Doing Business with Persons Who Are Deaf & Hard of Hearing ABOUT THIS GUIDE: This guide is intended to help businesses in the Lehigh Valley better serve and communicate with people who are deaf and hard of hearing. It is meant to dispel myths about deafness and hearing loss, and to provide specific techniques for effective communication. While the guide does include some information on the Americans with Disabilities Act (ADA), the guide is not intended to provide legal guidance. The survey that helped to form the recommendations in this guide was funded through the Pennsylvania Developmental Disabilities Council (PADDC) and administered by the Lehigh Valley Center for Independent Living (LVCIL). The survey was offered online and in print through outreach from various community organizations, civic groups, faith-based organizations, and other communities. Persons who are deaf and hard of hearing in the Lehigh Valley were asked about their positive and negative experiences in dealing with area businesses, and what suggestions they may have to better improve business relations. We hope that you will respect and learn from the responses provided, as these individuals shared candid, true experiences in the community. Produced by: LVCIL through funding from the Pennsylvania Developmental Disabilities Council, January 2010 Printed by: Bethlehem Business Forms Picture Credits: 1. Front cover picture provided by: http://www.wilsonwebsiteconsultants.com/about/Mix_race_group_of_people2.jpg. Accessed through Google. 2. PADDC logo provided by the Pennsylvania Developmental Disabilities Council. 3. Page 11: Hard of hearing graphic provided by: http://www.queens-theatre.co.uk/access/logos.htm. Accessed through Google. 4. Page 12: Picture provided by: http://www.telostraining.co.uk/working-with-older-people.html. Accessed through Google. 5. Page 14: Americans with Disabilities Act logo provided by: http://www.roymatheson.com/courses/post-offer-courses. Accessed through Google. TABLE OF CONTENTS Why You Need This Guide…………………………………………………………………3 Differences Between Deaf and Hard of Hearing………………………………………...3 General Etiquette for Deaf and Hard of Hearing………………………………………...4 Communicating With Someone Who is Deaf…………………………………………….6 Communicating With Someone Who is Hard of Hearing ………………………………..8 Aging and Hearing Loss……………………………………………………………………9 Legal Considerations…………………………………………………………………….....9 Technology…………………………………………………………………………………10 FAQs………………………………………………………………………………………..13 Glossary of Terms…………………………………………………………………………14 Resources………………………………………………………………………………….15 Index………………………………………………………………………………………...18 WHY YOU NEED THIS GUIDE According to the U.S. Census Bureau, nearly 7% of Pennsylvania residents identify themselves as having a hearing disability, or as being deaf or hard of hearing. By making simple accommodations, your business could increase services to over 675,000 Pennsylvanians. This guide will provide you with a variety of ways to make your business deaf and hard of hearing friendly, and help: • Widen your client base • Increase your revenue • Improve your community image • Promote diversity in the business community DIFFERENCES BETWEEN DEAF AND HARD OF HEARING People who are hard of hearing will likely require different accommodations or services than people who are deaf. According to the online publication “Deaf, Inc.,” many people who are deaf view themselves not as “disabled,” but as members of a distinct cultural community. The distinction between deaf and hard of hearing is important in understanding the different ways to best communicate. “Deaf, Inc.” provides the following definitions: Deaf: Typically indicates hearing loss is severe and occurred before the learning of formal language; primary communication mode is visual or tactile. “Working Effectively with Persons Who are Hard of Hearing, Late-Deafened or Deaf,” published by Cornell University states that, ”persons are generally considered deaf if they are unable to hear and understand speech (even with a hearing aid), and so must rely on vision for communication.” Hard of Hearing: Indicates the presence of some residual hearing that may enable an individual to use spoken English with amplification. People who are hard of hearing may also have trouble hearing sounds within certain ranges or frequencies, and their hearing loss is often variable and may change from one day to the next. Late-Deafened: The onset of hearing loss (of all levels) that occurs post-lingually, or after the development of speech or spoken language. Have you ever been swimming and heard voices under water? Maybe you could tell that it was a human voice or who was speaking, but probably could not make out what they were saying. This is the way many persons who are hard of hearing experience the human voice. Did you ever put on the big, older model ear phones to listen to music? If someone was speaking to you from behind, it is not likely that you were aware they were speaking. Think about this situation but without the music. This is what it’s like for people who are deaf all the time. Persons who are deaf or hard of hearing communicate in various ways because of educational experience, cultural identity, family/peer influences, time of life when hearing loss occurred, degree of hearing loss, and many other factors. Often