iPhones and Hearing-Aid Compatibility: Re-Defining Accessibility?

Gael Hannan
March 22, 2016
Kathi Mestayer takes a look at the possible changes to rules for wireless hearing aid compatibility, including Apple’s request to be exempt from putting telecoils in their iPhones.


By Kathi Mestayer



Apple has certainly been in its share of dust-ups lately.  Now there’s one that has raised eyebrows in the hard-of-hearing tech arena.  It has to do with the iPhone, hearing aid accessibility, and the FCC.

In November of last year, the FCC started things rolling with a Public Notice that they intended to review their existing rules for wireless hearing aid compatibility.  They also solicited comments on hearing aid compatibility and accessibility for wireless phone handsets.


Hearing loss and wireless tech organizations respond

In short order, a consortium of hearing-loss and wireless industry organizations, led by HLAA, submitted a consensus letter to the FCC.   Signatories included: Competitive Carriers Association, CTIA – The Wireless Association®, the Hearing Loss Association of America, the National Association of the Deaf, Telecommunications for the Deaf and Hard of Hearing, and the Telecommunications Industry Association.

The letter recommended that: “Within five years of the effective date of the new rules adopted, 85% of wireless handsets offered to consumers should be compliant with Sections 20.19(b)(1) and (b)(2).”  Those (existing) standards are detailed and quantitative, but FCC’s website offers a simplified description: telephones are hearing-aid compatible if they “have an internal feature that works with telecoil or T-coil hearing aids.”

The consensus letter also made several other recommendations, including interim compliance dates, inclusion of consumer and industry groups, and considering innovation.
A shot across the bow

Things got quiet for awhile.  Then, at the end of January, Apple submitted its comments to the FCC, proposing that the iPhone be exempted from the t-coil requirement.

Apple’s proposed alternative is its proprietary Bluetooth connection protocol that links MFi (Made For iPhone) hearing aids to the iPhone.  Although several manufacturers have acquired licenses to use Apple’s Bluetooth pairing in their hearing aids, the link only works between iPhones and MFi hearing aids.  And there is no hint in Apple’s FCC letter that that is going to change any time soon.

Apple’s arguments include the following:

  1. Bluetooth is better. Apple’s proprietary Bluetooth pairing “supports not only voice call output, but also lets individuals with MFi hearing aids access audio from FaceTime, VoiceOver, Siri (Apple’s intelligent personal assistant), turn-by-turn navigation, stereo music and movies, and output from third party apps, including games, audiobooks, and educational programs.”
  1. It’s not that expensive. Although there are a few MFi aids on the market, a recent visit to Costco revealed a price of $1799.99 for a pair of Kirkland’s version, manufactured by ReSound. The Hearing Instrument Specialist told me that those aids do not include t-coils as an option.  So, the train is pulling away from the station.
  1. Allowing proprietary approaches “Furthers the Goal of Technological Neutrality.” As Apple points out in their letter, “the FCC has not in the past, and should not now, require that manufacturers ubiquitously implement coupling technologies that can function with every hearing aid. To do so would undermine companies’ ability to attract consumers with hearing loss by differentiating their products in the marketplace, and would severely constrain innovation.”  (Section III.B)
  1. We need new compatibility standards. Apple suggests adopting a new qualitative testing protocol – “Method for the subjective assessment of intermediate quality level of audio systems,”which uses people (with normal hearing) to rate audio quality (Section 4.1.1.).


So, where does that leave the consumer?

Nick Hunn, Chair of Bluetooth’s Hearing Aid Working Group, puts it this way: “This might be good for Apple, but it’s an awful decision for everyone else.”

One reason is that people generally get new mobile phones far more often than we switch hearing aids.  Again, Hunn: “Apple actually encourages its users to upgrade their phones every year through its iPhone upgrade program, and most users upgrade at least once every 18 months.  But hearing-aid users typically change their hearing aids no more than once every five years.”   So if you have Apple’s MFi hearing aids, and decide to switch mobile phone brands, it might severely constrain innovation.


Not so fast!

Hunn’s primary argument is that Apple is jumping the gun by asking FCC to approve the proprietary system.  Hunn’s Bluetooth Working Group is developing a set of specifications that they anticipate “will be widely used and be interoperable for a variety of speech and music applications.  Our aim is to make it generic so that all manufacturers will want to use it.  It should add no cost to a phone, tablet or TV which already uses a Bluetooth chip, so we’re hoping it will become the standard for the next 10 – 15 years of Bluetooth audio,” Hunn points out.

