SDQStrengths and Difficulties Questionnaire ZNA Z€ urich Neuromotor Assessment AIM This cross-sectional study investigates the relationship between motor performance and mental health in a representative population of children with hearing impairment.METHOD Ninety-three pupils (45 males, 48 females) aged 6 years to 16 years (mean 11y 3mo, SD 2y 9mo) with hearing impairment of at least 40dB and a Nonverbal IQ greater than 70 were assessed for motor performance with the Z€ urich Neuromotor Assessment (ZNA) and for mental health with the parent version of the Strengths and Difficulties Questionnaire (SDQ).
RESULTS Children with hearing impairment had lower motor performance scores in all fourZNA subscales compared with ZNA norms (z-scores À1.42 to À2.67). After controlling for Nonverbal IQ, ZNA pure motor performance correlated negatively with the SDQ total difficulties score. Pure motor, pegboard, and dynamic balance subscales correlated negatively with peer-relationship problems. Dynamic balance correlated negatively with emotional problems. Performance in pure motor and dynamic balance skills correlated negatively with age. Except for static balance, no correlation was found between motor performance and the degree of hearing impairment.INTERPRETATION Results confirm that a high percentage of children with hearing impairment have poor motor performance. These problems are associated with difficulties in social relationships. Early recognition of these problems may lead to interventions to assist children with hearing impairment with their peer relationships.In Western countries, 1 to 2 of every 1000 children are affected by permanent bilateral hearing loss of at least moderate degree. 1,2 Hearing impairment is associated with a large range of consequences on the child's social, cognitive, emotional, and neuromotor development.3-5 Previous research has concentrated on the impact of hearing impairment on language development and mental health. 3,4,6 With respect to motor performance, several studies have found that children with hearing impairment show deficits in motor development. These studies used a variety of instruments and were based on samples that may not have been representative of the population of children with hearing impairment.5,7-9 Studies reporting normal levels of motor development were based on parent questionnaires (Vineland Adaptive Behavior Scales) and had no direct motor examination. 10,11 Livingstone and McPhillips showed that about 80% of 25 children with a bilateral hearing impairment >60dB (mean age 8y 8mo) scored in the bottom 15% (borderline) and about 50% in the bottom 5% (definite problems) of the standardized sample of the Movement Assessment Battery for Children. 5 In other words, 80% of those with hearing impairment reached the cut-off of motor performance for a possible diagnosis of developmental coordination disorder.
12Considering different aspects of motor development, the greatest deficits were shown in balance and complex motor tasks. 5,7,13 One study matching 32 children wi...