31. Chronic infection of the middle ear can cause hearing impairment . 32. Testing may include an audiological referral to exclude hearing impairment . 33. Dragon's hearing impairment causes him difficulty in following Jack's directions. 34. No classical source mentions hearing impairment in connection with Caesar. 35. He was convinced that John's hearing impairment was a punishment for his own sins. 36. A second factor is that many forms of hearing impairment mean that dB input range. 37. At the age of 10 Ferdinand suffered hearing impairment ( for an unknown reason ). 38. Even the most minimum hearing impairment or auditory processing deficit can considerably affect language development. 39. The patient experienced neither speech nor hearing impairments , but suffered from a few brain deficits. 40. Freddy has a hearing impairment that prevents him from being on the Big Apple force.