What is deafness or hearing loss?
Deafness or hearing loss is when the ears can’t do all or some of the things they should be able to do. For example, deafness or hearing loss might include:
- muffled hearing
- difficulty hearing sounds coming from some directions
- difficulty hearing certain frequencies or sounds.
Deafness or hearing loss can be mild, moderate, severe or profound. It can affect one or both ears.
In this article, we say ‘deafness’ or ‘hearing loss’ when we’re talking about the condition. We say ‘deaf’ or ‘hard of hearing’ when we’re talking about people. This use of language is guided by consultation with experts and advocates for children who are deaf or hard of hearing.
Types of deafness or hearing loss
Deafness or hearing loss can be:
- congenital – this is deafness or hearing loss from birth or soon after birth
- acquired – this is deafness or hearing loss that happens later in life.
There are 2 main types of deafness or hearing loss – conductive and sensorineural.
Conductive hearing loss is when sounds from outside your child’s ear have trouble getting through the outer or middle ear. Conductive hearing loss is usually caused by middle ear fluid from middle ear infections and is usually temporary.
Sensorineural hearing loss is when the inner ear or the auditory nerve doesn’t work properly. Sensorineural hearing loss lasts for life and can get worse over time.
Mixed hearing loss is when a child has both conductive and sensorineural hearing loss.
Diagnosing deafness or hearing loss: universal newborn hearing screening
Early diagnosis of hearing loss is important. The earlier you find out your child is deaf or hard of hearing, the sooner your child can begin early intervention and develop language to communicate .
In Australia, universal newborn hearing screening is an essential part of diagnosing deafness or hearing loss in babies and children.
All Australian states and territories have a universal newborn hearing screening program that aims to:
- screen the hearing of all babies by 1 month of age
- refer any babies with possible hearing loss for diagnostic testing with an audiologist by 3 months of age to confirm whether they have hearing loss
- start early intervention for babies with hearing loss by 6 months of age.
What is hearing screening?
During screening, special equipment plays specific sounds into your baby’s ears and records the responses from your baby’s brain. The screening technology might be different in different parts of Australia.
In most places, your baby will be screened in hospital, before you take your baby home. Each state has its own way of following up on babies who don’t have a hearing screen in hospital.
Each state also has its own way of referring babies to audiology and supporting parents and families.
Hearing screening isn’t compulsory, but it is strongly recommended. You have to give your permission for your baby to be screened, which means signing a consent form.
The Australasian Newborn Hearing Screening Committee website has links to each state and territory newborn hearing screening program, as well as information about hearing loss.
Signs of deafness or hearing loss
If your baby or child is deaf or hard of hearing, they might not hear people speaking. This means that your baby might not respond to your voice and other noises in the ways you’d expect. As your baby gets older, you might notice that their speech and language aren’t developing like other children’s.
As a guide, if your child isn’t doing the following things, it might be a good idea to talk to your GP or child and family health nurse:
- At 0-4 months, your baby should startle at a loud noise, turn their head or move their eyes to locate the source of the sound. If your baby is upset by the noise, they should calm down when they hear your voice.
- At 4-8 months, your baby should notice sounds nearby, smile when you speak to them, and start to babble.
- At 8-14 months, your baby should understand simple words like ‘bye-bye’, respond to their name, say simple words like ‘mama’ and ‘dada’, copy simple sounds and use their voice to get attention from people nearby.
- At 14-24 months, your toddler will start to develop vocabulary, understand and follow simple instructions, and put 2 or more words together.
Even if everything seems OK but you still feel worried, see your GP or child and family health nurse.
Learning to communicate: children who are deaf or hard of hearing
The most important thing for your child’s development, and for your relationship with your child, is being able to communicate.
If your child is deaf or hard of hearing, they might use spoken language, sign language or a combination of sign and spoken language to communicate.
Many families choose to teach their child to both speak and sign, regardless of whether the child can use spoken language. If this is your family’s choice, it’s important for you and the rest of your family to learn sign language too.
In Australia, sign language is called Auslan. You can ask the health professionals who are caring for you and your child for more information and support to learn sign language.
Listening devices for children who are deaf or hard of hearing
Amplification devices or assistive listening devices are devices that can help your child hear spoken language. And when your child can hear spoken language, they can start learning to use spoken language.
The right type of device for your child will depend on their age, the type of hearing loss they have, and how severe it is. These devices include:
Your child might use one device, or a combination of devices, because each device does a slightly different job. Your child might also use these devices in combination with spoken language and sign language.
Many children who are deaf or hard of hearing use an assistive listening device on one or both ears.
Your child’s audiologist can help you tell whether the devices are helping your child.
Hearing Australia’s Hearing Services Program pays for hearing aids, bone conduction devices, remote microphone systems and replacements for cochlear implant processors, as well as rehabilitation. The Program is for all Australian citizens and permanent residents under 26 years of age.
Early intervention for children who are deaf or hard of hearing
Early intervention is the best way to support your child’s development. Early intervention includes therapies, education and other supports that will help your child reach their full potential.
Early intervention should also include helping you learn how to spend time with your child in ways that support their development. Children learn best from the people who care for them and with whom they spend most of their time, so everyday play and communication with you can help your child a lot.
You and your child will probably work with many health and other professionals as part of your child’s early intervention. These professionals include audiologists, speech pathologists, teachers of the Deaf, and family counsellors. You’ll probably also meet with other families with children who are deaf or hard of hearing and also adults who are deaf or hard of hearing.
It’s good to see yourself working in partnership with your child’s professionals. When you combine your deep knowledge of your child with the professionals’ expertise, your child is more likely to communicate, interact and thrive.
Some children who are deaf or hard of hearing have other support needs too. There are early intervention services specifically for infants and preschoolers with hearing loss and other support needs. Multidisciplinary teams of specialists and professionals can support these children and their families.
Financial support for children who are deaf or hard of hearing
If your child has a confirmed diagnosis of permanent hearing loss, your child might be able to get support from the National Disability Insurance Scheme (NDIS). The NDIS helps you get services and support in your community and gives you funding for things like early intervention services.
Looking after yourself and your family
It’s important to look after yourself physically, mentally and emotionally. If you take care of yourself, you’ll be better able to care for your child.
Talking to other parents can be a great way to get support. You can connect with other parents in similar situations by joining a face-to-face or an online support group.
If you have other children, they might have a range of feelings about having a sibling with disability. They need to feel that they’re just as important to you as your child with disability – that you care about them and what they’re going through. It’s important to talk with your other children, spend time with them, and find the right sibling support for them.
Hearing loss, deafness, hard of hearing, deaf and Deaf: terminology
There are various ways of describing people with hearing loss:
- ‘Hearing loss’ and ‘deafness’ usually refer to the condition or diagnosis of reduced hearing, ranging from mild to severe or profound.
- ‘Hard of hearing’ usually describes people who have hearing loss, ranging from mild to severe.
- ‘deaf’ (with a lower-case d) usually describes people who have profound hearing loss. They might have little or no hearing.
- ‘Deaf’ (with a capital D) usually describes people who use sign language to communicate and who identify as members of the signing Deaf community.
Some organisations and people in Australia use the term ‘hearing impaired’ or ‘hearing impairment’ rather than ‘deafness’, ‘hearing loss’, ‘hard of hearing’, ‘deaf’ or ‘Deaf’. During the diagnosis process, audiologists and other health professionals might talk about hearing impairment. Many people who are deaf or hard of hearing don’t like this term because it suggests they’re damaged or have a deficit.