Progressive Hearing Loss

A person who performs certain job-related tasks for a person with a disability to help overcome limitations resulting from the disability. Examples include a page turner for a person who has no hands, or a travel attendant to act as a sighted guide to assist a blind employee on work-related travel. WPAS may include personal care-related assistance such as helping an employee to access the restroom, eat or drink at work, or travel for business purposes.

Alerting devices can be used to notify a person who is deaf or hard of hearing to sounds in the environment. An individual can be alerted to sounds like a telephone ringing, a doorbell or an emergency alarm through vibration or a light signal. A transmitter detects certain sounds and then sends a signal to a receiver that vibrates or blinks a light.

Medical professionals with hearing loss may find it difficult to use a standard stethoscope. The following resources offer amplified stethoscope products for individuals who are hard of hearing, who cannot place ear tips in the ears due to ear deformity or hearing aid use, or for individuals who work in noisy environments and need amplification or noise attenuation.

Personal assistive listeners reduce problems associated with background noise in one-on-one listening situations. By sending the sound signal directly to the individual's ears (using a headset, ear bud, hearing aid, etc.), an ALD enables an individual to hear and understand important sounds. Personal assistive listeners provide amplification and sound clarity.

Assistive listening systems, also known as assistive listening devices (ALD), transmit sound directly to an individual who is wearing a sound receiver (hearing aid, headphone, neck loop etc.). ALDs reduce problems associated with background noise in one-on-one and group communication. By sending the sound signal directly to the individual's ears, an ALD enables the individual to hear and understand important sounds while also reducing frustration associated with hearing unwanted background noises.There are three major types of ALD technology: FM radio signal, infrared light, and induction loop systems. FM systems transmit sound via radio waves. FM broadcast frequencies (72-76 MHz) are designated for use by FM systems. Infrared systems use lightwaves to send electrical signals to receivers that convert the electrical signals back to electrical energy and then sound. Induction loops use electromagnetic transmission to send sound through a loop of wire surrounding a seating area. A personal amplified system is another ALD option for one-on-one conversations and home media purposes. The personal systems are very small and portable and involve the use of a small microphone and receiver.ALDs can be used to accommodate applicants or employees who are hard of hearing and who benefit from amplification. ALDs can be used for one-on-one communication with coworkers or clients, small group meetings and training situations, or large-area listening situations, such as conferences or social events.   Hearing loop systems generally need to be professionally installed. For a list of installers, see HearingLoop.org's vendor list or another list provided by the Hearing Loss Association of America (.pdf).

Amplification and clarity technology can be beneficial to many people, but sometimes text communication is needed. For individuals who have some degree of functional hearing but who still have difficulty using the telephone, a captioned telephone may be the solution. For example, the Captioned Telephone (CapTel) is a phone that works like any other telephone but it displays live captions of the conversation. The CapTel phone automatically connects to a captioning service where a trained operator transcribes what is being said. The message is then displayed on the phone's display for the CapTel user to read while listening to the caller. Another option that may be helpful to federal employees is Relay Conference Captioning (RCC). This service is available to all federal employees nationwide who are deaf or hard-of-hearing and gives them equal access as participants in conference calls and/or multi-party calls. Relay Conference Captioning is a service of Sprint and GSA. It is made available free of charge to all Federal Employees. For details, visit: http://www.fedrcc.us/fedrcc/.

Individuals who are deaf or hard of hearing may benefit from the use of Communication Access Realtime Translation (CART) services during small and large group communication situations when verbatim conversation is essential to effective communication. CART is a process of converting speech into text through a third party (CART writer). A trained CART writer or stenographer uses a keyboard or stenographic machine to transcribe spoken speech into written text which is then transmitted onto a viewing device (e.g., computer monitor, video screen). Many captioning services offer remote CART and internet captioning where the CART writer is not physically present at the event but can listen-in through a telephone line.

CART enables people who are deaf, hard of hearing, or who have auditory processing difficulties, to participate in meetings and training events by viewing realtime text of the lecture/training/meeting. However, sometimes it is not practical or possible to have a CART writer available on-site. It may be possible to access CART services remotely.

