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Review |

Psychopathology and Its Risk and Protective Factors in Hearing-Impaired Children and Adolescents:  A Systematic Review FREE

Stephanie C. P. M. Theunissen, MD1; Carolien Rieffe, PhD2,3; Anouk P. Netten, MD1; Jeroen J. Briaire, MSc, PhD1; Wim Soede, MSc, PhD1; Jan W. Schoones, MA4; Johan H. M. Frijns, MD, PhD1,5
[+] Author Affiliations
1Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands
2Department of Developmental Psychology, Leiden University, Leiden, the Netherlands
3Dutch Foundation for the Deaf and Hard of Hearing Child, Amsterdam, the Netherlands
4Walaeus Library, Leiden University Medical Center, Leiden, the Netherlands
5Leiden Institute for Brain and Cognition, Leiden, the Netherlands
JAMA Pediatr. 2014;168(2):170-177. doi:10.1001/jamapediatrics.2013.3974.
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Published online

Importance  Pediatric hearing impairment is a chronic handicap that can potentially lead to the development of psychopathology. Yet, for hearing-impaired children and adolescents, the exact occurrence of various forms of psychopathology and its causes are unclear, while this knowledge is essential to enable targeted screenings and interventions.

Objective  To investigate the level of psychopathological symptoms in hearing-impaired children and adolescents as compared with normally hearing peers. Second, the influence of type of hearing device and possible risk and protective factors on psychopathology were examined.

Evidence Review  A systematic literature search was performed covering relevant databases, including PubMed, Embase, and Web of Science. Two independent researchers identified the relevant articles. The final search was performed on May 2, 2013, and resulted in a total of 35 articles.

Findings  Literature consistently demonstrated that hearing-impaired children and adolescents were more prone to developing depression, aggression, oppositional defiant disorder, conduct disorder, and psychopathy than their normally hearing peers. Levels of anxiety, somatization, and delinquency were elevated in some, but not all, hearing-impaired participants, for reasons related to sex, age, and type of school. Divergent results were obtained for the level of attention-deficit/hyperactivity disorder and the influence of type of hearing device on psychopathology. Possible risk and protective factors were identified, including age at detection and intervention of hearing loss, additional disabilities, communication skills, intelligence, type of school, and number of siblings.

Conclusions and Relevance  Literature on psychopathology in hearing-impaired children and adolescents is scarce and sometimes inconsistent. To define a more precise occurrence of psychopathology, more studies are needed. These studies should have a longitudinal design to draw firmer conclusions on causality. Hopefully, this will lead to more knowledge in the future to help and support each hearing-impaired individual.

Figures in this Article

In the last few decades, research in the field of social and emotional development and psychopathology in hearing-impaired (HI) children and adolescents has emerged gradually. As promoted by the World Health Organization, many studies reported on broad and general concepts, such as quality of life and mental health.1,2 These studies demonstrated fairly consistent outcomes, with lower quality of life and more mental health problems in HI children and adolescents than in normally hearing (NH) children and adolescents.1,311 For example, HI individuals have more difficulties with making friends and are more socially isolated.1214 Although quality of life and mental health give a good first impression, knowledge on specific psychopathological forms, such as depression or attention-deficit/hyperactivity disorder (ADHD), gives a more differentiated view.15 In fact, this knowledge allows for targeted screenings and interventions on psychopathology in HI children and adolescents, since nowadays only the ones who evidently stagnate in their functioning are helped.

In line with the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition), 2 broad categories of psychopathological symptoms can be identified: internalizing and externalizing symptoms. Internalizing reflects symptoms such as depressive/anxious feelings and somatization, whereas externalizing refers to symptoms such as aggressive, oppositional defiant, and delinquent behavior and impulsivity.16 Both internalizing and externalizing symptoms have a destructive impact on daily social and occupational functioning and are precursors to various psychiatric disorders later in life.17,18 Hence, it is of the utmost importance to prevent HI children from developing psychopathology. Additionally, researchers stress the fact that factors that increase risks for, or conversely protect against, psychopathology must be listed.1,5,11 Therefore, the aim of this review is 3-fold: (1) to describe the occurrence of psychopathological symptoms in HI children and adolescents as compared with NH peers; (2) to examine the possible effect of type of hearing device on the development of psychopathology; and (3) to study which auditory, medical, communication, intellectual, and sociodemographic factors potentially influence the level of psychopathology.

Inclusion Criteria

This review included studies that reported on internalizing (ie, depression, anxiety, and somatization) or externalizing symptoms (ie, aggression, delinquency, ADHD, oppositional defiant disorder [ODD], conduct disorder [CD], and psychopathy). Involving the participants of each study, the following inclusion criteria were formulated: (1) having permanent bilateral hearing losses, (2) that are moderate to profound (ie, 40-120 dB at the better ear, calculated by averaging unaided hearing thresholds at 500, 1000, and 2000 Hz), and (3) being a child (6-12 years) or adolescent (12-18 years). We chose this age range because it is a transition phase marked by large psychological and cognitive changes that pertain to emerging adulthood.

Literature Search

A systematic literature search on various forms of psychopathology in HI participants covered relevant databases, including PubMed (1946-2013), Embase (OVID version, 1974-2013), and Web of Science (1945-2013). The subject query was applied in all databases taking into account the terminological differences between these databases. The query consisted of the combination of 3 subjects: (1) hearing impairment; (2) psychopathology; and (3) child or adolescent. Various synonyms and related terms for the subjects were used (the eTable in the Supplement shows all accompanying search terms). The final search was performed on May 2, 2013. Papers that were under review were also included, because of scarce literature. Limits were set to include English-, French-, German-, and Dutch-language articles. Case reports, editorials, and letters were excluded.

Selection of Articles

Two investigators (S.C.P.M.T. and A.P.N.) independently screened all unique article titles and abstracts to identify which articles were relevant. Disagreements were solved by discussion. Additionally, a manual review of citations within the bibliography of relevant articles was performed. The initial search generated a total of 7954 abstracts, of which 206 were identified as potentially relevant. Involving our first aim of this review (ie, the occurrence of psychopathology), 15 met the inclusion criteria. Most of these studies reported on 1 form of psychopathology, but some included more forms. For the second aim (ie, type of hearing device), another 3 new studies were included, and for the third aim (ie, risk and protective factors), 17 other studies were included (Figure). All studies were published in peer-reviewed journals and were assessed for their level of evidence. In line with the guidelines of the Cochrane Collaboration,19 the included studies had recommendation B (cohort or case-control study), except for 1 study by Vostanis et al7 that had recommendation C (case-series study). Because of differences in outcomes when examining different study samples, the 18 included studies on specific psychopathological symptoms were grouped based on the study sample and recapitulated in Table 1 (community-based samples), Table 2 (samples with children attending special schools and/or profoundly HI children), and Table 3 (children with cochlear implants [CIs]).

