Hearing impairment, deafness, and hard of hearing: what these terms mean

If your child is hard of hearing or deaf, it means that your child’s ears can’t do all or any of the things they should be able to do. For example, your child might have muffled hearing, or she might not be able to hear sounds coming from some directions, or she might have trouble hearing certain frequencies or sounds.

Some organisations and people in Australia use the term ‘hearing impairment’ rather than ‘deafness’ and ‘hard of hearing’. During the diagnosis process, audiologists and other health professionals might talk about hearing impairment or hearing loss.

Types of deafness or hearing impairment

Deafness or hearing impairment can:

  • happen at birth – this is congenital deafness or hearing impairment
  • start after birth – this is acquired or progressive deafness or hearing impairment.

There are two main types of deafness or hearing impairment – conductive and sensorineural.

Conductive hearing impairment is when sounds from outside your child’s ear have trouble getting to or going through the different parts inside the ear. Conductive hearing impairment is usually caused by middle ear fluid from middle ear infections, and is usually temporary.

Sensorineural hearing impairment is when the nerves that are in charge of receiving sound and sorting out what it means don’t work properly. Sensorineural hearing impairment can be mild, moderate, severe or profound. Sensorineural hearing impairment usually lasts for life and can get worse over time.

Mixed hearing loss is when a child has both conductive and sensorineural hearing impairment.

Diagnosing deafness or hearing impairment: universal newborn hearing screening

In Australia, universal newborn hearing screening is an essential part of diagnosing deafness or hearing impairment in children.

All Australian states and territories have a universal newborn hearing screening program that aims to:

  • screen the hearing of all babies by one month of age
  • refer any babies with possible hearing impairment for diagnostic testing with an audiologist by three months of age to confirm whether they have hearing impairment
  • start early intervention for those babies with hearing loss by six 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. 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. 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 other important newborn hearing screening links.

Signs of deafness or hearing impairment

All typically developing babies and young children have the same developmental milestones. Babies develop at different rates, but should reach the milestones in the same order.

If your baby is deaf or hard of hearing, he won’t hear people speaking, which means he might not respond to your voice and other noises in the way you’d expect. As he gets older, you might notice that his speech and language aren’t developing like other children’s.

As a guide, here’s what you’d expect in a typically developing baby. If your child isn’t doing these 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 her head or move her eyes to locate the source of the sound. If she’s upset, she should calm down when she hears your voice.
  • At 4-8 months, your baby should notice sounds around him, smile when spoken to, babble and understand simple words like ‘bye-bye’.
  • At 8-14 months, your baby should respond to her name, say simple words like ‘mama’ and ‘dada’, copy simple sounds and use her voice to get attention from people nearby.
  • At 14-24 months, your child will start to develop vocabulary, understand and follow simple instructions, and put two words together.

Even if everything seems OK but you still feel worried, you should see your doctor or nurse. After all, you know your baby best.

Some children who are deaf or hard of hearing have another disability too. There are early intervention services specifically for infants and preschool children with hearing impairment and other disabilities. These children and their families will need support from a team of professionals, not only those who specialise in hearing impairment.

Learning to communicate: deaf children and children who are hard of hearing

If your child is deaf or hard of hearing, he might use spoken language, sign language or a combination of sign and spoken language to talk.

Even with the best technology, learning to communicate with spoken language for children with severe or profound deafness is really hard work, takes many years and doesn’t always succeed. The most important thing for your child’s development, and for your relationship with your child, is being able 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, you and the rest of your family need to learn sign language too.

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 deaf children and children who are hard of hearing

There are devices that can help your child hear spoken language. And when she can hear spoken language, your child can start learning to use language.

The right type of device for your child will depend on what type of hearing impairment he has and how severe it is. These devices, called amplification devices or assistive listening devices, include:

Your child might use one device, or a combination of devices. Using a combination might give your child more opportunities to hear sounds because each device does a slightly different job. Your child might also use these devices in combination with spoken language and sign language.

Most children with hearing impairment use assistive listening devices on both ears.

Your child’s audiologist can help you tell whether and how much the devices are helping your child.

Early intervention services for deaf children and children who are hard of hearing

The earlier you find out your child has a hearing impairment, the sooner she can begin early intervention and have language to communicate with. It also means you and your family can get advice and support as soon as possible, giving your child the best start in life.

The team of professionals involved in supporting you and your child might include audiologists, speech pathologists and special education teachers. When you’re working with these professionals, it’s OK to ask lots of questions about the best ways to support your child.

Learning as much as possible from your speech pathologist and audiologist will help. Don’t be afraid to ask lots of questions. Forming a relationship with these professionals means that they can continue to work with you and your child as he grows and becomes more independent.

When you play, connect and communicate with your child throughout the day in ways that encourage her hearing and development, it can help her a lot. Children learn the most from the people who care for them and with whom they spend most of their time.

Financial support for deaf children and children who are hard of hearing

If your child has a confirmed diagnosis of hearing impairment, your child might be able to get support under 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 therapies or one-off items like hearing aids.

If you live in an area that isn’t yet covered by the NDIS, your child can get funding under the Better Start for Children with Disability initiative. If your child is eligible for the NDIS, he can move to the NDIS when it comes to your area. Read our NDIS and Better Start FAQs for more information.

Looking after yourself and your family

Although it’s easy to get caught up in looking after your child, it’s important to look after your own wellbeing too. If you’re physically and mentally well, 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, these siblings of children with disability need to feel that they’re just as important to you – that you care about them and what they’re going through. It’s important to talk with them, spend time with them, and find the right support for them too.