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Category: Blog

Video Remote Interpreting (VRI) in Healthcare

example of video remote interpreting in a medical setting

Imagine that you’re Deaf and you must go to the emergency room. No sign language interpreter is available, so the staff nurse looks for the video remote interpreting (VRI) equipment to set up, but finding the equipment takes two hours. In the interim, the nurse nearly gives you an injection without your knowledge or consent.  

This scenario, which happened to Corey Axelrod, drives home the importance of effective communication in healthcare for Deaf and hard-of-hearing people. An American Journal of Audiology study shows that there are higher mortality rates among Deaf people than hearing people.  

However, some Deaf people are unaware of VRI and how it works. Ironically, these are the people who may benefit the most from VRI in health care settings.     

Take Yolanda Hernandez, who’s hard of hearing and uses speech and ASL to communicate. She requests an in-person sign language interpreter for her daughter’s regular medical appointments. However, Ms. Hernandez goes without communication assistance because the interpreter often cancels.  

“We drive two hours to our appointment and then they say, ‘Oh, the interpreter had to cancel. She can’t make it,’” Ms. Hernandez says.  

Unfortunately, because cancellations have happened so often, Ms. Hernandez resolves this by bringing in her husband as an unofficial interpreter. However, this situation is not ideal, and neither is it the case for those who don’t have family support.

But before delving further, let’s learn more about VRI and how it works.  

What is VRI? What makes it an asset in healthcare?

vri healthcare communication

VRI is an off-site telecommunication service that enables a Deaf or hard-of-hearing person to access a sign language interpreter through a videophone, webcam, or tablet. Title III under the ADA covers this service under enterprises that serve the public. Such enterprises include:

  • Hotels
  • Restaurants
  • Retail stores
  • Educational institutions
  • Banks
  • Medical centers/hospitals (private and public)  

Title III does not cover two types of enterprises: religious organizations and private memberships.

Pros and cons of VRI in healthcare 

VRI is a solution when in-person interpreters are not available or practical. You can schedule VRI or sign up for VRI on-demand services.   

Many Deaf people prefer in-person interpreters to VRI, which allows direct communication with doctors. The National Association for the Deaf (NAD) argues that “providing on-site interpreters should be the primary method by which health care providers and their sign-language-using patients communicate.”  

Mr. Axelrod, the founder and CEO of 2axend and a member of a multigenerational Deaf family, says VRI is ideal in low-risk situations such as a standard doctor’s appointment. 

“These appointments are often where the interactions are one on one,” Mr. Axelrod says.  

It’s important to learn about the different benefits that VRI provides, and choose the right fit for you, based on the situation.

However, there are benefits to using VRI:  

  • Accessibility: Ideal in emergencies and in rural areas where few interpreters are available. Deaf and hard-of-hearing patients can request an interpreter based on language/cultural preferences.
  • Cost-effectiveness: VRI is a more affordable option than in-person interpreters. Most in-person interpreters require you schedule at least two hours of interpreting per session.  
  • Convenience: Available on any video conferencing platform around-the-clock with scheduling, or even on demand.
  • Flexibility: Easy to schedule or cancel appointments. Enables the healthcare provider to easily confer with nurses and other doctors on medical matters with the patient present.    

VRI is helpful for straightforward appointments when interaction is one-on-one with the doctor. Even in those instances, though, VRI can fall short, notably if the doctor doesn’t know VRI best practices or the interpreter struggles to hear or understand what’s happening in the room. Then, there are technical issues that also arise.  

As a healthcare professional, it’s critical to respect the Deaf patient’s specific communication requests. Follow their lead. Be mindful that effective communication access is essential for any patient’s healthcare needs. Their needs supersede your own, keeping with the Hippocratic Oath of doing no harm.  

“The motto, ‘Nothing about us without us’ needs to hold true in every encounter where Deaf, hard-of-hearing, and DeafBlind individuals are looked at as experts for their own accessibility experience,” Mr. Axelrod says.  

The dangers of healthcare communication barriers

A few years ago, Ms. Hernandez became pregnant with her third child. The pregnancy was high risk. One day, she began bleeding profusely and needed to go to the hospital. Her husband was working far from home, and knowing that a sign language interpreter would be unavailable, he had Ms. Hernandez’s sister put him on speaker phone during the consultation with the doctor. 

“My sister put my hubby on the phone so he could hear what the nurse and doctor were saying,” Ms. Hernandez says. “It was a scary moment. I was seven months [pregnant].”  

Many cases are not as frightening as Ms. Hernandez’s, but her story underlines the need for available and qualified sign language interpreters for critical medical situations. (As you may recall, Ms. Hernandez was unaware of VRI as an option.) 

Title III of the ADA  

As I mentioned at the beginning of this article, the implementing regulations of Title III of the ADA advises against having a family member stand in as an interpreter in any healthcare setting. The healthcare professional alone is responsible for hiring qualified sign language interpreters for their Deaf and hard-of-hearing patients.  

Nevertheless, there are two situations where it’s permissible to have a friend or family member stand in as an unofficial interpreter:

  1. In an emergency, when there is a threat to someone’s safety, it might be necessary for an adult (or even a child) who’s with a Deaf or hard-of-hearing person to help them communicate. This is acceptable when a professional sign language interpreter is not available.  
  2. In non-emergencies, when a Deaf or hard-of-hearing person needs someone to interpret and this “someone” is fine with interpreting, this is acceptable. However, this doesn’t include young children.  

There are two exceptions to the above permissible situations.  

One, when a case involves spousal abuse, a spouse is not allowed to interpret the situation. Second, if a friend or family member has a personal involvement in a situation or feels uncomfortable relaying information, they’re not obligated to interpret it. 

Some Deaf people can quickly obtain a sign language interpreter. However, the doctor-patient experience often falls short, and some Deaf patients end up with interpreters who lack experience in medical terminology. This is a common complaint among Deaf people about interpreters in healthcare.

“One of the most challenging experiences is working with a VRI interpreter who does not have the requisite knowledge to interpret in healthcare settings,” Mr. Axelrod says.  

There is currently no national certification available for healthcare interpreters for the Deaf and hard of hearing. Certification is relegated to spoken languages; many states do have their own certification requirements. However, the Certification Commission for Healthcare Interpreters (CCHI) offers a Core Certified Healthcare Interpreter credential. The National Council on Interpreting in Health care (NCIHC) also provides trainings and resources and includes national standards that outline the healthcare interpreter’s responsibilities in providing effective communication, with some input from the Registry of Interpreters for the Deaf (RID). 

Be patient  

Sheena Lyles, also known as MsDeafQueen on Instagram, tells me using VRI for doctor appointments is awkward and her doctor becomes impatient.  

“Using VRI during medical appointments is always frustrating because of the long wait to get VRI to work when my appointments were supposed to be wrapped up sooner,” Ms. Lyles says. Because of this experience, she prefers in-person interpreters.  

Based on these Deaf people’s experiences, we must ask ourselves, “Who is responsible for effective communication access: me or the patient?” The answer is the medical establishment.   

VRI: a convenient solution for medical services

Healthcare professionals using VRI can get the most out of the service by adjusting how they talk and behave to account for space and the use of audiovisual equipment. At times, setting up VRI can be more complicated than simply pressing a button. Familiarizing doctors and nurses with VRI technology can prevent wasting precious minutes and, as in Mr. Axelrod’s case, the patient having to set up the VRI.

For a seamless experience for both Deaf patients and healthcare professionals, keep these items in mind when requesting VRI:  

  • Reliable high-speed internet with enough bandwidth.
  • Familiarity with VRI technology and setup. 
  • Accommodate the Deaf patient’s communication needs (use VRI as secondary option if the patient’s preference is an in-person interpreter) and note for future reference.
  • Position the video screen so that the interpreter’s hands, face, and upper body are visible to the Deaf patient.  
  • Talk with the Deaf patient directly, not the interpreter.  
  • Provide supplemental information and materials in plain language to the Deaf patient.
  • Be patient and allow enough time to put the Deaf patient at ease and answer their questions clearly. 
  • Request a qualified interpreter.  

For more information on optimizing VRI services in the healthcare setting, please refer to NAD’s position statement.

Conclusion  

VRI can be the bridge to adequate communication access between healthcare providers and their Deaf or hard-of-hearing patients. Consider this just one aspect of providing equal access that can build the foundation for accessible and inclusive healthcare.

While using VRI requires planning — to ensure a stable internet connection, clear video and audio quality, quality interpreter selection, and patient comfort — it’s on par with the preparation to secure an on-site interpreter, and one can’t overlook the benefits of this service. Remember, the goal is to promote a patient experience as close to the in-person experience as possible.  

The objective should be clear: Healthcare should use VRI as a communication option. This technology can set a new standard for inclusiveness in the healthcare industry that respects and caters to the diverse communication needs of all Deaf and hard-of-hearing patients.   

Take the first step toward improved accessibility in your healthcare facility. Consult with Sorenson for VRI and in-person interpreting services today and start building successful communication access tailored to the unique needs of the Deaf and hard-of-hearing community.  

American Sign Language (ASL) Interpreting Services

Providers of sign language interpreting may offer several different solutions, all with different use cases, each with their own benefits. When considering which interpreting solution to choose, it is important to consider these uses and benefits. The major solutions are:

Common interpreting needs

This is a different categorization than the types of interpreting need — such as education, legal, healthcare, retail, governmental, financial, or enterprise.

All interpreting requires fluency in the sign language and spoken language of the Deaf and hearing participants in the conversation. In the United States, this is American Sign Language (ASL) and usually spoken English, but there’s increasing demand for spoken Spanish.

Interpreting vs. translation

Interpreting solutions are different from translation. Many people use “interpreter” and “translator” interchangeably, but they are distinct roles. An interpreter works with the spoken word, converting speech from a source language into a target language. A translator works with the written word, converting text from the source language to the target language. This includes translating from the written word to a signed language.

Both interpreting and translating consider the style and tone of the message content as well as taking into account differences in culture, dialect, and setting. With few exceptions, translators typically work only in one direction at a time while interpreters usually work in both directions.¹

On-site interpreting

On-Site interpreting (also called in-person interpreting or face-to-face interpreting) means that the Deaf person, hearing person, and interpreter are all at the same location. One example of when this is the best choice is when all three parties are moving around, such as a new employee tour or a healthcare facility where patients need interpreting in multiple locations (reception, triage, exam room, etc.).

Other examples are:

  • Academic or conference-type environments where multiple people may be speaking.
  • Legal situations, such as court or contract signings.
  • A team dinner at a restaurant.
  • Job interviews where all parties are local.
on site asl interpreting services

You may also choose on-site interpreting when your location does not have an internet connection or video conferencing equipment for VRI.

Questions that often come up regarding on-site interpreting

Why do agencies charge for a required minimum time (generally two hours) or some sort of appearance fee for on-site interpreting?

On-site interpreters generally have appointments throughout the day for different people at different locations. They may start with a 9:00 appointment at one location then have subsequent appointments at multiple different locations.

The interpreter must travel to each location so they can’t follow that first 9:00 appointment with one immediately afterwards at 9:30 — that is logistically impossible. As a result, their scheduling must allow for travel as well as their time and service.

