Volume 30 Issue 4

HOH-LD-News
Vol. 30, Issue 4
January 27, 2007

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Table of Contents
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- Article 1: Introduction to mobile phones - Part 2

- Article 2: Bilateral Cochlear Implants - Medical Perspective

- Article 3: Deaf Documentary to Air

- Article 4: Short Takes

Our advertisers make it possible for us to provide HOH-LD-News as a free service. Please let them know you appreciate their support, and please mention that you saw their message in HOH-LD-News.

- Advertisers in this Issue
First Premium Placement:
Available - Contact larry@hearinglossweb.com
Second Premium Placement:
More Anniversary Savings at Harris Communications
Third Premium Placement:
Hearing Aid Repairs from Hearing Haven
Fourth Premium Placement:
Switch to Sprint
Get your special Valentine's gift from Sound Clarity Inc.
Classified Section:
Two online stores and two employment opportunities

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Contact information and disclaimers are at the end of this newsletter.
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- Article 1: Introduction to mobile phones - Part 2
Presented by Scott Kelley
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With improvements in both telephone technology and hearing aid technology, more people with hearing loss are able to use mobile (cell) phones. Here's Motorola's Scott Kelley with great information on mobile phones and how to choose one.

This article is part of our coverage of the 2006 ALDA National Convention (ALDAcon). For more coverage of this great convention, please point your browser to http://www.hearinglossweb.com/res/hlorg/alda/cn/2006/2006.htm

This is part two of two parts.

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Wireless phones can interfere with some hearing aids and cochlear implants, causing an annoying or even painful buzzing. There are two types of interference. One is the radio frequency (RF) interference when my phone is talking to the tower. The second type is baseband (0-5kHz) interference. There are all kinds of components in the phone doing all kinds of things. People with normal hearing can't hear them, but sometimes hearing aids pick them up. They can be particularly loud when people are using their telecoils.

Q. Are we talking about things specific to the cell phone, or other things in the environment?
A. We're talking about signals produced by the cell phone.

Q. Can you shield against this interference?
A. Yes, and we'll talk more about it later.

Q. Is the buzzing sound similar to the buzz caused by fluorescent lights?
A. Different types of interference produce different kinds of buzzing. The fluorescent light ballast produces a 60 Hz signal. The backlight of some phones produces 50 Hz signals, which are similar to the 60 Hz signal. Keypads are also notorious for producing interference.

If you hear a buzz when you hold the phone up to your ear, and it goes away when you move the phone away from your ear, it's caused by your phone. Phones typically don't cause interference when they're more than a foot or so away from your hearing aid.

Something like a backlight may be on for 10 seconds. So when you use your phone, the interference may be on for a while and then go away.

When there is interference there is a source and a receiver. And the interference is never the fault of just one of them. Hearing aids, for example, can be shielded to help remove interference. Capacitors on the input circuitry of your Tcoil can reduce the buzzing, so shielding and filtering are two ways to immunize hearing aids from interference.

Hearing Aid Compatibility (HAC) is a systems compatibility issue, and both the telephone industry and the hearing aid industry must work to make the problem go away.

Hearing aids produced in the last 18 months or 2 years tend to be shielded and filtered, so those are less susceptible to interference.

C. When you get your hearing aid refurbished, you can ask them to refurbish your Tcoil, as well. That might help with preventing interference. You typically have to ask to have your Tcoil included, or they normally won't do it.

Measuring individual devices to predict system compatibility - ANSI C63.19 is the standard. The idea was to allow you to test a hearing aid and a cell phone separately and be able to predict if they will work together.

The standard was released in 2001. It discusses hearing aid immunity, which is how well the hearing aid blocks RF and baseband signals. It also discusses telephone immunity, which is how well the phone blocks the signals. Both hearing aids and phones are given ratings from one to four, with higher numbers being better. In general if the sum of the ratings for a hearing aid and a phone is five or higher, the performance of the phone with the hearing aid should be acceptable.

The testing has become quite complex, with fixtures that allow the phone and hearing aid to be tested under very precise conditions.

