Effects Of Hearing Loss

A hearing loss is much more than just the inability to hear loudly enough. People with a hearing loss can have problems hearing and localizing a sound source.

They may also have a discrimination loss – having difficulty discriminating words from each other, even if they are fairly loud. A person may hear the words of a sentence, but fail to understand the spoken message.

Hearing loss impacts on the quality of life for the person and the family. It has a negative impact on physical, emotional and mental health and also affects work and school performance.

A hearing loss, no matter if it is mild or only in one ear, can have a significant negative effect on a child’s speech development, educational achievement and formation of social skills.

The Effects Of Hearing Loss On A Child


Degree Of Hearing Loss: Based On Modified Pure Tone Average (500 to 4000 HZ) Possible Effect Of Hearing Loss On The Understanding Of Languages & Speech Possible Psychological Impact Of Hearing Loss Potential Education Needs & Programs
Normal Hearing -10 to +15 dB HL Children have better hearing sensitivity than the accepted normal range for adults. A child with hearing sensitivity in the -10 to +15 dB range will detect the complete speech signal even at soft conversation levels. However, good hearing does not guarantee good ability to discriminate speech in the presence of background noise
Minimal (Borderline) 16 - 25 dB HL May have difficulty hearing faint or distant speech. At 15 dB, a student can miss up to 10% of speech signal when the teacher is at a distance greater than 3 feet and when the classroom is noisy, especially in the elementary grades when verbal instruction predominates May be unaware of subtle conversational cues, which could cause the child to be viewed as inappropriate. May miss portions of fast-paced peer interaction, which could begin to have an impact on socialization. May have immature behaviour. May be more fatigued than classmates due to the additional listening effort needed. May benefit from mild gain hearing instrument or personal FM system dependent on loss configuration. Favourable seating will help. May need attention to vocabulary or speech, especially with recurrent otitis medical history. Appropriate medical management necessary for conductive losses. Teacher must be educated to understand the impact of hearing loss on language development and learning
Mild 26 - 40 dB HL At 20 dB, a child can miss 25 - 40% of speech signal. The degree of difficulty experienced in school will depend upon the noise level in the classroom, distance from the teacher and the configuration of the hearing loss. Without amplification, the child with 35 - 40 dB loss may miss at least 50% of classroom discussions, especially when voices are faint or the speaker is not in the line of vision. Will miss consonants, especially when a high frequency hearing loss is present Barriers beginning to build, with a negative impact on the self esteem as the child is accused of "only hearing when he / she wants to," "daydreaming," or "not paying attention." The child has increasing difficulty suppressing background noise, which makes the learning environment stressful. The child is more fatigued than classmates due to additional listening effort needed. Will benefit from a hearing instrument and use of a personal FM System. Needs favourable seating and lighting. Needs auditory skill building. May need attention to vocabulary and language development, articulation and / or special support in reading. May need help with self esteem. Teacher training required
Moderate 41 - 55 dB HL Understands conversational speech at a distance of 3 - 5 feet (face to face) only if structure and vocabulary are controlled. Without amplification the amount of speech signal missed can be 50% - 75% with a 40dB loss and 80% to 100%with a 50dB loss. Is likely to have delayed or defective syntax, limited vocabulary, imperfect speech production and an atonal voice quality Often with this degree of hearing loss, communication is significantly affected, and socialization with peers having normal hearing becomes increasingly difficult. With full-time use of hearing instruments / FM Systems, the child may be judged as a less competent learner. There is an increasing impact on self esteem Refer for language evaluation and for education follow-up. Amplification is essential (Hearing instruments and FM System). Special education support may be needed, especially for primary school children. Attention to oral language development, reading and written language is required. Auditory skill development and speech therapy usually needed. Teacher training required
Moderate to Severe 56 to 70 dB HL Without amplification, conversation must be very loud to be understood. A 56 dB loss can cause child to miss up to 100% of speech information. Will have marked difficulty in school situations requiring verbal communication in both one - to - one and group situations. Delayed language, syntax, reduced speech intelligibility and atonal voice quality likely Full time use of Hearing Instruments / FM Systems may result in child being judged by both peers and adults as a less competent learner, resulting in poorer self concept, social maturity and contributing to sense of rejection. Therapy to address these attributes may be helpful Full time use of amplification is essential. May need specialized teacher or special needs class depending on magnitude of language delay. May require specialized help in all language skills, language based academic subjects, vocabulary, grammar, pragmatics as well as reading and writing. Probably needs assistance to expand experiential language base. Teacher training required
Severe 71 to 90 dB HL Without amplification, the child may hear loud voices about one foot from the ear. When amplified optimally, children with hearing ability of 90 dB or better would be able to identify environmental sounds and detect all the sounds of speech. If loss is of prelingual onset, oral language and speech may not develop spontaneously or will be severely delayed. If hearing loss is of recent onset, speech is likely to deteriorate with quality becoming atonal Child may prefer other children with hearing impairments as friends and playmates. This may further isolate the child from the mainstream. However, these peer relationships may foster improved self concept and a sense of cultural identity May need full-time special aural / oral program with emphasis on all auditory language skills, speech reading, concept development and speech. As loss approaches 80 - 90 dB, may benefit from Total Communication Approach, especially in the early language years. Individual hearing instrument / FM System essential. Need to monitor effectiveness of communication modality. Participation in regular classes as much as beneficial to student. Training of mainstream teachers essential
Profound 91 dB HL or more Aware of vibrations more than tonal pattern. Many rely on vision rather than hearing as primary avenue for communication and learning. Detection of speech sounds dependent upon loss configuration and use of amplification. Speech and language will not develop spontaneously and is likely to deteriorate rapidly if hearing loss is of recent onset Depending on auditory / oral competence, peer use of sign language, parental attitude, etc. Cochlear implant may be considered May need special program with emphasis on all language skills and academic areas. Program needs specialized supervision and comprehensive support services. Early use of amplification likely to help if part of an intensive training program. May be cochlear implant or vibrotacile aid candidate. Requires continual appraisal of needs with regard to communication and learning mode. Part-time in regular classes beneficial to student
Unilateral - One normal hearing ear and one ear with at least a permanent mild hearing loss May have difficulty hearing faint or distant speech. Usually has difficulty localizing sounds and voices. Unilateral listener will have greater difficulty understanding speech when environment is noisy and / or reverberant. Difficulty detecting or understanding soft speech from side of bad ear, especially in a group discussion Child may be accused of selective hearing due to discrepancies in speech understanding in quiet versus noise. Child will be more fatigued in classroom setting due to greater effort needed to listen. May appear inattentive or frustrated. Behaviour problems sometimes evident May benefit from personal FM System in classroom. CROS hearing instrument may be of benefit in quiet settings. Needs favourable seating and lighting. Student is at risk of education difficulties. Education monitoring warranted with support services provided as soon as difficulties appear. Teacher training is beneficial

The Effects Of Hearing Loss On An Adult


Adults May Experience One Or All Of The Following In Anything From A Mild To Severe Degree:

  • Hyperacusis – When a person find it difficult to tolerate everyday sounds that most other people find acceptable and natural
  • Tinnitus – The sensation of hearing sound such as a rushing or ringing sound or white noise that can vary in intensity and be constant or periodic. Tinnitus often accompanies hearing loss

Workers with a hearing loss (mild – profound) are more likely to be unemployed, leading to significant personal and social adverse effects. Not treating the hearing loss can lead to lost wages, lost promotions, lost opportunities and lower income in retirement

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