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Connection in Mixed Deaf, Hearing, and Hard-of-Hearing Families

Family is where it all begins. Those are the people who shape us and our worldview. They’re our first and most important relationships. They teach us to communicate. When hearing loss or deafness adds complexity to our family, we don’t give up on connection: we make it work.

We’re going to explore how a variety of families connect across different hearing statuses and the information and resources to support mixed hearing communication:

What are the different categories of hearing loss?

According to the National Library of Medicine (2): 

A hearing loss of up to 20 decibels below the hearing threshold is still considered to be normal hearing. More severe hearing loss can be described according to severity, as follows: 

  • Mild hearing loss: Hearing loss of 20 to 40 decibels.
  • Moderate hearing loss: Hearing loss of 41 to 60 decibels.
  • Severe hearing loss: Hearing loss of 61 to 80 decibels.
  • Profound hearing loss or deafness: Hearing loss of more than 81 decibels.

“Hard-of-hearing” is a loss between mild to moderate on this scale (4), where there may be enough residual hearing that an auditory device, such as a hearing aid, benefits the individual (5). These people may struggle with a quiet or typical conversation.

The profound hearing loss that qualifies as medical deafness equates to very little or no functional hearing (5).

For perspective, these are the decibel levels of some common sounds

  • Quiet conversation: 40 dB
  • Normal conversation: 60 dB
  • Traffic: 80 dB
  • Industrial noise: 100 dB
  • Very loud music, for example at a rock concert or a nightclub: 120 dB
  • Nearby thunder: 120 dB
  • Jet engine: 140 dB

The only way to accurately measure a hearing loss of specific decibels is a hearing loss test. An audiologist can perform a variety of hearing loss tests and can recommend treatment or technology that may make everyday life and communication easier.

Communication in hard-of-hearing and hearing families

More than 37 million Americans say they have some trouble hearing, and it’s more common with advancing age.

There are a lot of people out there who don’t have “perfect hearing”, especially in older generations. The greatest amount of hearing loss is in the 60-69 age group (1). Many of them are used to being able to hear and speak normally for most of their lives and start experiencing hearing loss at some point. Young and middle-aged adults are developing hearing loss at a higher rate than previous generations, largely due to noise exposure, including listening to media at a high volume through ear buds or headphones. (8)

People new to hearing loss often are embarrassed, apologetic, or in denial. These feelings may present additional challenges in communicating even with the people closest to them. But many families include someone with hearing loss, and they adjust to get through to each other:


On the other end of the spectrum is Irene, who was relieved at her recent diagnosis of “hidden hearing loss”/Central Auditory Processing Disorder (CAPD) after 47 years of not “knowing that what I was inadvertently struggling with could be managed with hearing aids.” She says for decades her hearing loss affected how she interacted with her family. “More than anything it’s been incredibly annoying. I was diagnosed … about 6 weeks ago. I ‘heard’ just fine but didn’t always understand.”

“I did not realize that I had any hearing issues until I kept using CC (closed captions) while watching TV. I was struggling to parse out different instruments while listening to music, and I had trouble hearing/understanding others while in conversation. I currently use hearing aids and keep the CC on. The hearing aids are Bluetooth, which is pretty cool and easy to manage.”

Irene is part of a growing trend of young and middle-aged people who use hearing aids to improve their quality of life and communication. (9) They’re defying years of stigma attached to hearing loss and generating mainstream demand for assistive technology. “Oddly enough,” Irene adds, “now that I know what makes it harder for me to understand, I have zero shame in telling others. If I can help others in a similar situation, I will do it!”

She says figuring out her hearing situation has eased the frustration of trying to connect with people she cares about and enhanced her daily life. “Please, please get your hearing checked, and not just the standard test. Ask about CAPD and ask that you get tested for it. Now that I can hear and understand so much better, my burden is so much lighter. I had no idea how much mental energy I was using on a day-to-day, existing basis. I had no idea that music is so much more vast and colorful!”

