Letter, word and picture boards

Introduction

Equipment for people with hearing loss

Personal sound amplifiers for one-to-one or group conversation

These products are portable amplifiers for use in one-to-one or group conversations. They generally consist of a hand-held microphone, table-top amplifier (placed near the sound source) and headphones. It is usually unnecessary to use a hearing aid with these amplifiers.

If you find it physically difficult to hold the microphone, it may be possible to get a clip-on microphone instead or use it with a floor-standing or table-top microphone stand.

Styles and sound quality of headsets or headphones may vary. Make sure that the one you choose is comfortable and works well for your particular type of hearing loss. If you normally use a hearing aid and cannot hear the amplified sound clearly using a headphone or headset, you may find a neck loop or ear loop a more useful device. A neck loop or ear loop are small inductive couplers which should be used with your hearing aid in the ‘T’ position. The amplified signal is received by your hearing aid directly from the loop by electrical induction.

Personal sound amplifiers for amplification of TV audio equipment and conversation

These are portable amplifiers designed to amplify TV and audio equipment. They generally consist of a microphone, which is placed near to the loudspeakers of a TV or audio equipment, an amplifier and an earpiece for the user. They have dials to alter volume and allow high and low tone selection.

Some amplifiers are also useful for amplifying conversation. There may be the option of a loop receiver version for people who use hearing aids with 'T' position switch.

Other amplifiers connect directly to TV and audio equipment using connecting leads instead of using a microphone.

Personal or domestic loop systems, including those for use in a car

If you use a hearing aid, domestic loop systems provide an alternative to listening through a headset or earpiece. These systems consist of an induction loop placed in a room or car, and a microphone and amplifier placed near the sound source.

Anyone sitting within the loop system with their hearing aid on 'T' will receive amplified sound from the source without background noise. This device eliminates the need for any wires between the user and the apparatus.

Public loop systems for use with hearing aid on 'T'

Public loop systems are more powerful versions of the personal loop systems described above. They are used in public buildings, meeting rooms, conference halls or across the counter in banks and other organisations.

They consist of an induction loop wire which encircles the room. The unit then provides amplified sound to anyone within the loop system who has a hearing aid switched to the 'T' position.

Induction loop receivers for people without 'T' position hearing aids

If you do not use a 'T' position hearing aid, an induction receiver enables you to benefit from a loop system using light, cordless headphones, earphones or behind the ear receivers, instead of a hearing aid. They are battery powered and can be pocket-sized, with built-in amplification and volume controls.

Radio microphone systems

These are radio microphone units designed to be used in conjunction with hearing aids or headphones.

They consist of a transmitter and microphone worn by the person talking and a receiver worn by the person who is hard of hearing.

Sound is amplified using a neck loop, or can be input directly if the user has a direct input hearing aid. The system helps the listener to hear the speaker's voice without unwanted background interference.

Since the system uses radio waves to transmit sound, it allows complete freedom of movement and is particularly useful in educational settings.

Radio microphones can also be used with amplification systems and public loop systems for group use.

Infra-red amplifiers for amplification of environmental sounds and conversation

Infra-red amplifiers are cordless systems consisting of a small infra-red transmitter which plugs directly into the headphone socket of the TV, radio or hi-fi, or, if fitted with a built-in microphone, is placed adjacent to the sound source.

Sound is sent through an infra-red signal to a receiver which is hand-held or connected to headphones or to a hearing aid in the 'T' position.

They can be used for group listening with one transmitter and several receivers with headsets.

Tax-deductible hearing aids

Hearing aids are tax deductible for businesses if the employee requires a hearing aid to carry out their role. The same rule applies for people who are self-employed. This is evidenced in the HM Revenue and Customs (HMRC) Employment Income Manual. You can speak to your employer for further information and guidance, or if you are self-employed, you can contact HMRC for guidance on claiming tax relief.

Equipment for speech and speech replacement

This is sometimes known as Augmentative and Alternative Communication (AAC).

Types of equipment used for speech and speech replacement include:

• Letter, word, picture charts, folders and/or books
• Eye pointer boards
• Rotary pointer boards
• Scanning communication boards
• Specialist switches for communication aids
• Communication strategies

Letter, word, picture charts, folders and/or books

These items offer a simple solution for basic communication if you have little or no speech. They can also be particularly useful if you are unable to write things down easily. Letters, words, or pictures are shown to you in a folder, book or on a chart. You can then select individual letters, words, pictures or symbols to convey your respective needs to another person.

They may also provide an aid to basic two-way communication if you are deaf or hard of hearing. If the product contains a page of alphabet letters and numbers, you can construct words and sentences by pointing at one letter or digit at a time.

Larger systems may contain over 300 picture cards to represent words, food and drink, people or feelings. They may be categorised using colour codes or be arranged in a pocked-sized presentation folder to make them easy to use.

