Hearing Loss

The causes and degrees of hearing loss vary across the deaf and hard of hearing community, as do methods of communication and attitudes toward deafness.

Types of Hearing Loss

In general, there are three types of hearing loss:
  • Conductive loss affects the sound-conducting paths of the outer and middle ear. The degree of loss can be decreased through the use of a hearing aid or by surgery. People with conductive loss might speak softly, hear better in noisy surroundings than people with normal hearing, and might experience ringing in their ears.
  • Sensorineural loss affects the inner ear and the auditory nerve and can range from mild to profound. People with sensorineural loss might speak loudly, experience greater high-frequency loss, have difficulty distinguishing consonant sounds, and not hear well in noisy environments. 
  • Mixed loss results from both a conductive and sensorineural loss.

General Considerations

  • Given the close relationship between oral language and hearing, students with hearing loss might also have speech impairments. One’s age at the time of the loss determines whether one is prelingually deaf (hearing loss after oral language acquisition) or adventitiously or postlingually deaf (hearing loss after oral language acquisition). Those born deaf or who become deaf as very young children might have more limited speech development. In addition, students with learning disabilities, which affect auditory processing, may exhibit behavior resembling a hearing impairment.
  • The inability to hear or process language quickly does not affect an individual’s native intelligence or the physical ability to produce sounds.
  • Some students who are deaf are skilled lip readers, but many are not. Many speech sounds have identical mouth movements, which can make lip-reading particularly difficult. For example, “p”, “b”, and “m” look exactly alike on the lips, and many sounds (vowels, for instance) are produced without using clearly differentiated lip movements.
  • Only about one third of all English words can be lip-read. Many of those words that can be lip-read are identical to other words. Students who lip-read pick up contextual clues to fill out their understanding of what is being said.
  • Make sure you have the visual attention of a student who is deaf before speaking directly to him/her. A light touch on the shoulder, a wave, or other visual signal may be helpful.
  • Look directly at a person with a hearing loss during a conversation, even when an interpreter is present. Speak clearly, without shouting. If you have problems being understood, rephrase your thoughts. Writing is also a good way to clarify.
  • Make sure that your face is clearly visible. Keep your hands away from your face and mouth while speaking. Sitting with your back to a window, gum chewing, pencil biting, and similar obstructions of the lips can also interfere with the effectiveness of communication.
  • Common accommodations for students who are deaf or hard of hearing include sign language or oral interpreters, assistive listening devices, Telecommunications Devices for the Deaf (TDDs), volume control telephones, peer note takers, captioned videos, and time extensions for assignments and exams.
  • For many students who are deaf English is a second language. Their first language is often American Sign Language (ASL), which utilizes English syntax and grammar. This creates some difficulty when writing papers and essay examinations. Students who are having difficulty with English grammar and syntax will need to utilize the services of the Writing Lab. For in-class essay exams you should allow some flexibility when grading for grammar or syntax.

Modes of Communication

Not all students with hearing impairments are fluent users of all of the communication modes used across the deaf community, just as users of spoken language are not fluent in all oral languages. For example, not all students who are deaf can read lips.  

  • American Sign Language (ASL) is a natural, visual language having its own syntax and grammatical structure. 
  • Signed Exact English (SEE) is a manual system, which utilizes English syntax and grammar. 
  • Fingerspelling is the use of the manual alphabet to form words. 
  • Pidgin Sign English (PSE) combines aspects of ASL and English and is used in educational situations often combined with speech. 
Nearly every spoken language has its own unique accompanying sign language.

In addition to sign language and lip-reading, students who are deaf also use oral language interpreters. These are professionals who assist person who are deaf or hard of hearing with understanding oral communication. Sign language interpreters use highly developed language and Fingerspelling skills; oral interpreters silently form words on their lips for speech reading. Interpreters also use voice, when requested. Interpreters will attempt to interpret all information in a given situation, including instructors’ comments, class discussion and pertinent environmental sounds.

Instructional Strategies

  • Include a disability access statement in the course syllabus such as: "To obtain disability related accommodations and/or auxiliary aids, students with disabilities must contact Access Services as soon as possible by calling 507.457.5878 or emailing access@winona.edu." 
  • Circular seating arrangements offer students who are deaf or hard of hearing the best advantage for seeing all class participants. 
  • When using a FM wireless assistive listening device (ALD) for group discussion it would be helpful to pass the microphone around to the class members who are speaking. 
  • When desks are arranged in rows, keep front seats open for students who are deaf or hard of hearing and their interpreters. 
  • Repeat the comments and questions of other students, especially those from the back rows. Acknowledge who has made the comment so students who are deaf or hard of hearing can focus on the speaker. 
  • When appropriate, ask for a hearing volunteer to team up with a student who is deaf or hard of hearing for in-class assignments. 
  • Assist the student in finding effective peer note takers from the class. 
  • If possible, provide transcripts of audio information. 
  • Most videos produced in recent years are closed-captioned for the hearing impaired. Be sure to arrange for a video monitor that is capable of displaying the closed-captioning. Familiarize yourself with the controls for turning on the captions. Older videos may lack captioning. These videos may need to be captioned or a script needs to be prepared in advance to allow the hearing-impaired student access to the material. 
  • Allow several moments extra for oral responses in class discussions. 
  • In small group discussions, allow for participation by students with hearing impairments. 
  • Face the class while speaking; if an interpreter is present; make sure the student can see both you and the interpreter. 
  • If there is a break in the class, get the attention of the student who is deaf or hard of hearing before resuming class. 
  • People who are deaf or hard of hearing often use vision as a primary means of receiving information. Captioned videos, overheads, diagrams, and other visual aids are useful instructional tools for students with hearing impairments. 
  • Be flexible: allow a student who is deaf to work with audiovisual material independently and for a longer period of time. 
  • When in doubt about how to assist the student who is deaf or hard of hearing, ask him or her as privately as possible without drawing attention to the student or the disability. 
  • Allow the student who is deaf or hard of hearing the same anonymity as other students (i.e., avoid pointing out the student or the alternative arrangements to the rest of the class.) 

Guidelines for Working with Interpreters

  • Interpreters are bound by the code of ethics developed by the National Registry of Interpreters for the Deaf, which specifies that interpreters are to serve as communication intermediaries who are not otherwise involved. Thus, when an interpreter is present, speak directly to the deaf person rather than to the interpreter and avoid using phrases such as "tell them" or "ask her".
  • Relax and talk normally, noting that there may be a lag time between the spoken message and the interpretation. Interpreters listen for concepts and ideas (not just words) to render an accurate interpretation.
  • When referring to objects or written information, allow time for the transition to take place. Replace terms such as "here" and "there" with more specific terms, such as "on second line" and "in the left corner".
  • Be aware of the fact that the deaf student cannot read or write at the same time that the instructor is talking, since their eyes cannot be watching the interpreter and looking down at the paper or book.
  • Reminder: If videos are shown, they must be closed-captioned. Interpreting a video is a major challenge to both the interpreter and student.
These guidelines were adapted from guidelines used by the Division of Disability Resources & Educational Services at the University of Illinois at Urbana-Champaign.