"Try the Alternative...where the client AND employee matter."

1. Assistive Listening Devices for D/deaf and Hard of Hearing Populations January 9, 2013 3:00 PM to 4:00 PM EST "Try the Alternative...where the client AND employee matter."

2. Who is Speaking Today? • Valerie Stafford-Mallis, M.B.A., Business Development Manager • Alternative Communication Services, LLC • CART provided compliments of ACS

3. Today’s Program • Remote Transcription and Interpreting • Assistive Listening Devices • Hearing Aid Technology Updates • Implants & Bone Conduction Updates • Trends in Affordable Hearing Healthcare • Hearing Loss and Dementia • Q & A

4. Types of Communication Impacts

5. Levels of Hearing Loss

6. The Speech Banana

7. Remote Voice-to-Text

8. Technology Options • Laptop • iPad/Tablet • Smart phone • Internet connection (Ethernet or Wi-Fi) • Phone line (conference phone) • Skype (VoIP)

9. What is CART? • CART (Communication Access Real-Time Translation) • Verbatim: capture 100% of conversation • Certification requires 96% minimum accuracy rate • ACS requires 98.5% minimum accuracy rate • At least 180 WPM – ACS requires 225 WPM • Specially trained court reporter • NCRA certifications: CCP, CRR, CBC • Remote CART (internet) • On-site CART (service provider in room)

10. CART And so I was thinking that's a neat way to start things out. You recognize, it's like, I've done lots of fun things, and I've had lots of fun opportunities, but this morning is the first day of the rest of my life. And so I look forward tosharing with you a little bit this morning, and I look forward continuing to grow in this industry. It's pretty exciting. Pretty unique opportunity. Name is Phil Hyssong. My work within NCRA is certified manager of reporting services. I will tell you right upfront. TEXT INTERPRETING I thought that was neat. I've done lots of fun things, but this morning is the first day of the rest of my life. My name is Phil Hyssong. I am a certified manager of reporting services. I'm not a steno writer. I think the work you do is a gift and it's a fun profession to be a part of.

11. What is Text Interpreting? • C-Print or TypeWell • Abbreviation software used to provide real-time communication access • Regular laptop - no special equipment or keyboard • Meaning-for-meaning • Condenses the language into fewer words • Can be quicker and easier to read than verbatim • Training takes 1-3 months • Transcriptionist can be on site or remote

12. What is Voice-Recognition Software? • Dragon, Windows Speech Recognition, CapTel, others • Good for dictation, basic computer commands, and editing • Not as effective for facilitating effective two-way communication with multiple speakers • Used in Captioned Telephony • Some voices difficult to recognize • Humans outperform software • Remote over the internet significant lag time

13. Captioned Telephony via the Internet Drag picture to placeholder or click icon to add yeah and are you a swimmer ? Oh excellent because uh um my my ex dermatologists won the mail message every event every event world < masters > don't know if you miss name was um gosh how have to I will have to I am sorry I'll have to think about that it has been a while < i will > he has got a different sort of name but he was a he was an Olympic swimmer and he just could not wait until he was 70 or 72 or whatever he had to be this guy look he he was 70 or 72 and he looked like 50 at best so I guess um 2 things that I like about this is subtle color changes and it looks like some really strong color changes but there's a lot of them that are subtle and it is also um not just a few OK ? < the hue > of the tone in other words like dark < but > medium kind of like that thing < light > so it may it hmm ? Mm hmm and

14. Benefits of Using Remote Voice-to-Text • Real-Time Access to Text: 2-3 second delay. • Roughly Edited Transcripts: Word document sent within 24-48 hours. • On Demand: Services can be scheduled in 30-minutes or less. • Availability: Writers can be located anywhere. • Quality: Writer expertise can be matched to subject matter.

15. Remote Sign Language Interpreting

16. How VRI Works

17. Difference between VRI and VRS 17 • VRS = Video Relay Service • VRI = Video Remote Interpreting • The Two Are Not the Same Thing!

