Mental health problems in adolescents with cochlear implants: peer problems persist after controlling for additional handicaps.

Maria Huber,Thorsten Burger,Ludwig Braun,Gerhard Rasp,Angelika Illg,Andreas Becker,Silke Kunze,Alexandros Giourgas,Annerose Keilmann,Stefanie Kröger,Andreas Nickisch

doi:10.3389/fpsyg.2015.00953

Abstract

The aims of the present multi-center study were to investigate the extent of mental health problems in adolescents with a hearing loss and cochlear implants (CIs) in comparison to normal hearing (NH) peers and to investigate possible relations between the extent of mental health problems of young CI users and hearing variables, such as age at implantation, or functional gain of CI. The survey included 140 adolescents with CI (mean age = 14.7, SD = 1.5 years) and 140 NH adolescents (mean age = 14.8, SD = 1.4 years), their parents and teachers. Participants were matched by age, gender and social background. Within the CI group, 35 adolescents were identified as “risk cases” due to possible and manifest additional handicaps, and 11 adolescents were non-classifiable. Mental health problems were assessed with the Strengths and Difficulties Questionnaire (SDQ) in the versions “Self,” “Parent,” and “Teacher.” The CI group showed significantly more “Peer Problems” than the NH group. When the CI group was split into a “risk-group” (35 “risk cases” and 11 non-classifiable persons) and a “non-risk group” (n = 94), increased peer problems were perceived in both CI subgroups by adolescents themselves. However, no further differences between the CI non-risk group and the NH group were observed in any rater. The CI risk-group showed significantly more hyperactivity compared to the NH group and more hyperactivity and conduct problems compared to the CI non-risk group. Cluster analyses confirmed that there were significantly more adolescents with high problems in the CI risk-group compared to the CI non-risk group and the NH group. Adolescents with CI, who were able to understand speech in noise had significantly less difficulties compared to constricted CI users. Parents, teachers, and clinicians should be aware that CI users with additionally special needs may have mental health problems. However, peer problems were also experienced by CI adolescents without additional handicaps.

Highlights

A cochlear implant (CI) is a prosthesis for the hair cells in the inner ear of persons with severe or profound hearing loss
Inter-rater agreements between self, parent, and teacher-ratings were assessed for each Strengths and Difficulties Questionnaire (SDQ) scale in adolescents with CI and normal hearing group via Pearson correlations
While contrary to our expectations, the age at first CI, the duration of CI use as well as the audiological results were not related to mental health problems, the results indicate that the ability to hear and to understand in noise may be important

Summary

Introduction

A cochlear implant (CI) is a prosthesis for the hair cells in the inner ear of persons with severe or profound hearing loss. In children with a severe or profound sensorineural hearing loss it usually allows the development of speech understanding and speech production. Long-term studies have shown that language and speech performance improve slowly over time after cochlear implantation and require years to reach the final level (Beadle et al, 2005; Uziel et al, 2007). The language development of children implanted at a very young (

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