{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T15:42:10Z","timestamp":1792510930945,"version":"4.5.0"},"reference-count":105,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Audiology Research"],"abstract":"<jats:p>Background\/Objectives: Hearing loss (HL) is a prevalent condition that can lead to social exclusion. This review explores the epidemiological, cultural, and social dimensions of HL and examines the barriers to accessibility that individuals with HL encounter. Methods: This research employs a narrative review approach to provide a comprehensive overview of HL, focusing on stigma, gender disparities, cultural and social differences, and accessibility challenges. Results: The review highlights pervasive prejudices surrounding HL and hearing devices. Gender disparities are evident, with Deaf women facing compounded challenges. Cultural perspectives on HL differ widely, ranging from the medical model, which emphasizes treatment using hearing devices, to the Deaf community\u2019s social model, which views deafness as a cultural identity. Socioeconomic disparities further restrict access to modern technologies, particularly in low-income settings, while intersectional discrimination affects marginalized groups within the Deaf community. Public spaces also present significant barriers related to communication, architecture, and technology, which hinder accessibility for individuals with HL. Conclusions: A cultural shift is essential to dismantle societal stereotypes and reduce discrimination associated with HL. Moreover, improving accessibility for individuals with HL necessitates a multifaceted approach, including accessible design, staff training, and the integration of assistive technologies.<\/jats:p>","DOI":"10.3390\/audiolres15030046","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T06:18:02Z","timestamp":1745475482000},"page":"46","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["The Ongoing Challenges of Hearing Loss: Stigma, Socio-Cultural Differences, and Accessibility Barriers"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5511-8511","authenticated-orcid":false,"given":"Mirko","family":"Ald\u00e8","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy"},{"name":"Audiology Unit, Department of Specialist Surgical Sciences, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Umberto","family":"Ambrosetti","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4574-2193","authenticated-orcid":false,"given":"Stefania","family":"Barozzi","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Ald\u00e8","sequence":"additional","affiliation":[{"name":"Department of Sociology and Social Research, University of Milano-Bicocca, 20126 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1179\/000349809X12459740922372","article-title":"Deafness\u2014The neglected and hidden disability","volume":"103","author":"Mackenzie","year":"2009","journal-title":"Ann. Trop. Med. Parasitol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"492","DOI":"10.16993\/sjdr.1058","article-title":"Deaf People\u2019s Retrospective Views and Lived Experiences of Ableism and Discrimination in Education: A Qualitative Study Informed by Critical Disability Studies","volume":"26","year":"2024","journal-title":"Scand. J. Disabil. Res."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Kim, H., Hwang, H., Gwak, S., Yoon, J., and Park, K. (2024). Improving communication and promoting social inclusion for hearing-impaired users: Usability evaluation and design recommendations for assistive mobile applications. PLoS ONE, 19.","DOI":"10.1371\/journal.pone.0305726"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Blazer, D.G., Domnitz, S., Liverman, C.T., and Committee on Accessible and Affordable Hearing Health Care for Adults, Board on Health Sciences Policy, Health and Medicine Division (2016). Hearing Health Care for Adults: Priorities for Improving Access and Affordability, National Academies Press.","DOI":"10.17226\/23446"},{"key":"ref_5","first-page":"351","article-title":"Socioeconomic position and hearing loss: Current understanding and recent advances","volume":"30","author":"Malcolm","year":"2022","journal-title":"Curr. Opin. Otolaryngol. Head Neck Surg."},{"key":"ref_6","unstructured":"Anastasiadou, S., and Al Khalili, Y. (2025, March 10). Hearing Loss, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK542323\/."