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Contributed by Jane Hager, telecommunications device evaluator, MD AT Program

This is a fictional story with real implications for those of us with hearing loss.

Mary Smith is 54 years old. She is 1 in 8 people in America who has hearing loss. She leads a successful career in sales for a large corporation, is married, has kids, loves to cook, and is an athlete.  She was just diagnosed with COVID19. Her symptoms escalated and she was admitted to a local hospital for treatment. Mary uses 2 powerful behind-the-ear hearing aids and was considering a cochlear implant but hoped to wait a few more years since she was making good use of her residual hearing.

During Mary’s hospitalization, her wife, Sue was only allowed in for brief interactions. Sue and the rest of the hospital workers wore full protective gear including a mask that completely covered the lips. Without being able to see lips and full facial expressions, and with the diminished clarity and projection of voice caused by the face mask, Mary struggled to comprehend what was being said. Sue and Mary asked the hospital if they had access to clear protective masks so that Mary could read lips. Unfortunately, because clear masks are new on the market and with the onset of COVID 19, the hospital’s order for them had not yet been fulfilled.  In addition, Mary was leaving her aids out to comfortably rest as she battled for her life with COVID19.

It’s amazing that technology is becoming a critical personal healthcare tool but in these COVID 19 times it’s REALLY true, especially for those of us with hearing loss. Mary was up-to-date on assistive technology apps and found them to be life-savers for communication during her hospital stay. She was a member of Hearing Loss Association of America and before her condition worsened, had downloaded a personal information sheet from their site to bring to the hospital. It explained her hearing loss and communication needs. She brought a whiteboard and markers as a quick easy method of communication. On her android cell phone, she had Live Transcribe, a free app through Google Play for androids using automated speech recognition to caption what’s being said, real-time. Sue made sure Mary’s cell phone was connected to the internet but Live Transcribe will also run from cell service. Mary also made sure she had her charger, extra hearing aid batteries, and her assistive hearing devices that work with her hearing aids to reduce background noise and increase speech comprehension.

Mary’s doctor had an accent. Mary tried using Live Transcribe but it could not accurately transcribe her speech to text. Mary asked her doctor to text what she was saying so Mary could read it on her phone and respond back by voice. This worked.

As Mary began to recover, there were conversations she needed to be part of preparing for her discharge. Sue asked the staff involved to download the Ava & Me app to their phones. This allowed a group conversation transcribing voice to text, with each person identified on Mary’s phone in real-time. Because the speech is seen on the user’s phone as well, each person could check and make sure what they said was accurately transcribed. This was very important because of the muffling of masks and accents of people on the healthcare team.

This is a fictional story with real implications for those of us with hearing loss.

Consider proactive steps to take. Read these resources. Practice and plan.

https://www.hearingloss.org/communication-access-recommendations-hospitals-covid-19/#tools

 

Barriers, challenges and some solutions for people who are deaf/Deaf/hard of hearing during the COVID19 crisis:

 Hearing Loss Exhaustion

  • The brain of a person with hearing loss is working very hard to continue processing incoming information while at the same time filling in gaps of missing sounds. Stress and anxiety drain our brain’s energy causing even greater reduced comprehension. Add to that lack of rest, illness and worry and you have the perfect storm of hearing loss exhaustion.

Some Solutions:

Rest, alert, relax

  • If possible, communicate when the individual is rested and feels alert. A clear mask is ideal to support lipreading. Encourage the individual to relax, joining them in a few mindful or if possible, deep breaths before beginning a conversation. It’s helpful if the conversation starts with simple light talk so that the person with hearing loss’s brain can adjust to the sound of the speaker’s voice. There are some DIY alternatives to commercially made clear masks that made suffice recovering at home.

Clear-Speech

  • The speaker will want to practice rules of clear speech and a technique called chunking. To do this, be sure to annunciate clearly but without over annunciating. You may speak up but DO NOT SHOUT. This is embarrassing, annoying and distorts words. Clear speech is speaking a few words, pausing briefly, then continuing. The pause is not long and should be very natural. This allows the brain time to fill in the missing sounds while keeping up with incoming information.

Framing

  • Give a framework to your discussion by naming the topic i.e. “I want to talk to you about your test results.” This prepares the brain of the person with hearing loss for likely vocabulary and topics this conversation might cover.

