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Sign Language Studies

American Annals of the Deaf

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Reflections: My Life in the Deaf and Hearing Worlds
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Degrees and Types of Hearing Loss

The terms mild, moderate, severe, and profound are frequently used to roughly delineate different degrees of hearing loss. A mild hearing loss means that a person might have difficulty following conversations, particularly in a relatively noisy setting, often without using a hearing aid. A person with a moderate hearing loss probably would need to turn up the volume on a television or a telephone and would almost certainly benefit from using a hearing aid. A person with a moderate hearing loss might also benefit from closed captions on television programs. A severe hearing loss means that the person needs a powerful hearing aid and will likely have considerable difficulty understanding conversations without lipreading, especially in noisy situations. Many people with a moderate to severe hearing loss are candidates for cochlear implants, especially if they do not derive much benefit from using a hearing aid. People with a profound hearing loss can hear only extremely loud sounds, such as a lawnmower or fire truck, without amplification. Given the likelihood of poor discrimination ability even with an aid, most individuals in this category would be candidates for implants.

More technically, a person who is moderately hard of hearing might be described as having a 50-dB (decibel) average hearing loss, whereas a person who is severely hard of hearing might have a 90-dB loss. This means that if a person with “normal” hearing can hear a sound (a dripping faucet, for example) at 20 dB (very soft), it would require amplification to 50 dB for a person who is moderately hard of hearing to hear the same sound and amplification to 90 dB for a person with a severe hearing loss to hear the sound. It is important to keep in mind that because the decibel scale is logarithmic, rather than linear, each 10-dB increase corresponds to a tenfold increase in sound pressure level. That is, a sound at 50 dB is 1,000 times greater than a sound at 20 dB (10 × 10 × 10). In this example, for a person with a moderate hearing loss to hear the dripping faucet, the sound would have to be 1,000 times greater than it needs to be for a person without a hearing loss. And for a person with a 90-dB hearing loss? The sound of the dripping faucet would have to be 10 million times greater—that is, more intense—for the person to be able to hear it (10 × 10 × 10 × 10 × 10 × 10 × 10).

In addition to these different degrees of hearing loss, there are also several different types of hearing loss, including conductive, sensorineural, and mixed. A conductive hearing loss occurs because of a problem in the outer or middle ear that interferes with the transmission or conduction of sound waves to the inner ear. This type of hearing loss is frequently mild or moderate and often can be corrected by surgery or by draining fluid from the ear. A sensorineural hearing loss, which is caused by damage within the cochlea—especially damage to the thousands of microscopic hair cells in the cochlea or to the acoustic nerve linking the cochlea to the brain—is permanent and usually cannot be corrected by surgery. A sensorineural loss can range from mild to profound. A mixed hearing loss would be a combination of both conductive and sensorineural types of hearing loss.

The Looking-Glass Self

As I grew older, it became increasingly apparent to me that there was often a poor fit between what I thought about myself and what others thought about me. I continue to have an image of myself as a reasonably friendly and outgoing person (as my daughter Amanda, who is no doubt totally objective in these matters, reminds me). However, many of my former high school friends and classmates, in the unlikely event they remember me at all, might not see me that way. This would be perfectly understandable. The guy sitting quietly on the sofa, or off in the corner during a party and not contributing much besides some embarrassed head nodding and an occasional and often irrelevant comment is not likely to be invited back to many parties. In such situations, good friends in elementary school or junior high (middle) school have a way of becoming more difficult to stay in contact with by the time high school rolls around.

Sociologists often talk and write about something called the looking-glass self, a concept associated with the late Charles Cooley, who taught for many years at the University of Michigan. Looking-glass is another term for a mirror, but in a sociologist’s conceptualization, a looking-glass is one’s audience, typically friends, classmates, family, and coworkers, not an actual mirror. In this perspective, our feelings about ourselves, our self-image as it were, are based to a great extent on what we think others think about us, how we perceive ourselves as reflected in the reactions of others. If we believe others think well of us, this naturally makes us feel pretty good about ourselves. If we think they don’t, the opposite is likely to occur. What’s important here is our perception of what others think about us, not how they might really feel.

For many deaf and hard of hearing people, there is often a bad fit between the image we have of ourselves and the image other people may have about us (or, more precisely, the image we think other people have about us). I’m sure this observation is true for many other people as well. For example, a well-educated, well-dressed, professional African American man who can’t get a taxi may experience a dissonance between his image of himself and the cab driver’s perception. No doubt many people with disabilities that are more visible than being deaf or hard of hearing have similar experiences.7

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