ALD Primer

* Courtesy: League for the Hard of Hearing

Questions and Answers:

Why do we need Assistive Listening Devices?
While the efficacy of modern hearing aids has long been established, many hearing aid users will still experience difficulty hearing in various situations. For these individuals as well as for individuals who do not wear hearing aids, the properly chosen assistive listening device (ALD) can prove invaluable in helping to alleviate these difficulties.
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What types of ALDs are there?
ALDs can be divided into two basic categories, alerting devices and communication devices. An alerting (or alarm) device would indicate that something important is occurring whereas a communication device would facilitate the reception and understanding of spoken material.
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What types of things can an alerting device tell us?
An alerting device can tell us that it's time to wake up, there is someone at the door, the telephone is ringing, the baby is crying or a smoke alarm has gone off.
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What are the different ways an alerting device can tell us something important is happening?
An alerting device can indicate that something important is happening by producing sound, extra loud sound, light, vibration or a combination of some or all of these.
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I have trouble hearing my doorbell but live in apartment and don't want to get an extra loud bell because this might disturb my neighbors. What can I do?
A common problem with doorbells is that the bell cannot be heard in a distant room. There are wireless doorbell systems in which the sound producing element (or receiver) can be placed at a location far away from the pushbutton (or transmitter) such as a bedroom, basement or attic. In addition, it is possible to use multiple receivers that can produce sound in more than one location at the same time which can make it possible to hear the doorbell in different locations within the same house or apartment.
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The small battery operated alarm clocks are just not loud enough for me to hear. What can I do? 
Some people use a radio clock set to a loud volume and tuned to a news station. There are still mechanical alarm clocks available which some people find easier to hear. There are also extra loud alarm clocks that can also be used with a flashing light and/or a bed shaker. In addition, there is a small battery operated vibrating alarm clock that can be placed under the pillow and is especially useful for people who travel.
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If I use a flashing light for the doorbell, what happens if I'm in another room when the doorbell rings? 
Many flashing light ALDs can also be used with remove receivers. These receivers can be plugged into other outlets in the house or apartment and have an outlet into which a lamp or light bulb can be plugged. When the main unit is activated, the remote units will also be activated causing the lights that plugged into them to flash. The main unit communicates with the remote units by sending a high frequency signal over the house AC wiring so that no additional wiring is required. You can have as many remote units as you need.
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If want to have a remote unit flash a light when the phone or doorbell rings and the light flashes, how do I tell whether my phone is ringing or there is someone at the door? 
The rhythm of the flashing will be very different depending on whether the telephone is ringing or there is someone at the door so that it is very easy to tell them apart.
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Are there alarm devices that can be used with body worn receivers? 
Body worn receivers are available which will vibrate and indicate the nature of the alarm condition, and may also be used by people who are deaf-blind.
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What are some smoke alarm ALD issues? 
Individuals with normal hearing can usually hear a smoke alarm even when it has gone off in another room or area of the house so that there is no problem with using separate and independent smoke alarms. Using separate and independent smoke alarms that have flashing lights may present a problem if the individual is in another room and does not see the flashing light. The best type of separate flashing smoke alarms to use in this case would be those units that have the capability of being wired in tandem so that if one of them goes off, all of them will go off so that the flashing can easily be observed no matter where one happens to be within the house or apartment.

