Boerrigter Merle, Vermeulen Anneke, Marres Henri, Mylanus Emmanuel, Langereis Margreet
Department of Otorhinolaryngology, Radboud University Medical Center, Nijmegen, Netherlands.
Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands.
Front Psychol. 2019 Jul 16;10:1591. doi: 10.3389/fpsyg.2019.01591. eCollection 2019.
Internalizing and externalizing behavioral problems were frequently reported in profoundly hearing-impaired (HI) children with hearing aids. Due to the positive effect of cochlear implants (CIs) on hearing and language development, a positive effect on behavioral problems was expected. However, there is no consensus about the frequency of behavioral problems in CI children, and studies are often based on one informant with the risk of missing behavioral problems in other contexts. The first aim of this study was to investigate the frequency of behavioral problems in children with CIs as compared to a hearing normative sample. The second aim was to measure the agreement between the parents' and teachers' rates on the behavioral problem scales. And the third aim was to investigate the relation between speech perception, language skills and the frequencies of reported behavioral problems. Of 71 CI children, 51% were girls and 49% were boys, and the mean age was 8.6 ( = 3.3). Behavior was reported by parents using the Child Behavior Checklist (CBCL) and by teachers using the Teacher Report Form (TRF). Frequencies of behavioral problems of CI children (6-16 years) were compared to a normative sample with the chi square test. Parent-teacher agreement was measured with the intraclass correlation coefficient (ICC 2,1). Next CI children were divided into four ability level categories regarding speech perception and language skills. Frequencies of behavioral problems were compared between the categories with the chi square test. Parents and teachers of CI children reported similar frequencies of behavioral problems to the normative sample. Fair to low parent-teacher agreements were found on the behavioral problem scales. A significantly higher frequency of behavioral problems was reported in children with low speech perception and receptive vocabulary at school. Parents and teachers report similar frequencies of behavioral problems children with CIs compared to a hearing normative sample. Children with lower speech perception and language levels are more at risk of developing behavioral problems at school. Adequate speech perception and language levels are found to be protective factors for the development of behavior.
佩戴助听器的极重度听力障碍（HI）儿童经常出现内化和外化行为问题。由于人工耳蜗（CI）对听力和语言发展有积极作用，因此预期对行为问题也有积极影响。然而，关于CI儿童行为问题的发生率尚无共识，而且研究通常基于单一报告人，存在遗漏其他情境中行为问题的风险。本研究的首要目的是调查与听力正常的标准样本相比，CI儿童行为问题的发生率。第二个目的是测量家长和教师在行为问题量表上评分的一致性。第三个目的是调查言语感知、语言技能与报告的行为问题发生率之间的关系。71名CI儿童中，51%为女孩，49%为男孩，平均年龄为8.6岁（标准差 = 3.3）。家长使用儿童行为检查表（CBCL）报告行为，教师使用教师报告表（TRF）报告行为。通过卡方检验将CI儿童（6至16岁）的行为问题发生率与标准样本进行比较。使用组内相关系数（ICC 2,1）测量家长与教师评分的一致性。接下来，根据言语感知和语言技能将CI儿童分为四个能力水平类别。通过卡方检验比较不同类别之间的行为问题发生率。CI儿童的家长和教师报告的行为问题发生率与标准样本相似。在行为问题量表上，家长与教师评分的一致性为中等偏低。在学校言语感知和接受性词汇水平较低的儿童中，报告的行为问题发生率显著更高。与听力正常的标准样本相比，CI儿童的家长和教师报告的行为问题发生率相似。言语感知和语言水平较低的儿童在学校出现行为问题的风险更高。充分的言语感知和语言水平被发现是行为发展的保护因素。
