The document discusses hearing impairment and its classification, emphasizing the difference between hearing impairment and deafness, and outlines the types of hearing loss (conductive, sensorineural, and mixed). It details the educational challenges faced by students with hearing impairments and the importance of individualized support and strategies for their learning. Additionally, it highlights provisions and legislative actions taken by the Indian government to support individuals with hearing impairments through education and rehabilitation services.

1. Hearing
Impairment
Inclusive Education (4.3)

2. Introduction
Though there lies a difference between hearing impairment and deafness,
they are more or less treated similarly for the purpose of deciding their
disability category. According to the Individuals with Disabilities Education
Act (IDEA), hearing impairment can be defined as ‘an impairment in hearing,
whether permanent or fluctuating, that adversely affects a child’s
educational performance but is not included under the definition of
“deafness”. In order to comprehend this definition better, it is imperative to
understand deafness so that there is a clarity about the type of disabilities
that fall under the category of hearing impairment. A person suffering from
a hearing loss above 90 decibels is termed as deaf. Thus, it can be said that a
hearing loss below 90 decibels would be termed as hearing impairment.

3. Introduction
The type of hearing loss is determined as per the location inside the ear
where the hearing impairment occurs. Certain types of hearing loss may be
encountered with the help of hearing aids. But the same may not hold true
for all types of hearing loss. Hearing loss is classified as slight, mild,
moderate, severe or profound, depending on how well an individual can
hear the frequencies that are commonly associated with speech. Hearing
impairment can cause many problems in the lives of the people suffering
from it, especially in the lives of students who experience difficulties due to
this impairment such as understanding the language subjects, taking
important notes during lectures, taking part in discussions, comprehending
educational videos, giving PowerPoint presentations, etc.

4. Introduction
The American system of education is set up to meet disability requirements. It is a model
based on shortfalls, planned to react when the student deviates or fails in a way that can be
chased back indisputably to the condition that disables him or her. After ascertaining the
shortfall, the system tries to make up for it through special education. Seeing the student’s
shortfalls due to his or her disability, a need to incorporate specialized instructions in
teaching was felt. Defining and determining the curriculum, teaching learning tools and
mode of instruction for the specialized instruction should be a collective effort on part of
the special educators, learner’s parents or guardians and others involved in the activity (for
example speech-language pathologists, occupational therapists, parents, psychologists,
interpreters, general educators, counsellors and other applicable representatives). This
group would function as a team to create a document called the Individual Education
Programme (IEP), which sets rolling the educational aims and objectives for learners, based
on their special needs.

5. Introduction to Types of Hearing
Impairment
After getting a general overview of what hearing impairment is,
the various types of hearing loss will be discussed. It is also
important to understand the degree and descriptors associated
with them.
The three basic types of hearing loss are as follows:
(a) Conductive hearing loss
(b) Sensorineural hearing loss
(c) Mixed hearing loss

7. Conductive hearing loss
It is a condition in which sound is not directed easily via the outer
ear canal to the eardrum and the small bones (ossicles) of the
middle ear. A person suffering from conductive hearing loss is
able to hear soft sounds and encounters difficulty in hearing. This
type of hearing loss is generally temporary and can normally be
rectified through medical or surgical means.

8. Conductive hearing loss
Conductive hearing loss could be caused due to the following reasons:
• Accumulation of liquid in the middle ear due to common cold or an allergy
• Malformation of the outer ear, ear canal, or middle ear
• Accumulation of earwax
• An infection in the ear
• Water retention in the outer ear due to swimming, rafting, etc.
• Malfunctioning of the Eustachian tube
• Foreign body in the ear canal
• Hole in the eardrum

9. Sensorineural hearing loss (SNHL):
It occurs in cases of damage to the inner ear or to the nerves
attaching the inner ear to the brain. Generally, this condition is
beyond medical or surgical correction. This is the most common
type of permanent hearing loss. A person suffering from SNHL is
able to hear only faint sounds. An individual suffering from
hearing impairment due to SNHL may hear unclear or muffled
sound even when the sound is actually loud and clear.

10. Sensorineural hearing loss (SNHL):
SNHL could be caused due to following reasons:
• Ingestion of drugs which are harmful to hearing
• Genetic or hereditary SNHL
• SNHL due to increasing age
• Some kind of an injury to the head
• Problem with formation of the inner ear
• Close and prolonged contact with loud noise

11. Mixed hearing loss:
It is the result of combination of conductive hearing loss and
sensorineural hearing loss. This condition occurs when there is a
damage in the outer or middle ear along with a damage to the
inner ear or the auditory nerve.

12. Degree of Hearing Loss
Degree of hearing loss indicates the severity of the loss. The table
below illustrates one of the normally used grouping systems. The
numbers are demonstrative of an individual’s hearing loss range in
decibels (dB HL).
Degree of hearing Hearing loss range (dB HL)
Normal 10 to 15
Slight 16 to 25
Mild 26 to 40
Moderate 41 to 55
Moderately severe 50 to 70
Severe 71 to 90

13. Other Descriptors Related with Hearing
Loss
Bilateral or unilateral hearing loss: The literal meaning of the word
‘bilateral’ is ‘effecting both sides’. Thus, a bilateral hearing loss
means loss of hearing in both ears.
Symmetrical or asymmetrical hearing loss: When a person
experiences same degree of hearing loss in both ears, it is known
as symmetrical hearing loss. Asymmetrical, on the other hand,
means different degree of loss and configuration in each ear.

