When you find out someone has some hearing loss or describes themselves as deaf, do you picture them as not being able to hear at all? This may or may not be so. Every person’s hearing loss is different and unique. In this article, we will shed light on why we can’t assume cookie-cutter communication for this seemingly cookie-cutter issue.

Mistaken assumptions often happen when someone finds out that the person they’re trying to communicate with has some form of hearing loss. Most of the time they will start speaking louder, or ask them if they can read lips, or even hand them a menu in Braille. (It’s true!)

A quick review of the anatomy of the ear is necessary before we discuss the different types of hearing loss. So, here we go…


OUTER EAR: Responsible for collecting the sound waves and directing them into the ear through the ear canal to the eardrum.
MIDDLE EAR: Responsible for transmitting the sound from the outer ear, after reaching the eardrum to the inner ear through 3 bones, the oval window, the round window and then through a tube.
INNER EAR: Responsible for taking these sound waves from the middle ear and transforming them into electrical pulses which are then sent to the brain.


There are many factors that come into play when it comes to hearing loss. Let’s take a quick look at the three basic types of hearing loss.

First, conductive hearing loss. This means that sound cannot arrive at the inner ear because of some physical issue with the outer ear, ear canal, eardrum or middle ear and its bones. Some examples include ear wax stuck in the ear canal, ear infection, a perforated eardrum or being born without the bones in their middle ear. This type of hearing loss usually can be corrected. Corrections may include wax removal, medication, surgery, etc.

Next, we have sensorineural hearing loss. This type of hearing loss means that the inner ear has been damaged in some manner. The most common type of damage occurs to the hair-like cells within the cochlea. Damage can occur due to illness, side effects of medication, genetics, exposure to loud music, noise or explosions, autoimmune diseases, aging and so forth. Issues with the nerve connection from the inner ear to the brain also fall under this category. Surgery or medication can correct this type of hearing loss most of the time.

Last, we have mixed hearing loss, which is a combination of the previous two. This means that part of the hearing loss cause is due to conductive issues and other part is because of sensorineural issues. This type of hearing loss can be helped by correcting the conductive issues and then being able to address the remaining sensorineural part.


Now that we’ve pinned down the types of hearing loss, and with just three types of hearing loss, it should be a cut-and-dry procedure of diagnosing and treating hearing loss. That, unfortunately, is not the case. Determining the degree of hearing loss is next.

Two people with the same conductive issue may be influenced in different degrees, resulting in dramatically different experiences. The different degrees are known as mild, moderate, severe and profound. In the 1960s, there was a rubella epidemic that resulted in sensorineural hearing loss for many infants and young children. However, not each child who contracted rubella experienced the same outcome. Some could get by with mild sensorineural hearing loss. Others were diagnosed with a profound hearing loss.


Besides the types and degrees of hearing loss, we also can categorize each type of hearing loss by its severity. There are also different factors to consider:

  • Unilateral vs bilateral
    Is the degree of hearing loss the same in both ears? Sometimes only one ear is affected while the other one may be perfectly fine (unilateral). Or both ears may have a hearing loss with the same or differing degrees. For example, mild and profound or both moderate (bilateral).
  • Symmetrical / asymmetrical
    When the hearing in one ear declines differently than the other, resulting in one ear hearing worse than the other, this is asymmetrical loss. Symmetrical loss is diagnosed when the amount of loss is the same in each ear over time.
  • Pre-lingual vs Post-lingual
    Some people may experience hearing loss before they learn how to speak. They may be born with hearing issues. Others may lose their hearing after they have learned to speak and may maintain their ability to do so.
  • Progressive vs sudden
    Some types of hearing loss happen gradually such as aging; while others are sudden such as being in an accident, damaging the person’s ability to hear.
  • Fluctuating vs stable
    Not all hearing loss issues remain the same over time. People with Meniere’s disease may hear normally then suddenly their hearing declines for some time then returns to normal. For others, their hearing loss is permanent and does not change at all.
  • Congenital vs delayed onset
    Some types of hearing loss are present at birth from natural causes or a disease like rubella (congenital). Other types happen gradually over time from aging or ongoing exposure to loud noise like military experiences or construction (delayed).


With all these different factors to consider when we talk about hearing loss or deafness, we need to keep in mind that not everyone with hearing loss will communicate the same way. Not all types of hearing loss are equal. We need to be sensitive to these people and ensure that they feel they can communicate the way they prefer, rather than letting our assumptions make that decision for them and make them feel even more out of place.


In future articles, we will talk about next steps for people new to the experience of hearing loss, and provide resources available to individuals who are deaf/hard of hearing people, their families, businesses and more. Check those out!


Access Simplified is a leader in the deaf and hard of hearing accessibility industry, having created an offline communications access app. 



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