Improved Speech Understanding Using Closed Captioning on the Television and Telephone

Learning Outcomes

After this course, participants will be able to: 

• Identify assistive devices that can improve understanding of speech on the television and telephone.
• Describe research and data on the success of captioning and speech understanding.
• Discuss the eligibility requirements in order to receive a free captioning telephone.

Introduction 

Brief History of Closed Captioning

Television closed-captioning began with Julia Child. The nation's first captioning agency, The Caption Center, was founded in 1972 at the Boston public television station, WGBH. The station introduced open television captioning to rebroadcasts of The French Chef with Julia Child and began captioning rebroadcasts of ABC News programs as well, in an effort to make television more accessible to the millions of Americans who were deaf and hard of hearing. While preparing for this presentation, I also found out that Sesame Street is currently the longest-running captioning children's program. Additionally, the captioning of commentary on a live sports event was first provided for the 1985 Super Bowl.

Closed Captioning and the Law

In 1990, The Television Decoder Circuitry Act was passed, mandating that all televisions 13 inches or larger manufactured for sale in the U.S. contain caption decoders. Sixteen years later, the FCC ruled that all broadcasts and cable television programs must include captioning, with a few exceptions. Today, you can turn on any TV channel, press a button and instantaneously access closed captioning for virtually any program. 

The Benefits of Hearing Aids and Closed Captioning for Television Viewing by Older Adults with Hearing Loss (Callahan & Gordan-Salant, 2009)

Not surprisingly, 95% of people 75 years and older watch television every day. Adults older than 65 years watch more television than younger age groups. However, there are some factors that may limit television viewing by older people. One such factor is hearing loss. In older adults with hearing loss, not only is their volume decreased, but the clarity of speech can be compromised as well. A second issue which may limit television viewing is that with age, a person's ability to process auditory information is diminished, and cognitive processing becomes slower. Other factors may relate to the viewer's listening environment, such as open rooms with high ceilings, whether the floor is carpeted or tiled, or if the room is reverberant.

A variety of assistive devices are available to improve speech understanding, the principle one being hearing aids. Although hearing aids are beneficial for improving speech in many environments, approximately 25% of older hearing aid users still report dissatisfaction with their hearing aids for television viewing. A second assistive technology that is potentially beneficial for understanding televised speech is closed captioning.

Objectives

Although watching television is a common leisure activity of older adults, the ability to understand televised speech may be compromised by an age-related hearing loss. Two potential assistive devices for improving television viewing are hearing aids and closed captioning, but prior to this study, their use and benefit by older adults with hearing loss were unknown. The primary purpose of this initial investigation was to determine if older hearing-impaired adults would show improvements in understanding televised speech with the use of these two assistive devices, as compared to conditions without these devices. A secondary purpose was to examine the frequency of hearing aid and closed captioning use among the sample of older hearing aid wearers.

Design

The investigation entailed a randomized, repeated-measures design of 15 older adults with bilateral sensorineural hearing loss who wore hearing aids. They also had to have worn their hearing aids for at least two months prior to the study, to increase the likelihood that the hearing aid benefit and acclimatization period had occurred. There were no restrictions on the degree of hearing loss because the goal of this initial study was to sample the performance of a random clinical population. Participants had to be native English speakers, with a minimum of a high school education and were required to have their vision corrected to 20/20. The final sample of 15 older adults consisted of nine men and six women, ages 59 to 82 years, with a mean age of 74 years. Hearing sensitivity ranged from mild to profound.

The participants viewed three types of televised programs: news, drama, and a game show. These programs were each edited into lists of speech segments and provided an identification response. Each participant was tested in the following four conditions:

1. A baseline condition (no hearing aid and no closed captioning)
2. A hearing-aid-only condition
3. A closed-captioning-only condition
4. A hearing-aid-plus-closed-captioning condition

Also, pilot testing with young, normal-hearing listeners was conducted to establish list equivalence and stimulus intelligibility with a control group. All testing was conducted in a quiet room to simulate a living room using a 20-inch flat screen television. Questionnaires were administered to participants to determine the frequency of hearing aid and closed captioning use while watching television.

