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Deafness and Hearing Impairment Snapshot
This Disability Snapshot provides general information about deafness and hearing impairment to assist you in communicating effectively and supporting the participant in developing their goals in a planning meeting. Each person is an individual and will have their own needs, preferences and experiences that will impact on the planning process. This information has been prepared for NDIA staff and partners and is not intended for external distribution.
Peak body consulted
In developing this resource we consulted with Deaf Australia, Deafness Forum of Australia and Deafblind Australia, peak bodies for people with deafness, hearing impairment or deafblindness.
What is deafness and hearing impairment?
Deaf, deafness, hard of hearing, hearing loss, and hearing impairment are all terms used to describe the sensory disability that affects a person’s ability to hear.
Levels of deafness vary from mild to profound and can occur at birth or at any age regardless of a person’s gender or background. However, it can become more common as age increases.
The terms deafness and hearing impairment mean different things to different people and must be used sensitively. Deaf is the preferred term used by people who use Australian Sign Language (Auslan) as a primary or preferred communication method and who identify themselves as a member of the signing Deaf community. It is used to describe their unique cultural identity which is a result of their rich visual language and is used with pride. In this case the D in Deaf is capitalised.
Many in the Deaf community regard the terms ‘hearing impairment’ and ‘hearing loss’ as alienating and damaging because it implies deafness needs to be ‘fixed’.
Because of the sensitivities around the different terms, it is particularly important that participants are encouraged to take the lead in describing themselves and their disability or cultural identity. Care needs to be taken to ensure that the terminology preferred by the participant is consistently used in all meetings and correspondence. See the language and terminology section of this Disability Snapshot for further detail.
People who are deafblind have specific needs beyond deafness and blindness. Their communication and mobility requirements will be highly specialised and often require one-on- one supports. See the separate Deafblind Snapshot for further detail.
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How are deafness and hearing impairment diagnosed?
Australia has a system of universal, hearing screening for newborns in all hospitals. When deafness or hearing impairment is identified, a referral is made for the newborn to be assessed by a diagnostic audiologist.
In some states, hearing testing is done in primary schools. People can also be referred to an audiologist by their GP, health provider or family members.
Approximately 95% of children born with hearing loss are born to parents who can hear and speak. These parents may have no prior knowledge of deafness or hearing impairment. They may experience a range of emotions and not fully understand the implications of the diagnosis.
A number of children may have multiple disabilities, including deafness or hearing impairment. These children will need a range of supports to address their different needs.
People may acquire hearing loss through a wide range of causes such as illness, accident, exposure to loud damaging noise and the natural process of ageing. Often it is a family member that notices the hearing loss and encourages the person to seek professional advice.
Australian Hearing is the only provider in Australia who receives government funding to deliver hearing services (including the fitting of hearing devices) for children and young adults (under 26 years of age). Australian Hearing do not do diagnostic testing. Once a child has a confirmed hearing loss they are then referred to Australian Hearing.
Common characteristics
Lack of access to communication and information is the primary barrier to inclusion and wellbeing - communication and quality of life are very closely linked. Poor access to communication and lower levels of interaction are known to negatively impact on social, emotional, psychological and physical wellbeing.
People who experience deafness and hearing impairment need access to a range of strategies to access information and to communicate. They may need to access several of the following supports and strategies:
listening and spoken language therapies in conjunction with assistive hearing
technologies Auslan, the sign language used by the Deaf community in Australia lip-reading (a specialised skill used by a small part of the population) devices that amplify or replace sound (e.g. hearing aids, cochlear implants) and
therapy / rehabilitative supports hearing augmentation systems such as hearing loops, remote microphone systems,
soundfield systems and captioning
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assistive visual devices and systems (for example flashing doorbells, telephones
and smoke alarms and live captioning).
For more information see Appendix A: technology as an enabler as the end of this document.
The most helpful approach to the provision of supports is to provide a person and their family with as much information as possible to identify strategies that might work for them. It is not true that people who are deaf only require Auslan interpreters, or that a single item of assistive technology (AT) (for example a cochlear implant) is sufficient to resolve access to communication and information.
It is important that planners, Local Area Coordinators and Early Childhood partners support participants and their families to obtain independent recommendations for interventions and/or AT from organisations that are independent of service provision.
