Problems in social functioning are frequently noted in the literature with respect to deaf or hard-of-hearing children. Yet, their emotional development is a severely understudied area, even though an impaired emotional development is likely one of the underlying factors for problems in the social domain. Within our lab multiple research projects are being conducted aimed at studying various aspects of social-emotional development, and involving different age groups. These projects are conducted in close collaboration with the ENT department of the LUMC and with the NSDSK.

Outcomes of the various projects listed below are published in (inter)national journals. See our list of publications on deafness.



Social cognition in infancyeye tracker

Deaf and hard-of-hearing children often experience difficulties concerning their theory of mind development. To date, most of the studies reporting this outcome were conducted with children age four or over. Yet, eye tracking makes it possible to assess children's socio-cognitive skills at a much earlier age. This technology provides the opportunity to assess whether deaf and hard-of-hearing children aready show impaired theory of mind in infancy or whether this develops later on as a result of impaired communication.

Besides theory of mind, we also study early moral development by examining whether deaf and hard-hearing infants differ from their hearing peers concerning their sense of fairness. In addition, we examine if and how early parent-child interaction is associated with infants' socio-cognitive abilities.

Researchers involved: Lizet Ketelaar, Evelien Broekhof, Carolien Rieffe 

This research is a collaboration with Professor Luca Surian from Trento University, Italy.


The origins of emotion control

In order to interact with others properly, you need to be able to control your emotions. This involves the ability to acknowledge your own emotions and to know how to communicate these most effectively. For deaf and hard-of-hearing children this seems to be problematic but the origins of this lack of emotion control are unclear. Are these children more easliy aroused than their hearing peers? Do they lack insight into the communicative function of emotions? By using mood induction techniques and by varying the salience of a goal (i.e., reaching a personal or a social goal) we aim to study the origins of emotion control.

Researchers involved: Carolien Rieffe


Social-emotional outcomes following cochlear implantationCI meisje

Most deaf and severely hard-of-hearing children nowadays receive a cochlear implant. The literature has clearly proven that cochlear implants benefit children's language development. But what about its effect on social-emotional development? In a longitudinal study, multiple components of social-emotional functioning are examined in a sample of 1- to 5-year-old children with cochlear implants. Results thus far show that children with cochlear implants behave just as empathically towards others as hearing children. Yet, they fall behind on understanding others' emotions, theory of mind and moral development. We are currently examining how early (impairments in) emotional skills relate to later social functioning and psychopathology.

Project website: Emoties 1 tot 5 (in Dutch)

Researchers involved: Lizet Ketelaar, Carolien Rieffe, Anouk Netten

Funding: This research is funded by ZonMw.

Key publications:

  • Ketelaar, L., Rieffe, C., Wiefferink, C.H., & Frijns, J.H.M. (2013). Social competence and empathy in young children with cochlear implants and with normal hearing. The Laryngoscope, 123, 518-523.
  • Wiefferink, C.H., Rieffe, C., Ketelaar, L., De Raeve, L., & Frijns, J.H.M. (2013). Emotion understanding in deaf children with a cochlear implant. Journal of Deaf Studies and Deaf Education, 18,175-186.
  • Ketelaar, L., Rieffe, C., Wiefferink, C.H., & Frijns, J.H.M. (2012). Does hearing lead to understanding? Theory of mind in toddlers and preschoolers with cochlear implants. Journal of Pediatric Psychology, 37, 1041-1050.
  • Wiefferink, C.H., Rieffe, C., Ketelaar, L., & Frijns, J.H.M. (2012). Predicting social functioning in children with a cochlear implant and in normal-hearing children: The role of emotion regulation. International Journal of Pediatric Otorhinolaryngology, 76, 883-889.


Social-emotional outcomes in deaf and hard-of-hearing teenagers

Deaf and hard-of-hearing children are known to more often experience social difficulties and are at higher risk for psychopathology. This research aims to address which aspects of emotional functioning contribute to social development and to (symptoms of) psychopathology. In a longitudinal study, a group of 9- to 15-year-old deaf and hard-of-hearing children is compared to a group of hearing peers. Results thus far confirm that deaf and hard-hearing children experience higher leveld of anxiety and depression.

Project website: Kind en emotie (in Dutch)

Researchers involved: Carolien Rieffe, Stephanie Theunissen, Maartje Kouwenberg

Funding: This research is funded by a NWO Vidi grant to Carolien Rieffe.

Key publications:

  • Theunissen, S.C.P.M., Rieffe, C., Kouwenberg, M., De Raeve, L.J., Soede, W., Briaire, J.J., Frijns, J.H.M. (2014). Behavioral problems in school-aged hearing-impaired children: the influence of sociodemographic, linguistic, and medical factors. European Child & Adolescent Psychiatry, 23, 187-196.
  • Rieffe, C. (2012). Awareness and regulation of emotions in deaf children. British Journal of Developmental Psychology, 30, 477-492.
  • Theunissen, S.C.P.M., Rieffe, C., Kouwenberg, M, De Raeve, L., Soede, W., Briaire, J.J., & Frijns, J.H.M. (2012). Anxiety in children with hearing aids or cochlear implants, compared to normally hearing controls. The Laryngoscope, 122, 654-659.
  • Theunissen, S.C.P.M., Rieffe, C., Kouwenberg, M, Soede, W., Briaire, J.J., & Frijns, J.H.M. (2011). Depression in hearing-impaired children. International Journal of Pediatric Otorhinolaryngology, 75, 1313-1317.


