The hearing aid is great, now what about my cell phone?

2. The hearing aid is great, now what about my cell phone? Melissa Pacey Mahaffey, AuD Jana Wells Rentz, AuD

3. Objectives • Telecoil overview • How to select for hearing aid compatible cell phones • FCC regulations & ratings • How to program for cell phone use in iPFG • Bluetooth options for cell phone use • Other options to connect to cell phones • Resources

4. Telecoils

5. Can I use the cell phone with my “T” button? • The telecoil was created to bridge communication between the telephone receiver and hearing aid • It does this by turning the magnetic energy emitted from the telephone into electrical energy • The cell phone does not produce the same magnetic field

6. What does the label “hearing aid compatible” mean? • This does not always mean a “telecoil” should be used to gain access to cell phone communications • This simply means there is reduced Radio Frequency Energy compared to the average allowable level in cell phone communications

7. Radio Frequency Energy (RFE) • Current generated for wireless broadcasting and communications • There is an allowable amount regulated by the FCC, ANSI and EEI • However, even the allowable amount can interfere with medical equipment • This is why cell phones have been known to have a high incompatibility rate with hearing aids

8. How Do Cell Phones Work? • When using a digital cell phone, the telephone conversation is transmitted over a wireless network using radio waves. • Cell phones may be thought of as sophisticated walkie-talkies, that use a separate transmission frequency for talking and receiving signals, enabling simultaneous two-way conversation.

9. How Do Cell Phones Work? • In typical applications, cell phone carriers chop the city up into cells across a city or region that are each around 10 square miles • Each cell has a base station that consists of a tower and a small building containing the radio equipment

10. How Do Cell Phones Work? • When moving in a car or on foot, communication between the base station and cell phone enable automatic switching from cell to cell via radio frequency (RF) transmissions • RF emissions create electromagnetic fields around the cell phones which cause interference with other electronic devices.

11. Digital Cell Phone Interference Basics • In addition to the RF interference, cell phones generate other emissions referred to a “magnetic interference“ • This type of emission originates from the cell phone's electronics and is independent of the basic interference caused by the RF transmission • Sources of this type of interference include: • backlighting on the display or keypad • the battery • the circuit board

12. Cell Phone/Hearing Aid Issue • The increase in cell phone use in recent years creates new challenges for hearing aid compatibility, as more and more hearing aid users are going “wireless” • When a cell phone is held up to a hearing aid, interference may be heard as a buzzing, pulsing, humming, or whining noise that can make speech recognition very difficult, regardless of whether the hearing aid is in “microphone” (M) or “telecoil” (T) mode

13. FCC Mandate • 2005: each provider make available 4 handsets rated at least M3 • 2006: each provider make available 5 handsets rated M3 or T3 • In addition, they had to make all of these available for testing IN-STORE! *Sprint/Nextel, Alltel, AT&T/Cingular, Verizon, T-Mobile

14. What do the ratings mean? • Acoustic (microphone) coupling: M3,M4 • T-coil coupling: T3,T4 • The higher the rating, the lower the interference, and better performance • M1/T1: poor • M2/T2: fair • M3/T3: good • M4/T4: excellent

15. More about the ratings • Hearing aids are also rated in this manner • To obtain the total rating value, add the hearing aid rating to the cell phone rating • i.e. Phonak instruments are all rated T2/M2. If a patient purchased a phone with an M3 rating, the total rating value would be M5

16. Tips for Patients • Patients should look for cell phones rated M3/T3 or M4/T4 • This does not guarantee that these phones will be interference-free with a particular hearing aid model, but will result in a combined ANSI 63.19 predictive rating of 5-6, indicating that the cell phone/hearing aid combination is “suitable for normal use” or “excellent”, respectively. • Patients should be reminded that other phone options such as keyboard displays and backlighting can cause additional interference. Turn these off when possible!