Test Group Characteristics

A chart was made, listing each member of the test group, along with their age, hearing characteristics, and length of hearing aid use. Individual four frequency pure-tone averages were shown for each ear (500, 1000, 2000 and 4000 Hz) as well as aided monosyllabic speech recognition scores. The average thresholds across frequency showed a moderate to severe gradually sloping sensorineural hearing loss, typical of presbycusis. The hearing aids worn by this group varied in style, power, and manufacturer, reflecting the range of hearing aids worn by a clinical population. The youngest participant was 59 years old and had used a hearing aid for eight months. The oldest three participants were all 82 years old; their duration of hearing aid use ranged from nine months to five years.

Stimuli of Study

The stimuli included 124 sentences, or parts of sentences, from three different television programs: ABC World News Tonight (news), Jeopardy (game show), and The West Wing (drama). The programs were originally recorded in the fall of 2005 and winter of 2006. Four lists of 10 sentences each were recorded for each of the three shows, yielding 120 scorable sentences. Four additional practice sentences were recorded for screening purposes. Sentences contained at least four content words (i.e., nouns, verbs, adjectives, adverbs, and prepositions) that all could be used for scoring. Each sentence was spoken by one person at a time. However, several different speakers were included in each set of sentence stimuli in a given list.

Pilot testing with the 11 young adult listeners with normal hearing was conducted to verify that the final sentence lists for each program type yielded equivalent scores when the sentences were presented without closed captioning. The audio signal was at 60 dB with the closed captioning off. The young adult listeners also had normal vision, with or without correction, as indicated by self-report. There were 50 scorable words for each final sentence list. Pilot data for the audio-only and closed-captioning-only conditions showed no significant difference between the lists for both viewing conditions, confirming list equivalence. The average scores across the four sentence lists and three program types in this pilot study ranged from 86% to 98% correct without closed captioning, and from 95% to 100% correct with the closed captioning.

All testing of the older participants with hearing loss was performed in a quiet room. Participants were seated 80 inches from a 20-inch flat screen color television. They then viewed segments from three types of television programs in the same four different viewing conditions as outlined earlier:

1. A baseline condition (no hearing aid and no closed captioning)
2. A hearing-aid-only condition
3. A closed-captioning-only condition
4. A hearing-aid-plus-closed-captioning condition

The speech signal was presented through the speakers at an average conversational level of 60 dB, which was calibrated each day. Background noise was also measured and never exceeded 40 dB, which is typical for quiet rooms. The order of the viewing conditions was randomized across the listeners, as well as the assignment of sentence lists to the conditions. Thus, each listener received a unique assignment of sentence lists to the condition across each of the three shows.

Results

Post-hoc analysis indicates that the scores obtained in the hearing-aid-plus-closed-captioning conditions were significantly higher than the scores obtained in the baseline and the hearing-aid-only conditions. Surprisingly, there was no significant difference in scores between the hearing-aid-plus-closed-captioning versus the closed-captioning-only conditions. Similarly, there were no statistically significant differences in the scores measured between the baseline and hearing-aid-only conditions for all three programs. Furthermore, there was no significant difference between the hearing-aid-closed-captioning and closed-captioning-only conditions where that participant was not wearing their hearing aids. In my experience working with patients, they have a tendency to say, "I'm doing great with my hearing aids. I'm watching TV and I'm not missing anything." However, the data clearly shows that their viewing experience could be improved, simply by turning closed captioning on.

The results were as follows:

1. Baseline mean score: 23% correct
2. Hearing aid only mean score: 37% correct
3. Closed captioning mean score: 75% correct
4. Closed captioning plus hearing aid mean score: 81% correct

Clearly, there was a significant difference between the hearing-aid-only condition and the closed-captioning-plus-hearing-aid condition.

