Theory of mind
Being Deaf or Hard-of-Hearing has been noted to impact cognitive development as hearing loss impacts social development, language acquisition, and the culture reacts to a deaf child. Cognitive development in academic achievement, reading development, language development, performance on standardized measures of intelligence, visual-spatial and memory skills, development of conceptual skills, and neuropsychological function are dependent upon the child's primary language of communication, either American Sign Language or English, as well as if the child is able to communicate and use the communication modality as a language. There is some research pointing to deficits in development of Theory of mind in children who are Deaf and Hard-of-Hearing which may be due to a lack of early conversational experience. Other research points to lower scores on the Wechsler Intelligence Scale for Children, especially in the Verbal Comprehension Index due differences in cultural knowledge acquisition.