Assessment and Treatment of Behavioral Disorders in Children with Hearing Loss: A Systematic Review

Diana Bigler, Kristen Burke, Nicholas Laureano, Kristan Alfonso, Julie Jacobs, Matthew L. Bush

Research output: Contribution to journalReview articlepeer-review

19 Scopus citations


Objective: There is evidence that children who are deaf and hard of hearing (DHH) have a higher incidence of behavioral disorders. Assessment of behavioral health in this population is often complicated by language developmental delays, which may result in unrecognized and untreated behavioral problems. The purpose of this study is to assess the association of behavioral disorders among children who are DHH and to explore behavioral interventions for children in this population. Data Sources: PubMed, CINALH, PsychINFO, and Web of Science. Review Methods: Search terms included the following: problem behavior, child behavior disorders/diagnosis, child behavior disorders/psychology coupled with hearing loss, cochlear implants, hearing aids, or deafness. Studies from the last 30 years (1985-2016) were included. The articles were reviewed independently by 3 reviewers. Results: Thirty-six articles met criteria. There was an association between internalizing behaviors and hearing loss among children, which may persist after cochlear implantation. These problems may be more pronounced for children with additional disabilities. Conduct and hyperactivity disorders as well as emotional and executive function problems among children who are DHH may be related to poor language development. There was limited evidence regarding interventions to address the behavioral disorders of DHH children. Conclusions: There is a significant body of evidence demonstrating behavioral problems among DHH children but a lack of clear understanding of the mechanisms involved. There is limited evidence on interventions to address the behavioral problems of DHH children. Future research is warranted to mitigate the long-term effects of disruptive behavior among these children.

Original languageEnglish
Pages (from-to)36-48
Number of pages13
JournalOtolaryngology - Head and Neck Surgery (United States)
Issue number1
StatePublished - Jan 1 2019

Bibliographical note

Funding Information:
Funding source: National Institutes of Health: National Institute on Deafness and Other Communication Disorders (1K23DC014074 to M.L.B) and National Center for Advancing Translational Sciences (UL1TR000117 to D.B. and M.L.B.).

Publisher Copyright:
© American Academy of Otolaryngology–Head and Neck Surgery Foundation 2018.


  • behavioral disorders
  • cochlear implants
  • hearing loss
  • systematic review

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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