Miraculous, magical, or mundane? The development of beliefs about stories with divine, magical, or realistic causation.

Children's naïve theories about causal regularities enable them to differentiate factual narratives describing real events and characters from fictional narratives describing made-up events and characters (Corriveau, Kim, Schwalen, & Harris, Cognition 113 (2): 213-225, 2009). But what happens when children are consistently presented with accounts of miraculous and causally impossible events as real occurrences? Previous research has shown that preschoolers with consistent exposure to religious teaching tend to systematically judge characters involved in fantastical or religious events as real (Corriveau et al., Cognitive Science, 39 (2), 353-382, 2015; Davoodi et al., Developmental Psychology, 52 (2), 221, 2016). In the current study, we extended this line of work by asking about the scope of the impact of religious exposure on children's reality judgments. Specifically, we asked whether this effect is  domain-general or domain-specific. We tested children in Iran, where regular exposure to uniform religious beliefs might influence children's reasoning about possibility in non-religious domains, in addition to the domain of religion. Children with no or minimal schooling (5- to 6-year-olds) and older elementary school students (9- to 10-year-olds) judged the reality status of different kinds of stories, notably realistic, unusual (but nonetheless realistic), religious, and magical stories. We found that while younger children were not systematic in their judgments, older children often judged religious stories as real but rarely judged magical stories as real. This developmental pattern suggests that the impact of religious exposure on children's reality judgments does not extend beyond their reasoning about divine intervention. Children's justifications for their reality judgments provided further support for this domain-specific influence of religious teaching.

Tolerability of Otic Solutions Containing Different Enrofloxacin Concentrations in Dogs with Healthy Ears.

Otitis externa (OE) is a common disease in dogs, and topical medications are the preferred treatment. Compounded solutions of enrofloxacin are commonly used in practice to treat bacterial OE; however, the tolerability of different concentrations of this antibiotic in the ear canals of dogs has not been evaluated. The objective of this study is to determine if a higher concentration of enrofloxacin applied to the external ear canal is clinically tolerated in dogs with healthy ears. Sixteen client-owned dogs with bilateral healthy ears and no previous history of OE were enrolled. Injectable enrofloxacin 2.27% diluted with sterile sodium chloride in 1:1 (11.35 mg/mL) and 2:1 (15 mg/mL) ratios were applied into the dogs' right and left ears, respectively, q 12 hr for 14 days. Based on video otoscopic examination, clinical score for canine OE (OTIS3) results before application were ≤1 for all dogs. During the study and at the conclusion, all scores remained ≤2, which is considered normal. No cytologic inflammatory cells were seen in any of the dogs' ears throughout the study. Different concentrations of enrofloxacin solution applied topically were well tolerated by dogs with healthy ears and can be considered for the treatment of dogs with bacterial OE.

If I told you everyone picked that (non-affordant) tool, would you? Children attend to conventional language when imitating and transmitting tool use.

This study explored how conventional versus instrumental language influenced children's imitation and transmission of non-affordant tool use. Rather than examining children's imitation of unnecessary actions that do not impede goal completion, we examined children's conformity with a modeled behavior that may result in sacrificing goal completion. Children (N = 96 4- to 6-year-olds) were presented with either a conventional or instrumental description of a model's actions before watching the model choose a non-affordant tool. Children who heard conventional language imitated and transmitted the model's non-affordant tool choice at significantly higher rates than when they heard instrumental language. The results have implications for children, parents, and teachers regarding the extent to which children will conform with what "we" are "supposed" to do.

Culture is an optometrist: Cultural contexts adjust the prescription of social learning bifocals.

The "prescription" of humans' social learning bifocals is fine-tuned by cultural norms and, as a result, the readiness with which the instrumental or conventional lenses are used to view behavior differs across cultures. We present evidence for this possibility from cross-cultural work examining children's imitation and innovation.

Teaching Through Collaboration: Flexibility and Diversity in Caregiver-Child Interaction Across Cultures.

