Ong Jun Jean, Smith Libby, Shepherd Daisy A, Xu Jessica, Roberts Gehan, Sung Valerie
Centre for Community Child Health, The Royal Children's Hospital, Melbourne, VIC, Australia.
Murdoch Children's Research Institute, Melbourne, VIC, Australia.
Front Pediatr. 2023 Oct 4;11:1209736. doi: 10.3389/fped.2023.1209736. eCollection 2023.
Deaf and hard-of hearing (DHH) children often experience emotional/behavioral difficulties. The impact of unilateral/mild hearing loss (HL) on children's emotion and behavior are unclear. We aimed to describe emotional/behavioral, health related quality-of-life (HRQoL) and parent psychological distress outcomes of school-age children with unilateral/mild HL, compared to children with moderate to profound HL, and in relation to population norms; and identify predictive factors of emotional/behavioral difficulties.
Data of 339 DHH children, 5-12 years, enrolled in the Victorian Childhood Hearing Longitudinal Databank (VicCHILD), which include demographics, early development, medical/audiological characteristics and parent rated questionnaires of emotion/behavior, HRQoL and parental psychological distress collected at various stages of child's life were analyzed. We used Cohen's d to investigate the outcomes by measuring the mean score differences of both groups with published norms and logistic regression to analyze the factors predictive of emotional/behavioral difficulties.
The proportion of children with unilateral/mild HL and moderate to profound HL who experienced emotional/behavioral difficulties was similar (18.3% vs. 20.6%), with hyperactivity and poor prosocial behavior reported as the predominant symptoms in both groups. Mean emotional/behavioral scores of both groups were comparable and substantially higher than normative population scores. This was also the case for HRQoL and levels of parent distress. Among children with unilateral/mild HL, additional health needs were the strongest predictive factor, demonstrating an approximately 1.7-fold increase in odds of emotional/behavioral difficulties (OR = 1.67; 95% CI 1.29-2.17, < 0.001) with every additional health need. Early developmental concerns, other than communication milestone and attending mainstream schoolshowed weaker evidence of association.
Children with unilateral/mild HL were just as likely as those with moderate to profound HL to experience more emotional/behavioral difficulties, poorer HRQoL and higher parental distress scores compared to population norms. Our findings justify the provision of early intervention, support and medical services for all DHH children to identify those at risk of poorer outcomes.
失聪和重听（DHH）儿童经常出现情绪/行为问题。单侧/轻度听力损失（HL）对儿童情绪和行为的影响尚不清楚。我们旨在描述与中度至重度HL儿童相比，单侧/轻度HL学龄儿童的情绪/行为、健康相关生活质量（HRQoL）和家长心理困扰结果，并与总体标准进行比较；并确定情绪/行为问题的预测因素。
分析了维多利亚儿童听力纵向数据库（VicCHILD）中339名5至12岁DHH儿童的数据，这些数据包括人口统计学、早期发育、医学/听力学特征以及在儿童生命不同阶段收集的家长对情绪/行为、HRQoL和家长心理困扰的评分问卷。我们使用科恩d值通过测量两组与已发表标准的平均得分差异来研究结果，并使用逻辑回归分析情绪/行为问题的预测因素。
经历情绪/行为问题的单侧/轻度HL儿童和中度至重度HL儿童的比例相似（18.3%对20.6%），两组中多动和不良亲社会行为被报告为主要症状。两组的平均情绪/行为得分相当，且显著高于总体标准得分。HRQoL和家长困扰水平也是如此。在单侧/轻度HL儿童中，额外的健康需求是最强的预测因素，每增加一项健康需求，情绪/行为问题的几率增加约1.7倍（OR = 1.67；95% CI 1.29 - 2.17，< 0.001）。除了沟通里程碑和进入主流学校之外的早期发育问题显示出较弱的关联证据。
与总体标准相比，单侧/轻度HL儿童与中度至重度HL儿童一样，更有可能经历更多的情绪/行为问题、更差的HRQoL和更高的家长困扰得分。我们的研究结果证明为所有DHH儿童提供早期干预、支持和医疗服务以识别那些预后较差风险儿童的合理性。
