Language deprivation syndrome: a possible neurodevelopmental disorder with sociocultural origins

  • Wyatte C. Hall
  • Leonard L. Levin
  • Melissa L. Anderson
Original Paper



There is a need to better understand the epidemiological relationship between language development and psychiatric symptomatology. Language development can be particularly impacted by social factors—as seen in the developmental choices made for deaf children, which can create language deprivation. A possible mental health syndrome may be present in deaf patients with severe language deprivation.


Electronic databases were searched to identify publications focusing on language development and mental health in the deaf population. Screening of relevant publications narrowed the search results to 35 publications.


Although there is very limited empirical evidence, there appears to be suggestions of a mental health syndrome by clinicians working with deaf patients. Possible features include language dysfluency, fund of knowledge deficits, and disruptions in thinking, mood, and/or behavior.


The clinical specialty of deaf mental health appears to be struggling with a clinically observed phenomenon that has yet to be empirically investigated and defined within the DSM. Descriptions of patients within the clinical setting suggest a language deprivation syndrome. Language development experiences have an epidemiological relationship with psychiatric outcomes in deaf people. This requires more empirical attention and has implications for other populations with behavioral health disparities as well.


Behavioral health Language deprivation Sign language Hearing loss Social psychiatry 


  1. 1.
    Draine J, Salzer MS, Culhane DP, Hadley TR (2002) Role of social disadvantage in crime, joblessness, and homelessness among persons with serious mental illness. Psychiatr Serv 53(5):565–573. doi:10.1176/ CrossRefPubMedGoogle Scholar
  2. 2.
    Meyer IH (2003) Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychol Bull 129(5):674–697. doi:10.1037/0033-2909.129.5.674 CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Kelly CM, Jorm AF, Wright A (2007) Improving mental health literacy as a strategy to facilitate early intervention for mental disorders. Med J Aust 187(7 Suppl):S26–S30PubMedGoogle Scholar
  4. 4.
    Mazza JR, Boivin M, Tremblay RE, Michel G, Salla J, Lambert J, Zunzunegui MV, Cote SM (2016) Poverty and behavior problems trajectories from 1.5 to 8 years of age: Is the gap widening between poor and non-poor children? Soc Psychiatry Psychiatr Epidemiol 51(8):1083–1092. doi:10.1007/s00127-016-1252-1 CrossRefPubMedGoogle Scholar
  5. 5.
    Mensah FK, Kiernan KE (2010) Parents’ mental health and children’s cognitive and social development: families in England in the Millennium Cohort Study. Soc Psychiatry Psychiatr Epidemiol 45(11):1023–1035. doi:10.1007/s00127-009-0137-y CrossRefPubMedGoogle Scholar
  6. 6.
    Blackwell DL, Lucas JW, Clarke TC (2012) Summary health statistics for U.S. adults: national health interview survey, 2012. Vital Health Stat 10(260):1–163Google Scholar
  7. 7.
    Mitchell RE, Karchmer MA (2005) Parental hearing status and signing among deaf and hard of hearing students. Sign Lang Stud 5(2):231–244CrossRefGoogle Scholar
  8. 8.
    Institute GR (2011) Regional and national summary report of data from the 2009-10 annual survey of deaf and hard of hearing children and youth. pp 1–12Google Scholar
  9. 9.
    Mayberry RI, Lock E (2003) Age constraints on first versus second language acquisition: evidence for linguistic plasticity and epigenesis. Brain Lang 87(3):369–384CrossRefPubMedGoogle Scholar
  10. 10.
    Newport EL (1990) Maturational constraints on language learning. Cognit Sci 14:11–28CrossRefGoogle Scholar
  11. 11.
    Leybaert J, D’Hondt M (2003) Neurolinguistic development in deaf children: the effect of early language experience. Int J Audiol 42(Suppl 1):S34–S40CrossRefPubMedGoogle Scholar
  12. 12.
    Lederberg AR, Schick B, Spencer PE (2013) Language and literacy development of deaf and hard-of-hearing children: successes and challenges. Dev Psychol 49(1):15–30. doi:10.1037/a0029558 CrossRefPubMedGoogle Scholar
  13. 13.
