From Faull Audiology in Jacksonville, Fla to Ko’olau Audiology & Hearing Aid Services in Kailua, Hawaii, hearing care offices are beginning to promote hearing loop/telecoil technology to benefit both their clients and their practices. An Internet search today for “hearing care and hearing loops” will find offices in nearly every state that have devoted space on their website to hearing loops/telecoil technology in a clear demonstration that they are actively promoting the time-tested technology with their patients. To further show their commitment to the technology, many are installing loops in their waiting and fitting rooms and including counseling on the technology for their patients.

Offices not yet “in the loop” may not be aware of the many benefits that competitors have experienced after becoming a part of this consumer-driven movement. Increased patient satisfaction, both with their hearing aids and with their providers, have resulted in fewer returns and increased referrals.

Loops can help expand people’s range of hearing, particularly in a large public venue, by transmitting sound directly to hearing aids. A review of the listings in the most recent issue of the Consumer’s Guide to Hearing Aids1 shows telecoils, or t-coils, are embedded or available in over 70% of all current hearing aid models. Those telecoils can pick up electromagnetic signals transmitted by audio frequency induction loop systems (AFILS or ‘hearing loops’). This allows sound being broadcast on a venue’s public address (PA) system—such as a church sermon or theater performance—to be transmitted wirelessly to hearing aids. Some facilities may have an infrared or RF systems which requires a user to wear a borrowed receiver and an ADA-mandated neckloop. For those without telecoil-equipped hearing aids or cochlear implants, users would use a borrowed receiver and earphones instead of the neckloop.

How It All Began

The beginning of the looping movement in this country can be traced to a handful of pioneers that include audiologists Bill and Christine Diles of Kenwood Hearing Centers in the Bay Area of California. These looping pioneers first began demonstrating the technology to their patients nearly 20 years ago and then started a program where they not only bundled a home hearing loop into the sale of telecoil-equipped hearing aids, they actually installed the loop in the patients’ home. For a time they even became the US distributor for one of the major European hearing loop manufacturers.

A survey of Diles’ patients found that, among those with telecoils and a home TV loop, 91% said they were “satisfied” or “highly satisfied” with their hearing aids while only 29% of those without the technology made the same claim. In the May 2006 issue of The Hearing Journal, which can be viewed here—Diles Article—Bill wrote this about their unique program:

 We have found that three things occur when we loop our patient’s homes:

1)  The patients are more satisfied with their current hearing aids.

2)  They are more loyal to our office, and thus, more likely to return for their next hearing aids.

3)  They often refer friends to our practice. 

Having installed loops in 500 homes in our county, we know there are 500 locations where people talk about our office and what we have done to help them hear better and improve their quality of life.

That 500 looped homes figure grew to over 3,000 when Bill reports he stopped counting. Though still promoting hearing loops and telecoils with his patients, he is now focused on getting public facilities looped in his community for those 3,000+ patients and says, “Public venue looping is a wonderful way to provide excellent service to your patients and to the community at large. It’s also a great way to bring awareness to your practice. When the opportunity arises, I recommend facilitating the installation. We have looped 41 buildings to-date, and plan to add to this number in the months and years ahead.”

Initially, word spread slowly about the benefits to a practice from promoting hearing loops but with the advent of the Get in the Hearing Loop initiative (GITHL), other offices joined in the movement. Once hearing care providers saw the positive impact it had on their patients and practices, they not only counseled their clients on telecoils, they added a loop and telecoil section to their websites. Arizona Hearing Specialists ask on their website, “Are You In the (hearing) ‘Loop?’” and they offer a detailed explanation of the technology with graphics, to help readers understand how a loop works.

Audiologists Linda Remensnyder in the Greater Chicago area and Juliëtte Sterkens of Oshkosh, Wis, were two of the early hearing care professionals/looping advocates who joined Bill Diles in looping their offices to afford patients an on-the-spot demonstration. Both went on to advocate to their contemporaries the need for those demonstrations. Dr Sterkens has become the national voice of the Hearing Loss Association of America’s (HLAA) loop and telecoil education and awareness campaign where, when speaking to groups of hearing care providers, she stresses the importance of looping their offices and advocating for hearing loops in their communities.

The Salem Audiology Clinic in Oregon asks, “Do You Want to Learn How to Put in a Home Hearing Loop System?” and Ko’olau Audiology & Hearing Aid Services offers this list on their website with some of the benefits afforded clients by the technology:

  • Works with your existing hearing aids―no extra purchases or devices required.
  • Delivers customized sound specific to the requirements of your own hearing loss.
  • Eliminates background noise.
  • Reduces annoying wall bounce or echo.
  • Provides zero sound distortion.
  • Can be installed in your home, house of worship, or gathering places, such as those found in libraries and senior citizen meeting rooms.
  • Is more hygienic since you use your own hearing aids and not devices used previously by others.
  • Is easily available―no need to wait in lines to reserve a device prior to a performance or to return devices after a performance.

