Led by Dr Andrea Salins from ACU’s Australian Centre for the Advancement of Literacy, the study crunched data from four longitudinal databases involving more than 15,000 children aged 5-11 from Australia, the UK and the US.

It concluded that those with hearing issues had lower reading skills and ‘significantly more’ symptoms of anxiety, attention, peer and behavioural problems than their peers.

Salins says this is the first time that the relationship between reading skills and mental health has been scrutinised for this student cohort – a group it is already known likely struggle with reading throughout their schooling.

“The big finding was that children with hearing and reading difficulties are also at risk of developing mental health problems as much their hearing counterparts are…” Salins tells EducationHQ.

“And I guess the big message would be that it’s vital to monitor these children and provide them with both literacy and mental health support to reduce the risk of this cycle perpetuating through schooling and beyond.”

A whole body of research shows that children who battle with reading will find ways to avoid it at school, the expert notes. This can manifest in a few obvious ways.

“So in a classroom, particularly in primary school, if they’re asked to read aloud, they find excuses to not do that.

“[Teachers might see] increased bathroom breaks, refusal to go to school is an extreme form as well.

“We also see them ‘acting out’, which is disruptive behaviours in the classroom. Such behaviours are also seen in students with hearing problems, partly because they’re not getting access to the [teacher’s instruction].”

The research team is now planning to investigate whether the severity of hearing loss has any impacts on the relationship.

“The drawback of using big databases is that we don’t have specific audiological information for these children,” Salins explains.

“So the children included in the study, based on the databases, are those who have had consistent or persistent middle ear infections, ongoing problems with all types of media, and those with more severe hearing difficulties, but we don’t have information on their exact degree of hearing loss…”

The long-term consequences for students who experience difficulty with reading early on are clear, Salins adds.

“There’s research coming out of Finland, for example, where they’ve monitored those with typical hearing [and] their mental health outcomes later in life, and they found that early reading problems have been associated with poor mental health outcomes, depression, and employment problems well into adulthood.

“Now that we’ve identified that this is a similar relationship in kids with hearing difficulties, it’s very important to get them early support for both their literacy and their mental health problems so that we don’t see [that same trajectory].”

Dr Andrea Salins, pictured above, says there's more fine-grained research to come following the world-first study. 

Pam Snow, a professor of cognitive psychology at La Trobe University, has previously warned that children who exit Grade 3 with poor reading skills are at greater risk of falling into the ‘school to prison’ pipeline than their literate peers. 

Snow has conducted extensive research around adolescents who end up in the youth justice system and the risk and protective factors that can influence their slide away from mainstream education. 

“Wearing my speech pathology hat, I could see that there was a lot of research suggesting that people in the youth justice system had very weak academic skills; if there’s one thing that characterises their background, it’s weak academic achievement,” Snow said. 

“What our research recognised was that these young people have very high rates of undiagnosed, unrecognised language disorders and language difficulties, so that had a whole lot of implications around engagement in the justice process…” she said in a webinar. 

Explicit literacy instruction delivered at the whole class level, plus early intervention, is the most evidence-based means of giving all students the best chance of reading success from the outset, Salins emphasises.

But for students with hearing difficulties, this only becomes more critical.

“[And with] mental health difficulties as well, the additional complication is that they might not be engaging in the content, even if taught explicitly – which is why there’s more research now examining whether simultaneous support for both literacy and for mental health problems are the way to go.”

On this front there’s emerging research from the Black Dog Institute and researchers in Finland that is looking at the effectiveness of a dual intervention approach for children with hearing complications, Salins notes.

“A lot of educators working with this cohort very rightly focus on their literacy skills … but we’re also saying that we must monitor their mental health as well.”

ACU’s study also found that children with reported ear and hearing difficulties:

  • 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.
  • their 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.

More than 12,000 children in Australia have a significant hearing loss, and on average one child is identified with hearing loss every day, according to the Murdoch Children’s Research Institute.