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Hearing Impairment, Tinnitus 

     Though both terms "deafness" and "hearing impairment" refer to a degree of hearing loss, they are associated with various definitions depending on context and language. When in doubt, it is best to ask for clarity from the person in question. In this handbook, hearing impairment will refer to a broad panel of hearing losses, including deafness. The latter will then refer to a level of profound or complete hearing loss that keeps one from understanding speech, with or without amplification. A hearing impairment can be due to a sensorineural hearing loss (damaged inner ear), a conductive hearing loss (altered sound transmission from the external or middle ear to the inner ear), or a mixed hearing loss (combination of sensorineural hearing loss and conductive hearing loss). Regardless of the impairment's cause, several levels of hearing losses are categorized: mild (loss of 25 to 40 dB), moderate (loss of 40 to 60 dB), severe (loss of 60 to 80 dB), and profound (loss of more than 80 dB).

     To make up for hearing impairment, one can wear hearing aids or a cochlear implant. In addition, some more informal techniques such as lip-reading and guessing using context cues can help discern the general topic of a discussion. However, these solutions cannot provide full compensation for one's hearing loss. Indeed, even when one's hearing aids are well functioning, they do not bring their hearing level up to an average hearing person's. Moreover, lip-reading mostly works in expected situations where one's interlocutor talks about a known topic and if the keywords are simple. Thus, even when mild or moderate and partially compensated by an amplification system, a hearing loss can make social interactions, lectures, and many other parts of one's everyday life very challenging and taxing. Note that a hearing loss is not selective and occurs regardless of a situation's level of complexity: one might not be able to hear or understand even the most straightforward words during a discussion. This can lead to confused reactions or unexpected questions as their answers seem evident to hearing people. In general, only a written document can assure that the information will be understood completely. In some cases, the person with a hearing impairment may not be aware that they miss out on a piece of information.

     A related condition is tinnitus. Tinnitus translates to having ringing or other noises in one or both ears. Those noises are not caused by external sound and can usually only be heard by the person in question. The noises can be very diverse, as can be their volume. For some, the noises come and go, whereas, for others, they are constantly present. Tinnitus can alter one's ability to concentrate, fall asleep, hear external sounds and is associated with anxiety or depression.

In class


What is happening when the issue arises


Why is the situation challenging?


How can the situation be made more accessible?

The lecturer is speaking, and writing on the board or walking around the room at the same time. 

The student cannot see the lecturer’s face; their voice is projected in the opposite direction of the students’ position in the classroom. A student with a hearing impairment will likely miss the keywords or part of the information.

- Ask the teacher to repeat. 

If the teacher does not see the student raise their hand, they could need to interrupt them if the information is crucial to the comprehension of the following sentences. 


- The student may miss the simplest word and their questions can be unexpected.


- Use of the PowerPoint can partially help as it does not have the lecture’s script but some of its key points. 

- The teacher asks a question, a student answers. The answer is not repeated or rephrased, and the class moves on. 


- A student asks a question; the lecturer answers with a closed type of response (Yes / No)  or without using the question’s keyword.

Depending on where the student sits, a student with a hearing impairment might not be able to hear their voice and will most likely miss the student’s answer or questions. 

Ask the teacher to repeat what was asked and answered even though this might interrupt the flow of the lecture. 

The teacher uses a video as an interactive support for the lecture. The video does not have English subtitles (or subtitles in the native language of the student with a hearing impairment). 

Any recorded document is a real challenge, even in one’s native language as it prevents the use of compensation techniques such as lip readings and guessing. 

- The student can watch the video again when at home. However, they may still miss small parts of the content, even after rewatching, and miss out on the class discussion about the material. 


- Use of alternative sources to prepare for class or to use after class (if possible provided by the lecturer).

The lecturer asks a question and quickly launches a discussion. 

This also applies in “first come first served” situations (i.e., to pick partners for group work or a date for a presentation). 

A student with a hearing impairment may not have the time to hear the question, are unable to contribute on time, and will unwillingly end up with the “last pick”. 

- Giving a few minutes for reflection, especially for “first come first served situations” and making sure all students are ready. 