Teaching supports the high-fidelity transmission of knowledge and skills. This study examined similarities and differences in caregiver teaching practices in the United States and Vanuatu (N = 125 caregiver and 3- to 8-year-old child pairs) during a collaborative problem-solving task. Caregivers used diverse verbal and nonverbal teaching practices and adjusted their behaviors in response to task difficulty and child age in both populations. U.S. caregivers used practices consistent with a direct active teaching style typical of formal education, including guiding children's participation, frequent praise, and facilitation. In contrast, Ni-Vanuatu caregivers used practices associated with informal education and divided tasks with children based on difficulty. The implications of these findings for claims about the universality and diversity of caregiver teaching are discussed.

Are high levels of religiosity inconsistent with a high valuation of science? Evidence from the United States, China and Iran.

We asked whether high levels of religiosity are inconsistent with a high valuation of science. We explored this possibility in three countries that diverge markedly in the relation between the state and religion. Parents in the United States (n = 126), China (n = 234) and Iran (n = 77) completed a survey about their personal and parental stance towards science. The relation between religiosity and the valuation of science varied sharply by country. In the U.S. sample, greater religiosity was associated with a lower valuation of science. A similar but weaker negative relation was found in the Chinese sample. Parents in the Iranian sample, by contrast, valued science highly, despite high levels of religiosity. Given the small size of our United States and Iranian samples, and the non-probabilistic nature of our samples in general, we caution readers not to generalise our findings beyond the current samples. Despite this caveat, these findings qualify the assumption that religiosity is inconsistent with the valuation of science and highlight the role of sociocultural context in shaping adults' perception of the relation between religion and science.

Smart Conformists: Children and Adolescents Associate Conformity With Intelligence Across Cultures.

The current study used a novel methodology based on multivocal ethnography to assess the relations between conformity and evaluations of intelligence and good behavior among Western (U.S.) and non-Western (Ni-Vanuatu) children (6- to 11-year-olds) and adolescents (13- to 17-year-olds; N = 256). Previous research has shown that U.S. adults were less likely to endorse high-conformity children as intelligent than Ni-Vanuatu adults. The current data demonstrate that in contrast to prior studies documenting cultural differences between adults' evaluations of conformity, children and adolescents in the United States and Vanuatu have a conformity bias when evaluating peers' intelligence and behavior. Conformity bias for good behavior increases with age. The results have implications for understanding the interplay of conformity bias and trait psychology across cultures and development.

Trust me, I'm a competent expert: Developmental differences in children's use of an expert's explanation quality to infer trustworthiness.

In this study, we examined how 3-, 4-, 5-, and 7-year-old children respond when informants who are labeled as experts fail to provide high-quality explanations about phenomena within their realm of expertise. We found that 4-, 5-, and 7-year-olds discounted their initial trust in an expert who provided low-quality explanations in a task related to the expert's area of expertise. The 5-year-olds' distrust of the expert who provided low-quality explanations also generalized to additional learning tasks. When an expert provided explanations consistent with the expert's labeled expertise, 5-year-olds maintained a similar level of trust in the expert, but 7-year-olds displayed an increased level of trust in the expert within the expert's area of expertise. We did not find consistent preferences in 3-year-olds' judgments. We discuss the implications of these findings for age-based differences in children's relative weighting of trait-based versus real-time epistemic cues when evaluating informant reliability.

Importance ratings on patient-reported outcome items for survivorship care: comparison between pediatric cancer survivors, parents, and clinicians.

