Hi, everyone. I want to welcome you all to the webinar on Hearing Loops, How to Get Started in Your Community. We are thrilled you could be here today to learn more about proven, practical ideas on how to market with hearing loops in a busy practice and how to start a successful loop program in your area. Your moderators for today are me, Fran Vincent, IHS membership and marketing manager, and we also have Ted Annis, IHS Senior Marketing Specialist on the line. Today's webinar is being presented by IHS and the Academy of Doctors of Audiology. Our expert presenter today is Juliet Sterkens, AUD and National Loop Advocate for the Hearing Loss Association of America. Juliet has 30 years of experience in the fitting of hearing aids and is a passionate and vocal advocate for the wider use of hearing loops in the U.S. and beyond. She has extensive experience in working with patients and looping providers, and her advocacy efforts have resulted in more than 325 hearing loop installations in her local community alone. We're very excited to have Juliet as our presenter today, but before we get started, just a few housekeeping items. And we're going to go ahead and move over to the housekeeping items in just a moment, but I'm going to talk you through it. So we are recording today's presentation so that we can offer it on demand through the IHS and ADA websites in the future. This webinar is available for one continuing education credit through the International Hearing Society, as well as the Association of Hearing Instrument Practitioners of Ontario. Additionally, it is approved for .1 CEUs through the American Academy of Audiology. You can find out more about receiving continuing education credit at our website at IHSinfo.org. Just click on the webinar banner on the homepage or choose webinars from the professional development menu on the left side of the page. There you'll find the IHS CE quiz and a link and some information on AAA credit and how to obtain IHS and AHIP credit. Also on the webinar page at the IHS site, you'll find the slides from today's presentation to help you gather the information you need for the CE quiz, so if you haven't already downloaded the PDF of the slides, you can go ahead and do that now. As a special bonus, everyone who completes a 60-minute webinar and submits and passes a CE quiz for either IHS, AHIP, or AAA credit will be sent a special download packet filled with essential looping tools and resources to use in your practice and community. Tomorrow you will receive an email with a link to a survey on this webinar. It is brief and your feedback will help us create valuable content for you moving forward. Okay, everyone, so let's go through the agenda. We're going to be covering the following topics along with the Q&A within a 60-minute presentation. We're going to go through Hearing Loop Benefit Studies, IEC Induction Loop Standard and Why It Matters, How to Read a Telecoil Spec and Telecoil Programming, Juliet's Six-Step Program to Looping Your Community, and Avoiding Pitfalls. At the end, we'll move on to a Q&A session, and you can send us a question for Juliet at any time by entering your question in the question box on your webinar dashboard, usually located to the right of your webinar screen. We'll take as many as we can in the time we have available. Now I'm going to turn it over to Juliet. Thank you very much. You're welcome. I want to start by just making you all, can everybody hear me? I hope you can. I want to imagine yourself sitting in a house of worship or a lecture hall, and you're unable to hear, and it may be due to the distance, because of the severity of your hearing loss, but you can't hear. And suddenly, somebody hands you a set of headphones with a long wire, and the wire is plugged in directly into the PA system. Can you imagine how clear that would sound and how easy it would be to hear? That's exactly what happens in a hearing loop, except you don't need the wire. The magnetic field broadcasts the sound wirelessly to the telecoil in your hearing device. The microphone of the actor or the microphone on the umbo in the house of worship becomes the microphone to the hearing aid. That is why it sounds so amazingly good. Yep, and some people will blow this off as hype, but it does sound overwhelmingly clear, except it's even better than through headphones, because the hearing aids process the sound for the user's hearing loss. So the reason I am sitting here, the reason I'm talking about hearing loops is that hearing aids have limitations in public venues, but frankly, I did not realize the extent of the limitations until I started looping. But you also know that consumers know this. According to market track studies, 19%, almost one out of every five new hearing aid users return hearing aids with the complaint that they pick up too much background noise or they're not effective enough. And yes, FM and infrared assistive devices help to improve the signal to noise ratio we're offered, but loops do it wirelessly directly to hearing aids as long as they have a telecoil. So think of a hearing loop as a wheelchair ramp for somebody in a wheelchair. So that overwhelming experience, Dave Myers had such an overwhelming hearing loop experience is what motivated him to undertake a looping initiative in Holland, Michigan. By the way, my outreach is funded through his family foundation. And his efforts led to hundreds of hearing loops in western Michigan. And frankly, that is what motivated me to start looping in my area. I saw hearing aid users experience a loop. And within two or three years, we had 20 or 30 hearing loops installed in the Oshkosh area. And suddenly, I had this knowledge, you know, and that's what's motivating me. How could I not share this information? That's why I retired from my private practice of 25 years in Oshkosh, and that's why I'm doing this advocacy on a national level. Everybody deserves to hear like that. And by the way, this slide shows that I'm not doing this on my own. I get a lot of support from area audiologists. Only a few of them are listed here. So how beneficial are loops for our