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  Hearing Impairment

Core information

People with hearing impairments

• cannot hear at normal levels because of a variety of factors which affect transference of sound

• due to communication or language difficulty, cannot easily understand what is being said to them in every situation and therefore can't always respond with confidence

• people who are profoundly, pre-lingually deaf and may also have difficulty communicating in spoken English if Australian Sign Language (AUSLAN) is their first language.

Some other conditions which can give rise to a hearing disability include:

• Meniere's disease
• tinnitus
• acoustic neuroma
• strokes

These other conditions can result in significant additional handicaps to a hearing handicap. Because hearing impairment varies so greatly, it is not possible to generalise about interacting with people with significant hearing impairment and it is not possible to make general statements about interaction with people experiencing other hearing related conditions. The degree and type of hearing impairment will vary considerably depending on the cause of the hearing disability. A hearing impaired person's ability to hear and understand sound or recorded information will depend on the degree and extent of their hearing disability.

Facts about hearing impairment

D E S C R I P T I O N

Following the World Health Organisation typology of impairment, disability and handicap, impairment can be understood as follows:

• Impairment denotes limitation of one or more basic components of the auditory system - the eye, auditory nerve and auditory centre in the brain

• disability refers to the lack, loss or reduction of the ability to perform certain tasks such as listening, using the telephone and communicating

• handicap refers to social and environmental factors and results in disadvantage in areas such as education, employment, leisure and recreation

Hearing impairment ranges from mild to moderate to severe to profound. A person with a mild hearing impairment may not even be aware of their inability to hear certain sounds. A moderate hearing impairment may cause some difficulty in hearing, for example in background noise, but not in every situation. Many people with mild to moderate hearing impairment deny that their communication problems are caused by their hearing disability and instead, tend to blame others, for example, "people are always mumbling".

A person with a severe hearing impairment will have considerable difficulty in following speech and in hearing other environmental sounds. However, their own speech may not be affected by their hearing disability. Profound hearing impairment implies that the person's range of hearing is extremely limited. They may only hear low toned sounds at a much higher than normal volume or decibel level but are not able to hear enough to follow speech and will not hear most environmental sounds such as a telephone or smoke detector. They may use sign language or have difficulty monitoring the volume and pitch of their own voice when speaking.

Hearing impairments can be hereditary or caused by a variety of factors including viruses, diseases of the ear, exposure to noise, toxins and natural ageing.

There is no such term as "legally deaf". A person's level of hearing disability will depend on their degree of hearing impairment as well as the age at which it occurred and other factors which influence communication.

Profoundly pre-lingually deaf people are those who were born with insufficient hearing to enable them to acquire speech normally, or who lost their hearing prior to the age at which speech is acquired. They are not orientated to a world of sound and may not ever acquire speech although they are not necessarily unable to speak or "mute".

Some profoundly pre-lingually deaf people do use speech to communicate and have been taught to speak at a young age. If their preferred mode of communication is verbal they may be termed Oral Deaf. They rely on lip-reading and may or may not use sign language. People who are profoundly deaf and who use sign language as their preferred mode of communication may identify strongly with the Deaf community. They have a strong sense of culture and community and within that community function at a high level as there is no language barrier. They are visually orientated and may have difficulty coping with spoken communication in what they term the "hearing world". While accepting that they are different, they may not necessarily agree with being labelled disabled. Deaf people may request the services of an Auslan interpreter.

People who become profoundly deaf after they have acquired speech are termed profoundly post-lingually hearing impaired. Usually they will not identify with the Deaf community or use sign language. Their own speech may not be affected by their loss of hearing although they may have difficulty with voice modulation. They will rely on visual spoken language to communicate and may become highly proficient lip-readers although individual ability will vary considerably from person to person. They may request information in written form and/or request the services of oral deaf interpreters.

In the majority of cases, people who acquire a hearing impairment retain some residual hearing and continue to communicate in spoken language. Their degree of hearing loss will impact on their ability to communicate but other factors such as visual impairment, intellectual disabilities, literacy and language levels may also affect their ability to cope.

