Cochlear implants in children: Development in interaction with the social context

Between 150 and 200 deaf children are born in the Netherlands each year. Deafness has major consequences for these children’s development, as it deprives them of access to spoken language. Since the 1990s, deaf children have been able to have a cochlear implant (CI), which enables them to experience sound. The questions central to this thesis concern the way in which a CI affects children’s development, and the factors that play an important role in this. The framework for this thesis is provided by Bronfenbrenner’s social-ecological model, which proposes that children’s development is influenced by the quality and quantity of their interpersonal interactions. These interactions are influenced indirectly by the environment in which children live. In young children with a CI, language development and the social-emotional development are both delayed compared to their hearing peers. However, it is not yet cl ear how these children will develop in the future. The children who participated in this study were still very young, and a number of them received their CI relatively late. It is possible that they will catch up with hearing children when they are older and have had a longer period of access to spoken languageLEI Universiteit LeidenDevelopmental pathways of social-emotional and cognitive functioning - ou

Reasons why patients by-pass their GP to visit a hospital Emergency Department.

Knowledge about what motivates patients to visit the emergency department (ED) of a hospital for minor complaints, instead of visiting their general practitioner (GP), can help to reduce unnecessary utilization of expensive services. This paper reports on a study designed to investigate the reasons why patients visit the ED and to determine the influence of patient characteristics on specific motives. A multidimensional measurement instrument was designed to identify the motives of patients who bypass their GP and visit the ED. The instrument assessed 21 motives, all measured by means of three questions in Likert format. During a period of 1 week, all patients who visited the ED of two hospitals in Amsterdam were asked to complete a questionnaire when they were 'self-referred' with minor complaints. A total of 403 questionnaires were analysed, and the results show that motives relating to the GP play a minor role in the decision of patients to visit the ED. Profiles of two major patient groups could be identified. One group comprised patients with a high socio-economic status living in suburbs, whose motives for visiting the ED are mainly of a financial nature. Patients in the second group mainly lived in the inner-city, and preferred the expertise and facilities provided by the ED

The Developmental Trajectory of Empathy and Its Association with Early Symptoms of Psychopathology in Children with and without Hearing Loss

Empathy enables people to share, understand, and show concern for others’ emotions. However, this capacity may be more difficult to acquire for children with hearing loss, due to limited social access, and the effect of hearing on empathic maturation has been unexplored. This four-wave longitudinal study investigated the development of empathy in children with and without hearing loss, and how this development is associated with early symptoms of psychopathology. Seventy-one children with hearing loss and cochlear implants (CI), and 272 typically-hearing (TH) children, participated (aged 1–5 years at Time 1). Parents rated their children’s empathic skills (affective empathy, attention to others’ emotions, prosocial actions, and emotion acknowledgment) and psychopathological symptoms (internalizing and externalizing behaviors). Children with CI and TH children were rated similarly on most of the empathic skills. Yet, fewer prosocial actions were reported in children with CI than in TH children. In both groups, affective empathy decreased with age, while prosocial actions and emotion acknowledgment increased with age and stabilized when children entered primary schools. Attention to emotions increased with age in children with CI, yet remained stable in TH children. Moreover, higher levels of affective empathy, lower levels of emotion acknowledgment, and a larger increase in attention to emotions over time were associated with more psychopathological symptoms in both groups. These findings highlight the importance of social access from which children with CI can learn to process others’ emotions more adaptively. Notably, interventions for psychopathology that tackle empathic responses may be beneficial for both groups, alike

Detection of child abuse by Dutch preventive child-healthcare doctors and nurses:Has it changed?

Abstract Objective Child maltreatment (i.e., abuse and neglect) is a major cause of child morbidity and death. It is a principal topic in community child-healthcare services yet little is known about the actual detection of suspected cases. We examined trends in this detection, as well as the characteristics of parents and children associated with higher rates of detection. Methods We obtained data on suspected cases of physical maltreatment, as well as of emotional and sexual abuse, from Dutch national samples for children aged 3 ¾ , 5-6 and 8-12 years, for 1997/98 and 2002/03 (response rates 92% and 84%, respectively, about 4,000 children each), as registered by preventive child-healthcare doctors and nurses. We assessed changes in the detection of suspected cases and also assessed the association of suspicion with the background characteristics of parents and children. Results Rates increased slightly over this 5-years period, from .23% to .41%, due to a quadrupling of suspected emotional abuse cases (from .06% to .24%), but without statistical significance. Suspicion of maltreatment was found to be more likely among boys, older children, and children with low-educated fathers and mothers who were younger than 27 years at the child’s birth. Conclusions Professionals in Dutch preventive child-healthcare services detected fewer cases of child maltreatment than might be expected on the basis of prevalence rates of self-reported maltreatment. Detection of other types of child maltreatment thus still needs further improvement in order to reach the goal of better child health.

Short report:Longitudinal study on emotion understanding in children with and without developmental language disorder

Background: Children with Developmental Language Disorder (DLD) have difficult access to social interactions, which could in turn limit their opportunities to learn about others’ emotions. Aims: This study aimed to investigate the developmental trajectories of emotion understanding in young children with and without DLD. Methods and procedures: 95 DLD children and 149 non-DLD children were tested twice, with an approximately two-year interval (Mage = 3.58 years at Time 1), on three indices for emotion understanding (discrimination, identification, and attribution in emotion-evoking situations). Outcomes and results: At Time 2, DLD children fell behind their non-DLD peers on the non-verbal task for emotion discrimination, while catching up on the verbal tasks for emotion identification and attribution. The two groups developed most of these skills with a similar improvement over time, but DLD children showed a greater increase in positive emotion identification and attribution with age than non-DLD children. Conclusions and implications: The findings showed the potential of DLD children to understand others’ emotions in verbal tasks to a similar extent as their non-DLD peers. However, DLD children may still face difficulties understanding more implicit emotional messages in real-life situations, and longitudinal follow-ups are required to reveal these challenges.</p

Using the prototype willingness model to predict doping in sport.

