children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 5, no. 2, 2022 www.scholink.org/ojs/index.php/ct 31 original paper eroticism in ayu utami’s novels “saman” and “larung” and its implications for literature learning in high school ratu wardarita1*& erwanto2 1university of pgri palembang, south sumatera, indonesia 2university of baturaja, south sumatera, indonesia *ratu wardarita, university of pgri palembang, south sumatera, indonesia received: november 1, 2021 accepted: november 18, 2022 online published: november 28, 2022 doi:10.22158/ct.v5n2p31 url: http://dx.doi.org/10.22158/ct.v5n2p31 abstract this study aims to describe the depiction of female eroticism, the idea of feminism in saman and larung novels written by ayuutami, and its implications for learning literature in high school. the method used in this research is a descriptive method utilizing qualitative analysis. the data source in this research is saman and larung novels written by ayuutami. data analysis utilized work analysis technique. based research result, the types of eroticism include metabolic erotica, biological erotica, metabolic/biological erotica, whereas the expression of erotism includes the mention of genitals, descriptions of sexual scenes, descriptions of sexual intercourse scenes, descriptions of sexual misconduct, descriptions of sensual body parts. the idea of feminism is rebellion against the rules, customs, and norms of society, the movement that always opposes unjust rulers, representating women aiming for freedom, against the patriarchy on women, the struggle for equality and rights between men and women, the struggle against differences the sex system, and the struggle to resist discrimination and cultural values that undermine women. based research result and its the relevance of core competence and basic competence in the curriculum of 2013, these novels are not relevant to be used as a literary teaching material in schools, but in terms of feminism, ideas can add literature value in high school. keywords feminism, erotism, saman, larung, 2013 curriculum www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 32 published by scholink inc. 1. introduction literature is one of the forms of cultural representation that describes gender relations and routines. in addition, literary texts can also reinforce and create new gender stereotypes that are more representative of gender freedom (sofia, 2009, p.21). in modern times, women in various countries, including indonesia began to question, sue for domination, and injustice. these forms of injustice include marginalization or economic impoverishment, subordination or insignificance in political decisions, stereotypical formation or through negative labeling, violence, longer and more workloads, and socialization of gender roles (sofia, 2009, p.12). literature is a work that tells the society life in the past as well as present. literary works as verbal symbols have several roles among them as a way of understanding, how to connect, and the way of creation. the object of literature is the reality, the events that occur in the real world. thus, literary works can translate events into linguistic form in order to understand events according to the ability of the author. literary works can be a means for the author to convey thoughts, feelings, and responses about an event. literary work is also a re-creation of an event in accordance with the quality of the author’s knowledge. in creating his literary works can not release the language element. they automatically wrestle with language, because language is the medium for the pronunciation of his literary results (kasnadi & sutejo, 2010, p. 36). literary works have a wide opportunity to talk about things, including love, men, and women. creation of literary works can not be separated from social context. therefore, literary work is not just a daydream, a figment of imagination, or a fantasy, but rather the reality of another life in the author. the reality of life thus appears in self-experience, inner experience, language experience, and author’s aesthetic experience (kasnadi & sutejo, 2010, p. 134). a literary work must possess a theme and message conveyed to the reader. especially in saman and larung novels by ayu utami on sexuality. the issue of sexuality is one of the greatest humanitarian problems always encountered in literature at any time. the imagery of sexuality erotica is conceptually intended as all the pronunciation of the author (through language) depicting sexuality in the social touch of the imagery of erotic sexuality capable of providing an image (image) that leads the reader to discover beauty in a literary text (kasnadi & sutejo, 2010, p. 146). indonesian literature has raised a number of themes related to sex and love. previous literary works, both written by male and female writers, describes sex experience in metaphorical or disguise, as seen in several works including ronggeng dukuh paruk or bekisar merah by ahmad tohari. controversies about sex or images of erotic manners in literature have begun long ago. eroticism could be paired with pornography. however, between there is the difference between the two. according to hoed (in utomo et al., 2001, p.4), eroticism leads more to the description of behavior, circumstances, or atmosphere based on libido, in the sense of sexual desire. conversely, the atmosphere is based on libido (in a sexual sense) highlighted to arouse lust. thus, eroticism has the meaning of depictions in terms of action, www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 33 published by scholink inc. circumstance or atmosphere verbally depicted, whereas pornography has a meaning whose depictions are visual, indecent, and dirty. in the eastern societies, saman and larung novels discuss the most intimate and sexually discussed female organs, especially on the part of female characters. controversies on sex or images of erotic matters in literature have begun early on. in the balai pustaka generation’s nota rinkes, for example, it is considered to violate the norms of society or taboo and inflicts“moral corruption”, because the side of sexuality that feels more “new” because of the way of disclosure that is very different from previous patterns; making this feature into the main focus of the audience. so far, most people consider sex to be a taboo as a topic itself. from the point of view of the literary response, the word “taboo” and “moral corruption” is a form of a reader’s negative reception of the values or norms that represent the literary society against sex-themed literature. literature containing sexual theme serve as a bridge in the struggle of feminists to equalize gender. using these works as evidence, they are still eager to fight for the rights of women, especially in terms of writing sexuality in a literary work. feminists and women’s emancipation fighters want to position women in gender equality. feminism can not be separated from the female figure as a fighter. feminism is a women’s movement demanding equal rights between women and men (moeliono et al.,cited by sugihastuti, 2010, p. 18). feminism is related to the concept of feminist literary criticism which focuses its analysis on women. there is an assumption that those representing readers and creators in western literature are men. feminist literary criticism suggests that female readers bring perceptions and expectations into the literary experience (showalter cited by sugihastuti, 2010, p. 18). feminist literature critiques concerns “politics” in the literary system of communication, that is, a politics that alters the life relationships between women and men in literary communication systems (millet cited sugihastuti, 2002, p. 20). one of the results of human creation as an effort envision the relationship between women and men is a novel. novel is one type of literary work that reveals a wide range of events. novel gained a lot of attention and interest from many people. in addition, the novel possesses character, behavior, and plot. in other words, the novel involves a number of characters conducting something in a total context organized or arranged in logical order, chronological, causal, and so forth (azies & abdul, 2010, p. 4). saman and larungare novels oriented towards gender equality. the female characters featured by ayu utami are figures demanding equality, both in social, political and sex, in particular, the controversy over the issue of sexuality expressed in the two novels. both of these novels place female characters on par with men. the rapid development of feminism has shifted little by little the imbalances that have occurred so far. this is seen in saman and larung novels by ayu utami, they are more accepting of other advantages and strengths possessed by women. in connection with the development of feminism and sexuality controversy issue in both novels, this research is directed at erotism in saman and larung novels by ayu utami and its implications in high www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 34 published by scholink inc. school literary learning. the reasons for choosing the two novels are as follows: first, saman and larung’s novel by ayu utami has courage in raising sex problem and experience, even though the society considers it violates the norms of society. second, the emergence of two groups, the group that welcomed (positive) and the group who underestimate (negative) the emergence of novel works such as saman and larung by ayu utami which raises sexuality theme. third, the emergence of ayu’s work dared to fight society norm which is rooted in community with cultural conventions. the novel is interesting precisely because it violates the norms of traditional society, so through resistance against violating the norms of society, they discuss women phenomenon, especially in terms of sex. fourth, saman and larung are novel which content is loaded with gender issues such as politics and sex. when men are engaged in thrilling politics, women are busy discussing the issue of sexuality. saman and larungwere selected as an object of research in the study of feminist literary criticism. research on feminism especially on indonesian novels has been done by some literary observers. the study, among others. didi suhendi (2000) in his thesis entitled gender in ronggeng dukuh paruk, lintang kemukus dini hari, and jantera bianglala by ahmad tohari: criticism study of feminism literature (gender dalam ronggeng dukuh paruk, lintang kemukus dini hari, dan jantera bianglala karya ahmad tohari: kajian kritik sastra feminisme) exhibits evidence that women belong to men. the female identity is reduced only to the biological-sexual aspect that utilizes the body as an object of view and possession. ernalida (2000) examines the gender markers in saman novel by ayu utami and its relation to perceptions of the palembang society on gender roles (penanda gender dalam novel saman karya ayu utami dan kaitannya dengan persepsi masyarakat palembang tentang peran gender). research result, among others, is words that refer to the gender of men and women. there are words that refer only to the gender of men and women as well as neutral words, in the sense that they refer to both genders. rika ayu (2002) examines masculine females in saman and larung novels. research result indicates that there is a process of masculinization aspects of sexuality and aspects of the division of labor. yenny puspita (2003) in gender and patriarchy in saman and larung novels by ayu utami. research result indicate that there are female characters who experienced masculinization such as cok, shakuntala, yasmin, and laila. the female characters possess a strong character to object against and sue the patriarchal system. they have the intellectual power and obtain enough education. they are figures representing feminists. in addition, there are special female characters, upi, simbah larung and suprihatin. based on research results above, it is clear that the study of feminist literary criticism contained in the literary work is interesting to be studied. similar previous research with this research is both doing research studies of feminism literary criticism. in contrast to previous studies, this study examines the eroticism of women, especially the depictions of erotic text in saman and larung novels by ayu utami, www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 35 published by scholink inc. the emancipation movement and the idea ofwomen’s emancipation and feminism in saman and larung novels by ayu utami, and the implications of saman and larung novels by ayu utami in high school literature study. based on the background above, this research problem is formulated as follows: [1] how is the depiction of erotism in saman and larung’s novel by ayu utami? [2] how is the idea of feminism in saman and larung novel by ayu utami? [3] how are the implications of research results on the study of literature in high school? this research is expected to be beneficial theoretically and practically. the theoretical benefits areexpected to illustrate the eroticism described in saman and larung novels by ayu utami; describes the idea of feminism in the saman and larung novels by ayu utami and the implications of research results in high school literature study. research result can provide the following practical benefit: (1) for literature readers, adding insight and knowledge regarding eroticism, feminism ideas insaman and larungnovels by ayu utami. (2) for other researchers, this research could be utilized as a reference in conducting further research, especially about erotism, feminism idea in saman and larung novels by ayu utami. (3) for indonesian teachers, contributing literary learning materials, especially in high school literature study and taking the example of good character behavior from the results of the research analysis. 2. method in a broader sense, method is perceived as ways, strategies for understanding reality, systematic steps to break the next sequence of causation (ratna, 2011, p. 34). the method in this research is a descriptive method of qualitative analysis, is a combination of the descriptive method of analysis and qualitative method. “descriptive analytic method is done by describing facts followed by analysis” (ratna, 2011, p. 53). qualitative methods,“the qualitative method is to entirely utilize interpretive means by presenting it in the form of a description” (ratna, 2011, p. 44). in this research, descriptive method of qualitative analysis is used to describe the eroticism of female sexuality in saman and larung novels by ayu utami and its implications for literature learning in high school. the approach used in this research is feminist literary criticism. a feminist literary critique approach is a literary study that leads the focus of analysis to women. if it has been assumed that those representing readers and creators in literature are male, feminist literary critics suggest that women readers brings perception and expectations into the literary experience (sugihastuti, 2005, p. 18). 3. research result eroticism in saman and larung novels by ayu utami includes erotic expressions. the erotic expressions encountered by researchers in saman and larung novels by ayu utami is metabolic erotica, biological erotica, and metabolic/biological erotica. www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 36 published by scholink inc. based research result, erotism in samanwere erotic type and erotic disclosure. the erotic analysis encountered by researchers saman and larung novels by ayu utami is a metabolic erotica. metabiologically meaning, metaphorical, symbolic, and packed metaphorical imagery, which is described in subtle discourse, giving the reader more intensive imagination. in the metabolic erotica, the author delivers the scene to providereader sexual scenes without a rule, an adultery, a free sexual relationship between two characters or an affair. the author also describes the biological disclosure by using pronunciation to indicate infidelity, a free sexual relationship between two characters, scenes of sexual intercourse used naturally. the author also describes depictions through the introduction of human sexual organs expressed in a rough, transparent manner without a symbolic mention of the genitals. the author expressed openly without symbols. integrally pronouncing sexuality erotica is combined with the use of metabolic erotica and biological erotica. erotica metabiological sexuality is used in conjunction with biological erotica. the behavior and culture of a country’s sexual perception are depicted by the appearance of a tool that can add to the satisfaction of sex and sexual life in a school community. the manner in which the erotic disclosure by means of the genital description can be director indirect. for example, mentioning”natural pipe” on the script and so on. despite the mention of the genitals is disguised, the word implies and has the meaning of genitalia. it also described kiss, hugs scenes up to poking. descriptions of sexual intercourse scenes are described as something natural. descriptions of sexual misconduct in the form of sexual practices that deviate from modesty. this can be seen when the depictions of sexual abuse which exceeds existing limits or norms of decency, description of sensual body parts in the form of sensual body portrayals. this sensual depiction is illustrated in a character’s physical features such as lips, eyes, noseetc. there is metabiological disclosure aspect found in larung. in addition to exhibiting the turmoil and sexual behavior with various forms, the aspect of sexuality that describes sex in larung novel also describes the technique of prolonging the game of metaphorical sexuality. sex life in society is described inlarung. metabolic erotic disclosures describe sexual misconduct and infidelity, exhibiting free sex relationship between sexes. sex life illustrated in past tense and adultery in society are featured in larung. biological erotica illustrates sexuality which is visualized clearly, openly, transparently and in detail. it describes biological portrayal through the organs of human sexuality called organal and functional. ayu also reveals biological erotica and metabolic erotica together. the biological erotica was expressed in direct words describing male characters.metabolic erotica is expressed in symbolic and subtle words.larungmentions female genitalia and men exposed subtly or indirectly. the authormentions genitals directly in a vulgar manner, as described in a sex scene. it is described in hugs, kisses, or poking scenes. erotic element in sexual relationship is described as something natural. descriptions through sensual abuses are a description of abuse or deviation from modesty relating to sexuality. www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 37 published by scholink inc. sexual deviation is described in deviated manner compared to existing norm. description of erotic elements through the sensual body is a description of visible body parts which incites someone’s lust, which is a sensual body portrayal. the idea of feminism flow through each female character in the novel.it is a rebellion against the rules, customs, norms of society, the movement that always oppose unjust rulers, representing women struggle in obtaining freedom, opposing patriarchy which limits women, the struggle for equality and rights between men and women, against differences in the sex system, and rejecting discrimination and cultural values that undermine women. to obtain the unanimity of meaning in a study, it is necessary to discuss building elements in literary works, especially novels. the dominant elements of saman and larung novels by ayu utami are the characters. the characters of the story in ayu utami’s saman are human. they are named to distinguish one character from another. the names of the characters are saman and four female characters namely shakuntala, laila, cok, and yasmin. they are young, educated, and possess career. saman is a person who has an attitude of caring and loving fellow human beings. saman also has a gentle attitude, is not resistant to violence, and has a concern for the community. laila is a very courageous, caring, kind and ready to sacrifice herself to person she loves. yasmin is a lawyer, a smart, rich and productive person. cok is a cheerful person. sakuntala is a free person. the auxiliary character in the novel saman is sihar is a man who already has a wife and a man who is loved by laila. rosano is a son of a mining department official who has a friendly but arrogant attitude. upi is someone who is mentally retarded. anson is a hard worker who has a blind eye and is an older brother to upi. mak afgani is a kindhearted person. hasyim ali is a hard worker. the main characters in the novel larung are saman, cokorda gita magaresa, laila gagarina, shakuntala, yasmin moningka, sihar situmorang. the technique of depicting characters and characterizations in this novel uses dramatic techniques or indirect techniques. larung has a pleasant yet sometimes frightening, and loving nature. nenek (granny) larung is a modest and a strong female figure. a strong figure because his body is full pins. based on core competencies and basic competencies, the results of this study can not be used as a literary material, especially vulgar language usage. preferably in the application in school, teachers play an active role to explain as well as possible and guide students in the application of the literary work of the novel. good and bad wisdom that can be taken in the content of the novel under study. the idea of feminism based on research result is very relevant to be used as a literary study material, especially in increasing insight in high school. the idea of feminism is in line with wardani’s opinion (2011)whoexplained that larung is a novel that contains the efforts of the feminist movement, especially about gender conflict and society’s view of a woman. this novel is very appropriate to lift the feminism in the literature study through role playing activities.walidin (2007) explains that: www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 38 published by scholink inc. since the “nota rinkes” of balai pustaka, sexuality in indonesian literature works is considered a negative aspect by the community. however, since saman (1998) was published, the reader’s response to sexuality has changed. this is evident from the positive response of the literary critics of this multidimensional charge of the novel. the reader’s positive response was also born from other literary authors (mostly women) who felt confident to open up the issue of sexuality in a vulgar and diverse manner. in addition, there are indications of disagreement from the general public to the discourses of sexuality raised, such as educational observers, writers who still emphasize morality, and women who do not like being stripped naked in public. the above opinion provides an explanation that some reader agree with novels with sexual theme. but education-based observers stated their disagreement. furthermore, pradopo (in walidin, 2007) states that: …has started early. in the generation of balai pustaka ‘nota rinkes’ for example, is considered to violate the taboo and “damage the morale”. also, armijn pane’s “belenggu”which questioned love and infidelity also caused controversy. in the late 1960s, motinggo busye’s bibi marsiti’s trilogy is considered to contain many elements of pornography which caused never-ending discussion. the quotation above explains that in balai pustaka generation, literary work containing sex theme is considered to violate the taboo and caused lengthy discussion. however, djokosudjatno (http://mwalidin.blogspot.com/2007/12/seksualitas-dalam-novel-indonesia) explains that: in the case of sexuality disclosure in the literary works written by female authors, their works received positive readers’ receptions to this new type of novel. for example, djokosudjatno (2004, p. 7) appreciated ayu’s efforts in saman and larung as a positive contribution to the discourse on women’s superiority in sexuality. the above quotation explains that saman and larung novels by ayu utami is a positive contribution to women’s superiority in sexuality. the above quotation explains that the saman and larung novels by ayu utami is a positive contribution to the superiority of women in sexuality. 4. conclutions based on the results of this study can be summarized as follows: [1] saman and larung novels by ayu utami describes metabolic erotica, biological erotica, and metabolic/biological erotica. erotic disclosure in the two novels is seen in scenes that lead to erotism such as mentioning genitals, descriptions of explicit scenes, descriptions of sexual intercourse scenes, descriptions of sexual misconduct, descriptions of sensual body parts in the form of sensual body portrayals. www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 39 published by scholink inc. [2] based on analysis result, movement of women’s emancipation and the idea of feminism in saman and larung novels are a rebellion against the rules, customs and norms of society, the movement that always oppose unjust rulers, women struggles in obtaining freedom, against patriarchy that limits women, the struggle for equality and rights between men and women, against differences in the sex system, and to resist discrimination and cultural values that depreciate women. [3] based on research result associated with core competence and basic competence in the 2013 curriculum, viewed from erotism perspective, these novels are not relevant to be used as a material for high school literature study. therefore, teachers must play an active role to explain and guide students in teaching literature, especially novels. good and bad moral can be taken from the novel taught. however, in terms of feminism ideas, this research can add literature value in high school education. saman and larung novels by ayu utami has multi interpretative nature, hence the researchers suggest: [1] avoid eroticism related material for high school student usage, especially the use of vulgar language in the novel, there should be guidance from teachers and parents. [2] for indonesian language and literature teachers to be more careful in choosing novels to be taught, given vulgar language used. [3] for saman and larung novels by ayu utami readers to better understand the positive values that exist in the novel. references azies, a. h. (2010). menganalisis fiksi: sebuah pengantar. bogor: ghalia indonesia. djokosujatno. (2004). erotisme dalam sastra dan bahasa. edisi revisi. jakarta: lembaran sastra. kasnadi & sutejo. (2010). kajian prosa: kiat menyisir dunia prosa. yogyakarta: p2mp spectrum, pustaka felicha. pradopo, r. d. (2007). prinsip-prinsip kritik sastra. yogyakarta: gadjah mada university press. ratna, n. k. (2011). teori, metode, dan teknik penelitian sastra. yogyakarta: pustaka pelajar. sugihastuti. (2011). teori apresiasi sastra. yogyakarta:pustaka pelajar. sofia, a. (2009).aplikasi kritik sastra feminisme: perempuan dalam karya-karya kuntowijoyo. yogyakarta: citra pustaka. utami, a. (2013). saman. jakarta: kepustakaan populer gramedia. utami, a. (2004). larung. jakarta: kepustakaan populer gramedia. utomo, imam budi et al (2001). erotisme dalam sastra jawa klasik. jakarta: pusat bahasa departemen pendidikan nasional. walidin, m. (2014). seksualitas dalam novel indonesia kontemporer. retrieved may 24, 2014, from http://mwalidin.blogspot.com/2007/12/seksualitas-dalam-novel-indonesia) www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 40 published by scholink inc. wardani, e. d. (2014). penerapan model bermain peran dalam pengajaran sastra feminis di sekolah menengah atas. 2011. retrieved april 10, 2014, from http://idewardani09.blogspot.com/2011/01/pengajaran-sastra-feminis-di-sma) children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 3, no. 2, 2020 www.scholink.org/ojs/index.php/ct 1 original paper using cooperative learning model type of paired storytelling to improved speaking ability of students primary school harlina1 & ratu wardarita2* 1 state primary school 1, supat, muba, indonesia 2 universitas pgri palembang, indonesia * ratu wardarita, universitas pgri palembang, indonesia received: july 9, 2020 accepted: july 20, 2020 online published: july 30, 2020 doi:10.22158/ct.v3n2p1 url: http://dx.doi.org/10.22158/ct.v3n2p1 abstract this study aims to improve the speaking ability of students in 5a class state primary school i supat, muba through the cooperative learning model of paired storytelling. the subjects of this study were students of 5a class at state primary school i supat, muba. the research subjects numbered 24 people, consisting of 12 male students and 12 female students, with the object of research improving students' speaking abilities. this research method is classroom action research. data collection used in the form of observation and performance. the results of research conducted by researchers, seen a very significant increase from cycle i to cycle ii. therefore it can be concluded that the cooperative learning model of paired storytelling can improve the speaking ability of 5a class students at state primary school i supat, muba. keywords speaking ability, the cooperative learning model type of paired storytelling, classroom action research 1. introduction indonesian language learning in primary schools is directed to improve the ability of students, as well as supporting success in learning other subjects (nafiah, 2018). the indonesian language is a means of communication that used in learning and has an important role for the teacher and students to convey the idea (samsul, 2016). language learning is expected to help students get to know themselves, their culture, and the culture of others. in learning the indonesian language, speaking is one of the skills students must be capable of because this is a very important skill as well as a characteristic of students' communicative abilities (abidin, 2013). in primary school, indonesian language learning consists of four areas of skill, namely listening, www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 2 published by scholink inc. speaking, reading, and writing. according to linguis (quoted by tarigan, 2008), speaking is a language skill that develops in every child is preceded by listening skills, and from that time on the speaking ability continues to be learned. meanwhile, according to tarigan (2008), speaking is a skill to pronounce articulation sounds or words to express, convey ideas, thoughts, and feelings that can be heard, and utilize several human body muscles for the purpose to be conveyed. furthermore, speaking is also a form of human behavior that utilizes physical, psychological, neurological, semantic, and linguistic factors in such a way that it can be considered as the most important human tool in social control. malgrave (quoted by tarigan, 2008) states that speaking is more than just saying sounds, but speaking is a tool to express ideas that are arranged and developed according to the needs of listeners. based on some of the opinions above, it can be concluded that speaking is a skill that develops in every child that is preceded by listening skills, to produce sounds of articulation by utilizing several muscles of the human body (motor activity) to convey ideas, which are arranged and developed according to the situation and the needs of the listener. in the 2013 curriculum perspective, learning is carried out thematically, where learning programs depart from a particular theme/topic and are then elaborated from various perspectives on subjects taught at the school (kadir et al., 2015). in each theme taught, students are required to be able to convey/tell/discuss pictures, stories, ask/respond to questions, or tell their experiences to others. this is the following jalongo idea, (quoted by kamal, 2020) states that oral communication (speaking) prepares young children for later better learning. this indicator will never be achieved if students are not able to speak properly and correctly. this inability to speak greatly affects the learning outcomes in each theme, and this means it also affects the learning outcomes of each subject. this is the condition that occurs in 5a class students at state primary school 1 supat, muba. during the initial observation, 24 students consisted of 12 men and 12 women, only 4 students or 16% can speak well who have scores above 75 or have reached the minimum standard, while 20 people or 84% others have not been able to speak well and only get grades from 60 to 65. this condition is made worse because almost 80% of students take part in remedial in almost all themes and all learning, due to the inability of students to tell stories/ideas/discuss with others. this condition occurs because, there are still many teachers who treat the same between learning to speak with learning to read aloud, the teacher considers learning to speak is less important, learning to speak can be obtained by students in daily life, speaking ability is not tested nationally, and the low ability of teachers to master learning model. all this time, speaking learning in 5a class students at state primary school 1 supat is still carried out traditionally. learning is also very monotonous, teachers deliver subject matter with lectures and www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 3 published by scholink inc. students tend to listen, and they rarely practice to speak directly. even if you have to tell a story or the results of a discussion, all of that is conveyed by reading aloud. therefore the students' speaking abilities are very low. for this reason, an appropriate learning model is needed, so that students' speaking abilities can improve and learning indicators can reach the minimum standard. the cooperative learning model according to baharuddin et al. (quoted by fathurrohman, 2015) is one form of learning based on constructivism. philosophically, learning according to the concept of constructivism is to construct knowledge little by little, which then results are expanded through a limited context and not suddenly, and according to iserbyt et al. (quoted by yulianto et al., 2019) cooperative learning is a learning method in which students work together in small groups to develop their psychomotor, cognitive, and affective domains. knowledge is not a set of facts, concepts, or rules that are ready to be taken or remembered. humans must construct knowledge and give them meaning through real experience. cooperative learning is a learning model that prioritizes cooperation among students to achieve learning goals and to upgrade student's interest in learning. one of that can be done to upgrade students' interest in learning is to use a learning model that is interesting for students that can who can practice speaking ability and listen. so the learning can be active and not monotonous, one of used cooperative learning model type of storytelling in pairs (sambiring, 2017). in the cooperative learning model, there are several types of learning such as stad type, tgt type, circ type, and paired storytelling. in cooperative learning of paired storytelling, the teacher pays attention to the background of student experiences and helps students deliver the experience, so that the learning material becomes more meaningful. through this activity, students are stimulated to develop their thinking and imagination skills. their work is valued by showing it in front of the class, so students feel more moti5ated to learn. besides, students work together and have many opportunities to process information and improve communication skills, and the cooperative learning model of paired storytelling can also be used for all ages of students (faturrohman, 2015). lie (2007) also stated that cooperative learning of paired storytelling was developed as an interactive approach between students, teachers, and teaching materials. cooperative learning type of paired storytelling can be used in teaching reading, writing, listening, and speaking. this type combines the four activities. this type of cooperative learning model of paired storytelling can be used in social science, religion, and language subjects. teaching material that best fits this type is material that is narrative and descriptive. however, it does not rule out the possibility of other material, with the aim that students can tell fluently about their experiences to their friends (suyatno, 2004). as for the steps of cooperative learning the type of storytelling in pairs is as follows: (a) the teacher divides subject matter into two parts, (b) before the subject matter is given, the teacher conveys the topic to be discussed that day, then continues with apperception to activate the experience (initial knowledge) of students, so students are more ready to accept new material, (c) students are paired, and www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 4 published by scholink inc. each student is given different material from his partner, (d) students are asked to read/listen to the material in turn, (e) while reading/listening, students note down the main points of the story read, (f) after the material is read/listened to, students exchange the list of main points written to their partners, (g) while remembering the discourse read, students fabricate/convey the discourse with their own language, (h) students tell the results of writing to their partners, (i) the teacher then shares the whole discourse with the students, (j) the teacher and students end the lesson by discussing the material being studied in order to make conclusions. with the implementation of the learning model of paired storytelling, the problems that exist in 5a class students at state primary school 1 supat, muba namely the low ability of students to speak can be improved. because all of these problems can be overcome through discussion and storytelling activities with their friends as partners, so the students get used to speaking properly. based on the explanation above, a classroom action research (car) was conducted with the title “improving speaking ability of students through the cooperative learning model of paired storytelling at 5a class state primary school 1 supat, muba”. this study aims to determine to which extent the improvement in the speaking ability of 5a class students at state primary school 1 supat, muba after the application of cooperative learning model of paired storytelling. 2. research methods the research method is classroom action research (car). this research has a cyclic stage. according to kunandar (2013), the procedure of class action research consists of planning, implementing, observing, and analyzing or reflecting conducted in several cycles. in each cycle, learning is carried out following the lesson plans that have been prepared at the planning phase. the results of the implementation were then analyzed with colleagues. 2.1 research subjects this research was conducted at state primary school 1 supat, babat supat district, musi banyuasin regency, 2019/2020 academic year. with research subjects are 5a class students, amounting to 24 people, consisting of 12 men and 12 women. 2.2 technique data collection data collection in this study is conducted by observation and student performance. there are two types of data obtained from this study, namely qualitative data and quantitative data. qualitative data analysis techniques were used to illustrate the activeness, interest, participation, and courage of students in retelling the contents of the book/story that was conveyed. while qualitative data is used to measure students' ability to convey the accuracy of the story contents, the accuracy of details appointment of the story, the use of logic in the story, the accuracy of the www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 5 published by scholink inc. meaning of the whole story, the accuracy of words and sentences used, and fluency when talking/telling stories with their partners (nurgiyantoro, 2014). these results will provide an overview of the percentage of the increased speaking ability of students at 5a class at state primary school 1 supat, muba. a student is considered successful if he/she has achieved grades above the minimal completeness criteria (≥75). while this classroom action research was successful if 86% or more students could speak properly or achieve grades above the minimum standard. so, this action does not need to be continued in the next cycle. 3. research results the research was conducted on school year in the odd semester of the 2019/2020 at state primary school 1 supat, muba. this research was conducted in two cycles. the collected data is data on improving students speaking skills which are done through observation activities and student performance. and then, using qualitative descriptive methods for analyzed data obtained. cooperative learning model type of storytelling in pairs which emphasizes students to study in pairs. at the beginning of the learning, the teacher always stimulates student minds to focus on learning material through apperception activities. when apperception activities, the teacher uses events that are around him so that they are more easily understood by students. next, the teacher conveys the topic and learning objectives so students know what will be learned. in this research of implementation, the collaboration researchers with a senior teacher to observe the compatibility between planning and implementing learning. this is done to find out the deficiency that occurs during learning activities that result in low students speaking skills. that will become a replication material in the next cycle. the learning activities are carried out using a cooperative learning model type of storytelling in pairs. the model is the first time it is used in 5a class students of state primary school 1 supat, muba of theme 2, subtheme 2 about smog in learning 1. the findings in the first cycle using the cooperative learning model type of storytelling in pairs to improved speaking skills are illustrated in the following table. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 6 published by scholink inc. tabel 1. the results of speaking ability of students in cycle i speaking ability of students the results student who has reached minimal completeness criteria. 58% student who has reached minimal completeness criteria. 42% based on the picture above, the average speaking ability of students who at the time of observation was only 16%, increased to 58%. the average value of students’ speaking ability obtained after the implementation of the first cycle is on sufficient criteria on a four-grade scale nurgiyantoro (2014). if seen from the success of the four scale learning, the criteria for learning success is very good if 86% of students have reached the minimal completeness criteria of learning. by looking at this success criterion, the learning outcomes of the cycle i which only reached 58% have not met the requirements, so this study must be continued in cycle ii. the observations result and performance on the implementation in cycle 1 out classroom action research show that the application of cooperative learning models of storytelling in pairs there are still many shortcomings that must be corrected in the implementation of cycle 2. based on the results of reflection with collaborators, in the implementation of learning at cycle 1. most students were not interested in learning activities, this can be seen from the low interest of students in participating in learning, the students not familiar with the learning model so that the result is low cooperation between students and their partners. the students are not accustomed to speaking in front of their friends so students look very insecure when telling the contest of the story in front of their friends, so the students speaking ability is very low. based on the results of these reflections, in cycle 2, the research must foster student interest in learning by way of interesting packaging of learning through games that require students to speak their language wit partners or member group and applause, also varied reference books to using a learning media. the research must also students familiarize themselves with the learning model by motivating students to interact with their partners and other member groups, and giving awards to students who can tell stories well so they can foster student confidence when speaking in front of the class. the implementation of cycle 2 is not much different from cycle 1, the learning stars with planning, implementation, and reflection. it is that some are considered less applicable in cycle 2, to achieve the goal of improving learning. the finding of cycle 2 is an increase in students speaking ability in 5a class primary school, muba after using cooperative learning model type of storytelling in pairs, as follows. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 7 published by scholink inc. tabel 2. the results of speaking ability of students in cycle ii speaking ability of students the results student who has reached minimal completeness criteria. 88% student who has reached minimal completeness criteria. 12% based on the picture, we have known that are a result of students speaking ability learning 5a class students state primary school 1 supat, muba in cycle 2 it has reached 88%. which of the 24 research subjects, 21 students were able to speak well and only 3 students had not yet reached the minimal completeness criteria. 4. discussion from the results of the researchers' discussion with the collaborator, it can be seen that speaking learning using cooperative learning models type of storytelling in pairs at the second cycle works effectively, interactions between students, and between teachers and students are well established, even during a performance, students are so eager to perform to the front of the class. this happened because the teacher managed to package the cooperative learning model of storytelling in pairs well and interestingly, as well as following the character of primary school students who loved to play. so that in the second cycle of learning students are very interested in participating in learning. therefore, the learning activities of speaking through the type of cooperative learning model in pairing with cycle ii have achieved very good results or above 86% so that this study is considered successful. as for the improvement of the speaking ability of 5a class students at state primary school i supat, muba after implementing the cooperative learning model type of storytelling in pairs from cycle i to cycle ii is illustrated in the following picture. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 8 published by scholink inc. figure 1. speech results diagram the 5a class’ students of state primary school 1supat, muba based on the picture, the increase in the speaking ability of 5a class students state primary school 1 supat, muba which in the first cycle only amounted to 14 students or 58%, increased to 21 students or 88% in the second cycle. the enthusiasm, activeness, and courage of these students are built up because in this second cycle the cooperative learning model of storytelling in pairs is really implemented and packaged optimally so that it is interesting for students. where during learning the teacher always motivates students to continue to interact with partners or other group friends, be it through stories, songs, and games. this is following one of the characteristics of primary school students that children can learn anytime and anywhere even when they are playing (susanto, 2018). the success of researchers in improving students’ speaking skills through the cooperative learning model of storytelling in pairs is in line with research conducted by hermawan et al. (2016) under the title “application of the paired story telling learning model to improve the speaking ability of indonesian subjects” with the subject research 5 class students of primary school 4 tejakula buleleng regency. this research also lasted for 2 cycles. cycle i of the students 'speaking ability reached 60%, and then in cyclic ii, the students’ speaking ability increased to 87%. 5. conclusions based on the results that have been done by 5a class state primary school i supat, muba can be concluded that the application of cooperative learning models of storytelling in pairs has a huge positive impact on improved speaking ability of students. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 9 published by scholink inc. this condition is known, at the before research, class 5a state primary school i supat, muba almost 85% cannot speak properly. but this condition is changing after conducting research. in cycle 1 there were 58% of students who could well speak to their partners, which of 24 subjects, there are 14 students who have achieved grades above the minimal completeness criteria (≥75). the same as after held repair in cycle ii, the speaking ability of 5a class state primary school 1 supat, muba improving significantly up to 88%. which is the 24 research subjects, 21 students could well speak to their partners in front of the class. references abidin, y. (2013). pembelajaran bahasa berbasis pendidikan karakter. bandung: refika aditama. faturrohman, m. (2015). paradigma pembelajaran kurikulum 2013. strategi alternatif pembelajaran di era global. yogyakarta: kalimedia. hermawan, y., mahadewi, l. p. p., renda, n. t. (2016) penerapan model pembelajaran paired storytelling untuk meningkatkan keterampilan berbicara pada mata pelajaran bahasa indoneisa. e-jurnal pgsd universitas pendidikan ganesa jurusan pgsd, 4(1). retrieved from https://ejournal.undiksha.ac.id/index.php/jjpgsd/issue/view/393 kadir, a., & hanun, a. (2015). pembelajaran tematik. jakarta: rajagrafindo persada. kamal, m. i. m. (2020). digital storytelling or traditional storytelling to develop efl students’ oral communication? children and teenagers, 3(1). https://doi.org/10.22158/ct.v3n1p33 kunandar. (2013). langkah mudah penelitian tindakan kelas sebagai pengembangan profesi guru. depok: rajagrapindo persada. lie, a. (2007). cooperative learning mempraktekkan coperative learning di ruang–ruang kelas. jakarta: gramedia. nafi’ah, s. a. (2018). model-model pembelajaran bahasa indonesia di sd/mi. yogyakarta: ar-ruz media. samsul. (2016). peningkatan kemampuan berbicara siswa kelas iv sdn i galumpang melalui metode latihan. jurnal kreatif tadulako online, 4(8). retrieved from http://garuda.ristekbrin.go.id/documents/detail/277210 sambiring, r. (2017). upaya peningkatan minat membaca siswa melalui model pembelajaran kooperaif tipe tari bambu pada kompetensi dasar menanggapi isi verira secara lisan di kelas v sd negeri 068343 medan tuntungan. bahastra jurnal pendidikan bahasa dan sastra indonesia, 2(18). retrieved from https://jurnal.uisu.ac.id/index.php/bahastra/article/view/749 susanto, a., & rosdiana, z. (2018). materi dan pembelajaran bahasa indonesia sd. tanggerang selatan: universitas terbuka. tarigan, h. g. (2008). berbicara sebagai suatu keterampilan berbahasa. bandung: angkasa. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 10 published by scholink inc. yulianto, d., & yufiarti, m. a. (2019). a study of cooperative learning and independence: impact on children’s prosocial behavior. international journal of education, 12(1). retrieved from https://ejournal.upi.edu/index.php/ije/article/view/17522/pdf_1 children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 1, no. 2, 2018 www.scholink.org/ojs/index.php/ct 84 original paper between early prevention and statutory intervention: meeting the needs for targeted support for children and families geoffrey meads1* & kathleen butler2 1 health and wellbeing research group, university of winchester, winchester, uk 2 faculty of education, health & social care, university of winchester, winchester, uk * geoffrey meads, health and wellbeing research group, university of winchester, winchester, uk received: july 3, 2018 accepted: july 17, 2018 online published: september 29, 2018 doi:10.22158/ct.v1n2p84 url: http://dx.doi.org/10.22158/ct.v1n2p84 abstract the subject is services for vulnerable children aged up to fourteen years and their families in the winchester area of southern england. the services comprise three group-work based programmes, each lasting for twelve months. their review comprised a two stage study designed to scope future objectives for a host charity in its development alongside faith agencies. the first stage used a delphi process to define the principal priorities of trustees. these were then rated and applied to a follow up client satisfaction survey across the three programmes for 40 families. the overall 55% rate indicated a positive response from service users with a multi-dimensional approach to resilience building strongly endorsed. however, the analysis also scoped three areas for improvement. findings indicated first, that the significance of help with preparation for work and education is understated by trustees less familiar with employment shortfalls; secondly that family focused services should recognize the particular needs of fathers and not be slanted towards mothers and their children; and thirdly, decisions on social enterprise status must take into account potential disconnects between the values of service recipients and those of different socio-economic means in governance roles. these findings are relevant to comparable voluntary sector agencies. keywords vulnerability, early prevention, children, governance, charity, social enterprise, targeted support www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 85 published by scholink inc. 1. introduction friends of the family are a long standing local charity providing a programme of three group-work services to support vulnerable families in the winchester area of southern england. it operates from premises adapted specifically for its purposes by the quakers and salvation army. it has the backing of the local multi-denominational churches together movement which includes all the main christian worship venues in the area. the charity focuses on children up to the age of fourteen, where there are significant risks of domestic breakdown and/or child protection procedures, and the consequent use of legal powers by the local authority social services department (e.g., formal supervision or care orders). its groups are for a total membership of up to 40 families, with participation in each of the programmes limited to twelve months. the invitation to undertake an evaluation of the charity’s services came from its chair, in advance of a period when the uk national lottery and associated external funding sources are due for renewal. the evaluation was undertaken over a one-year period in 2016-2017, with this period including the initial dissemination of a draft report to trustees. if, on the one hand, the need for continued commissioning was a key practical imperative for the service evaluation, then there were also, on the other, more conceptual forces that were influential in the request for validation through external research. these were expressed through two central government policies. the first of these, dating from who inspired public health policy developments, promotes the role of private and voluntary organizations in welfare and wellbeing services through the business management models of new social enterprises (marmot, 2010). the second, in a period of restricted and restrictive public expenditure, looks to confine the roles and responsibilities of local councils in children’s services to that of overall preventive public health strategy and urgent casework. a series of studies indicate that the latter has become increasingly based on statutory criteria and safeguarding risk assessments (allen, 2011; national children’s bureau & children’s society, 2016; bates, 2017). together these two policies have been designed to underpin post-millennium “modernizing” concepts of a more participative democracy and a broader based stakeholder society (denham, 2001; henderson et al., 2004; public health england, 2015). as a result of the first of these policy drivers there has been a rapid expansion in what is termed “missional social action” by churches (diocese of winchester, 2016). launchpad, for example, as the agency established and hosted by the winchester anglican diocese, aims to provide up to 60 per cent of the county of hampshire’s under 5’s day care from premises in its parishes by 2020. this follows in the footsteps of a similar initiative for older people’s befriending service which has seen over 120 local good neighbour schemes come under the auspices of the diocese (ralph, 2015). the planned growth in faith based social enterprise corresponds to the reduction in state run children’s services arising from the second policy driver (faith action, 2014). this trend was well illustrated during the 2015-2016 period when 43 of the hampshire county council’s 54 children’s sure start centres—covering a www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 86 published by scholink inc. population of 1.8 million—were closed (bbc news, 2017; smith et al., 2018). the group-work undertaken by the trained staff counsellors and sessional volunteers of friends of the family are specifically targeted at support for fathers; the befriending of children aged between five and thirteen years with their carers; and the maintenance and rehabilitation of families with children under five. paternal support includes individual counselling sessions for fathers, some of whom are in custody. the befriending service includes named attachments by selected and trained volunteer visitors who are matched to particular homesteads. the under 5’s services includes playgroup and pre-school nursery based training sessions. while self-referrals are assessed and accepted most referrals do come from local nhs and social services agencies. “risk of breakdown” is defined to include traumatic events, poverty, social exclusion and isolation, as well as severe domestic relationship difficulties: all of which can be linked to child protection issues. the last items in this are the main reason for referral. purpose in seeking to gain a better understanding of the difference its support services make the trustees of friends of the family wanted to ensure that there was an effective alignment between the charity’s stated priorities, its intentions and the overall purpose of improving children’s experiences of family life. these were encapsulated in our pyramid model set out below in figure 1. figure 1. organisational priorities and delivery the initial discussion with the charity’s chair highlighted her concern that there should be a productive relationship between the actual experiences the charity’s clients and the aspirations of its trustees. this desire to understand both these perspectives helped us define and agree the following set of objectives www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 87 published by scholink inc. for the study, as follows: 1) to gain an enhanced understanding of the overall performance of the organisation. 2) to assess how funding translates into the support services of children and their families. 3) identify areas of service delivery that could be strengthened or improved. the objectives reflect the twin emphasis on getting right both service delivery and governance arrangements. 2. method this dual emphasis was also reflected in the methods of data capture and analysis. accordingly, in the first stage a three part delphi style process was designed to enable trustees to review and refine the corporate priorities. in stage two the results of this were then used to shape a client satisfaction survey employing a modified likert format (bryman, 2014). the questions corresponded to the individual service delivery items identified by trustees as significant in their delphi deliberations. questions were paired on a “before and after” basis to ensure that any changes in client experience over the preand post-entry time periods could be identified. the likert questionnaire is set out in table 1 below. after training from one of the researchers the survey was administered by trustees themselves, following an introductory letter from the chair. this guaranteed anonymity and all responses were subject to the charity’s data security procedures. participation in the project was voluntary for both clients and trustees. the questionnaire contains an open section for any form of comment. please score each of the following statements on a scale of 1-5. a score of 1 denotes “strongly disagree” and a score of 5 “strongly agree”: table 1. client satisfaction questionnaire 5 4 3 2 1 strongly agree agree neither or n/a disagree strongly disagree 1) before working with friends of the family i felt confident in sharing my views with professionals (teachers, social workers, health care professionals, etc.). 2) working with friends of the family has helped me feel confident in sharing my views with professionals (teachers, social workers, health care professionals, etc.). 3) working with friends of the family has helped me feel confident in sharing my views with my wider family. 4) before working with friends of the family i felt confident in the decisions i made in regards to parenting. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 88 published by scholink inc. 5) working with friends of the family has helped build my confidence in the decisions i make in regards to parenting. 6) friends of the family have helped me build a support network with people who share similar experiences. 7) i feel that my views and experiences are valued by friends of the family. 8) friends of the family have helped/are helping me develop some goals in relation to employment/education/training. 9) i feel that i have something to offer other people who may have similar experiences to mine/with on-going support through friends of the family i feel that i will have something to offer people who may have similar experiences. 10) i feel that i have learned/am learning new skills through being involved with friends of the family. 11) my involvement with friends of the family has helped me feel able to manage my own day-to-day challenges (work, meetings, sustaining household routines, attending appointments). 12) before my involvement with friends of the family i felt able to manage my own day-to-day challenges (work, meetings, maintaining household routines, attending appointments). 13) i belong to other social networks outside of friends of the family. 14) before my involvement with friends of the family i felt involved in the other social networks. 15) before my involvement with friends of the family i felt overwhelmed in creating and maintaining routines for my family (school, homework, appointments). 16) friends of the family has helped me feel able to create and maintain routines for my family (school, homework, appointments). 17) friends of the family have helped me recognize the skills and abilities that i have. 18) i would recommend friends of the family to others. 3. results ten trustees took part in the delphi process. for this purpose they were regarded as the expert data sources, by dint of their positions in the governance structure, with each having nominated specialist roles based on their past experience and interests in the children’s services sector. three meetings took place with the researchers as joint facilitators to ensure consistency of approach. the first was a sub-group exercise to map, through consensus, the key goals of the charity. to respond to the chair’s constitutional mandate for friends of the family, as a charity distinctive in its capacity to tailor inputs to particular individual circumstances, this exercise employed the thematic of personalization as its overall framework. the result was the clustering of aims by trustees around the three headings of resilience, confidence and vocation, with four items in each identified and agreed across the trustee sub groups. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 89 published by scholink inc. the second meeting was a plenary session in which participants were asked in groups a question requiring them to prioritize in order the specific individual goals identified at the first stage. the results were confirmation of the groupings in the threefold classification with some revised wording; and a weighting scale given to each of the three clusters by majority voting, using a graduated 0-1 scale. an updated personalization agenda of priority items from this exercise was defined as now follows. the principal components were, in order of priority: family relationships, inclusion/isolation, life skills, occupational equipping and calling, survival skills/resilience, and self-esteem/social confidence. this list of items in the trustees’ weighted agenda was then applied in the researchers’ design of the likert scale in table 1. this was internally tested, revised at the trial stage in discussion with trustee representatives, and finally signed off by the charity chair. as the final phase of validation in the delphi process, prior to dissemination of findings, the trustees were asked to consider the relationship—the degree of alignment—between the publicly stated aims of the charity and the agenda identified in the first two parts of the process. the survey response rate was 55%. the 22 respondents were spread quite evenly across the three group-work interventions, with a range from 6 to 10 between the under 5’s and befriending programmes. responses were overwhelmingly positive with seven items achieving positive satisfaction scores of over 75%. summaries of these are set out in below. • 82% of the participants in the survey felt that their involvement with friends of the family has helped them to feel confident in sharing their views with professionals (item 5). • 77% of participants think that their involvement with friends of the family has helped them build confidence in making parenting decisions (item 8). • 77% think that friends of the family has helped them to build a support base with people who share the same or similar experiences (item 9). • 91% of the participants in the survey feel that their views are valued by friends of the family (item 10). • 82% feel that they have something to offer, or with ongoing support through friends of the family will have something to offer other people who have similar experiences to them (item 12). • 77% feel that involvement with friends of the family has helped them to be able to manage day to day challenges (item 14). • 77% said that friend of the families has helped them to recognize the skills and abilities that they have (item 20). these positive findings were reinforced by the written comments received of which the following are illustrative. “friends of the family have given me emotional support throughout, providing counselling and helping me to access things when i had no money. i have made good and lasting friendships and my daughter www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 90 published by scholink inc. loves the company of other children. honestly i would have been lost without this group.” “after having counselling i am now a recovering alcoholic. i have tackled the abuse i suffered as a child and it no longer consumes me. i am able to function as a member of society and be comfortable with who i am”. “helping us to become the fathers we needed as children is the main point that i have learned through the wonderful support offered”. 100% of the respondents agreed they would recommend friends of the family to others. 77% stated they “strongly agreed” with this. such a high satisfaction rate should clearly assist in future funding applications. 4. discussion the use of weighted priorities by the trustees, however, allowed them to consider more nuanced findings than just this easy conclusion of high client satisfaction. their own delphi exercise had afforded “vocation” the lowest score at 0.5 as a priority, with “resilience” highest at 1.0 (and “confidence” midway between). survey respondents had also scored the vocational items lowest, but as an area of unmet need. overall the mean score of below 4.0—demonstrating positive agreement—on the items relating to work, schedules, appointments, schooling and homework (items 11, 15 and 18) appeared to indicate that clients did not view friends of the family as a charity which concentrated on practical support in respect of employment and training. the mean score for female correspondents on the cluster of relevant questions was 3.38 and 3.88 for men. the scores suggested to trustees that they should carefully consider if their limited focus on vocational issues may have contributed to some service delivery shortfalls. the scores in the areas of resilience and confidence were more positive. on all items covering encounters with professionals, daily challenges and children’s routines, parenting decisions and building social networks (items 4, 5, 14, 15, 18, 19, respectively), there were important “before and after” advances recorded. for example, with a mean of 3.0 for “agreement” overall average scores increased from 3.6 to 4.2 for the ability to deal with professionals; from 3.4 to 4.0 for competence in parental decision making; and from 3.0 to 3.4 for social group membership. interestingly, on all the relevant items the male respondents (n: 11) scored the services received higher. similar studies have also found that marginalized fathers appreciate supportive interventions more, seemingly because there are fewer are available to them (quinton, 2004; clapton, 2009). the enhanced scores by service users would seem to align with trustees’ own priorities and with their perspective on what constitutes the sources of confidence and resilience. the feedback, for example, provided encouragement to them in terms of maintaining the charity’s innovative approach to pre-release counselling support for fathers in custody. indeed it suggested more such services would be www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 91 published by scholink inc. welcome, with an emphasis on the recruitment of more male volunteers being a possible way forward. a final meeting was then held with the trustees with the results of the survey, leading to the recommendations for practice described below, and affirmation of the organizational model set out in figure 1 above. this meeting was convened by the chair of the charity. the research undertaken confirmed the positive impact in socio-emotional terms of the services provided by friends of the family in winchester. it identified some shortfalls in terms of unmet needs for practical assistance in relation to employment and training which require enhanced external linkages for the charity. this was especially apparent for male clients, who would appreciate more interventions tailored to their needs. the particular christian charity venues for friends of the family were found to offer secure and sympathetic surroundings for social skills and personal identity development; but the relatively closed environments, with some features akin to a sanctuary, could have also contributed to a lack of connectivity with outside community agencies. accordingly, it was recommended, that over time the charity carefully consider its future organizational status options, such as those of a community oriented or interested company, with its client families, to help ensure that its values continue to be reflected in its collaborative governance arrangements. specifically the chair recognized the requirement to ensure that selected trustees—including past service users—are equipped to fully recognize the full range of needs presented by those referred to friends of the family, and that agency partnerships are extended to provide accessible gateways to appropriate and restorative vocational opportunities. these linkages could valuably include charities which both operate alongside or combine with faith based social enterprises that possess wider remits, including employment and training opportunities. the general need to enhance integration between the rapidly growing volume and scale of wellbeing practices was acknowledged. for future research this project points to the need to address the question of which modes of organizational development most enhance services for children and teenagers in states where social policies are increasingly founded on relationships with and between a diversity of values based agencies. this research question is most pertinent where boundaries between central governments and civil society are shifting significantly. acknowledgements the evaluation team is grateful to group leaders, volunteers and trustees that participated in the evaluation. thanks to those parents who shared some of their experiences and views on the support offered by friends of the family. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 92 published by scholink inc. references allen, g. (2011). early intervention: the next steps. london: department for education. bates, a. (2017, june 26). early intervention, 7647. house of commons briefing paper (online). retrieved from http://researchbriefings.parliament.uk/researchbriefing/summary/cbp-7647#fullreport http://www.bbc.co.uk/news/uk-england-hampshire-36688258 (accessed 2017-08-15) bbc news. (2017). county to shut down children’s centres (online). retrieved october 16, 2017 from http://www.bbc.co.uk/news/uk-england-hampshire-36688258 bryman, a. (2012). social research methods (4th ed.). oxford: oxford university press. clapton, g. (2009). how and why social work fails fathers: redressing an imbalance. practice social work in action, 21(1), 17-34. retrieved september 15, 2017 from http://dx.doi.org/10.1080/09503150902745989 denham, j. (2001). building cohesive communities. london: home office. faith action. (2014). the impact of faith-based organizations on public health and social capital. (online). retrieved january 19, 2018 from http: http://www.faithaction.net/resources/ good neighbour support scheme 2015 impact briefing. (n.d.). portsmouth, uk: gnss, winchester social enterprises. henderson, p., summer, s., & raj, t. (2004). developing healthier communities. london: health development agency. marmot, m. (2010). fair society, healthy lives. the marmot review (online). retrieved february 22, 2018 from www.ucl.ac.uk/marmotreview national children’s bureau & the children’s society. (2016). losing in thelong run: trends in early intervention funding. london: action for children. public health england. (n.d.). a guide to community-centred approaches for health and wellbeing (online). retrieved december 19, 2017 from www.gov.uk/phe quinton, d. (2004). supporting parents. messages from research. london: jkp. ralph, n. (2015). smith, g., sylva, k., sammons, p., smith, t., & omonigho, a. (2018). stop start, survival, decline or closure? children’s centres in england 2018. oxford, sutton trust. http://www.bbc.co.uk/news/uk-england-hampshire-36688258 http://www.ucl.ac.uk/marmotreview children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 4, no. 2, 2021 www.scholink.org/ojs/index.php/ct 7 original paper social media use: a risk factor for depression among school adolescents in enugu state of nigeria agbo, maria charity (phd)1* 1 department of educational psychology, federal college of education, eha-amufu, nigeria * agbo, maria charity, department of educational psychology, federal college of education, eha-amufu, nigeria received: april 20, 2020 accepted: may 7, 2021 online published: may 29, 2021 doi:10.22158/ct.v4n2p7 url: http://dx.doi.org/10.22158/ct.v4n2p7 abstract social media just like the rest of information and communication technology (ict) channels aid and promote speedy and easy access to information more especially among school adolescents. social media use among school adolescents is a double-edged sword as they use them to connect friends and find information about many things including learning. however, they also spend too much time on them which affect their mental health and may cause them depression. this research investigated on the social media use: a risk factor for depression among school adolescents’ depression in enugu state. descriptive survey research was adopted for the study. the population of the study was all the school adolescents in enugu state. stratified random sampling was used to select 800 adolescents from 4 states. in each of the four states, 200 adolescents were selected. self-structured questionnaire and hamilton depression scale were used to elicit information for data collection. the results were analyzed using mean scores and standard deviations. the findings revealed that many adolescents spend up to 10 hours daily on social media, they prefers chatting on social media to talking to their parents, among other behaviours. the findings also indicated that; adolescents who spend up to 10 hours daily on social media have decreased activities and feeling of incapacity, adolescents who don’t have enough sleep in the night due their use of social media experience hallucination, low mood among other findings. keywords depression, social media, adolescents, cyber bulling, failure to achieve nigh use of social media www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 2, 2021 8 published by scholink inc. 1. introduction the use of social media in everyday life activities is a relatively recent development that is welcome by the old and the young. social media offer immeasurable benefits to humanity by creating a world in which people can gaze into their own crystal ball to see what their friends are doing at almost any time of the day. the world infact has been reduced to a global village. social media applications actually are changing virtually everything now more than ever before, such as how we connect and make friends that are immediate and those in far-away lands, how we transact businesses, market our products and purchase goods. all these have changed drastically these days. in the same vein, access to information for personal and social use is also changing in a quick way. the changes in the telecommunication sect according to abdullahi et al. (2018) has increased internet access and use among the general public and young people in particular. young people especially adolescents in schools benefit from social media in a tremendous manner, as they offer students the opportunities to connect with friends and peers and have access to educational resources such as learning materials, online tutoring, study and or educational tips. nevertheless, the way young people especially the adolescents are actively involved in global online communication through social media has become a source of worry for researchers, parents and educators, as they (adolescents) spend more time on social media than on real world, making friends easier online and making connections in far-away countries. adolescents in nigeria according researches spend less time with their friends in persons, less time reading their books or sleeping and more time on digital media (abdullahi et al., 2018). while social media use has become an integral part of daily life of an adolescent, there are number of risks associated with social media use especially the negative effects on mental health such as depression, anxiety, suicide, worry, low self-esteem, suicide thoughts and so on. research on social media use according to chonning (2020) is a new focus area. although a large number of studies on social media use and mental health with different vantage points has been conducted in both local and international journals. however, the researcher of the work feels that not much has been done on how social media use can lead to depression using any depression rating scale. for this work, the focus is on depression, highlighting on how social media raise depression. social media can be defined as an interaction among people in which they create, share and exchange information and ideas in virtual communities and networks. social media technologies are in different forms including magazines, internet forums, weblogs, social blogs, micro blogging, podcasts, photographs or pictures, video rating and social bookmarks (ali et al., 2018). social media according to cambridge dictionary (2019) are websites and computer programmes that allow people to communicate and share information on the internet, using a computer or mobile phone. there are seven types of social media which include: www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 2, 2021 9 published by scholink inc. photo sharing (instagram, snap chat, pinterest) blogs and micro blogs (such as twitter, umbir) social news networking sites (such as dig and leaker net) content communities (such as you tube and daily motion) social networking sites (such as facebook, linkedin, google +, whatsapp) virtual game-worlds (such as world war craft) virtual social world (such as second life) collative projects (such as wikipedia) (kaplan et al., 2010; cheung et al., 2011). among all these social media types, the most commonly used by school adolescents include: 1) photo sharing, blogs and micro blogs, content communities, and social networking sites. social media are dynamic and interactive computer mediated communication tools with high penetrating rates in the general population in high and middle class levels. depression on its own is a mood disorder that is characterized by persistently low mood and a feeling of sadness and loss of interest. it is a persistent problem that may last 6-8 months. it is the most common illness worldwide and the leading cause of disability (markus, 2017). depression is defined by higuera and holland (2019) as a mood disorder or feelings or sadness, loss or anger that interferes with an individual’s everyday activitie, people experience in different ways. it may interfere with one’s daily activities, resulting in lost time and low productivity. it can also influence relationships and some chronic health conditions such as asthma, arthritis, cancer, diabetes, cardiovascular disease and obesity. it is important to note that feeling of down at times is normal part of life, but if it persists up to 6 months, or becomes a regular experience, it is depression. depression is also viewed by ali et al. (2018) as a cluster of specific symptoms that have associated with impairment. the clinical and diagnostic features of the disorder are broadly similar in adolescents and adults. adolescence according to psychology today (2019) is transitional stage from childhood to adulthood which occurs between ages 13-19 although the physical and psychological changes that take place can start earlier during the preteen years between ages 9-12. adolescence is a time of both disorientation and discovery. the transitional period can raise questions of independence and identity; as adolescents cultivate their sense of self, they may face difficult choices about academics, friendships, sexuality, gender identity, and alcohol. they tend to have more egocentric view and often focus on themselves and feel that they are the centre of attraction from the best and closest friend to the most distant one. they may grapple with insecurities and feelings of being judged. the transition can naturally lead to anxiety about the physical changes to one’s body and his or her evolving relationship with others and the larger world. apart from physical and sexual maturation, adolescents also desire movement towards social, economic and moral independence where they will be free, earn their living, control their sense of judgment and socialize, and identify (brown, 2008). however, the duration and defining www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 2, 2021 10 published by scholink inc. characteristics of this period may vary across time and space, cultures and sociometric circumstances (shonde, 2010; who, 2015). while adolescence is a time of tremendous growth potential, it is also a time of considerable risks during which social contexts such as social media exert powerful influence on character building which may result in changing attitudes and behaviours for most adolescents. despite the popularity of social media platforms and the rapidity with which they have inserted themselves into nearly all facets of our lives, there is a remarkable lack of clear data about how they affect us personally, our behaviours, our emotions and mental health. however, studies according to mammoser (2018) have linked the use of social media to depression, anxiety, poor sleep quality, low self-esteem among other mental health problems especially in adolescents. heid (2019) states that a substantial amount of research has found associations between heavy technology use and poor mental health outcomes among adolescents and young people. research aside, many parents teachers, guidance and counselors and other people believe that social media and heavy technology use are a problem. it is because digital technology tends to expose adolescents to over load of information and stimulations, and a much bigger sphere of influence. due to vulnerability and the intensive need for intimate and healthy social connections during adolescence stage, social media are likely to influence young people. the notion that social media has a negative impact on depression is widespread. for instance, studies by diego according to miller (2018) revealed that smartphones were introduced in 2007 and by 2015, fully 92% of adolescents owned smartphones. the rise in depressive symptoms correlates with smartphone adoption during that period, even when matched year by year. at the same period, the reports on students seeking help principally for depression and anxiety jumped to 30% between 2010 and 2015. adolescents these days usually look to social media for connecting friends and seeing the world. the use of social media such as twitter, instagram, whatsapp. snapchat, and many others have grown almost in lockstep with the rate of mental health problems. epidemiological studies according to sulcel (2019) have revealed a strong correlation between social media and symptoms of depression. there had been a lot of arguments on the actual relationship between social media and depression, and how social media can influence depression or cause depression among adolescents. a new study out of texas state university suggests that it is how social media are used not the tool itself that may lie behind the correlation (sulcel, 2019). asmelash (2019) on her own, asserts that social media itself does not harm people, rather its frequent use. another research in support of the assertion according to asmelash opines that it is social media contents which young people are exposed to and its check spelling of healthy sleep and exercise that cause problems. in nigeria, many adolescents especially those in higher and middle class levels living in cities may have been spending too much time on social media. such adolescents usually fail in the academic performances which may also affect their mental health. many parents teachers and educators in enugu state worry so much as greater percentage of adolescents spend their time on twitter, facebook, video www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 2, 2021 11 published by scholink inc. games, whatsapp, instagram, at the expense of their education and interaction with their real friends and parent. an adolescent who spends several hours a day on facebook, twitter, whatsapp, instagram, video games and so on is likely to have less time to study, relate to physical friends and parents. such adolescent may have social media anxiety disorder which can affect both physical and mental health. spending too much time on social media has been proven to cause a lot of ill health and depression. for instance, according to miller (2018), a recent research proved that there is a link between social media and depression among social media users who spend the most of their time on intagram, facebook and other platforms. such people were reported to have a substantially higher rate of depression about sixty-six percent (66%) than those who spend the less time. there are many sources through which social media may lead to depression among adolescents. these include: • teen’s night time use of social media: adolescents who engage in social media during the night could be damaging their sleep and increasing their risk of depression and anxiety. research on over use of social media showed that night time use specifically correlate to poorer sleep quality, lower self-esteem, higher levels of anxiety and depression (heid, 2019). young people usually stay up late to use social media and are woken up by alarm coming from their phones beside their beds, making them depressed and anxious (ampbell, 2019). teenagers are so emotionally invested in social media that many of them will wake up at night and log in just to make sure that they do not miss out. perhaps, the worst thing about this is that adolescents need more sleep than adults do, so night time social media use could be detrimental to their health. research has shown that adolescents need 9.5 hours of sleep each day but unfortunately, many of them do not get up to six hours (6 hrs) sleep. this lack of sleep according udorie (2019) can make them depressed, irritable among other ill health. • another theory about the increase in depression is the loss of self-esteem especially in female adolescents who when they compare themselves negatively with artificial curated images of those with prettier, thinner appearance and more popular and richer, feel less attractive and worried. according to the study, many girls are bombarded with the most perfect pictures of their online friends and or celebrities and influencers who do a lot of photographing and makeup and hair teams. if the girls feel that these are normal, it is likely to affect their self-confidence (miller, 2018). curation of perfect images usually makes adolescents inadequate. sometimes, adolescents feel like joining the utopic world of their online friends but cannot. this also brings depressive mood especially on those with negative emotions and lack of sense of belonging. • failure to achieve: another possible source of depression may be what adolescents fail to achieve when spending too much time on social media, such as accomplishment on academic excellence, admission into a higher school or promotion to higher grade. when a student who spends much of his or her time on social media fails to achieve academically, it may lead to regrets, anger and www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 2, 2021 12 published by scholink inc. depression. such adolescents do not know that when they spend too much time online and less time studying that it cuts down their academic performance, and failure in academic performance has been proven to have a link with depression and suicide. • cyber bulling: cyber bullying refers to typical bullying behaviours such as verbal abuse, mocking, insults and threats, transmitted over electronic media like e-mails, mobile phones, text messages and internet sites where an individual is ridiculed, insulted, or ostracized. social network increased in recent years and with it the bullying, causing problems in young people’s mental health. these problems’ are expressed according to ehararifa et al. (2017) through depressive symptoms suicide ideas and suicide attempts for instance, many female adolescent who are blackmailed, or ridiculed through internet are likely to experience depressive mood. the statement of problem of this research works argues that social media primary functions are to aid and promote speedy and easy access to information among the world population including nigeria. however, adolescents are the most frequent users especially those in the school, and school leavers. these young people use social media to connect friends online get information about virtually everything they supposed to known about themselves and their environments. they also use social media to get information about job opportunities, school admissions and academic achievement. regrettably, this emerging trend has drastically changed adolescents’ attitudes, orientations and values to an extent that many of them prefer connections and interactions in social media to their interactions with parents, siblings, peers and teachers. they therefore spend most of their time on facebook, you tube, whatsapp, twitter among others connecting friends rather than learning. this social media abuse may lead to much mental health such as depression. this paper investigates the influence of social media on adolescents’ depression in enugu state. the major objective of this study is to investigate on social media use as a risk factor for depression among school adolescents’ in enugu state. in specific terms, the study tries to; 1) find out if adolescents spend most of their time on social media. 2) find out the sources of social media that can cause depressive behaviours among adolescents. the following research questions guided the study: 1) how do school adolescents use social media? 2) what are the sources of social media that can cause depression among school adolescents? descriptive survey design was used for the study. the population of the study was the entire adolescents in secondary schools in enugu state. a stratified random sampling technique was used to select 4 local government areas in enugu state. these include; igbo-etiti, nsukka, enugu south, and udenu local government areas. from each local government, 200 adolescents were selected, 100 males and 100 females. in all, there were 800 adolescents 400 males and 400 females for the study. the instrument for data collection was a 23 item structured questionnaire out of the 23 items, 12 items were developed personally by the researcher, while 11 items were adapted from hamilton depression www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 2, 2021 13 published by scholink inc. ham-d rating scale (hamilton, 1960). it was divided into 3 parts. part a was used to elicit information about the participants’ particulars, part b was used to find out if adolescents spend too much time on social media, while section c was adopted from hamilton depression rating scale to elicit data about the effects of social media on depression among adolescents. the data collected were analyzed using mean scores and standard deviation. the criterion for acceptance of the mean score was 2.5 and above, why any score below was rejected. the questionnaire was face – validated by psychiatric doctor and a psychologist. research question one: how do school adolescents use social media? table 1. mean scores and standard deviations of the social media use among school adolescents s/n how school adolescents use social media x − sd dec. 1 many adolescents use up to 10 and above hours daily chatting on social media 3.35 0.73 acc 2 adolescents prefer chatting on whatsapp and facebook to talking to their parents. 3.25 0.71 acc 3 most adolescent engage on 4-6 social media 2.40 0.80 rej 4 many adolescents spend their siesta period on social media 2.58 0.72 acc 5 many adolescents usually stay awake up to 2.00 am on social media 3.18 1.00 acc 6 adolescents get bored any day they fail to exercise their online connections. 1.70 0.84 rej 7 adolescents have more friends online than physical ones 2.25 0.84 rej 8 adolescents prefer searching for solution to their problems online to discussing with their parents. 3.20 0.79 acc 9 adolescents make connecting friends online a hobby 2.14 0.80 rej 10 adolescents use time for reading to chatting online 2.91 0.63 acc 11 adolescents eat and chat online simultaneously 2.60 0.99 acc 12 many adolescents chat on whatsapp and or facebook during class. 1.72 0.84 rej the result in table 1, revealed that the respondents rated items 1, 2, 3, 4, 5, 8, 10 and 11 out of 12 of the items as indicating the adolescents who spend most of their time on social media. these accepted items have 2.5 points and above, while items 3, 6, 7 and 9 were rejected. research question two: what are the sources of social media that can cause depression among adolescents? www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 2, 2021 14 published by scholink inc. table 2. mean scores and standard deviations of sources of social media use that can cause depression s/n way through which social media can be risk factors for depressive behaviours. (400 respondent) x − sd dec. 1 adolescents who spend up to ten hours daily on social media have decreased social activities and feelings of incapacity 3.25 0.72 acc 2 adolescents who stay awake up to 2.00 am may experience insomnia initial, headache and low mood 3.18 1.01 acc 3 adolescents who do not have enough sleep in the night because they use social media may experience hallucination, low mood, irritability. 2.89 0.68 acc 4 adolescents who compare themselves with artificial curated images online, may have low self-esteem and lack of interest on themselves. 2.73 0.74 acc 5 adolescents who prefer the environment of their online friends to their own environment experience gloomy attitude and percsimisism about the future 1.77 0.84 rej 6 adolescents who feel uglier than the images on social media have self-hate and withdrawal. 1.83 0.86 rej 7 when adolescents lose their admission due to over use of social media they feel guilty and that life is not worth living. 3.26 0.62 acc 8 when adolescents spend all their time on social media and fail in examinations they have feelings of sadness, tendency to weep and suicide ideas. 2.86 0.97 acc 9 if an adolescent is blackmailed by their assumed online friends, they lose appetite, have palpitation and lack of sleep. 3.25 0.84 acc 10 when adolescents receive threats online they experience insomnia middle, fear and loss of libido 2.88 0.96 acc 11 adolescents who are mocked and or cajoled online usually lose weight, have inferiority complex and self-absorption. 2.73 0.74 acc the data in table 2 indicated that the respondents rated items 1, 2, 3, 4, 7, 8, 9 and 11 as some sources through which social media can cause depression among adolescents. the results revealed that the respondents agreed that sources of social media influence on depression among adolescents were adolescents night engagement on social media which were on items 1, 2, and 3, adolescents loss of self-esteem as they compare themselves with their online friends which is on item 4, adolescents’ failure to achieve which is on items 7 and 8 and finally cyber bulling on adolescents which is on items 9, 10 and 11. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 2, 2021 15 published by scholink inc. 2. discussion the data in table one revealed that school adolescents in enugu state engage in social media. the data indicated that school adolescents in enugu state spend much of their time on social media through the following; using up to 10 hours and above on social media daily, prefer chatting on whatsapp and facebook to talking to their parents and siblings. this finding is in line with the findings by abdullahi et al. (2018) which showed that adolescents in nigeria spend more time on social media than with their parents and physical friends. other findings include; using their siesta period on social media, staying awake in the night on social media, preferring searching for solution to their problems online to discussing with their parents, using time for reading to chatting online and eating and chatting online at the same time. in table two, the data revealed that; night engagements on social media by adolescents may lead to depression. this finding supports a research carried out by udorie (2015) which showed that adolescents who use social media during the night could be damaging their sleep and increasing their risk of anxiety and depression. other findings include; that loss of self-esteem and failure to achieve are sources through which social media could cause depression, that cyber bulling may also lead to depression. this supports the finding by john et al. (2018) who after a research concluded that victims of cyber bullying are at greater risk of depression, self-harm, and suicide behaviours than non-victims. 3. conclusion social media refers to interaction among people in which they create, share and or exchange information and ideas in virtual communities and networks. currently, there are multiple social resources. the advent of s.m and smart phones is not only a strategy for improving social interactions but also contributes to impair health of nigerian adolescents especial in enugu state. many researches have proven a correlation between the use of s.m and depression especially among adolescents. references addullahi, a. a., & abdulquadri, n. (2018). influence of new media on adolescents’ sexual behaviours in sub-sahara africa. lining theories to realities. sage journal. https://doi.org/10.1177/2158244018804606 ali, s., al harbi, h. a., & rahman, s. r. (2018). the relationship between the use of social media and depression among female teenagers in buraidah, alceassim, soudi arabia. https://doi.org/10.4172/2375-4494.1000374 asmelash, l. (2019). social media use may harm teen’s mental health by disrupting positive activities, study says. retrieved from https://www.cnn.com social august 14 2019 www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 2, 2021 16 published by scholink inc. brown, t. d. (2008). managing the media monster. the influence of media (from television to text messages) on teens’ sexual behaviour and attitudes. washington d c. national campaign to prevent teen and unplanned pregnancy. cambridge advance learner’s dictionary and thesaurus. (2019). definition of social media. cambridge university press. retrieved from https://dictionary.cambridge.org 1st sept. 2019 campbell, d. (2019). depression in girls linked to higher use of social media. the giardoam. retrieved from www.thegnardian.com cheung, l. m., & wong, w. s. (2011). the effects of insomnia and internet addiction on depression. hong kong chinese adolescents an exploratory cross sectional analysis i. sleep res., 20, 311-317. https://doi.org/10.1111/j.1365-2869.2010.00883.x chonning, v. s. (2020). social media use, mental health and well-being among adolescents—a scoping review. frontiers of psychology 14th august 2020. https://doi.org/10.3389/fpsyg.2020.01949 echararifa, j. e., gonalez, l. e. m., bermal, d. r., & rodriguez, d. m. (2017). cyberbulling and suicidal behaviours. what is the connection? retrieved from https://www.elsevier.esen-revista-r fader, s. (2019). social media obsession and anxiety. anxiety & depression association of america. hamilton, m. (1960). hamilton depression hamd-rating scale. journal of neurology neurosurgery & psychiatry, 23, 56-62. https://doi.org/10.1136/jnnp.23.1.56 heid, m. (2019). depression and suicide rates are a rising sharply in young american, new report says. this may be one reason why. journal of abnormal psychology. retrieved from https://time.com depression suicide higvera, v., & holland, k. (2019). everything you want to know about depression. health line. retrieved from www.healthline.com john, a. cherles, a.g., & howton, k. (2018). selfharm,suicidal behaviours and cyberbulling in children and young people. system review. kpaplan, a. m., & haeniein, m. (2010). users of the world unite. the challenges and opportunities of social media. bus horrizons, 53, 59-62. https://doi.org/10.1016/j.bushor.2009.09.003 mammoser, g. (2018). how social media increases depression and loneliness. healthline. retrieved from https://healthline.com 9th dec. 2018 marku, m. i. (2017). what is depression and what can i do about it? medical news today. retrieved from www.medicalrewstoday.com 1st august 2017 miller, c. (2018). does social media cause depression? child mind institute. retrieved from https://www.childmind.org/art psychology today. (2019). adolescence. retrieved from https://www.psychologytoday.com 5th august 2019 www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 2, 2021 17 published by scholink inc. shonde, o. o. (2010). importance of impacting sex education among selected secondary school adolescents in odeta local government of abeokuta. retrieved from https://www.unacb. edu.ng/ugprojects/2010/scsh sulce, k. (2019). understanding the link between social media and depression. dan news. retrieved from https://dana.org/news/sco world health organization. (2015). maternal, newborn, child and adolescent health. geneva, switzerland. author. children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 2, no. 1, 2019 www.scholink.org/ojs/index.php/ct 1 original paper successful leadership in medicine anthony a. zehetner1, 2* 1 adolescent medicine unit, the children’s hospital at westmead, sydney, australia 2 faculty of medicine and health, the university of sydney school of medicine, sydney, australia * anthony a. zehetner, faculty of medicine and health, the university of sydney school of medicine, sydney, australia received: january 6, 2019 accepted: january 20, 2019 online published: january 28, 2019 doi:10.22158/ct.v2n1p1 url: http://dx.doi.org/10.22158/ct.v2n1p1 abstract leaders remain as visible, influential and controversial in today’s society and media as ever. twenty-first century doctors are called to be inherent leaders, dependent and determined by their surrounding team of staff, organizational hierarchy and health care system structure. this paper examines today’s clinician as leader: through differing leadership styles, workplaces, function, how they relate to (and are constrained by) the practice of medicine under the australian health care system and asks what makes a good medical leader. the unique setting of general practice and a woman’s perspective are also considered. sections on medical leadership’s contribution to change, risk-taking and tolerating chaos cover the concepts of unpredictability in medicine and if and how doctors as medical leaders attempt to cope with this eventuality. each assertion raised is supported by current business and medical literature referenced data. the reader is encouraged to ponder their own workplace committee practices, leadership style and consider areas which they may wish to address and improve upon. keywords leadership, workplace, risk, change, bureaucracy, transformation, protocol, organization, clinical governance www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 2 published by scholink inc. 1. introduction doctors in the twenty-first century are no longer solely clinicians. they are teachers, researchers, advocates, managers, employers, administrators and, most importantly, leaders. leaders are increasingly visible in today’s society, on social media and in the news. historically and now, they remain influential and controversial. though what makes a good leader and particularly in the field of medicine? the nature of modern medicine in australia, where practitioners manage a patient’s health in collaboration with one another, necessitates and defines a bureaucratic leadership model. patients are not treated in a vacuum or in isolation. the general practitioner (gp) coordinates allied health services and provides primary care. the subspecialist (secondary tier level of care) relies on referrals from the gp to see patients. hospitals (predominantly university teaching tertiary care sites) refer the patient back to local community health services and their gp once treatment is completed. each workplace operates under different environmental conditions and a leader is required to adapt any prevailing systemic processes suitably and logistically. to maintain advantage, the organization must have unique qualities (chiefly their staff’s skills) which differentiate it from its competitors. the effective leader is able to recognize and nurture these. this co-dependent leader-follower relationship ensures the organization’s viability and longevity. a strong leader knows their organization’s swots (strengths, weaknesses, opportunities and threats) (souba, 2000). this aspect of leadership is not unique to medicine but vital to its success. 2. method organizations may have many different leaders within them, each with a different leadership style. bureaucratic leaders with a directed-management approach (marshall et al., 2003) are most likely to succeed in medicine practiced within a hospital-setting. they are able to liaise with multiple departments, coordinate their operation, possess agency and meet outcomes, such as key performance indicators (kpis), within fixed resource and budgetary constraints. bureaucratic leaders tend to operate “by the book”, so staff are comfortable with their leadership style and know what to expect. however there may be few new changes in the organization’s direction. a bureaucratic leader may be a misnomer, because leadership is “by numbers” and protocol (transactional leadership). should there be a precedent, it is referred up the management line for an executive decision. this suits a hospital environment as systemic protocols, policies and pathways are embedded in workplace culture to maintain safety, operate at a proficient standard (best practice) and routine tasks are performed repetitively, consistently and precisely. leaders who adopt democratic or participative styles tend to be seen as more positive (successful), though this still assumes that one leadership style is “best”. certainly this arrangement works well for www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 3 published by scholink inc. committee meetings when taking into account different personalities and aligning them to a common process. it is less effective consulting staff junior in their roles. this behavioral construct does not take into account situational leadership. clinicians adept at coordinating cardiopulmonary resuscitation in the crucible of an emergency department may not translate these teamwork skills to the hospital’s boardroom. a nursing unit manager may not organize a team of non-nursing staff equally as well. within small private or solitary medical practices, autocratic leaderships tend to flourish. while this may prove useful in the context of new and inexperienced staff, it promotes staff becoming dependent on their managers and stunts initiative. over time, autocratic leaders are usually shunned by employees as work practices are shaped by negative consequences (less pay or reprimands) and employee input is not encouraged. visionary, transformational and charismatic leaders may reinvigorate and motivate any field, including medicine. this is usually reserved for large corporate practices as existing clientele (patients) do not take kindly to new approaches, which may be considered experimental in their eyes. quality is linked with trust in medicine (berwick, 2003) and any failed outcomes from unproven new processes can be damaging to both traditionalist patients and pressured managers. an inflexible, autocratic leader brought into any organization may stifle it if that leader is not cognizant of the existing workplace’s culture and needs. 3. result 3.1 why health care leaders and funding don’t always mix in australia, hospitals are funded via the state and outpatient general practice (medicare) services federally. the total health care budget in australia is 10.3% of gross domestic product (gdp) with two-thirds being derived from government sources and of this, 61% from federal and 39% from state funds (australian institute of health and welfare, 2018). the patient population case mix also determines funding rather than absolute numbers. for example, a patient undergoing an appendectomy with a history of smoking would receive more funding than one without, based upon coding under diagnostic related groups (drgs) and recently implemented activity based funding (abf). an orthopedic ward with a high turnover of patients may still receive less funding than a smaller oncology ward (with less “occasions-of-service”) due to the greater amount of comorbidities and treatment complications, even if total patient numbers are higher in the orthopedic ward. all of these instruments and measures are used to reduce heterogeneity between cases and provide effective benchmark comparisons (such as length-of-stay). this is to guide budget and resource allocation, optimize patient care (via staffing ratios matched to clinical need) and to predict (and plan for) future trends. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 4 published by scholink inc. abf is less accurate when there is an outlier present to skew results. the long-term ventilated patient may increase total length of stay and costs, possibly leading to a financial loss in the immediate term but an excess monetary gain in future if the budget is summarily increased but a second “outlier” doesn’t then arrive. if tertiary hospital a specializes in a specific procedure (e.g., organ transplant), it will attract funding dedicated to that specialty in the health budget, and away from hospital b, which does not perform that procedure. however, should hospital b wish to establish performing the procedure, resistance may be met? this may be because hospital b may be underfunded and cannot provide cost-effective resources to provide the new service, as it has not been budgeted for this in the past. there may also be resistance from hospital which may be unwilling or unable to relinquish funding, or fear an exodus of trained staff to hospital b. these cross-divisions and potential lateral tiers of management add another level of complexity to current hospital funding. there is a potential disincentive for hospitals to provide greater clinical services—does creating a service actually increase demand and potentially unhappy clientele who now have to wait for something they wouldn’t previously have been offered? as progress occurs in medicine, does availability become the new gold standard of care and thus best practice? if so, savings have to be found and the pie of resources carved up into ever smaller slices. by changing a reimbursable service from a hospital to a community general practice setting (state to federal funding), may result in savings from one sector (here the state health budget) to an increased deficit in another (here the federal health budget); while the total national health care expenditure remains the same. individuals and departments which are able to make efficient use of their budgets and resources are currently stripped away of their “excess” funding and are expected to fulfill the same outcomes in the next financial year using this new, smaller budget. this conflict of interest makes a department disinclined to save money and operate efficiently. in effect, proficient departments are penalized and inefficient ones rewarded! preventative health care also fares poorly under this arrangement. this field deals with potential (or virtual) inpatients. illness prevention campaigns usually require several years to become established and beneficial effects on illness rates may take years to be seen (for example, the reduction in melanoma incidence with increased sun protection initiatives). unfortunately the health budget is finalized each year and governments can rarely plan for a term in office beyond four years. “fashionable” illnesses in the public limelight of advocacy groups (such as breast cancer, childhood cancer and mental health) are also very visible on a political agenda (australian institute of health and welfare, 2018). this influences voters with these illnesses, rather than those too young to vote (or are yet to be born!) unfortunately rare congenital illnesses, such as metabolic disorders, are often www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 5 published by scholink inc. overlooked. the health dollars saved through health prevention are frequently channeled into other projects (reprioritized spending). even if those prevention programs pay for themselves over the long-term—a healthier population is able to pay more taxes for a longer time—the dollars saved are virtual (and not tangible; though are still likely to be spent before they have been collected)! 3.2 unique and general practice general practice is uniquely placed at a junction between small and large business, non-profit organization and commercial concern, private enterprise and public service. it has autonomy but answers to regulatory bodies (and is defined by them). funding may be public, private or a combination of both. practices may be established as sole-traders, partnerships, companies or franchisees. some clinics are not for profit concerns and are publically-funded; receiving a monetary allowance from the government to operate (e.g., aboriginal health services) (australian institute of health and welfare, 2018). within the practice, there may be a single practitioner (autocratic leader), a governing board (bureaucratic leadership) or an external one (if the organization is a satellite institution). the staff is likely to be diverse—administrative, clerical and clinical; each with differing levels of expertise and/or areas of interest. some general practices include allied health personnel (for example physiotherapists, psychologists, dieticians and pharmacists); others employ doctors holding specific skills; such as sexual health, addiction medicine, cosmetic medicine and obstetrics expertise. all of these factors influence the general practice workplace, the type of leader which is required and what sort evolves and thrives. competing interests of large gross profits are hindered by health insurance commission audits if too many patients are seen within a short period of time compared to peer benchmarks. other local general practices are seen as rival competition in the eyes of business but as colleagues and friends during area divisions of general practice and continuing professional development meetings. the autonomic practitioner may be constrained by health department directives, clinical practice guidelines and public health policy. similarly, alliances with a pharmaceutical wholesaler, pathology testing company or private franchise may also influence performance, profitability and scope of services offered. the leader of a general practice may be a non-clinical practice manager or a nurse in a co-dependent physician leadership arrangement (ponte, 2004). 3.3 a woman’s perspective general practice tends to have a varied workforce demographic, like the arts industry. within medicine, the specialty of general practice has a higher proportion of female workers (who may also work more part-time hours), contains more ethnicity minority groups and has diverse practice settings in both rural and urban localities (kilminster, et al., 2007). www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 6 published by scholink inc. women comprise the dominant gender within the healthcare industry and are the greatest consumers of health care (kirchheimer, 2007). female gender dominates part-time employment (australian bureau of statistics, 2018). women remain underrepresented in the top echelons of healthcare leadership. women are more likely to be departmental heads but men are more likely to be chief executive officers and corporate presidents. a salary disparity (up to 20% less for women) prevails, even when controlling for gender differences in educational attainment, age and experience (lantz, 2008). females are more likely to voluntarily withdraw from the workforce for a family-related reason, such as spouse career move or to raise children, than men. however with respect to patient care, communication style, not gender, is more important in determining patient response to a doctor (aruguete & roberts, 2000). 3.4 medical leadership’s contribution to change change is inherent to leadership, which may be described as an adjective referring to the capacity of motivation to change (fry, 2003). the leader’s vision will define the organization’s culture and attitude towards change (contingency theory). change involves loss: to the status quo, predictability and traditions. leaders need to make the pain of change worth the effort (tichy & devanna, 1986). this is achieved through clarity of purpose or mission (pietersen, 2002). honest communication, participation, goal and example setting are the currency to allow change to pay off. leaders are reformists under a myriad of guises: service redesign, workplace management, productivity review, etc. the clash of innovator and conservative, rather than generating a spark of dynamism, slows the winds of change. the more established an organization and its philosophy, the slower is the pace of change. a wise leader knows how to play the long game, position themselves ideally and achieve permanent change through increments, rather than introduce radical maneuvers which may prove a step too far to accept. stand still and they fail too by preventing future innovation from occurring. leadership without direction is useless (chervenak & mcculloch, 2001). change provides direction to pursue excellence. visionary leaders can see the benefits for change that others cannot and thus initiate it and do not resist it (ham, 2003). the transforming leader raises the aspirations of his or her followers so that the leader’s (or organization’s) and follower’s aspirations are fused (parry & bryman, 2006). skillfully handled, this will also apply to change. change is continual and anticipatory (hindle & natsagdori, 2002) and conditions need to be in place for it to happen (ham, 2003). rapid organizational change may cause demoralization and reduced quality of care (gershon, stone, bakker, & larson, 2004). being diplomatic, leaders can enlist other professionals (who may initially be reticent) and engage them in reform top-down. hopefully over time, within the organization a converse bottom-up process of input and reform is established that everyone may contribute to. this also has the advantage of the employees generating change themselves and not www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 7 published by scholink inc. having it thrust upon them (ham, 2003). by including this adaptation to change as part of continuing professional development, it also becomes integrated into workplace culture, collegially acceptable (adopted by existing and new workers), and an industry standard rather than revolutionary. we come full-circle back to systemic protocols, policies and pathways embedded in sites such as public hospitals. 3.5 risk-taking in medical leadership leadership involves taking risks (reinertsen, 1998). good leaders know which risks to take (bad leaders don’t). they take calculated risks but not unnecessary ones. an autocratic leader may make harmful decisions by not having the foresight and varied perspectives that a bureaucratic leader enjoys. similarly a paranoid mistrusting chief may make large, preventable mistakes (joni, 2004). however a bureaucratic leader may become an endemic “non-risk taker” due to the structure that system employs in maintaining the status quo—potentially stifling innovation and creativity (lok & crawford, 2004). workplace-leadership discrepancies may arise in situations where an entrepreneur in private practice takes over the running of a “not-for-profit” public hospital or when a temperate civil servant used to conservative “middle management” policy and decision via consensus, is asked to spearhead groundbreaking reforms. a leader must know when to take risks with personnel. excessive loyalty, such as a seniority hierarchy, engenders over-protectiveness and may reduce the productivity of the organization (joni, 2004). it may be time for new blood to reinvigorate the organization and challenge established work practices so they become more efficient. a true leader does not shy away from self-audit despite the potential pain of reality. responsibility over an organization also implies accountability for it. 3.6 risk-taking in medicine unlike the military or sporting arenas, the field of medicine is not traditionally seen as one in which to take risks. doctors like to deal with certainties (even though nature itself is uncertain), such as the predicted course of a disease or the response rate to a particular chemotherapeutic agent. the science of medicine means that doctors tend to remove emotion from decision-making, yet making decisions lies at the heart of taking risks. leaders in-tune with their employees’ emotions tend to be more effective decision-makers (parry & bryman, 2006). frequently doctors take risks on behalf of others: the patient with cancer, the one about to undergo surgery and when allocating spending from public coffers. while consent and the ultimate decision lies with the patient, budget signatory, health minister, etc., the way doctors frame risk and expected results influences the decisions being made in medicine. consumers (patients) in medicine are adverse to risks being taken for managerial protection and (those managers’) increased personal gain. this “customer-as-expert” shares decision making (and risk) with the technical expert (harrow, 1997). risk-taking is not simply acknowledging potential negative consequences, and weighing the risks against benefits, but also recognizing vulnerabilities and having an alternative plan to cope with www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 8 published by scholink inc. unexpected problems (mcgowan, 2007). this is where leaders shine or fall. risk-taking is not anathema to teamwork. being able to share risk with an informed team is a critical attribute for the modern leader. here the leader is not seeking self-protection from the team in the case of failure, rather gathering support and approval from the team through sharing the same vision, benefits and risks of the venture (mcgowan, 2007). the leader is captain of the team and is not coaching from the sidelines. 4. discussion 4.1 clinical governance inherent in any leadership position are expected outcomes. risk-taking is frequently the path travelled to achieve these. risk-taking in an organization is generally not seen as negative so long as it achieves results and is supported by effective leadership (borins, 2000). the concept of clinical governance in medicine places risk in a managerial context as something to be viewed openly. methodology, such as root cause analysis, seeks to define risk as a wholly manageable concept which can be negated through well-developed systems. while this may lead to greater (and more public) visibility of misadventures in medicine, unless remedial approaches are in place, best practice is not delivered and public confidence in medicine and its capacity for autonomy is eroded (donaldson, 1998) (the naive or overconfident leader feels that all risk may be negated!). some leaders are risk-avoiders to their peril. laissez faire (“hands off”) leadership, where free-reign is excessively delegated to subordinates, may result in targets not being met and the organization failing (a ship without a captain). staff may feel insecure under this type of leader. management by exception, where the leader avoids giving corrective direction as long as the old ways appear to work and performance goals are met (sarros & santora, 2001) is similarly destructive. an organization stagnates without innovation and self-reflection. the structure of a system remains fixed without the input of an effective leader and the potential for entropy increases (nolan, 1998). without risk and the prospect of failure, achievements lose their meaning. a risk-free workplace environment where employees operate through trial and error without consequence defeats the function and value of their work (denis, langley, & pineault, 2000)! good leaders don’t have a fear of failure they just have a healthy respect of it. great leaders learn from failure and act differently on subsequent occasions. they blame themselves and transform adversity into opportunity. like risk-taking, learning is another integral part of any good leader. 4.2 tolerating chaos as a medical leader chaos may be thought of as change without direction, uncertainty without purpose. before any new age there exists a tumultuous period of change, akin to volcanic activity occurring before the creation of a new land mass. reformation, like evolution, has the tendency to proceed through fits and starts (denis, www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 9 published by scholink inc. langley, & pineault, 2000). effective leaders adopt democratic or participative styles. they take into account the bureaucratic model but are not afraid to also be transformational or visionary. such a leader, assisted by charisma, is able to motivate an organization, provide reassurance and transcend work practices (and an atmosphere of apprehension) during times of chaos, so that employees remain calm and continue to strive for more. this empowers employees with morale, encourages dialogue and imbues a dedicated work ethic. modulating organizational performance from effective leadership is achieved through establishing a workplace culture (lok & crawford, 2004). good leaders create it, poor leaders don’t. management is primarily focused on short term (transactional) results. as stated earlier, leadership is about playing the (transformational) long game: motivating people to change, to achieve long-term results (fry, 2003). motivation energizes, directs and sustains human behaviour, as well as long-term change. by taking ownership of the change, even catalyzing it within the organization, the transformational leader may deftly navigate the organization through the storm of chaos. organizations demand of leaders hard evidence, that changes introduced incrementally over time or that their navigation through episodes of uncertainty, will truly result in more effective and enduring service improvements (sarros & santora, 2001); with the organization surviving intact (possibly even triumphing) when the period of chaos is over. leaders, being transformational and visionary, may not be able to offer such tangible guarantees, despite having a proven track record of taking gambles which pay off (and probably led to them being offered the position in the first place). 4.3 constancy influence is a tool to enable change intrinsically, authority is the right to do so and power enforces change extrinsically. an organization led through fear (control and employee compliance, a carrot and stick model) will reject change as it is solely extrinsically motivated. here workers respond only to low order needs, such as salary and working conditions, independent to the nature of the task. intrinsic motivation transcends self-interest for group worth. it promotes concern and enjoyment of an activity for its own sake, facilitating growth and satisfying higher order needs. in addition to the follower (employee), the leader similarly enjoys competence (task-mastery), autonomy (including internal motivation) and relatedness, through empowered teamwork. individuals, who take ownership and are completely engaged, stimulate creativity and take pride in their work. they also feel a sense of progress and accomplishment which ultimately leads to superior organizational gains and outcomes (fry, 2003). in times of uncertainty and chaos, capable leaders possess an eye for change and a steadying hand. they have an enduring vision and the reassurance that change can be mastered (barker, 2002). the one constant in change should be the organization’s leader. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 10 published by scholink inc. references aruguete, m. s., & roberts, c. a. (2000). gender, affiliation and control in physician—patient encounters. sex roles, 42(1⁄2), 107-118. https://doi.org/10.1023/a:1007036412480 australian bureau of statistics. (2018, december 20). 6202.0—labour force, australia, nov 2018. retrieved january 2, 2019, from http://www.abs.gov.au/ausstats/abs@.nsf/mf/6202.0 australian institute of health and welfare. (2018). australia’s health 2018. retrieved january 2, 2019, from https://www.aihw.gov.au/reports/australias-health/australias-health-2018 barker, l. (2002). power, influence and action: making leadership work. in australia institute of management. the heart and soul of leadership, sydney, australia: mcgraw-hill. berwick, d. m. (2003). improvement, trust, and the healthcare workforce. qual saf health care, 12, 448-452. https://doi.org/10.1136/qhc.12.6.448 borins, s. (2000, nov/dec). loose cannons and rule breakers, or enterprising leaders? some evidence about innovative public managers. public admin rev, 60(6), 498-507. https://doi.org/10.1111/0033-3352.00113 chervenak, f. a., & mccullough, l. b. (2001). the moral foundation of medical leadership: the professional virtues of the physician as fiduciary of the patient. american journal of obstetrics and gynecology, 184(5), 875-880. https://doi.org/10.1067/mob.2001.113854 denis, j. l., langley, a., & pineault, m. (2000, dec). becoming a leader in a complex organization. j manage stud, 37(8), 1063-1099. https://doi.org/10.1111/1467-6486.00217 donaldson, l. j. (1998). clinical governance: a statutory duty for quality improvement. j epidemiol community health, 52, 73-74. https://doi.org/10.1136/jech.52.2.73 fry, l. w. (2003). toward a theory of spiritual leadership. the leadership quarterly, 14(6), 693-727. https://doi.org/10.1016/j.leaqua.2003.09.001 gershon, r. r. m., stone, p. w., bakken, s., & larson, e. (2004). measurement of organizational culture and climate in healthcare. jona, 34(1), 33-40. https://doi.org/10.1097/00005110-200401000-00008 ham, c. (2003). improving the performance of health services: the role of clinical leadership. lancet, 361, 1978-1980. https://doi.org/10.1016/s0140-6736(03)13593-3 harrow, j. (1997). managing risk and delivering quality services: a case study perspective. int j pub sector manage, 10(5), 331-352. https://doi.org/10.1108/09513559710172140 hindle, d., & natsagdorj, t. (2002). treating organisational illness: a practical approach to facilitating improvements to health care. australian health review, 25(6), 171-180. https://doi.org/10.1071/ah020171a joni, s-nj. (2004). the geography of trust. hbr, 82(3), 82-88. kilminster, s. et al. (2007). women in medicine—is there a problem? a literature review of the www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 11 published by scholink inc. changing gender composition, structures and occupational cultures in medicine. medical education, 41(1), 39-49. https://doi.org/10.1111/j.1365-2929.2006.02645.x kirchheimer, b. (2007). a woman’s place is in... modern healthcare, 37(16), 6-7. lantz, p. m. (2008, sep-oct). gender and leadership in healthcare administration: 21st century progress and challenges. j healthc manag, 53(5), 291-301; discussion 302-303. https://doi.org/10.1097/00115514-200809000-00004 lok, p., & crawford, j. (2004). the effect of organizational culture and leadership on job satisfaction and commitment—a cross national comparison. journal of management development, 23(4), 12-18. https://doi.org/10.1108/02621710410529785 marshall, m. n. et al. (2003, september 13). managing change in the culture of general practice: qualitative case studies in primary care trusts. bmj, 327(7415), 599-602. https://doi.org/10.1136/bmj.327.7415.599 mcgowan, j. j. (2007, january). swimming with the sharks: perspectives on professional risk taking. j med libr assoc, 95(1), 104-113. nolan, t. w. (1998). understanding medical systems. annals of internal medicine, 128(4), 293-298. https://doi.org/10.7326/0003-4819-128-4-199802150-00009 parry, k. w., & bryman, a. (2006). leadership in organizations. in s. clegg, c. hardy, t. lawrence, & w. nord (eds), sage handbook of organization studies. london, uk: sage publications ltd. https://doi.org/10.4135/9781848608030.n15 pietersen, w. (2002). the mark twain dilemma: the theory and practice of change leadership. journal of business strategy, 23(5), 32-37. https://doi.org/10.1108/eb040272 ponte, p. r. (2004). nurse-physician co-leadership: a model of interdisciplinary practice governance. jona, 34(11), 481-484. reinertsen, j. l. (1998). physicians as leaders in the improvement of health care systems. annals of internal medicine, 128(10), 833-838. https://doi.org/10.7326/0003-4819-128-10-199805150-00007 sarros, j. c., & santora, j. c. (2001). leaders and values: a cross-cultural study. leadership & organization development journal, 22(5), 243-248. https://doi.org/10.1108/01437730110397310 souba, w. w. (2000). editorial: the core of leadership. the journal of thoracic and cardiovascular surgery, 119(3), 414-419. https://doi.org/10.1016/s0022-5223(00)70118-8 tichy, n. m., & devanna, m. a. (1986). the transformational leader. new york, ny: john wiley. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 12 published by scholink inc. note dr anthony zehetner is a staff specialist in adolescent medicine at the children’s hospital at westmead, a consultant paediatrician in private practice and a clinical senior lecturer for the university of sydney. he completed a master of medicine (paediatrics) including studies in medical leadership and also has a management degree. children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 1, no. 2, 2018 www.scholink.org/ojs/index.php/ct 68 original paper college stress: testing the unidimensionality of a standardized stress measuring inventory designed to assess stress among college students avdi s. avdija1* 1 department of criminology and criminal justice, indiana state university, usa * avdi s. avdija, department of criminology and criminal justice, indiana state university, usa received: june 1, 2018 accepted: june 18, 2018 online published: june 28, 2018 doi:10.22158/ct.v1n2p68 url: http://dx.doi.org/10.22158/ct.v1n2p68 abstract stress is a very common and unavoidable emotional strain among college students. the full domain of college stress has multiple dimensions, each with a unique perspective. the current study examines the unidimensionality and reliability of a 48-items standardized scale designed to measure perceived college stress among students. this perceived stress inventory (psi) consists of five subscales; each measuring a unique aspect of college stress. to test of unidimensionality and reliability of psi, factor analysis and psychometric properties were examined. the analyses are based on the data that were collected from 302 college students. the results of this study show that the all five subscales of the perceived stress inventory (psi) are reliable and each of them is unidimensional. keywords college stress, financial stress, academic stress, social stress, time management, family stress 1. introduction stress is a natural part of life. everyone experiences stress at some point in time or another. one particular time that many people experience stress is throughout their college experience. it is something that can determine their future, where they will meet lifelong friends, meet potential spouses and make memories that will last forever. college is also a time when students can obtain mountains of debt, struggling to obtain good grades, and other stressors. in the life of the typical college student, there are a plethora of factors that may prove difficult for students who find themselves engaged in the new and exciting environment that is college. while movies depict this time in life as nothing but a party, many students find out the hard way that stress plays a massive role in the life of a young www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 69 published by scholink inc. collegiate. in many cases, students face a combined number of stressors that include all different areas of their lives. academia, finances, time management, social, and familial stressors are among those. this literature review focuses on these factors and how they impact college students and their stress levels. 1.1 academic stressors academic stressors are very common among students. as one progresses in academia, presumably, the material which one is studying will increase in difficulty. however, many believe that the academic stressors facing college students today are relatable to that of symptoms of post-traumatic stress disorder or ptsd (woolman, becker, & klanecky, 2015). ptsd is commonly associated to life instances of intense stress which may cause and individual to develop coping mechanisms in order to deal with these symptoms. research shows that, in such instances of female college students who reported they had been exposed to some sort of trauma, including instance of academic trauma, a large percentage of these women turned to coping with alcohol in order to subside their symptoms. a number of these female students report that their low academic performance is directly related to their coping strategies which are maladaptive in nature (woolman et al., 2015). given that sufferers of ptsd include individuals who have fought in wars and seen things that are unimaginable to the average person, including female college students on the list of those sufferers of ptsd based off of negative academic performances appears to raise red flags. nonetheless, stress is manifested in different forms. one instance would be the inability of students to properly concentrate, absorb information, or the idea that students may lack the interest in the topic of study may increase a student’s risk of symptomatic academic stress (bhujade, 2017). while a simple solution may be to encourage students to engage in coursework that appeals to them, many students may find their academic path shifting as they navigate the curriculum on their campus. despite the ability for students to add and drop courses, grades may negatively be impacted as well as the timeline of a traditional undergraduate student timeline. students who choose to change their major while enrolled in a different program may have to find extra time and money to stay on campus for a longer amount of time which can then create additional stressors. according to recent research, the most frequently reported stressor within academic is grades and competition (lee, kang, &yum, 2005). nevertheless, college stress is a multifaceted emotional strain. 1.2 financial stressors students often times worry about debt loads and other financial responsibilities that negatively affect their well-being. this type of worry is even worse for those with financial difficulties, including low-income families, and those first generation college students. not only is there financial strain on a majority of college students, but those who are first generation college students may experience a higher influx of stress when determining how and where they will attend a four-year college. in this www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 70 published by scholink inc. regard, stress starts even before starting college. in fact, for some perspective students, financial stressors can determine if they ever attend or start college and drop out before completing it. research shows that, in comparison to their non-low income counterparts, only about 10% of students in low-income areas will obtain a college degree by the age of 25 (adams, meyers, & beidas, 2016). adams et al. (2016), in their study addressed the relationship between the financial strain and several outcome variables, including the psychological symptoms, academic, and social integration of students using a cross-sectional survey, all amongst first-generation college students. this shows that one type of stress, in this case, financial stress, can play the role of a mediating factor, in a negative way, affecting other factors such as physiological and psychological well-being. along this line, white and perrone-mcgovern’s (2017) study shows that those students who experience high financial stress would have lower levels of career decisions and academic self-efficacy. thus, financial stress has an effect on future choices that students make. furthermore, financial stress can also affect academic performance and retention. according to trombitas (2012), about one third of students admitted that financial stress negatively affected their academic performance. among the highest stress-producing factors were the need to repay loans, the cost of education, borrowing money for college, etc. (trombitas, 2012). students with higher amounts of student loans are less likely to continue college, and likely that they never graduate. britt, ammerman, barrett, and jone’s (2017) study confirm this hypothesis in their resent research, indicating that students who discontinued college had higher student loans compared to those who successfully completed or continued college (britt et al., 2017). 1.3 time management stressors students in college often struggled with time management. many students find it difficult to balance outside life and school. students who have multiple classes and/or jobs to financially care for themselves, find themselves multitasking quite frequently. they tend to struggle with time management often because of the responsibility they have placed upon themselves with other things. although school may come first in a student’s life, jobs tend to be equally important factors as well. not only does a student have to excel in school, but at work as well, that is if they want to keep a good work history. many jobs in college towns are willing to work with college students to make their schedule a little less hectic; nevertheless that is not always the case. students must utilize time management wisely and prioritize activities accordingly. thus, time is another aspect of the life of a collegiate may find difficult to manage while attempting to go to school and to have a social life at the same time. macan and shahni (1990) study shows that those who reported they have good time management skills are those students who show success in their gpa and academic performance (macan & shahni, 1990). after studying a group of over 100 undergraduate students, they found that there were many correlations between time management and those who reported stress or performance issues. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 71 published by scholink inc. similarly, misra and mckean (2000) looked at ways to increase time management skills among young people looking at goal-setting, making lists of priorities, organizing their work space, and how those undergraduate students perceived their control of time. in this study, a significant finding was the differences between gender roles, indicating that females experience stress at a higher level than their male counterparts. however, this finding contradicts the findings of a more recently published research article by khatib (2014). according to khatib, females reported a higher time managements compared to males, and higher time management was negatively associated with stress (khatib, 2014). this means, that individuals with higher time management experienced lower stress level. 1.4 social stressors on top of schooling, working, and other aspects of life, students must find time to engage friendships and relationships outside of those activities. one of the great aspects of the college experience is meeting new people. by meeting new people, individuals are able to possibly meet people that may be culturally different and build long lasting relationships with such people. once these relationships are built, students find it hard to maintain these relationships due to the fact they find themselves busy with other aspects of the college life. looking at it from another point of view, students also feel that they are not the only ones busy, so are their friends. whether their friends are on campus with them, or different university, or back in their hometown, often times students struggle trying to stay connected or reconnecting with their friends. students must find time out of their busy schedules to do things for themselves socially. as mentioned above, making time to have a social life in college can cause stress when one is trying to remain social, but also focus on school and perhaps work. many scholars connect stress, which may be social in nature, to drug use among college students. coleman and trunzo look at over 200 undergraduate and graduate students that aged 18-24 in order to determine minor drug use (alcohol and marijuana) and more serious drug use (narcotics). by using self-report tools, researchers were able to gather information concerning stress levels and drug use. their study found that social stress and neuroticism, which was found to be a common trait of drug users, in combination, were largely able to predict total drug use (coleman & trunzo, 2015). so, in addition to dealing with social stressors that face college students, those who display neurotic tendencies are more likely to engage in these risky behaviors while in college, further contributing to failures in college. 1.5 family stressors after examining those stressors that are determined to be financial concerning, the ability of parents to be able to send their children to a university while not breaking the budget, this can also be an applied family stressor to college students. perhaps students feel guilty for using what little money their parents have in order to send them to school. this can create a stressor amongst the family unit whether or not it actually exists. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 72 published by scholink inc. in addition to these notions, students may feel that their families have higher expectations than what a student may feel he/she is able to realistically achieve. katz and nelson (2007) tested a hypothesis regarding those students who feel as though their needs in regards to parental care have not been met while pursuing their undergraduate degrees. these additional familial stressors may induce a greater amount of self-criticism on behalf of the student (katz & nelson, 2007). after gathering information from undergraduate students using the self-reporting levels of self-criticism scale, they found that there was a correlation between family stress and self-criticism, which may then affect a student’s likelihood of being successful in the secondary education ventures. moreovver, family stress can also be manifested in a form of a broken quality of relationship between the family and the student, which correlates with stress (yazedjian, toews, & navarro, 2009; putwain, woods, & symes, 2010). in other words, a good quality relationship between the family and the student acts as a stress-reducing factor (anders, 2011). 2. summary college can be a very stressful time for students and families alike. academic stressor, financial stressors, time management stressors, social stressors, and family stressors can create additional challenges for those students attempting to be successful while working towards their academic and career goals. as all of these studies show, perceived stress, regardless of what type of stress it may be, can have a negative impact on college students and their abilities to maintain a positive self-image. these stressors may cause college students to engage in risky behaviors, such as drug use, which can create additional issues for students, can lead to problems with retention, etc. all in all, stressors, whether they are real or perceived, can create additional issues for students who are attempting to have a successful secondary educational experience. 3. the present study as stated in the abstract, the primary objective of this research study is to determine whether the subscales of a 48-item perceived stress inventory (psi) designed to measure stress among college students are unidimensional or not. the second objective is to measure the reliability of the survey instrument. the first objective will be achieved by examining the results of factor analysis and the second objective by examining the psychometric properties of subscales. building on previous studies, the measuring inventory that is tested in this study has been refined and re-constructed to broaden the domain of the perceived stress inventory (note 1). the primary base of this inventory is the 1999’s student stress survey (sss) (ross, niebling, & heckert, 1999), as well as insel and roth’s 1995 stress inventory. however, the current measure (psi) is reorganized and more complete. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 73 published by scholink inc. 4. methods 4.1 the data and participants the data were collected from a sample of 302 college students. of which, 6.6% were freshmen, 28.8% were sophomores, 39.1% juniors, and 25.5% seniors. the majority of them were between the ages of 18 and 22 years old (89.7%, m = 21.2, sd = 3.03). in terms of gender, 44.7% were females and 55.3% were males. the racial composition of the sample is a good representation of the university from which the data were collected. the descriptive statistics show that 70.2% of the participants were whites, 15.9% african americans, 4% hispanic/latinos, 2.3% asians, and the rest were other races. 4.2 the data analysis since the primary objective of this research study was to determine whether or not the subscales of perceived stress among college students are unidimensional, the analyses focused primarily on looking at the factor analysis, including the scree plots for the subscales. however, the first step in this process was to determine the reliability of the composite measures for each scale. the reliability of the perceived stress subscales were measured by looking at the internal consistency and stability of scores within each subscale equated with cronbach’s alpha (devellis, 1991). the next step included factor analysis. this analysis also include the kaiser-meyer-olkin (kmo) measure of the sampling adequacy (kaiser, 1974), and bartlett’s test of sphericity to determine that the correlation between items within each subscale is statistically different from zero. the last step that contributed significantly to the main objective of this study was the scree plot for each subscale. the reason for including scree plots was to show a visual display of the dimensionality of each subscale. the “elbow” on the scree plot shows whether or not the subscales are one-factor solutions or multiple-factor solutions. 5. results the perceived stress instrument (psi) that was designed to measure stress among college students has 48 items total. this inventory is designed to measure stressors in five different areas: financial stressors (7 items), time management stressors (9 items), social stressors (12 items), academic stressors (13 items), and family stressors (7 items). in terms of content validity of this inventory, these five dimensions describe the full domain of perceived college stress among students. each item on these scales is measured on a 10-point lickert scale, ranging from 0 (no stress) to 10 (high stress). see appendix a for a complete list of items. 5.1 reliability analysis reliability of a measuring instrument refers to the consistency of that measuring instrument when it’s used on repeated trials (carmines & zellrn, 1979). it is the first step in assessing the validity of the measuring instrument, which is not assessed in this study. in other words, reliability is the prerequisite for validity of a measuring instrument. in this study, the purpose of testing the reliability of subscales www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 74 published by scholink inc. was to see the relationship between individual items within each subscale. that way, the subscales consistently reflect the constructs that are measured. the reliability of subscales was assessed by looking at the crombach’s alpha levels, which is widely known as the test of internal consistency of scales. crombach’s alpha tests the average correlation of items in the measuring instrument (santos, 1999). crombach’s alpha values range from 0 to 1, and values that approach 1 have a higher internal consistency, which are desirable for every measuring instrument. since stress is a psychological construct, a 0.70 would be the cut-off value of internal consistency measure (kline, 1999; devellis, 2003). based on this cut-off value as a base measure for assessing the reliability, the crombach’s alpha level for each subscale, as shown in table 1, is adequate. in fact, most subscales show an internal consistency value of 0.08 or above. this means that the measuring instrument is expected to produce reliable results when used in repeated trials. furthermore, even if these subscales are used independent of one another (i.e., some researchers may consider using them selectively to measure a particular dimension of college stress), they still produce reliable results. table 1. cronbach’s alpha for each subscale in the perceived stress inventory (psi) subscales crombach’s alpha number of items financial stress .891 7 items time management stress .871 9 items social stress .820 12 items academic stress .906 13 items family stress .739 7 items 5.2 factor analysis the purpose of using factor analysis in this study was to uncover the underlying structure (norris & lecavalier, 2010) of this stress measuring inventory designed to specifically measure college stress among students. to put it another way, factor analysis is a statistical technique that helps identify whether the subscales of this inventory are one-factor solution or multi-factor solution. it is one of the techniques used to determine whether the subscales are unidimensional or not. a unidimensional scale is one that measures only one thing/dimension. if a scale or subscale measures only one dimension of stress, then it is considered a one-factor solution scale/subscale, which is a desirable outcome for research purposes. before looking at the eigenvalues on table 3, it is important to review the results of kaiser-meyer-olkin measure of sampling adequacy (kmo) and bartlett’s test of sphericity, both sets www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 75 published by scholink inc. of results are presented in table 2 below. as stated in the “data analysis” section above, the kmo is considered a test of sampling adequacy, and the bartlett’s test of sphericity measures whether the variables in the composite measure are correlated statistically different than zero. for the bts test, the correlation matrix of variables should be statistically significant compared to the identity matrix. the significance level of bartlett’s test of sphericity should be less than .05 to be considered adequate. the kmo values range from 0 to 1. higher values, typically those that approach 1, are desirable because they indicate that using factor analysis would be an adequate statistical technique to explore the data. the cut-off value of kmo is 0.50 (field, 2009). some researchers argue that the cut-off value should be 0.60 (tabachnick & fidell, 2014). based on the above parameters for the kmo and bts, the data in table 2 show that all subscales have adequate scores. the kmo for each subscale is way above the cut-off value of .05/.60, and the bts is statistically significant at p < .000, indicating the correlation between items in subscales is statistically significant and different from zero. table 2. kaiser-meyer-olkin measure of sampling adequacy and bartlett’s test of sphericity subscales kmo bts chi-square bts sig. bts df financial stress .879 1230.52 .000 21 time management stress .832 1323.18 .000 36 social stress .833 931.87 .000 66 academic stress .901 2249.86 .000 78 family stress .776 423.54 .000 21 table 3 below shows the eigenvalues for the first three components of each subscale. ideally, a scale/subscale with only one eigenvalue above 1 is considered unidimensional. however, even if there are more than one eigenvalue with the value of 1 or above, the first component with the highest eigenvalue should explain a significantly larger portion of the variance compared to other components with eighenvelues 1 or above. the factor analysis in table 3 show that the financial stress subscale has only one eigenvalue of 4.292 (above 1), explaining a significantly larger portion of the variance (61.31%). the time management stress subscale had two eigenvalues above 1. the first eighenvalue (4.493) explained 49.92% of the variance, whereas the second eigenvalue explained 12.60% of the variance. the social stress subscale has two eigenvalues above 1. the first explains 34.41% of the variance, and the second explains 11.35% of the variance. the academic stress subscale has two eigenvalues above 1 also. the first explains 48.47% of the variance and the second explains 13.03%. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 76 published by scholink inc. the family stress subscale has two eigenvalues above 1, with the first one explaining 39.74% of the variance and the second one explaining 13.03% of the variance. overall, the first eigenvalue of each subscale is significantly larger than the second one, which is a convincing piece of empirical evidence to conclude that these subscales are a one-factor solution scales. table 3. factor analysis for all subscales subscales eigenvalues for the first three components % of variance for the first three eigenvalues 1 2 3 1 2 3 financial stress 4.292 .815 .583 61.31% 11.64% 8.32% time management stress 4.493 1.134 .978 49.92% 12.60% 10.87% social stress 4.129 1.136 .910 34.41% 11.35% 9.01% academic stress 6.301 1.695 .848 48.47% 13.03% 6.52% family stress 2.782 1.208 .831 39.74% 17.25% 11.87% note. extraction method: principle component analysis with varimax rotation. the scree plots presented in figure 1 show a visual display of computed eigenvalues that are presented in table 3. even though this statistical technique is considered somewhat not a clear decision-making model in research (see courtney, 2013), it is one of the best visual displays that can be used to determine the unidimensionality of a measuring instrument. based on the scree plot display of eigenvalues, the subscales are considered a one-factor solution (e.g., unidimensional). the “elbow” on the scree plot represents a sharp change on the eighenvalues with the first component significantly different than other components. if there is only one component above the elbow, then the scale/subscale is considered unidimensional, measuring only one dimension of, in this case, college stress. the scree plots in figure 1, coupled with the percent of variance for the first eigenvalue of each subscale in table 3, clearly show that, for most subscales, the number of components above the elbow is only one, which is a good indication of unidimensionality of subscales. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 77 published by scholink inc. figure 1. scree plot showing eigenvalues for each components of subscales, in factor extraction of the data from 302 subjects 6. discussion there are many scales that have been developed to measure college stress, but not all of them are as complete as the psi inventory that’s tested in this study. some of them have 14 items designed to measure college stress (civitici, 2015). brown and blankson (2013), for example, used an 18-item inventory to measure college stress, but their scale focused on specific race; particularly focusing on colleges students stress for black women. oh, blondin, cochran, and williams (2011) tested an 11-item college student stress scale inventory developed by feldt (2008). however, one inherited weakness of that scale is that it does not include the full domain of college stress. thus, it lacks content validity. other researchers have developed and used stress inventories, but again most of them are area-focused inventories with one or two dimensions of stress (i.e., measuring only academic stress, college life stress, a combination of two different dimensions, etc.). such scales were used by struthers, perry, and menec (2000) focusing on academic stress, rocha-singh’s (1994) gsi-r inventory focusing on environmental, academic, and family dimensions of stressors; burge’s (2009) 22-items scale focusing on three dimensions of stress: academic stress, time-related stress, and social-environmental stress, etc. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 78 published by scholink inc. the perceived stress inventory that is tested in this study has 48 items, measuring five unique domains of college stress (see appendix a). this psi inventory measures financial stress, academic stress, social stress, time management stress, and family stress. it has a very broad domain, thus contributing to an advanced content validity of this stress inventory. the analyses in this study show that the 48-items perceived stress inventory (psi) designed to measure college stress is a reliable measure. more importantly, what comes out of this current study is that all five subscales are unidimensional. they can be used individually to measure a specific segment of college stress, a combination of two or more, or all together to measure the full domain of college stress. references adams, d. r., meyers, s. a., & beidas, r. s. (2016). the relationship between financial strain, perceived stress, psychological symptoms, and academic and social integration in undergraduate students. journal of american college health, 64(5), 362-370. https://doi.org/10.1080/07448481.2016.1154559 anders, k. (2011). stress and family relationships among college students. poster presented at the 39th annual western pennsylvania undergraduate psychology conference, new wilmington, pa. bhujade, v. m. (2017). depression, anxiety and academic stress among college students: a brief review. indian associate of health, research and welfare, 8(7), 748-751. britt, s. i., ammerman, d. a., barrett, s. f., & jone, s. (2017). student loans, financial stress, and college student retention. journal of student financial aid, 47(1), 24-37. brown, a. i., & blankson, n. (2013). developing the college student stress inventory for black women (cssi-bw). interdisciplinary journal of undergraduate research, 2, 1-15. burge, j. (2009). coping frequency, coping effectiveness, and personality factors in university students (unpublished thesis). university of canberra, australia. carmines, e. g., & zellrn, r. a. (1979). reliability and validity assessment. beverly hills, ca: sage publishing, inc. https://doi.org/10.4135/9781412985642 civitci, a. (2015). perceived stress and life satisfaction in college students: belonging and extracurricular participation as moderators. procedia—social and behavioral sciences, 205, 171-181. https://doi.org/10.1016/j.sbspro.2015.09.077 coleman, j., & trunzo, j. (2015). personality, social stress, and drug use among college students. psi chi journal of psychological research, 20(1), 52-58. https://doi.org/10.24839/2164-8204.jn20.1.52 www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 79 published by scholink inc. courtney, m. g. r. (2013). determining the number of factors to retain in efa: using the spss r-menu v2.0 to make more judicious estimations. practical assessment, research and evaluation, 18(8), 1-14. devellis, r. f. (1991). scale development: theory and application. newbury park, ca: sage publications, inc. devellis, r. f. (2003). scale development: theory and application (2nd ed.). thousand oaks, ca: sage publications, inc. feldt, r. c. (2008). development of a brief measure of college stress: the college student stress scale. psychological reports, 102, 855-860. https://doi.org/10.2466/pr0.102.3.855-860 field, a. (2009). discovering statistics using spss (3rd ed.). london: sage publications, inc. insel, p. m., & roth, w. t. (1985). core concepts in health. palo alto, ca: mayfield. kaiser, h. f. (1974). an index of factorial simplicity. psychometrika, 39, 31-39. https://doi.org/10.1007/bf02291575 katz, j., & nelson, r. (2007). family experiences and self-criticism in college students: testing a model of family stress, past unfairness, and self-esteem. the american journal of family therapy, 35, 447-457. https://doi.org/10.1080/01926180601057630 kline, p. (1999). a handbook of psychological testing (2nd ed.). london: routledge publishing, inc. lee, d. h., kang, s., & yum, s. (2005). a qualitative assessment of personal and academic stressors among korean college students: an exploratory study. college student journal, 39(3), 442-448. maca, t. h., & shahani, c. (1990). college students’ time management: correlations with academic performance and stress. journal of educational psychology, 82(4), 760-768. https://doi.org/10.1037/0022-0663.82.4.760 misra, r., & mckean, m. (2000). college student’s academic stress and its relation to their anxiety, time management, and leisure satisfaction. american journal of health studies, 16(1), 41-52. norris, & lecavalier. (2010). evaluating the use of exploratory factor analysis in developmental disability psychological research. journal of autism and developmental disorders, 40(1), 8-20. https://doi.org/10.1007/s10803-009-0816-2 oh, e. j., blondin, c. a., cochran, j., & williams, r. l. (2011). perceived stressors among college students in an american and korean university. korean social science journal, 38(2), 81-113. putwain, d. w., woods, k. a., & symes, w. (2010). personal and situationsl predictors of test anxiety of students in post compulsory education. british journal of educational psychology, 80, 137-160. https://doi.org/10.1348/000709909x466082 rocha-singh, i. a. (1994). perceived stress among graduate students: development and validation of graduate stress inventory. educational and psychological measure, 54(3), 714-727. https://doi.org/10.1177/0013164494054003018 www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 80 published by scholink inc. ross, s. e., niebling, b. c., & heckert, t. m. (1999). sources of stress among college students. college student journal, 33(2), 312-318. santos, r. a. (1999). cronbach’s alpha: a tool for assessing the reliability of scales. journal of extension, 37(2). retrieved from http://www.joe.org/joe/1999april/tt3.php struthers, p., & menec. (2000). an examination of the relationships among academic stress, coping, motivation, and performance in college. research in higher education, 41(5), 581-592. https://doi.org/10.1023/a:1007094931292 tabachnick, & fidell. (2014). using multivariate statistics (6th ed.). boston, ma: pearson. trombitas, k. (2012). financial stress: an everyday reality for college students. retrieved from https://www.universitybusiness.com/sites/default/files/inceptia_financialstress_whitepaper.pdf white, a. v., & perrone-mcgovern, k. (2017). influence of generational status and financial stress on academic and career self-efficacy. journal of employment counseling, 54, 38-48. https://doi.org/10.1002/joec.12049 woolman, e. o., becker, m. m., & klanecky, a. k. (2015). ptsd symptoms mediate academic stress and drinking to cope in college students. journal of drug education: substance abuse research and prevention, 45(2), 96-112. https://doi.org/10.1177/0047237915607282 yazedjian, a., toews, m. l., & navarro, a. (2009). exploring parental factors, adjustment, and academic achievement among white and hispanic college students. journal of college student development, 50, 458-467. https://doi.org/10.1353/csd.0.0080 note note 1. this current study does not test the construct validity of this stress-measuring inventory. it only tests the reliability and unidimensionality of subscales within the 48-item inventory designed to measure stress among college students. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 81 published by scholink inc. appendix a perceived stress scale (psi) this inventory contains statements dealing with student-life stressors. read it carefully and respond to each statement as it relates to you as a student. use the 10-point scale to rank the level of stress each college stressor brings to your life experience as a student. circle only one answer for each statement. financial stressors no stress moderate high stress 1. worried about financial responsibilities 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 2. borrowing money for college 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 3. the need to repay loans 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 4. the cost of tuition 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 5. the cost of textbooks 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 6. loss of financial support from college 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 7. the need to find a job after school 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 time management stressors no stress moderate high stress 8. difficulties managing both school and work at the same time 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 9. difficulties finding time to study 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 10. i’m unable to control the time i spend 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 11. hard time getting papers done on time 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 12. missed too many classes 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 13. not getting enough time to sleep 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 14. sleeping too much 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 15. change in eating habits 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 16. change in sleeping habits 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 social stressors no stress moderate high stress 17. being on one’s own in a new environment – with new responsibilities 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 18. awareness of one’s sexual identity and orientation 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 19. new love interest 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 82 published by scholink inc. 20. hard time making friends at school 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 21. problems with boyfriend / girlfriend 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 22. change in social activities 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 23. making decisions, on a higher level than one is used to 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 24. substance abuse 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 25. minor violations of the law (e.g. traffic ticket) 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 26. first term in college 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 27. exposure to new people, ideas, and temptations 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 28. problems with roommate 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 academic stressors no stress moderate high stress 29. greater academic demands 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 30. failing grade in an important or required class 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 31. change in college (transfer) 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 32. not being able to take good notes in classes 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 33. academic probation (or fear of being placed) 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 34. serious conflict with instructor 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 35. lower than expected grades 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 36. change in major 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 37. increased workload from college 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 38. course load 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 39. preparing for exams 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 40. writing term papers 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 41. keeping up with the required readings 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 family stressors no stress moderate high stress 42. i don’t get enough support from my family 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 83 published by scholink inc. 43. being away from home, often for the first time 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 44. parental issues (child care issues) 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 45. preparing for life after graduation 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 46. my parents’ expectation of my grades 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 47. serious argument with significant other 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 48. parental alcoholism and family dysfunctions 0----1-----2-----3-----4-----5-----6-----7----8-----9----10 children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 3, no. 2, 2020 www.scholink.org/ojs/index.php/ct 36 original paper infant social evaluations in response to unequal resource distribution evan m. jordan1*, david g. thomas1 & elisabeth ponce-garcia2 1 psychology, oklahoma state university, stillwater, usa 2 psychology, southeastern oklahoma state university, durant, usa * evan m. jordan, psychology, oklahoma state university, stillwater, usa received: august 24, 2020 accepted: august 31, 2020 online published: september 10, 2020 doi:10.22158/ct.v3n2p36 url: http://dx.doi.org/10.22158/ct.v3n2p36 abstract healthy emotional development provides a foundation for the development of prosocial motives and their subsequent behaviors, especially those emotions specifically related to empathic responding. previous research has demonstrated a preference for individuals who behave prosocially, as opposed to antisocially, in infants as young as 3 months of age (hamlin et al., 2010). it has also been suggested that by 18 months of age infants may be evaluating the equitable and inequitable distributive actions of others as being either prosocial or antisocial behaviors, respectively (geraci & surian, 2011). this previous work has focused exclusively on the agents of the distributive actions. the purpose of the current study is to focus on the recipients of those actions, i.e., to determine if infants engage in social evaluations directed toward the individuals who are on the receiving end of prosocial and antisocial distributive behaviors. specifically, this study assesses infant responses toward receivers that have been treated antisocially to determine if infants are displaying an empathically charged response toward individuals affected by antisocial actions. keywords infant, development, resource distribution, inequity aversion, social evaluation 1. introduction throughout development, infants and young children will encounter many situations that will require them to engage in social evaluation and reasoning, some of it complex. a problem that will arise in these developmental periods concerns the fairness of the distribution of resources. humans, as an ultra-social species, must remain in compliance with social norms to maintain a functioning human society. adult humans, as well as other social species such as non-human primates and even dogs, have www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 37 published by scholink inc. been found to display negative responses to the unequal distribution of resources, specifically when the distribution represents reward allocation (brosnan, schiff, & frans, 2005; fehr & rockenback, 2003). in humans, this understanding of equitable resource distribution has been found to begin in late infancy and strengthen throughout development (geraci & surian 2011; ziv & sommerville, 2018). previous studies have reported evidence of infants under the age of 2 years forming egalitarian expectations regarding the distribution of resources, demonstrating a more positive evaluation of egalitarian distributors compared to non-egalitarian distributors. for example, geraci and surian (2011) showed 12and 18-month-old infants a series of trials on a computer screen in which a colorful cartoon distributor allocated resources to two receivers, with either equal or unequal distributions. in the former scenario, the distributor evenly dispersed colorful discs to two receiving agents. the latter scenario resulted in the uneven dispersal of discs by the distributor to the two receiving agents, providing one receiver with two colorful discs and the other receiver with none. the infants were then shown the two distributors. there was no significant difference in how often the younger infants looked at the fair and unfair distributors. however, the older infants looked significantly longer at the fair distributor, which was assumed to demonstrate infant preference for that distributor. this would indicate that infants appear to be able to evaluate the fairness of the behavior of others, though this ability is dependent on the age of the participant. research supporting the findings of geraci and surian (2011) that infants in their second year can indeed make such evaluations was carried out by schmidt and sommerville (2011). they found that 15-month-old infants looked longer at the outcome of an event depicting a distribution of unequal resources compared to when the infants observed an event in which resources were distributed equally across agents. this longer looking presumably indicated that the infants’ expectations of the event outcome had been violated by the distribution of unequal resources. while these looking behaviors may seem to conflict with the study by geraci and surian that measured infant preferences by longer looking times, it should be noted that in preference paradigms, looking time at the distributor is being assessed. on the other hand, in violation of expectation paradigms (e.g., schmidt & sommerville), looking time at the event outcome is measured. therefore, geraci and surian found 18-month-olds to look longer—i.e., prefer—distributors who distribute equal amounts, while schmidt and sommerville found 15-month-olds to look longer at events showing unequal distribution, presumably because such events violated the infants’ expectations of equal distribution. these outcomes suggest older infants expect equal distribution of resources and prefer distributors who do so. importantly, schmidt and sommerville (2011) also found that the previous emergence of spontaneous sharing behaviors with caregivers and peers was necessary to consistently elicit a violation of expectation of equal distribution in the infants. more specifically, infants that had already demonstrated sharing behaviors in a naturalistic setting looked longer at the unfair distributive outcome than infants www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 38 published by scholink inc. that had not yet demonstrated sharing behaviors. according to ziv and sommerville (2018), infants’ understanding of fairness is related to their ability to perform sharing actions, which may influence how infants perceive distributive actions and allow for the development of an expectation of fairness. additional work by meristo and surian (2013) has provided evidence that 10-month-old infants are capable of making social evaluations of fairness based on previous behaviors by the receiving individuals. meristo and surian (2013) used a paradigm in which two distributing agents treated two identical receivers either fairly, by distributing two strawberries equally across the two receivers, or unfairly, by distributing both strawberries to one receiver and ignoring the remaining receiver. following this phase, a new agent entered and distributed strawberries to either the unfair or fair distributor. longer looking time in this study was assumed to indicate that the infants’ expectations of the event outcome had been violated. infant looking times were significantly longer when the new agent distributed strawberries to the agent that had previously distributed an unequal number of strawberries compared to looking times when the new agent distributed these resources to the agent that had distributed the resources equally between receivers. thus, these 10-month-old infants were considered to be positively evaluating the fair, equal distributor rather than the unfair, unequal distributor and were surprised when the distribution of resources by the new agent favored the latter. similar findings were reported by surian and franchin (2017) in their violation of expectation paradigm. this study, conducted with 15and 20-month-old infants, found that by 20 months of age infants preferred to see agents of equal merit receive equal distributions and children and agents of unequal merit to receive distributions proportional to their relative merit. the 15-month-old infants demonstrated a similar pattern of behavior, but the results were not statistically significant. however, this indicates that by later in the second year of life infants may be taking merit and deservingness, rather than just surface level equity, into account when making evaluations of fairness and instead deservingness may trump egalitarian principles in infants’ reasoning. to reiterate, in preference paradigms, looking time at the agent(s) is being evaluated, but in violation of expectation paradigms, looking time at the event outcome is evaluated. that said, contrasting results investigating the socio-moral competence of infants have been found across several studies following the violation of expectation paradigm. for example, longer looking times were recorded in a study by sloane, baillargeon, and premack (2012) demonstrating events of unequal resource distribution, and when unfair agents received rewards rather than fair agents (meristo & surian, 2013). while there may be plausible explanations for these differences, the interpretation of longer looking times in more than one way within either the preference paradigms or the violation of expectation paradigms would lead to non-falsifiable hypotheses and therefore, non-scientific measures of preference or aversion. overall, infants have been observed displaying differential responding toward equitable and inequitable resource distribution paradigms. while various measures have been used in these paradigms, each has www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 39 published by scholink inc. attempted to demonstrate that infants recognize differences in equitable and inequitable resource distribution and each has attempted to demonstrate that infants have an aversion toward inequitable distribution or a preference for equitable distribution. while it can be theorized that infants are making these complex social evaluations based on learned reactions from social interactions, namely cognitive and/or affective components of empathy, a greater understanding of infant responding in these paradigms is required to more fully understand why infants are indicating a preference for equitable distribution and an aversion toward inequitable distribution. as the above review demonstrates, research observing the development of inequity aversion and preference for resource equality has been conducted across a variety of age groups (hamlin & wynn, 2011; hamlin et al., 2011; geraci & surian, 2011). however, to our knowledge, all of the previous research has focused on the responses of infants and toddlers toward the agent actively distributing in an equitable or inequitable manner. while this research provides an understanding of early moral and social development and its effects on preference for equal resource distribution, little is known about infant evaluations of individuals on the receiving end of inequitable resource distribution. additionally, few studies observing reactions to distributive behaviors have included non-social entities as either active or passive agents to allow for a behavioral comparison of infant responding to inequitable resource distribution directed toward inanimate, non-social (lacking facial features) agents. by comparing behavioral differences that occur toward both social and non-social entities, we can gain a clearer understanding of the factors that influence infant preferences for one agent over another. the purpose of the current study was to determine if infants in their second year of life prefer individuals who receive, rather than give, a greater number of resources in an inequitable distribution trial, or individuals that have received fewer resources. a preference for the receiver of more resources would suggest that infants value prosperity. however, a preference for the receiver of few or no resources would suggest a potential empathic emotional response to individuals that are victims of unequal resource distribution. this purpose was addressed through the behavioral observation of infants that were exposed to a paradigm of resource distribution, consisting of unequal distribution trials that used both animate and inanimate receivers. the aforementioned literature can be interpreted to mean that infants have the capacity for compassion. thus, we hypothesized that infants would demonstrate a greater preference for receiving agents that are provided with fewer resources compared to the alternate receiver due to an affective empathic response by the infant observer. furthermore, we hypothesized that when the receiving agents were inanimate the infant would show a greater preference for the receiving object to which was distributed a greater number of resources, thereby indicating that infants may be aligning with greater resource amounts when empathy is seemingly removed from the situation. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 40 published by scholink inc. 2. method 2.1 participants twenty-seven full-term, healthy infants (9 males; 18 females) accompanied by their mothers were assessed between the ages of 16 and 20 months (m = 79.68 weeks, sd = 4.96). maternal ages ranged between 24 and 48 years (m = 34.35), with the majority of mothers being caucasian (80%), married (68%), and college educated (84%). one female infant did not complete all six trials and the procedure was aborted at the request of the caregiver due to excessive distress, and one female infant’s responses were unable to be coded due to equipment malfunction. therefore a final sample of 25 infants was analyzed. 2.2 materials and procedures 2.2.1 demographic questionnaire primary caregivers were administered a demographic questionnaire to collect general information regarding the infants and the members of their immediate families. information on income level, marital status, number of siblings, birth order, household language, and parental education level was gathered. 2.2.2 distribution display the distribution paradigm occurred in a custom wooden display (48” l x 34” h x 22” d) that emulated a “black box theatre”. two receiving agents were placed on either side of the stage. the resources, which were brightly colored wooden rings approximately three inches in diameter, could be placed during the test phase of the procedure on a stationary wooden peg situated in front of each of the receiving agents. a cut-out in the rear wall of the display allowed for the distributing agent to enter and distribute the resources to the receivers on either side of the stage. 2.2.3 agents animate distributing and receiving agents consisted of seven different plush stuffed animals of various colors. the inanimate receiving agents consisted of six plush geometric shapes (7 x 7 in) of various colors. an animate agent was still used as the distributor in the inanimate conditions, which explains the discrepancy between the numbers of animate to inanimate agents. 2.2.4 stimuli and procedure upon arrival at the laboratory the infant and mother engaged in free play until the infant acclimated to the laboratory environment. acclimation was marked by a baseline behavioral state of a 2 or 3 as outlined by the affex behavioral scaling system (izard, dougherty, & hembree, 1983), indicating that the infant was alert/calm or alert/active, respectively. during free play, the mother was provided one of the wooden rings and instructed to become excited, attempt to share the ring with her infant and try to elicit excitement in the infant to help establish that it was a desirable resource. following free play, the 10-minute test procedure began and the infant was seated on the caregiver’s lap facing away from her www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 41 published by scholink inc. and toward the distribution display at which time they watched six distribution trials (3 animate and 3 inanimate), each followed by a choice phase. several stimulus and procedural variables were counterbalanced and/or randomized, including color, animal type, pairing, and lateral position of receiving agents, as well as the order of trial types. the caregiver was instructed to remain neutral and not attempt to elicit a choice from the infant or influence the infant in any way. the test phase began when the curtain opened to reveal two receiving agents positioned on either side of the display with empty wooden pegs in front of each of them. a third agent emerged from the cut out in the back of the stage and distributed resources to the receiving agents. using exaggerated movements, the distributor placed the resources on the wooden pegs in a 5:1 distribution ratio. after the distributing agent dispersed all six resources to the receiving agents, it disappeared through the cut out in the back of the display and the experimenter closed the curtain of the distribution display. following each of the six trials, a second experimenter, blind to the number of resources each agent had received, emerged from behind the curtain and administered a forced choice procedure by presenting both of the receiving agents at an equal distance from the infant. infants were prompted (e.g., “which one do you like?” and “can you pick one?”) until they reached for one of the agents. if an infant did not attempt to reach for an agent for 2 minutes it was counted as “no choice”. reaching and grasping behavior were measured to indicate preference toward the agents, but only when the behavior was preceded by a look toward that same agent. coding for reaches differed from that of grasps. the infant would have to take hold of the agent and remove it from the experimenter’s hand to be coded as a grasp and signify the end of the trial, whereas reaches were coded across the two minute trial, but reaching behavior alone was not sufficient to end the trial. additionally, the total duration of infant looking toward each of the agents was recorded. these behavioral measures were video recorded using a camera worn on the chest of the experimenter to be coded offline at a later time. 3. result observation oriented modeling (oom; grice, 2011; grice et al., 2012) was used to analyze the data. oom allows for the comparison of the grasps and looking times made by each infant during each trial with expected patterns of outcomes, with results summarized using accuracy indices identifying how many infants fit the expected pattern. depending on the statistical test, traditional null hypothesis testing (nhst) relies on a variety of assumptions, such as homogeneity and normality of population distributions, whereas oom utilizes randomization tests that are free of such assumptions. many of our agent preference measures violated nhst assumptions, but because oom is similar to non-parametric methods, we were able to avoid the strict assumptions of nhst and focus attention on the reaches, grasps, and looking times for each agent by the individual infants in the study. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 42 published by scholink inc. 3.1 hypothesis 1 an ordinal pattern analysis tested the prediction that infants would indicate a preference for an animate agent that had received a smaller number of resources in the distribution paradigm (“animate poor”) compared to an agent that had received a larger number of resources (“animate rich”). with regard to the number of looks per unit of time toward the animate receivers of resources, the expected ordinal pattern for each infant was therefore animate poor > animate rich. results indicated that 14 of the 25 infants matched this pattern with respect to the number of looks toward animate agents. this frequency can be converted to a percentage (56.00%) which is referred to as the percent correctly classified (pcc) in an ordinal pattern analysis. a simple randomization test was then used to assign a probability statistic, referred to as the chance value (or c-value), to the pcc. based on 1000 random trials for number of looks per unit of time, the c-value was .14 indicating that a pcc of at least 56% was likely to occur by chance 14% of the time for the current data and expected ordinal pattern. for the duration of looks per unit of time toward the animate receivers of resources, the overall ordinal pattern (animate poor > animate rich) was again examined and results indicated that again 14 of the 25 infants (pcc = 56.00, c-value = .32) matched the expected pattern and looked more frequently toward the animate poor receiver compared to the animate rich receiver. additionally, an ordinal pattern analysis (animate poor > animate rich) of the sum of grasps indicated that only 10 of 25 infants (pcc = 40.00, c-value = .68) chose the animate poor receiver over the animate rich receiver. two infants did not complete a grasp to either agent. when the infants that did not grasp an agent were removed from the analysis 10 of 23 infants (pcc = 43.48, c-value = .65) choose the animate poor receiver over the animate rich receiver (see table 1). 3.2 hypothesis 2 an identical set of ordinal pattern analyses was conducted for the responses to the inanimate receiving agent. the expected ordinal pattern outcome for inanimate trials was as follows: inanimate rich > inanimate poor. with respect to the total number of looks per unit of time, results indicated that 16 of the 25 infants (pcc = 64.00, c-value = .02) matched the ordinal pattern and looked more frequently toward the inanimate rich receiver compared to the inanimate poor receiver, which was consistent with the original hypothesis for inanimate agent preference. similarly, 13 of 25 infants (pcc = 52.00, c-value = .41) yielded longer durations to the inanimate rich receiver compared to the inanimate poor receiver. however, similar to the grasping in the animate trials, only 7 of 25 infants (pcc = 28.00, c-value = .81) completed grasps to the rich receiver compared to the poor receiver. three infants did not complete a grasp to either agent. when the infants that did not grasp an agent were removed from the analysis this ratio increased to 7 out of 22 (pcc = 31.82, c-value = .81) infants choosing completed grasps to the rich compared to the poor receiver (see table 1). www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 43 published by scholink inc. table 1. ordinal pattern analysis for measures agent preference for animate and inanimate trials ordinal pattern tested measure n pcc c-value animate: poor > rich number of looks 25 56.00 .14 duration of looks 25 56.00 .32 sum of grasps 25 40.00 .68 manual choosers only 23 43.48 .65 inanimate: poor < rich number of looks 25 64.00 .02 duration of looks 25 52.00 .72 sum of grasps 25 28.00 .81 manual choosers only 22 31.28 .81 note. manual choosers row is an additional sum of grasps analysis but includes only the participants that made a manual choice and includes only 22 infants. 4. discussion 4.1 hypothesis 1 the primary aim of this study (hypothesis 1) was to determine if infants showed a preference toward a poor recipient of resources compared to a rich recipient of resources, thereby supporting the contention that infants have the capacity to make social evaluations toward individuals that are treated unfairly and potentially responding empathically toward recipients of fewer resources. while previous research (geraci & surian, 2011) has found that infants of similar age to our participants engage in social evaluation toward an acting distributing agent, the present study focused on the social evaluation of passive receiving agents. in the animate trials, only a small majority (56.00%) of the infants followed our hypothesized pattern with regard to number and duration of looks. further, when infants grasped one of the two receivers, a greater number of infants chose the rich receiver more often. as these findings were weak, relative to those previously discussed that provided a basis for this study, it does not provide substantial evidence that infants are being motivated by social evaluation to the poor receiver over the rich and rather indicates that evaluating a passive receiving agent may be fundamentally different from evaluations of an acting distributing agent. alternatively, there could be components of our methodology that are influencing infant behaviors. the research of meristo and surian (2013) appears to indicate that when making social evaluations based on equity distributions, infants as young as 10 months of age take social contexts such as deservingness www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 44 published by scholink inc. and merit into consideration. further, these expectations are found to increase across infancy as infants become capable of more complex cognitive processes (surian & franchin, 2017). as the distribution paradigm in the present study did not provide any social context that would allow for the appraisal of deservingness or merit, it is possible that infant responses were influenced by the lack of social context. similarly, receiving agents remained static during the distribution paradigm, giving no indication that the receivers were “excited” or “disappointed” by the number of resources received. a lack of response by the receiving agents may have been interpreted by the infants as indifference toward the allocated resources, either toward the resources themselves, or toward the inequitable distribution. the lack of response by the receivers was a result of a direct methodological choice to reduce bias in response differences. for example, in a hill-climbing paradigm used by hamlin and colleagues (2007) focusing on infant preferences for helping behaviors versus hindering behaviors, a protagonist “climber” bounced after being helped up the hill by a “helping” agent. the findings were robust in that a significant number of infants indicated a preference for a helping agent compared to a hindering agent through their looking and grasping behaviors. however, these results were challenged by scarf and colleagues (2012) when they demonstrated that infants chose the helping agent when the protagonist bounced after being helped up the hill, but chose the hindering agent when the protagonist bounced after being “pushed” down the hill. when the protagonist bounced in both the helping and the hindering trials, the infants showed no significant differences in preference and chose both equally. therefore, while the inclusion of an “emotional” response by the receiving agents may have increased clarity of how these agents should feel in response to inequitable resource distribution, it may also have introduced a confounding perceptual or emotional bias. an additional replication of the hill-climbing study was recently conducted and found less than half of the infants choose the helping agent compared to the hindering agent (colaizzi, 2016). hamlin (personal communication, may 25, 2016) attributed this deviation in findings to minor methodological differences in the color of the agents being used in the paradigm. specifically, hamlin stated that infants tend to demonstrate a preference for the color blue (one of the colors of the agents) and that the use of a blue agent in the paradigm may have skewed the results in the replication study even though the roles of the agents were counterbalanced. another failed replication occurred in an attempt to replicate the findings of hamlin and wynn (2011). in that study, a protagonist agent attempts to open a box and attain a toy. similar to the 2007 research, one condition showed a helping agent facilitate the protagonist in opening the box and a second condition showed a hindering agent inhibit the protagonist in opening the box. once again, while findings from this initial study were robust with a significant number of infants (79%) at both 5 and 8 months of age preferring the helper over the hinderer, salvadori et al. (2015) found that only 62% of the infants in their replication paradigm demonstrated a preference for the helper compared to the www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 45 published by scholink inc. hinderer. similar to colaizzi (2016), salvadori et al. (2015) attributed these differences to minor methodological dissimilarities of procedure, materials, or demography. however, the findings of hamlin and wynn (2011) were robust enough that they should still be evident in the face of only minor dissimilarities. one methodological issue that is not addressed with the original 2011 study and then again overlooked by salvadori and colleagues (2015) is the noise that occurs when the box lid is slammed shut by the hindering agent. although not outlined in the publication, in a recording of the paradigm (hewitt & bloom, 2013) there is a clear, audible noise when the hindering agent slams the lid of the box closed. it is plausible that the infants have an aversion to a loud noise that causes them to react negatively toward the hindering agent, making it appear as though they are showing a preference toward the helping agent. this methodological issue should be addressed in further replications. together these three studies, coupled with the present findings, indicate that the research on social evaluations and the conclusions drawn from their findings are not conclusive and remain questionable due to mixed results across this area of study. 4.2 hypothesis 2 hypothesis 2 predicted that behavioral differences in preference toward the receiving agents when resources were distributed unevenly between two non-social entities, or inanimate receiving agents. based on basic evolutionary theory and natural selection (darwin, 1965), humans are motivated to seek out the best possible source for resources that aid in survival and reproduction. therefore, we hypothesized that in the absence of social entities (i.e., agents with animate facial features), infants would be more likely to demonstrate a preference toward the rich inanimate receiver, thereby indicating a preference for aligning with the best possible outcome for survival. though a greater number of infants looked more frequently and longer at the rich receiving agent with more resources to potentially “share”, this number was just over half, but yielded a robus c-value of .02, but these preference behaviors did not extend to the grasping measure, with a minority of infants choosing the rich over the poor receiver. previous research found that infants do not place similar expectations of equitable resource distribution on the distributing agent when allocating resources to inanimate agents such that infants look equally between the fair and unfair distributor (sloan et al., 2012). this is further supported by gredeback, et al. (2015) who found that neural responses in the p400 erp, a component of the brain that has been previously linked to empathy and prosocial responding, only occurred when the agents in the paradigm were animate (i.e., had eyes), suggesting that when the social valence is removed from the paradigm, the action is no longer interpreted by the infant as being goal-related. again, sloan et al. (2012) and others using similar paradigms are still making claims regarding infant evaluation between fair and unfair animate distributing agents that had distributed to inanimate objects, thus, still evaluating the social actor. in the present study, the distributing agent is still animate even in the inanimate trials, but www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 46 published by scholink inc. the infants are only making social evaluations directed toward the inanimate receiving agents. in other words, the direction of their social evaluation in the present paradigm is toward inanimate objects, which differs from the previously conducted research. however, a greater number of infants did look longer at the inanimate agent with greater resources, which could be an indicator that infants do have an interest in a greater number of resources when issues of morality are minimized. once again, the findings of this study were not as robust as those of previous studies using similar paradigms (geraci & surian, 2011; hamlin & wynn, 2011; schmidt & sommerville, 2011). hamlin et al. (2007) found that infants preferred a prosocial helping agent over an antisocial hindering agent, but did not attribute their own attitudes to the protagonist that had been helped or hindered. in other words, infants may be capable of evaluating the actions of others before they are capable of evaluating the effects of those actions on passive receivers, a process that requires perspective taking, which some suggest emerges around 18 months of age (thompson, 1987), the average age of our sample. if perspective taking is just emerging at this time, it would be reasonable to suggest that this cognitive skill may not be developed enough to attribute actions to passive receivers that are either lacking facial features or lacking previous behavior that would provide a social context for the infant. 4.3 implications to summarize, this study did not provide robust evidence that infants are evaluating the equitable or inequitable distribution of passive receiving agents and it is plausible to suggest that infant’s social evaluations of a passive receiving agent differ from their evaluations of an acting distributing agent. while they may be engaging in social evaluation toward both parties, the evidence of social evaluations toward agents making the choice to distribute evenly or unevenly is much stronger than the evidence provided by the current study, though considerations of the multiple failed replication attempts should be made before making claims that infants are capable of any of the evaluative and preferential responses to which the previous research is alluding. previous research in this area has aided in informing much of what we already know about prosocial understanding, inequitable resource distribution, and empathic responses to these behaviors by infants. however, in order to gain traction in this area of research and learn more about the developmental trajectories of the various forms of social evaluation we must expand on the current research and supplement the field with new means for the identification of social evaluation, an area crucial to a well-rounded understanding of the socialization process. 4.4 limitations and future directions one way that future research can help to clarify the outcome of this study is to provide an opportunity for infants to either distribute or reallocate resources between the rich and poor receivers. hamlin et al. (2011) found that when given the option to either give or take a treat away from prosocial or anti-social agents, toddlers in the “give a treat” condition distributed treats more often to the prosocial rather than www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 47 published by scholink inc. the anti-social agent. similarly, toddlers asked to “take a treat” removed the treat from the anti-social agent more often than they removed a treat from the prosocial agent. if infants are making social evaluations toward receivers similar to their evaluations of distributors, they would likely be inclined to reallocate resources evenly if given the opportunity, or to distribute additional resources to the poor receiver in an attempt to achieve fairness. as mentioned previously, neither the poor nor the rich agent responded upon receiving resources. this was purposeful to prevent preference based on any perceptual or emotional biases that agent response may have elicited. however, modifying the paradigm to include some indication that the receivers are happy or unhappy with their allotted resources may be necessary. if having the protagonist “bounce” upon receiving help leads to preference of the agent nearest the bouncing protagonist as it was found to do in the study by scarf and colleagues (2012), then it may be necessary to include a different indicator that the agents are interested in the resources. providing a familiarization trial in which the agents interact with the resources and indicate excitement toward the resources may be enough to inform the infants that receiving more resources should excite them and receiving fewer resources should disappoint them. another modification that could be included in a future study would be the inclusion of a parental self-report on the sharing behaviors of their infants in other social situations. background information on the infants understanding of sharing and fairness would be beneficial and could provide some insight as to how their environment and their interactions with caregivers and peers influence their tendency to make social evaluations regarding unequal resource distribution. references brosnan, s. f., schiff, h. c., & frans b. m. de waal. (2005). tolerance for inequity may increase with social closeness in chimpanzees. proceedings of the royal society b: biological sciences, 272, 253-258. https://doi.org/10.1098/rspb.2004.2947 colaizzi, j. m. (2016). empathy and prosocial behaviors in infancy. proquest dissertations & theses global (1841278122). darwin, c. (1965). the expression of the emotions in man and animals. chicago, il: university of chicago press (original work published 1872). https://doi.org/10.7208/chicago/9780226220802.001.0001 fehr, e., & rockenbach, b. (2003). detrimental effects of sanctions on human altruism. nature, 422, 137-140. https://doi.org/10.1038/nature01474 geraci, a., & surian, l. (2011). the developmental roots of fairness: infants’ reactions to equal and unequal distributions of resources. developmental science, 14, 1012-1020. https://doi.org/10.1111/j.1467-7687.2011.01048.x www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 48 published by scholink inc. gredebäck, g., kaduk, k., bakker, m., gottwald, j., ekberg, t., elsner, c., … kenward, b. (2015). the neuropsychology of infants’ pro-social preferences. developmental cognitive neuroscience, 12, 106-113. https://doi.org/10.1016/j.dcn.2015.01.006 grice, j. w. (2011). observation oriented modeling: analysis of cause in the behavioral sciences (1st ed.). london; burlington, ma: academic, 2011. grice, j. w., barrett, p. t., schlimgen, l. a., & abramson, c. i. (2012). toward a brighter future for psychology as an observation oriented science. behavioral sciences, 2(1). 1-22. https://doi.org/10.3390/bs2010001 hamlin, j. k., bloom, p., & wynn, k. (2007). social evaluation by preverbal infants. nature, 450, 557-559. https://doi.org/10.1038/nature06288 hamlin, j. k., wynn, k., bloom, p., & mahajan, n. (2011). how infants and toddlers react to antisocial others. proceedings of the national academy of sciences, 108, 19931-19936. https://doi.org/10.1073/pnas.1110306108 hamlin, j. k., & wynn, k. (2011). young infants prefer prosocial to antisocial others. cognitive development, 26, 30-39. https://doi.org/10.1016/j.cogdev.2010.09.001 hewitt, d. (writer), & bloom, a. (director). (2013). born good? babies help unlock the origins of morality [television series episode]. in s. finkelstein (producer), 60 minutes. new york, ny: cbs. izard, c. e., hembree, e. a., dougherty, l. m., & spizzirri, c. c. (1983). changes in facial expressions of 2to 19-month-old infants following acute pain. developmental psychology, 19(3), 418-426. https://doi.org/10.1037/0012-1649.19.3.418 meristo, m., & surian, l. (2013). do infants detect indirect reciprocity? cognition, 129, 102-113. https://doi.org/10.1016/j.cognition.2013.06.006 salvadori, e., blazsekova, t., volein, a., karap, z., tatone, d., mascaro, o., & csibra, g. (2015). probing the strength of infants’ preference for helpers over hinderers: two replication attempts of hamlin and wynn (2011). plos one, 1-10. https://doi.org/10.1371/journal.pone.0140570 scarf, d., imuta, k., colombo, m., & hayne, h. (2012). social evaluation or simple association? simple associations may explain moral reasoning in infants. plos one, 7(8). https://doi.org/10.1371/journal.pone.0042698 schmidt, m. f. h., & sommerville, j. a. (2011). fairness expectations and altruistic sharing in 15-month-old human infants. plos one, 6, e23223. https://doi.org/10.1371/journal.pone.0023223 sloane, s., baillargeon, r., & premack, d. (2012). do infants have a sense of fairness? psychological science, 23, 196-204. https://doi.org/10.1177/0956797611422072 surian, & franchin. (2017). infants reason about deserving agents: a test with distributive actions. cognitive development, 44, 49-56. https://doi.org/10.1016/j.cogdev.2017.08.009 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 49 published by scholink inc. thompson, r. a. (1987). empathy and emotional understanding: the early development of empathy. in n. eisenberg, & j. strayer (eds.), empathy and its development (pp. 119-145). new york, ny us: cambridge university press. ziv, t., & sommerville, j. (2017). developmental differences in infants’ fairness expectations from 6 to 15 months of age. child development, 88(6), 1930-1951. https://doi.org/10.1111/cdev.12674 children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 1, no. 1, 2018 www.scholink.org/ojs/index.php/ct 34 original paper teacher bullying: a reality or a myth? kathleen g. burriss1* & donald snead2 1 department of elementary and special education, middle tennessee state university, tennessee, united states 2 department of educational leadership, middle tennessee state university, tennessee, united states * kathleen g. burriss, department of elementary and special education, middle tennessee state university, tennessee, united states received: april 12, 2018 accepted: april 27, 2018 online published: may 11, 2018 doi:10.22158/ct.v1n1p34 url: http://dx.doi.org/10.22158/ct.v1n1p34 abstract the topic of teachers who may bully children is uncomfortable to discuss, but because of the vulnerable nature of children in the classroom context, it is justified. in order to uncover instances of teachers who bully, the purpose of this project is to explore teachers’ and students’ perceptions of bullying behaviors. this mixed method project involves two data sets. in the first study, classroom teachers (n=186) provided rationalistic data identifying occurrences of observed bullying behaviors. included in the survey, teachers referenced definitions of emotional, physical, and intellectual bullying. quantitative analysis showed nonsignificant findings; classroom teachers reported they do not bully and do not observe other educators bullying children. in the second study, teacher education students (n=341) completed an open-ended survey describing any instances where they either observed children bullied by a teacher or where they were victims of a teacher bully. qualitative analysis described incidents ranging from early childhood through university instruction wherein student-participants observed or were victims of teachers who bullied. the purpose for this project was to begin to reconcile the lack of relevant findings describing teachers who bully. these current data provide evidence for the teacher as bully phenomenon and contribute to the literature by confirming descriptions associated with emotional, physical, and intellectual bullying. implications discuss the culture of teaching and university teacher preparation. keywords teachers, bullying, vulnerable, social www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 35 published by scholink inc. 1. introduction this current discussion contributes to the literature by providing additional data describing how teachers demonstrate emotional, intellectual, and physical bullying. additionally, these data initiate a discussion regarding the contrastingly different perspectives shared between practicing classroom teachers and teacher candidates who are not yet licensed and not accepted as professional educators. although distasteful, without an honest consideration of all possible indicators for educators who may bully students, children remain vulnerable. each school year, children spend more than one thousand hours with their classroom teacher. the social context of the classroom experience, as guided by the teacher, is significant with potential influence on children’s sense of self and diverse others. with this understanding of the importance of the social context for children’s optimal intellectual learning and emotional development, vygotsky’s (1962) theory of social constructivism underpins the current study. in addition to the instruction of traditional academic content areas, the classroom is perceived as an arena for children’s social and emotional constructions of self. children’s emerging self-concept and self-esteem remain integral with respect to their abilities to communicate and interact with others. developing a sense of self and framing expectations for interacting with others remain as ongoing, active, and dynamic. the child/student is regarded as an information-constructor. from the objective reality, through interpersonal interactions and ongoing feedback, students construct personally subjective meanings of themselves and diverse others. new information is linked to prior understandings. using the theoretical lens of social constructivism, the authors assume the level of potential development refers to the level at which learning takes place. still developing, cognitive structures will only mature under the guidance of or in collaboration with others. a teacher who bullies has a profound and long lasting negative influence on a child with respect to their own self-concept and, consequently, influences their future interactions with others. because social constructivism builds upon a regard for proactive and informed collaboration, a child’s ability to establish trust, initiate activity, and ensure industry are contingent on their sense of self and diverse others. considering the pervasive influence of the classroom teacher on the lives, attitudes, and successes of their students, this current mixed method project warrants consideration in contributing to the understanding of the potential of a teacher as bully phenomenon. with the vast number and range of diverse educators, researchers believe most teachers practice integrative and compassionate pedagogy. yet, considering this large number and diverse range of educators, it is also probable to believe some teachers may exhibit bullying behaviors. in order to ensure the emotional, social, physical, and intellectual security for all children, the current research contributes to the literature by describing how different populations define teacher-bullying. typically, the first image that comes to mind associated with bullying is a larger and/or older person shoving a smaller/younger person in a remote area of a school or community. this traditional image is www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 36 published by scholink inc. limiting and does not accurately depict the range of potential bullying behaviors. a person calling names or pushing in line may be distressing, but is this bullying? bullying is the behavior of someone who seeks power and control over another person who has been determined as weak, vulnerable, or unable to defend themselves. there is premeditation. potential victims may come from a non-traditional family, wear different clothes, or have some type of atypical physical or emotional trait. students targeted as victims of bullying are often socially isolated individuals. therefore, the difference between simple conflict and bullying is the existence of an imbalance of power between the victim and bully with an intent to cause harm. the harm can be direct and assume face-to-face confrontation (fekkes, pijpers, & verloove-vanhorick, 2005). bullying refers to a range of different behaviors including physical actions (hitting, pushing, kicking), verbal actions (name calling, provoking, threatening, spreading slander), or other behaviors such as making faces or social exclusion (fekkes et al., 2005). adopting mcevoy’s (2005) definition, the current discussion defines bullying as any verbal or non-verbal action intended to intimidate or harass another. bullying includes negative physical (pushing and inappropriate touching), intellectual (forcing agendas, compelling compliance, ignoring or negating others’ views), and emotional (yelling, belittling, threatening) behaviors toward perceived vulnerable others. the research literature clarifies behaviors associated with children’s peer-on-peer bullying, but limited data are provided toward adults who bully. informal conversations with administrators, teachers, and parents suggest the issue of teachers who bully does exist. for example, it is a common practice for some principals to intentionally not place at-risk students with certain teachers (twemlow, fonagy, sacco, & brethour, 2004). why does this practice occur? this strategy may be understood as a consequence of deficient knowledge with respect to diversity on the part of the teacher, inability of the administrator to insure “best practice”, or a veteran teacher receiving administrator favoritism. such placements could be interpreted as an institutional strategy to diminish the potential for teacher bullying behaviors. the following section discusses the literature describing peer-on-peer bullying and draws the implications for teachers who may bully. the chronic nature and public display of student peer-on-peer bullying behaviors share similarities with adult bullying. in both peer-on-peer and adult-child bullying behaviors, the bully intends to draw attention by humiliating the victim, which causes the victim to become publically undermined. there are a range of potential opportunities to support or undermine children during a single day in a classroom. for example, twemlow et al. (2004) describe teachers reporting bullying students on a frequent basis and admitting to bullying students in isolated events. additionally, data describe how elementary school teachers were more likely to bully students in or out of the school setting if they had experienced bullying themselves as children. mcevoy (2005) asserts, in many schools, at least one or www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 37 published by scholink inc. more teachers could be identified as abusive toward students. the bullying scenario, in contrast with popular belief, shows the child peer-on-peer bully does not evidence a lower self-esteem than the non-bullying child (rigby & slee, 1993). furthermore, it is not true that children’s bullying behaviors are the consequence of low academic performance or poor school achievement (olweus, 1993). the bully does not hold low status in the group (salmivalli, lagerspetz, bjorkqvist, osterman, & kaukialnen, 1996). admittedly, these data describe interactions ages eight through sixteen, but the implications become illustrative when attempting to understand how or why teachers who bully children may remain in the educational system. the existing data, identifying peer-on-peer bullies, negate the argument that bullies evidence low self-esteem, struggle for group status, or exhibit poor academic achievement. teachers who bully may be established and secure in their positions (mcevoy, 2005). this means, teachers who bully can be self-confident, represent high teacher/administrative acceptance, and demonstrate intellectual capacity. these descriptors help to explain why bullying teacher-behaviors continue; teacher-bullies may be perceived as accepted and leaders in the school community. exploring why some teachers may bully students warrants a consideration of the demands of the contemporary classroom. daily, teachers confront a range of students’ differences including culture, ethnicity, ses, race, language, ability, sexual orientation, and gender. in many instances, the teacher’s history, experiences, and worldview are dissimilar from their students (whitted & dupper, 2008). this disparity places daily demands on an individual’s knowledge, skills, and dispositions that may result in teachers becoming frustrated, overwhelmed, or threatened (zerillo & osterman, 2011). while most educators do not favor bullying attitudes, teachers in schools with low and high rates of suspensions tend to see fewer differences between bullying and non-bullying teachers than those from schools with medium rates of suspensions. teachers who experienced bullying as children tend to or are more likely to grow up to bully. additionally, they are more aware of other bullying adults (twemlow & fonagy, 2005). for both children and adults, bullying can be a social event that involves more than the bully and the victim. bystanders become part of the bullying interaction (kaukiainen et al., 1999). in legitimizing bullying as a group process, an understanding of the human experience as a social context is important; societal groups reject victims of bullying behaviors (salmivalli, 1996). in addition to a bully’s taunts, the victim experiences the stress of a group’s rejection (kaukiainen et al., 1999). for the school community, teachers as well as students may fear this rejection. motivated by a fear of becoming bullied, bystanders become reticent to assist victims (mcevoy, 2005). mcevoy (2005) argues, if not stopped by an authority figure, the bullying behavior may be interpreted by the victim as acceptable. the victim believes the bully’s values are shared by others. regardless of age, the victim’s rejection is highly stressful. eventually, if the bullying behaviors are not stopped, the www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 38 published by scholink inc. victim begins to assume responsibility for the bully’s actions and internalizes a sense of worthlessness (mcevoy, 2005). when teachers publically embarrass, belittle, or humiliate a student, they not only bully the targeted student, but they as well create a hostile and vulnerable environment for all children. in doing so, bullying teachers undermine the potential learning environment for all students. educators who bully often use motivation or instruction as a justification for their intimidating behaviors. teachers may claim to use intimidation as a form of disciplinary response to a student’s misbehaviors (mcevoy, 2005). as a result of a teacher’s behavior, victimized students may experience confusion, anger, fear, and begin to doubt their social and academic competencies. mcevoy describes how adults, when challenged for their perceived bullying behaviors, attempt to convince the victim they misunderstood or misrepresented the behaviors. educators who bully also attempt to undermine the credibility of those who challenge their actions (2005). it appears these responses are only an attempt to shift focus away from the bully’s inappropriate behaviors. this is an attempt to create an impression that these events are more of a personal misunderstanding than genuine abuse (mcevoy, 2005). findings link health issues with the victims of bullying behaviors. longitudinal data (copeland, wolke, angola, & costello, 2013) reveal victims of bullying experienced a higher rate of psychological health problems later in life (agoraphobia, anxiety. and panic disorders). data also describe how victims of bullying experience a higher rate of anti-social behaviors. victims of teacher bullying are more likely to be rated as less academically capable, less inclined to complete school, and more likely to be involved in high-risk behaviors (gambling, drug use, and under-age drinking) (delfabbro et al., 2006). additionally, both those who bully and those who are bullied are more disposed to depression and suicidal ideation than those who are neither bullied nor demonstrate bullying behaviors (forero, mclellan, rissel, & baumann, 1999). therefore, in planning to maximize proactive professional learning communities, it is critical to examine the potential for children who may be victims of teacher bullying. research questions: do classroom teachers exhibit bullying behaviors? what kinds of bullying behaviors do teachers demonstrate? is bullying, as practiced by teachers, a social event? which children may be targeted by teacher bullying behaviors? 2. method 2.1 study one: a quantitative project describes classroom teachers’ reports of their bullying behaviors or observations of other teachers who bullied students 2.1.1 purpose and participants www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 39 published by scholink inc. the purpose of study one was to collect rationalistic data to determine the types and frequencies of teacher-bully behaviors as observed by other practicing teachers. one hundred eighty-six (n=186) early, elementary, middle, and high school teachers (139 females, 30 males, and 17 non-responders) volunteered to complete surveys describing their observance of, or participation in a range of defined bullying behaviors. the definitions were adapted from mcevoy (2005) and included descriptions for emotional, physical, and intellectual bullying. twenty-six participants did not identify their level. 2.1.2 instrument surveys were passed out at county schools in a large urban area in the southeastern united states. the surveys included no identifying information. using a five-item likert scale 1-5 (1=none of the time, 2=rarely, 3=some of the time, 4=most of the time, 5=all of the time), 186 participants described their workplace experiences as observing or participating in bullying events. before completing the survey, teacher-participants reviewed definitions of bullying as adapted from mcevoy (2005). 2.2 study two: a qualitative project describing teacher candidates’ experiences with teachers who bully 2.2.1 purpose and participants the purpose of the second study was to collect narrative data to determine the types and frequencies of teachers who bully as reported by teacher candidates. students preparing to be licensed teachers (n =341), attending a large urban university located in the southeastern us, responded to a one-open-ended question. the survey asked for any descriptions of events where they observed children being bullied by teachers or instances where they were themselves, victims of teacher bullies. the return rate was 88%. 2.2.2 instrument the open-ended nature of the single question allowed participants to consider all possibilities describing teachers who bully. this open-ended response included university students’ personal history as a student. definitions of teacher bullying were not provided for participants to reference. no restrictions were placed upon participants’ memories or recall. researchers did not attempt to validate participants’ stories. students’ third-party or heresay narratives were not included in the qualitative analysis. this means the participant had to either be a victim of bullying or first-hand observed a bullying event. participants never personally experiencing a bullying event or never observing another student being bullied by a teacher, checked a box describing this “lack of observed bullying behavior”. this was done to identify the total population of students who “never experienced bullying.” www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 40 published by scholink inc. 3. results 3.1 study one 3.1.1 data analysis for all measures, participants rated responses less than a score of three (1.29 > 2.37). participants reported infrequent involvement in bullying encounters. cumulatively, 84% of respondents indicated verbal or non-verbal intellectual bullying occurred some of the time, rarely, or none of the time. the mean score for all categories of intellectual bullying was less than 2.43. smaller numbers indicate absence of bullying. these data indicate intellectual bullying behaviors rarely occurred or were non-existent. in the category of emotional bullying, a cumulative frequency indicated more than 83% of participants reported non-verbal or verbal emotional bullying occurred some of the time, rarely, or none of the time. the mean score for all categories of emotional bullying was less than 2.37. data indicate emotional bullying behaviors rarely occurred or were non-existent. with respect to reporting incidents of bullying, cumulatively, more than 89% (m > 1.79) indicated some of the time, or rarely, taking the responsibility to report incidents of observed bullying behaviors. when participants were asked whether they had experienced bullying encounters with an instructor/coordinator or university instructor, data indicated cumulatively, 95% (m > 1.55) indicated some of the time or rarely did they experience incidents of bullying behaviors. ninety-seven percent of respondents reported either some of the time, or rarely, reporting any incidents of bullying behaviors in this category. there was less than 2% (m > 1.40) reporting of any experiences with physical bullying. finally, data reveal no indication of administrators engaging in nonverbal bullying behaviors. however, bullying was described as a group process 80% (m =2.63) of the time when it did occur. the data suggest minimal incidents whereby educators were either perpetrators or bystanders to intellectual, emotional, or physical bullying encounters. if these data are to be accepted, classroom teachers are not bullies. 3.2 study two 3.2.1 data analysis narrative data were coded to generate categories emerging from the participants’ responses. content validity was determined by the multiple layers of constant comparative analysis (lecompte & preissle, 1993). the two researchers analyzed all surveys using a layered approach. initially, the two coders independently read through the data multiple times and identified common themes/categories. a range of categories began to represent the teacher candidate-participants’ shared bullying stories. the two researchers then read through all data as a collaborative team. through ongoing discussion, data determined category names by providing participants’ narratives as examples. finally, interpretations www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 41 published by scholink inc. were reviewed for any potential inconsistencies. in addition to the open-ended response, the survey allowed for participants to initially check one of three descriptors to indicate their perception of how often teacher bullying occurs. a total of 341 completed the survey and responded to the statement to reveal their belief regarding teacher bullying. sixty-five (19%) students reported they believed teacher bullying occurs rarely while only seven participants (2%) indicated that they had never seen, heard or been a victim of teacher bullying. one hundred-forty (41%) of students indicated that they believe teacher bullying occurs sometimes while 120 (35%) indicated that they believe teacher bullying occurs more frequently than people want to admit. the remaining nine (3%) students did not provide an answer to this statement. based on these data, roughly three-fourth of respondents indicated, at the least, some degree of awareness that teacher bullying occurs. in the open-ended section of the survey, students were provided opportunity to comment on their experiences with teachers who bully. forty-five students indicated that they never observed teacher bullying, while 63 students indicated no personal encounter with teacher bullying. one hundred fifty-two students reported that they had personally experienced bullying directly or indirectly. consistent with the existing literature, two students equated bullying to “tough love”. this is the case when a teacher is seemingly too hard on a particular student. the remaining respondents did not provide data for this question. using the constant comparative analysis, the authors identified three primary categories describing teachers’ bullying behaviors. within each of the primary behavioral categories, applying the participants’ responses, authors were able to further describe sub-categories of behavior within each of the broader labels. primary categories were identified as verbal, shaming, and targeting. subcategories within each primary category included: calling-out, singling-out, and humor (verbal); demeaning, embarrassing, humiliating, and belittling (shaming); and finally power, and differences (targeting). for the subcategory “differences”, participants’ comments further delineated subcategories for the ways in which teachers targeted students’ differences. the extended subcategories for the subcategory “differences” included physical appearance, diversity difference, and ability difference. for the verbal bullying subcategory “calling out”, one university student-participant wrote: “in elementary school, i remember having a couple of teachers who would call students dumb or stupid in front of the whole class”. another university student-participant commented: “i’ve witnessed teachers bullying students that aren’t the best of students by making fun of them and always calling them out”. in verbal bullying subcategory “single out” a university student-participant commented; i have been part of a class where the teacher always picked on one student no matter what that student was doing. the teacher always had something negative to say. likewise, another university student-participant said: www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 42 published by scholink inc. “i have been bullied by a teacher. i was in high school and this teacher seemed to have it out for me. she would yell at me in front of the class if i asked a question that required her to repeat the instruction.” in the third verbal bullying subcategory “humor”, a university student-participant said: “i have seen teachers playing jokes with students sometimes that can be taken too far or taken the wrong way”. regarding bullying activities within the shaming subcategory “demeaning”, one university student-participant wrote, “i once had a teacher in fourth grade yelling in my ear for answering a question incorrectly. i’ve seen a teacher give smarties candy to smart kids and ‘dumdum’ lollipops to the dumb kids.” in the shaming subcategory of “embarrassment”, a university student-participant wrote, “i can’t think of an exact time, but i have seen teachers call students out too much. to the point i think, the teacher is purposefully embarrassing the student”. an additional example of a university student-participant’s comment said, “i had a teacher that i knew of who would talk down to the kids and told them that they would not do well in life.” in shaming subcategory “humiliation”, a university student-participant wrote, “once my teacher became frustrated. she walked me down to a kindergarten classroom and said, ‘if you don’t understand something this simple, this is the kind of class you belong in’”. finally, in the shaming subcategory “belittle”, a university student-participant wrote, “i have witnessed several teachers at a school belittle the students. they would yell at them, they did not consider that sometimes they did not understand what the teacher was saying because they spoke different languages other than english”. in the third category of targeting, several university student-participants reported experiencing teacher bullying. in the subcategory “power”, one university student-participant wrote, “there were several instances in high school when some teachers who abused their power and picked on certain students who gave them trouble. instead of helping a troublesome student, they seemed to target them during class”. another university student-participant commented, “i’ve noticed before some students getting higher grades if the teacher likes them and others getting lower grades when a teacher does not like them”. another university student-participant wrote, “teachers verbally attack students and use their authority to make it seem like it is not bullying. i have had teachers who publically shame students for their personal business and make them feel bad about themselves”. another university student-participant reported, “i have seen where the teacher will have favorites and if they are not his or her favorites and treat the other students worse and bully them for grades”. an additional university student-participant stated, “in fifth grade a teacher, made fun of me in class. he also threw markers at us for certain reasons”. for the primary category, targeting, subcategories include “difference” and “appearance”. one university student-participant stated, “my teacher in elementary school used to make fun of how my legs were shaped. he called me turkey legs”. another university student-participant wrote, “i got bullied because of my big curly hair in middle school”. another www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 43 published by scholink inc. university student-participant wrote, “when i was in middle school, the pe teacher would make several comments about my weight. that led to students in class saying it too”. data also indicated that there were several comments describing diversity with respect to english as second language (esl) students and students who appeared to have ability differences. a university student-participant wrote, “i’ve seen several teachers before mentally bully one student. unfortunately the students were mainly those students who may have learned a little slower than everyone else or just could not learn what the teacher taught. the teacher would use words as losers or tell the students they were losers or telling the students they would never become anything”. third-hand reports of teacher bullying were not included in the analysis. participants either directly observed the bullying event or were victims of a teacher who bullied. 3.2.2 limitations researchers acknowledge time and memory may be potential mediating influences. furthermore, researchers acknowledge the two populations for study one and two are different and cannot be directly compared. yet, the question remains why a closed population of “practicing” teachers observed minimal to no observed teacher bullying behaviors, while the second population of university teacher education students described a range of bullying behaviors. in order to maximize the positive learning experiences for all children, authors argue further research identifying and describing teachers who bully is warranted. 4. discussion twemlow et al. (2006) describe teacher bullying as an attitudinal characteristic. emerging from a coercive power dynamic established during childhood experiences, family roles, and school environments, children, victims of status in-balance, appear to be more likely to be trapped in future bully-victim interactions. toward improving the lives of children, this would involve changing victim and bully roles as well as being more alert to the bullying of others. further, twemlow et al. (2006) also describe reasons for teachers’ bullying behaviors including lack of administrative support, inadequate classroom management strategies, and fear of injury by students, large class sizes, and teacher envy of smart students. these indicators describe the daily reality of the contemporary classroom. if the findings from study one are to be accepted, teachers do not verbally or nonverbally harass students, teachers do not threaten or inappropriately compel students’ intellect, and teachers do not compromise the students’ emotional well-being. in collecting data for study one, a principal denied data collection because she claimed, “the act of bullying among the staff at this school is non-existent and to give this survey is nonsense”. while some administrators may believe their staff members do not demonstrate bullying behaviors, why deny the opportunity to substantiate the claim. this particular www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 44 published by scholink inc. principal’s perspective was affirmed by study one; teachers do not bully children. study two data clearly described the several ways in which teachers bully children. assuming the lens of the university student-participants’ histories and not the classroom teachers’ perspectives, study two narratives overwhelmingly described how teachers bully children from preschool through university. interestingly, although the university student-participants in study 2 were not previously provided with mcevoy’s (2005) definitions of bullying, their open-ended responses consistently aligned with mcevoy’s indicators. additionally, university student-participants’ narratives overwhelmingly described how teacher bullying was framed as a public event. the bullying actions were seen and heard by other students and teachers. even if a student is not directly targeted as a victim by the teacher, because of the balance of power, all students are vulnerable. consequently, students are reluctant to support their peers or, as victims, are unable to speak out against the teacher. students understand the role of teacher to be associated with power, influence, and authority. in several of the university student-participants’ narratives, there was an implied reference to power. there were several descriptions of teachers throwing items at students. one student-participant said that the teacher was frustrated because students were not doing homework, so through his gradebook across the room. this same teacher also through a dry erase marker at a student who was not paying attention and as well threw a chair across the front of the classroom. another university student-participant stated witnessing a teacher throwing things at students with no specific description of the object. furthermore, university student-participants’ narratives described teachers targeting students with respect to their appearance, diversity, and ability differences. for a variety of reasons, many children are unable to maintain the grade-level standards. university student-participants’ narratives described how students’ intellectual capacity, language difference, and/or maturity level became the target for teacher ridicule. regardless of individual student difference, the role of the teacher is to support, instruct, and guide students. negotiating a range of diverse students’ needs and abilities is not extraordinary, it is what teachers do. as a professional, teachers do not exhibit frustration, anger, or preference. mainstream media and other news agencies (copeland et al., 2013; bradshaw, 2013) devoted considerable airtime broadcasting issues related to bullying among school-age students. it is well documented that health issues and suicides among school-age students are closely associated with bullying victimization. popular media highlighted incidents of peer-on-peer bullying encounters resulting with the mainstream population responding with shock and horror. parents asked, “how is this possible?” students, educators, and administrators have long known children are bullied by other children. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 45 published by scholink inc. however, not until the recent media focus did the peer-on-peer bullying issue motivate school leaders and officials to create anti-bullying programs. why were educators, those in the schools each day, not the first to discuss the peer-on-peer bullying issue? is this similar to what happened in study one? once you are a member of the school community, is there a lack of institutional introspection to identify weaknesses, vulnerabilities, and problems within your own profession? study one data clearly reported teachers do not bully. yet, for study two, university participants, who were still students, described a range of teacher-bullying from the early years to university. the difference between the two populations, practicing teachers and teacher candidates, provided incongruent and contrasting perspectives. is it not reasonable to ask if there are some teachers who are unprepared or ill-equipped to effectively and compassionately interact with diverse student populations? in the future, will it be left to popular media to continue the bullying discussion to include classroom teachers? alternatively, can practicing teachers and teacher education programs collaborate and monitor the profession? when children are systematically ridiculed, harassed, or left vulnerable to others, the outcomes are significant and long-term. this is especially devastating when the bully represents authority, power, and influence. authors believe teachers are responsible, not only for the academic delivery of material, but also are obliged to ensure the emotional, physical, and intellectual safety of all children. in an effort to understand the teacher bullying phenomenon, the school community is obliged to consider this potential threat to children. until this discussion begins, children are vulnerable. in order to manage students, some educators praise teachers who use tough language, strong intimidation, and harsh posturing. in contrast, compassionate management and effective instructional behaviors are designed to invite and involve students; bullying disengages children. yet, in the current study, another reason for lack of reporting of bullying incidents might be because identifying bullies may seem to be an act of anti-collegial behavior. in almost all instances, faculty and staff are expected to support and nurture one another. reporting wrongful incidents often becomes a silent issue in order to prevent being labeled in a negative or non-supportive manner. in study one, practicing teachers denied any bullying by their colleagues. this notion teachers may be reticent to “whistle blow” on their colleagues is supported by the literature describing bullying as a social and group experience. yet, university teacher education students, in study two, well described a range of teacher bullying behaviors. is the difference that, as students, they are not yet “a part” of the system and are more ready to describe the injustice? 5. contributions initially, the purpose of the first study was to describe what teachers reported with respect to different types of teacher bullying behaviors; minimal evidence for teacher bullying was generated from the www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 46 published by scholink inc. teacher data set. lack of data is not necessarily lack of evidence. despite the dismissive findings from study one, researchers were not convinced some educators do not bully students. researchers wondered, in preparing study two, if teacher candidates, not yet professionals in a school community, might be more willing to report events of observed bullying by teachers. collecting data from this university student population clearly demonstrated examples of teachers’ emotional, physical, and intellectual bullying. current revisions in teacher education programs, council for the accreditation of educator preparation, systematically incorporate the use of dispositional standards. this means, a teacher candidate may earn an adequate gpa for admission to a teacher education program, but without satisfactory dispositions, may be forwarded for remediation. findings report that most problems arising in the student teaching semester are a consequence of inappropriate dispositions (brabeck & koch, 2013). teacher education programs scaffold the understanding for planning, instruction, and assessment of learning and teaching, but it is the candidates who must as well inherently possess the core dispositions to consistently respond to their future children with empathy, respect, and regard. a teacher’s concept of self, competency in the profession, and ability to relate with diverse others are critical in resolving the issues related to teachers who bully. implications for future research reflecting upon an educator’s potential influence on children’s academic learning and emotional well-being highlights the need to identify key aspects related to school personnel. for this reason, it is important for public school faculty to be knowledgeable with respect to the range, types, and roles associated with the bullying phenomenon. in order to maintain standards and ensure the protection of children, self-examination and monitoring related to teachers who bully warrant further discussion. references bradshaw, c. (2013). bulling, violence, and gangs. national center on safe and supportive learning environment. retrieved from: http://www.stopbullying.gov/blog/archive/201305/ brabeck, m., & koch, c. (2013). why the new teacher ed. standards matter. education week, 33(4), 26-27. copeland, w. e., wolke, d., angola, a., & costello, e. j. (2013). adult psychiatric outcomes of bullying and being bullied by peers in childhood and adolescence. jama psychiatry, 70(4), 419-426. https://doi.org/10.1001/jamapsychiatry.2013.504 delfabbro, p., winefield, t., trainor, s., dollard, m., anderson, s., & metzer, j. (2006). peer and teacher bullying/victimization of south australian secondary school students: prevalence and psychosocial profiles. british journal of educational psychology, 76(1), 71-90. https://doi.org/10.1348/000709904x24645 www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 47 published by scholink inc. fekkes, m., pijpers, f. i. m., & verloove-vanhorick, s. p. (2005). bullying: who does what, when and where? involvement of children, teachers and parents in bullying behavior. health education research, 20(1), 81-91. https://doi.org/10.1093/her/cyg100 forero, r., mccellan, l., rissel, c., & baumann, a. (1999). bullying behavior and psychosocial health among school students in new south wales, australia: cross sectional survey. british medical journal, 319, 344-348. https://doi.org/10.1136/bmj.319.7206.344 kaukiainen, a., bjorkqvist, k., lagerspetz, k. m. j., osterman, k., salmivalli, c., & forsblom, s. (1999). the relationships between social intelligence, empathy, and three types of aggression. aggressive behavior, 25, 81-89. https://doi.org/10.1002/(sici)1098-2337(1999)25:2<81::aid-ab1>3.0.co;2-m lecompte, m. d., & preissle, j. (1993). ethnography and qualitative design in educational research (2nd ed.). mcevoy, a. (2005). teachers who bully students: patterns and policy implications. in paper presented at the hamilton fish institute’s persistently ontario safe schools conference. philadelphia, usa. olweus, d. (1993). bullying at school: what we know and what we can do. oxford: blackwell. rigby, k., & slee, p. t. (1993). dimensions of interpersonal relating among australian schoolchildren and their implications for psychological well-being. journal of social psychology, 133, 33-42. https://doi.org/10.1080/00224545.1993.9712116 salmivalli, c., lagerspetz, c., bjorkqvist, k., osterman, k., & kaukianinen, a. (1996). bullying as a group process: participant roles and their relations to social status within the group. aggressive behavior, 22, 1-15. https://doi.org/10.1002/(sici)1098-2337(1996)22:1<1::aid-ab1>3.0.co;2-t twemlow, s. w., fonagy, p., sacco, f. c., & brethour jr., j. r. (2006). teachers who bully students: a hidden trauma. international journal of social psychiatry, 52(3), 187-198. https://doi.org/10.1177/0020764006067234 twemlow, s. w., & fonagy, p. (2005). the prevalence of teachers who bully students in schools with differing levels of behavioral problems. american journal of psychiatry, 162, 2387-2389. https://doi.org/10.1176/appi.ajp.162.12.2387 twenlow, s. w., fonagy, p., sacco, f. c., & brethour jr., j. r. (2004). teachers who bully students: a hidden trauma. international journal of social psychiatry, 52(3), 187-198. http://doi:10.1177/002076400606 vygotsky, l. s. (1962). thought and language (e. haufmann, & g. vakar, eds. and trans.). cambridge: mit press. https://doi.org/10.1037/11193-000 whitted, k., & dupper, d. (2008). do teachers bully students? findings from a survey of students in an alternative education setting. education and urban society, 40(3), 329-341, www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 48 published by scholink inc. http://:10.1177/001312450730447 zerillo, c., & osterman, k. (2011). teacher perceptions of teacher bullying. improving schools, 14(3), 239-257. https://doi.org/10.1177/1365480211419586 children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 2, no. 2, 2019 www.scholink.org/ojs/index.php/ct 92 original paper adolescents within risk zones. moreover, does it also have an influence on further biographical unfolding? lillian lundstrøm 1* & lisbet oeygard 1 1 dept. of psychosocial science, university of bergen, bergen, norway * lillian lundstrøm, dept. of psychosocial science, university of bergen, bergen, norway received: august 29, 2019 accepted: september 7, 2019 online published: october 9, 2019 doi:10.22158/ct.v2n2p92 url: http://dx.doi.org/10.22158/ct.v2n2p92 abstract alternative school day (asd) is a project for adolescents with difficulties in several areas. the pupils attended asd one day per week, and the content in the program was more practical and adjusted. in this study thematic analysis was conducted. principal inclusion is formulated in educational legislation in many countries worldwide; however, different special initiatives may have positively affected adolescents in risk zones. some theorists have emphasized that regular school is based on middle-class values, and for pupils with other class backgrounds, the school represents “represent an away ground”. further, we have debated whether reflexive modernization is an important topic in the general knowledge within society nowadays, with globalization, extended consumption, and several risks associated with modern society. we are questioning whether the students could experience the immersive turning points and fateful moments in the biography, where they started to look upon themselves as clever and competent pupils while attending asd. the positive attention and expectation from the teachers and the tasks were more practical-oriented, representing the core factors in the positive outcome measures found through this study. keywords the alternative school day, adolescents at risk, marginalized youths, globalization, new risks within modern society, reflexive modernization 1. introduction teenagers’ dropping out of school is a major problem in norway, scandinavia, and many other european countries today. this article will examine a particular school initiative, namely “alternative school day” (asd). the asd is a preventive project for adolescents who engage in antisocial behavior and who have difficulties in several areas, for example, at school, within the family, or in their www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 2, 2019 93 published by scholink inc. leisure time. processes of marginalization at a young age are important, not only because adolescents are in a vulnerable situation, but also because exclusion at a young age can have long-term consequences. the question is whether one is included or excluded from what is recognized as important social arenas and activities in society (heggen, jørgensen, & paulsgaard, 2003; shifrer, callahan, & muller, 2013). pupils who attend the asd are between 14 and 16 years of age and all have working-class backgrounds. the ones who were picked out have been out of school for a long time, so based on these terms, there is a great challenge to get those students back into the ordinary school arrangement again. the schools pick out the students who will have the opportunity to participate, but the students and their parents must give their admission. the students took part in the asd one day per week throughout the school year, during the era from august to june. in fact, most of the time, the students show up on alternative school day (asd). important goals during participation in asd are to promote the adolescent's capacity for learning, coping, and personal responsibility, as well as risks associated with the new challenges within society nowadays. individual goals for each student are developed in cooperation with the schools based on individual educational plans. by identifying the students’ life situations, plans are worked out for how one best can work with each of them. the students must obtain reliable and positive contact with the counselors at the asd. consequently, there are two adults and a maximum of six pupils in each group. scholars have argued that school reproduces differences that already exist in society, and in some cases, the gap increases (nordahl, 2010, 2013). bourdieu (1996) introduced the concept of habitus, which refers to the subjective dispositions that reflect a class-based social grammar of tastes, knowledge, and behavior inscribed in the “body schema and the schemes of thought” of each developing person. since many teachers come from the middle class, they tend to favor students from the same background and inherit the same habitus as themselves. therefore, students coming from other conditions and exposing different behaviors and comportments offer teachers greater challenges in communicating, understanding, and organizing education for them (bourdieu & passeron, 1990; giroux, 1983; anyon, 2011). the school has become more theoretically oriented (reform 94), and some students seem to fall more easily outside of the school because they come from a more practical background, which many students prefer (heggen, båtevik, & olsen, 2000; markussen, løddingen, sandberg, & vibe, 2006). research has also shown that norwegian pupils don’t thrive in school as much as we could have hoped for. there are nuanced and extended explanations for why the situation is like this (pisa, 2000-2012), (elstad, 2008/2012). the problems presented in this article are as follows: this paper aims to see whether asd can enhance an adolescent's ability to learn more school-related knowledge by presenting it in a more practical way. it also creates “a kind of atmosphere and learning environment” where the students have a qualitative, different, and positive learning experience. this can create a kind of “turning point” or “fateful moment in the biography” regarding their own experiences of their school curriculum and their www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 2, 2019 94 published by scholink inc. learning abilities (giddens, 1991, 1994). moreover, if some experienced these magic “turning points,” what would the characteristics of these students be? we also aim to map out how alternative school day (asd) may enhance the pupils' general awareness and consciousness about the “new risks” in society. for instance, risk related to globalization, extended consumption, and incorporating it into generic knowledge and continuous reflection. this reflection is something that the student can bring with them as a kind of prerequisite and abilities into the grown-up life. 2. theoretical contribution to understanding adolescence as a transitional phase and its possible exclusions from central arenas adolescents have been described as a marginal social category. the marginality points to the adolescent period as a transition phase and that adolescents have a peripheral role in society (frønes & solvang, 1991). to understand the processes of marginalization, one must consider significant institutions, such as the family, friendships, schools, and organizations. roberts (1995) claims that while a railway journey might have been a suitable metaphor for youth in modern society, driving in a private car is a more relevant image today. thus, we have moved from a situation where short, collective, and predictable transitions to adulthood were dominant to a long, twisting, and individual path (see buchmann, 1989). through a series of important choices or turning points in adolescence, youths encounter the risk of society. they must make momentous choices. they can succeed or fail. this individualization of the youth stage can be grasped through reflexive modernization, which refers to an increasing pressure on youth to reflect on the subjective consequences of their actions (giddens, bech, & lash, 1994). another example of this phenomenon can be taken from the media and the appearance of fake news (nupi, 2018). the consequence of this societal development is that it puts pressure on everyone to do their reflected deliberation concerning which news to rely on. this phenomenon was not common only some years ago. we hypothesize that the student’s participation in the asd might help them to understand several aspects of their personalities better. in the youth theory of the 1990s, one frequently encounters the terms choice, individualization, risk, globalization, and reflexivity (bauman, 2001; beck, 1992, 2002; bernstein, 2000; furlong & cartmel, 1997; giddens, 1991, 1994, 1999). more than in previous social systems, youth scenes in post-industrial society might be characterized by dissolving tradition, diversity, individual solutions, uncertainty, and risk. a central concept in this pronouncement is “disembodying mechanisms,” which is the impairment and dissolution of the earlier strong structures, like social classes, local society, church society, etc. (giddens, 1991). these perspectives reveal that education and other forms of qualification activities to an extended degree will get a weak characteristic which the parents monitor. it is important to make the right and deliberate choices: the right schools and teachers, the accurate subjects and marks, the appropriate friends and manners, the accurate leisure activities, and the right time. when www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 2, 2019 95 published by scholink inc. institutions are dissolute as behavior cooperation, local knowledge will also be affected as this cooperation produces dissoluteness. in increasing several arenas, i will be met with a more locally developed understanding and knowledge and meet more public and non-place anchored expertise (from nursery schoolteachers to social workers to doctor specialists and flight leaders). in order to function in such a society, we must develop a certain degree of confidence that these expert systems are functioning correctly. life will become tough if we go around with fundamental doubt in every context where we depend on such expertise. giddens (1991, 1994) emphasized knowledge, competence, and choices as the basic challenges in entering the risk society. on the other hand, ulrich beck (1986) links this entrance to concepts like increased globalization, new lifestyles, and the increasing use of world resources and consumptions and modern technology (beck, 2000) as the new challenges. these can be exemplified by nuclear threats, environmental pollution, for example, through air, water, or groceries, and risks associated with modern traffic systems (beck, 1992). however, there are contexts where theorists have attributed several main characteristics to post-modernity that will still be challenged by tradition, local culture, class, and social organization. moreover, marginalization, although deeply connected to what has been termed the fateful moments of biography, or “turning point” in the curriculum. this cannot be understood without considering traditional sociological variables like problem identification, false communication, stigmatization, and multiple problems (furlong, 1997; carrigan, 2013; øia & heggen, 2005). this sociological perspective, incidentally, does not use marginalization as a central concept but depicts identity problems, for example, as an effect of a series of discontinuities, “critical moments,” or “fateful moments in the biography” (giddens, 1991, 1994). along with the dissolution of the old social structures, increased globalization, “dis-embedding” mechanisms, and more impulses and choices, every person is going through a period of individualization. consequently, the individual must be related to oneself to an increasingly extended degree and his/her placement in society—thus self-reflection. thus, this dissolution of social arrangement transfers new demands, like freedom, expectation, control, and challenges, to the individuals. this gives many individuals an exceeded number of choices but can also mean that the individual becomes more vulnerable and adjourned for marginalization. this allows the individual to create their biography but amplifies the possibility that they will not have the power to deal with the pressure. moreover, the risk of developing what beck and beck-gernsheim (2001) have called a total “collapse biography” is the most current. 3. the context eight boys and one girl, their parents, and teachers were interviewed about several topics connected to asd. the pupils were interviewed twice, during autumn (t1) and spring (t2). in this program, the www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 2, 2019 96 published by scholink inc. emphasis is to make the tasks more concrete. in that manner, it can be easier to visualize, for example, mathematical magnitudes. for instance, during the school kitchen session, the teacher shows how much 10 dl of milk, and 600 grams of butter are. then, the students can see, feel, and measure the content of the liquid or populace, making it more comprehensible to understand and fully relate to the different mathematical magnitudes. 4. method the method at use is thematic analyses, evolved by braun and clark. we used a semi-structured interview and inductive reasoning as the method. the qualitative interview is defined as a dialogue to obtain descriptions of the life world of informants concerning their interpretation of important phenomena (kvaale & brinkmann, 2009). the semi-structured interview has a sequence of themes to be covered and suggested questions. it is open to changes in sequence and forms of questions to follow up the answers given and the stories told by the subjects. the interview has the advantage of covering deeper essential meaning compared to quantitative approaches. in this study, meaning condensation or an abridgment of the meanings expressed by the interviewees into shorter formulations was utilized. for example, several teachers formulated, “he does not understand anything regarding theoretical subjects, but he is very clever in gymnastics and mechanical subjects.” this statement was condensed to “he is very weak in theoretical subjects, but he manages quite well in practical subjects.” regarding trustworthiness, there was a relatively strong correspondence between what the pupils, parents, and teachers reported. however, it must be noted that regarding school problems, the students and their parents often meant that the teachers or the school represented the challenge. in contrast, the teachers, on their side, looked upon the students as being problematic. further on, it is possible that the questions were not always adequate since it was common for the pupils to answer, “i do not know” or “i have not thought about this.” the interview guides at both t1 and t2, three interview guides were constructed. these contain questions for the pupils, their parents, and teachers. the first interview with the pupils covers the school situation, well-being, mastery experience, and self-esteem related to theoretical achievements. further, questions concerning the relationships between parents and friends were elaborated, and questions concerning the reflected deliberation due to the new challenges within society are at risk. at t2, the focus was on possible changes since t1, for example, if the students shook school if their relationships with parents and teachers had improved, and if they had changed themselves in any way. further on, they were asked whether the lessons about the risks related to extended consumption and risks associated with globalization were helpful for them. they also questioned whether the knowledge about the countless possibilities nowadays led them to do more deliberate reflection before choosing, for example, an www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 2, 2019 97 published by scholink inc. educational trajectory or making decisions concerning other important topics. questions directed to parents at t1 involved whether they thought their children would benefit from participating in the asd and the conditions regarding their children’s school, leisure, and family situation. the questions to teachers at t1 involved what kind of influence they think asd will have upon the students, their social competencies, school subjects coping, level of truancy, and general societal concern. additionally, they were asked if they had been involved in mockery and if they conflicted with teachers and other pupils. at t2, questions primarily focused on potential changes in the students’ lives since t1 from the perspectives of parents and teachers. moreover, whether the students had become more socially engaged. 5. data analysis at t1, all the pupils were interviewed face-to-face at the asd. at t2, five were interviewed at the same place, one at home and three by telephone because they had traveled away on summer vacation. the teachers received the questions via email before they were interviewed. because a tape recorder may distract the respondents, it was decided to do the notetaking on the spot. the interviews were transcribed, and the written texts became the material for the subsequent interpretation. by transcribing the interviews from oral to written, we make the interview conversations more amenable for closer analysis. structuring the material into text facilitates an overview and comprises a preliminary analysis (strauss & corbin, 1990). the pupils were split into three groups over three days. as mentioned, there was one girl in the sample. this represented an anonymity problem, and the solution was that all the pupils acquired boy names. all the students had working-class backgrounds. 5.1 the participants the pupils were divided into three tentative groups: the marginalized (m-group), the twilight zone (t-group), and the integrated (i-group). this was one way to structure the material. some of the pupils were easy to place while others were not. two students could, for example, be referred to as marginalized but were placed under the twilight zone because they were better off in some areas. the integrated students were easier to place. however, all the students had two factors in common. first, they did not cope with the theoretical subjects at school, and second, they did not feel at home in the regular school environment. 5.2 marginalized joachim, jonas, and tom showed negative development during the school year. joachim and jonas quit school, and tom attended a special school. tom resided with both parents, while joachim and jonas cohabited with their mothers. all three had a bad relationship with their parents. heggen and colleagues (2003) found that marginalized adolescents who had problematic relationships with their parents developed close relationships with friends. among their friends, they got confirmation of themselves, www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 2, 2019 98 published by scholink inc. and such positive experiences were important regarding the adolescents’ sense of belonging and identity. this was not the case for tom and joachim. they gave the impression that friendships were unimportant; they seemed to have problems establishing close relationships with friends and adults. further, they were depressed and seldom took the initiative themselves. the distant relationship between tom and his parents might have been the reason why he found excitement in drugs. thus, it worsened an already bad relationship. for jonas, the situation was somewhat different. his mother had psychiatric problems, and they were poor. additionally, he seldom met his father. jonas was also into drugs, but he had friends outside this milieu as well. he conflicted with his mother, but they were in contact, and he often brought friends home. tom chose another strategy; he seldom went home to avoid quarreling and fussing. tom and jonas had been in contact with the police several times. tom was arrested for using drugs, and jonas for stealing. all three boys had withdrawn from family and school, which can be seen as an attempt to avoid social control in arenas important for adolescents’ social integration. 5.3 twilight zone lars and adrian quit school. lars started to work, and adrian attended a special school. even though they were not at the ordinary school any longer, they were better off in other areas, compared to the students in the marginalized group. this was the case especially regarding their relationships with their parents. both lars and adrian reported that they had a good and close relationship with both of their parents. lars lived with both parents, while adrian resided with his father. it was common that the students had most contact with their mothers, so the bond between adrian and his father was an exception. lars played football, which meant a lot to him, although he had few friends in this group. 5.4 the integrated andy, sam, martin, and tony were still at the ordinary school, and they did not work hard, and sometimes they came late to school. all four showed positive development during the year. moreover, all were engaged in sports activities that meant a lot to them, and they had friends in these milieus. they had relatively good contact with their parents but felt most attached to their mothers. all of them, except andy, reported quarreling with their parents. andy was the only one who did not reside with both parents. all of them also had good relationships with other students. 5.5 reflexivity the second researcher in this paper conducted the interviews and transcribed them. she is, unfortunately, deceased. her background was as a sociologist, and she invited me to participate in the project to gain a more psychological understanding of the research field. we have been cooperating closely, and she told me about asd daily during the interviews. as a sociologist, i would assume that she was colored by her theoretical background, with discourses like the agency-structure perspective. that i, as a psychologist, found absorbing. because i was trained within a tradition preoccupied with www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 2, 2019 99 published by scholink inc. looking after pathology on the individual and putting up diagnoses on pupils with behavioral or adjustment problems. 6. findings the asd as a comfort zone and relationships to adults. quality of life is related to a subjective feeling of comfort or its absence. to feel comfortable refers to different conditions: to feel at home, to be seen, to be taken seriously, and to have something that one experiences as meaningful in one's life. the adolescents felt they were at home at the asd and that this represented a significant contrast to how they experienced school. all the adolescents said that they felt comfortable with asd. tony reported, “we are like a big, happy family.” joachim said he often had significant problems getting out of bed in the mornings, but he always showed up at the asd because this day offered him a day with positive experiences. however, the asd was not only a comfort zone. the project also gave the students a feeling of freedom, i.e., freedom from school and a place where they could change their ways. joachim said it meant a lot to him being there because the adults treated him respectfully and mutually, and he respected them. they also reported that the societal topics they were discussing were exciting. all the students reported that the experience in the asd was in great contrast to their experiences and relationships with the teachers in the ordinary school. martin expressed how it was much easier talking to the adults in the asd, compared to the teachers at school, because they understood him much better. it is obvious that the adolescents’ satisfaction with asd was related to a break from school but also the opportunity to do something meaningful. they participated in activities they otherwise had no chance of taking part in. a central factor related to the students’ contentment was their significant contact with the adults. all the students reported that the teachers both listened to them and helped them. they were regarded with respect and understanding. jonas’ teacher said it was important for jonas to be acquainted with adults, as they could not care for all the students. she also claimed that he did not want to talk to her but believed that the adults at the asd managed to get in close contact with him. in addition, adrian’s teacher gave a similar report. she meant it was essential for adrian to get support from the adults at the asd. she also claimed that the asd had given him better self-esteem, and he seemed more reflected and content. similarly, martin’s teacher said that asd had given martin better self-confidence because he was coping better with the theoretical subjects at school. the asd had a positive effect on the i-group. all four got better marks, did not skip school anymore, and functioned better socially. their teachers are very positive when discussing asd and its meaning for the students. andy’s teacher says that he has become more motivated to work with different subjects, and she relates this to his role at the asd: “he says that at the asd, he is a resource and an important person. he feels he is very clever there, which is very different from what he feels at school. he also seems to like the www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 2, 2019 100 published by scholink inc. subject, which is more practical. moreover, the themes concerning consumption and globalization, he finds absorbing”. from this expression, it seems like we can conclude that the students in this group have experienced a kind of “turning point” accordingly that they started to look at themselves in possession of good abilities, and that their efforts matter. the students in this group have better prerequisites than those in the two other groups. 7. discussion the asd represents an effort to prevent antisocial behavior, but the findings in this study show that not all the students benefit from attending this project. one of the employees in asd said: “we have to confess that we cannot help all the students, but for most of them, i think we can prevent further negative development”. however, even though a negative development occurred among three of the students, asd represents a sanctuary in a chaotic life phase. the adults at the asd are important to all the students; they support them and show respect, and the youth feel secure and comfortable among the other adolescents. further, asd offers them coping experiences. some of the teachers report that their students function better at school, and both pupils and their parents confirm that attendance has positively influenced their relationships. one may, therefore, conclude that asd has succeeded in its work. this study has focused on the school as a middle-class arena, and for students with working-class backgrounds, it is regarded as an “away ground.” the findings may indicate that adolescents from the working class do not feel at home in regular school to the same extent as those from the middle class. participating in the alternative school day might also strengthen the adolescents’ capacity to make the right choices at the right time and better prepare them to create their own bibliography. concerning their lessons about consumption and the new risks in society today, most students said that they found these societal topics engaging, interesting, and advantageous. regarding the “turning points” in the biography, it seems like especially adrian came to a state where he had those experiences. moreover, these immersive experiences happened in the special school. his father reported that his son had learned more in the special school within a year than in all the other school years. the other students who placed themselves in the integrated group also benefited extensively from participation in the asd. they have better self-esteem and are more content, so from this description, it seems like they might have experienced a kind “turning point” and have started to look upon themselves as competent agents, not losers in the academic field. however, the students in the integrated group were better off in terms of different factors than those in the twilight and marginalized groups. it seems like it was easier for the pedagogues to give a little extra so that the students could significantly change their pedagogic experience when offered better and more positive conditions. the asd had a positive effect on the i-group. all four got better marks, did not skip school anymore, and functioned better socially. their teachers are very positive when discussing asd and its meaning for the students. andy’s teacher says www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 2, 2019 101 published by scholink inc. that he has become more motivated to work with different subjects, and she relates this to his role at the asd: “he says that at the asd, he is a resource and an important person. he feels he is very clever there, which is quite different from how he feels at school. he also seems to like the topics that are more practical and the notions about consumption and globalization, which he finds very “interesting”. from this expression, it seems like we can conclude that the students in this group have experienced a kind of “turning point,” in that way that they started to look at themselves in possession of good abilities, and that their efforts matter. the students in this group have better prerequisites than those in the two other groups. in the discourse about the agent versus structure perspective, some theorists have argued that when the students fail, it is the schools and the teachers who are not able to arrange the school into an adequate arena for all pupils (christie, 1973; giroux, 1983; nordahl, 2010; nordahl, 2013). regarding the critique of the individualization thesis, it has been postulated that it empathizes with free choices to an extent and does not notify the restrictions within already established structures (furlong & cartell, 1997; brannen & nilsen, 2005). theorists have also pinpointed that the individualization thesis requires a well-established welfare state to offer each alleged choice and possibility (brannen & nilsen, 2005). 8. limitations connected to the study one limitation of this investigation was that only students from the working class participated in this study. it is, therefore, impossible to say anything about how students from the middle-class experience school. many middle-class students experience school as boring and may also have problems in different areas. however, it is thought-provoking that only adolescents from the working class attend the project. further, the individuals under investigation have problems in one or several areas, which means they generally do not represent working-class students. when it comes to studying “the fateful moment” and “turning points” in the biography, there are challenges for an inquiry that seeks to avoid taking professions of agency and self-narratives of transition at face value. however, this becomes particularly problematic given what andy furlong and fred cartmel describe as the “epistemological fallacy of late modernity”: the tendency to diversify individual experience to give rise to an individualized self-understanding of its underlying causes. this allows us to step back from the actualism inherent to “fateful moments” and “turning points” while still retaining a focus on the role played by human action in shaping biographical unfolding. therefore, the realist approach to biography thus involves understanding and explaining how individuals are shaping biographical unfolding. it also allows us to take subjectivity seriously while avoiding the empiricist temptation to “give voice” to the narrative of a participant. to this end, derek layder’s (1997) notion of psychobiography has proved useful in thinking through exactly what a biography is in an ontological sense. he offers this concept to avoid conflations in understanding individual transition over the life www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 2, 2019 102 published by scholink inc. course (carrigan, 2007). 9. conclusion the asd represents an effort to prevent antisocial behavior, but the findings in this study show that not all the students benefit from attending this project. one of the employees in asd said: “we must confess that we cannot help all the students, but for most of them, i think we can prevent further negative development”. however, even though a negative development occurred among three of the students, asd represents a sanctuary in a chaotic life phase. the adults at the asd are important to all the students; they support them and show respect, and the youth feel secure and comfortable among the other adolescents. further, asd offers them coping experiences. some of the teachers report that their students function better at school, and both pupils and their parents confirm that attendance has positively influenced their relationships. one may, therefore, conclude that asd has succeeded in its work. this study has focused on the school as a middle-class arena, and for students with working-class backgrounds, it might be regarded as “a detour.” the findings may indicate that adolescents from the working class do not feel at home in regular school to the same extent as those from the middle class. finally, asd exists in the “battlefield” between integration and segregation, and one question is whether students exposing antisocial behavior should be offered help from school or be assisted in ordinary classes. we recommend that the asd offers a full-time project for those not fitting into the ordinary school. however, at the same time, asd can succeed quite well for some if its methods and philosophy are integrated into the regular school system. some of the teachers have shown a tendency to blame parents who have “problematic” children. the pupils’ future situation can only be improved by trustworthiness and equivalent cooperation. when children and youths encounter positions of power, how they are seen and heard, evaluated and sanctioned, is decisive. participating in alternative school day might also strengthen adolescents’ capacity to make the right choices at the right time and, hopefully, create their own bibliography. however, this is only claiming speculation. will it be possible to enhance young people's awareness regarding issues like education and jobs to apply to? which partner should you marry and continue to stay married with, and which habits concerning training and food consumption should you choose in a chaotic, globalized, and changing world? it becomes a difficult task, although the pupils at asd claimed that they found these problem positions exciting and engaging, and “that is a kind of extended their thinking and reflection.” although, some of the students reported that they had not thought about all those issues before. as mentioned earlier, regarding the “turning points” in the biography, it seems like adrian especially came to a state where he had that experience. moreover, these immersive experiences happened in the special school. his father reported that his son had learned more in a special school in a year than in all the other school years. the other students who placed themselves in the integrated group also benefited extensively from participation in www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 2, 2019 103 published by scholink inc. the asd. they got better self-esteem and were more content, so from this description, it seems like they might have experienced a kind of “turning point.” from this experience, they started to look upon themselves as competent agents and not losers in the academic field. however, the students in the integrated group were better off in terms of different factors than those in the twilight and marginalized groups. it seems like it was easier for the pedagogues to give a little extra so that the pupils could significantly change their pedagogic experience when offered better and more positive conditions. the fact that asd can be characterized as a “ghetto”, or a “sanctuary” is not necessarily a problem. as a middle-class arena, the school has and still will have huge problems with offering fundamental support to “difficult” pupils. if this is the case, students exposing antisocial behavior will be those who need asd the most as protection. the problem is, however, that this protection is too weak. the asd should, therefore, be developed into a more comprehensive project, for example, through a full-time arrangement. as we have seen above, this resolution was chosen for two special school students. for the others, especially those in the i-group, the asd functioned very well. however, the integration work could function better for these students if the asd was included in the ordinary school. based on this, it would be interesting if the asd develops both offerings, i.e., a full-time educational offer for those who do not fit into the school and an arrangement in the schools for those who will benefit from integration. however, establishing a full-time offer represents a considerable challenge economically because the professional pedagogical arrangement must be changed significantly compared to the existing praxis. at the same time, asd has some serious weaknesses. since the ambition is integration, it is alarming that five have quit school after they attended the asd. this might happen due to reactance, and it might be elevated due to the pupil’s attainment in the program, where they felt they were being seen and understood. it is also a result of the pupils' feeling of many years of playing the looser role, alienation, and boredom in the regular school. therefore, these pupils quitting normal schools can be seen as a reaction to their negative feelings within the normal school for many years. the pupils quitting school can be interpreted as not wanting to participate in an activity where they feel that they are not respected or positively valued and do not feel at home anymore. thus, the asd represented an upgrade in their self-worth through their attendance in the asd. references anyon, j. (2011). marx and education. new york, ny: routlegde. doi.org/10.4324/ 9780203829615 bauman, z. (2001). the individualized society. cambridge: polity press. beck, u. (1992). risk society. in towards a new modernity. london: sage. beck, u. (2000). what is globalization? cambridge: polity. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 2, 2019 104 published by scholink inc. beck, u., & beck-gernsheim, e. (2001). individualization. london: sage publications. berger, a.-h. (2000). som elevene ser det. hva får elevene til å bråke eller lære? [as the pupils see it—what makes the pupil’s to disturb or learn?]. oslo: cappelen akademiske forlag. bernstein, b. (2000). pedagogy, symbolic control and identity: theory, research, critique. lanham, maryland: rowman and littlefield. bourdieu, p. (1996). symbolsk makt. artikler i utvalg [symbolic power, article in assortment]. oslo:pax. bourdieu, p., & passeron, j. c. (1990). reproduction in education, society and culture. london: sage publications. brannen, j., & nilsen, a. (2005). individualization, choice and structure: a discussion of current trends in sociological analysis. sociological review, 412-428. https://doi.org/10.1111/j.1467-954x.2005.00559.x buchmann, m. (1989). the script of life in modern society. in entry into adulthood in a changing world. chicago and london: the university of chicago press. carrigan, m. (2013). beyond-fateful moments and turning points a realist approach to biographical research. retrieved from http://markcarrigan.net/2013/07/27/beyond-fateful moments and turning points a realist approach to biographical research christie, n. (1973). hvis skolen ikke fantes-ville barn og unge trives bedre? [if the school did not exist-would children and adolescence thrive better?] in t. tamburstuen (ed.), trivsel i skolen. ide-hefte basert på to seminarer arrangert av kirke-, forsknings-og utdanningsdept., oslo. christie, n. (1989). bortenfor anstalt og ensomhet. in behind institution and loneliness. oslo: universitetsforlaget. eriksen, h. t. (2007). globalization. berg: oxford. erikson, e. h. (1950). childhood and society. new york: norton. elstad, e. (2008). skolens arbeid med læringsstrategier. in i. e. elstad, & a. turmo (eds.), læringsstrategier-søkelys på lærerens praksis (3. oppl. s. 245-s. 262). oslo: universitetsforlaget. elstad, e. (2012). elevers selvdisiplin og lærerens rolle. bedre skole, nr2, 56-59 [the pupils self-discipline and the teachers role. better school, nr 2, 56-59]. furlong, a., & cartmel, f. (1997). young people and social change. in individualization and risk in late modernity. buckingham: open university press. froestad, j., & solvang, p. (2000). forskning om funksjonshemning: konstruksjon og narrasjon, profesjon og stat [disability research: construction and narration, profession and state]. in j. froestad, p. solvang, & m. söder (eds.), funksjonshemning, politikk og samfunn [disability, politics, and society]. oslo: gyldendal akademiske forlag. giddens, a. (1991). modernity and self-identity. in self and society in the late modern age. cambrigde: policy press. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 2, 2019 105 published by scholink inc. giddens, a. (1994). living in a post-traditional society. in u. beck, a. giddens, & s. lash (eds.),reflexive modernization, politics, tradition and aesthetics in the late modern social order.cambrigde: polity press. giddens, a. (1999). runaway world: how globalization is shaping our lives. london: profile. giroux, h. (1983). theories of reproduction and resistance in the new sociology of education: a critical analysis. harvard critical review, 53(3), 257-293.//doi.org/10.17763/haer.53.3.a 67x4u33g7682734 grandpre et al. (2003). adolescent reactance and anti-smoking campaign: a theoretical approach.health communication, 15, 349-366. https://doi.org/10.1207/s15327027hc1503_6 heggen, k. (2000). marginalization: on the fringe of the periphery—youth as a risky life stage? young,8 (2), 45-62. https://doi.org/10.1177/110330880000800203 heggen, k. (2004). risiko og forhandlinger. in ungdomssosiologiske emner [risk and negotiatings. in youth sociological topics]. oslo: abstrakt forlaget. heggen, k., båtevik, f. o., & olsen, g. m. (2000). kompetanse. in yrkesutdanning i to regionar etter reform 94. [competence. the vocational education into regions after the reform 94]. rapport 41, høgskolen i volda/ møreforskning volda. heggen, k., jørgensen, g., & paulsgaard, g. (2003). de andre. in ungdom, risikosoner ogmarginalisering. [the others. youth, risk zones and marginalization]. bergen: fagbok forlaget. layder’s, d. (1997). modern social theory: key debates and new directions. london: university college press. kuf. (1996). læreplan for grunnskolen (l97) [the learning plan for the primary school (l97)]. oslo: nasjonalt læremiddelsenter. kunnskapsdepartementet, k. d. (1994). a reform within the norwegian school system, in which gives all the pupils that have the 9 years obligated school, the right to participate in the three years high school. initiated by gudmund hernes. reform, 94. oslo. retrieved from http://www.kildenett.no/portal/artikler/2007/1185371254.28 kvale, s., & brinkmann, s. (2009). det kvalitative forskningsintervju [the qualitative research interview]. gyldendahl akademisk. lash, s. (1994). reflexivity and its doubles: structure, aesthetics, community. in u. beck, a. giddens, & s. lash (eds.), reflexive modernization. politics, tradition and aesthetics in the modern social order. cambridge: polity press. markussen, e., lødding, b., sandberg, n., & vibe, n. (2006). forskjell på folkhva gjør skolen? valg, bort valg og kompetanseoppnåelse i videregående opplæring blant 9749 ungdommer som gikk ut av grunnskolen på østlandet våren 2002. hovedfunn, konklusjoner og implikasjoner tre og et halvt år etter [differences on people—what is the school doing? choice, dropout and competence achievement in secondary education among 9749 youths who when out of the main school on the www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 2, 2019 106 published by scholink inc. est-side of norway, spring 2002. main findings, conclusion and implication three and a half year after.] (rapport nr.3). oslo: nifustep. nordahl, t. (2010). eleven som aktør [the pupil as an actor]. oslo: universitetsforlaget. nordahl, t. (2013). bedre læring for alle elver: om skoler som har problemer med elver, og om elever som har problemer i skolen [better learning for all pupils: about schools that have problems with the pupils, and about students that is having problems in the school]. gyldendahl norske forlag. nou (2003). forsterket kvalitet i en grunnopplæring for alle, nr 16. [strengthening the quality concerning the basis of training for all]. nupi. (2018). fake news! in hhd artikkel nupi. retrieved from http://www.nupi.no/skolehdd-artikler/2018/fake-news… fagfornyelsen. (2020). læreplanverket. i overordnede prinsipper for opplæring. the subjects renewal. (2020). the curriculum [the overall principles for education.] lash, s. (1994). reflexivity and its doubles: structure, aesthetics, community. in u. beck, a. giddens, & s. lash (eds.), reflexive modernization. politics, tradition, and aesthetics in the modern social order. cambridge: polity press. markussen, e., lødding, b., sandberg, n., & vibe, n. (2006). forskjell på folkhva gjør skolen? valg, bort valg og kompetanseoppnåelse i videregående opplæring blant 9749 ungdommer som gikk utav grunnskolen på østlandet våren 2002. hovedfunn, konklusjoner og implikasjoner tre og et halvt år etter [differences on people—what is the school doing?]. choice, dropout and competence achievement in secondary education among 9749 youths who when out of the main school on the east-side of norway, spring 2002. main findings, conclusion and implication three and a half year after.] (rapport nr.3). oslo: nifustep. nordahl, t. (2010). eleven som aktør [the pupil as an actor]. oslo: universitetsforlaget. nordahl, t. (2013). bedre læring for alle elver: om skoler som har problemer med elver, og om elever som har problemer i skolen [better learning for all pupils: about schools that have problems with the pupils, and about students that are having problems in the school]. gyldendahl norske forlag. nou. (2003). forsterket kvalitet i en grunnopplæring for alle, nr 16. [strengthening the quality concerning the basis of training for all nupi. (2018). fake news! in hhd artikkel nupi. retrieved from http://www.nupi.no/skolehdd-artikler/2018/fake-news… ogden, t. (1998). elevatferd og læringsmiljø. læreres erfaringer med og syn på elevatferd og læringsmiljø i grunnskolen [pupil behaviours and learning milieu. the teachers experience with, and view upon pupil behaviours and learning milieu in the primary school.]. oslo: kirke-utdannings-og forskningsdept., rapport 98. pisa. (2000-2012). norske elever presterer på gjennomsnittet/utdanningsdirektoratet [the norwegian students are scoring within the average area.]. retrieved from http://www.udir.no/tall og www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 2, 2019 107 published by scholink inc. forskning/ finn-forskning/rapport/pisa 2012/ roberts, k. (1995). youth and employment in modern britain. oxford: oxford university press. shifrer, d., callahan, r. m., & muller, c. (2013). equity or marginalization? the high school course—taking of students labelled with a learning disability [likhet eller marginalisering? kursdeltagelse hos videregående studenter diagnostisert med lærevansker.]. american educational research journal, 50(4), 656-682https://doi.org/10.3102/0002831213479439 strauss, a., & corbin, j. (1990). basics of qualitative research. newbury park: sage publications. øia, t., & heggen, k. (2005). marginalisering og tilpasning [marginalization and adaptation]. universitetsforlaget: oslo. children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 4, no. 1, 2021 www.scholink.org/ojs/index.php/ct 64 original paper an investigation of eating disorders among gifted adolescents sally r. beisser1* & catherine w. gillespie1 1 teaching and learning department, school of education, drake university, des moines, iowa, usa * sally r. beisser, teaching and learning department, school of education, drake university, des moines, iowa, usa received: january 14, 2020 accepted: january 23, 2021 online published: february 5, 2021 doi:10.22158/ct.v4n1p64 url: http://dx.doi.org/10.22158/ct.v4n1p64 abstract gifted students may experience greater risk of disordered eating, especially during adolescence, which is already a high-risk time for the development of eating disorders. in particular, the novel covid-19 global pandemic exacerbates stress that may influence adolescents with disordered eating. this study investigated eating disorders of 33 identified gifted adolescents (77% female) in one midwest state with an online survey using a well-validated instrument, the eating disorder examination-questionnaire (ede-q), that contains subscales of eating restraint, eating concern, shape concern, and weight concern. narrative responses were included in the data. results indicated 20% of the gifted adolescents in this study revealed concerning responses about their weight, shape, and dietary restrictions. voluntary comments revealed apprehension, concerns, and distress among some respondents. recommendations are provided for teachers, parents, as well as for students themselves. keywords eating disorders, gifted teens, mental health, survey research 1. introduction gifted students may experience greater risk of disordered eating, especially during adolescence, which is already a high-risk time for the development of eating disorders. fear of fatness and avoidance of fatness through dietary restraint, dieting, and fasting, place adolescents at greater risk for eating disorders. to date, there is very little literature on eating disorder experiences of gifted adolescents. educators of gifted students are naturally concerned with facilitating advanced academic learning experiences for their students. however, they may be unaware of social-emotional needs, mental health challenges, and incidence of eating disorders. in particular, males are at higher risk of being unidentified, yet eating disorders of males are becoming more problematic, especially among people who do not think males have eating disorders. this study will provide essential information for educators, parents, and the www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 65 published by scholink inc. students themselves. the researchers were curious about the connections between gifted students and eating disorders. the overarching question became, “what are the experiences of gifted adolescents concerning their eating restraint, shape, and weight concern?” although this study was conducted prior to the covid-19 pandemic, the authors believe that this information is more important than ever, as people with mental health challenges, including eating disorders, are often negatively impacted by unexpected and stressful situations. 2. review of literature 2.1 description and prevalence of eating disorders three primary eating disorders have been recognized by the most recent (2013) 5th edition of the american psychiatric association’s diagnostic and statistical manual of mental disorders (dsm-v): anorexia nervosa (often referred to as anorexia or an), bulimia nervosa (often referred to as bulimia or bn), and binge eating disorder (often referred to as binge eating or bed). each of these eating disorder diagnoses are described below in the three following paragraphs. if individuals do not meet the dsm-v criteria for full-blown eating disorders, they may still have clinically significant partial-syndrome eating disturbances that are equally worthy of clinical attention and further study (bakalar, shank, vannucci, radin, & tanofsky-kraff, 2015). core features of anorexia include low weight status and dietary restriction. the typical clinical presentation of a person with anorexia includes undue concern about their own body shape or weight, weight concerns, and body dissatisfaction (culbert, racine, & klump, 2015). lifetime prevalence of anorexia ranges between 2-4% for women depending on the region and population studied and less than 1% for men (smink, van hoeken, hoek, 2012). in a u.s. sample of 35,995 participants, snapshot (not lifetime) prevalence was 0.77% for heterosexual respondents and more than double at 1.71% for non-heterosexual respondents (kamody, grilo, & udo, 2019). in a surveillance study of the united kingdom and ireland, 305 cases of anorexia were reported over an 8-month period, with the average age of individuals being 14.6 and the majority being white (92%) young women (91%) (petkova, simic, nicholls, ford, prina, stuart, 2019). although the percentages of people affected by anorexia in the population are low, 300 teens in two countries over eight months is still a sizeable number of young people. help-seeking rates among the 275 out of 36,309 survey respondents who met criteria for anorexia were 34.5%%, with men and non-whites seeking help at lower rates than women and whites (coffino, udo, & grilo, 2019). bulimia typically includes binge eating, compensatory behaviors (purging), over-evaluation of body shape or weight, body dissatisfaction, weight concerns, and dietary restriction (culbert, racine, & klump, 2015). lifetime prevalence of bulimia ranges between 2-3% for women depending on the region and population studied and less than 1% for men (smink, van hoeken, & hoek, 2012). additionally, bulimia rates have decreased over the years whereas the other eating disorders have not decreased. in a www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 66 published by scholink inc. u.s. sample of 35,995 participants, snapshot (not lifetime) prevalence of bulimia was 0.24% for heterosexual respondents and more than triple at 1.25% for non-heterosexual respondents (kamody, grilo, & udo, 2019). help-seeking rates among the 91 out of 36,309 survey respondents who met criteria for bulimia were 62.6%, with men and non-whites seeking help at lower rates than women and whites (coffino, udo, & grilo, 2019). it is noteworthy that the lowest number of survey respondents had bulimic symptoms compared to symptoms of anorexia (275/36,309) and binge eating disorder (256/36,309), yet it had they were the group most likely to seek help. binge eating disorder is distinguished by binge eating without compensatory behaviors (purging). clinically, a person with binge eating disorder may exhibit emotional eating in addition to the typical bulimia issues of over-evaluation of body shape or weight, body dissatisfaction, weight concerns, and dietary restriction (culbert, racine, & klump, 2015). lifetime prevalence of binge eating disorder ranges between 2-4% for women depending on the region and population studied and less than 1% to 2% for men (smink, van hoeken, & hoek, 2012). in a u.s. sample of 35,995 participants, snapshot (not lifetime) prevalence of binge eating disorder was 0.81% for heterosexual respondents and more than doubt at 2.17% for non-heterosexual respondents (kamody, grilo, & udo, 2019). help-seeking rates among the 256 out of 36,309 survey respondents who met criteria for binge eating disorder were 49%, with men and non-whites seeking help at lower rates than women and whites (coffino, udo, & grilo, 2019). in an example of partial-syndrome eating disorders with wide-ranging impact, 154 undergraduate women at palestine polytechnic university were assessed and 50% had some level of binge eating symptoms (badrasawi & zidan, 2019). those who struggled with binge eating were more likely to also have higher levels of depression, stress, and anxiety. 2.2 risk factors for eating disorders risk factor for eating disorders include those that are sociocultural or socio-environmental, such as social media and living in a culture that idealizes thinness, those that are psychological, such as inborn temperament and the trait of perfectionism, and those that are genetic or biological, such as hormonal changes and disturbances (bakalar, shank, vannucci, radin, & tanofsky-kraff, 2015). reviewing all three of these spheres of influence over 50 research studies, culbert, racine and klump (2015) concluded that all three of the areas interact with each other. for instance, when individuals do not internalize the cultural message of the thin ideal, that is partly due to genetics and partly due to the individual’s sociocultural environment. even with the interactions among them, researchers were able to identify these variables as eating disorder risk factors: “sociocultural influences (media exposure, pressures for thinness, thin-ideal internalization and thinness expectancies) and personality characteristics (negative emotionality/neuroticism, perfectionism, and negative urgency)” (p. 1156). biological factors such as serotonin or dopamine disturbances emerged not as risk factors, but rather as correlates of eating disorder development. similarly, the following sociocultural and psychological risk factors predicted the onset of eating disorders for 1,272 women who were followed from a three-year www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 67 published by scholink inc. period from 18-21 years of age: internalization of the thin ideal, body dissatisfaction, denial of the costs of pursuing the thin ideal, dieting, fasting, overeating, positive expectations of what thinness would bring, and mental health care (stice, gau, rohde & shaw, 2017). recent conceptualizations of the sociocultural effects of a culture that idealizes thinness points to the internalized thin ideal as being both a cultural and individual fear of fatness. fear of fatness and avoidance of fatness predicted eating restraint among 79 young (averaging 19 years old) australian women (macleod, macleod, dondzilo, & bell, 2019). dietary restraint can include taking smaller servings to avoid weight gain, and it is related to eating disorder symptoms. specifically, dietary restraint predicts binge eating, and varies according to individuals’ level of sense of eating-related self-efficacy (which is people’s perception of their ability to control their overeating in various situations, including around holidays or when upset). in linardon’s (2018) sample of 237 young women (averaging 25 years old), stronger eating-related self-efficacy was related to lower levels of binge eating, but no matter how much eating-related self-efficacy was exhibited, higher levels of eating restraint predicted higher levels of binge eating. 2.3 biological risk factors biological risk for eating disorders includes hormonal including hormonal changes associated with puberty as well as genetic risk factors. although genetic associations have been made with anorexia, bulimia, and binge eating disorder, the manifestation of these disorders is still multifactorial, including input from genetic and environmental factors (bulik, blake, & austin, 2019). the presence of a definite genetic component to eating disorders could reduce the stigma and help individual who are struggling and their families to experience less shame about their condition, but unfortunately, according to one-third of 50 women with a history of eating disorders, blaming genetics could also increase stigma, one half of the interviewees thought that a genetic explanation would lead to less personal agency, and that would be harmful to people with eating disorders (easter, 2012). similarly, a study of 216 participants investigating the impact of genetic explanations for eating disorder development, researchers found it less helpful to emphasize the biological nature of eating disorder development because although self-blame was avoided, recovery self-efficacy was decreased (farrell, lee, & deacon, 2015). 2.4 other familial factors over ten years ago, the academy for eating disorders (aed) released a position paper emphasizing that although families can play a role in the development of their children’s eating disorders, it “stands firmly against any etiologic model of eating disorders in which family influences are seen as the primary cause of anorexia nervosa or bulimia nervosa, and condemns generalizing statements that imply families are to blame for their child’s illness” (le grange, lock, loeb, & nicholls, 2010, p. 1). the aed organization argued instead for the engagement of families, where appropriate, in their children’s eating disorder recovery treatment. this is still somewhat of a contentious issue in the field of eating disorders. it is certainly too simplistic and not helpful in any way to assert that parents cause eating disorders. however, www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 68 published by scholink inc. families can play a role in the development of eating disorders, even if they are not the primary cause. for instance, in a study of 50 families with adolescents receiving treatment for eating disorders, it was found that the adolescents with eating disorders were more likely than the general population to have lower perceived family functioning (tafà et al., 2017). additionally, mothers of those with anorexia were more likely to be rigid, mothers of those with bulimia were more likely to be enmeshed, and mothers of those with binge eating disorder were more likely to be chaotic than those in the general population. similarly, children’s attachment relationships with their parents can influence the development of eating disorders. cortés-garcia, hoffman, warschburger, and senra (2019) found that secure attachments between mothers and children were protective against the later development of disordered eating among a general population sample of 904 boys and girls who were followed for six years, starting at age 10. additionally, secure attachments to fathers were found to play a smaller but significantly positive role, especially for boys. secure attachments to peers did not have any observable effect on disordered eating. 2.5 adolescents and eating disorders three major studies have been conducted that follow children over a period of at least five years to determine the sequence of risk factors in the development of eating disorders (davis & smith, 2018; goldschmidt, wall, zhang, loth, & neumark-sztainer, 2016; rohde, stice, & marti, 2015). all three studies point to the possible opportunity for early identification of and intervention with young people exhibiting eating disorder risk factors. when rohde, stice, and marti (2015) followed 496 young women for eight years starting at age 13, they could determine who was at risk by age 14. over the course of the study, 12% of the participants experienced at least one eating disorder. the sociocultural factors of perceived pressure to be thin, thin-ideal internalization, and body dissatisfaction all had positive linear relationships with increases in eating disorder symptoms, which of course was not positive at all for these young women. all the young women experienced the risk factors at higher rates as they got older, but those who developed eating disorders experienced the risk factors more from the start of data collection. onset of puberty is one of the factors that contributes to the development of eating disorders. davis and smith (2018) followed 1,906 children from 5th to 10th grade (from age 11) and found that when onset of puberty leads to negative urgency (“when i am upset i often act without thinking”) and then in turn leads to thinness expectancies (“if i were thin, i would feel more worthwhile”) or eating expectancies (“eating helps me forget bad feelings, like being sad, lonely or scared”), binge eating or purging is a significantly significant possible result. it is a developmental sequence that could possibly be interrupted at any point. davis and smith (2018), like rohde, stice, and marti (2015), concluded that risk factors for the later development of eating disorders can be identified in elementary or middle school. goldschmidt, wall, zhang, loth, and neumark-sztainer (2016) followed 1,902 young people over a 10-year period starting in 7th grade (age 13). they found that although for over half of participants, overeating and binge eating decreased over time, those with greater psychological challenges (depressive www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 69 published by scholink inc. symptoms, body dissatisfaction, and low self-esteem) in late adolescence and early adulthood were more likely to have persistent eating disorder symptoms. overeating was more likely to resolve itself among participants over time than was binge eating, although some earlier overeaters became later binge eaters. 2.6 eating disorder risk for gifted students there is no reason to suspect that gifted students are at lower risk for eating disorders than other students. gifted students may experience a greater risk, especially during adolescence, which is already a high-risk time for the development of eating disorders. fear of fatness and avoidance of fatness through dietary restraint, including dieting and fasting, all put individuals at greater risk for eating disorders. to date, there is very little researcher literature on the experiences of gifted adolescents. in 1991, garner wrote, “gifted adolescents may be more vulnerable to the development of both anorexia nervosa and bulimia nervosa because those youngsters possess many of the traits that have been identified as risk factors for these eating disorders” (p. 61), but others have not followed up by investigating gifted adolescents’ experiences of their food, eating, body and weight. the current study is a much-overdue response to garner’s suggestion. 3. method this institutional review board (irb) approved study investigated the question, “what are the experiences of gifted adolescents concerning their eating restraint, shape, and weight concern?” in order to explore this research question, this study was designed to gather data directly from adolescent gifted students with an online survey that included a well-validated instrument, the eating disorder examination-questionnaire called the ede-q containing four subscales of eating restraint, eating concern, shape concern, and weight (fairburn & beglin, 1994). the ede-q has been widely-used enough that berg, peterson, frazier and crow (2012) were able to conduct a review of the reliability and validity literature on it based on 10 studies. they concluded that there is a robust test-retest reliability of on the four subscales of the ede-q. additionally, ede-q’s validity in determining whether a person has an eating disorder was confirmed. 3.1 survey design an online survey is an ideal method for allowing secondary gifted students privacy, autonomy, and confidentiality of responses. this online survey of 28 questions (appendix a) was constructed using qualtrics© survey software with five sections. first was a sliding scale containing four questions on “how happy are you with your weight, shape, eating, and eating restraint?” the scale represented a happy face j to an unhappy face l and representative faces in between. next there were 12 questions on feelings pertaining to weight, shape, eating, and eating restraints with a range of seven responses from feeling concerns “every day” to “no days” with responses in between. the third section had eight questions about risk behaviors (e.g., throwing up) experienced in the last month with responses representing frequency. this section had seven questions on emotions tied to satisfaction with responses www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 70 published by scholink inc. ranging from “not at all” to “markedly”. the last section invited open-ended responses from participants. 3.2 participants in this midwest state, the department of education lists 462 teachers or coordinators as “gifted education contacts”. an email was sent to all middle school and high school contacts. while the majority of these contacts listed appeared to work in middle school and high school settings, some contacts had changed, some emails were wrong, and some educators were responsible for both elementary and secondary students. consequently, some emails bounced back as incorrect and others were forwarded to the correct recipient. eventually, as a result of this outreach email, 462 gifted and talented education contacts were invited to recruit participants in the study by forwarding the survey link to parents of their gifted adolescent students. there were 23 female and 6 male respondents, with one participant defined as “other” for their gender. the participant age range was from 10 years of age to over 18 years, with 22.6% as an average age of 15 years. the 10-year-old was clearly an outlier with respect to the population of respondents, however, her sisters were taking the survey and she chose to respond. all participants were from the same u.s. state and were identified as talented and gifted (tag) according to their school districts. there were an estimated 28,752 identified grade 7-12 (2020) gifted students in this state at the time of this study. 3.3 procedure an invitation email to tag educators in each district included four research-based statements highlighting the severity and importance of disordered eating (arcelus et al., 2011; mond et al., 2014; whitaker, 1992). subsequently, those teachers or coordinators of gifted students in their districts were asked to forward the qualtrics survey link (appendix a) to the parents of the middle school and high school gifted students. parents, then, were asked to share this survey with their gifted child or children. by this method, researchers were able to gain parental consent, from emails or from u.s. postal service as a hard copy to the researchers. next, the gifted students sent the completed surveys back to the researchers, again via email or postal mail. the time frame of this study was approximately six months from the beginning of the initial communication to district educators until researchers received the completed confidential surveys through qualtrics. a total of 30 responses were received. considering the difficulty of getting this survey to the tag teachers or coordinators, reaching the gifted adolescents, and securing parental consent, we were happy with this response rate. in this study, no direct benefit or compensation was provided. 4. results the ede-q (fairburn & beglin, 1994) scores were calculated (table 2) for the group of respondents in this study and their scores are compared below to established community norms. qualitative comments (table 1) regarding eating habits and attitudes were reviewed, analyzed, and are presented below. while most participants did not offer qualitative responses, some comments were positive such as “i feel fine www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 71 published by scholink inc. about my body”, “i am very happy about my eating habits”, and “i think i'm happy with the way i look. my body has changed a lot recently, but i am happy with the way i look”. however other comments were concerning such as “i barely tolerate myself”. table 1 represents examples of internal struggles with body image, social isolation, perceived lack of support, focus on controlling food, issues with food, image, eating, weight, and shape. all names represented in table 1 are pseudonyms. table 1. narrative comments on weight, shape, or feelings about eating concerning comments of adolescents from survey data erin reflects, “i’m not the skinniest girl in the world, nor do i come from a skinny family, so when i was younger i just kinda ate whatever i wanted. lately i’ve been losing weight and since coming out as gay i’ve been trying to lose as much as possible”. jennifer says, “i’m in recovery from anorexia, but i still struggle to an extreme every day. whether with wanting to lose weight or feeling like i have to maintain or gain weight to make everyone else happy. there are days i don’t eat so the next day i eat till i feel sick because i “have” to make up for it. i “have” to be the poster child in recovery. i have to make everyone happy”. kim “i know i have an eating disorder, i have since around seven years old. it started with binge eating, i had no one to talk to and was very alone so i turned to food. in middle school i began restricting calories. i would eat a max of 300 calories a day. i was working out excessively. whatever food i did eat was most likely thrown up. i still have issues with food, but i’m trying. i actually did a presentation in class on eating disorders. i would love to take part in this study. i am not happy with my body or shape. i have had issues with eating and my control over it my whole life. thanks!” megan: summarizes, “i....think about it more than i should. i know, technically, i am within normal weight for my age, but it doesn't...stop. every time after i eat i look at my stomach in the mirror and go no. no this isn’t good enough. i know in my subconscious that the food i eat has to go somewhere but it doesn’t shake the feeling”. sophie states, “it is really hard to get my mind off of food and the way i look a lot. it is a struggle”. the ede-q instrument is divided into four subscales (i.e., restraint, eating concern, shape concern, and weight concern) and also offers a global score (i.e., a combination) of the four subscales. gifted adolescent survey participants scored significantly higher in the eating concern subscale of the ede-q compared to established community norms (table 2). this indicates greater concern among gifted student participants compared to community norms regarding their eating. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 72 published by scholink inc. table 2. ede-q results compared to community norms restraint subscale mean (sd) eating concern subscale mean (sd) shape concern subscale mean (sd) weight concern subscale mean (sd) global score mean (sd) gifted survey participants n=30 1.7 (2.84) 1.84 (1.88)* 2.26 (2.25) 2.23 (1.88) 2.01 (2.22) norms from fairburn & beglin, 1994 n=241 1.25 (1.32) 0.62 (0.86) 2.15 (1.60) 1.59 (1.37) 1.56 (1.21) norms from mond et al. 2006 for their youngest group, 18-22 year olds n=1186 1.29 (1.41) 0.87 (1.13) 2.29 (1.68) 1.89 (1.60) 1.59 (1.32) * p < .01 comparing study participants to fairburn & beglin, 1994 norms and also to mond et al. 2006 18-22 year old norms using a two-tailed independent samples t-test, assuming equal or unequal variances the eating concern subscale consists of responses to questions 7, 9, 19, 20, and 21 in the ede-q, which are as follows: 7. has thinking about food, eating, or calories made it very difficult to concentrate on things you are interested in (for example, working, following a conversation, or reading)? 9. have you had a definite fear of losing control over eating? 19. over the past 28 days, on how many days have you eaten in secret (i.e., furtively)? 20. on what proportion of the times that you have eaten have you felt guilty (felt that you’ve done wrong) because of its effect on your shape or weight? 21. over the past 28 days, how concerned have you been about other people seeing you eat? these items are all scored on a 0-6 point scale, with 0=not at all or no days; 2=slightly or 6-12 days; 3-4=moderately or 13-22 days, and 6=markedly or every day. survey participants are closer to slightly or 6-12 days out of the past 28, whereas community norms are closer to not at all or no days. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 73 published by scholink inc. 5. discussion and implications the statistically significant difference between study participants and established community norms (table 2) is consistent with narrative comments of the respondents (table 1) regarding their distress around eating where additional comments reflected dissatisfaction with body image, social isolation, perceived lack of support, focus on controlling food, issues with food, image, eating, weight, and shape. not all gifted adolescents are overly concerned about food, eating, body image, or weight. however, 20% of the students in this study shared negative attitudes about their body image and eating habits, indicating possible risk factors for mental and physical health challenges. educators of gifted are well-positioned to help students and their families receive information about disordered eating through knowledge and awareness of the potential that their students may be suffering silently about these issues. teachers and parents will want to pay special attention to student behaviors and attitudes in order to help them receive early and appropriate interventions. multiple risk factors have been identified among the participants in this study. age alone is a known risk factor for disordered eating, as adolescents are more likely to experience eating disorders. significantly, while this study was conducted prior to the covid-19 pandemic, the authors believe that this information is more important than ever, as people with mental health challenges, including eating disorders, are often negatively impacted by unexpected and stressful situations. students at risk are not likely to cope well with adjustments to teaching and learning environments, virtual communication, and online learning. therefore, at the end of the survey, we encouraged students and families to seek resources they may need, such as the in-school counselor or a private counselor. we highly recommended the national eating disorders website https://www.nationaleatingdisorders.org/help-support as a resource. they have a screening tool and a helpline number +1 (800) 931-2237 on their website, among other valuable resources. these resources are invaluable for educators, parents, and students themselves. another helpful website is national association of anorexia and associated disorders (anad) to learn about eating disorder identification and recovery. see this website: https://anad.org/education-and-awareness/about-eating-disorders/eating-disorders-statistics/ 6. recommendations for practice school personnel. teachers, counselors, administrators, school nurses, dieticians, and other school personnel, including coaches, can help normalize body changes during adolescence through informal conversations, refraining from comments and comparisons about bodies, clothing, appearance, sexuality. and other issues related to body esteem. in addition, we encourage teachers to not ignore warning signs of possible eating disorders such as rapid weight loss or weight gain, sudden onset of food anxiety, baggy clothing, or submitting of written work that concerns food, eating, body, or weight issues. educators can provide identification and early intervention by providing resources (including websites above) to https://anad.org/education-and-awareness/about-eating-disorders/eating-disorders-statistics/ www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 74 published by scholink inc. students whom they perceive to be at risk. they are in a unique position to provide support to ameliorate social isolation, facilitate peer support, and be aware of classroom and extra-curricular dynamics. parents and guardians. parents of teens, who are appropriately less involved in the school setting, are encouraged to not overlook changing behaviors and attitudes of their gifted teens including food, eating, body, or weight issues. be observant of family meals or celebrations with eating opportunities where their child seems to exhibit control or avoidance of food. importantly, refrain from making negative comments about their own bodies or eating behaviors. if they suspect their teen is developing an eating disorder we encourage them to engage in a crucial conversation to discuss their concerns and to offer support to reassure their child of their unconditional love. in addition, parents can educate themselves of characteristics of anorexia, bulimia, and binge eating disorders. they may consult helpful resources including books, articles, websites such as the national eating disorders website https://www.nationaleatingdisorders.org. community professionals may include the school counselor, pediatrician, dietician, private counselor, or eating disorder specialist. these non-school related health professionals are often covered by health insurance. gifted students. gifted students with eating disorders are unlikely to recognize or address their own problematic eating or image behaviors or seek help from others. therefore, teens would benefit from being open to conversations, care, and concern from others. peers can provide timely support for their friends who have concerning issues with eating, body image, weight, and shape. self-deprecating behaviors, while tempting for all teens, are particularly counter-productive with respect to developing body esteem. finally, we encourage ongoing prevention, intervention, and encouragement from school, family, and friend support systems. references arcelus, j., mitchell, a. j., wales, j., & nielsen, s. (2011). mortality rates in patients with anorexia nervosa and other eating disorders. archives of general psychiatry, 68(7), 724-731. https://doi.org/10.1001/archgenpsychiatry.2011.74 american psychiatric association. (2013). diagnostic and statistical manual of mental disorders (5th ed.). arlington, va: author. https://doi.org/10.1176/appi.books.9780890425596 badrasawi, m. m., & zidan, s. j. (2019). binge eating symptoms prevalence and relationship with psychosocial factors among female undergraduate students at palestine polytechnic university: a cross-sectional study. journal of eating disorders, 7(33). https://doi.org/10.1186/s40337-019-0263-1 bakalar, j.l., shank, l.m., vannucci, a., radin, r.m., & tanofsky-kraff, m. (2015). recent advances in developmental and risk factor research on eating disorders. current psychiatry reports, 17(42). https://doi.org/10.1007/s11920-015-0585-x https://doi.org/10.1176/appi.books.9780890425596 www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 75 published by scholink inc. berg, k. c., peterson, c. b., frazier, p., & crow, s. j. (2012). psychometric evaluation of the eating disorder examination and eating disorder examination-questionnaire: a systematic review of the literature. international journal of eating disorders, 45, 428-438. https://doi.org/10.1002/eat.20931 bulik, c. m., blake, l., & austin, j. (2019). genetics of eating disorders: what the clinician needs to know. psychiatric clinician of north america, 42, 59-73. https://doi.org/10.1016/j.psc.2018.10.007 coffino, j. a., udo, t., & grilo, c. m. (2019). rates of help-seeking in us adults with lifetime dsm-5 eating disorders: prevalence across diagnoses and difference by sex and ethnicity/race. mayo clinic proceedings, 94(8), 1415-1426. https://doi.org/10.1016/j.mayocp.2019.02.030 culbert, k. m., racine, s. e., & klump, k. l. (2015). research review: what we have learned about the causes of eating disorders—a synthesis of sociocultural, psychological, and biological research. journal of child psychology and psychiatry, 56(11), 1141-1164. https://doi.org/10.1111/jcpp.12441 cortés-garcia, l. hoffman, s., warchburger, p., & senra, c. (2019). exploring the reciprocal relationship between adolescents’ perceptions of parental and peer attachment and disordered eating: a multiwave cross-lagged panel analysis. international journal of eating disorders, 52, 924-934. https://doi.org/10.1002/eat.23086 davis, h. a., & smith. g. t. (2018). an integrative model of risk for high school disordered eating. journal of abnormal psychology, 127(6), 559-570. https://doi.org/10.1037/abn0000365 easter, m. m. (2012). “not all my fault”: genetics, stigma, and personal responsibility for women with eating disorders. social sciences and medicine, 75, 1408-1416 http://dx.doi.org/10.1016/j.socscimed.2012.05.042 fairburn, c. g. & beglin, s. j. (1994). assessment of eating disorders: interview or self-report questionnaire? international journal of eating disorders, 16, 363-370. farrell, n. r., lee, a. a., & deacon, b. j. (2015). biological or psychological? effects of eating disorder psychoeducation on self-blame and recovery expectations among symptomatic individuals, behavior research and therapy, 75, 32-37. http://dx.doi.org/10.1016/j.brat.2015.08.011 garner, d. m. (1991). eating disorders in the gifted adolescent. in m. bireley, & j. genshaft (eds.), understanding the gifted adolescent: educational, developmental, and multicultural issues (pp. 50-64). teachers college press. goldschmidt, a. b., wall, m., zhang, j., loth, k. a., & neumark-sztainer, d. (2016). overeating and binge eating in emerging adulthood: 10-year stability and risk factors. developmental psychology, 52(3), 475-483. https://doi.org/10.1037/dev0000086 kamody, r. c., grilo, c. m., udo, t. (2019). disparities in dsm-5 defined eating disorders by sexual orientation among u.s. adults. international journal of eating disorders. https://doi.org/10.1002/eat.23193 https://doi.org/10.1016/j.mayocp.2019.02.030 https://doi.org/10.1111/jcpp.12441 https://doi.org/10.1002/eat.23193 https://doi.org/10.1002/eat.23193 www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 76 published by scholink inc. le grange, d., lock, j., loeb, k., & nicholls, d. (2010). academy for eating disorders position paper: the role of the family in eating disorders. international journal of eating disorders, 43(1), 1-5. https://doi.org/10.1002/eat.20751 linardon, j. (2018). the relationship between dietary restraint and binge eating: examining eating-related self-efficacy as a moderator, appetite, 127, 126-129. https://doi.org/10.1016/j.appet.2018.04.026 macleod, j. s., macleod, c., dondzilo, l., & bell, j. (2019). the role of fear of fatness and avoidance of fatness in predicting eating restraint. cognitive therapy and research, 1-12. https://doi.org/10.1007/s10608-019-10052-9 malek, r. (2020). personal communication. iowa department of education. mond, j. m., mitchison, d., & hay, p. (2014). prevalence and implications of eating disordered behavior in men. in l. cohn, & r. lemberg (eds.), current findings on males with eating disorders. philadelphia, pa: routledge. petkova, h., simic, m., nicholls, d., ford, t., prina, a. m., stuart, r., & byford, s. (2019). incidence of anorexia nervosa in young people in the uk and ireland: a national surveillance study. bmj open, 9, e027339. http://doi.org/10.1136/bmjopen-2018-027339 rohde, p., stice, e., & marti, c. n. (2015). development and predictive effects of eating disorder risk factors during adolescence: implications for prevention efforts. international journal of eating disorders, 48, 187-198. https://doi.org/10.1002/eat.22270 smink, f. r., van hoeken, d., hoek, h. w. (2012). epidemiology of eating disorders: incidence, prevalence and mortality rates. current psychiatry reports, 14(4), 406-414. https://doi.org/10.1007/s11920-012-0282-y stice, e., gau, j. m., rohde, p., & shaw, h. (2017). risk factors that predict future onset of each dsm-5 eating disorder: predictive specificity in high-risk adolescent females. journal of abnormal psychology, 126(1), 38-51. http://dx.doi.org.10.1037/abn0000219 tafà, m., cimino, s., ballarotto, g., bracaglia, f., bottone, c., & cerniglia, l. (2017). female adolescents with eating disorders, parental psychopathological risk and family functioning. journal of child and family studies, 26, 28-39. https://doi.org/10.1007/s10826-016-0531-5 whitaker, a. h. (1992). an epidemiological study of anorexic and bulimic symptoms in adolescent girls: implications for pediatricians. pediatric annals, 21, 752-759. https://doi.org/10.3928/0090-4481-19821101-10 https://doi.org/10.1002/eat.20751 https://doi.org/10.1002/eat.20751 https://doi.org/10.1016/j.appet.2018.04.026 https://doi.org/10.1016/j.appet.2018.04.026 http://doi.org/10.1136/bmjopen-2018-027339 about:blank https://doi.org/10.1007/s10826-016-0531-5 www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 77 published by scholink inc. appendix appendix a qualtrics survey title of study: a needs assessment of eating disorders among gifted students investigators: omitted for blind review the purpose of this study is to complete a needs assessment for eating disorder prevention or intervention. gifted students in middle school and high school are invited to participate in this study to better understand issues related to weight, shape, and eating concerns. procedures. if you agree to participate, you will be asked to complete an online survey of 32 questions that will take about 20 minutes of your time. the first four questions are a sliding scale of how happy you are with weight, shape, and eating. the rest of the questions ask about your activities in the month that include items such as limiting food, concern about weight or shape, losing weight, or exercise to control weight. some questions define your age, sex, and school. the final section invites open ended comments. risks. while participating in this study you may experience discomfort that relates to attitudes or habits that relate to eating, dieting, shape, or weight. however, there are no foreseeable risks in participation in this study. benefits. if you decide to participate in this study there is no compensation. the information in this study may help gifted students and society in general, to gain information on possible issues related to eating, dieting, weight, or shape. participant rights. your participation in this study is completely voluntary and you may skip survey questions or stop answering them at any time. this will not result in any consequence. confidentiality. all responses are anonymous and confidential. you will not be identified in any way. reports or publications no will represent only group data. only the researchers have access to the data. contacts and questions. if you have questions about the survey, contact [authors]. if you have questions about the research process, contact irb@drake.edu or call 515-271-3472. by starting this survey, you understand and voluntarily agree to participate in this study. questions are welcome. contact the researchers above. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 78 published by scholink inc. participant's name _________________________________________ date: _____________________________ please keep a copy of this form for your records. how do you identify yourself? male female other your age? 10 11 12 13 14 15 16 17 18 18+ 1. how happy are you with your weight on most days? [sliding scale] 2. how happy are you with your shape on most days? [sliding scale] 3. how happy are you about your eating on most days? [sliding scale] 4. if you restrain your eating, how do you feel about it? [sliding scale] please rank the following statements based on feelings around eating in the last month. no days 1-5 days 6-12 days 13-15 days 16-22 days 23-27 days every day www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 79 published by scholink inc. 1. have you been deliberately trying to limit the amount of food you eat to influence your shape or weight (whether or not you succeeded)? 2. have you gone for long periods of time (8 waking hours or more) without eating anything at all in order to influence or shape or weight? 3. have you tried to exclude from your diet any foods that you like in order to influence your shape or weight (whether or not you succeeded)? 4. have you tried to follow definite rules regarding your eating (for example, a calorie limit in order to influence your shape or weight (whether or not you have succeeded)? www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 80 published by scholink inc. no days 1-5 days 6-12 days 13-15 days 16-22 days 23-27 days every day 5. have you had a definite desire to have an empty stomach with the aim of influencing your shape or weight? 6. have you had a definite desire to have a totally flat stomach? 7. has thinking about food, eating, or calories made it very difficult to concentrate on things you are interested in (for example, working, following a conversation, or reading)? 8. has thinking about shape or weight made it very difficult to concentrate on things you are interested in (for example, working, following a conversation, or reading)? www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 81 published by scholink inc. no days 1-5 days 6-12 days 13-15 days 16-22 days 23-27 days every day 9. have you had a definite fear of losing control over eating? 10. have you had a definite fear that you might gain weight? 11. have you felt fat? 12. have you had a strong desire to lose weight? questions 13-18: please select the appropriate number in the drop-down box on the right. remember that the questions only refer to the past four weeks (28 days). 13. over the past 28 days, how many times have you eaten what other people would regard as an unusually large amount of food (given the circumstances)? 14. on how many of these times did you have a sense of having lost control over your eating (at the time you were eating)? 15. over the past 28 days, on how many days have such episodes of overeating occurred (i.e. you have eaten an unusually large amount of food and have had a sense of loss of control at the time)? www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 82 published by scholink inc. 16. over the past 28 days, how many times have you made yourself sick (vomit) as a means of controlling your shape or weight? 17. over the past 28 days, how many times have you taken laxatives as a means of controlling your shape or weight? 18. over the past 28 days, how many times have you exercise in a "driven" or "compulsive" way as a means of controlling your weight, shape or amount of fat, or to burn off calories? for questions 19 and 20: please select the appropriate number. please note that for these questions that term "binge eating" means eating what others would regard as an unusually large amount of food for the circumstances, accompanied by a sense of having lost control over eating. no days 1-5 days 6-12 days 13-15 days 16-22 days 23-27 days every day 19. over the past 28 days, on how many days have you eaten in secret (i.e., furtively)? do not count episodes of binge eating. 20. on what proportion of the times that you have eaten have you felt guilty (felt that you've done wrong) because of its effect on your shape or weight? do not count binge eating. for questions 21-28 please select the appropriate response to the right. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 83 published by scholink inc. not at all slightly moderately markedly 21. how concerned are you over other people seeing you eat? 22. has your weight influenced how you think about (judge) yourself as a person? 23. has your shape influenced how you think about (judge) yourself as a person? 24. how much would it have upset you if you had been asked to weigh yourself once a week (no more, or less, often) for the next four weeks? 25. how dissatisfied have you been with our weight? 26. how dissatisfied have you been with your shape? www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 84 published by scholink inc. 27. how uncomfortable have you felt seeing your body (for example, seeing your shape in the mirror, in a shop window reflection, while undressing or taking a bath or shower)? 28. how uncomfortable have you felt about others seeing your shape or figure (for example, in communal changing rooms, when swimming, or wearing tight clothes)? please share any insight or thoughts on your feelings around your weight, shape, or feelings around eating. please answer openly and honestly. thank you for your reply. children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 3, no. 2, 2020 www.scholink.org/ojs/index.php/ct 93 original paper building resilience: the invisible childhood emotional neglect mbutitia f. n.1* & adeli s. m.2 1 department of educational psychology, school of education, eldoret, kenya 2 department of sociology and psychology, school of arts and social sciences, eldoret, kenya * mbutitia f. n., department of educational psychology, school of education, eldoret, kenya received: october 18, 2020 accepted: october 28, 2020 online published: november 26, 2020 doi:10.22158/ct.v3n2p93 url: http://dx.doi.org/10.22158/ct.v3n2p93 abstract early emotional maltreatment (eem) is a major risk factor for impairments in social functioning and mental health. eem is one of the emotional neglects and it constitutes a major public health concern with devastating consequences to the individual and society as a whole. based on this background the study adopted a qualitative approach and data was collected using unstructured interviews. the sample consisted participants from different social economic backgrounds aged between 10 to 46 years old. the study findings established that the emotional neglect occurs as parental rejection, feeling unloved, violence in the family, discrimination, emotionally unavailable parents, discovering the existence of a step family, separation/divorce just to mention a few. the eem manifest in the individual’s daily life though unconsciously as anger outburst, resentment/hatred, bitterness, poor relations with the peers and parents, low self-confidence, cannot handle criticism, rebellion, poor academic performance, loneliness, mistrust, fear, feelings of inadequacy, drug and substance abuse and in extreme cases hopelessness, depression and suicidal tendencies. the study recommends empowerment of the children to accept themselves, express their thoughts and feelings, and create awareness among parents and caregivers to be responsive to children’s thoughts and feelings therefore promote holistic growth. keywords eem, emotional neglect, manifestation, responsiveness 1. introduction resilience is characterized by a positive adaptation to adversity, or a bouncing-back from a negative event (snyder, lopez, & pedrotti, 2010; theron, 2010). it is, described as an immunization-like effect for dealing with life’s barriers (snyder et al., 2010), or providing “resistance to environmental risk experiences” (rutter, 2012, p. 34). resilience is also often regarded as both a process and an outcome. emotional maltreatment on the other hand can be broadly defined as “a repeated pattern of caregiver’s www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 94 published by scholink inc. behavior or extreme incident(s) that convey to children that they are flawed, unloved, unwanted, endangered, or of value only in meeting another’s needs” (american professional society on the abuse of children, 1995, p. 2). researchers have speculated that emotional maltreatment is a core component underlying all forms of child maltreatment that has equivalent, if not greater, developmental consequences than childhood experiences of physical and/or sexual abuse (chamberland, fallon, black, & trocmé, 2012; chamberland, fallon, black, nico, & chabot, 2012;). despite the high rate of co-occurrence with other forms of child abuse (bruce, heimberg, blanco, schneier, & liebowitz, 2012; vachon, krueger, rogosch, cicchetti, 2015; waxman, fenton, skodol, grant, & hasin, 2014), the independent effects of emotional maltreatment on poor mental and physical health outcomes are rarely investigated and not well understood. emotional maltreatment encompasses both acts of com-mission (i.e., emotional abuse) and acts of omission (i.e., emotional neglect). other potential mediators of the relationship between childhood emotional maltreatment (primarily emotional abuse) and later mental health problems that have received some support in the literature include emotional dysregulation (coates & messman-moore, 2014), immature coping styles and low self-esteem (finza-dottan & karu, 2006), hopelessness (hamilton et al., 2013), and negative automatic thoughts (gibb, benas, crossett, & uhrlass, 2007). in contrast, the effects of childhood emotional abuse appeared to manifest across a broad spectrum of mental disorders across the lifespan of the individual affected. this could be evidence for the non-specificity of effects of childhood emotional abuse on adult mental health. while emotional neglect is a more singular construct (e.g., denying emotional responsiveness to the child), emotional maltreatment encompasses a variety of different parental actions (e.g., threats, belittling, degradation, hostility) and it could be that specific types of emotional abuse have specific effects on mental health. childhood emotional maltreatment has been linked to depression (hamilton et al., 2013), anxiety (bruce et al., 2012; hamilton et al., 2013; taillieu & brownridge, 2013), dissociative symptoms (ferguson & dacey, 1997), post-traumatic stress disorder (gibb, chelminski et al., 2007), psychotic disorders (ackner, skeate, patterson, & neal, 2013), substance use problems (rosenkranz, muller, & henderson, 2012), several axis ii personality disorders (waxman et al., 2014), as well as lower self-esteem (taillieu & brownridge, 2013) and decreased quality of life (bruce et al., 2012). compared to sexual and physical abuse, emotional childhood maltreatment was less frequently considered in previous research. in order to transfer our research findings into practice, there is a great need for awareness-raising on the issue of emotional neglect to reduce a potentially accompanied mental health burden (gerkea et al., 2018). a growing body of research suggests that many otherwise healthy families raise their children with emotional neglect—a failure to value or respond to emotions. according webb (2016), childhood emotional neglect happens when a parent fails to respond to a child’s emotional needs. “it may sound like nothing, and it often looks like nothing”, webb (2016) writes, “but actually, [it] can have as great an impact upon a child as abuse, even though it’s not noticeable or memorable like abuse is”. often, that https://blogs.psychcentral.com/childhood-neglect/about/ www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 95 published by scholink inc. lack of emotional response doesn’t look unhealthy at all; the parents may take great care of the child overall. but something invisible is missing: the parent doesn’t validate their child’s feelings or respond to their child’s emotional needs. and that has consequences. webb says emotionally neglected children can end up feeling deeply alone. the children feel like their needs aren’t important, their feelings don’t matter, or that they should never ask for help (because it’s perceived as a sign of weakness). when the individual grows up, childhood emotional maltreatment can stick around as unnecessary guilt, self-anger, low self-confidence, or a sense of being deeply personally flawed. childhood emotional neglect tends to be (not always, of course) a bit more subtle, a bit more nuanced, a bit harder to pinpoint, and thus a lot hard to recognize and to understand. in a nutshell, emotional neglect is when a parent fails to see, know, or understand their child as they really are, rather than through the lens of what the parent thinks they are or want them to be. it sometimes means a lack of attention and care, at others; it is a lack of boundaries, rules, and structure. sometimes it is a lack of encouragement and a failure to provide the tools and lessons needed to navigate the world. other times it is parents who are overly busy and distracted and simply fail to see their child in the way the child needs to be seen. emotional neglect can be present even when the parent is providing for all of the child’s physical needs noted webb (2018). emotional neglect can be present in otherwise loving, caring, and well-meaning parents, and has the ability to camouflage unfortunately it has long-lasting impact on the mental health of an individual. the reason why emotional neglect is so rarely discussed is, in part, because it is a product of neglect, i.e., not seeing, not knowing. however, despite its subtle presentation, emotional neglect can have deep and lasting impact on an individual, far into adulthood. more research examining emotional neglect in different setting may help to clarify the relationship between childhood emotional abuse and mental health. therefore, this study was conceived as researchers and educationists try to shed light on emotional neglect and mental health among the population in kenya. 2. method the study used the childhood emotional neglect questionnaire (cen) administered to fifty (50) participants in different settings and varying ages. this cen questionnaire helped the researchers to identify those who had experienced childhood emotional neglect (appx 1). the respondents had an option of yes or no. a response of yes meant 1 point while no meant no score (0). the censr had twenty-two (22) items and the minimum score was 0 while the maximum score was 22. for interpretation the scores were divided into three (3) categories as follows 0-8 low cen, 9-15 average cen and 16-22 high cen. those who scored highest were five respondents and they formed the sample for this study. the study used qualitative approach to generate rich, detailed data from the selected respondents. the data allowed the participants’ perspectives to remain intact and provide multiple contexts for understanding the emotional negligence. the study was anchored on social constructionism which views reality as being socially constructed as noted by merriam (2014). social www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 96 published by scholink inc. actors like the participants of this study place many different interpretations on the situations in which they find themselves. these different interpretations are likely to affect their actions and the nature of their social interaction with others. the study adopted a naturalistic research design where the real-world situations unfold naturally; non-manipulative and non-controlling. the researchers were open to whatever was emerging as the study was being conducted. i.e., there were no predetermined constraints as noted by hammarberg, kirkman and de lacey (2016). researchers conducted in-depth interviews with participants in a face-to-face setting and a predetermined list of questions which formed the themes of the study while allowing the conversation to evolve based on the participants responses. the in-depth interviews captured direct quotations about the participants’ personal perspectives and lived experiences; and they were derived from carefully conducted case studies. the sample was drawn from religious gathering (religious camps), schools, colleges and working environments (offices) where the researchers interacted with the participants. at the conclusion of the study the participants were sent to professional counsellors for debriefings to ensure no psychological harm occurred to the participants during the study. the study was guided by the following research questions: 1) what is the participant current stressor? 2) would the participant be able to trace the source of this stressor? 3) what coping mechanism have the participant adopted to deal with the current stressor? 4) in your opinion are the coping mechanism you are using helped you to positively deal with the stressor? 5) in the light of your experience what would you suggest to help children and adults? the above questions formed the themes under which the results were discussed 3. result the participants were self-reporting and the cen-sr questionnaire score was used to identify those who may have experienced childhood emotional neglect. the study sought to establish the current stressors of the participants and the findings were as follows 3.1 current stressor a participant (*jane not her real name) a 16-year-old girl when asked what her current stressor was, she had this to say: excerpts 1 i am always angry and struggling with anger outbursts and i find myself fighting with everybody around me, in class and even at home with my small brother. i need the slightest provocation and i am all out and i do not know how to control myself. i am also very anxious because my mother is always on me, there is nothing i do right according to my mother she www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 97 published by scholink inc. only sees and speaks negative towards and about me. so, i am fearful and always on edge because i do not know what to expect there …... however, much i try agraaaah i am lost. another participant (*john not his real name) 23 years who had dropped out of a prestigious university college was asked to describe his current stressor and he had this to say; excerpts 2 i went to college but the course i was pursuing was not the course of my choice, though my mother was paying the school fees. i did not have the courage to tell her that i was not interested with the course because i didn’t want to disappoint her. so, i reported to college to please her unfortunately i found myself missing out on classes, not taking my assignment seriously and finally failed my exams. now my current stressor is, what do i do with myself? my dad is just telling my mother that he was right all along; there was no need to waste money on a foolish boy like me. my mum has moved out of our home and i want to go with her because she is the only one who is accommodative and tries to step in when i am desperate. unfortunately, mum does not seek out my opinion she does what she thinks is best for me which is not always the case. i am feeling so low, empty, ashamed and lost. i do not know where to start again…so stressed. another participant 10-year-old (*dot) not her real name asked was what is really bothering her (current stressor)? the participant had this to say; excerpt 3 i really feel bad that i am living with my mum and my dad is not there for us. he promises so many times that he will visit us, pick us up for an outing or even attend school meeting but does not keep his promises. “i feel so… so bad how can he fail not once but so many times surely why…why”? (sobbing)…given time to compose herself. *mary not her real name was an adult by the time this study was asked to explain what she was going through currently (current stressor) and she responded as follows; excerpt 4 i am in a marriage that has not been so good, i have stayed in it for so long and i do not know what to do. my marriage has been very abusive and now i have reached a point where i am asking myself why have i stayed on for this long when i am hurting so bad? i need to get out this situation but still i care so much about my in-laws. a respondent male *peter not his real name aged 17 years was asked to describe his current stressor and he had this to say; except 5 i am in a family where i strongly feel that no one cares about another’s emotions…somebody wrongs you today but the following day he/she acts like nothing happened and i am supposed to continue with life as usual. i am wondering, is this the way people live in families? i am www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 98 published by scholink inc. even afraid to express my emotions because i will be the odd one out. i sincerely do not know what to do. from the above excerpts the stressors were identified as; not being appreciated by parents which creates fear, anxiety, failure to meet expectations which leads to low self-esteem, feeling unworthy, emptiness, children not able to trust their parents which makes them to mistrust people around them, bitterness and resentment. one feeling that their thoughts and feelings do not matter so they stay in abusive relations. all these are happening within a family setting which should be able to provide a safety net for the individuals concerned. 3.2 source of stressor *jane the participant was asked to try and trace the source of feelings unappreciated/ unloved and she had this to say: excerpts 6 my mum and dad always quarrel over me, on one side my dad blames my mum for all my mistakes and when dad leaves for work and he works very far away my mum turns her anger on me. she never appreciates anything i do! even when i decide i am not going to do anything; she must pick something negative so that she has a reason to make me feel bad. i know she loves my small brother and she has categorically told me that my brother is her heartbeat. i feel that she hates me and i am lost, i love my mum very much and i desire to have a healthy relationship with her but i do not know where to start”. so, i am anxious most times and fearful the young man (*john) was asked to try and explain the source of his current stressor and he gave a long story from his childhood and it is summarized below: excerpts 7 from the time i was a young a child i have never connected with my parents especially my dad. when i turned seven years old, i was taken to live with my paternal aunt and i would only stay with my parents during the school holidays. i was feeling really unwanted and i had the courage as a young boy to ask them why they didn’t want me to stay with them and attend school nearby. i was told that there were no good schools in the rural area where we were living and this was to enable me access good schools in town. in standard five i was taken to a boarding school and i hated school the more. all my life i feel that my parents never loved me and they prefer my siblings. i do not experience a sense of belonging in my family i am the odd one out actually a “black sheep”. i am not sure i can do much because i have been referred to as a failure especially by my dad. my big sister is working while my young brother is in a national school and here, i am a college drop-out and no idea what i want to do with my life. the feeling of rejection has been quite overwhelming very stressful. for *dot when asked to trace when she started feeling unloved by her dad and her response is as stated www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 99 published by scholink inc. below; excerpt 8 the fact that my dad and mum are not living together and i know dad has another family. i keep on asking myself what did we do wrong that he abandoned? can we change for him to come back? when he visits us, he gives us so many promises that he does not honor. i have not been able to express my feeling to mum because i think she does not take time to understand me. i feel bitter about the whole situation and i do not know when it is ever going to come to an end. mary* the participant was asked whether she would be able to trace the origin of her current stressor and the summary of the narrative is given in excerpt 9; excerpt 9 it is a long story…we met while in college and started a family soon after graduation. i realized he was violent and very controlling man but all along i thought things will change for the better. his family members are so good to me so held on to the marriage. i didn’t want my in-laws to know the other side of my family that involved their son. this son is a special child in the family because he is the last born among seven girls while the only brother, he has is the first born. so, he was really pampered by the sisters and i think he wants me to pamper him the same and i am not the sister(s) and according to him i cannot meet the sisters’ standards. i have always avoided to express my needs and feelings in this relationship because as a child i was never given that chance. i feel inadequate, i have never believed in myself and other people’s needs and feelings will always take precedence. i have always believed my feelings do not matter so long as other people around me are okay and i think this is what it was in my relationship with my husband. now i am asking myself for how long will i remain in this situation? according to *peter his father is the source of his troubles and discomfort in the family. excerpt 10 my father is abusive especially physical and verbal abuse. he literally looks for anything to around to either quarrel or beat me. if i do something like cooking, he abuses me if i don’t, he still abuses or beats me so i am confused because i do not know what to expect from him. he beats me with this uncontrolled anger that one day i found myself in hospital and my mother lied to the hospital staff about my injuries. it hurts me so much that none of my family members try to stop him including my mother. the study identified source stressors from the participants’ responses as; unloved, rejection, poor or no communication between parents and children, abandonment, violence, no self-confidence and unpredictable parents. the participants’ felt that they do not matter to their significant others so they would rather not talk about their thoughts and feelings. 3.3 coping strategies adopted by the participants www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 100 published by scholink inc. the teenage girl (jane*) was asked how she dealing with this situation and this is what she had to say; excerpts 11 i try to keep the house neat and prepare dinner for the family just to make my mum happy. unfortunately, this has not worked so i lock myself up in the bedroom and try to do my studies but i am not able to concentrate no wonder my grades are nosediving from bad to worse hence further straining my relationship with my mum. the participant *john was asked how he is trying to deal with this feeling of rejection by his family. excerpts 12 many times, i have felt so overwhelmed by this feeling of hopelessness that i have found myself using drugs especially alcohol and cigarettes where i am becoming dependent. i also try as much as i can to keep to myself as i have painfully realized that no one seems to understand or cares about me. i take my meals and go to my “simba” (a house built for young men in this community after initiation) and no one knows what happens there. sometimes i feel so low and hopeless that i have often contemplated suicide. *dot was asked this question “when daddy fails to keep his promises how do you deal with the disappointment?” excerpt 13 i find myself being so annoyed and many times i burst out on my mum and my big sister who have no idea what is happening to me. i am finding it very difficult to trust anyone and feel betrayed by one person who should be there for me. i suffer loneliness despite being with by sister, mother, classmates and friends. *mary “what coping mechanism have you adopted to deal with the current issues of abusive partner?” *mary’s response was as follows excerpt 14 i have decided to leave this home even if i really contributed towards the building of this home. i have realized this man is capable of killing me as i noted one day, we were watching news and a news item was aired where a man had killed his children and wife, he looked at me and told me the same fate can befall me. currently i have moved to a house in my place of work my children do not have a problem with my decision because they have witnessed the violence but i do not know what to tell my in laws. *peter was asked to explain how he is coping with the situation he is facing and this what he said, excerpt 15 one time after a serious physical beating i ran away from home and went to stay with my aunt just to be away from my family that does not care about my wellbeing. i stayed there for a while but i had to come back. currently i keep myself busy with my phone and i avoid my dad. i ensure we do not meet at all though we live in the same house. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 101 published by scholink inc. the coping strategies identified were; withdrawal/isolation, suicidal tendencies, avoidance, annoyance/anger, bitterness, drug abuse and making decision but not sure they are the right ones. the coping strategies adopted by an individual can either be helpful or unhelpful and this led the researchers to the next question. 3.4 helpfulness of the coping strategies used in your opinion, is the coping mechanism you are using helpful to you? this is what *jane’s response was; excerpt 16 i am talking to you hoping i will find better ways of dealing with my situation. when i withdraw to my bedroom and pretend to be reading and grades are nosediving, i know whatever i am doing is not helping me out. again, fighting with everybody around me is just making things worse and the stress levels are just increasing day by day. poor relations with my parents, classmates and schoolmates i have found myself alone with poor grades not a good place to be. so, my coping mechanisms are not helpful currently. the respondent*john (23 year) said “i know whatever i have been doing to cope with my emotions has not helped me that’s why i am drifting towards drug abuse and many times i feel like life is worthless” (suicidal). the 10-year-old participant was asked “when you react like this do you feel better?” excerpt 17 no not at all, i just withdraw in my own world and i do not want anybody to interfere. this feeling makes me to have very poor relations with my sister, peers and even my mum” mum believes i am a bitter girl and so my way of dealing with my situation have not made things any better for me. from *mary the adult participant excerpt 18 the decision to leave an abusive marriage has given me temporary reprieve but i fear meeting my in laws who have always thought all was well with our marriage. so, i am going to keep off from these families until i am sure i have the courage and strength to explain to them my situation and decision. when *peter was asked whether the way he is dealing with the situation is helpful he had this to say “running away from home was not helping me and even the avoiding my father doesn’t help either. i need to face my situation and learn to deal with it in a way that is helpful”. from the responses the coping strategies the participants have adopted do not seem not helpful as they stated that stress levels are increasing, worsening relations in the family and in school as evidences by fights and drug abuse. 3.5 suggestions www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 102 published by scholink inc. the participants were asked to give suggestions they think can help mitigate eem among children, teenagers and adults. *jane suggested that she would write a letter to her mum and express her thoughts and feelings “because i have no courage to face my mum and whenever i try to talk to her she does not listen to me and we end up fighting even more”. this suggestion of one being able to communicate using other means helps the children to bring to the attention of the parents their feelings and emotions they are struggling with. according to this teenager *jane argued that “even if my mother does not and act lovingly towards me, at least it is on record that i tried and she is aware of my thoughts and feelings”. one of the participants *john suggested that excerpt 19 that family’s need to have frequent meeting and let the parents take time to listen to their children and connect emotionally and let the parents understand that children have needs and they are individuals (human beings) not robots may be this will make them to be sensitive to their children emotions. another participant *mary the adult said excerpt 20 from today henceforth i will start living my life not for others, i feel like i have cared so much about what other people have so say and at the end of it i have been suffering. i will be true to myself, even when the feelings of inadequacy will get into my mind i will start to encourage and push myself as much as i can (self-soothing skills). i would suggest to many women who could be going through challenges similar to what i have gone through can draw strength from within themselves. but sincerely speaking women really need encouragement and empowerment in their personal and social life, socio-economic status notwithstanding. the young participant that is dot (10 years old) had this to say: excerpt 21 i would wish that my dad will keep his word. i do not understand why a grown up should lie i don’t think i would feel as bad if he would be truthful and told me and my sister the truth at least has the courtesy to explain to us why. this would make a whole lot of difference and i would suggest to parents to please be truthful to their children whatever the circumstances and age. on the other hand, *peter suggested that “families need to start being connected emotionally. there is no need to come giving me food when i am hurting so much. find out how i am feeling first and then we can talk about food. it’s not about provision, because that’s not enough”. from the foregoing the suggestions given by the respondents were; using alternative ways of communicating with their parents, parents consulting children as they make decisions that affect them, www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 103 published by scholink inc. parents being truthful to their children, encouragement and empowerment, self-soothing talk to self and connecting emotionally with each other within the family setting. 4. discussion childhood emotional neglect was associated with lifetime diagnoses of specific mental disorders (i.e., major depression, dysthymia, social phobia, as well as schizoid and avoidant personality disorders). as noted by this study the emotional maltreatment disorders seem to suggest social withdrawal and avoidance of, or difficulty interpersonal relationships. the lack of love, affection, and support that characterizes emotional neglect compromises an individual’s ability to form a secure attachment with parents, siblings, peers and even the spouse. therefore, childhood emotional neglect doesn’t disappear when one grows up. adults carry it with them into their lives, and it affects their relationships, their self-image, self-esteem and their mental wellbeing as noted with the adult client *mary. the total lifetime economic burden resulting from new cases of fatal and nonfatal child maltreatment in the united states is approximately $124 billion fang, brown, florence and mercy (2012). these statistics are not available in kenya and the ultimate goal should be to stop early life emotional neglect before it starts or gets worse. strategies that promote safe, stable, and nurturing relationships (ssnrs) and environments for children and families are key to protecting against neglect and other harmful childhood experiences. the prevention strategies include improving parent-child relationships by teaching positive parenting. child emotional neglect has a negative effect on mental health. in addition, emotional maltreatment causes stress that can disrupt early brain development (national scientific council on the developing child 2008). extreme stress can harm the development of the nervous and immune systems (national scientific council on the developing child 2008). as a result, children who are abused or neglected are at higher risk for health problems as adults. these problems include alcoholism, depression, drug abuse, eating disorders, obesity, high-risk sexual behaviors, smoking, suicide, and certain chronic diseases. these are the common public issues kenyan society is grappling with spending so much resources treating people in hospitals, rehabilitation centers or even in prisons. this clearly indicates that beyond health and social consequences of emotional maltreatment there is economic impact inform of hospitalization, mental health treatment and long-term health costs. a satisfactory state of wellness requires achieving a basic level of fulfillment through the synergistic and well-balanced interaction of an individual at the three levels of needs (personal, relational, and collective), and entails more than simply an absence of risk (prilleltensky, 2010). these three levels of wellness are interdependent and cannot exist, or be addressed, in isolation (prilleltensky, 2010). the study concurs with this in that the three areas of relationship have to be addressed for resilience to be built among individuals who may have experienced childhood emotional maltreatment. webb (2016) says that emotional neglect is the white space in the family picture; the background rather www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 104 published by scholink inc. than the foreground. it is insidious and overlooked while it does its silent damage to people’s lives. children who are emotionally neglected then grow up to have a particular set of struggles. because their emotions were not validated as children, they may have difficulty knowing and trusting their own emotions as adults. they have difficulty understanding their own feelings, as well as others’. because an important part of themselves (their emotional self) has been denied, they find themselves feeling disconnected, unfulfilled or empty. they may have difficulty trusting or relying upon others and this is the experience of the participants in this study. the way an individual was treated emotionally as a child by parents determines how they treat themselves as an adult and others if no intervention mitigates this then the vicious cycle continues. 5. conclusion individuals who receive emotional validation from their parents in childhood are able to provide it automatically to their own children as adults. it is important for a parent to recognize what s/he didn't get and make a conscious effort to learn the missing skills, fill in the blind spots, and give the children what one didn’t get and deal with the resentment of the past, which is making many people ill (mager, 2017). as webb (2018) opinioned that children in helping relationships are asked by helpers that even if both parents were/are alcoholic, even if they mistreated, confused, exploited, beat, and totally overloaded them, they must forgive. unfortunately, forgiveness does not resolve latent hatred and self-hatred but rather covers them up in a very dangerous way webb notes. if one day the secret of childhood were to become no longer a secret, the state would be able to save immense sums that it spends in hospitals, psychiatric clinics and prisons noted schweigemauer (1990). the possibility of change depends on whether there is a sufficient number of enlightened people (parents, teachers, caregivers and psychologist) to create a safety net for the growing consciousness of those who have experienced childhood emotional neglect, so that they do not fall into darkness of forgetfulness and later emerge as criminals or the mentally ill persons. guidance and counseling should be an inherent part of health and educational services where children and adults are empowered and helped to understand and accept themselves. self-acceptance is an important step towards accepting one’s needs as normal and valid. psychologist’s role is “not just fixing what is broken, it is nurturing what is best” within others. so, psychologist need to adopt positive psychology in building resilience among individuals helping them to accept that their feelings, needs, and wants matter as much as anyone else’s therefore, voice them clearly drawing personal boundaries for emotional health to prevail. acknowledgement the authors are grateful to all the participants in this study who made the collection of narrative data www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 105 published by scholink inc. possible. we also acknowledge the schools and churches that gave the researchers the opportunity to meet the participants. there is no conflict of interest for the authors. references ackner, s., skeate, a., patterson, p., & neal, a. (2013). emotional abuse and psychosis: a recent review of the literature. journal of aggression, maltreatment, & trauma, 22(9), 1032-1049. https://doi.org/10.1080/10926771.2013.837132 american professional society on the abuse of children. (1995). psychosocial evaluation of suspected psychological maltreatment in children and practice guidelines. american professional society on the abuse of children.chicago, il. bruce, l. c., heimberg, r. g., blanco, c., schneier, f. r., & liebowitz, m. r. (2012). childhood maltreatment and social anxiety disorder: implications for symptom severity and response to pharmacotherapy. depression and anxiety, 29, 131-138. https://doi.org/10.1002/da.20909 gerkea, j., koeniga, a. m., cornelia, d., doyen-waldeckera, c. d., paulye, m., gündeld, h., wilkera, s., & iris-tatjana, k. (2018). childhood maltreatment as risk factor for lifetime depression: the role of different types of experiences and sensitive periods (pp. 56-65). retrieved from https://www.elsevier.com/locate/mhp chamberland, c., fallon, b., black, t., nico, t., & chabot, m. (2102). correlates of substantiated emotional maltreatment in the second canadian incidence study. journal of family violence, 27(2012), 201-213. https://doi.org/10.1007/s10896-012-9414-8 coates, a. a. & messman-moore, t. l. (2014). a structural model of mechanisms predicting depressive symptoms in women following childhood psychological maltreatment. child abuse & neglect, 38, 103-113. https://doi.org/10.1016/j.chiabu.2013.10.005 fang, x., brown, d. s., florence, c. s., & mercy, j. a. (2012). the economic burden of child maltreatment in the united states and implications for prevention. child abuse and neglect, 36, 156-165. https://doi.org/10.1016/j.chiabu.2011.10.006 felitti v., anda, r., nordenberg, d., williamson, d., spitz, a., & edwards, v. (1998). relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. american journal of preventive medicine, 14(4), 245-585. https://doi.org/10.1016/s0749-3797(98)00017-8 ferguson, k. s., & dacey, c. m. (1997). anxiety, depression, and dissociation in women health care providers reporting a history of childhood psychological abuse. child abuse & neglect, 21(10), 941-952. https://doi.org/10.1016/s0145-2134(97)00055-0 finza-dottan, k. t. (2006). from emotional abuse in childhood to psychopathology in adulthood: a www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 106 published by scholink inc. path mediated by immature defense mechanisms and self-esteem. the journal of nervous and mental disease, 194(8), 616-621. https://doi.org/10.1097/01.nmd.0000230654.49933.23 gibb, e., benas, j. s., crossett, s. e., & uhrlass, d. j. (2007). emotional maltreatment and verbal victimization in childhood: relations to adults’ depressive cognitions and symptoms. journal of emotional abuse, 7(2), 59-73. https://doi.org/10.1300/j135v07n02_04 hamilton, j. l., shapero, b. g., stange, j. p., hamlat, e. j., abramson, l. y., & alloy, l. b. (2013). emotional maltreatment, peer victimization, and depressive versus anxiety symptoms during adolescence: hopelessness as a mediator. journal of clinical child & adolescent psychology, 42(3), 332-347. https://doi.org/10.1080/15374416.2013.777916 hammarberg, k., kirkman, m., & de lacey, s. (2016). qualitative research methods: when to use them and how to judge them. human reproduction, 31(3), 498-501. https://doi.org/10.1093/humrep/dev334 mager, d. msw. (2017). 8 strategies to work through anger and resentment. even when justified, these challenging emotions can adversely affect us. retrieved from https://www.psychologytoday.com/us/blog/some-assembly-required/201701/8-strategies-work-thr ough-anger-and-resentment merriam, s. b. (2014). qualitative research: a guide to design and implementation (3rd ed.). san francisco, ca: john wiley & sons. national scientific council on the developing child. (2005). excessive stress disrupts the architecture of the developing brain, working paper no. 3. retrieved from https://www.developingchild.net morsillo, j., & prilleltensky, i. (2007). social action with youth: interventions, evaluation, and psycho political validity. journal of community psychology, 35(6), 725-740. https://doi.org/10.1002/jcop.20175 prilleltensky, i. (2010). child wellness and social inclusion: values for action. america journal of community psychology, 46(1-2), 238-249. https://doi.org/10.1007/s10464-010-9318-9 rosenkranz, s. e., muller, r. t., henderson j. l. (2012). psychological maltreatment in relation to substance use problem severity among youth. child abuse & neglect, 36, 438-448. https://doi.org/10.1016/j.chiabu.2012.01.005 rutter, m. (2012). resilience: causal pathways and social ecology. in m. unger (ed.), the social ecology of resilience. a handbook of theory and practice (pp. 33-42). new york: springer. https://doi.org/10.1007/978-1-4614-0586-3_3 runyan, d., wattam, c., ikeda, r., hassan, f., & ramiro, l. (2002). child abuse and neglect by parents and caregivers. in e., krug, l. l. dahlberg, j. a. mercy, a. b. zwi, & r. lozano (eds.), world report on violence and health (pp. 59-86). geneva, switzerland: world health organization. schweigemauer, a. (1990). breaking down the wall of silence. retrieved from https://libquotes.com/alice-miller/quote/lbu5e8k www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 107 published by scholink inc. snyder, c. r., lopez, s. j., & pedrotti, j. t. (eds.). (2010). positive psychology: the scientific and practical explorations of human strengths (2nd ed.). thousand oaks, ca: sage publications inc. taillieu, t. l., brownridge, d. a., sareen, j., & afifi, t. o. (2016). childhood emotional maltreatment and mental disorders: results from a nationally representative adult sample from the united states child abuse and neglect, 59(2016), 1-12. https://doi.org/10.1016/j.chiabu.2016.07.005 theron, l. c. (2012). does visual participatory research have resilience-promoting value? teacher experiences of generating and interpreting drawings. south african journal of education, 32(4), 381-392. https://doi.org/10.15700/saje.v32n4a656 vachon, d. d., krueger, r. f., rogosch, f. a., & cicchetti, d. (2015) assessment of the harmful psychiatric and behavioral effects of different forms of child maltreatment. jama psychiatry, 72(11), 1135-142. https://doi.org/10.1001/jamapsychiatry.2015.1792 widom, c. s., dumont, k., & czaja s. j. (2007). a prospective investigation of major depressive disorder and comorbidity in abused and neglected children grown up. archives of general psychiatry, 64(1), 49-56. https://doi.org/10.1001/archpsyc.64.1.49 waxman, r., fenton, m. c., skodol, a. e., grant, b. f., & hasin, d. (2014). childhood maltreatment and personality disorders in the usa: specificity of effects and the impact of gender. personality and mental health, 8(1), 30-41. https://doi.org/10.1002/pmh.1239 webb, j. (2018). how to learn the skill for a lifetime: self-soothing. psych central. retrieved from https://blogs.psychcentral.com/childhood-neglect/2018/05/how-to-learn-the-skill-for-a-lifetime-sel f-soothing/ webb, j. (2016). running empty: overcome your childhood emotional neglect. morgan james publishing. yin, r. k. (2015). qualitative research from start to finish (2nd ed.). new york: guilford. children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 4, no. 1, 2021 www.scholink.org/ojs/index.php/ct 43 original paper improved intersubjectivity—does it also helps to facilitate the other learning acquisitions skills in vulnerable groups of adolescents? lillian lundstrøm 1 * & lisbet øygard 1 (deceased) 1 dept. of psychosocial science, university of bergen, christies gate 13, 5015 bergen, norway * lillian lundstrøm, dept. of psychosocial science, university of bergen, christies gate 13, 5015 bergen, norway received: december 30, 2020 accepted: january 14, 2021 online published: february 1, 2021 doi:10.22158/ct.v4n1p43 url: http://dx.doi.org/10.22158/ct.v4n1p43 abstract the alternative school day (asd) is a project for adolescents with difficulties in several arenas. nine pupils (14-16 years old), their parents, and teachers were interviewed in autumn and spring. the pupils attended asd one day per week. none of them was coming from academic homes. bandura’s (1982) self-efficacy and social cognitive learning theory were utilized to investigate which kind of learning processes seem to be involved in the positive outcome measures found through participation in this unique program. this, as well as the concept of intersubjectivity. do the teachers in the unique program (asd) share another intersubjectivity with the participants, both logically and emotionally? the asd is more unconventional, and each student gets more attention; the atmosphere is more unbound and playful. a whole body of research employs the importance of play in children and adolescent’s development (glynn & webster, 1993; barnett, 1990, 1991; basi & hurwitz, 2012). an ongoing debate ought to be whether adapted education should be incorporated within an earlier stage through the school curriculum for children and adolescents in the risk zone. keywords alternative school day (asd), self-efficacy, social cognitive learning theory, intersubjectivity, adapted education www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 44 published by scholink inc. 1. introduction the schools in norway and scandinavia have been, and still are, strongly influenced by policy and ideology of equality and democracy. the school should be a good place to be and a good place for learning and personal growth for everyone. class, gender, and ethnicity should not influence how the pupils experience the school. although not all students express that they fit into norwegian schools, it has been argued that the school reproduces the differences already existing in society. and eventually, in some cases, the gap increases (nordahl, 2010; nordahl, 2013). high status in the school is highly connected with good marks, which offer opportunities in the educational system and, later, in the labor market. pupils who engage in antisocial behavior are exposed to different forms of adjustment pressure. for example, in norway, 7-12 % of all children aged 10-17 demonstrate such a high degree of undesirable behaviors that they can be considered behavioral problems. about 2% of the pupils have severe antisocial behavior (nordahl, sørlie, manger & tveit, 2005). those regarded as a problem for the class, or the school, are often directed toward special treatment options. earlier, we had b-classes for students who were not as “clever” or “adjusted” as those in the a-classes, and more special schools existed. today, many of these special initiatives have been moved into ordinary schools, and the initiatives are more directed against the individual with support from the norwegian learning plan from 1997 and a strong focus on individual training programs (kuf, 1996). this can include extra teachers or assistant resources. as early as 1987, it was decided that students who had problems at school should, as a principal rule, get an education within the framework of regular classes. inclusion was formulated as a key value and grounded in the principle of democratic participation (arnesen, 2002, p. 55). this aim is a slogan and a statement that can be traced in the education act from 2006 (opplærings-loven, 2006). through this paper, we aim to answer the following research questions: does participation in alternative school day (asd) improve the students’ self-efficacy? research question two: may participation in asd facilitates improved conditions to benefit from the social cognitive learning theory? furthermore, research question three: do the teachers working at the asd possess better abilities and skills to share a more significant and appropriate intersubjectivity with the pupils in comparison to the teachers within the regular school? in the way that communication becomes easier and understanding and respect towards the pupils at asd runs smoother. these are the research questions we are aiming to answer through this article. 2. theoretical framework adolescence and marginality. the concept of marginalization is widely used in research and debate in social science today, though without any precise definition. the term was originally used in economics but was adopted by social science and sociology in the 1870s through robert park and the so-called chicago school of the 1920s (park, 1967). the etymological origin of the concept is found in the latin term margin, which means outskirt or border. in youth studies, marginalization is often tied to www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 45 published by scholink inc. employment (hammer, 1992; nyyssölän, 1999; ref. in heggen, 2000). an important contribution to youth research shows that youth transition is extended in time, that it is quite likely to include different roles and stages such as pupil/student, employee versus unemployed, cohabitant/married, etc. roles which may be consecutive or simultaneous, and phases which may have a different sequence from what used to be normal. concerning such lengthy, individual, changeable, and, at times, complex youth transitions, there may be good causes to look for criteria of marginalization. marginalization depends not only on the youth’s position in or outside the labor market, but also on their degree of integration or isolation concerning several other important arenas, such as schools, family organizations, and groups. we talk of marginalization only when a youth has a weak position in several arenas. such positions limit their access to economic, social, and political resources (heggen, 2000). when it comes to children and youths, many researchers have claimed that studying marginalization is more of a process than a permanent state. today, the trend is that adolescents must struggle hard to get a position in society. as never before, marks are important for what the future might bring. the conditions were considerably different 40-50 years ago since one could terminate school after seven years and begin to work. it can be discussed how satisfactory it was to start working so early since many wanted to take further education, but economic conditions did not allow it. however, today, normative demands exist that one should at least complete high school, and many from the working class and the lower middle class get university degrees. social mobility through educational “class journeys” has increased and given youth new possibilities (solvang, 2002). at the same time, those who do not feel that they belong in the school will become even worse off. one challenge is that many pupils consider the school meaningless (nordahl, 2003, 2010, 2013). 3. intersubjectivity intersubjectivity is an appellation of a common understanding between two or more people. it is a concept that problematizes objective knowledge since objectivity as a concept is a rather controversial field. within scientific disciplines, it is common to posit that it is an intersubjective agreement concerning something if competent professionals agree that something is valid and correct. like for example, in terms of treating cancer, there seems to be a strong consensus that chemotherapy is the most adequate treatment in most cancer care. this is based upon massive research and testing over many years, so there seems to be a strong intersubjective agreement that this is the most adequate and convenient treatment for cancer among doctors and scientists. however, intersubjectivity is a major topic in philosophy. philosophers have long contemplated the duality of self and others, what it means to have an intersubjective experience, and what sort of lessons can be drawn from them. ethics, for example, deals with how one should act and what one does in an intersubjective experience with an identifiable other. according to rommetveit’s point of view, intersubjectivity is a basic assumption taken for granted when communicating. communication takes part in a contemporary shared social www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 46 published by scholink inc. world. therefore, that happens within the space in which communication is created (helgevold, 2011; helleve, 2008, ref. in solbue, 2014; mortimer & wertsch, 2003). intersubjectivity can be defined as a way to learn to see, hear, be mindful of other people, and strive to be alert and open in a perspective of diversity and not of differences. this calls for the recognition and experience of otherness, an experience that is acquired and practiced (abdallah-pretceille, 2006, p. 478). nowadays, the human mind, language, and action are understood and studied as thoroughly social and intersubjective phenomena in many research fields. simultaneously, human sociality and intersubjectivity per se have become topics for multidisciplinary studies. intersubjectivity can be defined as “the sharing of subjective states by two or more individuals” (scheff, 2006). it refers to shared emotion (attunement), shared attention, and intention. the asd can be described as a temporary shared social reality. in this social reality, we find a multitude of different backgrounds that engage in dialogue with each other: a class that is a good place to be precisely because the pupils are given more attention, and the teachers respect the students more and have positive expectations towards each of them. the subject is also more practical-oriented. to our knowledge, the monumental work by mortimer and wertch (2009) emphasizes that in school, the teachers are not skillful enough to meet the student’s inductive and deductive reasoning. or spelled out in another way, the individual student’s model of the phenomena. often, the teachers see themselves as in charge of the education and don’t show enough refinement in adapting to where the individual students are in theirs, for example, inductive reasoning within the model of matter in chemistry. specifically, they are concerned with categorizing abstract semiotic objects as “a decontextualized word meaning” (wertsch, 1985). what emerges in connection with the uses of language associated with literacy? as in the syllogistic reasoning studies, the non-schooled participants demonstrated an inability or unwillingness to engage in theoretical forms of discourse and thinking. the sort of difference we have in mind is reflected in the following dialogue between luria and the non-schooled participants from the experiments. luria was conducted in central asia in the 1930s (luria, 1976; ref. in mortimer & wertsch, 2009). [the participant is shown drawings of a hammer, a saw, a log, and a hatchet, and the experimenter poses the question]: which of these things could you call by one word? “how is that? if you call all three of them a “hammer,” that won’t be right either?” rejects use of a general term. but one fellow picked three things—the hammer, saw, and hatchet—all must work together. but the log must be there too!” reverts to situational [empirical thinking]. why do you think he picked these three things and not the log? “probably because he’s got much firewood, but if we’re left without firewood, we won’t be able to do anything”. true, but a hammer, a saw, and a hatched are all tools. “yes, but even if we have tools, we still need wood otherwise, we can’t build anything”. and using the same words but understanding them differently. nevertheless, when the teacher explicitly suggested that they could leave behind their everyday phenomena to think about a general category of matter, the students experienced much more difficulty considering the task as something meaningful. ultimately, they resisted participating in the speech www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 47 published by scholink inc. genre proposed by the teachers, a genre concerned with the second reality of abstract objects. bakhtin (1986) emphasizes different utterances in the different speech genres, as well as the active dialogue as opposed to the teacher’s monologue. the researcher has demonstrated that the private world students bring to science, instructions are often not the same as that introduced by the teacher. however, when the teachers asked the students to use a scientific model to explain everyday phenomena (for example, gas) for which they had their explanation, they could consider the teacher’s questions authentic and make them their own. they could also use particulate models’ general features (mortimer & wertsch, 2009). when asked how they experienced the learning situation, the students said the logical explanations were easier to understand during the asd. most reported that this was because mathematical magnitudes and equations were displayed in more concrete examples. for instance, when they learned about phi, they had to draw a circle in the forest and then a line through the circle, indicating the diameter. further, they must write the equation in the ground; a circle’s circumference divided by the circle’s diameter gives phi (3,14). this was something that they remembered at a later time when they were questioned about the equation. secondly, the pedagogues at the asd showed more patience if the students could not understand the equation right away, and they also came up with more appropriate questions when questioning about a task, leading them in the right direction through the conversation with the pupils. however, intersubjectivity was first connected within the study of phenomenology and empathy, which is connected to pathos. edith stein was a jewish student who studied german literature and history, and in 1913, she was taken up as a scientific assistant by edmund husserl at the university of freiburg. and in 1916, she delivered her doctoral dissertation: “zum problem der einfühlung. einwicklung un in phänomenolgischer betrachtung”. “on the problem of empathy” (1917/1989). noteworthy, intersubjectivity was mainly connected to the despairing of empathy (meneses & larkin 2012. further on, the german psychologist theodor lipps, born in 1851, is best known for his theory of aesthetics, particularly the concept of einfühlung, or empathy. he elaborated on stein’s work and proclaimed that empathy is projecting oneself into the object of perception. for stein, empathy (german spelling) understanding is an experiential, intuitive knowing of someone else’s present experience that is not lived as a personal, sympathetic, or intellectual form of social understanding. interpersonal understanding is a natural everyday form of relating to others and their experiences. recently, there has been a revived interest in stein’s phenomenological claims about the nature of empathy, principally in phenomenological and phenomenology-informed theories. then, the field of empathy would surely benefit from some conceptual revision and clarity. there may be an alternative route for interpersonal understandings that might deserve to be empirically investigated, firstly qualitatively, to gather evidence of its presence in people’s experiences of their social understandings and then also from within experimental and neuropsychological paradigms so that the underlying processes may be tested. as garmin (2007), we propose that “stein’s phenomenological approach can offer neurologists a comprehensive account of empathy that will aid them in so far as www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 48 published by scholink inc. they “reflect’ on scientific explanations” (p. 100) and that its implications have the potential to extend some way beyond this. in the asd, the students reported feeling like they were respected and understood to a greater extent than in the normal school arrangement. this could be a sign of the better employment of intersubjectivity and empathy among the pedagogues at the asd. the students said that they felt their well-being was important to the teachers in the asd. they had time to talk to them, and it also seemed that they were interested in finding out if the pupils were not thriving at the asd. eventually, what could be done to make them feel better at school and in other areas? this greatly contrasts with how they were treated in the normal school; some of the pupils said they just felt that they were in the way. it was because they were not clever, so the teachers did not bother to pay attention to them. further, we are aiming to explain which learning procedures take place in a normal school arrangement and how they can be enhanced and promoted through participation in asd. 4. social cognitive learning theory children are normally like sponges, sucking up knowledge, both from parents, peers, and teachers. albert bandura’s theory does not decline the stimuli-respondlearning, but he integrates more concepts like, for example, expectation, which belongs to cognitivism (imsen, 2005). learning becomes a result of the interaction between three factors: behavior, the condition within the person (cognitive, emotional, and biological) (krumsvik & säljø, 2013, p 156), and social circumstances (imsen, 2005). bandura called this interaction for reciprocal determinism (bandura, 1997, in krumsvik, saljø, 2013, p. 156). the social cognitive learning theory contains elements from the theory about self-efficacy, or expectation regarding one’s ability to master a specific task. 4.1 self-efficacy self-efficacy has been defined as “judgments of how well one can execute courses of action required to deal with the prospective situations” (bandura, 1982). further, bandura has suggested that self-efficacy varies along the dimensions of magnitude, generality, and strength (1986). kok et al. (1991) suggested that if one measures a person’s perceived ability to perform a behavior due to several different situations, one captures both strength and magnitude. further on, self-efficacy is shown to be the most significant variable affecting academic performance (cf. multon et al., 1991; schunk & pajares, 2005, cited in manger et al., 2013, p. 247). the teacher has, therefore, an important role in increasing the mastery expectation of the student. individuals with high self-efficacy seem to choose performances with more challenging tasks. they set higher goals and stick to them (locke & latham, 1990). actions are pre-shaped in thought, and people anticipate either optimistic or pessimistic scenarios in line with their level of self-efficacy. once an action has been taken, highly self-efficacious people invest more effort and persist for longer than those with low self-efficacy. when setbacks occur, the former recover more quickly and maintain commitment to their goals. positive self-efficacy allows people to select more challenging settings, explore their environments, or create new situations. a sense of competence www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 49 published by scholink inc. can be acquired by mastery experience, vicarious experience, verbal persuasion, or physiological feedback (bandura, 1977). self-efficacy is not the same as positive illusion or unrealistic optimism since it is based on experience and does not lead to unreasonable risk-taking. instead, it leads to venturesome behavior that is within the reach of one’s capabilities. self-efficacy makes a difference in how people feel, think, and act. in terms of feelings, a low sense of self-efficacy is associated with depression, anxiety, and helplessness. 4.2 model learning much of what we do is learned through model learning from our parents, trainers, and teachers. like for example, “why do you make the white sauce in this way? yes, this is because my mother taught me to do it like this,” “and how do you know how to repair a bicycle wheel? i do it this way because this is how my dad taught me to do it.” humans can remember and recall earlier experiences. observation, imitation: the child can remember what he has seen, then accomplish the imitation, and do what he has observed himself. secondly, the child must be motivated to do it. the child must feel that he has something to benefit from, which means a positive result (imsen, 2005). 4.3 self-regulating and reflexive the theory has changed from social learning theory to social cognitive learning theory. the theory has also changed its outfit in planning, executing action, and forming expectations; one continuously evaluates, regulates, and appraises one’s own behavior. if negative anticipations are expected from others, it isn’t easy to keep up with positive expectations. what seems so crucial is that these expectations are rather fragile and easy to destroy during the early years (therefore, we have been questioning whether the principal within asd should be implemented during an earlier phase in the school curriculum for some of the students to prevent such a negative outcome seen in some of the students.). 4.4 internal control or controlled by others? bandura postulated that motivation is characterized by what the individual believes they can manage, not what is objective. this is significant in his theory. he emphasized personal expectations concerning coping and english self-efficacy (krumsvik & säljö, 2013, p. 156; imsen, 2005, p. 456). he differentiates between two types of expectations concerning coping: efficacy expectations, which are our expectations about what is needed to solve a certain task, and outcome expectations, which are expectations about the result of what one has achieved from a pedagogic perspective. these two expectancies are crucial whether a student dares to do an assignment (imsen, 2005, p. 466; krumsvik & sälö, 2013, p. 158). the expectation of mastery is developed in the students based on four factors. the first one is authentic coping experiences. the student becomes motivated to solve a specific assignment if he previously has managed to solve a similar task. he will expect to cope with the task, work harder, and perform better (krumsvik & säljö, p. 156; manger et al., 2013, p. 251). secondly, vicarious experiences happen when the pupils observe others, in which they can compare themselves and cope www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 50 published by scholink inc. with a field or problem area. on some occasions, some pupils have few previous experiences with similar tasks, are unsure, and learn from others (krumsvik & säljö, 2013, p 157; imsen, 2005, p. 466). the third factor is verbal/ social persuasion, which involves support others can give the pupil. to function, such support must be realistic. is it within an area where the student will master? (krumsvik & säljö, 2013, p. 157; manger et al., 2013, p. 255). the fourth factor is a somatic and emotional condition like, for instance, anxiety, shivering, and stress. in the case of a high emotional reaction, will the level of performance be impaired? this will again lead to negative thoughts and low self-efficacy (krumsvik & saljo, 2013, p. 158; imsen, 2005). people learn through observing others’ behavior, attitudes, and outcomes of those behaviors (bandura, 1977). “most human behavior is learned observationally, through modeling: from observing others, one forms an idea of how new behaviors are performed, and on later occasions, this coded information serves as a guide for action” (bandura, 1986). social learning theory explains how human behavior can develop in terms of continuous reciprocal interaction between cognitive, behavioral, and environmental influences. bandura believed in “reciprocal determinism,” which means that the world and a person’s behavior cause each other. meanwhile, behaviorism states that one’s environment causes behavior (bandura, 1986). bandura, who was studying adolescent aggression, found this too simplistic. therefore, he suggested that behavior also affects the environment (bandura, ross, & ross, 1961). later, bandura considered personality an interaction between three components: the environment, behavior, and psychological processes (one’s ability to retain images in mind and language). social cognitive learning theory is sometimes called a bridge between behaviorist and cognitive learning theories because it encompasses attention, memory, and motivation. the theory is related to vygotsky’s social development theory and wenger and lave’s situated learning, which also emphasize the importance of social learning (1991). the asd offered a different learning situation, contributing to extended well-being, better self-esteem, and learning outcomes. however, we have chosen that situational learning to be out of the scope of this specific article. 5. the context eight boys and one girl, their parents, and teachers were interviewed about several topics connected to asd. the pupils were interviewed twice, during autumn (t1) and spring (t2). in this program, the emphasis is to make the tasks more concrete. in that way, it can be easier to visualize mathematical magnitudes. likewise, the pupils and teachers play pool, and this playful and competitive activity forms a positive experience that creates a positive atmosphere that might transcend the whole learning environment. therefore, elements from situated learning are incorporated into the pedagogic setting. since children and teenagers are like sponges, they easily benefit from this positive experience and gain self-confidence and assertiveness, which can have a positive spillover effect on other learning domains. further on, the teacher shows how much 10 dl of milk, and 600 grams of butter is during the school www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 51 published by scholink inc. kitchen session. as shown in the school kitchen session with, for instance, the milk carton and the butter (with cl versus gram), the student can then make a logical decision between the two different measuring methods. when all the senses are activated, learning is in all senses. the students find more options to remember, as shown in the experiment by multi-dimensional learning. from there, the students can find more options for remembering what they have learned. 6. method the qualitative interview is defined as a dialogue to obtain descriptions of the life world of informants concerning their interpretation of important phenomena (kvaale & brinkmann, 2009). the interview form is a semi-structured interview; it has a sequence of themes to be covered and suggested questions. at the same time, it is open to changes in sequence and forms of questions to follow up on the answers given and the stories told by the subjects, and the method at use is inductive reasoning. the interview has the advantage of covering deeper essential meaning compared to more quantitative approaches. in this study, meaning condensation or an abridgment of the meanings expressed by the interviewees into shorter formulations was utilized. for example, several teachers formulated, “he does not understand anything regarding theoretical subjects, but he is very clever in gymnastics and mechanical subjects”. this statement was condensed to “he is very weak in theoretical subjects, but he manages quite well in practical subjects”. regarding trustworthiness. there was a relatively strong correspondence between what the pupils, parents, and teachers reported. however, it must be noted that regarding school problems, the students and their parents often meant that the teachers or the school represented the challenge. in contrast, the teachers, on the other hand, looked upon the students as problematic. further, it is possible that the questions were not always adequate since it was common for the students to answer, “i don’t know” or “i have not thought about this”. so, probably, the intersubjective validity wasn’t so well formulated/relevant through this study. 6.1 the interview guides at both t1 and t2, three interview guides were constructed. these contain questions for the pupils, their parents, and teachers. the first interview with the pupils covers the school situation, relationships with parents and friends, and their leisure time. at t2, it was focused on possible changes since t1, for example, if the students shirked school, if their relationships with parents and teachers had changed, and if they had changed themselves in any way. questions directed to parents at t1 involved whether they thought their children would benefit from participating in the asd and the conditions regarding their children’s school and family situation. they were also asked about what their children did in their leisure time. the questions to teachers at t1 involved what kind of influence they think asd will have on the students, social competencies, school subject management, and shirking. additionally, they were asked if they had been involved in mockery and if they conflicted with teachers and other pupils. at t2, questions primarily focused on potential changes in the students’ lives since t1 www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 52 published by scholink inc. from the perspectives of parents and teachers. 6.2 the data analysis at t1, all the pupils were interviewed face-to-face in an asd location. at t2, five were interviewed at the same place, one at home and three by telephone because they had traveled away on summer vacation. the teachers received the question via e-mail before they were interviewed. because a tape recorder may distract the respondents, it was decided to do the notetaking on the spot. the interviews were transcribed, and the written texts became the materials for subsequent interpretation. by transcribing the interviews from an oral to a written mode, we make the interview conversation more amenable for closer analysis. structuring the material into text facilitates an overview and comprises a preliminary analysis (strauss & corbin, 1990). the pupils were split into three groups over three days. as mentioned, there was one girl in the sample. this represented an anonymity problem, and the solution was that all the pupils acquired boy names. all the students had a working-class background. none of the students came from families with academic backgrounds. 7. the participants the pupils were divided into three tentative groups: the marginalized (m-group), the twilight zone (t-group), and the integrated (i-group). this was one way to structure the material. some of the pupils were easy to place while others were not. two students could, for example, be referred to as marginalized but were placed under the twilight zone because they were better off in some areas. the integrated students were easier to place. however, all the students had two factors in common. first, they did not cope with the theoretical subjects at school, and second, they did not feel at home in the regular school environment. 7.1 the marginalized joachim, jonas, and tom showed negative development during the school year. joachim and jonas had quit school, and tom had attended a special school. heggen and colleagues (2003) found that marginalized adolescents who had problematic relationships with their parents developed close relationships with friends. tom resided with both parents, while joachim and jonas cohabited with their mothers. among friends, they got confirmation of themselves, and such positive experiences were important regarding the adolescents’ sense of belonging and identity. all three had a bad relationship with their parents. this was not the case for tom and joachim. they gave the impression that friendships were unimportant; they seemed to have problems establishing close relationships with friends and adults. further, they were depressed and seldom took the initiative themselves. the distant relationship between tom and his parents might have been the reason that he found excitement in a drug-taking company and worsened an already bad relationship. for jonas, the situation was somewhat different. his mother had psychiatric problems, and they were poor. additionally, he seldom met his father. jonas was also into drugs, but he had friends outside this milieu as well. he was conflicted with www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 53 published by scholink inc. his mother, but they had contact, and he often brought friends to his home. tom chose another strategy; he seldom went home to avoid quarreling and fussing. tom and jonas had been in contact with the police several times. tom was arrested for drug use and jonas for stealing. all three boys had withdrawn from family and school, which might be interpreted as an attempt to avoid social control in important areas for adolescents’ social integration. 7.2 the twilight zone lars and adrian quit school. lars started to work, and adrian attended a special school. even though they were no longer at the ordinary school, they were better off in other arenas than the marginalized. this was the case, especially about their relationship with their parents. lars and adrian reported that they had a close and good relationship with their parents. lars lived with both parents, while adrian resided with his father. it was common that the students had most contact with their mothers, so the bond between adrian and his father was an exception. lars played football, which meant a lot to him, although he had few friends in this group. 7.3 the integrated andy, sam, martin, and tony were still at the ordinary school, and they did not work hard but sometimes came late to school. all four showed positive development during the year. moreover, all were engaged in sports activities that meant a lot to them, and they had friends in these milieus. they had relatively good contact with their parents but felt more attached to their mothers. all of them, except for andy, reported quarrels with their parents. andy was the only one who did not reside with both parents. they also had good relationships with other students and a relatively good connection to the teachers. this changed from t1 to t2, which will be discussed later. table 1. overview of the pupils participating marginalized twilight integrated joachim, jonas and tom lars and adrian andy, sam, martin and tony 8. reflexivity the second researcher conducted the interviews and transcribed them. her background was as a sociologist, and she invited me to participate in the project to gain a more psychological understanding of the research field. we have had close cooperation. and during the interviews, she told me about the different informants daily. unfortunately, she is deceived now. as a sociologist, i would assume that she was affected by her theoretical background, with discourses like the agency-structure perspective. i found this absorbing because of my background as a psychologist, where i was trained within a tradition preoccupied with looking after pathology and putting up diagnoses on people. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 54 published by scholink inc. 9. findings the social interaction during the participation in asd was characterized by a joyful and light atmosphere, with a respectful and reciprocal interaction. this greatly contrasted how the pupils experienced the feedback within the regular school. secondly, the subjects were extensively more practical oriented. for instance, during the school kitchen session, the teachers showed how much 250 grams of butter, and five dl of milk there are while baking a cake. in this way, getting a visual picture of the unit at the task is easier. according to the behavioral perspective on learning, the interaction during the sessions is more rewarding and characterized by an open, respectful, and nurturing interaction between pupils and teachers (cf. rosenthal, 1968). the expectations are important here; the teachers have positive expectations towards these earlier neglected and overseen students, and the positive expectation tends to be mutually reinforced by the pupil. these seem to contrast greatly with how the student experienced the normal school. for instance, the m-group and adrian had a relatively high status in the class because they did not follow the rules. all of them had resigned; they did not participate and did not want to have any contact with the teachers within the regular school setting. the teachers, especially one of them, treat us differently. the clever ones are never criticized, but i have never been treated well (joachim, t1). i feel comfortable with my classmates, but the teachers are very annoying. they don’t treat us equally; i am scolded when the guilty ones are not. i think it’s because they are much cleverer than i am. if i am in trouble with the teachers, i can’t do anything because they don’t care (martin, t1). these statements illustrate that some pupils feel unequally treated because they are not clever and think the teachers favor skillful ones. the teachers do not treat me respectfully. i am dissatisfied with everything at school, especially the teachers. i’m continually in conflict with them (tom t1). i have a bad relationship with all the teachers. they don’t like me, and i don’t like them (adrian, t1). he nags about nothing and criticizes the teachers but has a good relationship with his mates. but when we are alone, he is very kind (tom’s teacher, t1). because the pedagogues at the asd treated them respectfully, which was the opposite of the teachers in the ordinary school. they also play substantially better role models than in the normal school arrangement. the tasks were more oriented towards a more practical reality, and these two factors seem to facilitate an extensive environment where a positive learning model can take place. many of the students reported that the school was boring. this boredom may happen when the pupil withdraws from teaching in an ordinary classroom. this boringness might also reflect the fact that the teachers are not skillful enough to share pupils’ intersubjectivity. theorists have proclaimed that when one can share nourishing intersubjectivity, this will lead to other motivation in the pupils because they feel they are taken seriously in the pedagogic setting (mortimer & wertsch, 2003). this aligns with paulo freire (2011), who claimed that all learning is dialogic. and true dialogue depends on love, humility, faith, and mutual trust. according to giroux (2001), in the behavior of subordinate groups and marginalized youths, there are moments of cultural and creative expressions informed by a different logic, whether existential, religious, or otherwise. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 55 published by scholink inc. moreover, looking at oppositional behavior in school, giroux argues that there is a need to reformulate the relationship between ideology, culture, and hegemony to make clear how these categories can enhance the understanding of oppositional behavior, as well as how such concepts can form the theoretical basis for a radical pedagogy that takes human agency seriously. regarding self-efficacy with school subjects, the results seem somewhat different. for the pupils in the m-group, it seems like the intervention was coming a bit late. an exception was for tom because changes appeared after he attended special education at school. tom’s new teacher says that he copes much better with his anger and is more persevering in new situations. the teacher says that this can be primarily interpreted because of the asd. because at asd he felt comfortable there, but he also thinks that this is because tom gets special education at school. for joachim, jonas, and lars, asd’s influence on the school situation has had minimal effects. however, his father reported that one student (adrian) who started to participate in a special school learned more in that school year than he did during all the other school years. however, the asd seems to have a positive effect on the i-group. all four have got better marks, do not shirk school anymore, and function better socially. their teachers are very positive when discussing asd and its meaning for the students. andy’s teacher says that he has become more motivated to work with different subjects, and she relates this to his role at the asd: he says that at the asd, he’s a resource and an important person. he feels he is very clever there, which is very different from what he feels at the regular school. tom (marginalized) and adrian (twilight), who moved to a special school, reported being incredibly satisfied with this. finally, they felt that they did something meaningful. life had become much easier for lars, who had begun to work. surprisingly, only four out of nine adolescents were still in normal school at the end of the school year. while we reviewed our data, we debated whether participation in the special pedagogic program was coming too late. for some, it seems like a pattern has been made, so we have been questioning whether these interventions should have been intervening earlier to become more effective. over time, the pupil may become associated with social roles that are unbearable not only for themselves but also for others. it may create a need for escaping from the school to a milieu where one can achieve minimal approval. since only four students are left in the ordinary school, this may have happened here. the social cognitive theory emphasizes self-efficacy beliefs, which seem to be the greatest predictor of school results. during the earliest years in school, these expectations are fragile and must be built up step by step. when pupils have been able to build up positive learning expectations and anticipations, they also build internal control over their learning acquisitions and start to feel like they can influence their learning process. when these learning conditions occur, the pupils also start to reflect positively about their own learning abilities and skills. the students may start believing that they can master even difficult tasks if they just put enough effort into it. if this happens, the learning process may become self-rewarding, which means that the pupils feel like they are receiving a reward when they learn new things and get good grades. the opposite is that some pupils do not have the motivation and lack positive outcomes expectations; again, www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 56 published by scholink inc. this will affect them and make them not try so hard. these students are deliberately more dependent upon support and guidance from their teachers, external motivation, and much positive appraisal from others when they achieve positive results. these students have had setbacks and negative experiences within ordinary schools for years. this pattern seems difficult to change after years of failures, setbacks, and disappointments during the school curriculum. therefore, an ongoing debate ought to be whether this special pedagogic program should be implemented earlier in the school curriculum so that the students can benefit from it. other researchers have empathized that intervention at an earlier stage might play an important role in correcting a negative school development and later preventing dropouts from high school (hardy-fortin, 2012). many years of defeat and failure are not easy to change; therefore, early interventions seem essential in terms of building internal beliefs regarding self-efficacy and internal motivation in contrast to external ones. 10. limitation connected to the study one limitation in this investigation was that only students coming from non-academic homes participated in this study. therefore, it is impossible to say anything about how students from academic homes experience the school. many students from academic families also experience school as boring and may have problems in different areas. further, the individual under investigation has problems in one or several areas, which means they are not representative of pupils from non-academic homes. another limitation of this study is that “intersubjectivity” doesn’t seem well enough to be operationalized. because some of the students claimed: i have not thought about that domain, or i do not know. when questioned about that field… 11. conclusion as we have seen, most of the participants in this study have had a problematic relationship with school for many years. the school years have become a project without meaning. none of the students coped with the theoretical subjects. in some cases, this results in shirking school for long periods, where they are only physically present when at school, and they do not pay any attention during the lessons. self-efficacy is also formed and developed during the early years at school. the pupils in the asd did not have so good self-efficacy due to many negative experiences in the ordinary school. even though others can influence expectations and efforts, we refer hereby to the well-known rosenthal—effect, described and discovered by robert rosenthal (1968). some students became smarter and had higher iqs after a year in school when the teachers thought these children were extraordinarily gifted. the extended positive expectation from the pedagogues at the asd can describe some of the positive outcome variables found through this study. however, during the school year, five students quit while studying was going on, and only four are still in regular school. this may be due to pupils’ reaction to a school system that does not arrange for a school environment that doesn’t meet their needs, abilities, www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 57 published by scholink inc. and interests (christie, 1973). tom and tony, who have attended a special school, are satisfied. finally, they feel that they do something meaningful. for lars, who has begun working, life has become much easier. one of the pedagogues in the asd said: we must confess we can’t help all the students, but for most of them, i think we can prevent further negative development. the school is foreign for the students in this study; it represents a “detour”. the students cope “relatively well” socially, but this is insufficient. since the credibility and ideals are middle-class based, theoretics like (bourdieu, 1993) proclaim that pupils with another habitus will always struggle uphill. the “equality for all” principle that should ideally exist in norwegian schools seems to be malfunctioning. some are “more equal than others,” and this may concern, first and foremost, children coming from academic backgrounds. they possibly adjust to school because they largely feel at home there. ogden claims that “the student’s failure also is the school’s failure when it can’t give a qualitative good offered and adjusted education” (1998). therefore, the public eye should be directed towards the ordinary school as a problem so that the complicated relationship between “the ordinary” and “the special” can be challenged. brown and duguid (1996) used the evocative phrase “stolen knowledge” to refer to all knowledge that learners glean from teachers beyond or despite their pedagogical intentions. the asd seem to change their look on themselves because their teachers now invest more in them, and they now start to feel like important pupils and that their efforts matter. therefore, we can hypothesize that the pupils get another “stolen knowledge” through participation. they do not feel like losers to the same extent as they did within the regular school. in the asd, they participated in joyand playful activities, like kayaking paddling, playing darts, and pool. research has shown that participating in playful, joyful, and challenging activities develops cognitive, social, and physical learning and self-esteem (hurwitz, 2002/2003). further, researchers have proposed that for children to be successful, let them play! this is because there is much interpersonal learning in play. for example, turn-taking, empathy, and cognitive and physical learning develop through play (glynn & webster, 1990; barnett, 1990). the asd has had a positive effect on most of this study. it is primarily close contact with the adults who spend time with them and who are engaged in them that is important. through this, the asd manages to make them believe that they can manage and that they can learn. furthermore, asd offers them concrete coping experiences, and this has affected their self-esteem positively. at the same time, asd has some serious weaknesses. since the ambition is integration, it is alarming that five have quit school after they attended the asd. the asd can thus maybe have increased these pupils’ aversion towards the school. conversely, the schools eliminate a problem less, i.e., lodging them. this situation can thus be a pretext for doing nothing. on one side, the asd’s ghetto-resembling feature increases, and on the other side, schools get reasons to avoid carrying out serious integration work. it is difficult for schools to find resources, and the teachers reported that asd is a unique offer for the pupils and the classes because the teaching functions better when those pupils are absent. one may, therefore, ask if projects like the asd legitimate the status quo in the schools. that the asd can be characterized as a ghetto, or a www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 58 published by scholink inc. “renewing oasis” is not necessarily a problem. as a middle-class arena, the school has, and will still have, huge problems with offering “difficult” fundamental support to pupils. if this is the case, students exposing antisocial behavior will be those who need asd the most as protection. the problem is, however, that this protection is too weak. the asd should, therefore, develop into a more comprehensive project, for example, through a full-time arrangement. or be implemented within a much earlier phase through the pupils’ school curriculum. due to many defeats and failures during those early and vulnerable school years, two of the students with asd started to attend a special school and were very satisfied with this solution. for the others, especially those in the i-group, the asd functions very well. however, the integration work could function better for these students if asd was included in the schools. on this basis, it would be interesting if the asd develops a bothand offer, i.e., a full-time educational offer for those who do not fit into the school and an arrangement in the schools for those who will benefit from integration. however, establishing a full-time offer represents a considerable challenge economically because the professional pedagogical arrangement must be changed significantly compared to the existing praxis. alternatively, could an earlier implementation of the asd contribute to a better and more ancillary effect of the program to build up good self-efficacy beliefs earlier? references abdallah-pretceille, m. (2006). interculturalism as a paradigm for thinking about diversity. intercultural education, 17(5), 475-483. https://doi.org/10.1080/14675980601065764 arnesen, a. l. (2002). ulikhet og marginalisering. [inequality and marginalization.] universitetet: oslo. barnett, l. a. (1990). developmental benefit of play for children. journal of leisure research, 22(2), 138-153. https://doi.org/10.1080/00222216.1990.11969821 berger, a. h. (2000). som elevene ser det. hva får elevene til å bråke eller lære? [as the pupils see it what makes the pupils to disturb or learn?]. oslo: cappelen akademiske forlag. bakhtin, m. m. (1986). in emerson, & m. holoquist (eds.), speech genres and other late essays (v. w mc gee. trans.). austin. university of texas press. bandura, a. (1977). social learning theory. englewood cliffs, nj: prentice hall. bandura, a. (1986). social foundations of thought and action: a social cognitive theory. prentice-hall, inc. bandura, a. ross, d., & ross, s. a. (1961). transmission of aggression through the imitation of aggressive models. journal of abnormal and social psychology, 63, 575-582. https://doi.org/10.1037/h0045925 basi, m., & hurwitz, s. c. (2012). for parents particularly: to be successful—let them play! childhood education, 79(2), 101-102. https://doi.org/10.1080/00094056.2003.10522779 www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 59 published by scholink inc. buchmann, m. (1989). the script of life in modern society. entry into adulthood in a changing world. chicago and london: the university of chicago press. bourdieu, p. (1993). the field of cultural production. oxford: political press. brown, j. s., & duguid. (1996). stolen knowledge. in h. mclellan (ed.), situated learning perspective (pp. 47-56). englewood cliffs, nj: educational technology publications. barstad, a. (2016). opphopning av dårlige levekår. en analyse av levekårsundersøkelsen eusilc 2013. [accumulation of bad living conditions. an analysis the living condition investigation eu silc 2013.]. christie, n. (1973). hvis skolen ikke fantes—ville barn og unge trives bedre? [if the school did not existwould children and adolescence thrive better?]. in t. tamburstuen (ed.), trivsel i skolen. ide hefte basert på to seminarer arrangert av kirke-, forskningsog utdannings dept., oslo. erikson, e. h. (1950). childhood and society. new york: norton. fogarty, j. s. (1997). reactance theory and patient noncompliance. social science and medicine, 45, 1277-1288. https://doi.org/10.1016/s0277-9536(97)00055-5 furlong, a., & cartmel, f. (1997). young people and social change. buckingham: open university press. giroux, h. a. (2001). teachers as intellectuals. towards a critical pedagogy of learning. introduced by paulo freire. usa: greenwood publishing group. gurmin, h. (2007). edit stein and tania singer. a comparison of phenomenological and neurological approaches to the “problem of empathy” maynooth philosophical papers, 4, 99-122. https://doi.org/10.5840/mpp200748 hardy-fortin, k. l. (2012). looking at students’ perceptions of why they did or didn’t drop out of new bedford high school. doctoral thesis to the college of professional studies. hebdidge, d. (1979). subculture: the meaning of style. london: methuen. hirschi, t., & gottfredson, m. r. (1995). control theory and the life course perspective. studies on crime and crime prevention, 4(2), 131-142. heggen, k. (2000). marginalisation: on the fringe of the periphery—youth as a risky life stage? young, 8(2), 45-62. https://doi.org/10.1177/110330880000800203 heggen, k. (2004). risiko og forhandlinger. ungdoms sosiologiske emner. oslo: abstrakt forlaget. heggen, k., båtevik, f. o., & olsen, g. m. (2000). kompetanse. yrkesutdanning i to regionar etter reform 94. [competence. the vocational education in two regions after the reform 94]. rapport 41. høgskolen i volda/ møreforskning volda. helgevold, n. (2011). å lære å kommunisere i det moderne klasserommet: en kvalitativ studie av interaksjonsformer på ungdomstrinnet (doktoravhandling). [to learn to communicate in the modern classroom: a qualitative study of different forms of interaction during the junior high-school years.] doctoral dissertation. university of stavanger. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 60 published by scholink inc. helleve, i. (2008). productive interactions in ict supported communities of learners (doktoravhandling). [doctorial dissertation]. university of bergen. imsen, g. (2005). elevens verden: innføring i pedagogisk psykologi. [the student’s world: introduction to pedagogic psychology] (4. utg.). oslo: universitetsforlaget. kuf. (1996). læreplan for grunnskolen (l97). the learning plan for the primary school (l97). oslo: nasjonalt læremiddelsenter. krumsvik, r. j., & og sälj, r. (2013). praktisk—pedagogisk utdanning: en antologi [practical pedagogic education: an antology]. fagbokforlaget: bergen. kvale, s. (1996). inter views. an introduction to qualitative research interviewing. london: sage publications. lave, j., & wenger, e. (1991). situated learning. legitimate peripheral participation. united kingdom: cambrigde university press. https://doi.org/10.1017/cbo9780511815355 manger, t., lillejord, s., nordahl, t., & helland, t. (2013). livet i skolen 1 [life within the school 1] (2.utgave). fagbokforlaget. meneses, r. w., & larkin, m. (2012). edith stein and the contemporary psychological study of empathy. journal of phenomenological psychology: atlantic highlands, 43(2), 151-184. https://doi.org/10.1163/15691624-12341234 møller, t. m., & nygård, m. (2000). edith stein. filosof og mystiker [edith stein. the philosopher and mystic). emilia viten. mortimer, e. f., & wertsch, j. v. (2009). the architecture and dynamics of intersubjectivity in science classroom.mind,cultureandactivity,10(3),230-240. https://doi.org/10.1207/s15327884mca1003_5 multon, k. d., brown, s. d., & lent, r. w. (1991). relation of self-efficacy beliefs to academic outcomes: a meta-analytic investigation. journal of counselling psychology, 38, 30-38. doi/10.1037/0022-0167.38.1.30 https://doi.org/10.1037/0022-0167.38.1.30 møller, t. m., & nygård, m. (2000). edith stein. filosof og mystiker [edith stein. the philosopher and mystic). emilia viten. nordahl, t. (1998). er det bare eleven? [is it just the pupil?] oslo: nova. report no, 12d/1998. https://doi.org/10.7577/nova/rapporter/1998/12e nordahl, t. (2010). eleven-som aktør [the pupil as an actor]. oslo: universitets forlaget. nordahl, t., & sørlie, m. a. (1996). prosjekt skole og samspills vansker [the project school and interaction difficulties.]. oslo: barnevernets utviklingssenter. nordahl, t., sørlie, a. m., manger, t., & tveit, a. (2005). atferdsproblemer blant barn og unge. bergen: fagbokforlaget. nou. (2003). forsterket kvalitet i en grunnopplæring for alle. nr 16 [strengthening the quality concerning the basis of training for all]. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 61 published by scholink inc. ogden, t. (1998). elevatferd og læringsmiljø. læreres erfaringer med og syn på elevatferd og læringsmiljø i grunnskolen [pupil behaviours and learning milieu. the teachers experience with, and view upon pupil behaviours and learning milieu in the primary school.] oslo: kirke-, utdanningsog forskningsdept., rapport 98. opplæringsloven. (2006). the education act. retrieved from http://www.regjeringen.no/no//documenter/opplæringsloven/id213315/ park, r. (1967). on social control and collective behaviour—selected papers. the university of chicago press. roberts, k. (1995). youth and employment in modern britain. oxford: oxford university press. rosenthal, r., & jacobsen, l. f. (1968). teachers expectations for the disadvantaged. scientific american, 218(4). https://doi.org/10.1038/scientificamerican0468-19 willis, p. (1977). learning to labour. how working—class kids get working class jobs. hampshire: gower publishing company limited. kunnskapsdepartementet. (2013). st.meld.nr 20. på rett vei. kvalitet og mangfold i fellesskolen. oslo: kunnskaps departementet. rommetveit, r. (1974). on message structure: a framework for the study of language and communication. london: wiley. rommetveit, r. (1979). on the architecture of intersubjectivity. in r. rommetveit, & r. m. blakar (eds.), studies of language thought and verbal communication. new york:academic press. rommetveit, r. (1985). language acquisition as increasing linguistic structuring of experience and symbolic behaviour control. in j. v. wertsch (ed.), culture, communication and cognition: vygotskian perspectives. cambridge (bookcapter): cambridge university press. scheff, t. et al. (2006). goffman unbound!: a new paradigm for social science (the sociological imagination). paradigm publishers. solbue, v. (2014). dialogen som visker ut kategoriene [the dialogue that earase the categories]. doktorgradsavhandling. doctorial dissertation. universitet i bergen. solvang, p. (2002). annerledes. uten variasjon, ingen sivilisasjon. different. without variation, no civilization. oslo: aschehoug. stern, d. (2004). the present moment in psychotherapy and everyday life. norton books. strauss, a., & corbin, j. (1990). basics of qualitative research. newbury park: sage publications. sørlie, m. a. (1991). alternative skoler. lokale kompetansesentra for utsatt ungdom. alternative schools [the locale competence competence-centres for adolescents in risks.]. barnevernet’s rapport serie 4/91. children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 7, no. 2, 2024 www.scholink.org/ojs/index.php/ct 1 original paper subalternity and displacement in rafia zakaria‟s “upstairs wife”: a critique upon pakistani fiction maria jabbar 1 , & dr. muhammad arfan lodhi 2 1 m.phil scholar, department of english, ncba&e university bahawalpur 2 higher education department (collegiate wing) punjab, pakistan received: june 20, 2024 accepted: july 5, 2024 online published: july 26, 2024 doi:10.22158/ct.v7n2p1 url: http://dx.doi.org/10.22158/ct.v7n2p1 abstract the study explored the themes of subalternity, displacement, and resistance in rafia zakaria’s book “upstairs wife”, which is set in pakistan in the 1970s and 1980s against a backdrop of sociopolitical unrest. the research examined how characters—especially the heroine amina—maneuver through overlapping kinds of oppression and marginalization within a patriarchal, economically stratified, and politically unstable society through careful reading and thematic analysis of the text. the research highlighted the widespread injustices and inequities that marginalized groups in pakistani society must contend with, such as economic precarity, gendered subalternity, and religious othering. in addition, the research looked at the several ways that characters have been displaced on a physical, emotional, and political level. the research clarified the intricate processes of power, identity forms, and resistance among disadvantaged groups by examining the connections between subalternity and displacement. the findings provide insights for future study and scholarship on literature, identity, and power relations, as well as to larger conversations about social justice, empowerment, and human rights in pakistan and throughout the world. keywords displacement, subalternity, diaspora, pakistani fiction 1. introduction scholars have been using literature as a prism to examine complicated socio-political issues more often in recent years, especially those involving marginalization, identity, and displacement. in the framework of pakistani culture, rafia zakaria‟s “upstairs wife” presents a gripping story that deftly integrates themes of subalternity and displacement. zakaria‟s book provides a nuanced analysis of the difficulties underprivileged people confront navigating emotional and societal turmoil via the www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 2, 2024 2 published by scholink inc. experiences of its protagonist, amina. in order to develop better understanding about the concepts of subalternity and displacement as they are portrayed in “upstairs wife”, the study has examined how zakaria highlights the ways in which power, identity, and agency intertwine in the story. the objective of this research is to examine the text‟s depiction of the intricacies of subaltern life and experiences of displacement via a critical lens that is informed by feminist and postcolonial ideas. gayatri chakravorty spivak, a postcolonial theorist, stresses the experiences and voices of underprivileged people who are suppressed by prevailing power systems. this is where the concept of “subalternity” originates. within the framework of “upstairs wife”, amina‟s experience as a woman facing interlocking forms of oppression based on class, gender, and religion is embodied by subalternity. by describing her tale, zakaria challenges readers to consider the difficulties of living as a subaltern and the struggle for autonomy under oppressive regimes. in addition, the story revolves on the idea of displacement on both a personal and political level. amina‟s psychological and emotional dislocation in her marriage to sohail is indicative of more general family and social circumstances where alienation and estrangement occur. the characters‟ sense of political dislocation is further exacerbated by the political unrest that permeates pakistan, which is marked by military control, religious extremism, and social unrest. this research seeks to understand how people navigate identity, belonging, and resistance in unstable and changing environments by looking at the intersections of personal and political displacement. this research study attempts to contribute to a better understanding of subalternity and displacement as represented in rafia zakaria‟s moving narrative by means of a close reading of “upstairs wife”, augmented by critical analysis influenced by postcolonial and feminist theories. by delving into these topics, readers and academics alike may learn more about the intricacies of agency, power, and resilience in disadvantaged communities, which will eventually enhance our comprehension of how literature can shed light on urgent social concerns. 1.1 conceptual framework the elements of subalternity and displacement in rafia zakaria‟s “upstairs wife” are examined through the lens of multidisciplinary theoretical frameworks, which are mostly based in feminist and postcolonial theories. these conceptual frameworks offer a means of examining the intricate relationships between agency, identity, and power in the story. 1.1.1 postcolonial theory this paradigm explores how colonial histories and legacies influences modern societies and human experiences, drawing on the writings of postcolonial theorists like edward said, homi k. bhabha, and gayatri chakravorty spivak. the perspectives and experiences of marginalized individuals are highlighted by postcolonial theory, especially those who are on the periphery of prevailing power systems. it challenges academics to consider how colonialism, gender, racism, and class interact in literary works and other cultural outputs. it is also noteworthy that postcolonial theory offers a prism www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 2, 2024 3 published by scholink inc. through which to examine amina‟s subaltern status in pakistani society in the setting of “upstairs wife”, examining the ways in which colonial histories continue to influence oppressive and dominating structures. 1.1.2 feminist theory this theoretical approach provides a crucial foundation for comprehending patriarchy, gender dynamics, and women‟s experiences inside social systems. in particular, intersectional feminist perspectives highlight how gender is linked to other axes of identity, including race, class, and religion. in “upstairs wife”, feminist theory allows researchers to analyze the intricacies of amina‟s experiences negotiating patriarchal expectations and conventions. feminist theories of resistance and empowerment also offer analytical tools for examining instances of subversion and resilience within the text, as characters negotiate and contest oppressive social norms. this helps to illuminate the ways in which gender intersects with other forms of marginalization, shaping amina‟s sense of agency and belonging. studies on displacement provide a framework for examining political, emotional, and physical displacement experiences in literary works and cultural narratives. in “upstairs wife”, the theme of displacement manifests on multiple levels, including amina‟s emotional estrangement within her marriage, the political upheaval of general zia-ul-haq‟s regime, and the broader societal disruptions caused by religious extremism and social unrest. this framework encompasses both forced displacement, such as migration and exile, and voluntary forms of displacement, such as travel and spiritual seeking. a framework for comprehending the manner in which various types of displacement interact and influence personal experiences is offered by displacement studies. by including these theoretical frameworks, the research piece aims to offer a thorough examination of subalternity and displacement in “upstairs wife”, shedding light on the intricate relationships between agency, identity, and power in the story. informed by feminist, postcolonial, and displacement studies, zakaria‟s multifaceted approach allows researchers to delve further into the socio-political aspects of zakaria‟s work and its significance for larger discussions of resistance, literature, and identity. 1.2 background of the study this research paper‟s background on subalternity and displacement in rafia zakaria‟s “upstairs wife” is set within the larger framework of feminist studies, postcolonial literature, and sociopolitical processes in south asia. 1.2.1 postcolonial context like many other postcolonial countries, pakistan struggles to overcome the effects of colonialism and the challenges of nation building after independence. pakistani society has been permanently shaped by the colonial past of british dominion over the indian subcontinent, which shaped individual experiences, cultural norms, and socio-political systems. scholars study how colonial history continue to influence modern power structures, identity forms, and cultural products under the framework of www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 2, 2024 4 published by scholink inc. postcolonial theory. within this postcolonial context, “upstairs wife” appears as a book that provides insights into the intricacies of pakistani culture and the lasting repercussions of colonialism on individual lives. 1.2.2 feminist perspectives “upstairs wife” revolves around women‟s experiences and gender issues. like many patriarchal countries, pakistan shapes women‟s identities, possibilities, and restrictions through inflexible gender standards and expectations. analytical tools for examining how gender intersects with other axes of identity, such class, religion, and nationality, are provided by feminist studies. scholars analyze how women negotiate patriarchal systems, oppose oppression, and claim agency in their families and communities via a feminist viewpoint. likely, “upstairs wife” tackles the challenges and resiliency of its female heroine—amina—amid the patriarchal limits of pakistani culture, providing fertile ground for feminist critique. 1.2.3 south asian socio-political dynamics geopolitical rivalries, ethnic conflicts, religious diversity, and complicated histories define the socio-political environment of south asia, and pakistan in particular. in light of the region‟s history of colonization, partition, military rule, and social movements, “upstairs wife” offers a nuanced portrayal of pakistani society and insights into the difficulties faced by individuals navigating personal and political upheaval. these events have left an indelible mark on both individual and collective identities. the story illuminates the ways in which gender, politics, and religion interact in pakistani homes and communities. scholars are better able to place “upstairs wife” in its socio-historical setting and comprehend its relevance as a literary work that addresses contemporary societal challenges by looking at the study‟s history within these larger contexts. by employing multidisciplinary methodologies that draw from postcolonial theory, feminist viewpoints, and south asian studies, scholars are able to provide intricate examinations of subalternity and displacement in zakaria‟s memorable story. 1.3 rationale of the study the following important reasons support the idea of doing a research study on subalternity and displacement in rafia zakaria‟s “upstairs wife”: literary significance: “upstairs wife” is a novel in south asian literature that presents a complex portrait of pakistani society through the lens of political and personal upheaval. the novel, much praised by critics, is worthy of scholarly scrutiny and examination, especially given its examination of marginalized experiences and displacement-related topics. social relevance: “upstairs wife‟s” themes of subalternity and displacement are relevant to larger social and political realities in pakistan and beyond. scholars may contribute to larger discussions on social justice and human rights by examining these topics and shedding light on the intricacies of power dynamics, identity forms, and resistance within oppressed groups. www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 2, 2024 5 published by scholink inc. theoretical frameworks: to comprehend the intricacies of subalternity and displacement within literary texts, one might employ analytical methods such as feminist studies, postcolonial theory, and displacement studies. through the application of these theoretical frameworks to “upstairs wife”, scholars can reveal deeper levels of importance and meaning within the story, enhancing our comprehension of the novel‟s socio-political aspects. scholarship gap: although “upstairs wife” has received positive reviews, there is still a lack of research on the film‟s thematic examination of subalternity and displacement. by writing a research paper on these subjects, i may close this knowledge gap and provide fresh perspectives on the novel‟s relevance in the context of literature. interdisciplinary approach: the examination of subalternity and displacement in “upstairs wife” demands an interdisciplinary approach that incorporates elements from several domains, including literature, sociology, anthropology, and cultural studies. through overcoming these academic barriers, scholars are able to provide thorough evaluation that address the complex aspects of the novel‟s themes. given these elements, writing a research paper on subalternity and displacement in “upstairs wife” offers a chance to expand on our knowledge of the socio-political significance of the book, make a valuable literary contribution, and participate in more general discussions regarding power, identity, and resistance in marginalized communities. by means of meticulous examination and thoughtful involvement, academics may elucidate the intricacies of zakaria‟s story and its pertinence to modern socio-cultural environments. 1.4 research questions 1) how does rafia zakaria‟s “upstairs wife” portray subaltern realities in pakistan‟s sociopolitical setting, especially through the figure of amina? 2) how does the concept of displacement come through in the story of “upstairs wife”, and how do political and personal forms of displacement interact and influence the lives of the characters in the text? 3) in what ways does “upstairs wife‟s” examination of subalternity and displacement add to larger discussions concerning the relationships of power, the construction of identities, and forms of resistance among disadvantaged groups in pakistan and throughout the world? 1.5 significance of the study the research paper on subalternity and displacement in “upstairs wife” by rafia zakaria has important ramifications for the study of literature, sociopolitical discourse, and the development of identities and power structures in marginalized groups. the following important factors highlight the importance of this study: 1) literary scholarship contribution: this research paper adds to the expanding corpus of knowledge on south asian literature, postcolonial studies, and feminist theory by critically www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 2, 2024 6 published by scholink inc. examining the themes of subalternity and displacement in “upstairs wife”. it deepens our comprehension of the novel‟s literary value within current literary landscapes and provides fresh perspectives on the sociopolitical aspects of zakaria‟s story. 2) interaction with socio-political realities: “upstairs wife‟s” examination of subalternity and relocation offers an eye through which to interact with more general socio-political realities in pakistan and elsewhere. scholars can contribute to larger discussions about social justice and human rights by illuminating the nuances of power dynamics, identity formations, and resistance within marginalized communities through examining the ways in which personal and political upheaval intersect within the narrative. 3) intersectional analysis: this research study provides a thorough comprehension of the intersections of gender, class, religion, and nationality within the book through an intersectional analysis informed by postcolonial, feminist, and displacement studies. through an investigation of the ways in which various axes of identification influence personal experiences of subalternity and displacement, academics may provide nuanced interpretations that are meaningful to a variety of readerships and add to the discourse surrounding intersectional identities and social justice. 4) pertinence to current concerns: the issues of displacement and subalternity that “upstairs wife” examines are still very important in today‟s globalized, migratory, and culturally changing sociopolitical environments. by examining these topics critically, academics may contribute to larger conversations on resistance, resilience, and social transformation by providing insights into how people manage their agency, power, and sense of belonging in unstable and changing environment. 2. review of the related literature 2.1 description of the “upstairs wife” our lives‟ public and private domains are inextricably linked in ways that are beyond comprehension. for example, one lady is forced to give birth at home in the middle of family strife while hindus and muslims struggle over land in india, creating carnage and making it hazardous for anyone to venture outside their houses. in the same way, a lady returns to her father‟s home after a personal tragedy brokenhearted and determined to carry on his heritage and lead her people and, eventually, the nation. a man is allowed to have up to four wives in pakistan, which might cause a woman to be crushed and publically humiliated if her husband chooses to use this legal privilege. journalist and human rights advocate rafia zakaria examines this interaction between the public and private spheres in her debut book, the upstairs wife: an intimate history of pakistan. zakaria‟s aunt amina‟s experiences are paralleled in the novel, which is a combination of family tale, biography, and historical chronicle of pakistan. her husband remarries during a pivotal moment in history. www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 2, 2024 7 published by scholink inc. on december 27, 2007, the upstairs wife: an intimate history of pakistan opens. a second devastating piece of newsbreaks while zakaria‟s family is waiting to hear about aunt amina‟s polygamous husband: benazir bhutto has been slain in rawalpindi. every phase of aunt amina‟s marriage narrative, like the first, is associated with a historical event in pakistan. the book is readable and often interesting, with deft wording that begins and ends with a captivating message. one day when rafia was little, aunt amina pays them a visit and spends the night and the next several days at their house. in pakistan, married women do not spend the night in their parents‟ houses; therefore it was unimaginable at the time. the story gradually becomes known over the next few days: uncle sohail, aunt amina‟s husband, had made the decision to remarry and take on a second wife—something that was legal but rarely accomplished. he had approached her for permission, but she had declined, so he had chosen to move forward nonetheless. after becoming agitated, aunt amina went to her folks‟ house. at some time after the elders from both sides convene and deliberate the matter, aunt amina returns to her husband‟s house to cohabit with a second wife. rafia zakaria now travels back in time to give us her grandmother‟s tale from her time in bombay, india, prior to the partition. she then tells a third tale about pakistan after it gained its independence. zakaria interweaves three narratives: the tales of her aunt, grandmother, and pakistan. zakaria exhibits a unique skill in depicting society from both a private and a public perspective. the author does a good job of revealing insights into the nation‟s larger geopolitical issues as well as detailing amina‟s wedding and the upstairs wife‟s misery at being reminded by semi-malicious bystanders that she is unmarried. for example, emotional accounts are given of the ojhri camp blasts, the swat earthquake, and the deadly bushra zaidi bus tragedy. despite this tragedy, the author‟s love for karachi is apparent in the meticulous attention to the city‟s historic landscape, as zakaria describes the aging of saddar, the significance of clifton, and the emerging middle-class environment of gulshan-e-iqbal with an almost panoramic grace. it wouldn‟t be a stretch to say that zakaria is one of the few pakistani writers with such a mastery of evoking the image in words. her work skillfully blends picture and feeling in a way that is visually appealing and compelling, while still maintaining a sense of wit and metaphor. after her husband‟s new wife moves in on the level above her own apartment, zakaria skillfully captures the once-bubbly amina‟s spiral into sorrow as she continuously navigates the intricacies of her new existence. according to the holy quran, which states that a man should only have more than one wife if he can treat them both with “perfect justice”, the plan called for the husband to spend one week with one wife, the next week with the other, and so on. but in reality, the arrangement turned out to be more complicated than that, and zakaria explores the nuances of these connections to gain a full understanding of them. www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 2, 2024 8 published by scholink inc. the plot of “the upstairs wife” develops gradually: a scenario from pakistani history is linked with each new scene of amina and sohail‟s marriage. these combinations frequently have a wry grace. within days of pakistan‟s forfeiture of east pakistan (bangladesh), which zakaria refers to as “the first and only public surrender in modern military history”, uncle sohail proposes aunt amina to marry him. that same year, aunt amina returns home upset, and benazir bhutto returns home after a seven-year self-imposed exile from pakistan. zakaria effectively contrasts individual aspirations and divides with public ones. while aunt amina may be the only woman on the lane forced to share her husband, she is by no means the only one who finds it difficult to accept the “perfect justice” that pakistani law has awarded her. others mention in passing the various factors that molded the nation between 1947 and 2007, the year benazir bhutto was killed: migration waves, sectarian strife, a string of military takeovers, political unrest, tensions from the cold war, conflicts with india and afghanistan, the 9/11 attacks, and so forth. here, there isn‟t just one through line. there are unanswered questions that may fill multiple books due to zakaria‟s pick of historical events.the personal narrative of zakaria is also not discussed. “the upstairs bedroom windows from which amina first saw sohail became mine”, she says about the family house. her aunt‟s fate was clearly a source of great personal worry from a young age, as seen by the sensory details she lavishes on the narrative. but more precisely, how would it have influenced her perspective and decisions as an adult? zakaria mentions in passing in the epilogue that she disobeyed her own scheduled marriage. she refers to the cherished aunt whose window she inherited and adds, “my story was built on hers”. 2.2 narrative reviews of previously conducted research on upstairs wife abd el-aziz, h. (2022) examined how zakaria has navigated both public and private spheres, keeping in mind how immigration and mobility have reshaped muslim women‟s identities along cultural, ethnic, and religious lines. she also emphasized women‟s empowerment in pakistan by defining women‟s choices that guarantee their future agency and give them authority, as well as by telling the tales of women told by women. in summary, the study examined how zakaria empowers pakistani women by elevating them from the periphery of the home to the social realm and challenging both personal and collective perceptions in a nation experiencing transformation. farooq, a., rehman, h. j. u., ayaz, m., and rahman, a. u. (2023) conducts a historical analysis to demonstrate the political and historical fiction classification of pakistani english fiction. they spoke about the concepts and demonstrated how rafia zakaria‟s upstairs wife exposes pakistan‟s turbulent political past. 2.3 description of subalternity a term that emerged from postcolonial studies, “subalternity” describes the state of marginalization, oppression, and subservient status that some groups in society endure. this is especially true for those who have historically been marginalized by systems of power like capitalism, colonialism, imperialism, patriarchy, and caste hierarchies. the phrase was developed in postcolonial studies to characterize the social, political, and cultural state of people that are oppressed, marginalized, and placed in a www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 2, 2024 9 published by scholink inc. subordinate position inside a hierarchical power system. although the idea first appeared in the writings of italian marxist academic antonio gramsci, it became more well-known thanks to the works of researchers of subaltern studies like gayatri chakravorty spivak and ranajit guha. originally used to describe lower-ranking military subordinates or members of the british army, the word “subaltern” was subsequently adopted and broadened by gramsci to include people who are excluded socially and politically as well as those who are economically disadvantaged. peasants, indigenous peoples, women, members of racial and religious minorities, members of the working class, and people who have been colonized are just a few examples of the diverse identities that make up subaltern groupings. within the framework of subaltern studies, spivak‟s seminal article “can the subaltern speak?” explores the nuances of representation and agency. she draws attention to the difficulties in accurately portraying the experiences of marginalized groups, contending that representation itself is rife with power relations that further silence and marginalize the voices of the oppressed. in addition to stressing the significance of amplifying subaltern perspectives, spivak highlights the necessity for academics and activists to practice “strategic essentialism”, which acknowledges the constraints and difficulties of representation. thus, being subaltern involves more than just social or economic disadvantage—it also involves resistance, power, and representation. it draws attention to the ways that oppressive and dominating institutions interact with and mold the experiences that marginalized groups live, and it emphasizes how crucial it is to give these groups‟ voices and perspectives a central place in movements to oppose and change these systems. subalternity fundamentally deals with the experiences of people who, for a variety of reasons—including race, ethnicity, gender, class, religion, or other—are marginalized in popular discourse and under the control of dominant groups. subaltern groups frequently have their voices suppressed, misinterpreted, or ignored. the word “subaltern” refers to and describes colonial communities in postcolonial studies and critical theory that are socially, politically, and geographically excluded from both the metropolitan heartland of an empire and its colony‟s power structure. karl marx‟s theory of history uses the proletariat‟s perspective to examine and analyze the political role of subaltern populations. it holds that the economic relationships between a society‟s social classes determine the what and who of social class. since the 1970s, the word “subaltern” has been used to refer to the colonial peoples of the indian subcontinent; it is imperial history as it is presented from below, from the viewpoint of the colonized peoples, as opposed to the viewpoint of the western european colonizers. by the 1980s, south asian historiography began using the subaltern studies approach of historical inquiry. the idea of the subaltern emerged as an intellectual discourse technique for the study of non-western peoples (of africa, asia, and the middle east) and their relationship to western europe as the center of global history. it was initially developed as a eurocentric approach of historical inquiry. the paradigm for historical study of the subaltern‟s encounter with colonialism in the www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 2, 2024 10 published by scholink inc. indian subcontinent emerged from subaltern studies. subaltern studies, postcolonial theory, and critique acquired traction in the latter two decades of the 20th century, particularly in third world nations because of globalization. subaltern studies draws inspiration from marxism and poststructuralism and integrates into postcolonial criticism if it is understood as a branch of postmodernism. displacement in fiction the issue of displacement in literature is complex and includes aspects related to the physical, emotional, cultural, and psychological spheres. it centers on people or groups being uprooted from their comfortable surroundings, willingly or inadvertently, and the difficulties they then have in adjusting to new situations. the theme of displacement and the pursuit of belonging has been addressed in a variety of genres, historical eras, and cultural situations. it is a reflection of the universal human experience. the representation of actual travel and geographical relocation in literature is one important facet of displacement. characters may be compelled to from their homes because of natural disasters, political turmoil, war, or economic hardship. the protagonists‟ physical dislocation frequently acts as a springboard for narrative inquiry when they encounter foreign social systems, cultures, and landscapes. as an illustration, consider the wanderings of odysseus in homer‟s “the odyssey”, the dust bowl migrants in john steinbeck‟s “the grapes of wrath”, and the experience of refugees in more recent works such as mohsin hamid‟s “exit west”. another important aspect of literary analysis is emotional displacement, in which characters experience alienation or disconnection from their surroundings even in familiar settings. this may be the result of existential anxiety, social exclusion, or personal trauma. the psychological intricacies of displacement are a topic that writers frequently explore, showing individuals battling emotions of isolation, loneliness, or displacement even in the middle of vibrant cities or close-knit communities. for instance, the characters in virginia woolf‟s “mrs. dalloway” negotiate the fractured structure of contemporary urban life, while holden caulfield‟s sense of alienation in j.d. salinger‟s “the catcher in the rye” reflects a larger existential melancholy common among teenagers. the difficulties of managing several cultural identities and negotiating one‟s sense of self in various social circumstances are examined in the book cultural displacement. for instance, characters in immigrant fiction frequently explore the conflict between cultural preservation and assimilation as they navigate the boundaries between their native country and their adopted one. authors that tackle the intricacies of cultural displacement include chimamanda ngozi adichie (“americanah”) and jhumpa lahiri (“the namesake”), emphasizing the ways in which people must reconcile divergent cultural norms, traditions, and expectations. furthermore, authors use displacement as a symbolic element in their works to delve further into issues of human condition, change, and metamorphosis. the emotional or physical travels of characters frequently reflect inward searches for atonement, enlightenment, or self-discovery. in addition, the www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 2, 2024 11 published by scholink inc. displacement motif may serve as a critique of social institutions by drawing attention to problems with injustice, inequality, and authority. for example, in ralph ellison‟s “invisible man”, the protagonist‟s invisibility is both a metaphor for african americans‟ social marginalization and a more general existential invisibility that people who feel invisible or unacknowledged by the world around them experience. literary representations of displacement cover a wide range of events, including real-world migrations, psychological turmoil, cross-cultural discussions, and allegoric travels. writers illuminate the common human search for identity, belonging, and purpose in a world of perpetual change and flux by delving into the complexity of relocation. another well-known instance of displacement in english literature may be found in the writings of authors such as joseph conrad, whose book “heart of darkness” examines the protagonist charles marlow‟s literal as well as metaphorical voyage into the congo. marlow‟s move from his comfortable european surroundings to the center of africa is a metaphor for the voyage into the shadowy recesses of human nature and the darkness that exists inside civilization itself. in modern literature, such as the writings of writers like zadie smith, displacement is also evident. characters as archie and samad, who are immigrants forced to flee their home countries and settle in england in her book “white teeth”, have to deal with questions of identity, cultural integration, and the legacy of colonialism in their new environment. in english literature, displacement is a potent narrative device that writers use to explore intricate ideas of identity, belonging, and the human condition via the experiences of people who are uprooted from their comfortable environments. readers are prompted by the stories to consider their own sense of place in the world and to feel sympathy for others who have to deal with the difficulties of being uprooted. one important idea and topic that appears in both postcolonial and contemporary literatures is displacement. it attempts to understand the identity problem brought on by modernism or colonialism as a critical idea. people that were colonized were compelled to leave behind or break away from their home countries, initial locations, cultures, customs, and languages. because he was no longer a part of the tradition he had grown up with for ages, modern man was changing into a separate, displaced subject. however, there is a subtle difference that should not be overlooked between the colonized and contemporary displaced subjects. three prominent characteristics of their displacement are alienation, disassociation, and deracination. their literary works encapsulate the agonizing narratives of their culturally and existentially estranged identities. it needs a “first place or some basic identity” to withstand the pain of being uprooted. it‟s fascinating to see how the notion of displacement itself incorporates the idea that “the first place of any creature turns into its paradise”. in essence, displacement is the source of several issues. one finds it difficult, for a number of reasons, to separate oneself from the new location, nation, and language that they either decided to adopt or were forced to embrace. on the one hand, one cannot forget the people, www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 2, 2024 12 published by scholink inc. culture, landscapes, and language of the abandoned place. a certain inevitability of settling in a new nation contrasts with nostalgic memories of one‟s motherland. because of its wide spectrum of effects on post-colonial countries and people‟s psyches, displacement is a hot topic in postcolonial literature. two phases of displacement take happen. one is psychological, while the other is physical. in order to depict the struggle, postcolonial writers concentrate on both stages in their work. 2.4 narrative reviews of previously conducted researches on subalternity and displacement de jong and mascat. (2016) introduced the special issue “relocating subalternity: scattered speculations on the conundrum of a concept”, in which they address the “foreclosure” of subalternity by starting with spivak‟s unique invocation of (gendered) subalternity and its scholarly reception. they suggested that removing the subaltern from her (non)place may open up positive opportunities for carrying out a fruitful “ab-use” of the concept of subalternity, even though the gesture of (re)locating invariably sets off a tense dialectic between the attempt to define contingent empirical loci and subalternity‟s resistance to being empirically circumscribed. according to thomas, p. d. (2018), since the early subaltern studies collective‟s innovative reading of antonio gramsci‟s carceral works, the subaltern has often been viewed as an excluded person. in his paper, he made the case that fresh tools for “refiguring” the subaltern may be found by doing a contextualist and diachronic analysis of the evolution of the idea of subaltern classes over the course of gramsci‟s whole prison notebooks. in order to understand certain aspects of gramsci‟s theories, he put out three substitute figures: the “irrepressible subaltern”, the “hegemonic subaltern”, and the “citizen-subaltern”. such a reconfigured idea of the subaltern has the ability to provide insight on the paradoxical evolution, far from being exhausted by the eclipse of the conditions it was called upon to analyze in subaltern studies. mehzabeen, m. (2022) concentrate on the post-colonial era‟s displacement theory. she attempted to highlight the difficulties and issues poc experienced in the post-colonial era with her article. this covers cultural displacement, shifting perspectives on displacement, and beneficial literary opportunities resulting from displacement. saha, a. (2015) investigated how postcolonial writers dealt with the problem of displacement in their writings and representations. here, the diverse depictions of displacement in naipaul‟s the enigma of arrival, coetzee‟s disgrace, and desai‟s the inheritance of loss—three books that also depict the struggles and outcomes of three locations—were examined from a variety of angles. 2.5 synthesis and thesis statement rafia zakaria‟s “upstairs wife” synthesizes the literature on subalternity and displacement, revealing a nuanced interaction between academic frameworks, feminist analyses, and literary critiques. this analysis, which draws on feminist theory, postcolonial theory, and literary criticism, offers a thorough grasp of the socio-political settings and thematic issues of the book. www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 2, 2024 13 published by scholink inc. fundamentally, “upstairs wife” explores the stories of marginalization and relocation in pakistan‟s patriarchal and unstable political environment. the novel provides a sophisticated examination of power relations, identity constructions, and resistance within oppressed populations through the eyes of its heroine; amina. within the context of wider theoretical frameworks like feminist theory and subaltern studies, the story explores how people navigate belonging and agency in oppressive regimes. thesis statement “in „upstairs wife‟, rafia zakaria deftly examines the complexities of displacement and subalternity within the complex web of pakistani culture. zakaria sheds light on the intricate relationships between power, identity creation, and resistance in oppressed areas via the persona of amina. the book provides remarkable insights into the manner in which political and personal crises collide to create people‟s sense of agency and belonging when read in the context of larger theoretical frameworks and feminist analyses”. this well-crafted thesis statement highlights zakaria‟s deft handling of intricate socio-political topics within the “upstairs wife” story and summarizes the main points of the research paper. scholars may contribute to larger conversations on power dynamics, identity forms, and resistance within oppressed groups by delving into the intersections of gender, class, religion, and politics. 3. research methodology research design: rafia zakaria‟s “upstairs wife” employs a qualitative research methodology to analyze subalternity and displacement, with the goal of exploring and interpreting the novel‟s complex themes and narratives. using theoretical frameworks and critical views to provide light on the socio-political circumstances and thematic issues of the tale, this qualitative research approach enables a thorough analysis of the text. the book “upstairs wife” itself serves as the main source of data for this study. the book provides complex stories, characterizations, and thematic explorations that shed light on subalternity and displacement in pakistani culture, and these elements form the basis of the analysis. additionally, information was gathered from david waterman‟s book “history memory, fiction”. secondary data sources also support the study by offering theoretical frameworks and critical viewpoints that guide the interpretation of the novel. examples of these sources are research articles, theoretical writings, and critical assessments. the population for this research comprises various personalities in the “upstairs wife” each of whom comprised different traits. purposive sampling is used in this qualitative study to pick texts, articles, and academic publications that provide pertinent insights into the subjects being studied. to enable a detailed examination of the novel‟s thematic issues, important passages and fragments from “upstairs wife” that highlight significant subaltern experiences and displacements are also chosen through theoretical sampling. www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 2, 2024 14 published by scholink inc. the textual analysis of “upstairs wife” is the main method used to gather data. in order to pinpoint important themes, storylines, and instances of subaltern experiences and displacement, this entails closely reading and interpreting the book. academic publications, theoretical writings, and critical evaluations are employed to enhance the textual examination of “upstairs wife”. these resources offer critical viewpoints, historical background, and theoretical frameworks that help readers understand the novel‟s topics. the purpose of the literature review is to support and contextualize the results of the textual analysis through triangulation. searching the narrative for instances of subalternity and displacement was the primary objective of the analytical criteria. textual sections and fragments are categorized thematically according to recurrent themes of displacement and subalternity. thematic coherence, contextual knowledge, interdisciplinary engagement, comparative analysis, and critical reflection are given top priority in the data analysis criteria of this research study. following these guidelines will enable the research to provide a thorough and perceptive examination of subalternity and displacement in “upstairs wife”, so adding to the larger conversation on literature, identity, and power relations in marginalized communities. 4. narrative analysis of data the narrative analysis of “upstairs wife” entails a close examination of textual excerpts and passages to uncover underlying themes, motifs, and narrative elements related to subalternity and displacement. through a systematic analysis of the novel‟s narrative structure, character development, and plot dynamics, researchers can gain insights into the lived experiences of marginalized individuals within pakistani society. 4.1 identification of key themes finding significant issues in the book about subalternity and displacement is the first step in the investigation. finding recurrent ideas, themes, and narrative strands that, especially via the persona of amina, represent the realities of disadvantaged people is required to accomplish this. reflecting the socio-political and cultural conditions in which the story is set, themes like marginalization, silence, resistance, physical displacement, emotional displacement, and political displacement emerge as major themes in the narrative. the issue of marginalization runs throughout “upstairs wife”, depicting the manner in which people—women in particular—are sidelined in pakistan‟s patriarchal and socially stratified society. rafia zakaria illuminates the intricate relationships between privilege, power, and oppression in pakistani culture by delving into the lives of amina, the protagonist, and other characters. 