1 00:00:00,157 --> 00:00:06,120 [LTA intro music] 2 00:00:10,820 --> 00:00:13,120 This is a presentation from LiveTextAccess: 3 00:00:13,200 --> 00:00:16,282 Training for real-time intralingual subtitlers. 4 00:00:16,955 --> 00:00:20,943 This presentation is from the Unit 1: Understanding accessibility. 5 00:00:21,078 --> 00:00:24,440 Element 2: Target Users and their needs. 6 00:00:24,650 --> 00:00:28,040 The overall topic of this presentation is Audiological Treatment 7 00:00:28,120 --> 00:00:29,620 and aided hearing. 8 00:00:30,330 --> 00:00:33,240 Aided hearing includes as well the audiological treatment 9 00:00:33,320 --> 00:00:35,617 as the use of assistive listening system. 10 00:00:36,181 --> 00:00:39,440 Two topics that are closely related to one another 11 00:00:39,520 --> 00:00:43,012 and therefore both topics shall be presented in this presentation, 12 00:00:43,147 --> 00:00:44,338 which also means, 13 00:00:44,643 --> 00:00:47,615 that this presentation shall be somewhat longer. 14 00:00:48,731 --> 00:00:52,435 Professionals working as real-time subtitlers need to know 15 00:00:52,480 --> 00:00:55,920 and understand the different types of audiological treatments 16 00:00:56,157 --> 00:00:59,776 and how they relate to the needs of persons with hearing loss. 17 00:01:00,000 --> 00:01:03,166 In this video lecture we will discuss this topic. 18 00:01:04,280 --> 00:01:06,185 My name is Aïda Regel Poulsen. 19 00:01:06,240 --> 00:01:10,289 I represent European Federation of Hard of Hearing - EFHOH. 20 00:01:10,492 --> 00:01:13,796 I am the secretary of EFHOH, and I have a hearing loss. 21 00:01:14,338 --> 00:01:18,595 I have created this video lecture in collaboration with the SDI München. 22 00:01:19,170 --> 00:01:23,571 On completion of the training sequence, trainees will be able to: 23 00:01:24,045 --> 00:01:27,350 Distinguish between the different types of audiological treatment. 24 00:01:27,553 --> 00:01:31,172 Illustrate what Assistive Listening Systems are and how they work. 25 00:01:31,680 --> 00:01:34,509 Use the terminology related to this field. 26 00:01:35,015 --> 00:01:38,160 The Hard-of-Hearing population use audiological treatments 27 00:01:38,240 --> 00:01:40,955 as one of the main technologies that support us. 28 00:01:41,497 --> 00:01:42,746 Often this is not enough, 29 00:01:42,800 --> 00:01:46,844 and we add on use of Assistive Listening Systems (ALS). 30 00:01:47,111 --> 00:01:50,388 Some call it Assistive Listening Devices (ALD). 31 00:01:51,369 --> 00:01:57,267 We often refer in writing to HA, CI, or BAHS, 32 00:01:57,538 --> 00:02:01,940 when the spoken word will be Hearing Aid, Cochlear Implant 33 00:02:02,075 --> 00:02:04,503 or Bone Anchored Hearing System. 34 00:02:05,078 --> 00:02:08,007 Same goes for ALS/ALD. 35 00:02:09,960 --> 00:02:11,478 Audiological treatments. 36 00:02:12,000 --> 00:02:14,374 Referring to a hearing test at the clinic, 37 00:02:15,017 --> 00:02:17,200 the Hard-of-Hearing client can be presented 38 00:02:17,280 --> 00:02:18,974 with different types of Hearing Aids, 39 00:02:19,177 --> 00:02:21,786 that could be relevant to try or use. 40 00:02:22,647 --> 00:02:27,112 Typically, the client will be presented with how the different Hearing Aids work. 41 00:02:27,280 --> 00:02:29,480 Often the audiologist can give some advice 42 00:02:29,560 --> 00:02:32,235 as to what is likely to work best for the client. 43 00:02:33,240 --> 00:02:36,661 Reimbursement works different from one country to another. 44 00:02:37,080 --> 00:02:39,960 Some European countries provide audiological treatment 45 00:02:40,040 --> 00:02:41,786 via national health insurance. 46 00:02:42,019 --> 00:02:45,248 In other countries the client needs to go to a private clinic 47 00:02:45,485 --> 00:02:47,414 and pay for the Hearing Aids himself. 48 00:02:48,361 --> 00:02:51,200 In some countries, national health insurance will pay 49 00:02:51,280 --> 00:02:53,676 part of the expenses for the Hearing Aids 50 00:02:53,720 --> 00:02:55,811 purchased from a private clinic. 51 00:02:56,552 --> 00:02:59,520 This means, that often the financial situation 52 00:02:59,600 --> 00:03:04,440 and cost of Hearing Aids is a huge argument in the final choice 53 00:03:04,520 --> 00:03:07,186 of which product the client may end up with. 54 00:03:08,370 --> 00:03:10,163 Let me give you an example: 55 00:03:10,806 --> 00:03:13,618 Cochlear Implants, in short CI, 56 00:03:13,680 --> 00:03:16,498 are provided via national health insurance 57 00:03:16,560 --> 00:03:18,498 in many European countries, 58 00:03:18,690 --> 00:03:21,912 and the operation is carried out through public health care. 59 00:03:22,320 --> 00:03:24,080 But in some European countries 60 00:03:24,160 --> 00:03:28,192 there are also private clinics offering Cochlear Implant treatments. 61 00:03:29,015 --> 00:03:30,520 In some European countries 62 00:03:30,600 --> 00:03:33,668 the client can have Cochlear Implant bilaterally. 63 00:03:33,973 --> 00:03:37,254 In other countries this is thought to be too expensive 64 00:03:37,320 --> 00:03:38,543 and there is a quota 65 00:03:38,600 --> 00:03:42,636 of how many Cochlear Implant operations can be done over a year. 66 00:03:43,651 --> 00:03:47,618 Some Cochlear Implant users have Cochlear Implant unilaterally 67 00:03:47,990 --> 00:03:49,464 and nothing on the other ear. 68 00:03:49,640 --> 00:03:55,661 Or they have Cochlear Implant unilaterally and a Hearing Aid on the other ear. 69 00:03:56,033 --> 00:03:59,844 Again, some get Cochlear Implant bilaterally. 