By David H. Kirkwood
One of the most exciting recent developments in the hearing care field is the growing use of induction loops in both public and private spaces. As Dr. David Myers, probably America’s most prominent advocate for hearing loops, wrote on this blog several month ago:
“The animating vision behind the Loop America campaign is nothing short of doubling hearing instrument functionality, by enabling them to serve an important second function as customized, wireless loudspeakers.”
It’s hard to think of anything more beneficial for people who wear hearing aids, for those who fit them, and for those who manufacture them, than a technology that so greatly increases the utility of hearing aids. The more ways that hearing aids can help them, the more satisfied users will be. And the more satisfied users are, the more likely their friends and family will be to get help for their hearing loss.
Just imagine if you or a patient or a friend who wears hearing aids could attend services in almost any local church or synagogue, enjoy a concert or a lecture in an auditorium in your area, take a guided tour of a historic building, or board a flight out of your regional airport and be confident that the speaker or musicians or public address system would be easily and clearly audible.
That requires no imagination at all if you live in or around Holland, Michigan. There, Dr. Myers, a hard-of-hearing psychology professor at Hope College, and those who have rallied behind his cause, have persuaded the owners and operators of a great many public facilities to install loops. As a result, when people with telecoil-equipped hearing aids—which means virtually everyone fitted with hearing aids in that part of Michigan area—go to looped facilities, they receive clear, customized sound from inside their ears.
Looping initiatives are also moving forward in other pockets of this country, from Manhattan to Sarasota, FL, and from Chicago to California’s Silicon Valley.
Even if hearing aid users don’t get out of the house much, they can still benefit from loops. If the room where they watch television is looped, they can enjoy watching TV without turning the volume up so high their family can’t stand to watch it with them. Bill Diles, an audiologist in California, has installed more than 1800 home loops and he reports that patient satisfaction has markedly improved.
Looping is beginning to make its mark on the national level. Last year, the American Academy of Audiology and the Hearing Loss Association of America launched “Get in the Hearing Loop,” a collaborative public education campaign. Their goal was to enlighten and excite hearing aid users, as well as audiologists and other professionals who dispense hearing aids, about the benefits of telecoils and hearing loops.
That effort helped generate very positive coverage of this technology in national media, including The New York Times, National Public Radio, AARP News, and Scientific American.
CHALLENGES REMAIN
In talking about his “avocational passion,” to “loop America,” Dave Myers says, “We are now approaching a cultural tipping point.” I think he’s right. However, there is still a long way to go before hearing aid wearers in this country enjoy anything like the access that they have in the United Kingdom, the Netherlands, and Scandinavia, where people expect public venues to be looped.
One issue here is that there are still relatively few areas of the country with enough looped facilities to raise public consciousness of this technology’s enormous potential. If people don’t know what they are missing, they won’t ask for it.
That’s why it is so important that those consumer advocates and hearing professionals who do recognize how much looping technology can do for people with hearing loss take up the cause.
SKEPTICISM ABOUT TELECOILS
There’s another issue that I’ve encountered in speaking with practitioners about hearing loops. I was surprised when two of the best-informed audiologists I know expressed reservations about the value of loop systems for many people, especially those with moderate losses who tend to wear open-fitting BTEs that amplify primarily high frequencies.
Both reported that their patients with less severe losses were often dissatisfied when they tried using their telecoil with the telephones. They didn’t like the sound quality, and they found it difficult to hold the phone in a position that allowed them to get what little benefit was available. Needless to say, this experience didn’t make either their patients or the audiologists positive about trying telecoils with loops—even if they had occasion to do so.
Juliette Sterkens acknowledged that the use of telecoils with telephones can be problematical, often because there’s an acoustic mismatch between phones and telecoils. However, she said, that’s not the case with loops, which have a frequency response up to 5000 Hz and work well with any type of hearing aid that has a properly placed telecoil.
As for the doubters, she said, “Audiologists who don’t believe that hearing loops are good for users have never been in a looped room with users.”
With all due respect to those who are skeptical about hearing loops, I find the testimony of the real experts compelling. By the “real experts,” I mean the hearing aid wearers I’ve talked to and traded e-mails with and read about. To a person, they say how their experiences with hearing loops have opened up new opportunities they had never enjoyed with hearing aids alone.
HEAR FOR YOURSELF
To hear out how much difference a loop can make for a hearing aid user, here are two links to videotapes.
The first, Looped Subway Station, courtesy of the Hearing Access Project, demonstrates what someone asking for directions at a New York City Subway information booth hears when not using and then using the loop, which is one of hundreds installed in the world’s largest subway system.
For a recording by Juliette Sterkens revealing what a church service sounds like with and without the heasring loop, go to Trinity Episcopal Church.
