View in EDS HTML Full Text PDF Full Text

Flourishing Intervention: Basic Psychological Needs Satisfaction in Hard-of-Hearing Adolescents

Saved in:
Bibliographic Details
Title: Flourishing Intervention: Basic Psychological Needs Satisfaction in Hard-of-Hearing Adolescents
Language: English
Authors: Sayed Hossein Siadatian Arani (ORCID 0000-0001-5523-4427), Mohammad Ashori (ORCID 0000-0002-1685-2932), Salar Faramarzi (ORCID 0000-0002-0140-0335), Ghasem Norouzi (ORCID 0000-0002-8624-7818), Linda J. Spencer (ORCID 0000-0002-5155-6207)
Source: International Journal of Disability, Development and Education. 2026 73(1):163-175.
Availability: Routledge. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 13
Publication Date: 2026
Document Type: Journal Articles
Reports - Research
Descriptors: Foreign Countries, Adolescents, Hard of Hearing, Psychological Needs, Need Gratification, Competence, Personal Autonomy, Intervention, Sense of Belonging, Feasibility Studies
Geographic Terms: Iran
DOI: 10.1080/1034912X.2024.2403379
ISSN: 1034-912X
1465-346X
Abstract: The present study aimed to explore the effect of the PERMA (Positive emotion, Engagement, Relationship, Meaning, and Accomplishment) flourishing intervention on basic psychological needs satisfaction in hard-of-hearing adolescents. This research was a quasi-randomised controlled trial design. Twenty-eight hard-of-hearing adolescents aged 14-17 years were randomly selected from the Deaf Center and Baghcheban Deaf School in Kashan, Iran. They were randomly replaced to experimental (n = 13) or control (n = 15) groups. The experimental group participated in the 10-session intervention, while the control group did not participate in this programme. Both groups completed the Basic Needs Satisfaction in General Scale (BNSG-S before and after intervention. The results showed that after intervention, scores on the subscales of basic psychological needs (competence, autonomy, and relatedness) in hard-of-hearing adolescents significantly and positively increased (p < 0.001). Therefore, the PERMA flourishing intervention was feasible and acceptable to these adolescents.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1504281
Database: ERIC
Full text is not displayed to guests.
FullText Links:
  – Type: pdflink
    Url: https://content.ebscohost.com/cds/retrieve?content=AQICAHj0k_4E0hTGH8RJwT4gCJyBsGNe_WN95AvKlDbXJGqwxwGdnTg4rjxg-DQwrdJpyGq-AAAA4zCB4AYJKoZIhvcNAQcGoIHSMIHPAgEAMIHJBgkqhkiG9w0BBwEwHgYJYIZIAWUDBAEuMBEEDGaDiXQebpkV-hd0mgIBEICBm7BwQ-RENz0n41WEpCbEB5QQ7n5Ou3SbZLpHtL9e6wzm7ARvGJWldilKJ7GLlTVBfMRiXIqyNQnrcsGShNr2JhlRTPCrbxLx_NBL9TThITNMu8eJHYxKy4EYTxHrPWFvkwOLQquJ9qdOQyB7jY2TBoujYNuOHgZ2hTN-dqybxLhxxbEU7TvPBZtwkVU8TcmfnDPk92g6fRlvcRP-
Text:
  Availability: 1
  Value: &lt;anid&gt;AN0190413000;54q01jan.26;2025Dec24.08:08;v2.2.500&lt;/anid&gt; &lt;title id=&quot;AN0190413000-1&quot;&gt;Flourishing Intervention: Basic Psychological Needs Satisfaction in Hard-Of-Hearing Adolescents&#160;&lt;/title&gt; &lt;p&gt;The present study aimed to explore the effect of the PERMA (Positive emotion, Engagement, Relationship, Meaning, and Accomplishment) flourishing intervention on basic psychological needs satisfaction in hard-of-hearing adolescents. This research was a quasi-randomised controlled trial design. Twenty-eight hard-of-hearing adolescents aged 14–17 years were randomly selected from the Deaf Center and Baghcheban Deaf School in Kashan, Iran. They were randomly replaced to experimental (n = 13) or control (n = 15) groups. The experimental group participated in the 10-session intervention, while the control group did not participate in this programme. Both groups completed the Basic Needs Satisfaction in General Scale (BNSG-S before and after intervention. The results showed that after intervention, scores on the subscales of basic psychological needs (competence, autonomy, and relatedness) in hard-of-hearing adolescents significantly and positively increased (p &amp;lt; 0.001). Therefore, the PERMA flourishing intervention was feasible and acceptable to these adolescents.&lt;/p&gt; &lt;p&gt;Keywords: PERMA; competence; autonomy; basic needs satisfaction&lt;/p&gt; &lt;hd id=&quot;AN0190413000-2&quot;&gt;Introduction&lt;/hd&gt; &lt;p&gt;Happiness and life satisfaction are two components of how people perceive life or subjective well-being (Pollenne, [&lt;reflink idref=&quot;bib29&quot; id=&quot;ref1&quot;&gt;29&lt;/reflink&gt;]). Increasing attention is being given to understanding factors that promote individuals&#39; happiness and life satisfaction (Fosco et al., [&lt;reflink idref=&quot;bib12&quot; id=&quot;ref2&quot;&gt;12&lt;/reflink&gt;]). During recent years, outcomes have improved for hard-of-hearing adolescents in areas such as speech and language; however, the psychological development and happiness of these adolescents is still not equal to that of their hearing peers (Byatt et al., [&lt;reflink idref=&quot;bib3&quot; id=&quot;ref3&quot;&gt;3&lt;/reflink&gt;]). Hearing impairment is a risk factor for a adolescents&#39; appropriate development but is not a risk factor for the development of resilience and basic psychological needs satisfaction (Radovanović et al., [&lt;reflink idref=&quot;bib31&quot; id=&quot;ref4&quot;&gt;31&lt;/reflink&gt;]). Accordingly, providing support services is essential for psychosocial and personal development in hard-of-hearing adolescents (Marschark et al., [&lt;reflink idref=&quot;bib22&quot; id=&quot;ref5&quot;&gt;22&lt;/reflink&gt;]).&lt;/p&gt; &lt;p&gt;Adolescence is a period of rapid physical and emotional growth and coincides with important emotional and social processes in the life (Handa et al., [&lt;reflink idref=&quot;bib16&quot; id=&quot;ref6&quot;&gt;16&lt;/reflink&gt;]). Hard-of-hearing adolescents who experience stress and anxiety often seek help from specialists in behavioural health care systems (T. V. Crowe, [&lt;reflink idref=&quot;bib6&quot; id=&quot;ref7&quot;&gt;6&lt;/reflink&gt;]; K. Crowe &amp;amp; Dammeyer, [&lt;reflink idref=&quot;bib5&quot; id=&quot;ref8&quot;&gt;5&lt;/reflink&gt;]). Historically it has been stated that hard-of-hearing adolescents do not achieve age-appropriate outcomes in social and academic skills. However, there have been changes in this area over the last 20 years (Mayer et al., [&lt;reflink idref=&quot;bib25&quot; id=&quot;ref9&quot;&gt;25&lt;/reflink&gt;]). Hard-of-hearing adolescents may have fewer friends and more peer problems than their hearing peers (Terlektsi et al., [&lt;reflink idref=&quot;bib40&quot; id=&quot;ref10&quot;&gt;40&lt;/reflink&gt;]). Therefore, these adolescents need special interventions to meet their psychological needs (Hallahan et al., [&lt;reflink idref=&quot;bib15&quot; id=&quot;ref11&quot;&gt;15&lt;/reflink&gt;]). For this reason, more studies are needed in order to identify the problems and needs unique to hard-of-hearing adolescents (Danadel &amp;amp; Ashori, [&lt;reflink idref=&quot;bib7&quot; id=&quot;ref12&quot;&gt;7&lt;/reflink&gt;]).&lt;/p&gt; &lt;hd id=&quot;AN0190413000-3&quot;&gt;Basic Psychological Needs&lt;/hd&gt; &lt;p&gt;Some theorists appeal to the concept of basic needs (P&#246;lzler et al., [&lt;reflink idref=&quot;bib30&quot; id=&quot;ref13&quot;&gt;30&lt;/reflink&gt;]). In recent decades, the theory that people have basic needs has been proposed by many researchers (Sorebo et al., [&lt;reflink idref=&quot;bib39&quot; id=&quot;ref14&quot;&gt;39&lt;/reflink&gt;]), albeit theories have differed on what constitutes each need. Some have theorised that needs are psychological (Murray, [&lt;reflink idref=&quot;bib27&quot; id=&quot;ref15&quot;&gt;27&lt;/reflink&gt;]), while others have reported that needs are physiological. Some researchers have also suggested that needs are a combination of both (Maslow, [&lt;reflink idref=&quot;bib24&quot; id=&quot;ref16&quot;&gt;24&lt;/reflink&gt;]). Furthermore, some theorists have proposed that human needs are innate (Deci &amp;amp; Ryan, [&lt;reflink idref=&quot;bib8&quot; id=&quot;ref17&quot;&gt;8&lt;/reflink&gt;]), while others have stated that needs are learned over time (McClelland, [&lt;reflink idref=&quot;bib26&quot; id=&quot;ref18&quot;&gt;26&lt;/reflink&gt;]). In sum, self-determination theory describes needs as psychological, innate, and necessary to well-being (Deci &amp;amp; Ryan, [&lt;reflink idref=&quot;bib9&quot; id=&quot;ref19&quot;&gt;9&lt;/reflink&gt;]; Kiltz et al., [&lt;reflink idref=&quot;bib20&quot; id=&quot;ref20&quot;&gt;20&lt;/reflink&gt;]). Sorebo et al. ([&lt;reflink idref=&quot;bib39&quot; id=&quot;ref21&quot;&gt;39&lt;/reflink&gt;]) identify three basic psychological needs: competence, autonomy, and relatedness.&lt;/p&gt; &lt;p&gt;Competence is the need to feel effective and able to perform acts at different difficulty levels. Autonomy is defined as having the authority to make decisions and the freedom to act on those decisions (Oshodi et al., [&lt;reflink idref=&quot;bib28&quot; id=&quot;ref22&quot;&gt;28&lt;/reflink&gt;]; Skar, [&lt;reflink idref=&quot;bib38&quot; id=&quot;ref23&quot;&gt;38&lt;/reflink&gt;]). Relatedness is the desire to feel loved, to communicate with others, and to engage meaningfully with the broader social world (Ryan &amp;amp; Deci, [&lt;reflink idref=&quot;bib33&quot; id=&quot;ref24&quot;&gt;33&lt;/reflink&gt;]). Self-determination theory states all three needs must be met for psychological well-being to occur (Deci &amp;amp; Ryan, [&lt;reflink idref=&quot;bib9&quot; id=&quot;ref25&quot;&gt;9&lt;/reflink&gt;]). Hard-of-hearing adolescents have difficulty meeting their basic psychological needs, especially in the areas of competence, autonomy, and relatedness, which constitute self-determination, and experience more challenges than their hearing peers (Ashori &amp;amp; Ghasemzadeh, [&lt;reflink idref=&quot;bib1&quot; id=&quot;ref26&quot;&gt;1&lt;/reflink&gt;]). Given that 96% percent of deaf and hard-of-hearing children are born to hearing mothers (Humphries et al., [&lt;reflink idref=&quot;bib17&quot; id=&quot;ref27&quot;&gt;17&lt;/reflink&gt;]) who do not have experience raising a child with hearing loss, it would stand to reason that use of psychological programmes such as PERMA (Positive emotion, Engagement, Relationship, Meaning, and Accomplishment) flourishing intervention could reduce the emotional problems in hard-of-hearing adolescents and improve their psychological well-being (Siadatian Arani et al., [&lt;reflink idref=&quot;bib36&quot; id=&quot;ref28&quot;&gt;36&lt;/reflink&gt;]).