Writing Without Sound - How to Write Deaf and Hard of Hearing Characters

What, Why, and How.

What kind of hearing loss does your character have?

Conductive Hearing Loss: This is when sound is not conducted properly through the canal to the eardrum and the tiny bones of the middle ear. Conductive hearing loss usually involves a reduction in sound level or the ability to hear faint sounds. This type of hearing loss can often be corrected medically or surgically.

Sensorineural Hearing Loss: This is when there is damage to the inner ear, or to the nerves that carry sound to the brain. It usually cannot be corrected medically. With SNHL, even loud speech can unclear.  It is also the most common type of permanent hearing loss.

Mixed Hearing Loss: This happens when there is be damage in the outer and/or middle ear AND the cochlea and/or auditory nerve. (This is what I have.)

How did your character become deaf/hoh?

Causes of Conductive Hearing Loss:

Poor eustachian tube function

Benign tumors

Absence or malformation of (or damage to) the outer ear, ear canal, or middle ear

Causes of Sensorineural Hearing Loss:

Illness

Ototoxic Medications

Genetics (oftentimes running in families)

Head trauma

Malformation of inner ear

Old age

Lound noises generally do NOT cause significant hearing loss unless they are very loud or very frequent.  Basically, playing your music too loud will not make you go deaf (you may damage your high-frequency hearing some)

What frequencies and decibels can your characters hear:

The below graph is really helpful when figuring out what exactly your character can hear. Most deaf and hard of hearing people have some residual hearing.

Hearing loss is often classified according to the shape of the audiogram.

Ski-slope loss is the most common kind of hearing loss. People with ski-slope hearing loss can often hear sounds at low frequencies, but not at higher ones.

Reverse-slope:

Cookie-bite loss:

Flat loss:

How is your character's understanding of speech affected?

Spoken words are reflected by the yellow (and purple) areas in the charts above. Each person's audiogram is unique. What they can hear is defined by what is BELOW the audiogram line.