The FCC HAC mandate specifies that a certain number of phones from each manufacturer and for each digital language must be HAC.

C. I go to the phone stores and I find that the people who work there really don't know much about which phones work well for people with hearing loss.
A. We're not a carrier, so we aren't directly involved in this. And you have to understand that these stores are often manned by 16 year olds who are working there for the summer, and they don't have a clue about how to help you. But I also understand that it's very frustrating for you. One thing we're doing is coming up with a DVD to train the people who work in the stores. We hope that helps.

The FCC is the governing body for wireless phones. They looked at the standard that we talked about, and said that they don't regulate hearing aids, but they do regulate cell phones. So they took the cell portion and mandated that you have to have a certain number of phones that rate M3 or M4 and rate T3 or T4. The M is the immunity rating when the hearing aid is used with the microphone, and the T is the immunity rating when the hearing aid is used with the telecoil.

What's missing from much of this discussion is the hearing aid. The hearing aid ratings aren't nearly as far along as the phone ratings. Most people have no idea how their hearing aid is rated. To find out how the system will perform, you need to add the cell phone number to the hearing aid number to get a system score. You can't do that if you don't know how your hearing aid performs.

Q. Can we call the CI companies and ask them what their score is.
A. The standard is really for hearing aids, and I don't know if it really applies to CIs. Because of the similarities between the functions, I think they may apply to CIs, but I really don't know.

The moral of the story is that you're stuck with the hearing aid or CI aid you have. So your best bet is to go to a phone store and try a phone, and if that doesn't work, try another one. And if the store won't let you do that, go to a different store.

Remember that this is a system issue. We think it's a little strange that when your $50 phone interferes with your $5000 hearing aids, you get upset about the $50 phone. We think that the hearing aid manufacturers have some responsibility here, as well, even if the FCC doesn't mandate it.

Bluetooth is a system that lets devices talk to each other wirelessly. For example, a headset can talk to a phone, or a PDA can talk to a laptop. The most common application is a wireless headset.

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- Article 2: Bilateral Cochlear Implants - Medical Perspective
Presented by John Vaughn, M.D.
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John Vaughn, M.D. discussed the medical aspects of bilateral cochlear implants at the January meeting of the San Diego Cochlear Implant Group. Dr. Vaughn is one of the premier CI surgeons in the San Diego area.

Dr. Vaughn began his presentation by reminding us how extraordinary the cochlear implant is. It's the first electronic replacement for a natural sense, and it has progressed remarkably in the roughly twenty years since the first CI was approved by the FDA.

The cochlear implant is also interesting because of the controversy surrounding its use. Many culturally Deaf people have opposed and continue to oppose the use of a cochlear implant to treat deafness. The first National Association of the Deaf position paper that outlined the benefits of the cochlear implant appeared only in 2000.

The Research Triangle Institute is renowned as an independent, nonpartisan organization that engages in research of biomedical technology. One of their areas of specialization is the cochlear implant, and Dr. Vaughn reported on some of their findings, with an emphasis on real-world benefits.

The most obvious benefit of bilateral cochlear implants is that they overcome the head shadow effect. This is the phenomenon that the ear on the side of the head away from a sound hears that sound far less well than the ear on the side near the sound. So one obvious benefit of having CIs in both ears is that a person has access to sound regardless of which side it's coming from.

Somewhat more interesting is the fact that bilateral implants provide significantly better speech intelligibility in the presence of noise. One test that was done had speech coming from in front of the subject and noise from one side. As you would expect people with a single CI were much better able to understand speech when the noise was coming from the side away from their implant.

But what happens when testing is done on a person with bilateral implants. In this case tests are repeated with each implant individually, and with both implants. People do significantly better when using both implants than when using either individually. .

A second real world effect is binaural summation, the fact that something heard with both ears seem louder than the same thing heard with only one ear. This effect seems to be especially important with moving sound sources.

An interesting side note is Marion Downs' theory that each of us has a dominant ear and that it generally corresponds to the dominant hand. There isn't a lot of evidence to support this yet, but as bilateral implants become more common, it should become clear if this is the case or not.

