Let’s loop America!

Hearing loops broadcast sound from a sound source wirelessly to hearing aids. All users need to do is switch their hearing aid to the telecoil or Mic + telecoil mode.  Hearing loops provide phenomenal hearing in situations where poor acoustics, reduced word discrimination and auditory processing problems would have made understanding nearly impossible. For a sound demo in and out of a hearing loop – Listen here

If you would like to learn more about bringing hearing loops to your community feel free to post questions or remarks.  The goal of this blog is to inform and bring those interested together to help loop one community at a time.

Juliette Sterkens, AuD – Audiologist 
HLAA National Hearing Loop Advocate

 

What every hearing aid user should be told by their audiologist or hearing aid provider

There is some confusion among hearing professionals regarding Blue Tooth and Hearing Induction Loops.  The misunderstanding that is that Bluetooth and hearing loop technology are mutually exclusive when in fact they complement each other and have tremendous capability to improve quality of life for the user.

Hearing aid users can take advantage of both: many of my clients benefit from Bluetooth wireless technology watching TV at home, while using their cellphone or on Sunday morning when they happily switch to their telecoil in church.  Hearing aid users cannot benefit from telecoils if they are not educated about them and so equipped. One unhappy – because her audiologist failed to mention telecoils even once in 30+ hearing aid adjustment appointments – hearing aid user from Minnesota wrote me:  “One has to have one to take advantage of the loop. I would have chosen a different instrument”.

Bluetooth does a great job linking two devices together.  Some examples where Bluetooth is used to link are: a mouse to a lap top, a hearing aid to a TV device, a cell phone to a head set, a cell or home phone to a hearing aid.  Bluetooth’s effective range is limited to 30 feet and requires linking aka pairing the devices in order to communicate together.

When Bluetooth is used in hearing aids the hearing aid manufacturer’s employ proprietary versions of Bluetooth which are not compatible with other hearing aids or earlier version of Bluetooth devices.  This means that each user would need their own, individual Bluetooth transmitter to hear in a large venue, and would need to sit within 30 feet of the transmitter to receive the signal.

In a house of worship all the Bluetooth users would need to have their own Bluetooth microphones attached to the presenter and would need to sit less than 30 feet away in order to receive the signal in their hearing aids.  The sound quality of Bluetooth is limited and people who have listened to TV using Bluetooth and then through a Hearing Loop report that the sound quality of the Hearing loop is clear and instantaneous while the Bluetooth sounds can sound  more fuzzy, and users with normal hearing in the low frequencies have discerned delays in the audio.

Finally Bluetooth draws considerable battery power with some hearing aids consuming batteries 10 times faster when in the 2.4 GHz mode. For this reason many manufacturers use an intermediary device which utilizes NFMI (near field magnetic induction) which looks like a small iPod or remote control. This intermediary device receives the signal from the Bluetooth transmitter and sends it via a near field magnetic induction to the hearing aid.

While Hearing Loops can be used one-on-one such as:  a neck loop attached to a Walkman or telephone, or a home loop attached to a TV,  they are the technology of choice when many people need to listen in a large venue with a sound system such as a house of worship, conference room, or auditorium.  The loop signal is universally compatible (around the world) with all T-Coil equipped hearing aids.  A Hearing Loop installed to the IEC standard will have excellent frequency response from 100 to 5 kHz, often beyond what most hearing aids are capable of amplifying.   T-coils get their power from the loop signal and draw no, or nearly negligible power from the battery.

