Personal, Social, and Family Adjustment in School-Aged Children with a Cochlear Implant

Abstract

In Brief Objective The present study sought to document the psycho-social adjustment of 181 school-aged deaf children who have had a cochlear implant for 4 or more yr and to examine parental satisfaction with the outcome of the implantation process on their child’s life and on their family’s life in general. Design Three measures were employed. One measure was a self-report instrument designed to assess perceived self-competence in children, one was a rating scale completed by parents that sought to assess the degree of their child’s personal-social adjustment, and the third was a questionnaire given to parents on which they rated their satisfaction with aspects of the cochlear implant and how it had affected their child’s functioning within the context of family life. Results Children generally perceived themselves (and parents perceived their children) as being competent and well adjusted in most aspects of daily life. Parents expressed a generally positive view of cochlear implantation and its effects on family life. None of the social-emotional adjustment measures was significantly related to the speech perception, speech production or language skills the child achieved postimplant. However, the parents’ satisfaction with their child’s cochlear implantation was significantly related to their child’s speech and language achievements. On the perceived self-competence instrument, younger children and those with longer use of the updated SPEAK speech processor gave themselves higher ratings. Parent ratings of their child’s adjustment tended to be higher for girls than for boys, for more rather than less intelligent children, and for children enrolled in private as opposed to public school settings. Conclusions Deaf children who have used a cochlear implant for 4 to 6 yr report that they are coping successfully with the demands of their social and school environment, regardless of their speech and language achievements after implantation. Parents’ ratings indicate that these children are emotionally and socially well adjusted and that they have benefited from cochlear implantation. To the extent that the children and their parents accurately reported their attitudes and feelings regarding their experiences at home and at school, these results represent an impressive level of personal and social adjustment when compared with previous literature on adjustment problems in deaf children. The extent to which these results are associated with cochlear implantation has not been determined and awaits comparative data from children without implants. This study assessed the perceptions of children and their parents regarding the child's social and emotional adjustment and satisfaction with the effect of the implant on their lives. Children saw themselves as being competent and well adjusted in most aspects of their daily life, and their parents reported similar positive perceptions. Parents exhibited a generally positive view of cochlear implantation and its effects on their family life, with greater satisfaction expressed by families with children who exhibited better postimplant outcomes. Although absence of comparison groups of either normal-hearing or deaf age-mates on these measures restricts their generalizability, average ratings close to the upper limits of the scales suggest that the majority of these early-implanted children are well adjusted, both personally and socially.