Predicting Quality of Life and Behavior and Emotion from Functional Auditory and Pragmatic Language Abilities in 9-Year-Old Deaf and Hard-of-Hearing Children
Abstract
:1. Introduction
1.1. Psychosocial Abilities and Functional Language Use
1.2. Quality of Life and Functional Language Use
1.3. Aims of the Current Study
- Do nine-year-old children with hearing loss who use spoken language to communicate differ from their hearing peers in behavior and emotion and QOL?
- To what extent does performance on tests of functional abilities and structural language abilities predict concurrent behavior and emotion and QOL in nine-year-old children with hearing loss who use spoken language to communicate?
2. Materials and Methods
2.1. Procedure
2.2. Participants
2.3. Predictor Measures: Language Assessments, Nonverbal Cognitive Ability, Pragmatic Skills, Auditory Functional Performance, and Speech Intelligibility
2.3.1. Spoken Language Ability
2.3.2. Nonverbal Cognitive Ability
2.3.3. Pragmatic Use of Spoken Language
2.3.4. Auditory Functional Performance
2.3.5. Speech Intelligibility
2.4. Dependent Measures: Behavior and Emotion and Health-Related Quality of Life
2.4.1. Behavior and Emotion
2.4.2. Health-Related Quality of Life
2.5. Statistical Analysis
3. Results
3.1. Outcomes of DHH Children Compared to Norms
3.1.1. Functional and Language Outcomes
3.1.2. Behavior and Emotion
3.1.3. Quality of Life
3.2. Factors Influencing Behavior and Emotion, and Quality of Life
3.2.1. Correlations among Measures
3.2.2. Behavior and Emotion
3.2.3. Quality of Life
4. Discussion
4.1. Behavior and Emotion
4.2. Quality of Life
4.3. Summary and Clinical Implications
4.4. Strengths and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Characteristics | No. of Participants (%) | |
---|---|---|
Sex | ||
Female | 74 (51.4%) | |
Male | 70 (48.6%) | |
Hearing device | ||
Hearing aid (HA) | 102 (70.8%) | |
Cochlear implant (CI) | 42 (29.2%) | |
Degree of hearing loss | ||
≤40 dB HL (mild) | 33 (22.9%) | |
41–60 dB HL (moderate) | 50 (34.7%) | |
61–80 dB HL (severe) | 18 (12.5%) | |
≥80 dB HL (profound) | 43 (29.9%) | |
Age at first HA fitting (months) | ||
Mean (SD) | 11.7 (11.1) | |
Median | 6.2 | |
Interquartile range | 2.9–20.3 | |
Age at first CI (months) | ||
Mean (SD) | 26.2 (17.4) | |
Median | 20.5 | |
Interquartile range | 12.5–38.1 | |
Primary mode of communication | ||
Oral only | 132 (91.7%) | |
Mixed (spoken and sign-supported) | 12 (8.3%) | |
Education setting | ||
Mainstream | 123 (85.4%) | |
Special | 5 (3.5%) | |
Unknown | 16 (11.1%) | |
Maternal education | ||
University or Diploma | 62 (43.1%) | |
Diploma/certificate | 46 (31.9%) | |
12 years or less of schooling | 36 (25.0%) |
Measure | Scale | Normative | All Participants | HA (n = 102) | CI (n = 42) | |
---|---|---|---|---|---|---|
Mean (SD) | Mean (SD) | Mean (SD) | Mean (SD) | |||
Nonverbal IQ | ||||||
