Demographic Characteristics of Participants.

Many deaf and hard of hearing (DHH) adolescents and adolescents with developmental language disorders (DLD) face communication problems (CP) that may increase their vulnerability to adverse childhood experiences (ACEs). ACEs have been shown to affect physical and mental health, and in particular, the accumulation of ACEs is associated with high stress levels, which can have detrimental effects on well-being. This study examined the prevalence of ACEs and their impact on stress and well-being in adolescents with CP (DHH, DLD) compared to a reference group.127 adolescents with CP (32 DHH adolescents and 95 adolescents with DLD) in special secondary education were compared to a reference group of 86 adolescents in mainstream secondary education. T-tests, chi-square tests, and proportion tests were used to compare all groups on ACEs, stress impact, and well-being. A mediation analysis tested the indirect effect of stress on the relationship between ACEs and well-being. Adolescents with CP reported significantly more (accumulations of) ACEs (p < .05, p.001), higher stress impact (p < .001), and lower well-being (p < .05) than the reference group. The origin of communication problems (DHH versus DLD) appeared to induce no differences between groups. Mediation analysis revealed that ACEs indirectly influenced adolescents’ well-being through their effect on stress impact (p < .001). Adolescents with CP in special secondary education are highly vulnerable to encountering ACEs, which increases the risk of experiencing high stress levels that detract from their well-being. Therefore, structural screening of this group for stress impact and well-being should be mandatory.

许多聋症与重听症（deaf and hard of hearing, DHH）青少年及发育性语言障碍（developmental language disorders, DLD）青少年均面临沟通障碍（communication problems, CP），这可能使其更易遭受儿童期不良经历（adverse childhood experiences, ACEs）的侵害。已有研究表明，儿童期不良经历会影响个体的身心健康，且儿童期不良经历的累积与高水平压力密切相关，进而对个体福祉产生不利影响。
本研究针对存在沟通障碍的青少年（含聋重听群体与发育性语言障碍群体），探讨了其儿童期不良经历的流行情况，以及与对照组相比，该群体的儿童期不良经历对压力水平和福祉的影响。
本研究共纳入127名就读于特殊中等教育机构的沟通障碍青少年（其中32名聋重听青少年、95名发育性语言障碍青少年），并以86名就读于普通中等教育机构的青少年作为对照组。研究采用t检验、卡方检验及比例检验，比较两组在儿童期不良经历、压力影响及福祉水平上的差异；同时通过中介分析，检验压力在儿童期不良经历与福祉之间的间接效应。
相较于对照组，沟通障碍青少年报告的儿童期不良经历（累积量）显著更多（p<0.05，p<0.001），压力影响程度更高（p<0.001），且福祉水平更低（p<0.05）。不同沟通障碍亚型（聋重听与发育性语言障碍）并未对组间差异产生显著影响。
中介分析结果显示，儿童期不良经历可通过提升个体的压力影响程度，间接对青少年的福祉产生负面影响（p<0.001）。
就读于特殊中等教育机构的沟通障碍青少年极易遭遇儿童期不良经历，这会提升其出现高水平压力的风险，进而损害其福祉。因此，对该群体开展压力影响程度与福祉状况的结构性筛查应成为强制性要求。