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

 

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if-at-first-you-dont-succeedIf at First You Don’t Succeed,
Try, Try Again (or Email me) 

Recently, I sent a letter to a reporter in response to her question how I have tackled a “No!” answer when I advocated for a hearing loop. While I don’t have all the answers, below is a list of my persuasion tactics.

  1. I make a phone call or a pay a visit and explain why people with hearing loss (even if they use hearing aids and cochlear implants) have trouble hearing. I describe how hearing loss is more about the clarity and not the loudness. That hearing aids do not restore hearing to normal regardless of level of technology and that they generally don’t work in places with reverberation, background noise or over distances of 6-10 feet.I also explain how hearing loops work: A hearing loop sends the audio signal wirelessly from the facility’s microphone and sound system to those wearing t-coil compatible hearing aids, cochlear implants or a wireless headset (for those without hearing aids or without t-coil hearing aids).

    It is my experience that most facility managers are receptive to this message and want to help. I can be more effective if a member or patron of the facility writes his or her story of not being able to hear or participate. It is just that the facility managers are often unaware of the difficulties people with hearing loss experience. During a visit I often play parts of sound demos in and out of hearing loops or a mother’s testimonials of a home loop installation. These sound demos can be eye – or should I say ear – opening?

  2. Because hearing loops work so well, many testimonials include superlative language. Over the last few years I have collected responses from hearing loop users to let them do the talking. Other comments have been gathered here: loopwisconsin.com/testimonials.aspx 
  3. Advocating is made easier if I know that a facility will soon be undergoing a remodeling. The installation of the loop wire is usually easier (and less costly) when the carpeting is going to be replaced anyway. I have referred to the website from an experienced loop installer where hundreds of hearing loop installation photos in a variety of situations and types of flooring including terrazzo, tile, carpet and vinyl tiles to carpet are shown.
  4. I explain that if a facility has a crawlspace and/or basement, loop wire installation can be done underneath the auditorium, sanctuary or meeting room to be looped. I make the facility aware that metal in the floor can affect the magnetic signal, and an in-situ hearing loop test is always required and refer to the Best Practices in Hearing Loop Procurement

  5. If cost is a concern, I offer information as to how other venues have handled this expense or my blog on how to (find funding) to loop churches .  For example, there are grant monies available for some venues (libraries and some houses of Worship). Many communities have a Community Foundation that may be willing to help fund a loop particularly if it improves access for a population with a disability. For example, in late 2008 the Oshkosh Area Community Foundation was helping to fund a remodel of the Oshkosh Convention Center. I made a couple of phone calls and sent a letter with information to the executive director.   The result was they helped fund two hearing loops at the convention center about 2 weeks before the carpeting was to be laid down.  The executive director believed me when I told her that having a hearing loop at the convention center would convince other venues to do the same.  Oshkosh, WI now has over 50 hearing loops including its 100+ year old Grand Opera House, a funeral home, several court rooms, the City Council Room, several retirement communities, and the  UW Alumni Welcome and Conference Center.
  6. To increase attention to a need, I have found that a letter to the editor  of a local newspaper can be of tremendous help. And the best part of such letters? They are free!

  7. There is strength in numbers: If you are advocating for improved access ask a friend or family member or a local hearing professional to write a short letter of support as well.
  8. The last resort would be to play the ADA card (Americans with Disability Act).  The ADA mandates that facilities offer “in each assembly area where audible communication is integral to the use of the space, an assistive listening system (ALS) shall be provided.” Read up on the law and share the guidelines found here on page 36978 .

    Public facilities are required to comply with the ADA law, and, in some states even non-profit facilities are required to install assistive technology. For example, the California Building Code requires houses of worship to always provide an ALS. Other states do not go that far, but may require a non-profit facility to provide an ALS if their space is rented to the public.

    Finally, if a public facility is unwilling to comply with the law and provide an ALS, I refer people to the Department of Justice where they can tell their story and file a complaint.   www.ada.gov/complaint/

Frankly, I have yet to see anyone I personally know resort to filing a complaint. Informing the venue – in writing – the intent of filing a complaint has convinced facilities to do the right thing. If this happens and a hearing loop gets installed, don’t forget to send a public “Thank You and Kudos for Installing a Hearing Loop” letter to the editor of your local newspaper. Such a public “shout out” and positive PR helps our cause. And who knows? This letter may even “nudge” other places to follow suit.