Alistair Knight, marketing director of  the British loop manufacturer Ampetronic, says, “Hearing loops have been the default form of assistive listening in Europe, Scandinavia, and Australasia for over 25 years as it’s the most popular solution with hearing aid users.”

It was in a remote abbey in Scotland that Professor David Myers of Hope College in Holland, Mich first experienced a hearing loop. He then repeated the experience in the UK, including in London taxicabs. Myers returned home to Michigan and became a pioneer advocate for loops. First, he promoted the technology for assembly areas on his college campus, then in the community, and then throughout the state. Eventually, he “went national” and during a presentation he made in Wisconsin, Dr Sterkens became inspired to join the movement. He’s looked upon by looping advocates as the founding father of the looping movement in America.

Today Michigan boasts over 900 known looped public venues including the 12,000-seat Breslin Center at Michigan State University, the convention center in Grand Rapids, and the first three of the nation’s growing list of airports using the technology. Myers has gone on to make presentations on the technology throughout the US. As a published author, he has also been successful in placing articles on hearing loops in a variety of magazines and newspapers including The Wall Street Journal and his family foundation has been a major underwriter of the GITHL movement. Myers’  site is the go-to web address for those seeking information on hearing loops.

In 2010, looping technology had a watershed year. Revisions to the Americans with Disabilities Act (ADA) mandated that new or significantly upgraded assistive listening systems be hearing-aid compatible. The only technology that met that mandate was electromagnetic induction broadcasting to telecoils and that’s still the case today; 2010 was also the year the Hearing Loss Association of America (HLAA) and the American Academy of Audiology (AAA) kicked off the GITHL education and awareness campaign. The GITHL initiative was scheduled to end in June of 2011, at the conclusion of the 2nd International Looping Conference in Washington, DC; it received such overwhelming support from their members, that HLAA continued and recently expanded the campaign. Led by volunteers, this consumer-driven campaign is in the process of expanding a treasure trove of material for looping advocates as they continue to encourage the nation to “Get in the Hearing Loop.”

Texas Chain Jumps on Board

A newcomer to the looping movement is Livingston Hearing Aid Center, Inc of Lubbock, Texas, and, as Texans do, they’re doing things in a big way. Though headquartered in Texas, Livingston has over 90 offices spread out over a map that also includes Arizona, Colorado, New Mexico, and soon, Oklahoma.

Following the national AAA convention in Ohio last March, Richard Davila II, President and CEO of Livingston, announced, “I have plans to loop every office in my company…”  Davila plans to not just loop their offices, but to develop new processes/procedures and, more importantly, specific training material to ensure that their team properly counsels every prospective candidate for amplification about the latest hearing aid design options and methods by which a direct connection between hearing aids and an ALS can be realized.

Davila began the implementation of their comprehensive plan with a training seminar for staff from their offices in two states. That all-day training session began with a workshop on hearing loops and the consumer-driven looping movement by Stephen Frazier of the information clearinghouse, Loop New Mexico  It also included a workshop on other assistive listening technology by Romy Pierce, an assistive listening device retailer and loop installer in Albuquerque, as well as a workshop on Starkey telecoil-capable hearing aids from Amanda Edwards. The meat of the meeting, though, was two hours of training on telecoil technology and adjustment by Dr Sterkens.

The organization and implementation of this loops’ and telecoils’ initiative at Livingston fell on the shoulders of Debra Fischenich, AuD, the firm’s vice president of training and education. Fischenich organized the seminar, held in Albuquerque, for 30+ team members. In addition, she is overseeing the creation of an education page on Livingston’s website where the public will find information on the technology and links to other resources, as well as an educational area on the practice’s intranet site for their team members.

Fischenich determined they should loop the waiting area of each office with a loop made of bright copper tape under a clear plastic cover so clients could see where it is installed. Counter loops will be placed at each reception desk and a portable “loop pad” from Contacta, Inc that can be taken from fitting room to fitting room will complete the package. A reliable installer has been found to do all Livingston facilities in New Mexico. These installations will now be evaluated to determine how to proceed with looping of the remainder of their offices. It’s anticipated that all New Mexico locations will be looped by the end of summer and the offices in the remaining states are targeted for completion before the end of the year.

