Self-concept and self-esteem among children and young adults with visual impairment: A systematic review

Figures & data

Table 1. Characteristics of the evaluated studies of self-esteem and self-concept

Author(s) (Publication year)	Methods^1				Main results (Quality rating according to the Quality Assessment Tool for Studies with Diverse Designs (QATSSD))
	Sample	Main measurements	Definition of VI^2	School type
Country
Datta and Talukdar (2016)	25 VI	Tennessee Self-Concept Scale (TSCS)	Visual acuity from 6/18 or less to 3/60 and less (blind)	Specialist and mainstream	No differences between gender and scores on self-concept. The majority of the students with VI scored low on all dimensions on self-concept
	Age: 15–25 years
Australia					(Good)
Papadopoulos (2014)	84 VI	Rosenborg Self-Esteem Scale	Visual acuity, visual field, reading media, age at loss of sight, recency of vision loss	Not mentioned	The significant predictors of self-esteem were vision status, age loss of sight, recency of vision loss and educational level. Significant predictors of LOC were vision status and independent movement. Higher self-esteem among young adults with blindness compared with low vision group, and among the congenital VI group compared with those with recent vision loss or in the low vision group
Greece					(Moderate)
	51 VI from birth	Rotter Internal-External Locus of Control Scale (IE-LOC)	42 blind, 42 low vision
	49 VI acquired at a later age
	Age: young adults
Pinquart and Pfeiffer (2013)	178 VI (24 with second disability)	EIPQ^3 for identity	WHO^6 definition	DSFVI^7	No difference in perceived identity between children. Lower perceived identity among children with congenital VI compared with children with acquired VI. Perceived identity increased with increased age. Better parental education and support from peers, fewer behavioral problems
	526 sighted	Subscales SBSSS^4 for social support		RSFVI^8
	Mean age: 16 years	SDQ^5 for behavior problems
Germany					(High)
Mishra and Singh (2012)	100 VI 100 sighted	Self-Concept Inventory by Mohsin	Not mentioned	Different schools in Delhi	Significant lower self-concept among students with VI. No significant differences in self-concept between boys and girls. The majority of students with VI had average self-confidence, but greater self-confidence among sighted participants
India		Self-Confidence Inventory by Pandey			(Moderate)
Pandith et al. (2012)	N = 150	Sagar and Sharms Self-Concept Inventory^, Shah’s Level of Aspiration tool	Not mentioned	Various secondary schools	Same level of real self and aspiration among the three groups. Due to lower self-concept and level-of-aspiration scores, their achievements came out very low
	50 VI
	50 hearing impaired
	50 crippled secondary school
India					(Moderate)
Halder and Datta (2012)	60 VI	General Information Schedule, PHCSCS^9	Visual acuity ≤ 6/60 or 20/200	MS^10	Sighted adolescents had higher overall self-concept scores compared with their blind peers, including the domains physical appearance, popularity, happiness and satisfaction
	100 sighted
	Age: 15–18 years		Blind	DSFVI
India					(Moderate)
Halder and Datta (2011)	60 VI	PHCSCS	Visual acuity ≤ 6/60 or 20/200	MS	Lower self-concept, including the domains physical appearance, popularity, happiness, and satisfaction in all youths with VI. Sighted male adolescents scored highest on overall self-concept
	100 sighted
	Age: 15–18 years		Blind	DSFVI
India					(Moderate)
Kotb et al. (2011)Egypt	100 VI	Socioeconomic Scale	Not mentioned	El-Noor School	Children with VI from high social classes had a higher quality of life and normal self-esteem compared with other children with VI
					(Good)
	Age: 12–18 years
		Rosenborg Self-Esteem Scale
		Quality of Life Scale
Bolat et al. (2011)	40 VI	Children’s Depression Inventory	Congenital complete visual impairment	School for children with VI	Compared to sighted peers, adolescents with VI had similar depression levels and self-concept characteristics, but higher anxiety levels
	40 sighted
	Mean age: 12.8 years
		PHCSCS
Turkey		Spielberger Trait Anxiety Inventory for Children
					(Good)
Were et al. (2010)	291 VI	Self-Description Questionnaire Individual Evaluation (SDQI)	Snellen Chart	168 special school,82 integrated in MS, 28 inclusive program	Girls scored higher than boys on self-concept and hence in achievement tests than their male counterparts among pupils with VI. Student with higher self-concept scored higher on achievement. Pupils who were totally blind had lower self-concept than pupils with low vision
	210 partially sighted
	81 totally blind
		Academic Achievement Test (AAT)
	Class eight
					(High)
Kenya
Bowen (2010a)	60 VI	B/G STEEM^11 for self-esteem and locus of control	Snellen Chart 1/120 defined as severe VI, 6/9 defined as mild VI	MS	Self-esteem of the majority of children with VI: normal or high level. Higher self-esteem in girls compared to boys. Degree of VI and age may affect self-esteem
	Age: 6–14 years
United Kingdom
					(Moderate)
Bowen (2010b)	4 VI	B/GSTEEM for self-esteem	Snellen Chart	MS	Six months’ educational intervention over half of a school term improved the self-esteem of children with VI who had low or very low self-esteem from baseline
United Kingdom
					(Moderate)
	Age: 7–12 years
Garaigordobil and Bernarás (2009)Spain	29 VI	LAEA^12	VI: 24% vision level between 0.4 and 0.3, 28% between 0.25 and 0.12, and 35% 0.1 or less Eye diagnostic test	Centre of Resources for the Educational Inclusion (CRI)	No significant differences in self-concept and self-esteem, but the children with severe VI scored significantly higher in psychopathological symptoms. Girls with severe VI scored lower in self-esteem. Higher scores on self-esteem: correlated with higher scores on extroversion. Low psychoticism, high extravertion, and low hostility were identified as predictors of high self-concept
