The Massachusetts Commission for the Deaf and Hard of Hearing (MCDHH) estimates that there are approximately 546,000 people with hearing loss living in the Commonwealth. Hearing loss can range from mild to profound, and each person's level of hearing loss is unique. A person who is deaf is not necessarily unable to hear any sounds. Deafness and hearing loss can be caused by factors such as prolonged exposure to excessive noise, illness (such as bacterial meningitis or ear infections), and conditions during pregnancy that can affect the fetus, or birth, or heredity.

How Deaf People Describe Themselves

While most people perceive deafness merely as a "medical condition", many Deaf people view themselves not as "disabled" but as members of a distinct cultural community with its own language, values, and social mores.

There are no specific hearing levels or personal characteristics that determine how a person identifies themselves. For example, a person with profound hearing loss and the ability to engage in spoken conversation may identify themselves as Hard of Hearing, while another person with moderate hearing loss identify as Deaf. How an individual chooses to identify is based on a variety of factors that include hearing status, communication preference, cultural orientation, and use of technology.

Individuals may identify themselves in one of several ways:

•  deaf (lowercase ''d'') - Generally, this refers to the audiological condition of hearing loss and includes all groups with hearing loss. People who identify themselves as deaf typically do not identify with or participate in Deaf culture and typically do not know or use American Sign Language (ASL).

•  Deaf (uppercase ''D'') - Individuals who identify themselves as Deaf use ASL as their primary language and mode of communication and may have any level of hearing loss. Deaf people share common language, values, social norms, traditions, and beliefs that characterize Deaf culture.

•  DeafBlind - a DeafBlind (DB) or deafblind (db) person has a combination of hearing loss and vision loss. Like hearing loss, there are varying levels of vision loss, such as reduced peripheral vision or close vision. Depending on their vision and hearing loss, many DB/db individuals use tactile ASL to communicate; others may use modified versions of sign language. People who are DB/db may or may not identify themselves as culturally Deaf or culturally DeafBlind.

•  Hard of Hearing - People who are Hard of Hearing typically have some residual hearing that enables them to use spoken language for everyday communication. Many Hard of Hearing people use ASL to communicate, or other forms of sign language in addition to spoken language. A Hard of Hearing person may or may not identify with the culture of the Deaf community.

•  Late-Deafened - This indicates hearing loss that occurred after spoken language is fully developed (during childhood). Late-Deafened people may or may not identify with the culture of the Deaf community.


Deaf people use a variety of means to communicate, but the most widely used in Deaf culture in the United States is American Sign Language (ASL). ASL is a visual language with a distinct vocabulary, grammar, and syntax separate from the English language. In Massachusetts and many other states, ASL is recognized as a foreign language. Some Deaf people choose to use a manually coded form of English, such as Pidgin Sign Language (a combination of ASL and signed English) or Signed Exact English. Other communication methods include speech and speech-reading.

Assistive technologies are available to those who choose to use their residual hearing to communicate orally. These include amplifying devices, magnifying screen readers, and Computer Aided Real-time Transcription (CART).

It is important to remember that each individual's communication preference is unique and shaped by many factors, including educational experiences, cultural/linguistic identity of family of origin, peer influences, and the like.

Sign Language Interpreters

Sign language interpreters are often used to facilitate communication between a signing Deaf person and a non-signing person. It is important to know that interpreters are certified professionals who adhere to a strict professional code of ethics and code of conduct in which confidentiality and neutrality is maintained in all situations. The interpreter mediates between two language users and cultures, but is not a participant in the interaction.

For more information about Deaf, DeafBlind, Hard of Hearing, and Late-Deafened people and community, visit our Resources page.