Emily Pfender, an assistant professor in the Department of Communication at the University of Delaware and a researcher on the study, explained the central concern driving the work. Traditional scholarship on the Theory of Memorable Messages holds that people recall lifelong guidance from trusted individuals within their own networks, such as relatives, mentors, or physicians. Yet when her team asked young adults about the health messages they remembered most, participants pointed overwhelmingly to social media figures. Strikingly, many respondents did not even follow the influencer in question. They stumbled across the content a single time, perhaps scrolling through a recommended feed, and the message stuck. Some participants reported recalling these one-time encounters for six years or longer, and the literature on memorable messages suggests such memories can persist for a lifetime.

The mechanics of why a fleeting encounter with a stranger can outlast repeated advice from a trusted clinician is one of the most technically interesting questions raised by the research. Memorable messages, as defined in communication science, are verbal and nonverbal messages that are recalled with unusual clarity and are perceived to have shaped a person’s attitudes, beliefs, or behaviors over the long term. They tend to be emotionally charged, framed in vivid and concrete language, and delivered at moments of receptivity. Social media platforms, particularly short-form video environments, are engineered to maximize precisely these qualities. Influencers craft punchy, absolute claims; the platforms optimize for content that triggers strong reactions; and the sheer volume of exposure increases the odds that at least one message will breach the threshold of long-term memory.

The findings cut in two directions at once, and Pfender was explicit about that duality. On the one hand, many of the memorable health messages recalled by participants were problematic in ways that experts would flag immediately. Some promoted sweeping universal prescriptions with little or no scientific basis: taping one’s mouth shut at night to reshape the jaw, drinking two cups of spearmint tea per day to manage polycystic ovary syndrome, or avoiding seed oils as a catch-all dietary cure. On the other hand, some of the recalled messages were genuinely empowering, encouraging young people to view health holistically, to treat mental health as an integral component of overall well-being, and to take an active, autonomous role in their own care. The same channel that spreads dubious pseudoscience also spreads framing that can genuinely improve how people think about their bodies.

The alarm in the research centers less on any single claim than on the structural change it reveals. When a person’s most memorable health message comes from a stranger, that stranger may well have a financial stake in whether the audience follows the recommendation. An influencer selling mouth tape, supplements, or dietary programs profits directly when a memorable message converts into a purchase. This differs fundamentally from the traditional model of memorable messages, in which the trusted source, a grandmother, a coach, a family physician, typically had no commercial interest in the advice being remembered. Pfender described this shift as changing everything researchers thought they knew about how memorable messages work, and the word she used to characterize it was alarming.

For public health communication, the implications are considerable. Health agencies and clinicians have long operated on the assumption that their authoritative position in the information ecosystem gives their messages durability. If young adults are demonstrably anchoring their long-term health beliefs to one-time encounters with monetized strangers, then the durable-message slot in memory is being filled by actors with no accountability and no obligation to accuracy. A memorable but false message, such as the idea that a simple daily habit can structurally alter one’s facial development, is not merely a harmless quirk of memory. It can steer health decisions, delay legitimate care, and establish a template for evaluating future advice that privileges confidence and relatability over evidence.

The study also illuminates a subtle vulnerability of the one-encounter model of influence. Traditional memorable-message theory emphasized repeated reinforcement within close relationships, which meant that questionable claims could be corrected or contextualized by other network members over time. A message from a stranger encountered once in a feed arrives with no surrounding relationship, no possibility of follow-up, and no community context in which it can be questioned. The receiver is left alone with the claim and its emotional charge. In that sense, the very features that make algorithmic distribution efficient, the endless novelty, the frictionless discovery of new voices, may also strip away the social scaffolding that historically helped people calibrate which advice to trust.

Pfender and her collaborators argue that the appropriate response is not to lament the new media environment but to meet it where it operates. She identified digital health literacy interventions as the crucial next step, including dedicated social media platforms and accounts designed to teach young audiences how to evaluate health claims online. Critically, she argued that these interventions should take the form of short-form content and be posted natively on the same platforms where the problematic messages circulate, particularly TikTok and Instagram. A digital health literacy campaign delivered through a static brochure or a university website would be competing in a different arena entirely; the point is to give audiences memorable counter-messages in the same format, style, and channel that made the original claims memorable in the first place.

Pfender practices what she describes. As a content creator herself, she actively shares her research findings on social media, where she has built a following of more than 34,000 people. Her call, in her own framing, is simple: the scientific community needs more scientists online. The reasoning is practical rather than rhetorical. If the slot for memorable health messages is now filled by whoever earns the algorithm’s recommendation, then evidence-based voices that refuse to participate in short-form video are effectively conceding that slot to whoever shows up. Engagement, clarity, and repetition, the same qualities that make misinformation sticky, are available to accurate communicators as well, but only if they enter the environment.