70 00:04:00,419 --> 00:04:03,320 Just now, in 2020, 71 00:04:03,400 --> 00:04:04,800 there is research showing, 72 00:04:04,880 --> 00:04:08,650 that more Hard-of-Hearing people could benefit from Cochlear Implant 73 00:04:08,853 --> 00:04:10,535 but are not provided with it. 74 00:04:12,328 --> 00:04:16,690 Bone Anchored Hearing System is not so commonly well known, 75 00:04:16,760 --> 00:04:18,690 but this also needs surgery, 76 00:04:18,889 --> 00:04:22,023 because part of the treatment relies on an implant. 77 00:04:22,531 --> 00:04:27,111 Audiological treatment needs to be carried out by professional audiologists: 78 00:04:27,280 --> 00:04:31,145 medical, technical and educational audiologists. 79 00:04:31,958 --> 00:04:34,160 After the audiogram has been measured 80 00:04:34,240 --> 00:04:37,182 and other functions in the hearing have been tested 81 00:04:37,240 --> 00:04:39,129 (e.g. discrimination loss), 82 00:04:39,298 --> 00:04:42,245 different types of Hearing Aids may be relevant. 83 00:04:42,780 --> 00:04:47,305 The main 3 treatments are: first, Hearing Aids, in short HA, 84 00:04:47,360 --> 00:04:50,625 second; cochlear implants, in short CI, 85 00:04:50,789 --> 00:04:56,171 and third, Bone Anchored Hearing Systems, in short BAHS. 86 00:04:57,051 --> 00:05:00,080 In general all Hearing Aids in the category needed 87 00:05:00,160 --> 00:05:03,640 can be fully adjusted to the needs according to the audiogram 88 00:05:03,736 --> 00:05:05,027 and other hearing tests. 89 00:05:05,230 --> 00:05:08,469 But different brands of Hearing Aids work differently, 90 00:05:08,977 --> 00:05:11,755 just like cars, shoes, clothes. 91 00:05:12,529 --> 00:05:13,920 The professional medical 92 00:05:14,000 --> 00:05:16,040 and technical audiologists will know 93 00:05:16,120 --> 00:05:18,815 what to look for when speaking to the patient. 94 00:05:19,080 --> 00:05:22,661 The patient may need to try out different brands to compare. 95 00:05:23,067 --> 00:05:26,720 This takes time, and it is difficult to change to compare. 96 00:05:26,960 --> 00:05:30,960 In different countries the period of testing different Hearing Aids vary. 97 00:05:31,110 --> 00:05:32,891 In Denmark it is 10 weeks. 98 00:05:33,500 --> 00:05:36,236 This is a limit set by the manufacturers. 99 00:05:36,560 --> 00:05:39,440 It is not beneficial to take too long to decide 100 00:05:39,520 --> 00:05:41,315 because once there is a hearing loss, 101 00:05:41,548 --> 00:05:43,463 hearing is also becoming difficult, 102 00:05:43,666 --> 00:05:46,478 so you need to settle as soon as possible. 103 00:05:47,151 --> 00:05:48,760 It is also important to know 104 00:05:48,840 --> 00:05:51,330 what programs are available in the Hearing Aids, 105 00:05:51,597 --> 00:05:54,240 and even though the same programs are available 106 00:05:54,320 --> 00:05:56,202 in different brands of Hearing Aids, 107 00:05:56,473 --> 00:06:00,158 the operation may feel different from one device to another. 108 00:06:00,443 --> 00:06:03,000 Some do fine with many different programs. 109 00:06:03,203 --> 00:06:07,990 For others, it is plenty to have just one, maybe two programs in their Hearing Aid. 110 00:06:09,005 --> 00:06:13,640 It is important to know if you can benefit from tele coil in your Hearing Aid 111 00:06:13,720 --> 00:06:16,153 and/or streaming (Bluetooth). 112 00:06:16,880 --> 00:06:20,316 If you are a Cochlear Implant (CI) candidate, 113 00:06:20,655 --> 00:06:24,840 it is not possible to try out different brands before operation. 114 00:06:25,043 --> 00:06:28,369 Then it depends on the clinic which brands they offer, 115 00:06:28,538 --> 00:06:31,239 which companies they cooperate with. 116 00:06:32,018 --> 00:06:34,873 Cochlear Implants also have different programs. 117 00:06:35,009 --> 00:06:38,240 And also for Cochlear Implant, it is important to find out 118 00:06:38,409 --> 00:06:42,460 if you can benefit from tele coil and/or streaming (Bluetooth). 119 00:06:43,069 --> 00:06:47,535 If you have a hearing loss (HL) at about 50dB, 120 00:06:47,772 --> 00:06:52,817 you have the dynamic range from 50dB to 120dB, 121 00:06:53,257 --> 00:06:57,152 which in total is a range of 70dB. 122 00:06:57,423 --> 00:07:02,853 And a pair of Hearing Aids will aid your hearing up to between 20-30 dB. 123 00:07:02,920 --> 00:07:08,685 In total you will then have a dynamic range of 90 to 100 dB. 124 00:07:09,836 --> 00:07:13,960 With a Cochlear Implant you get a dynamic range of 40 dB. 125 00:07:14,040 --> 00:07:15,666 This will typically be placed, 126 00:07:16,343 --> 00:07:19,358 or adjusted, in the level around the speech banana. 127 00:07:19,726 --> 00:07:24,295 Surrounding sounds will be put into the 40dB dynamic range. 128 00:07:25,107 --> 00:07:30,462 Bone Anchored Hearing Systems are for conductive losses only 129 00:07:30,520 --> 00:07:34,172 and can only be offered from certain audiological clinics. 130 00:07:34,815 --> 00:07:35,921 Hearing Aids. 131 00:07:36,631 --> 00:07:41,726 Overall, all Hearing Aids do the same: they amplify sound for the client. 132 00:07:41,880 --> 00:07:44,440 But it is important to know which brand of Hearing Aid 133 00:07:44,520 --> 00:07:46,414 you have to know how it works. 134 00:07:46,920 --> 00:07:50,459 On this slide, I show you a few different types of Hearing Aids 135 00:07:50,628 --> 00:07:52,812 from the companies Phonak and Oticon. 136 00:07:53,218 --> 00:07:55,453 There are many more Hearing Aid manufacturers, 137 00:07:55,520 --> 00:07:58,560 but Phonak and Oticon are the companies who have responded 138 00:07:58,640 --> 00:08:01,983 to my request for pictures and information material 139 00:08:02,040 --> 00:08:05,154 for this presentation on audiological treatment. 