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Background Little is known about the nature and reactions to sexual abuse of children with intellectual disability (ID). The aim was to fill this gap. Method Official reports of sexual abuse of children with ID in state care were examined (N = 128) and compared with children without ID (N = 48). Results Clear signs of penetration or genital touching by male (adolescent) peers or (step/foster) fathers were found in most ID reports. Victims often received residential care and disclosed themselves. Type of perpetrator seemed to affect the nature and reaction to the abuse. Cases of children with and without ID seemed to differ in location and reports to police. Conclusions Screening of (foster)homes seems crucial. Residential facilities should find a balance between independence of children and protection. Care providers should be trained in addressing sexual issues and sexual education, accounting for different types of perpetrators (peers/adults). Uniform reporting guidelines are needed.
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Motivating gifted children to become and stay engaged with classroom tasks can be a huge struggle for primary education teachers. This concurrent parallel mixed method design study investigates the relative differences in the importance of the basic psychological needs between gifted children and children with an average IQ with respect to triggered and maintained engagement to learn. A total of 1,017 students (512 girls and 505 boys) from 35 schools participated in this study. The qualitative analysis showed that children identify a wide array of themes related to both the context of their learning experiences and to themselves. In addition, statistical analyses showed that while all children benefit from the fulfillment of their basic psychological needs, gifted children experience a greater need for autonomy support to become engaged in school tasks. To maintain engagement, even in the face of resistance, all children, regardless of their IQ, indicate that structure is important. Possible implications for teachers are addressed in the discussion.
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In this thesis, we focus on developing behaviours for socially interactive agents (SIAs). The context in which the agent is used is a self-regulated learning system for children. We focus on personalising learning objectives and interaction content within an intelligent tutoring system (ITS). We envision a system where children can train diabetes selfmanagement knowledge and skills independent of space and time and in collaboration with the health care professional, legal caretakers, and a SIA. To facilitate long-term interaction with such a system, relevant learning content and appropriate ‘intelligent’ social behaviour of the SIA are necessary. The envisioned system was developed within the Horizon 2020 PAL-project and evaluated in an iterative design process. The main contributions of the research described in this thesis are: insights into the behaviour design for a NAO robot and its virtual avatar, and the formalisation of learning objectives facilitating personalised learning content. Most studies on SIA behaviour focus on the design of emotional expressions or implement roles (e.g., peer or tutor) that were not validated for perception. We argue that strategical pedagogical interaction style (i.e., style purposefully selected based on knowledge about the user, task and context such as done by teachers in traditional classroom settings) is necessary but not yet sufficiently studied to design meaningful interactions that surpass the initial novelty and fun. Further, we argue that learning content must be relevant to the child’s needs and developmental stage. These two challenges are the subjects of study in the two parts of this thesis. The main research question addressed in part I is: How to design SIA behaviours that express different pedagogical styles and what is the effect on learning outcomes? We answer this question in the four included chapters. In a systematic review we focus on non-verbal expressions by parameter-based manipulations of bodily shape and motion of humanoid robots and virtual agents, and how these manipulations are perceived by humans. We present a comprehensive review of peer-reviewed published articles and analyse and summarise the available work. Research in this field is multidisciplinary and shows a large variety in concept definitions, behavioural manipulations and evaluation methodologies. We developed the TAXMOD taxonomy as a starting point to develop a shared understanding and interpretation of research objectives and outcomes, and to formulate a road-map. We applied TAXMOD to position and compare research, and to explicate progress in this area. We found structural support for the fact that some social signals can be displayed by behaviour manipulation in the form of posture- or motion modulation or designed key expressions (fixed behaviours with a specific target expression). Key findings include: 1) the expression of personality traits using virtual or robot bodies is limited to the trait extraversion; 2) the expression of social dimensions such as warmth, competence and dominance is possible, but only when using the whole body, and more research is needed to disentangle individual effects on friendliness, competence and dominance; 3) the expression of emotion is restricted to generic positive versus negative signals; and 4) context seems important for users for the correct interpretation of the expressive behaviour. In a first perception study we evaluate an educational robot displaying non-verbal behaviours expressing high or low warmth and competence with children at primary schools and a camp. We show that style expression by a humanoid robot is possible. Bodily posture, hand gestures and paralinguistic cues were manipulated to evoke an expression of a specific level of warmth and competence. The competence dimension in our model was successful. Warmth manipulations were perceived as intended only in combination with high-competence. Moreover, context influenced children’s perceptions: at school the robot was perceived warmer and more competent than at camp. In a second perception study we evaluate an educational robot displaying non-verbal behaviours expressing high or low dominance. We modulate bodily posture and movement, specifically by manipulating body expansiveness. We show the validity of body expansiveness modulation for dominance expression in both postures and gestures and showthat with a limited set of parameterswe can moderate dominance expression. Specific postures and gestures have a natural tendency towards being perceived as more or less dominant. Further, the manipulation effect is consistent for a variety of behaviours except a sitting pose. This