1. Virginia Thompson, M.A., C.R.C., C.V.E., L.A.C. AT Arizona vthompson@acbvi.org (602) 358-1726 Acbvi.org

2.  The term "Hearing Impaired" is a technically accurate description of someone who is hard of hearing or who has no hearing... however, many Deaf, hard of hearing and late deafened people prefer not to be called impaired. They don't want to be primarily defined by their lack of (or poor) hearing. http://www.nchearingloss.org/hi.htm

3.  Deaf: “The use of the cultural label of being Deaf can be a declaration of personal identity rather than an indicator of hearing ability. American Sign Language unites people with profound hearing loss throughout the United States. Deaf Communities have their own educational institutions, social clubs and athletic organizations. A variety of events, conferences and conventions take place on a regular basis, providing individuals who are deaf a wide variety of options in which to interact with others. In addition, the Deaf Community engages in social and political activities exclusive to the Deaf Community. The Deaf Community provides a sense of belonging for deaf people who might otherwise feel excluded from hearing culture. A belief commonly shared by Deaf people is that deafness should not be regarded as an impairment or a disability.” Source: acdhh.org

4.  Hard of Hearing The term "hard of hearing" refers to those who have some hearing and are able to use it for communication purposes (NAD, 2008)

6.  Conductive Hearing Loss- This occurs when sound waves are blocked from reaching the inner ear. Hearing is still normal once past the blockage. If left untreated, conductive hearing loss can result in permanent impairment.

7.  Sensorineural Hearing Loss- This occurs when the cause of the deafness is in the cochlea or in the auditory (hearing) nerve. Sensorineural deafness often reduces the quality of sound as well as its loudness.  Mixed Hearing Loss- It is a combination of both the sensorineural and conductive hearing loss.

9.  Mild - Sounds softer than 25 dB (decibels) to 40 dB are not detected. Soft sounds such as a faucet dripping, birds chirping, and some speech sounds may not be heard. Sounds that are moderately loud to a normal hearing person, such as speech, will be soft.  Moderate - Sounds softer than 40 dB (decibels) to 65 dB are not detected. Most speech sounds, and louder sounds such as a vacuum cleaner may not be heard. Sounds that are loud to a normal hearing person will be soft.

10.  Severe - Sounds softer than65 dB (decibels) to 90 dB are not detected. Most speech sounds will not be understood, and other loud sounds such as a phone ringing or a dog barking may be missed. Sounds that are very loud to a normal hearing person will be very soft.  Profound or Severe-Profound - sounds softer than 90 dB (decibels) are not detected. Very loud sounds such as a lawnmower may not be detected.

11.  What it sounds/looks like ◦ https://www.youtube.com/watch?v=1EJ4g3J6cJM&noredi rect=1 https://www.youtube.com/watch?v=1EJ4g3J6cJM&noredi rect=1 ◦ http://www.youtube.com/watch?v=zRoMzd8AQoI http://www.youtube.com/watch?v=zRoMzd8AQoI ◦ https://www.youtube.com/watch?v=Bcz7AeBMLSc https://www.youtube.com/watch?v=Bcz7AeBMLSc Comments/Thoughts

13.  GUIDELINES FOR EFFECTIVE COMMUNICATION ◦ Get the person’s attention. ◦ Keep your face and mouth visible. ◦ Be sure your face is adequately lit. ◦ Face the person directly when speaking. ◦ Only one person should speak at a time. ◦ Use an Assistive Listening Device. ◦ Reduce background noise or move to a quieter location.

14.  DURING THE CONVERSATION ◦ Speak clearly and at a moderate pace. ◦ Speak just a bit louder. ◦ Ask a question to see if you are understood. ◦ Write down information or key words. ◦ Be aware that accents or slang may be difficult to understand.

15.  TIPS FOR WORKING WITH INTERPRETERS ◦ What is an American Sign Language Interpreter? ◦ An American Sign Language interpreter is an intermediary who facilitates communication between people with hearing loss or speech difficulties and those without hearing loss. ASL interpreters may specialize in sign language, oral, or another communication method. ◦ Interpreters must be licensed in the State of Arizona unless interpreting in a K-12 educational setting, a religious setting, or on a volunteer basis with no pay in non-legal settings.

16.  When scheduling an Interpreter, please provide the following information: ◦ Who? ◦ Which Day(s)? ◦ What? ◦ What Time(s)? ◦ Where? ◦ Setting(s)? ◦ Other specifics?

17.  BEFORE the conversation starts: ◦ Ask the person what is the best way to communicate with her or him. ◦ Get the person's attention. For a d/Deaf or a late deafened person, a wave from a distance or a gentle tap on the shoulder is usually sufficient. A hard of hearing person may also benefit from this procedure, but calling the person's name may also help. ◦ Keep your face and mouth visible—don't turn your head or cover your mouth.

18. ◦ Remove gum, cigarettes, food, or other objects from your mouth. Speech reading is easier if the speaker's mouth area is free of objects. ◦ Be sure your face is adequately lit. ◦ Be aware of light sources. Windows or other bright light sources can create shadows on your face. This can make speech reading or watching signing more difficult. ◦ Face the person directly when speaking. ◦ Speak directly to the person—not to the interpreter, the CART provider, or the person’s companion. ◦ Negotiate a comfortable conversation space. ◦ Only one person should speak at a time.

