Here’s a look at a selection of phone captioning products available to open up the lines of communication for audiology clients.

CapTel Captioned Telephone

1-800-233-9130; CapTel@CapTel.com; www.CapTel.com

The inventor of captioned telephones, CapTel shows captions of what a caller says, empowering people with hearing loss to enjoy talking on the phone again with confidence. CapTel offers multiple phones—traditional models and touch screen options, using high speed Internet or analog phone lines—giving users control of how calls are captioned, either automatically or with assisted captions. All CapTel phones caption answering machine and voice mail messages, include a powerful speakerphone for “hands free” calling, and provide 24/7 one-touch help. Most importantly, CapTel enables people to re-connect over the phone. Assembled in USA.

ClearCaptions

888-870-8114; hcp@clearcaptions.com; clearcaptions.com/providers

Hearing loss can make phone calls with loved ones difficult, but what if you could see every word they say, as they say it? The ClearCaptions Phone provides near real-time phone captioning services for the hard of hearing at no cost to eligible individuals. So they can stay connected to those who matter most. Features include:

• Word-for word captions of conversations

• Easy-to-use phone with touchscreen display

• Large buttons and speakerphone amplification

• Free in-home installation, training, and support

ClearCaptions is available in the United States and its territories only

FEDERAL LAW PROHIBITS ANYONE BUT REGISTERED USERS WITH HEARING LOSS FROM USING INTERNET PROTOCOL (IP) CAPTIONED TELEPHONES WITH THE CAPTIONS TURNED ON.

IP Captioned Telephone Service may use a live operator. The operator generates captions of what the other party to the call says. These captions are then sent to your phone. There is a cost for each minute of captions generated, paid from a federally administered fund. No costs are passed along to individuals who qualify for the service.

Hamilton CapTel

877-455-4227; info@hamiltoncaptel.com; www.hamiltoncaptel.com

Since 2003, Hamilton CapTel has made more than 400 million captioned telephone conversations possible for individuals with hearing loss, providing the ability to listen and read captions of what’s said over the phone. Whether looking for a traditional telephone experience, an option for at work, or a mobile app for on-the-go—Hamilton CapTel solutions offer clarity, confidence, and independence. Learn more at HamiltonCapTel.com

InnoCaption

support@innocaption.com; www.innocaption.com

InnoCaption is a free, FCC-certified mobile app that provides real-time captions for phone calls, empowering individuals with hearing loss to communicate with confidence. Users can choose between live stenographers or automated speech recognition—switching modes even mid-call. Designed for ease and independence, the app also features call forwarding, visual voicemail, saved transcripts, and Bluetooth hearing aid compatibility. InnoCaption helps bridge communication gaps, making phone calls more accessible, reliable, and stress-free.

Nagish

833-362-4474; hello@nagish.com; www.nagish.com

Certified by the FCC, Nagish captions phone calls in real time and makes it easy to communicate using text or voice. It’s designed to be fast, private, and accurate. The free AI-powered app captions calls and in-person conversations with no time limits and allows users to keep their existing phone number.

Featured image: ID 98363270 © Syda Productions | Dreamstime.com

Key Takeaways:

1. Enhanced Auditory Function: Roger technology consistently improves speech perception in noise, reduces the impact of distance on hearing, and lowers listening effort across various settings and populations.
2. Psychosocial Benefits: Use of Roger systems is associated with improved social interaction, reduced stress, and better behavioral outcomes, particularly among children with autism spectrum disorder.
3. Research Gaps Identified: While current findings are promising, more longitudinal and neurophysiological research is needed to isolate Roger’s effects and determine long-term benefits.

This review consolidates existing literature on the effects of Phonak Roger remote microphone systems on auditory processing and psychosocial functions across diverse populations.

By Wanting Huang, PhD, and Jingjing Guan, PhD

1 Introduction

Auditory processing represents a fundamental aspect of human perception, serving as a basis for decoding and interpreting acoustic information from the environment. This capability facilitates essential functions such as language comprehension, musical appreciation, and environmental awareness.^{1, 2} The neurocognitive mechanisms involved in auditory processing, such as sound localization, temporal resolution, and binaural integration, are instrumental in extracting meaning from acoustic signals.³ However, the accuracy of auditory processing can be substantially impaired by noise,^{4, 5} reverberation, and distance,^6,7 even among individuals with normal hearing.

Various auditory processing difficulties can adversely affect social interactions and emotional well-being.⁸ For example, children with auditory processing disorder (APD) may experience increased anxiety and social isolation due to the challenges of understanding speech in noisy environments and misinterpreting social cues.⁹ Similarly, older adults with hearing loss often face reduced socialization, which can subsequently lead to social isolation,^{10, 11}loneliness,¹² apathy,¹³ and depression.^14-16 Therefore, identifying and addressing auditory processing difficulties in these populations is crucial for promoting positive psychosocial outcomes and preventing long-term challenges in social and emotional domains.

Phonak Roger is a wireless microphone system developed in 2013 to address challenges in auditory processing within adverse listening environments. It consists of a Roger transmitter and a compatible Roger receiver and is referred to as Roger technology throughout the remainder of this article. This advanced technology utilizes adaptive digital wireless transmission to enhance speech intelligibility amidst background noise and over distance. The Roger technology provides features beyond typical remote microphones, such as adaptive gain, low latency, multi-talker networks, and a wide portfolio of products for various use cases. Since its launch, it has gained large adoption primarily by individuals with hearing loss.^17-19 However, studies have also indicated its potential benefits for those with neurodevelopmental disorders, such as autism spectrum disorder (ASD)^{20, 21} and listening difficulties.²² Research suggests that individuals with other neurodevelopmental conditions may experience auditory processing deficits even with normal audiometric thresholds.^{23, 24}

The increasing adoption of Roger technology in this population necessitates a review of its impact on auditory processing and psychosocial functions, domains currently lacking comprehensive investigation in the existing literature. This review aims to synthesize disparate findings, clarifying the efficacy of Roger technology in these key areas. This work will provide hearing care professionals (HCPs) with evidence-based intervention strategies for different populations who could benefit from the technology’s use, while also identifying knowledge gaps to guide future research focused on optimizing the development and application of remote microphone technology for users.

2. Methods

The primary inclusion criteria for this review focused on studies assessing the impact of Roger technology on auditory processing and psychosocial functions in individuals of all ages, including those with typical hearing, hearing loss, and neurodevelopmental disorders. The comprehensive literature search was carried out on PubMed and the Phonak Evidence Library using a list of specific key words, guided by the PICO framework. This framework is recognized for aiding searchers in obtaining more relevant and precise results,²⁵ as it structures the clinical question into four components: population (P), intervention (I), comparison (C), and outcome (O), ²⁶ enhancing the specificity and conceptual clarity of the clinical problem. 

3. Results

From the search, we filtered out duplicates; articles not relevant to the topic of interest; studies that were not written in English; and types of publications such as systematic reviews, meta-analyses, and books. Ultimately, 21 peer-reviewed articles and 1 peer-reviewed scientific poster remained for the review. Across the 22 studies, participant demographics varied substantially, and very few of them reported effect sizes. Therefore, the data could not be pooled for meta-analyses, and the results are presented descriptively.

3.1 Improved speech perception in noise

Seventeen of the 22 articles reviewed investigated the impact of Phonak Roger technology on speech perception in noisy environments. These studies consistently evaluated outcomes using two primary measures: speech recognition accuracy and speech reception thresholds (SRTs). Thirteen of these 17 articles specifically examined the effect of Roger technology on speech recognition accuracy. The   accuracy improvement was demonstrated both directly, through higher scores on standardized speech perception tests (e.g., Hearing in Noise Test, Consonant-Nucleus-Consonant [CNC] word test; Table 1) with Roger technology versus without,^{18-22, 27-31} and indirectly, through enhanced listening performance (e.g., following verbal instructions)^{32, 33} and improved academic outcomes.³⁴ In line with these accuracy improvements, the research also showed that SRTs were significantly lower with Roger technology than without (Figure 1), indicating an improvement in speech reception thresholds ranging from 3 dB to 14.95 dB.^{17, 35-37}

Table 1. Summary of study characteristics and results on the impact of Phonak Roger wireless microphones on the speech perception accuracy in noise, organized by publication year.

3.2 Reduced impact of distance on speech perception

Selected studies also indicate that Roger technology mitigated the detrimental effects of distance on speech communication for target uses. For example, research comparing children’s speech access at home during typical weekends, with and without Roger technology, revealed notable findings. Although caregivers produced a comparable quantity of speech overall across both weekend conditions, children with hearing loss demonstrated significantly greater access to speech when using Roger technology.^{39, 40} Specifically, these children experienced approximately 42% more words³⁹ and a 12% increase in child-directed speech per day.⁴⁰ Concurrently, the implementation of Roger technology resulted in a significant reduction in caregivers’ speech modifications.⁴¹

Compared to conditions without Roger technology, caregivers demonstrated a decrease in casual repetitions (1.75 ± 0.34 (with Roger) vs. 2.79 ± 0.50 (without Roger)), intentional repetitions (2.49 ± 1.22 (with Roger) vs. 8.74 ± 5.33 (without Roger)), and alerting phrases (1.44 ± 0.39 (with Roger) vs. 3.46 ± 0.65 (without Roger)). ⁴¹

Table 2. Summary of scores on listening effort before and after using the Roger technology.

SD: standard deviation.

3.3 Reduced listening effort

Reduced listening effort represents another key benefit associated with Roger technology. Listening effort, defined as the deliberate allocation of cognitive resources required to overcome perceptual obstacles in pursuit of a specific auditory goal, is particularly salient when tasks demand focused listening.⁴² Elevated levels of listening effort are commonly experienced by individuals with hearing loss, and in any situation where the auditory signal quality is compromised. 

Among the 22 selected articles, a subset of seven studies rigorously investigated and compared listening effort levels both prior to and following the implementation of Roger technology. These investigations encompassed a variety of auditory tasks administered across diverse scenarios, including ecologically valid classroom settings, controlled laboratory environments, and naturalistic home environments. 

