Peer victimization experienced by children and adolescents who are deaf or hard of hearing

Parent-reported quality of life in children with cochlear implants differs across countries

Pediatric cochlear implantation affects communication skills and quality of life, specifically how children interact with others and feel about themselves. Numerous studies worldwide examine well-being among pediatric cochlear implant users, but none to date compare condition-specific quality of life across countries. This retrospective study compares parent-reported cochlear implant-specific quality of life summary data across 14 published studies spanning 11 countries and 9 languages. Sample size ranged from 7 to 370 participants, and children across studies varied in mean chronologic age (3.1-12.2 years), implantation age (1.5-4.6 years), and cochlear implant experience (1.3-8.2 years). Parents completed the Children with Cochlear Implants: Parental Perspectives (CCIPP) questionnaire, an instrument assessing parent-reported cochlear implant-specific quality of life, in their home language. Analysis of variance tests were run for each CCIPP subscale across studies using summary data to determine significant differences between published manuscripts. Across countries, parents of children with cochlear implants appraise communication, social relations, and self-reliance most positively, and the effects of implantation and supporting the child least positively. Cross-country analyses revealed a significant effect of study (country) on quality of life ratings in each domain, with the largest differences in the communication domain. Limited access to implant-related accommodations, cultural awareness of hearing loss, and varying parent expectations may explain country differences in parental ratings of quality of life. Culturally sensitive psychoeducation for the entire family may foster improved life satisfaction for pediatric cochlear implant users and their families.

Cyberbullying Among Adolescents with Chronic Illnesses in Thailand: Prevalence and Relationship with Health-Risk Behaviors

BACKGROUND

The use of social media may enhance the quality of life in adolescents living with chronic illnesses but may increase the risk of cyberbullying.

OBJECTIVE

The aim of this study was to estimate the prevalence of cyberbullying among adolescents with chronic illnesses and relationship with health-risk behaviors.

METHODS

This is an online survey of randomly recruited adolescents aged 11 to 18 years with chronic illness managed at Siriraj Hospital, Thailand, during 2019 to 2020. Participants were asked to respond anonymously to validated online questionnaires to evaluate health-risk behaviors, experience with cyberbullying, and depression-screening questions.

RESULTS

Three hundred forty-one participants with a mean age of 15.02 ± 2.17 years (interquartile range 12.8, 17.2) responded. Reported risk behaviors included sexual activity in 42 participants (12.3%) with almost half (47.6%) having practiced unsafe sex. Alcohol drinking and polysubstance use were also found in 8.5% and 1.2%, respectively. 38 (11.1%) felt depressed within the previous 2-week period. 56 (16.4%) had been a cyberbully victim. Among the victims, 25 (44.6%) were also cyberbullies themselves. Chronically ill adolescents were more likely to be a victim of cyberbullying if they knew someone who had also been a victim (adjusted odds ratio [aOR] 5.25 [95% confidence interval [CI] = 1.80-15.29], p < 0.001) or had a positive depression screening (aOR 6.182 [95% CI = 2.41-15.85], p < 0.001). Underlying diseases, age, sex, risky behaviors, and time spent online were not associated with being cyberbullied.

CONCLUSION

Thai adolescents with chronic illness were similar to their healthy peers regarding health-risk behaviors and the likelihood of being a victim of cyberbullying. Screening for risky behaviors, evidence of depression, and online activity during routine medical visits was an opportunity to prevent cyberbullying.

Wellbeing as Capability: Findings in Hearing-Impaired Adolescents and Young Adults With a Hearing Aid or Cochlear Implant

In the Western world, for deaf and hard-of-hearing children, hearing aids or cochlear implants are available to provide access to sound, with the overall goal of increasing their wellbeing. If and how this goal is achieved becomes increasingly multifarious when these children reach adolescence and young adulthood and start to participate in society in other ways. An approach to wellbeing that includes personal differences and the relative advantages and disadvantages that people have, is the capability approach, as developed by Nobel Prize laureate Amartya Sen. Capability is the set of real opportunities people have to do and be things they have reason to value. We interviewed 59 young people, aged 13 through 25, with cochlear implants (37) or hearing aids (22) to capture their capability. We found that their hearing devices enabled them to actively participate in a predominantly hearing society, with few differences between cochlear implant and hearing aid recipients. They did, however, report challenges associated with prejudices and expectations, and with feeling poorly understood, all of which appeared to impact their capability. Through the lens of capability, alleged differences between hearing aid and cochlear implant recipients began to fade. We discuss the implications for initiatives focused on the long-term support young recipients of hearing devices to meet their specific requirements over time.

