Self-esteem in hearing-impaired children: the influence of communication, education, and audiological characteristics.
OBJECTIVE
Sufficient self-esteem is extremely important for psychosocial functioning. It is hypothesized that hearing-impaired (HI) children have lower levels of self-esteem, because, among other things, they frequently experience lower language and communication skills. Therefore, the aim of this study was to compare HI children's self-esteem across different domains with those of normal hearing (NH) children and to investigate the influence of communication, type of education, and audiological characteristics.


METHODS
This large (N = 252) retrospective, multicenter study consisted of two age- and gender-matched groups: 123 HI children and 129 NH controls (mean age  = 11.8 years). Self-reports were used to measure self-esteem across four domains: perceived social acceptance by peers, perceived parental attention, perceived physical appearance, and global self-esteem.


RESULTS
HI children experienced lower levels of self-esteem regarding peers and parents than NH controls. Particularly HI children who attended special education for the deaf were at risk, even after correcting for their language development and intelligence. Yet, levels of global self-esteem and self-esteem involving physical appearance in HI children equalled those of NH controls. Furthermore, younger age at implantation and longer duration of having cochlear implants (CIs) were related to higher levels of self-esteem.


CONCLUSIONS
HI children experience lower levels of self-esteem in the social domains. Yet, due to the heterogeneity of the HI population, there is high variability in levels of self-esteem.


CONCLUSIONS
Clinicians must always be aware of the risk and protective factors related to self-esteem in order to help individual patients reach their full potential.
Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Stephanie C P M
SC
Theunissen
Department of Developmental Psychology, Leiden University, Leiden, The Netherlands; Dutch Foundation for the Deaf and Hard of Hearing Child, Amsterdam, The Netherlands.
Carolien
C
Rieffe
Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Anouk P
AP
Netten
Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Jeroen J
JJ
Briaire
Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Wim
W
Soede
Department of Developmental Psychology, Leiden University, Leiden, The Netherlands.
Maartje
M
Kouwenberg
Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden, The Netherlands.
Johan H M
JH
Frijns
D000293:Adolescent; D001298:Audiology; D002648:Child; D019929:Cochlear Implantation; D003054:Cochlear Implants; D003142:Communication; D005260:Female; D034381:Hearing Loss / Q000503:physiopathology / Q000523:psychology*; D006801:Humans; D007804:Language Development; D008297:Male; D019986:Persons with Hearing Disabilities / Q000523:psychology* / Q000534:rehabilitation; D012189:Retrospective Studies; D012649:Self Concept; D013997:Time Factors