Cooperative Children Research Articles

The psychological impact of eyedrops administration in children.

To determine the psychological effects of eyedrops administration in children. Children requiring eyedrops for cycloplegic refraction were recruited in this cross-sectional study. Nurses administered eyedrops in 2-3 cycles spaced 5-10 minutes apart, and optometrists performed refraction 30 minutes after the last drop. Ophthalmologists, nurses, and optometrists rated the children's cooperation level at first review, after each eyedrop, at refraction, and at final review. Parents chose a personality type best describing their child, and monitored their child's anxiety using a modified Yale Preoperative Anxiety Scale (m-YPAS). Children were "uncooperative" if nurses noted significant distress during the first drop cycle. A total of 298 children 2-12 years of age were included. Of these, 77 (26%) experienced pre-drop distress and 39 (13%) were uncooperative with drops. Compared to cooperative children, uncooperative children tended to be younger (2.0-4.9 years vs ≥8 years; OR, 4.11; 95% CI, 1.14-14.83; P = 0.031), male (OR, 2.55; 95% CI, 1.06-6.10; P = 0.036), have had a previous negative eyedrop experience (84.2% vs 25.3%; P < 0.001) and were more anxious (m-YPAS scores, 41.4 ± 22.0 vs 30.6 ± 12.6: P < 0.001). Children described as "demanding and aggressive" were more uncooperative than "timid and anxious" children. It took longer to instill drops (3.1 vs 1.3 minutes), and perform refraction (11.6 vs 7.2 minutes) in uncooperative children. A small group of children were uncooperative with eyedrops and 26% experienced significant pre-drop anxiety. Factors such as age, sex, a previous negative eyedrop experience, and pre-drop anxiety, associated with uncooperativeness need to be considered when developing strategies to improve the eyedrops experience in children.

Non-pharmacological interventions for assisting the induction of anaesthesia in children.

Induction of general anaesthesia can be distressing for children. Non-pharmacological methods for reducing anxiety and improving co-operation may avoid the adverse effects of preoperative sedation. To assess the effects of non-pharmacological interventions in assisting induction of anaesthesia in children by reducing their anxiety, distress or increasing their co-operation. In this updated review we searched CENTRAL (the Cochrane Library 2012, Issue 12) and searched the following databases from inception to 15 January 2013: MEDLINE, EMBASE, PsycINFO and Web of Science. We reran the search in August 2014. We will deal with the single study found to be of interest when we next update the review. We included randomized controlled trials of a non-pharmacological intervention implemented on the day of surgery or anaesthesia. At least two review authors independently extracted data and assessed risk of bias in trials. We included 28 trials (2681 children) investigating 17 interventions of interest; all trials were conducted in high-income countries. Overall we judged the trials to be at high risk of bias. Except for parental acupuncture (graded low), all other GRADE assessments of the primary outcomes of comparisons were very low, indicating a high degree of uncertainty about the overall findings. Parental presence: In five trials (557 children), parental presence at induction of anaesthesia did not reduce child anxiety compared with not having a parent present (standardized mean difference (SMD) 0.03, 95% confidence interval (CI) -0.14 to 0.20). In a further three trials (267 children) where we were unable to pool results, we found no clear differences in child anxiety, whether a parent was present or not. In a single trial, child anxiety showed no significant difference whether one or two parents were present, although parental anxiety was significantly reduced when both parents were present at the induction. Parental presence was significantly less effective than sedative premedication in reducing children's anxiety at induction in three trials with 254 children (we could not pool results). Child interventions (passive): When a video of the child's choice was played during induction, children were significantly less anxious than controls (median difference modified Yale Preoperative Anxiety Scale (mYPAS) 31.2, 95% CI 27.1 to 33.3) in a trial of 91 children. In another trial of 120 children, co-operation at induction did not differ significantly when a video fairytale was played before induction. Children exposed to low sensory stimulation were significantly less anxious than control children on introduction of the anaesthesia mask and more likely to be co-operative during induction in one trial of 70 children. Music therapy did not show a significant effect on children's anxiety in another trial of 51 children. Child interventions (mask introduction): We found no significant differences between a mask exposure intervention and control in a single trial of 103 children for child anxiety (risk ratio (RR) 0.59, 95% CI 0.31 to 1.11) although children did demonstrate significantly better co-operation in the mask exposure group (RR 1.27, 95% CI 1.06 to 1.51). Child interventions (interactive): In a three-arm trial of 168 children, preparation with interactive computer packages (in addition to parental presence) was more effective than verbal preparation, although differences between computer and cartoon preparation were not significant, and neither was cartoon preparation when compared with verbal preparation. Children given video games before induction were significantly less anxious at induction than those in the control group (mYPAS mean difference (MD) -9.80, 95% CI -19.42 to -0.18) and also when compared with children who were sedated with midazolam (mYPAS MD -12.20, 95% CI -21.82 to -2.58) in a trial of 112 children. When compared with parental presence only, clowns or clown doctors significantly lessened children's anxiety in the operating/induction room (mYPAS MD -24.41, 95% CI -38.43 to -10.48; random-effects, I² 75%) in three trials with a total of 133 children. However, we saw no significant differences in child anxiety in the operating room between clowns/clown doctors and sedative premedication (mYPAS MD -9.67, 95% CI -21.14 to 1.80, random-effects, I² 66%; 2 trials of 93 children). In a trial of hypnotherapy versus sedative premedication in 50 children, there were no significant differences in children's anxiety at induction (RR 0.59, 95% CI 0.33 to 1.04). Parental interventions: Children of parents having acupuncture compared with parental sham acupuncture were less anxious during induction (mYPAS MD -17, 95% CI -30.51 to -3.49) and were more co-operative (RR 1.59, 95% CI 1.01 to 2.53) in a single trial of 67 children. Two trials with 191 parents assessed the effects of parental video viewing but did not report any of the review's prespecified primary outcomes. This review shows that the presence of parents during induction of general anaesthesia does not diminish their child's anxiety. Potentially promising non-pharmacological interventions such as parental acupuncture; clowns/clown doctors; playing videos of the child's choice during induction; low sensory stimulation; and hand-held video games need further investigation in larger studies.

