Auditory Disabilities

Table of Contents

  1. Demographics
  2. Medical Details
  3. Accommodations

Demographics

Central Auditory Processing Disorder has a global prevalence of 5%.

Disabling hearing loss is experienced by 430 million people globally.

The EU estimates that 750 thousand people use sign language as their first language. Note that there are many hearing children of Deaf adults that might figure into this number.

According to the World Health Organization (linked source in the BoK), the quality of life of people with hearing loss is more impacted in developing countries than in developed countries; many are limited in opportunities for education and employment.

Medical Details

Central Auditory Processing Disorder

Folks with CAPD have trouble interpreting sounds, not hearing sounds.

This is not a hearing disorder per se. This is a neurological disorder that affects different audio processing skills such as locating the source of a sound, learning sounds, understanding speech, and differentiating different sources of sound. We might think of it as a listening disorder.

ASHA (source linked in the Body of Knowledge), offers a very detailed profile of this diagnosis. It can vary wildly in its presentation, and standardized diagnostic criteria and procedures don't exist. Due to this fact, the figure of 5% global prevalence is a bit suspect. CAPD is sometimes accompanied by language disorders.

ASHA offers functional definition of CAPD where impairment is seen in some or many of the following skills:

The Biology and Social Dimensions of Hearing Loss

According to WebAIM (linked in the BoK), hearing loss has many types and degrees of severity. Loss can be mild to profound, with mild hearing loss causing some difficulty in understanding daily speech, moderate hearing loss perhaps requiring a hearing aid, severe hearing loss requiring a hearing aid and it still might be enough, and profound hearing loss being almost no sound at all.

This hearing loss is caused by two mechanisms: nerve damage in the inner ear (referred to as sensorineural hearing loss) and damage in the outer or middle ear (referred to as conductive hearing loss). When there is both nerve damage in the inner ear and damage to the outer or middle ear, we call that mixed hearing loss.

ASHA (linked in the BoK) outlines some scenarios that might cause conductive and sensorineural hearing loss. Conductive hearing loss might be caused by infection, a hole in the eardrum, or a malformed ear. Sensorineural hearing loss may be caused by illnesses, repeated exposure to loud noises, and even just old age.

That's a lot of the phrase 'hearing loss' being stated over and over again. It's important to note that many members of the Deaf community feel uncomfortable about this medical nomenclature. They've responded to it with the phrase 'Deaf gain' which frames deafness as a positive attribute which enriches both the self and the entire human population.

Deaf, Hard-of-Hearing, deaf, Late-deafened

These words have medical and social definitions.

The Body of Knowledge, relying on a medical definition, wants you to understand two concepts: Deafness, and Hard of Hearing. According to them, the primary distinguisher between a person who experiences deafness and a person who is hard of hearing is the degree of hearing loss. Deafness indicates severe to profound hearing loss. Hard of Hearing people have mild to moderate hearing loss. Many use hearing aids and can use the phone.

The social definition of these words indicate one's status and relationship to a Deaf community.

Deaf communities are linguistic minorities that use a sign language as their main means of communication. There are many sign languages! According to the EU Knowledge Center on Interpretation (linked in the BoK, broken link accessed via Wayback Machine), there are 31 national sign languages in the EU. Some countries have multiple sign languages (for example, people residing in the place known as 'canada' have four and maybe even more: American Sign Language ASL, Quebec Sign Language LSQ, Maritime Sign Language MSL, and Inuit Sign Language IUR).

WebAIM (a linked source) draws attention to the fact that sign languages used across the English-speaking world vary. British Sign Language and American Sign Language are from two separate language families: as different as French is from Japanese.

The Deaf Anglosphere uses the terms Deaf, deaf, Hard of Hearing (HOH), and late-deafened to describe different degrees of fluency in the language and culture of the Deaf community. Capital-D Deaf refers to people who have hearing loss and sign fluently, are entrenched in the community, etc. Lowercase-d deaf refers to people who have severe to profound hearing loss, but no fluency in sign language. HOH refers to a person with hearing loss, but not full fluency in Deaf culture. Late-deafened describes deaf people who become deaf due to age-related hearing loss, and who don't pick up sign language.

But this only really refers to how a few select Deaf communities treat the words and it varies around the world. Additionally, some members of the community have recently been trying to get rid of the uppercase-lowercase distinction on the basis of it being too exclusionary.

Accommodations

Accessible communications is of prime concern when it comes to auditory disabilities. A person might use hearing aids, might have a cochlear implant or might use a personal listening device. Bright lighting conditions are essential if the person is relying on 'lip-reading.' Use of CART or STTR to provide live transcripts and captioning are good in live presentations. Culturally Deaf people will often prefer sign language interpretation.

Transcripts and captions are important to include in time-synchronized media. Additionally, announcements should be available in visual form. This is of prime concern at a place like an airport.Deaf people will also often use flashing doorbells, under-the-bed shaking alarm clocks, and haptic alerts to receive notifications.

A person with CAPD might require slightly different accommodations. For example, Understood (a linked source in the BoK) suggests systems that equally distribute sounds throughout a room, noise-cancelling headphones that can filter out background noise, use of text-to-speech voices that the person is more skilled at interpreting, and audio-recording presentations that the person with CAPD can review them later at a slower frequency or different pitch.