Developmental differences in children's learning and use of forensic ground rules during an interview about an experienced event.

Children often answer questions when they do not have the requisite knowledge or when they do not understand them. We examined whether ground rules instruction-to say "I don't know," to tell the truth, and to correct the interviewer when necessary-assisted children in applying those rules during an interview about a past event and whether doing so was associated with more accurate accounts. We compared children with intellectual disabilities (mild or moderate severity, n = 44, 7-12 years) with 3 groups of typically developing children (2 matched for mental age, and 1 for chronological age, n = 55, 4-12 years) on their understanding of 3 ground rules, their use of these rules in an interview, and their accuracy in recalling a personally experienced event. Many children were able to demonstrate proficiency with the rules following simple instruction but others required additional teaching. Children applied the rules sparingly in the interview. Their scores on the practice trials of each rule were unrelated to each other, and to the use of the rules in context. Their developmental level was significantly related to both of these skills. Regression models showed that developmental level was the best predictor of children's accuracy when they recounted their experience during the interview but that use of responses consistent with the rules, in conjunction with developmental level, predicted accurate resistance to suggestive questions. Future research should identify how best to prepare children of different ages and cognitive abilities to answer adults' questions appropriately. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Narrative skill and testimonial accuracy in typically developing children and those with intellectual disabilities.

Children must describe maltreatment coherently for their testimony to be influential in court. We know little about how well children with intellectual disabilities (CWID) describe their experiences relative to typically developing (TD) children, despite CWID's vulnerability to maltreatment. We investigated children's reports of an experienced event and compared coherence in CWID (mild to moderate impairment: 7-11 years) with TD children matched for mental (4-10 years) or chronological age (7-11 years). All children included important markers of narrative coherence in their reports. Children with lower mental ages, particularly those with an intellectual disability, included fewer markers of narrative coherence in their reports than children with higher mental ages. Individual markers of narrative coherence, particularly recall of content, predicted accuracy of testimony and resistance to suggestion even when disability and mental age were taken into account. These findings highlight the importance of helping children to describe their experiences coherently.

A Tailored Family-Based Obesity Intervention: A Randomized Trial.

OBJECTIVE: To determine whether a 2-year family-based intervention using frequent contact and limited expert involvement was effective in reducing excessive weight compared with usual care. METHODS: Two hundred and six overweight and obese (BMI ≥85th percentile) children aged 4 to 8 years were randomized to usual care (UC) or tailored package (TP) sessions at university research rooms. UC families received personalized feedback and generalized advice regarding healthy lifestyles at baseline and 6 months. TP families attended a single multidisciplinary session to develop specific goals suitable for each family, then met with a mentor each month for 12 months, and every third month for another 12 months to discuss progress and provide support. Outcome measurements (anthropometry, questionnaires, dietary intake, accelerometry) were obtained at 0, 12, and 24 months. RESULTS: BMI at 24 months was significantly lower in TP compared with UC children (difference, 95% confidence interval: -0.34, -0.65 to -0.02), as was BMI z score (-0.12, -0.20 to -0.04) and waist circumference (-1.5, -2.5 to -0.5 cm). TP children consumed more fruit and vegetables (P = .038) and fewer noncore foods (P = .020) than UC children, and fewer noncore foods were available in the home (P = .002). TP children were also more physically active (P = .035). No differences in parental feeding practices, parenting, quality of life, child sleep, or behavior were observed. CONCLUSIONS: Frequent, low-dose support was effective for reducing excessive weight in predominantly mild to moderately overweight children over a 2-year period. Such initiatives could feasibly be incorporated into primary care.

Preserving the Past: An Early Interview Improves Delayed Event Memory in Children With Intellectual Disabilities.

The influence of an early interview on children's (N = 194) later recall of an experienced event was examined in children with mild and moderate intellectual disabilities (CWID; 7-12 years) and typically developing (TD) children matched for chronological (7-12 years) or mental (4-9 years) age. Children previously interviewed were more informative, more accurate, and less suggestible. CWID (mild) recalled as much information as TD mental age matches, and were as accurate as TD chronological age matches. CWID (moderate) recalled less than TD mental age matches but were as accurate. Interviewers should elicit CWID's recall as early as possible and consider developmental level and severity of impairments when evaluating eyewitness testimony.

