Get your patients excited about loops! – guest post by Juliette Sterkens

Hearing loops broadcast sound from a sound source wirelessly to hearing aids. All users need to do is switch their hearing aid to the telecoil or Mic + telecoil mode. Hearing loops provide phenomenal hearing in situations where poor acoustics, reduced word discrimination and auditory processing problems would have made understanding nearly impossible.

Information about this “directly hearing aid-compatible” assistive listening has recently been featured in Scientific American, as a cover story in the Hearing Review, on NPR’s Science Friday, and in other print media. Mark Ross has written extensively about the benefits of telecoils as have Doug Beck and Preben Brunved. Sergei Kochkin of the Better Hearing Institute has long advocated for increased utility of hearing aids and envisions a future with “miniaturized wireless receivers in every hearing aid”.

How to get in the loop you ask? For starters read how Dr. David Myers, who uses hearing aids, brought hearing loops to his community. Read about my efforts in Wisconsin on the BHI website and in Women .  In our Fox Valley Hearing Center practice we familiarize each patient with the telecoil, providing a hearing loop handout with area installations on the back and taking 5 minutes to demonstrate the loop in the waiting room.

I offer the let’s loop America’s Worship Centers  article to anyone willing to bring loop technology to the attention of their church council.  My patients delight in doing the latter!   It is easy to bring attention to hearing loops in your community by presenting a “Get in the Loop” lecture to service or Sertoma clubs , church groups and local HLAA chapters. The American Academy of Audiology offers a free PowerPoint slide show  and fact sheet.  Donate a hearing loop to your local Senior Center.

Unlike smaller loops that are designed for a single room, large area hearing loops must meet IEC 60118-4  standard and require trained hearing loop vendors. If there is no installer in your area, you might be able to interest a local A/V contractor with this Sound & Communications article. Two years ago there were no trained hearing loop installation companies in Wisconsin; now there are nearly a dozen!

This blog post was contributed by Dr. Juliette Sterkens, AuD, an audiologist and owner of Fox Valley Hearing Center, Inc. in Oshkosh, Wisconsin. She was honored in 2011 by the Wisconsin Speech & Hearing Association as the Audiologist of the Year and recently awarded the prestigious President’s Award at the 2011 AudiologyNow Annual Convention in Chicago for her efforts in looping America. For more information and answers to your questions about hearing loops, please contact Dr. Sterkens directly via e-mail at jsterkens@new.rr.com

About AU Bankaitis

A.U. Bankaitis, PhD is a clinical Audiologist with extensive clinical, research, and business experience within the hearing industry. Dr. Bankaitis created this blog to educate her colleagues on viable product solutions for their patients and/or clinical practice.
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18 Responses to Get your patients excited about loops! – guest post by Juliette Sterkens

  1. Years ago I did a comparison of induction loops, FM, and IR systems for the ADA manual. All systems have their pros and cons and my experience has been that, when properly installed, each system can work well. Regarding electromagnetic interference when using the telecoil: This can occur with ALL three systems for hearing aid users who depend on the telecoil for interfacing to FM and IR receivers (using neck loops). Years ago I was also hired to review IR and FM systems in a group of movie theaters in the DC area (no loops had been installed). My investigation found that there were interference issues with many of the IR and FM systems due to poor installation and poor choice of product. Again, by adherence to strict performance standards and by employing careful installation, these issues can be removed. Of all the systems out there, I have to agree that the loop system is the easiest to use because it’s “just there” and all the hearing aid user has to do it walk into the venue, flip to “T” and enjoy (provided the user has telecoils and those telecoils have been programmed properly). In some situations, a person might prefer an IR system as, unlike loops, it can provide true stereo (dichotic) sound. Whether or not this is an issue depends, of course, on the person’s preference and on how the music sound track has been recorded (some sound tracks provide obvious separation and others do not). Let’s just all agree that this Looping America initiative is a great thing because it is (1) providing access where access is needed and (2) it is calling attention to a long-standing issue that needs to go away. Everyone deserves receptive communication access. Hurray for Looping America!