a person with hearing loss can hear certain sounds like a door slamming but, due to the complexity of the sounds, may not know that someone is speaking. Additionally, people who are deaf may not be able to hear certain sounds, but instead respond to vibrations that they feel. This guide will provide tips on friendly ways to effectively determine how to communicate with both persons who are deaf and persons who are hard of hearing. GENERAL ETIQUETTE FOR DEAF AND HARD OF HEARING Did you ever say “Hello” and not get a response? Perhaps you thought that the person was ignoring you or just being rude. It may have simply been that the person was deaf or hard of hearing. It’s possible that they would have appreciated another, different way of communicating. When asked how a business/agency was made deaf/hard of hearing friendly, the most frequent survey suggestions were: • Repeating themselves when asked • Having closed captioning on instructional videos • Looking directly at me while speaking so I could read lips • Having closed captioning on television in waiting rooms • Having closed captioning on television at the gym or bar • Smiling and acknowledging me • Reducing background noise These suggestions are FREE and easy to implement! In certain situations, like describing the services provided by a business or organization, printed materials may be the best method to communicate large pieces of information. Written materials, such as transcripts, help in situations like presentations and meetings, and additional materials, such as instructions and inventory lists, are perfect for illustrating the proper use of a device or providing a general overview of the items a store sells. However, do not assume that all persons who are deaf or hard of hearing are fluent at reading or writing in English. Some terms used to describe persons who are deaf or hard of hearing have become commonplace, but are now considered inappropriate and offensive language. For example, “the deaf” should be replaced with “a person who is deaf or hard of hearing.” Also, never use the terms “dumb” or “mute.” Instead, say “someone who cannot speak,” “non-verbal,” or “who has difficulty speaking.” People without a hearing disability may be unaware of, or become de-sensitized to, background noises or other environmental factors that affect our ability to hear well. In our survey we asked, “If [you are] hard of hearing, what factors in the environment make hearing more difficult for you?” Responses included: • Street noise/background noise • Radio/music • Soft voices/speaking • Large group settings • Cross talking • Heating/ventilation/cooling (HVAC) fans. When talking to a person who is deaf or hard of hearing, consider moving to a quiet setting away from open windows and doors, the sound of fans, the sound of music, or groups of people talking and use a clear voice. You can also tap someone on the shoulder to get their attention (smile!) and continue your greeting. Once again, these are FREE suggestions that can help you better communicate with your customers and associates. So what happens if you try these ways of communicating and you think the person may be deaf? Read on... COMMUNICATING WITH SOMEONE WHO IS DEAF People who are deaf use a variety of ways to communicate including American Sign Language (ASL), specially designed phones, text messaging, and email. Some people who are deaf also practice speech reading, or lip reading, but do not assume that all people who are deaf can read lips. ASL is a manual language and has its own separate, distinct grammar and syntax. A person who is deaf or hard of hearing may request a sign language interpreter for presentations, meetings, or events. When providing an interpreter it’s essential for a person who is deaf to be able to see the interpreter fully, and for the interpreter to clearly hear and understand any speaker(s) present. Under the Americans with Disabilities Act (ADA), it is the responsibility of the business providing services to accommodate the request for an interpreter. Payment for the interpreter falls on the host business or entertainment venue as well. Some interpreters are certified in specific fields, such as legal, meaning preparation for a sign language interpreter may require some planning. To optimize the quality of the interpretation, provide the following information to the interpreter prior to arrival: • Name of event with location and accurate directions • Contact person with phone number • Correct billing address • Parking passes or other related parking/check-in information • Correct spelling of names of those speaking/performing • A written summary of subjects, talking points, notes, or musical lyrics that will be presented by the speaker(s) in advance • Description of where the interpreter will stand during the event. More information on the conduct and credentials of interpreters can be found at the Registry of Interpreters for the Deaf at www.rid.org. Other communication methods persons who are deaf employ include speech and speech reading (lip reading). Please note that not all people who are deaf read lips and not all are familiar with ASL. These differences occur because of the time in the person’s life when they became deaf. Other factors include if the hearing loss was gradual or sudden, and their family or