The Ampetronic team recently attended, and were the Gold Sponsors of, the 3rd International Hearing Loops Conference in Eastbourne, which was held in the Winter Gardens complex on the 6th and 7th of October, and I am delighted to report that it was, once again, a very positive experience for everyone (unless you were attending as a representative of a hearing aid manufacturer, more on that later).
It was the first time that the United Kingdom has had the honour of hosting the conference and it was the charity Hearing Link that took up the challenge of organising and promoting it. Ampetronic have been heavily involved in the organisation of all the previous Hearing Loop conferences, and I’m glad to say that Loraine Gailey and Julie Leggett of Hearing Link sought our help and advice once again. So we not only gave workshop presentations to the delegates, but also helped plan the event and looped one of the main rooms and the Hearing Link members conference held the day before.
The attendance was impressive and the delegation of around 250 people had come from around the world to take part, including a striking number who had made the 3,500 mile or so hop across the pond from the United States. It was a pleasure to be reacquainted with advocates like David Myers, Juliette Sterkens, Brenda Battat, Richard Einhorn and Linda Remensnyder who have been so pivotal in promoting hearing loops in America.
There were a number of industry and healthcare experts taking part, a full list is available here, and therefore a lot of great information presented and discussed over the two day event, and whilst I couldn’t be present for all the concurrently held lectures I think it can be distilled into a few key points.
1. Lessons can be learnt from the UK and applied positively in countries adopting Loops
Despite the fact that in the U.K. Hearing Loops, or ‘Induction Loops’ as they are generally referred to on these shores, have a greater proliferation of installations than anywhere else in the world (mainly thanks to equal access legislation and the National Health Service distributing free t-coil enabled hearing aids) they have garnered a rather shaky reputation with end users over the last 30 years or so.
There are a number of reasons for this:
a) When they were first introduced in the 1970’s Hearing Loops were more of a hit and miss affair, often installed as a hobby or experimental project by electrical engineers using standard audio amplifiers and some telephone wire.
b) Assistive listening legislation has helped provide an enforceable incentive to encourage retailers and venue operators to install loops, but unfortunately there is no enforceable Standard mentioned in this law. This has had the unfortunate effect of allowing venue operators to concentrate on cost, adopting a ‘tick box’ approach to legislation compliance without due consideration of the quality of service offered to the system users.
c) Since their introduction Portable Counter Hearing Loops have become a considerable problem for hearing aid users, whilst they offer an easily managed and cheap solution for the retailer or venue operator, they often bread bad practice when it comes to operation.
They are often purchased in bulk and distributed through retail chains without staff training, their portable nature encourages stores with multiple cash desks / payment points to only keep one system on charge but use signage at all points (which means that the user has to ask to use the system and rather defeats one the main attractions of Hearing Loops in that the user can remain inconspicuous), they often have an on-board omni-directional microphone which picks up all the sounds in the localised area offering no advantage over the intended users own hearing aids, and more often as not they aren’t charged or can’t be located and operated by untrained staff.
These problems, now identified, are rectifiable and easily avoided.
Standards are now in place that define what a good Hearing Loop system is (IEC 60118-4), and manufacturers such as Ampetronic have not only developed specifically designed current drive amplifiers but also defined the type of loop system necessary to provide a genuine benefit to the end user and meet the Standard in almost any application.
In the United States there is currently a push to include the operational hearing loops standard IEC 60118-4 in the ANCI building code for any new loop installation, which would go some way to solving the low-cost tick-box approach to legislation and provide a good example to other countries.
It is now widely accepted by most informed professionals that portable counter loops are only a suitable solution for a very small number of applications.
In my opinion, which is far ffrom unique on this topic, they shouldn’t be used on retail counters unless they meet strict criteria:
- A unit is made available at each point where the service is advertised with a Hearing Loop sign (so that the hearing aid users don’t lose their anonymity by asking for it)
- Be switched on at all times when the counter is attended.
- Make use of an external microphone that is placed close to the mouth of the member of staff behind the counter (the only sound that is required to be captured)
- The unit must have a designated position on (or in) the counter that has been checked with a field strength meter to produce Standard compliant audio at the ear height(s) of the intended users
- Importantly a member of staff (on site) must be fully trained to make sure all these factors are taken into consideration at all times.
