Hearing Loops: What consumers and professionals need to know

Hearing loops have been in use for more than five decades in Europe and are widely used in museums, transportation systems, even stadiums. Yet, North Americans have been reluctant to embrace this simple, cost-effective technology which provides an invisible, direct, wireless connection between hearing aids or cochlear devices and listening environments.

Recently, the Canadian Hard of Hearing Association began a discussion about how to promote looping technology to better serve the more than 3.1 million Canadians who suffer from hearing loss.

There’s just one problem: many consumers and installers complain that hearing professionals don’t activate their telecoils or T-coils, or even bother to tell their customers that the looping technology exists and is available for churches, businesses or public institutions.

“Unprogrammed T-coils virtually nullify usage - unless one wants to use a receiver and headphones which is nothing more than a "un-T-coil / loop" mentality,” says Bill Droogendyk, a loop installer and owner of Better Hearing Solutions. He reports a general lack of interest and awareness about the benefits to looping among hearing health care providers.

We talked to Juliette Sterkens (AuD), an award-winning American advocate for hearing loops, about what hearing health professionals can do to promote the use of hearing loops, and about the challenges ahead.

 

Rose Simpson: Looping has been used extensively throughout Europe for decades, yet it has failed to catch on in North America. Why are professionals reluctant to embrace this as a tool for their patients?

Juliette Sterkens: What is needed is education of the audiologists and hearing healthcare providers. They put too much faith in the hearing aids and CIs, or too much faith in upgrading to more technologically “advanced” hearing aids.  But even the best of hearing aids cannot give a person with hearing loss normal hearing nor can hearing aids restore the users’ auditory processing issues (just like new running shoes don’t make you a marathon runner). Plus hearing aids cannot overcome poor acoustics, distance and background noise that occurs from all around. Yes, new directional microphones can make a difference if the noise is less than six feet away, if the noise is behind the person and if the person’s auditory processing issues are not too involved.  

(Background: In our case, in the United States at least, in the past, few hearing aids had the built in T-coil, unlike the European hearing aid users whose government (national health service) issued hearing aids that had built in T-coils. The focus (for years) has been on small (and hearing aids were made small by removing… you guessed it… the telecoil). Today, the availability of t-coils is on the rise because more hearing aid users are going to the BTE models and it is estimated that over 70% of the devices now have the telecoil built in or in a remote control or streamer.)

RS: What is being done to create greater awareness among the professional population about the advantages of turning on the T-coil?

This education is happening through articles in professional magazines, webinars,  letters on professional list serves and presentations at professional conferences – you can imagine that this was  s-l-o-w going when  only a few people like Dave Myers (from www.hearingloop.org) and I traveled the country to do this. The good news is looping is picking up speed thanks to hundreds of active Hearing Loss Association of America (HLAA) members, who, having experienced loops at the last several HLAA annual conventions, are actively working to loop their communities.  

The reason hearing professionals are “in the dark” as you have indicated is because some may not keep up with the professional journals where there has been a lot published on looping in the last several years.  Some professionals  don’t attend professional meetings and  rely on the manufacturers for their continuing education or CEUs. And the hearing aid manufacturers don’t educate the AuDs and Hearing Health Care Providers (HHPs) about the telecoils – they’d rather talk about what is new, sexy such as Bluetooth, wireless microphones, streamers and Made for iPhone technology – so the professionals are not educated about the telecoil, how to program the telecoils and how to teach clients how to benefit from telecoils.

 

An example: Recently I heard of a professional who discouraged a minister of installing a loop claiming that loops don’t equally serve those not equipped with hearing devices and that FM systems are the preferred technology. This person is misinformed: Hearing loops can serve 100 percent of people, by direct connection to the telecoils in hearing aids and cochlear implants as well as through loop receivers and head sets, if need be. Plus, experienced users, as shown in a recent study (2) prefer loops 9 to 1 over FM or Infrared technology.

 

RS: Where does the patient fit in?

 

JS: Audiologists don’t educate clients on the benefits of telecoils, they do not tell them about their right to reasonable access under the ADA, they do not teach them to use assistive technology nor do they demonstrate the telecoil in the office (See 1,2)   Not even the most hard of hearing clients are taught – a disgrace in my opinion. When clients don’t know any better they don’t speak up – they stop attending and unfortunately few join HLAA or other support groups where they could learn from experienced peers. They also report reduced satisfaction with their hearing devices, which is not in the hearing industry’s best interest (see 3 and 4). 

 

RS: What do you think is needed in the future to encourage the public to embrace the T-coil?

 

JS: What is needed is:

 

·        Consumer education via – associations, articles in AARP, senior magazines, newspapers etc. Some of this is happening.  When newspapers pick up stories about loops; we have seen loops appear.

·        Parents of children with hearing aids and CIs need educating.(See 5)  

·        Audio visual engineers need educating and training on how to install hearing loops (as loops can be difficult to install and most engineers face somewhat of a learning curve) and they need to be educated why users prefer loops over FM or infrared technology as shown in a recent study published in the Hearing Review (See 2)

·        Ministers, theater operators, senior centre operators and business owners need to be educated about this technology and how it will greatly improve accessibility and may actually increase business (See 6).

