Introduction

Despite the growing investment in the study of the relationship between hearing loss and fatigue, the available research does not demonstrate, as clearly as would be expected, the causal relationship between levels of effort and subsequent fatigue in deaf and hard of hearing individuals1. Research has not yet found an irrefutable hypothesis that relates hearing loss, effort (cognitive effort and physical effort), and higher fatigue levels (typology and duration) in DHH participants, than in those of hearing participants, when studying the comparison between samples, as other idiosyncratic variables seem to have a significant impact in self-reported fatigue levels2. Considering that the concept of fatigue is a complex concept to study, the choice of data collection testing methods also proves to be a challenge3,4, especially when studying such a heterogeneous population. The bibliographical research demonstrates that there is still room for further investigation in the area, since the impact of fatigue dimensions in DHH adults’ lives is still little known. Nevertheless, literature maintains that the additional attention, concentration, and effort needed to overcome the communicative problems associated with hearing loss, in hearing aid users especially, result in increased reports of auditory effort, stress and fatigue compared to individuals with normal hearing5,6. It has been shown that high levels of effort daily may result in mental fatigue in the DHH population

Existing research has recognized the increased difficulties of DHH students regarding the lower effectiveness of the instructional material presented in class when there is an overlap of semiotic resources14. Research into the multilingual or ‘translingual’ communicative classroom practices has encompassed a focus on multimodality15 stressing the need to re-think simultaneous communicative actions in more efficient sequential ‘chaining’ of modes, to avoid semiotic overlap and thus, increased levels of effort and subsequent communication difficulties and fatigue. We find claims, in the literature, that using communication and information technologies (ICT) increases the learning capacities of DHH students, especially when multimedia resources are designed according to their specific needs16. The desired effectiveness of using multimedia in teaching DHH students remains, however, dependent on the efficiency of the instructional design that should consider modern learning theories, like the Cognitive Load Theory (CLT). This theory assumes that a cognitive load occurs when cognitive processing requirements exceed the capacities already available to students17. Researchers state that the CLT is concerned with the instructional implications of interaction between information structures and cognitive architecture. However, in tandem with the “interactivity” element, the way in which information is presented to learners and the learning activities required can also impose a cognitivity

As we witness a COVID-19 motivated push towards digital migration with the transition to online work and online classes speeding up without careful impact analyses, the effects of this accelerated transition towards distance learning modalities within the DHH population, must be thoroughly investigated. Here we search for evidence on the putative differential impact that a traditional model of an e-learning situation might have on DHH compared to PSL hearing users and non-users22.

Conclusion

^{The e-learning reality is not an unprecedented reality, namely in the educational field. Given the great adhesion to information and communication technologies, the DHH population is generally elected for distance learning modalities. However, during the pandemic period triggered by Covid-19 and the post-pandemic transition, there was an exponential increase in this type of knowledge transmission, whose benefits, in certain situations, outweigh the losses of in-person training, class or lecture22. For the DHH population, these benefits are not evident, and here we demonstrate different levels of possible harm. Faced with higher fatigue rates and lower performances, the DHH population might be at disadvantage in the several dimensions of academic challenges, leading to further inequalities and constraints that affect well-being and participation opportunities. With this research we hope to contribute to the discussion concerning the pros and cons of digital migration and shed new light that might help redesign more accessible and equitable methodologies and approaches, especially in the DHH educational field, ultimately supporting policymakers in redefining optimal learning strategies.}