As detailed in Table 2, these studies employed a range of methodologies to assess listening effort. These methods included simple oral questioning techniques,²⁷ validated questionnaires such as the Children’s Auditory Performance Scale (CHAPS)²⁰ and the Listening Inventory for Education-Revised (LIFE-R), ²⁹ as well as objective behavioral measurements.⁴³ Across these diverse methodological approaches, the findings consistently indicate a statistically significant reduction in listening effort for users of Roger technology. This robust body of evidence suggests that Roger technology effectively minimizes the cognitive resources necessary for individuals to successfully engage in and complete auditory tasks.

3.4 Enhanced psychosocial functions

In addition to improved auditory processing—such as better speech perception in noise, reduced listening effort, and more access to speech at a distance—psychosocial functions have also been shown to be enhanced among users of Roger technology. Initial evidence came from parent questionnaires (CHILD) and student self-reports (LIFE-R), which indicated significant benefits in social situations after using Roger wireless microphones.³⁶ Further research explored potential underlying mechanisms.

Given that stress is negatively correlated with psychosocial functions in individuals with autism spectrum disorder,^{44, 45}Rance et al investigated the impact of Roger technology on stress levels among a group of children with ASD. By comparing salivary cortisol concentrations before and after device use, researchers found a significant reduction with Roger technology (-0.18 nmol/L ± 0.45 nmol/L) compared to the pre-use condition (0.30 nmol/L ± 0.56 nmol/L). This demonstrated decreased stress levels, indirectly suggesting a positive pathway to improved psychosocial function.²¹

Building on this foundation and providing more direct evidence for psychosocial function, Leung et al.⁴⁶ combined a remote microphone hearing system (RMHS; i.e., Roger technology) with targeted computerized emotion perception training for children with ASD. After one year of intervention, these children showed significant improvements in behavioral social scores, ultimately exceeding those of their typically developing peers. Notably, these behavioral gains were supported by electrophysiological (EEG) evidence. Post-intervention recordings showed altered cortical auditory evoked potentials (CAEPs), including shorter mismatch negativity (MMN) latencies and enhanced neural differentiation of emotional stimuli, indicating improved underlying auditory processing that aligned with the observed behavioral gains.⁴⁶

This convergence of behavioral and neurophysiological data strongly supports the positive impact of interventions incorporating Roger technology on psychosocial functions in children with ASD.

4 Discussion

Since its inception in 2013, Phonak Roger technology has been the subject of a growing body of research investigating its efficacy across diverse clinical populations. This review synthesized findings from 22 studies, revealing a consistent pattern of benefits associated with the use of Roger technology. The aggregated evidence demonstrates that Roger technology is effective in enhancing crucial aspects of auditory processing and psychosocial function. 

Specifically, statistically significant improvements were consistently reported in speech recognition in noise,^{17-22, 27-37}a mitigation of the detrimental effects of distance on speech perception,^39-41 and a reduction in listening effort.^{20, 21, 27, 29, 36, 37, 43} These benefits were observed across a wide range of users, including normal-hearing adults,²⁸ children and adults with hearing loss using hearing aids or cochlear implants,^{17-19, 30, 31, 35, 39-41, 43} individuals with normal hearing thresholds but presenting with listening difficulties²² or auditory processing disorder,²⁷ and individuals with neurodevelopmental disorders such as autism spectrum disorder^{20, 21, 32-34, 36, 46} and neurofibromatosis Type 1.²⁹

The observed improvements in fundamental auditory processing skills are likely to contribute to broader functional benefits. Enhanced speech perception in challenging environments and reduced listening effort may facilitate better academic engagement,³⁴ increased participation in social interactions,³⁶ and reduced listening-related stress.²¹ The diversity of populations studied underscores the robustness of Roger technology in addressing listening challenges arising from various etiologies, including both peripheral hearing loss and central auditory processing difficulties.

A key insight from this review is that the evidence supporting Roger technology’s efficacy has relied predominantly on behavioral measures. While behavioral outcomes (e.g., speech perception scores, questionnaire ratings) offer strong face validity regarding end-user benefit and are often simpler to obtain in clinical or educational settings, they provide limited insights into the underlying neural mechanisms mediating these improvements. Furthermore, subjective reports may be confounded by factors such as listener motivation, attention, and placebo effects.

Luckily, recent research has begun to bridge this gap by exploring the electrophysiological correlates of interventions involving Roger technology. Notably, Leung et al⁴⁶ combined Roger technology with targeted computerized emotion perception training for children with ASD. To our knowledge, this study is the first to provide neurophysiological evidence supporting the behavioral outcomes. We found that the improved social perception scores were associated with post-intervention EEG changes, including altered CAEPs indicating enhanced neural processing of emotional stimuli, and faster MMN responses. 

However, it is crucial to interpret these neurophysiological findings with caution. The observed changes resulted from the combined effects of Roger technology and the specific auditory-cognitive training program used. The current evidence does not allow for the definitive isolation of the electrophysiological impact attributable solely to the use of Roger technology itself. Disentangling these effects necessitates future research specifically designed to evaluate the neural consequences of Roger technology use independent of concurrent structured training paradigms.

