Descriptive analysis of the test of everyday attention for children in a Spanish normative sample

Introduction. Test of Everyday Attention for Children (TEA-Ch) has been validated in different countries demonstrating that it is an instrument with a correct balance between reliability and duration. Given the shortage of trustworthy instruments of evaluation in our language for infantile population we decide to explore the Spanish version of the TEA-Ch. Methods. We administered TEA-Ch (version A) to a sample control of 133 Spanish children from 6 to 11 years enrolled in school in the Community of Madrid. Four children were selected at random by course of Primary Education, distributing the sex of equivalent form. Descriptive analysis and comparison by ages and sex in each of the TEA-Ch's subtests were conducted to establish a profile of the sample. In order to analyze the effect of the age, subjects were grouped in six sub-samples: 6, 7, 8, 9, 10 and 11 years-old. Results. This first descriptive analysis demonstrates age exerted a significant effect on each measure, due to an important "jump" in children's performance between 6 and 7 years-old. The effect of sex was significant only in two visual attention measures (Sky Search & Map) and interaction age and sex exerted a significant effect only in the dual task (Score DT). Conclusions. The results suggest that the Spanish version of the TEA-Ch (A) might be a useful instrument to evaluate attentional processes in Spanish child population.

A virtual agent to sustaining children's engagement in language learning

In this thesis we aimed to explore the potential of gamification - defined as “the use of game elements in non-game contexts” [30] - in increasing children's (aged 5 to 6) engagement with the task. This is mainly due to the fact that our world is living a technological era, and videogames are an example of this engagement by being able to maintain children’s (and adults) engagement for hours straight. For the purpose of limiting complexity, we only addressed the feedback element by introducing it with an anthropomorphic virtual agent (human-like aspect), because research shows that virtual agents (VA’s) can influence behavioural change [17], or even induce emotions on humans both through the use of feedback provided and their facial expressions, which can interpreted in the same way as of humans’ [2]. By pairing the VA with the gamification concept, we wanted to 1) create a VA that is likely to be well-received by children (appearance and behaviour), and 2) have the immediate feedback that games have, so we can give children an assessment of their actions in real-time, as opposed to waiting for feedback from someone (traditional teaching), and with this give students more chances to succeed [32, 43]. Our final system consisted on a virtual environment, where children formed words that corresponded to a given image. In order to measure the impact that the VA had on engagement, the system was developed in two versions: one version of the system was limited to provide a simple feedback environment, where the VA provided feedback, by responding with simple phrases (i.e. “correct” or “incorrect”); for the second version, the VA had a more complex approach where it tried to encourage children to complete the word – a motivational feedback - even when they weren’t succeeding. Lastly we conducted a field study with two groups of children, where one group tested the version with the simple feedback, and the other group tested the ‘motivational’ version of the system. We used a quantitative approach to analyze the collected data that measured the engagement, based on the number of tasks (words) completed and time spent with system. The results of the evaluation showed that the use of motivational feedback may carry a positive effect on engaging children.

Using health-related quality of life instruments for children with long-term conditions : On the basis of a national quality registry system

Introduction: There has been a continuous development of new technologies in healthcare that are derived from national quality registries. However, this innovation needs to be translated into the workflow of healthcare delivery, to enable children with long-term conditions to get the best support possible to manage their health during everyday life. Since children living with long-term conditions experience different interference levels in their lives, healthcare professionals need to assess the impact of care on children’s day-to-day lives, as a complement to biomedical assessments. Aim: The overall aim of this thesis was to explore and describe the use of instruments about health-related quality of life (HRQOL) in outpatient care for children with long-term conditions on the basis of a national quality registry system. Methods: The research was conducted by using comparative, cross-sectional and explorative designs and data collection was performed by using different methods. The questionnaire DISABKIDS Chronic Generic Measure -37 was used as well as semi-structured interviews and video-recordings from consultations. Altogether, 156 children (8–18 years) and nine healthcare professionals participated in the studies. Children with Type 1 Diabetes (T1D) (n 131) answered the questionnaire DISABKIDS and children with rheumatic diseases, kidney diseases and T1D (n 25) were interviewed after their consultation at the outpatient clinic after the web-DISABKIDS had been used. In total, nine healthcare professionals used the HRQOL instrument as an assessment tool during the encounters which was video-recorded (n 21). Quantitative deductive content analysis was used to describe content in different HRQOL instruments. Statistical inference was used to analyse results from DISABKIDS and qualitative content analysis was used to analyse the interviews and video-recordings. Results: The findings showed that based on a biopsychosocial perspective, both generic and disease-specific instruments should be used to gain a comprehensive evaluation of the child’s HRQOL. The DISABKIDS instrument is applicable when describing different aspects of health concerning children with T1D. When DISABKIDS was used in the encounters, children expressed positive experiences about sharing their results with the healthcare professional. It was discovered that different approaches led to different outcomes for the child when the healthcare professionals were using DISABKIDS during the encounter. When an instructing approach is used, the child’s ability to learn more about their health and how to improve their health is limited. When an inviting or engaging approach is used by the professional, the child may become more involved during the conversations. Conclusions: It could be argued that instruments of HRQOL could be used as a complement to biomedical variables, to promote a biopsychosocial perspective on the child’s health. According to the children in this thesis, feedback on their results after answering to web-DISABKIDS is important, which implies that healthcare professionals need to prioritize time for discussions about results from HRQOL instruments in the encounters. If healthcare professionals involve the child in the discussion of the results of the HRQOL, misinterpreted answers could be corrected during the conversation. Concurrently, this claims that healthcare professionals invite and engage the child.