In other words, a fixed counter Hearing Loop is a far better and more manageable solution.
2. Previously negative user experiences can be quickly converted into new positive ones
Because of the problems mentioned previously, both market research and anecdotal evidence suggest that hearing aid users in the United Kingdom have all come across hearing loop installations that didn’t work, produced poor quality audio, or simply weren’t even turned on. This creates a poor perception of the benefits of the technology for users and they are unlikely to ask for it in the future.
I heard a number of horror stories about poor loops before the conference started, and the people telling me seemed justifiably annoyed about them. But as soon as they experienced the professionally designed and installed loops temporarily installed in the venue the tone changed dramatically – words and phrases like ‘wonderful’, ‘thank you’ and ‘why aren’t they all like this?’ were suddenly being used.
When listening to a good loop system the benefits are very obvious, indeed, I used a loop receiver myself during the conference due to the poor acoustics in the grand old building and the difference was dramatic.
If the users of the system have a good experience they will proactively use, and go in search of Hearing Loops, even suggesting that it should be installed to venue operators.
Manufacturers and distributors have a responsibility to assist in this change. Distributors who sell component products and loop solutions that aren’t suitable for the application they are to be used in are not only complicit in putting a system in place that is unlikely to provide a genuine benefit for hearing aid users, but is also undermining confidence in their own products for short term gain – bad business by anyone’s reckoning.
A good user experience should be expected, not a pleasant surprise. Responsible sales, adherence to Standards and training of uninformed loop installers are key to achieving this.
Since our inception over 25 years ago, and as part of our commitment to our company mantra ‘Provide a Genuine Benefit’, Ampetronic have long held the policy of not selling a Hearing Loop amplifier without first identifying if it is suitable for the application it is being used in, and we encourage our Global network of distribution partners to do the same. This attitude needs to be adopted across the industry to effect meaningful change.
3. Loops Work! But hearing aid manufacturers and many audiologists are not invested in promoting them
A recurring theme throughout the conference was the issue of hearing aid manufacturer’s product marketing, and more specifically the claims made within it.
The large manufacturers of hearing aids make claims in their product literature about how well they operate in group settings, when out and about in busy shops, or over large distances. To promote that the hearing aid is compatible with Hearing Loops undermines this message, and as such it isn’t mentioned at all in some product literature.
Another problem is that hearing aid manufacturers often create proprietary accessories that only work with their own equipment, no doubt because this obviously stimulates sales, and so to promote that the aids are compatible with a publicly accessible sound source that doubles the effectiveness of the device at little or no cost is also not in their best interests financially.
Adam Beckman of the British Academy of Audiologists spoke briefly on the subject and Juliette Sterkens covered the subject in her presentation ‘It’s not so much about loops as it is about hearing loss’ stating that the actual effective range of a hearing aid is about six feet in one to one settings and that they could not possibly compete with the benefits a Hearing Loop can offer.
Hearing aid marketing and technology limitations was in-fact mentioned by most of the audiology speakers, and when Per Kokholm Sorenson of Widex took part in a panel questions and answer session at the end of the conference he was asked so many questions about it that he said he would ‘bring a tin hat’ if he attended again.
What can be done about this? Well, in the case of hearing aid manufacturers it is simply pressure from their customers, the people who buy the products. In the United States there has been a step increase in the amount of hearing aids fitted with telecoils as a results of the pressure from advocacy groups, but whether the manufacturers can be convinced to be a little more frank about the limitations of their technology remains to be seen.
Audiologists on the other hand have a commitment to helping their clients and providing the best solution they possibly can for each client. Audiologists in some countries are simply not aware of the technology and others have been convinced by the hearing aid manufacturers that it is no longer required and obsolete, so they don’t promote its use, and some don’t even bother to activate the telecoils when programing hearing aids. Education is essential to changing this.
Audiologists need to be made aware of the real and tangible benefits that Hearing Loops provide over simply using a hearing aid (or cochlear implant for that matter). We, as manufacturers, can supply the information, but this can only be done effectively by demonstrations and pressure to find out about Hearing Loops from other informed audiologists and by users insisting that the products they buy are Hearing Loop enabled.