As far as the timing goes, Hunn estimates that “We should have the spec complete sometime next year – it takes time to do all of the interoperability testing to make sure it works properly before we release it. Hearing loss is too important to make rushed decisions.”


FCC: Ball’s in Your Court

Apple’s letter to the FCC requesting an exemption from the t-coil compatibility standard reads like a good move for innovation and accessibility.  But it’s not that straightforward.  Apple’s decision to “go it alone” is, according to Hunn, “one that stands to disrupt the hearing-aid experience for millions – and fragment the hearing-aid business altogether.”

Perhaps the FCC should take a few deep breaths and see what the Bluetooth Working Group comes up with.  In practical, market terms, a proprietary solution to improving accessibility might be, in this case, an oxymoron.


kathi mestayerKathi Mestayer writes for Hearing Health Magazine, Be Hear Now on BeaconReader.com, and serves on the Board of the Virginia Department for the Deaf and Hard-of-Hearing.  In this photo she is using her iPhone with a neckloop, audio jack, and t-coils which connects her to FaceTime, VoiceOver, turn-by-turn navigation, stereo music and movies, and output from third party apps, including games, audiobooks, and educational programs.

birdsong hearing benefits
  1. I agree with you Kathi that Apple should not be allowed to redefine hearing-aid compatibility and accessibility. Thanks for writing this blog. I too agree that the FCC should say a loud “No!” to this rather sneaky proposal, and couched in wording to make you believe that Apple truly cares for those with hearing loss. An on-line petition on Change.org was created by Abram Bailey where you can voice your opinion in this matter. Please take a minute to do so and send a message to Apple and the FCC. To vote click here: http://bit.ly/fcchacpetition

    1. Well-said. How many signatures are on that petition now? I’m curious.

  2. Apple’s bluetooth solution is remarkable. It has changed my hearing aid experience and my life. Phone calls and music come right to my ears. I can listen to music thru my iphone and also cut out all background noise so i can use it in a gym. Clarity and vomprehension is measurably improved and its binaural. I hope bluetooth capatibility becomes standard in hearing aids and i can link dirct to TV or movies. That is the wsy this technology should be moving.

  3. “Bluetooth is better.” Certainly there are many arguments for and against this. Bluetooth is only one of several wireless options. Other 2.4GHz and 900MHz options are as good or better and offer the same experience as Paul writes here in the comments. Apple controls interoperation with it’s devices with an iron fist. MFi will never ever be open nor will it be accessible to competing cell phone manufacturers. The only way the FCC should consider ever dropping t-coil support is if a truly open multi-manufacturer wireless standard is developed. Right now the t-coil is the only one.

    The following quote is laughable, basically saying that anything coming out of the headphone jack is somehow special to Apple. Give me a break.

    “Apple’s proprietary Bluetooth pairing “supports not only voice call output, but also lets individuals with MFi hearing aids access audio from FaceTime, VoiceOver, Siri (Apple’s intelligent personal assistant), turn-by-turn navigation, stereo music and movies, and output from third party apps, including games, audiobooks, and educational programs.””

    1. …not to mention that rumors are circulating….again…that the next iPhone will not have a headphone jack. That will make me, and probably others, have to switch phones. Tough call? Not.

    2. I love that quote…BT does “voice call output, but also lets individuals with MFi hearing aids access audio from FaceTime, VoiceOver, Siri (Apple’s intelligent personal assistant), turn-by-turn navigation, stereo music and movies, and output from third party apps, including games, audiobooks, and educational programs.””
      I do all of that stuff with my telecoils and a neckloop. Hands-free. Great audio signal. Don’t tell anybody… 🙂

  4. Apple did not define anything – they created their own system, paid for it them selves and put it on their phones at no extra cost. Android is free to create their own, just as any hearing aid maker is free to adopt the MFI or not. Apple is saying “here it is, it works great on our phones.” The trouble is not Apple, it is the hearing aid makers all wanting to stake out their own little fiefdoms and not agree on anything. They want to sell their overpriced BT conversion devices for extra money. Telecoil is vastly inferior and ancient tech. My MFI aids and my iPhone work great together. Frankly, when I had them on a previous set of aids, I hated telecoils. But if the industry hangs its hat on telecoil compatibility, very soon, Bluetooth will come along and render telecoils moot. Then the “wearables” which are BT compatible and on the market now, will deal a grievous blow to the hearing aid business.

