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Digital Televisions and Hearing Loss
by Steve Hillson
Equipment Specialist, HSDC Seattle
February 18, 2008 updated 1/07/2011

When traditional, analog television signals came to an end on June 12th of 2009, there were three choices for dealing with the new digital television environment.
  • Keeping your old analog TV and connecting your antenna to a digital-to-analog converter box.
  • Purchasing a high-definition, digital television to take full advantage of the new broadcast and cable technology.
  • Subscribing to a cable television service that provides an analog signal to your existing analog TV.

On the surface, this appears to be simple enough.

It is important to note that digital television reception is very different from analog reception.

When an analog TV gets poor reception, it is often possible to watch the snowy picture, listen to the scratchy audio and follow the program anyways. The digital TV screen, on the other hand, is either 100% on or 100% off. When the digital signal is interrupted the entire picture may freeze or drop out, and all sound will disappear. Following a program can become very difficult when chunks of the image and whole parts of the dialogue go missing. Constantly getting up to readjust the TV antenna could become an annoying fact of life if you live in an apartment building or busy urban environment. In addition, hills and large bodies of water can create digital dead zones where no signal is available at all.

For best results, the FCC recommends an external TV antenna mounted on a 35 foot tall pole. Since that is not an option for many people, an amplified HD indoor antenna should provide better reception than standard "rabbit ear" sets can. Visit for more information about indoor and outdoor antenna options for digital TV reception.

Digital cable, on the other hand, will provide an uninterrupted signal to your digital TV or your digital-to-analog converter box. Whether or not cable services are worth the monthly charges for the way you watch TV, I can't say. If you are considering signing up for cable, make a list of your regular TV viewing habits and see which service packages best match your needs.

For those of you considering a new, digital television, I've done some informal research at local electronic stores. Most of the salespeople I spoke with hadn't considered the effects of hearing loss, but were willing to think it through when I explained what features would be useful for hard of hearing and Deaf people. Just like buying a car, if you don't understand the basic technology, you could get taken for a ride.

I've also noticed that most stores have their display models optimized to provide an eye-popping visual experience. This can be amusing the first time, but unless the characters in your favorite program always wear lime green jackets with shocking orange hair, you are going to want to look past the bright colors and pay attention to what any specific television can do for you. I'm going to break this down into a kind of check list that I hope you will find useful.


Unlike the often disappointing speakers found in many older TVs, the new digital units often have very good speakers built into them with internal menus that allow you to adjust the high (treble) and low (bass) frequencies for better clarity. There are even some digital TVs that offer a "voice enhancement" feature which automatically turns down the background noise and turns up the frequencies in the speech range. You can reproduce this effect by reducing the bass levels and turning up the treble until the voices sound clearer.

At the heart of things, hearing aids and CI processors are designed to focus on one person speaking in front of you in a quiet room. Think of your TV as that one person. Ask the sales person to walk you through the audio menu, and if possible, listen to the same program with the factory preset levels and then adjust the audio settings to try to improve the speech clarity.

Assistive Listening Systems

People who prefer to use Assistive Listening Systems still have that option. This is a good solution if the TV will be shared by others who don't have a hearing loss because the listening system operates independently of the TVís own volume level. All assistive listening equipment is designed to connect to the analog Audio Output jacks. Some recent TVs only offer digital (Coaxial or optical TOSLINK) Audio Output connections. Digital-to-Analog audio converters are available for both types of digital output.

Analog Audio Outputs

Digital Audio Outputs

Some TVs come with these Audio Output jacks disabled. You may need to go into the TV's audio menu to activate these output connections. Tell the sales person that you want to connect an analog listening device to the TV. They can walk you through the menu and demonstrate how to activate these outputs and show you a digital-to-analog converter if that is going to be necessary.

Recently, some TVs have been made that automatically turn off the TV speakers whenever the Audio Output jacks are being used. There are also some models that have Audio Output jacks that are not connected to anything inside the TV. These are simplified TVs that use recycled parts from previous models. In any case, itís always a good idea to talk with the sales staff about how you want to use the Audio Output jacks before making a purchase.

Also, watch out for TVs that are actually video monitors. These TVs only have a single, HDMI cable connection available. This is strictly an input jack. There is no way to connect an assistive listening system to a video monitor. The audio output jacks on a cable box, DVD player or sound system amplifier can be used instead.

Plasma TVs are based on chemical reactions in the screen that produce infrared light as a by-product. Infrared listening devices can pick up this background light as an annoying static or buzzing sound. If plasma is the technology of your dreams, you should consider using a radio frequency listening device such as the Direct Ear series . These radio frequency systems connect to the TV just like their infrared counterparts, but without the sensitivity to the infrared light produced by the plasma screen. They also offer the benefit of allowing you to walk around the home or to go outside to the porch or garden while listening to your television program.