Place holder to copy figure label and caption
Figure.
Flowchart for Search Results
Graphic Jump Location
Table Graphic Jump LocationTable 1.  Literature on Psychopathology in Community-Based Samples
Table Graphic Jump LocationTable 2.  Literature on Psychopathology in Samples Drawn From Special Schools and/or Profoundly HI Individuals
Table Graphic Jump LocationTable 3.  Literature on Psychopathology in CI Samples
Internalizing Symptoms

Seven studies investigated depression in HI children and adolescents. Three studies included representative community-based samples23,31 and 4 studies examined children with a minimum hearing loss of 90 dB, who almost all attended special or residential schools for deaf children.46,42 These 7 studies had coherent results; when compared with NH controls, higher scores were obtained both by parent reports5,6 and self-reports.4,29,31,42 Lifetime prevalence for depression was 26%, based on clinical interviews with parents,23 and this was significantly higher than that of the NH population (15%-20%).23,49 Two of the earlier-mentioned studies investigated children at both special and mainstream schools and detected more depression in children at special schools.4,31 Based on these outcomes, HI children and adolescents appear to be more prone to developing depression than their NH peers, particularly when attending special schools.

Four studies examined levels of anxiety.10,26,34,41 Two studies included community-based samples and found that parent-reported levels of anxiety were higher in HI than in NH participants,34 whereas self-reported levels of anxiety were equal in both groups.26 For children with profound losses and/or attending special schools, the 2 available studies both revealed more self-reported anxiety in HI compared with NH children.10,41 So, HI individuals have at least as much anxiety as NH individuals, but it is plausible that they in fact experience more anxiety, especially the children with profound losses attending special schools.

For somatization, 6 different studies were carried out.46,20,26,32 Some researchers found no difference in level of somatization between HI and NH children and adolescents,5,26,32 while others reported more somatic complaints in HI individuals,4,6,20 with a reported prevalence varying from 17% to 20% for HI participants.4,6 These seemingly inconsistent outcomes could not be explained by differences in study samples, since community-based samples as well as samples derived from special schools were included in both groups. Yet, age differences between the samples were present. That is, the studies with higher scores included fairly older participants, and more somatization has been linked to increasing age, both in HI6,26 and NH50 individuals. Therefore, we can conclude that mainly HI adolescents, and not HI children, could be at risk for somatization.

Externalizing Symptoms

Five studies examined aggression.46,26,37 Irrespective of the study sample, all but 1 of these studies revealed more parent- and self-reported aggression in HI than in NH children and adolescents37 and found levels of aggression that ranged from 15% to 23% in HI participants46 and about 5% in NH controls.4,5 The study that showed no difference was the only one that used relatively many girls,26 who generally demonstrate less aggressive behavior than boys.51,52 In conclusion, these studies suggest that HI children have higher levels of aggression than NH children.

For delinquency, 5 studies were carried out.46,26,37 Three studies had community-based samples and reported similar levels of delinquency of HI and NH participants.26,37 Three other studies included participants who experienced hearing loss of more than 90 dB and almost all attended special schools.46 These studies demonstrated elevated levels of delinquency in HI children and adolescents (10%-20%), which were significantly higher than in NH controls (4%-6%). In conclusion, delinquency in HI children and adolescents equaled that in NH children, but children attending special schools may be at risk.

Three studies were carried out involving symptoms of ADHD.22,23,37 Compared with NH peers, parents of HI children and adolescents reported more symptoms of ADHD,37 even up to 12% of HI children.23 Yet, the Gallaudet Research Institute demonstrated a prevalence of ADHD of 5.6%,22 which is lower than in the NH population, of which 8% to 10% have been diagnosed with ADHD.53 Unfortunately, the Gallaudet Research Institute did not describe the study methods, so we are unable to further examine the possible causes for this difference. It thus remains unclear whether HI children experience higher or lower levels of ADHD than NH controls.

The final 3 externalizing symptoms, ODD, CD, and psychopathy, have large conceptual overlaps and are therefore grouped together in this paragraph. Prevalence of these antisocial behaviors in NH children is a matter of debate, whereas almost no studies with HI individuals have been published. To the best of our knowledge, only 2 studies (both with community-based samples) examined antisocial behavior.23,37 The first study found more symptoms of ODD, CD, and psychopathy in HI than in NH children and adolescents but did not investigate exact prevalences.37 The second study found that 8% of HI children have ODD,23 which is higher than in NH children (approximately 1%-3%).54 In summary, the few studies that are available indicate that more symptoms of ODD, CD, and psychopathy occur in HI individuals compared with NH controls, but more studies are definitely needed to confirm these findings.

Influence of Type of Hearing Device on Psychopathology

The earlier-mentioned studies showed that levels of most internalizing and externalizing symptoms can be higher in HI than in NH children, irrespective of the type of hearing device. Only a few studies investigated the influence of type of device on psychopathology (S.C.P.M.T., C.R., W.S., J.J.B., L. Ketelaar, MSc, M. Kouwenberg, MA, MSc, and J.H.M.F., unpublished data).23,29,31,32,34,37,46 Various researchers found that a CI can be protective for psychopathology (S.C.P.M.T., C.R., W.S., J.J.B., L. Ketelaar, MSc, M. Kouwenberg, MA, MSc, and J.H.M.F., unpublished data).34,37,46 For example, studies with large and representative samples showed positive results for children with CI; levels of both internalizing and externalizing symptoms were similar to those of NH children,46,48 whereas children with hearing aids had higher levels than the other groups in both areas (S.C.P.M.T., C.R., W.S., J.J.B., L. Ketelaar, MSc, M. Kouwenberg, MA, MSc, and J.H.M.F., unpublished data).34,37 Not all studies could confirm these encouraging outcomes; others detected no difference between children with CI and children with hearing aids.23,29,31,32,34,37 Yet, children with hearing aids never performed better than children with CI on these measures, despite their smaller initial hearing loss.

Auditory and Medical Factors Affecting Psychopathology

Next to type of device, other risk and protective factors for psychopathology have been identified, starting with auditory and medical factors (S.C.P.M.T., C.R., W.S., J.J.B., L. Ketelaar, MSc, M. Kouwenberg, MA, MSc, and J.H.M.F., unpublished data).3,5,6,9,23,31,34,37,5563 A first auditory factor is degree of hearing loss. Although it is plausible that the greater the degree of hearing loss is, the more psychopathology occurs, this hypothesis appears to be incorrect. Most literature found no influence of the degree of hearing loss on psychopathology (S.C.P.M.T., C.R., W.S., J.J.B., L. Ketelaar, MSc, M. Kouwenberg, MA, MSc, and J.H.M.F., unpublished data).3,5,6,9,23,31,34,37,6163 Apparently other factors are more important for the prediction of psychopathology. For example, age at detection and age at intervention of hearing loss were essential; early detection and intervention of a child’s hearing loss have been related to lower levels of psychopathology (S.C.P.M.T., C.R., W.S., J.J.B., L. Ketelaar, MSc, M. Kouwenberg, MA, MSc, and J.H.M.F., unpublished data).34 Furthermore, several specific forms of etiology of hearing loss, such as rubella or prematurity, as well as various syndromes, have been associated with more psychopathology, even up to 6 times more (S.C.P.M.T., C.R., W.S., J.J.B., L. Ketelaar, MSc, M. Kouwenberg, MA, MSc, and J.H.M.F., unpublished data).9,5558,60 Particularly when hearing loss is associated with central nervous system disorders9,5558 or when additional disabilities are present,9,55,59,60 the risk of psychopathology increases.