Because hearing loops get their signal directly from the source (the speaker’s microphone or other audio output) there is no need to process the sound so there is no need for the loop to use digital processing, and take advantage of any digital processing that is being done by the hearing aid itself.  And last but not least, in a looped venue the person with hearing difficulties need not self-identify as having difficulty understanding the spoken word, nor wear listening devices with unsightly and unhygienic headphones – all they need to do is discretely push the button on the hearing devices they are wearing to activate the telecoils. Testimonials of such experiences are abound on the internet on sites such as www.hearingloop.org and testimonials )

Hearing aid engineers advise that while a universally compatible Bluetooth-like device which would have similar one-to-many, wide area capability is technically feasible the hurdles of frequency spectrum allocation (not all countries have the same frequency authorizations), arriving at a mutually agreeable technology among the manufactures, and the need for people with hearing aids to buy new compatible hearing aids in order to listen.  If such a technology will ever exist it will not be in the foreseeable future and some experts in the field such as Dr. Jason Galster from the American Starkey Hearing Aid company see here  and Dr. Laurel Christensen from GN ReSound (who addressed this at the recent Minnesota Academy of Audiology annual meeting  2/23/2012) spoke publicly that a universal wireless standard may be 5 or 10+ years out.

It is my understanding that none of the big 6 hearing aid manufacturers and cochlear implant companies are seriously developing, or considering developing such a universal technology. The hearing aid companies continue to sell three different wireless technologies to the hard of hearing public (900MHz, 2.4GHz, and NFMI). Considering that the devices sold today as “state-of-the-art” will continue to be used between 5-7 years by the average hearing instrument user, and that Oticon recently introduced in 2nd generation NFMI computer chip platform (named the Alta see www.oticon.com/products ) and added a telecoil to the new Streamer Pro (Oticon only introduces platform changes every 3-4 years, and the first iPhone compatible hearing aids by GN ReSound are being introduced see hearingmojo , and no MFR has agreed to one type of technology as of yet, the estimate that a digital worldwide universal assistance listening system will be offered in 10 years is most probably conservative and it will likely be 15+ years – if ever.

Is it possible that hearing aid providers, who have failed to inform their clients of the benefits of telecoils, may be reluctant to admit their oversight?  I had similar feelings when I first started working with hearing loops in my community yet quickly realized that it was not right to put my embarrassment ahead of my patients’ well-being.   The overwhelming positive responses led me to work harder to find solutions for clients who did not have telecoils but could really benefit from them. It took some doing but I was able to either add telecoils or change many of clients’ instruments (some at my expense and some gratis thanks to my suppliers) to models that were T-coil equipped.

Audiologists and hearing aid dispensers who are recommending Bluetooth wireless or FM technology for their hearing aid and CI clients (because the BT wireless technology is beneficial for hearing on a cell phone, for TV or microphone clip in a restaurant) and counsel their clients on the use of telecoils in large venues equipped with hearing loops (now found all over the country in houses of worship, meeting rooms, as well as in transient situations such as check-out counters, theaters and airport gates see locations here or here) are meeting standard of care guidelines as specified by the American Academy of Audiology guidelines and endorsed by the American Speech Language and Hearing Association, see here. They may also be aware of the Hearing Loss Association of America (HLAA) and American Academy of Audiology Hearing Loop Task force recommendations regarding telecoils and hearing loops here)

Notable audiologists such as Mary Caccavo, PhD  (past president of the Academy of Doctors of Audiology and owner of a successful audiology practice in Lafayette, IN) and many others around the country are finding that by fostering loop installations in their communities they greatly their clients’ quality of life.

Advocates are not for hearing loops per se, they are for a technology that is relatively low cost, worldwide universal, non-proprietary, directly compatible with the majority of hearing aids useful in a variety of large area listening. BT wireless technology – though useful in many one-on-one situations is not setup for large area listening systems and won’t be for years to come. My husband is still waiting for his jetpack.

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Hearing Loop sign at Trinity Episcopal Church in Oshkosh, WI

At this time no universal wireless digital technology exists (or is in the near future) that will help the millions of hearing aid users in this country and around the world hear well in public places. The only universal technology available is telecoils and induction hearing loops.

I believe that telecoils has the potential to excite all those involved with hearing care: the providers, the users and the manufacturers. We all know the truth: hearing aids and Cochlear Implants have their limitations due to the degree and type of hearing loss and the fact that users go through life hearing the world through microphones. And microphones have limitations too – they pick up what is closest and pick up what is loudest and cannot distinguish between the two and this problem is aggravated in places where there is background noise and reverberation.