    1. Many people do like their telecoils, Rick. It allows them to connect to many other devices and systems besides telephones. Looped rooms, for example, in theatres, churches, etc. I want my phone to have both in them….sometimes the bluetooth doesn’t work as well for me on the iPhone as my telecoil.

      1. Amen. I wonder whether the “tcoils are old” argument is just that….old. I thought my turntable was obsolete until recently, when I discovered…..my 15-year-old nephew wanted vinyl albums for his birthday.

    2. Hey Rick, Have you ever attended a performance in the looped Marriott Theater? Have you ever attended a service in St. Mary’s Catholic Church in Oshkosh where this recording was made https://www.youtube.com/watch?v=_3XoVrUjfaY, have you ever read the testimonials on this website: http://www.loopwisconsin.com/DisplayTestimonials.

      There is nothing inferior and ancient about being able to hear. The telecoil is simply another way to pick a signal in a hearing instrument and this case it is wireless and through magnetic induction. That Telecoils could be improved upon, there is no doubt; Better noise reduction, a built in sensor to alert the user that they are in a hearing loop, optional and variable mixing of the Mic + telecoil response, you name it. But let’s not throw the baby out with the bathwater until a universal technology – that has all the advantages that telecoils have today – is on the market. And from what I gather, the latter is still 5-10 years out.

      1. I think Rick is talking about fidelity. Certainly neck loops are inferior to what we *could* have, but for many people it’s good enough. At least for voice. I agree that digital (like Bluetooth or other protocols) can be superior. I just hope that some standard is created. Maybe it will come out or the hearables market and maybe it will be Bluetooth LE.

        1. Entirely disagree. Most Bluetooth iterations I’ve heard sound awful and heavily compressed– they are not “good” by any standard. They’re also prone to dropouts and eat battery life, both on the phone and the aid.

          I’m not a huge fan of neckloops either, but earhooks solve the signal issues and deliver stereo sound through the telecoil system, just like any set of headphones. Telecoils are prone to interference issues, though, so i’ll give you that.

          As others have noted, telecoil is also far more flexible. It works extremely well with the phone handset directly (and, really, any phone, ever) and is flexible enough to work in other looped environments. There will come a point where a better standard will come along, but for now, FCC regulations are one of the few things ensuring that standards remain open and accessible to all HA users.

          It’s not realistic to expect theaters, taxis, subways, phone manufacturers, and more to build systems that work with a hodgepodge of standards. I’m thankful enough they’re required to build any systems at all– if the ADA and FCC didn’t require them, they almost certainly would not.

  5. Here in Lake County, Illinois (northern suburbs of Chicago, we have a looped city hall, a looped senior center, a looped senior residence facility, a looped auditorium, a looped meeting room in our community center, two looped places of worship, and a Landmark 5 cinema theatre in an adjacent suburb. The hearing aid industry will be ignoring the dual functionality of the telecoil by going down this route with Apple and I have serious concern why the American Academy of Audiology and the Academy of Doctors of Audiology is not making waves about this self-interested endeavor

  6. This is not an “or- or” issue. Consumers benefit from having access to BT technology AND telecoils as written about here: https://loopwisconsin.wordpress.com/2013/03/02/ready-to-buy-a-new-hearing-aid-be-sure-it-includes-bluetooth-and-telecoil-technology/ The good news is that most manufacturers now provide both options in one device or via the hand held gateway device.

    A survey published in Hearing Review asked 866 people 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.

    What is not to like about being able to hear in places where everyone knows hearing aids are unable to deliver due to distance, reverberation or background noise? Hearing loops offer simplicity of use (no need to seek out or fuss with extra equipment or linking or pairing), affordability (telecoils are essentially free), energy efficiency (with no drain on battery power), and customized sound (unlike the generic sound output of theater headsets). To hear the difference in and out of the loop Google “hearing loop” on YouTube where several videos are posted on this remarkable old (but so is the wheel or the wine glass, yes?) technology.