The association between childhood hearing loss and self-reported peer victimisation, depressive symptoms, and self-harm: longitudinal analyses of a prospective, nationally representative cohort study

BACKGROUND

Childhood hearing loss (HL) predicts poor mental health and is associated with a higher risk of communication difficulties. The relationship of childhood HL with specific types of poor mental health (such as depressive symptoms or self-harm) and peer victimisation remains unclear.

METHODS

We analysed data from the Millennium Cohort Study (MCS), a prospective observational cohort study of children living in the UK at age 9 months and born between 2000 to 2002. Data were available on the children and their families at ages 9 months, then at 3, 5, 7, 11, and 14 years. Participants were 10,858 singleton children with self-reported data on peer victimisation, depressive symptoms, and self-harm at age 14 years. Multivariable logistic regression models were fitted to estimate odds ratios (OR) for HL with peer victimisation, depressive symptoms, and self-harm. HL presence was examined in terms of any HL between ages 9 months and 14 years, as well as by HL trajectory type (defined by onset and persistence). Analyses were adjusted for potential sources of confounding, survey design, and attrition at age 14 years. Interactions between sex and HL were examined in each model and multiple imputation procedures used to address missing data.

RESULTS

Children with any HL had increased odds of depressive symptoms (OR: 1.32, 95% CI: 1.09-1.60), self-harm (1.41, 1.12-1.78) and, in girls only, peer victimisation (girls: 1.81, 1.29-2.55; boys: 1.05, 0.73-1.51), compared to those without HL. HL with later age at onset and persistence to age 14 years was the only trajectory associated with all outcomes.

CONCLUSIONS

Childhood HL may predict peer victimisation (in girls), depressive symptoms, and self-harm. Further research is needed to identify HL trajectories and methods to facilitate good mental health in children with HL.

Clinical utility of smartphone-based audiometry for early hearing loss detection in HIV-positive children: A feasibility study

BACKGROUND

Paediatric human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) often manifests with hearing loss (HL). Given the impact of HL, early detection is critical to prevent its associated effects. Yet, the majority of children living with HIV/AIDS (CLWHA) cannot access hearing healthcare services because of the scarcity of audiologists and expensive costs of purchasing screening equipment. Alternative solutions for early detection of HL are therefore necessary.

AIM

The overall aim of this study was to assess the feasibility of using self-administered smartphone-based audiometry for early HL detection amongst CLWHA.

SETTING

This study was conducted at the paediatrics department of a state hospital in the Eastern Cape province, South Africa.

METHODS

This was a feasibility study conducted amongst twenty-seven (27) CLWHA who were in the age group of 6-12 years. The participants self-administered hearing screening tests using a smartphone-based audiometric test. The primary end-points of this study were to determine the sensitivity, specificity and test-retest reliability of self-administered hearing screening.

RESULTS

The sensitivity and specificity for self-administered screening were 82% and 94%, respectively, with positive and negative predictive values of 90% and 88%, respectively. Moreover, a strong positive test-retest reliability (r = 0.97) was obtained when participants self-administered the screening test.

CONCLUSION

Six- to 12-year-old CLWHA were able to accurately self-administer hearing screening tests using smartphone-based audiometry. These findings show that self-administered smartphone audiometry can be used for serial hearing monitoring in at-risk paediatric patients.

The impact of mild-to-severe hearing loss on the neural dynamics serving verbal working memory processing in children