140 00:08:06,609 --> 00:08:10,440 Many of us use Behind-the-Ear (BTE) Hearing Aids 141 00:08:10,520 --> 00:08:13,270 to which we use a dome, as on the slide, 142 00:08:13,320 --> 00:08:16,210 to insert the Hearing Aid into the ear canal, 143 00:08:16,379 --> 00:08:20,000 or some use a mould which will fit more tight. 144 00:08:20,474 --> 00:08:23,355 This typically has to do with type of Hearing Loss. 145 00:08:23,728 --> 00:08:25,040 The bigger one’s Hearing Loss is, 146 00:08:25,120 --> 00:08:28,572 the more likely is it that the client will need a mould. 147 00:08:30,000 --> 00:08:31,360 Family and friends, 148 00:08:31,440 --> 00:08:35,120 even hairdressers, are likely to comment on people’s Hearing Aids 149 00:08:35,200 --> 00:08:40,040 and in general give advice on choosing a Hearing Aid that is less visible. 150 00:08:40,388 --> 00:08:44,472 But how the Hearing Aid looks is less important than how it sounds. 151 00:08:44,641 --> 00:08:47,897 However, these comments do fuel the stigma. 152 00:08:49,521 --> 00:08:55,008 From Phonak, I also show Hearing Aids to be In-the-ear canal (ITE). 153 00:08:55,820 --> 00:08:59,080 They come in different sizes, and some are so very small, 154 00:08:59,160 --> 00:09:01,322 that we cannot see them when they are worn. 155 00:09:01,661 --> 00:09:05,351 They are Completely in the ear Canal (CIC). 156 00:09:05,560 --> 00:09:08,160 But it depends on the degree of Hearing Loss, 157 00:09:08,240 --> 00:09:11,386 which type the client will benefit from the most. 158 00:09:11,690 --> 00:09:14,559 Also, for in-the-ear canal Hearing Aids, 159 00:09:14,729 --> 00:09:18,781 it is not always possible to add on use of Assistive Listening Systems. 160 00:09:19,221 --> 00:09:21,560 We need to know which brand and type of Hearing Aid, 161 00:09:21,640 --> 00:09:25,538 the user has to know how it is operated and how it works. 162 00:09:25,775 --> 00:09:28,640 Also to know what types of programs are available 163 00:09:28,720 --> 00:09:30,577 in this specific brand and type, 164 00:09:30,776 --> 00:09:33,400 and which of the programs have been activated 165 00:09:33,480 --> 00:09:35,998 and which ones have not been activated. 166 00:09:36,570 --> 00:09:38,539 According to who the user is, 167 00:09:38,600 --> 00:09:43,415 what are the consequences of slimming or expanding the choice of programs. 168 00:09:43,801 --> 00:09:46,800 If the user uses the buttons on the Hearing Aids 169 00:09:46,880 --> 00:09:48,408 to operate the Hearing Aids, 170 00:09:48,607 --> 00:09:54,090 it is needed to toggle from, e.g. program 1 to 3, via program 2. 171 00:09:54,530 --> 00:09:55,756 This takes time. 172 00:09:56,230 --> 00:10:00,320 If the users uses a remote control or an app on the mobile phone 173 00:10:00,400 --> 00:10:01,872 to operate the Hearing Aids, 174 00:10:02,075 --> 00:10:05,259 it is possible to choose the program directly. 175 00:10:05,527 --> 00:10:07,080 But then it takes time 176 00:10:07,160 --> 00:10:10,752 to either get the remote control out of a bag or a pocket, 177 00:10:11,019 --> 00:10:14,673 or it takes time to open the app on the mobile phone. 178 00:10:14,943 --> 00:10:17,647 People are different what they prefer. 179 00:10:18,561 --> 00:10:19,760 In some Hearing Aids, 180 00:10:19,840 --> 00:10:24,048 it is not possible for the user to adjust volume in everyday use. 181 00:10:24,280 --> 00:10:26,680 In some Hearing Aids the feature is there, 182 00:10:26,760 --> 00:10:28,484 but has not been activated. 183 00:10:28,683 --> 00:10:32,038 And for some, this feature has been activated. 184 00:10:33,087 --> 00:10:35,196 For many, newer Hearing Aids, 185 00:10:35,670 --> 00:10:37,720 if it is possible to adjust volume, 186 00:10:37,800 --> 00:10:42,855 it will often turn up/down the volume on both ears at the same time. 187 00:10:42,920 --> 00:10:46,040 But some users may need to turn up or down the volume 188 00:10:46,120 --> 00:10:47,560 in just one ear, 189 00:10:47,640 --> 00:10:50,831 according to the listening environment he or she is in. 190 00:10:51,440 --> 00:10:52,677 Cochlear Implant. 191 00:10:53,658 --> 00:10:56,047 Cochlear Implant candidates are people 192 00:10:56,120 --> 00:10:58,441 who do not benefit enough from Hearing Aids. 193 00:10:58,742 --> 00:11:02,822 This means that it is for people who have severe to profound Hearing Loss. 194 00:11:03,397 --> 00:11:05,800 If you are a Cochlear Implant candidate, 195 00:11:05,880 --> 00:11:09,853 it is not possible to try out different brands before operation. 196 00:11:10,040 --> 00:11:13,593 Then, it depends on the clinic which brands they offer, 197 00:11:13,720 --> 00:11:16,191 which manufacturers they cooperate with. 198 00:11:16,631 --> 00:11:19,960 It also depends if you have additional diseases 199 00:11:20,040 --> 00:11:22,338 for which you may need regular scannings. 200 00:11:22,480 --> 00:11:25,586 Only one brand is recommended if you need scannings. 201 00:11:26,094 --> 00:11:28,760 Cochlear Implants also have different programs, 202 00:11:28,840 --> 00:11:30,700 and also for Cochlear Implant 203 00:11:30,865 --> 00:11:34,680 it is important to find out if you can benefit from tele coil 204 00:11:34,760 --> 00:11:39,107 and/or streaming (Bluetooth) as Assistive Listening System. 205 00:11:40,677 --> 00:11:44,280 In Europe we have 4 manufacturers for Cochlear Implants. 206 00:11:44,461 --> 00:11:49,275 3 of these responded to my request for pictures and information materials. 207 00:11:49,715 --> 00:11:53,879 They are: Cochlear, Oticon Medical and MedEl. 208 00:11:54,521 --> 00:11:59,530 Cochlear Implants can be Behind-the-Ear, or a round, outer processor: 209 00:11:59,699 --> 00:12:03,483 in Cochlear it is called Kanso, in MedEl it is called Rondo. 