It may also be possible for you to create a folder of your own using a photograph album. This could include pictures of everyday objects such as a clock face or cup of tea with corresponding words or phrases written underneath. This can have the added advantage of being personalised to meet your own specific requirements and photos can be of known and familiar objects or people. This will make it more meaningful to the user.

Eye pointer boards

Eye pointer boards are communication displays that are designed for access by 'eye gaze'.

Your communication partner is positioned facing you on the other side of the board and will be able to see where your eyes are focused. This is because the board is either transparent or made with a square cut out in the centre.

At a basic level, the user indicates/builds up a message by gazing at the appropriate item (letter, word, symbol, picture) on the display. At a more complex level, colour coding allows more items to be displayed.

Rotary pointer boards

These products are battery powered pointer boards that can help you to communicate a message. They work by using a switch to rotate a pointer. As it turns, you stop its movement as it points to a chosen picture, word or symbol, to indicate the required message.

If you have difficulty using a standard switch, several alternatives are available to suit your individual requirements.

Scanning communication boards

Scanning communication boards assist in facilitating communication for users who struggle to point at letters with a finger, a pointer or a laser, via blinking, nodding or other small movements.

They contain a number of squares which can be lit sequentially or, in some instances, in programmable patterns, to facilitate communication.

Symbols, real or miniature objects can be placed on the areas to be illuminated, and you can stop the light when the required object or symbol is illuminated. They can be either mains or battery powered and are operated by switches chosen to suit your specific needs.

Some of these products may be further enhanced with sounds or speech selection. Speech-based communication boards may have press keys that operate spoken words or phrases.

Specialist switches for communication aids

If you have limited dexterity or motor function and find it difficult to operate conventional switches, you may need an alternative type of switch to enable you to control your communication equipment.

Before buying a device, ensure that you can operate any switches easily. If you require an alternative style of switch, check it is compatible with the product you are buying.

Alternative types of switches include:

• Suck or blow switches - These are simple switches that you operate using your mouth with a suck or blow action. The switch can be stand-mounted on a bed or wheelchair, or to a wall or floor stand.
• Plate switches - These devices consist of a large active plate area and a low operating pressure which enable you to easily activate a communication aid using your hand, knee, chin, elbow and head. They can be mounted on a flexible bracket stand for use in a wheelchair, bed or chair. Some models can be fitted with guards to prevent accidental activation.
• Foot switches - These are durable switches that are operated by moving your foot.
• Micro switches - These are easy-to-use, light to touch switches mounted on a flexible stand, which you can activate by using your hand, head or chin. The flexible stand makes it easy to position and move them on a bed, chair or wheelchair, using a clamp.
• Chin switch - This is a single switch mounted on a tube that you can operate simply by using your chin.

Communication strategies

These techniques are designed to help you overcome communication difficulties. Some are published resources which are useful for developing alternative or augmentative communication skills, but not necessarily tied to any specific equipment.

They may include vocabulary selection and sets of signs or symbols.

Makaton Core Vocabulary system

The Makaton Core Vocabulary is a language programme system aimed to develop your communication, language and literacy skills. It is designed to support spoken language, and the signs and symbols are used with speech, in spoken word order. It is suitable for both children and adults with communication difficulties.

It features 450 specially selected concepts or ideas which are graded in complexity, and a vocabulary resource of approximately 6,000 words. The vocabulary is generally used with speech, manual signs and graphic symbols.

The signs are derived from British Sign Language (BSL). Training courses, resources and publications are also available through the Makaton Charity.

Multi-fit hook and loop wrist bands

These are a simple, inexpensive low-cost solution designed for basic communication. The bands are in three colours: GREEN for ‘Yes’, RED for ‘No’ and BLACK for ‘Mixed’. Self-adhesive symbols can also be attached to the bands using a hook so that the basic message is enhanced.

They are mainly used in environments where symbol books or VOCA (Voice Output Communication Aids) cannot be used, such as in a swimming pool, or on a bus. One advantage of this system is that it can be easily understood by an unfamiliar communication partner.

Using the Deaf-Blind Manual

Although it is a language designed for people with sight and hearing loss, the Deaf-Blind Manual may also be a useful communication tool for some people with speech difficulties.

Communication is made by using one of your hands to touch various parts of your partner’s hand, to represent letters of the alphabet to form words. Some hand movements are similar to British Sign Language (BSL). The basic alphabet is quick and easy to learn and has the advantage that it can be used anywhere with your interpreter.

Using objects of reference

It may be possible to devise your own basic communication language or strategy using everyday objects when communicating with someone you know. For example, you could pick up a fork to indicate that you are hungry, or that it is time to eat, or perhaps a towel to say that you want to go swimming.

Supply and provision

The supply of equipment depends upon the type and extent of your disability, your age and your circumstances.

Eligibility for sensory communication equipment can also vary, depending on where you live. Many councils apply eligibility criteria for home care packages including assistive technology such as communication equipment. You will need to contact your local social services and ask for information about their communication equipment services. They may arrange for you to receive an assessment to see if you meet their criteria to receive the equipment. Some social services may only provide communication equipment to those with ‘substantial’ or ‘critical’ needs.