&lt;/p&gt; &lt;hd id=&quot;AN0190413000-4&quot;&gt;PERMA Flourishing Intervention&lt;/hd&gt; &lt;p&gt;Interest in the experience of health and well-being, as both a policy goal and as a research topic, has increased in recent years (Jang et al., [&lt;reflink idref=&quot;bib18&quot; id=&quot;ref29&quot;&gt;18&lt;/reflink&gt;]; Martela &amp;amp; Sheldon, [&lt;reflink idref=&quot;bib23&quot; id=&quot;ref30&quot;&gt;23&lt;/reflink&gt;]). Seligman ([&lt;reflink idref=&quot;bib34&quot; id=&quot;ref31&quot;&gt;34&lt;/reflink&gt;]) described five building blocks of wellbeing, which he called the PERMA flourishing model. This model includes positive emotion, engagement, relationship, meaning, and accomplishment (Donaldson et al., [&lt;reflink idref=&quot;bib10&quot; id=&quot;ref32&quot;&gt;10&lt;/reflink&gt;]; Kern et al., [&lt;reflink idref=&quot;bib19&quot; id=&quot;ref33&quot;&gt;19&lt;/reflink&gt;]). Positive emotions are based on staying optimistic and seeing the situations and events that life offers us positively and constructively. Engagement is also an important component of a successful life and enhances strength, sacrifice, and commitment (Eli&#252;ş&#252;k, [&lt;reflink idref=&quot;bib11&quot; id=&quot;ref34&quot;&gt;11&lt;/reflink&gt;]). Relationships refer to the quality of interactions that each person establishes with those around them to have a life full of positive energy and vital well-being (Seligman, [&lt;reflink idref=&quot;bib34&quot; id=&quot;ref35&quot;&gt;34&lt;/reflink&gt;]). Meaning is defined as determining the direction of life, connecting with something higher than oneself, feeling that life is important and valuable, and believing that there is a purpose to life (Eli&#252;ş&#252;k, [&lt;reflink idref=&quot;bib11&quot; id=&quot;ref36&quot;&gt;11&lt;/reflink&gt;]). Accomplishment means pursuing a goal, achieving it, and striving for greatness (Donaldson et al., [&lt;reflink idref=&quot;bib10&quot; id=&quot;ref37&quot;&gt;10&lt;/reflink&gt;]).&lt;/p&gt; &lt;p&gt;Well-being is used as a critical consequence in several areas of psychology ranging from health psychology, clinical psychology, and developmental psychology to organisational, social, and educational psychology (Martela &amp;amp; Sheldon, [&lt;reflink idref=&quot;bib23&quot; id=&quot;ref38&quot;&gt;23&lt;/reflink&gt;]; Pollenne, [&lt;reflink idref=&quot;bib29&quot; id=&quot;ref39&quot;&gt;29&lt;/reflink&gt;]). On the other hand, the PERMA flourishing model is strongly associated with well-being (Goodman et al., [&lt;reflink idref=&quot;bib13&quot; id=&quot;ref40&quot;&gt;13&lt;/reflink&gt;]). This model successfully captures well-being and specifies the building blocks of well-being (Seligman, [&lt;reflink idref=&quot;bib35&quot; id=&quot;ref41&quot;&gt;35&lt;/reflink&gt;]). Seligman believes that the PERMA flourishing model, the cornerstone of human well-being, can lead to a more engaged, happier, and more satisfying life (Kern et al., [&lt;reflink idref=&quot;bib19&quot; id=&quot;ref42&quot;&gt;19&lt;/reflink&gt;]). The PERMA flourishing model seems to reinforce positive resources in each individual systematically. Therefore, it is very important to identify and study the effects of this model that can improve well-being (Siadatian Arani et al., [&lt;reflink idref=&quot;bib37&quot; id=&quot;ref43&quot;&gt;37&lt;/reflink&gt;]).&lt;/p&gt; &lt;hd id=&quot;AN0190413000-5&quot;&gt;Literature Review&lt;/hd&gt; &lt;p&gt;Interventions such as the PERMA flourishing programme may differentially influence outcomes of interest. For example, Siadatian Arani et al. ([&lt;reflink idref=&quot;bib37&quot; id=&quot;ref44&quot;&gt;37&lt;/reflink&gt;]) found that the PERMA flourishing model had a positive and significant effect on forgiveness in mothers of hard-of-hearing students. Ziaee et al. ([&lt;reflink idref=&quot;bib41&quot; id=&quot;ref45&quot;&gt;41&lt;/reflink&gt;]) reported that the PERMA flourishing programme significantly increased students&#39; happiness, competence, and social participation. Donaldson et al. ([&lt;reflink idref=&quot;bib10&quot; id=&quot;ref46&quot;&gt;10&lt;/reflink&gt;]) found that the PERMA flourishing intervention significantly increased the well-being in participants. Similarly, Ashori and Ghasemzadeh ([&lt;reflink idref=&quot;bib1&quot; id=&quot;ref47&quot;&gt;1&lt;/reflink&gt;]) noted that positive psychological immunisation intervention had a positive and significant effect on competence, autonomy, relatedness, and basic psychological needs satisfaction in hard-of-hearing adolescents.&lt;/p&gt; &lt;p&gt;Research results of Goodman et al. ([&lt;reflink idref=&quot;bib13&quot; id=&quot;ref48&quot;&gt;13&lt;/reflink&gt;]) demonstrated that the PERMA building blocks are strongly associated with health and well-being. Roncaglia ([&lt;reflink idref=&quot;bib32&quot; id=&quot;ref49&quot;&gt;32&lt;/reflink&gt;]) showed that the PERMA flourishing programme improved the coping skills, participation, engagement, well-being, and quality of life in adolescents with autism spectrum disorders and learning problems. Additionally, research findings of Lambert D&#39;raven and Pasha-Zaidi ([&lt;reflink idref=&quot;bib21&quot; id=&quot;ref50&quot;&gt;21&lt;/reflink&gt;]) demonstrated that the PERMA flourishing programme improved the satisfaction and well-being of adolescents and adults. Similarly, Coffey et al. ([&lt;reflink idref=&quot;bib4&quot; id=&quot;ref51&quot;&gt;4&lt;/reflink&gt;]) found that the PERMA flourishing programme enhanced participants&#39; well-being, vitality, life satisfaction, flourishing, and physical health. In summary, recent findings highlight the importance of the PERMA flourishing programme in improving basic psychological needs and satisfaction (Siadatian Arani et al., [&lt;reflink idref=&quot;bib36&quot; id=&quot;ref52&quot;&gt;36&lt;/reflink&gt;]). Using this programme helps to increase personal well-being and basic psychological needs and provides the opportunity to identify particular elements of basic psychological needs such as competence, autonomy, and relatedness.&lt;/p&gt; &lt;hd id=&quot;AN0190413000-6&quot;&gt;The Current Study&lt;/hd&gt; &lt;p&gt;Many hard-of-hearing children and adolescents have strong skills in many aspects of spoken language (K. Crowe &amp;amp; Dammeyer, [&lt;reflink idref=&quot;bib5&quot; id=&quot;ref53&quot;&gt;5&lt;/reflink&gt;]; Guo &amp;amp; Spencer, [&lt;reflink idref=&quot;bib14&quot; id=&quot;ref54&quot;&gt;14&lt;/reflink&gt;]). However, we have limited information is available about their basic psychological needs (Ashori &amp;amp; Ghasemzadeh, [&lt;reflink idref=&quot;bib1&quot; id=&quot;ref55&quot;&gt;1&lt;/reflink&gt;]). In recent years, the basic psychological needs of mothers of deaf children has been identified as an essential issue (Hallahan et al., [&lt;reflink idref=&quot;bib15&quot; id=&quot;ref56&quot;&gt;15&lt;/reflink&gt;]). Given that hard-of-hearing adolescents experience low levels of autonomy and are often shown to have poor competence and relatedness, it is important to evaluate interventions such as PERMA flourishing programme that could support these adolescents in these domains (Siadatian Arani et al., [&lt;reflink idref=&quot;bib36&quot; id=&quot;ref57&quot;&gt;36&lt;/reflink&gt;]). Although the PERMA flourishing intervention has been most extensively trialled, few trials investigated the efficacy of basic psychological needs such as competence, autonomy, and relatedness in hard-of-hearing adolescents. For this reason, this study aimed to examine the impact of PERMA flourishing intervention on basic psychological needs satisfaction in hard-of-hearing adolescents. Three hypotheses guided the present study:&lt;/p&gt; &lt;hd id=&quot;AN0190413000-7&quot;&gt;H1.&lt;/hd&gt; &lt;p&gt;There would be a significant difference in autonomy between the intervention and control groups post-intervention.&lt;/p&gt; &lt;hd id=&quot;AN0190413000-8&quot;&gt;H2.&lt;/hd&gt; &lt;p&gt;There would be a significant difference in competence between the intervention and control groups post-intervention.&lt;/p&gt; &lt;hd id=&quot;AN0190413000-9&quot;&gt;H3.&lt;/hd&gt; &lt;p&gt;There would be a significant difference in relatedness between the intervention and control groups post-intervention.&lt;/p&gt; &lt;hd id=&quot;AN0190413000-10&quot;&gt;Methods&lt;/hd&gt; &lt;p&gt;&lt;/p&gt; &lt;hd id=&quot;AN0190413000-11&quot;&gt;Participants&lt;/hd&gt; &lt;p&gt;This study was a quasi-randomised controlled trial design. The statistical population included all hard-of-hearing adolescents in Kashan, Iran. Twenty-eight hard-of-hearing adolescents aged 14–17 years were randomly selected from the Deaf Center and Baghcheban Deaf School in Kashan city. These centres had 100 hard-of-hearing adolescents. Twenty-three adolescents did not meet the inclusion criteria. Therefore, other adolescents were screened, and 15 were randomly selected and assigned to the intervention group. Two were excluded from this group during the intervention sessions due to COVID-19 disease. As a result, 13 adolescents (seven girls; six boys) remained in the group. Also, 15 adolescents (seven girls; eight boys) were randomly selected and assigned to the waiting list control group.