Communication in Deaf and hearing families

There can be wide variations in communication methods in Deaf/hearing families to fit the preferences of Deaf people who are oral (speaking with their own voice and listening with the assistance of devices such as hearing aids or simply lipreading) or use signed languages as well as the language skills and hearing ability of their loved ones.

More than 90% of Deaf children have hearing parents (1) – and, likewise more than 90% of Deaf parents have hearing children (6) – so Deaf, hearing, and hard-of-hearing people learn to connect across hearing status with their own family members.


Yuliya is Deaf and is the only person with hearing loss in her birth family. Her husband is Deaf but they accommodate her hearing family. “None of my family members sign. My kids sign, but the adult members of my family don’t. I speak with them. I am used to it – I grew up oral. I was not really exposed to Deaf culture while growing up. When I went to college, I was exposed more to Deaf culture, the history, the language, etc., and I loved it.”  

Yuliya’s children are Codas and she sees the mixture of cultures and languages in them. “My children are mostly in the Deaf culture right now because they are still pretty young and are just with my husband and me. They communicate with us through sign language. But when they see the hearing members of my family, they will use their voice, so we’ll see how things change (which culture they feel most part of) as they get older.”

What is a Coda?

With the success of the 2022 movie, CODA, this term has been in the media more. Coda (sometimes “CODA” or “coda”) stands for Child of Deaf adults. A Coda may have one Deaf parent or both, or a legal guardian raising them who is Deaf (3).

90% of Codas are hearing. These people frequently navigate between Deaf and hearing culture as they grow up in much the same way as a child born to immigrants navigates between the culture of the country in which they live and the culture of their parents’ countries of origin. Codas frequently feel they are a part of Deaf culture even though they are not Deaf themselves.


Gregg is a Coda – he has Deaf parents and a Deaf Aunt, uncle, cousin, and niece. He signs with his Deaf family members. He occasionally will use his voice with his mom, who has some hearing, just to get her attention and then he will sign after that. He both talks and signs with his niece, who has some hearing and wears Cochlear Implants, a version of hearing aids. He adds, “Because I can sign, I tend not to use Video Relay Services. I will text or use apps where I can sign.”

“Culturally I feel half and half. I feel the connection with my family, friends, people I grew up with. But I am also part of the hearing culture.”


Rosa is also a Coda. On her dad’s side, he is the only one that has a hearing loss. On her mom’s side, there are many Deaf relatives – grandparents, aunts, uncles, and cousins – mixed in with the hearing relatives. “My parents are both Deaf,” Rosa said, “so it was just part of our life growing up. We’d go to events at the Deaf school such as football games and basketball games. We’d also go to other community events like Deaf bowling nights. And of course, we’d go to our parents’ friends’ or they’d come to our place.”

She said, “Our family only signs. My mom can’t hear at all so she was pretty strict about us signing instead of speaking when we were growing up, and it’s just normal now.” She keeps up easily with her family via text and FaceTime.


Britnee is hard-of-hearing and has a Deaf mother and hearing father. Her brother is Deaf and her grandparents on both sides are Deaf. She says her communication methods depends on who she is talking to and what the situation is. Her hearing is good enough with hearing aids that she can talk verbally with hearing family members who don’t sign well. She signs with the other Deaf people in her family. If she is talking with a hearing family member who does not sign well and a Deaf member enters the room, she will start signing. 

Britnee says mixed influences growing up have shaped how she identifies and communicates with the people around her. She attended a mainstream elementary school and junior high with hearing peers. Then in high school, she went to a school for the Deaf. She uses a hearing aid when she is around hearing people out in the community or with hearing family members but when she is at home, she generally takes them off.

“For the longest time I identified mostly as hard-of-hearing because I can hear pretty good and can speak and that is what others see me as. But lately I have started to identify more as Deaf since I started working at my current job. Really, I decide if I am Deaf or hard-of-hearing depending on the perception I want to create, how I want to communicate my specific words, and sometimes just my mood.”