Interventions for the cessation of non-nutritive sucking habits in children

Interventions for the cessation of non-nutritive sucking habits in children

"I Teach Better with the Puppet" - Use of Puppet as a Mediating Tool in Kindergarten Education – an Evaluation

A focus of interest among researchers and educators is to find teaching methods adjusted to developmental aspects in early childhood. Teaching that generates significant learning and creates motivation, interest and enjoyment in young children is a real challenge in contemporary education. The effectiveness of using puppets in early childhood has been demonstrated in clinical areas as having the potential to create communication, increase involvement and change attitudes. However, there is limited research literature relating to the use of puppets as a teaching method, and therefore a methodology based on measurement and evaluation is lacking in this field. This article presents partial results of a broader study that examined the influence of an intervention program integrating a puppet as a mediation tool on learning motivation, and enhancing literacy achievements in regular and special kindergarten children. One of the aims of this research was to evaluate, from mediators' perspectives, the use of puppets as a mediation tool for kindergarten children. This evaluation was carried out by means of personal interviews with each of the mediators at the end of the intervention program. From the interviews it became apparent that the mediators considered the puppets to be an effective tool for young children's developmental aspects, by means of which they could relate to cognitive, emotional, and social realms. Mediation using puppets facilitated learning processes, while using puppets, children's cooperation level increased, as did interest, attention span and their involvement in learning interaction was evident. The puppets contributed to the mediators' self-confidence and to their sense of professionalism. During the puppets mediation, the mediators felt that they were teaching in a clear manner, and they felt they were being interesting and. interactive. By using puppets, they succeeded in creating a close personal connection with the children. These findings have an applicable contribution in presenting the effectiveness of the puppet as a mediation tool for use in kindergarten and with special needs children.

Coparenting and children's temperament predict firstborns' cooperation in the care of an infant sibling.

This study examined how coparenting and firstborn children's temperament predicted children's cooperative behavior in response to maternal requests for assistance in the care of a 1-month-old infant sibling. Children's cooperative responding was observed during a diaper change session for 216 firstborns (ages 13 to 70 months; M = 32). Parents also completed questionnaires assessing coparenting and children's temperament. Results suggested that coparenting quality moderated the association between children's temperament (i.e., soothability) and children's cooperation as revealed in a Temperament × Cooperative Coparenting × Undermining Coparenting interaction. Specifically, low soothability predicted low levels of children's cooperation in families with high undermining and low cooperative coparenting, over and above the effects of child age, gender, and mothers' education. Findings further our understanding of how temperamental characteristics and coparenting quality conjointly predict individual differences in firstborn children's positive adjustment across the transition to siblinghood.

Stability of cognitive performance in children with mild intellectual disability.

