Tests May Underestimate Cognitive Skills of Deaf Young Adults

Executive functioning—the suite of mental skills that allows people to plan, hold information in mind, switch between tasks, and control impulses—has long been flagged as a potential vulnerability in deaf individuals. A new systematic review now argues that part of that vulnerability may be an artifact of the tests themselves. Published in SN Social Sciences by Saksham Kesarwani and Rebeka Debbarma of the Department of Psychology at Central University of Punjab, the review followed PRISMA 2020 reporting guidelines and sifted the literature on hearing impairment and cognition down to twelve studies that specifically examined executive functioning in deaf young adults, a population the authors describe as conspicuously under-researched relative to deaf infants and older adults.

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