Background: Successful social interaction depends on communication and emotion recognition skills; however, these are areas in which adolescent cochlear implant users often perform more poorly compared with their peers with typical hearing. Purpose: This study used a multivariate approach to investigate independent and interdependent associations between auditory emotion recognition, pragmatic language, and social satisfaction among adolescents with typical hearing and cochlear implants. Study Sample: This study included 25 adolescents with typical hearing (mean age 14.56 years) and 15 adolescents with at least one cochlear implant (mean age 14.27 years). The age of the participants ranged from 12 to 18 years. Adolescents with cochlear implants had bilateral hearing loss and primarily communicated using spoken language. The cochlear implant group had a mean implantation age of 4.07 years and mean duration of cochlear implant experience of 10.20 years. Data Collection and Analysis: All participants completed measures of auditory emotion recognition using a subset of the Morgan Emotional Speech Set, self-reported emotional communication (Emotional Communication in Hearing Questionnaire), and social satisfaction (National Institutes of Health Toolbox) using an online questionnaire. A pragmatic language skill assessment (Comprehensive Assessment of Spoken Language-2) was completed with an examiner in person or virtually. Analyses of covariance and multivariate analyses of variance were conducted to evaluate the effect of auditory status on emotion recognition performance, self-reported emotion recognition, and self-ratings of social satisfaction. Descriptive statistics and trends were used to examine the effect of auditory status on pragmatic language abilities. Finally, correlations were used to assess the relationship between factors. Results: Compared with their peers with typical hearing, adolescent cochlear implant users exhibited significant deficits in auditory emotion recognition. However, the participant groups did not differ in terms of self-reported emotion recognition or social satisfaction ratings. Greater variability in pragmatic language abilities was observed in the cochlear implant group. Conclusions: Auditory status affects emotion recognition such that adolescents with typical hearing outperform those with cochlear implants. Future studies should investigate emotion recognition performance relative to specific areas of social relationships to determine more nuanced aspects of social communication in adolescent cochlear implant users. Clinical Relevance Statement: Clinical audiologists should monitor and identify adolescents at risk for poorer emotion recognition and social well-being who may need additional counseling and resources.
Crow et al. (2026) studied this question.