    Mayberry RI, Chen JK, Witcher P, Klein D (2011) Age of acquisition effects on the functional organization of language in the adult brain. Brain Lang 119(1):16–29. doi:10.1016/j.bandl.2011.05.007 CrossRefPubMedGoogle Scholar
  14. 14.
    Penicaud S, Klein D, Zatorre RJ, Chen JK, Witcher P, Hyde K, Mayberry RI (2013) Structural brain changes linked to delayed first language acquisition in congenitally deaf individuals. Neuroimage 66:42–49. doi:10.1016/j.neuroimage.2012.09.076 CrossRefPubMedGoogle Scholar
  15. 15.
    Skotara N, Salden U, Kugow M, Hanel-Faulhaber B, Roder B (2012) The influence of language deprivation in early childhood on L2 processing: an ERP comparison of deaf native signers and deaf signers with a delayed language acquisition. BMC Neurosci 13:44. doi:10.1186/1471-2202-13-44 CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Hyde M, Punch R, Komesaroff L (2010) Coming to a decision about cochlear implantation: parents making choices for their deaf children. J Deaf Stud Deaf Educ 15(2):162–178. doi:10.1093/deafed/enq004 CrossRefPubMedGoogle Scholar
  17. 17.
    Kral A, Kronenberger WG, Pisoni DB, O’Donoghue GM (2016) Neurocognitive factors in sensory restoration of early deafness: a connectome model. Lancet Neurol 15(6):610–621. doi:10.1016/S1474-4422(16)00034-X CrossRefPubMedGoogle Scholar
  18. 18.
    Duchesne L, Sutton A, Bergeron F (2009) Language achievement in children who received cochlear implants between 1 and 2 years of age: group trends and individual patterns. J Deaf Stud Deaf Educ 14(4):465–485. doi:10.1093/deafed/enp010 CrossRefPubMedGoogle Scholar
  19. 19.
    Niparko JK, Tobey EA, Thal DJ, Eisenberg LS, Wang NY, Quittner AL, Fink NE, Team CDI (2010) Spoken language development in children following cochlear implantation. JAMA 303(15):1498–1506. doi:10.1001/jama.2010.451 CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Davidson LS, Geers AE, Blamey PJ, Tobey EA, Brenner CA (2011) Factors contributing to speech perception scores in long-term pediatric cochlear implant users. Ear Hear 32(1 Suppl):19S–26S. doi:10.1097/AUD.0b013e3181ffdb8b CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Tobey EA, Geers AE, Sundarrajan M, Shin S (2011) Factors influencing speech production in elementary and high school-aged cochlear implant users. Ear Hear 32 (1Suppl):27S–38S. doi:10.1097/AUD.0b013e3181fa41bb CrossRefPubMedCentralGoogle Scholar
  22. 22.
    Lund E (2015) Vocabulary knowledge of children with cochlear implants: a meta-analysis. J Deaf Stud Deaf Educ 21(2):107–121. doi:10.1093/deafed/env060 CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Liddell SK (2003) Grammar, gesture, and meaning in American Sign Language. Cambridge University Press, New York, NYCrossRefGoogle Scholar
  24. 24.
    Humphries T, Kushalnagar P, Mathur G, Napoli DJ, Padden C, Rathmann C, Smith SR (2012) Language acquisition for deaf children: reducing the harms of zero tolerance to the use of alternative approaches. Harm Reduct J 9:16. doi:10.1186/1477-7517-9-16 CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Lyness C, Woll B, Campbell R, Cardin V (2013) How does visual language affect crossmodal plasticity and cochlear implant success? Neurosci Biobehav Rev 37:2621–2630CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Sugar M (2016) Dispelling myths about deafness. Accessed 4 Apr 2016
  27. 27.
    Hassanzadeh S (2012) Outcomes of cochlear implantation in deaf children of deaf parents: comparative study. J Laryngol Otol 126(10):989–994. doi:10.1017/S0022215112001909 CrossRefPubMedGoogle Scholar
  28. 28.
    Amraei K, Amirsalari S, Ajallouiyan M  (2016) Comparison of intelligence quotients of first- and second-generation deaf children with cochlear implants. Int J Pediatr Otorhinolaryngol 92:167–170. doi:10.1016/j.ijporl.2016.10.005 Google Scholar
  29. 29.