210 00:12:04,431 --> 00:12:07,809 Some get a Cochlear Implant on one ear, unilaterally. 211 00:12:08,283 --> 00:12:11,829 Then they may be able to use a Hearing Aid on the other ear. 212 00:12:12,235 --> 00:12:15,775 If the client gets a Cochlear Implant from Cochlear or MedEl, 213 00:12:15,911 --> 00:12:19,120 they will then need a Hearing Aid from a different manufacturer 214 00:12:19,200 --> 00:12:20,691 on that other ear. 215 00:12:20,860 --> 00:12:24,822 Whereas, if the client gets a Cochlear Implant from Oticon Medical, 216 00:12:25,296 --> 00:12:28,683 Oticon has the Hearing Aid to match the Cochlear Implant, 217 00:12:28,849 --> 00:12:32,974 and the two will be using the same platform for good connectivity. 218 00:12:34,091 --> 00:12:36,928 Some get Cochlear Implant bilaterally. 219 00:12:37,943 --> 00:12:40,880 Many of the same issues, that I mentioned about Hearing Aids, 220 00:12:40,925 --> 00:12:43,117 count also for Cochlear Implants 221 00:12:43,160 --> 00:12:47,295 and it is needed to take the time and sort all these things out 222 00:12:47,498 --> 00:12:49,024 for each client. 223 00:12:49,960 --> 00:12:53,311 Bone Anchored Hearing System, BAHS. 224 00:12:53,514 --> 00:12:56,839 This is typically for treating conductive Hearing Loss. 225 00:12:57,177 --> 00:13:00,000 There are different brands and different types. 226 00:13:00,688 --> 00:13:02,112 Surgery is needed. 227 00:13:02,200 --> 00:13:04,826 A screw needs to be implanted in the skull. 228 00:13:05,537 --> 00:13:08,360 BAHS is a well-known audiological treatment 229 00:13:08,440 --> 00:13:13,013 and has been known for many years, and yet it is also very new. 230 00:13:13,480 --> 00:13:15,125 Because surgery is needed, 231 00:13:15,200 --> 00:13:19,663 the BAHS are tried out with user wearing a softband at first. 232 00:13:20,269 --> 00:13:23,872 The BAHS will transmit sound vibrations to the skull. 233 00:13:24,177 --> 00:13:27,361 If this works, then a screw can be implanted, 234 00:13:27,497 --> 00:13:32,059 and the outer Hearing Aid can be attached to the screw like a snap lock. 235 00:13:33,000 --> 00:13:36,504 For many years there was only one manufacturer of BAHS, 236 00:13:36,673 --> 00:13:39,316 and this need was low priority. 237 00:13:39,786 --> 00:13:42,200 Now there are 3 manufacturers of BAHS: 238 00:13:42,280 --> 00:13:45,663 the Oticon Medical, the Cochlear and MedEl. 239 00:13:46,709 --> 00:13:50,665 The Oticon Medical and Cochlear screws are identical, 240 00:13:50,902 --> 00:13:53,840 and this means that patients having had surgery 241 00:13:53,920 --> 00:13:55,760 with one of these products can change 242 00:13:55,840 --> 00:13:58,923 and try the other company’s outer part of the BAHS. 243 00:13:59,701 --> 00:14:02,760 When the BAHS is primarily for conductive Hearing Loss, 244 00:14:02,869 --> 00:14:04,489 it is important to know 245 00:14:04,640 --> 00:14:08,582 that conductive Hearing Loss can be caused by different malformations, 246 00:14:09,090 --> 00:14:13,459 or the Hearing Loss can be mixed conductive and sensorineural Hearing Loss, 247 00:14:13,730 --> 00:14:16,280 and there are different implants that can be used 248 00:14:16,360 --> 00:14:19,290 according to what type of mixed Hearing Loss it is. 249 00:14:20,000 --> 00:14:22,480 Also within the last 10 to 15 years, 250 00:14:22,560 --> 00:14:25,235 it is now possible to have BAHS bilaterally. 251 00:14:25,480 --> 00:14:28,295 This was not possible 10 to 15 years back. 252 00:14:29,039 --> 00:14:32,204 BAHS users may also need Assistive Listening System, 253 00:14:32,677 --> 00:14:36,532 but it has taken longer to develop this accessibility for BAHS. 254 00:14:36,837 --> 00:14:40,200 Some BAHS users may therefore rely more on subtitling 255 00:14:40,280 --> 00:14:42,274 and speech-to-text in general. 256 00:14:43,122 --> 00:14:47,269 There is still research and development going on within the BAHS, which is good. 257 00:14:47,438 --> 00:14:50,120 Overall, there is ongoing research going on 258 00:14:50,200 --> 00:14:52,673 within all types of audiological treatments, 259 00:14:52,720 --> 00:14:56,277 be that Hearing Aids, Cochlear Implants, or BAHS. 260 00:14:57,160 --> 00:15:01,360 Many of the same issues, that I mentioned about Hearing Aids and Cochlear Implants, 261 00:15:01,440 --> 00:15:02,800 also count for BAHS, 262 00:15:02,880 --> 00:15:06,369 and it is needed to take the time and sort all these things out 263 00:15:06,572 --> 00:15:07,895 for each client. 264 00:15:12,240 --> 00:15:16,239 Now about Assistive Listening Systems, in short ALS. 265 00:15:16,400 --> 00:15:18,080 In this part of the presentation, 266 00:15:18,160 --> 00:15:22,210 I shall talk about different types of Assistive Listening Systems, 267 00:15:22,375 --> 00:15:25,368 different technologies within Assistive Listening Systems 268 00:15:25,504 --> 00:15:30,714 and also about Assistive Listening Systems in use without an audiological treatment. 269 00:15:31,661 --> 00:15:34,120 When we apply for Assistive Listening Systems, 270 00:15:34,200 --> 00:15:36,160 this is because we need further help 271 00:15:36,240 --> 00:15:38,842 than the audiological treatment provides us. 272 00:15:39,440 --> 00:15:43,560 The Assistive Listening System needs to be able to technically cooperate 273 00:15:43,603 --> 00:15:46,521 with the audiological treatment that we have received. 274 00:15:46,927 --> 00:15:50,782 The technology that covers most broadly is the loop and tele coil. 275 00:15:51,320 --> 00:15:55,245 Since new technologies have come up along with the tele coil and loop, 276 00:15:55,482 --> 00:16:00,000 we have had a very long discussion if loop and tele coil is old fashioned. 