Audiologists and hearing care providers need to incorporate hearing loops because loops offer their clients solutions in locations where hearing aids will not work well – no matter the level of technology in the instrument.  The MFRs know it; the providers know it; and the hearing aid users find out as soon as they start using the instruments that hearing aids don’t offer good hearing beyond 6-8 feet. Read the comments from hearing aid and CI user Katherine Bouton  It is not anybody’s fault – it is just the way it is. What is needed are hearing loop installations and telecoil equipped hearing aids as they allow the user to hear much, much, (did I say MUCH?) better.

Once we get that message out and providers and consumers start demanding that hearing access be done with hearing aid compatible systems (i.e. hearing loops) and loops become ubiquitous in places where assistive listening is needed (houses of worship, lecture halls, board rooms, airport gates, theaters and pharmacy ticket counters to name a few) consumer satisfaction with hearing devices will increase,  and I even dare say, dramatically.

Looping a community can be done but takes some tenacity. I speak from experience but the change is worthwhile. Read my previous blog: http://loopwisconsin.wordpress.com/2013/02/27/improving-hearing-access-with-hearing-loops/

 

 

I believe that together we can forge a change in how America does hearing access.Image

It has taken me four years in Oshkosh and the Fox Valley but it is changing – I am proud to say. Hearing loops are now appearing in a variety of locales thanks to the support of the users, their family members, audiologists and hearing aid providers, AV engineers (who have stopped installing what is easy and what they know – FM technology – and are doing what is most likely to be used,  for many reasons,  by people with hearing loss) and ministers and venue operators who are finding out how pleased their patrons are with hearing loops.

Two stories I would like to share: 

Recently, while traveling as the HLAA Hearing Loop Advocate, I received an email from my business partner audiologist back in Oshkosh: One of our patients, a n experienced hearing aid  user told her that he found out while attending a funeral, that the loop at St. Andrew was not working. Could my husband Max (who installed over 50 loops in the area before he stopped due to my advocacy work) investigate further when we would be back in town?    I emailed her back: The loop at St. Andrew’s is not working because they don’t have one installed yet! 

The second story happened last November. While sitting in a church waiting for a community event to begin, I overheard a woman wearing hearing instruments tell her companion, who also was sporting hearing aids, say: “Be sure to turn your telecoils on before the program begins”.

That tells me that two things are happening in Oshkosh that may be unique to our nation: Hearing aid users are starting to expect that a hearing loop is provided in facilities and churches and the telecoil is becoming a part of the hearing instrument user’s vocabulary. I would have never guessed this when I started my advocacy.

Some new clients don’t know the telecoil or T-coil by name but come into our office referred by friends or ministers asking for that hearing aid that lets users hear in church. Ministers have thanked me for educating them about hearing loops and hearing aids. They now feel better equipped to advise their parishioners when they get complaints about intelligibility in church. There is also a greater awareness about the importance of using a microphone during all aspects of the service.  

Improving hearing access requires a comprehensive approach:  All those involved need to be educated:

  1. The hearing aid users and their partners and family members need to fully understand that wearing hearing aids with microphones on the ears will not restore hearing back to normal regardless of what the advertising in the newspaper leads them to believe and they need educated in the telecoil feature of their instruments.

2. The audiologists and hearing aid provides need to be educated that regardless of what they are being told by the hearing aid manufacturers’ reps hearing aids ALONE are not enough and that in order for their clients to utilize ALDs they need a properly installed and programmed telecoil.  

3. The venues operators of theaters and meeting rooms and the ministers need to be educated what constitutes effective hearing access and work towards implementing it with the proper sound mix. They also need to demand IEC standard meeting loop installs by well-trained AV engineers.

4. AV engineers need to undergo the training to do IEC standard meeting hearing loop installations and do a proper test PRIOR to a loop installation. They need to be able to demonstrate that the loop they installed meets the standard.   

