tag:blogger.com,1999:blog-43977561429508263812024-03-13T11:36:47.833+00:00Evidence-based ParentingUsing my scientific knowledge to answer parenting questionsDrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.comBlogger26125tag:blogger.com,1999:blog-4397756142950826381.post-53740168275017075492013-06-27T15:47:00.000+01:002013-06-27T15:47:07.750+01:00What's wrong with dummies?This is a summary, kind of, of part of a <a href="http://scienceshowoff.wordpress.com/2013/03/20/aprgig/">Science Showoff</a> slot I did back in April.<br />
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One of the first decisions we were asked to make when our baby was born (I suspect because he was in the neonatal unit) was whether or not to give him a pacifier, otherwise known as a dummy. I've never had a particular prejudice one way or the other, but I've since met a lot of UK parents who either are very proud their baby doesn't use one, or who say they don't like how they look, or who are happy their child sucks their thumb. And the very term for it tells you how they are seen in the UK - dialect words are more neutral (soother, dodie) as is the US word pacifier.<br />
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There's some very emotive language out there - both from lay people ("can't you take that thing out of his mouth" - My mother, 2012) and from researchers ("Harmful oral suction habits" - just as a for example, <a href="http://revistaseletronicas.pucrs.br/fo/ojs/index.php/fo/article/viewArticle/6269">Moimaz et al</a>., 2010)<br />
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The two main objections that people seem to have are that pacifiers harm babies' teeth, causing malocclusions (misalignment, aka overbite or underbite) and that they slow babies down in learning to talk.<br />
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So, what's the evidence for these?<br />
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Thumb/finger sucking and sucking a pacifier tend to be know, together, as "non-nutritive sucking". Both types of these have definitely been associated with malocclusions - for example, <a href="http://adc.bmj.com/content/89/12/1121.short">here</a> they are compared to bottle and breast feeding, and the type of feeding didn't make as much of a difference to children's dental alignment as did sucking a comforter (of whatever type).<br />
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From that point of view, yes, sucking a pacifier does seem to cause some dental problems. But is there an alternative? Should parents just not let their child have a pacifier? Should we have said no?<br />
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Well, if parents don't allow children to have a pacifier - the likelihood is that <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1834-7819.1981.tb03938.x/abstract?deniedAccessCustomisedMessage=&userIsAuthenticated=false"> they will suck their thumb or finger</a>. If both of these can cause dental problems, maybe that's OK. And if your mum is complaining about the pacifier, maybe she wouldn't complain as much about the thumb. That article is pretty old, but this issue seems to bother people less currently, so there isn't much later research looking at the same thing.<br />
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One of the largest studies of infants and children in the UK, ALSPAC, has some great data showing why it might not be such a good idea to prefer thumb/finger sucking over pacifier sucking. Firstly, pacifier use was <a href="http://europepmc.org/abstract/MED/11121676">more common</a> among less well off and less educated families (see, I knew everyone thought I was a slummy mummy for using one!). But although at 15 months almost twice as many children used a pacifier as a thumb/finger, by 36 months <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1365-263X.2007.00905.x/abstract?deniedAccessCustomisedMessage=&userIsAuthenticated=false">about the same number used each one</a>. So, pacifier users were twice as likely to drop the sucking habit by the age of 3. If you don't want your child to turn out like Pike in Dad's Army, still sucking his thumb at the age of 17, better stick to pacifiers.<br />
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What about speech and language? Well, there's very little evidence here at all - but basically <a href="http://www.asha.org/uploadedFiles/asha/publications/cicsd/2008STheImpactofProlongedPacifierUse.pdf">it doesn't make any difference</a> (pdf).Children who've used a pacifier for a long time have no more speech problems than those who haven't.<br />
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There are some good things about pacifiers - they do seem to reduce the risk of SIDS, and obviously sucking in general (not just pacifiers) soothes babies, as well as older toddlers. There does though seem to be some evidence for an increase in middle ear infections in babies who use pacifiers. The evidence for reduction in SIDS seems to be about as strong as the evidence for increased middle ear infections. As one is a lot more serious than the other, on balance for health reasons using a pacifier is probably better than not.<br />
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But you know, that isn't going to stop your mother from telling you it "looks bad" for your baby to use a pacifier. So, here's my husband's suggestion for what to do with your mother:<br />
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<a href="http://4.bp.blogspot.com/-yErZANfIDb0/UcxQNKDT_XI/AAAAAAAACds/NVREK2QziOU/s574/adult+woman+with+dummy.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="298" src="http://4.bp.blogspot.com/-yErZANfIDb0/UcxQNKDT_XI/AAAAAAAACds/NVREK2QziOU/s320/adult+woman+with+dummy.jpg" width="320" /></a></div>
<br />DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com0tag:blogger.com,1999:blog-4397756142950826381.post-51368314321724512722013-06-26T12:03:00.001+01:002013-06-26T12:03:26.157+01:00I promise, I really do...Back in April I did a <a href="http://scienceshowoff.wordpress.com/2013/03/20/aprgig/">Science Showoff</a> standup slot on the science of being a new parent. I talked about odd remedies that you might have recommended to you by the health visitor or GP (homeopathic teething granules, gripe water) and about the science behind dummies/pacifiers.<br />
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I have a draft of a post on pacifiers and I REALLY REALLY promise I will put it up! Soon! Honest!DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com0tag:blogger.com,1999:blog-4397756142950826381.post-81669721356623409112013-05-15T21:58:00.005+01:002013-05-15T21:58:41.526+01:00Evidence for treatments for abused/neglected children - part 2This is part 2 of a series of posts looking at the treatments that parents of abused and/or neglected children might be offered. Part 1 which explains a bit of the background, and a bit more about why evidence matters, is <a href="http://evidence-based-parenting.blogspot.co.uk/2013/04/therapies-for-children-who-have-been.html">here</a>.<br />
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So, moving on from the names mentioned in the previous post, we come to <b>Bessel Van der Kolk</b>. Here, I'm starting to feel a little more confident. The research (and there is actually research, with actual data) is grounded in well-established theories - I'm not a specialist in PTSD, but I do know that it's a well-established disorder, that we know it happens in children as well as in adults, and that a lot of research groups work on the disorder. This all gives us confidence both that the disorder exists, and that no one group of psychologists is going to be the only ones saying something, which could just be their personal theory.<br />
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A couple of interesting background articles include <a href="http://onlinelibrary.wiley.com/doi/10.1002/jts.20444/abstract">this one</a> which talks about multiple instances of trauma in childhood (e.g. through repeated abuse, or different types of abuse) and whether this might increase the complexity of PTSD. As I say I'm not a specialist but they include neglect and abandonment as two categories of childhood abuse (but importantly they are ONLY two categories and they weren't the most common either).<br />
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They found that more instances of abuse did increase the complexity of PTSD, and interestingly the more trauma there was in childhood the worse were symptoms - but more trauma in adulthood didn't mean more symptoms. <br />
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I know many parents whose children were neglected but there's no evidence of abuse are interested in how this can affect them - it's hard to say specifically from this paper but because there were several possible traumas in childhood, it doesn't look like "only" being neglected is likely to lead to complex PTSD. I'd have to do more reading to say what the link was between neglect and any PTSD at all, though.<br />
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The diagnosis of complex PTSD does seem to be applied to a proportion of children who have been abused and/or neglected and Van der Kolk also has some ideas on treatment, such as <a href="http://books.google.co.uk/books?hl=en&lr=&id=Dii1VMq_KhwC&oi=fnd&pg=PA127&ots=d0JZNgr06V&sig=FmuWOGr_xgetE41t87W7jmTnG4Y&redir_esc=y#v=onepage&q&f=false">this chapter</a>. The suggestion is for what he calls Phase Oriented Treatment, which briefly seems to start with symptom management and move on via other steps to therapies including Exposure Therapy and EMDR.<br />
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However, I started to get a little sceptical when I looked up this<b> treatment programme</b> (it's not so much a treatment as a programme of different treatments, that must be applied in a particular order). I can't find a group that has evaluated the programme in a valid way - no controlled trials. Van der Kolk in this same chapter says that his programme of treatment for adults (note not children, and we have to be very wary of recommending treatments for children on the grounds that they work for adults) works better with PTSD patients, citing a controlled trial. I can't find the precise trial he talks about, but another <a href="http://gsappweb.rutgers.edu/cstudents/readings/Summer/Heffernan_WorkingTrauma/mcdonagh_random.pdf">paper </a> (pdf) by the same group says that the two treatments were just as effective as each other, and the part of that study that Van der Kolk calls "prolonged exposure and cognitive restructuring" - his recommended treatment - seems to be CBT, about which a lot is known, and seems to be effective.<br />
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I find it a bit odd that Van der Kolk uses this study to suggest that CBT (or PE/CR as he calls it) is no use for PTSD while the original researchers suggest it is good for PTSD. And it's all very well to say (even if it's true) that "lots of patients drop out in conventional PTSD treatment" (the figure was 30%) but to go on to say, which he does, they are "harmed" by it seems a bit strong. The study he's citing here does not actually include the programme of treatment he recommends, anyway. So I'm not sure what to conclude about his treatments.<br />
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Although Van der Kolk doesn't seem to be saying that his treatment recommendations in general are all about EMDR (which is an eye-movement based treatment, but which does have something in common with CBT. It has a bit of a bad press among a few quack-watch types but there does seem to be some evidence for it), he himself has published a <a href="http://ww.traumacenter.org/products/pdf_files/van_der_Kolk_JCLINFINAL.pdf">controlled trial</a> (pdf) of EMDR in adults (versus a drug treatment or a drug placebo - there wasn't a therapy control group), and there's <a href="http://informahealthcare.com/doi/abs/10.1080/08039480701643464">another study</a> of EMDR versus a waiting list group in children. As I said in my previous post, waiting list (or no therapy control groups) are not great to evaluate psychological therapies - just talking generally to a helpful therapist is likely to make people feel better.<br />
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Both of these studies though seem to show that EMDR helps PTSD symptoms - and continued to help after 2 months in the child study and 6 months in the adult study.<br />
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Phew! After posting this the very nice <a href="http://keithsneuroblog.blogspot.co.uk/">Keith Laws</a> sent me a metanalysis (a research study that analyses other research studies) <a href="http://t.co/jm8FMiySAa">here</a> (pdf) specifically looking at EMDR and PTSD in children, which does look at some studies that compare EMDR to other therapies. The conclusion is it's a lot better than waiting list or other types of treatment that aren't particularly tailored to PTSD, and it's actually a little better than CBT (about which more anon). But there were, really, very few studies that did a full, direct comparison.<br />
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<b>Recommend to a friend test</b>: I think a cautious yes on the EMDR, but most of the evidence is only versus no therapy. Though Van der Kolk's theories on the development of PTSD in children are backed up, there doesn't seem to be anything at all backing up his ideas on his programme of therapy - that's a definite No, especially as it seems to be so very time consuming and lengthy (and therefore expensive. Am I very wrong to hypothesise that he charges a lot? And charges a lot to train people to do it?). He himself criticises dropout rates in other therapies but doesn't tell us how many people drop out from his multi-phase treatment.<br />
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<b>It's time to talk more here about treatment for PTSD in general. </b>The <a href="https://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CDIQFjAA&url=http%3A%2F%2Fwww.nice.org.uk%2Fnicemedia%2Flive%2F10966%2F29772%2F29772.pdf&ei=ahBxUefjM8naPNargPgO&usg=AFQjCNHFYNJBra8NMLYgggUzxUO4Wy-NVA&sig2=uFydlbuewea4SVqLU01aYw&bvm=bv.45373924,d.d2k">NICE recommendations</a> (pdf - the NHS best clinical evidence recommendations) say that there isn't enough evidence of complex PTSD being different from "regular" PTSD so they look at treatments for all kinds of PTSD (other researchers say this too. Let's be conservative and say more trauma in childhood probably = <i>worse</i> PTSD). Because it's difficult to diagnose in children (Van der Kolk's first study is of outcomes in adults whose trauma was in childhood), and there aren't that many studies, most of the studies are on those who have experienced sexual abuse - though behaviour and mental health difficulties are, as Van der Kolk says himself, similar.<br />
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There are some controlled trials here - phew! <br />
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For older children, there seems to be some help from CBT (compared to "supportive therapy", in other words talking to a therapist without a specific type or plan for treatment) on some aspects of children's behaviour and mental health, but not others. For children under 7, it's hard to measure mental health directly but CBT also seems to help children's behaviour. None of the studies went on for long enough to tell if the CBT affected children's behaviour or mental health in the long term. As families often drop out of therapy when they don't find it's helpful, they also looked at whether the dropout rates differed. Again, it wasn't possible to tell. These all seem to have been studies of trauma-focussed CBT, in particular.<br />
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Interestingly some practitioners and some of the trials, compared what happened when the mother had CBT with giving it to the child. I wasn't too surprised to read that it didn't help to give this instead or as well!<br />
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<b>RtaF:</b> As far as we can tell this particular type of CBT <i>does</i> help PTSD in children, at least in the short term, and it helps quite young children too. I would recommend this, but would love to see more data.<br />
