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Objectives: Children with hearing loss often undergo considerable pain and distress due to their hearing impairment, leading to challenges in engaging constructively with others. Using games, mainly through play therapy, can significantly enhance interaction and adjustment in children, especially those with hearing impairments. This research seeks to evaluate the impact of play therapy on the adaptation and self-confidence of children dealing with hearing challenges.
Methods: This randomized controlled trial was conducted at a welfare center affiliated with the Hamadan University of Medical Sciences in western Iran. Sixty-two children with hearing loss were selected from the welfare center. They were then assigned to the play therapy or control group using block random sampling. The pre- and post-intervention assessments included completing demographic information, an adaptability questionnaire for elementary school children, and a self-esteem inventory. 
Results: The implementation of play therapy led to a significant increase in adaptability immediately after the intervention and one month later (P<0.001). Moreover, a notable difference was observed between the two groups at the end of the study (P<0.001). Throughout the research, play therapy consistently elevated the self-esteem of the children. After the study, a noticeable difference was observed between the two groups (P<0.001).
Discussion: lay therapy effectively increased adaptability and improved self-esteem in children with hearing loss. So, caregivers can use play therapy as therapeutic care to increase social adaptation and self-confidence in these children.