277 00:16:00,440 --> 00:16:01,508 It is not. 278 00:16:02,320 --> 00:16:05,211 I should also like to draw your attention to the fact, 279 00:16:05,516 --> 00:16:08,159 that some people do not have a Hearing Loss 280 00:16:08,426 --> 00:16:11,013 that can be measured in an audiogram. 281 00:16:11,200 --> 00:16:15,348 But they will find it very difficult to, e.g. discriminate words, 282 00:16:15,484 --> 00:16:18,602 maybe struggle to determine where the sound comes from, 283 00:16:18,771 --> 00:16:20,169 and more things. 284 00:16:21,714 --> 00:16:26,631 And this is called APD, Auditory Processing Disorders. 285 00:16:26,760 --> 00:16:30,157 This is in the auditory pathways in the brain. 286 00:16:30,698 --> 00:16:34,080 Some of these will be granted an Assistive Listening System: 287 00:16:34,200 --> 00:16:38,661 the receiver for the Assistive Listening System may well look like a Hearing Aid, 288 00:16:38,830 --> 00:16:40,792 but this is a Radio Aid. 289 00:16:41,435 --> 00:16:45,341 Auditory Processing Disorder is a fairly new diagnosis, 290 00:16:45,480 --> 00:16:49,033 but this group may on top of using Assistive Listening System, 291 00:16:49,160 --> 00:16:51,831 also benefit from speech-to-text. 292 00:16:52,880 --> 00:16:54,880 I should probably mention as well 293 00:16:54,960 --> 00:16:58,440 that several of the Assistive Listening Systems manufacturers 294 00:16:58,520 --> 00:17:01,470 also sell so called sound field systems. 295 00:17:01,760 --> 00:17:03,229 These are basically: 296 00:17:03,280 --> 00:17:07,600 when a speaker in a class or conference room uses a microphone 297 00:17:07,680 --> 00:17:10,821 and a number of loudspeakers are installed in the room. 298 00:17:11,280 --> 00:17:14,639 Unfortunately, in many places it so happens 299 00:17:14,680 --> 00:17:19,549 that these loudspeakers are not installed according to the acoustics in the room. 300 00:17:19,846 --> 00:17:22,130 Some places they do a wonderful job. 301 00:17:22,200 --> 00:17:23,200 In other places 302 00:17:23,280 --> 00:17:26,400 these systems cause more confusion to all in the room 303 00:17:26,480 --> 00:17:28,075 than they manage to support 304 00:17:28,360 --> 00:17:31,528 the individual who may need this kind of support. 305 00:17:32,070 --> 00:17:35,120 You can in particular tell if a system is not installed 306 00:17:35,200 --> 00:17:37,333 according to the acoustics in the room, 307 00:17:37,440 --> 00:17:41,520 if it is a loudspeaker which is suggested to be moved around. 308 00:17:41,858 --> 00:17:45,125 EFHOH and IFHOH recommend that all Hearing Aids, 309 00:17:45,294 --> 00:17:48,786 Cochlear Implants, and BAHS have tele coil activated. 310 00:17:49,531 --> 00:17:50,920 Why do we do that? 311 00:17:52,600 --> 00:17:53,520 We have realized, 312 00:17:53,600 --> 00:17:56,960 that far too many receive Hearing Aids/Cochlear Implants 313 00:17:57,040 --> 00:18:00,489 with a tele coil in it, but it has not been activated. 314 00:18:02,240 --> 00:18:06,054 There are also Hearing Aids, where there is no tele coil to be found. 315 00:18:06,720 --> 00:18:09,776 The tele coil is of great help to a great number of us, 316 00:18:10,080 --> 00:18:13,049 when there is also a loop, that we can use, 317 00:18:13,320 --> 00:18:15,760 and this is up until now the easiest way 318 00:18:15,840 --> 00:18:18,800 to provide accessibility for Hard-of-Hearing population, 319 00:18:18,982 --> 00:18:21,228 that will benefit from using sound. 320 00:18:22,243 --> 00:18:25,560 Furthermore, tele coils and loops are fairly cheap. 321 00:18:26,440 --> 00:18:28,217 Loop and Tele Coil. 322 00:18:28,860 --> 00:18:31,680 Users’ associations recommend tele coils 323 00:18:31,760 --> 00:18:37,791 in all audiological hearing devices to be activated and to work with loops. 324 00:18:38,401 --> 00:18:42,680 This means that users of audiological hearing devices find tele coil 325 00:18:42,760 --> 00:18:46,075 and loop to be a help and great support for us. 326 00:18:46,380 --> 00:18:49,114 Users also recognise, that there are times 327 00:18:49,160 --> 00:18:51,313 where we are together with others with Hearing Loss, 328 00:18:51,360 --> 00:18:55,107 and then we need a technology that works for us in common. 329 00:18:55,750 --> 00:19:00,840 So far, the loop and tele coil has been the only technology working well for us 330 00:19:00,920 --> 00:19:02,654 in these situations. 331 00:19:04,110 --> 00:19:05,880 When using tele coil and loop, 332 00:19:05,949 --> 00:19:10,080 there is not a bigger consuming of battery capacity in Hearing Aids, 333 00:19:10,171 --> 00:19:12,023 Cochlear Implants, or BAHS, 334 00:19:12,328 --> 00:19:15,343 which there tends to be using other technologies. 335 00:19:15,480 --> 00:19:17,280 When using tele coil and loop, 336 00:19:17,360 --> 00:19:20,870 there is no big delay in the audiological hearing systems, 337 00:19:21,080 --> 00:19:24,411 which there tends to be using other technologies. 338 00:19:24,850 --> 00:19:27,920 It is important knowledge what hearing technology 339 00:19:28,022 --> 00:19:31,480 the user of speech-to-text has to work with 340 00:19:31,560 --> 00:19:35,680 to identify what are the issues for this person to follow 341 00:19:35,760 --> 00:19:37,851 and understand communication. 342 00:19:39,500 --> 00:19:42,986 Assistive Listening Systems work on frequencies. 343 00:19:43,291 --> 00:19:44,400 It has happened 344 00:19:44,480 --> 00:19:48,160 that there has been interference between Assistive Listening Systems 345 00:19:48,240 --> 00:19:50,388 and speech-to-text technologies 346 00:19:50,440 --> 00:19:52,388 at various conferences. 