View this published article at: https://psyche.co/guides/tips-and-tools-for-navigating-hearing-loss
Need to Know
I’m no stranger to hearing loss. I was born deaf in my right ear and hearing in my left. I grew up in a hearing family that communicated only in spoken English, but was fortunate to find the Deaf community and learn American Sign Language (ASL) as a teenager. Then in my twenties, I started progressively losing the hearing in my left ear too, followed by a dramatic overnight loss that left me with limited residual hearing. As much as I knew being Deaf wasn’t a tragedy, just a different way of navigating the world, I still found myself overwhelmed by changes and fear of the future.
The life I had designed for myself up to that point was dependent on hearing and spoken communication. The future I had to build would look very different. For me, losing my hearing meant losing my career as a paramedic and facing new barriers to employment, like many Deaf people do. I wondered if I’d be able to keep pace in my college courses to graduate on time, and feared how my new communication needs would impact my personal relationships.
Thankfully, I’ve discovered that whether you prefer to speak, sign or a combination of the two, there are many tools available to help you more easily navigate a hearing world. Traditional hearing devices, such as hearing aids or cochlear implants, are important tools for many people with hearing loss that can help increase our access to sound. But in this Guide I’m going to walk you through a range of other ‘accessibility tools’ that don’t rely on hearing at all. These supportive tools have helped me, and many others, navigate the uncertainty that living with hearing loss can bring, and I hope that they can help you too.
Michelle Hu, a paediatric audiologist, Deaf/hard-of-hearing woman, and bilateral cochlear implant user herself, says that ‘one of the biggest, most common misconceptions’ is that hearing devices (such as hearing aids and cochlear implants) ‘are a fix’ – as if that’s all you need to navigate the hearing world. Hu encourages her patients and their families to also have a range of accessibility tools at their disposal, so they are never without options for comfortable communication. Whether your hearing loss is mild, profound, or somewhere in between, and no matter where you are in your hearing loss journey, this Guide aims to introduce you to the many communication tools and other assistive technologies available to you.
What to Do
Accessibility tools are not usually one size fits all. Different environments require different tools, and what may work for one person won’t always work for another. Here, you’ll find tools grouped by different contexts and challenges so you can easily find what you need: personal conversation; educational and professional settings; personal safety and alerts; and entertainment.
Personal conversation
Personal conversations tend to be fast-paced and can be challenging to follow when you have hearing loss. But communication shouldn’t be solely the responsibility of the deaf or hard-of-hearing person. As Hu says, ‘If one person in your family is deaf or hard of hearing, you’re a deaf or hard of hearing family.’ In addition to using accessibility tools, she emphasises the importance of setting some ground-rules with those around you to lessen the communication burden. For example, not initiating conversation with a TV on in the background or while someone is doing the dishes.
Use live captioning apps and text services
Live-captioning apps use your phone’s microphone to capture speech and transform it into written text on your screen in real time. For example, if you’re chatting with a friend in person you could turn on the app, prop your phone up on the table between you, and read what they’re saying. For Apple users, I recommend the Live Transcribe app, which can be distinguished from similarly named applications by its blue elephant icon. It supports many languages and provides excellent distinction between speakers in group conversation. For Android users, Hu endorses Google Live Transcribe.
Before losing my hearing, I loved long phone and video calls with my sister. After becoming Deaf, finding a way to sustain those daily calls was one of my top priorities. When I discovered Apple’s live-captioning feature on FaceTime, which can be enabled during any active FaceTime call, it made all the difference. Apple devices also have a native live-captioning feature for voice calls. Enable it in your iPhone’s accessibility settings, and your phone will automatically display real-time captioning for voicecalls, without needing a separate app. On certain phones, Android users can similarly benefit from native live-captioning features for voice and video calls that work across apps such as WhatsApp or Google Meet.
The main drawback for the automated captioning options built into your phone is their patchy accuracy. Hu says InnoCaption, available free to qualifying US residents on both Apple and Android devices, solves this problem through the use of live stenographers who transcribe spoken audio in real time, with captions appearing on your phone, tablet or computer. InnoCaption also recently launched a version that works with video calls. If you’re outside the US, you may benefit from similar services (such as Relay UK in the UK or NRS Captions in Australia) that use trained intermediaries to transcribe the other person’s speech.
Yet another option for voice calls, available on both Apple and Android phones (but dependent on your network provider), is Real Time Text (RTT), which allows you and the other person to type ‘live’ responses back and forth with text appearing on the screen as you type it, without the delay of a ‘send’ button. RTT can be used alongside spoken conversation or instead of it.
Use online resources to help you learn sign language
Sign languages, such as American Sign Language (ASL), remove hearing loss as a barrier entirely. If signing is new to you, the prospect of learning a new language might be intimidating, but know the Deaf community is very welcoming. Many Deaf people learn sign language later in life and signers are understanding of the challenges newcomers face. It’s worth the time it takes. Communicating in ASL is the only time I feel fully involved in conversation rather than one step behind everyone else.
