Summary:
Assistive listening systems are more accessible and varied than ever, helping people with or without hearing aids hear clearly in public spaces, but users need education and guidance from hearing care professionals to take full advantage of the technology.
By Mike Cyprus
New assistive listening technology delivering clear audio in public spaces is more accessible than ever before. That’s good news since the need for hearing assistance is ever present and increasing.1
But the expanded array of available options can be confusing to people who use hearing devices—whether they’ve worn them for years or are new users. Hearing care professionals can help patients benefit from assistive listening systems by raising awareness about them and demonstrating how they can complement hearing aids and cochlear implants to improve speech clarity and enhance listening experiences in public spaces and at home. With that in mind, here’s an updated guide to aid in educating patients about these useful technologies.
Explaining How Assistive Listening Systems Help People Hear Better
Patients can benefit from an overview of who assistive listening systems help and how. HCPs can start by explaining that they help overcome a manner of environmental challenges that impact people with or without hearing loss, including background noise, distance from the source of audio, language, etc., to deliver intelligible audio. They transmit relevant audio to listeners via a receiver device. Listeners hear the audio directly in their ears and can control the volume level to suit their preference. Ambient noise is filtered out, so listeners can focus on the audio they want and need to hear.
Anyone can benefit from assistive listening systems, whether they have hearing loss or not, and regardless of whether they wear hearing aids or cochlear implants. But it’s important for patients to know that not all systems are suitable or able to work directly with hearing aids. This can prevent users from taking advantage of the technology, as they have to indicate they need assistance.
Education is an important element of hearing assistance; therefore, it will be important to provide examples to patients of what signage to look for and where to look for it when entering venues that should have assistive listening systems, as required under the Americans with Disabilities Act (ADA)2 and international accessibility standards.
Differences Patients Need to Know
Each assistive listening system features a transmitter that connects to an audio source—e.g., a microphone, TV, public address system, or a mixing desk—and transmits audio to a receiver. The receiver may be a user’s smart device, hearing aids, or a unit they borrow from the venue for use during their visit.
Of course, how audio transmits to receivers depends on the type of technology powering the system.
Hearing Loops
Hearing loop systems feature a copper wire that surrounds a space. This “loop” is often beneath the floor, under carpet, or along perimeter walls. A hearing loop driver, or amplifier, connects to an audio source in the space and the loop. This creates a magnetic field that transmits the audio to the small copper wires, called telecoils, or t-coils, inside some hearing aids, cochlear implants, and dedicated receivers.
When individuals with t-coil-equipped devices are within the parameters of the loop, they can activate the t-coil feature in their device and hear the transmitted audio directly in their ears, or, if they are using a receiver, via headphones connected to the receiver.
Unfortunately, even when a hearing device is equipped with the t-coil, it is not always enabled. It is critical that hearing care professionals ensure patients with t-coil-equipped hearing aids are aware of this functionality and know how to activate the t-coil in environments that have loop systems.
It may help patients considering t-coil-equipped hearing aids to know that hearing loop systems are common in venues throughout Europe and are increasing in prevalence in the United States.3 Environments likely to feature loop systems include houses of worship, performing arts centers, theaters, and transportation hubs. Loop systems can also be installed around ticket windows and kiosks and on buses and trains.
Radio Frequency
Radio frequency (RF)-based systems transmit venue audio over radio frequency to dedicated receivers. Receivers are typically small, lightweight devices and can be worn on a lanyard around the neck. In venues with this type of assistive listening system, users check out a receiver and attach their own or venue-provided headphones to hear the audio. RF-based systems are for anyone who would like assistive listening.
They are compatible with hearing aids, but only via an integrated neck loop (think of a neckloop as a portable hearing loop system) lanyard that lets users with t-coil-equipped hearing aids transmit the audio directly to their hearing aids. Users can move about without losing the signal or experiencing any degradation in sound quality, within range of the signal, so they don’t have to be in a specific location to enjoy the audio.
Tips for Patients to Find and Access ALDs in Venues
- Look for signage on-site. The international symbol for assistive listening or hearing assistance features the silhouette of an ear with diagonal lines moving through it. A “T” near the silhouette on signage indicates the space is outfitted with a hearing loop.
- Check before visiting. Use the ALD Locator and/or check the venue website. Information about accessibility services and available technologies that support people with hearing loss may be posted, along with tutorials on how to use ALDs.
- If it’s not clear whether an assistive listening system is available, ask. Venues that have ALDs will be happy to see guests utilizing them. If venues don’t have an assistive listening system, they may be inclined to install one to meet guests’ needs/ requests.
- Know what type of hearing aid you have and how it works (Does it feature telecoil? Is it Bluetooth enabled or Auracast compatible?) to ensure compatibility and optimize use of ALDs.
Infrared
With infrared (IR)-based systems, venue audio transmits to receivers via infrared light. Users borrow a receiver and ensure it is in line of sight of the transmitter. They will need to avoid inadvertently covering the receiver, or this will result in a loss of signal. They can listen to audio from the receiver via headphones or with a neck loop that transmits audio from the receiver to the t-coil in their hearing aid(s).
The infrared light does not transmit through walls, making these systems ideal in spaces where confidentiality is important, such as courtrooms, boardrooms, and medical offices. They are also useful and likely to be found in environments where audio spillover into adjacent spaces could be disruptive. Examples include classrooms and offices.
