Definitions of some of the key terms used in the RCSLT deafness guidance.

Language and communication

British Sign Language (BSL)

BSL is a visual means of communicating using gestures, facial expression, and body language. BSL is not strongly related to spoken English as it has its own grammatical structure.


A range of different strategies (speaking, signing, pointing, writing, etc) that someone can use to get their message across to another person. For example pointing to indicate a choice, saying or signing “hello” when you meet someone.

Deaf community

People who identify as belonging to a specific cultural group characterised by shared lived experience and signed communication.


Language can be spoken or signed. It is a structured way of putting words or signs together to communicate.

Lip reading

Lip reading is a strategy in which a person uses visual cues (watching the person speaking) as well as their own knowledge and general awareness to make sense of what a person is saying.


Being able to say specific sounds so that people can understand what you are saying.


When working with children, young people and adults who are deaf, it is likely that you will receive reports from audiologists describing the tests they have attempted and the results. Here are some of the most common tests and terms:


A diagram which is used to record a person’s type and degree of deafness.

Decibels (dB)

Used to measure loudness levels on an audiogram.

Hertz (hz)

Used to measure the frequency of the sound on an audiogram.

Behavioural assessments

These assessments are subjective as they rely on an individual’s response to the test stimuli. There are different tests that can be done (which are described below) and the appropriate test will be chosen depending on the age of an individual and the presence of any additional difficulties.

Visual reinforcement audiometry (VRA)

This is a hearing test that is typically done with babies and young children. In this test the child is taught to search out a visual reward (such as a picture or puppet) which has been linked to the sound used during testing.
VRA can also be used with children and adults with additional difficulties when this is the most appropriate audiological test.

Play audiometry

This is a hearing test that is typically done with young children. In this test, the individual is taught to respond to the test sounds by carrying out a specific action, such as putting a peg in a board or putting a man in a boat. Using games increases the concentration and interest making testing more reliable.

Play audiometry can also be done with children and adults with additional difficulties when this is the most appropriate audiological test.

Pure tone audiometry

This is a hearing test that is routinely done with adults and some older children. In this test the individual is given a button to hold and is instructed to press the button when they hear a test sound.

Air conduction (AC)

The process by which sound is sent (conducted) to the inner ear through the external ear canal and middle ear. Air conduction testing is performed by sending sounds to the ear through an earphone or loudspeaker.

Bone conduction (BC)

The transmission of sound through the bones of the skull to the inner ear. Bone conduction testing is completed using a bone oscillator (vibrator) that is placed on the skull (mastoid bone) behind the ear or on the forehead.

Objective assessments

These assessments are objective as they rely on physical, acoustic or electrophysiologic measurements. They do not require the individual to respond specifically to the presented stimuli.

Auditory brainstem response (ABR)

This audiological test is done under natural sleep or, in some cases, under a general anaesthetic (GA). Small pads will be placed on a person’s head at different points. Neural responses to sounds (click and tone bursts) are recorded to give an indication of the level of hearing loss.


This is a pressure test to measure the movement of the eardrum. It will also indicate whether or not an individual has fluid in the middle ear (glue ear).

Acoustic reflex

This test measures the involuntary muscle contraction that occurs in the middle ear in response to loud sound stimuli.

Otoacoustic emissions (OAE)

During testing, a little microphone is placed in the ear canal and an acoustic signal is presented to the ear and the following otoacoustic emissions (or ‘cochlear echoes’) are measured. The presence of an evoked otoacoustic emission indicates normal (or near normal) outer hair cell function within the cochlea and normal middle ear function.



This is caused by damage to the inner ear and/or auditory nerve. It is permanent.
It can be acquired or congenital.


This is caused by damage to the outer or middle ear. It is usually temporary but can be permanent. This also includes congenital conditions such as microtia and atresia.
It can be acquired or congenital.


This is a combination of both sensorineural and conductive.


An individual who is deaf from birth. This is sometimes also known as being prelingually deaf.


An individual who becomes deaf later in life. The individual may become deaf at a few months or years of age or perhaps much later in their life as an adult. This is sometimes also known as being postlingually deaf.


This can be described by individuals who are deaf and have noise, or ringing, in the ears. It may be a symptom of an underlying condition, such as presbycusis, ear injury or a circulatory disorder.


It is likely that an individual who is deaf will see an ear nose throat (ENT) consultant. Here are some of the common tests and procedures that they might do:


This is a procedure in which an otoscope (or auriscope) is used to look in a person’s ear.

CAT (CT) Scan

A type of x-ray, used for imaging the bone structures of the inner ears.

MRI (magnetic resonance imaging)

This scan provides images of nerves and soft tissues of the body. It can show the presence and size of the auditory nerve.