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84 Parent Ratings of Everyday Social, Emotional, and Behavioral Functioning in Children with Unilateral versus Bilateral Hearing Loss
- Samantha Hasenbalg, Rachel Landsman, Matthew Fasano-McCarron, Megan Herlihy, Peter K Isquith
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 76-77
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Objective:
Reduced hearing is associated with increased risk for social, emotional, and behavioral difficulties. Studies to date have typically compared DHH children with their hearing peers without regard for unilateral hearing loss (UHL) versus bilateral hearing loss (BHL). Children with UHL are often perceived as more like their typically hearing peers than their peers with BHL. Children with UHL typically access sound and spoken language which facilitates their functioning with fewer supports (e.g., interpreters, captioning). These children, however, show cognitive, academic, and communication profiles more similar to children with BHL than typically hearing peers. They may also experience similar social, emotional, and behavioral challenges as their BHL peers. We examined social, emotional, and behavioral functioning in a clinically referred sample of children with UHL versus BHL.
Participants and Methods:Parents of 100 children aged 2 to 17 years (M=7.12) with either UHL (n=30) or BHL (n=70) completed the Behavioral Assessment System for Children, Third Edition (BASC-3) as part of neuropsychological evaluation in a Deaf and Hard of Hearing Program within a tertiary pediatric hospital. BASC-3 scores based on General Combined norms were compared to an expected distribution of typically developing hearing children using non-parametric one-sample tests. Profiles of scores for children with UHL and BHL were examined in a repeated measures MANOVA.
Results:The groups of children with UHL and BHL showed similar age, gender, race, ethnicity, and Area Deprivation Index compositions. Eighty four percent of BHL children communicated with spoken language, and 100% of UHL children communicated with spoken language (p=.02). There were similar rates of comorbid diagnoses for ADHD (20%), Anxiety/Depression (18%), Autism Spectrum Disorder (8%), and Intellectual Disability/Global Developmental Delay (9%). However, children with BHL tended to be at greater risk for Language Disorders (50%) than those with UHL (30%, = 3.41 p=.065). Together, children with hearing loss showed significantly higher scores on the BASC-3 Hyperactivity, Aggression, Attention Problems, Atypicality, and Withdrawal clinical scales than expected (One-Sample Kolmogorov-Smirnov Test; p<.01). Profile analysis showed that children with any type of hearing loss had a varied pattern of scores across scales (F(7,686)=4.33, p<.01), with highest scores on Hyperactivity and Attention Problems scales and lowest scores on Somatization. Scale profiles did not differ, however, between UHL and BHLgroups (p=.127).
Conclusions:Children with UHL have access to auditory input, typically enabling early language development more like their hearing peers compared to children with BHL. In turn, these children may be overlooked more so than their BHL peers. However, the likelihood of social, emotional, and behavioral difficulties is similar between the two groups of children with hearing loss, whether that is unilateral or bilateral. Our study showed both groups of children had similar profiles across BASC-3 scales with elevations relative to norms. Measuring these everyday functions in children with hearing loss is important for early detection of risks to promote early intervention.
71 Profiles of Parent Ratings on the Behavior Assessment System for Children-Third Edition in Children with Autism Spectrum Disorder who are Deaf and Hard of Hearing
- Megan Herlihy, Rachel Landsman, Matthew Fasano-McCarron, Arielle Spellun, Samantha Hasenbalg, Peter Isquith
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 746-747
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- Article
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- You have access Access
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Objective:
Standardized assessment measures can provide data to inform a diagnosis of Autism Spectrum Disorder (ASD). Most measures assessing ASD characteristics rely on some degree of behavioral response to sound (e.g., responding to name, demonstrating listening response), and are often not appropriate for use with children who are Deaf and Hard of Hearing (DHH), especially with individuals who use signed languages. Few studies have reported on the Behavioral Assessment System for Children, Third Edition (BASC-3) for DHH children, and we aim to describe BASC-3 profiles in children with ASD who are DHH.
Participants and Methods:Participants include eight DHH patients diagnosed with ASD through interdisciplinary team evaluations by developmental-behavioral pediatricians, speech-language pathologists, and neuropsychologists with expertise in DHH child development. Demographics include a mean age of 6.17 years, and 62.5% were Male. Self-reported racial distribution was 75% White, 12.5% Black and 12.5% declined to answer. Average Area Deprivation Index (marker of socioeconomic status) was 32.13%tile. As a part of the evaluation, parents rated their children using the BASC-3. Languages include spoken English (75%) and American Sign Language (25%). Relevant co-occurring
neurodevelopmental/psychological diagnoses include Global Developmental Delay (n=1), Moderate Intellectual Disability (n=1), and Depression (n=1). Types of hearing loss include sensorineural (75%), conductive (12.5%), and mixed (12.5%). Three participants had different degrees of bilateral hearing loss in each ear: mild sloping-severe, moderate rising-mild (n=1), profound, moderate rising-normal level (n=1), and profound, moderate (n=1). Four participants had the same level of hearing loss in both ears: moderate-moderately severe (n=1), moderately severe-severe (n=1), severe-profound (n=1), and profound (n=1). One child had a unilateral moderate hearing loss. Technology utilized: unilateral hearing aid (n=2), bilateral hearing aids (n=2), unilateral cochlear implant (n=1), bilateral cochlear implants (n=2), and bimodal technology (n=1). BASC-3 scales of interest in this study were the developmental social disorders scale (DSD), Autism probability index (AUI), clinical scales, and adaptive scales. BASC-3 scores were standardized using General Combined norms and means were plotted.
Results:BASC-3 mean scores on clinical scales were elevated (T>60) on Atypicality (M=71), Hyperactivity (M=63), Withdrawal (M=63), and Attention Problems (M=65) in children with ASD who are DHH in this sample. BASC-3 mean scores on adaptive scales were below threshold (T<40) on Social Skills (M=37), Functional Communication (M=39), and overall Adaptive Skills (M=39). DSD scores were in the at-risk (T>60<70) range for 2 out of 8 cases and clinically significant (T>70) for 5 out of 8 cases.
The AUI was clinically significant for 2 out of the 3 cases within the age range for reporting AUI data.
Conclusions:In this preliminary sample of DHH children with a confirmed diagnosis of ASD by comprehensive specialized interdisciplinary clinical evaluations, parent ratings on the BASC-3 were consistent with what is known about BASC-3 profiles in hearing children diagnosed with ASD. Our findings suggest it may be helpful to review the DSD, AUI, clinical scales, and adaptive skills scales profiles when assessing DHH children at risk for ASD. Further research, including a larger sample size and assessment of language differences among participants, is necessary.