&lt;/p&gt; &lt;p&gt;The inclusion criteria included a 3-frequency, (500 Hz, 100, Hz, 2000 Hz) pure tone average (PTA) sensorineural hard of hearing in the better ear between 45 and 65 dB. Additional criteria included: age range between 14 and 17 years, living with parents, studying in deaf schools from 9th to 12th grade, no concomitant severe disability (e.g. intellectual disability, visual impairment, autism or behavioural disorder), and using the oral language.&lt;/p&gt; &lt;p&gt;The terms &#39;hard of hearing&#39; versus &#39;deaf&#39; versus &#39;deaf&#39; have different meanings in different communities. Hard of hearing is an accepted term to describe someone with mild to moderate hearing loss. Hard of hearing people may use an auditory device, such as hearing aids and cochlear implants to enhance their hearing. The Deaf (with an uppercase &#39;D&#39;) is used to describe people who are culturally Deaf and are actively engaged with the Deaf community. While deaf people (with a lowercase &#39;D&#39;) are often those who don&#39;t identify themselves with the Deaf community, culture, norms, and beliefs. It is also most likely that they don&#39;t use sign language as a means of communication and prefer to rely more on oral language. Exclusion criteria included participation in similar interventions during the study, having any mental disorder or any severe problem other than hearing loss, and not attending more than one session in the intervention. Table 1 presents the population characteristics of participants.&lt;/p&gt; &lt;p&gt;Table 1. Population characteristics of participants.&lt;/p&gt; &lt;p&gt; &lt;ephtml&gt; &amp;lt;table&amp;gt;&amp;lt;thead&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Variables&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Category&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Intervention group (&amp;lt;italic&amp;gt;n&amp;lt;/italic&amp;gt; = 13)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Control group (&amp;lt;italic&amp;gt;n&amp;lt;/italic&amp;gt; = 15)&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/thead&amp;gt;&amp;lt;tbody&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Age (years)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;M (SD)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;15.07 (1.11)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;15.60 (1.24)&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Sex&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Girl&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;7 (54%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;6 (46%)&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Boy&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;7 (47%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;8 (53%)&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Race/ethnicity&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Iranian/Persian&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;13 (100%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;15 (100%)&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Grade level&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;9&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;4 (31%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;4 (27%)&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;10&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;4 (31%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;3 (20%)&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;11&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;2 (15%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;3 (20%)&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;12&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;3 (23%)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;5 (33%)&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Hearing level&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;M (SD)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;55.30 (4.32)&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;57.40 (4.30)&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/tbody&amp;gt;&amp;lt;/table&amp;gt; &lt;/ephtml&gt; &lt;/p&gt; &lt;p&gt;As shown in Table 1, the mean age in the intervention and control groups was 15.07 years (&lt;emph&gt;SD&lt;/emph&gt; = 1.11) and 15.60 years (&lt;emph&gt;SD&lt;/emph&gt; = 1.24), respectively. Also, out of 28 participants, eight (29%) were in the ninth grade, seven (25%) in the tenth grade, five (17%) in the eleventh grade, and eight (29%) in the twelfth grade. The 3-frequencey of the intervention and control groups was 55.30 dB (&lt;emph&gt;SD&lt;/emph&gt; = 4.32) and 55.40 dB (&lt;emph&gt;SD&lt;/emph&gt; = 4.30), respectively.&lt;/p&gt; &lt;hd id=&quot;AN0190413000-12&quot;&gt;Measures&lt;/hd&gt; &lt;p&gt;&lt;/p&gt; &lt;hd id=&quot;AN0190413000-13&quot;&gt;Basic Needs Satisfaction in General Scale (BNSG-S)&lt;/hd&gt; &lt;p&gt;The BNSG-S was designed by Deci and Ryan ([&lt;reflink idref=&quot;bib8&quot; id=&quot;ref58&quot;&gt;8&lt;/reflink&gt;]) and included 21 items. This test consists of 3 subscales: competence (e.g. &#39;I have been able to learn interesting new skills recently&#39;), autonomy (e.g. &#39;I generally feel free to express my opinions and ideas&#39;), and relatedness (e.g. &#39;I really like the people I interact with&#39;). The scale was scored by a seven-point Likert scale ranging from &#39;Not at all true&#39; (&lt;reflink idref=&quot;bib1&quot; id=&quot;ref59&quot;&gt;1&lt;/reflink&gt;) to &#39;Very true&#39; (&lt;reflink idref=&quot;bib7&quot; id=&quot;ref60&quot;&gt;7&lt;/reflink&gt;). The competence, autonomy, and relatedness subscales consist of 7, 6, and 8 items, respectively. The scores of items 3, 4, 7, 11, 15, 16, 18, 19 and 20 were reversed before analysis. The score of each subscale was obtained from the sum of the scores of the same items and higher scores are indicative of a higher level of satisfaction of needs. The reliability was confirmed by Cronbach&#39;s alpha, whose results for competence, autonomy, and relatedness subscales were 0.80, 0.85, and 0.89, respectively (Sorebo et al., [&lt;reflink idref=&quot;bib39&quot; id=&quot;ref61&quot;&gt;39&lt;/reflink&gt;]). In Iran, Ashori and Ghasemzadeh ([&lt;reflink idref=&quot;bib1&quot; id=&quot;ref62&quot;&gt;1&lt;/reflink&gt;]) estimated the reliability of competence, autonomy, and relatedness subscales by Cronbach&#39;s alpha were 0.79, 0.77, and 0.83, respectively. Also, the validity by the confirmatory factor analysis was 0.79.&lt;/p&gt; &lt;hd id=&quot;AN0190413000-14&quot;&gt;Procedure&lt;/hd&gt; &lt;p&gt;After the Research Ethics Committees of the University of Kashan and with the 1964 Helsinki Declaration and its later amendments or comparable amendments ethical standards, the principal of Kashan Deaf School was contacted and informed about the aim of this research. Subsequently, written informed consent was obtained from all hard-of-hearing adolescents and their parents, and they were informed that participation in the research was voluntary.&lt;/p&gt; &lt;p&gt;All participants completed the Basic Needs Satisfaction in General Scale (BNSG-S) in Baghcheban Deaf School as the pre-intervention measure. Participants were divided into small groups and then told how to complete the questionnaires. The participants were informed that the present research examined whether basic psychological needs were satisfied. Completion of this questionnaire took about 10 to 15 minutes.&lt;/p&gt; &lt;p&gt;In the next step, the 10-session flourishing intervention developed based on Seligman&#39;s PERMA model ([&lt;reflink idref=&quot;bib34&quot; id=&quot;ref63&quot;&gt;34&lt;/reflink&gt;]) was implemented for the intervention group for five weeks (two sessions per week, each session lasted 80–90 minutes). This programme was administered to the intervention group by a psychologist trained by the research team who had experience working and teaching deaf students and their mothers. The PERMA flourishing intervention is developed to enhance the well-being of adolescents and adults. The purpose is to enable people to enjoy their life and satisfaction of basic psychological needs. This intervention included the topics of positive emotion, engagement, relationship, meaning, and accomplishments. The summary of the PERMA flourishing intervention is presented in Table 2.&lt;/p&gt; &lt;p&gt;Table 2. Summary of PERMA flourishing intervention.&lt;/p&gt; &lt;p&gt; &lt;ephtml&gt; &amp;lt;table&amp;gt;&amp;lt;thead&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;No&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Aim&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Summary&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/thead&amp;gt;&amp;lt;tbody&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Introducing the program and goals&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Creating a good and positive mood, creating a sincere atmosphere, getting to know each other, positively introducing yourself, explaining the PERMA flourishing program, and the process of training sessions.