Children with hearing loss (CHL) exhibit delays in language function relative to children with normal hearing (CNH). However, evidence on whether these delays extend into other cognitive domains such as working memory is mixed, with some studies showing decrements in CHL and others showing CHL performing at the level of CNH. Despite the growing literature investigating the impact of hearing loss on cognitive and language development, studies of the neural dynamics that underlie these cognitive processes are notably absent. This study sought to identify the oscillatory neural responses serving verbal working memory processing in CHL compared to CNH. To this end, participants with and without hearing loss performed a verbal working memory task during magnetoencephalography. Neural oscillatory responses associated with working memory encoding and maintenance were imaged separately, and these responses were statistically evaluated between CHL and CNH. While CHL performed as well on the task as CNH, CHL exhibited significantly elevated alpha-beta activity in the right frontal and precentral cortices during encoding relative to CNH. In contrast, CHL showed elevated alpha maintenance-related activity in the right precentral and parieto-occipital cortices. Crucially, right superior frontal encoding activity and right parieto-occipital maintenance activity correlated with language ability across groups. These data suggest that CHL may utilize compensatory right-hemispheric activity to achieve verbal working memory function at the level of CNH. Neural behavior in these regions may impact language function during crucial developmental ages.

Self-concept of children and adolescents with cochlear implants

OBJECTIVES

Communicative disorders can complicate social interactions and may be detrimental for one's self-concept. This study aims to assess the self-concept of children with Cochlear Implants (CI). Results of educational peer groups (special needs or typical) were compared. Correlations amongst speech perception, language comprehension, self-concept and other study variables are determined.

METHODS

This retrospectively patient file study contained 53 CI participants with a mean age of 14.2 (SD = 2.8). Self-concept was measured with the Dutch language version of the Self-Perception Profile for Children and Adolescents. Proportions of low, normal and high competence scores were compared to a normative sample. Outcomes were analyzed for the total CI group and for the two educational peer groups.

RESULTS

In the Scholastic Competence, Athletic Competence, Physical Appearance and Behavioral Conduct domains larger proportions of high perceived competence levels were found in the CI Total group compared to the hearing normative sample. Children with CIs in the Mainstream educational subgroup were found to have larger proportions of high levels on these domains. Remarkably, children with CI in the Special hearing impaired educational subgroup reported comparable self-concept scores as their hearing peers. Speech perception and language comprehension were positively correlated to Scholastic Competence.

CONCLUSION

This study has shown that self-concept levels of profoundly hearing impaired children with CI are comparable to those of hearing peers. They are generally satisfied with their functioning in various domains. Better speech perception and language comprehension levels are related to higher outcomes in the Scholastic Competence domain.

Bullying and Children who are Deaf or Hard-of-hearing: A Scoping Review

OBJECTIVE/HYPOTHESIS

The goal of this scoping review is to evaluate and synthesize the published research regarding bullying and children who are deaf or hard-of-hearing (DHH).

STUDY DESIGN

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping review (PRISMA-ScR) statement was used as the guideline for conducting this review.

METHODS

This review included studies assessing pediatric (0-21 years) DHH children. Seventy records underwent the initial title-abstract screening, 33 underwent full-text review, and 23 studies met inclusion criteria. During the data extraction process, an additional six were excluded, resulting in a total of 17 evaluated studies.

RESULTS

Of the 17 studies assessed, nine compared peer victimization of DHH children and their hearing peers. Of those, seven studies reported that hearing loss (HL) is significantly associated with increased victimization. Two studies found that HL is significantly associated with decreased bullying perpetration. Notably, bullying in DHH children was not associated with a visible sign of disability, such as a hearing assistive device. Rather, variables such as educational setting, parental, and peer support are more likely to mediate bullying in this population.

CONCLUSIONS

DHH children have a higher risk of peer victimization and may bully others less often than their hearing peers. Studies described the health consequences of bullying in children who are DHH, including sleep issues and anxiety. These consequences may have implications for the patients' overall HL management. Additional research regarding bullying interventions and prevention in this population should be conducted.

LEVEL OF EVIDENCE

NA Laryngoscope, 131:1884-1892, 2021.

Peer victimization and experiences of violence at school and at home among school age children with disabilities in Pakistan and Afghanistan

