Assistive Listening Devices - UCSF EARS
TECHNOLOGY

Assistive Listening Devices

Beyond hearing aids: discover assistive listening devices that enhance communication in specific situations—from theater loops to smartphone apps to alerting systems that keep you safe and connected.

What This Article Covers

Assistive listening devices (ALDs) work alongside or independently of hearing aids to improve communication in specific situations where hearing aids alone aren't enough. This comprehensive guide explores the full spectrum of devices—from systems that improve sound in theaters and classrooms, to smartphone apps that provide live captioning, to alerting devices that flash lights when your doorbell rings. You'll learn which technologies work best for different situations, how to access them in public venues, and practical strategies for incorporating them into daily life.

You're sitting in a darkened movie theater, excited to see the film everyone's been talking about. Your hearing aids are in and working fine during the previews. But when the movie starts, the surround sound system, background music, and rapid dialogue leave you struggling to follow the plot. You can hear sound—plenty of it—but you can't understand the words. Your companion leans over to whisper what you've missed, but that defeats the purpose of seeing the movie in the first place.

Or perhaps it's 3 a.m. when the smoke detector starts chirping. Your hearing aids are on the nightstand, and you're sleeping soundly—too soundly to hear the alarm that could save your life. Your neighbors hear it. Your family members in other rooms hear it. But you don't. The next morning, you discover the low-battery warning went unnoticed all night, and you realize that your current safety system has a dangerous gap.

These situations illustrate a fundamental truth: hearing aids are powerful tools, but they can't solve every communication or safety challenge you'll face. Background noise overwhelms them. Distance degrades their effectiveness. And when you take them out at night, you're left vulnerable. This is where assistive listening devices become essential—not as replacements for hearing aids, but as complementary technologies that fill the gaps.

The good news? Today's assistive listening devices have evolved far beyond the bulky equipment of the past. From sophisticated theater sound systems you can access with your smartphone to visual alert systems that flash when someone rings your doorbell, these technologies offer practical solutions for specific situations where hearing aids need support. Understanding what's available, how to access it, and when to use it transforms these challenges from insurmountable barriers into manageable inconveniences.

Understanding assistive listening technology

Assistive listening devices capture sound at its source and deliver it directly to your ears, bypassing the distance, background noise, and reverberation that make hearing difficult in many environments. Think of them as creating a direct audio connection between the speaker or sound source and your ears, similar to how a telephone eliminates the challenges of hearing someone across a crowded room.

These devices work on a simple principle: the closer you are to the sound source, the easier it is to hear clearly. ALDs essentially bring the sound source right to your ear, even when you're sitting far away. In a lecture hall, this means placing a microphone near the speaker's mouth and transmitting that clear audio signal directly to you, cutting out the echoes, audience noise, and distance that normally make understanding difficult.

How ALDs differ from hearing aids

Hearing aids are sophisticated medical devices programmed to compensate for your specific hearing loss pattern across different frequencies. They amplify sounds around you, process them according to your audiogram, and help your brain make sense of the acoustic environment. They're remarkably effective for everyday communication, especially in quiet or moderately noisy settings.

Assistive listening devices take a different approach. Rather than amplifying everything around you, they deliver a specific audio signal directly to your ears—whether that's a teacher's voice in a classroom, dialogue in a theater, or an alert that your doorbell has rung. Many ALDs work best in combination with hearing aids, streaming the amplified signal directly into devices that are already programmed for your hearing loss. Others work independently, providing amplification or visual alerts when hearing aids aren't being worn.

When you need more than hearing aids

Even well-fitted hearing aids struggle in certain situations. These include environments with significant background noise, large spaces with poor acoustics, situations where you're far from the speaker, or times when you're not wearing your hearing aids at all. Assistive listening devices excel in exactly these circumstances, providing targeted solutions for specific challenges.

ALDs Complement, Don't Replace

Assistive listening devices are not substitutes for hearing aids if you have hearing loss that warrants amplification. They're supplementary technologies designed for specific situations where hearing aids alone aren't sufficient. Always consult with your audiologist about the right combination of technologies for your needs.

Large-venue assistive listening systems

Public venues—theaters, lecture halls, places of worship, conference centers—often provide assistive listening systems to improve accessibility. These systems are required by the Americans with Disabilities Act (ADA) in venues with 50 or more seats or that use audio amplification. Understanding the different types helps you request the system that works best for your hearing technology and preferences.