    • aubankaitis says:

      Thank you for your feeback and sharing your research experiences. This is great information to share and I appreciate you taking the time to share your knowledge!

    • Regarding electromagnetic interference when using the telecoil: This can occur with ALL three systems for hearing aid users who depend on the telecoil for interfacing to FM and IR receivers (using neck loops).

      No kidding! Just because you use FM or IR to bring the audio to the user, if you switch on the T-coil in an EMI-rich environment to transmit it the last few inches, the T-coil will faithfully pick up the noise and reproduce it in the users’ ears.

      My investigation found that there were interference issues with many of the IR and FM systems due to poor installation and poor choice of product. Again, by adherence to strict performance standards and by employing careful installation, these issues can be removed.

      EMI has nothing to do with the loop “installation,” as it’s pretty well idiot-proof: The issue is of electromagnetic interference to the baseband audio signal from other sources.

      Dan Schwartz,
      Editor, The Hearing Blog
      Follow The Hearing Blog on Facebook

  2. Some hearing aid users who experience a hearing loop for the first time are emotionally blown away by the experience. I think this because they remember years of frustration, having missed so much and then realizing that in a loop you no longer have to “reach for the sound” because the sound comes right to YOU and the voices appear to be inside your head. No need to reach, No need to strain or struggle or fill in the gaps. Just sit back and listen and enjoy what is being said. The tears are tears of joy for the wonder of the whole experience. I will never tire of attending hearing loop dedications in houses of worship – they lift me up and remind me why I became an audiologist.

  3. Really, Great blog, You are doing great job with your blog. I like your information. Hearing loops provide phenomenal hearing in situations where poor acoustics, reduced word discrimination and auditory processing problems would have made understanding nearly impossible.

  4. aubankaitis says:

    Check out this link on AudiologyOnline about loops that was recently published by Juliette; another great informational piece to read up on at http://www.audiologyonline.com/articles/article_detail.asp?article_id=2388

  5. David Myers says:

    Regarding interference, the good news is that we now have a couple hundred successful loop installations here in west Michigan, and there are tens of thousands in the UK, and interference just isn’t a problem. There have been a few cases with old fluorescent lights or some other such interference source, but our loop professionals have easily resolved such issues in virtually every case. The experience of so many Scandinavians and Brits, and now of so many hundreds of venues across the USA, happily validates the practical possibility of assistive listening that is directly hearing aid compatible.

  6. aubankaitis says:

    Hi Dan:
    It seems that many of the points that you bring up do have potential solutions. For example:
    RE: Hearing Aid T-coil orientation: hearing instrument wearers have solved this issue by tilting the handset of the telephone to match the telephone’s magnetic field to the t-coil oreintation. Not that differnt from when one has to adjust the antennae on a portable radio to bettter receive an AM or FM station

    RE: Electromagnetic Interference: PROPERLY installed wiring will not generate magnetic noise. The devices you mentioned do give off noise but only nearby. Venues that use hearing loops (churches, theaters, or meeting rooms) usually don’t have those devices in the area where the loop in being used.

    RE: Distortion and Attentuaion of Magnetic Field: metal can certainly be a challenge but can be overcome by using an 8 loop, or, in extreme situations, a phased array in which the loop wires are closer together and overcome the loss

    RE: Energy inefficiency: loops use comparable power to equivalent sound systems.

    RE: ADA compliance: not completely sure of what market penetration has to do with a viable solution particularly since loops are probably the least expensive way of assisting a mass of people than any other competing assistive technology.

    RE: Theaters have standardized infra-red: It is not uncommon for theaters with 95KHz listening systems to have a broken transmitter and/or not enough headsets, and/or not to have the transmitter on. With infra-red systems, you are required to wear a headset. As a hearing aid wearer, you must remove your hearing aids to wear the headset. The headset will not be programmed to the user’s needs. It would be more efficient to just be able to switch your hearing instrument to t-coil mode in a looped theater.