Individuals who have difficulty communicating orally may be able to communicate effectively by typing, writing, or using sign language. In addition, individuals who have difficulty communicating in writing may be able to communicate effectively orally.

Glasses/head-mounted rear-view mirrors, also knows as cyclist's mirrors, consist of a small mirror with a mount designed to attach to eyeglass or sunglass frames.

Disability awareness/etiquette trainings are designed to enhance employees’ awareness on the different ways that individuals with disabilities communicate, move about, tolerate changes and interactions, and view the world around them. This can help increase employees’ sense of confidence and tolerance when interacting with their coworkers who have disabilities. For more information on disability etiquette, please see JAN's A to Z: Disability Etiquette.

The following telephone headset products are designed for use by individuals who need amplification or clarity using a headset. Many of these products are designed for use with t-coil equipped hearing aids while others can be enabled via Bluetooth. Some of these products are to be used with cellular phones and audio devices (e.g. MP3 players), while others can be used with cellular, corded, cordless, single-line, and multi-line phones. Products that offer tone control are also listed. Go to the web sites provided or contact the resources listed for technical assistance regarding these products.

Hearing protection might be used as an accommodation for an individual who is hard of hearing, who needs to work in a noisy environment and still be able to communicate with co-workers. Active hearing protection and special purpose ear muffs that attenuate sound as the noise level rises, may enable effective performance in moderate noisy environments. Hearing aids may fit under certain muff style hearing protectors that have large, rectangular openings. An audiologist may be helpful in determining whether a particular individual can wear hearing aids under hearing protection and what product combination would best suit their needs.

Mirrors sized and standardized for industrial settings.

Sign language interpreters are professional who assist with communication between individuals who are deaf or hard of hearing and use sign language and individuals who do not use sign language.  In the US most sign language interpreters use American Sign Language (ASL).  However, other types of interpreters such as Certified Deaf Interpreters (CDI), tactile interpreters, or Cued Speech interpreters may be needed in addition to or instead of ASL interpreters depending on the communication needs of the individuals involved.

Job restructuring is a form of reasonable accommodation which enables many qualified individuals with disabilities to perform jobs effectively. Job restructuring as a reasonable accommodation may involve reallocating or redistributing the marginal functions of a job. However, an employer is not required to reallocate essential functions of a job as a reasonable accommodation. Essential functions, by definition, are those that a qualified individual must perform, with or without an accommodation. An employer may exchange marginal functions of a job that cannot be performed by a person with a disability for marginal job functions performed by one or more other employees. Although an employer is not required to reallocate essential job functions, it may be a reasonable accommodation to modify the essential functions of a job by changing when or how they are done.

Masks with a clear section near the mouth for use in lip reading. See also: Masks – General/Chemical/Allergen Masks – Face Shield Masks – Respirator

Extraneous noises can be very distracting. Noise from radios, office equipment, traffic and employee conversations can make it difficult for someone who is hard of hearing to focus on important sounds in the environment. To block extraneous noise, sound control products such as carpeting, hanging baffles, wall panels or cubicles might be used. If possible, discontinue the use of personal stereos or provide the employee with a space free from extraneous sounds resulting from copy machines, faxes or printers.

Noise canceling headsets and headphones designed for listening tasks use a combination of passive soundproofing and type of technology called active noise control to reduce exposure to unwanted background noise and improve the signal to noise ration when listening to music or another sound source through the headset.  Headphones and headsets of this type usually have a small battery door built into one of the ear cups. When purchasing a noise canceling headset, be sure that you are purchasing the correct type for the task at hand.  Some headsets that are advertised as having noise canceling microphones are intended for speaking rather than listening tasks.  These only have noise cancellation in the microphone portion of the headset and do not have a battery on the ear cup.

Notepads or white boards can be used for many accommodation-related functions in the workplace. These can generally be purchased from any office supply or general merchandise store.

Paging products and services can be used in place of traditional overhead paging, such as code paging in a hospital, and may be used to notify a person who is deaf or hard of hearing to routine or emergency announcements. These devices and services can offer paging in text format to pagers, smart phones, tablets, and desktop computers, as well as through remote interpreter services.

