Kentucky's Office for the
Americans with Disabilities Act

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Hearing Impairments

A hearing impairment is a hearing loss that prevents a person from totally receiving sounds through the ear. If the loss is mild, the person has difficulty hearing faint or distant speech. A person with this degree of hearing impairment may use a hearing aid to amplify sounds. If the hearing loss is severe, the person may not be able to distinguish any sounds. There are four types of hearing loss:

  • Conductive: caused by diseases or obstructions in the outer or middle ear that usually affect all frequencies of hearing. A hearing aid generally helps a person with a conductive hearing loss.
  • Sensorineural: results from damage to the inner ear. This loss can range from mild to profound and often affects certain frequencies more than others. Sounds are often distorted, even with a hearing aid.
  • Mixed: occurs in both the inner and outer or middle ear.
  • Central: results from damage to the central nervous system.

People with hearing impairment can communicate using numerous methods of communication, such as:

  • American Sign Language (ASL): This is the primary language of people who are deaf. It consists of a combination of hand movements and positions to express thoughts and phrases.
  • Finger spelling: This is a manual form of communication in which the hand and fingers spell out letters of the alphabet to form words.
  • Lipreading: This is a difficult skill used only by about 10% of people with hearing impairments. Therefore, don't assume that a deaf person to whom you are speaking can lip read. Even if a person cannot lip read, however, being allowed to see the speaker's mouth provides helpful visual cues.
  • Written communication ("Pad and Pencil"): This is a fairly simple way to communicate with a person who is deaf. Remember, however, that sign language is the primary language for most persons who are deaf; English is a second language, so keep your words simple.
  • Oral communication

(From: "Those of Us DisLabeled: A Guide to Awareness and Understanding", University of Kentucky Human Development Institute, Cooperative Extension Service)


  • Smile and maintain eye contact during the time you are talking to a person who is hearing impaired. The person always needs to be able to see your lips if he has learned to read lips. If a sign language interpreter is present, talk directly to the person who is deaf, not the interpreter.
  • If at all feasible, use complete sentences, especially when communicating with children. Good language development is dependent upon correct use of verbs, adjectives, adverbs, nouns, etc. Restricting communication to a single word or short phrase deprives this population of opportunities to master the English language, thus limiting their academic development.
  • Speak slowly and clearly, but do not exaggerate. Be expressive, but not overly so.
  • If a word is not understood, try another word. Demonstrate if possible.
  • Use sign language only if you're qualified. Otherwise, incorrect information may be conveyed.
  • Do not shout. Hearing aids make sounds louder, but they do not clarify the person's reception or understanding of the sound. The presence of a hearing aid does not mean that the person can hear normally.
  • If all else fails, use a pad and pencil to communicate. Since this often isolates the person with a hearing impairment from the group, try to use writing only if oral speech, lip reading, sign language, gestures, and finger spelling have failed.
  • During group gatherings, seat the person with a hearing impairment so s/he can see others in the group. Try a semi-circle arrangement. If possible, arrange to have an interpreter or note-taker. Use visual aids whenever possible.
  • Watch the person who is deaf or hearing impaired carefully for facial expressions and body language that will help you determine the success of your communication.
  • If you have trouble understanding the speech of a person who is deaf, don't hesitate to ask him to repeat what he said. Your willingness and desire to communicate is what is most important, not the ease with which you understand.
For more information:

National Information Center on Deafness (NICD)
Gallaudet University
800 Florida Avenue NE
Washington, D.C. 20002-3695
(telephone 202-651-5051 voice, 202-651-5052 TTY)

National Association of the Deaf
814 Thayer Avenue
Silver Spring, MD 20910-4500
(telephone 301-587-1788 voice, 301-587-1789 TTY)

Gail Kovalic & Frank Kruppenbacher's "Libraries and the ADA: Providing Accessible Media to Deaf and Hard-of-Hearing People" link here: 


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