18. Technology Requirements • Computer for person needing interpreting services • Free download of Skype* software www.skype.com* • High-speed Internet connection with a reliable upload/download speed of at least 512 kbps and preferably 1Mbps each way (wired connection preferred but wireless can work). • Frame rate of 30 fps or better required with H.264 or H.323 compression • Revolabs Xtag* wireless lapel or omnidirectional microphone for speaker(s) audio capture

19. Benefits of Using VRI - Video Remote Interpreting • Shorter notices than on-site interpreting • No two-hour minimums • No portal to portal or travel charges • Availability: Interpreters can be located anywhere. • Quality: Interpreter expertise can be matched to subject matter. • No on-site visitor security clearances necessary

20. Assistive Listening Devices • Source: Hearing Loss Association of America Assistive Listening Device Brochure • http://www.hearingloss.org/sites/default/files/docs/HLAA_ALDS_Brochure.pdf

21. Common Assistive Listening Devices 21

22. Common Assistive Listening Devices

23. Hearing Aid Technology Updates

24. Hearing Aid Types BTE Behind-the-Ear Mini Behind-the-Ear RIC Receiver-in-Canal ITE In-the-Ear Half-shell ITE ITC In-the-Canal CIC Completely-in-the-Canal

25. Source: Barbara Jenkins Au.D., BCABA Hearing Health Foundation www.hearinghealthmag.com Summer 2012 Pages 28-31

26. Implants and Bone Conduction Updates

27. BAHA – Bone Anchored Hearing Aid source: http://products.cochlearamericas.com/baha • BAHA bypasses outer and middle ear • Sends sounds to inner ear via bone conduction • Mixed hearing loss, conductive hearing loss, single-sided sensori-neural deafness • New Cochlear Americas design approved FDA Nov 2012 • Simplified surgical procedure • Minimizes need for soft-tissue removal

28. Cochlear Implants • Miniaturization: All three getting smaller • Moisture resistance: Cochlear Americas Nucleus 5 Sound Processor with rechargeable battery • Waterproof: Advanced Bionics Neptune • Alkaline and/or rechargeable battery options • Improved hearing programming • Cochlear Americas SmartSound • Advanced Bionics ClearVoice • Med-EL’s Fine Hearing

29. Middle Ear Implant Systems • Med-El’s Vibrant Soundbridge FMT (Floating Mass Transducer) electromagnetic system manufactured by Med-EL uses an implanted magnet and an external coil coupled to a microphone to directly cause middle ear structures to vibrate. • http://www.vibrant-medel.com/ • Esteem Hearing System manufactured by Envoy uses the eardrum itself as the microphone with a sensor placed inside the ear on the stapes. Battery life span is 4-5 years. • http://www.envoymedical.com/

30. Trends in Hearing Healthcare Delivery

31. November/December 2012 Issue pps. 7-8Hearing Loss Magazine, published by Hearing Loss Association of America • Communique from 3 major hearing health organizations acknowledging marketplace changes • Veterans Affairs is piloting teleaudiology • Hearing aid manufacturers developing remote hearing aid assessment and programming software available via internet connection • Government research to improve affordability (NIDCD) of hearing health care services • Insurance companies are delivering hearing health care.

32. Purchasing Hearing Aids Through the Internet • Usually limited to open-ear hearing aids or C-I-C • Hearing losses up to moderately severe • Consumer sends vendor audiogram and places order • Amount of service after the sale varies • Reputable vs non-reputable: • New devices directly from manufacturer vs reconditioned models • Full factory-supported warranties • Full-understanding what is and is not included

33. Direct to Consumer Hearing Tests http://lloydhearingaid.com/shopping/audiogram_steps.asp

34. United Health Group’s hi HealthInnovationshttps://www.hihealthinnovations.com/page/ourstory Drag picture to placeholder or click icon to add

35. Hearing Loss and Dementia

36. Hearing Loss Linked to Dementia – Archives of Neurology February 2012 • Researchers from Johns Hopkins and National Institute on Aging – led by Frank Lin, MD • 639 subjects aged 36 to 90 followed for nearly 20 years • Tested every two years during that time • Risk of dementia rises once hearing loss affects ability to communicate. • Even mild hearing loss doubled the risk of dementia.

37. Questions? Alternative Communication Services, LLC Valerie Stafford-Mallis Voice: 800-335-0911 x 706 Cell/Text: 941-201-7805 valerie@acscaptions.com Website:www.acscaptions.com