Communication and Intellectual Factors Affecting Psychopathology

Several studies reported on communication and intelligence factors that affected psychopathology (S.C.P.M.T., C.R., W.S., J.J.B., L. Ketelaar, MSc, M. Kouwenberg, MA, MSc, and J.H.M.F., unpublished data).4,5,7,9,13,26,31,34,37,62,64,65 Lower levels of internalizing and externalizing symptoms have been described in children with better language, speech understanding, speech production, or vocabulary.5,13,34,37,65 This finding is supported and extended by others, who detected that once speech and language abilities were good, no psychopathological symptoms were present at all (S.C.P.M.T., C.R., W.S., J.J.B., L. Ketelaar, MSc, M. Kouwenberg, MA, MSc, and J.H.M.F., unpublished data).62 Moreover, Dammeyer9 demonstrated that when communication skills were good, regardless of the modality (sign or spoken), no psychosocial differences were observed between HI and NH children. In this respect, deaf children born to deaf parents function psychosocially better than deaf children born to NH parents, but this could also be contributed to factors related to bonding, parents’ expectations, or parenting style.59 However, other studies did not agree and showed that sign language was significantly associated with more psychopathology.26,31,37,64 For example, the study by Vostanis and colleagues7 examined HI children who used sign language. The prevalence of psychopathology in this group was very high, ranging from 40% to 77%. The additional use of spoken language, next to sign language, was considered to be a protective factor for psychopathology.7 Lastly, higher levels of psychopathology arise more often in children with intellectual impairments.4,37,64

Sociodemographic Factors Affecting Psychopathology

A body of literature investigated sociodemographic factors (S.C.P.M.T., C.R., W.S., J.J.B., L. Ketelaar, MSc, M. Kouwenberg, MA, MSc, and J.H.M.F., unpublished data).47,9,10,13,14,34,37,41,64,66 Older age has been related to more psychopathology46,10,13,37,41,66 except for anxiety because younger children tend to be more anxious than older children.10 Furthermore, HI girls experience more internalizing symptoms than HI boys, particularly depression and anxiety.4,5,7,9 Boys experienced more externalizing symptoms.37 Next, for family income, as an indicator of socioeconomic status, mixed results were obtained, with studies reporting no relation with psychopathology5,34,64 and studies reporting more psychopathology in families with lower socioeconomic status (S.C.P.M.T., C.R., W.S., J.J.B., L. Ketelaar, MSc, M. Kouwenberg, MA, MSc, and J.H.M.F., unpublished data).13,37 Concerning number of siblings, only 1 study was available, which showed that lower number of siblings was associated with less psychopathology (S.C.P.M.T., C.R., W.S., J.J.B., L. Ketelaar, MSc, M. Kouwenberg, MA, MSc, and J.H.M.F., unpublished data). Finally, type of school appeared to be relevant: children attending special schools for deaf children exhibited more psychopathology than HI children at regular schools.4,5,31,64 They “saw themselves in a less favorable light” than children in regular schools.14

This review investigated the occurrence of psychopathological symptoms in HI children and adolescents with bilateral hearing loss of at least 40 dB at the best ear. The outcomes suggest that HI children and adolescents experience higher levels of most internalizing and externalizing symptoms than NH controls. Yet, the literature was not fully consistent for anxiety, somatization, and delinquency and reported elevated levels that applied to certain subsamples of HI participants, related to sex, age, and type of school. Divergent outcomes were obtained for the level of ADHD. Furthermore, the type of hearing device appeared to have an effect on the level of psychopathology. Although the outcomes between studies varied, we can conclude that levels of psychopathology in children with CI and adolescents lie somewhere between HI counterparts wearing conventional hearing aids and NH peers. This is a positive outcome for children with CI, because the majority of them initially had more severe hearing losses than children with conventional hearing aids, but the occurrence of problems was not higher. Additionally, several possible risk and protective factors that affect psychopathology were found, including age at detection and intervention of hearing loss, additional disabilities, communication skills, intelligence, type of school, and number of siblings.

Five major pitfalls occurred when reviewing the literature and drawing conclusions from the included articles. First, literature on specific forms of psychopathology in hearing-impaired children and adolescents is scarce and sometimes inconsistent. Per psychopathological symptoms, the number of studies varied between 1 and 7. Almost none of the studies investigated and reported exact prevalence rates, which would be very helpful to quantify the problems.

Second, because of the large heterogeneity in the HI population, diverse samples were investigated, as shown by Tables 1, 2, and 3. It is important to know which sample has been examined, because this affects the extent to which the findings can be generalized to the total population of HI individuals. Many studies revealed less favorable results for children attending special/residential schools; caution is warranted when interpreting these findings, because HI children with extra problems are more likely to be referred to these schools. For example, 30% of HI children experience additional disabilities, such as autism spectrum disorder or mental retardation,67 which are associated with more psychopathology. Unfortunately, we cannot deduct from the included studies how many children have additional problems. We also do not know which other neurocognitive processes affected HI children, because these processes can also lead to inferior outcomes.68 It thus remains unclear how large the effect of these disabilities on psychopathology is.

A third pitfall is that different informants (child, parent, or teacher) were used in the included studies. Past research showed that, particularly for internalizing symptoms, parents and teachers frequently underreport the level of problems, while for some externalizing symptoms, parents and teachers give more accurate levels. So, perceptions per informant can truly differ, potentially leading to an informant bias.69

Fourth, all studies had cross-sectional designs and none of them had a longitudinal data collection. A follow-up study design could provide the opportunity to draw firmer conclusions on causality. Additionally, many more factors could be relevant for the development of psychopathology. For example, chronic adversities, concomitant physical health problems, residual hearing, or intrapersonal factors could contribute in this respect. Furthermore, cultural identity (ie, deaf or hearing community) was not taken into account in any of the studies, and it is known that HI individuals often experience cultural conflicts, potentially leading to issues related to social identity, acceptation, and isolation.11,70

Fifth, the majority of studies have been using general questionnaires to assess psychopathology, such as the Child Behavior Checklist or the Strengths and Difficulties Questionnaire.24,25,27,28 Although these questionnaires give a good first impression, they are not tools that measure psychopathology to a very large extent. However, the Strengths and Difficulties Questionnaire is a short, easy-to-administer questionnaire for children, parents, or teachers that can be useful in providing clinicians with a first global impression of the HI child’s level of psychological functioning. Once the Strengths and Difficulties Questionnaire shows elevated levels, the child can immediately be referred to a psychologist for a more in-depth and precise examination on symptoms of psychopathology.

Based on these 5 issues, we defined several recommendations for future studies. First, further and extensive research on the different forms of psychopathology in HI children and adolescents must be carried out to define precise prevalences. In addition to the earlier-mentioned factors that could contribute to psychopathology, attachment and bonding between parent and child would be worth investigating. Hearing impairment impacts bonding and attachment, often resulting in parenting stress. These parent-related factors have been linked to the genesis of psychopathology, both directly and indirectly.

