Hearing loss covers a wide spectrum. Some people are prelingually deaf - that is, they became deaf before they could speak - and others become deaf later in life. People who are prelingually deaf can find it harder to acquire spoken and written language. Their spoken language skills may not be well developed and they may prefer sign language. They may, in effect, have English as a second language.
Many deaf or hearing impaired people have speech that sounds unusual or is difficult to understand. The intelligibility of speech, however, is not an indicator of an individual's proficiency in language or of their intelligence. Students may use speech, lipreading, signing, a hearing aid or a mixture of these. Most deaf students and students with hearing loss use lipreading to some extent.