Scheduling in larger blocks of time also allows for the interpreter to be available for communication outside the actual appointment. While it may seem easy to calculate how long to schedule an interpreter for a medical appointment, for example, people frequently only consider the actual appointment itself. It is easy to forget to account for things like the interpreter and the client meeting prior to the appointment, the check-in with reception, staff calling the patient in and checking health history and preliminary testing, plus other necessary tests (bloodwork or x-rays for example) outside of the actual doctor/patient meeting.

Additionally, there are often unexpected delays which could happen at any stage of the visit. In this way, a simple 20 minutes appointment actually requires the interpreter for much longer.

Why do agencies sometimes send more than one interpreter?

Sign language interpreting is a mentally and physically taxing job. No matter how expert the interpreter is, after a long period of continuous interpreting, they will become mentally exhausted and unable to fully focus on the work of interpreting cultural and linguistic information between two languages. As a general rule, interpreters should have regular breaks of half the time they are present.² As such, the agency schedules two or more interpreters if the situation calls for continuous interpreting for a long period of time.

Video Remote Interpreting

Video Remote Interpreting (VRI) is a flexible solution for in-person or virtual conversations with an interpreter over video, which makes it appropriate for a range of use cases.

Just like on-site interpreting, one of the users — usually a business or organization — has a contract or account with a VRI provider for scheduled VRI, on-demand VRI, or both.

Scheduled VRI

Scheduled VRI is ideal for a pre-scheduled meeting — either online via any of the videoconferencing platforms such as Zoom or Google Meet with both the Deaf and hearing people in the same location and the interpreter in a remote location.

scheduled vri interpreting services

Some examples of pre-scheduled meetings are:

  • Interviews
  • Meetings with employees
  • Parent-teacher conferences
  • Doctor’s appointments

The interpreting agency assigns either an individual interpreter or a team of interpreters, depending on the length and complexity of the meeting. A significant benefit of scheduled VRI is the ability to consider the subject matter of the meeting when selecting interpreters and provide background information to prepare for the appointment. The user may even have a list of preferred interpreters the provider will attempt to assign when possible. This ensures the meeting has the appropriate interpreters for the users’ needs and, when possible, preferences.

On-demand VRI

On-demand VRI is the best solution when there is an unscheduled need, such as an emergency meeting or impromptu conversations. The VRI provider gives the user a contact number or app for a tablet, mobile device, or computer with a camera. In some situations, the VRI provider loans the user the equipment itself.

on demand vri interpreting services</p><br /> <p>

Some examples of use cases for on-demand VRI include:

  • Unscheduled interviews, employee meetings, doctor’s appointments
  • Walk-in visits to retail and hospitality businesses
  • Pharmacies
  • Utility offices
  • Government services such as police, fire, and EMS as well as the DMV or Department of Workforce Services

On-demand VRI is generally first-come, first-serve. The user may get an interpreter immediately or there may be a waiting time until one is available. Either way, they get the interpreter that is next up from the pool of available interpreters.

This method of getting an interpreter quickly is sufficient for most situations. However, this has some limitations. On-demand VRI is best for quick conversations. If a meeting goes long, the interpreter may need to take a break and get another interpreter to take over; if the subject is complicated or has a lot of context dependencies, the new interpreter may take a few moments to get necessary context.

vri on demand example on screen</p><br /> <p>

In addition, not every interpreter has the same experience level with the specialized language of law, medicine, or technical fields. The option of having a smaller pool of interpreters with this specialized experience to answer the calls from a particular user may be something the interpreting agency can arrange. But consider whether the need is great enough to accept the tradeoff of possible longer wait times to get an interpreter from that smaller pool.

Specialized interpreting

Some situations require specific training and education and may require additional certifications. These situations highlight an advantage of using an established industry leader like Sorenson. With the largest private interpreting workforce in the world, Sorenson employs qualified interpreters for the full range of specialized needs.

Legal interpreting requires knowledge of law, protocol, and training in interpreting strategies unique to legal situations. These include court and law enforcement proceedings where matters involving high-risk and personal freedoms are often the focus.³

States may require either a specific level of certification⁴ or have a process for qualifying, or both.⁵ When talking to interpreting agencies, ask them if they have sufficient numbers of interpreters who already meet those criteria to cover the need.

This type of interpreting is in high demand due to the breadth of the legal field. It includes law enforcement investigations, interviews and interrogations, client-attorney interactions, and a wide range of court and legal proceedings.³

Medical interpreting

Medical interpreters must be familiar with various medical interpreting requirements.

These include:

  • When they may or may not be in the room with the patient
  • Where they must stand to preserve the patient’s physical privacy (in the case of an ob-gyn exam, for example)
  • Any legal requirements (HIPAA, ADA, etc.)
  • Any special considerations for mental health situations⁶
medical interpreting services

In some situations they also may need to have specific immunizations or wear clothing similar to medical professionals to maintain sterile conditions, such as in an operating room.

When discussing your needs with the interpreting agency, think about if your practice or facility would expose interpreters to any such situations. If so, tell the interpreting agency up-front so they can make sure their interpreters prepare with any additional immunizations and necessary training.

Interpreting for government

While interpreting for government agencies may not often require specialized knowledge, these agencies often deal with highly confidential information and may require interpreters to pass the agencies’ own background and security checks. This can be a long process that sometimes repeats at regular intervals for renewal. Interpreting agencies such as Sorenson that frequently contract to interpret for government agencies maintain a pool of interpreters who have passed these checks.

DeafBlind and low-vision

Some Deaf people are also either Blind (DeafBlind) or legally blind or close to it (low-vision). Those situations call for interpreters with training in signing for people with limited vision or other ways of conveying information.

A DeafBlind client, for example, rests their hands on the interpreter’s hands to “see” the signs so the interpreter needs to know how to adjust their signing. This may include signing “smaller” — not moving their hands too far away from their body. The interpreter also needs to know the appropriate way to show the emotion of the message without using facial expressions.

A client who is not DeafBlind but is low-vision may need the interpreter to sit or stand close and sign smaller so the signs do not go out of their range of vision.

Certified deaf interpreting

Education opportunities and early language access remain a challenge for many Deaf individuals.  Because of this, there likely are Deaf people who, through no fault of the hearing interpreter, do not have the ASL vocabulary level or world experience context to understand the interpreted message. In that situation, a Certified Deaf Interpreter (CDI) is a great option.  The CDI is a communication specialist, working with their hearing team to use their native language abilities and in-depth understanding of Deaf communication dynamics to tailor the message so the Deaf person will best understand the message.

How does this work? The CDI typically briefly meets with the Deaf client just prior to the appointment (15 minutes before) to assess their communication needs. During the appointment, the hearing interpreter and the CDI work together to adjust the message and make it specific to the Deaf client. During the appointment the CDI will utilize different strategies to maximize the Deaf client’s understanding of and full participation.

Common CDI needs

An example that many may be familiar with is government update broadcasts, increasingly seen with interpreters, such as emergency updates such as those during the COVID-19 pandemic. Those interpreters are usually CDIs, working to ensure the message can be understood by most Deaf people while off-camera, there is a hearing interpreter team “feeding” them the news verbatim for them to adapt and present directly to the camera.

CDIs are especially in demand for medical or legal situations where it is critical for the Deaf client to have full, unequivocal understanding of information/choices and full participation in decision making.

Trilingual interpreting

Some situations call for interpreters who know multiple languages. In the United States, the most common need is for those who are fluent in English, Spanish, and ASL due to the large number of immigrants from Latin America. Like CDIs, these interpreters are in demand for general, legal, medical, and government situations.

Video Relay Service

Video Relay Service (VRS) is a no-cost, subscriber-based service for Deaf people who use ASL. It provides interpreting services via videophone calls using ASL and spoken English or Spanish. VRS rules require that the Deaf person, hearing person, and interpreter all must be at different locations. It’s part of the Telecommunications Relay Service (TRS) program as a provision under the Americans with Disabilities Act (ADA) of 1990.

video relay service example

You can find more information on VRS and how it works in our “What is Video Relay Service (VRS)?” post.

Who can be an ASL interpreter?

To work professionally as an ASL interpreter, the interpreter learns not only American Sign Language but also Deaf culture. They learn how to correctly relay signed and spoken information back and forth between the Deaf and hearing people in the conversation, including how to account for dialects, settings, and more.

Naturally the question then arises, can someone hearing or Deaf be an ASL interpreter. The answer is both can be interpreters. Deaf interpreters are their own category — Certified Deaf Interpreter (CDI). CDIs specialize in communication with Deaf individuals who need enhanced access to participate fully.

Choosing an interpreter with the right qualifications

For most people searching for interpreting services, many agencies remove the burden of verifying an interpreter’s credentials by checking those credentials themselves. When contracting with an interpreting agency, you should ask them if they do this.

Continuing education is critical to the profession and ensures that interpreters develop in-demand skills.

  • The RID provides further professional development courses through Continued Education Units (CEUs) so interpreters can maintain their certification or qualify for advanced certification as well as stay up to date on industry trends or changes such as signs for new terms in different industries.
  • Sorenson Communications not only provides CEU training to the ASL interpreting community but also provides the most comprehensive interpreting training and development program in the world to upskill interpreters for all types of interpreting scenarios through its in-house training department.

Which type of interpreting to choose?

So, you need at least one of these services but aren’t sure which? It can be an overwhelming decision, whether your company is searching for accessibility services for employees, clients, or customers, or if you are a Deaf person trying to help others contract for these services.

Simply contacting a local interpreting agency does not always get the direction you need. Many agencies specialize in one type of interpreting, usually on-site interpreting. Sorenson not only offers a full range of types of interpreting, it also offers Design Consultants. These are people with in-depth knowledge of the Deaf community, ASL interpreting, and accessibility who can guide you in identifying the most appropriate services for your needs.

Sources

  1. Translator vs. Interpreter — American Translators Association (ATA)
  2. One Interpreter Or Two? — Language Scientific
  3. Legal
  4. Functional Descriptions of Interpreter Levels | Deaf and Hard of Hearing
  5. American Sign Language Interpreters
  6. ASL/English Medical Interpreter Domains and Competencies 

How to Promote Inclusion and Equity with Sign Language in Microsoft Teams

on demand microsoft teams or sorenson express interpreter

Experience the impact of inclusive communication on-demand for Microsoft Teams.

Request a trial of Sorenson Express

Part of building a successful business is creating an environment where employees can thrive. By embracing inclusion and accessibility, employees can do their best work and the entire company benefits. Studies reveal that companies who champion disability-inclusion have 28% higher revenue and twice the net income. In addition to higher profits, readily available technology and resources make it easy to support your employees with accessible communication. Any business can provide inclusive communication for the estimated 38K Deaf individuals in the American workforce.

Moreover, implementing technology to advance communication equity can decrease the number of deaf people who are unemployed or not in the labor force. According to NDC (National Deaf Center) in 2019 42.9% of deaf individuals were not in the labor force. This includes parents, caretakers, and retired people but also students who may have been looking to enter the workforce. In contrast to the 3.4% of hearing individuals who were unemployed, there was an additional 3.8% of deaf people who were considered unemployed and actively seeking work. These are people who could be contributing employees of companies. Through technology, accessibility practices can be improved and benefit both these individuals and businesses alike.

Using VRS for sign language interpreting in video meetings

When taking a look at how you can empower employees in their job functions, videoconference meetings are an area where you can make a great impact.