		RSES^13
		SCL-90-R^14
				MS
		NEO-FFI^15
					(High)
	61 no VI
	Age: 12–17 years
Shapiro et al. (2008)	43 VI	Self-Perception Profile for Children (SPPC) and Adolescents (SPPA)	Snellen Chart and assessment of field of vision	Participants attended a one week summer camp for individuals with VI	Children with VI discounted the importance of physical appearance, athletic competence, and social acceptance and had moderately high ratings on global or overall self-worth(High)
	9 B1—Athletes
			United States Association of Blind Athletes definition
United States	7 B2—Athletes
	14 B3—Athletes
	13 unknown
	−33 Age: 8–14 years
	−10 Age: 15 years and over
Al-Zyoudi (2007)Jordan	23 low vision	TSCS^16	WHO definition	MS	Youths with VI had higher self-concept in physical appearance and performance, lower self-concept in social relation, family involvement, moral and behavior to self for girls compared to boys(Good)
		Minnesota Multiphase Personality Inventory (MMPI)
	Age: 12–17 years
Lifshitz et al. (2007)	40 VI	“I am/He is” an Israeli Questionnaire	US definitions (National Eye Institute, 2002)	20 RSFVI	Similar self-concept profile for the adolescents (High)
				20 VI in Public School
	41 sighted
	Age: 13–18 years
		Nottingham Adjustment Scale
Israel
		Quality of Friendship Scale
Shapiro et al. (2005)United States	43 VI	Self-Perception Profile for Children (SPPC) and Adolescents (SPPA)	Snellen Chart and assessment of vision field The definition from the US Association for Blind Athletes	Participants attended a one week summer camp for individuals with visual impairment	Differences in the perceived competence of the girls, but not the boys, after they attended one-week summer camp. No differences in the perceptions of competence with age
					(High)
	9 B1—Athletes
	7 B2—Athletes
	14 B3—Athletes
	13 unknown
	33 Age: 8–14
	10 Age: 15 years and over
Griffin-Shirley and Nes (2005)United States	71 VI	CSEI^17 short form for self-esteem	The best correction of VI still affects educational performance	RSFVI	No differences in self-esteem, empathy toward others, and bonding with pets between children (High)
	88 sighted
	Age: 8–14 years
		IECA^18 for empathy
		CABS^19 for bonding with pets
Roy and MacKay (2002)Scotland and United Kingdom	16 blind or low vision	Twenty Statements Test (TST) (self-perception)	Self-definition	College	A generally positive view of self-emerged, but negative TST responses focusing on disability occurred, sometimes associated with deteriorating vision loss and recency loss. Highly external LOC responses. Experience low vision may be more fraught with anxiety and self-evaluation and identity than blindness
					(Moderate)
		IELOC
	Age: 18–34 years (mean age 23 years)
Kef (2002)	316 VI (60 blind, 58 severe VI, 198 moderate VI)	Rosenberg Self-esteem Scale (RSES)	Functional Vision Scale	RSFVI	The adolescents with VI reported a slightly higher level of self-esteem, and more difficulties to make friends
		Locus of Control Construct^20
	495 sighted
	Age: 14–24 years				(High)
Netherlands
Lopez-Justicia et al. (2001)	58 congenital low vision	PAI^21 for age 4–7 years	WHO definition	MS	Lower self-esteem among children with congenital low vision compared to sighted
	58 sighted
		SCSDQ^22 for age 8–11 yearsTennesse Self-Concept Scale (TSCS) for age 12–17 years
					(Good)
	Age groups: 4–7, 8–11, and 12–17 years
Spain
Cardinali and D’Allura (2001)United States	31 VI	Parental Autority Qusetionnaire (PAQ for parenting style (self-report and report from mothers)	Not mentioned	Finished school	Parenting style related to children’s self-esteem (High)
	Age: 18–23 years
	17 mothers
		TSCS
Huurre et al. (2001)	115 VI607 sighted controls	Beck Depression Inventory	Ophthalmological information from the Finnish Register of Visual Impairment	MS	The impact of relationships with friends on depressive symptoms was mediated through self-esteem. Unlike the controls, relationship with parents was not an explanatory factor of depression in adolescents with VI
					(High)
		Self-esteem Scale developed for Finnish school students, scales for relationships
	Age: 12–17 years
Finland
Gronmo and Augestad (2000)	8 Norwegian and 12 French (blind), 41 Norwegian and 43 French (controls)	Shortened versions HSPPA^23 for Self-Concept and Global Self-Worth	14 born blind and the rest became blind later in life	MS: Norway	School type or country had no influence on the reported self-concept and global self-worth. Significant differences in global self-worth between blind and sighted youths
					(Good)
				DSFVI: France
Norway and France
	Age: 13–16 years
Rosenblum (2000)	10 adolescents with VI	Semi-structured interviews and quantitative data	Self-reported low vision or functionally blind	MS	Heterogeneity of the population of adolescents with VI in their experiences of VI and perceptions of how VI affected their lives. Adolescents with VI felt excluded and that had a negative impact on their self-esteem and self-worth (Good)
	23 sighted friends (of the 10 adolescents)
United States
Huurre et al. (1999)	115 VI	Finnish 5-point scale for self-esteem and social relationships	Braille users defined as blind	MS	Friendship improved self-esteem for children with VI. Lower self-esteem among girls with VI. No difference in self-esteem between boys with VI and boys without VI. No influences of severity of VI or onset of VI on the self-esteem of children with VI
					(High)
	607 sighted
	Age: 12–17 years
Finland