On Sabbatical to Advocate for Hearing Loops

With HLAA Keynote speaker Dr. David Myers and Audiologist Dr. Mark Ross

My yearlong sabbatical to advocate for hearing loops has started! This promises to be an interesting and exciting year as so much is happening with hearing loops.

In June I taught a class to audiology students at the University of Texas at Dallas. Thanks to the wonderful world of computers, Skype, a camera on my laptop computer and PowerPoint I was able to appear in the classroom and talk to these students of the benefits of hearing loops. They had many questions and several expressed an interest in doing some research with hearing loops. Something that is much needed!  Kudos to Carol Cokely, PhD audiologist and professor at UTD for arranging this seminar.

On June 20th Max, my husband (and hearing loop engineer) and I traveled to Providence RI to attend the Hearing Loss Association of America (HLAA ) 2012 convention. Dr. David Myers (creator of www.hearingloop.org ) was the invited keynote speaker and he introduced me as the HLAA National Hearing Loop Advocate.  It was great to see so many friends from the past 2 HLAA conventions we have attended.  I spoke with many members interested in moving hearing loops forward in their own communities all over the country. As audiologist Cynthia Compton-Conley discusses in her blog:  If you have a hearing loss and are searching for information, HLAA is a great place to start.

Brenda Battat, HLAA’s executive director has written eloquently about the benefit of hearing loops to all hearing aid and cochlear implant users in her: blog  That many members enjoyed the hearing loop during the opening session at the convention can be clearly seen in this short video clip   where I can be seen ( though  barely) and heard (loud and clear – thanks mam and dad for giving me a loud voice!).

Bergen Harbor

From Rhode Island Max and I traveled to Bergen Norway to attend the IFHOH World Congress for People with Hearing Loss.  This was an international meeting where I had a chance to meet many attendees and their families who represented national organizations of and for hard of hearing and deafened people from 40 countries.  Brenda Battat and Dr. Patricia Kricos, past president of the American Academy of Audiology and I presented on the progress of hearing loop usage in the United States.

The simplicity (all a user needs to do is push on a button on their hearing instrument), immediacy (it works right away – no need to pick up a separate listener device),  the invisibility (no one even needs to know you are using a hearing loop!), the power effectiveness (loops don’t drain the hearing aid battery) and universality (loops in Amsterdam or Oslo’s Opera Houses and the Marriott Theater in Lincolnshire, Ill all work the same way) make hearing loops the assistive hearing technology of choice of users worldwide. There was much interest in the progress that has been made in the last three years in the USA.

Bergen Harbor in the background

Thanks to dry weather (most unusual for Bergen,  so we heard) we got to see some beautiful sights in Norway; we enjoyed a few hikes, dropped off several geocaches, ate local salmon on the famous local fish market, and toured the Sognafjord by train, bus and boat, and Edvard Grieg’s home near Bergen.

Max at IFHOH registration

With the support of consumers, audiologists and hearing healthcare professionals and audio engineers Max and I will work to travel to help jumpstart hearing loop initiatives all over the country in the next year.  We are looking forward to this adventure.

Stay tuned for another progress report!http://loopwisconsin.files.wordpress.com/2012/07/bergen-max-js1.jpg

 

The information for audiologists  on the LoopWisconsin website was completely rewritten.  I hope you find it useful in your efforts to loop your communities

Hearing loops have certainly been in the news lately. Perhaps you caught New York Times Front Page article ?   NPR weighed in a month later with a story on “All Things Considered”  “With The Flick Of A Switch, It’s Crystal Clear To Hear”   Audiologist Jay Sheehan wrote an excellent technical article  on Audiology Online. Hearing loops were also discussed by several other well-known authors such as David Kirkwood here and  here and Robert Trynor .

Read of Dave Myers’ efforts in the December American Psychological Association magazine Monitor on Psychology. Few know he has been working to loop America for 12+ years!  Thank you Dave!

In my next newsletter I will explain how someone looped her Toyota Prius to hear the radio and husband clearer. Stay tuned!

I wish you all Blessed Holidays!

Juliette Sterkens, AuD
Hearing Loop Advocate

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