Furthermore, researchers must be aware of the potential informant bias when assessing psychopathology. Trying to include the type of respondent that is known to give most accurate answers is of utmost importance to receive reliable results. Generally, reports involving internalizing symptoms can best be administered to school-aged children and adolescents, whereas externalizing symptoms can be administered to parents as well. Additionally, multi-informant assessment would be helpful to gain more knowledge on specific contributions and shared variance of diverse respondents, as well as on how to combine data from varying respondents and from varying settings.25,71 Fourth, measuring psychopathology at different stages in the lives of HI children and adolescents will allow researchers to deduct causal relations and enable them to prevent psychopathology on an individual basis. Fifth, specific diagnostic tools should be used to assess psychopathology, instead of general questionnaires that are not primarily designed and validated to measure one form of psychopathology. It would be interesting and helpful to develop these measurements specifically for the HI population.

Concluding, to increase our understanding of psychopathological development in HI children and adolescents and to realize focused counseling and treatment in the future, there is a need for further and extensive study of psychopathology in the HI population, as also emphasized by others.1,5,11,61,72 Hopefully, this knowledge will lead to more awareness and provide guidance for professionals working with this group of vulnerable children and adolescents to help and support each HI individual.

Corresponding Author: Stephanie C. P. M. Theunissen, MD, Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands (s.c.p.m.theunissen@lumc.nl).

Accepted for Publication: August 9, 2013.

Published Online: December 2, 2013. doi:10.1001/jamapediatrics.2013.3974.

Author Contributions: Drs Theunissen and Netten had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Study concept and design: Theunissen, Rieffe, Netten, Briaire, Soede, Frijns.

Acquisition of data: Theunissen, Schoones.

Analysis and interpretation of data: Theunissen, Rieffe, Netten.

Drafting of the manuscript: Theunissen, Netten, Soede.

Critical revision of the manuscript for important intellectual content: Theunissen, Rieffe, Netten, Briaire, Schoones, Frijns.

Statistical analysis: Theunissen, Rieffe, Briaire.

Obtained funding: Briaire, Frijns.

Administrative, technical, or material support: Theunissen, Netten, Schoones.

Study supervision: Rieffe, Briaire, Soede, Frijns.

Conflict of Interest Disclosures: None reported.

Funding/Support: This research was supported by the Innovational Research Incentives Scheme (VIDI grant 452-07-004) by The Netherlands Organisation for Scientific Research (Dr Rieffe).

