As late as the mid-20th century children with a hearing loss were often misdiagnosed and parents were told their child had a mental deficiency.(2)

Research has found that if children do not receive stimulation to the auditory nerves during the early formative years (preferably before about age 2) then this will result in lifelong communication and language problems.(3)

90% of deaf children are born to hearing parents(3). These people usually have no experience of deafness and have no idea how to treat it. Many are in denial, feel guilty, frustrated and scared. Without early intervention important bonding may not form because the parent and child are unable to communicate. Research shows that a hearing parent interacts with a hearing child in a significantly different way than with a deaf child. Interaction is often short with more interruptions, encouraging short attention in the child. Some parents become more controlling and this encourages behavourial domination in the child(5).

A number of research studies have quite clearly demonstrated that children with a hearing loss have many disadvantages particularly if left unrecognised, untreated or under treated.

Hearing loss disadvantages and quality of life issues
Research conducted by Hearing Review in late 2007(1) found there are a number the quality of life issues faced by deaf children. A mild loss creates a personal nuisance for the child and their family but a profound loss is a major disability which affects all aspect of life.


Kochkin et al(1) as well as other researchers have found that hearing impaired children had issues in a number of areas
(1) Social interaction
(2) Language and Communication
(3) Education
(4) Behaviourial Problems
(5) Mental Health
(6) Safety


Social Interaction
• Social skills were poor or under developed and may have a negative impact on social development.
• Self-esteem and confidence were low and this affected their relationship with peers and family.
• They find it hard to hear in group situations, therefore group participation is lower than that for their peers and this affects their leisure/play activities.
• They could not easily use a phone, something their hearing peers could, and this made them different.
• They do not always hear, so others have to yell at them causing embarrassment.
• If the child doesn’t answer, peers think they are being ignored causing misunderstanding.
• Many withdraw from social situations because of embarrassment and this contributes to isolation.
• They often have poor speech meaning others cannot understand them so they become self-conscious.

Language & Communication
Language and communication develop within the first two years of life.

Kochin et al(1) found Hearing Impaired children
• Often have delays in, as well as poor, speech and language development hindering their ability to communicate effectively.
• Have poor mental acuity due to poor speech and language development.
• Do not have the skills to ask the questions to get help because they do not know what they do not hear and parents have to guess whether the child is hearing well enough to cope with their hearing loss because the child doesn’t have the experience to know and explain where they need help.
• Need others to repeat themselves and frequently people show frustration at having to do this resulting in embarrassment.
• Many need sign language but it is imperative their family and close friends learn it as well so the child is exposed to as much language as possible.

Education
If a child is to attend a main stream school then oral and written communication are necessary. However, a deaf child may not have the skills to allow them to keep up with their peers.
• Davis et al 1984 found that “hearing loss of any degree appeared to affect psychoeducational development adversely, leading to the conclusion that even minimal hearing loss places children at risk for language and learning problems.”(6)
• 71% of hearing impaired children had difficulty maintaining attention compared to 9% of normal hearing children.(5)
• Children with a mild to profound loss were behind in education achievement and their grades were lower than their hearing peers.(1)
• Reading development will be delayed. Average reading age of profoundly deaf 16 year olds was that of hearing 9 year olds.
• 50% of the children researched could not read at all.(3)
• The child needs personal attention especially in school. 1 in 3 children with a hearing loss need help in the classroom to interpret the teacher’s instructions.(1)
• Children need to learn coping mechanisms such as sitting at the front of the class or positioning themselves on the best hearing side or learning lip reading. One third of hearing impaired children receive preferential seating (ie at the front of the class).(1)
• Lip reading is only possible if they already know the language.
• May need a note taker or translator.(1)
• Many drop out early because they cannot cope resulting in a poor education and this means fewer job opportunities.

Behavioural problems
Misunderstandings causes confusion and results in behavioural problems.
• Behavioural problems are caused because of the frustration the child feels especially with peer group.
• Teachers report behavioural problems for one third of their hearing-impaired students particularly impulsivity and inattention.(5)
• Hearing impaired children may listen to music or TV too loud disturbing the rest of the family.(1)

Mental Health
Children especially, do not like to be different and if they feel different or ‘lacking’ their emotional health can be effected.(1)
• Because the child must rely on others to be their ears they lack a sense of independence.(1)
• Frustration at not making themselves understood nor being able to understand.
• Frustration and anger because they cannot perform as well as their peers.
• Lack of self-esteem and confidence.

Safety
• Both parents of as well as deaf children lack a sense of safety.(1)
• Not hearing in noisy situations can mean a child misses safety cues.(1)
Intervention issues
• Parents are often told the child cannot be helped although this is not necessarily the case.(1)
• Parents in denial (will grow out of it!) or see it as nothing terrible and easily dealt with.(1)
• Children are not comfortable with a hearing aid and parents fear they will lose it.(1)
• There is a stigma in wearing a hearing aid. Hearing aids are for old people, makes the child feel different. They are ugly and don’t work. Other kids make fun of them.(1)

Recommended intervention
When the recommended intervention was implemented Kochkin(1) found that:
(1) 61% of children’s grades improved
(2) 46% had improved social skills
(3) 51% had improved classroom behaviour
(4) 49% had improved self-esteem
(5) If children under 6 months of age wear hearing aids then some of the effects on communication development can be prevented or minimized(4)

Most of the issues deaf children face; social interaction difficulties, behavioural issues, language and communication difficulties, poor education and so on, come about because these children have poor linguistic skills.

References:
(1) Kochkin, S; Luxford, W; Northern, J; Mason, P; Tharpe, Anne Marie; Hearing Review September 2007: Are a million dependents with hearing loss being left behind? http://www.betterhearing.org/pdfs/marketrak7-children.pdf Accessed 6/8/08
(2) Perry, George; July 2008; Bet the Vet can hear http://www.c-a-network.com/georgep.php Accessed 7/8/08
(4) O’Donoghue, Gerard M; BMJ 1999: Hearing without ears: Do cochlear implants work in children? http://www.bmj.com/cgi/content/full/318/7176/72 Accessed 7/8/08
(8) Dettman, S, Pinder, D, Briggs, R, Dowell, R and Leigh, J; Communication Development in Children Who Receive the Cochlear Implant Younger than 12 Months - Risks versus Benefits 0196/0202/07/282 Supplement-0011S/0 • Ear & Hearing • Copyright © 2007 by Lippincott Williams & Wilkins • Printed in the USA
(10) Tye-Murray N, Spencer L, Woodworth GG, University of Iowa Hospitals and clinics; Acquisition of speech by children who have prolonged cochlear implant experience. http://www.ncbi.nlm.nih.gov/pubmed/7596098?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=2&log$=relatedarticles&logdbfrom=pubmed Accessed 7/8/08
(14) Tomblin J, Spencer L, Flock S, Tyler R, Gantz B. A comparison of language achievement in children with cochlear implants and children using hearing aids. J Speech Lang Hear Res. 1999;42:497-509. http://jslhr.asha.org/cgi/content/abstract/42/2/497?ijkey=27a96bce4e87880681dc6daf9322e818f6615c29&keytype2=tf_ipsecsha Accessed 7/8/08