Background: Children with disabilities are more likely to experience violence or injury at school and at home, but there is little evidence from Central Asia. Objective: To describe the prevalence of disability and associations with peer violence perpetration and victimization, depression, corporal punishment, school performance and school attendance, among middle school children in Pakistan and Afghanistan. Method: This is a secondary analysis of data gathered in the course of evaluations of interventions to prevent peer violence conducted in Pakistan and Afghanistan as part of the 'What Works to Prevent Violence against Women and Girls Global Programme'. In Pakistan, the research was conducted in 40 schools, and disability was assessed at midline in 1516 interviews with Grade 7s. In Afghanistan, the data were from the baseline study conducted in 11 schools with 770 children. Generalized Linear Mixed Modeling was used to assess associations with disability. Results: In Afghanistan, the prevalence of disability was much higher for girls (22.1%) than boys (12.9%), while in Pakistan 6.0% of boys and girls reported a disability. Peer violence victimization was strongly associated with disability in Afghanistan and marginally associated in Pakistan. In Pakistan, perpetration of peer violence was associated with disability. In both countries, disability was significantly associated with higher depression scores. Food insecurity was strongly associated with disability in Afghanistan. Conclusion: Disability is highly prevalent in Afghanistan and Pakistan schools and this is associated with a greater risk of experiencing and perpetrating peer violence. It is important to ensure that all children can benefit from school-based prevention interventions.

Blockchain and IoMT against Physical Abuse: Bullying in Schools as a Case Study

By law, schools are required to protect the well-being of students against problems such as on-campus bullying and physical abuse. In the UK, a report by the Office for Education (OfE) showed 17% of young people had been bullied during 2017–2018. This problem continues to prevail with consequences including depression, anxiety, suicidal thoughts, and eating disorders. Additionally, recent evidence suggests this type of victimisation could intensify existing health complications. This study investigates the opportunities provided by Internet of Medical Things (IoMT) data towards next-generation safeguarding. A new model is developed based on blockchain technology to enable real-time intervention triggered by IoMT data that can be used to detect stressful events, e.g., when bullying takes place. The model utilises private permissioned blockchain to manage IoMT data to achieve quicker and better decision-making while revolutionising aspects related to compliance, double-entry, confidentiality, and privacy. The feasibility of the model and the interaction between the sensors and the blockchain was simulated. To facilitate a close approximation of an actual IoMT environment, we clustered and decomposed existing medical sensors to their attributes, including their function, for a variety of scenarios. Then, we demonstrated the performance and capabilities of the emulator under different loads of sensor-generated data. We argue to the suitability of this emulator for schools and medical centres to conduct feasibility studies to address sensor data with disruptive data processing and management technologies.

Cross-lagged model of bullying victimization and mental health problems in children with autism in middle to older childhood

LAY ABSTRACT

Youth with autism spectrum disorders are disproportionately at risk for bullying victimization compared to typically developing children and adolescents. While internalizing and externalizing mental health problems have been linked to victimization experiences, few studies have examined the longitudinal effects bullying victimization experiences may have on youth mental health outcomes. The present study investigated longitudinal associations between bullying victimization and mental health problems in a sample of children with autism in middle childhood to early adolescence (aged 5 to 12 years). Findings from our study suggest that youth with autism who experienced bullying victimization (versus no victimization) were older in age, had more severe autism symptoms, and higher levels of internalizing and externalizing mental health problems at study onset. Though externalizing mental health problems at study onset (Time 1) did not relate to change in the likelihood of being bullied one year later (Time 2), experiences of bullying victimization did relate to an increase in parent reports of internalizing mental health problems. This study expanded on previous cross-sectional studies by including two waves of data in a relatively large sample of youth with autism and highlights important information that may be helpful in adapting approaches to intervention at the individual level. Moreover, our findings support the need for bullying programs that may need to focus particular attention to subgroups of youth with autism who may be most at-risk for bullying victimization such as those with more autism symptoms and those with past experiences of victimization (given the chronic nature of bullying).

Capability of deaf children with a cochlear implant

INTRODUCTION

The main idea underlying this paper is that impairments such as deafness are particularly relevant to the extent that they lead to deprivation of capability. Likewise, the impact of healthcare services such as cochlear implants and subsequent rehabilitation can best be inferred from the extent that they protect or restore capability of those affected.

METHODS

To explore children's post-implant capabilities, we tested two newly developed digital, adaptive child self-report and parent-report questionnaires in 19 deaf children (aged 8-12 years) and their parents during rehabilitation, as well as in 23 age peers with normal hearing.

RESULTS

Despite the impressive speech-language results that were recorded with cochlear implants, the post-implant capabilities of the deaf children we evaluated differed from those of their hearing peers, with the cochlear implant group appearing particularly disadvantaged in areas such as accessing information, communication, social participation, and participation in school.