clients? You know, what is the human experience? And I just want to zip over a couple of slides that demonstrate this. This is a Bill Diles study, and he asked 71 of his clients, how do you hear TV with just your hearing aids in your ears? And he obtained these beige results, and you see a typical bell curve. On the left, a few unhappy clients. On the right, a few very happy clients with their hearing aids watching TV. But frankly, most of them are in the middle. And then he asked them how they heard TV in the loop, and the results dramatically shift to the right side. Almost everybody hears significantly better in the loop. So Bill Diles' results and my highly enthusiastic local clients in Oshkosh, Wisconsin motivated me to undertake a study. That study was just published in the October Hearing Review. And in this study, the participants used a variety of devices, and yes, it is weighed heavily towards people with more moderate, severe to profound hearing loss, and there are a significant number of cochlear implant and cochlear implant plus hearing aid users. But I used either cards or a web-based survey, and this is just one of the survey cards. And I asked people, how do you hear without the loop, just with your hearing aids in a particular venue? And this client filled out St. Ralph's. That's a church in Oshkosh. It's actually my Catholic church. And without the loop, he rated his hearing ability a 2, and in the loop, he rates his hearing ability or she, I don't know who this is, on a 10-point scale, a 9. The frequency distribution for 866 participants are shown in this slide. Right here is a card, the one that I was discussing about St. Raphael's Church, where somebody completed the survey card, and these are the aggregate results, the frequency distribution of how people hear out of the loop, just using their hearing device. And on average, clients rated their hearing ability a 4.9, almost a 5, and 13 percent of the people said even just with their hearing aids, they can hear an 8, a 9, or a 10. When they turned their telecoil on in the hearing loop, their hearing ability increases to an 8.7, and 85 percent of the respondents rated their hearing ability an 8 or higher. So it's a huge, huge difference. And of course, the benefits to clients are big also, and it's this enthusiasm from the users that really moved me forward in pushing for more loops in my community, because they say they can hear better than their spouse, they don't need to read lips, I feel like I have normal hearing, I mean, I can belabor this, but this is all written up in the hearing review article. And of course, there's benefits to the providers. You know, Bill Diles, who, by the way, has looped over 2200 of his client homes, speaks of great word-of-mouth advertising, fewer returns, an increase in patient referrals, and great practice loyalty. Mary Cacavo, a Ph.D. audiologist in Indiana, speaks of her clients becoming more open to other wireless solutions, streamers, mini-mics, TV systems. And when I started looping, it absolutely increased my visibility in Oshkosh. I was invited to speak at local service clubs, to be on local television, to be interviewed for newspaper articles. So you may wonder where loops are being used. Well, they're used in a variety of places. They can be used at ticket windows, at airport gates, and they're increasingly so being used. Some bus companies have gone as far as to install loops in buses. New York City are installing loops in their taxi cabs. Of course, churches, houses of worship, and even the Breslin Center at Michigan State Stadium has a hearing loop. They do graduations in that auditorium. So what ensures that a loop system works well for our client? It's the standard, because you may have heard that some loops don't work well. The reason those loops don't work well is because they don't meet the standard. The hearing loop standard, the IEC standard, and you may want to think of it as some kind of real ear test for hearing loops, measures on the left-hand side the evenness of the magnetic field across the listening area. It ensures that there is a broad frequency response from 100 to 5,000 hertz across that listening area, and that there is little or no electromagnetic interference. And why is this standard important? Well, it ensures that the loops that are being installed in your area or the loops in Australia or in Oshkosh, Wisconsin are all set to a uniform standard so that they work the same for every hearing aid users. It also ensures that no loops are installed in areas where there is electromagnetic interference. And by the way, electromagnetic interference is rarely an issue and is almost always solvable. It also ensures that the seated area, all of the seated area is covered. And when those requirements are met, the signal-to-noise ratio improvement to the user can be on the order of 10, 20, and yes, even 30 decibels. To show you a loop that's out of spec, just so you have a visualization, the white and the yellow areas in this loop area are within spec. They're loud enough. But note that in the center of that hearing loop, the signal droops dramatically. This is almost always due to metal in the building or a loop that's been made too wide. The average hearing loop can be at maximum between 30 and 33 feet wide. And of course, installers have to verify the evenness of the magnetic signal strength. And they should never be okay with this kind of hearing loop. No one should ever tell you you have to go sit on the outside of the hearing loop or hold your head a certain way to hear. These are properly engineered hearing loops. On the right is a perimeter loop. That means it's a single looped wire around a seated area. The white and yellow and light green show that the hearing loop is evenly and within three decibels and loud enough. Yes, there is a little bit of overspill, which is not necessarily bad. It just happens. But that kind of loop is inappropriate for places with a lot of metal or where confidentiality is involved. And then you go to the left-hand side loop, which is a phased array loop. Note that there is a lot more wiring involved, much