Emerald Group Publishing Limited
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Accessibility of Library and Information Services for Hard of Hearing People
David Johnson, Column Editor
Accessibility of Library and Information Services for Hard of Hearing People
[Ed.: "EASI Access to Library Technology," a regular feature of Library Hi Tech News, examines new technology, information sources and services, and other news of interest to librarians concerned with providing quality services to their patrons with disabilities. EASI (Equal Access to Software and Information), in affiliation with the American Association of Higher Education (AAHE), is concerned with new and emerging technologies for computer users with disabilities.]
People with Hearing Loss: A Large and Diverse Group
People with hearing loss comprise the largest disability group: over half of the 54 million people with disabilities in the USA. This accounts for approximately one in every ten people in the USA according to the NIDCD (National Institute on Deafness and Communication Disorders). Of the 28 million total people with hearing loss, a large majority, 26 million, are hard of hearing. The other two million are deaf. Ironically, hard of hearing people have traditionally not been well accommodated, due, in part, to the invisible nature of hearing loss, as well as their tendency to deny or minimize their hearing loss.
One of the challenges in helping library patrons and staff with hearing loss is to understand the wide range of their needs. Although there is some overlap between the needs of people who are hard of hearing and those who are deaf, there are significant differences in their communication needs. People who are hard of hearing generally do not know sign language and therefore will not benefit from the provision of a sign language interpreter. People with partial hearing often prefer to maximize the use of their residual hearing, especially if the hearing loss was acquired (not present at birth). Many of them wear hearing aids or cochlear implants and use hearing assistance technologies.
This article will discuss hearing assistance technologies that can be used to accommodate hard of hearing people in libraries, as well as other means of accommodation. It will also identify sources of information on hearing loss issues, particularly those that are pertinent to the needs of hard of hearing people.
Hearing Assistance Technologies
Hearing assistance technologies include telecommunications aids such as TTYs; assistive listening systems, which can improve patron/staff communication and enable patrons who are hard of hearing to understand speakers and movies and participate in public meetings; and alerting or signaling devices.
Flashing smoke detectors may be required by local building code. Other types of signaling devices, such as flashing telephone ringers or vibrating personal pagers, probably would not be needed unless a staff member with a hearing loss required them as a job accommodation. A door entry flasher might help a hard of hearing person to notice someone walking into a secluded study room.
Check-out desk amplification systems (e.g. "counter loops"). A counter loop allows a hard of hearing patron to hear a staff member more clearly across the counter, by minimizing background noise so that the patron can focus on the staff member's speech. The staff person speaks into a microphone and his or her speech is transmitted in the form of an electromagnetic field. In this wireless system, a hard of hearing person hears through a hearing aid equipped with a telecoil (which serves as a magnetic pick up). The patron who has no hearing aid (80 per cent of hard of hearing people) could use an inductive loop receiver with a listening coupler, such as a headset. Unfortunately, it is rare at this time to find a library counter equipped with such technology, or to find staff who regularly encourage patrons to use it. A one-to-one corded amplifier could also be used. These are portable and cost less than $200.
Different sound systems may be appropriate depending on the type of public gathering. The appropriate set-up for a board meeting or community group differs from that for a public showing of a movie or a single speaker delivering a lecture. An ideal board meeting sound system would consist of a PA (public address) system with good-quality speakers; multiple microphones at a ratio of one microphone for every two seats; a wireless microphone that can be passed among those not seated at the table or clipped on the speaker; a mic mixer; and an assistive listening system transmitter with a sufficient number of receivers.
There are many types of listening attachments to meet the varying needs of hard of hearing people, some of whom utilize different hearing instruments, such as hearing aids or cochlear implants. For example, a non-hearing aid user could be provided with a headset, while someone with a hearing aid equipped with a telecoil needs a neckloop, which connects to a receiver and generates a magnetic field in the same way as the larger counter loop described earlier. Less than one-third of hearing aids are equipped with telecoils, but those that are can be switched to the "t" position to pick up sound inductively from the neckloop. Placing a headphone over a hearing aid is likely to produce acoustic feedback (squealing). Furthermore, it makes no sense to give receivers with ear plugs to hearing aid users. How would they put the plugs in their ears? We do not encourage people to take out their hearing aids for this purpose.
