Articles About Hearing Loss

Hearing Loss Association of North Carolina

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"Deaf and Hard of Hearing"

The following discussion, written by Steve Barber, provides a look at the people that make up the broad category we call “Deaf and Hard of Hearing”. It was adapted from a chapter originally published in the “Fundamentals in Assistive Technology, 4th Edition”. That textbook was designed to accompany the Fundamentals in Assistive Technology course developed by RESNA, the Rehabilitation Engineering and Assistive Technology Society of North America.

The hearing world often perceives Hearing Loss and Deafness as the same thing. They are not. Deafness, alone, has wide variations in how it's perceived by people who are deaf. Hearing loss varies so much that there are very wide ranging differences in its impact and in how it might be dealt with. This article attempts to define broad categories that are important to understand when considering who the "Deaf and Hard of Hearing" really are.

Who Are the "Deaf and Hard of Hearing"

Hearing loss or deafness can affect people of any age, but the incidence rises, as we grow older. About 30% of people over 65 have a significant hearing loss. An estimated 3% of babies are born deaf or have a significant hearing loss. More people under age 65 have a hearing loss than those over age 65. According to, the number of people in the United States who are Deaf or Hard of Hearing ranges from 22 million to 36 million (or about 10%). A person with hearing loss may refer to themselves as Deaf, deaf, hard of hearing, hearing impaired or just refuse to associate themselves with any of these terms. It is a personal choice that is not always based on actual ability to hear. This makes categorization based on hearing difficult so there are no exact figures, but this pie chart estimates percentages in the following categories:

People who are Deaf

People who are Deaf have little or no hearing ability. The word “Deaf”, (often written with a capital “D”) typically refers to people who use American Sign Language as a primary language – either directly with others who sign or indirectly through an interpreter with people who do not sign. They may hear environmental sounds, and may even understand some speech, but they identify with what is known as the “Deaf Culture”. Deaf people are often proud of their culture and happy to be a part of it. They do not feel impaired and, as a result, do not wish to be called “hearing impaired”. Some people who have lost their hearing post-lingually (after acquiring spoken language) do become fluent in American Sign Language and identify themselves as “Deaf”. However, most people who identify themselves as “Deaf” are “Born Deaf” or at least became Deaf pre-lingually (before acquiring spoken language).

People who are Oral Deaf or Late Deafened

People who are deaf (often written with a lower case “d”) also have little or no hearing, but they typically do not use American Sign Language as a primary language and often have no signing ability at all. Their primary language is their native spoken language. They rely on speech reading (improperly called “lip reading”) and text alternatives. Many were raised by hearing parents, who wanted their children to remain part of the “hearing world”. Over 90 percent of babies who are born deaf are born to hearing parents. Although most people who experience hearing loss do not become deaf, many people do become completely deaf later in life due to gradual or sudden hearing loss. These late-deafened people often choose not to learn sign language, or to identify with the “Deaf Culture”. Some of the reasons are practical, such as all their current friends and family not knowing sign language, and the difficulty of becoming fluent in sign language, but some of the reasons are based on a denial of their hearing loss. If people could get beyond that denial, they might find that they don’t have to become fluent or join “Deaf Culture” to benefit from some sign language among friends and family.

People with a Profound Hearing Loss

People with a profound hearing loss usually must use assistive technology in addition to powerful and full-featured hearing aids in order to understand speech. Even the best hearing aids and assistive technology will not restore enough hearing to understand speech for people with profound hearing loss in less than optimal situations. Most people are aware that their hearing loss is a significant limitation for them and will do anything needed to over come it. Some people with profound hearing loss may continue to deny that it is a serious problem and may withdraw from society or situations where hearing is required.

People with a Severe Hearing Loss

People with a severe hearing loss usually can use hearing aids and assistive technology to communicate effectively in most situations. This technology does not provide “normal” hearing for them, but can usually provide sufficient improvement that understanding speech is possible in all but the worst of situations. Some people with severe hearing loss may still be in denial and refuse to use hearing aids or assistive technology, but a large percentage of those with severe hearing loss do use hearing aids effectively and many also supplement that with assistive technology.

People with a Moderate Hearing Loss

People with a moderate hearing loss can communicate in many situations even without hearing aids. Even with hearing aids, people with a moderate loss will have difficulty in noisy environments or when they can’t see the person they are speaking with. Certainly, hearing aids could make a huge difference for them in making speech clearer, and many more people are using this technology, now that hearing aids are better able to fit their needs. While some people with a moderate hearing loss do not use hearing aids because of the cost, denial or unwillingness to admit that they have a hearing loss is more often the reason. Most people with a moderate hearing loss can substantially benefit from hearing aids and would not normally use assistive technology beyond an amplified phone to supplement hearing aid use.

People with a Mild Hearing Loss

People with a mild hearing loss are least likely to do anything about their hearing. They can understand speech in most situations, but may have difficulty in noisy environments. They may say things like “other people mumble” or “talk too fast”. They may say “Huh?” a lot, but may not see their hearing as a problem serious enough that they would accept hearing aids, even though hearing aids might help them.

Steve Barber is a 2007 Co-President of Hearing Loss Association of North Carolina. Email him at

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