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Ald\u00e8, M., Cantarella, G., Zanetti, D., Pignataro, L., La Mantia, I., Maiolino, L., Ferlito, S., Di Mauro, P., Cocuzza, S., and Lechien, J.R. (2023). Autosomal Dominant Non-Syndromic Hearing Loss (DFNA): A Comprehensive Narrative Review. Biomedicines, 11.","DOI":"10.3390\/biomedicines11061616"},{"key":"ref_8","unstructured":"Sooriyamoorthy, T., and De Jesus, O. (2025, March 10). Conductive Hearing Loss, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK563267\/."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Ald\u00e8, M., Bosi, P., Muck, S., Mayr, T., Di Mauro, P., Berto, V., Aleandri, B.G., Folino, F., Barozzi, S., and Zanetti, D. (2024). Long-Term Impact of Recurrent Acute Otitis Media on Balance and Vestibular Function in Children. Brain Sci., 14.","DOI":"10.3390\/brainsci14121246"},{"key":"ref_10","unstructured":"Tanna, R.J., Lin, J.W., and De Jesus, O. (2025, March 10). Sensorineural Hearing Loss, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK565860\/."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"725","DOI":"10.2471\/BLT.19.230367","article-title":"Hearing loss grades and the International classification of functioning, disability and health","volume":"97","author":"Olusanya","year":"2019","journal-title":"Bull. World Health Organ."},{"key":"ref_12","unstructured":"World Health Organization (WHO) (2025, March 10). Deafness and Hearing Loss. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/deafness-and-hearing-loss."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"111262","DOI":"10.1016\/j.ijporl.2022.111262","article-title":"Hearing outcomes in preterm infants with confirmed hearing loss","volume":"161","author":"Ambrosetti","year":"2022","journal-title":"Int. J. Pediatr. Otorhinolaryngol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"23312165211053707","DOI":"10.1177\/23312165211053707","article-title":"Associations Between Hearing and Cognitive Abilities From Childhood to Middle Age: The National Child Development Study 1958","volume":"25","author":"Okely","year":"2021","journal-title":"Trends Hear."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/S0140-6736(20)30367-6","article-title":"Dementia prevention, intervention, and care: 2020 report of the Lancet Commission","volume":"396","author":"Livingston","year":"2020","journal-title":"Lancet"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.neuron.2020.08.003","article-title":"How Can Hearing Loss Cause Dementia?","volume":"108","author":"Griffiths","year":"2020","journal-title":"Neuron"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Ishak, E., Burg, E.A., Pike, J.R., Martinez Amezcua, P., Jiang, K., Powell, D.S., Huang, A.R., Suen, J.J., Lutsey, P.L., and Sharrett, A.R. (2025). Population Attributable Fraction of Incident Dementia Associated With Hearing Loss. JAMA Otolaryngol. Head Neck Surg., e250192.","DOI":"10.1001\/jamaoto.2025.0192"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1177\/0194599820910377","article-title":"Hearing Loss, Loneliness, and Social Isolation: A Systematic Review","volume":"162","author":"Shukla","year":"2020","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Ald\u00e8, M., Zanetti, D., Ambrosetti, U., Monaco, E., Gasbarre, A.M., Pignataro, L., Cantarella, G., and Barozzi, S. (2024). Unilateral Sensorineural Hearing Loss in Children: Etiology, Audiological Characteristics, and Treatment. Children, 11.","DOI":"10.3390\/children11030324"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1007\/s11136-024-03851-5","article-title":"A qualitative systematic review of the impact of hearing on quality of life","volume":"34","author":"Henderson","year":"2024","journal-title":"Qual. Life Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1097\/AUD.0000000000001420","article-title":"Hearing Loss Prevalence, Years Lived with Disability, and Hearing Aid Use in the United States From 1990 to 2019: Findings From the Global Burden of Disease Study","volume":"45","author":"Haile","year":"2024","journal-title":"Ear Hear."},{"key":"ref_22","unstructured":"The Joint Committee on Infant Hearing (2019). Year 2019 Position Statement: Principles and Guidelines for Early Hearing Detection and Intervention Programs. J. Early Hear. Detect. Interv., 4, 1\u201344."