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Hearing difficulties linked to reading-related mental health issues

Children with hearing difficulties who experience early reading struggles are at risk of developing poor mental health outcomes, world-first research led by Australian Catholic University shows.

The research, led by Dr Andrea Salins of ACU’s Australian Centre for the Advancement of Literacy, is the first of its kind to examine the relationship between the reading-related mental health of children with reported ear and hearing difficulties (rEHD).

Dr Salins said the research, published in the Journal of Speech Language and Hearing Research, provided new and vital insight into how low reading ability and mental health difficulties co-occurred in children with rEHD.

“This is the first study to demonstrate a relationship between the two in these children,” Dr Salins said.

“When a child is identified with some degree of hearing difficulty, their literacy needs are often monitored by teachers and/or clinicians. Our results suggest that in addition to literacy, it is important to also monitor mental health symptoms.”

Based on an analysis of four longitudinal databases involving more than 15 000 children aged five to 11 from Australia, the United Kingdom, and the United States, the study found that among children with rEHD:

• They experienced lower reading skills and significantly more symptoms of anxiety, attention problems, peer problems, and behavioural problems than children with typical development, but the strength of the associations between difficulty reading and mental health problems were similar for both cohorts.
• They were likely to report more symptoms of mental health issues at age 9 or 11 if they had poor reading skills at ages 7 or 9.
• Difficulty paying attention at age 5 was linked to reading problems at age 7.
• Those who had poor reading ability at age 7 were more likely to have trouble paying attention, experience problems with peer relationships, depression, behavioural problems, anxiety, and poor self-concept, and to be bullied at age 9 or 11.
• Poor reading ability at age 7 was associated with a lower opinion of themselves as readers.

Dr Salins said while the relationship between reading ability and poor mental health outcomes was established for children without rEHD, the new research identified a concerning cycle for those with hearing difficulties.

“It is possible that problems such as disruptive behaviours in the classroom could be related not just to students’ hearing problems, but also to their reading difficulties,” she said.

“Poor reading may trigger anxiety, lead to poor self-beliefs about reading, and cause a breakdown in peer relationships. This cycle may continue to be maintained by inattention and behavioural problems.

“This highlights the importance of monitoring for mental health problems and providing appropriate interventions to break the negative cycle of poor reading and mental health problems.”

She said early interventions, explicit literacy instruction, introducing books at a young age and encouraging engagement through independent and shared reading activities were important ways to practise reading and create positive literacy experiences.

Dr Salins’ colleagues, Professor Genevieve McArthur and Honorary Fellow Dr Serje Robidoux, of ACU’s Australian Centre for the Advancement of Literacy, as well as Dr Alana Jones, of Macquarie University’s School of Psychological Sciences, were also part of the research team behind the study.

The team hopes to further investigate the association between poor reading ability and mental health conditions in children with varying degrees of hearing difficulty.