God day ladies and gentlemen and welcome to the helping people with hearing loss conference call. Ought participants are in a listen-only mode. If anyone requires conference press star and then zero open your touchtone telephone. As a reminder, this conversation is being recorded. I will now turn the call over to the host, Claudia Diaz from the Great Lakes ADA center. You may begin.
Great. Thank you. Welcome everyone. Before we get started I wanted to do a sound check with our presenters and make sure that the Captioner can hear them well in the room. If Juliette, can you say welcome and good afternoon.
Well, good afternoon everybody. This is Juliettete Sterkens. And my name is spelled -- there you go. Thank you very much.
And Don, if you can say good afternoon and.
Good afternoon everyone. My name is Don Bataille and I''m located in Rochester, New York.
Great. Sound is good. At this time my name is Claudia Diaz, associate director at the Great Lakes ATA center. Today''s audio conference is being real-time captioned. To access the webinar platform and follow with today''s session you can listen via the telephone or you can listen via your blackboard collaborate perform. If you are experiencing problems with your audio you can go ahead and look on the left-hand side and find a box labeled audio and video and it has an icon of a speaker wave and a microphone. Move it left and right and it will add just the sound for today''s session. If that''s still not working go ahead and walk through the audio setup wizard. You do that by clicking the microphone with the red star burst and that had open the audio wizard and walk you through that. The blackboard collaborate platform can be accessed via mobile device; it is compatible for the iPhone, iPad, Android devices and Kindle Fire. That is a free down load from the Google place store, apple store. As I said we are real-time captioning today''s session. If you would like to access the real-time captioning for today''s session go ahead and look for the box labeled Audio and Video in the left side. There''s an icon with a CC on it. Click on that icon it and will pop up the box. That box will allow you to stretch and shrink it and you can change your font size and save the transcript at the end of the session. I also want to announce that today''s session is being recorded and we will post the recording and the transcript on our archive Web site. So submit questions, all comments and questions are private so you can send your questions in the webinar platform throughout the session. If you are listening on the telephone please go ahead and send your questions and comments via e-mail to webinars@ADA-audio.org. The whiteboard is the section where we look at the slides that can be customized. If you look at the top part before the presentation you can see that slide that says fit page and you can adjust that to fit your needs. Also if you want to adjuster the overall screen, the box on the left hand side can be moved or detached if you look in those sections. Right-hand corner there''s an icon that looks like lines on a sheet of paper. Go ahead and click on that it and will bring a drop down. Click on the last option that says detach panel and you can move around stream. If you''re still experiencing problems with the webinar platform, go ahead and call our offers at 877-232-1990. And any one of our staff members can assist you or you can send me a message via e-mail at webinars@ADA-audio.org. The e-mail is webinars@ADA-audio.org. Or if you''re in the platform and you want to make a suggestion you can do so by putting it in the chat box. So today''s session is helping people with hearing loss and here in public places through hearing loop technology. Our presenters are Juliettete Sterkens and Don Bataille. Juliette recently retired from her private audiology practice in Oshkosh, Wisconsin, to volunteer at the national hearing loop detective for hearing loss association of America. In this capacity she represents -- she is -- excuse me -- in this capacity she presents professional conferences and consumer events on benefits and use of hearing aids and hearing loops. Her efforts have leveraged over 300 inductions of hearing loops in Wisconsin and others. She holds a degree in audiology from the University of Wisconsin. For her effort she has received several awards including Wisconsin audiologist of the year, the American academy of audiology presidential awards and many more. If you would like to read more about our presenter Juliettete Sterkens, visit our Web site, ADA-audio.org and you can read her bio. Our other presenter today is Don Bataille. Don received his bachelor of architect from the University of Kentucky and he is a registered architect radioing in Rochester New York providing architectural services for consulting firms and owns hearing loop unlimited. Hearing loop unlimited is a company that designs and installs hearing loops in western New York. Don served as a hearing loss association of America, Rochester, New York chapter board president and currently service on the HLAA NY State Association Professional Advisory Council. You can also read his complete bio at www.ada-audio.org. At this time I would like to present our first speaker, Juliettete Sterkens for today''s session, Helping People with Hearing Loss. Juliette you have the microphone.