The participants were also asked to rate the frequency of hearing aid and closed captioning use. Among the 15 participants, approximately 73% reported always or usually wearing their hearing aids while watching television. However, only 13.33% noted that they always used the closed captioning while watching television. Surprisingly, about 87% of the participants reported never using the captioning while watching television. Perhaps it's not that they didn't want to use closed captioning; it may be that they didn't remember to use it. When counseling patients during follow-ups and fittings, we could remind them about using closed captioning as an option for better understanding while television viewing. 

A significant effect of viewing condition was observed for all programs. Participants exhibited significantly better speech recognition scores in conditions with closed captioning than those without closed captioning. Use of personal hearing aids did not significantly improve recognition of televised speech compared with the unaided condition. The conditioning effect was similar across the three different programs. Most of the participants (73%) regularly wore their hearing aids while watching television, while very few of them (13%) had ever used closed captioning.

Conclusion

As a result of this study, these researchers concluded that closed captioning results in a large and significant improvement in word recognition and speech understanding by older adults with varying degrees of hearing impairment. Most of the older adults indicated that they had never used closed captioning technology, despite its potential to improve understanding of television dramatically for older adults. Because the aging population is growing, and the prevalence of age-related hearing loss is high, primary care physicians, audiologists and hearing aid dispensers alike need to be aware of simple assistive tools that could enhance their patients' quality of life. Closed captioning seems to be an excellent option for a low cost, high-quality assistive tool for older adults to improve their understanding of television, which is a common leisure activity of this population.  

Captioned Telephone Service

The Federal Communications Commission regulates interstate and international communications by radio, television, wire, satellite, and cable in all 50 states, the District of Columbia and U.S. territories. An independent U.S. government agency overseen by Congress, the FCC is the federal agency responsible for implementing and enforcing America’s communications law and regulations. As such, they also regulate closed captioning on television, as well as internet protocol captioned telephone services (IPCTS). IPCTS is the means by which the internet is used to provide captioned telephone services to hard of hearing individuals.

As defined by the FCC, "Captioned telephone service allows a person with a hearing loss, but who can use his or her own voice and has some residual hearing, to speak directly to the called party and then listen, to the extent possible, to the other party and simultaneously read captions of what the other party is saying." Since they are using the internet, communication between parties is fast. This is an improvement over earlier devices that required multiple phone lines or calling a second phone number to relay the phone call. They are able to utilize their current existing phone number. They don't need a new phone number when using these services.

History of ADA

The Americans with Disabilities Act (ADA) was passed in 1990. Most people are aware of the mobility-related issues that were addressed with this law. However, other disabilities in the law included covering hearing loss. The ADA led to the development of relay and captioned telephone services. Specifically, Title IV of the ADA required that assistive services be made available free of charge to qualified end users in any state, at any time, at a cost no greater than what a person with normal hearing would pay for telephone services. As technology advanced, telephone relay services (TRS), internet relay and video relay were developed, enabling those with hearing loss to communicate remotely with hearing individuals.

The Importance of Captioned Telephone Service in Meeting the Communication Needs of People with Hearing Loss (Kochkin, 2013)

Currently, just over half of consumers are satisfied with their hearing aids on the phone. In addition, consumers report that hearing aids provide, on average, only about 55% benefit during a phone conversation. When asked, approximately eight out of 10 consumers rate improvement in hearing aid telephone utility as being highly desirable. While difficulty in hearing on the telephone is linearly related to the degree of hearing loss, significant numbers of people with mild, moderate and severe hearing loss report great difficulty communicating on the telephone.