Despite consistent positive findings, several limitations within the current evidence base warrant consideration. Many studies included in this review featured relatively small sample sizes, potentially limiting statistical power and the generalizability of results. Furthermore, participant heterogeneity across studies, particularly concerning comorbidities (e.g., Schafer et al³⁶ included children with ASD, many of whom also had ADHD), makes it challenging to conclusively attribute observed benefits to Roger technology in individuals with a ‘pure’ primary diagnosis. This variability underscores the need for careful participant characterization and recruitment in future work. Additionally, most studies have focused on immediate or short-term outcomes (often within weeks of device fitting), leaving the long-term effects and sustainability of benefits largely unknown.

Future Research

Building on the existing evidence and its limitations, we identified multiple potential directions for future research. There is a clear need for longitudinal studies to track the effects of Roger technology over extended periods, assessing the persistence of benefits and potential developmental impacts. Larger-scale investigations with well-defined, homogeneous participant groups are required to strengthen the evidence base for specific populations and potentially identify predictors of successful outcomes. 

Crucially, research employing objective neurophysiological and neuroimaging techniques (e.g., EEG/ERP, fNIRS) is essential to elucidate the specific neural mechanisms through which Roger technology impacts auditory processing and reduces listening effort, ideally using paradigms that control for or isolate the effects of the technology from other interventions. 

Exploring the utility of Roger technology in broader populations—such as children who pass standard hearing screenings but exhibit auditory processing difficulties associated with ADHD, dyslexia, or other learning disorders—represents another important direction. 

Finally, comparative effectiveness studies evaluating different remote microphone systems could provide valuable clinical guidance.

5 Conclusion

This review provides a comprehensive understanding of the significant positive impact of Roger technology on auditory processing and social functioning across diverse populations. While the assumption is that most remote microphones will function similarly, the research in this review provides evidence of the benefits of Roger technology, in particular. Based on the data presented, hearing care professionals can expect this remote microphone solution to provide benefits to patients in various populations. Continued research and advancement in wireless microphone technology will likely yield an even higher quality of life for individuals with listening challenges in the future.

About the Authors:

Wanting Huang has been conducting research on speech and auditory processing from a cognitive neuroscience perspective. She earned her PhD in Speech and Hearing Sciences from the University of Hong Kong in 2021. From 2021 to 2023, she engaged in postdoctoral research at the Southern University of Science and Technology. Since 2024, she has been working as a senior hearing researcher at Sonova Innovation Center in Shanghai. Email: wanting.huang@sonova.com

 Jingjing Guan holds a PhD from University of Texas at Austin and worked in Texas Tech University Health Sciences Center as an assistant professor and a licensed audiologist. She started her journey with Sonova Innovation Center in Shanghai in 2018. Her main research interests include psychoacoustics and hearing aid outcome measures. Email: jingjing.guan@sonova.com

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By Gina Geissler, AuD, FAAA

Medical research for many years has reported patient compliance is typically 50% when it comes to listening to their doctors or healthcare professionals. Is this because patients don’t remember?  Is this because they are overwhelmed or stressed with the information they are being told or simply because they cannot hear it correctly? The answer remains a mystery.

I have been a private practice doctor of audiology for over 20 years. I sincerely love my job of helping people be able to communicate to the best of their abilities. After I conduct a hearing evaluation in my office and learn that a patient has hearing loss, it has been my common practice to explain the test results and verbally talk to them about their results and make recommendations.

The irony of this situation is I am verbally giving test results and recommendations to someone I just diagnosed with a hearing loss and have documented has difficulty hearing!  

We are all familiar with the PockeTalker. For years, I have occasionally used the device when I have a severe hearing loss patient who cannot hear me well. But I don’t stock or sell PockeTalkers since they are available online. I now realize I’ve been missing an opportunity to connect with patients, and they’ve been missing an opportunity to hear clearly. I recently was introduced to a new set of wireless conversation amplifying earphones and I have been so impressed with it that I have changed my counseling protocols in my office. The ClearCast PAL (personal assistive listening) device is a new FDA-registered device that has a neckband form factor and two different microphones that are useful in different settings.  

Key Takeaways:

1. Hearing Loss and Compliance – Many patients struggle to hear and retain medical advice, impacting their ability to follow healthcare recommendations.
2. Personal Listening Device as a Solution – These devices enhance communication between audiologists and patients, improving understanding and engagement.
3. Broader Benefits – Beyond medical settings, personal amplification devices help individuals hear better in daily life, strengthening relationships and emotional connections.

Improving Communication for Consultations

Now, after I finish a patient’s hearing evaluation, I immediately put the ClearCast on the patient to communicate the results to them. Even if the patient has never used a device like this before, doing so is quick, easy, and effective. I simply put the neckband around their neck and an earbud in each ear. I turn the wireless microphone on and clip it to my shirt or lab coat. Once I begin speaking, the microphone picks up my voice and immediately streams my voice directly into the patient’s ears. 

There is a volume control on the neck loop that either the patient or I can very easily adjust to make it louder or softer to be most comfortable for the patient, so they can hear my voice very well. When significant others are present, I can pass the microphone to them or place it on the desk between us and it can then pick up both of our voices.

When using this personal listening device on my patients with hearing loss, I know they are able to hear me loud and clear when I’m counseling them about test results and giving recommendations for their personal hearing healthcare needs. They don’t need to have a severe hearing loss for this to be useful. Many times, patients will react with, “Wow, I can really hear you.” I simply respond, “Good, because what I need to tell you and your loved one is very important.”