I have the microphone. Well, thank you very much for the introduction and that means that we can skip over the first slides that introduce Don. So you know who you are listening to and this is myself, Juliettete. I am in Wisconsin. And for the record, I might have fostered nearly 400 hearing loop installations in Wisconsin. That advocacy started in early 2009 and currently hearing loop installations are installed at a rapidly increasing rate. Let''s explain why. In this session we will be covering a pretty wide area of topics and what I would really like everybody to fully understand is hearing loss, the benefits and the limitations of hearing instruments. Then we''re going into why loops are the user preferred technology. And Don will then take over and you will be informed of the ADA and as it pertains to hearing loss and the IEC standards and go a little bit into myths and truths about hearing loops and how to find hearing loop installers and vetting hearing loop installers and leave plenty of time for questions and answers. On the first slide this is a slide that presents the prevalence of hearing loss in the United States. And what I would like you to get away with from this particular slide is that the prevalence of hearing loss essentially doubles every decade. And that by the age of 70 and over, nearly two out of every three Americans have a clinically significant hearing loss. And if you use this for a definition, defined at 25 dB or more hearing loss it''s estimated well over 40 million Americans have some degree of hearing loss. That doesn''t mean they all need hearing aids or amplification but it does mean that many of them experience difficulties in certain situations. Now on my next slide, again it refers to the prevalence of hearing loss and I''m showing you on the left side a graph of the progression of hearing loss as we age, between age 25 and age 65 and on the right side is a graph showing the degree of hearing loss for women. You will see that women have a little more hearing loss in the lower picture on the left-hand side of the square underneath "women" and that men have a little more hearing loss in the high tones and that may explain why women have trouble hearing men and men have trouble hearing women sometimes. In this Department of Hearing loss it very much depends on who your parents are, genetics, very much so, whether you have a history of ear infection, injury, whether you have been exposed to noise, and if you have chosen your parents wisely, shall we say. Because if there is hearing loss in the family there''s a pretty good chance that you, too, will have hearing loss. Now, hearing loss depends very much on two processes or our ability to hear depends on two processes. One is the transmission of sound into the ear, sound striking the eardrum and the inner ear called the cochlea, up to the auditory nerve. A second process is the process of understanding, of decoding of the sound, if you will, by the brain. So if you are a normal hearing person in this lecture and you were to put your fingers in the ears you can give yourself a little bit of a hearing loss. But as long as a person is speaking loud enough or comes close enough to your ears, the words would still come through pretty clearly. And about 5% of all hearing loss is of that type of hearing loss. We call that conductive hearing loss. That would mean that the image that you see on the screen on the left-hand side which shows clear print would perhaps be made a little bit duller or smaller but you would still be able to hear. But over 90 percent of people experience what is known as nerve or sensorineural hearing loss and this type of hearing loss affects how clearly a person hears. Most people with hearing loss complain they can hear but they can''t understand and it sounds like people are mumbling and speech is difficult to get under most situations and those situations are a background of noise. People with hearing loss have trouble hearing over distance, when speakers speak too fast, have a mustache, mumble, drop their voice at the end of the conversation, the topic is unfamiliar or when the speaker has an accent. So the image on the left of the screen, where you can clearly see the white letters on the black background are very distinct; whereas, on the right side, it''s like white paint has been splattered on the screen, on the image, so that the letters are not easily distinguished. That is truly a visual representation of what hearing loss might be. So to mimic hearing loss I could also during this conversation put my hand in front of my mouth. And then (mumbled . I hope you recognize that my voice came through mumbled. Essentially people with hearing loss hear the word mumbled, Here is another important -- I''m hearing background music. Claudia or --
Sorry, that was at my end.
Okay. So a number of people with hearing loss --
This is Claudia, if you could have a mute button and mute --
Okay. Good. So the number of people with hearing loss is expected to increase and that is, of course, because of the baby boomers. In the next 20, 25 years, the baby boomers are going to change the face of Americans. And it''s not just the hair color that is changing, folks; it''s their hearing. Over 70 million Americans are going to turn 65 to 85 by the year 2030. And that means that also the number of people with hearing loss will increase, mainly because as we age, we lose more of our hearing but also because we have not been so kind to our hearing. There''s a high incidence of noise-induced hearing loss. So we need solutions for aging adults who want to "age in place" so that when they lose their hearing and it''s not if they lose their hearing but when they lose their hearing, we need to have effective solutions in place that let them hear, that let them hear where they want to hear, and where they need to hear. And then -- in a house of worship, elder hospitals, retirement communities, reading rooms, airports, ticket counters -- anywhere where meaningful conversation takes place. Now if you do not have hearing loss or do not have experience with hearing loss, you may not need help. What can you do and don''t do? First of all hearing aids increase audibility of all sounds. But the hearing aids themselves don''t know which sounds are the most important for the user. In quiet environments, the hearing aids definitely improve the ability to hear softer sounds but you need to understand that as the hearing loss -- the degree of hearing loss increases that the hearing aids can effectively improve the hearing less and less. In other words, there''s more residual hearing loss for hearing aid users with more severe hearing loss. It''s more residual. So the expectation of hearing is good; it''s that they improve communication and small groups where people are close and making an effort to speak clearly. And it has been clearly shown in studies, one by the national council on aging, that hearing aids improve quality of life. Hearing loss has been positively linked to depression, to social isolation, seniors and fairly recent studies at Johns Hopkins University have shown that hearing loss may be a contributing factor to an early onset of dementia. That needs to be studied more. We don''t know if hearing loss and dementia are essentially the same process, but a different manifestation, or whether hearing loss is causing the dementia. Now the limitations of hearing aids; hearing aids have limitations mainly because of the microphones. Hearing aids do not work well in difficult listening environments that I mentioned earlier. Distance, reverberation and background of noise, individuals with hearing loss and that need increases with the degree of hearing loss, increasingly need the sound, the speech signal can be significantly louder than the background noise, something we called a "signal-to-noise ratio. So if there''s a zero signal to sound ratio the sounds they want to hear would be the same level of the sounds they don''t want to hear and the signal to noise ratio, if it was very positive like 16 or 20, that would give them a very, very cheer ability to pick up speech signals whereas the background noise and things they don''t want to hear would be quiet. By the way, young adults have no difficultly hearing in a very noisy bar where speech signals are actually negative, and the noise to signal ratio is negative. So young people can go in a bar where the speech noise is 5 to 10 dB quieter and can still follow along with the conversation, whereas older adults cannot. You should know that hearing instruments provide about 5 dB of improvement in the signal to noise ratio. If an adult needs 20, a hearing aid can only provide 5. Now, I just want to do a quick introduction on the next slide. That hearing aids have major limitations is recognized in the ADA, and for this reason, hearing aid users need access to technology that helps them hear in places where their hearing devices able to deliver enough audibility to understand speech. So in places where there''s a lot of background noise, reverberation or where distances involved. And the ADA recognizes different types of technology. It recognizes FM frequency modulation; it recognizes infrared