Role of the Sponsor: The Netherlands Organisation for Scientific Research had no role in the design and conduct of the study; collection, management, analysis, or interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Moeller  MP.  Current state of knowledge: psychosocial development in children with hearing impairment. Ear Hear. 2007;28(6):729-739.
PubMed   |  Link to Article
Kvam  MH, Loeb  M, Tambs  K.  Mental health in deaf adults: symptoms of anxiety and depression among hearing and deaf individuals. J Deaf Stud Deaf Educ. 2007;12(1):1-7.
PubMed   |  Link to Article
Hindley  PA, Hill  PD, McGuigan  S, Kitson  N.  Psychiatric disorder in deaf and hearing impaired children and young people: a prevalence study. J Child Psychol Psychiatry. 1994;35(5):917-934.
PubMed   |  Link to Article
van Eldik  T.  Mental health problems of Dutch youth with hearing loss as shown on the Youth Self Report. Am Ann Deaf. 2005;150(1):11-16.
PubMed   |  Link to Article
van Eldik  T, Treffers  PD, Veerman  JW, Verhulst  FC.  Mental health problems of deaf Dutch children as indicated by parents’ responses to the Child Behavior Checklist. Am Ann Deaf. 2004;148(5):390-395.
PubMed   |  Link to Article
Konuk  N, Erdogan  A, Atik  L, Ugur  MB, Simsekyilmaz  O.  Evaluation of behavioral and emotional problems in deaf children by using the Child Behavior Checklist. Neurol Psychiatry Br. 2006;13(2):59-64.
Vostanis  P, Hayes  M, Du Feu  M, Warren  J.  Detection of behavioural and emotional problems in deaf children and adolescents: comparison of two rating scales. Child Care Health Dev. 1997;23(3):233-246.
PubMed   |  Link to Article
Coll  KM, Cutler  MM, Thobro  P, Haas  R, Powell  S.  An exploratory study of psychosocial risk behaviors of adolescents who are deaf or hard of hearing: comparisons and recommendations. Am Ann Deaf. 2009;154(1):30-35.
PubMed   |  Link to Article
Dammeyer  J.  Psychosocial development in a Danish population of children with cochlear implants and deaf and hard-of-hearing children. J Deaf Stud Deaf Educ. 2010;15(1):50-58.
PubMed   |  Link to Article
Li  H, Prevatt  F.  Deaf and hard of hearing children and adolescents in China: their fears and anxieties. Am Ann Deaf. 2010;155(4):458-466.
PubMed
Fellinger  J, Holzinger  D, Pollard  R.  Mental health of deaf people. Lancet. 2012;379(9820):1037-1044.
PubMed   |  Link to Article
Hogan  A, Shipley  M, Strazdins  L, Purcell  A, Baker  E.  Communication and behavioural disorders among children with hearing loss increases risk of mental health disorders. Aust N Z J Public Health. 2011;35(4):377-383.
PubMed   |  Link to Article
Barker  DH, Quittner  AL, Fink  NE, Eisenberg  LS, Tobey  EA, Niparko  JK; CDaCI Investigative Team.  Predicting behavior problems in deaf and hearing children: the influences of language, attention, and parent-child communication. Dev Psychopathol. 2009;21(2):373-392.
PubMed   |  Link to Article
Keilmann  A, Limberger  A, Mann  WJ.  Psychological and physical well-being in hearing-impaired children. Int J Pediatr Otorhinolaryngol. 2007;71(11):1747-1752.
PubMed   |  Link to Article
Martikainen  P, Bartley  M, Lahelma  E.  Psychosocial determinants of health in social epidemiology. Int J Epidemiol. 2002;31(6):1091-1093.
PubMed   |  Link to Article
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders.4th ed, text revision. Washington, DC: American Psychiatric Association; 2000.
Pavuluri  MN, Birmaher  B, Naylor  MW.  Pediatric bipolar disorder: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry. 2005;44(9):846-871.
PubMed   |  Link to Article
Stein  DS, Blum  NJ, Barbaresi  WJ.  Developmental and behavioral disorders through the life span. Pediatrics. 2011;128(2):364-373.
PubMed   |  Link to Article
Evidence-based health care and systematic reviews. The Cochrane Collaboration website. http://www.cochrane.org/about-us/evidence-based-health-care. Accessed December 18, 2012.
Kent  BA.  Identity issues for hard-of-hearing adolescents aged 11, 13, and 15 in mainstream setting. J Deaf Stud Deaf Educ. 2003;8(3):315-324.
PubMed   |  Link to Article
King A, Wold B, Tudor-Smith C, Harel Y. The Health of Youth: A Cross-national Survey. Geneva, Switzerland: WHO; 1996. WHO Regional Publication European Series No. 69.
Gallaudet Research Institute. Regional and National Summary Report of Data From the 2007-08 Annual Survey of Deaf and Hard of Hearing Children and Youth. Washington, DC: Gallaudet Research Institute; 2008.
Fellinger  J, Holzinger  D, Sattel  H, Laucht  M, Goldberg  D.  Correlates of mental health disorders among children with hearing impairments. Dev Med Child Neurol. 2009;51(8):635-641.
PubMed   |  Link to Article
Goodman  R.  The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry. 1997;38(5):581-586.
PubMed   |  Link to Article
Goodman  R, Meltzer  H, Bailey  V.  The Strengths and Difficulties Questionnaire: a pilot study on the validity of the self-report version. Eur Child Adolesc Psychiatry. 1998;7(3):125-130.
PubMed   |  Link to Article
Remine  MD, Brown  PM.  Comparison of the prevalence of mental health problems in deaf and hearing children and adolescents in Australia. Aust N Z J Psychiatry. 2010;44(4):351-357.
PubMed   |  Link to Article
Achenbach  TM. Integrative Guide for the 1991 CBCL/4-18 YSR and TRF Profiles. Burlington: University of Vermont, Department of Psychology; 1991.
Achenbach  TM, Rescorla  LA. The Manual for the ASEBA School-Age Forms & Profiles. Burlington: University of Vermont, Department of Psychiatry; 2001.
Kouwenberg  M, Rieffe  C, Theunissen  SCPM.  Intrapersonal and interpersonal factors related to self-reported symptoms of depression in DHH youth. Int J Mental Health Deafness.2011;1(1):46-57.
Kovacs  M.  The Children’s Depression Inventory (CDI). Psychopharmacol Bull. 1985;21(4):995-998.
PubMed
Theunissen  SCPM, Rieffe  C, Kouwenberg  M, Soede  W, Briaire  JJ, Frijns  JHM.  Depression in hearing-impaired children. Int J Pediatr Otorhinolaryngol. 2011;75(10):1313-1317.
PubMed   |  Link to Article
Kouwenberg  M, Rieffe  C, Theunissen  SCPM, Oosterveld  P.  Pathways underlying somatic complaints in children and adolescents who are deaf or hard of hearing. J Deaf Stud Deaf Educ. 2012;17(3):319-332. doi:10.1093/deafed/enr050.
PubMed   |  Link to Article
Jellesma  FC, Rieffe  C, Terwogt  MM.  The Somatic Complaint List: validation of a self-report questionnaire assessing somatic complaints in children. J Psychosom Res. 2007;63(4):399-401.
PubMed   |  Link to Article
Theunissen  SCPM, Rieffe  C, Kouwenberg  M,  et al.  Anxiety in children with hearing aids or cochlear implants compared to normally hearing controls. Laryngoscope. 2012;122(3):654-659.
PubMed   |  Link to Article
Ollendick  TH.  Reliability and validity of the Revised Fear Surgery Schedule for Children (FSSC-R). Behav Res Ther. 1983;21(6):685-692.
PubMed   |  Link to Article
Gadow  KD, Sprafkin  J. Child Symptom Inventories. Stony Brook, NY: Checkmate Plus; 1994.