Anticipate setting

  • Reduce, as much as possible, the distance between you and the person with hearing loss
  • Eliminate or reduce any background noise (TV, radio, fans, heat/ac)
  • Make sure the room is well-lit. Be aware that you, the speaker, are not back-lit by windows or other light that will cast your face in shadow impairing lipreading
  • If possible, have your discussion in a smaller room with better acoustics (carpet, sound absorbing walls, cushioned furniture)
  • Keep your face clear – don’t put your hands in front of your lips or speak with anything in your mouth
  • Make eye contact

Communication repair strategies

  • If you are not understood, repeat once or say it in a different way, i.e. “the lab shows a…” “the test results indicate…”
  • The person with hearing loss may use strategies such as repeating what they heard and asking for what they missed. Respect this and just repeat what they missed.
  • The person with hearing loss may ask for clarification by saying “Was that b as in boy or d as in David?”
  • When spelling out by comparison like “B” as in boy, go slowly.
  • Clarify communication by writing notes or using apps such as Live Transcribe on androids or Otterai or Notes on iphones/ipads
  • Otterai or other transcription services are extremely useful however be very careful of the accuracy. It could also be disastrous if incorrect.
  • Google Recorder is another very useful tool for the healthcare provider and the patient. It’s currently only available on Pixel 3 or 4 phones but can record, transcribe and save the conversation for later viewing, organizing and searching. It does not need cell service or wi-fi to work.
  • Transcription apps could be utilized, checked for correctness and emailed to the patient as follow-up.
  • In meetings, use the Ava & Me or hire a CART transcription service.
  • Paper and pen, whiteboard and dry markers are all good back-up tools.
  • Does the hospital have a looped conference room? This may also be a great option for hoh people.
  • A hospital may consider an assistive listening device such as Maxi Pro or Pocket Talker. These have disposable ear covers and could be disinfected in UV cabinets.
  • Hospitals should also have phones with extra loud amplification, a Caption phone and an ipad for videophone services available as an accommodation for people who are deaf/Deaf/hoh.

For additional information contact:

Maryland Technology Assistance Program at

MD Department of Disabilities

410-554-9230; 1-800-832-4827

 

 

 

 

 

 

 

 

 

 

Hey guys,

Today I want to discuss an important but often overlooked aspect of social media: Is what your posting accessible to the blind and low vision community? Are ALL individuals able to experience your post how it is intended, regardless of visual impairment? Just like sighted people, blind and visually impaired people use social media which is undoubtedly a big part of our lives these days. Social media is used for news, sports, weather, current events, keeping in touch with family and friends, following your favorite celebrities (etc. etc. etc.) and is typically an extremely visual experience. I know that I am guilty of not always considering how accessible my posts are and how they could be experienced by visually impaired individuals. In an effort to educate myself and those around me I referred to another blog, Life of a Blind Girl, written by Holly who shares her experience with visual impairment and social media accessibility. She offers 6 quick tips to making social media platforms more accessible for sighted and visually impaired individuals alike that I will share below.

