Abstract
Studies have reported deficits in social understanding, as assessed by theory of mind tasks, in deaf children born to hearing parents (Peterson & Siegal, 2000), even when low-verbal tasks were used (Levrez, Bourdin, Le Driant, d’Arc, & Vandromme, 2012). It has been suggested that children with hearing loss may recognize some facial emotions better than hearing children, because from an early age they use visual clues as a basis for interpreting them. There is, however, no evidence to support this hypothesis. In fact, there is some work indicating that persons with hearing loss have more difficulty with emotion recognition and understanding than hearing persons (Wiefferink, Rieffe, Ketelaar, De Raeve, & Frijns, 2013). The purposes of this investigation were to (a) study whether there are differences between children with and without hearing loss in their capacity for facial emotion recognition and (b) study to what extent language and the characteristics of hearing loss may explain these possible differences.
Method
Participants
A total of 166 children between 3½ years and 9 years of age participated in the study, of which 91 were hearing children and 75 were children with hearing loss, onset before 12 months of age. All were in mainstream oral schools; none of them were reported to know a sign language. And 30 children had cochlear implants; one had a bone-anchored hearing device; the remainder had hearing aids.
Materials
Three tasks were administered to the participants in this study: an expressive vocabulary test, an emotion recognition task, and a test of nonverbal reasoning (cognitive ability). In addition, a questionnaire about the children’s communication was completed by their speech-language pathologist or teacher, and parents completed an informational questionnaire.
Naming Vocabulary
The Spanish version of the subscale Naming Vocabulary subtest of the second edition of the British Ability Scales (Elliot, Smith, & McCulloch, 1996; Spanish version adapted by Arribas & Corral, 2011) was administered to children to evaluate their expressive vocabulary. In this task, children are presented with a series of pictures and asked to label them with single words.
Emotion Recognition Task
A task of emotion recognition was created to assess the capacity to link emotion words with facial emotional expressions. In this task, the experimenter placed six colored handmade drawings in front of the participant of a child looking: happy, sad, scared, angry, surprised, and disgusted (the labels used for the emotions in Catalan were “contenta,” “trista,” “espantada,” “enfadada,” “sorpresa,” and “fàstic,” respectively). These drawings intended to represent the different emotions by changing the position of the mouth and the eyebrows of the face. The experimenter labeled each emotion by saying, “Could you point to the girl looking . . .” The children’s responses to each emotion were considered either correct or incorrect.
Cognitive Ability Task
The Spanish version of the Pattern Construction subtest of the British Ability Scales 2 (Elliot et al., 1996; Spanish version adapted by Arribas & Corral, 2011) was used to evaluate children’s nonverbal reasoning skills. Children are asked to construct patterns using either squares or cubes of different colors. The type and number of patterns that children need to reproduce depend on their age and performance.
Language and Personal Information Questionnaires
Two questionnaires were used to obtain information regarding the participants’ linguistic and communicative abilities and some personal data. The children’s speech therapists answered these questionnaires for children with deafness, whereas the teachers did the same for hearing children. This scale, which focuses on semantic and pragmatic features, was originally designed to evaluate the linguistic and communicative skills of deaf children, regardless of the language they use. It measures the global communication ability, rather than specific linguistic processes. A personal information questionnaire was used to obtain personal data regarding the parents and children (the child’s age, number of siblings, when they began schooling, the languages they used in different settings, the languages the parents used to address the child, the characteristics of their hearing loss including onset of the deficit, type and onset of sensory aids, degree of hearing loss, deafness in family members, and the educational level of parents).
Results
Emotion Recognition Abilities in Children With and Without Hearing Loss
Hearing children recognized significantly more of the emotions than children with hearing loss.
The groups did not differ on recognition of happy, angry, and sad; the children with hearing loss did less well than the hearing children on disgusted, surprised, and scared.
The order of difficulty was similar for both the hearing children and children with hearing loss: happy, angry, sad, disgusted, surprised, and scared.
Degree of hearing loss or type of hearing devices was not correlated with emotion recognition.
Emotion Recognition and Linguistic Variables
Children with and without hearing loss did not differ on level of cognitive ability. Cognitive level was not correlated with emotion recognition for either group.
Children with hearing loss had lower vocabulary and linguistic–communicative skills than hearing children.
Even when matched for vocabulary, hearing children were better than children with hearing loss on emotion recognition.
In both groups, the level of language (both linguistic–communicative skills and vocabulary) correlated positively and significantly with the total score in emotion recognition.
Conclusion/Implications
The authors of this study concluded that differences in facial emotion recognition between children could not be solely explained by linguistic skills. They consider the possibility that reduced opportunities for conversations may account for the deficits in facial recognition because participation in conversations and social situations may be important in the ability to recognize emotions beyond the influence of language (Stanzione & Schick, 2014). Hearing loss may lead to a reduction in incidental learning (passive exposure to events and overhearing information) that limits learning in social contexts (Netten et al., 2015). The authors, in their interpretation of this study, suggest that interventions for children with hearing loss should include efforts directed toward facial recognition and other aspects of social cognition should also be related to understanding the causes of emotions, or learning to regulate these emotions and their expression.