Hearing loop advocacy success is like an iceberg: While the first one or two installations may take several attempts,  once loops find their way into a community they beget others. Why? Because hearing loops deliver. Hearing loops truly help people hear.

Success-is-like-an-iceberg 2

 

Responding to Myths and Misconceptions about Hearing Loops

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Some hearing loop advocates run into unexpected roadblocks in their efforts to make community more accessible for people with hearing aids and cochlear implants. They write me for help to respond to comments from AV & IT engineers dismissive of hearing loop technology.

A physician, at a large well known medical center in NYC, recently asked me if the objections from the IT engineers, when he inquired why their facility doesn’t offer hearing loops in their auditoriums, were valid. He was told “There are no hearing loops in place and the reason behind that is that there is potential interference with the wireless mics within the auditoriums.“

If mic issues prevented successful loop installations, that would long ago have been apparent in the many thousands of installations in the UK, Scandinavia, and northern Europe, and the 1000 or so auditorium/worship place installations now in Wisconsin and Michigan . . . not to mention the countless more across the country.

I asked a local audio engineer, someone who has decades of experience in the audio field and personally installed hundreds of hearing loops. He explained: ”Hearing loops operate at audio frequencies (100 – 5000 Hz) created by a magnetic field. Wireless, Bluetooth or FM systems run at radio frequencies or a carrier frequency in the “GHz” or “MHz” range and in my opinion and experience, there is no interaction or interference between the two. 

Blogs on the web give some answers as well.  This blog  explains how interference problems can be avoided and recommends using trained loop installers who adhere to the IEC 60118-4 induction hearing loop standard. This article  explains that hearing loops can be difficult to install in some venues and they are best left to trained installers.

It is my experience that the average AV or IT engineer is not up to date of recent loop equipment development, not familiar with the IEC standard, lacks the proper training and experience installing loops. Perhaps, they remember hearing loop equipment and poorly functioning installations of yesteryear?  There is good news: hearing loops can be installed in the vast majority of venues and while there can be exceptions, there are very few.

Phased array loop installations can overcome effects of metal,  create even magnetic fields with little or no over-spill, state of the art loop drivers are more powerful than ever, loop performance verification is made easier and more precise with smart iPad apps , some systems even offer remote monitoring and email warnings to the installer should a malfunction occur and cancellation loops limit spill into areas where musical instruments with magnetic pick-ups, that are not properly insulated, could cause an issue. As always, proper engineering of the loop is key to successful installations: no different than the need for properly installed speaker systems.

To me – there is one more argument. Why should AV engineers, who often do not know much about hearing loss and even less about hearing aids and CIs, think they can decide on the type of assistive listening technology used in a facility? Where are the studies that demonstrate that consumers like, prefer and use the FM and IR systems they install? Nothing should be decided about people with hearing loss without them. And survey after survey has shown, that loop technology is, overwhelmingly, user preferred.

In my previous blog I made a case for the need for hearing loop technology in public places. For hearing loops to benefit consumers – the hearing loops have to be installed to meet the IEC 60118-4 standard, clear hearing loop signage has to be provided and the consumer needs to know how to link into the hearing loop signal.

The good news is that more and more hearing aids, even small mini-devices, now come equipped with telecoils. And, thanks to the advocacy of the Hearing Loss Association of America (HLAA),  active HLAA members and ardent hearing loop advocates around the country, more and more places are installing hearing loops.

But…a common complaint among loop advocates is that still way too many hearing aid using consumers are tragically unaware their hearing devices include this telecoil.  What can we do to correct this? That is where audiologists could play an important, even a pivotal, role. By including and activating telecoils in the hearing aids they fit, taking 5 minutes to demonstrating their benefit, and handing out information on the Americans with Disabilities Act would go a long way.