Longitudinal studies that have examined cognitive performance in children with intellectual disability more than twice over the course of their development are scarce. We assessed population and individual stability of cognitive performance in a clinical sample of children with borderline to mild non-syndromic intellectual disability. Thirty-six children (28 males, eight females; age range 3-19y) with borderline to mild intellectual disability (Full-scale IQ [FSIQ] 50-85) of unknown origin were examined in a retrospective clinical case series using linear mixed models including at least three assessments with standardized intelligence tests. Average cognitive performance remained remarkably stable over time (high population stability, drop of only 0.38 IQ points per year, standard error=0.39, p=0.325) whereas individual stability was at best moderate (intraclass correlation of 0.58), indicating that about 60% of the residual variation in FSIQ scores can be attributed to between-child variability. Neither sex nor socio-economic status had a statistically significant impact on FSIQ. Although intellectual disability during childhood is a relatively stable phenomenon, individual stability of IQ is only moderate, likely to be caused by test-to-test reliability (e.g. level of child's cooperation, motivation, and attention). Therefore, clinical decisions and predictions should not rely on single IQ assessments, but should also consider adaptive functioning and previous developmental history.

Seeing eye to eye or not? Young people's and child protection workers' perspectives on children's participation within the Dutch child protection and welfare services

ObjectiveChild participation is internationally seen as a crucial aspect of child protection and child welfare. Scholars have differences of opinion about what participation entails, but even less is known about whether children and case managers have similar perspectives on participation and its goals. MethodsAn exploratory study was conducted, including 16 interviews with case managers and 16 interviews with young people in the Amsterdam area, the Netherlands. ResultsThere is a large gap between case managers' perspectives on participation and its prevalence in practice and the experiences and perspectives of young people under the care of child protection and welfare services. Case managers see participation as important, but it is generally seen as an instrument to ensure the child's cooperation. Young people, on the other hand, understand participation differently. They primarily want to be heard, informed and taken seriously. Conclusions and implications for practiceThe level of participation that occurs and the different perspectives of young people and case managers show that there is currently no meaningful dialogue between the case manager and the young person. The knowledge and the experience of young people are not taken seriously, given the proper value or acted upon in the process of youth care. Although social scientists have shown that children are knowledgeable social actors, the practice of child protection is falling behind. Interventions to decrease barriers to participation should therefore focus on the case managers' perspectives of children and childhood, encouraging them to not only see but also approach children as knowledgeable social actors.

Trans-disciplinary Cooperation in Children with Autism Spectrum Disorder Intervention with Emphasis on the Speech and Language Therapist's Important Role

The contribution analyses the knowledge of aberrations affecting non-verbal communication in children with Autistic Spectrum Disorder (ASD) from the perspective of speech and language therapists (SLTs) working in schools as well as in medical settings in the Czech Republic via a questionnaire (n= 69 responding SLTs of 369 originally addressed). 50.72% of SLTs perceive the specifics regarding disruption of nonverbal communication. The most frequent deficits detected are those relating to pragmatics (44.93%), the lexical-semantic linguistic level (21.74%) and the morphological-syntactic linguistic level (20.29%). The research highlighted visible deficits associated mainly with the knowledge domain of SLTs within ASD.

Alternatives to restraining children for clinical procedures

On children's wards, restraint appears to be used often, rather than as a last resort, to assist the delivery of clinical procedures. The difference between restrictive physical intervention and therapeutic holding seems to depend on the degree of force used and whether the child gives consent. Restraint can have a negative emotional and psychological effect on children, parents or carers, and nurses. Healthcare staff need to examine their daily practice and always employ a range of interventions to seek a child's co-operation with procedures. Restraint should only be used when there is no alternative in a life-threatening situation. It is essential that all hospitals providing care for children have an explicit restraint policy and provide education, training and guidance for all healthcare staff.

Gender and Cooperation in Children: Experiments in Colombia and Sweden

In this article we compare cooperation among Colombian and Swedish children aged 9–12. We illustrate the dynamics of the prisoner's dilemma in a new task that is easily understood by children and performed during a physical education class. We find no robust evidence of a difference in cooperation between Colombia and Sweden overall. However, Colombian girls cooperate less than Swedish girls. We also find indications that girls in Colombia are less cooperative than boys. Finally, there is also a tendency for children to be more cooperative with boys than with girls on average.

The relationship between moral judgment and cooperation in children with high-functioning autism.

