CHAPTER or the other aspects of their personality

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A.    Hearing
Impairment: A Brief Overview

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B.    Need
and Significance of the Study

C.    Statement
of the Problem

D.    Definition
of the Key Terms

E.    Objectives
of the Study

F.     Hypotheses

G.    Method
in Brief

H.    Organization
of the Report








We live in a world full of
diversity. Every form of living and non-living being is quite unique and
different from each other. At times we lack words to appreciate the
unimaginable creativity of God when we find that no single creation is an exact
replica of the other. A child is born in this world with its own unique
abilities and capacities of body and mind. Some are fortunate enough to have
extraordinary abilities or capacities, while others are averages or even suffer
from so many deficits and deficiencies from birthonwards. This gap between the
abilities and capacities of the children related to their development, learning,
and adjustment found at an early stage may further be widened by the nature of
the environmental differences encountered by them in their nourishment and
education. It results in labeling them as unusually superior or inferior,
capable or incapable in one or the other aspects of their personality

 Some children deviate physically, mentally,
socially and educationally from normal children. Such children are called
exceptional children and they require special educational care and their
adjustment problems have to be tackled in an exceptional manner(Bala&Rao,2007).

According to Bala&Rao (2007)
the exceptional children can be categorized into four groups:

1.  Gifted children with a high level of
intelligence or a special aptitude for music, painting etc.

2.  Mentally retarded or challenged children with
a low level of intelligence.

3.  Physically challenged children such as blind,
deaf, dumb, etc., and

4.  Socially disadvantaged children such as
orphans, destitute etc.

The physically challenged includes
the hearing impaired, partially hearing impaired, or hard of hearing, partially
sighted, crippled, cerebral palsied, and those with special health problems
such as cardiac problems, epilepsy and diabetes,the present investigation takes
into consideration hearing impaired adolescents, and hence a brief description
about them.

The hearing impaired can be
classified into two types-deaf and hard of hearing. Deafness is a severe
disability. Those people who are deaf have a hearing loss to the extent that it
prevents understanding speech though the ear. On the other hand, people who are
hard of hearing can process information from sounds and they can be benefited
by hearing aids. These two groups of people can be categorized further into various
sub-groups on the basis of

Degree of hearing
Causes of the
deficit, and
Onset of the
disability, and language development.

of hearing impairment

of hearing loss refers to the severity of the loss. The
classification of Clark (1981) on the basis of the degree of hearing impairment
is as follows:

i.    Mild
hearing loss (26-40 dB loss): 
Children with mild hearing deficit may find
it hard to follow speech, particularly in noisy situations. They
need full integration with the regular classes with special services and
materials provided under the guidance of the specialists. They have difficulty
in hearing distant sounds and require hearing aids or microphones with loud

ii.   Moderate
hearing loss (41-70 dB loss): Those with moderate hearing
deficit have difficulty following speech without a hearing aid.The
hearing impaired need partial integration in regular schools with some classes
in regular setting and some classes in special settings. They have difficulty
in hearing distant sounds as well as near sounds of low frequency and pitch.
They require both special training and hearing aids.

iii.  Severe
hearing loss (71-90 dB loss): Children who have severe hearing impairment
need self-contained programmes in partially integrated system of education. The
severely hearing impaired rely primarily on lip-reading, even with a hearing

iv.  Profound
hearing loss (Above 90 dB loss): Their hearing impairment is so profound
that they cannot be benefited by integrated classes in any way. These children
always need special classes and special schools to study by using very special
materials and techniques. It is because they can neither hear distant nor near
sounds even if the sounds are above normal frequency. They require lip reading
or Sign Language for learning.

(b)  Causes of the deficit

hear by channelling sounds from the environment into the external ear,
converting these sounds into mechanical vibrations in the middle ear, and
converting the vibrations into the neural signals that go to the brain. The
four major causes of hearing loss are:

i. Conductive
hearing loss occurs when sound does not get through the outer and middle
ear structures efficiently. Any blockage of the ear canal can interfere with
sound transmission. Conductive hearing loss is often caused by a buildup of
fluids in the middle ear due to infections.

hearing loss occurs when sound that gets to the
inner ear is not transmitted to the brain or is transmitted in a distorted
manner. Damage to the cochlea and the auditory nerve will bring about
sensorineural hearing loss.

auditory processing problems results from the inability of the brain to
process or interpret the signals that are delivered. This symbolic processing
disorder may show itself in the inability of a person to perceive sounds,
discriminate among sounds, or even comprehend language that is received. People
with auditory processing problems will usually have difficulty learning or
using language.

hearing loss occurs when a person has a combination of both a conductive
hearing loss and a sensorineural hearing loss.

