The effect of interviewing techniques on young children's responses to questions

Idiosyncratic effects of interviewer behavior on the accuracy of children's responses

Children are interviewed to provide information about past events in various contexts (e.g., police interviews, court proceedings, therapeutic interviews). During an interview, various factors may influence the accuracy of children's responses to questions about recent events. However, behavioral research in this area is limited. Sparling et al. (2011) showed that children frequently provided inaccurate responses to questions about video clips they just watched depending on the antecedents (i.e., the way a question was asked) and consequences (i.e., the response of the interviewer to their answers). In the current study, we replicated and extended the procedures reported by Sparling et al. and found that two of five children were sensitive to the various antecedents and consequences that we manipulated. Our findings indicate a need for more research in this area to determine the relevant environmental variables that affect children's response accuracy.

Factors influencing the perceived credibility of children alleging physical abuse

Adults' assessments of the credibility of children's reports are affected by factors including the frequency of abuse, reporting delays and the child's age. The present study examined whether similar factors affect the perceived credibility of children reporting physical abuse, which is more common than sexual abuse. Two hundred and eight mock jurors read a simulated transcript of a child reporting physical abuse to police and made credibility ratings. Within each transcript, abuse frequency (once, repeated), reporting timing (recent, delayed), police question type (open, closed) and child age (6 or 10 years) were manipulated. The child was considered more credible when the abuse was only experienced once and reported shortly after it occurred, and when prompted with open questions. The child's age did not affect credibility judgments. Current findings support recommendations to prioritise open questions with children and provide evidence for extension of the benefits of open questions to children's credibility.

"Too much too soon, let me out of here!" Psychiatric and obstetric implications of a child's pregnancy

OBJECTIVE

Psychiatrists may become involved in circumstances where a child is seeking termination of pregnancy. Potential roles include capacity advice and advocacy, but ethical and legal uncertainties abound. This paper uses illustrative cases, in an Australian jurisdiction, to exemplify the issues.

CONCLUSION

Termination of pregnancy at the youthful extreme raises unique challenges for all involved.

Emotion regulation strategy flexibility in childhood: When do children switch between different strategies?

Emotion regulation (ER) flexibility involves switching between ER strategies to manage negative emotions, but the conditions under which children select a specific strategy or switch strategies are unclear. In prior work, adults who are instructed to use certain ER strategies have been shown to switch strategies more often and to favor emotional disengagement strategies such as distraction when negative emotions are more intense. This experimental study examined the developmental origins of ER strategy use patterns that support flexible ER. Children (N = 181; 4-11 years of age; 91 girls) received no ER instructions (control) or were instructed to implement a specific cognitive strategy (distraction or reappraisal) while watching a negative emotional film. They self-reported their emotions multiple times and were later interviewed using open- and close-ended questions about the ER strategies they used while watching the film. Results revealed that children described instructed strategies as well as other uninstructed strategies. Distraction was described more often when children reported negative emotion, suggesting early-emerging awareness of the utility of disengagement strategies for managing negative feelings. Reporting strategies consistent with instructions and descriptions of strategy switching were more common with felt negative emotion, but only for children who received specific ER instructions. The pattern of results was stronger for direct questions, suggesting that reliance on open-ended questioning about ER strategy use might not reveal the full extent of children's capabilities. Children's flexible ER strategy use emerges early, is related to intrapersonal aspects of emotion development, and should be considered in instructed ER paradigms.

Children's and teachers' perspectives on adjustments needed in school settings after acquired brain injury

BACKGROUND

Children with acquired brain injury (ABI) often present with functional deficits that influence their societal participation and well-being. Successful reintegration into school calls for individual support to meet each child's adjustment needs. The adjustment needs of children with ABI in school settings have not previously been explored.

AIM

The objectives of the present study were (a) to describe adjustment needs in school settings for children with ABI and (b) to explore differences and similarities between reports from the children and their teachers.

METHODS

In this cross-sectional study, 20 children with ABI (mean age 12.8 ± 3.4 years; class grade 1-10) and their teachers were interviewed individually, using the School Setting Interview (SSI). Data were analyzed with descriptive and with non-parametric statistics.

RESULTS

(a) In the overall group, children rated that 55.6% of the 16 activities in the SSI needed no adjustment. The corresponding percentage for teachers was 48.4%. (b) In the child-teacher pairs, there was a positive relationship between teachers' and children's responses only in 3 out of 16 school activities and agreement varied strongly according to the activity in question.

CONCLUSIONS AND SIGNIFICANCE

It is important for occupational therapists and other professionals to specifically consider adjustment needs relating to school activities from various perspectives when aiming to provide individualized interventions.

