Article on Phone Use and CIs

[Guest guest]

Given the discussions we've had on CIs and phone use, I thought some of you

might find this article in the March/April 2006 issue of Hearing Loss

Magazine of interest. The direct link is:

http://www.hearingloss.org/html/hlma06lt.html

The text of this article has also been copied and pasted below.

This article is reprinted from the March/April 2006 issue

of Hearing Loss Magazine

Telephone Options for Cochlear Implant Users

By Linn Tearney

Getting Started

I thought about the articles I have previously read on

telephones for individuals with hearing loss and decided to approach the

topic a little differently. Most articles discuss the features of various

models of telephones that are available now. That's fine except two months

later, the featured phones are no longer available, replaced by new models.

" New " doesn't always mean " better " for those of us with

hearing loss because electronics in our hearing devices may interfere with

the electronics in a new phone feature. Consumers continue to be confused by

the choices, especially because, in some cases, shoppers can't try them out

before purchase.

Carrying on a phone conversation wasn't a skill that was

immediate for me when I received my cochlear implant in 1992. With a lot of

practice, I gradually got better using the phone. Besides needing to be able

to understand speech without lipreading, I also had to get over the phone

fear that developed when Meniere's robbed me of my final conversations with

a human being who wasn't standing directly in front of me.

I'm sure that most of us with hearing loss have been

limited in some way by our inability to access telephones. The expanding

field of telecommunications and the regulations requiring equal access are

creating a variety of options for us. My goal with this article is to

provide basic information to help each individual choose the best telephones

for his or her needs.

Choosing a Telephone

Because of our diverse hearing histories and backgrounds,

one size does not fit all when it comes to finding the best phone. If you

struggle with every telephone you have tried, this article will guide you to

phones with special features like tone control or strong telecoil pick-up.

We will survey accessories that work with the telecoil as well as those that

allow direct connection to the cochlear implant sound processor.

There are also alternatives to conventional voice

telephone use. New systems such as CapTel allow you to make a call

seamlessly, using your own voice, while watching real-time captions on the

screen.

Evaluating your Speech Discrimination Skills

To be successful using a conventional voice telephone, you

must have an adequate understanding of speech without lipreading. Therefore,

it's a good idea to determine your skill level before deciding the type of

phone you will need. Many people practice their listening skills for months

before they feel ready to use the telephone with strangers.

Most of the cochlear implant users I've spoken with who do

well on the phone improved with listening practice. Test yourself with

recorded phone messages such as the ones listed in many telephone books. Be

aware that some of the recorded messages have background music and these

will be more challenging.

Other ways that individuals can practice are by listening

to audio books or taking advantage of free websites that feature easy

listening exercises.

Using Phone Features to your Advantage

One can find all types of telephones with volume control,

built-in answering machines and speakerphones. If you don't have an

opportunity to test the phone before purchase, be sure it can be returned if

it doesn't work well for you. Sometimes speakerphones are a great way to

practice because other family members can help if you don't understand every

word. When testing a phone, be sure to check the quality of the speaker, the

volume control and if possible, the telecoil strength to make sure the sound

is clear. Depending on the type of phone you are choosing, there may be many

other features or accessories you can use to your advantage.

All landline telephones must be telecoil compatible in the

United States according to FCC regulations. The strength of the telecoil

pick-up is not regulated so consumers must test the phone with their

activated telecoil to determine its strength. The three major cochlear

implant manufacturers offer some type of built-in telecoil or a telecoil

accessory designed to work with telephones and other assistive listening

devices such as room loops, neckloops and a custom accessory called Hatis®.

If you are using a telecoil, ensure that the phone is a

distance from electronic devices like TVs, computer monitors, operating

microwave ovens or florescent lighting that might interfere with the

telecoil. The buzzing sound is caused by the telecoil trying to interpret

electromagnetic signals that these devices are producing.

