Assistive Devices

Assistive Listening Devices for Improved
Communication and Greater Independence

The hearing aids of today offer an expanding array of options. The instruments are versatile, effective and of excellent quality. There are, however, communication and life situations when hearing aids are not enough. Such situations include communicating in a noisy restaurant; talking while driving a car; hearing at a theater, lecture, meeting, family dinner or party; catching all the lines in a favorite television program; feeling confident when reaching out to a friend or business associate by telephone; or being alerted to a telephone bell, smoke alarm, alarm clock or a baby’s cry. Such situations can be frustrating, frightening, and often demoralizing encounters for people who have trouble hearing.

It is for these circumstances that assistive listening devices and systems (ALDS) are helpful. The objective of this article is to provide an overview that addresses: 1) what ALDS are; 2) a criteria for selection; 3) a description of who will benefit from them and how, and 4) ways of introducing ALDS to persons with hearing impairment.

An assistive listening device and system is defined as any non-hearing aid device designed to improve a hearing-impaired person’s ability to communicate and to function more independently despite hearing loss either by transmitting amplified sound more directly from its source to the listener or by transforming it into a tactile or visual signal. Many of these devices, (e.g., alarm clocks connected to bed vibrators or to flashing lights, telephone and doorbell alarms) have been available for many years. Other items, such as television listening systems, personal one-on-one amplifiers, FM transmission systems, sophisticated telecommunications devices, wearable tactile alarms, and direct audio input options for hearing aids, have more recently entered the marketplace, many offering a great deal of assistance to people with varying degrees of hearing loss.

ALDS for persons with hearing impairment include alarm type devices which warn, signal, and alert the individual to sounds in the environment and those which aid the person to listen more efficiently.

Alarm Type Devices

Those devices which warn, signal, and alert are called sensory devices and function by providing one or more types of tactile, visual, or auditory stimuli. Examples of sensory devices include wake up and warning equipment which provide tactile or visual signals that can vibrate a wrist receiver or flash a light when there is a knock at the door or when the doorbell chimes or phone rings. Fone-alert is one of many such items designed to alter the frequency of the phone bell, an often unheard signal by the person with a high frequency loss. A large gong or flashing light can be installed independently or by a local telephone company to alert persons with a hearing loss that the phone is ringing. The pleasures and benefits of closed caption television provide visual clues to better understanding of the message, and the teletypewriter or TTY opens exciting lines of communication for the severely hearing-handicapped individual.

Listening Devices

The assistive devices which enhance listening are currently divided into four categories: hardwire, infrared, FM, and loop. Listening devices can play a vital role in determining the success of communication in a variety of ways, (e.g., social situations, personal interactions, education level and vocational achievements) and the enhancement of life through spiritual, cultural and recreational experiences.

The four categories of assistive listening aids all have one thing in common. They are designed to bring the listener closer to the source of the desired sound, thus reducing undesirable background noise and providing greater intelligibility. The individual’s frustration level, in turn, is lessened.

Hardwire Systems

Hardwire systems are so named because the user is connected directly to an immobile electronic system by an earphone or headphones. The hardwire systems are excellent for one-on-one communication such as patient interviews and counseling, as well as in small groups, and for TV viewing and radio and stereo enjoyment. Hardwire systems offer good sound quality, since minimal signal loss occurs and high fidelity headsets can be used. As a wire system, however, limitations may be placed on the mobility of the user depending on its application. Such systems are said to be the simplest and least expensive of the four types of ALDS. Examples of such systems include a user-assembled device with components available at electronic supply stores or several commercially available systems. Included in the hardwire classification are a wide variety of telephone amplification devices which simply connect into the wiring of the telephone or clip onto the handset. Portable clip-on amplification also is available.

Infrared System

Infrared systems consist of a transmitter and receiver; the medium is invisible light. The transmitter emits a signal consisting of lightwaves which spread throughout the room. The wavelength of the light is outside the range of what humans can see. These light waves carry the message from the sound source and are picked up by receivers worn by the user. A stethoscope earphone can be used, as can the infrared receiver coupled to the user’s own hearing aid telephone coil. Infrared systems are wireless, and offer excellent fidelity for radio, TV, stereo, concerts, lectures, and theater. Due to the light-based principle of operation, however, infrared signals must be contained within the physical confines of the space in which the transmitters are installed.

The FM System

The FM system is a radio system consisting of a small transmitter and receiver. The transmitter microphone is placed near the sound source, and a signal is sent to the receiver. The receiver picks up the signal and sends the sound to the user’s ears by way of some type of earphone receiver. A variation of this system consists of a receiver with a wire loop worn around the neck. The wire acts as an antenna and is connected to the receiver. It transmits the signal to hearing aids which when switched to the telephone or “T” position make the hearing aids sensitive to the magnetic field generated from the wire. The FM system is wireless, offers excellent fidelity for all communication and listening situations, and is generally free of interference. The user may also move anywhere within the transmitting range of the system and receive high quality signals from the source.

The Induction Loop System

The induction loop system is made up of a loop of wire placed around a room. This system uses a hearing aid’s telephone switch. The loop is connected to a special amplifier that receives the signal from the sound source. The loop system is useful for all size groups, small or large, as well as mini-systems which can be installed in the home to enhance TV listening. The biggest advantage of the loop is that the owner of a hearing aid already has half of the system, assuming the aid has a quality T-switch.