Due to technological advances in hearing aids today, hearing aids, for the most part, do an excellent job of helping people meet many of their communication needs. However, there are situations where assistive listening devices are needed. People with hearing loss experience more difficulty on the phone because the hearing loss makes the telephone signal softer, and therefore less intelligible. Furthermore, unlike face-to-face communication, there are no visual cues to help with understanding when talking on the telephone. Critical visual cues, such as eye contact, shifts in gaze or facial expressions to signal the end of an utterance or a new conversation turn, are not available. The talker's face also helps interpret emotions as well. Additionally, some hearing aids may not be compatible with some phones, resulting in feedback. Certainly, if the patient has a telecoil, it may not function properly, the patient may forget to use it, or they may not even know they have one.

Objectives

This study had several objectives:

1. To quantify the difficulty hard-of-hearing individuals have while conversing on the telephone.
2. To determine the importance of conversing on the phone compared to 18 other communication situations for people with hearing loss.
3. To document consumer satisfaction ratings with hearing aids on conventional telephones over the last 20 years, and measure subjective benefit with hearing aids on the phone.
4. To demonstrate that captioned telephone service is needed to serve a wide spectrum of hearing losses, not just the profoundly hearing impaired, and not just current hearing aid users.
5. To demonstrate that current hearing aid utility on the telephone is a significant obstacle to hearing aid purchase for hard-of-hearing people.

Method

The author of this paper developed a tracking survey of hard-of-hearing population and hearing instrument market in 1988. The survey was administered periodically, with extremely detailed surveys being conducted in 1991, 1994, 1997, 2000, 2004 and 2008. The latter two surveys were conducted while at the Better Hearing Institute in Washington, DC. Each survey contained questions designed to track many items longitudinally. 

Referring to the most recent survey in November and December of 2008, a short screening survey was mailed to 80,000 members of the National Family Opinion (NFO) Panel. The NFO Panel consists of households that are balanced to the U.S. latest census information with respect to market size, age of household, size of household, and income within each of the nine census regions, as well as by family versus non-family households, state (with the exception of Hawaii and Alaska), and the nation's top 25 metropolitan statistical areas.

The screening survey included the following items:

1. Whether physician/staff screened for hearing loss during their physical in the last year
2. Whether the household had one or more people with a hearing difficulty in one or both ears without the use of a hearing aid
3. Whether the household had one or more people who were the owner of a hearing aid
4. Whether the household had one or more people with tinnitus (ringing in the ears)
5. Perceptions of job discrimination in promotions and salary equity
6. Detailed quantification of employment status (beyond simpler NFO panel data)
7. Traffic accidents over the past five years and driving habits

In January 2009, an extensive seven-page legal-size survey was sent to the total universe of hearing aid owners in the panel database (3789 people). Of those, 3174 completed surveys were returned, representing an 84% response rate. In February 2009, an extensive seven-page legal-size survey was sent to a random sample of 5500 people with hearing loss who had not yet adopted hearing aids. The response rate for the non-adopter survey was 79%.

Since hearing aid adoption and communication performance are related to the degree of hearing loss, both aided and unaided subjects were asked to complete subjective measures of hearing loss. They were then segmented into one of 10 groups, called deciles, based on their response to five different measures of hearing loss. Those five different measures were:

1. Number of impaired ears (one or two)
2. Score on the Gallaudet scale (an eight-point scale in which the respondent indicated whether they can understand speech under different conditions)
3. Subjective hearing loss score (respondents subjectively evaluated their hearing loss on a scale from 1-4: 1 = mild, 2 = moderate, 3 = severe, 4 = profound)
4. Difficulty hearing in noise (a five-point scale that runs from extremely difficult to not difficult at all) 
5. BHI Quick Hearing Check (a 15-item, five-point Likert Scale hearing loss inventory which is shown to be correlated with objective measures of hearing loss) 

Based on their score with all of these items, they were then placed into one of 10 hearing loss groups, or deciles, from Decile 1 (mild hearing loss) all the way to Decile 10 (profound hearing loss).