Historically, many deaf meeting participants have used video relay service (VRS) to get interpreting for meetings with hearing individuals when an interpreter isn’t available to them. VRS is a no-cost interpreting service for deaf people who use American Sign Language (ASL) to communicate through video calls on videophones, smart phones, tablets, or computers. Using their VRS videophone or app, a deaf person would call the meeting’s dial-in number so the interpreter could connect as a third-party.

Unfortunately, using VRS as a workaround this way only connects an interpreter to the audio of the meeting. Visual and emotional cues are essential to sign language. Without access to video in the meeting, the interpreter and deaf participant can’t get the full context of the conversation. Moreover, deaf participants have to look back and forth between the window with the interpreter and the separate meeting window. This not only contributes to meeting fatigue but can also cause participants to miss words, expressions, or information that colleagues presented during screen sharing. If you hadn’t thought about meeting fatigue before, add these obstacles for deaf employees and you may have a real hindrance on your team’s happiness and productivity.

Accessibility and on-demand interpreting in Microsoft Teams

Whether you have remote employees or use video meetings to bridge the gap between multiple offices, you can take advantage of a range of Microsoft Teams features to make your videoconferencing more inclusive. Since its launch in March 2017, the communication platform has introduced ways to improve accessibility and help users get the most out of the platform. Features such as Closed Captions, High Contrast Mode, and Screen Reader support have helped workplace inclusion. However, deaf employees who use ASL needed more interpreting solutions.  

In 2022, Microsoft Teams launched Sign Language View. This is a personal feature that allows an individual to keep an interpreter’s video visible in one location no matter who is speaking and still spotlight other participants. Sign Language view is an excellent option for companies that have an interpreter on staff. If your company doesn’t employ full-time interpreters, there is another tech-enabled solution that can bring language equity to your team with ASL interpreting service as you need it. 

Providing sign language interpreting in video meetings

In 2024, Sorenson released a better way to get sign language interpreting in Microsoft Teams meetings. Instead of the cumbersome process of having an interpreter dial in separately, Microsoft Teams users can now request an interpreter in just a couple clicks with the Sorenson app integration called Sorenson Express. By subscribing to Sorenson Express, businesses can use the integration to enable an interpreter to appear on screen within moments and see and hear all meeting content.  

By pulling an interpreter directly into your Microsoft Teams meeting as a participant, you give both deaf and hearing meeting attendees a more convenient and immersive experience in a multilingual conversation. Since hearing participants also see the interpreter, they can allow time for interpreters to sign and see when a deaf participant has something to add. Overall, the increased visibility and awareness your team can experience while using Sorenson Express during Microsoft Teams meetings will help build connection and bridge communication gaps between all participants. 

How does Sorenson Express provide sign language in Microsoft Teams for businesses?

Sorenson’s VRI is an interpreting solution with a remote interpreter for both your virtual and in-person meetings. Scheduled VRI is ideal for scenarios when you know you’ll need an interpreter ahead of time because it allows for an assigned interpreter to meet specific needs. However, it doesn’t allow for impromptu conversations.  

Sorenson Express introduces a flexible, on-demand VRI experience that gives businesses access to videoconferencing app integrations for unplanned communications. You can request an interpreter directly in Microsoft Teams or via the Sorenson web app for flexibility on your desktop, tablet, or other mobile device.  

Businesses that are set up with a Sorenson Express account can quickly access interpreting through the Microsoft Teams integration for virtual meetings as well as on a tablet for in-person conversations. Expanding communication equity even further, Sorenson Express offers on-demand interpreting services in ASL-to-English or ASL-to-Spanish.  

When should you choose the Microsoft Teams integration vs the Sorenson web app?

Your situation and preferences will determine when you’ll want to invite an interpreter into Microsoft Teams from the integration or the web-based Sorenson app.   

You can use the web app:  

  • If you are the Microsoft Teams meeting presenter or an attendee (i.e., when you are participating from a different tenant, not your own company);  
  • If you have a Sorenson Express subscription; or 
  • Without downloading the Sorenson app from the Microsoft AppSource.  

You can use the integration in the Microsoft Teams app if you:  

  • Have a Microsoft Teams presenter role (which is typically the default role for Teams meetings); 
  • Are subscribed to Sorenson Express; or
  • Have permission to download and install Microsoft Teams apps.  

Why use Sorenson Express?

Sorenson Express offers a flexible and seamless experience in requesting the highest quality professional sign language interpreting, on-demand in Microsoft Teams. Sorenson has the largest team of private interpreters in the world and a trusted reputation a global language services provider with more than 20 years in the industry. More importantly, when you implement an innovative accessibility service like Sorenson Express for your business, you’re showing your teams, partners, and customers your commitment to increased connection and understanding as well as excellent service. On-demand interpreting with Sorenson Express removes the worry of potential barriers when scheduling Microsoft Teams meetings so everyone can focus on creating, problem-solving, building connections, and doing the work they love. 

microsoft teams sign language sorenson express

Beyond sign language interpreting in Microsoft Teams

Technology that makes inclusive communication in the workplace possible is more accessible than ever. As the worldwide leader in technology that connects deaf and hearing individuals, Sorenson makes it easy for your business to start strengthening relationships between deaf and hearing employees, clients, and customers. From Fortune 500 companies to small businesses, seamless language solutions from Sorenson, including Sorenson Express, are helping businesses everywhere to create meaningful connections through technology.  

To start removing communication barriers in your business, explore Sorenson’s range of accessible communication services. One of our Accessibility Consultants can talk you through all that we offer and help you decide which services might be a good fit based on your needs. 

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Captioned Phones for Seniors: Captioning Services and Benefits

Senior woman talking on a captioned phone

As we age, communication can become a challenge for many of us. While almost one out of every six American adults have some degree of hearing loss, it’s more prevalent with age. More than 30% of people 65 and older sustain hearing loss1, while approximately 40% of those 75 and older experience hearing loss.

Adequate communication for seniors with hearing loss is crucial for maintaining strong social connections and emotional well-being. Captioned phones for seniors can be a lifeline.2

Aging comes with many major life changes, such as retirement, friend and family losses, and aging-associated illnesses, which can shorten a senior’s lifespan. With captioned phones, however, seniors can remain independent without needing to rely on others to facilitate communication.

Taking advantage of these telecommunication devices can also provide a semblance of safety (through alerts and 911 calls).3 Furthermore, a Pew Research study shows that more than 27% of US adults ages 60 and older live alone, the highest of any country around the world.4 Religious and cultural factors, as well as geographic location and socioeconomic status, can affect whether you’re more likely to be lonely as you age.

The rise in telecommunication technology has made it easier for seniors to maintain contact with loved ones. Whether you struggle to understand your family or to have an important conversation with your doctor, closed caption phones can bridge that communication gap and help you maintain strong social ties.

What are captioned phones?

A captioned phone is a telecommunication device that looks like a typical landline phone, but with a display screen above the keypad. The device transcribes the call in real-time while you listen and read the screen, enhancing your overall experience of the phone call.

Benefits of captioned phones for seniors

Following the Federal Communications Commission’s (FCC) approval of closed captioning for TV in 1976, funding to further telecommunication access for the Deaf and hard-of-hearing people continued with the Internet Protocol Captioned Telephone Service (IP CTS) between 2000 and 2007, along with video relay services. The FCC funds these telephone and internet telephone services through the Telecommunication Relay Services (TRS) Fund.5 It was only in 2003 when the first captioned telephone was released.

With these three benefits, captioned phones can be an effective booster of psychological health in seniors:

  • Confidence: Using a captioned phone enables seniors with hearing loss to connect with anyone freely. Unlike before, they no longer need to avoid phone calls out of fear of missing any part of the conversation.
  • Decreased social isolation: Easily communicating with loved ones at any time has proven to ease social isolation in seniors.6
  • Better quality of life: As the telephone has been the central communication method throughout seniors’ lives using a captioned phone easily enhances their overall well-being.

Best captioned phone service for landline and mobile

Sorenson provides a range of telecommunication solutions aimed at Deaf and hard-of-hearing people, which can also benefit seniors with hearing loss. Here, we provide an overview of telecommunication products useful for seniors.

CaptionCall

People discussing phones for seniors

CaptionCall is available for landline and mobile use and has no cost for people whose hearing loss makes captions necessary to use the phone. It’s the #1 phone call captioning service in America. Its practical features make it among the best captioned phones on the market.

The CaptionCall landline phone captioning service has several features that make it an ideal senior phone option:

  • Hearing aid compatible
  • Smooth scrolling captions (thanks to SilkScroll® technology)
  • Adjustable settings
  • Saved conversation and voice message transcripts
  • Stored contact list
  • Caption 911 calls
  • English and Spanish captions

You can download CaptionCall Mobile (formerly Olelo) for Android and iOS. Some of the nifty features include:

  • High accuracy
  • Real-time captions
  • Saved conversation transcripts
  • Captioned voicemail
  • English and Spanish captions
  • Adjustable text size and color

You can download CaptionCall Mobile for iOS 15 and later, and Android 9 and later.

As a CaptionCall Mobile user myself, it feels very much like texting someone because the screen also displays your side of the conversation. You can switch the colors and text size, which I like. I’d rate the accuracy of the other person’s speech at 90%, complete with periods and commas, so you’re reading complete sentences.

How to qualify for a no-cost captioned phone service

A senior can qualify for CaptionCall service at no cost if they have hearing loss and need captions to communicate over the phone. The Telecommunication Relay Service (TRS)7 covers the cost of all captioned phone service for qualified people, and CaptionCall provides the caption phone or mobile app at no cost as part of your service.

Request CaptionCall service for your home or work phone, by completing the form. It’s not necessary for you to have landline phone service or high-speed internet.

You have three options for delivery and installation of CaptionCall:

  1. Red Carpet Service: in-person installation and training
  2. Remote installation: customer installs with live trainer on the phone
  3. DIY installation: customer installs with virtual instructions

How to choose the right captioned phone for seniors

When you’re selecting a captioned senior phone, look for one that’s practical, user friendly, and fits your specific needs. Here’s what to consider:

  • Read reviews. Choose a captioned phone based on user satisfaction and overall value.
  • Determine your level of comfort with technology. If you’re not tech savvy, opt for a simple interface and a few features. You use CaptionCall just like a landline phone except you’re reading the conversation.
  • Decide if you need landline, mobile, or both. You can use both. However, many people tend to use one more than the other. What you choose will depend on your lifestyle and your preferred communication mode. With CaptionCall and CaptionCall Mobile, you can have caption phone service at home, at an office, and on-the-go.
  • Consider emergency features. Some phones come equipped with alert buttons and location tracking. These features can give peace of mind to you and your family members. CaptionCall and CaptionCall Mobile caption 911 calls and can help direct emergency services to your location.
  • Look for built-in accessibility features. CaptionCall’s features include adjustable text size and color, and hands-free speakerphone.
  • Quality customer service. Sorenson delivers high-quality customer service by offering Red Carpet Service for CaptionCall in-person installation and activation. Even better is the 100% satisfaction guarantee. If you don’t like your phone and want to return it, you can do so at no cost. Sorenson’s customer service is based in the U.S., meaning no struggling to understand people overseas.