Hearing loops (induction loop systems)

Hearing loops are widely considered the most user-friendly assistive listening technology. These systems install a thin wire around the perimeter of a room or beneath carpet, creating a magnetic field that transmits sound directly to hearing aids and cochlear implants equipped with telecoils (also called t-coils). You simply switch your hearing device to the "T" or telecoil program, and you instantly receive clear audio directly from the sound system—no receiver to pick up, no headphones to wear, no additional equipment needed.

The beauty of loop systems lies in their invisibility and ease of use. Once you activate your telecoil, you're connected. The sound quality is customized to your hearing loss because it's being delivered through your personally programmed hearing aids. Background noise is dramatically reduced because you're receiving the sound directly from the microphone rather than trying to hear it across the room. When you see the hearing loop symbol (an ear with a diagonal line and a "T"), you know the venue is looped.

Many modern hearing aids include telecoils, though not all have them activated by default. Ask your audiologist to enable and program your telecoil during your next appointment. Some venues also provide headset-style loop receivers for people who don't have telecoil-equipped hearing aids or who don't wear hearing devices.

FM (Frequency Modulation) systems

FM systems use radio waves to transmit sound from a microphone worn by the speaker to a receiver worn by the listener. The speaker or sound source connects to a transmitter, which broadcasts the audio on a specific radio frequency. You wear a receiver that picks up this frequency—either as a standalone unit with earphones, or as a device that streams to your hearing aids through a neck loop or direct audio input.

FM systems work well in situations where the speaker moves around, such as in classrooms where teachers walk while they teach. Because FM signals can penetrate walls, they're effective in adjacent rooms, though this also means multiple systems in the same building must use different frequencies to avoid interference. The transmission range extends up to 300 feet, making FM systems suitable for large venues and outdoor spaces.

These systems require you to pick up a receiver from the venue, wear it throughout the event, and return it afterward. If your hearing aids have telecoils, you can use a neck loop adapter that converts the FM signal to a magnetic signal your t-coil can detect, allowing the sound to be processed through your personally programmed hearing aids.

Infrared systems

Infrared systems transmit sound using invisible light waves, similar to how a TV remote control works. A transmitter converts audio into infrared light signals and beams them throughout the room. You wear a receiver that converts these light signals back into sound, either through headphones or through a neck loop that works with your hearing aids' telecoils.

The key advantage of infrared systems is confidentiality. Because infrared signals cannot penetrate walls, the audio remains contained within the room—making these systems ideal for courtrooms, medical settings, and anywhere privacy matters. However, this same characteristic means infrared systems don't work well outdoors or in brightly lit rooms where sunlight can interfere with the signal.

Like FM systems, infrared requires picking up and returning a receiver. The devices need a direct line of sight to the infrared emitters, so positioning matters—you can't hide the receiver in a pocket or under layers of clothing.

Bluetooth and smartphone-based systems

The newest generation of assistive listening systems uses WiFi, Bluetooth, or emerging technologies like Auracast to deliver audio directly to smartphones or compatible hearing devices. These systems eliminate the need for venues to maintain separate receivers—you simply connect your own device to access the audio stream. Some venues use apps that provide not only live audio but also real-time captioning and translations.

Bluetooth-compatible hearing aids can stream audio directly from many venues' sound systems, though implementation varies by location. Auracast, a new technology standard, promises to make this process even more seamless, allowing hearing devices to automatically detect and connect to public audio broadcasts. However, as of 2025, Auracast is still in early adoption phases, and standards are continuing to develop.

How to Request Assistive Listening

Don't assume a venue doesn't have assistive listening just because it's not advertised. ADA requirements mean most public venues with 50+ seats must provide systems, even if they don't actively promote them. Ask at the box office, customer service desk, or usher station. Request the system type that works best with your hearing technology—loop if you have telecoils, FM or infrared if you need a receiver. Arrive early to get the equipment, test it, and troubleshoot any issues before the event starts.

Personal amplification systems

Personal amplifiers offer a portable, affordable solution for one-on-one conversations and small-group settings. Unlike the large-venue systems above, these devices are personal equipment you own and carry with you, ready to use whenever you need them. They're particularly valuable for situations where hearing aids alone struggle: restaurant conversations, medical appointments, watching TV with family, or chatting in the car.