more engineering, and therefore, obviously, that kind of loop is more costly. Added benefit, no or little overspill, which is good for confidentiality if it's being done in a courtroom. And even the magnetic field is even, so there is no head tilt issue, which isn't necessarily a bad thing. But in a phased array loop, that is a lot less so. And there are no dead spots above the wires. What do you need? By the way, when you look at these fields, when you look at these magnetic fields, it's the vertical component of the hearing loop that gets measured. So it's the vertical magnetic field strength. And that's why you need a vertically placed telecoil in a hearing aid. And fortunately, telecoils are definitely on the increase. They're in all cochlear implants. They are currently in even the smallest of BTE instruments. They can be found in remote controls from Siemens and in the streamers from Oticon and Widex. So how do you read a tecoil spec? Well, in the red circle is shown in solid the reference test gain. The solid line is the reference test gain to the hearing aid with a 60 decibel input. So the solid line, 60 dB input, shows the reference test gain of that particular hearing aid. And the dotted line, indicated by the arrows in yellow, shows the magnetic input. Now frankly, I never looked at the magnetic input numbers because I didn't know what milliamp per meter really meant. But 31.6 milliamp per meter is the equivalent of 60 dB SPL. So 60 dB SPL and 31.6 milliamp per meter are equivalent values. One is a sound input and the other one is a magnetic input. And you're going to see that those numbers, those two graphs pretty much overlap. So this is a good telecoil. However, this complicates matters or something is complicating this. If you look on the left-hand side, the third line from the bottom, it says splits. The splits level is the magnetic input where there's 31.6 milliamp per meter magnetic input to the telecoil. But the hearing aid is put in its optimum position. It's not necessarily measured in the as-worn position. So that's why you really need to look at the SPLIV test. And that is the magnetic input test with the hearing aid in the vertical or as-worn position. Now the good news is that the ANSI standard, the S3.22 hearing aid standard, will soon include the SPLIV test. So if the SPLIV test and the splits test overlap, then you can be pretty certain that the telecoil is mounted vertically. Here's a great example of a SPLIV test. This is a Widex Fusion hearing instrument. The red arrow points to the acoustic input to the microphone, the purple, the magnetic input to the telecoil, and anything above 3,500 hertz pretty much overlaps. This is an absolute great telecoil. A few telecoil considerations. Auto coils do not work in a loop. The magnetic field strength isn't strong enough to trigger that auto coil. So be sure to give the client a manual telecoil. I personally like linked binaural programs for clients. So if they push the right button, both hearing aids will switch to telephone mode. I really like voice prompts. I would like to see them in every hearing aid. I'm finding that a lot of our clients have no clue what one beep, two beeps, three beeps, four beeps, musical beeps mean. I'm sure you know what I'm talking about. If you are ordering custom instruments, you want to be absolutely certain that you're ordering a vertical T-coil orientation, although it can be all the way up to about 45 degrees from vertical and still provide a very strong telecoil signal for the client. You may wonder how does the sound of a loop and a T-coil compare to sound via Bluetooth. And this is a quote from a cochlear implant and a hearing aid user and a loop installer in Arizona who says, who wrote me that he installs a lot of loops in people's homes and some have hearing aids that use Bluetooth. But without fail, after I've installed the loop, the comments pretty much all say that the Bluetooth sound, the sound from Bluetooth doesn't begin to compare with the absolute clarity of sound heard through the loop. And having tried Bluetooth myself, I agree. However, Bluetooth does have its place, like in a car or to the telephone, but the sound is not pristine. So he recommends that people get Bluetooth and telecoils in their hearing aids, and there's no issue in having both. And of course, you all know that Bluetooth requires significant battery power, has limited transmission range, and is meant for one-on-one transmission, which requires pairing, which we have been told by experts in the industry is going to take perhaps a decade before they will solve this issue. So we're not gonna be seeing any digital large area assistive listening technology transmission soon. When you're programming telecoils, I really want you to consider the situation. If this is for a client who's gonna use it for TV, then you would want he or she to hear their partner or the doorbell or the phone ring. And in that case, I almost always program an MT setting. If it is for church and they really have a hard time with background noise or their quicksand or speech and noise tests are very, results are very poor, then I recommend to go to T only. So to recap, for occluding fittings, for people with closed ear molds, for television, I prefer MT, otherwise they can't hear the spouse or the doorbell. For house of worship, I recommend a T only as it really reduces all the background noise. But for my clients who can handle, I almost always give them two programs, one telecoil program and an MT program and have clients who switch easily between the two during services. For open fittings, I never include the microphone. I turn the microphone off and I only give them the T coil program. They hear enough low frequency through the open fit that they don't need that microphone response in the hearing aid and it can cause an echo just like it can cause an echo with Bluetooth. So let's start about the Hearing Loop Initiative. I'm assuming that's why you're all registered. Yep, you can do this and no one's gonna do it for you in your community. That's obviously what we've all been fighting out and the