Join NCRA   |  Store  |  NCRA Online Sourcebook  |  FAQ  |  Resource Center  |  Contact Us
Certification & Training

PDC Test - Characteristics of Hearing Impairment

You can earn 0.25 PDC by passing the exam following this article, which has been approved for publication by NCRA's Council of the Academy of Professional Reporters.

The questions are based on the material in the article but some may require additional research. Send your answer sheet to NCRA's Continuing Education Office, 12030 Sunrise Valley Drive, Suite 400, Reston, VA 20191, and enclose a check for $40 (member) or $50 (non-member) to cover the processing fee. 

Characteristics of Hearing Impairment

By Renee Cohen

A ringing phone, an alarm clock, the sound of running water. These occurrences are so common in our everyday lives.  But what if you were hearing-impaired? How would life be different if you could not do something as simple as use an ordinary telephone?

Have you ever stopped to think about how certain experiences manifest themselves in our brains?

It's amazing that invisible vibrations are interpreted and used as human communication tools. Like most of nature's gifts, we take sound and hearing for granted until we experience problems. Considering that there are approximately 28 million deaf and hard-of-hearing individuals in the United States today, we should probably pay more attention to our auditory mechanisms.

Sound passes through our ears as vibrations, which then stimulate nerves to send impulses to the brain. Familiar sounds and relative pitches, tones and pulses are processed and we interpret what we hear. Based on frequency and intensities, we are able to detect speech and other noises in our environment.

Degrees of hearing loss are measured using the decibel, or dB, threshold. Normal hearing is in the 0-25 dB range, and is characterized by no difficulty perceiving human speech, including whispers, or the sound of rustling leaves. Mild loss is between 25-40 dB, which is about the frequency of a ticking clock. A moderate loss is usually evidence of the need for a hearing aid, in the 40-55 dB range, while profound loss is significantly more disabling. The pain threshold for sound is generally considered to be 125-140 dB, which is the frequency emitted from a jackhammer at close range.

Hearing losses are categorized into five basic types:
1. Conductive hearing loss is due to dysfunction of the outer or middle ear, with a normal inner ear and central nervous system. A common cause of conductive hearing loss is associated with upper respiratory infections, but trauma or physical blockage, such as excess wax, can also disrupt the transmission of sound.

2. Sensori-neural hearing loss is due to inner ear dysfunction. It’s the most prevalent and also is a noncorrectable type of disorder. In this situation, there is sensory or nerve damage in the inner ear, the auditory nerve or the auditory cortex of the brain.

3. Central loss is the also most difficult to evaluate. Some of the causes include congenital brain damage or malformation, brain trauma or tumor, or ototoxic drugs. When surgical procedures are used for central loss, they are usually directed at saving the patient's life, rather than restoring hearing.

4. Mixed loss refers to the presence of both a conductive and sensori-neural loss in the same ear.

5. Functional loss is when the hearing impairment has no organic basis.

In addition to the physical manifestations of hearing loss, there are many social considerations that may not be readily apparent to those of us with normal hearing. Most importantly, an individual's support systems are indicative of degrees of appropriate social and emotional development. The family dynamics and socioeconomic levels play a significant role in a hearing-impaired person's life, as well as educational level and parental intervention, or lack thereof. Stereotypes, for obvious reasons, are generally harmful to people with hearing disabilities, i.e., deaf and dumb.

Gallaudet research indicates that 90 percent of deaf children are born to hearing parents. Most of the hearing parents of deaf and hard-of-hearing children have significant difficulty accepting the impaired condition of their child. Therefore, there is limited intervention at an early age, when development of communication skills is most crucial. Psychological factors, availability of resources and financial considerations also limit the language development of those who are born deaf. The initial deprivation of communication acquisition is extremely difficult to compensate for at later phases in life.