I would highly recommend that all hearing healthcare practices have something like this in their office so all your patients can hear the important things you need to tell them. I have found ClearCast to be an effective and affordable medical device, but it’s just one option. A wide range of personal amplification and assistive listening devices (ALDs) are available to help patients hear, whether they have hearing aids or not. The important part is having a device available that lets your patients hear you. Research shows that when patients hear well and understand instructions, they are more likely to have better patient compliance and therefore better overall physical and mental health.

Personal Use for Home and Elsewhere

Additionally, ALDs and other devices can provide patients with some great benefits for personal use at home and in other settings where they have difficulty hearing. 

For example, the ClearCast has a built-in microphone that works much like a body-worn hearing aid. And there is a second wireless microphone that can easily be worn by anyone so their voice can stream into the ears of a loved one who is hard of hearing, up to 60 feet away. It is very easy to place the microphone near the TV speaker and then the TV can also stream into the patient’s ears, giving them excellent speech clarity of what the people on TV are saying and allowing everyone in the room to listen to the TV at a comfortable volume. In a small group setting, the microphone can be placed on a table and pick up the voices of the people sitting around the table.

Who Benefits

I believe ALDs and amplification products can change the way hearing care professionals talk to and counsel their patients. I take great pride in knowing my patients can actually hear me when I am talking to them. This type of device is also a great “bridge solution” for people whose hearing is not quite as sharp as it used to be, but not significant enough where they would need or want custom hearing aids. At the 2024 AAA conference in Atlanta, it was mentioned that 70% of people that bought an OTC hearing aid had seen an audiologist prior to purchase. 

Products like ClearCast allow an audiologist to provide an amplification solution to those patients who are “tested not sold” and can establish a trusted relationship that will lead to future hearing aid sales. 

Elderly patients with vision or dexterity challenges are also great candidates for such devices. When patients have other medical challenges, it can make managing and maintaining custom hearing aids difficult.  

The experiences of streaming TV, hearing one’s significant other well, hearing in small groups, hearing in the car, hearing their doctor, and even hearing someone down the aisle in the grocery store are all enhanced when wearing a personal listening device with a wireless microphone such as ClearCast. 

Fostering Emotional Connections

Finally, when discussing end-of-life care, my experience has taught me that what people want most is to be able to say “I love you” or say their good-byes and know that their loved one heard their voice. Amplification devices and ALDs can be the answer for these extremely sensitive and emotional times. Patients in nursing homes and hospice settings could really benefit from this type of device. At the end of the day, all humans want to feel connected and heard by their friends and family, and products like ClearCast can make this possible. 

Gina Geissler, AuD, FAAA, is a longtime audiologist who practices in Munster, Ind. She has worked with the inventor of ClearCast, but has no financial relationship to the company.

Featured image: ID 59931319 © Monkey Business Images | Dreamstime.com

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.

Original citation for this article: Lundin A. How Phone Captioning Solutions Bolster Communication Accessibility. Hearing Review. 2025;32(1):12-13.

Featured image: 74217379 © Mimagephotography | Dreamstime.com

Takeaways:

1. Innovative Service Launch: InnoCaption Connect offers real-time captioning for phone calls in correctional facilities across ten states, ensuring accessibility for deaf and hard-of-hearing inmates.
2. FCC Compliance: The service aligns with updated FCC rules mandating telecommunications access for facilities housing 50 or more inmates in areas with high-speed internet.
3. Addressing Hearing Loss in Prisons: Approximately 9.5% of state and federal prisoners report hearing loss; this service enhances communication, reducing barriers to family, legal, and healthcare access.

InnoCaption, an FCC-certified provider of real-time captioning of phone calls for the deaf and hard-of-hearing community, announced the successful launch of InnoCaption Connect, a new service aimed at expanding telecommunications access to the deaf and hard-of-hearing incarcerated population. The program was officially launched after months of close collaboration between InnoCaption and multiple telecommunication provider partners who participated in successful pilot tests demonstrating secure access to communication services, according to the company.

Phone Captioning Service for the Incarcerated

This new service allows correctional facilities to provide inmates with real-time captions of phone calls through direct integration with InnoCaption’s FCC-certified real-time captioning technology. Telecommunication providers are deploying this new service through their own captioned telephone mobile apps on Android tablets or through a customized Android app provided by InnoCaption. Strict oversight and security are built into the service. 

Calls are tracked and monitored by the correctional facilities with the same restrictions that currently apply to other phone calls. This new accessible communication service has been rolled out to county jails and state Department of Corrections facilities across ten states.

“Bringing improved access to telecommunication through InnoCaption’s real-time captioning helps level the playing field for incarcerated individuals with hearing loss,” says Cristina Duarte, sr. director of regulatory affairs at InnoCaption. “Our goal is to help break the cycle of incarceration through transformative technology and services for these individuals and their support network. People with hearing loss often face unique communication barriers, and by partnering with InnoCaption, correctional facilities can ensure deaf and hard-of-hearing individuals who are incarcerated have the same opportunities to stay connected through phone calls as their hearing peers.”

