The Power of Hearing Loops: A Conversation with Juliette Sterkens and Susan Taulia

All right, everybody,

and welcome to another episode of this Week in Hearing.

I’m very excited to be joined today by Dr.

Juliette Sterkens and Dr. Susan Taulia

So thank you to very much for joining me today.

We’re going to have a conversation all about loops.

Juliette,

you’re a very big proponent of looping and all things looping,

so it made a lot of sense to have you on for this discussion.

And I really appreciate that you brought Susan as well to provide

a sort of first hand experience as a clinician that is really

kind of advocating for this on behalf of her patients and

in her community. So we’re going to get into all of that.

But first, why don’t we start with some introductions?

So I’ll kick it over to you, Juliette,

a little bit about who you are and what you do.

Thanks very much, Dave, for inviting us.

And I’m Juliet Sterkens.

Moved here from the Netherlands over 40 years ago,

studied speech pathology, then switched to audiology,

owned a private practice for almost 26 years in Wisconsin.

And since 2012,

I have been the HLAA National Hearing Loop Advocate.

I get grant funding and that allows me to really focus

on assistive listening. It’s not just about loops.

I keep saying that to everybody.

It’s really about helping our patients here, everywhere,

where their hearing aids are unable to deliver.

Awesome. Well, thanks for being here and Susan.

Hi, I am Susan Taulia.

I’m an audiologist in Lafayette, Indiana.

I’m a private practice owner.

We own the Lafayette hearing center.

And I started my career in large teaching hospital

and with Ear Nose and throat clinics.

Moved around some early in my career,

have been in Indiana since 2007.

I love working with Juliette.

I always say yes every opportunity I get.

She is fabulous. And so, Dave,

thank you again for inviting both of us to spread

the word about the beauty of hearing loops.

Absolutely. Thanks for being here.

So let’s start for anybody that isn’t well informed,

either of you can take this,

but do you want to just maybe give a background on what

loops are, how they work, the science, I guess, if you will,

behind this, maybe this would be good for you to do that.

Perfect, hearing loops in its simplest form.

Broadcast audio straight from a microphone,

could be a television, could be a podium,

could be a pulpit in a church.

Wirelessly to a hearing aid.

As long as the hearing aid has a telecoil and the telecoil has

been turned on, activated by the consumer, literally, you can.

Walk into a church in an auditorium,

but also a city cab in New York City or London

or in the Underground information point.

Switch your hearing aid to telecoil and get the sound from

the announcement or the PA system wirelessly

in the hearing aid. And as such,

it provides the best sound possible with

very high signal to noise ratios,

which means that people who have trouble hearing a background

of noise usually say, I can hear every word.

It’s like the minister is sitting right next to me,

and it’s been around for 40, 50 years.

But what is new is the hearing loop standard.

And so,

in a nutshell,

hearing loop sends clear audio straight into

telecoils of hearing aids. Beautiful.

Yeah,

it really is a fascinating technology.

It’s a very old technology, which is neat,

and

we’ll overlay an image of the logo,

and it’s cool to see these.

Once you see it, you see it everywhere,

but it’s one of those things that it really does.

To your point,

I think it adds value to T coil enabled hearing aids,

ones that have the T coil, like, literally integrated into it,

as well as some non hearing aid assistive devices

that are almost standalone for this application.

So you think of older adults that might

be inclined to go to church often,

and this gives them the ability to tether right

into that sound source. So, like you said,

it’s like the minister standing beside them or the priest.

It’s really cool technology.

So I think it’s one of those things where even

as it’s been around for as long as it is,

it’s kind of a chicken and an egg thing where it’s like

you have to have the environments that

you would be going into to be looped.

And so there needs to be awareness,

there needs to be advocacy of making the argument

for why these different venues should be looped,

which is why I’m really excited, Susan, that you’re here,

because I’m curious to kind of, like,

hear about your experience.

When was the first time that this started to become something

that you felt strongly about to the point to where you wanted

to start to get involved with some of these things,

maybe outside of the clinic where you are involving yourself

in your community to have these types of environments looped?

Can you just kind of give us a background of what your

experience has kind of been like

in this realm of your profession?

Well, I’m glad you asked that, Dave.

It’s a great question.

So where I live, we 10-15 years ago,

there were no loops here at all.

And after going. To a seminar hosted by Dr.

Sterkens and another audiologist in the Chicago area.