Here is what I believe hearing aid consumers should expect from hearing aid providers:

  1. The provider orders hearing aids that have built-in, vertically oriented telecoils. These telecoils, when turned on, need to offer the same gain and frequency response setting to a 60 dB sound input as compared to a 31.6 mA/m magnetic sound input. In audiology parlance this means the instrument has to have a matching ANSI SPLIV test The good news is that most European hearing aid makes meet this so called Nordic Telecoil standard.
  2. The audiologist activates the telecoil and offers the consumer clear instructions on how to use it (preferably in writing). The gold standard is that the telecoil setting is verified in a test box or in a waiting room with a TV connected to a hearing loop. If your provider doesn’t offer a hearing loop in their waiting or treatment room– share this article by Drs. Caccavo and Lopez . In it they explain why every provider needs a loop in the office.
  3. The hearing care provider explains the capabilities as well as the limitations of hearing aids, and how to overcome these limitations. Consumers need to be told that thanks to the Americans with Disability Act hearing well (in places where PA systems are used) is their civil right. That consumers should expect reasonable accommodations for people with hearing loss, just like people in wheel-chairs expect ramps and elevators. Every consumer needs to be given information how assistive technology works with a telecoil. Brochure examples can be found on the Hearing Loss Association of America  and the American Academy of Audiology websites.
  4. The audiologist is a vocal advocate for hearing access rights in the community. Where providers take on this role or where providers work hand in hand with their clients, hearing loops appear. Some providers even hand out hearing loop advocacy cards  their clients can take around in the community. Many a loop has been fostered when this conversation about hearing access was started. And when places are unwilling to offer access mandated by the ADA? Providers could offer the link to file complaints with the Department of Justice:ada.gov/filing_complaints on their practice websites.

Should you be told, when you ask about telecoils, that 1) you don’t need one, 2) that they are old technology or 3) that there aren’t enough loops around to make it worthwhile for you to get one – question his or her authority. Telecoils and hearing loops have greatly improved in the last decade and progress is being made daily in the Looping of America. To find hearing loops near you visit www.aldlocator.com , www.LoopFinder.com  or download the Loop My Phone app on iTunes.

Hearing advocates around the country are fighting for your right to hear. Join the fight – ask me how. Email me at jsterkens@hearingloss.org

 

waiting-room

 

Hearing aids have improved over the last decade but they still do not give the user normal hearing. Most hearing aid users need to use strategies to hear their best. Some strategies involve the help from others – like asking family and friends to face them, move closer, use Clear Speech  or reducing background noise such as from radio or TV.  Other strategies involve optimizing hearing aid features such as switching between hearing aid programs, and keeping most of the background noise rearward of the hearing aids (that way the forward facing directional microphones can do their job), or by directing young children to use their “big” girl/boy voices or by asking that the captions be used when watching TV with friends and family.

Most hearing aid users are also told by their provider that their hearing aids have a limited range. But not all are told how limited of a range and that this not dependent on the sound processing capabilities (level of technology) found in the hearing aid but primarily due to the microphone limitation.

How many proud grand/parents have made video recordings of their grand/children in a school play, only to be disappointed with the sound when they play back the video? The reason for this is that the person making the recording is hearing the live program with his own two ears and brain.  Anyone with normal hearing automatically compensates for distance, background noise and reverberation and is are able to separate the sounds he wants to hear over those he does not. The microphone on the video recorder cannot do this. It picks up what is loudest (the crying baby 6 rows away) what is closest (the person sitting beside you coughing or rustling the program paper or the shuffling of feet from late comers to the show) but doesn’t know what is wanted (i.e. the child actor) vs. the unwanted (all the other background) noises.

Users of hearing aids struggle with this same microphone issue. They hear the world through microphones and just like the mics on video or smartphone equipment, these mics are limited in their capabilities. Hearing aid experts and experienced hearing aid users agree that the most effective range is only 3-6 feet.  This doesn’t mean that hearing aid microphones cannot pick up sound that is over 6 feet away, but they are unable to separate the wanted from the unwanted sounds.

