Assistive Communication Devices

This brochure is a copy of an American Academy of Otolaryngology - Head and Neck Surgery Public Service Brochure.

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How Can You Make Your Home "Communication-Friendly"?

There are lots of ways you can make your home communication-friendly for your family and your child's friends. In fact, technology is going to make a huge difference in your child's life, equalizing the playing field between those who have normal hearing and those who do not. One of the exciting aspects is that much of this is "mainstream" technology, used by everyone, not just people with hearing loss.

You probably already have some of this equipment at home. Do you have a computer and access to the Internet? This will become your child's lifeline! Email has become ubiquitous and it is one of the simplest ways for people with and without hearing loss to communicate. Every year millions of people open Internet and email accounts, as the price of computers and Internet services decrease. In fact, people with hearing loss are usually the first to use new services, such as instant messaging or "chat rooms". Additionally, the Internet is a "no hassle" way to conduct research for school projects. There are also computer programs that are excellent for stimulating language and speech skills.

If you have a fax machine, you have another device that is excellent for non-verbal communication. One of the good features of faxes is that you have a "hard copy" of your communication. This way, both parties can be certain they have understood one another, avoiding mix-ups and misunderstandings which can occur in conversations where communication is difficult.

If you have a television set manufactured after 1993 with a screen that is 13 inches or larger, your child has instant visual access to TV. You may have noticed the number of programs that are captioned, designated with a "CC" in every television program guide. Television captioning is similar to the written text line you see running across the bottom of foreign movies. You may have also seen the captioning line used on televisions in noisy places like airports and restaurants.

You will need to use the closed captioning button on your T.V. to access the caption line. Check your T.V. instruction booklet if you are unsure how to activate closed captioning. Older televisions do not have a closed captioned button, but you can buy a separate closed captioned decoder from specialty catalogs featuring assistive devices. However, it may be a better investment to purchase a new television, rather than a caption decoder.

Your child can use a telephone, too. Children with mild-moderate losses, or even severe-to-profound losses (if they are well-aided or have a cochlear implant, and have been taught to use residual hearing), may be able to use the regular telephone. As a first step, ensure that your phone has a volume control option so that your child may amplify the caller's voice as necessary. Also, your child needs a hearing aid with a telephone ("t") switch, and a hearing-aid compatible telephone. Newer phones are all manufactured to be compatible with t-switches. If you have an older phone, your child will have to try it out with the t-switch turned on. Some of the digital wireless phones will emit a loud, squealing sound if used with a "t" switch. If you are going to purchase a digital wireless phone that your child will use, you need to have him/her try it out before committing to the purchase.

A TTY machine can be attached to your regular phone to turn the auditory signal into a visual print-out. In order to use a TTY, your child needs to know how to type and to read. The phone set is not held up to one's ear, but placed on the TTY machine. The person types in the message, and the words are transmitted to the person on the other end who also has a TTY machine. The message is read, one line at a time, on a small screen. There are a variety of TTY machines - some are very small and portable, others are desk units with the capability of printing a "hard copy" of the conversation. TTY machines can be ordered through specialty catalogs.

So, what do you do if the person being called doesn't own a TTY? Thanks to another federal law, the Americans With Disabilities Act, a nation-wide relay system has been set up. The person with the TTY first calls a relay operator. The relay operator gets the second party on the line. Now the person with the TTY starts typing in the conversation. The relay operator reads the message over his/her TTY and relays that message verbally to the second party. The second party answers verbally, the operator types in that message and it is relayed to the person with the TTY. The parties can talk as long as they wish. The rates for long-distance are reduced for relay calls, because they take longer than regular calls. The relay number for your state is located in the front pages of your telephone book.

There are other pieces of equipment that make communication helpful-for example, vibrating pagers with digital readouts, watches with vibrating alarms, visual alarm clocks-and dozens of gadgets and accessories helpful for enhancing communication. Keep your eyes and ears open for new technology and new ways of using existing technology. Consult AG Bell and other organizations serving the deaf and hard of hearing, and send for some of the specialty catalogs on assistive devices. Attend the AG Bell convention to learn more about advances in technology through our technology forums and research symposia.