    Humphries T, Kushalnagar P, Mathur G, Napoli DJ, Padden C, Rathmann C, Smith SR (2017) Discourses of prejudice in the professions: the case of sign languages. J Med Ethics (in press)Google Scholar
  30. 30.
    Fellinger J, Holzinger D, Dobner U, Gerich J, Lehner R, Lenz G, Goldberg D (2005) Mental distress and quality of life in a deaf population. Soc Psychiatry Psychiatr Epidemiol 40(9):737–742. doi:10.1007/s00127-005-0936-8 CrossRefPubMedGoogle Scholar
  31. 31.
    Anderson ML, Leigh IW (2011) Intimate partner violence against deaf female college students. Violence Against Women 17(7):822–834CrossRefPubMedGoogle Scholar
  32. 32.
    Pollard RQ Jr, Sutter E, Cerulli C (2014) Intimate partner violence reported by two samples of deaf adults via a computerized American Sign Language survey. J Interpers Violence 29(5):948–965. doi:10.1177/0886260513505703 CrossRefPubMedGoogle Scholar
  33. 33.
    van Gent T, Goehart AW, Treffers PDA (2011) Self-concept and psychopathology in deaf adolescents: Preliminary support for moderating effects of deafness-related characterisitics and peer problems. J Child Psychol Psychiatry 52(6):720–728CrossRefPubMedGoogle Scholar
  34. 34.
    Anderson ML, Wolf Craig KS, Hall WC, Ziedonis DM (2016) A pilot study of deaf trauma survivors’ experiences: Early traumas unique to being deaf in a hearing world. J Child Adolesc Trauma 9(4):353–358. doi:10.1007/s40653-016-0111-2 CrossRefPubMedGoogle Scholar
  35. 35.
    Fellinger J, Holzinger D, Pollard R (2012) Mental health of deaf people. The Lancet 379(9820):1037–1044. doi:10.1016/S0140-6736(11)61143-4 CrossRefGoogle Scholar
  36. 36.
    Sinkkonen J (1994) Hearing impairment, communication and personality development. University of Helsinki, HelsinkiGoogle Scholar
  37. 37.
    Kitson N, Fry R (1990) Prelingual deafness and psychiatry. Br J Hosp Med 44(5):353–356PubMedGoogle Scholar
  38. 38.
    Glickman NS (2007) Do you hear voices? Problems in assessment of mental status in deaf persons with severe language deprivation. J Deaf Stud Deaf Educ 12(2):127–147. doi:10.1093/deafed/enm001 CrossRefPubMedGoogle Scholar
  39. 39.
    Humphries T, Kushalnagar P, Mathur G, Napoli DJ, Padden C, Pollard R, Smith SR (2014) What medical education can do to ensure robust language development in deaf children. Med Sci Educ 24(4):409–419CrossRefGoogle Scholar
  40. 40.
    Gulati S (2003) Psychiatric care of culturally deaf people. In: Glickman NS, Gulati S (eds) Mental health care of deaf people: a culturally affirmative approach. Lawrence Erlbaum Associates, Mahwah, NJ, pp 33–107Google Scholar
  41. 41.
    Glickman NS (2009) Summary and conclusions. In: Glickman NS (ed) Cognitive-behavioral therapy for deaf and hearing persons with language and learning challenges. Routledge, New York, NYGoogle Scholar
  42. 42.
    Gulati S (2014) Language deprivation syndrome. ASL Lecture Series., Brown University
  43. 43.
    Humphries T, Kushalnagar P, Mathur G, Napoli DJ, Padden C, Rathmann C, Smith SR (2016) Avoiding linguistic neglect of deaf children. Soc Serv Rev 90(4):589–619. doi:10.1086/689543 CrossRefGoogle Scholar
  44. 44.
    Moher D, Liberati A, Tetzlaff J, Altman DG, Group P (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 6(7):e1000097. doi:10.1371/journal.pmed.1000097 CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Rainer JD, Altshuler KZ (1966) Comprehensive mental health services for the deaf. Columbia University, New York, NYGoogle Scholar
  46. 46.
    Basilier T (1964) Surdophrenia. The psychic consequences of congenital or early acquired deafness. Some theoretical and clinical considerations. Acta Psychiatr Scand 40(SUPPL 180):363CrossRefGoogle Scholar
  47. 47.