Yet, hearing aid users want and need to hear. Especially in places that are critical to quality of life: Hearing the wedding vows in an old stone church, words spoken during a lecture at a place of employment, while attending a play at a local theater, at a City Council meeting, asking for directions in a New York subway or understanding the announcements at an airport gate. IMG_6451

Hearing aid users deserve to be informed that in order to overcome difficult listening situations in public places, and the telecoil, found in a high percentage of hearing aids, in combination with a hearing loop, is one of the easiest to use work-arounds to the microphone limitation issue.  It is estimated that at least 2 out of every 3 hearing aids sold today comes equipped with a built in T-coil or telecoil, or the telecoil is found in a wireless accessory that can be purchased separately.  While other works-arounds for individual use, such as wireless BT microphones, and FM and IR devices deserve mention, none offer the easy, directly-hearing-aid-compatible listening solution for hearing in a public venue, that loops offer.

How does the hearing loop work? A hearing loop creates ripples in the local magnetic field that fluctuate with the sound from a source – this source can be a microphone on a podium, the mic used by an airport gate attendant or a TV. The telecoil can pick up these minor magnetic field changes and translate them back into sound inside the hearing aid. Just like a microphone picks up ripples of the sound waves the telecoil picks up these tiny ripples in the magnetic field.

The benefits of a hearing loop were recently described in a survey published in Hearing Review. In it 866 people were asked to rate the performance of their hearing aids or cochlear implants using a 10-point scale. The average response was 4.9 in a non-looped setting and 8.7 in a looped environment.

How can a hearing loop deliver such a dramatic improvement?  Simple. By overcoming the limitations of the hearing aid’s microphone. In a loop the microphone used on the stage becomes the microphone to the hearing aid. The listener gets a direct wireless feed from the sound system with little or no background noise. The result is that the user has access to the cleanest and purest sound possible. And the budding child actor on stage? He’ll be heard ‘in the loop’ with greater clarity than the normal hearing audience is able to hear ‘out of the loop.’

Read my next blog: Four Ways Your Audiologist Can Help You Hear in the Hearing Loop

I recently received a letter from an audiologist asking for help to find funding for a hearing loop in a church.  Here is how I would recommend he/she go about this.

Form a hearing loop committee – number of members is less important than the willingness of the committee members to make this happen by reaching out to church members and into the community.

It is my experience that members of the church should be asked first. They have a vested interest that all members are able to hear. Stories abound on the web how congregations made this happen. Often, members in the congregation will step up to pay for a loop but, not until after the congregation is educated about why people with hearing loss/hearing aid users need this kind of assistive listening technology.

A short article in the church bulletin will go long way in this education process. Explain that hearing loss does not only affect the ability to hear select or soft sounds (such as speech sounds) but that hearing loss often affects the person’s ability to understand speech. And while hearing aids have come a long way to improve the loss of audibility they do not give the user normal hearing. In places where sound has to travel over distance, or where it is affected by reverberation, hearing aid users complain. That is where an assistive listening system such a hearing loop can be of great help.

Explain that a hearing loop broadcasts the sounds picked up by the sound system, already in use in most churches, and via tiny ripples in the magnetic field sends the signals directly to the telecoil found in many hearing aids and in all cochlear implants.  For those who do not own hearing aids small listening boxes with headphones are available and, soon, consumers will be able to link into the wireless hearing loop signal by plugging special telecoil equipped headphones into their smart phone.

Another source of support and/or funding might be the local hearing care professional or audiologist. They likely see parishioners from the church and perhaps they are willing to make a contribution towards the loop at the church – you never know until you ask! They could be instrumental in the awareness of the hearing loop by educating their clients in the privacy of their offices.  Offer a copy of an article titled  Roadmap to a Looped Community written for providers published in the Audiology Today Magazine.

Several churches iEnvelope2n my area were successful in their fund raising efforts by inserting a special envelope in
the bulletin soliciting for donations towards the “Hearing Loop Fund” and by leaving a stack of these envelopes in the back of the church. (See image on the right. )

The hearing loop fund raising kick-off can be made more effective if accompanied by a personal verbal appeal from the pulpit by hearing aid using parishioners as it helps to put a face to this often overlooked need in the church.