  7. This article and change.org proposal is wrong and misleading…

    1) Neck-loops are cumbersome, outdated, bulky and give mediocre performance (always moving the cable, trying to get equal audio quality in both ears, etc). But if you like that sort of thing, you’re more than welcome to it. If you want to talk about companies padding their bottom line, the exorbitant prices being charged for neck-loops and other peripherals is tantamount to price-fixing.

    2) The MFi experience is EXCELLENT, and avoids almost all of the negatives that come with a neck-loop…no bulky third product, no signal strength issues, etc…

    3) BUT MOST IMPORTANTLY (and where this article seems to mislead the most) is that the choice does NOT have to be between a hearing aid that is MFi OR a hearing aid with telecoil. Some aids have both…mine do. I wear the Resound Linx2. This largely negates the argument about people having to chose aids or a phone. I currently own an iPhone and I love my MFi connectivity. However, my laptop is (obviously) not MFI, so when I watch a movie there, I use the telecoils in my hearing aids. If I ever decide to stop using an Apple phone, I’ll get a phone that has telecoil in it. I’m NOT in any way constrained to my choice of phone by the hearing aids I’m using OR restrained in my choice of hearing aids by the phone I’m using. If I attend a conference which is looped, one touch of the Resound Smart App on my phone, and “bam” my telecoils are turned on, AND I can separately control the volume of the telecoil vs non-telecoil sound as well as EACH ear volume independently.

    And lastly, Apple is right…making such laws only constrains innovation. And the only people who like to constrain innovation are those who are unwilling, for one reason or another, to learn something new, OR, those who are making lots of money off the current/old way, and don’t want to lose that. IF there are enough people who don’t like it if Apple iPhones don’t have a telecoil, then fine, let them talk with their wallets. But there aren’t..there are just a vocal few…I’m only 36…as my generation ages, I can guarantee you we have NO interest in neck-loops when our aids can have the option to stream in much more efficient ways.

    1. Wes, it’s not about what hearing aids have in them, but what the phones have. My hearing aids have both Bluetooth and telecoils. Bluetooth is great in certain situations but my telecoils connect me in loped rooms, museums, etc.

      1. I understand…but your telecoils don’t connect you through your phone, do they? You use the telecoils in your hearing aids with a different/third device, correct? So in this case, there’s no benefit to the iPhone having telecoil. Thus, there’s no reason that Apple (or any other phone manufacturer) should be required by law (though one would think that they’d be motivated by the money from the demographic, and that would be reason enough, but that’s their decision) to include telecoil. Or is there something (a device/technology) I”m not aware of by which the telecoil in our phone connects us to looped environments (because that WOULD be great).

        1. Hello Wes,

          New hi-fidelity T-coil equipped headphones by Otojoy are expected on the market soon: http://www.facebook.com/photo.php?fbid=10207400456030835&set=a.1595915539023.2076767.1270011423&type=3&theater

          This means that to hear in a hearing loop one can use a
          1) hearing aid or CI equipped with a telecoil
          2) gateway device with telecoil, like the Oticon Streamer Pro or the Widex M-Dex
          3) and soon…a smart phone – equipped with a sound app like SoundAPR or Petralex and these new LoopBuds by Otojoy

          I agree that if Apple could fix it in such a way that an on-board iPhone telecoil could pick up the hearing loop signal, Apple could market the iPhone as a universal loop listening device.
          A small study in a looped auditorium at Northern Illinois University demonstrated that nearly 98% of hearing aid users and 48% of NORMAL hearing students said they would be very likely/likely to use loop technology were it available. As a non-native English speaker and someone who has used a hearing aid or a loop listener in hundreds of hearing loops around the world– I can tell you that it is GREAT to be able to hear in a loop as it ensures excellent audibility and intelligibility and thus makes it easier to concentrate to What is being said. Of course the orientation of the telecoil inside the iPhone, for use in a loop, is important and will require the user to hold the phone in such a way that the telecoil is aligned (+/- 45 degrees) with the direction of the magnetic field.

  8. You guys are making me feel like I’ve been living under a rock! I’ve worn Hearing aids for about 15 yrs and just this week after doing some extracurricular reading I’m learning what I’ve been missing. Makes me sick. Just how or where should I have heard this exciting info. My hearing Specialist is apparently not so special. I live in Mn.that’s not too far from Wisc. How /where do I start?

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