cultural differences. Additionally, speech reading is made more difficult when a speaker mumbles or has a different dialect or accent than that of the lip reader. Many speech sounds are made in the mouth or throat, like “uh” or “k,” which are not visible externally. Realistically, the best speech reader can only understand less than half of what is said. When communicating with someone who practices speech reading, it is important to: • Look directly at the person reading your lips • Speak clearly and slowly • Do not shout as this inhibits lip reading • Keep food and cigarettes away from your mouth • Repeat statements when asked; do not re-phrase. It becomes more confusing to say something new than to repeat what you have already stated. If you are unsure that your message is being accurately conveyed or completely understood: • Offer to write notes • Send text messages to confirm appointments or convey other information. If you do not have a cell phone available for this, text messages can be sent from the computer. Many times it’s assumed that because someone speaks clearly they are not deaf. In actuality, a person who became deaf after learning to speak may appear to be able to communicate with speech similar to a hearing person (see Late-Deafened on page 5). Make no assumptions! In this situation, someone will likely tell you they are deaf and how best to communicate. Additionally, people who are deaf use specialized telephones to communicate. Refer to the “Technology” section in this guide for more information on using these devices. COMMUNICATING WITH SOMEONE WHO IS HARD OF HEARING The range of hearing loss varies greatly for someone who identifies him/herself as “hard of hearing.” While many people with hearing loss use a hearing aid(s), the hearing correction may not be equivalent to hearing “naturally.” Often people with some hearing loss can hear high or low pitches, but cannot discern the meaning of the sounds. When our survey respondents were asked “Have you received positive communication/accommodations in a public setting?” the responses were mostly no, somewhat, sometimes, and maybe. This led us to conclude that it is not common for someone who is hard of hearing to receive the simplest accommodations including: • Speaking clearly • Communicating in a quiet place without humming fans or other background noise • Speaking one-on-one • Looking at the person with whom you are communicating • Repeating statements when asked • Speaking louder when asked • Not shouting, as this can distort sound through a hearing aid • Smiling and acknowledging someone. AGING AND HEARING LOSS In 2010, it is estimated that the number of Pennsylvania residents over age 65 who work will top six million (as reported in Governor Rendell’s proclamation of “Employ Older Workers Week”). According to the US Census, Pennsylvania ranks third in the US behind Florida and West Virginia for number of citizens over age 65. The National Academy on an Aging Society also reports that 43% of people 65 years of age or older have hearing loss. This means that the approximately 2.6 million Pennsylvanians earning income from working are over 65 and have hearing loss. Although it may not be unusual to encounter an older person with hearing loss, they often do not receive proper accommodations from businesses because the perception may be that older adults do not work and are without disposable income. The National Academy on an Aging Society also notes that two out of three Americans age 65 and older with hearing loss do not use hearing aids. This can be attributed to poor performance, high cost, and the stigma of wearing a hearing aid. Hearing loss may be gradual, and may not even be realized that it is occurring. For more information on how to better serve older adults with hearing loss, refer to the “Communicating with someone who is hard of hearing” section on page 8. LEGAL CONSIDERATIONS This guide does not provide legal advice, but it does contain practical communication techniques that can improve your relationship with persons who are deaf and hard of hearing. If you have questions about what you are required to do to accommodate a person with a hearing disability, refer to the Americans with Disabilities Act Regulations. The ADA, a civil rights law, was passed in 1990 and is enforced by the US Department of Justice. Under the ADA, Titles II and III provide more specific information on the law’s requirements for businesses and public entities. Title II describes regulations on “discrimination on the basis of disability in all services, programs, and activities provided to the public by State and local governments, except public transportation services.” On the other hand, Title III covers “businesses and nonprofit service providers that are public accommodations, privately operated entities offering certain types of courses and examinations, privately operated transportation, and commercial facilities.” Additional laws discuss the requirements for sign language interpreters. Pennsylvania’s Act 57 refers to the “Sign Language Interpreter and Transliterator State Registration Act.” This law outlines the certification requirements for sign language interpreters and exceptions to situations when a certified interpreter is not required. TECHNOLOGY Persons who are deaf and hard of hearing