(c)Onset of the
Disability, and language development:

House conference on Child Health and Protection (1931) provides the following

1.     Born
defectives are those who are born with sufficient hearing loss to prevent
the spontaneous acquisition of speech. The speech of these children will always
be defective and they will be dumb forever.

2.     Pre-lingual
deafness occurs before the development of language and speech. The speech
of the affected person is retarded throughout life.

3.     Post-lingual
deafnessoccurs after the development of language and speech. Educational
treatment for postlingual hearing loss usually centers on the maintenance of
speech and learning skills that were developed prior to the onset of the
hearing problem (Glover, 1931).

The following are the signs
and symptoms of hearing impairment:

1.   Difficulties following oral presentations and

2.   Requires frequent repetition.

3.   Watches lips of teachers or other speakers
very closely.

4.   Turns head and leans toward speakers.

5.   Uses limited vocabulary.

6.   Uses speech sounds poorly.

7.   Shows delayed language development.

8.   Often does not respond when called from

9.   Answers or
responds inappropriately in conversation

10. Constantly turns volume up on radio or

11. Complains of earaches, have frequent colds or
ear infections, or has ear discharge.

12. Feels stressed out from straining to hear what
others are saying(Mangal,2007).

Impairment and Sign Language

Importance of sign
language as a communication skill for the hearing impaired was pointed out by
Mangal (2007). According to him, sign language is one of the popular methods
included under manual communication approach among the hearing impaired. By
sign language used for teaching communication skills to the hearing impaired
children (especially the most severe and profound ones), we mean a special
language based on some visual signs. These signs are nothing but different
gestures or manual codes designed through the use of hands, fingers and the
arms for representing the words, ideas and concepts used in the process of
communication. Several sign language systems have been invented to develop
communication and language skills for the education of the hearing impaired


The modern world poses a wide
variety of challenges before us. Our senses are constantly being assailed with
new sensations, environments, and experiences. We have to develop coping
strategies that allow us to move with confidence and to deal with these
challenges without becoming overwhelmed. For many of us, this is a significant
task. For others, particularly those with a disability, it is a monumental

Disability affects the individual,
family,and society in many aspects and lead to high social and economic
consequences in the whole world. Indeed disability is the outcome of
restrictions in basic physical, spiritual, and mental functions and these
restrictions are of vital importance in each individual. The impact of
disability on the social–psychological statuses is undeniable,because
disability apart from its limitations has consequential effects on a disabled
person, such as emotional or behavioral problemsGallucci, Antuono, Ongaro,
Forloni, Albani, Amici, and Regini(2009).

Many people see disability as a
personal tragedy, as something that needs to be cured or prevented, as a
punishment for wrong-doing, or as an indication of the lack of ability to
behave as expected in society. Stigma in society
is stronger than we realize. The attitude of the public towards personswith
disability is very depressing as they face discrimination due to their

The present
investigation was carried out to understand certain specific problems faced by
one category of such individuals known as the hearing impaired. It may be noted
here that AHI were the target group under study.

Hearing impairment or deafnessrefers
to a total or partial loss of hearing ability. It may result from a great
variety of causes, like congenital factors, lifestyle factors, and
environmental factors. Diagnosing hearing loss is a difficult task.But failing
to do so can cause significant hearing problems, including language learning(Benjamin,
1997). Living in a world where one’s language is knownbya few and understood by
even fewer distorts their self-perception. For centuries, hearing impaired
people had to undergo the treatment of being viewed as incomplete because of
their absence of hearing.

Hearing is the sensory pathway
through which speech and verbal communication develop.As hearing is a condition
that affects one’s everyday life, it can have a serious impact on one’s
well-being.  In the absence of hearing,
language symbols are not perceived and learned. The cognitive abilities of an
individual without a language system would be reduced to a level of functioning
much closer to that of the lower species of animals.