1) gender-based marginalization: the novel‟s examination of marginalization places a strong emphasis on the widespread prejudice and oppression that women experience due to their gender. as a woman in a culture where males predominate, amina faces marginalization in a variety of forms. these forms include restricted mobility and autonomy, expectations of www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 2, 2024 15 published by scholink inc. subservience and obedience to male authority figures, and limited access to education and economic possibilities. 2) economic and social marginalization: characters in “upstairs wife” face discrimination not just because of their gender but also because of their socioeconomic position and rank. because of their lower socioeconomic standing, amina‟s family, for example, experiences social and economic exclusion. social standards that elevate money, position, and social ties exacerbate this marginalization by pushing those from marginalized origins to the periphery of society. 3) religious and ethnic marginalization: the story delves into the subject of religious and ethnic minorities‟ marginalization in pakistani culture. characters that emphasize the ways in which religious minorities are oppressed and alienated from mainstream culture include the hindu friend of amina and the christian neighbor of sohail, who both experience prejudice and persecution as a result of their religious convictions. 4) marginalization intersections: crucially, “upstairs wife” illustrates how different types of marginalization connect, showing how people can endure numerous levels of oppression as a result of intersecting identities. as an illustration of the intricate interactions between gender, class, religion, and ethnicity in influencing experiences of marginalization, consider amina‟s experiences as a lower-class woman from a religious minority background and how these experiences compound her marginalization within pakistani culture. rafia zakaria depicts how people are uprooted and displaced within pakistan‟s socio-political context in “upstairs wife”, which delves into topics of physical, emotional, and political displacement. the book sheds light on the complex effects of relocation on relationships, communities, and individual identities via the stories of people like amina, sohail, and others. 4.2 physical displacement characters who are compelled to flee their homes and towns for a variety of causes, such as political violence, economic hardship, and social constraints, serve as examples of the novel‟s recurring issue of physical displacement. when amina‟s family is compelled to relocate from their ancestral home in india to karachi following the partition, they undergo bodily dislocation. they are forced to adjust to a new environment and way of life as a result of this displacement, which uproots them from comfortable surroundings and cultural settings. in addition, as individuals move from pakistan‟s rural areas to karachi in pursuit of social mobility and economic opportunity, the book depicts instances of internal displacement inside karachi itself. the patterns of urbanization and population mobility inside pakistan are reflected in this internal migration. 4.2.1 emotional displacement “upstairs wife” delves into both physical and emotional displacement, examining how characters deal with emotions of estrangement, loneliness, and separation from their loved ones and environment. amina feels emotionally displaced in her marriage to sohail as a result of sohail‟s emotional detachment www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 2, 2024 16 published by scholink inc. and adultery, which strains their bond. the psychological effects of interpersonal conflict and emotional neglect are highlighted by amina‟s sense of alienation and disconnection from her spouse and community as a result of her emotional estrangement.other characters in the book, like the hindu friend of amina and the christian neighbor of sohail, also go through emotional displacement while figuring out what it means to be a religious minority in a culture that is dominated by muslims. their sense of emotional dislocation is exacerbated by their experiences with discrimination and persecution, which breed emotions of insecurity and estrangement. 4.2.2 political displacement another theme covered in the book is political displacement, which refers to how people are muted and sidelined in pakistani politics, especially during general zia-ul-haq‟s oppressive rule. as they struggle with zia‟s harsh islamic laws, which restrict their freedom of speech, assembly, and dissent, characters like amina and sohail find themselves politically displaced. those who dare to confront the established quo feel politically dislocated as a result of this political persecution, which muzzles voices of dissent and struggle. the novel also portrays more general socio-political upheavals, such the declaration of martial law and the suppression of oppositional media and voices, which add to pakistani society‟s prevailing sense of political turbulence and unpredictability. understanding the sociopolitical and cultural background of “upstairs wife” is essential to comprehending the forces that mold the lives of the characters and the story‟s events. the novel, which is mostly set in karachi, pakistan, in the 1970s and 1980s, offers a complex portrait of the nation‟s sociopolitical and cultural environment at a time of profound social and political upheaval. the following are some essential components of the sociopolitical and cultural context: political instability: pakistan saw significant political instability in the 1970s and 1980s, which was marked by military dictatorship, political persecution, and civil unrest. the work makes analogies to political leaders like general zia-ul-haq and events like the declaration of martial rule, the suppression of the media, and the silence of dissident voices in order to hint at this instability. military dictatorship: during the time covered in the novel, pakistan‟s socio-political scene was greatly impacted by general zia-ul-haq‟s military rule, which was established in a coup in 1977. with far-reaching effects on society, zia‟s dictatorship enforced sharia law and marginalized religious and ethnic minorities. zia also adopted orthodox islamic policies. 4.3 gender dynamics the book examines the intricate relationships between gender and patriarchy in pakistani society, as well as gender roles and women‟s rights. the difficulties and limitations women have when attempting to establish agency and autonomy within familial and social systems are brought to light by amina‟s experiences as a woman living in a culture that is controlled by males. 1) cultural customs and norms: the lives and decisions of the protagonists are greatly influenced by cultural norms and traditions, which have their roots in religion and society www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 2, 2024 17 published by scholink inc. expectations. the people in the book negotiate traditional beliefs with desires for social and economic growth, illustrating the contradictions between tradition and modernity. 2) urbanization and migration: the story of the novel is set against the backdrop of karachi, a fast expanding metropolitan hub. the varied population of the city, which is made up of immigrants from pakistan‟s rural areas and other regions, is a reflection of the larger patterns of internal migration and urbanization that influence the city‟s socioeconomic dynamics and cultural exchanges. 3) ethnic and religious diversity: people from a wide range of ethnic and religious origins live in karachi, which adds to the lively cultural fabric of the city. but there are also disputes and tensions that emerge between various racial and religious groups, which are a reflection of larger societal divisions and power struggles. through presenting the story in the socio-political and cultural framework of pakistan in the 1970s and 1980s, “upstairs wife” provides insights on the intricacies of identity, power struggles, and societal transformation in the backdrop of the nation‟s changing environment. 4.4 character dynamics amina: as the book‟s main character, her experiences provide a starting point for examining issues of displacement and subalternity. readers are able to observe amina‟s issues with emotional relocation, voice suppression, and marginalization in her marriage to sohail via her point of view. amina‟s path also demonstrates female independence and fortitude in navigating patriarchal standards and society expectations. sohail: throughout the story, sohail, amina‟s husband, serves as a figure of authority and power. amina‟s experiences of marginalization and displacement are frequently influenced by his choices and behaviors, especially when he balances social constraints with his own aspirations. the complexity of gender dynamics and power dynamics in pakistani homes is shown by sohail‟s persona. plot developments:  important events: the storyline of the book is interspersed with significant occurrences that influence amina‟s experiences and life course. these incidents include sohail‟s choice to wed a second woman, amina‟s psychological anguish after learning this, and her final path to empowerment and self-discovery. every incident advances amina‟s story arc and clarifies the themes of resistance and displacement.  turning points: character dynamics and story developments change as a result of crises and revelations, which act as turning points in the story. for instance, a pivotal moment in their relationship occurs when amina confronts sohail about his second marriage, which causes both characters to pause and consider themselves. the novel‟s overall narrative tension and philosophical depth are enhanced by these pivotal moments. www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 2, 2024 18 published by scholink inc.  subalternity:amina‟s experiences throughout the book perfectly capture what it means to be a subaltern—one who is marginalized, has their voice suppressed, and has little agency within prevailing power systems. the struggles of disadvantaged people to claim their identity and agency in patriarchal and politically volatile environments are reflected in her story arc. 5. justification of research questions 5.1 how does rafia zakaria’s “upstairs wife” depict the experiences of subalternity, particularly through the character of amina, within the socio-political context of pakistan? in “upstairs wife”, rafia zakaria uses interlocking layers of marginalization within pakistan‟s sociopolitical setting to describe amina‟s experiences as a subaltern. amina‟s experiences as a lower-class hindu woman showing the intricacies of power relations and societal disparities, including religious othering, economic precarity, and gendered oppression. notwithstanding these difficulties, amina‟s story also demonstrates fortitude and acts of defiance, highlighting the complex relationship between subaltern agency and institutional limitations in pakistani culture. 5.2 in what ways does the theme of displacement manifest within the narrative of “upstairs wife”, and how do personal and political forms of displacement intersect and shape individual experiences within the text? “upstairs wife” explores the issue of displacement in its physical, emotional, and political manifestations. the characters undergo three types of displacement: emotional and psychological (due to relationship breakdowns and identity issues), physical (because to migration and relocation), and political (due to censorship and persecution). in pakistan throughout the 1970s and 1980s, personal and political upheavals intersected to shape individual lives within an unstable and unpredictable terrain. these kinds of displacement interact and affect individual experiences, reflecting the country‟s wider socio-political backdrop. 5.3 how does the exploration of subalternity and displacement in “upstairs wife” contribute to broader conversations about power dynamics, identity formations, and resistance within marginalized communities, both in pakistan and globally? “upstairs wife” provides insights on power dynamics, identity forms, and resistance within underprivileged groups in pakistan and throughout the world through its examination of subalternity and displacement. the book highlights the challenges of negotiating patriarchal, socioeconomic, and religious systems by illustrating the intertwined experiences of marginalization and oppression that people like amina endure. by reading amina‟s story, readers are encouraged to consider more general questions about agency, resiliency, and the transforming force of resistance within underprivileged groups. this helps to advance worldwide discussions about social justice, empowerment, and human rights. www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 2, 2024 19 published by scholink inc. 6. conclusion and recommendations in the end, the examination of rafia zakaria‟s “upstairs wife” offers significant perspectives on the subjects of subalternity, displacement, and resistance in the context of pakistani socio-politics in the 1970s and 1980s. the novel offers significant thoughts on power dynamics, identity forms, and resistance by illuminating the overlapping realities of oppression and marginalization encountered by individuals within marginalized groups via the narratives of amina and other characters. subalternity research exposes pakistani society‟s widespread injustices and inequities, especially those pertaining to gender, socioeconomic class, religion, and ethnicity. through amina‟s story, the intricacies of negotiating patriarchal norms, economic precarity, and religious prejudice are examined, bringing to light the agency and resiliency of those who live on the periphery of society. in a similar vein, how relocation is portrayed highlights the upheavals that mold people‟s lives in a politically unstable and socially stratified environment. character struggles are exacerbated by the intersection of political, emotional, and physical displacement, which reflects larger trends of social instability and upheaval. recommendations: in light of the examination of “upstairs wife”, the following suggestions might be made for more study and scholarly work: 1) additional investigation on intersectionality: future studies should examine how experiences of subalternity and displacement in pakistani society are shaped by the intersections of gender, class, religion, and ethnicity. scholars can get a deeper grasp of how several axes of identity interact to form people‟s experiences of marginalization and resistance by using an intersectional method. 2) comparative analysis: “upstairs wife” may be compared to other literary works or historical accounts that tackle related issues of resistance, subalternity, and displacement in comparative studies. scholars can learn more about the universality of zakaria‟s ideas and the particulars of its socio-political environment by placing the book within larger literary and historical contexts. 3) postcolonial theory engagement: increasing our knowledge of postcolonial theory might improve our comprehension of the novel‟s themes and narrative devices. through the utilization of postcolonial frameworks like the notion of hybridity by homi bhabha and the notion of the subaltern by gayatri spivak, researchers are able to provide intricate analyses of power dynamics, identity constructions, and resistance in the text. 4) empirical study: by analyzing actual accounts of subalternity, displacement, and resistance in modern pakistani culture, empirical study may supplement literary analysis. researchers can get insights into the lived reality of oppressed populations and the tactics they use to www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 2, 2024 20 published by scholink inc. challenge oppression and express agency through the use of surveys, ethnographic studies, and interviews. references abd el-aziz, h. (2022). the empowerment of women in the controversial landscape of pakistan in the upstairs wife. in muslim women‟s writing from across south and southeast asia (pp. 109-122). routledge. de jong, s., & mascat, j. m. (2016). relocating subalternity: scattered speculations on the conundrum of a concept. cultural studies, 30(5), 717-729. farooq, a., rehman, h. j. u., ayaz, m., & rahman, a. u. (2023). nomenclature and pakistani english fiction: politics, islamic ideology and history in fiction or politico/historical fiction. russian law journal, 11(2). mehzabeen, m. (2022). history through the pages of literature: a displacement theory in the post-colonial era (doctoral dissertation, brac university). saha, a. (2015). displacement & its consequences in the postcolonial literature: a brief discussion on naipaul, coetzee and desai‟s representation. asa university review, 9(2). thomas, p. d. (2018). refiguring the subaltern. political theory, 46(6), 861-884. web resources https://vishytheknight.wordpress.com/2020/06/24/book-review-the-upstairs-wife-an-intimate-history-of -pakistan-by-rafia-zakaria/ https://www.dawn.com/news/1181140 https://tribune.com.pk/story/882492/book-review-the-upstairs-wife-hopes-and-betrayals https://www.nytimes.com/2015/03/29/books/review/the-upstairs-wife-by-rafia-zakaria.html https://en.wikipedia.org/wiki/subaltern_(postcolonialism) https://literariness.org/2016/04/08/subaltern-postcolonialism/ https://scholarblogs.emory.edu/postcolonialstudies/2020/02/17/subaltern-studies/ https://www.thenews.com.pk/tns/detail/562972-displacement-literature https://www.researchgate.net/publication/339596063_displacement_its_consequences_in_the_postcol onial_literature_a_brief_discussion_on_naipaul_coetzee_and_desai‟s_representation children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 3, no. 1, 2020 www.scholink.org/ojs/index.php/ct 33 original paper digital storytelling or traditional storytelling to develop efl students’ oral communication? mahmoud kamal ibrahim mostafa 1* 1 english department, faculty of arts, jouf university, al-jouf, saudi arabia * mahmoud kamal ib rahim mostafa, english department, faculty of arts, jouf university, a l-jouf, saudi arabia received: january 19, 2020 accepted: january 31, 2020 online published: february 18, 2020 doi:10.22158/ct.v3n1p33 url: http://dx.doi.org/10.22158/ct.v3n1p33 abstract the present study investigated the effect of storytelling versus digital storytelling on developing fifth year efl primary school pupils’ oral communication performance. the study adopted the quasi-experimental design. sixty pupils of dr. ahmed zewail primary school were distributed into two experimental groups. one group served as the first experimental group (n=30) who was taught in digital storytelling, whereas the second experimental group (n=30) was taught in traditional storytelling. the experiment lasted for six weeks. the instruments o f the study included an oral communication skills test, an oral communication checklist, a semi -structured interview and a reflective log. they were approved by a panel of jury. results indicated that there was a statis tically significant difference between the mean scores of the first experimental group and that of the second one on the post-administration of the oral communication test for the first experimental group. moreover, results revealed that there was a statistically significant difference between the responses of the first experimental group and that of the second one on the post -administration of the semi-structured interview favoring the first experimental group. as such, it was concluded that storytelling versus digital storytelling had a positive effect on developing fifth year efl primary pupils’ oral communication performance. keywords storytelling, digital storytelling, efl oral communication performance www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 34 published by scholink inc. 1. introduction referring to the egyptian education system and its relat ion to english as a foreign language (efl) teaching and learning, the status of english in egyptian schools has changed from an optional subject to a compulsory one. most school children speak arabic as their first language, english as second and french or german are their third or foreign language (haridy, 2012). elmeshad (2012) states that the ministry of education of egypt (moe) started implementing english in schools in the 1860s. gradually, teaching english language in primary schools as a relatively new global phenomenon started in egypt in the 1990s. generally speaking, the link between knowledge of english and success in changing egyptian environment and in the global economic community has resulted in a growing demand for english language proficiency among individuals, sufficient enough to meet the new societal and g lobal market needs (akkari, 2004). despite many large scales, ministry of education (moe) in itiatives to change language pedagogy in the egyptian context, most classrooms and schools remain unchanged and evidence of improvement is still limited (ginsburg, 2010). for example, with respect to adopting communicat ive language teaching approaches as a way of improving the english language teaching and learning practices. concerning the primary education, juraid (2016) states that english as a global language has spread in primary schools in many non-english speaking countries. in addition, thapa, cohen, guffey, and higgins d’alessandro (2013) argue that pupils can learn literacy skills through instruction and practice of speaking, reading, writing and listening. oral communication is a way of exchanging informat ion through the sense of hearing and making meaning from what was pract iced. schady (2011) stated that childhood period is the most rapid period of development in human life. some children may develop at their own pace but most children progress through an identifiab le sequence of physical, cognitive, social and emot ional growth and change. moving to oral communication, jalongo (2008) assures that oral communicat ion prepares young children for later better learn ing. on the other hand, raghavendra, olsson, sampson, mcinerney, and connell (2012) submitted that it is crucial for a ch ild to develop good communication skills in order to cope with the academic demands of school and to learn adequate literacy skills. in the same line, ahern, bermejo, and fleta (2008) declared that oral communication skills (ocss) were usually placed ahead of work experience, motivation, and academic permits as criteria for new recru itment for employment. communicat ion skills help children to guide their self-inquiry and discover their individual possibilities. (mostafa, 2017) stated that children who are active communicators can incorporate the things they hear, chants and short stories, faster in their framework of knowledge than a passive counterpart. in his own view, tramel (2011) observed that children can also exh ibit better concentration and memory when they develop good communication. shiel (2012) explain that oral communicat ion is the child’s first, most important, and most frequently used structured medium of communication. in addition, and most significantly, oral communication is the primary mediator of culture, the way in www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 35 published by scholink inc. which children locate themselves in the world. basically, oral communication is about communicating with other people. it involves a process of utilizing knowledge and skills in o rder to listen and speak effectively. zhang (2009) asserts that pupils who study english as a foreign language (efl) usually have limited opportunities to communicate in english outside the classroom and also have limited exposure to english speakers or members of the international community. th is might be one reason for teachers to provide more situations, activities, and strategies for pupils to strengthen their ocp such as storytelling. nowadays educational institutes are constantly developing new techniques for sounds, pictures, and prints. st is used as the most basic level of communicat ionperson-to-person. past research has shown that teachers often ignore the ocss in classrooms assuming these skills are already developed. patil (2008) asserted that building up the learner's performance was a prio rity that the teacher should consider in order to make the learner feel comfortable with their language use. songsiri (2007) assures that ocss could be developed from an appropriate syllabus design, methods of teaching, and sufficient tasks and materials which are included in st. digital storytelling (dst) provides pupils of 10-11 years old with more opportunities to create and communicate different story texts (e.g., personal stories, historical stories, and quran ic stories) in english through different modes of communication, such as visualizing and writing ideas, using technology to document and present their stories as a historical diary, and using more meaning-making resources such as photographs, video clips, art, music, script text, audio narration, and sound effects. in this way, the pupils will learn integrated language skills, such as writing, speaking, listening, and reading through the creation of digital stories. widodo (2016) said that as teaching english to young learners (teyl) continues to flourish, research into this area has begun to grow. despite this, there remains a lack of classroom-based studies in english as a foreign language (efl) context. werner (2011) suggests using one of the participatory activities such as dst for improving oral communication performance (ocp). in addition, we know little about how young learners interact with technology such as digital stories to learn english or how they work multimodal texts such as digital stories. in addition, if children are engaged effectively, there will be a great potential for creat ivity, and a passionate commitment to things which interest them. tatum (2009) argues that almost nothing more exciting than a class of involved young people at this age pursuing a learning goal with enthusiasm as it happens in dst. our job, therefore, must be to provoke student’s engagement with material which is relevant and involving. at the same t ime, we need to do what we can to bolster our pupils’ self-esteem and be conscious, always, of their need for identity. in this respect, the researcher suggests that st and dst can be one of those activities/strategies which encourage pupils to learn and practice english. st is an aspect of oral communication which encourages young learners to be active during the learning process. it is not a one-way act as there are usually at least two people involved, a teller and a listener. norrick (2000) declares that st provides www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 36 published by scholink inc. familiar th ings to children and creates an active interaction amongst pupils. if a topic is difficult to explain to children, we can integrate the topic into a story. st presents the solution which might help children to visualize the textbooks and understand them better. in this study, to engage pupils in meaning making-oriented english learning, st and dst are introduced because this category is rarely taught in egyptian primary schools, and it is a new strategy suggested to be included in egyptian english curricula. in the context of primary schools, st helps to share knowledge, wisdom, morals and cultural values. with this in mind, teachers may be encouraged to include stories in their language classrooms. 2. method and procedures the current study methodology includes the research design, the participants and sample selection, the research instruments (oral communication checklist, semi-structured interview, pre-posttest, and the reflection log), the pilot study, and the procedures used for data collection as well as the data analysis. the study aimed to improve pupils’ english ocp via st/ dst. 2.1 research design the present study used the quasi-experimental design to detect the effect of using st versus dst to develop the english ocp of primary fifth pupils at dr. ahmed zewail primary school. two groups were selected to represent the experimental groups: the first experimental group (n=30 t aught according to dst) and the second experimental group (n=30 taught according to st). the whole experiment from beginning to the end lasted for six weeks. the results of the pre-post tests were analyzed using t-tests for independent samples to investigate if there was any significant difference between the mean scores of the two groups and between the pre-posttest for each group as well. 2.2 participants of the study the participants of the study consisted of 60 pupils from the fifth year at dr. ahmed zewaill primary school, new damietta for the academic school year (2017-2018). they were divided into two experimental g roups: the first group (n=30) and the second group (n=30). the first experimental group was taught in using the dst to improve their english ocp and the second experimental group was taught in using regular st to improve their english ocp. the following table shows the distribution of the participants. 2.3 variables of the study to assure the results’ accuracy and avoid any marginal interference, the groups were randomly chosen from a purposive sample (150 5th grade pupils) from dr. ahmed zewaill p rimary school where the researcher works by using the following procedures: • the participants were filtered by drawing out pupils who have a hearing or sight impairment. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 37 published by scholink inc. • the researcher divided the participants into two groups by choosing the individual numbers for the first experimental g roup and the even numbers for the second experimental group to avoid bias. • the researcher tried to control some variables before apply ing the study: 1) age variab le: the researcher recorded the pupils' ages from their school files at the beginning of the school year (2017-2018) 2) determin ing the equivalence between the two experimental groups: to make sure that the participants are equivalent in their previous english language achievement, the researcher admin istrated the preachievement test. the results of the participants were recorded and statistically analyzed by using t-test. table 1 shows the mean and the standard deviation of each group in english previous learning. the results indicate that there are no statistically significant differences between the first experimental group and the second experimental group at (0.05 ) level. 2.4 the instruments and materials of the study 1) the oral communication skills checklist. 2) a pre-posttest for assessing pupils’ efl oral communication skills. 3) the semi-structured interview of the fifth-year primary pupils. 4) reflect ive log 2.4.1 the ocss checklist the oral communicat ion skills checklist:  the purpose of the checklist: the checklist aimed at determining the most important ocss to be developed for the fifth year efl primary school pupils and constructing the oral communication pre-posttest.  sources of the checklist: in order to construct a checklist of the most appropriate ocss for the fifth year efl primary pupils to be the basis of the pre-post oral communication test, the researcher made use of the following sources; a. rev iewing the relevant literature and related studies of oral communication and st/dst. b. questioning specialists and experts in the field of tefl. c. reviewing the specifications of the activities assigned to the fifth year efl language primary pupils in the teachers’ guide to determine if there was anything related to ocp skills.  checklist description: after rev iewing the sources, it could be concluded that the relevant literature is fu ll of ocss and every researcher and specialist divided them according to his variables and participants. while choosing the skills, the clarity and the appropriateness of these skills to the fifth year efl primary pupils were taken into consideration. therefore, an init ial checklist including seventeen ocss thought to be appropriate to the fifth year efl primary pupils was designed. the skills were written in a logical order according to the pupils’ stage and the nature of the text they were going to tackle (see appendix, a). www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 38 published by scholink inc.  checklist scoring: to let the jury be confined to a particular standard, the seventeen ocss were put in three levels of importance. each level of importance was given an estimated value. the first level (very important ) was assigned 3 marks. the second level (important) was assigned 2 marks. the third level (not important) was assigned one mark.  checklist admin istration: the checklist init ial form was submitted to a tefl panel of the jury (7 members) to determine the degree of importance and the appropriateness of each skill to the fifth year efl primary pupils. moreover, the panel of the jury was kindly requested to modify, omit, or add to the ocss checklist whatever they considered important. the jury recommended some modifications; 1) restating the following skill: “listen to identify the words of a story” to “listen to identify the keywords of a story”. 2) omitting some skills 3) confin ing the research to a fewer number of skills to be more manageable and applicable for the final form of the ocss checklist and for all the modifications  checklist validity: in order to obtain the content and the face valid ity of the ocss checklist, the jury responses were statistically calcu lated. the researcher selected the skills that were agreed upon at least by 80% of the jury members. the ju ry indicated 7 skills to be valid, very important and required for the fifth year efl primary pupils. then, two formulas were used to get the percentage and the relative weight of each sub-skill. after validating the checklist, it was concluded that there were seven english ocss to be valid, very important and required for the fifth year efl primary pupils. consequently, those skills were used as a basis for the pre-post ocss test. the selected ocss were operationally defined as follows: listening to identify the keywords of a story: pupils try to identify the keywords during listening to the story. listening and repeating sentences in a story: pupils’ ability to repeat full sentences cut out of the story. listening and answering some questions in a story: pupils think out of the box reflect their understanding of the story events. listening and rearranging the parts of a story: pupils’ ability to predict the init ial and forthcoming parts of a story. describing some p ictures of a story: pupils’ ability to form ideas about things they watch. playing a character role in a story: pupils’ ability to imitate and impersonate others. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 39 published by scholink inc. retelling parts of a story: pupils’ ability to restate and recap the events of a story. 2.4.2 the oral communicat ion skills test  purpose of the test: the main purpose of the test was to measure the efl pupils ’ performance level in the identified seven ocss before and after implementing the tradit ional st and dst in teaching time for english syllabus. another purpose of administering the posttest was to identify if there was any difference between the two experimental groups (digital and traditional st).  test description: based on the identified seven ocss, the final version of the oral communication test was designed. the test consisted of seven questions. all the skills were given the same score for the final fo rm of the oral communicat ion test  test validity: different facets of validity; fo rmative and self-validity were used by the researcher. the format ive validity was obtained by examin ing the content presented to the two experimental groups (tradit ional and digital) with the purpose of determining its objectives to be measured by the test. a. the self-validity this was done through the square root of the validity coefficient which reached (0.86), and it is a high coefficient valid ity which indicates the accuracy of the phrases of the test and their abilities to measure what they are intended to measure. b. construct validity: the validity of the sub-skills of the test was calculated as follows: the calculation of the coefficient correlat ion between the score of the subtest and the total test. table 3. es tablishing test construct validity the contents of the test coefficient correlat ion significance at (0.01) listening 0.712** significant speaking 0.608** significant table 3 proved that the ocss test was statistically valid.  test reliability: in order to verify the test reliability, the internal consistency method was used. cronbach's alpha technique was calculated by (spss) program using (coefficient alpha). accordingly, the test was www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 40 published by scholink inc. administrated to a randomly drawn group of (20) the fifth year primary pupils at ahmed zewail school. those pupils were not included in the study groups. the reliability coefficient of the test was 0.74, see table 3. so, this result proved that the ocss test was statistically reliable. table 4. finding test reliability the test alpha coefficient 0.74 after analyzing the statistical value of the previous table, it can be said that the coefficient consistency of the test as a whole is high which mean that the test was high in the consistency and steadiness.  test piloting: the test was administered to a pilot sample of 20 efl fifth year primary pupils in order to make sure that the questions were understood by pupils. based on piloting the test, it was estimated that a period of 40 minutes would provide suitable time for pupils to answer the test questions . the group used to calculate the test reliab ility was the same group used to estimate the test time. this t ime was estimated according to the time which is taken by all the pupils divided by their number. it was 40 minutes.  test scoring: the test was scored by the researcher; as the questions included in the test with its skills were controlled in scoring. when scoring the question; two marks were given for a ‘complete answer’ of the skill; one mark was given fo r an ‘uncompleted answer’ of the skill and ze ro for ‘wrong or missed answer’ of the skill. thus, the total score of the test was 14 marks as each skill was given two marks.  test instructions: to avoid pupils’ misunderstanding, the researcher exp lained the test content and instructions clearly and orally before admin istering it. the researcher somet imes had to use the arabic language to explain some instructions for the pupils in order to make sure that they understood what is required for each task.  test administration: after modify ing the test items and estimat ing the time according to the result of the test piloting as well as the suggestions offered by the jury, it was pre-admin istered to the two experimental groups on the first of october 2017. the post-test was admin istered to the two experimental groups two days after the experiment, which ended on the 14thof november 2017. post-test conditions were nearly the same as those of the pre-test in terms of time and place. 2.4.3 the semi-structured interview (ssi)  the purpose of the semi-structured interview www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 41 published by scholink inc. the semi st ructured interview aimed at highlighting the most important categories of pupils’ responses to the ocss through st/dst to be developed for the fifth year efl primary pupils and constructing the oral communication responses’ items post-test according to the juries’ opin ions and modifications.  sources of the semi-structured interview: the researcher made use of the stories included in this study, the ocss, the specifications of the activities assigned to the fifth year efl primary pupils in the teachers’ guide to determine if there was anything related to ocp skills. he also consulted the efl primary school teachers, the efl researchers, and curriculum designers to construct the items of the semi structured interview.  the semi-structured interview description: in order to construct the rubric of the semi-structured interview, the researcher reviewed the general english supervision directives of the egyptian ministry of education and the relevant literature and related studies of the english ocss. the semi-structured interview consisted of three main categories including fourteen items (appendix, d). these items are rated for the extent to which “the statement is fulfilled by the pupil” (1=“cannot”, 2=“can hardly”, 3=“can”). the three main ca tegories are basic skills, content understanding skills and learning strategies skills. the basic skills (oral, written and digital), content understanding skills (core knowledge and personal reflect ion) and learning strategies skills. those semi-structured interview items were modified according to the jury panel and used to measure each of the english ocss (listening and speaking).  the semi-structured interview scoring : to let the jury be confined to a part icular standard, the semi-structured interview was designed in three levels of importance appropriateness. each item of importance and appropriateness was given an estimated value. the first item (can) was assigned three marks, the second item (can hardly) was assigned 2 marks, and the third item (cannot) was assigned one mark.  the semi-structured interview administration: the researcher submitted the initial fo rm of the semi-structured interview to a tefl panel of the jury (7 members) to determine the degree of importance and the appropriateness of each item to the fifth year efl primary school pupils. moreover, the panel of the jury was requested to modify, omit , or add to questionnaire whatever they considered important and relevant to the v irtual world of literature. the jury recommended some modifications: 1) restating some words in the ssi to be convenient to the current study as follows: replacing the word ‘story’ with the phrase ‘part of a story’ to be more specific. replacing the second and third categories in the orig inal form of the semi-structured interview namely ‘content understanding and learning strategies’ with a new category proved to be related to the current study after reviewing literature namely ‘oral skills. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 42 published by scholink inc. 2) omitt ing one or two items from each category completely (see appendix, d) and blending all the items under one subtitle as follows: oral skills listen to/understand stories retell a part of a story identify the sounds the keywords of a story identify the characters of a story elicit what a story tells play some roles of the story present some informat ion of the story  the semi-structured interview validity in order to obtain the content and the face valid ity of the semi-structured interview (ssi), the jury's responses were statistically calculated. the researcher selected the response items that were agreed upon at least by 80% of the ju ry members. the jury indicated three categories to be valid, very important and required at the fifth year efl primary school pupils. then, two formulas were used to get the percentage and the relative weight of each item. according to the jury's responses, the percentage and the relative weight of each item of responses to the semi-structured interview were assigned and deducted the final form of the semi-structured interview. the study material (storytelling/digital storytelling) procedure (sessions): this section covers the main procedure for the study and provides a systematic guide to teachers, administrators or any educationists who wish to emulate this study. description the experiment continued for six weeks for both experimental groups as follows: concerning the second group (taught in regular storytelling) the teacher told the stories (the campsite, around the house, the amusement park, food festival, etc.) and the pupils then retold parts of the stories individually in simple sentences. concerning the first group (taught in digital storytelling) the teacher presented the stories using multimedia (computer &data show) to show pupils the stories in powerpoint slides using audio and pictures to encourage the pupils to communicate orally, the teacher asked them to retell parts of the stories in groups. the pupils had the choice of what part of the story to act and how to present it in front of their classmates. (for sessions see page 148) follow-up activit ies steps www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 43 published by scholink inc. 1) in the second session the teacher asked comprehension questions about the stories carefully. he used the usual who, what, where, when, how much, and why questions. 2) he used more creat ive ways of questions like mult iple choice questions and questions that can be answered by inference. 3) the teacher used exercises based on the story such as introduction of new vocabulary in lexical sets, rhyming sets, or grammat ical sets; verbal practice and grammat ical analysis of repeated phrases. 4) the teacher used listening activit ies. after the story, listeners can demonstrate comprehension by: comparing, discriminating, p redicting, sequencing, classifying, transferring informat ion, etc. unlike other listening activities, stories are often repeated, but never in exact ly the same words. a) the teacher did oral act ivities. choral read ing, story fill– in, add-on stories, building a tale from key words, etc. b) the teacher used discussion topics which are taken from the story ’s themes. c) students retold their favorite parts of the stories. 8) the teacher asked pupils to rewrite and summarize the story activities. 9) the teacher encouraged pupils to use visual activities. they used posters, models, collages, crafts, masks, puppets, mobiles, photos, picture stories, blackboard drawing, etc. 10) he encouraged them to do creative drama activities. he prepared dialogues from the stories which can be recited or retold. 11) the teacher organized story corner where pupils can read stories of their own choice and at their own pace. the role of the teacher a critical friend was the english teacher for other fifth grade classes who is very experienced in teaching english to that grade level took part in the experimentation procedures t o help the researcher accomplish this work. group work the researcher created six five-member groups in the fifth grade in each experimental group. he asked each group to arrange and retell the story parts to encourage their oral communication. in the camp site and around the house and around the house stories, the teacher told the beginning of the story and each group was encouraged to think and expect the end of the story in their own words. in the other story the campsite, he told the beginning and the end of the story and pupils were encouraged to create the middle. some of the shy pupils told short but vivid endings and middle parts, whereas the more outgoing pupils gave longer and more viv id components. the teacher observed pupils throughout the story, both when he was telling the stories and when their peers were telling one, to see their reaction. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 44 published by scholink inc. pupils’ reactions (smiling, laughing, some pupils even writ ing new words down, etc.) suggested that the method was effectively communicative. group story outline in one set (3 groups) using dst and the other set (3 groups) using traditional st, pupils decided just to have scripts with pictures to act on (picture reading). however, in six groups, story outlines and scripts with some sketches representing the pictures they intended to draw were handed to the teacher at the end of the lesson, for assessment and feedback. pupils handed in the assessment form, which the teacher went through and gave written comments to mot ivate them. assigning roles group members came to a settlement after long discussions as to what roles each member should take. it turned out that the original criteria under which the groups were formed changed in most of the groups. according to pupils, some of the members were better at play ing certain ro les than the original roles assigned in the creation of the group. in some cases, group members thought some other pupils should take certain roles (e.g., acting, drawing, etc.) other than the ones originally assigned. pupils later d iscussed their decisions with the teacher, exp lain ing that those pupils were taking certain groups such as singing or translating and were already good in those areas. the teacher allowed them to change roles if they were comfortable and better in playing those roles other than the original roles since that would bring out the strongest intelligence in them. even though pupils sat in groups, they performed different ro les, such as drawing, writing songs, or making musical noises here and there. the researcher sent pupils to the school’s sound room for their musical rehearsal. a ll groups communicated their final roles with him for corrections and suggestions before presenting them. pupils accepted some suggestions and rejected others. putting work together (gallery walk) before the final, the teacher checked groups’ roles in the stories. pupils then made posters on which they pasted their drawn pictures according to the beginning, middle and end of their stories. some groups decided to also paste copies of their stories on posters so that after they were posted on walls, other pupils from other classes could see and read the stories they had presented. pupils did the final rehearsal of their stories, ready for presentation in the next step. presentation of group stories pupils came to school more dressed up than usual on the day of their presentation. pupils’ enthusiasm, smiling faces and the way they carried themselves suggested that they were proud of the stories roles and were happy to show what they had learned. the presentation started with group members saying their names, the tit le o f their story. stories had both narrators and translators in the arabic language. one pupil from each group narrated the story; other pupils pointed to the pictures with a pointer; others sang or recited poems, and the more outgoing pupils became the translators for the stories. group www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 45 published by scholink inc. members who had drawn pictures for their group story introduced themselves as the helping group. the whole process brought the scenes of both the campsite and around the house stories in the school playground that day. at the end of the presentation, pupils were given fifteen minutes to respond to a semi-structured interview generally about how they liked telling and p laying the roles of the stories and the st method in teaching them. 3. results the first hypothesis: “there is a statistically significant difference (α ≤ 0.05) between the mean score of the first experimental group (taught in digital storytelling) on the pre-post oral communication test, in favor of the post administration”. the following table shows the results reached: table 6. t-test results of the pre and post measurements of the first experimental group (taught in digital storytelling) oral skills the experimental group (taught in digital storytelling) n mean standard deviation t-test significance effect size listening the pre-admin istration 30 11.36 3.34 5.32** (0.000<=0.05) sign 0.46 the post admin istration 30 14.40 3.72 large speaking the pre-admin istration 30 11.13 2.73 8.44** (0.000<=0.05) sign 0.68 the post admin istration 30 14.53 3.17 large skills as a whole the pre-admin istration 30 22.50 5.40 8.32** (0.000<=0.05) sign 0.60 the post admin istration 30 28.93 5.57 large table 6 shows the following: a) listening skills: as shown in table 6, there is a clear statistically significant difference between the mean scores of the first experimental group (taught in digital storytelling) in the test in favor of the post administration of the post test. in addition, t. calculated shows that there is statistical significance which reached (5.32) and it is higher than t. value which reached (1.69) at the significance level of (0.05). therefore, the first hypothesis is verified as there is statistically significant difference between the mean scores of the first experimental group in the pre-measurement and the post measurement of listening skills in favor of the post-measurement. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 46 published by scholink inc. speaking skills: there is a clear statistically significant difference between the mean scores o f the first experimental group in the test in favor of the post administering. in addition, t. calculated shows that there is statistical significance which reached (8.44) and it is higher than t. value which reached (1.69) at the significant level of (0.05). therefore, the first hypothesis is verified as there is statistically significant difference between the mean scores of the first experimental group in the pre-measurement and the post measurement of speaking skills in favor of the post-measurement. b) the oral communication performance as a whole: there is a clear statistically significant difference between the mean scores of the first experimental group in the test as a whole in favor of the post admin istering. in addition, t. calculated shows that there is statistical significance which reached (8.32) and it is higher than t. value which reached (1.69) at the significant level o f (0.05). therefore, the first hypothesis is verified as there is statistically significant difference between the mean scores of the first experimental group in the pre-measurement and the post measurement of the test in favor of the post-measurement. this means that pupils' communicat ion performance, in general, has developed due to the experimentation. a lso, it can be said that the digital storytelling has a great effect on developing pupil’s skills with a doubt degree at the level of (0.05). table (6) and figure (1) shows that the digital storytelling had a positive effect on developing the overall o ral communication skills of the efl fifth year primary pupils. therefore, this provides enough evidence to support hypothesis one. according to the referential framework of the effect size, it is apparent that digital storytelling has a large effect size. the second hypothesis states that “there is a statistically significant difference (α ≤ 0.05) between the mean score of the second experimental group (taught in traditional storytelling) on the pre -post oral communicat ion test, in favor of the latter”. the following table shows the results reached: table 7. the results of the pre and post measurement of the first experimental group pupils on the skills test as a whole the experimental group (taught in tradit ional storytelling) n mean standard deviation t-test significance effect size listening the pre-admin istration 30 11.33 3.55 4.97** sign 0.42 the post admin istration 30 13.16 3.44 large speaking the pre-admin istration 34 11.06 2.46 5.64** sign 0.49 the post admin istration 34 12.43 2.12 large skills as a the pre-admin istration 34 22.40 4.87 7.73** sign 0.64 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 47 published by scholink inc. whole the post admin istration 34 25.60 4.70 large discussion table 7 shows the following: a) listening skills: there is a clear statistically significant difference between the mean scores of the second experimental group in the test in favor of the post administering. in addition, calcu lated t. value shows that there is statistical significance which reached (4.97) and it is higher than t. value which reached (1.69) at the significant level of (0.05), therefore, the second hypothesis is verified as there is a statistically significant difference between the mean scores of the second experimental group in the pre-measurement and the post measurement of listening skills in favor of the post -measurement. b) speaking skills: there is a clear statistically significant difference between the mean scores of the second experimental group in the test in favor of the post administering. in addit ion, t. calculated shows that there is statistical significance which reached (5.64) and it is higher than t. value which reached (1.69) at the significant level o f (0.05), there for the second hypothesis is verified as there is statistically significant difference between the mean scores of the second experimental group in the pre-measurement and the post measurement of speaking skills in favor of the post-measurement. c) oral communicat ion skills as a whole: there is a clear statistically s ignificant difference between the mean scores of the second experimental group in the test as a whole in favor of the post admin istering. in addition, t. calculated shows that there is statistical significance which reached (7.73) and it is higher than t. value which reached (1.69) at the significant level of (0.05). therefore, the second hypothesis is verified as there is statistically significant difference between the mean scores of the second experimental group in the pre-measurement and the post measurement of the test in favor of the post-measurement. th is means that pupils' communication skills, in general, has developed due to the experimentation. also, it can be said that storytelling has a great effect on developing pupils’ oral communicat ion perfo rmance with a doubt degree at the level of (0.05). table 7 and show that storytelling had a positive effect on developing the overall o ral communication skills of the efl fifth year primary pupils. therefore, this provides enough evidence to support hypothesis one. according to the referential framework of the effect size, it is apparent that traditional storytelling has a large effect size. the third hypothesis states that "there is a statistically significant difference (α ≤ 0.05) between the mean score of the first experimental group (taught in dig ital storytelling) and that of the second experimental group (taught in traditional storytelling) in the post -test of oral communication. the following table shows the results reached: www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 48 published by scholink inc. table 8. the results of the first experimental group and second experimental group in the post administration of the communication test as a whole the post admin istration n mean standard deviation t-test significance effect size listening the first experimental group (taught in digital storytelling) 30 14.40 3.72 1.33 (0.189>=0.05) not significance at 0.05 0.030 the second experimental group (taught in storytelling) 30 13.16 3.44 low speaking the first experimental group 30 14.53 3.17 3.01** (0.004>=0.05) significance at 0.05 0.15 the second experimental group 30 12.43 2.12 large skills as a whole the first experimental group 30 28.93 5.57 2.50* (0.015>=0.05) significance at 0.05 0.11 the second experimental group 30 25.60 4.70 average discussion a) listening skills: table 8 clarifies that the pupils ’ mean score in the first group of the listening skills as a whole is (14.40), whereas the pupils’ mean scores in the second experimental group of the listening skills as a whole are (13.16). so, the pupils’ mean score in the first experimental group was higher than their mean score in the second experimental group. the above table also clarifies that the calculated t value, which reached (1.33), which indicates that there is no significant statistical d ifference between the pupils' mean scores in the first and second experimental group of the listening skills as a whole. it was compared with the value of t table in order to know the significance level. it was found to be (2.00) at the level of (0.05). b) speaking skills: table 8 clarifies that the pupils ’ mean score in the first group of the speaking skills as a whole is (14.53) whereas the pupils’ mean scores in the second experimental group of the speaking skills as a whole are (12.43). so, the pupils’ mean score in the first experimental group was higher than their mean score in the second experimental group. the above table also clarifies that the calculated t value, which reached (3.01), which indicates a significant statistical d ifference between the pupils ’ mean scores in the first and second experimental group of the speaking skills as a whole. it was compared with the value of t www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 49 published by scholink inc. table in order to know the significance level. it was found to be (2.00) at the level of (0.05). c) oral communicat ion skills as a whole: table 8 clarifies that the pupils ’ mean score in the first group of the oral communications as a whole is (28.93), whereas the pupils’ mean scores in the second experimental group of the oral communication as a whole are (25.60). so, the pupils ’ mean score in the first experimental group was h igher than their mean score in the second experimental group. the above table also clarifies that the calcu lated t value, which reached (2.50), which indicates a significant statistical difference between the pup ils' mean scores in the first and second experimental group of the oral communications skills as a whole. it was compared with the value of t table in order to know the significance level. it was found to be (2.00) at the level of (0.05). the semi-structured interview statistics the following table shows the results reached: table 9. the results of the first experimental group and second experimental group in the post administration of the semi-structured interview test as a whole the post administration n mean standard deviation t-test significance effect size listen to and understand the story the second experimental group 30 3.0 not significance at 0.05 the first experimental group 30 3.00 retell a part of the story the second experimental group 30 2.36 0.76 1.29 (0.200>=0.05) significance at 0.05 0.04 the first experimental group 30 2.60 0.62 large say the key words of the story the second experimental group 30 2.50 0.57 0.61 (0.538>=0.05) not significance at 0.05 0.01 the first experimental group 30 2.60 0.67 low recognize the characters of the story the second experimental group 30 2.80 0.48 significance at 0.05 the first experimental group 30 2.80 0.48 elicit what the story tells the second 30 2.26 0.78 0.72 (0.469>=0.05) 0.015 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 50 published by scholink inc. experimental group not significance at 0.05 the first experimental group 30 2.40 0.62 average play the roles in the story the second experimental group 30 2.33 0.80 2.16 (0.035<=0.05) significance at 0.05 0.12 the first experimental group 30 2.70 0.46 low present some in formation of the story the second experimental group 30 2.23 0.72 2.60 (0.004<=0.012) significance at 0.05 0.17 the first experimental group 30 2.66 0.54 large as a whole the second experimental group 30 17.50 2.14 2.62 (0.011<=0.05) significance at 0.05 0.11 the first experimental group 30 18.76 1.54 average table 9 clarifies that the pupils ’ mean score in the first group of the semi-structured interview as a whole is (18.76), whereas the pupils ’ mean scores in the second experimental group of the speaking skills as a whole are (17.50). so, the pupils' mean score in the first experimental group was higher than their mean score in the second experimental group. the above table also clarifies that the calculated t value, which reached (2.62), which indicates a significant statistical difference between the pupils' mean scores in the first and second experimental group of the semi-structured interview as a whole. it was compared with the value of t table in order to know the significance level. it was found to be (2.00) at the level of (0.05). 4. discussion the results of the present study, the post-test results and the semi-structured interview results, proved that storytelling (tradit ional and digital) had a positive effect on developing the english oral communicat ion performance. therefore , the significant difference which was found on the post administration may be due to exposing such sample to the reflective learn ing using storytelling. this result agrees with the studies of richard (2006), tsou, wang and zeng (2006), belmonte (2007), lester (2008), rains (2009), rahman (2010), kearney (2011), efrizal (2012), alam, bashiruddin, ampha jenprai (2013), odoubwu and oluwakemi (2014), and seckin celik (2016). which approved the significance of storytelling on developing the english oral communication performance of primary school pupils. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 51 published by scholink inc. main findings can be summarized as follows: 1) there is a statistically significant difference between the mean scores of the first experimental group (taught in digital storytelling) on the pre-post-admin istration of the oral communication test, in favor of the latter. 2) there is a statistically significant difference between the mean scores of the second experimental group (taught in storytelling) on the pre-post administrations of the oral communication test, in favor of the post-test results. 3) there is a statistically significant difference between the mean scores of the first experimental group (taught in digital storytelling) and that of the second experimental group (taught in storytelling) on the post-admin istration of the oral communication test, in favor of the first experimental group. 4) there were also highly significant differences between the first experimental pupils’ scores and the second experimental pupils’ scores on the post measurement of the semi-structured interview in favor of the first experimental group (taught in digital storytelling) 5) storytelling/digital storytelling has an effect on developing efl oral communication performance among fifth year efl primary pupils. reflective log what have been achieved: the current study emphasized the effect of digital storytelling on d eveloping the oral communication skills especially listening and speaking. and this supported the previous researches results of: richard (2006), tsou, wang and zeng (2006), belmonte (2007), lester (2008), rains (2009), rahman (2010), kearney (2011), efrizal (2012), alam, bashiruddin, ampha jenprai (2013), odoubwu and oluwakemi (2014), and seckin celik (2016). in addition, the current study emphasized the effect o f trad itional storytelling on developing the oral communication skills especially listening and speaking. and this supported the previous researches results of: bas (2008), reeder (2009), hsu,trudel and voho (2010), brady and millard (2012), leahy (2013), eman mohamedand, hasnaa sabry, kirby and perrin (2014), byrine, katsara and zandian (2015), yim (2016), and january and mostafa (2017). what have not been achieved: the sample size was about 60 pupils and they represented one elementary school of thousands of schools in egypt. this was one of the limitations which faced the researcher as it was difficu lt to generalize the results on all the egyptian elementary schools. so, the researcher hopes that the results could be generalized on all the elementary schools to improve the oral communicat ion performance. 5. conclusions this chapter presented the findings, discussions of results. accordingly, the main question which stated “what is the effect of storytelling vs digital storytelling on developing the primary school pupils ’ efl www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 52 published by scholink inc. oral communicat ion performance?” was answered as it was approved that there is a highly significant difference between the mean scores of the pre and post admin istration of the two experimental groups test in favor of the post one. in addition, it was proved that the first experimental g roup’s performance was higher than that of the second experimental group. summary, recommendations derived from these findings and suggestions for further research. references ahern, a. k., bermejo, m. l. g., & fleta, t. (2008). holistic learn ing through stories: children’s literature in the efl classroom. elt in primary education, 98-103. akkari, a. (2004). education in the middle east and north africa: the current situation and future challenges. international education journal, 5(2), 144-153. elmeshad, s. (2012). egypt’s school system: taking a look at schools, their curricula, and accreditation . egypt independent newspaper. ginsburg, m. (2010). improving educational quality through active-learning pedagogies: a comparison of five case studies. educational research, 1(3), 62-74. haridy, a. s. m. (2012). investigating the developments of the methodologies used in english textbooks in the egyptian public schools: a descriptive study. jalongo, m. r. (2008). beyond a pets theme: teaching young children to in teract safely with dogs. early childhood education journal, 36(1), 39-45. https://doi.org/10.1007/s10643-008-0272-1 juraid, r. a., ibrah im, m. m. a., methods, t., & munawrah, m. (2016). the effectof storytellingon developing communication skillsof efl females studentsandtheir attitudestowards it, 5(november). mostafa, m. k. i. (2017). the effect of chants and short stories on primary stage pupils’ communicat ion and attitudes. world journal of educational psychology, 1, 1. patil, z. n. (2008). rethinking the objectives of teaching english in asia. asian efl journal, 10(4), 227-240. ryokai, k., vaucelle, c., & cassell, j. (2003). virtual peers as partners in storytelling and literacy learning. journal of computer assisted learning , 19(january), 195-208. https://doi.org/10.1046/j.0266-4909.2003.00020.x schady, n. (2011). parents’ education, mothers’ vocabulary, and cognitive development in early childhood: longitudinal evidence from ecuador. american journal of public health , 101(12), 2299-2307. https://doi.org/10.2105/ajph.2011.300253 shiel, g., cregan, á., mcgough, a., & archer, p. (2012). oral language in early childhood and primary education (3-8 years). dublin : national council fo r. songsiri, m. (2007). an action research study of promoting students’ confidence in speaking english, www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 53 published by scholink inc. (march). tatum, m. e. m. (2009). digital storytelling as a cultural-historical activity: effects on information text comprehension. thapa, a., cohen, j., guffey, s., & higgins -d’alessandro, a. (2013). a review of school climate research. review of educational research , 83(3), 357-385. https://doi.org/10.3102/0034654313483907 zhang, y. (2009). reading to speak: integrating oral communicat ion skills. english teaching forum. retrieved from http://eric.ed.gov/?id=ej923446 widodo, h. p. (2016b). engaging young learners of english in a genre-based digital storytelling project, (march). retrieved from http://languageresearch.cambridge.org/images/pdf/2015-16_widodo_cup_trp_final_report.pdf children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 5, no. 2, 2022 www.scholink.org/ojs/index.php/ct 1 original paper analysis of the discourse of disrespect of women in politics: hating hillary and getting gillard dr pamela d schulz oam 1* 1 senior adjunct research fellow, school of law justice and society, university of south australia, adelaide, australia (oam order of australia medal) * pamela d schulz, senior adjunct research fellow, school of law justice and society, university of south australia, adelaide, australia received: october 10, 2022 accepted: october 26, 2022 online published: november 3, 2022 doi:10.22158/ct.v5n2p1 url: http://dx.doi.org/10.22158/ct.v5n2p1 abstract from june 2010 until june 24th 2013, and at times into 2014 the then prime minister of australia the honourable ms julia gillard was subjected to the most intense and ruthless political rhetoric ever seen in australian media. personal attacks and talk back callers openly admitting they “hated her” and calling into question her mental state and hormonal status was just part of a brutal media campaign aided and abetted by opposition leader in tony abbott. he linguistically derailed a reforming and intelligent woman who held together a minority parliament which delivered significant legislation. in addition, a selection of media articles and a review of media analysis of the candidacy of hillary clinton in preparing a run for the white house in the usa during the years 2015-2016 echoes eerie parallels to a sub textual cultural discourse of misogyny especially in politics. this discourse analysis and media study questions whether the core of the real matilda misogyny reported by miriam dixson in australia since 1976 is alive and well and lingers on in our linguistic heritage. the polarisation of political debate and concomitant bias some media quarters is analysed and shown to have a significant pattern beginning with disapproval and ending in directional linguistic commands from media. the end result was that the politicians listened to the unrelenting chorus of demands to “end leadership speculation “and complete chaos and to go to an election. keywords women, misogyny, disrespect, politics, discourse www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 2 published by scholink inc. introduction: women and politics in ancient times there was indeed a celebration of women who could argue their case and be seen as shining examples in discourse between armies and ideologies. indeed, as plutarch (translated by goodwin 1684) noted: “the women placing themselves between the armies, took up the controversies, argued them so accurately, and determined them so impartially, that an admirable friendly correspondence and general amity ensued, both civil and domestic. hence the celts made it their practice to take women into consultation about peace or war, and to use them as mediators in any controversies that arose between them and their allies” there is scant literature on the discourse of politics and women, but it is replete with actual representations of misogyny and gender inequality in general media and society. for example, the early work of miriam dixson in the book the real matilda which was first published in in 1976 to a hostile reception showed a highly segmented work force and a discourse of sexism directed at women who were often known as sheilas. the notion that women were not equal was anathema at this time. this is despite australia having been one of the first places in the western world to give women the right to stand and vote in elections (including aboriginal women) as early as 1896. new zealand often seen as a cousin to australia “across the ditch” (note 1) gave women the vote in 1894 two decades ahead of britain and of course the usa. dixson has since been well and truly proved correct despite the 40 years that has transpired since it rings true. a more recent edition echoes these views (1994; 1999, p. 84) which outlines the strong and continual mistrust of women in australian history. she noted this when she suggested: “some might argue that the greateer the social weight of aristocrat and bourgeois the less democratic by definition, the moral economy of a community. so if historians, political philosophers and political scientists were to begin to consider the sitiatuaion of women with any intellectual seriousness, they might then have to recasst some basic conceptual structures. if they were to include women as a first approximation, on emihgt have to begin with an apparently paradoxical furmulation: the greater the degree of democracy, the greater the misogyny,…‘demos’ means people. a more accurate term would clearly be ‘andocracy’”. she adds that the key standards on which modern democracy are based are masculine and that the fundamental political discourses may need to be reconfigured in some way. this is echoed in the work of other political and discourse analysts where examples of gender bias are overtly noted and discussed (delahunty, 2014; goldsworthy, 2013; campbell, 2012). there is a consistent avenue of discourse which highlights the notion of gender wars or when women themselves raise the issues related to misogynistic issues, they are often accused of playing the “gender card”. for example, in britain research has shown a similar focus on women in political battles and are highlighted for entertainment in media (coole, 1993; fairclough, 1995). coole highlights the historical evidence which is cited by www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 3 published by scholink inc. her of rousseau and aristotle both of whom ascribe to women “natural characteristics” as evidence of their womanly roles. indeed, she states: “the characteristics ascribed to women rob them of their credentials for citizenship: they lack the right sort of reason, autonomy, judgement, sense of justice and the ability to consent”. this view was brought into sharp relief when mr donald trump suggested he could sexually push himself onto a woman because he was “famous…and they let you do it”. this notion that a woman lacks this ability to consent when faced with fame and fortune was strongly evident throughout the campaign. fairclough (1995, p. 44) echoes this view by suggesting that the mass media has in the last decades become a form of entertainment and that audiences are manipulated so that they are “spectators” rather than citizen participants. the visual and active process of debate and discussion of issues is left to media to shape and in some instances set the ideological agenda. what trump managed to do is shift the agenda to uncertainty which in itself became the news. in recent times and especially during his candidacy for the us presidency donald trump the nominee for the republican party usa presidential election has himself incurred the wrath of political feminist researchers and media alike by referring to women in pejorative language. some examples have been significantly vitriolic and would in any other context other than the political sphere be considered as clearly inappropriate. it also suggests a latent hatred of women. a list of them has been identified by nadia bahadur (2015) which emphasise a notion that perhaps women have no place in holding political or public office. his constant attacks on women in general appear to have any place in modern democracy but nevertheless the frequency of his comments are now legendary website and active on social media. one example a tweet which suggested that presidential candidate for the democratic party in the us presidential race hillary rodham clinton “cannot satisfy her husband” appears on the bahadur (2015) webpage. method the entire study took over three years and has been in a draft format seeking feedback and comments since then on collegial terms with other discourse scholars the results of which are this current political and discourse analysis modified and corrected over the last few years. from 2010-2014 a series of headlines, stories and media platforms totalling more than 175 news sites, television news channels, printed newspapers, and social media sites were examined and subjected to a media discourse analysis. areas that were examined in detail included the following: • themes and topics which occurred on a significant basis • descriptors and adjectival clauses used to report on women in political life as they were seen at press conferences and on television programs reporting on the political day to day drama as chosen by television reporters and political commentators on various media platforms www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 4 published by scholink inc. • frequency anaphora or repetition: this type of study first identified by altheide (2003) and aronson (1994) in which the frequency of themes and topics are seen as a measure of author mindset • metaphor: often used in political discourse to describe culturally appropriate information so that a collective understanding is delivered to the audience. this has been described in detailed by lakoff and johnston (2003) as a way of defining a set of beliefs such as conflict (factional fighting) and chaos marking a style of politics. indeed, the notion of political debate being full of fire and discord is also characterised by elections as a type of horse race or race to the finish a style of metaphor which shows people “running for office” and being able to defeat an opponent. some media platforms considered for this discourse analysis were in fact called infowars. • topoi or collective belief systems delivered via media or language. within society the notion of a collective belief in democracy is often used by politicians to promote their view in fact history as a foundation of political democratic development has been seen by many theorists as a way of determining the mindset of media and reportage according to shenhav (2006) and that this can lead to a point of view being considered as true or representative. media stories and media sensationalism for anyone with red hair in the world there is an apparent discriminatory situation which is known and reported as “gingerism”. since 1652 and even earlier the problem with red heads has been documented as in this advice given by gillemeau in 1612 for choosing a wet nurse to feed a baby: (note the archaic spelling of this extract) “she must not be deformed, neither squint-ey’d, lame, nor crump shouldred: she must be one that is healthfull, and not subject to any disease: the complexion and colour of her bodie, must be lively, and rosie; she must not be spotted with rednesse, and especially she should not have red hair ( bold my input): and therefore, such as are of a browne complexion, are held to be best, whose haire is of a chest-nut colour, betweene yellow and blacke”. excerpt from childbirth or the happy deliverie of women by james guillemeau, london 1612. reproduced by dacapo press, the english experience series, no. 464, 1972. transcribed from the original by jacquelyn j. smith clearly being a red head and female (note 2) has been a problem for sections of the media and community…julia gillard, the red headed politician, lawyer, first female prime minister of australia has been signally brutalised by media and community. this paper seeks to explain what happened and whether it could happen again. again, in many articles there have been references to her red hair or supposed red headed temperament. indeed, from the first few days of her elevation by the australian labor party caucus (unopposed) to the position of leader and therefore prime minister she was www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 5 published by scholink inc. subjected to advice about being a red-haired leader (wilson, 2010). this article begins with comparisons between a former queen of england elizabeth 1 and how she rose to power as the result of bloody factional fighting which had been “ripping the country apart” and this was seen as an “echo of the day 452 years ago” when a subject exclaimed “oh lord the queen is a woman!”. other articles from business chic related to her style and dress sense right from the very beginning and suggested ways in which to attain style for the “top job”. it would appear that from the very beginning ms gillard was a marked woman. other commentary noted that she was indeed a “ranga” australian slang for a red headed person. this refers to the colour of orang outangs (the colour of jungle people as the words translates from bahasa malay and indonesian) this was often used to suggest by hard line radio talk show hosts that she somehow used the “rule of the jungle” to attain power. she was marked for being female, for being a red head, for being smart, for being unmarried, and for being childless and more of that can be considered later in this paper. hillary clinton is also marked for her style and lack of glamour and indeed her age is also is question. in addition shock jock style magazines are questioning her health and ability. for example, the “new dawn” magazine suggests that she has a significant oral cancer and that her strange speaking style is due to this anomaly. are the media to blame? media analysts talk about and research the main frameworks which outline stories that are considered suitable to print and publish in any media platform. the fit within this summarised form that i have identified using the work of the glasgow school as a guide “emotion; sensation; conflict; division and celebrity” the old adage if it bleeds it leads only now works with a sensational addition. this happened when megyn kelly fox news host interviewed donald trump in august 2015 and he retaliated with his reply to probing questions that she must be “bleeding from i don’t know where” and casting aspersions on female menstrual cycles. she had probed him about a range of matters on the campaign trail and kelly also pressed trump about misogynistic and sexist comments that he made in the past, such as calling some women "fat pigs, dogs, slobs, and disgusting animals (yan, 2015)”. the media according to tanner (2011) see politics as a form of entertainment and that politicians are fair game and are seen as performance artists. the sheila “who asked for it” in australia the term “sheila” while also being a female name is often used for a collective term for women. in australian folklore the term is often used a pejorative term for women of a lower class by men (often called blokes in australia) who consider all women who stand out from the crowd as fair game. for anyone accessing media of any kind in the period 2010 to the end of june 2013 when prime minister julia gillard lost a caucus ballot of the parliamentary australian labor party, they would have www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 6 published by scholink inc. expected this outcome. an unrelenting and brutal linguistic attack on the person of this prime minister (pm) is unheralded in australian politics. traditionally politics is played fairly and squarely and attacks on policy and their implementation are fair game. but for australia in the period of minority government 2010-2013 a campaign of destabilisation attributed to the former deposed pm kevin rudd found…this campaign was aided and abetted by a ruthless mainstream media still in thrall to the notion of politics as a contest; a horse race or football match with winners and losers identified. the minority parliament which required constant negotiation and working with traditional political foes did not sit well with the business community, the press gallery who prefer the notion of contest between two parties. eventually the general public were persuaded by this and grew to dislike this style of politics. during the election campaign called by ms gillard following the deposing of kevin rudd in 2010 the media were treated to ongoing “leaks” about her lack of commitment to national security, her betrayal of pensioners, and her obvious power-hungry behaviours. this is carefully documented by kerry ann walsh (2013) in her seminal analysis of the media in her book where she documents these continued attacks reported faithfully by the mainstream media and in turn the talk back radio hosts who took to criticising her via the shock jocks approach. terminology such as “menopausal monster” “bob brown’s bitch” “hate her” and “she should be taken to sea in a chaff bag and drowned” and even questioning her parents as too “ugly to conceive her” and should have “taken precautions” were not uncommon. during this period, she was subjected to what many people have suggested was the fiercest and most prolonged hate campaign ever seen in australian politics (see for example the mama mia (2013) website for a brief summary of this). in addition, there is strong evidence cited by many authors that there is a streak of misogyny that runs throughout australian political history and in some other cultures such as america where the notion of women as equals has been at the forefront of community pride. this is not borne out in my research. for example, anna goldsworthy calls this “unfinished business: sex freedom and misogyny” in her essay which details a long and unhappy history of sexism in australia. citing former minister for foreign affairs in the howard government as an example where he is quoted as saying “i think it is disgraceful to go around calling people sexist and misogynist” on sky news (goldsworthy, 2013, p. 14). in the quarterly essay she notes that: “his objection is not that it was disgraceful to be sexist of misogynist; nor that it is disgraceful to call people sexist and misogynist inaccurately; simply that it’s disgraceful to use these words at all”. (goldsworthy, 2013, p. 14) in response to the now famous misogyny speech delivered in the national australian parliament in october 2012 it become obvious that ms gillard as pm had struck a chord with a community not just in australia but around the world. the speech was widely reported both in australia and abroad. nevertheless, it sparked a series of media commentary in which she was accused of “playing the www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 7 published by scholink inc. gender card” and where paul sheehan columnist in the sydney morning herald suggested that this had become a driver of the politics of hate in australia. later he also wrote: “when her standing sank and her government was in real trouble, and several cynical deals were unravelling, the first woman prime minister played the gender card. she threw mud and called it misogyny. for her passion and her eloquence on that day she has been roundly praised but it was a desperate act and it helped create an astounding gender gap”. (sheehan 2013 web page 1) in fact it has been widely reported that despite the adversarial nature of politics where opposing sides determine and debate policy that ms gillard had more than one opposition to her term of office. erik jensen (2013) argues that kevin rudd the former pm waged a continuous campaign to regain office by co-opting the media to great effect. this campaign was waged with the help of social media platforms, twitter and facebook as well as significantly placed commentary and media releases each time ms gillard made announcements designed to highlight the positive aspects of new legislation or policy developments. these were clearly highlighted by walsh (2013) showing instances of competing media interest whenever rudd (former prime minister) made appearances clearly in contest with her and her team. hillary hated by media shows a similar trait mrs clinton is often shown as lacking in integrity and a liar. thus in media analysis some lexical choices clearly identify of whom the constituency should be afraid. some media have reported the strange and often disgraceful comments made not only about mrs clinton but direct to reporters who dare to ask him to probe questions and despite the shortcomings identified of mr trump and his rhetoric it is mrs clinton who is consistently reported as having difficulty in relating with the community. the media have consistently suggested that somehow the racist and bigoted comments attributed to mr trump (see for example his comments on muslims and mexican immigrants) are connecting with people who are afraid and left behind. commentators even while visiting australia have suggested that mrs clinton is the embodiment of what to “hate” in a politician standing for office. this view has been aired on programs such as the popular comedic review of american politics here on australian abc television known as planet america. mrs clinton is often referred to as elite and part of the “washington elite”. further research of websites related to the so called unpopularity of mrs clinton described in a recent google search showed no less than 23,000 sites devoted to this topic alone. one example included an article by matthew continetti from the national review dated november 7th 2015 which gave a listing of her failures and how she could be beaten at the polls. within this article was a report of a cbs poll which reported that 64% of the respondents concluded that mrs clinton was “not honest” and considered as “untrustworthy”. richter (2016) also considers that she will be an abject failure and www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 8 published by scholink inc. several stories of this ilk are to be found on line. a recent content analysis showed that in identifying ms clinton in media reports mr donald trump the republican nominee for the presidential election has referred to her as being “crooked” and a criminal on more than 70 occasions. this of course is amplified by the number of media stories and social media platforms that echo these sentiments. in recent times mr trump has been referring to hillary clinton as hitlery [sic] clinton and this has been echoed by website and social media ad infinitum. military and conflict metaphor a feature of gillard being instated by the labor party caucus and her coming to power reportage of her time as prime minister most of the reportage of the deposition of june 2010 clearly used conflict and military metaphor to highlight the seriousness of the situation. a selection of articles considered for this article shows a strong preference for suggesting that ms gillard had overthrown the former pm in some sort of coup d’etat. a striking number of lexical choices indicate this view. some examples of this genre echo the work of schulz (2010) and teo (2008) who indicate that marginalising unwanted members of society or a group is often done by describing them as aggressive, ruthless and cold. this is clearly identified in various headlines just following the deposition via the party room, and later after kevin rudd was reinstated. it should be noted for international readers that the leadership of the party in power in australia is the gift of party room by ballot and negotiation of numbers and not through voting via the ballot box. • gillard takes top job in bloodless coup “the 7-30 report” abc and on line at http://www.abc.net.au/7.30/content/2010/s2936441.htm • gillard knifes rudd in bloodless coup abc report 24th june 2010 • prime minister julia gillard reveals why i knifed kevin rudd news.com.au june 18th 2011 • rudd knifed • rudd decapitated • gillard knifes rudd in overnight coup • kevin rudd calls julia gillard a coup plotter and backstabber “the australian” sept 24th 2014 • bloodied but unbowed rudd returns • where gillard went wrong “catallaxy files” june 23d 2013 • the battle for supremacy gillard… gillard prevails in leadership battle sydney morning herald http://www.smh.com.au/federal-politics/political-news/gillard-prevails-in-leadership-battle-20 120226-1txbz.html • gillard attacks abbott the famous misogyny speech in which prime minister julia gillard responds to what she believes is overt sexism in the australian parliament…https://www.youtube.com/watch?v=jegeoozoude and seen millions of times on youtube. the above selection is reflected in thousands of blogs, on line reports and news stories which shows ms www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 9 published by scholink inc. gillard as antagonistic and belligerent in her approach to parliamentary debate. several theorists have described the traditional methods of debate in modern democracy as significant in how it responds to protagonists…recent media reports highlight conflict as a significant factor in stories contesting policy and ideas. for example “war breaks out” is often a precursor of headlines and echoes the work of teo (2001) who identified conflict as way of “othering”. dumbing down democracy and the failure to report nuance and complexity lindsay tanner (2011, p. 36) a former minister in the ruddgillard australian federal governments has suggested in his book sideshow: dumbing down democracy has suggested that the focus on trivia, titillation and distortion has allowed the news media to see politics as a sideshow worthy of entertainment where and when serious issues are set to one side and ignored. this is to the detriment of modern democracy where what is said and how it is said is constantly in the news, but the major issues ignored. for example, in australia the race discrimination act section 18c allows people who are offended or insulted to lodge a claim. this issue is under constant debate and review and subject to a myriad of controversial commentary. however, during the insulting of julia gillard pm in her time in office not once did the commentariat suggest that she too could have lodged her own claim of being offended? for example some insulting lexical choices have included the following in headlines for both women who it seemed could not turn the tide of unpopularity. these can be easily accessed through on line posts and archived news stories. table 1. topoi in discourse as a reporting genre julia gillard lexis juxtaposed in headlines and stories hillary clinton lexis juxtaposed in headlines and stories road kill liar anger crooked power hungry improper practices toppled unpopular juliar ( julia liar implicit) liar red headed, ranga ( taken from red coloured orang-utang) blonde haired (fake) grandmother witch /bitch bitch dominant power domineering deliberately barren by choice absent mother unmarried ( living with partner ) married to lying cheating former president execution of pm in office back stabber big arse ( large bottom hips) dress sense questioned www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 10 published by scholink inc. fierce domineering lemke’s (1998) view is that discourse analysis should always include a number of resources and strategies, such as lexis and grammar, rhetorical formations, and the construction of thematic formations and cohesion chains; the whole set building upwards, as broader formations are detected with the same “patterning” of responses. such elements are used in assembly of any discourse describing and surrounding a reality, to reveal the particular characteristics of a community and its public perceptions. this is echoed in the work of fairclough (1995), who indicates that powerful participants within a given communication format can control and constrain what is said or done within a particular discourse. nowhere is this more evident than in the constraints imposed on the political female candidates by the commentators and reporters, within their own professional “habitus’ (bourdieu, 2003, p. 101). the reporters and political commentariat, by their very situation, are architects of a punctiliously observed set of ideas on how and what to say when writing about politics. echoed in the work of tanner (2015) there is a view that the entertainment value takes precedence followed by what mc combs and shaw indicate is the framing sequences. my own view (schulz & cannon, 2013) is seen as connecting with emotion sensation division conflict and celebrity where those in the spotlight are often placed on trial by the media for trivial “gotcha moments” or what they were wearing on the day of the report. for example ms gillard’s jackets were so often remarked upon that they literally had their own twitter hashtag. in fact many stories devoted to ms gillard fashion sense or “dressing for power” moments were faithfully recorded. when celebrities or others are persuaded to comment, either within their own professional circles or in response to some of the issues raised about the reportage a, their topoi are strongly connected to community understanding of politics current public opinion, media reporting, and those outcomes which relate directly to community concerns and issues of public confidence. it is surprising then to note that germaine greer a known feminist provocateur had a derogatory attack about the way ms gillard was dressed (august 27th 2012). she could only muster comment about the size of ms gillard’s bottom in her preferred jackets which left a highly acclaimed abc australia program qanda audience laughing but serious political scholars amazed that a feminist scholar of some note could be so negative about a woman in power. it is thus where the discourse community of media in all its forms show a consistency of effort in topoi or themed topics which reappear time and time again in discussion within a discourse community that is in charge over what is to be considered and to be reported. when it is political debate over two high profile women at different ends of the earth who attain power it is clear that the media set the tone and tenor of reportage which is then echoed in the new public square of cyberspace. the topoi of appearance www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 11 published by scholink inc. the topoi of appearance was a constant theme in mrs clinton’s candidacy for the presidency and many websites attested to this theme. this was a common one held by media commentary within the confines of celebrity and how they deem those in the news are supposed to be presented. this is echoed strongly by media scholars who suggest that the cult of celebrity is a known two way approach to relationships with media (bennett hall & holmes, 2008). in a way the notion of schadenfreude as outlined by cross and littler (2010 cited in harvey et al below) indicates a type of attack against privileged people such as politicians who are constantly in the limelight and evaluated via public opinion. for example one website the daily wire suggested that hillary had worn the “ugliest outfit in human history”. in a similar vein the topoi of appearance was credited in the discourse related to hillary clinton’s underperforming in engaging young female voters by suggesting that she had made several fashion failures which led to her poor polling with this demographic by the federalist websites in april 2016. “cross and littler (2010) locate schadenfreude as a ‘trans-individual affective pro-cess of resentment’ and response to the contemporary political conjecture of neoliberal capitalism, where individuals have a ‘desire for equality but [are] unable to think of anything other than levelling through humiliation’ (p. 397)” cited in harvey allen and mendinck, 2015) some examples of this appear in a myriad of websites from traditional mainstream media to off grid conspiratorial websites which heralded negative commentary about the candidate and her appearance throughout the campaign. several media stories about mrs clinton’s appearance showed her with an open mouth and evidence of a supposed tongue biopsy as proof of her inability to lead the nation. the conservative tree house website (july 31, 2016) condemned her for a number of ailments which had not been publicly mentioned in mainstream media and which was affecting her appearance with the american public. criticism of mrs clinton was unrelenting and constantly upbraided her fashion style, weight and health profiles. similarly ms gillard was also subjected to the discourse topoi of appearance and one example of the blue shoe lost in a secret service removal of ms gillard from turmoil and a significant scuffle was a prime example of this genre. the media were busy reminding the community that gillard lost her blue shoe in the active strong armed escort, and that she had stumbled once too often, lost her footing politically, and avoiding framing her in a narrative of the victim of protesters (generated by remarks reportedly made by the then opposition leader mr tony abbott) but rather as a metaphor for how her prime ministership was also stumbling and tripping over. such lexical choices were indeed pejorative and according to some researchers set the tone for public opinion. for example hallahan (1999) suggests that knowledge of political issues and candidates can be set in media frames that encourages a point of view and sets the tone for reporting and commentary: “mccombs (2004) labelled the media's ability also to frame attributes as second-order agenda setting or frame setting. the extension of the familiar description of www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 12 published by scholink inc. agenda-setting thus suggests, although media are not necessarily effective in telling people what to think, media can be strikingly effective in telling people what to think about—and how to think about it”. (hallahan, 1999, p. 213) the tone of commentary was thereafter very pejorative and focussed on the federal government’s inability to get anything right and that ms gillard stumbled and tripped from one disaster to another on a regular basis. such reporting is according to mc combs and form of agenda-setting and framing the narrative in order to glean a particular point of view. the topoi of trust/integrity as an evaluative tool to disparage throughout the entire campaign for the election of the us president (won by donald trump on november 8th 2016) the topoi of distrust and integrity was raised consistently. mr trump and some of his colleagues asked the question whether the community of electors could or should trust hillary clinton as she had allegedly committed crimes by using a private email service during her term of office as secretary of state for the usa. the refrain was used often at debates and rallies by donald trump and was effective in that in the latter part of the campaign his collocations or relational word contexts with mrs clinton often included the chant or phrase “she should be locked up” and calls for a special prosecutor to ensure that she is thoroughly investigated. since the end of the election campaign mr trump’s office and he himself have remained remarkably silent on this issue. collocation as a form of control information. some extreme examples of this form of anaphora (repetition) are readily available on line and can be seen to echo the theoretical principles outlined in discourse analysis by fairclough (2001, p. 95) in which he suggests that collocation of assumed behaviour gives an ideological scheme for classifying someone or their behaviour and thus metaphorically represents a form of imprisonment via discourse. the main examples of collocation that are evident include the following words used in juxtaposition most often in the more than 175 sites examined include: • crooked [hillary] • criminal • untrustworthy • corrupt [includes terms such as most corrupt] • member of the elite • hopeless • lock her up (three word slogan) • liar • elite • left leaning • too liberal (progressively left wing) www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 13 published by scholink inc. the pejorative nature of the above collocations with the term hillary or clinton appeared constantly and indeed in recent times have been reiterated by trump and his team. the topoi of popularity and celebrity qualities the topoi of popularity and celebrity qualities were significant in the election to the white house and clearly showed that the cult of celebrity has enormous influence in community decision making. for example bennett et al (2008) and the work of yi (2012, p. 2) indicates that: “in the celebrity world, then, there are far fewer standardised methods of predicting and measuring celebrity success, as celebrities are not confined to any one set of designated rules. but the answer actually lies in the way fans and news follow every little detail of celebrities’ personal lives and appearances”. this was indeed the issue as trump’s tweets dominated the news media at all hours in the 24 hour news cycle. trump was known to have tweeted in the early hours of the morning and often news looking to break with an item of interest would headline anything that seemed controversial or significantly anti his opponents. one example in late 2016 is typical of this genre in which trump attacked hillary and her supposed connections with “rigging the election”. “this election is being rigged by the media pushing false and unsubstantiated charges, and outright lies, in order to elect crooked hillary!” donald j trump 15th october 2016 on twitter feed. earlier in september 2015 when it became clear that ms clinton would be a major presidential candidate he had also called attention to ms clinton’s fainting (according to some news outlets due to heat exhaustion) and her lack of stamina and health status. this became a news phenomenon when pictures emerged of her shoe left on the kerb following a stumble and other stories featured a possible brain tumour or haemorrhage. a twitter storm can still be found online through most search engines. stories written by newspapers and on line media platforms (see for example revesz, 2015) highlighted the fainting episode but continued to discuss the issue and this made it possible for trump to insist that she was unfit for office. the topoi of feminine traits and attributes trum often used the issues raised by allowing the country to fall into the hands of someone without the significant attributes to run the white house and the world’s most powerful nation. some examples include suggestions that former president clinton had been unfaithful due to ms clinton’s inability to please her man. other collocated terms with ms clinton questioning her feminine qualities ranged from wearing pantsuits to other more derogatory comments. • lacks the authenticity and the kind of charisma required to unite a nation. ... model, that inspiring leadership traits • embodying masculine leadership traits • she embodies too few of the traditional feminine traits we like to see in women (likeability • she lacks in charisma and excitement that many look for when choosing leaders www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 14 published by scholink inc. • too much like a man • characteristics we tend to associate with women—such as being facilitative or caring—are not at all what we think of as leadership traits. mclean parks has studied the differences in perceptions of male and female leaders, and says that clinton faces an uphill battle trying to overcome voter bias all this discourse echoes the notion that while women are gaining in being seen in political and public life the community can be easily persuade of the shortcomings of female candidates in political life. see for example holtz bacha (2013) in which she describes the significant hurdles faced by women entering politics. the collocations listed alongside and juxtaposed near the descriptors clearly indicate a mindset that is anti the female leaders and finds fault with a large variety of things such as their failings in dress, femininity, ability to placate voters and deride falsity. she describes voter bias as media becomes obsessed with a range of issues related to the private lives of female candidates: “women politicians know that the media act as a significant hurdle for their career. the media report differently on women and men. since decades (sic) we have been hearing from women all over the world complaining that the media only seem to be interested in their looks and in their private life but not so much in their political aims and concerns: how she dresses, how is her hairdo, does her husband have to prepare his own meals and who takes care of the children while she is doing politics? her male colleagues are rarely confronted with these sorts of questions. that means female politicians are confronted with evaluation criteria that do not come from the political field and that do not play a role for the evaluation of male politicians”. (holtz-bacha ,2013, p. 64) the topoi of power in female hands many male politicians describe power in female hands as somewhat dangerous. since the early days of margaret thatcher being dubbed the iron lady other titles have been used to discredit powerful women. the following collocations alongside hillary clinton and also former prime minister of australia ms gillard clearly identify the issues of concern raised by their opponents. • machiavellian • mendacious • thirsts for power • unlikeable aggression • a sea of men will pay no heed • not really in charge • witch using hexes to get ahead • wearing a mask • who knows what they are thinking? www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 15 published by scholink inc. • expertly tailored • coiffed • dressed for power • problem with women seeking power it appears then that when a woman strives for power, she loses likeability. this is consistently hammered by the press and the echo chamber of trump followers or those that opposed julie gillard when she attained the role of the first pm of australia the discourse of direction by media it could now be a problem created by media which hungry for news in a competitive online world greedily and actively reported the twitter storms and the stumbles both literal and metaphorical by both women. is it the problem with american or australian culture? do we have a more conservative community than we like to think? the decision is open. however, as schulz (2010, pp. 51-52) in her study in courts and judges on trial that often the discourse of direction is indeed media driven by the frames that continue to attract and court viewers and media users. hallahan (1999) argues strongly that emotions are a quick and easy route to engender responses from readers (and twitter) participants in media consumption. there is a lot of emotion and back stories in feisty women demanding to be heard (red headed or coiffed expensively and aggressive) or those that leave the home and hearth for a political stage. the questions from community must now be if not how dare they? but how come it has taken so long to be heard? how were the media persuaded by trump and his team? it would appear that in general the media have been mesmerised by the trump phenomenon as he appears to be so unpredictable and use the social media platform twitter as a public forum in which to express his often-controversial views and beliefs. to some extent he has embodied the idea of infotainment to a large degree in which the media cannot wait to see what he is going to say or do next! postscript 2017 issues for consideration by future discourse analysis since the election of november 2016 there is much to consider if women are to gain their proper position in public life. • mr trump has backed away from elements of the investigation of mrs clinton for her “crooked behaviour” • he has made overtures that the cia after first declaring that their intelligence was wrong in suggesting that the notion of hacking into the us networks by russian agencies was completely false • a young and charismatic new prime minister of new zealand has been elected and in recent times has announced she is pregnant and expecting a child later in 2018. since then has been actively a working mothers and is highly respected both here and abroad in western democracies as a socially progressive woman. already questions are being www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 16 published by scholink inc. raised about her having a “stay at home husband” and juggling baby formula and world politics” in light of the trump phenomenon in winning the usa presidential election there has been much speculation as to why a certain university and its students appeared to feature prominently in a an article entitled “pc monsters” in which the difficult and strained relations between ethnic and minority groups students has escalated to the point where a bulk of some of the students at oberlin university in ohio apparently voted for mr trump. the article went on to claim that many students literally only will consider information and social media input from their own echo chamber where there view and only their views are passed on and discussed. in a school where students have asked for “trigger warnings’ for such classical theatrical and literary works such as the great gatsby and antigone there is a chance that the notion of trumpist discourse will prevail as the community becomes scared to offend and distress minority groups. this was in response to perceived traumatising content. “the relationship my students have with the world is constantly mediated. they only have access to it through their i phone screens and through their social networks. they have joined what we would call the ‘virtual reality’ what is the real world for them. what occurs is that a filtered reality is suddenly finding a discourse of grievance [a reality suspended]”. it could be said that it may allow the trumpisms of recent memory to flourish in a world of language gone awry. professor roger copeland cited by phillip oehmke in the australian financial review weekly p 36 postscript october 2022: in recent weeks the turnaround of prime ministers in britain has been punctuated with the appearance of yet another female leader after teresa may was ousted by boris johnston over the failures of the brexit implementations. ms liz truss has also been subjected to humiliating descriptors and to regular input of the topoi of a power-hungry woman. for example the website which clearly identifies her as incapable and dangerous to britain outlines the problems that need fixing by a proper leader who knows how to placate the community and the stock market… in fact in one media outlet the toronto star she was described as the “human hand grenade” and as bringing about “popular discontent”. in another outlet she is described as defeated and gutted by the bond market’s disapproval of her. she is also accused of putting the market on edge and failing to bring about stability. latterly some other descriptions refer to her mode of dress and has in fact made headlines and several forum sites on her choice of hosiery and her supposed love affairs. meanwhile mr sunak the new prime minister of the uk has been spared such scrutiny. in contrast the newly selected pm rishi sunak a billionaire is said to provide a safe pair of hands and that the uk can now “deliver on the promises made by others” and that indeed he was” anointed” for www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 17 published by scholink inc. the position by his colleagues. this clearly identifies a male preference for political leadership, and i will leave it to others to analyse his future and political prowess. references abc. (2015-2016). australian broadcasting corporation website accessed frequently from 2014-june 2016 available on line at www.abc.net.au see also the i view connection on this website for the serious and also comedy reviews of the american primaries and both the republican and democratic conventions of 2016. retrieved from http://iview.abc.net.au/programs/planet-america/nu1644h029s00 abc. (2016). website “prime minister gillard loses shoe in scuffle” story by abc australia august 2012 and accessed nov 15th 2016. retrieved from http://www.abc.net.au/news/2012-01-26/riot-police-escort-gillard,-abbott-from-protest/3795036 altheide, d. (2003). notes towards a politics of fear. journal of crime, conflict and the media, 1, 37-54. aronson, j. (1994). a pragmatic view of thematic analysis. qualitative inquiry, 2(1). bahadur, n. (2015). 18 real things donald trump has actually said about women. the huffington post australia. retrieved september 5, 2016, from http://www.huffingtonpost.com.au/entry/18-real-things-donald-trump-has-said-about-women_us_ 55d356a8e4b07addcb442023 bennett, j., holmes, p., & hall, k. (2008). media studies. essex pearson education publishing. bourdieu, p. (2003). distinction—a social critique of the judgement of taste. new york and london routledge translated by richard nice. campbell, p. (2012). sex gender and politics. deakin university website research. retrieved september 4, 2016, from http://www.deakin.edu.au/research/research-news/articles/sex,-gender-and-politics continetti, m. (2015). national review on line “how to beat hillary clinton”. retrieved from http://www.nationalreview.com/article/426698/hillary-clinton-untrustworthy-unlikeable-extreme accessed august 18th 2016 coole, d. (1993). women in political theory: from ancient misogyny to contemporary feminism. harvester wheatsheaf publications new york toronto london. daily telegraph. (2017). the jackets of julia gillard. retrieved from http://www.dailytelegraph.com.au/pm-fashions-variations-on-a-theme/story-fn6e0s1g-122614508 7985 dixson, m. (1994). the real matilda (3rd ed.). penguin melbourne. dixson, m. (1999). the real matilda: women and identity in australia 1788 to the present. university of new south wales press sydney. www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 18 published by scholink inc. duerst-lahti, g. (2008). masculinity on the campaign trail. in h. l. cox, & h. caroline (eds.), madam president. are we ready for a woman in the white house? (pp. 87-112). boulder, colorado: lynne rienner publishing. fairclough, n. (1995). media discourse. london hodder headline group. fairclough, n. (1995). media discourse. oxford arnold publishing london and co-published by university press new york. fairclough, n. (2001). language and power (2nd ed.). longman pearson harlow essex uk. gilbertson, m. (2011). ditch the witch. news commentary. retrieved from http://www.adelaidenow.com.au gillard, j. (2012). misogyny speech in the australian parliament. retrieved august 20, 2013, from http://www.youtube.com/watch?v=sopsxpmzyw4 and retrieved november 27, 2013, from http://www.newyorker.com/online/blogs/newsdesk/2012/10/julia-gillards-misogyny-speech.html goldsworthy, a. (2013). unfinished business: sex freedom and misogyny. quarterly essay, 50. goodwin, w. (trans.). (1684). plutarch “morals vol 1”. retrieved december 10, 2017, from http://oll.libertyfund.org/titles/plutarch-the-morals-vol-1 goodwin, w. (trans.). (1684). plutarch “morals vol 1”. retrieved december 10, 2017, from http://oll.libertyfund.org/titles/plutarch-the-morals-vol-1 greer, g. (2012). quoted on q&a abc (australian broadcasting corporation) program by aap report. retrieved from http://www.smh.com.au/federal-politics/political-news/greer-defends-fat-arse-pm-comment-20120 827-24x5i.html hallahan , k. (1999). seven models of framing: implications for public relations. journal of public relations research, 11(3), 205-242. harvey, l., allen, k., & mendinck, h. (2015). extraordinary acts and extraordinary pleasures: rhetoric in young people’s talk of celebrity. discourse and society, 26(4), 428-444. holtz-bacha, c. (2013). who takes care of the children? the presentation of female top politicians in the media. revista con politica (spain), 2(3). infowars radio programs. (2016). will hillary steal the election? why she is unfit to lead [election fraud anticipated]. retrieved december 19, 2016, from http://www.infowars.com/insider-how-hillary-plans-to-steal-the-election/ jensen, e. (2013). the saboteur: kevin rudd’s unrelenting campaign to regain power. the monthly. retrieved from http://www.themonthly.com.au/issue/2013/may/1367364737/erik-jensen/kevin-rudd-s-unrelentingcampaign-regain-power lakoff, g., & johnson, m. (2003). metaphors we live by. chicago and london university of chicago press . www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 19 published by scholink inc. lemke, j, (1998). analysing verbal data: principles, methods and problems. in k. tobin, & b. fraser (eds), international handbook of science education. new york and amsterdam kluwer academic publishers. mama mia website and blog. (2013). julia gillard shouldn’t have had to endure this. retrieved november 26, 2013, from http://www.mamamia.com.au/news/julia-gillard-sexism/ manne, k. (2017). before hillary there was another witch. huffington post. retrieved april 21, from https://www.huffingtonpost.com/kate-manne/before-hillary-there-was-another-_b_9722158.html mccombs, m. (2004). setting the agenda: the mass media and public opinion. cambridge and malden ma polity. oehmke, p. (2017). liberal america’s pc monsters. australian financial review weekly, 36. revesz, r. (2015). the independent uk hillary collapses. retrieved september 13, 2015, from http://www.independent.co.uk/news/world/americas/hillary-clinton-health-faint-collapse-pneumon ia-poll-trust-lying-reasons-allergies-a7239786.html richter, s. (2016). the globalist articles. retrieved august 17, 2016, from http://www.theglobalist.com/the-causes-of-hillary-clinton-undoing/ schulz, p. d. (2011). courts and judges on trial: analysing and managing the discourses of disapproval. lit verlag berling muenster london and new jersey. schulz, p. d., & cannon, a. j. (2013). trial by tweet? findings on facebook? social media innovation or degradation? the future and challenge of change for courts. international journal of courts administration, 2. sheehan, p. (2012). why gillard will win the history wars. sydney morning herald. retrieved from http://www.smh.com.au/comment/why-gillard-will-win-the-history-wars-20130918-2tzor.html#ix zz2ltiftjm1 shenhav, s. (2006). political narratives and political reality. international political science review, 27(3), 245-262. sunak rishi. (oct 25 2022). paul norman co star news online description. retrieved from https://www.costar.com/article/141611567/new-uk-prime-minister-sunak-considered-safe-pair-ofhands-by-real-estate-industry sydney morning herald. (2015). commentary on the misogyny shown by former prime minister tony abbott. retrieved from http://www.smh.com.au/federal-politics/political-news/julia-gillard-on-the-moment-that-should-ha ve-killed-tony-abbotts-career-20150622-ghug63.html tanner, l. (2011). sideshow: dumbing down democracy. scribe publications carlton victoria australia . teo, p. (2008). racism in the news: a critical discourse analysis of news reporting in two australian newspapers. discourse and society, 11(1), 7-49. https://scholars.huji.ac.il/shaulshenhav/publications/political-narratives-and-political-reality www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 20 published by scholink inc. the conservative tree house. (2016). what was really cut out of hillary’s tongue? retrieved november 14, 2016, from https://theconservativetreehouse.com/2016/07/31/someone-in-media-needs-to-ask-hillary-clintonwhat-was-cut-out-of-her-tongue the daily wire. (august 25th 2016). hillary wears the ugliest outfit in human history. retrieved november 15, 2016, from http://www.dailywire.com/news/8658/hillary-breaks-out-ugliest-outfit-human-history-amanda-pre stigiacomo# the federalist website. (2016). the seven most awkward fashion failures of the pro-hillary campaign. retrieved from http://thefederalist.com/2016/04/08/the-7-most-awkward-pro-hillary-fashion-fails/ trump, d. (2016). donald trump threatens to jail hillary clinton in second presidential debate. the guardian. retrieved december 19, 2016, from https://www.theguardian.com/us-news/2016/oct/10/debate-donald-trump-threatens-to-jail-hillary-c linton trump, d. (2016). twitter feed “crooked hillary rigs election”. retrieved october 15, 2016, from https://twitter.com/realdonaldtrump/status/787258211283918848?lang=en trump, d. (october 8th 2016). on line and cited by the guardian statement on twitter.com. retrieved december 18, 2016, from https://www.theguardian.com/us-news/2016/oct/07/donald-trump-leaked-recording-women truss, l. (2022). reporter liz horowitz. retrieved october 14, 2022, from https://edition.cnn.com/2022/10/14/investing/uk-market-credibility-truss/index.html truss, l. (october 19 2022). the toronto star online. retrieved from https://www.thestar.com/news/world/analysis/2022/10/19/why-british-pm-liz-truss-nicknamed-the -human-hand-grenade-has-blown-it-for-the-tories.html walsh, k.-a. (2013). the stalking of julia gillard: how the media and team rudd brought down the prime minister. allen and unwin crow’s nest nsw australia. wilson, a. (2010). sydney morning herald. lessons for julia gillard from an earlier red headed ruler. retrieved from http://www.smh.com.au/national/lessons-for-julia-gillard-from-an earlier-redheaded-ruler yan, h. (2015). cnn report “donald trump’s blood comment about megan kelly draws outrage”. retrieved from http://edition.cnn.com/2015/08/08/politics/donald-trump-cnn-megyn-kelly-comment/ yi, s. (2012). celebrity endorsement: star value-evaluating a celebrity’s roi. admap warc publications, september, 1-6. www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 21 published by scholink inc. notes note 1. across the ditch is an affectionate term used by australians to denote a trip across the tasman sea to new zealand. note 2. another red headed politician (senator pauline hanson) in australia who is seen as a far right (at times extremist) also received a great deal of attention and often her red hair was considered in stories and media commentary. children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 6, no. 1, 2023 www.scholink.org/ojs/index.php/ct 1 original paper functional health literacy, invented spellings, and myplate representations of 2nd and 3rd grade children learning about breakfast eating and food groups in health education valerie a. ubbes1*, sophia whitesel2, & nancy parkinson2 1 miami university, department of kinesiology, nutrition, and health, oxford, ohio, united states 2 miami university, oxford, ohio, united states * valerie a. ubbes, miami university, department of kinesiology, nutrition, and health, oxford, ohio, united states received: november 22, 2021 accepted: december 14, 2022 online published: december 31, 2022 doi:10.22158/ct.v6n1p1 url: http://dx.doi.org/10.22158/ct.v6n1p1 abstract purpose: we had three purposes for this study: 1) to introduce 2nd and 3rd grade children to the concepts of breakfast and food groups in the myplate nutrition model while using an interactive constructivist approach; 2) to evaluate what foods children ate for breakfast over two days and to assess the visual-textual-lexical representations that they constructed to show their thinking about the myplate food model; and 3) to explore functional health literacy and inventive spellings from children who learned about food groups over two class sessions. methods: pre to post student assessments focused on self-reported breakfast eating and ability to represent the myplate food model during the learning process. student thinking about those topics were also elicited by multimodal approaches: oral language (conversations), written language (visual-textual-lexical illustrations), and body language (making nutritious snacks). for the latter, students constructed a snack to eat on both days at school and were encouraged to make the food at home to model nutritious eating behavior. results: most children who participated in the lesson ate breakfast either at home or at school. some students chose to communicate in words and pictures when asked to write about the foods they ate for breakfast. many students illustrated and labeled food groups by drawing and using inventive spellings about their early understandings of the myplate food model. from the first to the second day of instruction, breakfasts with three food groups increased from 3% to 7% but breakfasts with two food groups declined from 55% to 41% due to more children (n = 60) eating breakfasts with only one food group on the second day. conclusions: some of the food items that students ate were not sufficient to www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 2 published by scholink inc. produce an adequate nutritional benefit. the constructivist pedagogical approach assisted children with multimodal ways to communicate their understanding, including making two different snacks when planning a breakfast with multiple food groups. functional health knowledge about a nutritious breakfast made with three food groups should be further aligned with functional health literacy skills of speaking and writing in multimodal ways in order to improve health behaviors. inventive spellings demonstrated a developmental step in learning a vocabulary in a new domain. use of written words and pictures reflected a positive way to learn health and nutrition, because children represented their understanding in more than one way. recommendations: by adding fruit to the breakfasts of children who participated in the lessons, almost one-half of the children would be able to increase their consumption from two food groups to three food groups when consuming an ideal breakfast. future work should elaborate on the role of interactive health literacy in school and home contexts when children are learning about breakfast eating and food groups. future integration of the myplate food model with the national health education standards can foster new classroom assessments that will support students to practice observable nutrition behaviors that can lead to consistent health habits for personal, family, and school health. keywords food groups, nutrition, myplate food model, breakfast, constructivist theory, multimodal, functional health literacy, functional health knowledge, interactive health literacy 1. introduction a standard breakfast should contain 20% to 35% of daily energy requirements from at least three food groups such as milk and milk derivatives, whole grain cereals, and fresh fruit or juice without added sugar (giovannini, verduci, scaglioni, et al., 2008). however, 10% to 30% of children and youth report skipping breakfast based on a systematic review of studies in 33 countries with five of those studies reporting a lower quality of dietary intake among the breakfast skippers (monzani, ricotti, caputo, et al., 2019). skipping breakfast was associated with poorer lipid profiles and blood pressure levels, including challenges with insulin-resistance and metabolic syndrome. hence, skipping breakfast is thought to be a risk factor for metabolic diseases and a marker for overweight and obesity conditions (manzani, ricotti, caputo, et al., 2019). adequate breakfast is connected to both psychological and physiological health benefits (ferrer-cascales, sanchez-sansegundo, ruiz-robledillo, et al., 2018). breakfast is foundational to academic achievement and a higher cognitive performance (rampersaud, pereira, girard, et al., 2005) which is measured by the ability to read, write, and reason. breakfast eaters with adequate nutrients showed lower levels of stress and depression than breakfast eaters who ate a poor or very poor quality breakfast (ferrer-cascales, sánchez-sansegundo, ruiz-robledillo, et al., 2018). child breakfast skippers (n = 36) have worse metabolic profiles when compared to child breakfast consumers (n = 76) www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 3 published by scholink inc. as indicated by insulin growth factor-1 (igf-1), a modulator of lipid metabolism, while correlating negatively with ldl cholesterol (r = −0.442, p = 0.024) in breakfast skippers. total and low-density lipoprotein (ldl) cholesterol, triglycerides (p < 0.05), and the triglyceride/hdl cholesterol ratio (p < 0.001) were higher, while the beneficial hdl cholesterol was lower in skippers (p < 0.01) when compared to consumers (blasetti, franchini, castorani, et al., 2020). eating carbohydrates for breakfast after a night fast is beneficial for the brain because it reduces the production of the stress hormone, cortisol, which releases during a stress response by the body (lee, park, ju, et al., 2009). when breakfast is consumed, the stress response in the body is reduced. research has shown that “adolescents who habitually consumed breakfast ( > 5 days per week) had significantly reduced likelihood of disruptive behavior [odds ratio (or): 0.29, 95% ci: 0.15–0.55] compared with those who ate breakfast less frequently ( ≤ 5 times per week)” (adolphus, lawton, & dye, 2013). carbohydrates for breakfast are converted to glucose which is “essential for the formation of tryptophan, a precursor protein for the synthesis of serotonin, which regulates depressive symptoms, irritable mood and cognitive functioning” (lee, park, ju, et al., 2018; miller, maletic, & raison, 2009). cognitive functioning affords children and their social peers more developmental opportunities to think about and practice skill-based health education that leads to health behaviors such as nutrition and healthful eating. health educators and elementary teachers can use the whole school, whole community, and whole child framework (lewallen et al., 2015) to invite guest speakers and nutrition educators from the community into classrooms to facilitate the teaching and learning of “health topics, concepts, and skills” (ubbes, 2008). a health literacy approach in the curriculum also ensures the need for valid and reliable health information, product, and services (national consensus for school health education, 2022, p. 8) from which to build a strong functional knowledge in healthy eating and other healthy behaviors (national consensus for school health education, 2022, p. 20) constructivist theory in health education posits that learning through a social and collaborative way while using language as a tool will generate multiple perspectives among the learners, leading to understanding and meaning making that is constructed and determined by each learner (ubbes & ausherman, 2022). using the metaphor of scaffolding that moves learners from a foundational lower level understanding to a more sophisticated higher-level understanding, vygotsky (1962) derived constructivist theory to include a zone of proximal development where there are “guides on the side” to support each learner, but who do not do for the learner what the learner can do for themself. while in proximity to the learner, an effective educator will offer assistance to the learners as they construct meaning and reason out their understanding; students may need redirection during a moment of misunderstanding, or need more accurate information when faced with misconceptions. the supportive role that classroom teachers and health educators play in providing a culture of inquiry about health and nutrition is important for elementary children at an early age, because such factual and topical information builds a metaphorical scaffolding for learning important conceptions (or unsupported www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 4 published by scholink inc. misconceptions) about health. significant “guides on the side” serving as social role models need to have developed functional health knowledge built on credible information. learners will arrive there while using health literacy skills. the most frequently used scaffolding strategy in a child-centered study was inferential questioning, followed by eliciting, expansion, validation feedback, and drawing attention to relevant features of a problem or the environment (zurek, torquati, & acar, 2014). because constructivist theory suggests that “learners who participate in both individual and collaborative processes can construct and reconstruct meanings about their health and educational status better than either process alone” (ubbes, black, & ausherman, 2010, p. 96), the learning activities that are planned for health education should be assessed in ways that capture the thinking and knowing of the learners. as such, formative and summative assessments should employ written, oral, and body language using “snapshots” of the learning process which can indicate whether children have had adequate practice from session to session in their progression to health mastery. visual and tactile representations of healthy foods in contrast to poor quality discretionary foods can afford opportunities for elementary teachers and health educators to make learning more authentic for children. beyond significant human role models that help children shape their learning outcomes, food models, simulated food props, and actual foods are concrete objects that help to scaffold learning for children. two-dimensional photographic models can provide children with colorful printed props of realistic serving sizes for a variety of foods, and three-dimensional plastic or cloth replicas of foods can simulate the form and structure of certain foods for manipulation and sorting into food groups. for example, different iterations of the u.s. department of agriculture food models have changed over the years (chang & koegel, 2021), culminating with the most recent myplate campaign that divides a visual plate into food groups. the use of educational models for teaching children about food portion sizes has been studied with variable results (foster, matthews, lloyd, et al., 2008). however, no studies have posited whether food models afford children opportunities for language acquisition and vocabulary development. hence, the current investigation explored the role of different food models as a priming effect for learning food names that are either eaten or planned to be eaten by children after two nutritional lessons on the topics of breakfast and food groups. by using language as a tool for thinking and learning (roumell, 2018), children could potentially use new language patterns to interpret and internalize nutrition information into a new behavior of healthful eating. this priming effect (from food models) may increase the transfer of learning to new contexts through higher-order thinking and communication skills (roumell, 2018). learning transfer requires learners to apply their new knowledge and skills in a different context than the one in which the learning originally took place (detterman, 1993). the first purpose of the pilot study was to introduce 2nd and 3rd grade children to the concepts of breakfast and food groups found in the myplate nutrition model while using an interactive constructivist approach. the second purpose of the study was to evaluate what foods children ate for www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 5 published by scholink inc. breakfast over two days and to assess the visual-textual-lexical representations that they constructed to show their thinking about the myplate food model. the third purpose of the study was to explore functional health literacy and inventive spellings from children who had learned about food groups over two class sessions. 2. method 2.1 participants participants (n = 126) were children from two 2nd grade classrooms at two elementary schools and one 3rd grade classroom at another elementary school in the same ohio school district. ages of the children ranged from 7 to 8 years. classroom instruction was led by the same faculty member, who was a registered dietitian and clinical instructor of a senior-level nutrition course at the referent university. the instructor contacted the local school district for the possibility of offering two nutrition education lessons in three of the district’s elementary schools in a midwestern u.s. town. access to the classroom was approved and coordinated by the district-level school health coordinator and the elementary teachers at each school. informed consent was obtained through the institutional review board at the referent university. 2.1.1 overall procedure although the michigan model for comprehensive school health had been implemented as a curriculum throughout the school district ten years prior (ubbes & zullig, 2008; zullig, ubbes, pyle, et al., 2006), the district was not encouraging their elementary teachers to teach health education more recently. as such, a registered dietitian involved her university students as co-instructors (n = 15) in implementing scripted nutrition lessons in the 2nd and 3rd grade classrooms. the lessons were organized and implemented over two days for a total of 2.5 hours of instruction. the nutrition instructors were introduced by the elementary teachers before sharing the purpose of the nutrition lessons with the children. the three elementary teachers remained in their respective classrooms during the lessons. 2.1.2 day 1 learning process the learning process on day 1 included the following steps: 1) a written assessment was given to the children before any nutrition content was shared; 2) instruction about the myplate food model began by drawing a myplate diagram on the white board and asking students what food groups made up the myplate; 3) each child then selected a three-dimensional plastic food model from the food model box; 4) children approached the whiteboard with their plastic food model and then wrote the name of their selected food where it belonged in the myplate diagram. if children needed guidance in writing, other students in the class offered to help them. in some classes, one or two children were chosen to write all of the food names on the whiteboard while other children in the class identified, named, and placed the food into the myplate diagram. sometimes the classroom teacher suggested which students had legible www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 6 published by scholink inc. penmanship and spelling to write information on the board and sometimes the guest nutrition educators assisted in writing content on the board with oral language from the students; 5) the closing activity consisted of making a snack called yogonanas which contained rice cereal (grain), yogurt (dairy), and bananas (fruit). a class discussion followed after eating the yogonanas which included identifying and naming the food items included in the snack, and then sorting and categorizing which food group each ingredient belonged to; and 6) as an assessment during day 1, children wrote down which foods they ate for breakfast that day, and the written handout was collected by the teacher. 2.1.3 day 2 learning process the learning process on day 2 included the following steps: 1) as an opening discussion topic, students were asked whether they made the yogonana food at home for one of their family members then students reviewed which food groups made up the food; 2) students were asked again what they ate for breakfast before school, their favorite breakfast foods, and the different food groups those foods belonged to; 3) as a summative assessment, students drew pictures and wrote names of food groups based on the myplate model they had learned about over the two days; and 4) the closing activity involved students making another nutritious snack to eat in the classroom. the snack consisted of several components: a tortilla (grain), cheese (dairy), turkey (protein), and vegetables. the lesson ended with students singing a “rap” song about the “wrap” snack. 3. results data collected during the pre-assessment on day 1 (n = 112) and post-assessment on day 2 (n = 117) indicated that 84 children ate breakfast at home, 15 received breakfast at school, 6 reported eating at home or at school, and 4 students reported not eating breakfast at all. composition of breakfast foods eaten by second graders (n = 109) and third graders (n = 17) are reported in tables 1 (pre-assessment) and 2 (post-assessment). table 1 shows an alphabetical list of breakfast foods using the exact words that students reported and listed for their breakfast that day. column 1 shows the breakfast food by name, and column 2 shows the number of students who reported eating the food for breakfast. column 3 shows the potential number of food groups that the food represented using the myplate model. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 7 published by scholink inc. table 1. pre-assessment of breakfast foods in alphabetical order that students reported that they ate for breakfast on the day of the pre test breakfast foods in alphabetical order number of students eating the food (n = 108) the number of food groups the food represents bacon 1 1 bacon and eggs 1 1 bagel 2 1 bagel and apple 4 2 bagel with cream cheese 3 2 banana and yogurt 1 2 birds nest or cereal 1 1 bread and nutella 1 1 breakfast sandwich 3 2 cereal 42 2 cereal and apple 2 2 cereal or donut 1 1 cereal or toast 2 1 cereal or yogurt 1 1 cherry brownie 1 2 croissant 1 1 donuts or bagels 2 1 eggs 3 1 eggs and toast 1 2 www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 8 published by scholink inc. granola bar 1 1 granola bars and milk 1 2 hash browns, toast, and bacon 1 3 hot chocolate 1 n/a mcdonald’s 2 n/a milk, eggs, and bread 1 3 oatmeal 6 1 oatmeal, yogurt, or cereal 1 1 pancakes 2 1 pancakes with nutella 1 1 peanut butter and jelly 1 2 peanut butter sandwich 1 2 pop tarts 3 1 rice, bread, or cereal 2 1 toast 2 1 waffles 5 1 yogurt 2 1 yogurt and granola 1 2 yogurt, granola, and berries or a smoothie 1 3 summary results from the pre-assessment given on the first day of instruction for both second and third grade students (n = 112) indicated that 44 students ate one food group for breakfast; 62 students ate two food groups for breakfast; 3 students ate three food groups for breakfast; and 3 students were ambiguous in their reporting of breakfast eating. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 9 published by scholink inc. during the second day of instruction, breakfasts were discussed again in the context of the myplate food model. table 2 shows that 60 students ate one food group for breakfast; 48 students ate two food groups for breakfast; 8 students ate three food groups for breakfast; and 1 student reported an ambiguous answer of breakfast eating. table 2. post-assessment of breakfast foods in alphabetical order that students self-reported that they ate for breakfast on the day of the post test breakfast foods in alphabetical order number of students eating the food n = 118 the number of food groups the food represents bacon and waffle 1 2 bagel 2 1 bagel with cream cheese and raspberries or blueberries 4 3 banana 2 1 biscuits and gravy 3 1 bread 2 1 bread and nutella 2 1 cereal 40 2 cereal and yogurt 3 2 cereal; or eggs and bacon 2 1 cereal or bread 2 1 cereal or toast 1 1 cereal or waffles, apple, and milk 2 3 cereal or yogurt and granola 1 2 cheese stick 1 1 cinnamon roll 2 1 www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 10 published by scholink inc. cocoa bar 2 1 croissant 1 1 donut 3 1 eggs 5 1 eggs and bacon 2 1 eggs and meat 1 1 eggs, bacon, and toast 1 2 granola bars and milk 1 2 grapefruit 1 1 honey bread 1 1 mcdonald’s 1 0 milk 1 1 milkshake 1 1 muffin 1 1 oatmeal 3 1 oatmeal or french toast 1 1 oatmeal or yogurt 1 1 oatmeal, strawberries 1 2 oatmeal, yogurt, banana, and bread 1 3 pancakes 2 1 pancakes or waffles 1 1 peanut butter banana toast, fruit 1 3 pop tart 4 1 www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 11 published by scholink inc. rice or bread 1 1 vegetables 1 1 waffle 6 1 yogurt 1 1 yogurt or bagel 1 1 figure 4 shows the pre-assessment results for the number of food groups that children ate for breakfast: 3% (n = 3) ate breakfasts with 0 food groups; 39% (n = 44) ate breakfasts with 1 food group; 55% (n = 62) ate breakfasts with 2 food groups; and 3% (n = 3) ate breakfasts with 3 food groups. figure 5 shows the post-assessment results for the number of food groups that children ate for breakfast: 1% (n = 1) ate breakfast with 0 food groups; 51% (n = 51) ate breakfasts with 1 food group; 41% (n = 48) ate breakfast with 2 food groups; and 7% (n = 8) ate breakfasts with 3 food groups. figure 4. number of food groups that children consumed for breakfast during the pre-test www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 12 published by scholink inc. figure 5. number of food groups that children consumed for breakfast during the post-test 4. discussion the first purpose of the pilot study was to introduce 2nd and 3rd grade children to the concepts of breakfast and food groups in the myplate nutrition model while using an interactive constructivist approach. results on the pre-assessment showed that 42 children ate cereal for breakfast, and 40 children ate cereal for breakfast on the post-assessment. children did not name the type of cereal they ate, so the sugar content of the cereal could not be distinguished between high-sugar versus low-sugar content. only three children reported eating a breakfast of three food groups on the pre-assessment, but eight children reported eating a breakfast of three food groups on the post-assessment. however, if the children who reported eating cereal for breakfast would choose to pair fruit with their cereal, 40 more children would have consumed a breakfast with three food groups resulting in a more nutritious meal to start their day. eating a balanced breakfast is the key to starting off the day with adequate nutrition. breakfast consumption is linked to a healthier body mass index (bmi), higher grades, higher energy levels, and higher rates of on-task behavior in children (adolphus, lawton, & dye, 2013). adolphus, lawton, and dye (2013) found a significant difference when individuals consumed at least three food groups for breakfast, which included eating cereal grains paired with both milk and fruit. cereal has been categorized as a core food rather than a discretionary food, which is defined as extra calories above the daily nutritional needs (manohar, hayen, scott, et al., 2021). eating an adequate breakfast influences many factors in a child’s life. unfortunately, household food insecurity and insufficient access to nutritious foods can negatively impact child health and nutrition. household food insecurity has been linked to child developmental risks in intelligence and cognition, which are directly related to lower academic abilities in vocabulary and mathematics (shankar, chung, & frank, 2017). household food insecurity has also been linked to poorer motor development and inadequate school readiness (de oliveria, de almedia, gubert, et al., 2020). mozaffarian, fleischhacker, www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 13 published by scholink inc. and andrés (2021) claim that u.s. policies toward hunger and food insecurity need to move beyond sufficient calories and food quantities to addressing nutrition security, which is “defined as having consistent access, availability, and affordability of foods and beverages that promote well-being and prevent disease”. the lessons in breakfast eating and myplate representations aimed to focus on nutrition improvement over two days of classroom instruction. although instructors were not privy to issues of food insecurity, the school district is situated in a 48% poverty zone so food insecurity has been addressed by weekly backpack programs where food is sent home for low-income families. during the covid-19 pandemic, families drove their cars to school to pick up weekly food portions for each child member at home; this program was called a “drive up and drive away” program. social workers and the district health coordinator also made special deliveries to low-income families each week. according to the children’s defense fund-ohio (2020), 15% of children lived in poverty in the county of the study and 23% of children received the supplemental nutrition assistance program (snap) benefits. thus, community nutrition programs, school breakfast and lunch programs, and supplemental nutrition programs (e.g., snap) must be coordinated and implemented to ensure that children and their families are able to access and consume the foods that their bodies and brains need. the second purpose of the study was to evaluate what foods children ate for breakfast over two days and to assess the visual-textual-lexical representations that they constructed to show their thinking about the myplate food model. over the two days of instruction, children reported a variety of breakfast options. some of the most frequently repeated foods were cereal, waffles, oatmeal, eggs, or a bagel with cream cheese and fruit (see table 1 and 2). after the educational sessions, the majority of children remained in the category where their breakfast included one or two food groups; however, the number of children who ate a breakfast with three food groups almost tripled (from 3 to 8 children). research highlights the importance of examining the impact of daily meals in whole rather than for only one part of the diet like for breakfast or for single nutrients (manohar, hayen, scott, et al., 2021). however, dietary choices like whole-grain cereals and fresh foods are known to be more expensive (kant & graubard, 2013). coulthard, palla, and pot (2017) found that children who consumed breakfast on a regular basis had an improved nutrient profile with higher intakes of fiber, folate, vitamin c, calcium, iron, and iodine compared to children who skipped breakfast and fell short of obtaining the functional nutrients. for example, calcium is necessary for bone growth and mass during development (coulthard, palla, & pot, 2017). other examples include: fiber is necessary for digestion; folate is needed for red blood cell production; vitamin c helps to support the immune system; iron promotes bone growth; and iodine is needed for the production of thyroid hormones, which regulate metabolism. after an inquiry-based lesson on food patterns, children reproduced or copied the myplate model when asked to represent their functional health knowledge of food groups. children made a visual www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 14 published by scholink inc. representation of what they had learned to demonstrate their recall and understanding of the lesson. figure 1 shows how one child understood the five food groups in the context of a plate with a dairy beverage. the colorization of the different food groups emphasized the differentiation between the groups. mirroring the food model that was shared in class, the child provided visual-textual-lexical representations of food categories in the form of colors, shapes, and words without drawing pictures of specific foods. figure 1. myplate drawing from a child depicting a visual-textual-lexical representation of food groups in contrast, figure 2 shows a specific food illustrated by another student. a breakfast pizza was depicted with an ingredient from each of the food groups: cheese from the dairy food group, pepperoni as the protein, peppers as the vegetable, pizza crust as the grain, and pineapple (and olives) as fruits. student visual-textual-lexical drawings depict the essence of constructivist theory (vygotsky, 1962), because the student was able to take the new information learned about different food groups and construct a summative picture of a food through learning transfer. before learning about food groups, the child may have known that a pizza had many different toppings, but the child might not have known that different toppings belonged to various food groups. after learning about the food groups, the child was able to categorize the toppings and recognize where they belonged by labeling them on the slice of pizza. this transfer of knowledge from one form to another is called knowledge transfer. visual-textual-lexical information provides health and nutrition educators with insights into young children’s thinking when they make their thinking public. this representation of information in words and pictures demonstrates the functional health knowledge needed for a breakfast meal that represents more than one food group. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 15 published by scholink inc. figure 2. pizza drawing from a child depicting a visual-textual-lexical representation of food groups the united states department of agriculture promotes the importance of food groups to help visualize daily food recommendations using the myplate model. this allowed children to organize foods based on food groups rather than specific nutrients in the food model to fulfill their daily dietary needs. chang and koegel (2021) highlighted this advantage of the myplate model, “...it’s much easier to try to eat two cups of fruit a day than 75 milligrams of vitamin c and 25 grams of fiber” which are found in the fruit. by simplifying how the five food groups are represented on the myplate model, children were able to look at their own plate of food and determine what was missing in comparison. this is an example of priming effects because the nonlinguistic representation of the myplate model could help children reason out what might be missing on their plate by comparing it against their mental model (or schema in their memory) and a physical copy of a myplate picture. with practice during each of their meals throughout a week, children would be able to identify that the food group, fruits and vegetables, are missing if their plate only contained grain, dairy, and protein. health and nutrition educators play an important role in building the background knowledge of their students. background knowledge can be increased when health educators use a variety of valid and reliable resources about nutrition in the form of books, audiovisuals, podcasts, and posters in the lesson design (ubbes & ausherman, 2022). when educators provide multiple representations of educational content, such as food group models in addition to making and eating a breakfast food option in the www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 16 published by scholink inc. classroom, children learn how to elaborate on their learning through new skills, use of new vocabulary words (lexicon), and multiple ways to practice what they have learned. at first, functional health literacy is developed, which is reading, writing, and speaking about health (ubbes, dillhoff, & maldonado, 2018, p. 50, p. 56, p. 59), but students must also be able to “demonstrate health literacy by accessing valid and reliable health information, products, and services to enhance health” (national consensus for school health education, 2022, p. 8). in a nutrition context, students can read and talk about instructional brochures, food models, and food labels in order to learn word knowledge and image recognition of valid and reliable sources of food products. through formal and informal social interactions, students can write and talk about valid and reliable nutrition information while using real food, interactive props, and print or electronic media for developing their interactive health literacy skills around food groups and breakfast choices. the third purpose of the study was to explore functional health literacy and inventive spellings from children who had learned about food groups over two class sessions. the instruction about food groups, categorized by the myplate food model, afforded the classroom teachers, the registered dietitian, and guest nutrition educators some observations and insights into the receptive and expressive language skills of children in a health and nutrition context. during the educational lessons, children actively participated by using oral language as they talked about, sorted, and manipulated the food models, then they later used written language to list what they ate for breakfast. as such, the children used expressive language skills through oral and written communication to elaborate on their knowledge through multimodal symbol systems (taylor & leung, 2020). some children (n = 25) represented their food options using either words or pictures, and others used words and pictures by drawing and labeling pictures of food as a written example of their functional health literacy. students elaborated on their functional health knowledge by representing what they knew and understood about breakfast and food groups in more than one symbol system (national consensus for school health education, 2022). drawing is a precursor to writing and serves as an important way for children to elaborate on their learning. drawings are an effective way to communicate “language beyond the sentence” (strasser & río, 2014), and pictures can help children increase their vocabulary and understand health-related information that they learn (bray, blake, protheroe, et al., 2021). comprehension, referred to as understanding what was learned, can be similar across different learning modalities such as listening, viewing television, and reading written stories (kendeou, bohn-gettler, white, et al., 2008; lynch, van den broek, kremer, et al., 2008; tompkins, guo, & justice, 2013). although critical or creative thinking can be used when interpreting a picture, children can learn many words to describe and communicate their ideas from a single image. the pairing of written depictions (i.e., illustrations) with vocabulary words enhances the child’s understanding and recall of the information using multimodal representations. children need to connect different modes of communication at a young age so that their vocabulary (word knowledge) and drawing elaborations (schema) expand into more sophisticated www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 17 published by scholink inc. ways of knowing as they grow and develop. students who participated in the lessons were able to demonstrate their comprehension (understanding) by practice this pairing of drawing and labeling images of the myplate food picture when prompted to “list the food groups” (figure 3). figure 3. invented spellings that show what a child knew about food groups after learning about the myplate food model figure 3 highlights the invented spellings that the 2nd and 3rd grade children used to represent their emerging understanding of food groups. invented spellings are a lexical form of word knowledge (vocabulary) (treiman, 2017). lexical representations contain overlapping phonological (sounds), orthographic (spelling), semantic (meaning) and syntactic information (grammar) (perfetti, 2007)—all four are inherent in morphemes or the smaller units of meaning within a language (levesque, breadmore, & deacon, 2021). in addition to drawing a visual representation of the myplate food model after learning about it, four different children also wrote words to name the different food groups—even though some of those words were spelled incorrectly. unconventional spellings indicated that children had some knowledge of the sounds and spellings of written words (treiman, kessler, pollo, et al., 2016) and could make a connection between the visual form of words and their corresponding sounds (morais, 1995). cunningham and cunningham (1992) stated that “writing with invented spelling should be a regular part of every basic reading program”, because writing letters and words support children as they learn www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 18 published by scholink inc. to decode words and learn a vocabulary. decoding involves children listening for the sounds in words to guide and improve their invented spelling (clay, 1985). invented spelling leads to better reading but not the other way around (ouellete & sénéchal, 2017). nagy, berninger, abbott, et al. (2003) found that 4th graders needed to work “to coordinate orthographic, phonological, and morphological cues in written words”, and that oral vocabulary and spelling were significantly related to the ability of 2nd graders to read words. in summary, by representing new topics and concepts about nutrition and healthy eating using literacy skills, students are learning to read, write, and speak about health and thus, learning to develop their functional health literacy skills. in summary, food options for breakfast were the focus of a nutrition lesson in three elementary classrooms from one ohio school district. the myplate food model was used to plan a healthy breakfast from more than one food group, and two-dimensional food models were used to name and categorize a variety of foods into five food groups. nutrition educators and children used both receptive language (e.g., listening) and expressive language (e.g., speaking, writing, spelling, and drawing) to learn nutrition. children drew pictures using visual-textual-lexical representations to show what they knew about breakfast eating and food groups. invented spellings were evident as children labeled different foods on their myplate drawings, highlighting that the 2nd and 3rd graders were learning new vocabulary about certain foods while writing these words phonetically for the very first time. implications for earlier and more frequent instruction in nutrition education is warranted with an emphasis on giving children more time to use their expressive language to write, draw, and talk about the foods that they ate through an inquiry-based constructivist approach. the food-making lessons, visual-textual-lexical writing activities, and classroom conversations provided children with opportunities to transfer their nutrition knowledge from school to home environments where they could continue to practice their functional health literacy with their families. however, future work should also elaborate on the role of interactive health literacy in school and home contexts when children are learning about breakfast eating and food groups. by adding fruit to the breakfasts of children who participated in the lessons, almost one-half of the children would be able to increase their consumption from two food groups to three food groups when consuming an ideal breakfast. students could write and then discuss among their peers and their family members how to go about improving their fruit intake for breakfast while practicing their interactive health literacy skills. there are three recommendations for this study. future lessons could introduce sociocultural variance in food selections for breakfast and discuss the benefits of eating breakfast at school while being mindful of perceived social stigmas associated with it (soldavini & ammerman, 2019). another way to address cultural variance in the classroom is to acknowledge that students can “analyze the influence of family, peers, culture, social media, technology, and other determinants on health behaviors” when guided by the performance expectations of the national health education standards for grades prek-2, grades 3 to 5, and so forth (national consensus for school health education, 2022). second, students www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 19 published by scholink inc. in this study were between the ages of seven to nine years old (2nd and 3rd grade), which limited their ability to obtain and prepare nutritious foods without the assistance of an adult. if this instructional program is repeated, children could “show parents what they know” during parent-teacher conferences or at a school open house, and teachers could distribute children’s picture book lists about food and nutrition to parents so they can learn together with their children at home (ubbes & spillman, 2000) while developing their interactive health literacy skills (national consensus for school health education, 2022, p. 8). parents and their own health habits strongly influence and determine the health behaviors of their children. if the parents of the children are not practicing healthy eating habits, the children are likely to disregard what they have learned and continue to follow the health modeling of their parents. therefore, future instructional lessons might involve parents in several ways by validating what children ate at home for breakfast, by agreeing to post the myplate picture on their refrigerators at home, and by taking the model with them when grocery shopping as a family. third, prior to the instructional lessons, children did not receive nutrition education or health education in the classroom. classroom nutrition lessons aligned to the national health education standards using a literature-linked approach (ubbes & spillman, 2000) can support children in practicing interpersonal communication, making decisions, and setting goals for eating the most nutritious food options available to them. two of the revised national health education standards (national consensus for school health education, 2022) also outline that prek-12 students can be taught to “demonstrate observable health and safety practices” and “advocate for behaviors that support personal, family, peer, school, and community health”. to those points, elementary children can be encouraged to transfer their functional health knowledge about food groups and breakfast from the school classroom to home settings through planned “show and tell” conversations with their families, supported by multimodal food models and snack making, which has the potential to foster their interactive health literacy skills. children can use these social interactions around snack making and the sharing of their written depictions of the myplate model to elaborate on their own learning in a new context through a priming effect. in this context, a priming effect through the use of a food model and snack making can help children increase the transfer of learning from school to home through concrete to abstract thinking and communication skills (roumell, 2018). as such, this type of learning transfer enables students to apply their new knowledge and skills in a different context than the one in which the learning originally took place (detterman, 1993). beyond interactive health literacy applications that employ a priming effect for learning transfer, health and nutrition educators can implement new curriculum standards for building stronger connections between how they teach and what they teach. hence, future integration of the myplate food model with the national health education standards can foster new classroom assessments that will support students to practice observable nutrition behaviors that can lead to consistent health habits for personal, family, and school health. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 20 published by scholink inc. references adolphus, k., lawton, c. l., & dye, l. (2013). the effects of breakfast on behavior and academic performance in children and adolescents. frontiers in human neuroscience, 7, 425. https://doi.org/10.3389/fnhum.2013.00425 blasetti, a., franchini, s., castorani, v., comegna, l., fornari, e., daniele, f., prezioso, g., piona, c., federico, v., zona, d., bresadola, i., chiarelli, f., & maffeis, c. (2020). skipping breakfast is associated with an atherogenic lipid profile in overweight and obese prepubertal children. international journal of endocrinology, 2020, 1-6. https://doi.org/10.1155/2020/1849274 bray, l., blake, l., protheroe, j., nafria, b., de avila, m. a. g., ångström-brännström, c., forsner, m., campbell, s., ford, k., rullander, a.-c., robichaud, f., nolbris, m. j., saron, h., kirton, j. a., & carter, b. (2021). children’s pictures of covid-19 and measures to mitigate its spread: an international qualitative study. health education journal, https://doi.org/10.1177/00178969211019459 chang, s., & koegel, k. (2021, august 3). back to basics: all about myplate food groups. center for nutrition policy and promotion in food and nutrition. retrieved september 26, 2021, from https://www.usda.gov/media/blog/2017/09/26/back-basics-all-about-myplate-food-groups children’s defense fund-ohio. (2020). kids count data book. annie e. casey foundation. cdf-oh provides state and county-level data at www.datacenter.kidscount.org clay, m. (1985). the early detection of reading difficulties (3rd ed). heinemann. coulthard, j. d., palla, l., & pot, g. k. (2017). breakfast consumption and nutrient intakes in 4-18-year-olds: uk national diet and nutrition survey rolling programme (2008-2012). british journal of nutrition, 118(4), 280-290. https://doi.org/10.1017/s0007114517001714 cunningham, p. m., & cunningham, j. w. (1992). making words: enhancing the invented spelling-decoding connection. the reading teacher, 46(2), 106-115. retrieved from https://www.jstor.org/stable/20201026 de oliveira, k. h. d., de almeida, g. m., gubert, m. b., moura, a. s., spaniol, a. m., hernandez, d. c., perez-escamilla, r., & buccini, g. (2020). household food insecurity and early childhood development: systematic review and meta-analysis. maternal & child nutrition, 16(3), e12967. https://doi.org/10.1111/mcn.12967 detterman, d. k. (1993). the case for the prosecution: transfer as an epiphenomenon. in d. k. detterman, & r. j. sternberg (eds.), transfer on trial: intelligence, cognition, and instruction (pp. 1-24). ablex publishing. ferrer-cascales, r., sánchez-sansegundo, m., ruiz-robledillo, n., albaladejo-blazquez, n., laguna-perez, a., & zaragoza-marti, a. (2018). eat or skip breakfast? the important role of breakfast quality for health-related quality of life, stress and depression in spanish adolescents. international journal of environmental research in public health, 15, 1781. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 21 published by scholink inc. https://doi.org/10.3390/ijerph15081781 foster, e., matthews, j. n. s., lloyd, j., marshall, l., mathers, j. c., nelson, m., barton, k. l., wrieden, w. l., cornelissen, p., harris, j., & adamson, a. j. (2008). children’s estimates of food portion size: the development and evaluation of three portion size assessment tools for use with children. british journal of nutrition, 99(1), 175-184. https://doi.org/10.1017/s000711450779390x giovannini, m., verduci, e., scaglioni, s., salvatici, e., bonza, m., riva, e., & agostonic, c. (2008). breakfast: a good habit, not a repetitive custom. journal of internal medicine research, 36, 613-624. https://doi.org/10.1177/147323000803600401 kant, a. k., & graubard, b. i. (2013). family income and education were related with 30-year time trends in dietary and meal behaviors of american children and adolescents. the journal of nutrition, 143(5), 690-700. https://doi.org/10.3945/jn.112.165258. kendeou, p., bohn-gettler, c., white, m. j., & van den broek, p. (2008). children’s inference generation across different media. journal of research in reading, 31(3), 259-272. https://doi.org/10.1111/j.1467-9817.2008.00370.x lee, s. a., park, e. c., ju, y. j., lee, t. h., han, e., & kim, t. h. (2017). breakfast consumption and depressive mood: a focus on socioeconomic status. appetite, 114, 313-319. https://doi.org/10.1016/j.appet.2017.04.007 levesque, k. c., breadmore, h. l., & deacon, s. h. (2021). how morphology impacts reading and spelling: advancing the role of morphology in models of literacy development. journal of research in reading, 44(1), 10-26. lewallen, t. c., hunt, h., potts-datema, w., zaza, s., & giles, w. (2015). the whole school, whole community, whole child model: a new approach for improving educational attainment and healthy development for students. journal of school health, 85(11), 729-739. https://doi-org/10.1111/josh.12310 lynch, j. s., van den broek, p., kremer, k. e., kendeou, p., white, m. j., & lorch, e. p. (2008). the development of narrative comprehension and its relation to other early reading skills. reading psychology, 29(4), 327-365. https://doi.org/10.1080/02702710802165416 manohar, n., hayen, a., scott, j. a., do, l. g., bhole, s., & arora, a. (2021). impact of dietary trajectories on obesity and dental caries in preschool children: findings from the healthy smiles healthy kids study. nutrients, 13(7), 2240. https://doi.org/10.3390/nu13072240 miller, a. h., maletic v., raison c.l. (2009). inflammation and its discontents: the role of cytokines in the pathophysiology of major depression. biological psychiatry, 65, 732-741. https://doi.org/10.1016/j.biopsych.2008.11.029 monzani, a., ricotti, r., caputo, m., sillito, a., archero, f., bellone, s., & pro-am, f. (2019). a systematic review of the association of skipping breakfast with weight and cardiometabolic risk www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 22 published by scholink inc. factors in children and adolescents. what should we better investigate in the future? nutrients, 11(2), 387-410. http://dx.doi.org/10.3390/nu11020387 morais, j. (1995). do orthographic and phonological peculiarities of alphabetically written languages influence the course of literacy acquisition? reading and writing: an interdisciplinary journal, 7, 1-7. https://doi.org/10.1007/bf01026944 mozaffarian, d., fleischhacker, s., & andrés, j. r. (2021). prioritizing nutrition security in the us. jama, 325(16), 1605-1606. https://doi.org/10.1001/jama.2021.1915 nagy, w., berninger, v., abbott, r., vaughan, k., & vermeulen, k. (2003). relationship of morphology and other language skills to literacy skills in at risk second grade readers and at risk fourth grade writers. journal of educational psychology, 95(4), 730-742. https://doi.org/10.1037/0022-0663.95.4.730 national consensus for school health education. (2022). national health education standards: model guidance for curriculum and instruction (3rd ed.). retrieved from https://www.schoolhealtheducation.org ouellette, g., & sénéchal, m. (2017). invented spelling in kindergarten as a predictor of reading and spelling in grade 1: a new pathway to literacy, or just the same road, less known? developmental psychology, 53(1), 77. https://doi.org/10.1037/dev0000179 perfetti, c. a. (2007). reading ability: lexical quality to comprehension. scientific studies of reading, 11(4), 357-383. https://doi.org/10.1080/10888430701530730 rampersaud, g. c., pereira, m. a., girard, b. l., adams, j., & metzl, j. d. (2005). breakfast habits, nutritional status, body weight, and academic performance in children and adolescents. journal of the american dietetic association, 105(5), 743-760. https://doi.org/10.1016/j.jada.2005.02.007 roumell, e. a. (2018). experience and community grassroots education: social learning at standing rock. new directions for adult and continuing education, 2018(158), 47-56. https://doi.org/10.1177/1045159518791281 shankar, p., chung, r., & frank, d. a. (2017). association of food insecurity with children’s behavioral, emotional, and academic outcomes: a systematic review. journal of developmental & behavioral pediatrics, 38(2), 135-150. soldavini, j., & ammerman, a. s. (2019). serving breakfast free to all students and type of breakfast serving model are associated with participation in the school breakfast program. journal of the academy of nutrition and dietetics, 119(7), 1142-1149. https://doi.org/10.1016/j.jand.2019.03.001 strasser, k., & río, f. d. (2014). the role of comprehension monitoring, theory of mind, and vocabulary depth in predicting story comprehension and recall of kindergarten children. reading research quarterly, 49(2), 169-187. https://doi.org/10.1002/rrq.68 taylor, s. v., & leung, c. b. (2020). multimodal literacy and social interaction: young children’s literacy learning. early childhood education journal, 48(1), 1-10. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 23 published by scholink inc. https://doi.org/10.1007/s10643-019-00974-0 tompkins, v., guo, y., & justice, l. m. (2013). inference generation, story comprehension, and language skills in the preschool years. reading and writing, 26(3), 403-429. https://doi.org/10.1007/s11145-012-9374-7 treiman, r. (2017). learning to spell words: findings, theories, and issues. scientific studies of reading, 21(4), 265-276. http://doi.org/10.1080/10888438.2017.1296449 treiman, r., kessler, b., pollo, t. c., byrne, b., & olson, r. k. (2016). measures of kindergarten spelling and their relations to later spelling performance. scientific studies of reading, 20, 349-362. https://doi.org/10.1080/10888438.2016.1186168 ubbes, v. a. (2008). educating for health: an inquiry-based approach to prek-8 pedagogy. champaign, il: human kinetics. ubbes, v. a., & spillman, d. m. (2000). literature links for nutrition and health. needham heights: allyn & bacon. ubbes, v. a., & ausherman, j. (2022). oral language development in university classrooms: building health communication through a constructivist theoretical framework. international journal of interdisciplinary educational studies. https://doi.org/10.18848/2327-011x/cgp ubbes, v. a., black, j. m., & ausherman, j. a. (2010). teaching for understanding in health education: the role of critical and creative thinking skills within constructivism theory. in j. m. black, s. r. furney, h. m. graf, & a. e. nolte (eds.), philosophical foundations of health education (chapter 11, pp. 95-107). san francisco, ca: jossey-bass. ubbes, v. a., dillhoff, r., & maldonado, w. (2018). reading and writing attitudes of children: conceptual implications for health education and health literacy. journal of health education teaching, 9(1), 49-67. ubbes, v. a. & zullig, k. j. (2008). impact of a comprehensive health education curriculum (chec) on selected risk behaviors of students in grades 5-12. future focus: ohio journal of health, physical education, recreation, and dance, 29(2), 25-31. vygotsky, l. (1962). thought and language. cambridge, ma: mit press (original work published in 1934). zullig, k. j., ubbes, v. a., pyle, j., & valois, r. f. (2006). self-reported weight perceptions, dieting behavior, and breakfast eating among high school adolescents. journal of school health, 76(3), 87-92. https://doi.org/10.1111/j.1746-1561.2006.00074.x zurek, a., torquati, j., & acar, i. (2014). scaffolding as a tool for environmental education in early childhood. international journal of early childhood environmental education, 2(1), 27-57. figure 3. invented spellings that show what a child knew about food groups after learning about the myplate food model children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 5, no. 2, 2022 www.scholink.org/ojs/index.php/ct 22 original paper psychosocial implications of covid-19 on children in nigeria abiodun adewole1 , kayode anthony ogedengbe2, oluwagbemiga oyinlola2, & oyebade olanike2 1 department of social work, university of ibadan, ibadan 2 medical social services department, university college hospital, ibadan * oyinlola oluwagbemiga, medical social services department, university college hospital, ibadan received: august 7, 2021 accepted: october 21, 2022 online published: november 21, 2022 doi:10.22158/ct.v5n2p22 url: http://dx.doi.org/10.22158/ct.v5n2p22 abstract there has been a plethora of research since the emergence of covid-19 around the world but several of these studies have not focused on the psychosocial implication of the novel coronavirus on children in nigeria. though the psychosocial impact of the virus is huge, there is paucity of literature addressing the needs of the nigerian children during the pandemic. the paper explored the psychosocial implications (health, poverty issues, safety needs and learning) of covid-19 on children in nigeria. the study recommends the expansion of social assistance for children of families in extreme poverty, and there is a need to adapt standard physical distancing protocols to reflect the characteristics of children in different settings. also, the government of nigeria should prioritize child-centred services. training parents and caregivers on how to talk to their children about the pandemic, managing their mental health and providing tools to help children’s learning will be crucial. keywords psychosocial, children, covid-19, social work 1. introduction the covid-19 pandemic has caused one of the most significant tests the world has experienced since the second world war leading to the formation of the united nations. the coronavirus diseases-2019 has affected over 200 countries worldwide; containment measures, including lockdowns adopted by various countries, have led to a significant curtailment of the virus in the day -to -day lives of citizens in the respective countries. these measures have addressed the spread of the virus, but this comes with unexpected adverse outcomes among vulnerable groups, including children (world health organisation, 2020). covid-19 affects every child directly or indirectly as this is a public health problem which has affected the economic situation of every country and also complicates the growing needs of children in most developing countries where there are limited resources to help cope with the psychosocial www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 23 published by scholink inc. experiences during the pandemic (defence for children international, 2020). the disproportionate representation of children among vulnerable families makes them experience shock because available support for young children is primarily outside their formal system and might be overlooked (world bank, 2020). very few pieces of literature explicitly focused on the psychosocial implication of covid-19 on children. therefore, this paper will focus on the experience and psychosocial implications of the pandemic on children in nigeria. 2. experience of covid-19 among children the global covid-19 pandemic continues to increase and unfold all over the world, young children are more vulnerable, and the experience of children during the pandemic has been related to fear, promiscuity, insecurity, reorganization of the family system, and unprecedented dimension presented by the pandemic have had negative impacts on the right of the child in the country (committee on rights of the child, 2020). children are also deprived of liberty and participation in social activities due to lockdowns across the country, which negatively impacts children’s physical and mental wellbeing in most developing countries (chan, yuan, & kok, 2019). the importance of getting facts and information would assure the safety and protection of every child and their family members in the society in nigeria, but, unfortunately, there is much information out there that is incorrect (unicef, 2020). moreso, there is much misinformation during misinformation which has left individuals and their families unprotected and seriously vulnerable to the diseases (unicef, 2020) and also have tendencies to experience stigma among friends and family members (chan et al., 2019) children around the world in most hospitals are presented with symptomatic reactions, which are equally shared among older persons to date because the world health organisation has categorized them as one of the most vulnerable groups to the pandemic around the world (who, 2020). however, most cases of child mortality have now been succumbed to by covid-19 as this is a likely reaction of prior medical conditions in most regions in nigeria (logie & turan, 2020). most common occurrences have been related to children tragically losing their parents, family members or caregivers to covid-19; hence, the psychological impact should not be overlooked. before the pandemic, the world has failed to provide adequate care and support for children; a situation where children who are below the age of 15 dies every second, one in every five children is been malnourished and more than 53% of the 10year old children in low and middle-income countries finds it difficult to read and understand stories (unicef, 2017). there is paucity of literature focusing on the psychosocial experience of children and their families, which is practically problematic for the development of children in nigeria (cao & feng, 2019; lin & li, 2020). this indicates that, the longer the covid-19 pandemic, the more dramatically the negative impact on these vulnerable children across the country (unicef, 2020). there are possibilities for an increase in the number of children negatively affected by the virus, but the economic struggles and the restriction on government spending keep www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 24 published by scholink inc. lingering in the country (who, 2020). 3. the psychosocial implication of covid-19 on children since there are multiple channels through which the pandemic affects children psychosocially, they are highly susceptible to falling into poverty, learning problems, survival and health problems and poor safety of children in their communities (world bank, 2020). -falling into poverty: the result of physical distancing and measures resulting from lockdown to save lives and curtail the transmission of the spread of the virus has led to a significant reduction in activities across the economies while also leading to the global recession. the impact of the recession remains and is seen to have a significant socio-economic impact on families of children in developing countries (world economic outlook, 2020). in most households, the collapse in income hurts the livelihood of millions of homes where children reside around the world. these inputs to the forecasts of imf reported that there are possibilities for an increase in extreme poverty ($1.90 per day) this year from the current poverty rate of 84 to 132 million people, with approximately more than half of whom are children living in low and middle-income countries as compared to before the pandemic scenario (international monetary fund, 2020). this implies that a global downturn on poor households impacts breadwinners as they are forced to look for shelters or even migrate to rural settlements. however, most countries have adopted social protection measures focusing on support for families and children (gentiini, 2020). the lockdown of public spaces is still unclear as there might be a possible lockdown in the future outbreak of covid-19 or related pandemic worldwide. -difficult learning new things: the worldwide closure of schools has affected more than 1.5 billion children and youth worldwide (unesco, 2020), in contrast to the previous outbreak of diseases. most schools plan to extend lockdown, with over 58 countries having to reschedule their exams, while over 11 countries have to cancel their exams (unesco, 2020). these have potential losses on the developing human capital among young people. however, several schools have to develop distance learning programs for their pupils. however, this is only available to very few children; where the majority of the children reside in low-income countries where there are no facilities to achieve learning for children (unesco, 2020). there is less access to digital technologies for the girl child than for boys, possibly reducing participation in online learning (unicef, 2020). for children residing in resource -constrained environments like informal settlements, internally displaced camps have limited access to internet facilities and are significantly impacted. more importantly, children with disabilities are finding it very hard to access distance education programmes in the country. therefore, the possibility of school drop-out might be higher when the pandemic is over in all of this sub-group of children (evans & miguel, 2013). -the health of the children: the direct health impact of covid-19 on children has been milder than other age groups like older persons with comorbidities. data from most affected regions, like china and www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 25 published by scholink inc. the united states of america, indicated that the hospitalization rate for symptomatic children is between 9 to 20 times lower than for middle-aged and can be 25 and 100 times lower than for older persons (centre disease communication, 2020). for example, 1 in 25,000 children in china is lost to covid-19, which is more than 30 times less than the middle-aged and over 3,000 times less than older persons. it must be noted that the impact of the virus in terms of epidemiological impacts should be expected to differ over time in different contexts. the broader impact of the virus on child health is significant. it can impact household income as low-income families are forced to cut their food expenditures and essential health care (unicef, 2020). based on the imf forecast, there are possibilities for hundreds of thousands of additional child deaths in 2020 compared to before the pandemic scenario; this hurts the progress of the 2 to 3years target of reducing infant mortality within a single year (international monetary fund, 2020). the estimation only focused on the effect of this year’s global recession and not on several ways there has been a disruption in health services across the country during the pandemic. this includes reduced access to essential child health services like vaccination and immunization, as these have been suspended in over 23countries around the world (unicef, 2020). in nigeria, over 2 million children rely on school meals as a reliable source of daily nutrition, which has to stop while they look for other sources due to the lockdown in schools (world food programme, 2020). also, the close-down of schools has a higher possibility of increasing the number of teenage pregnancies in the years ahead. there is a negative impact of physical distancing measures and restriction of movement on children’s mental health as it causes concerns and anxiety about the pandemic's negative impact on their lives and their communities. -safety concerns: several children see the homes as a form of safety and security, but for some, it is a tragic experience as they experience violence from caregivers, one of the most common forms of violence children experience (united nations on women, 2020). children are witnesses of domestic violence;, the rates have possibilities of being higher in several countries (unwomen, 2020). the act of domestic violence is more likely in most families during confinement at home as they experience intense anxiety and fear. over 60% of children worldwide are in full or partial lockdown somewhere (unicef, 2020). this presents opportunities for child abusers to harm children as they rarely report the act because they have no access to their teachers, while social protection and legal instruments are scaled back in most countries (global social service workforce alliance & international federation of social workers, 2020). very significantly, children are exposed to online predators and inappropriate content due to the introduction of distance learning. the high level of digitalization magnifies the vulnerability of children to harm (american academics of child and adolescent psychiatry, 2020). since there is practically no data in nigeria available in the literature regarding the psychosocial implications of covid-19 among children, caution should be taken among this population as non-available data suggest an increased risk of severe infection has not been demonstrated among this population. as social workers and other clinicians are thinking of innovative ways of helping children www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 26 published by scholink inc. and families, it would be encouraging to consider new opportunities the pandemic has created for individuals and communities to recover better towards building a more robust system for children attending nigerian hospitals. 4. case reports of covid-19 among children in nigeria although there are very few reported cases of covid-19 among children in nigeria because most children are not allowed to go out with peers or mingle with anyone within their environment as a result nationwide lockdown (park et al., 2020; nadeem et al., 2020), however, among the few reported cases of covid-19 among children is a case report of three children from the same parent whose age is between 3months to 8years they were managed in an isolation and treatment centre in katsina. these children were admitted to the isolation and treatment centre between 16th april and 15th may 2020; they had a confirmatory test at the national reference laboratory in abuja through the polymerase chain reaction. their father was previously diagnosed with covid-19, and the second child was symptomatic with mild cough and nasal discharge cases, with an x-ray showing pericardiac and paratracheal region. these children were isolated in the isolation centre, separated from their parents and other close family relations (ibrahim et al., 2020). the children could not see the face of doctors, nurses and social workers providing treatment as they were wearing personal productive equipment, there was reduced level of confidence and trust from these children. the implication of this psychosocial wellbeing of these includes total exclusion from their parents and other social environments. in another case report from unicef, (2020) from lagos, nigeria, there was a reported case of violence against children. this is a 13year old female, rose (name not real) was sexually and physically abused by her father several times. she grew up in a separated family because her mother had left when she was still very young. her father resides in a one-room apartment in the suburb of lagos state. her neighbour alerted the owner, and the case was reported to the state ministry of women’s affairs and social welfare for justice. the emergence of covid-19 worsened the case due to the closure of schools and the compulsory implementation of social distancing; this gave her father an avenue to rape her every night, and she was often tied and physically harassed when trying to stop him. rose's consistently stifled cries during nights arose the attention of her neighbour, and she was finally rescued. there was an immediate provision of medical and psychosocial support services to rose; her father was taken into police custody while she underwent a medical examination to ascertain there was pregnancy and other traces of sexually transmitted infection in the child (unicef, 2020). this implies that her case has led to an over 50 percent increase in the number of cases of sexual violence during the lockdown, with more than 85% of cases relating to children and adolescents (partnership for justice, 2020). there is every possibility that cases of sexual and physical violence have been underreported during the covid-19 lockdown. there is a very possibility that when children are allowed to go back to school freely, they will hopefully meet people they can confide in and there will be an influx of cases (partnership for justice, 2020). restriction www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 27 published by scholink inc. in movement, loss of income, isolation, and high-stress levels are the main predisposing factors for children to experience psychosocial problems at home as they have made it extremely difficult for the victims – children to avoid their abusers (unicef, 2020). from oyo state, nigeria, there was a reported case of a covid-19 patient that gave birth, delivered at the infectious disease centre of the university college hospital, ibadan. this was the first covid-19 patient to have a delivery at the isolation centre. although, mother was symptomatic while the baby was asymptomatic. (punch healthwise corner, 2020). 5. conclusion and recommendations the impact of covid-19 on children’s poverty, survival and health cannot be neglected. however, this impact is unequal, as some children will bear the consequences without appropriate interventions. the potential negative psychosocial impact for several children worldwide can be catastrophic as it slows down the progress of many sustainable development goals targeting children while also putting the ambitious target out of sight. in conclusion, information to address multiple psychosocial risks to save most at-risk children is very important as the rapid accumulation of data on the impact on children and their families. covid-19 has shown a test of solidarity within communities, the scientific community and the nation, which will build a sense of unity among people. however, there is a wide range of activities by the government around the world to mitigate the pandemic by developing best practices to prevent psychosocial issues arising from the pandemic among children. the paper recommends immediate expansion of social assistance for families and universal child grants to protect children from extreme poverty. there is a need for an urgent supply of food chain to prevent children from food security crisis. in urban settings, the adaptation of standard physical distancing is essential in low-income settings by following preventive guidelines by the government authorities while also reflecting on the characteristics of children in different settings. the government of nigeria should prioritize child-centred services which focus on equity of access like schooling, nutrition programme, maternal and immunization services, sexual and reproductive health services, mental health services and psychosocial services for children. protection services for vulnerable children, including children with disabilities and settlements like banning the arrest and detention of children that violates covid-19 directives. training parents and caregivers include how to talk to their children about the pandemic, how they can manage their mental health and themselves, and tools to help their learning. acknowledgement we acknowledged children and their caregivers. www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 28 published by scholink inc. references american academic of child and adolescent psychiatry. (2020). talking to children about coronavirus (covid19). retrieved from https://www.aacap.org/app_themes/aacap/docs/latest_news/2020/coronavirus_covid19__c hildren.pdf cao, y., li, l., & feng, z. (2019). comparative genetic analysis of the novel coronavirus (2019-ncov/sars-cov-2) receptor ace2 in different populations. cell discovery, 6(11). https ://doi.org/10.1038/s4142 1-020-0147-1 centre disease communication. (2020). novel covid-19. new york. retrieved from:https://www.cdc.gov/grants/public-health-emergencies/covid-19/index.html chan, j. f. w., yuan, s., kok, k. h., to, k. k. w., chu, h., yang, j., & yuen, k. y. (2020). a familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. the lancet, 395(10223), 514-523. https://doi.org/10.1016/s0140-6736(20)30154-9 committee on rights of the child. (2020). response to covid-19. retrieved from https://www.childrightsconnect.org/child-rights-connect-responses-to-covid-19/ defence for children international. (2020). the impact of covid-19 on children’s right. geneva, switzerland. evans, d. k., & miguel, e. (2013). orphans and schooling in africa: a longitudinal analysis. demography, 44(1), 35-57. https://doi.org/10.1353/dem.2007.0002 evans, o. (2020). socio-economic impacts of novel coronavirus: the policy solutions. bizecons quarterly, 7, 3-12. gentiini, u., almenfi, m. b. a., orton, i., & dale, p. (2020). social protection and jobs responses to covid-19: a real-time review of country measures “"living paper”" version 5 (april 17, 2020). world bank. new york. international monetary fund. (2020). the global economic outlook during the covid-19 pandemic: a changed world. retrieved from https://www.worldbank.org/en/news/feature/2020/06/08/the-global-economic-outlook-during-thecovid-19-pandemic-a-changed-world li, q., guan, x., wu, p., wang, x., zhou, l., tong, y., & feng, z. (2020, march 26). early transmission dynamics in wuhan, china, of novel coronavirus-infected pneumonia. new england journal of medicine. massachusetts medical society. https://doi.org/10.1056/nejmoa2001316 lin, l., & li, t. s. (2020). interpretation of “guidelines for the diagnosis and treatment of novel coronavirus (2019-ncov) infection by the national health commission (trial version 5)”. zhonghua yi xue za zhi, 100, e001. www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 29 published by scholink inc. logie, c. h., & turan, j. m. (2020). how do we balance tensions between covid-19 public health responses and stigma mitigation? learning from hiv research. aids and behavior. springer. https://doi.org/10.1007/s10461-020-02856-8 nadeem, s. (2020). coronavirus covid-19: available free literature provided by various companies, journals and organizations around the literature provided by various companies, journals and organizations around the world. journal of organic chemistry research, 5(1), 7-13. olayinka, r. i., bello, m. s., abdallah, s., taofeek, o., surajudeen, o. b., umar, i. b., shamsudeen, y., adamu, d., & sulaiman, s. b. (2020). covid-19 in children: a case series from nigeria. pan african medical journal, 35(2), 53. doi: 10.11604/pamj.supp.2020.35.2.23597 park, m., cook, a. r., lim, j. t., sun, y., & dickens, b. l. (2020). a systematic review of covid-19 epidemiology based on current evidence. journal of clinical medicine, 9(4), 967. punch healthwise corner. (2020). covid-19 patient gives birth in oyo. retrieved from https://healthwise.punchng.com/covid-19-patient-gives-birth-in-oyo/ unesco. (2020). education: from disruption to recovery. retrieved from https://en.unesco.org/covid19/educationresponse unicef. (2017). the state of the world’s children 2017: children in a digital world. retrieved fromhttps://www.unicef.org/sowc2017/?utm_campaign=sowc+english+&utm_medium=bitly&u tm_source=media unicef. (2020). covid-19 children suffer violence during lagos lockdown. retrieved from https://www.unicef.org/nigeria/stories/covid-19-children-suffer-violence-during-lagos-lockdown unicef. (2020). covid-19: 950 more nigerian children under five could die every day without urgent action. retrieved from https://www.unicef.org/nigeria/press-releases/covid-19-950-more-nigerian-children-under-five-co uld-die-every-day-without-urgent unicef, global social service workforce alliance, the international federation of social workers, and the alliance for child protection in humanitarian action. (2020). technical note: the care and protection of the social service workforce during the covid-19 response. retrieved from https://www.ifsw.org/wp-content/uploads/2020/05/ssw-tn-2.pdf unwomen. (2020). meeting of african ministers in charge of gender and women’s affairs on “covid-19 response and recovery”—a gendered framework. retrieved from https://www.unwomen.org/en/news/stories/2020/5/announcer-african-ministers-in-charge-of-gend er-and-women-on-covid-19-response-and-recovery who. (2020). coronavirus. retrieved january 20, 2020, from https://www.who.int/health-topics/coronavirus world bank. (2020). 15 ways to support young children and their families in the covid-19 response. new york: usa. www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 2, 2022 30 published by scholink inc. world economic outlook. (2020). covid-19: an unprecedented threat to development. retrieved from https://www.imf.org/en/publications/reo/ssa/issues/2020/04/01/sreo0420 world health organisation. (2020). mental health and psychosocial considerations during covid-19. geneva, switzerland. children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 4, no. 2, 2021 www.scholink.org/ojs/index.php/ct 1 original paper flexibility & grace: lessons learned in k-12 during the covid-19 pandemic dr. chevella t. wilson1* & raymond j. ankrum1* 1 engage llc, winston salem, united states * raymond j. ankrum, engage llc, winston salem, united states; dr. chevella t. wilson, engage llc, winston salem, united states received: april 20, 2020 accepted: april 30, 2021 online published: may 15, 2021 doi:10.22158/ct.v4n2p1 url: http://dx.doi.org/10.22158/ct.v4n2p1 abstract the start of the school year 2020 was a tumultuous time for stakeholders. parents had to make accommodations for school programs. teachers and students on the frontlines had to make mental and physical adjustments to in-person and online learning. no matter how one looks at it, post covid-19 school will never be the same. this article takes a deep dive into why schools that had to adjust learners will be in a more situated space to ensure learning occurs in a manner consistent with schools that provide high-quality instruction for students and families. keywords pandemic learning, covid-19, hybrid instruction, online learning introduction in the early months of 2020, a cataclysmic virus unleashed itself on our country. covid-19 has since been the cause of over 200,000 deaths to date. the covid-19 pandemic has ruptured financial institutions and american businesses to their very core. such destruction to our financial markets reminded us briefly of the great depression of the 1920s. american schools did not escape the onslaught. according to bhamani et al. (2020), most governments worldwide temporarily suspended schools until there was a better command over how to contain and defend against covid-19. in new york state, schools were closed in mid-march and remained closed until early september. each school had to submit a learning plan that required approval by the new york state education department, allowing schools to transition into the 2020-2021 school year. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 2, 2021 2 published by scholink inc. literature review teaching during covid-19 may prove to be a challenge. teaching during regular times pre-covid-19 has proven to be difficult for many teachers; adding a pandemic to the plate will highlight existing deficiencies. adjusting to a new routine will take an adjustment period for educators. haverback (2020) posits we ask teachers to make adjustments on the fly for conditions that they are untrained to handle. given the sudden need for adjustments and flexibility from teachers, quality instruction could diminish due to a lack of proper training. henceforth, “enhancing and transforming teachers’ self-efficacy beliefs may help to guide teachers through this difficult time” (haverback, 2020, p. 2). quite naturally, in order for our teachers to continue to provide quality instruction to students during pandemic learning, school systems, and building leaders will have to provide professional development and coaching to assist educators on how to navigate. on the other hand, covid-19 was supposed to cause a reset at how we viewed school. many things that were mundane and taken for granted were now put squarely in our faces. the connections of being in-person. the ability for students and teachers to build their bond, a bond that directly impacts student achievement, is critical. in notes from the field, an article written to capture the impact of covid-19 on teachers, nagle (2020) perfectly depicts the first couple of weeks surviving as an educator during the covid-19 pandemic. the article captures the initial enthusiasm of online learning while also stating how this quickly waned as teachers began to miss their students. teachers are resilient beings; they make adjustments on the fly. one does not doubt that with a few adjustments, teachers will give quality instruction to students. the students are essential to the learning environment of schools. pandemic or not, educators are tasked with providing rigorous learning opportunities for students to thrive. our student expectations are to make transitions on the fly in order to help facilitate their learning. such transitions rarely account for proper ways to administer services deemed necessary for the child’s learning, i.e., iep accommodations and other anticipatory measures put in place to ensure the most vulnerable students receive adequate education during the pandemic. schaefer et al. (2020) espouse how difficult it can be to educate students in non-pandemic times; now, stakeholders provide instruction to students without factoring in economic stress, health, and socio-emotional well-being. while we know our kids to be resilient, to not account for their mental well-being becomes a vast ask for students and families. many schools have proven an inability to deal with such a tall order. moreover, it is counterintuitive to want to highlight the breakthroughs of pandemic learning. one such breakthrough is relationship strengthening between students and parents. family engagement is bound to increase, as parents now have to play a more active role in educating the minds of their children. bhamani et al. (2020) posit that when parents and their children engage in collaborative efforts that facilitate learning, bonding between parent and child increases exponentially, allowing for the accounted time to have a more significant impact facilitating relationship building. the article goes on www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 2, 2021 3 published by scholink inc. to theorize that online schooling could be a catalyst to improve bonds between families. one downside among many that need capturing in scholarship is the internet dependency for online learning and hybrid learning platforms. internet access also highlights the inequities that exist in schools. whereas socio-economically disadvantaged students sometimes do not have access to a stable internet, nor do they have access to devices. schools that did not invest in their infrastructure by purchasing devices that students can take home and learn may run into obstacles. not to mention rural access to wi-fi services may also be problematic for schools. romero-ivanova et al. (2020) states, “the internet, while it has never been completely reliable or dependable, was found to be even more problematic during this crisis period, and globally students who lived in rural areas, ones who lived in areas that did not have adequate wi-fi, or students who could not afford access were often marginalized because of these issues” (romero-ivanova, 2020, p. 83). participants the researcher is a school superintendent uniquely situated in a charter school district that serves students and families from grades k-9. the school has over 700 students located on long island. the demographics of the school are 78% hispanic, 20% african american, and 12% white. the researcher tasked the school’s principal with creating and sharing a likert-styled survey to obtain feedback related to questions and concerns exhibited by the school’s teachers. the purpose of obtaining the feedback was to help the school leadership team adequately prepare the learning environment while helping to mitigate teacher concerns identified from the survey. the researcher thoroughly explained the purpose of the survey and the usage of the survey data. all teachers that participated in the survey are certified by the new york state education department (nysed). apparatus and materials the researcher explained that participation in the survey was voluntary. teachers could opt out of taking the survey with no judgment or recourse. the teacher demographics of the survey participants are 83% white, 15% african american 2% asian. sixty out of sixty teachers provided with the link responded to the likert survey. the likert survey was composed of several questions, with responses ranging from 1-5, 1 representing strong disagreement, and 5 representing strong agreement. the survey was created using google forms, which also collects and analyzes the data as well. there was also space providing to teachers to leave additional thoughts and concerns that may not have been captured in the survey. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 2, 2021 4 published by scholink inc. procedure the survey tool selected for this study was a likert survey instrument. the questions in the survey encompassed how teachers felt about returning to live in-person instructions and procedures that would need to be put in place for teachers to feel comfortable delivering live instruction to students. the survey link was sent to teachers via our online google platform, the teacher's first initial and last name, followed by rcsli.org. the link to the survey was sent to all of the teachers simultaneously. discussion during this time of utter chaos and uncertainness, it was important for school leaders to hear the voices of the teachers on the front lines. we knew there would be some reluctance to teachers returning face to face to teach students. rather than force teachers back into buildings, we thought the best approach would be to allow teachers to participate in determining the likelihood of returning into school safely. one of our immediate goals was to commit to being overly transparent with our school community. conversations that may have previously been on a need-to-know basis were now opened up for feedback and criticism. it was vital that we also set realistic expectations for staff and instructors. we also made sure to ask students and staff to be flexible, given pandemic learning was uncharted territory (ross & desalvo, 2020). as a parent and a school leader, one was immediately able to identify the weaknesses presented by our online learning program. unlike many other schools, we anticipated the need to invest in our infrastructure. we had already transitioned to one-to-one devices for students. the problem we uncovered was not a groundbreaking one. however, we were able to ascertain that in-person learning was more impactful than our more than robust attempt to educate students online (carpenter & dunn, 2020). we watched many other districts make decisions as top-down directives, and we wanted to ensure that we approached the situation differently. teachers had just as much of a right to express their concerns as anyone else involved in pandemic learning. by listening to our teachers, we were able to quell many of their concerns. having teachers eager to return to a safe building got us to our ultimate goal: to return safely to face-to-face learning. hypothesis the hypothesis for the study was if teachers were provided with protective gear (ppe), they would be okay with retiring to work to provide live instruction. results out of the surveyed staff, 65% of staff members were okay with returning to face-to-face instruction. 35% of staff members expressed concerns with returning to work. compared to some of the data www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 2, 2021 5 published by scholink inc. released from the three largest school districts in the united states, our teacher’s willingness to return to face-to-face instruction outperformed those districts. teachers that fell into the category of willing to return to work also requested enhanced cleaning protocols, social distancing, and consistent health screenings. the teachers also insisted that we follow the advice of the center for disease control. study limitations the limitations of the study are finite in that the study is being conducted during a pandemic. there are underlying factors such as mental health and well-being that the study does not take into account. another limitation is that the researcher could not extrapolate additional data sources, i.e., interviews, due to pandemic concerns. lastly, opening the study up to include additional schools would have been beneficial to the results and claims of the study. further research the covid-19 global pandemic caught many by surprise. it is safe to say that most americans were unprepared to adjust to the ramifications presented by covid-19 properly. if history has served us correctly, we know that there will be future pandemics. the hope is that this research will help in preparing for future pandemics. education in the united states is central to everything. with our country coming to a screeching halt, while teaching and learning become proportional compared to where it has always been, we know there is still much work to do in k-12 education. using lessons learned from the covid-19 pandemic will serve us well in how we address our need to be prepared for future emergencies. references bhamani, s., makhdoom, a. z., bharuchi, v., ali, n., kaleem, s., & ahmed, d. (2020). home learning in times of covid: experiences of parents. journal of education and educational development, 7(1), 9-26. https://doi.org/10.22555/joeed.v7i1.3260 carpenter, d., & dunn, j. (2020). we’re all teachers now: remote learning during covid-19. journal of school choice, 14(4), 567-594. https://doi.org/10.1080/15582159.2020.1822727 haverback, h. r. (2020). middle level teachers quarantine, teach, and increase self-efficacy beliefs: using theory to build practice during covid-19. middle grades review, 6(2), n2. nagle, t. (2020). covid notes from the field: differentiation in the digital classroom. georgia educational researcher, 17(2), 6. https://doi.org/10.20429/ger.2020.170206 romero-ivanova, c., shaughnessy, m., otto, l., taylor, e., & watson, e. (2020). digital practices & applications in a covid-19 culture. higher education studies, 10(3), 80-87. https://doi.org/10.5539/hes.v10n3p80 www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 2, 2021 6 published by scholink inc. ross, a. f., & disalvo, m. l. (2020). negotiating displacement, regaining community: the harvard language center's response to the covid-19 crisis. foreign language annals, 53(2), 371-379. https://doi.org/10.1111/flan.12463 schaefer, m. b., abrams, s. s., kurpis, m., abrams, m., & abrams, c. (2020). “making the unusual usual”: students’ perspectives and experiences of learning at home during the covid-19 pandemic. middle grades review, 6(2), n2. children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 2, no. 1, 2019 www.scholink.org/ojs/index.php/ct 72 original paper analysis of pinterest as a tool for dissemination of nutrition information for parents of teenagers holly a. black1, julie r. schumacher1*, rachel l. vollmer2 & tammy s. harpel1 1 illinois state university, normal, il, usa 2 bradley university, peoria, il, usa * julie r. schumacher, illinois state university, normal, il, usa received: may 3, 2019 accepted: may 18, 2019 online published: may 24, 2019 doi:10.22158/ct.v2n1p72 url: http://dx.doi.org/10.22158/ct.v2n1p72 abstract this study focused on exploring the type of nutrition information disseminated on the social media site, pinterest. the information analyzed focused specifically on nutrition information for teenagers. data were collected by purposive sampling based upon specific inclusion criteria. five sets of search terms were used: teen breakfast healthy, teen lunch healthy, teen dinner healthy, teen nutrition and healthy snacks for teens. from these sets of search terms, 99 pins were collected for through mixed methods by two separate researchers. data collected from the pins were compared to the myplate guidelines. at least one food group from myplate was featured in the information shared, with the majority of pins featuring two to five of the myplate guidelines. the results indicated that overall, the pins were not from nutrition-related credible sources; rather, the information came primarily from parents of teenagers sharing their personal experiences. in general, the nutrition information shared was mostly accurate, albeit vague. due to the lack of nutrition-related credible sources, this study highlights a platform that registered dietitians and other health professionals could use to share relatable, evidence-based nutrition and wellness information to parents and adolescents. keywords nutrition information, myplate, social media, pinterest, teenagers, parents www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 73 published by scholink inc. 1. introduction myplate is produced by the united states department of agriculture as a visual representation to help americans form balanced meals and support healthy eating and drinking habits (myplate, 2017). the myplate model replaced the mypyramid in 2011 (a brief history of the usda food guides, 2017). according to the cdc (2017), children ages 2-18 years have increased their consumption of fruit but not vegetables. while fruit consumption is increasing, it still falls short of the recommendations. on average, over 90 percent of children are not consuming the recommended servings of fruits and vegetables (centers for disease control and prevention, 2017). sixty-five percent of american adults use social media networks, according to pew research center (2015). social media has changed how americans work, share political viewpoints, as well as search and retrieve health information—including nutrition information (perrin, 2015). there has been an increase in internet usage, and a large proportion utilize social media websites, such as facebook, pinterest, twitter, instagram, and linkedin via mobile devices or desktop (duggan, 2015). according to the pew research center, the use of pinterest is steady, and users are predominately women younger than 50 years of age (duggan, 2015). the internet and social networks provide a low-cost platform for increased reach of information dissemination (cugelman, thelwall, & dawes, 2011). over the recent years, over one-third of us adults used the internet and social media to seek health-related information, which prompted some to pursue additional medical advice (fox & duggan, 2013). according to pew research center, approximately 80% of mothers accessed social media to research feeding practices for their children (duggan, lenhart, lampe, & ellison, 2015). the us centers for disease control (cdc) has released guidelines for developing a social media marketing strategy in order to promote the use of social media as a layperson-friendly platform for credible information (o’flahavan & goulet, 2012). with ample access to nutrition information, research must also be conducted to determine how nutrition information is applied. nutrition literacy is an emerging topic of interest in the realm of social media utilization. it consists of the use of literacy skills in order to analyze and apply nutrition-related information to one’s own life (begley, 2014). research has shown that individuals with higher levels of nutrition literacy tend to have healthier lifestyles (silk et al., 2008). it has been noted that nutrition literacy is essential for healthy weight maintenance and overall healthful lifestyle choices (brewer, church, & brewer, 2016). research related to feeding practices and child nutrition have primarily focused on children under the age of five as well as breastfed babies (doub, small, & birch, 2016b; mccann & mcculloch, 2012). nutrition at these points in the lifespan is critical for growth and development, and research has shown that mothers seek information to best support healthy feeding practices (doub, small, & birch, 2016b; mccann & mcculloch, 2012). however, there has been little research on information presented on www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 74 published by scholink inc. social media for adolescent or teenage nutrition in the us. some research has focused on teens 13-17 years old across australia, the united states, and the united kingdom in regards to social media marketing for food and beverages, tobacco use, and alcohol use. it was found that increased exposure to potentially harmful products via social media marketing may impact the overall health of the teens (dunlop, freeman, & jones, 2016). because of this, more research is needed to determine how teenagers and their parents are retrieving nutrition information. social media is generally defined as a networking platform with which users can share and retrieve information within a community setting, such as facebook, instagram, pinterest, twitter, and youtube. the purpose of this current study was to use existing information shared on pinterest to analyze the use of social media in the retrieval of nutrition information focused on teenagers 13-19 years old. the primary research questions that guided this research study were: 1) do pins on pinterest related to teenage health and nutrition align to the myplate guidelines? 2) what is the credibility of nutrition-related information shared on pinterest? 2. method 2.1 sample all data was collected based upon content analysis of public pins and boards on the social networking site, pinterest. the sample of pins focused on teenage health, an age range of 13 to 19 years old. using purposive sampling, search terms were applied and the first 25 pins that met inclusion criteria were pinned to a private board for data collection. the total sample size was 99 pins. 2.2 procedures the following methodology was adapted from research by doub, small, and birch (2016a) and h. brewer, church, and s. brewer (2016). data was collected from the social networking site, pinterest, using purposive sampling. pinterest allows users to access a search bar in order to find specific types of information. using this search bar, five sets of specific search terms were used in order to generate information on healthy items for teenagers. the sets of search terms included the following: teen breakfast healthy, teen lunch healthy, healthy snacks for teens, teen nutrition, and teen dinner healthy. each set of search terms was typed into the pinterest search bar, and the first 25 pins that met inclusion criteria were considered part of the sample. five sample sets, each based upon the sets of search terms, had separate, private boards as a means to collect pins. specific inclusion and exclusion criteria was applied to the pins. only the pins that met inclusion criteria were qualitatively analyzed. this procedure was repeated for all five sets of search terms. a total of 99 pins were collected for all sets of search terms (figure 1). www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 75 published by scholink inc. figure 1. purposive sampling and final sample size for each search term 2.3 inclusion and exclusion criteria in order to collect data, pins were included if they were linked to content, such as a blog or recipe. further, pins were included in data collection only if they were content-based with recipes and/or nutritional information. the pin also must have had information that focused specifically to teenagers’ ages 13 to 19 years and healthy food choices. pins that were advertisements were excluded from data collection. additionally, any pins that did not contain a direct link to content were excluded. for example, if the pin linked to only a picture and not a website, it was excluded from the sample set. pins were also excluded if they were not considered relevant to the search terms, such as a pin that may be considered healthy but not related to teenagers. if the pin was a duplicate of the same link to information within a specific search term, it was also excluded. 2.4 data collection from each pin included in data collection, several pieces of information were collected for mixed methods analysis. information collected included: name of the pin, author of the pin, website link, credentials/background of information source (if applicable), type of post, and target population (gender, athletics, etc.). if available, data were collected on the number of re-pins or how often the information was shared. information collected from pins was compared to myplate guidelines. each link was analyzed to determine the inclusion of the five food groups of myplate: fruits, vegetables, grains, protein, and dairy. if a component of the food group was included in the recipe, it was documented as part of the data collection. credible sources of information were defined as those with a www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 76 published by scholink inc. bachelor’s degree or higher in nutrition or credentials such as registered dietitian. content was analyzed for trends in information collected from pins. after initial review of compiled data for themes in information, the data was reviewed by a separate researcher. the secondary researcher was trained to analyze pertinent nutrition information identified in the pins collected. in addition, the secondary researcher had previous knowledge on myplate guidelines prior to qualitative data analysis. data were further analyzed with descriptive statistics. 3. results pins were collected based upon inclusion criteria and data were analyzed qualitatively and quantitatively. overall, the results from each search term met an average of three of the five myplate food groups which include fruits, vegetables, grains, protein, and dairy. some of the pins provided more in-depth nutrient information, but the overall collection of blogs, articles, slideshows, etc. focused on basic nutrition information and recipes targeting teens or a specific subset of teenagers, such as athletes. table 1 provides a summary of the descriptive statistics, and table 2 provides overarching themes found for each search term. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 77 published by scholink inc. table 1. the descriptive analysis of pins for teenage nutrition collected on pinterest number of pins collected average number of re-pins target populations number of pins with credible nutrition sources, n (%) pins that met all myplate guidelines, n (%) average number of myplate guidelines met by pins, n (%) teen breakfast healthy 24 221 teen girls, tweens, teens, school-aged children, teen athletes 3 (12.5) 8 (33) 3.79 (75.8) teen lunch healthy 24 1741 teen girls, teen boys, high school athletes, tweens, teens 1 (4.2) 15 (62.5) 4.5 (90) teen dinner healthy; teen supper healthy 2 204 teens 0 (0) 0 (0) 3 (60) teen nutrition 25 635 teens, teen athletes, high schoolers, teen boys, teen girls 6 (24) 14 (56) 3.8 (76) healthy snacks for teens 25 233 teens, teen athletes, tweens 3 (12) 10 (40) 3.96 (79.2) www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 78 published by scholink inc. table 2. the overarching themes of pins for teenage nutrition collected on pinterest search term overarching themes teen breakfast healthy primarily lacking in vegetables main focus on grains and protein, usually in form of dairy eggs and oatmeal were predominant foods observed breakfast burritos, smoothies, and acai bowls were trendy options for teens quick, easy to make by parents and/or teens teen lunch healthy large focus on back to school more vegetables included than breakfast easy to grab-and-go, modifiable for picky eaters specialty and themed lunch boxes were trendy limited credible nutrition sources of information some youtube videos of teens sharing lunch ideas different portion sizes based on gender for satiety concerns teen dinner healthy teen supper healthy lack of information within these search terms “teen-friendly” recipes featured paleo cookbook written by a teen featured parents likely more focused on healthy dinner ideas for whole family, not just teenagers teen nutrition vague information, fairly accurate focus on adequate macronutrients, calcium few sites contrasted with myplate recommendations (grains, dairy) highlights gap in information for teen athletes healthy snacks for teens no true “well-rounded” snack—complication of different myplate groups that can be mixed and matched grab-and-go items featured protein and carbohydrate or vegetable common pairings www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 79 published by scholink inc. 3.1 teen breakfast healthy the first search term yielded 24 pins that linked to content related to breakfast items for teens. the breakfast ideas shared in this set of data were primarily focused on protein and grains. the main sources of protein came from dairy products as well as eggs. one of the predominant foods observed from multiple pins was oatmeal, either in its original form or baked. another trend that was observed was breakfast burritos or a variation of eggs with tortilla shells. smoothies and acai bowls were also observed, which contributed adequate fruit servings. these smoothie and acai bowls also contained granola or chia seeds. overall, the pins analyzed seemed to have a common trend of quick to make, either by the parents or teens themselves, as well as some that were intended to be portable. there was a distinct lack of vegetables observed in the shared information and pins. of these pins, only eight pins (33%) provided enough information to meet all five myplate guidelines. on average, the pins sampled met 3.79 myplate guidelines (75.8%). the target populations of these pins were teen girls, school-aged children, tweens, and teen athletes. the number of credible nutrition-related sources was 12.5% (n=3). the average number of re-pins, or how often information was shared on pinterest, was 221 times. 3.2 teen lunch healthy the second search terms yielded 24 pins that linked to content related to lunch items for teens. in general, these pins focused on school lunch options, grab-and-go ideas, as well as modifications for picky eaters. based upon analysis of pins collected, specialty and themed lunch box ideas were popular options for teenagers at school. in general, many of the lunch options focused on sandwiches or wraps as well as salads. one of the interesting aspects of this data set is that some of the pins included in search criteria were linked to youtube videos of teens who were preparing healthy lunch options. these videos were geared towards other teenagers, which made the content relatable. the lunch options analyzed had more vegetable options than the grain, protein, and fruit focus of breakfast items. many of the authors of blogs shared a common theme of concern for healthy, well-balanced lunches to help teenagers focus and succeed in school. some of the sources encouraged their teenagers to pack the lunch for themselves, while others focused on packing items they knew their children would consume. a few of the blogs focused on keeping teenagers full, specifically boys; these pins highlighted protein and whole grains as well as bigger servings for satiety. of these pins, only one pin (4.2%) provided enough information to meet all five myplate guidelines. however, on average, the pins sampled met 4.5 myplate guidelines (90%). this search term had the largest average number of myplate guidelines featured in the content provided. the target populations of these pins were teen girls, teen boys, school-aged children, tweens, teens in general, and high school athletes. the number of credible nutrition-related sources was 62.5% (n=15), and the average number of re-pins was 1741 times. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 80 published by scholink inc. 3.3 teen dinner healthy the third search term only yielded one pin that met the inclusion criteria. a second search was performed under the search tern, teen supper healthy, and only one additional pin met inclusion criteria. because of this, data analysis was only based upon two links. these pins highlighted ten dinner ideas that were termed teen-friendly as well as dinner recipes from a cookbook written by a teenager. part of the commentary of the sources was geared towards recipes that pickier teens would approve of instead of wanting to eat fast food or at a restaurant. recipes suggested were oven-fried chicken, quesadillas, and pasta, as well as hotdogs. two salad recipes were also suggested, but one did not have a protein source. as for the link featuring a teenage cookbook author, the cookbook included only paleo recipes, avoiding certain food groups and nutrients. due to this, only vegetables and protein were highlighted in the recipes. these pins focused on teens in general, and there was an average of 204 re-pins. the first link was not written by a credible nutrition-related source, and neither pin met all the guidelines for myplate. on average, the pins sampled met three myplate guidelines (60%). the second link was written by a private chef and full-time nutrition student; however, the commentary of the article was from a high school student with no nutrition-related credibility. 3.4 teen nutrition the fourth search term yielded 25 pins that linked to content related to some type of nutrition advice for teens. in general, these pins focused on fairly accurate information related to carbohydrates, protein, and fats as well as their respective sources. there was mention in some of the links the concern for adequate calcium intake for bone health. overall, the information shared was somewhat vague. a few of the pins focused on foods teens should be eating, which highlighted foods such as salmon, lentils, walnuts, avocados, dairy (specifically yogurt), as well as whole grains such as brown rice or quinoa. an article written by a dietitian focused on good nutrition for tweens and teens, specifically highlighting adequate hydration and the myplate principles. two of the articles, including the one previously mentioned, directly referenced myplate for proper teen health and nutrition. there was one pin that promoted the paleo diet for teenage athletes, with an emphasis on a high-fat, high-protein, low-carbohydrate diet. of these pins, 14 pins (56%) provided enough information to meet all five myplate guidelines. on average, the pins sampled met 3.8 myplate guidelines (76%). the target populations of these pins were teen girls, teen boys, teens in general, high school students, and teen athletes. the number of credible nutrition-related sources was 24% (n=6). the average number of re-pins was 635 times. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 81 published by scholink inc. 3.5 healthy snacks for teens the final search term yielded 25 pins that linked to content related to snacks for teens. the focus of the different snacks shared seemed to be on grab-and-go for teens after school. one of the recurring themes was that the snacks needed to be easy and appealing to teens so that they choose them without prompting. some of the trends in snacks included vegetables with low-fat dips or hummus, fruit and yogurt, popcorn, as well as peanut butter and trail mixes. cheese sticks and sandwiches were also featured snacks. sweet vegan snacks like muffins, granola bars, and homemade fruit roll-ups were the feature of one vegan-focused blog. of these pins, 10 pins (40%) provided enough information to meet all five myplate guidelines. on average, the pins sampled met 3.8 myplate guidelines (79.2%). the target populations of these pins were teens in general, tweens and teen athletes. the number of credible nutrition-related sources was 12% (n=3). the average number of re-pins was 233 times. 4. discussion 4. 1 types of nutrition information provided the research conducted in this study was primarily exploratory; however, certain themes arose through the course of data collection. many of the pins found through the respective search terms were from parents pinning general healthy pins for their children. these types of pins did seem to adhere to most of the myplate guidelines based upon content analysis; however, they were not included in this study as they did not specifically focus on teenagers specifically. overall, the majority of pins included in this study could be modified to include at least one more area of myplate. while a snack may not necessarily meet all five of the myplate guidelines, encouraging teenagers and their parents to strive to include as many as possible may help to increase fruit and vegetable consumption. this idea of incorporating more of myplate guidelines emphasizes a need for nutrition education. many of the pins analyzed contained between two to five of the guidelines. on average, three of the five myplate guidelines were met within each search term. basic nutrition education could promote the idea of adding one more element to make a meal well-rounded. for instance, an evening meal could contain whole grains, lean protein, dairy, and vegetables. this model is lacking a fruit component. nutrition professionals could easily alleviate this by suggesting the addition of a fruit for dessert. as previously mentioned, the search term teen healthy dinner (teen healthy supper) only produced two results, which made it difficult to analyze. due to the limited nature of these search terms, it is possible that parents may be more focused on healthy dinner recipes for the whole family. in addition to general, healthful information, some of the nutrition-related information shared via pinterest centered on more specific areas of nutrition. some of the information shared under the teen nutrition search term was geared towards weight loss, which could be an area of focus for teenagers or their parents. adolescents tend to have a shift in self-esteem and body image due to the changes faced www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 82 published by scholink inc. during puberty (markey, 2010). previous research has shown that body image during this time of life is crucial to overall health and well-being, and higher levels of body dissatisfaction may result in low self-esteem and eating disorders (markey, 2010). de vries, peter and de graaf (2016) found that both adolescent boys and girls had higher levels of body dissatisfaction. they also had greater peer influence with increased time spent on social media, which adds to the growing body of research that has found correlation between body image and social media use. the researchers suggest that parents should be aware of this correlation and take preventative action (de vries, peter, & de graaf, 2016). the information provided in pins was generally vague, focusing on a healthier diet, avoidance of junk foods and sugar-sweetened beverages, as well as recommendations for moderate exercise. only a few of these sources mentioned calorie levels, but they mentioned it as a topic to discuss with a physician. another specific area of focus from the pins included in the study were vegan and vegetarian considerations. some of the pins were geared towards families that were vegetarian based upon ethical, ecological, or religious considerations. however, one source addressed how parents could help to transition mealtimes when their teenagers have made the decision to become vegetarian. adolescents and teenagers are at a transitional period in which they are discovering their personal identities as well as developing their beliefs and morals (cobb, 1992). this same period may result in newfound autonomy in food choices. one study analyzed the growing trends of adolescents becoming conscientious about where and how their food is grown (bissonnette & contento, 2001). with increasing awareness of sustainability practices and locally-grown agriculture, the environmental impacts of food production could influence teenagers to choose plant-based diets. according to the academy of nutrition and dietetics (2016), vegetarian diets are rich in fiber and antioxidants while being low in saturated fat. research has shown that there is a correlation between vegetarianism and lower risks of heart disease, diabetes, hypertension, some cancers, and obesity. teenagers can safely follow a vegetarian diet with the proper planning of complementary protein sources and well-balanced meals, although vitamin b12 supplementation may be necessary if not consuming fortified food products (melina, craig, & levin, 2016). the information shared in the pins sampled for the current study only provided recipes and alternative protein sources, such as soy, to meet protein requirements. this could be an area for registered dietitians to provide nutrition education to help teenagers and their parents safely form balanced, vegetarian meals. 