What You Don't Know About Hearing Aids: Juliëtte Sterkens (Transcript)

Here is the full transcript of Juliëtte Sterkens’ talk titled “What You Don’t Know About Hearing Aids” at TEDxOshkosh conference.

Juliëtte Sterkens, a seasoned audiologist with over four decades of experience, delivered a compelling TEDx talk “What You Don’t Know About Hearing Aids,” shedding light on the common misconceptions and limitations associated with hearing aid technology. She began by engaging the audience in a demonstration to simulate mild hearing loss, setting the stage for a discussion on the prevalence and impact of hearing impairment.

Sterkens emphasized that hearing loss is not just about reduced volume but also affects how we perceive pitches and distinguish between similar sounds, especially in noisy environments. Despite technological advancements in hearing aids, she pointed out that these devices cannot fully restore normal hearing, particularly in terms of speech clarity and the spatial dimension of sound. She highlighted the importance of auxiliary tools and strategies, such as Bluetooth-enabled devices and telecoils, to enhance the hearing aid experience.

Furthermore, Sterkens advocated for the widespread installation of hearing loops in public venues and the activation of telecoils in hearing aids, illustrating their benefits through personal anecdotes and professional insights. Her talk not only informed but also encouraged individuals and society to better accommodate those with hearing loss, promoting greater accessibility and understanding.

Listen to the audio version here:

TRANSCRIPT:

I’d like to start with a short demonstration. Now, I can’t see many of you, but I’d like you to take your two fingers and put them lightly against the pointy bits in front of your ears. Now, I’d like you to push until your ears are completely plugged, and keep them plugged. And what you’re experiencing right now is mild hearing loss.

Okay, you can let go. What you experienced just now is mild temporary hearing loss.

In my audiology practice, I routinely tested new patients with hearing loss twice as bad as you just experienced.

Hearing loss is common. For many of us, it’s not a matter of if, but when we will lose some of our hearing. About half of us will acquire it by age 75, two-thirds of us when we reach our mid-80s. It’s on the increase in children, and baby boomers are experiencing more hearing loss than those of past generations. And if hearing loss runs in the family, there’s a good chance you’ll get it too.

The Impact of Hearing Loss

You’ve got to choose your parents wisely. But kidding aside, besides affecting quality of life, it can have serious repercussions such as depression, social isolation, contribute to cognitive decline, and even increase the risk of falls in older adults. And hearing loss is much more than a loss of volume, the kind of hearing loss that you just experienced. Pitches are heard unequally.

My father could stand right under a smoke alarm, not hear a thing, but he had no trouble hearing the garbage truck rumble down the street from inside the house. And hearing loss due to aging and noise exposure changes how we understand speech. And it causes words that sound similar, like zip and sip, wake and late, mad and dead and bad, to sound the same, especially when there’s background noise. And as unintuitive as it may be, loud sounds can become unbearably loud, distortingly loud.

The Limitations of Hearing Aids

Hearing loss is a complex problem. Perhaps you know people who, even wearing hearing aids, still have to have the TV volume up, always watch TV with subtitles, frequently ask everybody to repeat that. “Would you please repeat that?” Aren’t hearing aids supposed to solve these problems?

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When I began helping people with hearing loss over 44 years ago, I expected that hearing aids would be like eyeglasses, and that wearing them would make everything sound crystal clear. If that were only true. I have personally witnessed over four decades of hearing aid developments, advancements, from analog to digital devices, devices that can be remotely programmed, that include fitness tracking and feedback and noise reduction using artificial intelligence. They still don’t work the way we hope they would. And how can they?

Advancements and Challenges

Hearing aids can’t make hearing normal. They’re good at making sound louder. But they can’t always make sound, the speech, clearer, especially when the inner ear and the hearing nerve are affected. And hearing aid microphones have a limited effective range of about four or five arm’s length.

And hearing the world through these tiny hearing aid microphones reduces our exquisite three-dimensional hearing ability down to one dimension. Consequently, hearing aids cannot improve the clarity of the sounds we want to hear relative to the sounds we don’t want to hear beyond that critical microphone distance. Something that normal hearing ears accomplish effortlessly. Of course, hearing aids are needed to make sound audible.

Enhancing Hearing Experience

But for many, they are not a complete solution, especially when you consider that hearing aids, at best, even the most advanced hearing aids, can only restore about half of the hearing loss sensitivity.

Well, what about the other half? What about those microphone distance limitations? Better hearing is possible. And let’s talk about some tools and some strategies that can make that happen. We’re all familiar with these little wireless earbuds that allow people to listen to music and make phone calls whenever they’re on the go.

Did you know many modern hearing aids can do that also? Hearing aids can be paired via Bluetooth technology and an app on the smartphone to make hands-free phone calling possible, as well as the streaming of podcasts and audio books and those Google maps navigation directions right into hearing aids.

And additional Bluetooth accessories can be purchased to make hearing over distance possible. So, a small TV transmitter can send sound from the TV direct into hearing aids, and wireless microphone accessories can be added to improve hearing under those noisy situations. They can be clipped to the collar of a shirt or put on the table in the restaurant, closer to the people you’re trying to hear, or handheld, pointed at people at a cocktail party. Sometimes you don’t need any technology at all, but simply being considerate of one another.

Practical Communication Tips

If you know that hearing aids don’t restore hearing to normal, don’t speak from the other room. Right? Get the other person’s attention and make eye contact before speaking. Rephrase part of a conversation. Repeat a punch line. Speak a little clearer, a little bit louder, a little bit slower. And most important of all, move closer. When you move closer, you make communication a lot easier for the person with hearing loss and you allow the hearing aids to be in their most effective range. All doable at home and in the office, but not always very practical.