Dr. Linda Remensteider,

the woman that started the private

practice where I now work,

and I hosted an event this has been more than

ten years ago now, at a community center.

We got some people to come.

One of the people that came to that event was

the the head bishop of the diocese,

the Catholic diocese where we live.

And in that presentation,

we had a temporary loop set up by a loop installer,

and we talked about the importance of the signal

to noise ratio, like what Juliet mentioned.

And Juliette has a wonderful presentation that she does where

she’s got all the acoustics recorded in a church with

a live microphone, and then through the loop,

where you don’t have that reverberation.

And that was a real eye opener for particularly Father Dan,

who was there at our presentation.

And he promptly went back to his diocese and got money

to get the St. Mary’s Cathedral here in Lafayette Looped.

And that was the first loop besides our waiting room

in our area. And after that, it just kind of spread,

not as fast as wildfire, but it just spread, like,

little bit by little bit by little bit.

At first it was St.

Mary’s, and that was St.

Mary’s and St. Lawrence. And then it was St.

Mary’s, St. Lawrence and the Red Room at St.

Lawrence. And then it was St.

Mary’s, St. Lawrence and St.

Bonaface And it was just like one after another after another.

Now, a lot of the Catholic churches around here are looped,

and it’s kind of you have to remember which ones aren’t,

because they mostly are.

And then the Presbyterians started looping and then

The methodists.

It’s just kind of, like, spread out.

And Linda and Juliette both have a saying.

They said loops beget loops.

And I think that’s very true.

And one thing that’s kind of neat now we have a list

that we try to maintain of all the loops in our area.

And

I’m at the point now where we’re finding out that, oh,

we didn’t know that place got looped.

And so there’s stuff that’s not on our list because nobody even

told us that it got looped because they did it on their

own. That’s awesome. Which is really great.

Yeah.

So do you feel that it’s really interesting how you just

described the cascading effect, loops beget loops-

I think that’s really a great way to put it.

Are you finding that the people that are really advocating

for this are the churchgoers themselves?

Is it the clergy

who are the ones that are spreading the word of, hey,

I just saw that this church was looped.

We should really be I’m assuming it’s kind of a mix,

but can you give me any sense of that?

Of like,

who’s really kind of going to bat unbeknownst

to you about we need to have these things,

and we need to figure out how to raise money in order to do so.

I think this is one that both of us can probably address.

It’s a combination.

It’s a combination of patients and their loved ones saying,

I can’t.

Tell you how many times we’ve heard stories of

I almost stopped going to church because I couldn’t hear.

I almost canceled my theater tickets, my season tickets,

because I couldn’t hear anymore and it was not fun.

And now I can do it.

And people are excited.

It’s a combination of those people and then talking

to people who are in decision making positions.

So I call it people in power are people within for it.

You have to have those people in the mix and tied in because,

you know,

a church is a collection of people and not all,

not one person is going to make those kinds of decisions with

the church’s finances and the money and

then who’s going to do it and all of that.

So you have to have the push from people who would benefit

from it combined with people that are powerful enough

to make those decisions. Yeah.

And what I did, Dave,

for about a year and a half,

everybody who came into my office, I asked,

do you belong to a house of worship?

Do you like going to the library meetings or

do you go to the performing arts center?

And basically kept track of who went where.

And I live in a community with 75,000 people

and then surrounding communities.

Basically every time when somebody says, oh,

I belong to st. Mary’s, oh, I go to grace lutheran,

I basically put their name under the g for

grace lutheran and under the m from st.

Mary’s. So within a year I knew who went where.

And frequently our patients don’t know from

each other that they can’t hear in church.

They all sit there, they nod, they smile,

and they say amen because they know when they have to do that,

but they really aren’t hearing.

And by bringing those people together,

I was able to kind of literally get them to advocate.

I gave them tools,

but first you have to give them the experience.

So I don’t know, Susan,

if you sent lutherans to catholic churches,

but I did too, but I’m not catholic or I’m not Lutheran,

I don’t care.

Go

in the beginning,

we would actually have a little list of like,

these are the service times,

you’re welcome to go go and experience this.

And it’s interesting,

I brought this up at the university where

I did a lecture just a couple of days ago,

and they said that’s a question we cannot ask of our patients.

So being in private practice,

maybe I have a little bit more leeway,

but I was so involved with my patients,

and so when they started coming back saying,

I can hear every word in church and say, well,

where else do you go?

Where else? Why go to the library meeting sometime?

