15th ANNUAL EARLY HEARING DETECTION & INTERVENTION MEETING
March 13-15, 2016 • San Diego, CA

| - | 3 - Language Acquisition and Development

The impact of social functioning on behavior in young children who are deaf or hard of hearing

Background: Children who are deaf or hard of hearing (D/HH) are at risk for communication and social function delays which may affect behavior. The study objective was to evaluate the relationship between social functioning and behavior in young children who are D/HH. Methods: Analysis included children with mild to profound permanent bilateral hearing loss (mean age mos 57.1±13.8) enrolled in a language-functional outcomes study. Children completed standardized language and cognitive assessments. Functional skills were assessed with the Pediatric Evaluation of Disability Inventory (PEDI); behavioral skills with the Child Behavior Checklist (CBCL). PEDI social function scores were correlated with CBCL behavior domains; specific items were evaluated as they related to behavior. Results: Among 90 children, 56.7% were male, 46% had a cochlear implant, median identification age was 6 months. The mean nonverbal IQ was 94.3 (±19.5), the mean receptive language score was 80.6 (± 8.5), the mean PEDI social function score was significantly lower than the population mean (38.3 vs. 50, p<.0001). Overall, only 5% of children had clinically significant internalizing or externalizing behavior scores, suggesting low rates of behavior problems. However, 12.5% had clinically significant attention problem domain scores; ~18% of children<5 years had attention problems compared to 3% of older children. Poorer social functioning was significantly associated (p<0.01) with worsening internalizing (r=-0.27) and externalizing (r=-0.39) behaviors. Poorer social functioning was associated with worse scores on the attention problems subdomain (r=-0.42). Specific PEDI items associated with attention problems included difficulty asking questions, describing feelings, taking turns, and understanding time concepts. Conclusions: Most young children who are D/HH did not have clinically significant behavioral concerns on standardized measures; there was an association with poorer abstract reasoning and executive functioning with higher ratings on behavioral measures (attention domain). Early language deficits may contribute to perceived attention issues in children who are D/HH.

Describe how social functioning may impact behavior in young children who are deaf or hard of hearing

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