It may be seen that hearing
impairment lowers the positive qualities of the affected persons. Research
shows that hearing impaired people have more mental health problems than the
general population (Kvam, Loeb, , 2007). About seven per 10,000
people worldwide are having hearing impairment severely or profoundly.

A study of the problems encountered
by the hearing impaired people, especially adolescents, is extremely essential
to understand the intensity of the problems faced by them. This disability
deprives language which, in turn, leads to serious educational backwardness or
causes certain psycho-social problems in the individual.

Most people are ignorant about problems
of the hearing impaired. Comparatively little has been written about hearing
impaired adolescents, yet of all the disabilities it has a crucial effect on
the quality of life of an individual. It affects speech, language, reading ability,
educational attainment, employment prospects, and social relationships. A
person with hearing impairment is confronted with the dilemma of having the need
to find ways to overcome the deficits. An individual’s well-being hinges upon
the ability to satisfy, at least in part, certain fundamental needs.

Further, having all the
natural tendencies and capacities but being defective, the hearing impaired
individuals have to face a lot of struggles in their life.The various emotional,
social and educational problems encountered by the hearing impaired community are
not given due consideration in today’s world. They are often neglected and
humiliated. Some of them even lose their capabilities to dream about their

Hearing impairment is not
just a health problem or attribute of an individual, but it reflects the problems
the individual experiences in his interaction with society and physical
movements. The hearing impaired remain neglected part of society, and they also
experience various obstacles in social participation due to their disabilities.They
show problems in their personal and social development because the handicap in
the development of their language creates a barrier for normal communication
with others and this barrier, plays an important role in their personal and
social development. In addition to the communication barriers they experience, the
hard of hearing and hearing impairedare victims of physical, emotional, and
sexual abuse (Knutson, Johnson, & Sullivan, 2004). One of the most
significant determinants of social handicap of the hearing impaired or the
partially hearing impaired is the self-realization of their inadequacy, which
causes inferiority or guilt in them.    

As far as the stage of adolescence
is concerned,it is a time when individuals are faced with the task of figuring
out their identities and to find an appropriate way to fit into the world as
they go through many physical, psychological, emotional and social changes.As
adolescence is a time of confusion, a period when children start to notice
differences between themselves and others, they become particularly susceptible
to social and cultural pressures (Choudhury,2010). It is a time of great emotional and
psychological change, of emerging sexuality and important life choices about
employment and education. During this transition period, adolescents, with
disabilities, may be vulnerable in society.It is
widely acknowledged that the greatest impediment to the lives of adolescents
with disabilities is prejudice,socialisolation,discrimination,and denial of
access to human rights as their non-disabled peers.Adolescents with hearing impairments are among one of the most
marginalized segments of the community.

A study of the problems encountered
by the hearing impaired adolescents is extremely essential to understand the
intensity of the problems faced by them. It is not wise to leave a large number
of frustrated adolescents as a burden to society,especially when a majority of
them can become,with a little assistance,well-adjusted and economically
productive individuals.

It may further be noted that hearing
impairment may lead to delayed speech, paranoiaand isolation in individual
arena;unreal laziness and false backwardness in educational arena; and antisocial
disorders and behaviors in social arena. Social anxiety disorder is one of the
problems seen among the individuals with hearing impairment. They were found to
suffer from more intellectual, behavioral, and emotional problems, including
incidence of socially inappropriate behaviors. Moreover, most of them experience
academic failures, peer avoidance, isolation, and depression (Hindley,2005).

People with hearing loss encounter
practical and social problems beyond those experienced by people who have their
hearing. This may increase the risk of people with hearing loss developing
mental health problems.The sources of the difficulties faced by the hearing
impaired adolescents lie partly in the social conditions, and partly in the
biological and psychological changes associated with growth and development.
Any approach to improve the conditions must take into account all these
factors. Psycho-social problems include
undesirable emotional, social, and behavioral aspects, such as anxiety,
loneliness, maladjustment, shame, and depression.  Development within these areas is associated
with one’s mental health, which is defined by WHO as “a state of well-being in
which every individual realizes his or her own potential” (WHO, 2014). There is a substantial continuity in psychosocial
difficulties from preschool years to middle childhood and adolescence (Luby,
Gaffrey, Tillman, April, & Belden, 2014),
thus emphasizing the importance of early intervention in this area.

