There are two kinds of cause in hearing impairments

• Pre-lingual hearing impairment in which the impairment can be congenital, a condition that exists at birth, before the individual has acquired speech and language, thus rendering the disadvantages more difficult to treat because the child is unable to communicate from the outset. Pre-lingual hearing impairment can also be adventitious as in a situation where a child born with normal hearing contracts a disease or sustains an injury that causes hearing impairment, but has not yet acquired a mastery of spoken language. Most pre-lingual hearing impairment is due to adventitious loss.
• Post-lingual hearing impairment where hearing loss is adventitious and develops due to disease or trauma after the acquisition of speech and language, usually after the age of six.

Post-lingual hearing impairments are far more common than pre-lingual impairments. Typically, hearing loss is gradual, and often detected by family and friends of the people so affected long before the patients themselves will acknowledge the disability.

In cases where the causes are environmental, the treatment is to eliminate or reduce these causes first of all, and then to fit patients with a hearing aid, especially if they are elderly. When the loss is due to heredity, total deafness is often the end result. On the one hand, persons who experience gradual deterioration of their hearing are fortunate in that they have learned to speak. On the other, they often experience social isolation, because they can no longer understand their friends, who cannot communicate effectively with them. Ultimately the affected person may bridge communication problems by becoming skilled in speech-reading (lip-reading ), accepting elective surgery to use a prosthetic devices such as a cochlear implant, using a hearing aid, or acquiring skill in sign language for communication.

In some cases, the loss is extremely sudden. Most often, the cause is unknown. Sometimes, it can be traced to specific diseases, such as meningitis, or to ototoxic medications, such as Gentamicin. In both cases, the final degree of loss varies. Some experience only partial loss, while others become profoundly deaf. In the former case, hearing aids can be used with varying degrees of success, depending on the exact nature of the loss. In the latter, ultimately the affected person will depend on speech-reading and/or sign language for communication.

Contents

1 Partial Loss of Hearing 2 Social Impact of hearing loss 3 How to communicate with someone who has a hearing loss 4 See also 5 Quotation 6 External links

Partial Loss of Hearing

People who are hard-of-hearing have moderate amounts of hearing loss but not enough to be considered deaf.

The phrase hard-of-hearing, normally used as an adjective or adverb, can also be used as a noun, referring to people with hearing impairment as the hard-of-hearing.

Hearing impaired persons with partial loss of hearing may find that the quality of their hearing varies from day to day, or from one situation to another or not at all. They may also, to a greater or lesser extent depend, on both hearing-aids and lip-reading. They may perhaps not always be aware of it, but they do admit to it being important to see the speaker's face in conversation.

Many people with hearing loss have better hearing in the lower frequency ranges (low tones), and cannot hear as well or at all in the higher frequencies. Some people may merely find it difficult to differentiate between words that begin with consonantal sounds such as the fricatives or sibilants s, z, or th, or the plosives d, t, b, or p. They may be unable to hear thin, high-pitched or metallic noises, such as birds chirping or singing, clocks ticking, etc. Often, they are able to hear and understand men's voices better than women's.

Others will find their condition so much worse if circumstances in their immediate environment affect the way they are able to use their hearing-aids, or prevent them from employing their lip-reading skills. A room with a high ceiling and a lot of reverberation will affect the sound of a speaker's voice adversely. The position of the listener, too, sitting at a right angle to the speaker at a long seminar table, thus being able to hear only with one, maybe the ineffectual ear, can make a difference. Difficulties can also arise for the listener trying to lip-read, if the speaker is sitting with his back against the light-source and is in this way obscuring his face. A rule of thumb is that bright lighting is to the hearing-impaired what noise is to the hearing; a source of distraction.

The speaker's accent; the topic under discussion, possibly with many unfamiliar words; the softness of his voice; possibly his having a speech impediment; a habit of holding a hand in front of his mouth or turning his face away at times: all these tendencies cause problems to the hard-of-hearing, especially when they have to rely on lip-reading. The rustling of papers, and notebook pages being turned are precisely the noises that will be the first thing hearing-aids pick up.

Social Impact of hearing loss

Those who lose their hearing later in life, such as in late adolescence or adulthood, face their own challenges. For example, they must adjust to living with the adaptive devices that make it possible for them to live independently. They must also adapt to using hearing aids and/or learning sign language. Loneliness and depression can arise as a result of isolation (from the inability to communicate with friends and loved ones) and difficulty in accepting their disability. The challenge is made greater by the need for those around them to adapt to the person's hearing loss.

How to communicate with someone who has a hearing loss

1. Take a class in sign language with the individual along with family and friends. Show your support by striving to master the language.
2. Ask the person what will be most useful for them; this varies from one individual to another.
3. Speak normally. Do not shout or over-enunciate. Both of these make it more difficult to understand speech, not less.
4. Conversely, do not mumble, cover your mouth, or whisper when speaking. All of these can conceal vital speech-reading cues that hearing impaired people use to decipher what is being said. A "favorite" pet peeve of the hearing impaired is people who speak from another room - How are they to speech-read with a wall between them and the speaker? Additionally, speak while facing the hearing impaired person.
5. If asked to repeat yourself, don't. Rephrase instead. By using different words, your friend will be able to use two data sets to understand what you meant. (This is good advice for those with normal hearing, too!) Obviously, if only one word was missed, you can try just repeating that word, or a synonym. This is the area where people vary most: some hearing-impaired people find rephrasing very frustrating, because they have to start over: when a sentence is repeated, they can put together the syllables or words they heard the first time with those in the repetition. When in doubt, ask "Should I repeat that exactly?"
6. Emphasize keywords in your phrases. Most hearing-impaired people can piece together keywords (along with the context of the conversation) into a statement that they can understand.
7. Reduce background noise by turning off the TV and radio, and closing windows. All of these can provide distractions that cause communication to break down completely. They also impede the perception of whatever auditory cues your friend is able to pick up and use.
8. For small children learning to talk, use context to help them decipher what you are saying. (Additionally, some studies indicate that hearing impaired children who are allowed to lead conversation acquire speech much more successfully than those whose parents attempt to guide conversation for them.)

Sensory system - Auditory system

Nervous system - Sensory system

See also

• hearing aid

Quotation

• "Blindness cuts you off from things; deafness cuts you off from people." -- Helen Keller

External links

• Hearing Loss Web http://www.hearinglossweb.com : A resource specifically for the hearing impaired, as opposed to the deaf.
• Association of Late-Deafened Adults http://www.alda.org : A website for the post-lingually deaf.
• National Association for the Deaf http://www.nad.org : A website for the Deaf.