Home Theatre Systems

Besides stunning visual content, digital TVs promise a wide range of audio options from simple stereo to surround sound with any number of extra speakers. There is more to it than buying a TV and a box of 4 speakers. Serious audio/video stores offer a range of sound systems for that "theatre" experience in your home. When you see systems described 5.1 or even 7.1, this indicates the number of speakers involved with the .1 referring to the sub speaker that provides that rumbling bass sound you can feel as much as hear.

These speaker systems can be alot of fun to play around with, but bringing a hearing aid or CI processor into the mix raises questions that are not addressed directly by the manufacturers. Think of the last frustrating time you had at a movie theatre and then imagine paying your hard earned money to reproduce the effect in your own home on a daily basis. Your hearing aid or CI processor should be considered part of the sound system you are buying.

Standard hearing programs tend to make the hearing aids or CI processors act like little directional microphones that filter out environmental noises and emphasize the speech sounds in front of you. Without careful adjustments, home theatre systems can scatter speech and other important environmental sounds. For instance, when an actor starts speaking from the left side of the screen and then walks across to finish speaking on the right side of the screen, the chances are that it will seem like two different people are talking.

If there is a home theatre in your future, talk to your audiologist about creating a "TV" program for your hearing aid that would be omni-directional with a low compression factor to reduce any distortion of the music and sound effects from the home theatre speakers.

You will want to find a salesperson you can trust to help you build a home theatre. It will take a fair amount of experimentation to design a system that successfully accommodates your hearing loss.


Like any televisions sold in the US, digital TVs must have closed caption decoding ability. You will want to have the sales people go into the TV's control menu and preview the captioning options for you. I have noticed a wide range of captioning styles used by the various manufacturers. Some are large and clear, others are fuzzy and some are too small for comfort. Most digital TV's offer some control over the caption display, allowing you to adjust size, letter shape and the background color of the captions. If you are a routine caption reader, you really want to test drive these features before making any purchase.

Many digital converter boxes also come with built in closed caption decoders. These often allow you to adjust the size and color of the captions. Check the product description on the box or the user manual for more details.

There are a few technical problems related to the use of closed captioning that you will want to investigate before making a purchase:


Plasma TVs have a problem with their screens called "burn in" that you need to be aware of. Burn-in happens when there is an image shown repeatedly in the same place on the screen for long periods of time. This can cause a permanent "ghost" image to remain on the screen no matter what you are watching. For example, watching mostly widescreen, letterboxed movies can cause the "black bars" to burn into the screen after many hours of use.

Closed captions can also burn into the plasma TV leaving one or more gray stripes on the screen even when the captions are turned off. If you rely on captions, you will want to discuss this burn in problem with your salesperson who should be able to suggest non-plasma TVs for you to look at.

If you already have an older plasma TV, check to see if the caption menu allows you to move the position of the captions from the bottom to the top of the screen. Changing the caption location on a frequent basis should protect your existing plasma screen from burn-in damage.

Another technique is to turn off the captions when your show is over and let the TV run for about 20 minutes or so to exercise that part of the screen. This should help to prevent the worst of the burn-in effect over time.

HDMI and CC signals

HDMI is a common technology for connecting home theatre equipment such as DVD players to a digital TV. Unfortunately, the HDMI connection strips out the closed caption signal from incoming DVDs and cable programming. As a result, the TV's built-in caption decoder becomes useless.

It is possible to reroute the DVD player and cable box into the TV using the component (Audio/Video) connectors (these are the round, multi-colored plugs on the side or back of the TV). However, the quality of component video is lower than HDMI, so this may not be a long-term solution.

The current advice for enjoying the benefits of HDMI technology is to purchase a DVD player and request a cable box that has its own closed caption decoding ability. These merge the captions into the video signal where the HDMI technology doesn't interfere with them.

Internet and On Demand cable services

Another issue related to closed captioning is not so much a television issue as it is an internet regulation problem. Digital cable companies are able to offer additional features such as On Demand programming by merging high-speed internet into their standard cable signal.

When you order your favorite film these days, it is usually not coming from your local cable company directly. Instead, the program is being sent over the internet and channeled into your cable connection. Standards for internet captioning are not set yet, and what you are watching may be an internet entity, not a pre-recorded tape or DVD which is covered by existing captioning legislation. Talk with your cable company about closed caption availability in the various parts of their service packages to avoid paying for extra features that you can't access.

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