Louder is not always better: assistive devices for people with hearing disabilities

Participation is not the same as taking part. Many people with a disability are no strangers to this realization. At REHACARE 2023, Susanne Schmidt from the German Association for the Hearing Impaired explained to us where the problems lie in the participation of people with a hearing impairment and what technical, but also very human solutions are possible.

Imagine you are planning an event in which people with hearing disabilities should participate. It's an inclusive goal. But how does the implementation work? Set up loudspeakers, turn them up full blast, and leave the rest to the hearing aids that people with a hearing impairment often wear? Obviously, it's not that simple.

"A loudspeaker distorts. It makes sounds louder, but not necessarily clearer. But hearing loss mainly means hearing unclearly. And that is why loudspeaker systems are often counterproductive," says Susanne Schmidt. She is the chairwoman of the North Rhine-Westphalia branch of the German Association for the Hearing-Impaired (DSB LV NRW) and knows: "Inclusion and participation also mean that I, as someone who is not affected, use assistive devices. People often find it difficult to speak into a microphone. Many say to themselves: 'I can be understood without a microphone' because they are afraid to speak into one.

Yet the requirements for both premises and events are neither magic nor arbitrary. Standards such as DIN 18030 "Barrier-free building" and DIN 18041 "Hearing in rooms" show which implementations are necessary to enable people with disabilities to participate and live a self-determined life. The requirements of those affected are considered just as much as the financial and constructional feasibility.

Another problem that many organizers and non-affected people often do not think about is that not all hearing impairments are the same. People who are hard of hearing have different requirements for assistive devices than people who are deaf. The latter usually communicate using sign language. It helps them if a sign language interpreter translates the spoken word into sign language at an event. However, most hearing-impaired people have grown up with spoken language. They do not understand sign language and often cannot read lips.

But what solutions are available for hard-of-hearing people to not only passively but actively participate in an event? One possibility is microphone systems that transmit directly into the hearing aids or cochlear implants of those affected. The advantage over loudspeakers: Since the sound is transmitted directly into the device or implant and does not have to travel through the room, it remains clear and easily understandable for people with hearing impairment. Ideally, the hearing aids or cochlear implants are equipped with a so-called T-coil. It reduces the noise and eliminates disturbing background noises. The prerequisite for this is that the hearing system used in the room also uses the corresponding technology (induction). With modern devices, Bluetooth can also be an option for transmitting sounds directly to the aid and thus minimizing disturbing external influences.

An alternative to this are speech-to-text reporters, who convert spoken words into written form. The advantage is that people who cannot hear even with hearing aids or cochlear implants can be included as well.

Thanks to modern technology, it is now also possible to let devices translate speech into writing. However, the devices are expensive, are often not paid for by health insurance companies and do not always translate accurately. It can happen that people with a hearing impairment no longer understand the content because the automatic translator misinterprets words that are pronounced unclearly.

Many assistive devices also require additional equipment that must be borrowed locally – a problem for people who shy away from social interactions due to constant insults and hardship in everyday life. Therefore inclusion goals demand that the need for such interactions is reduced to a minimum and organizers address the issue early and openly.

This is another point that is irreplaceable for social participation: we all, whether affected or not, must be aware of the responsibility and the task that lies ahead of us. The best microphone system is of little use if presenters talk past the microphone, and anyone who thinks that speaking particularly loudly will solve the problem is also wrong. If the accessibility of an event is really important to you as an organizer and if you want to not only explain participation but make it a tangible experience, you should contact associations such as the RNID, the Hearing Loss Association of America, the British Deaf Association or affected persons in advance.

Matthias Groß
REHACARE.com