The implications of a hearing loss can go far beyond the linguistic domain. Several studies have revealed that deaf and hard-of-hearing children are at risk in their social-emotional development. This chapter argues that executive functions and theory of mind are two central underlying cognitive factors in people’s social-emotional functioning. We briefly review what is currently known about executive functioning and theory-of-mind development in deaf and hard-of-hearing children and adolescents and then present a cognitive model with a central role for inner speech in relation to executive functioning and theory of mind. We hypothesize that inner speech both enables and urges the regulation of oneself (executive function) and also the mentalization of one’s own and others’ inner worlds (theory of mind). We discuss the implications for assessing and treating social-emotional problems in deaf and hard-of-hearing children and adolescents.