Everyday Deaf and Hard-of-Hearing Communication Solutions

Communication is not only face-to-face, and families rely on phone and internet services to connect when they’re apart. For decades, that presented additional challenges for families who use sign language, read lips, and have difficulty hearing over the phone. But now, there are many services available to the Deaf and hard-of-hearing for communication and accessibility:

Video Relay Service

Video Relay Service (VRS) is a no-cost service Deaf or hearing people can call where the hearing person in the middle is a qualified ASL interpreter who signs with the Deaf person and speaks with the hearing person.


A videophone is a standalone device that connects to the internet and streams both video and audio. It’s one of the devices Deaf individuals can use to make video relay calls to hearing people. The first videophones had basic dialing/ringing/answering functions and a contact list to save phone numbers. Nowadays videophones designed for the Deaf – such as the latest videophone from Sorenson, the Lumina – are more sophisticated. Some of the newest features are the ability to leave a video message (similar to voicemail), change the UI to Spanish, linking multiple devices to one VRS phone number, and customizable light ring settings (similar to ringtones).

Computers with webcams 

While videoconferencing apps such as Zoom and Microsoft Teams existed before COVID, the COVID-19 pandemic prompted an explosion in their popularity. Many businesses used these apps to continue operating. They also found widespread usage in families and friends who wanted a way to see each other when they were not able to visit in person. The arrival of Sorenson for Zoom VRS in Spring 2023 offered a new level of functionality for Deaf and hearing conversation, allowing an interpreter to join the meeting as a participant for fluid interpreter communication with everyone on the same screen.

Image of six people participating in a Zoom call with four showing and two hidden.

Smartphones with cameras and videoconferencing capabilities 

There are many smartphone apps that offer accessibility benefits for the Deaf and hard-of-hearing allowing users to pick and choose what’s helpful to them. For Deaf smartphone users, front-facing cameras introduced a wave of videoconferencing apps. Those apps include mobile VRS applications, like ntouch, so Deaf users can make and receive calls anywhere they take their phone.

Captioned Phone Calls

Phone call captioning (IP-CTS) is a no-cost service for hard-of-hearing people who need captions to use the phone. It provides real-time captions of their phone conversations on a specialized caption phone or a smartphone app.

CaptionCall by Sorenson and CaptionCall Mobile are both no-cost call captioning products. With CaptionCall, eligible users can sign up even without home internet service.

Hearing aids

Hearing aids were the first “technology” to improve communication for people with hearing loss, and they have transformed over the years. Some hearing aids are now so small they’re practically invisible in your ears.

About two percent of adults aged 45-54 have disabling hearing loss, meaning they could benefit from hearing aids. That number trends upward with age: 8.5 percent of adults aged 55-64, 25 percent of adults aged 65-74, and 50 percent of adults aged 75+ have a disabling hearing loss that hearing aids may help with (1).

The vast majority of people who could benefit from hearing aids do not use them. Only 30% of adults 70+ in that category has ever used them and only 16% of qualifying adults 20-69 have ever used hearing aids (1).

Many recent hearing aid models now have Bluetooth technology which allows users to pair them with other technology such as their smartphones or captioning phones.

Effort is the Biggest Factor in Hard-of-Hearing, Hearing, and Deaf Communication

Communication is critical to understanding. When the desire and effort is there, a shared language is not a necessary starting place. The effort you put into trying to communicate leads to greater understanding and a broader knowledge of other people. Personal stories suggest most of us aspire to connect beyond words.

We see the same adaptability in communication across hearing abilities in immigrant communities. When families span geography for various reasons – moving for a better life, escaping a bad situation, or uniting people from different backgrounds – and have children, those children typically are quick to learn new languages through exposure at school or friends. They can be a great example to the rest of us of how doing ones best to communicate can benefit all of us.

Putting forth the effort to communicate with people who may not hear or communicate the same way you do is a statement of value. Work together to make those connections. There are many apps available to communicate. There’s always good old paper and pen. And, if all else fails, gestures can be useful. Many are universal concepts: eat, drink, sleep, cry, laugh, love.

This concept is the one that matters with communication – if we care enough about each other, we’ll figure it out. Every family with Deaf, hearing, and hard-of-hearing people has proven that if you’re caring, patient, and willing to try, there are no insurmountable obstacles to connection across language and hearing ability.