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<b>Before I finish what was supposed to be a concluding post</b> but is going to be one of at least a couple more, I can tell, I can see (!) I wanted to comment on another theory that Van der Kolk has, which is that as well as the category of PTSD there should be a category of Developmental Trauma, for children who have suffered prolonged abuse and neglect and have consequent behavioural and mental health problems. This may or may not be a separate category of disorders according to the "official" manual used to classify psychiatric problems (the DSM). A new version is about to come out and I can't find out if it is going to include this.<br />
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Van der Kolk, among others, has suggested this would be a good idea and that it should form a separate diagnosis. He thinks it would be a better diagnosis than PTSD, and he's probably right in saying that there are more symptoms in a lot of children than would be covered under this. But <a href="http://www.traumacenter.org/products/pdf_files/neurobiology_childhood_trauma_abuse.pdf">as he also says</a> (pdf), many children who have suffered abuse meet another diagnostic criterion. <br />
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And there hasn't been any particular treatment proposed for this group as a whole - who's to say that lumping all these children together isn't a mistake too, and that you need to look more closely at their symptoms and/or other diagnoses they might have, to treat them effectively? The consensus among some researchers is that if the diagnosis exists with an emphasis on cause, there might be too much temptation to diagnose all children with this background with the same thing, regardless of what problems they have. Children not only may have differing problems but vary in their resilience in the face of trauma - so will have differing degrees of the same problems.<br />
<br />DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com1tag:blogger.com,1999:blog-4397756142950826381.post-81755015665116680662013-04-11T19:53:00.000+01:002013-04-11T20:01:47.902+01:00Therapies for children who have been abused or neglected part 1<br />
<span style="font-family: Times, Times New Roman, serif;">Children who are adopted often need a new family because their first family abused or neglected them. This maltreatment can have lifelong consequences for behaviour and development. Parents often experience huge difficulties with their children, and don't know where to turn. They feel disempowered, that they don't know anything, and that no-one will help. Like parents of children with disabilities, they may feel very grateful if anyone offers a solution. The problem may come with those solutions.</span><br />
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<span style="font-family: Times, Times New Roman, serif;">I'm reposting this, slightly edited, from my personal diary blog - I wasn't sure where to post it originally but have been persuaded to put it in both places. </span><span style="font-family: Times, 'Times New Roman', serif;">I originally started this blog to look at simple, everyday parenting issues like reading and writing, friendship, babies' development but the issues brought up by reading about parents of children with difficulties have meant I want to have a look at therapies.</span><br />
<span style="font-family: Times, Times New Roman, serif;"><br /></span><span style="font-family: Times, Times New Roman, serif;">To give this some background, I've also been having some Twitter conversations with psychologists who don't have anything to do with adoption, but who are getting increasingly irritated with scientists and clinicians publishing papers saying "this therapy is brilliant!" when it isn't. And I also follow a lot of quack-watch type people (Ben Goldacre etc.), and frankly, the state of "therapeutic" offerings for children who have had dreadful early life experiences is way, way below the standard offered by the slightly self-promoting scientists and clinicians. It seems in some cases to be nearer the homeopathy, cranial osteopathy, and pseudo-qualified nutritionists of this world that are the subject of quack watch types.</span><br />
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<span style="font-family: Times, Times New Roman, serif;">Let me say at this point that I know I am going to get comments by people saying "but but but we've tried A B or C and it was FABULOUS and our lives have been TURNED AROUND and this person is a God!".</span><br />
<span style="font-family: Times, Times New Roman, serif;"><br />Fine. You can believe that. But if something, on average, has no effect - then that means half the group gets better, half gets worse. What if you ended up in the group that got worse? Would you be happy you spent your money on it?</span><br />
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<span style="font-family: Times, Times New Roman, serif;">And if on average children on a treatment get better (but only compared to themselves at the beginning, or only compared to children who weren't getting any treatment) then it could easily be because they are growing older (children learn things and become better behaved, mainly, as they get older) or because they've had some special attention. This is usually cheaper than therapy.</span><br />
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<span style="font-family: Times, 'Times New Roman', serif;">If you need to be persuaded further why we need evidence on parenting have a look at my </span><a href="http://evidence-based-parenting.blogspot.co.uk/2009/05/what-is-evidence-based-parenting.html" style="font-family: Times, 'Times New Roman', serif;">introductory post</a><span style="font-family: Times, 'Times New Roman', serif;">.</span><br />
<span style="font-family: Times, Times New Roman, serif;"><br />So... I thought I'd see what evidence there was for a couple of the really popular training and therapy centres that are talked about a lot by adoptive parents: the Child Mental Health Centre (Margot Sunderland's place) and Family Futures (which is a voluntary adoption agency,and I believe in that capacity has great inspection reports, I'm not sure that its training side gets inspected).</span><br />
<span style="font-family: Times, Times New Roman, serif;"><br />The Child Mental Health Centre says one of its aims is:</span><br />
<blockquote class="tr_bq">
<b>Dissemination of Research</b><br /><br />To promote positive social change through disseminating the latest research in child, parent and family mental health<br /><br />To make available to parents, teachers, child-care professionals, providers and custodians of services, politicians and the lay-public at large, a comprehensive up-to-date knowledge base in child and family well-being<br /><br />To fund an effective dissemination of psychologically and neurobiologically based research. Organisational isolation can be costly: ...wasting time slowly re-discovering what is already known (Baron Peter Slade, 2000)</blockquote>
<span style="font-family: Times, Times New Roman, serif;"><br />Family Futures says:</span><br />
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Our therapeutic interventions draw upon and are informed by the work of Dan Hughes, Theraplay, Bruce Perry, Bessel Van der kolk, Babette Rothchild and Dr A. Jean Ayres and many others.</blockquote>
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<br /><span style="font-family: Times, Times New Roman, serif;">I'm still looking for a list of research that the Child Mental Health Centre is disseminating. So I'll start with Family Futures. Let's take those in turn and see what evidence there is that these theories and therapies work.</span><br />
<span style="font-family: Times, Times New Roman, serif;"><br /><b>Dan Hughes</b>: I found <a href="http://www.tandfonline.com/doi/pdf/10.1080/14616730412331281539" target="_blank">this</a> paper by him about his therapy and its basis. It doesn't present any evidence for its evaluation, and I am not completely sure (because it's not my area of specialisation) that his therapy described there is the same as Dynamic Developmental Psychotherapy, but DDP is compared in a few studies to treatment-as-usual, and it seems to <a href="http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2206.2008.00557.x/full" target="_blank">come out well</a>. The studies aren't large, but then fully diagnosed Reactive Attachment Disorder isn't common. The studies don't tell us anything about DDP in children who haven't got RAD. <a href="http://www.ncbi.nlm.nih.gov/pubmed/21288932" target="_blank">This review</a> suggests however that the statistics in Hughes' study are pretty rubbish, and worries about some of the ethics of it.</span><br />
<span style="font-family: Times, Times New Roman, serif;"><br />Family Futures now offer a training course that includes DDP, which they call "Neuro-Physiological Psychotherapy". I'm not sure what makes it neurophysiological, as neurophysiologists are generally medical doctors who have a speciality in a branch of neurology, or lab scientists who work with lab animals. I'm also not quite sure whether the hyphen makes a difference.</span><br />
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<span style="font-family: Times, Times New Roman, serif;">The "Recommend to a Friend test": I might recommend this to a friend whose child had a diagnosis of RAD. But probably not. I'm not sure if enough is known about it to know if it would be harmful or helpful, or neither, to a child who didn't have such a diagnosis.</span><br />
<span style="font-family: Times, Times New Roman, serif;"><br /><b>Theraplay</b>: Chapter 5 in <a href="http://books.google.co.uk/books?hl=en&lr=&id=wxAE3BeTc24C&oi=fnd&pg=PA103&dq=theraplay&ots=186AHBZANl&sig=PdjmP5pvMyHrht5blpq5fJxis6w#v=onepage&q&f=false" target="_blank">this book </a>by Wettig talks about the evaluation of Theraplay. The studies randomised children to either treatment or waiting list controls (which aren't necessarily the best control - partly because just giving children attention rather than no treatment can improve outcomes). A lot of the children in this study had some developmental disability, which is typical of children who also have the kind of behaviour problems Theraplay is often recommended for. </span><br />
<span style="font-family: Times, Times New Roman, serif;">The chapter says that the children who had therapy improved more than the children who were on the waiting list, though I can't seem to find (perhaps I'm not looking hard enough) any graphs or figures that directly compare these two groups, only graphs showing children's behavioural problems before and after Theraplay. A review I found <a href="http://www.ncbi.nlm.nih.gov/pubmed/21288932" target="_blank">here</a> says there aren't any other studies showing Theraplay is effective, and makes a good point about its theoretical basis in attachment theory but the fact that it kind of ignores attachment theory in how it is supposed to work.</span><br />
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<span style="font-family: Times, Times New Roman, serif;">The RtaF test: I'm not convinced I would. The Wettig book chapter is rather grandiose in how many different disorders it claims Theraplay can treat or influence, too, which puts me off considerably.</span><br />
<span style="font-family: Times, Times New Roman, serif;"><br /><b>Bruce Perry</b>: I can find a lot of articles by Bruce Perry on the theory behind what happens to children if they are neglected or abused. Certainly (if you are getting accurate information) it can be helpful to understand what's going on when you have a child that's difficult to parent. He does talk a little about therapy, but doesn't recommend or describe any particular type, saying instead </span><br />
<blockquote class="tr_bq">
the Neurosequential Model of Therapeutics (NMT) allows identification of the key systems and areas in the brain which have been impacted by adverse developmental experiences and helps target the selection and sequence of therapeutic, enrichment, and educational activities.</blockquote>
<span style="font-family: Times, Times New Roman, serif;">It's beyond the scope of this post (read: I should be doing something else) to evaluate ALL of his ideas about what affects what when development is disrupted. He does have a tendency to say "brain" when he means "behaviour" or "cognitive development". For example he talks about "</span><br />
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<span style="font-family: Times, Times New Roman, serif;">NMT Functional Status and Brain ‘‘Mapping’ [...] An interdisciplinary staffing is typically the method for this functional review. This process helps in the development of a working functional brain map for the individual [see Figure 2, which is a rather odd pyramid showing the names of brain areas shaded in dark or light]. This visual representation gives a quick impression of developmental status in various domains of functioning: A 10-year-old child, for example, may have the speech and language capability of an 8-year-old, the social skills of a 5-year-old, and the self-regulation skills of a 2-year old. </span></blockquote>
<span style="font-family: Times, Times New Roman, serif;">(In other words, they will do some behavioural and cognitive testing, make assumptions about which brain area is responsible in children, and tell parents they are making a brain map. My quack detectors are twitching. We know very little about how normal brain-behaviour links are mapped,and even less about how they develop in children who have difficulties. Many very clever and famous people have said this, lots of times). He is careful not to recommend any specific types of therapy but he also says:</span><br />
<blockquote class="tr_bq">
the sequence in which these are addressed is important. The more the therapeutic process can replicate the normal sequential process of development, the more effective the are (see Perry, 2006). Simply stated, the idea is to start with the lowest (in the brain) undeveloped=abnormally functioning set of problems and move sequentially up the brain as improvements are seen.</blockquote>
<span style="font-family: Times, Times New Roman, serif;">Erm... well, I'm a developmental neuropsychologist, and I've never, ever heard of this principle. As he's quoting himself, do you think possibly he might be the only person who thinks this? </span><br />
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<span style="font-family: Times, Times New Roman, serif;">OK, it's possible that he's right, and everyone else is wrong - 64 other articles have cited this article. The fact that I can't find any neuropsychologists who have cited it might tell you something. I also looked up his affiliations and tried to find papers he'd published which had experimental data in them, or anything really that evaluates this method. I didn't have any luck. </span><br />
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<span style="font-family: Times, Times New Roman, serif;">I could be missing something, but most of the articles I can find seem to be theory, and not to have any data. </span><span style="font-family: Times, 'Times New Roman', serif;">He's listed as head of his own Child Trauma Academy, and as an Adjunct Professor in his alma mater - but at that institution all I found was a simple listing, again with no research papers.</span><br />
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<span style="font-family: Times, Times New Roman, serif;">The RtaF test: Go and do a university developmental psychology course, preferably also a university neuropsychology course, if you want to know how the brain develops. The Open University is very good. Also, i</span><span style="font-family: Times, 'Times New Roman', serif;">f you want to know the state of knowledge (which isn't very much) about how brain and behaviour links develop, especially in atypically developing brains, I'd highly recommend Annette Karmiloff-Smith's articles - </span><a href="http://www.psyc.bbk.ac.uk/research/DNL/personalpages/aks/TICS.Development_itself.pdf" style="font-family: Times, 'Times New Roman', serif;">this one</a><span style="font-family: Times, 'Times New Roman', serif;"> (pdf) is one of my favourites. </span><br />
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<span style="font-family: Times, 'Times New Roman', serif;">She talks a lot about how we cannot be sure that, especially if brain development is disrupted, all the same processes are going on that would be happening without disruption (which we know little enough about anyway), or in adult brains (which is what we know most about). Bruce Perry's theory seems quite wedded to the idea that specific areas of the brain do specific things, we know exactly what they do and therefore we can be sure which areas aren't working properly if certain functions are disrupted, and you can (or indeed must) work on their functions separately - more or less the opposite of what many developmental neuropsychologists would say.</span><br />