Hearing Loss Among State and Federal Prisoners

The most recent data available from the U.S. Department of Justice estimates that approximately 9.5% of state and federal prisoners report hearing loss.(1) This number is expected to increase with an aging prison population. Undiagnosed hearing loss can lead to frustrations among both inmates and guards as instructions are missed or misinterpreted. Additionally, lack of captioning accessibility for phone calls can limit communication with family, healthcare providers, educational services and legal contacts.

Further Reading

“At InnoCaption, we are committed to creating innovative and empowering solutions that help break down telecommunication barriers. We are excited to extend our captioning service to an underserved population within the prison system and improve access through our new partnerships,” says Paul Lee, chief operating officer, InnoCaption.

The Federal Communications Commission (FCC) recently expanded rules governing access to telecommunications services for deaf and hard-of-hearing incarcerated individuals. Beginning Jan. 1, 2024, a provider serving correctional facilities with an average daily population of 50 or more incarcerated persons must provide access to all relay services eligible for Telecommunications Relay Services fund support in any correctional facility that is located where high-speed internet service is available and has not been prohibited by the correctional authority overseeing the facility. InnoCaption’s new solution helps facilities meet these new rules.

Photo: InnoCaption

References:

1. Maruschak L, Bronson J, Alper M. Survey of Prison Inmates, 2016 Disabilities Reported by Prisoners. Bureau of Justice Statistics. March 2021, NCJ 252642.

Takeaways:

1. Unified Leadership: Maile Keone becomes president and CEO of both companies, with Julian Pieters as chief strategy officer, streamlining operations and strategic direction.
2. Expanded Product Portfolio: The combined expertise of Listen Technologies and Ampetronic offers a broader range of assistive listening solutions for industries like education, transportation, and entertainment.
3. Enhanced Global Reach: The partnership builds on their successful collaboration on products like Auri, positioning the two companies to offer comprehensive solutions and lead the industry in accessibility.

Listen Technologies Corporation, a provider of advanced wireless listening solutions, and Ampetronic, a provider of audio induction loop systems, are joining forces and combining their decades of expertise to redefine assistive listening and communication.

The two companies are deepening their partnership under the Allvida umbrella, aligning their operations, leadership, and resources to deliver greater value to customers and partners. While collaborating closely, Listen Technologies and Ampetronic are both established as the leading brands in their different technologies and applications, and will retain their unique brand names.

By joining forces, Listen Technologies and Ampetronic aim to provide the assistive listening and communication industry with expanded resources, and a broad suite of products.

New Leadership Structure

The combined leadership team includes Maile Keone serving as president and CEO of both Listen Technologies and Ampetronic, ensuring consistent leadership and strategic alignment across the organization. Julian Pieters will assume the role of chief strategy officer, focusing on business strategy, product and technology development, and partnerships.

The centralized leadership streamlines operations to deliver seamless customer and partner experiences. This unified structure enhances collaboration across teams and regions, drives innovation, and ensures consistent excellence in customer support and global accessibility.

A History of Collaboration

Listen Technologies and Ampetronic are part of Allvida, a rapidly growing group of companies focused on accessibility. In 2023, Listen Technologies and Ampetronic announced that they would be distributors for each other’s solutions in North America and the UK, respectively, and created a single source for their comprehensive and complementary assistive listening solutions. They also collaborated to develop Auri, an Auracast broadcast audio-based assistive listening system.

“Our collaboration with Ampetronic on Auri showcases the incredible synergy between our teams and our shared passion for innovation and accessibility,” says Keone. “Under the Allvida umbrella, we’re taking that successful partnership to the next level, delivering complementary solutions and expanding our global impact. This alignment is more than a natural progression—it’s a powerful opportunity to help even more people hear clearly and engage in any environment.”

Further Reading

Portfolio of Accessible Audio Solutions

The union of Listen Technologies and Ampetronic aims to ensure that their full portfolio of products are available to meet the evolving needs of customers and industries worldwide. This combined strength empowers their distribution network to offer comprehensive solutions tailored to the diverse requirements of sectors such as transportation, performing arts centers, houses of worship, higher education institutions, and more.

“With our expanded resources and shared expertise, we can accelerate our innovation in both technology and services. There are so many opportunities ahead, with the world of public audio services entering a new and exciting chapter,” says Pieters. “Together, Listen Technologies and Ampetronic will set a new standard for assistive communication, enhancing accessibility for all.”Listen Technologies and Ampetronic will showcase their combined suite of solutions in booth 3R400 at Integrated Systems Europe (ISE) 2025, Feb. 4-7, 2025.

Summary:
InnoCaption has acquired CaptionMate, a mobile call captioning service for the deaf and hard of hearing, to enhance accessibility for users through InnoCaption’s support and expertise.

Key Takeaways:

1. FCC Support: Both InnoCaption and CaptionMate provide free call captioning services, funded and certified by the FCC, to eligible users.
2. Language Accessibility: CaptionMate’s app supports over 100 languages and allows interface changes to multiple languages, broadening accessibility.
3. Commitment to Continuity: CaptionMate will operate as a standalone service under InnoCaption, with its founder advising during the transition to maintain service quality.