CONCLUSION

Deaf children with cochlear implants who are performing well on linguistic and auditory tests can still experience serious limitations in desired functioning. Our findings suggest that a capability approach may reveal aspects of what is being achieved through rehabilitation that might otherwise remain unnoticed, and that could help to further improve the well-being of our patients.IMPLICATIONS FOR REHABILITATIONOverall, children with cochlear implants appeared disadvantaged in certain capability areas, like accessing information, communication, social participation, and participation in school.It may be worthwhile to also ascertain capabilities in these children, representing a domain not covered by clinical measures, tapping directly into areas that are valuable to the patient.

Psychological Distress in Bullied Deaf and Hard of Hearing Adolescents

Bullying victimization at school is an important concern in terms of mental health, in particular, for deaf and hard of hearing (DHH) adolescents who may be more vulnerable than hearing peers. This study determined the prevalence of bullying victimization among DHH adolescents in Taiwan and ascertained the relation of bullying victimization experiences and family and school variables with their psychological well-being. Data were collected from the 2011 Special Needs Education Longitudinal Study database. Multivariate regression analysis was performed on variables comprising seven items measuring psychological distress; four types of bullying victimizations; and family-, school-, and peer-related factors. Approximately 65% of DHH adolescents experienced at least one type of bullying victimization. Factors such as exclusion bullying, female gender, delayed bedtime, conflicts with parents, unfavorable relationship with parents, inability to get along with friends, dislike for school, and bullying victimization experiences increased psychological distress in the DHH adolescents. Bullying victimization of DHH adolescents is a risk factor for poor mental health. However, a good relationship of these adolescents with their parents and peers could be protective for their psychological well-being. Therefore, parents and teachers should understand the needs of DHH adolescents and establish antibullying strategies to diminish their mental health problems.

Cyber-Victimization of People With Chronic Conditions and Disabilities: A Systematic Review of Scope and Impact

The victimization of individuals with chronic conditions or disabilities is prevalent with severe impact at psychological and physiological levels. With the increasing use of technology these experiences were further reshaped. This systematic review aimed at scoping the experiences of cyber-victimization of people living with chronic conditions or disabilities and examine the documented impact on them. Following a four-stage search strategy in several databases including MEDLINE, Embase, PsychINFO, CINAHL, Cochrane and snowballing of references, a total of 2,922 studies were scanned and 10 studies were eventually included. Quality assessment was done in two phases using tools specific to observational studies and cyber-victimization research. A narrative synthesis of reported results covered a total of 3,070 people. Sample size ranged between 42 and 823 participants, and the age range was 6-71 years with a majority of White ethnic backgrounds. Most studies (n=9) were cross sectional. The prevalence range of cyber-victimization was 2%-41.7% based on variable definitions, duration and methods. Targeted conditions included physical impairments, intellectual disabilities and specific chronic diseases. The most common documented impact was psychological/psychiatric, mainly depression followed by anxiety and distress. Somatic health complaints and self-harm were also reported. We concluded that people with chronic conditions and disabilities were consistently at higher risk of victimization with devastating health complications. Research gaps were identified such as the need to address more conditions and acknowledge differences between heterogeneous health conditions. Other recommendations include allowing flexibility and accountability to patients/victims in research design, education on victimization and health consequences, and improving primary care.

GCG, financial architecture on stock return, financial performance and corporate value

Purpose

The purpose of this paper is to observe and analyze the influence of good corporate governance (GCG) and financial architecture on stock returns and financial performance and its implication for corporate value.

Design/methodology/approach

The data were analyzed using generalized structured component analysis. The unit of analysis for this research was LQ45 listed companies at the Indonesian Stock Exchange, taking data from the Indonesia Capital Market Directory (ICMD), and the annual reports and financial reports of these companies. The population researched was as many as 84 companies. For the sample, LQ45 companies with annual reports, financial reports and long-standing, continuous ICMD membership were examined using “purposive sampling.” The research sample was about 22 companies assessed over the course of five years (i.e. 110 samples).

Findings

First, GCG has a significant and negative relationship to stock returns; second, financial architecture has a significant and positive relationship to stock returns, financial performance and corporate value; third, stock returns have a significant and positive relationship to financial performance and corporate value; and fourth, financial performance has a significant and positive relationship to stock returns and corporate value.

