Deafness/Hearing Impairment


Our nation’s special education law, the Individuals with Disabilities Education Act (IDEA) defines deafness as...

"...a hearing impairment so severe that a child is impaired in processing linguistic information through hearing, with or without amplification, that adversely affects a child’s educational performance."

[34 Code of Federal Regulations §300.8(c), (3)]

Our nation’s special education law, the Individuals with Disabilities Education Act (IDEA) defines hearing impairment as...

"an impairment in hearing, whether permanent or fluctuating, that adversely affects a child's educational performance but that is not included under the definition of deafness."

[34 Code of Federal Regulations §300.8(c), (5)]

Hearing loss is generally described as slight, mild, moderate, severe, or profound depending upon how well a person can hear the intensities or frequencies most strongly associated with speech. Impairments in hearing can occur in both measurements of sound (loudness and/or frequency), and may exist in only one ear or in both ears. Generally, only children whose hearing loss is greater than 90 decibels (dB) are considered deaf.

(Center for Parent Information and Resources, 2015)

Although person-first language is preferred by some organizations and individuals with disabilities (e.g., a person with an intellectual disability), others use identity-first language to emphasize the disability as an integral and important part of the person. Individuals who describe themselves as Deaf (capital D) often have close ties to the Deaf community.  Others who associate more with the hearing community and culture may use the term deaf (lower-case d).


Hearing loss can be either acquired, meaning the loss occurred after birth due to illness or injury, or congenital, meaning that the hearing loss or deafness was present at birth. The most common cause of acquired hearing loss is exposure to noise. Other causes can include: buildup of fluid behind the eardrum; ear infections; childhood diseases, such as mumps, measles, or chicken pox; and head trauma. Congenital causes of hearing loss and deafness include: a family history of hearing loss or deafness; infections during pregnancy (such as rubella); and complications during pregnancy (such as the Rh factor, maternal diabetes, or toxicity). A child’s hearing loss or deafness may also be characteristic of another disability of Down syndrome, Usher syndrome, Treacher Collins syndrome, Crouzon syndrome, and Alport syndrome.

  • Conductive
  • Conductive hearing losses are caused by disease or obstructions in the outer or middle ear. Conductive hearing losses usually affect all frequencies of hearing evenly and do not result in severe losses. A person with conductive hearing loss is usually able to use a hearing aid well or can be helped medically or surgically.
  • Sensorineural
  • Sensorineural hearing losses result from damage to the delicate sensory hair cells of the inner ear of the nerves that supply it. These hearing losses can range from mild to profound. They often affect a person’s ability to hear certain frequencies more than others. Thus, even with amplification to increase the sound level, a person with sensorineural hearing loss may perceive distorted sounds, sometimes making the successful use of a hearing aid impossible.
  • Mixed hearing loss
  • A mixed hearing loss refers to a combination of conductive and sensorineural loss.
  • Auditory Neuropathy Spectrum Disorder
  • Occurs when sound travels to the inner ear normally, but further transmission of sound to the brain is impaired. This type of hearing loss can result from damage to the inner hair cells or auditory neurons. Hearing loss of this type can range from mild to severe.

(Alexander Graham Bell Association for the Deaf and Hard of Hearing, 2019)
(CPIR, 2015)


Each year in the United States, more than 12,000 babies are born with a hearing loss; often, the cause is unknown. Profound deafness occurs in 4-11 per 10,000 children; in at least 50% of these cases, the cause is genetic. More than 90% of children with hearing loss or deafness are born to hearing parents.

(CPIR, 2015)


The American Hearing Research Foundation (AHRF) provides suggestions for preventing hearing loss. Loud noise is the leading cause of preventable hearing loss and the use of ear plugs and ear protection can help prevent injury. Regular medical examinations and proper immunizations can help prevent diseases and infections that may lead to hearing loss. With proper preventative measures, factors that contribute to permanent hearing loss can be detected early and remedied.


If you observe any of the following behaviors or symptoms of hearing loss, you should consider having your child’s hearing evaluated further by a certified audiologist.

  • Reporting "muffled" hearing
  • Inconsistent response to sound
  • Language and speech development is delayed
  • Difficulty understanding speech in noise, on the telephone, and/or particularly of women and children
  • Speech is unclear
  • Volume is turned up high on electronic equipment (radio, TV, iPod, etc.)
  • Asking for repetition
  • Tinnitus (ringing in ears)
  • Does not follow directions and/or has difficulty attending
  • Often says, "Huh?"
  • Often does not respond when called

(American Speech and Hearing Association, 2019)


As a result of Early Hearing Detection and Intervention (EHDI) legislation enacted in 2000, most hospitals today screen for hearing loss before a newborn is discharged from the hospital. Follow-up testing may be recommended to confirm a suspected hearing loss is present and, if so, the type and nature of the loss. Most states offer early intervention up to age three through the local public school, healthcare, or family service systems.

The treatment of hearing loss depends on the cause. A bacterial infection of the middle ear can be treated with antibiotics; blockages of the outer and middle ears can be cleared; damaged eardrums can be repaired surgically; and ossicles affected by otosclerosis can be replaced with artificial bones. Some causes of sensorineural hearing loss can also be improved. For example, an acoustic neuroma can be removed surgically.