&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;2&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Realities and living better&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Focus on personal life, attention to life realities, personal abilities and limitations, collective potential, and better life with emphasis on different dimensions of human development over a lifetime.&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;3&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Positive emotions and competence&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Emotional faces, wheel of emotion, joy, vivacity, passion, hope, optimism, relaxation with the story of the tree and the sea, acceptance, and positive thinking.&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;4&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Competence and motivation to flourish&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Behavioral and cognitive skills, internal and external motivation, self-awareness, self-management, autonomy, self-determination, mastery, and desire for well-being.&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;5&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Constructive participation&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Social and effective participation, collaboration, lifelong learning, popularity, acceptance, improving conditions, reinforcers, modelling, and its types.&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;6&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Psychological and personality assets&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Hope, self-efficacy, optimism, flexibility, resilience, curiosity, innovation, creativity, attractions, extraversion, openness, agreement, conscientiousness, and responsibility with an emphasis on role, duty, and task.&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;7&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Positive and quality relationships&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Effective communication (closeness, dependence, and conflict); cognitive errors and their correction based on the interrelationships of thought, emotion, and behaviour; happiness; enrichment of relationships based on counselling techniques.&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;8&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Meaning of life&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;The real meaning of life, spirituality, value for activities, trust, approval and respect, hope and hope-creation, ways to achieve the meaning of life.&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;9&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Progress, success, and achievement&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Successes in different areas, enjoyment of work, goal-setting with conditions-goal- strategy method, goal-setting with intelligent method (specific goal, measurable, achievable, realistic, and time-limited), goal-setting with hard method (inspiring and difficult heart desires).&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;10&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Path of flourishing in the throughout life&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Review positive interaction, good work-good feeling, moving forward in life, higher-level goal, health, productivity, happiness, life satisfaction, and psychological well-being.&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/tbody&amp;gt;&amp;lt;/table&amp;gt; &lt;/ephtml&gt; &lt;/p&gt; &lt;p&gt;This intervention used group discussion, role-playing, video clips, images, and presentations from psychological training booklets to train in each session. The intervention group had one facilitator per session, and rules of confidentiality were applied. The facilitator was a female teacher of the deaf and hard of hearing who had ten years of teaching experience and a master&#39;s degree in psychology. The control group was put on the waiting list. Three days after the last session, the intervention and control groups answered BNSG-S as the post-test. One week after the post-test, a two-day PERMA flourishing intervention workshop was held for the control group. No tests were administered to this group after the end of this workshop.&lt;/p&gt; &lt;hd id=&quot;AN0190413000-15&quot;&gt;Data Analysis&lt;/hd&gt; &lt;p&gt;SPSS 26 software was used to analyse the data. Descriptive statistics were obtained for all variables. The normality of all variables was assessed by the Shapiro-Wilk test. An independent t-test was conducted to examine age and hearing threshold differences between the intervention and control groups. The result showed no significant difference in the mean age between these groups (&lt;emph&gt;t&lt;/emph&gt; = 1.16, &lt;emph&gt;p&lt;/emph&gt; = 0.25) or hearing thresholds (&lt;emph&gt;t&lt;/emph&gt; = 0.05, &lt;emph&gt;p&lt;/emph&gt; = 0.95). Multivariate Analysis of Covariance (MANCOVA) was also performed to examine the changes in subscales of competence, autonomy, and relatedness in the intervention and control groups pre and post intervention.&lt;/p&gt; &lt;hd id=&quot;AN0190413000-16&quot;&gt;Results&lt;/hd&gt; &lt;p&gt;The mean and standard deviation of subscales of the basic psychological needs satisfaction (competence, autonomy, and relatedness) for the intervention and control groups are presented in Table 3.&lt;/p&gt; &lt;p&gt;Table 3. Mean and standard deviation of variables.&lt;/p&gt; &lt;p&gt; &lt;ephtml&gt; &amp;lt;table&amp;gt;&amp;lt;thead&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Variables&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Test&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Intervention group&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Control group&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Mean&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;SD&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Shapiro-Wilk&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Mean&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;SD&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Shapiro-Wilk&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/thead&amp;gt;&amp;lt;tbody&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Autonomy&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Pre-test&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;26.38&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;6.93&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.93&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;28.93&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;8.25&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.55&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Post-test&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;36.23&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;4.65&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.45&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;28.80&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;7.64&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.64&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Competence&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Pre-test&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;25.92&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;4.83&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.97&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;28.26&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;7.01&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.15&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Post-test&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;33.92&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;3.63&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.21&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;29.80&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;6.51&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.19&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Relatedness&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Pre-test&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;33.07&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;7.36&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.75&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;36.66&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;8.17&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.23&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Post-test&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;42.07&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;4.78&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.35&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;36.66&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;8.24&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.44&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/tbody&amp;gt;&amp;lt;/table&amp;gt; &lt;/ephtml&gt; &lt;/p&gt; &lt;p&gt;Table 3 presents the descriptive statistics of the variables. The Shapiro-Wilk test confirmed the normality of these variables (&lt;emph&gt;p&lt;/emph&gt; &amp;gt; 0.05). To investigate the effect of PERMA flourishing intervention on the subscales of basic psychological needs satisfaction (competence, autonomy, and relatedness), the Box&#39;s M test showed the variance-covariance equality (&lt;emph&gt;Box&#39;M&lt;/emph&gt; = 7.48, &lt;emph&gt;p&lt;/emph&gt; = 0.36). The regression line slope assumption was checked, and indicated that the interaction between the pre-intervention and the conditions was not significant (&lt;emph&gt;p&lt;/emph&gt; &amp;gt; 0.05); that is, the linearity of the relationships among variables was met. Bartlett test confirmed an appropriate correlation among these variables (&lt;emph&gt;p&lt;/emph&gt; = 0.0001). Leven test showed the homogeneity of the variance for autonomy (&lt;emph&gt;p&lt;/emph&gt; = 0.11), competence (&lt;emph&gt;p&lt;/emph&gt; = 0.06), and relatedness (&lt;emph&gt;p&lt;/emph&gt; = 0.14); In this way, the MANCOVA assumptions were met. Roy&#39;s largest root test was then conducted to examine the difference between two groups in competence, autonomy, and relatedness (&lt;emph&gt;F&lt;/emph&gt; = 18.34, &lt;emph&gt;p&lt;/emph&gt; = 0.0001). The results suggested that control and intervention groups differ from each other. To explore these differences, the MANCOVA test was conducted, the results of which are shown in Table 4.