(PP1104) Effects of Auditory Status and Temperament on Social Well-Being in Adolescents

This study explores effects of auditory status, communication, and temperament on social well-being in adolescents. Adolescent participants completed an online study assessing self-rated communication skills, temperament, and social well-being. Both groups achieved mean social well-being ratings within the normative range. However, significantly more adolescent cochlear implant users reported concerning levels of low friendship and high loneliness compared to peers with typical hearing. Social well-being measures correlate with self-rated communication abilities and temperament. Professionals working with adolescent cochlear implant users should pay close attention to warning signs of poor social well-being and make appropriate referrals to foster higher quality of life.


Summary: 

Introduction. Historically, children who are deaf or hard of hearing have more difficulty making and maintaining friends and exhibit higher rates of social isolation and peer rejection than peers with typical hearing (TH). The impact of hearing loss on social well-being may become exacerbated in adolescence when friends take a more prominent social role over family. Few studies to date examine both positive and negative aspects of social relationships in a contemporary group of adolescents who are DHH and use a cochlear implant (CI). This study explores the effect of auditory status (CI vs. TH), communication skills, and temperament on four aspects of social well-being in adolescents.

Methods. Participants included adolescents (13-17 years) who had TH (n=50) or used CIs (n=23). The CI group had a mean implantation age of 3.2 years and long-term CI experience (M=10.6 years). All adolescents completed an online study assessing (a) self-rated communication skills (e.g., speech perception, speech intelligibility); (b) temperament via the Early Adolescent Temperament Questionnaire-Revised; and (c) social well-being (i.e., loneliness, companionship, friendship, perceived rejection) via the NIH Toolbox Emotional Domain.

Results. Both groups achieved mean social well-being ratings within the normative range, with the TH group having slightly more positive ratings for friendship and emotional support compared to the CI group. However, the DHH group had a higher proportion of children achieving scores more than one standard deviation from the normative mean for loneliness (33% vs. 24%) and friendship (42% vs. 16%) compared to the TH group. In the CI group, higher ratings of friendship coincided with younger age at CI and lower rejection ratings co-occurred with better self-rated speech perception in noise. For the TH group, higher depressive mood was associated with more loneliness and peer rejection as well as lower friendship and emotional support ratings. Most social well-being measures significantly corelated with speech in noise ratings.

Conclusion. Social well-being measures correlate with self-rated communication skills and temperament in adolescents with TH and CI. Group mean comparisons may not capture nuanced differences in social well-being between adolescents with CI and TH, particularly proportional differences in children whose scores warrant heightened concern (i.e., scores >1 standard deviation from the normative mean). A higher proportion of adolescent CI users reported concerning levels of low friendship and high loneliness compared to TH peers. Thus, professionals working with adolescent CI users should pay close attention to warning signs of poor social well-being and make appropriate referrals to trained mental health professionals to foster higher quality of life in CI recipients.