The hearing impaired subjects feel
inferior, helpless, have poor self-concept, exhibit temper tantrums, are
submissive, have poor gross motor coordination, delayed hand preference,
hyperactivity, short attention span, emotional instability, slightly low
intelligence quotient than normal persons, poor language and communication
skills. They experience difficulty in understanding abstract concepts and have
difficulties in vocational adjustments(Panda,1997).

People who lose their hearing may
give up interests and activities, and this can have a negative impact on their
psychological wellbeing (Aplin,1987).Poor communication plays a large part in
increasing the risk of anxiety and depression, and it can lead to a feeling of
isolation in the profound hearing impaired  andpartial hearing impaired  people. Hearing impaired individuals were
reported to have significantly more depressive symptoms, lower self-efficacy
and mastery, more feelings of loneliness, and a smaller social network than
normally hearing peers (Kramer, Kapteyn,Kuik,&Deeg2002). They also suffer
rejection, alienation, doubt, fear, prejudice and bias (Alsaaideh, 2017).

According to  census in Kerala, 2011, there were about 102983
hearing impaired persons in Kerala(Indian Express,January,2016),as shown in
Table 1.1.


An Estimate of the Hearing

 Population in Kerala as per 2011 Census


of Hearing impaired































persons with disabilities deserve proper
care,protection,training,employment,and rehabilitation.  Accurate and dependable data relating to the
disabled population,type of disabilities,onset of disability,possible cause of
disabilities,rural and urban population, andtheir economic status are  highly essential for proper planning,framing
of policies,and developing programs in a focused manner  at State and Local level.

Even though there are several
welfare organizations in Kerala providing services for the disabled population,
it is doubtful whether the hearing impaired population is getting due
attention. There is a common misconception that providing hearing aids will
resolve half of their problems. Unfortunately many people are unaware of the
psycho-social problems faced by this silent minority. It may also be noted here that a vast majority of programs for the
disabled tend to focus either on young children or adults, without giving
specific attention to the needs and interests of adolescents. This can
negatively affect the opportunities for adolescents to develop skills and
participate in community life.

The hearing impaired needs a vast
improvement in their education, training, and employment. In India, very few
researches have been undertaken in the field of hearing impaired; especially,their
psycho-social problems. Studies in this area can provide effective guidelines for
dealing with the issues faced by the hearing impaired adolescents. The needs of
hearing impaired adolescents are strikingly similar to those of their
non-disabled peers, and most of these needs remain unfulfilled. In order to
help the hearing impaired adolescents achieve long-lasting development
prospects, they should be empowered. Those barriers should be removed, which
prevent them participating in their communities, getting quality education,
finding suitable jobs, and having their voice heard.

From what has been said
above, it becomesclear that an investigation highlighting the psycho-social
problems of adolescents will be of use to hearing impaired adolescents themselves,their
parents,teachers and society in general,so that useful measures can be taken by
counselors and Government for the welfare of these “silent minority”.

It is quite natural that hearing
impaired adolescents may feel isolated and are generally apprehensive about
their future.  They also have a tendency
to get worried and feel anxious about their future. Most often they are maladjusted
in their behavior. It is no wonder that they feel ashamed of themselves because
of their disability in hearing, and most often they may feel depressed. The
hearing–impaired suffer the tough and complicated life circumstances because of
their inability to communicate with the hearing population which leads to
isolation, aversion from others, anxiety, indifference and psychological alienation.
It could be said that the feeling of psychological alienation is the starting
point for many problems and disorders suffered by the hearing impaired. The
assumptions held in the present investigation may be similar to those of other
studies conducted in this area.

on five important psycho-social variables,as noted earlier,
namely,anxiety,loneliness, maladjustment,shame, and depression. These problems
were selected for the investigation especially because most of the AHI consider
themselves as inferior and inadequate and also face problems in dealing with
others in the society. All these factors affect this adolescents and may lead
to anxiety, loneliness, maladjustment, shame and depression.

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