&lt;/p&gt; &lt;p&gt;Table 4. MANCOVA results for subscales of basic psychological needs satisfaction.&lt;/p&gt; &lt;p&gt; &lt;ephtml&gt; &amp;lt;table&amp;gt;&amp;lt;thead&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Variables&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Source&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;SS&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;df&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;MS&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;F&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Sig.&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Eta&amp;lt;sup&amp;gt;2&amp;lt;/sup&amp;gt;&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Test power&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/thead&amp;gt;&amp;lt;tbody&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Autonomy&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Pre-test&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;180.16&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;180.16&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;17.71&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.0001&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.43&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.98&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Group&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;563.05&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;563.05&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;55.35&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.0001&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.70&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1.00&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Error&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;233.93&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;23&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;10.17&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Corrected total&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1463.25&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;27&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Competence&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Pre-test&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;95.77&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;95.77&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;7.94&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.010&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.25&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.77&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Group&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;214.30&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;214.30&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;17.78&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.0001&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.43&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.98&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Error&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;277.18&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;23&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;12.05&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Corrected total&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;871.71&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;27&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Relatedness&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;Pre-test&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;78.40&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;78.40&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;5.96&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.023&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.20&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.64&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Group&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;428.95&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;428.95&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;32.61&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.0001&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;0.58&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1.00&amp;lt;/td&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Error&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;302.46&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;23&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;13.15&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;tr&amp;gt;&amp;lt;td&amp;gt;Corrected total&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;1430.10&amp;lt;/td&amp;gt;&amp;lt;td&amp;gt;27&amp;lt;/td&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;td /&amp;gt;&amp;lt;/tr&amp;gt;&amp;lt;/tbody&amp;gt;&amp;lt;/table&amp;gt; &lt;/ephtml&gt; &lt;/p&gt; &lt;p&gt;As shown in Table 4, the group source had a positive impact on post-intervention scores of autonomy (&lt;emph&gt;F&lt;/emph&gt; = 55.35, &lt;emph&gt;p&lt;/emph&gt; &amp;lt; 0.0001), competence (&lt;emph&gt;F&lt;/emph&gt; = 17.78, &lt;emph&gt;p&lt;/emph&gt; &amp;lt; 0.0001), and relatedness (&lt;emph&gt;F&lt;/emph&gt; = 32.61, &lt;emph&gt;p&lt;/emph&gt; &amp;lt; 0.0001). These results show that 70% of the variance is associated with autonomy, 43% is associated with competence, 58% is associated with relatedness.&lt;/p&gt; &lt;hd id=&quot;AN0190413000-17&quot;&gt;Discussion&lt;/hd&gt; &lt;p&gt;This study aimed to explore the efficacy of the PERMA flourishing intervention on the basic psychological needs satisfaction in hard-of-hearing adolescents. The finding of this study suggested that after intervention, the scores for the experimental group improved on the subscales of basic psychological needs satisfaction (competence, autonomy, and relatedness). This finding was consistent with Siadatian Arani et al. ([&lt;reflink idref=&quot;bib37&quot; id=&quot;ref64&quot;&gt;37&lt;/reflink&gt;]), who found that the PERMA flourishing model improved forgiveness in mothers of hard-of-hearing students. Ziaee et al. ([&lt;reflink idref=&quot;bib41&quot; id=&quot;ref65&quot;&gt;41&lt;/reflink&gt;]), who found that the PERMA flourishing programme improved the happiness, competence, and social participation of students. The finding is also consistent with Donaldson et al. ([&lt;reflink idref=&quot;bib10&quot; id=&quot;ref66&quot;&gt;10&lt;/reflink&gt;]), Goodman et al. ([&lt;reflink idref=&quot;bib13&quot; id=&quot;ref67&quot;&gt;13&lt;/reflink&gt;]), and Lambert D&#39;raven and Pasha-Zaidi ([&lt;reflink idref=&quot;bib21&quot; id=&quot;ref68&quot;&gt;21&lt;/reflink&gt;]), who noted that the PERMA flourishing intervention increased well-being in participants. Furthermore, this finding is in concert with Ashori and Ghasemzadeh ([&lt;reflink idref=&quot;bib1&quot; id=&quot;ref69&quot;&gt;1&lt;/reflink&gt;]), who concluded that positive psychological intervention improved competence, autonomy, relatedness, and basic psychological needs satisfaction in hard-of-hearing adolescents.&lt;/p&gt; &lt;p&gt;While hard-of-hearing adolescents may have difficulty managing basic psychological needs satisfaction, effective interventions can be facilitative (Ashori &amp;amp; Ghasemzadeh, [&lt;reflink idref=&quot;bib1&quot; id=&quot;ref70&quot;&gt;1&lt;/reflink&gt;]). Basic psychological needs such as competence, autonomy, and relatedness are vital issues in which everyone, including hard-of-hearing adolescents, may need support and help (Hallahan et al., [&lt;reflink idref=&quot;bib15&quot; id=&quot;ref71&quot;&gt;15&lt;/reflink&gt;]). PERMA flourishing intervention seems to significantly contribute to increasing well-being (Ziaee et al., [&lt;reflink idref=&quot;bib41&quot; id=&quot;ref72&quot;&gt;41&lt;/reflink&gt;]). Since hard-of-hearing adolescents may struggle to manage emotions, engagement, relationships, meaning, and accomplishment, they need a specific programme such as the PERMA flourishing intervention that emphasises well-being to regulate or manage their basic psychological needs (Siadatian Arani et al., [&lt;reflink idref=&quot;bib36&quot; id=&quot;ref73&quot;&gt;36&lt;/reflink&gt;]).