Hearing Impairments


The Individuals with Disabilities Education Improvement Act of 2004, formerly the Education of the Handicapped Act (P.L. 94-142), includes "hearing impairment" and "deafness" as two of the categories under which children with disabilities may be eligible for special education and related service programming. While the term "hearing impairment" is often used generically to describe a wide range of hearing losses including deafness, the regulations for IDEA define hearing loss and deafness separately.

Hearing impairment (called auditory impairment in Texas) is defined by IDEA as "an impairment in hearing, whether permanent or fluctuating, that adversely affects a child's educational performance."

Deafness is defined as "a hearing impairment that is so severe that the child is impaired in processing linguistic information through hearing, with or without amplification."

Thus, deafness may be viewed as a condition that prevents an individual from receiving sound in all or most of its forms. In contrast, a child with hearing loss can generally respond to auditory stimuli, including speech.


The U.S. Department of Education reports 5,971,495 students receiving special education services in the 2003-2004 school year. Of that number, roughly 1.2%, or 71,903 students, received special education services based on a classification of hearing impairments.


There are four major types of hearing loss that are categorized by the site of the disorder in the auditory system. These hearing disorders can be caused by genetic or hereditary factors, infections, developmental abnormalities, or environmental/traumatic factors.

Conductive Hearing Loss is caused by damage or obstruction in the external or middle ear that disrupts the efficient passage or conduction of sound through those chambers. Most conductive losses can be treated medically; however, repeated conductive losses can affect children's language development.

Sensorineural Hearing Loss is caused by damage to the inner ear (cochlea) or auditory nerve that transmits impulses to the brain. Sensorineural hearing loss tends to be more severe, permanent, and usually affects oral language development.

Mixed Hearing Loss is a combination of both a conductive and a sensorineural hearing loss.

Central Hearing Disorders are the results of a disorder or dysfunction in the central auditory system between the brain stem and the auditory cortex in the brain.

It is useful to know that sound is measured by its loudness or intensity (measured in units called decibels, dB) and its frequency or pitch (measured in units called hertz, Hz). Impairments in hearing can occur in either or both areas and may exist in only one ear or in both ears. 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 greatly associated with speech. Generally, only children who cannot hear sounds generating less than 90 decibels (dB) are considered deaf for the purposes of educational placement.

Impact on Learning

Variations in causes, onset, degree, and type of hearing loss, as well as family and educational situations, result in a widely diverse hearing impaired population. However, students with auditory impairments characteristically experience significant issues with regard to social and intellectual development, speech and language, and educational achievement.

Social Development: Social-emotional development in children with hearing impairments follows the same developmental pattern as those without a hearing loss. However, since social-emotional development relies so heavily on communication, the student with a hearing impairment may not participate in cooperative play or learning activities. Without a common communication system, the ability to develop friendships is negatively impacted.

Intelligence: Research has determined that individuals with hearing impairments have normal cognitive ability, in the absence of any coexisting disability. Any difficulties in performance appear to be closely associated with speaking, reading, and writing the English language, not the level of intelligence.

Speech and Language: Speech and language skills are the areas of development most severely affected for those with a hearing impairment, particularly for children who are born deaf. For individuals with mild or moderate hearing loss, the effect may be minimal, especially with early diagnosis and treatment. Children with more profound hearing impairments and deafness are unable to access auditory feedback, impairing the normal development of speech and language.

Educational Achievement: The educational achievement of students with hearing impairments may be significantly delayed in comparison to that of their hearing peers. Students with a hearing impairment have considerable difficulty succeeding in an educational system that depends primarily on the spoken word and written language to transmit knowledge.

Teaching Strategies

Students with auditory impairments are provided special education services by a variety of professionals. These include the following specially trained individuals:

  • Audiologists are professionals who diagnose, treat, and manage individuals with hearing loss.
  • Teachers of the Hearing Impaired are specially trained educators who provide educational support to the student, the family, and other educators.
  • Speech-Language Pathologists provide treatment for speech and language disorders.
  • Interpreters are specially training individuals who relay to the student anything that is said in the class by employing communication processes such as repetition, sign language, fingerspelling, body language, and verbal expression.

Children who are hearing impaired 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 modes (such as sign language, fingerspelling, and Cued Speech) and/or amplification and aural/oral training can help reduce this language delay.

