Bullying in adolescents with hearing loss

1. Bullying in adolescents with hearing loss Andrea Warner-Czyz, Ph.D., CCC-A Betty Loy, AuD

2. 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, ElikaCokely, Kathryn Wiseman, Roshini Kumar • Consulting • Emily Tobey, Nadine Connell • Professionals who recruited • Adolescent participants

3. Reactions to hearing aids and cochlear implants Curiosity Teasing Bullying

4. What is bullying? • Intentional, unprovoked abuse • Imbalance of power • Repetition (though not always) 30% of students (grades 6-10) have been bullied at least once. Smith and Brain , 2000; van Cleave et al., 2006.

5. What is bullying? Being made fun of, called names, or insulted 18% 18% Having rumors spread about you Being threatened with harm 5%

6. What is bullying? Being pushed, shoved, tripped, or spit on 3% Being coerced to do things you did not want to do 6% Having your property destroyed on purpose 5%

7. What is bullying? Being excluded from activities on purpose 3% Had hurtful information posted online (cyberbullying) 9% What does bullying really look like?

8. Effects of bullying • Physical and behavioral problems • Psychosocial and emotional development • Reduced quality of life (QoL) • Self-esteem • Mental health • Academic performance and absenteeism “… lying in bed, in the dark, afraid of going back to school, afraid of seeing the bullies ...” ~ Stuart McNaughton, He is not me McKay et al., 2008; McNaughton, 2013; Willkins-Shurmer et al., 2003.

9. Bullying and hearing loss • Children with hearing loss are at risk for being bullied. • Twice as likely? • 20-30% overall? Similar percentage to typical adolescent population Anmyr et al., 2011; Dalton, 2011; Bauman et al., 2000; Sullivan, 2006.

10. 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 .

11. Bullying and hearing loss Percy-Smith et al. .

12. 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 “… those girls who ridiculed my advances in the cruelest ways possible.” ~ Stuart McNaughton, He is not me Kouwenburg et al., 2012.

13. 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.

14. 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

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

16. Methods • Online survey via Qualtrics • Bullying • School Crime Supplement (SCS) to the national Crime Victimization Survey • Nationally used questionnaire • Instances and frequency of bullying

17. 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?

18. 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?

19. Results: Overall bullying 16% more children with hearing loss vs. hearing peers experience bullying at least once.

20. Results: Types of bullying

21. 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%)

22. Results: Gender differences We expect boys to report higher percentages of physical bullying.

23. Results: Gender differences

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

25. Results: Gender differences We expect girls to report higher percentages of social bullying.

26. Results: Gender differences

27. Results: Gender differences Girls with hearing loss more often experience teasing (31% vs. 19%), coercion (17% vs. 6%), and exclusion (17% vs. 2%).

28. Results: Age differences 62% 50%

29. Results: Frequency of bullying

30. Results: Reason for getting bullied • Do you think you were bullied because of your hearing loss?

31. Results: Reason for getting bullied • Do you think you were bullied because of your hearing loss? • 52.3% said yes.

32. 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.

33. 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.

34. 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

35. 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.

36. 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

37. Future directions

38. 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?

39. Thank you.

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

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

42. 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.

43. 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.

44. 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 Higher proportions of children with special health care needs experience bullying: 43% vs. 32%. Frisen et al., 2010; Olweus, 1978; Hugh-Jones & Smith, 1999; Sullivan, 2006; Van Cleave et al., 2006.