Fiorillo Caitlin E, Rashidi Vania, Westgate Philip M, Jacobs Julie A, Bush Matthew L, Studts Christina R
*Department of Otolaryngology-Head and Neck Surgery †College of Medicine ‡Department of Biostatistics §College of Public Health ||Department of Health, Behavior, and Society, University of Kentucky, Lexington, Kentucky.
Otol Neurotol. 2017 Dec;38(10):1456-1462. doi: 10.1097/MAO.0000000000001583.
To compare the prevalence of disruptive behavior problems between preschool-aged children with hearing loss and normal hearing.
Cross-sectional study.
Tertiary academic center.
Caregivers of children (2-5 yr old) with normal hearing (NH) (n = 39), hearing loss using hearing aid(s) (HA) (n = 29), or cochlear implant(s) (CI) (n = 21).
INTERVENTION(S): Demographic information and a mental health history were obtained. Child behavior and language development were assessed.
MAIN OUTCOME MEASURE(S): The Young Child-Diagnostic Interview Schedule for Children-IV and the MacArthur-Bates Communication Development Inventory III.
Distributions of race, socioeconomic status, insurance status, and parental home situation (single versus two parent family) were similar across all groups. Parents of children with hearing loss were significantly more likely to report behavior problems (HA = 41%, CI = 38%) than parents of NH children (10%; p = 0.002). Children with hearing loss were significantly more likely to meet diagnostic criteria for oppositional defiant disorder (HA = 48%, CI = 48%) than NH children (23%; p = 0.02). More NH children (8%) than hearing impaired children (0%) had accessed mental health services (p = 0.08). NH children were found to have more advanced language development than hearing-impaired children (p < 0.01), but controlling for Communication Development Inventory III percentiles, the observed behavioral differences remained.
Controlling for language development, children with hearing loss have higher prevalence of and impairment from disruptive behaviors than their NH peers. These children are less likely to receive appropriate behavioral interventions. Further research is warranted to investigate the impact of disruptive behaviors on speech and hearing rehabilitation. Methods to improve access to effective behavioral interventions in this population are needed.
比较听力损失学龄前儿童与听力正常学龄前儿童破坏性行为问题的患病率。
横断面研究。
三级学术中心。
听力正常（NH）儿童（2 - 5岁）的照料者（n = 39）、使用助听器（HA）的听力损失儿童的照料者（n = 29）以及使用人工耳蜗（CI）的听力损失儿童的照料者（n = 21）。
获取人口统计学信息和心理健康史。评估儿童行为和语言发育情况。
《儿童诊断访谈量表 - 第四版》和《麦克阿瑟 - 贝茨沟通发展量表第三版》。
所有组在种族、社会经济地位、保险状况以及父母家庭情况（单亲家庭与双亲家庭）的分布相似。听力损失儿童的父母报告行为问题的可能性显著高于听力正常儿童的父母（使用助听器组 = 41%，使用人工耳蜗组 = 38%，而听力正常儿童组为10%；p = 0.002）。听力损失儿童符合对立违抗障碍诊断标准的可能性显著高于听力正常儿童（使用助听器组 = 48%，使用人工耳蜗组 = 48%，而听力正常儿童组为23%；p = 0.02）。使用心理健康服务的听力正常儿童（8%）多于听力受损儿童（0%）（p = 0.08）。发现听力正常儿童的语言发育比听力受损儿童更超前（p < 0.01），但在控制《沟通发展量表第三版》百分位数后，观察到的行为差异仍然存在。
在控制语言发育的情况下，听力损失儿童的破坏性行为患病率及损害程度高于听力正常的同龄人。这些儿童接受适当行为干预的可能性较小。有必要进一步研究破坏性行为对言语和听力康复的影响。需要采取方法改善这一人群获得有效行为干预的途径。
