Archives for posts with tag: hearing loop

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

 


Recently I received a letter (in Danish mind you) from an experienced cochlear implant user who describes her personal experience with Cochlear’s new Loop Booster accessory. Thanks to Google Translate and Janni, the writer of the letter, I was able to translate it so that English speaking CI users can read about her Loop Booster experience.

Full disclosure: Janni Glæsner is the past president of the Danish Adult Cochlear Implant Association CIF http://cochlearimplant.dk/ and is currently is employed by Danaflex, the Danish distributor of Cochlear Products.

Johannes Kirke

The Johannes Church in Greve, DK offers a hearing loop for hearing device users. Like nearly all churches in Scandinavia

 

And the Noise Disappeared…

I don’t have to use a hearing loop often with my cochlear implant processors, but recently I was a confirmation at the Johannes Church in Greve Denmark and needed to turn on my telecoil to follow the sermon. I heard what I nearly always hear when I turn the telecoils my Cochlear CP810 processor on: a hum and crackling and my head orientation affects the loop signal strength.  Now, this noise doesn’t really bother me as it will not drown out the speech I want to hear. The crackle is just there, like the humming of a heating system or a fan. So if I think the sound is a bit too far away and requires me to pay very close attention to hear, such as at a lecture,  I use the telecoil, where possible.

A few weeks ago I learned of a new product from Cochlear called a Loop Booster. The Loop Booster is externally mounted on my Cochlear Implant device replacing the internal telecoil in the processor. The Loop Booster is larger and is said to improve the reception of sound through an induction loop system. Well, this aroused my curiosity!  Could a Loop Booster, I wondered, dampen – or perhaps even eliminate the hum and crackling I hear when using a  loop system? It was time for another visit to Johannes Church. So last Sunday I made the trek back to church to attend the All Saints Service.

I found a place discreetly on one of the back rows and settled in with a hymnal, my implant’s remote control and two Loop Boosters. Let the experiment begin!

loop Booster only

Loop Booster Attachment

My first thought turned to the loop system itself. Would it be turned on for the service? It sure was. But, as soon as I turned my processors’ telecoils on, the familiar hum and crackling appeared and when I moved my head the voice of the minister faded and the hum became even worse. It was time to attach the Loop Boosters on both processors. What happened next was amazing: The humming and crackling noise disappeared … and the sound was louder and clearer. It was as if an audio cable was connected from the microphone in the church to my processors. And when I moved my head, the signal did not disappear like it did when I used the built in telecoils. I also did not need to fine-tune using my remote control like I had to in the past.  The sound was clear and bright, just like I like! Wow!

Loop Booster

Cochlear CP810 Processor with the Loop Booster attached

Janni 2

Janni Glæsner

Because I have heard that other CI users have problems with noise when they use the processor’s telecoils I am sharing this experience with you, and am curious as to whether the Loop Booster works for others.
Signed: Janni Glæsner 

PS: Readers of this blog may want to know that Janni lives in Denmark where, fortunately for all telecoil equipped hearing aids and all cochlear implants users, hearing loops are common place.  She uses Cochlear Model 5 CP810’s in both ears, but told me that the Loop Booster can also be used for the Nucleus Model 6 CP 910 processors. Janni and I would love to hear from other users of the Loop Booster. Janni can be reached via her Facebook page www.facebook.com/janni.glaesner?fref=ts and I can be reached at jsterkens@new.rr.com

Kudos to Cochlear for listening to its customers.
A few years back, many cochlear implant users complained that the older Freedom processors with their vertically positioned telecoils had better hearing loop reception than the newer Nucleus devices whose telecoils were mounted horizontally. It is nice to know the company took these complaints seriously and developed this new telecoil attachment. Telecoils can dramatically enhance the cochlear implant user’s hearing experience in public venues that offer hearing loops as shown in a recently published study in the October 2014 Hearing Review

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This is a rerun of a letter to the editor of Hearing Journal – back in December 2010

As an audiologist for close to 27 years in a small private practice, I think I’ve stumbled on what will finally make many of my patients happy. I have been in houses of worship and other public places where, although I have normal hearing, it was difficult to hear. That made me think about my patients: If I could barely hear, how wouldthey fare? I know that few of them speak up, pick up an assistive device, or move closer. More often they will complain about their hearing aid (to me!) and just sit there or stop attending these events.