Portable text communication devices are a type of assistive technology (AT) that is designed for one-on-one communication. There are a number of communication access technologies that are uniquely designed to be used by and with individuals who are deaf or hard of hearing. These access technologies offer such features as: face-to-face text communication; speech to text; speech to video sign-language; speech to computer-generated voice; and text to computer-generated voice or computer generated video signing.

What are captions? Captions are defined by the National Captioning Institute as, "subtitles, translations of the spoken word to the written, which permit deaf and hard-of-hearing people to see what they cannot hear. There are two kinds of captioning--open and closed. Open captions always appear on the screen, while closed captions must be 'opened' to be seen. Closed captioning is the process whereby captions are converted to electronic codes and inserted in the regular television signal, specifically on Line 21, a portion of the picture normally not seen." As of July 1993, all televisions 13" or greater in size that are manufactured in the United States or imported for use in the United States must be equipped with built-in decoder circuitry to enable the viewing of closed captioned video and television programming.Why consider using captions as a work-site accommodation for someone who is deaf or hard of hearing? Employers often use videotapes as training tools for employees. When tapes are used that have not been captioned, the tapes are inaccessible to employees who are deaf or hard of hearing. Employers should make an effort to ensure that all employees can benefit from training tools. When purchasing training tapes, consider purchasing tapes that have either open or closed captions or contact captioning service providers that can add captions to training videos. Employers might also use captioning as a way to provide real-time communication access to meetings, special events and web casts. Communication Access Real-time Translation (CART) offers word for word translation of audio information and is provided by a professional who is skilled and trained in using stenographic equipment. Many captioning providers offer remote CART and Internet captioning where the stenographer is not physically present at the event.

Relay Conference Captioning (RCC) is a free service to all Federal Employees and is dedicated to providing functional equivalency to deaf and hard-of-hearing participants in conference calls and/or multi-party calls. The service uses high-quality captioners that deliver live, realtime text streamed to an Internet-connected computer anywhere in the world. During captioned conference calls, participants can follow along with the dialogue by reading it on-screen as it is spoken and captioned.

A scribe or notetaker writes or types information that is communicated to him by another person. A scribe does not interpret information or perform essential job functions.

Most noise that is transmitted through a wall from one side to the other is airborne; this includes sounds made by TVs, stereos, voices and loud music, especially bass. This noise can be quite loud if the sound source is close to the wall. By soundproofing the party or common wall, the sound produced on your side will stay on your side and little or no noise from the other side will pass through. You can achieve wall soundproofing by installing our noise blocking products for walls. Another common noise problem is absorbing sound and reducing echo or reverberation within a room. You can achieve an acoustically enhanced room by installing our sound absorbing products for walls to improve acoustics.

Individuals with physical, cognitive, sensory, and learning impairments may have difficulty accessing computers. Traditionally, a computer user accesses a computer with a standard point and click mouse and a QWERTY keyboard (named for the top left-hand side of the rows). The computer takes the information that is inputted and processes it. Individuals with physical, sensory, or developmental limitations may not be able to use these standard input devices effectively and may benefit from using speech recognition. Standard computer input devices are keyboards made for typists who use two hands and ten fingers; speech recognition software is made for computer users with a variety of limitations, including individuals with no hand or finger movement.

Strobe lights can be useful as an accommodation to alert workers who are deaf to oncoming vehicles in an industrial environment.

Telephone amplification can be of benefit to some individuals who are hard of hearing. Amplification can be achieved through many assistive technology solutions, such as an in-line amplifier, portable amplifier, amplified phone, personal amplifier (assistive listening device), t-coil compatible headset, or clarity amplifier.Choosing the right amplification solution may take some time. Individuals are encouraged to try various assistive technology solutions until the right product is identified. Many vendors and manufacturers offer money back guarantees on the products they sell. Contact the vendor for more information regarding return policies.It may be helpful to contact the State Assistive Technology (AT) Project for assistance in selecting an amplification product. State Assistive Technology Projects are funded under the Assistive Technology Act of 1998 (P.L. 105-394). These projects can provide technical assistance on assistive technology, consultation, product demonstrations, equipment borrowing, and low-interest loans for individuals with disabilities.