17. Features to look for • Options that may help those with hearing impairment use cell phones: • Vibrating ringer • Choice of ring tones • Volume control • Visual displays to indicate call functions – i.e. in use, no service, etc • Text messaging, email, instant messaging • T-coil compatibility • TTY compatible • Neckloop or Silhouette compatible • 2.5 mm audio jack Information courtesy of www.accesswireless.org

18. FCC MANDATE

19. PHONE SCOOP – phone finder

20. PHONE SCOOP – phone finder

21. Resources • http://www.fcc.gov/cgb/consumerfacts/accessiblewireless.html • www.phonescoop.com • http://www.accesswireless.org/ • Cell phone websites: • Sprint—search “hearing aid compatible” • Alltel—phones & accessories/disability access/speech & hearing • Verizon—store • AT&T—search “hearing aid compatible” • T-mobile—”hearing aid phones”

22. Software Programming • Touchless or “Easy” T-coil and microphone options • How this works with land lines & cell phones • Manually selectable phone programs • Common programming tips to improve phone usage

23. Touchless / “Easy” Phone • Touchless T-coils are popular options and available from every major manufacturer • The telephone program is automatically activated when the phone handset is placed in front of the hearing aid • The reed-relay switch inside the aid detects the presence of magnetic energy leaking from the phone and activates the phone program

24. Touchless / “Easy” Phone • If there is not sufficient magnetic energy (as in cell phones) a magnet can be placed on the handset to activate this switch • Some manufacturers (such as Phonak) allow the Easy or automatic phone program to be configured as a T-coil, microphone or combined M+T input • The choice is based on the type of phone(s) used by the patient

25. Touchless / “Easy” Phone • If the patient is using an M rated cell phone, then an acoustic or microphone setting should be selected • If the patient’s cell phone has a T rating, then a T-coil setting can be selected • More often than not, patients use a variety of phones during the day and a combined M+T may be the best option • Patients may also prefer to have M selected for one ear, and T for the other ear

26. Manual Phone Programs • Most manufacturers also allow the use of manual phone programs so that the patient can select the phone program • These can be configured as either a microphone (“acoustic”), T-coil or combined M+T setting • Again, the choice is based on the phone(s) the patient will be using – if their cell phone has a T rating a T-coil may be used, otherwise a microphone setting is best • In some cases, patients may wish to have a microphone setting in one ear and a T-coil in the other – some manufacturers make this possible through programming

27. Programming Tips • Whether using a T-coil or microphone setting, the following tips may improve patient’s phone experience: • Increasing overall gain, or gain for loud sounds (G80), especially between 500 Hz and 3000 Hz • Ensuring MPO is high enough – insufficient headroom will make speech sound “muffled” • Decreasing compression for more linear processing • Increasing strength of noise cancellation if T-coil is “buzzing” – i.e. set to moderate or strong

28. What about hands-free? • Many states now require hands-free cell phone use by law • There are several ways for your patients to comply with these laws and use their hearing aids too • The following options focus on using Bluetooth streamers or silhouette and neckloop products to link a patient’s hearing aids to their cell phone

29. What is Bluetooth ? • Where did the name “Bluetooth” originate • it is named after a Danish Viking and King, Harald Blåtand (translated as Bluetooth in English), who lived in the latter part of the 10th century. Harald Blåtand united and controlled Denmark and Norway (hence the inspiration on the name: uniting devices through Bluetooth). * • Bluetooth enables devices to communicate wirelessly with each other when they are in range. * • Bluetooth devices use a secure, globally unlicensed short-range radio communications system, so they do not have to be in line of sight of each other.* *Wikipedia.org

30. Bluetooth • Hearing aid manufacturers are taking advantage of this technology – more options coming out every year • Bluetooth accessories - Phonak iCom, Oticon Streamer, Siemens Tek, Starkey ELI • Bluetooth hands-free mics that utilize silhouette and neckloop connections • FM transmitter with added Bluetooth function

31. Patient pairs Bluetooth streamer with cell phone Wireless connection to hearing aids Cell phone conversation is streamed to hearing instruments – BINAURALLY – through the Bluetooth device Streamer acts as hands-free microphone - their voice is streamed back to person on the other end of the phone Additionally can give patient access to most any Bluetooth device – GPS, computer, etc Bluetooth Streamers

32. Bluetooth Streamers • Starkey Eli plugs directly into HA via DAI and audio shoe • Some streamers offer additional features such as: • Music streaming via cable – connect to MP3, iPod, etc • Audio streaming via cable – connect to DVD player, laptop, etc • FM – can plug in universal FM receiver such as MLxi – currently this is exclusive to Phonak’s iCom • More bang for the buck if device can do more!