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Li, Y., Chen, F., Sun, Z., Weng, Z., Tang, X., Jiang, H., and Wang, Z. (2019). A Smart Binaural Hearing Aid Architecture Based on a Mobile Computing Platform. Electronics, 8.","DOI":"10.3390\/electronics8070811"},{"key":"ref_24","first-page":"690","article-title":"Cochlear Implantation","volume":"117","author":"Dazert","year":"2020","journal-title":"Dtsch. Arztebl. Int."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1097\/00003446-200212000-00004","article-title":"A sensitive period for the development of the central auditory system in children with cochlear implants: Implications for age of implantation","volume":"23","author":"Sharma","year":"2002","journal-title":"Ear Hear."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.otorri.2017.10.007","article-title":"Guideline on cochlear implants. Gu\u00eda cl\u00ednica sobre implantes cocleares","volume":"70","author":"Manrique","year":"2019","journal-title":"Acta Otorrinolaringol. Esp."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"La Grutta, S., Piombo, M.A., Spicuzza, V., Riolo, M., Fanara, I., Trombini, E., Andrei, F., and Epifanio, M.S. (2023). The Relationship between Knowing Sign Language and Quality of Life among Italian People Who Are Deaf: A Cross-Sectional Study. Healthcare, 11.","DOI":"10.3390\/healthcare11071021"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1898","DOI":"10.1038\/s41591-024-03023-5","article-title":"Bilateral gene therapy in children with autosomal recessive deafness 9: Single-arm trial results","volume":"30","author":"Wang","year":"2024","journal-title":"Nat. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"4S","DOI":"10.1097\/AUD.0000000000001543","article-title":"Development of Measures for d\/Deaf and Hard of Hearing Stigma: Introduction to the Special Supplement on Stigma Measurement Tools","volume":"45","author":"Stockton","year":"2024","journal-title":"Ear Hear."},{"key":"ref_30","unstructured":"Goffman, E. (1963). Stigma Notes on the Management of Spoiled Identity, Prentice-Hall."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"15","DOI":"10.53841\/bpscpf.2021.1.348.15","article-title":"History of deafness from ancient Greek\/Roman times to today","volume":"1","author":"Berry","year":"2021","journal-title":"Clin. Psychol. Forum"},{"key":"ref_32","unstructured":"UNICEF (2025, March 10). Study on Stigmatization of Children with Disabilities. Available online: https:\/\/www.unicef.org\/georgia\/media\/1181\/file\/stigmatization.pdf."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Ekberg, K., and Hickson, L. (2023). To tell or not to tell? Exploring the social process of stigma for adults with hearing loss and their families: Introduction to the special issue. Int. J. Audiol., 1\u201311.","DOI":"10.1080\/14992027.2023.2293651"},{"key":"ref_34","unstructured":"Montano, J., and Spitzer, J.B. (2009). The psychological effects of social stigma: Applications to people with an acquired hearing loss. Advanced Practice in Adult Audiologic Rehabilitation: International Perspective, Plural Publishing Inc."},{"key":"ref_35","unstructured":"NIDCD (2025, March 10). Quick Statistics About Hearing, Balance, & Dizziness. [Updated 20 September 2024], Available online: https:\/\/www.nidcd.nih.gov\/health\/statistics\/quick-statistics-hearing."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"E2387","DOI":"10.1002\/lary.29369","article-title":"Social Perceptions of Pediatric Hearing Aids","volume":"131","author":"Qian","year":"2021","journal-title":"Laryngoscope"},{"key":"ref_37","unstructured":"Auditdata (2025, March 10). Exploring the Double Standard of Hearing Aids and Glasses. Available online: https:\/\/www.auditdata.com\/insights\/blog\/exploring-the-double-standard-of-hearing-aids-and-glasses\/."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.3390\/audiolres14060087","article-title":"Toward Alleviating the Stigma of Hearing Aids: A Review","volume":"14","author":"Madara","year":"2024","journal-title":"Audiol. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e14060","DOI":"10.1111\/hex.14060","article-title":"The (in)visibility of deafness: Identity, stigma, quality of life and the potential role of totally implantable cochlear implants","volume":"27","author":"Lo","year":"2024","journal-title":"Health Expect."