Title: Adverse childhood experiences, parental self-efficacy, and language outcomes for children with hearing loss
Description: Maternal-child relationships are among the most influential contexts in which children learn language. The well-being of both members of this dyad affects its efficacy as a vehicle for language learning. Adverse Childhood Experiences (ACEs) are a set of adverse life events that, when experienced before the age of 18, have the potential to negatively affect both physical and mental health across the lifespan. Conversely, parental/maternal self-efficacy has been identified as a predictor of linguistic development. While both of these factors (ACEs and maternal self-efficacy) have been investigated in hearing mother-child dyads, little research has been conducted on the influences of these particular risk and protective factors on children with any level of permanent bilateral hearing loss and their mothers. This study examined the effects of maternal and child ACEs and maternal self-efficacy on spoken English language outcomes for children with hearing loss ages 3-12. One hundred twenty-four mother-child dyads completed assessments of mother and child ACEs and maternal self-efficacy.

Of those 124 participants, 32 also submitted language testing information for their children. Adverse Childhood Experiences (ACEs) were measured using the Center for Youth Wellness Adverse Childhood Experiences Questionnaire (CYW ACE-Q; Burke Harris & Renschler, 2015). Parental self-efficacy was measured using “Efficacy” subscale of the Parenting Sense of Competence Scale (PSOC; Johnston & Mash, 1989). Receptive and expressive language was measured using either the Clinical Evaluation of Language Fundamentals - Preschool, 2nd Edition (CELF-P2; Semel, Wiig, & Secord, 2004) or the Clinical Evaluation of Language Fundamentals, 5th Edition (CELF-5; Wiig, Semel, and Secord, 2013), as appropriate based on the participant’s age. Both maternal and child participants in this study reported higher levels of ACE exposure than previously reported in studies of the general population. Maternal and child ACEs were significantly correlated. White/Caucasian mothers experienced significantly fewer ACEs than mothers of other races/ethnicities.

Children living in adoptive, foster, or guardianship placements experienced significantly more ACEs than children living with their biological mothers. Maternal self-efficacy levels were generally high and were not significantly correlated with maternal ACEs or demographic factors. Between-subjects comparisons showed no significant effects of maternal or child ACE exposure or maternal self-efficacy on children’s language scores. Children who communicated primarily using spoken English had significantly higher language scores on a measure of receptive and expressive English than peers who used visual communication. The results of this study suggest that maternal and child ACEs are significantly correlated in children with hearing loss and their mothers, as has been found in literature on hearing mother-child dyads. In this sample, many demographic factors and the independent variables of maternal and child ACE exposure and maternal self-efficacy did not significantly influence language outcomes, suggesting either resilience effects or a need for further investigation with a sample more representative of the population of deaf/hard of hearing children in the United States.