Behavior problems in children with cochlear implants.
OBJECTIVE
(1) To examine behavior problems in Mandarin-speaking children with cochlear implants (CIs); (2) to investigate the associated factors of problem behaviors; (3) to understand the relationships between behavior problems and parenting stress.


METHODS
Sixty patients (25 boys, 35 girls) aged 6-18 years (mean=12.2±3.2) who used CIs for a mean duration of eight years participated in the study. Behavior problems were assessed by Achenbach's child behavior checklist (CBCL). Categorical auditory performance (CAP) and speech intelligibility rating (SIR) scales were utilized to investigate auditory performance and speech production intelligibility. Parenting stress index (PSI) was filled out by parents to measure parenting stress level.


RESULTS
Significantly more CI subjects had problems with 'Withdrawn/Depressed' (p=0.010), 'Social Problems' (p<0.001), 'Thought Problems' (p<0.001), 'Attention Problems' (p<0.001), 'Aggressive Behavior' (p=0.010) and 'Overall Behavior' (p=0.001) than the normative sample did. 'Social Problems' was the most common problem and could be independently associated with gender, socioeconomic status and CAP (R(2)=0.361). CAP score was also associated with Overall Behaviors (R(2)=0.081). The results of PSI had a significant positive correlation with almost all CBCL subscales (p<0.05).


CONCLUSIONS
The CI subjects still exhibit social and attention problems, which may in turn increase parenting stress. Good family support as well as aural-verbal rehabilitation are of particular importance in determining behavioral outcomes in CI children.
Department of Otolaryngology-Head and Neck Surgery, Chang-Gung Memorial Hospital, Keelung, Taiwan; Department of Otolaryngology-Head and Neck Surgery, Chang-Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang-Gung University, Taoyuan, Taiwan.
Wei-Chieh
WC
Chao
Department of Otolaryngology-Head and Neck Surgery, Chang-Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang-Gung University, Taoyuan, Taiwan.
Li-Ang
LA
Lee
Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan.
Tien-Chen
TC
Liu
Department of Otolaryngology-Head and Neck Surgery, Chang-Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang-Gung University, Taoyuan, Taiwan.
Yung-Ting
YT
Tsou
Department of Otolaryngology-Head and Neck Surgery, Chang-Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang-Gung University, Taoyuan, Taiwan.
Kai-Chieh
KC
Chan
Department of Otolaryngology-Head and Neck Surgery, Chang-Gung Memorial Hospital, Linkou Branch, College of Medicine, Chang-Gung University, Taoyuan, Taiwan. Electronic address: bobwu506@hotmail.com.
Che-Ming
CM
Wu
D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D002653:Child Behavior Disorders / Q000150:complications* / Q000523:psychology; D003054:Cochlear Implants; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000150:complications* / Q000601:surgery; D006801:Humans; D008297:Male; D010290:Parents / Q000523:psychology*; D012737:Sex Factors; D012920:Social Behavior Disorders / Q000150:complications / Q000523:psychology; D012923:Social Class; D013315:Stress, Psychological / Q000209:etiology*; D013624:Taiwan
Auditory performance; Behavior problems; Cochlear implant; Mandarin Chinese; Parenting stress