CART can be provided in a number of settings; colleges, universities, high schools, self-help meetings, large and/or small conferences, the possibilities are endless. Traditionally, CART is provided one-on-one. The CART Provider is connected to a steno machine, types in a phonetic type of shorthand into the machine, and the steno text is translated into English on a laptop screen. The person with hearing loss is then able to participate fully by reading the proceedings rather than struggling to hear what is happening. The text can be made as small or as big as the client wants. The colors can be changed; the most common color schemes are yellow on a deep blue background, black on white, and some people with vision loss prefer white on black. There is the ability to have a file produced, but the client must get permission from all involved beforehand. CART is for the purposes of communication access only and never to be considered an official record of any kind.
CART can also be streamed live with the person in the room. The CART provider does everything as above, only this time a link is provided through an Internet service. The consumer then uses their own laptop, tablet, or phone and is able to then click on the link and read the proceedings. The benefits to live streaming are that the client does not need to sit with the CART provider. This enables the provider to sit in a location where she/he can hear the best and then the client is able to sit wherever they want and has the ability to remain anonymous.
Providing captions within a presenter's PowerPoint presentation is now possible using a technology called "Text on Top." The captions can be added to the bottom of the screen, to the top of the screen, or within the screen. This makes it possible for a person with hearing loss to follow along without being a "bobblehead."