Interpreting information about medication side effects: differences in risk perception and intention to comply when medicines are prescribed for adults or young children

This study investigates whether, and how, people's perception of risk and intended health behaviours are affected by whether a medicine is prescribed for themselves or for a young child. The question is relevant to the issue of whether it is beneficial to produce medicines information that is tailored to particular subgroups of the population, such as parents of young children. In the experiment, participants read scenarios which referred either to themselves or their (imagined) 1-year-old child, and were required to make a number of risk judgements. The results showed that both parents and non-parents were less satisfied, perceived side effects to be more severe and more likely to occur, risk to health to be higher, and said that they would be less likely to take (or give) the medicine when the recipient was the child. On the basis of the findings, it is suggested that it may well be beneficial to tailor materials to broader classes of patient type.

Production of relative clauses in monolingual Turkish children

Research on the production of relative clauses (RCs) has shown that in English, although children start using intransitive RCs at an earlier age, more complex, bi-propositional object RCs appear later (Hamburger & Crain, 1982; Diessel and Tomasello, 2005), and children use resumptive pronouns both in acceptable and unacceptable ways (McKee, McDaniel, & Snedeker, 1998; McKee & McDaniel, 2001). To date, it is unclear whether or not the same picture emerges in Turkish, a language with an SOV word-order and overt case marking. Some studies suggested that subject RCs are more frequent in adults and children (Slobin, 1986) and yield a better performance than object RCs (Özcan, 1996), but others reported the opposite pattern (Ekmekçi, 1990). Our study addresses this issue in Turkish children and adults, and uses participants’ errors to account for the emerging asymmetry between subject and object RCs. 37 5-to-8 year old monolingual Turkish children and 23 adult controls participated in a novel elicitation task involving cards, each consisting of four different pictures (see Figure 1). There were two sets of cards, one for the participant and one for the researcher. The former had animals with accessories (e.g., a hat) whereas the latter had no accessories. Participants were instructed to hold their card without showing it to the researcher and describe the animals with particular accessories. This prompted the use of subject and object RCs. The researcher had to identify the animals in her card (see Figure 2). A preliminary repeated measures ANOVA with the factor Group (pre-school, primary-school children) showed no differences between the groups in the use of RCs (p>.1), who were therefore collapsed into one for further analyses. A repeated measures ANOVA with the factors Group (children, adults) and RC-Type (Subject, Object) showed that children used fewer RCs than adults (F(1,58)=7.54, p<.01), and both groups used fewer object than subject RCs (F(1,58)=22.46, p<.001), but there was no Group by RC-Type interaction (see Figure 3). A similar ANOVA on the rate of grammatical RCs showed a main effect of Group (F(1,58)=77.25, p<.001), a main effect of RC-Type (F(1,58)=66.33, p<.001), and an interaction of Group by RC-Type (F(1,58)=64.6, p<.001) (see Figure 4). Children made more errors than adults in object RCs (F(1,58)=87.01, p<.001), and children made more errors in object compared to subject RCs (F(1,36)=106.35, p<.001), but adults did not show this asymmetry. The error analysis revealed that children systematically avoided the object-relativizing morpheme –DIK, which requires possessive agreement with the genitive-marked subject. They also used resumptive pronouns and resumptive full-DPs in the extraction site similarly to English children (see Figure 5). These findings are in line with Slobin (1986) and Özcan (1996). Children’s errors suggest that they avoid morphosyntactic complexity of object RCs and try to preserve the canonical word order by inserting resumptive pronouns in the extraction site. Finally, cross-linguistic similarity in the acquisition of RCs in typologically different languages suggests a higher accessibility of subject RCs both at the structural (Keenan and Comrie, 1977) and conceptual level (Bock and Warren, 1986).

Poverty, HIV, and barriers to education: street children's experiences in Tanzania

This article discusses the links between poverty, HIV/AIDS, and barriers to education, based on the first-hand experiences of ‘street children’ in northern Tanzania. Within the context of national levels of poverty, ‘cost-sharing’ in health and education sectors, and the AIDS epidemic, poor families in Tanzania are under considerable pressure, and increasing numbers of girls and boys are consequently seeking a living independently on the streets of towns and cities. My research with street children shows that some children orphaned by AIDS are subject to rejection and exploitation by the extended family after the death of their parent(s). They are exposed to considerable risks of abuse, sexual violence and HIV within the street environment. Here, I discuss the links between poverty, HIV and barriers to education, which compound young people’s vulnerability, and offer some policy recommendations in response to the young people’s experiences.

