Sign language is more than a way to communicate. Like spoken languages, it has its own vocabulary, grammar and even regional variations.

Today marks the 69th International Day of Deaf People, drawing attention to the experiences and communication needs of millions of people around the world.

More than 430 million people require rehabilitation for disabling hearing loss, according to the World Health Organization, and that number is expected to exceed 700 million by 2050.

In China, about 85 million people live with disabilities, including an estimated 27.8 million people with hearing impairments. For many, sign language is an important means of communication.

And just like spoken languages, sign languages have their own "dialects."

Different signs, different regions

There are more than 140 standardized sign languages around the world. Even within China, regional variations are common, with people in different parts of the country often using different signs for the same word.

Take the word "money," for example. In some regions, the sign resembles the action of counting banknotes. In others, the thumb and index finger are brought together to form a small circle.

The word "father" provides another example. In commonly used Chinese sign language, it is expressed by placing an upright thumb beneath the nose. In Beijing, however, the thumb and index finger may both be extended – a gesture associated with the number eight in Chinese. Since "eight" and "father" have similar pronunciations in Mandarin, the regional sign developed accordingly.

Such regional differences are a natural feature of language, but they can also create barriers to communication.

China introduced the "Lexicon of Common Expressions in Chinese National Sign Language" and the "Chinese Common Braille Scheme" on July 1, 2018. The two standards were designed to reduce regional inconsistencies and make communication more accessible to people with hearing and visual impairments.

The move was described by China's Ministry of Education as an important milestone in the standardization of sign language and Braille, giving millions of people with hearing and visual impairments a more standardized system of communication and writing.

Communicating with people with hearing loss

Hearing loss does not only affect a person's ability to hear. It can also gradually change the way they communicate and interact with others.

Some people may initially ignore a decline in hearing, only to find themselves increasingly unable to follow conversations. Over time, they may become reluctant to communicate or avoid social situations altogether.

So how can we communicate better with people experiencing hearing loss?

Li Yongxin, director of the Department of Otology at Beijing Tongren Hospital affiliated with Capital Medical University, said hearing intervention is about more than simply buying a hearing aid.

The first step is a comprehensive ear and hearing evaluation to identify the cause and extent of hearing loss. Different interventions – including hearing aids, cochlear implants and remote microphones – have different indications, while devices also need to be appropriately fitted and adjusted during the initial trial period.

Hearing can also change over time. Li recommends regular follow-up examinations, particularly six months to a year after the initial trial period.

Hearing loss is affecting younger people

Clinical data also point to a noticeable trend toward younger patients with sudden hearing loss.

Among people aged 20 to 35, factors including insufficient sleep, high-pressure work and prolonged headphone use have become increasingly common.

Li said prolonged periods of intense concentration and stress may affect circulation in the inner ear, potentially leading to temporary ischemia and, in some cases, sudden hearing loss.

The window for treating sudden hearing loss is short. According to Li, the optimal time to seek treatment is within 72 hours after symptoms begin. Delaying medical attention can significantly reduce the chances of recovery.

Protect your hearing every day

For many young people, hearing damage does not necessarily come from a single extremely loud noise. Instead, it can result from repeatedly exceeding the safe amount of time and volume for listening.

Traffic, construction and other environmental noise are part of everyday urban life, while headphones and earbuds have become a constant companion for many people.

Li warns that prolonged headphone use can contribute to problems such as inflammation of the external ear canal. In noisy environments, turning up the volume can further increase the risk of damage to the inner ear.

The sensory hair cells in the inner ear cannot regenerate, meaning damage to them is irreversible.

Regardless of the type of headphones used, Li recommends following the "60-60" rule: keep the volume below 60% and limit continuous listening to no more than 60 minutes. When surrounding noise exceeds 60 decibels, he recommends avoiding headphone use.

He also advises against frequently cleaning the ears with cotton swabs or other objects.

Even something as simple as blowing your nose should be done properly: gently press one nostril closed with your thumb and blow outward through the other, then switch sides. This helps avoid excessive pressure on the ears.

Hearing connects us not only to sound, but also to communication, work and social life. Protecting it means paying attention to our ears before a small problem becomes a lasting one – and making communication more accessible for those who experience hearing loss.