Cellphones and Hearing Aids

1. Cellphone Compatibility for Individuals with Hearing Loss

The purpose of this questionnaire is to collect information on current cellphone models in use today. Our goal is to gather this information for a database on cellphone technology and how it works for individuals with hearing loss. This information will enable you, the end user, to select and purchase cellphone technology that will be effective and compatible with your hearing device. When sufficient data has been collected, the information will be posted on the Western Institute for Deaf and Hard of Hearing blog (http://www.widhh.blogspot.com)

Thank you for participating in our survey. We expect this survey will take about 10 minutes.

1. Age

Age Under 16 years of age

17 to 40 years old

40 to 65 years old

65 or older

2. Gender

Gender Male

Female

3. Years of experience wearing amplification:

Years of experience wearing amplification: None

Under 5 years

Between 5 and 10 years

Between 10 and 25 years

Over 25 years

4. Average degree of hearing loss in primary telephone ear:

Average degree of hearing loss in primary telephone ear: Borderline normal (15 to 25 dBHL)

Mild (25 to 40 dBHL)

Moderate (40 to 55 dBHL)

Moderately-severe (55 to 70 dBHL)

Severe (70 to 90 dBHL)

Profound (90 dBHL and greater)

Do not know

5. Rate the clarity of speech in your primary telephone ear:

Rate the clarity of speech in your primary telephone ear: Excellent

Good

Fair

Poor

6. What type of hearing aid or cochlear implant do you currently use in your primary telephone ear?

What type of hearing aid or cochlear implant do you currently use in your primary telephone ear? Make (manufacturer)
Model number or model name

7. If you are unable to/or choose not to use a cellphone, please select the reason why:

If you are unable to/or choose not to use a cellphone, please select the reason why: Too much interference with my hearing aid

Poor sound quality

Not loud enough

Cost

Other (please specify)

8. Please select the manufacturer of the cellphone you use or select "none".

	Manufacturer
Manufacturer	Please select the manufacturer of the cellphone you use or select "none". Manufacturer Manufacturer

9. Please provide the model number/name of your cellphone or type "none" if you don't use a cellphone. Note: You may need to look in the battery compartment of the cellphone, or remove the battery in order to find the model number.

Please provide the model number/name of your cellphone or type "none" if you don't use a cellphone. Note: You may need to look in the battery compartment of the cellphone, or remove the battery in order to find the model number.

10. What cellphone service provider do you use?

What cellphone service provider do you use? Telus

Bell

Rogers

Fido

Virgin

Verizon

Sprint Canada

Other (please specify)

11. If you use the cellphone WITHOUT your hearing aid, please rate the quality of the following:

	Poor	Fair	Good	Very Good	Excellent	N/A
Volume range	If you use the cellphone WITHOUT your hearing aid, please rate the quality of the following: Volume range Poor	Fair	Good	Very Good	Excellent	N/A
Speaker phone	Speaker phone Poor	Fair	Good	Very Good	Excellent	N/A
Handsfree headset	Handsfree headset Poor	Fair	Good	Very Good	Excellent	N/A
Clarity	Clarity Poor	Fair	Good	Very Good	Excellent	N/A

12. If you use the cellphone WITH your hearing aid, please rate the quality of the following:

	Poor	Fair	Good	Very Good	Excellent	N/A
Volume range	If you use the cellphone WITH your hearing aid, please rate the quality of the following: Volume range Poor	Fair	Good	Very Good	Excellent	N/A
Speaker phone	Speaker phone Poor	Fair	Good	Very Good	Excellent	N/A
Clarity	Clarity Poor	Fair	Good	Very Good	Excellent	N/A

13. What style of hearing aid do you use?

What style of hearing aid do you use? Behind-the-ear

In-the-ear custom

Completely-in-the-canal custom

Cochlear implant

Bone anchored hearing aid

None

Other (please specify)

14. Behind-the-ear hearing aid users: Where do you hold your cellphone?

Behind-the-ear hearing aid users: Where do you hold your cellphone? On your ear and you listen through the earmold?

Over the top of your ear (over the hearing aid microphone)?