Participatory Video

(project concluded)video1

The project Hoe laat ik mijn wereld zien? (i.e., How do I show my world?) is a collaboration of our research group with trainer Ivet Pieper and the NSDSK. In this project, we develop a methodology to strengthen deaf and hard-of-hearing children's capacities by using participatory video methods (PV). PV strengthens children's capacity for emotional self-reflection and may have positive effects on their social and emotional development. The children who participate in this project learn how to create videos about their school, the classes they attend or the friends they play with. Through video, these children will become more aware of their own behaviour, how they present themselves, and the effect this has on others.

Project website: Dove kinderen maken video (in Dutch)

Researchers involved: Carolien Rieffe, Neeltje van den Bedem

Funding: This project is funded by VSB Fonds, Revalidatie Fonds, Maatschappij tot Nut van 't Algemeen

Key publications:

  • Rieffe, C., Pieper, I., Van den Bedem, N., Wolthuis, K, De Vries, M., & Uilenburg, N. (2014). Kijk mij nou; Participatieve Video met dove en slechthorende kinderen om sociaal bewustzijn te bevorderen. Van Horen Zeggen, 55, 10-18.


News Archive Deafness

Understanding Emotion Processing in CI Children Cross-Culturally

CTP pilot5

Deaf children with a cochlear implant (CI) have an altered auditory experience that limits their access to the social world, yet it remains unknown how this limitation affects their processing of emotions. Our new project aims to tackle this question by comparing between CI and hearing children in The Netherlands and in Taiwan. We are happy that on 15 March 2017 we started data collection in the Netherlands for the first part of the project — facial emotion processing! Through eye-tracking technology, we will be able to understand how children, with and without hearing loss, process emotional cues from faces. In Summer, Yung-Ting will go back to Taiwan and collaborate with Chang-Gung Memorial Hospital, which has one of the largest CI centers in Taiwan, for data collection.

Lecture in Birmingham

EvelienB Birminham Jan2017

On 9 January 2017, Evelien Broekhof gave a lecture for a Hearing Impairment programme at the University of Birmingham, UK. The programme is designed for teachers of the deaf. Evelien's session, Learning emotions in children and adolescents with hearing loss, focused on the emotional competence in DHH group. The lecture was very well-received. In the picture, Evelien is with programme leader Dr. Emmanouela Terlektsi (right) and co-coordinator Angela Wootten (left).

  Paper Published: Empathy in Toddlers with Moderate Hearing Loss


Our latest findings on empathy in toddlers with moderate hearing loss have recently been published by the Journal of Deaf Studies and Deaf Education! The study was done by Evelien Dirks, Lizet Ketelaar, Rosanne van der Zee, Anouk Netten, Johan Frijns, and Carolien, and was a collaboration between our lab at Leiden University, the University Hospital (LUMC), and Dutch Foundation for the Deaf and Hard of Hearing Child (NSDSK). The results show that toddlers with moderate hearing loss and with hearing have similar levels of affective empathy, yet toddlers with moderate hearing loss lag behind on some precursors of cognitive empathy, such as intention understanding and joint attention. It suggests that toddlers with moderate hearing loss are at risk for problems in their empathy development. Although they are aware of other people's emotions, they show a delayed development of more complex skills required for an adequate empathic response in comparison with their hearing peers. 


Discussion on DHH children at NSDSK 30 November 2016
Royal Kentalis Knowledge Day 26 November 2016
Lecture in Liverpool on social-emotional development of deaf children 24 October 2016
Two new PhD projects on children with hearing impairments
25 September 2016
Childhood hearing loss and parental stress
02 June 2016
Early signs of psychopathology
01 June 2016
Less moral emotions in children with CI
04 November 2015
Book release: Educating deaf learners
16 September 2015
Conference on Implantable Auditory Prostheses (CIAP)
17 August 2015
Anouk speaking in Belgium and Germany
06 May 2015
Paper in press: Empathy in DHH adolescents
23 March 2015 
Paper in press: Moral emotions in children with CI
10 Februari 2015
Sign language app
03 November 2014
BPS Developmental Congress
03 September 2014
CI conference in Munich
01 July 2014
Paper in press
27 March 2014
Teaching deaf learners
27 March 2014
Successful symposium
10 December 2013
Kirsten in Copenhagen
02 December 2013
Paper accepted
18 September 2013
Talks from Kentalis symposium
28 March 2013
Participatory video project
14 April 2013
New project
20 December 2012
Kentalis symposium
12 March 2012
Paper accepted
14 November 2012