<span style="font-family: Times, Times New Roman, serif;"><br />Incidentally, and I'll come back to this if I find more, if you have a child who's suffered trauma, there <i>is</i> an evaluated treatment for this - which is again mentioned by the Allen <a href="http://www.ncbi.nlm.nih.gov/pubmed/21288932" target="_blank">review article</a> - Trauma-Directed CBT. I can't see either of the centres I'm looking at recommending this or training people on it. I'll keep looking. It's <a href="http://publications.nice.org.uk/post-traumatic-stress-disorder-ptsd-cg26">recommended by NICE</a> for children who have PTSD. I've seen very few mentions of children or young people being offered it, or parents looking for it.</span><br />
<span style="font-family: Times, Times New Roman, serif;"><br />So, sensing that my readers' patience might be wearing thin, I'm going to leave my trawl through this branch of therapy for the moment, and hopefully come back to it in the future.</span><br />
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DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com3tag:blogger.com,1999:blog-4397756142950826381.post-85072626558184667502013-04-11T11:17:00.001+01:002013-04-19T15:10:09.994+01:00Parents getting control of money? Shock Horror!The Department for Education recently announced that they will be <a href="http://www.education.gov.uk/childrenandyoungpeople/families/adoption/a00219199/adoption-support">piloting "personal budgets"</a> for adoptive parents, to fund therapy and services. Sounds fabulous! Why am I sceptical of this idea?<br />
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We have no horse in this race (our son was adopted, but not from care) but as someone passionate about evidence-based parenting I am very wary of the wide range of training, therapies, and interventions that are out there for children with difficulties. I knew about this before I became an adoptive parent, through my work with children with disabilities. And I'm becoming increasingly aware, mainly through social media, of the types of interventions adoptive parents seek and would love to have funded.</div>
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The trouble is - and this is the subject of many very long blog posts, at least one of which is pending - we know nothing or next to nothing about the treatments and interventions that work for children who have suffered abuse and neglect. There is a multiplicity of organisations that talk lovely stuff and promote themselves, and have expensive training days. There are some therapies that purport to work. Parents find it very difficult to get these therapies funded, currently. But many of the websites and books seem to throw around "brain", "science" and names of brain areas in ways that sound suspiciously like <a href="http://neurobollocks.wordpress.com/">neurobollocks</a>. My preliminary trawl of one or two has yet to come up with a therapy with a good evidence base. I'll keep you posted on that.</div>
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In fact, some of the organisations, therapies and trainings that neurobollocks specifically talks about are the very ones that adoptive parents seem to be told about, and that they would like for their children (in the category of home remedies, brain training on handheld computer games comes up a lot for example, and is taken at face value, ditto fish oils for ADHD).</div>
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I have <a href="https://twitter.com/drspouse/status/321217616670756865">tweeted</a> the DfE (<a href="https://twitter.com/drspouse/status/322287921241681921">twice</a>) to ask whether there will be safeguards to ensure treatments and interventions are evidence-based and vulnerable parents will not be exploited. I'll let you know if I get a response to that too.<br />
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<b>Edit</b>: I got a reply! DfE sent me <a href="http://www.education.gov.uk/childrenandyoungpeople/send/changingsen/a00218886/pathfinders">a web page</a> that has <a href="http://www.sendpathfinder.co.uk/">a link to another site</a> that talks about the piloting of personal budgets. I'm not clear if they are already piloting them (it doesn't look like it) but as far as I can see, the budgets are to be used on service provided by local NHS Trusts (for those outside the UK, hospitals or primary care/mental health care) and education authorities OR (and I'm not completely clear on this) partners who are charities working in children's developmental needs or mental health needs.<br />
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I asked them if they had any adoption-specific charities to add to this because that would be very interesting - are they adding any and if so, which ones. I wasn't surprised not to get an immediate answer to that as the Twitter monkey typist will be off asking the ringmaster for information.<br />
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I am not completely reassured by the use of the budgets only in NHS or education authority circles though. We all know about various neurorubbish like Brain Gym and learning styles that's used in schools, and <a href="http://evidence-based-parenting.blogspot.co.uk/2013/04/therapies-for-children-who-have-been.html">several of the therapies</a> I'm researching at the moment (see my new post) are provided by NHS mental health services.<br />
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<b>Edit 2</b>: I got another reply! "The Government is currently exploring options on how to pilot personal budgets for adoption". So they don't know yet, but they haven't got any providers of dodgy therapies that charge loads on board, just yet. At least there's that.</div>
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DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com0tag:blogger.com,1999:blog-4397756142950826381.post-2212101859893744142013-02-26T13:15:00.002+00:002013-02-26T14:06:37.512+00:00Attachment in traditional, "AP" type societies<br />
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Do traditional societies promote strong attachment in the way that "Attachment Parenting" enthusiasts would like to suggest? I've posted some <a href="http://evidence-based-parenting.blogspot.co.uk/2012/08/this-is-totally-based-on-anecdote-and.html">personal opinion</a> on this issue a while ago, but I thought some evidence was in order.<br />
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I have been reading work on attachment in African societies - there are a few studies over the years, some quite old, some fairly recent - and first I should explain a couple of things:<br />
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Firstly, and I know a lot of people will realise this, babies are not "attached" or "unattached". Researchers in this field talk about babies having a "style" which does seem to lead to some differences in older childhood or later life. But some styles - mainly a "secure" style - have been suggested may lead to children being more confident and able to cope with life when they are older. And others - in particular a "disorganised" style seem to be associated with risk factors. If you want to read more about the overall theory of attachment,<br />
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Secondly, although mainstream attachment researchers believe that a mother's sensitivity to her child's behaviour is what leads to differences in attachment, there's now a lot of evidence that other differences between mothers (especially <a href="http://www.psychologytoday.com/blog/dad-the-observer/201005/reading-the-babys-mind">mind-mindedness</a> - parents' ability to work out what a baby might be thinking) are more important.<br />
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So although the mainstream attachment researchers might not completely agree with other researchers who look at babies' development on what is <i>driving</i> babies' attachment styles, it's still interesting to look at what's happening in traditional societies - especially since some of the core components of "Attachment Parenting" are found in these societies - especially bedsharing, breastfeeding on demand, and carrying babies close in a sling or arms most of the time.<br />
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Some of the factors in the African societies I've been reading about, though, are far less than what child development researchers - and a lot of parents - would consider optimal for babies. Other factors are just a little different to what we in the North or West might be used to.<br />
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It's pretty common in a lot of developing countries for older children to spend a lot of time caring for young infants. This is something most of us might consider a neutral influence - in the extreme it might not be ideal for the older children, and it's different to the standard Western setting where a parent or two are the main carers, but it's unlikely to be harmful, would be most people's thought at the outset.<br />
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Among the Gusii people in Kenya this is the standard caring practice but older children spend most of the day playing with the baby, while the mother still feeds and washes the baby. Some schools of thought would say that it's the main <i>carer</i> - the one who does all the practical stuff for the baby - that would be the person a baby is most attached to. But in this group, babies are attached both to their mother and to their older child playmates. And interestingly, it was the attachment to the playmate that predicted babies' cognitive development - not, as we'd expect from Western families, their attachment to their mother.<br />
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<table align="center" cellpadding="0" cellspacing="0" class="tr-caption-container" style="margin-left: auto; margin-right: auto; text-align: center;"><tbody>
<tr><td style="text-align: center;"><img height="240" src="http://3.bp.blogspot.com/_MvQ165PNF-Q/TC0phomJUzI/AAAAAAAAAhA/vw5yjjFP7TI/s320/Kisii.jpg" style="margin-left: auto; margin-right: auto;" width="320" /></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Gusii woman and toddler</td></tr>
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A couple of other situations that are common in developing countries, that we might think were less than ideal (to put it mildly), are polygamy* and high infant mortality. Two of the African attachment studies were in societies that practice polygamy and with particular dangers to infants, and/or high infant mortality.<br />
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In the Hausa society in Nigeria, many adults - including co-wives - live in a compound with children of all of the adults. Babies are cared for by one caregiver in particular, usually an adult, but not always the mother - in some cases, the mother feeds the baby and then the baby is immediately passed back to the caregiver. Infants aren't allowed to move around or to explore physically, but they are happy to explore objects they are given or to look around their environment - but only if they feel secure, if their main caregiver is present. They seem to be attached, mainly securely, to their main caregiver - and as in the Gusii society it's not necessarily the person who feeds them.<br />
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<tr><td style="text-align: center;"><img alt="The ethnographic research conducted by The Population and Reproductive Health Partnership highlighted several social, cultural, and economic factors that underlie poor health including lack of opportunity and women’s circumscribed decision-making power" height="320" src="http://bixby.berkeley.edu/wp-content/uploads/2009/03/norther-nigeria-woman-with-baby-300x450.jpg" style="margin-left: auto; margin-right: auto;" width="213" /></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Hausa woman and toddler</td></tr>
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In the Dogon group in Mali, life seems to be quite similar to among the Hausa. Babies suffer very high infant mortality, and live with their mother and her co-wives. Babies are fed on demand - as the "AP" enthusiasts would like - and kept physically close. However in this group a lot more babies seemed to be "disorganised" in their attachment. This seemed to be related not to any failure in the main "AP" practices but to some rather frightened or frightening behaviour on the part of the mother. Interestingly this doesn't fit into the main "attachment is due to sensitivity" theory as well as it does to the "attachment follows from mind-mindedness" - appearing frightened or negative when a baby wants to play positively is a good example of not being mind-minded. It may be that mothers feel the need for toddlers to be obedient and stay close, due to the dangerous nature of their life, and that they think frightening the babies is the best way to achieve this.<br />
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<tr><td style="text-align: center;"><a href="http://guenther-eichhorn.com/images/MALI/Mali_0042_1024x1536.jpg" imageanchor="1" style="clear: left; margin-bottom: 1em; margin-left: auto; margin-right: auto;"><img border="0" height="320" src="http://guenther-eichhorn.com/images/MALI/Mali_0042_1024x1536.jpg" width="213" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">Dogon woman carrying baby</td></tr>
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If you're interested in finding out more:<br />
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<a href="http://books.google.co.uk/books?hl=en&lr=&id=8TbfjV5EZHAC&oi=fnd&pg=PA181&dq=attachment+theory+culture+and+africa+tomlinson&ots=QjTLm_gF0h&sig=ECVQL7Wc-_StTPVUx_3vKGvaxMU#v=onepage&q&f=false">Tomlinson, M., Murray, L., & Cooper, P. (2010). Attachment theory, culture, and Africa: Past, present, and future. Attachment: Expanding the cultural connections, 181-194.</a><br />
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*which is a bad thing, if you are interested, because it only works on a society wide basis with very young marriage of women, similarly very young first pregnancies, and very large age gaps between husbands and wives.DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com1tag:blogger.com,1999:blog-4397756142950826381.post-10473301478688188112012-08-14T10:21:00.002+01:002012-08-14T10:21:53.776+01:00This is totally based on anecdote and personal opinionI started writing a comment on <a href="http://www.psychologytoday.com/blog/nation-wimps/201207/the-worst-idea-in-the-world">this</a> post on why Attachment Parenting is a bad idea, and more particularly on the comments which all say It's Been Around For Thousands Of Years And It Works. The comment got a bit long so I'm going to write it here and post a link there... or something.<br />
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I've had the opportunity to observe both Western proponents of attachment parenting AND parenting in a very traditional society with a lot of co-sleeping, breastfeeding till age 2 and beyond, and carrying in slings.<br />
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The attitudes and motivations of parents are totally different. That's what makes the "babies have been brought up this way for thousands of years" argument spurious.<br />
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AP proponents discuss their practices in I have to say (as another parent) very self-righteous and self-satisfied tones. They claim loudly and proudly that their baby "won't sleep anywhere else than in our bed" while traditional society parents wouldn't crow about it - they would just quietly move a non-night-feeding baby to a sibling's bed. In most such societies there are simply not enough beds for everyone, but in some areas it has been a priority traditionally to provide everyone with a bed, and small children do get their own beds. I've only heard this reported, not seen it for myself, but those in bed-sharing areas don't regard it as child abuse by those in individual-bed areas.<br />
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Co-sleeping is safer if you don't have blankets, covers, quilts etc. And many traditional societies are in tropical areas where you don't need those things. We rejected co-sleeping on safety grounds, but have had some snooty looks from families that do co-sleep.<br />