Experiencing Support During Needle-Related Medical Procedures: A Hermeneutic Study With Young Children (3-7Years)

Needle-related medical procedures (NRMPs) are something that all young children need to undergo at some point. These procedures may involve feelings of fear, pain and anxiety, which can cause problems later in life either when seeking healthcare in general or when seeking care specifically involving needles. More knowledge is needed about supporting children during these procedures.

AIM

This study aims to explain and understand the meaning of the research phenomenon: support during NRMPs. The lived experiences of the phenomenon are interpreted from the perspective of younger children.

METHOD

The analysis uses a lifeworld hermeneutic approach based on participant observations and interviews with children between 3 and 7years of age who have experienced NRMPs.

RESULTS

The research phenomenon, support for younger children during NRMPs, is understood through the following themes: being the centre of attention, getting help with distractions, being pampered, becoming involved, entrusting oneself to the safety of adults and being rewarded. A comprehensive understanding is presented wherein younger children experience support from adults during NRMPs in order to establish resources and/or strengthen existing resources.

CONCLUSIONS

The manner in which the child will be guided through the procedure is developed based on the child's reactions. This approach demonstrates that children are actively participating during NRMPs. Supporting younger children during NRMPs consists of guiding them through a shared situation that is mutually beneficial to the child, the parent and the nurse. Play during NRMP is an important tool that enables the support to be perceived as positive.

Communication Strategies for Empowering and Protecting Children

Communication with children and adolescents is an area that requires special attention. It is our job as health care professionals to ensure that the information being relayed is provided at a level that can be understood, to ensure patient safety as well as keep a child or adolescent engaged in their own medical care and decision making. This article discusses the importance of communication with children, adolescents, and their caregivers. It focuses on the overall importance of health literacy in communicating health care information to both caregivers and their children. Included are points to consider when communicating at different developmental stages, as well as strategies to help establish rapport. Lastly, the importance of technology and how it can help facilitate communication with this population is introduced.

The conversation: interacting with parents when child abuse is suspected

This article reviews some of the challenges and pitfalls in communicating with families when abuse is part of the differential diagnosis and offers some suggestions for improving communication with parents and children in these challenging clinical settings.

Eye-closure increases children's memory accuracy for visual material

Research shows that closing the eyes during retrieval can help both adults and children to remember more about witnessed events. In this study, we investigated whether the eye-closure effect in children is explained by general cognitive load, modality-specific interference, or a combination. 120 children (60 female) aged between 8 and 11 years viewed a 5-min clip depicting a theft and were questioned about the event. During the cued-recall interview, children either viewed a blank screen (blank-screen condition), kept their eyes closed (eye-closure condition), were exposed to visual stimuli (visual-distraction condition), or were exposed to auditory stimuli (auditory-distraction condition). Children in the blank-screen and eye-closure conditions provided significantly more correct and fewer incorrect responses about visual details than children in the visual- and auditory-distraction conditions. No advantage was found for auditory details. These results support neither a pure cognitive-load explanation (in which the effect is expected to be observed for recall of both visual and auditory details), nor a pure modality-specific account (in which recall of visual details should only be disrupted by visual distractions). Practical implications of the findings are discussed.

Family-centred care during midface advancement with a rigid external device: what do families need?

Midface advancement with distraction osteogenesis using the rigid external device (RED) is an effective but invasive treatment to correct the hypoplastic midface. This study draws up an inventory of the stressors, needs and coping strategies of families during this treatment, to determine the best conditions for family-centred care. Data were collected by reviewing the patients' files and administering semi-structured interviews. The data were analysed using the software program Atlas.ti and were re-analysed by an independent researcher. Parents and patients were interviewed separately. Fourteen families participated. Four patients had an absolute indication for surgery. All families were eager to have the patient's facial appearance improved. Nevertheless, despite psychological counselling, they experienced stress when confronted with the changed facial appearance. Another stressor was weight loss. Six patients were in a state of acute malnutrition and needed supplementary feeding. We conclude that the best conditions for family-centred care should be aligned to the different phases of treatment. Leading up to surgery it is important to screen families' expectations regarding aesthetic, functional and social outcomes and to assess their capacity to cope with the long treatment and effects of changed facial appearance. Peer contact and psychosocial training to increase self-esteem are tools to enhance co-operation and satisfaction. During the distraction and stabilisation phase, we advise the monitoring of nutritional intake and weight. During all phases of treatment easy accessibility to the team is recommended.

Young children's response tendencies toward yes-no questions concerning actions

Two experiments investigated response tendencies of preschoolers toward yes-no questions about actions. Two hundred 2- to 5-year-old children were asked questions concerning actions commonly associated with particular objects (e.g., drinking from a cup) and actions not commonly associated with particular objects (e.g., kicking a toothbrush). The impact of delay and comprehension of questions were also investigated. Results revealed a consistent developmental transition: Younger children tended to display a yes bias whereas older children did not display a bias unless they faced incomprehensible questions, in which case they displayed a nay-saying bias. Delay shifted children's responses in such a way that "no" answers were given more often. These findings hold important implications regarding the use of yes-no questions with children.