InnoCaption, a mobile call captioning technology provider for the deaf and hard of hearing community, has completed the acquisition of CaptionMate. Certified and funded by the Federal Communications Commission (FCC), both InnoCaption and CaptionMate provide eligible end users with free mobile app-based call captioning services. CaptionMate uses advanced automated speech recognition technology to provide real-time captions of phone calls for users in more than 100 languages and offers unique features like the ability to change the mobile app interface language to Spanish, Chinese, or Vietnamese.

Further Reading: Phone Captioning App Improves Communication for Users with Hearing Loss

With the closing of this acquisition, CaptionMate will be supported by the InnoCaption team as a standalone service. InnoCaption will continue to manage and support CaptionMate’s users by utilizing the engineering and customer service expertise of the InnoCaption team. Beryl Bucher, founder and CEO of CaptionMate, will serve in a temporary advisory capacity to the InnoCaption team to ensure a smooth transition of service.

“We have been impressed with the CaptionMate team’s technology platform and focus on high quality service to their user base,” says Paul Lee, InnoCaption’s chief operating officer. We are excited to welcome CaptionMate and their users to the InnoCaption family and continue to provide the best call captioning experience possible.”

Further Reading: InnoCaption Report Highlights Communication Difficulties for Hearing Impaired During Pandemic

“We felt that InnoCaption and CaptionMate had a strong alignment of mission and values,” adds Bucher. “Today’s acquisition ensures that our users will be well-supported and that we will see our investment in advancing accessibility continue through this next phase of CaptionMate’s journey.”

Both InnoCaption and CaptionMate are privately held.

About InnoCaption

InnoCaption is a caption phone service that offers real-time captioning of phone calls through automated speech recognition technology and live stenographers. The InnoCaption mobile app is available on iOS and Android devices, and the service is free of charge to anyone in the United States with hearing loss who needs captions to understand their phone calls. As an FCC-certified provider, InnoCaption receives compensation from the federal Telecommunication Relay Services Fund for providing call captioning services. InnoCaption is headquartered in Irvine, California, and its mission is to provide the best accessible telecommunication technology to the deaf and hard-of-hearing community. To learn more, visit www.innocaption.com. 

Takeaways:

1. Advanced Hearing Aid Styles: GN is expanding the ReSound Nexia portfolio with the launch of a wireless non-rechargeable ITC hearing aid and a wireless rechargeable CROS BTE style, providing advanced solutions for various hearing needs, including single-sided deafness.
2. Auracast-Enabled Remote Microphone: The new Multi-Mic+ remote microphone, the first of its kind with Auracast technology, improves hearing in noisy environments by significantly boosting the signal-to-noise ratio, supporting Telecoil, FM systems, and direct audio input.
3. Improved Fitting Software: The updated ReSound Smart Fit 2.0 software offers faster workflows, reduced clicks, and a streamlined interface, enhancing both the fitting experience for hearing care professionals and satisfaction for hearing aid users.

GN announced the release of updated hearing aid fitting software, ReSound Smart Fit 2.0, a new remote microphone with Auracast for Resound Nexia hearing aids, and the launch of new hearing aid styles.

Updating the ReSound Nexia Portfolio

Complementing the existing ReSound Nexia portfolio, GN is launching its smallest in-the-canal (ITC) hearing aid in a wireless non-rechargeable design and a new wireless rechargeable CROS behind-the-ear (BTE) solution, to support different hearing needs and preferences; another solution in treating single-sided deafness in addition to the already successful wireless CROS RIE launched in 2023. The new Auracast enabled styles give even more people with hearing loss access to GN’s most advanced technology, better equipping them for the new standard of Bluetooth connectivity.

New Remote Microphone with Auracast

In addition, GN is now offering the world’s first remote microphone with Auracast. As well as supporting Telecoil, FM systems, and DAI/direct audio input, the new Multi-Mic+ is designed to support users in challenging listening environments, including distances and noisy acoustics. The technology in the new Multi-Mic+ boosts signal-to-noise ratio (SNR) by at least 10.6 dB compared to adaptive directionality for better hearing in noisy environments. (1)

“We are continuously striving to cater to the needs of hearing aid users worldwide,” says Scott Davis, hearing division president at GN. “I’m delighted that more people can now benefit from ReSound Nexia’s best-in-class hearing in noise technology and experience the ‘next era’ of hearing and connectivity. With the introduction of these new technologies, people with hearing loss can strengthen their connections to people and the world around them and hear the sounds that matter.”

Further reading: Beltone Unveils Auracast-Enabled Portable Mic for Serene Hearing Aid

Updated ReSound Smart Fit Tech

Hearing care professionals consistently rank fitting software as the most critical tool for achieving hearing aid user satisfaction. In fact, up to 55% of a hearing aid fitting consultation is spent in the software which can be complex to navigate, slow to load, and requiring many clicks. (2) The new ReSound Smart Fit 2.0 delivers a 33-second improvement in clickthrough speed and a 62% click reduction when selecting preferences and settings.(3) The faster workflows and significantly improved home screen allow for a smoother, smarter, and more personalized fitting experience.

“Over the years, we have been improving our fitting software, so it performs consistently to the needs of hearing care professionals around the world,” says Laurel Christensen, chief audiology officer in GN’s Hearing division. “ReSound Smart Fit 2.0 addresses some of the key challenges faced by hearing care professionals. By simplifying and speeding up the fitting experience, we are enhancing both the professional and the user experience, leading to greater satisfaction.”

