Hearing Loss – Tips, Tools and Facts

Hearing Impaired symbol

Hearing Loss Quick Facts

As an Assistive Technology Practitioner, referrals for evaluation can include pediatric to geriatric clients. Their unique disability needs can be focused or multi-faceted, especially when age is a factor. When multiple disabilities exist, referring individuals to other specialists is important for expert advise. One of those areas of expertise often referred or seeking consultation are those with hearing loss.

Reviewing statistics on the prevalence of hearing impairment, here are a few basic facts about hearing loss¹:

  • At age 65, one out of three people has a hearing loss.
  • 60 percent of the people with hearing loss are either in the work force or in educational settings.
  • While people in the workplace with the mildest hearing losses show little or no drop in income compared to their normal hearing peers, as the hearing loss increases, so does the reduction in compensation.
  • About 2-3 of every 1,000 children are hard of hearing or deaf
  • Estimated that 30 school children per 1,000 have a hearing loss.


Did you  know the incidence of hearing impairment in adults over 65 years was this high? One in three adults over the age of 65 have a hearing impairment. For OT’s or ATP’s working with older adults (LTC, Home Health, Acute Care, Veterans, etc.) that could mean a third of your clients have difficulty hearing and using good disability etiquette for hearing impairment would be employed during every work day most likely!  Certainly, as OT’s we are good at evaluating our clients needs and adapting to their needs by positioning of ourselves, talking to them so they can see our face and lips, speaking slowly and concisely with adequate volume.  Below, however, are tips from the Hearing Loss.org  to remind us of good communication when working with individuals with hearing loss. Checking to see if they have hearing aids and are turned on may be need to be explored.

Basic Communication Tips

Tips for Hearing Person to Communicate with Person who has a Hearing Loss (from the Hearing Loss.org website)²:

Set Your Stage

  • Face person directly.
  • Spotlight your face (no backlighting).
  • Avoid noisy backgrounds.
  • Get attention first.
  • Ask how you can facilitate communication.
  • When audio and acoustics are poor, emphasize the visual.

Get the Point Across

  • Don’t shout.
  • Speak clearly, at moderate pace, not over-emphasizing words.
  • Don’t hide your mouth, chew food, gum, or smoke while talking.
  • Re-phrase if you are not understood.
  • Use facial expressions, gestures.
  • Give clues when changing subjects or say “new subject.”

Establish Empathy with Your Audience

  • Be patient if response seems slow.
  • Talk to a hard of hearing person, not about him or her to another person.
  • Show respect to help build confidence and have a constructive conversation.
  • Maintain a sense of humor, stay positive and relaxed

Assistive Technology for Hearing (HAT)

What other tools or assistive technology might be considered when working with individuals with hearing loss?

More HAT Tools to Consider

As OT’s, we don’t always readily have immediate access to equipment or tools for individual with hearing impairment. Certainly paper and pencil is a low tech method for clients that can  write. If you have access to a mobile device here are a few other basic tools that can help with communicating with individuals with hearing loss:

  • HearYouNow app for iOS (free; iPhone/iPad) provides amplification with options of volume, near/far and low, medium or high frequency challenges. A earphone is required. Recent trial with a client found this easy to use, works in the background on both iPhone and iPad. This worked well as an inexpensive option for occasional need for a clients’ high frequency hearing loss at work. If needed on a regular basis, a compatible device that pairs with the clients hearing aids was identified, however cost was also significant. This app provided a low cost/no cost option using his work based iPad Mini when needed. Earphones are required.
  • HearingAmp Lite app for iOS (free/1.99; iPhone/iPad) also provided basic amplification tools, runs in the background and provides the ability to create individual profiles for different situations or environments. Earphones are required (dependent on the users head aids).
  • The FlipWriter AAC app provides separate keyboards for both communication partners to create text based messages for individuals who can write and type.
  • Using an iPad or Android tablet with a general note app (Notes  app – the native app in iOS) or Color Notepad Notes app (free; Android) to type text messages.
  • The UbiDou2 is a communication device for individuals who are deaf or hard of hearing. This device offering two communicating word processing units that will relay/share information typed up to 300 feet using its own proprietary wireless network system. Many medical or work situations use this portable technology as an accommodation for a employer or for clients, when Sign language interpreters or personal listening devices are not available. Users must be able to type and have fair spelling skills to use this text based communication system.


If working with older adults, their is a 1 in 3 chance that the individual may have a hearing impairment. Accommodating them with use of their dedicated listening devices, environmental modifications and tips for communication can support communication. A variety of assistive technology devices also exist for individuals with a hearing loss. In some situations, apps on a mobile device can aid communication when a more significant hearing loss is present.

Many web based resources on hearing loss are available. One excellent website with information and many resources is the Hearing Loss Association of America, a helpful resource if you want to learn more about HAT or other supports for individuals with hearing loss.

More for your OT eTool Kit!



¹Retrieved on 3/13/2016 from: http://www.hearingloss.org/content/basic-facts-about-hearing-loss

²Retrieved on 3/13/2016 from: http://www.hearingloss.org/content/living-hearing-loss

About Carol Leynse Harpold, MS, OTR/L, SCLV, ATP, CATIS

OTR/L with more than 35 years experience in pediatrics, school based therapy and adult rehabilitation. Masters of Science in Adaptive Education/Assistive Technology with 20 years experience in AT in education of elementary, middle school, secondary, post secondary students and work environments for adult clients. A RESNA Assistive Technology Practitioner with ACVREP CATIS credentials, AOTA Specialty Certification in Low Vision, USC Davis Executive Certificate in Home Modifications, servicing adults and students with disabilities in employment, education, and home environments. A 2020 graduate of the University of Alabama Birmingham Low Vision Certification Program.
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