study provides evidence that body expansiveness is an important factor for dominance expression and that this effect is independent of specific behaviours and view angle. We study the effect of stylised behaviours on children’s learning approach and learning gain by having a NAO robot guide children while performing an inquiry-based science learning task where children roll rollers down a slope to discover laws ofmovement, friction and gravity. Robot style is implemented as variations in verbal strategy and nonverbal style expression, resulting in an expert or facilitator interaction style. No effect of robot interaction style on children’s learning approach or gain is reported. Based on only verbal behaviour variations children perceive the explaining robot (either the expert style or explaining verbal strategy with neutral non-verbal behaviour) as more competent than the robot giving evidence descriptions (either the facilitator style or evidence descriptions verbal strategy with neutral non-verbal behaviour). These perception differences did not impact the learning approach or gain in the present study. We did not find perception differences based on the variation of non-verbal behaviour. We did find that the presence of a robot giving feedback on children during rolling trials did cause children to play longer and do more informative experiments compared to no feedback. However, this difference in learning approach did not impact learning gain. The main research question addressed in part II is: How to personalise learning content based on personal learning objectives? First, we look into how learning goals are formulated in pedagogy and ontologies for education: effective learning goals must attune to the appropriate and desired difficulty level. A way to structure this is Bloom’s taxonomy. A learning goal must also have attributes presenting relations between and descriptions of goals. Then, we model educational objectives (i.e., achievements, learning goals and accompanying tasks) in an ontology. The upper ontology structures the classes and relations and defines domain independent constructs (i.e., level and topic). The domain model specifies diabetes self-management training objectives for young children based on current checklists and expert input. The resulting knowledge base was considered relevant to, and covering, the diabetes domain to a considerable extent. From this we conclude that our upper model adequately supports the formalisation of implicit knowledge of health care professionals on diabetes self-management training. A field study with children with type 1 diabetes in the Netherlands and Italy showed that an SIA-ITS offering tasks based on our model to support basic needs for autonomy, competence, and relatedness of children with diabetes. For the formalisation of domain specific learning goals, achievements, tasks and materials in the knowledge structure we recommend the following design guidelines: work in a multidisciplinary team (to define an inventory of important learning goals and define learning activities include domain- and pedagogic experts next to knowledge engineers); formulate achievements from logical learning units (e.g., daily challenges) that require a subset of the knowledge and skills encapsulated in the goals to improve relevance; formulate achievements and goals from the perspective of the child to facilitate ownership and increase experienced relevance; and, define user characteristics relevant to goal and/or task selection. For the integration of the knowledge structure in a multi-modal intelligent tutoring system we recommend the following design guidelines: provide instruction and explanation to the child on how achievements, goals and tasks are selected and can be attained (i.e., that progress on a goal is gained by task completion, and benefits earned by this); embed the objectives in the ITS application to make them easily accessible to the (child) user and integrate them in other system functionality such as feedback on progress provided by a SIA; and offer sufficient learning content such as games and quizzes to maintain interest and engagement. We developed an authoring tool with a tree-based interface adapted from game design for collaborative personal goal setting and monitoring that implements the ontology of diabetes self-management education, and we co-evaluated this interface with health care professionals. We propose the following design guidelines for an authoring tool: provide clear, visual feedback on goal structure, and active state and progress; consistently use a different representation (e.g., shape) for different concepts of the model (e.g., goal and achievement); cover the full domain and different skill levels with the finite set of goals; and, support assessment of current abilities next to goal setting, progress monitoring and goal attainment registration. We developed an mHealth dashboard as interface for personal goal and task selection and monitoring, and co-evaluated this interface with children with diabetes. The interface implements our ontology of diabetes self-management education. The following design elements were understandable for all children: colouring indicating status, and navigation between layers of information. Children experienced difficulties interpreting the meaning conveyed in iconic presentations, understanding of the layered information, and navigation. Based on reported usability issues, we present guidelines for the design of a dashboard for children: provide descriptive labels next to visual elements because children lack experience using apps and thus understanding of icons and such; connect elements accordingly by placing them in close proximity and in boxes with appropriate labels; ease navigation between layers when hiding detailed information to avoid cognitive overload; and avoid cluttering elements such as navigation bars. The work in this thesis shows that robots can express different pedagogical styles perceivable by young children. Dominance expression is mainly dependent on body expansiveness. Warmth and competence expression rely on a complex set of behaviour modulations. However, current style variations are too subtle to impact learning approach and gain. With respect to content personalisation, we show that a structure for and selection of learning objectives provide both a personalised learning path as well as personalised content. Overall we conclude that to impact learning approach and gain not only SIA behaviour must be modulated, it must be noticed by the learner as well. Learning objectives and content should be formalised within a structure and a user-friendly interface is needed to select objectives and tasks with accompanying content, and monitor progress. The success of an SIA-ITS depends on the amount of available content and social interaction capabilities of the SIA.
