Early Childhood Communication Neglect and Mental Health Outcomes in Adults Who Are Deaf: Examining the Role of Social and Communication Health as Moderators

Introduction: Communication neglect, a recently identified adverse childhood communication experience unique to children who are deaf, is linked to increased risk of chronic diseases and mental health diagnosis in adulthood. This study utilizes patient-reported outcome data to examine the association between adverse childhood communication experience and self-reported symptoms of depression, anxiety, anger, and fatigue. The authors also investigated the potential moderating role of communication health and social support in adulthood in the relationship between childhood communication neglect and mental health symptoms in adulthood. Methods: This cross-sectional study utilized patient-reported outcome data from a national U.S. sample of over 2,000 adults who are deaf who completed the PROMIS-DEAF Profile. Generalized linear regression models were conducted to investigate the association between retrospective adverse childhood communication experience communication neglect and self-reported physical and mental health outcomes in adulthood. To explore the potential moderation effect of communication health and social support in adulthood, 2 additional analyses were conducted, including interactions of the communication health and social support scores with communication neglect. Results: Communication neglect had a small but significant effect on PROMIS-Global Physical Health, Anxiety, Depression, and Fatigue but not on Anger. Neither communication health nor social support in adulthood moderated the relationship between communication neglect and self-reported mental health symptoms in adulthood. Conclusions: This study highlights the impact of early-life communication neglect on perceived physical health and mental health symptoms in adulthood. Implications for future research, prevention, and public health policy are discussed.