For a single speaker, one or two mics may be sufficient. It may be better for a speaker who cannot keep the hand held microphone close to the mouth when speaking to use a clip-on lapel microphone. Sometimes speakers move their arms when gesturing and thus move the microphone away. An ideal placement for a hand-held microphone is below the lips, not directly in front of the mouth. This allows a hard of hearing person to see the mouth for speech reading and also facilitates better sound pick up. If the presentation is a monthly movie, the transmitter just needs to be patched-in to the sound output. Simply placing the transmitter microphone next to the sound source will result in a more distorted pick-up, but might be adequate in some cases.
Some people might expect that a hard of hearing person would not notice a difference in sound clarity, but the opposite may be true. A hard of hearing person may require greater acoustic fidelity in order to achieve the same level of understanding as a person without a hearing disability. It is a myth to think that hard of hearing people only want an increase in volume. Sometimes when the sound intensity is increased they just hear louder distortion. They may have a loss in specific frequencies and therefore desire the best clarity possible. That could include minimizing background noise by doing something as simple as closing a door to extraneous/competing sounds in the hallway.
In addition to installing equipment for an assistive listening system, it is important to make sure all the "human factors" are considered. Are spare batteries available? Does the staff know about checking to make sure batteries are working before dispensing devices? Do they understand hearing aid inductive listening and related types of listening attachments, so they can remind patrons to adjust their hearing aid T switches? (Hearing aids need to be switched from the "m" or microphone position to the "t" or telecoil position in order for the telecoil magnetic pick up to work with a neckloop connected to the ALD receiver.) There is much more to learn. Libraries need to work closely with consumer organizations, such as Self Help for Hard of Hearing People (SHHH), to ensure that sound contractors who sell assistive listening systems make a proper selection and install the sound systems correctly.
For CART (computer-aided real-time transcription), a captionist (who could be a stenographer/court reporter hired for this purpose) types the words of speakers and audience members into a computer, and they appear on a large screen or TV monitor. CART is similar to the real time captioning one might see on television. Some hard of hearing people will require both assistive listening systems and real-time captioning for total hearing access. Real-time captioning or CART is essential for people who are late deafened who cannot hear with an assistive listening system and do not know sign language.
When CART is used in public gatherings, it is amazing to see how many audience members will be reading the captions even though they do not have hearing loss. This is partly because it helps them pick up missed words resulting from variations in speech. This is an example of an "electronic curb cut", a disability accommodation that yields secondary benefits to people without disabilities. This concept is important to remember when making the case for the value of an accommodation. The term is a reference to sidewalk curb cuts, which helped wheelchair users but also made it easier for people pushing baby strollers or shopping carts.
Pay phone amplification is an easy accommodation to provide. All libraries with pay phones inside or immediately outside should evaluate their public phones. The phone companies will usually gladly convert their pay phones to include amplification if you ask them. This is another good example of an electronic curb cut. The amplification is designed to help hard of hearing people, but can benefit others who need a boost in volume during their phone conversations when it is noisy.
TTYs are data terminals that allow people with hearing or speech disabilities to read or type conversations as needed with their other party. The library may have its own direct TTY number, and should make an effort to list it as such in TTY directories as well as the local phone company directory. Library staff should regularly be trained in how to use a TTY. It is also possible to obtain TTYs that connect to pay phones.
An alternative to purchasing a TTY is to use a computer to communicate with TTY users. In order to accomplish this, a library needs to purchase special TTY emulating software and usually a new modem. There are four manufacturers of this type of product. One advantage to installing the modem in a central server is that workers at various stations throughout the library may be able to share a central modem for TTY communication. The US Department of Education is a good example of an organization that has successfully utilized this approach.
Interactive voice response systems (IVRS) are a source of frequent complaints from hard of hearing people. Those are the recordings that patrons hear when calling the library after hours or that put them "in queue" when the lines are busy. A similar problem occurs on lines that the public uses for automated book renewal. Have these been evaluated from a hard of hearing person's perspective? Some voices are easier to understand than others. Some menu trees are less complicated than others. Hard of hearing people want the ability to "opt out" or press a button to default to a live person. They want the ability to slow down speech and to repeat a message.
