Family-Level Executive Functioning and At-Risk Pediatric Hearing Loss Outcomes

Abstract

Purpose Using a new measure of family-level executive functioning (EF; the Family Characteristics Scale [FCS]), we investigated associations between family-level EF, spoken language, and neurocognitive skills in children with hearing loss (HL), compared to children with normal hearing. Method Parents of children with HL ( n = 61) or children with normal hearing ( n = 65) completed the FCS-Parent, and clinicians evaluated families using the FCS-Examiner. Children completed an age-appropriate version of the Concepts and Following Directions subtest of the Clinical Evaluation of Language Fundamentals and the Peabody Picture Vocabulary Test–Fourth Edition. Child EF was assessed via the parent report Behavior Rating Inventory of Executive Function. Results Two higher order components were derived from FCS subscales: Family Inhibition and Family Organization. For both samples, Family Inhibition was positively associated with child inhibition, child shifting, and child language comprehension skills. Family Organization was differentially associated with child inhibition, working memory, and planning/organization skills across the samples. Additionally, Family Inhibition was associated with child planning and organization skills for children with HL. Conclusions Results support the FCS as a measure of family-level EF. Family-level inhibition related to better child inhibition, flexibility/shifting, and language comprehension across both samples and to better planning and organization skills in children with HL. As children with HL experienced greater difficulties in EF, families demonstrated greater organization, possibly as a compensatory measure. Results suggest that inhibition and organization at a family level may be important targets for the development of novel interventions to promote EF and language outcomes for children with HL.

Variation in Auditory Experience Affects Language and Executive Function Skills in Children Who Are Hard of Hearing

“…The current analysis relied mostly on laboratory measures of language and executive function, but the positive relationships between auditory dosage, language and the BRIEF working memory subscale support that these effects extend in the child’s real-world environment. The BRIEF working memory subscale assesses the parent’s perceptions of working memory function in the child’s real world environment, and the observation that auditory dosage and language were related to this scale is consistent with Biopsychosocial Systems Theories and recent evidence that the family environment has an important influence on executive function in children who are deaf or hard of hearing (Holt et al 2020; Blank et al 2021). Likewise, language and executive function skills were associated with measures of nonverbal intelligence, supporting the role of general neurocognitive factors in these complex relationships for CHH and consistent with systems-based theoretical models.…”