Clinical Information

As with many different kinds of sensory loss, hearing loss brings with it some emotions before acceptance of the loss. These emotions can include denial and anger, as well as a sense of isolation. They are taken into account as part of an aural rehabilitation program. However, there is a less commonly addressed aspect of hearing loss and emotion: How hearing loss affects the patient's ability to perceive the emotions of others.

Do hearing impaired children and adolescents have difficulty recognizing and understanding the reactions of others? An Australian study¹ has found that children with severe hearing loss were 50% less able than their hearing peers to interpret the feelings of other people. This occurred, in particular, when the emotional response was different than expected. For example, John is a child with a severe hearing loss. As a surprise for Mothers' Day, John decides that he will do the washing to help his mum with her regular domestic duties. However, John throws his red sunhat into the washing with his mother's white sheets. When all of the laundry comes out pink, John's mum is a bit upset. This study reveals that, because of his hearing loss, John is 50% less able to detect the emotional cues indicating that his mum is upset, particularly when he is expecting her to be pleased.

Researchers also found that these severely hearing-impaired youngsters had difficulty judging the expected emotional response of others in certain situations. The children in the study had an ability that was 30% below that of normal hearing youngsters. In other words, even though John was expecting his mum to be pleased, he would have been 30% less likely than his normalhearing friend to detect that his mum was pleased.

Finally, the study found that, had John looked at his mother's face, he would still be 25% less likely to accurately interpret the meaning of her facial expressions, as children with severe hearing loss do not pick up facial cues as easily as normal hearing children.

These results are indicative of what can happen when early intervention fails to take place, and they indicate that lack of emotion recognition among hearing-impaired children is a significant problem. Communication includes more than spoken language; it includes gestures, facial expressions and other kinds of body language. Normal social behaviour involves a constant exchange of all these forms of communication, based on the ability to interpret and recognize these different forms of communication. Children begin communicating by imitating what they see and hear.

Birth to age 5 is considered the optimal and critical period for acquisition of language skills and this would also be an important time for the development of emotion recognition. While all children, with and without hearing loss, develop differently, hearing-impaired children's ability to adopt appropriate social behaviours depends on a number of factors including the degree of hearing loss, the child's age, time of diagnosis, treatment and personality.

Advances in technology have made it possible to test the hearing of patients of all ages, from newborn onwards. Procedures are noninvasive, and most easily completed while the child is sleeping. Parents and caregivers are typically present throughout testing, so that they can witness the entire process.

Treatment of permanent hearing loss typically begins with the fitting of hearing aids. While research is still on-going with respect to how the fitting of hearing aids may improve emotion recognition, there is extensive research documenting the advantage of fitting amplification as early as possible. Hearing aids allow children access to speech sounds which will hopefully stimulate the development of speech, language and appropriate social behaviours.

Dilworth Hearing continues to be the only private practice that caters to the testing and fitting of hearing-impaired children. In addition to a pleasant paediatric "bedside manner", we are familiar with government programmes available to assist hearing-impaired children and their families. For all of your paediatric hearing needs, do not hesitate to contact your local Dilworth Hearing clinic.

1. Emotion Recognition/Understanding Ability in Hearing or Vision-impaired Children: Do Sounds, Sights, or Words Make the Difference?, Journal of Child Psychology and Psychiatry, No.4 2004.