Behavioral problems in school-aged hearing-impaired children: the influence of sociodemographic, linguistic, and medical factors

Abstract

The purpose of this study was to examine several behavioral problems in school-aged hearing-impaired children with hearing aids or cochlear implants, compared to normally hearing children. Additionally, we wanted to investigate which sociodemographic, linguistic, and medical factors contributed to the level of behavioral problems, to pinpoint where targeted interventions can take place. This large, retrospective study included a sample of 261 school-aged children (mean age = 11.8 years, SD = 1.6), that consisted of three age- and gender-matched subgroups: 75 with hearing aids, 57 with cochlear implants, and 129 normally hearing controls. Self- and parent-reports concerning reactive and proactive aggression, delinquency, and symptoms of psychopathy, attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder were used. In addition, several language and intelligence tests were administered. Hearing-impaired children showed significantly more proactive aggression, symptoms of psychopathy, attention deficit hyperactivity disorder, oppositional defiant disorder, and conduct disorder than their normally hearing peers. More behavioral problems were associated with special schools for the deaf, sign (-supported) language, hearing aids (in contrast to cochlear implants), higher age, male gender, lower socioeconomic status, lower intelligence, and delayed language development. Hearing-impaired children face multiple problems regarding their behavior. The outcomes implicate that professionals should be aware of the higher risk of developing behavioral problems, in order to screen, detect, and treat in time. Furthermore, the associated risk and protective factors emphasize that clinicians must always consider the heterogeneity of the group of hearing-impaired children, in order to help and support the individual patient.

Assessment of Behavioral Problems in Children With Hearing Loss

“…34 However, in DHH children without development delays, behavioral problems have been identified in areas of hyperactivity, aggression, peer interactions, and isolation. 35,36 These behavioral issues often go unrecognized and untreated. Theuniseen et al demonstrated that school-aged DHH children who used either HA or CI were more likely to exhibit behavioral problems and aggression than NH children, based on multiple parent- and self-report instruments.…”

Aggression Behaviors in Children with and without Hearing Impairment

“…In addition, although no difference was found between these two groups in terms of aggressive behaviors until they reach 14 years of age, the increase in the aggressive behaviors of children with hearing impairment after this age is noteworthy. When we reviewed the studies focusing on this topic, although there are some studies suggesting that aggression increases as the age of children increases (Tok, 2001;Theunissen et al, 2014), some other studies suggest that aggression is a behavior that can be seen at every age of the children (Köksal, 1991;Arıcak, 1995;Tuzgöl, 1998;Gümüş, 2000). Children included in the study group are in their adolescence period.…”

What can we expect of normally-developing children implanted at a young age with respect to their auditory, linguistic and cognitive skills?

“…Recent research shows that contemporary children with CI(s) have approximately the same levels of anxiety as normal hearing children and less than children with hearing aids (Barker et al, 2009;Theunissen et al, 2012Theunissen et al, , 2014a. Lower levels of general and social anxiety are attributed to early intervention, and possibly also to more intensive rehabilitation (than children with hearing aids).…”