Auditory Disabilities


Auditory disabilities or hearing loss range from mild or moderate in one or both ears (“hard of hearing”) to substantial and uncorrectable impairment of hearing in both ears (“deafness”) 1.

People with hearing disabilities may use hearing aids or not, may use sign language as their first language (or not), and may or may not struggle with written English.

Examples of disabilities

  • Hard of Hearing – people who have mild to moderate hearing loss in one or both ears 1.
  • D/deafness – people who have severe hearing loss in both ears 1.
  • Deafblindness – people who have severe hearing loss in addition to moderate to severe vision loss. 1.

D/deaf culture

Some people with deafness identify themselves as being part of a specific Deaf culture and community, with a strong Deaf identity, and refer to themselves as being “Deaf” or “big-D Deaf” 2. In many cases, their primary or first language is sign language 2. They may be proud to be deaf and not see their hearing loss as a disability 2.

Generally, people who have hearing loss but do not associate themselves with Deaf culture identify themselves as being “deaf” or “small-D deaf” 2. There may be many reasons why they do not consider themselves Deaf, which include having been born hearing, having been raised in hearing culture, or having not learned sign language 2

Some people with mild to moderate hearing loss may refer to themselves as hard-of-hearing 2. Generally, people who identify themselves as hard-of-hearing don’t speak sign language 2.

Many people with hearing loss consider the term “hearing impaired” to be offensive so it should be avoided 2.

It’s generally accepted practice to refer to these groups combined as “d/Deaf” (or “D/deaf”). As with any situation where identity is involved, if you’re unsure how to refer to a D/deaf person, ask.

Sign language

Some people with auditory disabilities use a form of sign language as their primary language. Sign language uses a different grammar and structure than spoken language. American Sign Language (ASL) is the most commonly used sign language in the United States 3. It has more similarities to Japanese or Navajo than it does English 3.

  • Don’t assume that all people who have hearing loss can sign 1.
  • Don’t assume that ASL has anything in common with other sign languages around the world — there is no universal sign language 3.
  • Don’t assume that people whose first language is ASL are fluent in English 3
  • Don’t assume that all D/deaf people use the same

For D/deaf people who sign, access to a sign language interpretation may be more effective than captions, because sign language may be their primary language 4.

Design considerations


  • Provide transcripts for audio files 4.
  • Provide synchronized captions for audio/video content 4. Your software should be able to pass WCAG 1.2 Time-Based Media. People should be able to adjust the text size and color of the captions 1.
    • Note: for people with Deafblindness, you still need to provide a transcript as well 4.
  • Write in plain language 5.
  • Use a linear, logical layout 5.
  • Break up content with sub-headings, images, and videos 5.
  • Let users ask for their preferred communication support when booking appointments 5.
  • Provide options to stop, pause, and adjust the volume of content independently from the system volume 1.
  • Ensure any foreground audio is high quality and distinguishable from background audio or background noise 1.
  • Provide any important information in sign language and use simpler text with images, graphs, or other illustrations to assist people may not be fluent in English 1.


  • Don’t use complicated words or figures of speech 5.
  • Don’t put content in audio or video only 5.
  • Don’t make complex layouts or menus 5.
  • Don’t make users read long blocks of content 5.
  • Don’t make telephone the only means of contact for users 5.
  • Don’t require the use of web-based services that require voice interactions 1.

Own Voices

What people with blindness say about themselves.

Additional Resources


  1. Diverse Abilities and Barriers by the WAI[][][][][][][][][][]
  2. The Difference Between d/Deaf and Hard-of-Hearing by ai media[][][][][][][][]
  3. American Sign Language by the state of Rhode Island Commission on the Deaf and Hard of Hearing[][][][]
  4. Accessibility Fundamentals – Disabilities, Guidelines, and Laws at Deque University[][][][]
  5. Dos and Don’ts on designing for accessibility by Karwei Pun at Gov.UK[][][][][][][][][]