Parental motivation to change body weight in young overweight children.

OBJECTIVE: To determine what factors are associated with parental motivation to change body weight in overweight children. DESIGN: Cross-sectional study. SETTING: Dunedin, New Zealand. SUBJECTS: Two hundred and seventy-one children aged 4-8 years, recruited in primary and secondary care, were identified as overweight (BMI ≥ 85th percentile) after screening. Parents completed questionnaires on demographics; motivation to improve diet, physical activity and weight; perception and concern about weight; parenting; and social desirability, prior to being informed that their child was overweight. Additional measures of physical activity (accelerometry), dietary intake and child behaviour (questionnaire) were obtained after feedback. RESULTS: Although all children were overweight, only 42% of parents perceived their child to be so, with 36% indicating any concern. Very few parents (n 25, 8%) were actively trying to change the child's weight. Greater motivation to change weight was observed for girls compared with boys (P = 0.001), despite no sex difference in BMI Z-score (P = 0.374). Motivation was not associated with most demographic variables, social desirability, dietary intake, parenting or child behaviour. Increased motivation to change the child's weight was observed for heavier children (P < 0.001), those who were less physically active (P = 0.002) and more sedentary (P < 0.001), and in parents who were more concerned about their child's weight (P < 0.001) or who used greater food restriction (P < 0.001). CONCLUSIONS: Low levels of parental motivation to change overweight in young children highlight the urgent need to determine how best to improve motivation to initiate change.

Do parents recall and understand children's weight status information after BMI screening? A randomised controlled trial.

OBJECTIVES: As parents of young children are often unaware their child is overweight, screening provides the opportunity to inform parents and provide the impetus for behaviour change. We aimed to determine if parents could recall and understand the information they received about their overweight child after weight screening. DESIGN: Randomised controlled trial of different methods of feedback. SETTING: Participants were recruited through primary and secondary care but appointments took place at a University research clinic. PARTICIPANTS AND INTERVENTION: 1093 children aged 4-8 years were screened. Only overweight children (n=271, 24.7%) are included in this study. Parents of overweight children were randomised to receive feedback regarding their child's weight using best practice care (BPC) or motivational interviewing (MI) at face-to-face interviews typically lasting 20-40 min. 244 (90%) parents participated in a follow-up interview 2 weeks later to assess recall and understanding of information from the feedback session. PRIMARY AND SECONDARY OUTCOME MEASURES: Interviews were audio-taped and transcribed verbatim before coding for amount and accuracy of recall. Scores were calculated for total recall and sub-categories of interest. RESULTS: Overall, 39% of the information was recalled (mean score 6.3 from possible score of 16). Parents given feedback via BPC recalled more than those in the MI group (difference in total score 0.48; 95% CI 0.05 to 0.92). Although 94% of parents were able to correctly recall their child's weight status, fewer than 10 parents could accurately describe what the measurements meant. Maternal education (0.81; 0.25 to 1.37) and parental ratings of how useful they found the information (0.19; 0.04 to 0.35) were significant predictors of recall score in multivariate analyses. CONCLUSIONS: While parents remember that their child's body mass index is higher than recommended, they are unable to remember much of the information and advice provided about the result. TRIAL REGISTRATION NUMBER: Australian New Zealand Clinical Trials Registry ACTRN12609000749202.

Using motivational interviewing for weight feedback to parents of young children.