Before an appeal is made it is important that a quote (or better yet, two quotes) for a hearing loop install are obtained from local reputable hearing loop installers.  Read the www.hearingloop.org/How_to_purchase_loop_your_facility  handout. Look for installers on this national (though not exhaustive) list of loop installers. It is important to vet installers’ qualifications and be sure to check out two or three references.  I know several loop installers who will travel around the country to help with loop installations.  Email me if you have questions about this process or are unable to find an installer.

Where else to find funding for a hearing loop?  Some church denominations have access to a foundation. For example, the United Methodist Church Foundation, the United Church (of Christ) Funds, The Unitarian Universalist Funding Program as do many Catholic Dioceses. These foundations have been known to offer matching grants to “strengthen their institutions.”  Email me if you would like to know what kind of wording others have used to make such an appeal.

If this is the first hearing loop in a town/city and if the loop committee would like to make the church a shining example of hearing access done right, a local Community Foundation might be willing to support the loop. PR ideas include: sending a news release to the paper, doing an interview for the newspaper, talk about the loop on local Community TV, or writing an article in the church denomination’s state or regional magazine. Make an appointment to talk to the foundation’s director to explain about the hearing loop.

Doing a short PowerPoint presentation to a local Rotary (Lions, Kiwanis or Sertoma) club s another good way to find “movers and shakers” in an area.  There is no right or wrong way… what works in Oshkosh WI may not work in Littleton, CO and vice versa. Email me for a short PPT slideshow.

It is my experience that money is rarely the issue. When objections are raised it is usually because the benefits of the loop are not really understood and further explanations are needed. (Some AV professionals have been known to lobby for FM systems with neck loops as being much more economical and “just as beneficial.” (Experience has shown that these systems usually end up sitting in the back of the church. Unused.) Email me if you run into roadblocks like this. I am happy to help.TFWM

A visit with the minister,
priest or rabbi and/or the church council is usually the best way to start.  Share a copy of the Technology for Worship Magazine reprint, play an “in” vs. “out” of the loop audio demonstration , and share a couple of testimonials. And, in closing, ask if everyone doesn’t deserve to hear the Word like Dorothy?


I used to clap when others clapped. I used to laugh when others laughed,
though I usually didn’t hear what it was about. Now I hear every word in church.
I absolutely love the hearing loop. 

 

 

 

 

Consumers with hearing loss around the country should be interested in bills introduced in New Mexico (Senate Bill SB70 and House Bill HB70) that would mandate hearing care providers educate potential hearing aid purchasers on the information offered to allow the client to make an informed decision as to what hearing aid device to purchase.

These bills are being demanded by educated consumers who, once they find out how telecoils are essential to hear in public venues equipped with assistive listening systems mandated by the ADA, are upset they were not told about the telecoil when they first consulted their audiologist or hearing aid dispenser.

 

Some hearing care professionals label telecoils as “old” or analog technology and mention only Bluetooth technology.  Yet, once these consumers become educated, they perceive their hearing care provider as only out to sell hearing aids, and not feel responsible or be concerned about the well being and overall functioning of their clients in public venues.

Hearing Loops are amazingly beneficial to consumers.  This was demonstrated in a recent survey published in Hearing Review where 866 people were asked to rate the performance of their hearing aids or cochlear implants using a 10-point scale. The average response was 4.9 in a non-looped setting and 8.7 in a looped environment.

Until a newer universal, easy to use, good sounding, and affordable assistive listening technology becomes available around the country (and the world for that matter) telecoil technology will continue to be used as the universal technology that allows consumers access to important information and speech in places where hearing aids and cochlear implants are unable to deliver.  Loop technology is widely used in Europe (in taxi cabs, theaters, opera houses, ticket windows, trains and airports) and thanks to Dr. Dave Myers’and many other advocates’, efforts are spreading in the USA www.hearingloop.org. Please note that these efforts are not for hearing loops perse, but for directly hearing aid compatible assistive technology.

