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

<h2>Abstract</h2><h3>Objectives</h3> Communication neglect, a recently identified adverse childhood communication experience (ACCE) unique to deaf children, is linked to increased risk of chronic diseases and mental health diagnosis in adulthood. This study utilizes patient-reported outcome (PRO) data to examine the association between ACCE and self-reported symptoms of depression, anxiety, anger, and fatigue. We 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. <h3>Methods</h3> This cross-sectional study utilized PRO data from a national U.S. sample of over 2,000 deaf adults who completed the PROMIS-DEAF Profile. Generalized linear regression models were conducted to investigate the association between retrospective ACCE 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, two additional analyses were conducted including interactions of the Communication Health and Social Support scores with Communication Neglect. <h3>Results</h3> Communication Neglect had a small but significant effect on PROMIS-Global Physical Health, Anxiety, Depression, and Fatigue, but not Anger. Neither Communication Health nor Social Support in adulthood moderated the relationship between Communication Neglect and self-reported mental health symptoms in adulthood. <h3>Conclusions</h3> 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.