How can those involved in the care of children with hearing loss identify those at risk of low self-esteem? This study provides some guidance. Overall differences from hearing peers in terms of communication skills, physical appearance and social maturity place this group at risk. The authors of the study explore the effect of generic and specific factors on self-esteem in children and adolescents with hearing loss. Fifty children with cochlear implants (38) or hearing aids (12) were assessed using interview questionnaires that included validated questionnaires on communication skills, social engagement, temperament and self esteem. The age range of the children was eight to 18 years (mean 12.88, SD=2.32) with an almost equal ratio M:F. Mean age for fitting of the device was 3.43 years (SD=2.28. Age 8m - 9yrs).

Interestingly the findings in the study were that this particular group rated their self-esteem slightly but significantly more positively than typically developing children. Temperament and behaviour characteristics were the only factors that correlated with self esteem appraisal. Greater affiliation and attention had a positive effect whilst depressive mood had a negative effect. The authors highlight early implantation and device use as a factor that would potentially explain the positive result. A proportion of participants with cochlear implants were chosen from a cochlear implant summer camp which in itself would provide a positive environment and would include children who are well supported overall.

The recommendation for professionals working with children with hearing loss is that they should pay attention not only to communication performance but also quality of life. A full assessment of factors affecting self-esteem would identify those at greater risk of lower self-esteem. This in turn would allow for earlier referrals to the required services and for appropriate support mechanisms to be accessed. 

Self-esteem in children and adolescents with hearing loss.
Warner-Czyz A, Loy B, Evans C, et al.
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Ameera Abdelrahim

City Hospital Birmingham, UK.

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