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A new study finds that a mobile phone intervention, commonly referred to as mHealth, may be as effective as a clinic-based group intervention for people with serious mental illness.

For the study, researchers compared the mHealth approach (FOCUS) to a more traditional clinic-based group intervention, the Wellness Recovery Action Plan (WRAP). The research team, led by Dror Ben-Zeev, Ph.D. from the University of Washington, Seattle, analyzed the differences in treatment engagement, satisfaction, improvement in symptoms, recovery and quality of life.

The research involved 163 participants with long-term, serious mental illness, including schizophrenia, schizoaffective disorder, bipolar disorder and major depressive disorder. Participants were randomly assigned to either the smartphone-based FOCUS group or the clinic-based WRAP group.

The interventions lasted 12 weeks. Assessments were conducted pre-intervention, post-intervention, and at a six-month follow-up.

FOCUS is a smartphone-delivered intervention developed for people with serious mental illness. It has three main components: the FOCUS app, a clinician dashboard, and support from an mHealth specialist.

It includes daily self-assessment prompts and content that can be accessed 24 hours a day as either brief video or audio clips, or a series of written material with images. The patients’ responses to the daily self-assessments are sent to the support specialist, who holds weekly calls with each individual.

WRAP is a widely used group-based, self-management intervention led by trained facilitators with personal experience of mental illness. It emphasizes equipping oneself with personal wellness tools and focusing on recovery concepts, such as hope and self-advocacy.

On random assignment, participants in the mHealth group were more likely to begin mental health treatment (90 percent), compared with WRAP (58 percent). Significantly more FOCUS participants completed eight or more weeks of treatment, but the percentage completing the full 12 weeks was similar for the two groups.

Once the intervention was over, patients in both groups had improved significantly. WRAP participants showed significant improvements in recovery at the end of treatment (three months), and mHealth participants showed significant improvement in recovery and quality of life at six months.

Participants in both groups reported high satisfaction, noting the interventions were enjoyable and interactive and helped them feel better. Age, gender, race, having prior experience with smartphones, and number of previous psychiatric hospitalizations were not tied to recovery outcomes.

The study is the first randomized controlled trial comparing a smartphone intervention to a clinic-based intervention involving individuals with schizophrenia spectrum disorders.

The findings are published in the journal Psychiatric Services.

Source: American Psychiatric Association

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Reading bedtime stories isn’t the only key to success in developing language and literacy at a young age, according to a new study.

Researchers from Michigan State University found that a child’s ability to self-regulate is a critical element in childhood language and literacy development.

They also found that the earlier children can hone these skills, the faster language and literacy skills develop, leading to better skills in the long run.

“Self-regulation is an umbrella term to define children’s abilities to keep information in their working memories, pay attention to tasks, and even to inhibit behaviors that might prevent them from accomplishing tasks,” said Dr. Lori Skibbe, an associate professor in the university’s human development and family studies department and lead author of the study.

Through her research, Skibbe said she found that children who could self-regulate earlier had higher language and learning skills through at least second grade.

“We’ve known that there is a relationship between self-regulation and language and literacy, but our work shows that there is a lasting impact,” she said. “The early advantage of self-regulation means children are learning these critical language and literacy skills earlier and faster, which sets the stage for developing additional skills earlier as well.”

For the study, Skibbe and her research team assessed 351 children twice a year from preschool to second grade on self-regulation and language and literacy.

To assess self-regulation, the children were asked to play a game that required them to follow prompts from the researchers.

“We asked them to touch their heads, shoulders, knees and toes, similar to the childhood ‘Simon Says’ game,” Skibbe explained. “Then, we reversed or mixed the commands to see who could follow based on the instructions they retained.”

To assess academic development, Skibbe looked at four language and literacy skills: comprehension; vocabulary; early decoding, which is the ability to identify letters of the alphabet and read short words; and phonological awareness, or understanding the sound structure of language.

Some children are biologically predisposed to develop self-regulation skills earlier, according to Skibbe.

But there are things parents can do to help their children in the development of these skills, she added.

“By nature, humans are not effective multitaskers and children need time where they focus on only one thing,” she said.

“Parents need to be aware of how their children can regulate their own behavior based on what’s going on around them,” she continued.

“Parents can structure their home environment and routines in ways that support children. A full night of sleep, playing games with children, and having time without distractions in the background are things you might not think help language and literacy development, but they do.”

Source: Michigan State University
 
PHOTO: ‘By nature, humans are not effective multitaskers, and children need time where they focus on only one thing,’ Skibbe said. Credit: Michigan State University.

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A new study finds that African-Americans and Latinos are significantly more likely to experience serious depression than whites.