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Likewise breastfeeding mothers in traditional societies are happy to pass their baby over to be carried by someone else when not feeding, and they carry their baby because it's practical (strollers don't work well on mud tracks, plus they cost more than a cloth carrier). AP proponents don't particularly like back carries for young babies (no eye contact), and they talk proudly of having a "velcro baby" who "won't be put down", presumably because (aged 2 or 3) they never really have. <br />
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Traditional society parents almost exclusively use back carries, even from birth, expect their child to walk when they can, and expect older siblings to take their turn at carrying a baby who can't walk (and even very small older siblings carry the ones who can't walk yet). Many of them are not shy of telling their toddlers they can't have a carry because Mama is carrying something else on her back.<br />
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And I've heard a traditional society mother happily tell her friends her talking toddler didn't really like mother's milk any more, solid food was more filling. AP parents in contrast (though breastfeeding beyond about 2 is uncommon, as commenters have said - breastfeeding till 6 is an exaggeration), are again smug and self-satisfied when their baby carries on breastfeeding and imply that when a child stops, it's because the mother wasn't committed enough.<br />
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My own parenting attitude? I'd say it was like traditional society parents: we do what's practical and what we can afford. We do use a baby carrier - the baby is just as happy in it as in a stroller, but some places have a ridiculous number of steps, and it means we can go on short hikes. We use a back carry more to save our own backs. I carry a small backpack on my own back sometimes, and the baby must then go in the stroller or on my front (he's not walking yet). We were given a front-facing stroller (sorry, no eye contact there either!), so we didn't buy one.<br />
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We've never co-slept as the medical indications for our baby were that it was less safe than for a lot of other babies. And the baby is now at the age where in a traditional society an older sibling's bed or, in fact, room would be the spot for sleeping (we don't have one of those, but the baby is in a crib in a room alone now, and seems very happy).<br />
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And breastfeeding? well, that wasn't going to happen without non-UK-approved drugs. Thankfully I haven't had anyone be so crass as to suggest to my face I should have taken these, and I've mainly listened to AP smugness over breastfeeding towards mothers who were able to breastfeed, but stopped early.<br />
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Personally, I would have loved to breastfeed for the convenience and the low cost. I hate sterilising, remembering to make up bottles of formula, taking bottles on a day out but leaving them too long so they aren't usable any more. But I'm grateful formula exists, as in former years a baby in such a situation would have been given solid food, or an odd mixture of unsterilised milk and flour. And the husband is very glad he's been able to sit and gaze at the baby adoringly while feeding, too.<br />
DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com1tag:blogger.com,1999:blog-4397756142950826381.post-21413912996772515672011-03-22T15:18:00.002+00:002011-03-22T16:02:50.767+00:00LinkingBen Goldacre of Bad Science recently asked "<a href="http://www.badscience.net/2011/03/why-dont-journalists-link-to-primary-sources/">why don't journalists link to primary sources?</a>". Science journalists often - but not always - write an article based on a published, peer reviewed scientific journal article.<br /><br />Sometimes not, though. Sometimes an article is a feature - based on a number of sources. Sometimes it's based on a press release on some pilot or unpublished work, or perhaps a report submitted when a research grant ends, plus an interview with the scientisist involved and (one would hope) another couple of experts. Sometimes it's based on a conference presentation or press conference or similar.<br /><br />Having seen this from both sides I'd say there are a number of reasons. Some are administrative or technical, some definitely journalistic, some due to laziness, and some done with the best of intentions.<br /><br />In some cases, the press release was only made available via email. It might be possible to put it up on the newspaper's/journalist's website. I may be misrepresenting this situation - it's possible that all the press releases that come round by email also end up on some website or other - but I'm not sure. Let's say that at least some press releases are not ultimately stored on the web. Certainly, before the embargo deadline, they aren't publicly available.<br /><br />This leads on to a major category of administrative reasons why journalists don't link to papers and press releases. They have been told not to yet, and they don't have the link yet. If you are writing an article for an embargo of 8pm and you have written it, proofed it, and your editor has signed off on it, and someone else is going to put it up on the website for you because you have to go home/work on something else, it's really unlikely they are going to search out the (non-live till that exact moment, and possibly later) link to the brand new article. Sure, you can edit a web article the next time you are able, but where you've already put in a link to the journal or scientist's website, or both, and you are busy with other stuff, sometimes this might not happen. Plus, there is the whole paywall issue.<br /><br />Of course, if the article is based on something else such as a presentation or several interviews, there's a chance these aren't available at all - not everyone is happy with their presentations being recorded, not for sinister reasons - some inexperienced presenters are simply shy. There's a big difference between 30 academics hearing your every word and a recording being made for posterity. The slides you write for a presentation might make sense to the audience, but they could be in gibberish for all other purposes.<br /><br />The <span style="font-weight: bold;">second category</span> is the lazy one. Regurgitation of press releases without any further research. I'm guessing errors like assuming "heels" means "shoe heels" fall into this category.<br />I would imagine a journalist who rehashed a press release without talking to the scientists or reading any articles would not really want this known by all and sundry - especially if the press release is barely re-written. Not all press releases are perfectly transparent (shock horror!) and sometimes this is the fault of a scientist, sometimes a press officer, sometimes just one of those things where no-one involved in writing something considers what alternative meaning it could have.<br />I do think it's possible to write something informative for the general public based on publicly available materials without conducting any additional interviews. Otherwise, everyone would just go to the primary sources, and there would be no point in journalism. Leaving aside the point that the general public doesn't have the resources to know everything about what is out there happening at any given instant (even in science), it seems pretty unlikely that any one person - even with scientific training - could understand the full implications of scientific articles in every single field. That, as I say, is why we have journalists.<br /><br />Perhaps if the scientist in question communicated with the reader and explained the article, they could understand it - but given the number of people who contact me with weird queries that make no sense after I either write a popular science article or my own work is reported on, I'm just hoping that there are at least some people for whom the article made sense on its own and who therefore didn't contact me, and thus saved me a bit of time.<br /><br />I think this point is linked to my <span style="font-weight: bold;">third </span>(and you'll be happy to hear, final) reason why journalists don't link to primary sources. They really genuinely think there is no point. Sure, the geeky readers of Bad Science want to read some primary source articles. They might represent, what, 0.1% of the newspaper reading public (that is a random figure plucked from my head, before you ask). But I bet those readers don't bother looking at the primary source article more than, say 1% of the time. And if they do (and I have seen this in the Bad Science comments section, where an article has been in my general field) they often show that they think the article was badly designed/run/reported when in fact they are just displaying they know little about experimental design/conduct/analysis. No offence, Bad Science readers, and of course this is very much <span style="font-style: italic;">not</span> a reason for non-specialists not to read original articles - but though sometimes you<span style="font-style: italic;"> <span style="font-style: italic;">have</span></span> spotted something the author missed, or the journalist tried to sweep under the carpet - sometimes you haven't.<br /><br />I have noticed that many science bloggers rant about this whole issue, and few science journalists (that's not to say <span style="font-style: italic;">no</span> science journalists, but few). Privately science journalists I've spoken to feel more or less as I have summarised. One thing to note particularly about science bloggers is that some of them - by no means all - don't write in a way that would make sense to a non-specialist. I love some of the debates on specialist science blogs, but frankly, you could not possibly pretend they are for the non-specialist reader. General readers prefer newspaper and BBC reporting because it's aimed at them. That's who the (non-ranty) parts of my blog are aimed at too (and I will write some more evidence-based parenting articles some day, honest).DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com1tag:blogger.com,1999:blog-4397756142950826381.post-29430737153782091642010-12-02T10:28:00.009+00:002010-12-08T17:46:30.026+00:00A Diet of Worms<span style="font-family:times new roman;">I was excited to spot Dorothy Bishop's <a href="http://www.guardian.co.uk/science/blog/2010/nov/25/neglected-tropical-diseases?CMP=twt_gu">article</a> about the neuropsychological effects of neglected tropical diseases. I've been working in this field for 15 years now but really stumbled into it by chance. It is quite a good dinner party conversation piece (either that, or everyone's too polite to tell me to shut up - but they do generally ask) so I thought I'd share my almost certainly non-replicable path to this field. I'm writing more for a scientific reader but from a personal perspective - apologies for a few technical terms.<br /><br />After I finished my undergraduate degree (in Neuroscience, if you're interested) I wanted to go and "save the world", as one does. A volunteer post teaching Biology in Zambia presented itself, so off I trotted.<br /><br />I lived on the least money I have ever managed (stamps were a stretch), talked to my pupils about sex ("Alcohol causes HIV, madam" "Are you sure?" "Yes madam, when people get drunk they do not mind who they sleep with". Such wisdom from one so young...), learned a small amount about Bantu grammar (but no real conversation past How are you, Fine, and Thank you), and did a little bit of travelling into the bargain. I lost my passport and got it back twice, and crossed from Zimbabwe (at the time, the "rich" country where you could buy stuff and go to nice hotels) into Zambia on just an identity card.<br /><br />Back to real life, and I started a PhD on motor abilities in language disorders, which I still also work on. In fact, not too surprisingly, it's what most people, if they've heard of my research, associate me with.<br /><br />About a year before I was due to finish the PhD I spotted a job ad for a postdoc looking at the effects on cognitive development of parasitic infections in children in Tanzania. As the only applicant with my rather unusual combination of qualifications - experience in African schools and a PhD project in developmental cognitive neuropsychology - I wasn't hugely surprised to be offered the job. The other candidates also seemed intrepid, capable, and intelligent, but I got the impression they were grasping at straws when they shortlisted (one had worked on gorilla cognitive development but had had to leave Rwanda due to the war there, one worked on schizophrenia and had taught in a remote area of South America, a couple had been travelling in Africa). My only doubt was whether I would be finished with the PhD in time, and I remember my future boss sounding extremely stressed on the phone when I said I needed to think about it!<br /><br />Nearly a year later, I'd submitted my thesis and was packing - we all went to the pub and everyone was asking me whether it was exciting to have finished - I was far more excited by my new Swiss Army knife. I flew off to Tanzania and spent the next two years running a huge project (after not too long my bosses saw sense and employed both an additional scientist and a very well qualified local administrator). We had a sample of 1000+ children, about 20 staff, a five room office that needed refurbishing (as did my flat upstairs), two 4WD vehicles, payday each month... I had only just finished my PhD and was used to my hand being held. I learned Swahili pretty quickly once I realised I needed it to eat, get water, electricity, and floors in the building, get the cars serviced, and communicate with the children participating and, indeed, most of the project staff. At least the Bantu grammar came in handy.<br /><br />In this field, at least 75% of the effort is in developing tests. As Dorothy Bishop says, culturally appropriate tests are usually lacking, and (even once we've developed them) they are not standardised or validated. Another huge hurdle is a lack of psychologists. It's one of the most popular degree courses in the West, but in many countries there are no psychology degrees. This was true in Tanzania, and also in Indonesia and Uganda where I have worked more recently. In Tanzania we were working in a school setting and we tended to employ school teachers as research assistants. In Indonesia, it has been child nutritionists, and in Uganda, nurses and medical officers. I was at a meeting recently in Kampala to set up a network of people working in child psychology - mainly educationalists and psychiatrists, with a couple of paediatricians.<br /><br />Where psychology degrees exist, most graduates go into private counselling. Any child psychologists also tend to go into private practice, working with the children of the new middle classes. University psychologists have horrible teaching loads, have to run a private practice to make ends meet and cannot get any research done. You're right, </span><span style="font-family:times new roman;">you don't know you're born in Europe or North America.<br /><br /></span><span style="font-family:times new roman;">One of my colleagues who has completed her PhD in developmental cognitive neuropsychology is a psychology graduate from her home country but was seconded from her lecturing job to the group we were both working with. Her supervisor found some great postdoc funding but she wasn't supposed to continue research - and she was a government employee - so she's had to be careful to avoid her university when she's in her home country. She could easily have got a good teaching job outside her home country, but she wants to do something for psychology in the country, we're pretty sure they won't re-employ her if she just leaves, so she's juggling for the moment.<br /><br /><a href="http://www.globalnetwork.org/">Neglected tropical diseases</a> are of course incredibly important causes of delay in cognitive development. But there are many other factors that mean children in developing countries are at risk for neuropsychological deficits and cognitive delay.<br /><br />One of the most satisfying projects I worked on was a "boring" construction and standardisation of a "bog standard" test of cognitive development - in essence the same as an IQ test - for a project trying to estimate the <a href="http://www.psych.lancs.ac.uk/people/uploads/KatieAlcock20050930T140820.pdf">prevalence of cognitive and neurological deficits (pdf)</a> in a population of children. We made sure that our tests were do-able, at least in part, by children with motor or sensory problems. And we found a group of children who were profoundly deaf, had no spoken language, and weren't in school - because of parents' beliefs that deaf children are uneducable. But these children were performing at normal limits on non-verbal tests. So we arranged for them to go to school.