No Association Between Vocal Emotion Recognition and Subjective Parental Reporting of Alexithymia in School-Age Children With Hearing Aids.

Objectives: Alexithymia is characterized by difficulties in identifying and describing one's own emotions. Alexithymia has previously been associated with deficits in the processing of emotional information at both behavioral and neurobiological levels, and some studies have shown elevated levels of alexithymic traits in adults with hearing loss. This explorative study investigated alexithymia in young and adolescent school-age children with hearing aids in relation to (1) a sample of age-matched children with normal hearing, (2) age, (3) hearing thresholds, and (4) vocal emotion recognition.

Design: A translated-to-Turkish version of the Children's Alexithymia Measure (CAM), where higher scores indicate higher levels of alexithymic traits, was filled in by the parents of 37 children (5.5 to 17.8 yr) with bilateral hearing aids and 37 children (5.1 to 18.3 yr) with normal hearing, all native speakers of Turkish. Vocal emotion recognition scores, assessed using the psychophysical vocal emotion recognition test for hearing-impaired populations (EmoHI), were available from a previous study for the group with hearing aids. This test uses non-language-specific pseudospeech sentence recordings expressing three basic emotions: angry, happy, and sad.

Results: Parent-reported CAM scores of children with normal hearing (mean = 7.19 ± 6.61) and children with hearing aids (mean = 8.59 ± 4.38) were within the range previously reported for neurotypical children. Group-level comparison showed no statistically significant difference in CAM scores. However, when considering age, CAM scores of children with normal hearing increased as a function of age, while CAM scores of children with hearing aids were not affected by age. Furthermore, for the youngest children up to 8.8 yr, children with hearing aids had significantly higher CAM scores than children with normal hearing. In children with hearing aids, neither unaided nor aided pure-tone audiometric thresholds were significant predictors for CAM scores. Furthermore, the CAM scores and EmoHI scores were not significantly correlated.

Conclusions: Although the developmental patterns of parent-reported alexithymia scores as a function of age differed between the sample of children with hearing aids and the sample of children with normal hearing, the group difference was observed only for the youngest participants (<8.8 yr). When collapsed across the full age range, there was no group effect, and for both groups, the parent-reported alexithymia scores were within the ranges previously reported in neurotypical children. For the children with hearing aids, unaided and aided hearing thresholds did not have a predictive value for parent-reported alexithymia scores and there was no significant correlation between the CAM and EmoHI scores. These findings together indicate no elevated levels of alexithymic traits in children with hearing aids, at least for 8.8 yr and older. This is not consistent with previous research with adults with hearing loss, assessed with adult-directed questionnaires via self-report. The difference between our findings with children and earlier results from studies with adults with hearing loss may be due to differing methodologies. Alternatively, alexithymia patterns may be different between children and adults with hearing loss. The lack of alexithymia indications implies that the difficulties in vocal emotion recognition for children with hearing aids may be specific to the perception of auditory information and not related to challenges in the general processing of emotional information.