Conclusion

We know that loneliness among seniors can significantly impact their mental and physical health, creating serious repercussions for global health. Captioned phone service can be a lifeline for seniors with hearing loss, helping them maintain social ties, independence, and stave off social isolation.

When choosing a captioned phone, it’s important to consider factors such as vision, emergency features, and familiarity with technology that meet your unique needs and preferences. The right captioned phone can breed self-confidence and an overall sense of well-being.

Experience the benefits of captioned phone service for the elderly by getting started with CaptionCall today. Take that first step toward improving your communication and well-being.

Request CaptionCall

Sources

  1. Hearing Loss Statistics 2024: More Common Than You Might Think
  2. Can Communication Technologies Reduce Loneliness and Social Isolation in Older People? A Scoping Review of Reviews
  3. Aging Well: Helping the Elderly Maintain Independence
  4. Older people are more likely to live alone in the U.S. than elsewhere in the world
  5. FCC Broadens TRS Fund Contribution Formulas to Add Intrastate VRS and IP Relay Revenues; Updates TRS Contribution Factors
  6. The Benefits of Social Technology Use Among Older Adults Are Mediated by Reduced Loneliness | Cyberpsychology, Behavior, and Social Networking
  7. Telecommunications Relay Services (TRS)

Inclusion in Retail: Upgrading the Retail Environment for Deaf Customers


retail accessibility for deaf customers

Experience the impact of inclusive communication on-demand for retail.

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Inclusion in retail has gained more attention in recent years, thanks to increased focus on diversity and inclusion. More consumers than ever are shopping based on their personal beliefs and values.
A recent Accenture study showed that 29 percent of all shoppers are likely to switch to a retailer that embraces diversity and inclusion. But are we doing enough to include Deaf customers?

Melissa Greenlee, a Deaf woman, went into a women’s clothing store recently, prepared to dole out a couple of hundred dollars on new athletic clothes.

When a clerk approached her, Ms. Greenlee signed that she was Deaf. The clerk looked at her, said, “Sorry,” and then disappeared. Ms. Greenlee said the clerk completely dismissed her, but she quickly bought one item and left the store.

Ms. Greenlee is the CEO and co-founder of Deaffriendly.com, a retail review site where Deaf and hard-of-hearing people leave reviews for stores they visit. The goal is to shine a light on Deaf-friendly retailers and to educate businesses on how they can be Deaf friendly. Ms. Greenlee believes businesses can do better.

“I literally had money burning a hole in my pocket,” Ms. Greenlee said. “Luckily, there was a competitor next door, and because my experience was more positive there, I spent my money there.”

Shopping is typically fun, but inclusion in retail is lacking for Deaf customers. The loud noises (especially for Deaf and hard-of-hearing customers who wear hearing aids) and crowds alone can be off-putting, but even worse is if the retail staff has a dismissive attitude and general lack of awareness of the Deaf customer’s needs.

According to the National Deaf Center (NDC), about 11 million Deaf people live in the U.S. alone. That’s a lot of potential customers who can benefit from a Deaf-centric retail experience.

This blog post explores the critical topic of inclusion in retail for Deaf customers. Deaf people face many obstacles when navigating the retail environment, both in-store and online. We explain the shortcomings of the typical retail environment and provide strategies to help you create an inclusive shopping experience for Deaf and hard-of-hearing customers, from enhancing the store layout to implementing Deaf-friendly online features. Let’s dive into how we can make the shopping space a better experience for the Deaf community.

Impact of accessibility on brand image and customer retention

The accessibility laws passed 50 years ago mandated equal access for how disabled people live and work. Many corporations have followed these laws, legally and because it’s the right thing to do. But in the last seven to eight years, companies started realizing that accessibility isn’t just a moral imperative but also a business advantage. They see their brand reputations, consumer and employee experiences, and financial strategies getting a boost because of their commitment to accessibility.

Deaf consumers represent $9B in discretionary income in the U.S. alone (American Institutes for Research). And their networks — your value-based shoppers — equal a whole lot more. In fact, two out of three Americans say their social values now dictate their shopping choices (McKinsey)​.

When Deaf customers can express their needs in the store and are understood, that creates a positive feeling that encourages them to return to the store repeatedly. If this is missing, frustration sets in, and the customer — Deaf or hearing — will simply go to another accommodating store, which Ms. Greenlee did.

Whenever a Deaf customer has a notably good or bad experience in a retail store, they talk about it with other Deaf people, friends, and family. Word spreads fast, and a store’s reputation can soar or suffer.

Molly, a Deaf advocate, describes some of her difficulties when shopping at Walmart.

“Most are supercenters with a large layout to navigate,” Molly says. “It’s their store policy that if someone asks an employee where something is, they should walk them to that aisle and show the location. But [in my experience] they never do.”

Current state of accessibility for deaf customers

The current state of accessibility in retail globally can seem dim, judging by a UK survey of customers with disabilities. But with some large, well-known retailers (e.g., Google and Target) leading the way for inclusive customer service, this can serve as a call to other retailers that it’s time to embrace language equity for Deaf customers.

One Starbucks store, near Gallaudet University in Washington, D.C., is remarkably accessible to the Deaf population, but customers in all areas want that level of service.

Accessibility is paramount to creating a seamless retail shopping experience.

deaf customers retail inclusion

Conclusion

Everyone deserves an enjoyable shopping experience. Making your store inclusive of the Deaf customer shows that you value their engagement and loyalty.

By optimizing your retail environment to be Deaf-friendly, you’re making a powerful statement about your commitment to inclusivity and respect for every customer, regardless of (dis)ability.

So, are you ready to make your retail space accessible? Sorenson’s experts can help you evaluate how you can start integrating scalable accessibility solutions to support Deaf and hearing customers and staff.

What is the Difference Between a Diverse and Inclusive Workplace?

Diverse and inclusive workplace

For starters, the idea of making your business diverse has been around for a while now, so much so that it is now a cultural mainstay. We have come to embrace the fact that the world is filled with diversity, and for companies to thrive, adding accurate representation in their employment pool is critical for sustained growth. However, workplace diversity comes in many flavors, and some are still underrepresented. This is where we emphasize the importance for businesses to consider a cultural shift around accessibility and inclusion.

Building on workplace diversity: seizing opportunities through inclusion and accessibility

With over 60 million people with disabilities in the US alone, many businesses are not only missing out on a market worth over half a trillion dollars, they’re overlooking the opportunity to strengthen their workplace culture by fostering inclusion.

Accessibility is the foundation to center product inception, content accessibility, event accessibility — heck, even your online website or store. Those values need to start on the inside. To put it in better terms, does your approach to accessibility and inclusion for your teams reflect what you want to present to the public? Are you considering the 26% of people who have some level of disability? Have you considered the Deaf, Blind, and hard-of-hearing communities? More importantly, can ALL your employees have equitable work experiences — from breakroom chats about the weekend to private conversations with HR?

Think about it.

Inclusion starts with creating representation across all types of users. Let’s start with some tips to consider when creating a business shift to accessibility:

What employers need to think about when creating accessible communications

  • Consider adding captions to all internal videos and even adding sign language interpreters to convey your message in ASL (or the predominant sign language for your audience).
  • If you have a company intranet, consider adding videos in ASL for Deaf employees to better understand your corporate messaging.
  • Showcase recruiting materials that feature sign language — providing a diversification of assets to cater to different audiences.
  • Create a website that meets WCAG and ADA compliance standards for users with disabilities.
  • Add accessibility in user-centered design.

If you have Deaf and hard-of-hearing employees on your team, capitalize on their valuable perspective. Analyzing your approach from multiple angles is key to spotting opportunities and missteps for accessible communications.

What it takes to build an inclusive workplace (and why it’s worth it)

Now let’s look into decision-makers and why they play a critical role in bridging the gap between diversity and accessibility.

What business decisions should private and public entities consider when making strides to incorporate accessibility as their business model?

Start by asking:

  • Are our products, marketing, and support teams accessible to everyone? If not, what do we need to change to make them accessible?
  • Are my employees and customers equipped with the right tools to communicate with everyone? If not, what tools exist to provide equal service to everyone?
  • Does my organization employ individuals with disabilities? If not, what do I need to do to attract the right talent for my business?
  • How does shifting to an accessibility-centric business impact our bottom line?
  • How does my company’s brand reputation reflect accessibility and inclusion?

As the worldwide leader of inclusive technologies for Deaf and hearing connection, we’ve made it easy with answers for you and your business to get started. These curated tips are coming from our Sorenson committees who represent an inclusive pool of users who are Deaf, Blind, hard of hearing, and hearing.

Making your products, marketing, and support teams accessible to everyone

Start an inclusive committee (think Employee Resource Groups) including external and internal end-users as part of your product development process. Use them as feedback loops to optimize and generate better ways to make the product and content accessible to a diversified group.

Equip employees and customers with the right tools to communicate with everyone

Embrace diverse cultural and accessibility needs by showcasing communication and accessibility tools to attract diversified talent and customers for your business. For example, Sorenson Express is a first-of-its-kind video-conferencing tool for on-demand ASL interpreting. It’s both an employee and customer solution for spontaneous or urgent interpreting needs.

Learn more about Express here

Employ individuals with disabilities within your organization and attract the right talent for your business

Before you start spending money on recruiting or creating talent attraction campaigns, look at what your company has done for the community and what changes you’ve made as a business to be 100% inclusive for all. Candidates will notice your communications and support channels, so make sure you are optimizing those departments to be accessible. Some great companies who are leading by example are Apple (via its SignTime support program) or Ford Motors with its steps to cultivate a culture of inclusion and accessibility.

The impact of shifting to an accessibility-centric business on your bottom line

Businesses with a focus on democratizing communication for everyone see an increase in their bottom line, with 28% – 30% greater profit margins and twice the net income of their industry peers, per the Inclusion Advantage study by Accenture Research.

While many organizations have prioritized workplace diversity over inclusive workplaces, both are equally important to business success. Language solutions, including sign language interpreting services like Sorenson Express, are helping companies — from Fortune 500s to small businesses, including Deaf-owned enterprises, higher education, and government agencies — leverage new ways to make meaningful connections through technology.

Hearing Loss and Mental Health: Risks and Resources for Veterans

veteran with hearing loss lifting weights

It is common for many people to thank members of the Armed Forces for their service. This is especially true around the major military-related holidays such as Veterans Day. We do so because we respect them and what they’ve done for our nation, both active-duty and Veterans.

We also recognize that they often put themselves at risk in the course of their military service. This is why, fair or not, this gratitude can be more heartfelt or be expressed more frequently when the Veteran has a visible disability such as scarring or the loss of a limb.

However, not all disabilities are visible, which we often forget. We tend to look at someone who is walking around without any visible issues as being “fine”. This is not always the case and that is especially true for Veterans.

Two hidden disabilities that are prevalent among Veterans are hearing loss and mental health. Both can have substantial impacts.

Is Veteran hearing loss common?

Hearing loss is one of the most common conditions among Veterans, particularly among those who have been exposed to loud noises and combat-related situations during their military service.1 Loud noise from gunfire, explosions, machinery, and other military equipment can contribute to both temporary and permanent hearing damage.

