Hearing loss and communication

Also called Deafness and communication, Deaf children and language, Hard of hearing

Deaf and hard-of-hearing people, the languages involved, the choices families face in the first year, and why the only bad choice is delay.

What it is

Hearing loss ranges from mild high-frequency loss in later life to profound deafness from birth, and the Health A-Z covers it as deafness and hearing loss. This entry is about communication, which is a different question at each end. An older adult with age-related loss needs the room quieter and the speaker visible. A deaf baby needs full access to a language, any language, in the first years or language itself is at risk.

Some deaf people are Deaf, with a capital D: members of a community whose first language is British Sign Language, a full language with its own grammar, recognised in law by the BSL Act 2022. Others use spoken English with hearing aids or cochlear implants and lip-reading. Many do both. None of these is a lesser choice.

Who it can help

Parents of a baby identified as deaf by newborn screening, who face decisions fast. Deaf children in mainstream schools, where most now are. Adults losing hearing, who usually wait years before doing anything about it. And the hearing people around all of them, who do most of the adapting when they know how.

Over ninety per cent of deaf children are born to hearing parents, which is why the early choices are so hard: the family is choosing a language route they don't yet know.

How it works

For a deaf child, the priority is a language in the brain by the time the language windows close, and the evidence favours giving the child full access early, by whatever route works. Hearing technology (aids, implants) can give access to spoken language; BSL gives full access from day one regardless of technology; sign-supported English and cued speech sit between. Families who use more than one route lose nothing. Delay loses a great deal.

For a hard-of-hearing adult, the mechanism is simpler: hearing aids fitted and worn, the speaker's face visible and lit, background noise cut, one person at a time, and technology such as Relay UK, captions and hearing loops. Untreated hearing loss is linked to isolation and to dementia risk, and the average wait before seeking help is around ten years.

The Accessible Information Standard requires NHS services to provide BSL interpreters and accessible formats, and the Equality Act requires adjustments everywhere else.

Getting started

For a baby: go to the audiology and teacher-of-the-deaf appointments, ask about hearing technology and BSL both, and start signing at home now; the National Deaf Children's Society runs free family sign courses. Talk to Deaf adults.

For a child at school: check the hearing aids daily, ask for a radio aid, and ask the teacher to face the class, repeat other children's answers and caption videos. Deaf awareness training for the class helps more than most things.

For an adult: get a hearing test this month. Tell people what helps ("face me, one at a time"). Turn on captions. Try a hearing loop wherever there's a sign.

Where to get help

The National Deaf Children's Society supports families of deaf children with a helpline, family sign courses and education advice. RNID covers adults, with hearing checks, technology and rights advice. The British Deaf Association is the Deaf community's own organisation, and SignHealth works on Deaf people's health. Hearing Link supports adults adjusting to hearing loss. NHS audiology is via the GP, and every deaf child has a teacher of the deaf through the council.