In comparison to hearing children, children with hearing loss more often experience social-emotional problems. This thesis aimed to assess whether this was also true for 1-to-5-year-old children... Show moreIn comparison to hearing children, children with hearing loss more often experience social-emotional problems. This thesis aimed to assess whether this was also true for 1-to-5-year-old children who had received a cochlear implant (CI) to remediate their hearing loss. In comparison to hearing peers, children with CI were found to be delayed on some but not all aspects of social-emotional functioning. No delays were found regarding social behavior or empathy. However, children with CI did show delays on theory of mind understanding and on the development of moral emotions. Against expectations, language skills did not have a major influence on children's social-emotional development. Parents in both groups had adopted similar parenting styles. Positive parenting was associated with better social-emotional functioning in children, whereas negative or uninvolved parenting were associated with lower social-emotional functioning. Based on this thesis we can conclude that a CI is beneficial for the social-emotional development of children with a hearing loss. However, these children are still at risk of developing delays in some areas of social-emotional functioning. Furthermore, we should not assume that children with CI who have a strong language development will also show a healthy social-emotional development. Show less
This thesis provides insights in characteristics of newly introduced echocardiographic parameters in healthy children and their use in follow-up of patients with a congenital heart defect (CHD)... Show moreThis thesis provides insights in characteristics of newly introduced echocardiographic parameters in healthy children and their use in follow-up of patients with a congenital heart defect (CHD) after surgery. In healthy children, reference values and characteristics of two echocardiographic techniques, tissue Doppler imaging (TDI) and speckle-tracking strain imaging, are described. TDI-derived velocity parameters are reproducible and feasible in children. Yet use of age or growth-dependent reference values is recommended, especially in neonates. Speckle-tracking strain-derived global peak strain parameters have a good reproducibility, are age-independent and remain unchanged during periods of significant growth, such as the neonatal period. We encourage use of these parameters. In contrast, the limited reproducibility of parameters describing intraventricular time-differences is worrying. Our follow-up studies in CHD patients undergoing corrective surgery with cardiopulmonary bypass, describe a significant decrease in biventricular performance immediately postoperatively. Subsequently, left ventricular performance recovered to control values. In contrast, right ventricular performance remained impaired in most subgroups of CHD patients up to one year postoperatively. Considering the prognostic value of right ventricular performance parameters, these studies underline the need for careful evaluation of both left and right ventricular performance postoperatively. Furthermore, a longer-lasting negative influence of cardiopulmonary bypass on ventricular performance was suggested. Show less
