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Deafness

Key points about deafness

Deafness is a partial or complete loss of hearing.
You may be born with deafness or it may occur at any stage of life.
Deafness is measured by categories of mild, moderate, severe or profound hearing loss. This page focuses on severe and profound deafness.
People who have been deaf since birth or early childhood are likely to identify as members of a Deaf community and generally use New Zealand Sign Language as their preferred means of communication.

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Deafness can occur as a result of illness, accident, over-exposure to noise, drugs and medication, trauma, genetics or simply getting older. You may be born with deafness or it may occur at any stage of life.
Deafness is measured by categories of mild, moderate, severe or profound hearing loss. This page focuses on severe and profound deafness. You can read more about hearing loss in adults(external link) and hearing loss in babies and children(external link).
People who identify with the Deaf community generally regard this as a language and cultural identity rather than a disability.
People who have been deaf since birth or early childhood are likely to identify as members of a Deaf community and generally use New Zealand Sign Language as their preferred means of communication.
Hearing impaired people who become deaf later in life and some other deaf people can speak and lip read.
NZSL users typically access appointments with public service providers through NZSL interpreters. NZSL users have various levels of literacy as childhood deafness affects the development of childhood literacy.

Hearing loss at birth is known as congenital hearing loss, while hearing loss that occurs after birth is called acquired hearing loss.

Congenital hearing loss

Some of the many causes of congenital deafness include the following:

Hereditary disorders – this means parents pass on affected genes to their children. In most cases, hereditary hearing loss is caused by malformations of the inner ear.
Genetic disorders – genetic mutations may happen, for example, at the moment of conception. Some of the genetic disorders that can cause deafness include osteogenesis imperfecta, Trisomy 13 (Patau syndrome) and Treacher Collins syndrome.
Prenatal exposure to disease – a baby will be born deaf or with hearing problems if they are exposed to certain diseases in utero, including rubella (German measles), influenza and mumps. Other factors that are thought to cause congenital deafness include exposure to methylmercury and medications such as quinine.

Acquired hearing loss

Acquired hearing loss from other causes throughout life may also lead to severe or profound deafness. These include noise-related hearing loss, illness, accident or trauma and aging-related hearing loss. See hearing loss in adults for more information.

Hearing loss is measured in decibels hearing loss (dB HL). It can be graded as follows:

20-40 dB HL: mild, cannot hear whispers.
41-70 dB HL: moderate, cannot hear conversational speech.
71-95 dB HL: severe, cannot hear shouting.
>95 dB HL: profound, cannot hear sounds that would be painful to listen to for a hearing person.

Read more about the symptoms of hearing loss in adults and hearing loss in babies and children.

Audiologists carry out tests to assess your level of hearing. They begin by examining your ear canal with an otoscope. This helps them identify any temporary problems that may affect your hearing, such as build-up of ear wax or a burst eardrum.

You then wear headphones to do a tone test, where you listen to beeps at different pitches. The beeps get quieter until you no longer hear them.

Your cochlear (inner ear) may also be tested and you may be given a speech test to check you understand the sounds of speech. Read more about hearing tests for adults.

Apps reviewed by Healthify

You may find it useful to look at some Hearing test apps.

Some deafness is treated with the use of hearing aids. Hearing aids are most effective at helping mild, moderate or severe hearing loss caused by conductive hearing loss or reduced sensory hearing loss.

Hearing aids are usually not as effective as cochlear implants for assisting very severe or profound hearing losses.

Hearing aids can also provide some benefit for hearing problems caused by damage to the hearing nerve or brain.

People who have lifelong severe or profound deafness may identify socially as Deaf. In Aotearoa, members of the Deaf community use New Zealand Sign Language to communicate and they are less likely to see treatment for deafness.