Or go to City hall,

basically.

I don’t want to say nudge them,

but encourage them to speak up and not

keep their inability of hearing a secret.

We need to tell people or the world when

a person with hearing loss isn’t hearing.

And I know Susan has developed really cute cards that give

patients permission to complain and

then to also help spread the word.

That’s very interesting. So in my mind, there’s this piece,

right, which is, like, developing patient advocacy,

making your patients their own advocates.

And I can imagine that’s actually probably a great way to

just dramatically enhance your word

of mouth value in your marketing.

Because you imagine that as soon as people start

singing the praises of, I have this hearing aid,

or even this Amplified device that I’m using in this setting,

chances are they’re telling their friends that, too, right?

So that could be a great source of referrals, I would imagine.

And basically, when a church got looped,

I frequently got called in to do a hearing loop dedication

or a little brief presentation from the pulpit.

And then I’d say,

I’ll be here afterwards if you have any questions about your

hearing aids I’m happy to look at your hearing aid.

And basically, I would send and look at hearing aids and say,

you need to go back to your audiologist

and have the T coil activated.

So within no time in the community,

people had heard or seen me.

And that was good. Pray then.

Yeah,

because you have this this is one of the different pillars.

And then I think that demonstrating the value and just

being able, like you said, having people go Catholics,

go to Lutheran churches and that stuff.

But I almost think of, like and I’m curious to ask you, Susan,

in your clinic, how are you,

I would imagine are you showing off what a loop sounds like?

Do you have a small personal loop, more or less,

to demonstrate how this works for people?

We have the luxury of having a pretty wide waiting room.

And so part of it is

got kind of what I call normal clinical type of chairs that

aren’t super comfortable. I mean, they’re not uncomfortable,

but they’re not like, plush or anything.

And then we have another side of our waiting room that is

set up kind of like a living room, and that area is looped.

And we actually leave the TV volume off,

and there’s a sign under the TV that says,

if you want help hearing this TV,

ask us or put your hearing aids on loop.

And so that area is lubed.

And then we also can demonstrate other systems.

Transmit TV into their hearing game.

So it’s a very comfortable setting.

And so a lot of patients that use the T coil,

they’ll just come in and turn the TV on

and sit down and put themselves on.

You got to go look for them.

And it’s a nice way to practically show people how to

use the loop to walk them out there and say, okay,

now get your app out and put it on T coil.

And then they’re like, oh, I could hear the TV.

haha

seeing is believing. Yeah,

that’s very interesting. Yeah, it’s hearing is believing Dave.

And they all say the same thing to their spouse.

Can you hear that? No, because they don’t have a t-coil.

Right.

And I would turn the volume very quiet on the television

so they could still hear it, but it was told very quiet.

And then I would make them switch back and forth so that

they fully understood that it’s really the loop

that’s helping them understand speech.

And that’s a great lead in to talk about TV Streamers,

because if you don’t do TV Streamers,

you’re missing this whole opportunity to get

people to hear television so much better.

Yeah,

I think that just the notion of being able to help

with communication across the board.

It’s positioning yourself as not just a single solution

professional.

I’m going to help tailor all aspects of your life

in any way that I possibly can to optimize it.

I think there’s tremendous opportunity there,

and I think that what you said, Susan,

setting up your waiting room in a way where you can

make it conducive to this, I think, is so powerful.

I’m sure you could attest to that,

whether it’s like proving the value of the

loop or being able to show people, like,

here’s what a TV listening device sounds like,

those kinds of things. Because to your point, Juliet, it is.

It’s like hearing is believing until you see it,

and you’re just sort of like reading the description of it.

It doesn’t click, it doesn’t register, I think,

the way that it does when you actually

get to experience it firsthand.

I think another thing that is really important for people

watching this to understand is that getting you can’t do

this as audiologists. We don’t have the background.

I mean, maybe a few of us do,

but most of us don’t have the engineering

background to do this ourselves.

You’re working, you’re doing your job every day.

You don’t have the time to go out and install loops,

for example, or things like that.

But you can empower your patients,

to empower the people in your community

to be advocates for this.

I mean,

there are tons of hearing impaired people out there,

and they all need help in these big, large public environments.

And all it takes is one or two who know people,

who know people to keep them motivated to get it to happen.

We’re in Purdue University’s backyard.

And there was an architect there that.

That works at the university, but he has hearing loss.

And he’s been very instrumental in getting university

to invest in hearing loop technology.