},{"key":"ref_40","unstructured":"Zappi, R.E. (2025, March 10). \u2018Toy Story 4\u2019 Features a Child with a Cochlear Implant. The ASHA Leader, 3 July 2019. Available online: https:\/\/leader.pubs.asha.org\/do\/10.1044\/toy-story-4-features-a-child-with-a-cochlear-implant\/full\/."},{"key":"ref_41","unstructured":"American Academy of Audiology (2025, March 10). Barbie Gets Hearing Aids! 23 May 2022. Available online: https:\/\/www.audiology.org\/barbie-gets-hearing-aids\/."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1080\/08831157.2018.1492848","article-title":"Irrefutable arguments: Teresa de Cartagena defends her right to authorship","volume":"65","author":"Scarborough","year":"2018","journal-title":"Roman. Q."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1353\/aad.2012.0471","article-title":"The career status of deaf women. A comparative look","volume":"137","year":"1992","journal-title":"Am. Ann. Deaf."},{"key":"ref_44","unstructured":"Garberoglio, C.L., Palmer, J.L., Cawthon, S., and Sales, A. (2019). Deaf People and Employment in the United States: 2019."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"111","DOI":"10.16993\/sjdr.39","article-title":"Women\u2019s Lived Experiences of Disabling Hearing Loss in Daily Life","volume":"20","author":"Jonsson","year":"2018","journal-title":"Scand. J. Disabil. Res."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1044\/1059-0889(2002\/020)","article-title":"Hearing loss- and hearing aid-related stigma: Perceptions of women with age-normal hearing","volume":"11","author":"Erler","year":"2002","journal-title":"Am. J. Audiol."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Pedalino, F., and Camerini, A.-L. (2022). Instagram Use and Body Dissatisfaction: The Mediating Role of Upward Social Comparison with Peers and Influencers among Young Females. Int. J. Environ. Res. Public Health, 19.","DOI":"10.3390\/ijerph19031543"},{"key":"ref_48","first-page":"71","article-title":"Intimate Partner Violence in the Deaf Community","volume":"46","author":"Crowe","year":"2021","journal-title":"JADARA"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"a1490","DOI":"10.4102\/ajod.v13i0.1490","article-title":"Hear our voices: The perceptions and experiences of women who are Deaf on gender-based violence","volume":"13","author":"Davids","year":"2024","journal-title":"Afr. J. Disabil."},{"key":"ref_50","first-page":"1","article-title":"Intimate Partner Violence in the Deaf Community: 5 Things You Need to Know & 5 Things You Can Do","volume":"11","author":"Anderson","year":"2014","journal-title":"Psychiatry Inf. Brief"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1177\/1077801211412544","article-title":"Intimate Partner Violence Against Deaf Female College Students","volume":"17","author":"Anderson","year":"2011","journal-title":"Violence Against Women"},{"key":"ref_52","first-page":"172","article-title":"Anglican church response to gender violence against women with impaired hearing: An appraisal","volume":"7","author":"Green","year":"2024","journal-title":"Nnadiebube J. Philos."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1093\/deafed\/enr048","article-title":"Is it abuse? Deaf female undergraduates\u2019 labeling of partner violence","volume":"17","author":"Anderson","year":"2012","journal-title":"J. Deaf Stud. Deaf Educ."},{"key":"ref_54","unstructured":"Thomas, D.J. (2013). Not a Hearing Loss, a Deaf Gain: Power, Self-Naming, and the Deaf Community. [Ph.D. Thesis, Educational Foundations & Leadership, Old Dominion University]."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Aziz, M., and Othman, A. (2023). Evolution and Trends in Sign Language Avatar Systems: Unveiling a 40-Year Journey via Systematic Review. Multimodal Technol. Interact., 7.","DOI":"10.3390\/mti7100097"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1093\/deafed\/eni030","article-title":"Ethnicity, ethics, and the deaf-world","volume":"10","author":"Lane","year":"2005","journal-title":"J. Deaf Stud. Deaf Educ."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1146\/annurev-linguistics-043020-092357","article-title":"Acquisition of Sign Languages","volume":"7","author":"Henner","year":"2021","journal-title":"Annu. Rev. Linguist."