Originality/value

The originality of this research is to be found in its examination and analysis of relationships between stock returns and financial performance, which was discovered to be reciprocal, namely, the relationship between the variables occurring affected each other (causality alternating with turning), whereas in previous studies the relationship between variables was unidirectional. Besides the research undertaken before, an analysis was made to understand the influence of GCG on stock returns, corporate value and financial performance. There are differences in the results between studies that support the conjecture that financial architecture has a significant positive effect on financial performance and corporate value, and also that financial architecture has a significant positive effect on financial performance and corporate value. Given those existing differences, this study reexamines the effect of financial architecture on financial performance and corporate value.

Effect of auditory status on visual emotion recognition in adolescents

Adolescents with severe to profound hearing loss who wear cochlear implants (CIs) experience significantly more peer problems compared to peers with typical hearing (TH). Differences in peer social dynamics may relate to perception not only of message content, but also message intent based on a speaker's emotion from visual (e.g. facial expressions) and auditory (e.g. prosody) cues. Pediatric CI users may experience greater difficulty with auditory emotion recognition due to an impoverished signal representation provided by the device, but the effect of auditory status on visual emotion recognition yields conflicting results.

OBJECTIVES

The current study examined accuracy and speed of visual emotion recognition in adolescents with CIs and peers with TH.

METHODS

Participants included 58 adolescents (10-18 years) stratified by auditory status: 34 CI users and 24 TH peers. Participants identified the intended emotion (i.e. happiness, sadness, anger, fear, disgust, and surprise) of static images of faces displayed on a computer screen.

RESULTS

No significant differences by auditory status emerged for response accuracy, response time to all trials, or response time to correct trials. Type of emotion significantly affected both accuracy and response time.

CONCLUSION

Adolescents with CIs show similar accuracy and response time in recognizing static facial expressions compared to TH peers. Future studies should explore the association between visual emotion recognition and social well-being to determine the relationship between emotion recognition and overall quality of life in adolescents with CIs.

Evidences of the association between individual attributes and bullying: a cross-sectional study with adolescents from Florianópolis, Santa Catarina State, Brazil

This study aimed to estimate the prevalence of bullying and to verify the association between nutritional status, demographic and socioeconomic factors, and individual attributes among schoolchildren aged from 11 to 14 years. This is cross-sectional study with a probabilistic sample of 975 adolescents attending public and private schools in Florianópolis, Santa Catarina State, Brazil. Bullying was investigated with a self-administered questionnaire by applying Item Response Theory and dichotomized according to victimization or not. Body mass index (BMI) was classified according to the World Health Organization criteria. Data such as age, school type and location, household income, as well as the education background of the parents were collected by a questionnaire given to the parents. Crude and adjusted analyses were performed using logistic regression. The prevalence of victims of bullying and of overweight/obese adolescents was 13.2% and 29%, respectively. No association was found between bullying and age, sex, school type, mother's education, household income, and overweight/obesity. The crude analysis model indicated that overweight/obese adolescents and those with individual attributes (fat, thin, tall, short, good-looking, ugly, from a different ethnic background, rich, poor, with a disability and/or other) had a greater chance of being bullied. In the analysis model adjusted by household income and stratified by sex, boys were discriminated for being fat, good-looking, ugly, or for having a disability, while girls were discriminated for being fat, tall, short, ugly, rich, poor, among other individual attributes.

Socio-emotional adjustment of adolescents with cochlear implants: Loneliness, emotional autonomy, self-concept, and emotional experience at the hospital

Recent studies have reported contrasting results in the socio-emotional adjustment of Italian adolescents with cochlear implants (CIs). The aim of the present study is to explore the relationship between the socio-emotional adjustment of adolescents with CIs, the quality of their hospital stay, and their age at CI activation. The participants were 29 adolescents with CIs (CI group) and 29 typically developing adolescents (TD group). The Emotional Autonomy Scale, the Loneliness and Aloneness Scale for Children and Adolescents, and the Multidimensional Self-Concept Scale were administered to each participant. The emotional experience reported during the hospital stay was considered for each participant in the CI group. The adolescents with CIs displayed significantly higher levels of loneliness and lower levels of aversion toward aloneness than the TD group participants. Adolescents who had received the CI in preschool displayed a higher level of physical self-concept than adolescents who had received it later. The adolescents' emotional experiences at the hospital were reported to be quite complex and related to their relationships with parents. In summary, the findings point to a specific type of fragility in socio-emotional adjustment-focused on loneliness/aloneness-rather than a general one.