19. ◦ Use an Assistive Listening Device, CART or Interpreter services if appropriate. If a hard of hearing person has hearing aids or assistive listening devices, give the person time to adjust the equipment. ◦ If Assistive Listening Devices, CART or Interpreter services are not available, use paper and pen to assist with the communication process if needed. ◦ Reduce background noise or move to quieter location. ◦ Maintain eye contact. Eye contact facilitates direct communication. When working with special populations such as the elderly or children be sure they can see you clearly, and if they wear glasses for daily activity make sure they have them on. acdhh.org

20.  BTE—behind the ear—are about one inch long and fit snugly behind your outer ear. A small tube connects with the amplification device behind your ear and delivers amplified sound into your ear canal. It has an adjustable volume control. The battery fits into a compartment at the bottom of the aid. Its larger size allows for more power and features, such as telecoils. BTEs are suitable for the entire range of hearing loss. 

21.  OTE—on the ear—are a new style of BTE that is extremely small and sits on top of the outer ear. The tube going into the ear canal can be very narrow and, in some OTEs, may have a speaker located in the ear canal itself.

22.  ITE—in the ear—are custom-fitted to your outer ear’s contours. Both the volume control and the battery are smaller than the ones used in a BTE. The smaller size may not amplify sufficiently for those with very severe loss. For some users, this small size can be difficult to insert or remove, change batteries, or adjust the volume. Most ITE aids have special features, such as telecoils, to make talking on the telephone easier. ITEs are appropriate for those with mild to moderate loss.

23.  ITC—in the canal—are smaller. They fit farther into the ear canal so they are barely visible. They are cosmetically appealing but are harder to manipulate and may not be powerful enough for someone with severe loss. They are customized to fit the size and shape of your ear canal.

24.  CIC—completely in the canal—are the smallest ITEs. Cosmetically, they may be the most flattering, but their tiny size can be a real disadvantage in handling. Because they are closest to your eardrum, they need less power and take a smaller battery. They are the most expensive ITEs because of their miniaturized circuitry, and they often need more frequent maintenance and cleaning than larger aids because of their placement in the canal.

25.  Telecoil or T-Switch – A setting on a hearing aid that can be used with a hearing aid-compatible telephone, assistive listening device, and audio loop system. When the hearing aid is switched to “T”, it activates the induction telecoil, causing the hearing aids to pick up the magnetic field generated by the “hearing aid-compatible” telephone assistive device, or audio loop system being used.

26.  Are Hearing Aids enough? ◦ http://www.youtube.com/watch?v=1l37lzLIgQU http://www.youtube.com/watch?v=1l37lzLIgQU ◦ Options  White Board  Ubi Duo  Telephone Amplification  Tablet  Smart Phone  Captioned Telephone  FM System (Integrated and Regular) and Loop System  Streamer  TTY, Uniphone, and NexTalk  Telephone Relay Service including VCO and HCO

29.  Assessment Process ◦ Check for self-advocacy skills ◦ Check for communication skills ◦ Ask about daily communication interactions, social life, etc. ◦ Ask about social and family support ◦ Ask about their knowledge of A.T. ◦ Ask about problems on the job  Were they fired?  Were they left out of water cooler talk?

30.  Psycho-Social Health ◦ Risk of depression ◦ Risk of alcoholism ◦ Risk of drug addiction ◦ Risk of abuse ◦ Sense of Isolation ◦ Low Self-Esteem ◦ Impact on other disabilities

31.  Rehabilitation Instructional Services ◦ Askjan.org  Counseling  Assistive Technology Evaluation  Assistive Technology Training ◦ Referral Information  Documentation of Hearing Loss  Documentation of other Disabilities  Psychological/Vocational Evaluation if available  Any concerns/observations

32.  Options ◦ White Board ◦ Ubi Duo ◦ Sign Language Interpreter ◦ Video Phone and Video Relay Service ◦ Video Remote Interpreting ◦ TTY and NexTalk ◦ Telephone Relay Service ◦ IP Relay (Internet Protocol Relay) ◦ Tablet ◦ Smartphone

38.  Title II o Access to Government Services o Access to telephone o Signage for access to accommodations  Title IV o Telephone Access o Relay Services o T-Coil Compatibility http://www.asha.org/public/hearing/Hearing-Aids-and- Cell-Phones/#1 http://www.asha.org/public/hearing/Hearing-Aids-and- Cell-Phones/#1  Enforcement o EEOC o FCC

39.  AT = Assistive Technology  Provided by RSA  Housed at Arizona Center for the Blind and Visually Impaired  Disability Awareness/Etiquette Sessions (All Disabilities)  Provided at your location or ours  1 ½ - 3 hour module sessions available  Available to employers  Hands-On Assistive Technology Awareness  Full Day Counselor Trainings  Includes awareness and hands-on AT experience for each disability

40. “Hello” Meeting & Greeting the Public General Disability Awareness Deaf / Hard of Hearing Blind / Visual Impairment Learning Disability / Cognitive Challenges Ergonomics and Physical Considerations Mobile Devices and AT (Special Session) Computer Skills for Professionals (Special Session)

41.  www.atarizona.com www.atarizona.com  www.acbvi.org www.acbvi.org  www.aztap.org www.aztap.org  www.askjan.org www.askjan.org  www.harriscomm.com www.harriscomm.com  http://www.dsi-tty.com/index.aspx http://www.dsi-tty.com/index.aspx  https://chs.asu.edu/shs/clinic https://chs.asu.edu/shs/clinic  http://lwhl.arizona.edu/ http://lwhl.arizona.edu/  www.acdhh.org www.acdhh.org  DES/RSA TTY 1-855-475-8194