We all know that technology is terrific. It really is. Hearing aids, cochlear implants and BAHA’s provide great access to speech and other auditory stimuli. BUT, we also know that there are a lot of situations in which a child with hearing loss cannot hear well. Hearing aids, cochlear implants and BAHA’s work well when the talker and listener are close by and it is quiet. How often is that? Well, not often enough, that’s for sure.
Where do you need to hear?
How do you manage hearing on the playground when you are 10 feet from other kids and it is noisy? How do you hear on the phone when you can’t see the person who is talking? How do you hear in the auditorium of school, or in the movies? How do you hear at the dinner table when the dishwasher is on? And, of course, classrooms. How do you hear movies and computers.
Hearing Assistive Technology (HAT)
All children need HAT. Everyone acknowledges that FM systems are great for school, but is that the only place they are needed? And what do kids need to hear in school? Do they only need to hear the teacher? Obviously not. They need to hear other kids asking questions; they need to hear classroom discussion; they need to hear movies in the classroom; they need to hear when working with the computer. They need to hear in the auditorium. They need to hear on the playground.
FM systems
FM systems are a great classroom solution. Teachers wear an FM transmitter and the kids have a receiver attached to their personal technology. But if children need to hear their peers in the class, there needs to be a pass-around microphone that the other kids use. The school-based audiologist needs to assist in connecting the FM system to classroom technology. A hearing loop system may be useful in the auditorium, but it will not provide as clear a signal as an FM system because the telecoil of the hearing aid usually has a reduced frequency range.
Home-based listening
It is important to be able to hear well at home too. FM systems can be used at the dinner table, or connected to the TV. An FM mic can be placed on siblings or on other playmates. A hearing loop system can also be used at home to facilitate hearing in a variety of situations.
Pre-school
Don’t pre-schoolers need to hear? Many audiologists believe that we should not be putting FM systems on children until they can report when the system is not working well. I understand their reasoning, but I disagree with their conclusion. For children to develop excellent language and literacy it is essential that they hear well enough all day long. If the child is using a hearing aid or a BAHA, the parent or teacher can listen to the system to be sure that it is working.
This is not possible with a cochlear implant. However, by observing the child carefully, it is possible to recognize if the child is not hearing well. Since the child will not use the FM system full time, families and teachers will have the opportunity to observe if a child is hearing differently with and without the FM.
Phone
Kids need to be able to use the telephone. With texting and email it may be less critical than it was 10 years back, but sometimes you still do need to use the phone. Families need to be encouraged to try different phones to determine which one provides the best signal. Hearing binaurally works better than hearing monaurally, so whenever possible connecting to both ears is best. Bluetooth can often help.
iPads, computers, etc.
As soon as kids are interested in doing so, we need to help them connect with their technology. Clinical audiologists and school-based audiologists should be able to help kids connect to any form of technology.
Conclusion
We need to remember that kids need to hear all day, every day. They need to hear everything that their typical hearing peers hear. So, let’s keep our eyes and ear open and be sure that we are helping kids connect.
Featured image from http://www.karthikchidambaram.com.
We are working to change the misconception that telecoils do not a broad enough frequency response.
Before I delved into hearing loops a few years ago I was skeptical about telecoils too. Frankly – I had never really studied the telecoil spec – and even today I bet that 9 out of 10 audiologists cannot tell what input signal is used to test telecoils (mA/m) and how this magnetic signal relates to the acoustic signal (70dB SPL equals 100mA/m and 31.6Ma/m equals 60dB SPL).
The typical response from many professionals is that this is “old” technology – well frankly so is the wineglass or the wheel on a car. There is a lot misinformation out there based on old information and experiences of old hearing loops. These loops and these telecoils are not old… the standard is new, sound phenomenal when installed to the IEC standard, the telecoil response is so much better matched to frequency response of the hearing and many have frequency responses that extend beyond 5000Hz for example see the ReSound specs here http://www.gnresound.com/~/media/DownloadLibrary/ReSound/00-local-downloads/US/resound-verso/datasheets/Verso%20Spec%20Sheet%20for%20RIE.ashx
My study among adult consumers showed they prefer hearing loops over 8 to 1. There is very little recent info out there among younger kids. There is one (albeit small) study that did study the preferences of students with hearing loss see here: http://www.cfh.dk/%28informationsmateriale/materialer/Do%20school%20children%20with%20hearing%20loss.pdf When these students were asked what type of technology they preferred – and this involved loops that met the IEC standard in classrooms of the Danish Fredericia school –there was clear a preference among the students who preferred/used assistive technology – the loop was preferred over FM nearly 3 to 1!