Hearing Impairment

Hearing plays an important role in development and daily performance. Hearing impairment occurs when there's a problem with, or damage to, one or more parts of the hearing mechanism.

Specialist Behaviour Support Services and Speech Pathology

young child's ear being examined by a doctor to assess for hearing impairment

Definition of Hearing Impairment

Hearing plays an important role in development and daily performance. Hearing impairment occurs when there's a problem with, or damage to, one or more parts of the hearing mechanism.

Types of Hearing Impairment

Hearing impairment can be classified into four categories depending on the site of the problem in the ear: conductive, sensorineural, mixed, and central auditory processing disorder:

  • Conductive hearing loss: a conductive hearing impairment results from blockage or damage to the outer or middle ear structures. This problem interferes with the transmission of sound through the outer and middle ear to the inner ear, resulting in reduced loudness of the sound. Conductive hearing loss can fluctuate according to the presence or severity of the blockage.
  • Sensorineural hearing loss: sensorineural hearing loss results from damage to the inner ear or the auditory nerve. Sensorineural hearing loss can range from mild to profound, and often affects the individual's ability to hear certain frequencies more than others. Thus, even with amplification to increase the sound level, the individual with sensorineural hearing loss may perceive distorted speech sounds, resulting in difficulty with understanding speech and interpreting various sounds (quantity and quality of sound). 
  • Mixed hearing loss: mixed hearing loss refers to a combination of conductive and sensorineural hearing loss, indicating that there may be damage in the outer or middle ear and the cochlea or auditory nerve.   
  • Central auditory processing disorder: this form of hearing impairment occurs when the auditory centers of the brain are affected by injury, disease, tumor, heredity, birth trauma, head trauma, or unknown causes. Although the outer, middle, and inner parts of the ear deliver sound signals, these signals are unable to be processed and interpreted by the brain. Thus, even though the person’s hearing may be normal, there are difficulties with understanding what is being said, resulting in learning problems.


Causes of Hearing Impairment

Causes for conductive hearing impairment include excessive earwax (cerumen); middle ear infections (such as otitis media, when pus, fluid build-up or inflammation causes pain and reduces the ability of the eardrum to vibrate); a hole or perforation of the ear drum and otosclerosis (the eardrum and the ossicles have decreased mobility). In many cases, a conductive hearing impairment can be corrected with medication, hearing aids, or surgery.

Causes for sensorineural hearing loss include genetic disorders (which can interfere with proper development of inner ear structures); injuries; complications during pregnancy or birth; infections or illnesses (such as mumps, measles, chickenpox) and medication side effects.

Causes for mixed hearing loss include damage in the outer or middle ear and the cochlea or auditory nerve. 

Causes of central auditory processing disorder may be genetic, a brain injury, diseases and repeated middle ear infections.


Symptoms for Hearing Impairment

Possible signs of a hearing impairment include:

  • Lack of, or delayed development of, speech and language.
  • Not responding when addressed.
  • Difficulty with following directions or instructions.
  • Seeming distracted and/or confused.
  • Turning head to position ear in the direction of the speaker.
  • Favouring one ear over another.
  • Using a loud voice when speaking.
  • Mispronouncing words (such as misarticulation of certain speech sounds or omitting certain consonant sounds).
  • Asking for information to be repeated frequently.
  • Appearing to be inattentive, restless, tired, or daydreaming
  • Getting distracted easily by visual or auditory stimuli.
  • Intently watching faces during conversation.
  • Giving incorrect answers to questions.
  • Not being startled by loud noises.
  • Preferring to be by themselves (i.e., playing alone rather than with a group, or withdrawing from social situations).
  • Problems hearing environmental sounds (i.e. doorbell, telephone ringing, people calling).
  • Sitting close to the sound source (e.g. TV, radio, and/or turning up the volume).


Behaviour Help

If you are supporting an individual with this diagnosis, please refer to our services and resources. They aim to help children, adolescents and adults achieve better communication, social, emotional, behavioural and learning outcomes. So whether you are wanting guidance on parenting, teaching, supporting or providing therapy, Behaviour Help is at hand.

Note: This is not an exhaustive list of all the possible causes, symptoms and types but some general information that can be further explored. Based on what you have read if you have any concerns about an individual, please raise them with the individual/s. The caregiver can then raise these concerns with their local doctor who can provide a referral to the relevant professional (e.g. paediatrician, psychologist, psychiatrist, allied health professional and learning specialists) for diagnosis and treatment if appropriate.

Which resources are right for you?


Based on the Taking CHARGE of Rainbow of Emotions Workbook this app helps children of all ages develop emotional regulation skills. The app guides the child to firstly, identify and express their emotion in appropriate ways. Then the child is guided to use emotional management tool/s from the CHARGE tool kit to manage their emotions in a healthy way.

The acronym CHARGE stands for the different categories of emotional management tools – Chat tools, Helpful thinking tools, Amusement tools, Relaxation tools, Good routine tools and Exercise tools.

Behaviour Help App - Using the evidence-based approach of Positive Behaviour Support (PBS), the Behaviour Help web-based app allows people supporting individuals with emotional and behavioural difficulties to complete a Functional Behaviour Analysis and put together a comprehensive Behaviour Support Plan (BSP). The BSP can then be used by everyone interacting with the individual to manage and prevent challenging behaviours and ultimately improve their lives, and the lives of those who support them.


If you want to learn more about emotional and behavioural difficulties then we have a great range of books you can read on your Kindle or order from Amazon.


Personalised and practical one to one help tailored specifically to your family.

Online Courses

Access these online courses anytime online to learn about a range of diagnoses, practical skills and strategies to help develop the individual’s emotional regulation skills. Also learn to utilise the positive behaviour support framework to address anxiety, aggression, ADHD, ASD and ODD.

SEL Educational Videos

Minimise or eliminate the occurrence of challenging behaviours by teaching children of all ages appropriate ways of communicating, interacting, managing their emotions and behaviours.

The SEL curriculum uses video modelling to provide direct, explicit and systematic teaching of the various skills by discussing the importance of the skill, modelling the skill so the child learns what the skill looks like? sounds like? feels like? and learn the skill in staged situations that simulate real life scenarios.


Personalised and practical behaviour therapy tailored specifically to your family.


Webinars discuss a range of practical strategies to guide your child learn positive ways of behaving and managing their emotions.


Attend our practical and interactive workshops to learn about a range of diagnoses, practical skills and strategies to help develop the individual’s emotions, behaviours, social and communication skills in your learning environment.

Ask Dolly

Since you’re here, you probably have questions and concerns. I am Dolly Bhargava, am here to help. I am a NDIS registered behaviour support practitioner and speech pathologist.

I have worked in a number of settings for over 21 years so, how can I help?

Please tell me what is worrying you right now and I will do my best to recommend resources and/or services that will be most useful to you in your situation.

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