And there are a number of buildings on campus now

that are looped and classrooms and things like that.

And they even have a few classrooms

with what they call a reverse loop,

where there are microphones that can then feed back

into the system for anybody with a hearing loss,

whether you’re the lecturer or a participant in the room.

And of course,

that really requires smart and savvy hearing loop installers.

And not just a hearing loop installer,

but somebody who fully understands audio and knows how

to tap into the audio signal and whether a loop needs

to be fed with a handheld microphone, wireless,

or whether perhaps it can be done with microphones

hanging from the ceiling in a classroom.

Yes.

So this segues nicely into kind of the

last big section I wanted to discuss,

which is if I’m putting myself in the shoes of a provider that

is listening to this and they’re really excited about it all,

that the question is sort of like, where do you start,

in a way?

And a big part of this whole thing is the loop installation.

So I’m curious from both of you,

just what can you share with either your experience, Susan,

of what you’ve gone through?

It sounds like you’ve made some great connections that are

people that are savvy and they’re good at

this kind of thing, but just like in general,

where can you turn to find

any kind of existing installation

partners or anything like that?

Because it seems like this could be kind of part of the gap is,

I believe in this. I really want this to be a big part of it,

but how do I get that theater or that church looped?

It’s a process, right?

And so what are some of the things that

I’m sure you get these questions a lot.

How can people be thinking about this

and how can you speak to that?

Well,

we’re in the Midwest,

and we’re lucky enough to have a couple of loop installers

in our area. There’s a wonderful company,

Thunderhearing, that’s based out of Wisconsin,

and they

got a husband that went right through.

Yeah, tom and his son.

They have done a lot of the loops in this area.

And then there’s another gentleman who was

he ran an audio he runs an audio business and he went and

got specialized training from Contacta and has

done a lot of the loops in our area as well.

And

so, developing that relationship,

if you don’t have if you go to the manufacturer’s websites and

they don’t have anybody in your area listed as a contact person,

you might be able to foster a relationship with

somebody that it is really those audio,

the people that do audio in your area and talk to them and.

And see if you can get them interested in getting

some training to add this to what they do.

Yeah.

I was lucky enough that I had an engineer husband who said,

honey, if you let me retire, I’ll become the loop installer.

But it quickly dawned on us that we were not going

to loop Wisconsin. Right. It was its physical work.

It means installing the wire.

It’s ceilings in basements, crawling over floors.

The wire has to be installed where it must be

in order to create a strong magnetic field.

And these installers need to be trained.

This is not just, let’s put in plug in an FM system,

plug and play. In the Midwest,

there’s some really great installers,

and the first place to look would be hearing

loop.org under the word vendors.

So if you Google hearingloop.org and vendors,

there’s a number of vendors that pop up.

There’s another website called Time 2 Loop America.

Time number 2, loop America.

He also has a list of vendors.

And then frequently I get emails from audiologists.

There’s a church or there is a theater that’s getting

ready to remodel. Now is the time to put in a loop.

And that’s kind of when I jump into gear,

because there are loop installers who will literally

travel hundreds of miles to loop installations.

They’re efficient, they know what they can do,

and they can do it in a very short time.

And every hearing loop that has to be installed needs to a site

visit. You cannot just look at a picture and go, oh, yeah,

we can put a loop in this place because it really depends on

the amount of metal in the building, the size of the venue,

and the difficulty hiding the wire in effect.

So if there’s a beautiful Torazo floor,

it’s going to be a lot trickier than if there is a dropped

ceiling where the wire can be hidden in the dropped ceiling.

So this installer needs to come do a measurement,

verify that it can be done the way he envisions it can be done.

And that’s when you will end up with a quote.

Some of my patients literally stepped forward and said,

you mean a loop in my little Lutheran church cost four grand?

And I go, yeah. And they wrote out a check.

Wow. No lie.

These are the same patients who complained about the

high cost of hearing aids and they turn around.

Have you had the same thing?

Susan yeah,

frequently. Money is not the issue.

It’s they don’t know about it.

And if it’s something that will benefit the community,

people step forward.

Yeah, 100%. Is that you’ve gone through the same thing?

Susan oh, yeah.

I’m just thinking of my patient.

that paid to loop his own church,

and then some of his other people that

went to his church have come to us.

Do I have the T coil?

Can you turn it on your hearing aids?

It just feeds on itself.

And then of course,

it helps if you have connections with the newspaper.