4.2 credibility of the nutrition-related information with the variety of information analyzed during this study, there were many different sources of information, some of which came from individuals with nutrition-related backgrounds. however, the majority of pins were written by the layperson; specifically, most of the information was written by mothers based upon personal experience as part of their journey through parenthood. while this information can be helpful to other parents with similar concerns, it does not make them credible www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 83 published by scholink inc. sources of nutrition-related information for teenagers. the online community of parent bloggers has come together to provide information via experience rather than credentials. nutrition and health of children seem to be a unifying factor in the desire to write blogs and articles regarding the health of teenagers, especially if they are athletes with busy schedules or picky eaters. previous research has found that parents will consistently seek out nutrition information in order to best support their child’s growth and development (mccann & mcculloch, 2012; doub, small, & birch, 2016a). while this has not been studied in teenagers, it has been studied in both young children and babies being breastfed (mccann & mcculloch, 2012; doub, small, & birch, 2016a). one study found that mothers who followed food and recipe blogs, especially those geared towards younger children, were more likely to let the food served as well as portion sizes be influenced by the information shared (schneider, mcgovern, lynch, & brown, 2013). one trend noted in content analysis was that of parents who use endorsements of perceived healthy food items in order to generate revenue. the federal trade commission (ftc) regulates blog endorsements. while it is legal to make money from product endorsements as a blogger, the ftc is specific on how endorsements must be stated clearly on the blog in order to not mislead readers (the ftc’s endorsement guide, 2015). per the federal regulations, all blogs analyzed that sponsored products had a disclaimer. while these endorsements were clear, it poses the question of perceived healthfulness based upon certain ingredients or an organic label. while these products may be useful for parents, the main goal of endorsed posts is not to provide nutrition information. this concept was not the focus of the current study, but it is an area that requires ongoing research. in addition to the general layperson sharing nutrition information based upon experience, there were some questionable sources of information. these sources of information labelled themselves as holistic or health and beauty experts without mention of credentials supporting their expertise. other sources of information came from various nutrition novels referenced loosely, in which individuals interpreted the information and applied it in their blogs. the recommendations from these sources included paleo diet recommendations for teenage athletes and fear of food colorings in processed foods and beverages. other advice that deviated away from myplate guidelines was the avoidance of added sugars as well as dairy products. myplate does briefly mention limiting added sugars as well as sodium; however, it is not yet part of the visual component of myplate. information on added sugars includes new research suggesting that consumers, including teens, should limit their daily intake. the most recent dietary guidelines for americans 2015-2020 included recommendations on the maximum amount of added sugars allowable in the diet without incurring the correlated health consequences. the dietary guidelines recommends less than 10 percent of calories daily from added sugars (u.s. department of health and human services & u.s. department of agriculture, 2015). in contrast, dairy products have more speculation circulating in popular media sources regarding the health benefits. in general, the www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 84 published by scholink inc. argument against dairy is human consumption of dairy is not natural, which critics claim is the reason behind high rates of lactose intolerance (gunnars, n.d.). however, a meta-analysis reviewed existing research and found that dairy consumption has many positive health benefits—such as lower rates of obesity and comorbidities including cardiovascular disease and diabetes—and no known adverse effects (thorning et al., 2016). this meta-analysis was unable to compare plant-based dairy alternative to cow’s milk products due to a lack of research (thorning et al., 2016). analyzing the content of blogs and other information shared by parents of teenagers can determine the credibility of the information. however, the concept of sharing information via the internet and technology is evolving. the internet has become a wealth of information for many individuals, including the layperson. while the internet enhances the ease of sharing and retrieving information, not all of the information comes from credible sources, as this current research has observed. this highlights the significance of registered dietitians and the increasing use of social media and the internet as a means of disseminating evidence-based, credible nutrition information. one study analyzed the use of twitter by dietitians in order to see what type of information is available for patients with heart failure (hand, kenne, wolfram, abram, & fleming, 2016). they found that health professionals tend to be more inclined to use the internet and social media for their own research, but they tend to doubt the credibility of information shared. this study also highlighted a gap in nutrition information and the potential for dietitians to remedy this in the future (hand, kenne, wolfram, abram, & fleming, 2016). other health care professionals are acknowledging the potential for outreach to the layperson in order to disseminate pertinent educational materials. one study focused on redesigning their website as well as increasing their presence on twitter and facebook in order to better engage their audience (goldstein et al., 2013). this is a growing area of interest and further investigation is needed. 4.3 limitations of this study as this study was exploratory, there are several limitations to be noted. one of the biggest issues with using pinterest as a tool to research the search habits of parents of teenagers is that the algorithm used to populate pins is somewhat randomized based upon popularity of the pin and popularity of the person pinning the information, as well as the relevancy of the pin itself to the search criteria. additionally, there were many pins of different pictures that all linked back to the same website. the pinterest search engine does not eliminate duplicates of the same source of information. this made data collection difficult and limited the data available for analysis. the captions on pins also were factored into the search algorithm of pinterest. some of the captions of pins generated by the search terms used in this study were relevant to the inclusion criteria, but upon further inspection, the pin was completely irrelevant to actual content of linked website. this made pins appear misleading, as individuals who pin links can add any caption they desire, even if it does not directly relate to the content of the pin. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 85 published by scholink inc. another limitation of the search algorithm of pinterest is the vague concept of teens. using this search term generated a plethora of information, none of which had a specific age range of interest. based upon observation, the pins included information on “tweens” (10-12 years old), 13and 14-year-olds, as well as general high school students. based upon the definition of the individual sharing the information, any of these age ranges could be perceived as teenagers. additionally, the lack of pins specifically related to teenagers was a limitation. as previously mentioned, most pins contained general, healthful information and were not specific to teen dietary needs or considerations. for example, the search term teen dinner healthy generated 50 to 100 pins, but only one pin was specific to teenagers. based upon the data analyzed in this study, there seems to be a lack of information geared towards teenagers. as demonstrated in previous research, the focus seems to be on children in elementary school or younger. additionally, the information seems to shift to college students as well in preparation for newfound independence and necessity to learn to cook. the information analyzed in this study did not equally focus on specific populations. there seemed to be a distinct gender difference in the type of information shared. for example, information pertaining to weight loss was generally geared towards teenage girls. in contrast, information specific to teenage boys seemed to be geared more towards athletics and physical activity. while this study did not specifically focus on weight loss or sports nutrition, further research is needed to understand the gap in nutrition information in relation to gender. 5. conclusion the primary research question that this study set out to answer was “do pins on pinterest related to teenage health and nutrition align to the myplate guidelines”? based upon the data collected, pins related to teen health generally correlate with myplate guidelines. most of the pins analyzed contained at least one of the food groups from myplate. overall, the information was somewhat vague, but the authors of the information tended to focus on adequate protein, inclusion of dairy, as well as the ease and convenience of food choices for busy, active teenagers. there is still concern regarding adequate fruit and vegetable intake, which highlights the need for nutrition education. the credibility of information seems to be concerning, as most of the sources of information were mothers of children and teenagers. however, there were a few articles written by nutrition experts such as registered dietitians. teenagers could be a focus age range for registered dietitians to provide evidence-based nutrition education that is relatable and easy to implement by parents of teenagers. as this study was focused on exploratory research, more studies need to be conducted on the type of information disseminated on social media sites such as pinterest, as well as how registered dietitians can use this platform to share relatable, evidence-based nutrition information. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 86 published by scholink inc. references a brief history of the usda food guides. (2017, january 25). retrieved february 5, 2017, from https://www.choosemyplate.gov/brief-history-usda-food-guides bissonnette, m. m., & contento, i. r. (2001). adolescents’ perspectives and food choice behaviors in terms of the environmental impacts of food. journal of nutrition education, 33(2), 72. https://doi.org/10.1016/s1499-4046(06)60170-x brewer, h., church, e. m., & brewer, s. l. (2016). the impact of content-based network technologies on perceptions of nutrition literacy. american journal of health education, 47(4), 243-252. https://doi.org/10.1080/19325037.2016.1178609 centers for disease control and prevention. (2017). children eating more fruit, but fruit and vegetable intake still too low. retrieved from https://www.cdc.gov/nccdphp/dnpao/division-information/media-tools/dpk/vs-fruits-vegetables/in dex.html cobb, n. j. (1992). adolescence: continuity, change and diversity. mountain view, ca: mayfield. cugelman, b., thelwall, m., & dawes, p. (2011). online interventions for social marketing health behavior change campaigns: a meta-analysis of psychological architectures and adherence factors. journal of medical internet research, 13(1), e17. https://doi.org/10.2196/jmir.1367 de vries, d. a., peter, j., & de graaf, h. (2016). adolescents’ social network use, peer appearance-related feedback, and body dissatisfaction: testing a mediation model. journal of youth & adolescence, 45, 211-224. https://doi.org/10.1007/s10964-015-0266-4 doub, a. e., small, m., & birch, l. (2016a). research article: an exploratory analysis of child feeding beliefs and behaviors included in food blogs written by mothers of preschool-aged children. journal of nutrition education and behavior, 48(2), 93-103. https://doi.org/10.1016/j.jneb.2015.09.001 doub, a. e., small, m., & birch, l. l. (2016b). a call for research exploring social media influences on mothers’ child feeding practices and childhood obesity risk. appetite, 99, 298-305. https://doi.org/10.1016/j.appet.2016.01.003 duggan, m. (2015, august 19). mobile messaging and social media 2015. retrieved from http://www.pewinternet.org/2015/08/19/mobile-messaging-and-social-media-2015/ duggan, m., lenhart, a., lampe, c., & ellison, n. b. (2015, july 16). parents and social media. retrieved from http://www.pewinternet.org/2015/07/16/parents-and-social-media/ dunlop, s., freeman, b., & jones, s. c. (2016). marketing to youth in the digital age: the promotion of unhealthy products and health promoting behaviours on social media. media and communication, 3, 35-48. https://doi.org/10.17645/mac.v4i3.522 www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 87 published by scholink inc. fox, s., & duggan, m. (2013, january 15). pew research center’s internet and american life project: health online 2013. retrieved from http://www.pewinternet.org/2013/01/15/health-online-2013/ goldstein, k., briggs, m., oleynik, v., cullen, m., jones, j., newman, e., & narva, a. (2013). article: using digital media to promote kidney disease education. advances in chronic kidney disease, 20, 364-369. https://doi.org/10.1053/j.ackd.2013.04.001 gunnars, k. (n.d.). is dairy bad for you, or good? the milky, cheesy truth. retrieved february 1, 2017, from https://authoritynutrition.com/is-dairy-bad-or-good/ hand, r. k., kenne, d., wolfram, t. m., abram, j. k., & fleming, m. (2016). assessing the viability of social media for disseminating evidence-based nutrition practice guideline through content analysis of twitter messages and health professional interviews: an observational study. journal of medical internet research, 18(11), 3. https://doi.org/10.2196/jmir.5811 markey, c. n. (2010). invited commentary: why body image is important to adolescent development. journal of youth and adolescence, 39, 1387-1391. https://doi.org/10.1007/s10964-010-9510-0 mccann, a. d., & mcculloch, j. e. (2012). establishing an online and social media presence for your ibclc practice. journal of human lactation, 28(4), 450-454. https://doi.org/10.1177/0890334412461304 melina, v., craig, w., & levin, s. (2016). from the academy: position of the academy of nutrition and dietetics: vegetarian diets. journal of the academy of nutrition and dietetics, 11(6), 1970-1980. https://doi.org/10.1016/j.jand.2016.09.025 merolli, m., gray, k., & martin-sanchez, f. (2013). health outcomes and related effects of using social media in chronic disease management: a literature review and analysis of affordances. journal of biomedical informatics, 46, 957-969. https://doi.org/10.1016/j.jbi.2013.04.010 myplate. (2017, january 25). retrieved february 5, 2017, from https://www.choosemyplate.gov/myplate o’flahavan, l., & goulet, a. (2012). cdc’s guide to writing for social media. retrieved from http://www.cdc.gov/socialmedia/tools/guidelines/pdf/guidetowritingforsocialmedia.pdf perrin, a. (2015, october 8). social media usage: 2005-2015. retrieved from http://www.pewinternet.org/2015/10/08/social-networking-usage-2005-2015/ schneider, e. p., mcgovern, e. e., lynch, c. l., & brown, l. s. (2013). do food blogs serve as a source of nutritionally balanced recipes? an analysis of 6 popular food blogs. journal of nutrition education and behavior, 45(6), 696-700. https://doi.org/10.1016/j.jneb.2013.07.002 silk, k. j., sherry, j., winn, b., keesecker, n., horodynski, m. a., & sayir, a. (2008). increasing nutrition literacy: testing the effectiveness of print, web site, and game modalities. journal of nutrition education and behavior, 40(1), 3-10. https://doi.org/10.1016/j.jneb.2007.08.012 the ftc’s endorsement guide: what people are asking. (2015, may). retrieved february 1, 2017, from www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 88 published by scholink inc. https://www.ftc.gov/tips-advice/business-center/guidance/ftcs-endorsement-guides-what-people-ar e-asking thorning, t. k., raben, a., tholstrup, t., astrup, a., soedamah-muthu, s. s., & givens, i. (2016). milk and dairy products: good or bad for human health? an assessment of the totality of scientific evidence. food & nutrition research, 60, 1-11. https://doi.org/10.3402/fnr.v60.32527 u.s. center for disease control and prevention. (2014, august 5). children eating more fruit, but fruit and vegetable intake still too low. retrieved april 4, 2017, from https://www.cdc.gov/media/releases/2014/p0805-fruits-vegetables.html u.s. department of health and human services and u.s. department of agriculture. (2015). 2015-2020 dietary guidelines for americans (8th ed., p. xiii). retrieved december 1, 2016, from http://health.gov/dietaryguidelines/2015/guidelines/ children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 3, no. 1, 2020 www.scholink.org/ojs/index.php/ct 1 original paper testing the psychometric properties of the habits of health scale for children and youth valerie a. ubbes1*, karly s. geller1, rebecca schweitzer2 & katherine robison3 1 miami university, oxford, ohio, united states 2 university of hawaii at manoa, honolulu, hawaii, united states 3 sga youth & family services, chicago, illinois, united states * valerie a. ubbes, miami university, oxford, ohio, united states received: november 21, 2019 accepted: december 1, 2019 online published: december 13, 2019 doi:10.22158/ct.v3n1p1 url: http://dx.doi.org/10.22158/ct.v3n1p1 abstract this paper describes the validity testing we performed on one-half of the habits of health and habits of mind© model to increase research on the daily habits of children and youth and to substantiate the teaching and dissemination of the model with greater confidence. child and adolescent health habits were tested with a new habits of health scale (hhs). the study purpose was to test the construct and criterion validity of the habits of health measurement subscales which included physical activity, nutrition, relationships, safety, and hygiene behaviors. two specific hypotheses were tested. the first hypothesis was that the hhs items would show acceptable factorial validity. the second hypothesis was the hhs factors would demonstrate high criterion validity, or the sensitivity of the scale to detect differences and associations that theoretically should exist. the hhs factors were expected to differ based on participants’ gender, perceived health status, perceived academic success, body mass index (bmi), and multiple health behaviors. results showed that each subscale demonstrated acceptable internal consistency and criterion validity. health patterns and routines of kids can now be measured by the habits of health scale, which is a multi-behavioral assessment tool that assesses the health status of children and youth. keywords child health, adolescent health, health habits, psychometric properties, construct validity, criterion validity, habits of health scale www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 2 published by scholink inc. 1. introduction a need exists for psychometrically sound tools for the measurement of child health habits. a few tools (cartland & ruch-ross, 2006; landgraf, maunsell, nixon speechley, bullinger, campbell, abetz, & ware, 1998) exist but a conceptual model of child and adolescent health habits has not been tested. child and adolescent health status is investigated by exploring developmental changes in biological growth; health risk behaviors (garrido, weiler, & taussig, 2017); declarative and procedural metacognitive knowledge (gascione, higgins, & wall, 2017); motivations toward cognitive skill development (kanfer & ackerman, 1989); achievement motivations, school connectedness, and getting along with others (lemberger, selig, bowers, & rogers, 2015). other adolescent health outcomes include salient beliefs to predict behavioral intentions (yzer, 2012) and the functional role of health literacy (broder et al., 2017) in preventive health behaviors (zullig, ubbes, & mann, 2013). a variety of instruments are available for measuring the subjective impact of an injury or disease on a child's physical, emotional, and social wellbeing (mccarthy, 2007). health status is the term used to describe how a person feels and functions within four categories: mental function, physical function, role function, and social function (ward, 2009). mental function includes the mood and ability to perform tasks requiring memory, thought, or concentration (ward, 2009) and may be described as cognitive vitality. physical function includes the different movements, activities, and abilities attributed by daily health routines and may be somatic, gestural, and procedural. procedural memory allows for the acquisition, consolidation, and use of motor skills and cognitive routines (magallón, narbona, & crespo-eguilaz, 2016). health-related habits are often described as cognitive-motor procedures that become automated through repeated practice. the habits of health and habits of mind© model (ubbes, 2008, p. 113) is used in health education to teach children and youth how to think about and do healthful behaviors on a daily basis. when young people have ongoing skill practice in cognitive thinking patterns, they are developmentally more capable to turn health behaviors into consistent health habits without as many social cues from significant others. conversely, poor role models and negative media examples of adolescent and parental health can persuade children to try negative risk behaviors that significantly impact their health status. hence, social functions help to define child health status through the relationships that are formed, changed, and maintained with daily practice in different settings and contexts (ward, 2009). in addition, the functional roles that children and youth learn by performing their schoolwork, housework, and occupational work practices on a daily basis also contribute to one of the four functions of health status (ward, 2009). routine habits of health (ubbes, 2008) have been hypothesized as five healthful behaviors that are known to increase health status: 1) physical activity, exercise, and play; 2) food, beverages, and nutrients; 3) sleep and quiet time; 4) relationships; 5) safety and hygiene. routine habits of mind (ubbes, 2008) have been hypothesized as five cognitive skills that lead to the practicing of healthful behaviors: 1) decision making, 2) goal setting, 3) communication, 4) conflict resolution, and 5) stress management. when the www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 3 published by scholink inc. habits of health and habits of mind© model (ubbes, 2008) is practiced on a daily basis in an integrated and consistent way, an individual may increase one’s health status. as a cognitive-behavioral curriculum, the habits of health and habits of mind© model (ubbes, 2008) may lead to acquisition of procedural memory when children and youth practice one habit of health with one habit of mind through trial and error until automaticity is attained (ubbes, 2008). little is known about the level of cognitive effort and motivation needed when children and youth practice multiple health habits in tandem with and without environmental supports from school, home, and community. the literature is replete with high-risk behavior data for middle school and high school students (u.s. cdc, 2017). few studies are available to promote the multiple health habits that collectively make up a healthy lifestyle for children and youth. figure 1. the habits of health and habits of mind© model the main purpose of the study was to validate the habits of health and habits of mind© model (ubbes, 2008) to determine how one or more healthful behaviors can be used to characterize the daily routines of healthy youth. through factor analyses, we investigated whether the different habit of health behaviors organized by subscales could detect differences among 7th grade youth from two different midwestern states. we hypothesized these associations should theoretically exist based on the literature, then sought to explore the robustness of the habits of health model. the habits of health model is one-half of the habits of health and habits of mind© model (ubbes, 2008) with the former focused on health behaviors www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 4 published by scholink inc. and the latter focused on cognitive skills. we specifically examined differences and associations between habits of health and the participants’ gender, perceived health, and multiple health behaviors. this study provides an empirical test of the conceptual model outlined in figure 1. the first hypothesis was that the habits of health scale (hhs) items would show acceptable factorial validity. the second hypothesis was the habits of health factors would demonstrate high criterion validity, or the sensitivity of a measure to detect appropriate differences and associations that theoretically should exist. more specifically, the hhs factors were expected to differ based on participants’ gender, perceived health, perceived academic success, body mass index (bmi), and multiple health behaviors. 2. methods 2.1 participants seventh graders (n=105) were recruited from two health education classrooms in indiana and ohio through teacher partnerships. all study procedures were approved by the institutional review board of the university. parental informed consent and youth assent were completed prior to all study procedures. participating youth were asked to complete a 15-minute paper-and-pencil questionnaire targeting their health-related habits and lifestyle health behaviors. incentives to the teachers included classroom and gymnasium enhancement gifts, such as sport equipment and stationary bicycles. 2.2 instruments participating youth self-reported their age, gender, perceived academic performance, perceived health, and height and weight. classroom teachers reported youth ethnicities and grade-levels. perceived academic performance and perceived general health were assessed on a 6-point likert scale, ranging from “very poor” (1) to “excellent” (6). perceived academic performance was assessed by asking youth, “overall, how well do you think you do in school?”, and perceived health was measured by asking, “overall, how would you rate your general health?”. height and weight scores were converted into body mass index (bmi; weight (kg)/[height (m)]2) by using bmi norm-referenced growth standards by age and gender. youth were categorized as normal weight or at-risk for overweight (85th percentile) or obesity (95th percentile) (kuczmarski et al., 2010). the next two sections describe the assessments used to measure youth self-reported health behaviors and youth self-reported health habits. youth self-reported health behaviors physical activity and sedentary activity. physical activity was defined to youth as “any activity that gets your arms and legs moving fast enough to increase your heart rate and make you sweat”. examples included “running, brisk walking, rollerblading, biking, skateboarding, dancing, swimming, soccer, basketball, football, volleyball, and other types of physically demanding activities, like mowing the lawn”. youth were then asked to report the number of days they perform 60 minutes of physical activity www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 5 published by scholink inc. during a typical week. sedentary time was assessed by asking youth: “on average, how many hours per day do you watch television or movies?”, which was calculated into daily television minutes prior to statistical analyses. finally, weekday sleep was assessed by asking youth, “how many hours do you usually sleep on school nights?”, which was calculated into daily minutes prior to analyses. fruit and vegetable and soda intake. based on recommendations outlined in the dietary guidelines for americans (u.s. department of health and human services, 2005), youth were first asked to report their daily intake of fruit and vegetables in serving sizes. youth responded to two separate questions regarding fruit and vegetable consumption: “how many servings of fruits and vegetables do you usually eat each day?” a serving of fruit was described to participants as “one medium piece of fresh fruit, ½ cup of fruit salad, ¼ cup of raisins, apricots, or other dried fruit, 6 ounces of 100% orange, apple, or grape juice (do not count fruit punch, lemonade, gatorade, sunny delight or fruit drink)”. a serving of vegetable was described to participants as “one medium carrot or other fresh vegetable, 1 small bowl of green salad, ½ cup of fresh or cooked vegetables, or ¾ cup of vegetable soup (do not count french fries, onion rings, potato chips, fried tempura or fried okra)”. youth also reported their daily intake of soda consumption with the question, “how many cans or bottles of soda pop do you usually drink each day?”. alcohol and smoking tobacco. in three separate questions, youth reported their previous experience with alcohol and cigarette smoking. youth were asked “have you ever consumed alcohol?”, and “have you ever tried cigarette smoking, even one or two puffs?”. participating youth responded either “yes” or “no” to both questions. youth self-reported health habits. participating youth responded to 25 items that focused on five health habits: physical activity, nutrition, safety, hygiene, and relationships. for each question, youth were asked to “please circle only one answer that agrees or disagrees with how you feel about your health”. youth then responded on a 5-point likert scale, ranging from “strongly disagree”, (1) to “strongly agree”, (5). table 1 provides the exploratory factor analysis of all scale items. 2.3 factorial validity all analyses were performed with ibm spss (version 23.0). factorial validity was examined with an exploratory factor analysis (efa). efa outcomes were used to guide the determination of the number and manner of factors accounting for the variation or covariation among habits of health items (brown, 2006). the efa was performed using a principal axis factor (paf) extraction method followed by direct oblique (oblimin) rotation. this rotation method was used due to hypothesized correlations among the underlying factor structures of youth’s health habits. the number of components retained was estimated using three criteria: (1) kaiser’s (kaiser 1961) retention of factors with unrotated eigenvalues >1.0, (2) cattell screen test (cattell, 1966) and (3) factor loadings exceeding .40 (gorsuch, 1983). internal consistency reliability for each subscale was estimated using cronbach’s alpha and split-half internal www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 6 published by scholink inc. consistency coefficients. next, the criterion validity of the emerging habits of health latent factors was examined. 2.4 criterion validity analyses were used to test the sensitivity of the habits of health factors revealed in the efa. specifically, we examined subgroup mean differences and associations based on youth demographics and health behaviors. anova f-test was used to test subgroup differences. due to low subgroup sample sizes, significance for mean difference tests was set at p<0.10. when necessary, pairwise comparisons were completed using tukey’s hsd post hoc analyses with bonferroni correction (0.10/n=3; =p<0.03). criterion validity was also examined via multiple linear regression with a significance level of p<0.05. following preliminary tests, only significant covariates were included in final analyses. 3. result 3.1 description of the sample participating youth (n=105; 50% female) had a mean age of 13.38 (sd=0.55), including 7th graders (95%) and 8th graders (5%) attending middle school in either ohio (25%) or indiana (75%). youth included in analyses were predominantly caucasian (>95%) and 39% were overweight/obese (bmi percentile>85). the mean (m) and standard deviation (sd) of youth’s perceived health was 4.47 (sd=1.06). on average, youth reported their perceived academic success as 4.50 (sd=1.05). the youth’s average daily intake of fruits and vegetable servings was 5.96 (sd=4.93), and the average daily intake of soda was 5.35 (sd=1.74). youth reported 120.00 minutes of physical activity weekly (sd=70.60) and 466.86 (sd=89.61) minutes of sleep during a typical week day. 3.2 factorial validity as hypothesized, habits of health were best explained as being multidimensional. the paf analysis of the initially tested 24-item measurement model extracted 6 factors with eigenvalues >1.0, paralleling both practical and theoretical reasoning. five items were dropped due to factor loadings <0.40 on all identified factors. the items dropped included: “i can take a bath or shower every day to keep clean”; “i know to wash my hands throughout the day to avoid people's germs”; “i tend to eat packaged foods from the grocery store at lunch”; “i enjoy eating cereal with milk for breakfast or as a snack”; and, “i am happy with my body size”. all other items had factor loadings exceeding 0.40 on only 1 of the 6 emerging factors, meeting all statistical criteria and accounting for approximately 59.38% of the variability among the final 19 items. table 1 shows results of the efa. the first factor identified habits related to home relationships, which was captured with 6 items; overall, youth reported a mean of 4.58 (sd=0.67). factor 2 was defined by habits that recognized youth’s perception of their friendships by age and gender consisting of 3 items (m=4.11, sd=0.81). factor 3 was identified by 2 items for habits related to fruit and vegetable www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 7 published by scholink inc. consumption (m=3.76, sd=1.14). factor 4 was identified by 2 items for physical activity habits (m=4.15, sd=0.98). the fifth factor represented youth’s perceptions of relationships within the school setting with 2 items (m=3.74, sd=1.01). factor 6 was identified by 4 items, conceptualized as prevention habits for safety and hygiene (m=4.11, sd=0.71). internal consistency was high for the entire 19-item questionnaire (α=0.86), ranging between 0.63 and 0.86 for the 6 subscales. split-half internal consistency method was also employed to determine reliability, resulting in 0.72 for all 19-items (equal-length spearman-brown, n=105); and coefficients were high among subscales, ranging between 0.61 and 0.82. table 1. habits of health scale: exploratory factor analysis (efa); n=105 habit of health identified subscales age & fruit & home gender vegetable physical school safety relationships friends nutrition activity relationships hygiene i feel close to at least one person in my life. .845 .113 .109 .283 .004 .003 i know at least one person i can talk to. .765 .077 .081 .363 .067 .038 i have friends i can trust. .642 .394 .082 .052 -.031 .111 i can trust at least one person in my life with a secret. .578 .223 -.104 -.071 .111 .076 i am close with at least one family member. .709 .114 .235 .106 .336 -.008 i can count on my family to help me when i have a problem. .654 .163 .194 .170 .374 .135 i have more friends than most kids my age. .098 .724 -.035 .060 .252 .006 i have lots of friends who are girls and/or boys. .234 .631 -.014 .241 .090 -.077 i like my social life. .319 .687 .142 .026 .052 .173 i like to eat more than two fruits a day. .135 .041 .765 .229 -.017 .227 i like to eat more than two vegetables a day. .088 .042 .809 .186 .090 .144 i like to make time to play outside every day. .188 .228 .211 .815 .145 .089 i prefer to move around and get lots of exercise. .281 .069 .239 .568 .192 .044 i like the people i go to school with. .117 .048 .038 .153 .499 .103 i think my classmates like what i share during class. .169 .317 .020 .031 .838 .142 i know to wear a seatbelt when in the car. -.043 .053 .032 -.014 .144 .513 i like to brush my teeth at least twice a day. .161 .153 .103 .261 .226 .414 i know to wash my hands before i handle food. .186 -.001 .197 .303 -.140 .562 i know i should wear my helmet every time i ride my bike, rollerblades, skateboard, or scooter. .050 -.113 .394 -.185 .111 .559 eigenvalue 6.125 2.286 1.650 1.338 1.238 1.018 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 8 published by scholink inc. percent variance 30.412 9.927 6.767 4.983 4.243 3.042 skewness (standard error) -2.419 (.236) -.734 (.236) -1.106 (.240) -.766 (.236) -.574 (.237) -.899 (.239) kurtosis (standard error) 7.137 (.467) -.331 (.467) .730 (.476) -.275 (.467) -.326 (.469) 1.169 (.474) 3.3 criterion validity the first tests of criterion validity examined potential mean differences in habits of health subscales based on weight status, perceived health, and perceived academic success. there were no significant covariates. youth with a normal bmi reported higher physical activity habits than overweight or obese youth (mean difference (md)=0.47, p=0.02). youth who perceived excellent health (n=21) reported higher physical activity habits than youth with very poor to average health (md=1.01, p=0.00). youth with excellent health also reported higher fruit and vegetable habits (md=0.47, p=0.01) (m=4.81) compared to youth in good to very good health and youth in very poor to average health (md=1.21, p=0.01). compared to youth with good to very good academic success, those reporting excellent academic success had higher fruit and vegetable habits (md=0.84, p=0.01) and higher safety and hygiene habits (md=0.43, p=0.02). table 2 illustrates differences in health habits based on gender and whether or not youth reported previously trying alcohol or smoking tobacco. there were no differences based on gender. compared to their counterparts, preventive safety and hygiene habits were higher among youth who never tried alcohol (md=0.44, p=0.00) and never tried smoking tobacco (md=0.42, p=0.01). outcomes of criterion validity tests via multiple linear regression are shown in table 3. the model to predict youth’s bmi was significant (r2adj=0.12, p=0.02) with no significant covariates. unique significant influences on youth’s bmi included home relationship habit (β=0.28, p=0.02) and physical activity habit (β=0.38, p=0.00). the perceived health variable was significant (r2adj=0.14, p=0.01) with no significant covariates. perceived health was significantly influenced by physical activity habit (β=0.35, p=0.01). the academic success model was also significant (r2adj=0.18, p=0.00), including significant influences from gender as a covariate (β=0.30, p=0.00) and youth’s preventive health habit as measured by hygiene and safety (β=0.24 p=0.03). www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 9 published by scholink inc. table 2. mean differences in health habits by gender and behavioral influences n (%) home relationship habit age and gender friends habit fruit and vegetable habit physical activity habit school relationship habit safety and hygiene habit mean (sem) *p mean (sem) *p mean (sem) *p mean (sem) *p mean (sem) *p mean (sem) *p gender female 47 (51%) 4.49 (.13) .72 3.84 (.16) .18 4.22 (.19) .94 3.92 (.24) .78 3.59 (.20) .79 4.32 (.14) .13 male 46 (49%) 4.67 (.11) 4.39 (.13) 4.36 (.16) 3.98 (.20) 3.96 (.17) 4.15 (.12) tried alcohol no 69 (72%) 4.56 (.08) .72 4.04 (.10) .33 4.15 (.11) .94 3.71 (.14) .64 3.81 (.12) .13 4.25 (.08) .00 yes 27 (28%) 4.61 (.13) 4.22 (.16) 4.14 (.18) 3.84 (.23) 3.45 (.20) 3.81 (.13) tried smoking no 78 (80%) 4.57 (.08) .75 4.06 (.09) .34 4.16 (.11) .77 3.79 (.13) .54 3.71 (.12) .99 4.21 (.07) .01 yes 19 (20%) 4.62 (.15) 4.26 (.19) 4.09 (.21) 3.61 (.27) 3.71 (.23) 3.79 (.15) sem=standard error of the mean. bold indicates statistical significance at p-value≤.10. significant covariates included were perceived health (1 to 6 likert scale). www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 10 published by scholink inc. table 3. association of youth self-reported health habits and youth self-reported health behaviors home relationship habit age and gender friends habit fruit and vegetable habit physical activity habit school relationship habit safety and hygiene habit n=105 β *p β *p β *p β *p β *p β *p body mass index .280 .024 -.019 .871 .201 .100 .375 .002 -.142 .225 .172 .158 health status .002 .987 .098 .392 -.053 .646 .351 .003 -.011 .918 .120 .276 academic success -.051 .669 -.041 .713 .001 .990 .151 .189 -.059 .585 .240 .027 daily fv servings -.110 .378 -.028 .813 .382 .002 .044 .711 -.058 .610 .010 .930 daily soda can intake -.063 .592 .059 .596 .090 .427 -.219 .056 .370 .001 -.366 .001 weekly pa days -.092 .403 .051 .624 .245 .021 .341 .002 .241 .018 -.161 .108 daily tv hours -.270 .032 .036 .760 .098 .408 -.210 .082 .121 .288 -.138 .221 weekday sleep minutes .213 .102 -.011 .927 .115 .350 -.260 .039 .114 .334 .080 .490 fv=fruit and vegetable intake; pa=physical activity; tv=television. bold indicates statistical significance at p-value<.10. all models were adjusted for gender, age, and school location. specific to youth’s self-reported health behaviors, the physical activity model was significant (r2adj=0.30, p=0.00) with no significant covariates. significant predictors of participants’ weekly physical activity included fruit and vegetable health habit (β=0.25 p=0.02), physical activity habit (β=0.34, p=0.00) and school relationship habit (β=0.24, p=0.02). the fruit and vegetable model was also significant with no covariates (r2adj=0.10, p=0.03), including youth’s fruit and vegetable health habits as a significant predictor (β=0.38, p=0.00). the daily television model with no covariates was also significant (r2adj=0.10, p=0.03), demonstrating youth’s home relationship habits as having a significant, www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 11 published by scholink inc. inverse relationship (β=-0.27, p=0.03). the weekday sleep minutes model with no covariates was not significant overall (r2adj=0.03, p=0.26); however, youth’s physical activity habit demonstrated a significant, inverse relationship (β=-0.26, p=0.04) with their weekday sleep minutes. the model to predict participants’ daily soda intake was significant (r2adj=0.21, p=0.00), including positive influence from participants’ age (β=0.28, p=0.00) and school relationships habit (β=0.32, p=0.00) and an inverse relationship with youth’s safety and hygiene habits (β=-0.37, p=0.00). 4. discussion this is the first study to explore the validity of the habits of health and habits of mind© model (ubbes, 2008) which focuses on multiple health behaviors and cognitive skills working together for daily routines of health. results of this study lay the groundwork for future studies to identify how cognitive skills in the habits of mind model may co-join with health behaviors to form daily routines for health. two types of daily health routines important to this study were safety and hygiene habits. in the current study, perceived academic performance was significantly associated with safety and hygiene habits. the mean differences in safety and hygiene habits were significant if youth reported ever trying alcohol or ever trying smoking. therefore, the preventative habits of safety and hygiene are key behaviors to teach in school environments. youth who practice safety and hygiene habits on a consistent basis are associated with not trying alcohol and tobacco substances and having a higher perceived academic performance. these current findings on academic performance are supported by previous literacy research showing that safety habits (e.g., wearing sunscreen) and hygiene habits (e.g., regular dental check-ups) were positively associated with reading attitudes and reading behaviors (zullig, ubbes, & mann, 2013). health literacy is a key determinant of health and an indicator of educational status. lower-than-average literacy among youth is related to more risk-taking behaviors (dewalt & hink, 2009). fourteen-year-old youth with lower literacy levels are more likely to use alcohol and tobacco (hawthorne, 1997) and for boys, smoke tobacco (conwell, o’callaghan, andersen, bor, najman, & williams, 2003), than those youth with higher literacy levels. for eight countries participating in the european health literacy survey (kickbusch, pelikan, apfel, & tsouros, 2013), the higher the health literacy, the higher the frequency of physical exercise. physical exercise was found to be the highest and most consistent indicator of health literacy when including smoking, alcohol, and body mass index as determinants of health. in the current study, youth’s perceived health status was significantly influenced by the physical activity habit and body mass index. youth who indicated weekly physical activity days had significantly associated intakes of daily fruit and vegetable servings. youth’s physical activity habits were inversely associated with weekday sleep minutes. because physical activity is associated with several health behaviors in the habits of health model, youth should be encouraged to be physically active as a key www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 12 published by scholink inc. indicator of their health status. results of the exploratory factor analysis also showed that social relationships had three dimensions, including a home relationship habit, a school relationship habit, and an age and gender friendship habit. youth who reported “feeling close to at least one person in my life” resulted in the highest exploratory factor of .845. also for the home relationship habit, “knowing at least one person i can talk to” and “being close with at least one family member” loaded as .765 (second highest exploratory factor) and .709 (third highest exploratory factor), respectively. for the school relationship factor, youth who reported “i think my classmates like what i share during class” resulted in an equally high exploratory factor of .838 (second highest exploratory factor in the whole efa model). these findings are significant toward social support models and the value of family and school involvement in youth development (foster, horwitz, thomas, opperman, gipson, burnside, stone, & king, 2017). parent caregiving behaviors, both positive and negative, are known to influence health and literacy of teenagers (kennedy-hendricks, schwarts, thornton, griffin, green, kennedy, burkhauser, pollack, 2015) by playing “a critical role in their children’s health by providing food, shelter and care; teaching children about healthy eating; creating opportunities for physical activity; and molding children’s understanding of health and related behavioral norms”. other studies (zullig, ubbes, & mann, 2013) have shown that youth practice fewer preventative health habits, e.g., regular dental check-ups and wearing sunscreen, when they indicate difficulties reading a survey, exhibit negative attitudes toward reading, do not read outside of school, or do not see a parent or caregiver reading every day or one day of the past two days. several limitations can be highlighted with this study. subjects were mostly caucasian from two health education classrooms in two midwestern schools from two different states. due to the small sample size, type ii errors may exist in our analysis. a larger sample size is needed to show differences between groups and increase our variability. 5. conclusions continuous development of robust measurement scales will enhance the understanding of how children and youth practice healthy habits and daily health routines on a consistent basis. this study investigated construct validity and criterion validity of the habits of health scale (ubbes, 2008) among seventh grade youth who self-reported their health behaviors. more validation studies are needed to quantify and conceptualize the cognitive skills outlined in the habits of mind model which is the other component of the habits of health and habits of mind© model. models are inherently linked to measurement of health behavior (redding, rossi, rossi, velicer, & prochaska, 2000, p. 180). future research should include structural equation modeling and be longitudinal in scope to determine how health behaviors and cognitive skills form an integrative curriculum model for children and youth of different ages. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 13 published by scholink inc. implications for school health are warranted. this study sought to conceptualize and measure five daily health habits of youth. multiple health habits were associated with perceived general health (e.g., physical activity), perceived academic performance (e.g., safety and hygiene), school relationships (e.g., daily soda can intake, physical activity), fruit and vegetable intake (e.g., weekly physical activity days), and safety and hygiene (e.g., daily can of soda intake, ever tried tobacco, ever tried alcohol). school health education curricula should focus yearly instruction on multiple health behaviors and not reduce learning time on the preventive habits of hygiene and safety since those behaviors mediated whether youth had ever tried tobacco, ever tried alcohol, or drank a daily soda in this study—which are all negative behaviors for this age group. focusing on multiple prevention behaviors by comparing habits by time and frequency may help youth build upon and sustain daily health routines and patterns. for example, physical activity showed a high association with perceived general health and other health habits (e.g., fruit and vegetable intake), so physical activity behavior remains a critical action for youth when establishing and practicing lifestyle patterns. teachers need to show the interrelationships of healthy habits in routines of daily living rather than focusing on one instructional unit at a time. habits of health were all significant in the current conceptual model, which now strengthens the need for validation of the cognitive skills that make up the habits of mind model. in the future, a psychometric study focusing on the habits of mind model (e.g., decision making, goal setting, communication, conflict resolution, and stress management) should conducted to determine if these specific cognitive skills are significantly associated with youth’s perceived general health status and perceived academic performance. references brӧder et al. (2017). health literacy in childhood and youth: a systematic review of definitions and models. bmc public health, 17(361), 97. https://doi.org/10.1186/s12889-017-4365-x brown, t. a. (2006). confirmatory factor analysis for applied research. guilford press, new york, ny. cartland, j., & ruch-ross, h. s. (2006). health behaviors of school-age children: evidence from one large city. journal of school health, 76(5), 175-180. https://doi.org/10.1111/j.1746-1561.2006.00091.x cattell, r. b. (1966). the screen test for the number of factors. multivariate behavioral research, 1(2), 245-276. https://doi.org/10.1207/s15327906mbr0102_10 conwell, l. s., o’callaghan, m. j., andersen, m. j., bor, w., najman, j. m., & williams, g. m. (2003). early adolescent smoking and a web of personal and social disadvantage. journal of paediatric child health, 39(8), 580-585. https://doi.org/10.1046/j.1440-1754.2003.00240.x dewalt, d. a., & hink, a. (2009). health literacy and child health outcomes: a systematic review of the literature. pediatrics, 124(3), s265-s274. https://doi.org/10.1542/peds.2009-1162b www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 14 published by scholink inc. foster, c. e., horwitz, a., thomas, a., opperman, k., gipson, p., burnside, a., … king, c. a. (2017). connectedness to family, school, peers, and community in socially vulnerable adolescents. children and youth services review, 81, 321-331. https://doi.org/10.1016/j.childyouth.2017.08.011 garrido, e. f., weiler, l. m., & taussig, h. n. (2017). adverse childhood experiences and health-risk behaviors in vulnerable early adolescents. journal of early adolescence, 027243161668767. https://doi.org/10.1177/0272431616687671 gascoine, l., higgins, s., & wall, k. (2017). the assessment of metacognition in children aged 4-16 years: a systematic review. review of education, 5(1), 3-57. https://doi.org/10.1002/rev3.3077 gorsuch, r. l. (1983). factor analysis (2nd ed.). hillsdale, nj: lawrence erlbaum associates, inc. hawthorne, g. (1997). pre-teenage drug use in australia: the key predictors and school-based drug education. journal of adolescent health, 20(5), 384-395. https://doi.org/10.1016/s1054-139x(96)00181-4 kaiser, h. f. (1961). a note on guttman’s lower bound for the number of common factors. british journal of mathematical and statistical psychology, 14(1), 1-2. https://doi.org/10.1111/j.2044-8317.1961.tb00061.x kanfer, r., & ackerman, p. l. (1989). motivation and cognitive abilities. journal of applied psychology, 74(4), 657-690. https://doi.org/10.1037/0021-9010.74.4.657 kennedy-hendricks, a., schwarts, h., thornton, r. j. griffin, b. a., green, h. d., kennedy, d. p., ... pollack, c. e. (2015). intergenerational social networks and health behaviors among children living in public housing. american journal of public health, 105, 2291-2297. https://doi.org/10.2105/ajph.2015.302663 kickbusch, i., pelikan, j. m., apfel, f., & tsouros, a. d. (2013). health literacy: the solid facts. world health organization. retrieved from http://www.euro.who.int/__data/assets/pdf_file/0008/190655/e96854.pdf redding, c. a., rossi, j. s., rossi, s. r., velicer, w. f., & prochaska, j. o. (2000). health behavior models. the international electronic journal of health education, 3(special issue), 180-193. ubbes, v. a. (2008). educating for health: an inquiry-based approach to prek-8 pedagogy. in champaign, il: human kinetics (p. 113). u.s. centers for disease control and prevention. (2017). youth risk behavior survey. retrieved from https://www.cdc.gov/healthyyouth/data/yrbs/results.htm. u.s. department of health and human services. (2005). dietary guidelines for americans (6th ed.). washington, dc: u.s. government printing office. ward, m. m. (2009). physical function. in m. c. hochberg, a. j. silman, j. s. smolen, m. e. weinblatt, & m. h. weisman (eds.), rheumatoid arthritis (p. 231). amsterdam: elsevier. https://doi.org/10.1016/b978-032305475-1.50033-1 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 15 published by scholink inc. yzer, m. c. (2012). the integrated model of behavioral prediction as a tool for designing health messages. in h. cho (ed.), designing messages for health communication campaigns: theory and practice (pp. 21-40). thousand oaks, ca: sage. zullig, k. j., ubbes, v. a., & mann, m. (2013). early adolescent literacy influences, reading ability, and preventative health behaviors. american journal of health studies, 28(3), 134-141. children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 4, no. 3, 2021 www.scholink.org/ojs/index.php/ct 18 original paper the effectiveness of online learning in the conditions of the covid-19 pandemic in senior high school ratu wardarita1* & hairun nisak2 1 university of pgri palembang, indonesia 2 state senior high school 1, palembang, indonesia * ratu wardarita, university of pgri palembang, indonesia received: may 30, 2021 accepted: june 18, 2021 online published: july 26, 2021 doi:10.22158/ct.v4n3p18 url: http://dx.doi.org/10.22158/ct.v4n3p18 abstract pandemic covid-19 has disrupted the conventional learning process. so a solution is needed to answer these problems. online learning is an alternative that can solve this problem. the research objective was to obtain an overview of the implementation of online learning at state senior high school 1 palembang, as an effort to reduce the spread of covid-19 in schools. the research subjects were students of class x ipa1 until x ipa6 (100 students). data were collected by an interview via zoom cloud meeting. data analysis was performed using interactive analysis techniques by miles & huberman. the results showed that: (1) students already have the basic facilities needed to take part in online learning, (2) online learning has flexibility in its implementation and can encourage independent learning and motivation to be more active in learning, and (3) distance learning encourages the emergence of social distancing behavior and minimizes the appearance of student crowds so that it is considered to reduce the potential for the spread of covid-19 in the school environment. weak supervision of students, unstable mobile device signal, and high quota fees are challenges in online learning. increasing independent learning, interest and motivation, courage to present ideas and questions are other advantages of online learning. keywords online learning, covid-19 pandemic, social distancing 1. introduction the development of information and communication technology in the industrial 4.0 era has had a major influence on the teaching and learning process. ease of access to technology has been used by teachers to facilitate the learning process. access to technology can also improve the quality of www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 19 published by scholink inc. education. since the discovery of internet technology, almost anything has been possible in the world of education. currently students can learn not only anywhere but at the same time and anytime with the existing online learning facilities. online learning is increasingly recognized as a way to solve education and training problems, both in developed countries and developing countries, especially indonesia. many people use different terms for online learning, but in principle, online learning is learning using gadgets as learning media. currently, not only in indonesia, but even in various countries the covid-19, epidemic of a disease is very worried because this epidemic of a disease which originated in the city of wuhan, china’s ubei province around december 2019 began to spread and even hit all corners of the world very quickly, so who on march 11 2020 set this epidemic of a disease as a global pandemic. according to hidayat (1986) effectiveness is a measure that states how far the target (quantity, quality and time) has been achieved. where the greater the percentage of targets achieved, the higher the effectiveness. meanwhile, handoko (1997) explains that effectiveness is the ability to choose the right goals or the right equipment to achieve the goals set. the effectiveness level of the ability to achieve goals appropriately and well (devung, 1988). steers (1985) explains that effectiveness is the range of efforts of a program as a system with certain resources and means to meet its goals and objectives without paralyzing the means and resources and without putting undue pressure on its implementation. in learning, careful planning is needed, making learning tools, choosing strategies, media, techniques, learning models, and evaluating learning, all of which are mutually sustainable. it is necessary to use effective and innovative learning models so that learning can be more varied and run smoothly. the use of the learning model is also adjusted to the material to be taught so that the suitability between the two and all components becomes appropriate. one indicator of the effectiveness of learning is the achievement of a learning goal. learning objectives are achieved maximally, it can be said that learning reaches its effectiveness. in addition, active student involvement shows the efficiency of learning. the teaching and learning process is said to be effective if the learning can achieve the expected goals and students can absorb the subject matter and practice it. learning methods and strategies are now experiencing a shift leading to a shift in the educational paradigm. this affects the function of educators as facilitators, mediators and motivators in the learning process. the teacher has always been considered the center of learning, but now it has turned into students as learning itself. one of the reasons, among others, is that the rapid progress of information technology requires a paradigm shift in the learning process carried out by all students. according to koran (2001) e-learning is any teaching and learning that uses electronic circuits (lan, wan, or the internet) to convey the content of learning, interaction, or guidance. darin e. hartley (2011) explains that e-learning is a type of teaching and learning that allows teaching materials to be delivered to students using the internet, intranet or other computer network media. rosenberg (2001) emphasizes that e-learning refers to the use of internet technology to deliver a series of solutions that www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 20 published by scholink inc. can increase knowledge and skills. e-learning has shortened learning time and made study costs more economical. e-learning facilitates interaction between students with material or subject matter, students and teachers or instructors and fellow students. students can share information with each other and can access learning materials at any time and repeatedly, with such conditions students can further strengthen their mastery of learning material. in e-learning, the teacher’s role is computers and guides—electronic guides designed by contents writers, e-learning designers and computer programmers. learning from home is still maximized because through the online system students can take part in learning with various existing applications. as stated by keengwe & georgina in their research, it has been stated that technological developments provide changes to the implementation of teaching and learning (keengwe & georgina, 2012). information technology can be accepted as a medium in carrying out the educational process, including helping the teaching and learning process, which also involves finding references and sources of information (wekke & hamid, 2013). the corona covid-19 virus currently has an impact on all people and the world of education in indonesia. this global covid-19 pandemic can also increase student stress in addition to reducing students’ thinking power as well as disrupted eating patterns so learning will be hampered (beisser & gillespie, 2021). up to 300 million students have been disrupted by teaching and learning activities in schools because of this pandemic, which was recognized by unesco on thursday (5/3). the public is encouraged to carry out activities outside the home with activities inside the home or social distancing to prevent the spread of the corona virus. since the implementation of social distancing has had an impact on education. minister of education and culture (mendikbud) nadiem makarim supports the local government policy to allow students to study from home because the spread of this virus is increasingly worrying. using lessons learned from the covid-19 pandemic will serve us well in how we address our need to be prepared for future emergencies (wilson & ankrum, 2021) the delivery of material through online can be interactive so that learning participants can interact with computer as their learning media. as one example of students using learning using gadgets as learning media or establishing relationships (browsing, chatting, video calling) through electronic media, in this case, computers and the internet will later get more effective and better learning outcomes than conventional learning. the use of instructional media in the teaching and learning process is an effort to increase the effectiveness and quality of the learning process which in turn can improve the quality of student learning outcomes. the use of instructional media in the teaching and learning process has several benefits including: (1) teaching will attract students’ attention so that it can foster student learning motivation, (2) the teaching material will be clearer so that students can understand and master the teaching objectives well, (3) teaching methods will be more varied, (4) students will interact more in www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 21 published by scholink inc. learning activities because they do not only listen to teacher explanations but also other activities such as observing, demonstrating and others. with research on the effectiveness of online learning in the conditions of the covid-19 pandemic in senior high schools, the problems that exist in class x ipa1 x ipa6 students in state senior high school 1 palembang, south sumatera, namely the effectiveness of online learning can be improved even better in teaching. and the use of learning media through online learning. based on the description above, a study was conducted with the title “the effectiveness of online learning in the conditions of the covid-19 pandemic in high schools”. this study aims to determine the effectiveness of online learning during the covid-19 pandemic. 2. method 2.1 research methods this type of research is qualitative research. the purpose of this study was to describe online learning held at state senior high school 1 palembang, indonesia as an effort to suppress the chain of covid-19 spread in the school environment. online learning referred to in this research is learning that uses learning media that can be accessed using internet services. the research was conducted by first conducting surveying students regarding the application of online learning. the survey is distributed using a google form given to students via whatsapp messages. there are 100 subjects who have responded to the distributed survey. the results of the survey were then grouped into three categories of student responses: (1) agree with the application of online learning; (2) disagree with the application of online learning; (3) doubt about the implementation of online learning. 2.2 research subject the research subjects were students of class x ipa1 x ipa6 students in state senior high school 1 palembang who had carried out online learning and were grouped based on the response of the research subject. 100 research subjects were obtained from class x ipa1 x ipa6. 2.3 data collection technique data collection was carried out through interviews via zoom cloud meetings or distributing questionnaires to google form. the aspects that are asked in the interview are: (1) the facilities and infrastructure owned by the students to carry out online learning; (2) student responses regarding the effectiveness of online learning; (3) implementation of online learning in breaking the chain of spreading covid-19 in the school environment. 2.4 data analysis technique analysis of research data was carried out using the analysis model of miles and huberman (1994) which consists of three stages, namely data reduction, data display, and conclusion drawing and verification. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 22 published by scholink inc. figure 1. stages of research data analysis analysis of research data, the data reduction stage is the stage of collecting all the information needed from the interview results and then grouping the data. the data display stage is the exposure of data that is needed in research and which does not need to be discarded. the withdrawal and conclusion verification stage is the stage of interpreting research data to draw conclusions based on the phenomena obtained (miles & huberman, 1994). 3. research results researchers conducted interviews with research subjects related to their experiences about online effectiveness in learning. the result was 44 out of 100 respondents felt that online learning was more effective and 56 respondents stated that face-to-face learning was felt to be more effective. they feel that the application of online learning that they get is only focused on giving assignments, the ratio of giving material is very small. in addition, access to questions is not as extensive as during face-to-face learning, both asking questions of teachers and friends. tabel 1. the results of effectiveness of online learning in the conditions of the covid-19 pandemic the effectiveness of online learning the results face-to-face learning is more effective 56% online learning is more effective 44% figure 2. the effectiveness of online learning based on the results of research on the delivery of teaching in online learning, it shows that 12% of respondents answered very well with their understanding, 18% of respondents answered well, 15% of data reduction data display withdrawal and verify conclusions www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 23 published by scholink inc. respondents answered sufficiently, then 55% of respondents answered lack of understanding. this proves that during online learning, the teaching delivered by the teacher cannot be understood as a whole by students. this can occur because the delivery of teaching is not good in using learning media, and cannot interact directly with student complaints. this is natural because generally each subject only takes one hour every week. tabel 2. teaching results on online learning teaching results on online learning the results very good understanding 12% good understanding 18 % quite understanding 15 % lack understanding 55% figure 3. teaching results on online learning 4. discussion researchers conducted interviews with research subjects related to their experiences about online effectiveness in learning. the result was 44 out of 100 respondents felt that online learning was more effective and 56 respondents stated that face-to-face learning was felt to be more effective. they feel that the application of online learning that they get is only focused on giving assignments, the ratio of giving material is very small. in addition, access to questions is not as extensive as during face-to-face learning, both asking questions of teachers and friends. based on the results of research on the delivery of teaching in online learning, it shows that 12% of respondents answered very well with their understanding, 18% of respondents answered well, 15% of respondents answered sufficiently, then 55% of respondents answered lack of understanding. this proves that during online learning, the teaching delivered by the teacher cannot be understood as a www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 24 published by scholink inc. whole by students. this can occur because the delivery of teaching is not good in using learning media, and cannot interact directly with student complaints. this is natural because generally each subject only takes one hour every week. researchers conducted interviews with research subjects regarding their experiences about the advantages and disadvantages of online-based learning. the experiences students feel about the advantages and disadvantages of online are very varied. the advantages; students feel more relaxed and happy, have more time at home with their families, have more time to rest and relax, and students do not have to wear full uniforms and come to school early. disadvantages; students feel wasteful because the quota runs out quickly, it is more difficult to understand the material presented by the teacher, sad because the pocket money they get is reduced, and students feel that social activities with their friends are hampered. researchers conducted interviews with research subjects regarding their experiences about the atmosphere they felt during online-based learning. the result was 44 respondents stated that online learning was not fun; they felt several obstacles such as signal interference during learning. meanwhile, 56 other respondents stated that online learning was more enjoyable; they felt that online learning was more efficient to implement. researchers conducted interviews with research subjects regarding their experiences regarding improvements that should be made during online application so that online-based learning can be better. the suggestions that the respondents gave were varied, such as: explanation of learning materials: students expect teachers to continue to provide explanations for learning materials. students recommend explaining the material through video, they feel the material is easy to accept and understand. follow the trend of technological advances: students hope that teachers will be able to follow the trend of technological advances, namely by utilizing applications/social media that are being liked by students so that students feel more enthusiastic, enthusiastic, and not easily bored. students recommend that occasional learning can be done with google cloud/zoom, telegram, google classroom, whatsapp group, they feel happy and when conducting a question and answer session they feel made easier. references beisser, s. r., & gillespie, c. w. (2021). an investigation of eating disorders among gifted adolescents. journal of children and teenagers. https://doi.org/10.22158/ct.v4n1p64 devung, s. (1988). pengantar ilmu administrasi dan manajemen. jakarta: departemen pendidikan dan www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 25 published by scholink inc. kebudayaan, direktorat jenderal pendidikan tinggi, pengembangan lembaga pendidikan dan tenaga kependidikan. handoko, t. h. (1997). manajemen. yogyakarta: bpfe. hartley, d. e. (2011). selling e-learning, american society for training and development. information technology services (its). course and learning management system project report and recommendations. retrieved february 27, 2012, from http://www.utexas.edu/its/course-mgmt/governance/lms project report and recommendations-final.pdf hidayat. (1986). teori efektivitas dalam kinerja karyawan. yogyakarta:gajah mada university press. keengwe, j., & georgina, d. (2012). the digital course training workshop for online learning and teaching, education and information technologies, 17(4), 365-379. https://doi.org/10.1007/s10639-011-9164-x koran, j. k. c. (2001). aplikasi e-learning dalam pengajaran dan pembelajaran di sekolah malaysia. retrieved from http://www.tutor.com.my/tutor/pix/2001/0716/duniapend pendidikan/kertas_k erja / kk_01.pdf miles, m. b., & huberman, a. m. (1994). an expanded sourcebook: qualitative data analysis. london: sage publications. rosenberg, m. j. (2001). e-learning: strategies for delivering knowledge in the digital age. usa: mcgraw-hill companies. steers, r. m. (1985). keefektifan organisasi dari aturan praktik (terjemahan magdalena). jakarta: erlangga. wekke, i. s., & hamid, s. (2013). technology on language teaching and learning: a research on indonesian pesantren. procedia-social and behavioral sciences, 83, 585-589. https://doi.org/10.1016/j.sbspro.2013.06.111 wilson, c. t., & ankrum, r. j. (2021). flexibility & grace: lessons learned in k-12 during the covid-19 pandemic. journal of children and teenagers. https://doi.org/10.22158/ct.v4n2p1 http://www.utexas.edu/its/course-mgmt/governance/lms children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 6, no. 2, 2023 www.scholink.org/ojs/index.php/ct 1 original paper are younger medical cannabis users at risk? comparing patterns of use and mental health in younger and older medical cannabis dispensary users lindsay a. lo1, caroline a. maccallum2,3, jade c. yau4, william j. panenka5,6, & alasdair m. barr4,6* running title: cannabis abuse characteristics 1 department of public health sciences, dalla lana school of public health, university of toronto on, canada 2 department of medicine, faculty of medicine, university of british columbia, vancouver, bc, canada 3 faculty of pharmaceutical sciences, ubc, vancouver, bc, canada 4 department of anesthesiology, pharmacology & therapeutics, university of british columbia, 2176 health sciences mall, vancouver, bc, v6t1z3 5 department of psychiatry, ubc, vancouver, bc, canada 6 british columbia mental health and substance use services research institute, vancouver, bc, canada * dr. alasdair m. barr, department of anesthesiology, pharmacology & therapeutics, university of british columbia, 2176 health sciences mall, vancouver, bc, v6t1z3; british columbia mental health and substance use services research institute, vancouver, bc, canada received: february 18, 2023 accepted: march 5, 2023 online published: march 20, 2023 doi:10.22158/ct.v6n2p1 url: http://dx.doi.org/10.22158/ct.v6n2p1 abstract while there has been a considerable amount of research on recreational cannabis use in youth to date, much less is known about patterns of medical cannabis use in youth. adult medical versus recreational cannabis users may differ in how they use the product on important factors such as dose, frequency and route of ingestion, and so it is important to understand whether adolescents and young adults differ in how they use medical cannabis compared to adults, and if this increases risk of impaired mental health. in the present study, one hundred members of a community cannabis dispensary who endorsed cannabis use for medical purposes were assessed for major psychiatric disorders, and completed questionnaires related to stress, depression, sleep and somatic symptoms. detailed information about www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 2 published by scholink inc. cannabis use was collected. in the sample, 35% were aged 19-24 years old, and 24% were aged 25-30 (categorized as youth/young adults). in comparison to the older medical cannabis users, there were unexpectedly few differences, both in mental health status as well as pattern of medical cannabis use. these findings contrast with those of recreational cannabis users, and indicate that medical cannabis in youth may be as effective and well-tolerated as in older adults. keywords cannabis, dispensary, mental health, teenagers, youth 1. introduction young people often perceive cannabis as harmless (pacek et al., 2015). this may be even more true for individuals using cannabis for medical purposes. however, there is a growing body of research associating younger age of cannabis use with a host of issues including worsening anxiety, depression, psychosis, social dysfunction, and increased risk of substance misuse (crean et al., 2011; gicas et al., 2020; gobbi et al., 2019; jacobson et al., 2019; nocon et al., 2006; urbanoski et al., 2005). although much of the literature focuses on adolescents under the age of 19, the world health organization categorizes young people as individuals between the ages of 10 and 24 (world health organization, 2011). this encompasses a notable period of young adulthood between the ages of 19 to 24 years of age. accordingly, brain development has been shown to continue until at least 25 years of age (johnson et al., 2009). while a great deal of attention has been given to investigating the impacts of cannabis use in adolescents, the literature for young adults is less comprehensive. furthermore, the majority of evidence comes from studies where cannabis was used recreationally, whose subjects tend to have different goals and patterns of use from medical cannabis users (eadie et al., 2021; lo, maccallum, yau, & barr, 2022; turna et al., 2020). as such, it is not yet clear if cannabis-related risks identified in adolescents specifically using medical cannabis persist into young adulthood, or if these risks are even present in medical users. the endocannabinoid system is an important substrate of brain development (goldstein ferber et al., 2021; schonhofen et al., 2018). it has been shown to regulate the activity of local neurons and larger brain pathways, such as corticolimbic circuitry, impacting the regulation of stress, anxiety and depression (hill et al., 2007; meyer et al., 2018). although most neurodevelopment occurs before the age of 18, the fine-tuning of neural pathways continues into the mid-'20s (hurd, 2020). this is especially pronounced in the prefrontal cortex (pfc), a brain region crucial for higher cognitive function and emotional regulation (jones & graff-radford, 2021). this has led to concerns about the impact cannabis may have on mental health. though the directionality of associations has not yet been established, some evidence links earlier cannabis use with anxiety, depression, and bipolar disorder (degenhardt et al., 2003; gobbi et al., 2019; lo, maccallum, yau, panenka, et al., 2022; lowe et al., 2019; moore et al., 2007). the strongest evidence regarding risk has been associated with early age of www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 3 published by scholink inc. initiation and frequent use of high δ9-tetrahydrocannabinol (thc) products (gobbi et al., 2019; murray et al., 2017). the recent rise in popularity medical cannabis, coupled with societal views that it is a “safe” alternative, may lead to an underestimated risk of potential harms. therefore, there is a pressing need to evaluate both patterns of use and mental health status in young people using cannabis for medical purposes. furthermore, there is a need to evaluate if patterns of use and associated risks differ from older aged groups to inform policy, healthcare practices and possible areas of intervention. the aim of this study was therefore to investigate cannabis use patterns and associated mental health in young people (aged 19-24) using cannabis with medical intent. the primary research question is whether younger cannabis users are at a greater risk for adverse mental health outcomes compared to older users. secondary investigations aimed to assess if cannabis use patterns differ between age groups, as these may help explain any potential differences in mental health outcomes. this information could be used to help evaluate risks associated with medical cannabis use in young people and provide details on where, or if, potential interventions are needed. 2. method 2.1 study population study ethics were approved by the behavioural research ethics board of the institutional review board (protocol h16-01830). a sample of participants (n = 100) was recruited in 2018 from evergreen cannabis society compassion club, a cannabis dispensary in vancouver, canada. participants had a membership to the cannabis dispensary and reported using cannabis for medical purposes, however, most were not under the direct care of a healthcare provider. participants were 19 years or older and able to give informed consent. the study took approximately four hours to complete per subject and consisted of self-report questionnaires and the mini-international neuropsychiatric interview (mini) version 6, conducted by a trained research associate as previously (alexander et al., 2019; barr et al., 2011; zhou et al., 2019). participants were provided an honorarium for their time. no subjects were excluded, and none withdrew. 2.2 measures demographic information was collected including age, gender, ethnicity, and education level. self-reported information on cannabis use patterns were collected, such as preference in chemovar (strain), route of consumption, frequency of use, amount of use, and negative experiences of any severity associated with cannabis use. individuals were able to select multiple preferences for each measure. validated self-report questionnaires were used to collect information on well-being and mental health. the perceived stress scale 10 (pss10) was used to rate perceived stress by collecting information on life unpredictability, lack of control, and stress overload as rated by participants (cohen et al., 1983). depressive symptoms and attitudes within the last two weeks were captured using the beck depression inventory-ii (bdi-ii) (beck et al., 1961). the patient health questionnaire 15 www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 4 published by scholink inc. (phq-15) was used to assess the severity of somatic symptoms (kroenke et al., 2002). finally, the patient reported outcomes measurement information system (promis) sleep disturbance scale was used to assess sleep disturbance within the last seven days (buysse et al., 2010). to determine whether participants met criteria for the psychiatric diagnoses of major depressive disorder (mdd), general anxiety disorder (gad), or bipolar disorder (bd, either type i, ii, or not otherwise specified (nos)), the mini version 6 was administered. the mini is a structured clinical interview for psychiatric diagnoses based on the diagnostic and statistical manual of mental disorders 4th edition (dsm-iv) and the international classification of diseases, 10th edition (icd-10) (sheehan et al., 1998). 2.3 data analysis all analyses were completed using the statistical package for the social sciences (spss) software version 27 (spss inc., armonk, usa). the shapiro-wilk test of normality was used to check if continuous variables were normally distributed. continuous measures were compared using an analysis of variance (anova) or kruskal-wallace test, if non-parametric. associations between categorical variables were assessed using the chi-square test of independence or fisher-freeman-halton exact test, if cell count assumptions were violated. 3. result 3.1 demographics the sample consisted of the following age groups; 19-24 (n = 35), 25-30 (n = 24), 31-40 (n = 19), and 41+ (n = 22). “young people” were represented in the 19-24 age group, while “young adults” encompassed the 19-24 and 25-30 age groups. fifty nine percent of the sample was under the age of 30. the majority of the participants were caucasian / white (66%) and had at least a college degree (51%). 3.2 mental health scales there were relatively few differences between mental health status among age groups (table 1). young people (19-24) did not significantly differ from any of the other age groups for pss-10 scores (f(3, 95) = .883, p = .453), bdi-ii scores (h(3) = 4.818, p = .186), or phq-15 scores (h(3) = 3.813, p = .282). overall, most participants endorsed “moderate” or greater levels of perceived stress via the pss10 (62%). the phq-15 scale showed 74% of the sample ranked as having minimal or low somatic symptoms. only 17% of the sample had depressive symptomatology ranked worse than “normal” on the bdi. thirty four percent of the sample had a standardized promis sleep disturbance score over 50, indicating above-average sleep disturbance. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 5 published by scholink inc. table 1. associations between age group and mental health outcomes age group, n (%) p-value 19-24 (n=35) 25-30 (n=24) 31-40 (n=19) 41+ (n=22) pss-10 .453 mean 16.77 (sd 5.8) 16.63 (sd 5.7) 13.89 (sd 7) 16.09 (sd 7.8) median 17.00 (iqr = 12.00 – 21.00) 15.00 (iqr = 13.00 – 22.25) 12.50 (iqr = 9.50 – 18.50) 15.50 (iqr = 9.75 – 21.25) bdi-ii .186 mean 7.4 (sd 6.7) 8.83 (sd 7) 5.32 (sd 6.4) 8.77 (sd 7.6) median 6.00 (iqr = 2.00 – 9.00) 6.00 (2.00 – 9.00) 3.00 (0 – 9.00) 4.00 (iqr = 3.00 – 8.00) phq-15 .282 mean 6.29 (sd 3.8) 5.71 (sd 3.9) 5.11 (sd 3.5) 7.9 (sd 5.2) median 6.00 (iqr = 3.00 – 9.00) 4.50 (iqr = 3.00 – 7.75) 4.00 (iqr = 3.00 – 8.00) 7.00 (iqr = 3.00 – 11.25) promis sleep disturbance .490 mean 46.08 (sd 7.21) 45.84 (sd 9.18) 45.49 (sd 8.09) 46.60 (8.546) median 45.50 (iqr = 41.40 – 51.20) 42.90 (iqr = 39.80 – 54.75) 45.50 (iqr = 39.80 – 53.30) 50.10 (iqr = 42.52 – 54.80) psychiatric diagnoses cannabis dependence or abuse 9 (25.7) 11 (45.8) 6 (31.6) 4 (18.2) .203 alcohol dependence or abuse 10 (28.6) 5 (20.8) 5 (26.3) 5 (22.7) .910 gad current 6 (17.1) 6 (25.0) 2 (10.5) 2 (9.1) .443 mdd current 3 (8.6) 0 (0) 0 (0) 0 (0) .286 mdd past 16 (45.7) 5 (20.8) 6 (31.6) 6 (27.3) .211 bd current 0 (0) 1 (4.2) 0 (0) 1 (4.5) .420 bd past 17 (48.6) 10 (41.7) 2 (10.5) 5 (22.7) .020 abbreviations: pss-10 = perceived stress scale 10, bdi-ii = beck depression inventory-ii, phq-15 = patient health questionnaire 15, promis sleep = patient reported outcomes measurement information system sleep disturbance scale, gad = generalized anxiety disorder, mdd = major depressive disorder, bd = bipolar disorder www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 6 published by scholink inc. age group and psychiatric diagnoses were not significantly associated with any of the investigated conditions, except for meeting criteria for a prior diagnosis of bipolar disorder (type i, ii, or nos), x2 (3, n=100) = 9.852, p = .02. the age groups under 30 had a significantly higher incidence of a lifetime diagnosis compared to the over 30 age groups. 3.3 patterns of use several differences were found between age groups and conditions used for, but general patterns of cannabis use remained similar across age groups (table 2). there was a significant relationship between age and use for depression (x2 (3, n=100) = 3.427, p = .036), with the under 30 age groups reporting most frequent use (19-24 = 54.5%, 25-30 = 62.5%). young people also reported significantly more use for sleep issues (71.4%) than any other age group, x2 (3, n=100) = 9.221, p = .026. the proportion of subjects who reported use for anxiety did not significantly differ between age groups x2 (3, n=100) = 3.427, p = .330, but was the highest reported condition for cannabis use among all age groups. the 19-24 age group was not found to significantly differ in preference for almost all other use pattern variables. the two exceptions were having less preference for tinctures (fisherfreeman-halton exact test, p = .035), compared to the over 30 age groups, and more preference for high cbd low thc chemovars compared to the 31-40 age group (x2 (3, n=100) = 7.330, p = .033). young people were not more likely to prefer high or pure thc chemovars than other age groups (x2 (3, n=100) = 1.961, p = .581). table 2. cannabis use patterns across age groups age group, n (%) p-value 19-24 (n=35) 25-30 (n=24) 31-40 (n=19) 41+ (n=22) condition using for anxiety/ stress 28 (80) 21(87.5) 13 (68.4) 15 (68.2) .330 depression 19 (54.3) 15 (62.5) 4 (21.1) 9 (40.9) .036 sleep issues 25 (71.4) 13 (54.2) 7 (13.3) 8 (15.1) .026 amount .958 1g or less 13 (37.1) 7 (29.2) 6 (31.6) 6 (27.3) 3.5g 14 (40.0) 11 (45.8) 6 (31.6) 8 (36.4) 7g or more 8 (22.9) 6 (25.0) 7 (36.9) 8 (36.4) frequency of use .533 non-daily 10 (28.6) 9 (37.5) 5 (26.3) 6 (27.3) 1x/day 11 (31.4) 5 (20.8) 2 (10.5) 7 (31.8) ≥ 2x/day 14 (40.0) 10 (41.7) 12 (63.2) 9 (40.9) www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 7 published by scholink inc. preferred consumption forms smoking 27 (77.1) 19 (79.2) 13 (68.4) 12 (54.5) .224 vaporization 13 (37.1) 9 (37.5) 9 (47.4) 11 (50.0) .719 edibles 8 (22.9) 5 (20.8) 2 (10.5) 5 (22.7) .753 tinctures 3 (8.6) 1 (4.2) 4 (21.1) 7 (31.8) .035 capsules 6 (17.1) 2 (8.3) 5 (26.3) 4 (18.2) .476 only prefer smoking 14 (40) 10 (41.7) 6 (31.6) 4 (18.2) .297 preferred chemovar pure thc 9 (25.7) 2 (8.3) 4 (21.1) 5 (22.7) .385 high thc low cbd 12 (34.3) 9 (37.5) 8 (42.1) 7 (31.8) .913 equal thc and cbd 10 (28.6) 7 (29.2) 9 (47.4) 9 (40.9) .468 pure cbd 8 (22.9) 3 (12.5) 2 (10.5) 5 (27.8) .598 high cbd low thc 10 (28.6) 7 (29.2) 0 (0) 4 (18.2) .033 prefer pure or high thc only 10 (28.6) 8 (33.3) 9 (47.4) 8 (36.4) .581 prefer pure or high cbd only 7 (20) 3 (12.5) 1 (5.3) 2 (9.1) .494 negative adverse events experienced negative adverse events 22 (62.9) 15 (62.5) 9 (47.4) 8 (38.1) .233 4. discussion currently, there is a lack of literature available on the patterns of medical cannabis use in young adulthood, compared to adolescents. the current study aimed to assess mental health status and patterns of use in young people using medical cannabis, and to compare these findings to older age groups. the conditions medical cannabis was reported as being used for differed between age groups, with the young adult age groups reporting greater use for depression and sleep issues. interestingly, however, young people did not appear to have worse scores on validated scales or a greater occurrence of psychiatric diagnoses (table 1). the one exception to this was a greater amount of past bd diagnoses in the under 30 age groups. further, young people had use patterns similar to older age groups (table 2). in all, there were relatively few differences between age groups for most measures of mental health and patterns of use. the lack of difference between age groups on indicators of mental health and psychiatric diagnoses is a reassuring, but a somewhat unexpected finding. the literature from recreational studies has shown that frequent cannabis use, as would be seen in this sample, may be associated with increased risk of depression (degenhardt et al., 2003; moore et al., 2007). further, earlier age of regular use has been associated with elevated risk for poor mental health outcomes and substance dependence (degenhardt et al., 2003; eadie et al., 2021; gicas et al., 2020; gobbi et al., 2019; maccallum, eadie, et al., 2021; mcgee et al., 2000). sleep disturbance has also been found to moderate a relationship between www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 8 published by scholink inc. depressive symptoms and problematic cannabis use, in addition to being associated with stress and higher levels of anxiety in young adults (babson et al., 2017; manzar et al., 2021). some evidence suggests there may also be an association between earlier cannabis use and worsening bd symptoms (bally et al., 2014). even though a greater proportion of young people self-reported using cannabis for depression and sleep issues, outcomes from the validated scales and assessment measures showed no significant differences. as such, it appears younger individuals were not at a greater risk for adverse mental health outcomes. most of the sample had beck depression inventory and promis sleep disturbance scale scores within normal ranges. furthermore, there was low incidence of current mdd and bd, including in young people. this is a promising finding, as it suggests that young people over the age of 19 may not face the same risks that were found for adolescent users below the age of 19. additionally, this may also reflect a difference in intent of use, compared to recreational-use populations, such that use patterns are unlikely to invoke adverse mental health outcomes. one related finding of interest was that, although there were very low rates of current bd, there was a significantly higher proportion of past bd diagnoses in the under 30 age groups. this may indicate that young people are seeking out medical cannabis to help control symptoms. a similar trend was seen for mdd, although it was consistent across age groups. while these findings should not be inferred as causal, this may indicate that medical cannabis was helpful in improving symptoms. overall, our findings suggest that young people using medical cannabis (age 19-24) are not at a greater risk of adverse mental health outcomes compared to older adults. the similarity of cannabis use patterns across age groups was also an unexpected finding. older adults have been reported to perceive cannabis as having a greater risk of harm compared to young people (okaneku et al., 2015; pacek et al., 2015). accordingly, we expected there to be differences in how cannabis was being used between the younger and older age groups. the similarity observed may partly explain why there were minimal differences for mental health outcomes. many cannabis-related harms are thc dose dependent (maccallum, lo, et al., 2021). as such, differences in factors, such as chemovar and frequency, impact risk of harm. hence, those with similar patterns of use may have similar risks. in contrast to our study, (haug et al., 2017) found that younger users reported a higher quantity of use, and older users reported more preference for oral formulations. differences may be due to different age groupings, as (haug et al., 2017) used categories of 18-30, 31-50, and 51-74. their larger sample size (n = 217) also contained more individuals in older age categories, which may have increased statistical power to detect subtle differences. despite these contrasting findings, one notable similarity was the common preference for smoked cannabis. smoking cannabis is a known respiratory harm (hoffmann & weber, 2010; national academies of sciences et al., 2017; tashkin, 2014). this is a particular concern for young people and young adults who may continue to smoke throughout their lifetime. our findings support the need for a greater emphasis on education and diversion away from smoking cannabis. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 9 published by scholink inc. finally, although not significantly different across age groups, this sample showed high rates of current problematic cannabis (30%) and alcohol (25%) use. this is particularly concerning for the younger age groups. it should be noted that currently available measures for cannabis misuse have not been validated for medical cannabis populations. nevertheless, consideration is still warranted. this finding is consistent with previous studies suggesting an elevated risk for co-use of cannabis and alcohol (metrik et al., 2018; yurasek et al., 2017). this also may imply that increased vigilance for problematic cannabis use and co-use with alcohol is needed. one important distinction within this sample, however, is that although participants reported use for medical purposes, most were not government-authorized medical cannabis users. as such, findings from this study are more relevant to self-guided medical cannabis users, obtaining cannabis from a dispensary, than authorized cannabis users under the care of a healthcare professional. 5. limitations generalization to broader populations may be limited as the sample was obtained from an affluent neighbourhood and generally had higher levels of education. additionally, although sample participants reported use for medical purposes, few had guidance from a healthcare professional as authorized medical cannabis patients do. therefore, generalizations between this population and government authorized medical cannabis patients under the care of a healthcare professional should be made with caution. finally, the present assessments, while comprehensive, did not address all areas of mental health—such as pain, where both preclinical and clinical evidence for benefits of cannabis have been reported (duarte et al., 2021; legare et al., 2022; maccallum, eadie et al., 2021; rouhollahi et al., 2020; ware et al., 2015). 6. conclusion this investigation of patterns of use and mental health outcomes in a sample of cannabis dispensary users revealed that young people and adults did not have significantly different patterns of use. more importantly, it does not appear that young people had an elevated incidence of adverse mental health outcomes. this serves as a starting point to better evaluate differences in use and risk factors between younger and older medical cannabis users. further, it illustrates potential differences between those using with a recreational vs. medical intent. despite this, more research is needed to provide stronger evidence and guidance for potential risk factors for adverse mental health outcomes, particularly in younger age groups. in the future, larger sample sizes would better help clarify associations between age groups, use patterns, and mental health outcomes. additionally, comparisons between self-medicating cannabis users and medical cannabis patients authorized by a licensed healthcare professional should be investigated. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 10 published by scholink inc. acknowledgement funding support by the canadian centre on substance abuse. references alexander, p. d., gicas, k. m., cheng, a., lang, d. j., procyshyn, r. m., vertinsky, a. t., panenka, w. j., thornton, a. e., rauscher, a., wong, j. y. x., chan, t., jones, a. a., vila-rodriguez, f., honer, w. g., & barr, a. m. (2019). a comparison of regional brain volumes and white matter connectivity in subjects with stimulant induced psychosis versus schizophrenia. psychopharmacology (berl), 236(12), 3385-3399. https://doi.org/10.1007/s00213-019-05298-w babson, k. a., sottile, j., & morabito, d. (2017). cannabis, cannabinoids, and sleep: a review of the literature. curr psychiatry rep, 19(4), 23. https://doi.org/10.1007/s11920-017-0775-9 bally, n., zullino, d., & aubry, j. m. (2014). cannabis use and first manic episode. j affect disord, 165, 103-108. https://doi.org/10.1016/j.jad.2014.04.038 barr, a. m., panenka, w. j., honer, w. g., khara, s., & procyshyn, r. m. (2011). excessive antipsychotic dosing in a canadian outpatient population. psychiatr serv, 62(6), 682-683. retrieved from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=citation&list_ uids=21632741 beck, a. t., ward, c. h., mendelson, m., mock, j., & erbaugh, j. (1961). an inventory for measuring depression. arch gen psychiatry, 4, 561-571. buysse, d. j., yu, l., moul, d. e., germain, a., stover, a., dodds, n. e., johnston, k. l., shablesky-cade, m. a., & pilkonis, p. a. (2010). development and validation of patient-reported outcome measures for sleep disturbance and sleep-related impairments. sleep, 33(6), 781-792. https://doi.org/10.1093/sleep/33.6.781 cohen, s., kamarck, t., & mermelstein, r. (1983). a global measure of perceived stress. j health soc behav, 24(4), 385-396. crean, r. d., crane, n. a., & mason, b. j. (2011). an evidence based review of acute and long-term effects of cannabis use on executive cognitive functions. j addict med, 5(1), 1-8. https://doi.org/10.1097/adm.0b013e31820c23fa degenhardt, l., hall, w., & lynskey, m. (2003). exploring the association between cannabis use and depression. addiction, 98(11), 1493-1504. https://doi.org/10.1046/j.1360-0443.2003.00437.x duarte, r. a., dahmer, s., sanguinetti, s. y., forde, g., duarte, d. p., & kobak, l. f. (2021). medical cannabis for headache pain: a primer for clinicians. curr pain headache rep, 25(10), 64. https://doi.org/10.1007/s11916-021-00974-z eadie, l., lo, l. a., christiansen, a., brubacher, j. r., barr, a. m., panenka, w. j., & maccallum, c. a. (2021). duration of neurocognitive impairment with medical cannabis use: a scoping www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 11 published by scholink inc. review [systematic review]. frontiers in psychiatry, 12(286). https://doi.org/10.3389/fpsyt.2021.638962 gicas, k. m., cheng, a., panenka, w. j., kim, d. d., yau, j. c., procyshyn, r. m., stubbs, j. l., jones, a. a., bains, s., thornton, a. e., lang, d. j., vertinsky, a. t., rauscher, a., honer, w. g., & barr, a. m. (2020). differential effects of cannabis exposure during early versus later adolescence on the expression of psychosis in homeless and precariously housed adults. prog neuropsychopharmacol biol psychiatry, 110084. https://doi.org/10.1016/j.pnpbp.2020.110084 gobbi, g., atkin, t., zytynski, t., wang, s., askari, s., boruff, j., ware, m., marmorstein, n., cipriani, a., dendukuri, n., & mayo, n. (2019). association of cannabis use in adolescence and risk of depression, anxiety, and suicidality in young adulthood: a systematic review and meta-analysis. jama psychiatry, 76(4), 426-434. https://doi.org/10.1001/jamapsychiatry.2018.4500 goldstein ferber, s., trezza, v., & weller, a. (2021). early life stress and development of the endocannabinoid system: a bidirectional process in programming future coping. dev psychobiol, 63(2), 143-152. https://doi.org/10.1002/dev.21944 haug, n. a., padula, c. b., sottile, j. e., vandrey, r., heinz, a. j., & bonn-miller, m. o. (2017). cannabis use patterns and motives: a comparison of younger, middle-aged, and older medical cannabis dispensary patients. addict behav, 72, 14-20. https://doi.org/10.1016/j.addbeh.2017.03.006 hill, m. n., barr, a. m., ho, w. s., carrier, e. j., gorzalka, b. b., & hillard, c. j. (2007). electroconvulsive shock treatment differentially modulates cortical and subcortical endocannabinoid activity. j neurochem, 103(1), 47-56. https://doi.org/10.1111/j.1471-4159.2007.04688.x hoffmann, d. e., & weber, e. (2010). medical marijuana and the law. n engl j med, 362(16), 1453-1457. https://doi.org/10.1056/nejmp1000695 hurd, y. l. (2020). cannabis and the developing brain challenge risk perception. j clin invest, 130(8), 3947-3949. https://doi.org/10.1172/jci139051 jacobson, m. r., watts, j. j., boileau, i., tong, j., & mizrahi, r. (2019). a systematic review of phytocannabinoid exposure on the endocannabinoid system: implications for psychosis. eur neuropsychopharmacol, 29(3), 330-348. https://doi.org/10.1016/j.euroneuro.2018.12.014 johnson, s. b., blum, r. w., & giedd, j. n. (2009). adolescent maturity and the brain: the promise and pitfalls of neuroscience research in adolescent health policy. j adolesc health, 45(3), 216-221. https://doi.org/10.1016/j.jadohealth.2009.05.016 jones, d. t., & graff-radford, j. (2021). executive dysfunction and the prefrontal cortex. continuum (minneap minn), 27(6), 1586-1601. https://doi.org/10.1212/con.0000000000001009 www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 12 published by scholink inc. kroenke, k., spitzer, r. l., & williams, j. b. (2002). the phq-15: validity of a new measure for evaluating the severity of somatic symptoms. psychosom med, 64(2), 258-266. legare, c. a., raup-konsavage, w. m., & vrana, k. e. (2022). therapeutic potential of cannabis, cannabidiol, and cannabinoid-based pharmaceuticals. pharmacology, 1-19. https://doi.org/10.1159/000521683 lo, l. a., maccallum, c. a., yau, j. c., & barr, a. m. (2022). differences in those who prefer smoking cannabis to other consumption forms for mental health: what can be learned to promote safer methods of consumption? j addict dis, 1-5. https://doi.org/10.1080/10550887.2022.2107332 lo, l. a., maccallum, c. a., yau, j. c., panenka, w. j., & barr, a. m. (2022). factors associated with problematic cannabis use in a sample of medical cannabis dispensary users. psychiatry and clinical psychopharmacology, 32, 262-267. https://doi.org/10.5152/pcp.2022.22358 lowe, d. j. e., sasiadek, j. d., coles, a. s., & george, t. p. (2019). cannabis and mental illness: a review. eur arch psychiatry clin neurosci, 269(1), 107-120. https://doi.org/10.1007/s00406-018-0970-7 maccallum, c. a., eadie, l., barr, a. m., boivin, m., & lu, s. (2021). practical strategies using medical cannabis to reduce harms associated with long term opioid use in chronic pain [perspective]. front pharmacol, 12(907). https://doi.org/10.3389/fphar.2021.633168 maccallum, c. a., lo, l. a., & boivin, m. (2021). "is medical cannabis safe for my patients?" a practical review of cannabis safety considerations. eur j intern med. https://doi.org/10.1016/j.ejim.2021.05.002 manzar, m. d., salahuddin, m., pandi-perumal, s. r., & bahammam, a. s. (2021). insomnia may mediate the relationship between stress and anxiety: a cross-sectional study in university students. nat sci sleep, 13, 31-38. https://doi.org/10.2147/nss.s278988 mcgee, r., williams, s., poulton, r., & moffitt, t. (2000). a longitudinal study of cannabis use and mental health from adolescence to early adulthood. addiction, 95(4), 491-503. https://doi.org/10.1046/j.1360-0443.2000.9544912.x metrik, j., gunn, r. l., jackson, k. m., sokolovsky, a. w., & borsari, b. (2018). daily patterns of marijuana and alcohol co-use among individuals with alcohol and cannabis use disorders. alcohol clin exp res, 42(6), 1096-1104. https://doi.org/10.1111/acer.13639 meyer, h. c., lee, f. s., & gee, d. g. (2018). the role of the endocannabinoid system and genetic variation in adolescent brain development. neuropsychopharmacology, 43(1), 21-33. https://doi.org/10.1038/npp.2017.143 moore, t. h., zammit, s., lingford-hughes, a., barnes, t. r., jones, p. b., burke, m., & lewis, g. (2007). cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. lancet, 370(9584), 319-328. https://doi.org/10.1016/s0140-6736(07)61162-3 www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 13 published by scholink inc. murray, r. m., englund, a., abi-dargham, a., lewis, d. a., di forti, m., davies, c., sherif, m., mcguire, p., & d'souza, d. c. (2017). cannabis-associated psychosis: neural substrate and clinical impact. neuropharmacology, 124, 89-104. https://doi.org/10.1016/j.neuropharm.2017.06.018 national academies of sciences, e., medicine, health, medicine, d., board on population, h., public health, p., committee on the health effects of marijuana: an evidence, r., & research, a. (2017). the national academies collection: reports funded by national institutes of health (the health effects of cannabis and cannabinoids: the current state of evidence and recommendations for research. national academies press (us). https://doi.org/10.17226/24625 nocon, a., wittchen, h. u., pfister, h., zimmermann, p., & lieb, r. (2006). dependence symptoms in young cannabis users? a prospective epidemiological study. j psychiatr res, 40(5), 394-403. https://doi.org/10.1016/j.jpsychires.2005.07.011 okaneku, j., vearrier, d., mckeever, r. g., lasala, g. s., & greenberg, m. i. (2015). change in perceived risk associated with marijuana use in the united states from 2002 to 2012. clin toxicol (phila), 53(3), 151-155. https://doi.org/10.3109/15563650.2015.1004581 pacek, l. r., mauro, p. m., & martins, s. s. (2015). perceived risk of regular cannabis use in the united states from 2002 to 2012: differences by sex, age, and race/ethnicity. drug alcohol depend, 149, 232-244. https://doi.org/10.1016/j.drugalcdep.2015.02.009 rouhollahi, e., macleod, b. a., barr, a. m., & puil, e. (2020). cannabis extract ct-921 has a high efficacy-adverse effect profile in a neuropathic pain model. drug des devel ther, 14, 3351-3361. https://doi.org/10.2147/dddt.s247584 schonhofen, p., bristot, i. j., crippa, j. a., hallak, j. e. c., zuardi, a. w., parsons, r. b., & klamt, f. (2018). cannabinoid-based therapies and brain development: potential harmful effect of early modulation of the endocannabinoid system. cns drugs, 32(8), 697-712. https://doi.org/10.1007/s40263-018-0550-4 sheehan, d. v., lecrubier, y., sheehan, k. h., amorim, p., janavs, j., weiller, e., hergueta, t., baker, r., & dunbar, g. c. (1998). the mini-international neuropsychiatric interview (m.i.n.i.): the development and validation of a structured diagnostic psychiatric interview for dsm-iv and icd-10. j clin psychiatry, 59 suppl 20, 22-33;quiz 34-57. retrieved from http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&dopt=citation&list_ uids=9881538 tashkin, d. p. (2014). increasing cannabis use: what we still need to know about its effects on the lung. respirology, 19(5), 619-620. https://doi.org/10.1111/resp.12308 turna, j., balodis, i., munn, c., van ameringen, m., busse, j., & mackillop, j. (2020). overlapping patterns of recreational and medical cannabis use in a large community sample of cannabis users. compr psychiatry, 102, 152188. https://doi.org/10.1016/j.comppsych.2020.152188 www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 14 published by scholink inc. urbanoski, k. a., strike, c. j., & rush, b. r. (2005). individuals seeking treatment for cannabis-related problems in ontario: demographic and treatment profile. eur addict res, 11(3), 115-123. https://doi.org/10.1159/000085546 ware, m. a., wang, t., shapiro, s., & collet, j. p. (2015). cannabis for the management of pain: assessment of safety study (compass). j pain, 16(12), 1233-1242. https://doi.org/10.1016/j.jpain.2015.07.014 world health organization. (2011). youth and health risks. sixty-fourth world health assembly. https://apps.who.int/gb/ebwha/pdf_files/wha64/a64_25-en.pdf yurasek, a. m., aston, e. r., & metrik, j. (2017). co-use of alcohol and cannabis: a review. curr addict rep, 4(2), 184-193. https://doi.org/10.1007/s40429-017-0149-8 zhou, l. w., panenka, w. j., jones, a. a., gicas, k. m., thornton, a. e., heran, m. k. s., volders, d., lang, d. j., vertinsky, a. t., rauscher, a., su, w., barr, a. m., macewan, g. w., honer, w. g., & field, t. s. (2019). prevalence and risk factors of brain infarcts and associations with cognitive performance in tenants of marginal housing. j am heart assoc, 8(13), e011412. https://doi.org/10.1161/jaha.118.011412 children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 1, no. 2, 2018 www.scholink.org/ojs/index.php/ct 93 original paper motivation, fortitude and success: the impact of academic efficacy and academic commitment on academic performance among minority high school students christina hughes1, carla jones-adams2 & david branham sr.1* 1 department of social sciences, university of houston-downtown, houston, texas, united states 2 boys and girls clubs of greater houston, masters of nonprofit management program, university of houston-downtown, houston, texas, united states * david branham sr., department of social sciences, university of houston-downtown, houston, texas, united states received: september 11, 2018 accepted: september 28, 2018 online published: october 8, 2018 doi:10.22158/ct.v1n2p93 url: http://dx.doi.org/10.22158/ct.v1n2p93 abstract the importance of understanding the elements of success in the education of minority high school students is immense. recognizing the causes of academic success for these students allows educators to employ better educational and motivational strategies. it has been shown that academic efficacy and academic commitment have a positive impact on academic performance. however, the interaction and relationship between these two variables in having a positive effect on education outcomes among minority high school students is not clear. this paper looks at the relationship between academic efficacy and academic commitment on academic performance among minority high school students. the findings reveal that academic commitment is positively associated with academic performance. however, while academic efficacy has a positive impact on academic commitment the results show that academic efficacy has no direct impact on academic performance among the respondents. keywords minority education, educational commitment, educational efficacy www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 94 published by scholink inc. 1. introduction despite the view put forth by horace mann in 1854 that education could be the “great equalizer”, educational success and opportunities in the united states are still far from being the same for everyone. there are still vast differences in achievement when students are disaggregated by race/ethnicity, socio-economic status, and parental education. education policy researchers have long proposed that these educational outcome differences are a result of differences in school funding, lack of resources, and school overcrowding (burtless, 1996; card & krueger, 1996; hoxby, 1998). other researchers point to factors outside the school such as human, family, and social capital found in the homes and communities of these students (bankston et al., 1997; bankston, 2004; coleman, 1988; desimone, 2001; lareau, 1987). social cognitive theory looks at the impact of psychological variables on student outcomes, mainly students’ motivation and efficacy. perhaps the most prominent research in this realm was done by morgan (2005) who showed that student beliefs were directly related to commitment and success in education. a big part of this success has been due to an educational culture that values high commitment by rewarding committed students with higher grades (farkas et al., 1990). this finding was particularly important in understanding educational success for minority children. morgan et al. (2013) reinforced this finding by showing that student beliefs were not only directly related to student commitment and success, but that beliefs were important to success outside of their connection to educational commitment. efficacy is defined as the “people’s judgments of their capabilities to organize and execute courses of action required to attain designated types of performance” (bandura, 1986, p. 391). a vast amount of empirical research support the theory that self-efficacy has an impact across a multitude of human activities (bandara, 1997). research has demonstrated that efficacy beliefs impact career choice, persistence in certain majors, and academic performance among college students (betz & hacket, 1981, 1983; lent, brown, & larkin, 1984, 1987; brown, lent, & larkin, 1989; bembenutty & white, 2013). focusing on young children, schunk found a link between children’s self-efficacy, motivation, and performance (schunk, 1991). many studies have been conducted specifically looking at the link between self-efficacy beliefs and academic performance. in mathematics, perceived efficacy has been shown to be a stronger predictor of academic outcomes than skills and past performance (pajares & graham, 1999). in a meta-analysis of thirty-eight studies on the relationship between self-efficacy beliefs and academic outcomes, multon et al. (1991) found efficacy beliefs account for approximately 14% of the variance on students’ academic performance. in addition, they also found a consistent relationship between self-efficacy and academic persistence across the thirty-eight studies (multon, brown, & lent, 1991). more recent studies have demonstrated a direct link between self-efficacy beliefs and academic outcomes across multiple subject areas (schunk et al., 2008; usher & pajares, 2008; hassankhani et al., 2015; hsia, huang, & hwang, www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 95 published by scholink inc. 2016; salasar & hayward, 2018). 1.1 research questions this research focuses on the link between efficacy, commitment, and student performance among minority high school teenagers. three hypotheses are statistically tested. these include: hypothesis 1: minority high school students with high educational efficacy will have higher academic commitment than students with low academic efficacy. hypothesis 2: minority high school students with a high level of educational commitment will do better in math and reading/language arts than those with lower confidence levels. hypothesis 3: minority high school students with a high level of educational efficacy will do better in math and reading/language arts than those with lower confidence levels. 2. methodology 2.1 research participants the analysis uses survey responses from 63 minority high school students at various boys and girls clubs in the houston area. the instrument used for the analysis was a 34 item questionnaire designed to ascertain students’ education attitudes. the survey was conducted from january to may in 2017. 2.2 data collection the survey was collected in a face to face manner by the united way greater houston and administered to 9th to 12th grade students in various agencies around the city. demographic data was collected but not reported publically to protect the identity of the students. students who reported that they were black, hispanic, or from a race/ethnicity other than non-hispanic white were included in this analysis. those who identified themselves as non-hispanic whites or refused to identify their race/ethnicity were eliminated from the analysis so that the focus could be on minority students. each question in the instrument was given to the student in text form and read allowed to them to make sure there was complete understanding. in asking opinion questions students were told that there was no right or wrong answer. in addition, they were asked to refrain from answering until the question was read completely and were asked to answer as truthfully as possible. students were also assured that their parents or guardians would not be given their answers, and that their names would not be used. 2.3 research design the dependent variables for the multivariate analysis were student reported grades in reading and language arts, and math. students were asked to record the grades that best described their performance in each subject area. the breakdown of the reported scores for the 63 students is displayed in table 1. overall, 22 of the 63 students report making mostly a’s in reading and language arts. another 23 report making mostly b’s and 17 more report making mostly c’s in the subject. only one student reported making mostly d’s in reading and language arts. the reported math grades were somewhat lower. only www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 96 published by scholink inc. 17 students reported making mostly a’s, 25 students reported making mostly b’s, and 17 students reported making mostly c’s. three students reported making mostly d’s in math and one student reported making mostly f’s in the subject. table 1. dependent variable cross tabulation of 63 minority high school students what grades do you usually receive in: reading/language arts? math? mostly ___ a’s (100-90) 22 17 mostly ___ b’s (89-80) 23 25 mostly ___ c’s (79-70) 17 17 mostly ___ d’s (69-60) 1 3 mostly ___ f’s (59 or below) 0 1 2.4 data analysis two latent variables, academic commitment and academic efficacy, serve as independent variables in the analysis. these two latent variables in the analysis are measured with factor scores in a non-rotated confirmatory factor analysis using a series of six observed respondent answers as indicators. students were told “i am going to read some sentences to you. i really want to know how you honestly feel about school. i will read each sentence twice. there are no right or wrong answers—just please answer the questions as truthfully as possible”. students were asked if they “strongly agree”, “agree”, “disagree”, or “strongly disagree” with each question. to measure academic commitment the responses to four statements are used. they are: 1) i work as hard as i can in my classes. 2) i always concentrate on school subjects during class. 3) i keep trying at something until i succeed. 4) i motivate myself to do my schoolwork. academic efficacy is measured with responses to two statements. they are: 1) the harder you work at something the better you will be at it. 2) you can always change how smart you are. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 97 published by scholink inc. to test the hypotheses a recursive structural equation model is constructed. academic efficacy will serve strictly as an independent variable and is hypothesized to have a positive impact on both academic commitment and student performance in both reading/language arts and math. academic commitment will be an intervening variable in the mediation model presented and is hypothesized to have a positive impact on academic performance. 3. results the principal components extraction results for the two latent variables in the confirmatory factor analysis are presented in table 2. the four indicators of academic commitment produced a single eigenvalue over one of 2.11. each indicator correlated with the latent variable at .65 or higher. nearly 53% of the variance was explained by the indicators. the two indicators of academic efficacy produced an eigenvalue of 1.53 explaining 76.3% of the variance. the indicators correlated at .87. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 98 published by scholink inc. .72 .65 .87 .76 .72 .87 figure 1. principal components extraction of latent independent variables in the analysis. the eigenvalue for academic commitment is 2.11 (52.7% of variance explained). the eigenvalue of academic efficacy is 1.53 (76.3% of variance explained). coefficients are component loadings i keep trying at something until i i motivate myself to do my the harder you work at something the better you can always change how i work as hard as i can in my i always concentrate on school subjects academic commitmen academic efficacy www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 99 published by scholink inc. .31* .27* .03 .35* .27* -.01 figure 2. structural equation models for latent variable prediction of academic performance coefficients are standardized beta estimates. * = statistically significant at the .05 level, two tailed test. to test the hypotheses the structural equation model was designed to test three separate relationships. first, academic efficacy is hypothesized to increase academic commitment. the premise in this theory being that the belief that education can make a positive difference will provide motivation in the form of academic commitment. the second hypothesis is that academic commitment will positively impact academic performance, in this case performance in reading/language arts and math. the final hypothesis is that educational efficacy will have a positive impact on academic performance controlling for its effect on academic commitment. this hypothesis asserts that academic efficacy, the belief that an individual has the power to produce a positive academic outcome, will increase academic achievement academic commitment academic efficacy math performance academic commitment academic efficacy reading/language arts performance www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 100 published by scholink inc. not only as a factor to improve commitment, but simply as an available avenue of success. the results from the structural equation model are exhibited in figure 2. the data reveal that minority high school students who have strong believes that education can change their lives and that they can succeed are significantly more committed in their studies. this commitment translates into significantly better academic performance, both in reading/language arts and in math. however, the hypothesis that academic efficacy by itself will increase academic performance is not supported in either model. in fact, the standardized coefficients are almost exactly zero. the data suggest that academic efficacy has power to produce academic success by motivating academic commitment. however, the impact is only indirect with academic efficacy not producing educational success directly. a look at the final portion of the model can be seen in table 2. here the coefficients are presented in an ordered probit model. a model such as this is optimal when the dependent variable is ordinal in nature as is the case with the student success measures presented in this analysis. the results in table 2 further confirm the results of the structural equation models. the evidence suggests that academic commitment is very important to minority student success among high school students. in addition, while academic efficacy is positively related to academic commitment, academic efficacy outside of its contribution to academic commitment has no impact on student success. two of the models also include racial and ethnic categorical variables. these variables were not statistically significant and their addition to the model made no impact on the hypotheses tests. the data suggests that there is not a significant difference in academic performance between racial and ethnic groups among these minority high school students. table 2. ordered probit results predicting academic commitment math performance reading/language arts performance latent variable coef. (std err) coef. (std err) coef. (std err) coef. (std err) academic commitment .43 (.15)* .43 (.15)* ..45 (.16)* .44 (.15)* academic efficacy -.03 (.15) .02 (.14) .01 (.15) -.02 (.15) hispanic -.86 (.73) ----------.60 (.67) --------- black -.47 (.73) ----------.37 (.68) --------- cut 1 .04 (.72) -.67 (.18) -.95 (.67) -.44 (.17) cut 2 1.21 (.73) .47 (.17) .10 (.66) .61 (.18) cut 3 2.41 (.76) 1.64 (.26) 1.86 (.78) 2.37 (.43) cut 4 3.11 (.85) 2.32 (.44) ------------------ *indicates that coefficient is significant at the .05 level, two tailed test. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 101 published by scholink inc. 4. discussion 4.1 contributions of the current study the importance of finding keys to educational success among minority teenagers is extremely high. finding pathways to success for minority students can lead to a generation of economic and social achievement that has yet to be realized in united states history. supplemental support systems for minority students in schools and nonprofit organizations should take strides to understand the needs of minority teenagers and intervene accordingly. the results here shed light on those pathways to success. this research underscores the importance of commitment to academic success among minority high school students. minority students who work hard on their studies, are tenacious in their pursuit of knowledge, are intrinsically motivated, and are more successful at school than those who are not. while this may seem intuitive the priority of improving student commitment can take a back seat to providing educational resources and qualified teachers. such omissions in priorities must be avoided. the data also suggests that academic efficacy, the belief that an individual has the power to produce a positive academic outcome, also plays an important role in academic success for minority teenagers. however, the results of this research indicate that academic efficacy’s role is primarily in motivating students to commit themselves to their education. while the impact of academic efficacy appears to be indirect its importance should not be underscored. previous research shows that a lack of academic self-efficacy most often occurs with minority students who are more likely to have a family background without educational success. it is important that minority teenagers have an understanding that educational attainment is a worthwhile adventure and that working hard in education will bring results with long term payoffs. 4.2 implications for future research further study should focus on the unique circumstances that minority children face in obtaining the efficacy and commitment necessary to succeed in education. in particular, it will be important to find interventions that make a positive and resilient impact on the attitudes of minority children toward educational attainment. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 102 published by scholink inc. references artino, a. r., la rochelle, j. s., & durning, s. j. (2010). second-year medical student’s motivational beliefs, emotions, and achievements. medical education, 44(12), 1203-1212. https://doi.org/10.1111/j.1365-2923.2010.03712.x bandura, a. (1986). social foundation of thought and action: a social cognitive theory. englewood cliffs, nj: prentice-hall, inc. bandara, a. (1997). self-efficacy: the exercise of control. new york: w. h. freeman and company. bankston, c. l. iii., caldas, s., & zhou, m. (1997). the academic achievement of vietnamese american students: ethnicity as social capital. sociological focus, 30, 1-16. https://doi.org/10.1080/00380237.1997.10570679 bankston, c. l. iii. (2004). social capital, cultural values, immigration, and academic achievement: the host country context and contradictory consequences. sociology of education, 77, 176-179. https://doi.org/10.1177/003804070407700205 bembenutty, h., & white, m. c. (2013). academic perfomance and satisfaction with homework completion among college students. learning and individual differences, 24, 83-88. https://doi.org/10.1016/j.lindif.2012.10.013 betz, n. e., & hacket, g. (1981). the relationship of career-related self-efficacy expectations to perceived career option in college women and men. journal of counseling psychology, 28, 399-410. https://doi.org/10.1037/0022-0167.28.5.399 betz, n. e., & hacket, g. (1983). the relationship of mathematics self-efficacy expectations to the selection of science-based college majors. journal of vocational behavior, 23, 329-345. https://doi.org/10.1016/0001-8791(83)90046-5 brown, s., lent, r. w., & larkin, k. (1989). self-efficacy as a moderator of scholastic aptitude-academic performance relationships. journal of vocational behavior, 35, 64-75. https://doi.org/10.1016/0001-8791(89)90048-1 burtless, g. (ed.). (1996). does money matter? the effect of school resources on student achievement and adult success. washington, d. c.: brookings institution press. card, d., & krueger, a. (1996). school resources and student outcomes: an overview of the literature and new evidence from north and south carolina. journal of economic perspectives, 10, 31-40. https://doi.org/10.1257/jep.10.4.31 coleman, j. s. (1988). social capital in the creation of human capital. american journal of sociology, 94, s95-s121. https://doi.org/10.1086/228943 desimone, l. (2001). linking parent involvement with student achievement: do race and income matter? the journal of education research, 93, 11-30. https://doi.org/10.1080/00220679909597625 www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 103 published by scholink inc. farkas, g., grobe, r. p., sheehan, d., & shuan, y. (1990). cultural resources and school success: gender, ethnicity and poverty groups within and urban school district. american sociological review, 55, 127-42. https://doi.org/10.2307/2095708 hassankhani, h., aghdam, a. m., rahmani, a., & mohammadpoorfadrd, z. (2015). the relationship between learning motivation and self-efficacy among nursing students. research and development in medical education, 4, 91-101. https://doi.org/10.15171/rdme.2015.016 hoxby, c. (1998). the effect of class size and composition on student achievement: new evidence from natural population variation. national bureau of economic research working paper, 6869. retrieved from http://www.nber.org/papers/w6869 hsia, l., huang, i., & hwang, g. (2016). effects of different online peer-feedback approaches on student performance skills, motivation and self-efficacy in a dance course. computers and education, 1, 9655-9971. https://doi.org/10.1016/j.compedu.2016.02.004 lareau, a. (1987). social class differences in family-school relationships: the importance of cultural capital. sociology of education, 60, 73-85. https://doi.org/10.2307/2112583 lent, r. w., brown, s., & larkin, k. (1984). relation of self-efficacy expectations to academic achievement and persistence. journal of counseling psychology, 31, 356-362. https://doi.org/10.1037/0022-0167.31.3.356 lent, r. w., brown, s., & larkin, k. (1987). comparison of three theoretically derived variables in predicting career and academic behavior: self-efficacy, interest congruence, and consequence thinking. journal of counseling psychology, 34, 293-298. https://doi.org/10.1037/0022-0167.34.3.293 morgan, s. l. (2005). on the edge of commitment: education attainment and race in the united states. stanford university press. morgan, s. l., leenman, t. s., todd, j. j., & weeden, k. a. (2013). stutter-step models of performance in school. social forces, 91(4), 1451-1474. https://doi.org/10.1093/sf/sot037 multon, k. d., brown, s. d., & lent, r. w. (1991). relation of self-efficacy beliefs to academic outcomes: a meta-analytic investigation. journal of counseling psychology, 38, 30-38. https://doi.org/10.1037/0022-0167.38.1.30 pajares, f., & graham, l. (1999). self-efficacy, motivation constructs, and mathematics performance of entering middle schools students. contemporary educational psychology, 24, 124-139. https://doi.org/10.1006/ceps.1998.0991 salazar, l. r., & hayward, s. l. (2018). an examination of college students’ problem-solving self-efficacy, academic self-efficacy, motivation, test performance, and expected grade in introductory-level economic courses. decision sciences journal of innovative education, 16(3), 217-240. https://doi.org/10.1111/dsji.12161 www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 2, 2018 104 published by scholink inc. schunk, d. h. (1991). self-efficacy and academic motivation. educational psychologist, 26, 207-231. https://doi.org/10.1080/00461520.1991.9653133 schunk, d. h., pintrich, p. r., & meece, j. l. (2008). motivation in education: theory, research and applications (3rd ed.). upper saddle river, nj: merrill-prentice hall. usher, e. l., & pajares, f. (2008). sources of self-efficacy in school: critical review of the literature and future directions. review of education research, 78, 751-796. https://doi.org/10.3102/0034654308321456 children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 4, no. 3, 2021 www.scholink.org/ojs/index.php/ct 1 original paper the prevalence of cyberbullying among adolescents: a case study of middle schools in vietnam to phuong oanh1* 1 faculty of social work, hanoi national university of education, vietnam * to phuong oanh, faculty of social work, hanoi national university of education, vietnam received: may 28, 2020 accepted: june 7, 2021 online published: june 14, 2021 doi:10.22158/ct.v4n3p1 url: http://dx.doi.org/10.22158/ct.v4n3p1 abstract this paper aims to investigate the prevalence of cyberbullying among vietnamese adolescents. special emphasis was placed on gender differences regarding different forms of cyberbullying and victimization. in this study, 200 middle school students from four state schools in vietnam were online surveyed to obtain information about the prevalence of cyberbullying and victimization. the results show that most of the students used the internet daily and that almost all of them possess mobile telephones. on average, 7% of students reported that they have cyberbullied others online, whilst 14% of them were victims of cyberbullying. the most common types of victimization reported by students were harassment including “prank or silent phone calls” or “insults on instant messaging and website”. there were not any significant gender differences in cyberbullying and being victimized by cyberbullies than females. keywords cyberbullying, vietnam, victim, social work 1. introduction the range of definitions of cyberbullying proposed by researchers reflected a correlation between the development of technology and how cyberbullying behaviours have (kowalski et al., 2014; patchin & hinduja, 2015). cyberbullying can occur via mobile phone developed include internetmediated communications. since 2003, tablets have also become popular when the term “cyberbullying” was first proposed. “cyberbullying” has been increasing with the use of technology, specifically electronic communication and social networking(wright, 2018). this phenomenon appeared only a few years ago as the use of electronic devices such as computers and mobile telephones by young people increased. the term “cyberbullying” can be defined as “an aggressive, intentional act carried out by a group or individual, using electronic forms of contact, www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 2 published by scholink inc. repeatedly and overtime against a victim who cannot easily defend him or herself” (slonje et al., 2013). thus, cyberbullying is considered as a means of bullying in which peers use electronic devices “to taunt, insult, threaten, harass, and/or intimidate a peer” (raskauskas & stoltz, 2007). traditional cyberbullying is divided into physical (hitting, kicking), verbal (teasing, threatening) and indirect (social exclusion, spreading rumours). cyberbullying can reach particularly large audiences in a peer group compared with the small groups who are the usual audience in traditional bullying. compared with most traditional forms of bullying, the person carrying out cyberbullying may be less aware or even unaware of the consequences of his or her actions. that would be lack of opportunities for empathy or interventions. on the other hand, nasty text messages or email can be simply deleted and blocked. moreover, cyberbullying doesn't cause physical harms. this could occur through different devices such as email, social networking, cellphone… significantly, cyberbullies might conceal if they desire. cyberbullying refers to bullying through technology like social networking, messages, email… existing surveys on the prevalence of cyberbullying show that it is common among adolescents in developed countries. previous school or telephone surveys from the united states and the united kingdom showed that the rates of being a victim of cyberbullying and being a cyberbully are in the range of 5% to 20%. in the us survey on internet use among individuals aged 10 to 17 years, 12% reported being aggressive to someone online, 4% were targets of aggression, and 3% were both aggressors and targets (sourander et al., 2010). currently, the statistics are wide-ranging as to how often or how many children and adolescents are being bullied by a cyberbully. the cyberbullying research center has most recently reported that about 20% of a randomly selected sample of 4,400 eleven to eighteen-year-olds in the united states report having been cyberbullies or cyber victims at least once in their lifetime ((erdur-baker, 2010). numerous researchers have found that 20-40% of their middle school samples in the united states report being victims or perpetrators of cyberbullying in the last year or less (pergolizzi et al., 2009). the review of literature about cyberbullying, race/ethnicity and mental health outcomes mention that in 2013, nearly 20% of the youth in grades 9–12 in the us reported being traditionally bullied and almost 15 % reported being cyberbullied (edwards et al., 2016). according to the pew research center, 92% of children report going online daily, and 71% use more than one type of social media. cyberbullying might be harmed by using technology and media. in 2004, antibullying measures were proposed in the us house of representatives to be included in the safe and drug-free schools and communities act, and all states currently have antibullying policies. although the us congress passed the protecting children in the 21st century legislation in 2008, which also addresses cyberbullying, 21 not all states have updated their laws to include cyberbullying. cyberbullying can be very emotionally damaging. victims of cyberbullying may experience depression, isolation, poor academic performance, and even suicidal ideation. furthermore, unlike traditional bullying, which children can typically escape once they return home from school, cyberbullying is www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 3 published by scholink inc. present wherever youth have a mobile device or an internet connection. the ever-present nature of cyberbullying can cause great anxiety among children and adolescents, as they may feel like they no longer have a safe haven. this anxiety, combined with the fact that cyberbullies often make harsher and more hurtful statements online than they would in person, makes cyberbullying a particularly destructive form of bullying. the coronavirus pandemic is forcing people all over the world to practice social distancing and stay home and children are adjusting to e-learning. some researchers have documented the effects of cyber victimization, which has been associated with academic and emotional problems, lowered self-esteem, lower psychological well-being, and lower perceptions of school safety (devine & lloyd, 2012). this study aims to explore the prevalence of cyberbullying among middle-school students during covid-19 in students. 2. method 2.1 participants, measures and procedures the online questionnaire was designed to include including demographic information, the bullying & cyberbullying scale. all four schools were contacted and invited to participate in the current study by the research team with 200 students. the demographic information sheet asked students for their age (in years), gender, grade and school. data collected the information about frequency and types of internet students have been using, their favour on internet. since then, the sheet asked students about cyberbullying (understanding and experiences). data collection took place over approximately one week via monkey. students completed their questionnaires by choosing answers and tick on the box. they could move the other questions unless they finish the previous one. if a participant withdrew from the study during the period when he/she was completing the questionnaire, the information was deleted. the bullying & cyberbullying scale, designed to be used with children, measures bullying & victimization behaviour among peers in or near the school. this scale consists of comparisons of behaviours associated with bullying and cyberbullying. while this scale was based on the olweus’ bully & victim questionnaire which has sufficient construct and discriminant validity (solberg & olweus, 2003), the specific validity and reliability for the current measure remain unknown (smith et al., 2008). the entire scale was composed of 8 items, each of which has multiple responses from which the student can choose. this scale also has questions regarding internet usage, which include seven questions about the student’s ability to use computers and how long they use the internet per week. 2.2. ethical considerations this research received approval from hanoi national university of education research ethics committee (hnue-rec). www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 4 published by scholink inc. 3. result table 1 presents the demographic characteristics of students participating the study. eligible participants were middle school students in hanoi, vietnam. as described below, we recruited 482 students including 47.72 % female (n=248) and 51.45 % male (n=230) and 1.24 % others (n=6). specifically, we recruited participants from two state-owned public schools (school a and c) and two private schools (school b and d). only school a (n=117) located in the suburb area while three others including school b (n=125), school c (n=128) and school d (n=112) located in the inner city. students are from 9th grade (n=108), 8th grade (n=129), 7th grade (n=138) and 8th grade (n=107). table 1. characteristics of participating schools and participants characteristic n=482 percent (%) school kim tan 164 80.4 cam linh 22 11 minh quan 11 5.5 grade 8th 119 59.5 9th 81 40.5 gender male 248 51.45 female 230 47.72 other 6 1.24 age 13 8 33% 14 126 63 15 66 33 3.1. usage of the internet the results revealed that 99% of students have used the internet. more than half of students reported spending several times per week (64%). other students reported spending several times on the internet per day (63 students; 31.5%). other options were not using the internet (0.5%), using one a day (0.5%) and 2.5% for once a week 1% for once a month. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 5 published by scholink inc. almost all students paid attention to online learning and sent or received emails. the average time on the internet is 10 to 15 hours (72.5%) per week. when asked about the place they use the internet, most students used the internet in their bedroom (97.9%). others used the internet at friend’s house (17.1%); in café internet (9.3%) and at school (6.2%). just a few students (2.1%) reported using the internet at relative’s house. a majority of students (93.5%) reported using social networking sites (such as facebook, myspace etc.) and sending or receiving emails. 91% of students used instant messaging (messenger, zalo, wechat, viber etc.). while over half use the internet for surfing the net (50.3%), just 27.1% of students) reported using chat rooms. 81.4% of the students reported using the internet for school work or virtual learning (zoom, conference call etc.) additionally, the most favourite of students were downloading music, films or programs 80.9%), others loved playing game account for (30.2%) and online shopping (27.1%). 3.2. victims of cyberbullying among 200 students who answered the questionnaire, almost reported that they had never been cyberbullied, (86%) while 14% of students told that they had been suffered from cyberbullying. when asked about the period of time they have been cyberbullied, over half of the students (53.6%) reported that gone through within the last school year, 28.6% of students had experienced within last month, only 14.2% of them had been cyberbullied over one school year ago. and 3.6% of students dealt with this problem last week. totally, there were 9 students who suffered from cyberbullying as survey results (table 2). table 2. period of time students experienced cyberbullying students (n) percentage (%) within the last week 1 3,6 within the last month 8 28,6 within the last school year 15 53,6 over one school year ago 4 14,2 total (n=) 28 100 the differences in the forms of being cyberbullying experienced by middle school students are shown in table 3. half of the students who were victims of cyberbullying reported being cyberbullied through nasty text messages and plank or silent phone calls (50%) students being insulted on instant message (21.4%), few students reported being cyberbullied through a website (including facebook, myspace etc.) (10.7%) through rude or nasty emails (7.1%). no one is insulted by photos or videos. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 6 published by scholink inc. table 3. victimization through cyberbullying among vietnamese middle school student form of cyberbullying students (n) percentage (%) through nasty text messages (making threats and comments) 14 50 prank or silent phone calls 14 50 insults on a website 3 10,7 insults on instant messaging 6 21,4 rude or nasty email 2 7,1 survey also indicated students have shared with others (friends, family…) about their problems. only a few of the students (4 students) haven’t dared to express. this proves students are also brave to share and find solutions, not avoid problems. there was no significant gender difference was found in the rate of being cyberbullied. 3.3. students who are cyberbullies most students (92.5%) have never taken part in cyberbullying. few of the students (7.5%) were cyberbullies. they could distinguish kindness and unkindness through cyberbullying. however, 7.5% of students who have taken part in cyberbullying were not sure that they haven’t had any cognition about their behaviours. in terms of the period time of taking part in cyberbullying. both male and female could take part in cyberbullying because of various reasons. among students having to cyberbully, there was 9 female while six were male ones. the number of females has a little more than male in this case. when asking about the period of time students took part in cyberbullying, only 1 student refused to answer this question (table 4). most students participated in cyberbullying within the last school year (64.3%). in terms of cyberbullying, the most popular was a prank or silent phone calls (40%). therein, insulted someone on a website and on instant messaging are the second and third popular behaviours. moreover, 20% (n=3) is the percentage of threatening text messages (making threats and comments) and insulted someone in a chat room. table 4. period of time students took part in cyberbullying students (n) percentage (%) within the last week 2 14.3 within the last month 2 14.3 this term 1 7.1 within the last school year 9 64.3 total 14 100 www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 7 published by scholink inc. in terms of cyberbullying, the most popular was a prank or silent phone calls (40%). therein, insulted someone on a website and on instant messaging are the second and third popular behaviours. moreover, 20% of students had threatening text messages (making threats and comments) and insulted someone in a chat room (table 5). there was no significant gender difference was found in the rate of having cyberbullying activities. table 5. period of time students took part in cyberbullying students (n) percentage (%) threatening text messages (making threats and comments) 3 20 prank or silent phone calls 6 40 insulted someone on a website 5 33.3 insulted someone on instant messaging 4 26.7 insulted someone in a chat room 3 20 4. discussion this study investigated the prevalence of cyberbullying among vietnamese adolescents, based on a survey of 200 students from four middle schools in vietnam. special emphasis was placed on the frequency of using the internet, rate and different forms of cyberbullying and victimization. first, we found that most students use the internet on a daily basis and that almost all of the participants. this fact implies that internet has become a part of the everyday lives of vietnamese adolescents especially in the covid_19 time, and therefore it can be expected that cyberbullying problems may occur. several kinds of media they have used including facebook, zalo or social networking websites, and learning software like zoom and emails. the results of this study have shown that the information technology in this region especially in covid-19 time is sufficiently developed and accessible to young people. this prospect is emphasized by the fact that teachers and parents in vietnam lack control over the children’s activities, which eventually results in violence and victimization in cyberspace. second, the findings of the present study indicate that a significant number of vietnamese students are involved in cyberbullying, either as a victim or a bully. about 7% of the participants reported that they were involved in cyberbullying, about 14% reported that they were victims of online bullying. the most common types of victimization reported by the students were “prank or silent phone calls” “insults on instant messaging and website”. these results regarding the prevalence of cyberbullying and victimization are in accordance with other studies conducted in other countries (lee, 2017; popović-ćitić et al., 2011). third, in our study, gender was found to no significant role in identifying victims, however no difference in bullies. although a number of a female having bullying seems higher than male students. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 8 published by scholink inc. this is not consistent with previous research (lee, 2017) which has shown that females are less likely to bully than males. from this study, the influence of gender on cyberbullying need further research. in summary, cyberbullying is a problem for a significant number of students in vietnam and it takes many different forms. cyberbullying has increased very quickly and educators and researchers are understandably concerned that this problem is growing more rapidly than educators’ and parents’ ability to respond effectively. the study indicates that it is necessary to create a school-based comprehensive program to react to cyberbullying. it is important to provide adolescents with strategies that are effective, and this is particularly true for boys, as they are more likely to be involved in cyberbullying problems. in addition, it should be noted that male students are engaging in ineffective strategies in response to bullying and that they believe that these solutions are effective (craig et al., 2007). the information obtained in this study can be used to provide a fuller picture of the issue of cyberbullying, which may be relevant for the successful planning of preventive programs. therefore, we recommend “cyberbullying: a prevention curriculum” focus on together participations “group social work”. this is a program that deals with attitudes and behaviours associated with cyberbullying. it consists of an eight-session curriculum, with additional resources on a cd-rom that reproducible parent resources, student fact sheets, program poster and student handouts, resources to address cyberbullying school-wide (school policies, legal concerns etc.), peer leader training materials, and a short training on cyberbullying for program facilitators. this is not a research-based program, but it is based on the latest research in prevention and on the topic of cyberbullying. many of the lesson activities are patterned after prevention models that research has shown to be effective in decreasing negative student behaviour, and increasing student attitudes toward refraining from negative behaviours. these models include selecting and using peer leaders, providing parent-student activities, doing cooperative learning and project activities, and identifying the causes of why students behave as they do. the curriculum also recommends that schoolwide policies and procedures be implemented to effectively address cyberbullying in a broad way while establishing a climate that is conducive to positive interactions among students. the 8-session cyber bullying: a prevention curriculum is recommended to raise student and parent awareness of what cyberbullying is and why it is so harmful, equip students with the skills and resources to treat each other respectfully when using online tools, give students information about how to get help if they, or others they know, are being cyberbullied and teach them how to use technology in a positive way. each session can be completed in fifty minutes and includes detailed instructions on presenting the information, activities to reinforce the key concepts, and reproducible student handouts. this study has some limitations that should be taken into account when interpreting its findings and conclusions. although the study encompassed schools from communities from different socio-demographic backgrounds, the fact remains that the data have been collected from an urban environment in vietnam, the capital of vietnam, and its surroundings; therefore, we must be cautious www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 9 published by scholink inc. when generalizing the findings to other regions of vietnam and beyond. in addition, it is also important to examine cyberbullying at other age levels. references craig, w., pepler, d., & blais, j. (2007). responding to bullying: what works? school psychology international, 28(4), 465-477. https://doi.org/10.1177/0143034307084136 devine, p., & lloyd, k. (2012). internet use and psychological well-being among 10-year-old and 11-year-old children. child care in practice, 18(1), 5-22. https://doi.org/10.1080/13575279.2011.621888 edwards, l., kontostathis, a. e., & fisher, c. (2016). cyberbullying, race/ethnicity and mental health outcomes: a review of the literature. media and communication, 4(3), 71-78. https://doi.org/10.17645/mac.v4i3.525 erdur-baker, ö. (2010). cyberbullying and its correlation to traditional bullying, gender and frequent and risky usage of internet-mediated communication tools. new media and society, 12(1), 109-125. https://doi.org/10.1177/1461444809341260 kowalski, r. m., giumetti, g. w., schroeder, a. n., & lattanner, m. r. (2014). bullying in the digital age: a critical review and meta-analysis of cyberbullying research among youth. psychological bulletin, 140(4), 1073-1137. https://doi.org/10.1037/a0035618 lee, e. b. (2017). cyberbullying: prevalence and predictors among african american young adults. journal of black studies, 48(1), 57-73. https://doi.org/10.1177/0021934716678393 patchin, j. w., & hinduja, s. (2015). measuring cyberbullying: implications for research. aggression and violent behavior, 23, 69-74. https://doi.org/10.1016/j.avb.2015.05.013 pergolizzi, f., richmond, d., macario, s., gan, z., richmond, c., & macario, e. (2009). bullying in middle schools: results from a four-school survey. journal of school violence, 8(3), 264-279. https://doi.org/10.1080/15388220902910839 popović-ćitić, b., djurić, s., & cvetković, v. (2011). the prevalence of cyberbullying among adolescents: a case study of middle schools in serbia. school psychology international, 32(4), 412-424. https://doi.org/10.1177/0143034311401700 raskauskas, j., & stoltz, a. d. (2007). involvement in traditional and electronic bullying among adolescents. developmental psychology, 43(3), 564-575. https://doi.org/10.1037/0012-1649.43.3.564 slonje, r., smith, p. k., & frisén, a. (2013). the nature of cyberbullying, and strategies for prevention. computers in human behavior, 29(1), 26-32. https://doi.org/10.1016/j.chb.2012.05.024 sourander, a., klomek, a. b., ikonen, m., lindroos, j., luntamo, t., koskelainen, m., ristkari, t., & helenius, h. (2010). psychosocial risk factors associated with cyberbullying among adolescents: a population-based study. archives of general psychiatry, 67(7), 720-728. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 10 published by scholink inc. https://doi.org/10.1001/archgenpsychiatry.2010.79 wright, m. (2018). cyberbullying victimization through social networking sites and adjustment difficulties: the role of parental mediation. journal of the association for information systems, 19(2), 113-123. https://doi.org/10.17705/1jais.00486 children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 3, no. 1, 2020 www.scholink.org/ojs/index.php/ct 54 original paper evaluation of an ebook for oral health literacy© to promote child health: readability, suitability, understandability, actionability, and gist-based message design valerie a. ubbes1*, abby m. witter1, carly m. kraska2 & ellen e. justus3 1 miami university, oxford, ohio, united states 2 st. louis, missouri, united states 3 huron, ohio, united states * valerie a. ubbes, miami university, oxford, ohio, united states received: may 3, 2020 accepted: may 14, 2020 online published: may 20, 2020 doi:10.22158/ct.v3n1p54 url: http://dx.doi.org/10.22158/ct.v3n1p54 abstract the purpose of the study was to evaluate an oral health curriculum called an ebook for oral health literacy© to determine its effectiveness for promoting child health. a secondary purpose was to describe and explain the design characteristics of readability, suitability, understandability, and actionability of the 17 chapters of the ebook. a third purpose was to conduct evaluations on verbatim representations (or literal facts) that are presented in the ebook chapters, including the gist representations that are not explicitly presented but inferred by the reader from the chapter information. results found that the ebook for oral health literacy© had acceptable, and in many cases, favorable scores, for the five design elements of readability, suitability, understandability, actionability, and gist comprehension. ongoing dissemination of the ebook for oral health literacy© curriculum has the potential to boost children who are “learning to read” and “reading to learn” about oral health hygiene and nutrition. future studies should use one or more chapters from the curriculum as an intervention to test this educational premise as an explanatory basis for functional health literacy. keywords child health, oral health literacy, reading, comprehension, readability, suitability, understandability, actionability, verbatim-based representations, gist-based representations, evaluation, ebook, health behavior www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 55 published by scholink inc. 1. introduction the number one chronic infectious disease among children is dental caries. pain from tooth decay and gum inflammation keeps children from attending school. school absenteeism due to sick days from dental pain can be detrimental to the academic progress of student learning (carroll, 2010; jackson, van william, kotch, pahel, & yee, 2011). absenteeism from school means that younger children will not gain the literacy and numeracy skills that advance them successfully through middle school and high school. youth who graduate from high school increase their average lifespan by six to nine years (allensworth, lewallen, stevenson, & katz, 2011) and their high risk health behaviors are associated with lower academic achievement (cdc, 2020). thus, the ability to support children to practice health-related habits increases their chance of academic success and a higher quality of life. oral health hygiene is a daily habit that promotes life quality and prevents disease. research has shown that heart disease, cancer, obesity, diabetes, and alzheimer’s disease starts in the mouth microbiota (lu, xuan, & wang, 2019; shoemark & allen, 2015; olson, 2015). the mucosal membranes of the mouth, especially the gums surrounding the teeth, are essential environments for a healthy mouth. dental caries are infections that proliferate when germs are not removed through adequate teeth brushing, flossing, and rinsing with water. the daily intake of healthy foods and beverages with adequate nutrients boosts positive health outcomes for children’s teeth, tongue, and gums. overall body health depends upon an interactive relationship between oral microbiota and gut microbiota by fostering key environments for oral health and gut health (lu, xuan, & wang, 2019). in keeping with an ecological model of health promotion and disease prevention, a focus on children's health habits at the intrapersonal level must be coordinated by family members at home and by health professionals in school-based health clinics and academic classrooms. community partnerships that integrate interpersonal and institutional levels of health will build safety nets for children and their families. policies such as the national health education standards (joint committee on national health education standards, 2007) outline what students should “know and be able to do” through eight curriculum statements for health instruction. as such, health educators play key roles in developing the knowledge, attitudes, and skills that children need for practicing daily oral health routines for the prevention of infectious diseases. health education teachers may not think to cover dental caries as an infectious disease to be prevented and only focus on a healthy smile or time management skills to do personal health routines. however, by incorporating and applying national health education standards 4, 5, and 6 to dental health education, students will be able to communicate a healthy smile, demonstrate how to make a daily decision for oral health hygiene, and demonstrate how to set goals to go to a dentist every six months, respectively. there is an ongoing need for combining literacy and health into health literacy agendas when educating children and their families. national health education standard 3 focuses on the importance of health www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 56 published by scholink inc. literacy so students “will demonstrate the ability to access valid information, products, and services to enhance health”. health literacy is a requisite skill for making health-related decisions (paasche-orlow & wolf, 2007) and helps to mediate certain health behaviors (friis, lasgaard, rowlands, osborne, & maindal, 2016). more recent work in health literacy has focused on certain health conditions or diseases, e.g., diabetes health literacy (baily, brega, crutchfield, elasy, herr, kaphingst et al., 2014); oral health literacy in child caregivers (baskaradoss, althunayan, alessa, aolbaidy, alwakeel et al., 2019); and health literacy of children with asthma (tzeng, chiang, chen, & gau, 2017). health literacy is an all-encompassing concept that has been defined from multiple perspectives for multiple purposes (allen, auld, logan, henry montes, & rosen, 2017; sorensen, van den-broucke, fullam, doyle, pelikan, slonska, & brand, 2012). inadequate to poor health literacy has been associated with “nonadherence to treatment plans, increased health care costs, and greater hospitalization rates” (ayyaswami, padmanabhan, patel, prabhu, hansberry, agarwal, & magnani, 2019) and reduced “perceptions of health, less utilization of services, and poorer understanding of verbal and written instructions for self-care” (jackson, van william, kotch, pahel, & yee, 2011). self care is a lifelong goal of health education. self care self efficacy can be defined as “one’s perceived ability to perform relevant self-care activities” (mak, law, woo, cheung, & lee, 2009). eller, lev, changrong, and watkins (2016) found that “self care self efficacy” is the adaptation of the self efficacy concept in the context of self-care. to date, school health education classes have not often focused on the term “self care” with children and youth. by shifting the language of prek-12 health education to “self care” instead of “personal health”, a more active engagement may result in child health outcomes due to an implied action of care needed over a lifetime. the relationship of health literacy to various health behaviors among young people has recently been investigated (klinker, aaby, ringgaard, vang hjort, hawkins, & maindal, 2020; jang & yoon, 2018; friis, lasgaard, rowlands, osborne, & maindal, 2016). jang and yoon (2018) analyzed oral health behaviors among elementary students and the relationship of oral health behaviors to oral health literacy and oral health knowledge. zullig, ubbes, and mann (2013) conducted the first quantitative study to examine the relationship between perceived literacy skills and preventive health behaviors and found that middle adolescence was a time when behavioral patterns were becoming established. the middle school youth risk behavior survey was used to study the health behaviors of 244 students in seventh and eighth grades. analysis of variance and tukey post-hoc analyses indicated that as students’ reading abilities and supportive literacy influences declined, students reported significantly fewer dental check-ups and lower sunscreen use (p<.05), even after controlling for socioeconomic status. these results suggested that adolescent perceptions of their reading abilities and reading activities are positively associated with health behaviors like oral health. connecting reading and literacy abilities to health behaviors are important steps forward in health education research. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 57 published by scholink inc. eltora, ghanian, adams, born, and daniels (2014) found that educational materials about trauma prevention and safety education located on the american association for surgery of trauma website did not meet the sixth-grade readability standards that are needed for the public. hendrickson, huebner, and riedy (2016) determined that readability of child health materials for preventive dental care should not exceed the sixth-grade reading level. in the release of the digital health communication common agenda 2.0, updates were made to consensus statements for academic, governmental, and technological sectors to advance public health with the plan that people “have access to health information that is timely, credible, and available at the health literacy level of the intended population…to protect or promote individual or population health” (gold, auld, abroms, smyser, yom-tov, & allegrante, 2019). ebooks can support children’s literacy development through interactive narratives (thompson long, hall, hogan et al., 2018). hiniker (2016) highlighted that american children are avid technology users and spend more time using technology than any other activity besides sleeping. the international literacy association (2019) advocated for the use of technology by children to strengthen school-home connections and that “meaningful use of high-quality resources is essential in preparing all young children for long-term academic success”. 1.1 development of oral health literacy material an ebook for oral health literacy© was written from a template designed by ubbes in 2010 and launched online in 2013 as an academic service learning project in health education and early childhood education for a wide variety of health behaviors (ubbes & miami university libraries, 2013-2020). a slightly enhanced visual-textual design template was employed (ubbes, coyle, & tzoc, 2018) when the project director narrowed the project to focus on oral health, because healthy people 2020 (odphp, 2020) highlighted that people from two years old into adulthood were not going to the dentist for regular check-ups. therefore, an ebook was written to improve a leading health indicator oral health oh-7, which reads “increase the proportion of children, adolescents, and adults who used the oral health care system in the past year”. overall, the ebook for oral health literacy© contains 17 chapters with a focus on five topical themes about oral health: 1) oral health hygiene of children, 2) oral health & nutrition of children, 3) oral health & beverages of children, 4) oral health & medicine safety, and 5) dental health checkups for young boys and girls. figure 1 shows a sample chapter cover and a last page template from the ebook for oral health literacy© www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 58 published by scholink inc. figure 1. sample chapter cover and a last page template from the ebook for oral health literacy© the ebook for oral health literacy© curriculum is available on the digital literacy partnership website at miami university (ubbes, 2020). the key feature of the curriculum is teaching children about health and literacy in tandem while they practice their reading skills and oral health hygiene skills in an integrated way. full-page photographs show children taking care of their teeth, mouth, and gums supported by skill-based declarative sentences on each page. each sentence in a chapter describes a child having an intention to act through an action verb, e.g., decision making, goal setting, or communication skills, supported by reasoned actions for doing a variety of oral health habits. the specific self-care behaviors modeled by children in the photograph include teeth brushing, flossing, and rinsing, including how to interact with family, friends, and dental professionals in different sociocultural contexts. 1.2 readability a test of readability was first used in health education by doak, doak, and root (1996) to analyze the effectiveness of informational materials. readability refers to the “reading difficulty of a resource and www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 59 published by scholink inc. uses word and sentence length to determine a score” (rhee, von feldt, schumacher, & merkel, 2013). the american medical association (ama) and the national work group on cancer and health have recommended that health education materials be written at the 5th to 6th reading level to provide an appropriate readability level for readers (ayyaswami, padmanabhan, patel, prabhu, hansberry, agarwal, & magnani, 2019). rudd (2020) indicated that “...well over 800 peer-reviewed articles in public health and medical journals attest to the fact that health materials are written at reading grade levels that far exceed the average reading skills of high school graduates. this mismatch between literacy demands and literacy skills limits access to important information as well as to health care and services”. readability is an important factor to consider in the design and use of health materials because improving readability is a cost-effective way to make the materials more useful to patients. analyzing the readability of health education materials costs very little time and money and is a very efficient way to maximize the materials distributed to a particular audience (ayyaswami, padmanabhan, patel, prabhu, hansberry, agarwal, & magnani, 2019). several tests are commonly used to calculate readability of written materials. readability tools measure how hard or easy it is to read educational materials according to grade levels in the united states (eltorai, ghanian, adams, born, & daniels, 2014). examples of measurement tools include the flesch-kincaid grade level (fkgl) readability test, the fry readability formula, and the simple measure of gobbledygook (smog) readability formula. the fry readability formula was developed by edward fry in order to provide a simplistic method for determining a material’s reading level to correlate highly with other established readability tests such as the fkgl readability test (fry, 1968). the fkgl readability test was developed for the u.s. navy by rudolf flesch (crosby, 1977) and was used by the u.s. army to assess military training manuals in the 1970’s. flesch was a linguist who was a strong proponent of plain english in the u.s. and advocated for phonics rather than sight reading to enable students to sound-out unfamiliar words. his co-author, j. peter kincaid, was a professor and a scientist for the u.s. military. to estimate reading level for the fkgl readability test, a weighted combination of sentences in a passage are counted along with the syllables per word and the words per sentence (magnuson, jain, roomian, pagni, tran, & finkelman, 2020). there are some cautions in using readability formulas according to the u.s. centers for medicare and medicaid services (2020). in their toolkit for making written material clear and effective, four cautions are indicated: 1) calculating readability does not mean that the materials are also clear and written effectively; 2) readability formulas vary widely so grade level scores can differ considerably; 3) grade level scores can be over-interpreted for a population; and 4) written passages that are reduced to too low of a grade level may appear choppy and lack cohesion. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 60 published by scholink inc. 1.3 suitability a suitability of assessment materials tool was published for the first time in the 2nd edition of the seminal book entitled teaching patients with low literacy skills (doak, doak, & root, 1996). suitability measures “how well the material can be understood and accepted by the reader” (rhee, von feldt, schumacher, & merkel, 2013). to calculate the suitability of health education materials, the designer and evaluator rate the materials in six different areas (see methods) to determine which areas need to be improved (hoffmann & ladner, 2012). the sam tool classifies a score of 70-100 percent as superior material, a score of 40-69 percent as adequate material, and a score of 0-39 percent as not suitable material for health education (doak, doak, & root, 1996). 1.4 understandability understandability is an important aspect of educational materials to study because improving a text’s understandability will help readers to interpret the message of the materials. shoemaker, wolf and brach (2019) stated that “patient education materials are understandable when consumers of diverse backgrounds and varying levels of health literacy can process and explain key messages”. in order for health education materials to be considered understandable, the patient education materials assessment tool (pemat) outlines 19 items to be scored. these items demonstrate the purpose, style of language used, organization and layout of the material, and use of visual aids. 2. purpose of the study the purpose of the study was to evaluate an oral health curriculum called an ebook for oral health literacy© to determine its effectiveness for promoting child health. a secondary purpose was to describe and explain the design characteristics of readability, suitability, understandability, and actionability of the 17 chapters of the ebook. a third purpose was to conduct evaluations on verbatim representations (or literal facts) that are presented in the ebook chapters, including the gist representations that are not explicitly presented but inferred by the reader from the chapter information. 3. methods 3.1 procedures undergraduate students enrolled in a public health communication course computed the readability scores of the ebook chapters as instructed by the first author. since the students were instructed how to do readability assessments of health education materials in two different sections of the same course, the readability scores were calculated on an ungraded handout and submitted by at least two different students taking the course. two evaluators did an independent assessment of the suitability assessment of materials (sam) for the ebook for oral health literacy©. a third evaluator was added to the research project to ensure internal consistency when conducting the patient education materials assessment tool www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 61 published by scholink inc. (pemat), which measures understandability and actionability (shoemaker, wolf, & brach, 2014) of the ebook for oral health literacy©. 3.2 instruments three different instruments were used to measure the readability of the ebook for oral health literacy©: 1) a fkgl readability test uses a weighted combination of sentences in a passage; syllables per word and words per sentence are counted (magnuson, jain, roomian, pagni, tran, & finkelman, 2020); 2) a fry readability formula uses the average number of sentences and average number of syllables in randomly selected 100 word passages of a reading material. these averages are plotted on the fry readability graph, then the area in which the points fall, determines the grade level at which the material is read (fry, 1968); and 3) a simple measure of gobbledygook (smog) reading level is calculated by counting the number of words with 3 or more syllables found in the first 10 sentences, the middle 10 sentences, and the last 10 sentences of a reading material. the square root of the number of words with 3 or more syllables is calculated and added to 3. the smog grade level formula is as follows: smog grade = 3 + √polysyllable count. smog provides a representative score of the tested material as it samples a total of 30 sentences throughout the entire text (mclaughlin, 1969). two other instruments were used to measure the suitability, understandability, and actionability of the ebook for oral health literacy©: 1) the suitability assessment of materials (sam) was employed to evaluate content, literacy demand, graphics, layout and type, learning stimulation and motivation, and cultural appropriateness of the ebook as a whole. two reviewers scored the ebook in 6 different areas using standards of superior (2 points), adequate (1 point), or not suitable (0 points). all points were totaled then divided by 42 to determine an overall percentage (doak, doak, & root, 1996); 2) the patient education materials assessment tool (pemat), available online from the agency for healthcare research and quality, provides a way to evaluate and score educational materials on their ability to be understood by diverse audiences (i.e., understandability) and then be acted upon (i.e., actionability). the pemat provides descriptions of 19 items on the topic of understandability and 7 items on the topic of actionability. the scorer can determine if the item is included in the educational text by selecting agree or disagree. one point is given to the text for each agree response. an overall score can then be determined by adding all of the agree points and dividing by 26 to obtain a percentage. a score in the domain of understandability can be determined by adding the agree points for items 1-19 and dividing by 19, and a score in the domain of actionability can be determined by adding the agree points for items 20-26 and dividing by 7. 4. results data for the 17 chapters of the ebook for oral health literacy© are organized below by the four design characteristics (e.g., readability, suitability, understandability, and actionability) and by verbatim-based www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 62 published by scholink inc. versus gist-based message design. 4.1 readability table 1 outlines the number of words, number of sentences, and words per sentence for calculating readability of the 17 chapters of the ebook. the fkgl test indicated that the 17 chapters averaged a reading grade level of 6.5 with an overall range between grades 4.6 and 9.9 depending on the chapter. calculations using the fry reading level formula indicated that the ebook chapters averaged a reading grade level of 7.1 with an overall range between grades 4.5 and 10. the simple measure of gobbledygook (smog) indicated that the ebook chapters averaged a reading grade level of 5.8 with an overall range between grades 4 and 8. table 1. evaluation of the ebook for oral health literacy© for readability chapters total words total sentences total words per sentence fkgl fry smog chapter 1 195 11 16.9 5.9 5.5 5.0 chapter 2 223 12 17.8 6.2 5.5 6.0 chapter 3 197 12 15.6 7.0 6.0 6.0 chapter 4 195 11 17.0 4.6 6.0 7.0 chapter 5 168 11 14.7 4.7 6.0 4.0 chapter 6 156 12 13.0 5.9 10.0 6.6 chapter 7 200 12 15.8 7.9 9.0 6.3 chapter 8 199 12 16.0 6.5 6.0 6.6 chapter 9 183 12 14.5 5.2 7.5 5.0 chapter 10 200 11 17.4 7.3 7.0 5.0 chapter 11 207 11 18.0 7.2 7.0 6.7 chapter 12 174 10 16.2 8.1 9.0 7.2 chapter 13 160 12 12.7 7.2 9.0 5.0 chapter 14 176 9 18.6 5.3 6.0 4.0 chapter 15 176 9 18.6 5.3 6.0 4.0 chapter 16 152 12 11.7 5.7 4.5 6.6 chapter 17 225 13 17.3 9.9 10.0 7.9 averages 187 11 16.0 6.5 7.1 5.8 key: fkgl = flesch-kincaid grade level readability; fry = fry readability formula; smog = simple measure of gobbledygook readability www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 63 published by scholink inc. 4.2 suitability table 2 shows the ebook results for six different categories of the suitability assessment of materials (sam) evaluation. in the area of content, the ebook received a score of 83 percent. in the area of literacy demand, the ebook received a score of 90 percent. in the area of graphics, the ebook received a score of 100 percent. in the area of layout and type, the ebook received a score 83 percent. in the area of learning stimulation and motivation, the ebook received a score of 100 percent. in the area of cultural appropriateness, the ebook received a score of 83 percent. overall, the scores in the six categories ranged from 83 to 100 percent. when the scores of each area were averaged together, an overall score of 91 percent out of 100 resulted, which indicated a superior material. table 2. evaluation of the ebook for oral health literacy© using the suitability assessment of materials suitability categories (n = 6) scores* 1. content 0.83 2. literacy demand 0.90 3. graphics 1.00 4. layout and type 0.83 5. learning stimulation and motivation 1.00 6. cultural appropriateness 0.83 total percentage of suitability 91% out of 100% *maximum score of 1 4.3 understandability the patient education materials assessment tool (pemat) indicated a score of 94 percent in the domain of understandability. this indicated that 94 percent of the objectives comprising an “understandable” material were met by the ebook. shoemaker, wolf, and brach (2014) define an understandable text as one in which “consumers of diverse backgrounds and varying levels of health literacy can process and explain key messages”. the list below shows the key messages of the 17 chapters of the ebook for oral health literacy©. the topics, concepts, and underlined skills in the ebook chapter summaries show key vocabulary that is read by children when interacting with each of the 10 pages in a chapter for a total of 170 pages of content: chapter 1: setting dental hygiene goals for healthy teeth learn how to set dental hygiene goals for healthy teeth by brushing every morning and night, buying toothpaste with fluoride, flossing regularly, and visiting your dentist to ensure a healthy smile. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 64 published by scholink inc. chapter 2. making decisions to have fun with my oral health learn how to make decisions for brushing your teeth, tongue, and gums every morning and night while singing songs for 2 minutes to ensure a proper cleaning. chapter 3. taking action and making decisions to have healthy teeth learn how to take action for oral health by making decisions to brush your teeth, eat healthy fruits and vegetables, and floss away leftover food to prevent plaque buildup on your teeth. other healthy decisions include buying oral health products with your parents at the grocery store and practicing oral hygiene habits with your family at home. chapter 4. setting daily goals to rinse my mouth learn how to set a goal to rinse your mouth with water and mouthwash for a fresh breath and clean teeth. chapter 5. setting food goals for healthy teeth learn how to set goals for healthy teeth by eating foods rich in calcium and fiber, brushing after snacks and meals, and visiting with your dentist every 6 months. other oral health goals include buying floss and toothpaste at the grocery store and following healthy role models from your parents at home. chapter 6. decisions to keep my teeth healthy and strong learn how to make decisions to keep your teeth healthy and strong by eating healthy snacks and drinking healthy beverages with your friends at school and your family at home. chapter 7. deciding to improve my dental health by drinking more water learn how to make decisions to improve your dental health by drinking more water to clean your teeth and to prevent cavities and dry mouth. chapter 8. deciding to drink milk for healthy teeth learn how to make healthy decisions for your teeth by drinking milk at breakfast, lunch, and dinner and not drinking sugary beverages. learn the many benefits of drinking milk to improve your oral health. chapter 9. setting beverage goals for healthy teeth (african american) learn how to set beverage goals for healthy teeth by choosing nutritious food and beverages when eating alone and with your family and friends. chapter 10. setting beverage goals for healthy teeth (latin american) learn how to set beverage goals for healthy teeth by choosing nutritious food and beverage when eating alone and with your family and friends. chapter 11. coping with the stress of dental pain learn how to set a goal to cope with the stress of dental pain by always brushing, flossing, and scheduling a dental appointment for pain management. chapter 12. communicating how to take medicine safely with a trusted adult learn how to communicate with your words and actions when taking medicine given to you from trusted adults such as your dentist, doctor, and parents. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 65 published by scholink inc. chapter 13. deciding to follow rules for taking medicine learn how to make decisions to follow safety rules when taking medicine by first talking with your doctor, dentist, trusted adults, and other health professionals. chapter 14. setting goals for going to the dentist (boys) learn how to set a goal to go to the dentist for a 6-month check up on your mouth, teeth, and gums. other healthy goals include brushing daily for fresh breath and clean teeth. chapter 15. setting goals for going to the dentist (girls) learn how to set a goal to go to the dentist for a 6-month check up on your mouth, teeth, and gums. other healthy goals include brushing daily for fresh breath and clean teeth. chapter 16. communicating through my smile and teeth at a very young age learn how to communicate through your smile and teeth at a very young age by recognizing early signs of tooth growth and practicing healthy habits with family members. chapter 17. communicating with health professionals about my child's oral health care learn how to communicate and advocate for your child’s oral health by recognizing early signs of tooth growth, establishing a positive relationship with your child’s dentist, and identifying possible dangers and risks for your child’s oral health. 4.4 actionability the patient education materials assessment tool (pemat) indicated a score of 80 percent in the domain of actionability. this means that 80 percent of the objectives comprising an “actionable” material were met by the ebook. shoemaker, wolf, and brach (2014) defined an actionable text as one in which “consumers of diverse backgrounds and varying levels of health literacy can identify what they can do based on the information presented”. 4.5 verbatim-based versus gist-based message design a coh-metrix protocol was used to analyze the ebook for oral health literacy© for verbatim-based versus gist-based message design. a gist inference score (gis) was calculated in order to determine if the messages in the chapters were written to embrace verbatim memory with exact numbers, words, and pictures or to embrace gist memory with an implied meaning of the messages (lloyd & reyna, 2001), the ebook earned a gist inference score (gis) of 0.10, which is slightly above average. gist is defined as the likelihood that a text will yield appropriate inferences about its bottom-line meaning in contrast to its exact literal meaning. a gis is a metric in the coh-metrix protocol that determines whether the material leads to verbatim memory or gist memory (reyna, 2020) or the more-valued gist comprehension when the health information is complex (wolfe, reyna, widmer, cedillos, fisher, brust-renck, & weil, 2015). the underlying intent is to help people to explain the gist of oral health information, which may help them to make better health decisions. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 66 published by scholink inc. the ebook scored high on coherence and interconnectivity of actions. figure 2 shows an analysis of other coh-metrix components expressed in z scores. since the ebook chapters were written to be highly concrete and didactic through the use of declarative sentences, young readers will likely form age-appropriate understanding through verbatim representations found in the words and pictures on each page. message designers should also build the potential to form gist representations through the health education materials. gist comprehension scores are shown from left to right for the first three items in figure 2; verbatim comprehension scores make up the next four items. *gist scores = referential cohesion, deep cohesion, and verb overlaplsa. **verbatim scores = verb overlap-wn, concreteness, imageability, and hypernymy figure 2. gist comprehension* versus verbatim comprehension** scores for the ebook in the case of the ebook, the textual messages scored the highest on referential cohesion (3.72) and deep cohesion (3.0), which suggests that readers are very likely to comprehend the text and make appropriate gist inferences. another gist score, verb overlap lsa (0.6), is slightly greater than the verbatim score found within the verb overlap wordnet (0.5) suggesting that readers will also make gist inferences about the actions in the chapters. verb overlap indicates the repetition of the lexical verb patterns in the sentences. however, on the right side of figure 2 indicated by verbatim scores, the ebook is also quite high on concreteness (2.25), imageability (2.96), and hypernymy (0.9), but not as high as the gist scores on the left side of figure 2. these high z scores lower the gis score considerably, which may be suboptimal for adult readers, but likely helpful to children (ubbes & wolfe, 2019). www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 67 published by scholink inc. research conducted within the framework of fuzzy trace theory and its central concept of gist (reyna, 2020) indicates a developmental trend from verbatim informational processing to gist information processing in message design. thus, there are sound theoretical reasons to believe that a text with a gis profile of 0.10 is ideal for children when comprehending health-related information. further empirical research is needed on whether children have enough background knowledge about oral health so that they can “get the gist” (reyna, 2020) of the different chapters making up the ebook for oral health literacy©. reyna (2020) also claimed that “the uptake of a message depends not just on what is said but what is heard”. 5. discussion the ebook for oral health literacy© takes a multimodal, multisensory, and multidisciplinary approach to skill development (ubbes, coyle, & tzoc, 2018). the international literacy association (2019) states that “according to the multimodal perspective, children make meaning using multiple modes (texts, pictures, words, gestures, movements, or production of artifacts), and all these modes complement one another as children seek to interpret their world and convey their understanding”. recent eye movement research by pellicer-sánchez, tragant, conklin, rodgers, serrano, and llanes (2020) showed that the presence of audio in reading-while-listening conditions allowed children to look at images in a text more and that children who increased processing time on images was positively related to their reading comprehension. this seems extremely useful for the ebook for oral health literacy© as explained below. the ebook for oral health literacy© is written in first person narrative with one “reasoned action step” stated on each page in the implied voice and actions of a child. a large photograph on each page shows the actions of a child performing a series of oral hygiene behaviors supported by a sentence beneath the photo as a written caption. when a reader clicks on the auditory icon on each page, the sentence is narrated aloud by a child’s voice. when reading along with the narrated scripts, children simultaneously learn to read vocabulary words and phrases while viewing photographs that show a child doing an oral health action in different situations at home, at school, or in a dental clinic. for example, child-centric photographs show what health behaviors are being encouraged by the picture and the lexical script such as: 1) brushing teeth, tongue, and gums; 2) flossing teeth; 3) eating fresh fruits and vegetables; 4) drinking healthy beverages; and 5) going to the dentist every 6 months. a unique design contribution of the ebook for oral health literacy© is the co-development of reading skills and health-related skills for children who are in elementary school. one of the goals of the ebook curriculum is to advance the u.s. healthy people 2020 objective 5.3.1. for adolescent health that is focused on reading skills: to increase the proportion of 4th grade students whose reading skills are at or above the proficient achievement level for their grade. however, in order to determine if the curriculum www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 68 published by scholink inc. contributes to reading outcomes in general, and to health literacy outcomes specifically, we first needed to evaluate the characteristics of the ebook curriculum for readability, actionability, suitability, understandability, and gist versus verbatim comprehension. 5.1 readability in this study, three different types of readability tests were used to determine an overall average grade level of 6.5 for the 17 chapters, (i.e., fkgl 6.5, fry 7.1, and smog 5.8). in the ebook design, oral health hygiene is explained through vocabulary words with two-syllables (e.g., brushing, toothbrush) and three-syllables (e.g., infection, appointment). owing to the fact that reading comprehension of material is improved by the practice of vocabulary and fluency (pikulski & chard, 2005; varlas, 2013; rasinski, rupley, paige, & nichols, 2016), the more that children are exposed to the ebook and listen to the stories being read, the more potential they have in gaining further understanding of the chapters, including the pronunciation of vocabulary words with visual and auditory cues. this assumption that the ebook can lead to an improvement of health-related skills and behaviors for oral health literacy still needs to be tested. 5.2 understandability the pemat was used to evaluate the entire ebook curriculum beyond the readability assessments. zuzelo (2019) suggested that “while readability is an important measure, the…pemat...ensur[es] the educational materials satisfy the informational needs of diverse learners, specifically those with a wide range of literacy abilities and challenges”. in order to improve understandability in the ebook for oral health literacy©, six children were recruited at the end of the design phase to make an audio recording while reading a chapter of the ebook. the children read aloud with prosody (intonation and expression) using fluency (speed) to enhance the understandability (comprehension) of the materials. if children are able to read aloud with prosody and fluency, the cognitive load of the reading material on memory is reduced. when children have a low cognitive load, comprehension of the material increases. the use of children’s voices enhances and primes the readers’ identification with how to do the oral health behaviors in the child-centric photographs. presenting contextual information in practical situations such as teeth brushing at home with a sibling or shopping for toothpaste with a parent in a grocery store primes children’s identification with how to do a variety of oral health behaviors, e.g., brushing, flossing, and rinsing (hawkins, 2008). skill development is a vital component of any health education curriculum. according to the national health education standards (joint committee on national health education standards, 2007), students in prekindergarten to 12th grade should “know and be able to do” many cognitive skills related to their health status. ubbes (2008) describes cognitive thinking skills as habits of mind “that young people learn in order to successfully demonstrate habits of health” or health behaviors (p. 54). in the current project, the ebook for oral health literacy© curriculum addresses the cognitive skills of decision making, goal www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 69 published by scholink inc. setting, and communicating when practicing oral health hygiene and nutrition. those three skills align to the national health education standards 5, 6, and 4, respectively. each of the 17 chapters in the ebook focuses on one of the cognitive skills for 10 pages; the cognitive skill is highlighted as a lexical pattern by an underlined verb. for example, in chapter 2, students learn how to make decisions for brushing their teeth, tongue, and gums every morning and night while singing songs for 2 minutes to ensure a proper cleaning. therefore, the word “decide” is underlined in each sentence to emphasize the cognitive skill development that is needed in order to practice brushing for good oral health. please revisit the prior list to see the topics and concepts by themes for the 17 chapters, including the underlined cognitive skill that is needed in order for children to take action and do the oral health behavior. 5.3 actionability studying the actionability of educational materials is important in order to write materials that teach readers how to perform the health behavior or take action for their health. shoemaker, wolf & brach (2019) stated that “patient education materials are actionable when consumers of diverse backgrounds and varying levels of health literacy can identify what they can do based on the information presented”. the theory of reasoned action dictates that actions that individuals take are influenced both by the information given about the behavior and the beliefs that individuals hold about that behavior (fishbein & ajzen, 2011). each chapter of the ebook is written based on the three types of salient beliefs in the theory of reasoned action in order to improve their actionability. each chapter includes the same sequence of a self efficacy belief (n = 1), health outcome beliefs (n = 3), normative beliefs (n = 3), another self efficacy belief (n = 1), and interactive health literacy (n = 1) (ubbes, coyle, & tzoc, 2018). the self efficacy beliefs in the ebook present “i believe” statements in order to model strong self-care self-efficacy beliefs to the children. if children take on and embody these strong self-care self-efficacy beliefs, they will have greater confidence that they can perform the oral health behavior and making the demonstrated behavior more actionable (eller, lev, changrong, & watkins, 2016). the health outcome beliefs in the ebook inform readers of the positive effects that result when performing the demonstrated health behaviors. the expected outcome that one holds about a behavior has a strong influence on the individual’s attitude toward that behavior. if one perceives that there are more positive outcomes than negative outcomes, that individual is more likely to take action to perform the behavior (fishbein & ajzen, 2011). the normative beliefs in the ebook demonstrate that children can practice the targeted health behaviors with their peers, family members, or dental professionals. by presenting a targeted health behavior as one that is socially normative and acceptable, the behavior is reinforced for the child, making it more actionable. using normative beliefs to encourage children to practice positive health behaviors can prove to be effective, because children tend to conform highly to practices which they consider to be the norm www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 70 published by scholink inc. (quilliam, mckay, lapinski, viken, plasencia, wang, & fraser, 2018). as previously shown in figure 1, interactive health literacy initiates feedback through reading participation when the reader is asked “how about you? can you set goals for going to the dentist too?” higher interactive health literacy has been correlated with increased ability to perform self care behaviors (van der heide, heijmans, schuit, uiters & rademakers, 2015), so the use of several interactive health literacy statements in the ebook can lead to greater actionability. design characteristics of written educational materials also require careful decisions around content, format, layout, language, legibility, and illustrations (griffin, mckenna, & tooth, 2002). learners “require accurate, balanced, and comprehensive information if they are to make informed choices, participate in decision making about their health and take responsibility for their own well-being” (griffin, mckenna, & tooth, 2002, p. 176). comprehension of health information also contributes greatly to material effectiveness. 5.4 comprehension the ebook for oral health literacy© has a focused goal of building reading fluency and comprehension in tandem with skill development in health literacy. comprehension is a key concept in a few definitions of health literacy in childhood (bröder, okan, bauer, bruland, schlupp et al., 2017). for example, the national health education standards for preschool to grade 12 (joint committee on national health education standards, 1995) were the first to define health literacy as “the capacity of an individual to obtain, interpret, and understand basic health information and services and the competence to use such information and services in ways which are health-enhancing”. later, the patient protection and affordable care act of 2010, title v, defined health literacy as “the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions” (cdc, 2020). when children are learning to read, literacy research indicates that fluency and vocabulary are the two main steps to reading comprehension (or understanding what is read). pikulski and chard (2005) indicated that fluency is a bridge between decoding and reading comprehension. varlas (2013) claimed that “academic vocabulary is one of the strongest indicators of how well students will learn subject area content”. in the ebook chapters, many vocabulary words are used to build functional knowledge for knowing how to practice oral health hygiene, how to set a goal to go to a dental appointment, and how to make food and beverage decisions for oral health. in the ebook for oral health literacy©, fluency is enhanced by multimodal cues that are heard and read. fluency involves the rhythmic and auditory aspects of the reading pace and can be improved by practice (rasinski, rupley, paige & nichols, 2016). each chapter of the ebook is read aloud through an audible narration by a child’s voice to encourage modeling of fluent reading to a child peer. each text is also “read” in visual form through the words and lexical patterns that are underlined in each sentence to www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 71 published by scholink inc. support skill development. each page also uses photographs showing children modeling the intended behavior. bandura (1975, p. 187) stated that “when a model is provided, patterns of behavior are rapidly acquired in large segments or in their entirety”. hence, we hope that children are able to learn “how to read” and then “read to learn” when, why, with whom, and where to brush their teeth through multiple patterns and cues provided by the ebook design. another key aspect of fluency is the ability to read textual material with flow and prosody. prosody is the expression given to the meaning of the words as one reads…and the continuity that is modeled when polysyllabic vocabulary words are pronounced and articulated. when child peers serve as role models and are able to read polysyllabic words with fluency and prosody as narrators, this can support less experienced readers to gain practice and to improve. through repetition and increased exposure to oral health vocabulary and word patterns, children can also benefit when more difficult vocabulary words are encountered. increased reading fluency can then free up cognitive load which is the memory needed for comprehending what was read. because we envision children and their parent caregivers (or teachers) reading along with the audible narration on the ten pages of each ebook chapter, the opportunities for word cuing and vocabulary support for children can occur in real time as needed. 6. strengths by design, the ebook for oral health literacy© enables children to practice literacy skills and oral health behaviors at home, especially when children are absent from school and unable to experience their academic curriculum in the classroom. framing the ebook for oral health literacy© as a co-curricular approach helps to bolster the health-related and literacy-related challenges associated with missed school attendance, which can be a significant detriment to the academic progress of student learning (carroll, 2010; jackson, van william, kotch, pahel, & yee, 2011). children also miss portions of their academic lessons when parents take their child to dental appointments during the school day. during this lost school time, one chapter of the ebook can provide a brief health literacy intervention during the travel time to and from the community dental clinic. with an internet connection on a smartphone or mobile device in the car, children can read along with one chapter and then read another chapter when they transition from the car into the dental waiting room or vice versa. school-based health clinics can also give students convenient access to dental care “on campus” for teeth cleaning, filling caries, and/or applying fluoride varnish on developing teeth. with the potential for lost time from the academic curriculum, school-based health clinics (e.g., dental, medical, and eye) become incredible child-centered opportunities for health literacy interventions. healthy people 2020 objectives for oral health 9.2 state that americans need to “increase the proportion of school-based health centers with an oral health component that includes dental care”. even if a school-based health center is not part of a school district, mobile vans converted to dental clinics on wheels can support children who do not www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 72 published by scholink inc. have a dental home and who have not seen a dentist in the last six months. both site-based and mobile-based dental clinics are curriculum venues for the ebook for oral health literacy©. another strength of the ebook is the intentional design of visual textual gestural material so that children will be more motivated as they “read to learn” about oral health practices and habits. the self-paced design of the ebook is sequentially organized in a pattern for multimodal learning: visual, auditory, tactile, and kinesthetic movement sequences, which primes the human senses to process and attend to information. the multisensory “workout” or “training” for children include eye tracking for reading pictures and words and ear training to hear words being read with rhythmical fluency and prosody (meaningful expression). there are two possibilities with the latter. the first possibility is that our technology-assisted reading builds sight learning and sound learning. when the reader listens quietly to the ten sentences of a chapter being read by the narrator, one level of fluency instruction is met because fluency refers to the accuracy and automaticity rate of reading (kuhn, schwanenflugel, & meisinger, 2010). reading fluency by the narrator through a role modeling process can help children learn polysyllabic words related to oral health and dental care. the second possibility is that children can also read aloud with the narrator using a paired reading response. oral reading fluency is associated with the overall reading skills of elementary children (roehrig, petscher, nettles, hudson, & torgesen, 2008). when children read texts accurately with fluency, their working memory no longer has to focus on decoding the words and can begin to process the text for meaning (perfetti, 1985). prior research has demonstrated strong correlations between oral reading fluency and reading comprehension, ranging from .67 (good, simmons, & kame’enui, 2001) to .76 (roberts, good, & corcoran, 2005) for students in grades one to three. 7. limitations one limitation of the ebook for oral health literacy© is the potential that overuse of digital reading material could lead to developmental delays in children who may be exposed to excessive screen time (madigan, mcarthur, anhorn, eirich & christakis, 2020). developmental delays could occur if children do not spend the necessary time needed to practice their oral language skills, increase their reading fluency skills, and/or act on their motor movement skills after viewing and listening to the digital materials. however, developmental delays may be reduced if the digital material being viewed contains educational content, or if children view the material with a caregiver and are exposed to digital literacy materials at a later age (madigan, mcarthur, anhorn, eirich, & christakis, 2020). when children “read to learn” about oral health and nutrition habits with a caregiver, the next step is to cue children to practice the skills demonstrated in the ebook in order to develop body language postures, gestures, and actions for daily oral health hygiene. hence, parental support and supervision are essential in the effective implementation of the ebook chapters. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 73 published by scholink inc. another limitation of the ebook for oral health literacy© could be the speed at which the material is advanced on the screen from page-to-page. even though the design of each chapter has only 10 pages guided by a narrated voice that reads the script out loud to the children, the reading pace should ideally be controlled by the children when they are ready to click on the arrow to advance the next page. when children are able to moderate the pace of the story, they can focus their attention on both the pictures and the written text. for example, some children may like to study the photographs while being read to by the narrator whereas some children may like to read the words aloud while the narrator is silent. more advanced children can be cued to read aloud in tandem with the narrator to practice reading fluency and prosody (expression) skills. any of these reading options are available (but not explicit in the material design), so parental guidance is needed. parents, caregivers, and educators who understand the developmental needs of children will be able to scaffold the interactions that children have with the digital material so that the children remain challenged and engaged in improving their oral health literacy skills and especially their oral health hygiene behaviors for many years to come. 8. implications for public health education our current social marketing project called “reading for a healthy smile” hypothesizes that health-related reading materials can have reciprocal effects for children and their caregivers as a form of interactive health literacy. dentists who are upstream influencers, and teachers and parents who are midstream influencers on children, are critical access points for the dissemination and use of the ebook chapters with children who are in the downstream position of the campaign. future research needs to address the concepts of “self care self efficacy” or “intentions to act” for improving oral health behaviors of children when they read chapters from the ebook for oral health literacy© as an educational intervention in school-based health clinics and community-based dental clinics. in addition, research is needed on the role of parents in the oral health hygiene practices of children and whether reading materials for health literacy can enhance parent-child communication at home. parent-child communication that is developed routinely through oral language, written language, and body language interactions are critical for understanding how a variety of health behaviors, especially oral health habits, develop across the lifespan. 9. conclusion the curriculum purpose of the ebook for oral health literacy© is to help children “learn to read” through an integrative oral, written, and body language approach while practicing oral health literacy skills as they “read to learn” health. children benefit from all forms of language and literacy strategies as they form functional (essential) knowledge in health. children will first learn how to read, then they use reading as a way to learn about more topics, concepts, and skills in health (ubbes, 1999). to demonstrate www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 74 published by scholink inc. health literacy, children will also need explicit and consistent practice time to do health-related skills and behaviors to improve their health status and quality of life. there is educational value in evaluating the readability, suitability, understandability, and actionability characteristics of health literacy materials for children, including whether curriculum cohesion results in verbatim comprehension leading to the preferred gist comprehension. our evaluated ebook for oral health literacy© has filled the gap of providing multisensory and multimodal materials for children who are learning to read while also learning to manage their oral health hygiene habits in their daily lives. our digital material provides photographic narratives that are read to children with visual, textual, and gestural instructions for self-care routines in oral health and nutrition. our 17 chapters contain 10 pages each and take approximately one-minute to read, forming a lexical pattern of reasoned actions for health through visual, textual, and gestural cues to action. we found that the ebook for oral health literacy© had acceptable, and in many cases, favorable scores, for the five design elements of readability, suitability, understandability, actionability, and gist comprehension. ongoing dissemination of the ebook for oral health literacy© curriculum has the potential to boost children who are “learning to read” and “reading to learn” about oral health hygiene and nutrition. future studies should use one or more chapters from the curriculum as an intervention to test this educational premise as an explanatory basis for functional health literacy. references agency for healthcare research and quality. (2020). the patient education materials assessment tool (pemat) and user’s guide. rockville, md: u.s. department of health and human services. retrieved april 29, 2020, from https://www.ahrq.gov/ncepcr/tools/self-mgmt/pemat.html allen, m., auld, e., logan, r., henry montes, j., & rosen, s. (2017). improving collaboration among health communication, health education, and health literacy. nam perspectives. discussion paper, national academy of medicine, washington, dc. https://doi.org/10.31478/201707c allensworth, d., lewalen, t. c., stevenson, b., & katz, s. (2011). addressing the needs of the whole child: what public health can do to answer the education sector’s call for a stronger partnership. preventing chronic disease, 8(2), a44. retrieved from http://www.cdc.gov/pcd/issues/2011/mar/10_0014.htm ayyaswami, v., padmanabhan, d., patel, m., prabhu, a. v., hansberry, d. r., agarwal, n., & magnani, j. w. (2019). a readability analysis of online cardiovascular disease-related health education materials. health literacy research and practice, 3(2), e75-e80. https://doi.org/10.3928/24748307-20190306-03 bailey, s. c., brega, a. g., crutchfield, t. m., elasy, t., herr, h., kaphingst, k. et al. (2014). update on health literacy and diabetes. the diabetes educator, 40, 581-604. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 75 published by scholink inc. https://doi.org/10.1177/0145721714540220 bandura, a. (1975). the role of modeling processes in personality development. in d. m. gelfand (ed.), social learning in childhood, readings in theory and application (2nd ed.). monterey, ca: brooks/cole publishing co. bröder, j., okan, o., bauer, u., bruland, d., schlupp, s., bollweg, t. m., … pinheiro, p. (2017). health literacy in childhood and youth: a systematic review of definitions and models. bmc public health, 17(1), 361. https://doi.org/10.1186/s12889-017-4267-y bryan, n. s., tribble, g., angelov, n. (2017). oral microbiome and nitric oxide: the missing link in the management of blood pressure. current hypertension reports, 19(4), 33. https://doi.org/10.1007/s11906-017-0725-2 carroll, h. t. (2010). the effect of pupil absenteeism on literacy and numeracy in the primary school. school psychology international, 31(2), 121-125. https://doi.org/10.1177/0143034310361674 crosby, g. c. (1977). readability and the royal navy. applied psychology unit, report no. apu/t23/108/77, admiralty research laboratory, teddington, middlesex. de silva, a. m., martin-kerry, j. m., van, k., hegde, s., & heilbrunn-lang, a. (2017). developing a practical readability tool for assessing written oral health promotion material for people with low literacy. health education journal, 76(7), 809-817. https://doi.org/10.1177/0017896917715498 doak, c. c., doak, l. g., & root, j. h. (1996). teaching patients with low literacy skills (2nd ed.). philadelphia: j.b. lippincott. https://doi.org/10.1097/00000446-199612000-00022 eller, l. s., lev, e. l., changrong, y., & watkins, a. v. (2016). describing self-care self-efficacy: definition, measurement, outcomes, and implications. international journal of nursing knowledge, 29(1), 38-46. https://doi.org/10.1111/2047-3095.12143 eltorai, a. e., ghanian, s., adams, c. a., jr., born, c. t., & daniels, a. h. (2014). readability of patient education materials on the american association for surgery of trauma website. archives of trauma research, 3(2), e18161. https://doi.org/10.5812/atr.18161 fishbein, m. & ajzen, i. (2011). predicting and changing behavior: the reasoned action approach. burlington, ma: taylor & francis. https://doi.org/10.4324/9780203838020 friis, k., lasgaard, m., rowlands, g., osborne, r. h., & maindal h. t. (2016) health literacy mediates the relationship between educational attainment and health behavior: a danish population-based study. journal of health communication, 21, 54-60. https://doi.org/10.1080/10810730.2016.1201175 fry, e. (1968). a readability formula that saves time. international literacy association and wiley, 11(7), 513-516, 575-578. gold, r. s., auld, m. e., abroms, l. c, smyser, j., yom-tov, e., & allegrante, j. p. (2019). digital health communication common agenda 2.0: an updated consensus for the public and private sectors www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 76 published by scholink inc. to advance public health. health education & behavior, 46(suppl. 2), 124s-128s. https://doi.org/10.1177/1090198119874086 good, r. h., simmons, d. c., & kame’enui, e. j. (2001). the importance and decision-making utility of a continuum of fluency based indicators of foundational reading skills for third-grade high stakes outcomes. scientific studies of reading, 5, 257-288. https://doi.org/10.1207/s1532799xssr0503_4 griffin, j., mckenna, & tooth, l. (2003). written health education materials: making them more effective. australian occupational therapy journal, 50, 170-177. https://doi.org/10.1046/j.1440-1630.2003.00381.x hawkins, r., kreuter, m., resnicow, k., fishbein, m., & dijkstra, a. (2008) understanding tailoring in communicating about health. health education research, 23(3), 454-466. https://doi.org/10.1093/her/cyn004 helitzer, d., hollis, c., cotner, j., & oestreicher, m. (2009). health literacy demands of written health information materials: an assessment of cervical cancer prevention materials. cancer, culture, and literacy, 16(1), 70-78. https://doi.org/10.1177/107327480901600111 hendrickson, r. l., huebner, c. e., & riedy, c. a. (2006). readability of pediatric health materials for preventive dental care. bmc oral health, 6, 14. https://doi.org/10.1186/1472-6831-6-14 hiniker, a., schoenebeck, s. y., & kientz, j. a. (2016). not at the dinner table: parents’ and children’s perspectives on family technology rules. cscw '16: proceedings of the 19th acm conference on computer-supported cooperative work & social computing, february 2016 (pp. 1376-1389), https://doi.org/10.1145/2818048.2819940 hoffmann, t., & ladner, y. (2012). assessing the suitability of written stroke materials: an evaluation of the interrater reliability of the suitability assessment of materials (sam) checklist. topics in stroke rehabilitation, 19(5), 417-422. https://doi.org/10.1310/tsr1905-417 international literacy association. (2019). digital resources in early childhood literacy development [position statement and research brief]. newark, de: author. jackson, s. l., vann william, f., kotch, j. b., pahel, b. t., & yee, j. l. (2011). impact of poor oral health on children’s school attendance and performance. american journal of public health, 101(10), 1900-1906. https://doi.org/10.2105/ajph.2010.200915 jang, s. j. & yoon, s. u. (2018). the relationship of oral health behavior with oral health literacy and oral health knowledge among elementary school students. journal of korean society of dental hygiene, 19(1), 93-103. https://doi.org/10.13065/jksdh.20190011 joint committee on national health education standards. (1995 & 2007). national health education standards: achieving health literacy. atlanta, ga: american cancer society. klinker, c. d., aaby, a., ringgaard, l. w., vang hjort, a., hawkins, m., & maindal, h. t. (2020). www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 77 published by scholink inc. health literacy is associated with health behaviors in students from vocational education and training schools: a danish population-based survey. international journal of environmental research in public health, 17(2), 671. https://doi.org/10.3390/ijerph17020671 kuhn, m. r., schwanenflugel, p. j., & meisinger, e. b. (2010). aligning theory and assessment of reading fluency: automaticity, prosody, and definitions of fluency. reading research quarterly, 45(2), 230-251. https://doi.org/10.1598/rrq.45.2.4 lu, m., xuan, s., & wang, z. (2019). oral microbiota: a new view of body health. food science and human wellness, 8, 8-15. https://doi.org/10.1016/j.fshw.2018.12.001 madigan, s., mcarthur, b. a., anhorn, c., eirich, r., & christakis, d. a. (2020). associations between screen use and child language skills: a systematic review and meta-analysis. jama pediatrics. https://doi.org/10.1001/jamapediatrics.2020.0327 magnuson, b., jain, s., roomian, t., pagni, s., tran, d. t., & finkelman, m. d. (2019). conducting surveys in dental education research: guidelines and reminders. journal of dental education. mak, w. w., law, r. w., woo, j., cheung, f. m., & lee, d. (2009). social support and psychological adjustment to sars: the mediating role of self-care self-efficacy. psychology & health, 24(2), 161-174. https://doi.org/10.1080/08870440701447649 mclaughlin, g. h. (1969). smog grading: a new readability formula. international literacy association and wiley, 12(8), 639-646. office of disease prevention and health promotion. (2010). healthy people 2020. u.s. department of health and human services. retrieved from https://www.healthypeople.gov office of the surgeon general. (2000). oral health in america: a report of the surgeon general. u.s. department of health and human services. retrieved from https://www.nidcr.nih.gov/research/data-statistics/surgeon-general olsen, i. (2015) commentary. journal of oral microbiology, 7, 1. https://doi.org/10.3402/jom.v7.27847 paasche-orlow, m., & wolf, m. (2007). the causal pathways linking health literacy to health outcomes. american journal of health behavior, 31, supplement 1(1), s19-s26. https://doi.org/10.5993/ajhb.31.s1.4 pellicer-sánchez, a., tragant, e., conklin, k., rodgers, m., serrano, r., & llanes, á. (2020). young learners’ processing of multimodal input and its impact on reading comprehension: a eye-tracking study. studies in second language acquisition, 1-22. https://doi.org/10.1017/s0272263120000091 perfetti, c. a. (1985). reading ability. new york, ny: oxford university press. pikulski, j. j., & chard, d. j. (2005). fluency: bridge between decoding and reading comprehension. the reading teacher, 58, 510-519. https://doi.org/10.1598/rt.58.6.2 quilliam, e. t., mckay, b. a., lapinski, m. k., viken, g., plasencia, j., wang, z., & fraser, a. (2018). a content analysis of hand hygiene materials targeting elementary-age children. health education www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 78 published by scholink inc. research, 33, 1-11. https://doi.org/10.1093/her/cyy033 rasinski, t. v., rupley, w. h., paige, d. d., & nichols, w. d. (2016). alternative text types to improve reading fluency for competent to struggling readers. international journal of instruction, 9(1), 163-178. https://doi.org/10.12973/iji.2016.9113a reyna, v. f. (2020). a scientific theory of gist communication and misinformation resistance, with implications for health, education, and policy. proceedings of the national academy of sciences, 1-6, 201912441. https://doi.org/10.1073/pnas.1912441117 rhee, r. l., von feldt, j. m., schumacher, h. r., & merkel, p. a. (2013). readability and suitability assessment of patient education materials in rheumatic diseases. arthritis care & research, 65(10), 1702-1706. https://doi.org/10.1002/acr.22046 roberts, g., good, r., & corcoran, s. (2005). story retell: a fluency-based indicator of reading comprehension. school psychology quarterly, 20, 304-317. https://doi.org/10.1521/scpq.2005.20.3.304 rudd, r. e. (2000). book review on teaching patients with low literacy (2nd ed.). retrieved april 22, 2020, from https://www.hsph.harvard.edu/healthliteracy/resources/teaching-patients-with-low-literacy-skills/ shoemark, d. k., & allen, s. j. (2015). the microbiome and disease: reviewing the links between the oral microbiome, aging, and alzheimer’s disease. journal of alzheimer’s disease, 43, 725-738. https://doi.org/10.3233/jad-141170 shoemaker, s. j., wolf, m. s., & brach, c. (2014). development of the patient education materials assessment tool (pemat): a new measure of understandability and actionability for print and audiovisual patient information. patient education and counseling, 96(3), 395-403. https://doi.org/10.1016/j.pec.2014.05.027 sorensen, k., van den-broucke, s., fullam, j., doyle, g., pelikan, j., slonska, z., & brand, h. (2012). health literacy and public health: a systematic review and integration of definitions and models. bmc public health, 12, 80. https://doi.org/10.1186/1471-2458-12-80 thompson long, b., hall, t., hogan, m. et al. (2017). enhancing children’s literacy skills: designing the q-tales ecosystem for children’s e-book design and publication. literacy, epub ahead of print 20 july 2017. tzeng, y. f., & gau, b. s. (2018). suitability of asthma education materials for school-age children: implications for health literacy. journal of clinical nursing, 27, 921-930. tzeng, y. f., chiang, b. l., chen, y. h., & gau, b. s. (2018). health literacy in children with asthma: a systematic review. pediatric neonatology, 59, 429-438. https://doi.org/10.1111/jocn.13993 ubbes, v. a. (2020). digital literacy partnership at miami university. retrieved april 8, 2020, from https://dlp.lib.miamioh.edu www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 79 published by scholink inc. ubbes, v. a., geller, k. s., schweitzer, r., & robison, k. (2020). testing the psychometric properties of the habits of health scale for children and youth. children and teenagers, 3(1), 1-15. https://doi.org/10.22158/ct.v3n1p1 ubbes, v. a., & wolfe, c. (2019, march). evaluation phases of an oral health literacy ebook for children: material refinement and user feedback. dublin, ireland: 4th european health literacy conference. ubbes, v. a., coyle, j., & tzoc, e. (2018). evaluation of an oral health curriculum: design feedback from three audiences. the international journal of health, wellness, and society, 8(4), 1-10. https://doi.org/10.18848/2156-8960/cgp/v08i04/1-10 ubbes, v. a. & miami university libraries. (2013-2020). health literacy database at miami university: a collection of electronic materials that educate for health. oxford, oh. retrieved april 29, 2020, from https://dlp.lib.miamioh.edu/healthliteracy u.s. centers for disease control and prevention. (2020). health literacy definition. the patient protection and affordable care act of 2010, title v. retrieved april 8, 2020, from https://www.cdc.gov/healthliteracy/learn/index.html u.s. centers for medicare and medicaid services. (2020). toolkit for making written material clear and effective. baltimore, md. retrieved april 8, 2020, from https://www.cms.gov/outreach-and-education/outreach/writtenmaterialstoolkit u.s. centers for disease control and prevention. (2020). youth risk behavior survey: data summary and trends report (2007 to 2017). division of adolescent and school health, national center for hiv/aids, viral hepatitis, std, and tb prevention. retrieved april 29, 2020, from https://www.cdc.gov/healthyyouth/data/yrbs/pdf/trendsreport.pdf van der heide, i., heijmans, m., schuit, a. j., uiters, e., & rademakers, j. (2015). functional, interactive and critical health literacy: varying relationships with control over care and number of gp visits. patient education and counseling, 98, 998-1004. https://doi.org/10.1016/j.pec.2015.04.006 varlas, l. (2014). ascd express call for content: building academic vocabulary. alexandria, va: ascd newsletters & publications. retrieved april 23, 2020, from https://inservice.ascd.org/ascd-express-call-for-content-building-academic-vocabulary wolfe, c. r., reyna, v. f., widmer, c. l., cedillos, e. m., fisher, c. r., brust-renck, p. g., & weil, a. m. (2015). efficacy of a web-based intelligent tutoring system for communicating genetic risk of breast cancer: a fuzzy-trace theory approach. medical decision making, 35, 46-59. https://doi.org/10.1177/0272989x14535983 zullig, k., ubbes, v. a., & mann, m. (2013). early adolescent literacy influences, reading ability, and preventative health behaviors. american journal of health studies, 28(3), 131-141. zuzelo, p. r. (2019). understandability and actionability using the pemat to benefit health literacy. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 80 published by scholink inc. holistic nursing practice, 33(3), 191-193. https://doi.org/10.1097/hnp.0000000000000327 children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 2, no. 1, 2019 www.scholink.org/ojs/index.php/ct 49 original paper the effectiveness of chants and short stories on primary stage pupils’ communication mahmoud kamal ibrahim mostafa1* 1 english department, faculty of arts, jouf university, al-jouf, saudi arabia * mahmoud kamal ibrahim mostafa, english department, faculty of arts, jouf university, al-jouf, saudi arabia received: january 27, 2019 accepted: february 9, 2019 online published: february 16, 2019 doi:10.22158/ct.v2n1p49 url: http://dx.doi.org/10.22158/ct.v2n1p49 abstract the aim of the study is to investigate the effectiveness of using chants and short stories in developing the third primary graders’ english communicative skills in damietta governmental schools. in order to answer the questions of the study, the researcher adopted the quasi-experimental approach. the sample of the study consisted of 50 pupils from dr ahmed zwail primary school in new damietta city. the chants/songs and short stories were used with the study group in the second term of the academic school year (2014-2015). an oral communication test of six questions with 30 items was designed to be used as a pre-post test. the study indicated that there are statistically significant differences in mean scores of communicative skills test in favor of the post application. it also showed that there were statistically significant differences in mean scores of each of the communication skills in favor of the post application. in light of these results, the study recommended the necessity of using children chants/songs and short stories in teaching and learning. it also suggested that further researches should be conducted on the effect of songs and stories on the four skills of english language. keywords oral communication skills (ocs), integrated chants, short stories www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 50 published by scholink inc. 1. introduction the english language is a system of sounds and signs organized by grammatical rules of combination to communicate meaning successfully. oral communication is the most important aspect of the english language which is used to express thoughts, hopes, ambitions, and daily actions. moreover, effective communication is an integral part of daily life, especially in education. it is the core of every aspect of interaction with others. according to schady (2011) childhood period is the most rapid period of development in human life. although individual children develop at their own pace, all children progress through an identifiable sequence of physical, cognitive, social and emotional growth and change. juraid, ibrahim, methods and munawrah (2016) claim that the status of english as a global lingua franca has led to policy on primary english education in many non-english speaking countries. teaching english in formal educational settings (e.g., primary schools) is a relatively new global phenomenon, and it started in egypt in the 1990s. in addition, thapa, cohen, guffey and higgins d’alessandro (2013) argue that pupils can learn literacy skills through instruction and practice of speaking, reading, writing and listening. oral communication is the process of exchanging information through the sense of hearing and making meaning from what was practiced. jalongo (2008) assures that oral communication prepares young children for later better learning. this may be the reason why raghavendra, olsson, sampson, mcinerney and connell (2012) submitted that it is crucial for a child to develop good communication skills in order to cope with the academic demands of school and to learn adequate literacy skills. communication skills help children to guide their self-inquiry and discover their individual possibilities. children who are active communicators can incorporate the things they hear faster in their framework of knowledge than a more passive counterpart. in his own view, tramel (2011) observed that children can also exhibit better concentration and memory when they develop good communication. shiel, cregan, mcgough and archer (2012) cited that oral communication is the child’s first, most important, and most frequently used structured medium of communication. in addition, and most significantly, oral communication is the primary mediator of culture, the way in which children locate themselves in the world. basically, oral communication is about communicating with other people. it involves a process of utilizing knowledge and skills in order to speak and listen effectively. ferrari, punie and redecker (2012) assert that although the curriculum places a strong emphasis on oral communication, it has been widely acknowledged that the implementation of the oral communication strand has proved challenging and there is evidence that some teachers may have struggled to implement this component because the underlying framework was unclear to them. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 51 published by scholink inc. children, as beginners, may face many communication problems. salmon (2017) reveals that around half of children enter schools with a lack of communication ability. all those who have poor communication skills may face many difficulties relating to what is known as speech, language and communication needs (slcn). lindsay, dockrell, desforges, law and peacey (2010) declare that the reasons for such difficulties are various. these include families with lower socioeconomic status, children with hearing loss, brain injury, learning disabilities and for some, the cause is unknown. after they have these difficulties, many children become silent, friendless, and feel lonely and easily rejected by classmates, when trying to make friends or join a group activity. zhang (2009) asserts that pupils who study english as a foreign language (efl) usually have limited opportunities to communicate in english outside the classroom and also have limited exposure to english speakers or members of the international community. this might be one reason for teachers to provide more situations, activities and strategies for pupils to strengthen their oral communication performance. 2. method and procedures this chapter deals with all the research design, participants and instruments of the study. also, it tackles the materials of the study, the experimental procedures and administration of the study instruments. 2.1 research design the research adopted the quasi-experimental one group pre-posttest design. children’s songs and stories were used with the study group. by the end of the experiment, a pre-posttest was administrated to the study group in order to determine the effectiveness of children songs and short stories in developing pupils’ communicative skills. 2.2 participants of the study the participants of the study were 50 pupils enrolled in the third year, dr ahmed zewail primary school, new damietta city. they were aged 8-9 years old during 2014/2015 academic year. they were treated as one quasi-experimental group, having a pre-posttest before and after the experimental procedures. 2.3 variables of the study the study included the following variables: a) the independent variable is represented in the integrated chants/songs and short stories. b) the dependent variable is represented in the development of the third graders’ english communication skills. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 52 published by scholink inc. 2.4 the instruments and materials of the study the researcher used the following instruments: a) an oral communication skills checklist. b) an oral communication skills test. c) a teacher’s guide based on the integrated songs/chants and short stories. 2.4.1 the oral communication skills checklist the checklist aimed to determine the oral communication skills necessary for 3rd primary graders. the checklist was constructed in light of the following: 1) reviewing previous studies concerned with efl oral communication skills, especially those related to integrated songs/chants and short stories in teaching efl in the primary stage. 2) reviewing the syllabus directives of time for english book of grade three. 3) consulting supervisor’s curriculum planners about what is suitable for the primary stage pupils. the checklist relied on the 3rd-grade syllabus (time for english) oral skills (listening & speaking). these oral communication skills (ocss) were extracted from units 7 and 8 in addition to the literature moe directives. the ocss checklist contained oral communication skills (listening & speaking). checklist validity to validate the checklist, it was submitted to a panel of juries in curriculum and methods of teaching efl. the juries were asked to evaluate the checklist in terms of clarity, readability and its suitability for 3rd-year pupils’ communication skills. the jury members validated the checklist items and their comments were modifying some items to suit 3rd primary stage pupils such as 8, 12, 14, 16 and 19 items of the first version of the checklist. 2.4.2 an oral communication skills pre-post test it aims to determine the participants’(ocss) level in their entry level as to oral communication skills before the test administration. the oral communication skills test was constructed in light of the following resources: 1) reviewing the previous studies concerned with efl tests, especially those related to communication skills. 2) reviewing literature of teaching oral communication skills. the oral communication skills pre-posttest consisted of 6 questions; two questions for speaking skills, two questions for listening skills, one question for grammar and one question for vocabulary. each question consisted of five items. so, the total items of the pre-post test were 30. to validate the ocss test, the researcher submitted the test to a panel of the jury who are specialized in curriculum and methods of teaching efl. the jury members were asked to validate the test and judge the clarity of its questions and their suitability for the pupils’ levels and what these questions aimed to measure. they were also asked to add, omit or modify any question(s) as they saw fit. according to the jury’s remarks, modifications were made. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 53 published by scholink inc. the reliability the reliability of the test was computed using the test-retest method before administrating the test to the participants of the study. it was administrated to 20 pupils on 3rd november 2014. four weeks later, on 30th november 2014, the same test was applied to the same group under the same conditions. then, the correlation coefficient between the first and the second administrations of the test was calculated using the correlation coefficient analysis as shown in tables 1 and 2. the reliability coefficient was 0.87 as shown in table 3 which was statistically significant at 0,001, thereby reflecting test reliability. table 1. internal consistency of oct items (person correlation) items of speaking correlation items of listening correlation items of grammar correlation items of vocab. correlation 1 0.427* 11 0.393* 21 0.650** 26 0.421* 2 0.506** 12 0.607** 22 0.641** 27 0.541** 3 0.522** 13 0.678** 23 0.579** 28 0.613** 4 0.249 14 0.806** 24 0.650** 29 0.794** 5 0.464** 15 0.694** 25 0.697** 30 0.368* 6 0.444 16 0.468 7 0.750* 17 0.401* 8 0.362** 18 0.491** 9 0.553** 19 0.495** 10 0.519 20 0.763** www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 54 published by scholink inc. table 2. total correlation of oral communication skills skill alpha cronbach split-half speaking 0.62 0.55 listening 0.76 0.84 grammar 0.64 0.66 vocabulary 0.42 0.59 total 0.87 0.84 *correlation is significant at the 0.05 level (2-tailed). **correlation is significant at the 0.01 level (2-tailed). table 3. reliability coefficient of oral communication test skill total correlation speaking 0.890** listening 0.931** grammar 0.699** vocabulary 0.825** test scoring the researcher graded the pupils’ oral communication skills in the pre-post test and the mean score was calculated. the following procedures were applied to score the test: the listening test is marked in terms of listening skills. the total score out of 10 on the whole test divided as follows: -a score out of 5 on the part (listen and number). -a score out of 5 on the part (look and say). the speaking test is marked in terms of speaking skills. the total score out of 10 on the whole test divided as follows: -a score of 5 on the part (listen and say the answer). -a score of 5 on the part (listen and act the conversation). -scores given by two raters are summed and divided by two to get the average. 3. results 3.1 the first hypothesis there is a statistically significant difference at ≤ 0.05 level in the mean scores of primary stage pupils’ overall group overall oral communication skills (ocs) post test. to test the hypothesis, the researcher performed an independent sample t-test on the post test scores of www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 55 published by scholink inc. the experimental group on overall communication skills. table 4 shows the results of this t-test. table 4. paired samples statistics of total mean scores and correlations (first hypothesis) test n mean st.d. df t significant pre-test 50 21.52 5.59 49 2.64 ≤ 0.05 post-test 50 24.14 3.02 table 4 shows that the experimental mean score of the posttest is higher than those of the pre-test. this table shows that the experimental group’s mean score of total pre-test is (21.52), whereas the mean total post-test score is (24.14). the t-value is (2.64), which is significant at the ≤ 0.05 level. the former results indicate that there is a statistically significant difference between the participants’ mean score in the pre-test and their mean score in the post-test, regarding oral communication skills in favor of the latter. so, the first hypothesis was verified. the above table shows that there was a statistically significant difference between the subjects’ mean score in the pre-test and their mean score in the post-test; regarding oral communicative skills (listening & speaking) in favor of the latter. so, the first hypothesis was verified. 3.2 the second hypothesis there are statistically significant differences at ≤ 0.05 level in each of the (ocs) tests including listening and speaking. to investigate this hypothesis, the researcher performed a t-test on the post test scores of the experimental group on each of the oral communicative skills (listening & speaking). table 5 shows the results of this t-test. table 5. paired samples statistics of mean scores and correlations (second hypothesis) skill pre-measurement post-measurement df t-test p. sig. m sd m sd speaking 5.6 2.18 7.04 1.55 49 3.36 0.002 sig. listening 7.56 2.25 8.44 1.21 49 2.18 0.034 sig. grammar 4.28 1.06 5.46 1.19 49 2.88 0.038 sig. vocabulary 4.06 1.02 5.20 1.13 49 2.69 0.049 sig. the above table shows that there was a statistically significant difference between the subjects’ mean score in the pre-administration (before applying the study) and their mean score in the post-administration (after applying the study); regarding each skill of oral communication skills (listening and speaking) in favor of the latter. so, the second hypothesis was verified. also, there was a www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 56 published by scholink inc. statistically significant difference between the subjects’ mean score in the pre-administration (before applying the study) and their mean score in the post-administration (after applying the study); regarding grammar and vocabulary, but it was not as high as the oral communication skills mean scores. 4. discussion of the results the purpose of the study was to investigate the effectiveness of chants/songs and short stories in developing english communication skills (listening & speaking skills) of the third graders. in light of the finding of this study, it can be stated that the main result was that children's songs and stories were highly effective in the students’levels of communication skills. the first hypothesis: table 5 shows that there is a statistically significant difference between the subjects’ mean score in the pre-test and their mean score in the post-test; regarding oral communicative skills (listening & speaking) in favor of the latter. this means that the suggested study helped in developing the oral communication skills of the 3rd primary graders as their performance in the post-test is better than their performance in the pre-test. this result came out of involving the pupils in a variety of activities (chanting, story-telling, role-play, repetition, video shots and school broadcast) that were included in the experiment presented in the chants/songs and short stories activities. so, these activities encouraged the pupils to practice chanting and story-telling independently and fluently which reflected on their efl oral communication skills. chants and stories helped them understand and learn new conversations. the pre-test means score was 21.52 and the post-test mean score was 24.14 with a difference at the p ≤ 0.05 level. this could mean that chants and short stories were effective in the pupils learning process. the second point of significance is the use of chants and short stories linked to teaching english through music, body movements, rhythm and amusement. with regard to the nature of primary stage pupils, chants and short stories played an important role in their learning process a gradually in their creativity. the result of the first hypothesis agrees with the results of: a) chocova (2013), aina (2012)-rosa (2011), virjee (2011)-sangadah (2010), refiee (2010), chen and chen (2009)-liu (2008), siskova (2007), mardliyatun (2007), rtnasari (2007), lee (2004), el-nashar (2003) and ankey et al. (2002). b) torun’s (2014), karlesson (2012), zigardyova (2006), rosberg (1995) and abd el-muteleb (1990). in the following points:  chants/songs and short stories are important to encourage pupils to participate in classroom activities.  chants/songs and short stories are important to enrich pupils’ efl.  chants/songs and short stories are important to improve and develop pupils’ ocss and creativity. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 57 published by scholink inc.  chants/songs and short stories can be used as a tool to teach young learners throughout various activities. concerning the second hypothesis, table 6 shows that there is a statistically significant difference at ≤ 0.05 level between the subjects’ mean score in the pre-test and their mean score in the post-test in each of the oral communicative skills (listening & speaking) tests in favor of the latter. a point of significance is using chants and short stories are near to the natural approach to teaching english to young learners. the mean score of speaking skill in the pre-measurement was 5.6 and 7.04 for the post-measurement. this difference is significant at ≤ .01 level (p = 0.002). this could mean that pupils were more likely to report an improvement in their speaking skills and that chants and short stories help them improve their language as a whole. the mean score of listening skill in the pre-measurement was 7.56 and 8.44 for the post-measurement. this difference is significant at ≤ 0.01 level (p = 0.034). this also could mean that pupils listening skills improved and they benefited from listening to the chants and short stories which were included and used during the study. the mean score of grammar in the pre-measurement was 4.28 and 5.46 for the post-measurement. this difference is significant at ≤ 0.05 level (p = 0.038). this also could mean that pupils’ grammar improved and they benefited from listening to the chants and short stories which were included and used during the study. the mean score of vocabulary in the pre-measurement was 4.06 and 5.20 for the post-measurement. this difference is significant at ≤ 0.05 level (p = 0.049). this also could mean that pupils’ vocabulary improved and they benefited from listening to the chants and short stories which were included and used during the study. this means that the suggested study helped in developing oral communication skills (listening & speaking). this, in turn, led to developing efl performance. this can be interpreted as a result of using the proposed study as it helped pupils to enhance their communication skills and so be able to develop efl oral performance. the chants and stories used included short and long vowels which helped pupils to improve their listening and speaking skills (long o as in boat, snow, home, coat, window, note and long u as in blue, glue, true, flute, june, tube). the results of the second hypothesis are consistent with the results of many researchers such as chen and chen (2009) and radwan (2008) results showed that the majority of students were interested in learning english songs and short stories and their learning motivation increased. for learning performance, students felt that their english ability especially listening ability have improved after listening to the songs and stories. this result agrees with the study of radwan (2008) in the following points: -interaction with other pupils has an effect on developing oral communication skills. -classroom chanting and story-telling could represent a technique for motivating participation, promoting creativity and testing language skills in a meaningful context. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 58 published by scholink inc. -using oral activities leads to creativity. -providing pupils with efficient learning strategies. -assisting learners in identifying their own preferred ways of learning. -developing skills needed to negotiate the curriculum. -encouraging pupils to set their own objectives. -overcoming some language learning problems of the primary stage pupils. -helping pupils to be creative learning efl in and out of the classroom. 5. conclusions the outcome of this study substantiates an initial belief regarding the fact that the study group learners were able to comprehend the integrated chants/songs and short stories and provide some fluent oral communication skills. in fact, even though the learners started from a slightly lower level of english, they improved their oral communication skills (listening & speaking) and performed the songs and short stories successfully. however, in order to obtain better results, the researcher believes that there is an urgent need to develop new materials and resources adapted to non-native young learners. if the existent materials are to be used in the efl classroom, and just to mention some of the paths to explore, they need to include higher quality sound, chants/songs and slower storytelling pace. graded pedagogical tasks responding to the learners’ age and the developmental stage would also be necessary. finally, suitable chants and short stories for children are needed, both from a cognitive and communicative perspective, and, perhaps more importantly, to ensure their relation to the syllabus and the nature of children. references ferrari, a., punie, y., & redecker, c. (2012). understanding digital competence in the 21st century: an analysis of current frameworks. in 21st century learning for 21st century skills (pp. 79-92). springer. https://doi.org/10.1007/978-3-642-33263-0_7 forster, e. (2006). the value of songs and chants for young learners. international journal of language & communication disorders, 45(4), 448-460. jalongo, m. r. (2008). beyond a pets theme: teaching young children to interact safely with dogs. early childhood education journal, 36(1), 39-45. https://doi.org/10.1007/s10643-008-0272-1 juraid, r. a., ibrahim, m. m. a., methods, t., & munawrah, m. (2016). the effect of storytelling on developing communication skills of efl female students and their attitudes towards it, 5(november). lindsay, g., dockrell, j., desforges, m., law, j., & peacey, n. (2010). meeting the needs of children www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 59 published by scholink inc. and young people with speech, language and communication difficulties. raghavendra, p., olsson, c., sampson, j., mcinerney, r., & connell, t. (2012). school participation and social networks of children with complex communication needs, physical disabilities, and typically developing peers. augmentative and alternative communication, 28(1), 33-43. https://doi.org/10.3109/07434618.2011.653604 salmon, c. (2017). storytelling: bewitching the modern mind. verso, b., & schady, n. (2011). parents’ education, mothers’ vocabulary, and cognitive development in early childhood: longitudinal evidence from ecuador. american journal of public health, 101(12), 2299-2307. https://doi.org/10.2105/ajph.2011.300253 shiel, g., cregan, á., mcgough, a., & archer, p. (2012). oral language in early childhood and primary education (3-8 years). dublin: national council for. thapa, a., cohen, j., guffey, s., & higgins-d’alessandro, a. (2013). a review of school climate research. review of educational research, 83(3), 357-385. https://doi.org/10.3102/0034654313483907 zhang, y. (2009). reading to speak: integrating oral communication skills. english teaching forum. retrieved from http://eric.ed.gov/?id=ej923446 children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 4, no. 4, 2021 www.scholink.org/ojs/index.php/ct 1 original paper using errorless learning and discrimination training to teach early literacy skills in a pre-school setting elisa p. belfiore1 & phillip j. belfiore2* 1 winchester thurston school, pittsburgh, usa 2 department of special education and applied disability studies, mercyhurst university, erie, usa * phillip j belfiore, winchester thurston school, pittsburgh, usa received: september 29, 2021 accepted: october 9, 2021 online published: october 18, 2021 doi:10.22158/ct.v4n4p1 url: http://dx.doi.org/10.22158/ct.v4n4p1 abstract this case study investigates the effects of using an intervention package of errorless learning and discrimination trial training to teach a 4-year old preschool student to read consonant-vowel-consonant (cvc) words. a single case multiple baseline design across three equal instructional sets was used to evaluate the effects of the intervention package. each set contained six cvc words incorporating words with each of the five vowels. the results of this study indicate that utilizing both errorless learning and discrimination training to teach a preschool student how to read cvc words was effective. in addition, generalization assessments post-intervention showed an increase in (a) mastering new unknown cvc words, as well as (b) book text reading. keywords literacy decoding, phonemic awareness, preschool reading, flashcards, error correction, discrimination training, single case research 1. introduction the primary goal of early reading instruction is to teach children the print-to-sound decoding process (wolf, 2016). developing reading skills early in a child’s education is vital to their overall success in future grades (turan & gul, 2008). for instance, when a preschool age student demonstrates the skills of verbally stating letter name and corresponding letter sound, they should be capable of progressing into blending those isolated sounds into words. while it is important to visually discriminate topographical differences of the printed letter (saunders, johnston, & brady, 2000), reading development depends primarily on the understanding that (a) letter names have distinct letter sounds, (b) combining those letter sounds produce words, and (c) decoding those sound patterns results in reading www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 4, 2021 2 published by scholink inc. the printed word (national institute of child health and human development, 2000). adams (1990) stresses the understanding that letters have a one-to-one relationship to sounds in words is foundational to the successful beginner reader. one critical literacy skills is the understanding of phonemic awareness (adam, 1990; ehri, 2005). although the terms phonological awareness and phonemic awareness are often times used interchangeably, they do have slightly different meanings. phonological awareness, the larger of the two ideas, is the awareness of various sound aspects of language (as distinct from its meaning) (national institute for literacy, 2008). phonological awareness skills include recognizing words with similar beginning and end sounds, recognizing the number and pattern of sounds in a word (e.g., consonant-vowel-consonant), spelling, and rhyme skills (turan & gul, 2008). turan and gul (2008) consider phonological awareness skills the most important indicators of early reading skills. phonemic awareness is more specific, identified as the ability to detect phonemes (individual sounds) in words (national institute for literacy, 2008). furthermore, phonemic awareness involves the ability to hear, identify, and manipulate individual phonemes (sounds) in spoken word production, helping students understand that the letters in written words translate to the sounds in spoken words, serving as a precursor to decoding unfamiliar printed words (wolf, 2016). the purpose of this research was to assess the benefits of using discrimination training combined with errorless learning to teach early literacy decoding and letter blending skills in a pre-school setting. this research will help determine whether children of pre-school age who are demonstrating skills of letter recognition and phonemic awareness are capable of progressing into reading and decoding cvc words. 2. method 2.1 participant and setting in this study, the single participant, dorothy, was a typically developing 4-year-old female enrolled in a rural preschool half-day program (8:45 am to 12:00 pm). prior to the study, dorothy demonstrated an understanding of letter sounds and names and more so, indicated an interesting in being able to read books independently. sessions usually lasted 10 minutes including both assessment and intervention. the session typically included one teacher (the first author), except for when inter-observer agreement and procedural integrity were measured. the intervention was set up at a separate table away from other students. the dependent measure was the percentage of consonant-vowel-consonant (cvc) words read correctly during repeated assessment sessions. eighteen cvc word were identified, resulting in creation of three sets of six words. each set was taught separately. set a contained cvc words ending in either /at/ (3 words) or /ad/ (3 words). set b contained cvc words ending in either /eg/ (3 words) or /id/ (3 words). set c contained cvc words ending in either /op/ (3 words) or /ug/ (3 words). www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 4, 2021 3 published by scholink inc. table 1. cvc instructional sets a, b, c and generalization sets set a set b set c generalization sets cat peg mop pet net hat leg top sit dot bat beg cop vet cut mad did bug nut hit bad hid rug pot hut dad kid mug bit hot at the onset of each session, dorothy was presented the 18 flashcards, containing one cvc word per card, in a randomized order and asked to read the word aloud. she was given approximately 3 seconds to respond to each flashcard as it was presented. if she responded correctly that word was recorded as correct. if she responded incorrectly or stated that she did not know, the word was recorded as incorrect. once all 18 cvc flashcards were presented, the teacher thanked dorothy for participating, and the assessment session ended. 2.3 experimental design the experimental design used was a single case multiple baseline design across three equal sets of six words. once dorothy demonstrated mastery of a set during assessment (read all six words in the set correctly), the next set of words was introduced and practiced during intervention. for example, once mastery at 100% was achieved for set a, intervention began for set b. in this way, intervention was introduced sequentially to each of the three word sets. to establish experimental control, a single case multiple baseline design (a) sequential introduces intervention across the three instructional sets, (b) documents initial baseline stability, (c) achieves acceptable levels of inter-observer agreement and procedural integrity, and (d) documents at least three demonstration of experimental effect (i.e., no treatment-treatment comparisons) (belfiore, 2018). 2.4 interobserver agreement and procedural integrity two teachers collected procedural integrity during two of the intervention sessions. the purpose of procedural integrity is to ensure that intervention was delivered consistently across the intervention phase. both teachers were provided a checklist of steps, and asked to check each intervention step as it was appropriately completed. the steps included, teaching verbal prompts, wait time and teacher error correction. procedural integrity was measured by dividing the number of steps completed correctly by the total number of required steps then multiplying by 100. acceptable levels of procedural integrity were met with a total mean of 96% (range 92%-100%). two teachers collected inter-observer agreement during 15% of sessions. while one teacher administer the flash card procedure, another teacher sat nearby. both teachers wrote down the words they heard dorothy read correctly aloud. acceptable levels of inter-observer agreement were met with a total mean www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 4, 2021 4 published by scholink inc. agreement of 100%. inter-observer agreement was calculated by taking the number of agreements, dividing it by the number of agreement and disagreement, then multiplying by 100. 2.5 procedural steps 2.5.1 baseline during baseline, dorothy was presented with the 18 flashcards, containing one cvc word per card, in a randomized order and asked to read the word aloud. she was given approximately 3 seconds to respond to each flashcard as it was presented. once all 18 cvc flashcards were presented to dorothy, she was thanked for participating, and the baseline session ended. 2.5.2 intervention before each intervention, in order to collect valid assessment data, dorothy was assessed on reading all 18 words aloud and words read correctly were recorded. this assessment prior to intervention was identical to the baseline assessment. after assessment, intervention was introduced. the first component of the intervention was errorless learning. first, each cvc word flashcard was placed in front of dorothy, and the teacher stated each letter aloud (e.g., “c-a-t”) while pointing to that letter. dorothy followed, saying each letter name aloud while pointing at that letter. second, the teacher said the sound of each letter aloud while pointing to that letter, followed by dorothy repeating each letter sound aloud. lastly, the teacher instructed dorothy to say the letter sounds faster, “blending” them together. the teacher and dorothy together blended the sounds, saying the sounds of each letter quickly to form the word. after repeating this blending process together, the teacher and dorothy together stated the word. this procedure was repeated for each word in the set of six. then, the entire set was practiced one more time, for a total of two errorless trials per word. the second component of the intervention was a discrimination training game. in this component, the six flashcards were arranging face down on the table. dorothy was asked to pick any card, turn it over and read it aloud. she was reminded to “sound out” the letters if she did not initially recognize the word. if she stated the word correctly within 3 seconds, the teacher praised her by saying, “good, the word is ____”, and the card was removed from the table. if dorothy did not say the word correctly or give an answer within 3 seconds, the teacher, “no, let’s sound it out together”. together, they would repeat the procedure from the errorless learning component; stating the letter sounds, blending the sounds, and stating the word. the word was returned to the table to be practiced again. this continued until dorothy read all cards on the table independently, without error correction. following the game, dorothy was presented with a sticker to put on her folder. stickers were provided contingent on participation, and not for word accuracy. 2.5.3 generalization once during baseline and once at the end of the study, dorothy was presented with a set of 30 cvc words (the 18 words targeted for intervention and 12 additional unknown cvc words) to read aloud to www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 4, 2021 5 published by scholink inc. assess word generalization. generalization sessions were identical to baseline and intervention assessment procedures. in addition, once during baseline and once at the end of the study dorothy was also presented with a bob book (maslen, 1999) and asked to read it aloud as best she could. 3. results overall, dorothy showed success across each set of words during the intervention phase (see figure 1), attaining 100% accuracy for all words in all sets. set a was unique in the sense that dorothy mastered two of the words during the baseline phase. after the baseline stabilized across all three sets of words, set a was introduced to intervention the following session. there was an immediate jump from two words read correctly to three words read correctly indicating the intervention had an immediate effect on her learning, reaching 100% accuracy on the 6th session of intervention. after dorothy showed 100% accuracy in reading the words of set a, set b was introduced to intervention the following session. after, the intervention was introduced, there was an immediate jump from 0% accuracy to 33% accuracy. the percentage of words read correctly for set b increased steadily until she showed 100% accuracy on the 5th session of intervention. in addition, dorothy maintained 100% accuracy in reading set a words throughout set b intervention. once dorothy reached 100% accuracy on set b words, intervention was introduced to set c. the data for set c showed an ascending trend, until all words met 100% accuracy during the 9th session of intervention. in addition, dorothy maintained 100% accuracy in reading set a and set b words throughout set c intervention. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 4, 2021 6 published by scholink inc. figure 1. the percentage correct in reading cvc words displayed in a single case multiple baseline design. each data series represents words read correctly during baseline, then intervention phases across one of three word lists www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 4, 2021 7 published by scholink inc. 3.1 generalization generalization data were collected to assess if the cvc reading skills dorothy learned during intervention would carry over to reading novel words. the first method used to assess generalization was presenting a set of 12 unknown cvc words (see table 1). during the baseline generalization probe dorothy correctly decoded 0 of the 12 new words (0%). at the post-intervention generalization probe dorothy correctly decoded four of those 12 new words (33%). a second method used to assess generalization was reading words in text. dorothy was asked to select a bob book (maslen, 1999) which included some of the words she learned during intervention, but mostly novel words. during the baseline generalization probe dorothy did not read any of the words in the book correctly. at the post-intervention generalization probe she correctly read aloud 43% of the words (33 words read correctly out the total 76 words). 3.2 social validity a 4-question social validity survey was read to dorothy at the end of the study to assess satisfaction with procedures and outcomes. dorothy was asked the following questions orally; her answers were recorded (in italics): 1) was reading practice fun? “yes, i love my words”. 2) do you want to continue learning words like this? “yes and i want to read books”. 3) are you going to keep reading on your own? “i don’t know if i can read on my own”. 4) do you think your friends would like to learn words like this? “only if they know their letters”. anecdotally, during the generalization phase, after reading the bob book (maslen, 1999), though somewhat challenging, she stated, “i want to read stories now”. 4. discussion in this study, dorothy, a 4-year old, was able to quickly master cvc words when participating in a simple and concise intervention package of errorless learning and a discrimination training game. of equal importance, once targeted cvc words were mastered at 100%, dorothy was able to generalize that knowledge to decode (a) novel cvc words and (b) words in an age-level appropriate book. assessing each sequential component of the intervention provides some analysis as to its effectiveness. first, the errorless learning trials provided dorothy with a correct model to the targeted letter name, corresponding letter sounds, and the cvc word. requiring dorothy to repeat the correct response after the teacher delivered the prompts guaranteed her correct response in the presence of the stimulus flashcard. the errorless learning component established an immediate history of success with each new target word. after errorless learning trials, the second intervention component, a discrimination training game provided dorothy the response opportunity to state independently the correct target letter name, letter sound, and cvc word when presented with the corresponding flashcard. the discrimination www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 4, 2021 8 published by scholink inc. training trials also provided corrective feedback for any correct (e.g., “yes the word is cat”), incorrect (“no, the correct word is cat, what is the word?”), or no response (“the correct word is cat, what is the word?”). this feedback provided labelled reinforcement to the correct student response, or the correct model for the dorothy to repeat if she responded incorrectly or not at all. each discrimination training game ended with dorothy stating the correct response in the presence of the corresponding flashcard. interventions such as these are brief, but effective in allowing students to be successful, even at an early age of four. additionally, the opportunity to work one-on-one with the teacher provided reinforcement for continued participation in this intervention. lastly, using repeated intervention sessions over time allowed dorothy to monitor her own learning. anecdotally, during intervention sessions, dorothy would talk about her struggles with specific words and letter sounds, as well as her successes with other words and letter sounds, both of which are necessary parts of the learning process. it is vital for teachers to acknowledge the eagerness or motivation that young children have to learn new information, and present the opportunities to challenge them in their learning. prior to the implementation of this study, dorothy indicated that she wanted to learn to read. dorothy’s motivation to learn to read may certainly have an effect on her academic engagement. teachers need to (a) be able to recognize the unique interests of children in their classroom, (b) structure academic opportunities to build upon those interests, (c) implement evidence-based strategies that increase student success, and more importantly, (d) create an overall educational environment that challenges their students, regardless of age. references adams, m. j. (1990). beginning to read. thinking and learning about print. cambridge, ma: mit press. belfiore, p. j. (2018). single subject experimental research: monograph. mercyhurst university publishing. erie, pa. ehri, l. (2005). development of sight word reading: phases and findings. in m. snowling, & c. humes (eds.), the science of reading: a handbook (pp. 135-154). malden, ma: blackwell. maslen, b. l. (1999). ok, kids. bob books. level a, set 2, book 7. ny: scholastic. national institute for literacy. (2008). developing early literacy: report of the national early literacy panel (pp. 1-231). jessup, md: national center for family literacy. national institute of child health and human development. (2000). report of the national reading panel: teaching children to read: an evidence-based assessment of the scientific research literature on reading and its implications for reading instruction. nih publication no. 00-4769). washington dc: u.s. government printing office of health publish no. 00-4754. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 4, 2021 9 published by scholink inc. saunders, k. j., johnston, m. d., & brady, n. c. (2000). identity matching of consonant-vowel-consonant words by prereaders. journal of applied behavior analysis, 33, 309-312. turan, f., & gul, g. (2008). early precursor of reading: acquisition of phonological awareness skills. educational science: theory and practice, 8, 279-284. wolf, g. m. (2016). letter-sound reading: teaching preschool children print-to-sound processing. early childhood education journal, 44, 11-19. children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 6, no. 3, 2023 www.scholink.org/ojs/index.php/ct 1 original paper teachers’ efforts and barriers to implementing empirically-based practices in addressing disability stigma rachel l. oates1* 1 university of delaware, school of education, newark, de, usa * rachel l. oates, university of delaware, school of education, newark, de, usa received: june 22, 2023 accepted: june 30, 2023 online published: july 15, 2023 doi:10.22158/ct.v6n3p1 url: http://dx.doi.org/10.22158/ct.v6n3p1 abstract stigmatization of students with disabilities leads to adverse long-term effects and teachers experience challenges implementing empirically-based practices to address this stigma. this study explored teachers’ efforts to address stigma in the classroom and barriers to implementing such efforts. the disability stigma perspectives and practice (dspp) survey was completed electronically by 330 teachers from a school district. descriptive analysis revealed that 90 percent of teachers reported attempts to address stigma, with social contact based practices being most frequently endorsed. additionally, descriptive analysis indicated that the most commonly reported barriers to implementing empirically-based practices to address stigma included constraints of time, materials, class size, and feeling overwhelmed. the implications of these findings for school psychologists, administrators, and educational institutions in providing the appropriate support for teachers to successfully implement strategies to reduce stigma are discussed. keywords disability stigma, inclusion, teacher support 1. introduction individuals with physical or mental disabilities are often targeted by public stigma in society, provoking a risk of self-stigma and other adverse effects as a result (adler & wahl, 1998; bell, long, garvan, & bussing, 2011; bellanca & pote, 2013; campbell, ferguson, herzinger, jackson, & marino, 2004; corrigan & penn, 1999; crisp, gelder, rix, meltzer, & rowlands, 2000; eisenman & tascione, 2002; gillespie-lynch, brooks, someki, obeid, shane-simpson, kapp, daou, & smith, 2015; segall, 2011; segall & campbell, 2012; ventieri, clarke, & hay, 2011; vogel, wade, & hackler, 2007). research has found overwhelming evidence for the presence of stigma towards individuals with disabilities, in the www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 2 published by scholink inc. general public, in childhood peer relationships, and specifically in schools (bellanca & pote, 2013; corrigan & penn, 1999; gillespie-lynch et al., 2015; katz et al., 2012; lee, 2014; segall, 2011; segall & campbell, 2012; ventieri et al., 2011; vogel et al., 2007; yu et al., 2016). this stigma presents as stereotyped beliefs, such as the perception that individuals with disabilities are dangerous, dysfunctional, unpredictable, unintelligent, incompetent, lazy, or noncontributing, which lead to prejudiced attitudes and discriminatory behaviors (corrigan & shapiro, 2010; ferrari, 2016; wahl, susin, kaplan, lax, & zatina, 2011). the literature on disability stigma in the general public provides abundant evidence for the existence and harmful effects of such stigma (adler & wahl, 1998; corrigan & penn, 1999; crisp et al., 2000; ventieri et al., 2011; vogel et al., 2007). for instance, this stigma was examined in a study conducted by crisp, gelder, rix, meltzer, and rowlands (2000). typically developing individuals were interviewed on their perceptions of common mental disabilities. this study revealed that the majority of respondents viewed individuals with disabilities negatively, maintained stereotypes of these individuals, and avoided talking to individuals with disabilities. research focusing on childhood specific stigma towards peers with disabilities reveals similarly negative cognitions, attitudes, and behaviors (bell et al., 2011; bellanca & pote, 2013; campbell et al., 2004; gillespie-lynch et al., 2015; ohan et al., 2013; segall & campbell, 2012). one such study conducted by ballanca and pote (2013) examined this stigma. children participating were asked to read a vignette about a child with attention deficit hyperactivity disorder (adhd), depression, or a learning disability or a vignette about a typically developing child. they were then surveyed about their attitudes toward the child in the vignette. findings showed that the children maintained more negative beliefs and attitudes towards the children with disabilities as compared to the typically developing child. another study conducted by campbell, ferguson, herzinger, jackson, and marino (2004) presented similar results. in this study, children watched videotapes of a child who engaged in typical behaviors and a child who engaged in behaviors characteristic of an individual with autism. when surveyed about their attitudes and behavioral intentions towards the children in the videotapes, the participants reported much more favorable attitudes and intentions towards the child engaging in typical behaviors as compared to the child displaying behaviors characteristic of autism. the development of school-based stigma of students with disabilities has also been a focus of research (chamberlain, kasari, & rotheram-fuller, 2007; eisenman & tascione, 2002; katz et al., 2012; lee, 2014; segall, 2011; yu et al., 2016). this school-based stigma is often manifested as peer victimization, bullying, and social alienation. one study conducted by yu, ostrosky, meyet, favazza, mouzourou, and van luling (2016) utilized teacher report to explore students’ relationships and attitudes towards peers with disabilities. results revealed that typically developing students tended to avoid peers with disabilities and often became upset or bothered by the behaviors of the children with disabilities. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 3 published by scholink inc. 1.1why is stigma important to understand? examining and understanding the processes of stigmatization, especially of individuals with disabilities is invaluable, as the presence or absence of this stigma has the potential to precipitate long-term outcomes (bell et al., 2011; corrigan et al., 2010; corrigan & shapiro, 2010; dunn, 2016; fellner, 2015; ludwikowski et al., 2009; ventieri et al., 2011; wahl et al., 2011). as eloquently explained by the former u.s. surgeon general, “stigma tragically deprives people of their dignity and interferes with their full participation in society” (u. s. department of health and human services, 1999). whereas the absence of stigma in individuals with disabilities has been found to lead to positive self-beliefs and developments of social ties to the community, the presence of stigma causes long-term negative outcomes, such as worsened prognosis for the disability itself, interference with treatment effects, worsened self-esteem and wellbeing, diminished social outlooks, decreased academic and professional achievements, and adverse influence on risks of incarceration and homelessness (bell et al., 2011; bellanca & pote, 2013; corrigan & penn, 1999; corrigan & shapiro, 2010; dorsey, mouzourou, park, ostrosky, & favazza, 2016; dunn, 2016; eisenman, pell, poudel, & pleet-odle, 2015; fellner, 2015; katz et al., 2012; ludwikowski et al., 2009; o’driscoll et al., 2012; vogel et al., 2010). the stigma of individuals with disabilities has been found to predict the course and impact of the disability both directly and through its influence on treatment (corrigan & shapiro, 2010; power & green, 2010; ludwikowski et al., 2009; vogel et al., 2007; vogel et al., 2010; vogel et al., 2013). abundant research has provided evidence of the harmful effects of stigma on individuals’ attitude toward treatments, such as counseling, psychiatric care, and other supports, as well as their likelihood to seek treatment, stay in treatment, and fully comply with such treatment (bell et al., 2011; corrigan & shapiro, 2010; esters, cooker, & ittenbach, 1998; ferrari, 2016; ludwikowski et al., 2009; mann & himelein, 2008; martin, j., 2010; murman et al., 2014; nasp, 2010; ohan et al., 2015; power & green, 2010; sirey, bruce, alexopoulos, perlick, raue, friedman, & meyers, 2001; ventieri et al., 2011; vogel et al., 2007; vogel et al., 2010; vogel et al., 2013; wahl et al., 2011; weisman et al., 2016). beyond the effects of the stigma towards individuals with disabilities, the literature labels specific negative attitudes towards individuals who seek treatment as help-seeking stigma, which is defined as the perception that people who seek treatment are undesirable or socially unacceptable (ludwikowski et al., 2009). studies have consistently found support for the adverse effects of stigma on treatment (murman et al., 2014; vogel et al., 2007; vogel et al., 2010). the effects of both public and self-stigma on attitudes towards treatment and willingness to seek treatment were revealed in a study conducted by vogel, wade, and hackler (2007). based on the analysis of student survey responses, findings determined that perceptions of public stigma influenced self-stigma, which effected attitudes toward treatment, which then impacted willingness to seek treatment (vogel et al., 2007). this relationship is presented in figure 1, drawn from the 2007 study conducted by vogel, wade, and hackler. these findings were replicated in a similar study conducted by vogel, shechtman, and wade (2010) focusing www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 4 published by scholink inc. on group counseling as the treatment in question. another study conducted by sirey, bruce, alexopoulos, perlick, raue, friedman, and meyers (2001) revealed parallel effects of stigma on treatment. individuals who were newly admitted to treatment were surveyed about their perception of public stigma and their treatment compliance was tracked over time. results indicated that the participants who perceived greater stigma were more likely to withdrawal from treatment early. the literature presents ample empirical indication of the detrimental impact of stigma on confidence, self-esteem, self-efficacy, and overall wellbeing (bell et al., 2011; chen & schwartz, 2012; corrigan et al., 2010; corrigan & penn, 1999; corrigan & shapiro, 2010; dorsey et al., 2016; mann & himelein, 2008; martin, j., 2010; wahl et al., 2011; weisman et al., 2016). these adverse effects arise in part from the influence of discrimination, social alienation, and victimization resulting from the stigma, which lead to discouragement and damage self-esteem (chen & schwartz, 2012; wahl et al., 2011). another explanation of this process is suggested in a theorized self-fulfilling prophesy influence known as the “why try effect”. specifically, it is suggested that when individuals believe and internalize stigma, they discontinue attempts to succeed and become convinced that they are unable to achieve their goals, thus diminishing their self-esteem and self-efficacy (corrigan & shapiro, 2010). social rejection is another great risk for individuals targeted by stigma (bell et al., 2011; bellanca & pote, 2013; chen & schwartz, 2012; corrigan & penn, 1999; dorsey et al., 2016; katz et al., 2012; ventieri et al., 2011; wahl et al., 2011; weisman et al., 2016). in some cases, the discriminatory behavior caused by the stigma of individuals with disabilities is then compounded by symptomatic social and emotional impairments, making social isolation an even larger risk (bellanca & pote, 2013; dorsey et al., 2016). studies have found that children with disabilities are bullied in school at alarming rates, with some finding that as many as ninety-four percent of students with disabilities are bullied each year (chen & schwartz, 2012). this social isolation and lack of peer relationships may lead to many other risk factors in education, employment, and emotional development (chen & schwartz, 2012; corrigan & penn, 1999; ventieri et al., 2011). stigmatization is known to adversely affect individuals’ academic and professional achievement (bell et al., 2011; chen & schwartz, 2012; corrigan et al., 2010; corrigan & penn, 1999; corrigan & shapiro, 2010; dorsey et al., 2016; katz et al., 2012; mann & himelein, 2008; martin, j., 2010; morrow, hubbard, & swift, 2014; o’driscoll et al., 2012; ventieri et al., 2011; weisman et al., 2016). in particular, individuals targeted by stigma and associated discriminatory behavior are more likely to experience academic failure, less positive school attitudes, increased problem behavior, more suspensions, worse attendance, and higher retention rates (chen & schwartz, 2012; dorsey et al., 2016; katz et al., 2012; morrow et al., 2014; o’driscoll et al., 2012; weisman et al., 2016). moreover, perceived public stigma has been shown to decrease the likelihood that students disclose their disabilities to teachers in later education, precluding them from receiving necessary supports in class (martin, 2010). the experienced stigma as well as this diminished academic achievement then www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 5 published by scholink inc. negatively impact professional outlook by increasing risk of unemployment, discrimination in the workplace, and interference with goals at work (bell et al., 2011; corrigan et al., 2010; corrigan & penn, 1999; corrigan & shapiro, 2010; mann & himelein, 2008; o’driscoll et al., 2012; ventieri et al., 2011). finally, discrimination and diminished employment rates resulting from stigma may harm housing options and increase risk of delinquency and incarceration frequency and duration (bell et al., 2011; mann & himelein, 2008; o’driscoll et al., 2012). however, preventing public and self-stigma from early in an individual’s childhood would effectively reduce the risk of these many negative outcomes, as well as increase the incidence of positive self-beliefs and social connections (dunn, 2016; eisenman, et al., 2015). the positive effects of successful efforts to maximize acceptance of students with disabilities were demonstrated in a study conducted by eisenman, pell, poudel, and pleet-odle (2015). students with disabilities in an inclusive high school who were interviewed about their experiences in this study specifically described how the acceptance of peers and teachers improved their confidence and self-beliefs. clearly, the abundant detriments to individuals targeted by stigma contrasted with the positive effects of increasing acceptance provides evidence for the necessity to thoroughly understand the development of stigma in order to effectively combat its impact on those effected. 1.2 empirically-based practices to increase acceptance in the classroom research provides evidence of the critical nature of implementing empirically-based practices to increase acceptance of students with disabilities in the classroom (fellner, 2015; katz et al., 2012; murman et al., 2014; segall & campbell, 2012; staniland & byrne, 2013; weisman et al., 2016). these practices should be preventative, multi-tiered, and promote inclusion, understanding, solidarity, social acceptance, and respect for all people (chen & schwartz, 2012; dorsey et al., 2016; fellner, 2015; katz et al., 2012). teachers should protect students with disabilities from teasing and bullying both because of their responsibility to create a safe, educational environment, as well as the research support for the greater relative effectiveness of acceptance efforts run by teachers in school for children at a young age (bellanca & pote, 2013; mcauliffe, hubbard, & romano, 2009; segall & campbell, 2012; staniland & byrne, 2013; ventieri et al., 2011; weisman et al., 2016). the literature supports three primary methods of increasing acceptance in the classroom: education, social contact, and advocacy or protest (corrigan & penn, 1999; corrigan & shapiro, 2010; ferrari, 2016). education based methods teach students about disabilities, characteristics and treatment, and how to approach individuals with disabilities. empirically based educational methods may include explicit educational programs, programs integrated into the curriculum, educational videos, fiction or non-fiction books, or theater productions (salinger, 2020). social contact based methods involve interaction with individuals with disabilities to reduce stigma. some research suggests that social contact may be most effective in increasing acceptance and maintaining the impact long-term (corrigan & shapiro, 2010; ferrari, 2016; mann & himelein, 2008; staniland & byrne, 2013). social contact www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 6 published by scholink inc. may involve direct social contact with peers or adults with disabilities, or indirect or vicarious social contact involving video narratives about experiences with disabilities, written narratives by people with disabilities, descriptions about personal relationships with individuals with disabilities, or discussions of well-known figures with disabilities (salinger, 2020). finally, advocacy or protest methods reduce stigma through involvement in student clubs or organizations to increase awareness or acceptance of disabilities, school-wide movements to increase acceptance, or organized protests of stigma or discrimination within the community or through publications (salinger, 2020). each of these strategies may take on various forms, an understanding of which enables schools to suggest the most appropriate for use by their teachers. 1.2.1 school-wide initiatives practices to increase acceptance of students with disabilities may also be implemented at the school-wide level through anti-stigma or anti-bullying campaigns, organizations, or behavior support systems. school wide campaigns may contest stigma of individuals with disabilities by focusing on increasing acceptance of behavioral or emotional difficulties, mental health issues, or seeking professional help (anti-defamation league, 2017; bear, witcomb, elias, & blank, 2015; best buddies international, 2017; mha, 2017; ministry of education, 2012; pacer center, inc., 2016; southern poverty law center, 2017; the department of safe schools, 2017). research has found that these types of large-scale advocacy campaigns are effective in decreasing stereotypes (corrigan & penn, 1999). many school-based campaigns also work through the provision of factual information about disabilities to decrease stigma through the improvement of accurate understandings of disabilities (corrigan & penn, 1999; corrigan & shapiro, 2010; lequia, 2015; mann & himelein, 2008). for instance, the #ok2talk initiative changes the dialogue about mental illness in the school, home, and community, while also providing prevention and early intervention resources in schools (geisler, heidlberg, & van velsor, 2014; mha, 2017). similarly, the it’s ok to get help! campaign implements education and awareness methods to decrease the stigma of seeking professional help for disabilities or mental health issues (mha, 2017). other school-wide campaigns focus more generally on improving peer acceptance or decreasing bullying on a broader scale. the no place for hate initiative, for example, aims to create unified, inclusive school settings by empowering students, teachers, and parents to stand against bias and bullying (anti-defamation league, 2017). another school-wide campaign to increase acceptance is the teaching tolerance operation, which provides classroom and school-wide resources for this purpose (southern poverty law center, 2017; the department of safe schools, 2017; the school district of palm beach county, 2017). additionally, schools may endorse national or international awareness campaigns, such as the national bullying prevention month, which provides education to prevent bullying, and pink shirt day, an international unified movement to take a stand against bullying (ministry of education, 2012; pacer center, inc., 2016; the school district of palm beach county, 2017; thompson, 2017). www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 7 published by scholink inc. school based organizations focusing on increasing acceptance are also effective in reducing stigma, as types of empirically-based advocacy or protest methods (corrigan & penn, 1999; corrigan & shapiro, 2010; cramer, 2015; ferrari, 2016; murman et al., 2014). several of these groups focus specifically on decreasing disability stigma, and may also work through the incorporation research based education or social contact practices (corrigan & penn, 1999; corrigan & shapiro, 2010; lequia, 2015; mann & himelein, 2008; park & chitiyo, 2011; staniland & byrne, 2013). for instance, the best buddies program promotes inclusion and acceptance of students with intellectual disabilities by pairing them with typically developing peers to facilitate shared activities, experiences, and social participation (best buddies international, 2017; hardman & clark, 2006). mpower for teens, a high school level student organization, reduces stigma of mental health issues by providing education on these issues, involving specialists in the field in discussions and projects, and facilitating community service initiatives to benefit individuals with mental health issues (mha, 2017). alternatively, student led organizations may focus on contesting bullying in general. the safe school ambassadors (ssa) program, for example, recruits students in grades four to twelve who have been identified as confident, motivated, and socially aware leaders to combat social exclusion, bullying, and peer mistreatment in their schools (the department of safe schools, 2017; the school district of palm beach county, 2017). behavioral support systems may also increase acceptance of all students by improving school climate to create socially safe learning environments (bear, 2010; bear et al., 2015; emmer & sabornie, 2015; harrison & thomas, 2014). the school-wide positive behavior support (swpbs) system in particular supports social, academic, and behavioral competence through the implementation of school-wide targeted interventions. swpbs emphasizes the importance of data based decision making, systems change, and empirically-based practices (bear, 2010; bear et al., 2015; emmer & sabornie, 2015; harrison & thomas, 2014; the department of safe schools, 2017; the school district of palm beach county, 2017). likewise, the social emotional learning (sel) approach works towards students’ long-term social and emotional capabilities through the employment of explicit social emotional education, promotion of positive school climate, and provision of opportunities for contributory service (bear, 2010; bear et al., 2015; emmer & sabornie, 2015; harrison & thomas, 2014). although these behavioral support systems have much broader and wide reaching aims, research shows that effective implementation increases acceptance of all students (bear, 2010; bear et al., 2015; emmer & sabornie, 2015; harrison & thomas, 2014). considering these research based school-wide initiatives, it is evident that there are many practices to increase acceptance of students with disabilities that may take place outside the classroom in addition to those within. 1.3 barriers to implementing efforts to reduce stigma considering factors that may be preventing teachers from implementing efforts to reduce stigma of students with disabilities is necessary in developing supports for teachers for this purpose. based on research, one of the most commonly reported barriers to implementing efforts to reduce stigma is lack www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 8 published by scholink inc. of training, which decreases understanding of how to implement strategies and feelings of competency in this practice (bell et al., 2011; cramer, 2015; segall, 2011; weisman et al., 2016; yu et al., 2016). studies surveying teachers about their training found that seventy-seven to ninety-nine percent of teachers report a desire for more training on working with students with disabilities (bell et al., 2011). another frequently cited barrier is lack of administrative support for using resources to reduce stigma (lee, 2014; segall, 2011; segall & campbell, 2012; weisman et al., 2016; yu et al., 2016). this may also preclude teachers from obtaining the necessary in-service training and resources to implement such interventions. other regularly noted barriers include lack of time or resources, difficulties with logistics, overabundance of responsibilities, programs that are difficult to sustain, difficulties with student engagement and behavior, and lack of teacher motivation (dorsey et al., 2016; lee, 2014; weisman et al., 2016; yu et al., 2016). by understanding these barriers, supports may be developed to encourage and enable teachers to employ evidence based strategies to reduce stigma in their classes. 2. method 2.1 research questions 2.1.1 research question 1: employment of empirically-based practices the frequency of teachers’ use of empirically-based practices to increase acceptance of students with disabilities in the classroom is known to be scarce (cramer, 2015; segall, 2011; weisman et al., 2016; yu et al., 2016). however, measures corresponding to the most updated research on strategies to reduce stigma are lacking. in order to fully understand the present classroom conditions teachers establish, it was imperative to gather an accurate estimate of their use of empirically-based practices. it was predicted that all teachers would report using at least one method of attempting to address stigma in the classroom in the past year, although not all would report an empirically-based practice. this research question was answered by analyzing frequency tables generated from teachers’ reports of their use over the past year of strategies to increase acceptance in their classrooms. 2.1.2 research question 2: barriers to implementation commonly reported barriers to implementing efforts to increase acceptance in the classroom include lack of training, administrative support, time, or resources, difficulties with logistics, overabundance of responsibilities, programs that are difficult to sustain, difficulties with student engagement and behavior, and lack of teacher motivation (bell et al., 2011; cramer, 2015; dorsey et al., 2016; lee, 2014; segall, 2011; segall & campbell, 2012; weisman et al., 2016; yu et al., 2016). the previous research on this topic was not related to increasing acceptance of students with disabilities in particular and may be somewhat outdated. for these reasons, gaining an understanding of the most frequently reported barriers could enable recommendations to be made in supporting teachers in implementing empirically-based practices to address stigma of these students. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 9 published by scholink inc. based on the literature, it was predicted that the most commonly reported barriers to implementing empirically-based practices to increase acceptance of students with disabilities would be lack of training, administrative support, and time. this research question was answered through descriptive analysis of teachers’ responses to items on their experienced barriers to addressing stigma. 2.2 participants three hundred and thirty teachers, including 169 from the elementary level and 161 from the secondary level, were surveyed about their attempts to address stigma and barriers to addressing stigma to conduct the analyses necessary to answer the research questions for this study. based on an a priori power analysis completed using g*power 3.1 software with overall power set to 0.80 and an anticipation of a medium effect size (cohen’s [1988] f = .25), a sample size of at least ninety six participants was required to answer the research questions (faul, erdfelder, buchner, & lang, 2009). the intended sample size was larger to ensure more accurate results. the participants were recruited through a large school district in south florida, with the approval of the appropriate district officials. current demographic information on the teaching workforce was obtained and effort was made to approximate these demographics in the participant sample in order to increase the external validity of the findings. the demographics of the participants are presented in table 1 and with the results. the eligibility criteria for the participants included individuals who currently work in schools as classroom teachers at the elementary, middle, or high school level. consent forms were presented as an access step to the survey measure. the consent procedures were followed as required for research with human subjects by the university of delaware institutional review board and the school district department of research and evaluation. table 1. demographic characteristics of participants and teaching workforce pilot study participants research study participants teaching workforce a characteristic n % b n % b n (in thousands) % b total 142 100 330 100 3,385 100 gender female 116 82 269 82 2,584 76 male 25 18 59 18 802 24 other 1 1 2 1 0 0 age 20-39 59 42 135 41 1,497 44 40-59 63 44 162 49 1,632 48 www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 10 published by scholink inc. 60 or more 12 8 30 9 256 8 did not provide 9 6 3 1 0 0 ethnicity/race white 108 76 268 81 2,773 82 black or african american 12 9 31 9 231 7 american or alaska native 1 1 1 0 17 1 asian or asian american 1 1 3 1 61 8 multiracial 9 6 13 4 35 1 other 11 8 14 4 0 0 highest degree high school diploma 0 0 1 0 0 0 associate’s degree 1 1 1 0 128 4 bachelor’s degree 64 45 172 52 1,350 40 master’s degree 69 49 136 41 1,614 48 specialist’s degree 3 2 9 3 257 8 doctorate degree 5 3 11 3 37 1 years of teaching experience 1-9 47 33 123 37 1,433 43 10-20 60 42 125 38 1,232 36 more than 20 35 25 82 25 720 21 grades taught elementary 61 43 169 51 1,726 51 secondary 81 57 161 49 1,659 49 a the figures provided for the “teaching workforce” were located in a report published by the national center for education statistics (nces, 2016). b percentages are rounded to the nearest number and therefore may not add to 100. c these figures were not provided in the nces report. 2.3 measures the disability stigma perspectives and practice (dspp) survey measure was developed and pilot tested in a previous, related study (oates, 2023). the five-part questionnaire focused on teachers’ personal attitudes towards students with disabilities, recognition of public stigma, attempts to address stigma, barriers to addressing stigma in the classroom, and background information. responses from the first and fourth scales were utilized to answer the research questions in the current study. 2.4 procedure institutional review board approval was obtained prior to data collection. permission was then obtained www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 11 published by scholink inc. from the governing body of the school district to recruit their members for this study. information about the study and invitations to participate were distributed through email to the members of the participating school district. the email invited potential participants to use an included link to participate in the survey via the online survey software qualtrics or to contact the researchers with any questions. consent forms were included in the online survey as an access step to the survey measure. respondents were asked to complete each survey measure involved in the study. analyses were conducted through a series of statistical tests run on the spss and mplus software to answer the research questions. 2.5 data analysis the demographic characteristics of the participants used in the pilot study were compared to those of the respondents used to answer the research questions to ensure consistency and generalizability. prior to addressing the research questions, differences in responses from elementary as compared to secondary teachers were examined. data was analyzed by level, as significant differences were apparent. to answer the first question on attempts to address stigma in the classroom, frequency tables were run to examine how commonly empirically-based practices were used and which were most usually implemented. the second research question on barriers to implementing empirically-based practices to reduce stigma was answered using descriptive analysis. this was conducted with participants’ responses to the fourth scale. 3. results 3.1 employment of empirically-based practices frequencies of reported employment of empirically-based practices for increasing acceptance in the classroom are displayed in table 2, both by teacher level and combined totals. of the 330 teachers, 297 (90%) reported using at least one method of attempting to address stigma in the prior year. nearly all of these indicated use of at least one empirically-based practice (293, 89%). the non-empirically-based practices include those written in as responses to the “other” item that do not align with any empirically-based practice or include enough information to make a determination, such as “bullying,” “provide information in students’ home language with disability if home language is other than english,” and “setting goals for an activity, day, or period of time.” on average, teachers used 6.70 empirically-based practices from the twenty-three listed on the survey measure. the most commonly implemented practices overall included facilitating meaningful contact between students with and without disabilities (201, 61%) and facilitating peer support methods in the classroom between students with and without disabilities (196, 59%). conversely, the least commonly implemented practices included plays or puppet shows (22, 7%), watching video taped first person narratives (21, 8%), and organization of clubs to increase awareness of disabilities (29, 9%) or to support those with disabilities (32, 10%). www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 12 published by scholink inc. reported use of empirically-based practices from each of the three primary types, education, social contact, and advocacy, was also examined. overall, teachers most commonly implemented educational practices (269, 82%), followed by social contact practices (267, 81%), and then advocacy practices (83, 25%). teachers were also asked about school-wide practices to address stigma, as well as their involvement in these activities. the most commonly reported school-wide practices included school-wide positive behavior supports (227, 69%), pink shirt day (192, 58%), national bullying prevention month (175, 53%), safe school ambassadors (76, 23%), and best buddies (70, 21%). the majority of teachers (235, 71%) reported some involvement in some school-wide practice to address stigma or bullying. correlational analysis revealed that the presence of school-wide practices was significantly associated with teachers’ attempts to address stigma in their own classrooms (rpb = .169, p = .002), such that teachers were more likely to implement attempts to address stigma in their classroom if there were school-wide practices in place as well. furthermore, teachers’ degree of involvement with such school-wide practices was significantly related to their use of empirically-based practices in their own classrooms (rpb = .342, p = .001), in that teachers were more likely to implement attempts to address stigma in their own classrooms if they were more involved in school-wide practices. table 2. reported use of empirically-based practices for addressing stigma elementary teachers secondary teachers total practices n % n % n % total 169 100 161 100 330 100 facilitate meaningful social contact between students with and without disabilities 114 68 87 54 201 61 facilitate peer support methods in the classroom between students with and without disabilities 106 63 90 56 196 59 providing typically developing students with strategies and skills to work with students with disabilities 98 58 69 43 167 51 ensure that assistants in the classroom are viewed as support for whole class, not individual students 96 57 71 44 167 51 teaching about strengths and difficulties of students with disabilities 95 56 59 37 154 47 openly share about personal experience with an 76 45 64 40 140 42 www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 13 published by scholink inc. individual with a disability discussing myths and facts about disabilities 74 44 62 39 136 41 fictional books involving characters with disabilities 104 62 22 14 126 38 originally developed lesson(s) focusing on disabilities 66 39 52 32 118 36 embedding mental health awareness into curriculum (i.e. teach about disability as form of diversity in social studies, read and discuss literature about disabilities in language arts, etc.) 57 34 50 31 107 32 discuss celebrities known to have disabilities 51 30 42 26 93 28 non-fiction books on disabilities 75 44 11 7 86 26 discussions or q & a with an individual with a disability 44 26 38 24 82 25 packaged curriculum to educate students about disabilities 36 21 28 17 64 19 reading first person narratives by individuals with disabilities 43 25 17 11 60 18 videos on disabilities 38 23 22 14 60 18 discussions about videos on disabilities 33 20 21 13 54 16 involve students in advocacy campaigns for disability 23 14 23 14 46 14 facilitate a week dedicated to anti-stigma 27 16 17 11 44 13 organize or lead club to support those with disabilities 13 8 19 12 32 10 organize or lead club to increase awareness about disabilities 10 6 19 12 29 9 watching video taped first person narratives by individuals with disabilities 16 10 11 7 27 8 plays or puppet shows about disabilities 18 11 4 3 22 7 3.1.1 elementary teachers ninety-three percent (157) of elementary teachers reportedly implemented at least one method of attempting to address stigma. similarly, 92% (156) of elementary teachers used at least one empirically-based practice. elementary teachers used on average 7.77 empirically-based practices from the twenty-three listed. the most commonly implemented practices for elementary teachers included facilitating meaningful contact between students with and without disabilities (114, 68%) and facilitating peer support methods www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 14 published by scholink inc. in the classroom between students with and without disabilities (106, 63%). the least commonly implemented practices included organization of clubs to increase awareness of disabilities (10, 6%) or to support those with disabilities (13, 8%), and watching video-taped first person narratives (16, 10%). in terms of the types of empirically-based practices, elementary teachers most commonly implemented educational practices (152, 90%), followed by social contact practices (146, 86%), and then advocacy practices (44, 26%). for elementary teachers, the most commonly reported school-wide practices to address stigma included school-wide positive behavior supports (125, 74%), pink shirt day (104, 62%), and national bullying prevention month (93, 55%). the majority of teachers (132, 78%) reported some involvement in some school-wide practice to address stigma or bullying. correlational analysis revealed that the presence of school-wide practices was significantly associated with teachers’ attempts to address stigma in their own classrooms (rpb = .177, p = .021), such that teachers were more likely to implement attempts to address stigma in their classroom if there were school-wide practices in place as well. teachers’ degree of involvement with such school-wide practices was also significantly related to their use of empirically-based practices in their own classrooms (rpb = .244, p = .001), in that teachers were more likely to implement attempts to address stigma in their own classrooms if they were more involved in school-wide practices. 3.1.2 secondary teachers eighty-seven percent (140) of secondary teachers used at least one method of attempting to address stigma, a slightly lower percent than elementary teachers. comparably, 85% (137) of secondary teachers implemented at least one empirically-based practice. secondary teachers used 5.58 empirically-based practices of the twenty-three listed on average. results showed a statistically significant difference between elementary and secondary teachers on reported quantity of implemented empirically-based practices to address disability stigma (t = 3.95, df [327], p = .001). the effect size was medium (d = .44). the most commonly implemented practices for secondary teachers included facilitating peer support methods in the classroom between students with and without disabilities (90, 56%) and facilitating meaningful contact between students with and without disabilities (87, 54%4). conversely, the least commonly implemented practices for included plays or puppet shows (4, 3%), watching video-taped first person narratives (11, 7%), and non-fiction books on disabilities (11, 7%). the most commonly implemented types of empirically-based practices by secondary teachers were social contact practices (121, 75%), followed by educational practices (117, 73%), and then advocacy practices (39, 24%). for secondary teachers, the most commonly reported school-wide practices to address stigma included school-wide positive behavior supports (102, 63%), pink shirt day (88, 55%), and national bullying prevention month (82, 51%), best buddies (62, 39%), and safe school ambassadors (51, 32%). the www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 15 published by scholink inc. majority of teachers (91, 57%) reported some involvement in some school-wide practice to address stigma or bullying. correlational analysis revealed that the presence of school-wide practices was significantly associated with teachers’ attempts to address stigma in their own classrooms (rpb = .165, p = .037), such that teachers were more likely to implement attempts to address stigma in their classroom if there were school-wide practices in place as well. furthermore, teachers’ degree of involvement with such school-wide practices was significantly related to their use of empirically-based practices in their own classrooms (rpb = .388, p = .001), in that teachers were more likely to implement attempts to address stigma in their own classrooms if they were more involved in school-wide practices. 3.2 barriers to implementing empirically-based practices mean values of endorsed barriers to implementing empirically-based practices for increasing acceptance in the classroom are displayed in table 3, both by teacher level and combined. overall, the most highly endorsed barriers included lack of time to implement interventions (m = 4.87, sd = 1.92), lack of time to create interventions (m = 4.78, sd = 1.89), class size (m = 4.76, sd = 2.03), and lack of materials to use with students (m = 4.63, sd = 1.92). the least endorsed barriers included thinking interventions would not work (m = 2.95, sd = 1.86), lack of administrative support (m = 3.45, sd = 2.05), lack of communication/support from school psychologist (m = 3.55, sd = 1.91), and ineffectiveness of previous  interventions suggested (m = 3.59, sd = 1.83). responses were also analyzed by the factors of lack of training, lack of resources, and other barriers, as indicated by the factor analysis. overall, lack of resources was most highly endorsed (m = 4.67, sd = 1.75), followed by lack of training (m = 3.91, sd = 1.72), and then other barriers (m = 3.83, sd = 1.47). table 3. barriers to implementing empirically-based practices for addressing stigma elementary teachers secondary teachers total barriers mean sd mean sd mean sd factors lack of resources 4.76 1.67 4.57 1.83 4.67 1.75 lack of training 3.88 1.61 3.93 1.83 3.91 1.72 other barriers 3.71 1.43 3.95 1.51 3.83 1.47 lack of time to implement intervention 4.93 1.88 4.80 1.96 4.87 1.92 lack of time to create intervention 4.86 1.83 4.68 1.96 4.78 1.89 class size 4.37 2.06 5.17 1.93 4.76 2.03 www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 16 published by scholink inc. lack of materials to use with students 4.77 1.84 4.48 1.99 4.63 1.92 lack of time to investigate intervention possibilities 4.75 1.87 4.41 2.06 4.58 1.97 lack of time to analyze stigma 4.51 1.82 4.48 2.00 4.50 1.91 overwhelmed or exhausted from teaching duties 4.40 1.99 4.49 2.22 4.45 2.11 demands to perform nonteaching duties 4.25 2.01 4.29 2.09 4.27 2.04 lack of training on evidence-based interventions 3.99 1.84 4.19 1.93 4.09 1.88 lack of training on stigma of children with disabilities 3.86 1.82 4.07 2.02 3.96 1.92 lack of communication with parents 3.78 1.91 4.02 2.06 3.90 1.98 lack of training on research procedures 3.95 1.78 3.82 1.99 3.89 1.89 lack of training on reading and understanding research 3.72 1.74 3.66 1.97 3.69 1.85 inability of students to benefit from regular instruction 3.59 1.85 3.76 1.91 3.67 1.88 severity of stigma 3.60 1.83 3.73 1.89 3.66 1.86 ineffectiveness of previous interventions suggested 3.55 1.77 3.36 1.89 3.59 1.83 lack of communication/support from school psychologist 3.37 1.79 3.75 2.02 3.55 1.91 lack of administrative support 3.36 2.06 3.55 2.03 3.45 2.05 think intervention will not work 2.82 1.78 3.09 1.93 2.95 1.86 3.2.1 elementary teachers for elementary teachers, the most highly endorsed barriers to implementing empirically-based practices to address stigma included lack of time to implement interventions (m = 4.93, sd = 1.88), lack of time to create interventions (m = 4.86, sd = 1.83), lack of materials to use with students (m = 4.77, sd = 1.84), and lack to time to investigate intervention possibilities (m = 4.75, sd = 1.87). the least endorsed barriers included thinking interventions would not work (m = 2.82, sd = 1.78), lack of administrative support (m = 3.36, sd = 2.06), lack of communication/support from school psychologist (m = 3.37, sd = 1.79), and ineffectiveness of previous  interventions suggested (m = 3.55, sd = 1.77). lack of resources was the most highly endorsed factor by elementary teachers (m = 4.76, sd = 1.67), followed by lack of training (m = 3.88, sd = 1.61), and then other barriers (m = 3.71, sd = 1.43). www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 17 published by scholink inc. 3.2.2 secondary teachers for secondary teachers, the most highly endorsed barriers to implementing empirically-based practices to address stigma included class size (m = 5.17, sd = 1.93), lack of time to implement interventions (m = 4.80, sd = 1.96), and lack of time to create interventions (m = 4.68, sd = 1.96). the least endorsed barriers included thinking interventions would not work (m = 3.09, sd = 1.93), ineffectiveness of previous interventions suggested (m = 3.36, sd = 1.89), and lack of administrative support (m = 3.55, sd = 2.03). lack of resources was the most highly endorsed factor by secondary teachers (m = 4.57, sd = 1.83), followed by other barriers (m = 3.95, sd = 1.51), and then lack of training (m = 3.93, sd = 1.83). 4. discussion the purpose of the current study was to examine the influences on teachers’ attempts to address disability stigma in the classroom. such stigma had been shown to negatively affect children in numerous varied ways and research had provided support for empirically-based practices to reduce it within the classroom. however, evidence had also been found that teachers often were not implementing such practices. two research questions were addressed in the present study. the first question further assessed the extent to which teachers employ empirically-based practices to address stigma in the classroom. the second question examined the barriers preventing teachers from implementing such practices in their classrooms. 4.1 employment of empirically-based practices it was hypothesized that all teachers would report using at least one practice to attempt to address stigma, although not all teachers would report implementing an empirically-based practice. frequency analysis revealed that for each grade level set, approximately 90% of teachers (87% for secondary and 93% for elementary teachers) reported using at least one practice in their classroom to attempt to address stigma, whereas roughly 89% (85% for secondary and 92% for elementary teachers) implemented at least one empirically-based practice. this is consistent with prior findings that every teacher does not implement empirically-based practices in the classroom (cramer, 2015; segall, 2011; weisman et al., 2016; yu et al., 2016). however, greater percentages of teachers than predicted did report implementing these practices. this study serves as an examination of teachers’ use of empirically-based practices specifically to address disability stigma, as previous studies did not provide information about practices for this purpose in particular. furthermore, the present study adds to the body of knowledge on teachers’ use of empirically-based practices to address disability stigma by providing information on frequency of implementation of specific types of practices. although research had suggested that advocacy based practices were the least commonly used (corrigan & penn, 1999; corrigan & shapiro, 2010; murman et al., 2014), the specific practices and comparison between social contact and educational practices was uncertain. the www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 18 published by scholink inc. current study was consistent with the literature proposing that advocacy practices are the least commonly implemented. additionally, it revealed that the most frequently implemented practices involved social contact, through meaningful contact within the classroom and peer support methods between students with and without disabilities. fortunately, research has suggested that social contact may be the most effective type of practice to reduce disability stigma (corrigan & shapiro, 2010; ferrari, 2016; mann & himelein, 2008; staniland & byrne, 2013). another significant finding on use of empirically-based practices to address stigma was that the presence of school-wide efforts for this purpose, as well as teachers’ increased involvement in these efforts, made them significantly more likely to implement these practices in their own classrooms. this finding held constant for all grade levels and aligns with research on the positive influence of school-wide initiatives on school climate, and in turn, on classroom climate (bear, 2010; bear et al., 2015; emmer & sabornie, 2015; harrison & thomas, 2014). in other words, school-wide initiatives increase positive school climate, which is characterized by supportive student teacher relationships, reduced behavior problems, and high academic achievement (bear, 2010). this improved and more supportive atmosphere both directly improves classroom climate and also encourages teachers to further support their students. based on the additional evidence from this study, it may be ascertained that an effective way to increase efforts to address stigma in the classroom may be to begin at the school level. 4.2 barriers to implementation it was hypothesized that the most commonly reported barriers to implementing empirically-based practices to address disability stigma would be lack of training, administrative support, and time. descriptive analyses revealed that for the overall sample, the elementary sample, and the secondary sample, the highest endorsed barriers included all of the items involving a lack of time, as well as those detailing class size, lack of materials, and being overwhelmed from teaching duties. the presence of the factor of lack of time among the most frequently endorsed barriers is consistent with the literature (yu et al., 2016). additionally, the impeding effects of class size, lack of materials, and overabundance of responsibilities have been suggested by previous research (dorsey et al., 2016; lee, 2014; weisman et al., 2016; yu et al., 2016). however, it was interesting that these barriers were more highly endorsed than the barriers of lack of training and administrative support, which were predicted to be among the most endorsed. this may be due to progress in these areas in recent years that may not have been captured in prior publications (bell et al., 2011; campbell, 2012; cramer, 2015; segall, 2011). therefore, these findings from the current study provide additional, updated information that may be drawn upon in efforts to decrease barriers for teachers to implementing empirically-based practices to address stigma in the classroom. 4.3 implications for practice the findings from the present study on implementation and barriers to using empirically-based www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 19 published by scholink inc. practices to address stigma have several practical implications for school psychologists, administrators, and educational institutions. the results from the analysis of the types of empirically-based practices already being used by teachers provide implications for future practice in the school setting. in particular, teachers reported the most implementation of several social contact based practices to address stigma. these practices, which have been found to reduce stigma by challenging stereotypes and attitudes through first person interactions, have been identified in some studies as the most effective method to combat stigma (corrigan & penn, 1999; dunn, 2016; ferrari, 2016; mann & himelein, 2008). due to this previous research and the findings from the present study, school psychologists and administrators should consider simply encouraging the continued use of these practices. additionally, the school psychologist could guide teachers to discuss with one another how social contact is already being used in their classrooms in order to inspire the remaining teachers to implement these types of efforts. the school psychologist may also explain to teachers, either through professional development or individualized consultation, how to further build on the use of social contact practices by adjusting or adding elements of education or advocacy efforts as well, in order to further contest disability stigma. this focus on social contact efforts should be balanced with additional information on alternative, effective strategies of addressing stigma through educational or advocacy efforts. additional implications for school practice may be drawn from the findings on school-wide initiatives to increase acceptance and their association with teachers’ use of additional practices in their classrooms. prior research has also demonstrated the affirmative effect of school-wide initiatives on positive school climate, which in turn affects classroom climate and practices (bear, 2010; bear et al., 2015; emmer & sabornie, 2015; harrison & thomas, 2014). therefore, implementing school-wide initiatives or advocacy efforts would benefit students both directly by improving student teacher relationships, creating a supportive community, and cultivating social emotional development, and indirectly by increasing teachers’ use of further efforts to increase acceptance in their classrooms. these school-wide efforts may include clubs or school-wide campaigns, such as school-wide positive behavior supports, pink shirt day, national bullying prevention month, safe school ambassadors, or best buddies, aimed at reducing stigma and stereotypes of individuals with disabilities or those who are diverse in any nature. although these initiatives should be supported by the administration and school psychologist, engaging teachers in the leadership may further improve their attempts to increase acceptance in their own classrooms, based on the findings in the present study that the level of teacher involvement in school-wide campaigns is related to their use of practices within their classrooms. examination of teachers’ reported barriers to implementing efforts to address stigma provides further implications for school based practice. this analysis revealed that the constraints of time, limited materials, class size, and feelings of being overwhelmed were barriers to attempting to address stigma in the classroom, consistent with the literature (dorsey et al., 2016; lee, 2014; weisman et al., 2016; www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 20 published by scholink inc. yu et al., 2016). school psychologists and administration should provide support to teachers in overcoming these barriers. specifically, professional development led by school psychologists or other experts could help teachers by providing specific examples of how to address disability stigma through education, social contact, or advocacy based practices to prevent teachers from having to spend the time researching empirically-based practices themselves. these sessions could also aid teachers in understanding how to incorporate attempts to address stigma into their class schedule without adding any time burden. for instance, the teachers could integrate instruction about disabilities and related stigma into their already existing subject curriculums (dunn, 2016; eisenman & tascione, 2002; nasp, 2010; ventieri et al., 2011; watson, otey, westbrook et al., 2004; weisman et al., 2016). additionally, professional development sessions could be used as a time to explain how large class sizes may be used as an advantage in this case, by providing opportunities for social contact practices during already scheduled group work for example (corrigan & penn, 1999; dunn, 2016; ferrari, 2016; mann & himelein, 2008). in leading the professional development, the school psychologist could also distribute ready to use materials for implementing empirically-based practices in the classroom or provide information about how to obtain these materials easily and without financial encumbrance. these materials could include curriculums for explicit educational programs for this purpose, such as the special friends or breaking the silence curriculums (dorsey et al., 2016; meyer & ostosky, 2016; wahl et al., 2011; weisman et al., 2016; yu et al., 2016), books on disabilities or guidelines on selecting effective books to utilize to reduce stigma (gaffney & wilkins, 2016), practitioner articles that serve as ready to use instructions of how to apply empirically-based practices, or guidebooks for clubs or advocacy efforts, such as the let’s erase the stigma (lets) organization (murman et al., 2014). as some of these materials may need to be purchased, administration should consider the vast benefits in investing for this critical need. finally, the school psychologist should make him or herself available to teachers following the professional development session in order to support their personalization or implementation of empirically-based practices for their classes through continued consultation (martin, h., 2010; salas & cannon-bowers, 2001). by providing instruction on practices to reduce disability stigma, guidelines on how to overcome time or class size constraints, materials to use in implementing practices, and sustained, individualized support to teachers, the school psychologist may also help teachers to overcome the barrier of feeling overwhelmed by the prospect of engaging in these practices in addition to the more tangible obstacles that each suggestion targets. 4.4 limitations of the study there are some limitations of the current study in terms of the sample, data collection methods, and factors examined. specifically, the sample was collected from a single school district and although examination of the demographic characteristics revealed similarities to the teaching workforce across the country, this may still limit the generalizability of the results. moreover, the low response rate, which may have been due to the distribution of the survey through email, could affect the www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 21 published by scholink inc. generalizability of the results. additionally, the sampling method may have led to a selection bias in that teachers who may have more negative attitudes towards individuals with disabilities or who do not attempt to address stigma in their classrooms may not have responded to the survey. this may further impact the generalizability of the findings, as a specific subset of the population may have been unintentionally excluded from the sample. the data collection methods utilized in the current study may also serve as a limitation. although teachers were asked in the survey to recall and report which practices they had used to address stigma in the past year in their classrooms, they were not actually followed over the course of this year. therefore, teachers may have over or under reported their use of practices due to simple fault of memory. alternatively, collecting the data in a longitudinal manner in which teachers were asked to record their use of practices as they were implemented may have provided a more accurate representation of use. additionally, employing surveys as the data collection method, rather than observation or interview, may have caused a response bias whereby teachers may have tended to over report their use of empirically-based practices in an effort to appear more conscientious. these methods may have therefore affected the validity of the results. 4.5 conclusions the findings of the current study provide information about teachers’ present use of empirically-based practices to address disability stigma in the classroom and barriers to the employment of these research based practices. the majority of teachers already attempt to address stigma in some way and almost all use at least one empirically-based practice. several of the social contact based practices are the most frequently implemented by teachers. additionally, the most salient barriers teachers experience to implementing empirically-based practices to contest stigma include the constraints of time, materials, class size, and feeling overwhelmed. overall, this study revealed that there are distinct factors that may be utilized to understand teachers’ attempts to address stigma. this finding is critical as this information may be applied by school psychologists, administrators, and educational institutions to develop plans to support teachers across the country in efforts to increase acceptance of individuals with disabilities in order to affect vast improvement for the academic, social, and emotional outcomes of countless students. acknowledgement the preparation of this manuscript was part of the author’s doctoral dissertation. therefore, she would like to acknowledge her dissertation committee chair, dr. marika ginsburg-block, as well as her dissertation committee members, dr. laura eisenman, dr. ratna nandakumar, and dr. julie hubbard. this work was supported by the university of delaware school of education phd student dissertation support award and the florida association of school psychologists research award. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 22 published by scholink inc. references adler, a. k., & wahl, o. f. (1998). children’s beliefs about people labeled mentally ill. american journal of orthopsychiatry, 68(2), 321-326. anti-defamation league. (2017). no place for hate. retrieved from https://www.adl.org/who-we-are/our-organization/signature-programs/no-place-for-hate bear, g. g. (2010). school discipline and self-discipline: a practical guide to promoting prosocial student behavior. new york, ny: guilford press. bear, g. g., witcomb, s. a., elias, m. j., & blank, j. c. (2015). sel and schoolwide positive behavioral interventions and supports. in j. durlak, t. gullotta, c. domitrovich, p. goren, & r. weissberg (eds.), handbook of social and emotional learning. guilford press. bell, l., long, s., garvan, c., & bussing, r. (2011). the impact of teacher credentials on adhd stigma perceptions. psychology in the schools, 48(2), 184-197. bellanca, f. f., & pote, h. (2013). children’s attitudes towards adhd, depression and learning disabilities. journal of research in special educational needs, 13(4), 234-241. best buddies international. (2017). best buddies friendship programs. retrieved from https://bestbuddies.org/what-we-do/friendship/ campbell, j. m., ferguson, j. e., herzinger, c. v., jackson, j. n., & marino, c. a. (2004). combined descriptive and explanatory information improves peers’ perceptions of autism. research in developmental disabilities, 25, 321-339. chamberlain, b., kasari, c., & rotheram-fuller, e. (2007). involvement or isolation? the social networks of children with autism in regular classrooms. journal of autism and developmental disorders, 37, 230-242. chen, p., & schwartz, i. s. (2012). bullying and victimization experiences of students with autism spectrum disorders in elementary schools. focus on autism and other developmental disabilities, 27(4), 200-212. cohen, j. (1988). statistical power analysis for the behavioral sciences (2nd ed.). hillsdale, nj: lawrence erlbaum associates, inc. corrigan, p. w., morris, s., larson, j., rafacz, j., wassel, a., michaels, p., wilkniss, s., batia, k., & rusch, n. (2010). self-stigma and coming out about one’s mental illness. journal of community psychology, 38(3), 259-275. corrigan, p. w., & penn, d. l. (1999). lessons from social psychology on discrete psychiatric stigma. american psychologist, 54(9), 765-776. corrigan, p. w., & shapiro, j. r. (2010). measuring the impact of programs that challenge the public stigma of mental illness. clinical psychology review, 30, 907-922. cramer, e. (2015). shifting least restrictive environments in a large urban school district. journal of urban learning teaching and research, 11, 40-49. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 23 published by scholink inc. crisp, a. h., gelder, m. g., rix, s., meltzer, h. i., & rowlands, o. j. (2000). stigmatisation of people with mental illnesses. the british journal of psychiatry, 177, 4-7. dorsey, e. a., mouzourou, c., park, h., ostrosky, m. m., & favazza, p. c. (2016). teacher perceptions of two multi-component interventions: disability awareness and science. topics in early childhood special education, 36(2), 103-114. dunn, d. s. (2016). teaching about psychosocial aspects of disability: emphasizing person–environment relations. teaching of psychology, 43(3), 255-262. eisenman, l. t., pell, m. m., poudel, b. b., & pleet-odle, a. m. (2015). “i think i’m reaching my potential”: students’ self-determination experiences in an inclusive high school. career development and transition for exceptional individuals, 38(2), 101-112. eisenman, l.t., & tascione, l. (2002). “how come nobody told me?” fostering self-realization through a high school english curriculum. learning disabilities research & practice, 17(1), 35-46. emmer, e. t., & sabornie, e. j. (eds.). (2015). handbook of classroom management (2nd ed.). new york, ny: routledge. esters, i. g., cooker, p. g., & ittenbach, r. f. (1998). effects of a unit of instruction in mental health on rural adolescents’ conceptions of mental illness and attitudes about seeking help. adolescence, 33(130), 469. faul, f., erdfelder, e., buchner, a., & lang, a.-g. (2009). statistical power analyses using g*power 3.1: tests for correlation and regression analyses. behavior research methods, 41, 1149-1160. fellner, g. (2015). the problem is education not “special education”. cultural studies of science education, 10, 1089-1101. ferrari, a. (2016). using celebrities in abnormal psychology as teaching tools to decrease stigma and increase help seeking. teaching of psychology, 43(4), 329-333. gaffney, m., & wilkins, j. (2016). selecting picture books featuring characters with autism spectrum disorder: recommendations for teachers. international journal of inclusive education, 20(10), 1024-1031. geisler, j., heidlberg, s., & van velsor, s. (2014). ok2talk: using tumblr to give youth a voice to discuss mental illness. paper presented at the national conference on health marketing and media, atlanta, ga. gillespie-lynch, k., brooks, p. j., someki, f., obeid, r., shane-simpson, c., kapp, s. k., daou, n., & smith, d. s. (2015). changing college students’ conceptions of autism: an online training to increase knowledge and decrease stigma. journal of autism and developmental disorders, 45, 2553-2566. hardman, m. l., & clark, c. (2006). promoting friendship through best buddies: a national survey of college program participants. mental retardation, 44(1), 56-63. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 24 published by scholink inc. katz, j., porath, m., bendu, c., & epp, b. (2012). diverse voices: middle years students’ insights into life in inclusive classrooms. exceptionality education international, 22(1), 2-16. lee, j. (2014). predictors of teachers’ intention to refer students with adhd to mental health professionals: comparison of u.s. and south korea. school psychology quarterly, 29(4), 385-394. lequia, j. (2015). social acceptance of students with significant disabilities by general education peers in inclusive elementary school settings (doctoral dissertation). university of wisconsin-madison, madison, wi. ludwikowski, w. m., vogel, d., & armstrong, p. i. (2009). attitudes toward career counseling: the role of public and self-stigma. journal of counseling psychology, 56(3), 408-416. mann, c. e., & himelein, m. j. (2008). putting the person back into psychopathology: an intervention to reduce mental illness stigma in the classroom. social psychiatry and psychiatric epidemiology, 43, 545-551. martin, h. j. (2010). improving training impact through effective follow-up: techniques and their application. journal of management development, 29(6), 520-534. martin, j. m. (2010) stigma and student mental health in higher education. higher education research & development, 29(3), 259-274. mcauliffe, m. d., hubbard, j. a., & romano, l. j. (2009). the role of teacher cognition and behavior in children’s peer relations. journal of abnormal child psychology, 37, 665-677. meyer, l. e., & ostosky, m. m. (2016). impact of an affective intervention on the friendships of kindergarteners with disabilities. topics in early childhood special education, 35(4), 200-210. meyers, l. s., gamst, g., & guarina, a. j. (2006). applied multivariate research: design and interpretation. thousand oaks, ca: sage. mha. (2017). mental health association of palm beach county, inc. retrieved from http://www.mhapbc.org/ ministry of education. (2012). pink shirt day. retrieved from http://www.erasebullying.ca/resources/resources-pink-shirt.php morrow, m. t., hubbard, j. a., & swift, l. e. (2014). relations among multiple types of peer victimization, reactivity to peer victimization, and academic achievement in fifth-grade boys and girls. merrill-palmer quarterly, 60(3), 302-327. murman, n. m., buckingham, k. c., fontilea, p., villanueva, r., leventhal, b., & hinshaw, s. p. (2014). let’s erase the stigma (lets): a quasi-experimental evaluation of adolescent-led school groups intended to reduce mental illness stigma. child youth care forum, 43, 621-637. nasp. (2010). children’s mental health promotion and support: strategies for educators. bethesda, md: williams, b. b., boyle, k., white, j. m., & sinko, a. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 25 published by scholink inc. national center for education statistics. (2016). digest of education statistics, 2015 (nces publication no. 2016-014). washington, dc. oates, r. l. (2023). disability stigma perspectives and practice survey: predicting teacher efforts to improve acceptance. current research in psychology and behavioral science, 4(2). o’driscoll, c., heary, c., hennessy, e., & mckeague, l. (2012). explicit and implicit stigma towards peers with mental health problems in childhood and adolescence. journal of child psychology and psychiatry, 53(10), 1054-1062. ohan, j. l., ellefson, s. e., & corrigan, p. w. (2015). brief report: the impact of changing from dsm-iv “asperger’s” to dsm-5 “autistic spectrum disorder” diagnostic labels on stigma and treatment attitudes. journal of autism and developmental disorders, 45, 3384-3389. ohan, j. l., visser, t. a., moss, r. g., & allen, n. b. (2013). parents’ stigmatizing attitudes toward psychiatric labels for adhd and depression. psychiatric services, 64(12), 1270-1273. pacer center, inc. (2016). national bullying prevention month. retrieved from http://www.pacer.org/bullying/nbpm/ park, m., & chitiyo, m. (2011). an examination of teacher attitudes towards children with autism. journal of research in special educational needs, 11(1), 70-78. power, m. j., & green, a. m. (2010). the attitudes to disability scale (ads): development and psychometric properties. journal of intellectual disability research, 54(9), 860-874. salas, e., & cannon-bowers, j. a. (2001). the science of training: a decade of progress. annual review of psychology, 52, 471-99. salinger, r. (2020). empirically based practices to address disability stigma in the classroom. journal of applied school psychology, 36(3), 324-345. segall, m. j. (2011). exploring student and teacher variables relating to inclusion of students with autism spectrum disorder in general education classrooms (doctoral dissertation). university of georgia, athens, ga. segall, m. j., & campbell, j. m. (2012). factors relating to education professionals’ classroom practices for the inclusion of students with autism spectrum disorders. research in autism spectrum disorders, 6, 1156-1167. sirey, j. a., bruce, m. l., alexopoulos, g. s., perlick, d. a., raue, p., friedman, s. j., & meyers, b. s. (2001). perceived stigma as a predictor of treatment discontinuation in young and older outpatients with depression. american journal of psychiatry, 158, 479-481. southern poverty law center. (2017). teaching tolerance. retrieved from http://www.tolerance.org/ staniland, j. j., & byrne, m. k. (2013). the effects of a multi-component higher-functioning autism anti-stigma program on adolescent boys. journal of autism and developmental disorders, 43, 2816-2829. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 3, 2023 26 published by scholink inc. the department of safe schools. (2017). safe schools. retrieved from https://www.palmbeachschools.org/safeschools/ the school district of palm beach county. (2017). the 2017 wellness annual report. retrieved from https://www.palmbeachschools.org/wppannualreport/bullying/ thompson, k. d. (2017, february 20). wear pink, stop a school bully in palm beach county. palm beach post. retrieved from http://wpbc.blog.palmbeachpost.com/2017/02/20/wear-pink-stop-a-school-bully-in-palm-beach-co unty/ u. s. department of health and human services. (1999). mental health: a report of the surgeon general—executive summary. rockville, md: u. s. ventieri, d., clarke, d. m., & hay, m. (2011). the effects of a school-based educational intervention on preadolescents' knowledge of and attitudes towards mental illness. advances in school mental health promotion, 4(3), 5-17. vogel, d. l., bitman, r. l., hammer, j. h., & wade, n. g. (2013). is stigma internalized? the longitudinal impact of public stigma on self-stigma. journal of counseling psychology, 60(2), 311-316. vogel, d. l., shechtman, z., & wade, n. g. (2010). the role of public and self-stigma in predicting attitudes toward group counseling. the counseling psychologist, 38(7), 904-922. vogel, d. l., wade, n. g., & hackler, a. h. (2007). perceived public stigma and the willingness to seek counseling: the mediating roles of self-stigma and attitudes toward counseling. journal of counseling psychology, 54(1), 40-50. wahl, o. f., susin, j., kaplan, l., lax, a., & zatina, d. (2011). changing knowledge and attitudes with a middle school mental health education curriculum. stigma research and action, 1(1), 44-53. watson, a. c., otey, e., westbrook, a. l., gardner, a. l., lamb, t. a., corrigan, p. w., & fenton, w. s. (2004). changing middle schoolers’ attitudes about mental illness through education. schizophrenia bulletin, 30(3), 563-572. weisman, h. l., kia-keating, m., lippincott, a., taylor, z., & zheng, j. (2016). mental health stigma prevention: pilot testing a novel, language arts curriculum-based approach for youth. journal of school health, 86(10), 709-716. yu, s., ostrosky, m. m., meyer, l. e., favazza, p. c., mouzourou, c., & van luling, l. (2016). using teacher impression journals to improve intervention effectiveness. topics in early childhood special education, 35(4), 245-255. children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 1, no. 1, 2018 www.scholink.org/ojs/index.php/ct 63 original paper the boy who wouldn’t eat pomegranates (an attention-deficit hyperactivity disorder, adhd, allegory) anthony a. zehetner1,2* 1 adolescent medicine unit, the children’s hospital at westmead, sydney, australia 2 faculty of medicine and health, the university of sydney school of medicine, sydney, australia * anthony a. zehetner, adolescent medicine unit, the children’s hospital at westmead, sydney, australia received: april 30, 2018 accepted: may 15, 2018 online published: may 24, 2018 doi:10.22158/ct.v1n1p63 url: http://dx.doi.org/10.22158/ct.v1n1p63 abstract an allegorical vignette describing the pathway of diagnosis and treatment of controversial societal disorders which may exist in children, using attention-deficit hyperactivity disorder (adhd) as an example and template. the child’s perspective is described as well as potential pitfalls of the “therapeutic” process beyond simple clinical modalities. finally the impact of such practice is questioned at a societal level and is made relevant to our contemporary understanding of medicine. keywords attention-deficit hyperactivity disorder (adhd), bias, categorical, diagnosis, diagnostic and statistical manual of mental disorders (dsm-5), dimensional, evidence-based medicine, misdiagnosis, oppositional defiant disorder (odd) 1. introduction in the following article, please read the text first, ignoring descriptors contained within brackets “[]”. a recent study of american physicians (peckham, 2016) found those aged over 46 years reported that biases affect patient treatment negatively; they offer less time and are less friendly. for physicians aged 45 years or younger, the reverse holds, with biases resulting in more positive patient interactions. as i approach that notational milestone, i ponder whether my clinical experiences improve or hinder my skills as a doctor. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 64 published by scholink inc. 2. method 2.1 diagnosis as a cultural concept critique and skepticism are essential elements in the practice of medicine. any theory is only as strong as its ability to withstand critical appraisal. in his divisive work (2014), craig newnes (retired editor of the journal of critical psychology, counseling and psychotherapy and director of psychological therapies for shropshire, uk) asks some uncomfortable questions. he asserts that under the aegis of scientism, “branding” (diagnostic labels and drugs) and the psy-complex professions; there lies much hypocrisy, self-interest and confusion. while some of it may be dismissed as a rant against the status quo, consumerism and his own professional identity, newnes challenges current mental health service provision, the “drive to prescribe” and reiterates the importance of culture and perspective in patient care. do you see what i see? 2.2 diagnostic and statistical manual of mental disorders (dsm-5) the doctor-patient relationship is inherently unbalanced, principally in the field of medical knowledge and the power of providing a diagnosis. the diagnostic and statistical manual of mental disorders (dsm-5, american psychiatric association, 2013) is the most widely accepted nomenclature used by clinicians and researchers for the classification of mental disorders. to be able to diagnose mental illness it is implied that one must have faith in one’s tools, yet many doctors do not (cassels, 2014). 2.3 case study, billy consider billy, the boy labeled as the “boy who wouldn’t eat pomegranates”. we might describe billy categorically as a pomegranate eater or not [has attention-deficit hyperactivity disorder, adhd, or not]; or in a dimensional context: he likes them sometimes [he can’t concentrate if he hasn’t had enough sleep and/or there is a lot of background activity or noise]. it might be that pomegranates are an accepted staple of societal diet and to not eat them is an anomaly (such as being a teetotaler in an alcohol-using society). there may be a push to consume them or buy them [fill a prescription]. at school, if all of the other kids are eating pomegranates, should you too (even if you don’t need to?) [societal “peer pressure”]. 3. result belonging is a basic human need. it drives our emotions and not fitting-in adversely affects one’s self-esteem, mood and daily functioning. many aspects of our lives are beyond our volitional control: genetics, intellectual ability, learning style, sensory preferences and personality trait(s). doctors might extol the nutritional, antioxidant and anti-inflammatory virtues of eating pomegranates [evidence-based medicine] and formulate dietary [read as adhd treatment] guidelines. since pomegranates are deemed to be so good to daily health and rated as “safe”, public health officials and/or politicians may consider supplementing them in other foods and even the water supply [public www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 65 published by scholink inc. health policy/population medicine]. if billy mentions that he is allergic or intolerant to pomegranates, some may not believe him and he risks being excluded and stigmatized [food allergies/intolerances]. why is he being so “difficult” against all of the “evidence” [moral objectors to immunization]? what makes billy so “special”? who is ostracising whom? maybe it’s all down to billy’s parents. they liked pomegranates when they were kids and grew up eating pomegranates so he should too. after all, they say that pomegranates never did them any harm [doctor’s personal perspective]! maybe billy doesn’t eat pomegranates now because he was force-fed them too often as a child? he probably will make his own mind up about them one day (like going to church and religion) but because he is not yet a “mature minor”, for now his parents have the right to decide what billy eats or not. billy doesn’t think that is fair—it’s his body after all, he counters. this antagonism means that billy is labeled with oppositional defiant disorder (odd). maybe he just doesn’t like the seeds? because billy refuses to cooperate and eat pomegranates at school, his teachers describe him as “disruptive” and requiring 1:1 attention. they suggest he sees a doctor. billy’s father is irritated by this and doesn’t think there is a problem. he feels the teacher should mind her own business. dad’s brother (billy’s paternal uncle) was just like this when he was billy’s age. billy’s mother is a little overwhelmed and mildly embarrassed as they didn’t have this problem with his siblings [again social stigma]. all this talk makes billy start to worry that there may be something wrong with him; like his sense of taste [vision] and smell [hearing] don’t work, but his parents had those tested and they were found to be normal. so what if he likes the taste of lychees [atypical, kinaesthetic learner] over pomegranates; many of his friends do too! he is told that he will see a specialist doctor [paediatrician] and will have the day off school. billy wonders if it matters whether the doctor he will see likes pomegranates or not [subjective specialist’s viewpoint]. the doctor can’t tell whether billy’s dislike for pomegranates is a genetic or environmental determinant. he could prescribe some pomegranate vitamins (so billy doesn’t have to eat the raw fruit) but his parents think this is an easy way out, too expensive, “unnatural” (“he is too young to be on medication” they cry) and doesn’t it just caters to his behaviour and not “fix” the problem? apparently they knew of a case where one child went on the tablets and now wouldn’t eat anything [adverse effects, making the matter worse]! grandma weighs in and says that she never had this problem in her day. “too few boundaries”, she chides and goes back to smoking [lack of personal insight into health determinants of others]. billy feels that smoking is worse than not eating pomegranates, but they don’t listen to him [often a child’s opinion and autonomy are correct but not factored into their health care decisions]. at school the bullying starts and people even throw a pomegranate at billy which splatters his clothes. the red juice looks like blood though it distracts people from noticing his tears. billy has never really www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 66 published by scholink inc. liked school or had anything against pomegranates, though some of his best friends do like them [spectrum of disorder severity and treatment tolerance]. the bullying does make billy feel sick in the mornings and he doesn’t attend some days [onset of secondary anxiety, possible treatment-related negative effects]. billy is taken to see another specialist [psychologist] who will perform taste-testing [psychometric assessments] to see if he has a “sensory deficit” or a “processing disorder”. most of the test samples taste similar to billy [imprecise testing process] and after a while he just chooses any answer to make the process end quicker [false-positive results]. one of billy’s friends has a totally different idea about what constitutes palatable food and yet they are both “diagnosed” with the same condition [predominantly inattentive and hyperactive-impulsive adhd have different phenotypes though are classified as the same disorder, adhd]! maybe the specialist’s test samples have gone out of date and need to be updated [revalidation]? maybe they used the asian umami sample during the consultation and not the australian (sweet, salty, bitter and sour) ones [population error]? there are other tests out there which are suggested billy should complete but they are very expensive [poor access to appropriate health care] and billy is not very interested [“assessment fatigue”]. his classmates keep asking why he is taken out of school so often [disruption to schooling due to frequent medical appointments and ostracisation]. as billy isn’t taking the pomegranate vitamin supplement (he tried them unwillingly for a few days but they “didn’t work”) [lack of appropriate treatment duration, e.g., three months with atomoxetine], the doctor wants to trial a medicine which will change the signals in his taste buds so that pomegranates are more palatable [restore “chemical imbalance”/neurotransmitter function]. billy would take these until he develops a taste for pomegranates on his own over time [pre-frontal cortex maturation with age]. it all sounds like the same thing to billy. so that he doesn’t have to go to more specialists and take medicines, billy agrees to start eating pomegranates [reluctant assent to therapy in children]. he is actually only pretending to and is secretly throwing them away [poor adherence to medication regimens in adolescence]. however the plan seems to be working as it gets his parents and teachers off his back and they all think that billy is now doing well [placebo effect]. maybe billy never needed to eat pomegranates in the first place [misdiagnosis] and should have just pretended to [societal conformity]? 4. discussion if you re-read the story, replacing adhd for not eating pomegranates and now substituting the descriptors contained within the brackets, the narrative “journey” and zeitgeist for the condition is paralleled. actually, any condition and treatment for which controversy and societal discord exist may be used, e.g., gluten-intolerance, lyme disease, autism spectrum disorder (asd), etc. the real tragedy is that billy is labeled as “the boy who wouldn’t eat pomegranates”, as if it was totally www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 67 published by scholink inc. his choice to act in that manner. rather it would have been more apt for billy to be referred to as “the boy who didn’t eat pomegranates” as that is a description of his behaviour and does not involve a judgment or value statement. as doctors age, we should continue to question the tenements, ideals and philosophy of the profession we have dedicated our lives to. we must ensure that we, and our patients, are open to new ideas and do not become “fussy eaters” [rejecters of new medical information which may be against accepted “norms”]. we must also respect that our tastes differ, as do those of the next generation. and we haven’t even mentioned the pomegranate sellers [big pharma]! references american psychiatric association. (2013). diagnostic and satistical manual of mental disorders (5th ed.). arlington, va: american psychiatric publishing. https://doi.org/10.1176/appi.books.9780890425596 cassels, c. (2014). one third of psychiatrists not using dsm-5. medscape. retrieved april 30, 2018, from http://www.medscape.com/viewarticle/830099 newnes, c. (2014). clinical psychology: a critical examination (1st ed.). ross-on-wye: pccs books. peckham, c. (2016). medscape lifestyle report 2016: bias and burnout. medscape. retrieved april 30, 2018, from http://www.medscape.com/features/slideshow/lifestyle/2016/public/overview microsoft word ct-v2n1-p60 children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 2, no. 1, 2019 www.scholink.org/ojs/index.php/ct 60 original paper the house of the little tooth diniz: an oral health educational project maria do rosário dias1*, letícia g. naben2, irene ventura3, sofia coroado4, viriato m. dias4 & sofia o. santos4 1 egas moniz university institute (iuem), faculty of psychology and educational sciences, university of lisbon, portuguese association of psychoanalytic psychotherapy and psychoanalysis & em-cimps/ciiem, monte da caparica, portugal 2 em-cimps & egas moniz university institute (iuem), monte da caparica, portugal 3 egas moniz university institute (iuem), university of seville, mimd–iuem, omd & em-cimps/ciiem, monte da caparica, portugal 4 em-cimps & egas moniz university institute (iuem), monte da caparica, portugal * maria do rosário dias, egas moniz university institute (iuem), faculty of psychology and educational sciences, university of lisbon, portuguese association of psychoanalytic psychotherapy and psychoanalysis & em-cimps/ciiem, monte da caparica, portugal received: march 7, 2019 accepted: march 18, 2019 online published: march 21, 2019 doi:10.22158/ct.v2n1p60 url: http://dx.doi.org/10.22158/ct.v2n1p60 abstract dental caries is currently one of the major public health problems, given its high incidence among 6-12-year-old children. this age group of children is considered a priority group, due to the transitional period of the replacement of deciduous teeth. this article intends to present a ludic-pedagogical instrument for oral health education, targeted at these children, based on the learning of problems related to oral health through a story narrative and associated pictograms. by means of a health education manual with several pictorial representations of dentistry clinical acts, we intended to imagetically reinforce the therapeutic adherence of children to paediatric dentistry as well as oral health prevention care, which are considered determinant factors for oral health success amongst children. the choice of a handbook format for this purpose was considered a health education pedagogical strategy with added value to the paediatric dentistry appointment setting, granting patients an active and leading role in their therapeutic path. the handbook can also be of use to younger children, through parental storytelling, establishing a dyadic communication between parents, educators and professionals. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 61 published by scholink inc. keywords pictograms, paediatric dentistry, oral health education, caries, deciduous teeth 1. introduction dental caries is currently one of the major public health problems, given its high incidence among children—45.2% in 6-12-year-old children (dgs, 2015), thus negatively affecting the quality of life and systemic health of individuals. this age group is considered a priority group, due to the transitional period of the replacement of deciduous teeth. in addition, this is also the time frame when the internalization of good life-lasting oral hygiene behaviours is more effective (dias, amorim, esteves, reis, & duque, 2006). nevertheless, the anticipatory fear associated to caries’ pain seems to discourage subjects from dental medicine appointments, in turn impeding preventive dental care strategies and contributing to a vicious cycle of permanent malaise (dias, amorim, duque, & guilherme, 2006; góes, domingues, couto, & barreira, 2010; marques, gradvohl, & maia, 2010; oliveira et al., 2012; dias, cruz, & martins, 2015; dias & martins, 2016). in a study carried out at the egas moniz university clinic (reis, dias, & leal, 2008), it is noteworthy that early first-time appointments in paediatric dentistry are a future determining variable of the therapeutic adherence to good oral hygiene behaviours in patients. according to this study, the early experience of neutral or positive experiences in the odontopaediatric therapeutic setting, may serve as a “neutralizing barrier”, preventing the development of future traumatic dental care experiences. as such, it is imperative to overcome the therapeutic obstacles found in paediatric dentistry hastily and with maximum effectiveness, in order to promote the early adoption of oral health education strategies. the use of pictograms as an oral health education pedagogical instrument is one of such strategies, (chernoff, 1973; magalhães, alvarenga, & nina-e-silva, 2013) aiming to promote the intrapsychic involvement of children’s playfulness, as well as their active participation in dental care, thus stimulating a selfcare routine behaviour (cook, 1971; dias, amorim, esteves, reis, & duque, 2006; reis, dias, & leal, 2008). furthermore, the use of ludic-pedagogical instruments in the oral health education of children allows for the expansion of symbolic thinking, which in turn supports the therapeutic relationship dentist-patient (dias, monteiro, naben, sobral, & neves, 2018). with the present paper, we intend to present an interactive handbook as an oral health education instrument. the playful narrative allows children to identify themselves to the characters present in the story, connecting the characters’ personal oral health experiences with their own (magalhães, alvarenga, & nina-e-silva, 2013). simultaneously, we intend to support the learning of relational and pedagogical communication strategies in the preand post-graduate training of paediatric dentistry health professionals, promoting the strengthening of the therapeutic alliance dentist-patient in future clinical practice. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 62 published by scholink inc. 2. method the main objective of the present oral health education handbook entitled “the house of the little tooth diniz” was the retelling of a story that symbolically illustrated possible clinical acts practiced in the paediatric dentistry appointment setting, as well as the revaluation of oral hygiene habits adopted by children. during the story’s retelling, patients should be able to identify themselves with the character by means of projective identification, thus relating to the character who leads the story (dias & simões, 2016). we also intended for this handbook to be used during periods that precede or proceed the dental care treatment act itself, as well as to engage parents as secondary patients regarding the oral health care provided to children (sarnat, arad, hanauer, & shohami, 2001; dias, monteiro, naben, sobral, & neves, 2018). chromatic and figurative contrasts were sought to create visually dynamic sensations and pictorial appeal in the handbook’s panels. in addition to the chromatic focus given to the panels, textured elements were added, with the goal of capturing children’s attention. in fact, touch invites sensorial contact, in turn leading to more archaic and sensorial intrapsychic mental representations. small “interactive highlights” were also created in panels’ layouts, which aimed to encourage children to interact with the handbook and to be attentive to the pictorial and symbolic plotting of the narrative. examples of such are: i) the story of dr. cobra, symbolically depicting the paediatric dentist as the traditional mutilating tooth puller (triggerring archaic fears in the children’s imaginary) (dias, amorim, duque, & guilherme, 2006); ii) the opening of the paediatric dentist’ office door in kinetic form; iii) the interaction of the plaque revealer and the use of translucid paper in the panel; iv) the tooth brush attached to velcro as a detailed explanation of the brushing technique; v) the shedding of deciduous teeth, symbolizing the first loss of a deciduous tooth by placing it in a small teeth box. 3. instrument’s description the target population of the present oral health education instrument were children of both genders, aged six to twelve years. in addition, this handbook was also aimed at parents, teachers and health educators as a secondary target population, due to their fundamental pedagogical role in children’s daily life, which makes them the social partners of choice in the implementation of oral health education strategies. the handbook’s leading character was a boy named simão, placed on its cover emphasizing an excessively open mouth (chernoff, 1973; magalhães, alvarenga, & nina-e-silva, 2013), in clear opposition to other elements of the face. in contrast, “diniz, the tooth”, a supporting character, was deliberately enlarged by the use of an intraoral reflecting mirror, symbolically attesting to its relevance in the story’s narrative (figure 1). www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 63 published by scholink inc. figure 1. handbook’s front cover in the handbook’s first panel we are invited to step inside “diniz, the tooth’s” house, the interior of the oral cavity, where much of the action takes place. here, the introduction of his tooth family is metaphorically highlighted, and each tooth given a name. the images and names given to deciduous teeth allow children to formulate an idea of the anatomical constitution of the dental arch, thus enabling an easy recollection of the teeth’ categorization. by resorting to teeth’s anthropomorphization, namely by drawing them with facial expressions that refer to basic human emotions, we intended to emphasize in children’s imagination teeth are with personalities and feelings, thus conferring a greater importance to their preservation and to good oral hygiene. in the handbook’s second panel entitled “the brushing hour”, simão’s facial expression clearly demonstrates his non-cooperative attitude towards tooth brushing, despite the anthropomorphic friendly expressions of the toothbrush and toothpaste (figure 2). www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 64 published by scholink inc. figure 2. handbook’s panel entitled “the brushing hour: facial expressions of simão towards dental hygiene” the handbook’s fourth panel points to the detrimental consequences of pathogenic eating (e.g., too much sugar). hence, in this panel the story’s villains emerged, destroying the oral cavity’s flora and allowing the development of dental caries in the dental arc (figure 3). figure 3. handbook’s panel entitled “the attack of the tooth puller: antropomorphized representation of tooth decay” www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 65 published by scholink inc. in the handbook’s fifth to tenth panels, “bia”, a secondary character, is introduced as a metaphorical proxy of the tongue. bia represents the voice of reason and the moral of the story, narrating the attack operated by the tooth puller to the dental family (figure 3) and emphasizing the role of cariogenic foods and poor oral hygiene in the destruction caused by dental caries. these panels attested to several passages of simão’s daily life, marked by the discomfort of dental pain, as well as by fear associated to the paediatric dentistry’s appointment (figure 4). the set of panels that depict the anxiogenic thoughts experienced by simão, refer to the somewhat intimidating unconscious ideas of children regarding a therapeutic setting experienced as unsettling and threatening. figure 4. handbook’s 7th panel entitled “dental nightmares: illustration of a child’s fears related to the perception of the dentist and of dental care’ instruments” the goal of the handbook’s panels 10 to 12 was to focus on a good oral hygiene, demonstrating the need of adequate tooth brushing. in fact, the dental arch may present at a first glance a clean and healthy appearance, which may not correspond to a real good oral hygiene. for this purpose, a dental plaque revealer is used, described playfully as a paint that reveals the teeth attacked by the tooth puller (the dental caries), as a children’s symbolic equivalent for “the moment of the truth” revealer (figure 5). indeed, technically speaking, the application of a dental plaque revealer exposes the dental plaque present in the oral cavity, denouncing poor oral hygiene. thus, in panel 10, a translucid paper which can be coloured by children was attached over the represented teeth, creating a visual image with different shades and textures associated to damaged teeth—thereby revealing the dental caries caused by the accumulation of harmful bacteria. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 66 published by scholink inc. figure 5. handbook’s 10th panel entitled “the moment of truth—dental plaque revealing moment” the handbook’s panel 11 entitled “turbine in action” aims to demonstrate the relevance of early intervention in dental care, which allows avoiding pain caused by dental plaque, while providing at the same time adequate aesthetics-asepsis (figure 6). this panel resorts to captivating pictorial playfulness, particularly by the rough textures of the panel’s materials (associated to the black holes caused by the existence of cavities in the teeth) and by panel’s protrusions (symbolizing turbine’s water droplets). once again, the anthropomorphization of pictograms was used, namely of the turbine and drill, which were drawn with friendly facial expressions, vigorous colours and imposing postures. in parallel, linguistic euphemisms were employed in the narrative, namely by adopting the term “water shower”; in fact, the use of water is associated to many dental care instruments, which may frighten children during dental treatment. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 67 published by scholink inc. figure 6. handbook’s 11th panel entitled “turbine in action—intervention of the dental instruments” due to the importance of the relational and pedagogical communication between the paediatric dentist and the children, in the handbook’s panel 12 entitled “new notification” the role of the dentist as a health educator was highlighted. here, the panel revealed greater narrative density in proportion to the drawing content and a dentist-patient dialogue via social media chat is simulated. characters are turned into “emojis”, expressing their emotions in the virtual world. the use of social media iconography in the present handbook presupposed a greater motivation for children’s digital content learning, since younger generations are strongly influenced by information technologies. the themes of the handbook’s panels 13 to 16 were strongly related to the shedding of deciduous teeth, reinforcing the concept that the way deciduous teeth are cared for will affect the good oral health of permanent teeth, in turn promoting self-preventive behaviours (dias, 2005; dias, amorim, esteves, reis, & duque, 2006) that aim to hinder future iatrogenic dental care habits. as an example, panel 14 entitled “waggling, waggling, falling out”, was based on the unconscious fear experienced by children related to the loss of the first deciduous tooth. here, we intended to show children what happens when a deciduous tooth falls out, thus appeasing a certain persecutory mourning and feelings of loss that may otherwise be experienced. we consider this to be a critical milestone in patients’ education, letting them know that deciduous teeth, despite falling out, are preceded by permanent teeth that can be maintained for the rest of life, given a correct oral hygiene (figure 7). www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 68 published by scholink inc. figure 7. handbook’s 14th panel illustrating the shedding of a deciduous tooth and its permanent tooth replacement finally, handbook’s panels 15 to 16 refer to children’s imaginary world and are centred on the tooth fairy myth. the tooth fairy is a symbolic character of folk mythology in numerous countries, stating that when children lose one of their baby teeth, they should place it underneath their pillow and the tooth fairy will visit while they sleep, replacing the lost tooth with a wish come true. ironically, the tooth fairy of this oral health education handbook does not correspond to the literary stereotypes (usually represented by a fragile and feminine creature) but is rather a robust character willing to tackle poor oral hygiene behaviours (figure 8). www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 69 published by scholink inc. figure 8. handbook’s 16th panel entitled “the tooth fairy” 4. results and discussion the present oral health education instrument entitled “the house of the little tooth diniz” arose from the urgent need to create educational play instruments resorting to pictograms with symbolic value, as a means of linking clinical acts practiced under dental care treatment to children’s imagination. the presence of several pictorial representations throughout the narrative course of this oral health education manual intended to imagetically reinforce the therapeutic adherence of children to paediatric dentistry, as well as to oral health prevention care, which are considered determinant factors for oral health prevention amongst children aged six to twelve years. in addition, the choice of a children’s literature handbook format for the present oral health education manual was considered an oral health education pedagogical strategy with added value to the paediatric dentistry appointment setting, granting the patient an active and leading role in their therapeutic path. although the target population is composed of subjects aged six to twelve years, this instrument can be extended to a larger target population, namely to younger children, who can benefit from interactive storytelling, in turn creating a dyadic communication bridge between parents, educators and health professionals. alternatively, younger children may also individually interact with the imagetic and visual reading of the pictograms, thus enabling their self-education concerning oral health care concepts. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 70 published by scholink inc. references chernoff, h. (1973). the use of faces to represent points in k-dimensional space graphically. journal of the american statistical association, 68(342), 361-368. https://doi.org/10.1080/01621459.1973.10482434 cook, m. (1971). interpersonal perception. harmondsworth: penguin education. dias, m. r. (2005). serão os mass media estrategas de saúde? lisboa: climepsi editores. dias, m. r., amorim, a., duque, a. f., & guilherme, n. (2006, september). the “masked” dentist in the therapeutic setting. proceedings of each—international conference of comunication in healthcare. basileia, suíça. dias, m. r., amorim, a., esteves, a., reis, m. f., & duque, a. f. (2006, september). tooth fairy myth: a project for child oral health education. proceedings of each—international conference of comunication in healthcare. basileia, suíça. dias, m. r., cruz, j. a., & martins, n. l. (2015). eu sou o favolas: um instrumento de educação para a saúde em dentisteria. journal of human growth and development, 25(3), 325-330. https://doi.org/10.7322/jhgd.106012 dias, m. r., & martins, n. (2016). contágio emocional de ansiedade encarregada de educação/criança em odontopediatria. revista portuguesa de estomatologia, medicina dentária e cirurgia maxilofacial, 57(3), 164-170. https://doi.org/10.1016/j.rpemd.2015.12.006 dias, m. r., & simões, n. p. (2016). on the mental representation of (un)healthy tooth: (un)healthy tooth profiles among children. journal of educational and developmental psychology, 6(1), 110-116. https://doi.org/10.5539/jedp.v6n1p110 dias, m. r., monteiro, a. l., naben, l., sobral, a., & neves, a. c. (2018). no consultório do odontopediatra: um manual de educação para a saúde oral. omnia, 8(3), 35-41. direção geral de saúde. (2015). iii estudo nacional de prevalência das doenças orais 6, 12, 18, 35-44 e 65-74 anos. retrieved october 26, 2018, from https://www.dgs.pt/documentos-e-publicacoes/iii-estudo-nacional-de-prevalencia-das-doencas-ora is.aspx góes, m. p. s., domingues, m. c., couto, g. b. l., & barreira, a. k. (2010). ansiedade, medo e sinais vitais dos pacientes infantis. odontologia clínico-científica, 9(1), 39-44. magalhães, l. m., alvarenga, l. f., & nina-e-silva, c. h. (2013). atribuição de emoções a traços faciais artificiais. revista da universidade vale do rio verde, 11(2), 462-469. https://doi.org/10.5892/ruvrd.v11i2.462469 marques, k. b. g., gradvohl, m. p. b., & maia, m. c. g. (2010). medo e ansiedade prévios à consulta odontológica em crianças do município de acaraú-ce. revista brasileira em promoção da saúde, 23(4), 358-367. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 71 published by scholink inc. oliveira, m. a., bendo, c. b., ferreira, m. c., paiva, s. m., vale, m. p., & serra-negra, j. m. (2012). association between childhood dental experiences and dental fear among dental, psychology and mathematics undergraduates in brazil. international journal of environmental research and public health, 9(12), 4676-4687. https://doi.org/10.3390/ijerph9124676 reis, f., dias, m. r., & leal, i. (2008). a consulta no setting odontopediátrico: a percepção subjectiva do medo. análise psicológica, 26(2), 239-250. https://doi.org/10.14417/ap.491 sarnat, h., arad, p., hanauer, d., & shohami, e. (2001). communication strategies used during pediatric dental treatment: a pilot study. pediatric dentistry, 23(3), 337-342. children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 2, no. 2, 2019 www.scholink.org/ojs/index.php/ct 89 original paper an analysis on mobile and interactive media use by young children: the good, the bad and the unknown carlene olivia fider1* & shey quinton olaoshebikan1 1 pacific oaks college, school of human development, pasadena ca 91103 * carlene olivia fider, pacific oaks college, school of human development, pasadena ca 91103 received: june 18, 2019 accepted: june 28, 2019 online published: july 5, 2019 doi:10.22158/ct.v2n2p89 url: http://dx.doi.org/10.22158/ct.v2n2p89 abstract the introduction of mobile media to children of very young ages continues to be a topic of discussion in many academic and professional circles. over time, the suggested guidelines specific to children and interaction with mobile and interactive technology have changed, yet there are still some unknowns regarding the impact of replacing actual human interaction with interactive devices. while there are certainly benefits to having children exposed to these forms of technology, there are potential drawbacks. this current opinion article seeks provide a narrative regarding current work that is related to children and their engagement with interactive technology. keywords mobile, media, interactive, children, play, cortisol, attachment, behavior 1. introduction with the increase in access to mobile media, radesky, schumacher, and zuckerman (2014) posit that there needs to be specific guidelines for children. in their article, the authors outline the good, the bad and the unknown of interactive media. “interactive media, on the other hand, allow for contingent responses to children’s actions and thus may facilitate more retention of taught material” (p. 1) state radesky, schumacher, and zuckerman (2014). in keeping with the benefits of such technology, radesky, schumacher, and zuckerman (2014) further indicate that “promising research suggests that interactive media such as learn-to-read apps and electronic books (e-books) may increase early literacy skills by providing practice with letters, phonics, and word recognition” (p. 1). based on these findings, one can clearly see the benefit of mobile media for children, yet there is another side to the use of technological innovation for children. radesky, schumacher, and zuckerman (2014) state that “…the use of mobile media to occupy young children www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 2, 2019 90 published by scholink inc. during daily routines such as errands, car rides, and eating out is becoming a common behavioral regulation tool: what the industry terms a ‘shut-up toy’” (p. 2). what we found interesting and want to provide some insight regarding relates to the statement that indicates that: because young children need to develop internal mechanisms of self-regulation, it needs to be determined whether mobile device use, although helpful in the short term, could be detrimental to later social-emotional outcomes when used as the principal way in which children are taught to calm themselves down (p. 2). this is the premise of this opinion piece. 2. discussion the world is changing. the way we communicate now and with whom we communicate has brought about swift changes thanks in part to mobile media. mobile media, while having its positive effects for and on young children, and can be linked to and with tactile functionality, neuropathway development, and such, can also have an impact on social/emotional regulation and development in this phase of life. if communication continues to be fortified more and more through media for children entering the schooling system, how foreign could the concept of human to human communication become? exposure theory lends its belief to the idea that the more we are engulfed in something, the more we are able to learn, utilize, and grow. however, we wonder if the levels of engagement of mobile and interactive media limits the engagement and exposure time a young child may be spending playing outside and engaging with others. children’s media diet should contain open-ended, hands-on, imaginary, screen-free play. children have access to a lot of passive entertainment, yet, there is little engagement in play that is active and that which is fueled by their imagination, which gives then opportunities to develop social, emotional, and cognitive skills that are necessary for a successful and fulfilling life. the brain of a child is primed to receive and process information. this naturally extends to information provided my mobile media. when children are born, the primitive portions of their brain are capable of responding based on reflexes. as the child grows older, the brain begins to navigate more complex tasks and overtime; behaviors become less reflective and more intentional. the higher regions of the brain, the cortex, are responsible for purposeful behaviors and as such, are impacted by the use of technology. there is a wealth of knowledge that a child can obtain from technological innovation, and this information impacts the ways in which their brains process data. at birth, the number of synapses per neuron is about 2,500, but by age two or three; it’s about 15,000 per neuron. as these synapses are formed, the brain’s ability to create pathways that will store, recall and reproduce information becomes easier and more evident. the more often an event occurs, the more likely it is that the brain pathways www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 2, 2019 91 published by scholink inc. related to that event will become stronger resulting in the behavior becoming more fluid. this suggests that early life events have a huge influence on the pattern of brain architecture as well as behavioral development. when taking in to account mobile devices and children, the more they engage, the less they are to be interacting with others which has the potential to impact their social skills. research suggests that cortisol levels increase and self-regulation is easier navigated when children carry safety blankets, or toys/animals. these types of practices involving such objects is dwindling, and we are now using mobile media (cell phones, tablets, etc.) to emotionally regulate heightened emotional states. the question that we continue to ponder is how and in what ways will this be shaping future generations? attachment principles have often been linked to something that feels good through touch, now stimulation through interactive media is serving as a form of replacement. what new behaviors may be replaced with this change in how our children are now spending their time? 3. conclusion the realities of mobile media and artificial intelligence is just that; artificial. the complexities of human behavior are often ones that continue to baffle us into early and late adulthood, a concept that people often continue to struggle to grasp. at what point are we causing a hindrance to a skill set we have yet to master (communication with others) by shifting the focal point of communication to interaction with artificial intelligence? while technology continues to advance, we have seen media and its evolution become able to master something we all struggle to figure out—ourselves, our emotions, and how we engage with others. play has often been the principle behind learning, but what we’re playing with and how we play with it is a step in a direction we have yet to truly understand. reference radesky, j., schumacher, j., & zuckerman, b. (2014). mobile and interactive media use by young children: the good, the bad, and the unknown. pediatrics, 135(1), 1-3. https://doi.org/10.1542/peds.2014-2251 children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 2, no. 1, 2019 www.scholink.org/ojs/index.php/ct 13 original paper child rape in nigeria, implications on the education of the child maria charity agbo1* 1 department of educational psychology, federal college of education, eha-amufu, enugu state, nigeria * maria charity agbo, department of educational psychology, federal college of education, eha-amufu, enugu state, nigeria received: december 21, 2018 accepted: january 14, 2019 online published: january 30, 2019 doi:10.22158/ct.v2n1p13 url: http://dx.doi.org/10.22158/ct.v2n1p13 abstract the purpose of this study was to investigate child rape in nigeria, its implications on the education of the child. descriptive survey design was adopted. three research questions guided the study. the population of the study was all the young parents in nigeria whose female children are between 0-12 years old. disproportionate random sampling was used to select 100 respondents each from 8 states out of 36 states in the country, making it 800 respondents. structured questionnaire and interview were used to collect data from the respondents. frequency, percentage and rank order were used to analyze the data collected for research question one. mean, standard deviations and rank order were used to analyze data for research questions two and three. the findings revealed a high prevalence of child rape in nigeria. the findings also identified in rank order; lack of reports on rape cases, mishandling of rape cases, child labour, children being left alone without care, men raping children for ritual purposes, indecent dressing as the causes of child rape. according to the findings, the effects of child rape in rank order include; emotional traumas, social stigma, sexual transmitted infections, termination of child’ life, low academic performance, physical pains and injuries, school dropout, poor attendance to school. recommendations and implications were also made. keywords child, rape, stigma, shame, infections www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 14 published by scholink inc. 1. introduction human sexuality is not just a matter of instinct as many people believe. it is rather an action which is controlled by decisions and social norms. it is a decision because no matter the reasons behind sexual activities, the two parties involved should under normal circumstances decide or take a decision to carry out the act. it is also controlled by social norms in the society because there are social sexual norms and ethical standards that guide how humans express their sexuality even though it varies from one culture to another. however, the variation of social sexual norms in different cultures does not rule out the fact that sexual abuse called rape is considered a taboo and strongly condemned and shunned all over the world. it is more serious when it involves children (minors) especially children and babies of eight years and below. child rape in nigeria is a new dimension of rape which has left many mouths agape and eyebrows raised. it is so embarrassing and heart breaking to hear that children who suck breasts are raped by beings who call themselves men. one begins to wonder what type of pleasure such worthless men derive from raping babies and children. how can a man with all his senses insert his manhood in the tender and undeveloped private parts of toddlers? are these men human or beats? apart from the fact that the female child due to her directional ability cannot make a decision about her sexuality, the child’s psychological state according to catholic diocese of nsukka (2009) makes her vulnerable for rape. rape is the crime of forcefully having sexual relationship with somebody against the person’s wish or consent. the term rape according to wikipedia (2017) originated from latin word “rapere” meaning to snatch, grab or to carry off. child rape is a form of sexual abuse committed against a child that is not old enough to have sex, in which an adult or older adolescent uses the child forcefully for sexual gratification. there has been an outcry against child rape in nigeria, which attracted the attention of not only the government, and non-governmental organizations in nigeria, but also international non-governmental bodies (uzoanya, 2015). the senate in nigeria has passed a bill in 2015 which prescribed life imprisonment for rapists and anybody who has sexual relationship with children under the age 11 years, but unfortunately, the bill has not deterred the rapists (halim, 2016). as individuals, and groups both governmental and non-governmental organizations try to quench the evil fire of rape of children, the fire burns farther and wider to consume the lives, future and the education of the innocent female children in nigeria. the news of child rape is worrisomely increasing. it is now usual to hear that a man has raped his biological daughter, or that a baby girl of some months old has been defiled carnally by an old man. what lures men into raping children and babies really confuses people. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 15 published by scholink inc. despite the measures taken so far to combat the menace of the rape of children in nigeria, the problem tends to escalate geometrically. in enugu state, national mirrow (2016) reported that a 16 year old boy has raped three kids including a 10 month old baby girl in udi local government area of the state. according to national mirrow (2016), the police in the state confirmed the arrest of the rape suspect, adding that the case has been transferred to the police headquarters in the state where the suspect was being detained. police also arrested a 50 year old headmaster, mr. nathaniel idoko from igbo-eze north local government area of enugu state for allegedly raping his four female pupils aged between 5-6 years in a bush in july 2018 (ossai, 2018; njoku, 2018). one of the ugliest rape cases in recent time as observed by the international federation of women lawyers (fida) was the rape of a 3 year old girl by the biological father in 2013. the act was done when the father was changing the daughters pampers (vanguard national newspaper, 2013). again in december 2016, in enugu-ezike community in igbo-eze north local government area of enugu state, one mr. ojobo has been arrested by enugu state police command for raping 11 children between the ages of 3 and above. olujisting (2016) states that the culprit confessed that he flashed a magic white cloth before the children who became unconscious and followed him to where he abused them sexually for ritual purpose of becoming rich. in ebonyi state, the news of child rape is not less serious as an 8 month old baby was reported to have been defiled by the very man who is her biological father. according to the mother of the baby (the wife of the rapist), the incident has repeated itself which attracted the mother’s attention. in ebonyi state also, a 16 year old boy has been arrested for raping a 4 months baby. according to vanguard national newspaper (2017), the boy carried the baby into his room and raped her repeatedly until the baby started bleeding through the private part and anus. in abia state, one mr. emeka asirionu, a 65 year old man has been arrested and paraded for raping a 2 year old girl child kept under his care at oriendu near umuahia. according to abia state commissioner of police mr. adeleye oyebade, the suspect was arrested in september 28, 2016 (punch newspaper, 2016). baby rape has also been cited in imo state. for instance, five men were reported for allegedly raping an 8 year old girl. the girl who hawks sachet water was lured by the rapists to a lonely part of relief market in owerri where they serially raped her until she became unconscious. vanguard newspaper (2017) and onyejiuwa (2016) reported that angry mob on discovering what happened caught three out of the five, tore their clothes, and beat them thoroughly before handing them over to police. child rape was also investigated in cross-rivers state and it was revealed that a 24 year old man-chijioke nwafor has raped an 8 year old miss alice eneji to death, chijioke has forcefully engaged alice in a marathon sex at st. patrick’s primary school okuku which resulted to the victims www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 16 published by scholink inc. death. the police relation officer mr. hogan bassey confirmed this to vanguard newspaper (prenium time, 2013). in calaber, also, one mr. macellinus nwabiri defiled his 3 year old step daughter. she was admitted to the general hospital calabar where medical reports stated that the hymen of the victim had been broken, confirming that the rape actually happened. further, medical investigations by nigerian navy hospital calabar also confirmed the act (cross river watch, 2016). in osun state, a man of 27 year old has been arrested by the police and charged to court after reports that he had forcefully defiled a 2 year old toddler (vanguard newspaper, 2016). in ibadan, oyo state, according to gbemileke (2015) one pastor was arrested for raping a 7 year old girl (bidemi) on the altar of his church in may 2017. the accused confessed that he really attempted the crime but could not penetrate. what a sacrilege that a pastor would use an altar of god for rape nest. in kaduna state, a 24 year old haruna tukur, a bus conductor has been arrested, and charged to magistrate court in the state in 29th february 2016 for raping a 5 year old girl repeatedly even after he had been arrested and set free on bail for raping the same child. according to garba (2016), this case has prompted an outrage in social media, as the culprit has been reported to have repeatedly raped the child for two years starting from when she was only 3 years old. also in kaduna, mr. daniel joseph a 31 year old man has been handed over to kaduna police command for raping his 2 year old daughter in gonin-gorachikum local government area of the state. the mother of the child was late and the culprit used the opportunity to destroy what he should protect. the crime was confirmed by a medical doctor who reported penetration and serious infection (daily post, 2016). in kano state, a 6 month old baby girl has been raped by the husband of her mother’s friend in 2016. the man raped the baby with the help of his wife who held the infant’s legs. the rapist (name withheld) confessed that his wife and he were barren, and have agreed for the rape of the baby as they have been told by a ritualist that the only way they could have their own babies was for the man to rape a baby for rituals (dachen, 2017; nigerian news today, 2017). child rape is not limited to nigeria alone. other nations of the world have their own ugly stories to tell about rape of children or minors in their own lands. for instance, a 25 year old man has been arrested at a home in annaloug country down in northern ireland for raping a 2 year old baby girl. the culprit later appeared before magistrates in armah and was charged with rape, causing a lot of grievous bodily harm to the child (darko, 2018). in assin adadientem municipality in central ghana, a 4 year old girl has been brutally raped by her mother’s neighbor when her mother was away attending funeral. shockingly, the chief of the area allegedly refused to take any action against the rapist, claiming that “gods” said the man was innocent (ngugi, 2017). www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 17 published by scholink inc. in jijiga southeast addis ababa, a 4 year old girl had died in a hospital from injuries sustained during rape. according to the medical reports, the girl suffered from severe lacerations when she was raped. however, the culprit, a twenty-four year old man has been handed over to police (the irish times, 2002). rape cases in nigeria have taken a new dimension of involving children and babies. however, nothing goes for nothing as an adage says. the rape of children therefore has many causes which may include. 1.1 mishandling of rape cases it is an established fact according to achunike et al. (2014), that rape and sexual violence against women are not prosecuted as expected. alhassan et al. (2013) lament that over one hundred cases of rape and violence against females often go without any of the culprits being prosecuted; falayan et al. (2014), stress that sometimes, the police do not take appropriate actions by not making official report. the nigerian criminal code of law section 357 of criminal code act, laws of the federal republic of nigeria recommends life imprisonment for rape convicts and 14 years imprisonment for attempted rape (itoro, 2015). the nigerian senate has also approved life imprisonment for rapists of children under 11 years and people who have sexual intercourse with minors. however, only very few persons have been convicted since the enactment of the law to 2018. this is because sexual abuse matters in law court are sometime frustrated by the government which usually acts as the prosecution. the governmental prosecution of the offenders according to uzoanya (2015) may have not been encouraging as it has been reported that sex offenders have in some cases asked to do community service as a form of punishment, contrary to the stipulated laws. furthermore ejim (2013) observed that nigerian laws appear to in addition victimize and humiliate the female folk as they do not bring justice to them. the rigorous requirements involved in producing the authentic evidence of rape in question seem to trivialize the whole matter. for instance, before a rape case is established, the victim must get a medical report to confirm that rape has taken place, as well as getting police report within the shortest interval of time. unfortunately, some nigerian police demand bribe from rape victims in order to investigate rape cases and give reports, and when the bribe is not given to them, they accuse the rape victims of consenting to the sexual intercourse with the rapists. in some cases, the complainant becomes the accused and vise vasa, depending on who gives the highest bribe. olatunji (2012) conducted an extensive review of the nigerian anti-rape law and identified some short-comings of which some are; that a rape victim must establish that penetration occurred, and that consent was not given. these limitations with establishing consent make proving many of the few valid rape cases difficult. consequently, rapists increase in number as they are not adequately punished. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 18 published by scholink inc. 1.2 shame and stigmatization many families and rape victims feel that reporting of rape incidents would circulate the news of the victims’ defilements which may result to shame, ridicule and social stigma. consequently, many families prefer to conceal rape assaults that involve their family members in order to save themselves from shame, character assassination, backslash, rigorous legal procedures and public embarrassments among others. as a result, rape victims do not have the zeal to pursue their cases to conclusion. this undue silence over rape crimes encourages rapists go scot free, leading to more rapes (uzoanya, 2015; achunike et al., 2013; this day live, 2018). supporting the statement that lack of report of rape increases rape incidents noi-polls (2014), falayan et al. (2014) opine that majority of child rape cases which are never reported as parents want to protect the image of their children against social stigmatization and embarrassment increase the incident instead. 1.3 cultism and rituals ocultism and rituals are other causes of child rape in nigeria. due to unemployment, acute economic recession and more especially high rate of materialism and satanism in the country, many young men have sold their consciences to money, affluence and materialism. for instance, according to nairaland forum (2015), some people believe that when women especially virgins (children) are raped, the destiny of the victim is transferred to the perpetrator through magical means. an example of this is where a rapist * used white cloth to charm 11 children and abused them sexually. he confessed that the act would reap the destiny of the victims spiritually to make him rich, but that he has not started being rich by the time he was caught (olujisting, 2016). the rape of 6 month old in kano was also for ritual purpose (dachen, 2017; nigerian news today, 2017). 1.4 indecent dressing indecent dressing is another factor that leads to rape in nigeria. many parents purchase all sorts of dresses for their children which expose the inner body and contour of the kids that should be covered from public views, such as tighs, butocks stomach and breasts. these days, young female children are dressed shabbily in boxers, short nickers, pants and leggings (achunike et al., 2014). as a result, one wonders whether the parents of these kids still remember that these children are females who need woman dignity and respect. female children who indulge in such dresses become tomboyish with male stereotyped behaviours of sitting and spreading their legs, dancing seductively just like boys whom they share their dress code with. all these may arouse sexual urge in men and adolescents especially the sexy and irresponsible ones. ayogu (2011), after conducting a research on sexual abuse revealed that parents knowingly or unknowingly buy clothes with inscriptions such as “i am a sexy girl”, “kiss me deep”, “hug me tight”, “romance me” or “fuck me baby” for their female children to wear. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 19 published by scholink inc. expectedly, such ludicrous and psychedelic dresses that advertise female nudity are inviting to rapists to carry out their exploits. 1.5 another cause of child rape in nigeria is parental carelessness and irresponsibility many parents due to quest for money or tight office work feel that bombarding the children with food stuff and other luxuries are always the best for them (kids). such parents abandon their little children early in the morning at the mercy of yard members or even without anybody to guard them, and come back late in the night. in such situations, children are denied of love, affection, close monitoring and guidance. the children become their own mothers, loitering around without restrictions or being monitored. these attitudes expose children to all sorts of dangers including rape. 1.6 child labour due to economic recession and poverty in nigeria, children especially girls hawk goods along the streets as early as 6 or 7 years old. the introduction of young girls into street trading or hawking increases the chances of child rape in nigeria (ali, 2018; chukwu et al., 2018; agbo, 2017 p. 3). unfortunately still, most of these hawkers go nudy as they hawk their wares. commenting on the nudity of nigerian girl hawkers, nairaland forum (2016) opines that girl hawkers in the country have carried out a dressing code of wearing indecent dresses such as miniskirts, leggings, nickers and hanging tops that expose their little bodies-nipples, novels, hips, and laps. furthermore, these girls in a bid to sell their goods are usually determined to follow their presumed customers to any length to dispose their items. some criminals and rapists capitalize on the children’s innocence and gullibility and lure them to lonely places where they may be raped or molested sexually. child rape just like other rapes has many negative effects on both the raped and the rapists, ranging from social, psychological or emotional, and physical consequences to health challenges on the survivors (click, 2016). 1.7 sociological efects of child rape child rape carries with it social stigma both for the victims and the perpetrators. the perpetrator if known, receives negative remarks from people whether convicted or not. many people including friends and relations will disassociate themselves from him which may affect his social life including marriage. he is likely to be a loser in any competitive position or election. the victim has the greatest shame, and stigmatization that may cost her self-esteem, and self-image especially in marriage. as long as people remember the rape incident, they may doubt her health status including her fertility and ability to bear children, which may lead to her being rejected in marriage. our society relies on moral beliefs, ethics and human etiquettes. so when a child is raped, it becomes a social stigma and makes the society lose its morality on the victim’s life. the stigma may follow the child to adulthood and become a hindrance to her marriage as not every man would like to marry a rape victim for shame. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 20 published by scholink inc. in igbo culture, just like many nigerian cultures, virginity is a virtue, and a girl child who preserves her virginity till her marriage is honoured by her spouse and any other person who knows about it. nevertheless, if a girl child is forcefully robbed of her virginity through rape, it leaves a permanent wound in her that can affect her interpersonal or heterosexual relationships, leading to rejection in marriage, frustration, and disappointments. another issue of sociological consequences of child rape is the mistreatment of rape case. after rape, according to wikipedia (2017), the victim is subjected to investigations and interrogations by the police including medical examinations, and in some cases mistreatments. during the criminal trials, rape victims suffer loss of privacy and their credibility may be challenged. most of them become the target of slut shaming and cyber bullying if public bans are not used to protect them. 1.8 psychological or emotional effects of child rape child rape generally may result to short-term or long-term psychological effects on the victim, including psychopathology in later life (dinwiddies et al., 2000; nelson et al., 2002). rape terribly hurts women. olufemi kayode according to laments that rape is like stabbing a heart and leaving the dagger on the bleeding wound. rape goes with anger, regret, denial, rejection coupled with emotional pains that arise from the fact that an individual is overpowered physically and forced to do what she hates and does not want to do. for children who are raped, the horror and emotional trauma that accompany the act can be devastating. many raped children according to click (2016), hardly recover from the emotional trauma as they experience loss of self-esteem, loss of childhood, loss of confidence in male adults, depressing and psychological crisis, depending on the age of the child. for example, the six month baby that was raped according to this study might not remember anything and she is better off if she is not told about it. for older children, the trauma can be extreme especially if the child is threatened with weapons or garged before the act as some perpetrators do. this according mulugetta et al. (1998) may lead to short term psychological impacts of self-blame, suicide attempts, stress disorder, depression, loss of appetite, anxiety disorder. other effects include dissociative and learning problems, destructive behaviours such as self-destruction, autophobia (fear of being alone) and achluophobia (fear of darkness) (dinwiddies et al., 2000; nelson et al., 2002). rape can also leave long term emotional or psychological adverse effects on the child victim. rape leaves painful memories and life-long psychological consequences on its victims and may result to permanent damage of self-worth. it can cause post traumatic stress disorder (ptsd). this is a mental disorder that can develop after an individual has witnessed traumatic events such as rape, murder, traffic accident or warfare. the symptoms include disturbing thoughts, feelings or dreams related to the event, fright responses, schizophrenia and so on. an individual with ptsd is at higher risk of suicide, intentional self harm and criminality in adulthood (lahane et al., 2010). www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 21 published by scholink inc. the risk of long psychological effects is greater if the rapist is a relative or a family member of the rape victim. incestual rape has been shown according (dinwiddies et al., 2000; nelson et al., 2002), to be one of the most extreme form of childhood trauma, a trauma that often does a serious and long term emotional damage on the part of the rape victim. it may lead to a child having problems relating with her family members or running away from home and committing suicide or even joining criminal gangs. another psychological problem of child rape is sexual dysfunction at later age, such as hypoactive sexual desire disorder (hsdd) or inhibited sexual desire (isd) (wikipedia, 2017). this is a sexual dysfunction that is characterized by lack or absence of sexual fantacies and desire for sexual activity. ebby et al. (1995) state that a victim of rape suffering from this problem will not start or respond to her partners desire for sexual activity. rape can also result to frigidity in a raped child in later life. sexual frigidity is an abnormal sexual behaviour or sexual dysfunction in which a woman hates sexual intercourse or is unable to enjoy love making or show any feeling for sexual activity. (nwachukwu, 1994, p. 246). a sufferer of sexual frigidity does not relax her body for easy penetration, consequently experiencing sexual pains that may lead to further hatred for sex. vaginismus is another psychological after effect of rape that hunts a rape victim especially the children. this is another sexual dysfunction that is more serious than hypoactive desire disorder (hsdd). vaginismus sometimes called vaginism is a condition in which a woman is unable to engage in vaginal penetration including sexual intercourse, manual penetration, insertion of tampons or menstrual cups and penetration involving gynecological examinations (paptests). lahane et al. (2010) assert that vaginismus results in involuntary muscle spasm, which makes any vaginal penetration painful and impossible. a woman who has been raped at tender age is likely to develop this problem at later age. the sufferer does not control spasm just as a person has no control over shutting the eye when an object comes towards it (ebby et al., 1995). 1.9 health risks of child rape health risks of child rape can be enormous and devastating. the risks are more on the infections that cause havocs on the victims. infections: sexual transmitted infections (stis) are the worst effect of rape including child rape. many researches according to holemes et al. (1996) have revealed that rape is a risk factor for hiv/aids and other sexual transmitted infections in the victim. rapists according to nwachukwu (1994, p. 246) often have underlying psychological problems ranging from strong emotion to influence of drug and organic brain disease like dyscontrol syndrome. since they do not have right mindset, they usually engage in casual unprotected sexual relationships that may lead to vulnerability to sexual transmitted diseases and infections. therefore, most of them are potential vectors of diseases and infections including www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 22 published by scholink inc. hiv/aids. when they rape, they spread epidemic that may lead to premature death or terminal diseases and reproductive problems among the rape victims. the damage to reproductive organ can as well lead to bareness with its everlasting emotional trauma, regret and frustration for life time (falayan et al., 2014). another infection that rape victim can contract is viginitis or vaginal inflammation which in most cases is a symptom of infection of the vagina. the inflammation can also involve both the vagina and vulva. in this case, it is called vulvogavinitis, resulting in discharge, itching and pain (holmes et al., 1996; pobby, 2014; healthline, 2018). urinary track infection (uti) is also another infection associated with rape. it is an infection which affects part of urinary track. ebby et al. (1995) opine that when it affects the lower urinary track, it is known as bladder infection called cystitis, and if it affects the upper urinary track, it is called kidney infection known as psycho-nephritis. statement of the study problem rape is bad, but child rape is evil. there has been a lot of outcry in newspapers, radio broadcast, blogs, and other mass media about child rape in nigeria. many children including babies have been raped or even died as a result of rape. some have been raped by their neighbours, family members and friends and strangers, while others have been raped by men who call themselves biological fathers of those children. child rape has caused a serious insecurity among female children in the country. babies are no longer safe in their cods because their biological fathers rape them while changing their pampers. school children develop school phobia because their teachers defile them instead of protecting them. errand children’s lives are at risk as some of them are lured or abducted into bushes where they are raped for ritual purposes, while pastors use god’s sanctuaries as love nest as they rape toddlers of their own churches. all these cause a lot of havoc in nigerian society as many children’s lives and education have been affected adversely. the researcher was moved by this heart-breaking situation to investigate on child rape in nigeria and the implications on the education of the child. 2. objectives of the study 1) to ascertain the level of parents awareness of child rape in nigeria. 2) to find out the causes of child rape in nigeria. 3) to identify the effects of child rape in nigeria. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 23 published by scholink inc. 3. research questions 1) how aware are parents of the prevalence of child rape in nigeria? 2) what are the causes of child rape in nigeria? 3) what are the effects of child rape in nigeria? 4. method the study adopted descriptive survey. the population of the study was the entire young parents in nigeria whose female children are between 0-12 years. this group was chosen to accommodate the age of children under study. disproportionate random sampling technique was used to select the respondents. 8 out of 36 states in nigeria were selected. in each state, 100 respondents comprising male and female were sampled for the study. the sample size was therefore 800 (100x8 = 800). parents were used because the researcher found it difficult to get in touch with child rape victims. annonymity and confidentially were granted to the respondents for security purposes. structured questionnaire and interview were used to collect data. the data collected were analyzed using frequency and percentage, mean and standard deviations and rank order. a criterion mean of 2.5 was used to accept or reject an item. 5. findings research question 1: how aware are parents of the prevalence of child rape in nigeria? table 1. responses of parents on the prevalence of child rape in nigeria s/n child rape prevalence fr. % 1 i have heard news of child rape 709 88.6% 2 my child has been raped when she was b/w 0-8 years 32 4% 3 a child related to me has been rape at the age of 0-8 years 66 8.2% 4 there has been a case or cases of child rape in my locality 124 15.5% 5 i have not heard about child rape 91 11.4% total 800 100% table 1 above showed the parents’ responses on their awareness of prevalence of child rape in nigeria. 709 respondents representing 88.6% agreed that they have heard about incident of child rape in nigeria, while 91 (11.4%) said they have not. 32 respondents (4%) agreed that their children have been raped between at the age of 0-8 years. 66 respondent (8.2%) agreed that a child/children of 0-8 years related www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 24 published by scholink inc. to them have been raped. 124 respondents representing 15.5% agreed that there has been a case or cases of child rape in their locality. research question 2: what are the causes of child rape in nigeria? table 2. mean standard deviations and rank order of respondents on the causes of child rape in nigeria s/n causes of child rape x sd rk dec 1 mishandling of rape cases encourages rapists to rape more 3.17 1.01 2nd * 2 lack of reports on rape by rape victims encourages rapists in their evil acts 3.18 1.06 1st * 3 men rape children for occultic and ritual purposes 2.92 0.85 5th * 4 indecent dressing among children lures rapists into raping them. 2.63 0.87 6th * 5 children who are usually left alone without care are exposed to rape 3.10 0.82 4th * 6 child-labour exposes children to rape 3.17 101 2nd * the analysis of data in table 2 revealed that the causes of child rape in nigeria are; lack of report on rape by rape victims (3.17 1st), * mishandling of rape cases encourages rapists to rape move (3.17 2nd), child labour exposes children to rape (3.17 2nd), children who are usually left alone without care are exposed to rape (3.10 4th) men rape children for occultic and ritual purposes (2.92 5th), indecent dressing among children lures rapists into raping them (2.63 6th). www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 25 published by scholink inc. research question 3: what are the effects of child rape? table 3. mean, standard deviations and rank order of respondents on the effects of child rape s/n effects of child rape x sd rk dec 1 child rape results to social stigma and shame 3.36 0.89 2nd * 2 rape victims suffer serious emotional traumas 3.75 0.84 1st * 3 rape victims suffer sexual dysfunction 2.68 0.56 8th * 4 rape victims may contract sexual transmitted infections. 3.26 0.97 3rd * 5 child rape victims may drop out of school due to shame and depression 3.05 0.46 6th * 6 injuries and pains sustained during rape may prevent a victim from attending school 2.78 1.13 7th * 7 emotional traumas due to rape may result to low academic performance 3.10 0.75 5th * 8 sexual transmitted infections including hiv may terminate child life and education 3.24 0.91 4th * the data in table 3 indicated that the most severe consequence of child rape is that rape victims suffer emotional traumas. (3.75 1st) others arranged in rank order include; child rape results to social stigma and shame (3.36 2nd), rape victim may contract sexual transmitted infections (3.26 3rd), sexual transmitted infections including hiv may terminate the life of a rape victim and education 3.24 4th), emotional traumas due to child rape lowers academic performance (3.10 5th), child rape victims may drop out of school due to shame and depression (3.05 6th) injuries and pains sustained during rape may prevent a victim from attending school (2.78 7th), rape victims suffer sexual dysfunctions (2.68 8th). www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 26 published by scholink inc. 7. discussion the findings in table one showed that there is high prevalence of child rape in nigeria. it was revealed that 8 out of 10 parents believed that there is prevalence of child rape in nigeria. this result is in line with the research carried out by noi-polls (2014) which revealed a high prevalence of child rape in the country. also in support of this result, the centre for environment, human rights and development reported that 1,200 children have been raped in 2012 in rivers state, southeastern nigeria alone (vanguard newspaper, 2013; wikipedia, 2016). the findings in table two indicated that lack of report of rape cases by rape victims increases the problem. the result was in line with observations by ebuenyi et al. (2018) that lack of reports of rape cases promotes the evil. the results also revealed that child rape may be caused by mishandling of rape cases which encourages rapists to rape more. the result is in agreement with a study by alhassan et al. (2013) which reported that mishandling of rape cases by anti-rape laws increases the chances of rape. the results also revealed that occultic and ritual purposes, indecent dressing, children being left alone without care, and child labour are also causes of child rape. the findings in table three revealed that child rape leaves behind it a lot of consequences; social stigma and shame. the victims also suffer emotional trauma. this was supported by alhassan et al. (2013) research which showed that 1/3 rape victims has thought of suicide, and approximately 17% actually attempted suicide, 30% has developed depression. all these are due to serious emotional traumas. the result also indicated that child rape leads to sexual dysfunction. this finding is supported by stephen et al. (2010) who revealed that vaginismus is the leading cause of unconsummated marriages and often a threat for divorce and health risk. other effects of child rape as revealed are body pains and injuries, sexual transmitted infections as supported in researches by falayan et al. (2014), achunike et al. (2014) and national centre for ptsd (2017) that rape is a risk factor for hiv and other infections. the findings also indicated school dropout, low school attendance, low academic performance and termination of life and education as other effects of child rape. 8. educational implication of child rape child rape has very serious adverse implications on the education of the child in nigeria. it is important to note that the overall consequences of child rape can affect learning and education directly or indirectly, hence rape hampers all children’s life activities including learning. the social stigma and shame associated with child rape is capable of causing truancy or school dropout for the rape victim. emotionally, child rape can lead to depression, fear, school phobia and other emotional crisis depending on the age of the rape victim. she can develop suicide thoughts, anxiety disorder. such child may feel worthless, guilty, hopeless, regretful which may result to little or no interest in life including education, difficulty in concentration in learning, and recall of memories. all these may affect learning www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 27 published by scholink inc. and academic performance (thomson, 2007; ofuebe, 2015, p. 74). if the rape involves school environment or a male teacher, the child may develop school phobia and lack of trust on her male teachers forever. emotional trauma generally impairs physical health as well as mental efficiency, both of which impede learning. academically, children with emotional traumas are noted for low grade in school work, failure in school examinations, repeating of class or grade and school dropout (agbo, 2018, p. 143). there is no gain-saying that physical consequences of child rape may involve fever, loss of appetite, injuries, pains and hospitalization and death, which of course affect attendance to school and life adversely. it is significant to note that health risks of children are detrimental to their education. a child who is infected with sexually transmitted diseases such as hiv/aids, gonorrhea, syphilis and or cervical cancer may have her life and education endangered sooner or later. 9. recommendations the following recommendations are made: 1) laws should be effective so as to protect the girl child, and bring culprits to justice as quickly as possible. 2) agencies fighting against rape should partner with the governments, parents, and other stakeholders on how the society should treat rape offenders and what to be done to bring succor to the rape victims. 3) female children should be taught that they must report to their parents anybody who tries to touch their private parts. 4) mothers being naturally closer to children should have strong cordial relationship with the children to enable children confide in the mothers any event in their lives on daily basis. 5) children should not watch pornographic films. children’s films should be scrutinized in order to prevent them from watching immoral films and videos. 6) female children should be dressed properly to maintain the dignity of womanhood. 7) on no account should female children be left under the care of private male teachers, family drivers, male neighbours, or security guards alone. 8) female children should be discouraged from sitting on the laps of males. 10. summary rape is a serious offence against humanity at large and women in particular, but child rape is a horror. it is very irritating o hear a news of a male adult raping a baby of few months old. however, nothing goes for nothing as the research has identified many reasons for such atrocious act against children in nigeria which include; the mishandling of rape cases which seems as if the laws are protecting the rape www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 28 published by scholink inc. offenders more than the rape victims, lack of reports of rape cases among other reasons. the effects of child rape according the findings are that many rape victims suffer shame and stigmatization, serious emotional traumas, sexual dysfunction among others which leave indelible marks on the lives and education the girl child. however, the researcher is quite optimistic that if the recommendations made in this study are followed religiously such as reporting rape cases to the appropriate quarters, and laws handling rape cases adequately among other points, that the dust of child rape shall settle. 11. suggestion for further research educational consequences of the rape of primary school children in southeastern nigeria. references achunike, h. c., & kitause, r. h. (2014). rape epidemic in nigeria, cases, causes and consequences and responses to the pandemic. international journal of research, applied natural and social sciences, 4(1), 31-44. agbo, m. c. (2017). the health & educational consequences of child labour in nigeria. health science journal, 11(1.486). retrieved from https://www.hsj.gr/archive agbo, m. c. (2018). a handbook on special education (revised edition). nsukka: chuka educational publishers. alhassan, et al. (2013). child rape. who speaks for the victims. retrieved july, 2014, from https://www.hopefornigerianonline.com/childrape-who-speaks... ali, a. a. (2018). girls are especially at risk for child labour. global post. retrieved july 30, 2018, from https://www.pri.org→stories ayogu, c. b. (2011). are we really christians. enugu: chrisbest production. catholic diocese of nsukka. (2009). the nigerian child: any hope for the future. nsukka: justice, development and peace. caritas commission. chukwu, i., & ishemati, f. (2018). child rape: watch, the enemy is within. business day. retrieved december 16, 2018, from https://www.businessdayonlinecom-news click. (2016). victims of sexual molestation and rape: exploring enugu. retrieved from https://www.click042.com/...exploring-enugu... cross rivers watch. (2016). calabar: how police scuttled investigation of man who raped 3 year old step-daughter. retrieved from https://crossriverwatch.com/.../calabar-how... dachen, 1. (2017). hell bound: man rapes 6-month old baby with wife�s support. pulse news. retrieved may 4, 2017, from https://www.pulse.ng→gist→hell www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 29 published by scholink inc. daily post. (2016). father rapes his 2 year old daughter in kaduna. retrieved from https://www.dailypostngr.com/.../father-rapes-his2yr... darko isaac. (2018). 25 year old man arrested for raping a 2 year old baby leaving it fighting for life. pulse ghana. retrieved from https://www.pulse.com.gh1725/21/10/2018 dinwiddies et al. (2000). early sexual abuse & life time pathology: a cotwin control study. psychological medicine, 30(1), 4153. https://doi.org/10.1017/s0033291799001373 ebby k., et al. (1995). health effects of experiences of sexual violence for women with abusive partners. healthcare for women international, 16(6), 563-576. taylor and francis. https://doi.org/10.1080/07399339509516210 ebuenyi, i. d., uzoechi, e .c., & dairah, g. o. (2018). implications of silence in the face of child sexual abuse. african journal of reproductive health, 22(2). retrieved from https://www.ajrh.info-ajrh-article ejim, a. (2013). molestation and rape. retrieved july 4 2013, from https://pennewsnigeria.com/2013/04/30 falayan, m. o., odetoyinbor, m., harrison a, & brown, b. (2014). rape in nigeria. a silent epidemic among adolescents with implications for hiv infection. global health action. retrieved august 22, 2014, from https://www.globalhealthaction/.../rape... garba, m. (2016). how a bus conductor in kaduna allegedly raped a 5 year old girl. premium times. retrieved from https://www.premiumtimesng.com/204137-6... gbemileke, a., & oladepo, o. (2015). pastor arrested for raping a 7 year old girl. african biomed research, 18, 109-121. halim, k. (2016). nigerian child endangered. the sun newspaper. retrieved april 30, 2016, from sunnewsonline.com/nigerianchild… health line. (2018). vulvogavinitis: causes, symptoms and diagnosis. retrieved from https://www.healthline.com-health-vul holmes, m. m. et al. (1996). rape related pregnancy estimates and descriptive characteristics from a national sample of women. american journal of obstetrics & gynecology, 175(2), 320-324. https://doi.org/10.1016/s0002-9378(96)70141-2 itoro, e. a. (2015). premium times on 18 rape convictions recorded in nigeria legal history. retrieved from https://www.premiumtimesng.com/.../192895. lahane, m. a., boyer, s. c., amsel, r., khalife, s., & binik, y. m. (2010). vaginismus, a review of the literature on the classification, diagnosis, etiology and treatment. women health care, 6(5). london, england. mulugeta, e., kassaye, m., & berha, y. (1998). prevalence and outcomes of sexual violence among high school students. ethiopian medical journal, 36(3), 167-174. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 30 published by scholink inc. nairaland forum. (2015). rape and its causes-family. retrieved from https://www.nairaland.com nairaland forum. (2016). rape causes. retrieved from https://www.nairalandforum.com /2205036/rape national centre for ptsd. (2007). sexual assault against females. information on trauma and post-traumatic stress disorder (ptsd): veteran, general public & family. retrieved from https://www.ptsd.vo.gov/pub/pages/sexual-assult... national mirrow. (2016). burgeoning cases of rape. retrieved december 19, 2016, from https://www.nationalmirrow.ng.com/burgeoning-cases... nelson, e. c. et al. (2002). association between self reported childhood sexual abuse & adverse psychological outcomes-results from a twin study. archives of general psychiatry, 59(2) 139-145. https://doi.org/10.1001/archpsyc.59.2.139 ngugi, f. (2017). a ghanaian man rapes 4 year old girl, but gods say he’s innocent. women. retrieved from https://face2faceafrica.com nigeria news today. (2017). baby girl abuse. retrieved from https://www.naij.com/1104906-baby-girl-abus... njoku, l. (2018). 50-year-old headmaster nabbed for defiling four pupils in enugu. the guardian. retrieved september 4, 2018, from https://www.guardianonlineng.com noi—polls. (2014). child rape cases on the rise in nigeria. retrieved from https://www.no1-polls com-root nwachukwu, t. a. (1994). a handbook of abnormal psychology and education. nsukka: chulbson international press. odeh, n. (2013). seige of child rapists. the news, 14-20. ofuebe, j. i. (2015). emotional, mental and social health. enugu: fred-ogah publishers. olatunji, a. o. (2012). penetration, corroboration & non-concent: examining the nigerian law of rape and addressing its shortcomings. university of ilorin law journal, 8, 79-105. olugisting. (2016). man uses white cloth to charm 11 children and raped them for ritual purposes. retrieved december 19, 2016, from https://www.olujisting.com/man-uses-whitecloth-to… onyejiuwa. (2016). 5 men rape 8-year old girl. sun news online. retrieved june 2, 2016, from https://www.sunnewsonline.com→national ossai, j. (2008). police arrest headmaster for raping 4 school children in enugu. the tribune. retrieved september 4, 2018, from https://www.tribuneonlineng.com pobby. (2014). vulvogavinitis: causes, signs, diagnosis and treatment information. retrieved from http://www.checkpregnancy.com premium time. (2013). 8 year old raped to death. retrieved from https://www.premiumtimesng.com/.../8yr.. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 31 published by scholink inc. punch newspapers. (2016). 65 year old man rapes two year old girl. retrieved october 24, 2016, from https://punchng.com>65year-old-man-rapes-tw.. stephen, j., & betchem, d. (2010). vaginismus: a most challenging problem. a special intervention for a special disorder. the irish times. (2002). 4 year old ethiopian girl dies after rape. retrieved september 14, 2002, from https://www.irishtimes.com-new this day live. (2018). rape and schools. retrieved july, 2018, from https://www.thisdaylive.com thomson, h. (2007). ranking america’s mental and emotional health. an analysis of depression across the u.s. journal of workplace behavioural health, 23(4), 11-19. uzoanya, e. p. (2015). living with alarming rape cases in nigeria. retrieved from https://www.saturday magazine-m.guardian.ng/…living with-alarming… vanguard national newspaper. (2013). man rapes his three year old baby. retrieved from https://www.vanguardngr.com/.../man rapes-his-three... vanguard national newspaper. (2017). boy, 16, rapes 4 month old baby in ebonyi state. retrieved from https://www.vanguardngr.com/2017/04/6g-16-rapes... vanguard national newspaper. (2017). police arrested 27 year old man for raping 6 year old child. retrieved july 4, 2017, from https://www.vanguardngr.com/...policearrested 27 yr vanguard newspaper. (2013). hoodlums rape 1,200 girls in rivers state. retrieved february 27, 2013, from https://www.vanguardngr.com-hoodlums-rape vanguard newspaper. (2014). 27 year old man arrested for raping a 2 year old girl. retrieved february 11, 2014, from https://vanguardngr.com-27-year-old... vanguard newspaper. (2016). 5 men beaten for raping 8 year old girl in imo state. retrieved june 3, 2016, from https://www.nanguardngr.com→5-men-beaten... wikipedia. (2016). sexual abuse in nigeria. retrieved from https://en.m.wikipedia.org/...child-sex... wikipedia. (2017). effects and aftermath of rape. retrieved from https://en.m.wikipedia.org wikipedia. (2017). rape. retrieved from https://en.m.wikipedia/org/.../rape... wikipedia. (2017). vaginismus. retrieved from https://en.m.wikipedia.org-wiki-vagin children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 4, no. 3, 2021 www.scholink.org/ojs/index.php/ct 11 original paper recommendation of school social work activities to address students issues in vietnam dang thi huyen oanh1* 1 faculty of social work, hanoi national university of education, vietnam * dang thi huyen oanh, faculty of social work, hanoi national university of education, vietnam received: may 28, 2020 accepted: june 7, 2021 online published: june 14, 2021 doi:10.22158/ct.v4n3p11 url: http://dx.doi.org/10.22158/ct.v4n3p11 abstract bullying and physical violence, truancy, self-harm and other mental health issues are increasingly experienced within the school population. in being a crucial part of addressing such issues and the more traditional areas of poverty, family relationships and parenting, child abuse and neglect, home-school relationships, support for children with disabilities, school social work has become a specialist area of professional practice with a growing evidence base of effectiveness. this paper aims to explore issues related to middle-school students in vietnam and their needs in school social work activities to address those problems. implications for school social work research and practice which are recognized as a key area for students’ wellbeing are discussed. keywords school students, social work, school issues, school social work, middle school 1. introduction vietnam, a country of some 94 million citizens has grown markedly since winning the war at great cost in 1975 and then introducing market reform in 1986. integral to sustaining a commitment to equal opportunity and social justice for all citizens has been the national education system. another commitment to citizens' wellbeing has been the government endorsement in 2010 of the professional development of social work. the vietnamese government through molisa (ministry of labour, invalids and social affairs) officially classified social work as a profession. following decision 32/2010/qd-ttg by the prime minister on the development of social work as a profession, the government allocated $us130 million for the training and development of social work staff. now more than 50 universities and colleges offer social work degrees at some combination of bachelor, masters and phd level. many offer a special focus on developing the skills, knowledge and values for school www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 12 published by scholink inc. social work practice. while an increasing number of research projects, including action research, and students on placement at schools are evidencing the value of this profession in the school setting, there is as yet no legal and financial base for the employment of professional social workers in schools within the national educational system. in vietnam, there are specific cultural issues underlying the emergence of intractable problems in schools. the school environment plays an important role in the life of vietnamese children due to both the emphasis on education and the many hours they spend in school per week. while most children become productive citizens and achieve academically, many others have had negative experiences affecting their future. both schools and families have high expectations of students’ academic performance. this pressure results in stress, anxiety, school avoidance and even suicide. vietnam, like other school systems in the world, must contend with bullying, physical violence, truancy, self-harm, antisocial behaviours, and other mental health issues (pells et al., 2016). furthermore, other challenges for schools include serving areas with high rates of poverty, difficulties in family relationships and parenting, child abuse and neglect, the need to bridge home-school relationships, and supporting children with disabilities (pells et al., 2016). thus, school social work is a necessary field and specialized area of practice that can effectively address these issues (villarreal sosa & ha, 2020). the aim of this paper is to explore the current problems among students and assess the need for school social work activities to address this. 2. method we distributed survey questionnaires to 200 students studying from grade 6 to grade 9 at 02 survey schools. therefore, the number of samples to analyze was 200. after obtaining the results, we use statistical software in social sciences (spss 16.0) for processing and analysis. before data collection, school principals, homeroom teachers received consent letters from the authors. students were also not surveyed if they confirmed orally that they did not want to participate. the researchers were introduced to the students by homeroom teachers who explained the purpose of the survey. this research received approval from the hanoi national university of education research ethics committee (hnue-rec). 3. result table 1 presents the demographic characteristics of students participating in the study. eligible participants were from one middle school students in hanoi, vietnam. as described below, we recruited 250 students including 44.8 % female (n=112) and 55.2% male (n=138). student from grade 6th and grade 7th was the same number (n=80) (n=108), and the 9th grade was 90. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 13 published by scholink inc. table 1. characteristics of participants characteristic n=482 percent (%) gender male 138 55.2 female 112 44.8 grade 6 80 32.0 7 80 32.0 8 90 36.0 the results in table 2 showed that students faced several issues in which, the most popular was “poor academic performance” with the highest rate at 87.2%. 88.4% of students reported that the most difficulties related to their love and friendship and then was game addiction as reported. other issues also reported as cheating in exams, vocational orientation, school violence or disrespect to teachers. table 2. students’ issues in school poor academic performance (n) cheating in exams (n) games online addiction (n) vocational orientation (n) love and friendship (n) school violence (n) disrespectful to teachers (n) others (n) yes 218 57 212 43 216 43 53 29 no 32 193 38 207 34 207 197 221 total 250 250 250 250 250 250 250 250 there are several factors related to student’s issues in school. the most popular reported wasp psychophysiological characteristics (66.5%), then was family-related factors (60%), lack of life skills and values (50%), lack of school social work and school counselling services (45.7%) and others including lack of coordination between family-school-community, study pressures and rapid development of information technology (table 3). www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 14 published by scholink inc. table 3. factors related to students’ issues in school order factors percentage 1. psychophysiological characteristics 66.5% 2 family-related factors 60% 3 lack of life skills and values 50% 4 study pressure 27.2% 5 lack of coordination between family-school-community 37.3% 6 the rapid development of information technology 21.1% 7 lack of school counselling and school social work services 45.7% 8 lack of career direction 20.1% 9 others 8.1% table 4 showed the different needs for school social work in van canh school. participants reported that the most important was the cooperation between school and social work training schools to form a professional practice room on social work at the school (72%), school social work training for homeroom teachers (70%) and other staff in school (65.5%). table 4. students’ needs needs very important (%) important (%) slightly important (%) not important (%) 1 homeroom teachers are trained in school counselling and social work 70 20.1 3.4 6.5 2 subject teachers are trained on how to integrate school social work into classrooms and experiential activities, etc. 49.4 40.9 5.5 4.2 3 other staff in schools are trained school social work 65.5 23.6 12.0 0.9 4 forming psychological clubs to support students 42.9 28 13.9 15.1 5 having school social work department 40.9 39.7 11.9 7.5 6 having 1 or 2 school social workers 46.2 37.7 10.7 5.5 7 the school form a professional practice room on social work at the school. 72 18.1 2.4 7.5 www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 15 published by scholink inc. 4. discussion and conclusion the results of this study reflect several issues that students have faced within school like in the previous study (dang et al., 2016; le et al., 2011; nguyen & fahey, 2001; villarreal sosa & ha, 2020). the results of this study show that the problems faced by students were diverse and complex. this showed that there is still a lack of supportive activities of school social work. from the actual situation, the need for school social work has been raised. this is the orientation and basis to build a school social work. the school social work training provided opportunities for a greater understanding among school teachers of the role of the school social worker, including psychosocial assessment, needs assessment, addressing issues such as bullying and mental health challenges such as suicidality, multi-tiered systems of support, and the evidence-based process. the importance of school climate and environmental factors was an issue for both students and teachers. tier 1 or universal interventions are needed in order to address these issues in preventative ways, including teacher training around issues such as inclusion and mental health. second, there is a need to continue to explore issues of equity and differences in ethnic groups and expanding ideas about what inclusive education means. there were few inclusive schools or classrooms for children with disabilities, and some of those that did “include” children with disabilities needed additional support with developing appropriate accommodations beyond simply having them present in the classroom without full participation in classroom activities. finally, there are serious and unrecognized mental health concerns among the children in vietnam. though mental health concerns exist, there are few school and community resources to address them(phuong et al., 2013). school social work can provide vital services in counselling centres in schools, as well as provide important linkages to community resources when available. the concept of school mental health a focus on prevention and universal intervention was also introduced during this project. in addition, school social workers can provide professional development to teachers to support them in including students with mental health challenges in the classroom and reducing stigma. this paper also recommends some possible solutions for developing school social work in vietnam. firstly, establishing a reputation for effectiveness. while vietnam lacks a nationally established practice base, it should not need the sixty years needed in victoria to establish a good reputation with citizens and government decision-makers. considerable research is already being conducted by faculties of social work and students are having an impact through their placement. a key task is to raise social awareness as to school social work and its effectiveness in practice. secondly, national commitment: to move closer to closing the circle between professional education as school social workers and professional practice at the national level requires a legal and financial commitment from national decision-makers. part of this will be overcoming the silo thinking common in bureaucratic structures. for social work to flourish in a host organization it needs acceptance and commitment from the host whether health or education—both essential government services for www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 16 published by scholink inc. national wellbeing. the other aspect is that decisions to employ social workers should not come out of local budgets as the schools with the least resources are the most likely to benefit from social work services. the government needs to recognize and officially categorize professional school social workers in the school staff system with school social workers having an appropriate professional salary code. thirdly, for faculties of social work: to further develop collaboration between universities and with organizations in school social work at all levels to fully tap expertise and experience in training and practicing social work. this would enable enrichment of learning materials and the creation of a network for training, researching and practicing school social work. school social work curriculum in vietnamese universities should meet agreed professional standards and be continuously updated. collaboration would support the publication of textbooks and other resources in the field of school social work. the school social work programs should be practicable and relevant while aware of international standards. for students to achieve the necessary beginning competency in these on graduation, it could be possible to lengthen and structure placements in schools to strengthen the learning. the ministry of education and training (moet), ministry of labours, invalids and social affairs (molisa) could cooperate to organize courses to train and license graduate social workers as school social workers. and last but not least piloting a vietnamese model this has advantages but one of the strengths of school social work is the ability to respond to context and culture. so what works in one school will only be partially transferable to schools in general. so while perhaps a range of pilot projects could be held in different settings it might be possible to extend the employment of social workers in schools by defining the term counsellor to cover both psychologist and social workers. in australia, for many positions, both professions are recognized as certified in counselling skills. references dang, h. m., weiss, b., & trung, l. t. (2016). functional impairment and mental health functioning among vietnamese children. social psychiatry and psychiatric epidemiology, 51(1), 39-47. https://doi.org/10.1007/s00127-015-1114-2 le, p., hagans, k., powers, k., & hass, m. (2011). developing school psychology in vietnam. communique, 39(6), 8-10. nguyen, k. c., & fahey, s. (2001). the relationship between students’ achievement and early school leaving in rural vietnam. melbourne studies in education, 42(2), 49-67. https://doi.org/10.1080/17508480109556384 pells, k., ogando, m., & revollo, p. (2016). experiences of peer bullying among adolescents and associated effects on young adult outcomes: longitudinal evidence from ethiopia, india, peru and viet nam. unicef, 3(1), 61. retrieved from www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 17 published by scholink inc. http://ovidsp.ovid.com/ovidweb.cgi?t=js&csc=y&news=n&page=fulltext&d=cagh&an= 20173035967%0ahttp://lshtmsfx.hosted.exlibrisgroup.com/lshtm?sid=ovid:caghdb&id=pmid:& id=doi:&issn=&isbn=&volume=&issue=2016-03&spage=61&pages=61+pp&date=2016&title=% 3d%3d%3d&ati phuong, t. b., huong, n. t., tien, t. q., chi, h. k., & dunne, m. p. (2013). factors associated with health risk behaviour among school children in urban vietnam. global health action, 6(june), 1-9. https://doi.org/10.3402/gha.v6i0.18876 villarreal sosa, l., & ha, n. t. (2020). school social work in vietnam: development and capacity building through international collaboration. international journal of school social work, 5(2). https://doi.org/10.4148/2161-4148.1065 children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 4, no. 1, 2021 www.scholink.org/ojs/index.php/ct 31 original paper the relationship between students’ negative coping strategies with school violence and social support factors: a case study in vietnam nguyen thi mai huong 1* & nguyen thu trang1 1 faculty of social work, hanoi national university of education, vietnam * nguyen thi mai huong, faculty of social work, hanoi national university of education, vietnam received: november 29, 2020 accepted: december 11, 2020 online published: december 18, 2020 doi:10.22158/ct.v4n1p31 url: http://dx.doi.org/10.22158/ct.v4n1p31 abstract this study examined relationships between the social support factors such as peer relations (3 items), teacher influences (6 items), familial influences (5 items) and the negative coping strategies of students experiencing school violence including negative thought (5 items); negative emotion (7 items) and negative action (8 items).participants were a sample of 482 students from four middle schools around hanoi who had experienced at least 1 violence or more participating in the study. they are distributed relatively evenly by school and from grades 6 to 9. the major finding was social support factors (peer relationships, teacher-student relationship and school environment and family relationships) and negative coping strategies were negatively correlated (p<0.01). students who had negative relationships with friends, teachers, and family members often showed negative coping strategies after experiencing school violence. the article proposes the solution of social work intervention in building a safe and friendly environment to minimize the negative coping strategies of students at schools keywords social work, school violence, student, vietnam, behaviors, social factors 1. introduction the happen of violence in school climate had been documented that it will increase students’ fears, create negative emotion on students, affect student’s desire and ability to learn, reduce their trust and expectations on the school (eisenbraun, 2007; scheckner et al., 2002), damage the students confidence (schreck et al., 2003), causes higher symptoms of depression, anxiety and lower self-esteem among students (raskauskas, 2010) and impact of students’ and teachers’ social, physical and psychological www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 32 published by scholink inc. wellbeing (roffey, 2012). school violence may occur for diverse reasons such as substance abuse, personality problems, dysfunctional families, violent media or even legal systems. there are risky factors that contribute to the rise of school violence including social (such as poverty), familial (such as negative parental model), school-related (such as low student participation, lack of social activities, unfair practices and teacher attitudes) and individual (such as developmental difficulties, antisocial behaviour, academic failure, not adapting to school) (morrison & furlong, 1994). other risk factors related to school management and some teacher characteristics, such as lack of subject knowledge and communication skills, aggressive leadership styles, unfair practices, inability to manage student behaviour or not supporting student development (finley, 2008; mertoglu, 2015). school violence has been associated with poor social, emotional, psychological, and academic outcomes for students directly involved in violence, as well as bystanders of violent episodes at school (nabuzoka et al., 2009; rivers et al., 2009; swearer et al., 2010). students employ various cognitive and behavioral strategies to feel safe from school violence at school. pellegrini and bartini (2000) point out that students purposely congregate in specific groups to protect themselves from bullying by others (pellegrini & bartini, 2000). students modify their behavior to conform with their peers and to avoid being bullied by them (burns et al., 2008). coping strategies of students experiencing school violence include cognitive problem-solving skills and emotion-focused skills (tenenbaum et al., 2011). lazarus (2006) defined coping as an individual’s efforts to manage environmental stress and the resulting emotions. the ability to cope with the stressors of life is essential in fostering psychological and emotional well-being (lazarus, 2006). folkman and lazarus (1980) developed a scale called the ways of coping checklist, which used eight categories to examine coping strategies: confrontive coping, taking aggressive action to change a situation; distancing, detaching oneself from the situation and minimizing its importance; self-controlling, regulating one's feelings and emotions; seeking social support, discussing the problem with somebody else and receiving emotional and informational support; accepting responsibility, recognizing how one contributed to the problem and attempting to make a change; escape-avoidance, thoughts and behaviors to escape and avoid the problem; planful problem solving, analysing the problem in order to resolve it; and positive reappraisal, thinking positively about the situation (folkman & lazarus, 1988; nuttman-shwartz & dekel, 2009). coping could also be divided into two orientations aimed at addressing stress: approach and avoidance (roth & cohen, 1986). approach coping strategies involved focusing on the threatening stimulus and addressing the threat directly. avoidance strategies involved staying away from the stressor and escaping the threatening stimuli (roth & cohen, 1986). causey and dubow developed a self-report coping measure based on the approach-avoidance model that consisted of five subscales: social support seeking, distancing, problem solving, internalizing, and externalizing (causey & dubow, www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 33 published by scholink inc. 2012). previous studies have indicated that high-quality social support and positive interpersonal relationships can work as a buffer to reduce the negative impact of a stressful situation. it is believed that strong peer support and positive teacher-student relationships may enhance feelings of security and coping ability, as well as reduce or even overcome the negative impact of school violence on self-esteem and depression (cowie & olafsson, 2000; davidson & demaray, 2007; naylor & cowie, 1999). additionally, the roles of parents and families should also be valued in addressing and coping with school violence among students who are victims (de oliveira et al., 2017). to date, empirical evidence regarding the relationship between peer support and student-teacher relationships and family relationship on the coping of school violence in vietnamese is still limited. the present study explores how the quality of peer support and student teacher relationships and family relationships influences the coping strategies of students experiencing school violence in a vietnamese cultural context. the current study explored children’s perceptions of how they cope with victimization using a semi-structured interview method, and three research questions were addressed: (1) what are negative strategies would students report use when coping with school violence (2) how are social factors ( related to their chosen negative coping strategies? 2. method 2.1 participants a cross-sectional and descriptive research was developed based on the application of a structured questionnaire in a stratified random sample, consisting of 482 students from the sixth until the ninth grade of vietnamese educational system at 02 state-owned public schools and 02 private schools in hanoi. all four schools were contacted and invited to participate in the current study by the research team. 2.2 procedures before data collection, school principals, homeroom teachers received consent letters from the authors. students were also not surveyed if they confirmed orally that they did not want to participate. the researchers were introduced to the students by homeroom teachers who explained the purpose of the survey and several popular types of school violence including physical violence, psychological violence, sexual violence and others… it should be highlighted that students who indicated that they engaged in at least 3 types of school violence for three times or more (≥3) in the last 6 months were considered as victims of school violence. based on that, we randomly identified 896 students and identified 482 students experiencing school violence as research criteria. the data were collected anonymously through the application of a self-report questionnaire. this tool was constructed to investigate social factors associated with school violence coping strategies. we collected data with a www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 34 published by scholink inc. questionnaire included 40 questions, subdivided in 03 parts: 1) identification demographic factors; 2) negative coping responses includes 20 items: negative thought (5 items); negative emotion (7 items) and negative action (8 items); 3) social relationship factors related to their coping strategies such as peer relations (3 items), studentteacher relationship and school support (6 items), and family relationships (5 items). all items are scored on a 5-point likert-type scale ranging from “1=strongly disagree” to “5=strongly disagree”. spss for windows version 22 was used to analyse the data. questionnaires were self-completed in classrooms from 25 to 30 mins. a member of the research team and a teacher supervised each class. at the end of the process, questionnaires were placed in envelopes and sealed to protect the confidentiality and to ensure standard administration procedures. this research received approval fromhanoi national university of education research ethics committee (hnue-rec). 2.3 ethical considerations this research received approval fromhanoi national university of education research ethics committee (hnue-rec). 3. result table 1 presents demographic characteristics of students participating the study. eligible participants were middle school students in hanoi, vietnam. as described below, we recruited 482 students including 47.72 % female (n=248) and 51.45 % male (n=230) and 1.24 % others (n=6). specifically, we recruited participants from two stated-owned public schools (school a and c) and two private schools (school b and d). only school a (n=117) located in the suburb area while three others including school b (n=125), school c (n=128) and school d (n=112) located in the inner city. students are from 9th grade (n=108), 8th grade (n=129), 7th grade (n=138) and 8th grade (n=107). table 1. characteristics of participating schools and participants characteristic n=482 percent (%) school a 117 24.90 b 125 24.90 c 128 25.73 d 112 24.90 grade 9 108 24.90 8 129 24.90 www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 35 published by scholink inc. 7 138 24.90 6 107 25.73 gender male 248 51.45 female 230 47.72 other 6 1.24 table 2 presents descriptive statistics (including mean, standard deviation, and correlation) of the latent variables in our theoretical model. the reported coping strategies of the respondents were categorized as shown in table 1 together with the mean score of the respondents who stated each type. first, the results showed that all students being victims of school violence had negative coping strategies. the most popular coping strategies were having negative emotions (m=3.08), followed by negative thought (m=2.91) and negative behavior (m=2.70) (table 1). second, it can be seen that the three types of negative coping strategies (negative emotions, negative thought and negative thought) were positively correlated (r=.348 to .426, p<.001) with each other. table 2. descriptive statistics of negative coping strategies mean sd correlation 1 2 3 1. negative thoughts 2.91 0.418 1 .351** .426** 2. negative emotions 3.08 0.623 .351** 1 .348** 3. negative behaviors 2.74 0.542 .426** .348** 1 (** p<.001) table 3 showed the manifestations coping thoughts with school violence among students. all items had the scores above the average, the most popular strategies was tolerance like “i see other students being treated like me, so i just let them do whatever they want” (m=2.94, sd=1.15) or i think no one can help me if i speak, so i just let others treat me badly (m=2.96, sd=0.84). www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 36 published by scholink inc. table 3. negative coping thought in case of experiencing school violence negative coping thoughts mean sd i see other students being treated like me, so i just let them do whatever they want 2.94 1.15 i think no one can help me if i speak, so i just let others treat me badly. 2.96 0.84 i am a helpless person. i am so weak that can not to protect myself 2.80 1.08 it is someone who tried to talk bad behind my back 2.92 0.89 i think that if anyone knows that i was being bullied, i will be upbraided and punished 2.93 0.95 table 4 showed the mean scores of emotional manifestations coping with school violence among students. students sometimes use negative emotions (including two responses to “showing” and “avoiding” negative emotions such as anger, anxiety, fear, depression) as a coping strategy to school violence (m=3.08, sd=0.86). more students showed emotions (m=3.18) than avoided emotions (m=2.84). table 4. negative coping emotions in case of experiencing school violence negative coping emotions mean sd i felt worried and fear every time my friends treat me violently 3.09 0.87 i got angry with other students who have behaved me unfairly 3.30 0.85 i felt depressed, sad and i did not want to do anything 3.15 0.84 i felt worried because i'm afraid people will find out that i was being treated badly by other students 3.15 0.78 i got irrationally angry with other people around (friends, family members, teachers...) 3.19 0.82 i hide my anxiety, fear, insecurity or anger with my friends, relatives, and teachers because i don’t want people to know i was bullied 2.91 0.97 i pretend to be happy with everyone around me to hide my insecure feelings 2.78 0.91 www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 37 published by scholink inc. in this survey, students also choose avoidance strategies in their coping behaviors, they “i avoid meeting, contacting with friends who have not treated me well” (m=3.10, sd=0.90), “i avoid or switch to another topic when someone asks me what i'm dealing with” (m=2.91, sd=0.97). few students find smoking or drinking alcohol or self-harm activities “fasting, banging my head against the wall, hurting myself after being hurt by my friends” (m=2.37, sd=0.67). table 5. negative coping behaviours in case of being bullied negative coping behaviors mean sd i avoid meeting, contacting with friends who have not treated me well 3.10 0.90 my bruises, scratches, lost or damaged were hidden. 2.91 0.88 i avoid or switch to another topic when someone asks me what i'm dealing with 3.06 0.74 i found solutions, and planned to retaliate against the person who treats me badly 2.91 0.97 i created another groups to fight against the one who treated me 2.88 1.02 i obeyed all requests of friends so that they do not treat me badly 2.36 0.75 i hurted myself like: fasting, banging my head against the wall, hurting myself after being hurt by my friends. 2.37 0.67 i used drugs, played violent games, and tried to win to get a sense of revenge against someone who treats me badly. 2.36 0.72 in this present study, results showed that there were three factors related to students coping strategies with school violence. among them, peer relationship influenced most (m=3.68), then parents relationship (m=3.51) and related school factors (m=3.50). table 6 showed social support factors (peer relationships, teacher-student relationship and school environment and family relationships) and negative coping strategies were negatively correlated (r=-0.41 to -0.52, p<0.01). www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 38 published by scholink inc. table 6. correlation coefficient between the support factors and the negative coping strategies latent variables negative thought negative emotion negative behavior peer relationships -0.53 -0.52 -0.45 teacher-student relationship and school environment -0.46 -0.52 -0.41 family relationships -0.45 -0.48 -0.39 (** p < 0.01) in terms of peer relationships, most students participating in this study all agreed that they had a quite positive friend relationship. their friends are willing to share, encourage and help them any time they need. for example, "friends always care and listen to me anytime i meet difficulties" (m=3.73) “when having difficulties, i will share with friends” (m=3.66) “my friend immediately recognizes my feelings if i am unhappy or behave differently” (m=3.66). table 7. descriptive statistic of peer relationships peer relationships mean sd friends always care and listen to me anytime i meet difficulties 3.73 8.09 when having difficulties, i will share with friends 4.98 6.85 regarding the relationship between students and teachers, the majority of students participating in this study agreed that they had a positive teacher-student relationship. they agreed that: “teachers are always listening, sharing and willing to support me in solving difficulties at school” (m=3.55), “school has measurements to deal with violence and bullying occurring between students” (m=3.50), “teacher treat every student the same” (m=3.43). with inverse statements like “i do not dare to share anything with teachers because i am afraid of them” (m=2.56), “teachers are very strict” (m=2.45). www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 39 published by scholink inc. table 8. descriptive statistic of teacher-student relationships and school environment teacher-student relationships mean sd teachers are always listening, sharing and willing to support me in solving difficulties at school. 5.81 5.19 when i have difficulties, i will ask teachers to support 4.77 5.19 teachers treat every student the same 5.81 8.51 i do not dare to share anything with teachers because i am afraid them * 24.48 27.39 school has policies to prevent school violence 5.60 8.51 teachers are strict* 20.12 28.22 note. statement with (*) have inverse meaning results also indicated that students had support from their parents and family members. in particular, they agreed that “parents always listen, share and support me when i have difficulties at school” (m=3.50), “my family members are willing to listen, share, sympathize and respect each other” (m=3.59), “when having difficulties at school, i will seek help from my parents” (m=3.49). with inverse statements like “my parents are so strict that i dare not actively speak out about my school difficulties” (m=2.57), “my parents are so busy that they do not have time to care about my friends” (m=2.45). table 9. descriptive statistics of family relationships family relationships mean sd parents always listen, share and support me when i have difficulties at school 3.50 0.95 when having difficulties at school, i will seek help from my parents 3.49 1.03 my family members are willing to listen, share, sympathize and respect each other. 3.59 0.89 my parents are so busy that they do not have time to care about my 2.57 0.93 www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 40 published by scholink inc. friends* my parents are so strict that i dare not actively speak out about my school difficulties* 2.45 0.87 note. statement with (*) have inverse meaning 4. discussion in this study, we aimed to investigate reported negative coping strategies used by students experiencing school violence. we also looked for interpersonal factors related to these strategies like peer relationships, teacher-student relationships and family relationships. regarding the reported coping strategies, the results indicated that negative emotion was the most popular among middle-school students. the correlation between the negative coping strategies among students experiencing violence indicated that if students have negative thoughts, they would also have negative coping emotions and behaviors. whereas, if students have positive thoughts when faced with school violence, they also have positive emotions and behaviors. in terms of coping strategies, when being bullied, most students endured and kept negative thinking about themselves. in particular, they often “let others treat them badly”, “let them do whatever they want to do” and even think that “someone talks bad behind my back” or “i am an useless person and not strong enough to protect myself”. they often deduce the problem rather than accept them. both coping strategies in the long run do not help students solve their problems, but also make the problem more complicated and negatively affect the student's mental health. emotions that they expressed including “i felt depressed, sad and i did not want to do anything” or “i got irrationally angry with other people around”. besides, some students selected avoiding such as “i pretend to be happy with everyone around me to hide my insecure feelings”. “i hide my anxiety, fear, insecurity or anger with my friends, relatives, and teachers because i don’t want people to know i was bullied”. in this survey, students would also select avoidance as one behavior strategy to copy with school violence. few students would look for smoking, drinking alcohol or taking revenge. the presence of peer support systems, teacher-student relationships and family support encourages students to cope with school violence positively. the results indicated that the more positive and supportive peer relationships, the more support and concern from teachers, the school and the student's family, the more positive the student’s response to negative actions reduction. in conclusion, the present study highlights that students need continuing intervention in coping with school violence effectively even where the participants come from schools with well-established systems of support and active whole school anti-bullying policies. there is an urgent need for school social work to identify those students who are victims and enable them to seek out the help that they need. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 41 published by scholink inc. acknowledgement the development of this study is under the financial support of the project “school social work in preventing school violence among middle school students”, ministry of education and training, vietnam, code b2019-sph-10. references burns, s., maycock, b., cross, d., & brown, g. (2008). the power of peers: why some students bully others to conform. qualitative health research, 18(12), 1704-1716. https://doi.org/10.1177/1049732308325865 cowie, h., & olafsson, r. (2000). the role of peer support in helping the victims of bullying in a school with high levels of aggression. school psychology international, 21(1), 79-95. causey, d. l., & dubow, e. f. (2012). development of a self-report coping measure for elementary school children david. ministério da agricultura, pecuária e abastecimento. ministério do desenvolvimento agrário, coordenação da casa civil da presid~encia da república-brasilia: mapa/acs., january 2015, 173. https://doi.org/10.1207/s15374424jccp2101 davidson, l. m., & demaray, m. k. (2007). social support as a moderator between victimization and internalizing-externalizing distress from bullying. school psychology review, 36(3), 383-405. https://doi.org/10.1080/02796015.2007.12087930 de oliveira, w. a., da silva, j. l., sampaio, j. m. c., & silva, m. a. i. (2017). students’ health: an integrative review on family and bullying. ciencia e saude coletiva, 22(5), 1553-1564. https://doi.org/10.1590/1413-81232017225.09802015 eisenbraun, k. d. (2007). violence in schools: prevalence, prediction, and prevention. aggression and violent behavior, 12(4), 459-469. https://doi.org/10.1016/j.avb.2006.09.008 finley, l. l. (2008). teachers’ perceptions of school violence issues. journal of school violence, 2(2), 51-66. https://doi.org/10.1300/j202v02n02 folkman, s., & lazarus, r. s. (1988). an analysis of coping in a middle-aged community sample. kango kenkyu. the japanese journal of nursing research, 21(4), 337-359. lazarus, r. s. (2006). emotions and interpersonal relationships: toward a person-centered conceptualization of emotions and coping. journal of personality, 74(1), 9-46. https://doi.org/10.1111/j.1467-6494.2005.00368.x mertoglu, m. (2015). the role of school management in the prevention of school violence. procedia -social and behavioral sciences, 182, 695-702. https://doi.org/10.1016/j.sbspro.2015.04.815 morrison, g. m., & furlong, m. j. (1994). school violence to school safety: reframing the issue for school psychologists. school psychology review, 23(2), 236-256. nabuzoka, d., rønning, j. a., & handegård, b. h. (2009). exposure to bullying, reactions and psychological adjustment of secondary school students. educational psychology, 29(7), 849-866. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 42 published by scholink inc. https://doi.org/10.1080/01443410903326613 naylor, p., & cowie, h. (1999). the effectiveness of peer support systems in challenging school bullying: the perspectives and experiences of teachers and pupils. journal of adolescence, 22(4), 467-479. https://doi.org/10.1006/jado.1999.0241 nuttman-shwartz, o., & dekel, r. (2009). ways of coping and sense of belonging in the face of a continuous threat. journal oftraumatic stress, 22(6), 667-670. https://doi.org/10.1002/jts pellegrini, a. d., & bartini, m. (2000). an empirical comparison of methods of sampling aggression and victimization in school settings. journal of educational psychology, 92(2), 360-366. https://doi.org/10.1037//0022-0663.92.2.360 raskauskas, j. (2010). multiple peer victimization among elementary school students: relations with social-emotional problems. social psychology of education, 13(4), 523-539. https://doi.org/10.1007/s11218-010-9124-0 rivers, i., poteat, v. p., noret, n., & ashurst, n. (2009). observing bullying at school: the mental health implications of witness status. school psychology quarterly, 24(4), 211-223. https://doi.org/10.1037/a0018164 roffey, s. (2012). pupil wellbeing -teacher wellbeing: two sides of the same coin? educational and child psychology, 29(4), 8-17. scheckner, s., rollin, s. a., kaiser-ulrey, c., & wagner, r. (2002). school violence in children and adolescents: a meta-analysis of the effectiveness of current interventions. journal of school violence, 1(2), 5-32. https://doi.org/10.1300/j202v01n02_02 schreck, c. j., miller, j. m., & gibson, c. l. (2003). trouble in the school yard: a study of the risk factors of victimization at school. crime & delinquency, 49(3), 460-484. https://doi.org/10.1177/0011128703252275 swearer, s. m., espelage, d. l., vaillancourt, t., & hymel, s. (2010). what can be done about school bullying? linking research to educational practice. educational researcher, 39(1), 38-47. https://doi.org/10.3102/0013189x09357622 tenenbaum, l. s., varjas, k., meyers, j., & parris, l. (2011). coping strategies and perceived effectiveness in fourth through eighth grade victims of bullying. school psychology international, 32(3), 263-287. https://doi.org/10.1177/0143034311402309 children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 5, no. 1, 2022 www.scholink.org/ojs/index.php/ct 1 original paper the effect of skimming on educational reading texts mahmoud kamal ibrahim mostafa1* 1 english department, faculty of common first year, jouf university, al-jouf, saudi arabia * mahmoud kamal ibrahim mostafa, english department, faculty of common first year, jouf university, al-jouf, saudi arabia received: march 29, 2022 accepted: april 14, 2022 online published: april 25, 2022 doi:10.22158/ct.v5n1p1 url: http://dx.doi.org/10.22158/ct.v5n1p1 abstract the present study investigated the effect of skimming on the learners’ educational reading comprehension skills. in order to answer research questions, the researcher used both qualitative and quantitative methods. the researcher used observation and questionnaires as instruments to collect the data. the participants were 28 students in the common first year at al-jouf university for the academic year 2020/2021. the study lasted for four weeks. the instruments of the study included observation and a questionnaire. they were approved by a panel of jury. the result of the study showed that most of the students positively responded that the skimming technique was an effective way to understand educational reading texts and helped them to answer the questions attached to the texts easily and quickly. as such, it was concluded that skimming had a positive effect on developing efl university learners’ reading comprehension skills. keywords reading comprehension, skimming technique 1. introduction learning to read is very important to enable formal education in which reading to learn takes the central focus (william, 1998). educational institutions today demand readers who are able to read and find the main ideas faster than before. there are now more media in which information is being conveyed which requires more effective instruction approaches to assist learners in effectively understanding the ever-increasing variety of textual formats (morrow & gambrell, 2003). the basis of it all is the ability to read which has been defined as; “the process of deriving meaning from print” (reynolds & fletcher-janzen, 2002; njuki & nakitende, 2013, p. 12). in addition, (harris, 1981) defines reading as an interpretation of written word symbols through interaction between graphic symbols which represent language, and the readers’ skills in the language www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 1, 2022 2 published by scholink inc. with an aid of cognitive and background knowledge. alvermann and moore (1991) investigate that students are assigned to read increasingly complex materials, but teachers spend little time showing them how to be strategic. therefore, it is very important to encourage the students to create a different perspective on why the reading practice is important for them. based on the researcher’s colleagues' experience, students tend to be away from reading comprehension texts. they do not want to think about the main idea or particular features of texts. so, they need a creative way to encourage them to think to find the main idea. according to the topic of the researcher, educational reading comprehension texts are more suitable for high school students. they practice reading from time to time, and it is a smart way to include skimming techniques to improve their reading comprehension skills. the main emphasis in this study is skimming as a technique used for improving reading comprehension, but it cannot be isolated from the other components of reading comprehension. comprehension means the degree to which the reader is able to extract relevant information from a text. during the process of reading, an encoder gets involved in the sending and receiving of the message respectively. the encoder is the writer who acts as the sender of the message and the decoder is the reader who acts as a recipient. vacca (2000) is emphasizing that teachers should be in a position of putting into practice the new approaches and skills in order to ensure effective reading comprehension. according to pressley (2006, p. 35), “reading comprehension is about getting the meaning out of the text”. at the same goodman agrees that reading comprehension should be understood as making sense of print (goodman, 1994; pressley, 2006). so in this study, according to the researcher’s point of view, skimming is a method of rapid reading which will help students to understand the overall theme or general meaning of the text. it is a fast reading technique that helps readers quickly identify the main idea of a text. the skimming technique is used to obtain the gist or overall sense of a text. the reader does not pronounce each and every word of the text, rather he focuses his attention on the subject matter, an overall view of the text, and prepares himself to summarize the given text, give points of the text, rewrite the subject matter in his own words, and give a suitable title to the text. such points indicate that skimming is like global listening. the prior knowledge has been proven to have a positive effect on reading by many researchers (roth, 2004). as such, it is very important to regard learners as individuals who have a foundation in them on which classroom instruction can build. skimming is a systematic process of reading by which reading speed, as well as comprehension (understanding), can be enhanced throughout four stages: in the first stage, the reader collects general information through a survey of the text. it is some sort of skimming in its nature. the reader looks at the layout, titles, sub-titles, tab of contents, and illustration to get a general impression of the text. in the second stage, the reader makes questions (in his mind) related to the text. it is to make sure that he is going to involve in a purposeful study and will try to find out answers to the questions arising in his mind. in the third stage, the reader begins reading the text. www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 1, 2022 3 published by scholink inc. this reading is an intensive reading in which the reader concentrates on the script, punctuation marks, variation in type (or composting), the way paragraphs are formed, etc. in the fourth stage, the reader stops actual reading and recalls to his mind whatever he has read so far. he tries to bring back to mind what he has extracted from the text. in the fifth stage, the reader gets indulged in the process of “review”. so the reader practices four steps such as survey, questioning, reading, and recalling. the main aim of this study is to investigate how efl learners’ reading comprehension is. the special focus will be on methods, resources, and assistance that teachers give to learners in an inclusive setting. other areas of interest are the challenges that are encountered in teaching reading comprehension and suggestions on how these challenges can be overcome. harrison (2004, p. 51), declares that comprehension is the process of getting meaning of a communication, as in a personal letter, speech, or sign language; the knowledge or understanding that is the result of such a process. it means that reading comprehension is a kind of silent communication between the writer and the reader. the writer is the sender of information, and the reader is the receiver of information. furthermore, the reader uses skimming to get the main idea by jumping from one paragraph to another. the recent research on reading comprehension is not focused on the degree to which the reader is able to extract relevant information from a text, especially educational reading texts. reading requires the reconstruction of the message. it demands thinking and planning on the part of the reader. the reader must distinguish the text from the supporting ideas and at the same time, he has to recognize the hidden meanings. so, high school students need to be developed through the total act of reading the “decision making” process as the reader attempts to discover meaning according to his own sense. therefore, this study is set at enhancing the use of effective instructional strategies for reading comprehension. reading requires the reconstruction of the message. it demands thinking and planning on the part of the reader. the reader has to distinguish the text from the supporting ideas and at the same time, he has to recognize the hidden meanings. the total act of reading is a “decision-making” process as the reader attempts to discover meaning according to his own sense. therefore, from a skimming perspective, learners may be at different levels of understanding, but they should necessarily have the same understanding. by skimming the speed of reading can be increased. it is to go through the text quickly to get a general understanding. one of the easiest ways to skim-read is to look at the center section of a text and then run the eyes down the center area. it is not reading every word but reading very quickly to get general ideas about a text. 2. method the current study methodology includes the research design, the participants and sample selection, the research instruments (observation and questionnaire), and the procedures used for data collection as well as the data analysis. the study aimed to improve efl university learners’ reading comprehension skills. www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 1, 2022 4 published by scholink inc. 2.1 research design the present study used quantitative and qualitative methods. johnson and christensen (2012) mentioned that quantitative research generally discusses the measurement of numbers. in survey research, it is usually measured by using scales (p. 376). the questionnaire usually provides statements with multiple choice allowable response categories. after getting the answers from the students, the researcher starts calculating the average for the groups of respondents. therefore, this method is useful to investigate the effect of skimming on the reading comprehension improvement of efl learners. this research took place at al-jouf university. this research was conducted on educational reading passages of the cfy (common first year) students’ headway intermediate book. the duration of every meeting was 50 minutes twice a week. this program lasted for two weeks with four meetings. it included the observation and the questionnaire which were the instruments used in the research. 2.2 participants of the study the participants of this program were second-semester students of the cfy at aljouf university, the academic year 2021/2022. there were 28 students in the educational reading class and the researcher focused on the effect of the skimming technique on the students’ reading comprehension. 2.3 the instruments and materials of the study 1) the observation notes. 2) the questionnaire. in order to collect the data of the research, the researcher used two instruments, the observation, and the questionnaire. according to ary et al. (1979), there are two types of questionnaires, closed-form and open one. “the closed-form is used to make it easy for the participants because they just choose the available options, while the open form is used to obtain more information” (p. 75). this research used the closed-form of questionnaires to show the importance of using the skimming technique to improve efl university students’ reading comprehension skills. the researcher observed the participants in four different sessions while educational reading classes from headway intermediate level using skimming as a technique to generate the main ideas and main points of each educational reading passage in order to improve the students’ reading comprehension skills. after the four sessions, the researcher gave the participants the questionnaire to respond to its components. all items of the questionnaire are related to the research problem formulated in chapter one. every statement in the questionnaire is made based on theories related to the research topic. the questionnaire was set from the reading theories as follows: 2.4 data analysis data analysis took place after receiving the participants’ responses for the questionnaire. first, the researcher analyzed the observation and made the descriptions of the observation. next, the researcher analyzed the questionnaire that had been given after the observation finished. the questionnaire was counted by using a degree of agreement and disagreement on the item statements of the questionnaire www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 1, 2022 5 published by scholink inc. form. the researcher had given five degrees of agreement. after that, the researcher made the percentage and interpretation of the questionnaire that had been counted. after the researcher got the data from the questionnaire, the researcher made a description of each statement of the questionnaire. the data was presented in a form of a table (see table 4). 3. results based on the data collected, the researcher found out that the skimming technique gave students the chance to improve their reading comprehension skills. the following tables show the result. table 3. statements & theories no statements theories 1 the skimming technique can contribute a valuable experience in reading comprehension research and give information and knowledge to the readers of how to get the main point of the text. skimming is a process of quick coverage of reading comprehension to establish its gist or main idea ( brown, 2004, p. 213) 2 skimming allows us to have a general idea of what we are reading. skimming is a predictive strategy to give the reader a sense of the main topic and the purpose of the text, the organization of the text, the perspective or point of view of the writer, its ease or difficulty, and/or its usefulness to the reader ( brown, 2004, p. 213) 3 after the skimming technique has been applied, it is easier to answer the questions in a reading text. the purpose of reading is simply to find the answer to a question. the students skim through the reading passage looking for just one thing, the answer ( fry, 1963, p. 61) 4 skimming saves time while reading and understanding the text. skimming helps students to find the general idea without taking a long time (fry, 1963, p. 60) 5 the skimming technique facilitates me to find the specific information from the text. skimming is a skill that requires concentration, superior vocabulary, and adequate comprehension skills (simanjuntak, 1988, p. 55) 6 the skimming technique facilitates me to understand difficult words. skimming is a skill that requires concentration, superior vocabulary, and adequate comprehension skills www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 1, 2022 6 published by scholink inc. (simanjuntak, 1988, p. 55) 7 while reading, i need more time to read and understand the context of the passage. it needs a high accuracy in determining the precise time for reading activity (santoso, 2017, p. 24) 8 it is difficult for me to understand new vocabulary while using the skimming technique. skimming needs extra time to solve students’ problems in reading skills (sntoso, 2017, p. 24) table 4. findings (participants' responds) no statements strongly agree agree neutral disagree strongly disagree 1. skimming allows us to have a general idea of what we are reading. 