Category Archives: Hearing

Domestic Violence, Sexual Assault, and AT Resources and Webinars


Aimee Sterk, LMSW, MATP Staff

MDRC staff members have been working on a multi-year collaborative grant from the Office of Violence Against Women in the U.S. Department of Justice. Through that work, all of our staff has become more familiar with the services and supports available from the domestic violence/sexual assault prevention and support community. People with disabilities experience sexual assault and domestic violence at a higher rate than the general population and these violations can also lead to disability.

How does this all relate to assistive technology (AT)?

In a variety of ways:

  1. Perpetrators may withhold people with disabilities’ access to assistive technology they need as a means of control.
  2. Perpetrators may monitor conversations of people with disabilities, especially people who are Deaf and use communication devices. This is another means of control.
  3. Many shelters are not accessible and need to develop ways to help people with disabilities access AT when they flee a situation.
  4. Sexual Assault and domestic violence program staff may not be aware or capable of assisting people with disabilities who have intellectual, processing, or communication disabilities due to their own lack of knowledge and skills. Access to assistive technology can help.
  5. Apps for PTSD can be useful to survivors of domestic violence and sexual abuse. For example, I am a sexual abuse survivor and use T2 Mood Tracker to monitor my symptoms, Gratitude! for mindfulness and PTSD Coach.
  6. There are apps and devices for safety like Circle of 6 which lets you send out messages to your friends like “come get me” and gives your GPS location. Circle of 6 also can connect you to resources. There is also Cuff, a jewelry-device that in addition to tracking your steps and location, can be used to call for help.
  7. Survivors who are Deaf and hard of hearing need to know their rights and the systems of help available. Some communication and relay systems keep transcripts of conversations automatically unless the user specifically requests that they don’t. Perpetrators have also impersonated Deaf survivors through electronic communication methods so shelters and survivors may want to develop codes phrases.

Do you know about domestic violence and sexual assault services in your community? Are they accessible? Have they done an accessibility audit? Are they welcoming and able to serve people with all types of disabilities?

A series of webinars on disability and domestic violence/sexual assault is coming up. Put on by VERA Institute of Justice Center on Victimization and Safety, these webinars cover social media and people with disabilities and safety and the ins and outs of AT for people with disabilities and safety. Below are descriptions, dates and links to register.

Engaging People with Disabilities Through Social Media

June 14, 2016

2:00-3:30 pm ET

Do you use social media in your prevention or intervention work? Learn what a group in Austin, Texas found when they initiated a project to explore social media use in their community.

Register Now


Working with Survivors with Disabilities: Understanding Tech Misuse & Online Privacy

June 30, 2016

2:00-3:30 pm ET

When is technology an advantage and when can it be dangerous? Learn from the experts at the National Network to End Domestic Violence as they present about the safety implications you should consider when using social media in your work.

Register Now


The In’s and Out’s of Safety and Assistive Technology

July 12, 2016

2:00-3:30 pm ET

During this presentation, participants will learn about common assistive technology devices, ways that abusers may use those devices to compromise safety, and how to promote the safe usage of assistive technologies.

Register Now


Join us as we fight domestic violence and sexual assault and raise awareness of AT.


Assistive Technology and Politics


Poster covering common techniques for making content accessible for people with Visual, Auditory, Ambulatory, and Cognitive characterisitcs

Abilities Affect Digital Access

An article about the response by the real time captioner at the recent Republican debate to the chaos of the debate caught my eye and got me thinking about the potential role of AT in the modern political process.

So much of what passes for presidential campaign politics now is emotional and ideological. Being unable to capture the full real range of the communications in debates, advertisements, interviews, and other real-time communication venues make it more difficult to appreciate the meaning of the campaigns, and the intentions of the candidates. I believe this greater dependence on real-time communication is very different from previous campaigns (my memory of them goes back to the 1956 campaign), back beyond the time when radio was easily available.

Technology has now allowed the “any-time” streaming of such events whenever we wish to review them. But this constant availability of digital versions still doesn’t deal with accommodations that would make the meaning of the events in their visual, auditory, cognitive, and emotional dimensions transparent, permitting us the best possible judgement of political meaning.