Results

The degree of hearing loss was documented for the 3109 hearing aid owners and 4209 hard-of-hearing non-hearing aid owners. The results show that hearing aid owners are more likely:

• To have a bilateral hearing loss (87% versus 61%)
• To have a perceived loss of severe to profound (40% versus 12%)
• To have more difficulty hearing normal speech across the room without visual cues (64% versus 34%)
• To have difficulty hearing in noise (66% versus 34%)
• To score in the top quartile (75th percentile) of the BHI Quick Hearing Check (45% versus 17%)

Difficulty hearing on the phone is highly related to the degree of hearing loss. One out of 10 people with a mild hearing loss (Decile 1), four out of 10 with a moderate hearing loss (Decile 5), and nine out of ten with severe hearing loss (Decile 10) report difficulty hearing on the phone without the use of hearing aids. From this data, we can estimate the market size for assistive help on the telephone by multiplying percent need by the population for each decile. Ultimately, it can be extrapolated that approximately 16 million people nationwide would benefit from assistive help on the telephone. 

Both hearing aid owners and hard-of-hearing non-HA owners were presented with a list of 19 listening situations and were asked to indicate the importance of hearing in that situation using a four-point scale: very important, important, somewhat important, or not important at all. Communicating on the telephone was rated the second highest important listening situation, ranking just behind one-on-one conversation. A total of 57% of people with hearing loss indicated that communicating on the telephone was very important to them. Results also indicated a preference for using a regular, landline telephone over a cell phone. Many of our patients, especially the elderly, may be home-bound, or they may require transportation. Utilizing the telephone is their way to gain access to the world, to their friends, and to their family. Interestingly, difficulty hearing on the phone is the number two reason that people return their hearing aids. When you're thinking about that hearing aid sale, if you can eliminate a patient's frustration, you will more likely retain that patient and that sale.

The aforementioned consumer surveys measured consumer satisfaction with various hearing aid features, quality of hearing health service, and performance of the hearing aid in 19 listening situations, one of which was on the telephone. For the period of 1991 to 2000, all items were measured on a five-point Likert Scale, ranging from very satisfied to very dissatisfied. The 2004 and 2008 surveys expanded the scale to a seven-point Likert Scale, adding "somewhat satisfied" and "somewhat dissatisfied." Subsequent research has determined that "somewhat satisfied" is close to a neutral rating. It's no surprise that consumer satisfaction with hearing aids on the phone has improved from 37% in 1991 to 55% in 2008, as we have moved from analog to digital hearing aids. In a 2000 survey, 82% of hearing aid consumers indicated that hearing aids that work better on the telephone were either "desirable" or "very desirable." 

With regard to the degree of hearing loss, among those with milder hearing losses (Deciles 1 through 3), slightly less than 70% are satisfied with their ability to hear on the telephone while wearing newer hearing aids. For moderate hearing losses (Decile 5), 60% report being satisfied, while only 40% of those with the most severe hearing loss (Decile 10) are satisfied with their ability to hear on the telephone while wearing hearing aids.

What about benefit derived from hearing aids in improving speech intelligibility? In the survey, using a zero to 100% scale, consumers were asked to estimate the percent improvement they experienced specifically due to the use of their hearing aids in 10 listening situations, with one of the listening situations being the telephone. Hearing aid owners reported that hearing aids improved their ability to communicate on the phone by 55%, with the median being 50%. One in four people experienced a 90% or higher improvement, while one in 10 reported that they experienced no benefit at all.

Conclusion

As evidenced by the data collected in this study, people who are hard-of-hearing are at a distinct disadvantage compared to normal-hearing people when communicating on the telephone. Necessary visual cues needed for effective communication are not available to the listener on a normal telephone. Captioned telephones that are customizable to deliver a speech signal based on the unique needs of the hard-of-hearing, while quickly displaying the speech in text format, would appear to offer a viable, functional solution to those with hearing loss.

CaptionCall

When counseling patients, keep in mind that although they may own a cell phone, their preferred mode of communication may be their landline phone. For these patients, a captioning phone may be more suitable as part of their hearing care package.