33. Additional Bluetooth Devices Phonak SmartLink FM Transmitter • FM transmitter – provides basic FM function • Bluetooth device – can pair to any Bluetooth cell phone also • Phone conversation is streamed to hearing aids via FM receivers • Device is also hands-free microphone back to listener on the other end of phone • Many FM receiver options make this an option for most BTE users as well as patients using custom aids with a T-coil

34. Hands-free via Bluetooth • Bluetooth silhouette headsets • Beetle H2 or H2ST - Bluetooth connection to cell phone • Silhouette and neckloop options • H2ST is compatible with cell phones as well as other devices • Bluetooth Loopsets – connected to cell phone via Bluetooth – connected to hearing aids via T-coil and neckloop – also connect to computers, etc • Artone – amplified neckloop – mild to moderate HL • ClearSounds – amplified neckloop – mild to severe HL • MaxIT – amplified neckloop – mild to moderate HL

35. Important Note! • It is important to remember that neckloops and silhouettes do NOT work with touchless / “Easy” phone programs • The patient must use a manual T-coil program • May be configured as T or T+M

36. Beetle H-2 or H-2ST H-2 • Bluetooth stereo headset • Wireless music and audio streaming in stereo • Single or Twin options • Silhouette or neckloop available • $169 – 179 • Bluetooth headset for cell phone • Compatible with Bluetooth computer • Single silhouette only • $108 H-2ST

37. Bluetooth Loopsets Artone - $169 MaxIT - $175 ClearSounds CLA7BT - $169

38. Bluetooth headsets & Loopsets • Many options available • Vary by price, features and options • Things to consider: • Type of battery – alkaline or rechargeable • Talk time and stand-by time • Ease of use • Clarity / reception • Warranty – all list 1 year standard • http://www.tecear.com/Bluetooth_Comparison_Guide.htm

39. Tecear Bluetooth Comparison Guide

40. Hands Free Options (non-Bluetooth) • Corded connection to cell phone – connected to hearing aids through silhouette or neckloop and T-coil • Tecear T Link • NoiZfree Mobile • HATIS – several models – including one for ITE users • CLA7 powered neckloop

41. Noizfree Mobile • Wireless hands-free headset for hearing aids • Silhouette product • Set manually selectable memory to T or M+T • Works just like any other hands free headset for your cell phone! • Monaural or binaural • $39-49

42. T Link from TecEar.com • Hands-free cordedheadset • Silhouette product • Monaural or binaural options available • For BTEs only, set to T or M+T • www.tecear.com • 2.5mm plug • $49 Photos courtesy of Jana Rentz

43. HATIS • “Director” • Plugs into cell phone or landline phone • Uses T-coil & silhouette connection to BTEs • Boom microphone • Can order monaural or binaural silhouette • $200 - $300 • www.hatis.com

44. HATIS • “Freedom” • Plugs into cell phone • Uses T-coil & silhouette connection to BTEs • In-line microphone • Can order monaural or binaural silhouette • $150 – 160 • www.hatis.com

45. HATIS • “Producer” • For use with ITE hearing aids • Utilizes T-coil in HA • Plugs into cell phone or landlines • Has volume control • $190 • www.hatis.com

46. Resources for these devices: • www.oaktreeproducts.com • www.tecear.com • www.hatis.com • www.atsrecourses.org • www.elihearing.com • www.phonak.com • www.oticon.com • http://hearing.siemens.com

47. References • Ross, M. Telecoils are about more than telephones. The Hearing Journal; May 2006; 59; 24-28. • Marshall, B. Expanding roles for telecoils. The Hearing Journal; Sep.2002; 55; 40-41.

48. What to do with old cell phone? www.cellphonesforsoldiers.com • Started in 2004 by a 12 and 13-year old brother and sister in Massachusetts • Goal is to help soldiers serving overseas call home • Take old cell phones (any model, no matter how old) and recycle them via ReCellular • Money received from ReCellular for each phone donated is then used to buy prepaid calling cards for soldiers • They work with all branches of the US military

49. THANK YOU!!