 percent of the population over the age of 3 years have hearing loss, only about 20 percent of those who could benefit from hearing aids actually use the devices.
In comparison, as of 2011 more than 10 million people in the UK, or 1 in 6, have some form of hearing loss. More than 6 million of this group would benefit from hearing aids, but only about 2 million actually have hearing aids, and only 1.4 million use them regularly.
Why don’t people wear hearing aids? Reasons typically cited include: they are uncomfortable; they whistle; they are not useful in a large crowd; wearing them results in over-stimulation or hearing overload; getting used to them takes effort; and the lack of support available to recipients after being given them.
In the US, increasing the rate of hearing aid usage was a Health & Human Services (HHS) Healthy People 2010 goal and continues as a Healthy People 2020 goal. Research supported by the National Institutes of Health (NIH) and the National Institute on Deafness and Other Communication Disorders (NIDCD) has driven the development of hearing aids from their inception in the 1950s and remains, today, an ongoing priority for NIDCD.


Proposed Legislation would let Deaf and Hearing Impaired Serve in USAF

On July 30, Rep. Mark Takano (D-CA) introduced legislation in the House that would allow a small number of hearing-impaired individuals to serve in the United States Air Force. The legislation would give 15 to 20 people who are deaf or hard-of-hearing, but otherwise fit for military duty, the chance to serve their country in a demonstration program. Original co-sponsors include Rep. Niki Tsongas, Rep. John Garamendi, Rep. Henry Waxman, and Rep. Chris Van Hollen.

The proposed legislation is a companion to a Senate bill introduced in December by Tom Harkin (D-Iowa), who has noted that the military allows service members who acquire a disability while serving their country to remain on active duty.

The Department of Defense, which sets medical standards for enlistment, excludes from service those who are deaf, use a hearing aid, or have a cochlear implant.

Capt. Casey Doane, of Joint Base Andrews, Maryland, who grew up in a deaf family and is currently on active duty in the Air Force, believes hearing-impaired Americans are capable of serving, pointing to his own experience in support of the claim. Capt. Doane acknowledges that certain accommodations and limitations would have to be made, but ultimately no more than for other individuals with unique circumstances who are already serving.

Rep. Takano further explains that in past decades, the Armed Forces have given groups who were previously excluded the opportunity to serve and calls on the Armed Forces to do the same for fully-qualified individuals with auditory impairments. Congressman Takano would like to see these accommodations offered by all service branches.

The National Association of the Deaf has endorsed the legislation.


Improving communication between deaf and hard of hearing persons in the EU.

Improving communication between deaf and hard of hearing persons in the EU.
Evolving efforts to ensure equal rights for the deaf and hearing impaired in Europe include a 2007 treaty stemming from the United Nations Convention on the Rights of Persons with Disabilities. The treaty offers a baseline standard for such rights as guaranteed in the U.S. under the Americans with Disability Act.
The basic rights of the hearing impaired under the Convention treaty, while currently not as broad as those required by the ADA, include freedom of expression and opinion, and access to information. “Appropriate” measures must be taken to ensure that the hearing impaired may participate on an equal basis with others. Specific means advocated to accomplish this are “sign languages … augmentative and alternative communication, and all other accessible means, modes and formats of communication of their choice,” to be provided in “a timely manner and without additional cost….” Private entities in the EU are “urged” to consider using the Internet in their efforts, while the mass media is simply encouraged to do so. The ADA also addresses the Internet, but distinguishes obligations based on the nature of the Web site.


Improving communication between deaf and hard of hearing persons in the EU.

The basic rights of the hearing impaired under the Convention treaty, while currently not as broad as those required by the ADA, include freedom of expression and opinion, and access to information. “Appropriate” measures must be taken to ensure that the hearing impaired may participate on an equal basis with others. Specific means advocated to accomplish this are “sign languages … augmentative and alternative communication, and all other accessible means, modes and formats of communication of their choice,” to be provided in “a timely manner and without additional cost….” Private entities in the EU are “urged” to consider using the Internet in their efforts, while the mass media is simply encouraged to do so. The ADA also addresses the Internet, but distinguishes obligations based on the nature of the Web site.


Reasonable Accomodation

 

Legislated arrangements for hearing-impaired individuals can be found world-wide. Though terminology may differ, “reasonable accommodation” is a cornerstone of these efforts, all of which rely on defining hearing impairment as a disability and the failure to reasonably accommodate the disability as discrimination. Broader thinking may reject the disability label; the effect of this characterization on accommodations offered merits a discussion of its own.
A growing acceptance of the need to adapt work, educational or living environments is evident in legislative steps taken to remove the barriers that prevent a disabled person from participating in an activity or receiving services on an equal basis with others. Specific examples include: word-recognition software in British Columbia; audio-loops in Norway; the rewording of examination questions in Tasmania. The specifics may vary, but at their root is the belief that accommodating the hearing-impaired is an issue of human, civil, and political rights.
Of course, some nations are more successful than others in recognizing and addressing the issue. An international effort to raise standards is in place, but there is much to be done.


