iPhone Hearing Loss Accessibility Guide: iOS 15 Update

Laura Pratesi is no stranger to the accessibility options available to her through her iPhone. She is a Florida-based audiologist who is hard-of-hearing and says that the tools available through her iPhone 11 support both her work and her personal life.

Dr. Laura Pratesi

Dr. Laura Pratesi

“I'm the only one small enough to wedge in between the two car seats in the very back of my parent's big van. So, I'm in between my son and my four-year-old nephew, and they're loud, and I have a hard time hearing my husband or anybody who's up in the front. So I might  put my phone on Live Listen, and put my phone up in the cupholder up front and when they talk, I can hear what they're saying to me back in the back.”

Built-in remote microphone with Live Listen

Live Listen, a feature that was released in 2014 and allows a person’s phone to be used as a remote microphone, is just one of the accessibility features that Apple offers its Deaf and hard-of-hearing users. Live Listen works with AirPods, AirPods Pro, AirPods Max, Powerbeats Pro, and a slew of Made for iPhone (MFi) hearing aids.

Pratesi uses Live Listen in her work as an audiologist. “If I have a student that is inside or outside the booth, I'll put my phone on Live Listen and have them take my phone with them. And then they can communicate with me while they're in the soundproof booth or if I'm in the soundproof booth and they're on the outside.”

How to use Apple's Live Listen. Closed captions are available on this video. If you are using a mobile phone, please enable captions clicking on the gear icon.

A full list of hearing aids that support Live Listen are available on Apple’s website. If you have one of the devices listed, a guide to pairing your aid is easily accessible as well.

Headphone Accommodations and Apple Health

Pratesi says a lot of the support she gets from her iPhone comes from the Apple Health app. The app will tell her her listening volume is too high or if environmental sounds may also be affecting her hearing. She’s also able to add her audiogram (hearing test results) to Apple Health and receive personalized sound amplification through Apple’s Headphone Accommodations feature.

Sound Recognition

Another of the more valuable features of the iPhone is Sound Recognition, which identifies certain sounds and notifies the user of particular sounds of interest. This could be a notification for a fire alarm, a doorbell, or in Dr. Pratesi’s case, an alert that one of her children may need her.

“I'm a mom, I was worried about not hearing my children cry when I had my hearing aids out. You know, I frequently would miss that the doorbell was ringing. So, having my phone give me that awareness of some of those environmental sounds. That was a really exciting development for me.”

She combines those indicators with sensory alerts that help relieve stress when it comes to the fear of missing something in her environment.

Other features to help those with hearing loss in iOS 15

Other commonly used accessibility tools that are available to iPhone users with minimal configuration are mono audio support, Facetime for signing, LED flash alerts, voicemail transcriptions, and auto captioning on certain apps, like Apple TV  (system-wide auto captioning is available on some Android phones, like Pixel). This is in addition to the ability—enabled by Bluetooth—to stream  content, including phone calls, podcasts, and your Apple Music library straight to your MFi hearing aids.

iOS 15 also delivered a new “background sounds” feature, which plays continuous background sounds, like the sound of the ocean, through your headphones. Background sounds are meant to “mask unwanted environmental or external noise”, but also offer a tremendous benefit to those with tinnitus.

Mono audio support allows for the same audio information to be sent to both headphones, rather than the splitting that can occur when stereo mode is enabled. This feature could be a godsend for users with hearing loss in one ear who don’t want to miss all the information delivered to both headphones.

But where do you find these features?

All these options are available within Apple’s accessibility section in the settings menu. Additionally, new features are consistently being released. Apple’s Conversation Boost—which adds directional microphone technology to AirPods Pro—was released to the general public through an over-the-air firmware upgrade only yesterday.

How to Set Up your Apple Airpods Pro as Hearing Aids: Guide and Review 2022. IOS 15.4.1 Closed captions are available on this video. If you are using a mobile phone, please enable captions clicking on the gear icon.


Apple has a long history of supporting the Deaf and Hard of Hearing communities. Apple was the first to enable Teletype (TTY) and real-time text (RTT) calling directly on device. For the uninitiated, TTY and RTT provide a text-based chat alternative to voice for those who are not able to hear clearly on the phone. With TTY, the user must hit the send button before the chat is transmitted, and with RTT, chats are sent in real-time, as text is typed.

Federal Communications Commission mandated support for RTT in 2018—at least by nationwide carriers. In June of 2021, local and regional carriers came to the end of their transition period, meaning that these providers have to implement support for RTT. More information on the FCC’s requirements can be found here.

All modern iPhones are also considered to be Hearing Aid Compatible (HAC), and this is accomplished by providing inductive coupling for hearing aids that operate in telecoil mode and reduced radio-frequency interference to enable acoustic coupling for those hearing aids that aren’t equipped with a telecoil.

How many people use iPhone’s accessibility features?

It’s important to note that, while definitive data is hard to come by, the amount of iPhone users who have these accessibility features available to them is staggering. The Verge reported in January that the number of iPhone users has crossed the billion mark. Apple also produced their own hearing study—more on that by HearingTracker’s own Carly Sygrove is available here—which found that 10% of the thousands who had their data collected disclosed a significant hearing loss. Even though 75% of those respondents did not identify using a hearing aid or cochlear implant, that’s still a massive user base who may find these features appealing.

Further reading

For more information on the accessibility features offered by Apple for iPhone and other iOS devices, check out this guide. One caveat: the guide is for the latest version of the iPhone operating system, iOS 15. Make sure you check back to hear about new updates to Apple’s accessibility that HearingTracker will continue to cover.