What Is the Difference of Deaf or Hard of Hearing?

3 girls communicating with american sign language
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What is the difference between being hard of hearing (HOH) and being deaf? It depends on who you ask. 

Medical Definition

A complete hearing test looks at how loud sounds across the frequency range have to be in order to be detected and how well a person understands speech. If you are unable to detect sounds quieter than 90dB HL, the hearing loss is considered a profound hearing loss for those frequencies.

If the average of the frequencies at 500Hz, 1000Hz, and 2000Hz is 90dB or higher, the person is considered deaf. 

A person who is hard of hearing can have a range of hearing loss from mild to severe. It should be noted that amplification technology is available for people with mild to profound hearing loss. 

Cultural Definition

The cultural definition is much different than the medical definition. According to the cultural definition, being deaf or hard of hearing has nothing to do with how much you can hear! It has to do with how you identify yourself - do you identify more closely with hearing people or with deaf people? Many medically hard of hearing people consider themselves culturally deaf. Sometimes, this difference between cultural deafness and those with profound hearing loss can be indicated in the way the word "deaf" is written. If you see "Deaf" with a capital D, this indicates deaf culture, while deaf spelled with a lowercase d indicates hearing loss and the person does not consider themselves part of deaf culture.


Psychological Definition

Have you ever heard a person who was medically and functionally deaf insist, "I'm not deaf, I'm hard of hearing?" This statement is often made by people with hearing loss who are in denial about the degree of their hearing loss and are not yet ready to admit the severity of their hearing loss.

With the advances in the technology of cochlear implants, many more people with profound hearing loss are able to communicate orally and participate as a hearing person. It's all about personal choice. 

Dual Definition

Are people with cochlear implants whose hearing losses are reduced to as little as 20 dB hard of hearing or deaf? In the author's layperson opinion, the answer is, "both." When a person with a cochlear implant has the implant on and can hear well, they are hard of hearing. When the implant is off and they can not hear anything, they are deaf. The same is true for hearing aids. Long ago, the author would say that she was "on the air" when wearing her hearing aids and functioning like a person with hearing loss, but "off the air" when not wearing the hearing aids and unable to hear anything.


Community and Culture - Frequently Asked Questions (n.d.). National Association for the Deaf. Retrieved 1/26/2016 from https://nad.org/issues/american-sign-language/community-and-culture-faq

What is Deaf Culture? Deafculture.com. Retrieved 1/26/2016 from http://www.deafculture.com/definitions/

Updated by Melissa Karp, AuD

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