Understanding Variability in Long-Term Psychological Adjustment of Prelingually Deaf Young Adults Implanted During Childhood

BACKGROUND: Young adults who received cochlear implants (CI) during childhood experience considerable variability in psychological adjustment. Understanding and explaining this within-group variability can help to identify CI users who are at risk for adjustment problems and suggest intervention strategies. This study investigated associations between psychological adjustment and hearing history, speech-language skills, and nonverbal intelligence in young adults who received CIs in childhood. METHODS: Study participants were 30 young adult CI users aged 18-27 years, who were implanted at age 6 years or younger between the years of 1988 and 2003. Self-reported psychological adjustment was assessed in two domains: behavioral-emotional problems and executive functioning problems. Measures of device/hearing history, nonverbal intelligence, speech recognition, vocabulary, and everyday language comprehension problems were obtained to test for contributions to psychological adjustment outcomes. RESULTS: Participants displayed significant variability in psychological adjustment scores, with sample mean scores falling in the average or the minimal problem range. Between 13% and 20% of the sample reported clinically elevated psychological adjustment problems. Psychological adjustment was not related to demographic or device/hearing history variables. In regression equations, fewer everyday language comprehension problems were associated with better psychological adjustment. Speech recognition, vocabulary, and nonverbal intelligence were inconsistently related or unrelated to psychological adjustment. CONCLUSION: Pediatric CI recipients vary in psychological adjustment outcomes during young adulthood. Functional, everyday, higher-order language comprehension skills appear to be centrally important for psychological adjustment in young adult CI users.