Common misconceptions about deafness and hearing impairment
Hearing aids or cochlear implants can significantly reduce the disabling effects of
hearing loss although hearing loss is irreversible. The ability to hear and the ability to
understand sounds are two different things. People who wear hearing devices may
still have difficulty hearing in a noisy environment, on the phone or comprehending
spoken language and speech.
- A misconception is that hearing aids or Cochlear implants ‘fix’ or restore hearing loss. For many Deaf people, being deaf is an essential part of their identity which leads to
positive social, emotional and language developments. An assumption that
intervention is needed to fix the deafness needs careful consideration of each
person’s choice, communication needs and participation opportunities.
- A misconception is that deafness needs to be ‘fixed’. Technology is usually most effective when combined with hours of learning to
interpret the device’s sounds. This may be with the support of a speech pathologist
or teacher, particularly during early childhood. Similar for all people with disability,
intensive therapy needs to be balanced with other important elements of life such as
recreation time, social interaction and general downtime.
- A misconception is that hearing devices immediately allow a person to hear. Auslan (Australian Sign Language) is a visual and spatial language that has its own
grammar rule. It has no written form. Auslan is recognised as a language. Auslan is
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different to English and does not translate directly. Sign language is not universal,
Auslan is a unique language used within Australia.
- A misconception is that Auslan is just a signed form of spoken English language. Lip-reading and listening skills are acquired through years of practice and training
and these skills vary widely. It is difficult and complicated because there are many
different speech sounds that look similar on the lips (for example ‘b’, ‘p’ and ‘m’).
Lip-reading is a tiring exercise - it requires high levels of concentration irrespective
of the age of the person.
- A misconception is that all deaf people can lip-read.
Language and terminology
Terminology is a sensitive issue in the deafness and hearing impairment communities. NDIS participants must be given the opportunity to describe themselves and their disability. Take care to ensure the participant’s preferred terminology is always used in any meetings and correspondence.
Preferred terms
Deaf, for a person whose first language is Auslan. Person who is deaf and has other disability/s.
Description of terms
Deaf (with capital ‘D’) is the preferred term used by people who use Auslan as a
primary or preferred communication mode, and who identify themselves as a
member of the signing deaf community. This group of people may also identify
themselves as culturally Deaf. Auslan users have a unique language and
experience, and like all cultural and linguistic groups, English is their second
language. Auslan users are more likely to have been born deaf or have become
deaf in early life. There are some who discover Auslan later in life and then use it as
their primary language. deaf (with lower case ‘d’) is a general term used to describe people who have a
physical condition of hearing loss of varying degree, no matter which communication
mode they use (for example hearing devices, Auslan or lip reading). The term ‘hearing impairment’ refers to a full or partial decrease in the ability to hear.
It is one of the commonly used terms to describe a person who has a hearing loss,
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irrespective of their level of hearing. This term must not be used as a blanket term
for people who identify as ‘capital D’ Deaf. Some individuals may prefer to use
hearing impairment to describe their identity but many Deaf and hard of hearing
people find this term derogatory. ‘Hard of hearing’ is the internationally preferred term used to describe people with
acquired hearing loss in a way that does not imply impairment.
Enabling social and economic participation
A person’s support needs for social and economic participation will vary depending on their strengths and level of function. Identifying potential solutions for increasing access to communication and information is critical. This could include arranging assistive technology or Auslan.
To enable and maintain work, ongoing supports or adjustments at work may be needed. This might require NDIS funding for specialist disability or employment related assessment services. Alternatively the person may access external employment retention and support initiatives such as Work Assist provided by the Disability Employment Services (DES) program.
Peer support from people who identify themselves as a member of the signing community or with other people who are deaf can also assist to address challenges to social and economic participation.
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How can I tailor a meeting to suit people who experience Deafness or hearing impairment?
Offer a variety of options to contact you: email, fax, text message or letter. Some
people will nominate a TTY phone contact via the National Relay Service (NRS) as
their preference. Ensure you are familiar with the NRS before use.
- Do not use a phone call as the first point of contact. It is important to communicate with people in the means which they find accessible and most
comfortable. Always ask what communication access is needed for the meeting. This could be a
hearing loop, live captions, a room with Auslan interpreters or a combination of
supports.