&lt;/p&gt; &lt;p&gt;Seligman&#39;s PERMA flourishing model includes five elements of well-being: positive emotion, engagement, relationship, meaning, and accomplishments (Kern et al., [&lt;reflink idref=&quot;bib19&quot; id=&quot;ref74&quot;&gt;19&lt;/reflink&gt;]; Siadatian Arani et al., [&lt;reflink idref=&quot;bib37&quot; id=&quot;ref75&quot;&gt;37&lt;/reflink&gt;]). Positive emotions have the most obvious connection with the general concept of happiness. Focusing on positive emotions does not just mean smiling during the day, rather it is more about finding the ability to stay optimistic (Seligman, [&lt;reflink idref=&quot;bib34&quot; id=&quot;ref76&quot;&gt;34&lt;/reflink&gt;]). When a person is actively engaged in doing something he enjoys, his body is actively filled with hormones and endorphins that enhance the sense of well-being Engagement involves using strengths to meet challenges and experiencing flow (Seligman, [&lt;reflink idref=&quot;bib35&quot; id=&quot;ref77&quot;&gt;35&lt;/reflink&gt;]). Humans are designed to belong and when they engage in relationships they connect with others, they love, and are loved. This is a vital aspect of being human that allows one to experience intimate communication as well as emotional and physical contact with other people (Kern et al., [&lt;reflink idref=&quot;bib19&quot; id=&quot;ref78&quot;&gt;19&lt;/reflink&gt;]). When life has meaning, we find purpose and feel that our lives and actions are important (Donaldson et al., [&lt;reflink idref=&quot;bib10&quot; id=&quot;ref79&quot;&gt;10&lt;/reflink&gt;]). We derive a sense of accomplishment when we work towards and reach goals, obtain mastery, and gain efficacy in completing tasks (Butler &amp;amp; Kern, [&lt;reflink idref=&quot;bib2&quot; id=&quot;ref80&quot;&gt;2&lt;/reflink&gt;]).&lt;/p&gt; &lt;p&gt;While competence, autonomy, and relatedness are important predictors of self-determination in hard-of-hearing adolescents (Ashori &amp;amp; Ghasemzadeh, [&lt;reflink idref=&quot;bib1&quot; id=&quot;ref81&quot;&gt;1&lt;/reflink&gt;]), research has consistently highlighted the significant effect of PERMA flourishing intervention on adolescents&#39; competence, autonomy, and relatedness across the life span (Seligman, [&lt;reflink idref=&quot;bib35&quot; id=&quot;ref82&quot;&gt;35&lt;/reflink&gt;]). In addition, this intervention reduces the psychological problems of participants. The PERMA flourishing intervention is directly related to improving competence, autonomy, and relatedness, thus it stands to reason that the intervention significantly affects the basic psychological needs satisfaction in hard-of-hearing adolescents.&lt;/p&gt; &lt;hd id=&quot;AN0190413000-18&quot;&gt;Limitations and Directions for Future Research&lt;/hd&gt; &lt;p&gt;There were several limitations in this study. A self-report questionnaire was used and participants may not be careful in answering questions or respond with bias. The PERMA flourishing intervention was implemented in only ten sessions, and the follow-up phase of the research was not possible. In addition, various factors such as the degree of hearing loss, the type of hearing impairment, and the type of hearing aid in adolescents may also affect their basic psychological needs satisfaction. The current results were found in students who had on average, moderate to severe hearing loss, and these may not generalise to students with profound hearing loss.&lt;/p&gt; &lt;p&gt;Future researchers are recommended to use other tools in addition to the questionnaire, such as observation and interview, and to consider the factors such as the degree and type of hearing loss in participants. Finally, it is suggested that this intervention considered and assessed with other groups of exceptional children.&lt;/p&gt; &lt;hd id=&quot;AN0190413000-19&quot;&gt;Conclusion&lt;/hd&gt; &lt;p&gt;In general, the findings of the current study revealed the beneficial effect of PERMA (Positive emotion, Engagement, Relationship, Meaning, and Accomplishment) flourishing intervention on on basic psychological needs satisfaction in hard-of-hearing adolescents.&lt;/p&gt; &lt;p&gt;The current findings have implications for those professionals working with hard-of-hearing adolescents both educationally and clinically in terms of the importance of awareness of competence, autonomy, and relatedness throughout the lifespan. Parents and professionals should be aware of the valuable and unique aspects of basic psychological needs in hard-of-hearing adolescents and attend to these important needs and psychological treatments such as PERMA flourishing intervention.&lt;/p&gt; &lt;hd id=&quot;AN0190413000-20&quot;&gt;Acknowledgments&lt;/hd&gt; &lt;p&gt;We would like to appreciate the hard-of-hearing adolescents and personnel of Baghchehban Deaf School who made this research possible.&lt;/p&gt; &lt;hd id=&quot;AN0190413000-21&quot;&gt;Disclosure Statement&lt;/hd&gt; &lt;p&gt;No potential conflict of interest was reported by the author(s).&lt;/p&gt; &lt;hd id=&quot;AN0190413000-22&quot;&gt;Declaration of Conflicting Interests&lt;/hd&gt; &lt;p&gt;The authors declare that they have no conflicts of interest with respect to the research, authorship, and/or publication of this article. All authors are part of the D-SCOPE consortium and declare to have contributed in a substantial manner.&lt;/p&gt; &lt;hd id=&quot;AN0190413000-23&quot;&gt;Data Availability Statement&lt;/hd&gt; &lt;p&gt;Data available on request from the authors.&lt;/p&gt; &lt;hd id=&quot;AN0190413000-24&quot;&gt;Ethical Approval and Informed Consent&lt;/hd&gt; &lt;p&gt;This study was approved by the Research Ethics Committees of University of Isfahan, Iran on 24 November 2021 (IR.UI.REC.1400.086).&lt;/p&gt; &lt;p&gt;https://ethics.research.ac.ir/EthicsProposalView.php?id=233898&lt;/p&gt; &lt;p&gt;https://ethics.research.ac.ir/ProposalCertificateEn.php?id=233898%26Print=true%26NoPrintHeader=true%26NoPrintFooter=true%26NoPrintPageBorder=true%26LetterPrint=true&lt;/p&gt; &lt;ref id=&quot;AN0190413000-25&quot;&gt; &lt;title&gt; References &lt;/title&gt; &lt;blist&gt; &lt;bibl id=&quot;bib1&quot; idref=&quot;ref26&quot; type=&quot;bt&quot;&gt;1&lt;/bibl&gt; &lt;bibtext&gt; Ashori, M., &amp;amp; Ghasemzadeh, S. (2018). The effectiveness of mental immunization training on alexithymia, self-determination and life orientation of adolescents with hearing impairment. Journal of Psychological Studies, 14 (2), 7 – 23. https://doi.org/10.22051/psy.2018.19563.1608&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibl id=&quot;bib2&quot; idref=&quot;ref80&quot; type=&quot;bt&quot;&gt;2&lt;/bibl&gt; &lt;bibtext&gt; Butler, J., &amp;amp; Kern, M. L. (2016). The PERMA-Profiler: A brief multidimensional measure of flourishing. International Journal of Wellbeing, 6 (3), 1 – 48. https://doi.org/10.5502/ijw.v6i3.526&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibl id=&quot;bib3&quot; idref=&quot;ref3&quot; type=&quot;bt&quot;&gt;3&lt;/bibl&gt; &lt;bibtext&gt; Byatt, T. J., Dally, K., &amp;amp; Duncan, J. (2019). Systematic review of literature: Social capital and adolescents who are deaf or hard of hearing. Journal of Deaf Studies and Deaf Education, 24 (4), 319 – 332. https://doi.org/10.1093/deafed/enz020&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibl id=&quot;bib4&quot; idref=&quot;ref51&quot; type=&quot;bt&quot;&gt;4&lt;/bibl&gt; &lt;bibtext&gt; Coffey, J. K., Wray-Lake, L., Mashek, D., &amp;amp; Branand, B. (2014). A multi-study examination of well-being theory in college and community samples. Journal of Happiness Studies, 17 (1), 187 – 211. https://doi.org/10.1007/s10902-014-9590-8&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibl id=&quot;bib5&quot; idref=&quot;ref8&quot; type=&quot;bt&quot;&gt;5&lt;/bibl&gt; &lt;bibtext&gt; Crowe, K., &amp;amp; Dammeyer, J. (2021). A review of the conversational pragmatic skills of children with cochlear implants. Journal of Deaf Studies and Deaf Education, 26 (2), 171 – 186. https://doi.org/10.1093/deafed/enab001&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibl id=&quot;bib6&quot; idref=&quot;ref7&quot; type=&quot;bt&quot;&gt;6&lt;/bibl&gt; &lt;bibtext&gt; Crowe, T. V. (2019). Deaf child and adolescent consumers of public behavioral health services. Journal of Deaf Studies and Deaf Education, 24 (2), 57 – 64. https://doi.org/10.1093/deafed/eny036&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibl id=&quot;bib7&quot; idref=&quot;ref12&quot; type=&quot;bt&quot;&gt;7&lt;/bibl&gt; &lt;bibtext&gt; Danadel, M., &amp;amp; Ashori, M. (2024). Effects of emotion regulation training on social problem-solving in hard-of-hearing adolescents. Current Psychology, 43 (17), 15366 – 15375. https://doi.org/10.1007/s12144-023-05498-w&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibl id=&quot;bib8&quot; idref=&quot;ref17&quot; type=&quot;bt&quot;&gt;8&lt;/bibl&gt; &lt;bibtext&gt; Deci, E. L., &amp;amp; Ryan, R. M. (2000). The &quot;what&quot; and &quot;why&quot; of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11 (4), 227 – 268. https://doi.org/10.1207/S15327965PLI1104_01&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibl id=&quot;bib9&quot; idref=&quot;ref19&quot; type=&quot;bt&quot;&gt;9&lt;/bibl&gt; &lt;bibtext&gt; Deci, E. L., &amp;amp; Ryan, R. M. (2011). Levels of analysis, regnant causes of behavior and well-being: The role of psychological needs. Psychological Inquiry, 22 (1), 17 – 22. https://doi.org/10.1080/1047840X.2011.545978&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Donaldson, S. I., Heshmati, S., Lee, J. Y., &amp;amp; Donaldson, S. I. (2020). Examining building blocks of well-being beyond PERMA and self-report bias. The Journal of Positive Psychology, 1–8 (6), 811 – 818. https://doi.org/10.1080/17439760.2020.181881&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Eli&#252;ş&#252;k, B. A. (2018). Adaptation of the PERMA well-being scale into Turkish: Validity and reliability studies. Educational Research &amp;amp; Reviews, 13 (4), 129 – 135. https://doi.org/10.5897/err2017.3435&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Fosco, G. M., Brinberg, M., &amp;amp; Ram, N. (2021). Day-to-day changes in parent-adolescent connectedness: Relations with daily subjective well-being and eudaimonia differ for parents and adolescents. The Journal of Positive Psychology, 16 (5), 640 – 650. https://doi.org/10.1080/17439760.2020.1791945&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Goodman, F. R., Disabato, D. J., Kashdan, T. B., &amp;amp; Kauffman, S. B. (2018). Measuring well- being: A comparison of subjective well-being and PERMA. The Journal of Positive Psychology, 13 (4), 321 – 332. https://doi.org/10.1080/17439760.2017.1388434&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Guo, L.