This study investigated moral judgment in children with high-functioning autism and their cooperation in prisoner's dilemma game with partners of different moralities. Thirty-eight 6- to 12-year-old high-functioning autistic (HFA) children and 31 typically developing (TD) children were recruited. Children were asked to judge story protagonists' morality. After making this moral judgment correctly, they were asked to play with the morally nice and the morally naughty child in a repeated prisoner's dilemma game. Results showed that both HFA and TD children made correct moral judgments, and that HFA children might even have more rigid criteria for what constitutes morally naughty acts. HFA children's cooperation did not differ depending on the morality of the interaction partner, while TD children showed higher cooperation when interacting with the morally nice than the morally naughty child did. Thus, partner's morality did influence TD children's but not HFA children's subsequent cooperation.

An Hypnotic Suggestion: Review of Hypnosis for Clinical Emergency Care

BackgroundHypnosis has been used in medicine for nearly 250 years. Yet, emergency clinicians rarely use it in emergency departments or prehospital settings. ObjectiveThis review describes hypnosis, its historical use in medicine, several neurophysiologic studies of the procedure, its uses and potential uses in emergency care, and a simple technique for inducing hypnosis. It also discusses reasons why the technique has not been widely adopted, and suggests methods of increasing its use in emergency care, including some potential research areas. DiscussionA limited number of clinical studies and case reports suggest that hypnosis may be effective in a wide variety of conditions applicable to emergency medical care. These include providing analgesia for existing pain (e.g., fractures, burns, and lacerations), providing analgesia and sedation for painful procedures (e.g., needle sticks, laceration repair, and fracture and joint reductions), reducing acute anxiety, increasing children's cooperation for procedures, facilitating the diagnosis and treatment of acute psychiatric conditions, and providing analgesia and anxiolysis for obstetric/gynecologic problems. ConclusionsAlthough it is safe, fast, and cost-effective, emergency clinicians rarely use hypnosis. This is due, in part, to the myths surrounding hypnosis and its association with alternative-complementary medicine. Genuine barriers to its increased clinical use include a lack of assured effectiveness and a lack of training and training requirements. Based on the results of further research, hypnosis could become a powerful and safe nonpharmacologic addition to the emergency clinician's armamentarium, with the potential to enhance patient care in emergency medicine, prehospital care, and remote medical settings.

Low-Income Central American Immigrant Mothers' Goals and Their Children's Classroom Competencies in Preschool

Research Findings: Unlike other Latino groups, there is little information about the early socialization of children from Central American (CA) immigrant families. This study examined CA immigrant mothers' short-term goals and the implications of these goals for children's behavior in preschool. A total of 47 low-income mothers described their goals for their children's behavior at home/with family and at school. Nearly all mothers described relatedness-oriented goals for their children at home and at school. Mothers emphasized autonomy-oriented goals predominantly for the school context. Mothers' emphases on certain goals in the home, but not goals for school, predicted teacher reports of children's social cooperation and approaches to learning in the classroom. Practice or Policy: Educators should be aware that relatedness-oriented goals are highly salient for CA immigrant parents. Immigrant parents might benefit from more information regarding the general goals of preschool. Educators should encourage mothers to set multiple early goals for their children, including learning-related goals for home. Educators and CA immigrant parents may support home–school continuity for children through mutual understanding of goals and values.

Cooperation in Children with High-functioning Autism

Cooperation in Children with High-functioning Autism

Quality of bitewing radiographs in children in relation to the type of film holder used

To assess the frequency of use with young uncooperative children of the bitewing radiograph film holders: KWIK-BITE, Snap-a-ray, and a Sticky tape, and to compare the quality of bitewing radiographs achieved with these types of film holders. This retrospective study assessed 298 pairs of bitewing radiographs of children aged 3-14years. The radiographs were evaluated according to age, type of behavioural management approach used, extent and degree of overlapping surfaces, visibility of the alveolar bone, and the presence of folds, cone-cut and elongated teeth. Snap-a-ray was used more frequently in younger children (p<0.001), less cooperative children (p<0.001), and in those who were treated under sedation (p<0.001). The KWIK-BITE holder was used more frequently in older children (p<0.001), cooperative children (p=0.001), and in those under general anaesthesia (p<0.001). About 76.5% of the radiographs contained technical errors. The degree of overlapping surfaces in radiographs was not correlated with the type of film holder used, but rather with the degree of children's cooperation. The Snap-a-ray film holder was used more frequently in young uncooperative children; nevertheless, its use was not associated with an increased frequency or degree of overlapping surfaces.

