Deafness/Hearing Impairment

Definition

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).

Types & Causes

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.

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

Facts and Stats

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)

Prevention

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.

Characteristics

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.

(American Speech and Hearing Association, 2019)

Medical Treatment

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)

Prognosis

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)

Educational Implications

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:

(CPIR, 2015)

Organizations & Resources

Alexander Graham Bell Association for the Deaf and Hard of Hearing
www.agbell.org
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)
www.american-hearing.org
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)
www.aslta.org
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)
www.deafchildren.org
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)
www.asha.org
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)
www.nad.org
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.