<br /><br />The main reason I mention that project is because the majority of children who do have neurological deficits in that group are those who have suffered <a href="http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T1B-4G10642-12&_user=196517&_coverDate=04%2F29%2F2005&_rdoc=1&_fmt=high&_orig=search&_origin=search&_sort=d&_docanchor=&view=c&_acct=C000013818&_version=1&_urlVersion=0&_userid=196517&md5=33d97ba6bdd6f1e72d25140ca1903e63&searchtype=a#SECX1">cerebral malaria</a>. The article I've linked to estimates that a million children under five die each year and 250,000 are left with neurological complications or developmental delay. Just as with worms, if this parasite were affecting "our" children, people would be up in arms.<br /><br />One interesting fact is that, of course, all of these parasites (worms, malaria) did affect "our" children in the past. Malaria was common in the Southern US until at least the <a href="http://www.cdc.gov/malaria/about/history/">1930s</a>. Hookworm flourishes most places where there aren't enough privies and children don't wear shoes - again very common in the southern US in <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2024661/?page=1">fairly recent history</a>. Educators at the time recognised that wormy children did not learn well, but had little evidence to back it up.<br /><br /><blockquote>The "widespread prevalence"of hookworm weakened the "bodies and minds" of schoolchildren, declared Virginia state school officials in a pamphlet circulated to teachers. Infected children became "easily fatigued,"unable to study with interest; even with the teachers' determined involvement, children with hook- worms made "poor progress" and probably left school uneducated.</blockquote>It's not just infections, either. Another project I've been involved with has been giving pregnant mothers micronutrients (vitamins and minerals) and comparing outcomes to mothers who got the standard iron and folic acid normally supplied by midwives on their Indonesian island. My PhD student looked at the outcomes of nutritional supplementation on both mothers and their preschool children. We're still analysing the data, but we're interested to see that mothers who were given supplementation <a href="http://www.micronutrientforum.org/meeting2009/PDFs/Poster%20Presentations/2_Wednesday/DO/W58_Prdo.pdf">improved in their cognitive functioning (pdf)</a> - so we now want to know if they might make better, more attentive and stimulating, mothers for their preschoolers.<br /><br />The thing that all of these - the biological risk factors - have in common is that they occur when people are materially poor. We commonly find effects in our results of relative poverty - the differences between mothers who have managed to go to secondary school and those who have only a couple of years of primary school, between families who can afford a bicycle and a tin roof (and probably enough to eat) and those that cannot. But we find on top of those effects of the biological risk factors we study. Schooling is well known to influence cognitive functioning, and we've got <a href="http://www.psych.lancs.ac.uk/people/uploads/katiealcock20080709T124017.pdf">some interesting data</a> on what happens when you try and test children who haven't been to school.<br /><br />It would be bad enough if we were, in fact, talking about children who have these biological risk factors, but who then went to lovely primary schools and had heaps of Surestart resources and well-trained teachers, enabling them to overcome their disadvantaged start in life. Although some schools in Asia are clean, pleasant, and have at least some equipment suitable for small children, many schools in the developing world struggle to have enough desks, and for the roofs not to leak in the rainy season. Teachers can be poorly trained and equally poorly motivated. Their salaries don't cover their living expenses, so they neglect their classes for outside jobs, spend classroom time working their vegetable gardens, and in some cases deliberately leave crucial subjects untaught so that pupils have to pay for outside tuition to pass Government exams.<br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://4.bp.blogspot.com/_AhhlNjfCa6Y/TP_DfYgFs1I/AAAAAAAAALQ/sLbWYGQgSNI/s1600/classroom.JPG"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 364px; height: 260px;" src="http://4.bp.blogspot.com/_AhhlNjfCa6Y/TP_DfYgFs1I/AAAAAAAAALQ/sLbWYGQgSNI/s400/classroom.JPG" alt="" id="BLOGGER_PHOTO_ID_5548368209864143698" border="0" /></a><br /><br />Children leave school early because their families need them to work, because another child needs to go to school and there is not enough money for fees or uniform, or because they started school at a relatively old age and have reached puberty. Just a few years at school may teach children to read, but they may not retain it once they have left.<br /><br />I'm going to have a mini professional moan at this point, just to say that this is the type of field where one works with very large teams of researchers, and rightly the large teams are credited on research papers. Unfortunately, because this isn't common in psychology, it's often not recognised that if you are going to have a great paper in a great journal, you are going to share authorship with 10 other people, and the only way to avoid that is not to be an author on that paper or (which has been suggested to me) not to do this kind of research. Personally, I feel this kind of research is much too important not to carry on doing it.<br /><br />I started this post to give a flavour of the path I've taken in doing this research and the experiences I've had but - probably because it's something I feel passionately about! - it's taken on more of an educational character! Sorry about that... but anyway, I have had some incredible experiences and worked with some incredible and dedicated people.<br /><br />It's not every research psychologist that has to arrange for a bridge to be built over the weekend to get the team to the testing location. You don't often get to have a beer watching the sun go down over both sides of the Indian Ocean*. And fortunately you don't in most research psychology jobs lose child participants, research assistants, and a project driver to malaria, HIV, and one of the biggest killers in the developing world - road traffic accidents - respectively.<br /><br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="http://1.bp.blogspot.com/_AhhlNjfCa6Y/TP_DeZIuYII/AAAAAAAAALI/v6CpQZL-4p8/s1600/sunset2.JPG"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 400px; height: 137px;" src="http://1.bp.blogspot.com/_AhhlNjfCa6Y/TP_DeZIuYII/AAAAAAAAALI/v6CpQZL-4p8/s400/sunset2.JPG" alt="" id="BLOGGER_PHOTO_ID_5548368192854712450" border="0" /></a><br /><br />*before you get confused, not simultaneously, two different research sites widely separated but both with quite undulating coastlines.<br /></span>DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com0tag:blogger.com,1999:blog-4397756142950826381.post-91906765095579589002010-09-23T13:48:00.002+01:002010-12-02T14:54:57.176+00:00On (the) telly<span style="font-family:times new roman;">Yesterday I spent mostly trying to stay out of shot, and trying to keep my shadow out of shot, too.<br /><br />My placement at the BBC has been organised by a presenter who doesn't do much science news, but who's been the contact for a while in organising the BBC placements. In previous years someone was attached directly to TV news and spent about 3 weeks trailing him which though interesting, wasn't massively productive - it just takes so long to learn how to do telly that you can't actually <span style="font-style: italic;">make</span> anything in that time. But watching a couple of interviews in a day is not such a bad idea.<br /><br />We were seeing two authors for a Meet the Author segment, one at lunchtime and one in the afternoon. Of course we got off to a bad start with traffic, though I have no real idea what London traffic "should" be like to drive in. The cameraman/producer wasn't really sure why I was there, though he seemed impressed and surprised that I would be writing stories that actually get on the website, and that were on non-psychology stories.<br /><br />Filming was actually pretty efficient, which is really interesting to know - I can imagine it being really tempting to film hours and hours for a 5 minute segment, when really, doing it two or three times and then re-doing the bits you aren't sure about is more efficient - certainly, there will be less editing.<br /><br />What I really had not realised was how much setup there can possibly be for a filming session. It's not like radio, where the most you have to do is get people to turn off the air conditioning and their mobile phones*. Apart from moving the furniture, the cameras are incredibly heavy, time-consuming to set up, and take up loads of space, and then there are the lights... and like the old-fashioned data projectors, you have to let them cool down before you leave the room. It's been a revelation.<br /><br />I wasn't much use to the whole enterprise of course, though apparently they had a sound failure recently and the cameraman didn't have his headphones on, so I was In Charge of headphones. And I do have a reasonable memory for conversations, so recapped what exactly had been the questions asked so the interviewer could run them through again. Apparently I should have been given a "real" producer's job and then would have been taking notes on them - which would have been fine - if I get another chance to go out filming, I may see if I can be a bit more useful.<br /><br />*which I have learned to my cost, though thankfully only on recordings made for note-taking purposes, when I discovered how much interference a phone can cause to a digital recording.<br /></span>DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com0tag:blogger.com,1999:blog-4397756142950826381.post-49885006961709376182010-09-22T13:06:00.003+01:002010-12-02T14:54:57.177+00:00Phew!<span style="font-family:times new roman;">I spent last week at the British Science Festival with large numbers of other science journalists, and very interesting it was too. Some of the interesting part was the science, and some was learning about how science journalists think, what gets into the news, and why.<br /><br />I spent four days there and for most of the first three another BBC person was there. So this should mean we shared the stories and either did half each, or one of us did something for the radio (not me) and one of us for the website (me). In practice this did happen, but then I was left on my own for a day and a half... and got very panicky about what seemed to be an important story.<br /><br />As it turned out, it was an important story for geeky scientists, and the <a href="http://www.guardian.co.uk/science/blog/2010/sep/17/willetts-science-funding-homeopathy">Guardian </a>covered it in quite a bit of depth on their website, but what happened after the interview was that everyone rang their editors (including me) who told them to ring their health editors (ditto) who said, not a very interesting health story. In fact, the BBC Online health editor gave a different reason to some of the other health editors, but I was a bit relieved to see that none of the other papers covered it, since we weren't!<br /><br />I tended to be a bit random about which stories I covered, partly because I knew I had some backup, if anything was ultra important I wouldn't get in trouble for not covering it, but also because of course I'm not as attuned or experienced in what makes a good story, what's been covered, what's hot... But there were a few stories that were covered by absolutely everyone else (but not me), or by me (but no-one else). I wasn't entirely sure what to make of it when one story I wrote up for the website was mainly ignored by the other papers, but our radio guy decided to put it on the news. More exciting than everyone else thought, or I was over-hyping it to him?<br /><br />But one thing that I've experienced this week is having soooo many stories out that older ones begin to fade into insignificance. And it does mean I was less bothered when I found a science blogger criticising one of my <a href="http://www.bbc.co.uk/news/science-environment-11340881">stories </a>- not sure if that's why, but it was the most-read Science story for 2 days running, and I don't really mind <span style="font-style: italic;">why</span> people are reading my stories!<br /><br /><br /><br /><br /></span>DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com0tag:blogger.com,1999:blog-4397756142950826381.post-13768215921715052822010-09-09T15:23:00.003+01:002010-12-02T14:54:57.177+00:00It's always nice if someone noticesAs I said before, quite a few people ended up reading my story about Arabic. Of course that one has my name on it, but today I was at a press launch for the British Science Festival which all the Media Fellows are going to next week, and someone from the British Science Association mentioned a study that looked at what happens when people disagree with scientific findings.<br /><br />I spotted this study while I was in the Science Radio Unit and researched it, and got the author, and another psychologists looking at attitudes to science, to come on the programme. You can read/listen <a href="http://www.bbc.co.uk/programmes/b00tdr1s#synopsis">here</a>. It was actually broadcast after I left the unit so I hadn't put it up here. So it was really nice to know someone had been listening (or, possibly, reading Ben Goldacre's blog, but I like to dream!).<br /><br /><a href="http://www.bbc.co.uk/programmes/b00t9r4g">Another story</a> I researched also went out after I left - and in some ways was the most challenging radio story I did. I not only knew nothing about solar cells, but had to look up what a synchrotron was - I researched this one quite early on so it was a rude introduction to "how to use Wikipedia to your advantage". Don't worry, I checked I had all my facts and terms correct with the scientist in question! But perhaps a lesson for the person who wrote the press release? I'm not a physical scientist, but nor are all science journalists, though I am finding that this job makes you incredibly knowledgeable at a surface level about a wide variety of topics. So I now know about theropods, the Cretaceous, the Palaeolithic etc. etc.DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com0tag:blogger.com,1999:blog-4397756142950826381.post-52677076629876061082010-09-08T17:47:00.002+01:002010-12-02T14:54:57.177+00:00Carry On And Keep Calm<span style="font-family:trebuchet ms;">I used to live and work in London but was never really phased by travel disruptions as I could cycle (or, in fact, walk) to work so if there was a strike I just hopped on my bike. Unfortunately where I'm staying during my placement is a leeetle far from Television Centre, where I'm based at the moment, so I had a slightly lengthy but not too stressful journey to work on Tuesday. I thought it was one of those ironic co-incidences that the strike was on the anniversary of the start of the Blitz.<br /><br />People were remarkably cool and collected and only a few rude words were heard. My journey home wasn't as easy (although we were going to a friend's house for dinner, the hardest part of it was the bit I would have had to do anyway), and I can see if you don't like London you might find it overwhelming.<br /><br />Though it's not directly relevant to my placement, I <span style="font-style: italic;">do</span> like London and I'm enjoying working here again - in fact, the two most irritating things about working here are specifically about TVC. One is that it is incredibly easy to get lost here - despite following signs for the Restaurant Building the other day, it took me 10 minutes and a couple of useless changes of floor to get there - it's probably 2 minutes' walk away. The other is the celebrities. How dare they get in the way of our work.<br /><br />I'd been working on a Health story and wanted to ring up a private clinic to cheekily ask their prices. But outside my office window was, in full flow, the launch of Strictly Come Dancing. Lots of <span style="font-style: italic;">Good Life</span> fans, it seems, as the applause for Felicity Kendal was probably the loudest.