Screening of Psychiatric Disorders among Hearing-Impaired Children and Adolescents Aged 4 - 16 Years Attending Special Education Institutions in Karachi

Aim: The aim of this study was to estimate the prevalence of psychiatric problems and to identify associated factors among hearing-impaired children and adolescents (aged 4 - 16 years) attending special education institutions in Karachi, Pakistan. Methods: A cross-sectional study, using stratified random sampling was conducted in two special education institutions in Karachi from September 2010 to July 2011 on 272 hearing-impaired children aged 4 - 16 years. Multi-informant rating (responding parent and teacher) was used to assess the prevalence of psychiatric problems on Strengths and Difficulties Questionnaire (SDQ). Kappa statistic was computed to assess agreement between parents/teachers ratings. Multivariable logistic regression analysis was conducted to identify the factors associated with psychiatric problems of children. Results: An overall parent-rated prevalence of psychiatric problems among hearing-impaired children was estimated as 18% and teacher-rated prevalence as 32.7%; poor inter-rater agreement was found between the two raters (Kappa statistic = 0.09). Multivariate model indicated protective effect of child’s age greater than 6 months at the time of diagnosis AOR: 0.49; 95% CI (0.25, 0.96). Depression among responding parents AOR: 2.61; 95% CI (1.34, 5.11) was identified as a risk factor. Children with good performance AOR: 3.09; 95% CI (1.04, 9.25) and fair/poor performance AOR: 3.43; 95% CI (1.17, 10.04) were more likely to have psychiatric problems compared to children with outstanding/excellent performance. Cronbach’s alpha of 0.71 on overall SDQ indicated an acceptable internal consistency. Conclusion: Awareness programs should be held for parents and teachers for better dealing with hearing-impaired children.