The seminars I’ve given at churches and senior centers did little to increase use of FM assistive devices, and advocating for neckloop purchases rarely turned them into believers in FM technology. I have tied myself in pretzels trying to get them to advocate for themselves. That is, until I heard Dr. Dave Myers speak at a meeting about his success in looping Western Michigan.

Hearing loops turn any telecoil-equipped hearing instrument into a speaker for the PA system. This simple, unsexy, low-tech t-coil turns your hearing aid into a personalized listening device that significantly and effortlessly improves the signal-to-noise ratio—that elusive goal we all are looking for when we fit directional-microphone instruments.

As audiologists, we also know that the small SNR improvements these D-microphones provide rarely satisfy the needs of the patient, who, besides having a hearing deficit, frequently has auditory processing challenges and therefore needs an SNR improvement not possible with an ear-level device, no matter what its level of technology. This is a physics problem, not a hearing aid problem.

Enter the hearing loop, also known as “Wi-Fi for hearing aids.” It circumvents the physics problem. It does for hearing aids what no other assistive device can: Make our patients hear better in situations where heretofore they could not. It is truly the missing link in our practice. Hearing loops use the t-coil, which is present in 60% of all hearing aids sold in the U.S. and in over 90% of high-power instruments. The t-coil is low cost, low in power consumption, and, best of all, easy to use.

As audiologists, we need to advocate for our patients. Our advocacy will help them hear so much better. I will even go as far as to say that, under some circumstances, persons using the loop will hear betterthan the persons sitting beside them.

Advocating for hearing loop technology is easy. You start with your own waiting room: Install a small loop driver and start demonstrating it. Contact a reputable professional audio company and explain that you would like to work with them in bringing this technology to area churches. Donate a hearing loop driver/amplifier to your own church, community theater, or seniors meeting room to get it going. And start giving speeches to service clubs or retirement centers. Trust me, hearing is believing!

Collectively supporting “hearing loop initiatives” in our local communities will result, sooner rather than later, in a “Looped America,” as Dr. Dave Myers has written in the Sept./Oct. 2008Hearing Loss Magazine.

No technology now or in the near future can do what induction hearing loop technology can do today! Our advocacy will let America know we truly “Care for America’s Hearing” and we will benefit with increased acceptance and use of hearing aids.

Juliette Sterkens, AuD

Oshkosh, WI

 (The original letter can be found here: http://journals.lww.com/thehearingjournal/Fulltext/2010/12000/Hearing_Loops_Make_Consumers_Flip_Where_Hearing.9.aspx)

On July 17th the ANSI A117.1 Committee convened in Washington DC voted to revise the current 2009 International Building Code to include a statement that when a hearing loop is installed it shall meet the IEC 60118-4 induction hearing loop standard.  This paper explains why this is important.

There are so many different groups involved each with their own acronyms… it is enough to drive someone like me, an advocate focused on helping people with hearing loss hear better in public places, to exasperation.  ADA, ANSI, ICC and IBC, Chapter 11 and Section 706 did not mean much to me up until a few weeks ago but the light is beginning to dawn.

The Americans with Disabilities Act, commonly referred to as the ADA, is a law that among other things, ensures access to the built environment for people with disabilities.  The ADA standard establishes design requirements for the construction and alteration of facilities subject to the law.  These enforceable standards apply to places of public accommodation, commercial facilities, and state and local government facilities.

It is the US Access Board that is responsible for developing and updating design guidelines known as the ADA Accessibility Guidelines (ADAAG).  These guidelines are used by the Department of Justice (DOJ) and the Department of Transportation (DOT) in setting enforceable standards that the public must follow.