  1. Add photo descriptions.
    1. Just because of someone’s visual impairment affecting how they visually perceive the photo doesn’t mean they don’t want to interact with the post.
    2. Each social media platform is different so let’s delve into each one:Blue background with white letters spelling "Facebook"
      1. Facebook:
        1. This app uses artificial intelligence (AI) to describe pictures. Although this is helpful it has its flaws. AI may see a photo and say “3 people. Grass. Food. Dog.” As this is a good start it is not always as accurate as it could be making it hard for a visually impaired user to interact with the photo the way it was intended.
        2. One way to assist the AI is to add a photo description to the caption. You can write your caption as you normally would then underneath write something like “photo description…” or “this photo shows…” so blind and visually impaired people can then picture the image.
      2. Instagram: Instagram logo white camera outline in orange and red background
        1. Instagram has come a long way since solely relying on the caption’s users would write to describe the image. They have since added AI much like Facebook (with the same flaws).
        2. IG has now added ‘Alt Text’ which is a feature where users can add descriptions to images they post.
          1. Before pressing ‘share’ and uploading your Instagram post, press on ‘advance settings’, there is then an option to add alt text to your image.
  • Twitter:Twitter logo, light blue lower case t in blue background.
    1. Was one of the first social media platforms to implement photo descriptions.
      1. This setting can be easily enabled which allows the user to write a description of the image (420 characters or less) so when a screen-reader detects the image it will be read aloud and describe the photo in detail.
    2. Transcribe memes and gifs
      1. Memes and gifs are not accessible to people with visual impairments and are extremely popular on social media these days. These types of posts are inaccessible to screen-readers which view them just as images.
      2. To make these aspects of social media more accessible simply add a description of the meme or gif in the body of the post, such as ‘this meme shows…’ or ‘this gif shows…’
    3. Use a capital letter #ForEachWordInAHashtag
      1. Using capital letters for each word in a hashtag enables a screen-reader to pronounce it correctly and is also a lot easier or people with useful vision to read so it’s a win-win.
      2. If you don’t do this screen readers will read it as a bunch of jumbled letters.
    4. Always use inclusive language
      1. This isn’t just in regards to social media, please always consider this. Using inclusive language means that you are being respectful and not reinforcing common stereotypes and misconceptions.
    5. Don’t overuse emojis
      1. Screen readers translate emojis literally, meaning they read out exactly what each emoji used is. If you use 50 emojis you could see how this can get time consuming and even slightly annoying for a visually impaired person having to hear a screen-reader read out: Angry face, surprised face, kiss face, and so forth. Be mindful!20 different emojis of yellow circle faces with emotiions
    6. Post various types of content on your stories
      1. Stories on social media platforms such as Instagram and Snapchat are very popular at the minute, however it’s important to post a wide range of content on these if you want your story to be accessible to everyone. Screen-readers will not read text or images on stories and they can often be hard for people with some useful vision to see, why not post videos and have a chat with your followers as well so that everyone can interact with some of your content on stories? Remember to add a transcription of the video if you can so that people with hearing impairments or other disabilities aren’t excluded from this sort of content.

These six tips to increasing accessibility on social media can help your posts be experienced as they are intended among people with visual impairments!

 

Here is a link to Holly’s blog for anybody who wants to see her posts about living life with visual impairment! https://lifeofablindgirl.com/

Black and white headshot of James Whitney, wearing a collared shirt.

Hello everyone

I wanted to write a blog introducing myself! My name is James Whitney and I have recently joined the Maryland Department of Disabilities Assistive Technology Program as an assistive technology (AT) clinician. First – a little background about myself: I hail from Salisbury, MD. I received a bachelor’s degree in Psychology from Salisbury University. About halfway through this degree I thought to myself: “how am I going to use this psych degree?” I was unsure how I should apply it: to further my education or try and start a career? (school doesn’t answer this question for you). After some research I found the field of Occupational Therapy to be quite fitting for my goals and my interests in the ‘human being’ both mentally and physically. I began taking the prerequisites necessary and the GRE and blah blah blah to apply to programs and eventually got accepted to Virginia Commonwealth University’s Occupational Therapy Doctoral Program (I graduate May 9th of this year).

 

For those of us who have NOT heard of occupational therapy (OT) let me describe it for you: OT is a part of the allied health therapy field that physical therapy and speech-language pathology are also a part of. OT focuses on treating injured, ill, or disabled patients through the therapeutic use of everyday activities to help patients develop, recover, improve, as well as maintain the skills needed for daily living and working. So how does a psychology and an occupational therapy degree qualify me to be an assistive technology clinician? During an OT evaluation, therapists will: ask the patient what their goals are, run objective assessments to measure what their abilities / deficits are, and develop a plan to assist the patient in meeting their goals. This process is very similar to an AT consultation which includes: talking with the patient to find out more about their unique lifestyle, their goals, their abilities / disabilities, and then finding an AT device to help them better meet their needs! As I have seen in my classroom education and hands-on clinical experiences quite often in OT sessions AT devices are used to increase an individual’s ability to participate in these daily activities. For example, if someone is having trouble getting dressed a therapy session might include practicing dressing techniques and incorporating AT devices to assist this activity i.e. dressing stick, sock donning device, long handled shoehorn, etc. (these are low-tech examples of AT). AT devices can also help an individual meet a variety of goals e.g.: accessing a computer, communicating with others, writing with pen and paper, compensating for deaf / hard of hearing or low-vision deficits to assist the individual in performing daily activities. OT and AT often go hand-in-hand and my background will allow me to be able to assist future clients to find the appropriate technology to meet their needs to allow them to better reach their goals and complete their daily activities.