A third effect is the squelch effect, which affects intelligibility of speech in the presence of noise from the same direction. A person with bilateral implants does better on this test when using both implants than when using either implant alone.

Dr. Vaughn then spent some time discussing insurance coverage for bilateral implants.

The best news was the fact that Anthem (the corporate umbrella for Blue Cross and Blue Shield) has approved bilateral cochlear implants! One of the reasons for this decision is probably the fact that an overwhelming percentage of appeals regarding bilateral cochlear implants have been decided for the patient. It may well be less expensive for them to simply provide bilateral implants rather than provide them only after losing a protracted lawsuit.

Unfortunately the news with Medicare is not so good. They established a new cochlear implant policy about a year and a half ago, and did not include bilateral implants. They also made the cochlear implant acceptance criteria more restrictive!

It's important to get pre-authorized with Medicare, and they seem to be doing this strictly by the book. A patient who doesn't exactly satisfy all of the conditions will be denied, even if the common sense answer is that he should get an implant. Note also that it's dangerous to proceed without an authorization. If Medicare selects your case for audit and you do not meet the requirements, you become responsible for all the costs!

Dr. Vaughn then took questions from the floor.

Q. Can you comment on hair cell regeneration?
A. Hair cell regeneration does seem to offer significant hope that people may eventually be able to regain some hearing. The bad news is that we're not there yet, and we don't know when we will get there. And even after we have procedures that work, the trial and procedure process could take another five to ten years. So it's promising, but probably a long way off.

Q. I have recently decided to pursue a second CI. How much hassle can I expect?
A. That's a good question, and it depends on your particular situation. You may be hassled and denied by your insurance company (although I expect all of them will soon follow Anthem and routinely approve bilateral CIs). You may even be hassled by your audiologist and doctor. Many of them aren't current on cochlear implant research, and may be unaware of the demonstrated benefits of bilateral CIs.

Q. Do you know the status of Advanced Bionics' Harmony processor?
A. The last I heard was that it would be available in early 2007. So I guess the question is, "how early?" I believe people with the Auria processor will get a letter explaining the trade in policy. There may be an upgrade charge, depending on what equipment you have. Most insurance companies will cover that charge under durable medical equipment. I think they generally cover up to $5000 for that, which is probably more than the upgrade charge.

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Visit our website, call 888-412-3337, or email us at
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- Article 3: Deaf Documentary to Air
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Editor: PBS will be airing a 2-hour documentary on Deaf history in America on March 21. Don't miss it!

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Mark your calendars for the premier of the first comprehensive film on deaf history - Through Deaf Eyes, to be shown on the Public Broadcasting System (PBS), March 21, 2007. "Through Deaf Eyes" will be broadcast nationally at 9 p.m. ET (check local listings).

"Through Deaf Eyes" is a two-hour HDTV documentary for PBS exploring nearly 200 years of Deaf life in America. The film presents the shared experiences of American history - family life, education, work, and community connections - from the perspective of deaf citizens. Interviews include community leaders, historians, and deaf Americans with diverse views on language use, technology and identity. Bringing a Deaf cinematic lens to the film are six artistic works by Deaf media artists and filmmakers.

Outreach partners are the National Association of the Deaf, Gallaudet University, the National Technical Institute for the Deaf at Rochester Institute of Technology, and California State University-Northridge. As part of the outreach campaign, numerous local organizations, some in association with their public television stations, will mount events and discussions exploring the issues raised in the film.

The film was inspired by the exhibition History Through Deaf Eyes, curated by Jack R. Gannon at Gallaudet University. "Through Deaf Eyes" is a production of WETA Washington, D.C. and Florentine Films/Hott Productions in association with Gallaudet University. The producer is Emmy and Peabody Award winner Larry Hott. The editor is Diane Garey. The writer is Ken Chowder. The executive producers are Karen Kenton and Dalton Delan, WETA. The project director at Gallaudet is Jean Bergey. Senior advisor to the project is Harry G. Lang, professor in the Department of Research and Teacher Education, National Technical Institute for the Deaf at Rochester Institute of Technology, and the author of many books on deaf history.

