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Hearing Impairment: Deaf and Hearing Loss Information

Disabled World: Revised/Updated: 2019/08/28

Synopsis: Information on hearing and deafness including common auditory system conditions and sign language communication. Hearing loss can occur on only one side (unilateral) or on both (bilateral) The commonest cause of hearing loss is aging, and three-quarters of people who are deaf are aged over 60.

Main Document

Hearing is one of the traditional five senses. It is the ability to perceive sound by detecting vibrations via an organ such as the ear. The inability to hear is called deafness. A hearing impairment or hearing loss is a full or partial decrease in the ability to detect or understand sounds. Caused by a wide range of biological and environmental factors, loss of hearing can happen to any organism that perceives sound.

Hearing loss, deafness, hard of hearing, anacusis, or hearing impairment, is defined as a partial or total inability to hear. In children it may affect the development of language and can cause work related difficulties for adults. Hearing loss is caused by many factors, including: genetics, age, exposure to noise, illness, chemicals and physical trauma.

Hearing loss can also be classified based on which portions of the hearing system (auditory system) are affected. When the nervous system is affected, it is referred to as sensorineural hearing loss. When the portions of the ear that are responsible for transmitting the sound to the nerves are affected, it is referred to as conductive hearing loss.

A sensorineural hearing loss is due to insensitivity of the inner ear, the cochlea, or to impairment of function in the auditory nervous system. It can be mild, moderate, severe, or profound, to the point of total deafness. This is classified as a disability under the ADA and if unable to work is eligible for disability payments.

There are two main types of hearing loss:

  • One happens when your inner ear or auditory nerve is damaged. This type is permanent.
  • The other kind happens when sound waves cannot reach your inner ear due to ear wax build up, fluid or a punctured eardrum.

Two persons with the same severity of hearing loss will experience it quite differently if it occurs early or late in life. Furthermore, a loss can occur on only one side (unilateral) or on both (bilateral). Hearing loss is categorized by its severity and by the age of onset and may be ranked as mild, moderate, moderately severe, severe or profound:

  • Mild:
    • for adults: between 26 and 40 dB HL
    • for children: between 20 and 40 dB HL
  • Moderate: between 41 and 54 dB HL
  • Moderately severe: between 55 and 70 dB HL
  • Severe: between 71 and 90 dB HL
  • Profound: 91 dB HL or greater
  • Totally Deaf: Have no hearing at all.

People who are severely deaf rely a lot on lip-reading, even with a hearing aid. Profoundly deaf people can also use sign language to communicate. Hearing impaired persons with partial loss of hearing may find that the quality of their hearing varies from day to day, or from one situation to another or not at all. They may also, to a greater or lesser extent, depend on both hearing-aids and lip-reading.

Any form of communication between people is a two way street. It is very important then to determine how a deaf person prefers to communicate. There are a number of options available to them such as sign language, lip reading or using text. There will be a way of making a connection. It may sometimes be difficult or awkward but the effort is well worth it.

The commonest cause of hearing loss is aging, and three-quarters of people who are deaf are aged over 60. At around 20 years of age, our hearing starts a gradual decline. Higher frequencies are usually the first to go. This age-related hearing loss is normal and doesn't lead to total loss of hearing. Age-related hearing loss (presbycusis) typically begins with the loss of higher frequencies, so that certain speech sounds - such as 's', 'f' and 't' - end up sounding very similar. This means the older person can hear, but not always understand.

Many people who are deaf consider spoken language their primary language and consider themselves "hard of hearing". How one classifies themselves relative to hearing loss or deafness is a very personal decision and reflects much more than just their ability to hear.

Basic labeled illustration showing the structure of the human ear, detailing the parts of the outer, middle, and inner ear.
Basic labeled illustration showing the structure of the human ear, detailing the parts of the outer, middle, and inner ear.

Deaf Culture

Describes the social beliefs, behaviors, art, literary traditions, history, values, and shared institutions of communities that are affected by deafness and which use sign languages as the main means of communication.

When used as a cultural label especially within the culture, the word deaf is often written with a capital D and referred to as "big D Deaf" in speech and sign. When used as a label for the audiological condition, it is written with a lower case d.

Facts and Statistics

  • Some medications may reversibly affect hearing. This includes some diuretics, aspirin and NSAIDs, and macrolide antibiotics.
  • The term hearing impaired is more likely to be used by people with a less than severe hearing loss and people who have acquired deafness in adulthood rather than by those who have grown up deaf.
  • There is a progressive loss of ability to hear high frequencies with increasing age known as presbycusis. For men, this can start as early as 25 and women at 30, but may even affect teenagers and children.
  • Hearing loss can be inherited. Around 75-80% of all cases are inherited by recessive genes, 20 to 25% are inherited by dominant genes, 1 to 2% are inherited by X-linked patterns, and fewer than 1% are inherited by mitochondrial inheritance.
  • Members of the deaf community tend to view deafness as a difference in human experience rather than a disability. A positive attitude toward being deaf is typical in deaf cultural groups. Deafness is not generally considered a condition that needs to be fixed.
  • Deaf culture is recognized under article 30, paragraph 4 of the United Nations Convention on the Rights of Persons with Disabilities, which states that "Persons with disabilities shall be entitled, on an equal basis with others, to recognition and support of their specific cultural and linguistic identity, including sign languages and deaf culture."
  • 60% of Iraq and Afghanistan veterans have hearing loss.
    Source: HHF http://hearinghealthfoundation.org/statistics
  • Hearing loss has doubled in the past 30 years in the U.S.
    Source: HHF http://hearinghealthfoundation.org/statistics
  • 48 million Americans (20% of population) have hearing loss.
    Source: HLAA http://hearingloss.org/content/basic-facts-about-hearing-loss
  • Profound, early-onset deafness effects 4-11 /10,000 children.
    Source: ASHA http://www.asha.org/public/hearing/Prevalence-and-Incidence-of-Hearing-Loss-in-Children/
  • 30 million Americans are regularly exposed to hazardous sounds.
    Source: ASHA http://www.asha.org/public/hearing/Prevalence-and-Incidence-of-Hearing-Loss-in-Adults/
  • 738,000 in U.S. have severe to profound hearing loss; 8% are under age of 18.
    Source: ASHA http://www.asha.org/public/hearing/Prevalence-and-Incidence-of-Hearing-Loss-in-Children/
  • One in three Americans age 65+ has hearing loss. Half of Americans 75+ has hearing loss.
    Source: HLAA http://hearingloss.org/content/basic-facts-about-hearing-loss
  • There are no accurate statistics regarding the ASL signer population, some project it at 250,000 to 500,000.
    Source: Wikipedia https://en.wikipedia.org/wiki/American_Sign_Language
  • 60% of people with hearing loss are in the workforce or educational settings. Many older Americans are staying in the workforce longer.
    Source: HLAA http://hearingloss.org/content/basic-facts-about-hearing-loss
  • The U.S. population is aging. The number of Americans ages 65+ is projected to double in the next 25 years, from 46 million to about 72 million.
    Source U.S. CDC https://www.cdc.gov/aging/pdf/state-aging-health-in-america-2013.pdf
  • 80% of people who could benefit from hearing aids do not use them. High cost and negative association with old age and appearance are primary factors in not using hearing aids.
    Source: HLAA http://hearingloss.org/content/basic-facts-about-hearing-loss



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