Jessica Phillips

The present study had two main aims: to determine whether deaf children show higher rates of key behaviors of ADHD and of Conduct Disorder—CD— than hearing children, also examining whether the frequency of these behaviors in deaf children varied based on cochlear implant use, type of school and level of receptive vocabulary; and to determine whether any behavioral differences between deaf and hearing children could be explained by deficits in inhibitory control. We measured behaviors associated with ADHD and CD in 34 deaf and hearing children aged 9–10 years old, using the revised Spanish version of the Conners scale. We then assessed inhibitory control ability using a computerized Stroop task and a short version of the Attention Network Test for children. To obtain a measure of the level of receptive vocabulary of the deaf children we used a Spanish version of the Carolina Picture Vocabulary Test for Deaf and hearing-impaired children. Deaf children showed significantly higher rates of behaviors associated with ADHD and CD, and over 85% of cases detected with high risk of ADHD-inattentive type in the entire present sample were deaf children. Further, in the group of deaf children a negative correlation was found between receptive vocabulary and frequency of disruptive, aggressive, or antisocial behaviors associated with CD. However, inhibitory control scores did not differ between deaf and hearing children. Our results suggested that the ADHD-related behaviors seen in deaf children were not associated with a deficit in inhibitory control, at least in the interference suppression subcomponent. An alternative explanation could be that these behaviors are reflecting an adaptive strategy that permits deaf children to access information from their environment which is not available to them via audition.

Clinical ethics records offer bioethics researchers a rich source of cases that clinicians have identified as ethically complex. In this paper, we suggest that clinical ethics records can be used to point to types of cases that lack attention in the current bioethics literature, identifying new areas in need of more detailed bioethical work. We conducted an analysis of the clinical ethics records of one paediatric hospital in Australia, focusing specifically on conflicts between parents and health professionals about a child’s medical treatment. We identified, analysed, and compared cases of this type from the clinical ethics records with cases of this type discussed in bioethics journals. While the cases from journals tended to describe situations involving imminent risk to the child’s life, a significant proportion of the clinical ethics records cases involved different stakes for the child involved. These included distress, poorer functional outcome, poorer psychosocial outcome, or increased risk of surgical complications. Our analysis suggests that one type of case that warrants more detailed ethics research is parental refusal of recommended treatment, where the refusal does not endanger the child’s life but rather some other aspect of the child’s well-being