10 10 6 2 0 2. skimming makes me aware of the benefits of the information available in reading materials both authentic and inauthentic. 4 14 6 2 2 3. after the skimming technique has been applied, it is easier to answer the questions in a reading text. 4 19 5 0 0 4. skimming saves time while reading and understanding the text. 12 13 3 0 0 5. the skimming technique facilitates me to find the specific information from the text. 6 14 6 2 0 6. the skimming te0chnique does not only focus on asking me to do reading text but also focuses on equipping me with the technique used in different texts. 1 12 11 3 1 www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 1, 2022 7 published by scholink inc. 7. skimming makes me aware of the reading strategy used to find the stated and unstated information in the text. 11 9 7 1 0 8. it is difficult for me to understand new vocab while using the skimming technique. 2 6 18 2 0 9. skimming technique facilitates me to predict the content of the text. 4 19 5 0 0 10. the skimming technique prepares me to be an independent reader. 7 16 2 2 1 discussion table shows the results of the questionnaire about the effect of the skimming technique in educational reading comprehension texts as follows: 1) skimming allows me to have a general idea of what we are reading. in skimming, “the students attempt to get the main idea of every paragraph plus a few of the facts” (fry, 1963, p. 53). skimming is a technique that drills the reader to reads the keywords to get the main idea and then they would find a few of the facts or information in the passage. therefore, students should be concentrated when they read a passage. there were 35.72 % (10 students) of the total respondents strongly agreed and 53.57% (10 students) of the respondents agreed with this statement. there were 21.43% (six students) of the total respondents chose neutral. there were 07% (two students) of the total number chose to disagree with the statement and none of the respondents strongly disagreed with that statement. based on the result, it can be concluded that the skimming technique allowed students to have a general idea of the reading passages. 2) skimming makes me aware of the benefits of the information available in reading materials both authentic and inauthentic. wase was 21.43 % (6 students) of the total respondents strongly agreed and 42.9% (12 students) of the respondents agreed with this statement. there were 21.43% (six students) of the total respondents chose neutral. there were 07% (two students) of the total number chose to disagree with the statement and 07% (two students) of the respondents strongly disagreed with that statement. based on the result, it can be concluded that the skimming technique made students aware of the information available in reading passages both authentic and inauthentic. www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 1, 2022 8 published by scholink inc. 3) after the skimming technique has been applied, it is easier to answer the questions on a reading text. there was 14.30 % (4 students) of the total respondents strongly agreed and 67.85. % (19 students) of the respondents agreed with this statement. there were 67.85% (nineteen students) of the total respondents chose neutral. there were 17.85% (five students) of the total number chose to disagree with the statement and none of the respondents strongly disagreed with that statement. based on the result, it can be concluded that after applying the skimming technique, it was easier to answer the questions in the reading passage. 4) skimming saves time while reading and understanding the text. there were 42.85 % (12 students) of the total respondents strongly agreed and 46.42% (13 students) of the respondents agreed with this statement. none of the students of the total respondents chose neutral. there were 17.85% (three students) of the total number chose neutral to the statement and none of the respondents disagreed nor strongly disagreed with that statement. based on the result, it can be concluded that the skimming technique saves time while reading and understanding the text. 5) skimming technique facilitates me to find the specific information from the text. there was 21.43 % (6 students) of the total respondents strongly agreed and 50% (14 students) of the respondents agreed with this statement. none of the students of the total respondents chose neutral. there was 21.43% (6 students) of the total number chose neutral to the statement and 07% (2 students) of the respondents disagreed and none of the students strongly disagreed with that statement. based on the result, it can be concluded that the skimming technique saves time while reading and understanding the text. 6) skimming technique does not only focus on asking me to do reading text but also focuses on equipping me with the technique used in different texts. there were 0.035 % (one student) of the total respondents strongly agreed and 39.28% (11 students) of the respondents agreed with this statement. there were 42.85% (12 students) of the total respondents chose neutral. there were 10.71 % (three students) of the total number chose to disagree with the statement and 0.035 % (one student) of the respondents strongly disagreed with that statement. based on the result, it can be concluded that the skimming technique helped students to understand different texts. 7) skimming makes me aware of the reading strategy used to find the stated and unstated information in the text. “skimming technique keep the students informed in their general field of interest without taking their time that average reading would” (fry, 1963). based on the questionnaire results, it showed that students who chose agree and strongly agree were almost equal. they were agreed and also strongly agreed that when the skimming technique is implemented in the teaching reading activity. there were 39.28% (eleven students) of the total respondents strongly agreed and 32.14 % (nine www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 1, 2022 9 published by scholink inc. students) of the respondents agreed with this statement. there were 25 % (seven students) of the total respondents chose neutral. there were 0.035 % (one student) of the total number chose to disagree with the statement and 0.00 % (no student) of the respondents strongly disagreed with that statement. based on the result, it can be concluded that the skimming technique helped students to be aware of the reading strategy used to find stated and unstated formations in the reading text. 8) it is difficult for me to understand new vocab while the skimming technique. there were 7.14% (two students) of the total respondents strongly agreed and 21.42 % (six students) of the respondents agreed with this statement. there were 64.28 % (eighteen students) of the total respondents chose neutral. there were 7.14% (two students) of the total number chose to disagree with the statement and 0.00 % (no student) of the respondents strongly disagreed with that statement. “skimming needs extra time to solve students’ problems in reading skills” (santoso, 2017). one of the students’ problems in the reading activity understands the meaning of a new word in the passage. however, there were almost more than half of the students chose neutral in this statement. it showed that sometimes students can understand the meaning of a word when skimming technique and sometimes they cannot, it depends on the level of difficulties in a passage. based on the result, it can be concluded that the skimming technique did not help students to understand new vocabulary in the reading text. this is because skimming is different from scanning as it is searching for the main idea of a text. so, there is no time to find out the meaning of new vocabulary. 9) skimming technique facilitates me to predict the content of the text. this statement related to the theory that brown (2004) stated that “skimming is a prediction strategy used to give a reader a sense of topic and purpose of the text, the organization of the text, the perspective or point of view of the writer, it eases or difficulty, and/or its usefulness to the reader.” there were 14.28% (four students) of the total respondents strongly agreed and 67.85 % (19 students) of the respondents agreed with this statement. there were 17.85 % (five students) of the total respondents chose neutral. there were 0.00% (no students) of the total number chose to disagree with the statement and 0.00 % (no student) of the respondents strongly disagreed with that statement. based on the result, it can be concluded that the skimming technique helped students a lot to predict the content of the reading text. 10) skimming technique prepares me to be an independent reader. there were 25 % (seven students) of the total respondents strongly agreed and 57.14% (sixteen students) of the respondents agreed with this statement. there were 7.14 % (two students) of the total respondents chose neutral. there were 7.14% (two students) of the total number chose to disagree with the statement and 3.57 % (one student) of the respondents strongly disagreed with that statement. www.scholink.org/ojs/index.php/ct children and teenagers vol. 5, no. 1, 2022 10 published by scholink inc. 5. conclusions based on the result, it can be concluded that the skimming technique helped students to be independent readers and have the capacity to paraphrase sentences and add their own points of view while and after reading educational texts. references ary, d., jacobs, l. c., & razavieh, a. (1979). introduction to research in education (2nd ed.). new york: holt rine and winston inc. alvermann, d. e., & moore, d. w. (1991). secondary school reading. new york: longman. bam ford, j., & richard, r. d. (2004). extensive reading activities for teaching language. cambridge handbooks for language teachers. cambridge, england. brown, h. d. (2004). language assessment principles and classroom practice. brown, h. d. (1994). teaching by principles: an interactive approach to language pedagogy. upper saddle river, prentice hall regents. harrison, c. (2004). understanding reading development. london: sage publications. njuki, e. p., & nakitende, r. c. (2013). the effect of training teachers in phonemic awareness and letter-sound knowledge on children’s reading competencies: a ugandan urban context dissertation. the university of oslo. nuttal, c. (1982). teaching reading skill in a foreign language (new edition.). heinemann educational book: oxford university press. santoro, n., & read, j. a. (2010). all things to all people. european journal of teacher education, 22. susanti, m. (2013). an analysis of students’ reading comprehension achievement by using scanning and skimming techniques for introvert and extrovert students at smpn 29. william, e. (1998) language proficiency and reading ability in first and second language (electronic version). london: overseas development administration. children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 1, no. 1, 2018 www.scholink.org/ojs/index.php/ct 24 original paper the research of early childhood art education in taiwan yi-huang shih1* 1 department of early childhood educare, ching kuo institute of management and health, keelung, taiwan * yi-huang shih, department of early childhood educare, ching kuo institute of management and health, keelung, taiwan. received: march 13, 2018 accepted: april 2, 2018 online published: april 11, 2018 doi:10.22158/ct.v1n1p24 url: http://dx.doi.org/10.22158/ct.v1n1p24 abstract in general, the research of early childhood art education has its importance. for this reason, research into early childhood art education in taiwan has been emphasized by scholars, in the hope that preschool teachers can better understand the early childhood art education. by reading, analyzing and discussing related studies, this paper aims to explore the research of early childhood art education in taiwan. hopefully, such an exploration can help teachers understand concepts related to early childhood art education, and most importantly develop an excellent praxis of early childhood art education. after reading, analyzing and discussing related studies, the research issues of early childhood art education in taiwan we identified are as follows: (1) young children’s art making processes, (2) the practice of implementing an aesthetic thematic curriculum, (3) the development of learning indicators of the aesthetic domain for kindergarten curriculum in taiwan, (4) the teaching principles of aesthetic education in early childhood, (5) multicultural art education for children, (6) investigation of art education in kindergartens, (7) children’s art learning with parents, (8) making use of picture books to design a suitable art integrated curriculum for children, (9) teaching art appreciation in kindergarten, (10) employee retention and collaboration with art institutions on early childhood education, (11) integrating mangrove environmental education into art teaching for young children, and (12) the progress of implementing aesthetic feelings by integrating a community based viewpoint. keywords early childhood art education, research, young children’s art www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 25 published by scholink inc. 1. introduction early childhood education is the foundation of all basic education and plays an important role in individual development. thus, it has an important impact on the future. there is less academic pressure at the learning stages of early childhood than at any other stages. as such, this stage is an important period in which to perform childhood art education. young children in this learning stage are often curiosity about many things (chen, 2016). instilling reasonable beliefs about early childhood art education will promote the aesthetic development of young children at this stage. presently, due to rapid economic development in taiwan, many mothers with young children have joined the workforce. unlike the traditional family structure in taiwan, most younger parents do not live with their own parents, who used to help take care of their grandchildren. presently, most nuclear families in big cities include only parents and young children. these young parents need to take on the child-care responsibilities by themselves. when young mothers also need to work outside the home during the day, kindergartens or day care centers become the only choice available as a substitute to fulfill these child care needs. in addition, when considering the educational needs of their young children, mothers may prefer to send their children to kindergartens to receive education even if they do not need to work. this phenomenon is especially evident in the big cities (lai, 2000). the ministry of education proposed the provisional guidelines for preschool’s educare activity and curriculum for teaching kindergarten in taiwan. curriculum of preschools includes six domains. one of the six domains is the aesthetic domain. furthermore, providing meaning-rich learning experiences can be seen as one of the most important goals of education. how can learners have meaning-rich learning experiences? this question may be briefly understood based on two aspects: the content of subject matter and pedagogy (hung, 2018). therefore, teachers play an important role in the process of providing meaning-rich learning experiences. art can be one kind of language for young children. children's drawings provide a window to see into their own personal world (wei & lin, 2009). many scholars have discussed the importance of early childhood art education research in taiwan (shih, lai, & wang, 2017). for this reason, by reading, analyzing and discussing related studies, this paper aims to explore the research of early childhood art education in taiwan, help teachers understand related concepts, and develop the excellent praxis of early childhood art education. 2. the importance of early childhood art education 2.1 value of young children’s art as we all know, young children are very interested in art and art creation. why is this so? in addition to serving as presents for parents and decorations for the home refrigerator, art serves as a natural vehicle for young children to present their creative ideas and express their inner feelings (lai, 2000). art is basic. of course, every subject area is important, but no program for young children could succeed www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 26 published by scholink inc. without emphasizing art. through making, looking at, and talking about their own artwork and the art of others, three-, four-, and five-year-old children are doing the following: (1) expressing their feelings and emotions in a safe way. they learn to control their emotions and recognize that they can express and handle negative as well as joyous feelings through positive action; (2) practicing and gaining fine muscle control and strengthening eye-hand motor coordination; (3) developing perceptual abilities. awareness of colors, shapes, forms, lines, and textures result as children observe these and try to replicate them through art; (4) being given the opportunity to make choices and solve problems. making art offers children a multitude of choices and many decisions to make; (5) seeing that others have differing points of view and ways of expressing these than they do; (6) becoming aware of the idea that, through art, culture is transmitted; (7) experiencing success. because art leaves the end open to the creator, all children experience a measure of success (seefeldt & wasik, 2006). 2.2 the praxis of early childhood art education is important if education were to continue along the old lines of mere transmission of knowledge, the problem would be insoluble and there would be no hope for the world (montessori, 1963). in other words, education is not just transmission of knowledge, but it should also provide different learning experiences for young children. children’s art creation is one of these learning experiences. however, traditionally, art teachers put a lot of emphasis on drawing techniques, while neglecting the process of art experiences and the importance of provoking creativity. in this new century, the holistic experiences obtained through art are integrated within multiple cultures. piscitelli and weier pointed out that the new trade of art education offers support for integrating rich, meaningful art experiences. by doing this, the art teacher challenges children to reach a deeper level of understanding that goes beyond their current mental level of functioning (wei & lin, 2009). moreover, infants and toddlers readily enjoy activities and experiences in the arts that reflect their environment and everyday life. art related activities can be designed to include one-on-one interaction with a parent, professional or other caregiver. activities in the arts should encourage infants and toddlers to use their senses, curiosity and imagination, while reinforcing early language and literacy skills; for example, singing and playing, or even dancing to “the itsy bitsy spider…”. such activities also encourage new word learning and reinforce the child’s language by providing as many experiences as possible to label objects used in an art form or even label works of art. for instance, “these are shakers. let’s shake them together to make some music” (malley, 2005). every child is born with creative potential. it is our job in early learning programs, and later school years, to nurture that creativity and support resourceful problem-solving, imaginative thinking, and transference of skills and knowledge to new experiences. this new review adds to the growing evidence about how art participation helps young children develop strong social and emotional skills www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 27 published by scholink inc. (national endowment for the arts, 2015). the praxis of early childhood art education is important. on the intuitive level, there is significant merit in setting up art centres in preschool classrooms and allowing children to play with art materials. there is something good about it (kindler, 2010). 3. the research issues of early childhood art education in taiwan the research issues are illustrated as follows: 3.1 young children’s art making processes the arts are a wonderful way to help children learn, express themselves and have fun! the arts take many forms that include music, singing, dance, movement, drawing, painting, sculpting, storytelling, performing, and dramatic play. all young children need opportunities to create, participate in and perform a variety of activities in the different art forms. these experiences should reflect the child’s preferences and interests, as well as developmental skills and culture (malley, 2005). furthermore, arts participation in early childhood often includes such activities as music, song, and dance; drama and theater; visual arts, crafts, and artistic creation (nea, 2004). for example, shih, lai and wang’s research explores the process of a day-care teacher’s art course teaching. by such an exploration, young children can encounter art. to fulfill this purpose, weaving a “spider web” is used as an example to illuminate young children’s art making process. it was hoped that art can enter young children’s minds through this kind of exploration (shih, lai, & wang, 2017). 3.2 the practice of implementing an aesthetic thematic curriculum chen’s study aimed to investigate the practice of implementing an aesthetic thematic curriculum in a preschool in taiwan. the major findings are as follows: (1) based on young children’s life experiences, the co-teachers applied a thematic approach to integrating the aesthetic domain and other learning domains in the aesthetic thematic curriculum, focusing on the topic of “beautiful restaurants”; (2) the young children’s aesthetic abilities were developed in terms of exploring and perceiving, performing and creating, and responding and appreciating. moreover, there was a significant difference in the children's aesthetic abilities; (3) the co-teachers promoted their professional development in aesthetic curriculum design and aesthetic teaching skills (chen, 2017). 3.3 the development on the learning indicators of aesthetic domain for kindergarten curriculum in taiwan in lin’s study, in order to prepare for the curriculum guideline after the integration of preschool and kindergarten in taiwan, the ministry of education commissioned some scholars to construct the learning indicators for six learning domains in the new preschool and kindergarten curriculum guideline between 2006 and 2008. based on the empirical research findings, lin constructed a drama indicator and scale as an example to show the development of the aesthetic learning indicators. the findings provide foundations for theory and studies in both the aesthetic domain of young children in www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 28 published by scholink inc. taiwan and the process of constructing learning indicators (lin, 2012). 3.4 the teaching principles for aesthetic education in early childhood since broadening the aesthetic experiences of young children is an element of early childhood education, aesthetic education is important at this stage. shih’s study aimed to give preschool teachers a better understanding of the teaching principles for aesthetic education in early childhood so that young children can receive the appropriate type of aesthetic education. these principles broaden the aesthetic experience and promote the children’s aesthetic literacy. the teaching principles for aesthetic education in early childhood are: (1) artistic teaching, (2) life-based teaching, (3) diversified teaching, (4) teaching through experience, (5) teaching by doing, (6) individual teaching, (7) imaginative teaching, and (8) perceptual teaching. this study was intended to allow preschool teachers to more fully incorporate aesthetic teaching in early childhood education (shih, 2018). 3.5 multicultural art education for children in the 1970s, a worldwide movement toward multiculturalism grew out of the 1960s civil rights movement in the united states. multicultural education has since become an international education reform movement. in art education, reconceptualized curricula have been recommended to reflect the nature of the culture and the environment in which the students are socialized. historically, taiwan has been the home of immigrants and in recent years, it still is. cultural diversity is a fact in taiwan. however, visual art education has not reflected the multicultural nature and democratic society of taiwan. kuo’s study advocated the understanding and respect for the multi-cultures of taiwan in order to enhance the equity of society. this study discussed some alternative conceptions and characteristics of culture, the nature of culture in taiwan, multicultural perspectives in visual art education and the implementation of art instruction which celebrates diversity through a multicultural approach (kuo, 2010). in addition, wu’s study aimed to explore a 4-unit teaching plan and children’s performance in the study of multiculturalism through a self-designed “culturally diverse arts” course unit, and to conduct course assessment and feedback analysis. results of the study are as follows: (1) the implementation of the course promotes the children’s acknowledgement of native culture; (2) children’s understanding and identification of multiculturalism come from their cultural experience. they interpret different cultures with their cognition of life experience and express their opinions on multiculturalism and the application of culture with artistic materials; (3) course assessment and feedback: the experiential cultural activities included in culturally diverse arts courses are very popular among children because they conform to the principle of “learn by doing”. during the process, the teacher’s ability to design a course and to review his/her teaching activity was improved (wu, 2009). 3.6 investigation of art education in kindergartens wu’s research explored the practice of art education in taipei city. the general conclusions were: (1) www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 29 published by scholink inc. art teachers’ professional training was varied, so they should enhance their professional skills before and during their teaching; (2) most art teachers’ teaching was based on the kindergarten curriculum standards and aimed to promote children’s creativity; (3) most art teachers approve of their teaching approaches; (4) art teachers chose various evaluation approaches; evaluations were mostly carried out by the teachers, and the results were meant to provide parents with knowledge concerning their children’s art studies; although children nearly all had their own portfolio, only one fifth of the art teachers adopted portfolio evaluation; and (5) the most reflected difficulties were: (a) art teachers needed to do more studying and training in art education, and (b) insufficient teaching time (wu, 2007). 3.7 children’s art learning with parents taiwan’s parents today pay greater attention to children’s art education. given that parents play crucial roles in children’s early development stage, it is very meaningful for children to be guided by their parents in art learning. lia’s research adopted a qualitative case study method in which three cases of parents’ teaching experiences were studied. the research findings suggest that: (1) a child’s mother and father may have different expectations, teaching styles, and use different language that may impact a child’s attitude toward learning and creativity; (2) authoritative teaching style coupled with guidance over a child’s capacity are likely to divert a child’s attention from parents’ instructions, causing them to feel puzzled and confused, lose attention, and be less confident; (3) parents’ teaching helps a child to develop his/her potentials and thus to improve child learning; (4) parents’ teaching changes the communication between a child and his/her parents and attitude toward art learning; (5) the biggest problem that parents encounter in art teaching is the lack of time and psychical capacities due to long work hours; (6) when parent’s teaching extends the topics taught in school, it is more likely to make a child motivated and creative (lia, 2011). 3.8 making use of picture books to design integrated art curriculum suitable for children hsieh’s study made use of picture books to design an integrated art curriculum suitable for children and investigate the procedure and its effect on children’s learning after carrying out of the instruction. hsieh’s study was an action research applied to kids in a class. during the process of the action research, various picture books were used. the major findings of the study are: (1) art education helps promote the positive sides of society and individuals during preschool education; (2) teachers’ playing applying scaffolding design to integrated children’s art curriculum should consider children’s developmental processes and experiences; (3) the diversity and artistic quality of picture books can balance children’s development of diverse intelligence and inspire their imagination and creation, and thus, improve children’s art leaning; (4) integrated art curriculum with picture books can promote children’s appreciation of beauty as well as attitude toward creation for art. furthermore, these books help to build up their confidence and enjoyment of reading (hsieh, 2012). 3.9 teaching art appreciation in kindergarten www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 30 published by scholink inc. yu’s study focused on teaching art appreciation in kindergarten. based on the classroom observation of art teaching and the conclusions from literature reviews, the following conclusions were obtained: (1) for curriculum design: researchers have blended art appreciation ideas into their learning units to develop art education for preschool kids. picture book appreciation, art experience activities and art creation have also been adopted for art education; (2) the process and the effect: preschool kids are more interested in learning art appreciation through picture books. by experiencing art, preschool kids learn to explore the sensory experiences in their environment. they also learn to show their feelings and thoughts through art creation; (3) preschool kids learn to know art and are inspired by art. they learn to think, to appreciate and to create with art. teachers are more enthusiastic about teaching with art and were are inspired by art (yu, 2011). 3.10 employee retention and collaboration with art institutions on early childhood education chen’s study investigated and resolved the issues of turnover and unwillingness to collaborate with employees in an art institution on early childhood education. based on action research methodology, results of the analysis are as follows: with regards to employee retention, the results show that proper job analysis prior to employee hiring is able to help determine the appropriate skills and competencies needed for a specific job. furthermore, sample teaching and in-depth interviewing during employee selection makes the entire process more systematic. in sum, refining the entire employment process makes possible the hiring of appropriate individuals fit for the organization. with regards to employee collaboration, the use of mentorship or mentoring is able to provide new comers with the appropriate training. promoting organizational training that fosters collaboration and cohesion are seen as crucial. lastly, the utilization of healthy competition for flexible work schedules is able to both effectively promote collaboration and help nurture group learning (chen, 2014). 3.11 integrating mangrove environmental education into teaching arts to young children wu’s study used the methods of literature review and field research to design a course. through the integration of mangrove environmental education into visual arts, students can express their feelings about the mangrove ecological environment observed through their own artistic creation. the outcomes are as follows: (1) curriculum design regarding the integration of mangrove environmental education into teaching arts to young children: visual art creation can be achieved individually or through peer cooperation; (2) the effectiveness of integrating mangrove environmental education into teaching arts to young children: art courses can help achieve the goals of environmental education; an integrated course can enhance children's learning, facilitate their understanding of community culture; (3) the integration of mangrove environmental education into teaching arts to young children: integrated courses can inspire children’s appreciation of the environment, enhance motivation for artistic creation, improve interpersonal interaction, promote understanding of living art, beautify living spaces, integrate local resources, and resonate with their life experiences (wu, 2011). www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 31 published by scholink inc. 3.12 the progress of implementing aesthetic feeling by integrating a community based viewpoint kuo’s research adopted action investigation of “teacher as researcher” to study the progress of implementing aesthetic feeling by integrating a community based viewpoint. kuo’s study offered the following conclusions: (1) the course began with a community based viewpoint, i.e., teaching about aesthetic feelings based on the spirit of culture from community based viewpoint; (2) the course emphasized reconstruction of children’s aesthetic feelings, i.e., reproducing children’s understanding of community culture through art. learning starts at school, expands outward into the community, and then moves back to school. the role of children changes from visiting to take the leading role in learning to obtain an aesthetic feeling experience; (3) aesthetic learning courses should follow the rules of integration, providing enough course time, a plentiful environment and various media. courses can extend children’s aesthetic feeling experiences by encouraging and leading them to play; teachers should accept children’s unique thoughts and innovations (kuo, 2015). 4. conclusion art has traditionally been an important part of early childhood programs. friedrich froebel, the father of kindergarten, believed that young children should be involved in both making their own art and enjoying the art of others. to froebel, art activities were important, not because they allowed teachers to recognize children with unusual abilities, but because they encouraged each child’s “full and all-sided development”. more than a century later, early childhood teachers are still concerned with the “all-sided” development of each child. curriculum includes activities that will help children develop their cognitive, social, and motor abilities. as froebel recognized, making art and enjoying the art of other people and cultures are very important to the development of the whole child (fox & berry, 2017). based on the above description, we can understand the importance of early childhood art education. for this reason, by reading, analyzing and discussing related studies, this paper first aims to explore the importance of early childhood art education and the research of early childhood art education in taiwan. the research issues of early childhood art education in taiwan we identified are as follows: (1) young children’s art making processes, (2) the practice of implementing an aesthetic thematic curriculum, (3) the development of the learning indicators of aesthetic domain for kindergarten curriculum in taiwan, (4) the teaching principles for aesthetic education in early childhood education, (5) multicultural art education for children, (6) investigation of art education in kindergartens, (7) children’s art learning with parents, (8) making use of picture books to design an integrated art curriculum suitable for children, (9) teaching art appreciation in kindergarten, (10) the employee retention and collaboration with art institutions on early childhood education, (11) integrating mangrove environmental education into teaching arts to young children, and (12) the progress of implementing aesthetic feeling education by integrating a community based viewpoint. the above www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 32 published by scholink inc. description reveals the diversity of the research issues of early childhood art education in taiwan, and shows what previous scholars have emphasized in the research of early childhood art education in taiwan. it is hoped that such an exploration can help teachers understand concepts related to early childhood art education, and most importantly, develop an excellent praxis of early childhood art education. references chen, p. y. (2016). the implication on life education in early childhood based on “freedom” education of maria montessori—a study about developing wellbeing early children (unpublished master dissertation). ching kuo institute of management and health, keelung. chen, y. h. (2014). an action rsearch on the employee retention and collaboration within the art institution of early childhood education (unpublished master dissertation). new taipei city: fu jen catholic university. chen, y. t. (2017). collaborative action research on the implementation of a preschool aesthetic thematic curriculum. asia pacific journal of research in early childhood education, 11(2), 1-23. https://doi.org/10.17206/apjrece.2017.11.2.1 fox, j. e., & berry, s. (2017). art in early childhood: curriculum connections. retrieved july 16, 2017, from http://www.earlychildhoodnews.com/earlychildhood/article_view.aspx?articleid=113 hsieh, c. w. (2012). an action study of using picture books to construct children’s arts integrated curriculum (unpublished master dissertation). chiayi: nanhua university. hung, r. y. (2018). a lifeworld critique of “nature” in the taiwanese curriculum: a perspective derived from husserl and merleau-ponty. educational philosophy and theory, 44(10), 1121-1132. https://doi.org/10.1111/j.1469-5812.2009.00629.x kindler, a. m. (2010). art and art in early childhood: what can young children learn from “a/art activities?” international art in early childhood research journal, 2(1), 1-14. kuo, b. y. (2010). multicultural art education for children in taiwan. journal of early childhood education & care, 4, 1-18. kuo, p. j. (2015). action research of community-based art education with children aesthetics experiences-an example of liao tan ding temple (unpublished master dissertation). hsinchu: national hsinchu university of education. lai, p. h. (2000). taiwanese kindergarten teachers’ and principals’ beliefs and attitudes concerning developmentally appropriate art education (unpublished doctoral dissertation). iowa: iowa state university. lia, y. l. (2011). a case study of children’s art learning with parents (unpublished master dissertation). hsinchu: national hsinchu university of education. https://doi.org/10.17206/apjrece.2017.11.2.1 https://doi.org/10.1111/j.1469-5812.2009.00629.x www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 33 published by scholink inc. lin, m. c. (2012). the development on the learning indicators of aesthetic domain for kindergarten curriculumb in taiwan－using the construction of drama indicator and scale as example. contemporary educational research quarterly, 20(4), 1-44. malley, c. (2005). young children and the arts: making creative connections. information for families and professionals, 6(4), 1-8. montessori, m. (1963). education for a new world. madras, india: kalakshetra. national endowment for the arts (2015). the arts in early childhood: social and emotional benefits of arts participation. washington, dc : national endowment for the arts. seefeldt, c., & wasik, b. a. (2006). early education: three, four, and five year olds go to school. upper saddle river, nj: prentice hall. shih, y. h., lai, p. h., & wang, y. w. (2017). letting young children ecounter art: a day-care teacher practices the art course process. journal of ching kuo institute of management and health, 33, 117-130 shih, y. h. (2018). helping young children perceive beauty: exploring the teaching principle of aesthetic education in early childhood. journal of chinese management development, 7(1), 16-28. wei, m. h. , & lin, s. c. (2009). a window to explore children’s minds through art education and its changing trade. kmu journal of general education, 4, 45-69. wu, c. h. (2009). an action research on the incorporation of multicultural education into art courses for children (unpublished master dissertation). chiayi: national chiayi university. wu, x. z. (2011). an action research on integrating mangrove environmental education into teaching arts to young children—a case study at the affiliated kindergarten of po-he elementary school (unpublished master dissertation). hsinchu: national hsinchu university of education. wu, y. j. (2007). investigation of art education in kindergartens in taipei city (unpublished master dissertation). pingtung: national pingtung university of education. yu, f. (2011). the action research of teaching art appreciation in kindergarten (unpublished master dissertation). taipei: national taipei university of education. children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 1, no. 1, 2018 www.scholink.org/ojs/index.php/ct 49 original paper secondary school variables in predicting technology, engineering, mathematics (tem) major choice philip ruse1* & yonghong xu1 1 department of educational psychology and research, university of memphis, memphis, usa * philip ruse, department of educational psychology and research, university of memphis, memphis, usa received: april 19, 2018 accepted: may 9, 2018 online published: may 21, 2018 doi:10.22158/ct.v1n1p49 url: http://dx.doi.org/10.22158/ct.v1n1p49 abstract this paper addresses the growing body of research into factors that can influence the decision for high school students to enter into a technology, engineering, mathematics (tem) major in college. a total n of 691, including 372 tem majors (143 females and 229 males) were selected from the education longitudinal study of 2002 (els, 2002) using propensity matching. a structural equation modeling (sem) methodology was utilized in the social cognitive career theory framework and showed good model fit in the whole group, female only and male only groups. though intent to major was a strong predictor, observed gender differences were observed related to latent and endogenous variables. keywords social cognitive career theory, major choice, secondary school, stem 1. introduction the need for researchers to study the enrollment of students into science, technology, engineering, and mathematics (stem) majors is predicated on two fundamental aspects: the individual benefits of such a degree and the collective need for the degree. this study aims to add to the growing body of research regarding the gender gap in stem, specifically in computer science (technology), engineering, and mathematics (tem). the ability of the country to remain competitive in specialized job markets, such as tem, requires that policy makers understand the factors that lead students into a stem field, to better meet the demands of a changing job market (chen, 2013; stater, 2011). in order to meet the growing demand of tem related careers tapping into the under-represented groups of women and racial minorities becomes paramount. it is clear that secondary schools foster the development of student academic interest and subsequent career choices, therefore it is prudent to analyze the influence the www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 50 published by scholink inc. secondary school environment plays. the primary goal of the paper is to identify high school level factors that are viable indicators of student major choice into technology, engineering, and mathematics (tem) utilizing the social cognitive career theoretical framework. an additional goal is to identify if any gender difference exists in the factors that lead to a tem major. a multitude of studies have been dedicated to illuminating gender differences, with special focus on educational differences as they relate to the gender gap in stem occupations, college majors, and high school interests (blickenstaff, 2005; ceci & williams, 2010; ceci & williams, 2011; riegle-crumb, king, grodsky, & muller, 2012; sax et al., 2015). due to the growing need of stem occupations anticipated for the coming years, policy makers must be clear on how these differences manifest themselves in stem disciplines, what the reasons are for such a gender disparity in tem, and why does it become critical to decrease the gender gap in tem. one significant reason for reducing the gender gap is the potential economic benefit. the sustainable financial future of tem careers could provide a viable path to economic mobility in under-represented groups. the statistics surrounding female involvement in stem are somewhat disappointing. though females are conferred degrees at a near equal proportion to males, there is a large discrepancy the matriculation of stem degrees (mann & diprete, 2013). only 33% of females intend to major in stem, 12% less than males and 3 times less likely to enter the majors (moakler & kim, 2014; national science board [nsb], 2014). the explanation of the disproportionate enrollment in tem fields by women was produced by blickenstaff (2005). it was suggested that 9 possible reasons were influencing women interest in tem, of the 9 one was attributed to biological differences and the other 8 were categorized as cultural exclusion of women in science. with the growing need of stem professionals in the coming years it becomes critical to understand the reasons behind the gender disparity in tem and make efforts to decrease it. the gender differences become apparent in academic indicators; females score lower on both math and science, 4% and 6% respectively (neap, 2009; nsb, 2014). more troubling is that the difference goes beyond achievement and enters self-concept. when females have similar math achievement their self-concept scores lower than male students, thus females are less likely to enroll in upper level math (correll, 2001; mann & diprete, 2013; nagy et al., 2006; sax et al., 2015; wang, degol, & ye, 2015). understanding these differences is even more vital because subsequent major choice is thought to be predicated on achievement, self-efficacy, and course selection (lent, brown, & hackett, 2004; wang, 2012). there are multiple needs for research specifically into tem. first, the greatest need for individuals is in tem fields rather than stem. tem offers substantial income and professional opportunities compared to other stem majors (nsb, 2014). this is made apparent by the lower unemployment rate and higher salaries of individuals when juxtaposed to lab-based sciences. furthermore, the lab-based sciences have the lowest percentage of graduates employed in occupations related to their majors indicating that a www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 51 published by scholink inc. surplus may exist in lab-sciences (xue & larson, 2015; u.s. census bureau, 2014). second, there is a more significant gender gap in tem. though women have continuously increased enrollment in stem majors and occupations the growth is seemingly relegated to the biological science. though women make up 24% of stem professionals they are grossly under-represented in engineering (14%) and computer science/mathematics (27%) (beede et al., 2011). female students tend to place greater focus on social aspects rather than the material, this difference in value helps to explain why women preferentially select biology majors over the more object-oriented engineering and computer science majors (ceci & williams, 2010; ceci & williams, 2011; wang, degol, & ye, 2015). in fact, males and females show no statistical difference between attitudes toward biology, however the same cannot be said about technology, math, and engineering. men report a more positive attitude towards tem fields and as a result, continue to dominate engineering and computer sciences. this has continued to the point that, though the participation of women in stem has grown, there has been a decrease over the last several years in choosing to enter tem majors (christensen et al., 2014; maltese & tai, 2010; riegle-crumb, king, grodsky, & muller, 2012). this trend continues into the workforce where women make up 33% of the stem professionals (nsf, 2012). women workers are considerably under-represented in engineering (15%) and computer science/mathematics (25%). where as in laboratory sciences women make up 48% and physical sciences 31%. the 2 categories that have seen the greatest change in participation since 1993 are a 5% reduction of females in math and computer science and a 14% increase in biological sciences (nsf, 2012). it is this that resonates with researchers and policymakers because the majority of job growth is expected to be in the technology, engineering, and computer science areas. finally, the focus of this study on tem is also determined by the nature of the data set used. as discussed later, the 2002 els surveyed math teachers, making the data more conducive to study tem. based on a conceptual understanding of the research questions and a review of the literature, social cognitive career theory (scct) provides a logical theoretical framework in which to create the model (carrico & tendhar, 2012; lee, 2013; lent et al., 2008; maltese & tai, 2010; moakler & kim, 2014; sax et al., 2015; sheu et al., 2010; wang, 2012). developed by lent, brown, and hackett (1994) as an extension of bandura’s social cognitive career theory, scct was designed to explain the career and academic choices made by individuals. by incorporating self-efficacy, outcome expectation, interests, and choice goals scct is a comprehensive theory that provides a conceptually salient model that allows for the incorporation of the most critical constructs in the development of vocation and academic interests (lent, brown, & hackett, 1994). in a review of the literature related to college major choice, scct is the dominant theoretical framework utilized by researchers (carrico & tendhar, 2012; lee, 2013; lent et al., 2008; maltese & tai, 2010; moakler & kim, 2014; sax et al., 2015; sheu et al., 2010; wang, 2013). further to the point www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 52 published by scholink inc. of this work scct has been shown to be effective in describing gender differences as well as in longitudinal data sets (lent et al., 2008). another advantage of scct is that it allows the researcher to investigate specific actions of individuals, i.e., the selection of a specific major (carrico & tendhar, 2012; lent et al., 2008). the ability of scct to elucidate the characteristics that influence college major selection and the flexibility of the inclusion of variables makes it a prudent choice for a theoretical framework. the foundation of scct is how self-efficacy, outcome expectation, interests, and choice goals influence both vocational and academic choice. it is customary for researchers to include supporting variables of supports and barriers, learning experiences, and intention of goal fulfillment in the model as well (carrico & tendhar, 2012; garriott, flores, & martens, 2013; lent et al., 2008; sax et al., 2015; sheu et al., 2010; wang, 2013). self-efficacy can be regarded as an individual’s personal belief about their ability to complete tasks related to achieving a particular level of success. this is related to maintaining actions to attain the goal through adversity. an outcome expectation is understood to be the perceptions that one has about the consequences of engaging in and completing an action. social or cultural pressures placed on a woman in science could influence outcome expectation. interests can be thought of as a measure of an individual’s enjoyment of a particular activity. goals are positive future outcomes that individuals have undertaken legitimate steps to attaining and committed resources to the successful fulfillment of them (carrico & tendhar, 2012; lent, brown, & hackett, 1994). 1.1 research questions scct must be confirmed as a viable framework to study the factors associated with student entrance into tem. additionally, there is a need to improve the participation of under-represented groups in stem fields; women attack problems in ways that are substantially different than men. low female participation in tem reduces the human capital the result of which can be detrimental to the technological and scientific growth of the nation (sax et al., 2015). therefore, this study will address: 1) how are students impacted by academic experiences, their own self-efficacious beliefs of math and science, and the value of such a degree relate to their entrance into a tem major? 2) do these relationships vary across gender? 2. method data was acquired from the education longitudinal study of 2002 (els, 2002). base year data from 2002 was collected from high school sophomores with subsequent follow-up surveys conducted in 2004, 2005, 2006, 2012, and 2013. these surveys were administered to students, parents, teachers, and school support staff and consisted of an academic focus on math and english. els: 2002 was a suitable data set to use for this analysis because it connected high school level variables to subsequent college www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 53 published by scholink inc. major choice. in addition, the focus on math teachers and attributes was congruent with the point of this study. the original els data set consisted of 16197 individuals (47.2% male, 47.6% female), of which approximately 6500 reported attending post-secondary education in the 2006 follow-up. of these respondents, only 10% reported enrollment in a tem major. further cleaning of the data was accomplished using case wise deletion on the utilized variables bringing the total n to 3254, with 10% tem (44% male, 66% female). before conducting the sem analysis additional data management was required to bring the two groups into a more balanced data set. matching the tem majors (n = 327) to the non-tem majors (n = 2927) using propensity scores can provide an effective way to balance the data and continue with the analysis. this method is further validated by parsons (2004) who explains that, in order to detect differences between experimental and control groups there must be a reduction in the treatment selection bias. to maximize the number of tem majors, propensity scores were generated via sas (parson, 2004; relyea, 2016). all tem cases were retained and 473 non-tem majors with the highest propensity scores were retained as matches. the final total was n = 709, 79% male and 236 (33%) tem majors. outliers were removed using from the 709 individuals using mahalonibis distance (χ2 p<.001) for a final n=690. 2.1 variables 2.1.1 math self-efficacy self-efficacy, according to lent, brown, and hackett (1994) is one of the pillars of scct and primary indicator of interest in academic and professional goals. subject specific self-efficacy is an essential predictor of stem interest and major choice; many more studies that could be named that implement scct include it as a predictor (engburg & wolniak, 2013; moakler & kim, 2013; sax et al., 2015; wang, 2012). following the guidelines of scct self-efficacy has a path to outcome expectations, interest, intent, and major selection (lent, brown, & hackett, 1994). for this latent variable 6 factors were included. one continuous measure of self-efficacy score from 10th grade. in addition, five measures of 12th grade attitudes toward math were also included. these measures were rated on a 4-point likert scale and were comprised of statements such as, can do excellent job on math assignments or can understand difficult math class. 2.1.2 outcome expectations an outcome expectation as a latent variable has a direct path to interest, intention, and major choice (lent, brown, & hackett, 1994). the value of intrinsic and extrinsic rewards along with expectation of graduate degree are factors that are consistent with other studies to load onto outcome expectations (mann & diprete, 2013). three measures taken in the 2006 senior follow-up were used for the latent variable outcome expectations. the questions were based on a 3-point scale from not important (1) to very important (3). www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 54 published by scholink inc. these survey items inquired about the relative importance of success in jobs, the importance of making a lot of money, and the importance placed on family and children. 2.1.3 learning experience math and science achievement in high school is a strong predictor of interest in stem and the later choice of major in college (engburg & wolniak, 2013; maltese & tai, 2010; riegle-crumb, king, grodsky, & muller, 2012; wang, 2012). achievement is measured at 10th grade and 12th grade using the els: 2002 data. the third measure, teacher recommendation for advanced courses in mathematics (1-3 not recommend to highly). 2.1.4 interest previous studies suggest that course selection should be a predictor of interest in stem. students who enroll in upper level math and science courses as upper classmen in high school are more likely to have a greater interest in stem and thus choose a stem major (correll, 2001; engburg & wolniak, 2013; lee, 2013; maltese & tai, 2010; mann & diprete, 2013; riegle-crumb, king, grodsky, & muller, 2012; wang, 2012). two variables were created to quantify the number of math and science electives were taken in high school. upper level math course electives were number 0-4 to include courses trigonometry, pre-calculus, calculus, and business math. the science courses included were only physics and technology courses numbered 0-2. only tem science courses were included due to the scope of this study. 2.1.5 supports and barriers the use of ses and the highest level of parent degree have both been used as supports and barriers in previous sem studies (garriot, flores, & martens, 2013; sax et al., 2015; wang, 2012). loading the supports and barriers onto major choice is congruent with literature on stem major choice within the scct framework. three variables were loaded onto supports and barriers. a measure of ses, (byses2qu) which divided students into quartiles 1-4. the parents highest level of education (bypared) recorded as 1-8, did not graduate high school to doctorate respectively. also included was the number of academic risk factors, this variable was recoded 1-6 in order to reflect 1 having 5 or more risk factors and 6 having 0 risk factors. 2.1.6 intent intent is simply a measure of an individual’s perspective major. this was coded 1 = tem major and 0=non-tem major. 2.1.7 dependent variable a dichotomous variable was recorded as 0 = non-tem and 1 = tem major. lab-based sciences such as chemistry or biology were excluded from the study variable (table 1). www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 55 published by scholink inc. table 1. variable descriptions in model *. reverse coded. 3. result four models were ran and model fit was assessed using kline’s (2011) guidelines. the measurement model suggests a strong fit with a rmsea = 0.027, with a 90% confidence interval upper bound below 0.08 and cfi = 0.99 (see table 2). all factor loadings were above 0.24 (table 1). three sem analyses were ran, one assessing whole group and one each for males and females. fit indices are provided in table 2. latent variable observed variable factor loading description scale learning experience (l_e) bytxmstd 0.87 math test standardized score (10 grade) cont f1txmstd 0.98 math test standardized score (12 grade) cont bytm19 0.44 teacher recommendation for upper math 1-3 self-efficacy (s_e) bymathse 0.49 f1 mathematics self-efficacy cont f1s18a 0.82 can do excellent job on math tests 1-4 f1s18b 0.83 can understand difficult math texts 1-4 f1s18c 0.82 can understand difficult math class 1-4 f1s18d 0.81 can do excellent job on math assignments 1-4 f1s18e 0.87 can master math class skills 1-4 interest (int) math_ele 0.66 math electives (trig, precal, calc, business math recoded as number of courses 0-4) 0-4 sci_tech 0.53 science electives (physics and technology) recoded as number of courses 0-2) 0-2 outcome expectation (o_e) f1s40a 0.44 importance of being successful in line work 1-3 f1s40c 0.47 importance of having lots of money 1-3 f1s40e 0.58 importance of being able to find steady work 1-3 intent f2b15 1.00 field of study most likely to pursue upon entering 0/1 supports and barriers (s_b) bypared 0.87 parents' highest level of education 1-8 byses2qu 0.92 quartile coding of ses2 variable 1-4 byriskfc* 0.24 number of academic risk factors in 10th grade (recoded) 1-6 major mjr_tem 1.00 major in 2006 2-digit code 0/1 www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 56 published by scholink inc. table 2. goodness of fit indices for measurement and structural models model χ2 df χ2/df cfi rmsea ci for rmsea srmr measurement 185.16* 123 1.505 .99 .027 (.019, .035) .036 structural group 220.11* 126 1.580 .99 .033 (.026, .040) .047 structural male 199.08* 126 1.401 .99 .033 (.024, .041) .049 structural female 131.74 126 1.045 .99 .018 (.000, .046) .064 *. p<.05. the whole group model demonstrated a strong fit to the data, rmsea = 0.033 (90% ci = 0.026; 0.040) and the cfi = 0.99. the model fit indices fall within the suggested limits of rmsea<0.06 and the cfi>.95 to show strong model fit (kline, 2011). all path coefficients were significant (p<0.05) except learning experience to self-efficacy and to outcome expectation as well as self-efficacy to interest. the model explained 26% of the variance in major. the model was then applied to only the males in the sample (tem = 33% of 548). the model fit the sample well with rmsea = 0.033 (90% ci = 0.024; 0.041) and a cfi = 0.99. the path coefficients had the same significance as the whole group. the variance explained in major saw a 11% increase to 37%. the same model was then ran using only females from the sample (tem = 33% of 143). again, the model fit was very strong, rmsea = 0.018 (90% ci = 0.0; 0.046) and the cfi = 0.99. learning experience showed a significant path to outcome expectation, which was not seen in the other models. the variance explained in major was reduced to 30%. table 3. covariance matrix of latent variables (whole group) 1. 2. 3. 4. 5. 6. 7. 1. s_e 0.19 2. o_e 0.00 0.01 3. interest 0.10 0.00 0.53 4. major 0.00 0.00 0.02 0.22 5. intent 0.02 -0.01 0.04 0.12 0.24 6. l_e 1.27 -0.18 0.66 0.05 0.21 56.33 7. s_b 0.06 -0.01 0.03 -0.01 0.01 1.63 0.73 www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 57 published by scholink inc. table 4. structural equations of unstandardized path coefficients (whole group) latent variable structural equation r2 s_e 0.022*l_e + 0.029*s_b .15 o_e -0.0034*s_e – 0.0031*l_e 0.045 int 0.50*s_e – 0.17*o_e 0.091 intent 0.080*s_e – 0.35*o_e + 0.066*int 0.028 major -0.033*s_e – 0.063*o_e + 0.49*intent – 0.013*s_b 0.26 4. discussion this paper continues to add to the growing body of literature dedicated to illuminating the influence of the high school experience on the decision to enter into a tem major as well as identifying variables associated with the gender gap in tem majors. through the strong model fit of the sem analysis in both the whole group and male group scct is clearly an adequate choice to identify such variables in predicting a college major choice. the female group had strong model fit but was not significant, which was likely due to the small sample size of the group. this paper further supports the use of scct to understand the factors that lead students to choosing a specific major. oddly, the paths from learning experience were largely nonsignificant as was the paths from self-efficacy to interest, this could be due to sample composition and the relative homogeneity of students. it is not unprecedented to have small values from outcome expectations as small but significant paths from outcome expectation to interest have been reported in other studies (garriott, flores, & martens, 2013). it does not come as a surprise to see academic achievement, outcome expectations, or self-efficacy as poor differentiators among college students. many college students regardless of the major they choose will perform well in high school. the 2 largest and significant paths for the group were interest to intent (.103) and intent to major (.51) (table 5). this suggests that course selection and intent to major are 2 of the more important and strong predictors of a student choosing to major in tem. table 5. indirect paths path whole female male s_einterestintentmajor .016 .025 .0106 s_e intentmajor .0357 .0324 .0488 s_emajor -.03 -.02 -.04 s_e total .0217 .0374 .0194 interestintentmajor .0525 .1134 .0366 standardized path coefficients. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 58 published by scholink inc. several noticeable differences appeared between the genders. the only significant path from learning experience was to outcome expectation in females, and surprisingly it was negative. this means as math achievement increases outcome expectation decreases. the observed value could be a result of social and cultural constructs limiting female interest in tem (blickenstaff, 2005; ceci & williams, 2010; ceci & williams, 2011; mann & diprete, 2013; riegle-crumb, king, grodsky, & muller, 2012; sax et al., 2015). female college students face added societal pressures to place greater value on intrinsic rewards and choosing a career path that favors home and family life, further widening the gender gap (blickenstaff, 2005; mann & diprete, 2013; sax et al., 2015). these factors, whether the cause or the effect, serve to place women in a “chilly climate” when pursuing stem (blickenstaff, 2005; mann & diprete, 2013). all things considered, women are identified as an under-represented group in stem (engburg & wolniak, 2013). another curious difference was in supports and barriers. females had a positive path coefficient compared to males’ negative value. as available resources increased females had a greater likelihood of a tem major, but the same could not be said for males. the greatest difference was the path from interest to intent which was nearly 4 times larger for females. this resulted in greater influence from self-efficacy, which at .0374, was nearly double that of males. the results of this study suggest that females with greater exposure to tem related courses in high school is the greatest predictor of their intent to major in tem majors in college. furthermore, interest is the greatest difference between the genders, coupled with the role of supports and barriers it is likely that providing women more exposure to tem in high school could increase their potential decision to major in it in college. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 59 published by scholink inc. figure 1. standardized path coefficients (whole/female/male) bold: p>.05 though the data set used, els 2002, is a large national data set there were several issues that presented themselves to the research questions. one such problem was that of the sample size. a small number of students choose to enroll in a tem major and created an unbalanced data set. in addition, males were over-represented in the data set making comparison between genders difficult. this presented a secondary problem in that the number of females in the study is low for sem. adding more individuals to the study and increasing female representation could alleviate many issues. additionally, a more up to date sample would benefit the study, the implemented data set is dated and technology has seen monumental changes in 15 years. scct is the dominant framework in determining student major choice, however, it is not alone. a comparison of scct, pekrun’s control value theory, could provide new and unique insights into student choice. l e s_e s_b interest o_e intent major .37 .38 .37 -.21 -.25 -.19 -.01 .02 -.01 -.08 -.04 -.08 -.03 .07 -.02 .30 .22 .29 .07 .06 .08 .103 .21 .06 .51 .54 .61 .06 -.05 .08 -.02 .09 -.05 -.03 -.02 -.04 -.01 -.01 -.02 www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 60 published by scholink inc. references beede, d. n., julian, t. a., langdon, d., mckittrick, g., khan, b., & doms, m. e. (2011). women in stem: a gender gap to innovation. blickenstaff, c. j. (2005). women and science careers: leaky pipeline or gender filter? gender and education, 17(4), 369-386. https://doi.org/10.1080/09540250500145072 brown, s. d., tramayne, s., hoxha, d., telander, k., fan, x., & lent, r. w. (2008). social cognitive predictors of college students’ academic performance and persistence: a meta-analytic path analysis. journal of vocational behavior, 72(3), 298-308. https://doi.org/10.1016/j.jvb.2007.09.003 carrico, c., & tendhar, c. (2012). the use of the social cognitive career theory to predict engineering students’ motivation in the produced program. in american society for engineering education. american society for engineering education. ceci, s. j., & williams, w. m. (2010). sex differences in math-intensive fields. current directions in psychological science, 19(5), 275-279. https://doi.org/10.1177/0963721410383241 ceci, s. j., & williams, w. m. (2011). understanding current causes of women’s underrepresentation in science. proceedings of the national academy of sciences, 108(8), 3157-3162. https://doi.org/10.1073/pnas.1014871108 chen, x. (2013). stem attrition: college students’ paths into and out of stem fields. in statistical analysis report. nces 2014-001. national center for education statistics. christensen, r., knezek, g., & tyler-wood, t. (2014). student perceptions of science, technology, engineering and mathematics (stem) content and careers. computers in human behavior, 34, 173-186. https://doi.org/10.1016/j.chb.2014.01.046 correll, s. j. (2001). gender and the career choice process: the role of biased self-assessments. american journal of sociology, 106(6), 1691-1730. https://doi.org/10.1086/321299 engberg, m., & wolniak, g. c. (2013). college student pathways to the stem disciplines (doctoral dissertation, teachers college). retrieved from http://www.tcrecord.org/ garriott, p. o., flores, l. y., & martens, m. p. (2013). predicting the math/science career goals of low-income prospective first-generation college students. journal of counseling psychology, 60(2), 200. https://doi.org/10.1037/a0032074 hall, c., dickerson, j., batts, d., kauffmann, p., & bosse, m. (2011). are we missing opportunities to encourage interest in stem fields? retrieved from http://scholar.lib.vt.edu/ kline, r. b. (2011). principles and practice of structural equation modeling. new york: guilford press. lee, a. (2013). determining the effects of pre-college stem contexts on stem major choices in 4-year postsecondary institutions using multilevel structural equation modeling. journal of pre-college engineering education research (j-peer), 3(2), 3. https://doi.org/10.7771/2157-9288.1059 lent, r. w., brown, s. d., & hackett, g. (1994). toward a unifying social cognitive theory of career and www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 61 published by scholink inc. academic interest, choice, and performance. journal of vocational behavior, 45(1), 79-122. https://doi.org/10.1006/jvbe.1994.1027 lent, r. w., sheu, h. b., singley, d., schmidt, j. a., schmidt, l. c., & gloster, c. s. (2008). longitudinal relations of self-efficacy to outcome expectations, interests, and major choice goals in engineering students. journal of vocational behavior, 73(2), 328-335. https://doi.org/10.1016/j.jvb.2008.07.005 maltese, a. v., & tai, r. h. (2011). pipeline persistence: examining the association of educational experiences with earned degrees in stem among us students. science education, 95(5), 877-907. https://doi.org/10.1002/sce.20441 mann, a., & diprete, t. a. (2013). trends in gender segregation in the choice of science and engineering majors. social science research, 42(6), 1519-1541. https://doi.org/10.1016/j.ssresearch.2013.07.002 moakler, m. w., & kim, m. m. (2014). college major choice in stem: revisiting confidence and demographic factors. the career development quarterly, 62(2), 128-142. https://doi.org/10.1002/j.2161-0045.2014.00075.x nagy, g., trautwein, u., baumert, j., köller, o., & garrett, j. (2006). gender and course selection in upper secondary education: effects of academic self-concept and intrinsic value. educational research and evaluation, 12(4), 323-345. https://doi.org/10.1080/13803610600765687 national assessment of educational progress, the nations report card. (2015). mathematics and reading at grade 12. retrieved from https://www.nationsreportcard.gov/reading_math_g12_2015/#mathematics/gaps national assessment of educational progress, the nations report card. (2015). science assessment. retrieved from https://www.nationsreportcard.gov/science_2015/#gaps?grade=12 national science board. (2014). science and engineering indicators 2014. arlington va: national science foundation (nsb 14-01). parsons, l. s. (2004). performing a 1: n case-control match on propensity score. in proceedings of the 29th annual sas users group international conference (pp. 129-165). relyea, g. (2016). macro one to many match_revised5.sas. unpublished protocol. riegle-crumb, c., king, b., grodsky, e., & muller, c. (2012). the more things change, the more they stay the same? prior achievement fails to explain gender inequality in entry into stem college majors over time. american educational research journal, 49(6), 1048-1073. https://doi.org/10.3102/0002831211435229 sax, l. j., kanny, m. a., riggers-piehl, t. a., whang, h., & paulson, l. n. (2015). but i’m not good at math: the changing salience of mathematical self-concept in shaping women’s and men’s stem aspirations. research in higher education, 56(8), 813-842. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 62 published by scholink inc. https://doi.org/10.1007/s11162-015-9375-x sheu, h. b., lent, r. w., brown, s. d., miller, m. j., hennessy, k. d., & duffy, r. d. (2010). testing the choice model of social cognitive career theory across holland themes: a meta-analytic path analysis. journal of vocational behavior, 76(2), 252-264. https://doi.org/10.1016/j.jvb.2009.10.015 stater, m. (2011). financial aid, student background, and the choice of first-year college major. eastern economic journal, 37(3), 321-343. http://doi:10.1057/eej.2009.41 u.s. department of commerce, u.s. census bureau. (2014). census bureau reports majority of stem college graduates do not work in stem occupations (release number cb14-130). retrieved from https://www.census.gov/newsroom/press-releases/2014/cb14-130.html wang, m. t., degol, j., & ye, f. (2015). math achievement is important, but task values are critical, too: examining the intellectual and motivational factors leading to gender disparities in stem careers. frontiers in psychology, 6. https://doi.org/10.3389/fpsyg.2015.00036 wang, x. (2013). why students choose stem majors motivation, high school learning, and postsecondary context of support. american educational research journal. http://doi:10.3102/00028312134488622 xue, y., & larson, r. c. (2015). stem crisis or stem surplus: yes and yes. monthly lab. rev., 138(1). https://doi.org/10.21916/mlr.2015.14 children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 1, no. 1, 2018 www.scholink.org/ojs/index.php/ct 1 original paper individual instruction as catalyst in the transformation of teaching dr. hait shaham1* 1 primary school department, beit berl college, beit berl, israel * dr. hait shaham, primary school department, beit berl college, beit berl, israel received: february 4, 2018 accepted: february 24, 2018 online published: march 20, 2018 doi:10.22158/ct.v1n1p1 url: http://dx.doi.org/10.22158/ct.v1n1p1 abstract this research examines the connection between classroom learning environment and individual instruction methods in the context of the reform known as “new horizon”. within this framework of individual instruction, teachers are given opportunities to experiment with various innovative teaching methods and in the process, motivate students and strengthen the personal relationship. communication and a positive relationship between teachers and the students in the group may contribute to the improvement of the learning environment in the classroom as a whole. the quantitative research was conducted within the framework of a correlative study among 60 teachers (98.3% women and 1.7% men); all of them provide individual instruction to students in first through sixth grade in three elementary schools located in haifa and other areas in the north. the sample included home room teachers (53.3%), subject teachers (36.7%) and grade coordinators (1.7%). the age of the participating teachers ranged from twenty seven to fifty two years old. their tenure in teaching, between two and thirty two years; they took part in the new horizon reform program for one to eight years. the teachers were asked to complete questionnaires; one measured the teaching methods of the individual instruction sessions, the second examined nurturing the best learning environment in this setting. keywords individual instruction, facilitator, coach, exploration and discovery, pbl, collaborative learning, small group, learning environment www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 2 published by scholink inc. 1. introduction the new horizon reform, operating in the elementary education system for the last few years, provides a responsive channel for conducting pedagogical education processes using the individual instruction hours assigned to teachers in participating schools. these individual teaching-learning hours are designed to provide additional instruction to individuals or groups of no more than five students that experience difficulties, or to other common interest groups. new horizon reform emphasizes teaching-learning that is designed for individuals. the individual framework expands the possibilities available to teachers for the purpose of advancing each student from a cognitive perspective, intra-personal and interpersonal relationship (videslavsky, 2010). this individual framework provides ample opportunities for students as well as to teachers. the students get the opportunity to realize their potential, promote achievements, develop thinking skills and creativity, and strengthen their sense of belonging to the school community. the teachers get the opportunity to experiment with new and diverse ways of teaching and evaluating, motivate students to learn, and expand a personal relationship with them. communication and positive mutual relationship between teacher and students may contribute to an improvement in classroom learning environment and to advancing the teacher’s ability to work efficiently. each student has a distinct personality, style, culture, set of beliefs and background knowledge that are not always fully expressed in the school environment. learning through diverse teaching-learning methods that are tailored to the student’s individual needs may assist them in dealing with the difficulties and challenges ahead, develop and establish the various functioning skills school requires and accomplish these goals working in line with these students’ relative abilities and skills. the more the teacher assists, demonstrates genuine interest in the student and treats her at “eye level”, the more the classroom learning environment improves (bar, 2007). an optimal classroom learning environment facilitates a positive and productive environment for learning. 1.1 theoretical background 1.1.1 individual instruction individual instruction is an educational approach that recognizes the differences in people. this type of teaching is focused on the individual and assumes that each learner is unique. the teaching is a personal process that takes place in a social context and within the framework of a relationship with a significant adult among a group of equals. individual instruction assumes that students have different needs and have a learning style that is particular to them and exists within their scope of interest (dressler, 2010). the individual learning framework (teacher-student) and the small group setting were intended to facilitate meaningful learning and provide a better response to the different students in the group and to each student personally. the goal is to enable in them the development of diverse aspects—the mental, www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 3 published by scholink inc. emotional, social, and kinesthetic and by that, to attain the necessary achievements for success in school. individual teaching is fundamentally different in essence and methods than instruction in a classroom setting and requires the teacher undergo special training. it also enables the teacher to better track his students’ progress and provide a relevant and effective response to their need to advance forward (ceo memo, 2012/9 (a)). another characteristic of individual instruction is forging a stronger bond between the teacher and her students. the result is a closer and more meaningful relationship between teacher and students and among the students in the group. every student can fully express himself and experience acceptance, community and appreciation (ceo memo, 2012/9 (a)). 1.1.2 individual instruction within new horizon reform the new horizon reform was first implemented into the educational system in israel in 2007. the reform recognizes the need to adapt the educational processes, instruction and learning to the student; the importance of establishing a personal relationship; and ultimately, the creation of a supportive environment conducive to learning. the individual instruction part of the new horizon reform is implemented through the individual instruction hours which are at the very core of the reform. the main goal of the individual instruction hours is to facilitate and promote the progress and academic achievement of all students. through the individual instruction hours it becomes possible to provide education, instruction and learning that are focused on the individual, thereby allowing for better realization of the educational goals. every teacher is required to provide instruction hours to individual students and/or to a group of 2-5 students in addition to their scheduled classroom instructional hours. the approach is that “every student can” and the educational system is responsible and accountable in acting to promote the success of each student (ceo 2012/ 9 (a)). the individual instructional hours given to students focus on reducing the academic gaps in core subjects; it takes place at the end of the school day or at the same time frontal learning hours are in session. the distribution of the individual instruction hours depends on resources available to the school. it is also conducted in a way that provides a proper response to the various needs of a diverse population of students who were identified through a mapping process performed by their teachers. the social and learning structure of the individual groups varies to make the collaborative learning experience available to all students. the material covered during the individual instructional hour has already been discussed in the classroom and is taught by the same teachers who teach group members in their home room as well as subject classes. in most cases, teachers that participate, teach the subjects they specialize in (national council on measuring and evaluating education, 2012; ceo 2012/9(a)). www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 4 published by scholink inc. 1.1.3 teacher intervention with the small learning group the teacher is allowed to choose the type of intervention with the small group, but he has to be able to navigate different styles of engagements and tailor them to any given situation at any time it is deemed necessary. the types of intervention available to a small group are: the teacher as a mediator, facilitator, coach or sometimes a group member. the mediator style acts as a type of mentor, the cooperative action of a novice and a master in the area of the student’s close development (vigodetzki, 2004). the mediated learning takes place when a firm, knowledgeable, and experienced person stands between the learner and the world and engages the student with that world, making it more understandable, giving it proper meaning and thereby promoting the development of flexible thinking and structural change (foyrshtein, 1994). the mediation process is vital to advancing the learning process in a small heterogeneous group of students. the teacher as mediator is an active partner in the learning process, supports, organizes the learning environment and enriches it in a way that builds up the students’ development; all while managing a differential curriculum. the teacher as a facilitator carries the overall responsibility for the group and its work process. she has to create the necessary conditions for productivity, growth and development. it is important that the facilitator has presence, confidence, courage, self-awareness, honesty, authenticity, creativity and trust in the group process. she has to plan the group structure in advance, create a positive environment, assist the participants in working on subjects that are significant to them, sum up things, provide a sounding board and assist passive, quiet participants in the group to fully express themselves. the facilitator is also required to have other proficiencies, such as the ability to actively listen, clarify, reflect, sum up and interpret, validate and support the participants in order to effectively promote the process (shechtman, 2006). the teacher as coach motivates and leads the students to explore their goals and the results they are looking to attain for themselves. the teacher uses coaching tools to develop each student’s accountability for his own learning and that of the group and to create an empowering teacher-student dialogue. the coaching is a structured, professional process, methodical, result focused and whole. the perceptional starting point assumes that the sum total of the academic and personal data of the individual or the group (skills, proficiencies, etc.) is the best foundation for their future success (videslavsky, 2010). the teacher as a participant in the group deals with learning through dialogue, where both the student and the teacher teach and learn. on the one hand the teacher has to thoroughly be familiar with the subject and on the other, he must be able to shed the “profession’s uniform” and learn from his students. during the learning process, an equal dialogue between students and teachers takes place, one that emerges from and is relevant to the students’ lives and is based on mutual respect. through this dialogue, the teacher gets to personally www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 5 published by scholink inc. know the students and the things that are meaningful to them and comes to rely on their cultural world in teaching. the teacher and students learn through this conversation and jointly take part in decisions about the learning and the material chosen for study (gur, 2007). in dialogue learning within the individual instruction group the learning partners build personal knowledge and create knowledge that is meaningful to each member of the group through sharing and mutual respect (videslavsky, 2010). 1.1.4 emotional resolution through the individual instructional hour the new horizon individual instructional hours create an opportunity to promote the personal connection so essential to and at the base of meaningful learning. organizing the students in the small group facilitates an intimate encounter of the students with each other and with the teacher. the individual instruction takes place in a warm social and educational environment, one that supports and challenges, provides the students with self-confidence, one on one interaction, affection and acceptance. these hours focus the teacher’s attention on the individual student, creating a personal relationship with them. the group allows for “eye contact” among the participants, the opportunity to listen to each student and respond to them individually. in addition to academic aspects, it becomes possible for the teacher to track the student’s emotional and intrapersonal functioning. as a result, the students experience a sense of belonging, appreciation, acceptance and competency. (videslavsky m., 2010; ceo 2012/9 (a)). the personal instruction leads to a wider perspective of the teacher’s role. there is a personal dialogue in the group, between the teacher and the students, emphasizing active listening and paying attention to students’ perceptions and feelings. the importance of the personal dialogue is in demonstrating empathy towards the students’ problems and naturally leads to identifying difficulties and solutions appropriate to the student’s individual needs. strengthening teachers’ familiarity with their students was also designed to customize for them the teaching-learning process in a way that allows them to develop various aspects such as: mental (cognitive), emotional (effective), social-values, kinesthetic (motor); all towards reaching the anticipated goals. as a result of this, the students in the group have a positive view of themselves and higher self-esteem than students in regular classrooms (videslavsky, 2010). 1.2 learning based on the constructive approach within the frame work of the constructive perception, teaching-learning processes are based on the assumption that students are not “a blank board we must fill” with knowledge. these, as well as evaluation processes, must be planned while recognizing the thinking structures, personal knowledge, and pervious perceptions of the students as factors that influence the learning process. the learning process happens when previous knowledge is incorporated into new information and the introduction of a new perception. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 6 published by scholink inc. the better the student’s cognitive structure, the more new and complex information will become available to her existing cognitive structures (brooks & brooks, 1997). in the constructive approach to learning, great importance is placed on social interaction. the learning evokes internal processes that only act if there is interaction between the students and their surroundings. effective interaction takes place as a result of students confronting the point of views other students have as well as adults whose academic level is higher than their own (vygotsky, 1978). the constructive approach includes a profound learning strategy of creating connections, generalizing, deciphering, comparing and contrasting the existing knowledge with the newly acquired information and learning that is based on solving problems while using active knowledge (hativa, 2003). as a result, the learning becomes a meaningful learning; the type that includes comprehension and acquired knowledge applicable by the students in many different contexts. 1.3 learning through exploration and discovery learning through exploration and discovery is intended to encourage the discovery of patterns, connections, rules and meaning of the things that surround us. the research process is usually done in a cooperative, shared study setting in the specialized subject. the student is given maximum autonomy to understand the subject of study. she has to research in order to discover the principals of the study material through research that includes: identifying a phenomenon or a problem; making assumptions; identifying logical conclusions that arise from these assumptions; collecting information, analyzing and interpreting then evaluating and examining based on the initial assumptions, and finally, drawing conclusions (gil, 2009; videslavsky, 2010). learning-teaching through research allows for many forms of learning experience and activities that involve objects and materials, the performance of presentations and experiments, conducting observations and short field trips (videslavsky, 2010). in this way, the student develops intellectual independence and proficiency, critical thinking, approaches and tactics to solve problems outside the framework of conventional learning (gil, 2009). 1.4 project based learning project based learning is a structured learning method whereby groups of students are selected to work together towards the accomplishment of a common goal. the participants are involved in learning essential information and life skills through a structured investigation. the students ask questions, make assumptions, plan, collect and analyze information, and exchange their opinions. the project is three to four weeks long with specific assignments scheduled in a well-defined timeline. the process is organized around complex, authentic queries, deliverables and assignments are meticulously planned out in advance (videslavsky, 2010). project based learning has many advantages such as: an invitation to learn about the real world, development of independent study proficiency (planning the study, assignments, tools and execution), www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 7 published by scholink inc. space to express different styles of learning, encouragement of personal engagement, the opportunity for multi directional and cross subject learning while using various sources, cooperative learning to complete assignments, an opportunity to express values, opinions and ideas of the students with equally varied learning outcomes (reeves, herington, & oliver, 2002) projects expand the learning experience beyond the classroom by conceptualizing a research driven idea appropriate to scientists, community and families. in addition, they encourage cooperative learning and interaction among the students in a small group setting. this type of learning encourages collaboration with members of the community and even scientists to gather the necessary information to answer their questions and discuss their findings. professional literature indicates that project based learning facilitates meaningful learning that breeds an independent, self-directed learner, i would go as far as saying: the ability to work in a team, reflective and critical thinking abilities (tal & miedijensky, 2005). the evaluation of the project is personal and relates to the quality of the outcome, the depth of the content, the demonstrated comprehension of the subject and the project’s contribution to learning. the evaluation is incorporated and becomes an integral part of the learning process as a whole and part of structuring the project or the outcome in particular (tal & miedijensky, 2005). 1.5 learning in the ict environment the small group instruction expands the learning environment to create a learning center equipped with a variety of technological tools. this way, the students expand the learning sources available to them for information. the personal computer is a central learning tool and one example of the many options available in a digital environment. the collaborative learning, using a personal computer, develops and expands skills such as: design, productive brainstorming, real time response, and verification of assumptions through the use of various data base sources. in addition, collaborative learning through a personal computer improves social skills, deepens the bond between the students, and develops positive team work skills that include empathy and mutual respect. online learning in a small group allows the teacher to observe students’ academic strengths and weaknesses then adjust the instruction accordingly. in addition, this type of environment makes it possible for the teacher to bring up for discussion meaningful and authentic subjects such as computer work ethics (videslavsky, 2010). 1.6 collaborative learning collaborative learning takes place in a small heterogeneous group of students and is based on the premise that students collaborate in the act of learning and become ultimately responsible for their own learning as well as that of the group. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 8 published by scholink inc. within the construct of collaborative learning, students engage in cooperative work in a way that allows each student to take part in the group’s assignment and contribute without direct and immediate intervention of the teacher. the group is considered successful once all its members achieved their well-defined learning goals. the learning assignment determines the level of collaboration and the dynamic created in the group where cooperation and mutual assistance is highly emphasized. the learning activities in the collaborative instruction-learning model develop and encourage fundamentals such as: sharing work and personal responsibility, facilitating mutual dependency by connecting with and following through an entire assignment; the will to advance each member of the group while accommodating and evaluating each individual’s ability to contribute to the group. all these dynamic processes take place in an atmosphere of support, acceptance, assistance and encouragement (gil, 2009). teachers must plan positive social interaction opportunities to allow for meaningful interactive learning and to help students acquire good communication skills they can use to improve their discussion and dialogue skills. in addition, they must prepare learning activities that allow for a flexible learning pace to fit the variety of skills and abilities of the learners. to facilitate effective activity by the students, the arrangement of the class has to fit the needs of the various assignments (dressler, 2010). the adjustment of instruction to the individual groups allows the students to best advance towards their academic goals. 1.7 learning environment learning environment is a concept that describes the unique environment created in the classroom as a result of the way learning takes place, students creating a social structure; students’ relationship to themselves, the teacher and school (bar-lev, 2007). there are three parameters to evaluate a learning environment. the first is relationship and it includes involvement, a sense of belonging, sensitivity and support from a teacher who takes into consideration each student’s unique point of view. the second is personal development and includes intellectual learning development, meta cognitive skills, awareness and understanding of thought processes. the cognitive and linguistic development of the child depends on opportunities that adults provide to allow her to express existing, more complex skills. the third parameter, system maintenance, is the organizational part and includes things such as bylaws, rules, organization, and time and attention management. teachers that use efficient organizational strategies that include well organized administrative structures and routines come up against a lot less discipline issues and experience much higher levels of learning engagement (trickett & moss, 1995; pianta, 2007). the best learning environment includes several components: openness of behavior and thought that allows both students and teacher to bring up different subjects for discussion and express independent points of view however unpopular. another important component in a learning environment is www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 9 published by scholink inc. teacher’s support of the students, at both, the social-emotional and the cognitive level. support is provided through encouragement, acceptance, engagement, assistance and collaboration. supportive environment nurtures a sense of belonging, unification and affinity among the group members. another component is equal treatment by the teacher, avoiding favoritism or personal preferences. this equal status includes students in the process of daily classroom management thereby empowering them to have a say in what happens in their learning environment. the amount of contribution the students make in planning class activity and the teacher’s encouragement to develop new ideas and tasks, both come together to create an optimal learning environment. keeping a routine and a set class administrative procedures is another component that allows for organization, order in class, a sense of personal justice and confidence for all the students in the class (tzedkiyahoo, 1988). 1.8 the link between learning environment and individual instruction when the new horizon reform was formed by the teachers’ union along with the ministry of education and treasury, some goals were set in place. a few of these goals refer to the class environment during the individual instruction hour. according to the general manager’s memo 2011, (9/a) it is necessary to conduct a “positive dialogue with each student in order to provide each of them the proper space and consistent emotional support”. the teacher’s function is to create “the best educational-learning environment in a small group setting which provides each student with a sense of belonging, acceptance and empowerment”. the individual instruction hours lend themselves to activating a learning process that is focused on the individual with the understanding that this type of instruction allows for a better fulfillment of general educational goals and the students’ academic achievements. but beyond academic achievements, the results expected from these instructional hours are supposed to culminate in an intimate and productive dialogue between the students and the teacher and with themselves. 2. method 2.1 research assumption there is a correlation between teaching methods and classroom environment. this is a two part assumption: a. traditional teaching methods will be negatively correlated to learning environment. that is to say, the more the teacher uses traditional teaching methods in the individual instruction hour; the less productive the learning environment becomes. b. using various teaching methods will be positively correlated to learning environment. in other words, the more the teacher varies teaching methods during the individual instructional hour, the better the learning environment. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 10 published by scholink inc. 2.1.1 research population the research field spun three elementary schools in haifa and in the northern region of the country. the schools that participated in the sample population joined and have been a part of the new horizon reform for eight years prior to the research. the curriculum of these schools was altered because of the reform, and adjusted lesson plans were created for the small groups participating in the individual instruction hours. the school population is heterogeneous and includes students from all socio-economic levels. the sample population includes 60 teachers that teach the individual instruction hours within the construct of new horizon reform. each teacher works in a system that incorporates five individual instruction hours for groups of up to five students and in addition to frontal teaching time. 2.1.2 research tools the research tool is a structured questionnaire that contains three parts. the first part included a questionnaire designed to collect background data about the participants. the second part presented a teaching questionnaire for the individual instruction hour and the third part a questionnaire on developing the best educational environment in the small group. an explanation sheet on how the research will be conducted and a confidentiality clause was attached to each questionnaire. 1) personal data questionnaire personal data of the participating teachers was collected: age, sex, level of education, tenure, position, years teaching within new horizon reform and the level of the students participating in the individual instruction hour. 2) questionnaire on teaching during the individual instruction hour a part of this questionnaire was extracted from another on the subject of math during individual instruction hour then used here for our purpose. the questionnaire was created by esti pinsker as part of her final thesis: teaching math during individual instruction hours within the new horizon reform (pinsker, 2012). the original questionnaire had 29 responses the teachers had to place on likart scale between one–not at all to five–very much so. twenty five responses relating to teaching during individual instruction hour were taken from the original questionnaire. 3) questionnaire on the best learning environment in the individual group a questionnaire was designed to look into teachers’ behavior but not her output as it is being reflected by the relationship of the students with themselves and with the teacher. the questionnaire identified three specific factors: positive environment, encouraging involvement and engagement and personal attention to each student. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 11 published by scholink inc. personal data of the participating teachers was collected: age, sex, level of education, tenure, position, years teaching within new horizon reform and the level of the students participating in the individual instruction hour. 2.1.3 analysis of research results the data extracted from the research was processed using spss. the following analysis was performed using this program: theoretical statistics for the main research parameters designed to examine the characteristics of the information provided by the current population sample; quality control of the different scales. then the marginal matrix adjustment was calculated for the research variants in order to examine patterns of general correlation. the data output from the research questionnaires were processed using spss program. the data analysis led to insights which culminated with the conclusions drawn by this research. 3. results 1) advance analysis we checked for correlation between demographic variables such as age, tenure in teaching, tenure in the “new horizon” program and level of education, and the indices of the variables: teaching methods and classroom environment but no significant correlation was found between the background variables and the research variables. therefore, the statistical analyses will be performed with no oversight of background variables as intermediate or intervening. later, the inter-correlation between the different indices of each variable was tested using a series of pearson tests as they appear in tables 1 and 2. table 1. correlations between indices for methods of teaching (n = 60) peer assisted instruction personal instruction various teaching methods traditional instruction .28* .20 .10 traditional method .62*** .78*** various teaching methods .38** .73*** personal instruction *p<.05 **p<.01 ***p<.00 www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 12 published by scholink inc. from this table we conclude that the majority of teaching method indices are significantly and positively correlated and therefore represent a common body of content. however, the traditional teaching indices and varied and personal instruction were not significantly correlated. table 2. correlation between class environment indices (n = 60). personal approach encouraging involvement positive environment .34** .47*** environment positive .56*** encouraging involvement **p<.01 ***p<.001 in this table we find that the indices class environment are significantly correlated to each other and therefore represent a common body of content. verifying the research assumption to verify the research assumption that deals with the correlation between teaching methods and class environment, we conducted a pearson correlation test between the indices teaching methods and the indices class environment. the findings of the test are represented in table 3. table 3. correlations between teaching methods and class environment (n = 60) assisted peer personal varied/integrative traditional instruction of methods environment class .17 .18 .34** .06 positive environment .41** .28* .37** .26* encouraging involvement .39** .50*** .50*** .28* personal approach *p<.05 **p<.01 ***p<.001 www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 13 published by scholink inc. from this table we find that in contradiction to the research assumption, a significant positive correlation exists between traditional teaching methods and encouraging involvement (r=.26, p<.05) and with personal approach (r=.28, p<.05). however, no correlation was found between traditional teaching methods and positive environment. in line with these findings, the first part of the research assumption was rejected. as to the second part of the research assumption, significant positive correlation was found between varied/integrative teaching method and a positive environment (r=.34, p<.05), encouraging involvement (r=.37, p<.01) and personal approach (r=.50, p<.001). in a similar way, significant positive correlation were found between personal instruction and encouraging involvement (r=.28, p<.05) and personal approach (r=.50, p <.001). finally, significant positive correlations were found between peer assisted teaching and encouraging involvement (r=.41’ p<.01) and personal approach (r=.39, p<.01). it is worth noting that no correlation was found between personal instruction and peer assisted teaching and personal approach, therefore, the second part of the research assumption was almost completely verified. to check indices of teaching methods as predictors of classroom environment, a series of multiple regression analysis tests were done using the stepwise method. during the first phase, the background variables: age, level of education, tenure in teaching and the “new horizon” program were entered into the regression analysis model using the enter method in the control variables. during the second phase, all teaching methods indices were entered as independent variables (using stepwise method) and classroom environment indices were entered as dependent variables (each separately). the findings are presented in tables 4–6 and detailed below: it is important to note that the tables represent the indices that predict only in a significant way. table 4. multiple regression analysis for indices of teaching methods as predictors of positive environment environment positive change 2r f beta (enter) blesvaria background .18 2.99* .54 tenure education, of level age, (stepwise) indices methods teaching .08 5.55* .28 varied/integrative teaching www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 14 published by scholink inc. *p <.05 the findings indicate that varied-integrative instruction significantly predicts the index of positive environment [f(5, 59) = 5/55, p<.05] and explain 8% of the variance in the index of positive classroom environment. table 5. multiple regression analysis for teaching methods indices as predictors to encouragement of involvement encouraging involvement r2 change f beta background variables (enter) .02 .22 .18 age, level of education, tenure teaching methods indices (stepwise) .16 10.13*** .41 peer assisted teaching ***p<.001 the findings indicate that peer assisted teaching significantly predicts the index encouragement of involvement = [f(5,59)=10.13, p<.001] and explains 16% of the variance in the index encouragement of involvement in class. table 6. multiple regression analysis for teaching methods indices as predictors of personal approach approach personal change 2r f beta background variables (enter) .01 .50 .04 age, level of education, tenure www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 15 published by scholink inc. (stepwise) indices methods teaching .25 18.85*** .46 personal instruction .05 4.05* .24 traditional teaching *p < .05 ***p < .00 the findings indicate that personal instruction and traditional instructions significantly predict the personal approach index [f(6,59)=4/46, p<.05] and explain the 31% variance in the personal approach index. 4. discussion the purpose of this research was to examine the correlation between classroom environment and teaching methods during an individual instruction hours. the individual instruction hours that are being taught as part of the new horizon program expand the possibilities available to teachers to advance each student’s cognitive, intra and inter personal aspects (videslavsky, 2010). teachers get the opportunity to experiment with alternative teaching and evaluation methods and motivate their students to learn while forging a personal bond with each. adjusting the instruction-learning methods to students’ needs and building team work around learning contribute to creating a positive, respectful, caring context and improves the classroom environment. (gil, 2009) this research presented a central assumption that was divided into two parts. the central assumption is that a correlation between teaching methods and classroom environment exists. the parts of this assumption are: 1) traditional teaching methods will have a negative correlation to classroom environment. in other words, the more a teacher uses traditional teaching methods during the individual instruction hour, the less productive the learning environment becomes; 2) using various teaching methods will prove to have a positive correlation to classroom environment. meaning, the more the teacher varies the teaching methods in the individual instruction hour, the better the classroom environment. the research was conducted using quantitative-correlated approach. the emphasis in the quantitative research is on the measurable aspect because this research mostly relies on numerical data collection. the quantitative research focuses on examining existing assumptions or theories (freidman, 2007). the research tool is a closed questionnaire containing three parts and designed to look at teaching methods during the individual instruction hour and to developing the best educational environment for the individual group. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 16 published by scholink inc. the first part of the assumption, claiming that traditional teaching methods will be negatively correlated to classroom environment was refuted. the second part of the research that claims that using various methods of teaching will be positively correlated to classroom environment was almost fully supported. a. assumption (a) which assumes that traditional teaching methods will be negatively correlated to classroom environment was refuted because a strong positive correlation was found between traditional teaching methods and the encouragement of class involvement through a personal relationship with the teacher. a personal attitude towards the students and encouraging involvement are the building blocks of classroom environment. research from literature indicates there is a large gap between the learning environments in the classroom as opposed to the individual instruction hour learning groups. teaching and learning within the classroom has become very difficult, the number of students is high and there’s a risk that some of the students are not going to be noticed or learn the study material (moshel-ravid, 1995). in addition, the time the teacher can provide each individual student in the home room class is very limited. the emotional dialogue in class is a lot less intimate and usually deals with educational subjects and solving class problems. the individual instruction may mitigate these difficulties. the personal attention the teacher provides during this time is evident whether the teacher uses traditional methods of teaching or varied ones. the small number of students allows the teacher to respond to the various needs of the students while taking into consideration their individual strengths and weaknesses in different subject (videslavsky, 2010). the focus of this research was to negate the traditional teaching methods in relation to classroom environment. in spite of it, it is evident that learning in a small group can become a positive extension to the educational-learning activity in the classroom through the practice or expansion of what was taught there (videslavsky, 2010). when the teacher checks the homework or gives the students in the group a workbook assignment for example, she is able to track each student separately, provide quality response and therefore advance the student through personal contact that provides support. the teacher’s ability to converse at eye level with each student in the individual group, gives the student a sense of confidence, trust and respect. indeed, data extracted from the national stirring committee for indexing and evaluation (abbrv, 2012), it turns out that teachers speak of the contribution individual instruction hours make to strengthening the bond with their students and allowing them an opportunity to get familiar with the student’s emotional sphere. the findings of this research shed light on the positive correlation between traditional teaching methods to encourage involvement. for students to demonstrate engagement and active participation in the learning process, they must feel safe and appreciated. the individual instruction hour naturally supports www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 17 published by scholink inc. itself to the engagement and active participation of each member of the group (slavin, 1995). the environment in the individual group allows students to experience a sense of belonging, appreciation and acceptance (videslavsky, 2010). that is why within this individual framework even mediocre and weak students that do not usually participate in class discussion allow themselves to get involved. another interesting finding of this research that did not receive statistical significance is the correlation between traditional teaching methods and a positive environment. professional literature suggests that the style of teaching affects the quality of the interaction in class and the emotional environment in it (mahlab, 2003). traditional frontal instruction is less effective in encouraging the social skills so crucial to students’ behavior in class and therefore to the resulting learning environment in it. the traditional teaching method is characterized by a competitive class structure focused on personal success and failure. the students are evaluated based on their achievements as compared to others so the reward of one student may be inversed to the reward of her peers. too much competition creates tension and can negatively impact the classroom environment (tzedkiyahoo, 1988). one of the components of a positive classroom environment is openness of mind, and in behavior. it allows students to bring up subjects for discussion and express independent opinions however unpopular (tzedekyahoo, 1988). frontal instruction does not allow the student to express his opinions and ideas because the assignments call for the use of one skill only and tend to encourage obedience and uniformity. as a result the student is more passive during frontal teaching lesson (mahleb, 2003; aliasi & ben-ari, 2008). professional literature reinforces the lack of connection between traditional teaching methods and a positive environment. b. the challenge in the current research was to examine the connection between using various teaching methods and classroom environment. the assumption formed assumed that various teaching methods will be found positively correlated to classroom environment. this assumption was almost completely supported, moreover, additional significant positive correlation was observed between varied-integrative instruction and a positive classroom environment, involvement and personal interaction. the link between varied methods of teaching and positive environment the findings indicate that varied, integrative instruction can significantly predict the measure of positive environment. research literature indicates that group learning has as its goal the development of academic, social and emotional functioning. in order to fully utilize the advantages provided by the construct of individual instruction hours, it is vital to foster unity among the students as a “studying social group” that contributes to developing relationship skills, functioning at high academic levels and optimal environment (gil, 2009). www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 18 published by scholink inc. this becomes possible through varied and collaborative teaching methods that emphasize positive relationships among the students. (ben-ari and eliasi, 2008). learning through social interaction is based on the constructive theory of the renowned psychologist vigotsky (vigotsky, 1978). according to vigotzky, learning evokes internal processes that are activated only when there is an interaction between the students and their environment. the constructive methods include a wide variety of teaching methods like research approach, alternative evaluation, project based and collaborative learning (dressler, 2010). these various teaching methods set a goal or collaborative goals for the group of students in the subject to learn, know or apply. in order to reach these goals, a mutual dependency is established and it leads to mutual activity among the participating students (videslavsky, 2010). group members establish a collaborative action construct and practice social skills such as: listening, speaking in turn, equal participation, tolerance, mutual respect and assistance, self acceptance and that of others, personal involvement and collective responsibility. the students learn because it is not possible to accomplish academic achievements without creating a socially supportive and organized environment (mahlab, 2003). as a result, students exchange opinions, feel free to inquire, explain things to each other, work through difficulties, help each other and thoroughly understand ideas and express their feelings about the learning process (slavin, 1995; mahlab, 2003). all this explains the positive correlation between varied teaching methods and a positive classroom environment. the correlation between peer assisted instruction and encouraging engagement aspect another unique finding of this research is a significant positive correlation between peer assisted instruction and the encouragement of involvement. this unique finding may contribute to the cumulative body of knowledge on the subject of individual instruction and classroom environment. peer assisted instruction refers to the professional cooperation among the school’s educational team teaching the same students in the individual instruction group. engagement or involvement refers to a student who is active in the learning process and experiences a sense of belonging to the class and the school. data from the national council on measuring and evaluation (rama, 2012) indicates that one of the significant results of “new horizon” is the establishment and reutilization of work teams on the subject of individual hours. it happens in the construct of a professional conversation, a discussion on methods and tools of learning, handling challenges and routine problems in the area of interest, applying school policy on operating individual hours and strengthening mutual contribution in the teachers’ lounge. it was found that schools organized flexible work teams that include coordinators, counselors, subject or age group teachers or a combination thereof. the frequent staff meetings are being held in between classes and include productive and enjoyable brain storming in a mutually supportive environment. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 19 published by scholink inc. teachers report that this type of work advances their personal professional work, assists in the overall learning environment in school and creates a friendly and pleasant environment. it is apparent from this data that these staff meetings on the subject of individual instruction hours actively engage teachers in the daily process of teaching and supports their efforts to create a successful learning environment, for the students and themselves. in addition, professional literature reveals that when teachers enter the process of collaborative research about students’ work and their learning, they develop the skills necessary to positively adjust their instruction to match the needs of the students and they deal with the challenges unique to their school environment (militello, rallis, & goldring, 2009). figure 1. synchronization between school teams on the subject of individual instruction hours it is clear from the chart that when the educational team works together synchronously, it is possible to handle the subject of individual instruction hours in the context of the school curriculum and ensure educational continuity. team members are active partners in the pedagogical work and are supported by each other in dealing with all the aspects of their work. as result, sharing information about the students becomes possible and conducive to collaborative decision making in regards to complex problems that arise from time to time. center to the process is the students’ best interest, their needs principal subject teachers group of students counselor home room www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 20 published by scholink inc. and success. this way, it is possible to develop an educational environment that is based on caring, concern for others, improving the learning process and students’ engagement. the correlation between individual and traditional instruction and personal approach the research findings point out that individual instruction and traditional instruction, both accurately predict the aspect of personal approach. this finding is new as far as the first part of the research assumption is concerned; the part that states that traditional instruction methods will be negatively correlated to classroom environment because a personal approach is a component of classroom environment; therefore this part of the assumption was refuted. in addition, this finding supports the second part of the assumption regarding varied instruction methods (including individual instruction) being positively correlated to classroom environment (including personal approach). according to data from the national council on measuring and evaluation (rama, 2012), individual education allows a more central space for students’ will and choice and bases the definition of individual educational and personal goals on dialogue and mutual choice. in other words, individual instruction provides a differential response to each of the students. this means that each member of the individual group can set up goals and build, in cooperation with the teacher, an individual study plan, adjusted and tailored to their own study pace and designed to advance that student based on her relative set of skills. (azulai, 2010; rama, 2012). traditional teaching methods, when used individually, also allow the teacher to respond to the various needs of a student and provide a personal approach. in the individual group it is possible to learn any subject or content that was originally learned in a full classroom and practice any teaching-learning activity available in the regular classroom, such as: discussion, lecture, explanation, practice. as compared with a regular classroom, where the teacher is not able to dedicate personal attention to each of the students, organizing the students in a small group during individual instruction hours creates an intimate educational encounter between students and teacher. the interaction in the small group is a lot more direct than in a conventional classroom setting and therefore becomes naturally conducive to a close personal relationship because of the small number of students participating. as a result, the teacher is able to maintain eye contact with each student, listen to her and respond accordingly (videslavsky, 2010). in conclusion, the current research examined the correlation between classroom environment and the instruction methods during the individual instruction hour. the results indicated a positive correlation between varied integrative teaching and a positive classroom environment and between personal instruction and traditional method of teaching to personal approach. the new aspect revealed with this research is the significant correlation between peer assisted instruction and the encouragement of student participation. this finding lays the ground work to a more detailed examination of professional www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 21 published by scholink inc. teaching constructs by educational teams at schools and their impact on student engagement during individual instruction hours. references allhusen, v., belsky, j., booth-laforce, c. l., bradley, r., brownwell, c. a., burchinal, m., & weinraub, m. (2004). does class size in first grade relate to children’s academic and social performance or observed classroom processes? developmental psychology, 40(5), 651-664. https://doi.org/10.1037/0012-1649.40.5.651 azolay, s., & wordy, a. (2010). answer to question: what is individual instruction? eureka, 29, 5-24. (hebrew) bar-lev, e. (2007). school climate: reality and vision. beer-sheva: kaye academic college of education. (hebrew) ben-ari, r., & eliasi, l. (2008). frontal teaching and complex teaching strategies: the differential impact of teaching environment on student achievement motivation. megamot, 45(3), 531-554. (hebrew). brikner, r., & ron t. (1999). adjusted instruction: development and reform from an experiential project to establishment and deeper practice: 1973-1999. (r. globman, & y. iram (eds.)). the development of instruction in israel’s educational institutions. tel-aviv: ramot. (hebrew) brooks, z., & brooks m. (1997). in search of understanding: the case for constructivist classrooms. jerusalem: the branco weiss institute for the development of thinking. (hebrew) dressler, m. (2010). individual instruction as opportunity to learning differences’s respond. eureka, 29, 33-47. (hebrew) feuerstein, r. (1993). mediated learning. hed hagan, 38, 135-139. (hebrew) friedman, y. (2006). quantitative research, qualitative research and combined methods: when and how? hagigey givah, 13, 153-164. (hebrew) gil, h. (2009). stages in the development of a social learning group. retrieved from http://pisgak8.com/resources.asp gur, h. (2007). dialogue in teaching. hed hachinuch, 82(1), 93-95. (hebrew) hativa, n. (2003). teaching processes in the classroom. tel-aviv: the academic publication, for the development of educational staff. (hebrew) hertz-lazarowitz, r., & fuchs, i. (1987). collaborative learning in the classroom. haifa: ach. (hebrew) howes, c., & ritchie, s. (2002). a matter of trust: connecting teachers and learners in the early childhood classroom. new york: teachers college press. www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 22 published by scholink inc. mahlab, h. (2003). choosing instruction method in the heterogeneous classroom. aspects in teaching computer science, jan., 30-42. (hebrew) militello, m., rallis, s., & goldring, e. (2009). leading with inquiry and action: how principals improve teaching and learning. thousand oaks, calif.: corwin. ministry of education & culture. (n. d.). prpcedures of administration of “new horizon” reform within kindergarten, elementary & secondary schools. retrieved from http://cms.education.gov.il/educationcms/applications/mankal/etsmedorim/3/3-1/horaotkeva/ k-2014-6-1-3-1-46.htm moshel-ravid, o. (ed.). (1995). learning, teaching, education & classroom size: review of the professional literature. jerusalem: szold institute. (hebrew) pianta, r. c. (1999). enhancing relationships between children and teachers. washington, d. c.: american psychological association. https://doi.org/10.1037/10314-000 pianta, r. c., belsky, j., houts, r., & morrison, f. (2007). opportunities to learn in american’s elementary classrooms. science, 315, 1795-1796. https://doi.org/10.1126/science.1139719 pianta, r. c., mashburn, a. j., downer, j. t., harmre, b. k., & justice l. (2008). effects of web mediated professional development resources on teacher-child interactions in pre-kindergarten classrooms. early childhood research quarterly, 23(4), 431-451. https://doi.org/10.1016/j.ecresq.2008.02.001 pinsker, e. (2012). teaching mathematics during individual hours format in the framework of the new horizon reform. haifa: gordon college academic. (hebrew) rama. (n. d.). evaluation the reform new horizon. retrieved from http://cms.education.gov.il/educationcms/units/rama/haarachatprojectim/ofek_hadash.htm reeves, t. c., herrington, j., & oliver, r. (2002). authentic activity as a model for web-based learning. in annual meeting of the american educational research association, april, 1-5. la: new orleans. reichert, r. (2009). democratic pedagogy’s answer to the question of individual instruction within new horizon reform. education and its environment, 31, 151-162. (hebrew) rubin. s., & koren, d. (2007). research ethics: fundamental background and practical suggestions. in shefler, g., achmon y., & weil, g. (eds.), ethical issues for professionals in counseling and psychotherapy, 603-619. jerusalem: magnes. (hebrew) schwartz, j. (1993). obesity affects economic, social status. the washington post, a1-a4. sharan, s., & sharan, y. (1976). small-group teaching. englewood cliffs, n. j. : educational technology. shechtman, z. (2006). group counseling and psychotherapy with children and adolescents: theory, research & practice. mahwah, n. j.: lawrence erlbaum associates. https://doi.org/10.1037/10314-000 https://doi.org/10.1126/science.1139719 https://doi.org/10.1016/j.ecresq.2008.02.001 www.scholink.org/ojs/index.php/ct children and teenagers vol. 1, no. 1, 2018 23 published by scholink inc. slavin, r. e. (1995). cooperative learning: theory, research and practice. boston: allyn & bacon. snow, d. (2003). noteworthy perspectives: classroom strategies for helping at-risk students. denver, co: mcrel. tal, r. t., & miedijensky, s. (2005). a model of alternative embedded assessment in a pull-out enrichment program for the gifted. gifted education international, 20, 166-186. https://doi.org/10.1177/026142940502000208 tomlison, c. a. (2000). differentiation of instruction in the elementary grades. eric digest. trickett, e. j., & moss, r. h. (1995). classroom environment scale manual. palo alto, ca: consulting psychologist press. tzedkiyahu, s. (1988). classroom environment: theory and practice. jerusalem: ministry of education & culture. (hebrew) videslavsky, m. (2010). opportunities in teaching and learning within a small group. eureka, 29. (hebrew) vygotsky, l. s. (1978). mind in society: the development of higher psychological processes. cambridge: harvard university press. https://doi.org/10.1177/026142940502000208 1) personal data questionnaire personal data of the participating teachers was collected: age, sex, level of education, tenure, position, years teaching within new horizon reform and the level of the students participating in the individual instruction hour. 2) questionnaire on teaching during the individual instruction hour 3) questionnaire on the best learning environment in the individual group a questionnaire was designed to look into teachers’ behavior but not her output as it is being reflected by the relationship of the students with themselves and with the teacher. the questionnaire identified three specific factors: positive environmen... personal data of the participating teachers was collected: age, sex, level of education, tenure, position, years teaching within new horizon reform and the level of the students participating in the individual instruction hour. 1) advance analysis we checked for correlation between demographic variables such as age, tenure in teaching, tenure in the “new horizon” program and level of education, and the indices of the variables: teaching methods and classroom environment but no significant corre... table 1. correlations between indices for methods of teaching (n = 60) table 4. multiple regression analysis for indices of teaching methods as predictors of positive environment table 5. multiple regression analysis for teaching methods indices as predictors to encouragement of involvement *p < .05 ***p < .00 the findings indicate that personal instruction and traditional instructions significantly predict the personal approach index [f(6,59)=4/46, p<.05] and explain the 31% variance in the personal approach index. children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 6, no. 1, 2023 www.scholink.org/ojs/index.php/ct 24 original paper utilizing creativity for adolescents’ recovery in inpatient psychiatric hospital (iph) yuko taniguchi1*, sue simon2, mason schlief3, rebecca houston3, chidiogo orakwue3, andrea r. collins4,6, samuel f. ekstein4, mikayla a. schmidt3, jered bright1, corri vanderwoude2 & jarrod m. leffler5 1 center for learning innovation, university of minnesota rochester, rochester, minnesota, united states 2 acute care inpatient psychiatric unit for children & adolescents, mayo clinic, rochester, minnesota, united states 3 university of minnesota rochester, rochester, minnesota, united states 4 mayo clinic alix school of medicine, rochester, minnesota, united states 5 college of medicine, division of child and adolescent psychiatry and psychology, mayo clinic, rochester, minnesota, united states 6 ucsf fresno department of psychiatry, fresno, california, united states * yuko taniguchi, center for learning innovation, university of minnesota rochester, rochester, minnesota, united states received: february 19, 2023 accepted: february 26, 2023 online published: march 5, 2023 doi:10.22158/ct.v6n1p24 url: http://dx.doi.org/10.22158/ct.v6n1p24 abstract the study aims to examine the impact of creative activities on adolescents, aged 12-18, hospitalized in an acute-care inpatient psychiatric hospital (iph) setting. while research on the health impact of creative writing has been discussed with adults, research on adolescents hospitalized in acute inpatient psychiatric units (ipu) is limited. this study highlights how creative activities generate self-discovery and insights that are necessary for coping among adolescents in iph. seventy creative writing and origami sessions were embedded as a part of group education from march, 2018 until feb. 2020. a curriculum that considered the interests of current teenagers and the iph short length of stay (4-5 days) was designed and delivered by a professional writer and their team that consisted of health sciences students, medical students, and ipu nursing staff. after each session, a post-session survey was administered. the findings from 568 post-surveys suggest that the adolescents at the iph expressed interest and engagement through creative activities. in addition, the findings suggest creative activities promote mood shifts, relaxation, www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 25 published by scholink inc. and self-awareness, all critical for adolescents during a mental health crisis. further studies are needed to assess if these activities lead to long-term coping strategies for participants following their hospitalization. keywords inpatient psychiatric hospitalization, adolescents, creative writing, origami, group therapy 1. introduction providing effective intervention and education programming is a critical practice of healthcare professionals who serve adolescents in an acute-care inpatient psychiatric hospital (iph) setting. the iph setting for children and adolescents in the united states provides a space in which patients can receive care when their safety is at risk due to crisis, self-harm, or harm to others, with the goal of achieving stabilization (american academy of child and adolescent psychiatry, 1990; balkin, 2006). patients receive a mental health diagnosis from the diagnostic and statistical manual of mental disorders 5th edition (dsm-v; american psychiatric association, 2022) upon admission to help guide care. over time, the length of stay in iph for adolescents has decreased to approximately one week or less (anderson, et al.; 2022; blanz & schmidt, 2000) impacting the overall amount of care one receives during their mental health crisis. in addition, hospitals have shifted the main focus of inpatient programs to patient stabilization rather than long-term treatment (balkin, 2006; nam et al., 2021). in 1990, the american academy of child and adolescent psychiatry proposed a model for minimum staffing in the child and adolescent acute inpatient psychiatric unit (ipu): hospitals offering treatment should include at a minimum one psychiatrist who provides progress notes every three days, one social worker for every ten patients, one psychiatric nurse for every twelve patients, and a child and adolescent psychiatric technician, with units ranging in census from 9 to 24 patients (american academy of child and adolescent psychiatry, 1990; woodward et al., 2017). group classes are generally offered in many acute adolescent psychiatric care facilities, yet there is a little discussion on the quality of group education, curriculum, and learning outcomes (janssens et al., 2013; thompson et al., 2021). moreover, the intervention curriculums and assessment methods for group education for adolescents in iph is rarely discussed or studied. as the average length of an iph stay continues to decline, the incorporation of relevant education and coping skills through engaging methods with consideration for sustainability are critical (gingerich, & peterson, 2013; thompson et al., 2021). carefully designed programs and assessments that obtain feedback from the patients benefit both the patients through effective treatments and staff by improving morale (pottick et al., 1993). the purpose of this study was to examine if the creative activities curriculum designed and delivered by a professional writer and their team were an effective intervention for deepening adolescents’ engagement in iph with a potential to maximize the treatment gains during short-term stays. this study also examined if adolescents in iph viewed creative activities as a potential long-term coping strategy www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 26 published by scholink inc. after participating in a creativity-based program. 1.1 creative process over the decades, the scientific research on creativity and the creative process has shown the function of navigating complex challenging thoughts (abdulla alabbasi et al., 2020; furnham et al., 2008; kaugman & gregoir, 2016; kaufman & kaufman, 2009; runco, 2014). creative processes allow us to navigate complexity, contradictions, and multiple points of view (barron, 1969). creativity researchers explain that individuals engaging in creative processes become “more intimate with themselves”, by facing various aspects of themselves (kaugman & gregoir, 2016). the intention of including creative writing for iph adolescents is to provide a container that allows them to capture all types of thoughts and feelings. authentic expressions cultivated through creative activities lead to self-discovery, allowing us to recognize a part of the self that is creative (richards, 2021). this kind of positive self-view benefits iph adolescents’ recovery process. 1.2 creative activities our study incorporates two types of creative activity: creative writing and origami. the combination of these two mediums were used since this combination, especially origami, is likely to be novel to adolescents in the united states, and may allow open-mindedness and reduce resistance. 1.2.1 creative writing for the purpose of this study, we define creativity as personal expression in the format of poetry, fiction, nonfiction, or any combination of these three formats. 1.2.2 origami origami is the traditional art of paper folding established in 17th century japan (sanderson & morin, 2017). as indicated in the name, ori (folding) and gami (paper) in japanese, the activity involves folding a paper square to create a three-dimensional item. the ritual and the practice of folding origami has been practiced globally as a healing activity, especially during difficult times (lockhart & anania, 2011; “the art of healing”, 2018). origami has been found to be useful in mindfulness practice and art therapy, as the activity involves focus, concentration, and engagement (edwards & hegerty, 2018). enriched origami art therapy (eoat) identifies origami as therapeutic by enhancing cognitive, social, creative and practical skills (kobayashi, 2007). while creative writing invites the participants to look within, origami is a physical activity that encourages interaction with other participants. this combination intends for the program to be enjoyable, playful, and fun. 2. methods 2.1 study setting the study was conducted at a hospital in the midwest and received irb approval. the team consisted of a professional writer, health science students, medical students, and nursing staff. this institution’s www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 27 published by scholink inc. model of care for the acute psychiatric treatment of children and adolescents is based on a short-term crisis intervention model providing a safe and nurturing therapeutic milieu. it is a closed unit with 18 beds, staffed by nurses, patient care assistants, psychiatrists, physician assistants, nurse practitioners, occupational therapists, child life therapists, chaplaincy, pet therapists, a music therapist, medical students, social workers, and specialty physicians. the average length of stay is 4-5 days. each day is highly structured, including meals that are served family style (i.e., dining together with staff present), multidisciplinary treatment team rounds, daily goals group, education group, relaxation group, and various structured groups and individual interventions throughout the day and evening. this study was conducted in a group room located on the unit. two to four health science undergraduate students also participated as learners, with the goal of adding socialization opportunities for the patients. to avoid developing an authoritative relationship, the undergraduate students were required to follow the same directions as the patients. 2.2 participants study participants consisted of 568 adolescents aged between 11and 18-years old (mean age of 15), hospitalized with parental/guardian consent for acute psychiatric care. all patients were diagnosed with a dsm-5 psychiatric disorder, were at imminent risk for suicide or homicide, or demonstrated an inability to fulfill age-appropriate responsibilities. participation in the creativity group activity was based on the mental health assessment of the participant’s assigned nurse. patients were excluded from participating in the creative writing and origami sessions if the patients were considered unfit due to the level of distress they were experiencing related to their psychiatric symptoms (i.e., psychosis, acute anxiety, cognitive distortions, violence, etc.). otherwise, all patients were invited and encouraged to attend. participation was voluntary. 2.3 session procedure the creative writing and origami program was offered as an hour-long group session in the afternoon once week. a total of 70 sessions were offered. all participants attended the session once during their hospitalization. the group room was prepared with colorful begin with pieces folders already placed on the table. the folders contain a guidebook, which provides brief instructions for creative writing and a poem entitled, “begin with pieces”, a list of 15 creative writing topics in the form of stickers, a thoughts bubbles sheet on which patients can fill in words and draw, a list of quotes and poems that focus on personal empowerment and acceptance of self, and a journal notebook. the setting highlights the feel of a playful community gathering instead of a skill-based class in a hospital. facilitators consisted of a professional writer as well as medical students and health science students who were interested in humanities in medicine. prior to each session, the group nurse provided an overview of the patients (i.e., patient handoff) to the facilitator(s) which included an overall assessment of the unit milieu and when present, potentially disruptive patient behavior(s). the group nurse communicated the level of patient acuity (i.e., potential for acting out verbally or physically, emotionally fragility/lability, www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 28 published by scholink inc. anxiety levels, etc.). the group nurse was available in case participants needed extra support during the session. first, the facilitator read the poem, begin with pieces, to set a tone of reflection. begin with pieces what makes you, you? how softly or strongly you sing the songs you love, the way your shadow persistently follows you, how enormous the darkness feels in your chest all the pieces you have touched huddle inside your arms like birds in the nest, ready to fly. (taniguchi, 2018). this poem aims to communicate that we are made of many thoughts and feelings, leading up to the next step of reflection on the self holistically. participants are invited to circle the words or phrases that resonated with them. a brief discussion and sharing of the words was conducted. then participants were guided to review the stickers and the list of creative writing topics (see appendix 1). they were invited to suggest two writing prompts to work on as a group. the facilitator aimed to receive at least two suggestions from the participants so that they could choose from the selected prompts. once the participants determined the topic, they peeled off the corresponding sticker and placed it on the front page of the journal notebook. five to ten minutes were provided for writing. after writing, a facilitator invited participants to share their work by reading it out loud. if no one volunteered, the facilitator was prepared to read his/her own work. the facilitator repeated this process of selecting writing prompts, peeling off the stickers, writing, and sharing. the facilitator ended the writing portion of the session by encouraging participants to use the rest of their creative writing stickers on their own before they were discharged. the last fifteen minutes were dedicated to origami. the origami project was usually a rose or heart, which required repeating the same folding technique several times. a wide range of decorative and colorful origami paper was passed around, and participants were encouraged to take several pieces that contained a design that resonated with them. participants were instructed to make the first piece by following the instructions. then, they were to repeat this process on their own. once they made several origami flowers, they had the option of keeping the several pieces as they were or creating a collage. everyone was required to donate at least one piece of origami to the community garden, which was a large piece of paper that hang on the wall. before submitting their origami flower or heart for donation, participants are asked to write a brief message they wished to share with their community. the facilitator gathered the www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 29 published by scholink inc. donated origami flowers or hearts and taped them to a large sheet with the title, “community garden”. the sheet, filled with origami flowers and hearts with participants’ messages, was posted on the wall of the group therapy room. the purpose of conducting origami was to provide an alternative activity for those who may not enjoy writing, provoke curiosity by engaging in a cultural experience (henderson & gladding, 1998), and to end with an activity that promotes mindfulness (kobayashi, 2007). 2.4 data collection and analysis the post survey (appendix 2) was administered by the nursing staff after each session without the facilitator’s presence. the survey responses were collected and organized into a spreadsheet. the responses to the open-ended question were transcribed, reviewed, and the codes were developed to gather qualitative data. these codes were grouped into categories, which were further analyzed to extract themes that respond to our research questions regarding the creativity-based activities as an effective method for group education for iph adolescents. the data was analyzed through the strength perspective theoretical framework of (lyons et al., 2000). this theory operates from the theoretical framework that individuals hold the ability and capability to navigate challenges. the focus is to find the strength that already exists inside them. the emphasis is, therefore, guiding individuals to become aware of their own strengths and to identify how they construct their own coping strategies (coholic & eys, 2016). this perspective empowers individuals to be the experts of their own lives, thus their responsibility to their own healing is also implied (tyson & baffour, 2004; tyson et al., 2010). this perspective is relevant for program development for adolescents in iph. walking into a creative writing session, participants are treated as writers/artists and are encouraged and required to step up to this role; this approach empowers them, especially adolescents, as they have great aspirations for their future. this framework allows a facilitator to ask participants to be responsible for engaging in the work of expression, reflection, and exploration (king, neilsen, & white, 2013). the data was also analyzed through the geneplore model which is often used to analyze the process of creative writing (ward & lawson, 2009; ward, 2001). this model indicates that the process of creative writing involves generative processes (putting down thoughts and ideas and exploring how the pieces fit together) and exploratory processes (evaluating and analyzing each piece to refine the original ideas) (lubart, 2009). 3. results a total of 568 post-session surveys were collected from 70 creative activity sessions. 3.1 self-reported reasons for being hospitalized table 1 shows the self-reported reasons for iph admission. categories were organized based on the frequency of responses. “other” refers to comments that included personal reasons other than identified categories. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 30 published by scholink inc. table 1. self-reported reason for inpatient admission reason percentage (n=568) suicidal thoughts suicide attempt attempted overdose depression self-harm anger anxiety other 32.9% 22.4% 9.3% 9.9% 7.1% 2.2% 3.4% 18.0% 3.2 self-reported symptom severity during the creative writing and origami session based on the following categorization of severity: 0-3 as mild, 4-6 as moderate, 7-9 as severe, and 10 as extreme, 45% of participants (n=568) report that their psychiatric symptoms ranged from severe to extreme during the creative writing and origami session, as indicated in figure 1. figure 1. symptom severity during group 3.2.1 previous experience of using art 52% responded that before coming to the hospital, they used writing or drawing for coping, indicating www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 31 published by scholink inc. that the majority of adolescents arrived in iph with experience in creativity-based activities. 3.2.2 the level of interest in the creative writing and origami session figure 2 shows participant’s self-reported (n=568) level of interest in the creative writing session on a 0-10 point rating scale (10 being the best). we define a participant who expressed interest as those who marked 5 and higher. the findings show that 82% of participants expressed interest in the creativity-based activity. figure 2. level of interest in group 3.3 participants’ experience during the creative writing and origami session participants were asked to identify (n=568) their experience in the creative writing and origami session. figure 3 shows the descriptions participants used to label their experience. “calming” (59.9%), “relaxing” (43.3%), “fun” (44.7%), and “break from life” (31%) are the most frequently selected. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 32 published by scholink inc. figure 3. experience during creative group 3.4 participants’ reaction to their own creative work participants’ responses (n=568) to how they felt about the writing and origami they created is presented in figure 3. “creative” (51.4%), “unique” (33.3%), “proud” (35.6%), and “inspired” (23.1%) were the top four most frequently selected terms. figure 4. self-reported appraisal of work in creative group 3.5 evaluation of creative thinking 408 participants (72 %) responded to the open-ended survey question, “what did you discover that you enjoy or like?” and 160 participants (28%) left it blank. the responses to open survey questions (n=408) www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 33 published by scholink inc. were analyzed by using association of american colleges and universities creative thinking rubric (appendix 3). 84% of the participants’ responses were considered as demonstrating creative thinking, and 16% of the participants’ responses were not considered as demonstrating creative thinking. regarding the specific types of creative thinking, 52% of the participants’ discovery was related to their innovative thinking (novelty or uniqueness of ideas, claims, questions, forms, etc.). from this group, 43% of the participants specifically reported “origami” as the source of a new enjoyable activity. 15% of the participants’ discovery was associated with connecting, synthesizing, and transforming, 15% of the participants’ discovery was related to acquiring competencies such as strategies and skills, 8% of the participants’ discovery was connected to taking risks (such as navigating failure, setbacks, discouragement, fear, and embarrassment), 5.6% of the participants’ discovery was connected to solving problems, and 5.6% of the participants’ discovery was related to embracing contradictions. table 2. self-reported discovery 3.6 creativity-based activities as long-term coping skills 356 surveys incorporated new questions that invited participants to imagine if creativity-based activity could be used as a long-term coping skill. 78% of the participants responded “yes”, and 28% of the participants responded, “no”. of the 78% who responded “yes”, figure 5 shows the situations when they indicated that they can imagine conducting creativity-based activities. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 34 published by scholink inc. figure 5. use of creative writing and origami 4. discussion the results suggest that creative-based activities (creative writing and origami) are an effective approach to gaining the engagement of adolescents in iph. the results also suggest that creativity-based activities prompt important attributes such as reflection, self-awareness, and enjoyment, which play an important role for coping and self-care. considered through the strength perspective, adolescents expressed interest in creativity-based activities because they identify their own creativity as strength through playful self-exploration. moreover, creativity-based activities may be fitting for the adolescents in iph. engaging in creative processes means becoming “more intimate with themselves”, by facing all aspects of themselves (kaugman & gregoir, 2016). the situations and reasons that led adolescents to be hospitalized are complex; they are, no doubt, navigating the difficult and challenging process of understanding their emotional crisis. therefore, this act of engaging in the creative process may be perceived as fitting by the adolescents in iph. furthermore, it is likely that many adolescents in iph have managed their crisis successfully in the past without getting to the point of iph (tyson & baffour, 2004). this means that many adolescents have already experienced thinking creatively in response to their challenges. 52% of adolescents reported that they have already used writing or drawing to feel better before the iph. this means that they have already found writing and drawing to be a tool to comfort them. the participant’s 82% interest rate may not mean that the adolescents have discovered new interests. rather, it is likely that they were able to rekindle a processing strategy that made sense to them and helped them feel better in the past. the activities of creative writing and origami may have been new, but www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 35 published by scholink inc. engaging in the creative process may have felt familiar. the strength perspective (lyons et al., 2000) assumes that individuals hold the abilities and capabilities to navigate challenges. from this perspective, it can be assumed that the creative writing and origami sessions did not necessarily teach adolescents to think creatively, but rather, this tool allowed them to recognize the strengths and skills they already possessed. a participant’s comment, “i knew i liked to write but not this much. i also didn’t realize how good of a coping skill it could be”, shows that this participant gained new insight into a tool he or she had already used and was reminded of the power of writing. the role of the creative writing and origami sessions may be to help adolescents realize their own capabilities. the claim, engaging in creative processes allows participants to face all aspects of themselves, explains why adolescents with moderate to the extreme levels of psychiatric symptoms still expressed interest in these activities. 90% of participants reported that they felt moderately to extremely distressed by their psychiatric symptoms. the severity of symptoms may suggest processing their complex situations is actually “relaxing” as 43 % of the participants reported. despite their struggling psychological state, this response suggests that they lean toward engaging in a creative process that allows them to process their complex thoughts which leads to feeling relaxed. 4.1 the impact of creative writing we have identified the geneplore model of creative process as a theory to further analyze the participants’ responses to creative writing. the theory indicates that creativity involves two stages of processing: generative processes (putting down thoughts and ideas, and exploring and synthesizing how the pieces work together) and exploratory processes (evaluating and examining the work, and refining the ideas). examined through the geneplore model, freewriting can be considered as a generative process, and sharing and listening to each other’s work as an exploratory process. 4.1.1 generative process the participants were encouraged to write down or draw anything that comes to mind. they were instructed to not worry about grammar, spelling, or coherence. once participants have written down their thoughts and ideas, they have a physical, concrete format for their thoughts. creative writing functions as a container to hold the seemingly uncontainable. once the thoughts and ideas are captured externally on paper, the participants can literally see their thoughts. the act of putting down their thoughts and emotions through writing may have generated the response, “calming” (60%) and “relaxing” (43%). in a study of writing (king, 2002; pennebaker, 1993) explains that unexpressed emotions are detrimental to physical health, and emotional release benefits physical and emotional health. while some may experience difficulty writing, it is possible that a majority of the participants felt that it was calming to externalize their thoughts by putting them on paper. writing our thoughts creates intellectual distance, and we begin to see our thoughts from a larger perspective. such a space is called self-distancing as writers take a step back from their own perspective (ayduk & kross, 2010, 2017). the writers can www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 36 published by scholink inc. physically see the shape and the quantity of their own thoughts, feelings, and imagination. the novelist, john gardner (1999), describes this space: “in some apparently inexplicable way the mind opens up; one steps out of the world. one knows one was away because of the words one finds on the page when one comes back, a scene or a few lines more vivid and curious than anything one is capable of writing” (p. 57). in the generative process, writers are retrieving ideas from within, and what is placed on the page often surprises them. the comment by a participant, “i learned what my words can be like”, captures the self-distancing view of seeing their words externally and how the words are communicated. it is during this process that participants might have felt that their creation was “creative” (51%) and “unique” (33%). another participant’s comment, “i can use journal prompts to express my feelings when i need to cope with my thoughts”, shows the recognition of how they can use their interest and ability to cope with their negative thoughts. 78% of the participants said “yes” to recognizing creative activities as the potential coping skill when they encounter difficult situations (indicated in figure 5). these responses suggest that they view themselves as someone who generates creative and unique work. recognizing the self as the creator of creative and unique work, participants often feel “proud” (36%) and perhaps “accomplished” (20%). this recognition of their strength and ability is crucial in building their self-worth. 4.1.2 exploratory processes participants are invited to read their work and talk about their writing experience. most of the time, participants were willing to share. sharing one’s own writing can present as a vulnerable experience. even if there were ground rules of listening and appreciating among the audience, sharing can feel risky. but those who shared their writing experienced being recognized and practicing courage. they witnessed how their stories were also meaningful to others. this space becomes an opportunity to rethink, reframe, and refine their ideas by recognizing various elements included in their creative expressions (kaufman & kaufman, 2009; mcardle & byrt, 2001). by interacting with others through creative work, the participants gain multiple perspectives which could help soften their rigid negative self-view. it is in this space that they begin challenging their own self-view while also feeling “encouraged” (18%) and “inspired” (23%). eight percent of participants expressed that “interaction with others” was what they discovered that they enjoyed or liked (table 2). listening to other stories that are creatively expressed generally does not provoke a judgment of being good or bad simply because a story truly belongs to the writer. the focus is how differently each person interpreted the prompt. writing is recognized as a collaborative act that requires community support (chandler & schneider, 2009). through listening, the participants generate new ideas of their own. in summary, the participants’ responses indicate that creative writing provided participants more insights about themselves. these insights may be the wisdom that participants would have not realized had it been www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 37 published by scholink inc. introduced through a more conventional approach such as a more skill-based educational program. hunt (1998, 2000) defined finding voice as about the connection between inner self and words on the page. this newly realized voice, that they can generate creative and unique products, is different from their old self-talk of inadequacy. their own writing becomes the physical evidence of their new voice. when they are caught by the single view of inadequacy, this physical form may function as a reminder that they hold multiple voices. the comment from a participant, “i am stronger than i thought”, shows an increase in confidence, reflecting a recognition of the participant’s own strength, indicating a change in perspective of themselves. creative writing requires self-distancing, holistic evaluation of the self, and reconnecting or finding one’s inner voice. all these are critical qualities for the adolescents’ healing. 4.2 impact of origami perhaps the most interesting response was found by the adolescents’ engagement in origami. of 75% of participants who listed specific activities they discovered that they enjoy or like, 43% of the participants reported “origami”. we analyzed each step of this origami activity considering the participants’ experience (figure 3). 4.2.1 folding paper participants selected two to three pieces of paper. this process generates excitement and conversation. touching the origami paper is a grounding experience, according to enriched origami art therapy (eoat) (kobayashi, 2007). participants are in control of this paper. the practice of gaining this type of responsibility and control requires a willingness to learn. the origami artist, samuel tsang, describes this as the “calm frame of mind”, which is also a learning mode where the entire focus is on the piece of paper (p. 16). participants’ responses, “calming” (60%), and “break from life” (31%) may be connected to this process of working with a simple physical tool with the mindset to learn. in addition, working with a physical material may feel novel to the adolescents as generation’s z’s time has been heavily consumed by social media. thus, introducing the sensation of working with an art material may lead to future usage. 4.2.2 following instructions specific instructions are provided for each origami model. the instructions of the folding order provide structure. initial learning requires focus and concentration, and this conscious effort naturally allows focus. the creative process is at the heart of origami since a passive mode is activated by following the instructions while an active mode is generated by physically folding the paper (kobayashi, 2007). eoat suggests that processing new information through physical activities in a structured environment allows problem solving (kobayashi, 2007). the facilitators provide a structured learning environment while still offering the flexibility to accommodate the speed of an individual’s ability to follow. the ground rule is that the participants look around and make sure that everyone is on the same page. origami allows participants to help and encourage each other. this component of building relationships is identified as rebuilding trust by making positive relationships (kobayashi, 2007). www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 38 published by scholink inc. 4.2.3 repeating repeating the act of folding is the main process of origami. the two models we introduce first are a rose and a heart. through simple repetition of three to four techniques, complex creations can be developed. this act of repetition releases concentration from learning, yet the mind is still focused on the hands moving. tsang describes this stage as meditative; when he is able to fold without following instructions, he begins contemplating on the theme of the origami he is creating (tsang, p.16) participants’ responses, “calming” (60%), “relaxing” (43%), and “break from life” (31%) may be the associated with this action. 4.2.4 completing a model is made by following the instructions. staying in this creative process produces a model. this activity is process-driven. the goal of competition is definitely there, but the real goal is to sustain the process. seeing the final product may be a “fun” (44%) experience. this comment by a participant reflects the process-driven component of this activity: “folding the paper in different ways can make cool shapes”. the physical model is evidence and a reminder of how they navigated this creative process. in summary, through writing, participants experienced gaining self-awareness through creative expression. through origami, adolescents practice calming the mind, passive and active modes of learning, sustaining in the creative process, and experiencing enjoyment. all of this serves to build resilience. achieving the completion is not without “h work” (7%) and can also be “stressful” (16%). at times, participants felt “discouraged” (5%). this program considers empowerment which does not exclude challenges. 19% of the participants indicated that this program was a “learning opportunity”. these results overall reflect that the participants are motivated to learn, grow, and explore if the environment and program content are fitting and inviting to them. 4.3 limitations limits of external validity and generalizability exist given there is no control group to assess the differing impact of creative writing and expressive writing implementation. the patients’ reasons for being admitted into the hospital are a self-report and not a clinical diagnosis. the process of self-reporting is a limitation since data on a 10-point scale is highly individualized/non-standard. 4.4 conclusion & future direction our study found that creativity-based activities gained the interest and engagement of the adolescents in iph and that these activities are a promising tool for group education in an iph setting. we also found that creativity-based activities prompt reflection, realization of strengths, enjoyment, and self-awareness. these skills are critically important to the development of coping strategies that allow the adolescents to manage their stressors by changing their thought processes and/or behaviors (gill et al., 2016; lazarus & flokman, 1984; spandler et al., 2007). specific techniques identified for effective intervention include incorporating creative processes, physical activities, a structured environment, and flexibility. the impact of creative collaboration on staff, especially psychiatric nurses who work closely with www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 39 published by scholink inc. patients, may be another important factor to study. successful collaboration requires a facilitator or collaborator who understands the culture and language of medicine and the discipline to be implemented. collaboration in itself is perceived as a creative process which requires navigating the various views and needs of the involved individuals. the art of facilitating collaboration may also be studied. as for the impact on patients, whether or not the experience of creativity-based activities at iph can lead to long-term coping strategies will be an important point of assessment. patients were intentionally allowed to keep their begin with pieces folder in hopes that they would continue to use the material throughout the remainder of their stay and beyond. a longitudinal study which includes following up with the adolescents who participated in the creativity-based activities may be considered along with applications in other ipus to assist with generalizability of the intervention. acknowledgement this project was supported in part by the bush fellowship from bush foundation awarded to yuko taniguchi. references abdulla alabbasi, a., sumners, s., paek, s., & runco, m. (2020). association, overlap, and inhibition: a study of implicit theories of creativity. creativity: theories-research-applications, 7(2), 251-283. american psychiatric association. (2022). diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787 association of american colleges and universities. (2009). inquiry and analysis value rubric. retrieved from https://www.aacu.org/initiatives/value-initiative/value-rubrics/value-rubrics-inquiry-and-analysis american academy of child and adolescent psychiatry. (1990). model for minimum staffing patterns for hospitals providing acute inpatient treatment. retrieved from http://www.aacap.org/aacap/policy_statements/1990/model_for_minimum_staffing_patterns_for_ hospitals_providing_acute_inpatient_treatment.aspx anderson, k., goldsmith, l. p., lomani, j., ali, z., clarke, g., crowe, c., jarman, h., johnson, s., mcdaid, d., pariza, p., park, a. l., smith, j. a., stovold, e., turner, k., & gillard, s. (2022). short-stay crisis units for mental health patients on crisis care pathways: systematic review and meta-analysis. bjpsych open, 8(4), e144. https://doi.org/10.1192/bjo.2022.534 the art of healing: students send well wishes to marshall county high school through origami. (2018, april 08). uwire text (p. 1). ayduk, o., & kross, e. (2010). analyzing negative experiences without ruminating: the role of self distancing in enabling adaptive self-reflection. social and personality psychology compass, www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 40 published by scholink inc. 4(10), 841-854. ayduk, o., &., kross, e. (2010). from a distance: implications of spontaneous self-distancing for adaptive self-reflection. journal of personality and social psychology, 98(5), 809-829. balkin, r. s. (2006). a reexamination of trends in acute care psychiatric hospitalization for adolescents: ethnicity, payment, and length of stay. journal of professional counseling: practice, theory, & research, 34(1-2), 49-59. barron, f. (1969). creative person and creative process. new york: holt, rinehart and winston. chandler, g., & schneider, p. (2009). creation and response: wellspring to evaluation. in s. b. coholic, d., & eys, a. (2016), benefits of an arts-based mindfulness group intervention for vulnerable children. child and adolescent social work journal, 33(1), 1-13. edwards, c., & hegerty, s. (2018). where it’s cool to be kitty: an art therapy group for young people with mental health issues using origami and mindfulness. social work with groups, 41(1-2), 151-164. furnham, a., batey, m., anand, k., & manfield, j. (2008). personality, hypomania, intelligence and creativity. personality and individual differences, 44(5), 1060-1069. gardner, j. (1999). on becoming a novelist. new york: w.w. norton. gill, f., butler, s., & pistrang, n. (2016). the experience of adolescent inpatient care and the anticipated transition to the community: young people’s perspectives. journal of adolescence, 46, 57-65. gingerich, w., & peterson, l. (2013). effectiveness of solution-focused brief therapy: a systematic qualitative review of controlled outcome studies. research on social work practice, 23(3), 266-283. henderson, d. a., & gladding, s. t. (1998). the creative arts in counseling: a multicultural perspective. the arts in psychotherapy, 25(3), 183-187. hunt, c. (1998). the self on the page: theory and practice of creative writing in personal development. london: jessica kingsley publishers. hunt, c. (2000). therapeutic dimensions of autobiography in creative writing. london: jessica kingsley. janssens, a., hayen, s., walraven, v., leys, m., & deboutte, d. (2013). emergency psychiatric care for children and adolescents: a literature review. pediatric emergency care, 29(9), 1041-1050. kaufman, s. b., & gregoire, c. (2016). wired to create: unraveling the mysteries of the creative mind. london: ebury digital. kaufman, s. b., & kaufman, j. c. (2009). the psychology of creative writing. new york: cambridge up. king, l. a., (2002) gain without pain? expressive writing and self-regulation, in s. j. lepore, & j. m. smyth (eds), the writing cure: how expressive writing promotes health and emotional well-being (pp. 119-134). washington, dc: american psychological association. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 41 published by scholink inc. king, r., nielsen, p., & white, e. (2013). creative writing in recovery from severe mental illness. international journal of mental health nursing, 22(5), 444-452. kobayashi, t. (2007). use of origami for children with traumatic experiences. in s. brooke (ed.), the use of the creative therapies with sexual abuse survivors (pp. 102-119). springfield: charles c thomas publisher. lazarus, r. s., & flokman, s. (1984). stress, appraisal and coping. new york: springer. lockhart, c., & anania, a. (2011). origami creations bring peace and hope to patients in transplantation unit (heart of oncology nursing). clinical journal of oncology nursing, 15(1), 106-107. lubard, t. (2009). in search of the writer’s creative process. in s. b. kaufman, & j. c. kaufman (eds.), the psychology of creative writing (pp.149-165). new york: cambridge up. lyons, uziel-miller, reyes, & sokol. (2000). strengths of children and adolescents in residential settings: prevalence and associations with psychopathology and discharge placement. journal of the american academy of child & adolescent psychiatry, 39(2), 176-181. mcardle, s., & byrt, r. (2001). fiction, poetry and mental health: expressive and therapeutic uses of literature. journal of psychiatric and mental health nursing, 8(6), 517-524. nam, e., lee, e., & kim, h. (2021). 10-year trends of emergency department visits, wait time, and length of stay among adults with mental health and substance use disorders in the united states. psychiatr q 92, 1159-1174 (2021). https://doi.org/10.1007/s11126-021-09894-y pennebaker, j. (1993). putting stress into words: health, linguistic, and therapeutic implications. behaviour research and therapy, 31(6), 539-548. pottick, k., hansell, s., gaboda, d., & gutterman, e. (1993). child and adolescent outcomes of inpatient psychiatric services: a research agenda. children and youth services review, 15(5), 371-384. richards, r. (2021). three cs revisited—chaos, complexity, and creativity: where nonlinear dynamics offers new perspectives on everyday creativity. journal of creativity, 31, 100007. runco, m. a. (2014). creativity: theories and themes: research, development, and practice (2nd ed.). london, england: academic press. sanderson, c., & morin, j. (2017). inspired origami. running press adult, philadelphia, pa. spandler, h., secker, j., kent, l., hacking, s., & shenton, j. (2007). catching life: the contribution of arts initiatives to “recovery” approaches in mental health. journal of psychiatric and mental health nursing, 14(8), 791-799. thompson, a., simmons, s., & wolff, j. (2021). nowhere to go: providing quality services for children with extended hospitalizations on acute inpatient psychiatric units. journal of the american academy of child and adolescent psychiatry, 60(3), 329-331. taniguchi, y. (2018, october 15). begin with pieces [web log post]. retrieved october 30, 2018, from https://wam.umn.edu/begin-with-pieces www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 42 published by scholink inc. tyson, e., & baffour, t. (2004). arts-based strengths: a solution-focused intervention with adolescents in an acute-care psychiatric setting. arts in psychotherapy, 31(4), 213-227. tyson, e., baffour, t., & duongtran, t. (2010). gender comparisons of self-identified strengths and coping strategies: a study of adolescents in an acute psychiatric facility. child and adolescent social work journal, 27(3), 161-175. ward, t. b. (2001). creative cognition, conceptual combination, and the creative writing of stephen r. donaldson. american psychologist, 56(4), 350-354. ward, t. b., & lawson. (2009). creative cognition in science fiction and fantasy writing. in s. b. woodward, s., berry, k., & bucci, s. (2017). a systematic review of factors associated with service user satisfaction with psychiatric inpatient services. journal of psychiatric research, 92, 81-93. woodward, s., berry, k., & bucci, s. (2017). a systematic review of factors associated with service user satisfaction with psychiatric inpatient services. journal of psychiatric research, 92, 81-93. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 43 published by scholink inc. appendices appendix 1 creative writing prompt x ← mark it as you respond to the prompts below! 1.what or who means the world to you? 2. when was the last time you felt as though you have been heard and understood? describe the conversation and feeling of "being heard." 3. what are you learning today? 4. if you could describe your favorite color to someone who is blind, how would you describe it? (what does the color feel like, look like, sound like, or taste like?) 5. how will you use what you have learned when you leave? 6. you wake up one day to discover your greatest weakness is now your superpower. who are you? 7. what is your favorite song? how does it make you feel? 8. if you could go anywhere in the world, where would you go? write a short story with future-you as a protagonist traveling. 9. write about things that are hard for you to talk about but wish that you could talk more with others. 10. what is your strength like? (example: “my strength is my humor. it’s like the bright sun making everyone open their windows”.) 11. smoke, fog, and haze: write about not being able to see ahead of you. how does it make you feel? what do you do to keep going? 12. after many months of hard work, you finally finished creating your own boat. what does your boat look like? where are you going? how does sailing make you feel? 13. a long time ago, a person could become a power animal, and a power animal could become a human being. sometimes, they were people, and sometimes, animals. there was no difference. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 44 published by scholink inc. which power animal are you? write a story. 14. what is your favorite food? describe everything about this food so that others can see and taste it! 15. a dog has arrived at your house on a cold rainy day. the dog has the power to communicate. it is here to stay with you. who is this dog? why is it here? appendix 2 creative writing and origami group post-questions thank you for attending the creative writing & origami session! please complete this survey to help us understand what you thought about this intervention! your answers are confidential. 1. what is your age? __________ 2. what was the primary reason you came into the hospital? 3. on a scale of 0-10 with 10 being the worst, how much do your symptoms bother you? ______________ 4. before coming to the hospital, did you use writing or drawing to help you feel better? yes_____ no_____ maybe______ 5. what was your experience of writing and making origami today? select the term(s) that are true to you! www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 45 published by scholink inc. calming a break from life fulfilling stressful energizing fun relaxing hard work safe space learning opportunity other: __________________ 6. on a scale of 0-10 with 10 being the best, how would you rate your interest in the origami and creative writing: _____________ 7. how do you feel about the writing and origami you created today? select the term(s) that are true to you! creative unique curious proud excited surprised discouraged encouraged puzzled inspired accomplished other___________ 8. do you think writing and origami can be a break from life for you? if so, when do you think you can use it? select the term(s) that are true to you! ____no, i don’t think this activity is for me. _____yes, i can do this activity when….. i am stressed i am alone i am bored i am with my family i am upset i feel creative i feel sad i feel like cutting i want to use drugs or alcohol i have suicidal thoughts i am with my friends i want to share new ideas with others other________________ 9. what did you discover today? www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 46 published by scholink inc. appendix 3 creative thinking value rubric definition: creative thinking is both the capacity to combine or synthesize existing ideas, images, or expertise in original ways and the experience of thinking, reacting, and working in an imaginative way characterized by a high degree of innovation, divergent thinking, and risk taking. evaluators are encouraged to assign a zero to any work sample or collection of work that does not meet benchmark (cell one) level performance. capstone milestones benchmark 4 3 2 1 acquiring competencies this step refers to acquiring strategies and skills within a particular domain. reflect: evaluates creative process and product using domain-appropriate criteria. create: creates an entirely new object, solution, or idea that is appropriate to the domain. adapt: successfully adapts an appropriate exemplar to his/her own specifications. model: successfully reproduces an appropriate exemplar. taking risks may include personal risk (fear of embarrassment or rejection) or risk of failure in successfully completing assignment (i.e., going beyond original parameters of assignment, introducing new materials and forms, actively seeks out and follows through on untested and potentially risky directions or approaches to the assignment in the final product. incorporates new directions or approaches to the assignment in the final product. considers new directions or approaches without going beyond the guidelines of the assignment. stays strictly within the guidelines of the assignment. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 1, 2023 47 published by scholink inc. tackling controversial topics, advocating unpopular ideas or solutions). solving problems not only develops a logical, consistent plan to solve problem, but recognizes consequences of solution and can articulate reason for choosing solution. having selected from among alternatives, develops a logical, consistent plan to solve the problem. considers and rejects less acceptable approaches to solving problem. only a single approach is considered and is used to solve the problem. embracing contradictions integrates alternate, divergent, or contradictory perspectives or ideas fully. incorporates alternate, divergent, or contradictory perspectives or ideas in an exploratory way. includes (recognizes the value of) alternate, divergent, or contradictory perspectives or ideas in a small way. acknowledges (mentions in passing) alternate, divergent, or contradictory perspectives or ideas. innovative thinking novelty or uniqueness (of idea, claim, question, form, etc.) extends a novel or unique idea, question, format, or product to create new knowledge or knowledge that crosses boundaries. creates a novel or unique idea, question, format, or product. experiments with creating a novel or unique idea, question, format, or product. reformulates a collection of available ideas. connecting, synthesizing, transforming transforms ideas or solutions into entirely new forms. synthesizes ideas or solutions into a coherent whole. connects ideas or solutions in novel ways. recognizes existing connections among ideas or solutions. children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 7, no. 1, 2024 www.scholink.org/ojs/index.php/ct 1 original paper navigating wellbeing and coping: quantitative analysis of the experiences of teenager of infidel parents in ibadan toluwanimi p. esan1 & yemisi l. olaleye1* 1 department of social work, university of ibadan, oyo, nigeria * yemisi l. olaleye, department of social work, university of ibadan, oyo, nigeria received: november 6, 2023 accepted: december 2, 2023 online published: december 29, 2023 doi:10.22158/ct.v7n1p1 url: http://dx.doi.org/10.22158/ct.v7n1p1 abstract infidelity has a pervasive impact on social systems, but none is more affected than the nuclear family. however, existing studies have not explicitly focused on the experience of teenagers in low and middle-income countries like nigeria. hence, this study explored the psychosocial wellbeing and coping mechanism of teenagers with infidel parents in ibadan. the study used descriptive survey research; 200 teenagers were selected through purposive sampling technique in secondary schools in ibadan metropolis. a validated questionnaire (parental infidelity, and psychosocial wellbeing questionnaire) was used. data was analyzed at 0.05 level of significance, using inferential statistics. the study indicated that parental infidelity negatively affects the psychosocial wellbeing of teenagers in ibadan metropolis (f (2/196) = 26.3 < 0.05); the multiple regression indicates that coping skills such as problem-focused, emotion-focused, and avoidant coping affects wellbeing of teenagers who have experienced parental infidelity in ibadan metropolis (p< 0.05). in conclusion, children experiencing parental infidelity utilize problem-focused coping skills, while there was a negative wellbeing among teenage from infidel parents. hence, social workers should help teenagers with infidel parents to cope while navigating live stressors through innovative social work skills. keywords parental infidelity, psychosocial wellbeing, coping mechanisms, teenagers 1. introduction adolescence is a critical developmental period characterized by significant physical, cognitive, emotional, and social changes. during this phase, individuals are particularly susceptible to the influence of their family, peers, and community, which can profoundly impact their psychological and emotional wellbeing. in diverse societies such as nigeria, where religious beliefs often play a central www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 1, 2024 2 published by scholink inc. role in individuals’ lives, the experiences of teenagers from families with non-faith orientations require careful examination. the wellbeing and coping of teenagers of infidel parents has become an important area of research because the experience of infidelity is a stressor that does not only affect the couple but also the children. infidelity has been defined as the “breach of trust and/or violation of agreed upon norms” (blow & hartnett, 2005) within a romantically, sexually, and emotionally exclusive monogamous relationship. infidelity, also known as extramarital affairs, can have profound and detrimental effects on married couples and their relationships. infidelity in marriage not only affects the couple directly involved but also has significant repercussions on children, teenagers, and adults (mark & janssen, 2019). previous studies have examined the effects of infidelity on married couples; the study by mark and janssen (2019) indicated that infidelity can lead to a breakdown of trust, emotional distress, and significant conflicts within marriage. the impact of infidelity on the marital bond may result in a higher likelihood of separation and divorce (amato & previti, 2003) in addition, feelings of betrayal, anger, and sadness, which can lead to a loss of intimacy and emotional connection between partners has been reported in the betrayed spouse (whisman & snyder, 2007). also, the effects of infidelity in marriage on children and adults have been reported in previous studies (amato, 2010; finzi-dottan & cohen, 2018). religious beliefs and practices have historically constituted a cornerstone of nigeria’s social, cultural, and psychological life. however, shifting global trends and increased exposure to different worldviews have given rise to a growing number of families with non-faith or alternative belief systems, including atheism, agnosticism, and secular humanism. consequently, adolescents raised in such households may grapple with unique challenges and opportunities in the realm of wellbeing and coping mechanisms. despite the general awareness of the impact of religious beliefs on mental health and coping strategies, limited empirical research has explored the experiences of teenagers in non-faith families within the nigerian context. for children, the revelation of infidelity within their parents’ relationship can be highly distressing and traumatic. witnessing parental conflict and experiencing the emotional aftermath of infidelity can lead to feelings of insecurity, anxiety, and a sense of betrayal (finzi-dottan & cohen, 2018). amaro reported that infidelity can weaken the parent-child bond as the adults’ focus may shift away from their children due to the intense emotional turmoil they are experiencing (amaro, 2010). yet, there have been few examinations of the effect marriage infidelity can have on teenagers’ psychosocial well-being and coping mechanism. practically, the insights gained from this research can inform mental health professionals, educators, and policymakers about the needs and resources required to support this understudied population’s mental and emotional growth. additionally, on a societal level, understanding the challenges and strengths of teenagers from non-faith families contributes to the ongoing discourse on religious diversity, tolerance, and pluralism in multicultural societies like nigeria. hence, this study aims to unravel the impact of parental infidelity on the www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 1, 2024 3 published by scholink inc. wellbeing and coping of teenagers in ibadan using appropriate data collection instruments and report their coping mechanisms. 2. research hypotheses ho1: there is no significant effect of parental infidelity on the psychosocial wellbeing of teenagers in ibadan metropolis. ho2: there is significant effect of coping skills (problem-focused, emotion-focused, and avoidant) on wellbeing of teenagers with infidel parents in ibadan metropolis. 3. methods and designs 3.1 research design the study is a cross-sectional design, and a descriptive survey research design was adopted. it is suitable for this research because it helps to describe, record, analyze and interpret the conclusion that exists in the study. it is described as the plan structure and strategies of investigation concerned so as to obtain answers to research questions which will elicit information on the survey of the coping mechanisms and psychosocial wellbeing of teenagers who experience parental infidelity in ibadan metropolis. 3.2 population the target population for the study consists of teenagers in schools and communities within ibadan south-west local government area, ibadan metropolis. ibadan south-west local government area is one of the local government areas in ibadan metropolis, nigeria. ibadan is the capital city of oyo state in southwestern nigeria and is one of the largest cities in the country. the city is known for its historical significance, cultural heritage, and academic institutions. ibadan south-west local government area is a political subdivision within the larger city of ibadan. local government areas in nigeria are administrative units that facilitate the governance and provision of public services at the grassroots level. these areas are further divided into wards, which are the smallest units of local administration. ibadan south-west local government area likely encompasses a portion of the southern and western parts of the ibadan metropolis. the local government administration is responsible for various services and development projects within its jurisdiction, including health care, education, infrastructure, waste management, and more. 3.3 sample and sampling technique a purposive sampling technique was used to select 200 teenagers for the study. the purposive sampling technique was used because the respondents shared common criteria. 5 wards were used for the study; 40 respondents were selected from each ward which makes 200 the total number of respondents used for the study. www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 1, 2024 4 published by scholink inc. 3.4 instruments the research instrument for the study is a single questionnaire tagged parental infidelity and psychosocial wellbeing questionnaire (pipswq). the structured questionnaire is made up of four sections viz a-d. section a: demographic characteristics: this consists of item questions on demographic characteristics (age, date of birth, gender, level of education, specialty, religion, tribe, parental marital status, and family background) of teenagers. section b: awareness of parental infidelity scale (apis): this consists of items developed by the researcher to measure the awareness of parental infidelity in the families of teenagers. section c: psychosocial wellbeingscale (psws). this consist of items questions adapted from an internationally tested scale by keyes c. l. m. (2009) titled adolescent mental health continuum-short form (mhc-sf) developed by the researcher to measure emotional wellbeing and aspects of psychological and social functioning of teenagers. the respondent mental health is classified into three-flourishing (high positive emotions and functioning), languishing (low positive emotions and functioning) and moderate (neither flourishing nor languishing). the scale contains fourteen items with a multiple-choice format measured on a 6-point scale: 1 (everyday) to 6 (never). respondents are said to flourish when they respond to 1 or 2 to one or more of the 3 emotional wellbeing questions and to 6 or more of the 11 positive functioning questions. respondents are said to be languishing when they give a response of 5 or 6 to one or more of the 3 emotional wellbeing questions, and to 6 or more of the 11 positive functioning questions. respondents are said to be have a moderate mental health when they are neither flourishing or languishing. section d: coping mechanism scale (cms): this consists of items of questions adapted from an internationally tested scale by carver, c. s. (1997) titled brief cope scale developed by the researcher to measure how the teenagers cope with the presence of parental infidelity in their family. the scale can determine someone’s primary coping styles with scores on the following three subscales: problem-focused coping, emotion-focused coping, and avoidant coping. scores are presented for three overarching coping styles as average scores (sum of item scores divided by number of items), indicating the degree to which the respondent has been engaging in that coping style. 1= i haven’t been doing this at all, 2= a little bit, 3= a medium amount, 4= i’ve been doing this a lot. 3.5 administration of the instrument the researcher obtained a letter of introduction from her supervisor who introduced the researcher as a postgraduate student of the department of social work for the purpose of identification and to enable the researcher has easy access to interview and administer questionnaire in the selected schools of teenagers. the researcher submitted the letter to all the selected schools in ibadan south west and permission to conduct the study was obtained by the researcher from the school principal before the commencement of data collection and verbal informed consent was obtained from each respondent www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 1, 2024 5 published by scholink inc. before the administration of the questionnaire. the researcher also ensured that no harm came on participants while filling the questionnaire. the researcher spent about 10minutes with each respondent. 3.6 ethical approval approval for the study was obtained from the university of ibadan/university college hospital institutional ethical review board (ui/ec/22/0351). informed consent from each respondent was obtained before the administration of the questionnaire. 3.7 data analysis the responses gathered from the respondents were analyzed. statistical analysis was carried out on the dependent and independent variables to test the research hypotheses using frequency table and percentage, analysis of variance (anova) and multiple regression analysis statistics methods. 4. results table 1. analysis of socio-demographic characteristics of the respondents n=200 variables frequency percentage age group 13 to 15years 111 55.5 16 to 17 years 68 34.0 18 to 19 years 21 10.5 gender male 117 58.5 female 83 41.5 religion islam 62 31.0 christianity 125 62.5 traditional 13 6.5 tribe hausa 27 13.5 igbo 35 17.5 yoruba 136 68.0 others tribes 2 1.0 parents marital status married 50 25.0 separated/divorced 48 24.0 widow 98 49.0 www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 1, 2024 6 published by scholink inc. widower 2 1.0 others 2 1.0 level of education junior secondary school 126 63.0 senior secondary school 58 29.0 o level certificate holder 14 7.0 graduate 2 1.0 specialty commercial/social sciences 58 29.5 arts 124 62.0 science 15 7.5 others 2 1.0 family background nuclear 48 24.0 polygamous 85 42.5 extended 67 33.5 table 1 revealed the frequency distribution according to age range of the respondents. the result showed that respondents with age range of 13 to 15 years were 111 (55.5%) while those with age range of 16 to 17 years were 68 (34.0%) of the total respondents and 21(10.5%) had age range between 18 to 19years. this showed that respondents with age range of 13 to 15years had the highest percentage. the study revealed that 117 representing 58.5% of the respondents were males, 83 of them or 41.5% were females. therefore, the above result implies that the majority of the respondents were males. the result showed that majority were christians 125 (62.5%) while those who were muslim were 62 (31.0%) of the total respondents and 13 (6.5%) of the total respondent are traditional worshippers. this showed that christians had the highest percentage. the result showed that yoruba were 136 (68.0%) while igbo were 35 (17.5%) of the total respondents and hausa were 27(13.5%) while other tribes were 2(1.0%) of the total respondents. this showed that yoruba had the highest percentage. the respondents. the result showed that married respondents were 50 (25.0%), while separated/divorced were 48 (24.0%) of the total respondents and 98 (49.0%) were widow, while widower and others were 2 (1.0%) of the total respondent respectively. this showed that married respondents had the highest percentage. the result showed that respondents in junior secondary school were 126 (63.0%) while those in senior secondary school were 58 (29.0%) of the total respondents and 14 (7.0%) were o level certificate holder while graduate respondents were 2(1.0%) of the total respondents. this showed that respondents in junior secondary school had the highest percentage. the result showed that respondents in www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 1, 2024 7 published by scholink inc. commercial/social sciences were 58 (29.5%) while those in arts were 124 (62.0%) of the total respondents and 15 (7.5%) were specialized in science while others specialty were 2(1.0%) of the total respondents. this showed that respondents specialized in arts had the highest percentage. the result showed that respondents from nuclear family were 48 (24.0%) while those from polygamous family were 85 (42.5%) of the total respondents and 67 (33.5%) were from extended family. this showed that respondents from polygamous family had the highest percentage. testing of hypothesis ho1: there is no significant effect of parental infidelity on the psychosocial wellbeing of teenagers in ibadan metropolis. table 2. analysis of variance (anova) showing the effect of parental infidelity on the psychosocial wellbeing of teenagers in ibadan metropolis variables sum of squares df mean square f-cal f-crit p between groups 379.003 2 42.111 26.3 1.99 <0.05 within groups 137.622 196 1.600 total 516.625 198 f=26.3, df=9/86, f-crit=1.99 table 2 shows that, there was a significant effect of parental infidelity on the psychosocial wellbeing of teenagers in ibadan metropolis. the result indicated that f-calculated (26.3) is greater than f-critical value (1.99) at 0.05 level of significance. thus, the hypothesis was rejected, and this indicated that there was a significant effect of parental infidelity on the psychosocial wellbeing of teenagers in ibadan metropolis. ho2: there is significant effect of coping skills (problem-focused, emotion-focused, and avoidant) on wellbeing of teenagers with infidel parents in ibadan metropolis. table 3a. multiple regression analysis showing the joint contribution of coping-skills variables on wellbeing in ibadan r= 0.939 r2=0.882 adjusted r2=0.879 standard error of estimate= 4.54426 analysis of variance sum of square df mean square f regression 2531.814 4 632.954 65.417 residual 338.635 142 2.385 total 2870.449 146 www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 1, 2024 8 published by scholink inc. table 3a which showed the combination of the independent variables (coping skills) account for 88% of the variance on wellbeing variables (r2 adjusted = 0.879). the analysis of variance of the multiple regression data yielded an f-ratio value which was found to be significant at 0.05 alpha level (f(4,142) =65.417; p < 0.05). table 3b. showing the contribution of independent variables (coping skills variables) on the dependent variable (wellbeing) unstandardized coefficients standardized coefficients t sig. b std. error beta contribution (constant) 2.649 .823 -3.219 .000 problem-focused 1.780 .090 .813 19.862 .000 emotion-focused .516 .066 .358 7.826 .000 avoidant skills .339 .063 .197 5.339 .000 the results obtained from table 3b above indicate the joint and relative effect of each of the independent variables (the use of problem-focused, emotion-focused, and avoidant coping mechanisms) on the dependent variable (wellbeing). in terms of most significant effect problem-focused contributed significantly to the wellbeing of teenagers who experienced infidel parents in ibadan metropolis (ß = 0.813; t=19.862; p < 0.05). next in terms of magnitude of contribution is emotion-focused (ß = 0.606, t = 18.070; p<0.05) and then avoidant skills (ß = 0.197, t = 5.339; p < 0.05). hence, the three coping skills variables are strong contributors to wellbeing of teenagers with infidel parents in ibadan metropolis. 5. discussion this study explored the psychosocial wellbeing and coping mechanism of teenager who have infidel parents in ibadan, which is an important step-towards documenting experiences of teenagers living with infidel parents in nigeria. although our study reported significant effect of parental infidelity on the psychosocial wellbeing of teenagers in ibadan metropolis, this finding is consistent with the view of amato and booth (2000) that adolescents whose parents have experienced infidelity are more prone to emotional distress, often reporting feelings of anger, sadness, and anxiety. moreover, this betrayal can erode trust, affecting teenagers’ capacity to form healthy relationships in the future (markham & stanley, 2011). academic performance may also suffer, likely due to increased stress and distractions at home (jeynes, 2002) found that beyond academic challenges, infidelity can disrupt social relationships, causing teenagers to withdraw from social activities or have difficulties trusting their peers. this body of evidence underscores the profound and lasting impact of parental infidelity on teenagers’ psychosocial wellbeing. www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 1, 2024 9 published by scholink inc. the second hypothesis also reported significant effect of coping skills of teenagers of infidel parents in ibadan metropolis on their wellbeing. this corroborates the findings of compas et al. (2001) that coping skills aid in stress reduction, which is vital as adolescents face stressors from academic pressures, peer relationships, family dynamics, and personal identity development. by helping teenagers manage and reduce stress, coping skills prevent it from becoming chronic and detrimental to their mental health. these skills facilitate emotion regulation, a critical aspect of adolescence marked by emotional fluctuations (zimmer-gembeck & skinner, 2011). therefore, effective emotion regulation enhances mental wellbeing and reduces the risk of mood disorders (hammen, 2005). additionally, coping skills build resilience, allowing teenagers to bounce back from adversity and challenges. resilience is associated with improved mental health outcomes and a reduced likelihood of developing mental health disorders (masten, 2001). moreover, these skills enhance problem-solving and decision-making abilities, equipping teenagers to navigate complex situations and make constructive choices, thereby reducing the impact of stressors (compas et al., 2001). hence, contributing to better social relationships by helping teenagers manage conflicts and communicate more effectively, ultimately improving their social wellbeing (aldao et al., 2010). our findings showed that wellbeing of the teenagers is based on the specific coping skill used, this is in tandem with that of compas et al. (2012) that adaptive coping strategies, such as problem-solving, seeking social support, and emotional regulation, have been associated with lower levels of anxiety and depression in teenagers. conversely, teenagers who rely on maladaptive coping strategies, such as avoidance, substance abuse, or aggression, often experience poorer mental health outcomes (connor-smith et al., 2000). this implies that negative coping strategies may provide temporary relief but can exacerbate stress and lead to long-term emotional difficulties. in conclusion, the wellbeing of teenagers is intricately linked to the coping skills they employ. adaptive coping strategies can enhance their mental and emotional health, while maladaptive ones may contribute to negative outcomes. 6. conclusion from this study, it is evident that parental infidelity has a significant effect on the psychosocial wellbeing of teenagers in ibadan. the significant influence of problem-focused coping mechanisms on the wellbeing of these adolescents suggests that when faced with the complex emotional aftermath of parental infidelity, practical problem-solving strategies play a crucial role in mitigating the adverse effects. emotion-focused coping mechanisms, while significant, appear to provide a secondary source of support, emphasizing the importance of emotional expression and regulation in this context. notably, the relatively lower contribution of avoidant skills may indicate that avoiding or suppressing emotions and issues related to parental infidelity is less effective in promoting the psychosocial wellbeing of these teenagers. these findings shed light on the importance of tailored interventions and support systems that focus on problem-solving skills and emotional expression to help teenagers navigate the www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 1, 2024 10 published by scholink inc. challenges posed by parental infidelity. recommendations the following recommendations are given based on the outcomes of this study: i. counseling and support services like counseling programs should be specifically designed to address the emotional and psychological needs of teenagers affected by parental infidelity. these programs can provide a safe space for teenagers to express their feelings, process their emotions, and receive guidance from trained professionals. ii. peer support groups where teenagers can interact with others who have faced similar experiences should be established. sharing stories and coping strategies within a supportive community can help reduce feelings of isolation and foster resilience. iii. community awareness and education should be conducted to educate parents, teachers, and caregivers about the potential impact of parental infidelity on teenagers’ mental health. encouraging open communication and empathy within families can create a more supportive environment for the affected teenagers. iv. improve access to mental health services by collaborating with local healthcare providers and organizations. this may involve establishing low-cost or free counseling centers and ensuring that mental health resources are available and easily accessible to those in need. v. implement regular mental health screenings in schools to identify teenagers who may be at risk or struggling with their mental wellbeing. early detection can lead to timely intervention and support. vi. tailor interventions to be culturally sensitive and relevant to the nigerian context. consider incorporating traditional practices and values that promote mental wellbeing and resilience. acknowledgement we acknowledge the department of social work, university of ibadan, nigeria and the teenagers in ibadan metropolis who participated in this study. references aldao, a., nolen-hoeksema, s., & schweizer, s. (2010). emotion-regulation strategies across psychopathology: a meta-analytic review. clinical psychology review, 30(2), 217-237. amato, p. r., & previti, d. (2003). people’s reasons for divorcing: gender, social class, the life course, and adjustment. journal of family issues, 24(5), 602-626. www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 1, 2024 11 published by scholink inc. amato, p. r., & booth, a. (1997). a generation at risk: growing up in an era of family upheaval. harvard university press. amato, p. r. (2010). research on divorce: continuing trends and new developments. journal of marriage and family, 72(3), 650-666. blow, a. j., & hartnett, k. (2005). infidelity in committed relationships ii: a substantive review. journal of marital and family therapy, 31(2), 217-233. https://doi.org/10.1111/j.1752-0606. 2005.tb01556.x carver, c. s. (1997). you want to measure coping but your protocol is too long: consider the brief cope. international journal of behavioral medicine, 4(1), 92-100. compas, b. e., connor-smith, j. k., saltzman, h., thomsen, a. h., & wadsworth, m. e. (2001). coping with stress during childhood and adolescence: problems, progress, and potential in theory and research. psychological bulletin, 127(1), 87. compas, b. e., jaser, s. s., dunn, m. j., & rodriguez, e. m. (2012). coping with chronic illness in childhood and adolescence. annual review of clinical psychology, 8, 455-480. connor-smith, j. k., compas, b. e., wadsworth, m. e., thomsen, a. h., & saltzman, h. (2000). responses to stress in adolescence: measurement of coping and involuntary stress responses. journal of consulting and clinical psychology, 68(6), 976. finzi-dottan, r., & cohen, o. (2018). adolescents’ appraisal of parental infidelity: the mediating role of family cohesion. journal of child and family studies, 27(11), 3506-3515. hammen, c. (2005). stress and depression. annu. rev. clin. psychol., 1, 293-319. härkönen, j. (2014). divorce: trends, patterns, causes, and consequences. the wiley blackwell companion to the sociology of families, 303-322. jeynes, w. h. (2002). examining the effects of parental absence on the academic achievement of adolescents: the challenge of controlling for family income. journal of family and economic issues, 23, 189-210. keyes, c. l. m. (2009). atlanta: brief description of the mental health continuum–short form (mhc–sf). resource document. emory university web site. retrieved january 25, 2012, from www.sociology.emory.edu/ckeyes mark, j., & janssen, e. (2019). extramarital affairs. in statpearls. statpearls publishing. masten, a. s. (2001). ordinary magic: resilience processes in development. american psychologist, 56(3), 227. markham, m. s., & stanley, s. m. (2011). a marital program for stepcouples facing transitions: an integrated approach. in j. h. bray, & m. j. stanton (eds.), the wiley-blackwell handbook of family psychology (pp. 414-427). wiley-blackwell. zimmer-gembeck, m. j., & skinner, e. a. (2011). the development of coping across childhood and adolescence: an integrative review and critique of research. international journal of behavioral www.scholink.org/ojs/index.php/ct children and teenagers vol. 7, no. 1, 2024 12 published by scholink inc. development, 35(1), 1-17. children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 3, no. 2, 2020 www.scholink.org/ojs/index.php/ct 50 original paper not race or age but their interaction predicts pre-adolescents’ inhibitory control shervin assari1,2* & golnoush akhlaghipour md3 1 department of urban public health, charles r drew university of medicine and science, los angeles, ca, usa 2 department of family medicine, charles r drew university of medicine and science, los angeles, ca, usa 3 department of neurology, ucla, los angeles, ca, usa * shervin assari, e-mail: assari@umich.edu; tel.: +(734)-232-0445; fax: +734-615-8739 received: october 12, 2020 accepted: october 21, 2020 online published: november 5, 2020 doi:10.22158/ct.v3n2p50 url: http://dx.doi.org/10.22158/ct.v3n2p50 abstract background: african american pre-adolescents are at a higher risk of risky behaviors such as aggression, drug use, alcohol use, and subsequent poor outcomes compared to caucasian pre-adolescents. all these high-risk behaviors are connected to low levels of inhibitory control (ic). aim: we used the adolescent brain cognitive development (abcd) data to compare caucasian and african american pre-adolescents for the effect of age on pre-adolescents ic, a driver of high-risk behaviors. methods: this cross-sectional analysis included 4,626 pre-adolescents between ages 9 and 10 from the abcd study. regression was used to analyze the data. the predictor variable was age measured in months. the main outcome was ic measured by a stop-signal task (sst). race was the effect modifier. results: overall, age was associated with ic. race also showed a statistically significant interaction with age on pre-adolescents’ ic, indicating weaker effects of age on ic for african american than caucasian pre-adolescents. conclusion: age-related changes in ic are more pronounced for caucasian than african american pre-adolescents. to eliminate the racial gap in brain development between african american and caucasian pre-adolescents, we should address structural and societal barriers that alter age-related development for racial minority pre-adolescents. social and public policies, rather than health policies, are needed to address structural and societal barriers that hinder african american adolescents’ brain development. interventions should add resources to the urban areas that many african american families live in so their children can have better age-related brain www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 51 published by scholink inc. development. such changes would be essential given ic in pre-adolescents is a predictor of a wide range of behaviors. keywords race, ethnicity, age, age-related development, pre-adolescents, impulse, brain, inhibitory control 1. introduction inhibitory control (ic), the ability to control one’s own impulses in order to select a more appropriate behavior in line with long-term goals (chikara, lo, & ko, 2020; deater-deckard, li, lee, king-casas, & kim-spoon, 2019), is closely correlated with a wide range of risk behaviors and factors such as poor diet and unhealthy eating, obesity and high body mass index, poor academic performance, weak social relations, problem behaviors, aggression, substance use, and early sexual debut (bartholdy et al., 2019; bessette et al., 2020; cabello, gutierrez-cobo, & fernandez-berrocal, 2017; dieter et al., 2017; ely et al., 2020; huijbregts, warren, de sonneville, & swaab-barneveld, 2008; humphrey & dumontheil, 2016; porter et al., 2018; troller-renfree et al., 2019). low ic is also a characteristic of attention deficit hyperactivity disorder (adhd) (neely et al., 2017). pre-adolescents from high socioeconomic status (ses) non-hispanic caucasian families who show high ic levels would be less likely to engage in a wide range of risk behaviors, relative to high ses pre-adolescents when compared to their counterparts from low ses and african american families (deater-deckard et al., 2019; froeliger et al., 2017; hao, 2017; hsieh & chen, 2017; nakamichi, 2017). some research suggests that ic may be specifically crucial for boys’ risk-taking behaviors, such as aggressive behavior (cabello et al., 2017). low ic may be one of the many mechanisms explaining racial and economic disparities in high-risk behaviors (cueli, areces, garcia, alves, & gonzalez-castro, 2020; deater-deckard et al., 2019; mora-gonzalez et al., 2020; porter et al., 2018; zhang, wang, liu, song, & yang, 2017). compared to caucasian pre-adolescents, african american pre-adolescents are at an increased risk of aggression (cotten et al., 1994) and early sexual debut (cavazos-rehg et al., 2009). as these undesired behavioral outcomes early in life are shown to be gateways for a wide range of future economic, emotional, and behavioral outcomes later in life (burchinal et al., 2011; cohen & sherman, 2005; gorey, 2009; hair, hanson, wolfe, & pollak, 2015), there is a need to study why and how ic is lower in african american and caucasian pre-adolescents. such knowledge has the potential to help with closing racial inequalities later in life (burchinal et al., 2011; cohen & sherman, 2005; gorey, 2009; hair et al., 2015). there is a close overlap between race and ses in the united states of america, meaning that african americans have lower ses and experience a higher level of a wide range of adversities (ahmad, zulaily, shahril, syed abdullah, & ahmed, 2018; merz, tottenham, & noble, 2018; valencia, tran, lim, choi, & oh, 2019). as such, african american adolescents face high levels of food insecurity, housing insecurity, family instability, economic adversities, stress, trauma, and financial difficulties (desantis et al., 2007; dismukes et al., 2018; hanson et al., 2015; miller & taylor, 2012). however, an open question www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 52 published by scholink inc. is whether the effects of race and associated ses are direct (alvarado, 2018; barreto, de figueiredo, & giatti, 2013; hemovich, lac, & crano, 2011; schreier & chen, 2013) or may operate by delaying healthy age-related changes in the brain. while caucasians, through low access to ses and associated buffers and resources, live in a context in which age-related development may naturally occur (alvarado, 2018; barreto et al., 2013; hemovich et al., 2011; schreier & chen, 2013), the same may not be accurate for african americans whose daily life means low access to resources, high stress, and trauma (kaufman, cooper, & mcgee, 1997) that may interfere with healthy age-related brain development. both mediation (bell, sacks, thomas tobin, & thorpe, 2020; fuentes, hart-johnson, & green, 2007; kaufman et al., 1997; samuel, roth, schwartz, thorpe, & glass, 2018) and moderation (assari, 2017d; assari, 2018a) explanations have been tested for racial health inequalities across age groups, including but not limited to pre-adolescents and adolescents. the first clusters of hypotheses, more traditional ones, have attributed racial gaps in pre-adolescents outcomes to the existing ses or stress gaps between african american and caucasian families (bell et al., 2020; fuentes et al., 2007; kaufman et al., 1997; samuel et al., 2018). in these hypotheses, low ses and high stress emerge across racial minorities, including african american pre-adolescents (assari, 2016, 2017b; assari, khoshpouri, & chalian, 2019). if these hypotheses are supported, then a real solution to closing racial inequalities is eliminating the ses gap through economic policies that redistribute income (e.g., tax policies, minimum wage). as such, african american families’ economic empowerment becomes the core strategy for closing the racial inequalities in pre-adolescents and beyond (williams, 1999; williams, costa, odunlami, & mohammed, 2008). the alternative explanation, however, argues that ses indicators (assari, 2017d; assari, 2018a), age, and other resources show weaker effects for african americans than caucasians, a pattern known as minorities’ diminished returns (mdrs) supported by extensive recent literature under the umbrella term mdrs, all economic and non-economic resources such as education (assari, farokhnia, & mistry, 2019) parental education (assari, 2018d; assari, 2018b; assari, 2018e), income (s. assari, c. h. caldwell, & r. mincy, 2018a; assari, thomas, caldwell, & mincy, 2018), marital status (assari & bazargan, 2019a), and coping (assari, 2017a, 2017c; assari & lankarani, 2016b) all generate less-than-expected tangible developmental outcomes for african americans than caucasians. this is partly due to the qualitative difference between african american and caucasian families’ lives, so the latter gets and the former does not get the opportunities to mobilize their resources to secure tangible outcomes (assari, 2017d, 2018a, 2018e; assari, caldwell, & mincy, 2018a; assari, caldwell, & zimmerman, 2018; assari & hani, 2018). as a result of these mdrs, we observe worse than expected outcomes across all ses levels of african american families (assari, 2017d; assari, 2018a; assari, caldwell, & mincy, 2018a; s. assari, c. h. caldwell, & r. b. mincy, 2018b; assari, thomas, et al., 2018). that is, low and high ses african american adolescents show the same (high) level of impulsivity (assari, caldwell, & mincy, 2018a), adhd (assari & caldwell, 2019a), depression (assari www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 53 published by scholink inc. & caldwell, 2018a), anxiety (assari, caldwell, & zimmerman, 2018), aggression (assari, caldwell, & bazargan, 2019), grade point average (gpa) (assari s, 2019; assari & caldwell, 2019b; assari, caldwell, et al., 2019), and substance use (assari, caldwell, et al., 2019) while for caucasian adolescents, high ses means low risk. if mdrs are true (assari & caldwell, 2018a; assari, caldwell, et al., 2019; assari, caldwell, & mincy, 2018a; assari, caldwell, & mincy, 2018b; assari, thomas, et al., 2018), then a real solution requires moving beyond ses and targeting structural inequalities that hinder one group and promote the other. 1.1 aims to fill the literature gap on social and developmental determinants of ic, which itself is a mechanism for a wide range of undesired behaviors (bartholdy et al., 2019; bessette et al., 2020; cabello et al., 2017; dieter et al., 2017; ely et al., 2020; huijbregts et al., 2008; humphrey & dumontheil, 2016; porter et al., 2018; troller-renfree et al., 2019), and to expand the mdrs literature, we studied the separate, additive, and interactive effects of race and age on pre-adolescents ic. to do so, we compared african american and caucasian pre-adolescents for the effects of age on ic. as suggested by the mdrs, we expected age-related changes in ic, however, we expected these changes to be smaller for african american than caucasian pre-adolescents. the results would have implications for pre-adolescents, and beyond, ic is a core predictor of high-risk behaviors (bartholdy et al., 2019; bessette et al., 2020; cabello et al., 2017; dieter et al., 2017; ely et al., 2020; humphrey & dumontheil, 2016; porter et al., 2018; troller-renfree et al., 2019) and may explain why family ses and race are linked to many high-risk behaviors pre-adolescents (bruce et al., 2013; holochwost, volpe, gueron-sela, propper, & mills-koonce, 2018; skowron, cipriano-essel, gatzke-kopp, teti, & ammerman, 2014; swingler, isbell, zeytinoglu, calkins, & leerkes, 2018; zaidman-zait & shilo, 2018). 2. methods 2.1 design and settings a secondary analysis was performed with a cross-sectional design. we used data from the adolescent brain cognitive development (abcd) study (alcohol research: current reviews editorial, 2018; casey et al., 2018; karcher, o’brien, kandala, & barch, 2019; lisdahl et al., 2018; luciana et al., 2018). abcd, a landmark study of brain development from pre-adolescence to emerging adults, is a unique study in the united states. although details of the abcd methods, measures, design, sample, and sampling are described elsewhere (alcohol research: current reviews editorial, 2018; auchter et al., 2018), here we briefly review them. 2.2 participants and sampling in the abcd, we only included pre-adolescents who were between the ages of 9 and 10 years. the abcd pre-adolescents were enrolled from multiple cities across the states. overall, pre-adolescents were recruited to the abcd study from a total of 21 sites. the primary strategy for sampling in the www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 54 published by scholink inc. abcd study was recruiting from school systems (garavan et al., 2018). in the current analysis, the sample was 4626 participants. our analysis’s inclusion criteria were having valid data on race, ethnicity, age, family ses, and task-based ic. additionally, participants should only be african american or caucasian. 2.3 study variables the study variables included race, ethnicity, age, sex, family ses (parental education), family marital status, and task-based ic. inhibitory control (ic). the abcd study applied the stop-signal task (sst) to measure pre-adolescents’ ic levels. the sst used in the abcd applied two runs of 180 trials. pre-adolescent subjects were shown images of a black arrow that were either pointing to right or left. these pictures were displayed on the monitor while the participant was in the scanner. participants were asked to click the appropriate button that corresponds with the arrow direction as soon as they can see the image. participants were instructed that they should all use their dominant hand. from all 180 trials, 30 did not display either of the options, signaling the participant to inhibit their answers. these were randomly dispersed throughout the trial. ic in this study was defined as a successful inhibition of motor response. impulsivity was defined as answering with a wrong answer or an unsuccessful inhibition. for this study, ic was captured as the total number of “stop” trials answered incorrectly (tfmri_sst_all_beh_incrs_nt). ic was treated as a continuous measure. a higher score was indicative of a higher level of ic (carver, livesey, & charles, 2001; clark, king, & turner, 2020; dupuis et al., 2019; hiraoka, kinoshita, kunimura, & matsuoka, 2018). race. race, a self-identified variable, was a binary variable: 1 for african americans and 0 for caucasians (reference category). age. age (months), calculated as the difference between birth and the time of enrollment to the study, measured in months, was reported by parents. sex. a dichotomous variable, sex was coded as below: males = 1, females = 0. marital status. parental marital status, a dichotomous variable, was self-reported by the parents and was coded as married = 1 vs. other = 0. parental educational attainment. participants were asked, “what is the highest grade or level of school you have completed or the highest degree you have received?” responses ranged from 0 for never attended or kindergarten only to 21 for a doctoral degree. this variable, with a range between 1 and 21, was treated as an interval variable. 2.4 data analysis the statistical package, spss, was applied for data analysis. mean, standard deviation (sd), frequency, and relative frequency (%) were used to describe the study variables. we also performed an independent t-test and chi-square test for bivariate comparison of the groups for the study variables. for multivariable modeling, four regression models were applied. model 1, an overall model, was performed without the www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 55 published by scholink inc. interaction terms. model 2, another overall model, also added an interaction term between race and age (months). model 3 and model 4 were tested in caucasian and african american pre-adolescents. in our models, age was used as the predictor, sex and family ses as the covariates, ic as the outcome, and race as the effect modifier. unstandardized coefficient (b), se, 95% ci, and p-value were reported for our model. p equal or less 0.05 was significant. 2.5 ethics the abcd study protocol received institutional review board (irb) approval from several institutions, including but not limited to the university of california, san diego (ucsd). all participating pre-adolescents provided assent. all participating parents signed informed consent (auchter et al., 2018). as we only performed a secondary analysis of fully de-identified data, our study did not require an irb review (exempt from a full irb review). 3. results 3.1 descriptives a total number of 4626 9-10 years old pre-adolescents were analyzed. participants were mainly caucasian (n = 3513; 75.5%), and only 24.1 (n=1113) were african americans. table 1 presents a summary of the descriptive statistics for the total sample and caucasian and african american pre-adolescents. table 1. data overall and by race (n = 4,626) all caucasians african americans n % n % n % race caucasian 3513 75.9 3513 100.0 african american 1113 24.1 1113 100.0 ethnicity non-hispanic 3872 83.7 2855 81.3 1017 91.4 hispanic 754 16.3 658 18.7 96 8.6 sex male 2273 49.1 1713 48.8 560 50.3 female 2353 50.9 1800 51.2 553 49.7 marital status* other 1437 31.1 692 19.7 745 66.9 married 3189 68.9 2821 80.3 368 33.1 mean sd mean sd mean sd age (year) 118.44 7.41 118.36 7.44 118.69 7.32 parental educational attainment* 16.82 2.53 17.26 2.36 15.42 2.55 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 56 published by scholink inc. financial difficulties* 0.07 0.15 0.04 0.12 0.14 0.21 family income* 7.26 2.43 7.90 1.95 5.26 2.70 ic (total number of “stop” trials answered incorrect) 27.01 7.20 27.16 6.77 26.54 8.41 ic= inhibitory control, sd= standard deviation * p < 0.05 3.2 multivariate analysis: all table 2 shows a summary of the two regression models’ results in the overall (pooled) sample. model 1 (main effect model) did not show a significant effect of age on ic. model 2 (interaction model) showed an interaction between race and age on ic, suggesting that the effect of age on ic is weaker for african american compared to caucasian pre-adolescents. table 2. overall regression models (n = 4,626) model 1 main effects model 2 interaction effects b se 95% ci p b se 95% ci p race (african american) -0.44 0.29 -1.02 0.13 .132 7.37 3.99 -0.45 15.19 .065 ethnicity (hispanic) -0.36 0.30 -0.95 0.22 .225 -0.37 0.30 -0.95 0.22 .218 sex (male) 1.40 0.21 0.99 1.82 < .001 1.40 0.21 0.99 1.82 < .001 married household 0.04 0.29 -0.53 0.60 .898 0.05 0.29 -0.52 0.62 .866 parental educational attainment 0.04 0.05 -0.06 0.15 .419 0.05 0.05 -0.06 0.15 .401 financial difficulty -0.16 0.76 -1.66 1.34 .834 -0.14 0.76 -1.63 1.36 .857 family income 0.03 0.07 -0.10 0.17 .633 0.03 0.07 -0.11 0.16 .684 age 0.02 0.01 -0.01 0.05 .196 0.03 0.02 0.00 0.07 .037 age x race -0.07 0.03 -0.13 0.00 .050 outcome: ic: total number of “stop” trials answered incorrect b= unstandardized regression coefficient se= standard error ci= confidence interval 3.3 multivariate analysis: each race table 3 summarizes two regression models, one in caucasians, and one in african americans. we found the effect of age on ic for caucasian but not african american pre-adolescents. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 57 published by scholink inc. table 3. race-specific regression models (n = 4,626) model 3 caucasians model 4 african americans b se 95% ci p b se 95% ci p ethnicity (hispanic) -0.48 0.32 -1.10 .128 -1.52 -1.00 0.91 .270 0.78 -1.10 sex (male) 1.41 0.23 0.96 .000 6.20 1.35 0.50 .008 2.34 2.67 married household -0.07 0.32 -0.70 .822 -0.23 0.36 0.63 .575 1.60 0.56 parental educational attainment 0.05 0.06 -0.07 .412 0.82 0.05 0.12 .661 0.29 0.44 financial difficulty -0.47 1.03 -2.48 .647 -0.46 0.03 1.25 .980 2.49 0.02 family income -0.07 0.08 -0.23 .403 -0.84 0.15 0.13 .240 0.41 1.17 age 0.03 0.02 0.00 .026 2.23 -0.03 0.03 .370 0.04 -0.90 outcome: ic: total number of “stop” trials answered incorrect b= unstandardized regression coefficient se= standard error ci= confidence interval 4. discussion we found that ic correlates with age for caucasian but not african american pre-adolescents. due to the race by age interaction, age-related brain development in pre-adolescents may be delayed/hindered. this finding is an indicator of diminished age-related brain development of african american than caucasian pre-adolescents. diminishing returns of age on ic is in line with the mdrs of family ses on ic (assari, 2020c). it is also in line with the diminished returns of ses on impulsivity (assari, caldwell, & mincy, 2018a), attention deficit hyperactivity disorder (assari & caldwell, 2019a), depressed mood (assari & caldwell, 2018a), anxious mood (assari, caldwell, & zimmerman, 2018), aggressive behaviors (assari, caldwell, et al., 2019), academic achievement (assari s, 2019; assari & caldwell, 2019b; assari, caldwell, et al., 2019), and tobacco use (assari, caldwell, et al., 2019). in other studies, mdrs were found for childhood trauma and stress (assari, 2020a; assari, 2020b). this is not the first study on mdrs, but it extends the literature by documenting mdrs of age-related brain development in african american when compared with caucasian pre-adolescents. many empirical studies have already documented mdrs for african americans (assari, 2018a, 2018c; s. assari, 2019a; assari, farokhnia, et al., 2019). past research shows that mdrs are not limited to pre-adolescents as they can be seen for all age groups such as adolescents (assari, caldwell, & mincy, 2018a; assari, caldwell, & mincy, 2018b; assari, thomas, et al., 2018), adults (assari, 2018a), and older adults (assari & lankarani, 2016a). also, mdrs is not a pattern that can be exclusively seen for african americans (assari, thomas, et al., 2018). in fact, same patterns are shown for hispanic (assari, www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 58 published by scholink inc. 2018g; shervin assari, 2019; assari, farokhnia, et al., 2019; shervin & ritesh, 2019) asian american (assari, boyce, bazargan, & caldwell, 2020), native american (assari & bazargan, 2019a), lesbian, gay, bisexual (lgb) (s. assari, 2019a), poor caucasian (assari, boyce, bazargan, caldwell, & zimmerman, 2020), and even immigrant (assari, 2020b) people. several potential intuitive mechanisms may explain mdrs of age-related brain development in african american pre-adolescents. african american families and their pre-adolescents face many stressors and adversities, including financial stress, race-related stress, and environmental pollutants (marshall et al., 2020). unfortunately, these structural aspects impact the lives of african americans across ses levels (assari, 2018a; assari, 2018h). african americans have a low chance of upward social mobility (chetty, hendren, kline, & saez, 2014) and pay very high costs when they succeed (hudson, sacks, irani, & asher, 2020). for african american families, stress and discrimination are always high, regardless of ses (assari, 2018b; assari, gibbons, & simons, 2018a; assari, gibbons, & simons, 2018b; assari, lankarani, & caldwell, 2018; assari & lankarani, 2018). for african american families, low ses means living in poor areas, and high ses means high exposure to caucasian families, which means very high levels of exposure to discrimination (assari, gibbons, et al., 2018a; assari, gibbons, et al., 2018b). stress across domains, including but not limited to race-related discrimination, interferes with normal brain development (assari & caldwell, 2018b; assari, lankarani, et al., 2018; assari, preiser, lankarani, & caldwell, 2018). an example of structural causes of inequalities that generates mdrs in the usa is residential segregation. as a result of residential segregation, african american families live in resource-scarce environments full of stress and poverty. due to residential segregation, african american pre-adolescents attend poor schools across ses levels (assari, boyce, bazargan, caldwell, et al., 2020; boyce, bazargan, caldwell, zimmerman, & assari, 2020; boyce, 2020). as a result, african american adolescents do not access many educational resources that stimulate brain development (assari, 2019b; assari, 2019; assari & caldwell, 2019b). however, poor education and schooling are only among the many differences in the lives of caucasian and african american families (jefferson et al., 2011). african american parents report a high level of stress across all ses levels (assari, 2020a; assari & bazargan, 2019b). high ses african american families experience more, not less, discrimination compared to low ses african american families (assari, gibbons, et al., 2018a; assari, gibbons, et al., 2018b; assari, lankarani, et al., 2018; hudson, bullard, et al., 2012; hudson, puterman, bibbins-domingo, matthews, & adler, 2013), which is in part due to proximity to whites (assari, 2018b; assari & lankarani, 2018). it is important to note that mdrs reflect a particular class of disadvantage for racial minorities (assari, 2017d; assari, 2018a). while some disadvantages are due to lack of access to ses resources, mdrs of ses and age mean that african americans experience poor outcomes across the same resources and assets (e.g., ses or age). thus, research, practice, and policy should not merely focus on differential www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 59 published by scholink inc. access to ses and different profiles of exposure to risk factors as causes of inequality. policymakers and researchers should be aware that some observed inequalities are due to differential returns of age, ses, and other resources and assets. this type of disadvantage places african americans at high risk across all levels of resources. it is also more difficult to undo mdrs-related inequalities than those that are due to poverty and low ses (assari, 2018a; assari, 2018h). mdrs theory is a sociological rather than a biological explanation of health inequality. among multilevel causes of mdrs, including economic, psychological, and societal mechanisms (assari, 2018a; assari, 2018h), racism and discrimination have a leading role. racism operates across multiple institutions and social structures (assari, 2018a; assari, 2018h). if mdrs are due to racism, then a real solution to health disparities should also address mdrs-related inequalities. such an approach requires increasing racial justice in the us. age can only generate the same brain development when all racial groups have the same opportunity for brain development (hudson et al., 2020; hudson, bullard et al., 2012; hudson, neighbors, geronimus, & jackson, 2012). african american families may stay in poor neighborhoods at all ses levels(assari, boyce, caldwell, bazargan, & mincy, 2020). caucasians, however, live in low-stress environments when they have high ses (assari, 2018b; assari, preiser, & kelly, 2018). thus, even when they have similar ses, african american families’ living conditions drastically differ from those of their caucasian counterparts (assari, 2018f; assari & bazargan, 2019b; assari & bazargan, 2019b; assari s; assari, 2019; assari, gibbons et al., 2018a; assari, gibbons et al., 2018b; assari, lankarani et al., 2018). similarly, across all ses levels, african american adolescents spend time with high-risk peers(boyce et al., 2020; shanika boyce, 2020). however, high ses caucasian adolescents have low-risk peers and family members (assari, boyce, bazargan, & caldwell, 2020; assari, caldwell et al., 2019). the current study only documented mdrs of age-related brain development without digging into their societal and contextual causes. we argue that age shows a weaker effect on the brain development of children in less enriched environments. 4.1 implications the major implications of knowledge regarding mdrs-related inequalities are that it helps us rethink the structural causes of inequalities. such knowledge is essential for finding the societal causes of racial disparities. it even helps us move our policies beyond equal access as a goal. in the presence of mdrs, equal access fails to generate equal outcomes. due to mdrs of resources/assets such as ses and age, equality does not generate equity. to achieve equity, we need to equalize access to ses and the very societal conditions that surround african american children’s development. the daily experiences of african american families should be improved. thus, age-related brain development would be more equal across racial groups. 4.2 limitations all studies, particularly secondary analysis of some existing data, are limited in their methodology. as our study used a cross-sectional approach, we cannot make causal inferences. while ic does not cause www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 60 published by scholink inc. age, age may impact ic. still, longitudinal data are needed for establishing racial differences in the causal link between age and ic. more research is needed on mdrs of age as a source of brain development. mdrs are commonly shown for ses indicators such as parental education, family income, and marital status; however, less is unknown about mdrs of age-related brain development. finally, we only described the mdrs of age-related brain development without exploring the mechanisms of the observed mdrs. future work is needed on the role of ses, trauma, stress, context, and family in explaining the observed mdrs of age-related brain development in african american adolescents. 5. conclusion for 9-10-year old american children, age is a predictor of ic for caucasian children. for african american pre-adolescents, however, ic remains poor at all ages. that means the brain’s age-related development that shapes ic differs for african american and caucasian pre-adolescents. the results may help us understand why high-risk behaviors such as alcohol use, aggression, and early sexual debut are more common in african american than caucasian children and adolescents. author contributions: sa: data analysis, conceptualization, draft, revision, and approval, ga: revision, conceptualization, revision, and approval. deap acknowledgment: deap is a software provided by the data analysis and informatics center of abcd located at the uc san diego with generous support from the national institutes of health and the centers for disease control and prevention under award number u24da041123. the deap project information and links to its source code are available under the resource identifier rrid: scr_016158. abcd funding: the abcd study is supported by the national institutes of health and additional federal partners under award numbers u01da041022, u01da041028, u01da041048, u01da041089, u01da041106, u01da041117, u01da041120, u01da041134, u01da041148, u01da041156, u01da041174, u24da041123, u24da041147, u01da041093, and u01da041025. a full list of supporters is available at https://abcdstudy.org/federal-partners.html. a listing of participating sites and a complete listing of the study investigators can be found at https://abcdstudy.org/consortium_members.pdf. abcd consortium investigators designed and implemented the study and/or provided data but did not necessarily participate in analysis or writing of this report. this manuscript reflects the views of the authors and may not reflect the opinions or views of the nih or abcd consortium investigators. the abcd data repository grows and changes over time. the current paper used the curated annual release 2.0, also defined in nda study 634 (doi:10.15154/1503209). author funding: sa is supported by the national institutes of health (nih) grants ca201415 02, u54md007598, da035811-05, u54md008149, d084526-03, and u54ca229974. conflicts of interest: none. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 61 published by scholink inc. references ahmad, a., zulaily, n., shahril, m. r., syed abdullah, e. f. h., & ahmed, a. (2018). association between socioeconomic status and obesity among 12-year-old malaysian adolescents. plos one, 13(7), e0200577. https://doi.org/10.1371/journal.pone.0200577 alcohol research: current reviews editorial, s. (2018). nih’s adolescent brain cognitive development (abcd) study. alcohol res, 39(1), 97. retrieved from https://www.ncbi.nlm.nih.gov/pubmed/30557152 alvarado, s. e. (2018). the impact of childhood neighborhood disadvantage on adult joblessness and income. soc sci res, 70, 1-17. https://doi.org/10.1016/j.ssresearch.2017.10.004 assari, s. (2016). distal, intermediate, and proximal mediators of racial disparities in renal disease mortality in the united states. j nephropathol, 5(1), 51-59. https://doi.org/10.15171/jnp.2016.09 assari, s. (2017a). general self-efficacy and mortality in the usa; racial differences. j racial ethn health disparities, 4(4), 746-757. https://doi.org/10.1007/s40615-016-0278-0 assari, s. (2017b). number of chronic medical conditions fully mediates the effects of race on mortality; 25-year follow-up of a nationally representative sample of americans. j racial ethn health disparities, 4(4), 623-631. https://doi.org/10.1007/s40615-016-0266-4 assari, s. (2017c). race, sense of control over life, and short-term risk of mortality among older adults in the united states. arch med sci, 13(5), 1233-1240. https://doi.org/10.5114/aoms.2016.59740 assari, s. (2017d). unequal gain of equal resources across racial groups. int j health policy manag, 7(1), 1-9. https://doi.org/10.15171/ijhpm.2017.90 assari, s. (2018a). blacks’ diminished return of education attainment on subjective health; mediating effect of income. brain sci, 8(9). https://doi.org/10.3390/brainsci8090176 assari, s. (2018b). does school racial composition explain why high income black youth perceive more discrimination? a gender analysis. brain sci, 8(8). https://doi.org/10.3390/brainsci8080140 assari, s. (2018c). family income reduces risk of obesity for white but not black children. children (basel), 5(6). https://doi.org/10.3390/children5060073 assari, s. (2018a). health disparities due to diminished return among black americans: public policy solutions. social issues and policy review, 12(1), 112-145. https://doi.org/10.1111/sipr.12042 assari, s. (2018d). parental education attainment and educational upward mobility; role of race and gender. behav sci (basel), 8(11). https://doi.org/10.3390/bs8110107 assari, s. (2018b). parental education better helps white than black families escape poverty: national survey of children’s health. economies, 6(2), 30. retrieved from http://www.mdpi.com/2227-7099/6/2/30 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 62 published by scholink inc. assari, s. (2018e). parental educational attainment and mental well-being of college students; diminished returns of blacks. brain sci, 8(11). https://doi.org/10.3390/brainsci8110193 assari, s. (2018f). race, intergenerational social mobility and stressful life events. behav sci (basel), 8(10). https://doi.org/10.3390/bs8100086 assari, s. (2018g). socioeconomic status and self-rated oral health; diminished return among hispanic whites. dent j (basel), 6(2). https://doi.org/10.3390/dj6020011 assari, s. (2018h). unequal gain of equal resources across racial groups. int j health policy manag, 7(1), 1-9. https://doi.org/10.15171/ijhpm.2017.90 assari, s. (2019a). education attainment and obesitydifferential returns based on sexual orientation. behav sci (basel), 9(2). https://doi.org/10.3390/bs9020016 assari, s. (2019b). parental educational attainment and academic performance of american college students; blacks’ diminished returns. j health econ dev, 1(1), 21-31. retrieved from https://www.ncbi.nlm.nih.gov/pubmed/31372601 assari, s. (2019). socioeconomic determinants of systolic blood pressure; minorities’ diminished returns. journal of health economics and development, 1(1), 1-11. retrieved from http://www.hedjournal.com/article_88938_d0f03c9e2607bdaeee1aa93938267b33.pdf assari, s. (2020a). college graduation and wealth accumulation: blacks’ diminished returns. world j educ res, 7(3), 1-18. https://doi.org/10.22158/wjer.v7n3p1 assari, s. (2020a). family socioeconomic status and exposure to childhood trauma: racial differences. children, 7(6), 57. retrieved from https://www.mdpi.com/2227-9067/7/6/57 assari, s. (2020b). income and mental well-being of middle-aged and older americans: immigrants’ diminished returns. international journal of travel medicine and global health, 8(1), 37-43. https://doi.org/10.34172/ijtmgh.2020.06 assari, s. (2020b). parental education and spanking of american children: blacks’ diminished returns. world j educ res, 7(3), 19-44. https://doi.org/10.22158/wjer.v7n3p19 assari, s. (2020c). parental education on youth inhibitory control in the adolescent brain cognitive development (abcd) study: blacks’ diminished returns. brain sciences, 10(5), 312. retrieved from https://www.mdpi.com/2076-3425/10/5/312 assari s. (2019). parental educational attainment and academic performance of american college students; blacks’ diminished returns. journal of health economics and development, 1(1), 21-31. assari, s., & bazargan, m. (2019a). being married increases life expectancy of white but not black americans. j family reprod health, 13(3), 132-140. retrieved from https://www.ncbi.nlm.nih.gov/pubmed/32201487 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 63 published by scholink inc. assari, s., & bazargan, m. (2019a). protective effects of educational attainment against cigarette smoking; diminished returns of american indians and alaska natives in the national health interview survey. international journal of travel medicine and global health. assari, s., & bazargan, m. (2019b). unequal associations between educational attainment and occupational stress across racial and ethnic groups. international journal of environmental research and public health, 16(19), 3539. retrieved from https://www.mdpi.com/1660-4601/16/19/3539 assari, s., & bazargan, m. (2019b). unequal effects of educational attainment on workplace exposure to second-hand smoke by race and ethnicity; minorities’ diminished returns in the national health interview survey (nhis). j med res innov, 3(2). https://doi.org/10.32892/jmri.179 assari s, b. m. unequal effects of educational attainment on workplace exposure to second-hand smoke by race and ethnicity; minorities’ diminished returns in the national health interview survey (nhis). . j med res innov., 3(2), e000179. https://doi.org/https://doi.org/ 10.32892/jmri.179 assari s, b. m. (2019). second-hand exposure home second-hand smoke exposure at home in the united states; minorities’ diminished returns. int j travel med glob health, 7(3). assari, s., boyce, s., bazargan, m., & caldwell, c. h. (2020). mathematical performance of american youth: diminished returns of educational attainment of asian-american parents. education sciences, 10(2), 32. retrieved from https://www.mdpi.com/2227-7102/10/2/32 assari, s., boyce, s., bazargan, m., caldwell, c. h., & zimmerman, m. a. (2020). place-based diminished returns of parental educational attainment on school performance of non-hispanic white youth. frontiers in education, 5(30). https://doi.org/10.3389/feduc.2020.00030 assari, s., boyce, s., caldwell, c. h., bazargan, m., & mincy, r. (2020). family income and gang presence in the neighborhood: diminished returns of black families. urban science, 4(2), 29. retrieved from https://www.mdpi.com/2413-8851/4/2/29 assari, s., & caldwell, c. h. (2018a). high risk of depression in high-income african american boys. j racial ethn health disparities, 5(4), 808-819. https://doi.org/10.1007/s40615-017-0426-1 assari, s., & caldwell, c. h. (2018b). social determinants of perceived discrimination among black youth: intersection of ethnicity and gender. children (basel), 5(2). https://doi.org/10.3390/children5020024 assari, s., & caldwell, c. h. (2019a). family income at birth and risk of attention deficit hyperactivity disorder at age 15: racial differences. children (basel), 6(1). https://doi.org/10.3390/children6010010 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 64 published by scholink inc. assari, s., & caldwell, c. h. (2019b). parental educational attainment differentially boosts school performance of american adolescents: minorities’ diminished returns. j family reprod health, 13(1), 7-13. retrieved from https://www.ncbi.nlm.nih.gov/pubmed/31850092 assari, s., caldwell, c. h., & bazargan, m. (2019). association between parental educational attainment and youth outcomes and role of race/ethnicity. jama netw open, 2(11), e1916018. https://doi.org/10.1001/jamanetworkopen.2019.16018 assari, s., caldwell, c. h., & mincy, r. (2018a). family socioeconomic status at birth and youth impulsivity at age 15; blacks’ diminished return. children (basel), 5(5). https://doi.org/10.3390/children5050058 assari, s., caldwell, c. h., & mincy, r. b. (2018b). maternal educational attainment at birth promotes future self-rated health of white but not black youth: a 15-year cohort of a national sample. j clin med, 7(5). https://doi.org/10.3390/jcm7050093 assari, s., caldwell, c. h., & zimmerman, m. a. (2018). family structure and subsequent anxiety symptoms; minorities’ diminished return. brain sci, 8(6). https://doi.org/10.3390/brainsci8060097 assari, s., farokhnia, m., & mistry, r. (2019). education attainment and alcohol binge drinking: diminished returns of hispanics in los angeles. behav sci (basel), 9(1). https://doi.org/10.3390/bs9010009 assari, s., gibbons, f. x., & simons, r. (2018a). depression among black youth; interaction of class and place. brain sci, 8(6). https://doi.org/10.3390/brainsci8060108 assari, s., gibbons, f. x., & simons, r. l. (2018b). perceived discrimination among black youth: an 18-year longitudinal study. behav sci (basel), 8(5). https://doi.org/10.3390/bs8050044 assari, s., & hani, n. (2018). household income and children’s unmet dental care need; blacks’ diminished return. dent j (basel), 6(2). https://doi.org/10.3390/dj6020017 assari, s., khoshpouri, p., & chalian, h. (2019). combined effects of race and socioeconomic status on cancer beliefs, cognitions, and emotions. healthcare (basel), 7(1). https://doi.org/10.3390/healthcare7010017 assari, s., & lankarani, m. m. (2016a). education and alcohol consumption among older americans; black-white differences. front public health, 4, 67. https://doi.org/10.3389/fpubh.2016.00067 assari, s., & lankarani, m. m. (2016b). reciprocal associations between depressive symptoms and mastery among older adults; black-white differences. front aging neurosci, 8, 279. https://doi.org/10.3389/fnagi.2016.00279 assari, s., lankarani, m. m., & caldwell, c. h. (2018). does discrimination explain high risk of depression among high-income african american men? behav sci (basel), 8(4). https://doi.org/10.3390/bs8040040 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 65 published by scholink inc. assari, s., & moghani lankarani, m. (2018). workplace racial composition explains high perceived discrimination of high socioeconomic status african american men. brain sci, 8(8). https://doi.org/10.3390/brainsci8080139 assari, s., preiser, b., & kelly, m. (2018). education and income predict future emotional well-being of whites but not blacks: a ten-year cohort. brain sci, 8(7). https://doi.org/10.3390/brainsci8070122 assari, s., preiser, b., lankarani, m. m., & caldwell, c. h. (2018). subjective socioeconomic status moderates the association between discrimination and depression in african american youth. brain sci, 8(4). https://doi.org/10.3390/brainsci8040071 assari, s., thomas, a., caldwell, c. h., & mincy, r. b. (2018). blacks’ diminished health return of family structure and socioeconomic status; 15 years of follow-up of a national urban sample of youth. j urban health, 95(1), 21-35. https://doi.org/10.1007/s11524-017-0217-3 auchter, a. m., hernandez mejia, m., heyser, c. j., shilling, p. d., jernigan, t. l., brown, s. a., . . . dowling, g. j. (2018). a description of the abcd organizational structure and communication framework. dev cogn neurosci, 32, 8-15. https://doi.org/10.1016/j.dcn.2018.04.003 barreto, s. m., de figueiredo, r. c., & giatti, l. (2013). socioeconomic inequalities in youth smoking in brazil. bmj open, 3(12), e003538. https://doi.org/10.1136/bmjopen-2013-003538 bartholdy, s., o’daly, o. g., campbell, i. c., banaschewski, t., barker, g., bokde, a. l. w., . . . consortium, i. (2019). neural correlates of failed inhibitory control as an early marker of disordered eating in adolescents. biol psychiatry, 85(11), 956-965. https://doi.org/10.1016/j.biopsych.2019.01.027 bell, c. n., sacks, t. k., thomas tobin, c. s., & thorpe, r. j., jr. (2020). racial non-equivalence of socioeconomic status and self-rated health among african americans and whites. ssm popul health, 10, 100561. https://doi.org/10.1016/j.ssmph.2020.100561 bessette, k. l., karstens, a. j., crane, n. a., peters, a. t., stange, j. p., elverman, k. h., . . . langenecker, s. a. (2020). a lifespan model of interference resolution and inhibitory control: risk for depression and changes with illness progression. neuropsychol rev. https://doi.org/10.1007/s11065-019-09424-5 boyce, s., bazargan, m., caldwell, c. h., zimmerman, m. a., & assari, s. (2020). parental educational attainment and social environment of urban public schools in the u.s.: blacks’ diminished returns. children, 7(5), 44. retrieved from https://www.mdpi.com/2227-9067/7/5/44 bruce, j., fisher, p. a., graham, a. m., moore, w. e., peake, s. j., & mannering, a. m. (2013). patterns of brain activation in foster children and nonmaltreated children during an inhibitory control task. dev psychopathol, 25(4 pt 1), 931-941. https://doi.org/10.1017/s095457941300028x burchinal, m., mccartney, k., steinberg, l., crosnoe, r., friedman, s. l., mcloyd, v., . . . network, n. e. c. c. r. (2011). examining the black-white achievement gap among low-income children www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 66 published by scholink inc. using the nichd study of early child care and youth development. child dev, 82(5), 1404-1420. https://doi.org/10.1111/j.1467-8624.2011.01620.x cabello, r., gutierrez-cobo, m. j., & fernandez-berrocal, p. (2017). parental education and aggressive behavior in children: a moderated-mediation model for inhibitory control and gender. front psychol, 8, 1181. https://doi.org/10.3389/fpsyg.2017.01181 carver, a. c., livesey, d. j., & charles, m. (2001). age related changes in inhibitory control as measured by stop signal task performance. int j neurosci, 107(1-2), 43-61. https://doi.org/10.3109/00207450109149756 casey, b. j., cannonier, t., conley, m. i., cohen, a. o., barch, d. m., heitzeg, m. m., . . . workgroup, a. i. a. (2018). the adolescent brain cognitive development (abcd) study: imaging acquisition across 21 sites. dev cogn neurosci, 32, 43-54. https://doi.org/10.1016/j.dcn.2018.03.001 cavazos-rehg, p. a., krauss, m. j., spitznagel, e. l., schootman, m., bucholz, k. k., peipert, j. f., . . . bierut, l. j. (2009). age of sexual debut among us adolescents. contraception, 80(2), 158-162. https://doi.org/10.1016/j.contraception.2009.02.014 chetty, r., hendren, n., kline, p., & saez, e. (2014). where is the land of opportunity? the geography of intergenerational mobility in the united states. the quarterly journal of economics, 129(4), 1553-1623. chikara, r. k., lo, w. c., & ko, l. w. (2020). exploration of brain connectivity during human inhibitory control using inter-trial coherence. sensors (basel), 20(6). https://doi.org/10.3390/s20061722 clark, s. v., king, t. z., & turner, j. a. (2020). cerebellar contributions to proactive and reactive control in the stop signal task: a systematic review and meta-analysis of functional magnetic resonance imaging studies. neuropsychol rev. https://doi.org/10.1007/s11065-020-09432-w cohen, g. l., & sherman, d. k. (2005). stereotype threat and the social and scientific contexts of the race achievement gap. am psychol, 60(3), 270-271; discussion 271-272. https://doi.org/10.1037/0003-066x.60.3.270 cotten, n. u., resnick, j., browne, d. c., martin, s. l., mccarraher, d. r., & woods, j. (1994). aggression and fighting behavior among african-american adolescents: individual and family factors. am j public health, 84(4), 618-622. https://doi.org/10.2105/ajph.84.4.618 cueli, m., areces, d., garcia, t., alves, r. a., & gonzalez-castro, p. (2020). attention, inhibitory control and early mathematical skills in preschool students. psicothema, 32(2), 237-244. https://doi.org/10.7334/psicothema2019.225 deater-deckard, k., li, m., lee, j., king-casas, b., & kim-spoon, j. (2019). poverty and puberty: a neurocognitive study of inhibitory control in the transition to adolescence. psychol sci, 30(11), 1573-1583. https://doi.org/10.1177/0956797619863780 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 67 published by scholink inc. desantis, a. s., adam, e. k., doane, l. d., mineka, s., zinbarg, r. e., & craske, m. g. (2007). racial/ethnic differences in cortisol diurnal rhythms in a community sample of adolescents. j adolesc health, 41(1), 3-13. https://doi.org/10.1016/j.jadohealth.2007.03.006 dieter, j., hoffmann, s., mier, d., reinhard, i., beutel, m., vollstadt-klein, s., . . . lemenager, t. (2017). the role of emotional inhibitory control in specific internet addiction an fmri study. behav brain res, 324, 1-14. https://doi.org/10.1016/j.bbr.2017.01.046 dismukes, a., shirtcliff, e., jones, c. w., zeanah, c., theall, k., & drury, s. (2018). the development of the cortisol response to dyadic stressors in black and white infants. dev psychopathol, 30(5), 1995-2008. https://doi.org/10.1017/s0954579418001232 dupuis, a., indralingam, m., chevrier, a., crosbie, j., arnold, p., burton, c. l., & schachar, r. (2019). response time adjustment in the stop signal task: development in children and adolescents. child dev, 90(2), e263-e272. https://doi.org/10.1111/cdev.13062 ely, a. v., jagannathan, k., hager, n., ketcherside, a., franklin, t. r., & wetherill, r. r. (2020). double jeopardy: comorbid obesity and cigarette smoking are linked to neurobiological alterations in inhibitory control during smoking cue exposure. addict biol, 25(2), e12750. https://doi.org/10.1111/adb.12750 froeliger, b., mcconnell, p. a., bell, s., sweitzer, m., kozink, r. v., eichberg, c., . . . mcclernon, f. j. (2017). association between baseline corticothalamic-mediated inhibitory control and smoking relapse vulnerability. jama psychiatry, 74(4), 379-386. https://doi.org/10.1001/jamapsychiatry.2017.0017 fuentes, m., hart-johnson, t., & green, c. r. (2007). the association among neighborhood socioeconomic status, race and chronic pain in black and white older adults. j natl med assoc, 99(10), 1160-1169. retrieved from https://www.ncbi.nlm.nih.gov/pubmed/17987920 garavan, h., bartsch, h., conway, k., decastro, a., goldstein, r. z., heeringa, s., . . . zahs, d. (2018). recruiting the abcd sample: design considerations and procedures. dev cogn neurosci, 32, 16-22. https://doi.org/10.1016/j.dcn.2018.04.004 gorey, k. m. (2009). comprehensive school reform: meta-analytic evidence of black-white achievement gap narrowing. educ policy anal arch, 17(25), 1-17. retrieved from https://www.ncbi.nlm.nih.gov/pubmed/27453681 hair, n. l., hanson, j. l., wolfe, b. l., & pollak, s. d. (2015). association of child poverty, brain development, and academic achievement. jama pediatr, 169(9), 822-829. https://doi.org/10.1001/jamapediatrics.2015.1475 hanson, j. l., nacewicz, b. m., sutterer, m. j., cayo, a. a., schaefer, s. m., rudolph, k. d., . . . davidson, r. j. (2015). behavioral problems after early life stress: contributions of the hippocampus and amygdala. biol psychiatry, 77(4), 314-323. https://doi.org/10.1016/j.biopsych.2014.04.020 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 68 published by scholink inc. hao, j. (2017). do children with better inhibitory control donate more? differentiating between early and middle childhood and cool and hot inhibitory control. front psychol, 8, 2182. https://doi.org/10.3389/fpsyg.2017.02182 hemovich, v., lac, a., & crano, w. d. (2011). understanding early-onset drug and alcohol outcomes among youth: the role of family structure, social factors, and interpersonal perceptions of use. psychol health med, 16(3), 249-267. https://doi.org/10.1080/13548506.2010.532560 hiraoka, k., kinoshita, a., kunimura, h., & matsuoka, m. (2018). effect of variability of sequence length of go trials preceding a stop trial on ability of response inhibition in stop-signal task. somatosens mot res, 35(2), 95-102. https://doi.org/10.1080/08990220.2018.1475351 holochwost, s. j., volpe, v. v., gueron-sela, n., propper, c. b., & mills-koonce, w. r. (2018). sociodemographic risk, parenting, and inhibitory control in early childhood: the role of respiratory sinus arrhythmia. j child psychol psychiatry, 59(9), 973-981. https://doi.org/10.1111/jcpp.12889 hsieh, i. j., & chen, y. y. (2017). determinants of aggressive behavior: interactive effects of emotional regulation and inhibitory control. plos one, 12(4), e0175651. https://doi.org/10.1371/journal.pone.0175651 hudson, d., sacks, t., irani, k., & asher, a. (2020). the price of the ticket: health costs of upward mobility among african americans. int j environ res public health, 17(4). https://doi.org/10.3390/ijerph17041179 hudson, d. l., bullard, k. m., neighbors, h. w., geronimus, a. t., yang, j., & jackson, j. s. (2012). are benefits conferred with greater socioeconomic position undermined by racial discrimination among african american men? j mens health, 9(2), 127-136. https://doi.org/10.1016/j.jomh.2012.03.006 hudson, d. l., neighbors, h. w., geronimus, a. t., & jackson, j. s. (2012). the relationship between socioeconomic position and depression among a us nationally representative sample of african americans. soc psychiatry psychiatr epidemiol, 47(3), 373-381. https://doi.org/10.1007/s00127-011-0348-x hudson, d. l., puterman, e., bibbins-domingo, k., matthews, k. a., & adler, n. e. (2013). race, life course socioeconomic position, racial discrimination, depressive symptoms and self-rated health. soc sci med, 97, 7-14. https://doi.org/10.1016/j.socscimed.2013.07.031 huijbregts, s. c., warren, a. j., de sonneville, l. m., & swaab-barneveld, h. (2008). hot and cool forms of inhibitory control and externalizing behavior in children of mothers who smoked during pregnancy: an exploratory study. j abnorm child psychol, 36(3), 323-333. https://doi.org/10.1007/s10802-007-9180-x www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 69 published by scholink inc. humphrey, g., & dumontheil, i. (2016). development of risk-taking, perspective-taking, and inhibitory control during adolescence. dev neuropsychol, 41(1-2), 59-76. https://doi.org/10.1080/87565641.2016.1161764 jefferson, a. l., gibbons, l. e., rentz, d. m., carvalho, j. o., manly, j., bennett, d. a., & jones, r. n. (2011). a life course model of cognitive activities, socioeconomic status, education, reading ability, and cognition. j am geriatr soc, 59(8), 1403-1411. https://doi.org/10.1111/j.1532-5415.2011.03499.x karcher, n. r., o’brien, k. j., kandala, s., & barch, d. m. (2019). resting-state functional connectivity and psychotic-like experiences in childhood: results from the adolescent brain cognitive development study. biol psychiatry, 86(1), 7-15. https://doi.org/10.1016/j.biopsych.2019.01.013 kaufman, j. s., cooper, r. s., & mcgee, d. l. (1997). socioeconomic status and health in blacks and whites: the problem of residual confounding and the resiliency of race. epidemiology, 621-628. lisdahl, k. m., sher, k. j., conway, k. p., gonzalez, r., feldstein ewing, s. w., nixon, s. j., . . . heitzeg, m. (2018). adolescent brain cognitive development (abcd) study: overview of substance use assessment methods. dev cogn neurosci, 32, 80-96. https://doi.org/10.1016/j.dcn.2018.02.007 luciana, m., bjork, j. m., nagel, b. j., barch, d. m., gonzalez, r., nixon, s. j., & banich, m. t. (2018). adolescent neurocognitive development and impacts of substance use: overview of the adolescent brain cognitive development (abcd) baseline neurocognition battery. dev cogn neurosci, 32, 67-79. https://doi.org/10.1016/j.dcn.2018.02.006 marshall, a. t., betts, s., kan, e. c., mcconnell, r., lanphear, b. p., & sowell, e. r. (2020). association of lead-exposure risk and family income with childhood brain outcomes. nat med, 26(1), 91-97. https://doi.org/10.1038/s41591-019-0713-y merz, e. c., tottenham, n., & noble, k. g. (2018). socioeconomic status, amygdala volume, and internalizing symptoms in children and adolescents. j clin child adolesc psychol, 47(2), 312-323. https://doi.org/10.1080/15374416.2017.1326122 miller, b., & taylor, j. (2012). racial and socioeconomic status differences in depressive symptoms among black and white youth: an examination of the mediating effects of family structure, stress and support. j youth adolesc, 41(4), 426-437. https://doi.org/10.1007/s10964-011-9672-4 mora-gonzalez, j., esteban-cornejo, i., solis-urra, p., migueles, j. h., cadenas-sanchez, c., molina-garcia, p., . . . ortega, f. b. (2020). fitness, physical activity, sedentary time, inhibitory control, and neuroelectric activity in children with overweight or obesity: the activebrains project. psychophysiology, e13579. https://doi.org/10.1111/psyp.13579 nakamichi, k. (2017). differences in young children’s peer preference by inhibitory control and emotion regulation. psychol rep, 33294117709260. https://doi.org/10.1177/0033294117709260 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 70 published by scholink inc. neely, k. a., wang, p., chennavasin, a. p., samimy, s., tucker, j., merida, a., . . . huang-pollock, c. (2017). deficits in inhibitory force control in young adults with adhd. neuropsychologia, 99, 172-178. https://doi.org/10.1016/j.neuropsychologia.2017.03.012 porter, l., bailey-jones, c., priudokaite, g., allen, s., wood, k., stiles, k., . . . lawrence, n. s. (2018). from cookies to carrots; the effect of inhibitory control training on children’s snack selections. appetite, 124, 111-123. https://doi.org/10.1016/j.appet.2017.05.010 samuel, l. j., roth, d. l., schwartz, b. s., thorpe, r. j., & glass, t. a. (2018). socioeconomic status, race/ethnicity, and diurnal cortisol trajectories in middle-aged and older adults. j gerontol b psychol sci soc sci, 73(3), 468-476. https://doi.org/10.1093/geronb/gbw080 schreier, h. m., & chen, e. (2013). socioeconomic status and the health of youth: a multilevel, multidomain approach to conceptualizing pathways. psychol bull, 139(3), 606-654. https://doi.org/10.1037/a0029416 shanika boyce, m. b., cleopatra caldwell, marc zimmerman, shervin assari (2020). protective effects of parental educational attainment on school social environmental risk: blacks’ diminished returns in urban public schools. children. shervin, a., & ritesh, m. (2019). diminished return of employment on ever smoking among hispanic whites in los angeles. health equity, 3(1), 138-144. https://doi.org/10.1089/heq.2018.0070 skowron, e. a., cipriano-essel, e., gatzke-kopp, l. m., teti, d. m., & ammerman, r. t. (2014). early adversity, rsa, and inhibitory control: evidence of children’s neurobiological sensitivity to social context. dev psychobiol, 56(5), 964-978. https://doi.org/10.1002/dev.21175 swingler, m. m., isbell, e., zeytinoglu, s., calkins, s. d., & leerkes, e. m. (2018). maternal behavior predicts neural underpinnings of inhibitory control in preschoolers. dev psychobiol, 60(6), 692-706. https://doi.org/10.1002/dev.21742 troller-renfree, s. v., buzzell, g. a., bowers, m. e., salo, v. c., forman-alberti, a., smith, e., . . . fox, n. a. (2019). development of inhibitory control during childhood and its relations to early temperament and later social anxiety: unique insights provided by latent growth modeling and signal detection theory. j child psychol psychiatry, 60(6), 622-629. https://doi.org/10.1111/jcpp.13025 valencia, m. l. c., tran, b. t., lim, m. k., choi, k. s., & oh, j. k. (2019). association between socioeconomic status and early initiation of smoking, alcohol drinking, and sexual behavior among korean adolescents. asia pac j public health, 31(5), 443-453. https://doi.org/10.1177/1010539519860732 williams, d. r. (1999). race, socioeconomic status, and health the added effects of racism and discrimination. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 71 published by scholink inc. williams, d. r., costa, m. v., odunlami, a. o., & mohammed, s. a. (2008). moving upstream: how interventions that address the social determinants of health can improve health and reduce disparities. j public health manag pract, 14 suppl, s8-17. https://doi.org/10.1097/01.phh.0000338382.36695.42 zaidman-zait, a., & shilo, i. (2018). parental adhd symptoms and inhibitory control in relation to parenting among mothers of children with and without adhd. j atten disord, 1087054718808063. https://doi.org/10.1177/1087054718808063 zhang, z., wang, q., liu, x., song, p., & yang, b. (2017). differences in inhibitory control between impulsive and premeditated aggression in juvenile inmates. front hum neurosci, 11, 373. https://doi.org/10.3389/fnhum.2017.00373 children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 6, no. 4, 2023 www.scholink.org/ojs/index.php/ct 1 original paper where are the parents? the drama of youth crime in the media an australian focussed discourse analysis dr. pamela d. schulz oam (note 1)1 1 senior adjunct research fellow school of law justice and society, university of south australia adelaide south australia received: august 18, 2023 accepted: august 28, 2023 online published: september 7, 2023 doi:10.22158/ct.v6n4p1 url: http://dx.doi.org/10.22158/ct.v6n4p1 abstract the language in media stories surrounding the high drama of juvenile and youth crime is very alarmist and continues to fuel political debates and demands for tougher penalties rather than the proverbial slap on the wrist for young offenders. further there are fear discourse elements that suggest that for some politicians cited in the daily news cycle as being “out of control”. in opposition to this fear and alarmist discourse in the notion that the media news cycle highlights youth crime for its sensationalist perspectives and poor reporting of youth courts and their judgments in such matters. a comprehensive discourse analysis of youth crime reporting may suggest that media must take the blame for some of the inappropriate focus on youth crime as being selective. this yearlong study suggests that the public need more information to see for themselves whether the current moves and political debates need to be reviewed and refreshed. in addition, family supports are a signal to consider as presented by expert authorities involved in decision making and reporting. introduction: a youth crime study in media: chaos drama and badly behaved. where is this coming from? thousands of years of complaining still echoes today for more than 2500 years there has been a plethora of complaints about the youth of today. we are mostly familiar with socrates complaints of them being disrespectful and not listening to their parents and refusing to do as they are told. clearly disobedient children and teenagers are not a new phenomenon. this study aims to see what is extant in today’s media. there is ample research that clearly identifies that youth and young people are affected by their upbringing and their parenting and when growing up in dysfunctional homes where love affection and education is ignored and not given chances to succeed are that young teenagers may find themselves in trouble. according to research conducted by boxall cooley and lawler in 2021 the percentage of young people who commit crimes www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 4, 2023 2 published by scholink inc. are more likely to emanate from dysfunctional home lives and have been subjected to domestic violence perpetrated on themselves or other members of the family. social work studies also reflect this view and there are significant examples that show…around the world social workers and professors of sociology are grappling with what appears in the news to be a world-wide phenomenon. for example, from as far away as ethiopia (tekelwoyni, zeleke, & kidane, 2021) the issues are considered and looking to other nations for similarities and differences. just as australia appears to be grappling with the problem of youth crime according to the media other countries are finding that their communities are facing similar issues. this media discourse study of over 100 media platforms focusses on media reporting of youth crime as a moral panic and political debates in australia and other countries which have presented reports of this type of criminal behaviour. moral panic in communities about crime have been reported in many studies and especially within the context of fear discourse as outlined by altheide and more recently by lee and mythen in their seminal book on fear of crime (lee & mythen, 2018). indeed, the notion of moral panic has set in as politicians step up to microphones detailing that if elected, they will be tough on crime and that those currently in government must do something to curb this problem. cohen first outlined moral panic in communities as early as 1976 and again revisited this idea in 2002 when he outlined the gangs of mods and rockers in england. other researchers joined the concern and the idea of concerns in media becoming a campaign to elicit a new form of policy became the norm in news reporting (cohen, 2001). in britain the problem of “aimless youth wandering the streets” and that gun and knife crime has been on the rise in britain. according to bhuller (2018) citing youth crime statistics from 2018 more than 40,000 young people were apprehended for proven possession of a knife and also suggesting large numbers of youth entering into the justice system. many researchers are considering more than a euro centric or modern democratic national approach and suggest that a nuanced view of community distress is often amplified by the method of reporting in modern media platforms. other media platforms in europe and the west suggest that the large number of young male refugees (alkoissa, 2018) from various countries that do not share the significant mores and values of that society are also fuelling the concerns in fear discourse. an early sweep of media platforms is replete with significant pejorative or aggressive lexis (word choices) which borrow heavily on conflict and war like tropes. they are charted below as a first measure of the type and style of reporting that leads to fear discourse and panic. such is the use of these discourse elements that it clearly is having some impact within media and some communities. in fact, david altheide (2023) is known for his work over many years in what he calls fear discourse and moral panic being used as a form of political football in order to encourage a tough on crime approach. there have also been many stories in mainstream newspapers that drive the communication of fear and demanding a tougher line from authorities such as the police and the justice system. in a story in the www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 4, 2023 3 published by scholink inc. australian by david penberthy (2023) who describes the city of pt augusta in the north of south australia (often known as the gateway to the outback) marked mayhem and that there are some people who are calling for change to prevent the spate or crime wave. this commentary and report suggested that; “port augusta has become synonymous with mayhem” he goes on to describe joyriding itself almost an oxymoron as a lexical choice as there is no joy when the car is crashed injuring young people attempting to escape police a regular type of news item on nightly tv news. it should be noted here that pt augusta has a large indigenous population and often the offenders are locals from that community. further in this story are details of booze filled crowds of yahoos and break-ins as commonplace and frequently used as descriptions. an indigenous man an elder in the pt augusta community mr malcom “tiger” mckenzie has described families as seemingly out of control and very dysfunctional which he blames on the withdrawal of the welfare cashless card which controls how indigenous families spend their money and in particular, on what is allowed to be bought on this card. within this article there were also reports of young people being injured and police officers being injured in the line of duty. in another recent story online and reports related to judicial officers the journalist raised the usual question related to youth crime waves reported in queensland and in the northern territory of australia (furler, 2023). he suggested that: “but after more than 20 years watching the courts, i think the justice is wrong on one big thing. some of our judges and magistrates are completely out of step with public opinion”. in his opinion widely circulated and repeated on social media there is a significant lexical choice of topic which blames the justice system for some of the ills reported daily by mainstream and other platforms. discourse analysts suggest that the major topics outline and then reiterated through semantic macrostructures such as headlines (teo, 2000) set in train a belief system of how to read the stories and this in turn creates a public perception of distrust and in this case with the justice system. similar reports of suggestion of the race and cultural or ethnic identity are overtly displayed when media cameras are deployed and despite pixilating faces to reveal their overt backgrounds and this can often be seen as their arms and legs are videotaped being placed in a paddy wagon or police vehicle for the nightly news reports. other subtext cues are given when the news anchor announces we spoke to xyz community leader for his/her report on the latest problem crime spree. for example, in the usa descriptions of offenders are quite blatantly reported as black african latino or arabic whereas in australia it is often ignored and only when the news pictures flash on screen and “community leaders” are asked for an opinion that the viewer clearly understands the cue… the offender is not white or caucasian. again mark furler has added that: “space limitations, particularly in radio and tv reports, mean every intricacy of a person's background is not revealed”. while this is true in principle it is clear that linguistic constructions will tell a different story and those often appear in headlines. various discourse analysts such as van dijk (1998) have researched the power of semantic www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 4, 2023 4 published by scholink inc. macrostructures that appear in discourse as headlines or paragraph leads and are often bolded on website to draw what is commonly termed clickbait. this attracts readers and viewers, and the type and style of language is often used to describe and cast attention via fearful statements. for example, the table below highlights headlined macro structures as descriptors of the youth involved in crime. it can also be seen that this table identifies significant behaviours in each of the elements of the table and they are not modified as youth that are neglected or disadvantaged or uneducated or disturbed suggesting that they are capable of intelligent choices and thus are to be blamed for the distress and disruption that are produced by their behaviours. several of the descriptions are designated by race and as such can be seen as overtly racist in nature. for example, teo cited above has indicated that at a certain point in time vietnamese youth were heavily involved in crime if newspapers at the time were to be believed. in addition, van dijk (2003) has suggested as immigration debates raged in europe in the 1980’s that a deal of the anti and right-wing approach to the ideology of migrants seeking a better life in the western democracies were race based. his research has since been identified by various un and other reports as significant in changing the support for refugees and migrants in political and other discourses. this appears to still be a topic of debate. discourse analysis method of lexical choice and newsworthy topics more than 150 websites were submitted to a lexical choice textual analysis and the major themes and topics were collated and listed according to frequency of appearances in news stories both on major online platforms and newspapers and other outlets. also included are television stories which used the term youth crime, teenage crime and youth crime wave as examples of headlines to each story. following the collation a table was commenced of each of the frequency themes and topics and listed in a table for ease of understanding the main methods of describing the crimes and critical incidents. the table below following shows a clear sensational approach which identifies young people as in control and having agency in upsetting and garnering media attention. in addition, it can be see that in most of the incidents reported that the community were likely to be in danger and that the government of the day needed to respond in some way. (examples of this include the demands by a parent advocacy group appearing on national television in australia). www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 4, 2023 5 published by scholink inc. table 1. of headlines: lexical choice topics and number of descriptions in media joyrider/ joyriding (stolen cars) 76 crime wave 45 stealing 33 rampage/aboriginal 21 spree 23 offenders/indigenous 57 callow youths 13 aimless 15 drug addicted 27 intoxicated 37 violent 24 murder charges 8 delinquents/misguided 20 crashing cars 26 illegal use (of motor vehicles) 22 young males/african gang 31 smash and grab raid 21 home invasion 7 black youths/indigenous 9 african gangs 5 crashing cars 13 knife carrying 9 stabbing 5 assaulting 8 danger/machete attack 27 anti social misfits 3 teen killers 2 media reporting of youth crimes online and mainstream the table above reveals that there is a lot of fear and trepidation surrounding the phenomenon of youth crime. as headlines and media platforms suggest headlines are actively indicating that youth crime and delinquent behaviour are soaring. from city to city and major regional towns the notion that young people are “out of control” is beyond the reach of caring parents, schools or community. communication theory holds that frequency is a clear indication that the media will begin a campaign of what schulz (2010-2011) calls the “discourse of direction”. in this the media start making inferences www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 4, 2023 6 published by scholink inc. that policies and practices should call for “tough on crime” or stricter controls by policing methods. this has certainly been seen in several media stories suggesting that the proverbial “slap on the wrist” penalties for youth crime are no longer stopping young people from offending. for example, abc political reporter kate mc kenna (2023) has written about the strict new laws passed by queensland parliament which will ensure “tougher penalties”. accompanying the story is a graphic series of icons displaying the effect these tougher laws will have on young offenders including stricter bail conditions of the age range affected (10-17-year-olds) and indeed, what will occur if they posted their escapades on social media and the likelihood of having to wear ankle bracelets if bailed to go home and await a court date. this has occurred as criticism of the slap on the wrist approach to giving young people extra chances to change their behaviour which appear to have failed. there are also calls to penalise dysfunctional families and parents for ignoring their children’s behaviours and allowing them to roam freely throughout the suburbs and creating mayhem and other fearful events such as burnouts and car crashes. the drama of such delinquent behaviour is such that an abc report from the far north of queensland described “a record spate of car thefts” (testa et al., 2022) and reporting on calls for greater punitive measures to stop this activity creating fear and uncertainty in the community. there are often calls for some sort of behavioural rehabilitation and occasionally we see calls to make children join the army for a spate of discipline. for example in new zealand (2013) there is a style of military intervention which has been used since 2010-2013 and has claimed a benefit of prevention of serious re-offending… their website claims that: “the mac programme was designed to provide intensive wraparound support to 40 of the most serious and persistent young male offenders each year to assist them to make pro-social choices (e.g., not reoffending) and ultimately make a successful transition to adulthood”. since then, various other options in new zealand have been tried as intervention and recent political activity by one party promises to bring back this specific program and expand it further. in australia the calls are getting louder via media that the government[s] must do something to stop this offending and to make communities feel safe again. among these are the calls to blame the parents for their children’s behaviour. one such example is the article by sonia hickey for australian criminal lawyers in which she asks the question: should parents be held responsible for the crimes of their children? as the article suggests the answer is very complex and may in fact need legal help to untangle the web of issues that are involved. whether in fact a parent can be proven to have by virtue of neglect or wilful default lead to the committing of a crime by their children can be considered within the children (parental responsibility act 1997 nsw). in australia the calls for getting tough on crime and children as offenders is increasing. only in recent times there have been pejorative descriptions of a failure of the justice system by various media platforms and the lexical choices of the reports echoes that of the table presented earlier. this again highlights the “moral panic” and fear discourse so prevalent in current media reporting of justice issues. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 4, 2023 7 published by scholink inc. such is the moral panic that in some places private security has been employed by residents to stop the “crime wave” (herbert & mackenzie, 2022). further research on this issue showed that other part of australia have resorted to doing likewise in order to ensure the safety of residents and community property owners. a full list of websites is available to view on most search engines and the significant word usage is similar to others media platforms that “call” for a range of options in order to stop the damage and distress it appears to cause. analysing the discourse: anaphora all discourse analysts suggest that the first sweep should most often check the topic and lexical choices and their frequency of usage. this is shown in the previous table. this appears to clearly represent the main focus of attention for the authors reporters and commentators. table one listed above is clear that there is a lot to be afraid of and further studies of the websites considered for this research clearly outline via anaphora the retracing or repetition of certain elements of the stories that add extra weight to the stories. while this research has focussed early on the frequency measurement of the lexical choices made by media a more intense examination of the most repeated phraseology or word choice via anaphora traces a clear path toward a system out of control, a community in fear of their lives and their property and personal well-being. table 2. anaphora and repetition in media reporting topic/anaphora (repetition) impact justice failure confidence in justice system disrespected judge bails teenage (killer car thief, hoon driver, home invader) judges cannot be trusted to do the right thing by community teenager commits crimes while on bail justice system cannot control anti-social behaviour slap on the wrist approach to youth crime is not working and too soft crime wave/spate herald an overwhelming problem judges are too soft suggest that courts can solve social problems by locking up offenders or placing them in some form of detention people living in fear government and authority unable to quell crime wave police resources stretched to limit as above www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 4, 2023 8 published by scholink inc. growing number of vigilantes in response to crime community decides to become the authority youth control the streets community fear government unable to quell crime wave vigilantes take matters into their own hands ? suggestion of the mob or people power taking over authority where are the parents? family dysfunction seen as a negative failure by society and community members who pays for the damage? calls for reparation and support community anxiety as youth crime escalates demands for action to quell and stop crime wave reported police are powerless police are blamed if they take action that results in injury or harm. anaphora (gill & whedbee, 1997) (repetition) is seen by several discourse analysts as a major rhetorical device used to indicate a speakers’ major focus. it draws in their audience and establishes—or at least claims—a commonality of ideology for the reporting teams whether on mainstream media platforms or on social media this is evident throughout the websites and media analysed. the terms public, confidence, criticism and justice failures while situated in open opposition to one another, are repeated many times within the texts. a recurrent—and powerful—narrative sequencing is established: one which is directed towards explanatory and justificatory purposes. and underlying this discourse of direction pattern of response to critique is an equally powerful set of conflict metaphors. the table below taken from media reports shows the power of such anaphora or retracing of the main points at issue. the table above clearly identifies that around australian and regional areas that young people offending are a menace to social order, community well-being and community trust in authority. as this author identified so many years ago the media campaigns are moving towards giving way to the discourse of direction. in addition, the media have started campaigns calling for tougher sentencing and changes to bail laws which place a strong emphasis on keeping young repeat offenders “off the streets” (rachwani, 2022). in discourse terms however, lacunae are evident. lacunae are what is missing in the discourse but evident to the readers or viewers (teo, 2000). this needs further study by others but clearly one anaphora is parental dysfunction that is constantly avoided. often what is deselected is as important as what is clearly focussed on in news reports. as schulz and cannon found (schulz & cannon, 2013) www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 4, 2023 9 published by scholink inc. missing terms in sentencing often found their way into media reports these included words such as penalty and punishment. there is some speculation that actually naming and shaming parents could in fact be considered as racially vilifying others. as a consequence little information is available about parental and family dysfunction categories. there are also similar stories around australia and indeed the world about order and control following youth offending or the unfortunate death of a presumed young offender whether in a stolen car that has crashed or some other reason that a police patrol has found them to be a person of interest. the police are required to protect law and order and to apprehend wrong doing and in the instance in france the case of nahel (no other name given) a 17 year old male of african descent known to police for failure to comply at traffic stops or being caught committing offences and placing people at risk has resulted in blazing headlines (semantic macrostructures) suggested that france is convulsed and that riots in the streets have plagued the community. smouldering cars set alight by the rioters have been used as a trope for “smouldering resentment” by people of colour who feel they are unfairly targeted. while the world grapples with children out of control on the front pages or headlining news services many journalists tread warily around terms such as disadvantage and ethnicity. this is surely worthy of further discussion and debate by others (note 2). media framing: emotion sensation division conflict and celebrity according to media theorists (mc combs, 2004) the above frames constitute most stories on mainstream media platforms, but the civilian journalists and bloggers are also using this keynote drama of youth crime to gain solidarity and click bait interest. one such example is the spate of issues raised about young black men here and abroad who when faced with police intervention may be arrested or other violence and car chases etc take place. these are often online showing cars ablaze or large crowds in the streets holding vigil over presumed police issues who have allegedly the facilitated death of a young person of colour. in all these stories the passion and division highlight these young people as celebrity if even for a moment while the story gathers momentum. emotion and the other elements are also more likely to find their way into news stories particularly if a number of teens (possibly a gang) actively attack and raid a worthy victim. there are several views on what constitutes a worthy victim particularly if they happen to be young and pretty or elderly and vulnerable or worse still in a wheelchair which almost always will guarantee a story to headline a news bulletin. this view is echoed by various theorists (silva & guedes, 2022). for example, silva and guedes suggest in their study that the way in which the media represent crime often includes “sensationalist” aspects, which focus on negative images of crime in communities. associated with the view of news as sensationalists is also the perception of them as realistic and they also suggest that the more sensational the crime or more vulnerable the victim will add more weight to the fear in www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 4, 2023 10 published by scholink inc. the community and draw attention to find a reason to watch and learn from the story. their study also includes the vulnerability of good citizens going about their daily lives and suddenly being preyed upon and traumatised by the experiences which are then actively pursued in the stories. example of this have included significant aggressive stealing of cars by groups of teens and then crashing the vehicle. sometimes the media shows a group of several young people hiding behind clothing being bundled into police cars. often this is accompanied by lurid scenes of crumpled cars and bold headlines relating teen crime. the story under the banner of sa news relays the “wild ride” and teenage boys facing multiple charges. often the headlines loudly proclaim yet another criminal activity perpetrated by these evil young men and sometimes women. collocation (or the words nearest the topics) collocation has been classified by many discourse analysts as a significant indicator of author mindset. de beaugrande (de beaugrande, 1997) calls the “collocation” of words the “company they keep”, and suggests that even modest word samples indicate a pattern that identifies issues or concerns that need attention. fairclough (fairclough, 2003) goes further, encouraging analysts to look for patterns that emerge in texts to show relationships, and especially clashes, between powerful and dominant discourses. according to atkins (atkins, 2002) frequent recurrences of such co-located selections can indicate a socially constructed point of view: one powerful enough to pull forward lexical items subconsciously as a speaker or writer composes, operating as a semi-automatic or pre-formed, “cued” selection. atkins suggests that language conditions people’s attitudes and expectations. those who habitually use, and re-use certain preferred words and phrases betray a settled way of thinking—and also the expectation that this will be shared by listeners. to some extent however this also applies to those who are the subjects of this language: those spoken of, who are objectified in the terms used, and who may well take up the positions of being discussed or identified. in other words, how language settles around an issue within a given community, controls community perspectives, and so behaviours. within media frameworks certain collocations are evident on most news stories and they are often placed next to the words featured strongly in this media analysis. they include crime, youth crime, teenage boys, and young offenders. below is a short selection to identify the type and style of reports and a table to exemplify this continuous author mindset. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 4, 2023 11 published by scholink inc. table 3. collocations: a selection juxtaposed either side of story themes main theme collocations implication crime by teenagers terrorise steal and abuse children as young as fourteen “out of control” car crashes at speed teenage boys led the police a merry chase for kilometres more than 2 hours teenage crime brings chaos joyriding in cars stolen from… young teenagers out for fun bringing sadness and distress to community and the suburban lives whose cars were stolen and crashed robbery at service stations, convenient stores, shopping centres snatch and grab robbed at knifepoint. distressed shop worker /shopper etc treated in hospital for stab wounds where are the police the justice system and parents and why don’t people know where they are at 2 am in the morning? stabbing frenzy at event knife wielding youth weapons of war against community car crash claims lives danger on the roads as driver aged only 14 wrong side of the road nowhere is safe? the drama that is implied in these stories are memorable and frightening for some readers and viewers in the community and calls to politicians to “do something” are often made by well-meaning leaders, mothers of victims, distressed parents and grieving public following inevitable terrible consequences. while collocations are part of the textual critical analysis one of the key areas of interest is the fact that for most of these stories as presented by news and major platforms it is implied that the children committing offences have “agency” and are in a level of control of the community. in fact this agency by youth is clearly identified by member of the media and general public in the topoi or collective thinking that follows such strident stories. topoi (or collective thinking by groups organisations or accepted reality by community) the drama of youth crime has been significant in terms of topoi by groups who all have a stake in the discourse… police, the justice system, politicians, community leaders, and indeed families and victims of crime. topoi has been described in many discourse analyses and suggest that based on the work of ruth wodak (wodak, 2009) list of the most common topoi which are used when negotiating specific agenda in meetings, or trying to convince an audience of one’s interests, visions or positions are often used in media stories they include: 1. topos of burdening 2. topos of reality 3. topos of www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 4, 2023 12 published by scholink inc. numbers 4. topos of history topos of authority 6. topos of threat 7. topos of definition 8. topos of justice 9. topos of urgency. in these stories can be found the reality of the crimes committed by young people who ought to be home and doing their homework, the burdens placed on communities dealing with the issues that are raised by young people out of control and the sheer number of these crimes which are often related to or referred to a history of dysfunction and disordered lives. there are also long suggested lists that occur in pragmatics and argumentation and have been described and list to augment the above groupings. they include references constantly to the need for urgent action, calls for change and for the justice system to lift the burden from weary frightened victims described as elderly vulnerable unable to sleep for fear and wanting their community to calm down and show respect for one another. for the media the collective trains of thought or ideologies often are predicated by the terms outlined below from the most often selected headlines and stories. table 4. topoi in media stories identified topoi statements description implications wild riding youth night of crime out of control young people topoi of threat where are their parents we’ve had enough of this people worn out by the drama of being in fear; topoi of justice injustice police and justice system not doing enough we have got to change this and stop this behaviour who is responsible? topoi of burden and reality of life in the suburbs should sentences be tougher even on children? let the justice system work that out. we must get tougher on these wild feral youths and teenage criminals if parents and the justice system do not fix the problem then perhaps changing laws might laws are too lax and allow freedom to continue to offend slap on the wrist for juveniles in trouble with the law easy to get away with crimes laws are not strong enough to control them issues raised by the clear notion that the young people have agency reflects the theory of appadurai (2006) and “the fear of small numbers”. indeed, he noted that the concept of fear and agency against such fear can affect responses and understanding. in today’s complex media and ideological landscapes, people often shape their views based entirely on what they read and see in the popular mass media. to some extent this process is deliberately perpetuated by media outlets, which seek to influence public responses as an everyday way of making news and in fact to get significant clicks on their internet platforms. further, the fear factor can often shape what people think needs to happen to change what www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 4, 2023 13 published by scholink inc. they see as needing fixing. this view is also shared by beck (2005) and points out that the current spate of “panic” discourse within media reporting gives the community of media viewers and readers an unrealistic view of the current world, where personal safety is in fact not notably at risk. this is a world where, as he argues, no one appears safe, and where the general population is persuaded to believe in an exaggerated risk of becoming victims of violent crime. the news media readily select and write about the bizarre, the sensational or the most violent crime cases. the reporting, increasingly not even local, is based on what sells… the oft cited “if it bleeds, it leads” still hold true, as do the ‘four c’ principles of courts, cops, crime and conflict. gross and aday (2003) refer to the consistent and frightening world that is brought into homes via the media, describing the “scary world in your living room” and commenting on how the constant viewing of criminal matters is leading many people to believe that crime is an overwhelming problem across all modern societies. it also appears even worse if the perpetrators are seemingly in control and have agency over others, their cars, their property, their parties or their homes. where are the parents? dysfunctional families their inability or unwillingness to step into the fray can at times be very frustrating. as there appears to be a community understanding that mothers and fathers ought to be doing more to make their children (often very young ones) who are committing crimes behave better and show respect to the community in which they live. the australian institute of family studies (2011) report made an early link between child maltreatment and criminal activity in adolescents and young people generally. part of their report suggests that there is evidence that: “a nexus between abuse and neglect and adolescent offending in the lives of some children and young people, and the lack of a coordinated response to these by both the child protection and juvenile justice systems. the “early years” message has had considerable influence, particularly in relation to child protection and early intervention, but early intervention has largely focused on interventions early in life rather than early in the pathway”. there are social work studies abounding showing that early intervention and parental support is a significant factor in ensuring that children have a decent chance at a good life free of intervention by the law. good food, nutrition, loving parents, good schooling and parental and family supports are a key factor often missing in these children who find themselves joy riding and committing daring robberies as they fear they are “missing out on the good life”. in fact, there is growing evidence that this may be a part of the problem and can be considered along with a range of other areas of concern. despite this queensland australia is about to become tougher in response to the crisis of young offenders which have resulted in two stabbing deaths. as a result, youth offender advocates have called for calm and asked for a review that does not include long periods of detention for convicted youth crime offenders. stories about alternatives to the fear society and calls for greater intervention are in fact few and far between as the moral panic has www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 4, 2023 14 published by scholink inc. taken hold and is used by politicians to garner votes on being “tough on crime” (smee, 2023). in praise of the justice system despite the topoi of laxity and the anaphora which described judicial officers and police as not fixing the problem. while there is ample evidence of the above topoi and anaphora judicial officers have indeed understood the information from experts such as the australian institute of family studies whose many reports show evidence that locking children up and placing them in detention harms them more than the public realises. for example, one youth justice bureau paper (2012) implied that in fact there was a drop in youth crime and that diversion programs such as conferencing have more merit than detention in a significant number of cases. there is a plethora of studies that shows how seriously judicial officers consider how to approach social justice issues such as youth offences, indigenous community offending and various crimes that annoy pester and make people fearful. in recent times the author approached a former deputy chief magistrate of south australia and asked his opinion about my study and the lurid media headlining that was clearly making strong statements around australia and around the western democratic nations. in reply he stated that there was significant evidence to show that over time young people (particularly boys) do take silly risks and play to their peers to show off. but he suggested that over time they mature grow up and become contributory members of society with appropriate social and community support. it is worth noting that this same judicial officer was among the first to start the idea of nunga courts and circle sentencing during his term of office in south australia. it shows that judges and other judicial officers are indeed alert to the times and that their suggestions should be heard and acted upon. in fact, when a youth criminal offender is sent home on detention with a security bracelet he has not “walked free from court, causing outrage” but is given a chance to reflect and re-position themselves into our community with respect for the law. in just under a decade ago magistrate jennifer bowles (2014) of queensland was reported by the media as asking a legitimate question of the time “why can i lock kids up, but i can’t ensure they receive treatment?” in this report she identifies the same problem occurring even then that there were …” too many children and young people appearing before children’s courts”. she also mentions the problem of substance abuse and mental health as being part of this problem because the offenders appearing have not been given the chance to engage in treatment for their problem. in addition, this issue is not confined to australia or new zealand as a myriad of reports are available online to discuss the matter. for example, children as young as fourteen are appearing for trial for serious felony charges in the usa (mistrett & espinoza, 2021). this controversial report showed that in2021 more than 250,000 children had been tried as adults and treated sentenced within the adult system. in fact, they state in opposition to this process and have reported that: “the children that remain exposed to the adult criminal legal system are overwhelmingly youth of colour. the vast majority serve short sentences in adult jail or prison and return home by their 21st birthdays, the age at www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 4, 2023 15 published by scholink inc. which services can be extended to in the youth justice system in the vast majority of states; indicating that many youths could be served, more appropriately, by the youth justice system”. from around the justice system judicial officers have consistently used the topoi of examining the fairness and injustice shown up by the harsh penalisation of such criminal activity by youngsters who often need support for their dysfunctional families, substance abuse or neglect situations. [executive summary p1]. back in australia late last year the former head of the queensland’s prison system has renewed calls for an overhaul of the youth justice system which he claims is “putting lives at risk”. the abc report (o’flaherty, 2022) named keith hamburger who, along with first nations leaders has impressed upon the report that the current circumstances are not fit for purpose and most particularly as detention facilities for young people. this appears to be an ongoing debate between those who call for stricter rules, harsher punishments and longer more punitive responsive sentencing. in fact, in copying a usa experiment in reinvesting into justice the town of bourke in new south wales australia, which has a high rate of first nations young offenders reported by the abc four corners investigation tv program (thompson, mc gregor, & davies,2016) which is claiming success in prevention rather than reactive detention and stopping the inevitable cycle of young offenders ending up in prison. in the western world there is a concern which is rising from the actual members of the justice systems seeing the result of the harsh revenge junkiesm outlined in earlier studies by schulz (2020). the very experts who see the results and the outcomes of the justice system for young people in trouble and in distress who act inappropriately suggests in their topoi of concerns the following lexical choices on a very regular basis: treatment intervention concern and support family support first nations input by elders children in need of care counselling substance abuse rehabilitation and avoidance of court processes. a final note: in every considered media platform in which these experts were reported the point was made to the author that the community is dealing with troubled children and not except in rare circumstances consistently violent and vicious adult persons. however, if the system fails to find a solution, then many will end up in prison learning to be violent and vicious and dangerous to society. references alkoissa, r. (2018). violent crime rises in germany and is attributed to refugees. retrieved from https://www.reuters.com/article/uk-europe-migrants-germany-crime-idukkbn1es173 altheide, d. (2003). mass media crime and the discourse of fear. hedgehog review, 9, 9-25. altheide, d. (2003). notes towards a politics of fear. journal of crime, conflict and the media, 1, 37-54. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 4, 2023 16 published by scholink inc. appadurai, a. (2006). fear of small numbers: an essay on the geography of anger. durham duke university press. atkins, a. (2002). critical discourse analysis: a letter to expatriates from the rt hon. sir norman fowler mp. retrieved from www.cels.bham.ac.uk/resources/essays australian institute of family studies. (2011). report archive. retrieved from https://aifs.gov.au/research/family-matters/no-89/link-between-child-maltreatment-and-adolescent -offending beck, u. (2005). risk society towards a new modernity. london thousand oaks sage publications see also altheide n.6. bhuller, a. (2018). youth crime on the rise in the uk. podcast on shout out uk. bowles jennifer magistrate. (2014). retrieved from https://stories.uq.edu.au/policy-futures/2021/the-case-for-effective-mandated-substance-abuse-trea tment-for-young-people/index.html boxall, h,, pooley, k., & lawler, s. (2021). do violent teens become violent adults? links between juvenile and adult domestic and family violence. trends & issues in crime and criminal justice, 641. cohen, s. (n.d.). “folk devils and moral panics” see also ungar (2001) on moral panic and the risk society and waddington (1986) “mugging as a moral panic” who brings a significant perspective on these issues. de beaugrande, r. (1997). the story of discourse. in t. a. van dijk (ed.), discourse as structure and process (pp 35-62). de beaugrande, r. (1999). discourse studies and the ideology of “liberalism”. discourse studies, 1(3), 259-295. dr andrew james cannon am adjunct professor of law adelaide university flinders university and the university of muenster germany. fairclough, n. (2003). analysing discourse. textual analysis for social research london and new york routledge. furler, m. (2023). digital editor apn regional media. retrieved from https://www.couriermail.com.au/news/queensland/central-queensland/australian-judges-way-too-s oft-and-slow-on-crime/news-story/fa73eda2cacf92fb33c7b139c8d635bd accessed june 7th 2023 gill, a., & whedbee, k. (1997). rhetoric. in t. van dijk (ed.), discourse as structure and process (pp. 157-184). london thousand oaks sage publications. gross, k., & aday, s. (2003). the scary world in your living room and neighborhood: using local broadcast news, neighbourhood crime rates and personal experience to test agenda setting and cultivation. journal of communication, 53(3), 411-426. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 4, 2023 17 published by scholink inc. heath, l., & gilbert, k. (1996). mass media and fear of crime. american behavioural scientist, 39(4), 379-386. herbert, b., & mackenzie, b. (2022). coraki crime wave leaves residents in fear in their own homes. abc report 21st sept 2022 abc online report. hickey, s. (2022). should parents be held responsible for their children’s crimes? in australian criminals lawyers website. retrieved february 28th, 2022, from https://www.sydneycriminallawyers.com.au/blog/should-parents-be-held-responsible-for-the-crim es-of-their-children/ http://www.online-literature.com/forums/showthread.php?17788-socrates-plato-complaining-of-the-y outh https://7news.com.au/news/sa/teenage-boys-wild-ride-in-allegedly-stolen-car-ends-in-head-on-crash--c -9924756 https://www.abc.net.au/news/2023-02-04/analysis-queensland-youth-crime-police-penalties-politics/10 1928856 https://www.reuters.com/world/europe/riots-shake-france-after-police-shoot-teenager-2023-06-29/ hüllse, r. (2000). looking beneath the surface-invisible othering in the german discourse about turkey’s possible eu accession. in conference papers presented at the ionian conference corfu greece, may 19th-22nd 2000. lee m and mythen g (2018) “the routledge international book on the fear of crime” see also altheide d (1999) on fear in the news mc combs, m. (2004). setting the agenda: the mass media and public opinion. cambridge and malden ma polity. mckenna, k. (2023). queensland parliament has passed new tough laws targeting young offenders. abc online story 16 march 2023. military activity program nz government. (2013). retrieved from https://www.msd.govt.nz/about-msd-and-our-work/publications-resources/evaluation/military-styl e-activity-camp/index.html mistrett, m., & espinoza, m. (2021). children in adult prisons courts and jails. report for the sentencing project. retrieved from https://www.sentencingproject.org/reports/youth-in-adult-courts-jails-and-prisons/ nsw bureau of crime statistics. (2012). the effects of youth justice conferencing on youth crime. retrieved from https://www.bocsar.nsw.gov.au/pages/bocsar_media_releases/2012/bocsar_mr_cjb160.aspx o’flaherty, a. (2022) abc news report “calls for healing centres for juvenile offenders”. retrieved from https://www.abc.net.au/news/2022-11-19/calls-for-healing-assessment-centres-for-juvenile-offend www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 4, 2023 18 published by scholink inc. ers/101660826 penberthy, d. (2023). the australian ‘calls for cashless card return in town hit by crime wave’ weekend inquirer, june 10-11, p. 20. rachwani, m. (2022). queensland government defends bail laws amid concerns over youth crime after emma lovell’s death in the guardian. retrieved from https://www.theguardian.com/australia-news/2022/dec/28/queensland-government-defends-bail-la ws-amid-concerns-over-youth-after-emma-lovells-death schulz, p. d. (2010-2011). courts and judges on trial: analysing and managing the discourses of disapproval. lit verlag munster and berlin transaction publishers rutgers university new jersey and uk p 51. schulz, p. d. (2010-2011). ibid. schulz, p. d. (2020). ibid see also “justice expliquée aux jeunes”. retrieved from https://www.cours-appel.justice.fr/bastia/la-justice-expliquee-aux-jeunes schulz, p. d., & cannon, a. (2013). trial by tweet? findings on facebook? social media innovation or degradation? the future and challenge of change for courts. international journal of courts administration, 1. silva, c., & guedes, i. (2022). the role of the media in the fear of crime: a quantitative study in the portuguese context. in criminal justice review journal georgia state university usa (april 18 2022). np vol 0 smee, b. (2023). guardian australia on line: “australians urged to ditch the tough on crime mindset for youth justice as it does not work”. retrieved from https://www.theguardian.com/australia-news/2023/jan/25/australians-urged-to-ditch-tough-on-min dset-for-youth-justice-as-it-does-not-work tekelwoyni, t., zeleke, t., & kidane, y. (2021). social causes of juvenile delinquency: the case for axum correctional and rehabilitation centre in northern ethiopia july 2020. international journal of scientific and research publications, 10(7), 520-536. teo, p. (2000). racism in the news: a critical discourse analysis of news reporting in two australian newspapers. discourse & society, 11, 7. teo, s. (2000). racism in the news: a critical discourse analysis of news reporting in two australian newspapers. discourse and society, 11(1), 7-49. testa, c. et al. (2022). cairns youth crime punishment warning as city endures record spate of car thefts… abc online story august 10th 2022. thompson, g., mc gregor, d. a. (2016). abc four corners report. retrieved from https://www.abc.net.au/news/2016-09-19/four-corners-bourkes-experiment-in-justice-reinvestment /7855114 www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 4, 2023 19 published by scholink inc. van der, v. r. (2003). right wing parliamentary discourse on immigration in france. discourse and society, 14(3), 309-348. van dijk, t. (1998). ideology. a multi-disciplinary approach. london sage wodak, r. (2009). the discourse of politics in action. basingstoke: palgrave macmillan. zagar, i. (2010). topoi in critical discourse analysis. lodz papers in pragmatics journal, 6(1). notes note 1. dr pamela d schulz is adjunct senior research fellow at the university of south australia at adelaide. the oam is the order of australia medal awarded on the queen’s birthday honours list in 2013 for her charity works in communications for the community in south australia. she has served as a ministerial appointed chair of defence reserves support council in south australia and nationally and has served for five years from 2014-2019 on the veterans advisory council. she is currently honorary communications officer of the defence reserves association of sa. note 2. a full list of the websites and media platforms researched in this study is available on request from the author. children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 2, no. 1, 2019 www.scholink.org/ojs/index.php/ct 32 original paper the struggle is real: advocacy, activism, and agency in young adult protagonists with autism vail matsumoto1 & rhonda s. black1* 1 university of hawaii at manoa, honolulu, hawaii, united states * rhonda s. black, university of hawaii at manoa, honolulu, hawaii, united states received: december 20, 2018 accepted: january 21, 2019 online published: february 16, 2019 doi:10.22158/ct.v2n1p32 url: http://dx.doi.org/10.22158/ct.v2n1p32 abstract while there is much research behind adolescent protagonists developing advocacy, activism, and agency in young adult literature in order to change the trajectory of their lives, fewer studies have examined adolescent protagonists with autism under similar circumstances. the image of the semi-comic, socially tragic autistic teenager is portrayed in the media more often than one who advocates for himself, takes action to be independent, and develops as an agent of change. this paper examines six award-winning young adult novels whose protagonists emerge as young people developing independence despite dealing with the challenges living with autism brings. how they exert this autonomy helps illustrate the multitude of ways in which teens handle frustration, challenges, and helplessness while managing a disability. readers not only engage with teenagers facing obstacles, but also have the opportunity to develop a better understanding of their peers, a deeper sense of empathy, and empowerment to make changes in their own lives. keywords autism spectrum disorder, young adult literature, self-advocacy, inclusion literature 1. introduction more children than ever before are being diagnosed with an autism spectrum disorder (asd) with one in 68 children being diagnosed in 2010 and that rate remaining stable through 2012 (cdc, 2015, 2016). in the last two decades, research focusing on children with asd has become a popular area of study (jang, et al.) with professional journals, documentaries, news reports, parenting guides and parent autobiographies filling our bookshelves, the internet, and our airwaves. clearly, autism is at the forefront of discussion and debate in both the scientific and popular literature (murray, 2010). for the general public, much of their learning about autism comes from the popular press or visual media, in particular, www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 33 published by scholink inc. fictional accounts through books and movies. as public awareness and curiosity about autism has increased, so has the number of characters with autism in young adult literature (yal) (irwin, goldsmith, & applegate, 2015). yal depicts a range of teen characters with diverse experiences across the range of the autism spectrum, largely reflecting research on actual teens (irwin et al., 2015). mark haddon’s the curious incident of the dog in the night-time (subsequently referred to as curious incident), is probably the best known novel with a protagonist on the autism spectrum. it became a worldwide best-seller in 2003, and has since sold over 10 million copies, has been translated into 44 languages and has won 17 literary awards (clinton, 2014). intended for both an adult and young adult audience, curious incident has been adopted on to many secondary school recommended reading lists and is therefore becoming an asd cultural reference point for young people. perhaps one of the most telling indicators of the novel’s popularity as a school requirement is the abundance of published study guides and summaries (www.bookrags.com; www.thebestnotes.com; sparknotes literature guides; gradesaver classic notes; insight study guides; cambridge wizard english guides; bookclub-in-a-box and more). the sheer number of art projects and videos created by students and posted to the internet attest to the novel’s reach and influence on young adults. curious incident has brought international attention to a single 15 year-old character with asd and started a rising wave of novels written from the perspective of a young person with asd (robinson, 2012). the way autism is portrayed in yal can have significant influence on young people’s beliefs about autism. this literature provides readers a chance to experience vicariously what it means to live with autism, and to see a little of themselves in characters “whose lives are parallel to their own and who struggle with similar conflicts and issues” (miller, 2013, p. 28). “teens can meet peers with asd in books as well as in life. since high-functioning characters with autism are predominantly mainstreamed, they appear at school and have classmates who can get to know them” (irwin et al., 2015, p. 14). according to bucher and manning (2014), the characters featured in young adult literature are undergoing changes and turmoil that reflect authentic issues that adolescents are experiencing in life. themes that readers encounter in adolescent literature include asserting independence, coming of age, accepting responsibilities, developing empathy, and filial and romantic relationships. while not universal, self-advocacy, agency, and activism are also common themes that arise in young adult literature. yal has the power to bring to light common experiences, emotions, and dilemmas while also promoting respect for differences. starting with curious incident as a reference point, we will explore how characters with asd in this book and others are presented in yal. more specifically, we will address the following research questions: 1) how are protagonists with autism portrayed in yal? 2) how do these protagonists express advocacy, agency and activism? www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 34 published by scholink inc. 2. method 2.1 selection criteria the selection criteria for books included in this review were that the book must: (a) be a fictional account written after 2000; (b) be an award winner in the area of young adult literature (award winners are more popular and more likely to appear on recommended reading lists, and have reviews about their contents published); (c) have a protagonist that is a young person with asd and the story is told from that person’s point of view; and (d) the young person with asd shows agency, advocacy and/or activism. eight books (with six characters) met the selection criteria (see table 1). table 1. books included in analysis book title author, publisher character year published awards the curious incident of the dog in the nighttime mark haddon new york: vintage a division of penguin random house christopher 2003 -costa book of the year (2003), -guardian children’s fiction prize (2003), -waverton good read award (2004), -whitbread award for novel and book of the year (2003), -mckitterick prize (2004), -los angeles times book prize (2003), -exclusive books boeke prize (2004), -ala alex award (2004), -zilveren zoen (2004), -commonwealth writers’ prize for best first book overall (2004) wild orchid 1 waiting for no one white bicycle beverley brenna markham, ontario: red deer press taylor 2005 2010 2012 -young adult book award by the canadian library association (wild orchid) -dolly gray children’s literature award winner (waiting for no one) -michael l. printz award, honor book 2013 (white bicycle) the london eye siobhan dowd ted 2008 -bisto book of the year, bisto merit www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 35 published by scholink inc. mystery new york: yearling awards, -cybils award for middle grade fiction (2008) -school library journal best book of the year -kirkus review’s best children’s book award marcelo in the real world francisco stork new york: arthur a. levine marcelo 2010 -schneider family book award for teen book (2010), -james cook book award (2011) -yalsa best book for young adults publisher’s weekly best book of the year mockingbird kathryn erskine new york: philomel a division of penguin random house caitlin 2012 -national book award for young people’s literature (2010), -international reading association award ala best fiction for young adults dolly gray children’s literature award colin fischer ashley miller and zack stentz new york: razorbill a division of penguin random house colin 2013 -aba young adult honor award (2013) 8 books, 6 different characters with autism spectrum disorders (cwa). 1 in waiting for no one, wild orchid, and the white bicycle, the same character, taylor, has asperger’s syndrome. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 36 published by scholink inc. case study methodology was used wherein each protagonist with asd was considered a case. we described the characters according to diagnostic hallmarks (e.g., communication and social interaction difficulties, sensory sensitivity, resistance to change in the environment or routines, intense interests) as defined by the individuals with disabilities education act of 2004 (idea, 2004). each character was then examined to determine how and when agency, activism, and advocacy were exercised in their lives. 3. results 3.1 case studies: the characters 3.1.1 the detectives christopher, in the curious incident of the dog in the nighttime, is a 15 year-old only child, who lives with his dad in swindon, england. as christopher investigates the death of a neighbor’s dog, he discovers that his father lied about his mother’s death. his mother is still alive, but left the family because the marriage was strained and she had difficulty dealing with christopher’s behavior. christopher no longer trusts his dishonest father, and runs away, seeking his mother in london. the solo journey to london tests many of christopher’s greatest fears such as noises, crowds, being away from home, and interrupting his known schedule and environment. christopher has very concrete ideas such as, “you can’t trust people who lie”, and he doesn’t like novels because they are “lies about things that did not happen and they make me feel shaky and scared” (p. 20). christopher likes symmetry and for things to be in order; he has a keen eye for patterns. he likes the color red, and hates the colors yellow and brown. he likes to know exactly what time it is, likes prime numbers, math puzzles and riddles. he is good with numbers and memorizing facts. he hopes to be an astronaut one day and likes sherlock holmes mysteries because there is a puzzle to be solved through observation and logic. christopher has difficulty with idioms and figurative language such as “catch you later”, or “being an apple in someone’s eye”. he doesn’t like words that can mean two different things. he does not care for metaphors because they are lies; similes are acceptable because they are words stating one thing looks “like” another and that is not hard to visualize (i.e., it really did look like the man had two mice hiding in his nostrils) (p. 17). christopher often finds jokes difficult to understand; he has difficulty reading body language, does not look at people’s faces, says he cannot tell what others are thinking, and assumes that others feel the same way he does. christopher is sensitive to sound, touch, crowds and too much information, such as someone asking too many questions too fast, or too much going on in the environment. he hums and groans to block out noise, and closes his eyes when too much information is coming in. although the book never specifically states christopher’s disability, it is presumed he has asperger’s syndrome (as). he is in the 10th grade at a separate school for students with disabilities. most of the students have intellectual and/or physical www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 37 published by scholink inc. disabilities and work on life skills and arts and crafts. christopher, on the other hand, is quite intelligent and will be the first person from his school to take advanced math. agency. readers are able to see christopher grow throughout the novel as he is forced to make difficult decisions, expand his limited comfort zone, find ways to cope independently, and act upon beliefs that may not correspond to information the adults in his life provide. discovering his father betrayed his trust and lied to him, christopher is jarred into action by taking control of his own life and making the decision to run away. prior to this, the navigation of his life was primarily in the hands of his father and school teacher. there are glimmers of agency prior to the betrayal, such as his personal philosophy that he explains as, “...i decide for myself what i am going to do and what i am not going to do” (p. 30), and his commitment to the canine murder mystery: “i decided that i was going to find out who killed wellington even though father had told me to stay out of other people’s business” (p. 28). however, most of christopher’s life illustrates a heavy reliance on others and is in stark contrast to the agency christopher must develop in a matter of hours as he is faced with decision after decision on his journey to find his mother. once he makes the decision to be with his mother, christopher’s actions and thoughts demonstrate a continuing sense of agency. one clear example of this is when he says, “i decided that i couldn’t go home again” (p. 129). another very telling example of christopher’s newly formed agency is his formulation of a plan that includes many obstacles that he is almost certain to face. this is not a journey of the unknown so much as it is a journey into what christopher knows will be fraught with hardship, but forges ahead with anyway. this is the sense of control and agency that christopher develops throughout the novel. it is evident that christopher himself acknowledges the growth and development through action and intervention that he undergoes, when he closes the story with, “and i know i can do this because i went to london on my own, and because i solved the mystery of who killed wellington? and i found my mother and i was brave and i wrote a book and that means i can do anything” (p. 221). ted, in the london eye mystery, is a 12 year-old boy with as who just finished his first year of secondary school. he lives in london with both parents and an older sister. ted’s father is a demolition expert; his sister, kat, is a typical teenager—very socially oriented, concerned about appearance, knows teen culture, and is adept at sneaking and lying to their parents. kat doesn’t have much time for ted and finds him annoying, but she does love him and says he has a good brain. during the summer, ted’s cousin comes to visit for a few days and disappears. ted investigates the mysterious disappearance with his sister. similar to christopher, he takes a train alone for the first time; a difficult task because it is new and he has difficulty with crowds. ted systematically makes observations, develops theories and tracks events to figure out where his cousin may be. ultimately, ted’s analytic mind saves his cousin’s life. like christopher, ted is good at remembering facts and recites them frequently. ted wants to be a meteorologist and is especially interested in weather, which he talks about at length, if allowed. his www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 38 published by scholink inc. routines include listening to the weather report during the day and the shipping forecast at night before he goes to sleep. he is also good at math and skilled at deductive reasoning. ted understands how different he is from his peers and says, “i know i’m a weirdo. my brain runs on a different operating system from other people’s. i see things they don’t and sometimes they see things i don’t” (p. 31). although ted is good at remembering facts, he forgets everyday things like his school gym bag. ted states, “i don’t like being different. i don’t like being in my brain. sometimes it’s like a big empty space where i’m all on my own. and there’s nothing else, just me” (p. 39). ted describes himself as clumsy and he does not like athletic activities. he wears his school uniform even on weekends and summer break and when anxious, “my hand shakes itself out”. he tilts his head to the side, looks beyond, rather than directly at people, and seems expressionless. ted is sensitive to noise, especially people talking loudly. he has difficulty understanding idioms and why they are used; yet he has memorized a few such as laughing one’s head off, up your street, talking up a storm, and driving someone bananas. ted is not good at lying, and has a hard time understanding when other people are not telling the truth. ted has learned if others look straight at you, then you could become friends; and when you are talking, if the muscles in people’s faces are not doing anything, it means they are bored. “mr. shepherd says if i learn how to be like other people, not just on the outside, but on the inside, then i’ll make more friends” (p. 38). ted has no friends his age. he claims his mum, dad, and mr. shepherd as his only friends. agency. ted’s powerful analytic mind and keen attention to details that others dismiss as insignificant enable him to solve the mystery of his cousin’s disappearance. what is most significant, however, is that ted does so by choice, displaying agency. ted sees the need, realizes that his way of thinking can serve a purpose in the situation, and becomes an agent of change out of necessity. “this is how having a funny brain that runs on a different operating system from other people’s helped me to figure out what had happened” (p. 4). ted also possesses another quality that others find annoying, but was crucial in serving his investigative skills in this situation: being relentless in the pursuit of the truth. no matter what the circumstances were, whether it was the appropriate time or not, whether it made him seem tactless or insensitive to others’ feelings, ted continued to pursue the truth and dig for facts. when the family is sitting in silence pondering the gravity of his cousin’s disappearance, ted breaks the silence by trying to present his theories. after being shushed, he refuses to give up and presents his ideas to his sister kat, ultimately recruiting her to share in this agency. however, even kat tries to surrender to frustration on several instances. even after kat tries to literally and figuratively trash all of ted’s theories, he presses on. “i picked up a pen... i was eager to see if we could eliminate all the theories…” (p. 143). when he forces the issue with his mother, he is rebuffed in no uncertain terms. instead of arguing or giving up, ted communicates his unwavering agency by purposely shattering a crystal glass on the floor. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 39 published by scholink inc. this vivid illustration of his agency continues throughout the novel as ted resists his natural urges and fears to speak to strangers, travel alone, and even wins the respect of a police investigator who says, “if only some of my officers had half your brains, ted” (p. 156). colin fischer, who has as, is 14 years old when the story begins on his first day of high school in the novel also named colin fischer. he lives with his parents, who work in the space industry, and a younger brother, danny, in the san fernando valley of california. danny is not at all kind to colin; he is jealous of the attention colin gets and relishes when colin makes mistakes. in describing himself to a teacher, colin stated, “i’m diagnosed as high functioning, but i still have poor social skills and sensory integration issues that give me serious deficits in areas of physical coordination” (p. 39). colin avoids eye contact, often doesn’t notice facial expressions, and when he does, he has difficulty understanding them. to assist in reading emotions, he refers to facial expression cards, which he keeps in his notebook. in fact, the tagline of the novel is “solving a mystery one facial expression at a time”. colin has a flat, robotic tone of voice and flat affect. like christopher and ted, he interprets language literally and has difficulty with figurative language/idioms. colin is brutally honest and says what he observes. disruption to his structure and routines is devastatingly distressing. like christopher, colin does not like fiction because it is too far removed from reality; inferences make him uncomfortable because he likes certainty. like christopher and ted, colin likes sherlock holmes and solving a mystery is part of the novel’s plot. colin loves star trek’s mr. spock and commander data, has a keen eye for details, and also likes math. like the other characters, colin doesn’t like to be touched. he is sensitive to fabrics and clothing, and is very sensitive to smells, which he says he can “taste”. he has food preferences and will only eat crunchy foods. like christopher, colin has color preferences and does not like the color blue. colin often suffers from sensory overload. on the first day of high school, colin shrieks with terror at the hallway noise. colin uses his notebook to record events at school including the movements of various groups—the nerds, popular girls, goths, and jocks. he watches his classmates “with the detached interest of an anthropologist”. one person in particular that colin watches is wayne, a school bully who put colin’s head in the toilet on the first day of school. ironically, this bully becomes his friend as colin tries to solve the mystery of who brought a gun to school. motivated by finding the truth, colin and wayne join forces to investigate. activism and agency. by teaming up with his tormentor, colin begins to step beyond his comfortable routines, leading to deeper involvement in real life and a real mystery. his parents, at one point in the novel, reminisce nostalgically about what life was like when colin was not independent, making decisions for himself, and befriending unsavory characters. yet the injustice that is unfolding right in front of him is more than colin can ignore. in fact, ignoring it and giving in to a sense of helplessness are not options for him. “wayne connelly is innocent, and i will prove it. the game is afoot” (p. 86). colin is wired for activism when it comes to analyzing the evidence, finding the answers, and seeking the truth. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 40 published by scholink inc. even though he is somewhat removed from the investigation after he is questioned by the police, he refuses to stop himself from taking action to exonerate wayne. this activism moves him to look beyond past wrongs to ensure that the boy isn’t wrongfully accused and punished. for colin, the search for the truth is more important than personal feelings of discomfort. colin also displays agency as he works to ensure the wrong person is not punished. the interventions that colin utilizes in his quest for the truth are not always purposeful, but ultimately work. “i just figured out the truth. the rest...happened” (p. 201), he says after his parents commend him for his agency in saving an innocent boy. colin’s acute sense of justice makes it easy for him to make what others would consider difficult decisions. and in the end, the most difficult decision for colin is not lending a helping hand to absolve an innocent boy, but literally offering a helping hand to the same boy getting on to the trampoline. the agency he applies to the mystery has an unexpected effect on his own response to the world. 3.1.2 the relentless taylor in wild orchid, waiting for no one, and the white bicycle is an 18 year-old girl with as who has just finished high school. by the third book, she is 19, and has completed her first year of taking classes at a university and has a job. taylor lives with her mother in saskatchewan, canada and is an only child. taylor’s father lives in wyoming with his girlfriend, who taylor likes. taylor does not like the men her mother dates. taylor remembers her parents fighting and believes they broke up because of her. taylor’s mother gets both exasperated with, and worried about taylor. in return, taylor gets frustrated with her mother. taylor is extremely focused on her resume, and works toward adding to it in a concrete, repetitive manner. her main goal is employment so that she can be independent, which is a theme throughout the three books. as a child, taylor lined up her toys and had difficulty when things changed or did not go her way. she had meltdowns that involved hitting, kicking, and biting others. kids teased her and called her names. as a teen, taylor still had difficulty with eye contact and preferred structured routines. taylor is good at sorting things, is a talented artist, and reads very well. she describes herself as a follower of rules. she has a photographic memory, especially when it comes to plants and animals and can identify them by their scientific names. she carries on long monologues about gerbils, flowers and other things in nature. taylor is actively working on learning to take the perspective of others, and on becoming more self-aware. taylor was diagnosed with as at age 11 (grade 6). she interprets language literally and often does not understand questions and expressions such as not my cup of tea and take your mind off it. she doesn’t understand why people say things they don’t mean. taylor also likes to count things, including the number of words people say and the number of steps she takes. she feels comforted with doing things a certain number of times. she experiences anxiety and obsessively cleans when stressed; she also has the urge to swear when feeling anxious. taylor is sensitive to noise, light, bright colors, and being wet. like www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 41 published by scholink inc. the other characters, she is sensitive to smells and doesn’t like being touched. when overwhelmed, feelings suddenly explode in her head until all she can see is white. over time, however, taylor has learned strategies to make the white go away. she is sensitive to certain fabrics and wears the same worn denim dress daily because it is comfortable. she does not like the color yellow because it makes her sneeze, and she likes foods that are white. agency and advocacy. the first novel is centered on a summer away from home and out of taylor’s comfort zone. not only is taylor in a new environment, surrounded by unfamiliar people, but she must also take it upon herself to advocate for her goal of becoming an adult. her mother, with whom she has a strained and sometimes forced relationship, treats her like a child, despite taylor’s repeated hopes of independence. while her mother refuses to recognize taylor’s transition to adulthood, taylor champions for her independence by making clear-cut decisions for herself. “she (her mother) went out of my room and banged the door. it’s not good to bang doors. it’s hard on the hinges. it’s good i locked the door, because now nobody will bang it again” (p. 9). while locking the door is a simple, somewhat juvenile solution, taylor is asserting her independence. by the middle of the book, taylor’s self-advocacy has moved from locking doors to running away. “you don’t know anything about what’s possible or necessary and just because you’re my mother you think you can be the boss of me and you aren’t... i’ll just run away again and keep running until i’m so far away…” (p. 142). part of taylor’s relentless advocacy for her own independence includes having a boyfriend. while she may be somewhat naive about what this entails, she knows that engaging in an adult relationship will prove to others that she is no longer a child. she zealously pursues any and all leads in this arena, finding that these kinds of relationships are as confusing as they are difficult to cultivate. instead of doggedly pursuing this, she shows her growth by saying, “i’m not sure if he is my boyfriend, and if he is, i’m not sure i like it” (p. 70). by the close of the first novel, taylor is no longer self-advocating for romantic relationships to prove her independence, but is acting like an adult instead. when she is forced to resign from her job to move home with her mother, she doesn’t take the easy way out by having her mother speak with her boss and co-workers. “i got this job by myself, and i will take care of quitting... remember, you’re not the boss of me” (p. 146). in the third book, the white bicycle, taylor and her mother fly to france to spend the summer with her mother’s new boyfriend and his sons. taylor agrees to the trip because she will be a personal care assistant for one of the sons who has cerebral palsy. she sees this job as a resume-builder to increase her employability because “being employable means something great: being independent” (p. 25). taylor continues the classic adolescent quest for differentiation from her mother. first, she rescues an old woman from drowning and wants to continue seeing the woman. taylor’s mother will not give her a ride to the woman’s home and tells taylor she cannot go. taylor defies her mother and researches how to take a bus to the city where the old woman lives, stating, “this is what a smart person would do if she wants to www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 42 published by scholink inc. go to cassis (the city) and her mother will not drive her” (p. 120). in thinking about the relationship with her mother taylor asks herself, “who has responsibility for my existence?” and “how can i be free if i don't make any decisions for myself?” (p. 125). taylor is afraid of going against her mother’s wishes, and is also afraid of taking the bus in a foreign country. despite her fears, she takes initiative and successfully maneuvers the bus system, and develops a friendship with the old woman. taylor again demonstrates agency when she overhears that her job as a personal care assistant was just a ruse to get her to go along on the trip. taylor asserts to her mother, “lies and deception. you have ruined my resume!... you have given me a summer with an empty resume, and now i will never get a full-time job, and i will be stuck with you until you die and i am living alone” (p. 156). taylor continues by reciting her good qualities as an employee, such as being dependable and responsible, and tells her mother and the boyfriend that she will not continue to help the young man unless “it is a real job and it is called personal care assistant” (p. 157). later, when calmer heads prevail, taylor tells her mother that she is going to make her own choices. “from now on, i am an adult and i will be making choices about myself. that is something i have control over... if i am going to be independent we both have to keep on choosing for ourselves and not the other person”. caitlin in mockingbird, is a 10 year-old girl in the 5th grade who has been diagnosed with as. caitlin has many dysfunctional behaviors similar to descriptions of taylor’s behavior in her younger years. like taylor, caitlin is a good reader and an excellent artist. caitlin’s brother was her social interpreter and told her specific things to do in social situations. unfortunately, caitlin’s brother was killed in a school shooting on the “the day our life fell apart”. caitlin’s mother died when she was only three years old. as a result, the family is comprised of only caitlin and her father, who is greatly incapacitated by grief. throughout the book, caitlin seeks “closure” believing it is a tangible thing. she finally finds closure by working with her father to complete a wooden chest that her brother had begun before his death. caitlin’s relentless quest for closure is similar to taylor’s quest for employment and independence. caitlin is uncomfortable looking people in eye. when she is nervous or unsure of what to do she flaps her hands, sucks on her sleeve, or hums. the sounds of some words hurt her ears, and she interprets idioms literally. she has difficulty with change, difficulty with directions, and dislikes certain shades of yellow and green, and all shades of pink. like taylor, caitlin wears the same thing day after day because her skin is sensitive; she can’t wear clothes that touch her skin too much. caitlin refuses to work with other children in the classroom. she hates recess because sounds and lights make it hard for her to breathe; when someone shouts, caitlin shakes. therefore, caitlin walks around the playground with the counselor during recess. the counselor points out how other kids interact with each other and works with caitlin on adapting to changes in routine, and behaviors that will help her to fit in better with kids her own age. caitlin has only one friend, a younger child whose mother was also a victim of the school shooting. although caitlin thinks she does not have emotions, she has a list of skills she does well, including www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 43 published by scholink inc. manners. caitlin reminds a bully at school when he doesn’t mind his manners. agency and advocacy. coping with life after her brother’s sudden and tragic death has been a struggle for caitlin, but has also propelled her down the path toward agency and advocacy. caitlin’s life has never been easy, but she is in an especially tenuous place at the opening of the book. her mother has been gone from her life due to cancer and is only a distant memory to caitlin. her brother devon, served as her anchor and advocate as she attempted to navigate the confusing world of friends, enemies, and everyone in between. after her brother’s tragic death, she could no longer rely on him to serve as her advocate. her father, unable to cope with his grief, also has difficulty trying to truly help his daughter. instead, caitlin must fill those roles for herself and learn how to become both agent and advocate while seeking closure. the most powerful way caitlin develops self-advocacy is through her memory of the varied lessons her brother taught her as they were growing up. she honors his memory by continually referring to things devon said in the past and being attentive to his voice that now exists in her head. these tips that devon imparted to her were more than just behavioral suggestions about fitting in with her peers, but larger than life lessons that shaped her into an advocate for herself as well as others who are in need. “it’s not about the dog! it’s about people! you shouldn’t hurt innocent people scout. that’s what is mean” (p. 80). caitlin searches for the intangible feeling of closure as she takes what she’s learned from devon and uses it as an agent of change in order to help herself, her father, her new friend michael, and eventually, the entire community. while she cannot dispel the cloud of grief her father is battling, she helps him face devon’s death by asking for his help in completing devon’s eagle scout project and bringing the light back into their home. “i go back in to put his shade up so the sun pours in and makes his room warm and bright and i can see dust particles in the beams of light that maybe are part of devon or maybe not but they make devon’s room look happy again... i leave devon’s door open” (p. 168). advocating for herself and for her father may be difficult, but for caitlin, empathy is a characteristic she continues to work on. her ability to advocate for her young friend, michael, is the consummate example of the next step of her growth. she is only able to advocate for a friend after she has felt empathy for him. “michael looks up at me with his bambi eyes. in them i see sadness and i think it’s fear or maybe it’s confusion. i also see friendship. and i think there’s a look that means i need to do something to help. to answer the question. i think it’s the look i gave devon. a lot” (p. 209). in the end, caitlin is able to parlay the successful advocacy for herself, her father, and michael into closure for the entire community. 3.1.3 the moral poet marcelo sandoval in marcelo in the real world is a 17 year-old with as who lives with his father, an attorney, and his mother, a nurse. he is close with his sister who lives away while attending yale. marcelo is bilingual, learning spanish from his grandmother and he talks about himself in the third person. the family represents a successful minority family with marcelo experiencing advantages of his www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 44 published by scholink inc. upper middle class upbringing such as attending an expensive private school for students with disabilities. like christopher in curious incident, marcelo is higher in cognitive functioning than most of the students at the school and he has an important role taking care of the ponies used for the therapeutic horseback riding program. marcelo wants to continue his last year of high school at the special school, but his father wants him to leave the protective environment and attend a regular public school for his senior year. to prepare for the real world, marcelo’s father arranges for him to work in his law firm during the summer. in describing his as, marcelo says, “i feel dishonest when i say i have as because the negative effects of my differences on my life are so slight compared to other kids who have as or other forms of autism and truly suffer” (p. 55). he later adds, “i always feel like i’m doing the people who have these conditions a disservice when i use the term, because then people say, ‘oh, that doesn’t seem so bad’” (p. 56). marcelo has been part of a study that is using mri technology to study the workings of his brain. his father doesn’t like it when marcelo sees the research doctor. he states that there is nothing wrong with his son; he wants to focus on marcelo being independent, self-sufficient, and learning about competition in the real world. marcelo is very introspective and intensely interested in religion and morality. he is childlike in demeanor, but tall and strong. he finds comfort in schedules and makes a daily time schedule down to the minute. he likes to be organized and keeps a notebook of rules and questions. marcelo isolates himself when possible, has difficulty when asked to do more than one thing at a time, and cannot navigate his surroundings without a map. he has difficulty with facial expressions and figures of speech. he has learned some small talk, but like ted in london eye mystery, prefers big talk, which is talk about important things. marcelo doesn’t like to be touched, and like ted, caitlin, and taylor, wears the same type of clothes every day—a short sleeve white shirt changing to long sleeves in winter. he opens and closes his fists when upset. marcelo’s co-worker and potential love interest says that marcelo has the heart of a poet. agency, activism, and advocacy. like christopher, in curious incident, this story begins with marcelo existing in a familiar routine where he feels comfortable and able to handle the day-to-day stressors with strategies he has been taught or has developed on his own. the first example of agency is presented early on when marcelo makes the decision to temporarily give up this safe world for the possibility of pursuing his dream of working full-time with the ponies after the summer. he accepts the opportunity in what is his first step toward self-advocacy, knowing that, “...after three months, it will be over, and i can be who i am” (p. 23). his summer job envelops him in unfamiliar, uncomfortable, and sometimes upsetting experiences that project marcelo toward developing a spirit of activism that not only conflicts with his father’s views, but also allows him to see beyond his world by helping someone he doesn’t know. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 45 published by scholink inc. like many activists, marcelo endures internal struggles that revolve around loyalty to his family, to himself, to those around him, and to his “pervasive interests” (p. 56). doing the right thing is something marcelo is comfortable with and understands, as it is black and white in the world he has existed in thus far. however, doing the right thing in “the real world, as his father calls it, is quite another thing. by going against his father in the pursuit of justice for a young girl who was harmed by a malfunctioning windshield, marcelo flexes his newly developed spirit of activism. as the attorney for the windshield company, marcelo’s father must come to terms with all that his son has learned and the culmination of this learning that manifests itself in marcelo’s stance in the real world. 4. discussion 4.1 agency and advocacy within the family, school or community of the six characters, three characters exhibited agency within their families. interestingly, these three characters (christopher, taylor, & caitlin) were only children in a single-parent family. the single-parents’ struggles with adult relationships played a prominent role in the storyline of these books and may have prompted the protagonists to assert their independence and detach themselves from the problems of their parents. christopher’s mother ran away leaving his father angry, confused, and keeping the truth from his son. christopher reacted strongly to his father’s “lie” and ran away from home. caitlin’s father was immobilized by the grief of recently losing his son, and his wife’s some years prior. caitlin searched for and found a way to bring closure to the situation to ease the pain of her father and others in the community. taylor’s mother had several unsuccessful dating relationships. taylor’s pursuit of a job, which she saw as a stepping stone towards independence, at times conflicted with her mother’s plans to relocate for several months to be near her latest boyfriend. the protagonists from single parent homes made life more difficult for an overstressed parent who was just barely hanging on. at the same time, they asserted themselves in an effort to take control over their own lives and make their own decisions. the protagonists’ needs for stability and structure was disrupted by outside influences, thus requiring them to advocate for themselves within the family to maintain equilibrium. however, separation and differentiation from one’s parent is a typical adolescent developmental task and a common theme in adolescent literature; it is not specific to those on the autism spectrum. the other three characters were from two-parent homes and had siblings. interestingly, these characters expressed their agency and advocacy in school or the community, rather than at home. ted solved the mystery of his missing cousin by finding him in a building ready for demolition. marcelo went against his father’s best interests to provide assistance for victims of a faulty windshield. taylor saves an older woman from drowning and becomes her friend and ally. colin solves the mystery of who brought a gun to school and exonerates a student who had bullied him for years. caitlin brings closure for her father and the community in relation to a school shooting. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 46 published by scholink inc. 4.2 agency and advocacy related to characteristics of autism talents and intense interests. the novels portray youth with asd as having islands of genius. of the four male characters, three were portrayed as interested in math, space and weather, with an intense interest in sherlock holmes making them natural detectives due to their analytical skills (christopher, ted, & colin). similarly, marcelo investigated to find the truth about his father’s law firm. all four of the male characters had an unwavering need to find the truth. like caitlin and her intense desire to find closure, this need drove the storyline. christopher counted prime numbers when afraid; taylor counted the number of words people said. taylor was interested in science; especially plants and animals, in particular gerbils. she was also a good artist, as was caitlin. caitlin and marcelo loved reading; marcelo had a particular interest in reading and discussing religious texts. while not everyone with asd is especially skilled at math or deductive reasoning, the authors of the yal included in this review did not go too far by portraying any of the characters as autistic savants, which represent less than 10% of the autistic population (edelson, n.d.). however, the characters in this review were verbal and had special interests that were more intense than the interests of their peers. their special interests were used in the plot to help the protagonists overcome obstacles and to assert themselves in dilemmas that highlight typical teenage identity issues (robinson, 2012). these yal protagonists had more in common with typical peers of this age than they had differences. language and communication. all six characters were verbal, but were described as having difficulty with social communication. telling the truth was a major plot theme in four books, curious incident, london eye, colin fisher and marcelo in the real world. all of the characters were portrayed as misunderstanding idioms, which was used to provide light-hearted comedy. the protagonists’ difficulty with figurative language was used heavily in all of the books to paint a picture of a quirky, highly intelligent individual, who understood language and had a complete vocabulary, but was very literal in interpretation and frequently made social faux pas. this underscores the similarities these characters have with their adolescent peers who are often embarrassed by their own social missteps. well-written first-person descriptions may influence young people’s beliefs by promoting awareness and empathy of what a young person with asd experiences (miller, 2013). despite social challenges, especially when the characters interacted with those outside of the family and/or comfort zone, the figurative language barrier did not keep them from advocating for their cause or taking action to meet their goals. sensory sensitivity. the novels describe sensory sensitivity from a first-person perspective quite well. the characters described how sights and sounds made their heads spin, or feel full; made them feel sick, or made it hard to breathe; all symptoms of anxiety. all characters were highly sensitive to sound, touch, and/or texture. this could provide information to peers as to why youth with asd become agitated (e.g., meltdowns, tantrums) and/or non-responsive (withdrawing into themselves, self-stimulatory behavior) in www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 47 published by scholink inc. situations where there is an overabundance of sensory stimulation. armed with this information, peers may be more understanding, accepting, and supportive of their classmates with asd. as the protagonists moved into uncharted territory, they were forced to support themselves through the use of learned coping strategies and calming techniques. caitlin called one of her strategies stuffed-animaling. when things would get blurry because of too much stimulation, she would blur all the colors and shapes together so they “change into fuzzy and warm instead of sharp and cold... if you take the monkey bars and the people and blur them together they get soft and fluffy and kind, just like a stuffed animal” (pp. 27-28). taylor would consciously push her anger down through her feet and out into the floor. christopher recited prime numbers in his head, marcelo searched for his internal music, and colin bounced on a trampoline. several characters relied on deep breathing and pressing their palms together. our protagonists provide examples of digging deep and using self-regulatory strategies to approach situations that were markedly uncomfortable. similar to typically-developing adolescents, our protagonists were faced with situations where they demonstrated independence and advocated for themselves. our characters showed the reader that perseverance and keeping an eye on the prize is worth even extreme effort and discomfort. they endured great physical anxiety and pain to achieve their objectives that included finding the truth, healing a community, seeking justice, and solving a mystery in the nick of time to save a life. 5. conclusion the books reviewed provided positive images and may challenge ablism/disabling attitudes (beckett ellison, barrett, & shah, 2010). for the protagonists in this review, their skills were valuable and helped others. the characters with disabilities are portrayed as an interesting curio, quirky geniuses, who are sensitive to sounds, light, and are thrown off by changes in routine or in the environment. readers do get an insider’s view into why sensory stimulation and changes are upsetting. most of the characters discuss how they learned to deal with the challenges. the insider’s view also includes glimpses into how students are teased for their differences, which may promote empathy in the young people reading the books. empathy is not the only thing readers may garner from these books. young adults may also learn the importance of activism—not only as a way to elicit change in their schools and communities, but also in their own lives. like their peers in the novels, readers may begin seeing themselves as potential agents of change as reflected in the actions and words of their peers with autism. young adults may learn to take the perspective of a student with asd, and can advocate for students they encounter. just as important as advocacy is, the idea of more empathy leading to more acceptance is a powerful one. while each of these books has its unique characters and its own plot, the common thread of agency, activism, and advocacy is a strong message for all young people. www.scholink.org/ojs/index.php/ct children and teenagers vol. 2, no. 1, 2019 48 published by scholink inc. references beckett, a., ellison, n., barrett, s., & shah, s. (2010). away with the fairies? disability within primary-age children’s literature. disability & society, 25(3), 373-386. https://doi.org/10.1080/09687591003701355 bucher, k., & manning, m. l. (2014, may 5). qualities of young adult literature. retrieved from http://www.education.com/reference/article/qualities-young-adult-literature/ centers on disease control and prevention. (2015). autism spectrum disorder. retrieved from http://www.cdc.gov/ncbddd/autism/research.html centers on disease control and prevention. (2016). community report on autism from the autism and developmental disabilities monitoring (addm) network. retrieved from http://www.cdc.gov/ncbddd/autism/documents/community_report_autism.pdf clinton, j. (2014, july 20). “i hate writing most of the time”, says author mark haddon. express. retrieved from http://www.express.co.uk/entertainment/theatre/489747/author-mark-haddon-on-curious-incide nt-of-the-dog-in-the-night-time individuals with education improvement act. (2004). building the legacy: idea 2004. retrieved from http://idea.ed.gov irwin, m., goldsmith, a. y., & applegate, r. (2015). the real deal: teen characters with autism in ya novels. journal of research on libraries & young adults, 6. retrieved from http://www.yalsa.ala.org/jrlya/2015/04/the-real-deal-teen-characters-with-autism-in-ya-novels/ jang, j., matson, j. l., adams, h. l., konst, m. j., cervantes, p. e., & goldin, r. l. (2014). what are the ages of persons studied in autism research: a 20-year review. research in autism spectrum disorders, 8, 1756-1760. https://doi.org/10.1016/j.rasd.2014.08.008 miller, d. l. (2013). literature opens doors for all children. kappan, 94(4), 28-33. https://doi.org/10.1177/003172171209400409 murray, s. (2010). autism functions/the function of autism. disability studies quarterly, 30(1). https://doi.org/10.18061/dsq.v30i1.1048 robinson, t. (2012). inspecting the trend of autistic-spectrum characters. retrieved from http://www.npr.org/2012/11/18/164207965/inspecting-the-trend-of-autistic-spectrum-characters children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 3, no. 2, 2020 www.scholink.org/ojs/index.php/ct 11 original paper religiosity and adolescent females’ characterizations of healthy dating dynamics donna howard1*, katrina j. debnam2, chandria jones3, zahra saboori1, nancy aiken4 & sharon o’brien5 1 university of maryland school of public health, college park, united states 2 university of virginia school of nursing, charlottesville, united states 3 westat, rockville, united states 4 counseling helpline and aid network, baltimore, united states 5 catholics for family peace, severna park, united states * donna howard, university of maryland school of public health, college park, united states received: july 16, 2020 accepted: july 28, 2020 online published: august 19, 2020 doi:10.22158/ct.v3n2p11 url: http://dx.doi.org/10.22158/ct.v3n2p11 abstract in this study, we utilize the socialization influence framework to examine how personal religiosity may influence adolescent dating dynamics. we conducted fifty in-depth interviews with adolescent females aged 15-18 attending high schools in a mid-atlantic city. six broad themes characterizing healthy dating dynamics were identified: investment in the relationship; healthy communications; harmonious interactions; non-destructive dynamics; relations with family, friends and others; and maintenance of personal integrity. differences in characterizations emerged in relation to the degree of personal religiosity. findings have implications for faith-based initiatives and efforts to promote positive youth development. the process by which internalization of religious beliefs may also translate into risk for unhealthy dating dynamics remains an important area of study. keywords adolescence, religiosity, teen dating relationships 1. introduction u.s. national data suggest that adolescents consider religion as an important factor that operates invisibly in the background of their lives (sinha, cnaan, & gelles, 2007; smith & denton, 2005; fletcher & kumar, 2014). as discussed by rostosky and colleagues (2004) in their review of longitudinal studies assessing the impact of religiosity on adolescent sexual behavior, an examination of the potentially www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 12 published by scholink inc. important role of religiosity on adolescent romantic relationships; specifically, on the initiation, maintenance and quality of these relationships is notably absent (rostosky, wilcox, wright, & randall, 2004). research is needed to better understand the mechanisms by which religiosity, as a personal belief system and cultural context, influences adolescent psychosocial development, specifically in dating dynamics. 1.1 religion as a protective mediator of teen risk behavior the role that religion plays in protecting adolescents from risky behavior is not fully transparent, mainly due to inconsistent definitions and operationalization of the construct (benson, roehlkepartain, & rude, 2003; wong, rew, & slaikeu, 2006). definitions of religion range from an affiliation with denominational or worship practices, to prayer and religious service attendance (howard, qiu, & boekeloo, 2003; levin, larson, & puchalski, 1997). in addition, measures of religiosity include religious involvement, salience of religion and faith, religious affiliation, frequency of prayer, and religious identity (cotton, zebracki, rosenthal, tsevat, & drotar, 2006; lopez, huynh, & fuligni, 2011). religious involvement among adolescent heterosexual females is associated with reduced binge drinking and substance use, and is protective against heavy episodic drinking during adulthood (drabble, trocki, & klinger, 2016; michalak, trocki, & bond, 2007). in addition, literature reviews of studies published between 1980 and 2015 suggest that religious involvement is associated with delayed sexual debut, positive mental health outcomes, and decreased likelihood of premarital sex, alcohol, and drug use (cotton et al., 2006; rostosky et al., 2004; wong et al., 2006). in one study, religiosity was a significant protective factor in buffering the association between adolescent dysfunctional dating attitudes and substance use (tharp, dewall, richman, & noonan, 2014). religious involvement (e.g., participating in religious services) may reinforce social norms and provide social support for adolescent engagement in pro-social behaviors (lippman & michelsen, 2004). involvement with religious congregations offer adolescents unique opportunities to engage in group activities and learn new life skills, many of which can reinforce certain psychosocial outcomes (hardie, pearce, & denton, 2016). messages from parents, clergymen, other congregants, and peers can mediate adolescent risk behavior and outcomes by highlighting personal values and attitudes that are disapproving of alcohol, drugs and sexual activity (barton, snider, vazsonyi, & cox, 2014). 1.2 religion as a potential risk factor for negative adolescent health outcomes although religion is readily recognized as a protective factor, there is also evidence that religious doctrine can result in feelings of guilt which is then used to enact power, control, and harm (koenig, king, & carson, 2012). for example, pearce and colleagues (2003) found that negative interpersonal religious experiences (i.e., negative and/or critical demands from their religious congregation) was associated with greater levels of depression in a sample of adolescents. additionally, negative religious coping, defined as conflicts relating to spirituality or conflicts with god (pargament, koenig, & perez, 2000), has been www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 13 published by scholink inc. associated with increased levels of anxiety, depression, obsessive-compulsiveness, and somatization (mcconnell, paragment, ellison, & flannelly, 2006). specific to adolescent relationships, some theological doctrines suggest that the roles of males and females are not only specific and hierarchical but also must remain to prevent moral chaos (nienhuis, 2005; nason-clark, 2000). while religious doctrine and practices may protect women, they may also serve to encourage males’ dominant behavior and females’ submission to men, which may lead to unhealthy dating dynamics. these observations raise questions as to whether certain religious beliefs or attitudes may be associated with staying in relationships that are emotionally, physically, and/or sexually unhealthy or harmful. in their systematic review of research on adolescent religiosity, wong and colleagues argue that investigation is needed on the potentially negative dimensions, such as religious guilt and depression (from feeling criticized by their religious communities), as it may negatively impact mental health and interpersonal dynamics (wong et al., 2006). 1.3 the present study given the complexity of adolescent dating attitudes and behaviors, we utilized the socialization influence framework (sif) to guide this research (wallace & williams, 1997). the sif identifies multiple domains of socialization influence and mechanisms that shape adolescent health-related attitudes, beliefs, and behaviors. in this framework, religion operates as a secondary socialization influence, which assists adolescents in fostering certain beliefs, values, and lifestyle patterns, and in turn influences behavior (wallace & williams, 1997). the present study is part of broader research which aims to better understand how conceptualizations of healthy and harmful dating relationships are formed by religious socialization and whether such socialization may be related to risk of, or protection against, teen dating violence (tdv) victimization. this paper focuses specifically on personal religiosity, which is a measure of internalized religious values and identity, and a key construct within the sif. the specific aims of this study include: 1) identify themes associated with adolescent females’ ideas of healthy teen dating dynamics; 2) gain an understanding of how personal religiosity shapes adolescent females’ conceptualizations of healthy dating relationships; 3) examine similarities and differences in conceptualizations of healthy dating relationships that emerge based on the degree of personal religiosity. while qualitative data does not afford an opportunity to test mediation (nor construct a structural equation or examine power), it does allow for stratified analyses, which we conducted to determine whether differences emerge in the characterizations of healthy dating relationships by degree of personal religiosity. 2. method 2.1 eligibility and recruitment the research team was comprised of the principal investigator (pi), counselors, and educational www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 14 published by scholink inc. psychologists who head community-based organizations focused on female victims of domestic violence. doctoral, masters, and undergraduate students enrolled in an academic public health program also participated in the research process. the sampling frame consisted of adolescent females aged 15-18 years who were recruited from public, private, secular, and religious high schools from a u.s. mid-atlantic state. the research team selected interested participants through purposive sampling in order to construct a sample with religious and ethnic diversity. the sampling frame purposively included religious and secular schools to inductively capture a range of personal religiosity levels from diverse educational settings. sampling, recruitment, and interview protocols received approval from the [blind for review] institutional review board (irb). eligibility criteria included: (a) female high school student between the ages of 15 and 18 years old; (b) enrolled in a participating high school; (3) agreed to have the interview digitally recorded. participants self-identified their race/ethnicity and grade level during the eligibility process and again in a socio-demographic survey completed prior to the interview. we employed a tri-pronged recruitment strategy to gain approval and support of the community of parents, principals, teachers, and students. first, we held meetings with the school principals, guidance counselors, and teachers at each school to discuss the aims, logistics, and protocol of the study and to garner their support/involvement. second, informational sessions took place during school hours and in the evening for interested students and parent/guardians at each school. announcements with the date and time of the informational evening sessions were sent home to parents in monthly school newsletters. project staff provided an overview of the study, distributed packets with program information (parental consent and youth assent forms), and were available to answer questions during these meetings. third, we utilized passive recruitment methods, which included the following: flyers posted throughout each school, program announcements in school newspapers, newsletters sent to students’ homes, emails sent via the school listserv, word of mouth, and snowball sampling. all recruitment materials included a telephone number, which connected interested students to a member of the research team who used a standardized script to determine the eligibility of callers, discuss the informed consent process, and check availability for scheduling an interview. if parents or teens seemed hesitant to participate, the staff implemented an additional script, per recommendations by smith and denton (2005). this script provided more information about the project and offered a phone number for the pi whom parents or teens could call with questions or concerns. 2.2 conduct of interview prior to conducting the interviews, all interviewers participated in a training session that covered the following: logistics of the interview; irb concerns/protection of human subjects; safety and liability issues; review and discussion of the interview guide; and the proper use of recording equipment. upon receiving consent from their parent/guardian, the interviewers conducted semi-structured one-on-one www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 15 published by scholink inc. interviews with adolescent females in a private room at their school. in order to maintain the confidentiality of participants, each school received information of the date and time of the interviews but did not receive any identifying information on the participant. all interviews lasted approximately 1-1.5 hours. if a participant disclosed that she or someone she knew was in danger during the interview, we employed an irb protocol to determine the nature and degree of harm and the need for further reporting and notification. all participants received an incentive “gift” bag that contained: a list of local and national hotlines, websites that address teen dating violence, and a 20-dollar incentive. 2.3 the interview guide the research team developed the interview guide to explore females’ perceptions of healthy and unhealthy dating relationships and the role of different socialization spheres (family, neighborhood, school, faith-based organizations and media) in shaping those perceptions. specific to this paper, participants were asked “what do you value in a dating relationship?” and “what makes a relationship healthy?” we used probing follow-up questions to elicit a detailed description of participants’ perceptions of a healthy relationship. for example, if the participant responded that she believed the trust was important in a healthy relationship, one follow-up question was “can you describe what you mean by trust?” 2.4 personal religiosity index we embedded a series of 5 closed-ended questions in the interview guide to facilitate the construction of a personal religiosity index. this personal religiosity index expands upon the measure used by jang and johnson (2001) and rostosky, regnerus, and wright (2003) and follows the recommendations of sinha, cnaan, and gelles (2007) with the inclusion of a critical question on religious beliefs. the scale has adequate internal consistency (α = 0.69), based on data from wave 1 of the national longitudinal study of adolescent health (add health) (halpern, oslak, young, martin, & kupper, 2001). two questions asked participants about their personal religious beliefs. using a 5-point likert scale (strongly agree to strongly disagree), participants were asked: “i don’t need religion to have good values” and “god has nothing to do with what happens to me personally” (manlove, terry-humen, ikramullah, & moore, 2006). a third question asked, “what role does religion play in your life?” the response format included a 5-point likert scale ranging from “very important” to “not at all important” (johnston, bachman, & o’malley, 2008). the remaining two questions asked participants to rate their frequency of attendance at religious services/activities and prayer use. these questions included: “do you participate in religious activities/programs/services? if so, in an average year how often do you engage in these activities?” and “how often do you pray?” response choices for both were “once a week or more”, “monthly”, “yearly”, or “less than yearly” (zelnick, kanter, & ford, 1981). we constructed a tri-chotomized religiosity variable to stratify participants into groups that were labeled “high”, “moderate”, and “low” personal religiosity. high religiosity consisted of a response of www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 16 published by scholink inc. “strongly disagree” or “disagree” to the 2 religious beliefs questions, “very important” or “somewhat important” to the question on importance of religion, and “once a week or more” to the question on frequency of attendance at any religious services/activities and prayer. responses of “neutral”, “strongly agree”, or “agree” to the religious beliefs questions, “neutral”, “not at all important”, or “somewhat unimportant” to the importance of religion question, and “less than yearly” or “once a month or less” to the questions on frequency of attendance at any religious services/activities or prayer placed participants in the low religiosity group. the remaining responses were identified as moderate religiosity. participants were grouped into high, moderate, and low groups based on their responses across the individual items. participants in the high religiosity group (n = 4) recorded “high” responses on all 5 religiosity items. girls in the low religiosity group (n = 6) reported “low” on all 5 religiosity items. girls who recorded mixed ratings of “high” and “low” on the religiosity items were included in the moderate religiosity group (n = 40). 2.5 data analysis in order to ensure the dependability and reliability of our qualitative data, we employed strategies developed by devers (1999). we transcribed audiotapes of interviews and entered word documents of each transcription into atlas.ti (atlas.ti, 6.1 ed, 2010). data analysis occurred in a series of phases. first, we created a codebook based on constructs of the sif model and other terms and concepts extracted from repeated reading of the transcripts. all codes were given operational definitions. we included codes such as “healthy”, “gender roles”, “partner characteristics”, and “unhealthy/harmful” to capture the perceptions of healthy dating relationships. phase 2 included coding the transcripts. to ensure reliability and validity of the codebook, a primary and secondary coder independently coded two transcripts. these coders then met with the pi to review and revise codebook terms and definitions. once we finalized the codebook, the coders and pi reviewed the first 10 transcripts twice to ensure consistent agreement. the primary coder coded the remainder of the transcripts. the secondary coder also reviewed coded transcripts after every 10 transcripts to ensure inter-rater reliability of the coding process. systematic coding of transcripts in atlas.ti reduced the interview data into meaningful narrative segments associated with specific codes. we stratified transcripts based on the high, moderate and low religiosity index. within each of these strata, we conducted specific queries in atlas.ti using the “healthy” codebook term. we analyzed all narrative passages within each personal religiosity strata individually to identify emergent themes. we then used an iterative process of reading and rereading the narrative passages to increase comprehension, forming subcategories and categories from the themed data to capture context and dimensionality (miles & huberman, 1994). finally, we compared themes across personal religiosity groups to determine similarities and differences among the depictions of healthy relationship characteristics. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 17 published by scholink inc. 3. results the final sample included 50 adolescent females, the majority of whom were 16 (40%) or 17 (34%) years of age (m = 16.41, sd = .86). participants self-reported their race, ethnicity, grade, and other demographic information. participants self-identified as white (46%), black (32%), mixed race (16%), and hispanic or latino (6%). by grade classification, 42% of the participants were juniors, 36% were seniors, and 22% were sophomores. 20% of the participants attended a public coeducational school, 40% attended an all-girls roman catholic school, 20% attended an all-girls private independent school, and 20% attended a coeducational jewish community school. qualitative analysis led to the identification of six broad themes and 17 sub-themes that characterized healthy dating dynamics. the high religiosity group endorsed 53%, the moderate religiosity group endorsed 94%, and the low religiosity group endorsed 71% of the sub-themes. overall, the high religiosity group endorsed 18% fewer themes than the low religiosity group and 41% fewer than the moderate group. descriptive differences in the narrative discourses emerged based religiosity (see table 1). quotations in this section include the participants’ age and religiosity group. table 1. healthy dating relationship themes by degree of personal religiosity degree of personal religiosity high (n=4) moderate (n=40) low (n=6) investment in the relationship · staying power x x · provision and receipt of social support x x healthy communication · open, easy, ongoing communication x x x · honest and authentic communication x x x · conflict resolution x x harmonious interactions · compatibility x x x · reciprocity x x x www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 18 published by scholink inc. · caring and affectionate x · not rushing into sex x x non-destructive dynamic · faithful and trustworthy x x x · non-abusive x x interactions with others · family x · friends x x x · pride in relationship x maintenance of personal integrity · self-assured x · autonomous x x · self-respecting x x x total # of sub-themes endorsed 9 16 12 percent 53% 94% 71% 3.1 investment in the relationship investment in the relationship encompassed two sub-themes: staying power and provision and receipt of social support. 3.1.1 staying power staying power reflected the participants’ desires for a sustainable relationship and their recognition of the work this required. key characteristics of staying power included “accept[ing] the hard times” and trusting that the other person would be there because of a shared commitment to the relationship. staying power manifested in the participants’ comments about “standing up for” or defending one’s partner or behaving in a way that demonstrates that the relationship is a priority. participants used key adjectives, such as “patience”, “loyalty”, and “tolerance” to describe the currency of “investment” in the relationship’s sustainability. both high and moderate religiosity groups addressed ideas about investing www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 19 published by scholink inc. in the relationship through staying power. indeed, a key conviction that resonated across their interviews was that one should not leave a relationship when it gets tough and instead should be committed to working things out. as one participant said: “like i feel like if you really think you’re mature enough to have a relationship, you have to work at it. and i mean an actually dating relationship, not friends with benefits anything like that…like something that you can work out; you’re not just going to leave it when it gets tough. and i feel like a relationship should be like life, you handle it a bit at a time and you work at it (15, moderate)”. participants with high personal religiosity described a healthy dating relationship in ways that suggest a type of true grit and tenacity that had multiple points of reference: “like a healthy relationship is something where people actually want to hang out with each other, be with each other, talk to each other, like effort in the relationship (15, high)”. participants with moderate personal religiosity expressed a similar concept when describing staying power. an important element was being “loyal”, which reduced worrying, showing “unity” and being “equals” which encouraged each partner to take initiative and make plans: “committed, like both of us are willing to work together, being each other's equal and be able to, you know, be with each other, tolerate each other, not fight every day, that's not healthy for anyone…be able to work things out, be able to work with each other (17, moderate)”. 3.1.2 provision and receipt of social support the sub-theme of provision and receipt of social support captured the participants’ descriptive and dimensional characterizations of healthy dating relationships in terms of reciprocal, emotional and instrumental assistance, advice, and appraisal. this comment by one participant summed up the varied utilities provided by a relationship: “…like if the person gives you good advice or they help you like they benefit your life in some way they help you with advice or maybe they are helping you with your homework or maybe they are helping you get a job or maybe they are just a good person to be with, to talk to, maybe they make you feel better about some stuff, so that you both benefit from the relationship (15, moderate)”. emotional support reflected the amount of “empathy” from dating partners and involved a willingness to “confide in” each other. comments about being sympathetic to each other’s needs and struggles reflected this concept. one participant mentioned, “i think that a healthy relationship involves…i guess you can confide in somebody (16, low)”. instrumental support refers to help, aid, or assistance with tangible needs that the participants would receive (langford, bowsher, maloney, & lillis, 1997). the ability to help each other was described as a valued characteristic of a healthy dating relationship. participants mentioned their partner being physically present to provide concrete assistance, such as helping with homework or helping to prepare for a job interview or application. appraisal support differs from instrumental support in that it relates to www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 20 published by scholink inc. help with decision making, giving appropriate feedback, or deciding which course of action to take (langford et al., 1997). as one participant put it, “…you supported the other person’s decisions. you’re encouraging of any decisions that they make, and you would hope that they do the same for you (17, moderate)”. informational support denotes the provision of advice or information in the service of particular needs (langford et al., 1997). participants discussed this in the context of giving advice to each other, based on ‘common principles’ of attentiveness and good listening skills. support in the form of “good” advice was seen as an asset in the relationship. one participant noted: “and if you do have advice, give it to them…(16, moderate)”. participants within both moderate and low personal religiosity groups explicitly discussed how the provision and receipt of social support was an important characteristic of a healthy dating relationship. this was not overtly mentioned by those with high religiosity. 3.2 healthy communication healthy communication included the sub-themes of open, easy, ongoing communication, honest and authentic communication, and conflict resolution. open, easy, ongoing communication dynamics were described as integral to a healthy relationship. participants used adjectives such as “honest”, “regular”, “open”, and “authentic” to characterize the form and substance of these communications. the following responses from participants across the personal religiosity spectrum underscore the importance of communication in a healthy dating relationship: “um, communication is really important because that way the female and the guy are on the same page as to what they want out of their relationship…(16, high)”; “um, communication definitely is a top thing because without communication you are going nowhere (16, low)”. another participant mentioned: “healthy? um when they communicate. i think communication is a major factor in a relationship that everybody should have for the relationship to move forward. because without communication, you really don’t have anything (18, moderate)”. 3.2.1 open, easy, ongoing communication participants across all levels of personal religiosity described open, easy, and ongoing communication as “talking to each other”. indeed, this was the central characterization among participants with high personal religiosity. in contrast, participants with moderate personal religiosity were more expressive in describing healthy communication as a key dynamic in healthy dating relationships. these participants noted that various forms of communication—whether it is in-person, via email, or through pictures being sent to each other—were equally acceptable if there was a “connection” and they were able to “express feelings”. conversations that were “fun”, “laid back”, and “not so serious” were described in a positive light that “leads to a comfortable feeling”. being able to talk about different “stuff” without it being “problematic” exemplified open, easy, ongoing communication for participants within the moderate personal religiosity group. communication that did not involve argument, “fighting over little things”, or “being at each other’s throat” allowed them to share their feelings with the other person. one participant www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 21 published by scholink inc. mentioned: “okay a healthy relationship would be talking to each other every day, um having things in common…being understanding of what the other person wants and what the other person needs and um just trusting the person and being very honest with the person and then enjoying all your time together and that’s pretty much all (17, moderate)”. 3.2.2 honest and authentic communication while there was overlap between the sub-themes under healthy communications, honest and authentic communication seemed to underscore critical elements of a healthy dating relationship. it included frank conversations about feelings that lead to a better understanding of the other person and contributed a healthy relationship. this type of communication was characterized as follows: “if you’re mad at him or her for something and you just stay mad at them but you won’t tell them what the problem is then you’re going nowhere (16, low)”. “not lying” exemplified honest and authentic communication for participants with high personal religiosity. participants with moderate personal religiosity spoke about “expressing one’s feelings” and “not withholding anything”. for these participants, it was very important to be able to “be yourself” and not pretend or try to maintain an image that was not really you. “authenticity” was an adjective they repeatedly used in the context of “being true to oneself and knowing who you really are”, “no pretense”, so that you communicate openly (i.e., “speaking your mind”) and honestly with the other person. it also conveyed their belief that a healthy relationship has to not only include disclosure but a fundamental understanding that you can believe what your partner tells you. 3.2.3 conflict resolution it was important for participants within the moderate and low personal religiosity groups to feel that they could express themselves without fighting or arguing and that conversations would flow easily, not be forced or awkward but instead allow mutual sharing. among participants with low personal religiosity, the amount of time spent talking to the other person was important. communication that did not involve arguing, “fighting over little things” or “being at each other’s throat” allowed them to share their feelings with the other person. in giving their view of healthy communication, participants acknowledged that arguments do occur in dating relationships and they needed to be addressed through conflict resolution than be ignored. the participants noted that good communication skills are often necessary to work through “obstacles” and solve problems. although participants with high personal religiosity did not talk much about conflict resolution, they did discuss the importance of being able to “get over arguments” in order to have healthy communication. this was expressed as follows: “if both people are happy. like, if people can get along and get over arguments, like, then that’s pretty much the general (16, high)”. participants with moderate religiosity were much more descriptive about the dynamics of conflict resolution. they recognized that obstacles will arise and spoke about problem solving, acknowledging that differences need to be addressed in order www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 22 published by scholink inc. to “make it work”. they even articulated what would appear to be a set of principles or ground rules for conflict resolution: 1) the importance of getting along or working together; 2) not yelling even when one was upset; and 3) putting effort into the relationship to make it work when distance was a factor. participant with low religiosity did not mention conflict resolution when describing healthy dating relationships or even in the context of their discussion of communication. 3.3 harmonious interactions harmonious interactions included four sub-themes: compatibility; reciprocity; caring and affectionate; and not rushing into sex. 3.3.1 compatibility compatibility reflected the ability to get along with the other person to the point of truly enjoying his or her company. wanting to “hang out with each other”, being “tuned in to each other”, and “fitting together” exemplified compatibility. participants mentioned the importance of getting to know the person and trying new things together. overall, participants felt it was essential to spend time together and accept each other, as in “not trying to change them” and/or being “willing to do what each other likes” for the relationship to be healthy. as one participant put it: “… healthy relationship umm just really be able to…do stuff have it doesn’t even have to have the same interest but as long as they’ll be willing to do what you like also…(17, high)”. participants within the high religiosity group highlighted the ability to get along and the desire to be around one’s partner using adjectives such as “sleep well”, “smiles”, and “being fed into”. the moderate religiosity group used unique adjectives like “good person” and "strong”, in addition to referencing “flaws”. only the moderate and low religiosity groups mentioned the term “best friends”. moreover, in the low religiosity group, compatibility included “not moving quickly”. the following quotes are illustrative: “um being in tune with the other person…knowing of the other person’s quirks and downsides, will allow you to see them and look past them. so i think you should discover all of each other's flaws before something happens and you notice something and it kills everything” (17, moderate); and “i don’t think you should just jump right into a relationship and when you dating’em, you should get to know’em better. like, because y’all have that relationship…like, y’all should be best friends as you get further into the relationship (16, low)”. 3.3.2 reciprocity reciprocity overlapped somewhat with compatibility but uniquely conveyed a clear sense of bi-directional dynamics. specifically, it reflected participants’ sensibility that a relationship requires give and take and doing what the other person may want, even if it is not always your preference. participants expressed that it was important to make the person “feel stronger”, to enable the relationship to flourish. one participant noted: www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 23 published by scholink inc. “i feel like both people should make the other person stronger instead of like not weaker cause the relationship in thriving would make both people feel better and they would feed off of each other and then it would just make the relationship better so (15, moderate)”. the notion of mutuality and give and take was most evident among the high and moderate religiosity narratives. participants with high religiosity spoke about what healthy relationships should not be, i.e., “not greedy”, “not selfish”; whereas participants with moderate religiosity repeatedly referred to mutuality in “feeling”, “effort and commitment”, “happiness”, “respect”, and “time”. one participant cogently put it as follows: “just have everything mutual because if one person is putting more effort into the relationship than the other, then what’s the point of doing it. in the end, that person is just going to leave (17, moderate)”. participants within the low religiosity group described how the other person should be “good to you”, and they also spoke about mutuality as in “mutual feelings about the relationship”, and: “yeah. um, i don’t know, it could like, share feelings with them, or and he doesn’t cheat on you, and hmm, you feel like he’s like good to you and just not abusive verbally or… (18, low)”. 3.3.3 caring and affectionate caring and affectionate only really emerged as a sub-theme among participants with moderate personal religiosity. they were quite expressive in this regard. the participants characterized healthy relationships as including public displays of affection with statements such as: “we are together”, having “physical chemistry” and “strong feelings” but emphasized that this was “not just for sex”. they described caring as “more than just words”, “doing cute little things”, “royal treatment”, being loving and kind, and remembering events. aspects of affection, physical chemistry, and physical attraction were displayed through kissing, hugs, hand holding; that is, showing love non-sexually, and public displays of affection. caring, however, was described as something much deeper than the physical plane, as is expressed in this quote: “if you care about each other a lot and really actually care and not just say you do…you have to actually be willing to do almost anything for that person. i mean, not like anything, but just like if something is important. maybe he’ll cancel his plans for you or something important because he wants to be with you…(17, moderate)”. 3.3.4 not rushing into sex only participants within the moderate and low religiosity groups described not rushing into sex as a characteristic of a healthy relationship. participants with high religiosity did not explicitly mention sex. not rushing into sex was seen as demonstration of respect for the participant and respecting the participants’ “bodies and space, ideas and goals”. participants with low personal religiosity made a singular reference to not rushing into sex as not wanting to be pressured or rushed into sex, especially before marriage. one moderate religiosity participant described this dynamic as follows: “these couples, that's the one probably the only consistent trend is that they don't rush into sex. they don’t rush into love. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 24 published by scholink inc. they just kind of enjoy each other’s company and don't even rush into saying “oh we're together (17, moderate)”. 3.4 non-destructive dynamic another major theme that emerged was the notion of a non-destructive dynamic, which encompassed two sub-themes: faithful and trustworthy and non-abusive. indeed, as one participant stated: “i think like if you guys trust each other i think that’s like onelike the most important thing for like a healthy relationship (15, moderate)”. 3.4.1 faithful and trustworthy a faithful and trustworthy dating relationship was described as when the other person was honest and accountable; that is, their words could be trusted to be “truth” worthy. “trust” and being “faithful”, or “not being unfaithful”, were frequent adjectives used to describe a healthy dating relationship. with such a foundation, participants felt their partners would be “dependable” and would not “question their loyalty”. a key characteristic of faithful and trustworthy was “not cheating”. this referred to “being faithful” to the other person and to the relationship. while participants across all three levels of personal religiosity described faithful and trustworthy as an important characteristic for a healthy dating relationship, participants within the high religiosity group characterized this as “not having a double standard … saying one thing and doing something different”; i.e., “going where you say”. as one participant mentioned: “trust. like, if a guy tells me ‘okay, i’m going to go to this place and that place and i’ll be back’, then i’m going to trust him. i have no reason not to trust you unless you’ve lied to me and then i just can’t trust you because if you lied to me once, you’ll lie to me again. i mean that kind of goes for me too; there shouldn’t be a double standard in any relationship (16, high)”. the comment of one participant summed up the sentiments of many of the participants: “i feel like the most important thing in a relationship is trust like i feel like if you can’t trust the person then you can’t be comfortable with the person because you’re always wondering you know ‘what if this’, ‘what if that’ (18, moderate)”. participants with both high and moderate personal religiosity, discussed trust as follows: “trust that you have the best interest [and are] not self-motivation” and “trust that you have no reason not to trust [the other person]”. participants with low personal religiosity were less descriptive about the idea of trustworthiness but said things such as “doesn’t cheat on you” and “don’t keep elaborating”. the latter seemed to be a red flag or indication of one partner having something to hide or trying to rationalize a dynamic. 3.4.2 non-abusive many participants spoke about what would not be characteristic of a healthy dating relationship. being non-abusive included little to no fighting, “no hitting”, “no hands”, and “no physical, mental, emotional, www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 25 published by scholink inc. or verbal abuse”. the moderate and low religiosity groups acknowledged not being partner to an abusive dynamic. they appeared well-aware of the multi-dimensional nature of abuse (physical, mental, and emotional). the following quotes are illustrative: “um...not hitting each other, and like, physical-wise if you get mad, oh, slap him or if she gets mad, hit her. that’s just not healthy at all (15, moderate);” “…belittling them with low blows essentially, with low blows meaning like inappropriate sayings or things that you know will hurt their feelings…(18, moderate);” “yeah. um, i don’t know, it could like, share feelings with them, or and he doesn’t cheat on you, and hmm, you feel like he’s like good to you and just not abusive verbally or…(18, low)”. participants within the low religiosity group stressed the importance of not being controlled. one participant noted that a healthy dating relationship does not dictate what you can do or does not try to change who you are. “like, like let’s say you wanna like go out with your friends on saturday night and not see him for one night and he’s like you know, not letting you go, or let’s say you wanna, like have a job, and he wants you to stay home. and he like dictates what you do (18, low)”. 3.5 interactions with others interactions with others included three sub-themes: relationship with family, relationship with friends, and perceptions by others. 3.5.1 relationship with family relationship with family only emerged from the interviews with participants of moderate personal religiosity. however, what they said was noteworthy. these participants characterized a healthy dating relationship as one where their partner would “respect me and my parents” and know their family. the participants noted that family history “helps figure out what’s healthy and what is unhealthy” and that “knowing one’s parent’s background” was important. one participant mentioned: “i think the perfect dating relationship is um like they can trust each other, like they have met their parents, they know their parents, their parents trust both of them to be together without doing anything they don’t supposed to be doing…(17, moderate)”. another said: “i guess just knowing like their background or stuff at least just knowing where they come from. and like if you see what type of parents they have or where they live or…that will explain to you like other reasons like, “well that’s why he does that” or “well that’s why he dresses like that” or does this or does that (16, moderate)”. 3.5.2 relationship with friends all participants viewed relationship with friends such as “getting along with friends” and “respecting them” (i.e., one’s friends) as vital to a healthy dating relationship. participants underscored the importance of a bi-directional dynamic for respect: “my friends respect the guy…the guy respects my www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 26 published by scholink inc. friends”. one participant mentioned, “respect that they are my friends and he can’t say anything rude about them because that’s like saying something rude about me. my friends reflect kind of who i am and so..., they need to respect my boyfriend (16, high)”. participants within the high religiosity group felt that it was really important that anybody they dated “get along with friends, especially closest friends”. participants with moderate personal religiosity spoke about the importance of gaining “approval from friends” as to whether they thought the relationship was healthy. these participants also mentioned the importance of a dating partner both knowing and liking friends and family. participants with low levels of religiosity only talked about friends in the context of “no mistreatment of you and friends”. one participant stated: “…having them know your friends and like are on good terms with them because if they’re not on good terms…and like your friends don’t like them then they could like always try to like break the relationship apart which isn’t good (15, moderate)”. 3.5.3 pride in the relationship only participants within the low religiosity group addressed pride in the relationship. they described this as “not afraid to tell others” and “not embarrassed about the relationship”. as one participant stated: “um i guess one that where they… are not like afraid to tell anyone that they’re together and they are i guess that’s pretty much (15, low)”. 3.6 maintenance of personal integrity maintenance of personal integrity encompasses three sub-themes: self-assured, autonomous and self-respecting. 3.6.1 self-assured self-assured only emerged from the narratives of participants with moderate personal religiosity. these participants spoke about “confidence in [one’s] choice” and underscored the importance of “be[ing] yourself”, staying the “same person you were before going out, only more confident”. one dimension of self-assuredness actually seemed to contradict elements of the interactions with others sub-theme. this contradiction was evident in the participants’ beliefs that the opinions of others should not matter in a healthy dating relationship. being self-assured included “not worrying about others” and “not needing approval”. the participants’ use of terms such as “accepting”, “not judging”, and “not letting society get to them” reflected being self-assured. 3.6.2 autonomous an important part of being autonomous was the notion of having time and space for oneself without forsaking the relationship. the participants often described autonomous as “taking a breath” and “taking time for yourself”. indeed, it appeared the time away strengthens and maintains the dating relationship by elaborating on the importance of the connection. these sentiments were cogently captured in the following quote: www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 27 published by scholink inc. “i think also with a healthy relationship, you have to understand that um people need time away so a lot of times people don’t see that and um like yes you may wanna be with them 24/7 but occasionally, you know, you have to go out with their friends, your friends, and they have to go out with their friends, and i mean i think it’s in that little span of time that you’ll realize how much more you care about each other (17, moderate)”. only participants in the moderate and low religiosity groups discussed being autonomous. autonomous often meant “not exclusive to [the] relationship”. they framed this as taking a breather. more specifically, participants with moderate religiosity mentioned: “being free” and having it be okay to spend time with others. participants within the low religiosity group additionally expressed the need for “keeping your independence”, as illustrated by this quote: “…a healthy relationship to me, is just keeping your independence to yourself like knowing who you are and not letting anybody touch that because if they don’t like you for who you are, then maybe they don’t belong in your life (16, low)”. 3.6.3 self-respecting self-respecting encompassed the notion of having “confidence in [ones] self” and being “fully happy with who you are”. the need to “speak up for yourself” illustrated this concept. it was important for the participants to “love themselves before loving anyone else”. participants addressed elements of self-respecting across all levels of religiosity. one participant with high religiosity stated that “being a good person was needed for being good in a relationship”. participants in the moderate religiosity group spoke about selfrespect in terms of “maturity”, “true to self”, and “respect for self” and referenced this in relation to both partners. as one participant puts it: “you should be confident in who you are and if the other person is confident who they are, and you both respect each other, then your relationship should be healthy (17, moderate)”. participants with low religiosity spoke about: being “fully happy with whom you are”, “knowing who you are”, “stand[ing up for] your own opinion”, and “say something back or speak up for yourself”. 4. discussion the current qualitative study sought to explore adolescent females’ conceptualizations of healthy dating relationships by analyzing descriptive differences in their narrative discourses relative to the degree of personal religiosity; 6 broad themes and 17 sub-themes emerged. our results suggest that personal religiosity is related to conceptions of dating dynamics among high school teenage females. 4.1 differences by personal religiosity our personal religiosity construct used likert response questions with adequate psychometrics, along with additional questions endorsed by previous research (jang & johnson, 2001; rostosky, regnerus, & wright, 2003; sinha et al., 2007). we stratified participants into high, moderate or low religiosity www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 28 published by scholink inc. categories based on their responses. with 80% of the sample being categorized as moderate religiosity, this group endorsed the most sub-themes (16); the high religiosity group endorsed the least (9); and the low religiosity group endorsed 12 sub-themes. subthemes recognized by the moderate religiosity group offer insights on the interplay of religiosity and attitudes regarding healthy dating relationships. a commonly held notion is that religions practiced in america value marriage and often herald those who endure a difficult one (murray, 2002; pyles, 2007). the “staying power” sub-theme identified in the current study most closely demonstrates this concept by illustrating the attempts of participants to place a priority on relationships with their partners despite experiencing problems such as fighting or “hard times”. interestingly, this theme was endorsed by both high and moderate religiosity sub-samples but not by participants in the low religiosity group. research indicates that adolescents with low religiosity have more favorable attitudes towards separation and ending romantic relationships than those with higher religiosity (shimkowski, punyanunt-carter, colwell, & norman, 2018). the “staying power” sub-theme may pose challenges for counseling professionals who, when providing services to women with a strong religious affiliation, must find an acceptable resolution that addresses the religious concerns of the individual, family, and sometimes even the larger community in which they are embedded. another sub-theme endorsed by high and moderate religiosity groups was that “conflict resolution” was part of a healthy relationship. this may also stem from religious teachings that encourage and value working through conflict in a marriage to preserve family stability (johnston, 1996). it is possible that participants with low religiosity did not perceive conflict to be part of a healthy relationship. data from add health suggest that adolescents who exhibit at least one risk factor for violence are also likely to use violence as a conflict resolution strategy in their relationship (halpern et al., 2001). taken together, these findings suggest that participants with stronger religiosity may value overcoming obstacles to maintain their existing relationships more highly than those with lower religiosity. it is heartening that the majority of participants (both moderate and low religiosity) directly mentioned the sub-theme of “non-abusive” when describing a healthy relationship. interestingly, those in the high religiosity group did not specifically mention a relationship without abuse as characteristic of healthy dating. another sub-theme with a similar pattern of endorsement was being “autonomous”. participants in the moderate and low religiosity groups made statements asserting their ability to be independent as indicative that the relationship was healthy; participants with high religiosity did not mention autonomy in their responses. finally, participants with moderate and low religiosity indicated that a healthy relationship includes the bi-directional provision and receipt of social support. these findings differ from “compatibility” but overlap with “reciprocity” in acknowledging both the importance of support and the mutuality of the process. not endorsing sub-themes of “non-abusive”, “autonomous”, and “provision of and receipt of social support” should not be interpreted to mean that these participants with high religiosity value dependent, www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 29 published by scholink inc. unsupportive, and abusive relationships. as these participants were the only ones to discuss the “staying power” and “conflict resolution” sub-themes, this suggests the emergence of a more nuanced set of contrasts regarding ideas of what constitutes a healthy relationship. these findings are consistent with those of bartkowski and colleagues, which indicate that adolescents with higher religious salience and personal religious commitment are more likely to resolve conflicts to maintain their relationships with their dating partner (bartkowski, xu, & fondren, 2011). 4.2 role of religion in dating dynamics regardless of denomination, religion plays an important but seemingly invisible role in the lives of many american teenagers, and this could influence how adolescents construct definitions of healthy and unhealthy dating dynamics (smith & denton, 2005). the sif guided our examination of the relationship between religiosity and adolescent dating relationships by addressing the influence of religion within primary and secondary socialization spheres of adolescent normative development (wallace & williams, 1997). the sif suggests that religion relates to health outcomes but only indirectly through the socialization mechanisms of social control, social support, encouragement, rewards, values and identity formation (wallace & williams, 1997; burkett & warren, 1987). furthermore, research suggests that socialization through doctrines, messages from, and ties to religious institutions reinforces attitudes, norms, and family practices, which do influence adolescent dating conceptualizations and experiences (armet, 2009). teenagers increasingly confront social pressures to engage in sexual behavior within their romantic relationships. the current data indicate that, in contrast to the high religiosity group, participants in the moderate and low religiosity groups believed that “not being rushed into sex” was characteristic of a healthy dating relationship. participants with high religiosity may not have spoken at all about this because they either believe or were socialized to regard pre-marital sex as inappropriate and/or unacceptable. in addition, though not mentioned in our interviews, abstinence education programs often use “virginity pledges” to encourage adolescents in making oral or written promises to refrain from sexual activity until marriage (rosenbaum, 2009; carpenter, 2011). secondary virginity pledges assist sexually active teenagers with making decisions to refrain from sexual activity (rosenbaum, 2009; carpenter, 2011). it is possible that teens utilize defense mechanisms and adaptive strategies in an effort to preserve religious values when navigating the complex arena of sexual relationships during adolescence (lefkowitz, gillen, shearer, & boone, 2004). these paths that teens and young adults forge may well reflect their personal interpretation of what their chosen faith dictates around relationship expectations. 4.3 strengths and limitations we endeavored to document conceptualizations of healthy dating relationships from the perspective or voice of adolescent participants, thus empowering them to contribute to our understanding of an issue www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 30 published by scholink inc. that has both personal importance and larger applicability. we conducted in-depth interviews with a diverse sample of 50 adolescent females across different types of schools and religious faiths. our team also followed a detailed, stepwise and systematic analytic process to enhance the rigor—both dependability and reliability—of the data (devers, 1999). we also made efforts to maximize adolescent participation by providing multiple opportunities to inform parents about the study. we asked questions in well-advertised orientation sessions and made frequent contacts with parents to address concerns or reservations. our findings help fill gaps in understanding the potentially important role of religiosity on adolescent romantic relationships. despite the demonstrated strengths, this study does present some limitations. since many of the study participants were minors and the data collection was not anonymous, we instructed participants, verbally and in writing, that we would have to break confidentiality and tell parents/and or authorities if teens reported abuse or if we had concerns of potential threat of abuse. although we did emphasize our interest in their attitudes and beliefs, as opposed to personal relationships and experiences, our irb protocol may have censured what participants were willing to disclose. we also did not interpret the current data based upon underlying spiritual belief systems or religious denomination. in addition, measuring religiosity is complicated by the multi-dimensional nature of the construct. our purposive sampling endeavored to maximize religious diversity in terms of affiliation. however, an analysis of the personal religiosity index indicates that few participants were labeled as high or low religiosity. that is, we stratified participants by degree of personal religiosity after all the interviews were completed, and thus, we could not correct for the imbalance in the distribution of high, moderate and low religiosity participants. while we could have tried to recruit our sample based upon adolescent’s degree of religiosity, due to the dynamic and complex process of identity development among adolescents, it would have been difficult to determine how adolescents would rate their religiosity beforehand (tanti, stukas, halloran, & foddy, 2011). finally, we based our analysis on the degree of religiosity, not by enrollment in different types of schools. a religious school context could inflate one’s individual religiosity. yet the fact that 80% of the sample were categorized as moderate religiosity reduces that likelihood (regnerus, 2000). while we did not see evidence of this effect within the data, it is possible that the school context is playing a “hidden” role in their dating behaviors. 4.4 implications and future directions our findings have important implications for faith-based initiatives and other efforts to promote positive youth development. focusing on the positive characteristics that teens associate with healthy dating relationships is both affirming and empowering and can facilitate ongoing dialog as well as their investment and co-ownership of school and faith-based programs. with over 80% of americans identifying with a religious affiliation and 20-25% of women in america experiencing violence from an intimate partner over their lifetime, there is reason to believe the intersection of faith and gender is fertile www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 31 published by scholink inc. ground for continued examination of healthy and harmful dating dynamics (pew research center, 2015; breiding et al., 2014). future research should examine how other aspects of religion can mediate dating dynamics with respect to social control and social support mechanisms. our study suggests a next step might be to examine how females’ engagement in different faith-based activities including, but not limited to, worship and prayer shapes their attitudes and normative beliefs. additional clarifications of how religion shapes intrapersonal, interpersonal, and institutional dynamics related to teen dating relationships can shed light as to what extent and why adolescent females may tolerate violence within their romantic relationships. 5. conclusion our findings suggest that perceptions of what constitutes a healthy teen dating relationship may differ based on degrees of personal religiosity. it raises important questions regarding how youth internalize religious teachings about healthy dating dynamics. future research should examine how other aspects of religion and socialization can mediate dating relationship dynamics with respect to social control and social support mechanisms. acknowledgements this research was supported by grant from the national institute for child health and human development (r03hd057984). appreciation is expressed to the young women who shared their insights with us and the community and school personnel who made this study possible. references armet, s. (2009). religious socialization and identity formation of adolescents in high tension religions. review of religious research, 50(3), 277-297. retrieved from http://www.jstor.org/stable/225593742 bartkowski, j. p., xu, x., & fondren, k. m. (2011). faith, family, and teen dating: examining the effects of personal and household religiosity on adolescent romantic relationships. review of religious research, 52(3), 248-265. barton, a. l., snider, j. b., vazsonyi, a. t., & cox, j. l. (2014). adolescent religiosity as a mediator of the relationship between parental religiosity and adolescent health outcomes. journal of religion and health, 53(1), 86-94. https://doi.org/10.1007/s10943-012-9596-7 benson, p. l., roehlkepartain, e. c., & rude, s. p. (2003). spiritual development in childhood and adolescence: toward a field of inquiry. applied developmental science, 7(3), 205-213. https://doi.org/10.1207/s1532480xads0703_12 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 32 published by scholink inc. breiding, m. j., smith, s. g., basile, k. c., walters, m. l., chen, j., & merrick, m. t. (2014). prevalence and characteristics of sexual violence, stalking, and intimate partner violence victimization—national intimate partner and sexual violence survey, united states, 2011. retrieved january 8, 2017, from https://www.cdc.gov/mmwr/preview/mmwrhtml/ss6308a1.htm burkett, s. r., & warren, b. o. (1987). religiosity, peer associations, and adolescent marijuana use: a panel study of underlying causal structures*. criminology, 25(1), 109-132. https://doi.org/10.1111/j.1745-9125.1987.tb00791.x carpenter, l. m. (2011). like a virgin…again?: secondary virginity as an ongoing gendered social construction. sexuality & culture, 15(2), 115-140. https://doi.org/10.1007/s12119-010-9085-7 cotton, s., zebracki, k., rosenthal, s. l., tsevat, j., & drotar, d. (2006). religion/spirituality and adolescent health outcomes: a review. journal of adolescent health, 38(4), 472-480. https://doi.org/10.1016/j.jadohealth.2005.10.005 devers, k. j. (1999). how will we know “good” qualitative research when we see it? beginning the dialogue in health services research. health services research, 34(5 pt 2), 1153-1188. drabble, l., trocki, k. f., & klinger, j. l. (2016). religiosity as a protective factor for hazardous drinking and drug use among sexual minority and heterosexual women: findings from the national alcohol survey. drug and alcohol dependence, 161, 127-134. https://doi.org/10.1016/j.drugalcdep.2016.01.022 fletcher, j., & kumar, s. (2014). religion and risky health behaviors among u.s. adolescents and adults. journal of economic behavior & organization, 104, 123-140. https://doi.org/10.1016/j.jebo.2014.03.018 halpern, c. t., oslak, s. g., young, m. l., martin, s. l., & kupper, l. l. (2001). partner violence among adolescents in opposite-sex romantic relationships: findings from the national longitudinal study of adolescent health. american journal of public health, 91(10), 1679. https://doi.org/10.2105/ajph.91.10.1679 hardie, j. h., pearce, l. d., & denton, m. l. (2016). the dynamics and correlates of religious service attendance in adolescence. youth & society, 48(2), 151-175. https://doi.org/10.1177/0044118x13483777 howard, d., qiu, y., & boekeloo, b. (2003). personal and social contextual correlates of adolescence dating violence. journal of adolescent health, 33(1), 9-17. https://doi.org/10.1016/s1054-139x(03)00061-2 jang, s. j., & johnson, b. r. (2001). neighborhood disorder, individual religiosity, and adolescent use of illicit drugs: a test of multilevel hypotheses*. criminology, 39(1), 109-144. https://doi.org/10.1111/j.1745-9125.2001.tb00918.x https://doi.org/10.1016/j.jadohealth.2005.10.005 https://doi.org/10.1016/j.jadohealth.2005.10.005 https://doi.org/10.1177/0044118x13483777 https://doi.org/10.1177/0044118x13483777 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 33 published by scholink inc. johnston, d. m. (1996). religion and conflict resolution. fletcher forum of world affairs, 20, 53. johnston, l., bachman, j., & o’malley, p. (2008). monitoring the future: questionnaire responses from the nation’s high school seniors 2007. university of michigan, institute for social research. koenig, h. g., king, d. e., & carson, v. b. (2012). handbook of religion and health (2nd ed.). oxford, england: oxford university press. langford, c. p. h., bowsher, j., maloney, j. p., & lillis, p. p. (1997). social support: a conceptual analysis. journal of advanced nursing, 25(1), 95-100. https://doi.org/10.1046/j.1365-2648.1997.1997025095.x lefkowitz, e. s., gillen, m. m., shearer, c. l., & boone, t. l. (2004). religiosity, sexual behaviors, and sexual attitudes during emerging adulthood. the journal of sex research, 41(2), 150-159. https://doi.org/10.1080/00224490409552223 levin, j. s., larson, d. b., & puchalski, c. m. (1997). religion and spirituality in medicine: research and education. jama, 278(9), 792-793. https://doi.org/10.1001/jama.278.9.792 lippman, l., & michelsen, e. (2004). the measurement of family religiosity and spirituality. office of the assistant secretary for planning and evaluation, u.s. department of health and human services. retrieved from https://aspe.hhs.gov/report/indicators-child-family-and-community-connections-companionvolum erelatedpapers/measurement-family-religiosity-and-spirituality lopez, a. b., huynh, v. w., & fuligni, a. j. (2011). a longitudinal study of religious identity and participation during adolescence. child development, 82(4), 1297-1309. https://doi.org/10.1111/j.1467-8624.2011.01609.x manlove, j. s., terry-humen, e., ikramullah, e. n., & moore, k. a. (2006). the role of parent religiosity in teens’ transitions to sex and contraception. the journal of adolescent health: official publication of the society for adolescent medicine, 39(4), 578-587. https://doi.org/10.1016/j.jadohealth.2006.03.008 mcconnell, k. m., pargament, k. i., ellison, c. g., & flannelly, k. j. (2006). examining the links between spiritual struggles and symptoms of psychopathology in a national sample. journal of clinical psychology, 62(12), 1469-1484. https://doi.org/10.1002/jclp.20325 michalak, l., trocki, k., & bond, j. (2007). religion and alcohol in the u.s. national alcohol survey: how important is religion for abstention and drinking? drug and alcohol dependence, 87(2-3), 268-280. https://doi.org/10.1016/j.drugalcdep.2006.07.013 miles, m. b., & huberman, a. m. (1994). qualitative data analysis (2nd ed.). thousand oaks, ca: sage publications. murray, k. a. (2002). religion and divorce: implications and strategies for counseling. the family journal, 10(2), 190-194. https://doi.org/10.1177/1066480702102008 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 34 published by scholink inc. nason-clark, n. (2000). making the sacred safe: woman abuse and communities of faith. sociology of religion, 61(4), 349-368. https://doi.org/10.2307/3712520 nienhuis, n. e. (2005). theological reflections on violence and abuse. journal of pastoral care & counseling, 59(1-2), 109-123. https://doi.org/10.1177/154230500505900111 pargament, k. i., koenig, h. g., & perez, l. m. (2000). the many methods of religious coping: development and initial validation of the rcope. journal of clinical psychology, 56(4), 519-543. https://doi.org/10.1002/(sici)1097-4679(200004)56:4%3c519::aid-jclp6%3e3.0.co;2-1 pearce, m. j., little, t. d., & perez, j. e. (2003). religiousness and depressive symptoms among adolescents. journal of clinical child and adolescent psychology: the official journal for the society of clinical child and adolescent psychology, american psychological association, division 53, 32(2), 267-276. https://doi.org/10.1207/s15374424jccp3202_12 pew research center. (2015). religious landscape study. retrieved may 24, 2017, from http://www.pewforum.org/religious-landscape-study/ pyles, l. (2007). the complexities of the religious response to domestic violence: implications for faith-based initiatives. affilia, 22(3), 281-291. https://doi.org/10.1177/0886109907302271 regnerus, m. d. (2000). shaping schooling success: religious socialization and educational outcomes in metropolitan public schools. journal for the scientific study of religion, 39(3), 363-370. https://doi.org/10.1111/0021-8294.00030 rosenbaum, j. e. (2009). patient teenagers? a comparison of the sexual behavior of virginity pledgers and matched nonpledgers. pediatrics, 123(1), e110-e120. https://doi.org/10.1542/peds.2008-0407 rostosky, s. s., regnerus, m. d., & wright, m. l. c. (2003). coital debut: the role of religiosity and sex attitudes in the add health survey. journal of sex research, 40(4), 358-367. https://doi.org/10.1080/00224490209552202 rostosky, s. s., wilcox, b. l., wright, m. l. c., & randall, b. a. (2004). the impact of religiosity on adolescent sexual behavior: a review of the evidence. journal of adolescent research, 19(6), 677-697. https://doi.org/10.1177/0743558403260019 shimkowski, j. r., punyanunt-carter, n., colwell, m. j., & norman, m. s. (2018). perceptions of divorce, closeness, marital attitudes, romantic beliefs, and religiosity among emergent adults from divorced and nondivorced families. journal of divorce & remarriage, 59(3), 222-236. https://doi.org/10.1080/10502556.2017.1403820 sinha, j. w., cnaan, r. a., & gelles, r. j. (2007). adolescent risk behaviors and religion: findings from a national study. journal of adolescence, 30(2), 231-249. https://doi.org/10.1016/j.adolescence.2006.02.005 smith, c., & denton, m. l. (2005). soul searching: the religious and spiritual lives of american teenagers. oxford, england: oxford university press. https://doi.org/10.1177/154230500505900111 https://doi.org/10.1080/10502556.2017.1403820 https://doi.org/10.1080/10502556.2017.1403820 https://doi.org/10.1016/j.adolescence.2006.02.005 https://doi.org/10.1016/j.adolescence.2006.02.005 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 35 published by scholink inc. https://doi.org/10.1093/019518095x.001.0001 tanti, c., stukas, a. a., halloran, m. j., & foddy, m. (2011). social identity change: shifts in social identity during adolescence. journal of adolescence, 34(3), 555-567. https://doi.org/10.1016/j.adolescence.2010.05.012 tharp, a. t., dewall, c. n., richman, s. b., & noonan, r. k. (2014). effect of religiosity and dysfunctional dating attitudes on youth substance use. journal of addiction, 2014, e143709. https://doi.org/10.1155/2014/143709 wallace, jr., j. m., & williams, d. r. (1997). religion and adolescent health-compromising behavior. in j. schulenberg, j. l. maggs, & k. hurrelmann (eds.), health risks and developmental transitions during adolescence (pp. 444-468). cambridge, united kingdom: cambridge university press. wong, y. j., rew, l., & slaikeu, k. d. (2006). a systematic review of recent research on adolescent religiosity/spirituality and mental health. issues in mental health nursing, 27(2), 161-183. https://doi.org/10.1080/01612840500436941 zelnick, m., kantner, j., ford, k. (1981). sex and pregnancy in adolescence. beverly hills, ca: sage publications. https://doi.org/10.1016/j.adolescence.2010.05.012 https://doi.org/10.1016/j.adolescence.2010.05.012 https://doi.org/10.1016/j.adolescence.2010.05.012 https://doi.org/10.1016/j.adolescence.2010.05.012 https://doi.org/10.1155/2014/143709 https://doi.org/10.1155/2014/143709 https://doi.org/10.1080/01612840500436941 https://doi.org/10.1080/01612840500436941 children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 3, no. 2, 2020 www.scholink.org/ojs/index.php/ct 72 original paper dimensional change card sorting of american children: marginalization-related diminished returns of age shervin assari1,2* 1 department of family medicine, charles r drew university of medicine and science, los angeles, ca 90059, usa 2 department of urban public health, charles r drew university of medicine and science, los angeles, ca 90059, usa * shervin assari, assari@umich.edu; tel.: +(734)-232-0445; fax: +734-615-8739 received: november 2, 2020 accepted: november 11, 2020 online published: november 23, 2020 doi:10.22158/ct.v3n2p72 url: http://dx.doi.org/10.22158/ct.v3n2p72 abstract background: while age is associated with an increase in cognitive flexibility and executive functioning as a result of normal development during childhood, less is known about the effect of racial variation in children’s age-related cognitive development. the marginalization-related diminished returns (mdrs) phenomenon suggests that, under racism, social stratification, segregation, and discrimination, individual-level economic and non-economic resources and assets show weaker effects on children’s development for marginalized, racialized, and minoritized families. aim: we conducted this study to compare racial groups of children for age-related changes in their card sorting abilities. methods: this cross-sectional study included 10,414 9-10-year-old american children. data came from the adolescent brain cognitive development (abcd) study. the independent variable was age, a continuous variable measured in months. the dependent variable was dimensional change card sort (dccs) score, which reflected cognitive flexibility, and was measured by the nih dimensional change card sort. ethnicity, sex, parental education, and marital status were the covariates. results: older age was associated with higher dccs score, reflecting a higher card-sorting ability and cognitive flexibility. however, age showed a weaker association with dccs for black than for white children. this was documented by a significantly negative interaction between race and age on children’s dccs scores. conclusion: age shows a weaker correlation with the cognitive flexibility of black than of white children. a similar pattern can be seen when comparing low-income with high-income children. conceptualizing race as a social factor that alters normal childhood development is a finding that is in line with mdrs. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 73 published by scholink inc. marginalization due to social stratification and racism interfere with the normal age-related cognitive development of american children. keywords age, children, pre-adolescents, card sorting, cognitive flexibility, executive function 1. introduction dimensional change card sort (dccs) is a useful tool to measure cognitive flexibility and executive function of children and adults (zelazo, 2006), which are main components of cognitive performance although overall, the dccs is believed to generate a valid and reliable measure of cognition (zelazo, 2006), it is still unclear to what degree it can be applied to compare cognitive function across racial and ethnic groups. the association between race, socioeconomic status (zelazo, 2006) (ses), and cognitive function is not only a scientific matter, but also a sensitive political issue(herrnstein & murray, 2010). over the past several decades, there has been an ongoing political debate on whether it is appropriate to study race, ses, and cognitive performance. specifically, whether race and ses correlate with cognitive function, and whether such effects are due to social forces or biological differences (nisbett, 1995). murray’s bell curve, that argued on the lower cognitive performance of black individuals, generated an extreme backlash by the scientific community (nisbett, 2009). in response to a biological claim, scientists questioned the validity of the argument that racial variation in cognitive performance is caused by biology (nisbett, 1998, 2005; nisbett et al., 2012a) and genetics (brown & day, 2006; jensen, 1976; nisbett et al., 2012b; rushton & jensen, 2005). since then, the research community has provided considerable evidence suggesting that lower cognitive scores of blacks compared to whites may be an artifact and measurement bias as opposed to a true difference that reflects poor performance of black people. others have argued that we can always better measure cognitive function in white populations, rather than blacks, which refutes any valid racial comparison of cognitive comparison across racial groups based on tests that are not well-validated in both groups (nisbett, 2013; turkheimer, harden, & nisbett, 2017). a recent research finding that cognitive scores predict the mortality of white but not black people (assari, 2020a) is another support for the argument that existing cognitive measures may fail to capture black populations’ true cognitive performance (assari, 2020a; dotson, kitner-triolo, evans, & zonderman, 2009; goldsmith, darity jr., & veum, 1998; nisbett, 2009). in addition, others have argued that low education quality, low ses, and other ecological reasons rather than a biological difference are in play (rowe, vesterdal, & rodgers, 1998). finally, minorities’ diminished returns (mdrs) (assari, 2017b; assari, 2018) suggests that ses resources and potentials better translate to actual outcomes for whites than for blacks, again providing a social theory for explaining cognitive differences between race, particularly among middle-class families (assari, 2018; assari, 2018f, 2020b). lack of predictive power of cognitive scores for black people may also be due to mdrs (assari, 2017b; www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 74 published by scholink inc. assari, 2018). the mdrs reflect weaker health effects of personal assets and resources including ses, coping, and cognition for any marginalized group such as black (assari, 2018; assari, 2018f), hispanic (assari, 2018e; assari, 2019; assari, farokhnia, & mistry, 2019; shervin & ritesh, 2019), asian american (assari, boyce, bazargan, & caldwell, 2020b), and native american (assari & mohsen bazargan, 2019) people. most of the research on mdrs have focused on economic resources such as parental education (assari, caldwell, & bazargan, 2019), family income (assari, caldwell, & mincy, 2018a; assari, thomas, caldwell, & mincy, 2018), and marital status (assari & bazargan, 2019). these studies have shown that economic resources generate fewer developmental, health, emotional, and behavioral outcomes for racial and ethnic minority group members than for whites (assari & caldwell, 2018a; assari, caldwell, et al., 2019; assari, caldwell, & mincy, 2018a; assari, caldwell, & mincy, 2018b; assari, thomas et al., 2018). to give a few examples, high ses shows weaker effects on impulsivity (assari, caldwell, & mincy, 2018a), depression (assari & caldwell, 2018a), anxiety (assari, caldwell, & zimmerman, 2018), aggression (assari, caldwell et al., 2019), and substance use (assari, caldwell et al., 2019) for black than for white children. as a result of these mdrs, black children with a high ses background does not greatly reduce their risk of impulsivity (assari, 2020a; assari, caldwell, & mincy, 2018a), reward sensitivity y (assari, akhlaghipour, boyce, bazargan, & caldwell, 2020; assari, boyce, akhlaghipour, bazargan, & caldwell, 2020), attention deficit hyperactivity disorder (adhd) (assari & caldwell, 2019a), obesity (assari, boyce, bazargan, mincy, & caldwell, 2019), aggression (assari, caldwell et al., 2019), chronic disease (assari, caldwell et al., 2019), anxiety (assari, caldwell, & zimmerman, 2018), depression (assari & caldwell, 2018a), and suicide (assari, boyce, bazargan, & caldwell, 2020a), attention (assari, boyce, & bazargan, 2020), school attachment (assari, 2019b), and grade point average (gpa) (assari, 2019; assari & caldwell, 2019b; assari, caldwell et al., 2019). there are other non-economic resources essential for cognitive development as well, including neighborhood quality (assari, 2016b), social network (assari, 2017c), emotion regulation (assari, 2016a; assari & burgard, 2015; assari, moazen-zadeh, lankarani, & micol-foster, 2016), and coping (assari, 2017a; assari & lankarani, 2016b). these all show weaker effects for black than for white families, a pattern fully in line with the mdrs phenomenon. that is, non-economic resources may show weaker effects for black than for white families. one of these resources and assets is age (chalian, khoshpouri, & assari, 2019), which is the precursor of age-related cognitive development (sowell, delis, stiles, & jernigan, 2001; sowell et al., 2004; sowell, thompson, tessner, & toga, 2001). in other age-dependent domains, mdrs were also observed., meaning that age showed a weaker effect for blacks than for whites (chalian et al., 2019). however, less is known about the mdrs of age-related changes in children’s cognitive development. if we observe weaker effect of age on cognitive performance in black children, we have indirect support for a social, rather than a biological explanation for racial variation in cognitive function of children. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 75 published by scholink inc. 2. aims built on the mdrs framework (assari, 2018; assari, 2018f, 2020b), we first estimated the overall effect of age on dccs score, a proxy of cognitive flexibility. then we compared racial groups of children for the effect of age on dccs scores. finally, we also compared groups based on household income for the effect of age on dccs scores. we expected a positive association between age and dccs (i.e., cognitive flexibility) overall. however, we expected this association to be weaker (diminished) for black and low-income than for white and high-income children. again, a similar finding in black and low-income sub-group would be another evidence supporting our sociological explanation of racial differences in cognitive function (due to mdrs). 3. methods 3.1 design and settings this secondary analysis used a cross-sectional design and borrowed data from the adolescent brain cognitive development (abcd) study (alcohol research: current reviews editorial, 2018; casey et al., 2018; karcher, o'brien, kandala, & barch, 2019; lisdahl et al., 2018; luciana et al., 2018). abcd baseline data collection was conducted from 2016 in 21 sites across the united states. for more information on the abcd study, consult here (alcohol research: current reviews editorial, 2018; auchter et al., 2018). 3.2 participants and sampling the abcd participants were 9–10-year-old children who were selected from multiple cities across the states. abcd recruitment primarily relied on the us school system. for a detailed description of the sampling and recruitment in the abcd, consult here (garavan et al., 2018). our analysis's eligibility was having valid data on all our study variables, including race, age, and cognitive flexibility. the analytical sample of this paper was 10,414. 3.3 study variables the study variables included race, ethnicity, sex, age, household income, parental education, marital status, and cognitive flexibility. race was self-identified: blacks, asians, mixed/other, and whites (reference category). parents reported the age of their children in months. the sex of the child was 1 for males and 0 for females. parental marital status was reported by the parents and was 1 for married and 0 for others. household income, reported by the parent, was a three-level categorical measure: less than 50k, 50-100k, and 100+k. cognitive flexibility was evaluated by the dimensional change card sort (dccs). this measure is one of the components of the nih toolbox for assessment of neurological and behavioral function. the dccs is an easily administered and widely used measure that evaluates cognitive flexibility and executive function for a wide range of ages. in this test, children are asked to sort a series of bivalent test cards, first according to one dimension (e.g., color), and then according to the other (e.g., shape). while children under three cannot properly switch and exhibit a pattern of www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 76 published by scholink inc. inflexibility similar to patients with prefrontal cortical damage, children older than five years of age can successfully switch when asked to. the performance score on the dccs test provides a standard index of cognitive flexibility and executive function development. the dccs is highly age-dependent and is impaired in children with psychiatric and developmental disorders such as autism, attention-deficit/hyperactivity disorder (adhd), and schizophrenia (zelazo, 2006). 3.4 data analysis we used data exploration and analysis portal (deap) for data analysis. deap uses the r package for statistical calculations. we reported the mean (standard deviation [sd]) and frequency (%) of our variables overall and by race. we also performed the chi-square and anova for our bivariate analysis. we used three mixed-effects regression models for multivariable modeling that allowed us to adjust to our data’s nested nature. this was because participants are nested to families that are nested to sites and states. all models were performed in the overall sample. model 1 did not have interaction terms. model 2 included interaction terms between race and age. model 3 included interaction terms between household income and age. in all models, the dccs score was the outcome. regression coefficient (b), se, and p-value were reported. our appendices 1 and 2 show our variables distributions and also our modeling strategy. 3.5 ethical aspect the abcd study has an institutional review board (irb) approval, and all participants have provided assent or consent, depending on their age (auchter et al., 2018). given that our analysis was performed on fully de-identified data, our analysis was exempt from a full irb review. 4. results 4.1 descriptives overall, 10,414 9-10-year-old children were analyzed. most participants were whites (n = 6,897; 66.2%), followed by other/mixed race (n = 1,768; 17.0%), and black (n = 1,515; 14.5%). only 234 (2.2%) children were asian. table 1 presents the descriptive data overall and by race. this table also compares racial groups for study variables. as this table shows, black and mixed/other race participants had the lowest parental education and income. white and asian children had the highest parental education and household income. dccs score was also lower for black than for white children. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 77 published by scholink inc. table 1. descriptive characteristics by race (n = 10414) level all white black asian other/mixed p n 10,414 6,897 1,515 234 1,768 n (%) n (%) n (%) n (%) n (%) sex female 4,996 (48.0) 3,254 (47.2) 760 (50.2) 117 (50.0) 865 (48.9) 0.128 male 5,418 (52.0) 3,643 (52.8) 755 (49.8) 117 (50.0) 903 (51.1) parental education <hs diploma 385 (3.7) 145 (2.1) 123 (8.1) 6 (2.6) 111 (6.3) <0.001 hs diploma/ged 862 (8.3) 327 (4.7) 340 (22.4) 3 (1.3) 192 (10.9) some college 2,674 (25.7) 1,462 (21.2) 600 (39.6) 18 (7.7) 594 (33.6) bachelor 2,766 (26.6) 2,057 (29.8) 230 (15.2) 65 (27.8) 414 (23.4) post graduate degree 3,727 (35.8) 2,906 (42.1) 222 (14.7) 142 (60.7) 457 (25.8) married family no 3,165 (30.4) 1,415 (20.5) 1,058 (69.8) 33 (14.1) 659 (37.3) <0.001 yes 7,249 (69.6) 5,482 (79.5) 457 (30.2) 201 (85.9) 1,109 (62.7) household income <50k 2,997 (28.8) 1,259 (18.3) 999 (65.9) 36 (15.4) 703 (39.8) <0.001 50k-100k 2,974 (28.6) 2,104 (30.5) 335 (22.1) 54 (23.1) 481 (27.2) >=100k 4,443 (42.7) 3,534 (51.2) 181 (11.9) 144 (61.5) 584 (33.0) hispanic no 8,451 (81.2) 5,737 (83.2) 1,439 (95.0) 215 (91.9) 1,060 (60.0) <0.001 yes 1,963 (18.8) 1,160 (16.8) 76 (5.0) 19 (8.1) 708 (40.0) mean (sd) mean (sd) mean (sd) mean (sd) mean (sd) age (months) 118.95 (7.46) 119.03 (7.49) 118.88 (7.23) 119.40 (7.77) 118.65 (7.51) 0.192 card sorting score 97.10 (15.26) 98.29 (15.07) 91.31 (13.98) 102.36 (17.94) 96.73 (15.46) <0.001 table 2 presents the descriptive data overall and by levels of household income. from our participants, 2,997 (28.8%) had a household income of <50k, 2,974 children (28.6%) had a househld income of between 50k and 100k, and 4,443 children (42.7%) were living in households with 100k+ income. children in families with higher household income showed higher dccs scores than low-income children. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 78 published by scholink inc. table 2. descriptive characteristics by household income (n = 10414) level all < 50k > =50k& < 100k > =100k p 10,414 2,997 2,974 4,443 n (%) n (%) n (%) n (%) race white 6,897 (66.2) 1,259 (42.0) 2,104 (70.7) 3,534 (79.5) < 0.001 black 1,515 (14.5) 999 (33.3) 335 (11.3) 181 (4.1) asian 234 (2.2) 36 (1.2) 54 (1.8) 144 (3.2) other/mixed 1,768 (17.0) 703 (23.5) 481 (16.2) 584 (13.1) hispanic no 8,451 (81.2) 2,039 (68.0) 2,396 (80.6) 4,016 (90.4) < 0.001 yes 1,963 (18.8) 958 (32.0) 578 (19.4) 427 (9.6) sex female 4,996 (48.0) 1,461 (48.7) 1,423 (47.8) 2,112 (47.5) 0.582 male 5,418 (52.0) 1,536 (51.3) 1,551 (52.2) 2,331 (52.5) parental education <hs diploma 385 (3.7) 361 (12.0) 22 (0.7) 2 (0.0) < 0.001 hs diploma/ged 862 (8.3) 678 (22.6) 151 (5.1) 33 (0.7) some college 2,674 (25.7) 1,379 (46.0) 923 (31.0) 372 (8.4) bachelor 2,766 (26.6) 393 (13.1) 1,016 (34.2) 1,357 (30.5) post graduate degree 3,727 (35.8) 186 (6.2) 862 (29.0) 2,679 (60.3) married family no 3,165 (30.4) 2,001 (66.8) 791 (26.6) 373 (8.4) < 0.001 yes 7,249 (69.6) 996 (33.2) 2,183 (73.4) 4,070 (91.6) mean (sd) mean (sd) mean (sd) mean (sd) age (months) 118.95 (7.46) 118.59 (7.40) 118.78 (7.49) 119.31 (7.47) < 0.001 card sorting score 97.10 (15.26) 92.87 (14.03) 97.58 (14.91) 99.63 (15.69) < 0.001 4.2 multivariate models table 3 presents the results of three mixed-effects regression models in the overall sample. model 1 showed a positive association between age and cognitive flexibility (figure 1). model 2 showed an interaction between age and race on cognitive flexibility. this interaction indicated that the boosting effect of age and cognitive flexibility is weaker for black than for white children (figure 2). model 3 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 79 published by scholink inc. showed an interaction between age and household income on cognitive flexibility. this interaction indicated that the boosting effect of age and cognitive flexibility is larger for high income than for low-income children (figure 3). table 3. mixed effects regressions overall (n = 10414) b se p model 1 age (months) 0.08*** 0.02 < 0.001 race (black) -4.25*** 0.50 < 0.001 race (asian) 2.82** 1.01 0.005 race (mixed/other) -0.05 0.42 0.903 model 2 age (months) 0.10*** 0.02 < 0.001 race (black) 11.36# 6.90 0.100 race (asian) -20.28 15.11 0.180 race (mixed/other) 4.87 6.26 0.437 race (black) x age -0.13* 0.06 0.023 race (asian) x age 0.19 0.13 0.126 race (mixed/other) x age -0.04 0.05 0.432 model 3 age (months) 0.03 0.04 0.407 race (black) -4.24*** 0.50 < 0.001 race (asian) 2.79** 1.01 0.006 race (mixed/other) -0.05 0.42 0.897 income (> =50k& < 100k) -1.00 6.13 0.871 income (> 100k) -10.57# 5.63 0.060 income (> =50k& < 100k) x age 0.02 0.05 0.636 income (> 100k) x age 0.11* 0.05 0.022 # p < 0.1 * p < 0.05 ** p < 0.01 *** p < 0.001 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 80 published by scholink inc. figure 1. association between age and dccs score (cognitive flexibility) overall figure 2. association between age and dccs score (cognitive flexibility) by race www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 81 published by scholink inc. figure 3. association between age and dccs score (cognitive flexibility) by income 5. discussion this study showed a positive association between age and dccs score (cognitive flexibility) overall; however, this association was stronger for white and high-income than for black and low-income children. that is, while age boosts the cognitive flexibility for american children, this effect is weaker in black and low-income than in white and high-income families. as a result, older black children and older poor children have low cognitive flexibility, a pattern which is absent for white and high-income children. in white and high-income families, age shows a substantial boosting effect on cognitive flexibility. we argue that due to structural inequalities, age-related development of cognitive flexibility is hindered in black and low-income children. our finding is in line with mdrs of age on cognitive flexibility for black children. this finding is in full harmony with what is already established on the mdrs of economic resources effect on children’s impulsivity (assari, akhlaghipour et al., 2020), reward responsiveness (assari, boyce, akhlaghipour et al., 2020), impulsivity (assari, caldwell, & mincy, 2018a), inhibitory control (assari, 2020d), attention (assari, boyce, & bazargan, 2020), and adhd (assari & caldwell, 2019a) in black families. similar mdrs are also reported for the effects of family ses indicators such as parental education, household www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 82 published by scholink inc. income, marital status on behavioral risks such as aggression (s. assari, c. h. caldwell, et al., 2019), substance use (assari, caldwell et al., 2019), and mental health risks such as anxiety (assari, caldwell, & zimmerman, 2018), depression (assari & caldwell, 2018a), and suicide (assari, boyce, bazargan, & caldwell, 2020a) in black children. these are all diminishing returns of economic resources for black compared to white youth (assari, 2018a, 2018c, 2019a; assari, farokhnia et al., 2019). as we found similar results for race and income (mdrs in poor as well as black families), the observed mdrs in black families are attributed to social rather than biological processes. the observed mdrs are not specific to one specific domain or outcome, suggesting that they are due to society but not culture, behavior, or biology. thus, the decreased association between age and cognitive flexibility seen in black children is not due to genetics, nor is it due to an innate difference in their cognitive ability. this is evident because similar mdrs are shown for all marginalized groups with all types of marginalizing identities (assari, 2017b; assari, 2018). thus, they are not only specific to blacks (assari, thomas et al., 2018) but also to hispanics (assari, 2018e; assari, 2019; assari, farokhnia et al., 2019; shervin & ritesh, 2019), asian americans (assari, boyce, bazargan, & caldwell, 2020b), native americans (assari & bazargan, 2019), lgbtqs (assari, 2019a), immigrants (assari, 2020b), and even marginalized whites (assari, boyce, bazargan, caldwell, & zimmerman, 2020). these mdrs are also not specific to a particular age group, as documented for children (assari, caldwell, & mincy, 2018a; assari, caldwell, & mincy, 2018b; assari, thomas et al., 2018), adults (assari, 2018a), and older adults (assari & lankarani, 2016a). finally, these mdrs are relevant to economic resources such as ses (assari, preiser, lankarani, & caldwell, 2018), (assari, farokhnia et al., 2019), (assari, caldwell, & mincy, 2018a), (assari, 2018d), (assari, caldwell, & zimmerman, 2018), and non-economic assets such as self-efficacy (assari, 2017a; assari & lankarani, 2016b). this paper extends the mdrs literature to the effects of age on cognitive performance in black families (chalian et al., 2019). a recent study established similar results for immigrants compared to non-immigrants, again emphasizing that these effects are social rather than biological (assari, boyce, bazargan, & caldwell, 2020). a wide range of sociological and economic mechanisms explain the mdrs of age and economic resources on cognitive flexibility for black related to white families (and also in low-income families). black families experience high levels of stress across all ses levels (bowden, bartkowski, xu, & lewis jr., 2017). social mobility is more taxing for black than for white families (chetty, hendren, kline, & saez, 2014). at all ses levels, exposure (assari, 2018b; assari, gibbons, & simons, 2018a; assari, gibbons, & simons, 2018b; assari, lankarani, & caldwell, 2018; assari & moghani lankarani, 2018) and vulnerability (assari, preiser et al., 2018) to discrimination is high for black families. while low ses black families struggle with food insecurity, poverty, and neighborhood disorder, high ses black families experience discrimination due to proximity to whites (assari, gibbons et al., 2018a; assari, gibbons et al., 2018b). as discrimination reduces the chance of healthy brain development (assari & caldwell, 2018b; assari, lankarani et al., 2018; assari, preiser et al., 2018), black children may remain www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 83 published by scholink inc. at risk of impulsivity across the whole ses spectrum. this offers an explanation to why age, the main driver of development, shows weaker black effects than white children. while low ses and poor outcomes are one type of disadvantage in black communities, mdrs reflect a qualitatively different set of disadvantages (assari, 2017b; assari, 2018). the former reflects unequal outcomes and opportunities, and the latter is reflective of low response to the presence of individual-level resources such as age and ses. it is due to the latter that policymakers may observe sustained inequality despite investments. to address the latter, there is a need to address the systemic causes of inequalities. as a result of the combination of these two, black families experience double jeopardies: not only resources such as ses are scarce, their influences are also hindered and dampened, given the many constrains in their environment (assari, 2018; assari, 2018f). multilevel economic and environmental mechanisms are in play that reduce the marginal returns of economic and non-economic resources and assets such as family ses and age (assari, 2018; assari, 2018f). mdrs are probably caused by social stratification, racism, and marginalization. these processes function across multiple societal institutions and levels (assari, 2018; assari, 2018f). racial injustice, prejudice, and discrimination have historically interfered with the gain of resources and assets for the black communities (hudson, sacks, irani, & asher, 2020; hudson, bullard et al. 2012; hudson, neighbors, geronimus, & jackson, 2012). black children live in poorer neighborhoods and attend worse schools compared to their white counterparts, even when they are from the very same ses backgrounds (assari, boyce, caldwell, bazargan, & mincy, 2020; boyce, bazargan, caldwell, zimmerman, & assari, 2020). another known cause of mdrs is childhood poverty (bartik & hershbein, 2018). as a result of environmental and structural injustice, we observe mdrs across resources, assets, outcomes, settings, and age groups. this paper broadens the effect of mdrs as it shows that it can also interfere with normal age-related cognitive development of black children. 6. limitations the current study has some methodological shortcomings. first, because of a cross-sectional design, it is inappropriate for us to draw any causal inferences. however, age is a known determinant of cognitive development. the direction of the association between age and cognitive flexibility is from age to cognitive performance, not vice versa. still, the findings reported here should be interpreted as correlations, not causes. to establish stronger causal evidence, we need to use longitudinal data with multiple observations of cognitive performance over time. such research will help us map changes and trajectories of cognitive function that occur as the child ages to structural barriers that surrounds black and low-income families. our expectation is that the age-related trajectories in cognitive development would only be hindered in black children who receive fewer cognition-promoting stimuli, live in worse neighborhoods, and attend worse schools when compared to their white counterparts. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 84 published by scholink inc. similarly, we only tested the mdrs of age. previous work had established mdrs of family ses on cognitive and emotional outcomes (assari, caldwell, & mincy, 2018a), (s. assari, 2020c; assari, akhlaghipour et al., 2020; assari, boyce, akhlaghipour et al., 2020). future research should test if mdrs in any other domain, such as ses, can explain the observed mdrs of age. in addition, we only controlled for family-ses, and all our confounders were individual-level. it is imperative to control for contextual and neighborhood-level indicators as well as physical and mental health status. for example, we did not control for autism, adhd, and other conditions that can interfere with cognitive development of children. finally, we did not study how these mdrs emerge or change over time. such research is necessary if we wish to find a window of opportunity for intervention. more research is needed on how the observed mdrs-related black-white inequalities in cognitive performance narrow, maintain, or widen over time and how they contribute to the future black-white gap in educational and economic success. 7. conclusions relative to their white counterparts, black children show lower cognitive flexibility at all age groups. this black-white gap is shaped by social forces rather than biological differences as we found the same pattern in lowvs highincome families. these diminished returns of age on cognitive development are important because cognitive flexibility is a driver for a wide range of education and economic outcomes later in life. to minimize the black-white gap in brain development, there is a need to address societal barriers that cause mdrs of age and other economic and non-economic resources and assets in black communities. there is a need for public and social policies beyond individual-level risk factors and address systemic, structural, and societal causes of inequalities. enhancing quality of education in predominantly black neighborhoods is needed. author contributions: single author. acknowledgment: author thanks luke sorensen for his contribution to the draft of the paper. funding: shervin assari is supported by the national institutes of health (nih) grants 5s21md000103, d084526-03, ca201415 02, da035811-05, u54md008149, u54md007598, and u54ca229974. conflicts of interest: the authors declare no conflict of interest. deap acknowledgment: deap is a software provided by the data analysis and informatics center of abcd located at the uc san diego with generous support from the national institutes of health and the centers for disease control and prevention under award number u24da041123. the deap project information and links to its source code are available under the resource identifier rrid: scr_016158. abcd funding: data used in the preparation of this article were obtained from the adolescent brain cognitive development (abcd) study (https://abcdstudy.org), held in the nimh data archive (nda). the abcd study is supported by the national institutes of health (nih) and additional federal partners www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 85 published by scholink inc. under award numbers u01da041022, u01da041025, u01da041028, u01da041048, u01da041089, u01da041093, u01da041106, u01da041117, u01da041120, u01da041134, u01da041148, u01da041156, u01da041174, u24da041123, and u24da041147. a full list of federal partners is available at https://abcdstudy.org/federal-partners.html. a listing of participating sites and a complete listing of the study investigators can be found at https://abcdstudy.org/principal-investigators.html. this manuscript reflects the views of the authors and may not reflect the opinions or views of the nih or abcd consortium investigators. abcd consortium investigators designed and implemented the study and/or provided data but did not necessarily participate in analysis or writing of this report. references alcohol research: current reviews editorial, s. (2018). nih's adolescent brain cognitive development (abcd) study. alcohol res, 39(1), 97. retrieved from https://www.ncbi.nlm.nih.gov/pubmed/30557152 assari, s. (2016a). gender differences in the predictive role of self-rated health on short-term risk of mortality among older adults. sage open med, 4, 2050312116666975. https://doi.org/10.1177/2050312116666975 assari, s. (2016b). perceived neighborhood safety better predicts risk of mortality for whites than blacks. j racial ethn health disparities. https://doi.org/10.1007/s40615-016-0297-x assari, s. (2017a). general self-efficacy and mortality in the usa; racial differences. j racial ethn health disparities, 4(4), 746-757. https://doi.org/10.1007/s40615-016-0278-0 assari, s. (2017b). unequal gain of equal resources across racial groups. int j health policy manag, 7(1), 1-9. https://doi.org/10.15171/ijhpm.2017.90 assari, s. (2017c). whites but not blacks gain life expectancy from social contacts. behav sci (basel), 7(4). https://doi.org/10.3390/bs7040068 assari, s. (2018a). blacks' diminished return of education attainment on subjective health; mediating effect of income. brain sci, 8(9). https://doi.org/10.3390/brainsci8090176 assari, s. (2018b). does school racial composition explain why high income black youth perceive more discrimination? a gender analysis. brain sci, 8(8). https://doi.org/10.3390/brainsci8080140 assari, s. (2018c). family income reduces risk of obesity for white but not black children. children (basel), 5(6). https://doi.org/10.3390/children5060073 assari, s. (2018). health disparities due to diminished return among black americans: public policy solutions. social issues and policy review, 12(1), 112-145. https://doi.org/10.1111/sipr.12042 assari, s. (2018d). life expectancy gain due to employment status depends on race, gender, education, and their intersections. j racial ethn health disparities, 5(2), 375-386. https://doi.org/10.1007/s40615-017-0381-x www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 86 published by scholink inc. assari, s. (2018e). socioeconomic status and self-rated oral health; diminished return among hispanic whites. dent j (basel), 6(2). https://doi.org/10.3390/dj6020011 assari, s. (2018f). unequal gain of equal resources across racial groups. int j health policy manag, 7(1), 1-9. https://doi.org/10.15171/ijhpm.2017.90 assari, s. (2019a). education attainment and obesitydifferential returns based on sexual orientation. behav sci (basel), 9(2). https://doi.org/10.3390/bs9020016 assari, s. (2019b). family socioeconomic position at birth and school bonding at age 15; blacks' diminished returns. behav sci (basel), 9(3). https://doi.org/10.3390/bs9030026 assari, s. (2019). socioeconomic determinants of systolic blood pressure; minorities’ diminished returns. journal of health economics and development, 1(1), 1-11. retrieved from http://www.hedjournal.com/article_88938_d0f03c9e2607bdaeee1aa93938267b33.pdf assari, s. (2020a). cognitive test score and 25-year mortality risk; does race matter? journal of medical research and innovation, 4(2), e000213-e000213. assari, s. (2020b). income and mental well-being of middle-aged and older americans: immigrants’ diminished returns. international journal of travel medicine and global health, 8(1), 37-43. https://doi.org/10.34172/ijtmgh.2020.06 assari, s. (2020c). parental education and youth inhibitory control in the adolescent brain cognitive development (abcd) study: blacks’ diminished returns. brain sciences, 10(5), 312. retrieved from https://www.mdpi.com/2076-3425/10/5/312 assari, s. (2020a). parental education on youth inhibitory control in the adolescent brain cognitive development (abcd) study: blacks' diminished returns. brain sci, 10(5). https://doi.org/10.3390/brainsci10050312 assari, s. (2020d). parental education on youth inhibitory control in the adolescent brain cognitive development (abcd) study: blacks’ diminished returns. brain sciences, 10(5), 312. retrieved from https://www.mdpi.com/2076-3425/10/5/312 assari, s. (2020b). understanding america: unequal economic returns of years of schooling in whites and blacks. world j educ res, 7(2), 78-92. https://doi.org/10.22158/wjer.v7n2p78 assari s. (2019). parental educational attainment and academic performance of american college students; blacks’ diminished returns. journal of health economics and development, 1(1), 21-31. retrieved from http://www.hedjournal.com/article_88998_0ea5f9591eeaa2aee5c592ea962a7541.pdf assari, s., akhlaghipour, g., boyce, s., bazargan, m., & caldwell, c. h. (2020). african american children’s diminished returns of subjective family socioeconomic status on fun seeking. children, 7(7), 75. retrieved from https://www.mdpi.com/2227-9067/7/7/75 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 87 published by scholink inc. assari, s., & bazargan, m. (2019). being married increases life expectancy of white but not black americans. j family reprod health, 13(3), 132-140. retrieved from https://www.ncbi.nlm.nih.gov/pubmed/32201487 assari, s., & bazargan, m. (2019). protective effects of educational attainment against cigarette smoking; diminished returns of american indians and alaska natives in the national health interview survey. international journal of travel medicine and global health. assari, s., boyce, s., akhlaghipour, g., bazargan, m., & caldwell, c. h. (2020). reward responsiveness in the adolescent brain cognitive development (abcd) study: african americans’ diminished returns of parental education. brain sciences, 10(6), 391. retrieved from https://www.mdpi.com/2076-3425/10/6/391 assari, s., boyce, s., & bazargan, m. (2020). subjective family socioeconomic status and adolescents’ attention: blacks’ diminished returns. children, 7(8), 80. retrieved from https://www.mdpi.com/2227-9067/7/8/80 assari, s., boyce, s., bazargan, m., & caldwell, c. h. (2020a). african americans’ diminished returns of parental education on adolescents’ depression and suicide in the adolescent brain cognitive development (abcd) study. european journal of investigation in health, psychology and education, 10(2), 656-668. retrieved from https://www.mdpi.com/2254-9625/10/2/48 assari, s., boyce, s., bazargan, m., & caldwell, c. h. (2020b). mathematical performance of american youth: diminished returns of educational attainment of asian-american parents. education sciences, 10(2), 32. retrieved from https://www.mdpi.com/2227-7102/10/2/32 assari, s., boyce, s., bazargan, m., caldwell, c. h., & zimmerman, m. a. (2020). place-based diminished returns of parental educational attainment on school performance of non-hispanic white youth. frontiers in education, 5(30). https://doi.org/10.3389/feduc.2020.00030 assari, s., boyce, s., bazargan, m., mincy, r., & caldwell, c. h. (2019). unequal protective effects of parental educational attainment on the body mass index of black and white youth. international journal of environmental research and public health, 16(19), 3641. retrieved from https://www.mdpi.com/1660-4601/16/19/3641 assari, s., boyce, s., caldwell, c. h., bazargan, m., & mincy, r. (2020). family income and gang presence in the neighborhood: diminished returns of black families. urban science, 4(2), 29. retrieved from https://www.mdpi.com/2413-8851/4/2/29 assari, s., & burgard, s. (2015). black-white differences in the effect of baseline depressive symptoms on deaths due to renal diseases: 25 year follow up of a nationally representative community sample. j renal inj prev, 4(4), 127-134. https://doi.org/10.12861/jrip.2015.27 assari, s., & caldwell, c. h. (2018a). high risk of depression in high-income african american boys. j racial ethn health disparities, 5(4), 808-819. https://doi.org/10.1007/s40615-017-0426-1 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 88 published by scholink inc. assari, s., & caldwell, c. h. (2018b). social determinants of perceived discrimination among black youth: intersection of ethnicity and gender. children (basel), 5(2). https://doi.org/10.3390/children5020024 assari, s., & caldwell, c. h. (2019a). family income at birth and risk of attention deficit hyperactivity disorder at age 15: racial differences. children (basel), 6(1). https://doi.org/10.3390/children6010010 assari, s., & caldwell, c. h. (2019b). parental educational attainment differentially boosts school performance of american adolescents: minorities' diminished returns. j family reprod health, 13(1), 7-13. retrieved from https://www.ncbi.nlm.nih.gov/pubmed/31850092 assari, s., caldwell, c. h., & bazargan, m. (2019). association between parental educational attainment and youth outcomes and role of race/ethnicity. jama netw open, 2(11), e1916018. https://doi.org/10.1001/jamanetworkopen.2019.16018 assari, s., caldwell, c. h., & mincy, r. (2018a). family socioeconomic status at birth and youth impulsivity at age 15; blacks' diminished return. children (basel), 5(5). https://doi.org/10.3390/children5050058 assari, s., caldwell, c. h., & mincy, r. b. (2018b). maternal educational attainment at birth promotes future self-rated health of white but not black youth: a 15-year cohort of a national sample. j clin med, 7(5). https://doi.org/10.3390/jcm7050093 assari, s., caldwell, c. h., & zimmerman, m. a. (2018). family structure and subsequent anxiety symptoms; minorities' diminished return. brain sci, 8(6). https://doi.org/10.3390/brainsci8060097 assari, s., farokhnia, m., & mistry, r. (2019). education attainment and alcohol binge drinking: diminished returns of hispanics in los angeles. behav sci (basel), 9(1). https://doi.org/10.3390/bs9010009 assari, s., gibbons, f. x., & simons, r. (2018a). depression among black youth; interaction of class and place. brain sci, 8(6). https://doi.org/10.3390/brainsci8060108 assari, s., gibbons, f. x., & simons, r. l. (2018b). perceived discrimination among black youth: an 18-year longitudinal study. behav sci (basel), 8(5). https://doi.org/10.3390/bs8050044 assari, s., & lankarani, m. m. (2016a). education and alcohol consumption among older americans; black-white differences. front public health, 4, 67. https://doi.org/10.3389/fpubh.2016.00067 assari, s., & lankarani, m. m. (2016b). reciprocal associations between depressive symptoms and mastery among older adults; black-white differences. front aging neurosci, 8, 279. https://doi.org/10.3389/fnagi.2016.00279 assari, s., lankarani, m. m., & caldwell, c. h. (2018). does discrimination explain high risk of depression among high-income african american men? behav sci (basel), 8(4). https://doi.org/10.3390/bs8040040 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 89 published by scholink inc. assari, s., moazen-zadeh, e., lankarani, m. m., & micol-foster, v. (2016). race, depressive symptoms, and all-cause mortality in the united states. front public health, 4, 40. https://doi.org/10.3389/fpubh.2016.00040 assari, s., & moghani lankarani, m. (2018). workplace racial composition explains high perceived discrimination of high socioeconomic status african american men. brain sci, 8(8). https://doi.org/10.3390/brainsci8080139 assari, s., preiser, b., lankarani, m. m., & caldwell, c. h. (2018). subjective socioeconomic status moderates the association between discrimination and depression in african american youth. brain sci, 8(4). https://doi.org/10.3390/brainsci8040071 assari, s., thomas, a., caldwell, c. h., & mincy, r. b. (2018). blacks' diminished health return of family structure and socioeconomic status; 15 years of follow-up of a national urban sample of youth. j urban health, 95(1), 21-35. https://doi.org/10.1007/s11524-017-0217-3 assari, s. a., g., boyce, s., bazargan, m., caldwell, c.,. (2020). parental human capital and adolescents’ executive function: immigrants’ diminished returns. . medical research archives, 8(10), 1-20. https://doi.org/10.18103/mra.v8i10.2235 auchter, a. m., hernandez mejia, m., heyser, c. j., shilling, p. d., jernigan, t. l., brown, s. a., . . . dowling, g. j. (2018). a description of the abcd organizational structure and communication framework. dev cogn neurosci, 32, 8-15. https://doi.org/10.1016/j.dcn.2018.04.003 bartik, t. j., & hershbein, b. (2018). degrees of poverty: the relationship between family income background and the returns to education. bowden, m., bartkowski, j., xu, x., & lewis jr, r. (2017). parental occupation and the gender math gap: examining the social reproduction of academic advantage among elementary and middle school students. social sciences, 7(1), 6. boyce, s., bazargan, m., caldwell, c. h., zimmerman, m. a., & assari, s. (2020). parental educational attainment and social environment of urban public schools in the u.s.: blacks’ diminished returns. children, 7(5), 44. retrieved from https://www.mdpi.com/2227-9067/7/5/44 brown, r. p., & day, e. a. (2006). the difference isn't black and white: stereotype threat and the race gap on raven's advanced progressive matrices. journal of applied psychology, 91(4), 979. casey, b. j., cannonier, t., conley, m. i., cohen, a. o., barch, d. m., heitzeg, m. m., . . . workgroup, a. i. a. (2018). the adolescent brain cognitive development (abcd) study: imaging acquisition across 21 sites. dev cogn neurosci, 32, 43-54. https://doi.org/10.1016/j.dcn.2018.03.001 chalian, h., khoshpouri, p., & assari, s. (2019). patients’ age and discussion with doctors about lung cancer screening: diminished returns of blacks. aging medicine, 2(1), 35-41. https://doi.org/10.1002/agm2.12053 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 90 published by scholink inc. chetty, r., hendren, n., kline, p., & saez, e. (2014). where is the land of opportunity? the geography of intergenerational mobility in the united states. the quarterly journal of economics, 129(4), 1553-1623. dotson, v. m., kitner-triolo, m. h., evans, m. k., & zonderman, a. b. (2009). effects of race and socioeconomic status on the relative influence of education and literacy on cognitive functioning. journal of the international neuropsychological society: jins, 15(4), 580. garavan, h., bartsch, h., conway, k., decastro, a., goldstein, r. z., heeringa, s., . . . zahs, d. (2018). recruiting the abcd sample: design considerations and procedures. dev cogn neurosci, 32, 16-22. https://doi.org/10.1016/j.dcn.2018.04.004 goldsmith, a. h., darity jr, w., & veum, j. r. (1998). race, cognitive skills, psychological capital and wages. the review of black political economy, 26(2), 9-21. herrnstein, r. j., & murray, c. (2010). the bell curve: intelligence and class structure in american life: simon and schuster. hudson, d., sacks, t., irani, k., & asher, a. (2020). the price of the ticket: health costs of upward mobility among african americans. int j environ res public health, 17(4). https://doi.org/10.3390/ijerph17041179 hudson, d. l., bullard, k. m., neighbors, h. w., geronimus, a. t., yang, j., & jackson, j. s. (2012). are benefits conferred with greater socioeconomic position undermined by racial discrimination among african american men? j mens health, 9(2), 127-136. https://doi.org/10.1016/j.jomh.2012.03.006 hudson, d. l., neighbors, h. w., geronimus, a. t., & jackson, j. s. (2012). the relationship between socioeconomic position and depression among a us nationally representative sample of african americans. soc psychiatry psychiatr epidemiol, 47(3), 373-381. https://doi.org/10.1007/s00127-011-0348-x jensen, a. r. (1976). test bias and construct validity. the phi delta kappan, 58(4), 340-346. karcher, n. r., o'brien, k. j., kandala, s., & barch, d. m. (2019). resting-state functional connectivity and psychotic-like experiences in childhood: results from the adolescent brain cognitive development study. biol psychiatry, 86(1), 7-15. https://doi.org/10.1016/j.biopsych.2019.01.013 lisdahl, k. m., sher, k. j., conway, k. p., gonzalez, r., feldstein ewing, s. w., nixon, s. j., . . . heitzeg, m. (2018). adolescent brain cognitive development (abcd) study: overview of substance use assessment methods. dev cogn neurosci, 32, 80-96. https://doi.org/10.1016/j.dcn.2018.02.007 luciana, m., bjork, j. m., nagel, b. j., barch, d. m., gonzalez, r., nixon, s. j., & banich, m. t. (2018). adolescent neurocognitive development and impacts of substance use: overview of the www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 91 published by scholink inc. adolescent brain cognitive development (abcd) baseline neurocognition battery. dev cogn neurosci, 32, 67-79. https://doi.org/10.1016/j.dcn.2018.02.006 nisbett, r. (1995). race, iq, and scientism. the bell curve wars, 36-57. nisbett, r. e. (1998). race, genetics, and iq. nisbett, r. e. (2005). heredity, environment, and race differences in iq: a commentary on rushton and jensen. nisbett, r. e. (2009). intelligence and how to get it: why schools and cultures count: ww norton & company. nisbett, r. e. (2013). schooling makes you smarter: what teachers need to know about iq. american educator, 37(1), 10. nisbett, r. e., aronson, j., blair, c., dickens, w., flynn, j., halpern, d. f., & turkheimer, e. (2012a). group differences in iq are best understood as environmental in origin. nisbett, r. e., aronson, j., blair, c., dickens, w., flynn, j., halpern, d. f., & turkheimer, e. (2012b). intelligence: new findings and theoretical developments. american psychologist, 67(2), 130. rowe, d. c., vesterdal, w. j., & rodgers, j. l. (1998). herrnstein's syllogism: genetic and shared environmental influences on iq, education, and income. intelligence, 26(4), 405-423. rushton, j. p., & jensen, a. r. (2005). thirty years of research on race differences in cognitive ability. psychology, public policy, and law, 11(2), 235. shervin, a., & ritesh, m. (2019). diminished return of employment on ever smoking among hispanic whites in los angeles. health equity, 3(1), 138-144. https://doi.org/10.1089/heq.2018.0070 sowell, e. r., delis, d., stiles, j., & jernigan, t. l. (2001). improved memory functioning and frontal lobe maturation between childhood and adolescence: a structural mri study. j int neuropsychol soc, 7(3), 312-322. https://doi.org/10.1017/s135561770173305x sowell, e. r., thompson, p. m., leonard, c. m., welcome, s. e., kan, e., & toga, a. w. (2004). longitudinal mapping of cortical thickness and brain growth in normal children. j neurosci, 24(38), 8223-8231. https://doi.org/10.1523/jneurosci.1798-04.2004 sowell, e. r., thompson, p. m., tessner, k. d., & toga, a. w. (2001). mapping continued brain growth and gray matter density reduction in dorsal frontal cortex: inverse relationships during postadolescent brain maturation. j neurosci, 21(22), 8819-8829. retrieved from https://www.ncbi.nlm.nih.gov/pubmed/11698594 turkheimer, e., harden, k. p., & nisbett, r. e. (2017). there’s still no good reason to believe black-white iq differences are due to genes. vox, jume, 17. zelazo, p. d. (2006). the dimensional change card sort (dccs): a method of assessing executive function in children. nature protocols, 1(1), 297-301. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 2, 2020 92 published by scholink inc. appendices appendix 1. distribution of predictor (a), outcome (b), qnantiles (c), and residuals (d) a b c d appendix 2. model formula model 1 nihtbx_cardsort_agecorrected ~ age + race.4level + sex + high.educ.bl + married.bl + household.income.bl + hisp model 2 nihtbx_cardsort_agecorrected ~ age + race.4level + sex + high.educ.bl + married.bl + household.income.bl + hisp + age x race.4level model 3 nihtbx_cardsort_agecorrected ~ age + race.4level + sex + high.educ.bl + married.bl + household.income.bl + hisp + age x household.income.bl all models: random: ~(1|abcd_site/rel_family_id) figure 1. association between age and dccs score (cognitive flexibility) overall children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 3, no. 1, 2020 www.scholink.org/ojs/index.php/ct 16 original paper i’ve changed, i’m smarter: empowering youth to thrive neurosequential approach to employment, education and training outcomes for youth lisa m. keegan 1* , jennifer cartmel 1 & paul harris 1 1 griffith university, school of human services and social work, meadowbrook, australia * lisa m. keegan, griffith university, school of human services and social work, meadowbrook, australia received: january 15, 2020 accepted: january 30, 2020 online published: februay 14, 2020 doi:10.22158/ct.v3n1p16 url: http://dx.doi.org/10.22158/ct.v3n1p16 abstract this paper explores the impact of a neurosequential brain development approach on employment, education and training outcomes of vulnerable long-term unemployed youth, aged 15-24 years. the empowering youth to thrive (eytt) program utilises neuroscience research, which underpin varied creative and sensory and regulatory experiences used to engage youth in social and emotional learning. the aim is to enhance brain pathways to increase youth’s higher order thinking functions such as problem solving, communication and critical thinking skills. these are considered necessary attributes for positive engagement in the current and future workforce. a bricolage methodology was used to evaluate the impact of the program, with findings determining the eytt program had benefits for participants in gaining successful training, education and/or employment opportunities. keywords youth, employment, education, training, neurosequential, trauma 1. introduction the eytt program is based on the work of bruce perry (2006) and dan siegel (2012). the program sought to respond to the need for a different approach to assisting youth into work, education or training. youth unemployment is at a record h igh in australia. twelve percent are unemployed; twice the national unemployment rate and three t imes the rate of those aged over 25 years (australian bureau of statistics (abs), 2019). youth hold higher qualifications than historically suggesting youth unemployment is impacted by variab les other than qualification attainment. www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 17 published by scholink inc. modernisation, globalisation, technology and a loss of junior ro les have reduced the number of unskilled jobs available for youth creating greater competition fo r less jobs (anglicare australia , 2019). increasing rates of depression and anxiety are also reportedly affect ing employability (national mental health commission, 2017). unemployment can lead to social isolation, poor physical and mental health, social and behavioural difficu lties, increased criminal involvement and representation in the justice system, reliance on income support, poverty, and homelessness (mitchell institute, 2017; reeve, marjolin, muir, powell, hannigan, ramia, & etuk, 2016). indeed, employment is a mitigator of disadvantage, providing increased wellbeing and potentially preventing cyclic disadvantage (lamb & huo, 2017). young people with lower educational attainment and minimal skills are most affected by changes to workforce opportunities. precarious employment and changing employment pathways affect young people’s capacities to contribute productively, creating financial and social burden for them and broader society (payton, 2017). this is especially so for vulnerable youth who have experienced toxic stress as a result of adverse childhood experiences (ace) (felitti, anda, nordenberg, williamson, sp itz, edwards, koss, & marks, 1998). cumulat ive stress created by ace can weaken brain structure and function (anda, felitt i, bremner, walker, whit field, perry, dube, & giles, 2006). this has implicat ions for life -long neurosequential development (larkin, sh ields , & anda, 2012). ace include violence, abuse, neglect and poverty related experiences (felitti, anda, nordenberg, williamson, sp itz, edwards, koss , & marks, 1998). these stressors can impede brain development, particularly higher order thinking functions (noble, houston, kan, & sowell, 2012), which can engender behavioural difficu lties, poor physical and mental health, low educational attainment, welfare dependency and/or substance abuse (centre on the developing child at harvard university, 2017). quantity and duration of ace impact the likelihood of neurosequential delays and lifelong accumulat ive affects (felitt i, anda, nordenberg, williamson, sp itz, edwards, koss, & marks, 1998). the higher order brain regulates working memory and mental plasticity essential for skills such as problem solving, focus, concentration, adaptability, communication and self-regulation that increases capacities to engage in employment (centre on the developing child at harvard university, 2017). these skills are vital for long-term learning, positive health and wellbeing and social and emotional competence (tomer, 2014). low level stress activates the brain’s fight, flight, freeze response to manage threat (real or perceived) (centre on the developing child at harvard university, 2017). toxic stress occurs when threat responses are prolonged “disrupting the development of brain architecture and other organ systems ” (centre on the developing child at harvard university, 2017, p. 1). mitigation of neurosequential delays as a result of prolonged stress occurs by building coping mechanisms and resilience through www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 18 published by scholink inc. supportive relationships with adults (perry, 2009). the absence of responsive adult attachments alters brain architecture and can lead to learning and behavioural difficu lties (gaskill & perry, 2015). seventy percent of genes are influenced by environmental experiences (goleman, 2006). schneider (2007) suggests “environmental factors and genes form a fu lly interactional system” (p. 91). secure dedicated relationships provide positive, safe, and supported engagement that assist youth to feel protected and can prevent or reverse the damaging effects of toxic stress (centre on the developing child at harvard university, 2017). the earlier in life these relationships occur the more positive the outcome. fostering meaningful, engaging relat ionships and attachments, which may not have previously been available to youth regulates youth’s brain function. the eytt program recognises that lower parts of the brain develop first and higher order thinking develops later (perry, 2004). the majority of brain development occurs in the early years of life (moore, arefadib, deery, keyes, & west, 2017). heightened stress leads to high production of cortisol and adrenalin impeding complex connections between the brain systems (anda, felitti, bremner, walker, whitfield, perry, dube, & giles, 2006). evidence also exists that young people’s brains are still developing until the age of 25 (arain, haque, johal, mathur, nel, rais , & sharma, 2013). positive experiences, interactions and environments create rapid brain development; disadvantaged environments and poor relationships impede brain function hindering capacities to engage positively with emotions and feelings and employ higher order thinking (perry & marcellus , 2004). the brain is capable of neuroplasticity; it can change and rebuild pathways if exposed to new, positive, ‘repetitive and patterned experiences’ (perry & marcellus , 2004, p. 2). the eytt program utilises this informat ion to provide a range of sensorimotor activit ies for part icipants. sensory exploration, music, rhythm, movement, creativity, mindfulness and positive attachments increase plasticity and calm the brain allowing access to higher order thinking (gaskill & perry, 2015). the intention of eytt was to expand youths’ brain plasticity so they are more likely to learn new skills and develop dispositions for the possibility of future workforce participation. these activit ies were built into a physical, emotional and culturally safe weekly program consisting of four days of attendance from 9 am to 3 pm. the program followed the neurosequential brain pathway. that is, morn ings consisted of lower brain focused activities such as ensuring the participants had sufficient rest and food, building to physical activity targeting the mid brain. this was followed by clin ical arts therapy experiences targeting the limbic (emot ional) area of the brain. higher order thinking experiences were able to be introduced in the later part of the day when the lower order areas of the brain had been calmed and regulated. the eytt program aimed to provide new ways of engaging youth and builds their capacities in transferable workforce skills necessary for present-day and future jobs. building young people’s www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 19 published by scholink inc. capacities in these attributes creates skills for mult iple jobs (torii & o’connell, 2017). the gradual repair of underdeveloped brain pathways potentially generates new ways of thinking and being th at creates greater potential to take on workforce opportunities. forming supportive relationships with each participant was vital to the build ing of these capacities. in this context, supportive staff ratios of one facilitator to every three participants were built into the program enabling conducive relat ionships to be established between each participant and at least one staff member and other peers. the eytt program sought to motivate youth to learn through experiences that are “ in a relationally safe context, and using adequate ‘dosing’ in a patterned, repetitive, rhythmic, and reward ing manner” (gaskill & perry, 2015, p. 188). build ing brain pathways empowers youth to create the possibility of change to their life trajectory, particularly the possibility of workforce engagement. as knowledge holders of their own experience youth are engaged in reciprocal learning integral to the eytt init iative. this establishes a relationship of openness and trust between the youth and facilitators (reich, liebenberg, denny, battiste, bernard, christmas, dennis, denny, knockwood, nicholas, & hugh, 2017). 2. method 2.1 methodology the eytt project was a collaborative and consultative venture that constructed new knowledge about the understanding and skills required by professionals and practitioners to work with long term unemployed youth. conclusions were drawn about the impact of using a neurosequential model of therapeutics in improving youth’s wellbeing and subsequent employment, education and training outcomes. these were based on a mult iple method, bricolage approach (rogers, 2012). the bricolage approach enabled opinions and perspectives to be sought and considered so that a new ’pedagogical space’ (kostogriz & peeler, 2007) was possible. the is derived from levi-strauss’s (1966) notion of creating pro jects using the different tools, methods and techniques available. a bricoleur then, requires knowledge of a variety of perspectives and approaches. theoretical and interpretive bricolage reinforces the notion that reliab le positions cannot be reached by the use of one perspective. it is not intended that the pieces of this program approach will fit together neatly. rather, the bricolage approach assists with the management of disparate data that inform the process of explanation of this innovative program (rogers, 2012). to examine the eytt program a methodological brico lage was used to underpin data collection and evaluation approaches. a guided reflection process, enrolment and case study data, and discourse about the program strengths and challenges undertaken with facilitators, created a patchwork of information that informed the research study. evaluation of the program occurred with participants (n=136) through written, verbal, and survey responses about their experiences in the p rogram and the changes that have www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 20 published by scholink inc. occurred for them. ethical approval (gu:2017/663) was granted by griffith university in line with the national statement on ethical conduct in human research (national health and medical research council, 2018). the researcher kept a journal o f field observations. qualitative and quantitative data was gathered to provide a more complete understanding of the research problem than using either method alone (creswell, 2015), see table 1 of data used in the bricolage. these available qualitative and quantitative tools collectively allowed a mult i-perspective evaluation of the program. 2.1.1 data collection and recru itment the multip le method used in this evaluation are summarised in table 1. table 1. data used in the bricolage individual data program information  background/enrolment information  hope scale  most significant change question responses  informal discussions  attendance data  physical space  practice  skills, knowledge and qualifications of staff researcher journal  informal discussions  observations  discourse  participant engagement  efficacy of experiences provided  relationships qualitative data was gathered using program facilitator case notes and researcher journal notes about conversations, observations, relationships, program experiences, participant engagement and discourse and narrative from all stakeholders about the program. a qualitative interview question was posed to the participants each week; “what has been your most significant change this week as a result o f participating in the program?” part icipants provided written responses collected by the researcher. quantitative data was co llected v ia surveys and attendance records. participant attendance was collected from daily sign in and out sheets to determine program dosage for each participant. the hope scale (synder, 1995) was administered to participants at the commencement and completion of the program. the hope scale is a validated tool which according to snyder (1995) recognises “hope is a construct based upon realistic evaluations about desires and the means to achieve them” (as cited in www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 21 published by scholink inc. pacico, bastianello, zanon, & hutz, 2013, p. 488). higher levels of hope generate increased life satisfaction, healthier physical and mental wellbeing and improved academic outcomes leading to enhanced work performance and opportunities due to better coping strategies and problem-solving capacities (pacico, bastianello, zanon, & hutz, 2013). pre and postest scores were analysed using the non-parametric test, the wilcoxon signed rank test to determine if median d ifferences represented a significant improvement. purposive sampling, which identified participants suitable for the program was used to recruit you ng people aged 15 to 24 years from job providers, queensland department of youth justice, department of human services and community referrals. community liaison staff at eytt connected with these organisations to recruit 136 part icipants see table 2 of participant recruitment numbers per cohort. table 2. participant recruitment numbers per cohort cohort 1 2 3 4 5 6 number of participants 22 17 17 18 33 29 eighty-nine participants (65.44%) successfully completed the program. in the interest of transparency about attendance, cohorts five and six consisted of 24 part icipants referred from juvenile justice who attended for one observation morn ing, after which the case worker determined the youth were not ready for this type of program. five other participants attended for one enrolment day but did not commence the program. cultural d iversity of part icipants included aboriginal, african, anglo australian, german, maori, samoan, spanish and torres strait islander. 2.1.2 limitations participant attendance ranged from 1-4 days per week and this variable attendance potential limited the data able to be collected. a member of the research team attended the eytt program once a week to collect data limiting informat ion to those participants attending on the day of data collection. hope scale surveys were disseminated by the researcher and the eytt team to maximise opportunities to ensure data was collected from all program part icipants, however, only 42 matched pairs were availab le for analysis. limitations in reach were evident for some participants that required parental or guardian consent, which was not able to be obtained. therefore, data about participants under 18 years old or those in foster/out-of-home care were not availab le. not all part icipants provided answers to the ‘most significant change’ question or they responded with ‘i don’t know’ at t imes, resulting in missed data. literacy concerns caused writ ing difficulties for some participants. this was mitigated by the researcher obtaining verbal responses from the participants. participants who did not feel comfortable to do this did not provide a response resulting in some further data losses. follow-up with participants about their employment, education and/or training status 12 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 22 published by scholink inc. months from completion of the program proved difficult due to contact issues. data about participants employment, education and/or training status is at one month after completion of the program. 3. results inductive frequency analysis of qualitative data identified key themes relat ing to neurosequential development and workplace transferability skills . these were obtained from the written documentation of conversations and observations, and ‘significant change’ question responses collected. the young people expressed what they have gained from the program through written responses to the question “what has been your most significant change this week as a result of your participation in the program?” the responses from all cohorts were collated and the following themes emerged: confidence “confident. i feel more motivated in my life and has given me a routine throughout my days. i’ve been eating heaps and i’ve felt like i’m changing as a person by being more motherly. more happier and loving life”. participant 6.1 motivation “more motivated. see life differently, happier, motivated, opening more doors/opportunities. got my licence, reached my goal, socialise more, confident, happy”. participant 2.4 “i feel like this program is really help ing keep me motivated, positive and focused! i’m feeling happy and even more mot ivated. i feel more confident. i have been feeling happier lately, but sad about the program ending soon. i have been sleeping better and doing more things”. part icipant 3.1 emotional changes “i changes a lot. feeling much better. my mum really notices that i’m much happier when i come home from here. anger control. when i first came here, i was scared and i happy to be here. my emotions are stable”. part icipant 3.4 lifestyle changes “i have progressed over the past week in a positive way. i have changed my lifestyle by becoming healthier and have improved my relationships with family and friends. overcoming barriers. getting out of my comfort zone. i was able to achieve something i thought i couldn’t”. participant 4.6 3.1 neurosequential changes neurosequential pathways development charts were developed from the writ ings of bruce perry (2006). participants’ confidential responses to the weekly question: “what has been your most significant change this week as a result of your participation in the program?” were frequency analysed against a coded list to determine changes to the youths’ neurosequential development as a result of participating in the program. table 3 identifies the frequency count for respective neurosequential pathways development. the most frequent responses across all neurosequential areas were self-awareness; www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 23 published by scholink inc. improved mood; confidence; improved attitude; and increased sense of safety/survival. most frequent responses for limbic/amygdala areas were mood; confidence; attitude; relationships; and emotions. the most frequent responses for cortical areas were awareness; affiliation; attachment/belonging; self-regulation; and goal setting. table 3. identi fied neurosequential pathways development and frequency counts neurosequential pathways brainstem/survival frequency count midbrain/physical frequency count b4 safety/ survival 117 m9 language 48 b3 physical health 45 m4 gross motor skills 27 b2 rest/sleep 24 m2 movement 20 b6 hearing/auditory function 19 m1 co-ordination 19 b5 sight/vision 13 m5 fine motor skills 14 b1 food/nutrition 12 m6 proprioception/force 13 b7 touch/tactile 12 m3 spatial awareness 11 b8 taste/texture 7 m7 vestibular function 4 b9 smell/olfactory 0 m8 balance 4 m11 pattern ing 4 m12 repetit ion 4 m10 crossing mid line 2 limbic/ amygdala/emotional frequency count cortical/higher order thinking frequency count l1 mood 143 n4 awareness 166 l11 confidence 134 n3 affiliat ion 83 l10 attitude 128 n1 attachment/belonging 81 l9 relationships 107 n2 self-regulation 79 l2 emot ions 104 n12 goal setting 61 l8 communication 90 n10 planning 55 l13 opt imism 81 n13 focus & attention 50 l12 independence 53 n11 priorit ising 47 l3 threat (fight, flight, freeze) 35 n6 respect 38 l4 anxiety 32 n8 prob lem solving 31 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 24 published by scholink inc. 3.1.1 transferability skills development a transferability skills chart was developed from a range of articles about the skills needed for current and future jobs (for example, committee for economic development of australia 2015; social ventures australia 2016; the foundation for young australians , 2017). tab le 4 presents the frequency counts of work t ransferability skills development observed. transferability skills are considered generalised proficiencies able to be utilised across a range of jobs. participant responses to the question “what has been your most significant change this week as a result of your part icipation in the program?” were frequency analysed against the skills list to determine the most recurrently developed skills of the youth as a result of participating in the program. most frequent responses of transferability skills were in relation to self-awareness; opportunity awareness; self-regulation; sociability; and decision making, learning, and confidence. the most frequent responses for cognitive skills were opportunity awareness; decision making; learn ing; problem solving and reasoning. most frequent responses for communication and social/emotional skills were sociability; emotional intelligence; comprehension; collaboration and teamwork; and written and verbal p resentation. the most frequent responses for personal behaviours skills were self-awareness; self-regulat ion; confidence; integrity/honesty; and self-management. table 4. work transferability skills development and frequency counts l7 stress 26 n17 literacy 29 l5 arousal 13 n14 memory recall 29 l6 fear response 7 n5 tolerance 27 n16 impulse control 22 n7 critical thinking 19 n15 multi-tasking 13 n9 negotiation 2 work transferability skills cognitive skills frequency count communicat ion and social/emotional skills frequency count personal behaviours frequency count c5 opportunity awareness 136 s1 sociability 123 p2 self-awareness 229 c1 decision making 121 s8 emot ional intelligence 120 p8 self-regulation 124 c8 learn ing 121 s5 comprehension 78 p4 confidence 121 c4 problem solving 37 s4 collaboration and teamwork 66 p5 integrity/honesty 103 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 25 published by scholink inc. the analysis of journal notes revealed the most frequent observations, relating to participants, were about non-judgment, acceptance and their sense of belonging (feeling like a family). the relat ionships formed between staff and participants and between the participants and their peers was seen by participants as pivotal to their success in the program. creating a safe, calm and inclusive space that met participants needs through consultation with participants was intentional in the program’s design and indeed this appeared to reduce participants’ fear and stress and create a sense of belonging and emotional safety. quantitative analysis of hope scale data enabled comparison of participants feelings of agency, pathway and hope on entry and completion of the program. pathway scores identify participants’ thinking about the possible options available to achieve desired goals (snyder, 2000). agency scores identify mot ivation and self-belief in part icipants’ capacity to achieve those goals. the integration of pathway and agency thinking produces a measure of hope. high hope individuals view ‘barriers as challenges to overcome and use their pathway thoughts to plan an alternative route to their go als’ (snyder, 1994, as cited in snyder, 2000, p. 10). the median scores and interquartile range for the pre and post administrations of the hope scale (n=42) are presented in table 5. the results of the wilcoxon sign rank test revealed that median differences were significant (z=4.115, p <0.001). as indicated in table 6, there were positive differences observed for 35 part icipants, a negative difference observed for five part icipants and scores for two participants were unchanged. overall, results indicate that the p rogram had a positive effect on part icipants as measured by the hope scale. table 5. median scores and interquartile range pre and post hope scale across all cohorts c3 reasoning 54 s3 written and verbal presentation 46 p3 self-management 92 c2 creativ ity 42 s2 listening to understand 41 p11 persistence 87 c9 curiosity 26 s7 caring 20 p1 responsibility 82 c7 innovation 13 s6 empathy 13 p12 motivation 71 c6 dig ital literacy 7 p9 determination 65 p10 initiat ive 32 p7 time management 29 p6 tolerance 21 p13 flexib ility 12 www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 26 published by scholink inc. median interquartile range 25% interquartile range 75% hope scale p re-measure (baseline) 20.5 17 26.5 hope scale post measure 28 24 37.5 figure1. patterns of positive and negative differences in hope scale scores observed sixty-five participants (60.75%) obtained work opportunities or engaged in education and training either during or soon after completing the program. the remain ing participants —19 are not employed nor in education and train ing and 23 have status unknown. the young people who did not complete the program were evidently impacted by external variables such as family violence, substance abuse, homelessness, mental health, d isability, juvenile justice, out of home care, and/or family relocation. 4. discussion the results of this program recognise that the brain is impressionable during all stages of life (flores , 2010) and shaped by early attachment and ongoing relationships and amenable to conducive, well-designed programming and support. as already recognised in the literature, relevancy and www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 27 published by scholink inc. intensity of experiences create motivation, potentially generating more rapid b rain development changes (kolb & muhammad, 2014). music experiences are strong motivators important to neurosequential programs (kolb & muhammad, 2014). the eytt program provided music, movement, art therapy and mindfulness in a physically, emotionally and culturally safe learn ing space, to engage participants, who reported increased social, emotional and cognitive skills that potentially lead to engagement in employment, education and training. the data indicated that the more attendance/experiences for participants, the more likely they were of having successful outcomes. the observed relevancy of experiences to help engage and motivate participants in attendance were therefore considered key to this success. a number of practical considerations regarding participants’ individual life circumstances were addressed to support their maximum part icipation in the program. circumstances included not having a current driver’s license and/or photographic identification nor access to a vehicle for transport, which made it difficu lt fo r part icipants to access support services, attend the eytt program and attend job interviews. the eytt mitigated this by providing minibus transport and assisting participants to negotiate the pathways to obtaining a driver’s license and/or identification cards. limited access to telephone and/or email was another consideration. while participants may have had phones, often they did not have credit nor access to internet for email contact. participants not receiving welfare benefits often did not have a bank account. as intensity of experiences impact outcomes, it was deemed important to participants’ successful outcomes that barriers to their participation be mit igated as much as possible. this is also considered a crit ical success factor in the program’s success. participants were found to have very complex needs. external barriers included a lack of stable housing, youth justice engagement, domestic/family violence, neglect, physical and/or sexual abuse, significant family/carer responsibilities, mental health, substance abuse, health and developmental issues, and literacy and numeracy concerns. these issues were often identified later in the program when a trusting relationship had been established and participants felt safe to disclose. staff were ab le to observe behaviours indicating these issues as they became more familiar with the part icipants. daily progress meet ings sans participants were held to d iscuss planning, so all staff were familiar with indiv idual needs of participants and to provide continuity in neurosequential experiences. individual program plans combining case notes, identified participant needs, and detailed personal history were developed for each part icipant. support agencies were engaged to assist participants when deemed necessary. it was important to gain information about the participants to ‘shape staff practices that strengthen relationships…, enhance personal safety…and [provide] services to vulnerable individuals…as early as possible’ (leitch, 2017, p. 1). delivering an innovative program required thoughtful planning about staff constitutions, experience, skills, knowledge and qualifications. facilitators recruited for the eytt program had varied capacities www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 28 published by scholink inc. to engage with youth and provide a neurosequential informed program. staff of diverse experience, gender, culture, age, education and artisanship allowed for diverse participants to feel a sense of connection and belonging. knowledge sharing between staff, and staff and participants provided distinct experiences of interest and intensity to motivate participants to regularly attend the program, improve their neurosequential development and work transferability skills potentially improvin g their employability outcomes. 4.1 future considerations critical reflection of program implementation and outcomes suggest the program’s approach was overall successful in engaging youth in employment, education and training. a number of future considerations were also identified. staff availability to contact potential employers and attend workp laces was limited due to the 1-on-1 engagement needed with participants in the program. eytt was successful in engaging large corporate organisations. smaller businesses were also approached. these were only willing to accept job ready young people. small family owned businesses became committed to the project and the participants they met; proving the most successful in meeting the employment needs of participants. this suggests further opportunities to engage more formal and informal supports in the design of such program in the future is needed. it is recommended further research, including longitudinal studies be undertaken on the benefits of neurosequential-based programs in improving youth employment, education and training outcomes. accessing social enterprise workp laces may be beneficial to creat ing collaborative approaches to the program by interlinking other community employment programs. a longer-term aim of training future neurosequential program facilitators and mentors may also be beneficial to youth employment, education and training outcomes. the twelve-week eytt program included follow up mentoring with participants for 12 months after complet ion. transience of some participants and their families resulted in loss of contact. contactable participants responded well to the mentoring process and some returned to the program as mentors (n=12). staff and participants felt an increased duration of the program would be beneficial. participants felt an improved sense of confidence and skills capacity in the last 3-4 weeks of the program and felt a longer timeframe would bring them to a greater level of success in job outcomes. staff also felt that more disadvantaged youth would benefit from an increased duration of neurosequential learning and support to achieve full job readiness. once neurosequential development has improved sufficiently to access the higher brain areas necessary for reading, writ ing and problem-solving, attendance in programs to improve literacy and numeracy would be beneficial . 5. conclusion www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 29 published by scholink inc. the eytt program intended to increase the workforce engagement, train ing and education capacities of participants who were identified as having complex needs . evaluation shows use of the neurosequential model of therapeutics was critical to the development of the program. relat ionships formed between facilitators and the young people participating were pivotal to the success of the program. most notably, the eytt program observed numerous benefits for participants in relation to their success in gaining further training, education and/or employment opportunities. references anda, r. f., felitti, v. j., bremner, j. d., walker, j. d., whitfield, c., perry, b. d., dube, s. r., giles, & w. h. (2006). the enduring effects of abuse and related adverse experiences in ch ildhood. a convergence of evidence from neurobiology and epidemiology. european archive of psychiatry and clinical neuroscience, 256(3), 174-186. https://doi.org/10.1007/s00406-005-0624-4 anglicare australia. (2019). jobs availability snapshot 2019. canberra: anglicare australia. arain, m., haque, m., johal, l., mathur, p., nel, w., rais, a., … sharma, s. (2013). maturation of the adolescent brain. neuropsychiatric disease and treatment , 9, 449-461. https://doi.org/10.2147/ndt.s39776 australian bureau of statistics. (2019). 6202.0 labour force, australia, oct 2019 . retrieved november13, 2019, from https://www.abs.gov.au/ausstats/abs@.nsf/7d12b0f6763c78caca257061001cc588/a8e6e58c355009 0eca2582ce00152250!opendocument centre on the developing child at harvard university. (2017). key concepts: executive function and self-regulation. retrieved march 19, 2019, from https://developingchild.harvard.edu/science/key-concepts/executive-function/ committee for economic development of australia. (2015). australia’s future workforce? melbourne: ceda. retrieved november 13, 2019, from https://www.ceda.com.au/ceda/media/researchcataloguedocuments/research%20and%20polic y/pdf/26792-futureworkforce_june2015.pdf creswell, j. (2015). educational research: planning, conducting, and evaluating quantitative and qualitative research. us: pearson. felitti, v. j., anda, r. f., nordenberg, d., williamson, d. f., spitz, a. m., edwards, v., koss, m. p., & marks, j. s. (1998). relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults: the adverse childhood experiences (ace) study. american journal of preventative medicine, 14(4), 245-258. https://doi.org/10.1016/s0749-3797(98)00017-8 flores, p. j. (2010). group psychotherapy and neuroplasticity: an attachment theory perspective. https://developingchild.harvard.edu/science/key-concepts/executive-function/ www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 30 published by scholink inc. international journal of group psychotherapy , 60(4), 546-570. https://doi.org/10.1521/ijgp.2010.60.4.546 gaskill, r. l., & perry, b. d. (2015). the neurobio logical power of play : using the neurosequential model of therapeutics to guide play in the healing process. in c. a. malchiodi, & d. a. crenshaw (eds.), creative arts and play therapy for attachment problems (pp. 178-194). us: guilford press. goleman, d. (2006). social intelligence: the new science of human relationships. us: bantam dell. kolb, b., & muhammad, a. (2014). harnessing the power of neuroplasticity for intervention. frontiers in human neuroscience, 8, p. 377. https://doi.org/10.3389/fnhum.2014.00377 lamb, s., & huo, s. (2017). counting the costs of lost opportunity in australian education. mitchell institute report no. 02/2017. melbourne: mitchell institute. larkin, h., shields, j. j., & anda, r. f. (2012). the health and social consequence of adverse childhood experiences (ace) across the lifespan: an introduction to prevention and intervention in the community. journal of prevention and intervention in the community , 40(4), 263-270. https://doi.org/10.1080/10852352.2012.707439 leitch, l. (2017). action steps using aces and trauma-informed care: a resilience model. health and justice, 5(5), 1-10. https://doi.org/10.1186/s40352-017-0050-5 levi-strauss, c. (1966). the savage mind. us: university of chicago press. moore, t. g., arefad ib, n., deery, a., keyes, m., & west, s. (2017). the first thousand days: an evidence paper–summary. parkville, victoria: centre for community child health, murdoch children’s research institute. national health and medical research council. (2018). national statement on ethical conduct in human research, 2007 (updated 2018). retrieved july 30, 2018, from https://www.nhmrc.gov.au/research-policy/ethics/national-statement-ethical-conduct-human-resear ch national mental health commission. (2017). the 2016 national report on mental health and suicide prevention. sydney: national mental health commission. noble, k. g., houston, s. m., kan, e., & sowell, e. r. (2012). neural correlates of socioeconomic status in the developing human brain. developmental science, 15(4), 516-527. https://doi.org/10.1111/j.1467-7687.2012.01147.x pacico, j. c., bastianello, m. r., zanon, c., & hutz, c. s. (2013). adaptation and validation of the dispositional hope scale for adolescents. sico ogia ef e o e r tica, 26(3), 488-492. https://doi.org/10.1590/s0102-79722013000300008 payton, a. (2017). skilling for tomorrow. presented at the 26th national vet research conference www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 31 published by scholink inc. “no frills”. adelaide: nat ional centre for vocational education and research (ncever). perry, b. d. (2009). examin ing child maltreatment through a neurodevelopmental lens: clinical applications of the neurosequential model of therapeutics. journal of loss and trauma, 14, 240-255. https://doi.org/10.1080/15325020903004350 perry, b. d. (2006). the neurosequential model of therapeutics: applying principles of neuroscience to clinical work with trau matized and maltreated children. in n. boyd webb (ed.), working with traumatized youth in child welfare (pp. 27-52). us: the guilford press. perry, b. d. (2004). the margaret mccain lecture series inaugural lecture, maltreatment and the developing child: how early childhood experience shapes child and culture . canada: the centre for children and families in the justice system. perry b. d., & marcellus, j. (2004). the impact of abuse and neglect on the developing brain . retrieved august 9, 2019, from https://www.scholastic.com/teachers/articles/teaching-content/impact-abuse-and-neglect-developi ng-brain/ reeve, r., marjo lin, a., muir, k., powell, a., hannigan, n., ramia, i., & etuk, l. (2016). austra ia’s social pulse. unsw sydney and uwa perth: centre for social impact. reich, j., liebenberg, l., denny, m., batt iste, h., bernard, a., christmas, k., dennis, r., denny, d., knockwood, i., nicholas, r., & hugh, p. (2017). in this together: relational accountability and mean ingful research and dissemination with youth. international journal of qualitative methods, 16, 1-12. https://doi.org/10.1177/1609406917717345 rogers, m. (2012). contextualizing theories and practices of bricolage research. the qualitative report, 17(48), 1-17. schneider s. m. (2007). the tangled tale of genes and environment: moore’s the dependent gene: the fallacy of “nature vs. nurture”. the behavior analyst, 30(1), 91-105. https://doi.org/10.1007/bf03392149 siegel, d. j. (2012). the developing mind: how relationships and the brain interact to shape who we are. us: the guilford press. snyder, c. r. (2000). hypothesis: there is hope. in c. r. snyder (ed .), handbook of hope theory, measures and applications (pp. 3-21). us: academic press. https://doi.org/10.1016/b978-012654050-5/50003-8 snyder, c. r. (1995). conceptualizing, measuring, and nurturing hope. journal of counselling and development, 73, 355-360. https://doi.org/10.1002/ j.1556-6676.1995.tb01764.x snyder, c.r. (1994). the psychology of hope: you can get there from here. us: free p ress. social ventures australia. (2016). fundamental principles for youth employment . retrieved july 30, 2018, from www.scholink.org/ojs/index.php/ct children and teenagers vol. 3, no. 1, 2020 32 published by scholink inc. https://www.socialventures.com.au/assets/fundamental-principles-for-youth-employment-report-f inal.pdf the foundation for young australians. (2017). the new work smarts: thriving in the new work order. retrieved july 30, 2018, from https://www.fya.org.au/wpcontent/uploads/2017/07/fya_thenewworksmarts_july2017.pdf tomer, j. f. (2014). adverse childhood experiences, poverty, and inequality: toward an understanding of the connections and the cures. world economic review, 3, 20-36. torii, k., & o’connell, m. (2017). preparing youth for the future of work. mitchell institute policy paper report no. 01/2017. melbourne: mitchell institute. children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 4, no. 1, 2021 www.scholink.org/ojs/index.php/ct 1 original paper teaching emotion regulation: k-12 teachers’ perceptions and practices across the curriculum louis s. nadelson1*, estefany soto1, tye smith1, sarah nekonchuk1, jessica ims1 & sandra g. nadelson2 1 college of education, university of central arkansas, 201 donaghey ave., conway, ar, 72035, united states 2 college of health and behavioral sciences, university of central arkansas, 201 donaghey ave., conway, ar, 72035, united states * louis s. nadelson, e-mail: lnadelson1@uca.edu received: november 17, 2020 accepted: november 30, 2020 online published: december 15, 2020 doi:10.22158/ct.v4n1p1 url: http://dx.doi.org/10.22158/ct.v4n1p1 abstract students can gain a range of skills and knowledge from interactions in schools, including emotional competencies such as regulation of emotions. teachers are positioned to support students’ development of emotion regulation in the social context of school. we sought to determine k-12 teachers’ sense of responsibility, preparation, engagement, comfort, and approach to teaching students emotion regulation. the quantitative and qualitative data we gathered from 155 general k-12 classroom teachers revealed a sense of responsibility, low preparation, varied engagement, and low to moderate comfort. we found differences by grade levels, school location, and teacher education level. there was moderate alignment between how the teachers regulate their emotions and the emotion regulation processes they teach their students. we share implications for school psychologists and suggest multiple directions for future research. keywords emotion regulation, teacher practices, student well-being, implications for practice 1. introduction students can gain a range of skills and knowledge through their school experiences that influence their development and long-term well-being (carter, 2016; mccaslin & good, 1996). while the focus on student learning tends to be on curriculum content, skills, and knowledge acquisition, students are likely to engage in peer and teacher interactions that influence their dispositions, social skills, and www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 2 published by scholink inc. character development (mccaslin & good, 1996; stefanou et al., 2004). students’ social interactions in schools are likely to influence their emotional learning, including their ability to regulate emotions. in our search of the literature, we found multiple reports of curricula or programs designed to teach students how to regulate their emotions (e.g., barton et al., 2014). however, we found few empirical studies that focused on the perceptions, preparation, practices, and support for teachers across grades prek-12, concerning teaching their students how to regulate their emotions (e.g., buchanona et al., 2009). briudgeland et al. (2013) recognize a gap in the research aligned with our focus and call for more empirical studies that explore classroom level teaching of social emotional learning. further, we were not able to find any empirical studies that linked a general sampling of general classroom teachers’ personal emotion regulation with how they teach their students to self-regulate their emotions. our research addressed these gaps in the literature as we explored prek-12 teachers’ perceptions and practices for teaching their students to regulate their emotions. 2. review of literature 2.1 importance of emotion regulation “emotional regulation” and “emotion regulation” includes the ability to appraise and reappraise a situation, express emotions adequately, and act in socially acceptable ways (mcrae & gross, 2020; reeck et al., 2016). emotion regulation also includes the ability to influence one’s own emotions and the emotions of others (gross, 1998) and is closely aligned with emotional self-regulation. “emotion regulation” and “emotional self-regulation” have, at times, been used interchangeably by various researchers even though there are subtle differences in the definition of the terms. there are multiple varied definitions of “emotion regulation” (cole et al., 2004; mcrae & gross, 2020). to guide our research and we synthesized the following definition based on the range of perspectives we found in the literature: “the ability to recognize and manage personal feelings and the potential emotional reactions that may impact self and others”. children need to learn to effectively manage their emotions in order to be productive and well-adjusted citizens. the development of emotion regulation occurs rapidly during the beginning years of life and becomes more stable in adulthood (eisenberg et al., 2010). it is unrealistic to expect children to have the capacity to consistently regulate their emotions without being taught how to or without a supportive environment in which they can develop their abilities to self-regulate. children may learn emotion regulation in a range of settings, including in schools. blair and diamond (2008) conclude that emotion regulation is linked to school success, specifically for children who are at risk for maladjustment. the association between learning and emotion regulation (reschly et al., 2008) increases the need to explore how educators teach their students to regulate their emotions (denham & browen, 2010; jackson & peck, 2018). www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 3 published by scholink inc. 2.2 teacher preparation to teach students emotion regulation general teacher preparation programs tend to focus on the fundamentals of teaching and subject content knowledge. additionally, teacher certification standards typically include expectations for preparing teachers to teach emotion regulation (e.g., melnick & martinez, 2019). however, as hoffman (2009) recognizes, social-emotional learning has yet to become a major focus of teacher preparation programs. programs that prepare teachers to reflect on the importance of emotion regulation are rare (fried, 2011). typically, there is little or no time devoted to preparing teachers to teach social-emotional learning in the classroom, indicating that many teachers enter the profession without adequate preparation to effectively teach their students how to regulate emotions (schonert-reichl et al., 2015). an exception is special education teachers, who commonly are required as part of their professional preparation to take courses in behavior management and are exposed to an array of content that is focused on teaching students how to regulate their emotions (hemmeter et al., 2008). even with preparation, it is unclear how the preparation translates to practice (elias, 2006; schonert-reichl et al., 2017). given the association between emotion regulation and successful learning there is a critical need for teachers to be prepared to teach students to regulate emotions. doss et al. (2019) recommends that researchers investigate teachers’ need for support related to teaching their students emotion regulation. thus, there is reason for exploring the level of teachers’ professional preparation and their desire for continued support for teaching their students to regulate emotions. 2.3 responsibility to teach emotion regulation the association between students’ ability to regulate their emotions and their academic performance (e.g., diamond, 2010; greenberg et al., 2003; graziano et al., 2007) suggests a level of responsibility for teachers to teach emotion regulation. in general, students are much more motivated and engaged in learning when they effectively regulate their emotions (denham & brown, 2010). thus, students benefit from teachers who help them learn to regulate their emotions, which lead to a positive learning environment (jackson & peck, 2018). the relationship provides justification for examining teachers’ perceptions of responsibility for teaching emotion regulation. multiple organizations have developed social emotional learning standards that indicate that teachers hold some responsibility for teaching their students emotion regulation. these standards are similar to or aligned with the collaborative for academic, social and emotional learning (casel) (2017). while standards for teaching emotion regulation are common, there is a dearth of information regarding teachers’ perceptions of their level of responsibility to teach students to regulate their emotions. we did find reports on early childhood educators indicating they take responsibility for supporting the social emotional development of their students (harrington et al., 2020; humphries et al., 2018). additionally, we located research on differences by country in expectations for teachers to take responsibility for teaching emotion regulation and differences in expectations and approaches between www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 4 published by scholink inc. teachers teaching special education and regular education students (ferreira-gonzalez et al., 2019). however, we were not able to locate any studies empirically documenting general education prek-12 teachers’ perceptions of their level of responsibility to teach their students to emotionally regulate. given the importance of social-emotional learning for students’ success, there is warrant for examining elementary and secondary general education teachers’ perceptions of responsibility to teach their students emotion regulation. 2.4 approaches for teaching emotion regulation there are different approaches that can be used to teach emotion regulation, including adopting and implementing of prepared curriculum (for lists of the curricula see casel, 2013, 2015; jones et al., 2017). casel (2015) recognizes packaged curriculum typically involves one or a combination of four common instructional approaches: integrate teaching emotion regulation into the current learning environment; infuse emotion regulation content into the general curriculum; shifts in policies and organizational structures to support student emotion regulation development; explicitly teaching emotion regulation as specific lessons. it is interesting to note that the actual implementation of school intervention programs and corresponding shifts in students’ emotion regulation are rarely studied and reported (schlesier et al., 2019). thus, according to schlesier et al. (2019) there are package curricula for teaching social emotional learning which tend to be evidence-based, but there is a lack of empirical evidence associated with how teachers are teaching the content. harley and colleagues (2019) propose a model of emotion regulation based on a reappraisal of situations. the translation of the model to teacher practice involves two approaches that include refocusing student attention. one approach involves teaching students to shift their expectations for what might happened in the future. a second approach involves adjusting perspective of events that have taken place. both approaches have been found to be effective for helping students regulate their emotions (gross, 1998; schutte et al., 2009). it is important to note that individuals are likely to use a combination of strategies in their emotion regulation (aldao & nolen-hoeksema, 2013). davis and levine (2013) documented how students’ ability to regulate their emotions enhances their learning. davis and levine report that when students navigate through sad events in ways that lowered their negative emotions, it resulted in an increased ability to remember, and therefore, learn. davis and levine recommend that teachers and parents work with children to help them learn to evaluate situations for importance and lower negative emotions to increase their ability to function effectively. yet, we speculate few teachers have been exposed to specific approaches to teaching emotional regulation and therefore, do not approach teaching emotion regulation strategically. given the potential for teachers to influence their students’ emotion regulation there is justification for examining the approaches teachers use. further, there is a need to determine if the approaches they are using are evidence-based. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 5 published by scholink inc. 2.5 teacher comfort and confidence for teaching emotion regulation as teachers are working with developing youth, they are in positions to implicitly and/or explicitly influence the development of their students’ emotion regulation (sutton, 2004). even though teachers may teach emotion regulation to their students, they may be uncomfortable or lack confidence with the process (cvar, 2019). doss and colleagues (2019) report that even those teachers who have received professional development focused on teaching students how to regulate emotion, continued to perceive a need for additional support to be effective. teachers’ ongoing need for support even with preparation may potentially reflect a lack of comfort or confidence for teaching students how to regulate their emotions (durlak & dupre, 2008). consequently, there is a justification for examining the relationship between level of preparation to teach emotion regulation and the comfort or confidence with the process. despite the increase in knowledge about emotion regulation and the importance of learning, there remains challenges (harley et al., 2019). due to the specialized knowledge needed to teach students to emotion regulate, it is common for certain groups of teachers, such as special education teachers, to have been prepared for the instruction (cressey, 2019). however, special education teachers typically focus on special education students, leaving the teaching of emotion regulation to the majority of the students, to general classroom teachers. however, if teachers lack comfort and confidence with the teaching emotion regulation they may be reluctant to engage in the process. in our search of the literature, we were not able to locate any empirical studies that explicitly focused on teacher confidence and comfort for teaching emotional regulation, particularly with regard to their levels of preparation for the process. the gaps in the literature and the lack of understanding of teachers’ confidence and comfort for teaching emotion regulation provides a justification for our research. 2.6 teacher self-regulation of emotions teaching is a physically and psychologically demanding profession, and it is common for teachers to become emotionally overwhelmed in the classroom (katz et al., 2018). teachers’ emotions are associated with their professional effectiveness (day & quing, 2009; sutton, 2005; trendall, 1989). therefore, teachers who are able to regulate their emotions are likely to be more effective at teaching students how to emotion regulate (young, 2016). given the physiological indicators of stress that teachers accumulate over the school year, some emotion regulation strategies may positively or negatively influence the progression of chronic stress (katz et al., 2018). for example, applying the strategy of cognitive reappraisal (i.e., changing perceptions of situations to reduce an emotional response) may help teachers manage their emotions and reduce their stress (katz et al., 2018). there is a high probability that teachers lack professional knowledge of how their emotion regulation affects their teaching practices (sutton et al., 2009). some teachers may have high levels of emotion regulation while other teachers may struggle, which may manifest in variations in how teachers interact www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 6 published by scholink inc. with students, colleagues, and community members (sutton, 2007; taxer & frenzel, 2015). research on teachers’ perceptions of emotion regulation indicate that teachers understand the benefits of emotional expression and acknowledge the importance in regulating emotions, particularly their negative feelings (zinsser et al., 2015). teachers will commonly engage in emotion regulation strategies to manage their anger and frustration (sutton, 2004). teachers may engage in cognitive, behavioral, and responsive strategies, which may include sitting in a quiet place, talking to peers, or diverting attention (sutton et al., 2009). teachers’ personal variables and professional experiences may influence their emotion regulation. demetriou et al. (2009) have identified gender differences in teachers’ expressions of emotions associated with their teaching. the research findings indicate personal traits of teachers may be predictive of their emotion regulation and ability to navigate emotional situations that occur during teaching. while teachers may utilize strategies to regulate their own emotions and recognize these strategies may improve their physiological and psychological stress, there is limited research on general classroom teachers engaging in emotion regulation strategies and modeling the practices for their students. research to date has focused on teachers teaching emotion regulation in physical education (klemola et al., 2013), in sports (wagstaff et al., 2013), and in elementary settings (zinsser et al., 2015). our study addressed the limited research reported in the literature by exploring elementary, middle, and high school general classroom teachers’ engagement in emotion regulation strategies and if and how they teach the strategies they use with their students. 3. methods 3.1 research question our overarching question was, “what are prek-12 teachers’ perceptions of and practices for teaching their students emotion regulation?” to answer this question, we developed the following guiding research questions: i. how have teachers been prepared to teach their students to regulate their emotions? ii. what level of responsibility do teachers feel they have in teaching their students emotion regulation? iii. what are teachers’ approaches for teaching their students emotion regulation? iv. what are teachers’ levels of comfort and confidence for teaching emotion regulation? v. what is the relationship between teachers’ personal emotion regulation and teaching their students to regulate their emotions? vi. what is the relationship between the perceptions and practices for teaching emotion regulation and teachers’ personal and professional variables? www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 7 published by scholink inc. 3.2 participants the participants in our research were prek-12 teachers working in a region of south-central united states. there were 155 teachers who completed the survey, of which 70% identified as female and 28% identified as male, 2% did not provide a gender. the educators’ ages ranged from 22-67 years of age, with the average age being 40.77 years old (sd = 11.67). the average teaching experience was 13.36 years (sd = 10.16) and the grades taught varied from elementary, middle/junior high, high school, or multiple levels. most of the educators taught elementary (37%), followed by 35% teaching high school, 27 % taught middle/junior high, and 1% indicated teaching multiple levels. class sizes ranged from three to 22 students, with the average class size being 21.06 students (sd = 8.02). the majority of the educators identified as white (94%), followed by asian (2%), and the remaining identified as either black, native american, or hispanic (4%). most of the teachers worked in a suburban setting (54.2%), 25.2% worked in a rural area, and the remaining 20% indicated working in an urban location. twenty-eight percent of the educators reported having a bachelor’s degree, 5% indicated post bachelor’s course work, 50% indicated having a master’s degree, 12% indicated post master’s course work, 2% indicated being an education specialist, and 2% indicated they held a doctoral degree. 3.3 measure in our search of the literature, we were unable to locate an extant instrument designed to assess the engagement of k-12 teachers across disciplines in teaching their students emotion regulation (most extant studies focused exclusively on teachers of special education). therefore, we deemed it necessary to develop an instrument. we started our instrument development by using our guiding research questions to frame the generation of multiple free and selected-response items. we developed a cache of items with representation for each area of our research focus (e.g., preparation, comfort, and confidence). we then reviewed the cache of items for redundancy, alignment, clarity, and complexity. our goal was to have about five survey items for each of our guiding research questions. through discussion and editing of items, we retained 23 selected-response items and two free-response items. the survey is designed for participants to respond to the selected-responses items on a likert scale (i.e., strongly disagree to strongly agree) or likert-like scale (i.e., never to constantly), with “1” being the lowest end of the range and “5” being the upper end of the range of possible answers. our selected-response items included items such as, “sometimes i have to put forth a lot of effort to regulate my emotions in the classroom” and “i feel uncomfortable working with students having an emotional breakdown”. our two free-response items were, “what strategies for emotion regulation do you model for your students?” and “how would you teach your students to self-regulate emotions?” once we created a working version of our survey, we sought to establish the instrument validity. we shared the tool with several prek-12 teachers and post-secondary faculty members in a college of education. we asked them to consider each item and the instrument as a whole, through a lens of www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 8 published by scholink inc. teaching students to regulate their emotions. based on their feedback, we made minor adjustments to the survey and prepared the tool for data collection. our process gave us the confidence we had established the content and construct validity of our tool. we assessed our survey cronbach’s alpha to be .83 (n = 155), indicating an acceptable level of internal consistency for our 23 selected-response items. 3.4 data collection the population from which we intended to sample were prek-12 teachers working in a range of situations and across disciplines in a region of the southern united states. to collect the data, we invited teachers from multiple schools and districts to participate in our research. after obtaining authorization to conduct our research, we emailed approximately 1,200 prek-12 teachers using publicly accessible email addresses. we had 155 of the teachers we contacted complete our survey. 3.5 data coding to analyze the participants’ responses to, “how do you teach their students to self-regulate their emotions” we developed and applied a coding system. the codes, definitions, and a representation of the participants’ responses are included in table 1. to assure interrater reliability, we coded a set of 20 responses collectively and discussed our justification of code classification. we then worked in pairs going through a similar process, with each pair of researchers coding a subset of the dataset and discussing their coding choices and resolving differences. the coding provided additional insight into the data, illuminating how teachers were teaching their students to regulate their emotions. table 1. codes, definitions, and representative responses to how the teachers teach their students to regulate emotions code definition representative participant response emotional awareness being conscious of personal emotions i would first attempt to teach students how to recognize their emotions, and then how to deal with them accordingly. emotional sharing sharing feelings and emotions with another every morning during morning meeting time with a different social emotional prompt that we all share and discuss out loud. breathing purposeful and conscious inhaling and exhaling we use tools from our occupational therapist (deep breaths, chair pushups). expectations plans and consequences for emotional stress third, at a later time frame we have a discussion to create an action plan for future frustrations. safe space a physical location to provide a cool down spot and tools. i teach them how to use the tools www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 9 published by scholink inc. escape from emotional stress before letting them use the area. reflecting thinking about and sharing emotional conditions i like to use reflection surveys, conversation circles, and scenarios to practice the skill. brain break using imagery or other mental/physical activities to redirect focus we learn an exercise to calm them down (stand, cross legs, cross arms and interlace fingers, rotate arms up so hands touch chin, take a deep yoga/belly breath). set curriculum a developed combination of content and instruction for teaching emotion regulation choose love or conscious discipline. classroom climate changes to the physical or social environments that results in different expectations and interactions with others sometimes we all take a calming break, listen to music, dim lights until the emotions have passed. disengage to end interactions with a situation if they feel they are getting upset, walk away and breathe. counselors professionals prepared to support emotion regulation development we use tools from our occupational therapist (deep breaths, chair pushups). modeling performing in a way that is noticeable and recognizable by others i model making mistakes and being kind to self. role playing interacting in situations that are not real but parallel reality role play, books, discussions on things i am seeing in class and what we could do in certain situations, calm down corner. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 10 published by scholink inc. social stories stories of interactions between and among individuals i use the zones of regulation, social stories, and the superflex social skills curriculum. don’t know no specific instructional approach identifiable there’s no problem in the classroom that is worth getting worked up over. i am emotionally on an even keel mostly 24/hrs a day because i know that most things are unimportant in the big picture. we replicated our process for establishing interrater reliability and coding to analyze the responses to our item asking the teachers to share how they regulate their own emotions. the codes that we developed, definitions, and representative responses are presented in table 2. table 2. codes and representative responses of teachers approaches for self-regulating emotions code definition representative response breathing purposeful and conscious inhaling and exhaling taking a moment to be silent and breathe emotional sharing sharing feelings and emotions with another “thinking aloud” (talking about how i feel and why), etc. emotional awareness being conscious of personal emotions i probably don’t let them know i’m having to regulate my emotions. brain break using imagery or other mental/physical activities to redirect focus i don’t raise my voice when tensions get high i have the student take a “time out” if need be and i have said to a class before “we all need to take a 5 minute brain break) when i saw frustration levels rising. i stay calm and considerate towards all students reflecting thinking about and sharing emotional conditions taking time out to breathe, keeping quiet, avoiding the frustrating situation, focusing on the positive. modeling performing in a practice with cognitive reframing. modeling regulation in front of them. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 11 published by scholink inc. way that is noticeable and recognizable by others de-stigmatizing emotional responses. safe space a physical location to escape from emotional stress deep breathing, taking a moment classroom climate changes to the physical or social environments that results in different expectations and interactions with others sometimes we all take a calming break, listen to music, dim lights until the emotions have passed. disengage to end interactions with a situation sometimes i may distance myself for a brief time and come back to regroup when student(s) are ready. expectations plans and consequences for emotional stress i watch my volume and tone when speaking or redirecting students. set curriculum a developed combination of content and instruction for teaching emotion regulation choose love or conscious discipline don’t know no specific instructional approach identifiable show professionalism, courtesy. remain calm, but firm. role playing interacting in situations that are modeling, explicit instruction, discussions, picture books, situation based, etc. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 12 published by scholink inc. not real but parallel reality social stories stories of interactions between and among individuals i try to teach them explicitly using examples from my own life with small bits of role-playing infrequently throughout the school year. 4, results 4.1 teacher preparation to teach students emotion regulation our first guiding research question asked, “how have teachers been prepared to teach their students to regulate their emotions?” to answer this question, we examined the teachers’ mean responses to our selected-response items assessing their preparation to support their students’ emotion regulation (see figure 1). we found the teachers agreed that they would like to know more about how to teach students emotion regulation (m = 3.98, sd = .77, mdn = 4.00). teachers’ responses also leaned to agree that they take time to educate themselves about how to help students regulate their emotions (m = 3.64, sd = .94, mdn = 4.00). in contrast, teachers were neutral in their responses about whether they have had professional development courses on teaching emotion regulation (m = 3.09, sd = 1.26, mdn = 3.00). additionally, teachers seemed to disagree with the statement, “i learned to teach students emotion regulation in my preparation program” (m = 2.28, sd = 1.15, mdn = 2.00). we interpret the results to indicate that the teachers had moderate levels of engagement in professional preparation to teach their students emotion regulation. our data suggest that the participants either wanted more support with preparation or were self-preparing to teach their students emotion regulation. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 13 published by scholink inc. figure 1. averages for the responses to our teaching emotion regulation items 4.2 responsibility to teach emotion regulation our second guiding research question asked, “what level of responsibility do teachers feel that they have in teaching their students emotion regulation?” we examined the teachers’ mean responses to the items assessing their perceived level of responsibility to teach emotion regulation to their students (see figure 2). our analysis revealed that overall, teachers agreed that it is important for them to support students’ emotion regulation development (m = 4.23, sd = 0.78, mdn = 4.00). the teachers also tended to agree with sending students to the counselor when they have emotion breakdowns (m = 3.58, sd = 0.99, mdn = 4.00), which suggests they rely on others in the school to help them teach their students emotion regulation. the teachers tended to disagree with the statement indicating that they do not have time to teach students emotion regulation (m = 2.52, sd = 1.03, mdn = 2.00), signifying that teachers tend to have time to teach their students to regulate their emotions. the teachers were more likely to disagree that it is the sole responsibility of parents to teach children emotion regulation (m = 2.11, sd = 0.78, mdn = 2.00) and that it is not their responsibility to teach students emotion regulation (m = 2.05, sd = 0.83, mdn = 2.00). overall, our results indicate that teachers feel a level of responsibility for teaching their students emotion regulation. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 14 published by scholink inc. figure 2. the mean responses for our responsibility for teaching emotion regulation items (r indicates negatively stated item stem) 4.3 approaches for teaching emotion regulation our third guiding research question asked, “what are teachers’ approaches for teaching their students emotion regulation?” we examined the participants’ mean responses to the selected items assessing their use of approaches to teach emotion regulation (see figure 3), their coded responses for how they would teach their students to self-regulate (see table 1), and the frequencies for each coded response (see figure 4). the teachers agreed to strongly agreed that they watch their students for signs of emotion breakdowns (m = 4.22, sd = .76, mdn = 4.00). teachers’ average responses indicated that they agreed they give students permission to sit in a place of their choice when they are feeling emotional (m = 3.97, sd = .78, mdn = 4.00). similarly, teachers were more inclined to agree that they do teach their students how to regulate their emotions (m = 3.62, sd = .82, mdn = 4.00). teachers’ also tended to agree to the statement, “i use specific strategies to help students regulate their emotions” (m = 3.55, sd = .95, mdn = 4.00). additionally, teachers’ responses tended to disagree when responding to whether they incorporate how to regulate emotions for their students into their lesson plans (m = 2.65, sd = .1.03, mdn = 2.00). overall, the data indicate that there were moderate levels of teachers attending to and teaching students emotion regulation, but the teaching was in response to potential or actual students’ outbursts and not necessarily structured or planned. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 15 published by scholink inc. figure 3. the mean responses for our approaches to teaching emotion regulation items we analyzed the frequency of the occurrences of codes in the participants’ responses to how they teach emotion regulation (see figure 4). we were able to identify 288 unique strategies in the 155 participant responses, as some teachers shared more than one instructional approach. the participating teachers’ responses were varied. about two-thirds of the teachers (94 of 155) indicated that they use emotional awareness or emotional sharing to teach their students to self-regulate. about one in three teachers (68 of 155) responses included using breathing, reflection, or set curriculums to teach emotion regulation. in contrast, only a few teachers (18 of 155) indicated that they teach their students emotion regulation through modeling, role-playing, or telling social stories to their students to facilitate learning about emotion regulation. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 16 published by scholink inc. figure 4. the frequency of the free-responses codes to our item asking the teachers how they teach emotion regulation 4.4 comfort and confidence for teaching emotion regulation our fourth guiding research question asked, “what are teachers’ levels of comfort and confidence for teaching emotion regulation?” to answer this question, we examined their mean responses to the items included to assess their comfort and confidence for teaching emotion regulation (see figure 5). teachers’ average responses were neutral about feeling competent working with students who are having an emotional breakdown (m = 3.1, sd = 1.04, mdn = 3.00). additionally, teachers’ responses were near neutral in feeling uncomfortable working with students having an emotion breakdown (m = 2.81, sd = 1.07, mdn = 3.00). overall, our results indicate that teachers were neutral to feeling competent and comfortable teaching their students to regulate their emotions. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 17 published by scholink inc. figure 5. the participants’ mean responses for our confidence and comfort for teaching emotion regulation to their students 4.5 teacher self-regulation of emotions our fifth guiding research question asked, “what is the relationship between teachers’ personal emotion regulation and teaching their students emotion regulation?” to answer this question, we began by examining the teachers’ mean responses to our survey items aligned with the self-regulation of emotions (see figure 6). on average, the teachers’ responses were in between agreeing and strongly agreeing that it is important to regulate their emotions in the classroom (m = 4.53, sd = .63, mdn = 5.00) with the majority strongly agreeing to the importance of regulating their emotions. similarly, teachers leaned towards agreeing that they get frustrated when their students do not listen (m = 3.82, sd = .73, mdn = 4.00). the teachers also tended to agree to having to put forth a lot of effort to regulate their emotions in the classroom (m = 3.31, sd = 1.07, mdn = 4.00), with the majority agreeing or strongly agreeing toward putting a lot of effort forth to regulate their emotions. interpreted, while the participants perceived the importance of regulating emotions and may need to regulate their emotions due to the likelihood of getting frustrated with their students, they may need to put forth a lot of effort toward the process. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 18 published by scholink inc. figure 6. the mean responses for our teachers’ self-regulation of emotions items we continued our analysis by determining the coding frequency of responses to our free-response item, which asked the participants to share how they teach their students to regulate emotions. these asked the teachers to share the approaches that they teach their students to regulate their emotions. our assessment revealed the teachers shared approaches to self-regulating their emotions similar to the strategies they teach their students. the most frequent approach (50 of 155) used by the teachers to model emotion regulation for their students was breathing techniques (see figure 7). a moderate number of teachers indicated they engaged in emotional sharing (34 of 155), emotional awareness (32 of 155), brain breaks (24 of 155), or reflection (21 of 155) to model for their students’ strategies for emotion regulation. only a few teachers indicated that they modeled emotion regulation by having a safe place for students, establishing a classroom climate, or by disengaging with the group and engaging with the group at a later time. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 19 published by scholink inc. figure 7. the frequency of the free-responses codes to our item asking the teachers how they self-regulate their emotions following the examination of how our participants self-regulate their emotions and how they teach their students to regulate their emotions, we examined the alignment between the frequency of the approaches (see figure 8). we found the highest frequency approaches teachers use to self-regulate emotions included three of most frequent strategies they teach their students. however, there was considerably less alignment among the moderate to low frequency used approaches to self-regulating and the approaches to emotion regulation the teachers teach their students. our interpreted data suggest that while teachers may be modeling emotion self-regulation to their students, the strategies they use may be of limited usefulness to the students. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 20 published by scholink inc. figure 8. frequency of the coded responses for the teachers’ self-regulation strategies and strategies they teach students 4.6 teaching emotion regulation relation to personal and professional variables our sixth research question asked, “what is the relationship among the perceptions and practices for teaching emotion regulation and personal and professional variables?” to answer this question, we conducted a series of tests of means and calculated correlations. we began our analysis by calculating the composite score for our measures of confidence and comfort teaching emotion regulation, responsibility for teaching emotion regulation, preparation to teach emotion regulation, approaches to teaching emotion regulation, and teacher self-regulation of their emotions. we generated the composite score by finding the average of the responses to the related items. using the composite scores, we calculated the correlation among the different facets of teachers’ perceptions and practices in teaching and engaging in emotion regulation (see table 3). we found that the composite scores for all the major construct composite scores were significantly positively correlated (p < .01), which indicates that if one area of emotion regulation teaching perceptions or www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 21 published by scholink inc. practices increases, the others are likely to increase as well. interpreted, our data indicates that preparation, engagement, responsibility, comfort and confidence for teaching students to self-regulate emotions are related. we found a positive relationship between teachers’ self-regulation of emotions and the responsibility for teaching emotion regulation (r = .25, p < .01) and with their approaches to teaching emotion regulation (r = .17, p < .05). the finding suggests as teachers’ self-regulation increases so does their level of responsibility for teaching emotion regulation and their approaches to teaching emotion regulation (see table 3). table 3. correlations between difference facets of teacher perceptions and practices composite scores m sd responsibility to teach er approaches to teaching er competent and comfort teaching er teachers’ er prepared to teach er 3.44 .63 .40** .50** .35** .05 responsibility to teach er 3.39 .43 .53** .50** .25** approaches to teaching er 3.45 .68 .47** .17* competent and comfort teaching er 3.14 .92 .14 teachers’ er 3.14 .55 ** p < 0.01 * p < .05 (2-tailed). we continued our analysis by examining the correlations among facets of teaching emotion regulation and the composite scores for different aspects of emotion regulation. we found a significant negative correlation between a teacher’s level of frustration and their perceived responsibility to teach emotion regulation (r = -.26, p < .01). this finding indicates an inverse relationship between teachers’ level of frustration and their perceived level of responsibility to teach emotion regulation. our analysis also revealed a significant negative correlation between teachers’ level of frustration and their emotion regulation (r = -.19, p = .02), indicating that as the level of frustration increases, self-reported level of ability to regulate emotions is likely to decrease. we also found a negative relationship between the www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 22 published by scholink inc. level of frustration and competency to teach emotion regulation (r = -.17, p = .037), indicating as the level of frustration decreases the level of competency to teach emotion regulation is likely to increase. we continued our analysis by conducting an anova using the school level (e.g., elementary, middle, and high school) as the factor. results revealed a significant difference in responsibility to teach emotion regulation (f [2,143] = 9.44, p < .01) and the approaches used to teach emotion regulation (f [2,143] = 4.55, p = .01). post hoc analysis revealed that the differences in responsibility to teach emotion regulation varied between elementary and middle school and between elementary and high school. our analysis suggests that elementary school teachers take a higher level of responsibility to teach emotion regulation than both their middle school and high school colleagues. the post hoc analysis for approaches to teach emotion regulation revealed that elementary school teachers engage in more emotion regulation teaching practices than high school teachers. using school location (e.g., urban, suburban, rural) as a factor revealed there was a significant difference in preparation to teach emotion regulation (f [2,151] = 4.64, p =.01). our post hoc analysis revealed that there was a difference between the teachers working in suburban and rural school locations. teachers in a suburban school location indicated a higher level of preparation to teach emotion regulation than teachers teaching in a rural location. additionally, we used education level as a factor to examine comfort and confidence in teaching emotion regulation. our results revealed a significant relationship (f [5,149] = 2.34, p = .04). post hoc results indicated that teachers with education beyond a bachelor’s degree had a higher level of comfort and confidence in teaching emotion regulation than teachers with just a bachelor’s degree. 5. discussion and implication the association between students being able to regulate their emotions and their learning in schools justifies determining how teachers are teaching their students to emotion regulate. the lack of research on the general classroom teachers’ comfort, confidence, engagement, commitment, and responsibility for teaching students to self-regulate provides additional support for our research. further, the potential association between teachers’ self-regulation of emotions and their effectiveness in teaching their students, increases the importance of assessing teachers’ perceptions of teaching and engaging in emotion regulation. there are multiple implications for our findings. 5.1 teacher preparation to teach students emotion regulation while many educational standards include social-emotional learning, which includes emotion regulation (e.g., casel, 2017), we found evidence to suggest that teachers tend to feel under-prepared and may not have experienced formal preparation to teach their students to regulate their emotions. we speculate that most teacher preparation programs focus more on the curricula the teachers will teach rather than educating the child as a whole, which limits the opportunity to prepare teachers to teach students to self-regulate emotions. similarly, we speculate that many professional development www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 23 published by scholink inc. offerings for inservice teachers focus on the cognitive aspect of student achievement or other school district issues (e.g., policies and procedures), limiting the opportunity to use the time to prepare teachers to teach students how to regulate their emotions. the implications are that teachers may be using approaches that are not evidence-based or are not engaging in teaching their students to self-regulate their emotions. examining how teacher preparation programs are preparing teachers to teach their students to self-regulate is a needed direction for research. 5.2 responsibility to teach emotion regulation our participants indicated that they agree that they have some responsibility to teach their students emotion regulation. many of the teachers recognized the potential interference emotional issues may have on students’ learning and therefore, realized they must teach their students to regulate their emotions to help them learn. teachers may recognize the potential disruption to the education of all students when some students have emotional outbreaks, and therefore, to keep the students learning as a group, may need to teach all how to regulate their emotions. the implications of our findings are the potential for teachers to commit to supporting the social-emotional development of their students. further examination is needed of teachers’ explanations for taking responsibility for teaching their students to regulate their emotions. 5.3 approaches to teaching emotion regulation our participants engaged in a wide range of approaches to teaching their students to regulate their emotions. given the lack of preparation to teach emotion regulation, we speculate that the teachers rely on their personal experiences, ideas from other teachers, their intuition, and perhaps some ideas they gained from self-sought knowledge. the implication of our findings is the approaches teachers use may or may not be evidence-based. further, it is possible that other strategies may be more useful for helping students regulate their emotions than the choices of the teachers. investigating teachers’ strategy preferences for teaching their students emotion regulation is likely to be a fruitful line of research. 5.4 comfort and confidence for teaching emotion regulation we found the participants were near neutral toward their comfort and confidence for teaching emotion regulation. comfort and confidence may be directly associated with their level of preparation to teach their students to regulate their emotions. our finding of a significant correlation between our survey comfort and confidence subscale and level of preparation subscale provides additional support for the potential relationship. the implication of our finding is that the lack of comfort and confidence for teaching emotion regulation may hinder teacher engagement in teaching their students how to regulate their emotions. exploring how to increase teacher comfort and confidence for teaching emotion regulation to their students is an excellent direction for future research. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 24 published by scholink inc. 5.5 teacher approaches to self-regulation we found the teachers used a range of approaches to regulate their emotions. teachers’ engagement in self-regulation is important as the majority indicated they get frustrated when interrupted. the lack of ability to self-regulate their emotions may result in inappropriate reactions to students who act in ways that elicit an emotional response from their teachers. however, we are not able to determine the situations the teachers were considering when sharing how they regulate their emotions. the specific approaches teachers take in response to emotional reactions is a needed line of research. 5.6 association with personal and professional variables we found school location, grade level of the school, level of education, class size, and level of frustration to be indicators of different facets of teaching students to regulate their emotions. our findings reinforce the notion that teaching emotion regulation is likely to be associated with multiple personal and professional variables. the implications for our findings are teachers (both preservice and inservice) may need different approaches to prepare for teaching emotion regulation. unlike content knowledge acquisition, where teachers need to acquire an understanding of concepts and phenomena, gaining the knowledge necessary to effectively teach emotion regulation may require self-reflection, shifts in attitudes, understanding of the needs of others, human behavior and emotions, and compassion. the range of potential predictors of teacher engagement in teaching their students emotion regulation likely requires additional research to refine how we prepare teachers to teach their students to regulate their emotions. 5.7 implications for school psychologists the lack of teacher preparation to teach their students emotion regulation and their varied approaches to emotion regulation instruction suggest there is a critical need for support. school psychologists are well-positioned to make differences in school by taking steps to increase teachers’ knowledge of evidence-based practices and approaches for teaching emotion regulation. our research made apparent teachers are not being prepared to teach their students emotion regulation in their preservice programs, suggesting there is currently a need to address teachers’ inservice professional development. thus, school psychologists should think about how they could facilitate and catalyze teacher preparation to teach their students emotion regulation using evidence-based methods. one approach that school psychologists might consider is identifying and sharing available and accessible resources teachers could use to learn more about teaching emotion regulation. shifting through the abundance of open access resources for teaching emotion regulation requires knowledge and understanding of approaches that are based on evidence and have been empirically documented effectiveness. school psychologists can provide direction for accessible resources, available at low or no cost, which are attainable for teachers to use to become better prepared to teach emotion regulation. school psychologists may also consider taking a proactive role in increasing inservice teachers’ preparation by providing professional development opportunities. school psychologists might consider www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 25 published by scholink inc. using innovations such as demonstration, role-playing, or simulation to help teachers envision and practice different approaches to teaching emotion regulation. by engaging teachers in active learning experiences, school psychologists can increase teachers’ understanding and comfort using different approaches to teach their students emotion regulation. regardless of the approach taken to support teacher preparation to teach emotion regulation, it is critical for school psychologists to be leaders. school psychologists have expert knowledge and skills associated with teaching emotion regulation, and therefore, can make a difference by preparing teachers with similar knowledge and skills. through the preparation of the teachers to teach emotion regulation, school psychologists can influence the well-being of entire school communities. 6. limitations the first limitation of our research is the nature of our data collection, which involved completing our survey. while we found consistency in our dataset, our survey does not allow us to determine why the teachers responded the way they did. also, we did not observe their practice. therefore, we could not determine their actual approaches to teaching emotion regulation or regulating their own emotions. researching deeper teacher engagement in emotion regulation teaching and self-regulation of emotions is an excellent direction for future research. the second limitation of our research is we recruited participants from a specific region in the southern united states. teachers from different regions or cultures may hold different perspectives and engage in various practices than the teachers in our sample. thus, our sample may not be representative of the larger population of teachers in the united states. there is a need to replicate our study with teachers recruited from different areas of the united states to determine the extent to which our results apply to the more significant population of teachers. a third limitation is a potential for other influences on teacher perceptions and practices in teaching emotion regulation that we did not consider in our research. we did find multiple personal and professional variables associated with the elements of teaching emotion regulation. yet, there may be some other variables that we did not consider, which may be critical to teacher engagement. exploring additional variables associated with teacher engagement in teaching emotion regulation is an essential consideration for future research. a fourth limitation is the potential for bias in our sample and in the participants responses. the sampling bias may have resulted from those who participated in our research holding an interest in teaching emotion regulation, while those with little interest chose not to participate. the response bias may have resulted from the participants providing socially desirable responses that may not be aligned with their actual perceptions and practices. additional research using a range of methodologies is need to determine the representativeness of our data. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 26 published by scholink inc. 7. conclusion the association between learning and students’ ability to regulate their emotions motivated us to determine k-12 teachers’ practices and perceptions for teaching emotion regulation. we designed our research to assess multiple facets of teacher engagement in teaching emotion regulation. we found a need to better prepare teachers to effectively teach their students emotion regulation across grade levels. the findings illuminated multiple new relationships, as well as situations that need further consideration. our findings have potential implications for school psychologists and their role in supporting teachers’ engagement in teaching their students emotion regulation. we hope other researchers will join our efforts to continue to explore the complex process of teacher engagement in teaching their students how to regulate their emotions. references aldao, a., & nolen-hoeksema, s. (2013). one versus many: capturing the use of multiple emotion regulation strategies in response to an emotion-eliciting stimulus. cognition & emotion, 27(4), 753-760. https://doi.org/10.1080/02699931.2012.739998 barton, e. e., steed, e. a., strain, p., dunlap, g., powell, d., & payne, c. j. (2014). an analysis of classroom-based and parent-focused social-emotional programs for young children. infants & young children, 27(1), 3-29. https://doi.org/10.1097/iyc.0000000000000001 blair, c., & diamond, a. (2008). biological processes in prevention and intervention: the promotion of self-regulation as a means of preventing school failure. development and psychopathology, 20(3), 899-911. https://doi.org/10.1017/s0954579408000436 bridgeland, j., bruce, m., & hariharan, a. (2013). the missing piece: a national teacher survey on how social and emotional learning can empower children and transform schools. a report for casel. civic enterprises. buchanan, r., gueldner, b. a., tran, o. k., & merrell, k. w. (2009). social and emotional learning in classrooms: a survey of teachers’ knowledge, perceptions, and practices. journal of applied school psychology, 25(2), 187-203. https://doi.org/10.1080/15377900802487078 carter, d. (2016). a nature-based social-emotional approach to supporting young children’s holistic development in classrooms with and without walls: the social-emotional and environmental education development (seed) framework. international journal of early childhood environmental education, 4(1), 9-24. cole, p. m., martin, s. e., & dennis, t. a. (2004). emotion regulation as a scientific construct: methodological challenges and directions for child development research. child development, 75(2), 317-333. https://doi.org/10.1111/j.1467-8624.2004.00673.x collaborative for academic, social, and emotional learning (casel). (2013). effective social and emotional learning programs—preschool and elementary school edition. collaborative for www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 27 published by scholink inc. academic, social and emotional learning. collaborative for academic, social, and emotional learning (casel). (2015). effective social and emotional learning programs—middle and high school edition. collaborative for academic, social and emotional learning. collaborative for academic, social and emotional learning (casel). (2017). social and emotional learning (sel) competencies. collaborative for academic, social and emotional learning. cressey, j. (2019). developing culturally responsive social, emotional, and behavioral supports. journal of research in innovative teaching & learning, 12(1), 53-65. https://doi.org/10.1108/jrit-01-2019-0015 cvar, k. h. (2019). practitioners’ beliefs regarding social and emotional learning and its implications for implementation (doctoral dissertation, california state university, fullerton). davis, e. l., & levine, l. j. (2013). emotion regulation strategies that promote learning: reappraisal enhances children’s memory for educational information. child development, 84(1), 361-374. https://doi.org/10.1111/j.1467-8624.2012.01836.x day c., & qing, g. (2009) teacher emotions: wellbeing and effectiveness. in p. a. schutz, & m. zembylas (eds.), advances in teacher emotion research (pp. 11-31). springer. https://doi.org/10.1007/978-1-4419-0564-2_2 demetriou, h., wilson, e., & winterbottom, m. (2009). the role of emotion in teaching: are there differences between male and female newly qualified teachers’ approaches to teaching? educational studies, 35(4), 449-473. https://doi.org/10.1080/03055690902876552 denham, s. a., & brown, c. (2010). “plays nice with others”: social-emotional learning and academic success. early education and development, 21(5), 652-680. https://doi.org/10.1080/10409289.2010.497450 diamond, a. (2010). the evidence base for improving school outcomes by addressing the whole child and by addressing skills and attitudes, not just content. early education and development, 21(5), 780-793. https://doi.org/10.1080/10409289.2010.514522 doss, c. j., steiner, e. d., & hamilton, l. s. (2019). teacher perspectives on social and emotional learning in massachusetts: findings from the american teacher panel. rand corporation. https://doi.org/10.7249/rr3171 durlak, j. a., & dupre, e. p. (2008). implementation matters: a review of research on the influence of implementation on program outcomes and the factors affecting implementation. american journal of community psychology, 41(3-4), 327-350. https://doi.org/10.1007/s10464-008-9165-0 eisenberg, n., spinrad, t. l., & eggum, n. d. (2010). emotion-related self-regulation and its relation to children’s maladjustment. annual review of clinical psychology, 6, 495-525. https://doi.org/10.1146/annurev.clinpsy.121208.131208 www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 28 published by scholink inc. elias, m. j. (2006). the connection between academic and social-emotional learning. in m. j. elias, & h. arnold (eds.), the educator’s guide to emotional intelligence and academic achievement (pp. 4-14). corwin press. ferreira gonzález, l., hennemann, t., & schlüter, k. (2019). teachers’ perception of an integrated approach to biology and emotional learning. journal of science education for students with disabilities, 22(1), 7. https://doi.org/10.14448/jsesd.11.0002 fried, l. (2011). teaching teachers about emotion regulation in the classroom. australian journal of teacher education (online), 36(3), 1. https://doi.org/10.14221/ajte.2011v36n3.1 graziano, p. a., reavis, r. d., keane, s. p., & calkins, s. d. (2007). the role of emotion regulation in children’s early academic success. journal of school psychology, 45(1), 3-19. https://doi.org/10.1016/j.jsp.2006.09.002 greenberg, m. t., weissberg, r. p., o’brien, m. u., zins, j. e., fredericks, l., resnik, h., & elias, m. j. (2003). enhancing school-based prevention and youth development through coordinated social, emotional, and academic learning. american psychologist, 58(6-7), 466. https://doi.org/10.1037/0003-066x.58.6-7.466 gross, j. j. (1998). antecedent-and response-focused emotion regulation: divergent consequences for experience, expression, and physiology. journal of personality and social psychology, 74(1), 224-237. https://doi.org/10.1037/0022-3514.74.1.224 harley, j. m., pekrun, r., taxer, j. l., & gross, j. j. (2019). emotion regulation in achievement situations: an integrated model. educational psychologist, 54(2), 106-126. https://doi.org/10.1080/00461520.2019.1587297 harrington, e. m., trevino, s. d., lopez, s., & giuliani, n. r. (2020). emotion regulation in early childhood: implications for socioemotional and academic components of school readiness. emotion, 20(1), 48-53. https://doi.org/10.1037/emo0000667 hemmeter, m. l., santos, r. m., & ostrosky, m. m. (2008). preparing early childhood educators to address young children’s social-emotional development and challenging behavior: a survey of higher education programs in nine states. journal of early intervention, 30(4), 321-340. https://doi.org/10.1177/1053815108320900 hoffman, d. m. (2009). reflecting on social emotional learning: a critical perspective on trends in the united states. review of educational research, 79(2), 533-556. https://doi.org/10.3102/0034654308325184 humphries, m. l., williams, b. v., & may, t. (2018). early childhood teachers’ perspectives on social-emotional competence and learning in urban classrooms. journal of applied school psychology, 34(2), 157-179. https://doi.org/10.1080/15377903.2018.1425790 jackson, l., & peck, s. (2018). managing the classroom by teaching emotional regulation. ascd express, 14(1). retrieved from www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 29 published by scholink inc. http://www.ascd.org/ascd-express/vol14/num01/managing-the-classroom-by-teaching-emotional -regulation.aspx jones, s. m., brush, k., bailey, r., brion-meisels, g., mcintyre, j., kahn, j., & stickle, l. (2017). navigating sel from the inside out: looking inside & across 25 leading sel programs: a practical resource for schools and ost providers (elementary school focus). the wallace foundation. katz, d. a., harris, a., abenavoli, r., greenberg, m. t., & jennings, p. a. (2018). educators’ emotion regulation strategies and their physiological indicators of chronic stress over 1 year. stress and health, 34(2), 278-285. https://doi.org/10.1002/smi.2782 klemola, u., heikinaro-johansson, p., & o’sullivan, m. (2013). physical education student teachers’ perceptions of applying knowledge and skills about emotional understanding studied in pete in a one-year teaching practicum. physical education and sport pedagogy, 18(1), 28-41. https://doi.org/10.1080/17408989.2011.630999 mccaslin, m., & good, t. l. (1996). the informal curriculum. in d. c. berliner, & r. c. calfee (eds.), handbook of educational psychology (pp. 622-670). prentice hall international. mcrae, k., & gross, j. j. (2020). emotion regulation. emotion, 20(1), 1-9. https://doi.org/10.1037/emo0000703 melnick, h., & martinez, l. (2019). preparing teachers to support social and emotional learning: a case study of san jose state university and lakewood elementary school. learning policy institute. reeck, c., ames, d. r., & ochsner, k. n. (2016). the social regulation of emotion: an integrative, cross-disciplinary model. trends in cognitive sciences, 20(1), 47-63. https://doi.org/10.1016/j.tics.2015.09.003 reschly, a. l., huebner, e. s., appleton, j. j., & antaramian, s. (2008). engagement as flourishing: the contribution of positive emotions and coping to adolescents’ engagement at school and with learning. psychology in the schools, 45(5), 419-431. https://doi.org/10.1002/pits.20306 schlesier, j., roden, i., & moschner, b. (2019). emotion regulation in primary school children: a systematic review. children and youth services review, 100, 239-257. https://doi.org/10.1016/j.childyouth.2019.02.044 schonert-reichl, k. a., hanson-peterson, j. l., & hymel, s. (2015). social and emotional learning and pre-service teacher education. in j. a. durlak, c. e. domitrovich, r. p. weissberg, & t. p. gullotta (eds.), handbook of social and emotional learning: research and practice (pp. 406-421). guilford. schonert-reichl, k. a., kitil, m. j., & hanson-peterson, j. (2017). to reach the students, teach the teachers: a national scan of teacher preparation and social and emotional learning. a report prepared for the collaborative for academic, social, and emotional learning (casel). www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 1, 2021 30 published by scholink inc. university of british columbia. schutte, n. s., manes, r. r., & malouff, j. m. (2009). antecedent-focused emotion regulation, response modulation and well-being. current psychology, 28(1), 21-31. https://doi.org/10.1007/s12144-009-9044-3 stefanou, c. r., perencevich, k. c., dicintio, m., & turner, j. c. (2004). supporting autonomy in the classroom: ways teachers encourage student decision making and ownership. educational psychologist, 39(2), 97-110. https://doi.org/10.1207/s15326985ep3902_2 sutton, r. e. (2004). emotional regulation goals and strategies of teachers. social psychology of education, 7(4), 379-398. https://doi.org/10.1007/s11218-004-4229-y sutton, r. e. (2005). teachers’ emotions and classroom effectiveness: implications from recent research. the clearing house, 78(5), 229-234. sutton, r. e., mudrey-camino, r., & knight, c. c. (2009). teachers’ emotion regulation and classroom management. theory into practice, 48(2), 130-137. https://doi.org/10.1080/00405840902776418 sutton, k. e. (2007). teachers’ anger, frustration. and self-regulation, in p. a, schutz, & r. pekrun (eds.), emotion in education (pp. 251-266). academic press. https://doi.org/10.1016/b978-012372545-5/50016-2 taxer, j. l., & frenzel, a. c. (2015). facets of teachers’ emotional lives: a quantitative investigation of teachers’ genuine, faked, and hidden emotions. teaching and teacher education, 49, 78-88. https://doi.org/10.1016/j.tate.2015.03.003 trendall, c. (1989). stress in teaching and teacher effectiveness: a study of teachers across mainstream and special education. educational research, 31(1), 52-58. https://doi.org/10.1080/0013188890310106 wagstaff, c. r., hanton, s., & fletcher, d. (2013). developing emotion abilities and regulation strategies in a sports organization: an action research intervention. psychology of sport and exercise, 14(4), 476-487. https://doi.org/10.1016/j.psychsport.2013.01.006 young, h. (2016). perceived lack of teacher empathy and remedial classroom conflicts (doctoral dissertation). nova southeastern university. zinsser, k. m., denham, s. a., curby, t. w., & shewark, e. a. (2015). “practice what you preach”: teachers’ perceptions of emotional competence and emotionally supportive classroom practices. early education and development, 26(7), 899-919. https://doi.org/10.1080/10409289.2015.1009320 children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 6, no. 2, 2023 www.scholink.org/ojs/index.php/ct 15 original paper fear and anxiety, as reflected in israeli children’s books lea baratz1* 1 achva academic college * lea baratz, achva academic college received: may 17, 2023 accepted: may 25, 2023 online published: june 5, 2023 doi:10.22158/ct.v6n2p15 url: http://dx.doi.org/10.22158/ct.v6n2p15 “forever, the first thing i will do in any new place is to look for the shelter” (ifrah, 2020). abstract this article aims to show elements of fear and anxiety in children’s books written about children living in the gaza strip region of israel. since the 1950s, this area has been a source of active terrorism against israel, although it should be noted that there have also been periods of relative calm alongside the waves of terrorism. the research methodology is based on a text analysis of 20 children’s books on this subject that reflect social processes during wartime and their effects on residents, who are mostly children. the vocabulary related to fear and anxiety highlights certain sociocultural contexts—in this case, a period of war—and the lexicon use expresses the unique atmosphere that was created in the gaza strip keywords war, fear, anxiety, trauma, children’s book, israeli gaza strip theoretical background life in the gaza strip in israel, in the border area in the gaza strip, children live in a unique sociopolitical context. as early as in the 1950s, the gaza strip was an active center of terrorism against israel, although the wave of terror at that time was accompanied by periods of relative peace. since 2001, the residents of the otef gaza, as the area is known in hebrew, have lived under a continuous security threat, during which several rounds of fighting have taken place, namely operation cast lead (2008-2009), operation pillar of defense (2012), operation protective edge (2014), operation guardian of the walls (2021), and operation breaking dawn (2022). these were followed by the most recent operation, operation shield and arrow. israeli citizens are accustomed to living in the shadow of violent events as they go about their daily routines. they are exposed to a state of continuous threat and traumatic reality that may www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 16 published by scholink inc. produce regressive symptoms in the emotional development of some children as a natural and normal reaction when they are confronted with reality. the meaning of “anxiety” is the perception that the world is not a safe place and that parents, who are a child’s primary source of security, are not immune to harm and cannot be trusted to protect the child at all times (masten & narayan, 2012). books are recognized as an important therapeutic instrument in all cultures. this is especially the case for children’s literature written in the context of the conflict in otef gaza, since children’s books are places of endless possibilities, where young people can open their minds to broad horizons, create new perspectives, find possible alternatives or solutions to problems, and develop strengths such as self-confidence and resilience (pulimeno et al., 2020). adults who avoid discussing the issue of war can provoke a sense of helplessness and additional fear in children. studies have shown that patterns of political behavior, such as support for a certain political party, tolerance of minorities, and support for freedom of speech, are formed and internalized during an individual’s childhood and early adolescence (ichilov, 2001). exposure to war zones can affect children’s feelings and behaviors and impede a normal way of life (yahav & cohen, 2007). fear and anxiety are part of normal child development, and for most children, these phenomena are mild and transient; however, unlike typical fears, the fear of war arises mainly when a threat is close in terms of time and place, and its effect is evident over time (cohen et al., 2017). a variety of psychological phenomena have been linked to children’s exposure to war (american psychological association, 2010; rakhman et al., 2022), with the symptoms reported being post-traumatic stress disorder, depression, and anxiety disorders. the experiences that children have to endure during and as a consequence of war are in harsh contrast to their developmental needs and their right to grow up in a physically and emotionally safe and predictable environment. the “qassam rocket”, “red alert” signals, exploding balloons, and “spending” long periods of time in shelters (a protected residential space) can create feelings of anxiety, which may lead to traumatic situations (sha’ar, 2015). the traumatic reality can create regressive symptoms in the emotional development of some children as a natural and normal reaction in the face of the reality that children and adults alike are being forced to live every day under constant threat in a war zone (nuttman-shwartz, 2017). war, which is essentially a great humanitarian catastrophe, provokes various reactions in mental functioning. children who grow up under continuous threat live in a situation that creates existential anxiety. the range of reactions in mental functioning provoked by war is quite broad, from social tension and psychosocial adjustment disorders to the development of clinically defined forms of pathology. among these manifestations, anxiety is dominant, and it occurs in the vast majority of cases in the event of a humanitarian catastrophe (rakhman et al., 2022). a semantic approach communication is established between people and groups based on their autonomous cultural identity—by having the same knowledge about an icon (wittgenstein, 1953). language is not a means www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 17 published by scholink inc. of representing reality (a picture) but one of action (a tool). we use this tool to do things (describe, command, convince, ask, etc.), and so every expression in a language has the purpose of an action. understanding language therefore involves understanding the actions we perform with it (wittgenstein, 1953). emotional language is a term used to describe the channel through which one expresses one’s deepest feelings, fears, and needs (amir, 2013). in this way, the starting point for examining the emotional semantic field of fear and anxiety as a result of war is the expression “red alert”, which is a voice announcement (a voice alert) system that warns about short-range rockets being fired toward settlements surrounding gaza. when the system detects a rocket being launched toward a populated area, the “red alert” signal is sounded, and shelter must be taken quickly. this is known as being “reminiscent of fear” (pat-horenczyk et al., 2019), since the mere sound of the alarm can cause feelings of panic and anxiety, and fear needs to be construed by a developed brain that is able to perform complex cognitive operations, supported by being embedded in a specific social and cultural environment/context, and largely shaped by our native language (chrzanowska-kluczewska, 2021). furthermore, language cannot be disassociated from the social contexts in which it is used, and every utterance is a unique expression of sociolinguistic interaction in a specific social context. as bakhtin (1981) claimed, an authoritative voice is disembodied and sounds reliable and objective. it expresses a rigid ideological position that rejects as out of hand, using various rhetorical devices, all “strange speech”—that is, every “voice” that is not in harmony with the ruling official ideological opinion of the time. “it demands that we acknowledge it, to make it our own. it handcuffs us in a way that almost does not depend on its power to be able to persuade us; in a way … its authority has already been acknowledged in the past” (bakhtin, 1981, p. 342). in language, words and phrases are interwoven or added to other existing words, and the connections between different elements in a text are combined into an overall meaning (fillmore, 1992). an analysis of a word or a concept is not isolated or dictated by the limits of its applicability in the world. it is conducted according to a preoccupation with the semantic and syntactic relations between a word and other words close to it within a common content framework, namely between words and the categories they belong to, between a category and the background for its creation, and between different categories. words are organized in knowledge frames that have been called by different names, such as “framework”, “script”, “cognitive model”, or “base template” on which what is happening is highlighted, and in the past, even “semantic field” was used. these are cognitive structures that underlie the concepts denoted by words, and based on the human experience and its understanding, they can be reduced or expanded depending on the circumstances (fillmore, 1977, 1982). all these cognitive structures contribute considerably to understanding language assimilation and socialization processes in a given society. there is a strong correlation, or even overlap, between identity and language. gee (1996) emphasized that discourse is a whole complex of common relations that define the usage of language and other symbolic utterances and their by-products, namely the thinking, feeling, www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 18 published by scholink inc. beliefs, values, and activities one can use to identify oneself as a member of a meaningful social group or a social network in order to convey to others one’s meaningful social function. a language is a basic component of culture within which one’s identity is formed as part of a unique and established group in that language (girtz, 1999). since war can have many detrimental effects on people’s mental health, well-being, and social functioning, children should be exposed to war literature (kelmendi et al., 2022). bat-ami (1994) listed the reasons why this should be done. first, children are afraid of war; therefore, they have misconceptions that produce anxiety. moreover, children have the ability to think critically and the opportunity to examine multiple perspectives in order to be able to create a better world in the future (mohr, 2014), especially those growing up in a conflict zone, which produces a sense of helplessness because of the trauma resulting from war (keselman, 2019). the “red alert”, linguistic icon evokes fear and anxiety in those who hear it because its meaning is based on social and cultural contexts (ledoux, 2015). it is also based on human psychology, according to which words can be found in organized knowledge frameworks, sourced from cognitive models of concepts, and each word that is heard conjures up a meaning in the mind based on an internal context of experience, belief, or habit (fillmore, 1985). the “red alert”, icon provides a functional definition that focuses on the process of metaphorical thinking, which allows one type of thinking to be replaced with another. this is the way the human mind transfers thoughts from one mental reality to another and uses the framework of thinking created when dealing with certain “worlds”, even when dealing with a completely different world (minsky, 1988). between fear and war ledoux (2015) described the differences between fear and anxiety as conceptual. in fear, attention is focused on a specific external threat—one that is present or close—whereas in anxiety, the threat is usually not easily identified, and its occurrence is less predictable. it is more internal; there is an expectation, rather than a fact; and it can also be an imaginary possibility with a low probability of occurrence. “conscious emotions denoted by basic emotional terms are not pre-packaged innate states that are released by external stimuli, but are cognitively constituted in consciousness” (ledoux, 2015, pp. 123-124). fear as a cognitive structure, and the way it is shaped by humans, is influenced by sociocultural contexts, as discussed in detail in the article by mobbs et al. (2019). fearful associations create an atmosphere of danger, and as a person becomes more emotionally experienced, situations of fear become more distinct and create feelings ranging from fear to panic, from panic to terror, and from concern to caution and nervousness. this is due to the labelling process, which depends on the personal learning process and the personal interpretation ability, so the use of these terms may vary for each person (ledoux, 2015). anxiety is to some extent a normal and psychologically adequate emotion in a dangerous situation. a person feels inner anxiety, overflowing with thoughts of approaching something https://pubmed.ncbi.nlm.nih.gov/?term=kelmendi+k&cauthor_id=32993418 www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 19 published by scholink inc. unpleasant, combined with fear at the physical level, with rapid breathing and heartbeat and bodily discomfort (in the chest, back, abdomen, and limbs). anxiety is a combination of emotions, such as fear, sadness, shame, and guilt, at the same time; it is not a stable state, but it develops according to certain patterns. lewis (2013) claimed that children act out of fear and anxiety long before they feel these emotions. logically, this is considered to be a sequence of cognitive, affective, and behavioral reactions that are actualized as a result of human exposure to stressors. in this case, stress can be due to both external and internal factors, which are interpreted by the subject as dangerous or threatening. cognitive hazard assessment thus actualizes a state of anxiety or an increase in the level of its intensity. the role of anxiety as a danger indicator is leading and ultimately decisive in finding the threat and stimulating defense mechanisms in the body. it should be noted that the alarm function extends far beyond the real situation and takes into account the individual’s past experience, and it also works in accordance with their vision of the future (mobbs et al., 2019). ledoux (2015) added that the language of fear is necessary for children for at least three reasons, as follows: (a) to shape thinking patterns that will help them deal with more direct danger (and anxiety later in life); (b) to tame death and reduce the fear of it—that is, one of the basic sources of horror in one’s own life; and (c) to prepare children for the treatment of fear using techniques that increase/reduce it. ledoux (2015) reminded us that language is the most powerful tool for dealing with fear and a useful one for dealing with fear and anxiety in psychotherapeutic approaches. reading can be a lot of things, such as entertaining, exciting, or relaxing, and educational reading is also known to help lower stress. well-being during times of crisis can be achieved by reading, because it works as an escape. thus, a children’s literature text creates two spaces: a “reflective space”, which helps participants reflect on sensitive topics, such as institutional environments, roles in interdisciplinary teams, and gender discrimination, and a “narrative space”, which allows them to tell powerful stories that provide cultural insights and challenge cultural hegemony. they describe conscious and subconscious identity transformations that evolve secondary to struggles with local power dynamics and social demands involving the impact of family, peers, and country of origin (zaidi et al., 2016). methodology the purpose of the study was to examine how children’s books written since 2009 reflect the fear and anxiety of children who live in the israeli otef gaza region. the discourse reflected routine hours; that is, regular activity that builds a daily routine with clear boundaries, as opposed to an emergency routine, which is a state of uncertainty that causes stress and anxiety due to a situation in the shadow of war. the following research question was posed: how useful are word groups related to fear and war content frameworks for creating meaningful relationships and thus illuminating the world of children’s www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 20 published by scholink inc. emotions. the research methodology was based on an analysis of texts examining the social and cultural processes that have been described, that influence the writer’s point of view, and that have an impact on the reader. “every verbal communication is related to the selection of certain elements and structures from within the system of language, which are responsible for the perspective created in conveying the message” (alter, 2001, p. 38). researchers perform several procedures on a text in order to derive significant distinctions and generalizations from the text itself (weber, 1990). in this process, patterns that recur in stories and constructed discourses can be identified, so that the derived meanings can be understood (stephans, 1992). through discourse (language), and also through story and meaning, assumptions can be derived about human existence, and from the meaning, we derive lessons, insights, and desired behaviors through which we can learn about the social being, ideologies, and opportunities for offering aesthetic and educational experiences to children. the database was based on a search of interpretive, signifying, symbolic, action, and cultural codes (barthes, 1974). these helped to build a semantic field focused on war and from which the fields related to excitement, occurrence, and cognitive knowledge were derived. these fields were rooted in a cultural code that helped to reveal details related to the sociocultural knowledge through which the author or narrator described fear and anxiety. the research corpus included about 20 children’s books written about the situation in the israeli otef gaza region that can be found in the national library. findings a rich lexicon of words, concepts, and vocabulary related to fear and anxiety is associated with the main theme. choices are based on the neuroscientific concept of ledoux (2015), in that the two emotions are related to each other, and examples show that the feeling of fear is not innate but a cognitive structure resulting from the use of one’s mother tongue in a certain sociocultural context—in this case, periods of war and the use of a lexicon expressed the unique atmosphere that had been created. verbal/linguistic usage the use of the words “afraid” and “fear” is in accordance with the dictionary meanings. the words “fear” and “afraid” are repeated in all the stories as literal language that took precedence over figurative expressions in the texts. examples of this include the following: everyone is afraid when there is a war. … my mother was afraid that a missile might hit her in the middle of the road. (cohen, 2021, p. 38) red alerts were heard from all sides, and people were frightened and afraid, both at night and during the day. i hugged my mother and told the children to take care of grandma and grandpa—both father www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 21 published by scholink inc. and mother, jews and arabs—almost every resident. (sternberg, 2015) and what do we do if there are booms? … i’m afraid to leave the house. (ailon, 2013, p. 2) in the latter book, the word ‘fear’ was counted 78 times out of 1008 words. the repetition of the word creates an unpleasant atmosphere; in addition to it, there are more descriptions of feelings, such as heart palpitations, sweating, and shaking. synonyms, or words that are related semantically to the word “fear”, were collected. these words strengthen not just the personal feeling but also the collective perception of those living in the israeli otef gaza. the words refer to the sounds that are heard, the placement of the shield, and the physiological phenomena that will be discussed later. the first sound is an alarm or the red alert. the signal even has a nickname, “ola”, which comes from the onomatopoeic feeling of the sound of the alarm—a sound that reminds people of the thing it signifies. the jews invented ola; ola knows exactly when a missile is flying, and she quickly exclaims: “ooooooooooollllaa! ooooooooooollllaa!” (ofri, 2009) ola appears in the book 13 times as a personified entity. the role of personification in the alert is to reduce the threat to children, although the word is associated with war. other words include “bombs”, “rockets”, and “missiles”. bombs and rockets fell all over israel, but the attack was overcome by “iron fist” shelters, and protected areas were immediately opened where parents and children would sleep on mattresses. in the communities surrounding otef gaza, the residents suffered greatly—it was a difficult experience not only for the residents of the cities but also for those throughout the country. in settlements far away from gaza, the alarms sounded and were silenced, with the smoke of date palms rose into the sky. red alerts were heard from all sides; people were alarmed and afraid, both at night and during the day. “hug me mother”, the children asked, taking care of grandma and grandpa, father and mother, jews and arabs—almost every resident (sternberg, 2015). the following examples illustrate the shelter that is taken take during the alarm: mom explained that the initials of the word mmad (shelter in hebrew) refer to a residential protected space, meaning a protected place in an apartment, and every house should have a shelter (israeli, 2021, p. 17). she quickly went to the security room in the house … everyone entered the security room in a hurry. mother quickly closed the steel door, and omari closed the heavy window. the children tried to catch their breath. they realized that it was a real alarm and waited to hear the boom … a qassam rocket fell in one of the areas of the western negev—the settlements announced this on tv … let’s hope it fell in an open area and didn’t hurt anyone (israeli, 2021, p. 14). the child summarized the situation in his own words: the child heard his parents talking in the language of adults and using words that he did not understand at all. they used strong words like “terror”, “war”, and “hate”, and he didn’t understand what the fuss www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 22 published by scholink inc. was about, but he started to worry terribly (bar-halpern, 2013, p. 13). the body language of the characters was expressed using all the senses to express fear (seeing, hearing, tasting, and touching, in this category): this is a true alarm. the enemy is launching missiles into israel to hit us. … at that moment, the kibbutz announcement system announced: “red alert”, “red alert”. tamar’s legs were a little shaky, and so were her hands, but she still gathered kip fun (the cat) in her arms and quickly headed for the security room inside the house. … everyone hurried into the security room. the mother quickly closed the steel door, and her brother closed the heavy window (israeli, 2021, p. 17). crying, shivering, and with snot dripping onto my mother’s shoulder, i was shaking all over. is this what fear looks like? (cohen, 2016, p. 12) when there is a red alert, my heart beats so violently that for a moment, i stop breathing, and my hands sweat as if i’m hot (ailon, 2013. p. 4). although i could not feel my eyes, mine began to cry (ailon, 2013, p. 8). we ran to the shelter, and my sister wet herself again. … this war is like a monster to us; “i’m locked in a room and i’m a little nauseous” (cohen, 2021, p. 48). the alarm rang inside my body, bursting into every corner and thought, even in places from which happy things like hopes and dreams usually emerge (cohen, 2016, p. 12). i became afraid and was under pressure, and tears flooded my eyes (cohen-biton, 2019, p. 6). mental and physiological characteristics—between fear and anxiety in the following excerpt, the use of multiple words related to war creates an emotional and mental compression that indicates not only the experience of the war but how fear is also replaced by anxiety; the child wants to stay away from sounds that suggest terror, such as noisy toys, creaking windows, or doors slamming. anxiety finds its expression in the desire to stay close to the protected space or in dialog about fearing the return of war. the child talks about anxiety in the two concepts of routine time and emergency routines, when he is aware of each of the characteristics of time. the anxiety is intensified or replaced by collective anxiety. the child is not only anxious for his father, who is going to war, or his mother, who is supposed to bear the burden when she is left alone at home, but also for the soldiers who are going off to fight. new words seep into his world—ones that we do not know in everyday life—such as bombs falling, death, leaving home, and becoming a refugee—and these words devour not only his agenda but his feelings. please don’t shoot firecrackers at me. on my birthday, don’t buy me balloons. when you close a door, don’t slam it hard. don’t make siren noises—they remind me of an alarm. don’t you dare say that my sister looks like a bomb; i’m not ready to hear it (cohen, 2021, p. 10). the fear that accompanies the child, living in a war environment, manifests itself in mental and physical sensations. fear and anxiety stem from the concrete threat of missiles and bombs, while anxiety comes from the dread of the possibility of returning to such a situation. the product of fear and www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 23 published by scholink inc. anxiety is the traumatic situation that accompanies the child as a result of the events of war. the rhetorical question asked by the child sums up the question of how to turn the abstract concept of fear into something concrete, and indeed, through the personification of fear, it is possible to identify a multitude of phrases that attempt to define or describe dictionary, psychological, and philosophical concepts. i don’t like hearing the alarms and the calls of “red alert” “red alert” all the time, and it’s also quite scary. we ran to the shelter (p. 12), and we heard a loud boom. this happened both during the day and at night. sometimes we remained asleep in our rooms, and it was also impossible to go outside and play with our friends (bibi, 2018, p. 14). the remnants of fear and the “sounds of war” are replaced by a feeling of anxiety: every time there is an alarm, i pray that it will be the last, but it is usually a “barrage”; the world continues to spin and nothing happens. and the media publishes documentation of injured, trembling children—and all of this only serves to raise my level of panic and concern … the first thing i will always do in any new place is to look for a shelter. … i am not ready to move a single step from the protected space. i heard my mother and the counselor whispering that i was a traumatized child with severe psychological damage (atlas, 2023, p. 228). the result of fear is more than a cultural trauma that affects group members when they “feel that they have been subjected to a terrible event that has left indelible marks on their group consciousness, marking their memories forever and changing their future identities in fundamental and irreversible ways” (alexander et al., 2004, p. 1). as part of dealing with fear, it was found that the protagonists of the story offered tools for managing fear, which are described in the following section. practice voices and situations typical of times of conflict one way to prevent fear, which in turn increases anxiety, is to be as prepared as possible. while practicing the situation with adults, the children see the shelter as a place where their lives are safe. therefore, when they hear the alarm, they must run there to protect themselves, with the role of adults being to strengthen their children’s sense of safety. i sit by myself for hours and try to relax, try to practice the sound of the alarm, and try not to be surprised. i’m mature, and positive thoughts come into my mind. (baron, ,2014, p. 18) i’ve already learned to calm down, breathe, and exhale; i imagine myself resting in a hammock on the beach (cohen, 2021, p. 44). the children fantasize about a dream that could magically change the situation: i can make rockets stop in mid-air, turn them into colorful fireworks, and surprise all the onlookers. after spending a few hours alone, trying to relax, practicing the sound of the alarm, and not being surprised, i tell myself i’m a hero and conjure up positive thoughts in my mind (baron, 2014, pp. 15-18). www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 24 published by scholink inc. together, we will be united and continue to cope. as a graduate, i want to find a global solution, even if it seems a little dreamy. i will draw the solution on the page with a brush, and whoever looks at the drawing will know that i am all-powerful (baron, 2014 p. 23). some children have a practical dream that has significance, such as building a resilience center: one day, when i become a rich contractor, i will build the resilience center, the most luxurious in the city. there will be ponds stocked with fish … and chocolates at the front desk … and unlimited ice cream. … there will be no psychologists waiting for you to speak first (cohen, 2021, p. 26). in addition to the suggestions made by the children as part of the plot, the adults also offer ways to deal with their fears. organizing an activity in the shelter; arranging it in an inviting way; creating an atmosphere for it that gives off a sense of calm; preparing sweets based on the understanding that they help people to calm down; bringing a toy into the room to serve as a transitional object; and ensuring that a pet is brought in—these are all practical actions in addition to conducting activities that have a spiritual dimension, such as talking about scary things, hugging, and kissing. mother took out a box of soap bubbles and told her daughter to inhale lots of air and forcefully blow out our dreams and desires. the room became a magical place for dreams, … up to the point that i didn’t want to leave it at all (cohen-biton, 2019, pp. 17-19). drawing a monster literary monsters remain present inside children’s imagination and represent a well-rounded package of imagination and fear. it is when individuals find themselves in this state of existence that the literary monster must be combined with positive qualities in order to help the individual rediscover their lost imagination and sense of positivity (christie, 2020). the child draws a “superhero” on the monster that will drive the monster away; this is a sublimate action designed to reinforce it: i started drawing a monster. it had the shape of a rocket, with fire on its tail, and it was chasing children … the monster will not come back; it is afraid of you, me, and the heroes. the ability to defeat the war monster—daniel, the hero of the story, managed to deal with the monster that had returned to his dreams, and gobi, who accompanied him, told him: “you see daniel, we really defeated the monster. the monster will be afraid to come back” (nahman & nahman, 2009, pp. 30-34). he sang: “never, ever come here, boom-boom monster. i’ll drive you out; get out there” (nahman & nahman, 2009, p. 14). singing a well-known song on a specific subject or composing songs are also a sublime way of coping. saying a prayer also has the power to bring calm: the color red is the color of an anemone. it calls us all to enter the shelter. when you hear the red alert, and your heart starts to tremble, three breaths will help you a great deal. … those with no need for fear can help everyone else. … when fear brings tears to your eyes, you don’t need to feel ashamed, as it sometimes calms you down (ailon, 2013, p. 16). www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 25 published by scholink inc. and sometimes, while waiting at the shelter, … they like to say a prayer—a prayer for you to protect them and their families and all the people of israel. but most of all, they pray that the conflict with the arabs will end; instead of hatred, love will come to pass, and jews and arabs will live together in peace (ofri, 2009, no page number) peaceful cooking is a future fantasy of the children—but as in any fantasy, the adult tries to explain to the child that he should lower his expectations, since because of the political situation, it is not certain that things will come true. children who often experience routine emergencies and fears are exposed to a whirlwind of emotions. at the same time, the stories reveal their dynamic, creative, and adaptive nature alongside their mental and emotional burdens. the children manage to adapt themselves to this reality, harnessing every available tool at their disposal to restore a sense of self-control and to keep normal life going as much as possible. discussion this article describes how fear and anxiety appear in children’s books written during the years of conflict in the israeli otef gaza—books whose aesthetic plots cover war scenarios containing violent experiences that leave behind trauma and even post-trauma. the use of words from the battlefield serves as a catalyst for the plots that are described and for the emotional deprivation and trauma present in the children’s world following the “voices” of combat. there are two points of view that are reflected throughout the plots: one is of the adult, and the other is of the child. every point of view expresses a different aspect of a given situation. the adult author is working through a traumatic experience (lacapra, 2006). the importance of this process may “act to reduce the power of the ‘acting out’”, in which the post-traumatic subject is “pursued by the past or infected by it and caught performatively for compulsive repetition of traumatic scenes—scenes in which the past returns and the future is blocked or condemned to imprisonment in a melancholic loop” (lacapra, 2006, p. 49). it not only describes threats and frightful experiences but is instrumental in overcoming fear and anxiety via introspection in a verbal examination and evaluation of our experiences, and ultimately in fear-management. psychiatric treatment conducted with the aid of language (conversations, explanations, and advice) often has a better outcome than medical treatment for fear/anxiety that targets the symptoms but not the cognitive sources of these emotions (ledoux, 2015). the effective implementation of mental health and psychosocial support programs during wartime helps to provide the necessary services to reduce suffering and provide decent support to help develop recovery, self-healing, and survival skills. therefore, an extremely urgent task not only for medical, psychological, or social professionals but also for society as a whole is the timeliness, accessibility, and professionalism of providing the necessary assistance to each person affected by the traumatic consequences of hostilities. mental health and psychosocial interventions for war-affected children should be multileveled, specifically target the child’s needs, be trauma-informed, and be strengthand www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 26 published by scholink inc. resilience-oriented (bürgin et al., 2022). to deal with this reality, the psychological services and the welfare department in israel provide position papers to parents and educators that contain information about what is happening, explaining how questions that arise on the subject should be answered by the child so that they overcome the war days. this explains why one must be careful not to be overwhelmed by unnecessary information and the importance of giving appropriate answers to children’s questions, even if they are difficult (israeli, 2021). it is necessary to moderate information that comes from the media so that children do not receive false and frightening messages. it is worthwhile to encourage children to realize that even adults may not always have the answers to all questions, although this is difficult for adults. with regard to formal activities, children’s books about the military conflict in the israeli otef gaza, which have been published since 2009, should be consulted, as these books have therapeutic children’s texts that become a means of expressing feelings of discomfort associated with traumatic events while empowering imaginative possibilities to create positive change both within the self and in the environment. thus, children’s texts provide an experience that enhances children’s inner vision and insight into themselves, and the narrative scenario bypasses resistance barriers, making it possible to absorb the messages conveyed in the stories (kobobi, 1992). it helps to establish personal resilience, especially after experiencing trauma (keselman, 2019). books are an important therapeutic tool (baratz & kass, 2011). textbooks are important because they create a “reflective space” that helps the participants reflect on sensitive topics—in this case, fear and anxiety as a result of war. they occupy a “narrative space”, or as zoran called it, the “third text”—that is, the voice of the text, through which the therapeutic discourse takes place. it is an area that winnicott (1953) called a “transitional object”, which is an area in between the preciousness of the cultural experience. the third text allows the inner reality of the person and the outer reality to be separate and yet interconnected (zoran, 2009, p. 21). the text helps to build political literacy, which is supposed to provide young people with tools for language development and a dictionary of terms for engaging in discourse about politics. these will be used to promote a cultural polemic, to analyze and explain the political situation, and to formulate a personal position. using political literacy through literature written about war makes it possible to understand political reality, develop social awareness, discover involvement in what is happening in the environment, cultivate critical thinking, and stimulate a desire to act for change. the acquisition of positive thought processes through children’s books allows children to build a sense of personal, community, and national resilience. children’s literature and storytelling can be helpful in promoting students’ global development and well-being when they are included in school curricular activities. children’s books are places of endless possibilities, where young people can open their minds to broad horizons, create new perspectives, find possible alternatives or solutions to problems, and develop their strengths, including self-confidence and resilience (pulimeno et al., 2020), through the implicit meanings embodied in stories, children indirectly acquire pedagogical messages that influence their www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 27 published by scholink inc. personality and stimulate a social sense of duty (baratz & kass, 2011), consequently, books can serve as powerful coping tools because they help children deal with real-life problems and explore uncertainties, depict them as active agents and shapers of their own destinies, and ultimately promote well-being. that way, children create their own strategies for resilience and develop the capacity to recover from difficult life events and crises (susemihl, 2021). stress disorders persist beyond the time-limited stress event and become a post-traumatic stress disorder. therefore, a suitable solution is to return to one routine in order to rehabilitate. these incessant occurrences frequently and radically undermine the daily routines of the residents of the area who experience severe stress and anxiety over their personal safety and that of their children (elran et al., 2015). lazarus (1999) included cognitive and behavioral efforts made in order to change the situation, which is influenced by a variety of personal and context-dependent factors, such as desiring to overcome fear, making friends with those who are afraid, and trying to imagine and find tools. immediate supportive interventions should focus on providing basic physical and emotional resources and care to children to help them regain both external safety and inner security (bürgin et al., 2022). to deal with fear, all these were observed in the children’s ways of coping in the stories. strengthening positive emotions has a restorative role in adaptation processes both during normal days and in emergency routine days, since the situation cannot be changed except to create feelings of self-satisfaction and thus reduce the stress dimension (folkman & lazarus, 1985; lazarus, 1999). from the findings, it becomes clear that treatment focusing on emotions (the cognitive-behavioral approach) or using books as a bibliotherapy tool that reinforces optimistic messages (kobobi, 1992) embedded in the story strengthen the mental well-being of both the story’s protagonist and the reader and instill self-confidence in the ability to succeed, give new hope and optimism, and indicate new and better directions for dealing with anxieties. they also help shape thinking patterns and cognitive consciousness and help connect to emotions in order to keep negative patterns away (greenberg, 2015). in conclusion, children’s books play a role in strengthening positive feelings both on normal days and in emergencies. we may not be able to change the political situation, but it is possible to strengthen the sense of resilience and self-control, thereby reducing the dimension of stress. references alter, r. (2001). hanaot akriea bedan hidology [the pleasures of reading in an ideological age]. haifa university and zamora bitten. alexander, j. c., eyerman, r., giesen, b., smelser, n. j., & sztompka, p. (2004). cultural trauma and collective identity. univ of california press. american psychiatric association. (2013). diagnostic and statistical manual of mental disorders (5th ed.). amir, e. (2013). tehom safa [cleft tongue]. magnes. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 28 published by scholink inc. atlas, y. (2021). yeladim shel af ehad [missiles and longing, nobody’s children]. the haruv institute. bakhtin, m. (1981). the dialogic imagination. university of texas press. bar-halpern, m. (2013). lhiot gibor al [becoming a superhero: the development of a book for children who have been exposed to terrorist attacks]. amazia. baron, a. (2014). boger hagan hadom [graduate of the red garden]. zamert. bat-ami, m. (1994). war and peace in the early elementary classroom. children’s literature in education, 25(2), 83-99. barthes, r. (1974). s/z (r. miller, trans.). hill and wang. (original work published 1973) baratz, l., & kass, e. (2011). the adult as message mediator in children’s books dealing with eating disorder. journal of reading, writing and literacy, 5(3), 1-11. bibi, v. (2018). bo nevasel salom [let’s cook peace], sha’ar. bürgin, d., anagnostopoulos, d., vitiello, b., sukale, t., schmid, m., & fegert, j. m. (2022). impact of war and forced displacement on children’s mental health—multilevel, needs-oriented, and trauma-informed approaches. european child & adolescent psychiatry, 31(6), 845-853. christie, l. (2020). the evolution of monsters in children’s literature. palgrave communications, 6(1), 1-7. chrzanowska-kluczewska, e. (2021). the language of fear in children’s literature: a case study of ted hughes’s poems for children. tematy i konteksty, 11(16). cohen, r., leykin, d., golan-hadari, d., & lahad, m. (2017). exposure to traumatic events at work, posttraumatic symptoms and professional quality of life among midwives. midwifery, 50, 1-8. cohen, r. h. (2021). me and ytotam hakassam: songs from the world of the children of otef israel. tov levvav. cohen-biton, k. (2019). add hebrew title here [breathtaking surprise]. zamert. eilon, l. (2013) hamtpahad sel yarden [dread shawel of jordan]. hakibutz hamehuhad. elran, m., israeli, z., padan, c., & altshuler, a. (2015). social resilience in the jewish communities around the gaza strip envelope during and after operation protective edge. military and strategic affairs, 7(2), 5-31. girtz, g. (1999). ideology as a cultural system. in commentary of cultures (pp. 15-39). keter. gee, j. p. (1996). discourse analysis: status, solidarity and social identity. in social linguistic and literacy, ideology in discourses. (chapter 5, pp. 90 121) bristol, pa: taylor and francis. greenberg, l. s. (2017). emotion-focused therapy: coaching clients to work through their feelings (revised edition). american psychological association. ichilov, a. (2001). civics education in a changing world: trends in the world and in israel. in i. yiram, s. shkolnikov, i. cohen, & a schechter (eds.), values and education in israeli society (pp. 441-480). jerusalem. israeli, n. (2021). hatula vesalom [a cat and peace]. zamert. www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 29 published by scholink inc. fillmore, c. j., & atkins, b. t. (1992). toward a frame-based lexicon: the semantics of risk and its neighbors. frames, fields and contrasts: new essays in semantic and lexical organization, 75, 102. fillmore, c. j. (1985, june). syntactic intrusions and the notion of grammatical construction. in annual meeting of the berkeley linguistics society, (vol. 11, pp. 73-86). fillmore, c. (1975). an alternative to checklist theories of meaning. proceedings of the first annual meeting of the berkeley linguistics society (pp. 123-131). fillmore, c. (1977). scenes-and-frames semantics. in a. zampolli (ed.), linguistic structures processing (pp. 55-82). amsterdam: north holland. fillmore, c. (1982). frame semantics. in the linguistic society of korea (ed.), linguistics in the morning calm (pp. 111-137). seoul: hanshin publishing company. folkman, s., & lazarus, r. s. (1985). if it changes, it must be a process: study of emotion and coping during three stages of a college examination. journal of personality and social psychology, 48, 150-170. kelmendi, k., mulaj, i., zymberi, m., & kadiri, s. (2022). meaning-making of war experiences: stories from kosova. omega journal of death and dying, 86(1), 89-118. keselman, m. (2019). presentation on creative arts interventions for older adults with a history of trauma. jewish federation of north america webinar. kobobi, d. (1992). bibliotherapy [bibliotherapy—literature, education and mental health]. magnes. lacapra, d. (2006). lictiv historia lictov trauma [writing history, writing trauma] (y. farkash, trans). resling. lazarus, r. s. (1999). stress and emotion: a new synthesis. springer. lazarus, r. s., & folkman, s. (1984). stress, appraisal, and coping. springer. ledoux, j. (2015). anxious: the modern mind in the age of anxiety. one world publications. lewis, m. (2013). the rise of consciousness and the development of emotional life. guilford press. masten, a. s., & narayan, a. j. (2012). child development in the context of disaster, war, and terrorism: pathways of risk and resilience. annual review of psychology, 63, 1-31. minsky, m. (1988). society of mind. simon and schuster. mobbs, d., adolphs, r., fanselow, m. s., barrett, l. f., ledoux, j. e., ressler, k., & tye, k. m. (2019). viewpoints: approaches to defining and investigating fear. nature neuroscience, 22(8), 1205-1216. mohr, e. (2014). posttraumatic growth in youth survivors of a disaster: an arts-based research project. art therapy, 31(4), 155-162. nahman, z., &, nahman, n. (2009). hakesem sel daniel [daniel’s magic, conquer the fear of war], international marketing. nuttman-shwartz, o. (2017). children and adolescents facing a continuous security threat: aggressive www.scholink.org/ojs/index.php/ct children and teenagers vol. 6, no. 2, 2023 30 published by scholink inc. behavior and post-traumatic stress. child abuse & neglect, 69, 29-39. ofri, i. (2009). ola, [ola], sa’ar. pat-horenczyk, r., & schiff, m. (2019). continuous traumatic stress and the life cycle: exposure to repeated political violence in israel. current psychiatry reports, 21(8), 1-9. pulimeno, m., piscitelli, p., & colazzo, s. (2020). children’s literature to promote students’ global development and wellbeing. health promotion perspectives, 10(1), 13-23. rakhman, l. v., plevachuk, o. y., shpylovyi, i. v., dzis, m. o., & suvalo, o. b. (2022). an anxiety as a response to distress and as a symptom of stress disorders in wartime. wiadomosci lekarskie, 75(8: 1), 1882-1887. sha’ar, y. (2015). a glimpse into the experiential mental space of the residents of the eshkol regional council following the “tzuk eitan” operation. psycho-actualia, (april), 20-24. stephens, j. (1992). language and ideology in children’s fiction. longman. sternberg, n. (2015). zuki and eitan mazu bait ham [zuki and eitan found a warm home] beit elim. susemihl, g. (2021). a story a day keeps pandemic stress away: children’s books and the corona crisis. oeuvres et critiques, 46(2), 45. weber, r. p. (1990). basic content analysis. sage. winnicott, d. w. (1953) transitional objects and transitional phenomena – a study of the first not-me possession. international journal of psychoanalysis, 34, 89-97. wittgenstein, l. (1953). philosophical investigations. basil blackwell. yahav, r., & cohen, m. (2007). symptoms of acute stress in jewish and arab israeli citizens during the second lebanon war. social psychiatry and psychiatric epidemiology, 42, 830-836. zaidi, z., verstegen, d., naqvi, r., dornan, t., & morahan, p. (2016). identity text: an educational intervention to foster cultural interaction. medical education online, 21(1), 33135. https://doi.org/10.3402/meo.v21.33135 zoran, r. (2009). hotam haotiot [the letter’s imprint—reading the identity within the bibliotherapeutic]. carmel. https://doi.org/10.3402/meo.v21.33135 children and teenagers issn 2576-3709 (print) issn 2576-3717 (online) vol. 4, no. 3, 2021 www.scholink.org/ojs/index.php/ct 26 original paper parental influences on children’s oral health behaviors, reading behaviors, and reading attitudes associated with the sharing of a digital story from the ebook for oral health literacy© curriculum valerie a. ubbes1* & abby witter2 1 miami university, department of kinesiology, nutrition, and health, oxford, ohio, united states 2 university of cincinnati, college of medicine, cincinnati, ohio, united states * valerie a. ubbes, miami university, department of kinesiology, nutrition, and health, oxford, ohio, united states received: july 13, 2021 accepted: july 31, 2021 online published: august 22, 2021 doi:10.22158/ct.v4n3p26 url: http://dx.doi.org/10.22158/ct.v4n3p26 abstract this study investigated the relationships between parents and their children on oral health behaviors, reading behaviors, reading attitudes, and liking perceptions of one chapter from an ebook curriculum intervention. a qualtrics platform was used to survey 316 parent-child dyads across the united states before and after the shared reading of one chapter from the ebook for oral health literacy© entitled “setting goals for going to the dentist”. participants answered 75 questions about their teeth brushing and flossing behaviors, number of cavities, how often they visited libraries and bookstores, enjoyment of reading, and perceptions (liking) of the words and pictures of the chapter that they read and heard. statistically significant relationships were found between parents and their children on oral health behaviors (χ2 = 49.12, p < 0.001); reading behaviors (χ2 = 10.4, p < 0.01), reading attitudes (χ2 = 8.773, p < 0.01), and perception (liking) of the ebook chapter that they read and heard (χ2 = 113.813, p < 0.01). results from 301 parent-child dyads point to the importance of social modeling that parents play in the development of their children’s oral health behaviors, reading behaviors, and reading attitudes. testing of additional chapters from the ebook intervention is warranted. keywords oral health literacy, oral health behaviors, reading behaviors, reading attitudes, parent-child dyads, ebook www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 27 published by scholink inc. 1. introduction oral health is a high-priority health issue as indicated by the healthy people 2030 document which sets public health agenda in the united states for the next ten years. oral health has been a leading health indicator for the past decade and the current decade (usdhhs, 2020b), owing to the importance of oral health being foundational to overall health. as former surgeon general satcher stated “you can’t have good oral health if you don’t have good general health” (lee, watt, williams, & giannobile, 2017). oral health hygiene, intake of water and milk, access to fluoride, and regular dental checkups are important factors in oral health promotion (singleton, day, thomas, schroth, klejka, lenaker, and berner, 2019). parents play important roles in modeling oral health behaviors for their children (okada, kawamura, kaihara, matsuzaki, kuwahara, ishidori, & miura, 2002), and low oral health literacy of parents is associated with higher dental caries of their children (firmino, ferreira, martins, granville-garcia, fraiz, & paiva, 2018). parents with low literacy have less health knowledge and poorer health behaviors (dewalt & hink, 2009), which may disadvantage the health behaviors and health literacy levels of their children who would benefit from healthy role models. low parent (caregiver) literacy has been associated with more cavities and poorer dental health of their children (miller, lee, dewalt, & vann, 2010). adults with limited oral health literacy have poorer oral health status, including more filled permanent teeth, more missing teeth due to disease, and increased gum disease (baskaradoss, 2018). parental behaviors and attitudes toward reading also influence their children’s linguistic and literacy development (niklas, wirth, guffler, drescher, & ehmig, 2020), including their early reading achievement (abu-rabia & yaari, 2012). according to vygotsky’s zone of proximal development (vygotsky, 1978 & 1986), children are influenced to learn language signs and symbols from their parents, peers, and other significant people who are proximally close and interacting with them. parents, peers, and professionals are responsible for scaffolding learning and serving as a guide on the side in helping children learn information that they would otherwise not be able to learn by themselves (leong, hassan, isa, & jalil, 2018). the home literacy environment has been found to mediate between parental attitudes toward shared reading time with their children and their children’s language comprehension and production (niklas, wirth, guffler, drescheer, & ehmig, 2020). one literacy objective from healthy people 2030 is to increase to greater than 63.2 percent of children whose parents read to them at least four days per week. in 2016-17, the national survey of children’s health (nsch) found that the proportion of children aged five years and younger whose family member read to them four or more days per week was 58.3 percent (usdhhs, 2020). the current project focuses on a reading intervention in which parents and their children share a chapter from the ebook for oral health literacy© while the story is read aloud at a pace comfortable for them. reading skills are “related to health knowledge and outcomes” (usdhhs, 2005, p. 181) and are one way to increase background knowledge when educating for health (ubbes, black, & ausherman, 2009; www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 28 published by scholink inc. ubbes, 2008; ubbes, 2002) and educating for science (kaefer, 2020), leading to the development of comprehension or the capability to understand something (johnson, 1982; deshpande, 2016). children also attain the knowledge needed to form health habits by observing the social behavioral patterns modeled by those around them in different situations (bandura, 1999), including home literacy environments (niklas, wirth, guffler, drescher, & ehmig, 2020). parents often serve as important role models for their children when it comes to developing daily health routines that lead to health habits. johnson, davy, boyett, weathers, and roetzheim (2001) showed that parent knowledge and attitudes for certain health practices can have a significant impact on the health of their children. for example, positive oral health behaviors in children have been linked to parent reading behaviors in a family. zullig, ubbes, and mann (2013) showed that students who saw a parent or caregiver reading in the past two days reported a significantly greater number of regular dental checkups than those who had not seen a parent or caregiver reading in the past two days. children living in low-income families are exposed to fewer words and less-affirming responses from parents which results in a lower vocabulary for their academic lives (hart & risley, 2003). parent’s ability to read dental terminology (word recognition) was not associated with vocabulary knowledge or with comprehension. however, vocabulary knowledge about oral health was strongly associated with comprehension (richman, hueber, leggott, mouradian, & mand, 2011). oral health is defined as the quality of an individual’s mouth, teeth, and gums. oral health is measured by the number of dental caries (cavities) and the frequency of teeth brushing and flossing behaviors. an individual’s oral health is influenced by the ability to access and understand oral health information and apply that information to oral health, which is called oral health literacy (horowitz & kleinman, 2008). the u.s. department of health and human services in its report, healthy people 2010, first defined oral health literacy as “the degree to which individuals have the capacity to obtain, process and understand basic oral health information and services needed to make appropriate health decisions”. according to an earlier report of a workgroup sponsored by the national institute of dental and craniofacial research (usdhhs, 2000b), the above definition addressed functional oral health literacy which includes the ability to use and apply knowledge when making oral health decisions and when communicating oral health information via speech, conversation, reading, writing, numeracy, speaking, and listening. oral health hygiene is the science of preserving the mouth, teeth, and gums via health-promoting practices. the american association of pediatric dentists recommends that children receive regular teeth cleaning and exams every six months. guidelines for oral health hygiene include brushing teeth with fluoride toothpaste twice a day, flossing daily, eating a healthy diet that limits sugary beverages and snacks, and visiting the dentist regularly for a check-up (american dental association, 2021). the first purpose of this study was to determine if there was a relationship between parents’ oral health behaviors and their child’s oral health behaviors. the second purpose of this study was to determine if there was a relationship between parents’ and children’s reading behaviors. the third purpose was to www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 29 published by scholink inc. determine if there was a relationship between parents’ and children’s reading attitudes. the fourth purpose was to determine if there was a relationship between parents’ perceptions (liking) of one chapter from the ebook for oral health literacy© curriculum and their children’s perceptions (liking) of the same chapter. 2. methods 2.1 participants participants included 316 parent-child dyads who answered online questions before and after an oral health story intervention which was also online. the parent-child dyads came from 43 states in the united states. after the data cleaning process, the final data set included a total of 301 parent-child dyads who answered separate and sometimes different questions on the oral health survey. the parents' ages ranged from 19 to 60, with the mean age being 38.5 years. parents included 89.8% females and 10.2% males. the children ranged in age from 9 to 11 years old, with the mean age being 10.1 years. children included 50.2% female and 49.8% males. participants were from 75% white families (n = 239) and 25% minority families. about 9.8% of participants (n = 31) identified as black, african american, or haitian; 6.3% of participants (n = 20) identified as hispanic or latinx; 3.5% of participants (n = 11) identified as asian, asian american, and pacific islanders; 0.9% of participants (n = 3) identified as american indian or alaskan native; and 3.8% of participants (n = 12) identified as another race. 2.2 procedures parent-child dyads (n = 316) took an online survey using the qualtrics platform (salt lake city, utah) before and after exposure to one chapter of the ebook for oral health literacy© entitled “setting goals for going to the dentist”. in order to participate, parents had to live with a child between the ages of 9 and 11 who would also participate in the study. researchers followed the approved protocol from the institutional review board for human subjects research at the referent university. parents first gave consent for their child to participate and then each child gave assent to participate. to the best of our knowledge, this study was one of the first to integrate educational curriculum material into the national qualtrics survey platform for use by participants online. hence, parent-child dyads answered a total of 75 questions divided before and after the intervention which included the shared reading of one chapter from the ebook for oral health literacy© curriculum. specifically, the qualtrics survey was presented in a phased process in which the parents began by answering 23 questions about personal demographics, oral health behaviors and attitudes, and reading behaviors and attitudes. parents then invited their child to the computer to answer 25 questions about personal demographics, oral health behaviors and attitudes, and reading behaviors and attitudes. next, parent-child dyads read and listened to the ebook chapter together known as shared reading. after exposure to the intervention, children answered 14 questions about their attitudes toward oral health and the ebook chapter. then parents www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 30 published by scholink inc. answered 13 questions about their attitudes toward the ebook chapter. 2.3 ebook curriculum intervention the ebook for oral health literacy© curriculum contains child-centered digital stories, which are organized by 17 chapters for learning about oral health hygiene, oral health and nutrition, oral health and beverages, and the importance of dental check-ups. the ebook curriculum is available as open-sourced educational material (https://dlp.lib.miamioh.edu/ebook/index.html) on the digital literacy partnership website @ https://dlp.lib.miamioh.edu/. the ebook curriculum has been evaluated for its readability, suitability, understandability, actionability, and gist-based message design (ubbes, witter, kraska, & justus, 2020) and for its eye tracking effects of the visual-textual-lexical page layouts (ubbes, coyle, & tzoc, 2018). each online composition includes ten sequential positive-frame photographs with declarative sentences as captions that promote oral health behaviors of children. each frame requires the user to scroll over or touch a sound icon with a cursor in order to activate and hear an audio narration of the message on each page. for the purposes of this research, chapters 14 and 15 were employed and selected by the child by their gendered preferences. if the child preferred to read and hear the narration of a highly visual account of a child’s life through the actions of a boy’s oral health routine, chapter 14 was chosen. if the child preferred to read and hear the narration of a highly visual account of a girl’s oral health routine, chapter 15 was chosen. the declarative sentences focused on setting goals for going to the dentist and were aligned to three salient beliefs from the integrative theory of behavioral prediction (fishbein & yzer, 2003; yzer, 2012). specifically, the second and last pages of the chapter focused on self-efficacy belief statements and the middle of the narrative contained three pages each of health outcome beliefs and (social) normative beliefs. peirce (1992) defined beliefs as “rules for action”. pajares (1996, p. 566) suggested “as such, beliefs become the internal rules individuals follow as they determine the effort, persistence, and perseverance required to achieve optimally”. 2.4 instrument and measures 2.4.1 parent-related data survey questions for parental oral health included how often parents brushed their teeth in a week, how often parents flossed their teeth in a week and the number of cavities in their lifetime. survey questions for parent reading behaviors included visits to a library in the past year, visits to an online bookstore in the past year, self-rated reading ability, and how often parents read books for fun. survey questions pertaining to parent perceptions of the online curriculum included how parents felt about the storyline words of the curriculum, how parents felt about the storyline pictures of the curriculum, and if the curriculum was written at an appropriate reading level for their child. 2.4.2 child-related data survey questions for child oral health included how often the children brushed their teeth in the morning and at night, if the children flossed their teeth, and how many cavities the children have had in their lifetime. survey questions pertaining to child reading behaviors included how often children read books www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 31 published by scholink inc. for fun, if children like to read books on the internet, children’s self-rated ability to read, children’s visits to a library in the past year, and if children like going to the library. survey questions pertaining to children’s perceptions of the online curriculum included how children felt about the storyline words of the curriculum, how children felt about the storyline pictures of the curriculum, and if the curriculum was written at an appropriate reading level for them. 2.4.3 recoding for binary indicators most of the survey questions included multiple answer options on a likert scale. as such, the answers were re-coded into binary indicators in order to perform chi square analyses. for example, parents were asked “how often did you floss your teeth over the past 7 days?” the answer options included once a day, every second day, once a week, and not at all. these answer options were re-coded into binary indicators so that the answer “once a day” was re-coded as a “1” indicating that the oral health goal was met, and the rest of the answers were re-coded as a “0” indicating that the oral health goal was not met. a similar method was employed for questions concerning teeth brushing of parents and children. oral health goals were met if participants brushed their teeth twice a day and flossed once a day. data for the reading behaviors of parents and children were calculated similarly. a “good” reading goal was met for the parent if the parent visited the library in the past year, visited an online bookstore in the past year, and enjoyed reading. a “good” reading goal was met for the child if the child visited a library in the past year, liked going to the library, and enjoyed reading. if one or more of the subcategories were not met, then the score for “good” reading behaviors was “0”. data were excluded whenever responses were listed as “not sure” which occurred occasionally for questions about visiting the library or an online bookstore. 2.5 data analysis chi square tests were calculated to evaluate the statistical significance of relationships between the categorical variables (mchugh, 2013). p-values greater than an alpha of 0.05 meant that the variables were independent from each other. a contingency coefficient was also used to measure the association between variables. the closer to 1 the contingency coefficient was, the stronger the relationship between the two variables. data analyses were completed in spss 25.0 (spss, inc., chicago, il). 3. results results are organized by our four research questions. the first research question asked if there was a relationship between the oral health behaviors of parents and the oral health behaviors of their children. the second research question analyzed the relationship between the reading behaviors of parents and the reading behaviors of their children. the third research question analyzed the relationship between the reading attitudes of parents and the reading attitudes of their children. the fourth research question investigated the relationship between parents’ liking of the ebook for oral health literacy© chapter and their children’s liking of the chapter. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 32 published by scholink inc. our independent variables were parent oral health behaviors, parent reading behaviors, parent reading attitudes, and parent perception of the ebook chapter. our dependent variables were child oral health behaviors, child reading behaviors, child reading attitudes, and child perception of the ebook chapter. 3.1 research question 1: are parents’ oral health behaviors related to their children’s oral health behaviors? the first research question examined the relationship between the oral health behaviors of parents with the oral health behaviors of their children. self-reported frequency of teeth brushing and flossing, as well as the number of cavities that parents and children have had in their lifetime, were used to evaluate oral health behaviors. in addition, self-reported frequency of confidence (self-efficacy) in teeth brushing was included. table 1. oral health behaviors of parents and children (n = 301) parent meeting daily oral health guideline no yes total children meeting daily oral health guideline no 130 61 191 yes 28 (17.7%) 82 (57.3%) 110 total 158 (52.5%) 143 (47.5%) 301 table 1 shows that there was a significant relationship between the oral health behaviors of parents and the oral health behaviors of their children (χ2 = 49.12, df = 1, p < 0.001). a large percentage of children (57.3%, n = 82) had positive oral health behaviors when their parents had positive oral health behaviors (47.5%, n = 143). positive oral health behaviors were defined as brushing teeth twice a day and flossing teeth once a day (american dental association, 2021). however, only 17.7% (n = 28) of children had positive oral health behaviors when their parents did not practice positive oral health behaviors (52.5%, n = 158). www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 33 published by scholink inc. table 2. parent teeth brushing behaviors and children oral health behaviors (n = 301) parent positive teeth brushing habit no yes total children positive oral health habit no 31 160 191 yes 6 (16.2%) 104 (39.4%) 110 total 37 (12.3%) 264 (87.7%) 301 table 2 shows that there was a significant relationship between the teeth brushing behaviors of parents and the overall oral health behaviors of children (χ2 = 6.55, df = 1, p < 0.05). children had significantly better oral health behaviors, as defined as brushing teeth twice a day and flossing teeth once a day, when their parents practiced positive teeth brushing behaviors, which was defined as brushing teeth twice a day, regardless of parental flossing behaviors. therefore, oral health behaviors were defined slightly differently between the children and their parents. when surveyed, 39.4% of children (n = 104) reported positive oral health behaviors when their parents practiced positive teeth brushing behaviors (87.7%, n = 264). however, only 16.2% of children (n = 6) had positive oral health behaviors when their parents did not have positive teeth brushing behaviors (12.2%, n = 37). table 3. parent flossing behaviors and children oral health behaviors (n = 301) parent positive flossing habit no yes total children positive oral health habit no 124 67 191 yes 27 (17.9%) 83 (55.3%) 110 total 151 (50.2%) 150 (49.8%) 301 flossing teeth is considered a positive oral health habit when completed once a day. table 3 indicates that there was a significant relationship between the flossing habits of parents and the oral health behaviors of their children (χ² = 43.92, df =1, p < 0.001). when surveyed, 55.3% of children (n = 83) reported good oral health habits when their parents practiced good flossing habits (49.8%, n = 150). however, only www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 34 published by scholink inc. 17.9% of children (n = 27) had positive oral health habits when their parents did not have positive flossing habits (50.2%, n = 151). table 4. flossing behaviors of parents and children (n = 301) parent flossing behaviors every second day not at all once a day once a week total child flossing behaviors never 8 20 10 7 45 sometimes 36 19 43 24 122 by myself 15 2 (04.9%) 77 (51.7%) 9 103 with help 8 0 19 4 31 total 67 41 (13.6%) 149 (49.5%) 44 301 table 4 shows that there was a significant relationship between the flossing behaviors of parents and their children (χ2 = 83.042, df =1, p < 0.01). when surveyed, 51.7% of children (n = 77) reported that they flossed their teeth by themselves when their parents flossed once a day (49.5%, n = 149). however, only 4.9% of children (n = 2) reported that they flossed their teeth by themselves when their parents did not floss their teeth at all (13.6%, n = 41). the contingency coefficient (0.465) showed a moderate relationship between the two variables. table 5. cavity numbers of parents and children (n = 301) parent cavity count 0 1 2 3 4 total child cavity count 0 57 (69.5%) 16 32 18 43 (46.7%) 166 1 10 11 16 12 16 65 2 10 5 7 3 15 40 3 4 1 1 0 12 18 4 1 1 2 2 6 12 total 82 (27.2%) 34 58 35 92 (30.6%) 301 www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 35 published by scholink inc. table 5 shows that there was a significant relationship between the number of cavities parents have had in their lifetime and the number of cavities their children have had (χ2 = 31.321, df = 1, p < 0.05). when surveyed, 69.5% of children (n = 57) reported that they had 0 cavities in their lifetime when their parents also reported 0 cavities in their lifetime (27.2%, n = 82). however, only 46.7% of children (n = 43) reported that they had 0 cavities in their lifetime when their parents had 4 cavities in their lifetime (30.6%, n = 92). the contingency coefficient (0.307) showed a moderate relationship between the two variables. table 6. confidence in teeth brushing of parents and children (n = 301) parent confidence in teeth brushing confident not confident not sure strongly confident strongly not confident total child confidence in teeth brushing not confident at all 1 3 0 1 2 7 not very confident 9 4 7 9 0 29 somewhat confident 40 2 7 31 1 81 very confident 43 (46.2%) 5 6 129 1 (25.0%) 184 total 93 (30.9%) 14 20 170 4 (01.3%) 301 table 6 shows that there was a significant relationship between the confidence of parents in teeth brushing and the confidence of their children in teeth brushing (χ2 = 116.600, df = 1, p < 0.01). when surveyed, 46.2% of children (n = 43) reported that they were very confident that they could brush their teeth twice a day when their parents also reported that they were confident that they could brush their teeth twice a day (30.9%, n = 93). however, only 25.0% of children (n = 1) reported that they were very confident that they could brush their teeth twice a day when their parents were strongly not confident that they could brush their teeth twice a day (1.3%, n = 4). the contingency coefficient (0.528) showed a moderately strong relationship between these two variables. 3.2 research question 2: is there a relationship between parents’ reading behaviors and their children’s reading behaviors? www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 36 published by scholink inc. the second research question investigated the relationship between the reading behaviors of parents and their children. self-reported frequency of positive reading habits, visiting a library, and visiting an online bookstore were used to evaluate the reading behaviors of parents and children. table 7. reading behaviors of parents and children (n = 301) parent positive reading habit no yes total children positive reading habit no 50 31 81 yes 88 (63.8%) 132 (81.0%) 220 total 138 (45.8%) 163 (54.2%) 301 table 7 shows that there was a significant relationship between the reading behaviors of parents and their children (χ2 = 10.4, df = 1, p < 0.01). a large percentage of children (81.0%, n = 132) had positive reading behaviors when their parents also practiced positive reading behaviors (54.2%, n = 163). positive reading behaviors for children were defined as visiting a library in the past year, liking the library, and enjoyment of reading. positive reading behaviors for parents were defined as visiting a library in the past year, visiting an online bookstore in the past year, and enjoyment of reading. only 63.8% of children (n = 88) had positive reading behaviors when their parents did not practice positive reading behaviors (45.8%, n = 138). table 8. visiting the library in parents and children (n = 301) parents visiting library no yes total children visiting library no 27 3 30 yes 33 (55.0%) 238 (98.8%) 271 total 60 (19.9%) 241 (80.1 %) 301 table 8 shows that there was a significant relationship between if parents visited a library in the past year and if their children visited a library in the past year (χ2 = 97.677, df = 1, p < 0.001). a large percentage of children (98.8%, n = 238) visited the library in the past year when their parents also visited the library in the past year (80.1%, n = 241). however, only 55.0% of children (n = 33) visited the library in the past year when their parents had not visited a library in the past year (19.9%, n = 60). www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 37 published by scholink inc. table 9. parents visiting an online bookstore and whether children enjoyed reading books online (n = 301) parents online bookstore visit no yes total children enjoyment of online book reading no 52 66 118 yes 49 (48.5%) 134 (67.0%) 183 total 101 (33.6%) 200 (66.4%) 301 table 9 indicates that there was a significant relationship between if parents visited an online bookstore in the past year and whether their children liked to read books on the internet (χ2 = 8.8613, df = 1, p < 0.01). a large percentage of children (67.0%, n = 134) enjoyed reading a book online when their parents had visited an online bookstore in the past year (66.4%, n = 200). however, only 48.5% of children (n = 49) liked to read books online when their parents had not visited an online bookstore in the past year (33.6%, n = 101). 3.3 research question 3: is there a relationship between parents’ reading attitudes and their children’s reading attitudes? the third research question investigated the relationship between the reading attitudes of parents and their children. self-reported frequency of reading enjoyment (love of reading) and reading motivations (reading for fun) by parents and children were used to evaluate the reading attitudes of participants. table 10. reading attitudes of parents and children (n = 301) parents love of reading no yes total children love of reading no 12 50 62 yes 15 (55.6%) 224 (81.8%) 249 total 27 (09.0%) 274 (91.0%) 301 table 10 indicates that there was a significant relationship between parents’ attitudes toward the love of reading and their children’s attitudes toward the love of reading (χ2 = 8.773, df = 1, p < 0.01). when surveyed, 81.8% of children (n = 224) reported that they loved to read given that their parent loved to www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 38 published by scholink inc. read (91.0%, n = 274). however, only 55.6% of children (n = 15) indicated that they love to read when their parents did not love to read (9.0%, n = 27). table 11. reading motivations of parents and children (n = 301) how often parents read books for fun never often rarely sometimes usually total how often children read books for fun always 1 (14.3%) 28 12 21 32 (42.7%) 94 never 1 1 2 0 1 5 often 0 34 6 20 13 73 rarely 1 3 4 8 6 22 sometimes 4 20 18 42 23 107 total 7 (02.3%) 86 42 91 75 (24.9%) 301 table 11 shows that there was a significant relationship between if parents’ motivation to read was for fun, and if children’s motivation to read was for fun (χ2 = 41.451, df = 1, p < 0.01). when surveyed, 42.7% of children (n = 32) reported that they always read books for fun given that their parents usually read books for fun (24.9%, n = 75). however, only 14.3% of children (n = 1) indicated that they always read books for fun when their parents never read books for fun (2.3%, n = 7). the contingency coefficient (0.348) showed that there was a moderate relationship between the two variables. 3.4 research question 4: is there a relationship between parents’ liking of the oral health curriculum and their children’s liking of the oral health curriculum? the fourth research question investigated the relationship between the parents’ liking of one chapter of the ebook for oral health literacy© and their children’s liking of the chapter. the parents’ and children’s liking of the storyline words and pictures, as well as their perceptions of the story’s reading level, were used to evaluate participants’ liking of the curriculum. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 39 published by scholink inc. table 12. parents and children liking of the oral health storyline-words (n = 301) did parents like the storyline words? maybe no yes total did children like the storyline words? maybe 7 10 37 54 no 11 24 17 52 yes 4 3 (08.1%) 188 (77.7%) 195 total 22 37 (12.3%) 242 (80.4%) 301 based on table 12, there was a significant relationship between the proportion of parents and children who liked the storyline words of the curriculum (χ2 = 113.813, df = 1, p < 0.01). when surveyed, 77.7% of children (n = 188) reported that they liked the storyline words of the curriculum given that their parents liked the storyline words (80.4%, n = 242). however, only 8.1% of children (n = 3) indicated that they liked the storyline words of the curriculum when their parents did not like the storyline words (12.3%, n = 37). the contingency coefficient (0.524) showed that there was a moderately strong relationship between parents’ perception of the storyline words and their children’s perception of storyline words. table 13. parents and children liking of oral health storyline-pictures (n = 301) did parents like the storyline pictures? maybe no yes total did children like the storyline pictures? maybe 3 6 24 33 no 9 19 15 43 yes 10 12 (32.4%) 203 (83.9%) 225 total 22 37 (12.3%) 242 (80.4%) 301 table 13 shows that there was a significant relationship between parents’ perception of the storyline pictures and children’s perception of the pictures (χ2 = 72.985, df = 1, p < 0.01). when surveyed, 83.9% www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 40 published by scholink inc. of children (n = 203) reported that they liked the storyline pictures of the curriculum given that their parents liked the storyline pictures (80.4%, n = 242). however, only 32.4% of children (n = 12) indicated that they liked the storyline pictures of the curriculum when their parents did not like the storyline pictures (12.3%, n = 37). the contingency coefficient (0.442) showed that there was a moderate relationship between parents’ perception of the curriculum pictures and children’s perception of the pictures. table 14. parents and children perceptions of story reading level (n = 301) parents’ perception just right for my child too easy for my child too hard for my child total children’s perceptions just right 140 (88.1%) 11 (08.2%) 2 (25.0%) 153 too easy 13 123 0 136 too hard 6 0 6 12 total 159 (52.8%) 134 (44.5%) 8 (02.7%) 301 as shown in table 14, there was a significant relationship between parents’ perception of the story reading level, and children’s perception of the story reading level (χ2 = 315.060, df =1, p < 0.01). when surveyed, 88.1% of children (n = 140) reported that they thought the story reading level was just right given that their parents thought that the story reading level was just right for their child (52.8%, n = 159). however, only 8.2% of children (n = 11) indicated that the story reading level was just right when their parents thought that the story reading level was too easy for their child (44.5%, n = 134), and 25.0% of children (n = 2) reported that the story reading level was just right given that their parents thought the story reading level was too hard for their child (2.7%, n = 8). the contingency coefficient (0.715) showed that there was a strong relationship between parents’ and children’s perception of the story reading level. 4. discussion given the importance of the family as a social determinant of health (maynard & harding, 2010), our findings point to the significant role of parents in offering their children opportunities for going to the dentist, going to a library, and reading health literacy materials. to date, there has been little emphasis on family oral health education (tseng, pleasants, ivey, sokal-gutierrez, kumar, hoeft, horowitz, ramos-gomez, sodhi, liu, & neuhauser, 2021). however, healthy people 2030 now provides new definitions for personal health literacy and organizational health literacy as recognition for the importance of multilevel interventions in public health at home, in the community, and at school. in the current project, personal health literacy of the parents and the children included their ability to www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 41 published by scholink inc. understand goal setting for going to the dentist who could “...inform health-related decisions and actions for themselves and others” (brach & harris, 2021, p. 1084). the dental clinic is a health organization where literacy-rich environments can be implemented to improve oral health literacy of the parent-child dyads. to build organizational health literacy, the dental clinic needs to “equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others'' (brach & harris, 2021, p. 1084). the current oral health literacy intervention called the ebook for oral health literacy© could be one way for dental clinics to incorporate decision making skills by providing oral health reading materials for their pediatric and adult patients. family-based clinics can also help to boost both individual and institutional health literacy, and in this context, oral health literacy. there is also a vital need to promote oral health literacy in schools on an organizational level. unless children are in multiple places where they see and talk with dentists in community clinics or in one of the 2500 school-based health clinics in the united states, there may be continued slow progress in developing the oral health behaviors of children if only left to parent messaging and role modeling at home. multiple studies have found that “low health-related reading and numeracy (i.e., functional health literacy) has been associated with poor health outcomes including less use of preventative services, higher rates of hospitalization, and poor overall health status” (lim, beauchamp, dodson, o’hara, mcphee, fulton, wildey, & osborne, 2017; berkman, sheridan, donahue, halpern, & crotty, 2011). therefore, newer interventions that focus on oral health literacy should include ways for parents and children to learn together and to learn from each other. the current study specifically focused on a skill-based approach to oral health literacy. the curriculum intervention emphasized goal setting as a cognitive-behavioral skill while employing reading and listening skills to boost oral health literacy. the short one-minute chapter that the parents and children read together included ten cues for setting a goal for going to the dentist and for improving oral health hygiene. goal-setting and shortand long-term planning are the most effective strategies for producing behavior changes (michie, abraham, whittington, mcateer, & gupta, 2009; lim, beauchamp, dodson, o’hara, mcphee, fulton, et al., 2017) and are key cognitive skills for effective health education curricula (cdc, 2021a). the ebook for oral health literacy© chapter that was read by the parent-child dyads in this study focused on goal setting, which is one of the eight national health education standards that students should know and be able to do for school health education because the cognitive skill of goal setting increases the adoption of healthy behaviors (cdc, 2021b). as such, “goal-setting skills are essential to help students identify, adopt, and maintain healthy behaviors” (cdc, 2021b). the visual-textual story called “setting goals for going to the dentist” included three main sections. the first and last slides were composed as “self-efficacy belief” statements and included: “i believe that i can be ready to go to the dentist for a check-up on my mouth, teeth, and gums”, and “i believe that i can have a good check-up at my dentist, so i can have healthy teeth and gums”. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 42 published by scholink inc. the second section of three slides included “health outcome belief” statements which explained why the behavior was important for health: “i set a goal to get a toothbrush from my dentist when i need one, so i can brush my teeth”, “i set a goal to brush my teeth every night with my mom, so i have a fresh breath and clean teeth”, and “i set a goal to visit my dentist 2 times a year, so i know i do not have any holes in my teeth (cavities)”. the last section of three slides included “normative belief” statements which emphasized social interactions with a dentist and peers: “i set a goal to open my mouth wide, so my dentist can see and count my 20 teeth”, “i set a goal with my friends to learn the right way to brush on the front and back of each tooth”, and “i set a goal to show my dentist my bright smile during my 6 month check-up”. by scripting a photographic narrative with different situations and scenarios for practicing oral health behaviors, children and their parents were guided by a gain-frame message design that emphasized the benefits of self-care while reading the story together. the international literacy association (2019) suggests that reading together around a blended use of digital and nondigital resources have the potential to increase oral language skills between parents and children. parent-child reading routines on a daily basis have been documented to enhance emergent literacy skills as promoted by the national program called reach out and read, endorsed by the american academy of pediatrics (diener, hobson-rohrer, & byington, 2012). parents who participated in the reach out and read program, which encourages reading books aloud to children every day, were more likely to report that reading was a favorite activity. furthermore, children participating in the shared book reading program with their parents show higher receptive and expressive vocabulary scores than children not participating in the pediatric program (high, lagasse, becker, ahlgren, & gardner, 2000; theriot, franco, sisson, metcalf, kennedy, & bada, 2003; sharif, rieber, & ozuah, 2002). multiple studies have found that families with more exposure to the reach out and read program showed larger effects in developing literacy skills (weitzman, roy, wallis, & tomlin, 2004; theriot, franco, sisson, metcalf, kennedy, & bada, 2003). positive oral health behaviors are linked to good overall health (usdhhs, 2000b), but a lack of positive oral health behaviors and dental checkups have been linked to heart disease (takahashi, davey, yumoto, gibson, & genco, 2006) and cancer (st. john, li, zhou, denny, ho, montemagno et al., 2004). zullig, ubbes & mann (2013) showed that higher reading abilities of middle school youth were linked to the practice of preventative health behaviors, such as frequent dental checkups. the importance of modeling by parents who show positive attitudes and proactive behaviors toward oral health hygiene (takahashi, davey, yumoto, gibson, & genco, 2006), including children who reported seeing their parents reading in the last two days (zullig, ubbes, & mann, 2013), will be able to influence the overall health of children. social cognitive theory (bandura, 1991 & 1999) is influential in describing human agency which supports individuals to self-regulate their actions by planning, making decisions about their behavior, and reflecting on their thinking and actions. reciprocal determinism (bandura, 1999) is the major principle that helps parent-child dyads to negotiate personal health literacy factors, oral health and reading www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 43 published by scholink inc. behaviors, and home environments. children who observed role modeling by their parents for teeth brushing and flossing may construct and come to understand the importance of oral health hygiene especially when observing these personal behaviors at home in a social context. children can also select the environments where they may brush and floss their teeth or not, depending on whether they are encouraged to do so when visiting grandparents, neighbors, and best friends' houses with different situational cues for oral hygiene behaviors. in the reciprocal interplay between personal factors, behavioral factors, and environmental factors, children need patterned influences to establish daily behaviors (bandura, 1978). genetics and environmental factors interact to influence individual health patterns, especially among mothers with poor self-rated oral health whose children are more likely to grow up with poorer oral health (shearer, thomson, broadbent, & poulton, 2011). the higher the number of a mother’s decayed, missing, or filled permanent teeth (dmft score), the higher the children’s dmft score was for their permanent teeth (lee, kim, lee, & kim, 2019). although dmft tends to increase with the age of the child (singleton, day, thomas, schroth, klejka, lenaker, & berner, 2019), parents also need to be educated on the role that cavities play beyond the consequences of decayed teeth of their children, which may include reduced nutritional deficiencies and unhealthy body weights (lee & vann, 2012). in the current study, parent-child dyads read an ebook that focused on setting goals. bandura (1999, 2001) stated that “goals, rooted in a value system and a sense of personal identity…give meaning and purpose” (p. 8) and “…serve as powerful motivators of action” (bandura, 1991). health educators need to consider the differences between children and their parents when they set goals to go to the dentist for a six-month checkup. children usually go to pediatric dental checkups in a community clinic or a school-based health clinic whereas adults usually go to a community dental clinics that cater to their age group. unfortunately from the standpoint of social modeling, children may not see their parents go to a dentist. also parents need to schedule dental appointments for their children or the child will not go to the dentist. the current online study asked written questions of the parent-child dyads before and after the oral health literacy intervention, which were embedded into a qualtrics panel study (facilitated for a fee by qualtrics). this maximized the ability of parents and their children to be in one location to discuss the oral health story and the social actions of the children regarding their oral health goals. more considerations must be made on how to evaluate oral health literacy of parent-child dyads and give them opportunities for sharing dental health checkups in virtual and real-time situations. efficacy beliefs are the foundation of human agency (bandura, 1999, 2001) and influence whether people are able to think optimistically or pessimistically to enhance their wellbeing (bandura, 1999, 2001). in the current study, table 6 showed that parental beliefs in their ability to brush and floss their teeth were significantly associated with their children’s ability to perform similar oral health behaviors. with regard to reading behaviors, table 7 showed that when a large percentage of children (81%, n = 132) had positive reading behaviors, their parents also practiced positive reading behaviors. these results were significant (χ2 = 10.4, p < 0.01). www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 44 published by scholink inc. positive reading behaviors for children were defined as visiting a library in the past year, liking the library, and enjoyment of reading, when their parents also practiced positive reading behaviors. positive reading behaviors for parents were defined as visiting a library in the past year, visiting an online bookstore in the past year, and enjoyment of reading. only 63.8% of children (n = 88) had positive reading behaviors when their parents did not practice positive reading behaviors. this may speak to the fact that children do have positive influences when they have access to school libraries and public libraries (garces-bacsal & yeo, 2017) regardless of what reading is observed by parents at home. however, the american academy of arts & sciences (2017) has reported a rather bleak picture with regard to the reading behaviors of adolescents and younger adults so a shift may be occurring. americans between the ages of 15 to 44 years spend approximately 10 minutes per day reading for personal interest, but they spend almost 3 hours watching television and 28 minutes playing games and using computers for leisure. garces-bacsal and yeo (2017, p. 248) urge children “to read for pleasure and to identify themselves as readers”, because reading helps provide an avenue for “self-construction and self-identification” (howard, 2011). our study alludes to the enjoyment of reading and going to libraries and bookstores as positive prosocial literacy behaviors. table 8 indicated that there was a significant relationship (χ2 = 97.677, p < 0.001) between parents and children who visited a library in the past year with a large percentage of children (98.7%, n = 238) reporting a visit to a library when their parents also visited the library in the past year. a large percentage of children in the current study (67%, n = 134) enjoyed reading a book online when their parents had visited an online bookstore in the past year (χ2 = 8.8613, p < 0.01), and there was a moderate but significant relationship between parents’ and children’s motivations to read for fun (χ2 = 41.451, p < 0.01). geurtsen (2008) found that children who visited a library reported more leisure time reading than a control group of students, and they also held a more positive attitude toward books. like the ebook for oral health literacy©, there remains a need for skill-based curriculum materials to bridge the gap between the role of health literacy in educating children and their parents about a variety of health behaviors, especially oral health hygiene. more reading materials are needed that show pro-social norms among family and friends to help build an emphasis influencing children to read for pleasure while learning about reasoned actions for doing healthy habits. ubbes, dillhoff, and maldonado (2018) found that reading attitudes toward recreational (leisure) reading differed among children with girls showing higher reading attitudes toward academic and recreational reading than boys. cunningham (2008) has argued that reading attitudes are investigated less in comparison to reading comprehension and that reading attitudes are important for two reasons: 1) attitude influences the engagement and patience needed when reading complexity increases, and 2) poor attitudes of a fluent reader may cause the child to choose other activities over reading. in the current study, the reading attitudes of parents had a significant positive effect on the reading attitudes of their children, owing to the important contribution that role modeling has on the culture of reading in a home environment. kleijnen, huysmans, ligtvoet, and elbers (2017) advocated for children needing access to a reading culture at home, because that culture is an www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 45 published by scholink inc. important predictor of reading attitudes and reading behavior. by reading for fun, children can gain a sense of pleasure along with cultural and practical knowledge (cunningham & stanovich, 1998) and new perspectives and solutions about daily life experiences (kortliever & lemmens, 2012). this is one of the first studies to conduct an online assessment of parents and children reading a story together in real time while also answering questions before and after a story intervention about oral health hygiene and the importance of a dental checkup. this study demonstrated that there is a significant relationship between parent-child attitudes and motivations surrounding reading. for example, table 14 showed that there was a strong significant relationship between parents’ perception of the reading level needed for the oral health story, and their children’s perception of the reading level as being just right, too hard, or too easy (χ2 = 315.060, p < 0.01). table 13 showed that there was also a significant moderate relationship between parents’ perception of the curriculum pictures and children’s perception of the pictures (χ2 = 72.985, p < 0.01); this relationship speaks to the value of offering visual-textual reading materials to promote oral health literacy, especially photographs where children are demonstrating action. table 13 shows that with the current curriculum intervention, children were also getting auditory cues because the stories were read to them and they were able to use the mouse to advance the pages of the chapter for tactile and kinesthetic effects. curricula that helps to develop functional health literacy should continue to use multisensory and multimodal cues for action (ubbes, coyle, & tzoc, 2018), while building a rich vocabulary of words and promoting the synergistic effects of oral language, written language, and body language. this may be especially helpful for children who are actively building cognitive-behavioral skills (e.g., goal setting, decision making, communication) with literacy skills (e.g., reading, writing, and speaking) across multiple health topics. bus, leseman, and keultjes (2000, p. 71) explained parental influence on the reading attitudes and motivations of their children by reporting that “when parents do not have important personal needs served by reading, they are less inclined to initiate conversations that may make texts enjoyable and comprehensible for young, inexperienced readers.” this shows that quality parent interaction with children is important in shaping children’s attitudes around reading, and the need for including health-related stories that build health literacy. parents can provide quality interactions by asking questions and making comments about the text and pictures, helping the child to understand the story, and relating the story to their own life (bus, leseman, & keultjes, 2000). interactions during shared reading are important because “poor readers tire easily, take words literally, read slowly, miss meaning, skip over words, and miss the context” (jamison, 2001, p. 333), which could apply to both adult readers and young readers alike. the health literacy materials used in the current study included the use of audio narration that supported the parent-child dyads in hearing and thinking about the oral health story to improve their understanding (comprehension) of going to the dentist for a checkup. parents also served as co-readers of the survey questions for their child before and after reading the story together with the hopes that comprehension would be enhanced. www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 46 published by scholink inc. 5. strengths one strength of this study was the large sample size of 316 parent-child dyads which were surveyed online and given access to the curriculum intervention through a qualtrics panel (see qualtrics.com). parent-child dyads were from 43 states in the united states, providing a geographically representative sample of parents and their children across the country. the second strength of this study was that the oral health story afforded the parent-child dyads a chance to view a realistic oral health environment as depicted in ten color photographs rather than simply reading ten declarative sentences without oral health pictures. the narrative composition included visual, textual, lexical, and gestural communication patterns for each of the ten pages, affording the parent-child dyads an authentic, multimodal experience for thinking about their own oral health behaviors as they read and listened to the story together. from a design perspective, the electronic story accessed from a digital platform represented a new genre of children’s literature that combined narrative storytelling with an informational expository text about the importance of oral health hygiene and a dental checkup. the third strength of the study was that the oral health literacy intervention helped children to build their self-efficacy beliefs, health outcome beliefs, and social norm beliefs for going to a dentist for a checkup. dental checkups have the potential to improve oral health hygiene, boost overall health, prevent chronic disease, and reduce dental caries. individuals with a high number of dental caries have been associated with a lower level of oral health literacy (lee, divaris, baker, rozier, & vann, 2012). in the current study, there was a significant relationship between the number of cavities that parents reported in their lifetime and the number of cavities their children had (table 5). therefore, the parent-child intervention written as a first person narrative to show a photograph of a healthy child believing in their ability to set a goal for going to the dentist for a checkup. as shown below, each sentence used a lexical repetition about goal setting, beginning with the title page: setting goals for going to the dentist “i believe that i can be ready to go to the dentist for a check-up on my mouth, teeth, and gums. i set a goal to get a toothbrush from my dentist when i need one, so i can brush my teeth. i set a goal to brush my teeth every night with my mom, so i have a fresh breath and clean teeth. i set a goal to visit my dentist 2 times a year, so i know i do not have any holes in my teeth (cavities). i set a goal to open my mouth wide, so my dentist can see and count my 20 teeth. i set a goal with my friends to learn the right way to brush on the front and back of each tooth. i set a goal to show my dentist my bright smile during my 6 month check-up. i believe that i can have a good check-up at my dentist, so i can have healthy teeth and gums. how about you? can you set a goal to have a healthy check-up at your dentist too?” since efficacy beliefs are the foundation of human agency (bandura, 1999, 2001), it is important for parents to motivate children to improve their oral health behaviors by brushing, flossing, and going to the dentist regularly and by building reading skills to increase vocabulary knowledge and comprehension about oral health literacy. ultimately, parents play a pivotal role in developing the oral health behaviors www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 47 published by scholink inc. and oral health literacy of their children. the ebook for oral health literacy© was an educational way to prime oral health behaviors and oral health literacy in tandem. future interventions should look at the benefits of using multiple chapters of the curriculum for improving brushing, flossing, rinsing, eating fresh foods and beverages, and other oral health habits while “reading to learn” about oral health literacy. 6. limitations the first limitation of the study is that the oral health literacy questions were not pretested so validity and reliability of the survey instrument cannot be reported. because we wanted to survey both parents and the children on different items, we did not find an instrument suitable to use from the existing oral health literacy tools reported in the literature (dickson-swift, kenny, farmer, gussy, & larkins, 2014), including a dearth of instruments in pediatric dentistry for parent-child dyads (wong, bridges, yiu, mcgrath, au, & parthasarathy, 2013; vann, lee, baker, & divaris, 2010). we sought to assess the perceptions of parent-child dyads on their liking of the ebook intervention and found one instrument for measuring the functional health literacy of parents in dentistry, but not with parent-child dyads (gong, lee, rozier, pahel, richman, & vann, 2007). a second limitation of the study is that a significantly larger proportion of the parents surveyed in the study identified as female. a significant relationship (p<0.001) was found among the oral health behavior of parents and their children (okada, kawamura, kaihara, matsuzaki, kuwahara, ishidori et al., 2002). future research will need to increase the participation of fathers in oral health literacy research, because the influence of female parent figures may differ from the influence that male parents have on their children’s oral health hygiene and their children’s reading behaviors. oral health research has frequently demonstrated the importance of maternal influences on oral health hygiene (shearer, thomson, broadbent, & poulton, 2011; lee, kim, lee, & kim, 2018; adil, eusufzai, kamruddin, ahmad, jamayet, karobari, & alam, 2020). a third limitation of the study is that, while many race ethnicities were represented in the study, minorities made up a smaller proportion of those surveyed. several studies have demonstrated that “parent-child joint book reading is sensitive to the cultural background of the family” (bus, leseman, & keultjes, 2000; diener, hobson-rohrer, & byington, 2012). thus, future research could increase the number of participants from different cultural backgrounds to read and respond to the oral health story books psychographics are a qualitative methodology that studies people based on their preferences, interests, values, lifestyle choices, and goals. more qualitative methodologies are needed in oral health research to ensure that we understand the emotions, attitudes, and beliefs of children and their parents regarding their dental routines, daily oral hygiene, and emotions for going to the dentist. elicitation interviews (erbe, middlestadt, lohrmann, & beckmeyer, 2020) are needed to learn the preferences, beliefs, and attitudes of children in health education. as such, structured and semi-structured interviews regarding children’s oral health practices (e.g., brushing, flossing, rinsing, and going to a dental check-up) www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 48 published by scholink inc. could be used to design even more oral health literacy curricula in the future that are skill-based and inclusive to goal setting, decision making, and communication. a fourth limitation of the study is that parents and children self-reported their number of cavities due to the online nature of the study instead of being assessed with an objective measure by a dental professional called the dmft (decayed, missing, and filled teeth). among the 316 parents who self-reported the number of their cavities they had in a lifetime, the average number of cavities were 3 (sd 1.59) with a low of 0 cavities and a high of 4 or more cavities. results showed that 95 (30%) parents reported four or more fillings; 36 (11%) reported three fillings; 61 (19%) reported two fillings; and 37 (12%) reported one filling. no fillings were reported by 86 parents (27%). research on the oral health literacy of parents in multiple countries has been significantly correlated with the mean dmft score of their children (adil, eusufzai, kamruddin, ahmad, jamayet, karobari, & alam, 2020). the lower the parental oral health literacy, the higher the prevalence of caries in their children. future research could implement the ebook for oral health literacy© in school-based health clinics so that dental professionals can assess the dmft of children as an objective measure and help to identify children in most need of dental, behavioral, and educational interventions. 7. recommendation for future research future recommendations for research include testing student knowledge and attitudes before and after reading several curriculum chapters associated with a theme, e.g., oral health hygiene, oral health and nutrition, oral health and beverages, dental checkups, rather than only one chapter as was done in this study. dentists and health educators may benefit by knowing the cumulative effect of many oral health literacy chapters on children spanned over several weeks. future research could also investigate the work and career niche of parents because literacy patterns play a role in individual health status. jaafar, ab malik, and al-kadhim (2020) showed that individuals in health, science, and technology fields had better oral health literacy than those individuals with careers in the social sciences. the connections between health, oral health, and literacy (e.g., reading and writing) still need further development in health education curricula and public health messaging for children and their parents. parent-child dyads will benefit from more environmental prompts, cues, and reminders about oral health hygiene through additional digital applications, electronic books, printed books, pamphlets, brochures, posters, and billboards so they can read and speak about oral health in a variety of situations and settings the more opportunities to see and hear different people of all ages and backgrounds talk about their smiles, the health of their teeth, and the benefits of going to a dentist, the better the social norms will be to reinforce oral health behaviors of children and their families. to develop skills for oral health literacy, children can learn to write their own picture stories about oral health using a design template modeled after the ebook for oral health literacy©, which is accessible on the digital literacy partnership website (ubbes, 2021). children can also practice their vocabulary words, spelling, and reading www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 49 published by scholink inc. comprehension by downloading the ebook for oral health literacy© workbook found at @https://dlp.lib.miamioh.edu/ebook/workbook/fullcurriculumworkbookubbes&wallacemay2021fin al.pdf associated with each of the 17 stories in order to build their functional health literacy in oral health. future researchers should use the reading comprehension questions in the workbook to determine what children actually recall from reading the chapters and correlate those scores with objective assessments of decayed, missing, or filled teeth (e.g., dmft) by dental professionals in school-based health clinics. 8. conclusion this oral health literacy study investigated the association of reading behaviors and oral health behaviors when children were educated on setting a goal for a dental checkup as outlined by a healthy people 2030 leading health indicator. the study demonstrated that parents had a significant influence on their children’s oral health behaviors (e.g., brushing, flossing) and oral health attitudes. the study also showed that parents had a significant influence on their children’s reading behaviors and attitudes. previous research has indicated that self-reported reading abilities were associated with better oral health (zullig, ubbes, & mann, 2013), linking reading with oral health behaviors. this study reinforced the fact that parents have the ability to build the oral health literacy of their children. reading one story from the ebook for oral health literacy© curriculum had a significant effect on the oral health literacy skills of children, especially how to set goals and make decisions for the development of their personal health literacy. future studies with parent-child dyads should try to quantify the effect of reading additional chapters of the oral health literacy curriculum in order to influence oral health behaviors, attitudes, and motivations especially self-efficacy beliefs. 9. acknowledgements we acknowledge the support of dr. michael hughes and his students, e.g., lindsay tighe, yangfeng shi, wangying yang, phuong ho, abbie klinker, and dani abramovitz, of miami university who assisted in statistical analysis and interpretation of the research results. references abu-rabia, s., & yaari, i. (2012). parents’ attitudes and behavior, the learning environment and their influence on children’s early reading achievement. open journal of modern linguistics, 2(4), 170-179. adil, a. h., eusufzai, s. z., kamruddin, a., ahmad, w., jamayet, n. b., karobari, m. i., & alam, m. k. (2020). assessment of parents' oral health literacy and its association with caries experience of their preschool children. children (basel, switzerland), 7(8), 101. https://doi.org/10.3390/children7080101 www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 50 published by scholink inc. american academy of arts & sciences. (2019). new evidence on waning american reading habits. retrieved from https://www.amacad.org/news/new-evidence-waning-american-reading-habits american dental association. (2021). https://www.mouthhealthy.org/en/oral-health-recommendations, https://www.mouthhealthy.org/en/az-topics/b/brushing-your-teeth, https://www.mouthhealthy.org/en/az-topics/f/flossing bandura, a. (1978). the self-system in reciprocal determinism. american psychologist, 33(4), 344-358. https://doi.org/10.1037/0003-066x.33.4.344 bandura, a. (1991). social cognitive theory of self-regulation. organizational behavior and human decision processes, 50, 248-287. bandura, a. (1999). social cognitive theory: an agentic perspective. asian journal of social psychology 2(1), 21-41. https://doi.org/10.1111/1467-839x.00024 bandura, a. (2001). social cognitive theory: an agentic perspective. annual review of psychology, 52, 1-26. baskaradoss, j. k. (2018). relationship between oral health literacy and oral health status. bmc oral health, 18, 172-177. https://doi.org/10.1186/s12903-018-0640-1 berkman, n. d., sheridan, s. l., donahue, k. e., halpern, d. j., & crotty, k. (2011). low health literacy and health outcomes: an updated systematic review. annals of internal medicine, 155(2), 97-107. https://doi.org/10.7326/0003-4819-155-2-201107190-00005 brach, c., & harris, l. m. (2021). healthy people 2030 health literacy definition tells organizations: make information and services easy to find, understand, and use. journal of general internal medicine, 36(4), 1084-1085. https://doi.org/10.1007/s11606-020-06384-y bus, a. g., leseman, p. p. m., & keultjes, p. (2000). joint book reading across cultures: a comparison of surinamese-dutch, turkish-dutch, and dutch parent-child dyads. journal of literacy and research, 32(1), 53-76. https://doi.org/10.1080/10862960009548064 centers for disease control and prevention. (2021a). characteristics of effective health education curricula. retrieved from https://www.cdc.gov/healthyschools/sher/characteristics/index.htm#:~:text=an%20effective%20c urriculum%20builds%20essential,avoid%20or%20reduce%20risk%20behaviors and centers for disease control and prevention. (2021b). national health education standards. retrieved from https://www.cdc.gov/healthyschools/sher/standards/6.htm cunningham, d. d. (2008). literacy environment quality in preschool and children’s attitudes toward reading and writing. literacy teaching and learning, 12(2), 19-36. cunningham, a. e., & stanovich, k. e. (1998). what reading does for the mind? american educator, 22(½), 8-15. deshpande, s. k. (2016). activating background knowledge: an effective strategy to develop reading comprehension skills. jeltl (journal of english language teaching and linguistics), 1(3), www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 51 published by scholink inc. 191-202. http://dx.doi.org/10.21462/jeltl.v1i3.28 dewalt, d. a. & hink, a. (2009). health literacy and child health outcomes: a systematic review of the literature. pediatrics, 124(3). dickson-swift, v., kenny, a., farmer, j., gussy, m., & larkins, s. (2014). measuring oral health literacy: a scoping review of existing tools. bmc oral health, 14, 148-160. https://doi.org/10.1186/1472-6831-14-148 diener, m. l., hobson-rohrer, w., & byington, c. l. (2012). kindergarten readiness and performance of latino children participating in reach out and read. journal of community medicine and health education, 2(133), 1-7. https://doi.org/10.4172/jcmhe.1000133 erbe, r. g., middlestadt, s. e., lohrmann, d. k., & beckmeyer, j. j. (2020). a salient belief elicitation examining adolescents’ meditation beliefs using the reasoned action approach. health promotion practice, 21(4), 633-641. https://doi.org/10.1177/1524839918811803 firmino, r. t., ferreira, f. m., martins, c. c., granville-garcia, a. f., fraiz, f. c., & paiva, s. m. (2018). is parental oral health literacy a predictor of children’s oral health outcomes? systematic review of the literature. international journal of paediatric dentistry, 28, 459-471. https://doi.org/10.1111/ipd.12378 fishbein, m., & yzer, m. c. (2003). using theory to design effective health behavior interventions. communication theory, 13(2), 164-183. garces-bacsal, r. m. & yeo, s. d. (2017). why and what they read when they don’t have to: factors influencing the recreational reading habits of gifted students in singapore. journal for the education of the gifted, 40(3), 247-265. geurtsen, n. (2008). bibiotheek hoorn. effectevaluatie van de brede school bibliotheek hoorn [library hoorn. effect evaluation of the community school library hoorn]. unpublished master’s thesis, utrecht university, the netherlands. hart, b., & risely, t.r. (2003). the early catastrophe: the 30 million word gap by age 3. american educator, 27(1), 4-9. howard, v. (2011). the importance of pleasure reading in the lives of young teens: self-identification, self-construction, and self-awareness. journal of librarianship and information science, 43, 46-55. high, p. c., lagasse, l., becker, s., ahlgren, i., & gardner, a. (2000). literacy promotion in primary care pediatrics: can we make a difference? pediatrics, 105, 927-934. horowitz, a. m., & kleinman, d. v. (2008). oral health literacy: the new imperative to better oral health, dental clinic of north america, 52(2), 333-344. https://doi.org/10.1016/j.cden.2007.12.001 international literacy association. (2019). digital resources in early childhood literacy development. newark, de: international literacy association. retrieved from https://literacyworldwide.org/docs/default-source/where-we-stand/ila-digital-resources-early-child hood-literacy-development.pdf?_ga=2.251547142.1406342296.1555946221-1719658842.153659 www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 52 published by scholink inc. 1936 jaafar, a., ab malik, n., & al-kadhim, a. h. a. (2020). do undergraduate universiti sains islam malaysia (usim) students with adequate oral health literacy have better oral health status? malaysian journal of science health & technology, 7, special issue, eissn: 2601-0003. https://doi.org/10.33102/mjosht.v7i.102 jamison, j. r. (2001). the health information brochure: a useful tool for chiropractic practice? journal of manipulative and physiological therapeutics, 24(5), 331-334. https://doi.org/10.1067/mmt.2001.115264 johnson, k., davy, l., boyett, t., weathers, l., & roetzheim, r.g. (2001). sun protection practices for children: knowledge, attitudes, and parent behaviors. archives of pediatric adolescent medicine, 155(8), 891-896. https://doi.org/10.1001/archpedi.155.8.891 johnson, p. (1982). effects on reading comprehension of building background knowledge. tesol quarterly, 16(4), 503-516. https://doi.org/10.2307/3586468 kaefer, t. (2020). when did you learn it? how background knowledge impacts attention and comprehension in read aloud activities. reading research quarterly, 55, s173-s183. https://doi.org/10.1002/rrq.344 kleijnen, e., huysmans, f., ligtvoet, r., & elbers, e. (2017). effect of a school library on the reading attitude and reading behaviour in non-western migrant students. journal of librarianship and information science, 49(3), 269-286. kortlever, d. m. j., & lemmens, j. s. (2012). relaties tussen leesgedrag en cito-scores van kinderen [relationships between reading behaviour and cito-scores of children]. tijdschrift voor communicatiewetenschap, 40(1), 87-105. lee, j. y., & van, w. f. (2012). children’s oral health. in j. b. kotch (ed.), maternal and child health: programs, problems, and policy in public health (3rd ed.) (chapter 15, p. 357-370). jones & bartlett publishers. lee, j. y., divaris, k., baker, a. d., rozier, r. g., & vann, r. f. (2012). the relationship of oral health literacy and self-efficacy with oral health status and dental neglect, american journal of public health, 102(5), 923-929. https://doi.org/10.2105/ajph.2011.300291 lee, s. m., kim, h. n., lee, j. h., & kim, j. b. (2019). association between maternal and child oral health and dental caries in korea. journal of public health, 27, 219-227. https://doi.org/10.1007/s10389-018-0936-2 lee, j. y., watt, r. g., williams, d. m., & giannobile, w. v. (2017). a new definition for oral health: implications for clinical practice, policy and research. journal of dental research, 96(2), 125-127. https://doi.org/10.1177/0022034516682718 leong, l. c., hassan, n., isa, f. m., & jalil, h. a. (2018). mobile x-space design, teaching strategies and undergraduate students’ collaborative learning behaviour: a case study in taylor’s university, www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 53 published by scholink inc. malaysia. malaysian journal of learning and instruction, 15(2), 175-205. https://doi.org/10.32890/mjli2018.15.2.7 lim, s., beauchamp, a., dodson, s., o’hara, j., mcphee, c., fulton, a., wildey, c., & osborne, r. h. (2017). health literacy and fruit and vegetable intake in rural australia. public health nutrition, 20(15), 2680-2684. https://doi.org/10.1017/s1368980017001483 maynard, m. j., & harding, s. (2010). perceived parenting and psychological well-being in uk ethnic minority adolescents. child care health development, 36(5), 630-638. https://doi.org/10.1111/j.1365-2214.2010.01115.x mchugh, m. l. (2013). the chi-square test of independence. biochemia medica: biochemia medica, 23(2), 143-149. https://doi.org/10.11613/bm.2013.018 michie, s., abraham, c., whittington, c., mcateer, j., & gupta, s. (2009). effective techniques in healthy eating and physical activity interventions: a meta-regression. health psychology, 28(6), 690-701. https://doi.org/10.1037/a0016136 miller, e., lee, j. y., dewalt, d. a., & vann, w. f. (2010). impact of caregiver literacy on children’s oral health outcomes. pediatrics, 126(1), 107-114. niklas, f., wirth, a., guffler, s., drescher, n., & ehmig, s. c. (2020). the home literacy environment as a mediator between parental attitudes toward shared reading and children’s linguistic competencies. frontiers in psychology, 11, 1628. https://doi.org/10.3389/fpsyg.2020.01628 okada, m., kawamura, m., kaihara, y., matsuzaki, y., kuwahara, s., ishidori, h., & miura, k. (2002). influence of parents’ oral health behaviour on oral health status of their school children: an exploratory study employing a causal modelling technique. international journal of pediatric dentistry, 12(2), 101-108. https://doi.org/10.1046/j.1365-263x.2002.00338.x pajares, f. (1996). self-efficacy beliefs in academic settings. review of educational research, 66, 533-578. peirce, c. s. [1878] (1992). how to make our ideas clear. in n. houser, & c. kloesel (eds.), the essential peirce: selected philosophical writings, 1867-1893 (vol. i, 124-141). bloomington: indiana university press. sharif, i., rieber, s., & ozuah, p. o. (2002). exposure to reach out and read and vocabulary outcomes in inner city preschoolers. journal of the national medical association, 94, 171-177. shearer, d. m., thomson, w. m., broadbent, j. m., & poulton, r. (2011). maternal oral health predicts their children’s caries experience in adulthood. journal of dental research, 90(5), 672-677. https://doi.org/10.1177/0022034510393349 singleton, r., day, g., thomas, t., schroth, r., klejka, j., lenaker, d., & berner, j. (2019). association of maternal vitamin d deficiency with early childhood caries. journal of dental research, 98(5), 549-555. https://doi.org/10.1177/0022034519834518 www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 54 published by scholink inc. st. john, m. a., li, y., zhou, x., denny, p., ho, c. m., montemagno, c.,..., d.t. (2004). interleukin 6 and interleukin 8 as potential biomarkers for oral cavity and oropharyngeal squamous cell carcinoma. archives of otolaryngology--head & neck surgery, 130(8), 929-935. https://doi.org/10.1001/archotol.130.8.929 takahashi, y., davey, m., yumoto, h., gibson, f. c., & genco, c. a. (2006). fimbria-dependent activation of pro-in ammatory molecules in porphyromonas gingivalis infected human aortic endothelial cells. cellular microbiology, 8(5), 738-757. https://doi.org/10.1111/j.1462-5822.2005.00661.x theriot, j. a, franco, s. m., sisson, b. a., metcalf, s. c., kennedy, m. a. & bada, h. s. (2003). the impact of early literacy guidance on language skills of 3-year-olds. clinical pediatrics, 42, 165-172. tseng, w., pleasants, e., ivey, s. l., sokal-gutierrez, k., kumar, j., hoeft, k. s., horowitz, a. m., ramos-gomez, f., sodhi, m., liu, j., & neuhauser, l. (2021). barriers and facilitators to promoting oral health literacy and patient communication among dental providers in california. international journal of environmental research and public health, 18(1), 216-233. https://doi.org/ 10.3390/ijerph18010216 ubbes, v. a., witter, a. m., kraska, c. m., & justus, e. e. (2020). evaluation of an ebook for oral health literacy© to promote child health: readability, suitability, understandability, actionability, and gist-based message design. children and teenagers, 3(1), 54-80. https://doi.org/10.22158/ct.v3n1p54 ubbes, v. a., dillhoff, r., maldonado, w. (2018). reading and writing attitudes of children: conceptual implications for health education and health literacy. journal of health education teaching, 9(1), 49-67. ubbes, v. a., coyle, j., & tzoc, e. (2018). evaluation of an oral health curriculum: design feedback from three audiences. champaign, il: common ground publishing. https://doi.org/10.18848/2156-8960/cgp/v08i04/1-10 ubbes, v. a., black, j. m., & ausherman, j. a. (2009). teaching for understanding in health education: the role of critical and creative thinking skills within constructivism theory. in j. m. black, s. r. furney, h. m. graf, & nolte, a. e. (eds.), philosophical foundations of health education. san francisco, ca: jossey-bass. ubbes, v. a. (2008). educating for health: an inquiry-based approach to prek-8 pedagogy. champaign, il: human kinetics. ubbes, v. a. (2002). picture book database strengthens children's vision of literacy and health. ascd curriculum technology quarterly, 11(3), 3. u.s. department of health and human services. (2020). healthy people 2030. u.s. department of health and human services. office of disease prevention and health promotion. https://health.gov/our-work/healthy-people/healthy-people-2030/health-literacy-healthy-people-20 www.scholink.org/ojs/index.php/ct children and teenagers vol. 4, no. 3, 2021 55 published by scholink inc. 30 https://health.gov/healthypeople/objectives-and-data/social-determinants-health https://health.gov/healthypeople/objectives-and-data/browse-objectives/children/increase-proporti on-children-whose-parents-read-them-least-4-days-week-emc-02 u.s. department of health and human services. (2000a). healthy people 2010: understanding and improving health. u.s. department of health and human services: washington, dc. https://www.healthypeople.gov/2010/document/pdf/uih/2010uih.pdf u.s. department of health and human services. (2000b). oral health in america: a report of the surgeon general. rockville, md: u.s. department of health and human services, national institute of dental and craniofacial research, national institutes of health. u.s. department of health and human services. (2005). the invisible barrier: literacy and its relationship with oral health. a report of a workgroup sponsored by the national institute of dental and craniofacial research, national institute of health, u.s. public health service, u.s. department of health and human services. journal of public health dentistry, 65(3), 174-182. https://doi.org/10.1111/j.1752-7325.2005.tb02808.x vygotsky, l. s. (1978). mind in society: the development of higher psychological processes. cambridge, ma: harvard university press. vygotsky, l. s. (1986). thought and language. cambridge, ma: mit press. weitzman, c. c., roy, l., walls, t., & tomlin, r. (2004). more evidence for reach out and read: a home-based study. pediatrics, 113, 1248-1253. wong, h. m., bridges, s. m., yiu, c. k., mcgrath, c. p., au, t. k., & parthasarathy, d. s. (2013). validation of the hong kong oral health literacy assessment task for paediatric dentistry (hkohlat-p). international journal of paediatric dentistry, 23(5), 366-375. yzer, m. (2012). the integrative model of behavioral prediction as a tool for designing health messages. in h. h. cho (ed.), health communication message design: theory and practice (pp. 21-40). sage publications, inc. zullig, k. j., ubbes, v. a., & mann, m. (2013). early adolescent literacy influences, reading ability, and preventative health behaviors. american journal of health studies, 28(3), 134-141. 