14. Other Descriptors Related with Hearing
Loss
Progressive or sudden hearing loss. In instances when a person loses
his/her hearing power gradually over a period of time it is said to be a
progressive hearing loss. On the other hand, quick and immediate
hearing loss is termed as sudden hearing loss, which needs immediate
medical attention in order to find out its cause and start the required
treatment.
Fluctuating or stable hearing loss. When the hearing capability varies
at different times, it is called a fluctuating hearing loss. Whereas, in a
stable hearing loss, condition of the child does not change over time
and remains constant.

15. Characteristics
Students with hearing impairment are often visual learners. Hearing impairment
may be congenital or acquired; some may have complete hearing loss, may have
residual hearing. Impact on learning will depend on the degree of the impairment
and cause of hearing loss.
• Poor in reading heavy text and making inferences from text.
• Delay in linguistic growth, leading to lack of general vocabulary and
• technical vocabulary of mathematics and mathematical problems.
• Inadequate in distinguishing mathematical words while student is reading verbally.
• Limited use of cognitive strategies to select relevant information and
• approaches necessary for solving problems.
• Poor in solving problems that involve more than one dimension.

16. Challenges
• Problem in taking meaningful notes.
• Poor or unintelligible reading.
• Difficulty in understanding verbal questions.
• Poor Vocabulary.
• Problem in responding to oral tests.
• Difficulty in following verbal / group conversations.
• Problem in understanding abstract concepts and figurative language (like
• similes, metaphors and idioms).
• Problem in reading and learning spellings (because of difficulty in phonemic awareness and speech /
sound discrimination).

17. Challenges
• Challenge in organizing or composing ideas.
• Deficits in communicating ideas due to restricted vocabulary.
• Problem in comprehending new vocabulary.
• Poor in discriminating difference between sounds and words.
• Problem in understanding / using phrases / words with multiple
• meanings, terminologies/technical terms, abstract concepts, facts,
• Challenge in forming connections between ideas or concepts
• Challenge in grammar usage and sentence construction.
• Poor in understanding of comparisons, cause effect relationships and chronology of events.

18. Provisions and Educational Facilities
for Persons with Hearing Impairment
Ali Yavar Jung National Institute for the Hearing Handicapped is an
independent organization providing services to the hearing impaired in
India. It began in 1983 under the aegis of Ministry of Social Justice and
Empowerment, Government of India, to be of service to people suffering
from hearing impairment.
The organization and its centres located in different districts provide
wideranging investigative, healing, scholastic and occupational services to
people suffering from hearing and speech impairment. An interdisciplinary
crew comprising audiologists, speech therapists, special teachers,
psychologists, social workers, ENT (Ear, Nose and Throat) specialists, child
specialists and neurologists are constantly attempting to retain a high
standard of rehabilitation services.

19. Steps taken by the Government of India
Numerous legislations have been passed by the Government of India
on disability in the last ten years. Following are some of the prominent
statutes:
• Persons with Disability Act (1995): Hearing impairment has been
included as a disability in the Persons with Disabilities Act, 1995. It also
defines hearing impairment (vide supra). The Act undertakes the
promotion and integration of learners with disabilities in regular
schools. It includes a section allocated to condensed syllabus for
children with disabilities and granting an allowance of a single
language to the student suffering from hearing impairment.

20. Steps taken by the Government of India
• National Programme for Prevention and Control of Deafness (2006):
National Programme for Prevention and Control of Deafness was introduced
with the long term aim of preventing and controlling major causes of
hearing impairment and deafness. The initial project was concluded in 2008.
According to a survey conducted by National Sample Survey Organization
(NSSO), presently 291 people per one lakh in India suffer from severe to
profound hearing loss (NSSO, 2001). A huge fraction of these are children
between 0 to 14 years of age. These young Indians suffering from hearing
impairment are a setback to the national productivity. To counter the
problem of hearing impairment, it is imperative that rehabilitation and relief
programmes reach all over the country, especially in the rural areas.

21. Catering to the Educational Needs of
Hearing Impaired Children
Before rendering support to hearing impaired children in a regular school environment, it is
a good idea to assess the kind of support required which will help in eliminating potential
obstructions to growth and development of the children. A precise and detailed knowledge
of a learner’s requirements reinforces good preparation and development. A good
assessment will entail:
• Learner’s self-assessment of any support needs
• Contemplation of support required to cater to any specific subject necessities
• Incorporation of technology and communication in teaching
• Participation of professionals, e.g. a teacher trained to teach students who are deaf
• Parents’ opinions about suitable facilities
• Use of expert evaluations
• Data and information at all levels of accomplishment

22. Teaching Approaches with Regard to
Hearing Impaired Learners
Adoption of certain measures in imparting education to children with hearing disability can
help speed up the process of special education. Some of these measures are as follows:
• Meeting specific requirements of individual learners
• Widespread use of visual aids
• Reading around the class by the teacher
• Making use of whiteboard and PowerPoint presentations
• Using videos/DVDs/online clips
• Helping children in taking notes
• Pre- and post-tutoring sessions for clarifications and doubt clearing
• Creation of small group for the purpose of teaching, assignments, projects, etc

23. Teaching Approaches with Regard to
Hearing Impaired Learners
• Supporting language development
• Making demonstrations for better explanation
• Classroom displays for better perception and understanding
• Making efforts to reduce tiredness by giving short breaks
• Providing vocabulary and support hand-outs
• Checking and re-checking comprehension of the learner

24. Teaching Approaches with Regard to
Hearing Impaired Learners
• Provide help and support during sports, swimming and other
physical education activities
• Providing subject specific support to higher class students
• Making required changes in the syllabus
• Giving prepared notes to learners for better reception of
teaching
• Making liberal use of mind maps to facilitate comprehension