The Difference Between Deaf and Hard of Hearing
The deaf and hard of hearing (HOH) 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 the deaf community or merely how their hearing loss affects their ability to communicate. They can either be deaf, Deaf, or hard of hearing.
Definition of "small 'd' deaf"
When we define "deaf", the parameters of the definition should be determined. The audiological definition can be used -- that is, one that focuses on the cause and severity of the hearing loss and whether or not hearing can be used for communication purposes. Generally, the term "deaf" refers to those who are unable to hear well enough to rely on hearing, and use it as a means of processing information. Or a cultural definition may be used, as Carol Padden and Tom Humphries, Deaf in America: Voices from a Culture (1988) clarify:
"We use the lowercase deaf when referring to the audiological condition of not hearing, and the uppercase Deaf when referring to a particular group of deaf people who share a language--American Sign Language (ASL)--and a culture. The members of this group have inherited their sign language, use it as a primary means of communication among themselves, and hold a set of beliefs about themselves and their connection to the larger society. We distinguish them from, for example, 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."
Padden and Humphries comment that "this knowledge of Deaf people is not simply a camaraderie with others who have a similar physical condition, but is, like many other cultures in the traditional sense of the term, historically created and actively transmitted across generations."
The authors also add that Deaf people "have found ways to define and express themselves through their rituals, tales, performances, and everyday social encounters. The richness of their sign language affords them the possibilities of insight, invention, and irony." The relationship Deaf people have with their sign language is a strong one, and "the mistaken belief that ASL is a set of simple gestures with no internal structure has led to the tragic misconception that the relationship of Deaf people to their sign language is a casual one that can be easily severed and replaced."
Causes of Hearing Loss
People lose their hearing in various ways. The most common causes of hearing loss are:
- Childhood illnesses (spinal meningitis and rubella/German measles are the most common examples)
- Pregnancy-related illnesses (such as rubella/German measles or dependence on drugs/alcohol)
- Injury (a severe blow to the head can damage the hearing)
- Excessive or prolonged exposure to noise
- Heredity (scientists involved with the mapping of the Human Genome Project have identified approximately fifty (50) "deaf" genes to date, and they are working on identifying the remaining 350 "deaf" genes)
- Aging (progressive deterioration of hearing in older people, which is a natural part of aging process)
- Ototoxic medications. Reactions to medications, especially antibiotics, are a rising cause of hearing loss
Definition of Hard of Hearing (HOH)
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. The terms "deaf" and "Deaf" have been described above. What about "hard of hearing?" Deaf Life magazine's "For Hearing People Only" article (October 1997, page 8) explains it this way:
"'Hard-of-hearing' can denote a person with a mild-to-moderate hearing loss. Or it can denote a deaf person who doesn't have/want any cultural affiliation with the Deaf community. Or both. The HOH dilemma: in some ways hearing, in some ways deaf, in others, neither."
Later in that same article, the term is analyzed further:
"Can one be hard-of-hearing and ASL-Deaf? That's possible, too. Can one be hard-of-hearing and function as hearing? Of course. What about being hard-of-hearing and functioning as a member of both the hearing and Deaf communities? That's a delicate tightrope-balancing act, but it too is possible.
As for the political dimension: HOH people can be allies of the Deaf community. They can choose to join or to ignore it. They can participate in the social, cultural, political, and legal life of the community along with culturally-Deaf or live their lives completely within the parameters of the 'Hearing world.' But they may have a more difficult time establishing a satisfying cultural/social identity."
For everyone with a 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.
Facts from the Minnesota Department of Human Services Deaf and Hard of Hearing Services Division
- The Center for Disease Control (CDC), National Center for Health Statistics, indicates that our 34 million Americans have a hearing loss.
- Of the 34 million Americans with a hearing loss, approximately 86 percent are hard of hearing and 14 percent are deaf.
- In Minnesota, approximately 67,623 individuals are deaf and approximately 429,606 are hard of hearing.
- Permanent hearing loss can result from loud noise, especially with repeated exposure over long periods. Noise in excess of 85 to 90 decibels may cause permanent hearing loss. Noise that is frequently over 90 decibels includes rock music, lawn mowers, power tools, kitchen appliances and farm equipment, etc.
- Males are more likely to experience a hearing loss than females.
- People living in rural areas are more likely to have a hearing loss than people living in metropolitan areas.
- Hearing loss is most common among the elderly. More than one out of every three people over the age of 65 has a hearing loss. By age 75, more than one out of two people have a hearing loss. The most common cause of hearing loss is the aging process or presbycusis.
- There are more than 39.5 million school children in the United States. Of these, approximately 8 million have some type of hearing loss.
- Three high risk factors for hearing loss in infants and young children include heredity, congenital infection and recurrent or persistent otitis media (ear infection).
- An average of three out of every 100 school children are affected by hearing loss. Three out of 100 children suffer from middle ear infections that may cause a temporary hearing loss.
- One to two of every 1,000 U.S. children have a moderate to severe hearing loss in both ears. For many of these children, the cause of the hearing loss is unknown.
- Research conducted by the Early Hearing Detection and Intervention (EHDI) programs suggest that all infants be screened for hearing loss by one month of age and preferably before hospital discharge.
American Sign Language (ASL)
American Sign Language (ASL) is the natural, visual-spatial language of the culturally deaf population in the United States and English-speaking parts of Canada. It is a linguistically complete, natural language that shares no grammatical similarities to English and should not be considered in any way to be a broken, mimed, or gestural form of English.
In terms of syntax, ASL follows a topic-comment formula, while English uses the Subject-Object-Verb canonical word order. Visual markers, mouth morphemes, eye gaze, sign pace and directionality, classifiers, and use of facial expressions or non-manual markers also signify grammar. American Sign Language is recognized as a bona fide language and one can say every language is perfectly attuned to the culture of native users.
ASL has strong ties to one’s identification of Deaf Culture. As per www.deafculture.com/, one possible definition of U.S. Deaf culture is a social, communal, and creative force of, by, and for Deaf people based on ASL. It encompasses communication, social protocol, art, entertainment, recreation (e.g., sports, travel, and Deaf clubs), and worship. It’s also an attitude of the majority who do not view deafness as a disability, but one of many riches of diversity. More information on deaf culture can be found by accessing various links provided in the Resources and Website Links section.