-Y., &amp;amp; Spencer, L. J. (2017). Development of grammatical accuracy in English-speaking children with cochlear implants: A longitudinal study. Journal of Speech, Language, &amp;amp; Hearing Research, 60 (4), 1062. https://doi.org/10.1044/2016_jslhr-h-16-0182&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Hallahan, D. P., Kauffman, J. M., &amp;amp; Pullen, P. C. (2023). Exceptional learners: An introduction to special education (15th ed.). Pearson Education, Inc.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Handa, S., Pereira, A., &amp;amp; Holmqvist, G. (2023). The rapid decline of happiness: Exploring life satisfaction among young people across the world. Applied Research in Quality of Life, 18 (3), 1549 – 1579. https://doi.org/10.1007/s11482-023-10153-4&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Humphries, T., Kushalnagar, P., Mathur, G., Napoli, D. J., Rathmann, C., &amp;amp; Smith, S. (2019). Support for parents of deaf children: Common questions and informed, evidence-based answers. International Journal of Pediatric Otorhinolaryngology, 118 (1), 134 – 142. https://doi.org/10.1016/j.ijporl.2018.12.036&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Jang, W. E., Chun, J. W., Kim, J. J., &amp;amp; Bucy, E. (2021). Effects of self-presentation strategy and tie strength on Facebook users&#39; happiness and subjective vitality. Journal of Happiness Studies, 22 (7), 2961 – 2979. https://doi.org/10.1007/s10902-020-00348-z&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Kern, M. L., Waters, L. E., Adler, A., &amp;amp; White, M. A. (2015). A multidimensional approach to measuring well-being in students: Application of the PERMA framework. The Journal of Positive Psychology, 10 (1), 262 – 271. https://doi.org/10.1080/17439760.2014.936962&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Kiltz, L., Trippenzee, M., Fleer, J., Fokkens-Bruinsma, M., &amp;amp; Jansen, E. P. W. A. (2023). Student well-being in times of COVID-19 in the Netherlands: Basic psychological need satisfaction and frustration within the academic learning environment. European Journal of Psychology of Education, 39 (1), 319 – 339. https://doi.org/10.1007/s10212-023-00680-x&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Lambert D&#39;raven, L., &amp;amp; Pasha-Zaidi, N. (2015). Using the PERMA model in the United Arab Emirates. Social Indicators Research, 125 (3), 905 – 933. https://doi.org/10.1007/s11205-015-0866-0&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Marschark, M., Machmer, E., Spencer, L. J., Borgna, G., Durkin, A., &amp;amp; Convertino, C. (2018). Language and psychosocial functioning among deaf learners with and without cochlear implants. Journal of Deaf Studies and Deaf Education, 23 (2), 187 – 187. https://doi.org/10.1093/deafed/eny004&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Martela, F., &amp;amp; Sheldon, K. M. (2019). Clarifying the concept of well-being: Psychological need satisfaction as the common core connecting eudaimonic and subjective well-being. Review of General Psychology, 23 (4), 458 – 474. https://doi.org/10.1177/1089268019880886&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Maslow, A. H. (1981). Motivation and personality. Prabhat Prakashan.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Mayer, C., Trezek, B. J., &amp;amp; Hancock, G. R. (2021). Reading achievement of deaf students: Challenging the fourth grade ceiling. Journal of Deaf Studies and Deaf Education, 26 (3), 427 – 437. https://doi.org/10.1093/deafed/enab013&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; McClelland, D. C. (1965). Toward a theory of motive acquisition. The American Psychologist, 20 (5), 321 – 333. https://doi.org/10.1037/h0022225&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Murray, H. A. (1938). Explorations in personality. Oxford University Press. https://archive.org/details/explorationsinpe031973mbp&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Oshodi, T. O., Bruneau, B., Crockett, R., Kinchington, F., Nayar, S., &amp;amp; West, E. (2019). Registered nurses&#39; perceptions and experiences of autonomy: A descriptive phenomenological study. BMC Nursing, 18 (1), 51. https://doi.org/10.1186/s12912-019-0378-3&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Pollenne, D. (2024). Understandings of happiness and life satisfaction among refugees in the UK. Journal of Refugee Studies, 37 (1), 51 – 71. https://doi.org/10.1093/jrs/fead088&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; P&#246;lzler, T., Tomabechi, T., &amp;amp; Hannikainen, I. R. (2024). Broad, subjective, relative: The surprising folk concept of basic needs. Philosophical Studies, 181 (1), 319 – 347. https://doi.org/10.1007/s11098-023-02080-9&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Radovanović, V., Šestić, M. R., Kovačević, J., &amp;amp; Dimoski, S. (2020). Factors related to personal resiliency in deaf and hard-of-hearing adolescents. Journal of Deaf Studies and Deaf Education, 25 (4), 430 – 437. https://doi.org/10.1093/deafed/enaa012&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Roncaglia, I. (2017). The role of wellbeing and wellness: A positive psychological model in supporting young people with ASCs. Psychological Thought, 10 (1), 217 – 226. https://doi.org/10.5964/psyct.v10i1.203&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Ryan, R. M., &amp;amp; Deci, E. L. (2002). Overview of self-determination theory: An organismic dialectical perspective. In E. L. Deci &amp;amp; R. M. Ryan (Eds.), Handbook of self-determination research (pp. 3 – 33). University of Rochester Press.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Seligman, M. E. P. (2011). Flourish. Nicholas Brealey Publishing.&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Seligman, M. E. P. (2018). PERMA and the building blocks of well-being. The Journal of Positive Psychology, 13 (4), 333 – 335. https://doi.org/10.1080/17439760.2018.1437466&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Siadatian Arani, S. H., Ashori, M., Faramarzi, S., Ghasem, N., &amp;amp; Spencer, L. J. (2022). Adaptation and validation of PERMA flourishing program to improve the psychological well-being of adolescents suffering from hearing loss and their mothers. Journal of Family Research, 18 (2), 355 – 370. https://doi.org/10.48308/jfr.18.2.355&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Siadatian Arani, S. H., Ashori, M., Faramarzi, S., Norouzi, G., &amp;amp; Spencer, L. J. (2023). The effect of training based on the flourishing psychological model on forgiveness in mothers of students with hearing loss. Journal of Family Research, 19 (2), 255 – 270. https://doi.org/10.48308/JFR.19.2.255&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Skar, R. (2010). The meaning of autonomy in nursing practice. Journal of Clinical Nursing, 19 (15–16), 2226 – 2234. https://doi.org/10.1111/j.1365-2702.2009.02804.x&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Sorebo, O., Halvari, H., Gulli, V. F., &amp;amp; Kristiansen, R. (2009). The role of self-determination theory in explaining teachers&#39; motivation to continue to use e-learning technology. Computers &amp;amp; Education, 53 (4), 1177 – 1187. https://doi.org/10.1016/j.compedu.2009.06.001&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Terlektsi, E., Kreppner, J., Mahon, M., Worsfold, S., &amp;amp; Kennedy, C. R. (2020). Peer relationship experiences of deaf and hard-of-hearing adolescents. Journal of Deaf Studies and Deaf Education, 25 (2), 153 – 166. https://doi.org/10.1093/deafed/enz048&lt;/bibtext&gt; &lt;/blist&gt; &lt;blist&gt; &lt;bibtext&gt; Ziaee, H., Rezaei, A., Talepasand, S., &amp;amp; Mohammadyfar, M. (2021). The effectiveness of training based on the flourishing psychological model on happiness, competence, and social participation. Positive Psychology Research, 7 (1), 19 – 34. https://doi.org/10.22108/ppls.2021.124754.1986&lt;/bibtext&gt; &lt;/blist&gt; &lt;/ref&gt; &lt;aug&gt; &lt;p&gt;By Sayed Hossein Siadatian Arani; Mohammad Ashori; Salar Faramarzi; Ghasem Norouzi and Linda J. Spencer&lt;/p&gt; &lt;p&gt;Reported by Author; Author; Author; Author; Author&lt;/p&gt; &lt;/aug&gt; &lt;nolink