    Vernon M (1969) Sociological and psychological factors associated with hearing loss. J Speech Hear Res 12(3):541–563CrossRefPubMedGoogle Scholar
  48. 48.
    Vernon M, Rothstein DA (1968) Prelingual deafness: an experiment of nature. Arch Gen Psychiatry 19(3):361–369CrossRefPubMedGoogle Scholar
  49. 49.
    Denmark JC, Warren F (1972) A psychiatric unit for the deaf. Br J Psychiatry 120(557):423–428CrossRefPubMedGoogle Scholar
  50. 50.
    Lane H (1976) The wild boy of Aveyron. Harvard University Press, Cambridge, MAGoogle Scholar
  51. 51.
    Vernon M, Raifman LJ (1997) Recognizing and handling problems of incompetent deaf defendants charged with serious offenses. Int J Law Psychiatry 20(3):373–387CrossRefPubMedGoogle Scholar
  52. 52.
    Altshuler KZ (1986) Perceptual handicap and mental illness, with special reference to early profound deafness. Am J Soc Psychiatry 6(2):125–128Google Scholar
  53. 53.
    Weiler C, Landsberger SA, Diaz DR (2013) Differential diagnosis of psychosis in a deaf inpatient with language dysfluency: a case study. Clin Schizophr Relat Psychos 7(1):42–45. doi:10.3371/CSRP.WELA.032513 CrossRefGoogle Scholar
  54. 54.
    Pollard RQ (1998) Psychopathology. In: Marschark M, Clark MD (eds) Psychological perspectives on deafness, vol 2. Lawrence Erlbaum, Inc., Mahwah, NJ, pp 171–197Google Scholar
  55. 55.
    Black PA, Glickman NS (2006) Demographics, psychiatric diagnoses, and other characteristics of North American Deaf and hard-of-hearing inpatients. J Deaf Stud Deaf Educ 11(3):303–321. doi:10.1093/deafed/enj042 CrossRefPubMedGoogle Scholar
  56. 56.
    Thacker AJ (1994) Formal communication disorder. Sign language in deaf people with schizophrenia. Br J Psychiatry 165(6):818–823CrossRefPubMedGoogle Scholar
  57. 57.
    Schenkel LS, Rothman-Marshall G, Schlehofer DA, Towne TL, Burnash DL, Priddy BM (2014) Child maltreatment and trauma exposure among deaf and hard of hearing young adults. Child Abuse Neglect 38(10):1581–1589. doi:10.1016/j.chiabu.2014.04.010 CrossRefPubMedGoogle Scholar
  58. 58.
    Denmark JC (1971) Psychiatry and the deaf. Curr Psychiatr Ther 11:68–72PubMedGoogle Scholar
  59. 59.
    Cooper AF (1976) Deafness and psychiatric illness. Br J Psychiatry 129:216–226CrossRefPubMedGoogle Scholar
  60. 60.
    Long G, Long N, Ouellette SE (1993) Service provision issues with traditionally underserved persons who are deaf. In: Welch OM (ed) Research and practice in deafness: Issues and questions in education, psychology and vocattional service provision. Charles C Thomas, Springfield, pp 107–126Google Scholar
  61. 61.
    Hauser PC, O’Hearn A, McKee M, Steider A, Thew D (2010) Deaf epistemology: deafhood and deafness. Am Ann Deaf 154(5):486–492CrossRefPubMedGoogle Scholar
  62. 62.
    Barnett S, McKee M, Smith SR, Pearson TA (2011) Deaf sign language users, health inequities, and public health: Opportunity for social justice. Prev Chronic Dis 8(2):A45PubMedPubMedCentralGoogle Scholar
  63. 63.
    McKee MM, Paasche-Orlow MK, Winters PC, Fiscella K, Zazove P, Sen A, Pearson T (2015) Assessing health literacy in deaf american sign language users. J Health Commun 20(Suppl 2):92–100. doi:10.1080/10810730.2015.1066468 CrossRefPubMedPubMedCentralGoogle Scholar
  64. 64.
    Altshuler KZ (1971) Studies of the deaf: relevance to psychiatric theory. Am J Psychiatry 127(11):1521–1526. doi:10.1176/ajp.127.11.1521 CrossRefPubMedGoogle Scholar
  65. 65.
