Kronenberger William G, Castellanos Irina, Beer Jessica, Pisoni David B
Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis.
Department of Psychiatry, Indiana University School of Medicine, Indianapolis.
J Speech Lang Hear Res. 2025 Sep 10;68(9):4490-4505. doi: 10.1044/2025_JSLHR-25-00005. Epub 2025 Jul 21.
Deaf children with cochlear implants (CIs) experience challenges in early development of hearing and language skills that may place them at risk for externalizing behavior problems, such as aggression, hyperactivity-impulsivity, and oppositional behavior. This study is a longitudinal investigation of (a) between-groups differences in externalizing behavior problems between preschool-aged children with CIs and normal-hearing (NH) peers, and (b) within-group factors that may explain variability in externalizing problems within the sample of CI users.
Parents of 26 children with CIs and 30 NH peers completed externalizing behavior checklists at two visits separated by 1 year, starting at ages 3 or 4 years. Demographic/hearing history variables, language (vocabulary), nonverbal intelligence, and coping flexibility were assessed for concurrent and predictive associations with externalizing problems within the CI sample.
Results showed significantly greater externalizing behavior problems in CI users compared to NH peers at Time 1, although these differences were less pronounced 1 year later. Poorer residual hearing and better coping flexibility at Time 1 were associated with fewer externalizing behavior problems in CI users at Time 2. CI users who showed improvement in coping flexibility over the 1-year period also showed improvement in externalizing behaviors during that period. Nonverbal intelligence and language were not associated with externalizing behavior problems.
Preschool-aged CI users may be at greater risk than NH peers for the early development of externalizing behavior problems. Improved coping flexibility may offer the potential for improvement in externalizing behavior problems for young CI users.
接受人工耳蜗植入(CI)的聋儿在听力和语言技能的早期发展中面临挑战,这可能使他们面临出现外化行为问题的风险,如攻击行为、多动冲动和对立行为。本研究是一项纵向调查,旨在研究(a)接受CI的学龄前儿童与听力正常(NH)同龄人在外化行为问题上的组间差异,以及(b)可能解释CI使用者样本中外化问题变异性的组内因素。
26名接受CI的儿童和30名NH同龄人的家长在相隔1年的两次访视中完成外化行为清单,访视从3岁或4岁开始。评估人口统计学/听力史变量、语言(词汇)、非言语智力和应对灵活性与CI样本中外化问题的同时期和预测性关联。
结果显示,在第1次访视时,CI使用者的外化行为问题明显多于NH同龄人,尽管1年后这些差异不太明显。第1次访视时残余听力较差和应对灵活性较好与第2次访视时CI使用者较少的外化行为问题相关。在1年期间应对灵活性有所改善的CI使用者在该期间的外化行为也有所改善。非言语智力和语言与外化行为问题无关。
学龄前CI使用者在早期发展外化行为问题方面可能比NH同龄人面临更大风险。改善应对灵活性可能为年轻的CI使用者改善外化行为问题提供潜力。