PURPOSE: To compare importance ratings of patient-reported outcomes (PROs) items from the viewpoints of childhood cancer survivors, parents, and clinicians for further developing short-forms to use in survivorship care. METHODS: 101 cancer survivors, 101 their parents, and 36 clinicians were recruited from St. Jude Children's Research Hospital. Participants were asked to select eight items that they deemed useful for clinical decision making from each of the four Patient-Reported Outcomes Measurement Information System Pediatric item banks. These item banks were pain interference (20 items), fatigue (23 items), psychological stress (19 items), and positive affect (37 items). RESULTS: Compared to survivors, clinicians rated more items across four domains that were statistically different than did parents (23 vs. 13 items). Clinicians rated five items in pain interference domain (ORs 2.33-6.01; p's < 0.05) and three items in fatigue domain (ORs 2.22-3.80; p's < .05) as more important but rated three items in psychological stress domain (ORs 0.14-0.42; p's < .05) and six items in positive affect domain (ORs 0.17-0.35; p's < .05) as less important than did survivors. In contrast, parents rated seven items in positive affect domain (ORs 0.25-0.47; p's < .05) as less important than did survivors. CONCLUSIONS: Survivors, parents, and clinicians viewed importance of PRO items for survivorship care differently. These perspectives should be used to assist the development of PROs tools.

Parents scaffold flexible imitation during early childhood.

Children use imitation flexibly to acquire the instrumental skills and conventions of their social groups. This study (N=69 parent and 3- to 6-year-old child dyads) examined the impact of instrumental versus conventional language on (a) children's imitative flexibility in the context of parent-child interaction and (b) how parents scaffold children's imitation. Children in dyads presented with conventional language imitated with higher fidelity than children in dyads presented with instrumental language. Parents in dyads presented with conventional language also provided their children with more instruction to imitate and engaged in more encouragement, demonstration, and monitoring than parents in dyads presented with instrumental language. The relation between language cue and children's imitative fidelity was mediated by parent scaffolding behavior. The results provide evidence that caregivers support the development of flexible imitation during early childhood by adjusting their scaffolding according to the goal of the behavior.

Cultural differences in the imitation and transmission of inefficient actions.

Across two studies, we explored cultural differences in children's imitation and transmission of inefficient actions. Chinese American and Caucasian American preschoolers (N=115) viewed either one or three models using two inefficient tools to perform two different tasks. In the video, when the model(s) performed the task, only the inefficient tool was available; thus, their choice to use that tool could be considered rational. Next, children were invited to complete the task with either the inefficient tool or an efficient alternative. Whereas the two cultural groups imitated a single model at similar rates, Chinese American children imitated significantly more than Caucasian American children after viewing a consensus. Similar results were found when exploring differences in information transmission. The Chinese American children were significantly more likely than their Caucasian American peers to instruct using an inefficient tool when they had initially viewed a consensus demonstrate it. We discuss these findings with respect to differences in children's use of social versus task-specific cues for learning and teaching.

Children begin with the same start-up software, but their software updates are cultural.

We propose that early in ontogeny, children's core cognitive abilities are shaped by culturally dependent "software updates." The role of sociocultural inputs in the development of children's learning is largely missing from Lake et al.'s discussion of the development of human-like artificial intelligence, but its inclusion would help move research even closer to machines that can learn and think like humans.

Instrumental and Conventional Interpretations of Behavior Are Associated With Distinct Outcomes in Early Childhood.

Four tasks (N = 191, 3- to 6-year-olds) examined the effect of instrumental versus conventional language cues on children's imitative fidelity of a necklace-making activity, their memory and transmission of the activity, and their perceptions of functional fixedness. Children in the conventional condition imitated with higher fidelity, transmitted more of the modeled behavior, and showed higher levels of functional fixedness than children in the instrumental condition. There were no differences in children's memory of the activity between conditions demonstrating that memory alone does not explain differences in imitative fidelity. The data demonstrate that children's interpretation of behavior as instrumental or conventional has wide-ranging implications for what children imitate, what they transmit to others, and how they reason about objects' functions.

Development of a Novel Patient-Reported Outcome Measure to Assess Symptoms and Impacts of Androgen Deprivation Therapy for Advanced Prostate Cancer.