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This article discusses a study of children's perspectives on disciplinary conflicts with their foster parents. Most children accept parental authority, but they also defend their personal autonomy and loyalties to peers. In this study, only birthchildren told real-life stories about fierce resistance to get their own way. Fierce resistance among foster children was motivated by inner conflicts and confusion. Obedience among foster children often derived from fear of punishment or a feeling of impotence. The authors discuss the theoretical and pedagogical implications of these findings.
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The purpose of this research is to find evidence for the assumption that allowing children to create their own news messages is an effective approach to teach them how to distinguish between reliable news and fake news. Three students of the primary teacher training programme of The Hague University of Applied Sciences developed five lessons concerning fake news and five Kahoot! quizzes for each of those lessons. They taught the lessons they developed under the supervision of a primary school teacher and one of their lecturers from the university. A Friedman test on the scores of the Kahoot! quizzes indicate that the children made progress over the course of the study. In addition, it appears that the children appreciated the lessons and that they have learned how news is created and how fake news can be recognised. The outcomes of this study have prompted a larger, international Erasmus+ project. Schools and libraries in three countries will investigate similar innovative blended-learning approaches for pupils between ages 12 to 15.
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Aims: To assess the effectiveness of a variety of physical treatments in the management of tension-type headache (TTH) in children. Methods: This review is reported in accordance with the PRISMA guidelines and was registered in the PROSPERO database (CRD42014015290). Randomized and nonrandomized controlled trials that examined the effects of all treatments with a physical component in the management of TTH in children and compared these treatments to a placebo intervention, no intervention, or a controlled comparison intervention were included. The Physiotherapy Evidence Database (PEDro) criteria for bias assessment and the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) Working Group criteria were used to assess the quality of the body of evidence. The outcome measures were pain, functioning, and quality of life. Only RCTs were included in the meta-analyses. Results: An initial search produced 10,464 published articles. Of these, 17 were relevant trials, including 1,815 participants. The overall GRADE rating of the included studies was moderate, and 11 of the 17 studies could be used in the meta-analyses. The effectiveness of physical treatments in terms of a reduction of pain of 50% or more showed a risk ratio (RR) of 2.37 (95% CI: 1.69 to 3.33). Relaxation training was the most evaluated intervention and proved to be significantly effective (RR: 3.00 [95% CI: 1.94 to 4.63]). In children having TTH combined with temporomandibular disorders, occlusal appliances were effective (RR: 2.58 [95% CI: 1.37 to 4.85]). Conclusion: This review supports the use of physical treatments to reduce pain in children with TTH.
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The current study analyzed blogs written by four Dutch parents of children with profound intellectual and multiple disabilities, with the aim of deepening the understanding of the parents’ concerns. Thematic analysis was conducted and five main themes were identified: Dealing with uncertainties addressed the impact of unpredictability present in the everyday lives of parents, Love and loss described the complexity of concurrently cherishing the child and grieving various types of loss, Struggling with time, energy and finances detailed imbalances and struggles related to parents’ personal resources, Feeling included in communities and society specified social consequences, and Relating to professional care services reflected on stress and support associated with professional care delivery. The study findings demonstrate how care professionals should acknowledge parents’ vulnerabilities by being aware of their existential distress and empowering parents to exercise control of family thriving.
