There are an
estimated demographic figure of 36 million deaf and hard of hearing in the
United States. Of this large number, only a few million are considered “deaf”
and the remainder are “hard of hearing.” Further confusing statistics is the
fact that some “deaf” people may actually be “hard of hearing,” and some “hard
of hearing” people may actually be “deaf.”
In previous
years, the labels “deaf” and “hard of hearing” were employed as subcategories
of the term “hearing-impaired.” During that time, it was used as a generic term
that was applicable to anybody with any degree of hearing loss. However, some deaf
people objected to the description of their hearing status as “impaired”
because they felt that the term also implied that the person was “impaired.”
Such degrading terms can actually cause depression and anxiety among deaf
people and, thus, this generic label has been dropped.
The deaf and hard
of hearing community is very diverse, differing greatly on the cause and degree
of hearing loss, age at the onset, educational background, communication
methods, and how they feel about their hearing loss. How a person “labels”
themselves in terms of their hearing loss is personal and may reflect
identification with their relationship with the deaf community or merely how
their hearing loss affects their ability to communicate. They can either be
deaf, Deaf (with a capital “D”), or hard of hearing.
Interestingly,
the lowercase “deaf” is used when referring to the audiological condition of
not hearing, while the uppercase “Deaf”
is used to refer to a particular group of people who share a common
language such as the ASL (American Sign Language) and culture. The members of
this group have inherited their sign language, used it as a primary means of
communication among themselves, and hold a set of beliefs and their connection
to the larger society. They are distinguished from those who find themselves
losing their hearing because of illness, trauma, or age. Although these people
share the condition of not hearing, they do not have access to the knowledge,
beliefs, and practices that make up the culture of Deaf people.
Generally, the
term “deaf” refers to those who are unable to hear well enough to rely on their
hearing and use it as a means of processing information. On the other hand, the
term “hard of hearing” refers to those who have some hearing, are able to use
it for communication purposes, and who feel reasonably comfortable doing so. A
hard of hearing person, in audiological terms, may have a mild to moderate
hearing loss.
To understand
hearing loss, it is important to understand how normal hearing takes place.
There are two different pathways by which sound waves produce the sensation of
hearing: air conduction and bone conduction.
In air
conduction, sound waves move through the air in the external auditory canal
(the “ear canal” between the outside air and the eardrum). The sound waves hit
the tympanic membrane (eardrum) and cause the tympanic membrane to move.
Hearing by bone conduction occurs when a sound wave or another source of
vibration causes the bones of the skull to vibrate. These vibrations are transmitted
to the fluid surrounding the cochlea and hearing results.
Fortunately,
there are many treatments that are available for hearing loss. People with
conductive hearing loss can have the middle ear reconstructed by an ear, nose,
and throat specialist. Hearing aids are effective and well-tolerated for people
with conductive hearing loss. People who are profoundly deaf may benefit from a
cochlear implant.
For people with
hearing loss, it is a matter of deciding whether to treat it as an audiological
perspective or as a cultural lifestyle. It's all about choices, comfort level,
mode of communication, and acceptance of hearing loss. Whatever the decision,
there are support groups and organizations that represent all deaf and hard of
hearing Americans and advocacy work that can benefit everyone, regardless of
the type of hearing loss and background.
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