Cultural Competency When Working with Persons with Hearing Loss

Alison Wetmur is a LCSW for ChangeInc. Today Alison is sharing a reference guide for us to utilize when working or communicating with individuals with hearing loss.

Quick Statistics: Compiled by the National Institute on Deafness and Other Communication Disorders (NIDCD).[1]

  • Approximately 17 percent (36 million) of American adults report some degree of hearing loss.
  • There is a strong relationship between age and reported hearing loss: 18 percent of American adults 45-64 years old, 30 percent of adults 65-74 years old, and 47 percent of adults 75 years old or older have a hearing loss.
  • Only 1 out of 5 people who could benefit from a hearing aid actually wears one. 

Important Terms:

Hearing impaired: the medical community’s term for people with hearing loss.  This term is not used or accepted in the Deaf community because it implies impairment that needs to be ‘fixed.’  Many Deaf and Hard of Hearing people do not consider themselves broken and therefore do not require ‘fixing.’

deaf: (Little d ‘deaf’) the actual audiological hearing loss that someone has; the inability to hear

Deaf: (Big D ‘Deaf’) someone who identifies as a member the Deaf community; knows, uses, and cherishes American Sign Language (ASL); follows Deaf culture and norms

Not everyone who is “Little d ‘deaf’” is “Big D ‘Deaf,’” but in order to be “Big D ‘Deaf,’” someone must be “Little d ‘deaf.’”

Hard of Hearing: someone who can interact comfortably with both hearing and Deaf people; s/he speaks as well as signs and usually uses an assistive listening device like a hearing aid or a cochlear implant

Late-deafened adult: An adult who has lost his/her hearing later on in life, perhaps as part of the normal aging process.  S/he most likely does not know ASL and may find communication and socialization difficult, which can create a sense of isolation and/or depression


  • When working with persons with hearing loss, the important thing to remember is that you should never assume that you understand how they would like to communicate (not every deaf person signs, but all Deaf people do!), or even what they self-identify (or call) themselves. Ask him/her how they would like to be called, and proceed from there.
  • When working with someone who is Deaf, don’t assume s/he can read and write English at an adult level. American Sign Language is NOT English—it has its own grammar and syntactical structure.  English is a very difficult language to learn if it is not someone’s native language, and many Deaf people may not be more than basically fluent in written English.  Instead, use gesture or fingerspelling if needed.


[1] From “Quick Statisics”

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