SLPs and audiologists use clear, consistent, and culturally sensitive terminology whenever possible. Terminology used may be dependent upon context—different terminology may be used to describe factors such as
- hearing levels
- ages of onset/identification
- languages and communication modalities
- educational/professional backgrounds, and
- cultural identities or perspectives
Employers and publications may have different policies on the use of person-first and identity-first language. Terminology in the law and in clinical documentation may not reflect terminology used by some individuals who are deaf and hard of hearing. On Practice Portal pages, ASHA uses the following terms when discussing hearing-related topics.
When Describing a Person or a Group
- coda or CODA (Children of Deaf Adults): refers to typically hearing children born to Deaf parents who use sign language and balance their Deaf and hearing cultural experiences.
- deaf and hard of hearing: refers to a collective group that does not necessarily coincide with audiometric hearing thresholds.
- intended to be inclusive of an entire spectrum of individuals representing different hearing levels and types as well as varied cultural identities (“deaf or hard of hearing” when referencing an individual).
- Deaf (with an uppercase “D”): refers to an individual or group of people who identify as part of a shared Deaf cultural community regardless of hearing levels or hearing technologies used.
- typically use signed languages (e.g., American Sign Language)
- in this community, being Deaf is not viewed as a disability but as an attribute that positively contributes to society.
- deaf (with a lowercase “d”): refers to people who are audiologically deaf based on hearing thresholds in the severe-profound range, but who may or may not identify with Deaf culture.
- deaf-blind: refers to deaf or hard of hearing individuals who have low vision or are blind, thus limiting access to both auditory and visual information.
- deaf and/or hard of hearing with disabilities: refers to deaf or hard of hearing individuals with concurrent diagnoses (e.g., intellectual disability) who may exhibit more complex communication needs.
- hard of hearing: refers to people who have hearing thresholds in audiologic ranges that would typically result in functional benefit from amplification and/or hearing assistive technologies (e.g., 26 to 55 dBHL).
- some people who identify as hard of hearing primarily use listening and spoken language to communicate, while others use signed language or are bimodal-bilingual.
- late-deafened: refers to people who grew up hearing, then lost most or all their hearing later in life to the level of becoming audiologically deaf
- may communicate using a combination of spoken language, signed language, and/or other visual systems
For more information, see APA's style guidelines on bias-free language.
When Describing Audiological Assessment Results and Diagnoses
- atypical hearing: reduced hearing/decreased hearing thresholds at birth obtained outside of the typical range of hearing
- hearing loss: hearing thresholds outside the range of typical hearing
- typical hearing: hearing thresholds recorded within the normal range of hearing (-10 to 15 dBHL) on an audiogram (also described as “normal hearing”)
Terms used to describe audiological assessment have different values or interpretations assigned to them depending on context and cultural perspective. For instance, some people feel “hearing loss” should only be used to describe hearing loss after birth, not to describe those born without the ability to hear. Instead, they support terminology such as reduced hearing, decreased hearing levels, and Deaf-gain to reflect that being Deaf is not viewed as something lacking but instead as a gain, which positively contributes to their life and to society.
Terminology will continue to evolve as language is always evolving. Terminology addressing hearing abilities, hearing status, or hearing levels has become more acceptable than impairment-centered terminology, which can have a negative connotation. SLPs and audiologists note the date in which resources were originally created, and update terminology as appropriate.
Given this shift in focus toward people’s abilities rather than what they can’t do, avoid terminology such as “hearing impaired” or “hearing impairment” unless referring to the Individuals with Disabilities Education Act (IDEA) disability category or a payer term used for reimbursement purposes, or unless an individual self-identifies in this manner.