4. There is a link between dementia and hearing loss, and Hearing Loops help
The link between cognitive decline and hearing loss has been around for some time now, we’ve posted numerous links to articles on our social media channels, and it is largely all down to research by Doctor Frank Lin at John Hopkins research center.
Linda Remensnyder gave an excellent and detailed presentation entitled ‘Can hearing loops reduce cognitive load in the ageing population?. She covered topics including the alarming statistics about the increasing number of people within the population suffering from Alzheimer’s and Dementia, describing it as a ‘time bomb’ and how the loss of hearing can lead people to shut themselves away, becoming socially isolated and how this in-turn leads to a decline in cognitive function.
If hearing health care in general can help, and the provision of good quality Hearing Loops in society can help delay the onset of cognative decline then they must be embraced, by all. After-all, you don’t need to be using a hearing aid to take advantage of a hearing loop, just ask for a receiver, or buy your own if need be.
5. There really is no new technology on the horizon that will replace loops in the near future
Dr Hannes Seidler and Per Kokholm Sorenson gave presentations on the ‘Near future of induction loop systems’ and ‘A possible successor to loop systems’ respectively.
Both examined what it is that makes Hearing Loops so universality accepted and whether or not radio technology, such as Bluetooth, could replace it in the near future.
Without getting too technical, both agreed that the barrier to replacing the Hearing Loop and Telecoil receiver combination with something better is that it is very hard to beat. In order to satisfy the same criteria any replacement technology must:
- Not drain the batteries of the hearing aid
- Be able to be controlled by area coverage so that the signal doesn't 'spill' outside of the required space, or so that they could be fitted at several counters in close proximity without interference (or cross talk)
- Not pass on a significant cost increase to the end user
- Be able to cover large areas
- Be able to allow an unlimited amount of connections at the same time
- Have no latency issues so that they can be used along side lipreading
- Be free to connect to and be universal
- Offer better sound quality than a hearing loop
It would seem that although many radio technologies are in development, and the hearing aid manufacturers are using some of them already, none of the can currently satisfy all the criteria above, especially when it comes to developing a common standard among competing manufacturers.
The conclusion; there isn’t anything on the horizon that is better than Hearing Loops in the next 10 years, and if one is developed the aids should still be compatible with inductive loop technology, so keep on looping.
6. Advocacy and promotion by ‘users’ and audiologists is the key to increasing the quality and quantity of Hearing Loop provision in all countries.
So what was the overall message at the end of the conference and where do we go from here?
Well, it seems to me that it boils down to this; Hearing Loops work, and when designed and installed with care they work very well, so there should be more of them and poor ones should be replaced. But who’s going to campaign and make it happen?
Hearing aid manufacturers aren’t likely to affect any real change and start to promote loops to audiologists, as it’s not in their financial interests, but they can be influenced to ensure their technology is compatible by the purchasers of the products – the audiologists, who are, ultimately, influenced by the hearing aid users and what they demand.
Governments and politicians will only strengthen legislation in response to public demand, they shouldn’t be at the mercy of commercial influence, but they are duty bound to represent their constituents. If enough of us ask for it, they will have to do something about it.
Hearing Loop manufacturers and retailers cannot effectively advocate to venue operators and audiologist for better hearing loop provision as we are seen as having a vested interest - in it for commercial gain, which of course we are – we’re businesses after-all. But that doesn’t mean that we manufacturers can’t be passionate about providing a great service to the hearing impaired users of the systems and work with them. We can of course also provide training to architects, specifiers and the installers of the systems to help reduce ignorance of Standards and increase quality.
So, that really only leaves the users of hearing aids, cochlear implants and, ultimately, Hearing Loops. Together they represent a huge demographic and can affect real and lasting change to improve their own quality of life. It might all seem like hard work, but it’s clearly achievable with organisation. We know this because of the sterling work performed by the Hearing Loss Association of America and their ‘Get in the Hearing Loop’ campaign.
By making the right information available to hearing aid users, pressurising local and national government, getting key audiologists to advocate for hearing loops amongst their peers and by holding technology demonstrations, Hearing Loops are now being installed all over America.
This model is easily duplicated and the 3rd International Hearing Loop conference was the perfect place to start.
Ask for our help, the team at Ampetronic are always more than happy to help out in any way we can.
By Alistair Knight
Marketing & Communications Manager