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CART: A System That Works for Nearly Everyone With Hearing Loss

How the technology operates and who can benefit

spinner image CART: A System That Works for Nearly Everyone with Hearing Loss
CART provides instantaneous captions and is useful for those with hearing loss in a variety of situations.
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Most of us have been at events with a sign-language interpreter, but how many have ever seen a CART screen?

CART, which stands for "communication access real time translation," provides instantaneous captions for what is being said. It's also one of the best-kept secrets in the hearing loss world.

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CART is one technology that works for almost everyone with hearing problems. It helps people with mild loss, who may have trouble hearing at a lecture, as well as the culturally deaf, who can't hear at a distance even with hearing aids and cochlear implants. It's also useful for hearing listeners for whom English is a second language.

For the moderately hard of hearing or the relatively new English speaker, the captions reinforce the spoken (or sung or played) sounds. For those who can't understand what they hear, even with other hearing assistance, the captions provide a live transcript.

Here's how it works: A trained CART operator types the spoken words in shorthand into a machine similar to a court reporter's. The machine's software converts the shorthand into standard English. The result is almost simultaneous captions, which are projected onto a screen or sent directly to a listener's smartphone, tablet or computer.

CART can also be used for conference calls that include people with hearing loss, with each hard-of-hearing caller connecting to a specific Web address to enable them to read the streaming text. They can also dial in by phone to get both voice and captioning at the same time.

A good CART operator will be able to type up to 260 words per minute (in shorthand) with 98 percent accuracy. Some CART operators are better than others, but all will have difficulty with unfamiliar names or words. Most CART operators ask speakers in advance for a list of any unfamiliar words they intend to use. An experienced CART operator can transcribe for two hours without a break. By comparison, most American Sign Language (ASL) interpreters prefer to work 15 to 20 minutes, trading off with a partner.

I'd venture that very few have ever seen a CART screen, even though there are some 600,000 deaf people in the United States, according to the Gallaudet Research Institute, and 48 million with hearing loss. This is unfortunate, because few can understand ASL, which is routinely provided, while CART remains essentially unknown — even though those who would benefit from it outnumber the ASL users by many thousands to one.

There's no one solution for people with hearing loss, but CART should always be an option. For more information about CART and how to find a CART operator, or how train to become one, go to Collaborative for Communication Access via Captioning at

Video: There's Something I Want You To Hear

(Video) There's Something I Want You To Hear: A chat over the phone. Answers to questions. An important conversation. These are things that should never be missed. Up to 40 percent of people age 50-plus have some hearing loss — and much of the time it is left untreated.

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