Telephone Listening for People with Hearing Loss




Ron Vickery






Another very informational article about phones, authored by Dana Mulvany, can be found here:

This article goes into more detail on some subjects, has some good photos, and explains "the painful mode" of telephone listening, and how to avoid it.



Residential Landline Phones


A landline phone is a phone that plugs into a telephone wall outlet and is serviced by a traditional telephone network. This kind of network has wiring from the residence to the phone central office. They can be the familiar type with a cord between the telephone to the handset, or the newer type that are cordless. The jargon for this type of phone is “POT” – Plain Old Telephone, and “POTS” – Plain Old Telephone Service.


Most people with hearing loss find that listening to a phone is best when the hearing aid is set to telecoil mode. This is also called T-Switch. The T-Switch selects either the hearing aid’s microphone or the hearing aid’s telecoil as the input source. Some hearing aids can have both sources on at the same time, but this feature is not particularly useful for listening to a phone. In telecoil mode, it does not matter how loud the phone is, as long as it emits a good signal that the telecoil can receive. The hearing aid provides the loudness, or amplification. Benefits of the telecoil mode of telephone listening:


1.      The hearing aid provides the amplification.


2.      A properly fitted hearing aid is customized for the user’s hearing loss, so speech comprehension should be optimal from the phone.


3.      Eliminates feedback since the hearing aid microphone is turned off. Feedback is caused when a phone, or anything, is brought up close to the hearing aid. 


4.      Eliminates noise in the room where the phone is located, so the user hears only the signal coming from the phone line. However, because of side tone, noise in the listener’s room can be picked up by the phone’s microphone and sent to the telecoil. This is only objectionable in very noisy locations. In noisy locations, such as a restaurant or sports bar, it is helpful if the phone’s microphone is covered when listening and uncovered when talking. Side tone is a feature built into most landline phones whereby a small amount of the signal picked up by the phone’s microphone is sent to the phone’s earpiece, as well as to the remote party. The purpose of side tone is for the user to regulate how loudly he or she is talking, and to give a sense that the phone is working. Without side tone, it seems like the phone is dead. 


Some cordless phones generate electromagnetic interference to the user’s telecoil. The interference may be very slight and not very objectionably or very strong and makes the phone unusable. It sounds like a buzz or hum or a higher pitched tone. It is mostly the systems that support multiple handsets that cause interference. TIA 1083 is a standard that was developed and is used on several brands of cordless phones that addresses the interference problem. The TIA 1083 logo is prominently displayed on packaging for cordless phones if the phone conforms to the standard.  


Hearing Aid Compatibility Act


The Hearing Aid Compatibility Act of 1988 mandates that all landline telephones manufactured or sold in the United States from 1989 on must be hearing aid compatible. To be compatible means the earpiece of the phone will transmit a signal a telecoil can receive, in addition to the normal acoustic output. This is called Hearing Aid Compatibility, or “HAC”.  HAC also specifies that phones must have a volume control. A user with a properly fitted hearing aid with a working telecoil should be able to use any phone purchased in the US since 1989. However, all hearing aids do not have the telecoil feature, or the feature may not have been set up properly. The feature is usually found on Behind-the-Ear hearing aids and Cochlear Implants and it may be possible to add the feature depending on the style of hearing aid. Wireless phones (cell phones) have a different compatibility standard which was established much later than 1989.  

Amplified Phones


These are landline phones that generate a stronger acoustic sound and a stronger signal for the telecoil. These are also called "specialty phones" or "specialized customer premises equipment".  Some amplified phones need a standard 110VAC power outlet, in addition to the phone line connection. They are available in both corded and cordless styles. Some benefits of amplified phones:


1.     They provide a stronger acoustic output. This is useful for people who do not have hearing aids, or people who prefer to remove the hearing aid when talking on the phone.


2.     Some hearing aids do not have the telecoil feature, and people find that a phone with stronger acoustic output is better with their hearing aid.

3.     They provide a stronger signal for telecoil mode. Some people find that their telecoil is not sensitive enough to use on a regular phone.


4.      Because amplified phones provide a stronger signal for the telecoil they can help to reduce or eliminate electromagnetic interference, such as from a TV, computer monitor, or fluorescent light. The stronger signal allows the telecoil sensitivity to be set to a lower level, which improves the “signal to noise ratio”.


5.      Some models have increased output at higher frequencies, or can be customized for frequency response. The standard landline phone service is limited to a frequency response of 300 to 3500 Hz., and it is a fairly uniform or “flat” frequency response. However, some people gain more understanding if the frequencies between 2000 to 3500 Hz can be increased.