The CaptionCall phone (Figure 1) offers users a number of interesting features, including:

• Large text, adjustable font sizes, screen brightness adjustability and smooth scrolling captions
• Wired or wireless internet capability
• Speakerphone for hands-free calling and ability to listen with both ears
• Customizable audio (the patient's audiogram can be put into the phone), allowing users to boost certain frequencies
• Saved conversations to save captions from a particular call
• Answering machine to caption messages when you are not able to get the call

Figure 1. CaptionCall Phone.

Features

The CaptionCall phone has a speaker optimized with advanced audio processing because listening with two ears is better than one. Also, CaptionCall is the only captioning telephone to receive TIA-4953 certification. That is a certification from an independent body indicating that we have the loudest captioning phone on the market, up to 121 dB SPL, and that the sound quality is never compromised as the amplification maxes out. 

We also have customizable audio. If you choose to submit the Professional Certification Form directly through Noah, you have the option of submitting the patient's audiogram for one ear or both ears. When you do that, the installer who goes into the home can input that customizable audiogram into the phone. It gives the patient a boost in the areas where they need it. 

One of the features that can come in handy is the saved conversation feature. Patients can save any phone call, and go back later to re-read the text conversation. This comes in handy when a person needs to remember what was said in a prior conversation, such as directions or details about an upcoming appointment. One example where this proved useful was with an elderly woman who was receiving phone calls from someone trying to scam her. She had saved all of her conversations with this caller. Ultimately, through the saved conversations on her CaptionCall phone, authorities were able to identify and capture the culprit. As a result of this story, CaptionCall was featured in the Orlando Sentinel newspaper. 

CaptionCall also has an app, CaptionCall Mobile, that works specifically with the Apple iPad (Figure 2). The iPad app can be used to make or receive phone calls anywhere you have Wi-Fi or cellular internet connection. An Apple iPad 2 or later is required for the app to work. Along the bottom of Figure 2, you can see the icons for accessing different features, such as Current Call, Recent Calls, Contacts, Saved Calls, and Settings. With CaptionCall, it is easy to stay connected on the go, making it a great option for patients that travel.

Note: At the time of this course, the CaptionCall app is not yet available for iPhone or Android devices. 

Figure 2. CaptionCall Mobile for iPad.

Eligibility Requirements

To be eligible to receive the no-cost CaptionCall phone and service, your patients must have:

1. An internet connection – wired or wireless. 
2. A signed Professional Certification Form certifying the patient has a hearing loss that requires captions to use the phone effectively.

You may have patients with mild hearing loss that perceive a lot of difficulty on the telephone (e.g., older patients with poor word recognition). Conversely, you may have patients with severe hearing loss who think that they are able to hear great on the phone. Use your professional judgment to ascertain whether a patient would be a good candidate and would benefit from this service.

For the CaptionCall phone to work, the person must have an internet connection. The purpose of the internet connection is so that the captioning will be fast, with no delays. If you're talking to your patient and offering them the CaptionCall phone, ask them if they have internet. It’s important to note that they don’t need a computer – just an internet connection to use CaptionCall.  There are a variety of low-cost internet options available depending on where your patients live.  We have brought those options together in one place for your convenience at www.captioncall.com/lowcostinternet. 

The signed Professional Certification form certifies that your patient has a legitimate need for captions to use the phone effectively, and that they qualify for CaptionCall based on their hearing needs. We want to install the phones for patients that will truly derive benefit from them. 

Certification forms can be submitted in a variety of ways. We encourage you to use the option that is most convenient for you:

• Visit www.captioncall.com and click on the blue CERTIFY PATIENT button where you can fill out and submit the online form in as little as 90 seconds.
• Use the CaptionCall Module for Noah System 4. To download the module just visit www.captioncall.com and click on the Professional’s tab where you will find a ‘Download NOAH 4 Module’ option. Once the module is downloaded, you can easily submit certification forms directly from your Noah 4 system.
• Or you are welcome to continue completing a hard copy or digital copy of the certification form, available at captioncall.com and submitting it following the instructions at the top of the form via fax or email.

