|Year : 2015 | Volume
| Issue : 1 | Page : 8-11
The psychosocial consequences of severe deafness and the modifying effect on the socioeconomic position in a special education institution setting: A pilot study
Sanyaolu Alani Ameye, Adekunle Adeyemo, Josephine Eziyi, Yemisi Amusa, Grace Ogunniyi, Bright Otoghile
Department of Otorhinolaryngology-Head and Neck Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun, Nigeria
|Date of Web Publication||13-Jan-2016|
Sanyaolu Alani Ameye
Department of Otorhinolaryngology-Head and Neck Surgery, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun
Source of Support: None, Conflict of Interest: None
Objective: To study the psychosocial consequences of severe deafness and the effects on the socioeconomic position of the affected individuals. Methods: A cohort study of a deaf student attending a special education secondary school for the deaf and some of their teachers were randomly selected for the study. Sociodemographic characteristics, self-reported deafness, employment situation, and financial conditions, psychosocial consequences such as social isolation, denial of privileges, educational attainment, the level of achievement, and satisfaction with life were assessed using a semi-structured questionnaire. Results: All the participants had severe to profound hearing loss, and all of them could communicate by sign language. Adverse psychosocial consequences were found in this study population. A significant percentage was not satisfied with their current placement. A significant percentage reported limitation in their achievements and more than a third of them admitted to having been denied privileges as a result of being deaf. Social isolation was a major source of worry for 70% of the respondents and close to 40% admitted to being angry mainly because of the attitude of the society towards them. Underemployment was found in 44%, of the sampled population. Conclusion: Hearing impaired individuals are faced with economic and psychosocial adverse consequences. Labor market and educational policies must take into consideration these challenges to integrate this segment of our population into the active, productive sector of the economy.
Keywords: Deafness, poverty, psycho-social effects, special education
|How to cite this article:|
Ameye SA, Adeyemo A, Eziyi J, Amusa Y, Ogunniyi G, Otoghile B. The psychosocial consequences of severe deafness and the modifying effect on the socioeconomic position in a special education institution setting: A pilot study. J Indian Speech Language Hearing Assoc 2015;29:8-11
|How to cite this URL:|
Ameye SA, Adeyemo A, Eziyi J, Amusa Y, Ogunniyi G, Otoghile B. The psychosocial consequences of severe deafness and the modifying effect on the socioeconomic position in a special education institution setting: A pilot study. J Indian Speech Language Hearing Assoc [serial online] 2015 [cited 2022 Jan 25];29:8-11. Available from: https://www.jisha.org/text.asp?2015/29/1/8/173859
| Introduction|| |
Hearing loss (HL) is one of the causes of chronic health condition. In the USA, HL is the third most prevalent chronic condition after arthritis and cardiovascular disease.  Beyond the disability experienced by the individuals with hearing impairment, there are secondary effects such as adverse social and economic consequences.  It is known that even after obtaining requisite training and securing employment, failure of effective interaction at workplace usually causes individuals with hearing impairment to make more mistakes and be less productive in the workplace. This ultimately leads to lack of employment or lower income.  Psychosocial disturbances such as social stigma, loneliness, low self-esteem, anxiety, and depression have also been found to be an issue with the hearing impaired.  These highlighted psychosocial problems may also lead to a reduction in performance on a job, denial of opportunities or privileges. 
The stereotypic image of people who are hearing impaired as being frail in body and mind, rude, slow, or stupid also has negative consequences. , In children language deficit usually leads to communication difficulties which results in learning problems, reduced academic achievement, and low self-esteem. Moreover, deaf children may not benefit from government policies such as national free primary education since their special needs are not usually addressed in such programs. 
This pilot study aims to document the prevalence of these adverse traits in our study population with the hope of drawing attention to them. Paying attention to them will allow appropriate intervention to be deployed.
| Methods|| |
Fifty respondents were randomly selected from a special education institution located in the North-Central part of Nigeria. There were 36 males and 14 females selected. The special education institution is at the secondary/tertiary school level, and the setting is that some of the students also work either in the institution as teaching assistance and artisan or outside the institution. The selection was made by balloting among the target population. A semi-structured questionnaire containing questions about the age, sex, living conditions such as employment situations, labor market placement, educational level, financial condition, and psychosocial situations was given the respondent.
Social consequences were evaluated by financial difficulty, economic inactivity, and unemployment. Assessment of economic inactivity was made in a subject without any kind of employment such as full time housewife and full time students. Unemployment concerns people who are actively looking for a job, while financial difficulty was measured by the respondents' affirmative answer to having difficulties with either paying rents, buying food or paying for school accommodation. The data were analyzed using SPSS for Windows, version 16.0. (SPSS Inc., Chicago) and the results presented using frequency tables and percentages.
| Results|| |
Of the 50 questionnaires distributed, one was not returned such that at the end of the study, there were 35 males and 14 females. The mean age was 22.19 ± 7.07. Thirty-eight (76%) are yet to complete secondary education, 10 (20%) were Secondary School Certificate holder and only 2 (4%) had tertiary education.
Seventeen (34%) respondents were currently employed, and only 2 (11.8%) of the employed population affirmed that they have job satisfaction. In the 15 (88.2%) without job satisfaction, the reason for the dissatisfaction was due to low pay and low placement as a result of their deafness. Economic inactivity was found in the 66% of the respondents.
Difficulty in paying rents was found in 23 (46%) while difficulty in paying for food expenses was reported in 29 (58%).
Adverse psychosocial consequences
Social isolation was reported in 36 (72%) of the respondent, limitation of attainment was found in 35 (70%), depression (being fed up with life) was expressed by 30 (60%) of the respondents while anger was affirmed in 18 (36%). Majority of the respondents who admitted to being angry claimed that their anger was based on the attitude of the society to the deaf. It was said that the "society does not reckon with the deaf people." Lack of confidence or low self-esteem was experienced by 22 (44%).
Nineteen (38%) of the respondents had experienced denial of privileges. These denials include lack of promotion and low wages and outright exclusion from an employment opportunity as a result of deafness. Not having a better choice of school to attend was also considered to be a denial of privileges by some of the students. Thirty-four (68%) respondents described themselves as very friendly persons while 25 (50%) of the study population believed they could have achieved more if they were not to have severe deafness. The two respondents with tertiary education who happened to be teachers admitted to being happy and believed that they were as good as any hearing individual. They were also satisfied with their life achievements. In general, all the respondents wanted the hearing society to have a positive attitude to the deaf population.
| Discussion|| |
HL has been associated with poverty.  The relationship can be causal, consequence or both. Although several studies have been done in the past 30 years to demonstrate the psychosocial and socioeconomic effect of HL, none these studies were done in this environment.  This survey is a preliminary report of an attempt to show this relationship in our setting.
In this study, the prevalence of adverse socioeconomic factors in this population was generally found to be high. More than three-quarter are yet to complete secondary education while only 2 completed tertiary education. Respondents who were students were found to be older when compared with the average age of students in the same educational level in the hearing population. A study in Sweden by Danermark et al., showed similar finding in that the percentage of hearing impaired students who continue their education at a postsecondary level is much lower than their normal hearing peers.  The study also showed that, in addition to educational difficulties related to hearing impairment, it is much more difficult for hard of hearing students in upper secondary education to cope with changes in objectives and educational goals than their hearing peers.  Another factor which could be responsible for this slow educational attainment are the low expectations from their teachers such that the levels of instruction were low. 
On the positive side, however, the two respondents who completed their tertiary education seemed to be happy about their stations in life. This raises a question of whether completion of tertiary education may help to attenuate the psychosocial issues experienced by the hearing impaired and we hope a larger study will help explore this.
Job dissatisfaction among the employed population was high, and the reason for the dissatisfaction was said to be due to deafness which caused them to be placed low in the workforce with consequent poor pay. Thus, financial difficulties as manifested by difficulty in paying rents was found in close to half of the respondents and difficulty in paying for food expenses clearly found in more than half of these respondents. The authors, however, appreciate the facts that these parameters for measuring financial difficulty may have underestimated the actual figure as some of the respondents being students will still be dependent. These adverse social, economic factors will ultimately lead to the worsening of the poverty level in the individual sufferers and of course in their entire households. This has clearly been demonstrated as reflected in various studies summarized by Shield in her work on this subject matter. 
Effective communication at the place of work is essential for effective interaction among workers or indeed any organization. Failure of effective interaction usually causes individuals with hearing impairment to make more mistakes, be less productive and this ultimately leads to lack of employment or lower salaries thus worsening the poverty level.  HL affects not only communication but, in addition, it affects the overall quality of life. 
The psychological burden such as social isolation, loss of self-esteem, loneliness, and anxiety are major effects of hearing impairment.  These effects may lead to loss of performance on a job, denial of opportunities/privileges.
We found in our study population the psychiatric disorders associated with deafness. Mental illness has been found to occur more in individuals with disabling hearing impairment. 
Programs aimed at prevention of deafness and HI should include, raising the awareness about the prevalence of adverse socioeconomic factors as well as the psychosocial consequences of disabling hearing impairment. This will help to shape interventional policies that would ensure the provision of adequate educational needs, as well as labor strategies that will absorb the sufferers into productive economic sectors thus leading to poverty reduction as well as improved quality of life.
| Conclusions|| |
Hearing impairment is associated with the adverse socioeconomic condition, and psychological burden that can lead to a reduction in the total health, quality of life and that can worsen poverty in our community. We recommend a larger multicenter study to examine these effects further so as to call attention to this phenomenon.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Lin FR, Niparko JK, Ferrucci L. Hearing loss prevalence in the United States. Arch Intern Med 2011;171:1851-2.
Arlinger S. Negative consequences of uncorrected hearing loss - A review. Int J Audiol 2003;42 Suppl 2:2S17-20.
Shield B. Evaluation of the Social and Economic Costs of Hearing Impairment. A Report for Hear-It. Brussels: Hear-it AISBL; 2006.
Béria JU, Raymann BC, Gigante LP, Figueiredo AC, Jotz G, Roithman R, et al.
Hearing impairment and socioeconomic factors: A population-based survey of an urban locality in southern Brazil. Rev Panam Salud Publica 2007;21:381-7.
McKenna L, O'Sullivan A. Psychological aspects of acquired hearing loss. Graham JM, Baguley DM, editors. United Kingdom: John Wiley and Sons; 2009. 258-71.
Kiyaga NB, Moores DF. Deafness in sub-Saharan Africa. Am Ann Deaf 2003;148:18-24.
O'Neil G. Hearing loss: A growing problem that affects quality of life. Chronic and Disabling Conditions 1999;2:1-6.
Danermark B, Antonson S, Lundström I. Social inclusion and career development - Transition from upper secondary school to work or post-secondary education among hard of hearing students. Scand Audiol Suppl 2001;30:120-8.
Haualand H, Grnningsµter A. Uniting divided worlds: Identity, family and education in the life projects of deaf and hard of hearing young people. Disabil Stud Q 2003;23:75-88.
Mohr PE, Feldman JJ, Dunbar JL, McConkey-Robbins A, Niparko JK, Rittenhouse RK, et al.
The societal costs of severe to profound hearing loss in the United States. Int J Technol Assess Health Care 2000;16:1120-35.
Rutman D. The impact and experience of adventitious deafness. Am Ann Deaf 1989;134:305-11.