In addition to flashing lights, there are also smoke detectors with a built in radio transmitter that will cause a receiver unit to activate a bed shaker causing it to vibrate. With this type of system, it is possible to use more than one smoke detector/transmitter so that smoke detection is available at more than one location.
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What types of communication ALDs are there? 
Basically, communication ALDs are used for the telephone, [the] TV, [as well as for large areas such as] the movie theater, classrooms, and noisy situations.  Learn more about communication ALDs.
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I'd like to get a louder telephone - what's out there? 
There are a number of possibilities - you may be able to make your present telephone louder (described below). There are also complete telephones available with built in amplification. These usually have other useful features as well such as a tone control, an extra loud ring and a flashing light. 
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What exactly is a T- coil? 
A telephone coil is small coil of wire within the hearing aid activated by a switch on the hearing aid which allows the hearing aid to pick up the phone signal directly. It will also prevent feedback and cuts out surrounding noise when making a phone call. A telephone whose ear piece emits a magnetic field that can be easily picked up by a hearing aid telephone coil is said to be hearing aid compatible. The telephone coil can also be used to easily and conveniently enable a hearing aid to work with various other types of ALDs. 
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Can I do anything to make my existing phone louder? 
There is a portable snap-on telephone amplifier which can be used with virtually any telephone; however, it may have to be attached and then removed each time the phone is used so that the phone can hang up properly. Also available are in-line telephone amplifiers which can be used with modular phones (where the handset can be unplugged and separated from the desk set) as long as they do not have the dialing keypad in the handset. These can be attached to just about any phone and can be left in place. 
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What about [amplified] cordless phones? 
There are cordless phones with built in amplification that are available. In addition, some of them have jacks that can be used with a hands free accessory. Some models also have a special jack into which special accessories such as a neck loop can be plugged into. 
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I travel a lot and sometimes have trouble using local telephones - any suggestions? 
Many travelers find the portable snap-on telephone amplifiers very useful. In addition, this device can also be used to turn a non hearing aid compatible telephone into one that is hearing aid compatible. 
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What is a TTY? 
A TTY (or TDD) is a device by means of which an individual can type to someone at the other end of the phone line who also has a TTY and can then read the response that has been typed back. 
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What if I want to communicate with a TTY user but don't have a TTY? 
You can go through the national relay system by means of which you speak to a special relay operator (called a communication assistant or CA) who would then type (or relay) the information to the TTY user. The TTY users typed response is then read back to the hearing caller. This service is available throughout the US and is accessed by dialing a special 1-800 telephone number or by dialing 711.
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No matter how loud I turn up my amplified phone, I still have a lot of trouble understanding what is being said - what can I do? I might consider using a TTY but can't type. 
Many hard of hearing people who can no longer use a conventional telephone are using a TTY with the relay system in a manner known as voice carry over or VCO. When used in this way, the TTY user is able to read the response of the person at the other end of the line which is typed by the relay operator. When it comes time for the TTY user to respond, he or she can just speak the way they normally would and their voice is then heard directly by the party at the other end. There are VCO/TTY telephones available that are specially designed to do this. 
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What about using a cell phone with my hearing aid? 
There can be problems of interference when using a hearing aid with a telephone coil with a digital cell phone however, there are certain digital cell phones that do seem to work well with hearing aids with T-switches. For those cell phones that do cause interference, there are accessories available such as hearing aid compatible hands free attachments or special neckloop or silhouette coils that permit the cell phone to be used at some distance away from the hearing thus reducing or eliminating this interference. 
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My TV is not clear and my neighbors complain that I have it on too loud. What can I do? 
A very simple solution would be the use of a remote loudspeaker which serves to bring the sound closer to the listener which will permit lower volume to be used and result in a clearer sound. Another option would be the use of a TV radio which does the same thing but will only work for transmitted channels numbers two through thirteen and not for special cable channels. There are also special radio frequency and infrared systems described below.
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I wear a hearing aid and have a particularly difficult time in noise - what can I do? 
Anything that will bring the speaker closer to your hearing aid will significantly improve this situation and to this end, an external microphone used with direct audio input (DAI) is highly recommended. DAI allows you to plug external devices into your hearing aid but only if your hearing aid has this feature. 
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What if I am 25 feet away from the speaker? 
Because a twenty five foot cord would be cumbersome, you could use a personal FM system which consists of a microphone and small body worn radio transmitter worn by the speaker and a small radio receiver that you wear that can either be used with headphones or with your hearing aid if your hearing aid has a telephone switch and/or direct audio input. A personal FM system and external microphone do essentially the same thing with the difference being that the FM system gives you a wireless capability and is a lot more expensive. [The Pocketalker would be another option.]
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I have an especially hard time understanding what is being said at the theater or at a movie. What can I do? 
Wireless headsets (either infrared or FM) should be available at theaters. You can also buy your own system to use at home with TV and then take the receiver with you to the theater or movies but keep in mind that these systems are not standardized and the headset you bring with you may not be compatible with the system in the theater. In addition to various listening systems, some movie theaters and some live theater as well are presenting special performances or showings that are captioned. Also keep in mind that at the movies, even though you may be using very good quality equipment, spoken dialogue may be difficult to understand because of background music and sound effects. 
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I know that some TV programs are captioned so that I can read what is being said but my TV set does not have this feature. What can I do? 
If you own a TV that does not have a built-in decoder chip (a set purchased prior to 1994), you can get an external decoder which will let you see the captions. Please keep in mind that although external decoders are still available, the easiest and most convenient thing to do might be to just purchase a new TV set. THIS ITEM HAS BEEN DISCONTINUED.
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I know that some people who wear hearing aids can use DAI and/or T coils to connect to external devices but I use a cochlear implant - what can I do? 
There are special cords known as patch cords that are available which will allow you to connect a telephone or other device directly to your cochlear implant processor if it has an external audio input jack. 
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Where can I see and try different ALDs? 
There are many centers available. You can check with your local SHHH chapter for local resources.
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Where can I purchase ALDs? 
Assistech carries a complete line of assistive listening devices for individuals with a hearing loss. Check out our products
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