use various technologies to communicate, some of which are commonly used by hearing persons. Our survey respondents reported using the following technologies, listed in the order most often used to least often used: Email: By far, email via computer is used the most to communicate by people who have a hearing disability. Businesses who schedule appointments benefit from sending email schedule changes and confirmations to communicate with people who are deaf and hard of hearing. Hearing Aid: Do not assume that when someone is wearing a hearing aid, normal verbal communication is possible. Hearing aids provide greater amplification of some sounds that are received, but do not necessarily amplify all sound. Hearing loss is not just about volume, but rather about the clarity of sound which may not be corrected with a hearing aid. Text Messaging: Text messages can be sent through a cell phone or via computer to a cell phone number. Again, this communication method may not be a substitute for conversation but it is valuable for scheduling and simple messages. Video Relay Services (VRS): A widely used means of communication for someone who uses American Sign Language (ASL). This type of phone system is used by two people who use ASL to communicate, or for one ASL user and one hearing person who does not use ASL. Calls are placed through an ASL trained/qualified interpreter via a high speed internet connection. ASL is transmitted through video phone to either the interpreter then to the hearing person, or directly to the other ASL user. If you are not an ASL user, an operator will come online and interpret between you and the person who is deaf. For the person receiving a VRS call, there is a delay from the time you pick up the receiver and say “hello” to getting a response from the caller. This delay appears very much like calls from telemarketers! Be patient and wait for a response. If you have caller ID available, a VRS call will be displayed as the caller’s number, not the VRS relay. Phone Amplification: Makes the voice on the telephone louder. Telephones equipped with amplification may also have an alerting device allowing the phone to ring louder or for a light to flash when the phone rings. It may also have a hearing aid compatibility feature but is only usable for hearing aids with a telecoil. These phones also come with features available on standard phones such as speakerphone and caller I.D. Computer Assisted Real Time Transcription (CART): CART is used for audience/group situations. A reporter uses a machine and shorthand system to type the transcript of the speaker during the presentation and the information is projected through a computer and projector to a screen where the text can be read. The speaker and comments from the audience must be spoken clearly and audibly for the transcriptionist to type accurately. Teletypewriter (TTY): Consists of a keyboard, which holds approximately 20-30 character keys, a display screen, and a modem. The letters that the TTY user types into the machine are turned into electrical signals that can travel over regular telephone lines. For communication with a TTY, and persons who do not have this device, a telephone relay system is used. This is available throughout the US. Toll free TTY relay services are listed in local phone directories. In Pennsylvania, callers can dial “711” to reach a communications assistant who will relay the call through a TTY. An operator transfers printed text to speech and vice versa. Please note there is a delay time when using this process. Captioned Telephone (CapTel): Similar to a standard telephone, except the transcript of the caller appears as text on a screen at the top of the telephone through a captioning service. A survey respondent noted that “…most providers use a menu and don’t give enough time to select the item. They also speak too fast…” Personal Listening Systems: Typically used in situations where there is a speaker and an audience. They provide a means of increasing the volume of sounds, reducing background noise, and overcoming poor acoustics. These systems are available as FM, infrared (IR), and audio induction loop, each having advantages based on the needs of the person who is hard of hearing. For example, FM systems are very portable and can be used indoors and outdoors, however they lack privacy and may not be appropriate in a situation like a jury deliberation room. The IR systems ensure confidentiality however they can only be used indoors and are less portable. The audio induction loop system is a loop of wire connected to the output of an amplifier and are used by people who are hard of hearing and who have a telecoil in their hearing aid. Video Remote Interpreting (VRI): Utilizes an over-the-phone interpreter who communicates to users through a screen, camera, and high speed internet connection. This system is typically used when someone does not speak the native language, and can be used to replace a live interpreter when he/she is not available or able to be presented. VRI should not be confused with VRS, as both have different sanctions imposed upon them by the Federal Communications Commission (FCC). VRI is often used in medical settings. FAQS 1. Why can’t I just write notes to someone who can’t hear? A person who became deaf early in life may have learned American Sign Language (ASL) as their primary language and may not be able to communicate well via written language. 