Hearing Loss Help  

by Neil Bauman, Ph.D.

Until now, captioned telephone service has been restricted to landline phones (CapTel), or to phones (landline or cell) used in conjunction with a computer (WebCapTel). Now, if you have Apple’s iPhone (cell phone) with 3G service, you can have CapTel captioned conversations where ever you are by just using your cell phone.

If you don’t have Apple’s iPhone with 3G service, you can use any cell phone for the speaking part, but you’ll need another web device in order to read the captions. This could be any portable computer with web access, one of the following smartphones—Apple iPhone, Motorola Q9C, HTC Mogul or the Treo800w or a mobile device that uses Windows Mobile 6 or Apple Mobile Safari.

Once this service becomes widely available on most cell phones, hard of hearing people will be able to “hear” on their cell phones, just like people with normal hearing. But for now, the Apple iPhone with 3G service is a viable option, and points the way to what will hopefully become commonplace in the future.

You can read about it in the CapTel News from Ultratec—Fall 2008 edition.

by Neil Bauman, Ph.D.

A lady wrote:

I read with interest about the lady who had trouble hearing her own voice when using the neckloop with her cell phone. I, too, had that problem and had 3 of my programs on my Freedom CI switched to M/T mode.

I don’t use the neckloop often but recently went to a convention and used the neckloop with my cell phone to contact my friends inside the convention center. I could hear them well. However, they had difficulty hearing me when I spoke into the neckloop mike. They said my voice sounded “tinny” and “far away”.

My hearing friends got frustrated and just wanted me to hear and speak directly into the cell phone. Is this a normal occurrence when using the neckloop, or does this mean there is something wrong with my neckloop? Other friends have expressed the same difficulty of hearing my voice via the neckloop on other occasions. Please let me know what I can do this solve this problem.

The problem is when you plug a neckloop into the headset jack, then the cell phone’s mic is cut off—so you can’t accommodate your friends by talking into the phone’s microphone even if you wanted to. (That is why the neckloop has the microphone built in.)

I think most of what you are experiencing is an inherent problem with the basic design because the microphone is hanging down on your chest instead of up by your mouth. Obviously, the closer the microphone is to your mouth, the better (and louder) your voice will sound to people listening to you at the other end. Thus a neckloop microphone isn’t the best choice in that respect as it is always so far away from your mouth. Furthermore, the noisier the location, the more noise a distant microphone will pick up. Thus neckloop microphones would sound better in quiet situations.

Now, what can you do to help things along? I can think of two things. First, I wonder if you talk quietly in the first place. That would make it difficult for the more distant neckloop microphone to adequately pick up your voice. So speaking up would almost certainly help.

Second, instead of talking “out”, try talking “down” to your microphone. Aim your voice as best you can at the microphone. This should help too.

Doing both would be even better. Try this and see if it makes any difference.

If all else fails, hold the microphone up closer to your mouth when you talk. This should make a difference by greatly reducing the distance from it to your lips. It might look funny, but it should work.

Finally, there is always a chance that your neckloop isn’t working properly—but I’d try the above first. If the microphone is bad, doing the above shouldn’t make much difference.

by Neil Bauman, Ph.D.

A man wrote:

I wear hearing aids. Are there any cell phone attachments so that I can wear my hearing aids and use my cell phone in hands-free mode while I am driving?

If your hearing aids have good t-coils in them, then there are two good possibilities for hands-free cell phone use.

One is to get a cell phone that has the standard 2.5 mm hands-free jack and plug in the T-Links that couples to the t-coils in your hearing aids. If your phone has a proprietary hands-free jack, you can likely get the necessary adapter here.

Second, is to get a cell phone that has bluetooth built in and then use a bluetooth neckloop that also couples to the t-coil in your aids. You can see such a bluetooth neckloop here.

My wife’s cell phone has both the 2.5 mm jack and bluetooth built in so I use either option when I use her cell phone. Both work well for me.

by Neil Bauman, Ph.D.

A human services specialist contacted me and explained:

I was recently contacted by a woman interested in a neckloop for her cell phone (via t-coil setting). She finally tried one out, and didn’t like the fact that she couldn’t hear herself speaking. She has a hearing aid in one ear, and a cochlear implant (CI) in the other. Do you have any suggestions on how to hook up a system where she’d be able to hear herself as well as have access to the t-coil amplification? I’ve racked my brain and am out of ideas! Any help you can offer would be greatly appreciated.

Unlike land line phones, cell phones don’t have “side tone” which allows you to hear your own voice in the receiver. If you have normal hearing, when using a cell phone, you hear your own voice via your other ear.