- Online sign-ups introduced in-class with an online reminder


- Writing down the question on the board or the PowerPoint.


- Writing down the discussion’s main points on the board.  

A groupwork or discussion is implemented, all students talk at the same time so there is a constant chatter in the classroom. 

A student with a hearing impairment will be completely lost and will not be able to contribute to their group’s work. They cannot effectively ask each student to repeat what they said because they will not understand their answer, and it takes too much time. Some students might feel that the student with a hearing impairment does not wish to contribute and is taking the position of a free rider. 

The group of the student can go work in a project room. 

Ideally, the lecturer booked a room prior to the class so that there is no time loss looking for one or moving to the room because it is far from the classroom.

Lectures with no PowerPoint or summary 

Written information allows students with a hearing impairment to follow the structure of the lectures and be aware of key words. Without it, they might be lost and miss out on (more) information.  

A PowerPoint or summary allows students to follow the lecture, and go through the class’s content again and catch up. 

Notes taking

Some students cannot take notes as it causes them to miss part of a discussion or follow the class. This is problematic to study later on. 

- Use of the PowerPoint. 

- Online: recording the class


- If agreed on with the lecturer, the student can record the class with their phone. 

Online lectures 

An unstable internet connection and / or bad quality mic affect the amount of information students with a hearing impairment understand during the lecture. They may miss out on essential information.

- Ask the lecturer to repeat what they or a student said. ​


- Use of the chat

Guest lecture

The new lecturer is not aware of the student’s disability and might not be considerate enough during their lecture. 

- Letting the lecturer know about the student’s disability in advance. 


- Giving time to the student with a disability to introduce themselves. 

Long classes

Students with a hearing impairment have to focus more intensely to be able to follow the class and thus can be more easily exhausted, lose attention and miss out on the class’ content. 

- Short classes (1h30): giving a 5 to 10 minutes break in the middle of the class. 

- Long classes (>1h30): giving a 5 to 10 minutes break every 45 minutes or hour. 

Adapted position in the class 

Some students may experience difficulties following the lecture in some positions in the classroom (i.e., backseats, on the side).  

- Letting the student choose their position in class. 

- Making sure others are aware of their position (either by the lecturer or by the student and if the student is comfortable with this) so that the student does not recurrently need to ask one to move.

Deadlines & Assignments


What is happening when the issue arises


Why is the situation challenging?


How can the situation be made more accessible?

Talking assignment

(presentation, roundtable, …)

A student with a hearing impairment might not hear what fellow students say during the presentation and thus  might not react to it. 

- Option of Extra time (informal, can be 5 minutes or more depending on the student’s need) for the assignment to make up with the time it takes to ask to repeat something.

Note: The difference between not hearing the question and not understanding the technical term (because of a lack of preparation) can be confusing to a lecturer.

Many deadlines in the same week

Navigating the world with a hearing impairment is very taxing because it requires a constantly high level of concentration. Added to the stress from various deadlines and exams, this can lead to exhaustion and the students might not be able to finish their work on time despite their best efforts. 

- Extension 

- At the beginning of the semester, giving the option to move deadlines during the period to avoid overlap with other classes.



What is happening when the issue arises


Why is the situation challenging?


How can the situation be made more accessible?

- Examinations 

- Late examinations (from 6pm)


- Examinations at the end of the week (Thursday / Friday)

Navigating the world with a hearing impairment is very taxing because it requires a constantly high level of concentration. Students with a hearing impairment may not be able to perform at their best at the end of the day or the week. 

- Extra time

- Avoiding planning exams at those time 


- Take home examinations (allow the students to work when they are able to perform).



What is happening when the issue arises


Why is the situation challenging?


How can the situation be made more accessible?


During an excursion, attention to the person speaking is required as much as to the places visited. Taking pictures and observing what is displayed is very challenging while listening to someone talking. 

It is even harder when the group moves around, and students with a hearing impairment cannot always be near the lecturer. 

Asking the accompanying teacher or another student to repeat results in a gap in the information as the other lecturer keeps speaking at the same time. 

- Staying near the speaker


- Asking to repeat


- Other students’ notes and pictures can compensate for the gap in the student’s documentation 

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