Parent-Reported Attention-Deficit/Hyperactivity Disorder–Linked Behaviors, Fatigue, and Language in Children Who Are Deaf and Hard of Hearing

Abstract

Purpose: The purpose of this study was to find out if children who are deaf and hard of hearing (DHH), particularly those without substantially delayed language, appear to be at risk for overreporting of inattentive and hyperactive behaviors and if attention-deficit/hyperactivity disorder (ADHD) measures are influenced by the presence of language-based items, by child language skills, and by child and parent report of fatigue. Method: This study included 24 children with typical hearing, 13 children with hearing aids (HA), and 16 children with cochlear implants (CI) in second through sixth grade. Parents of children in each group completed a measure reporting on inattentive and hyperactive behaviors, social and academic outcomes, and general fatigue for their child. Children participated in a norm-referenced language assessment and completed a self-report of fatigue. Results: Analyses revealed an effect of hearing status on overall inattention ratings and social/academic performance: Children with CI had significantly lower ratings of inattention, and children with HA had more social/academic performance deficits. Differences in inattention scores for children with CI remained even when items biased toward language skills were removed from the measure, but differences in performance for children with HA disappeared. Omnibus language scores significantly correlated with academic and social outcomes, whereas parent report of fatigue significantly correlated with inattention and hyperactivity. Conclusions: Parent report of behaviors linked with ADHD, including inattention and hyperactivity, is likely influenced by child language knowledge and overall fatigue. Comorbid diagnosis of ADHD in children who are DHH must consider these factors.