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Comment & Response |

Regarding Review of Psychopathology in Children and Adolescents Who Are Deaf or Hard of Hearing

Rachel St. John, MD1
[+] Author Affiliations
1Family Focused Center for Deaf and Hard of Hearing Children, Department of Otolaryngology, University of Texas Southwestern Medical Center/Children’s Medical Center, Dallas, Dallas
JAMA Pediatr. 2014;168(8):778-779. doi:10.1001/jamapediatrics.2014.605.
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To the Editor Theunissen and colleagues1 undertook a challenging task in their review of literature examining psychopathology in children and adolescents who are deaf or hard of hearing. The Results section of their review spoke to the complex role that language modality (eg, spoken compared with sign language) plays regarding the prevalence of psychopathology.

The authors stated in their article that a number of studies “showed that sign language was significantly associated with more psychopathology.” The authors cited these studies regarding deaf signing children and adolescents, referencing statements such as “the prevalence of psychopathology in this group was very high, ranging from 40% to 77%.” Several of these cited studies used the Child Behavior Checklist as a measure of possible clinical psychopathology. The Child Behavior Checklist is a questionnaire that asks parents to report observed symptoms (eg, isolation, aggression, or school behavior problems) that can indicate possible underlying psychopathology. It is validated as a screening instrument and has excellent use as a triage tool to guide practitioners to in-depth diagnostic testing when necessary2 but is not a stand-alone diagnostic measure, which the authors did acknowledge in their Discussion section. However, the studies were cited in a manner that implied a direct connection between diagnosed psychopathology (the use of “significantly associated” in this context) and the use of sign language. Despite the statements in the Discussion section, this could potentially mislead a reader with no background in sign language or experience with the presentation of psychopathology in deaf individuals.

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