Systematic Review: Bullying Involvement of Children With and Without Chronic Physical Illness and/or Physical/Sensory Disability-a Meta-Analytic Comparison With Healthy/Nondisabled Peers

Objective

To compare levels of victimization and perpetration associated with bullying among children and adolescents with and without chronic physical illnesses and/or physical or sensory disabilities.

Methods

In total, 107 studies were identified using a systematic search in electronic databases and cross-referencing. A random-effects meta-analysis was computed.

Results

Children and adolescents with chronic physical illness or disability were more likely to be victims of bullying in general (odds ratio [OR] = 1.65), particularly physical bullying (OR = 1.47), relational bullying (OR = 1.47), verbal bullying (OR = 1.67), cyberbullying (OR = 1.39), and illness-specific teasing (OR = 5.29). They were also more likely to be bullies in general (OR = 1.28), as well physical (OR = 1.38) and relational bullies (OR = 1.13). The effect sizes varied across different illnesses and disabilities and, in part, by visibility of the disease, school type, and year of assessment.

Conclusions

Although most between-group differences tend to be small, some form of intervention is needed to reduce bullying among children and adolescents with chronic physical illnesses and/or physical or sensory disabilities, and illness-specific weight- and appearance-related teasing in particular.

Hit, Robbed, and Put Down (but not Bullied): Underreporting of Bullying by Minority and Male Students

To tackle adolescent bullying and identify students most vulnerable to being bullied, it is essential to examine both occurrences of bullying behaviors and students' own likelihoods of reporting bullying. This study examines ethnic and gender differences in students' odds of reporting bullying using the Education Longitudinal Study of 2002, a nationally representative study of United States high school sophomores (N = 15,362; ages 15-19; 50.2% female). Compared to White and female students, minority (particularly Black and Hispanic) and male students report comparable or greater experiences of bullying behaviors (such as being threatened, hit, put down by peers, or having belongings forced from them, stolen or damaged), but are less likely to report that they have been "bullied." These findings point to racialized and gendered differences in reporting bullying experiences such that indicators of "weakness" in peer relations may carry a greater stigma for minority and male students.

Parental stress among parents of toddlers with moderate hearing loss

BACKGROUND

The purpose of this study was to examine parental stress in parents of toddlers with moderate hearing loss compared to hearing controls. Furthermore, the associations between parental stress and child- and parent-related factors such as language, social-emotional functioning and social support were examined.

DESIGN

The study sample consisted of 30 toddlers with moderate hearing loss and 30 hearing children (mean age 27.4 months). The two groups were compared using the Nijmegen Parenting Stress Index (NPSI) and parent-reports to rate the amount of social support and the children's social-emotional functioning. Receptive and expressive language tests were administered to the children to examine their language ability.

RESULTS

Parents of toddlers with moderate hearing loss reported comparable levels of parental stress to parents of hearing children. Individual differences in parental stress were related to child- and parent-related factors. Poorer social-emotional functioning and language ability of the child were related to higher stress levels in parents. Parents who experienced less social support reported higher stress levels.

CONCLUSIONS

Parents of toddlers with moderate hearing loss experience no more parental stress than parents of hearing children on average. Given parental stress was found to be related to poorer child functioning, early interventionists should be aware of signs of elevated stress levels in parents.

Traumatization in Deaf and Hard-of-Hearing Adult Psychiatric Outpatients

Deaf and hard-of-hearing persons are at risk for experiencing traumatic events and such experiences are associated with symptoms of mental disorder. We investigated the prevalence of traumatic events and subsequent traumatization in adults referred to specialized psychiatric outpatient units for deaf and hard-of-hearing patients. Sixty-two patients were diagnosed with mental disorders and assessed for potential traumatic experiences in their preferred language and mode of communication using instruments translated into Norwegian Sign Language. All patients reported traumatic events, with a mean of 6.2 different types; 85% reported subsequent traumatization not significantly associated with either residential school setting or communicative competence of childhood caregivers. Traumatization patterns in both sexes were similar to those in hearing clinical samples. Findings indicate that psychiatric intake interviews should routinely assess potentially traumatic events and their impacts, and that mental health professionals working with deaf and hard-of-hearing patients should be able to treat trauma-related disorders.

