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Assistive Listening Devices: Why, When, and Which One? AHEAD Conference/ pepnet 2 Training Institute June 2016 Your Presenter Becky Morris, Hearing Loss Assistive Technology Consultant Independence, Kentucky Hearing Loss in the United States • Third most common physical condition after arthritis and heart disease. • One in eight people in the United States (13 percent, or 30 million) aged 12 years or older has hearing loss in both ears. • Apprx. 15 percent of Americans (26 million people) between the ages of 20 and 69 have high frequency hearing loss due to noise exposure at work or during leisure activities. (NIDCD estimate) • Sudden, noise-induced hearing loss from gunfire and explosions is the number one disability caused by combat in current wars. • In the United States, roughly 58,000 cochlear implant devices have been implanted in adults and 38,000 in children (as of Dec.2012). Why Hearing Aids and Cochlear Implants May Not Be Enough Hearing Aids and Cochlear Implants • Hearing aid and cochlear implant (CI) technology processes sound from a microphone at ear level and delivers sound into the ear at prescribed amplification levels. • Even with all the recent technological advances, these devices don’t perform well in all situations. • Environmental factors challenge how well the hearing aid/CI perform. Factors Affecting Speech Recognition Reverberation caused by reflective walls presents an acoustic challenge. Sound is distorted. No Reverberation (Adapted from Olsen, 1988) – Courtesy Sam Atcherson, Ph.D. Reverberation (Adapted from Olsen, 1988) – Courtesy of Sam Atcherson, Ph.D. Effect of Reverberation on Speech: A Visual Example No Reverberation Low Reverberation Moderate Reverberation Too Much Reverberation Courtesy: Sam Atcherson, Ph.D. Factors Affecting Speech Recognition Factors Affecting Speech Recognition More Factors Affecting Speech Recognition • • • • Student Fatigue. Interactive class discussions (multiple speakers). Is the sound level loud enough? Is the sound level louder than competing background noise? • Is the sound level consistent throughout the room? Audiogram and Everyday Sounds 125 250 500 Normal threshold Breathing Whispering 30 Food blender 50 60 70 80 90 Power tools 100 110 Busy street 8000 0 10 20 40 Speech 1000 2000 4000 f z v j mdb n ng e i u th i a o r ph g ch sh k s Visual Example of How Speech Sounds are Heard by Person with Hearing Loss Photo credit - PA Hands and Voices Hearing Assistive Technology and ALDs ALD Benefits • ALDs use a remote microphone to pick up the desired sound source and deliver it to the hearing aid/CI via some type of connection. • Offers consistent sound signal regardless of distance. • Overcomes challenges of reverberation and background noise. • Some describe ALDs as “binoculars for the ears”. How ALDs Work SPEECH SPEECH SPEECH SPEECH SPEECH SPEECH Microphone Transmitter Receiver Courtesy Sam Atcherson, Ph.D. 3 Types of ALDs Permanent Portable Personal/Miniature 3 Types of ALDs • Permanent (Large Area) system installed with PA system – FM – Infrared – Room Loop • Portable FM system • Personal systems dependent on specific hearing aid manufacturer Permanent ALD Systems Large Area systems use a transmitter connected to an existing PA system. • Infrared and FM systems use a receiver listening option for connection to the hearing aid/CI. • Room Loops Use TELECOIL in hearing aid/cochlear implant. Large Area FM Systems Manufacturers: Williams Sound and Listen Technologies LT-L02 Basic FM Listening System from Listen Technologies. 1500 ft. range Personal PA 377 FM Listening System from Williams Sound. 1000 ft. range Large Area Infrared Systems Two Manufacturers: Williams Sound and Listen Technologies LS-90 ListenIR iDSP Level I System. Up to 50 seat range. WIR TX75 PRO System Room Loops Portable FM Systems For Mild – Moderate Loss Williams Sound PFM Pro (Motiva, Hearing Helper) Portable FM Systems For Mild – Moderate Loss Listen Technologies Systems Portable FM/Digital System For Mild – Moderate Loss Williams Sound Digiwave 300 Portable FM/Digital System For Mild – Moderate Loss Comfort Audio Contego Omni Directional Portable FM System For Severe to Profound Loss Comtek AT216 Portable Receiver Listening Options For People without Hearing Aids Earbud Dual Earbud Headphones Earphone Portable Receiver Listening Options Hearing Aids/CI Speech Processors w/telecoils Behind-the-Ear Aid w/telecoil Neckloop Ear Level Speech Processor w/telecoil Photos courtesy of Beltone, Cochlear Corp, Listen, Telecoils • An option built-into a majority of hearing aids. • Uses induction to pick up a sound signal. • Is a recognized universal method to receive sound. • Neckloops and Room Loops create the signal for the telecoil to pick up. Personal FM Systems • Systems include a body worn transmitter and miniature receiver. • Works only with BTE hearing aids or CI. • Good for group listening because hearing aid microphone can remain ON. • Can plug into some streamer devices. • Best option for many people with severe-toprofound hearing loss. Personal FM System From Phonak Roger Pen, Roger EasyPen, RogerMic MyLink Neckloop Receiver Roger MLXi Receiver Assistive Listening Systems with Multiple Microphone Options Phonak – up to 10 Roger Pens/Clip-on Mics Williams Sound DigiWave System Assistive Listening Systems for Severe-to-Profound Hearing Loss Phonak Comtek Which One Do I Choose? User Considerations • User’s previous experience with ALDs. • Level of hearing loss. • Hearing aid or cochlear implant model. • Telecoil programmed? Classroom Considerations • Size of lecture hall/classroom. • Is PA system set up in class. • Single speaker vs. multiple speakers. • Lecture vs. class interactions. The Student Who Wants to Use Bluetooth Only 2 hearing aid models have Bluetooth Built-into the aid. (Linx2 and Halo) These 2 models pick-up the Bluetooth signal from cell phones that they have been paired with. They do not function as a traditional style ALD (or FM system). Streamers • Device that uses Bluetooth to connect to cell phones or other Bluetooth enabled devices. • Must be worn around the neck like a neckloop or in a shirt pocket. (close proximity to ha/ci). • Delivers sound to a receiver built-into the hearing aid/cochlear implant. • Accessories include small remote mics and TV connectors. • (works similar to a neckloop) Streamers Are Not Universal • They are manufacturer specific. (Oticon hearing aids cannot use a Phonak streamer.) • An audiologist must program the streamer to the hearing aids. • Streamer accessories like remote microphones are also manufacturer specific. • Accessories use proprietary programming. (They are not universal.) Streamers Are Personal Devices While the streamers are generally considered personal devices, many of them can, in fact, connect to personal FM systems like the Phonak Roger receiver. Phonak Roger FM and Compilot Streamer Only 2 Streamers Can Connect 4 Streamers Cannot Connect Amplified Stethoscopes Thinklabs ONE Cardionics Viscope Cardionics Escopes Other Questions? Contact Information [email protected] 859-992-3794 (email preferred)