Assessment of Behavioral Problems in Children With Hearing Loss
Caitlin E Fiorillo1, Vania Rashidi, Philip M Westgate
1*Department of Otolaryngology-Head and Neck Surgery †College of Medicine ‡Department of Biostatistics §College of Public Health ||Department of Health, Behavior, and Society, University of Kentucky, Lexington, Kentucky.
Insights
Preschoolers with hearing loss show higher rates of disruptive behaviors than normal-hearing peers. These children also receive fewer mental health services, indicating a need for better intervention access.
Area of Science:
- Developmental Psychology
- Pediatric Audiology
- Child Psychiatry
Background:
- Disruptive behavior problems are common in preschool-aged children.
- Hearing loss can impact child development, including behavior and language.
- Understanding behavioral differences is crucial for early intervention.
Purpose of the Study:
- To compare the prevalence of disruptive behavior problems in preschool-aged children with normal hearing versus those with hearing loss.
- To investigate potential differences in diagnosis and intervention access for behavioral issues.
Main Methods:
- A cross-sectional study was conducted at a tertiary academic center.
- Caregivers of children aged 2-5 years with normal hearing (NH), hearing aid use (HA), or cochlear implants (CI) were recruited.
- Behavioral problems and language development were assessed using standardized instruments.
Main Results:
- Children with hearing loss (HA: 41%, CI: 38%) were significantly more likely to exhibit disruptive behaviors than NH children (10%).
- Higher rates of oppositional defiant disorder were observed in children with hearing loss (HA: 48%, CI: 48%) compared to NH children (23%).
- Normal-hearing children had more advanced language development, but behavioral differences persisted even after controlling for language skills.
Conclusions:
- Children with hearing loss demonstrate a higher prevalence of disruptive behaviors and related impairments compared to their normal-hearing peers, independent of language development.
- Children with hearing loss are less likely to access necessary behavioral interventions.
- Further research is needed to explore the impact of disruptive behaviors on rehabilitation and to develop strategies for improving intervention access.
Objective:
To compare the prevalence of disruptive behavior problems between preschool-aged children with hearing loss and normal hearing.
Study Design:
Cross-sectional study.
Setting:
Tertiary academic center.
Patients:
Caregivers of children (2-5 yr old) with normal hearing (NH) (n = 39), hearing loss using hearing aid(s) (HA) (n = 29), or cochlear implant(s) (CI) (n = 21).
Intervention(S):
Demographic information and a mental health history were obtained. Child behavior and language development were assessed.
Main Outcome Measure(S):
The Young Child-Diagnostic Interview Schedule for Children-IV and the MacArthur-Bates Communication Development Inventory III.
Results:
Distributions of race, socioeconomic status, insurance status, and parental home situation (single versus two parent family) were similar across all groups. Parents of children with hearing loss were significantly more likely to report behavior problems (HA = 41%, CI = 38%) than parents of NH children (10%; p = 0.002). Children with hearing loss were significantly more likely to meet diagnostic criteria for oppositional defiant disorder (HA = 48%, CI = 48%) than NH children (23%; p = 0.02). More NH children (8%) than hearing impaired children (0%) had accessed mental health services (p = 0.08). NH children were found to have more advanced language development than hearing-impaired children (p < 0.01), but controlling for Communication Development Inventory III percentiles, the observed behavioral differences remained.
Conclusion:
Controlling for language development, children with hearing loss have higher prevalence of and impairment from disruptive behaviors than their NH peers. These children are less likely to receive appropriate behavioral interventions. Further research is warranted to investigate the impact of disruptive behaviors on speech and hearing rehabilitation. Methods to improve access to effective behavioral interventions in this population are needed.
