Communication Accessibility

Tina Childress

In Episode 6 of the Hearing Tracker Podcast, we had the pleasure of interviewing Tina Childress, an Educational Audiologist and late-deafened adult with bilateral cochlear implants. In the interview, Tina discusses her passion for improving accessibility, with a focus on cutting-edge tech solutions like automatic speech recognition (ASR). She also discusses how communication has changed in the COVID-19 era and what you can do to stay connected.

Communication Accessibility with Tina Childress

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Podcast transcript

Steve Taddei (Host): Welcome back everyone. On this episode, we are joined by Dr Tina Childress and she is an educational audiologist, a strong advocate for the deaf and hard of hearing community, an adjunct lecturer and much more. So Tina, thank you so much for joining us today.

Tina Childress: Thanks, Steve. I'm really glad that you asked me to come here today.

Host: Before we get started, can you give us a little bit of a background about yourself and what you do within the world of hearing?

Tina Childress: As you mentioned, I am an educational audiologist and more. I am also a late deafened adult due to autoimmune inner ear disease. I was actually an audiologist with normal hearing when I came into the field and I had no idea that I would be experiencing hearing loss myself. So it definitely is quite ironic. I got my first cochlear implant in 2000 and I got my second one in 2005. I am fluent in ASL. And so I feel very grateful that I can navigate both the deaf and the hearing worlds. Some of my friends have called me and they gave me the nickname Techie Tina, because they know how much I love technology... my passion and my geekiness. I'm involved [in] things like keeping up with technology trends, making resources to help people understand their options so they can make informed choices, and then sharing these different resources through social media video, live presentations. I do some adjunct instructing at various universities. And I am also really active on numerous advisory and executive boards, especially for groups that support advocacy for individuals who are deaf and hard of hearing. I currently live not that far from where you are right now in central Illinois with my two daughters and my husband. Now I work part-time as an educational audiologist in the mainstream school setting, but I also work part-time for our state residential school.

Host: In there, you mention a lot, and I do want to touch bases on pretty much all of it. But before we get into the Techie Tina side, can you describe what an educational audiologist does for those who don't know?

Tina Childress: Sure. So my definition of an educational audiologist is an audiologist who specializes in maximizing communication for all children who are deaf or hard of hearing in a school setting. So this could mean collaborating with clinical audiologists, educators - such as teachers of the deaf and hard of hearing - the regular education and special education teachers in the schools, speech language pathologists, and all those other related professionals who work with our students. And so, you know, we generate reports that can help them guide their goals, but as educational audiologists, we can also do things like diagnostic testing. We fit, maintain, monitor, and fix hearing assistive technology. When that's appropriate, we do in-services for class rooms and school stuff. And that's all with the lens of making sure that our students are able to communicate with as many tools as are available to them. Now, unfortunately not all schools have access to educational audiologists, but there is a group of us called the Educational Audiology Association, and we're continuously striving to, to fix that. We believe very strongly that anytime there is a child that has hearing loss in a school system, they need to have access to an educational audiologist.

Host: Now, you mentioned that your hearing loss occurred later in life, which gives you a real unique perspective. Being an audiologist, being someone who had normal hearing, and now someone who is part of the hard of hearing community, can you talk about your experiences and what it's been like having hearing loss and with the technologies that are out there.

Tina Childress: So I came into this field with normal hearing. Not knowing that I would be completely deaf a year later. So that definitely turned everything on its head. So my hearing loss was a quickly progressive and fluctuating loss, which meant that basically every morning, I had no idea if it was going to be a good day or a bad day. In about six months, the bad days started outnumbering the good days. And a year later I got my first cochlear implant. Understand that when I was still a hearing aid user 20 years ago, wow, I was still using analog hearing aids because digital hearing aids were still in their infancy. I definitely continue to experience the various stages of grieving, if you will. You know, we talk about the stages of grieving, your former hearing self. And so there are days when my hearing loss is kind of a frustrating nuisance. Like I'm trying to hear someone behind a mask and they're six feet away. But there are also days when it's definitely an advantage. And I like to call that deaf o'clock where I get to go off the air when I need to concentrate on work or, you know, just ignore all of the background noise that I don't need to hear. I am such a geek that I'm always on the lookout for the latest gadget or a piece of technology. My philosophy really in, in all things is not to make decisions for what I think is right for you, but to provide you with information so that you know what the options are, some people are not tech savvy. They don't understand all this audiology lingo. They don't even know where to start. So sometimes I just give people a starting point. Now if people ask me what my favorite products are, I will tell you what they are. But generally I just like to kind of drop knowledge and let you make the decision about what works right for you. When I think about all of these options, what would we do without the internet? I love seeing stories, getting emails, doing research and reading posts about possible solutions. We have things like wireless connectivity now for, you know, our hearing aids and cochlear implants. We have the power of our computer in our pocket or purse with our smart phones. Um, and we share information and advocacy tips on social media. It's fantastic. And there are new technologies that are being developed every day.