Job training: An employer’s duty to accommodate

An employer’s obligation to accommodate hearing-impaired employees is an ongoing and multi-faceted one. An interpreter may be requested and required during any stage of the employment process. Yet employers may find themselves unprepared for situations that are not part of the daily routine. One such example is employee training. The ADA requirement that equal access and opportunity be provided to all employees may be understood by most to include employer-sponsored job-training, but under what circumstances? Training that is conducted on-site, by in-house staff, clearly triggers the requirement, but it may be less obvious that training offered through an outside contractor, whether on-site or off, also is covered by the Act.
The EEOC’s enforcement guidance spells this out: employers must provide sign language interpreters, CART services, and other reasonable accommodations to allow disabled employees an equal opportunity to participate in employer-sponsored training, absent undue hardship. Even if the company conducting the training is obligated by the ADA to provide “auxiliary aids and services,” this does not change or eliminate an employer’s obligation to provide such accommodation.
[SLUSA will work with you to determine which of these essential services will best meet your needs.]


Expanding the Universe

A study launched by a group of university students to enable the deaf to fully participate when visiting a planetarium has raised unlimited possibilities for the future use of Google Glasses, and similar concepts, by the hearing impaired community. The “Signglasses” research project at Brigham Young University is working on a system to project sign language narration onto the glasses. With the lights off, an ASL interpreter can’t be seen. With the lights on, the stars disappear. Experiments with deaf children in the planetarium allow the participants to try on the glasses and watch a movie with an interpreter on the screen of the glasses. The “real time” participation made possible by the process offers benefits beyond the planetarium. Team leader, BYU Professor Mike Jones, reports a joint effort with researchers at Georgia Tech to use the glasses to help deaf children learn to read. As conceived, students reading a book who come across a word they don’t know will be able to point to it, take a picture, and apply software that would send a video definition back to the student. We’ll have more on new technology as it evolves.


Accommodating the hearing impaired in legal proceedings

 

Advocacy on behalf of people who are deaf (used to include the hard of hearing), has increased the legal community’s awareness that accommodations may be needed to effectively deliver their services. Practitioners not regularly engaged with the deaf can benefit greatly from and should avail themselves of the expertise of those who are. Equal access to perspective or actual clients and compliance with the Americans with Disabilities Act (ADA) can be accomplished by a range of means, defined in the Act as “auxiliary aids and services,” including the provision of:

 

  • Qualified interpreters
    • understood to be someone who is fully fluent, with formal training or education sufficient to communicate the complex legal rights, concepts and proceedings involved
  • Written materials, note-takers
  • Computer-aided transcription services, known as real-time captioning or Communication Access Realtime Translation (CART)
    • these services can be delivered on location or remotely
    •  they provide the instant translation of the spoken word into English text
  • Telephone handset amplifiers, assistive listening devices, assistive listening systems
  • Telephones compatible with hearing aids
  • Closed caption decoders, open and closed captioning
  • Telecommunication devices for deaf persons, videotext displays, or other effective means of delivering aural materials to persons with hearing impairments

Reasonable accommodation is the law. SLUSA provides the means to comply.


Topic: Legal Services for the Deaf

It is a violation of federal laws to discriminate against deaf persons’ access to the legal system. But how well is the legal system geared to the needs of the hearing-impaired community?
The Americans with Disabilities Act (ADA) puts the entire system on notice. Title II of the ADA directs the courts and other public entities to provide equal access to their services. Title III states that those with disabilities are entitled to “full and equal enjoyment” of the services of a “public accommodation,” which includes legal services. The courts, other public entities involved in law enforcement, and legal-service providers, whether large, small, or solo, must reasonably modify their policies, practices, or procedures to comply with the law and give individuals with a disability the opportunity to “enjoy the benefits of a service, program, or activity conducted by a private entity.”
Communication, once again, is key, and communications with deaf persons must be “as effective as communications with others.”
Good intentions won’t suffice. Neither will relying on a client’s relatives or the well-meaning efforts of untrained staff. A service provider can be ready and willing, but still unable to properly serve and support a hearing-impaired person.
Check back later this month for more on the particular needs that arise when the hearing impaired step into the legal system. Accommodations are readily available to facilitate effective counsel, as required by law, whether for a simple will or more complex legal matters.


Perspective

Perspective

Deafness can be defined in many ways.  Is hearing impairment a handicap or a difference?  What impact, if any, does applying one label or another have on society’s willingness to address the issue? 

Recognizing that there is no single meaning, that the range of effects can be equally broad, makes possible an open and evolving discussion of what tools and public policies may be useful to the hearing impaired.  But it’s not a one-way street.  The right tools are critical, as well, to the hearing public’s natural interaction with the hearing impaired.  A hearing person can get out a pen and paper and write what they are trying to convey, or text the message on their phone.  A simple willingness to take the time to communicate by alternative means “speaks volumes” to the hearing-impaired person. 

Whether viewed as a medical disorder, a cultural difference, or something in between, those most affected by hearing impairment benefit by having a choice and from the freedom that comes with individual accommodation.  Instrumental to this is a wider understanding by all of the variety of services and enhancements available.