Rehabilitative Technologies and

Telephone Use

Submitted by:Appas Saha

• A number of individual rehabilitative can also be used with the
telephone to improve communication for the individual with Hearing
loss. One device, for example, consists of a disk shaped microphone
that attaches to the telephone handset. The signal is then routed into
the listener’s hearing aid via DAI. Often the use of an individual
personal rehabilitative technology, particularly DAI, can be beneficial
in environments where electromagnetic interference is high
Telephone Amplifiers

There are several types of telephone amplifiers viz.

• Amplified telephones
• Amplified telephone handsets
• In-line amplifiers
• Portable telephone amplifiers
• Acoustic-induction loop amplifiers
• Each of these amplifiers can be used with or without a hearing aid. If
used with a hearing aid, such amplification systems may be used
through acoustic coupling (through the microphone of the hearing
aid) or inductive coupling (through the telecoil of the hearing aid)
Amplified telephones
• Amplified telephones often provide adjustable gains, characteristics,
Tone controls and enhanced dynamic range. Amplified telephones
may also contain low frequency, high intensity ringers. Unfortunately,
many of the more inexpensive, electronic based telephones may not
provide enough amplification to assist listeners who have more than a
mild degree of hearing loss. In addition to amplified telephones,
speaker telephones, with adjustable gain characteristics, may also be
used by some individuals with hearing loss.
amplified replacement handsets
• Another form of telephone amplification is amplified replacement
handsets. Amplified handsets are generally available with volume
control capacities. In addition, several companies are now dispensing
amplified handsets with mute switches, tone controls and noise
cancellation circuitry. Replacement handsets can be attached to most
traditional modular telephones. Replacement handsets may not be
compatible with many of the newer, more inexpensive, electronic
telephonic systems.
• To overcome this problem, amplified replacements handsets may be
purchased with their own power supply. It should be noted that when
placing a replacement on a telephone the impedence characteristics
of the telephone handset and telephone must be matched.
Otherwise, the gain will not be maximized and signal shall be
distorted. If such handsets are coupled with hearing aids, it is
imperative that the handset is hearing aid compatible. The Americans
with Disabilities Act (ADA, 1990; PL 101-336) requires that all
commercially used pay telephones have handsets with adjustable gain
controls.
In Line telephones
• In Line telephones amplifiers are available only with modular
telephones. In line amplifiers come with variable gain controls,
frequency response controls, or both. The most common placement
of an in-line amplifier is between the base of the telephone and the
cord of the headset. In line amplifiers can either be externally or
internally powered. Such amplifiers can also be used with personal
rehabilitative technologies. For example, an in line amplifier can be
connected from the Telephone base into an FM system. In this case,
the individual would receive high SNR through FM systems and would
speak through the handset of the telephone. Most in line amplifiers
are relatively compact and portable.
Portable telephone amplifiers
• Portable 20-30 dB telephone amplifiers, or “strap-on” amplifiers, can
be coupled to the telephone acoustically, magnetically or both.
Portable amplifiers are acoustically coupled to the telephone provide
approximately 20 dB of Gain and can be used with the vast majority
of telephones (cellular, trimline, cordless, and pay phones) on the
market today. Portable telephone amplifiers can also be coupled
magnetically to the telephone. In this case, the user must switch the
hearing aid to the telecoil setting.
• Magnetic coupling strategies, however, can be only be used with
hearing-aid-compatible telephones. AS of 1991, all telephones
manufactured or imported for use in the U.S. were required to be
hearing aid compatible ( Public Law 394, The Hearing Aid
Compatibility Act, 1988) PL 394 excludes telephones used for the
transmission of classified information, public mobile services, private
radio services, and residential use if the phone was purchased prior to
1991. Recently, several companies have marketed portable telephone
amplifiers that can be coupled either magnetically or acoustically to
the telephone.
• Moreover, there are several acoustic-to-magnetic telephone adapters
on the market today. With acoustic to magnetic amplifiers, the
acoustic signal is received via the telephone handset, amplified and
transduced into an electromagnetic signal. The electromagnetic signal
is then picked up via the patient’s level.
TELE-communication Devices for the Deaf