best thing of all, your clients, your community will absolutely love you for it. So here are my six steps to a looped community and I'm gonna belabor all those steps a lot more. The first step, you wanna loop your waiting room and you wanna demonstrate and demonstrate and demonstrate to everybody who walks into your office. You wanna find or foster an installer and I have some recommendations about that. Then you definitely want to identify a list of places that benefit from a loop. Then I have a couple of slides on how to increase loop awareness and how to organize a hearing loop community event and the last step is on attending hearing loop dedications. So the first step, loop your office. This is not optional. It's absolutely true, hearing is believing. You wanna connect your loop to a TV or a DVD player and a word of caution there. You wanna select a DVD that has little or no background noise. I highly advise against you using some kind of manufacturer's marketing CD. Frequently there's too much background noise and too fast of a speech. You wanna listen to the DVD, perhaps a program that is a talk program with very clear speech. You also wanna purchase a couple of loop receivers so that you have them on hand to demonstrate to people who don't have hearing aids or who don't have telecoils or the spouses or the partners who wanna know what's going on in the hearing aids of their husband or their wife and you wanna demonstrate the loop to everyone. Here's an example of an office that has looped the waiting area. They moved that desk out of the way. They actually do small seminars right in that waiting room area. You want to be very clear about signage and I can help you or assist you with that but on the left, that TV doesn't have any sound. It only works through the hearing loop and on the right is an audiologist in Mequon, Dr. Holshue, who just installed the hearing loop in her office, proudly displaying the new loop sign in her waiting room. And of course you wanna demonstrate and you wanna demonstrate with a little loop listener. On the right is a loop listener that only works in the loop. It's very much like a pocket talker with headphones. The little device on the left from Comfort Audio is essentially a pocket talker if you switch it to mic and then if you slide the black switch down to T, it goes to telecoil and what's nifty about that setting is that it allows you to let people hear what it would sound like on the mic only and what it would sound like in the loop and you will certainly get some raised eyebrows when you do that. Now, how to find an installer. For large or commercial installations, you need a trained professional. You need somebody who can handle big churches, movie or civic theaters and these are almost always audio integrators. And in my area, there were none. I literally started calling large audio companies in Wisconsin and said, hey, why aren't you doing hearing loop installations? And we have now something like 12 or 13 trained installers and several are only doing hearing loop installations. There are two companies that offer recognized national training. One is the Contacta company, contactaglobal.com and the second one is Listen Technologies, can be found on the web under listentech.com and these companies will absolutely gladly direct you to well-trained installers who are proud of their work. So you contact them, they'll get you in contact with people who are in their area. Now, what if you wanna foster a local installer, a smaller installer? Maybe you have a good friend who is a good audio guy but he's never done an auditorium or has never done audio in an auditorium. First of all, you wanna tell this person that he absolutely has to follow a training. He has to go to IEC hearing loop installation training. They're being held all over the country and smaller installers for the audiologists and the dispensers I have relationships with, I find that they have the best relationships with small AV guys. They're good for waiting rooms. They will loop your patient's TV rooms. They can handle small meeting rooms or small churches or library rooms as long as they have the technical support and Contacta and ListenTech provide excellent technical support and they will work to make sure that the installation meets the IEC standard. And a small installer like that is also willing to then go with you when you're gonna do an educational seminar and when you loop your seminars. What does a professional installer do? Well, number one, he measures electromagnetic interference. You cannot have a loop installed in a facility without a field test at the facility. He also decides what type of hearing loop array is gonna be necessary. Can it be phased? Can it be a single perimeter? Can it be a figure eight or a snowman configuration? He will also integrate the loop with the existing PA system. So there's usually some work involved there and I hope that when you read those points, you understand why training for loop installers is so important. And good installers keep you in the loop of their work. They refer new installations to you for hearing loop dedications and they contact you because frequently, I will get an email from an installer saying, a minister contacted me and he or she would like to know what's involved with the hearing loop or how can they become better educated to talk to parishioners or to the congregation about hearing loops. This is a while back, but I ran into a minister at a church that was one of the first loops in Oshkosh, Wisconsin. And this minister spoke to me and said, I wanna thank you. She said, one of our parishioners who's quite up in age decided he or she, or was it he, was going to get a hearing aid. And she said, and I felt confident enough to tell this man, when you get a hearing aid, you need to make sure that you get a hearing aid with a telecoil so that you'll be able to use it in my church. So the word telecoil in our community is a common word. People walk into our office saying, I want a hearing aid with a T-coil or better yet, they say, I want a hearing aid that I can hear in church with. Now, the next