Though research has explored the experiences of signing children with severe to profound hearing impairments, children with milder hearing losses have largely been excluded from investigations. Evidence suggests that children with hearing impairments have an increased risk of developing emotional and behavioural problems. A paediatric conceptual model was modified to integrate generic with hearing-related factors, and together these were hypothesised to predict children's levels of difficulties. Thus, this study aimed to investigate the levels of emotional and behavioural difficulties in mainstreamed children with hearing impairments, their association with psycho-social factors and the extent to which their effects were mediated by children's self-cognitions. Results suggest that a large proportion (51%) of participants had clinically significant emotional and behavioural difficulties, the majority of these being internalising problems. Of the predicted associations, classmate social support and maternal awareness of children's attitudes to having a hearing loss independently predicted externalising behaviour and depressive symptoms. Family cohesion, conflict, organisation and expressiveness predicted internalising behaviour. The self-cognitions of global self-worth, physical appearance and communicative competence partially mediated the effects of maternal awareness and classmate social support, though not of the family environment. The mechanisms by which these associations operate are speculated on and theoretical and clinical implications are discussed.