The broader lesson of the study may be that memory itself has become contested territory. For most of the twentieth century, the messages people remembered about their health were filtered through relationships, institutions, and professional gatekeepers, however imperfectly. Those filters have not disappeared, but they no longer monopolize the channel. A young adult’s most durable health belief can now originate with an anonymous account encountered once, monetized behind the scenes, and optimized by recommendation systems that know nothing about medical accuracy. Understanding that shift, measuring it, and learning to compete within it is, on the evidence of this research, one of the central communication challenges for public health in the coming decade. The study was published in Health Communication on August 13, 2026.

Subject of Research: Memorable health messages received by young adults on social media

Article Title: For young adults, memorable health advice is increasingly coming from strangers online

Article References: For young adults, memorable health advice is increasingly coming from strangers online. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: memorable messages, health communication, social media, influencers, young adults, digital health literacy, misinformation, TikTok, Instagram, University of Delaware, public health, young

The theoretical starting point is the auditory deprivation hypothesis, which holds that early suboptimal auditory stimulation impairs the development of language, and that language, in turn, scaffolds the emergence of executive functioning. Classic work in this tradition, including Conway, Pisoni, and Kronenberger’s account of how sound supports cognitive sequencing, and Botting and colleagues’ demonstration that nonverbal executive function is mediated by language in deaf and hearing children, has framed deafness as a neurocognitive risk factor. Kesarwani and Debbarma accept this framework but add a crucial twist: the instruments used to measure executive functioning are themselves saturated with language, meaning that any assessment in the deaf population risks confounding true cognitive differences with linguistic load.

The search strategy combined terms for executive functioning and hearing impairment, including cognitive functioning, linguistic influence on executive functioning, and the influence of cochlear implants, with the keyword ‘young adults’ added to isolate the relevant age group. Databases such as Scopus, PsycINFO, and PubMed were queried, and twelve studies survived the inclusion criteria. The multidimensional nature of executive functioning was mapped using measures spanning working memory, inhibitory control, cognitive flexibility, planning, and theory of mind, ranging from self-report inventories such as the Behavior Rating Inventory of Executive Function–Adult version to behavioral paradigms like the Eriksen flanker task, which requires participants to respond to a target letter while ignoring distracting flanking letters—a design that can be delivered almost entirely visually.

The pattern that emerges is striking. On language-dependent measures—verbal fluency tasks, self-report questionnaires, and complex verbal reasoning batteries—deaf young adults consistently score lower than hearing peers. But when the review examined visually presented, low-language behavioral paradigms, the group differences shrank substantially, and in some domains disappeared altogether. This dissociation suggests that what has been interpreted as an executive functioning deficit in deaf young adults may, in considerable measure, reflect the linguistic demands of the assessment tools rather than a core cognitive impairment. In other words, the measuring stick itself may be bent.

The findings are consistent with the broader literature on visual attention in deaf populations. Studies such as those by Sladen and colleagues and Rothpletz and colleagues found that deaf adults can show intact, and in some cases enhanced, attentional deployment to the visual periphery, a plausible adaptation to a world perceived primarily through vision. Similarly, research on visual-spatial skills by Marschark, Spencer, and colleagues indicates that hearing status interacts with language experience in ways that do not map neatly onto simple deficit narratives. The new review synthesizes this evidence to argue that executive functioning in deaf young adults is mediated jointly by language exposure and task modality—two factors that most standard clinical batteries fail to disentangle.

Cochlear implants add another layer of complexity. The review reports that implantation is associated with improved cognitive skills, aligning with longitudinal work by Sarant and colleagues showing cognitive gains in older adults receiving implants, and with Kronenberger and colleagues’ neurocognitive risk model for implanted children. Yet even among implanted individuals, linguistic skills remain the primary predictor of executive functioning outcomes. This is a crucial nuance: restoring auditory input appears to help, but it does not erase the foundational role of early language access. The implication is that language-rich environments—whether signed or spoken—during the critical early years remain the strongest protective factor for later executive functioning.

The review also engages with theory of mind, the capacity to attribute mental states to others, which is often classified under the broader executive functioning umbrella. Studies of deaf college students by Marschark, Edwards, and colleagues, and work by Lecciso and colleagues on deaf adults, show that theory-of-mind performance is heavily dependent on linguistic proficiency and conversational access. Native signers with deaf signing parents frequently perform comparably to hearing peers, while deaf individuals with delayed or impoverished early language access show the largest gaps. This mirrors Woolfe’s findings with deaf native signing children and reinforces the review’s central thesis: language experience, not deafness per se, drives many of the cognitive differences documented in the literature.