347 00:19:53,572 --> 00:19:55,760 Loop, which works with the tele coil, 348 00:19:55,840 --> 00:20:00,631 is the only Assistive Listening Systems that is IEC-standardised. 349 00:20:00,971 --> 00:20:04,817 IEC is International Electronic Commission. 350 00:20:05,358 --> 00:20:09,520 With tele coil and loop the user can have access to attending 351 00:20:09,600 --> 00:20:12,840 and participating in communications 352 00:20:12,920 --> 00:20:16,296 such as meetings, seminars, education, 353 00:20:16,400 --> 00:20:21,080 communicating at a distance, when there is or are microphones, 354 00:20:21,401 --> 00:20:24,789 and this even together with others with Hearing Loss. 355 00:20:25,838 --> 00:20:28,423 The joy of hearing together with 356 00:20:28,480 --> 00:20:32,047 and at the same time as others is tremendous. 357 00:20:32,280 --> 00:20:35,366 This is for us to stay in the hearing loop. 358 00:20:35,840 --> 00:20:38,915 In public, there are in some countries counter loops 359 00:20:38,960 --> 00:20:42,201 in many shops, hotels, ticket offices. 360 00:20:42,569 --> 00:20:44,328 Shown on the picture. 361 00:20:45,479 --> 00:20:49,537 With counter loops users experience tends to be, however, 362 00:20:49,706 --> 00:20:52,458 that it does not necessarily work for us. 363 00:20:52,661 --> 00:20:53,830 But it could. 364 00:20:54,405 --> 00:20:56,320 What I have found myself has been: 365 00:20:56,400 --> 00:20:58,529 wrong installation of a counter loop, 366 00:20:58,831 --> 00:21:02,672 lack of knowledge from staff on how to use the equipment. 367 00:21:02,909 --> 00:21:07,159 It often takes instruction from me to staff on how to use it. 368 00:21:07,200 --> 00:21:10,160 This is disturbing our relation and communication, 369 00:21:10,240 --> 00:21:13,680 because it takes us talking about something completely different 370 00:21:13,760 --> 00:21:16,560 from what I came to that shop or ticket office for. 371 00:21:17,237 --> 00:21:19,720 In museums and on guided tours 372 00:21:19,800 --> 00:21:22,708 it becomes more and more common to ask for a neck loop, 373 00:21:22,908 --> 00:21:24,925 and these work in general fine. 374 00:21:26,110 --> 00:21:29,960 All these Assistive Listening Systems must be regularly checked 375 00:21:30,040 --> 00:21:33,959 and serviced, just like cars need to be checked and serviced. 376 00:21:34,120 --> 00:21:36,339 There is no system for this just yet. 377 00:21:37,726 --> 00:21:39,760 Over the latest 10 to 15 years 378 00:21:39,840 --> 00:21:42,681 Assistive Listening Systems have gotten much better, 379 00:21:42,760 --> 00:21:45,346 as has audiological treatments as well. 380 00:21:45,989 --> 00:21:49,600 This means we have been able to include many more pupils with Hearing Loss 381 00:21:49,680 --> 00:21:51,251 in local school settings. 382 00:21:51,691 --> 00:21:53,640 With use of Assistive Listening Systems 383 00:21:53,720 --> 00:21:57,520 these pupils have now far better possibilities to follow lessons 384 00:21:57,600 --> 00:22:00,215 and social life throughout their education. 385 00:22:00,820 --> 00:22:04,720 In particular in schools where there are also pupils’ microphones 386 00:22:04,800 --> 00:22:06,528 it can work very smoothly, 387 00:22:06,664 --> 00:22:10,509 rather than pass around microphones, which takes a lot of time. 388 00:22:11,592 --> 00:22:15,618 Personal Assistive Listening System is for more individual listening. 389 00:22:15,990 --> 00:22:18,880 Users of Assistive Listening System need to sort out 390 00:22:18,934 --> 00:22:21,280 when they join in with others with Hearing Loss 391 00:22:21,360 --> 00:22:24,691 and they should preferably be on the same technology, 392 00:22:24,760 --> 00:22:28,440 otherwise speakers will need to use different microphones, 393 00:22:28,520 --> 00:22:31,847 and this will cause confusion throughout the event. 394 00:22:32,490 --> 00:22:36,732 When using loop for personal use, e.g. TV at home, 395 00:22:36,901 --> 00:22:39,457 this can be done using portable neck loop. 396 00:22:39,627 --> 00:22:44,840 But neck loops need to recharge batteries and you need to activate both the loop 397 00:22:44,920 --> 00:22:46,560 as well as your Hearing Aids 398 00:22:46,640 --> 00:22:49,515 or Cochlear Implants must be switched onto tele coil. 399 00:22:50,000 --> 00:22:53,080 Using a neck loop involves also either Bluetooth 400 00:22:53,160 --> 00:22:55,603 or frequency modulation transmission. 401 00:22:55,908 --> 00:22:58,440 The more technologies that need to work together, 402 00:22:58,520 --> 00:23:00,269 the higher risk of dropouts. 403 00:23:01,280 --> 00:23:05,620 When you have a permanent loop installed in your living room to the TV, 404 00:23:05,891 --> 00:23:09,549 this is connected to the electricity or power in the house 405 00:23:09,640 --> 00:23:12,480 and all you need to do is switch your Hearing Aids 406 00:23:12,560 --> 00:23:14,838 or Cochlear Implants onto tele coil. 407 00:23:15,820 --> 00:23:19,800 Also, with permanently installed loop others with Hearing Loss can join in 408 00:23:19,880 --> 00:23:21,895 for the same program on the TV 409 00:23:21,960 --> 00:23:26,196 when they switch their Hearing Aids or Cochlear Implants onto tele coil mode. 410 00:23:27,106 --> 00:23:30,000 In my family we are more people with Hearing Loss, 411 00:23:30,200 --> 00:23:33,071 and I also have friends with Hearing Loss, of course. 412 00:23:33,920 --> 00:23:35,101 Loops are cheap. 413 00:23:35,608 --> 00:23:39,430 Even the permanently installed ones are cheap and they last long. 414 00:23:40,039 --> 00:23:43,629 For instance I only had my amplifier renewed last year. 415 00:23:43,765 --> 00:23:47,000 The installation of the cord in my living room stayed the same, 416 00:23:47,080 --> 00:23:49,173 only amplifier was changed. 