Hearing and Speech Communication Services and Devices

Pediatric Health Library

What are hearing and speech communication services and devices?

There are many devices and services to help people with speech or hearing problems communicate. In 1990, the Americans with Disabilities Act (ADA) began requiring all phone companies to provide telecommunications relay services. Other services and devices range from phone amplifiers to visual alert systems. New devices are portable and can work with cellphones. For help finding out about the services below, ask your speech-language specialist or your healthcare provider.

What is a telecommunication relay service?

A telecommunication relay service helps someone with a hearing loss or speech impairment communicate with people who have a phone. The hearing-impaired person calls another person with the help of a communications assistant (CA). The hearing-impaired person calls using a text telephone (TTY), which the CA then verbally relays to the other caller. The CA then types the person's response back to the TTY caller.

There are two types of telecommunication relay services:

Voice carry-over (VCO). The caller speaks directly to the other person but reads the response typed by the CA.
Hearing carry-over (HCO). The caller listens to the other caller but types their response.

The CAs are professional. They will relay your conversations word for word and are confidential. You can reach these free services by dialing 7-1-1.

Other assistive communication devices

Some other communication devices that assist the hearing-impaired or speech-impaired include:

Telephone devices for the deaf (TDD)	TDDs let you call another person who has a TDD. You can type messages that are displayed on a screen. TDDs come in many different models. They can also be used with telecommunication relay services. Another telephone device, a telecoil, can be used with certain hearing aids. The telecoil is a small magnetic coil in the hearing aid. It helps improve sound during telephone calls.
Phone amplifiers	Amplifiers that are portable or built into the receiver of a phone can help increase the volume for the listener. Some people may have trouble hearing a phone's high-pitched ring. That sound can be replaced with a lower-tone bell or buzzer. Or with a visual alert.
Radio, stereo, and TV amplifiers	These amplifiers can connect with hearing aids. They send audio signals directly from a radio, stereo, or TV with a receiver. Whether using headphone devices or wireless devices, these amplifiers let a hearing-impaired person listen to radio, stereo, or TV at a comfortable level. There is no background noise.
Signaling devices	Visual signaling devices can alert a hearing-impaired person to auditory signals they can't hear. Visual signaling devices that flash a light are available for phones, doors, alarms, baby monitors, and more. Other signaling devices include a vibrating option that can wake up a hearing-impaired person.
Captions for the hearing-impaired	Captions are the words shown on a TV screen that follow along with the audio part of the program. Hearing-impaired viewers can read the captions to follow the dialogue and action at the same time. Captions also describe sound effects that are important to the storyline. Captions can be open or closed. Open captions are on every TV. Closed captions need a set-top decoder or built-in decoder circuitry. Since closed-caption technology is widely available now, open-caption technology is rarely used.