According to the CDC, Veterans are 30% more likely to have severe hearing loss than a nonveteran.2 More than 1.3 million Veterans received VA hearing loss disability compensation in 2020, and another 2.3 million for tinnitus.1

This affects them in ways that may not be immediately obvious, such as employment. The Department of Labor reports that for the time period of October 2022 – September 2023 the employment rate of Veterans with a disability (5.1%) was slightly lower than that of nonveterans with a disability (7.1%) but significantly higher than that of Veterans with no disability (2.5%) and nonveterans with no disability (3.4%).3

Veterans of different eras may have varying levels of risk for hearing loss due to military service. For example, Veterans of World War II and the Korean War may have been exposed to noise levels that were not well-controlled, while modern Veterans from conflicts like Iraq and Afghanistan have had improved hearing protection and awareness.

This, unfortunately, does not completely remove or mitigate the risks inherent in being around these loud noises. Damaging noise levels often happen without warning while deployed.

Dave, an Army Veteran, explains, “The situation dictates, right? When we’re getting shot at or when things happen in theater, we can’t just go tell the enemy, ‘Hey, cease fire, wait ‘til we put our hearing protection in.’ Things are going to happen suddenly, and we can’t help that.” 4

Veterans with service-connected hearing disability can access VA benefits for hearing loss, including compensation and access to hearing healthcare. The VA encourages Veterans to undergo hearing evaluations and seek assistance if they believe they are experiencing hearing problems due to their military service. In fact, the VA is the largest employer of audiologists and speech-language pathologists in the United States.5

va hearing disability testing

Veterans with hearing loss may be at an increased risk for a range of mental health issues that affect the Veteran community:

  • Depression: Hearing loss can lead to feelings of isolation and social withdrawal, which are common triggers for depression. Veterans may struggle with the loss of communication and connection with loved ones, which can exacerbate depressive symptoms.5,6,7
  • Anxiety: The stress of coping with hearing loss, especially in social and work settings, can trigger anxiety. Veterans may worry about missing important information or being unable to effectively communicate with others, leading to heightened levels of anxiety.5,7
  • Communication difficulties: Hearing loss can hinder a person’s ability to communicate effectively, leading to frustration, anger, and a sense of helplessness. These emotions can contribute to mental health issues and may strain relationships.5,7,8
  • Social isolation and loneliness: Hearing loss can lead to social withdrawal and isolation, as individuals may avoid social gatherings due to communication difficulties. This isolation can worsen feelings of loneliness and contribute to mental health challenges.5,7
  • Post-Traumatic Stress Disorder (PTSD): Many Veterans have experienced traumatic events during their service, and the added stress of hearing loss can exacerbate symptoms of PTSD.9

These issues can be complex and interrelated, impacting individuals’ overall well-being.

For Jeremy, a Marine Veteran, having to constantly ask his wife, children, and colleagues to repeat themselves caused stress and tension as it became clear he was struggling to hear. As Jeremy’s hearing grew worse — a problem he suspects arose from shooting weapons with inadequate ear protection while in the military and from closely editing sound in films — he says he began experiencing pseudo-auditory hallucinations, a side effect of tinnitus and hearing loss due to military service. He blames the decline in his hearing for ending his career in communications.

Jeremy was one of the many Veterans who hesitate to get help. He says he avoided talking to anyone about it or going to a VA medical center, fearing they would say he was crazy and because he wasn’t sure it would actually help. Had he known about the prevalence of hearing loss in the Veteran community, he might have sought help sooner.

“No one ever talks to us about how tinnitus and hearing loss affects Veterans. It’s worse at night when we’re tired and things around us are dark and quiet, and we’re so close to falling asleep; the experience can be absolutely terrifying.” 10

Many Veterans may experience a combination of side effects from hearing loss. Seeking professional help, including hearing loss treatment, therapy, or support groups may make it easier to manage these challenges. Several organizations offer resources specifically for Veterans. There are also tools available that can improve communication, which may help.

Ways to avoid isolation and social withdrawal

Veterans with hearing loss risk isolation if they use avoidance to cope with difficulty hearing, which can feed mental health problems. Instead, tapping into resources will help them maintain their social connections and engagement.

Seek appropriate treatment

Consult with a healthcare provider or audiologist to assess the extent of hearing loss and discuss treatment options. This may include hearing aids, cochlear implants, or other assistive devices.

If they’re struggling emotionally due to hearing loss, counseling or therapy can help address feelings of isolation, depression, or anxiety.

Use assistive devices and communication apps

Modern technology offers many options for people with hearing loss. As VA Audiologist John K. says, “Today everyone has things in their ears — ear buds and headphones — so the stigma of wearing hearing aids has diminished. We have state of the art hearing aids that are connected to people’s smart phones. The advanced technology has been a game changer.” 10

High-quality hearing aids or cochlear implants have come a long way in both fit and features, and they can significantly improve people’s ability to hear and communicate. Modern hearing aids often come with Bluetooth connectivity for convenient communication and compatibility with their devices.

When Jeremy’s community provider learned he was a Veteran and suggested he check out the VA audiology clinic, saying it was one of the best, he got past his fear, applied for VA health care, and made an appointment. “I was shocked. I received top of the line care and hearing aids with the latest technology that works with my phone, something I couldn’t afford on my own,” he said. His doctor also programmed his hearing aids to his individual hearing level and needs. (10)

Communication apps and devices are also available for people with hearing loss. For example, Veterans who need captions of their phone calls because of their hearing loss are eligible for federally funded captioned phone services for home phone or mobile at no cost.

Video relay services are available for those who are Deaf or profoundly hard-of-hearing and use sign language.

Closed captioning can also fill in the gaps so people can continue to enjoy videos, movies, and television shows no matter what their hearing loss is.

Communication strategies

For hearing loss that is not significant enough to require hearing aids, learning effective communication strategies such as lip reading and visual cues can supplement hearing, especially when conversations are in loud environments such as restaurants or places with lots of background noise.

Veterans should educate friends and family about their hearing loss, its challenges, and how they can help. That could include speaking clearly and facing them when they talk to improve communication.

Join support groups

Connect with local or online support groups for individuals with hearing loss, including Veteran-focused groups. Many Veterans’ organizations offer support and activities tailored to Veterans with hearing loss.

These Veteran support groups may also host workshops or classes focused on hearing loss and communication skills that can build confidence in Veterans’ ability to communicate effectively despite hearing loss.

Remember that hearing loss is a common challenge, and there are many resources and strategies available to help Veterans stay connected and involved in their communities.

General mental health among Veterans

Hearing loss isn’t the only risk factor for mental health challenges among Veterans. Veterans — especially those who have served in combat — may experience mental health issues related to challenges they face during and after deployment. These mental health issues may begin during their service or pop up later. Some common mental health issues among Veterans are:

  • Post-Traumatic Stress Disorder (PTSD): PTSD is prevalent among Veterans who have been exposed to traumatic and life-threatening experiences during their service. Symptoms may include flashbacks, nightmares, hypervigilance (being especially alert to what is going on around them), and emotional numbness.11
  • Depression: Veterans may experience depression due to the stress of military service, difficult combat experiences, or the challenges of transitioning back to civilian life. Symptoms can be persistent sadness, fatigue, changes in appetite, and feelings of hopelessness.13,14
  • Anxiety: General anxiety, panic, and social anxiety can affect Veterans, often coming from the stress related to military life and deployment.11,12,13
  • Substance abuse: Some Veterans turn to drugs or alcohol as a way to cope with emotional and psychological challenges. Substance abuse can lead to addiction and worsen other mental health issues.14,15

Every Veteran has their own story.

After three tours in Iraq, Duane says he struggled with PTSD and alcohol misuse upon reentering civilian life in 2012. When he realized he needed to change, he says part of the process was admitting he couldn’t do it himself. “It takes strength to know you can’t do it on your own,” he said. “We’re so focused on being individuals, we forget that we’re better as a team. That’s what mental health treatment is. It’s about finding a team that works for you.” 15

Getting treatment for mental health can help with other parts of recovery and treatment from injuries.

Chad served in the Marines, and on his last tour an Improvised Explosive Device (IED) blew up under his tank, shattering everything below his knees. Besides the medical issues, he says he also had PTSD.

He describes having so much pain he was taking painkillers just to walk and get out of bed and work. Connecting with a psychologist through the VA is what he credits with helping him through the decision to move forward with life-changing amputations. “I probably went two times a week for six months and I can’t believe how much that helped me,” Chad said. “It was a real relief. So by the time I had my surgery in January of 2008 for a double amputation, I was comfortable. I was ready.” (18)

Mental health services are available through a number of organizations. Duane and Chad found teams that helped them tackle physical and mental trauma to lead happy, productive lives — so can other Veterans.

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Mental health resources for Veterans

Mental health resources for Veterans can assist in addressing the unique challenges after military service. Below are a few of the many mental health resources available to Veterans:

  • Department of Veterans Affairs (VA) Mental Health Services: The VA offers a wide range of mental health services, including counseling, therapy, and support groups. Veterans can access these services at VA medical centers and clinics.
  • Veterans crisis line: The Veterans Crisis Line provides 24/7 support for Veterans in crisis. Call +1 (800) 273-8255 and press 1, or text 838255 to connect with trained professionals who can help.
  • National Center for PTSD: This resource from the VA offers information on PTSD, including self-help tools, treatment options, and educational resources.
  • Give an hour: This nonprofit organization offers free mental health services to military personnel, Veterans, and their families through a network of volunteer mental health professionals.

Veteran hearing loss resources

There are also many resources available to help Veterans address and manage their hearing loss. Here are some hearing loss resources for Veterans:

  • Veterans Health Administration (VHA): The VHA provides comprehensive healthcare services to Veterans, including hearing healthcare. Veterans can receive hearing evaluations, hearing aids, and other related services through VHA facilities. The VHA website offers information on available services and how to access them.
  • Hearing Loss Association of America (HLAA): While not exclusive to Veterans, HLAA is a valuable resource for individuals with hearing loss, including Veterans. Its website and local chapters can provide information and support.
  • American Tinnitus Association (ATA): Tinnitus is a common issue associated with hearing loss, and many Veterans experience this condition. The ATA provides resources, support, and information about tinnitus.
  • VA prosthetics and sensory aids service: This VA service provides hearing aids for Veterans, assistive listening devices, and other adaptive equipment to Veterans with hearing loss. It can help Veterans assess their needs and provide the necessary equipment and support.

Additionally, Veterans with hearing loss should also explore the resources and support that various Veterans’ service organizations and nonprofits offer. These organizations often have programs and services that can assist Veterans with hearing loss and other disabilities.

Sources

  1. Veterans — Hearing Health Foundation
  2. The Prevalence of Hearing Loss in Veterans
  3. Veteran Unemployment Rates
  4. Off the battlefield, many veterans face a new foe: damaged hearing
  5. Hearing Loss
  6. Depression and Hearing Loss — American Academy of Audiology
  7. Veterans and Hearing Loss — Aspire Audiology
  8. The impact of hearing impairment and noise-induced hearing injury on quality of life in the active-duty military population: challenges to the study of this issue
  9. Co-occurrence of hearing loss and posttraumatic stress disorder among injured military personnel: a retrospective study
  10. Veterans with Hearing Impairment Provided State-of-the Art Treatment Options | VA Maryland health care | Veterans Affairs
  11. Veteran and Military Mental Health Issues
  12. For Most Vets, ‘Transition Stress’ Is the Problem, not PTSD. Here’s What That Means.
  13. VA.gov | Veterans Affairs
  14. Substance use disorders in military veterans: prevalence and treatment challenges
  15. Iraq War Veteran With PTSD Finds His Own Path to Peace
  16. Four Stories That Will Inspire You This Mental Health Awareness Month

Your Guide to Finding the Best Earplugs: Options for Comfort, Hearing Protection, and Noise Cancellation

There’s a wide variety of earplugs on the market these days: different sizes, shapes, materials, and designs to suit a range of needs and situations. Some options are downright fashionable, as much accessories as they are functional. The broad selection means you can find earplugs to meet your specific needs, whether that’s hearing protection or simply some peace and quiet.