Theunissen  SCPM, Rieffe  C, Kouwenberg  M,  et al.  Behavioral problems in school-aged hearing-impaired children: the influence of sociodemographic, linguistic, and medical factors [published online June 27, 2013]. Eur Child Adolesc Psychiatry. doi:10.1007/s00787-013-0444-4.
PubMed
Polman  H, Orobio de Castro  B, Koops  W, van Boxtel  HW, Merk  WW.  A meta-analysis of the distinction between reactive and proactive aggression in children and adolescents. J Abnorm Child Psychol. 2007;35(4):522-535.
PubMed   |  Link to Article
Baerveldt  C, Van Rossem  R, Vermande  M.  Pupils’ delinquency and their social networks: a test of some network assumptions of the ability and inability models of delinquency. Dutch Journal of Social Sciences.2003;39(2):107-125. http://hdl.handle.net/1854/LU-303778.
Frick  PJ, O’Brien  BS, Wootton  JM, McBurnett  K.  Psychopathy and conduct problems in children. J Abnorm Psychol. 1994;103(4):700-707.
PubMed   |  Link to Article
King  NJ, Mulhall  J, Gullone  E.  Fears in hearing-impaired and normally hearing children and adolescents. Behav Res Ther. 1989;27(5):577-580.
PubMed   |  Link to Article
Watt  JD, Davis  FE.  The prevalence of boredom proneness and depression among profoundly deaf residential school adolescents. Am Ann Deaf. 1991;136(5):409-413.
PubMed   |  Link to Article
Beck  AT, Ward  CH, Mendelson  M, Mock  J, Erbaugh  J.  An inventory for measuring depression. Arch Gen Psychiatry. 1961;4(6):561-571.
PubMed   |  Link to Article
Reynolds  CR, Richmond  BO.  Factor structure and construct validity of “what I think and feel”: the Revised Children’s Manifest Anxiety Scale. J Pers Assess. 1979;43(3):281-283.
PubMed   |  Link to Article
Reynolds  CR.  Concurrent validity of “What I think and feel”: the Revised Children’s Manifest Anxiety Scale. J Consult Clin Psychol. 1980;48(6):774-775.
PubMed   |  Link to Article
Sahli  S, Arslan  U, Belgin  E.  Depressive emotioning in adolescents with cochlear implant and normal hearing. Int J Pediatr Otorhinolaryngol. 2009;73(12):1774-1779.
PubMed   |  Link to Article
Rosenberg  M. Society and the Adolescent Self-image. Princeton, NJ: Princeton University Press; 1965.
Huber  M, Kipman  U.  The mental health of deaf adolescents with cochlear implants compared to their hearing peers. Int J Audiol. 2011;50(3):146-154.
PubMed   |  Link to Article
Fleming  JE, Offord  DR.  Epidemiology of childhood depressive disorders: a critical review. J Am Acad Child Adolesc Psychiatry. 1990;29(4):571-580.
PubMed   |  Link to Article
Campo  JV, Jansen-McWilliams  L, Comer  DM, Kelleher  KJ.  Somatization in pediatric primary care: association with psychopathology, functional impairment, and use of services. J Am Acad Child Adolesc Psychiatry. 1999;38(9):1093-1101.
PubMed   |  Link to Article
Harris  MB.  Aggression, gender, and ethnicity. Aggress Violent Beh. 1996;1(2):123-146. doi:10.1016/1359-1789(95)00012-7.
Link to Article
Crick  NR, Grotpeter  JK.  Relational aggression, gender, and social-psychological adjustment. Child Dev. 1995;66(3):710-722.
PubMed   |  Link to Article
Froehlich  TE, Lanphear  BP, Epstein  JN, Barbaresi  WJ, Katusic  SK, Kahn  RS.  Prevalence, recognition, and treatment of attention-deficit/hyperactivity disorder in a national sample of US children. Arch Pediatr Adolesc Med. 2007;161(9):857-864.
PubMed   |  Link to Article
Maughan  B, Rowe  R, Messer  J, Goodman  R, Meltzer  H.  Conduct disorder and oppositional defiant disorder in a national sample: developmental epidemiology. J Child Psychol Psychiatry. 2004;45(3):609-621.
PubMed   |  Link to Article
Bond  D. Mental health in children who are deaf and have multiple disabilities. In: Hindley  P, Kitson  N, eds. Mental Health and Deafness. London, England: Whurr; 2000:127-148.
Hindley  PA.  Mental health problems in deaf children. Curr Paediatr. 2005;15(2):114-119. doi:10.1016/j.cupe.2004.12.008.
Link to Article
Kelly  D, Forney  J, Parker-Fisher  S, Jones  M.  Evaluating and managing attention deficit disorder in children who are deaf or hard of hearing. Am Ann Deaf. 1993;138(4):349-357.
PubMed   |  Link to Article
Rutter  M, Graham  PJ, Yule  W. A Neuropsychiatric Study in Childhood. London, England: Heinemann Medical; 1970.
Polat  F.  Factors affecting psychosocial adjustment of deaf students. J Deaf Stud Deaf Educ. 2003;8(3):325-339.
PubMed   |  Link to Article
Hartshorne  TS, Grialou  TL, Parker  KR.  Autistic-like behavior in CHARGE syndrome. Am J Med Genet A. 2005;133A(3):257-261.
PubMed   |  Link to Article
Wake  M, Hughes  EK, Poulakis  Z, Collins  C, Rickards  FW.  Outcomes of children with mild-profound congenital hearing loss at 7 to 8 years: a population study. Ear Hear. 2004;25(1):1-8.
PubMed   |  Link to Article
Stevenson  J, McCann  D, Watkin  P, Worsfold  S, Kennedy  C; Hearing Outcomes Study Team.  The relationship between language development and behaviour problems in children with hearing loss. J Child Psychol Psychiatry. 2010;51(1):77-83.
PubMed   |  Link to Article
Fellinger  J, Holzinger  D, Sattel  H, Laucht  M.  Mental health and quality of life in deaf pupils. Eur Child Adolesc Psychiatry. 2008;17(7):414-423.
PubMed   |  Link to Article
van Gent  T, Goedhart  AW, Hindley  PA, Treffers  PDA.  Prevalence and correlates of psychopathology in a sample of deaf adolescents. J Child Psychol Psychiatry. 2007;48(9):950-958.
PubMed   |  Link to Article
Percy-Smith  L, Jensen  JH, Cayé-Thomasen  P, Thomsen  J, Gudman  M, Lopez  AG.  Factors that affect the social well-being of children with cochlear implants. Cochlear Implants Int. 2008;9(4):199-214.
PubMed
Warner-Czyz  AD, Loy  B, Tobey  EA, Nakonezny  P, Roland  PS.  Health-related quality of life in children and adolescents who use cochlear implants. Int J Pediatr Otorhinolaryngol. 2011;75(1):95-105.
PubMed   |  Link to Article
Fortnum  HM, Marshall  DH, Summerfield  AQ.  Epidemiology of the UK population of hearing-impaired children, including characteristics of those with and without cochlear implants: audiology, aetiology, comorbidity and affluence. Int J Audiol. 2002;41(3):170-179.
PubMed   |  Link to Article
Conway  CM, Pisoni  DB.  Neurocognitive basis of implicit learning of sequential structure and its relation to language processing. Ann N Y Acad Sci. 2008;1145:113-131.
PubMed   |  Link to Article
Cremeens  J, Eiser  C, Blades  M.  Factors influencing agreement between child self-report and parent proxy-reports on the Pediatric Quality of Life Inventory 4.0 (PedsQL) generic core scales. Health Qual Life Outcomes. 2006;4:58.
PubMed   |  Link to Article
Maxwell-McCaw  D, Zea  MC.  The Deaf Acculturation Scale (DAS): development and validation of a 58-item measure. J Deaf Stud Deaf Educ. 2011;16(3):325-342.
PubMed   |  Link to Article
Fombonne  E.  Epidemiological trends in rates of autism. Mol Psychiatry. 2002;7(suppl 2):S4-S6.
PubMed   |  Link to Article
Marschark M, Spencer PE. Epilogue: what we know, what we don't know, and what we should know. In: Marschark M, Spencer PE, eds. The Oxford Handbook of Deaf Studies. Vol 1. 2nd ed. New York, NY: Oxford University Press USA; 2010.

