Phone captioning technology continues to evolve, offering individuals with hearing loss more ways to stay connected. As advancements like AI enhance accessibility, hearing care professionals can help patients who need them understand and adopt these transformative tools.
By Andy Lundin
Phone captioning solutions provide a unique but still essential way for many individuals with hearing loss to communicate over long distances. These services work by converting spoken words into text that appears on a screen (e.g. a smartphone device), enabling users to follow conversations in real time.
Beyond their obvious accessibility benefits, research shows captioning solutions also offer other significant advantages to patients who use them, including positive impacts on mental health, such as reduced listening fatigue.1 Many individuals with hearing loss can access captioning services at no cost, thanks to a federally managed program established under the Americans with Disabilities Act, which champions equal access to telecommunications for all.
Despite their transformative potential for individuals with hearing loss, these solutions can be misunderstood and therefore underutilized by patients. While phone captioning technology continues to be a valuable tool in an audiologist’s arsenal and has evolved alongside advancements like AI, challenges still hinder its broader adoption for improved accessibility and communication.
Phone Captioning on the Smartphone
The range of phone captioning technologies, which once focused on landline devices, have significantly evolved with the advent of smartphones, offering easier access to advanced accessibility features that can make communication easier for individuals with hearing challenges, no matter where they are located. Unlike landline captioned telephones, which are limited to use in a stationary location, smartphone captioning apps allow users to access this technology anywhere, ensuring greater flexibility and convenience.
However, for less tech-savvy patients who aren’t privy to these newer forms of technology, audiologists play a crucial role in keeping them abreast of the latest advancements.
“Many free captioning options are available on smartphones, but it can take time to teach patients how to use these apps and services,” says Jessica Galatioto, AuD, assistant professor of audiology (in Otolaryngology – Head & Neck Surgery) at Columbia University Irving Medical Center. “Depending on the patient’s level of tech-savviness, this may be very time consuming and can be frustrating for the patient. Available counseling and rehab time can influence an audiologist’s ability to effectively train patients in using these resources. Aural rehabilitation groups could be an excellent setting to teach and train patients on these tools.”
Pediatric audiologist Michelle Hu, AuD, urges audiologists to become more familiar with available technologies to engage in more effective discussions with their patients about these newer solutions. Hu brings a unique perspective to this issue, as she is both an audiologist and someone with hearing loss who uses cochlear implants.
“Definitely download all of the apps and put yourself in situations that patients are in. This will best help you understand what it’s like,” says Hu. “Feel the anxiety of missing conversations or words. See the mistakes, see the misunderstandings happening, and then review the apps and compare and contrast.”
How Audiologists and Patients Support Each Other
Barbara Weinstein, PhD, professor of Audiology at the City University of New York Graduate Center, has observed that some audiologists have a tendency to primarily focus on hearing aid technology during patient conversations, neglecting to mention other auditory accessibility solutions like phone captioning technology.
If healthcare professionals don’t bring up these options, patients will most likely miss out on using these technologies because they may not even be aware they exist, let alone understand how they work or the benefits they offer. Weinstein emphasizes that exploring these tools can significantly enhance a patient’s communication experience and overall quality of life.
This is why Galatioto makes a point of discussing these options with her patients. “Some patients strongly believe that phone captioning is only meant for individuals with profound hearing loss, making them hesitant to use this technology,” she says. “They view it as an alternative to listening rather than a supportive tool. I explain to my patients that captions are just another resource, similar to other tools we use such as Bluetooth connectivity or hearing aids.”
Conversely, patients may sometimes even be more informed about emerging technologies than their audiologist, and could incidentally provide their clinician with insights into new tech trends during discussions with patients. In fact, this has been the case for Galatioto.
“Apps and mobile solutions have changed the demand for personal captioning,” Galatioto says. “I first learned about many of the apps and mobile technologies available from my patients. My patients who needed captioning were the early adopters of the mobile solutions. I feel fortunate that my patients have shared all the information with me, as it allowed me to learn and share with others.”
AI Advances for Phone Captioning
AI and automated technologies have become deeply integrated into the phone captioning solutions space for voice transcription, offering a new option to help address accessibility needs. Many leading companies now provide services and devices featuring AI-based captioning technologies while still offering human CART captioning, which remains the gold standard.
However, Galatioto notes that these human-driven services can be costly and have limited availability.
Hu adds that, at least for now, CART transcriptionists are better at deciphering unique or unusual accents, compared to the AI systems.
“As AI-generated captions become more acceptable and accurate I do believe they will have a greater presence,” adds Galatioto. “It also allows the user to be in control of when they want to use captions and not rely on others to provide accessibility.”
All the audiologists interviewed for this article agree that AI-based technology will continue to be a key component in this space, but complement rather than replace traditional practices.
“It is important to remember that it is the individual’s right to request a reasonable accommodation. Patients have a right to request a live/human captioner, particularly when they do not trust AI,” says Galatioto.
Looking Back at Landlines
The rise of smartphones and digital services has led to a seemingly perpetual decline in landline phone usage. However, many companies still offer landline captioning devices, even as the world increasingly operates in the digital space.
“I believe many people simply do not utilize landlines anymore. At least this is what I observe,” says Galatioto. “Patients with significant hearing loss also tend to enjoy texting and emailing when they can do so.”
But despite this decline, landline captioning devices still serve a purpose for certain individuals and settings where smartphones may not be as practical. Many phone captioning companies continue to offer landline devices, some of which now operate using high-speed internet for communication. Standard analog telephone lines are still available as well.
As Hu points out, these options remain practical in specific settings, such as traditional office environments, or for individuals who simply do not use smartphones or prefer landline devices.
What Can We Learn?
Phone captioning technology offers invaluable tools for improving accessibility and communication for individuals with hearing loss. However, bridging the gap between available solutions and their widespread adoption requires collaboration among audiologists, patients, and technology providers.
Fostering open dialogue and leveraging both human and AI-driven phone caption offerings can help audiologists ensure these transformative tools reach their full potential to benefit those who need them most. And given the rapid evolution of communication technologies, staying informed about what’s new in this space is crucial to achieving this goal.
References
1. Payne BR, Silcox JW, Crandell HA, Lash A, Ferguson SH, Lohani M. Text Captioning Buffers Against the Effects of Background Noise and Hearing Loss on Memory for Speech. Ear Hear. 2022;43(1):115-127. doi: 10.1097/AUD.0000000000001079. PMID: 34260436.
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