The options can be overwhelming, so we’ve broken it down and solicited a few audiologists’ advice to simplify your decision. We’ll cover considerations such as:

Decibels and hearing damage: what decibel level is harmful?

Let’s start with the most obvious reason you’d use earplugs: to protect your hearing in noisy environments.

We measure noise in decibels (dB); the higher the decibels, the louder the noise. For example, a still winter day in the woods would probably register 10 – 20 decibels. Compare that to a firetruck siren at 110 – 130 decibels.

dB vs dBA

If you start digging into the science of noise, you’ll come across both dB and dBA. Without geeking out too hard, dB is a measurement of decibels that includes frequencies humans don’t hear. To more accurately gauge the impact on our hearing, dBA is a weighted measurement of noise only in the range that humans can hear. That means the same sound can have a different dB and dBA.

What is noise-induced hearing loss

As a general rule, anything below 70 decibels won’t damage your hearing.

Exposure to noise levels above that, however, can cause temporary or permanent hearing loss. It’s called noise-induced hearing loss, and it can result from exposure to a single loud noise or prolonged exposure to noise that damages the sensitive parts of your inner ear that process and transmit sound waves.

Exposure to loud noise is one of the most common causes of hearing loss. About 19% of the world’s population has some degree of hearing loss, and those numbers are rising. Researchers estimate as much as 24% of American adults and 17% of teenagers have some degree of noise-induced hearing loss.

The higher the decibels, the shorter duration of exposure before you can damage your hearing. The following chart is a guideline for how long it takes for common noise levels to potentially cause hearing loss:

noise induced hearing loss chart for ear plugs

The good news is hearing loss from noise exposure is 100% preventable, and even if you already have some noise-induced hearing loss, you can prevent further damage by using hearing protection, like earplugs.

At what decibel level is hearing protection required?

You can gauge from the table above what decibel (dB) level is harmful. To avoid noise-induced hearing loss, you should use hearing protection for prolonged exposure to noise above 70 dB or even a short time in a very loud environment, like near a jackhammer.

Of course, it’s not realistic that you’ll know exactly how loud your surroundings are all the time…though, if you’re interested, you can get decibel meter or sound level meter apps for your smartphone. SoundPrint — which is also on our list of best hearing loss apps — is one example which not only includes a decibel meter, but allows users to submit the noise level of different locations to help others find quiet locations.

Do people with hearing loss need to wear earplugs?

“The volume never seems too loud to me. I have a hard time hearing as it is. Do I still need earplugs?”

Yes. If you have hearing loss, wearing high-fidelity earplugs in noisy places can actually help reduce background noise to allow you to better hear your conversation or music. And wearing any variety of earplug will help prevent further hearing loss.

If you’re concerned about using earplugs for hearing protection because of your existing hearing loss, custom hearing protection from a hearing healthcare provider/audiologist will be especially beneficial, and you may consider captioning as well. Live transcription apps for smartphones are also among our favorite hearing loss apps.

Understanding Noise Reduction Rating (NRR)

An obvious place to start in choosing the right earplugs is with Noise Reduction Rating (NRR). It’s going to be essential to your decision, whether you’re looking for earplugs for sleep, focus, or dangerous noise levels.

What is NRR?

Noise Reduction Rating (NRR) is a standardized measurement of the maximum amount a hearing protection device can reduce the intensity of noise (when used correctly), based on lab tests that factor in type of noise, frequency, and duration of exposure.

Conveniently, you’ll typically see NRR in decibels, so you can gauge whether an earplug will provide adequate noise reduction by subtracting its NRR from the noise level of your intended activity. For example:

  • If you’re on a motorcycle, with a noise level around 100 dB, and you’re wearing earplugs with an NRR of 30 dB, your noise exposure works out to 70 dB. That puts your exposure at a safe level even for prolonged riding.
  • If you share a bedroom with a loud snorer who’s sawing logs at 60 dB, and you’re using earplugs with an NRR of 20 dB, that reduces your noise exposure to the equivalent of the soft hum of a refrigerator.

When your goal in using earplugs is hearing protection, you should aim for an NRR that will reduce your noise exposure to a safe level, ideally 70 dB or lower.

Maximum possible NRR

If you’re looking for the best earplugs for noise reduction, you’re probably searching for the highest NRR out there, and you’re going to top out around 33 dB. For most use cases, that’s enough, but it won’t reduce very loud noise — like gunfire, heavy machinery, or explosions — to safe exposure levels. High decibel earplugs are a great place to start, and you have a couple options to better protect your hearing in very noisy environments.

Dual hearing protection

You can achieve an NRR above 33 decibels by combining two types of hearing protection. Most often, wearing foam earplugs and ear muffs together. However, when you double up on hearing protection, you don’t double your NRR. Using a second type of hearing protection will add roughly 5 dB of additional NRR. So if you add ear muffs while wearing earplugs with an NRR of 33 dB, you could get up to 38 decibels of total noise reduction.

Limit duration of noise exposure

If you can’t reduce your noise exposure to safe levels, reduce your length of exposure. When the noise in your environment averages above 70 dB, try to limit the time you spend around it.

For example, if you’re on your laptop and a construction crew is working nearby, making a lot of noise, move to another location where the noise is lower. Another example from Sorenson’s own audiologist Stephen DeMari: avoid positioning yourself right next to speakers at a concert; even with earplugs, that can be unpleasant.

Types of earplugs

Deciding on a type of earplug can be daunting. There are significant differences in NRR, comfort, and cost. To narrow down the selection, audiologist MarieAnn Z tells us her guidance is simple:

“Consider the situation you will be using the hearing protection, your expectations for hearing in noise (like a concert versus a work environment). Is this something you will use daily, weekly, monthly?”

While you have dozens of options varying in style, material, and cost, they boil down to a few basic categories:

foam ear plugs

Foam earplugs 

Low tech, low cost, and effective. These soft foam cylinders are readily available over-the-counter and have some of the highest noise reduction ratings (NRR) of any earplugs out there. You tightly roll the squishy foam before inserting and let them expand in your ear canal. These don’t play favorites with which sounds they block, so they make it difficult to hear speech (including your own) or music.

NRR: up to 33 decibels 

Pros:

  • Excellent noise reduction ratings
  • Affordable and widely available over-the-counter
  • Comfortable for extended use
  • Available in disposable or reusable options

Cons:

  • Some users experience discomfort or ear pressure
  • May not fit perfectly in all ear canals
  • Not as green an option as long-term reusable varieties

Cost: typically $0.10 – $0.50 per pair for disposable options or $2 – $15 for a reusable pair, depending on the brand and features

NRR: 20 – 33 dB when properly inserted

pre molded ear plugs

Pre-molded earplugs 

These reusable earplugs come in a variety of materials — plastic, rubber, or silicone — as well as several sizes and designs, including fashionable styles. They’re easy to put in, with no rolling required, and may create less sensation of pressure in your ear than expanding foam.

This category can include high-fidelity (hi-fi) earplugs, also called uniform-attenuation earplugs. They have the same effect as turning down the volume on a stereo: the sound intensity decreases evenly across different pitches, so it’s not distorted. You might find high-fidelity earplugs especially helpful at movies or concerts so you can appreciate audio quality and speech.

Pros:

  • Selection of sizes to better fit your ear canal
  • Reusable and easy to clean
  • Some create a watertight seal, making them suitable for swimming
  • High-fidelity options
  • Range of aesthetic options, including color and shape

Cons:

Cost: may range from as low as $10 for basic options to as much as $50 for specialized and high-fidelity

NRR: 15 – 25 dB

canal cap ear plugs

Canal caps  

Canal caps come in both pre-molded and formable varieties. You can even get custom-made canal caps as well as over-the-counter. Their distinguishing features is a stiff band that applies light pressure to hold the earplugs in place while inserted, and when not in use can hang around your neck. That makes them a popular choice among users who alternate between needing hearing protection in noisy environments and needing to hear clearly.

Because canal caps can include both off-the-shelf or custom options as well as formable or molded earplugs, cost and NRR will vary.

Pros:

  • A snug and secure fit
  • Multiple options for different use case
  • Custom and off-the-shelf varieties available

Cons:

  • May be more expensive than basic foam earplug
  • Limited size and shape options mean some users find them less comfortable for extended wear

Cost: a wide cost range, depending on features, intended use, and whether you opt for custom canal caps. Off-the-shelf, you may find a pair for as little as $5, while custom options may cost up $100 – $500.

NRR: varies by fit and material

wax silicone putty ear plugs

Wax or silicone putty earplugs 

Wax or silicone putty earplugs are the most pliable variety of hearing protection, allowing you to shape them to your ears for a comfortable fit and a tight seal. However, wax or silicone isn’t the best material to insert into your ear canal, which limits the effectiveness of this type of earplug for noise reduction. Audiologist Stephen DeMari points out they’re still a better option than no hearing protection at all or shoving cotton or tissue in your ears.

Pros: 

  • Mold to the shape of your ear, so you can adjust fit
  • Can create a watertight seal for swimming and water-related activities

ble use while sleeping

Cons: 

  • Less effective in very noisy environments
  • Some risk of melting in ear canal

Cost: typically $2 – $10

NRR: 20-25 dB

custom molded ear plugs

Custom molded earplugs 

Custom earplugs from a hearing health professional are the top-tier option for hearing protection and comfort. The provider will take a mold of your ears to create a perfect fit for your ears specifically. You can also tailor the design, NRR, and noise filtering for your intended usage — for everything from sleep to construction work. Custom fit earplugs also typically allow you to choose their color, even including options like glitter, glow-in-the-dark, or marbling effects.

Pros: 

  • Ideal fit for maximum comfort
  • Fully customizable to your intended use and NRR needs
  • High-fidelity options
  • Lower risk of getting stuck in ears

Cons: 

  • More expensive than most off-the-shelf options

Cost: $100 – $300+

NRR: 15 – 33 dB

If you consult a hearing health professional for custom hearing protection, you may also want to take the opportunity to test your hearing. If you already have some degree of hearing loss, an audiologist can recommend a holistic plan to protect you from further hearing loss and improve your day-to-day hearing as well.

If you have hearing loss that’s affecting your ability to use the phone and you need captions for your calls, your hearing health provider may suggest you sign up for no-cost phone call captioning using the CaptionCall Mobile app by Sorenson or CaptionCall by Sorenson for home phone.

noise cancelling ear plugs

Noise-cancelling earplugs 

In addition to conventional earplugs that physically block noise (noise-reducing earplugs), you also have the option to tap into digital technology in the form of noise cancelling earbuds. These electronically cancel out specific frequencies, like the hum of an airplane engine or the hubbub of a busy location. Because they can connect to your devices, noise-cancelling earplugs will also allow you to listen to audio through them while they remove background noise around you — earplug headphones.

