Customizing Methodological Approaches in Qualitative Research on Vulnerable Children with Autism Spectrum Disorders

Children with autism spectrum disorders often suffer from poor school inclusion, loneliness, and poor quality of life. Suitable support options for overcoming these risks are lacking, partly because children’s perspectives concerning their support needs are unknown. We need to improve the involvement of children in social research. However, involving children with autism in research is not always simple, and there is scant literature on qualitative methods for addressing challenges related to involving children with unique characteristics such as autism. Children with autism may lack mimetic expressions to reflect their feelings, and they may answer questions very briefly despite having a nuanced perspective on the issue addressed, thus leaving the researcher with few indicators to act upon. Consequently, it can be difficult for the researcher to “read” the child, assess ethical important moments, and adapt the methodology to the individual child. Based on a qualitative study of 22 children with autism in the capital region of Denmark, this article offers reflections on methodological and practical challenges in involving children with autism in research. Matching expectations between researcher and child, staying open to communication forms, and posing precise questions are shown to be important to have insight into the children’s perspectives.

The computer-assisted interview In My Shoes can benefit shy preschool children's communication

Interviewing children is a cognitively, socially, and emotionally challenging situation, especially for young and shy children. Thus, finding methods that aid rapport and increase these children's communication is important. The present study investigated whether children's verbal and non-verbal communicative behavior developed differently during the rapport phase, depending on whether children were situationally shy or not, and whether the interview was conducted using the computer-assisted interview In My Shoes (IMS) or a Standard verbal interview. The sample consisted of 60 children aged 4 to 5-years-old. The results showed that for the shy children in the IMS group their talkativeness increased and their answer latency decreased including the amount of encouragement the child needed to talk, while no changes were observed for the shy children in the Standard verbal interview group. There were no significant differences in the non-verbal behavior for the shy children regardless of the interview method used. For the non-shy children, overall, the interview method did not affect either the verbal or the non-verbal outcomes. Our findings indicate that IMS can be a useful tool during the rapport-building phase with shy children as it helps these children to improve their verbal communication.

Young children's ability to use two-dimensional and three-dimensional symbols to show placements of body touches and hidden objects

In two experiments, we investigated 3- to 5-year-old children's ability to use dolls and human figure drawings as symbols to map body touches. In Experiment 1, stickers were placed on different locations of children's bodies, and the children were asked to indicate the locations of the stickers using three different symbols: a doll, a human figure drawing, and the adult researcher. Performance on the tasks increased with age, but many 5-year-olds did not attain perfect performance. Surprisingly, younger children made more errors on the two-dimensional (2D) human figure drawing task compared with the three-dimensional (3D) doll and adult tasks. In Experiment 2, we compared children's ability to use 3D and 2D symbols to indicate body touch as well as to guide their search for a hidden object. We replicated the findings of Experiment 1 for the body touch task; for younger children, 3D symbols were easier to use than 2D symbols. However, the reverse pattern was found for the object locations task, with children showing superior performance using 2D drawings over 3D models. Although children showed developmental improvements in using dolls and drawings to show where they were touched, less than two thirds of the 5-year-olds performed perfectly on the touch tasks. Both developmental and forensic implications of these results are discussed.

Low-SES children's eyewitness memory: the effects of verbal labels and vocabulary skills

This study examined the effects of the verbal labels procedure and vocabulary skills on low-socioeconomic status (SES) preschool children's eyewitness memory. Children (N = 176) aged 3-5 years witnessed a conflict event and were then questioned about it in either a standard or a verbal labels interview. Findings revealed that children with higher rather than lower vocabulary skills produced more complete and accurate memories. Children who were given the verbal labels interview recalled more information, which included both correct and incorrect details. Overall, the verbal labels procedure did not improve children's performance on direct questions, but children with low vocabulary skills answered direct questions more accurately if they were given the verbal labels interview than when they were not. Implications of the findings for memory performance of low-SES children are discussed.

Eliciting accounts of alleged child sexual abuse: how do children report touch?

Investigative interviewers frequently question alleged victims of child sexual abuse about any touching or bodily contact that might have occurred. In the present study of forensic interviews with 192 alleged sexual abuse victims, between 4 and 13 years of age, we examined the frequency with which alleged victims reported bodily contact as "touch" and the types of prompts associated with "touch" reports. Even young alleged victims of sexual abuse reported bodily contact as "touch," and they used the word "touch" more frequently in response to recall than recognition prompts. Regardless of age, children typically referred to "touch" before interviewers used this term, suggesting that even young children are able to report "touch" without being cued by interviewers.

