Parent-Reported Stress and Child Behavior for 4-Year-Old Children with Unilateral or Mild Bilateral Hearing Loss

Abstract

Children with unilateral or mild bilateral hearing loss are increasingly identified in early childhood. Relatively little is known about how hearing loss affects their developmental trajectory or whether it contributes to parenting stress for these parents. This study aimed to examine child behavior and parenting stress in parents of children with unilateral/mild bilateral hearing loss compared to children with typical hearing. This prospective study involved 54 children with unilateral/mild bilateral hearing loss identified at a median age of 4.5 months (IQR 2.6, 6.5) and 42 children with typical hearing. At age 48 months, child behavior and parenting stress were measured. Auditory and language results were also analyzed in relation to child behavior and parenting stress. Parents of these children did not report significantly more parenting stress or behavior problems than parents of children with typical hearing. However, both parenting stress and child behavior were related to functional hearing in noise.

Parenting Stress in Mothers of Children with Permanent Hearing Impairment

“…According to these studies [ 7 , 8 , 9 , 10 , 11 ] factors that contribute to parenting stress in parents of deaf children include age at diagnosis, degrees of hearing loss, language abilities, mode of communication (spoken language or sign language), child behavior problems, perceived social support, cochlear implants, additional disability with poorer language skills, or higher rates of behavior problems [ 6 ]. Conversely, other studies have not found higher levels of stress among parents of deaf or hard-of-hearing children [ 33 , 34 , 35 , 36 , 37 , 38 ]. According to Dammeyer et al [ 34 ], it is not the hearing loss itself but child-related characteristics, such as additional disabilities and behavioral, emotional, and social difficulties, that negatively impact parenting stress.…”

“…According to Dammeyer et al [ 34 ], it is not the hearing loss itself but child-related characteristics, such as additional disabilities and behavioral, emotional, and social difficulties, that negatively impact parenting stress. Fitzpatrick et al [ 33 ] found that parents of children identified early with unilateral and mild bilateral hearing loss and normal performance in multiple domains including language and behavior, did not report higher stress levels than parents of children with typical hearing [ 31 , 32 , 33 , 34 , 35 , 36 ].…”

Impact of unilateral hearing loss in early development

“…Finally, as the management of pediatric UHL continues to evolve, it is important to recognize the significant emotional strain experienced by parents and caregivers as they attempt to gain access to and navigate care options for their child [11,86]. Recent studies have explored barriers to care access for pediatric patients with UHL and have highlighted inadequate screening tools which delay timelines to interventions, and financial barriers as the primary obstacles to care access [87,88].…”

“…Furthermore, parents are asked to navigate a confusing breadth of services and potential treatment options available for their child with UHL, ranging from school modifications, hearing amplification, contralateral routing of signal hearing aids, various bone-conduction hearing device options, to surgical placement of cochlear implants. In this process, caregivers often experience frustration with the lack of concrete guidance and often carry a significant level of guilt as they navigate the decision-making process [86,89,90 ▪▪ ]. The ambiguity in treatment guidelines for UHL can leave parents wondering if the severity of hearing loss in their child is significant enough to warrant intervention, or if they have made the best decision for their child's development [89,90 ▪▪ ].…”

Impact of Hearing Aids on Language Outcomes in Preschool Children With Mild Bilateral Hearing Loss

“…First, studies often combine MBHL, unilateral hearing loss, and high-frequency hearing loss, as they all fall under the umbrella term of “minimal hearing loss”. ( Fitzpatrick et al, 2010 , 2014 , 2015 , 2022 ; Fitzpatrick, Cologrosso, et al, 2019 ; Laugen et al, 2017 ). Second, mild HL classification often necessitates only the involvement of the better ear, potentially resulting in the categorization of asymmetric hearing loss ( Fitzpatrick et al, 2010 , 2014 , 2015 , 2022 ; Fitzpatrick, Cologrosso, et al, 2019 ; Laugen et al, 2017 ; Vohr et al, 2012 ; Walker et al, 2017 ).…”