Pros: 

  • Counteracts bothersome frequencies
  • Double as earphones for listening to audio

Cons: 

  • Cost is higher than many other off-the-shelf earplugs and may be more expensive even than custom earplugs
  • Don’t protect hearing from sudden loud noises
  • Require batteries or charging
  • Limited size and shape options mean some users find them less comfortable for extended wear

Cost: can range from $50 to $300+, depending on brand and features

Choosing the best earplugs for specific use cases


Earplugs for sleeping 

Comfort is critical when choosing earplugs for sleeping, and comfort will come down to a combination of material and fit. You’re likely to have the best luck with a soft material: foam, silicone, or wax.

Audiologist Marnie R. recommends that if you’re using earplugs primary for sleeping, size and shape are also worth considering:

“Sleeping plugs are most comfortable if they are made CIC style, just in the canal. The material should be somewhat softer than a standard earplug, so as not to cause discomfort if you are a side sleeper.”

To decide on an NRR, consider whether you want near-silence or need to be able to hear some sounds. For example, if you want to be able to hear a crying baby or are worried you won’t wake up to your alarm, you might choose an NRR in the mid to upper teens versus an NRR of 25 or above if you’re a light sleeper trying to drown out city noise or you share a room with someone who snores.

You can also try noise canceling earplugs for sleeping, but the firmer material may not be comfortable for side sleepers.

Earplugs for concerts, musicians, and movie theaters 

High-fidelity (hi-fi), or uniform attenuation, earplugs are going to be your best bet when you want to clearly hear audio while lowering the noise level. Pre-molded or custom fit earplugs offer this option, using filters to preserve sound quality and still lowering your noise exposure to prevent hearing damage.

For musicians or people who frequently attend concerts or movies, custom earplugs may be worth the investment for a perfect fit plus the ability to tailor them to your specifications for sound filtering.

As far as the NRR of earplugs for concerts, the decibel level of indoor live music can easily be more than 100 decibels, so you won’t regret an NRR of 25 of higher.

Earplugs for shooting 

When you’re looking for earplugs for the shooting range, go for maximum NRR. Either foam earplugs or custom earplugs with an NRR of 30+ are a must, and earmuffs on top of them is a good idea.

For hunting, it’s still important to protect your ears from the damaging decibel levels of gunfire, but it’s understandable you do want to be able to hear other sounds around you. Some companies make specialized electronic earplugs that can activate noise suppression when they detect loud noise, but amplify ambient sound when it’s quiet so you can hear what you need to.

Earplugs for focus, sensory overload, and audio sensitivity (hyperacusis and misophonia)

Individuals with sensory sensitivities, hyperacusis, or misophonia — including some people with autism or ADHD — notice significant benefit from using earplugs to reduce sensory overload or improve focus by blocking distracting noise.

What is hyperacusis? What is misophonia? And What’s the difference?

Hyperacusis is a heightened sensitivity to even everyday sounds that makes them seem louder to you than to everyone else, even to the point of hurting your ears.

Misophonia is an extreme dislike of certain noises, even at a normal volume, to the point that hearing them makes you agitated or downright angry. For example, hearing other people chew.

If you deal with hyperacusis or misophonia earplugs can stifle offending noises and offer a little peace.

Because you’re likely to wear these regularly and potentially for extended periods, comfort is likely to be a priority. Your most comfortable option is custom earplugs.

For a less expensive choice, foam, wax, or silicone putty earplugs are soft and bendable to the shape of your ear. These will block or muffle all noise, which may be exactly what you want.

You may prefer to block distracting or overstimulating ambient noise while still being able to clearly hear music or someone speaking to you, making high-fidelity custom or pre-molded varieties your best choice.

If your intended use is noise sensitivity and not hearing protection, noise cancelling earplugs may also work well for you.

Earplugs for swimming 

Swimming earplugs have one job: create a watertight seal to keep water out of your ears. But that doesn’t mean you can’t put them to work on two fronts. The best earplugs for swimming can also offer hearing protection to extend their usefulness.

Custom earplugs, wax, or well-fitting pre-molded earplugs can all seal off your ear canal from water. The custom or pre-molded route are reusable and can also offer hearing protection, so they’re an investment you’ll get double use of.

Just a one-off need because you forgot your molded earplugs? Wax or silicone putty are affordable and can do the job. Avoid foam earplugs for swimming because they’ll act like a sponge in the water.

Earplug fit and comfort

Remember that the effectiveness of earplugs also depends on proper fit and usage. No matter how much you spend on a set of earplugs or how high the NRR, they’re not going to give you the results you want if the fit isn’t right or you don’t have them inserted correctly.

Audiologist Marnie R. says nothing is more important than getting the right fit on your earplugs for comfort and effectiveness:

“I work with an office that does almost as much hearing protection as we do hearing aids. What we have found is that for those wanting hearing protection for hunting/concerts/construction...etc, the fit is extremely important…Custom built hearing protection works so much better than foam earplugs.”

Without investing in custom hearing protection, you can opt for foam earplugs or wax/silicone putty for their ability to form to the shape of your ear. The softness of the material means nearly anyone can squish the material to fit their ears.

With any earplugs, proper insertion will make or break their noise reduction and comfort. With foam plugs in particular, it’s important to follow the instructions, twisting them down to the narrow width you can fit in your ear canal and then letting them expand in your ear. Earplugs that comfortably fit deep in your ear canal will provide the most sound reduction.

DeMari suggests looking in a mirror or asking someone to look at you straight on. If your earplugs are visibly sticking out, they’re not in correctly.

Even in the case of fashionable pre-molded earplugs designed to be visible, they shouldn’t be hanging out of your ears. If you can’t wear them securely without discomfort, they’re not a good fit. Because no two people’s ears are quite the same size and shape, a molded earplug that comfortably fits someone else won’t necessarily fit you.

Material makes a difference not only in fit and use case, but also if you have allergies to plastics, silicone, or latex. If you have allergies to these common earplugs materials, you can ask a doctor or audiologist about alternative options.

Where to get earplugs 

Ultimately, the best choice of where to buy earplugs is going to come down to how you plan to use them.

From a hearing health provider

All of the audiologists we talked to agree that custom molded earplugs from a hearing health professional will give you the best fit for comfort and effective noise reduction. So for regular use — or if you struggle with earplugs that don’t fit your ears — they may be worth the investment.

To find a hearing health care provider, you can search through your health insurance directory, especially if you want to establish a relationship for hearing health care.

You can also look for providers in your area using an online directory like the one through Healthy Hearing to browse thousands of hearing health clinics.

Off-the-shelf

However, off-the-shelf options are perfectly acceptable for one-time or occasional use. You can find foam earplugs at a wide variety of retailers: hardware stores, pharmacies, department store chains, even some convenience stores carry them.

There’s a large selection of pre-molded earplugs and noise canceling earplugs online, but you can also find options from big box retail stores and specialty music stores.

Connection in Mixed Deaf, Hearing, and Hard-of-Hearing Families

Family is where it all begins. Those are the people who shape us and our worldview. They’re our first and most important relationships. They teach us to communicate. When hearing loss or deafness adds complexity to our family, we don’t give up on connection: we make it work.

We’re going to explore how a variety of families connect across different hearing statuses and the information and resources to support mixed hearing communication:

What are the different categories of hearing loss?

According to the National Library of Medicine: 1

A hearing loss of up to 20 decibels below the hearing threshold is still considered to be normal hearing. More severe hearing loss can be described according to severity, as follows:

  • Mild hearing loss: Hearing loss of 20 to 40 decibels.
  • Moderate hearing loss: Hearing loss of 41 to 60 decibels.
  • Severe hearing loss: Hearing loss of 61 to 80 decibels.
  • Profound hearing loss or deafness: Hearing loss of more than 81 decibels.

Hard-of-hearing is a loss between mild to moderate on this scale,2 where there may be enough residual hearing that an auditory device, such as a hearing aid, benefits the individual.3 These people may struggle with a quiet or typical conversation.

The profound hearing loss that qualifies as medical deafness equates to very little or no functional hearing.3

For perspective, these are the decibel levels of some common sounds

  • Quiet conversation: 40 dB
  • Normal conversation: 60 dB
  • Traffic: 80 dB
  • Industrial noise: 100 dB
  • Very loud music, for example at a rock concert or a nightclub: 120 dB
  • Nearby thunder: 120 dB
  • Jet engine: 140 dB

The only way to accurately measure a hearing loss of specific decibels is a hearing loss test. An audiologist can perform a variety of hearing loss tests and can recommend treatment or technology that may make everyday life and communication easier.

Communication in hard-of-hearing and hearing families

More than 37 million Americans say they have some trouble hearing, and it’s more common with advancing age.

There are a lot of people out there who don’t have perfect hearing, especially in older generations. The greatest amount of hearing loss is in the 60-69 age group4. Many of them are used to being able to hear and speak normally for most of their lives and start experiencing hearing loss at some point. Young and middle-aged adults are developing hearing loss at a higher rate than previous generations, largely due to noise exposure, including listening to media at a high volume through ear buds or headphones.5

People new to hearing loss often are embarrassed, apologetic, or in denial. These feelings may present additional challenges in communicating even with the people closest to them. But many families include someone with hearing loss, and they adjust to get through to each other:

Irene

On the other end of the spectrum is Irene, who was relieved at her recent diagnosis of “hidden hearing loss”/Central Auditory Processing Disorder (CAPD) after 47 years of not “knowing that what I was inadvertently struggling with could be managed with hearing aids.” She says for decades her hearing loss affected how she interacted with her family. “More than anything it’s been incredibly annoying. I was diagnosed … about 6 weeks ago. I ‘heard’ just fine but didn’t always understand.”

“I did not realize that I had any hearing issues until I kept using CC (closed captions) while watching TV. I was struggling to parse out different instruments while listening to music, and I had trouble hearing/understanding others while in conversation. I currently use hearing aids and keep the CC on. The hearing aids are Bluetooth, which is pretty cool and easy to manage.”

Irene is part of a growing trend of young and middle-aged people who use hearing aids to improve their quality of life and communication.6 They’re defying years of stigma attached to hearing loss and generating mainstream demand for assistive technology. “Oddly enough,” Irene adds, “now that I know what makes it harder for me to understand, I have zero shame in telling others. If I can help others in a similar situation, I will do it!”

She says figuring out her hearing situation has eased the frustration of trying to connect with people she cares about and enhanced her daily life. “Please, please get your hearing checked, and not just the standard test. Ask about CAPD and ask that you get tested for it. Now that I can hear and understand so much better, my burden is so much lighter. I had no idea how much mental energy I was using on a day-to-day, existing basis. I had no idea that music is so much more vast and colorful!”

Communication in Deaf and hearing families

There can be wide variations in communication methods in Deaf/hearing families to fit the preferences of Deaf people who are oral (speaking with their own voice and listening with the assistance of devices such as hearing aids or simply lipreading) or use signed languages as well as the language skills and hearing ability of their loved ones.