technology and induction or hearing loop technology. But one thing the ADA has never asked is what type of technology is preferred by the end user? That is what the next slide clearly shows. This is a questionnaire of over 550 hearing aid and cochlear implant users. They were asked what type of technology or are you more satisfied with your hearing aids or cochlear implants after using them with a hearing loop and the answer is 88% yes and 11% no. That question, there''s a study in progress where that question is asked again and it''s very, very clear that hearing aid users prefer loop technology over FM or infrared technology nine to 1. So if it''s 9:1, and if a consumer with hearing loss prefers hearing loop 9:1 why is infrared technology the mode of choice in this country? That''s basically what I go around the country talking about. Scandinavia countries and any own country in the Netherlands and the UK, hearing loops have been the go-to technology. And the reason this has not happened in this country is partially because we have let other decision-makers decide what to use. Perhaps FM or infrared technology is chosen because it''s cheaper? Or perhaps it''s chosen because it''s easier to install? So decisions for people with hearing loss are being made by people who are not the end users. What good is it if a venue installs an MF system and thus technically meets the ADA but the system doesn''t get used much? It doesn''t make any sense. So let''s look at i from it consumer''s and the users'' perspective. What do users say about hearing loop technology? The first comment is from somebody that said "I used to detest my hearing aids but now that they serve this second purpose, a device that lets me listen in the hearing loop I love the way they have enriched my life." Somebody else wrote: When she experienced this hearing loop "it was truly one of the most memorable moments in her life" and she "felt almost normal." That word "normal" appears frequently in hearing loop surveys. People with hearing loss always feel normal. And another sent a comment that said her son is "now able to watch TV or go to a place without needing captions. And still is able to hear and understand what is going on." So hearing loops greatly improve functionality of hearing aids. And from an audiology perspective, as an audiologist -- here is one more comment from a person who said "it was the first time I have heard a sermon in years. I''m amazed at the sound quality. I was a teenager when I last heard this well." This is from hearing loop users. Now from my point of view, from an audiologist''s point of view is that hearing loops significantly improve hearing and understanding and, thus, greatly improve the functionality and with hearing aids, it greatly improves the satisfaction with hearing instruments. And from my point of view, although I''m no longer in private practice, it meant that people were more confident that when they purchased the hearing aid that the hearing aids would let them hear in places where essentially they are unable to deliver. And the audiologist from Florida also made the comment that hearing loops reduce the barriers to access that many people with hearing loss experience on a daily basis. Here is an audiologist who, for the last several decades has been [inaudible] and the study showed a dramatic increase in the satisfaction with hearing television and dramatic satisfaction increase with hearing aids in general and something that is good for clients and for the provider. So having said that, what do hearing loops do? A hear loop brings the sound from the PA system or the sound source wirelessly into the hearing aid, although it could be a loop device, of the user. So the hearing aid, in effect, becomes part of the PA system. The ear from the listener is moved from the chair, where he is sitting, almost as close to where the microphone is being held by the speaker. Just within a couple of inches of the speaker. So the sound from the lecturer, the little blue box on the left-hand side goes into the microphone. The microphone sends the signal to the hearing loop amplifier, located in the back of the room. That loop amplifier sends the signal, the audio signal through electrical current through the loop wire that surrounds the audience or the group of people, and that looped wire creates a magnetic field that a small sensor called the telecoil that the hearing devices can pick up. So what is happening is that the microphone in the hand of the presenter in effect becomes the microphone of the hearing loop. And the sound goes directly into the telecoil of the hearing aid and that cause''s a huge signal to noise improvement. And of course that means that the listener who was struggling to hear the sound coming from the speaker trying to get rid of the background noise can now hear the speaker clearly and directly through the hearing aid. All the user has to do is activate what is called the telecoil or T-coil in the hearing aid. It''s a small copper tube found in over 85% of all hearing aids on the market. Over 85% of all the different models of the hearing aids. We estimate 40% of all instruments in the market have these features. That number is increasing because in newer devices, we''re switching to 60% open the right-hand side and those devices come almost standard with the telecoil and you can see the copper coil located in the hearing aid. By the way 100 percent of all of the cochlear implants have telecoils and some of the manufacturers now offer telecoils replacement controls in the streamer. How do you know if a hearing aid is equipped with a telecoil? Generally you can see there''s a bush button and you can see it on the left with the little blue arrow and the button almost always indicates that the user has access to a telecoil although that particular telecoil program may not have been activated. Now let''s compare that to a loop-to-FM technology. If a listener is sitting in the audience and wants to use an FM device they have to go to the front desk, pick up the device, take the device out of the ear and put this on their head to hear it through the box that they pick up at the front desk. [Inaudible] here I would like you to listen to a sound recording. In this sound recording, you will hear me speak as if you were hearing through a hearing aid. And that is followed by the exact same recording in the loop. This is repeated two more times. Note that if you wear a hearing aid and someone close to you makes a noise, a background noise, you will hear that clear I had as well. The benefit of a hearing aid is that the listener hears the sound right off the microphone or the sound board with little or no background noise which enhances the clarity. Claudia can you play the audio for me? For some reason I''m not hearing any audio from the video. I was not able to hear it. Claudia, are you there ?
Yes, I''m sorry. You didn''t hear it? I was hearing it on the computer
No. I didn''t hear it. But as long as everybody else heard it, so people just kind of let me know in the chatroom whether they did or didn''t hear it, that would be great. . OK. Super, I''m getting feedback that it was heard. And to be honest I''m an audiologist. I have been fitting hearing aids for almost 30 years and it wasn''t until I heard that recording where you are actually hearing as if you''re hearing through a microphone on the hearing aid that it dawned on me that that''s why people have so much trouble hearing in public venues. So just to end my section, I did a survey among almost 800 consumers and I asked them on a scale of 1 through 10, if 1 is I heard nothing and 10 is I heard every word and you did not use a telecoil, just your hearing aid, as if you were at church like you just heard, how well did you hear just hearing your hearing aid? And note only 14% of the respondents indicated that their listening experience was an 8, 9 are 10. The average listening experience was just about a 5. Now you ask that same question for hearing aid users who are using their hearing aid in a loop and the improvement is dramatic they have almost an average of 9 and 85% of the respondents was an 8, 9 or 10 meaning they just about heard almost every word so it was a huge benefit for hearing aid users with hearing loops. I also asked another group of people after I completed the first survey, how many of you prefer or what type of assistive technology do you prefer. Out of the 200 consumers, 177 clearly expressed an interest and a preference for hearing loop technology with their own devices. And this slide, they were asked: If there was a hearing loop at a venue, a theater, movie theater, if hearing loop assistance was provided how likely would you be to purchase a ticket for that type of performance, and again the majority, over 90% of the consumers were extremely likely or very likely to purchase if a hearing loop was offered. In the next chart, I''m showing you again how hearing loop technology is definitely the most preferred technology as compared to FM or infrared technology, even if a hearing loop is offered. Don, having said that, I''m going to turn it over to you. Don has been talking about the ADA standards as it stands at the moment.
