Theses and Dissertations

Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


College of Psychology

First Advisor

Angela M. Waguespack

Second Advisor

Lourdes Suarez-Morales

Third Advisor

Andre Maharaj


adolescents, children, cochlear implantation, deaf, hard of hearing


Recent data regarding social-emotional challenges indicate elevations in behavior problems (BPs) in deaf and hard of hearing (DHH) children (Austen, 2010; Stevenson et al., 2010; van Eldik et al., 2004). Factors affecting this include family and social contexts, language development (LD), and cochlear implantation (CIs). The purpose of this dissertation was to analyze findings across studies for trends in BPs in DHH children. Specifically, a model of the effect of deafness, CI use, and LD on the emergence of BPs in DHH children as compared to hearing children was examined. Studies were collected through systematic searches of psychology databases supplemented by studies referenced in other sources therein discovered. Random-effects meta-analyses using the restricted maximum likelihood estimation method were non-significant (g = 0.31, SE = 0.20, CI [-0.09, 0.71]), as were subgroup analyses (g = 0.36, SE = 0.22, CI [-0.07, 0.80]). A metaregression using CIs as a predictor evidenced a nonsignificant reduction in BPs for deaf children with CIs and CIs did not significantly predict BPs in deaf children. Unexplained heterogeneity remained elevated in all cases (I2 above 96%). In sensitivity analyses, I2 decreased to 87%, suggesting that designs of included primary studies may have impacted those studies’ data collection, analysis, and interpretation. Unmeasured variables such as LD may explain much of the remaining heterogeneity. Collaborating with researchers worldwide, using more inclusive selection criteria, and enacting a longitudinal design could collect a greater variety of data, creating a more complete understanding of the effect of hearing loss on BPs.

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