417 00:23:49,338 --> 00:23:52,563 The cost of this was around €130. 418 00:23:52,901 --> 00:23:57,485 The amplifier that did no more work I had had that for 32 years, 419 00:23:57,600 --> 00:24:00,384 and I expect this new one to last for the rest of my life. 420 00:24:00,756 --> 00:24:05,318 Just an example to show how easily and also cheap it can be done. 421 00:24:06,705 --> 00:24:10,480 Loop and Tele coil is the only Assistive Listening System 422 00:24:10,560 --> 00:24:13,392 that has been IEC-standardized. 423 00:24:13,440 --> 00:24:15,520 The manufacturers are responsible 424 00:24:15,600 --> 00:24:19,104 to have their Assistive Listening System products standardized. 425 00:24:19,409 --> 00:24:21,786 This is not on the consumer. 426 00:24:22,564 --> 00:24:25,289 Just like any other types of technology, 427 00:24:25,729 --> 00:24:27,000 the use varies, 428 00:24:27,080 --> 00:24:29,800 and the benefits differ from one situation to another 429 00:24:29,880 --> 00:24:31,620 and from one person to another. 430 00:24:32,120 --> 00:24:35,160 This is very difficult when applying for Assistive Listening System 431 00:24:35,240 --> 00:24:38,523 and not easily understood by granting authorities. 432 00:24:39,199 --> 00:24:40,280 At the same time, 433 00:24:40,360 --> 00:24:42,882 a lot of these situations could be solved better 434 00:24:43,085 --> 00:24:45,240 when society was more accessible 435 00:24:45,322 --> 00:24:47,797 and loops were installed in public places 436 00:24:47,920 --> 00:24:50,280 as well as good signing, text 437 00:24:50,360 --> 00:24:55,328 and, e.g. subtitles on screens in museums and public places in general, 438 00:24:55,520 --> 00:25:01,079 such as airports, train stations, waiting rooms at doctors etc. 439 00:25:02,280 --> 00:25:04,920 When we have received our audiological treatment 440 00:25:05,000 --> 00:25:08,113 with Hearing Aids, Cochlear Implants, or BAHS, 441 00:25:08,282 --> 00:25:11,160 different brands tend to match certain brands 442 00:25:11,240 --> 00:25:12,997 within Assistive Listening System. 443 00:25:13,674 --> 00:25:18,280 However, loop fits in with all tele coils, no matter brand of Hearing Aids, 444 00:25:18,360 --> 00:25:20,494 Cochlear Implant, or BAHS. 445 00:25:21,160 --> 00:25:24,200 Quality of tele coils differ from one brand to another, 446 00:25:24,280 --> 00:25:27,872 and at the same time the tele coil needs to be rated 447 00:25:28,071 --> 00:25:29,040 (adjusted) 448 00:25:29,209 --> 00:25:32,698 just like the Hearing Aid itself needs to be tuned in. 449 00:25:33,640 --> 00:25:39,082 There is a huge lack of knowledge in this particular area of this professional field. 450 00:25:40,165 --> 00:25:44,487 We also need to try out different types of Assistive Listening System, 451 00:25:44,859 --> 00:25:47,040 but this is often complicated, 452 00:25:47,120 --> 00:25:51,775 because we need to borrow the system to try it out for 3 to 4 weeks. 453 00:25:51,940 --> 00:25:54,502 This is very time consuming for the dealers 454 00:25:54,560 --> 00:25:58,397 and it takes up a lot of energy also for us users 455 00:25:58,563 --> 00:26:01,025 to try out and listen in different ways, 456 00:26:01,194 --> 00:26:03,837 involve family and friends in this try-out. 457 00:26:04,307 --> 00:26:07,720 It often also takes to write down your experiences 458 00:26:07,800 --> 00:26:11,038 and then go back to the clinic for further adjustments. 459 00:26:12,004 --> 00:26:14,960 For now Phonak seems to be the biggest manufacturer 460 00:26:15,040 --> 00:26:17,674 of Assistive Listening System on the market. 461 00:26:18,076 --> 00:26:21,200 For most convenient operation of the Assistive Listening System 462 00:26:21,280 --> 00:26:24,671 it may be advisable then with Phonak Hearing Aids. 463 00:26:24,874 --> 00:26:25,840 But, 464 00:26:26,352 --> 00:26:27,791 and there is always a but, 465 00:26:28,062 --> 00:26:32,120 maybe the Phonak Hearing Aids are not what you are most comfortable with 466 00:26:32,228 --> 00:26:35,915 regarding quality of sound for your particular Hearing Loss. 467 00:26:36,186 --> 00:26:39,846 This is nothing about some products being bad quality. 468 00:26:39,920 --> 00:26:42,821 This is, just like when you try out shoes, 469 00:26:42,990 --> 00:26:46,040 there are different brands but once you try out the shoes, 470 00:26:46,140 --> 00:26:48,475 you feel one pair fits you best. 471 00:26:49,739 --> 00:26:52,499 Other types of Assistive Listening Systems. 472 00:26:53,320 --> 00:26:57,708 We have through many years had Frequency Modulation, in short FM, 473 00:26:58,148 --> 00:27:01,535 as a transmitting technology in Assistive Listening System, 474 00:27:01,600 --> 00:27:04,434 but it has proven to have some difficulties. 475 00:27:05,043 --> 00:27:08,464 Now Bluetooth (BT) has been introduced. 476 00:27:08,520 --> 00:27:11,511 It is still a fairly new technology in this field, 477 00:27:11,560 --> 00:27:17,045 and neither FM nor Bluetooth has been IEC-standardised. 478 00:27:18,600 --> 00:27:23,251 I have added link in references on how the loop works for Hard-of-Hearing people. 479 00:27:23,817 --> 00:27:25,840 When I look up how Bluetooth works, 480 00:27:25,920 --> 00:27:29,489 it is all about how you pair your Hearing Aids with your phone. 481 00:27:29,692 --> 00:27:32,840 However, disadvantages that we do experience is 482 00:27:32,920 --> 00:27:36,224 that we hear from neighbouring people in trains or buses, 483 00:27:36,440 --> 00:27:40,833 because Bluetooth connects multiple and there are also occasions of dropouts. 