LET’S MOVE AHEAD
What can you do to advance the campaign to loop America? A good start is for everyone who buys or dispenses hearing aids to make sure they come with a t-coil. Now that t-coils have become smaller, the great majority of hearing aid styles can accommodate them, so you don’t have to sacrifice cosmetics for added hearing benefit.
And if you want to take the next step and help make your community more accessible to hearing aid users, then follow the lead of consumers such as Dave Myers in Michigan and Janice Schacter Lintz in New York and audiologists such as Juliette Sterkens of Oshkosh, WI, and Linda Remensnyder in the Chicago area and others too numerous to name.
Dr. Sterkens has compiled two lists of practical advice on loop advocacy—one for audiologists and one for consumers. I suggest that you check them out.
There is an enormous amount of information available online about hearing loops and how to advocate for them in your community. Among the sites I recommend are, in no special order: Hearing loop.org, AAA Get More from Hearing Aids, Loop Wisconsin, Audiology Today, a classic article from Dr. Mark Ross, an excellent piece from Audiology Online, and HLAA brochure.
Excellent article, David. In my experience, all properly installed (with interference issues solved) wireless systems work well with telecoils as long as audiologists program the telecoils correctly. Orientation is not an issue with phased array loops. And even with perimeter loops, a vertically mounted telecoil will still work with a phone, provided the telecoil programmed correctly. Of all of the wireless systems available, large area loops are, undisputedly, the easiest to use. I do not consider inductive technology to be old fashioned. On the contrary, it is a “classic” technology that has come of age. What IS old fashioned is to NOT counsel patients concerning how assistive technology can extend the reach of hearing aids and open the doors to an array of wonderful auditory experiences. To not provide patients with a way to conveniently access wireless systems is unethical certainly and not an example of best practices. Personally, I consider it malpractice. Some might say that focusing on loops ignores the other technologies (IR, FM, bluetooth/NFMI, 900 MHz, and 2.4 GHz), but I say it does the opposite. By showing consumers the auditory access they can achieve (and deserve), we show them what audiologists should be all about: Providing reception communication access. Once patient has listened to a loop, it becomes easier to show him or her all of the other possibilities available. People who use loops may also be open to other technologies that can provide improvement in face-to-face communication, the reception of media, and telephone reception. So I agree. Let’s move ahead and promote loop systems. By doing so, we make people happy, bring ourselves good press, see less hearing aid returns, and create world peace (well maybe not that last one). So kudos to the loop warriors! Let’s keep it going.
Thank you Cindy for speaking out so strongly about the need for hearing health professionals to tell their patients about assistive technology and to program their telecoils. This is a very common complaint that we hear from consumers. Venues with background noise, poor acoustics and long distances from the speaker diminish the amplification benefits of hearing aids and present significant and frustrating hearing challenges for patients. Its a quality of life issue for them that hearing health professionals just don’t get. It’s so short sighted to focus on the hearing aid alone because assistive technology gives more juice to hearing aids and makes patients more satisfied with their performance when they need it most. When are the providers going to wake up?
Excellent article David. You cover all the pertinent topics including the challenges we face to make American accessible. Quality of life is at stake for the growing number of hear of hearing Americans. Education for audiologists, the public and the hearing aid manufacturers is important. Professional installation by qualified installers is paramount to helping the hearing loops succeed.
Thank you for a great article!
Excellent, David, and right on comments from Brenda and Cindy. It is essential that hearing loops – a simple, rugged, and relatively inexpensive technology – be installed in as many places as possible. It is also essential that all hearing aids being manufactured today include tcoils.
I’d like to add just one conceptual tweak to the overall discussion, which is that it might to useful to consider hearing aids as simply one of many different kinds of assistive technologies available. I agree with Cindy that I, as a person with hearing loss, need “to conveniently access wireless systems” and that the best way to do that for many venues is via the combination of a telecoil in the hearing aid and the installation of a properly calibrated induction loop in the venue being fed with a good, strong audio signal. However, even if loops were far more numerous than they are, many of us with serious hearing losses would, in many circumstances, still need more than modern hearing aids offer. Until hearing aids exist that are far more flexible and powerful than present technology, we will need to avail ourselves of assistive devices in addition to hearing aids. Eventually, it would be nice if all assistive listening instruments would be delivered to the ear via a hearing aid. But we are not there yet. Therefore, we need to purchase and learn how to use assistive listening devices that require the removal of hearing aids and the use of earphones. It makes sense that hearing aid dispensers and audiologists carry such technology and offer training in its use.
At present, there is an enormous amount of information out there about such devices. Unfortunately, there is also a enormous amount of mis-information out there as well. This is due to inflated claims from manufacturers, as well as ignorance of how these devices can and should be used on the part of dispensers and users.