Accessories for Landline Telephones

When I started using the telephone again after years of

hearing loss, I used the telephone adapter that was provided with my

processor accessory kit. The telephone adapter can be used to connect the

cochlear implant directly to a corded landline telephone with the keypad in

the base of the phone. Commercially available telephone adapters are

designed to work with most cochlear implant processors. Direct connection

provides the best sound quality because the microphone is bypassed and the

sound is processed by the individual's processor.

Cordless phones are becoming a necessity. One can find

cordless telephones with features like volume control, tone control,

built-in answering machines and those equipped with jacks for headphones and

other accessories. Custom cables that work much like telephone adapters are

also available for cordless and cellular phones. Patch cables similar to the

one pictured below have a 2.5mm plug to connect to the cordless or cell

phone and a 3.5mm plug that connects to the cochlear implant processor. Most

hands-free accessories for cordless or cell phones have a clip-on microphone

because the handset's mouthpiece microphone is disabled when an accessory is

connected to the headset jack.

Some individuals can successfully use headsets with

cordless and cellular phones. I prefer the type with a large concave

earpiece that completely covers my microphone. The padded cuff provides a

comfortable fit and also helps block background noise. The headphone jack

also allows one to use custom patch cables, neckloops or Hatis® such as

those shown below. Hatis® is an accessory that consists of a flat plastic

piece that has a miniature induction loop inside. A wire runs from the

earpiece to a 2.5mm plug. The loop inside the Hatis® earpiece transmits the

sound from the phone to the built-in telecoil or telecoil accessory. The

telecoil sends the sound signal to the cochlear implant processor. If the

handset causes interference when held near the implant components, these

accessories may be the solution.

Many individuals have reported that when using a telecoil

accessory or T switch, analog cordless phones usually work better for them

than digital or digital spread spectrum phones. The digital features can

cause interference that produces buzzing which overpowers the voice.

Cordless phones with expanded range such as 2.4 or 5.8 GHz are also

available in analog and can provide a better signal than the 900 MHz

cordless phones. Be sure to read the packaging or advertisements carefully

to make sure the phone is analog. If you decide to purchase a digital

cordless phone, the telecoil mode might produce buzzing.

Cochlear Implant Compatible Cell Phones

With advancements in cochlear implant technology, more

people are able to discriminate speech without lipreading and have greater

access to cellular telephones. Today, many cellular handsets are cochlear

implant compatible. Choosing the phone is not the only consideration when

considering compatibility. The signal that the cellular provider uses to

transmit calls is also important.

CDMA signal technology seems to be the most reliable when

it comes to sound quality. The CDMA technology isolates each transmission

and encloses it within a code. This keeps out static and other noise that

might interfere with speech understanding. The largest providers of CDMA

phones are Verizon and Sprint PCS. The best cellular provider will be the

one that has the most coverage in the area where you will be using the

phone. Ask friends and relatives who live in your area if they are satisfied

with their cellular service. You might also wish to try out their phones to

see how they sound to you.

I have tried some phones using a strictly digital signal

but prefer the dual or tri-mode phones that offer an analog signal if there

is no digital signal available. Those who travel to less urban areas might

need to access an analog signal if they are to get service in those areas.

Nextel uses the iDEN signal technology and every Nextel handset I have

tested produces a constant clicking noise when held next to my cochlear

implant processor.

Selecting the Cellular Handset

Once you've decided on some cellular providers you'd like

to try, it is a good idea to test a variety of handsets. Most cellular

providers' retail stores have activated phones you can test right in the

store. If you have a headset, Hatis® or other hands-free accessory you'd

like to use, it's a great idea to bring it with you. If you plan to use a

telecoil, try it with each phone to make sure there is no interference.

Be aware that some screen backlights might cause some

interference with the telecoil while lit. Screen lights can usually be set

to go off after a few seconds so the interference may be brief. Phones with

integrated screen backlights usually have little or no interference.

I prefer the flip or clam shell shaped phones because they

are easy to position next to my implant microphone or telecoil. When in use,

the mouthpiece is close to my mouth so I can be heard well even in a noisy

environment. The flip phone is also less likely to have a battery or antenna

that interferes with the signal because of the way the phones are designed.