Telecommunications relay services (TRS) are telephone interpreting services for TTY users that enable them to communicate with voice telephone users through a communication assistant who types what is spoken by the party that has no hearing disability. A TRS conversation usually involves taking turns and speaking in short segments that the communication assistant types back to the caller. Anyone who answers the library phone needs to be prepared for a possible call from a patron calling through a relay. Some deaf or hard of hearing consumers may prefer to use TRSs instead of calling the library TTY number because they are unaware of the library TTY number, or because they believe that the TRS communication assistant will type better. Another possible reason is that the patron prefers to talk and use the TTY only for reading what the librarian says in return. A version of TRS called voice carry over (VCO) allows callers to speak using their own voices. In the past, before TRS offered VCO, hard of hearing people who required use of a TTY had to type what they wanted to say. It is important to encourage hard of hearing people to use TRS and VCO, since many people with acquired hearing loss are unfamiliar with text-based communication and are accustomed to talking into regular telephones most of their lives. As a result they often settle for ineffective understanding in phone communication and do not realize that they can capture all the words spoken if they talk with someone, such as a librarian, through a TRS.
Television access in libraries needs to be evaluated. Those representing the interests of people who are deaf will immediately point out the importance of using TVs with closed caption decoding ability and obtaining and showing VCR tapes with built-in captioning either closed or open captioned. Hard of hearing people want that, too, but many of them use their residual hearing with an assistive listening device that feeds sound directly into their ears and enables them to control personal volume. It is difficult to find a library at this time that offers an ALD for use with its in-house TV. Hard of hearing people use this at home all the time. It is easy to hook up. This technology can also be used for group viewing of movies in libraries.
A Proactive Approach to Accommodation
Even if patrons do not ask for all this technology, you can assume that one in ten Americans would benefit from it. Libraries can do their share in a "systems change" effort by offering and advertising hearing access technology. Libraries need to review whether they are trying to do the absolute minimum to provide access or whether they are truly committed to diversity in their outreach efforts.
One public library in Maryland reported recently that its conference room audio induction loop (a listening enhancement system) had not been used in over three years. This library needed to do more to alert the public to the availability and benefits of the assistive listening system (ALS). At a minimum they need to tell all who rent the room that such assistance for hard of hearing people is available.
Once a library has obtained assistive technology and trained its staff in its use, it might consider a program to raise public awareness. Such a program might include an open house to encourage people with disabilities to learn about the new devices. Communication access could be featured in the library display case one month. A sign could be posted prominently at the front door listing all the types of access the library provides, and the list could be duplicated in library brochures or county directory listings.
SHHH supports a program called Library Liftoff. This packet of materials is designed specifically to educate libraries about how to make themselves accessible and to encourage them to carry books on hearing loss. SHHH offers a special membership rate to libraries entitling them to receive multiple copies of Hearing Loss: The Journal of Self Help for Hard of Hearing People.
It is our hope that libraries will offer more specialized materials on hearing loss. Consumers are starved for information on how to cope with sudden hearing loss. Parents are lost about how to help their children with hearing loss. Adults with hearing loss are frustrated with the lack of available information on strategies to help them remain employed, so they do not have to retire early. A great deal of information is available on videos as well as books, magazines, and articles covering such subjects as hearing assistance technology, hearing aid telecoils, cochlear implants, hearing aid selection and research on hearing loss.
The Library Liftoff packet, a list of vendors of hearing assistance technologies, and a free Publications Catalogue may be obtained from: SHHH, 7910 Woodmont Avenue, Suite 1200, Bethesda, MD 20814. Tel: (301) 657 2248; TTY: (301) 657-2279; Fax: (301) 913-9413; E-mail: firstname.lastname@example.org www.shhh.org
There are many helpful Internet Web sites and discussion groups related to hearing loss. One example is the Beyond-Hearing list serve: http://www.geocities.com/heartland/prairie/4727/bhframe.htm
One group that has worked for many years to raise deaf awareness in libraries is Friends of Libraries for Deaf Action. Their objectives are to coordinate deaf awareness programs through public libraries; to create new deaf awareness products (kits, information sheets) every two years, and to advise local friends of library groups on how to enhance local deaf resources. They publish and distribute the Red Notebook, a loose-leaf binder on library and information services to the deaf community. It is slanted more to the needs of people who are culturally deaf, rather than hard of hearing.
FOLDA USA, c/o Alice Hagemeyer, Founder, 2930 Craiglawn Road, Silver Spring, MD 20904-1816. TTY: (301) 572-5168; Fax: (301) 572-4134; E-mail: email@example.com
David Baquis is Director of the National Center on Assistive Technology of Self Help for Hard of Hearing People (SHHH). firstname.lastname@example.org
David Johnson is an Abstractor/ Information Specialist at the National Rehabilitation Information Center (NARIC). DJohnson@kra.com