The ReSound Smart Fit 2.0 fitting software and new ReSound Nexia styles, along with the equivalent Beltone Solus Max software and Beltone Serene models, will be available in U.S. on Aug. 22, 2024.

References:

1. Jespersen et al. (2024)
2. FSW insights 2024 (data based on unique machine id)
3. Compared to ReSound Smart Fit 1

Featured image: ReSound Nexia in-the-canal (ITC) hearing aid. Photo: PRNewsfoto/GN Hearing (US))

Key Takeaways:

1. Funding and Investors: Nagish raised $16 million, including $11 million in Series A led by Canaan Partners, with participation from several prominent investors and founders of Datadog and Looker.
2. Product and Mission: Nagish offers an AI-powered speech-to-text and text-to-speech phone app that provides real-time transcription and customizable text display options, aiming to bridge the communication gap for the hard-of-hearing community.
3. Achievements and Future Plans: With recent FCC certification and partnerships with major enterprises, Nagish plans to expand its product offerings, increase hiring, and continue enhancing accessibility and inclusivity in communication.

Nagish, a startup using AI to make communication accessible for deaf and hard-of-hearing individuals, announced $16 million in funding. This includes $11 million in Series A led by Canaan Partners, with participation from existing investors K5 Global, Tokyo Black, Cardumen Capital, Vertex Ventures Israel, Contour Venture Partners, and Precursor Ventures, as well as the founders of Datadog and Looker. 

Further Reading: Phone Captioning App Improves Communication for Users with Hearing Loss

This financing complements Nagish’s $5 million seed round. According to the company, it will be used to fuel the continued development of Nagish’s AI-powered communication tools to transform how more than a billion people with hearing loss communicate, share information, and work.

Bridging the Communication Gap

“Nagish is not just another AI app. It’s a catalyst for empowerment, independence, and social inclusion, inspiring a new era of communication for millions of individuals with hearing loss,” says Laura Chau, partner at Canaan. “Nagish exemplifies the profound impact that AI can have on society, making inclusivity and accessibility a reality for millions.”

According to the company, Nagish’s mission is to bridge the communication gap faced by the hard-of-hearing community, leveraging advanced AI to create accessible, intuitive, and practical tools. With this new infusion of capital, Nagish plans to enhance its product offering and expand its reach so that more individuals around the globe can benefit from seamless communication to connect, learn, and thrive.

“This funding is a testament to the critical need for innovative solutions that address the daily challenges faced by millions of people who are deaf or hard of hearing,” says Tomer Aharoni, Nagish CEO and co-founder. “We believe in a future where inclusivity and accessibility are not just ideals but everyday realities, and Nagish is pioneering a new era of communication.”

Private Relay Service Features

Nagish has developed what the company says is the first end-to-end private relay service that empowers deaf and hard-of-hearing individuals to communicate without a third party. The company’s flagship product, an AI-powered speech-to-text and text-to-speech phone app, is designed to provide highly accurate and instantaneous transcription of spoken language into text. 

The company offers real-time transcription and customizable text display options, an intuitive interface that replaces native phone apps, and voice modulation features, to create a comprehensive communication tool for deaf and hard-of-hearing individuals. The Nagish product is designed to allow people with hearing loss to follow conversations in real-time, enhancing personal interactions and improving accessibility while keeping calls private and secure.

Nagish was recently certified by the Federal Communications Commission (FCC) to provide telecommunication relay services, an achievement that the company says underscores its commitment to regulatory compliance and user safety.

With this financial backing, Nagish plans to bring new products to the market and increase its hiring efforts, bringing top talent in AI development, product design, and customer support to ensure its users’ continued success.

Featured image: Photo 43637951 © Kritchanut | Dreamstime.com

Takeaways:

1. The Digi-Loop 104 is specifically engineered for small environments such as meeting rooms, waiting areas, and assisted living facilities, ensuring these spaces are inclusive and compliant with hearing legislation.
2. This device utilizes Class D amplification for efficient power usage and natural cooling, along with automatic gain control to deliver improved sound quality and intelligibility.
3. The Digi-Loop 104 features a user-friendly interface with clear status indicators that simplify monitoring and management for administrators, making it a practical choice for a variety of settings.

Williams AV, a provider of assistive communication technology, recently debuted new products at InfoComm, which included the announcement of a  new hearing loop device.

Williams AV’s Small Room, Perimeter Hearing Loop

Williams AV expanded its assistive listening solutions with the addition of the Digi-Loop 104, a compact, perimeter loop amplifier for small rooms. 

The Digi-Loop 104 is designed for venues looking to make meeting rooms, waiting rooms, reception areas, and assisted living facilities more inclusive for those with hearing loss, and compliant with hearing legislation.

This Class D amplifier features high-efficiency technology for lower power consumption and natural cooling, and features a user-friendly interface and clear status indicators to make it easy for admins to monitor, the company says.

It also features automatic gain control for superior sound quality and intelligibility. 

Williams AV’s product portfolio includes assistive listening, interpretation, intercom, guided tours, and entertainment offerings, reflecting a commitment to creating seamless and inclusive communication experiences, the company says.

Photo: Williams AV