# A Virtual Reality Platform for Evaluating Deficits in Executive Functions in Deaf and Hard of Hearing Children—Relation to Daily Function and to Quality of Life

## TL;DR

This study explores how hearing loss in children affects their executive functions and quality of life using a virtual reality platform.

## Contribution

The study introduces a virtual reality platform to assess executive functions in deaf and hard-of-hearing children and links them to quality of life.

## Key findings

- D/HH children showed significantly poorer executive functions and reduced quality of life.
- Executive function difficulties were correlated with lower quality of life in D/HH children.
- BRIEF scores were significant predictors of quality of life domains in D/HH children.

## Abstract

Background: Childhood hearing loss is a common chronic condition that may have a broad impact on children’s communication and motor and cognitive development, resulting in functional challenges and decreased quality of life (QoL). Objectives: This pilot study aimed to compare executive functions (EFs) as expressed in daily life and QoL between deaf and hard-of-hearing (D/HH) children and children with typical hearing. Furthermore, we examined the relationship between EFs and QoL in D/HH children. Methods: The participants were 76 children aged 7–11 yr: 38 D/HH and 38 with typical hearing. Parents completed the Behavior Rating Inventory of Executive Function (BRIEF) and Pediatric Quality of Life Inventory (PedsQL), while the child performed a shopping task in the virtual action planning supermarket (VAP-S) to reflect the use of EFs in daily activity. Results: D/HH children showed significantly poorer EFs (as measured by BRIEF and VAP-S) and reduced QoL. Difficulties in EFs were correlated with lower QoL. BRIEF scores were significant predictors of QoL domains. Conclusions: Difficulties in EFs may characterize children with D/HH and reduce their QoL. Therefore, EFs should be screened and treated. VAP-S and BRIEF are feasible tools for evaluating EFs that reflect children’s challenges due to EF difficulties in real-life contexts.