Mental health in adolescents with hearing loss

In our work with the Longitudinal Outcomes of Children with Hearing Impairment (LOCHI) cohort, we aimed to evaluate the prevalence of anxiety and depression in 250 adolescents with prelingual hearing loss who use spoken language and understand the factors that are associated with their well-being. 

Our findings, recently published in the Journal of Clinical Medicine, suggests the following: 

Comparable rates of anxiety 

Our data shows that adolescents with hearing loss report high-severity anxiety at rates nearly identical to their peers with normal hearing. Approximately 8% of both groups experienced anxiety at a clinical or borderline clinical level. 

While we observed that depression symptoms were reported more frequently in the hearing loss group (up to 15.8% based on parent reports), the difference compared to their normal-hearing peers (7.2%) did not reach statistical significance. These results suggest that early diagnosis and modern intervention are effective in narrowing the gap in emotional outcomes. 

Predictors beyond the audiogram 

There was no significant association between anxiety or depression and: 

• The degree of hearing loss. 
• The type of hearing technology used (hearing aids vs. cochlear implants). 
• The age at which the child was first fitted with devices. 

Instead, the most consistent predictors of emotional health were expressive language abilities and communication difficulty. When teenagers feel confident navigating social interactions and making themselves clearly understood, their risk of poor mental well-being decreases. 

The power of social support 

We also identified specific factors that protect these adolescents from depression, which vary slightly by the technology they use. 

• For cochlear implant users: Strong peer relations were a significant protective factor. 
  
• For hearing aid users: High levels of “prosocial behavior” (e.g., being helpful and considerate of others) were linked to better mental health. 

What audiologists can do 

Our findings highlight several practical steps we can take in the clinic to provide more holistic care: 

• Use a multi-informant approach: We must gather data from both the adolescent and their parent. While their reports often align, we found that in 10–15% of cases, only one informant identified a clinical concern. Relying on just one perspective can lead to missing teenagers who are quietly struggling. 
  
• Implement screenings: The periodic use of standard questionnaires, such as the RCADS-25, can help us identify adolescents who may need a referral to non-audiology professionals. 

• Partner with the school: We found a significant association between higher depression severity and increased school absenteeism. If a student is frequently missing school due to reported “sickness,” it may be an indicator of underlying emotional distress. 

Earlier identification and management of these symptoms may reduce the risk of long-term internalizing and academic challenges. By monitoring ease of communication and social engagement, we can better support the long-term well-being of our adolescent patients as they move toward adulthood and greater independence. 

Read the full publication to explore the findings in more detail.

Reference:

Easwar, V., Gavrilis, J., Söderström, P., Ching, T., Leigh, G. & Zhang, V. (2025). Anxiety and depression in adolescents with prelingual hearing loss: Prevalence and risk factors. J Clin Med;14(21):7538. doi: 10.3390/jcm14217538.

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Authors:

Viji Easwar, Head of the Paediatric Hearing Research Program at the National Acoustic Laboratories, Sydney, Australia.

Viji Easwar is an audiologist by training and completed her Bachelor’s degree in Audiology in India, Master’s in Audiology at the University of Southampton (UK), and a PhD at the National Centre for Audiology in Canada. Viji’s research focuses on developing clinical tools, including EEG-based measures, to evaluate and optimize hearing outcomes children with hearing loss. 

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Pelle Söderström, Senior Research Scientist in Paediatric Hearing Loss at the National Acoustic Laboratories, Sydney, Australia

Pelle has a passion for languages, linguistics, music and neuroscience. His work at NAL focuses on developing tools to investigate and improve language outcomes in children and adolescents with hearing loss.