Juliette, thank you very much. I have my voice back and I was on mute earlier. I assume I am on.
Yes, you are.
Okay. What I''m going to be covering is the 2010 ADA, American with disabilities act goes back to 1990. But the act was actually re-enforced due to a number of Supreme Court and other court rulings that was starting to reduce the effectiveness of ADA. In 2010 the ADA standards were accessible design was enacted. It''s referred to as the 2010 standards or simply "standards" when you see this in writing. The ADA amendments act was the act that improved the American standards -- the various sections. And one that we''re really -- that we want to take a look at is the accessible communication. But there are a number of important things to remember. The rulings or the new Act became effective in March of 2012, even though it was enacted in 2010. There were a number of states including New York that accepted and enforced the ADA 2010 -- in 2010. So if you have a building that received a building permit or start a construction before 2012, it more than likely should have -- it should be meeting the new ADA 2010 standards. One of the important things related to communication is that it brings Title II, government facilities and title III, public accommodations, into one standard. So we have one standard that we can utilize. And I just need to do one thing. The keyword that was added as part of the Amendments Act is just the simple word "communicating" and that, in effect, brought in sections 219.2 and 706, Communication elements and features. When we take a look at the two sections, relative to any code requirement, there''s three things we take a look at, understanding the scoping requirements; what is it, where is it and how many? If you think of a building with exits, the definition of an exit ask provided, how many exits are needed and where do they need to be located. It''s pretty specific if all of the cookbook formula, and this should be in the right ballpark. But we also need to understand these are minimal requirements. And it may not fit your specific room or location, because additional features may be needed and of course, with all building codes and ADA, there are exceptions. And we will take a look we will take a look at that in a minute. Some of the other terms you may see: DOJ, Department of Justice, ABA, which is the Architectural Barriers Act, refers to federally funded programs. ADA, as we mentioned ADAAG, accessibility guidelines for buildings and facilities that is now part of the 2010 standard. The ADA access board is probably the focus point that we would take a look at in terms of understanding interpretations and enforcement of the accessibility design criterion, certainly technical assistance. Most codes which would follow the IBC, International Building Code, refer to ANSI standards and you will see that quite often. So what is an assistive listening system, referred to as an ALS or an ALD, an assistive listening device? It is a permanent system that reinforces sound transmission within the area. It could be exterior, exterior rather outside, or interior space. It reduces the acoustical spaces. And Juliette had talked about what a hearing loop does; that it reduces that acoustical space in inches. In western New York some of you might know we have talking Buffalo. But this photograph shows that the Buffalo acoustical distance to the person in the car is inches and that''s really what hearing loop does; it brings that voice communication right between their ears. So what is an assistive listening system? It refers to three primary systems, hearing, infrared, and FM. And one thing that we always try to emphasize is that louder is not better. We want clear, distinct signal quality delivered to our hearing aids. I wear hearing aids so I refer to "we" as a person utilizing hearing aids and assistive listening systems. So again louder is not better. Clarity is what we -- is very critical. When we look at the three options, we have a hearing loop, FM, and an infrared. The hearing loop can be a loop around the room or sometimes a figure eight or there are different hearing loop designs to fit different space requirements. An FM system, a radar transmission, and infrared is a direct light communication. But all three systems interface with a person''s hearing aid or D-coil If you have an FM system or an infrared system then a neck loop is required, and the picture of a neck loop is located on the far right of the side of the screen, showing the neck loop. And you will see, at the end of the neck loop, there''s an 1/8-inch Jack or plug. ADA requires and has established a standard plug size which is the 1/8-inch, if issue a head set to an iPad or anything that home in your office that is pretty much the standard Jack and pin that is utilized per ADA equipment. The two graphics at the bottom of the sheet, down at the bottom of the slide indicate that, yes, it''s for active and passive environments. And any time a microphone is provided, an assistive listening system should be provided. Juliette talked about this a little bit and I think just a couple of points there that I would like to add. With the hearing loop, it''s privacy by design. It serves everyone equally within the space. The individual spent a fair amount of money for that technology. They can walk into the space, the area that is looped, and they simply turn on their T-coil. It is very user enabled and user- friendly. You may experience interference which would also affect a loop or infrared system. And, I apologize for the phone in the background. But that can be easily correctable. Typically it''s just taking a look at the electrical system, pin-pointing where that interference might take place, and fixing the ground requirements. If you look at the infrared and FM, both systems require a battery operated receiver. You need to receive the signal through the infrared or FM system and that is received through the T-coil. Any time you move from one system to another, there''s some degradation to the quality of sound. Infrared naturally requires a line of sight. FM requires a radio signal. And in some cases, especially in an urban environment, you may experience interference from other FM equipment. Both systems require maintenance, batteries, a place to store the equipment and take care of it. I also noted captioning. And if you''re -- it''s a system that also works very well but if you''re looking at Title II or employment situations, that captioning provides a good response. So we take a look at where an assistive listening system is required. Section 218 defines where that requirement is and that is "where audible communication is integral to the use of the space shall have an assistive listening system" and that''s further defined as we noted earlier in appendix L. The photograph at the bottom is the board room. It has a loop. It utilized either table top microphones or wireless microphones systems that is passed between the different speakers and also it can be tied into a sound system. The graphic on the right shows the loop surrounding the attendees; the person speaking with the microphone transmits that signal directly to an amplifier or a loop driver and provides a signal. We talked about the number of devices. There''s a chart that is provided that refers to the number of listening receivers required. So if you have an FM system, all FM systems and infrared systems have receivers to receive that signal and translate that to a head set. The advantage of a loop, if a loop is provided the number of receivers is reduced because you do not need a receiver with a neck loop. So the receiver picks up a system and translates that through the headset or neck loop. We talk about a few exceptions. an assistive listening system is required any time audio amplification is required. If it is not and the standard voices being provided then an assistive