Wednesday, May 30, 2007 A child’s special language, Part II By Zosimo T. Literatus, R.M.T. Breakthroughs
LAST week, we found that parental report on their child’s health and quality of life may not be as accurate as their kid’s own report.
Katharine Whiteborn, in her book How to Survive Children, expressed such a difference: “A food is not necessarily essential just because your child hates it.”
Quality of life, by definition, encompasses non-health related aspects of life, which are not directly amenable to healthcare services and medical products.
The level of such life as observed by the child herself can be a good measure on how ill her or she is.
But how old should a child be before he or she can be relied upon to accurately report symptoms and quality of life, which the pediatrician can use in diagnosis?
In a recent study, James Varni, Christine Limbers and Tasha Burwinkle found an age when a child can self-report reliably.
Varni and Limbers are professors in the Department of Pediatrics and Department of Psychology, respectively, of the Texas A&M University in College Station (Texas, USA). Burwinkle is a physician at The Children’s Hospital at Scott & White in Temple (also in Texas).
The researchers reviewed a sample of child self-report and parent-proxy report on 8,591 children, ages between five and 16 years, recruited from general pediatric clinics, subspecialty clinics, and hospitals of various ailments.
Results, published in the Health and Quality of Life Outcomes (2007), showed that children at age five can reliably and validly self-report when given the chance and to do so in a language appropriate to their age.
Apparently, a parent’s proxy report may be used as a secondary outcome measure for diagnosis but may not be a good substitute for a child’s own words even in clinical trials.
“Parent proxy-report should only be the primary outcome measure,” suggested Varni, “when the child is too young or ill or otherwise unable to self-report.”
In as much as parents wanted to believe that they knew their kids better than the kids knew themselves, children are in a long quest to assert their views of their own lives. This view may be entirely different from what their parents want to believe. US cognitive scientist Steven Pinker wrote in his article How the Mind Works in the Guardian (London): “At all ages children are driven to figure out what it takes to succeed among their peers and to give these strategies precedence over anything their parents foist on them.” (For comments or suggestions, text to 0927-979-3519 or email to zim_breakthroughs@yahoo.com.)
