Information about hearing loss

There are different forms of hearing loss, with various causes. It can be more difficult for people with hearing loss to communicate with people with normal hearing. But with a little good will from both the hearing impaired and the hearing impaired, it is certainly possible! Hearing-impaired people often master ways to compensate for reduced hearing. For example, they are extra good at reading faces or lip movements or they almost literally need half a word. The hearing impaired person may not only have problems with ‘understanding’ but also have difficulty functioning in other areas. For example, motor skills, balance or speaking. These may be the result of reduced hearing.

The functioning of the healthy ear

Sounds are waves of air. People only experience sound as sound when these sound waves have been processed as sound by the brain.
This requires an extensive process:

  1. The auricle collects the sound waves;
  2. The waves are carried through the ear canal to the eardrum. The eardrum forms the separation between the outer ear and the middle ear;
  3. The eardrum is set in motion by the passing sound waves;
  4. In turn, this vibrating eardrum sets three ossicles in motion (hammer, anvil and stirrup). This not only ensures further conduction of the sound, but it is also amplified;
  5. The stapes activates fluid in the cochlea (the cochlea is located in the inner ear). The moving fluid activates cilia in the cochlea;
  6. The vibration of the hairs sends a signal to the brain, after which we perceive the sound.

What is hearing loss and what are the gradations?

Being hearing impaired and deaf are not the same. Someone who is hearing impaired can, possibly with aids, perceive and understand environmental sounds and/or speech. This is not possible for someone who is deaf. Deaf people therefore have to rely exclusively on sign language, while spoken communication is possible for the hearing impaired.

There are different degrees of hearing loss, ranging from mild to severe hearing loss:

  • Mild hearing loss = 20 – 50 dB hearing loss
  • Moderately hearing impaired = 50 – 70 dB hearing loss
  • Severely hearing impaired = 70 – 90 dB hearing loss
  • (Deaf = more than 90 dB hearing loss)

Types of hearing loss

There are different types of hearing loss, namely:

  • Sensorineural hearing loss: there is damage in the inner ear, which causes sounds to sound less loud or distorted.
  • Conductive hearing loss: the outer ear or middle ear is damaged. This causes sounds to sound muffled.
  • Mixed hearing loss: a combination of sensorineural hearing loss and conductive hearing loss.

Possible causes of hearing loss

Hearing impairment can be present at birth (congenital hearing impairment) or develop at a later age (acquired hearing impairment). There are many possible causes, including:


  • Usher’s syndrome
  • Meniere’s disease
  • Bridge angle tumor

Brain and nervous system

  • Disrupted functioning of the auditory nerve
  • A brain disorder


  • Use of certain medications
  • Regular exposure to loud noises
  • Ear infections
  • Otosclerosis (excessive bone growth occurs in the inner ear. This hinders the (vibrating) function of the stapes.

What problems do hearing-impaired people face?

Poor hearing is more than ‘occasionally not understanding what is being said’ or not hearing a sound. The hearing impaired person may have difficulty with, among other things:

  • Hearing from which direction a sound comes;
  • Adjust your own voice volume to the environment (hearing impaired people often speak loudly because they hear themselves softer);
  • Hearing (subtle) intonation in someone’s voice. One often hears flatter/more monotonous;
  • Tolerating loud noises;
  • Distinguishing important sounds from incidental sounds;
  • Recognize sounds/voices

Additional problems

Not only the reduced hearing is difficult, other difficulties can also arise from it.


It’s tiring to hear worse. It takes an extra effort to do the daily things. Consider, for example, cycling or walking in traffic. Hearing-impaired people hear well in advance when a car is approaching. People who have poorer hearing only hear the car later. To prevent them from noticing the car too late, they have to make extra use of their vision. Scanning the environment does not happen automatically, you must consciously seek (visual) information that others receive through their hearing. People with hearing loss sometimes appear restless because their eyes regularly scan the environment.

Delayed development

When hearing loss occurs at birth or during early childhood, development may be slower.
Sometimes it takes the child longer to learn to speak (speaking is often more monotonous because the child’s hearing is also more monotonous), to read and to write. But it is also possible that the child has to put so much effort and energy into hearing that there is simply less energy left to develop/gain experience in other areas.

Motor skills and balance

Sometimes hearing loss is the result of many (middle) ear infections. In that case, problems with motor skills and balance may arise. This is because the organ of balance is located in the ear.

What can you pay attention to when talking to a hearing impaired person?

  • Some hearing-impaired people hear better with one ear than with the other. Then sit/stand on the side of the best functioning ear;
  • You can also sit directly opposite the hearing impaired person, which is especially useful for those who use lip reading and facial expressions a lot. In that case, also make sure there is sufficient light;
  • Regularly ask the hearing impaired person whether he/she is still following everything. Not everyone will indicate this on their own. For example, one may feel reluctant to ask for repetition;
  • Supplement spoken language with visual information. Make a gesture, point to something, use facial expressions, etc.

What should you not do?

In addition to the things you can do, there are also a number of things you should not do:

  • Raising your voice excessively: a slightly louder voice volume is nice, but if the voice is too loud, the sound will be distorted.
  • Don’t repeat what you said: sometimes you say something ‘through your nose’ and those things are often not understood. Repeat these comments as well, more often if necessary. Don’t dismiss it with, “Oh well, it wasn’t important.”
  • Commenting on the voice of the hearing impaired: if someone has poor hearing from an early age, this often affects the development of the voice. Avoid making comments and especially jokes about this. The hearing impaired person can hardly change their voice and at most it makes them feel extra insecure.

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