<br /><br />Anyway, although officially I'm on Science and Nature, I think my interests lie a bit closer to Health and I've had one story on <a href="http://www.bbc.co.uk/news/health-11181457">how the brain reads Arabic</a> which got a lot of interest over the weekend - and a couple of pretty negative emails! Some were easy to answer but I was told just to ignore one of them... This was a story where I spotted the press release, and checked who else had done it - turns out it was no-one in the UK - before writing the story. It was great then to see that actually I had been right and people did find it interesting.<br /><br />I had another couple of science stories out last week - and another one this week with some great <a href="http://www.bbc.co.uk/news/science-environment-11221459">dinosaur pictures</a>. The hard part about writing that one was struggling to understand the Spanish scientist's English. I don't speak Spanish well enough to talk to someone about their research in Spanish, but at least I had a small clue about some of the things he might be groping for or how a word might be mispronounced.<br /><br />One of the other Media Fellows told us the other day that she finds one of the hardest things about doing this is talking to people on the phone. I am not particularly phone phobic, but I have in the past tried really hard to make phone calls only in quiet circumstances. I just can't get away with that here. Both here at News Online and at the Science Radio unit the office is highly open plan - our "area" is smaller here but I don't even have a cubicle. I'm getting better at ringing people on the off chance, without having written down every single thing I want to say, and also at not getting a little nervous and forgetting important questions.<br /><br />Writing this blog, which is one of those things I've been doing in my off moments, waiting for someone to ring me back, waiting for a meeting etc., is a total stream-of-consciousness job. Write, and press "publish" or "save" depending on whether I've run out of things to say or am getting bored or someone calls me. I tend to write my stories quite quickly too but go back and look at them again (you'll be pleased to hear!) but never really do for the blog.<br /><br />So I was intrigued to see a slightly gimmicky website called "<a href="http://iwl.me/">I Write Like</a>". Apparently this blog is like Dan Brown. Urgh! At least my dinosaur story turned out to be like HP Lovecraft. I <span style="font-style: italic;">think</span> that's better!<br /></span>DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com0tag:blogger.com,1999:blog-4397756142950826381.post-41668314802636745722010-09-02T17:15:00.002+01:002010-12-02T14:54:57.178+00:00Busy busy<span style="font-family: trebuchet ms;">This week I started at News Online in a different BBC building. Apart from the fact that my nice BBC swipe card doesn't seem to work here, and I have to keep getting temporary badges every day, it is going really well.<br /><br />I sat down at one desk on the first day (it is all rotas and hot-desking here, one part of working life that I'm glad we mainly avoid in academia!) and was immediately handed a story to work on. Then another one. And another one. I also found some pretty pictures (it's nice to use pictures!) and two of my stories went out yesterday. Can you tell I was VERY EXCITED?<br /><br /><a href="http://www.bbc.co.uk/news/science-environment-11153193">Coral reef story</a><br /><br /><a href="http://www.bbc.co.uk/news/science-environment-11153902">Stone age funeral feast story</a><br /><br />These were very much time zone stories - I had to get on to the Australians on the coral reef story immediately before they went to bed (and I ended up begging one for pictures as he was getting home after an evening out) and then wait for the East Coast US researcher to get to work before calling her.<br /><br />It's a lot more immediate in this part of the BBC, though it's not necessarily a case of getting things out the minute we get a press release - stories can be embargoed for up to a week, giving us plenty of time to call people up. Also, even if we are a little late on a story, if it doesn't get picked up by a lot of other outlets, it doesn't matter if we get it a few days late as we will be first. <br /><br />And if something is really big news, and then a paper comes out, everyone will remember it. Personally, I am not that bothered by free kicks, but I gather that a lot of people are quite keen on that sport where men run up and down in shorts and try not to touch the ball - so a mathematical formula for a <a href="http://www.bbc.co.uk/news/science-environment-11153466">free kick that took place in 1997</a> is new enough to make the top story as I'm writing this.<br /><br />I'm just waiting for someone to get off the phone so I can publish two more stories which had an embargo time of 5pm here, however - I finished them about 4.45 but we can't put them out yet then, so sometimes the time is pretty precise.<br /></span>DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com0tag:blogger.com,1999:blog-4397756142950826381.post-77198575253092617442010-08-05T17:29:00.001+01:002010-12-02T14:54:57.178+00:00Week 3 - Getting to grips with editing software<span style="font-family: times new roman;">My last week at the Science Radio unit and time for me to try and edit some of the recordings I made a couple of weeks ago. I do some sound editing for my day job but this is a whole other kettle of fish. None of the programs do what I think they should and a lot of this week was spent accidentally deleting things or trying to copy or cut the same section of audio multiple times! This was actually something I'd hoped I'd learn a lot more about but one thing I have learned is that audio recorded "in the field" is really different to that recorded in my lab under carefully controlled conditions.<br /><br />Having collected audio under four headings while I was at my conference, I ended up editing segments and putting together a story for just one of these headings. One of them as I say was pretty plain to me, even, that it wouldn't really be usable as it wasn't very exciting to listen to. One of them I thought was interesting but what ended up being really useful was having the conversations with producers about whether it could be interesting, what could be interesting about it, and why it might not be really. <a href="http://mediafellow.blogspot.com/">The Hook</a>, as Cat is also finding out about. I did edit that audio down a bit and passed it over to the Africa Service who might end up using some of it, but I'm not holding my breath. <br /><br />But constructing the story which we're hoping will go out on <a href="http://www.bbc.co.uk/worldservice/science/2009/03/000000_health_check.shtml">Health Check</a> was great - really challenging, really interesting, and slightly frustrating in that I knew more or less exactly how I wanted it to sound but couldn't get it to work - and then what I wanted to say never came out right either!<br /><br />I had recorded myself asking the questions and the two scientists, plus the young people from the street kids' theatre, and I have to say I'd assumed that the questions I recorded would be used as well. But it doesn't really work out that way, especially when you need to rework things to make a shorter and easier-to-listen-to story. The other thing that hadn't really occurred to me was that if your interviewee says something in quite a long-winded way, or says an important thing, followed by a rambly anecdote, and then finishes off the important thing, you're going to have to summarise what they said. So it takes a lot of the following:<br /><br />Listening to what you've got<br />Deciding on the overall story<br />Working out what you can get from the audio that will tell the story<br />Working out what else you'll need to add<br />Writing the links<br />Working out if what the interviewee said <span style="font-style: italic;">really</span> fits with your link<br />Working out if you've said anything in the background that is unclear or just plain wrong<br />And then finally recording the links!<br /><br />Which of course is a learning curve in itself. I am highly aware of my personal tendency to talk much too fast - and my poor students are too. I tend to panic when confronted with a long piece of prose I have to read and try and read it all in one go. Big mistake! Sloooow down... and put more expression into it... and smile... and write in your pauses...<br /><br />So this story, which I'll link to when I know when it's going out, has a news trailer that should go out the same day on World Service News, also including me. So if/when that goes out I'll be glued to Listen Again.<br /><br />Although I was involved with the main programme I've been working on, <a href="http://www.bbc.co.uk/programmes/b006qyyb">Material World</a>, this week, I ended up working really hard on the other story and didn't go over for the recording. I had been interviewing one of the amateur scientists for <a href="http://www.facebook.com/BBCradio4.scientist?ref=ts">So You Want To Be A Scientist</a> who was getting very relaxed at doing interviews, but was a bit nervous - so I made the production assistant promise to hold her hand!<br />It is pretty interesting seeing the programme recorded so I will try and get back there when I'm back in London in a few weeks' time - apparently there is a free bus from White City to Broadcasting House. </span><span style="font-family: times new roman;">I also polished off the notes for the two upcoming issues of Material World this week, though (sneak preview) the poor producers then had to contact me to find out where one of the sets of notes was. I could have sworn I had put it in a public drive but you know what happens when you swear you know where something is...<br /><br />More in a couple of weeks' time when I am back from my sojourn in the day job and am at News Online. So far, this has been one of the most interesting and exciting things I've done recently, and everyone's been really friendly and helpful. Although you end up getting your writing slashed, edited, and critiqued - no-one is nearly as rude as the infamous <a href="http://www.facebook.com/home.php?ref=home#%21/group.php?gid=71041660468&ref=ts">Reviewer 2</a>.<br /></span>DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com0tag:blogger.com,1999:blog-4397756142950826381.post-25163576959787628972010-08-02T17:28:00.011+01:002010-12-02T14:54:57.178+00:00Week 2 1/2 - In which my friends appear on the radio<span style="font-family: times new roman;">As I blogged earlier, with the programme I've mainly been working on it can be a little while before stories make it out there. I spotted a press release about a story I knew something about and (perhaps because I spoke so clearly and intelligently about it, perhaps because it also appealed to him, or perhaps because he could see I was potty about it and there was no shutting me up) one of the producers let me loose on it. Unlike the other stories I've been working on - including other ones on psychology - I do know all the ins and outs and minor details of this one, so this one came with major warnings about not getting technical and making sure it was all accessible to the general listener.<br /><br />To start off with we were thinking we'd interview the author of the paper, plus someone who is in the US and does related brain imaging work. But the author is in the North of England - and wasn't at first thinking of coming down to London for the programme - which meant that both of the interviewees would be on a line. It's possible to do that but it's not ideal and you can usually tell. As an aside, I didn't go into the studio for this week's recording but listened to it while it was on - and one of the interviewees was in a studio and kept bumping the mike - it was <span style="font-style: italic;">really</span> obvious, at least to me.<br /><br />So the plan then was to get a friend/colleague of mine, who is a really chatty and enthusiastic person, who had gushed to me about how great the atricle was, and who works in London, to appear - while the author would be in the Newcastle studio. But in the end everything worked out even better, as the author came down for the day from Newcastle.<br /><br />I wrote questions for both of them, rang them up and took down their answers - with dire warnings about "forget it's me, pretend it's your granny, or you're showing a school kid round the department, blah blah" - they were both very good when they were talking to me. They were extremely excellent when they came on the show (though I know the Newcastle researcher was a little nervous, she ended up making a joke that was, I think, better than the presenter's) and a good time was had by all.<br /><br />A lot of the rest of the week was spent trying to find stories for future programmes, again. We had a couple of leads, one of which was a story about fossils, and in fact was research done by someone who'll be doing the same placement as me in a few weeks' time. The producer was fairly sure it would be a very popular story though - it's no good running something that everyone else has run, especially if they do it on a Monday and your show is on a Thursday. This turned out to be the case. Fortunately for everyone, the researcher was bored of going on the radio!<br /><br />Another one was a story about marine life that was very cool - but there were two problems. One was the same as the fossil story - too much likely media coverage. And the other was the same as the bacteria painting - too visual.<br /><br />So, I ended up researching yet another story - which isn't out yet. But I'll give you a taster. It's quite a cool story and though it's a psychology story, it's about science in general. I saw an article I really liked, on someone else's blog, and the producer said "hmm, interesting, bit philosophical, and really, stop plugging psychology already! is it topical?". The story was only out last month so that's OK on our programme, and then I spotted a book in the huge pile we have in the office which was by another psychologist, also out last month, and very relevant.<br /><br />So, I got in touch with the first guy and then waited to see if I'd hear from him - he's in the US. And although working on science radio over the summer is great in one way, because weird and wacky stories get on, in another way it's bloomin' frustrating. How dare scientists take holidays! How dare US universities have 3 month summer breaks?<br /><br />(Incidentally, if you ever send a book for review to a scientific journal - and I knew this already as I used to do reviews editing - probably about a 1 in 4 chance it will get read and reviewed. And half of them aren't relevant for the journal, so if it's relevant, let's say 1 in 2. If you send it to a media outlet? well let's just say there's a very very long shelf of unread books here...)<br /></span>DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com0tag:blogger.com,1999:blog-4397756142950826381.post-29839475600359457742010-08-02T17:28:00.008+01:002010-12-02T14:55:03.719+00:00Week 2 - In which I stick microphones up people's noses<span style="font-family:times new roman;">A conference would usually be a good opportunity to record some interviews of research that's just getting published, but this was even better because the unit I'm working in does World Service and anything coming out of Africa is particularly interesting. I browsed the conference programme and chose 3 topics that might be interesting and for each of them managed to get interviews with both researchers and normal people - the latter for most cases courtesy of an extremely friendly and nice Africa Service reporter based there.<br /><br />I ended up interviewing 5 researchers - of which 4 were very easy to talk to and sounded quite down to earth, though they waffled no end, repeated themselves, overlapped themselves... you name it... thankfully I'm not expected to edit the audio, or at least not do the fine stuff.<br /><br />One researcher was I'm afraid to say reeeeely boring and ended up sounding like he was lecturing me - I probably could have got a bit out of it but there wasn't really as much of a story as there could have been. That was a shame as to go with that one I and the BBC man chased around Lusaka trying to find a child selling things on the streets and ended up being chased out of the market, and finding a boy selling doughnuts, who turned out to be pretty good on the recording.<br /><br />The other two pairs of interviewees both worked out pretty well, as did their "counterpart" people-on-the-street. It was great fun tracking down a grandmother for one of the stories - we asked one nice old lady selling fruit but she didn't want to be recorded on the street, and in the end found a lady living in an area with some smaller houses, who was looking after her disabled husband. We wanted to buy her a present so went for some food for her dinner, and a notebook and pen for her littlest boy. She had previously been looking after five grandchildren too, but thankfully now they are all with other relatives.