Using Accessories for Cellular Compatibility

If your cellular phone or service is not compatible with

your cochlear implant, there are some easy solutions. By connecting an

accessory such as those discussed here, the phone can be used " hands free "

to create distance between the phone and the cochlear implant components.

Those who wish to use a telecoil can select from Hatis®, a telecoil

compatible cellular headset or a cellular neckloop like those pictured

above.

We are lucky to live in an era with options in both voice

and text phones. You might read of people on cochlear implant forums who

used the telephone with ease on the way home from their hook-up.

Statistically, the ability to use a voice telephone 'fluently' soon after

hook-up is an exception rather than the rule. Some individuals never feel

comfortable using conventional voice telephones and there are now many

popular options in text telephones such as the cellular phones like Treo and

Sidekick. It is simple to send text messages to other cellular phone users

who have text messaging capability.

For individuals who wish to use regular cordless phones or

cell phones but can't always rely on a voice telephone, there is VCO (voice

carry-over). The individual using VCO places their call through the

Telecommunications Relay Service and the relayed conversation is sent to the

LCD screen on the VCO device. A VCO accessory like the one shown below can

be connected to the headphone jack of most cordless and cellular phones.

Specialty landline phones are also available for those

with hearing loss. These telephones have a variety of features such as

amplification, tone control, loud ring tones, vibrating alerts, flashing

lights and jacks to connect accessories such as Hatis®, patch cables, or

neckloops.

One phone I tested recently is a good example of the

features one can find to help you hear your best. The Clear Sounds Freedom

Phone has all of the above features plus a large LCD screen for Caller ID

and large, easy to read buttons. There is also a cordless option for those

who prefer not to be tethered by cords.

There are a wide variety of telephones available today for

those of us who use cochlear implants. No matter what your current skill

level may be, there are phone options that work well. The resource list at

the end of this article will help you find the " perfect " phone for your

individual needs.

Resources for Phone Listening Practice

CapTel (Captioned Telephone)

www.captionedtelephone.com/index.phtml

888/269-7477 or 800-482-2424 (TTY)

Listening Practice

800 Directory - Find businesses that provide toll-free

recorded messages for listening practice www.inter800.com/

Randall's Listening Lab - Phone practice -

www.esl-lab.com/phone/phonerd1.htm

Randall's Cyber Listening Lab - www.esl-lab.com

Randall's Cyber Listening Lab basic self-study guide -

www.esl-lab.com/guide.htm

Randall's Listening Lab - A Day at School -

www.esl-lab.com/elem/elemrd1.htm

Telecoil Accessories

www.hatis.com

www.audex.com

www.soundbytes.com

www.etoengineering.com/Hearing-aids.htm

Telephone Adapters

Landline telephone adapters:

Nucleus Telephone Adapter - www.cochlearamericas.com

Sound Telelink Telephone Coupler

www.marilynelectronics.net/products/cochlear-implants/telelink-telephone-ada

ptors.htm

Cellular / Cordless Telephone Adapters

www.soundbytes.com

www.cihais.com

Headsets for Cellular/Cordless Telephones

www.plantronics.com

www.radioshack.com

Text Messaging Device for Cellular/ Cordless Telephones

www.hearmore.com

www.jdtravco.com

Specialty Telephones for Individuals with Hearing Loss

www.clearsounds.com

www.adcohearing.com

www.soundbytes.com

www.weitbrecht.com

www.ultratec.com

www.audex.com

www.hearmore.com

www.harcmercantile.com

www.harriscomm.com

Linn Tearney had normal hearing until she contracted

bacterial meningitis at the age of 19. She had varying degrees of hearing

loss until she became totally deaf at the age of 30. Linn received her 1992

and supports cochlear implant users at Cochlear Americas by providing

information and assistance. Linn enjoys helping other cochlear implant

recipients obtain the same benefits she has received from her cochlear

implant.

She can be reached at: ltearney@...

Mention of products does not mean endorsement by the

author or HLAA, neither does exclusion of products imply disapproval. This

list and mention is merely a help to readers.