OK folks, here is proof that the universe does in fact pay attention to what's happening to us ants here on the ground.  Just this morning, the following thread appeared on the AAA listserv, SoundOFF.  I have removed the names of the respondents and have added my comments to each post preceded by "[bi]"  This is not to show how smart I am, but rather to make a point about the lack of awareness of the realities of providing access to speech in non-ideal conditions.  Here we go. 

It started with this post:

Good morning everyone:

A patient, who happens to be a lawyer, has difficulty hearing in the court room. Specifically, this individual has been fit binaurally with Phonak Savia 211 and needs additional assistance hearing the judge, the person on the stand, the other lawyer, etc. I have no concerns regarding the hearing instruments themselves; just trying to come up with some viable solutions to assist in this environment. Couple of things comes to mind but I was hoping to get some insight from my colleagues. Any thoughts on this would be appreciated.

XXX PhD, FAAA

Vice President & General Manager

Oaktree Products, Inc.

[bi] OK kudos to this person for asking for advice, but given where they work, I would have liked some more details about the loss, speech-in-noise abilities, room acoustics, etc.  Guess not. 

First reply out of the gate:

Phonak makes an "iLINK" that may help

xxx, AuD

St Catharines Canada

[bi] Yes, they do make this product.  What data suggests that this "may help?"

next...

Speak to the FM department at Phonak - the smartlink with ML9S receivers couple to the Savias and should do the job for him.

xxx

Hearing Wellness Center

West Palm Beach, FL 33405

[bi] Of course, ask the people who sell the stuff.  Maybe THEY have some data to demonstrate how they "should"  "do the job."

next....

What about an induction loop system? If the aids have T-coils (or can be retrofitted) seems like that would be a cheaper alternative.

xxx MS, FAAA

Audiologist

Advanced Ear Nose and Throat Associates, PC

[bi] Here it is folks.. the bottom line.  Who needs outcomes when we can just shop for the cheapest solution?

next...

I fit a judge with the smartlink and Savias, he loves it. He notices a big difference in the courtroom by setting up the mic on the stand and such.

Also, talk with Phonak FM department as they may have other suggestions.

xxx, Au.D. CCC-A

Doctor of Audiology

[bi] Back to the manufacturer and an offering of a single user solution.  Oh, and my favorite pet peeve: Redundancy on the signature.  If the folks on the AAA Listserv don't know that AuD means "Doctor of Audiology"  then we are all in a lot more trouble than I thought.

So, I jumped in with this:

There are several ways to approach this, but all require looking at the physical and acoustical data, rather than a catalog.

1) The patient's job requires optimal speech understanding at distances well beyond the critical distance of any ear-level microphone

2) Even though most court rooms have pa systems, the speakers are generally also well beyond the critical distance of the ear level mics

3) The acoustics of the court room are most likely sub-optimal at best.

The solution set needs to include the "CCC" principle: Capture, Carry, Couple

If the court room already has a PA system, then these microphones will capture the speech at a distance less than 6 inches, which should be sufficient to maximize S/N

While an inductance loop would technically work very well, there are a couple of problems:

- The need for each and every courtroom to be looped. Not a bad idea as it would also provide access to anyone in the room with hearing loss and a telecoil, however

- Loops are not secure, and people outside the room can listen in with a simple inductance receiver

- Adjacent rooms will be able to hear each other

FM would also seem like a logical choice because of the ease of movement from room to room and relative ease of connecting the transmitter to the existing hard wired PA, however

- There are a finite numbers of channels available, and the security issue above can still exist if someone had a receiver with channel hopping ability

- This only solves the problem for this particular patient, and does nothing to promote universal accessibility for all people with court business.

Infrared is, IMO, the ideal solution for a coupe of reasons:

- It can easily be added to existing PA

- Receivers are readily available that allow for earphone, DAI and neck loop coupling making the entire courtroom accessible

- Since IR is line of sight, all transmissions stay within the walls of the courtroom

Please forward my email address to the court clerk so I can send them a bill.

Brad Ingrao, AuD

[bi] Which was followed by:

One consideration, besides all the others that were made, would be the Phonic Ear Lexus/Oticon Amigo FM. The transmitter can be used via "point and shoot", i.e. aim at the speaker in an ever narrowing beam. I have a few college students using that, preferring it to approaching the lecturer to use an FM mic attached to them.

[bi] Another brand-specific recommendation for a solution that only helps the lawyer.

Then the loop guy replies to my post with:

Brad,

My information is that the loop can be configured such that only the principals need to be "in the loop". I believe once you get beyond about

4 feet from the perimeter, stray pick up is very unlikely.

[bi] To which I reply:

This is true, however, if you are going to provide access to all persons in the courtroom, the loop would need to encompass the whole room. Unless the walls separating adjacent rooms are 4 feet thick, or you want to "corral"

all the people with hearing loss into a space in the center of the room at least 2 feet from any adjacent wall, then I still feel this is not a good solution.

The other problem with room loops is that, based on recurring comments I read on consumer lisstervs, a significant number of people are still being fit with hearing aids without telecoils, or if they have them, they are not oriented for optimal function in room loops.

Brad

[bi] So it's now lunch time, but I predict this thread will not see the end of business today.  Here is the issue folks.  Our colleagues have no experience in thinking outside the box, and very few know anything about universal design/accessibilit y.  These are the folks who run AAA and the convention.  I'm not saying don't keep up the fight for accommodations, but at least know what you're up against, and consider shopping for another convention.

Brad Ingrao