Emotional and behavioural difficulties in children and adolescents with hearing impairment: a systematic review and meta-analysis

Abstract

The aim of this study is to estimate the extent to which children and adolescents with hearing impairment (HI) show higher rates of emotional and behavioural difficulties compared to normally hearing children. Studies of emotional and behavioural difficulties in children and adolescents were traced from computerized systematic searches supplemented, where appropriate, by studies referenced in previous narrative reviews. Effect sizes (Hedges’ g) were calculated for all studies. Meta-analyses were conducted on the weighted effect sizes obtained for studies adopting the Strength and Difficulties Questionnaire (SDQ) and on the unweighted effect sizes for non-SDQ studies. 33 non-SDQ studies were identified in which emotional and behavioural difficulties in children with HI could be compared to normally hearing children. The unweighted average g for these studies was 0.36. The meta-analysis of the 12 SDQ studies gave estimated effect sizes of 0.23 (95 % CI 0.07, 0.40), 0.34 (95 % CI 0.19, 0.49) and −0.01 (95 % CI −0.32, 0.13) for Parent, Teacher and Self-ratings of Total Difficulties, respectively. The SDQ sub-scale showing consistent differences across raters between groups with HI and those with normal hearing was Peer Problems. Children and adolescents with HI have scores on emotional and behavioural difficulties measures about a quarter to a third of a standard deviation higher than hearing children. Children and adolescents with HI are in need of support to help their social relationships particularly with their peers.

Social skills in preschool children with unilateral and mild bilateral hearing loss

“…The number of reported difficulties was considerably higher in the HH group than in the TH group. The same conclusion was drawn in a recent systematic review and meta-analysis on emotional and behavioral difficulties in DHH children (Stevenson et al, 2015); however, the difference in our study was more profound (Hedge's g = .87) than the mean of the studies using SDQ included in the review (g = .23). Hence, our study suggests that HH preschool children have considerable risk for psychosocial difficulties, and the risk does not seem to be any less than for the DHH population in general.…”

“…Children who are deaf and hard of hearing (DHH) are at risk for language delays and psychosocial difficulties (Lederberg, Schick, & Spencer, 2013;Stevenson, Kreppner, Pimperton, Worsfold, & Kennedy, 2015). Traditionally, research and intervention programs have mostly included children with moderate to profound hearing loss, perhaps with a special interest in children with cochlear implants.…”

“…The term includes the presence or absence of emotional, social or behavioral problems, and is associated with terms like well-being, self-esteem and quality of life (Keilmann, Limberger, & Mann, 2007). DHH children are at risk for developing psychosocial difficulties, including emotional, social and behavioral problems; a recent review and meta-analysis reports substantially higher rates of emotional and behavioral problems in DHH children and adolescents than in children with TH (Stevenson et al, 2015).…”

“…Moreover, they are frequently used in both TH and HH populations Fraley, Roisman, & Haltigan, 2013;Stevenson et al, 2015;Sveen et al, 2013), facilitating comparisons across studies. However, parent ratings could be inaccurate, perhaps especially in the DHH population as some behaviors could be attributed to the hearing loss rather than to an emotional or social problem.…”

Adaptive Functioning in Students with Cochlear Implants Assessed in Spain through the Strengths and Difficulties Questionnaire

“…On the other hand, the possible consequences derived from communication difficulties of children with cochlear implants and the possible effects on their development (Calderón & Greenberg, 2003;Quittner, Leibach, & Marciel, 2004;Stevenson, Kreppner, Pimperton et al, 2009), has led these authors to suggest that there are more behavioral problems in implanted students than in their hearing classmates (Anmyr, Larsson, Olsson, and Freijd, 2012;Worsfold & Kennedy, 2015;Vostanis, Hayes, Du Feu, & Warren, 1997).…”