Self-Esteem in Strabismic and Anisometropic Children Age 4-7 Years
Eileen E. Birch, PhD; Yolanda S. Castaneda, BSN; Christina Cheng-Patel, BS; Sarah E. Morale, BS; Cynthia Beauchamp, MD; Lori Dao, MD; Krista R. Kelly, PhD
Retina Foundation of the Southwest
Introduction: Social acceptance and and physical competence are key determinants of self-perception, including self-esteem. We previously reported fine motor skill deficits in amblyopic children.(1) Here, we examine key determinants of self-esteem in 4- to 7-year-old children with or without amblyopia.
Methods: Children (n=35; age 4-7y) with strabismus, anisometropia or both completed the Pictorial Scale of Perceived Competence and Social Acceptance for Young Children.(2) For each of 24 items, the examiner presented two gender-appropriate pictures side-by-side, one of a child with high competence/ acceptance and one with less competence/acceptance. The child first decided which picture was most like him/her and then chose a large or small circle under the picture to indicate whether this was ‘really true for me’ or ‘sort of true for me.’ The instrument provides scores for two competence domains, Cognitive Competence and Physical Competence, and for two social acceptance domains, Peer Acceptance and Maternal Acceptance. Visual acuity was tested by ATS-HOTV protocol and stereoacuity by Randot Preschool Stereoacuity Test.
Results: Compared with nonamblyopic children, (n=18), amblyopic children (n=17) had significantly lower Physical Competence (2.83±0.10 vs. 3.17±0.11; t33=2.28, p=0.03)and Peer Acceptance [2.33±0.13 vs. 2.92±0.10; t33=3.62, p=0.001). No significant difference was found between groups for Cognitive Competence or Maternal Acceptance. Children with nil stereoacuity had significantly lower Physical Competence (p=0.006) and Peer Acceptance (p=0.03) than children with measureable stereoacuity. There was no significant association between patching or spectacle wear and lower scores.
Discussion: Amblyopia and associated conditions, including stereo deficits, may lower perceived physical competence and peer acceptance.
Conclusion: Rehabilitation of amblyopia and associated stereo deficits may benefit two key determinants of self-esteem, perceived physical competence and peer acceptance.
(1) Kelly KR et al (2016) Amblyopia disrupts the development of eye-hand coordination. AAPOS poster presentation.
(2) Harter S, Pike R (1984) The pictorial scale of perceived competence and social acceptance for young children. Child Dev 55: 1969-82.