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1093\/deafed\/enh025","article-title":"Audism: Exploring the metaphysics of oppression","volume":"9","author":"Bauman","year":"2004","journal-title":"J. Deaf Stud. Deaf Educ."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Ladd, P. (2003). Understanding Deaf Culture: In Search of Deafhood, Multilingual Matters.","DOI":"10.21832\/9781853595479"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1800","DOI":"10.1002\/lary.21886","article-title":"The right not to hear: The ethics of parental refusal of hearing rehabilitation","volume":"121","author":"Byrd","year":"2011","journal-title":"Laryngoscope"},{"key":"ref_61","first-page":"748","article-title":"Ethics of cochlear implantation in young children","volume":"114","author":"Balkany","year":"1996","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_62","first-page":"469","article-title":"Hear Me Out: Hearing Each Other for the First Time: The Implications of Cochlear Implant Activation","volume":"116","author":"Cooper","year":"2019","journal-title":"Mo. Med."},{"key":"ref_63","first-page":"27","article-title":"The Decision of Refusing Cochlear Implantation in Children: Bioethical Considerations","volume":"26","author":"Borsellino","year":"2020","journal-title":"Humanidades Tecnol. (FINOM)"},{"key":"ref_64","first-page":"125","article-title":"Cochlear implants and medical tourism","volume":"11","author":"McKinnon","year":"2010","journal-title":"Cochlear Implants Int."},{"key":"ref_65","first-page":"33","article-title":"Medical tourism: Globalization of the healthcare marketplace","volume":"9","author":"Horowitz","year":"2007","journal-title":"MedGenMed"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"e28464","DOI":"10.1097\/MD.0000000000028464","article-title":"Health disparities among Black deaf and hard of hearing Americans as compared to Black hearing Americans: A descriptive cross-sectional study","volume":"101","author":"Corbett","year":"2022","journal-title":"Medicine"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1089\/heq.2019.0009","article-title":"Health Disparities Among Mid-to-Older Deaf LGBTQ Adults Compared with Mid-to-Older Deaf Non-LGBTQ Adults in the United States","volume":"3","author":"Kushalnagar","year":"2019","journal-title":"Health Equity"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1089\/trgh.2020.0028","article-title":"Cross-Sectional Analysis of Medical Conditions in the U.S. Deaf Transgender Community","volume":"6","author":"Sanfacon","year":"2021","journal-title":"Transgend. Health"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"41","DOI":"10.3390\/disabilities4010004","article-title":"Queer and Disabled: Exploring the Experiences of People Who Identify as LGBT and Live with Disabilities","volume":"4","author":"Kempapidis","year":"2024","journal-title":"Disabilities"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1136\/bmj.325.7367.771","article-title":"Education and debate: Deaf lesbians, \u201cdesigner disability\u201d, and the future of medicine","volume":"325","author":"Savulescu","year":"2002","journal-title":"BMJ"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s11019-019-09922-6","article-title":"Is it ever morally permissible to select for deafness in one\u2019s child?","volume":"23","author":"Wallis","year":"2020","journal-title":"Med. Health Care Philos."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Simeoni, R., Pirrera, A., Meli, P., and Giansanti, D. (2023). Promoting Universal Equitable Accessibility: An Overview on the Impact of Assistive Technology in the UN, UNICEF, and WHO Web Portals. Healthcare, 11.","DOI":"10.3390\/healthcare11212904"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"17","DOI":"10.2478\/pcssr-2013-0010","article-title":"Tourism Activities of Deaf Poles","volume":"58","author":"Zajadacz","year":"2013","journal-title":"Phys. Cult. Sport Stud. Res."},{"key":"ref_74","unstructured":"Nilsson, L. (2025, March 10). The Experience of Traveling for Young People with a Hearing Impairment\u2013Voices of Invisible Disabled. Ume\u00e5 University, 2020. Available online: https:\/\/www.diva-portal.org\/smash\/get\/diva2:1448498\/FULLTEXT01.pdf."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"103549","DOI":"10.1016\/j.annals.2023.103549","article-title":"The future of deaf tourism studies: An interdisciplinary research agenda","volume":"100","author":"Jensen","year":"2019","journal-title":"Ann. Tour. Res."