listening system is not required, except for courtrooms. If you take a look at the second bullet in the last bulletin talking about the same thing with a little bit of difference, a building with more than one assembly area, say a theater or a room with several meeting rooms, the number of devices that are required is based on the total number of seats and not the number of seats in each space. But it does tend to reduce some of the listening devices that would be required. When we take a look at safe harbor, buildings built or constructed before 2010, ADA standards went into effect are not required to provide a new system unless they''re being renovated or in the case someone might ask for an assistance, then the assistance is required to meet that person''s needs. If have you a place of worship, private clubs, unless you''re renting out for public use, then they would follow the same ADA standards as any other facility. We talk a little bit about how loud sound is. In the terminology that is utilized as a decibel or dB, if we take a look at someone in the library that is relatively a 30 dB, If you''re sitting in a quiet room, 30 dB level. But if you move up to a loud rock concert, that''s 120 dB, threshold of pain 130. The progression of dB is a relative number. When we take a look at the next slide, what the ADA does provide us are performance requirements and that is that the receivers are hearing aids compatible and we talked about provision for neck root and establishes sound pressure, level requirements, how loud the system is, the signal to noise ratio. We talked about being able to hear over background noise and also clipping. Clipping refers to where the sound is cut off. And if you''re using hearing aids or some type of listening system that sound has a definite clip sound and it eliminates the top portion of what you''re hearing. Signage is also required, the standard symbol that we had have seen is the ear with a slash. When a telecoil is provided there''s a T in the right-hand corner. Let''s take a look at some places where loops are very effective. They are used very well, the Amtrak station in Penn Station -- the Amtrak station in Penn Station in New York. We refer to this as a point of service. This loop has an effective range of three to five feet. A person walks up. They see the sign. They turn the T coil on and they can hear the point of service or the person providing the service very clearly. Grand Rapids airport is a really interesting series of loop designs. The main concourse is looped. The primary areas for general waiting have a separate loop. All of the gates are looped. So as you walk through the facility with your T coil on, you''re able to hear any announcements: If your gate is being called, If there''s an emergency. You''re able to hear that very clearly. I had the opportunity of flying through Grand Rapids earlier this year and the person I was flying with was flying to another airport. And we were sitting in the waiting area. I heard the announcement very clearly. Then said, Joe your flight is on. He had no idea. He could not understand the garbled message coming over the intercom. So there are certainly some advantages. Because it reduces the background noise; the signal to noise ratio was greatly improved; and it''s providing the hearing level, sound level that is needed to be able to hear and discriminate voice. Trail ways, an Indian trail bus company, has a series of busses that looped. The announcers are providing communication to everyone throughout the bus. If you turn your T coil on and you can hear it clearly without all of the background noise and driving noise that you might hear. Again, a parking attendant, point of service, the porch at Graceland is looped. You can you''re able to lay in bed and watch flat screen TV and pick up the sound clearly. The interesting thing with the loop is, with a flat screen TV, you can actually turn the volume off so the person next to you might be sleeping and you''re able to watch the ballgame. New York City taxi, all new taxis coming online are being looped; Top right-hand corner, an office reception desk behind a window. A lot of times it''s a small space for that voice to come through but with a point of service loop or counter top loop and you''re t-coiled, you''re able to hear the person very clearly. We certainly loop a lot of churches. And different types of business facilities, meeting rooms, and other active program rooms. Michigan stadium at Michigan State is looped. In this case there''s a lot of steel and a lot of times we realize that that steel can be very problematic with a hearing loop because it tends to draw down some of that sound level. But in this case, every seat is looped in the stadium. Large rooms can also be looped with separate loop fields within the space. The slide on the left -- on the right, excuse me, is showing how we install a loop underneath a carpet. In this case, the carpet is lifted up. The loop is installed. We put down a protection tape. And the carpet goes back. In a lot of cases, this type of loop installation can take place within one to two days so you''re not interfering with the operation of a business. If you have an open floor area but actually install the loop in the floor, a groove is cut by the contractor. The loop wire, in this case it would be a 12-guage or 14 gage cable, would be placed in the groove and then the groove is covered with a grout material. Once it is finished, it''s a smooth surface floor tile carpet, engineered wood floors, would go back down right over it. So what is required with a good hearing loop? We want an even frequency response. We want a uniform signal and an acceptable level of electromagnetic interference. The uniform signal should be + or - 3B. When we talk about electromagnetic interference we want something between a - 50 to 35 dB difference. If you''re above that, someone with a hearing aid may be able to pick up some of that hum, related to an electrical interference, which, again, can certainly be corrected. These are referred to International Standards that is referred to the IEC 60118-4. The even frequency response applies to an even frequency across the hearing groom. We will look at a couple of graphics on how this is affected. On the first sheet what we''re taking a look at is a diagram showing, in this first slide rather, showing the hearing or the sound quality across the space, and we can see that it''s very even. If we take a look at another field, you can see that the sound quality. this is demonstrating the sound quality is pulling off in the center of the room. And this might be due to the loop that is too large or metal effects in the center of the room reinforcing steel but what we really want is an even signal and we are talking about if we follow the numbers across, that''s a +/- 3 dB which is a minimal signal difference across the field. Let''s take a look at a couple other options. The one on the left is a phased array. That''s a series of loops laid out in a kind of figure 8 pattern, a series of figure 8''s across the room and a second loop offsetting the first loop. And the advantage of the phased array is that the provides an even signal in horizontal and vertical directions so if you''re tilting your head to read or in a house of worship, church service for prayer, someone who may not have a good command of being able to hold their head up vertically this provides an even signal no matter which way you''re tilting your head or hearing aids. A loop around the primer of the room, in this case we''re showing how the signal would fade out as you step away from the room. If you''re looking at a room that you need to control we refer to this as a spill or a luke spill because you can pick up some of that luke signal outside of a room. We can control this with a type of design that is utilized. We completed a meeting room --
Operator, did we lose Don?
