Bullying in adolescents with hearing lossAndrea Warner-Czyz, Ph.D., CCC-ABetty Loy, AuD

Acknowledgments• E. Rhodes and Leona B.

Carpenter Foundation Grant• Dallas Cochlear Implant

Program• Colorado Neurological

Institute Cochlear Kids Camp• Rocky Mountain Ear Center • David Kelsall, Alison Biever

• Data collection• Trissan Jones, Hannah

Pourchot, Elika Cokely, Kathryn Wiseman, Roshini Kumar

• Consulting• Emily Tobey, Nadine Connell

• Professionals who recruited• Adolescent participants

Bullying

Reactions to hearing aids and cochlear implants

Curiosity Teasing

What is bullying?

• Intentional, unprovoked abuse• Imbalance of power• Repetition (though not always)

Smith and Brain , 2000; van Cleave et al., 2006.

of students (grades 6-10) have been bullied at least once.

What is bullying?Being made fun of, called names, or insulted

Having rumors spread about you

Being threatened with harm

What is bullying?Being pushed, shoved, tripped, or spit on

Being coerced to do things you did not want to do

Having your property destroyed on purpose

What is bullying?

What does bullying really look like?

Being excluded from activities on purpose

Had hurtful information posted online (cyberbullying)

Effects of bullying

• Physical and behavioral problems• Psychosocial and emotional development• Reduced quality of life (QoL)• Self-esteem• Mental health

• Academic performance and absenteeism

McKay et al., 2008; McNaughton, 2013; Willkins-Shurmer et al., 2003.

“… lying in bed, in the dark, afraid of going back to school, afraid of seeing the bullies ...”

~ Stuart McNaughton, He is not me

Bullying and hearing loss

• Children with hearing loss are at risk for being bullied.• Twice as likely?• 20-30% overall?

Anmyr et al., 2011; Dalton, 2011; Bauman et al., 2000; Sullivan, 2006.

Similar percentage to typical adolescent population

Bullying and hearing loss

• No significant difference on mean levels of victimization between children with hearing loss and hearing peers.• Self-report vs. proxy report

Kouwenburg et al., 2012; Percy_Smith et al., 2008 .

Percy-Smith et al. .

Bullying and hearing loss

Bullying and hearing loss

• However, children with hearing loss;• Have higher ratings of loneliness• Feel more ignored• Feel socially excluded• Received more mean comments• Reported fewer invitations to parties

Kouwenburg et al., 2012.

“… those girls who ridiculed my advances in the cruelest ways possible.”

~ Stuart McNaughton, He is not me

Bullying and hearing loss

• Previous studies• Expect higher percentages of overall bullying• Do not show higher overall bullying• Show differences in bullying types• Often use ad hoc instruments

• No studies have explored bullying in this population with national data.

Kouwenburg et al., 2012.

Our study

• Do children (10-18 years) with hearing loss experience bullying differently than hearing peers?• Overall percentage of children bullied• Type of bullying• Gender differences • Frequency of bullying• Reason for bullying

Participants

VariableHearing Aids

(n = 11)Cochlear

Implants (n = 44)

Mean age (months)

13.36 (1.75)10-15

12.70 (2.42)8-18

Mean age at Intervention

(months)*

6.25 (1.58)*3-8

42.74 (26.72)*12-108

Mean duration of device use (months)*

157.25 (19.35)125-174

12.64 (34.41)24-168

*Not all participants reported age at intervention or duration of device use.

Methods

• Online survey via Qualtrics• Bullying• School Crime Supplement (SCS) to the

national Crime Victimization Survey• Nationally used questionnaire• Instances and frequency of bullying

Has another student …

• Made fun of you, called you names, or insulted you?

• Spread rumors about you?

• Threatened you with harm?

• Pushed you, shoved you, tripped you, or spit on you?

• Tried to make you do things you did not want to do?

• Excluded you from activities on purpose?

• Destroyed your property on purpose?

• Posted hurtful information about you on the internet?