2. I never received/made a video phone call. How does it work? A video phone call is just like a regular phone call with two hearing individuals, except an interpreter is involved. For more information on receiving/making video phone calls, please refer to the “Technology” section of this guide. 3. Can’t they just read lips? Not all persons with a hearing disability can read lips, and those that do may not necessarily get the full and accurate meaning of what is being said. Depending on life situations, such as education and family, a person who is deaf may use ASL as their primary communication, and have not needed to learn or even be able to read lips. 4. Why can’t they bring their own interpreter? Per the Americans with Disabilities Act, “A public entity shall ensure that communications with applicants, participants, and members of the public with disabilities are as effective as communications with others. A public entity shall furnish appropriate auxiliary aids and services where necessary to afford an individual with a disability equal opportunity to participate. A public entity shall give primary consideration to the requests of the individual with disabilities.” Additionally, as per the ADA, CART and other assistive listening systems are required for persons who are deaf and hard of hearing as well. 5. I know someone who can sign—isn’t that good enough? Signing and interpreting are not the same thing. Being able to sign does not mean that the person can process spoken communication into the proper signs, nor does it mean that he/she possesses the proper skills to observe someone signing and change their signed or fingerspelled communication into words. The interpreter must be able to interpret both respectively. To ensure this, the Pennsylvania Department of Labor and Industry enacted the Sign Language Interpreter Transliterator State Registration Act (Act 57) which outlines the requirements for interpreters to be certified and register with the Pennsylvania Office of Deaf and Hard of Hearing. GLOSSARY OF TERMS ADA: Americans with Disabilities Act. This is a federal civil rights law which prohibits discrimination against people with disabilities in employment, transportation, public accommodation, communications, and governmental activities. The ADA also establishes requirements for telecommunications relay services. ASL: American Sign Language, a visual language used by people who are deaf and hard of hearing. Cochlear implant: A surgically implanted electronic device that provides a sense of sound for a person who is profoundly deaf or severely hard of hearing. Its use is not indicated for all causes of hearing impairment. Success is variable, and even after surgery a person who is deaf or hard of hearing may still need to have an interpreter, CART, or assistive listening system present. Deaf-blind: The combination of a hearing and visual disability that causes communication, developmental, and educational difficulties. Persons who are deaf-blind may experience the onset of their hearing or visual disability at different periods in their life. “Deaf” versus “deaf”: “Deaf” refers to members of the Deaf community and Deaf culture. Whereas “deaf” is a general term encompassing many groups of people who may not identify themselves as being part of the culturally deaf community. Finger Spelling: The use of hand shapes to represent letters of the alphabet in ASL. It is primarily used to spell out proper names or words for which there is no sign language equivalent. Interpreter: A person who translates information presented by a hearing person in spoken English to a person who is deaf or hard of hearing in sign language, or vice versa. Specialized interpreting includes oral interpretation between a person who is deaf or hard of hearing who mostly lip reads instead of signs, and tactile signing which is interpreting for a person who is deaf-blind by signing into their hands. For more information on working with a sign language interpreter, refer to the section in this guide, “Communicating with someone who is deaf.” Reasonable Accommodation: From the US Department of Justice, “A reasonable accommodation is any modification or adjustment to a job or the work environment that will enable a qualified applicant or employee with a disability to participate in the application process or to perform essential job functions. Reasonable accommodation also includes adjustments to assure that a qualified individual with a disability has rights and privileges in employment equal to those of employees without disabilities.” TTY/TDD: A Teletypewriter (TTY) is a telephone that allows for one or both parties to type conversations. Telecommunications Device for the Deaf (TDD) is an electronic device for text communication via a telephone line, primarily used when one or more of the parties involved has a hearing or speech disability. Refer to “Technology” section. RESOURCES: Lehigh Valley Center for Independent Living, Inc. “Provides independent living services to any person with any type of disability. Educates and affects changes that improve the quality of life for persons living in the Lehigh Valley.” 