nlid=&quot;nl1&quot; bibid=&quot;bib29&quot; firstref=&quot;ref1&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl2&quot; bibid=&quot;bib12&quot; firstref=&quot;ref2&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl3&quot; bibid=&quot;bib31&quot; firstref=&quot;ref4&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl4&quot; bibid=&quot;bib22&quot; firstref=&quot;ref5&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl5&quot; bibid=&quot;bib16&quot; firstref=&quot;ref6&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl6&quot; bibid=&quot;bib25&quot; firstref=&quot;ref9&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl7&quot; bibid=&quot;bib40&quot; firstref=&quot;ref10&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl8&quot; bibid=&quot;bib15&quot; firstref=&quot;ref11&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl9&quot; bibid=&quot;bib30&quot; firstref=&quot;ref13&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl10&quot; bibid=&quot;bib39&quot; firstref=&quot;ref14&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl11&quot; bibid=&quot;bib27&quot; firstref=&quot;ref15&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl12&quot; bibid=&quot;bib24&quot; firstref=&quot;ref16&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl13&quot; bibid=&quot;bib26&quot; firstref=&quot;ref18&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl14&quot; bibid=&quot;bib20&quot; firstref=&quot;ref20&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl15&quot; bibid=&quot;bib28&quot; firstref=&quot;ref22&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl16&quot; bibid=&quot;bib38&quot; firstref=&quot;ref23&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl17&quot; bibid=&quot;bib33&quot; firstref=&quot;ref24&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl18&quot; bibid=&quot;bib17&quot; firstref=&quot;ref27&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl19&quot; bibid=&quot;bib36&quot; firstref=&quot;ref28&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl20&quot; bibid=&quot;bib18&quot; firstref=&quot;ref29&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl21&quot; bibid=&quot;bib23&quot; firstref=&quot;ref30&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl22&quot; bibid=&quot;bib34&quot; firstref=&quot;ref31&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl23&quot; bibid=&quot;bib10&quot; firstref=&quot;ref32&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl24&quot; bibid=&quot;bib19&quot; firstref=&quot;ref33&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl25&quot; bibid=&quot;bib11&quot; firstref=&quot;ref34&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl26&quot; bibid=&quot;bib13&quot; firstref=&quot;ref40&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl27&quot; bibid=&quot;bib35&quot; firstref=&quot;ref41&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl28&quot; bibid=&quot;bib37&quot; firstref=&quot;ref43&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl29&quot; bibid=&quot;bib41&quot; firstref=&quot;ref45&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl30&quot; bibid=&quot;bib32&quot; firstref=&quot;ref49&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl31&quot; bibid=&quot;bib21&quot; firstref=&quot;ref50&quot;&gt;&lt;/nolink&gt; &lt;nolink nlid=&quot;nl32&quot; bibid=&quot;bib14&quot; firstref=&quot;ref54&quot;&gt;&lt;/nolink&gt;
Header DbId: eric
DbLabel: ERIC
An: EJ1504281
AccessLevel: 3
PubType: Academic Journal
PubTypeId: academicJournal
PreciseRelevancyScore: 0
IllustrationInfo
Items – Name: Title
  Label: Title
  Group: Ti
  Data: Flourishing Intervention: Basic Psychological Needs Satisfaction in Hard-of-Hearing Adolescents
– Name: Language
  Label: Language
  Group: Lang
  Data: English
– Name: Author
  Label: Authors
  Group: Au
  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Sayed+Hossein+Siadatian+Arani%22&quot;&gt;Sayed Hossein Siadatian Arani&lt;/searchLink&gt; (ORCID &lt;externalLink term=&quot;https://orcid.org/0000-0001-5523-4427&quot;&gt;0000-0001-5523-4427&lt;/externalLink&gt;)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Mohammad+Ashori%22&quot;&gt;Mohammad Ashori&lt;/searchLink&gt; (ORCID &lt;externalLink term=&quot;https://orcid.org/0000-0002-1685-2932&quot;&gt;0000-0002-1685-2932&lt;/externalLink&gt;)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Salar+Faramarzi%22&quot;&gt;Salar Faramarzi&lt;/searchLink&gt; (ORCID &lt;externalLink term=&quot;https://orcid.org/0000-0002-0140-0335&quot;&gt;0000-0002-0140-0335&lt;/externalLink&gt;)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Ghasem+Norouzi%22&quot;&gt;Ghasem Norouzi&lt;/searchLink&gt; (ORCID &lt;externalLink term=&quot;https://orcid.org/0000-0002-8624-7818&quot;&gt;0000-0002-8624-7818&lt;/externalLink&gt;)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Linda+J%2E+Spencer%22&quot;&gt;Linda J. Spencer&lt;/searchLink&gt; (ORCID &lt;externalLink term=&quot;https://orcid.org/0000-0002-5155-6207&quot;&gt;0000-0002-5155-6207&lt;/externalLink&gt;)
– Name: TitleSource
  Label: Source
  Group: Src
  Data: &lt;searchLink fieldCode=&quot;SO&quot; term=&quot;%22International+Journal+of+Disability%2C+Development+and+Education%22&quot;&gt;&lt;i&gt;International Journal of Disability, Development and Education&lt;/i&gt;&lt;/searchLink&gt;. 2026 73(1):163-175.
– Name: Avail
  Label: Availability
  Group: Avail
  Data: Routledge. Available from: Taylor &amp; Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
– Name: PeerReviewed
  Label: Peer Reviewed
  Group: SrcInfo
  Data: Y
– Name: Pages
  Label: Page Count
  Group: Src
  Data: 13
– Name: DatePubCY
  Label: Publication Date
  Group: Date
  Data: 2026
– Name: TypeDocument
  Label: Document Type
  Group: TypDoc
  Data: Journal Articles&lt;br /&gt;Reports - Research
– Name: Subject
  Label: Descriptors
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Foreign+Countries%22&quot;&gt;Foreign Countries&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Adolescents%22&quot;&gt;Adolescents&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Hard+of+Hearing%22&quot;&gt;Hard of Hearing&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Psychological+Needs%22&quot;&gt;Psychological Needs&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Need+Gratification%22&quot;&gt;Need Gratification&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Competence%22&quot;&gt;Competence&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Personal+Autonomy%22&quot;&gt;Personal Autonomy&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Intervention%22&quot;&gt;Intervention&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Sense+of+Belonging%22&quot;&gt;Sense of Belonging&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Feasibility+Studies%22&quot;&gt;Feasibility Studies&lt;/searchLink&gt;
– Name: Subject
  Label: Geographic Terms
  Group: Su
  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Iran%22&quot;&gt;Iran&lt;/searchLink&gt;
– Name: DOI
  Label: DOI
  Group: ID
  Data: 10.1080/1034912X.2024.2403379
– Name: ISSN
  Label: ISSN
  Group: ISSN
  Data: 1034-912X&lt;br /&gt;1465-346X
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: The present study aimed to explore the effect of the PERMA (Positive emotion, Engagement, Relationship, Meaning, and Accomplishment) flourishing intervention on basic psychological needs satisfaction in hard-of-hearing adolescents. This research was a quasi-randomised controlled trial design. Twenty-eight hard-of-hearing adolescents aged 14-17 years were randomly selected from the Deaf Center and Baghcheban Deaf School in Kashan, Iran. They were randomly replaced to experimental (n = 13) or control (n = 15) groups. The experimental group participated in the 10-session intervention, while the control group did not participate in this programme. Both groups completed the Basic Needs Satisfaction in General Scale (BNSG-S before and after intervention. The results showed that after intervention, scores on the subscales of basic psychological needs (competence, autonomy, and relatedness) in hard-of-hearing adolescents significantly and positively increased (p &lt; 0.001). Therefore, the PERMA flourishing intervention was feasible and acceptable to these adolescents.
– Name: AbstractInfo
  Label: Abstractor
  Group: Ab
  Data: As Provided
– Name: DateEntry
  Label: Entry Date
  Group: Date
  Data: 2026
– Name: AN
  Label: Accession Number
  Group: ID
  Data: EJ1504281
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=eric&AN=EJ1504281
RecordInfo BibRecord:
  BibEntity:
    Identifiers:
      – Type: doi
        Value: 10.1080/1034912X.2024.2403379
    Languages:
      – Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 13
        StartPage: 163
    Subjects:
      – SubjectFull: Foreign Countries
        Type: general
      – SubjectFull: Adolescents
        Type: general
      – SubjectFull: Hard of Hearing
        Type: general
      – SubjectFull: Psychological Needs
        Type: general
      – SubjectFull: Need Gratification
        Type: general
      – SubjectFull: Competence
        Type: general
      – SubjectFull: Personal Autonomy
        Type: general
      – SubjectFull: Intervention
        Type: general
      – SubjectFull: Sense of Belonging
        Type: general
      – SubjectFull: Feasibility Studies
        Type: general
      – SubjectFull: Iran
        Type: general
    Titles:
      – TitleFull: Flourishing Intervention: Basic Psychological Needs Satisfaction in Hard-of-Hearing Adolescents
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Sayed Hossein Siadatian Arani
      – PersonEntity:
          Name:
            NameFull: Mohammad Ashori
      – PersonEntity:
          Name:
            NameFull: Salar Faramarzi
      – PersonEntity:
          Name:
            NameFull: Ghasem Norouzi
      – PersonEntity:
          Name:
            NameFull: Linda J. Spencer
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 01
              Type: published
              Y: 2026
          Identifiers:
            – Type: issn-print
              Value: 1034-912X
            – Type: issn-electronic
              Value: 1465-346X
          Numbering:
            – Type: volume
              Value: 73
            – Type: issue
              Value: 1
          Titles:
            – TitleFull: International Journal of Disability, Development and Education
              Type: main
ResultId 1