To appear in Advance for Audiology, May/June, 2003
The Coming World of Hearing Aid Compatible Assistive Listening
An alternative to conspicuous listening assistance is gaining ground in the United States—and it
bodes well for audiologists.
By David G. Myers, PhD
In the short story “Silver Blaze,” Sherlock Holmes took note of the dog that didn’t bark, the dog
that curiously did nothing. What is similarly curious about the assistive listening devices (ALD) now
mandated for most public facilities by the Americans for Disabilities Act (ADA) is their visible
absence. Rarely does one see people using them. One theater manager in my city estimated that her
units get used once per month per theater. In a new, 20-screen theater complex, a ticket seller told
me (wrongly, I later learned) that they had no ALDs (at least nothing he had ever been told or asked
about). Receiver/headsets, purchased for about $100 a unit, often just sit in closets, many with dead
batteries.
Although the systems are designed, purchased and installed with the best of intentions, most
people who are hard of hearing won’t suffer the bother and embarrassment of wearing ALDs. One
friend, explaining why his mother-in-law wouldn’t use ALDs in worship, jested that “she would
rather be caught dead than look like a World War II aviator.” Even when unself-conscious hard of
hearing people locate and check out an ALD, the earbuds or headset offered is often incompatible
with their hearing aids, which must be removed.
A Hearing Utopia
Now imagine a happier world for the mushrooming millions with hearing loss. In this utopia,
hearing aids have double their present usefulness. They serve as sophisticated microphone amplifiers
and also as personalized loudspeakers. In churches, auditoriums, theaters and even home TV rooms,
clear sound, customized to one’s own needs, is broadcast by loudspeakers right inside one’s ears.
Turning on these in-the-ear “loudspeakers” requires but a tap on the hearing aid or a flick of a
switch. Tap again, and the person can hear both the broadcast sound and voices nearby. Telephone
sound also can be made to broadcast through both ears, enabling clarity beyond single-ear listening,
even with amplified phones.
As word-of-mouth and newspaper publicity inform people of the doubled functionality of hearing
aids, curious people call audiologists. Hearing aid use increases. Patients who are delightedly
benefiting from this effortless assisted listening seldom return their new hearing aids. In the public
eye, the stigma of hearing loss and hearing aids diminishes. The net result is improved quality of life
for many.
Fantasy Becomes Reality
In Holland and adjacent Zeeland, MI, this imagined future is rapidly becoming reality. Most major
churches and public facilities, and more and more homes, have installed modern induction loop
systems that broadcast sound to hearing aids via a magnetic signal from a wire that encircles the
audience. Supportive audiologists are equipping most of their new patients with telecoil receptors
(or “audio coils,” as Mark Ross, PhD, professor emeritus of the University of Connecticut, suggests
we rename them to convey their broadening usefulness). Issues that reportedly plagued poorly
designed loop systems of the past—interference, spillover of sound to adjacent rooms, and uneven
coverage—have rarely posed a problem for our trained audio engineers.
It’s not just in Holland. Aided by the spread of telecoil-compatible phones, more and more
hearing aids (surely more than the oft-quoted 30 percent) are coming with telecoils. In one recent
Self-Help for Hard of Hearing People (SHHH) member survey, 75 percent of respondents reported
their hearing aids had telecoils. Carsten Trads, President of GN ReSound North America, estimates
that 80 percent of their hearing aids, including all behind-the-ear (BTE) and in-the-ear (ITE) aids,
now come with telecoils.
Consumer Reactions
People’s responses to having sound broadcast through their hearing aids have been encouraging,
and sometimes moving. Many positive reports have come from the parishioners in the dozens of
newly looped churches in Holland, MI, and surrounding communities.
“It is actually fun to go to church, and hasn’t been that way for a long time,” reported one woman
who could have used her church’s previous infrared receiver and headset, but didn’t. Another—the
only one who had used the church’s old system—commented, “the experience of actually hearing
such clear sounds was thrilling and hard to describe. One has to experience the improvement; it
seemed overwhelming.”
At another church, one woman broke into uncontrollable sobs when she suddenly found herself
hearing sermons as she hadn’t in years, and then she awoke at 4 a.m. the next morning and cried
some more tears of happiness.
Some of our churches have been surprised at how quickly usage has expanded. One pastor initially
was disappointed to have no users of his church’s new loop system, despite the system coming with
a receiver and headset for those not yet with telecoils. Eight months later, the happy pastor had
three long-absent hard of hearing back and using the system, plus three more who began attending
his church because it was a place where they could hear.
A larger church held an informational meeting, guessing that four or five of their worshipers might
be interested in using ALDs. To their astonishment, 36 reportedly showed up, half of whom were
forgotten members with hearing loss who had stopped attending.
Use Gaining Momentum
Loop systems are now spreading throughout western Michigan. One Grand Rapids church sound
engineer reports that, “slowly, the members of our congregation have been updating their hearing
aids, and [in four months] we’ve gone from one user originally to over 10 now. Several members
have commented on the clarity and ease of use.”
