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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. 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 people who are hard of hearing that aren't self-conscious locate and check out an ALD, the ear buds 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 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 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, MI, and adjacent Zeeland, 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 pastinterference, spillover of sound to adjacent rooms and uneven coverage-have rarely posed a problem for our trained audio engineers.
It's not just in the town of Holland. Aided by the spread of telecoil-compatible phones, more and more hearing aids 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. Anotherthe only one who had used the church's old systemcommented, "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 members who are 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 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 reported 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 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!" initiative 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, PhD, 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 on the Web.
Sound Off
Audiologists' Reactions to Holland, MI Loop Initiative
Holland, MI recently became the first town in the United States to offer people who are hard of hearing a variety of looped venues for easier access to sound. 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, MA, CCC-A, owner, Holland Hearing Center
"In 2002, our audiologic 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, MA, 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, MA, CCC-A, FAAA, owner, K.A. Van Doorne & Associates, Zeeland, MI
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