The study also found that African-Americans and Latinos were more likely to have higher levels of chronic stress and more unhealthy behaviors.

To examine the relationship between unhealthy behaviors, chronic stress, and risk of depression by race and ethnicity, researchers used data collected on 12,272 participants, aged 40 to 70 years, from 2005 to 2012.

The data was part of the National Health and Nutrition Examination Survey (NHANES), a nationally representative health interview and examination survey of U.S. adults. This age range population was selected for this study to capture the effects of chronic stress over the lifetime of the participants, researchers explain.

“Understanding the social and behavioral complexities associated with depression and unhealthy behaviors by race/ethnicity can help us understand how to best improve overall health,” said senior author Dr. Eliseo J. Pérez-Stable, director of the National Institute on Minority Health and Health Disparities (NIMHD). NIMHD is part of the National Institutes of Health.

The relationship between race and depression is complex, and different measures have found varying risk.

The National Institute of Mental Health has found that African-Americans have a lower lifetime risk of depression than whites. But according to a 2010 study by the Centers for Disease Control and Prevention, African-Americans have the highest rate of current depression (nearly 13 percent), followed by Hispanics (11 percent), and whites (8 percent).

The unhealthy behaviors the scientists examined included current cigarette smoking, excessive or binge drinking, insufficient exercise and a fair or poor diet.

The researchers measured chronic stress using 10 objective biological measures, including blood pressure, body mass index, and total cholesterol. The researchers then assessed risk for depression using results from the Patient Health Questionnaire (PHQ-9).

Chronic stress during adulthood may be an important factor in depression, researchers noted.

This effect may be worse among racial and ethnic minorities due to the stress experienced from social and economic inequalities, but the relationships between race/ethnicity, stress, behavior, and depression are not well understood, they add.

According to the researchers, a theoretical framework called the Environmental Affordances model has been proposed to explain how chronic stress and risk behaviors interact to affect health. This model proposes, for example, that engaging in unhealthy behaviors actually reduces the effects of chronic stress on depression in African Americans.

The research team say they designed this study to gain a better understanding of the relationship between chronic stress and the chance for depression by race and ethnicity.

The study asked whether unhealthy behaviors — current smoking, excessive or binge drinking, insufficient exercise, and a fair or poor diet — reduce the chance for depression due to chronic stress in African=Americans, but increase the chance for depression due to chronic stress in Latinos.

On average, Latinos and African Americans had more chronic stress, more unhealthy behaviors, and more chance for depression.

However, the study found that engaging in more unhealthy behaviors was strongly associated with greater chance for depression only in African-Americans and whites.

Contrary to previous research, this study found that in all three racial/ethnic groups, chronic stress levels were inversely related to excessive or binge drinking — for example, more stress, less excess drinking, researchers reported.

This study also found no evidence — as some previous research has suggested — that African-Americans engage in unhealthy behaviors as a way to cope with chronic stress and reduce depression or that unhealthy behaviors interact with chronic stress in Latinos to increase depression.

According to the researchers, the Environmental Affordances model was not supported for any of the racial/ethnic groups analyzed.

The scientists point to differences in their research design and their use of physiological measures of chronic stress instead of self-reported measures as possibly contributing to their different findings.

They add that their results highlight the complex relationships between chronic stress, unhealthy behaviors, and mental health among different racial and ethnic groups.

The study was published in Preventive Medicine.

Source: National Institute on Minority Health and Health Disparities

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Healthy individuals with a family history of alcohol use disorder (AUD) release more dopamine in the brain’s primary reward center in the expectation of alcohol than those who are actually diagnosed with the disorder, or healthy people without any family history of AUD, according to a new study published in the journal Biological Psychiatry: Cognitive Neuroscience and Neuroimaging.

“This exaggerated reward center stimulation by expectation of alcohol may put the [individuals with family history] at greater risk of alcohol use disorder, and could be a risk factor in itself,” said first author Lawrence Kegeles, MD, PhD, of Columbia University.

For the study, the researchers evaluated 15 participants diagnosed with AUD, 34 healthy participants with no family history of AUD, and 16 healthy participants with a family history of the disorder (referred to as the family-history positive, or FHP, group).

The researchers used PET (positron-emission tomography) brain scanning to measure the amount of dopamine released in regions of the brain associated with reward and addiction. The participants received the brain scans after being given either an alcohol drink — a cocktail of vodka, tonic, and cranberry — or a placebo drink without the vodka.

While the participants weren’t told the order in which they would receive the drinks, if they received the placebo drink first they were cued into expecting the alcohol drink next.

All three groups had similar dopamine release-levels in response to the drinks that contained actual alcohol, suggesting that alcohol-induced dopamine release is a normal response in those with AUD.