WNV | Full scale | 100 (15) | 99.9 (13.5) | 99.1 (14.8) | 101.6 (9.8) | |
Language | ||||||
CELF-4 | ReLang | 100 (15) | 84.3 (15.0) | 83.9 (15.3) | 85.1 (14.5) | |
ExLang | 100 (15) | 84.6 (20.0) | 85.0 (19.7) | 83.6 (20.8) | ||
Functional auditory performance | ||||||
PEACH | Total score @ | 87.0 (13.2) | 78.4 (13.1) | 76.4 (13.6) | 83.1 (10.7) | |
Pragmatic use of language | ||||||
CCC-2 | Global composite score # | >45 | 57.5 (25.0) | 56.7 (25.1) | 59.6 (25.0) | |
Speech intelligibility rating | ||||||
SIR | Rating $ | 1.1 (0.3) | 1.6 (0.8) | 1.6 (0.9) | 1.5 (0.8) | |
Quality of life | ||||||
PedsQL | Total ^ | 81.3 (15.9) | 76.5 (14.4) | 75.5 (14.6) | 78.8 (13.7) | |
Physical ^ | 83.3 (20.0) | 88.8 (18.3) | 88.3 (17.8) | 90.0 (19.6) | ||
Psychosocial ^ | 80.2 (15.8) | 74.8 (15.7) | 73.6 (16.3) | 77.8 (14.0) | ||
Emotional ^ | 80.3 (17.0) | 72.9 (18.3) | 73.0 (18.5) | 72.7 (17.9) | ||
Social ^ | 82.2 (20.1) | 78.2 (20.2) | 77.2 (21.7) | 80.8 (16.1) | ||
School ^ | 76.9 (20.2) | 73.2 (18.7) | 70.5 (18.8) | 79.8 (16.8) | ||
Behavior and emotion | ||||||
SDQ | Total * | −0.12 (1.0) | −0.20 (1.0) | 0.07 (0.9) | ||
Emotion * | 0.25 (0.98) | 0.27 (1.0) | 0.23 (1.0) | |||
Conduct * | −0.10 (1.0) | −0.18 (1.1) | 0.10 (0.9) | |||
Hyperactivity * | −0.29 (1.1) | −0.37 (1.1) | −0.09 (1.0) | |||
Peer Problem * | −0.22 (1.0) | −0.31 (1.0) | 0.01 (1.1) | |||
Prosocial * | 0.02 (1.0) | −0.11 (1.0) | 0.32 (0.9) |
AgeFit | BE4FA | IQ | PEACH | SIR | GCC | ReLang | ExLang | PHY | EMOF | SOCF | SCHF | PSYSOC | QOLT | EMO | CON | HYP | PEER | PROS | SDQT | |
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
AgeFit | 1.00 | |||||||||||||||||||
BE4FA | −0.17 | 1.00 | ||||||||||||||||||
IQ | −0.07 | 0.08 | 1.00 | |||||||||||||||||
PEACH | −0.10 | 0.14 | 0.16 | 1.00 | ||||||||||||||||
SIR | 0.11 | −0.05 | −0.28 ** | −0.18 | 1.00 | |||||||||||||||
GCC | −0.17 | 0.04 | 0.28 ** | 0.52 ** | −0.37 ** | 1.00 | ||||||||||||||
ReLang | −0.19 | −0.04 | 0.54 ** | 0.20 | −0.52 ** | 0.49 ** | 1.00 | |||||||||||||
ExLang | −0.20 | −0.06 | 0.41 ** | 0.28 * | −0.50 ** | 0.61 ** | 0.84 ** | 1.00 | ||||||||||||
PHY | 0.05 | 0.06 | 0.16 | 0.28 * | −0.18 | 0.32 ** | 0.18 | 0.21 | 1.00 | |||||||||||
EMOF | 0.01 | 0.06 | 0.15 | 0.32 ** | −0.04 | 0.19 | 0.09 | 0.08 | 0.34 ** | 1.00 | ||||||||||
SOCF | −0.04 | 0.07 | 0.15 | 0.40 ** | −0.15 | 0.39 ** | 0.18 | 0.18 | 0.56 ** | 0.51 ** | 1.00 | |||||||||
SCHF | −0.08 | 0.23 ** | 0.22 ** | 0.47 ** | −0.16 | 0.49 ** | 0.29 ** | 0.31 ** | 0.52 ** | 0.44 ** | 0.60 ** | 1.00 | ||||||||
PSYSOC | −0.04 | 0.15 | 0.21 | 0.48 ** | −0.14 | 0.43 ** | 0.23 * | 0.23 | 0.57 ** | 0.78 ** | 0.86 ** | 0.82 ** | 1.00 | |||||||
QOLT | −0.01 | 0.12 | 0.21 | 0.45 ** | −0.18 | 0.44 ** | 0.24 * | 0.25 | 0.83 ** | 0.65 ** | 0.84 ** | 0.80 ** | 0.93 ** | 1.00 | ||||||
EMO | −0.02 | 0.05 | 0.09 | 0.33 ** | −0.09 | 0.29 ** | 0.09 | 0.10 | 0.30 ** | 0.64 ** | 0.34 ** | 0.42 ** | 0.56 ** | 0.50 ** | 1.00 | |||||