435 Allentown Drive Allentown, PA 18109 Voice: 610-770-9781 TTY: 610-770-9789 www.lvcil.org Pennsylvania Developmental Disabilities Council “Works to create favorable conditions for people with developmental disabilities and their families in the Commonwealth.” Room 561 Forum Building 605 South Drive Harrisburg, PA 17120 Voice: 717-787-6057 TTY: 717-705-0819 Toll Free: 1-877-685-4452 www.paddc.org Hearing Loss Association of America–Pennsylvania “Pennsylvania’s voice for people with hearing loss; organization has regional chapters.” 4 State Rd., #109 Media, PA 19063 info@hla-pa.org www.hla-pa.org Deaf Inc. “Encourages and empowers persons who are Deaf, Hard of Hearing, Deaf Blind and Late-Deafened to lead independent and productive lives.” D.E.A.F. Inc. 215 Brighton Ave. Allston, MA 02134 TTY/V: 617 254-4041 www.deafinconline.org National Association of the Deaf “The nation’s premier civil rights organization, of, by and for persons who are deaf and hard of hearing in the United States of America.” 8630 Fenton Street, Suite 820 Silver Spring, MD 20910 TTY: 301-587-1789 Voice: 301-587-1788 Fax: 301-587-1791 www.nad.org Pennsylvania Society for the Advancement of the Deaf “Maximize the participation and productivity of its Deaf and Hard of Hearing Citizens within the larger society of Pennsylvania through education, advocacy, and services.” Six chapters service different regions in Pennsylvania. www.psadweb.org Registry of Interpreters of the Deaf “A national membership organization representing the professionals who facilitate communication between people who are deaf or hard of hearing and people who can hear. Interpreters serve as professional communicators in a vast array of settings.” 333 Commerce Street Alexandria, VA 22314 703-838-0030 www.rid.org Pennsylvania Assistive Technology Foundation “The foundation offers low-interest cash loans for assistive technology (such as hearing aids and other assistive devices), lower interest rates than a traditional bank, extended repayment plans, information about other potential funding sources, and free consumer credit counseling.” 1004 West 9th Ave., 1st Floor King of Prussia, PA 19406 Voice: 888-744-1938 TTY: 977-693-7271 www.patf.us PA Office for the Deaf and Hard of Hearing “The PA ODHH provides advocacy, information, and referrals for Pennsylvanians who are deaf, hard of hearing, or deaf blind, and their families and caregivers.” PA Department of Labor and Industry 1521 North 6th Street Harrisburg, PA 17102 TTY/V: 717-783-4912 TTY/V: 800-233-3008 (PA only) Videophone: 866-572-2628 Email: ra-li-ovr-odhh@state.pa.us Pennsylvania Initiative on Assistive Technology “Strives to enhance the lives of Pennsylvanians with disabilities, older Pennsylvanians, and their families, through access to an acquisition of assistive technology devices and services, which allow for choice, control, and independence at home, work, school, play, and in their neighborhoods. A free Lending Library is also available for people with disabilities to try out items before purchase.” Institute on Disabilities 1755 North 13th Street Student Center, Room 411S Philadelphia, PA 19122 Voice: 800-204-PIAT (7428), in state TTY: 866-268-0579, in state Voice/ TTY: 215-204-1356 INDEX Accommodation………………………………………………………………….3, 8-10, 14, 15 Aging…………………………………………………………………………………...2, 6, 9, 10 Americans with Disabilities Act (ADA)……………………………...1, 2, 6, 9, 13, 14, 18, 19 American Sign Language (ASL)…………………………………………..6, 7, 11, 13, 14, 18 Captioned Telephone (CapTel)………………………………………………………….12, 18 Cochlear Implant………………………………………………………………………….14, 18 Computer Assisted Real Time Transcription (CART)………………………..11, 13, 14, 18 Deaf…………………………………………………………………………………..1-11. 13-18 Deaf-blind…………………………………………………………………………………..14, 18 “Deaf” versus “deaf”……………………………………………………………………….14, 18 Email……………………………………………………………………………………..6, 10, 18 Finger Spelling…………………………………………………………………………….14, 18 FM…………………………………………………………………………………………..12, 18 Hard of Hearing………………………………………………………..1-5, 8, 9, 12, 13, 16-18 Hearing Aid……………………………………………………………………….3, 8-12, 17, 18 Infared (IR)………………………………………………………………………………....12, 18 Interpreter………………………………………………………………………...6, 7, 10-16, 18 Late-Deafened……………………………………………………………………3, 4, 8, 16, 18 Lehigh Valley Center for Independent Living (LVCIL)…………………………1, 15, 18, 19 Lip Reading……………………………………………………………………………….6, 7, 18 Pennsylvania Developmental Disabilities Council (PADDC)…………………...1, 2, 15, 18 Personal Listening Systems……………………………………………………………...12, 18 Phone Amplification……………………………………………………………………….11, 18 Reasonable Accommodation…………………………………………………………….15, 18 Sign Language……………………………………………………………..6, 10, 11, 13-15, 18 Speech Reading…………………………………………………………………………6, 7, 18 Telecommunications Device for the Deaf (TDD)………………………………………15, 18 Teletypewriter (TTY)……………………………………………………………...11, 12, 15-19 Text Messaging…………………………………………………………………………6, 10, 18 Video Relay Service (VRS)………………………………………………………………11, 18 Video Remote Interpreting……………………………………………………………….12, 19 For additional assistance, copies of the guide, or this guide in a different format, please contact the Lehigh Valley Center for Independent Living. Voice: 610-770-9781 -or- TTY: 610-770-9789 www.lvcil.org For more information, please visit www.ADA.gov. This website provides comprehensive access to the publications related to the Americans with Disabilities Act.