However, when you want to use a cell phone with a neckloop or T-links, the hearing aid’s (and/or cochlear implant’s) microphones are turned off. Thus you can no longer hear yourself talk. As a result, you don’t know if you are talking too loud or whispering.

There are two ways to address this problem (apart from designing cell phones with side tone—but that would be too easy).

The simplest/easiest solution as I see it is to program her hearing aid (and/or CI) to the “MT” position (both microphone and t-coil on at the same time) instead of just the “T” position. Then she could hear her own voice as the microphone in her hearing aid (and/or CI) would pick her voice up and amplify it in that ear.

The other solution involves more technology—to create a pseudo-side tone. Here is one way she could do it using an independent system in tandem with the phone system.

For this to work, she’d need a PockeTalker (or other personal amplifier), a lapel microphone and a second neckloop or Music Links.

In practice, she would turn the PockeTalker on, place both neckloops around her neck and clip the lapel microphone to her collar. With her hearing aid and cochlear implant in their t-coil modes, she’d hear her cell phone via the one neckloop/T-links, and hear her own voice via the second neckloop/Music Links via the PockeTalker.

Most hard of hearing people just learn how much vocal effort it takes to talk at sufficient volume that the person on the other end can hear them, and yet not so loud they are blasting everyone within earshot. If this doesn’t work for her, then one of the above two solutions should.

You can get information here on a PockeTalker, neckloop and lapel microphone here  and information on the T-Links and Music Links here.

 by Neil Bauman, Ph.D.

A man wrote:

I have an appointment this Thursday to get new hearing aids with T-coils. I am truly excited about all the new better hearing avenues this will add to my “not too good hearing” life. I’m an accountant and, as you can imagine, I have to dress up every day for work (shirt & tie). I really like the features of the MaxIT Bluetooth Neckloop, but have one quick question:

Does the bluetooth apparatus have to remain on the loop necklace or is the necklace something I can remove and just keep the bluetooth piece in my shirt’s breast pocket?

The MaxIT Bluetooth Neckloop is one integrated piece. The “dongle” part contains the bluetooth electronics and battery. The “necklace” is really a neckloop. The bluetooth dongle wirelessly “connects” to your cell phone, while the neckloop “connects” to your hearing aids via their t-coils. Thus both parts are necessary. The neckloop is not just a lanyard to hold the dongle, but a vital part of the whole device.

Therefore, you need to wear the neckloop around your neck the way it was designed to work. However, if you want it to be reasonably invisible, wear the neckloop under your shirt and let the bluetooth dongle stick out the front of your shirt (so you can get at the buttons on it to make/answer calls), but it can be hidden behind your tie.

You can learn more about the MaxIT Bluetooth Neckloop, or order one for yourself by clicking on the above link.

by Neil Bauman, Ph.D.

A man wrote:

Dr. Neil: I have question. Are there cell phones that have the t-coil built in so you just hold the cell phone close and sound jumps to hearing aids t-coil? Thus, use of T-Links or neckloops are not necessary?

I’ve got good news for you. Yes—most cell phones are that way now. Therefore, all you need to do is hold your cell phone up to your hearing aid (in t-coil mode) and listen. If you hear well without any interference, that is all you need.

However, some phones and hearing aids still have too much interference (typically a loud buzzing) and by using the T-Links, you keep the phone far enough away from your hearing aids that you do not get this interference. (The interference drops off rapidly with increasing distance.) That is one reason to use the T-links.

Another reason you might want to use the T-Links is to have hands-free use—for when you are driving, or walking around. That way, you can have the phone in your pocket and hear it just fine. If you have a Bluetooth enabled phone, using a Bluetooth neckloop would have these same two advantages.

You can learn more about the T-Links here, and learn more about a Bluetooth neckloop here.

 by Neil Bauman, Ph.D.

A man wrote:

I love my T-Links. One thing I find is the sound is too loud with the T-Links, Oticon hearing aids, and many phones—even when set to their minimum volume. Any suggestions?

One of the reasons your T-Links sound so loud is that they are very close to you t-coils. The solution should be simple.

Have you audiologist reduce the amplification on the t-coils (in t-coil mode) to something that is just right when using the T-Links. It can be that simple to fix.

 by Neil Bauman, Ph.D.

A man wrote,

I currently have an in-the-ear hearing aid that is not bluetooth compatible, and I need a replacement. I want a behind the ear hearing aid that is bluetooth compatible. I was hoping to find an aid that is around $900.00. The bluetooth attachment adds another $400.00. Could you help me with locating an aid that is adaptable to a bluetooth attachment.

You sure don’t want much do you—a hearing aid for $900.00 with all the bells and whistles attached?