The phone lines dropped. It looks like Don''s line has dropped. It looks like Don''s line has dropped.
I apologize to the participants in the room. We''re having problems with Don, our presenter. Let us see if we can -
Do you want me to take over? Can you hear me okay? Claudia?
Yes, Juliette, we can hear you. I want to give Don a minute so see if he can get his line re-established.
Okay.What this slide shows are possible sources of electromagnetic interference and essentially just explains that fluorescent lighting interference, or old tube monitors or older dimmers, we''re seeing less and less in use, and that is why electromagnetic interference is less of a problem than it used to be. Certainly in some older established facilities and in particular you are thinking about churches, the EMI can be an issue because of that or old wiring that really should be corrected before the hearing loop gets installed. Is Don back on board?
I''m not showing him dialed back in as of yet.
Juliette you''re going to need to continue until we can get Don back, please.
You know what? I can tell that Don is clicking the slides, so my guess is he doesn''t know that he went off the air. And what I''m going to show you is that, okay -- what Don is talking about -- Okay. Sorry for this little interruption here. But what Don is showing in this particular slide that said good hearing loops are not affected by head tilt is that the -- in the room need to recognize that the telecoil, the little center that picks up the signal, is optimally located in the hearing aid in the vertical orientation. And if the T coil is in the vertical orientation it will allow for a little head movement forward or backward in the hearing loop and the user is still able to hear the sound. But if a person totally bends forward as if to pray or tie one''s shoe laces, then that signal would go off the air. If the phased array loop is installed, as Don explained, the signal is not only in a vertical orientation, the loop signal, but it''s also in a horizontal orientation, and so the telecoil -- it doesn''t matter what the orientation of the telecoil is; the listener is going to hear good sound. That then becomes important in the slide that is this one that shows the outdoor theater in Getty villa, California. If you were a listener in that auditorium and sometimes you need to look down, which means you bend your heads down and your head orientation varies a little bit, sometimes you need to look up at the upper balcony so your telecoil is going to move from had a vertical position to an almost horizontal position. That particular facility has a phased array loop installed so that the head loop is not on issue. To kind of sum it up, the benefits of hearing loops, there is one thing that you are all getting away with, you said the hearing loops have very simple to operate. All ages, children, adults and seniors. You don''t need any special equipment. All you need to do is push the button to activate the telecoil in the hearing aid. It''s very dignified. It''s very easy to access. You don''t need -- if you''re at the level of the bride are you going to get up and try to find a hearing aid device or listening device that is affordable. Loops - telecoils by the way do not add to the cost of already quite expensive hearing aids. They''re available in all but the smallest of instruments and now even in small remotes. Telecoils or hearing loops are very flexible and that is because the user can either use his aid in the t-, telecoil position only, only hearing what is happening on the stage or on the lectern but he or she can also program the hearing aid into a microphone combined with telecoil position and that means that the user would be able to hear immediately to the left and right and hear that sound mixed with what is coming from the loop system. The neat thing about hearing loops and telecoils, they don''t decrease battery life. You can be in a loop all day and it would not affect battery life on the hearing aid. It''s scalable as you saw. They can be used in ticket counters and in huge auditorium. They''re universal. The same signal serves everyone no matter where you are. That means it works in Australia, in the Netherlands and it works in Oshkosh, Wisconsin, as long as you have a hearing aid with a T coil, it doubles the usefulness of hearing aids and - this is a really big one-- it exceeds hearing instrument user expectations. Now, why not Bluetooth? You may be sitting here wondering about why not new wireless Bluetooth technologies? First there is no universal Bluetooth standard that fits inside of the hearing aid. Bluetooth technology always makes you use some type of remote device. They are much bigger that happen the hearing aid itself. Experts are predicting this will take about 10 years, if it''s ever going to happen but hopefully within the next 10 to 20 years this is going to happen but that means we''re still going to have millions of hearing aid users with older technology so we''re still going to have a phase in/phase out period of probably another five to 10 years. Theirs also major issues at the moment with Bluetooth, the quality of sound --And it takes valuable space inside of the hearing aids. So it was interesting developments because we''re kind of wrapping this up. It''s very possible that in the near future, in the next year or two we''re going to be seeing loop listening devices in the Smartphones, and that means that anyone who walks around with a smartphone will be able to access the loop signal and a recent study at Northern Illinois University has showed that normal hearing students would absolutely use a hearing loop if it were available with a connection with their smartphone. This is a slide that shows where hearing loop technology is really on the uptake, the Midwest, in the East and West Coast and along the coast of the Gulf Coast in the south. Here are a couple of signages; you will see different signs. The one with the red circle is the one I want to draw your attention to. That''s one that offers hearing assistive technology but most likely FM or infrared because it lacks the "T" for telecoil in the bottom. The bottom right sign stands for sign language and only one out of every hundred persons with a hearing impairment uses sign language. The other 99 need access to the spoken words that hearing loops provide and the one I would really like to draw your attention to is that hearing loops -- FM and hearing loop technology all improve signal to noise for the listener. It''s just that in the loop the listener walks in with their own hearing aid. Whereas with FM and infrared, the listener has to go and find and locate the device and put earphones on, et cetera, et cetera. So about vetting hearing loop installers, finding a good hearing loop installers, the questions to ask the loop installers is, are they trained in installation of the IEC standard and this is an absolutely must. The installer needs to be very familiar with the hearing loop standards. The installers, check do they have a Web site which list installations so you can check references. Note site visits are not optional. They are an absolute must. If you are designing a facility, ultimately when the facility is nearing completion somebody has to go into the facility and do a measurement and verify that a hearing loop installation as designed will be functional and operational to the IEC standard. And certainly you need to specify that signage will be taking care of questions about who so going to train the staff. And we have found in Wisconsin, that, quote, unquote, commissioning of the hearing loop certainly helps to bring people who are unaware of the technology "into the loop" so to speak. This is my second to last slide, a whole lot of resources for you. There''s loop sites for advocacy here at loop.org and hearingloopWisconsin.com there''s a list of loop vendors by state under hearingloop.org/vendors.HTM. There''s a Web site where you can locate hearing loops around the country if you''re interested in seeing unique installation techniques I refer you to a website by an installer in Wisconsin www.dlssound.com. To find trained installers that are not on the hearingloop.org list I highly recommend you contact the two largest hearing loop manufacturers - (inaudible) global.com and listen technologies. They also make FM and infrared technology and they will direct you to the nearest trained installers. I have uploaded the generic U.S. hearing loop specification that can be found at loopWisconsin.com and I''m also happy to e-mail it to you and let me please thank some very special people, Karen McLennon and Dr. Cynthia Compton-Connolly, both audiologist who have been very helpful with advice and slides, Richard McKinley and Cory Shaffer and Conny Anderson, from the U of X Company in Swedon. And that pretty much opens it up for questions and answers. I apologize we''re a little late but let''s open the floor for questions.
Thank you very much if we can have the operator. We start with questions from those that are on the phone at this time. So operator if you could give instructions to our participants.
Thank you. Press "*1". If you would like to ask a question, press "*1".
While we''re waiting on folks to cue up with that, we have persons that came in electronically and we will go ahead and start with those questions. So this individual said that they appreciated the statistics and the information that you shared in your slides related to the folks that were surveyed, et cetera about their preferences and things of that nature and also the slide that you had which showed where loops are installed et cetera, do you have any additional information in regards as to why you presented it, you know, from the perspective of the user, but do you have any thoughts other than the things that you shared about why more entities are resistant and such or don''t offer this technology out there more readily?
I think there''s a lot of misunderstanding about the needs of people with hearing lot. And certainly a resistance of users to use FM or infrared technology which leads facilities to surmise that perhaps this technology isn''t needed from an audiology point of view. I found that my clients stopped attending. They didn''t go to places. They knew they couldn''t hear and even though I would tell them about FM and infrared technology they didn''t bother. They didn''t want to bother. It was too much hassle and it wasn''t until hearing loop technology appeared in the area that my clients came back literally with over the top responses and it made them actively search out places that were looped. So, yes, I speak on behalf of the end user. And I don''t know if that totally answers your question but it certainly has been a misunderstanding from a reengineer that hearing loops are not being used or hearing loops are not needed because people don''t use the FM or infrared devices and that can''t be further from the truth.
I could wait and see if the person asked for clarification but I think you answered that one. We have another question that asks, what has been done or is being done from an advocate perspective on the side of users of loop, for example, we see that the blind community has done significant advocacy as it relates to having audio description available within theaters and things of that nature. What has been happening in the hard of hearing community related to the installation of loops?
Don, I hope you don''t mind that I take this answer as well. There''s a lot being done. The American academy of audiology and the hearing loss association of America teamed up a couple of years, had a task force and worked very hard to educate consumers and American academy worked very hard to educate audiologists about this technology, currently I work on a grant that allows me to travel around the country and educate audiologists as well as consumers of this technology and in areas where it''s happening it''s happening by word of mouth but if there are no hearing loops in an area it''s frequently the consumers, the HLAA members, and support groups that are starting what are called hearing loop initiatives and there''s even a Facebook group, mine''s called Fox Family Hearing Loop Initiative, there''s one called hearing loop advocates where a lot of information gets shared. It''s a grassroots movement that is picking up speed and a lot of being done.
Great. Thank you very much. Operator, were there any questions that dame came if from our audience.
Then we will continue with our questions from the electronically. This question is related specifically to the ADA. How, from an ADA perspective can someone push the fact that an entity does not have loop technology? Is there anything specifically that you could use the ADA other than the ADA identifying different types of technology? Is there any way to push that the loop technology is something that you can press from the ADA perspective?
The ADA in 2010, if we take a look at sections 219 and 706 that described providing communication to large groups any time a microphone is being used, so the ADA portion that we''re talking about today really has -- is related to providing communication which is integral to that part of the program. If you''re talking about the ADA requirements in terms of work provisions, employer, that''s a separate device that can be provided. I''m not sure if the question is in that direction or the group programs. If we are looking at ADA effective communication then one is a facility that has been built after the ADA in your particular state went into effect, some states it was 2010 and other states that was March 2012. So first thing to do, just check with your local building official and find out, when was ADA, when did ADA go in effect in a particular location. And then that would drive whether or not that facility was required to meet ADA 2010. If not, you can make a request to the facility for a particular event. We have things referred to as a temporary loop that could be provided. There are other systems perhaps that could be provided on a one to one system or a situation, rather, but ADA is pretty clear that it addresses every seat within the facility. I''m going to rumble on here for a minute, because a loop provides that very clearly to every seat. If you have FM or inferred, you''re limited to the number of devices. So if you''re going to a facility for the first time it''s incumbent on you, that person, to provide enough lead time. You can''t just walk in and say "I need an assistive listening device". You should call ahead and ask if they have an assistive listening device, if they do you''re in good shape, and if not you can see if they can provide it.