Fluidity in autobiographical memories: relationship memories sampled on two occasions

We investigated consistency of relationship memories. College undergraduates described five events (first meeting, first date, first fight, most embarrassing event, and favourite memory) from their current relationship or, if not currently dating, most recent relationship. Three months later, they were asked to describe the same events again. We scored the consistency of these narratives at three levels of analysis: event, basic information and propositions. The participants demonstrated low consistency in their descriptions, particularly at more detailed levels of analysis. Consistency depended somewhat on the events being recalled, with participants being more consistent for commonly retrieved relationship memories such as first dates. We also found that those individuals who continued in a relationship were less consistent than those describing a previous relationship. These still dating couples had increased opportunities to narrate event stories together and to update knowledge about the relationship through new episodes. In this fashion, updating of experiences may have led to more inconsistencies in recall over time. When considered with research on flashbulb memories, our findings indicate that updating and revisions may be general features of autobiographical memory.

Body maps do not facilitate older children's report of touch

In a single experiment, we assessed the effect of body maps on reports of touch by 5- and 6-year-olds, 9- and 10-year-olds, and adults. Children and adults participated in a staged event in which they were touched four times. Immediately following the event, children and adults were asked to either show using a body map or show using their own body where they had been touched. Consistent with prior research, body maps were ineffective with 5- and 6-year-olds. Furthermore, although older children and adults reported more touches and were more accurate than younger children, body maps did not enhance the quality of their reports. We conclude that the provision of a body map does not facilitate reports of touch by any age group, raising serious questions about their use in forensic contexts.

Divining Testimony? The Impact of Interviewing Props on Children's Reports of Touching

There is a long-held assumption that objects help bridge the gap between what children know and what they can (or are willing to) explain. In this review, we present research on the extent to which two types of objects used as props in investigative interviews of children, anatomical dolls and body (human figure) diagrams, actually help children report accurate information about autobiographical events. We explain why available research does not instill confidence that props are the best solution to interviewing challenges, and we consider practitioners' and policy-makers responses to this evidence. Finally, we discuss the types of developmental research that are necessary to advance the field of evidence-based interviewing of children.

Interviewing children versus tossing coins: accurately assessing the diagnosticity of children's disclosures of abuse

We describe a Bayesian approach to evaluating children's abuse disclosures and review research demonstrating that children's disclosure of genital touch can be highly probative of sexual abuse, with the probative value depending on disclosure spontaneity and children's age. We discuss how some commentators understate the probative value of children's disclosures by: confusing the probability of abuse given disclosure with the probability of disclosure given abuse, assuming that children formally questioned about sexual abuse have a low prior probability of sexual abuse, misstating the probative value of abuse disclosure, and confusing the distinction between disclosure and nondisclosure with the distinction between true and false disclosures. We review interviewing methods that increase the probative value of disclosures, including interview instructions, narrative practice, noncontingent reinforcement, and questions about perpetrator/caregiver statements and children's reactions to the alleged abuse.

Evidence supporting restrictions on uses of body diagrams in forensic interviews

OBJECTIVE

This study compared two methods for questioning children about suspected abuse: standard interviewing and body-diagram-focused (BDF) interviewing, a style of interviewing in which interviewers draw on a flip board and introduce the topic of touching with a body diagram.

METHODS

Children (N=261) 4-9 years of age individually participated in science demonstrations during which half the children were touched two times. Months later, parents read stories to their children that described accurate and inaccurate information about the demonstrations. The stories for untouched children also contained inaccurate descriptions of touching. The children completed standard or BDF interviews, followed by source-monitoring questions.

RESULTS

Interview format did not significantly influence (a) children's performance during early interview phases, (b) the amount of contextual information children provided about the science experience, or (c) memory source monitoring. The BDF protocol had beneficial and detrimental effects on touch reports: More children in the BDF condition reported experienced touching, but at the expense of an increased number of suggested and spontaneous false reports.

CONCLUSIONS

The two props that are characteristic of BDF interviewing have different effects on testimonial accuracy. Recording answers on a flip board during presubstantive phases does not influence the quality of information that children provide. Body diagrams, however, suggest answers to children and elicit a concerning number of false reports.

PRACTICE IMPLICATIONS

Until research identifies procedures and/or case characteristics associated with accurate reports of touching during diagram-assisted questioning, interviewers should initiate discussions about touching with open-ended questions delivered without a body diagram.

Forensic Interviewing Aids: Do Props Help Children Answer Questions About Touching?