CON | −0.03 | 0.17 | 0.25 ** | 0.37 ** | −0.11 | 0.29 ** | 0.21 | 0.22 | 0.25 * | 0.36 ** | 0.35 ** | 0.41 ** | 0.45 ** | 0.41 ** | 0.28 * | 1.00 | ||||
HYP | −0.01 | 0.16 | 0.34 ** | 0.35 ** | −0.15 | 0.46 ** | 0.26 * | 0.27 | 0.19 | 0.30 ** | 0.31 ** | 0.61 ** | 0.49 ** | 0.42 ** | 0.35 ** | 0.46 ** | 1.00 | |||
PEER | −0.09 | 0.14 | 0.15 | 0.34 ** | −0.23 * | 0.36 ** | 0.23 * | 0.25 | 0.37 ** | 0.42 ** | 0.66 ** | 0.47 ** | 0.63 ** | 0.60 ** | 0.36 ** | 0.52 ** | 0.37 ** | 1.00 | ||
PROS | −0.20 | 0.22 ** | 0.19 | 0.37 ** | −0.18 | 0.34 ** | 0.12 | 0.22 | 0.17 | 0.20 * | 0.25 * | 0.30 ** | 0.30 ** | 0.28 * | 0.19 | 0.53 ** | 0.32 ** | 0.43 ** | 1.00 | |
SDQT | −0.05 | 0.18 | 0.29 ** | 0.47 ** | −0.20 | 0.49 ** | 0.27 * | 0.29 ** | 0.37 ** | 0.58 ** | 0.56 ** | 0.66 ** | 0.73 ** | 0.65 ** | 0.67 ** | 0.73 ** | 0.79 ** | 0.75 ** | 0.49 ** | 1.00 |
SDQT | EMO | CON | HYP | PEER | PROS | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Est | (95% CI) | p-Value | Est | (95% CI) | p-Value | Est | (95% CI) | p-Value | Est | (95% CI) | p-Value | Est | (95% CI) | p-Value | Est | (95% CI) | p-Value | |
AgeFit | 0.05 | (−0.09, 0.20) | 0.45 | 0.02 | (−0.14, 0.18) | 0.84 | 0.05 | (−0.11, 0.21) | 0.51 | 0.08 | (−0.07, 0.23) | 0.27 | 0.001 | (−0.16, 0.16) | 0.99 | −0.13 | (−0.29, 0.02) | 0.09 |
BE4FA | 0.47 | (0.16, 0.78) | 0.003 | 0.45 | (0.10, 0.80) | 0.01 | 0.42 | (0.07, 0.76) | 0.018 | 0.33 | (0.01, 0.66) | 0.04 | 0.20 | (−0.15, 0.55) | 0.26 | 0.22 | (−0.12, 0.56) | 0.20 |
Device | 0.40 | (0.08, 0.71) | 0.01 | 0.52 | (0.15, 0.88) | 0.005 | 0.33 | (−0.13, 0.68) | 0.07 | 0.24 | (−0.09, 0.57) | 0.16 | 0.11 | (−0.25, 0.47) | 0.55 | 0.09 | (−0.26, 0.44) | 0.61 |
IQ | 0.13 | (−0.03, 0.30) | 0.11 | −0.01 | (−0.19, 0.18) | 0.95 | 0.14 | (−0.04, 0.32) | 0.14 | 0.23 | (0.05, 0.40) | 0.01 | 0.001 | (−0.18, 0.19) | 0.99 | 0.15 | (−0.03, 0.33) | 0.09 |
ReLg | 0.13 | (−0.15, 0.42) | 0.36 | 0.17 | (−0.16, 0.50) | 0.31 | 0.11 | (−0.21, 0.44) | 0.48 | 0.05 | (−0.12, 0.22) | 0.75 | 0.07 | (−0.24, 0.40) | 0.65 | −0.32 | (−0.63, 0.00) | 0.05 |
ExpLg | −0.13 | (−0.41, 0.16) | 0.38 | −0.25 | (−0.57, 0.07) | 0.13 | −0.01 | (−0.33, 0.30) | 0.94 | −0.06 | (−0.36, 0.24) | 0.68 | −0.03 | (−0.36, 0.29) | 0.84 | 0.22 | (−0.09, 0.53) | 0.16 |
GCC | 0.29 | (0.10, 0.49) | 0.004 | 0.19 | (−0.03, 0.41) | 0.09 | 0.06 | (−0.16, 0.27) | 0.6 | 0.35 | (0.15, 0.55) | <0.001 | 0.20 | (−0.03, 0.42) | 0.08 | 0.14 | (−0.07, 0.36) | 0.19 |
PEACH | 0.33 | (0.17, 0.50) | <0.001 | 0.31 | (0.12, 0.50) | 0.002 | 0.32 | (0.14, 0.51) | <0.001 | 0.17 | (−0.01, 0.34) | 0.06 | 0.21 | (0.02, 0.40) | 0.03 | 0.23 | (0.05, 0.41) | 0.01 |
SIR | −0.01 | (−0.18, 0.15) | 0.87 | −0.04 | (−0.22, 0.15) | 0.69 | 0.04 | (−0.14, 0.22) | 0.65 | 0.05 | (−0.12, 0.22) | 0.55 | 0.11 | (−0.25, 0.47) | 0.55 | −0.08 | (−0.26, 0.09) | 0.36 |
Adj R2 | 0.332 | 0.129 | 0.166 | 0.262 | 0.135 | 0.194 |