Pocket talkers and personal amplifiers

The Pocketalker by Williams Sound represents the gold standard in personal amplifiers, though several other manufacturers produce similar devices. These systems consist of a small amplifier unit (about the size of a smartphone), a microphone, and earphones or headphones. You wear the earphones, set the amplifier to your preferred volume and tone settings, and place the microphone near the person speaking or the sound source you want to hear.

Personal amplifiers work by making nearby sounds louder while reducing background noise. They won't match the sophisticated processing of hearing aids, but for targeted situations, they're remarkably effective. The Williams Sound Pocketalker 2.0, for instance, costs around $200-250 and can amplify sound up to 70 decibels. The device runs on batteries (typically lasting 100-200 hours), features adjustable volume and tone controls, and works with a variety of listening options including earbuds, headphones, or neck loops that interface with hearing aid telecoils.

These devices shine in specific situations. When watching TV, you can place the microphone near the TV speaker and wear headphones, allowing you to hear clearly without turning up the volume to levels that bother others. At restaurants, positioning the microphone near your companion's place setting helps you focus on their voice rather than surrounding conversations. During medical appointments, handing the microphone to your doctor ensures you don't miss important health information.

When personal amplifiers make sense

Personal amplifiers are not hearing aids and shouldn't be used as substitutes for professionally fitted amplification if you have significant hearing loss. However, they offer valuable benefits in several scenarios: as a temporary solution while waiting for hearing aid repairs, for people with mild hearing loss who aren't ready for hearing aids, for situations where background noise overwhelms hearing aids, or as a backup system for crucial conversations.

Consider personal amplifiers particularly useful if you need amplification only in specific situations, want an affordable backup to hearing aids, need a simple device that's easy for caregivers to use, or frequently find yourself in one-on-one conversations where hearing aids struggle. They're also helpful for family members who want to communicate more effectively with loved ones who have hearing loss but haven't yet obtained hearing aids.

Smartphone apps and digital captioning

Your smartphone can function as a powerful assistive listening device, providing live transcription, amplification, and captioning capabilities that complement or even replace traditional ALDs in some situations. These apps have evolved dramatically in recent years, with improvements in speech recognition technology making them increasingly accurate and practical for daily use.

Live transcription and captioning apps

Several apps convert speech to text in real-time, displaying conversations as they happen. Google Live Transcribe (Android) and similar apps from Apple provide instant captioning for face-to-face conversations. You simply open the app, place your phone on the table between you and your conversation partner, and read the transcribed text as they speak. You can type responses if you prefer not to speak aloud, or you can respond verbally while they read your transcribed words.

Otter.ai offers particularly strong features for meetings and professional settings. The app not only transcribes conversations but also identifies different speakers, allows you to search transcripts later, and can integrate with videoconferencing platforms like Zoom and Microsoft Teams to provide live captions. The free version offers 600 minutes of transcription per month, with paid tiers providing unlimited transcription and additional features.

Other valuable apps include Ava, which provides highly accurate transcriptions and works well for group conversations; Live Caption (Android 10+), which captions any audio playing on your device; and InnoCaption, a federally funded service that provides free phone call captioning for people with hearing loss. Each has strengths for different situations—Otter for meetings, Live Transcribe for casual conversations, InnoCaption for phone calls.

Phone call captioning

Several services provide real-time captions for phone conversations, making calls accessible in ways that were impossible just a few years ago. These services are either funded by federal telecommunications programs (making them free for eligible users) or available through subscription. InnoCaption, CaptionCall, and similar services use professional captionists or advanced speech recognition to transcribe what the other person is saying while you're on the call.

These services work through dedicated apps on your smartphone. When you make or receive a call, the audio is routed through the captioning service, transcribed in real-time, and displayed on your screen. You can stream the audio to your Bluetooth hearing aids or cochlear implants while simultaneously reading the captions. The combination of audio and text often provides better understanding than either alone.

Video call captioning

Most major videoconferencing platforms now include automatic captioning features, though quality and availability vary. Zoom offers live transcription (the host must enable it), Google Meet provides automatic captions, and Microsoft Teams includes captioning in most meeting scenarios. These built-in features continue improving, though they're not always as accurate as professional captioning services.