Figures

Place holder to copy figure label and caption
Figure.
Flowchart for Search Results
Graphic Jump Location

Tables

Table Graphic Jump LocationTable 1.  Literature on Psychopathology in Community-Based Samples
Table Graphic Jump LocationTable 2.  Literature on Psychopathology in Samples Drawn From Special Schools and/or Profoundly HI Individuals
Table Graphic Jump LocationTable 3.  Literature on Psychopathology in CI Samples

References

Moeller  MP.  Current state of knowledge: psychosocial development in children with hearing impairment. Ear Hear. 2007;28(6):729-739.
PubMed   |  Link to Article
Kvam  MH, Loeb  M, Tambs  K.  Mental health in deaf adults: symptoms of anxiety and depression among hearing and deaf individuals. J Deaf Stud Deaf Educ. 2007;12(1):1-7.
PubMed   |  Link to Article
Hindley  PA, Hill  PD, McGuigan  S, Kitson  N.  Psychiatric disorder in deaf and hearing impaired children and young people: a prevalence study. J Child Psychol Psychiatry. 1994;35(5):917-934.
PubMed   |  Link to Article
van Eldik  T.  Mental health problems of Dutch youth with hearing loss as shown on the Youth Self Report. Am Ann Deaf. 2005;150(1):11-16.
PubMed   |  Link to Article
van Eldik  T, Treffers  PD, Veerman  JW, Verhulst  FC.  Mental health problems of deaf Dutch children as indicated by parents’ responses to the Child Behavior Checklist. Am Ann Deaf. 2004;148(5):390-395.
PubMed   |  Link to Article
Konuk  N, Erdogan  A, Atik  L, Ugur  MB, Simsekyilmaz  O.  Evaluation of behavioral and emotional problems in deaf children by using the Child Behavior Checklist. Neurol Psychiatry Br. 2006;13(2):59-64.
Vostanis  P, Hayes  M, Du Feu  M, Warren  J.  Detection of behavioural and emotional problems in deaf children and adolescents: comparison of two rating scales. Child Care Health Dev. 1997;23(3):233-246.
PubMed   |  Link to Article
Coll  KM, Cutler  MM, Thobro  P, Haas  R, Powell  S.  An exploratory study of psychosocial risk behaviors of adolescents who are deaf or hard of hearing: comparisons and recommendations. Am Ann Deaf. 2009;154(1):30-35.
PubMed   |  Link to Article
Dammeyer  J.  Psychosocial development in a Danish population of children with cochlear implants and deaf and hard-of-hearing children. J Deaf Stud Deaf Educ. 2010;15(1):50-58.
PubMed   |  Link to Article
Li  H, Prevatt  F.  Deaf and hard of hearing children and adolescents in China: their fears and anxieties. Am Ann Deaf. 2010;155(4):458-466.
PubMed
Fellinger  J, Holzinger  D, Pollard  R.  Mental health of deaf people. Lancet. 2012;379(9820):1037-1044.
PubMed   |  Link to Article
Hogan  A, Shipley  M, Strazdins  L, Purcell  A, Baker  E.  Communication and behavioural disorders among children with hearing loss increases risk of mental health disorders. Aust N Z J Public Health. 2011;35(4):377-383.
PubMed   |  Link to Article
Barker  DH, Quittner  AL, Fink  NE, Eisenberg  LS, Tobey  EA, Niparko  JK; CDaCI Investigative Team.  Predicting behavior problems in deaf and hearing children: the influences of language, attention, and parent-child communication. Dev Psychopathol. 2009;21(2):373-392.
PubMed   |  Link to Article
Keilmann  A, Limberger  A, Mann  WJ.  Psychological and physical well-being in hearing-impaired children. Int J Pediatr Otorhinolaryngol. 2007;71(11):1747-1752.
PubMed   |  Link to Article
Martikainen  P, Bartley  M, Lahelma  E.  Psychosocial determinants of health in social epidemiology. Int J Epidemiol. 2002;31(6):1091-1093.
PubMed   |  Link to Article
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders.4th ed, text revision. Washington, DC: American Psychiatric Association; 2000.
Pavuluri  MN, Birmaher  B, Naylor  MW.  Pediatric bipolar disorder: a review of the past 10 years. J Am Acad Child Adolesc Psychiatry. 2005;44(9):846-871.
PubMed   |  Link to Article
Stein  DS, Blum  NJ, Barbaresi  WJ.  Developmental and behavioral disorders through the life span. Pediatrics. 2011;128(2):364-373.
PubMed   |  Link to Article
Evidence-based health care and systematic reviews. The Cochrane Collaboration website. http://www.cochrane.org/about-us/evidence-based-health-care. Accessed December 18, 2012.
Kent  BA.  Identity issues for hard-of-hearing adolescents aged 11, 13, and 15 in mainstream setting. J Deaf Stud Deaf Educ. 2003;8(3):315-324.
PubMed   |  Link to Article
King A, Wold B, Tudor-Smith C, Harel Y. The Health of Youth: A Cross-national Survey. Geneva, Switzerland: WHO; 1996. WHO Regional Publication European Series No. 69.
Gallaudet Research Institute. Regional and National Summary Report of Data From the 2007-08 Annual Survey of Deaf and Hard of Hearing Children and Youth. Washington, DC: Gallaudet Research Institute; 2008.
Fellinger  J, Holzinger  D, Sattel  H, Laucht  M, Goldberg  D.  Correlates of mental health disorders among children with hearing impairments. Dev Med Child Neurol. 2009;51(8):635-641.
PubMed   |  Link to Article
Goodman  R.  The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry. 1997;38(5):581-586.
PubMed   |  Link to Article
Goodman  R, Meltzer  H, Bailey  V.  The Strengths and Difficulties Questionnaire: a pilot study on the validity of the self-report version. Eur Child Adolesc Psychiatry. 1998;7(3):125-130.
PubMed   |  Link to Article
Remine  MD, Brown  PM.  Comparison of the prevalence of mental health problems in deaf and hearing children and adolescents in Australia. Aust N Z J Psychiatry. 2010;44(4):351-357.
PubMed   |  Link to Article
Achenbach  TM. Integrative Guide for the 1991 CBCL/4-18 YSR and TRF Profiles. Burlington: University of Vermont, Department of Psychology; 1991.
Achenbach  TM, Rescorla  LA. The Manual for the ASEBA School-Age Forms & Profiles. Burlington: University of Vermont, Department of Psychiatry; 2001.
Kouwenberg  M, Rieffe  C, Theunissen  SCPM.  Intrapersonal and interpersonal factors related to self-reported symptoms of depression in DHH youth. Int J Mental Health Deafness.2011;1(1):46-57.
Kovacs  M.  The Children’s Depression Inventory (CDI). Psychopharmacol Bull. 1985;21(4):995-998.
PubMed
Theunissen  SCPM, Rieffe  C, Kouwenberg  M, Soede  W, Briaire  JJ, Frijns  JHM.  Depression in hearing-impaired children. Int J Pediatr Otorhinolaryngol. 2011;75(10):1313-1317.
PubMed   |  Link to Article
Kouwenberg  M, Rieffe  C, Theunissen  SCPM, Oosterveld  P.  Pathways underlying somatic complaints in children and adolescents who are deaf or hard of hearing. J Deaf Stud Deaf Educ. 2012;17(3):319-332. doi:10.1093/deafed/enr050.
PubMed   |  Link to Article
Jellesma  FC, Rieffe  C, Terwogt  MM.  The Somatic Complaint List: validation of a self-report questionnaire assessing somatic complaints in children. J Psychosom Res. 2007;63(4):399-401.
PubMed   |  Link to Article
Theunissen  SCPM, Rieffe  C, Kouwenberg  M,  et al.  Anxiety in children with hearing aids or cochlear implants compared to normally hearing controls. Laryngoscope. 2012;122(3):654-659.
PubMed   |  Link to Article
Ollendick  TH.  Reliability and validity of the Revised Fear Surgery Schedule for Children (FSSC-R). Behav Res Ther. 1983;21(6):685-692.
PubMed   |  Link to Article
Gadow  KD, Sprafkin  J. Child Symptom Inventories. Stony Brook, NY: Checkmate Plus; 1994.