step, you want to identify places that would benefit from a hearing loop. And what I did, literally the first two years, I kept a small binder in my office. I would ask my clients, do you belong to a church? Do you belong to a house of worship? Oh yeah, I go to First English. I said, great. I'm keeping track of who belongs to what church. And then I would say, would you mind if I put your name in this schedule, in this book, so that if I do get a call from a minister about a hearing loop, I can share with them that you are one of the parishioners who's interested in getting a hearing loop in the facility. If they gave me their permission, I would put a check mark behind their name. Within a year or two, I knew where everybody went. Some people don't belong to churches. Some people belong to learning retirements. Some people belong to the book club at the library. But I pretty much had an idea of where people go to hear, where they need to hear. So a list of houses of worship, that's where you're gonna find the most hearing aid users, of course. So you're going to get the most bang for your buck, if you want to call it that. Libraries are interesting. There's federal grant money available for hearing loops. And if you look on my list of loops in Wisconsin, you're gonna see probably 100 libraries having installed hearing loops. Of course, retirement and assisted living facilities, perhaps you already provide services in one of those facilities. And trust me on this, our clients don't hear well in those meeting rooms. They don't hear bingo well. They don't hear well for the religious services. And perhaps there's a special venue in your area. In my community, it was the Oshkosh Grand Opera House. And while I was giving a lecture at a rotary club, or after the lecture, somebody came up to me and said, okay, how much is it gonna cost to put a loop in the Oshkosh Grand Opera House? And literally within a week, anonymously donated over $8,000 to have the installation done. I donated the equipment for the Oshkosh Grand Opera House. And that's how you kind of can move loops forward. Now, increasing awareness in the community can take all kinds of different forms. Mary Cacavo, and I stole this slide directly from her, developed a folder of looping materials that you can give to patients and other people interested in hearing loops. And the content of that folder can vary. She had pretty soon a local article that she copied that talked about the benefits of hearing loops. She put that in her folder. She put on the left-hand side, you see get in the hearing loop orange flyer. Those can be had from the Hearing Loss Association, from HLAA. There's a frequently asked questions on looping handout in there. A patient handout that explains what a hearing loop is. She started keeping a list of loops in the area. I did the same. And looping advocacy cards. And I have some examples of that. So this is a patient handout. One is pediatric, the one on the bottom. The one on the top is for adults. And then what I did is I copied on the back the places that had hearing loops installed and the places that were measured. Because if places are looking into getting a hearing loop but don't move forward, a parishioner in a facility can help nudge that forward. So these are patient handouts. She also, and I did include reprints that clients can share with their ministers. Because you gotta give your client something in their hand. These can be had from hearing loop installers and they can be found in a PDF form on the web. This is another reprint that discusses David Meier's Loop America campaign. And it's not so much faith-based as it just explains what looping is about and why he is doing this. And these are the Share the Gift of Hearing Advocacy cards that, again, are available in a PDF form or in a generic form. And my clients drop these cards off everywhere. They'd go to a funeral, if they couldn't hear, they would put a card in the collection box. So you wanna build awareness in the community. And there's no way you can do this alone. You need to kind of foster local torchbearers, clients with resources. And frankly, they're often interested in leaving a meaningful legacy. And not only that, when they help donate towards a hearing loop, they benefit. They can go to church the next week and hear in the church in the loop. The second group, besides your clients, would be to reach out to local HLAA members. I tell you, HLAA members are chomping at the bit to move hearing loops forward in their communities and they will work with you. They will help get the word out. And then there's a whole list of other potential people in the community, and the sky's the limit there, but these are the most common ones. Members of the clergy, perhaps you have clients who are clergy members, parents of hard of hearing children, community foundation members, librarians, facility managers of retirement communities, and of course the service clubs. Frankly, anyone who wants to improve the quality of life in your community. Other torchbearers, in this case, you want to use your connections. You want to write about loops in your patient newsletters. I gave probably 20, 30 public presentations to Rotary Alliance, PEOs, pretty much anybody who needed a speaker, I would go in and talk about how to get in the loop. You want to exhibit perhaps at social fairs or senior fairs, and if you are in a situation to make a charitable donation or offer some money towards a loop, so-called seed money, that kind of donation has moved loops forward. And at the bottom, you may even get your name on a plaque, as happened at the Performing Arts Center in Appleton. Audiologists donated between 25 and $30,000 from practices from Green Bay, Appleton, and Oshkosh, and with that money, we ended up getting all our names and practice names on a plaque. You want to encourage your clients to write thank you notes once places are looped. You may want to perhaps write a letter to the newspaper. I have perhaps had 10, 15 letters published in the newspaper on the new Wi-Fi for hearing aids in the area. They publish without fail. You also