Predicting quality of life and behavior and emotion from functional auditory and pragmatic language abilities in 9-year-old deaf and hard-of-hearing children

Teresa Y.C. Ching*, Linda Cupples, Greg Leigh, Sanna Hou, Angela Wong

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)
76 Downloads (Pure)


Children who are deaf or hard of hearing (DHH) are likely to exhibit difficulties in development of psychosocial skills, pragmatic language skills, and use of hearing for social communication in real-world environments. Some evidence suggests that pragmatic language use affects peerrelationships and school engagement in these children. However, no studies have investigated the influence of functional auditory performance and use of language and speech in real-world environments on children’s behavior and emotion, and on their health-related quality of life. This study explored the relationship in DHH children at 9 years of age. Data from 144 participants of the Longitudinal Outcomes of Children with Hearing Impairment study were analyzed. Parent reports were obtained on quality of life, behavior and emotion, pragmatic language skills, and auditory functional performance of children in real life. Children’s spoken language abilities and speech intelligibility were assessed by research speech pathologists. On average, performance of children in all domains was within the range of typically developing peers. There were significant associations among functional auditory performance, use of speech and language skills, psychosocial skills, and quality of life. Multiple linear regression analyses revealed that better auditory functional performance and pragmatic language skills, rather than structural language abilities, were associated with better psychosocial abilities and quality of life. The novel findings highlight the importance of targeted intervention for improving functional hearing skills and social communication abilities in DHH children, and emphasize the importance of collaborative approaches among medical, audiology, allied health, and educational professionals to identify those at risk so that timely referral and intervention can be implemented for improving psychosocial health and well-being in DHH children.

Original languageEnglish
Article number5357
Number of pages20
JournalJournal of Clinical Medicine
Issue number22
Publication statusPublished - 17 Nov 2021

Bibliographical note

Copyright the Author(s) 2021. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.


  • pragmatic language skills
  • auditory functional performance
  • speech intelligibility
  • quality of life
  • behavior and emotion
  • deaf and hard of hearing children
  • cochlear implants
  • hearing aids


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