title: Early identification: Language skills and social functioning in deaf and hard of hearing preschool children.
abstract: OBJECTIVE
  Permanent childhood hearing impairment often results in speech and language problems that are already apparent in early childhood. Past studies show a clear link between language skills and the child's social-emotional functioning. The aim of this study was to examine the level of language and communication skills after the introduction of early identification services and their relation with social functioning and behavioral problems in deaf and hard of hearing children.
  
  
  METHODS
  Nationwide cross-sectional observation of a cohort of 85 early identified deaf and hard of hearing preschool children (aged 30-66 months).
  
  
  METHODS
  Parents reported on their child's communicative abilities (MacArthur-Bates Communicative Development Inventory III), social functioning and appearance of behavioral problems (Strengths and Difficulties Questionnaire). Receptive and expressive language skills were measured using the Reynell Developmental Language Scale and the Schlichting Expressive Language Test, derived from the child's medical records.
  
  
  RESULTS
  Language and communicative abilities of early identified deaf and hard of hearing children are not on a par with hearing peers. Compared to normative scores from hearing children, parents of deaf and hard of hearing children reported lower social functioning and more behavioral problems. Higher communicative abilities were related to better social functioning and less behavioral problems. No relation was found between the degree of hearing loss, age at amplification, uni- or bilateral amplification, mode of communication and social functioning and behavioral problems.
  
  
  CONCLUSIONS
  These results suggest that improving the communicative abilities of deaf and hard of hearing children could improve their social-emotional functioning.
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, P.O. Box 9600, Leiden 2300 RC, The Netherlands. Electronic address: a.p.netten@lumc.nl.
authors.forename: Anouk P
authors.initials: AP
authors.lastname: Netten
authors.affiliation: Department of Developmental Psychology, Leiden University, P.O. Box 9555, Leiden 2300 RB, The Netherlands; Dutch Foundation for the Deaf and Hard of Hearing Child, Lutmastraat 167, Amsterdam 1073 GX, The Netherlands. Electronic address: crieffe@fsw.leidenuniv.nl.
authors.forename: Carolien
authors.initials: C
authors.lastname: Rieffe
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, P.O. Box 9600, Leiden 2300 RC, The Netherlands. Electronic address: s.c.p.m.theunissen@lumc.nl.
authors.forename: Stephanie C P M
authors.initials: SC
authors.lastname: Theunissen
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, P.O. Box 9600, Leiden 2300 RC, The Netherlands. Electronic address: w.soede@lumc.nl.
authors.forename: Wim
authors.initials: W
authors.lastname: Soede
authors.affiliation: Dutch Foundation for the Deaf and Hard of Hearing Child, Lutmastraat 167, Amsterdam 1073 GX, The Netherlands. Electronic address: edirks@nsdsk.nl.
authors.forename: Evelien
authors.initials: E
authors.lastname: Dirks
authors.affiliation: Willem-Alexander Children's Hospital, Department of Social Pediatrics, Leiden University Medical Center, P.O. Box 9600, Leiden 2300 RC, The Netherlands. Electronic address: a.m.h.korver@lumc.nl.
authors.forename: Anna M H
authors.initials: AM
authors.lastname: Korver
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, P.O. Box 9600, Leiden 2300 RC, The Netherlands. Electronic address: s.konings@lumc.nl.
authors.forename: Saskia
authors.initials: S
authors.lastname: Konings
authors.affiliation: Willem-Alexander Children's Hospital, Department of Social Pediatrics, Leiden University Medical Center, P.O. Box 9600, Leiden 2300 RC, The Netherlands. Electronic address: h.m.oudesluys-murphy@lumc.nl.
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Oudesluys-Murphy
authors.affiliation: Department of Clinical Epidemiology, Leiden University Medical Center, P.O. Box 9600, Leiden 2300 RC, The Netherlands. Electronic address: f.w.dekker@lumc.nl.
authors.forename: Friedo W
authors.initials: FW
authors.lastname: Dekker
authors.affiliation: Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, P.O. Box 9600, Leiden 2300 RC, The Netherlands; Leiden Institute for Brain and Cognition, Leiden University Medical Center, P.O. Box 9600, Leiden 2300 RC, The Netherlands. Electronic address: j.h.m.frijns@lumc.nl.
authors.forename: Johan H M
authors.initials: JH
authors.lastname: Frijns
mesh_terms: D002648:Child; D002653:Child Behavior Disorders / Q000209:etiology*; D002663:Child Language; D002675:Child, Preschool; D003142:Communication; D003430:Cross-Sectional Studies; D003638:Deafness / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D034381:Hearing Loss / Q000175:diagnosis / Q000523:psychology*; D006801:Humans; D007802:Language; D007807:Language Tests; D008297:Male; D019986:Persons with Hearing Disabilities / Q000523:psychology*; D066107:Social Skills; D011795:Surveys and Questionnaires
keywords: Behavioral problems; Communication; Hearing loss; Language; Preschool children; Social functioning