This is Juliette. I would love to add something to this. In my community a lot of these groups move forward because the consumers themselves took it upon themselves to talk to the venues, to a theater, to a church, to a funeral home, to have a loop installed, so, in effect, they did a lot of self-advocacy and perhaps consumers may want to draw attention to the fact that it can increase business if you have a hearing loop, it will attract hearing aid users and, on top of that, it''s a system that is very easy to manage, by the facility, and there''s a lot less hassle. The people who are most likely to use the technology are the ones with hearing aids and they walk no with their own device. So there''s a lot less maintenance and hassle from the facilities point of view and that has convince add lot of places, certainly in Wisconsin, to move forward with a hearing loop installation.
Great. Thank you. I think that is a good discussion and good ending for that. We have a question for clarification and I think Claudia is going to go back to slide 62 and I''m not sure if this is maybe a misspelling error but the question is, in this slide you use the terminology "emote" and is that a word or is that -- should that have been remote?
That is an error on my part. That should have been "remote" and it staring me right in the face right now. Sorry about that.
For the people that asked about that, that terminology should have been -- the question should be telecoils are offered in small instruments and now also in remotes. We will correct that on the handouts that we post with the archive of the section so we will have that correct.
Thank you very much.
Not a problem.
Okay. So I will just go back to our operator here and check to see if there are any additional questions from anybody on the phone at this time.
if you would like to ask a question, press "*1".
Another question submitted electronically somebody is saying why don''t architects incorporate more of this technology in to their recommended designs when they are doing specific areas like meeting rooms or auditoriums and things of that nature? Is that a lack of education on their part? Or is there a reluctance just because it''s not something that they''re that familiar with?
Very familiar with it. One is the lack of education and a lack of understanding what meets the needs of those with hearing loss. ADA 2010 came into effect and very few people looked at communication requirements. The code officials didn''t understand what is required to meet communication requirements. It wasn''t being enforced. We have contractors that are providing buildings that certainly did not understand that they were not meeting ADA. The interesting thing about ADA is that it puts an equal responsibility on the architects, the building owner and the contractors to meet the ADA requirements. So there''s a lot of education that''s just simply needed and it''s not there yet. Even though ADA now has been in effect for several years, there just isn''t the understanding and the realization that this is required. We are finding that a number of the -- of those installing sound systems and different assistive listening systems do understand. Another quick point is that if the facility is removing carpet. That qualifies as a renovation and loop systems are needed -- we also have been talking to carpet installers and they''re advised that they''re also required to respond to ADA requirements.
Great. Thank you. I think this is a follow-up to that as you were talking. Do you know whether or not what the language is in the International Building Code or do you know whether other state codes that have their own accessibility code follow similar requirements related to these issues?
Okay. IBC refers to the International Building Code. New York State pretty much follows IBC with some changes. New York State adopted, and I think also California and I know there''s a custom stays but they adopted requirements as part of the building code. I think what you have to do is contact your local building department and ask if ADA is part of the building code and if not follow up with the access board.
I have a follow-up comment. I testified before the 887-1 committee in Washington, D.C. about the International Building Code and that code will be amended in the future to read that where a hearing you install, it shall meet the IBC standards. Because the hearing loop that is thrown up in a room and somebody strings a wire around the corner of the room -- somebody strings a wire around the room and says "it''s looped" that will not meet the needs of the people that are hard of hearing. That loop signal, the magnetic strength, the fidelity of the signal and lack of electromagnetic interference all make that hearing loop a good loop. So the International Building Code soon will actually be stricter than the ADA. The International Building Code will reference the IBC standard 60118-4, and that means that where hearing loops are installed they shall meet the IBC standard.
Thank you for that clarification. Our participants appreciate that. So at this time we have no more questions coming in the chat area. I will ask if there''s any last question on the telephone at this time.
No questions at this time.
We''re just about at the bottom of the hour. So that''s good and fine. And I just want to thank Don and Juliette for this information. It''s not your typical information that you see out there and I think it''s one of the reasons that we wanted to include it as part of our series is that we are seeing a lot of dialogue about this issue but - we know it is an important one. An audience that is not as heard or their needs are not as loud maybe as are heard in some other groups and I think that has been reinforced by the comments that you heard today from our presenters. They did provide you their contact information. If anyone wants to follow up, both Don and Juliette provided contact information and you may be able to do that. Our materials will be posted with the archives and hand out materials. We will correct them and update those with the archive. The archive will be available within 24 hours after the end of this session on the ADA-audio.org Web site. We also will be posted an edited transcript. It takes us a little longer to get the transcript up so the transcript will be up in the next seven business days but the recording will be up with the captioning integrated into it prior to that. We will be also sending everybody out an e-mail, which will contain a link to the evaluation for today''s session. We do greatly appreciate your feedback regarding our sessions and your comments related to them so please fill that out and get that back to us. The e-mail also contains information about your continuing education recognition credits, AIA, certificate of attendance, etc. so please make sure that you follow the instructions if you are also seeking continuing education. We also invite you to participate in our session next month, September 16th, which will end our 12-month series. We operate from October-September time frame. And that topic is accessible construction and will feature Andrea from Cornelia university, their ADA coordinator to talk about the issues of working with and incorporating accessibility into construction that takes place in organizations and entities particularly those that have multi construction events taking place at different times, state government, post-secondary education, but it also is relevant to other construction projects that you might be interested or involved in so we invite you to join us. Back to our regular schedule next month which is the third Tuesday of the month. And at the same time, you can calculate where you are as to the start time for you. Registration is available at the www.ADA-audio.org. Thank you for your participation. Thanks to Juliette and Don for sharing this important topic with us at this time. This concludes today''s session so you can hang up your phone or disconnect from the webinar platform at this time. Again thank you everyone and have a good rest of your day.
Thank you very much.