 

I look forward to continuing to grow my personal knowledge of assistive technology, disabilities, compensatory techniques, and to use my expertise to increase Maryland residents with disabilities and our aging population’s access to AT. Stay tuned for more blogs by yours truly sharing my experience as an AT clinician, new articles, devices, stories, learning opportunities, community outreach opportunities and any/all things AT!  

PRC Core Communication boards for playgrounds

3 foot by 3 ft white board with pictures and words mounted in a playground.

A great bit of news for parents, caregivers, service providers and educators that work with individuals with communication disorders.  The article below highlights some work from The PRC Company to support those with communication challenges.  This particular bit of low tech kit, free to use, easy to setup and readily available!  To learn more about these no cost supports by PRC, click the link below:

https://www.prentrom.com/articles/playground-core-communication-boards-from-prc-saltillo?mode=view

Small girl points at picture on white board in playground

 

By Andrew Drummond

White and blue directional sign with wheelchair ADA logoHi guys, today’s blog post focuses on accessibility in a global-sense (well nationwide at the very least) and it highlights an awesome article about the ADA, also known as the Americans with Disabilities Act.  The ADA happens to be turning 30 years old this year!  Nationwide, regionally and statewide you guys should expect lots of events to mark, celebrate and market this civil rights law’s 30th birthday.  For those that do not know the ADA prevents discrimination in a variety of forms on the basis of disability. Please click on the following link to read all about it!!

 https://thehill.com/changing-america/well-being/prevention-cures/478658-the-americans-with-disabilities-act-is-turning

President Bush signing ADA law with four onlookers.

I hope you enjoyed learning more about the ADA and the anniversary of this vital civil rights law!  Later this year, we will be posting, advertising and sharing out information about events to mark the 30th birthday of the ADA here in Maryland.

Thanks for reading,

Andrew Drummond

close up of Airbus A380 Plane safety cardwith

On a recent trip to the United Kingdom, I opted to fly British Airways (BA) in the World Traveler section of the plane, also known as economy.  The transatlantic flight was very enjoyable (I had a surprisingly comfortable seat), an excellent IFE showing the latest movies, great staff and a very modern aircraft. 

close up of screen on seat back

During this trip, I flew on the BA Airbus A380 which is a ‘double-decker’ style, two level aircraft which seats several hundred people, comfortably.  The focus of today’s blog post is to highlight BA’s investment of resources into accessible IFE.  This particular IFE was built by Thales for British Airways and it is packed with features to support individuals with disabilities – a welcome feature!  The system by Thales is pictured below.

Close up of blue and green logo of closed captions

As a professional in the accessibility field, I am always ‘reviewing’ technology and I immediately noticed the graphic user interface was very responsive even with a pretty light touch this ideal for individuals with hand strength challenges.  The first accessibility feature, I trialed was the instant captioning, commonly referred to as Closed Captioning.  The icon for accessing the feature is below and it could be activated within the menu system.  It should be noted that all of the movies and video programming worked with the closed captioning from my observation.

close up of blue and green logo of audio description

The second accessibility feature, I trialed was audio description which would be pretty easy for a sighted individual to activate.  If a user was blind or severally visually impaired they would need sighted assistance to activate the feature but they would definitely benefit from this wonderful support.  Once activated, the movie or video programming was audio described in conjunction with the character’s audio.  I actually watched an entire movie like this and it was a very cool accessibility feature.  It should be noted that not all of the movies or video programming was available with audio description but it is clear that BA has made a significant effort for its non-visual customers so they have a good range of in-flight entertainment during their travels.

Seat back screen showing language options

Overall, I am extremely impressed with British Airways and their efforts to make their in-flight experience enjoyable for those with sensory impairments.  I would be more than happy to suggest BA as a great airline to fly if you are sensory impaired.

Thanks for reading,

Andrew Drummond

 

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