For important meetings where accuracy matters, you can use Otter.ai as a "participant" in Zoom meetings to provide more reliable transcription. Some meeting organizers hire CART (Communication Access Real-Time Translation) providers—professional captionists who provide word-for-word transcription in real-time. While CART services cost around $105-150 per hour in most regions, the accuracy far exceeds automatic captioning systems.

Accuracy Considerations

Automatic speech recognition technology continues improving but isn't perfect. Accuracy depends on speaker clarity, background noise, audio quality, accents, and technical terminology. Apps typically achieve 80-95% accuracy under good conditions—helpful, but not flawless. For critical communications (medical appointments, legal meetings, important business discussions), consider requesting professional CART services or at minimum using multiple apps simultaneously to catch what one app misses.

Alerting and signaling devices

When you're not wearing hearing aids—sleeping, showering, or simply giving your ears a break—traditional auditory alerts become useless. Alerting devices solve this critical safety gap by using visual signals, vibrations, or smartphone notifications to ensure you don't miss important sounds. These devices literally can be lifesaving, particularly for fire alarms and emergency notifications.

Smoke and carbon monoxide detectors

Standard smoke detectors emit a high-pitched beep that many people with hearing loss cannot hear, especially when not wearing hearing aids. Specialized smoke and carbon monoxide detectors designed for hearing loss use multiple alerting methods: extremely loud low-frequency alarms (520 Hz rather than standard 3000+ Hz), bright strobe lights that flash in specific patterns to indicate smoke versus CO, and bed shaker units that vibrate intensely to wake deep sleepers.

The most comprehensive systems, like those from Bellman & Symfon or Silent Call, use transmitters that detect smoke or carbon monoxide and send wireless signals to receivers throughout your home. A bedroom receiver might include a bed shaker, alarm clock with very loud alarm, and flashing strobe light. A living room receiver might focus on intense visual alerts. The systems work together, ensuring you're alerted no matter where you are or whether you're wearing hearing aids.

Another approach uses devices that "listen" for your existing smoke detector's T3 alarm pattern (the standard three-beeps-and-pause pattern required since 1996) and then trigger additional alerts. Products like the SafeAwake and Lifetone devices sit on your bedside table, listening continuously. When they detect your smoke alarm, they activate loud low-frequency alarms, flashing lights, and connected bed shakers. This option works with your current smoke detectors without requiring you to replace your existing safety system.

Doorbell and telephone signalers

Doorbell signalers connect to your existing doorbell system (or work wirelessly as standalone units) and trigger visual or tactile alerts when someone rings the bell. Options range from simple units that flash a lamp when the doorbell rings to sophisticated systems with multiple receivers throughout the house displaying distinct flash patterns for different alerts. Modern smart doorbell systems can send notifications to your smartphone and show video of your visitor, combining visual verification with the alert.

Telephone signalers work similarly, using flashing lights or vibrating alerts to indicate incoming calls. Many people now rely on smartphones with customizable vibration patterns and bright LED flash notifications instead of separate telephone signalers. Smart home integration allows doorbells, phones, and other alerts to trigger the same set of receivers or smart lights throughout your home.

Alarm clocks and bed shakers

Specialized alarm clocks for hearing loss combine multiple alerting methods: extremely loud alarms with adjustable volume and tone, bright flashing displays and strobe lights, and powerful bed shaker units that vibrate the entire mattress. The bed shaker typically connects to the alarm clock via cable and tucks under your mattress, providing strong vibrations that can wake even deep sleepers.

Many of these alarm clocks integrate with larger alerting systems, allowing the bedside unit to alert you not only when it's time to wake up but also when smoke detectors activate, doorbells ring, or phones call. The Sonic Boom alarm clock line represents the standard-bearer in this category, with powerful 113-decibel alarms, adjustable tone and volume controls, and bed shakers strong enough to wake almost anyone.

Smart home integration

Modern smart home systems offer increasingly sophisticated alerting options for people with hearing loss. You can program smart lights to flash in specific patterns when different events occur—red flashing for fire alarms, white flashing for doorbells, and so on. Smartwatches and fitness trackers provide vibrating notifications for calls, texts, and alerts. Smart speakers with displays can show visual notifications alongside audio alerts.

DIY enthusiasts can create custom alerting systems using home automation platforms that connect various sensors and alerts to your preferred notification methods. While this requires more technical expertise than buying pre-packaged alerting devices, it offers flexibility to customize exactly how you want to be notified about different events in your home.