All loop installations will be required to, upon completion, provide a Certificate of Conformity to the IEC 60118-4 standard for each installed device to ensure that sufficient signal strength, a wide frequency response, and uniformity through a level magnetic field is being provided.  That standard requires that the loop system be able to reproduce 400mA/m in program peaks measured with a RMS measuring device with 125ms integration time and achieve the frequency response 100-5000Hz+3dB.

To ensure that Livingston team members will be properly adjusting the telecoils in the hearing aids they dispense, every office has been equipped with state-of-the-art technology in the form of Audioscan Verifit devices. They believe Verifit to be the most advanced technology in hearing-aid verification with its Speechmap, directional testing, and full verification tests for Bluetooth- and t-coil-enabled hearing aids.

“We are developing a best-practices’ method to ensure hearing aids dispensed with t-coils are fit properly and have a transparent frequency response,” said Fischenich. “The Audioscan Verifit is just the tool for the job. After all, a poorly fit t-coil or improperly installed looping system can be detrimental to the patient experience.”

Hands-on training using multiple Audioscan Verifit machines and working hearing aids was performed at the Albuquerque workshop and the meeting room was equipped with a perimeter hearing loop so that Livingston team members could personally experience the technology with the hearing aids they had adjusted.

Davila said, “Livingston is determined to get in the loop!”  He feels his vision, planning, and implementation of best-practice models over the last 25+ years demonstrates Livingston’s commitment to the hearing-impaired community and to an optimal patient experience.

He said, “I’m charged with educating our team so they can, in turn, educate our patients as we begin our efforts to advocate for the looping movement.”

By referencing a list of known looped venues in New Mexico maintained by Loop New Mexico, Livingston has quickly identified a dearth of hearing loops in some of the communities they serve. As a result, Davila says he plans for audiologists and dispensers to become advocates for the technology in each of their individual communities. To support this effort, Livingston will also include information on the technology and their advocacy efforts in print and broadcast advertising as well as on their website. Livingston providers are also encouraged to fit telecoil-equipped hearing aids in those communities that have no or just a few looped venues so that, as the number of such establishments increases, patients can simply activate the telecoils and benefit from this technology.

State Regulations

Influencing Davila’s decision to get in the hearing loop were new or existing regulations in two of the five states in which they have offices. New Mexico had recently joined Arizona its regulation involving the counseling of clients on telecoil technology prior to the sale and dispensing of hearing aids. Nine states now have such rules and legislation is being drafted for one in Wisconsin. In Colorado, another Livingston state, consumers made an unsuccessful attempt at adopting a rule and it’s expected that effort will be repeated. Meanwhile, the states of Maryland, Minnesota, and Indiana, plus the city of New York have enacted a regulation that makes hearing loops the required ALS whenever feasible in fully, or even partially publicly funded, venues.

Looking Forward

The recent focus on telecoils in their new products by Phonak and Signia seems to indicate that manufacturers are also getting in the loop. With more and more users expected to be asking to be fitted with telecoil-equipped hearing aids and the burgeoning availability of hearing loops in public places, lists of known looped venues at such locally oriented websites as, www.loop, and are now becoming common. Other sites encompassing the entire country have been mounted to help telecoil users locate looped venues in their hometown, or while traveling. Three of those site are:,, and

Advocates are pushing manufacturers to expand the availability of telecoils in all hearing aids capable of containing them and, today, there is an organized looping campaign in almost every state. Many of them are affiliated with the local HLAA chapter and others are run by hearing care providers themselves or by firms that specialize in the installation of hearing loops.The nation’s Sertoma clubs have their own looping advocacy initiative and they sometimes partner with local hearing loss support groups to loop nonprofit venues. HLAA has expanded its involvement in the movement with a dramatically enlarged section on its website devoted to the technology and a 20-member volunteer task force working diligently to Get America in the Hearing Loop.

Stephen Frazier was trained as a hearing loss support specialist by the Hearing Loss Association of America (HLAA). He served as HLAA chapter coordinator in New Mexico for 10 years and also in a variety of positions in the Albuquerque chapter. Steve served for nearly eight years on the NM Speech-Language Pathology, Audiology, and Hearing Aid Dispensing Practices Board and is a founding member of the HLAA national Get in the Hearing Loop steering committee. He heads the award-winning Loop New Mexico initiative and is the founder/leader of the Committee for Communication Access in New Mexico. His articles on hearing loops, hearing loss, and noise pollution have run in numerous periodicals including Sound and Communications, Technologies for Worship, Hearing Health, and Hearing Life, among others. He can be contacted at [email protected].


  1.  The 2019 Consumer’s Guide to Hearing Aids, James W. Wilson, Inc, 222 N. Riverside Dr., Fort Worth, TX 76111

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