Social Participation of Children and Adolescents With Cochlear Implants: A Qualitative Analysis of Parent, Teacher, and Child Interviews

Abstract

Psychosocial factors, including socioemotional well-being, peer relationships, and social inclusion with hearing and deaf peers, are increasingly becoming a focus of research investigating children with cochlear implants. The study reported here extends the largely quantitative findings of previous research through a qualitative analysis of interviews with parents, teachers, and pediatric cochlear implant users themselves in three eastern states of Australia. We interviewed 24 parents, 15 teachers, and 11 children and adolescents. The findings displayed commonalities across the three groups of participants, indicating positive experiences around the children's psychosocial development with their cochlear implants, but also ongoing difficulties communicating in groups of people and problems related to social skills. Some children had little contact with other deaf children (with or without cochlear implants) despite parents and teachers perceiving such contact beneficial. Children attending schools where there were other deaf children valued friendships with both deaf and hearing peers. Adolescence was a particularly difficult time for some as they struggled with feelings of self-consciousness about their deafness and external cochlear implant equipment and worries around friendships, dating, and their future place in the world. Recommendations for practice and further research are made.

Social Maturity and Executive Function Among Deaf Learners

“…In part, that situation may be a result of the sensitivity of the issue, given a history in which deaf individuals were described as impulsive, egocentric, and lagging in moral development (e.g., Altshuler, Deming, Vollenweider, Rainer, & Tendler, 1976;Chess & Fernandez, 1980;Nass, 1964). Yet the lack of an evidence base with regard to the origins of social maturity among deaf learners means that parents and educators are unable to deal with it in any systematic fashion, with potentially negative implications for peer socialization (Caldarella & Merrell, 1997;Punch & Hyde, 2011), academic achievement (Antia et al, 2002), and later employment (Kelly, Quagliata, DeMartino, & Perotti, 2016).…”

“…It is notable that social maturity was measured via self-report in this study, however, and Antia, Jones, Luckner, Kreimeyer, and Reed (2011) found that deaf children appeared overly confident in self-reports of social competence relative to parent and teacher ratings. Furthermore, deaf individuals with poor social competence, or simply poor communication skills, may be less aware of subtleties in social interactions and the extent of their delays (Most, Ingber, & Heled-Ariam, 2012;Punch & Hyde, 2011).…”

“…Borgna et al (2011) suggested this as an example of the "unskilled and unaware effect" (Kruger & Dunning, 1999), wherein having lesser ability in a domain leaves one less able to recognize that fact. Indeed, a central aspect of social maturity is the ability to appreciate social situations from the points of view of others, a domain in which deaf children and adolescents have been found to have difficulty (e.g., Peterson, Slaughter, Moore, & Wellman, 2016;Punch & Hyde, 2011;Rhys-Jones & Ellis, 2000;Rieffe, Netten, & Broekhof, 2015;Terwogt & Rieffe, 2004). Caldarella and Merrell (1997) found self-management, including social maturity, self-control/social convention, and respect for social rules to be one of the most common dimensions to emerge from meta-analyses of studies examining social skills of (hearing) children and adolescents (see Doren et al, 2012).…”

Cochlear Implants in Children: A Review

“…Although there appear to be no negative reports on social/emotional development of children as a result of cochlear implantation, a cochlear implant will not guarantee that the social difficulties experienced by many children with severe-profound hearing loss are avoided (Punch & Hyde, 2011). The research does offer hope, however, that an early cochlear implant may not only facilitate the development of speech and language skills, but can also give children the potential to develop a healthy and positive social identity and competent interactional skills.…”

Social Determinants of Health in Deaf Communities

“…In the United States and other developed nations, the diffusion of such intervention strategies including a surgical procedure has been very rapid and widespread despite the fact that the success rates of these interventions tend to vary greatly depending on many other factors such as parental educational levels with failure rates approaching 20-50% in some studies (Gulya et al, 2010;Peterson et al, 2010;Bouchard et al, 2008). Studies that examine other measurable and meaningful outcomes of these auditory-based interventions for deaf children such as essential language development and long-term quality of life and studies that include alternative strategies to develop deaf children's language through visual modalities such as signed languages Punch & Hyde, 2011) have only very recently begun to penetrate the medical literature that influence hearing professionals and parents in their decision-making regarding the best ways to promote deaf children's and deaf people's long-term outcomes.…”