 Further, the term focuses entirely on the physical condition of deafness, while ignoring the linguistic and cultural distinction between those who sign and identify with Deaf culture, and those who do not.The term "hard of hearing" is preferred over "hearing-impaired" within the American Deaf community and accepted as a neutral term without negative or pathological connotations, with no implication about age of onset.It generally refers to people who depend primarily on a spoken language for communication or who have mild or moderate hearing loss.