},{"key":"ref_76","first-page":"102","article-title":"Accessibility of national cultural heritage to deaf tourists","volume":"15","author":"Escudeiro","year":"2022","journal-title":"Int. Conf. Tour. Res."},{"key":"ref_77","unstructured":"ELEVATOR Project (2025, March 10). Inclusive Tourist Guiding. Handbook for Guiding People with Special Access Requirements. Project Identifier: 2015-1-CZ01-KA204-014014. Available online: https:\/\/www.accessibletourism.org\/resources\/io2_english-final.pdf."},{"key":"ref_78","unstructured":"Local Governance Network for Development (2025, March 10). Inclusive Nature Tourism Trails for the Deaf, Disabled and Blind. A Guide for Municipalities in the MENA Region. Available online: https:\/\/www.connective-cities.net\/secure_doc\/documents\/Inclusive_Touristic_Trails_english.pdf."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"2333721415591935","DOI":"10.1177\/2333721415591935","article-title":"Evaluation of Speech Perception via the Use of Hearing Loops and Telecoils","volume":"1","author":"Alfakir","year":"2015","journal-title":"Gerontol. Geriatr. Med."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"71","DOI":"10.3390\/disabilities1020007","article-title":"Hard of Hearing Adults\u2019 Interpersonal Interactions and Relationships in Daily Life","volume":"1","author":"Olsson","year":"2021","journal-title":"Disabilities"},{"key":"ref_81","doi-asserted-by":"crossref","unstructured":"Mwaka, C.R., Best, K.L., Cunningham, C., Gagnon, M., and Routhier, F. (2024). Barriers and facilitators of public transport use among people with disabilities: A scoping review. Front. Rehabil. Sci., 4.","DOI":"10.3389\/fresc.2023.1336514"},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Auerbach, B.D., and Gritton, H.J. (2022). Hearing in Complex Environments: Auditory Gain Control, Attention, and Hearing Loss. Front. Neurosci., 16.","DOI":"10.3389\/fnins.2022.799787"},{"key":"ref_83","first-page":"261","article-title":"Deaf Architecture: Designing Inclusivity through Spatial Innovation","volume":"11","author":"Hapuhinne","year":"2023","journal-title":"J. Commun. Disord."},{"key":"ref_84","unstructured":"Cassi, R. (2023). Disability, Experience and Architecture: Towards Inclusive Sports and Leisure Buildings. [Ph.D. Thesis, Royal Danish Academy\u2014Architecture, Design, Conservation]."},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Millett, P. (2023). The Connected Life: Using Access Technology at Home, at School and in the Community. Educ. Sci., 13.","DOI":"10.3390\/educsci13080761"},{"key":"ref_86","doi-asserted-by":"crossref","unstructured":"Dom\u00ednguez Vila, T., Rubio-Escuderos, L., and Alez, E. (2024). Accessible tourism: Using technology to increase social equality for people with disabilities. Tour. Rev.","DOI":"10.1108\/TR-11-2023-0812"},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"e2411","DOI":"10.7717\/peerj-cs.2411","article-title":"Intelligent sensors in assistive systems for deaf people: A comprehensive review","volume":"10","author":"Silva","year":"2024","journal-title":"PeerJ Comput. Sci."},{"key":"ref_88","unstructured":"World Health Organization (WHO) and the United Nations Children\u2019s Fund (UNICEF) (2025, March 10). Global Report on Assistive Technology. 2022. Licence: CC BY-NC-SA 3.0 IGO. Available online: https:\/\/www.unicef.org\/oman\/media\/1296\/file\/Global%20Report%20on%20Assistive%20Technology.pdf."},{"key":"ref_89","unstructured":"Nierling, L., Mordini, E., Bratan, T., Capari, L., Cas, J., Hennen, L., Krieger-Lamina, J., Kukk, P., and European Parliament: Directorate-General for Parliamentary Research Services (2018). Assistive Technologies for People with Disabilities. Part II, Current and Emerging Technologies, Publications Office of the European Union."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1080\/13632434.2012.723621","article-title":"On education: Conversations with Riccardo Mazzeo","volume":"33","author":"Best","year":"2012","journal-title":"Sch. Leadersh. Manag."},{"key":"ref_91","unstructured":"RESTAT (2025, March 10). Receiving Tourists with Hearing Impairment. Available online: https:\/\/restatproject.eu\/wp-content\/uploads\/2021\/04\/M1-Receiving-tourists-with-hearing-impairment-1.pdf."