By the age of four or five, most children who are deaf are enrolled in school on a full-day basis and practice special work on communication and language development. It is important for teachers and other professionals to work together to teach the child to use his or her residual hearing to the maximum extent possible, even if the preferred means of communication is some type of visible communication. Since the great majority of deaf children (over 90%) are born to hearing parents, programs should provide instruction for parents on the implications of deafness within the family.

Other specific strategies and services include:

  • regular speech, language, and auditory training from a specialist
  • the use of amplification systems
  • services of an interpreter for those students who use one or more visual communication modes
  • favorable seating in the class to facilitate speechreading
  • captioned films/videos
  • the assistance of a notetaker who takes written notes so that the student with a hearing loss can fully attend to instruction
  • instruction for the teacher and peers in alternate communication methods such as sign language

People with hearing loss use oral or manual means of communication or a combination of the two:

  • Oral communication includes speech, speechreading and the use of residual hearing
  • Manual communication involves sign language, fingerspelling, and/or cued speech
  • Total Communication as a method of instruction is a combination of the oral method plus sign language, fingerspelling and cued speech

Assistive Technology

Modern technology has provided opportunities for students with hearing impairments to access the general curriculum. These include:

Hearing Aids and Auditory Training Devices: Hearing aids are one of the most well-known types of devices used by individuals with hearing impairments. There are a great variety of hearing aids, but all are intended to amplify sound. Auditory training devices include devices such as FM systems. FM systems are more simplistic than hearing aids. To use a FM system, the teacher speaks into a microphone and the student would use headphones or speakers.

Computers: There are many special software programs for students with hearing impairments. The programs can supplement instruction by providing speech drills, auditory training, sign language instruction, and reading and language instruction.

Alerting Devices: Many everyday devices have been adapted for individuals with hearing impairments, including items such as watches, doorbells, fire alarms, school bells, and alarm clocks. Instead of using noise, these devices use vibration and light to alert the individual.

Captioning: Televisions are equipped with the ability to provide captioning for individuals with hearing impairments. Closed-captioning makes television and film accessible for individuals with hearing impairments.

Telecommunication Devices: In order for individuals with hearing impairments to communicate using the telephone, they may use a telecommunication device for the deaf (TDD). A TDD is a small keyboard with a display and modem. In order to use the TDD, the individual must relay information to an operator. Text messaging has recently become a very useful avenue for individuals with hearing impairments to relay messages without using the TDD.

Cochlear Implants: The cochlear implant is a surgically implanted device designed to make sounds audible for individuals with sensorineural hearing loss.


Texas School for the Deaf

The Texas School for the Deaf provides educational and related services to students who are deaf and hard of hearing at their residential campus in Austin. In addition to serving its residential students, TSD serves as a resources center on deafness for students, parents, professionals, and others throughout the state.

1102 S. Congress Avenue
Austin, TX 78704-1728

Web: www.tsd.state.tx.us

Center for Disability and Development

Dept. of Educational Psychology
4225 Texas A&M University
College Station, TX 77843-4225

Email: cdd@tamu.edu
Web: cdd.tamu.edu

Education Resource Center on Deafness (ERCOD)

The Education Resource Center on Deafness provides information, referrals, resources, workshops, summer programs, distance learning, and interpreter training for students, families, and professional service providers.

Statewide Information at Texas School for the Deaf
1102 S. Congress Avenue
Austin, TX 78704-1728

Email: ercod@tsd.state.tx.us
Web: www.tsd.state.tx.us

Sorenson Communications

Sorenson Communications is a pioneer of industry-leading communication services for the deaf and hard-of-hearing community. The company's offerings include Sorenson Video Relay Service® (VRS), the line of high-quality videophones (VP), and Sorenson IP Relay ServiceTM (siprelay). Sorenson VRS enables deaf and hard-of-hearing callers to conduct video relay conversations with hearing friends, business colleagues, and family members through a qualified American Sign Language interpreter

4192 South Riverboat Road, Suite 100
Salt Lake City, Utah 84123

Web: www.sorensonvrs.com

Services for the Deaf and Hard of Hearing

Deaf Services manages the operation of the Agency's Regional Day School Program for the Deaf, performs all activities required to maintain a statewide program for students who are deaf or hard of hearing, and provides leadership to local regional day schools for the deaf in the planning, implementation and operation of comprehensive education programs for students who are deaf or hard of hearing.

