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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