Social & Emotional Development

Figure 3-4: Relationships of Degree of Long Term Hearing

Loss and Psychosocial Development

Degree of HL Based on Pure Tone Average 500-4000Hz	Possible Psychosocial Impact of Hearing Loss
Normal Hearing -10 - +15 dB HL
Minimal (Borderline)	May be unaware of subtle conversational cues which could cause a child’s comments to be viewed as inappropriate or awkward. May miss portions of fast-paced peer interactions which could begin to have an impact on socialization and self concept. May result in immature behaviour. Child may be more tired than classmates due to the effort of listening.
Mild 26-40 dB HL	Communication barriers beginning to build with negative impact on self esteem as child is accused of “hearing when he/she want to” or “not paying attention”. Child begins to have increasing difficult suppressing background noise; therefore, the learning environment is stressful. Child is more fatigued than peers due to the effort of listening.
Moderate 41-55 dB HL	Communication barriers beginning to build with negative impact on self esteem as child is accused of “hearing when he/she want to” or “not paying attention”. Child begins to have increasing difficult suppressing background noise; therefore, the learning environment is stressful. Child is more fatigued than peers due to the effort of listening.
Moderate 41-55 dB HL	Often with this hearing loss communication is significantly affected; socialization with peers with normal hearing becomes increasingly difficult. With full-time use of hearing aids/FM system child may be judged as a less competent learner. There is an increase in impact on self-esteem.
Moderate-Severe 56 – 70 dB HL	Full-time use of hearing aids/FM system may result in child being judged by both peers and adults as a less competent learner, resulting in poorer self-concept, social maturity and sense of rejection. Inservice to address these attitudes may be helpful
Severe 71 – 90 dB HL	Child may prefer other children with hearing losses as friends. This may further isolate the child from the mainstream, however, these peer relationships may foster improved self-concept and a sense of cultural identity. Child may experience embarrassment and low self-esteem by being singled out and receiving special support. Child is becoming increasingly aware of personal difference
Profound 91 dB HL or more	Depending on comfort with auditory/oral communication, peer, parental acceptance of hearing loss and communication child may prefer association with signing deaf peers and culture. The child’s feeling of isolation from or belonging to hearing world depends on comfort with auditory/oral communication. Parental acceptance of the hearing loss and effectiveness and depth of communication will impact on the child’s acceptance of own hearing loss and other factors such as confidence and self-esteem. Child may prefer association with signing peers and Deaf culture. Child may experience embarrassment and low self-esteem by being singled out and receiving special support. Child is becomingincreasingly aware of personal differences.
Unilateral One normal hearing ear; one ear with a permanent mild HL or greater.	Child may be accused of selective hearing due to discrepancies in speech understanding in quiet versus noise. Will be more tired in a classroom setting due to greater effort needed to listen. May appear inattentive or frustrated with behaviour problems sometimes appearing.

Adapted from: Bernero, R.J. & Bothwell, H. (1966). Relationships of hearing Impairment to educational needs. Illinois Department of Public Health and Office of the Superintendent of Public Instruction. Unit III: Intellectual, Social, and Emotional Development and Hearing Loss