In the ADA Standards, Chapter 2 on scoping, section 219, the reasons for accessible design are explained see http://www.ada.gov/regs2010/2010ADAStandards/2010ADAstandards.htm#pgfId-1010597

  • The term scoping refers to what facilities need to be accessible. In regards to hearing accessibility the scoping requirements dictate that in assembly areas where audible communication is integral to the use of the space, an assistive listening system shall be provided.  Section 219 lists one exception: Other than in courtrooms, assistive listening systems shall not be required where audio amplification is not provided.

It is in ADA Standards Chapter 7, section 706 that the technical requirements for accessible design are explained see http://www.ada.gov/regs2010/2010ADAStandards/2010ADAstandards.htm#pgfId-1006522

  • The technical requirements refer to the design and construction specifications and are found in section 706. In the case of hearing accessibility Section 706 dictates that 25% of the required assistive listening receivers shall be hearing aid compatible via the use of a neckloop, that a 1/8” standard mono jack shall be provided and that the individual receivers shall meet certain standards in regards to SPL, Peak-Clipping and  SNR levels.

It is the International Code Council (ICC), a member-focused association, dedicated to developing model codes and standards used in the design, build and compliance process to construct safe, sustainable, affordable and resilient structures that develops the International Building Code or IBC aka the “I-Code”.

Most U.S. communities and many global markets choose to reference the IBC. This code book, which is the most widely adopted building code in the United States, comprises of 35 chapters and a series of Appendices A thru M. When referenced in local, state or federal legislation, the IBC becomes the minimum requirement for construction.

Chapter 11 of the International Building Code addresses accessible design and construction of facilities for physically disabled persons. Chapter 11 is developed by the ANSI A117.1 committee. This A117.1 standard is a recognized accessibility standard that provides the technical criteria which must be met in order to accomplish the required level of accessibility. When sites, facilities, buildings and elements are built to the specifications in the A117.1 they become usable by people with disabilities.

A117.1 is comprised of 11 chapters and it is chapter 7, section 706 that specifically deals with Assistive listening systems. Section A117.1 is a scoping free document. In other words, it has no triggers telling the user when to apply the specific criteria, that is what the ADA standard does.

For the readers of this document it is important to know that section 706 of the ANSI A117.1 Standard is not Section 706 of the 2010 ADA Standards.  At this time, it is only ANSI A117.1, section 706 that has been changed.  Section 706 of the ADA standards has not been changed.  Once states adopt the new A117.1 building code, the IBC code will be more stringent than the ADA standards.

What exactly was accomplished at the ANSI A117.1 meeting?

Until A117.1 is officially adopted, slated for December 2014, hearing loop installers and advocates will be able to state to architects, designers, construction companies and building inspectors  that the proposal to modify the 2009 IBC was passed and will be changed to reference the IEC 60118-4 hearing loop standard.

It is important to keep in mind that once A117.1 is officially adopted it will not indicate that hearing loops are the assistive listening system of choice for hearing aid users nor does it recommend using hearing loops as the default assistive listening system.

Currently the ADA Standards lists FM and IR technology as an equivalent assistive listening option for people with hearing loss. The ADA guidelines fail to take the users’ preferences into account, one study show experienced hearing aid users preferring hearing loops over FM/IR technology nearly 9 to 1, nor does it mention the numerous advantages of hearing loops listed here: http://www.hearingloop.org/fq_preferred.htm).

That hearing loops should be considered the assistive listening system of choice, because they are fully hearing aid compatible and therefore do not require the use of an auxiliary receiver, needs to be addressed by the Hearing Loss Association of America (HLAA) and other consumer organization such as ALDA, NAD, TDI and AMPHL, when the ADA Accessibility Guidelines are up for review.

Juliette Sterkens, AuD
HLAA Hearing Loop Advocate