In the Loop

A new survey caused me to think about...

by Stephen Frazier on 09/11/23

Why don’t more people use assistive communication technology?

There are myriad opinions as to the answer to that question. Some say it's too much trouble. Some say people aren't aware that it's availabe because of inadequate signage. Some blame hearing care providers for not taking the time to counsel their clients/patients on devices and technology that do not directly contribute to the sale of hearing aids. Some blame the hard of hearing for not adequately searching for solutions to living with their hearing loss.

There's a new group, the Committee For Communication Access In America, that's now searching for information to validate or disprove some of those opinions. They claim that millions use assistive communication technology but that an even greater number should but doesn't – particularly in the case of ADA mandated assistive listening systems. As for captions, another communication technology that's sometimes offered, millions more would probably use it if it was available but it's not mandated and, consequently, many times presenters refuse to offer it even when it’s requested.

Interested parties can learn more about and participate in that CCAA survey by using a link on the home page of their website (www.ccaa.name).

The situation is changing

I believe this situation has changed over the last decade through the efforts an army of advocates pressing for improved communication access in public places. The mushrooming availability of hearing loops in public places is testament to that fact.  More and more hearing care providers are promoting telecoils on their websites and in their offices.  Remote hearing mics and other devices are now being fitted with telecoils. This pattern could continue over the next few years as the revolution now occurring in the hearing aid dispensing field matures. 

With the now legal sale of over the counter (OTC) hearing aids, plus the online sale of prescription hearing aids, reports indicate that hearing care providers are re-examining their business model. Some are selling OTC hearing aids. Some are unbundling their services and offer fitting and adjusting to buyers of OTC hearing aids and those of their online or brick and mortar competitors, for a fee. It's no longer uncommon for a hearing test to be administered for a fee with no expectation of actually selling prescription hearing aids to the eighty or so percent of clients who don't need the extra gain and other benefits prescription devices can provide. Some are placing more emphasis on diagnosing and treating other hearing related issues such as balance problems or tinnitus and offering aural rehab.

It would seem that for audiologists, they may revert to the sort of SOP used back in the 70's, before ASHA allowed them to make a profit from the actual sale of hearing aids. The newest ASHA guidelines place more emphasis on comprehensive rehabilitation services such as auditory training, counseling, manual communication, strategies to address tinnitus, misophonia and vestibular disorders in addition to technology interventions. This could provide the impetus to expand their counseling of patients on the availability and benefits of assistive listening systems and other technologies and devices that can supplement or take the place of hearing aids.

The inadequate signage issue noted earlier can only be resolved by people with hearing loss taking action by demanding that the ADA signage regs be followed at any venue they visit that does not properly call attention to the availability of an assistive listening system.

The final solution

With the just announced Samsung introduction of Auracast in their TVs and earbuds, another revolution has begun that will eventually see assistive listening technology used not just by the hard of hearing but, instead, by the general public at sporting events, sports bars and gyms, in theaters, in trains and planes and myriad other venues where they, too, have difficulty hearing. Like smartphones, tablets and other new tech devices, most people will either have earbuds or hearing aids to enable them to access an ALS anyplace where there's a public address system. It will take another decade, maybe even more, but I believe the Auracast system will become an integral part of any new or updated PA system and its ADA mandated ALS. At that point, the question of why people don't use the systems will have little practical relevance.


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Different people have different opinions and it’s okay to respect all of them.” – Juan Pablo Galavis-------------------------------

On Hearing Loops and Telecoils and Bluetooth®

by Stephen Frazier on 10/07/22

This Consumer's Perspective on Hearing Loops and Telecoils

By Stephen O. Frazier

 “You don't need telecoils, you'll have Bluetooth.”  Oh?

Alive and well and visiting in London, Mark Twain famously said of rumors in New York that he had died, “The report of my death was an exaggeration.” The same could be said about the very idea that hearing loops are on their death bed thanks to newer technology that has been developed. The same could be said for telecoils often made claim that, “You don’t need telecoils, you have Bluetooth®” Google Map's decision to post the presence of hearing loops where applicable in the accessibility information of venues on their website is just the latest example of recognition of the growing awareness and availability of this assistive listening technology here in the US.

While hearing aid manufacturers continue to reduce the number of hearing aid models that have or can be fitted with telecoils, the decision by Amtrak to include hearing loops in the new trains they have ordered from Siemens Mobility seems to indicate hearing loop technology has become recognized as an important means of providing communication assistance to people with hearing loss. The similar decision to include hearing loops in their new subway cars in New York City is further evidence of the continuing spread of this technology as the US continues to, as the Hearing Loss Association of America suggests, Get In the Hearing Loop. More performance spaces, places of worship and other “places of assembly” are being “looped” every day as a result of pressure from the hard of hearing public to have their disability addressed. Over the last decade, and with little support from some in the hearing care industry, hearing loops have spread across America as a result of consumer driven efforts. Many hearing care providers have gotten on board and promote the technology on their websites and in their practice.  There are over four-hundred offices around the country that have at least one loop installed for demo purposes according to one source.  Unfortunately, far too many providers still tell their clients, “You don't need telecoils, you'll have Bluetooth.”  Oh?Why are they stumped if the clients asks how Bluetooth will help at the theater or the client’s place of worship. Even in states like New Mexico where telecoil counseling is mandated before the fitting of hearing aids, some providers don't even mention it.

Hearing loop technology is international in application and telecoil equipped hearing aids and CIs purchased in the US can connect to loop signals at the airport in Moscow or London just as they can at Delta Airline's new terminal at LaGuardia in New York. They're just testing the concept in New York but city buses with hearing loops are already in use in the UK and Australia. It's neckloops and FM receivers that help tourists hear the tour guide on a river cruise up the Danube, not Bluetooth. The same is true at a Broadway theater that has not yet replaced their FM or Infrared system with a hearing loop as many of their competition have.

As a former retailer I've never understood why a hearing care provider would not tell clients of a feature that can double the functionality of a pair of hearing aids and cost them nothing. Is it a lack of familiarity with the technology? A lack of time permitted by a bottom line focused hearing care chain? Do manufacturers leave out telecoils in order to make their BTE hearing aids even smaller?

From my perspective, the choice as to whether or not to have telecoils in their hearing aids should be made by the buyer and user of those hearing aids, not by a hearing care provider. To not counsel a client in the technology and deny that client that right appears to me to violate the standards set forth in the ASHA Code of Ethics providers agree to observe that say,“Individuals’ statements to the public shall provide accurate and complete information about ...products for sale…”  It's not complete if the client is not told about the telecoil option.

Survey’s have shown that clients who get that counseling and, in most cases, get the technology are more satisfied with their hearing aids and with their provider. They’re more inclined to recommend that provider to others. Telecoil counseling looks like a win-win situation to me.

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