<br /><br />I also really enjoyed running round our conference dinner interviewing the entertainers, a group of kids who perform and work with street children - they are all of course dying to be on the radio as they are actORS darling, and hopefully at least one or two of them will get to be heard - of course the magic words "I'm from the BBC" open all kinds of doors.<br /><br />Lusaka at this time of year is in the middle of winter - after a nice week's break in Greece and warm and humid London, I was pretty freezing! I had fortunately packed one wool jumper and though it was about 25C in the afternoons I ended up wearing my jumper till lunchtime every day and all evening.<br /></span>DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com0tag:blogger.com,1999:blog-4397756142950826381.post-53225890739626073782010-07-28T11:09:00.006+01:002010-12-02T14:55:03.720+00:00In which I pretend to be a journalist<o:smarttagtype style="font-family: times new roman;" namespaceuri="urn:schemas-microsoft-com:office:smarttags" name="City"></o:smarttagtype><o:smarttagtype style="font-family: times new roman;" namespaceuri="urn:schemas-microsoft-com:office:smarttags" name="place"></o:smarttagtype><!--[if gte mso 9]><xml> <w:worddocument> <w:view>Normal</w:View> <w:zoom>0</w:Zoom> <w:punctuationkerning/> <w:validateagainstschemas/> <w:saveifxmlinvalid>false</w:SaveIfXMLInvalid> <w:ignoremixedcontent>false</w:IgnoreMixedContent> <w:alwaysshowplaceholdertext>false</w:AlwaysShowPlaceholderText> <w:compatibility> <w:breakwrappedtables/> <w:snaptogridincell/> <w:wraptextwithpunct/> <w:useasianbreakrules/> <w:dontgrowautofit/> </w:Compatibility> <w:browserlevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:latentstyles deflockedstate="false" latentstylecount="156"> </w:LatentStyles> </xml><![endif]--><!--[if !mso]><object classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id="ieooui"></object> <style> st1\:*{behavior:url(#ieooui) } </style> <![endif]--><style> <!-- /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman";} a:link, span.MsoHyperlink {color:blue; text-decoration:underline; text-underline:single;} a:visited, span.MsoHyperlinkFollowed {color:purple; text-decoration:underline; text-underline:single;} @page Section1 {size:595.3pt 841.9pt; margin:72.0pt 90.0pt 72.0pt 90.0pt; mso-header-margin:35.4pt; mso-footer-margin:35.4pt; mso-paper-source:0;} div.Section1 {page:Section1;} --> </style><!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} </style> <![endif]--> <p style="font-family: times new roman;" class="MsoNormal">I'm currently spending a few weeks as a British Science Association Media Fellow (see <a href="http://www.britishscienceassociation.org/web/scienceinsociety/MediaFellowships/">here</a>), one hopes reaping lots of rewards for my loyal reader in improving my skills at communicating science to the general public.</p> <p style="font-family: times new roman;" class="MsoNormal"><o:p><br /></o:p></p> <p style="font-family: times new roman;" class="MsoNormal">I started at the BBC Science Radio Unit about 2 weeks ago - mainly working on <a href="http://www.bbc.co.uk/programmes/b006qyyb">Material World</a>, with side forays into <a href="http://www.bbc.co.uk/worldservice/science/2009/03/000000_health_check.shtml">Health Check</a> and <a href="http://www.bbc.co.uk/worldservice/science/2009/03/000000_science_in_action.shtml">Science in Action</a>. Material World is a live programme which is broadcast on Thursday afternoons, meaning Fridays are really quiet and the week ramps up from there. The first week here, the producers were treating me really gently but it still felt quite scary.<br /><br />With a programme like this guests are interviewed first by us (that's the producers and random know-nothings like me and another work experience person), after we've written a list of relevant questions. We take notes on what the guest has to say, pass it on to the presenter, and a script for the programme is written - then you have to hope that what you've asked makes sense to the presenter, and that the interviewee gives roughly the same answers, and isn't too nervous!<br /><br />The first interview I was involved with was with an MP, now, it will be pretty easy for you to find out who it was, but I won't mention her by name. In typical politician fashion, she didn't say very much to me (or on the programme) and was full of clichés. Even the presenter, who prides himself on having a way with words, couldn't think of a synonym for "skilled up" once she'd said it to me three times and him twice. As I say, it felt quite scary to have that responsibility but it wasn't a huge job in reality.</p><p style="font-family: times new roman;" class="MsoNormal"><br /></p><p style="font-family: times new roman;" class="MsoNormal">Quite a lot of what I’ve been doing has been looking around to see what news is out there. I usually enjoy reading science blogs and feeds and it’s great to have this be temporarily part of my day job – hearing what’s new, getting press releases before things are out on the web, trawling feeds for something new and interesting.<span style=""> </span>A lot of what is actually really new and interesting doesn’t make great radio, unfortunately. Did you know Alexander Fleming <a href="http://scienceblogs.com/sciencepunk/2010/07/fleming_painted_with_bacteria.php">painted with bacteria</a>, for example? But pictures aren't that great on radio.<br /></p><p style="font-family: times new roman;" class="MsoNormal"><br /></p><p style="font-family: times new roman;" class="MsoNormal">Some of the stories end up being researched quite a while in advance.<span style=""> </span>In my first week I started researching two more stories for Material World, one of which has gone out at the time of writing and one of which will be out in a couple of weeks’ time.<span style=""> </span>The first one was my own “spot”, in fact of a colleague whose really interesting paper was about to come out – I raved about how cool the research was, the producers said “yeah, go for it”, and I talked to the main researcher, and after a bit of indecision also decided to ask another colleague on.<span style=""> </span>The preliminary work on that was in my first week here but there’s more to this story so I’ll leave that for another entry.</p><p style="font-family: times new roman;" class="MsoNormal"><br /></p><p style="font-family: times new roman;" class="MsoNormal">After my first week I was due to go to a conference in Lusaka, Zambia – so I was given a digital recorder, tiny, and a microphone, huge, and some quick instructions on how to use it, and some tips for recording (make sure the background isn’t too noisy but isn’t too quiet, push the microphone right up people’s noses, check the volume level), and the email and phone no of the Africa Service’s employee there. I have been to <st1:city st="on"><st1:place st="on">Lusaka</st1:place></st1:city>, but not for a really long time, so I was looking forward to having someone to show me round.</p><p style="font-family: times new roman;" class="MsoNormal"><br /></p><p style="font-family: times new roman;" class="MsoNormal">I'll try and write another entry on My Adventures in Lusaka shortly - it alternates between twiddling thumbs and manic here.<br /></p>DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com0tag:blogger.com,1999:blog-4397756142950826381.post-26398439083191351152010-07-01T12:21:00.008+01:002010-12-02T14:57:06.537+00:00Will the baby cry less and sleep more if we have him in the bed with us?<span style=";font-family:times new roman;font-size:100%;" >What has been called "attachment parenting"* has become ever so trendy in recent years and for a lot of parents of very young infants there is a whole set of things that goes together under this heading. This tends to include breastfeeding on demand, sleeping in a family bed, carrying in a sling for a lot of the day, and responding very quickly when infants cry - never leaving them to cry when nothing obvious is wrong. Another group of parents - again hugely stereotyping here - go more for scheduled feeding, own bed, and putting in a baby seat or buggy rather than carrying the baby in a sling.<br /><br />It's pretty hard to randomise parents to different groups and tell one "right, you lot sleep with baby in the bed but use a pushchair and feed on a schedule, and you lot over there, let's have feeding on demand but even if you think it's part of the package, don't have them in the bed with you or carry them in a sling".<br /><br />However, infants in most cultures cry a <span style="font-style: italic;">lot</span> and parents complain of them crying a lot, especially in the first three months. So it's probably safe to say that parents in two different European countries are both going to be complaining of infants crying and if they it might be helpful to compare how much the babies cry if infant care practices are different.<br /><br />In fact, it turns out they are - the two stereotyped groups I've described above are both groups found commonly in the UK but in Denmark, practices are a little different - even parents who don't sleep in a family bed or feed on demand, tend to hold or carry the baby for longer each day. So it's possible to separate the effect of sleeping in a family bed and feeding on demand (the "attachment parenting" or "non-conformist", mainly UK group) from the effect of a high level of responsiveness and carrying (the Danish group).<br /><br />What the study found was that it was the carrying and responsiveness - as practiced by "mainstream" Danish mothers - that led to less crying during the day and evening (and it's the evening crying that parents find so wearing). Sleeping together in one bed in particular didn't help crying or sleeping through the night. In fact, sleeping in one bed added on to carrying/holding made infants <span style="font-style: italic;">less</span> likely to have a settled, all-night sleep with little crying by 3 months.<br /><br />What was also interesting was that extreme crying - "colic", which really seems to have little to do with the digestive system - was no different between the groups. So "regular" cryers cry less in the daytime if they are held more, more at night if they are in a family bed, but "extreme" cryers are not a result of anything parents have or have not done. Frustrating if you have one of them, but a little bit reassuring if you are worried you are doing something wrong.<br /><br /><br />*It's a very distinct style of parenting which some parents prefer but there's no evidence it has much to do with attachment - I'm going to be writing on that shortly** so bear with me.<br /><br />**i.e. some time this millennium<br /><br />If you are interested:<br /><br /><a href="http://www.ncbi.nlm.nih.gov/pubmed/16740816">Pediatrics. 2006 Jun;117(6):e1146-55. Infant crying and sleeping in London, Copenhagen and when parents adopt a "proximal" form of care. St James-Roberts I, Alvarez M, Csipke E, Abramsky T, Goodwin J, Sorgenfrei E.</a><br /><br /><br /></span>DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com0tag:blogger.com,1999:blog-4397756142950826381.post-57122140441186201362010-06-07T14:25:00.005+01:002010-07-01T14:16:32.288+01:00Own goal?<span style=";font-family:times new roman;font-size:100%;" >As an experiment, I've enabled AdSense on my blog (not that I'm anticipating major revenue nor indeed any particular increase in traffic, but just in case).<br /><br />I note that half my ads so far (out of a microscopic sample size, a phrase including the words "fingers", "hands" and "both" springs to mind) are for unproven parenting products and untested (or tested-and-found-wanting) therapeutic materials for children with disabilities. I sense some bloggy material... let me just add a draft post along the lines of "dodgy therapies and why parents fall for them".<br /></span>DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com0tag:blogger.com,1999:blog-4397756142950826381.post-35272256151676866432010-03-25T18:27:00.006+00:002010-07-01T14:16:42.511+01:00Why do some children stop believing in Father Christmas?<div class="posterous_autopost" style="font-family:times new roman;"><span style="font-size:100%;">I have to confess to a slight obsession with this subject - I suspect because of my own difficulty with the concept (my parents never set anything up to make me believe in Father Christmas) and also a slight scepticism about who, exactly, parents are doing it for - though many parents would admit they want their children to carry on believing for their own sake, not the children's sake.</span><p> <span style="font-size:100%;">A fascinating area of research has been following children's response to an invented fantasy character, the Candy Witch, who is kind, visits at Halloween, and gives you toys if you leave out some sweets for her. For younger children (4-5-ish) generally children tended to believe she was real - the more other make-believe figures they believed in, the more likely they were to believe. Children didn't need "backup" in the form of a parent-organised "visit" if they believed in a lot of other fantasy figures.</span></p><p><span style="font-size:100%;"> By the time children are 7 or 8 few of them believed in a lot of other fantasy figures (Father Christmas, the Easter Bunny, the Tooth Fairy etc.), but if they did, <i>and</i> they got a "visit", they were more likely to believe in the Candy Witch. It seems as if, should parents wish to keep the belief in fantasy figures alive in older children, they are going to need to put a lot more effort into it, and provide a lot more "evidence" that Father Christmas really exists.</span></p><p><span style="font-size:100%;"> Although some people (Richard Dawkins, I'm looking at you) think that children are really quite credible, and will believe more or less what their parents tell them, without any evidence, in fact children do seem to need evidence - they are not as credible as some people would like to think. </span></p> <p></p><p> <span style="font-size:100%;">If you're interested:</span></p><p><span style="font-size:100%;"><a href="http://www.ingentaconnect.com/content/bpsoc/bjdp/2009/00000027/00000004/art00011" target="_blank">Return of the Candy Witch</a></span> </p> </div>DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com0tag:blogger.com,1999:blog-4397756142950826381.post-70529913364240767122010-02-13T15:00:00.007+00:002010-07-01T14:23:44.790+01:00The book I wish I'd written<span style=";font-family:times new roman;font-size:100%;" >Or, no, I did not steal their title.</span><span style="font-size:100%;"><br /><br /></span><span style=";font-family:times new roman;font-size:100%;" >Recently </span><span style="font-size:100%;"><a style="font-family: times new roman;" href="http://www.amazon.com/Parenting-Reason-Evidence-Based-Approaches-Dilemmas/dp/041541329X/ref=sr_1_5?ie=UTF8&s=books&qid=1266073277&sr=8-5">this book</a></span><span style=";font-family:times new roman;font-size:100%;" > landed on my desk for review. In fact I no longer pass books on for review, though this used to be part of my job, so I just kept it. I am pretty impressed (though already planning how I can persuade them to let me contribute to the next edition).</span><span style="font-size:100%;"><br /><br /></span><span style=";font-family:times new roman;font-size:100%;" >The chapters and topics span the whole of childhood, but majoring on infancy and adolescence, which is a fair reflection of both parents' concerns and the research that is out there. Most of the topics are related to behaviour, discipline, and social issues - my own research mainly concentrates on children's thinking and language so obviously I'd feel that was lacking - but I love the concept.</span><span style="font-size:100%;"><br /><br /></span><span style=";font-family:times new roman;font-size:100%;" >They begin by talking about the concept of evidence and why we need to look at more than just anecdotes in working out what works and what doesn't; there's a little history of child care advice and whether it's evidence-based or not (lots of crazy ideas out there in the past), which was interesting to me, at least.</span><span style="font-size:100%;"><br /><br /></span><span style=";font-family:times new roman;font-size:100%;" >The chapters that look like they might only be focussed on infancy (sleep, temperament, toilet training) also touch on related issues for older children - although I don't read most parenting books, I do get the impression that a lot of advice on some topics stops with infants - avoiding some quite distressing issues that mainly happen in older children. Soiling, for example, in an already-toilet-trained child can be really upsetting and hard to understand, though it's fairly easily dealt with.