want to add a looping page to your website and use some testimonials there and send news releases. Now, the fifth step, you want to host a community loop event. There are all kinds of examples available and community flyers that I'm happy to share with you. And to do a community loop event, you want to make sure that the event is going to be looped. Invite your patient database and the public. Be sure that you program as many T-coils in advance as possible. And be prepared for surprises. We had patients thinking that they pushed their button and they would say, oh yeah, yeah, sounds okay, sounds okay. But you could see on the face that they didn't really hear a big difference and then one of us in the practice would go over and turn the push button on and you would see their face turn white and red and just, there were people who cried because they couldn't believe the difference of how well they heard. And you may want to invite the looping expert to say a few words. Make sure you have plenty of loop receivers for demonstration. We put them on the tables. People could pick them up and listen. Now, the final step, the hearing loop dedication. That's where you, the provider, supports the place that has installed a hearing loop by either giving a presentation, by offering some news release. And again, you don't have to reinvent the wheel. This has all been invented already. On the left is an example of a news release. There's inserts for retirement communities. There's insert for bulletins. And you may wonder what do you do with a hearing loop dedication? Well, you would agree to attend the hearing loop dedication and the minister frequently does a short introduction. I've attended probably 30 or 40 hearing loop dedications. All of them are different. Sometimes the minister has me speak up. Sometimes the minister invites the provider to come up front and speak a few words about the hearing loop. And then you agree to stay following the service and answer questions that parishioners may have and chat, chat about hearing aids, chat about the loop. And usually people walk up to you and say, you know, how well they were able to hear. It's a very, very joyous event. And again, those bulletin inserts and news releases are available. A couple of pitfalls. We're nearing the end. The biggest pitfall, not listening for yourself. You absolutely want to walk into a, you don't want to walk into, cold into a venue having been told there's a hearing loop and it works. You want to go, you want to send your torchbearers or somebody who's willing to go out and try the loop and before they give, make sure that they give their A okay before you start using that venue for an event. Another pitfall, not engaging your clients in the process. Frankly, no one will listen to you. You're the person who sells the hearing aids, who fits the hearing aids, but they will listen to your passionate clients. Don't take I hear okay as gospel. I always referred clients to go try a hearing loop somewhere and they'd say, but I'm not Catholic. And I'd say, I don't care. I want you to go to St. Mary's and try the loop. It's lent, just go on a Wednesday and go listen in the back of the church. Just try it out. Be sure to host a loop event during daytime, daylight hours, don't host it in the evening. And your last pitfall, not beating your own drum once the hearing loop is in. A few benefits, you will spend a lot less time counseling regarding difficult situations because you make their most difficult situation their best situation. It certainly helps to set realistic expectations. It increases your client satisfaction with your services. It raises the awareness of the needs of people with hearing loss. Some of my most avid hearing loop advocates are normal hearing people. They get this. They understand that hearing loops benefit people with hearing aids. And your involvement will demonstrate your sincerity about helping your clients hear and wanting your clients to hear everywhere. So bunch of references that can be found on the web. I've written and other audiologists have written about this technology extensively. And yes, we come across as highly enthusiastic, perhaps somewhat overbearing, and I apologize if I sound that way, but you will never look again at the way your client can hear in the loop the same. It is amazing how well they'll be able to hear. So we're getting to the question and answer time. I'm happy to answer questions. And also on the next slide, I will show my email address. You're welcome to email me should we not answer your questions to your liking. So fire away, guys. Hi, everyone. Okay, Juliette, thank you for a great presentation. Everybody, we had about, gosh, I'm gonna say about 270 people today join us. So that is really exciting that we have so many audiologists and hearing aid specialists on the line today. So we do have some time for questions, as Juliette said. If you have a question, please do enter it in the question box on your webinar dashboard. Now, our first question is from Michael, and he wants to know how much time would one expect to get a looping program going in the practice from the time they say, okay, I wanna do this to the time that they're really ready to start offering it to patients and clients? Okay, I heard Dave Meyer speak on October 4th, and our first hearing loop went in in January. And it was one of my clients who heard me talk about this, and her husband very unexpectedly passed away, and she decided to use the memorial money for that hearing loop. So that was two, two and a half months. And that was at that time with my husband, who was an engineer, and who said that he would start looping to get this going in the community. He has since retired. This was in 2006 when this happened. I'm gonna say probably about three or four months. If you have a installer ready to go in your community, it could be faster, but probably that time before you can get a seminar together and get a venue looped. And you definitely wanna consider what kind of venue you're gonna be looping. If it's a venue that your clients only attend once a year, you're gonna get less