    Rather than getting into a back and forth, the bottom line is that no system will help everyone. Every solution or system may have limitations and that doesn’t mean that the solution is stupid, useless, or not appropriate. I think many of us, including me, could benefit from attending a loop installation class to learn more about loops and, in particular, ways to overcome the issues that have been brought up in your feedback.

  7. Some of my clients have extremely poor discrim in the 30-40% range; are unable to complete a Q-SIN and score over 6 or 8 dB SNR on the BKB yet they will report to be able to hear each and every word in church. See comments on my website: http://www.foxvalleyhearingloop.com/Testimonials.aspx

  8. Thanks, full of info… What are the levels of speech discrimination that must exist to really benefit from these hearing aids?

    • aubankaitis says:

      Martha:
      Not sure what your question is; are you curious as to what type of hearing instrument wearer may benefit from a looped environment?

    • Martha, the object of any room assistive listening system — FM, IR (infra-red), or baseband — is to remove deleterious room listening conditions, such as background noise and reverberation, bringing the sound directly to the hearing impaired users’ ears… And without introducing new challenges, such as additional noise.

      As an Electrical Engineer and Hearing Aid Dispenser, I do NOT recommend induction “hearing” loops, as IR and FM technology do not suffer the electromagnetic interference (humming, buzzing & whining) problems that plague ALL hearing aids when the T-coils are switched on.

      • aubankaitis says:

        Dan:
        infra-red systems are also susceptible to intereference from sources and can result in humming and buzzing. In addition, infra-red requires direct line of site; otherwise you end up with static. Just wanted to clarify so that people don’t think infra-red is a solution without inherent challenges!

    • Hi Martha,

      Read a recent study among 866 hearing aid and CI users published in the Oct 2014 Hearing Review: The users reported that their hearing ability improved from a “5” to nearly a “9” (on a scale where “1” meant they could not hear a word and “10” meant they could hear every word) – over 70% of the participants had severe to profound hearing loss!!! Less than 5% reported to get little or no benefit from a loop.
      http://www.hearingreview.com/2014/09/consumer-perceptions-impact-inductively-looped-venues-utility-hearing-devices/
      From this study it is clear that just about all hearing aid users benefit from loops (as did some normal hearing students ) and not just “some” as audiologist Dennis VanVliet suggested in his Final Word Column in that same issue of the Hearing Review.

    • Hi Martha,

      You may want to read a recent article in the Hearing Review: http://www.hearingreview.com/2014/09/consumer-perceptions-impact-inductively-looped-venues-utility-hearing-devices/. It is my experience that nearly all hearing device users (except those clients whose extremely poor word discrimination requires visual clues/lipreading in order to understand) benefit from hearing loops. Please note that my findings showed that the hearing experience out of the loop averaged less than 5 (on a 10 point scale) and it increased to an 8.7 in the loop. Do read the users comments – they are overwhelmingly positive. Small wonder – a loop connects them wirelessly to the mic of the PA system.

      A small study at Northern Illinois University showed that even normal hearing students like listening in a loop. We are unfortunately at least a decade if not longer away from a universal wireless solution that fits inside a hearing instrument or streamer, as finding a radio channel acceptable to all the administrations in the world is unlikely going to be easy.

      Here is my other thought for the day: The hearing industry has known for years that telecoils and loops work extremely well together yet have failed to educate the providers, the consumers or the venues to take advantage of this technology – so what makes you think that they suddenly have only the best for these groups at heart and will work like crazy to come up with a solution for far-field hearing/in those places where we know hearing aids and CIs are unable to deliver. Their effort (read more here: http://www.bluetooth.com/Pages/Press-Releases-Detail.aspx?ItemID=206) seems insincere if you ask me. The MFRs have an interest in perpetuating the myth that the reason a consumer cannot hear is because he/she is not wearing the latest and greatest technology and keep them buying into the “upgrade every 4-5 years is needed” myth.

      How long will hearing aid users have to wait? Who is going to install these new systems? Hearing loop advocacy helps your clients hear today and primes the locations for the need of some kind of hearing assist so that when the day comes that a new word wide standard does come available – they will of course want to add such a transmitter next to their hearing loop amplifier.

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