Some venues have mobile, two-way communication systems for guests to use. These systems include a transceiver (combination transmitter/receiver) that users wear on a lanyard around their neck and connected headphones. The transceivers can be grouped, and one assigned as the leader. When a leader speaks into a headset microphone, others in the group hear them. These systems are useful for assistive listening, tours, corporate training, and facilitating interpretation.
Audio Over Wi-Fi
Audio-over-Wi-Fi-based assistive listening systems let listeners use their smartphone as a receiver for assistive or personal listening. In venues with this type of system, users download a free app on their smartphone, select the channel they want to hear, stream the audio to their smartphone, and listen via headphones or earbuds. If they have Bluetooth® enabled earbuds, hearing aids, or cochlear implants and the Bluetooth is turned on, audio will stream from the smartphone directly to their Bluetooth devices.
With BYOD (bring your own device) systems such as audio-over-Wi-Fi-based assistive listening, the potential for latency is highly influenced by the age and manufacturer of the user’s device.
Dedicated receivers are available for guests who prefer not to use a smartphone. For individuals who want to use their device, Wi-Fi-based systems are convenient (no equipment to borrow or return), easy to use (familiar technology), and discreet (not an obvious assistive listening device, or ALD). The proximity of a receiver (many people carry a smartphone) means more listeners may use an ALD for assistive listening, audio description, to focus, or simply to hear better and have a richer, more engaging listening experience.
Audio-over-Wi-Fi systems are useful in multi-room, multi-screen, multi-channel environments like university campuses, sports bars, fitness centers, houses of worship, corporate spaces, and theaters. Applications include assistive listening, audio description, streaming audio from screens, and interpretation.
Bluetooth Low Energy
The most recent assistive listening technology is Auracast broadcast audio. This new standard for Bluetooth Low Energy audio is making clear, high-quality audio in public venues accessible to more people than ever before. Auracast broadcast audio offers lower latency (no lip sync issues) and consumes less power than standard Bluetooth, and other technologies, making it ideal for hearing aids, earbuds, headphones, and other devices and wearables that people are likely to use for extended periods.
In public spaces where Auracast broadcast audio is available, anyone with a device that is Auracast compatible can access the broadcast from a nearby Auracast transmitter. In an airport, that means hearing the gate information and announcements a listener cares about, not background noise. Similarly, at a lecture, listeners can access the presenter’s broadcast and tune out the surrounding din.
The process for choosing an Auracast broadcast is like choosing a Wi-Fi network. Listeners use an Auracast “assistant” (often an app on their smartphone) to search for available Auracast broadcasts. Once the listener selects a broadcast, the assistant instructs the receiver to begin receiving the broadcast directly to their device.
If listeners don’t have an Auracast-compatible device, they can borrow a dedicated Auracast receiver from the venue. Again, with a neck loop, the user is able to enjoy low-latency sound via t-coil hearing devices.
This technology is expected to become more broadly available. ABI Research forecasts that “annual shipments of LE Audio-enabled devices are expected to reach approximately 3 billion” by 2028.4
While some hearing aid manufacturers are already offering Auracast-enabled hearing aids (and even an Auracast-enabled TV-Streamer), and at least one TV manufacturer is offering TVs with Auracast incorporated into it, it will take several years for widespread adoption of these devices. Hearing aids are expensive and have an average lifespan of three to seven years, so consumers may be slow to purchase new hearing aids featuring Auracast.
Knowledge Patients Need to Succeed
Each assistive listening system is different, but all of them help improve speech clarity and deliver audio directly to listeners’ ears for a better overall experience. It’s important that patients know assistive listening systems exist, understand how they function, feel confident asking for them in public venues, and utilize them to complement their hearing aids and cochlear implants.
Patients need to know what type of hearing aid or cochlear device they have and utilize its features for optimal hearing. As patients are selecting hearing aids for the first time or looking to replace or upgrade their devices, hearing care professionals can help them determine which type of hearing aid and technology is best for them based on their needs and the venues they frequent.
About the Author:
Mike Cyprus is product manager at Ampetronic | Listen Technologies. Ampetronic designs and manufactures assistive listening solutions, specializing in hearing loop systems. Ampetronic and Listen Technologies, a provider of advanced wireless listening solutions, are sister companies dedicated to making audio accessible to everyone.
References
1. World Health Organization, Fact Sheet: Deafness and hearing loss. Available at: https://www.who.int/news-room/fact-sheets/detail/deafness-and-hearing-loss
2. 2010 ADA Standards for Accessible Design, 219 Assistive Listening Systems. Available at: https://www.ada.gov/law-and-regs/design-standards/2010-stds/#219-assistive-listening-systems
3. HearingTracker.com, “Hearing Aid Telecoil and Loop Update.” Feb. 9, 2025. Available at: https://www.hearingtracker.com/resources/hearing-aid-telecoil-and-loop-update-2024
4. Zignani A. ABI Research. “Auracast™ Broadcast Audio Retrofit Solutions And Opportunities.” 2024. Available at: https://go.abiresearch.com/hubfs/Marketing/Whitepapers/Auracast%20Broadcast%20Audio%20Retrofit%20Solutions%20and%20Opportunities/ABI_Research%20Auracast%20Broadcast%20Audio%20Retrofit%20Solutions%20and%20Opportunities.pdf?hsCtaTracking=4c37e4ce-37c6-46a8-a7b4-71a35cecbd04%7Cae79dfc9-7c90-443c-b3cc-0780de5b5bfe
Featured image: symbol showing a hearing loop for assistive listening is available. Image: Dreamstime