¹ All studies were cross-sectional studies except for the one by Bowen (2010b).

² VI: visual impairment.

³ EIPQ: Ego Identity Process Questionnaire.

⁴ SBSSS: Support Berlin Social Support Scales.

⁵ SDQ: Strength and Difficulties Questionnaire.

⁶ WHO: World Health Organization.

⁷ DSFVI: day school for children with VI.

⁸ RSFVI: residential school for children with VI.

⁹ PHCSCS: Piers-Harris Children’s Self-Concept Scale.

¹⁰ MS: mainstream schools.

¹¹ B/G STEEM questionnaire: Self-esteem Scale with Locus of Control Items by Maines and Robinson.

¹² LAEA: Adult and Adolescent Self-Concept Adjective Checklist.

¹³ RSES: Rosenberg Self-Esteem Scale.

¹⁴ SCL-90-R: Symptom Checklist-90-Revised.

¹⁵ NEO-FFI: Neo Five-Factor Inventory.

¹⁶ TSCS: Tennessee Self-Concept Scale.

¹⁷ CSEI: Cooper smith Self-esteem Inventory.

¹⁸ IECA: Index of Empathy for Children and Adolescents.

¹⁹ CABS: Companion of Animal Bonding Scale.

²⁰ Coping.

²¹ PAI: Perception del Autoconcepto Infantil.

²² SCSDQ: Self-Concept Scale of the Self-Description Questionnaire.

²³ HSPPA: Harter’s Self-perception Profile for Adolescents.

Datta, P., & Talukdar, J. (2016). The impact of vision impairment on students’ self-concept. International Journal of Inclusive Education, 20, 659–672.10.1080/13603116.2015.1111441

 Web of Science ®Google Scholar

Papadopoulos, K. (2014). The impact of individual characteristics in self-esteem and locus of control of young adults with visual impairments. Research in Developmental Disabilities, 35, 671–675.10.1016/j.ridd.2013.12.009

 PubMed Web of Science ®Google Scholar

Pinquart, M., & Pfeiffer, J. P. (2013). Identity development in German adolescents with and without visual impairments. Journal of Visual Impairment & Blindness, 107, 338–349.

 Web of Science ®Google Scholar

Mishra, V., & Singh, A. (2012). A comparative study of self-concept and self-confidence of sighted and visually impaired children. Excel International Journal of Multidisciplinary Management Studies, 2, 148–156.

 Google Scholar

Pandith, A. A., Malik, M. H., & Ganai, M. Y. (2012). Self-concept and level of aspiration among hearing impaired, visually impaired and crippled secondary school students of district Baramullah, J & K. International Journal of Current Research, 4, 115–118.

 Google Scholar

Halder, S., & Datta, P. (2012). Insight into self-concept of the adolescents who are visually impaired in India. International Journal of Special Education, 27, 86–93.