Real time captioning is available at the national level for many network political events, but is often not available through local events.Audio description would be a good addition to many events, but is only beginning to spread as a tool of communication. Accessible social networking apps (both text and text to speech) would help to expand ease in the understanding of political communication. But access requires some personal work to create and use these apps in a consistent effective way.

Perhaps the greatest lack in the universe of political communication accommodations is in the area of real-time cognitive accessibility, especially online. Summaries (whether in text or audio), links to further description, reading level assessment and editing, and supplemental information can all make it easier to understand the political and personal meaning of communication, but there is no standard or universal way to assure completeness in the communication of meaning. The reason for the difficulty that we face in cognitively accessible inclusive communication is a combination of deeply set information processing habits that we all have, and the reality that effective cognitive accommodation always requires a degree of individual customization to be effective. For all the talk about “mass customization”, it requires real work to make it happen in our common universe of cognitive diversity.

If this presidential campaign has taught us nothing else, it should point out to us in the starkest possible terms just how important our individual and disability community political engagement is. That engagement hinges on accessibility just as much as it requires any other factor of the political process.


Basic Guide to Understanding an Audiogram


By Liz Kobylak, HLAA-MI Hearing Technology Resource Specialist

Those of us who have been diagnosed with hearing loss have probably, at some point, looked with dread at our audio- grams which graph our hearing test results. This graph can be confusing to those just beginning their hearing loss journey. To understand the basics of how to read an audiogram we need to become familiar with a few terms related to hearing loss.

  • Air Conduction: hearing test signal (tones or speech) through the headphones.
  • Bone Conduction: hearing test signal (tones or speech) through a vibrating tool called the oscillator placed on the mastoid bone behind the ear.
  • Decibel (dB): unit of measurement for sound. This is a logarithmic measurement, not a linear one.
  • Frequency: pitch or tone, measured in Hertz (Hz).
  • Masking: a noise signal used to keep one ear “busy” while testing the other ear.
  • Threshhold: the softest level of a puretone to which a person responds 50% of the time.
  • Speech Reception Threshhold: the softest level at which a person correctly repeats two-syllable words 50% of the time.
  • Speech Discrimination: Testing with words at a comfortable level of loudness to identify problems with speech understanding beyond what is expected for the hearing loss.
  • Sensorineural loss: hearing loss which occurs in the cochlea (sense organ) or beyond (neural).
  • Conductive loss: hearing loss with better test results from the oscillator, generally means signal is being blocked in the canal or middle ear.
  • Mixed loss: hearing loss with a sensorineural and conductive component.

Now let’s take a look and become familiar with the audiogram:Chart of an audiogram

  • The numbers along the left side of the chart measure decibels (dB). The higher the number, the louder the This is not a linear scale, it is logarithmic.
  • The numbers along the top of the chart measure frequency or pitch of sound in Hertz (Hz). Think of this part as a piano keyboard with the lower pitch sounds on the left of the The sounds become higher in pitch as you move to the right.
  • The right side of this chart shows various levels/categories of hearing
  • Right ear air conduction threshholds are marked with a “O”
  • Left ear air conduction threshholds are marked with an “X”
  • The audiologist may mark the threshold results for the Right ear with RED ink and for the Left ear with BLUE
  • Right bone conduction results are marked with this “
  • Left bone conduction results are marked with this “>“

Asking for a copy of your audiogram is a good idea. It can be an important step in becoming empowered about your own unique hearing loss. It is, after all, a health condition that varies between individuals. Many patients find it useful to plot their own audiogram test results onto the blank audiogram to help identify their level of hearing loss. The individual test results can also be plotted onto the audiogram of familiar sounds. In either case, remember that everything above the lines of the connected O’s or X’s is what the patient cannot hear. This is a significant step toward understanding why we hear some sounds but do not hear others in daily life.chart of audiogram with pictures of common sounds

