Roughly 40 million U.S. adults live with hearing loss. Most use tools to help them navigate the hearing world, from hearing aids to cochlear implants. Now an ever-growing spate of captions services is expanding for those with hearing limitations.

The COVID-19 pandemic disrupted daily life for everyone. But for many with hearing loss, isolation hit harder. Masks made others “completely unintelligible to me,” says Pat Olken, who wears hearing aids. Face coverings not only muffle sound. They also make reading lips impossible.

Being unable to hear is a bigger problem than missed conversations. Research shows that untreated hearing loss can increase dementia risk.

Yet hearing devices are pricey. Plus, they don’t snap sound into focus the way glasses immediately correct vision. Instead, they require the brain to interpret sound in a new way. “The solutions out there are clearly not a one-size-fits-all model,” says Frank Lin, director of a large research center focused on hearing loss.

Captions have long been available on modern TVs. But now they crop up in videoconferencing apps, streaming services, social media videos, movie theaters, and live arts venues.

Olken attended her grandson’s bar mitzvah over Zoom before the company offered captions. Using a caption app called Otter, she could read along with the ceremony’s speakers.

Some services use human reviewers to make sure captions are accurate. Others rely on automatic speech recognition (ASR). ASR isn’t perfect. It has issues with lags and accuracy for the voices of women, people of color, and deaf people, says Christian Volger, a specialist in accessible technology. Jargon and slang are also stumbling blocks.

Toni Iacolucci says her book club could be draining even when she used Otter to transcribe the conversation. The captions weren’t always accurate. Plus, they didn’t identify individual speakers. That made it hard to keep up.

“It worked a little bit,” says Iacolucci. “It just takes so much energy.”

For Chelle Wyatt, the Wi-Fi signal at her doctor’s office was too weak for her transcription app to work. She had to ask for a written report afterward.

Musician Richard Einhorn uses a transcription service. He’s “aware sometimes it’s a hassle for other people.” But still, “sometimes you say, ‘I’m sorry, I just need to look at my captions.’”

Captions benefit those who hear too. Think of second language learners and people operating in noisy settings. But for folks with significant hearing loss, captions can be the difference between isolation and inclusion.

For more on efforts to integrate those with hearing loss more fully into the hearing community, see Serving the Deaf around the World.

Why? Making good communication possible is a way to love one’s neighbor as oneself. God places a high value on hearing—but even more on doing. (James 1:22)