Fire Safety Priority

If you sleep without hearing aids and don't currently have visual or vibrating smoke alarm alerts, prioritizing this safety equipment should be your first step. Standard smoke detectors are ineffective for many people with hearing loss, particularly during sleep. Check with your local fire department—some offer free or subsidized alerting equipment for residents with hearing loss. At minimum, ensure you have working smoke detectors with strobe lights and bed shakers in sleeping areas.

Television and media accessibility

Watching television presents unique challenges for people with hearing loss. Dialog often competes with background music and sound effects, actors mumble or speak quickly, and turning up the volume high enough to understand dialog makes commercials and loud scenes uncomfortable—not to mention disturbing to others in the room. Assistive listening solutions for TV range from simple headphone systems to sophisticated wireless streaming technologies.

TV listening systems

Wireless TV listening systems transmit audio from your television directly to headphones, earbuds, or hearing aids, allowing you to hear at your comfortable volume level while others listen at theirs. The most common systems use infrared, RF (radio frequency), or Bluetooth transmission. You connect a transmitter to your TV's audio output, and it sends the signal to a receiver you wear. Some systems allow multiple receivers, so several people can listen with headphones simultaneously.

Infrared TV systems (like those from Sennheiser) offer excellent sound quality without radio interference, though they require line-of-sight between transmitter and receiver. RF systems work throughout the house, even through walls, making them more flexible if you want to listen from different rooms. Bluetooth systems offer the advantage of working with many modern hearing aids that have streaming capability, eliminating the need for separate headphones.

Closed captions

All TVs sold in the US since 1993 include closed captioning capability. Accessing captions varies by device, but most remotes now include a "CC" button for quick access. Recent FCC regulations require TV manufacturers to make caption controls more accessible, standardizing menu locations and making it easier to adjust caption appearance (size, color, font). Captions provide text display of dialog and sound effects, allowing you to follow programming even in noisy environments or when audio alone isn't sufficient.

Streaming services have dramatically improved caption quality and availability. Most services offer customizable caption appearance, letting you adjust text size, color, background, and font to maximize readability. Some shows and movies include descriptive captions that go beyond dialog to describe music, sound effects, and tone of voice—particularly valuable when audio cues carry emotional or plot information.

Personal amplifiers for TV

Personal amplifiers work well for TV listening, particularly for people who don't want to wear headphones. You can place the Pocketalker or similar device's microphone near your TV's speaker and wear the earphones or headphones. This creates a direct audio path to your ears, often providing better clarity than simply turning up the TV volume. If your hearing aids have telecoils, using a neck loop adapter with the personal amplifier allows the sound to stream directly into your hearing aids with their custom programming intact.

Accessing and affording assistive listening devices

Understanding what assistive listening devices are available matters little if you can't access or afford them. The good news: many ALDs cost significantly less than hearing aids, and various programs and laws ensure access to systems in public venues. However, navigating the options requires knowing where to look and what questions to ask.

Costs and where to purchase

Assistive listening device costs vary dramatically based on type and sophistication. Personal amplifiers range from $150-400, with the Williams Sound Pocketalker 2.0 costing approximately $200-250. Specialized alarm clocks with bed shakers run $40-150. Complete smoke alarm alerting systems range from $200-800 depending on how many rooms you need to cover. TV listening systems cost $100-400. Smartphone apps represent the most affordable option—many are free (Google Live Transcribe) or offer free tiers with optional paid upgrades (Otter.ai at $17/month for premium features).

You can purchase ALDs from several sources. Specialty retailers focusing on hearing loss products (like Diglo, Harris Communications, and ADCO Hearing Products) offer comprehensive selections with knowledgeable staff. Some audiologists sell ALDs alongside hearing aids. Online retailers like Amazon carry many devices, though product quality and descriptions vary. Hearing aid manufacturers like Williams Sound and Bellman & Symfon sell directly from their websites.

Insurance and funding assistance

Most health insurance plans, including Original Medicare, do not cover assistive listening devices. Medicare Advantage plans occasionally include limited coverage for ALDs as supplemental benefits, though this varies by plan and region. Some state Vocational Rehabilitation programs will fund ALDs if hearing loss impacts your work. Veterans receiving VA healthcare benefits may qualify for ALDs through VA Audiology services.