  • Even a mild hearing loss (30-40 dB range) can impact speech
  • A moderate hearing loss (50 dB) indicates that most speech sounds are already being
  • People with a severe hearing loss (71 dB) have lost all ability to hear speech
  • Keep in mind that vowels are lower in frequency than Many words begin or end with conso nant sounds. People with hearing loss can miss whole syllables and speech can sound garbled as a result.
  • The human voice can make vowel sounds louder but not consonant This can lead to distortion of speech when people try to speak very loudly to some- one with hearing loss. (To demonstrate, try making the “s” sound as loudly as you can.)
  • The chart at the left is a great tool to educate oneself as well as family and friends about the real life implications of our hearing

Becoming familiar with some of the terms associated with hearing loss allows patients to participate in their hearing health care from the very beginning. Audiologists will gladly explain the nuances of your unique hearing loss.

In my own case, there is a sense of empowerment that comes with being able to tell people that I have severe to profound hearing loss in both ears, instead of just saying I have a hearing loss. Showing the audiogram of familiar sounds to my family really opened up their eyes (and in some cases, dropped their jaws) about how little I am actually able to hear without amplification. Knowledge is power.


Internet of Things (IoT) for AT? Pay Attention to the Details.


By Tony Ferack, Hearing Loss Association of America

I was reading a recent article titled “AT&T unveiling Drawing labeled "internet of things" and "Connect the world"Internet of Things-linked wheelchair“ and felt compelled to write this blog. First, if you have not yet heard the buzzword “Internet of Things”, I’ll fill you in. Internet of Things is often abbreviated IoT and has been around for several years. In a nutshell, the “Things” in IoT are simply devices that are connected to the internet.

If you have a Smart TV, it could be considered an IoT since the TV is connected to the Internet via your home router. Most, if not all, of the major appliance companies, are advertising Smart Appliances. The biggest advantage of having a smart appliance is that it can update itself if the manufacturer has made improvements on how the appliance operates. I’ve never heard of an appliance being recalled because the manufacturer found a way to make the device perform better.

With Smart technology, a manufacturer can make the improvement to your device automatically as long as the appliance is connected to the internet. Imagine a refrigerator that can alert you if there is something wrong. For example, wouldn’t it be cool (no pun intended) if your refrigerator sent you a text message if the temperature in the freezer went below a designated temperature? To take it a step further, how about a reminder phone call if you are low on eggs?

Now, let’s take this technology to Assistive Technology, the whole premise of this article. Let’s say you need to take your heart medicine at certain times during the day and you have a Smart pillbox. If you forget to take your medicine, a Smartwatch could vibrate to remind you. To take this further, a Smart pillbox could even detect if it has been filled with the correct medicine!5 different smartwatches

The above mentioned article talks about a Smart wheelchair. The features that the article talks about are “Seating Position and Cushion Pressure”, “Battery Level and Predictive Maintenance Requirements”, and “GPS Location and Fleet Management”. I am okay with this type of internet sensing since it doesn’t affect how the wheelchair moves or stops. What gives me the willies is when manufacturers sneak in additional functionality without the users knowledge.

For example, there was a recent article that mentioned how two researchers were able to hack into the computer of an automobile. This is scary stuff. The end result is that the manufacturer issued a recall to correct the problem. The problem could have been avoided. In this case, the vehicle was designed to give remote control of some critical functions of the car. This was indeed a major flaw. The recall removed the ability to remotely control vehicle safety functions. Think about how a wheelchair manufacturer might want to build in the ability to control the wheelchair. From a service standpoint, it could eliminate the need to send a repair person to service your wheelchair. Unfortunately, we do not live in a perfect world. If the manufacturer can control a device remotely, so could a hacker.

So, what about Internet of Things as it applies to hearing aids and cochlear implants? To the best of my knowledge, there is no hearing aid that has direct connectivity to the internet but there is an indirect path. This path is through a smartphone. Since some hearing devices connect directly to a smartphone (via Bluetooth) and the smartphone can connect to the internet, there is always the possibility that a hearing device could be altered remotely.

Keep Internet of Things in mind when a Smart product fails to work properly. There may be someone else watching you.