Psychological changes in students with hearing impairment after backflow: a qualitative study

With the rapid expansion of inclusive education in China, a small number of students with hearing impairment have returned from mainstream schools to special education settings—a phenomenon referred to as backflow in this study. However, little is known about their psychological adaptation following this reverse transition. Adopting a grounded theory approach, this longitudinal qualitative study explored the post-backflow psychological development of six students with hearing impairment. Data were collected through three rounds of in-depth interviews conducted over one year and were supplemented by information from parents, teachers, peers, and school-based observations. The analysis identified three interconnected and overlapping phases of psychological change—change and coping, reconstruction and adjustment, and integration and growth—through which students’ experiences unfolded in non-linear and dynamic ways. Across these phases, three patterns of psychological adaptation were analytically constructed: stable adaptation, active adjustment, and dynamic exploration. Rather than fixed categories, these patterns were understood as fluid configurations that may shift over time in response to relational, communicative, and identity-related contexts. The findings provide context-specific insights into post-backflow psychological adaptation within a particular institutional and cultural setting. The study advances the understanding of inclusive education and highlights the need for individualized support for students with hearing impairment during and after this transition.