 Google Scholar

Halder, S., & Datta, P. (2011). An exploration into self-concept: A comparative analysis between the adolescents who are sighted and blind in India. British Journal of Visual Impairment, 30, 31–41.

 Google Scholar

Kotb, S. A. M., Gadallah, M. A., & Marzouck, S. A. (2011). Self-esteem and quality of life among visually impaired children in Assiut City, Egypt. Journal of American Science, 7, 47–57.

 Google Scholar

Bolat, N., Dogangun, B., Yavuz, M., Demir, T., & Kayaalp, L. (2011). Depression and anxiety levels and self-concept characteristics of adolescents with congenital complete visual impairment. Turkish Psikiyatri Dergisi, 22, 77–82.

 PubMed Web of Science ®Google Scholar

Were, C. H., Indoshi, F. C., & Yalo, J. A. (2010). Gender differences in self-concept and academic achievement among visually impaired pupils in Kenya. Educational Research, 1, 246–252.

 Google Scholar

Bowen, J. (2010a). Visual impairment and its impact on self-esteem. British Journal of Visual Impairment, 28, 47–56.10.1177/0264619609349429

 Google Scholar

Bowen, J. (2010b). Visual impairment and self-esteem: What makes a difference? British Journal of Visual Impairment, 28, 235–243.10.1177/0264619610375504

 Google Scholar

Garaigordobil, M., & Bernarás, E. (2009). Self-concept, self-esteem, personality traits and pscychopathological symptoms in adolescents with and without visual impairment. The Spanish journal of psychology, 12, 149–160.10.1017/S1138741600001566

 PubMed Web of Science ®Google Scholar

Shapiro, D. R., Moffett, A., Lieberman, L., & Dummer, G. M. (2008). Domain-specific ratings of importance and global self-worth of children with visual impairments. Journal of Visual Impairment & Blindness, 102, 232–244.

 Web of Science ®Google Scholar

Al-Zyoudi, M. (2007). Gender differences in self-concept among adolescents with low vision. International Journal of Special Education, 22, 132–136.

 Google Scholar

Lifshitz, H., Hen, I., & Weisse, I. (2007). Self-concept, adjustment to blindness, and quality of friendship among adolescents with visual impairments. Journal of Visual Impairment & Blindness, 101, 96–107.

 Web of Science ®Google Scholar

Shapiro, D. R., Moffett, A., Lieberman, L., & Dummer, G. M. (2005). Perceived competence of children with visual impairments. Journal of Visual Impairment & Blindness, 99, 15–25.

 Web of Science ®Google Scholar

Griffin-Shirley, N., & Nes, S. (2005). Self-esteem and empathy in sighted and visually impaired preadolescents. Journal of Visual Impairment & Blindness, 99, 276–285.

 Web of Science ®Google Scholar

Roy, W. N., & MacKay, G. F. (2002). Self-perception and locus of control in visually college students with different types of vision loss. Journal of Visual Impairment & Blindness, 96, 254–266.

 Web of Science ®Google Scholar

Kef, S. (2002). Pschosocial adjustment and the meaning of social support for visually impaired adolescents. Journal of Visual Impairment & Blindness, 96, 22–37.

 Web of Science ®Google Scholar

Lopez-Justicia, M. D., Pichardo, M. C., Amezcua, J. A., & Fernandez, E. (2001). The self-concepts of Spanish children and adolescents with low vision and their sighted peers. Journal of Visual Impairment & Blindness, 95, 150–160.

 Web of Science ®Google Scholar

Cardinali, C., & D’Allura, T. (2001). Parenting styles and self-esteem: A study of young adults with visual impairments. Journal of Visual Impairment & Blindness, 95, 261–271.

 Web of Science ®Google Scholar

Huurre, T. M., Komulainen, E. J., & Aro, H. M. (2001). Relationship with parents and friends, self-esteem and depression among adolescents with visual impairments. Scandinavian Journal of Disability Research, 3, 21–37.10.1080/15017410109510766

 Google Scholar

Gronmo, S. J., & Augestad, L. B. (2000). Physical activity, self-concept, and global self-worth of blind youths in Norway and France. Journal of Visual Impairment & Blindness, 94, 522–528.

 Web of Science ®Google Scholar

Rosenblum, L. P. (2000). Perceptions of the impact of visual impairment on the lives of adolescents. Visual Impairemnt & Blindness, 94, 434–445.

 Web of Science ®Google Scholar

Huurre, T. M., Komulainen, E. J., & Aro, H. M. (1999). Social support and self-esteem among adolescents with visual impairments. Journal of Visual Impairment & Blindness, 93, 26–37.

 Web of Science ®Google Scholar