Having some of you come up on stage to hear me better right here might be cozy, but it’s a little awkward. And frankly, it’s not necessary. Because of the ADA, the ADA law, the Americans with Disabilities Act requires that places of public accommodation, think high school auditoriums and courtrooms and theaters like this one, where a PA system, a public address system, is in use, that they also provide an assistive hearing accommodation for patrons with hearing loss, analogous to venues having wheelchair ramps for patrons in wheelchairs.

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Similar laws exist elsewhere, like in the UK and the EU and Israel and Australia. These hearing accommodations, also known as assistive listening systems, broadcast audio from the PA system, from this microphone, wirelessly to hearing aids or to assistive devices, headset devices that the venue, by law, is required to provide and to make available at a service desk.

Yet, the typical hearing aid users and the general public are unaware that these laws apply to people with hearing loss and that these systems and that these assistive listening devices even exist. Consequently, they don’t take advantage of these assistive listening systems.

The Role of Telecoils in Hearing Aids

As an audiologist, an advocate with the Hearing Loss Association of America, I work to help consumers hear their best with their existing hearing aids and especially help them hear in public venues using these assistive listening systems. That’s made easier if their hearing aid includes what is called a telecoil. It’s a tiny antenna that comes to the consumer at little or no cost, and when that telecoil is turned on, generally it requires a push of a button, it will receive signals that are broadcast by a hearing loop system. Hearing loop is one type of assistive listening system.

Frequently, that little telecoil is already in the hearing aid, but the consumer is unaware because their audiologist may not have activated that feature in the computer and not explained what that little telecoil is for, or worse, there’s no telecoil in the hearing aid because it wasn’t recommended at the time of purchase. And why telecoils are so beneficial will hopefully become clear when you hear this next audio recording.

This historic 140-year-old theater has had a hearing loop installed for over a decade, and if you’re sitting in the audience and you are wearing hearing aids and this is news to you, now is the time to turn on the telecoil in your hearing aids so you can hear for yourself. You’ll be hearing a recording, the first part, you’ll hear as if you’re hearing through a hearing aid, with the hearing aid set to microphone, followed by a recording as if you were using a hearing aid with the instrument set to telecoil.

Personal Stories and Advocacy

Let’s listen. We all want to live a long life. We as Americans don’t want to get old in order to get there. We’re sitting there and our young people in their 20s and 30s and 40s making fun of older people, making cracks about older people.

If a person has a telecoil in their hearing aid and a venue has a hearing loop installed, all that consumer needs to do is walk in, sit down, and when the lecture or the show starts, turn on the telecoil.

In 2009, I was sitting in the back of a church where the week before a hearing loop had been installed when Russ, one of my dear patients with severe hearing loss, walked in. Now Russ was familiar with telecoils because he used the telecoil at home to hear on the telephone. And when the minister began to speak, Russ is sitting in front of me, I see Russ turn around, kind of gesturing at his hearing aid, looking at me, so I give him the nod that he should turn his telecoil on, and Russ goes, “Whoa, I can really hear now.”

That experience, helping Russ hear like that, you know, basically launched me on a hearing loop mission of 15 years. At first, I wanted all my patients to hear like that, and my patients and I began advocating for hearing loops in the community, but soon I could no longer be content just fitting hearing aids. I wanted every hearing aid user in the state, and frankly, in the country, to learn about telecoils, about hearing loops, and the advantage of assistive technology.

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And since that time, we’ve made some terrific progress, from about two dozen hearing loops in 2011, to nearly 900 hearing loops today. These hearing loops are in senior centers, and in library meeting rooms, in high school auditoriums, in courtrooms, in city halls, and in some 500 places of worship.

And around the country, thanks to my efforts, and the efforts of some very passionate other hearing loop advocates, hearing loops and their distinctive blue symbol with the letter T, which of course stands for telecoil, can now be found at airports, and large performing arts centers, and landmark places, outdoor theaters, and even in New York City taxicabs. There’s even a hearing loop in the U.S. Congress House of Representatives. I’ve always wanted to go over there and check it out. I’m not sure if it’s working.

Hearing Loops and Technology Integration

In one more development, thanks to big tech, hearing loops are being put on the map. Google Maps is now starting to show hearing loops in its accessibility section. It’s a work in progress, because there are many more hearing loops abroad than there are here in the United States. But it will allow anybody with a smartphone to check before they go to a wedding or to a lecture and see if a hearing loop has been installed. And if not, to go to the service desk and pick up a listening device.

If you use hearing aids, and you’d like to hear better, or you know someone who uses hearing aids, and you’d like to help them to hear better, you know, hear the half that hearing aids alone are unable to provide. I urge you to try out those Bluetooth accessories, get your telecoils activated by your audiologist, and insist your next set of hearing aids come equipped not only with Bluetooth technology but include telecoils as well. And if you don’t use hearing aids yet, but you would like to hear better, the next time you go to the theater, pick up a listening device. You’ll hear better than sitting in that front row seat, by the way.

Explore the Get in the Hearing Loop toolkit from the Hearing Loss Association of America. Or reach out to consumer organizations in your country for people with hearing loss. If in public places that are important to you, you have trouble hearing, or where an assistive listening system is not installed, or it’s not working, or it’s not providing a meaningful benefit, reach out to the venue and get them on board. As a last resort, you can always file a complaint with a regulatory agency, such as ADA.gov.

Become familiar with accessibility laws in your state or in your country. I believe that together we can make the world more accessible for people with hearing loss. If you have trouble hearing in a public venue, speak up.

What You Don’t Know About Hearing Aids: Juliëtte Sterkens (Transcript)