Although most people with impaired hearing can benefit from wearing a hearing aid or aids, many will neither acquire nor wear them. An understanding of the wide range of factors which influence this should be developed as many people with normal hearing have little understanding of what sound is like when heard through a hearing aid. As well as practical difficulties, the high cost involved and problems associated with sound reproduction, there is a social stigma attached to having a hearing impairment and many will reject wearing an aid for this and cosmetic reasons.

Hearing impairment is a varied and complex disability. Each hearing impaired individual experiences their hearing disability in a unique and individual way. The invisible nature of hearing impairment means that it is often not recognised and its impact on a person's ability to communicate has considerable implications for both their ability to function normally and in the way that they feel about themselves. Isolation and loneliness are aspects of hearing impairment not readily recognised by others and hearing impairment is often regarded as a less severe or secondary form of disability. This lack of understanding tends to exacerbate feelings of isolation and frustration.

C A U S E S  A N D  P R EV A L E N C E

The main causes of profound deafness at birth are genetic factors and exposure to the rubella (German measles) virus. Severe head injuries and viral attacks can cause a hearing impairment at any age but the most common causes of hearing impairment are associated with ageing or exposure to noise. Epidemic studies have revealed that as many as one in three people over the age of 65 have impaired hearing. Conservative estimates suggest that approximately 10 percent of the Australian population has some degree of hearing impairment with the majority being among people over the age of 60. It is difficult to gain accurate statistics as many people with a mild hearing impairment do not identify with having a disability or seek any assistance. 

Hearing impairment is a varied and complex disability. Each hearing impaired individual experiences their hearing disability in a unique and individual way.

F U N C T I O N A L   I M P L I C AT I O N S   F O R
EV E R Y D A Y   L I V I N G

The inability to communicate with ease is the most notable of the everyday functions which are significantly affected by hearing loss. Inability to communicate with confidence and ease can affect every facet of human experience, from education to gaining employment to forming relationships.

For deaf people who must function in an environment which is geared towards sound and in which they must communicate in a second language, their disability can have a profound impact on everything they do.

Systems which enable them to access television for information and leisure and systems which enable them to access the telecommunications network are fairly recent developments. Computers in education and training have improved access for deaf people but much written language is not appropriately pitched for their use. Access to information on a broad range of subjects which is available in printed form or as sound recordings is therefore inaccessible to many deaf people.

While written language may not present a problem for people who have acquired a hearing impairment in adulthood, their ability to access information which is relayed by television, film or sound recordings can be restricted according to their level of hearing loss. Safety is an issue as the inability to hear sound may impact on the reaction to sounds which warn of potential danger.

For some who are able to hear danger warnings, there is an added problem in being able to locate the source of the sound or direction from which it came.

I N D I V I D U A L  V A R I A T I O N S

Very few hearing impaired people are totally "deaf". The image of the person living in total silence fits only a small proportion of those who are deaf or hearing impaired. A minority of deaf people can distinguish sound but are not able to understand speech. Others can hear sound but not follow what is said. Some hearing impairments vary in their effects from day to day, especially when the hearing impaired person may also have Meniere's disease or experience tinnitus or be anxious or fatigued. 

People with hearing impairments inability to communicate with confidence and ease can affect every facet of human experience, from education to gaining employment to forming relationships.

S E R V I C E S,  A I D S, I N T E R V E N T I O N S

There are certain services and aids available to people with hearing impairments to help them live more independent and successful lives.

Services include:

• hearing assessments

• counselling - vocational, educational, personal,   financial

• needs assessments - personal, daily living, educational and recreational needs

• equipment advice

Aids which can assist include:

• hearing aids
• vibrating clocks, watches and alarms
• captioned videos
• interpreters - (sign language, oral deaf, Real time and notetakers)
• hearing dogs
• telephone typewriters (TTY) and computer modems
• amplified telephones
• listening devices
• audio loops
• TVs which receive closed captions

The Resource guide lists organisations which are able to assist with information relating to the provision of such aids and services.