Deaf Aotearoa(external link)(external link) A national organisation representing Deaf people (primarily NZ Sign Language users), and the national service provider for Deaf people in New Zealand
Hauora(external link)(external link) Deaf Aotearoa’s service for Deaf and hard-of-hearing people that provides needs assessment and coordination, applications for assistive equipment and information and advice
The National Foundation for Deaf and Hard of Hearing NZ(external link) This national organisation promotes the interests of over 880,350 New Zealanders who are deaf or hard of hearing
Deaf or hearing loss equipment for adults(external link) Whaikaha - Ministry of Disabled People
Cochlear implants(external link) Whaikaha - Ministry of Disabled People
Guide to Getting Hearing Aids - Hearing Aid Funding Scheme(external link) Ministry of Health, NZ, 2016
Deaf or hearing loss equipment for adults(external link) Whaikaha - Ministry of Disabled People
Deafness support groups Healthify He Puna Waiora, NZ, 2018

Here are some tips to help you communicate with deaf people:

Avoid background noise when communicating with someone with a hearing aid.
Speak clearly and a little more slowly and rephrase rather than repeat what you said if they don’t understand you.
Use simple gestures, write information down and point to subjects or objects.
Keep your lips and face clear of things that get in the way (eg, hands, cups, large moustaches)
Book an NZ Sign Language interpreter if you are organising an event.

If you are using NZ Sign Language:

Make sure the light is in front of you – try not to stand in front of a window. Dim light makes it hard to see facial expressions and sign language.
When signing, face the Deaf person and get their attention before speaking. Maintain eye contact and don’t turn away when they are signing to you.
If you didn’t understand what a person signed to you get them to sign it again. It's okay to check, clarify or ask them to slow down.
Give the other person enough space for arm movements.

Getting attention and interrupting conversations

Deaf people ask for attention by waving, stamping, touching or tapping one another, or switching lights on and off, so if someone deaf does any of those things, turn and face them.

Deaf people can’t interrupt conversations the way hearing people can. They need to see what is being said, so they can only pay attention to one person at a time. Deaf people wait for the person who is signing to stop before the next person signs.

Deaf people get annoyed when they are signing and the other person breaks eye contact and looks away. That is not a polite way to handle an interruption. Culturally polite ways to interrupt a signed conversation include to:

wait for a small pause before interrupting
wave or tap the shoulder of the other person lightly and then wait for them to look at you
tap harder if it’s urgent
before breaking off a conversation, tell the person you are talking with to ‘hold’, or point to the interruption so they can see why you will look away.

When two people are signing, it is okay to walk quickly between them – you don’t need to bend down.

Source: Deaf Aotearoa(external link)

For healthcare providers working with Deaf and hearing-impaired clients

Video: Say that again

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(Deaf Aotearoa, NZ, 2012)

Video: DHB staff captioned

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(Capital & Coast DHB, NZ, 2018)

Video: DHB staff no captions

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(Capital & Coast DHB, NZ, 2018)

Videos of Deaf people in Aotearoa New Zealand sharing true stories of who they are.

Video: It made me think about life – Andrew’s story

(Click on the image below to watch the video) This video may take a few moments to load.

(external link)
(Watch Us, NZ, 2019)

Video: I'm deaf; they're hearing – Shona’s story

(Click on the image below to watch the video) This video may take a few moments to load.
(external link)
(Watch Us, NZ, 2020)

Video: I learnt and learnt – Sharleen’s story

(Click on the image below to watch the video) This video may take a few moments to load.
(external link)
(Watch Us, NZ, 2019)

For more videos in the same series, visit Deaf people’s stories(external link) (Watch Us, NZ)

Video: Deaf health stories in New Zealand Sign Language

This video may take a few moments to load.

(Sign Language Section, NZ, 2017)

Hearing loss topics | Taringa turi
Hearing loss in adults | Taringa turi
Hearing loss in babies and children | Taringa turi
Hearing tests in adults
Deafness support

The following links provide further information about deafness. Be aware that websites from other countries may have information that differs from New Zealand recommendations.

Hearing problems(external link)(external link) Patient Info, UK, 2016
Deaf awareness courses(external link) Deaf Aotearoa, NZ Provides training to businesses and organisations about Deaf culture, the Deaf community and overcoming communication barriers with Deaf clients, ensuring all customers receive a positive experience.
First Signs(external link)(external link) Supports the learning of New Zealand Sign Language for family and whānau of Deaf or hard-of-hearing children aged 0–5 years.

Apps

Hearing test apps

Research about deaf communities' access to health services

"New Zealand Sign Language (NZSL) is the only language of many deaf people and the first and preferred language of others. It is also the basis for Deaf culture. The New Zealand Medical Journal recently published an article on the experiences of deaf people with NZSL health services. Following are a series of videos that translate the research in NZSL." Watch the first video in the series.(external link)