title: Predicting social functioning in children with a cochlear implant and in normal-hearing children: the role of emotion regulation.
abstract: OBJECTIVE
  The purpose of the present study was to compare children with a cochlear implant and normal hearing children on aspects of emotion regulation (emotion expression and coping strategies) and social functioning (social competence and externalizing behaviors) and the relation between emotion regulation and social functioning.
  
  
  METHODS
  Participants were 69 children with cochlear implants (CI children) and 67 normal hearing children (NH children) aged 1.5-5 years. Parents answered questionnaires about their children's language skills, social functioning, and emotion regulation. Children also completed simple tasks to measure their emotion regulation abilities.
  
  
  RESULTS
  Cochlear implant children had fewer adequate emotion regulation strategies and were less socially competent than normal hearing children. The parents of cochlear implant children did not report fewer externalizing behaviors than those of normal hearing children. While social competence in normal hearing children was strongly related to emotion regulation, cochlear implant children regulated their emotions in ways that were unrelated with social competence. On the other hand, emotion regulation explained externalizing behaviors better in cochlear implant children than in normal hearing children. While better language skills were related to higher social competence in both groups, they were related to fewer externalizing behaviors only in cochlear implant children.
  
  
  CONCLUSIONS
  Our results indicate that cochlear implant children have less adequate emotion-regulation strategies and less social competence than normal hearing children. Since they received their implants relatively recently, they might eventually catch up with their hearing peers. Longitudinal studies should further explore the development of emotion regulation and social functioning in cochlear implant children.
authors.affiliation: Dutch Foundation for the Deaf and Hard of Hearing Child, Lutmastraat 167, Amsterdam, The Netherlands. kwiefferink@nsdsk.nl
authors.forename: Carin H
authors.initials: CH
authors.lastname: Wiefferink
authors.forename: Carolien
authors.initials: C
authors.lastname: Rieffe
authors.forename: Lizet
authors.initials: L
authors.lastname: Ketelaar
authors.forename: Johan H M
authors.initials: JH
authors.lastname: Frijns
mesh_terms: D000223:Adaptation, Psychological; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000379:methods / Q000523:psychology*; D003054:Cochlear Implants; D003430:Cross-Sectional Studies; D003638:Deafness / Q000175:diagnosis / Q000601:surgery; D004644:Emotions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007398:Interpersonal Relations; D007804:Language Development; D008297:Male; D009426:Netherlands; D010287:Parent-Child Relations; D011237:Predictive Value of Tests; D011788:Quality of Life; D012016:Reference Values; D012307:Risk Factors; D012917:Social Adjustment; D013067:Speech Perception; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome