Available via license: CC BY 4.0
Content may be subject to copyright.
Open Journal of Medical Psychology, 2014, 3, 94-99
Published Online January 2014 (http://www.scirp.org/journal/ojmp)
http://dx.doi.org/10.4236/ojmp.2014.31012
OPEN ACCESS OJMP
The Effectiveness of Life Skills Training on Enhancing the
Self-Esteem of Hearing Impaired Students in Inclusive
Schools
Abbas Mahvashe Vernosfaderani
Department of Psychology, Social Welfare & Rehabilitation Sciences University, and Special Education,
Ministry of Education of Arak Province, Arak, Iran
Email: abasmahvash@yahoo.com
Received October 13, 2013; revised November 13, 2013; accepted November 20, 2013
Copyright © 2014 Abbas Mahvashe Vernosfaderani. This is an open access article distributed under the Creative Commons Attribu-
tion License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited. In accordance of the Creative Commons Attribution License all Copyrights © 2014 are reserved for SCIRP and the owner of
the intellectual property Abbas Mahvashe Vernosfaderani. All Copyright © 2014 are guarded by law and by SCIRP as a guardian.
ABSTRACT
This research investigates the effectiveness of life skills training on enhancing the self-esteem of 8 - 16 years-old
students with hearing impairment in inclusive schools. The sample was included of 54 students with hearing im-
pairment from inclusive school whom their age and IQ were matched. They were randomly divided into an ex-
perimental and a control group (27 students in each group). The participants were assessed by Coopersmith
Self-esteem Inventory (58-items version). The gathered data were analysed using the t-test method through the
SPSS package. The results showed that training life skills to students with hearing impairment promote their
self-esteem. In other words, life skills training is effective for enhancing the self-esteem of hearing impaired stu-
dents in inclusive schools.
KEYWORDS
Hearing Impaired Students; Self-Esteem; Life Skills Training; Inclusive Schools
1. Introduction
Hearing impairment is one of the most common conge-
nital and acquired diseases in children. About 1 - 3 child-
ren in 1000 are affected [1]. Most studies concentrate on
speech and language development and progress in school,
only few studies focus on psychosocial aspects such as
the quality of life, well-being or self-esteem in hearing-
impaired children [2,3]. Reduced participation of these
children in social life results in low self-confidence and
self-esteem and limit the quality of life [4]. Hearing dam-
age can cause secondary problems (perceptual problem,
communication problem, emotional problem, social
problem…) which based on the degree of hearing im-
pairment, the age of child at the onset and child’s intel-
lectual potential, the magnitude of problems may vary [5].
Self-esteem is among the factors that its disturbances
cause negative consequences (Kreitner and Kinicki,
2007). Students as agents of community in educational
settings may suffer different problems in absence of life
skills and self-esteem, since self-esteem as a necessary
item in psychological structure plays several roles in so-
cial-educational functioning of the individual. Children
begin to learn the social skills from early stages in life.
For children to attain the Self-esteem, they not only ac-
quire important social behaviors for interacting with oth-
ers, but also be able to use these skills in ways which are
acceptable to others in their environment [6]. For child-
ren the social skills and Self-esteem are effective skills to
participate in a game, cooperating, communicating and
supporting others [7]. Having conversation, asking ques-
tions and responding to other questions are necessary
skills for the play interaction [8]. Some researchers be-
lieve that communication deficits interfere with young
hearing impaired children’s normal play development
and due to delay in this skill, these children engage in
less social play than hearing children [9]. Self-esteem,
individual and social skills have been introduced as fac-
tors to improve social relations [10] and life skills are
A. M. VERNOSFADERANI
OPEN ACCESS OJMP
95
effective as a collection of these skills. Life skills educa-
tion can promote the social adjustment of the kids and
adolescents [11]. World Health Organization [12] indi-
cates life skills as “abilities for adaptive and positive be-
havior that enable individual deal effectively with the
demand and challenges of life”. The definition of life
skills may differ across culture and settings, however
analysis in this field suggest that these skills (decision
making, problem solving, interpersonal relationship skills,
communication skills…) are necessary for promotion of
the health and well-being of children. Kingsnorth, Healy
and Macarthur [13] were done a systematic review of life
skill programs for youth with physical disabilities and
stated that five of the six studies demonstrated short-term
improvements in targeted life skills. They stated conclu-
sions are limited because of different interventions, skills,
disabilities, and outcome measures with respect to the
effectiveness of the programs. Ahmadian and Fata [14]
on their study examined the effect of life skills education
on children with mild intellectual disability and indicated
that the effect of Life skills education program had posi-
tive effects on Self-knowledge, interpersonal relationship,
and anger-management.
Cunha, Heckman, Lochner & Masterov [15] in their
study stated that Skill formation is a life cycle process. It
starts in the womb and goes on throughout life. There are
many skills and abilities (inherited or acquired) which
are important for individuals’ success. Skill attainment in
one stage of life can lead to attaining the skills in later
stages. Cronin [16] defined life skills as “those skills or
tasks that contribute to the successful, independent func-
tioning of an individual in adulthood” (p. 54). These
skills may be grouped into five categories (aligned with
Halpern’s) [17]: self-care and domestic living, recreation
and leisure, communication and social skills, vocational
skills, and other skills vital for community participation.
The intervention literature indicates there are some effec-
tive interventions for teaching functional life skills to
individual with disabilities, and that there is a link be-
tween life skills acquisition and life quality. When a per-
son’s various life skills increases, his/her independent
functioning, social competence, and quality of life in-
creases too [18,19]. The inclusive education movement
has produced a shift toward accessing regular education
environments, and strategies to facilitate social inclusion,
meaningful participation, and academic learning instead.
Teaching youth with disabilities the skills needed to
function in and succeed beyond school, versus including
these same youth in general education classrooms where
the curriculum is largely focused on academics is prac-
tical [19]. Nunes, Pretzlik and Olsson [20] stated that
deaf pupils may not be rejected in mainstream schools
but they may feel isolated. They could have positive and
negative reactions from other pupils. The likelihood of
deaf pupils being chosen as a friend is smaller than that
of a hearing pupil. The hearing pupils who chose to have
deaf pupil as a friend indicated pro-social reasons for the
friendship, rather than the typical enjoyment and intima-
cy reasons. Huether [21] compared pupils in integration
classes with normal-hearing children in mainstream sch-
ools and with hearing-impaired children in special, non-
integration classes. Pupils in integration classes were
more interested in social contacts and said that the hear-
ing disorders played a much smaller role in their choice
of friends than with pupils in special schools. Pupils in
the integration classes demonstrated the same level of
leisure activities with their peers as normal-hearing pu-
pils, whereas non-integrated hearing-impaired pupils in
special schools. Children in special schools were less as-
sertive, and reached less favorable scores in making fri-
ends, anxiety and emotional mood.
It seems hearing impaired children have some prob-
lems with Self-esteem which cause them difficulties in
their relationships with other pupils and people. They
could learn these skills through good interventional pro-
grams. This study investigates the effectiveness of such a
program (life skills training) on enhancing self-esteem of
students with hearing impairment in inclusive schools.
2. Method
The experimental design with pre-test, post-test with
control group was used in this study. The participants
were 8 - 16 years-old students with hearing impairment,
in inclusive schools of Arak city (N = 73). Among them
Fifty-four students who received Low scores on Cooper
Smith self-esteem Inventory (58-items version) were
selected as the sample. To determine their IQ, Leiter In-
ternational Performance Scale was used. The participants
were matched based on the age and intelligence and ran-
domly assigned to experimental (n = 27 students) and
control (n = 27 students) groups. The experimental group
received life skills training two times a week and each
session took two hours. Life skills training lasted in 7
weeks. Post-test for Cooper Smith self-esteem Inventory
were administered immediately after intervention (Fig-
ure 1). The data were analyzed using the SPSS software
version 16, and the level of significance was set at 0.05
for all tests. T-test was used to compare variables be-
tween the two groups.
3. Instruments
3.1. Coppersmith Self-Esteem Inventory
Coopersmith’s Self-Esteem Inventory (1981) was used to
measure students’ self-esteem. Self-esteem was meas-
ured with the Persian version of the Coopersmith’s Self-
Esteem Inventory (SEI). The SEI form used in this study
is for use in schools and includes 58 items. Fifty of these
items correspond to self-esteem measurement; the re-
A. M. VERNOSFADERANI
OPEN ACCESS OJMP
96
Figure 1. Research design.
maining 8 items were constructed to determine if a par-
ticipant is taking the measure seriously (the “Lie scale”).
It is comprised of 58 unambiguous trait-descriptive sen-
tences to which participants respond by indicating whe-
ther the sentences describe them ) either “like me” or
“unlike me”). These statements describe feelings, opi-
nions, and reactions typical of the various everyday situ-
ations experienced by a college student (Coppersmith,
1975). The SEI is a self-reporting instrument with a test-
retest reliability of 0.88 and a high degree of internal
consistency. The SEI has been widely used in psycho-
logical research. The validity and reliability of this in-
strument are well confirmed. To estimate the reliability
coefficients of the inventory version in Iran, a test-retest
analysis was done on Iranian high school students. Re-
sults showed that the coefficient for the girls was 0.90
and coefficient for the boys was 0.92. Findings of the
study also showed that the validity coefficient of the in-
ventory test was 0.69 for boys’ respondents and 0.71 for
the girls. Furthermore, the coefficient of Reliability for
coppersmiths’ SEI was reported as 0.82 (Cronbach al-
pha), and its internal constancy of the Inventory test was
nearly the same to be after six weeks [22]. In addition,
Poursharifi (1992) utilized spilt-half reliability method in
testing the instrument. It was successfully used on a group
of adolescent respondents where a coefficient is 0.83 was
observed [23].
3.2. Leiter International Performance Scale
The Leiter International Performance Scale was origi-
nated by Russell Graydon Leiter who began work on his
performance scale in March 1927. The first commercial
publication of the Leiter International Performance Scale
appeared in 1940. The Leiter International Performance
Scale have been very widely used for the intellectual as-
sessment of different populations including deaf, intel-
lectually disabled, autistic, speech and language impaired,
non-English speaking, motor-involved, brain injured, and
intellectually superior persons. It is considered highly
correlated with traditional intelligence tests like the
WISC-III Full Scale IQ test. This test was standardized
by Tolooie and Mehdi Valojerdi [24].
4. Procedure
Life Skills Training: On the basis of the past researches
and review of existing programs, a life skills training
program was developed. The Life Skills program is a
comprehensive behavior change approach that concen-
trates on the development of the skills needed for life
such as self-awareness, communication, decision-making,
thinking, managing emotions, relationship skills, daily
living skills, survival skills, choices and consequences,
interpersonal/social skills, eye contact, tone and volume
of speech, conversational skills, and assertiveness. This
intervention program worked on promoting child’s cop-
ing resources, enhancing the social competency and con-
sequently imposing a positive effect on mental health.
Training sessions also focused on teaching skill modules
using brief didactic instruction, behavioral modeling,
role-playing, obtaining direct feedback from therapists,
behavioral rehearsal and assertiveness, accepting com-
pliments and implementing the skills.
5. Results
Homogeneity of variance studied groups according to
age and intelligence were compared using t-test. Ac-
cording to Table 1 using an independent t-test revealed
that there is no statistically significant difference between
the mean age (P = 0.94) and IQ (P = 0.30) in experimen-
tal and control groups.
As it is understood by the Table 2, there is no differ-
ence experimental and control groups in pre-test situa-
tion but the mean scores for experimental group was in-
creased in Post-test.The score for “self-esteem” of the
experimental group increased more than that of the con-
trol group. This difference was statistically significant (T
= −3.59, DF = 52, P = 037) (Table 2). It can be con-
cluded that life skill training can have a positive impact
on effective on increase of self-esteem in hearing im-
paired students.
6. Discussion
For everyone to reach their full potential, a number of
critical life skills must be learned. Specific learning op-
portunities are important for children with special needs.
Inclusive education facilitates an environment and oppor-
tunities for learning social and academic skills. Schools
and teachers could integrate life skills lessons which
Table 1. Compare the experimental and control groups of
homogeneous age and intelligence.
Variable Group N M ± SD DF T Sig.
Age Exp. 27 14.11 ± 1.94 52 0.316 0.94
Con. 27 13.98 ± 1.99
IQ Exp. 27 93.71 ± 6.99 52 0.571 0.30
Con. 27 92.48 ± 6.80
A. M. VERNOSFADERANI
OPEN ACCESS OJMP
97
Table 2. Comparison of self-esteem between experimental and control groups (N = 54).
Variable Group Pre-test Post-test Difference T DF P-Value
Mean Mean Mean (SD)
Self-Esteem Exp. 18.82 29.78 10.96 (3.94) −3.59 52 0.037*
Con. 19.21 22.04 2.83(3.52)
Exp.: experimental; Con.: control. *P < 0.05.
covers social skills training in their curriculum [25]. Self-
esteem and Social skill acquisition relates to the theory of
emotional intelligence [26]. Emotional intelligence is
“the ability to access and interpret a given situation ac-
curately and to manage oneself to relate effectively with
others” [27]. Emotional intelligence includes managing
emotions or self-control, self-awareness, recognizing emo-
tions in others and handling relationships. If the children
tend to be productive, they should manage their feeling
and interact with others [28]. Also Bandura’s social
learning theory can be applied to the social skills devel-
opment of children. This theory emphasizes the impor-
tance of observation, modeling of behaviors, attitudes
and emotional reaction of others [25]. In fact, “social
learning theory explains human behavior in terms of con-
tinuous reciprocal interaction between cognitive, beha-
vioral, and environmental influences” [29]. Halpern [17]
argued that curriculums of schools should be based on
some balance between social norms and the personal pre-
ferences, needs, and choices of the youth. This balance
should help the development of both objective and sub-
jective criteria (physical and material well-being, perfor-
mance of adult roles, and personal fulfillment) and pro-
mote life quality. Life skills instruction addresses each of
these domains, how and where skills are taught; com-
bined with the goals of inclusive education and commu-
nity membership. Practitioners must know utilizing the
settings and methods are not only effective in terms of
instruction, but also enhance community membership and
life quality.
The result of this study indicated that life skills train-
ing is effective in enhancing the self-esteem of hearing
impaired students. This result is consistent with the re-
sults of some other researches in this area. A study on
negotiation training [30] showed that this kinds of train-
ing resulted in stronger changes in overall competence,
with changes in the primary domains of interpersonal
understanding, interpersonal skills, self-esteem, and the
personal meaning of relationships. Some of the social
skills that children may develop are: making friends, in-
itiating conversation, joining social groups… which can
be taught by modeling, social skills exercises, stories and
etc. Development of self-esteem and social skills in hear-
ing impaired child depends on his/her degree of hearing
loss, maturity and the age which he/she was diagnosed,
the treatment, personality with the experiences they have
faced, and the exposure to situation with their peers [5].
Mainstreaming could be difficult for hearing impaired
students due to their delay in self-esteem and having
problems with social aspect of school. Most children
need minimum of instruction to learn these skills but
hearing impaired students may need special and directed
teaching [31]. Teachers can facilitate the self-esteem de-
velopment by promoting the interactions through struc-
turing the classroom activities and using appropriate
techniques [32].
7. Limitations
The sample size could be viewed as a potential limitation.
Since there were only 54 students participating in the
study (in which only 27 students in experimental group),
results of the findings could be difficult to relate to the
population of hearing impaired student. Accessibility to
one scale for rating the self-esteem could be another li-
mitation of this study. The time constraints of the study
could also be an indicator affecting the outcomes. Four-
teen session of the intervention occurred over the course
of seven weeks and the degree of improvement could not
be as expected.
8. Future Research
This study could be expanded to include a larger popula-
tion of students. Further studies resulting from this re-
search could revolve around incorporating any portion of
this program for variety of population. Preparation of this
program based on the needs of students with disabilities
would provide opportunities for their improvements in
specific areas. Schools could apply this program to their
curriculum too.
REFERENCES
[1] E. Seifert, S. Brosch, A. G. Dinnesen, A. Keilmann, C.
Neuschaefer-Rube, O. Goldschmidt, A. Nickisch, W.
Reuter, M. Röhrs and M. Tigges, “Peripheral Hearing
Disorders in Childhood. Results of an Evidenced Based
Consensus Conference,” German Society for and Audi-
ometry and Pediatrics, Vol. 53, No. 4, 2005, pp. 376-382.
[2] M. Huber, “Health-Related Quality of Life of Austrian
Children and Adolescents with Cochlear Implants,” In-
A. M. VERNOSFADERANI
OPEN ACCESS OJMP
98
ternational Journal of Pediatric Otorhinolaryngology,
Vol. 69, No. 8 2005, pp. 1089-1101.
http://dx.doi.org/10.1016/j.ijporl.2005.02.018
[3] E. Jambor and M. Elliot, “Self-Esteem and Coping Strat-
egies among Deaf Students,” Journal of Deaf Studies and
Deaf Education, Vol. 10, No. 1, 2005, pp. 63-81.
http://dx.doi.org/10.1093/deafed/eni004
[4] A. Keilmann, A. Limberger and W. Man, “Psychological
and Physical Well-Being in Hearing Impaired Children,”
International Journal of Pediatric Otorhinolaryngology,
Vol. 71, No. 11, 2007, pp. 1747-1752.
http://dx.doi.org/10.1016/j.ijporl.2007.07.013
[5] R. Patton, “Social Skills Issues of Mainstreaming Hearing
Impaired Children,” Washington University School of
Medicine, St. Louis, 2004.
[6] S. M. Sheridan and D. Walker, “Social Skills in Context:
Considerations for Assessment, Intervention, and Genera-
lization,” In: C. R. Reynolds and T. B. Gutkin, Eds., The
Handbook of School Psychology, 3rd Edition, Wiley,
New York, 1999, pp. 686-708.
[7] S. Oden and S. Asher, “Coaching Children in Social
Skills for Friendship Making,” Child Development, Vol.
48, No. 2 1997, pp. 495-506.
http://dx.doi.org/10.2307/1128645
[8] S. Antia and K. Kreimeyer, “Social Intervention and Ac-
ceptance of Deaf or Hard of Hearing Children and Their
Peers: A Comparison of Social Skills and Familiarity-
Based Intervention,” Volta Review, Vol. 98, No. 4, 1996,
pp. 157-180.
[9] B. Esposito and M. Koorland, “Play Behavior of Hearing
Impaired Children: Integrated and Segregated Settings,”
Exceptional Children, Vol. 55, No. 5, 1989, pp. 412-419.
[10] A. A. Samarei and A. Lalei Faz, “Efficacy of Teaching
Life Skills on Family Stress and Social Acceptance,” The
Quarterly Journal of Fundamentals of Mental Health,
Vol. 7, 2005, pp. 47-55.
[11] J. Maghsoudi, N. Hashemisabour, M. Yazdani and T.
Mehrabi, “The Effect of Acquiring Life Skills through
Humor on Social Adjustment Rate of the Female Stu-
dents,” Iranian Journal of Nursing and Midwifery Re-
search, Vol. 15, No. 4, 2010, pp. 195-201.
[12] WHO, “Life Skill Education for Children and Adoles-
cents in School,” World Health Organization, Geneva
1997.
[13] H. Kingsnorth, S. Healy and C. Macarthur, “Preparing for
Adulthood: A Systematic Review of Life Skill Programs
for Youth with Physical Disabilities,” Journal of Adoles-
cent Health, Vol. 41, No. , 2007, pp. 323-332.
[14] M. Ahmadian and L. Fata, “P02-161 the Effect of Life
Skills Education on Mild Intellectual and Developmental
Disability,” European Psychiatry, Vol. 24, Supplement 1,
2009, p. S851.
http://dx.doi.org/10.1016/S0924-9338(09)71084-3
[15] F. Cunha, J. Heckman, L. Lochner and D. Masterov,
“Chapter 12 Interpreting the Evidence on Life Cycle Skill
Formation,” Handbook of the Economics of Education,
Vol. 1, 2006, pp. 697-812.
http://dx.doi.org/10.1016/S1574-0692(06)01012-9
[16] M. E. Cronin, “Life Skills Curricula for Students with
Learning Disabilities: A Review of the Literature,” Jour-
nal of Learning Disabilities, Vol. 29, No. 1, 1996, pp. 53-
68. http://dx.doi.org/10.1177/002221949602900108
[17] A. S. Halpern, “The Transition of Youth with disabilities
to Adult Life: A Position Statement of the Division on
Career Development and Transition,” Career Develop-
ment for Exceptional Individuals, Vol. 17, No. 2, 1994,
pp. 115-124.
[18] M. Alwell and B. Cobb, “Teaching Functional Life Skills
to Youth with Disabilities,” Executive Summary, 2006.
www.nsttac.org
[19] D. Warnes, M. Sheridan, G. Geske and W. William, “A
Contextual Approach to the Assessment of Social Skills:
Identifying Meaningful Behaviors for Social Competence,”
Psychology in the Schools, Vol. 42, No. 2, 2005, pp. 173-
187. http://dx.doi.org/10.1002/pits.20052
[20] T. Nunes, U. Pretzlik and J. Olsson, “Deaf Children’s
Social Relationships in Mainstream Schools,” Journal of
Deaf Education International, Vol. 3, No. 3, 2001, pp.
123-136.
[21] A. Huether, “Impact of Integrated and Non-Integrated
Schooling of the Hearing Impaired in Special Schools.
Results of a Comparative Survey Students with Special
Emphasis on Results at Regular Schools,” Hearing Edu-
cation, Vol. 55, No. 1, 2001, pp. 28-133.
[22] H. Shokrkon and A. Nisi, “The Effect of Self-Esteem on
Function of Students,” Journal of Psychology, Vol. 1, No.
3, 1995, pp. 25-31.
[23] M. Roghanchi, A. Mohamad, K. Momeni and M. Golmo-
hamadian, “The Effect of Integrating Rational Emotive
Behavior Therapy and Art Therapy on Self-Esteem and
Resilience,” The Arts in Psychotherapy, Vol. 40, No. 2,
2013, pp. 179-184.
[24] A. Tolooie and M. Mehdi Valojerdi, “Standrized Leiter-R
in Persian,” Special Education Organization, 2007.
[25] M. Quigley, “The Effects of Life Skills Instruction on the
Personal-Social Skills Scores of Rural High School Stu-
dents with Mental Retardation,” A Dissertation Presented
to the Faculty of the School of Education, Liberty Uni-
versity, Lynchburg, 2007.
[26] D. Goleman, “Working with Emotional Intelligence,”
Bantam Books, New York, 1998.
[27] S. Kolb and C. Hanley-Maxwell, “Critical Social Skills
for Adolescents with High Incidence Disabilities: Parental
Perspectives,” Council for Exceptional Children, Vol. 69,
No. 2, 2003, pp. 163-179.
[28] Menta, “Clinical Services Model,” Special Education
Services, 2006. www.mentagroup.com
[29] G. Kearsley, “Social Learning Theory (A. Bandura). Ex-
ploration in Learning & Instruction: The Theory into
Practice Database,” 2006.
http://tip.psychology.org/bandura.html
[30] M. J. Nakkula and C. E. Nikitopoulos, “Negotiation Train-
ing and Interpersonal Development: Exploratory Study of
Early Adolescents in Argentina,” Adolescence, Vol. 36,
No. 141, 2001, pp. 1-20.