Host: You mentioned, I think you called it deaf o'clock where you can turn your cochlear implants off. And then you can actually in a way benefit from the complete silence. It's interesting. I was listening to another podcast recently and someone else who has cochlear implants, they mentioned that they did that as well. And they actually look forward to that part of their day, where they get to kind of meditate in the silence that they have. So it's very interesting to hear that from you as well. But you mentioned you started off wearing hearing aids and then you had to go to cochlear implants. So how would you describe cochlear implants for people who are listening, who might not know exactly what they are?

Tina Childress: So a cochlear implant is an electronic device that involves a surgery. There's essentially two parts and inside part and an outside part. The outside part is also called a processor. That's what you see on a person's head. Now in order to qualify for a cochlear implant, that means that hearing aids cannot help you. And so I did use hearing aids for about nine months before I then qualified for getting a cochlear implant. I actually probably could have gotten a cochlear implant earlier, but I was thinking that I was getting by and it really took an appointment with my audiologists when I was in the booth to realize how much I really relied on lip reading. And then I just knew it was time. One of the questions that people ask me is, you know, you used to be hearing, so what does a cochlear implant sound like? And I get this question mostly from parents and they say things like, oh, I heard these simulations on the internet and they were awful and they're so scary. And they sound so robotic and electrical. And I don't want that for my child. To which I respond. If you have a child that is born deaf and they get a cochlear implant, they don't know what quote unquote normal hearing is. They don't know what a robot sounds like. They don't know what if it sounds mechanical, what that sounds like, what they hear is what they hear. And our job is to help them make sense out of those blips and whistles and all of those different sounds that they hear just like we teach our kids with normal hearing how to make sense of the sounds around them and to help understand language. So as a late deafened person who had normal hearing that, you know, used to hear things acoustically, but now hears things electronically... yes, when I first got my cochlear implant, it did not make any sense. It really was like learning a new language and it took time for my brain to learn that language... and to make sense out of it. But. I was able to do that by consistently wearing my amplification, by having targeted practice, to help me make sense out of what I was hearing... and eventually it did get to the point where I was able to do things again, like talk on the phone. Now people ask me, does it sound normal? And that's kind of a loaded question, but my answer usually is that it is my new normal. And for me, as someone that had normal hearing, I have what's called auditory memory. So, you know, people talk about the fact that we really hear with our brains. The ears are just a mechanism to get that sound to our brains. So I hear with my brain. So when I go home and visit my mom with her Filipino suburban accent, she still sounds like my mom. And I can tell her voice compared to my sister, because I have that auditory memory. Now I'm very fortunate that I'm able to do things like that. And I know that not everybody is able to do that. And so there are some people that think a cochlear implant is a cure and we'll make them quote unquote hearing. And I just have to let you know that that's... first of all, not always the case, and also it takes a lot of work. And then finally that everybody's a little bit different. We all have different hearing histories, causes of our hearing loss, um, sense of auditory memory, which can really affect our, our potential with our cochlear implants

Host: Thank you for sharing that. So many great points in there that the hearing actually does happen in our brain, and, I can't imagine how scary it is going through the process of losing your hearing, realizing that hearing aids, that the current technology might not be appropriate for you, and then having to make that leap into this unknown world of cochlear implantation.