More than 90% of Deaf children have hearing parents4 — and, likewise more than 90% of Deaf parents have hearing children7 — so Deaf, hearing, and hard-of-hearing people learn to connect across hearing status with their own family members.

Deaf and hearing communication

Yuliya

Yuliya is Deaf and is the only person with hearing loss in her birth family. Her husband is Deaf but they accommodate her hearing family. “None of my family members sign. My kids sign, but the adult members of my family don’t. I speak with them. I am used to it — I grew up oral. I was not really exposed to Deaf culture while growing up. When I went to college, I was exposed more to Deaf culture, the history, the language, etc., and I loved it.”

Yuliya’s children are Codas and she sees the mixture of cultures and languages in them. “My children are mostly in the Deaf culture right now because they are still pretty young and are just with my husband and me. They communicate with us through sign language. But when they see the hearing members of my family, they will use their voice, so we’ll see how things change (which culture they feel most part of) as they get older.”

What is a Coda?

With the success of the 2022 movie, CODA, this term has been in the media more. Coda (sometimes “CODA” or “coda”) stands for Child of Deaf adults. A Coda may have one Deaf parent or both, or a legal guardian raising them who is Deaf.8

90% of Codas are hearing. These people frequently navigate between Deaf and hearing culture as they grow up in much the same way as a child born to immigrants navigates between the culture of the country in which they live and the culture of their parents’ countries of origin. Codas frequently feel they are a part of Deaf culture even though they are not Deaf themselves.

Gregg

Gregg is a Coda — he has Deaf parents and a Deaf Aunt, uncle, cousin, and niece. He signs with his Deaf family members. He occasionally will use his voice with his mom, who has some hearing, just to get her attention and then he will sign after that. He both talks and signs with his niece, who has some hearing and wears Cochlear Implants, a version of hearing aids. He adds, “Because I can sign, I tend not to use Video Relay Services. I will text or use apps where I can sign.”

“Culturally I feel half and half. I feel the connection with my family, friends, people I grew up with. But I am also part of the hearing culture.”

Rosa

Rosa is also a Coda. On her dad’s side, he is the only one that has a hearing loss. On her mom’s side, there are many Deaf relatives — grandparents, aunts, uncles, and cousins — mixed in with the hearing relatives. “My parents are both Deaf,” Rosa said, “so it was just part of our life growing up. We’d go to events at the Deaf school such as football games and basketball games. We’d also go to other community events like Deaf bowling nights. And of course, we’d go to our parents’ friends’ or they’d come to our place.”

She said, “Our family only signs. My mom can’t hear at all so she was pretty strict about us signing instead of speaking when we were growing up, and it’s just normal now.” She keeps up easily with her family via text and FaceTime.

Britnee

Britnee is hard-of-hearing and has a Deaf mother and hearing father. Her brother is Deaf and her grandparents on both sides are Deaf. She says her communication methods depends on who she is talking to and what the situation is. Her hearing is good enough with hearing aids that she can talk verbally with hearing family members who don’t sign well. She signs with the other Deaf people in her family. If she is talking with a hearing family member who does not sign well and a Deaf member enters the room, she will start signing.

Britnee says mixed influences growing up have shaped how she identifies and communicates with the people around her. She attended a mainstream elementary school and junior high with hearing peers. Then in high school, she went to a school for the Deaf. She uses a hearing aid when she is around hearing people out in the community or with hearing family members but when she is at home, she generally takes them off.

“For the longest time I identified mostly as hard-of-hearing because I can hear pretty good and can speak and that is what others see me as. But lately I have started to identify more as Deaf since I started working at my current job. Really, I decide if I am Deaf or hard-of-hearing depending on the perception I want to create, how I want to communicate my specific words, and sometimes just my mood.”

Everyday Deaf and hard-of-hearing communication solutions

Communication is not only face-to-face, and families rely on phone and internet services to connect when they’re apart. For decades, that presented additional challenges for families who use sign language, read lips, and have difficulty hearing over the phone. But now, there are many services available to the Deaf and hard-of-hearing for communication and accessibility:

Video Relay Service

Video Relay Service (VRS) is a no-cost service Deaf or hearing people can call where the hearing person in the middle is a qualified ASL interpreter who signs with the Deaf person and speaks with the hearing person.

Videophones

A videophone is a standalone device that connects to the internet and streams both video and audio. It’s one of the devices Deaf individuals can use to make video relay calls to hearing people. The first videophones had basic dialing/ringing/answering functions and a contact list to save phone numbers. Nowadays videophones designed for the Deaf — such as the latest videophone from Sorenson, the Lumina — are more sophisticated. Some of the newest features are the ability to leave a video message (similar to voicemail), change the UI to Spanish, linking multiple devices to one VRS phone number, and customizable light-ring settings (similar to ringtones).

Computers with webcams

While videoconferencing apps such as Zoom and Microsoft Teams existed before COVID, the COVID-19 pandemic prompted an explosion in their popularity. Many businesses used these apps to continue operating. They also found widespread usage in families and friends who wanted a way to see each other when they were not able to visit in person. The arrival of Sorenson VRS for Zoom in Spring 2023 offered a new level of functionality for Deaf and hearing conversation, allowing an interpreter to join the meeting as a participant for fluid interpreter communication with everyone on the same screen.

Smartphones with cameras and videoconferencing capabilities

There are many smartphone apps that offer accessibility benefits for the Deaf and hard-of-hearing allowing users to pick and choose what’s helpful to them. For Deaf smartphone users, front-facing cameras introduced a wave of videoconferencing apps. Those apps include mobile VRS applications, like ntouch, so Deaf users can make and receive calls anywhere they take their phone.

Captioned phone calls

Phone call captioning (IP-CTS) is a no-cost service for hard-of-hearing people who need captions to use the phone. It provides real-time captions of their phone conversations on a specialized caption phone or a smartphone app.

CaptionCall by Sorenson and CaptionCall Mobile are both no-cost call captioning products. With CaptionCall, eligible users can sign up even without home internet service.

Hearing aids

Hearing aids were the first “technology” to improve communication for people with hearing loss, and they have transformed over the years. Some hearing aids are now so small they’re practically invisible in your ears.

About two percent of adults aged 45-54 have disabling hearing loss, meaning they could benefit from hearing aids. That number trends upward with age: 8.5 percent of adults aged 55 – 64, 25 percent of adults aged 65 – 74, and 50 percent of adults aged 75+ have a disabling hearing loss that hearing aids may help with.4

The vast majority of people who could benefit from hearing aids do not use them. Only 30% of adults 70+ in that category has ever used them and only 16% of qualifying adults 20 – 69 have ever used hearing aids.4

Many recent hearing aid models now have Bluetooth technology which allows users to pair them with other technology such as their smartphones or captioning phones.

new hearing aid technology

Effort is the biggest factor in hard-of-hearing, hearing, and Deaf communication

Communication is critical to understanding. When the desire and effort is there, a shared language is not a necessary starting place. The effort you put into trying to communicate leads to greater understanding and a broader knowledge of other people. Personal stories suggest most of us aspire to connect beyond words.

We see the same adaptability in communication across hearing abilities in immigrant communities. When families span geography for various reasons — moving for a better life, escaping a bad situation, or uniting people from different backgrounds — and have children, those children typically are quick to learn new languages through exposure at school or friends. They can be a great example to the rest of us of how doing ones best to communicate can benefit all of us.

Putting forth the effort to communicate with people who may not hear or communicate the same way you do is a statement of value. Work together to make those connections. There are many apps available to communicate. There’s always good old paper and pen. And, if all else fails, gestures can be useful. Many are universal concepts: eat, drink, sleep, cry, laugh, love.

This concept is the one that matters with communication — if we care enough about each other, we’ll figure it out. Every family with Deaf, hearing, and hard-of-hearing people has proven that if you’re caring, patient, and willing to try, there are no insurmountable obstacles to connection across language and hearing ability.

Sources

  1. Quick Statistics About Hearing, Balance, & Dizziness
  2. Understanding the degrees of hearing loss
  3. Child of deaf adult
  4. NAD — Community and Culture – Frequently Asked Questions
  5. Questions: How are the terms deaf, deafened, hard of hearing, and hearing impaired typically used?
  6. The experiences of cypriot hearing adults with deaf parents in family, school, and society
  7. Telecommunications device for the deaf
  8. There’s an Increased Risk of Hearing Loss in Young People
  9. Hearing Aids Are Changing. Their Users Are, Too.

A Word on “Accessibility” from a Deaf Person and VP of Brand Marketing

by Ryan Commerson

By the time I reached the age of 5, I understood that the world was not built for people like me. Most importantly, I had this gut feeling that it was nobody’s fault. It wasn’t until college that I learned a new word: ideology. Two eminent thinkers influenced how I get the world around me: Louis Althusser and Stuart Hall.

“Ideology represents the imaginary relationship of individuals to their real conditions of existence.”

— Louis Althusser

“Race is more like a language than it is like the way in which we are biologically constituted.”

— Stuart Hall

To quickly sum up what I have come to realize: Everything that I have read or what others have told me about what being deaf means are made up. One example: because I don’t receive sound through ears does not necessarily mean that I cannot develop a language or a faculty for thinking.

Disability and accessibility as social constructs

So, here we are, talking about accessibility. The notion of “disability” and “accessibility” are also social constructs. The term “social construction” is fancy jargon for the concept that everything that eight billion people created through language is just that: a creation. We made it all up. If we can take a moment and realize that life is essentially empty and meaningless…until humans came along and started producing language, and thus created meanings for pretty much everything in life.

It’s not any one person’s fault that not everyone knows sign language and that interpreting service is expensive. Or that, although it’s possible to easily caption a regular phone call at high accuracy and speed with the help of the AI behind CaptionCall Mobile, call captioning isn’t universal. No one sat in a corner and came up with Machiavellian policies to deliberately make life difficult for some 16% of the world’s population that have a “disability”. Accessibility is actually just a word to describe an attempt to identify the engineering misconceptions resulting from thousands of years of ideological snowballing and “correct” them.

Principles of universal design

Quite essentially, accessibility in its current state is an afterthought (or oversight). If we were to consider universal design in the engineering of products to make them responsive to as many representations of humanity as possible, then we could move beyond accessibility as a corrective action. Universal design factors the lived stories of billions of people into one story — uni: one, verse: story — and expresses it in a functional design for everyone.

We all design our environment based on what works for us. It is only natural. When we employ others who are unlike us to collectively develop designs, we achieve greater universality simply because we incorporate experience that we don’t have.

Ramps for wheelchair users are not only enjoyed by them; they are immensely helpful to delivery people and parents with strollers. Captioning on television in public — for instance, in a loud restaurant or airport — is convenient and useful for more than Deaf and hard-of-hearing patrons. They are regarded as accessible only because the developers didn’t consider those use cases in the design from the beginning. If design were universal at its core, would you point out accessibility features or simply call it sensible, smart, and efficient?

The Sorenson approach: Connect Beyond Words

At Sorenson, we make it our business to offer handcrafted, branded, and thoughtful solutions on a silver platter that integrate seamlessly into daily life and business. We employ diverse Deaf, hard-of-hearing, and hearing people from all walks of life to ensure that our products go beyond that concept of accessibility as a fix. And we do it so individuals can connect with each other, communities can connect across language and culture, and enterprises can connect with some of the $500 billion disposable income of disabled Americans.

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