Deafness, an impairment or a difference?

By Nicholas Aribino and Takudzwa Mafongoya | Sep 18, 2025 | 4 Min read

SEPTEMBER is the International Deaf Awareness Month.

The success goals of September for deaf people per se are awareness raising regarding Deafness (cultural identity) and Deafness (hearing loss), promoting sign language and total communication and supporting deaf and hard of hearing people.

It is the intention of this opinion article to celebrate with Deaf and deaf people in this month of September by exploring the understanding of deafness within the deaf community and the medical fraternity.

From the outset, it is important to draw the attention of the readership to the conceptual boundaries between Deafness with an upper case “D” and deafness with a lower-case “d”.

There is an understanding by Deaf people that Deafness is not an impairment, but a difference as shall be seen infra.

The people who subscribe to Deafness with the upper case D firmly argue that people who are Deaf have nothing that has broken down that needs fixing.

They hold that Deafness symbolises cultural, anthropological and linguistic differences that ought to be essentialised, romanticised and celebrated.

For this group of people, a person who is Deaf will not need to undergo audiological assessments to ascertain the nature, severity and degree of his or her hearing loss, rather he or she needs to be understood as belonging to a Deaf Community that has its own source language (Sign Language), normative values and practices.

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Deafness should not be seen and measured according to deficits in receptive and expressive language.

The bottom line behind the Deaf community is to depathologise Deafness.

The Deaf community implies a people with a way of life that ought to be recognised and respected by the hearing world.

Each time reference is made to people who hold that Deaf people constitute a community of their own, the word Deaf with an upper-case D should be used.

In America, linguistic differentiation, attitudinal deafness, behavioural norms, endogamous marital patterns, historical awareness and voluntary organisational networks have stood out as critical facets of the Deaf community.

One other observation that may need to be highlighted is that the Deaf community does not necessarily involve just Deaf people; people who are not Deaf may decide to join the Deaf community and that is referred to as Attitudinal Deafness.

Attitudinal Deafness is characterised by positive affective commitment to the Deaf culture and community.

On the other hand, the word deaf with a lower-case “d”, views deafness as an impairment.

Those characterised as deaf largely have challenges with processing linguistic information.

However, people with deafness are not a homogeneous group, their levels of hearing loss may vary.

Given this understanding, there is a medical emphasis on audiological examinations that can establish the aetiology of the impairment.

An audiological assessment is also done so that intervention and/or management can be considered for people with hearing impairment.

For example, educational placement, counselling of parents of children with hearing loss, type of hearing aids to be used, prognosis of the hearing loss, speech training and training in selective perception of sound.

The concept of deafness with a small letter “d”, therefore, recognises that deafness is a medical condition that exists in a continuum, that is a condition that has varying degrees (mild, moderate, severe and profound).

This understanding of deafness argues that the audiological system has broken down and is crying out for remedial measures.

This worldview focuses on integrating children with hearing impairment to the hearing world by teaching them speech, that is the aural-oral approach.

Given the above perspectives, it is important to appreciate that they are as different to each other just as apples are to oranges.

Their worldviews inform educational practices differently.

For example, the Deaf community prefers a curriculum where Deaf children are taught using Sign Language.

Sign Language is to them a source language that help them to grasp concepts and Sign Language is a manual language that ought to be given a premium value like any other language in the hearing world.

Those in the Deaf community stoutly argue that what to teach and how to teach are considerations that should be made with the full consciousness of the needs and rights of the Deaf community.

With respect to those who hold that deafness is a medical condition, the school should emphasise speech training which helps deaf children to fit in the hearing world.

This approach has been identified as oralism, and its apologists have been characterised as oralists.

The characterisation of Deafness as either an impairment or a cultural difference would, therefore, depend on one’s orientation in terms of pragmatic scope.

If one is coming from a medical school where the biomedical model rules supreme, deafness becomes a pathology and if one is guided by the cultural polemic, Deafness is understood as an identity of a cultural and linguistic minority.