    Giddan JJ, Milling L, Campbell NB (1996) Unrecognized language and speech deficits in preadolescent psychiatric inpatients. Am J Orthopsychiatry 66(1):85–92CrossRefPubMedGoogle Scholar
  66. 66.
    Gaines J, Meltzer B, Glickman NS (2009) Language and learning challenges in adolescent hearing psychiatric inpatients. In: Glickman NS (ed) Cognitive-behavioral therapy for deaf and hearing persons with language and learning challenges. Routledge, New York, NY, pp 79–102Google Scholar
  67. 67.
    Horton HK (2010) Linguistic ability and mental health outcomes among deaf people with schizophrenia. J Nerv Ment Dis 198(9):634–642. doi:10.1097/NMD.0b013e3181e9dd23 CrossRefPubMedGoogle Scholar
  68. 68.
    Stevenson J, McCann D, Watkin P, Worsfold S, Kennedy C, Hearing Outcomes Study T (2010) The relationship between language development and behaviour problems in children with hearing loss. J Child Psychol Psychiatry 51(1):77–83. doi:10.1111/j.1469-7610.2009.02124.x CrossRefPubMedGoogle Scholar
  69. 69.
    Barker DH, Quittner AL, Fink NE, Eisenberg LS, Tobey EA, Niparko JK, Team CDI (2009) Predicting behavior problems in deaf and hearing children: the influences of language, attention, and parent-child communication. Dev Psychopathol 21(2):373–392. doi:10.1017/S0954579409000212 CrossRefPubMedPubMedCentralGoogle Scholar
  70. 70.
    Huber M, Kipman U (2011) The mental health of deaf adolescents with cochlear implants compared to their hearing peers. Int J Audiol 50(3):146–154CrossRefPubMedGoogle Scholar
  71. 71.
    Williams CE (1970) Some psychiatric observations on a group of maladjusted deaf children. J Child Psychol Psychiatry 11(1):1–18CrossRefPubMedGoogle Scholar
  72. 72.
    Mayberry RI (2002) Cognitive development in deaf children. In: Segalowitz SJ, Rapin I (eds) Handbook of Neuropsychology, vol 8. Elsevier Health Sciences, New York, NY, pp 71–107Google Scholar
  73. 73.
    Bonvillian JD, Charrow VR, Nelson KE (1973) Psycholinguistic and educational implications of deafness. Human Dev 16(5):321–345CrossRefGoogle Scholar
  74. 74.
    Bailes C, Erting C, Erting L, Thumann-Prezioso C (2009) Language and literacy acquisition through parental mediation in American Sign Language. Sign Lang Stud 9(4):417–456CrossRefGoogle Scholar
  75. 75.
    Stewart DA (1983) The use of sign by deaf children: the opinions of a deaf community. Am Ann Deaf 128(7):878–883CrossRefPubMedGoogle Scholar
  76. 76.
    Goldberg B, Lobb H, Kroll H (1975) Psychiatric problems of the deaf child. Can Psychiatric Assoc J 20(1):75–83CrossRefGoogle Scholar
  77. 77.
    Fromkin V, Krashen S, Curtiss S, Rigler D, Rigler M (1974) The development of language in Genie: a case of language acquisition beyond the “Critical Period”. Brain Lang 1:81–107CrossRefGoogle Scholar
  78. 78.
    Association AP (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, Arlington, VACrossRefGoogle Scholar
  79. 79.
    Glickman NS (2009) Adapting best practices in CBT for deaf and hearing persons with language and learning challenges. J Psychother Integr 19(4):354–384CrossRefGoogle Scholar
  80. 80.
    Cantwell DP, Baker L (1977) Psychiatric disorder in children with speech and language retardation. A critical review. Arch Gen Psychiatry 34(5):583–591CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  1. 1.Clinical & Translational Science InstituteUniversity of Rochester Medical CenterRochesterUSA
  2. 2.Lamar Soutter Library, Department of Education and ResearchUniversity of Massachusetts Medical SchoolWorcesterUSA
  3. 3.Systems and Psychosocial Advances Research Center, Department of PsychiatryUniversity of Massachusetts Medical SchoolWorcesterUSA

Personalised recommendations