When a phone rings, these devices will flash a light or turn a lamp on and off. Works with analog and digital phones.

Training modifications can include: receiving materials in alternate formats, such as Braille, large print, audio, and text; receiving materials in advance of training using assistive technologies, such as CART, interpreter, and recording devices; having trainings broken into smaller increments; allowing additional time for training; receiving one-on-one tutoring; seating away from distractions; and  logging in remotely.

Text-based communication devices.

Programs for text messaging on different machines and platforms to support hearing impaired individuals with communication.

A TTY is a text telephone device that enables individuals who are deaf, hard of hearing or who have a speech impairment to make and receive telephone calls. The device requires two TTY users to type messages back and forth to communicate instead of talking or listening. When messages are typed on the TTY keyboard, the information is displayed on the TTY display panel and transmitted through the phone line to a receiving TTY. Another term used for TTY is TDD. TTY is an abbreviation for the phrase "Tele-Typewriter" and TDD is an abbreviation for the phrase "Telecommunication Device for the Deaf."The Telecommunications Relay Service (TRS) is a 24 hour, 7 day a week, free relay assistance service that enables TTY access in situations where someone who uses a TTY may be calling a voice phone or vice versa. Using a TTY, Voice Carry Over phone (VCO), voice phone or videophone, an individual dials the toll-free number to contact the TRS system which will connect the caller to a communications assistant (CA). In some states it is possible to dial 711 for direct access. The CA directs the call for the individual. When the individual at the recipient end of the call answers, the CA explains his or her role in the call and from that point forward will relay the communication between the two parties, exactly as stated by both parties either in text, voice, or ASL.It may be helpful to contact the State Assistive Technology (AT) Project for assistance in selecting a TTY. State Assistive Technology Projects are funded under the Assistive Technology Act of 1998 (P.L. 105-394). These projects can provide technical assistance on assistive technology, consultation, product demonstrations, equipment borrowing, and low-interest loans for individuals with disabilities.

Two-way radios are often used to communicate "in the field". When it is difficult to understand what is being said using a two-way radio, or when the worker has no hearing, it may be possible to use a two-way radio that has text-messaging capabilities. There are a limited number of dual function two-way systems. For more information, contact the companies listed here.

A vehicle rear vision system might be used as an accommodation when a worker's ability to hear and see the environment is compromised. For example, a worker who is deaf who needs to operate a vehicle in the workplace, such as a forklift, may find it beneficial to see behind them when a mirror is not being used.

Watches that have programmable vibration function to help low-hearing individuals be aware of time and their schedules.

Deaf and hearing individuals can communicate by telephone through a sign language interpreter by placing a video relay call. Video relay calls are made using a high-speed or broadband Internet connection (i.e. DSL, cable, or T1 line) and a videophone connected to a TV, or through a personal computer equipped with a Web camera and video relay software. The person who is deaf signs to a video interpreter on their monitor, who then communicates with a hearing person via a standard phone line by relaying the conversation between the two parties.

Voice recording and playback devices can be used to create reminders and take notes. For example, due to difficulties with memory associated with a seizure disorder or from medications taken, an employee might benefit from the use of a voice recorder that would enable verbal directions / instructions to be recorded.  This would enable the employee to listen repeatedly and over an extended period of time if needed.

The following companies offer voicemail transcription services or voice to text products for voicemail. Voicemail transcription could be used as an accommodation for a number of reasons. In particular, someone who is deaf or hard of hearing might use a service or product to capture voicemail messages, convert them to text, and have the text message sent to an e-mail account, PDA, cell phone, or other mobile device.

Redesigning a worksite as an accommodation can include moving a workstation closer to a break room, restroom, office equipment, or employee parking lot; duplicating work materials in a workspace; teleconferencing into meetings; having others report to the employee physically; or communicating in an alternative way (instant messaging, pager, texting, or telephone). Modifying a workspace for an employee who experiences limitations in concentration can help limit or even eliminate both auditory and visual distractions. These modifications can include relocating employees to private area away from high traffic areas, reducing clutter in the employee’s work environment, redesigning an employee’s workspace to minimize visual distractions, and providing higher cubicle walls and/or cubicle doors.