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Objectives: The development of children’s motor competence (MC) from early to middle childhood can follow different courses. The purpose of this longitudinal study was to describe and quantify the prevalence of patterns of MC development from early to middle childhood and to identify undesirable patterns. Design: The study used a longitudinal design. Data were collected in three consecutive years, between February 2020 (T0) and May 2022 (T2). Methods: A total of 1128 typically developing Dutch children (50.2% male) between 4 and 6 years old at baseline (M = 5.35 ± 0.69 years) participated in this study. MC was measured with the Athletic Skills Track and converted into Motor Quotient (MQ) scores. To convert all individual MQ scores into meaningful patterns of MC development, changes in MQ categories were analyzed between the different timepoints. Results: A total of 11 different developmental patterns were found. When grouping the different patterns, five undesirable patterns were found with 18.2% of the children, showing an undesirable pattern of MC development between T0 and T2. The patterns of motor development of the other children showed a normal or fluctuating course. Conclusions: There is a lot of variation in MC in early and middle childhood. A substantial percentage of young children showed undesirable MC developmental patterns emphasizing the need for early and targeted interventions.
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For children it is important to consume enough vegetables to establish healthy dietary patterns. Taste acceptance is an important factor contributing to food choice and consumption. Sweetness and sourness enhancement can increase acceptance of specific foods in children. The aim of this study was to determine the effect of sweetness and sourness enhancement on acceptance of cucumber and green capsicum purees in 5-6-year-old children. Three concentrations of sucrose (2, 5 and 10%) and citric acid (0.05, 0.08 and 0.15%) were added to cucumber and green capsicum purees. Children (n = 70, 5.7 ± 0.5 yrs) assessed acceptance of the vegetable purees using a 5-point hedonic facial scale. Sweetness enhancement significantly increased acceptance of cucumber purees (5 and 10% sucrose) and green capsicum purees (2 and 10% sucrose) compared to unmodified purees. Sourness enhancement (0.05, 0.08 and 0.15% citric acid) did not significantly influence acceptance of cucumber and green capsicum purees compared to unmodified purees. Children differed in acceptance of vegetable purees with added sucrose and citric acid. Sweetness likers (cucumber 77.1%, green capsicum 58.6%) accepted sucrose concentrations better than sweetness non-likers in both vegetables. Sourness likers (cucumber 50.0%, green capsicum 44.3%) accepted medium and high concentrations of citric acid better than sourness non-likers in cucumber and all citric acid concentrations in green capsicum. We conclude that enhancement of sweetness increases acceptance of cucumber and green capsicum purees in most children whereas enhancement of sourness is better accepted by only a few children. This study highlights the challenge to get children to better accept vegetables, since only sweetness enhancement improved acceptance while addition of sucrose is undesirable. For a small subset of children enhancing sourness might be an alternative strategy to increase acceptance of vegetables
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Background: Art therapy (AT) is frequently offered to children and adolescents with psychosocial problems. AT is an experiential form of treatment in which the use of art materials, the process of creation in the presence and guidance of an art therapist, and the resulting artwork are assumed to contribute to the reduction of psychosocial problems. Although previous research reports positive effects, there is a lack of knowledge on which (combination of) art therapeutic components contribute to the reduction of psychosocial problems in children and adolescents. Method: A systematic narrative review was conducted to give an overview of AT interventions for children and adolescents with psychosocial problems. Fourteen databases and four electronic journals up to January 2020 were systematically searched. The applied means and forms of expression, therapist behavior, supposed mechanisms of change, and effects were extracted and coded. Results: Thirty-seven studies out of 1,299 studies met the inclusion criteria. This concerned 16 randomized controlled trials, eight controlled trials, and 13 single-group pre–post design studies. AT interventions for children and adolescents are characterized by a variety of materials/techniques, forms of structure such as giving topics or assignments, and the use of language. Three forms of therapist behavior were seen: non-directive, directive, and eclectic. All three forms of therapist behavior, in combination with a variety of means and forms of expression, showed significant effects on psychosocial problems. Conclusions: The results showed that the use of means and forms of expression and therapist behavior is applied flexibly. This suggests the responsiveness of AT, in which means and forms of expression and therapist behavior are applied to respond to the client's needs and circumstances, thereby giving positive results for psychosocial outcomes. For future studies, presenting detailed information on the potential beneficial effects of used therapeutic perspectives, means, art techniques, and therapist behavior is recommended to get a better insight into (un)successful art therapeutic elements.
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