If they answered yes to any item…• Frequency of occurrence• Once or twice this school year• Once or twice a month• Once or twice a week• Nearly every day• Don’t know

• Notification of an adult• Reason for being bullied• Do you think you were bullied because of

your hearing loss or cochlear implant?

Results: Overall bullying

16% more children with hearing loss vs. hearing peers experience bullying at least once.

Results: Types of bullying

Results: Types of bullying

Being teased: 8% difference (26% vs. 18%)Being coerced: 9% difference (15% vs. 6%)

Being excluded: 13% difference (16% vs. 3%)

Results: Gender differences

We expect boys to report higher

percentages of physical bullying.

Results: Gender differences

Results: Gender differences

Boys with hearing loss more often experience:Coercion (12% vs. 5%)Exclusion (15% vs. 3%)

Results: Gender differences

We expect girls to report higher

percentages of social bullying.

Results: Gender differences

Results: Gender differences

Girls with hearing loss more often experience teasing (31% vs. 19%), coercion (17% vs. 6%), and

exclusion (17% vs. 2%).

Results: Age differences

62% 50%

Results: Frequency of bullying

Results: Reason for getting bullied• Do you think you were bullied because of your

hearing loss?

Results: Reason for getting bullied• Do you think you were bullied because of your

hearing loss?

•52.3% said yes.

Discussion

• Overall rates of being bullied are higher in children with hearing loss (42% vs. 28%).• Children with hearing loss more often endure:• Teasing, coercion, and exclusion.

• These patterns persist across gender, but a higher percentage of girls experience them.• Bullying is highest between 12-15 years of age.• 50% of those who were bullied think it was

because of their hearing loss.

Overall rates of being bullied• Overall rates of being bullied are higher in

children with hearing loss (42% vs. 28%).• Higher than hearing peers• On par with other children with disabilities• Would expect greater difference with

concomitant conditions

Smith and Brain , 2000; van Cleave et al., 2006.

Types of bullying

• Children with hearing loss more often endure:• Teasing, Coercion, Exclusion

• In line with previous research• Feeling more ignored and left out• Receiving more mean comments

Age-related factors

• Bullying is highest between 12-15 years of age• Especially true for social/verbal bullying• Puberty onset• School changes• Social skills

Due et al., 2005; Archer & Cote, 2005; Peskin et al., 2006.

Reason for bullying

• 50% of those who were bullied think it was because of their hearing loss.• 50% of those who were bullied think it was

because of their hearing loss.• How do we know?• Explore why they perceive the hearing loss

as the reason• Did our question bias them?• Examine other indices of predisposition

Future directions

Future directions

• Focus groups• Physical, communicative, social differences?

• Effects of long-term bullying• Protective factors to decrease long-term

consequences• Bullying prevention programs• Develop student bill of rights• Tolerance and diversity• When to start?

Thank you.

Differences in children with hearing loss who do/do not get bullied?

Bullied at least once

Not bullied

Age (years) 12.9 (2.1) 12.6 (2.5)% Female 63% 53%Race

Caucasian 77% 83%African American 10% 3%Asian 7% 3%Native American 10% 0%

Ethnicity (Hispanic) 7% 17%

Differences in children with hearing loss who do/do not get bullied?

Bullying and gender

Girls•Rate QoL more positively through age 10•Social bullying (rumors, exclusion)

Boys•Rate QoL more positively after age 10•Physical bullying (hitting, pushing, etc.)

Frisen et al., 2010; Sullivan, 2006.

Bullying and age

• Instances of bullying decrease with age.• Higher levels in elementary, middle school• Peaks in transition years (e.g., 9th grade)

• However, the TYPE of bullying changes.

Graham et al., 2003; Due et al., 2005; Archer & Cote, 2005; Peskin et al., 2006.

Bullying and differences

• Being different from the majority increases likelihood of being victimized.• Children with observable disabilities• 2-3 times as likely to be bullied• Particularly with chronic conditions• Increased teasing focused on disability• Increased social isolation

Frisen et al., 2010; Olweus, 1978; Hugh-Jones & Smith, 1999; Sullivan, 2006; Van Cleave et al., 2006.

Higher proportions of children with special health care needs experience bullying: 43% vs. 32%.