What do loop systems cost?

What are common concerns about loop systems?

1. "It's said that only 30 percent of hearing aid wearers have the telecoil receptor, which means that loop systems can't serve 70 percent of hearing aid wearers."
The oft-cited "30 percent" may once have been true, but is no longer. Surveys of leading hearing aid manufacturers reveal that virtually all behind-the-ear hearing aids and most in-the-ear hearing aids now come with the audio coil ("telecoil") receptor. (Only the completely-in-the-canal aids--about 1 in 5 hearing aids--cannot have a telecoil.) GN ReSound, for example, estimates that 80 percent of their hearing aids now come with telecoils. Audiological researcher Mark Ross recommends that telecoils "be routinely incorporated in all hearing aids, as a kind of default position, unless there is an explicit request or reason not to do so." Consider also:

• The telecoil compatability of post-1989 telephones has helped fuel the increased inclusion of telecoils.
• Those most needing hearing assistance tend to have larger hearing aids, most of which have telecoils. In one 2002 SHHH survey of members, 75 percent had hearing aids or cochlear implants with telecoils.
• Some hearing aid wearers are unaware of their telecoils.
• If you build it, they will come. In countries, communities, and churches where loop systems have been installed, people get telecoils when purchasing future hearing aids.

2. "Loop systems aren't suitable in adjacent classrooms, theaters, or hotel conference rooms, because their output will spill over to adjacent spaces. They also aren't suitable for courtrooms and other venues where confidentiality may require sound to be contained."
Traditional perimeter loop systems indeed cannot be used in adjacent rooms. Today's modern loop engineering does, however, enable the containment of sound, and thus the looping of adjacent lecture halls, theaters, and hotel conference rooms.

3. "Loop systems aren't conveniently portable, and thus aren't suited for temporary meeting spaces."
Looping a temporary meeting room--taping wire to the floor and plugging in the attached amplifier--takes but a few minutes, and reduces time spent distributing special receivers and headsets (since fewer will be required).

4. "The sound broadcast by loop systems isn't loud enough (or is too loud)."
On hearing aids with preset volume output, one's audiologist can raise or lower the volume output for the telecoil as well as for the mic setting. Hearing aid manufacturers can also help, by orienting telecoils for optimal loop system reception (see #8 below).

5. "Interference from fluorescent lights, power lines, computer screens, electric guitars, etc., make loop systems often unworkable."
A site check---easily done by having a hearing aid wearer turn on the telecoil---usually confirms that interference is not a problem (and where it is, can be dealt with). Modern fluorescent lights do not create interference. Interference near electric guitars can be eliminated with a humbucker pickup coil on the guitar. Older computer monitors produce interference, but this is reduced in newer monitors, and the new flat screens produce no interference.

6. "Loop systems won't work in outdoor venues such as stadiums."
FM assistive listening systems, although not without problems, are more affordable in such venues. Loop systems have, however, been installed in very large venues, including both indoor arenas and outdoor stadiums. When installed, they are more likely to be used and they reduce the need for special receivers and headsets, which few hard of hearing people check out.

7. "FM and infrared systems afford more even coverage."
Loop system output is often experienced as louder by those sitting near (but not over) the loop wire. Professionally designed and installed loop systems following modern IEC standards do, however, provide quite even coverage throughout most of a facility. In venues with nonreflective walls, the coverage of infrared systems can also be uneven, as well as easily blocked by another person or object. FM radio signals also are vulnerable to problems, including interference, though they do enable stereo reception.

8. "Hearing aid manufacturers install telecoils that are oriented for optimum telephone, not loop system, reception."
In the September, 2002, Hearing Review, Mark Ross notes that a horizontal telecoil optimizes telephone reception, but that "to optimally detect a signal from a loop (e.g., floor or neck system), the telecoil should be situated in the vertical position. Often recommended is a compromise position in which the telecoil is angled so that adequate (though not optimal) inductive coupling can be achieved with both telephones and loops. However, since it is much easier for people to manipulate a telephone for optimal coupling than to angle their own heads relative to a loop, I would suggest the vertical position as the normative one. Still, there is a need for some creative engineering on the topic of telecoils, an area of research that does not seem to have sparked the collective imagination of the hearing aid industry."

With in-the-ear hearing aids, the telecoil orientation tends to vary with the shape of the ear and the resulting ear mold and hearing aid case. Some people find that, in certain venues, they may need to slightly cock their heads for optimum reception (but most would much prefer this minor adjustment to the hassle of conspicuous receivers and headsets).

9. "Using a loop system means that I can't hear others around me."
That's actually less of a problem with loop input than when one's ears are plugged with a headset. A simple tap switches the hearing aid from telecoil (T) to mic (M) setting. (That's much less hassle than taking off a headset and putting one's hearing aids back in.) Those who also have a combined mic/telecoil (M/T) setting can enjoy both inputs simultaneously. They can, for example, listen to TV broadcast directly through their hearing aids and hear others in the room.

The broadcast of sound through one's own hearing aids also guarantees that adjacent people won't be distracted by irritating sounds spilling out of an assistive listening headset. Sound broadcast through hearing aids is contained within one's ear.

10. "Might not alternative future assistive technologies achieve the same results?"
Perhaps, and, if so, all the better to hear you with, my dear. What informed hard of hearing people wish for is not so much loop systems, which are today's technology for broadcasting sound directly through hearing aids. What they wish for is, rather, a future that mandates hearing aid compatible phones and, likewise, hearing aid compatible assistive listening. Should it eventually become possible to, for example, broadcast sound to miniaturized, low-power radio receivers embedded in hearing aids, that could be wonderful. (Today's Bluetooth receivers are too large, and demand too much battery power, to be accommodated by hearing aids.) We welcome all audio engineers, manufacturers, and vendors to join the free market competition in support of hearing aid compatible assistive listening.

Imagine a future in which hearing aids have doubled functionality--as sophisticated microphone amplifiers, yes, but also as personalized loudspeakers for sound broadcast in most public venues and in homes, as well, where people's own hearing aids can be their TV loudspeakers and where they can listen to phone conversation with two ears. With doubled usefulness, and with none of the hassle and embarrassment that comes with using receiver/headsets, the number of people benefiting from assistive listening would soar. Moreover, the number of hearing aid users might double (which, along with fewer returns of hearing aids, would bring down their cost). And the stigma of hearing loss and hearing aids would diminish. The bottom line would be improved quality of life for millions of Americans.