Author: Dolly Bhargava, M. Spec. Ed.

“Configuration” refers to the overall shape or pattern of the hearing loss, depending on the extent of hearing loss across the range of sounds.  To determine the configuration, an audiologist (a professional who works with people who have hearing, balance, and related ear problems) performs a test that involves using a machine called an “audiometer” to measure hearing.  The audiometer makes sounds (pure tones) which go into headphones over the child’s ears. 

Information about the child’s hearing abilities is plotted on an “audiogram,” a graph displaying intensity in relation to frequency.  The softest sounds the child can hear (hearing thresholds) are plotted on the audiogram.  The vertical axis of the graph shows the volume (intensity) of the sound (in decibels).  The dB are listed from top to bottom starting from –10 dB to 120 dB.  The greater the number of decibels the louder the sound.  The horizontal axis shows the pitch (frequency) of the sounds tested (measured in cycles per second or Hertz). The lower the frequency numbers the lower the pitch.  The frequency starts on the left side with 250 Hz and ranges up to 8000 Hz.  Usually frequencies of 250-8000 Hz are used in testing because this range represents most of the speech spectrum, although the human ear can detect frequencies from 20-20,000 Hz (Marschark et al., 2002).

For example of audiograms, refer to

There are three types of configurations: rising, sloping, and flat.  The shape of the configuration provides insight into the type of speech-understanding errors that a student may be experiencing and the nature of the hearing impairment.  A rising configuration means that a person can hear high pitch tones better than low pitch tones. A sloping configuration means that a person can hear low pitch tones better than high pitch tones.  Finally, a flat configuration means that a student is experiencing the same amount of hearing loss for low and high sounds (Schwartz, 1987).  For examples of the different configurations refer to the Internet site

Other descriptors associated with hearing loss as described in ASHA (n.d):

  • Bilateral vs. Unilateral – A bilateral hearing loss means hearing is affected in both ears, whereas a unilateral hearing loss means hearing in only one ear is affected.
  • Fluctuating vs. Stable Hearing Loss - Some hearing losses change - sometimes getting better, sometimes getting worse. Such a change commonly occurs in young children who have hearing loss as a result of Otitis Media, or fluid in the middle ear. Other hearing losses will remain the same year after year and are regarded as stable.
  • Progressive vs. sudden hearing loss - Progressive hearing loss is a hearing loss that becomes increasingly worse over time. A sudden hearing loss is one that has an acute or rapid onset and therefore occurs quickly, perhaps as a result of head trauma, or perhaps a tumor in the auditory nerve.
  • Symmetrical vs. asymmetrical - Symmetrical hearing loss means that the degree and configuration of hearing loss are the same in each ear. An asymmetrical hearing loss is one in which the degree and/or configuration of the loss is different for each ear.

To summarize, there is no “typical” student with a hearing impairment.  Although all have some degree of hearing loss, it is important to note that hearing loss affects each individual differently. The effect that a hearing impairment has on a student will depend on a number of factors beyond the attributes described above.  Other important factors include the age of onset, when it was detected, how the student manages the hearing impairment (for example, level of compliance with wearing their hearing aids), the student’s abilities, personality, and the quality and type of auditory intervention programs.  Hence, it is extremely important to consider each student as an individual and find out the specific type of loss in order to accommodate needs.