Developing participatory research in radiology: the use of a graffiti wall, cameras and a video box in a Scottish radiology department

BACKGROUND

Participatory research is increasingly advocated for use in health and health services research and has been defined as a 'process of producing new knowledge by systematic enquiry, with the collaboration of those being studied'. The underlying philosophy of participatory research is that those recruited to studies are acknowledged as experts who are 'empowered to truly participate and have their voices heard'. Research methods should enable children to express themselves. This has led to the development of creative approaches of working with children that offer alternatives to, for instance, the structured questioning of children by researchers either through questionnaires or interviews.

OBJECTIVE

To examine the feasibility and potential of developing participatory methods in imaging research.

MATERIALS AND METHODS

We employed three innovative methods of data collection sequentially, namely the provision of: 1) a graffiti wall; 2) cameras, and 3) a video box for children's use. While the graffiti wall was open to all who attended the department, for the other two methods children were allocated to each 'arm' consecutively until our target of 20 children for each was met.

RESULTS

The study demonstrated that it was feasible to use all three methods of data collection within the context of a busy radiology department. We encountered no complaints from staff, patients or parents. Children were willing to participate but we did not collect data to establish if they enjoyed the activities, were pleased to have the opportunity to make comments or whether anxieties about their treatment inhibited their participation. The data yield was disappointing. In particular, children's contributions to the graffiti wall were limited, but did reflect the nature of graffiti, and there may have been some 'copycat' comments. Although data analysis was relatively straightforward, given the nature of the data (short comments and simple drawings), the process proved to be extremely time-consuming. This was despite the modest amount of data collected.

CONCLUSIONS

Novel methods of engaging with children have been shown to be feasible although further work is needed to establish their full potential.

Catastrophizing and symptoms of sleep disturbances in children

Catastrophizing about sleeplessness is a cognitive process associated with sleep disturbance in adults. This study aimed to (1) examine whether children catastrophize about the consequences of not sleeping; (2) define the topics that children catastrophize about; (3) assess whether there is a link between catastrophizing and sleep disturbance in children; and (4) examine whether an association between catastrophizing and sleep in children is mediated by anxiety and depression symptoms. Children completed the sleep self-report and a catastrophizing interview. Testing took place in two inner-city schools in London, UK and participants comprised 123 children aged between 8 and 10 years (49% male). Thirty-four (28%) participants reported concerns in response to the catastrophizing questionnaire. The main topics being catastrophized were concerns about sleep, physiological issues and one's own emotions. Catastrophes predicted sleep disturbance after controlling for age and sex (beta = 0.35, P < 0.001) but not when controlling additionally for anxiety and depression symptoms (beta = 0.15, P = 0.106). Symptoms of anxiety (Sobel test = 3.30, P < 0.001) and depression (Sobel test = 2.90, P = 0.004) mediated the influence of catastrophizing on sleep. A proportion of children catastrophized about the consequences of sleeplessness and this was associated with sleep disturbance, an association which was mediated through anxiety and depression symptoms.

Seven-year-old children's perceptions of participating in a comprehensive clinical birth cohort study

While several studies have explored parents' perceptions of their children's participation in research, very few studies have described the children's own perceptions of their participation in research. The aim of this study was to describe children's perceptions of their participation in a comprehensive longitudinal clinical study. Semi-structured qualitative interviews were conducted with 17 children aged seven participating in the Copenhagen Prospective Study on Asthma in Childhood. The interviews were audiotaped, transcribed and analysed using the template analysis method. The children rated their experiences with venepunctures on a Wong-Baker faces scale. The regular visits to the hospital and comprehensive clinical tests did not seem to have affected the children negatively. In particular, the children would happily engage themselves in medical tests mimicking play (moving, walking, running or playing with a computer). A majority of the children, however, disapproved of the venepunctures and some even refused to have it done. The results of this study indicate that participation in even comprehensive paediatric research can be a positive experience to the participants, with the most popular tests being those that required active participation from the children.

Awareness, dreaming and unconscious memory formation during anaesthesia in children

Recent studies have reported an incidence of awareness in children of around 1%, while older studies reported incidences varying from 0% to 5%. Measuring awareness in children requires techniques specifically adapted to a child's cognitive development and variations in incidence may be partly explained by the measures used. The causes and consequences of awareness in children remain poorly defined, though a consistent finding is that many children do not seem distressed by their memories. There are, however, some published reports of persistent psychological symptoms after episodes of childhood awareness. Compared to explicit memory, implicit memory is more robust in young children; however there is no evidence yet for implicit memory formation during anaesthesia in children. Children less than 3 years of age do not form explicit memory, although toddlers, infants and even neonates have signs of consciousness and implicit memory formation. In these very young children the relevance of awareness remains largely unknown.