- Do not impose unwanted supports. Interpreter and captioners preferences must be respected. NDIS meetings often include a lot of information and may be quite
overwhelming. Book communication support as soon as possible and confirm the details with the
participant.
- Do not ask interpreters and captioners to provide advocacy or other support. Their role is solely to interpret/caption all communication. There is a shortage of
Auslan interpreters, captioners are in high demand, and not all meeting rooms
have hearing loops. Make sure meetings are held in a quiet space that is well lit.
- Do not presume that a busy office or café is a welcoming environment. A quiet, well-lit space is a place where conversations can take place free of background
noise, strong background light and distractions. Ensure that you are clearly visible and facing the person.
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Do not wave hands or hold other objects near your face while speaking. Some people can read lips for some words. Use normal clear speech at normal speed.
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Do not exaggerate your speech. Try not to speak too quickly, don’t mumble and don’t yell. It’s clarity that counts. Hearing devices (including ears) work best
when they are receiving normal speech free of background noise. Some people
can read lips for some words.
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Look at and speak directly to the person.
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It is always good manners to look at the person you are speaking to.
Use plain language that is clear. Rephrase as needed.
- Do not keep saying the same thing over again or assume that a person with communication support needs has an intellectual disability because they have a
limited vocabulary or language difficulties. Hearing devices might not pick up every word clearly. Remember that a person
whose first language is not English (this may include users of Auslan) might not
have a high English literacy level. Have paper and pen available.
- Don’t rely on one communication method only. All people in the meeting need to have the same understanding about key information, support requirements,
outcomes and next steps. Ask for clarification and things to be reworded if you do not understand. Play it back
to check that both parties have the same understanding.
- Don’t assume you know what the person is trying to say.
Helpful links
Deaf Australia Deafness Forum of Australia Aussie Deaf Kids Better Hearing Australia CICADA (Cochlear implantee group) Parents of Deaf Children Hearing Topics A – Z The Meaning and Practice of Audism
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Appendix A: technology as an enabler
Hearing devices are one of several solutions for increasing communication, accessing information and improving safety. Devices include hearing aids, cochlear implants, or assistive listening devices that help with specific problems like hearing the TV or using a phone.
Captions are particularly useful for people with hearing loss, as well as those who are viewing content in a noisy environment, teaching or training and who are learning English. Captions can appear on a screen to accompany a speaker presentation–they can be delivered by a stenographer at the location (live) or by the internet (remote).
Captions can also be provided on television, DVDs, videos on the internet, cinemas, theatres and public places like museums. In this case, they are commonly referred to as subtitles.
Cochlear implants are an electronic medical device that replace the function of the damaged inner ear, unlike hearing aids, which make sounds louder, cochlear implants do the work of damaged parts of the inner ear (cochlea) to provide sound signals to the brain. Cochlear implants may not be a suitable device for all people.
Hearing aids are small electronic devices that are worn in or behind the ear. They make some sounds louder so that a person with hearing loss can listen, communicate and participate more fully in daily activities. A hearing aid has three basic elements: a microphone, amplifier, and speaker. The hearing aid receives sound through a microphone, which converts the sound waves to electrical signals and sends them to an amplifier. The amplifier increases the power of the signals and then sends them to the ear through a speaker.
Hearing Loop systems are usually installed in places where people gather. The sound from a microphone is transmitted into a person’s hearing device via the loop. It works the same way as a radio in transmitting sounds to a receiver. There are mobile and fixed Hearing Loop systems. For example some are fitted in meeting rooms or for example on railway platforms and others are mobile and can be brought into meeting rooms.
Hearing Loops can be used by people who have hearing aids fitted with a T-switch. In addition to permanently installed hearing loops, there are portable hearing loops for purchase or hire.
Remote microphone technology is a helpful resource because even if a person wears a hearing aid or cochlear implant, there will still be times when they struggle to pick up sounds and speech, particularly when there is a lot of background noise or they are trying to hear over distance. A speaker wears a small microphone which is the transmitter. Their speech then travels to a receiver that streams sound directly to the listener’s hearing aid or implant via a receiver. The sounds are not affected by distance or background noise.
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Version control
Version Amended Brief Description of Change Status Date by
1.1 KHM678 Annual review, additional information added DRAFT 2020-02-06 on employment.
2.0 NAN927 Class 1 approved. APPROVED 2020-03-13
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