IDEA Coordination
Texas Education Agency
1701 N. Congress Avenue
Austin, TX 78701-1494

Email: brent.pitt@tea.state.tx.us
Web: www.tea.state.tx.us/deaf

Office for Deaf and Hard of Hearing Services

The DARS, Division for Rehabilitative Services, Office for Deaf and Hard of Hearing Services (DHHS) works in partnership with people who are deaf or hard of hearing to eliminate societal and communication barriers to improve equal access for people who are deaf or hard of hearing. DHHS advocates for people of all ages who are deaf or hard of hearing to enable them to express their freedoms, participate in society to their individual potential, and reduce their isolation regardless of location, socioeconomic status, or degree of disability.

Department of Assistive and Rehabilitative Services
P. O. Box 12904
Austin, TX 78711-2904

Email: david.myers@dars.state.tx.us
Web: www.dars.state.tx.us

Telecommunications Relay Services for Individuals who are Deaf, Hard of Hearing, or with Speech Impairments

Phone: 800-735-2991 (ASCII); 877-826-6607 (Speech to Speech)

Alexander Graham Bell Association for the Deaf, Inc.

The Alexander Graham Bell Association for the Deaf and Hard of Hearing helps families, health care providers and education professionals understand childhood hearing loss and the importance of early diagnosis and intervention. Through advocacy, education, research and financial aid, AG Bell helps to ensure that every child and adult with hearing loss has the opportunity to listen, talk and thrive in mainstream society.

3417 Volta Place, NW
Washington, DC 20007

Email: info@agbell.org
Web: www.agbell.org

American Society for Deaf Children

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.

P.O. Box 3355
Gettysburg, PA 17325

Email: asdc1@aol.com
Web: www.deafchildren.org

American Speech-Language Hearing Association

The American Speech-Language-Hearing Association is the professional, scientific, and credentialing association for more than 130,000 members and affiliates who are speech-language pathologists, audiologists, and speech, language, and hearing scientists in the United States and internationally. Empowering and supporting speech-language pathologists, audiologists, and speech, language, and hearing scientists by: advocating on behalf of persons with communication and related disorders; advancing communication science, and promoting effective human communication

2200 Research Blvd. # 325
Rockville, MD 20852

Email: actioncenter@asha.org
Web: www.asha.org

Laurent Clerc National Deaf Education Center and Clearinghouse, KDES PAS-6, Gallaudet University

The Clerc Center has been mandated by Congress to develop, evaluate, and disseminate innovative curricula, instructional techniques and strategies, and materials. The aim of the Clerc Center is to improve the quality of education for deaf and hard of hearing children and youth from birth through age 21.

800 Florida Avenue N.E.
Washington, DC 20002-3695

Email: Clearinghouse.Infotogo@gallaudet.edu
Web: clerccenter.gallaudet.edu

National Institute on Deafness and Other Communication Disorders Clearinghouse

NIDCD is mandated to conduct and support biomedical and behavioral research and research training in the normal and disordered processes of hearing, balance, smell, taste, voice, speech, and language. The Institute also conducts and supports research and research training related to disease prevention and health promotion; addresses special biomedical and behavioral problems associated with people who have communication impairments or disorders; and supports efforts to create devices which substitute for lost and impaired sensory and communication function.

31 Center Drive, MSC 2320
Bethesda, MD 20892-2320

Email: nidcdinfo@nidcd.nih.gov
Web: www.nidcd.nih.gov

Hearing Loss Association of America

The HLAA mission is to open the world of communication to people with hearing loss through information, education, advocacy, and support. HLAA provides cutting edge information to consumers, policy makers, business professionals and family members through our dynamic website, www.hearingloss.org, an award-winning publication, Hearing Loss, an online newsletter, ENews, message boards. In addition, we bring consumers and policy makers together to learn about hearing accessibility issues at our national and regional conventions

7910 Woodmont Avenue, Suite 1200
Bethesda, MD 20814

Web: www.hearingloss.org


Gargiulo, R.M. (2006). Special education in contemporary society: An introduction to exceptionality. Belmont, CA: Thomson Wadsworth.

Turnbull, A., Turnbull, R. & Wehmeyer, M. L. (2007). Exceptional lives: Special education in today's schools. Upper Saddle River, NJ: Pearson Merrill Prentice Hall.



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