If your social services assess you as requiring communication equipment, they will also complete a financial assessment to assess the level of any contribution you may be required to make. The charges and how they work vary in different areas. Visit GOV.UK's website to find your local authority equipment assessment services or use the NHS search for care services for people with sensory impairments. 

In some areas of the country, a prescription scheme for equipment is in operation. There is a 'national catalogue' of equipment that may be provided by prescription, although local areas can choose which of these items they will include in their local equipment prescription schemes. This is part of the government’s Transforming Community Equipment Services (TCES) community programme. There is a small range of sensory communication equipment on the national catalogue that can be provided via prescriptions.

The first point of contact will be your GP, or local health authority. If you receive a prescription for one of these items, you take your prescription to a local accredited retailer who will provide you with the item. Alternatively, you can ‘top-up’ paying extra for an item that does what the specific item prescribed would do, but offers extra features or a different appearance, for example. The scheme is designed to encourage choice and control.

For adults

At present, most reading and writing aids may not be regarded as a daily living need and may therefore not supplied via a community occupational therapist.

If you have difficulty with verbal communication, you may be eligible for an assessment by a speech and language therapist at a communication aid centre. A referral is needed which can be made by your GP or hospital consultant. Each communication aid centre has a range of communication aids to try, and, if appropriate, may be supplied to you through the NHS.

If you are deaf or hard of hearing, equipment may sometimes be provided by your local authorities social services department. For further information, you should contact your local authority vision and hearing department. Further advice about living with hearing loss is provided by the Royal National Institute for Deaf People (RNID).

If you are in paid employment and need equipment to assist you with communication at work, then you may be entitled to help with the cost and provision of equipment

through a scheme called Access to Work. The scheme is run by the Department for Work and Pensions and is designed to pay for the additional cost of aids and adaptations needed because of your disability. In some circumstances, a part-time support worker may be funded to perform these tasks if you are unable to do them for yourself.

For children at school

If a child has a disability, is under the age of 18 and still at school, access to funding for equipment may be available if they have an Education Health and Care Plan (EHCP). For further information, contact your local education authority.

For students in further or higher education

If you are a student in higher education, you may be entitled to a Disabled Students’ Allowance (DSA). It is awarded by your local authority to cover the additional cost of your disability. 

If you are a student in further education, you may also be entitled to funding.  Disability Rights UK have further information regarding this topic on their website. 

Other sources of funding

Charitable trusts may sometimes provide funding for equipment. Charities will only give awards in accordance with a predetermined criteria, so it is important that you carefully select the trusts you apply to.

Most libraries hold directories of suitable funders in their reference section, such as the Directory of Grant Making Trusts.

Grants for Individuals in Need book can be bought on the  Directory of Social Change website and lets readers search for grants, but is intended for organisations searching for funding for individuals.

Try before you buy

If you decide to purchase equipment privately, try and compare the different ranges first. There is a considerable amount of Independent Living Centres located throughout the UK providing unbiased, expert advice and information about equipment, how much it costs and where to obtain it. They also offer the opportunity for you to try a wide range of products. Advice and information about other issues related to daily living is also available.

Be cautious of salespeople who try to persuade you to buy equipment that may not meet your needs fully or is overpriced. Buying from a company that belongs to a trade association, such as the British Healthcare Trades Association may give you some reassurance, as members have signed up to a code of practice governing standards of customer service.

References

British Healthcare Trades Association (BHTA) (2025). Available at: https://www.bhta.com/ (Accessed: 15 January 2025).

Directory of Social Change (2025). The Guide to Grants for Individuals in Need 2024/25. Available at: https://www.dsc.org.uk/publication/grants-individuals-need-2024-25/#buy-now (Accessed: 15 January 2025).

GOV.UK (2024). HMRC internal manual. Employment Income Manual. Available at: https://www.gov.uk/hmrc-internal-manuals/employment-income-manual/eim21846 (Accessed: 15 January 2025).

GOV.UK (2025). Access to Work: get support if you have a disability or health condition. Available at: https://www.gov.uk/access-to-work (Accessed: 15 January 2025).

GOV.UK (2025). Apply for a needs assessment by social services. Available at:  https://www.gov.uk/apply-needs-assessment-social-services (Accessed: 15 January 2025). (Accessed: 15 January 2025).

GOV.UK (2025). Find local authority adult social care services. Available at: https://www.nhs.uk/service-search/other-health-services/local-authority-adult-social-care (Accessed: 15 January 2025).

GOV.UK (2025). Help if you're a student with a learning difficulty, health problem or disability. Available at: https://www.gov.uk/disabled-students-allowance-dsa (Accessed: 15 January 2025).

NHS (2025). Find sensory impairments services. Available at: https://www.nhs.uk/service-search/other-health-services/sensory-impairments (Accessed: 15 January 2025).