Tina Childress: Yeah. And, you know, I, I want to say too that also during that time, when I wasn't really sure where my life was going to go, that was also when I found myself really doing kind of a deep dive into the deaf community and really honing my skills with ASL. And I don't think I've ever met a family that regretted learning ASL, or an adult that learned ASL, even if they grew up listening and talking, there are so many advantages to the fact that I can sign that I really am bilingual. That's the worst that can happen. And so for me, it was a great backup tool and it's another tool that I use even here at home when I'm in deaf o'clock mode, and my family wants to communicate with me. My whole family signs. And so we can still have communication, you know, even from across the room. And so my point and my suggestion would always be to keep your mind open to other tools

Host: That leads perfectly into this next question that I wanted to ask you. You seem extremely equipped to not seeing things as necessarily barriers, but just ways for you to modulate what you're doing and make things work. But what barriers have you faced and certainly how have they changed now with COVID-19?

Tina Childress: So I've been really lucky to be in a field that for the most part really understands my communication needs, though, I do have to admit that I feel more supported in the educational realm compared to the audiology realm sometimes. And it just fortifies my resolve to continue doing what I'm doing. And that means advocating for consumers when I'm talking to colleagues and peers and taking all of that audiology jargon and breaking it down and empowering the consumers. Now with COVID-19, I do feel like there is more empathy for communication difficulties, because now everyone is experiencing it.... not only with communication behind masks and social distancing, but also the reality of video conference fatigue. So one of my projects over the pandemic back in the beginning was trying to evaluate masks and shields. And I used to be hashtag #teamfaceshield because I thought it would solve the problem of seeing everyone's face for lip reading. What I didn't plan for or fully understand was how much it affected speech acoustics and distorted speech. So that lesson taught me that I was guilty of assuming that I knew what was right for others when that's not the case. There have been various research studies that have shown, and I even did kind of an informal test where I had my coworker test me with different kinds of PPE. And what we found is that some people may prefer the paper or the cloth masks. Even if it hides people's faces because they hear better. And some people may prefer a face shield or a mask with a clear window, because they do need that lip reading information. And again, that's not my decision to tell them what's best for them. So when people ask me, Tina, you know, what is the perfect mask or the perfect shield? I say, don't ask me, ask the people that you need to talk to. They will tell you what works best for them. Another project that's always ongoing, because technology is changing, is how to make video calls accessible. So I've collaborated on projects that use ASL interpreters, live real-time captioning, as well as automatic speech recognition or ASR captioning. Um, other projects have looked at optimal ways for kids and adults to hear through their computer tablet or phone with assistive technology. So these things have definitely filled my days.

Host: What are some of the emotional and social impacts of hearing loss?

Tina Childress: I think all people are feeling increased sense of isolation in the form... not only of things like shelter in place, but masks separating us from facial expressions and social distancing separating us from physical contact. And this can lead to more stress and even depression. For people that are deaf or hard of hearing the masks and social distancing can also increase our cognitive load and our sense of listening fatigue as we struggle to hear and make sense out of this kind of degraded signal. So communicating virtually hours a day takes its toll. And at the same time we're focusing on this like image, that's a fraction of the size of a real person, right? So we're taxing our ears as well as we're taxing our eyes. We know that our kids miss their friends, their teachers, and the different social opportunities. And I'm going to very specifically say some kids I've heard anecdotally that some kids are actually thriving in virtual learning because they don't have to navigate the minefields of social interactions or experience bullying in an in-person setting. They also don't feel self-conscious about using accommodations when they're at home. So for some of these kids, it's actually been a positive thing. But it's still not the same. You know, they're not only learning academics, but they're also learning self-advocacy skills for how to cope in these times. I think that it's really important that teachers and schools give them opportunities to learn from each other, to be with each other, to talk about kind of these feelings with other students that understand where they're coming from. So it can be really daunting on so many different levels. But I do want to end with a positive thought, in that I've heard that people are advocating for themselves for the first time. Or maybe stepping outside of their comfort zone and trying things like new technologies. So one example is my mom. So my mom has been very well versed in coupling her Bluetooth hearing aids to her iPad, to the point where she can ignore my dad for hours on end. And the last time we FaceTimed though, she actually looked at the video camera. As opposed to the home button. So there are triumphs as well.