It’s important to know which sign language is most widely used in your area before deciding where to start learning. Most countries have their own unique sign language, with variation even among countries that share a spoken language. For example, the US and Canada use ASL whereas British Sign Language (BSL) is used in the UK. Some sign languages share similar origins but have developed independently (just as distinct dialects of a spoken language can share a foundational language). This is the case with BSL and its similar counterparts Australian Sign Language (Auslan) and New Zealand Sign Language (NZSL).
When possible, attending an in-person sign language class taught by a Deaf instructor typically offers the most comprehensive learning environment. You can often find these classes at local libraries or universities, but availability and cost can vary. Thankfully, there are also many online resources available. For ASL learners, I highly recommend following the free structured videos provided by LifePrint’s ASL University, an online resource created by Bill Vicars, Emeritus Professor of American Sign Language and Deaf Studies.
The experienced ASL interpreter Brittany Black suggests that new signers also use a sign language video dictionary to keep conversation flowing smoothly. For general ASL vocabulary, she loves Signing Savvy or Spread the Sign (the latter has material in 43 sign languages in addition to ASL). However, she says the best resource for more complex academic ASL vocabulary is ASL Core. But, ‘When in doubt,’ Black says, ‘ask a Deaf person’.
For BSL, the UK has a nationally recognised charity called Signature that connects people with local accredited BSL classes at all levels and has variable funding available to make them affordable. Commanding Hands offers a free online BSL course with additional downloadable resources to support your BSL journey. Popular BSL dictionaries include SignBSL, which is available both online and as an app for Apple or Android devices, and the website BSL SignBank.
Use video relay services
Whether you’re a new or experienced sign language user, you can benefit from video relay services (VRS; such as Sorenson in the US and UK), which connect you to a live interpreter for phone calls. Dial any number and the interpreter will appear on your screen while the other person hears the interpreter’s voice. In the US it’s free to use for any deaf or hard-of-hearing person. Outside of the US, VRS availability and costs vary widely – for instance, you might find that it’s only available during certain hours.
I delayed trying VRS for a long time because I believed some of the common misconceptions about it, such as that I had to rely on the interpreter to communicate for me. In reality, you can always let the interpreter know if you prefer to voice for yourself rather than have them speak on your behalf. VRS phone calls also have the option to hear the audio at the same time you’re watching the interpreter. This can be helpful for new signers or for anyone who prefers auditory information but benefits from signed support. If you’re new to VRS, I recommend starting with short calls to build your confidence. For example, the first call I made with VRS was to ask a business what time they closed. It was short, with simple vocabulary, and helped me get familiar with the service.
I also used to believe that VRS and other accessibility services should only be used for ‘essential’ communication like doctor’s appointments. I now understand that deaf and hard-of-hearing people deserve access to the fun parts of life, not just essential daily tasks. Black fondly recalls a time she interpreted a VRS call for two friends, one hearing and one Deaf, who wanted to watch a movie together long-distance. ‘Most of the call was just me interpreting reactions, like them gasping or laughing,’ Black said. The content of the call made no difference in how she performed her job, but it made all the difference for the callers who didn’t want hearing loss to prevent them from enjoying their friendship.
Educational and professional settings
My overnight dramatic hearing loss happened two weeks before midterms in the fall of my senior year of college. At that time I didn’t have proper hearing aids or accommodations, and as I sat in the front row watching my professor’s mouth move with no perceivable sound coming out, I feared I’d have to drop out of the semester. Thankfully, I already knew what support was available to me, and with just one frantic email to the university’s Disability Services Office to get the right accommodations in place, I was back in classes the following week.
My experience highlights the importance of early notification of disability in both educational and professional settings. I had pre-registered with the school’s disability office years prior at the beginning of my programme, which allowed me to get quick changes to my accommodations without the delay of paperwork verification. Had I not been established with them, I wouldn’t have been able to get accommodations quickly enough to keep up with my classes. The takeaway is to connect early with the supports available to you, even if you aren’t yet sure you want to request an accommodation. Within education, the point of contact is typically a Disability Services office, and in the workplace, it’s almost always Human Resources. Any accommodation requests you make should go through one of these official points of contact.
Know your rights
Specific laws vary depending on where you live, but most countries have laws in place to protect people from discrimination based on disability. Taking the time to learn what your rights are based on the laws in your area can help you advocate for yourself better. In the US, that law is the Americans with Disabilities Act (ADA). In most cases, the ADA protects your right to an interpreter or other accessibility technology, and requires businesses to provide them at no cost to you. There are some exceptions and limitations, so I recommend familiarising yourself with the regulations around your specific needs. In the UK, your rights are protected by the Equality Act 2010.