Over your hearing aid (behind your ear)?

Other (please specify)

15. Custom hearing aid users (in-the-ear or completely-in-the canal): Where do you hold your cellphone?

Custom hearing aid users (in-the-ear or completely-in-the canal): Where do you hold your cellphone? Over your hearing aid?

Slightly away from the ear to avoid feedback (whistling)?

Other (please specify)

16. Cochlear implant users: Where do you hold your cellphone?

Cochlear implant users: Where do you hold your cellphone? Over the top of your ear (over the cochlear implant microphone)?

Over your cochlear implant (behind your ear)?

Other (please specify)

17. When using a cellphone, which hearing aid program do you use?

When using a cellphone, which hearing aid program do you use? On the regular listening program (M program)

On the telephone program (T-coil or T-switch)

On the microphone plus telecoil program (M-T)

On an autocoil program

Don't know

18. Do you use the speakerphone on the cellphone?

Do you use the speakerphone on the cellphone? Always

Sometimes

Never

I don't know what that is

Cellphone doesn't have one

19. Please select any of the following systems you may use with your cellphone and hearing aid:

Please select any of the following systems you may use with your cellphone and hearing aid: neckloop and handsfree microphone

headset and handsfree microphone

bluetooth connection

20. If you selected any of the 'connections' in Question 19, please rate how often you use them:

If you selected any of the 'connections' in Question 19, please rate how often you use them: Always

Sometimes

Never

My cellphone doesn't have a jack to plug one in

21. If you selected any of the 'connections' in question 19, do they work well?

If you selected any of the 'connections' in question 19, do they work well? Yes

If 'no' please tell us about the limitations of the system

22. Can you adjust the volume on your cellphone so that you can hear well?

Can you adjust the volume on your cellphone so that you can hear well? Yes

23. Please rate how well your cellphone works with your hearing aid or cochlear implant (i.e. clarity is good, sufficient volume etc.).

	Poor	Fair	Good	Very Good	Excellent	N/A
Behind-the-ear hearing aid users:	Please rate how well your cellphone works with your hearing aid or cochlear implant (i.e. clarity is good, sufficient volume etc.). Behind-the-ear hearing aid users: Poor	Fair	Good	Very Good	Excellent	N/A
Custom hearing aid users (in-the-ear and completely-in-the-canal):	Custom hearing aid users (in-the-ear and completely-in-the-canal): Poor	Fair	Good	Very Good	Excellent	N/A
Cochlear implant users:	Cochlear implant users: Poor	Fair	Good	Very Good	Excellent	N/A
Bone anchored hearing aid users:	Bone anchored hearing aid users: Poor	Fair	Good	Very Good	Excellent	N/A
Other hearing technology users:	Other hearing technology users: Poor	Fair	Good	Very Good	Excellent	N/A

24. Would you use a cellphone equipped with Bluetooth technology with your hearing aid or cochlear implant if you could?

Would you use a cellphone equipped with Bluetooth technology with your hearing aid or cochlear implant if you could? Yes

Don't know what Bluetooth is.

25. When you purchased your cellphone, how knowledgeable was the salesperson about connecting hearing aids or cochlear implants with a cellphone?

When you purchased your cellphone, how knowledgeable was the salesperson about connecting hearing aids or cochlear implants with a cellphone? Very knowledgeable

Somewhat knowledgeable

Not very knowledgeable

Did not offer any solutions

26. How did you find your phone?

How did you find your phone? Recommendation of your audiologist

Recommendation of a friend

Salesperson

Researched on-line or consumer reports

Other (please specify)

27. What do you think is the biggest problem with cellphone and hearing technology compatibility?

What do you think is the biggest problem with cellphone and hearing technology compatibility?

28. How much would you be willing to pay for a good quality cellphone that works well with your hearing aid?

How much would you be willing to pay for a good quality cellphone that works well with your hearing aid? $100 or less

$100 to $200

$300 or above

Price is not an issue

29. What feature(s) would you like to see in new cellphone technology?

What feature(s) would you like to see in new cellphone technology?

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