If there is no cure for the hearing loss (as with age-related hearing loss), a hearing aid for one or both ears usually helps most people, whether the hearing loss is the result of conductive or sensorineural problems. Many different types of hearing aids are available and the audiologist will advise as to which type best suits your needs.

Cochlear implants can be particularly valuable for deaf children when they are implanted around the age of two or three, the time when language skills are developing fastest.

Audiologic rehabilitation is also available to help train to improve hearing. Hearing rehabilitation focuses on adjusting to hearing loss, making the best use of hearing aids, exploring assistive devices, managing conversations, and taking charge of communication.

(AG Bell, 2019)
(ASHA, 2019)


Children who are hard of hearing will find it much more difficult than children who have normal hearing to learn vocabulary, grammar, word order, idiomatic expressions, and other aspects of verbal communication. For children who are deaf or have severe hearing losses, early, consistent, and conscious use of visible communication (such as American Sign Language, finger spelling, and cued speech) and/or amplification and aural/oral training can help reduce this language delay. By age four or five, most children who are deaf are enrolled in school on a full-day basis and do special work on communication and language development.

(CPIR, 2015)


Hearing loss of deafness does not affect a person’s intellectual capacity or ability to learn. However, children who are either hard of hearing or deaf generally require some form of special education services in order to receive an adequate education. Such services may include:

  • Regular speech, language, and auditory training from a specialist
  • Amplification system
  • Services of an interpreter for those students who use manual communication
  • Favorable seating in the class to facilitate speech reading
  • Captioned films/videos
  • Assistance of a note taker, who takes notes for the student with a hearing loss, so that the student can fully attend to instruction
  • Instruction for the teacher and peers in alternate communication methods, such as sign language and counseling
  • It is important for teachers and audiologists to work together to teach the child to use their residual hearing to the maximum extent possible, even if the preferred means of communication is manual. People with hearing loss use oral or manual means of communication or a combination of the two. Oral communication includes speech, lip reading, and the use of residual hearing. Manual communication involves signs and fingerspelling. Total Communication, as a method of instruction, is a combination of the oral method plus signing and fingerspelling.

(CPIR, 2015)


Alexander Graham Bell Association for the Deaf and Hard of Hearing
3417 Volta Place NW
Washington, DC 20007
(202) 337-5220, (202) 337-5221 (TTY)

The Alexander Graham Bell Association for the Deaf and Hard of Hearing (AG Bell) is a lifelong resource, support network, and advocate for listening, learning, talking, and living independently with hearing loss. Through publications, advocacy, training, scholarships, and financial, AG Bell promotes the use of spoken language and hearing technology. Headquartered in Washington, D. C., with chapters located in the United States and a network of international affiliates, AG Bell’s global presence provides its members and the public with the support they need – close to home. With over a century of service, AG Bell supports its mission: Advocating Independence through Listening and Talking!

American Hearing Research Foundation (AHRF) 
275 N. York Street 
Suite 401 
Elmhurst, IL 60126 
(630) 617-5079

The American Hearing Research Foundation is a non-profit organization dedicated to funding innovative research on hearing loss, its causes and potential therapies; and educating the public about these health issues. Since its founding in 1956, the AHRF has provided more than $1.5 million in research funding to scientists and physicians at universities throughout the United States.

American Sign Language Teachers Association (ASLTA) 
P.O. Box 92445 
Rochester, New York 14692-9998

The American Sign Language Teachers Association (ASLTA) is the only national organization dedicated to the improvement and expansion of the teaching of ASL and Deaf Studies at all levels of instruction. ASLTA is an individual membership organization of more than 1,000 ASL and Deaf Studies educators from elementary through graduate education as well as agencies.

American Society for Deaf Children (ASDC) 
3820 Hartzdale Drive 
Camp Hill, PA 17011 
1 (800) 942-2732 
(717) 703-0073 
1 (866) 895-4206 (TTY)

The American Society for Deaf Children supports and educates families of deaf and hard of hearing children and advocates for high quality programs and services. ASDC was founded in 1967 as a parent-helping-parent organization. Today, ASDC is a national, independent non-profit organization whose purpose is providing support, encouragement, and information to families raising children who are deaf or hard of hearing.

American Speech-Language Hearing Association (ASHA) 
10801 Rockville Pike 
Rockville, MD 20852 
1 (800) 638-8255

ASHA is the professional, scientific, and credentialing association for more than 123,000 members and affiliates who are audiologists, speech-language pathologists, and speech, language, and hearing scientists.

National Association of the Deaf (NAD) 
8630 Fenton Street 
Suite 820 
Silver Spring, MD 20910-3819 
(301) 587-1788 
(301) 587-1798 (TTY)

The National Association of the Deaf (NAD), established in 1880, is the oldest and largest constituency organization safeguarding the accessibility and civil rights of 28 million deaf and hard of hearing Americans in education, employment, health care, and telecommunications. A private, non-profit organization, the NAD is a dynamic federation of 51 state association affiliates including the District of Columbia, organizational affiliates, and direct members.

Last modified December 2019.