</span><span style="font-size:100%;"><br /><br /></span><span style=";font-family:times new roman;font-size:100%;" >I really appreciated the chapters that dealt with less-than-ideal circumstances though as the overall level of the book is pitched fairly high (probably because of where the authors are coming from) and the text is quite dense (yes, I know it's a book </span><span style="font-style: italic;font-family:times new roman;font-size:100%;" >about</span><span style=";font-family:times new roman;font-size:100%;" > children not </span><span style="font-style: italic;font-family:times new roman;font-size:100%;" >for</span><span style=";font-family:times new roman;font-size:100%;" > children but perhaps some graphics would have been nice), I'm not too sure how likely parents with desperate mental health issues are to read the book. But the sections on divorce and adoption are probably very good primers for well-educated parents in those situations, and there's also advice for those with child relatives and friends whose parents are struggling with depression, substance abuse, etc.</span><span style="font-size:100%;"><br /><br /></span><span style=";font-family:times new roman;font-size:100%;" >I think I may have either a British edition or the language has been tailored to be international (mentions of GPs etc.) but one section I felt didn't go far enough to reassure the very nervy subset of middle-class parents who are paranoid about vaccines - perhaps in the US the paranoia is not as great but here, it is really crazy (though thankfully calming down a bit). Some of these parents will never be reassured by anything professionals or researchers can say, but others might benefit from more calming statements and a clearer explanation than the fairly bald statements that "vaccines are safe". Or possibly just a direction to go and read Bad Science?</span>DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com0tag:blogger.com,1999:blog-4397756142950826381.post-3745179842433487262010-01-07T20:53:00.005+00:002010-01-08T11:27:33.361+00:00One in six children "have difficulty learning to speak"?<span style="font-family:times new roman;">This statistic has been recently widely reported <a href="http://news.bbc.co.uk/1/hi/education/8436236.stm">in the</a> <a href="http://www.telegraph.co.uk/health/children_shealth/6926505/One-in-six-children-have-talking-problems.html">media</a>, as well as by concerned charities (though one charity, <a href="http://www.ican.org.uk/">I CAN</a>, appears to have removed their press release from their website).<br /><br />Can this really be true? Does it mean children's language is getting worse? Is it because of the 10% who were reported to have a TV in their room before the age of 1?<br /><br />Well... probably not.<br /><br />There are various serious problems with the Yougov poll. Firstly, although this wouldn't necessarily weight it in the direction of finding too many speech and language problems, it's an email poll. The researchers claim to have a 35-50% response rate and, although they don't say this, I'm assuming they told people before they started the poll that it was about children's language (well, they'd have to tell them it was about children under 7 as they only published responses from parents of children that age). So, from the start, parents who think their child might have language problems are biased to respond.<br /><br />Secondly, the questionnaire asks: How old was your child when they said their first word?<br />The children being asked about are, at this point, aged up to 7 years. 71% of the children asked about were over 3. So the vast majority of these children said their first word more than a year ago.<br /><br />It is very difficult to get parents to give accurate information about their child's concurrent language (at the same time you are asking). The best way to do it is to give them a checklist from which they can recognise words that their child understands or says. People are much better at recognition than recall. And they are much better at concurrent report than past report. But this survey uses recall (it asks the parents to tell them, without prompts, the first word their child said) and it uses past report.<br /><br />Now, some researchers have successfully used past report. For example, a team working on children with autism and looking back at their milestones used prompts like "can you remember where you were staying, what you were doing, around your child's first birthday/first Christmas. Now, can you remember what kinds of play and toys your child liked then, and what they were doing. Can you remember if your chlid could do A, B, C at that time?". That study used home video of events like birthdays and Christmas to verify some of the things parents reported their children could do, but still couldn't verify them all.<br /><br />Finally, the Yougov poll relies on parents' judgment about what constitutes "experiencing difficulty learning to talk or understanding speech". Parents reported that mainly they decided this by comparing their child to another child the same age or to their other children. Children's speech and language development varies hugely within a wide normal range. To know your child is in the bottom 5% of children learning to talk (usually the cut-off for clinical difficulties) you'd have to compare them to 19 other children who would all have to be better than your child. It's probably true that slightly more than 5% of children have difficulties learning to talk (probably because there are many reasons a child can have difficulties) but even so, parents do not usually have 19 other children to compare their child to (either "another", implying one, or siblings!).<br /><br />Parents' judgments about whether their child is experiencing difficulties are hugely confounded by expectations and knowledge about typical language development. Parents expect boys to have difficulty learning to speak - and more parents reported their boys did have difficulty. 31% did report that they knew their child wasn't reaching milestones. Sadly, milestones reported in cheery helpful baby books and on cheery helpful baby websites are usually average. Surprise, surprise, half of children are below average. Being below average isn't "experiencing difficulty".<br /><br />And parents don't all know very much about children's language development. Current theories suggest that providing a correct model when children make mistakes in language is the best way to help them. Thankfully most parents do know this. But 14% thought the best response was to correct them - research shows this rarely works. Even more worryingly, and flying in the face of evidence that shows children flourish when bilingual, and do better in a wide range of cognitive and language skills, most parents thought that when parents' first language wasn't English, they should still speak English to their child at home if they live in the UK. One wonders how many Welsh-speaking parents they asked. Thankfully far fewer of the parents who didn't speak English as a first language thought using English at home was a good strategy.<br /><br />So we've seen that parents whose child has a problem are more likely to answer this poll, most parents were recalling their child's language a really long time ago, probably inaccurately, and a worryingly large proportion of parents failed to give an answer that would support their child's language development when asked about best practice in the home.<br /><br />In fact, the actual ages reported for first words - apart from a few children whose parents said they have a disability - are almost all within the range of "don't panic". Just 4% of children spoke their first words, as recalled by parents, past 24 months (and a few of the 11% whose first words were 18-24 months may have been in the "let's have a look at it" category). And nearly 69% reported their child put two words together before 18 months (in fact, the middle of the age range for this is probably about 21 months - so, erm, talkative middle class kids whose parents have email, much?)<br /><br />But one part of this survey rings a little true - some parents who thought their child had a speech problem felt unsupported. But again, perhaps given the figures this isn't a cause for concern. Only 23% thought their child didn't get any help - so, as 17% thought their child had a difficulty, 13% of parents thought their child had a difficulty but did receive some help. Since really only about 5-7% of children actually have a difficulty, this is pretty good - possibly another 8% of children are receiving help for a difficulty they don't have!<br /><br />*Gernsbacher, M. A., Sauer, E. A., Geye, H. M., Schweigert, E. K., & Hill Goldsmith, H. (2008). Infant and toddler oral- and manual-motor skills predict later speech fluency in autism. Journal of Child Psychology & Psychiatry & Allied Disciplines, 49(1), 43-50.<br /><br />(Note: if you fancy downloading the raw data, it's <a href="http://www.ican.org.uk/media/press%20releases/%7E/media/ICAN%20website/9%20Media/YouGov%20poll%20results%20spreadsheet.ashx">here</a> - an excel file)<br /></span>DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com0tag:blogger.com,1999:blog-4397756142950826381.post-74023326282457766982009-09-24T12:41:00.003+01:002010-02-25T19:59:37.913+00:00Why does everything always have to be the blimmin' same?A lot of parents of toddlers and preschoolers will have had the very frustrating experience of their child insisting on everything being done in exactly the same way again and again. Vegetables must be on the top of the plate, shoes must be put on before coat, teeth brushed after bath, bedtime story must be read in exactly the same way - no changing the voices - the same bowl for breakfast and one cup for juice, a different one for milk, and woe betide anyone who tries to change this.<br /><br />Well, you'll be reassured to know it IS just a phase - it's a very common phase - and there may be some explanation for it.<br /><br />As children grow older, they become better at behaviours called "executive functions". This set of behaviours particularly helps children to be more flexible and less focussed on the here and now. So one classic test of executive function asks children to sort cards that have different coloured shapes first by the colour that is on them - and then to switch to sorting by the shape that is on them. Younger children tend to stick to the same sorting method; they are very driven by what they are already doing. Children in this stage find it really difficult to play games like Simon Says - they can't switch from "do what I say" to "don't do what I say", and they find resisting tempting behaviours <span style="font-style: italic;">really</span> hard - put a sweet in front of them and ask them to wait for permission to eat it, and it will be gone before you blink. They respond to what they see, and find it hard to control their own behaviour to respond in a different way.<br /><br />It's been found that these types of executive functioning are quite closely related to the ritualised behaviours that toddlers and preschool children are so good at. It seems as if as children get older and have more control over their own behaviour, ritualised behaviours decrease - a great relief to parents. <a href="http://bpsoc.publisher.ingentaconnect.com/content/bpsoc/bjdp/2009/00000027/00000002/art00003">Recent research</a> suggests that this is broadly true, but with a slight difference as children get older. Younger children showed some relationship between ritualised behaviours and executive function but in older children this was even stronger - although it's not possible to tell from this study, this could be because if older children (especially those of young to mid-primary school age) have these ritualised behaviours, it's definitely because of somewhat poorer executive functioning, but in younger children all of the children have these behaviours to some extent.<br /><br />We do know that executive functions improve with practice, though. So it's not necessarily a case of just waiting it out until your child, and their brain, are mature enough to live without the ritualised behaviours. Although no-one's done any studies linking this directly to ritualised behaviours, <a href="http://www3.interscience.wiley.com/journal/70002156/abstract?CRETRY=1&SRETRY=0">another study</a> trained 4 to 5 year old children using a stop-go game in which they had to sometimes respond and sometimes hold themselves back. Training on different games - such as the card sorting game - helped children to stop themselves from responding inappropriately on the stop-go game.<br /><br />So although waiting it out should mean you can put away that essential Iggle Piggle plate eventually, helping children to think more flexibly by practicing games and behaviours where they have to exercise self-control will at least give them the skills they seem to need to grow out of the rituals.DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com0tag:blogger.com,1999:blog-4397756142950826381.post-44778895451814470092009-05-17T10:16:00.001+01:002009-05-19T17:12:17.692+01:00Should I correct their spelling when they are just beginning to write?When children are just beginning to read and write, they can come out with the most adorable spellings:<br /><br />Mummys e z de eg (easter egg)<br />livin rom<br />cichn<br />jragon<br />sdik<br />luv<br /><br />Usually these bear <span style="font-style: italic;">some</span> relationship to the word the child is aiming at. Often they have the sounds of the word (phonology) but not the spelling conventions (orthography). For example, in "livin rom" and "cichn" all of the sounds in the words CAN spell those sounds but don't usually in those particular contexts. So C can sound like /k/ or /s/ but usually sounds like /s/ before an I. CH is a very commmon spelling of the /ch/ sound but just happens not to be how it's spelled in the word "kitchen".<br /><br />Some of the spellings are more guesses at how to spell a particular sound. So, although some children will pronounce "living" as "livin'", many more will spell it that way - the /ng/ and /n/ sounds are really close and it's easy, if you can't quite hear the difference, or can't quite work out what the difference is really, to go "oh, whatever" and put down the one you <span style="font-style: italic;">know</span> how to spell.<br /><br />Other spellings represent children's concepts of the sounds of words that are actually, in some cases, <span style="font-style: italic;">more</span> accurate than adults'. The word "stick", most adults will tell you, has a /t/ sound after the /s/. In fact, it's not a /t/ but is a sound somewhere between a /d/ and a /t/ - it's not found on its own in English, though if you are a Hindi speaker you will have this as a separate sound. In English it only exists after /s/. So children who spell "stick" as SDIK are actually very cleverly working out what the second sound is in the word. Likewise "dragon" doesn't begin with the same /d/ as in, say, "dam" but in a slightly different sound, somewhere towards /j/. In fact, when you ask children who can't quite read or write yet about the sounds of words sometimes they are more right than adults.<br /><br />So, if your child makes this kind of mistake in their spelling, should you correct them? Probably not. They will probably be learning phonic patterns for simple spellings in school, and each pattern they learn will help them to get another set of spellings right - so, when they have learned that there are lots of words ending in -TCH but very few beginning TCH-, they will start spelling words with /ch/ in the middle or at the end with TCH and those with /ch/ at the beginning with CH. But the evidence is that just inventing the spellings themselves can help them with sounding out words and working out what sounds there are in words - essential skills for beginning reading and spelling. Personally, I'd just leave them to it, and have a quick giggle or an "awww" at their productions.<br /><br />If you're interested in reading more, here's a representative article:<br /><br /><a href="http://scholar.google.com/scholar?hl=en&lr=&cluster=7436108178828012526">Joseph K. Torgesen, Charlotte Davis, Individual Difference Variables That Predict Response to Training in Phonological Awareness, Journal of Experimental Child Psychology, Volume 63, Issue 1, October 1996, Pages 1-21</a>DrSpousehttp://www.blogger.com/profile/07259337858075146058noreply@blogger.com1