Stevenson Jim, Pimperton Hannah, Kreppner Jana, Worsfold Sarah, Terlektsi Emmanouela, Kennedy Colin
Faculty of Social and Human Sciences, University of Southampton, Southampton, UK.
Faculty of Medicine, University of Southampton, Southampton, UK.
Int J Pediatr Otorhinolaryngol. 2017 Oct;101:186-195. doi: 10.1016/j.ijporl.2017.07.031. Epub 2017 Jul 25.
It is known that during the middle childhood years those with permanent childhood hearing loss (PCHL) are at increased risk of showing emotional and behaviour difficulties (EBD). It has yet to be established whether this risk continues into the late teenage years. There is a paucity of longitudinal studies on the association between PCHL and EBD.
The Strengths and Difficulties Questionnaire (SDQ) was used to measure EBD based on parent, teacher and self-ratings in 76 teenagers with PCHL and 38 in a hearing comparison group (HCG) from a population sample of children that was followed up from birth to adolescence.
On parent-rated SDQ, the PCHL group had significantly higher Total Difficulties score than the HCG (Standardised mean difference (SMD) = +0.39, 95%CI 0.00 to 0.79). Amongst the PCHL group the presence of disabilities other than hearing loss had a substantial impact on the level of parent-rated EBD (SMD = +1.68, 1.04 to 2.33). There was a relationship between receptive language ability and EBD in both the HCG (r = -0.33, 95%CI -0.59 to -0.01) and the PCHI group (r = -0.33, 95%CI -0.53 to -0.02). The effect of PCHL on EBD became non-significant when receptive language was included as a covariate (F = 0.12, df = 1,95, p = 0.729). Early confirmation of hearing loss (i.e. before 9 months of age) did not have a significant effect on EBD scores (SMD = +0.31, 95%CI -0.15 to 0.77).
PCHL continues to be associated with elevated EBD scores as measured by parent rated SDQ into the late teenage years but the degree of this elevation is less than in childhood and is not apparent on teacher or self-ratings. Poor receptive language ability appeared to account for these elevated EBD scores in the group with PCHL. Particular attention needs to be paid to the mental health of children and adolescents with PCHL that is accompanied by other disabilities and to those with poor receptive language ability. However, the majority of teenagers with PCHL do not show clinically significant elevated levels of EBD.
众所周知，患有永久性儿童听力损失（PCHL）的儿童在童年中期出现情绪和行为问题（EBD）的风险会增加。目前尚不清楚这种风险是否会持续到青少年晚期。关于PCHL与EBD之间关联的纵向研究很少。
使用优势与困难问卷（SDQ），基于家长、教师和自我评分，对76名患有PCHL的青少年以及从出生到青春期进行随访的儿童群体样本中的38名听力对照组（HCG）青少年的EBD进行测量。
在家长评定的SDQ中，PCHL组的总困难得分显著高于HCG组（标准化均值差（SMD）= +0.39，95%置信区间0.00至0.79）。在PCHL组中，除听力损失外还存在其他残疾对家长评定的EBD水平有重大影响（SMD = +1.68，1.04至2.33）。在HCG组（r = -0.33，95%置信区间 -0.59至 -0.01）和PCHL组（r = -0.33，95%置信区间 -0.53至 -0.02）中，接受性语言能力与EBD之间均存在关联。当将接受性语言作为协变量纳入时，PCHL对EBD的影响变得不显著（F = 0.12，自由度 = 1,95，p = 0.729）。听力损失的早期确诊（即9个月之前）对EBD得分没有显著影响（SMD = +0.31，95%置信区间 -0.15至0.77）。
通过家长评定的SDQ测量，PCHL在青少年晚期仍与较高的EBD得分相关，但这种升高程度低于儿童期，且在教师或自我评分中并不明显。接受性语言能力差似乎是导致PCHL组EBD得分升高的原因。需要特别关注伴有其他残疾的PCHL儿童和青少年以及接受性语言能力差的儿童和青少年的心理健康。然而，大多数患有PCHL的青少年并未表现出临床上显著升高的EBD水平。