·        Building/construction companies and architects need to be brought up to speed, on how to specify loops including with each building design.

RS: What role does the hearing aid industry need to play?

JS: The hearing aid industry is not really fully supporting this movement. In fact, they recently announced that they are going to work to bring about a new digital wireless standard for hearing aids. That is nice but sounds somewhat disingenuous (what have they done to help with large area assistive listening technology in the past?) and the question is whether this will really happen very soon. Some experts predict it will take 5-10 years (see 7), some even suggest it may never happen. When the hearing industry makes such an announcement, they essentially discourage audiologists or consumers to bring about looping in their communities. After all, if a new wireless standard will happen “soon” – why would anyone bother with the hard wire installation of loops?

I say install loops now  to help today’s hearing device users , and when a new wireless standard does happen, be it 5, 7 or 10 years from now (imagine how long it will take for all current hearing aids to be replaced with instruments that offer this new wireless “chip”)  we will work just as hard  for places that have a loop installed to add a small wireless transmitter for the “new” hearing aids to work side-by-side with the loops for as long as people have telecoils:  make sense?  And if the new wireless standard does not happen – then we haven’t lost valuable time.  Just like my husband says: “I was promised a jetpack in the 1960’s and I still don’t have one.” What if this new digital wireless hearing device standard is all pie-in-the-sky for hearing aid users?

 RS: Do you have any advice for professionals who want to advocate on behalf of the use of hearing loops?

 

I recommend  that AuDs/HHPs start by educating themselves by reading some of the practical articles which  can be found on line (see 8, 9 and 10) and:

 

·        Install a hearing loop in their waiting and/or treatment rooms

·        Demonstrate the loop to each and every client as well as their significant others

·        Offer  clients materials to bring the technology to the attention of their churches (that is where loops can quickly gain momentum) (See http://www.loopwisconsin.com/PDFFiles/Card3.pdf and http://www.hearingloop.org/00TechWorship.pdf)

·        Donate funds towards loops or encourage their clients to make a difference

·        Educate their community on the benefits of loop  technology by public speaking and holding special “Hearing Loop Community Events” (See 11)

·        Reach out to AV engineers, refer them to articles in the professional audio magazines on looping and encourage them to attend training in the IEC Hearing Loop Standard (See 12 )

·        Invite speakers to their professional conferences to present on hearing loop technology

Yes this will take time – but most worthwhile things take time and are rarely easy. But to hear someone say they could hear every word at a wedding, a meeting or a play – makes this work very worthwhile.

(Dr. Juliëtte Sterkens recently retired from her private practice in Oshkosh, WI and travels to educate consumers and hearing care professionals as the HLAA National Hearing Loop Advocate thanks to a grant from the Carol and David Myers Family Foundation. She is the creator of www.loopwisconsin.com. Her efforts have led to well over 400 hearing loops in Wisconsin and many more beyond. She can be reached via jsterkens@hearingloss.org )

References:               

1.      http://www.hearingresearch.org/ross/hearing_aid_use/hearing_aid_services_and_satisfaction_the_consumer_viewpoint.php    

2.      http://www.hearingreview.com/2014/09/consumer-perceptions-impact-inductively-looped-venues-utility-hearing-devices/

3.      http://bhscouncil.org/pdfs/M8_Hearing_aid_satisfisfaction_2010.pdf

4.      https://www.phonakpro.com/content/dam/phonak/b2b/FM_eLibrary/Increasing_hearing_aid_adoption_through_multiple_environmental_listening_utility.pdf

5.      http://www.listeningandspokenlanguage.org/HearingLoops/

6.      http://www.marriotttheatre.com/listening-device  

7.      http://hearinghealthmatters.org/hearingnewswatch/2014/hearing-industry-seeks-new-wireless-standard-hearing-aids-t-coil-advocates-say-fast/

8.      A “How to Guide” for Practitioners at www.loopwisconsin.com/PDFFiles/ADA-invigoratepracticeLR.pdf  and “Telecoil Essentials” at www.loopwisconsin.com/PDFFiles/ADA-getinloopJS.pdf

9.      “Roadmap to a Looped Community” article (with permission from American Academy of Audiology): www.loopwisconsin.com/PDFFiles/SterkensATMayJun.pdf  

10.   “Hearing Loops: The WOW Factor—Hearing Beyond 8 Feet”, an AudiologyOnline webinar at: www.audiologyonline.com/audiology-ceus/course/hearing-loops-wow-factor-beyond-24045

11.    Tools and useful resources created by Academy of Audiology and Hearing Loss Association of America Get in the Loop Joint Task Force at: www.audiology.org/publications-resources/consumer-information/get-hearing-loop and http://www.hearingloss.org/content/get-hearing-loop

http://www.hearingloop.org/SoundCommunicationsArticle_2010.pdf