Host: So for those who are dealing with some emotional and social impacts of their hearing loss, as you mentioned, there's an increased cognitive load with having to be in this virtual world. What resources are out there for family members or people who are suffering in kind of that emotional realm?

Tina Childress: So if you have a child that has hearing loss, I highly encourage you to talk with their teachers of the deaf or hard of hearing if they have that kind of service on their IEP, or even talk to their classroom teachers. Because what I'm seeing in the schools is that they are doing very targeted, kind of, therapies and different strategies and different lessons, specifically looking at mental health because they recognize that our students are suffering. And so if you talk to the teachers, they are doing amazing work, looking at the social-emotional skills. And they will also connect students with mental health professionals if they feel like that's the next step. Some of them even use a very specific social-emotional learning curriculum. So if you know the different components that are part of that curriculum, you can help generalize that information by talking about it at home, maybe using some of them the methods with your own family. And I also want to let you know that there are different mental health services that work specifically with populations that are deaf or hard of hearing.

Host: A big part of what you were just talking about are the barriers that are in classrooms for students, for educators, for those, with hearing loss. So what technologies are out there for people who are struggling? What recommendations would you have?

Tina Childress: So when I think about technologies that help people that are deaf or hard of hearing, I group them into three different buckets. The first bucket would be sign language interpreters. For the people that use ASL to communicate in a virtual learning kind of environment one of the biggest challenges is figuring out the most efficient way to keep the sign language interpreter and the teacher, and a shared screen, and maybe their classmates all visible on a screen. There's definitely been a learning curve with that with using different software and different products like Chromebooks versus computers versus kids that have to use a cell phone to access their virtual e-learning. For deaf parents, if they need to use ASL to communicate, then they may actually be using a video relay service to access what their child has to hear on a computer. So then the second bucket is captioning. And when I think about captioning, there's two kinds of captioning that you can experience. One is what we call live real time captioning, and that's provided by an actual human person. The second kind of captioning that's out there uses ASR, or automatic speech recognition, provided through a speech to text app or a program that uses artificial intelligence and machine learning. So it's constantly learning. In my experience, each person has to determine what's best for them. Again, I can't tell you what works best for you. Some people prefer the more accurate, but the more delayed captioning that happens with the live real-time captioner. And then there are other people that prefer the sometimes less accurate ASR captioning, but it's also less delayed. And so we have to judge what works best for us. Knowing all of those options is really, really important. And then the third bucket is hearing assistive technology. Well, I'm talking Bluetooth enabled hearing aids and cochlear implants to personal streaming devices. We have remote microphone connectivity, things like amplified neck loops, you know, and all of those things are kind of high tech. But then we even have low tech solutions like, hey, why don't you get an external speaker and plug it into your computer so that sound is louder? Or try a good pair of headphones that help isolate noise, but also can help clarify what you're trying to hear.

Host: I do teach a few classes at a local university. What can educators do differently? There's a lot that educators are being faced with right now with having to switch to an online platform, learning all the technology necessary for that, making sure people show up for classes. What can we do to help students who might be struggling more with understanding the lectures and different content?

Tina Childress: So I also do some adjunct lecturing. I'm teaching a class this semester and one thing that I've taught my students to do. And that I also try to emulate is again, not assuming that I know what's best for them. So what I've done for my students when I start class and we're doing introductions... I say, okay, so now let's talk about communication. What works best for you? What is your wishlist? And if I know that a student has a specific disability, you know, what helps you, because what may work for one student may not work for other students. So it always helps to ask the students first, what helps them. But in general, there are some things that you can do that would help all students and especially students with disabilities and hearing loss. So slow down, maybe speak a little bit louder since you're behind a mask or, you know, you're trying to talk through your computer. Another thing that's very helpful is to indicate who's talking and repeat any questions or comments from any other students. So for example, you know, when you're on zoom and you've got 15 people on the screen, it's not always evident whose mouth is moving. Not all students will raise their hand and indicate that they want to make a comment. They just start talking. Okay. If you have normal hearing, you might be able to hear that person's voice and make that connection kind of automatically. But if you're deaf or hard of hearing, it's not that simple. So if the teacher can, first of all, control the classroom and say things like, okay, Johnny, what's your question? Okay, Johnny's question was blah, blah, blah. That's going to help all students. Don't assume that the student can hear you because they respond to their name. There's a whole other comprehension piece that goes beyond the ability to hear the name Johnny. You know, they may not even hear all of those different sounds. One thing that is also really important is that if the student has a remote microphone system, that it's really, really imperative that you use it. You know, it helps bring your voice closer to their ears through their hearing aids or cochlear implants. And they need that to access sound in the classroom. Another strategy that you can use is instead of repeating things that they didn't understand, and repeating the same question, try rephrasing it because there may be sounds in that sentence they couldn't hear. Lastly use as many visuals as possible, such as PowerPoint slide handouts and different links and make them printable or shareable. But definitely text-based, as opposed to, you know, requiring them to focus so much on their listening.

