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Updated: May 18, 2026

Systematic Hearing Performance Evaluation Process for Adolescents with Cochlear Implantation at Early Ages
Published on: March 24, 2023
Social competence and empathy in young children with cochlear implants and with normal hearing
Lizet Ketelaar1, Carolien Rieffe, Carin H Wiefferink
1Department of Developmental Psychology, Leiden University, Leiden, The Netherlands. lketelaar@fsw.leidenuniv.nl
Insights
Children with cochlear implants demonstrate similar social competence and empathy as normal-hearing peers. However, factors influencing social competence differ, impacting rehabilitation strategies for pediatric cochlear implant users.
Area of Science:
- Developmental Psychology
- Pediatric Audiology
- Social-Emotional Development
Background:
- Cochlear implants (CIs) aim to restore hearing but their impact on social-emotional development requires ongoing investigation.
- Understanding social competence and empathy in children with CIs is crucial for comprehensive developmental support.
- Previous research has yielded mixed results regarding social-emotional outcomes in children with CIs.
Purpose of the Study:
- To compare social competence and empathic behaviors in children with CIs versus normal-hearing children.
- To investigate if empathy predicts social competence similarly across both groups.
- To identify specific factors, such as emotion acknowledgment, influencing social competence in children with CIs.
Main Methods:
- A retrospective cohort study design was employed.
- 150 children (61 with CIs, 89 normal-hearing, mean age 39 months) participated.
- Parent reports and observational measures assessed empathy and social competence.
Main Results:
- Children with CIs and normal-hearing children exhibited comparable levels of empathy and social competence.
- Empathic behaviors significantly predicted social competence in both groups.
- Emotion acknowledgment was a stronger predictor of social competence in children with CIs compared to normal-hearing peers.
Conclusions:
- Children with CIs do not show delays in social competence or empathic behavior.
- The predictors of social competence vary between children with CIs and their normal-hearing counterparts.
- Findings underscore the need for tailored rehabilitation programs considering group-specific factors influencing social competence in pediatric CI users.
Objectives:
To examine the levels of social competence and empathic behavior in children with cochlear implants in comparison with normal-hearing children, and to determine whether empathy predicts social competence to the same extent in both groups of children.
Study Design:
Retrospective cohort study.
Methods:
A total of 150 children (mean age 39 months) participated in the study; 61 with cochlear implants and 89 without hearing loss. Parent reports and observation measures were employed to measure empathy and social competence.
Results:
Levels of empathy and social competence in children with cochlear implants and normal-hearing children were similar. Empathic behaviors were predictive of social competence in both groups alike. Emotion acknowledgment was more predictive of social competence for children with cochlear implants than for normal-hearing children. Language skills were unrelated to social competence or empathic behaviors in children with cochlear implants.
Conclusions:
Children with cochlear implants showed no delay concerning social competence or empathic behavior. The factors contributing to social competence, however, differed between the groups. This should be kept in mind when developing rehabilitation programs for children with cochlear implants.
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