ALDS in Rehabilitation

As can be seen, there are many types of assistive devices from which to choose. From this large variety, how are recommendations to be made? What criteria should be used in the selection of assistive devices? The following criteria, as proposed by Gwenyth Vaughn, PhD, are helpful to follow: 1) degree of listener’s hearing loss; 2) compatibility of the existing system and proposed aids; 3) consideration of lifestyle and communication need; 4) availability; 5) acceptability; 6) affordability; 7) accessibility; 8) feasibility; and 9) flexibility.

For a person with a mild, moderate or severe hearing loss, a complete aural rehabilitation program would combine the use of hearing aids, assistive communication techniques (speech reading, auditory training, hearing aid orientation), assistive listening devices (hardwire, infrared, FM, loop), and follow-up care.

For persons with severe/profound hearing impairment or deafness, the following comprehensive rehabilitation program would be advised. Hearing aids or a cochlear implant are recommended to increase sound awareness and directionality. Any one or a combination of these assistive communication techniques would be utilized: speechreading, auditory training, hearing aid orientation, cued speech, finger spelling, and signing. Of the assistive listening devices—hardwire, FM, loop (if adequate T-coils), possibly infrared—those that would be applicable are recommended. The following special sensory devices could provide useful: captioned TV, TTYs, gongs, bells, lights, vibrators, or hearing dogs. Finally, follow-up care is very important to assure the success of whatever program is developed.

The staff feels that assistive devices are items to be tried. All of the devices available in the Albany Demonstration Center can be tested and evaluated for each person’s needs. Should the individual wish to obtain a particular device, he/she then is referred to the most accessible distributor, either locally or through catalog mail order, for purchase.

The incorporation of a demonstration facility of assistive devices in this hearing rehabilitation center has yielded extremely satisfying results and, as has been noted, assistive devices can play a significant role in a complete program of hearing healthcare. In general, the trend toward providing additional help with assistive devices to persons with hearing impairment should be of particular interest to the professional because it allows wider dimensions for recom- mending help. Assistive devices, of course, will be of special interest to the person who lives with a hearing loss, since they offer many benefits beyond the hearing aid. In the final analysis, both the hearing impaired and their families should realize an improved quality of life with the use of both amplification and assistive devices.

Alerting Devices

Visual Call Alert Ring Indicator/Lamp Rotating Beacon Strobe Light Flasher Button Phone Flash/Strobe Clock Radio with Outlet Plug Baby Cry Knock Light	Telephone Amplification and Aid Portable Amplifier Handset Amplifier Telelink Whistle Stop Telephone Typewriter Relay System Earpads for Receiver
Auditory Ring Max Fone Alert Loud Ringer Buzzer Gong Rodelvox	Television Amplification and Aid Sound Jacks Amplified Speaker Transistor Radio/TV Band Closed Caption Decoder Personal Listening Extension Cord Pocketalker Stereo Amplified Listener Infrared Transmitter/Receiver
Tactile Shake/Awake Pillow Vibrator Bed Vibrator Fan Quest, Tactaid Hearing Dogs Wrist Vibrator Quiet Wake	Large Area Listening Infra-Red System Induction Loops Noise Buster FM System/Personal Receivers Transistor Radio/Headset or Ear Buds
Personal One-to-One Communication Pocketalker FM System Amplified Listener

Hearing Assistance Devices Loan-Out Centers in the Capital Region:

Albany
Madison & Saratoga Hearing Center
14 Columbia Circle, Suite 202
Albany, NY 12203
VOICE: (518) 690-2060
www.albanyhearclear.com

Amsterdam
Resource Center for Independent Living
347 W. Main St
Amsterdam, NY 12010
VOICE: (518) 842-3561
FAX: (518) 842-0905
www.rcil.com

Castleton
Madison & Saratoga Hearing Center
81 Miller Road, Suite 700
Castleton, NY 12033
VOICE: (518) 689-0792
www.albanyhearclear.com

Herkimer
Resource Center for Independent Living
Steuben Center
401 East German Street
Herkimer, NY 13350
VOICE: (315) 866-7245
FAX: (315) 866-7280
www.rcil.com

Glens Falls
Center for Better Hearing
318 Ridge Street
Glens Falls, NY 12801
VOICE: (518) 638-4363
www.hearingbest.com

Saratoga Springs
Madison & Saratoga Hearing Center
414 Maple Avenue, Suite 800
Saratoga Springs, NY 12866
VOICE: (518) 584-0578
FAX: 584-2568
www.albanyhearclear.com

Schenectady
Sunnyview Rehabilitation Hospital Foundation
1270 Belmont Avenue
Schenectady, NY 12308
VOICE: (518) 382-5462
FAX: (518) 382-4551
http://www.sunnyviewfoundation.org/m/Medical_Care/Sunnyview_Rehabilitation_Hospital/Specialty_Programs/Hearing_Center/

Troy
Hear USA
2200 Burdett Avenue
Troy, NY 12180
VOICE: (518) 272-7323
FAX: (518) 272-7243
www.hearusa.com

Utica
Resource Center for Independent Living
409 Columbia Street
P.O. Box 210
Utica, NY 13503
VOICE: (315) 797-4642
FAX: (315) 797-4747
www.rcil.com