},{"key":"ref_92","unstructured":"Australian Government, Department of Health and Aged Care (2025, March 10). Tips for Talking to People with Hearing Loss, Available online: https:\/\/www.health.gov.au\/sites\/default\/files\/2023-05\/tips-for-talking-to-people-with-hearing-loss.pdf."},{"key":"ref_93","unstructured":"NIDCD (2025, March 10). Assistive Devices for People with Hearing, Voice, Speech, or Language Disorders. NIH Publication 11-7672, Available online: https:\/\/www.nidcd.nih.gov\/sites\/default\/files\/Documents\/publications\/AssistiveDevices-508.pdf."},{"key":"ref_94","first-page":"298","article-title":"Hearing loops: The preferred assistive listening technology","volume":"63","author":"Kaufmann","year":"2015","journal-title":"AES J. Audio Eng. Soc."},{"key":"ref_95","unstructured":"Frazier SO (2025, March 10). Serving Passengers with Hearing Loss. TR NEWS. Available online: https:\/\/onlinepubs.trb.org\/onlinepubs\/trnews\/trnews337Hearing.pdf."},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Chidiac, S.E., Reda, M.A., and Marjaba, G.E. (2024). Accessibility of the Built Environment for People with Sensory Disabilities\u2014Review Quality and Representation of Evidence. Buildings, 14.","DOI":"10.3390\/buildings14030707"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1007\/s10209-023-00983-2","article-title":"Interactive description to enhance accessibility and experience of deaf and hard-of-hearing individuals in museums","volume":"23","author":"Kim","year":"2023","journal-title":"Univers. Access Inf. Soc."},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Papatsimouli, M., Sarigiannidis, P., and Fragulis, G.F. (2023). A Survey of Advancements in Real-Time Sign Language Translators: Integration with IoT Technology. Technologies, 11.","DOI":"10.3390\/technologies11040083"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"368","DOI":"10.3390\/software3030019","article-title":"Signsability: Enhancing Communication through a Sign Language App","volume":"3","author":"Ezra","year":"2024","journal-title":"Software"},{"key":"ref_100","doi-asserted-by":"crossref","unstructured":"Flores Ramones, A., and del-Rio-Guerra, M.S. (2023). Recent Developments in Haptic Devices Designed for Hearing-Impaired People: A Literature Review. Sensors, 23.","DOI":"10.3390\/s23062968"},{"key":"ref_101","unstructured":"Gallaudet University (2025, March 10). DeafSpace Design Guidelines. Available online: https:\/\/infoguides.rit.edu\/ld.php?content_id=59890829."},{"key":"ref_102","doi-asserted-by":"crossref","unstructured":"Libertun de Duren, N.R., Salazar, J.P., Duryea, S., Mastellaro, C., Freeman, L., Pedraza, L., Rodriguez Porcel, M., Sandoval, D., Aguerre, J.A., and Angius, C. (2021). Cities as Spaces for Opportunities for All: Building Public Spaces for People with Disabilities, Children and Elders, Felipe Herrera Library (Inter-American Development Bank).","DOI":"10.18235\/0003064"},{"key":"ref_103","unstructured":"Pi\u00f1eiro, A. (2025, March 10). Architecture for People with Hearing Loss: 6 Design Tips. ArchDaily. Available online: https:\/\/www.archdaily.com\/936397\/architecture-for-people-with-hearing-loss-6-design-tips."},{"key":"ref_104","unstructured":"Leardi, L. (2025, March 10). Basic Principles of Acoustics: Why Architects Shouldn\u2019t Leave It All To Consultants. ArchDaily. Available online: https:\/\/www.archdaily.com\/909793\/basic-principles-of-acoustics-why-architects-shouldnt-leave-it-all-to-consultants."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"1350","DOI":"10.3109\/09638288.2014.913710","article-title":"DeafSpace and the principles of universal design","volume":"36","author":"Edwards","year":"2014","journal-title":"Disabil. Rehabil."}],"container-title":["Audiology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-4349\/15\/3\/46\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:20:31Z","timestamp":1760030431000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-4349\/15\/3\/46"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,24]]},"references-count":105,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["audiolres15030046"],"URL":"https:\/\/doi.org\/10.3390\/audiolres15030046","relation":{},"ISSN":["2039-4349"],"issn-type":[{"value":"2039-4349","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,24]]}}}