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Unlike many conditions described in this volume, having a hearing loss or being deaf does not necessarily result in specific deficits in functioning. Functional outcomes depend on a complex interplay of physiological, developmental and environmental factors. We start with the premise that hearing loss by itself will often have an impact on cognitive organization but not necessarily or consistently on intellectual, neuropsychological, emotional, social or behavioral functioning. Disruption of these functions depends heavily on other factors that may be associated with etiology of the hearing loss or the interaction between individuals and their environment, including communication, family, educational, emotional and sociolinguistic environments. At the same time, effects related to a hearing loss can have significant negative impact in each of these areas, particularly without comprehensive and appropriate supports.
Hearing loss cannot be viewed as a single disorder or characteristic. A child with a congenital hearing loss secondary to prenatal infection is quite different from an older adult with hearing loss associated with the cumulative effects of aging, even if the mechanical aspects are similar. The child is likely to have had limited early access to language, potentially altering the child's educational, social and familial environments, whereas the adult has probably had typical developmental experiences. Even two children born with the same etiology and mechanics of hearing loss can develop along quite different trajectories depending on environmental variables.
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