Children who are deaf or hard of hearing may experience higher rates of adverse childhood experiences (ACEs) than their hearing peers, and these experiences pose long-lasting effects to adult mental and physical health, according to a research team led by Danielle "Danni" Guth, who started the project as an undergraduate at Penn State and continued it after graduating in 2021. The team published their work, which Guth said highlights both adversity and resilience within the d/Deaf - which encompases both those who have the audiological condition and are ingrained in Deaf culture - and hard-of-hearing community, in the Journal of Child & Adolescent Trauma.
Now a doctoral student studying clinical psychology at West Chester University, Guth worked with Penn State Associate Professor of Psychology Daniela Martin and West Chester University Assistant Professor of Psychology Lauren Brumley. Together, they found that d/Deaf children face unique adversities, including being bullied by peers and hearing-related information deprivation, which is particularly pertinent to d/Deaf and hard-of-hearing individuals when lacking full access to important points of communication and information regarding themselves or their care. They found that individuals who had been deprived of critical health information experienced twice as many of the "traditional" ACEs - potentially traumatic events, like abuse, neglect or household dysfunction, such as witnessing domestic violence, parental substance abuse or mental illness, or incarceration, in childhood - making them particularly vulnerable to struggles in adulthood.
To measure these effects, the researchers surveyed 81 d/Deaf and hard-of-hearing study participants. Based on their responses to the online survey questions about their childhood and adult life, the participants were assigned multiple scores related to their mental well-being, health and resilience. The researchers then compared those scores to publicly available data of a national representative sample. Echoing previous studies, Guth and her colleagues found there was a correlation between experiences of childhood adversity and current life outcomes measured as emotional well-being, health-related quality of life, and levels of energy and fatigue. Those who experienced greater numbers of ACEs had worse emotional well-being, lower energy and lower health-related quality of life.
However, they also found that study participants who reported higher levels of protective factors - including social support from friends and family around hearing loss, involvement in the Deaf community, and resilience - had better adult outcomes even for those who had significant ACEs.
Guth said this topic was very special for her, which is why she wanted to pursue research on it when she came to Penn State Brandywine in 2017.
"I am hard-of-hearing and have been my entire life, so I'm not immune to the unique struggles and things that this community faces," she said. "I've gone through adverse childhood experiences myself with bullying and discrimination, so I really wanted to study this as part of my career and studies in psychology. I also knew that this is a population I want to work with long-term in my psychology career. I want to be an advocate for the Deaf and hard-of-hearing community and spread awareness about this topic."
The research began when Guth approached Martin her first year at Brandywine after learning about Martin's work researching the psychological experiences of the Deaf community.
"The project came out of both our backgrounds. It came from Danni's interest in the topic, which she expressed to me in 'PSYCH 243: Introduction to Well-Being and Positive Psychology' when we were talking about resilience," Martin said. "Since Danni was in the Cooper Honors Program, we framed the project as an honors thesis for her requirements in the program."
The research process began in person but shifted online due to the COVID-19 pandemic. Guth read many journal articles about ACEs in the general population, but nothing in the scientific literature focused on the Deaf community, so the team developed their survey and distributed it to people in the d/Deaf and hard-of-hearing community via social media groups and audiologists distributing the survey to patients.
"Most of our past research was done on the general population because, at the time we were researching, there were no studies done on the prevalence of adverse childhood experiences among the d/Deaf and hard-of-hearing population. By the time we published, there were four studies, so we're the fifth one," Martin said. "One difference between our study and the four others is that we focused not only on the adversities and traumas Deaf and hard of hearing children face, but we highlighted the resilience and growth that can happen after trauma."
Conducting research within a community she is a part of helped her better understand her own experiences, Guth said, while also strengthening her commitment to advocacy and clinical work.
"On the personal growth side, it showed that I'm not alone and other people experience what I went through," she said. "On the professional growth side, I was able to see the impact of these different experiences and different avenues for resilience among future clients. My goal is to work with d/Deaf and hard-of-hearing clients as part of my clinical psychology career."
The undergraduate research was crucial for Guth's application and admission into graduate school, she said.
"When students are looking at applying to graduate school, it's important to have those research opportunities on the application," Martin said, noting that Guth also presented her work at a psychology conference prior to graduating. "In Danni's case, it's what made her most successful when she applied to graduate school and got into her doctoral program."
Guth is projected to graduate from West Chester University in 2027. She is also an advanced practicum student clinician for the Community Mental Health Services at West Chester University, a doctoral extern at human-services nonprofit Elwyn and a social media coordinator for Suburban Research Associates. She continues to serve as an advocate for this community and population through her social media page, Compassionately Inspired.
