Emotional and behavioral problems in children and adolescents with hearing impairment.

Background: Hearing impairment (HI) is a prevalent problem. The majority of cases have HI during the neonatal period, while the still cases have incidence up to adolescents. Hearing amplification is a promising modality to restore hearing with promising effects on speech and communication. The objective of this study is to assess the effect of being a child with HI on emotions and behaviors despite using a hearing amplification device early in life.

Patients and methods: The study is a cross-sectional descriptive study including 127 children aged from 4 to 17 years diagnosed with hearing loss; 71 were with hearing aids and 56 with cochlear implants recruited from the audio-vestibular unit, ENT department and referred to the child psychiatry clinic, department of pediatrics, Minia university, Egypt. The questionnaire used in this study is the parent-rated strength difficulty questionnaire (SDQ), which consists of 5 main components, namely "emotional problems," "conduct problems," "hyperactivity/Inattention problem," "peer relationship problems," and "prosocial behavior".

Results: On stratifying the patients according to the degree of sensorineural hearing loss, 66.6% of children with lesser degrees of hearing loss showed significant conduct behaviors. While on stratifying the patients according to the age groups; 86% of primary school children experienced significant peer relationship problems (p = 0.03), while 66.6% of children in the late childhood period had significant emotional disturbances (p = 0.023). On regrouping of the patients according to the type of amplification (hearing aids vs. cochlear implants) and side of amplification (right, left, or bilateral), no significant differences in emotional and behavioral disturbances were observed in any group.

Conclusion: Despite receiving early amplification, children with hearing loss still develop emotional and behavioral problems, with children who had a milder degree of hearing loss developing significant conduct behaviors. Additionally, those children developed significant peer relationship problems at school entry age, problems that older children can overcome, but with significant internalizing symptoms and emotional disturbances. These problems need more community orientation and psychological support to the child and their family, particularly during the transition to school. Furthermore, early screening and intervention for emotional disturbances in adolescents are essential to ensure timely management and support.

Clinical trial number: Not applicable.