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- Article 4: Short Takes
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Editor: Here are our picks of some additional stories that you may find interesting. For more, please point your browser to: http://www.hearinglossweb.com/news/curr.htm

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Deaf Culture and Gallaudet
By I. King Jordan

Frankly, what is happening at Gallaudet is a struggle between defining the deaf community in narrow, exclusive terms or in broad, inclusive terms. There is a very small but vocal group of deaf people who define the community narrowly. I call this group the "absolutists." They believe you are either deaf or you are not. You are either a supporter of ASL or you are not deaf. You either refuse to consider cochlear implants or you are not deaf. Many of our students, faculty and alumni who consider themselves deaf (including some born deaf to deaf families) would not be considered deaf by the absolutists.

http://preview.tinyurl.com/2vx2pk

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Support HLAA When You Book Your Travel

I think most of our readers are well aware of the great work being done by the Hearing Loss Association of America (HLAA), and would be willing to support them in their efforts on our behalf. Well, they've come up with a free and easy way for us to do so - just use their travel site when you book your next trip. From what I can see it works just like Expedia, Travelocity, etc. But booking tickets there benefits HLAA. So next time you're hit with wanderlust, point your browser to:

http://www.HLAAtravel.org

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Bilateral Cochlear Implants go Mainstream

Many cochlear implant recipients are happy with hearing from just one ear, but even good-hearing cochlear implant recipients commonly have difficulty hearing in noise. Even in mildly noisy situations, a single cochlear implant does not seem loud or clear enough, in part because two ears are needed to provide direction of sound, focus on a speaker, and suppress extraneous sounds. A growing body of research now shows that many of these deaf individuals benefit from bilateral (two ear) hearing restoration with cochlear implants. Fascinating is that the same physiological tools normal hearing folks use to hear better in noise with two ears (binaural hearing) also help bilateral cochlear implant individuals.

http://www.cochlearimplant.com/support/getconnected/ebeat/education.asp

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- Classifieds
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Two online stores and two employment opportunities appear in this issue. (Ads appear after this brief table of contents.)

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Potomac Technology. Everything You Need Under One Roof!
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Employment Opportunity 1
Various Positions
GLAD
Los Angeles

Employment Opportunity 2
Executive Director
CalCLAD
San Leandro, CA

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Employment Opportunity 1
Various Positions
GLAD
Los Angeles
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GLAD is an Affirmative Action Employer with equal opportunity for men, women and people with disabilities. For more information on the following positions, please go to: www.gladinc.org. The status of all positions is: Regular, Full-time, Non-Exempt, Full Fringe Benefits unless otherwise noted. All positions are open until filled.

* Building Manager - Los Angeles, CA
* Regional Director - Riverside, CA
* Community Interpreter - Los Angeles, CA
* Mexican Sign Language Interpreter - Riverside. CA
* Job Developer/Interpreter - Norwalk, CA
* Community Health Educator-Los Angeles, CA
* Grant Writer - Los Angeles, CA

If interested for any of these positions then please submit resume and application to:

Jeff Fetterman
Human Resources Specialist
Greater Los Angeles Agency on Deafness, Inc.
2222 Laverna Avenue
Los Angeles, CA 90041
V/TDD: (323) 550-4207
Fax #: (323)550-4204
E-mail: jfetterman@gladinc.org

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Employment Opportunity 2
Executive Director
CalCLAD
San Leandro, CA
-------------------

The California Center for Law and the Deaf seeks candidates for Executive Director. The position will be open as of July 1, 2007.

CalCLAD was established in 1978 and is the first and only non-profit full-service legal services corporation in America devoted exclusively to serving deaf and hard-of-hearing people. Its mission is to protect and advance their legal rights to enable them to live independent, productive lives, with full access to the rights, privileges, entitlements, services, educational and employment opportunities available to others. CalCLAD is located in San Leandro, CA, and provides services statewide.

For more information about duties, qualifications, and how to apply, please go to www.deaflaw.org or submit an inquiry to calclad@deaflaw.org.

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- Contact Information and Disclaimers
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