INTRODUCTION: This qualitative research study was conducted to develop a novel, comprehensive, patient-reported outcome measure (PRO), the "Symptoms and Impacts of Androgen Deprivation Therapy (ADT) for Prostate Cancer" (SIADT-PC), assessing hormonal therapy-related symptoms and their impacts on men with advanced prostate cancer. METHODS: Concept elicitation (CE) interviews were conducted among adult men with prostate cancer to evaluate their experiences with ADT. Based on key symptom and impact concepts mentioned, an initial PRO measure was developed. The draft measure was further assessed in cognitive debriefing (CD) interviews with men with prostate cancer, in which participants reviewed items, response options, and recall periods. Initial item-based psychometric analyses were conducted using interview data. The draft questionnaire was revised on the basis of participant feedback, quantitative psychometric results, and consultation with clinical experts. RESULTS: A total of 21 participants were interviewed (CE concept elicitation, n = 12; CD cognitive debriefing, n = 17; n = 8 completed both). Mean participant age (SD) was 59.7 (8.7) years and 76.2% were white. The de novo SIADT-PC measure consists of 27 items: 11 symptoms (e.g., fatigue, hot flashes, and erectile dysfunction), 2 long-term symptoms (e.g., weight gain), 10 impacts (e.g., impacts on physical activities and relationships), and 4 related to mode of administration (i.e., injection-site reactions). Items were assessed with a 5-point verbal rating scale, with answer choices that capture frequency or severity. CONCLUSIONS: Once fully validated, this de novo measure may be used in clinical studies and clinical practice to assess hormone therapy-related symptoms and impacts, enabling physicians to identify timely and appropriate interventions.

Everyone's a Critic (Sometimes): Young Children Show High Awareness of, But Lower Adherence to, Prosocial Lying Norms.

From an early age, children are taught norms about socially-acceptable behaviors; however, children's ability to recognize these norms often predates their tendency to follow them. This conflict between understanding and action has been predominantly studied in cases when enacting the norm would be costly for the child (i.e. when sharing would result in forgoing resources), but is underexplored in more low-cost scenarios. The current study examined the gap between children's knowledge and behavior in a context with a low personal cost: telling a prosocial, or white, lie. Children (N = 46) evaluated objectively poor drawings in three contexts: in one context, children were asked how a third-party character should act in a story (to assess knowledge) and in the other two contexts, children were asked to provide real-time feedback to another person and to a puppet (to assess behavior). Results indicated that children endorsed prosocial lying norms (i.e. said the story character should give the drawing a good rating) at a significantly higher rate than they demonstrated through their own lie-telling behaviors (i.e. their willingness to give social partners good ratings). These data indicate that the discrepancy between children's knowledge of social norms and their actual behaviors cannot simply be attributed to the personal costs of enacting social norms. Instead, this competence-performance gap may be due to the fact that children are often taught social rules via hypothetical situations but enacting behaviors in real-world situations may require additional skills, such as inhibition and the processing of complex, multimodal social cues.

Otitis media with effusion in two Boston terrier dogs.

Otitis media (OM) in dogs can occur as a primary condition instead of as an extension of an otitis externa (OE), characterized by the presence of fluid in the middle ear (ME) referred to as OM with effusion (OME). OME has been reported in a brachycephalic breed (boxer), and the same condition is described as primary secretory OM in Cavalier King Charles Spaniels. These dogs can be asymptomatic or present with pain, facial nerve paralysis and reduced hearing. This report describes two cases of OME with associated neurologic signs in Boston terriers with no previous history of OE, normal external ear canals and tympanic membranes. Neurologic evaluation revealed right head tilt along with vestibular ataxia and frequent walking tight circles to the right in case 1, and a dull mentation with a right-sided head tilt and torticollis, vestibular tetra-ataxia, ambulatory tetraparesis and circling to the right in case 2. MRI imaging of the brain was performed. Results showed bilateral OM with right-sided otitis interna and equivocal associated otogenic meningitis in case 1 and right-sided OM in case 2. Myringotomy was performed, and both dogs' ME sampled for cytology that only revealed inflammatory cells; and bacterial cultures which revealed a light growth of Pseudomonas aeruginosa in case 1. ME were flushed with sterile saline. Oral glucocorticoids and antibiotics based on the susceptibility results, and a compound antibiotic and glucocorticoid ear solution were prescribed to case 1. Neurologic improvement was observed a few days after the appointment, but a mild right-sided head tilt remained evident. Owner of case two elected humane euthanasia due to patient respiratory difficulties upon anaesthetic recovery and other concurrent healthy concerns. Current findings reinforce that brachycephalic dogs may be prone to develop OME, and advanced imaging tests are key to the diagnosis.