In late 2002, the Board of Michigan’s SHHH chapter unanimously adopted a resolution
advocating that “Michigan’s churches, auditoriums, theaters, courts, airports, and other venues
where sound is broadcast install assistive listening systems that broadcast sound directly through
hearing aids.” Although loop systems and “audio coils” are, for the foreseeable future, the
technology that best enables this, the mandate leaves the welcome mat out for alternative
technologies that might some day achieve the same end: hearing aid-compatible assisted listening.
A Worldwide Phenomenon
Although little known in this country, loop systems are becoming omnipresent in Britain and
Scandinavia. In my recent visits to the United Kingdom, I found loop systems operating not only in
every church and cathedral I visited, as well as lecture halls and auditoriums, but also in designated
store checkout lanes, post offices, and tourist information counter stations. By the end of 2004, UK
legislation will mandate that “any business or organization providing a product or service to the
general public must have an induction loop system fitted wherever information is verbally
provided.”
Our Michigan state legislators will soon be considering a proposed legislative mandate that,
effective at some future date, would require newly constructed facilities with ADA-mandated ALDs
to install equipment that broadcasts directly to hearing aids. Marsha Mazz, Technical Assistance
Coordinator for the U.S. Access Board, anticipates that facilities that install loop systems to achieve
this goal should enjoy a reduced requirement to purchase, maintain, and replace receiver-headset
units, given that many fewer would be needed. This cost savings should largely offset any small,
added cost to carefully engineered loop installations, enabling a no-burden, essentially cost-free
mandate.
National Initiative Considered
A full-scale national initiative—one that aims to make real the dreamed-of future where hearing
aids have doubled functionality and usage—is under consideration as one outreach of SHHH’s new
Center for Hearing Assistive Technology. SHHH has previously urged that “telecoils be given the
prominence they deserve as a valuable hearing aid feature that will allow the expanded use of
assistive listening devices."
An ambitious “Let’s Loop America!” would reach out to audiologists, hearing aid manufacturers,
audio engineers, architects, facilities managers, churches, people who are hard of hearing, and the
general public. Such audiences can be reached through their organizations, their periodicals, and
their educational institutions, as well as through media that reach the general public. We already have
had expressions of interest from national media.
Audiologists who wish to bring this technology to their community, and to enjoy the benefits of
increased public interest in hearing technology—perhaps including strategic partnerships with
equipment vendors or audio engineers—can visit www.hearingloop.org for further information on the
rationale for looping facilities, applications and cost of the technology, and its suppliers.
David Myers, a social psychologist at Hope College, in Holland, MI, is author of A Quiet World: Living with
Hearing Loss (Yale University Press, 2000). He can be reached at myers@hope.edu or via
hearingloop.org.
Sidebar:
Benefits of the Telecoil Hearing Aid/Induction Loop Marriage
“Judging from the complaints I receive, and from my own experiences, the logistics of
managing receivers are the major source of problems in ensuring auditory access in large area
listening situations. It seems that almost anything that can go wrong does, at one time or
another…With an induction loop system, on the other hand, no special ‘receiver’ is required, as
long as a person’s hearing aids include a telecoil…
“This is an enormous advantage for hearing aid users. There is no need to check out special
receivers. Not only is this more convenient, but it is especially conducive to use by those people
who are reluctant to wear a visible assistive listening device. Furthermore, and most important,
hearing aid users can be assured that their ‘receivers’ are functioning well and that any
individualized hearing aid programming is still operative.”
— Mark Ross, From Hearing Loss, January/February, 2003, pp. 32-35.
— Sidebar:
Audiologists’ Reactions to the Holland, MI Loop Initiative
Holland, MI recently became the first extensively looped American city. Most major churches,
auditoriums, and other public and senior center facilities now broadcast sound directly to hearing
aids, as do the TVs and telephones in an increasing number of homes. Some local audiologists
share their observations on the initiative.
The Holland loop initiative “is having a profound influence on the people I see. Nearly everyone
I’ve seen who uses the loop system has had favorable results.”
—James Welsh, M.A., CCC, owner, Holland Hearing Center
“In 2002, our audiological practice delivered over 90 percent of all hearing aids with t-coils
installed. Our patients benefit because the person speaking is broadcast directly to their ears. Our
practice benefits from hugs, excited stories and tears of happiness. People are often referred for
demonstration with the admonition, ‘You have to hear it!’ Never in my audiology career has
something so simple helped so many people at so little cost.”
—Jerry Owens, M.A., CCC-A, owner, Lakeshore Hearing Centers, Holland, MI
“‘Audio coils’ transform hearing aids into ‘personal communication systems,’ reducing the
stigma of hearing loss and replacing it with successful and less stressful communication between
patients and their families and friends. I am glad to be a part of an initiative that makes such a
significant difference in someone's ability not only to communicate, but to participate!"
—Karen Van Doorne, M.A., FAAA, owner K.A. Van Doorne & Associates, Zeeland, MI