Behavior problems in children with cochlear implants

Wei Chieh Chao, Li Ang Lee, Tien Chen Liu, Yung Ting Tsou, Kai Chieh Chan, Che Ming Wu*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

23 Scopus citations


Objectives: (1) To examine behavior problems in Mandarin-speaking children with cochlear implants (CIs); (2) to investigate the associated factors of problem behaviors; (3) to understand the relationships between behavior problems and parenting stress. Methods and materials: Sixty patients (25 boys, 35 girls) aged 6-18 years (mean = 12.2 ± 3.2) who used CIs for a mean duration of eight years participated in the study. Behavior problems were assessed by Achenbach's child behavior checklist (CBCL). Categorical auditory performance (CAP) and speech intelligibility rating (SIR) scales were utilized to investigate auditory performance and speech production intelligibility. Parenting stress index (PSI) was filled out by parents to measure parenting stress level. Results: Significantly more CI subjects had problems with 'Withdrawn/Depressed' (p=0.010), 'Social Problems' (p<0.001), 'Thought Problems' (p<0.001), 'Attention Problems' (p<0.001), 'Aggressive Behavior' (p=0.010) and 'Overall Behavior' (p=0.001) than the normative sample did. 'Social Problems' was the most common problem and could be independently associated with gender, socioeconomic status and CAP (R2=0.361). CAP score was also associated with Overall Behaviors (R2=0.081). The results of PSI had a significant positive correlation with almost all CBCL subscales (p<0.05). Conclusion: The CI subjects still exhibit social and attention problems, which may in turn increase parenting stress. Good family support as well as aural-verbal rehabilitation are of particular importance in determining behavioral outcomes in CI children.

Original languageEnglish
Pages (from-to)648-653
Number of pages6
JournalInternational Journal of Pediatric Otorhinolaryngology
Issue number5
StatePublished - 01 05 2015

Bibliographical note

Publisher Copyright:
© 2015 Elsevier Ireland Ltd.


  • Auditory performance
  • Behavior problems
  • Cochlear implant
  • Mandarin Chinese
  • Parenting stress


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