Several programs and organizations provide free or subsidized assistive listening devices for people with limited incomes. State equipment distribution programs (part of telecommunications access programs in most states) offer free or low-cost phones with amplification, captioning services, and sometimes other ALDs. Local fire departments sometimes provide free smoke detector alerting equipment to residents with hearing loss. Service organizations like Lions Clubs, Elks, and Kiwanis occasionally fund ALDs for people who cannot afford them.

Public venue access and ADA requirements

The Americans with Disabilities Act requires most public venues with 50 or more seats or that use audio amplification to provide assistive listening systems. Covered venues include theaters, lecture halls, courtrooms, conference centers, houses of worship (not legally required but many voluntarily comply), and auditoriums. Venues must provide receivers for at least 4% of seating capacity (with a minimum of two receivers), and at least 25% of receivers must work with hearing aid telecoils.

Despite these requirements, you often must actively request access to assistive listening. Many venues don't advertise the availability of systems, and desk staff may not know they exist. Ask at the box office, guest services, or information desk. Request systems should be provided free of charge. If a venue claims not to have assistive listening despite meeting ADA requirements, politely point out the legal obligation and consider filing an ADA complaint if they refuse to provide access.

Look for signage displaying the international symbol for assistive listening (an ear with a slash and the letter "T")—this indicates the venue has a system available. Some venues post signs near entrances, in programs, or on tickets. Google Maps sometimes includes accessibility information about hearing loops in venue listings, though this information isn't always current or complete.

Start With Priority Safety Devices

If budget is a concern, prioritize in this order: First, smoke/CO detectors with visual and vibrating alerts (safety); second, alarm clock with bed shaker (independence and reliability); third, doorbell signaler (not missing visitors and deliveries); fourth, personal amplifier for important conversations (communication); fifth, TV listening system (quality of life). Smartphone captioning apps provide valuable accessibility at no cost while you're working toward other equipment.

Choosing the right devices for your needs

The array of assistive listening options can feel overwhelming. Rather than trying to own every type of device, think strategically about which situations cause you the most difficulty and which devices address those specific challenges. A systematic approach helps you invest in technology that actually improves your daily life rather than accumulating unused equipment.

Assessing your specific situations

Start by identifying where you struggle most. Keep a journal for a week noting situations where hearing was particularly difficult. Was it restaurants? Medical appointments? Theater performances? Phone calls? Conference rooms at work? Family dinners? Watching TV? Once you see patterns, match assistive listening solutions to those specific needs.

For workplace challenges, your employer may be required to provide reasonable accommodations under ADA, which can include assistive listening systems for meetings and phone amplification for calls. Request these accommodations through your HR department. For social and entertainment situations, research which theaters, venues, and restaurants in your area provide assistive listening systems—then choose to patronize those accessible locations. For home situations, personal amplifiers and alerting devices address most challenges.

Working with your hearing aids

If you wear hearing aids, check whether they include telecoils and Bluetooth capability. Modern hearing aids increasingly include both technologies, dramatically expanding your assistive listening options. Telecoils allow you to connect with hearing loop systems, FM and infrared systems (via neck loops), and some telephone systems. Bluetooth streaming enables direct connection to smartphones, TVs with Bluetooth transmitters, and some public venue systems.

Discuss assistive listening devices with your audiologist. They can demonstrate how to use your hearing aids' telecoil program, connect to Bluetooth devices, and optimize settings for different ALDs. Many audiologists have demo equipment you can try before purchasing. They may also stock certain ALDs or can recommend reliable vendors.

Combining multiple solutions

Most people with hearing loss benefit from using multiple assistive listening technologies for different situations. You might use hearing loop systems at theaters, Otter.ai for work meetings, a personal amplifier for medical appointments, and bed shaker for overnight safety. Rather than seeking one perfect device, build a toolkit of complementary technologies that together address your full range of communication needs.

Modern technology increasingly works together. Your smartphone serves as hub for multiple functions—live transcription for conversations, phone call captioning, alerts from smart home devices, streaming audio to Bluetooth hearing aids, and remote controls for TV systems. Smart home platforms coordinate alerting devices. This convergence makes it easier to manage multiple assistive technologies without juggling numerous separate devices.