Cortisol levels in response to starting school in children at increased risk for social phobia

Background: Research on depression has identified hyperactivity of the HPA axis as a potential contributory factor to the intergenerational transmission of affective symptoms. However, this has not yet been examined in the context of social phobia. The current study compared HPA axis activity in response to a universal social stressor (starting school) in children of 2 groups of women: one with social phobia and one with no history of anxiety (comparison group). To determine specificity of effects of maternal social phobia, a third group of children were also examined whose mothers had generalised anxiety disorder (GAD). Method: Children provided salivary cortisol samples in the morning, afternoon and at bedtime across 3 time-blocks surrounding the school start: a month before starting school (baseline), the first week at school (stress response), and the end of the first school term (stress recovery). Child behavioural inhibition at 14 months was also assessed to explore the influence of early temperament on later stress responses. Results: All children displayed an elevation in morning and afternoon cortisol from baseline during the first week at school, which remained elevated until the end of the first term. Children in the social phobia group, however, also displayed an equivalent elevation in bedtime cortisol, which was not observed for comparison children or for children of mothers with GAD. Children in the social phobia group who were classified as 'inhibited' at 14 months displayed significantly higher afternoon cortisol levels overall. Summary: A persistent stress response to school in the morning and afternoon is typical for all children, but children of mothers with social phobia also display atypical elevations in evening cortisol levels when at school - signalling long-term disruption of the circadian rhythm in HPA axis activity. This is the first study to report HPA axis disruption in children at risk of developing social phobia, and future research should aim to determine whether this represents a pathway for symptom development, taking early temperament into account.

An experimental manipulation of responsibility in children: a test of the inflated responsibility model of obsessive-compulsive disorder

The objective of this study was to investigate whether Salkovskis (1985) inflated responsibility model of obsessive-compulsive disorder (OCD) applied to children. In an experimental design, 81 children aged 9– 12 years were randomly allocated to three conditions: an inflated responsibility group, a moderate responsibility group, and a reduced responsibility group. In all groups children were asked to sort sweets according to whether or not they contained nuts. At baseline the groups did not differ on children’s self reported anxiety, depression, obsessive-compulsive symptoms or on inflated responsibility beliefs. The experimental manipulation successfully changed children’s perceptions of responsibility. During the sorting task time taken to complete the task, checking behaviours, hesitations, and anxiety were recorded. There was a significant effect of responsibility level on the behavioural variables of time taken, hesitations and check; as perceived responsibility increased children took longer to complete the task and checked and hesitated more often. There was no between-group difference in children’s self reported state anxiety. The results offer preliminary support for the link between inflated responsibility and increased checking behaviours in children and add to the small but growing literature suggesting that cognitive models of OCD may apply to children.

Poisoning the mind: Arsenic contamination of drinking water wells and children's educational achievement in rural Bangladesh

Bangladesh has experienced the largest mass poisoning of a population in history owing to contamination of groundwater with naturally occurring inorganic arsenic. Prolonged drinking of such water risks development of diseases and therefore has implications for children's cognitive and psychological development. This study examines the effect of arsenic contamination of tubewells, the primary source of drinking water at home, on the learning outcome of school-going children in rural Bangladesh using recent nationally representative data on secondary school children. We unambiguously find a negative and statistically significant correlation between mathematics scores and arsenic-contaminated drinking tubewells at home, net of the child's socio-economic status, parental background and school specific unobserved correlates of learning. Similar correlations are found for an alternative measure of student achievement and subjective well-being (i.e. self-reported measure of life satisfaction), of the student. We conclude by discussing the policy implication of our findings in the context of the current debate over the adverse effect of arsenic poisoning on children.