Expressions of uncertainty in invisible scientific and religious phenomena during naturalistic conversation.

Across cultures, studies report more confidence in the existence of unobservable scientific phenomena, such as germs, as compared to unobservable religious phenomena, such as angels. We investigated a potential cultural mechanism for the transmission of confidence in the existence of invisible entities. Specifically, we asked whether parents in societies with markedly different religious profiles-Iran and China-signal differential confidence across the domains of science and religion during unmoderated conversations with their children (N = 120 parent-child dyads in total; 5- to 11-year-olds). The results revealed that parents used fewer lexical cues to uncertainty when discussing scientific phenomena, as compared to religious phenomena. Unsurprisingly, this cross-domain distinction was observed among majority belief, secular parents in China (Study 2). More importantly, however, the same pattern was observed among parents in Iran, a highly religious society (Study 1), as well as among minority belief, religious parents in China (Study 2). Thus, adults in markedly different belief communities spontaneously express less confidence in religious, as compared to scientific, invisible entities in naturalistic conversation. These findings contribute to theories on the role of culture and testimony in the development of beliefs about unobservable phenomena.

Content validity of a newly developed observer-reported measure for pediatric asthma in children aged 2-5 years.

BACKGROUND: An observer-reported outcome (ObsRO) measure assessing both symptom control and health-related quality of life (HRQoL) in children with asthma younger than 6 years is lacking. The objective of this study was to evaluate the content validity of the Pediatric Asthma Questionnaire (PAQ), a newly developed 6-item ObsRO measure for caregivers of children aged 2-5 years diagnosed with asthma. RESULTS: In-depth, qualitative interviews were conducted with 15 parents or caregivers. The first part of the interview was an open-ended discussion whereby participants were asked to describe their observations of their child's asthma symptoms and HRQoL impacts followed by a cognitive debriefing of a draft version of the PAQ. The most frequently reported symptoms were coughing (n = 15, 100%), wheezing (n = 14, 93%), and trouble breathing (n = 10, 67%). Overall, participants found the PAQ easy to complete and relevant to their child's experience with asthma, with most reporting the instructions, response scales, and recall period for the items to be appropriate. The majority of participants (93%) believed they could accurately report on the items included in the PAQ based on their observations of their child's asthma symptoms and impacts, or reliably get the information from the child's teacher, school, or caregiver when their child was not in their presence. One item was modified based on feedback about the phrase "oral steroids" to clarify modes of administration. A few other minor changes were incorporated into the PAQ following suggestions from participants, including replacing the phrase "how often" with "how many days" in one of the items to improve clarity and overall consistency with the response options. CONCLUSION: Qualitative data support the content validity of the PAQ as a fit-for-purpose and well-understood 6-item observer-reported outcome measure to evaluate both symptoms and asthma-specific HRQoL impacts experienced by pediatric asthma patients aged 2-5 years for use in clinical and real-world studies.

Cognitive flexibility supports the development of cumulative cultural learning in children.

The scale of cumulative cultural evolution (CCE) is a defining characteristic of humans. Despite marked scientific interest in CCE, the cognitive underpinnings supporting its development remain understudied. We examined the role cognitive flexibility plays in CCE by studying U.S. children's (N = 167, 3-5-year-olds) propensity to relinquish an inefficient solution to a problem in favor of a more efficient alternative, and whether they would resist reverting to earlier versions. In contrast to previous work with chimpanzees, most children who first learned to solve a puzzlebox in an inefficient way switched to an observed, more efficient alternative. However, over multiple task interactions, 85% of children who switched reverted to the inefficient method. Moreover, almost all children in a control condition (who first learned the efficient method) switched to the inefficient method. Thus, children were keen to explore an alternative solution but, like chimpanzees, are overall conservative in reverting to their first-learned one.