The belief that props help children report abuse has fostered the widespread use of anatomical dolls and body diagrams in forensic interviews. Yet studies involving alleged abuse victims, children who have experienced medical examinations, and children who have participated in staged events have failed to find consistent evidence that props improve young children's ability to report key information related to bodily contact. Because props elevate the risk of erroneous touch reports, interviewers need to reconsider the belief that props are developmentally appropriate in forensic interviews, and researchers need to explore new approaches for eliciting disclosures of inappropriate touching.

Extended evaluations in cases of child sexual abuse: how many sessions are sufficient?

This article provides new findings from a national study involving 18 forensic interview sites of 137 children who were randomly assigned to a four or eight session extended evaluation. Cases assigned to the eight session protocol were significantly more likely to be classified "credible disclosure" of sexual abuse (56.6%) than cases assigned to the four session protocol (29.5%) and significantly less likely to be classified "credible nondisclosure" of sexual abuse (9.2%) than cases in the four session protocol (24.6%). When four versus eight sessions, demographic variables, and case characteristics were entered into a regression, variables that predicted likelihood of sexual abuse were eight session protocol, older victim age, and caretaker belief the child had been sexually abused. When new disclosures were examined by session in the eight session protocol, 95% of new disclosures occurred by the sixth session.

Do human figure diagrams help alleged victims of sexual abuse provide elaborate and clear accounts of physical contact with alleged perpetrators?

The present study examined whether the use of human figure diagrams within a well-structured interview was associated with more elaborate and clearer accounts about physical contact that had occurred in the course of an alleged abuse. The sample included investigative interviews of 88 children ranging from 4 to 13 years of age. Children were interviewed using the NICHD Investigative Interview Protocol, and were then asked a series of questions in association with unclothed gender-neutral outline diagrams of a human body. A new coding scheme was developed to examine the types and clarity of touch-related information. Use of the HFDs was associated with reports of new touches not mentioned before and elaborations regarding the body parts reportedly touched. The HFDs especially helped clarify reports by the oldest rather than the youngest children. The clarity of children's accounts of touch was also greater when details were sought using recall prompts.

Supportive or suggestive: Do human figure drawings help 5- to 7-year-old children to report touch?

The authors examined the accuracy of information elicited from seventy-nine 5- to 7-year-old children about a staged event that included physical contact-touching. Four to six weeks later, children's recall for the event was assessed using an interview protocol analogous to those used in forensic investigations with children. Following the verbal interview, children were asked about touch when provided with human figure drawings (drawings only), following practice using the human figure drawings (drawings with instruction), or without drawings (verbal questions only). In this touch-inquiry phase of the interview, most children provided new information. Children in the drawings conditions reported more incorrect information than those in the verbal questions condition. Forensically relevant errors were infrequent and were rarely elaborated on. Although asking children to talk about innocuous touch may lead them to report unreliable information, especially when human figure drawings are used as aids, errors are reduced when open-ended prompts are used to elicit further information about reported touches.

Do jurors "know" what isn't so about child witnesses?

Are expert witnesses needed in child sexual abuse cases to educate jurors about children's memory, suggestibility, and reactions to abuse, or do jurors already know what such experts could tell them? To cast light on this question, we surveyed jurors and jury-eligible college students and compared their beliefs with what is known via scientific research regarding children's memory and ability to testify, reactions to interrogation, and reactions to sexual abuse. We also asked participants to infer results of four widely cited studies of children's suggestibility. Participants' beliefs were consistent with findings from research on some issues (e.g., that children can be led to claim that false events occurred) but diverged from the scientific consensus on other issues (e.g., whether children can remember painful events in infancy). Similarly, participants sometimes overestimated and sometimes underestimated the level of suggestibility observed in empirical studies. Individual differences in accuracy were related to participants' gender, education and ethnicity, and there was considerable disagreement among participants on many questions. Implications of findings for the admissibility of expert testimony in child abuse cases are discussed.

Children's memory for pain: overview and implications for practice

Children's memories of painful experiences can have long-term consequences for their reaction to later painful events and their acceptance of later health care interventions. This review surveys research on children's memory for pain, emphasizing implications for clinical practice. Topics reviewed include consequences of children's memories of pain; the development of memory; differences between explicit (declarative, verbal, autobiographic) memory and implicit (nondeclarative, nonverbal) memory; and individual differences, situational, and methodologic factors affecting memories of pain. Methods to prevent the adverse consequences of remembered pain are addressed with reference to current research on editing or reframing memories.