Request a live stenographer
In professional environments, you may have the option to request a live-stenographer for face-to-face conversation. The stenographer will either be in the room with you or receiving audio from the environment remotely. The advantage of having them in the room is that they can transcribe contextual information, such as a co-worker annoyingly clicking their pen, or sirens passing in the background. It can feel uncomfortable at first having someone physically in the room to support you – you might as well wear a big sign over your head saying ‘I can’t hear’. But the novelty for you and those around you will quickly dissipate.
Stenographers typically use one of two styles to transcribe the conversation: CART or C-print. CART is word-for-word transcription, including phrases like ‘um’ and sounds such as someone clearing their throat. C-print, on the other hand, is more akin to getting a conversation summary. The transcriber synthesises the information to provide the same meaning in fewer words. Personal preference varies, so I encourage you to try them both or watch video examples of their differences to help determine what suits your needs.
Request a sign language interpreter
Professional settings also afford the option to request a sign language interpreter at no cost to you. Black says there isn’t a minimum level of sign language fluency required to benefit from having an interpreter because ‘A good interpreter will work with you, at your level, to make sure things are clear’.
I hesitated to request an interpreter for my neuroscience classes in college because I’d never learned advanced scientific vocabulary in ASL. I worried I’d be just as lost with an interpreter as without one. In reality, by requesting interpreters, I was able to build both my ASL and English vocabulary concurrently, setting me up for better success in future courses.
If you haven’t used an interpreter before, you might be wondering what to expect. In lectures or presentations, the interpreter typically stands near or next to the speaker, but can move to wherever you’ll see them best. In smaller groups or one-on-one settings, like a lab class or a work meeting, they may feel like a more active presence – often sitting next to or across from you. Communicating with a ‘shadow’ might be a little uncomfortable at first, but I can honestly say that trying to participate in conversations I couldn’t understand was far more uncomfortable than using an interpreter. In my experience, other people are more understanding than you may expect, and the advantages are worth any temporary discomfort.
Black says it is important to give interpreters as much time to prepare as you can, especially if field-specific jargon will be used. I helped prepare the interpreters for my classes by requesting advanced copies of the slides and a list of any specialised vocabulary to be emailed to them beforehand.
Use accessibility tools for work video calls
Leveraging built-in accessibility features on video conferencing software like Zoom or Webex can prevent misunderstandings. Many platforms have an option to turn on live automated captions during a call, and to transcribe the call audio into a downloadable file. Using live-captions for group calls can be confusing because the change in speakers is not always clear. The best way I’ve found to navigate this is by enabling ‘active speaker’ in the video settings. This switches the display on your screen to always show the person actively speaking, helping you to match the captions to the right speaker. I prefer Zoom for its additional collaborative feature with the VRS company Convo that provides immediate free access to an interpreter for any call. The interpreter is shown in a box on your screen but is not visible to other callers. This feature is available at any level of Zoom profile and can be used for business or personal calls.
Personal safety and alert systems
Hearing people rely on many different sounds for awareness of their surroundings. As a Deaf person, if you’re not prepared, there’s a lot of information you can miss – whether it’s a knock at the door, a crying baby or a fire alarm going off. Having a range of alert systems can keep you safe and give you peace of mind. A good place to start is through your country or state’s disability or deaf services – many can introduce you to the types of products available and may be able to provide them to you free of charge.
Use multisensory alert systems
Safety in the home can be improved with alert systems such as flashing-light doorbells or fire alarms. There are also smart devices such as the Ring doorbell, which can send alerts and vibrations to your phone when someone is at the door.
Consider a ‘hearing dog’
It’s a big responsibility and not a decision to make lightly, but for more detailed daily awareness you could also consider applying to adopt a ‘hearing dog’. Unlike doorbells and alarms, these intelligent working dogs are bred and trained to assist deaf and hard-of-hearing people not just at home, but also when you’re out and about. They can increase safety by alerting you to a variety of essential sounds like crying babies or passing cars, and do simple but vital things like nudge you if someone calls your name.
Use vibrating alarm clocks
Waking on time can be a common source of stress for those with hearing loss. Picking the right alarm is essential for worry-free sleep. One popular solution is a vibrating or visual alarm clock. The four main types are under-the-pillow vibrating alarms, under-the-mattress vibrating alarms, wearable (eg, a watch that vibrates) and visual (eg, a clock that mimics sunrise or a smart bulb on a timer).
Alert others
While you may be used to hiding your hearing loss, there will be times when alerting others to it will improve your safety, such as when communicating with police or healthcare personnel. These situations rely heavily on verbal instruction, so it’s important to provide early notification that you may not be able to follow verbal commands.
On the road, car stickers, magnets or seatbelt covers stating ‘deaf driver’ or ‘hard-of-hearing driver’ can be a simple way to improve public safety interactions. Products such as The Pullover Pal can increase traffic stop safety for Deaf individuals (it attaches to your driver’s side window, allowing for quick display of necessary documents).