QOLT | PSYSOC | SCHF | SOCF | EMOF | PHY | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Est | (95% CI) | p-Value | Est | (95% CI) | p-Value | Est | (95% CI) | p-Value | Est | (95% CI) | p-Value | Est | (95% CI) | p-Value | Est | (95% CI) | p-Value | |
AgeFit | 0.08 | (−0.06, 0.23) | 0.26 | 0.05 | (−0.10, 0.20) | 0.52 | 0.05 | (−0.10, 0.19) | 0.51 | 0.03 | (−0.13, 0.19) | 0.7 | 0.04 | (−0.13, 0.20) | 0.67 | 0.12 | (−0.05, 0.28) | 0.16 |
BE4FA | 0.29 | (−0.03, 0.62) | 0.08 | 0.34 | (0.02, 0.66) | 0.04 | 0.28 | (−0.03, 0.60) | 0.08 | 0.11 | (−0.23, 0.46) | 0.52 | 0.46 | (0.10, 0.82) | 0.01 | 0.22 | (−0.14, 0.58) | 0.22 |
Device | 0.25 | (−0.08, 0.59) | 0.14 | 0.29 | (−0.04, 0.62) | 0.09 | 0.1 | (−0.22, 0.42) | 0.53 | 0.11 | (−0.25, 0.46) | 0.55 | 0.52 | (0.15, 0.88) | 0.006 | 0.2 | (−0.17, 0.57) | 0.28 |
IQ | 0.06 | (−0.12, 0.23) | 0.53 | 0.05 | (−0.12, 0.22) | 0.56 | 0.02 | (−0.15, 0.19) | 0.82 | 0.03 | (−0.15, 0.21) | 0.74 | 0.08 | (−0.11, 0.27) | 0.42 | 0.05 | (−0.14, 0.24) | 0.63 |
ReLg | 0.16 | (−0.15, 0.46) | 0.31 | 0.21 | (−0.10, 0.51) | 0.18 | 0.2 | (−0.10, 0.49) | 0.18 | 0.12 | (−0.21, 0.44) | 0.47 | 0.20 | (−0.13, 0.53) | 0.23 | 0.03 | (−0.30, 0.37) | 0.84 |
ExpLg | −0.14 | (−0.44, 0.16) | 0.36 | −0.19 | (−0.48, 0.11) | 0.21 | −0.07 | (−0.36, 0.22) | 0.63 | −0.17 | (−0.49, 0.14) | 0.28 | −0.22 | (−0.55, 0.10) | 0.18 | −0.01 | (−0.34, 0.32) | 0.93 |
GCC | 0.27 | (0.06, 0.48) | 0.01 | 0.25 | (0.05, 0.46) | 0.02 | 0.30 | (0.10, 0.50) | 0.003 | 0.28 | (0.06, 0.50) | 0.01 | 0.03 | (−0.19, 0.26) | 0.78 | 0.21 | (−0.02, 0.43) | 0.07 |
PEACH | 0.33 | (0.16, 0.51) | <0.001 | 0.38 | (0.20, 0.55) | <0.001 | 0.29 | (0.12, 0.46) | <0.001 | 0.28 | (0.09, 0.46) | 0.004 | 0.370 | (0.18, 0.57) | 0.004 | 0.180 | (−0.02, 0.37) | 0.080 |
SIR | −0.01 | (−0.19, 0.16) | 0.87 | 0.02 | (−0.14, 0.19) | 0.78 | 0.07 | (−0.10, 0.23) | 0.42 | −0.02 | (−0.20, 0.16) | 0.82 | 0.01 | (−0.17, 0.20) | 0.88 | −0.07 | (−0.26, 0.12) | 0.45 |
Adj R2 | 0.249 | 0.268 | 0.308 | 0.160 | 0.114 | 0.094 |
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Ching, T.Y.C.; Cupples, L.; Leigh, G.; Hou, S.; Wong, A. Predicting Quality of Life and Behavior and Emotion from Functional Auditory and Pragmatic Language Abilities in 9-Year-Old Deaf and Hard-of-Hearing Children. J. Clin. Med. 2021, 10, 5357. https://doi.org/10.3390/jcm10225357
Ching TYC, Cupples L, Leigh G, Hou S, Wong A. Predicting Quality of Life and Behavior and Emotion from Functional Auditory and Pragmatic Language Abilities in 9-Year-Old Deaf and Hard-of-Hearing Children. Journal of Clinical Medicine. 2021; 10(22):5357. https://doi.org/10.3390/jcm10225357
Chicago/Turabian StyleChing, Teresa Y. C., Linda Cupples, Greg Leigh, Sanna Hou, and Angela Wong. 2021. "Predicting Quality of Life and Behavior and Emotion from Functional Auditory and Pragmatic Language Abilities in 9-Year-Old Deaf and Hard-of-Hearing Children" Journal of Clinical Medicine 10, no. 22: 5357. https://doi.org/10.3390/jcm10225357