Interfaces entre família e bullying escolar: uma revisão sistemática

Objetivou-se conhecer e mapear a produção científica que evidencia relações entre o contexto familiar e o envolvimento em situações de bullying escolar, por meio de uma revisão sistemática da literatura. Foram consultadas as bases de dados Lilacs, Web of Science e a biblioteca Scielo. A busca resultou em 54 artigos publicados em português, inglês e espanhol, entre 2008 e 2013, e a análise dos dados permitiu a identificação de sete categorias analíticas: 1) características estruturais; 2) práticas parentais; 3) estilos parentais; 4) clima familiar; 5) sentimentos dos pais em relação aos filhos; 6) saúde mental dos pais; e 7) violências. Constatou-se um predomínio de publicações internacionais e de estudos quantitativos e, no conjunto, verificou-se que algumas características e aspectos familiares estavam associados ao envolvimento de estudantes em situações de bullying. O estudo amplia o olhar interpretativo sobre o fenômeno e suas complexidades com uma abordagem contextual, indicando caminhos para novas pesquisas.

The causes of bullying: results from the National Survey of School Health (PeNSE)

OBJECTIVE

to identify the characteristics and reasons reported by Brazilian students for school bullying.

METHOD

this cross-sectional study uses data from an epidemiological survey (National Survey of School Health) conducted in 2012. A total of 109,104 9th grade students from private and public schools participated. Data were collected through a self-applied questionnaire and the analysis was performed using SPSS, version 20, Complex Samples Module.

RESULTS

the prevalence of bullying was 7.2%, most frequently affecting Afro-descendant or indigenous younger boys, whose mothers were characterized by low levels of education. In regard to the reasons/causes of bullying, 51.2% did not specify; the second highest frequency of victimization was related to body appearance (18.6%); followed by facial appearance (16.2%); race/color (6.8%); sexual orientation 2.9%; religion 2.5%; and region of origin 1.7%. The results are similar to those found in other sociocultural contexts.

CONCLUSION

the problem belongs to the health field because it gathers aspects that determine the students' health-disease-care continuum.

Child maltreatment and trauma exposure among deaf and hard of hearing young adults

The purpose of the present study was to examine the prevalence of child maltreatment and lifetime exposure to other traumatic events in a sample of deaf and hard of hearing (DHH; n=147) and matched hearing (H; n=317) college students. Participants completed measures of child maltreatment (CM), adult victimization and trauma exposure, and current symptoms of posttraumatic stress disorder (PTSD). Overall, DHH participants reported significantly more instances of CM compared to H participants, with 76% of DHH reporting some type of childhood abuse or neglect. Additionally, DHH participants reported experiencing a higher number of different types of CM, and also reported increased incidents of lifetime trauma exposure and elevated PTSD symptoms. Severity of deafness increased the risk of maltreatment, with deaf participants reporting more instances of CM than hard of hearing participants, and hard of hearing participants reporting more instances of CM than H participants. Among DHH participants, having a deaf sibling was associated with reduced risk for victimization, and identification with the Deaf community was associated with fewer current symptoms of PTSD. A regression model including measures of childhood physical and sexual abuse significantly predicted adult re-victimization and accounted for 27% of the variance among DHH participants. DHH participants report significantly higher rates of CM, lifetime trauma, and PTSD symptoms compared to H participants. Severity of deafness appears to increase the risk of being victimized. Being part of the Deaf community and having access to others who are deaf appear to be important protective factors for psychological well-being among DHH individuals.

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.

CONCLUSION

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.

DISCUSSION

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.

[Deaf patients in psychiatry]

Prelingual deafness has multiple and far reaching consequences for the development of language, cognition and the psychosocial dimension. Almost one of a thousand of the population is affected. Barriers in communication limit access to knowledge and participation in society. The use of sign language connects deaf people socio-culturally. This review shows discrepancies between high prevalence rates of mental health disorders with complex psychiatric challenges and barriers to mental health care. The UN convention on the rights of persons with disabilities obliges to counteract these discrepancies. Services with specialised signing professionals and the use of interpreters can improve access to mental health care.