Abstract
Objectives:Children with hearing loss are at risk of developing psychopathology, which has detrimental consequences for academic and psychosocial functioning later in life. Yet, the causes of the extensive variability in outcomes are not fully understood. Therefore, the authors wanted to objectify symptoms of psychopathology in children with cochlear implants or hearing aids, and in normally hearing peers, and to identify various risk and protective factors.Design:The large sample (mean age = 11.8 years) included three subgroups with comparable age, gender, socioeconomic status, and nonverbal intelligence: 57 with cochlear implants, 75 with conventional hearing aids, and 129 children who were normally hearing. Psychopathology was assessed by means of self- and parent-report measures.Results:Children with cochlear implants showed similar levels of symptoms of psychopathology when compared with their normally hearing peers, but children with hearing aids had significantly higher levels of psychopathological symptoms, while their hearing losses were approximately 43 dB lower than those of children with implants. Type of device was related with internalizing symptoms but not with externalizing symptoms. Furthermore, lower age and sufficient language and communication skills predicted less psychopathological symptoms.Conclusions:Children who are deaf or profoundly hearing impaired and have cochlear implants have lower levels of psychopathological symptoms than children with moderate or severe hearing loss who have hearing aids. Most likely, it is not the type of hearing device but rather the intensity of the rehabilitation program that can account for this difference. This outcome has major consequences for the next generation of children with hearing loss because children with profound hearing impairment still have the potential to have levels of psychopathology that are comparable to children who are normally hearing.
Highlights
Bilateral permanent childhood hearing impairment affects approximately 1 to 1.3 of every 1000 live births (Fortnum & Davis 1997; Fortnum et al 2001; Watkin & Baldwin 2011)
In the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, a mental disorder is conceptualized as being a “clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is associated with present distress, disability, a significantly increased risk of suffering death, pain, disability, or an important loss of freedom” (APA 2000)
It first has to be said that the participants with hearing loss and with normal hearing were similar regarding age, gender, socioeconomic status (SES), and nonverbal intelligence
Summary
Bilateral permanent childhood hearing impairment affects approximately 1 to 1.3 of every 1000 live births (Fortnum & Davis 1997; Fortnum et al 2001; Watkin & Baldwin 2011). The prevalence of internalizing disorders in children with normal hearing is approximately 20% (Fleming et al 1990; Fellinger et al 2009b), while for externalizing disorders the rates range between 4% and 10% for hyperactive and aggressive behaviors (van Eldik et al 2004; van Eldik 2005; Froehlich et al 2007), and 1% and 3% for the more severe antisocial disorders (Maughan et al 2004) Both internalizing and externalizing symptoms can have detrimental consequences on academic and psychosocial functioning later in life and are risk factors for other psychiatric disorders, as well as substance abuse (Hinshaw 1992; Birmaher et al 1996; Kovacs & Devlin 1998; APA 2000; Zahn-Waxler et al 2000; Lilienfeld 2003; Masten et al 2005). Those children who are affected, their families, and the society, are faced with increased mental health care costs and a high prevalence of school dropout rates (Reef 2010)
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