AIM: To determine whether a single session of motivational interviewing (MI) for feedback of a child's overweight status promotes engagement in treatment following screening. METHODS: One thousand ninety-three children aged 4-8 years were recruited through primary and secondary care to attend health screening, including assessment of parenting practices and motivation (questionnaire). Families with normal-weight children were informed about their child's weight but had no further involvement. Parents of overweight (body mass index ≥ 85th percentile) children (n = 271) were randomised to receive weight feedback via MI or best practice care (BPC) using a traffic light concept to indicate degree of health risk. Follow-up interviews were held 2 weeks later to examine intervention uptake, changes to motivation and behaviour, and parental response to feedback. RESULTS: Recruitment into the intervention was high (76%) and not altered by feedback condition (percentage difference 6.6 (95% confidence interval -2.9, 16.0). High scores on the Health Care Climate Questionnaire (rating of the interviewer) indicated satisfaction with how the information was provided to parents. No differences were observed in multiple indicators of harm. However, self-determined motivation for healthy life-styles was significantly higher in the MI condition at follow-up (0.18: 0.00, 0.35), after only a single session of MI. CONCLUSIONS: MI and BPC were both successful in encouraging parents to participate in a family-based intervention, with MI offering little significant benefit over BPC. A traffic light approach to weight feedback is a suitable way of providing sensitive information to parents not expecting such news.

The NICHD investigative interview protocol: an analogue study.

One hundred twenty-eight 5- to 7-year-old children were interviewed using the National Institute of Child Health and Human Development (NICHD) Investigative Interview Protocol about an event staged 4 to 6 weeks earlier. Children were prepared for talking about the investigated event using either an invitational or directive style of prompting, with or without additional practice describing experienced events. The open invitation prompts (including those using children's words to encourage further reporting) elicited more detailed responses than the more focused directive prompts without reducing accuracy. Children were most responsive when they had received preparation that included practice describing experienced events in response to invitation prompts. Overall, children were highly accurate regardless of prompt type. Errors mostly related to peripheral rather than central information and were more likely to be elicited by directive or yes/no questions than by invitations. Children who provided accounts when asked about a false event were less accurate when describing the true event. Children who received preparation that included practice recalling a recent event in response to directive and yes/no questions were least accurate when questioned about the false event first. The data provide the first direct evaluation of the accuracy of information elicited using different prompt types in the course of NICHD Protocol interviews, and underscore the importance of how children are prepared for subsequent reporting.

The influences of delay and severity of intellectual disability on event memory in children.

OBJECTIVE: To examine the ability of children with intellectual disabilities to give reliable accounts of personally experienced events, considering the effects of delay, severity of disability, and the types of interview prompt used. METHOD: In a between-subjects design, we compared children with intellectual disabilities (7-12 years) that fell in either the mild-borderline range (n = 46) or the moderate range (n = 35) and typically developing children matched for either chronological age (7-12 years; n = 60) or mental age (4-9 years; n = 65) with respect to memories of an interactive event about which they were interviewed after either a short (1-week) or long (6-month) delay. Children were interviewed using the National Institute of Child Health and Human Development (NICHD) Investigative Interview Protocol (Lamb, Hershkowitz, Orbach, & Esplin, 2008) to elicit their recall of the event and were then asked a series of highly suggestive questions to allow both their reliability and suggestibility to be examined. RESULTS: The children with mild intellectual disabilities were as able as their mental age matches, whereas children with more severe cognitive impairments were qualitatively different across the various competencies examined. However, even children with more severe impairments were highly accurate in this supportive interview context. CONCLUSIONS: The findings indicate that children with intellectual disabilities can be valuable informants when forensically interviewed and can provide clear guidance about the ways in which they should be interviewed.

Supportive or suggestive: Do human figure drawings help 5- to 7-year-old children to report touch?

The authors examined the accuracy of information elicited from seventy-nine 5- to 7-year-old children about a staged event that included physical contact-touching. Four to six weeks later, children's recall for the event was assessed using an interview protocol analogous to those used in forensic investigations with children. Following the verbal interview, children were asked about touch when provided with human figure drawings (drawings only), following practice using the human figure drawings (drawings with instruction), or without drawings (verbal questions only). In this touch-inquiry phase of the interview, most children provided new information. Children in the drawings conditions reported more incorrect information than those in the verbal questions condition. Forensically relevant errors were infrequent and were rarely elaborated on. Although asking children to talk about innocuous touch may lead them to report unreliable information, especially when human figure drawings are used as aids, errors are reduced when open-ended prompts are used to elicit further information about reported touches.