6.      Some models have a jack where an accessory, such as a neckloop, can be connected.




1.      Neckloop. A neckloop is an induction coupling device worn around the neck. If the user has two hearing aids with telecoils, then both hearing aids can be set for telecoil mode and the user hears the remote party in both ears. Two ear listening is very beneficial to some people – better than twice as good. In this mode the telecoil receives the signal from the neckloop rather than from the handset earpiece and as such the earpiece does not have to be held in a certain spot near the hearing aid. Only certain models of amplified phones have a jack where a neckloop can be attached. However, a device called a handset coupler, can be used on phones that do not have a jack. This device attaches between the phone’s base and the phone’s handset cord. The power available at the handset cord is not enough to drive a neckloop so an amplifier must be used in addition to the device. A “recording control” can also be used in place of the handset coupler. Recording controls are used to send phone conversations to a tape recorder, but in this case it sends the signal to an external amplifier where the neckloop is attached. This arrangement can provide a very strong signal so the telecoil sensitivity can be kept low, reducing electromagnetic interference from other equipment in an office, such as a computer monitor.


2.      Silhouette. Silhouettes are also induction coupling devices, just like a neckloop, but they are small and fit beside a “behind-the-ear” hearing aid. Since they are close, they provide maximum coupling so less power is needed to drive them. They can be single or double silhouettes, with a “Y” cord. There are other devices that provide the same function but are shaped differently, like a hook, that also fit close to the hearing aid.


3.      Loopset.  The loopset contains both a neckloop and a microphone. They are used on phones that have a headset jack, usually the 2.5mm size. Most cordless phones and wireless phones have a headset jack. When a headset or loopset is plugged into this jack, the phone’s internal microphone is turned off, so the microphone in the loopset or headset must be available and used. Some brands call this an “amplified neckloop”.


4.      Bluetooth Neckloop. This is similar to the above but has wireless Bluetooth technology to connect to phones that have the Bluetooth feature.   




VoIP means Voice over Internet Protocol. It is an alternative to the standard traditional telephone service (POTS). VoIP uses an Internet connection to send and receive digital “packets” of voice data. One type of VoIP uses a phone adapter connected to the Internet, and standard "POTS" phones are plugged into it. Another type requires a computer. A microphone and headphones are used with the computer. Still another type are phones that are exclusively designed to use VoIP, and all the Internet interfacing circuitry is built into the phone.


VoIP can be a benefit to people with hearing loss because long distance calls can be much clearer than traditional long distance service. However, whether or not it is clearer depends on the Internet connection and the amount of traffic present.  Phones designed for VoIP only are not currently required to be HAC. Calls to 911 emergency services are handled differently than traditional POTS. See this FCC link for more information:


Suppliers & Equipment


HLAA has had a long standing policy of not recommending particular suppliers or particular brands of equipment. However, several suppliers have advertisements in the “Hearing Loss Magazine”, and in the bi-weekly e-News. Some suppliers offer discounts to HLAA members. It is quite easy to perform an Internet search on “Amplified Phones”, “Alerting Devices”, “Assistive Listening Devices” or other search terms, and receive a very large listing of suppliers and equipment. Go to this link to sign up for e-News:


HLAA has an on-line community, called the Message Boards, or Forums, where participants talk about their experiences with suppliers and equipment. There are many different Forums, covering lots of subjects. If a specific brand and model has not been found, a user could ask a question such as: “Has anyone tried XXXX? Go to this link to access the Message Boards:


CapTel Service

The Captel service uses a special phone that has a text display. A communication assistant listens to the conversation and "transcribes" what the remote party said. The text appears on the special phone. This is quite different from traditional Relay service in that the user hears the remote party as well as he or she can, and responds whenever possible. The text display is there for backup and to help with missing words or phrases. The remote party does not know the CapTel service is being used, unless the CapTel user tells him or her. 

CapTel has two models of the special phone. The first model plugs in to a standard POTS line, and it can use one line or two lines. The two line connection provides a direct connection to the service on incoming calls. With the one line connection, remote parties must first call the CapTel service and then connect to the CapTel phone.

The second model, just introduced in 2009, has a larger screen and a connection to a POTS line and an Internet connection. It provides the same two line connectivity as the first model but with just one POTS line, making both outbound and incoming calls automatically connected to the CapTel service.

The CapTel service is also available over the Internet where the user reads the text on a computer screen but talks on an ordinary phone. States that have the CapTel service fund the service under their relay administration. Currently Sprint Relay and Hamilton Relay provide the CapTel service. This link provides information about CapTel:

TEDP (Telecommunication Equipment Distribution Program)

Most states have a Telecommunication Equipment Distribution program. This is usually called TEDP, but it may go under a different name in some states. The program offers amplified phones, TTYs, and other equipment and it varies by state. Equipment may be provided on loan, or free, or at reduced cost. More information can be found at:


Questions or comments about this article can be directed to Ron.Vickery@USA.Net

Updated on 8/19/2009