bang for your buck, and you're gonna put a loop in a church where you have 30 clients. Thank you, Juliette. Now, we have a lot of questions coming in about the same thing. A lot of people wanna know, on average, and I'm sure costs vary depending on where you are in the country or in the world, but on average, what kind of costs are you looking at for the patients to loop? I should have said that. If we're talking about the loop equipment itself, it can be had from audiology supply companies or hearinglosshelp.com. They're about 200, $250, and there's handouts on the web that show how you can self-install a TV loop. Installing a TV loop, it doesn't have to meet the IEC standard, but if you're gonna be looping, let's say, a small, and now I'm talking Midwest here, church where there's a basement underneath the sanctuary and the wire can be installed against the ceiling underneath the sanctuary and radiate into the sanctuary, you're probably talking $2,500, $3,500, you know, $4,000 for a hearing loop for a church. If there is no basement or if there's a lot of metal in the facility, in order to meet the IEC standard and a phased array is required, then the cost doubles. So then you could be looking at $5,000, $6,000, $7,000 for a phased array hearing loop installation. A small theater, $15,000, $20,000 if it's an older theater like the Oshkosh Grand Opera House was 100 years old. If you're looking at a large performing arts center, you could be talking $100,000 and up. Great, thank you for the numbers. So when one wants to get into this, what kind of relationship do they have with the installers? Is the installer like a subcontractor of some sort or just someone that the specialist refers out to? You know, it goes in, I've seen it happen in a variety of ways where somebody set up a different division in their business or in their practice and they hired the contractor to do the hearing loop installations. In my area, since my husband retired, we did about 50 large hearing loops and he retired. And now when I get an inquiry, I basically refer to the audio and the loop installer and they do the hearing loop installation. And like I said, they then contact me for a presentation or to make a contact with the minister. And it never fails when an audio engineer contacts me to do that, to do a loop dedication. Somebody in the church or somebody in the facility says, you know, I know a church in a different place or my mom wears hearing aids or my dad wears hearing aids. And almost always hearing loops beget other hearing loops. So once you get bitten by that bug, you want hearing loops everywhere. And making those contacts is what's very valuable. But it comes in a variety of different ways and perhaps attendees to this lecture may wanna contact the ListenTech company or to contact a company to get some ideas of what kind of installers are in their area and how they're working. Great, thank you, Juliette. So some people would like to know, we had a few questions on this. What are the most common rooms in one's house that people want looped? Well, that's a great question because just to give you a name, the Univox DLS-50, that's one of the more common little loop drivers, that comes with 90 feet of wire, 90 or 93 feet of wire. So if your client lives in a fairly small home, frequently that includes the dining room and the TV. If there's a basement underneath the house, the wire can be stapled against the ceiling of the basement. And then the wire can be put through the wood floor to the back of the television. And 90 feet gives you a 20 by 25 foot area. So that's fairly large. The other solution is to use a loop pillow. A loop pillow is a very thin pad that comes with 30 feet of wire. And that wire can be tucked kind of behind the carpeting. You wanna make sure it's not a tripping hazard. And then put on the chair or hung behind the lazy boy chair and it will radiate around the chair and make that chair a looped chair. So it can be done a variety of ways. Now there are larger loop drivers available and literally you could loop quote unquote the whole house. But for a lot of our clients, if they're very hard of hearing, they don't only need to hear the sound, they need to see the sound as well. And you would wanna do it in a place where they can obviously watch the TV and see the screen. Great, great, thank you. I have a question from Vicky. She wants to know if the loop affects heart monitors since it's magnetic. A great question. And no, it doesn't. The magnitude of the magnetic field is less than the Earth's magnetic field, except it's a variation, it varies. So it's a fluctuating magnetic field, but there are no issues with the magnetic field strength. You would have to literally with your pacemaker be laying on top of the wire on the floor for that to be very close to that magnetic field. And even then the field strength is very, very low. Now, yes, I understand that there is a concern or the recommendation is for people who have heart monitors or pacemakers to, for example, not hang a neck loop right over their chest and over the pacemaker. But in the loop itself, there's absolutely no concern. Okay, good. So Martin wants to know if there is an app or some sort of directory where end users can find loops, not only in their area, but maybe when they're traveling or a Google map or something like that. Do you know if anything like that exists? I wish, I wish, but there is an attempt to do this called www.aldlocator, assistive listening device, aldlocator.com. That is not a crowdsourced site, unfortunately. And so if you know of a hearing loop in your area that's not on that list and it does meet the IEC standard, you can submit it to that website. There's a couple of other sites that are trying to keep track, but I'm hoping that somebody will develop a Yelp for hearing loops, but we're not quite there yet. So maybe an idea for someone out there listening who wants to take on yet another project. Yeah. Could be a really, could be a really good project. Okay, so we have a question from Josh and he says, traditionally I have used a T-coil for patients to talk on the