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Externalizing Behaviors in Preschool-Aged Children With Cochlear Implants.

William G Kronenberger1,2, Irina Castellanos1,2, Jessica Beer1

  • 1Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis.

Journal of Speech, Language, and Hearing Research : JSLHR
|July 21, 2025
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Summary

Children with cochlear implants (CIs) show more externalizing behaviors than hearing peers initially. Improved coping flexibility may help reduce these behaviors in young CI users over time.

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Area of Science:

  • Pediatric audiology
  • Developmental psychology
  • Behavioral science

Background:

  • Deaf children using cochlear implants (CIs) face developmental challenges.
  • These challenges may increase the risk of externalizing behavior problems.

Purpose of the Study:

  • Compare externalizing behaviors in preschool-aged children with CIs versus normal-hearing (NH) peers.
  • Identify factors influencing externalizing behaviors in children with CIs.

Main Methods:

  • Longitudinal study of 26 children with CIs and 30 NH peers (ages 3-4).
  • Parents completed behavior checklists over 1 year.
  • Assessed language, nonverbal intelligence, and coping flexibility.

Main Results:

  • CI users exhibited more externalizing behaviors than NH peers initially.
  • Differences lessened after 1 year.
  • Poorer residual hearing and better coping flexibility predicted fewer behaviors.
  • Improved coping flexibility correlated with behavioral improvements.

Conclusions:

  • Preschoolers with CIs may have a higher risk for early externalizing behaviors.
  • Enhanced coping flexibility shows potential for improving behaviors in young CI users.