Methodologically, the authors validated their instruments where possible. Hauser, Lukomski, and Samar demonstrated that the BRIEF-A can be reliable and valid for deaf college students, but only after careful adaptation, and their work appears alongside studies using the Adult Executive Functioning Inventory and general ability measures such as the General Ability Measure for Adults. The review highlights that self-report inventories pose a particular problem in the deaf population because their items are embedded in idiomatic written English, and comprehension of such language is itself a variable under study. When the test’s language load correlates with the construct’s linguistic dependence, measurement error and true variance become indistinguishable—a psychometric trap the authors urge the field to escape.

The real-world stakes are considerable. Executive functioning predicts academic achievement, employment, social maturity, and psychological adjustment, and Xiong and colleagues recently showed that executive dysfunction contributes to anxiety in hearing-impaired college students through pathways involving smartphone addiction and academic procrastination. If assessments systematically overestimate executive difficulties in deaf young adults, misdiagnosis, inappropriate support decisions, and lowered expectations may follow. Conversely, if genuinely deficient skills in verbal working memory or sequencing are masked by poorly designed visual tasks, individuals may miss interventions that could help. Accurate, linguistically sensitive measurement is thus not an academic nicety but a prerequisite for equitable education, clinical care, and workplace policy.

The authors close with a forward-looking recommendation: future assessment of executive functioning in deaf young adults should be linguistically sensitive by design, favoring visually delivered, low-language behavioral paradigms, reporting participants’ language histories explicitly, and treating modality of presentation as an experimental variable rather than a fixed convenience. They acknowledge the review’s limitations—twelve studies is a modest evidence base, and heterogeneity in samples, signing status, implantation history, and measures complicates synthesis—and note that no datasets were generated or analysed beyond the published literature. Still, the message lands with force. A generation of findings portraying deaf young adults as cognitively at risk may need recalibration, because a substantial share of the measured gap may belong to the tests, not the test-takers. For a population already navigating environments built for the hearing, that distinction matters: cognitive capacity should be measured on its own terms, not filtered through the language of those doing the measuring.

Executive functioning is not a single capacity but a family of interrelated processes that continue developing well into the mid-twenties, with the prefrontal cortex maturing gradually across adolescence and early adulthood. This protracted developmental trajectory means that the young adult years represent a window in which individual differences in cognitive control become consequential for real-world outcomes such as higher education, employment, and independent living. It also means that measurement choices made during this period can shape trajectories of support, since a young adult identified as having weak planning or working memory skills may be steered toward particular academic accommodations or clinical services on that basis.

The auditory scaffolding account underlying the review draws on a wider body of work in cognitive neuroscience suggesting that early sensory experience shapes the neural architecture available for later cognition. Temporal sequencing, in particular, is thought to depend on experience with the rapid, sequential structure of spoken language, so that children deprived of clear auditory input during sensitive periods may develop alternative but differently organized strategies for encoding order and sequence. Research with deaf native signers is informative here: when sign language is acquired from birth, many aspects of cognitive development proceed on a typical timetable, indicating that a fully accessible visual language can serve the same scaffolding function that spoken language serves for hearing children.

This perspective reframes deafness-related cognitive research as a natural experiment in modality and language experience rather than a search for deficits. Comparisons among deaf native signers, deaf late signers, oral deaf individuals with cochlear implants, and hearing controls allow researchers to separate the contributions of auditory access, language timing, and communication modality. Studies that include such detailed language histories tend to find that the timing and richness of early language exposure predict cognitive outcomes more consistently than audiological factors such as degree of hearing loss.

For practitioners, the practical takeaway is that assessment batteries for deaf young adults should be selected and interpreted with the linguistic demands of each instrument made explicit. Visual, nonverbal tasks can serve as a baseline against which performance on verbal measures is compared, and discrepancies between the two may signal linguistic load rather than cognitive weakness. Bilingual assessment frameworks that account for both signed and spoken language proficiency, and that involve examiners fluent in the client’s preferred language, offer a promising route toward measurement that reflects genuine ability rather than the accident of test design.

Subject of Research: Executive functioning in deaf young adults: a systematic review of measures and linguistic influence

Article Title: Executive functioning in deaf young adults: a systematic review of measures and linguistic influence

Article References: Kesarwani, S., & Debbarma, R. (2026). Executive functioning in deaf young adults: a systematic review of measures and linguistic influence. SN Social Sciences, 6(9), Article 402. https://doi.org/10.1007/s43545-026-01694-0

Image Credits: AI Generated

DOI: 10.1007/s43545-026-01694-0

Keywords: Executive, functioning, deaf, young, adults, systematic, review, measures, linguistic, influence, scientific research