"Communication Options" ? What Does That Mean?

School systems use a number of systems of communication for children who are deaf or hard of hearing. As a parent, you will find the information on communication options often conflicting and confusing, and one of your most difficult tasks will be to decide on the best option for your child. This may, in part, be dictated by what is available in your community. Large metropolitan areas may offer several options.

Auditory/Oral-These programs teach children to make maximum use of their residual hearing through amplification (hearing aids or cochlear implants), to augment their residual hearing with speech (lip) reading, and to speak. This approach excludes the use of sign language. The philosophy behind the Auditory/Oral method is to prepare children to work and live in a predominately hearing society.

Auditory/Verbal-The auditory/verbal approach is similar to the auditory/oral approach, except it does not encourage lip-reading. This method emphasizes the exclusive use of auditory skills through one-on-one teaching. It excludes the use of sign language, while emphasizing the importance of placing children in the regular classroom ("mainstream education") as soon as possible.

Cued Speech-This is a visual communication system combining eight handshapes (cues) that represent different sounds of speech. These cues are used simultaneously with speaking. The hand shapes help the child distinguish sounds that look the same on the lips-such as "p" and "b". The use of cues significantly enhances lip-reading ability. It is a particularly good system for a child who may not be able to learn entirely though amplified hearing.

Total Communication-Total communication uses a combination of methods to teach a child, including a form of sign language, finger spelling, speech reading, speaking and amplification. The sign language used in total communication (SEE sign) is not a language in and of itself, like American Sign Language, but an artificially-constructed language following English grammatical structure.

American Sign Language (Bilingual/Bicultural)-In this method, American Sign Language is taught as the child's primary language, and English as a second language. American Sign Language is recognized as a true language in its own right and does not follow the grammatical structure of English. This method is used extensively within the Deaf community, a group that views itself as having a separate culture and identity from mainstream society.

If you feel confused at this point, you are having a normal parental reaction! Ninety percent of parents who have a child with a hearing loss possess normal hearing themselves. Your knowledge of hearing loss probably extends to having seen it profiled occasionally on television or in the movies. The variety of educational options may make little sense to you right now. Which education methodology should you choose for your child? Should you enroll your child in the public program or with a private therapist or in a private school?

These decisions will be clearer after you've done some homework. As you gain knowledge, the right decision for you and your family will be clearer. We suggest that you take the following steps to help in gathering information in order to make an informed decision.

  • Read about the different educational options. A good book to start with is Choices in Deafness by Sue Schwartz, distributed by The book presents parental and professional views on all of the major educational options. You can also request publication catalogs and free brochures from AG Bell and other national organizations listed in the reference section of this booklet.
  • Visit the available programs in your community. Start by calling your local school district and asking for the person in charge of parent/infant programs for children with hearing loss. Make an appointment to talk with the person in charge and visit the program. Call AG Bell for a list of private programs in your area. Even if you are unsure about a private option, visiting such a program gives you a frame of reference for evaluating your public school's program and for requesting specific accommodations.
  • Communicate with other parents and professionals about local programs. What does your audiologist think of the local school program? Is there a better one in a nearby school system? Ask your audiologist to connect you with a parent of a slightly older child who could tell you about the local programs. Find out about the quality of the programs beyond the preschool level. Another good source of information is
  • After you have called or visited programs in your area and done some reading, make a list of educational options available, along with your impression of the quality of each program. The list might look like the one on the one below.
Communication Options Checklist
Available in my community? My Impression
Cued Speech  
Total Communication  
American Sign Language  

Perhaps you have decided on an educational option that is not available in your community, or does not seem to have quality staffing and programming. If so, are you willing to relocate? As your child gets older, would you consider a residential program?

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