Interpretation and expectation in childhood anxiety disorders: age effects and social specificity

Theory and treatment for childhood anxiety disorders typically implicates children’s negative cognitions, yet little is known about the characteristics of thinking styles of clinically anxious children. In particular, it is unclear whether differences in thinking styles between children with anxiety disorders and non-anxious children vary as a function of child age, whether particular cognitive distortions are associated with childhood anxiety disorders at different child ages, and whether cognitive content is disorder-specific. The current study addressed these questions among 120 7 - 12 year old children (53% female) who met diagnostic criteria for social anxiety disorder, other anxiety disorder, or who were not currently anxious. Contrary to expectations, threat interpretation was not inflated amongst anxious compared to non-anxious children at any age, although older (10 - 12 year old) anxious children did differ from non-anxious children on measures of perceived coping. The notion of cognitive-content specificity was not supported across the age-range. The findings challenge current treatment models of childhood anxiety, and suggest that a focus on changing anxious children’s cognitions is not warranted in mid-childhood, and in late childhood cognitive approaches may be better focussed on promoting children’s perceptions of control rather than challenging threat interpretations.

Missionary children: The French Holy Childhood Association in European context, 1843-c.1914

In the mid-nineteenth century, thousands of children in Europe and beyond were organized into battalions of fundraisers for overseas missions. By the end of the century these juvenile missionary organizations had become a global movement, generating millions of pounds in revenue each year. While the transnational nature of the children’s missions and publications has been well-documented by historians, the focus has tended to be on the connections that were established by encounters between the young western donors, missionaries overseas and the non-western ‘other’ constructed by their work. A full exploration of the European political, social and cultural concerns that produced the juvenile missionaries movement and the trans-European networks that sustained it are currently missing from historical accounts of the phenomenon. This article looks at the largest of these organizations, the Catholic mission for children, the French Holy Childhood Association (L’Œuvre de la sainte enfance), to understand how the principles this mission sought to impose abroad were above all an expression of anxieties at home about the role of religion in the family, childhood and in civil society as western polities were modernizing and secularizing in the nineteenth century.

Production of definite and indefinite articles in typically developing English-speaking children and children with SLI

The present paper examines the production of definite and indefinite articles in English-speaking typically developing (TD) children and children with Specific Language Impairment (SLI). Twenty four English-speaking children with SLI (mean age: 7;5), twenty nine TD age-matched (TD-AM) children (mean age: 7;5) and eleven younger (mean age: 5;5) TD vocabulary-matched (TD-VM) children participated in a production task involving short stories without picture props based on Schafer and de Villiers (2000). Article production was examined in two different semantic contexts for the definite article, namely in the anaphoric and the bridging context. In the anaphoric condition, definiteness is established via linguistic means, whereas in the bridging condition via shared world knowledge. Indefinite article production was examined in the referential specific, non-referential predicational, and non-referential instrumental contexts. The referential specific context involves [+speaker, −hearer] knowledge and the non-referential predicational and instrumental [−speaker, −hearer] knowledge. Results showed that in the definite article contexts, all three groups performed better on the bridging compared with the anaphoric condition; in the indefinite article contexts, they had better performance on the non-referential predicational vs. the referential specific and the non-referential instrumental conditions. In terms of errors, the TD-VM children and the children with SLI produced significantly more substitutions than the TD-AM children in the definite article contexts. In the indefinite article contexts, the three groups did not differ in terms of accuracy or error patterns. The present results point towards problems in the discourse integration of entities that are part of the speaker's and hearer's knowledge in children with SLI and TD-VM controls, especially in definite articles. These problems are accentuated in the children with SLI due to their grammatical impairment and suggest that children with SLI exhibit a delayed acquisition profile.

Threat interpretation bias in anxious children and their mothers

The role of parents in the development of anxiety disorders in children is of increasing research and clinical interest. This study investigated interpretation biases of anxious children and their mothers using the ambiguous stimuli task developed by Hadwin, Frost, French, and Richards (1997). Three groups of children (aged 7 to 12 years) and their mothers were recruited; 23 non-clinical controls, 18 children with an anxiety disorder and 15 children with an externalising disorder. Following diagnostic assessments of the children, children and their mothers independently completed the homophone task and self-report measures of anxiety. Mothers of anxious children had significantly higher self-reported anxiety than mothers of non-clinical children. As hypothesised, children in the anxious group had higher threat interpretation scores than the non-clinical group. The hypothesis that mothers of anxious children would make more threat interpretations was not supported. Paired correlations showed no significant association between threat interpretations made by children and their mothers. There was a significant positive correlation between maternal threat interpretation and child anxiety. The results suggest that there is a complex association between mother's anxiety and cognitions and those of their children, which requires further examination in controlled observational and experimental studies, including treatment trials.