484 00:27:41,341 --> 00:27:45,204 But many values this more individual Assistive Listening System greatly 485 00:27:45,407 --> 00:27:47,491 and the quality is improving. 486 00:27:48,642 --> 00:27:51,040 What is common for both systems is, 487 00:27:51,120 --> 00:27:53,609 that once you listen via loop or Bluetooth, 488 00:27:53,910 --> 00:27:57,012 you amplify the sound from the source you are connected to. 489 00:27:57,080 --> 00:28:01,182 You shall then seem less social in your family or community, 490 00:28:01,351 --> 00:28:05,043 because you have been enabled to focus more to the speaker, 491 00:28:05,440 --> 00:28:07,728 or TV, source of sound. 492 00:28:08,235 --> 00:28:10,400 You shall need to switch your Hearing Aid, 493 00:28:10,480 --> 00:28:13,149 Cochlear Implant, or BAHS onto microphone 494 00:28:13,200 --> 00:28:15,665 in Hearing Aid, Cochlear Implant, or BAHS 495 00:28:15,760 --> 00:28:20,080 to be able to listen to what the person next to you wishes to comment. 496 00:28:20,340 --> 00:28:23,800 This means you need to choose how you interact with others. 497 00:28:23,920 --> 00:28:27,790 Maybe remember something said during presentation, or a film 498 00:28:27,840 --> 00:28:29,688 and you can discuss it later. 499 00:28:30,768 --> 00:28:32,600 Hard-of-Hearing are not less social. 500 00:28:32,719 --> 00:28:34,468 We just listen in a different way 501 00:28:34,560 --> 00:28:38,024 and need to structure our working memory differently too, 502 00:28:38,280 --> 00:28:41,949 because we need to be able to talk about things later. 503 00:28:42,388 --> 00:28:46,820 Bluetooth LE means Bluetooth Low Energy. 504 00:28:50,800 --> 00:28:52,520 And terminology. 505 00:28:52,970 --> 00:28:55,800 Some of these terms were in particular mentioned 506 00:28:55,880 --> 00:28:58,357 in the presentation about hearing and hearing loss. 507 00:28:58,520 --> 00:29:02,320 But I add here also the typical types of audiological treatments 508 00:29:02,400 --> 00:29:04,800 and how this is in general shortened 509 00:29:04,979 --> 00:29:06,625 when we write about it. 510 00:29:06,896 --> 00:29:10,918 These abbreviations are very welcome in speech-to-text work. 511 00:29:12,339 --> 00:29:16,066 There are 3 slides with list of terms, and this is second slide. 512 00:29:17,000 --> 00:29:18,788 Third slide of list of terms. 513 00:29:19,261 --> 00:29:22,222 Please pay attention to the different brand names. 514 00:29:22,560 --> 00:29:24,600 They are not listed in list of terms, 515 00:29:24,680 --> 00:29:28,040 but during the work as speech-to-text interpreters, 516 00:29:28,120 --> 00:29:31,413 or subtitlers, brand names matter for us. 517 00:29:31,800 --> 00:29:33,760 We are target group for speech-to-text 518 00:29:33,840 --> 00:29:36,223 and it is very personal for us what we use. 519 00:29:36,280 --> 00:29:40,641 We each know the advantages and disadvantages of different brands. 520 00:29:40,810 --> 00:29:44,261 When we use speech-to-text for topics within audiology, 521 00:29:44,400 --> 00:29:46,818 we like these names to be spelled right. 522 00:29:50,168 --> 00:29:51,441 And the summary. 523 00:29:52,457 --> 00:29:56,000 This lecture has been about different audiological treatments 524 00:29:56,080 --> 00:29:58,582 and their benefits and discomforts. 525 00:29:58,950 --> 00:30:01,120 The need for use of Assistive Listening System 526 00:30:01,236 --> 00:30:04,500 when once audiological treatment has been carried through. 527 00:30:04,940 --> 00:30:06,080 The need for 528 00:30:06,160 --> 00:30:10,000 and use of Assistive Listening System is not always acknowledged. 529 00:30:11,274 --> 00:30:14,760 It is difficult for surrounding society to understand 530 00:30:14,840 --> 00:30:17,204 that we may even need speech-to-text, 531 00:30:17,373 --> 00:30:18,960 captioning, or subtitles, 532 00:30:19,040 --> 00:30:23,357 as well as audiological treatment and use of Assistive Listening System. 533 00:30:24,680 --> 00:30:26,240 A few exercises. 534 00:30:26,720 --> 00:30:30,720 The exercises for this video lecture are in the Trainer’s Guide 535 00:30:30,800 --> 00:30:32,794 and the PowerPoint file. 536 00:30:33,313 --> 00:30:39,280 [LTA outro music] 537 00:30:43,983 --> 00:30:46,449 LTA - LiveTextAccess. 538 00:30:46,990 --> 00:30:49,667 Universitat Autònoma de Barcelona. 539 00:30:50,614 --> 00:30:53,731 SDI - Internationale Hochschule. 540 00:30:54,915 --> 00:30:58,404 Scuola Superiore per Mediatori Linguistici. 541 00:30:59,588 --> 00:31:01,182 ZDFDigital. 542 00:31:02,366 --> 00:31:05,652 The European Federation of Hard of Hearing People - EFHOH. 543 00:31:06,769 --> 00:31:07,889 VELOTYPE. 544 00:31:08,633 --> 00:31:10,000 SUB-TI ACCESS. 545 00:31:11,184 --> 00:31:16,026 European Certification and Qualification Association - ECQA. 546 00:31:19,545 --> 00:31:23,406 Co-funded by the Erasmus+ Programme of the European Union. 547 00:31:25,406 --> 00:31:27,000 Erasmus+ Project: 548 00:31:27,643 --> 00:31:39,286 2018-1-DE01-KA203-004218. 549 00:31:40,707 --> 00:31:44,094 The information and views set on this presentation 550 00:31:44,432 --> 00:31:46,297 are those of the authors 551 00:31:46,360 --> 00:31:50,000 and do not necessarily reflect the official opinion 552 00:31:50,169 --> 00:31:51,661 of the European Union. 553 00:31:52,811 --> 00:31:56,367 Neither the European Union institutions and bodies 554 00:31:56,807 --> 00:31:59,484 nor any person acting on their behalf 555 00:32:00,161 --> 00:32:02,770 may be held responsible for the use 556 00:32:03,108 --> 00:32:06,495 which may be made of the information contained here.