To enable preventive measures to be designed, it is important to identify modifiable distal and proximal factors underlying doping behavior. This study investigated aspects of the prototype willingness model in relation to doping. A cross-sectional study was conducted involving 729 competitive athletes. Following ethical approval, athletes (mean age = 28.8 ± 10.1 years; 63% male) completed an online questionnaire, which assessed doping-related attitudes, norms, prototype perceptions, outcome expectancies, and behavioral willingness. Using hierarchical multiple regression analysis, 54.4% of the total variance in willingness to dope was explained. Specifically, past doping, attitudes, and favorability of performance enhancing substance user prototypes were the strongest unique predictors of willingness to dope. Athletes appeared most willing to dope if they were to suffer an injury, a dip in performance, or think others are doping and getting away with it. National-level athletes displayed significantly greater willingness to dope (Kruskal-Wallis γ2 = 35.9, P < 0.001) and perceived themselves as significantly more similar to a doper (Kruskal-Wallis γ2 = 13.4, P = 0.004) than athletes competing at any other level. The findings highlight the importance of extending anti-doping provision beyond elite-level sport and the need to target athletes' doping-related perceptions

Continuous admission to primary school and mental health problems

Background: Younger children in a school class have higher rates of mental health problems if admission to primary school occurs once a year. This study examines whether this relative age effect also occurs if children are admitted to school continuously throughout the year. Methods: We assessed mental health problems based on parent-reports (using the Child Behavior Checklist, CBCL) and on professional assessments, among two Dutch national samples of in total 12,221 children aged 5-15 years (response rate: 86.9%). Results: At ages 5-6, we found a higher occurrence of mental health problems in relatively young children, both for mean CBCL scores (p = 0.017) and for problems assessed by child health professionals (p < 0.0001). At ages 7-15, differences by relative age did not reach statistical significance. Conclusion: Continuous admission to primary school does not prevent mental health problems among young children, but may do so at older ages. Its potential for the prevention of mental problems deserves further study

Continuous admission to primary school and mental health problems

Background: Younger children in a school class have higher rates of mental health problems if admission to primary school occurs once a year. This study examines whether this relative age effect also occurs if children are admitted to school continuously throughout the year. Methods: We assessed mental health problems based on parent-reports (using the Child Behavior Checklist, CBCL) and on professional assessments, among two Dutch national samples of in total 12,221 children aged 5-15 years (response rate: 86.9%). Results: At ages 5-6, we found a higher occurrence of mental health problems in relatively young children, both for mean CBCL scores (p = 0.017) and for problems assessed by child health professionals (p <0.0001). At ages 7-15, differences by relative age did not reach statistical significance. Conclusion: Continuous admission to primary school does not prevent mental health problems among young children, but may do so at older ages. Its potential for the prevention of mental problems deserves further study

Why athletes say no to doping: A qualitative exploration of the reasons underpinning athletes' decision not to dope

Athletes’ motives for choosing not to use Performance Enhancing Drugs (PEDs) are likely to be diverse and complex, including a consideration of biological factors (e.g., performance advantage), psychological characteristics (e.g., risk taking behavior), and the athlete’s social environment (e.g., the opinion and influence of significant others). As such, a multifactorial (bio, psycho, and social) evaluation is important when examining the reasons against usage. The purpose of this study was to examine the reasons athletes cite for not using PEDs. A phenomenological approach was employed and data were collected from athletes (n = 36) and coaches (n = 10) using semi-structured interviews and analyzed using Interpretative Phenomenological Analysis. Personal and moral standards were identified as key factors that led to decisions to avoid PED. Psychological and social factors (e.g., the role of significant others such as the coach) also play significant roles in decisions to avoid doping. Although anti-doping testing and education is central to anti-doping strategy, athletes’ decision not to dope was made independent of, or at least not contingent on these structures. As such, these findings have the potential to inform educational initiatives designed to combat doping in sport outside the usual emphasis on sanctions and testing

The developmental trajectory of empathy and its association with early symptoms of psychopathology in children with and without hearing loss

Empathy enables people to share, understand, and show concern for others' emotions. However, this capacity may be more difficult to acquire for children with hearing loss, due to limited social access, and the effect of hearing on empathic maturation has been unexplored. This four-wave longitudinal study investigated the development of empathy in children with and without hearing loss, and how this development is associated with early symptoms of psychopathology. Seventy-one children with hearing loss and cochlear implants (CI), and 272 typically-hearing (TH) children, participated (aged 1-5 years at Time 1). Parents rated their children's empathic skills (affective empathy, attention to others' emotions, prosocial actions, and emotion acknowledgment) and psychopathological symptoms (internalizing and externalizing behaviors). Children with CI and TH children were rated similarly on most of the empathic skills. Yet, fewer prosocial actions were reported in children with CI than in TH children. In both groups, affective empathy decreased with age, while prosocial actions and emotion acknowledgment increased with age and stabilized when children entered primary schools. Attention to emotions increased with age in children with CI, yet remained stable in TH children. Moreover, higher levels of affective empathy, lower levels of emotion acknowledgment, and a larger increase in attention to emotions over time were associated with more psychopathological symptoms in both groups. These findings highlight the importance of social access from which children with CI can learn to process others' emotions more adaptively. Notably, interventions for psychopathology that tackle empathic responses may be beneficial for both groups, alike.Otorhinolaryngolog