Improving recognition of deaf-specific adverse childhood experiences: recommendations from an international e-Delphi survey

Aims: Exposure to adversities in childhood is pervasive amongst deaf people. Yet, additional impactful adversities, unique to deaf children, fall outside of the ACEs framework and limit its utility to estimate the prevalence and describe the experience of this population. The current study sought to address this omission and to improve the cultural competency of the ACEs model in relation to deaf people. Methods: Experts with academic and/or clinical knowledge of trauma and deaf people were recruited to a three-round international e-Delphi survey exploring adverse and potentially traumatic experiences specific to deaf people. Results: Forty-one experts, of whom 18 (43.9%) identified as deaf, completed an international three-round e-Delphi. Consensus (≥70% agreement) was obtained on eight potential sources of childhood adversity that are uniquely experienced by deaf people. These are related to social alienation, communication deprivation and enforced conformity to hearing social norms. Conclusions: Recognising and acknowledging the unique adverse childhood experiences of deaf people is critical to ensure that we develop effective preventative and management policies and clinical responses in order to improve developmental and mental health outcomes for all deaf people.