Hearing Loss Association of America members (www.hearingloss.org) who run volunteer consumer support groups around the country find time and time again that:

  1. Telecoils are not activated (how does a provider know that a client will not travel to places that offer loops, attend a looped Broadway theater or be present in a looped church for a wedding and could have benefited from an activated telecoil?)
  2. Consumers were dissuaded to purchase a hearing aid with a telecoil
  3. Few providers offer a hearing loop in their waiting room (or a neck loop connected to a Pocketalker) to demonstrate the benefits of the telecoil or make it part of their ROUTINE counseling practice.
  4. Even fewer providers have ever listened to assistive devices themselves or used a hearing loop in a public venue.

It is educated and passionate consumers who are now pushing for these consumer protection laws.  Yet, some hearing care providers as well as professional organizations are working against them. In New Mexico for example the New Mexico Speech Language and Hearing Association professionals are using arguments that people with severe to profound hearing losses do not benefit from the technology, hearing loops are not available to the user or that alternative technologies could be more effective. Perhaps they didn’t read the Hearing Review study. Imagine being sold a car but never been told it comes equipped with a headlight switch that allows driving in the dark?

Hearing impaired consumers need protection alright – protection from providers who do not educate consumers when they are making a very costly purchase.

Given the gravity of the needs of people with hearing loss and having personally seen thousands of consumers react with joy about the benefits of a simple telecoil in a hearing loop I would think providers and the hearing industry should jump on the opportunity to put hearing aids in a good light to give clients understanding in places where they know hearing aids and implants are unable to deliver.  Some proactive hearing aid manufacturers such as Unitron already have.

If you are a consumer, please join the grassroots hearing loop movement and invite your hearing care professional to get with our efforts to “Loop America”. Tell your provider it will change the way they practice hearing health care, that their efforts will result in delighted clients and that they will benefit professionally in the process.

Send your audiologist/hearing care provider to  www.loopwisconsin.com, suggest they watch this webinar or better yet – give them my email address jsterkens@new.rr.com and I will contact them and offer my personal and practical support.

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newspaper2-flatI wrote this blog in response to an article on how one person, Melissa Corson is making a difference in her community of Tallahassee: How More Americans With Hearing Loss Get to Hear Again – Tallahassee Magazine – January-February 2015.

Kudos to Melissa Corson (www.facebook.com/melissa.b.corson?fref=ts) from www.facebook.com/TallyENT?pnref=story who has been working hard advocating for hearing loops in her community. It is great that her efforts are paying off. Way to go Melissa and the Doctors of  Audiology at Tallahassee ENT!

Notice how it is always audiologists who are not involved with looping who make unhelpful comments about telecoils and hearing loops not having kept up with the current technology? What does Dr. Nathan Rhodes  audiologist at South Georgia Audiology and Hearing Services   know about the IEC 60118-4, the International Hearing Loop Standard and how it seamlessly works with telecoils in today’s hearing aids? How loops can improve the signal-to-noise ratio on the order of 15-to-25 dB? And that even some of the smallest instruments can be equipped with a telecoil? Does he know that some makes such as Widex, Oticon and Siemens offer telecoils in streamers and/or remote controls?

A recent study has clearly demonstrated just how beneficial the loops are to hearing aid and cochlear implant users in places where their devices (even those fit by Dr. Rhodes) are simply unable to deliver. These limitations are nobody’s fault – just a limitation of the microphones and distance (something that even the most advanced hearing devices are unable to overcome), the severity of hearing loss and speech recognition of the users. Limitations that the studies by Dr. Sergei Kochkin’s  have been shown to hearing care professionals for years. I also wonder how many hearing loops Dr. Rhodes fostered in his community before the advent of Bluetooth. Doesn’t everyone deserve to hear well in their favorite theater, meeting room or House of Worship?  I can guarantee that Dr. Rhodes’ patients will love him for it.  

A few references that might be helpful to professionals as they explore the grassroots hearing loop movement that hearing device users are so pleased about:

LoopWisconsinI am happy to support any hearing care provider or consumer who is looking to foster loops in their community. If my efforts and those of many consumers in Wisconsin can lead to 450 hearing loops in nearly 6 years imagine what a concerted effort by hearing care providers and consumers would do for hearing accessibility in the country.

I am only an email away:  jsterkens@hearingloss.org