telephone. So generally we have only put a T-coil on a custom hearing aid on one aid. Should we be working to have coils on both aids? Yes, that's the short answer, okay? Yes, now what you may want to do for those clients, if the hearing aid allows you to do this, because there are some wireless hearing aids where you cannot, but I would do T only on the side of the ear where he uses the telecoil on the phone. And then I would do MT on the opposite side so that in a loop, the spouse could sit on that side and he or she could still hear him, but he's still able to use the phone without feedback on the telephone ear. Oh, okay. Good, hopefully that answers the question. Otherwise email me. Okay, and we had a few people, and I believe you already covered this, but some people wanted to know about training locations to learn hearing loop installation. I believe you already covered that, correct? Yes, that's contactaglobal.com and Listen Technologies. And when you contact them on their websites and ask for the next hearing loop training, they will absolutely gladly teach you. Now, to learn to do hearing loop installations is a little bit like learning how to fit hearing aids. All you have to do is make the sound louder, right? So some hearing loop trainings are in-depth and take three days. So anybody can learn how to put a loop in a TV room. That's simple, but to do it in a venue and to have it meet the IEC standard, that requires significant amount of training. So those are the two companies that offer the best training, in my opinion. Okay, great. And we do have, everyone, just FYI, we have a ton of questions coming in, so we're trying to get to as many as possible. Julia, what is the, what would you say is maybe the oddest place that you've had looped or that you've heard of being looped? I had a client who wanted to loop his TV room, and then he got so excited and so carried away, he wanted two more. So he put one in the basement and one in his TV room and one in his bedroom. And then he contacted me and he said, but you can't have them all on at the same time. No, you can't, because these small TV loops radiate, there's a lot of spillover. So that was kind of a funny thing. And then I've had, this is a really, just a fun story. I have a family in the Appleton area, not my clients, but they decided to put a loop in their TV room for their two daughters who have hearing loss. And the first night, the kids went to bed and they were laughing upstairs. Oh my God, they had so much fun and they were giggling. And finally, Mom went upstairs. It turned out that they could hear TV in their bedroom if they turned their hearing aids full on gain. And so the parents then learned that as soon as the kids go to bed, they turn the loop driver off. Otherwise, the kids can hear everything what's going on downstairs in the TV room. Let this be a warning, guys. Just a great story, I think. Okay, one last question. We have a question from Angel, who wants to know if it's possible to install loops in a car? Yes, the answer is yes. It's generally done with a loop pillow. You may need to contact a company that does these extra speakers in your automobile. I have a client who drives a Prius or a friend who drives a Prius. And she went to one, I think she went to Best Buy and the Geek Squad and they pulled out a wire for her for an audio output. And then she plugs that into her little loop driver and she has a pillow that she sits on in the car. And there's another funny story. She wanted us to put that loop in her car and my husband ordered a special microphone so she could clip the microphone on her husband's lapel because the DLS-50, that's my hour, my hour is up. The DLS-50 allows for a microphone input. So you can hardwire a mic in that little loop driver and clip it on the passenger's lapel. And so my husband showed her the mic and she said, what am I gonna do with that microphone? And he said, well, that's for your husband. So you'll be able to hear him. And she looked at my husband and said, my husband, I don't wanna hear him, I wanna hear NPR. So she only uses it to listen to NPR, but you can do both, if not at the same time, folks. Oh, great. Well, hey, thank you for a great presentation. And everyone, we're just gonna go through a couple of things so you know where to get your CEs and CEUs. And Juliette, I just really wanna thank you for a wonderful presentation today and thank everyone for joining us today on the IHS webinar, Hearing Loops, How to Get Started in Your Community, presented by IHS and ADA. If you would like to get in contact with Juliette and you have further questions that we weren't able to address here, you can see her email up on the screen and we will send an email out tomorrow with her information again. So if you missed it or if you have to go, you're gonna get that information. So she is open to answering questions. As a reminder, you can get bonus materials from this presentation by completing and passing the CE slash CEU quiz, which is the same quiz. IHS and AHIP credit is available from IHS and AAA credit is available from ADA. So if you go to our website, IHSinfo.org, click on the webinar banner and you'll see the webinar for today listed. There's all the information you need on how to apply for these different credits. IHS and AHIP come to IHS and AAA credit goes to ADA. Tomorrow we're gonna send out an email asking for your feedback on today's presentation and there will be a link there for the AAA quiz as well as a link for the IHS AHIP quiz. So you'll have everything you need in order to get the credits that you need as well as the bonus materials. And when I say they're bonus materials, I mean, it's a whole packet that Juliette has put together for us with many of the materials she spoke about during her six steps to implementing a community looping initiative. So I wanna thank you all again for being with us today and thank you, Juliette, and thank you, ADA. And we will see you all at the next IHS webinar.

hearing loops

community

webinar

audiologist

listening experience

hearing loss

implementing hearing loops

telecoil spec

Q&A session