Behavioral and socio-emotional profiles in early-school-age children with cochlear implants versus normal-hearing peers

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Başoğlu Y., Başoğlu İ., Ölçek G.

INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY, cilt.200, ss.1-6, 2026 (SCI-Expanded, Scopus)

Özet

Objective: To compare teacher-reported socio-emotional and behavioral functioning in early-school-age children with cochlear implants (CI) versus normal-hearing (NH) peers using the Child Behavior Assessment Scale (CBAS), and to test whether group differences persist after adjustment for socioeconomic factors. Methods: In this cross-sectional study, 80 children aged 5–6 years were enrolled (CI = 40; NH = 40). Teachers completed CBAS subscales (Adjustment, Social Anxiety, Rule-breaking Behaviors) and total score. Between-group comparisons used Mann–Whitney U tests. ANCOVA on CBAS total adjusted for maternal education, paternal education, and household income. Exploratory correlations within the CI group examined age and clinical durations. Results: Compared with NH peers, the CI group showed lower Adjustment (mean ± SD: 61.45 ± 15.46 vs 80.95 ± 6.56; p < .001) and higher Social Anxiety (64.20 ± 13.27 vs 34.28 ± 7.02; p < .001) and Rule-breaking Behaviors (113.33 ± 26.77 vs 61.08 ± 15.98; p < .001). CBAS total was higher in the CI group (238.98 ± 48.22) than NH (176.30 ± 17.10; p < .001). In ANCOVA, the CI versus NH effect on CBAS total remained significant (F(1,75) = 33.846, p < .001; partial η 2 =0.311), while socioeconomic covariates were not significant. Within the CI group, child age correlated positively with Rule-breaking Behaviors (r = 0.331, p = .037). Conclusions: At school entry children with CI showed higher levels of socio-emotional and behavioral difficulties compared to NH peers; however, these findings should be interpreted with caution given the sample size and cross-sectional design. The results support routine psychosocial surveillance and targeted supports within CI follow-up and school settings.