• Individuals with severe to profound hearing loss, poor speech

recognition, or severe speech impairments may not be able to
effectively use the telephones even with amplification devices. For
these individuals Telecommunication device for the DEAF (TDDs) (also
called teletypewriters (TTYs) or Text telephones (TTs)) may be
required. The TDD transmits a typed, visual message (in Baudot code)
over standard telephone lines. The typed communication appears on
either a light emitting bulb display, or it can be printed out.
• Braille TDDs are available to those with visual as well as hearing
difficulties. For a TDD conversation to take place, both the sender and
receiver must have TDD instrumentation that is compatible with each
other. A TDD system can also be modified to communicate to a
computer. To allow this type of communication, an interface option is
required to proceed the slower transmission rate of the Baudot code
of the TDD to the faster transmission speed of the computer.
Telephone relay services
• Telephone relay services (TRS) are available to the TDD user who
needs to communicate with a non-TDD user. With the TRS, the
individual using the TDD types a message to a state designated
telephone number that is picked up by a normal hearing operator and
transmitted verbally to the non-TDD user. The non-TDD user can then
respond to the TDD user by verbally giving the message to the relay
operator, who in turn, relays the message via written text to the TDD
user. With TRSs, individuals with normal hearing can also telephone
persons who use TDDs. As of 1993, the ADA mandated that all
telephone companies provide within and across-state telephone relay
services.
Amplifying phones
• The simplest and crudest solution to improving a phone for someone
with a hearing impairment is obviously to make it louder. On an
amplifying phone, the loudness of the handset volume is usually
adjustable up to a maximum of about 100-150dB (people without
hearing impairment would find this painfully loud), though the
microphone volume is usually adjustable too (useful if one deaf person
is talking by phone to another). Since telephones are generally used by
more than one person, sound amplification may be switched on or
temporarily "boosted" by pressing a button just for the duration of a
call. Often the tone (treble-bass level) of the sound in the handset can
also be adjusted to match a person's particular hearing loss.
Amplifiers for existing phones
• If you like your existing phone and your hearing difficulty is more
moderate, you could invest in a telephone amplifier. The simplest ones
are little boxes that clip or strap onto the handset earpiece of a normal
phone. They have a microphone one side (which faces the phone
loudspeaker), a loudspeaker the other (which faces your ear), and a
battery-powered amplifier unit in the middle.
• More sophisticated "in-line" amplifiers fit in between the handset and
the base unit so they interrupt and boost the current going from the
base to the handset loudspeaker, making the sound louder that way.
Some have tone controls for added refinement of the amplified sound.
Generally, amplifiers like this boost volume by about 20-40dB
Identifying calls and callers

• Phones for the hearing impaired generally have much louder rings (a
maximum ring volume of 80dB is typical) and visual or vibrating alerts
(bright flashing strobe lights or vibrating buzzers similar to those in
cellphones and pagers). Hearing-impaired users often like to have a
number of extension bells and you can buy plug-in ringers (small boxes
that ring and flash) to fit to extension sockets around your home.
Some phones have LCD displays with caller identification (also known
as caller ID or caller display) so you can see who's on the line before
you decide whether you want to answer. Others can be programmed
to speak aloud the name and details of a caller in a loud, clear voice
(useful if a person has visual as well as hearing impairments).
Inductive coupling

• A hearing aid is an example of electromagnetism in action: it uses a

microphone to pick up and convert sounds to electricity, which it then
amplifies and turns back into louder sounds in a person's ear using a
miniature loudspeaker. The quality of the amplified sound can
sometimes be poor or confusing because a hearing aid will generally
amplify background noise as well as the sounds you actually want to
hear
• When those sounds are produced by a loudspeaker of some kind,
such as the one in a telephone, a person with a hearing impairment
can often produce a clearer, more audible sound in their ear by
induction coupling: linking their hearing aid directly,
electromagnetically, to the sound source and switching off the
microphone in their hearing aid
• Public places such as theaters and concert halls are often fitted with
induction loops, which are large circuits of wire fed with electrical
signals from the same source driving the main loudspeakers. As the
signals travel around an induction loop, it produces a small, safe,
fluctuating magnetic field all around it. Compatible hearing aids will
pick up these fields using a smaller loop of wire (called a "telecoil")
inside them and convert them directly into sounds.
• Effectively, you get a direct "feed" of the loudspeaker to your ear, so
your hearing aid receives only the sounds you want to hear and not
the background noise. Compatible hearing aids have a switch on them
called the T setting that allows them to pick up signals from induction
loops. Virtually all phones designed for hearing impaired people can
be used with inductive coupling in this way.
 Reference:

• Textbook of Hearing Aid Amplification by Sandlin

• http://www.explainthatstuff.com/telephones-for-hearing-
impaired.html