The first hearing aids with bluetooth attachments required a DAI (direct audio input) boot to attach a bluetooth gizmo called the ELI (which stood for “Ear Level Instrument”). Unfortunately, the ELI had a number of drawbacks. First, it was quite expensive. Second, it could only attach to certain makes and models of hearing aids thus limiting its usefulness. Third, it could only work with one hearing aid so you could never have binaural hearing via a bluetooth connection. This was because Bluetooth pairs with the remote bluetooth device—thus one aid pairs with your bluetooth device (phone, etc) and the other aid is locked out. Fourth, it had limited battery life.

Current technology places the bluetooth circuitry in a remote control, not in/on the hearing aids themselves. The remote then “talks” to both hearing aids at once. However, hearing aids that use this arrangement are high end aids and cost several thousand dollars each. At the same time, if you change your aids, you need a new bluetooth remote.

A much cheaper solution (which does my Scottish heart good) is a bluetooth neckloop that can be used with any hearing aids that have t-coils. This way you don’t have to throw out the bluetooth neckloop when you get new hearing aids. Furthermore, you don’t have a “pairing” problem as the neckloop couples to both aids via their t-coils.

What I’d do is keep my options open and get a bluetooth neckloop. That way you can hear with both aids (via their t-coils). The bluetooth “dongle” at the end of the neckloop pairs with your cell phone, MP3 player, etc. This way you are not tied to any brand of hearing aid—just that you need t-coils—which you should get in any case.

Personally, I like the MaxIT bluetooth neckloop.

by Neil Bauman, Ph.D.

A person asked:

Will a cell phone with an M3/T3 or an M4/T4 rating work OK as-is if held to my ear in “normal” use? Or should I purchase in addition the T- Links device you describe for optimal results? I have a difficult time hearing in noisy situations where the background noise level is moderate to high.

You’ll have to try each phone out and see. That’s the only way to tell for certain if it will really work with your particular hearing aids and t-coils.

Compatibility is a relative thing. There are many variables to consider. For example, you may find a given phone interference-free when it connects to a nearby cell tower, but find that it causes interference when the tower is far away.

This is because cell phones only put out enough power to reach the tower nearest them in order to extend battery life. Thus, if the tower is nearby, the cell phone puts out minimal power and with that, minimal interference, but if the tower is far away, the same phone has has to put out full power, and that may result in more interference.

Furthermore, some cell phone networks inherently cause less interference than others. For example CDMA networks cause the least interference, then comes TDMA and finally GSM with the most interference. So if your service provider uses CDMA technology (e.g. Verizon, Bell South, etc.) you will tend to get less interference than if your provider uses GSM technology (AT&T, etc).

As regards getting T-Links, much as I’d like to sell you a pair, I’d suggest you hold off on purchasing them until you see if you can use your new cell phone with just your hearing aids. If so, you have saved yourself some money and the inconvenience of using extra assistive devices. If you find you need the T-Links, you can always get them later.

by Neil Bauman, Ph.D.

A man wrote: “I found your website (http://www.hearinglosshelp.com/) with a keyword search via Google, and I’m grateful for the helpful information on it. I wear two Phonak hearing aids with telecoils. I haven’t used them so far, but I’m now shopping for a cell phone, and I believe my t-coils will be very helpful to me.

I’m looking online for a cell phone with M3-M4 and T3-T4 capability, and I’ve found several that seem suitable. I don’t want (and don’t need) the gizmos on most phones nowadays—camera, video, e-mail, messaging, exotic ring tones, etc. Can you recommend a “plain Jane” phone with M3-M4 and T3-T4 built-in?”

If you want a really plain and simple cell phone and system, have a look at the Jitterbug phones. They are simple and easy to use. They are also engineered for hard of hearing people. If you want to check them out, snoop around the Jitterbug web site to see if these phones may meet your needs.

According to the Jitterbug website:

Jitterbug phones feature a padded earpiece that’s not only more comfortable (especially for customers who wear a hearing aid), but keeps unwanted noise out. Plus, the volume adjusts from low to super-high, and has a speakerphone option that appears when you move through the volume choices. The volume can also be adjusted while you are on the call. The newest Jitterbug phones have the latest hearing aid compatibility technology called “T-coil” to ensure the best sound quality for those with hearing aids.

Note that Jitterbug phones have the highest hearing aid compatibility rating (M4/T4) although it doesn’t specifically say this on their website.

The one feature Jitterbug phones don’t currently have that you may find you want is a 2.5 mm headset jack. Without this jack, you can’t use these phones with t-links and neckloops. However, if you find you can hear well with just your hearing aids and/or t-coils just by holding the phone up to your ear, they should work just fine for you.