Host: I know you have lots and lots of information and resources for everything that we've been talking about today and much more. So how can people access that wonderful library of resources that you have created?

Tina Childress: There are so many great resources out there, but I have to say that my favorite place to actually learn about problems and possible solutions is social media. My favorite place to go to is this Facebook group and it's called DHH teaching during COVID-19. And it's my favorite because it's a collaboration of a whole bunch of different professionals that work with students that are deaf or hard of hearing. You have teachers, audiologists, speech pathologists, social workers, anybody that's on there as well as parents. There is such a treasure trove of information on there. People ask questions all the time to, you know, to help out their students. And it's been so awesome to see our educational community pulling together, to just make it work for our students. We really had to just turn education on its head. When we went into the pandemic and the way that we have to teach and the technologies that we had to use. And it's definitely been baptism by fire. Another great resource is YouTube. And I feel like you can find a video on just about anything. I feel like the most important skill is being specific and knowing what you're asking for. And sometimes people don't know the different jargon or the different phrases that they need to use. So that's why it's always great to kind of crowdsource and to collaborate with other professionals. As I mentioned earlier, one of the things that I've tried to do during this pandemic is to compile information and then categorize it and then make some kind of list. I try to make these digestible formats accessible to people. So I've been making a bunch of these different lists and charts that relate to things like technology and different options for accessibility. So that is another resource.

Host: We've talked about a lot today. Is there anything else you would like to add or share with us?

Tina Childress: I think the most frustrating thing about this pandemic is we just don't know. And we don't know what we don't know. So how do we plan? So I think as educators, you know, we always have this goal in mind and we have benchmarks. And if we don't know what that end goal is or what that might look like, it's hard to make that plan. And I see that as being very frustrating. And also the fact that there is no cookie cutter solution for things like going back to school, or going back to work, or having family gatherings. You have to do what you feel is right for your family. So I do want to end with some positives to the pandemic. Prior to the pandemic I traveled and I traveled a lot. And now that I'm home a lot mor,. I've had opportunities to reconnect with my family, try new recipes, you know, with an Instapot, because that's what people do, right? And I actually really do love to cook and do some house purging. Now I desperately do miss physical hugs and being at conferences with my colleagues and friends. I am totally a conference junkie. But I have been able to actually reach out and connect with more people. Maybe even more intimately because it's more like a one-on-one kind of conversation versus being in a whole group setting. You know, so we get to know each other even more. And also people now have the infrastructure and the equipment and the knowledge to do things like video calls. So I feel like as we go in and out of restrictions, as we kind of navigate our way through this pandemic, I feel confident and more confident that we are going to be able to stay in touch. I've loved seeing how the deaf and hard of hearing community and their allies have come together with knowledge, emotional support, and grace for each other. And probably my last thought is that just think about how much easier everything is going to seem when we get on the other side.

Host: Very true. Well, Tina, thank you so much for sharing all that information with us. Thank you for your positivity. We all need it right now. It's been wonderful talking with you. Thank you.

Tina Childress: Thank you very much for having me.

Host: We will have all of the resources mentioned in this podcast online and in the transcripts. So feel free to reference those. If you have any questions at all, or any ideas, any topics you would like us to go over, please feel free to email me at steve@heringtracker.com. And thank you for tuning in.