We have a church lady who writes a column every Sunday,

and basically I would feed her information,

information in the beginning, every six months.

Now it’s been every couple of years.

We just looped 500 churches in Wisconsin.

So it’s a huge mile marker, over 850 venues.

Lot of libraries. There’s grant funding available for libraries.

Community foundations are frequently very

interested in learning about hearing loops.

Schools have ADA funding that they can

at least contribute to the cost of a loop.

But it means that you need patients who will praise loops

and announce that there’s or the venue

announces that there’s a loop.

And that brings me to that last point that we already talked

about before we went on the air, and that’s Google Maps, right?

It’s kind of the missing link.

How do you know where there is a hearing loop and there’s

a committee, the HLAA get in the Hearing Loop committee,

Githl committee.

And we are working with Google Maps to map every

hearing loop in this country on Google Maps.

So you need your phone app.

You Google a name under the term about.

You can then see whether a venue has a loop.

You can also write a review if you’ve used a

loop and you can also make a comment.

This place would really benefit from a hearing loop.

And there’s all kinds of tools on HLAA’s website

if you Google Get in the hearing loop,

githl toolkit for audiologists who are watching this,

there’s handouts,

there things you can share with your patients,

lots of information, and it can sound all very overwhelming.

This doesn’t happen overnight.

And I know that there’s discussion about new technology

coming around the corner. Bluetooth LE Audio.

It’s very promising. I’ve heard it at a conference in Budapest.

But it means every hearing aid, every smartphone,

every smart TV,

every silent TV at an airport is going to have to

be equipped with this Auracast technology.

It’s going to take time, and in the meantime,

our patients deserve to hear now, today.

Yeah,

you’re right.

I think it’s something that’s cause to be excited about on

the horizon. And in the interim, I think that there’s.

A lot that you can do.

I mean, I’ve learned a lot today just talking with YouTube.

I’ve kind of known about loops,

but I didn’t know the ins and the outs of it like this.

And it’s really good to know about these different resources

that you mentioned about where you can find a

local vendor that could do the loop installation.

I think the Google Maps piece integrating that is huge.

More visibility into this. Very cool.

So just find this to be

I think, as Susan can attest here, it’s just a great way to,

I think,

really enhance the overall perception that your patients in

the broader community has about the hearing healthcare

professional and the role that they play is not just

a place that you go to get fit with hearing aids,

but it’s much more than that.

This is a place that can and a professional that can really

enhance all of these different parts of your life

and these things that really matter to you.

I think that, as we’ve discussed today,

some of the different scenarios that mean a lot to people.

You don’t have to give up your season tickets at the theater.

You don’t have to stop going to church.

Those things can actually really be made.

You can give people the gift of restoring the ability to feel

like they’re connected again to those they belong.

They belong. And I think if I can make one more plug sure.

That is that we as a hearing care provider community,

have failed their patients by not checking out assistive

listening systems every time we go to the theater.

Because if you’re going to a theater and you pick up an FM

device or an infrared device and you find

out that it’s not working, or worse,

that they’re not feeding any sound into these systems,

these systems should come equipped with neck loops.

And I’ve certainly heard of consumers that they like using

the neck loop. At the Oriental Theater in Chicago,

they have listening devices that come with neck loops.

And that can certainly work.

But you first have to educate your patients,

and we have to try these devices out to be able to give the

feedback to the venues. Like you’ve got this system,

it’s not working. If you’re looking at upgrading,

may I make a suggestion?

You put in the loop and now you’ve kind of planted a seed,

right? Yes. Well said. Susan, closing thoughts?

Well,

don’t wait. If you thought about this, get out there and do it.

No one else is going to do this in your community.

You have to do it yourself.

So waiting isn’t going to help.

Get out there.

Put together a presentation,

invite everybody in your community that you can invite,

host a meeting and get it going,

because you’re the one one is going to have to do this.

And I’m happy to share powerpoints and slides.

You’re.

Do not have to reinvent the wheel if

you’re watching this presentation,

literally,

I get grant funding from

fund to help. Kind of fuel this momentum, right?

So you do not have to go at it alone.

That’s awesome. What’s the best way to contact you?

I’m at Juliet- Jsterkens@hearing loss.org

Perfect. Awesome. Well, Susan, Juliette,

thank you so much for coming on today, sharing all of this.

It’s been really enlightening, so I appreciate that.

And thanks for everybody who tuned in here to the end.

We will chat with you next time.