Once you submit the form, we will contact your patient within 24 to 48 hours to schedule their in-home installation within 10 days. If you're talking to the patient, tell them to expect a phone call from CaptionCall and to go ahead and schedule that appointment.

Qualified individuals can receive a CaptionCall phone at no cost with a certification form from a hearing care professional. There are no monthly fees or yearly fees for the captioning service. We don't collect any financial data on your patients at all. The only information that we have on your patients are the demographics included on that Professional Certification Form (name, address, phone number). 

Understandably, some patients are skeptical of our service. They may feel that if it's free, it must be too good to be true. There are a couple of things that you can use to reassure those patients. First, you can provide them with a CaptionCall brochure, which nicely spells out our funding source. If you don't have brochures, you can call our toll-free number, 877-385-0936 and have them shipped directly to your office, or talk to your regional account manager, if you have one. Using the brochure, you can explain to qualifying patients that this is a federally funded program managed by the FCC. If you look at your monthly phone bill, it will show a tax labeled as "Federal Communications Commission." The amount may vary from state to state (in Florida, it's 22 cents). Since the 1990 Americans with Disabilities Act, from every phone bill that you pay, that small amount of tax is deducted and goes to the FCC. The FCC is not only funding our program but all of these programs that fall under the Americans with Disabilities Act. You can reassure your patients that they have already paid for this service through their taxpayer dollars.

Red Carpet Service

One thing that sets CaptionCall apart from other companies is our Red Carpet Service. CaptionCall strives to make using a CaptionCall phone at home a streamlined experience not only for you, the provider but also for the patient as well. CaptionCall has hundreds of representatives across the country that provide free delivery and installation, free hands-on training, and free customer support. Many of your patients may need a little bit of "hand-holding," and we are happy to walk them through everything, step-by-step. Our installers are background checked, drug screened and vetted. When you refer your patients to us, you can be confident in the fact that the installer is trustworthy.

We spend between one to two hours in their home, setting up the phone, going over all of the details. We ask the patient who they call on a regular basis, and we program all those numbers, including their hearing care provider's information, into their contact list. We'll set up the CaptionCall phone wherever they choose. That's why we offer wired or wireless installation. They may have an old-school computer that has "hard-wired" internet, but they want the phone by their armchair in the next room. In those instances, we will provide a wireless router at no charge. That way we can put the phone wherever they need it in their house, for their comfort and ease of use. We will provide them with an instructional booklet with big pictures and big words. That way after we leave should they forget something, it's always in there. If necessary, we can go back out and do re-instruction or fix something as needed, which sometimes happens.

Summary & Conclusion

Hearing loss, if left untreated, has a significant impact on one's ability to stay connected. It makes face-to-face interactions difficult and using the telephone extremely frustrating. This often leads to loneliness and isolation, the precursors for many serious health issues. Everything we do at CaptionCall is a reflection of our mission statement: Helping people with hearing loss stay socially connected for a longer, happier, healthier life. 

Feel free to reach out to your local CaptionCall representative or call our support line at 877-385-0936 if you have any questions. CaptionCall also has a variety of complimentary resources you can use to educate your patients about the phone and service.  CaptionCall is a great retention tool for your practice.  It can also be used as a tool to eliminate hearing aid returns due to phone utility.  We're happy to help you with anything that we can and to be of service to you. Thank you for listening and participating in today's presentation. 

References

Callahan, J. S., Au.D, & Gordan-Salant, S., PhD. (2009). The Benefits of Hearing Aids and Closed Captioning for Television Viewing by Older Adults with Hearing Loss. Ear & Hearing, 30(4), 458-465.

Kochkin, S., Ph.D. (2013, March). The Importance of Captioned Telephone Service in Meeting the Communication Needs of People With Hearing Loss. Hearing Review, 28-35.