Theunissen  SCPM, Rieffe  C, Kouwenberg  M,  et al.  Behavioral problems in school-aged hearing-impaired children: the influence of sociodemographic, linguistic, and medical factors [published online June 27, 2013]. Eur Child Adolesc Psychiatry. doi:10.1007/s00787-013-0444-4.
PubMed
Polman  H, Orobio de Castro  B, Koops  W, van Boxtel  HW, Merk  WW.  A meta-analysis of the distinction between reactive and proactive aggression in children and adolescents. J Abnorm Child Psychol. 2007;35(4):522-535.
PubMed   |  Link to Article
Baerveldt  C, Van Rossem  R, Vermande  M.  Pupils’ delinquency and their social networks: a test of some network assumptions of the ability and inability models of delinquency. Dutch Journal of Social Sciences.2003;39(2):107-125. http://hdl.handle.net/1854/LU-303778.
Frick  PJ, O’Brien  BS, Wootton  JM, McBurnett  K.  Psychopathy and conduct problems in children. J Abnorm Psychol. 1994;103(4):700-707.
PubMed   |  Link to Article
King  NJ, Mulhall  J, Gullone  E.  Fears in hearing-impaired and normally hearing children and adolescents. Behav Res Ther. 1989;27(5):577-580.
PubMed   |  Link to Article
Watt  JD, Davis  FE.  The prevalence of boredom proneness and depression among profoundly deaf residential school adolescents. Am Ann Deaf. 1991;136(5):409-413.
PubMed   |  Link to Article
Beck  AT, Ward  CH, Mendelson  M, Mock  J, Erbaugh  J.  An inventory for measuring depression. Arch Gen Psychiatry. 1961;4(6):561-571.
PubMed   |  Link to Article
Reynolds  CR, Richmond  BO.  Factor structure and construct validity of “what I think and feel”: the Revised Children’s Manifest Anxiety Scale. J Pers Assess. 1979;43(3):281-283.
PubMed   |  Link to Article
Reynolds  CR.  Concurrent validity of “What I think and feel”: the Revised Children’s Manifest Anxiety Scale. J Consult Clin Psychol. 1980;48(6):774-775.
PubMed   |  Link to Article
Sahli  S, Arslan  U, Belgin  E.  Depressive emotioning in adolescents with cochlear implant and normal hearing. Int J Pediatr Otorhinolaryngol. 2009;73(12):1774-1779.
PubMed   |  Link to Article
Rosenberg  M. Society and the Adolescent Self-image. Princeton, NJ: Princeton University Press; 1965.
Huber  M, Kipman  U.  The mental health of deaf adolescents with cochlear implants compared to their hearing peers. Int J Audiol. 2011;50(3):146-154.
PubMed   |  Link to Article
Fleming  JE, Offord  DR.  Epidemiology of childhood depressive disorders: a critical review. J Am Acad Child Adolesc Psychiatry. 1990;29(4):571-580.
PubMed   |  Link to Article
Campo  JV, Jansen-McWilliams  L, Comer  DM, Kelleher  KJ.  Somatization in pediatric primary care: association with psychopathology, functional impairment, and use of services. J Am Acad Child Adolesc Psychiatry. 1999;38(9):1093-1101.
PubMed   |  Link to Article
Harris  MB.  Aggression, gender, and ethnicity. Aggress Violent Beh. 1996;1(2):123-146. doi:10.1016/1359-1789(95)00012-7.
Link to Article
Crick  NR, Grotpeter  JK.  Relational aggression, gender, and social-psychological adjustment. Child Dev. 1995;66(3):710-722.
PubMed   |  Link to Article
Froehlich  TE, Lanphear  BP, Epstein  JN, Barbaresi  WJ, Katusic  SK, Kahn  RS.  Prevalence, recognition, and treatment of attention-deficit/hyperactivity disorder in a national sample of US children. Arch Pediatr Adolesc Med. 2007;161(9):857-864.
PubMed   |  Link to Article
Maughan  B, Rowe  R, Messer  J, Goodman  R, Meltzer  H.  Conduct disorder and oppositional defiant disorder in a national sample: developmental epidemiology. J Child Psychol Psychiatry. 2004;45(3):609-621.
PubMed   |  Link to Article
Bond  D. Mental health in children who are deaf and have multiple disabilities. In: Hindley  P, Kitson  N, eds. Mental Health and Deafness. London, England: Whurr; 2000:127-148.
Hindley  PA.  Mental health problems in deaf children. Curr Paediatr. 2005;15(2):114-119. doi:10.1016/j.cupe.2004.12.008.
Link to Article
Kelly  D, Forney  J, Parker-Fisher  S, Jones  M.  Evaluating and managing attention deficit disorder in children who are deaf or hard of hearing. Am Ann Deaf. 1993;138(4):349-357.
PubMed   |  Link to Article
Rutter  M, Graham  PJ, Yule  W. A Neuropsychiatric Study in Childhood. London, England: Heinemann Medical; 1970.
Polat  F.  Factors affecting psychosocial adjustment of deaf students. J Deaf Stud Deaf Educ. 2003;8(3):325-339.
PubMed   |  Link to Article
Hartshorne  TS, Grialou  TL, Parker  KR.  Autistic-like behavior in CHARGE syndrome. Am J Med Genet A. 2005;133A(3):257-261.
PubMed   |  Link to Article
Wake  M, Hughes  EK, Poulakis  Z, Collins  C, Rickards  FW.  Outcomes of children with mild-profound congenital hearing loss at 7 to 8 years: a population study. Ear Hear. 2004;25(1):1-8.
PubMed   |  Link to Article
Stevenson  J, McCann  D, Watkin  P, Worsfold  S, Kennedy  C; Hearing Outcomes Study Team.  The relationship between language development and behaviour problems in children with hearing loss. J Child Psychol Psychiatry. 2010;51(1):77-83.
PubMed   |  Link to Article
Fellinger  J, Holzinger  D, Sattel  H, Laucht  M.  Mental health and quality of life in deaf pupils. Eur Child Adolesc Psychiatry. 2008;17(7):414-423.
PubMed   |  Link to Article
van Gent  T, Goedhart  AW, Hindley  PA, Treffers  PDA.  Prevalence and correlates of psychopathology in a sample of deaf adolescents. J Child Psychol Psychiatry. 2007;48(9):950-958.
PubMed   |  Link to Article
Percy-Smith  L, Jensen  JH, Cayé-Thomasen  P, Thomsen  J, Gudman  M, Lopez  AG.  Factors that affect the social well-being of children with cochlear implants. Cochlear Implants Int. 2008;9(4):199-214.
PubMed
Warner-Czyz  AD, Loy  B, Tobey  EA, Nakonezny  P, Roland  PS.  Health-related quality of life in children and adolescents who use cochlear implants. Int J Pediatr Otorhinolaryngol. 2011;75(1):95-105.
PubMed   |  Link to Article
Fortnum  HM, Marshall  DH, Summerfield  AQ.  Epidemiology of the UK population of hearing-impaired children, including characteristics of those with and without cochlear implants: audiology, aetiology, comorbidity and affluence. Int J Audiol. 2002;41(3):170-179.
PubMed   |  Link to Article
Conway  CM, Pisoni  DB.  Neurocognitive basis of implicit learning of sequential structure and its relation to language processing. Ann N Y Acad Sci. 2008;1145:113-131.
PubMed   |  Link to Article
Cremeens  J, Eiser  C, Blades  M.  Factors influencing agreement between child self-report and parent proxy-reports on the Pediatric Quality of Life Inventory 4.0 (PedsQL) generic core scales. Health Qual Life Outcomes. 2006;4:58.
PubMed   |  Link to Article
Maxwell-McCaw  D, Zea  MC.  The Deaf Acculturation Scale (DAS): development and validation of a 58-item measure. J Deaf Stud Deaf Educ. 2011;16(3):325-342.
PubMed   |  Link to Article
Fombonne  E.  Epidemiological trends in rates of autism. Mol Psychiatry. 2002;7(suppl 2):S4-S6.
PubMed   |  Link to Article
Marschark M, Spencer PE. Epilogue: what we know, what we don't know, and what we should know. In: Marschark M, Spencer PE, eds. The Oxford Handbook of Deaf Studies. Vol 1. 2nd ed. New York, NY: Oxford University Press USA; 2010.

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