Hu’s solution to police interactions is a two-way communication card of her own design that is available to purchase online. The card has sections for the driver to indicate their hearing status, communication preference and if they are experiencing any kind of emergency. It also includes visuals for an officer to indicate the reason for being pulled over and what actions are being taken during the encounter. Hu adds that it’s also important to remember that you have a right to an interpreter.
Be prepared for healthcare situations
I recommend keeping a typed document with you at all times that includes your personal information, emergency contact and necessary healthcare information. Make sure your hearing status and communication preference is easily identified somewhere on the page. You can show this document at medical appointments or during a health emergency to help providers give timely and appropriate care. Know that you have the right to accessible communication, and in most cases you can’t be denied an interpreter even if you have someone with you that signs. But it’s important to be aware that in many jurisdictions, an adult friend or family member is legally permitted to interpret or communicate for you in a life-threatening situation.
Entertainment
At the beginning of my Deaf journey I spent a lot of time isolated because I believed I wouldn’t enjoy things if I couldn’t experience them the way I had been able to before. But I’ve come to realise I can often find some enjoyment, rather than missing out entirely. For instance, last summer, when my boyfriend took me to the Renaissance Fair (an outdoor festival with vendors, shows, and food set in medieval times) for the first time, he was so excited for me to see one of his favourite shows. The excitement faded as we took our seats and realised I wouldn’t be able to understand the actors. But what I could do was take in all the sights: the outfits, people laughing, the props, etc. Was it the same experience everyone else had? Definitely not. But it was still worthwhile. And thankfully, for most kinds of entertainment, there are ways to make them more accessible, such as at the movies.
Request captioning services at the movies
Most movie theatres offer captioning devices that can be requested at the ticket counter, which sit in your cupholder and display captions on a small screen. Some theatres offer screenings with captions on the movie screen itself (known as open-captions) which tend to offer a better experience. For instance, AMC theatres offer this during peak viewing hours for the first few weeks of a movie’s release – you can check your own local listings for these screenings.
Stream shows at home with sign language interpretation
At home, you have even more options. Along with traditional closed captions (known colloquially as subtitles in some countries), there are several new ways for sign language users to enjoy their favourite movies and shows. Streaming platform Max has gained popularity with the Deaf community for its ever-growing selection of media that can be watched with ASL interpretation. The company SignUp Media offers an even more expansive selection of interpreted media with selections in American Sign Language, British Sign Language and Indian Sign Language. The free browser extension can be installed on any major computer browser and used to access nearly 300 interpreted movies across several streaming platforms. Watching interpreted media is an especially great way for new signers to expand their vocabulary and storytelling skills.
The UK uniquely has an expansive streaming platform called Lumo TV that broadcasts shows featuring the Deaf and signing communities. Most of their programmes are in BSL, and can be accessed online through their website or YouTube channel, or directly on TV through one of their broadcast channels.
Check for interpreted live performances
Enjoying other local entertainment often requires calling ahead of time to schedule an interpreter or to request a specific accessibility device. But Black says some local entertainment companies may offer regularly scheduled interpreted performances that don’t require advanced preparation. In Atlanta, Georgia, for example, the well-known Fox Theater offers an ASL interpreted performance on the first Sunday afternoon of all their Broadway shows. In the UK, the organisation TheatreSign provides a calendar listing BSL-interpreted live shows across the country. In Australia, Auslan Stage Left provides a similar service. The Deaf community in your area may also organise accessible group outings throughout the year. This is a great way to enjoy entertainment without having to set up your own accommodations. Some Deaf outings in my area have included sporting events, theme parks and going to the zoo.
Getting used to planning ahead, no matter the situation, can take a little getting used to. But it’s worth the time and effort it takes to keep living life on your terms.
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Changing your perspective
Successfully navigating a hearing world is just as much about your relationship to your hearing loss as it is about the tools you use to communicate. In the Deaf community, we have a concept called ‘Deaf Gain’. While the world focuses on what being Deaf takes from us – our hearing – we can choose to focus instead on the ways our unique experience of the world adds positively to our lives. Even small things, like being able to sleep through a thunderstorm, are examples of Deaf Gain.
Even if you don’t identify with the Deaf community, I encourage you to find your own version of Deaf Gain. How has your hearing loss helped you? Maybe it’s made you more patient, introduced you to a new language and community, or helped you learn how to speak up for yourself.
Try spending five to ten minutes reflecting on the positive ways hearing loss has impacted your life. Write them down somewhere you can look back on later and remind yourself of on days when living with hearing loss feels particularly challenging.
Navigating hearing loss is a lifelong journey, but you don’t have to figure it out all on your own. Finding the right people and tools to support you along your journey can make all the difference in building a life you love.