Frequently Asked Questions

Can I use assistive listening devices if I don't have hearing aids?
Absolutely. Many assistive listening devices work independently of hearing aids. Personal amplifiers like the Pocketalker, smartphone transcription apps, visual alerting devices, and most public venue systems with headphone receivers all function without hearing aids. If you have hearing loss but haven't yet obtained hearing aids, assistive listening devices can improve communication in specific situations. However, if you have significant hearing loss, these devices shouldn't replace professionally fitted hearing aids—they're most effective as supplementary technology.
How do I know if my hearing aids have telecoils, and why does it matter?
Check your hearing aid specifications, user manual, or ask your audiologist whether your devices include telecoils (also called t-coils). Telecoils are small copper wire coils that receive magnetic signals from hearing loops and other compatible systems. Having telecoils dramatically expands your assistive listening options—you can use hearing loop systems in theaters and public venues without any additional equipment. If your current hearing aids don't have telecoils, consider requesting them when you purchase your next pair, especially if you frequently attend theater, worship services, or other venues that offer loop systems.
Are smartphone transcription apps accurate enough for important conversations?
Smartphone apps like Google Live Transcribe and Otter.ai typically achieve 80-95% accuracy under good conditions, which means helpful but not perfect. Accuracy depends heavily on audio quality, background noise, speaker clarity, accents, and technical vocabulary. For casual conversations, this level of accuracy provides valuable support. For critical communications—medical appointments, legal meetings, important business discussions—consider using multiple apps simultaneously to catch what one misses, or request professional CART (Communication Access Real-Time Translation) captioning, which provides near-perfect accuracy with trained human captionists.
Will insurance cover assistive listening devices?
Most health insurance plans, including Original Medicare, do not cover assistive listening devices. Medicare Advantage plans occasionally include limited ALD coverage as supplemental benefits. State Vocational Rehabilitation programs may fund devices if hearing loss impacts employment. Veterans with VA healthcare benefits may qualify for ALDs through VA audiology. Check your specific plan, and explore alternative funding sources including state telecommunications equipment distribution programs, local fire department programs for safety equipment, and service organizations like Lions Clubs or Kiwanis that sometimes provide grants for hearing-related equipment.
How do I request assistive listening systems at theaters or public venues?
Ask at the box office, guest services desk, or information counter about available assistive listening systems. Most venues with 50+ seats or that use audio amplification are required by the ADA to provide systems, even if they don't advertise them. Request the specific type that works with your hearing technology—loop system if you have telecoils, FM or infrared receiver if you need headphones. Arrive early to get equipment, test it, and address any problems before the event starts. Don't be discouraged if the first staff person you ask doesn't know about the system—request to speak with a manager or technical staff who should be familiar with accessibility equipment.
What's the most important assistive listening device to get first?
Prioritize safety first. If you sleep without hearing aids and don't have visual or vibrating smoke alarm alerts, make this your first purchase. Smoke detectors with strobe lights and bed shakers ensure you'll be alerted to fire or carbon monoxide even when not wearing hearing aids. After addressing safety, consider an alarm clock with bed shaker (reliable wake-up), then a personal amplifier for important conversations (medical appointments, family discussions), followed by other devices based on your specific communication challenges. Free smartphone apps like Google Live Transcribe provide excellent value while you're building your collection of assistive technology.

The Bottom Line

Assistive listening devices aren’t signs of hearing-aid failure—they’re smart tools that solve problems hearing aids can’t. Challenging acoustics, background noise, distance, and safety needs all call for technology built for those situations. The question isn’t whether you “need” them, but which ones best support your communication and safety.

Start with essentials: smoke-detector alerting systems and dependable alarm clocks protect you when you’re least able to respond. Then add tools for the situations you face most often—transcription apps for key conversations, personal amplifiers for medical visits and restaurants, and loop or FM systems in theaters and public venues. Each device has a purpose; together they form a flexible system that works across environments.

Technology is evolving quickly, with better apps, expanding Bluetooth/Auracast options, and slow but steady improvements in public accessibility. Stay curious, advocate for accessible venues, and mix tools as needed. The goal isn’t using the fewest devices—it’s achieving clear communication and reliable safety wherever you are.

Next Steps: Build Your Assistive Tech Toolkit

Focus on the situations that challenge you most, then add one or two assistive tools that directly target those moments—rather than trying to buy everything at once.