Promoting Toddlers' Positive Social-Emotional Outcomes in Low-Income Families: A Play-Based Experimental Study

This multimethod study of mothers and toddlers (a) examined the effectiveness of a play-based intervention (child-oriented play vs. play-as-usual) on children's cooperation with their mothers and socioemotional competence; (b) introduced a robust new measure of maternal engagement in the intervention, reflected in the dose of child-oriented play the mother delivered to the child; and (c) examined ecological factors that predicted maternal engagement, and the effect of engagement on the outcomes. Low-income mothers (N = 186, 11% Latino, 27% minority) were randomized into child-oriented play group or play-as-usual group, participated in 8 play sessions, and played daily with their children for 10 weeks. Microscopic coding of mothers’ behavior in play sessions assessed the dose of child-oriented play delivered to children; mothers’ diaries assessed time in daily play. Children's cooperation with maternal control, observed in the laboratory, and mother-rated competence were measured before randomization (Pretest), after play sessions (Posttest 1), and 6 months later (Posttest 2). Children in both groups made significant gains in both outcomes. The gains in cooperation appeared longer lasting in child-oriented play group. Both groups made significantly greater gains than a “historical community control” group, an unrelated longitudinal study without any intervention. Structural equation analyses revealed that married mothers and those with fewer children delivered higher doses of child-oriented play, and those doses predicted children's higher cooperation and competence, with the effects of earlier scores covaried. The dose of time spent in daily play had no effect. Child-oriented play may be a promising, effective, and inexpensive means of promoting toddlers’ positive development.

Dessin animé, anesthésie locale et mélange de protoxyde d’azote : une solution pour le traitement des plaies de la main de l’enfant

Wounds and injuries of child's hands are common and create anxiety. The context of stress makes difficult therapeutic cares, anesthesia and surgery, and prevents child's cooperation. We propose a technique combining a local anesthesia performed during inhalation of oxygen and nitrous oxide, and child distraction by watching a cartoon. In a prospective series of 39 children, we evaluated the feasibility of such care and its impact on the child's anxiety by a visual analog scale (VAS) at three moments of care sequence: arrival of the child (EVA1), at the end of the cartoon (EVA2), and at the postoperative visit (EVA3). Thirty-seven children were included (94.9%). Mean anxiety decreased throughout the therapeutic course: EVA1 (5.6), EVA2 (2.97), EVA3 (1.4). Children were less and less anxious along the procedure (100%, 46%, 10.8%, respectively). All children could be treated as outpatients. This procedure allows a rapid and adapted treatment for children's hand injuries. It reduces impact of children's anxiety.

Parental child-rearing practices, behavior problems and pre-school children's social competence

The study examined associations between parents' childrearing practices, behavior problems and pre-school children's social competence. A total of 48 mothers and 33 fathers, when their firstborn children were aged six, completed an interview about child-rearing practices and the Social Skills Rating System that also assesses behavior problems. Spearman correlations indicated positive associations between maternal coercive practices and children's behavior problems, especially those related to externalizing. Positive correlations were also found between fathers' coercive practices and internalizing problems, as well as among fathers' inductive and non-interference practices with children's cooperation and assertiveness, respectively. Girls' mothers reported higher levels of self-control and social competence than did boys' mothers. Moreover, lower SES mothers referred more coercive practices while higher SES mothers reported more inductive practices. Findings underscore the relationship between fathers' inductive practices and children's social competence. In addition, results suggested associations among both mothers' and fathers' coercive practices and children's behavior problems.

Impact of Dental Atmosphere and Behaviour of the Dentist on Children’s Cooperation

During dental treatment children are usually under psychological pressure. With the Sarnat Behaviour Score five different types of patients can be distinguished. There is no method that measures the impact of dental atmosphere and dentist's behaviour on the young patients' readiness to cooperate. The objective of the present study was the implementation and evaluation of a questionnaire on this subject. Eighty-eight patients participated in this study. In the first part of the new questionnaire personal information was collected. The second part consists of 43 items and investigates the relationship between dentist and patient and reflects the atmosphere of the environment. Statistical analysis was performed using the Chi-square test. There were statistically significant differences between the cooperative and non-cooperative group, as regards the perceived honesty of the dentist, the ability to explain and wish to help. Uncooperative children are significantly more often afraid of the dental environment. Sympathy alone has only a minor effect on children's cooperation. Children should be treated with empathy. Especially younger patients appreciate detailed explanations by the dentist. Children's non-cooperative behaviour results often from their aroused interest in the unknown environment, which causes an unpleasant perception of the whole setting.

Cooperative Children's Book Center (CCBC)

Cooperative Children's Book Center (CCBC)