Innovative Technology Applications to Enhance Rehabilitation Service and Outcomes

This ALDAcon workshop is a revue of some of the work being done by Federally-funded research organizations. The presenters were Douglas Watson, Ph.D, Steven Boone, Ph.D, Matt Bakke, Ph.D, and Judith Harkins, Ph.D, with each providing a brief overview of recent and/or future efforts at their center.

Douglas Watson, Ph.D

Dr. Watson is the Director of the University of Arkansas Rehabilitation Research & Training Center (RRTC). He began with a brief discussion of the Office of Special Education and Rehabilitation Services (OSERS), which is the agency that funds the various research centers.

OSERS consists of three divisions:
- Rehabilitation Services Administration
- Office for Special Education Programs
- National Institute for Disability and Rehabilitation Research (NIDRR)

Matt Bakke, Ph.D.

Dr. Bakke is Project Director for the Lexington Center and Gallaudet University Rehabilitation Engineering Research Center (RERC) on Hearing Enhancement. He began his presentation with the observation that many people use hearing aids or cochlear implants, but relatively few use assistive listening devices (ALDs), even though they can significantly improve hearing performance.

His RERC is entering a new five-year funding cycle, so Dr. Bakke included information on what they had accomplished in the last period and what they are proposing for the next period.

Research in Previous Cycle

Research areas in the previous period included hearing aids, hearing assistive technology (HAT), automatic speech recognition (ASR), tinnitus, and new instruments and techniques. Their charter also included the dissemination and utilization of what they learned, as well as training and technical assistance.

Hearing aid research focused on improving hearing in the presence of noise, especially the application of dual microphones or beamforming microphone arrays to provide directionality. Dr. Bakke noted that some hearing aids and the Nucleus 3G cochlear implant incorporate directional microphones. Their RERC developed a system that allows devices to be tested on a replica of a human head, which provides more realistic test results.

Their HAT research focused on four areas:
- the development of a BTE FM receiver with a remote handheld beamforming microphone
- increased directionality for low frequency sounds
- neckloop performance assessment
- the interaction of wireless phones and hearing aids

Their ASR work focused on efforts to identify some of the critical variables affecting speech recognition during one-on-one conversations.

Tinnitus research included efforts to develop subjective and objective measures of tinnitus. They currently measure tinnitus using otoacoustic emissions. They are also evaluating tinnitus therapies. They have had some success helping people cope with tinnitus, but little progress in "fixing" it.

Their dissemination and utilization efforts have focused on maintaining their website and publishing a newsletter. Both are titled HearingResearch.org.

Training efforts have included the following:
- Worked with SHHH to train local leaders
- Trained hearing health providers
- Trained vocational rehabilitation (VR) counselors
- Trained hearing aid developers

Research in Next Cycle

During the next funding cycle, the RERC will retain some, but not all, of the programs from the previous cycle. They will also undertake the following new research programs:
- Environment, with a focus on classroom acoustics. They will attempt to find out how well kids with hearing loss can perform in a classroom, and what HAT will help.
- Intervention and Assessment Tools - They are particularly interested in the role of synthetic speech for training and assessment.
- Computer Enabled Distance Aural Rehabilitation, which will include both a training program and a mentor program.

Judy Harkins, Ph.D.

Dr. Harkins is Project Director for the Gallaudet University RERC on Telecommunications Access. Their websites are:
tap.Gallaudet.edu
www.trace.wisc.edu

The Gallaudet RERC works to maintain the accessibility of telecommunications devices. Their goal is to have accessibility built in where possible, and to ensure compatibility everywhere else.

Cell Phone/TTY Compatibility

The FCC has recently ruled that digital cell phones must be compatible with TTYs. Their RERC worked with the cell phone manufacturers, the TTY manufacturers, and the cell phone service providers to make sure the equipment would all work together. They also established a mystery shopper program, in which people would go to cell phone outlets with TTYs and see if they could buy a compatible phone.

By the fall of 2002 every carrier had a phone that works with TTYs. For that to happen, both the phone and the TTY had to support compatibility. Note that the phone/TTY systems don't currently support voice carry over (VCO).

Of course, the goal is for accessibility to be built into general devices, rather than providing compatibility to "special" equipment. For example, RIM and Danger are considering building TTYs into their wireless devices, which would allow a TTY to communicate over a wireless voice network with no special equipment.

Q. As new technologies like Video Relay Service, chat, and IM increase, TTY use is actually declining. It's a dying technology. Why is so much research directed at a dying technology?
A. The specific TTY technology is dying, because it's analog. But as we move to digital technology, we still need the capability to transmit text, and that's where we need to do the research.

Cell Phone/Hearing Aid Compatibility (HAC)

Our focus with respect to HAC has been to evaluate different technologies and phones to see which are HAC and to provide tools that allow people to evaluate phones.

In July 2003 the FCC ordered the industry to produce low interference phones [Ed: compatible with hearing aids using microphone input] within two years and to provide HAC phones [Ed: compatible with hearing aids using telecoil input] within three years. The Cellular Telecommunications & Internet Association (CTIA) filed to eliminate that requirement. The RERC is fighting to ensure that the requirement remains in force. Note that the CTIA does maintain a website that lists phones they believe can be used by hearing aid users.

Currently Verizon, Sprint, and Nextel phones seem most usable by people with hearing aids. Also, clamshell phones seem to work better, because their antennas are farther from the hearing aids than the antennas of other phones.

Other projects

Voice over IP (VoIP) is a technology that sends voice over a computer network as just another kind of data. It's acceptable for hearing people using voice, but it doesn't work well for TTY signals. In Australia about half of TTY calls are garbled because they are sent over IP networks.

VoIP can also cause problems for hearing aid users on voice calls, because voice quality can be inferior to that using an analog line.

The RERC also has a project to evaluate video systems for ASL and lipreading utility. The issues here are frames per second, resolution, blurring, and delays.

They're also working with industry and standards groups to try to improve phone menus and voice mail. More information on this effort is available at www.atis.org

Steve Boone, Ph.D.

Dr. Boone is Director of Research at the University of Arkansas RRTC. He addressed several of the projects underway at that center.

One project concerns early intervention for children with hearing loss. Now that we are doing a much better job of screening infants for hearing loss, we need to begin planning communications strategies for the identified children very early in life.

They also have a project on remote interpreting using compressed video technology. This technology is involved is service delivery in a few places, so we do know that it works with today's capabilities.

The RRTC is also involved in a study to improve accessibility of information to people with hearing loss in airports. They installed infrared assistive devices at ticket counters at the Dallas - Fort Worth airport, and were pleased to discover that those systems worked quite well.

Phase two of that project was to install similar systems in other parts of the airport, but the 9/11 tragedy and the subsequent financial problems for the airline industry put a stop to that - at least for now.