Reduced hearing is associated with increased risk for social, emotional, and behavioral difficulties. Studies to date have typically compared DHH children with their hearing peers without regard for unilateral hearing loss (UHL) versus bilateral hearing loss (BHL). Children with UHL are often perceived as more like their typically hearing peers than their peers with BHL. Children with UHL typically access sound and spoken language which facilitates their functioning with fewer supports (e.g., interpreters, captioning). These children, however, show cognitive, academic, and communication profiles more similar to children with BHL than typically hearing peers. They may also experience similar social, emotional, and behavioral challenges as their BHL peers. We examined social, emotional, and behavioral functioning in a clinically referred sample of children with UHL versus BHL.

Parents of 100 children aged 2 to 17 years (M=7.12) with either UHL (n=30) or BHL (n=70) completed the Behavioral Assessment System for Children, Third Edition (BASC-3) as part of neuropsychological evaluation in a Deaf and Hard of Hearing Program within a tertiary pediatric hospital. BASC-3 scores based on General Combined norms were compared to an expected distribution of typically developing hearing children using non-parametric one-sample tests. Profiles of scores for children with UHL and BHL were examined in a repeated measures MANOVA.

The groups of children with UHL and BHL showed similar age, gender, race, ethnicity, and Area Deprivation Index compositions. Eighty four percent of BHL children communicated with spoken language, and 100% of UHL children communicated with spoken language (p=.02). There were similar rates of comorbid diagnoses for ADHD (20%), Anxiety/Depression (18%), Autism Spectrum Disorder (8%), and Intellectual Disability/Global Developmental Delay (9%). However, children with BHL tended to be at greater risk for Language Disorders (50%) than those with UHL (30%, = 3.41 p=.065). Together, children with hearing loss showed significantly higher scores on the BASC-3 Hyperactivity, Aggression, Attention Problems, Atypicality, and Withdrawal clinical scales than expected (One-Sample Kolmogorov-Smirnov Test; p<.01). Profile analysis showed that children with any type of hearing loss had a varied pattern of scores across scales (F(7,686)=4.33, p<.01), with highest scores on Hyperactivity and Attention Problems scales and lowest scores on Somatization. Scale profiles did not differ, however, between UHL and BHLgroups (p=.127).

Children with UHL have access to auditory input, typically enabling early language development more like their hearing peers compared to children with BHL. In turn, these children may be overlooked more so than their BHL peers. However, the likelihood of social, emotional, and behavioral difficulties is similar between the two groups of children with hearing loss, whether that is unilateral or bilateral. Our study showed both groups of children had similar profiles across BASC-3 scales with elevations relative to norms. Measuring these everyday functions in children with hearing loss is important for early detection of risks to promote early intervention.