PERSPECTIVE

This review covers topics of value to clinicians providing care to children undergoing painful procedures. Specific recommendations are offered regarding the importance of acknowledging and assessing children's previous memories of painful experiences, the type of information that benefits children before and after procedures, and the most appropriate questioning strategies. It might be possible to prevent or reduce the adverse effects of memories of pain.

Cold Case Homicides Investigative Interviews of Child Witnesses

Nurses interviewing child witnesses in cold case homicide investigations face unique challenges arising from the passage of time. 2. Postevent influences must be evaluated carefully when examining children's descriptions about remote events. 3. Interview strategies that incorporate various types of developmentally appropriate tasks offer highly traumatized children the opportunity to tell their stories. 4. Although years may have passed, some children are able to provide accurate and unique details about a homicide they witnessed.

Similarities and differences in eyewitness testimonies of children who directly versus vicariously experience stress

This study tested questions of ecological validity by comparing the eyewitness testimonies of children directly experiencing a painful inoculation experience those of children in a yoked-control group who vicariously experienced the inoculation onwith videotape. The study involved 86 5-year-olds, divided between 2 groups: the experiential and yoked control. The experiential group was followed through a health department with a video camera as they received diphtheria, pertussis, tetanus (DPT), and oral polio inoculations. They were tested immediately, 20 min later, and 1 month later. Each child in the yoked-control group merely watched the videotape of his or her counterpart in the experiential group, made similar ratings of pain, and was given the same tests and suggestions. Stress and personal experience affected items congruent with the stressor to produce flashbulb-like memories, with slower rates of forgetting for some items, such as nurse identifications, and greater suggestibility for other items, such as estimates of needle size. These and the apparently conflicting results in the literature were said to make sense when personally experienced stress was viewed from S.-A. Christianson's (1992) interactive perspective rather than as a single ubiquitous variable.

Remembering and reporting by children: the influence of cues and props

Until recently nonverbal props received little experimental attention in spite of the wide use of props such as toys and drawing in child clinical contexts. This article reviews research investigating the effectiveness of props as means of facilitating children's recall and reporting of past events. In the first section, developmental and theoretical considerations influencing effectiveness of various kinds of props as aids to the retrieval and communication of information are outlined. Thereafter, findings of empirical research are reviewed for real props from the event, toys including dolls, drawing, context reinstatement, and photographs. Research findings suggest that a range of factors influence the extent to which props facilitate children's reports of past events, including specificity of the information provided by the prop, the way the prop is presented during the interview, delay between the event and interview and, critical to these factors, the age of the child. Areas requiring future theoretical and research attention are identified.

Draw It again Sam: the effect of drawing on children's suggestibility and source monitoring ability

Preschool children (aged 3 to 6 years) participated in a magic show. Later, the children were given repeated true and false reminders about the show. Half the children were asked to draw these true and false reminders (drawing condition) and half the children were asked questions about the reminders but not to draw them (question condition). Later, children in the drawing condition had better recall of true reminders than children in the question group; however, children in the drawing group also recalled more false reminders than children in the question group. Finally, although children in the drawing group had better memory of the source of the reminders than children in the question group, both groups equally reported that the false reminders actually happened.

Interviewing children

The focus in health-related research on children has shifted from seeking information about children to seeking information directly from them. Children, even as young as three years old, can give graphic descriptions and have excellent recall of experiences related to adverse events, such as illness and hospitalization. Children use scripts as the primary means of anticipating, comprehending, and re-creating real-life experience. The content, timing, number, and structure of interviews will influence the completeness, accuracy, and consistency of children's recall of events. Although at times conflicting, the findings from recent scholarship on children's narrative competence will assist researchers to select the interviewing strategies most likely to yield faithful representations of experience.

Investigative interviews of alleged sexual abuse victims with and without anatomical dolls

Verbal and nonverbal responses by alleged victims of child sexual abuse were coded for length, amount of information, and the manner in which they were elicited by the interviewer. In 16 of the interviews, anatomical dolls were employed for the purposes of demonstration, whereas they were not used in another eight cases matched with respect to other characteristics of the children and the alleged events. Children interviewed with dolls provided an equivalent number of details and spoke as many words in the substantive portion of the interview as did children interviewed without dolls, and interviewers in the two groups used similar probes to elicit information. However, the average responses by the children were significantly longer and more detailed when dolls were not used. Children gave longer and more detailed responses to open-ended invitations when dolls were not used. Caution is necessary when interpreting these findings.