At the other end of the spectrum, we see families with hearing-impaired relatives become immersed in deaf culture, learning sign language and lip reading, and joining groups of similarly situated individuals where encouragement and support are offered. These people may also be mainstreamed through the educational system, where they are offered accommodations and rehabilitative measures. Success or failure in such settings is based entirely on individual attitudes and coping skills.

Mainstreaming deaf students in school can have both beneficial and adverse effects. On the one hand, a deaf child may be quite comfortable in the culture of his or her community, using American Sign Language proficiently and making progress academically. Once enrolled with the general population, that individual may feel forced into fitting into a hearing world, with intensive speech therapy, and ensuing lifetime psychological scars. Personality characteristics of the individual should be taken into consideration when deciding on intervention and/or rehabilitative methods. Some of the accommodations that are available today for hearing impairments include TTDs and TTYs, assistive listening devices, hearing aids, cochlear implants, and, most recently, realtime captioning. Many deaf and hard-of-hearing individuals have found a renewed sense of importance with the advent of Internet communications. Using e-mail is as rewarding and informative as a telephone conversation.

As I mentioned earlier, the number of hearing-impaired individuals in the United States today is about 28 million. In comparison, there are approximately 40,000 court reporters in the country. The ratio is around 700 to one. Wouldn't it be wonderful if each one of us could help at least one deaf person experience the joy of hearing what someone said verbatim?


Characteristics of Hearing Impairment Test

Most of the answers to the questions will be found in the article.  However, for some questions it will be necessary to consult a medical dictionary.


1. Hearing loss with no organic basis is: a) conductive loss  b) mixed loss c) functional loss d) central loss. 


2. Hereditary conditions, including incompatible Rh factors during the prenatal period, are examples of: a) central loss b) sensori-neural loss c) functional loss d) mixed loss.


3. When volume is reduced but sounds are not distorted, the hearing loss is considered: a) conductive b) sensori-neural c) mixed d) functional.


4. A hearing aid can amplify sound, but cannot a) increase understanding of sounds b) improve clarity of sounds c) impact physical conditions d) cause further distractions.


5. Removal of wax or a foreign object from the ear will help which type of hearing loss: a) profound b) conductive c) moderate d) central.


6. Many deaf children have never seen: a) hearing aids b) sign language interpreters c) deaf adults d) ear wax.


7. There are approximately ______ deaf and hearing impaired individuals in the United States today:  a) 2,800 b)28,000 c)280,000 d) 28,000,000.


8. A brain tumor or trauma are causes of a)conductive loss b) central loss c) sensori-neural loss d) functional loss.


9. Mainstreaming deaf individuals can affect all but which of the following: a) psychological development b) emotional development c)cochlear implantation d) learning mechanisms.


10. An immediate remedy to the communication barrier experienced by deaf individuals is a) hearing aids b) cochlear implants c) paper and pencil d) parental intervention.


11. What percent of deaf children have hearing parents? a) 25 b) 50 c) 75 d) 90


12. A ruptured or perforated tympanic membrane is an example of: a) functional loss b) mixed loss c) central loss d) conductive loss.


13. An upper respiratory infection or enlarged adenoids may result in a) conductive loss b) central loss c) functional loss d) sensori-neural loss.


14. Factors which affect communicative development include all of the following, except a) level of loss b) age of onset c) parents’ education and socioeconomic level d) local climate.


15. The threshold of pain is closest to a) 25 dB b) 50 dB c) 140 dB d) 200 dB.


16. Speech therapy is a) always indicated for deaf individuals b) a rehabilitative measure c) only helpful for children who are deaf d) a psychological remedy for impairment.


17. Stereotypes of deaf culture may include phrases such as a) deaf and dumb b) deaf by choice c) selective hearing d) all of the above.


18. One accommodation for deafness is a) Braille type b) realtime captioning c) corrective lenses d) a metronome.


19. When parents learn their child may have a hearing loss, the immediate reaction for most is a) denial b) complete acceptance c) difficulty accepting the condition d) medical intervention.



20. Sounds are created by a) vibrations b) electromagnetic waves c) cellular function d) aqueous fluids.