However, “we found that the FHP participants had a much more pronounced response to the placebo drink than the other groups, indicating that expectation of alcohol caused the FHP group to release more reward center dopamine,” said Kegeles.

Researchers believe that it is the release of dopamine into this primary reward center that reinforces alcohol consumption and possibly contributes to the risk of AUD.

“This research finding exemplifies how advances in imaging brain chemistry using PET scanning can provide new insights into how differences in brain function in people with a family history of alcoholism can explain their own potential for addiction,” said Cameron Carter, MD, and editor of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging.

The current study did not follow the subjects to see whether the increased dopamine response could actually predict development of AUD at a higher rate, so more research will be needed to determine if this abnormality does, in fact, increase risk for alcohol use disorder.

Source: Elsevier

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Depression is associated with accelerated brain aging, according to a new study by psychologists at the University of Sussex in England.

While previous research has shown that individuals with depression or anxiety have a greater risk for dementia in later life, this new study is the first to provide solid evidence for depression’s impact on the decline in overall cognitive function in the general population.

For the study, the researchers conducted a systematic review of 34 longitudinal studies with a focus on the link between depression or anxiety and decline in cognitive function over time.

The research involved 71,000 participants, including people with some symptoms of depression as well as those who were diagnosed as clinically depressed. The researchers investigated the rate of decline in older participants’ overall cognitive state — encompassing memory loss, executive function (such as decision making), and information processing speed.

Participants who had been diagnosed with dementia at the beginning of study were excluded from the analysis. This was done in order to better evaluate the impact of depression on cognitive aging in the general population.

The findings show that depressed participants experienced a greater decline in cognitive state in older adulthood than did non-depressed participants. Since there is a long preclinical period of several decades before dementia may be diagnosed, the findings are important for early interventions.

The study authors are calling for greater awareness of the importance of supporting mental health to protect brain health in later life.

“This study is of great importance — our populations are ageing at a rapid rate and the number of people living with decreasing cognitive abilities and dementia is expected to grow substantially over the next thirty years,” said author Dr. Darya Gaysina, a lecturer in psychology and lab lead at the Environment, Development, Genetics and Epigenetics in Psychology and Psychiatry (EDGE) Lab at the University of Sussex.

“Our findings should give the government even more reason to take mental health issues seriously and to ensure that health provisions are properly resourced. We need to protect the mental wellbeing of our older adults and to provide robust support services to those experiencing depression and anxiety in order to safeguard brain function in later life.”

“Depression is a common mental health problem — each year, at least one in five people in the UK experience symptoms,” said co-author Amber John, who carried out this research for her Ph.D. at the University of Sussex.

“But people living with depression shouldn’t despair — it’s not inevitable that you will see a greater decline in cognitive abilities and taking preventative measures such as exercising, practicing mindfulness, and undertaking recommended therapeutic treatments, such as Cognitive Behaviour Therapy, have all been shown to be helpful in supporting wellbeing, which in turn may help to protect cognitive health in older age.”

The findings are published in the journal Psychological Medicine.

Source: University of Sussex

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Posttraumatic stress disorder (PTSD) caused by traumatic military experiences is associated with feelings of anxiety, anger, sadness and/or guilt. New Penn State research suggests PTSD symptoms can also increase risks for academic difficulties.

In the new study, Dr. Steffany Fredman, assistant professor of human development and family studies explored the process by which PTSD symptoms may contribute to academic problems in student veterans.

“Many of these former service members are experiencing posttraumatic stress symptoms secondary to their military service, and these symptoms are associated with academic difficulties,” Fredman explained.

“There’s an extensive literature demonstrating that PTSD symptoms can cause disruptions in trauma survivors’ close relationships. However, less is known about ways that these relationship problems can, in turn, affect other domains of trauma survivors’ adjustment, such as students’ academic functioning.”

The study is the first to demonstrate the effects of military-related posttraumatic stress on academic adjustment through impairments in veterans’ relationships with family and friends.

The report appears in the journal Psychological Trauma: Theory, Research, Practice, and Policy.

For the study, Fredman and her collaborators examined data from a large, national sample of students seeking mental health services while enrolled in college. The data were collected from college- or university-based counseling centers affiliated with the Center for Collegiate Mental Health (CCMH).

The CCMH, which is housed at Penn State, is a national practice-research network of more than 500 college and university counseling centers that collects standardized data as part of routine clinical care and then pools de-identified data for research and clinical purposes.

Fredman and colleagues looked at a subsample of over 2,000 student service members and veterans, then further divided them into four groups based on relationship status and gender, including both partnered and non-partnered women, and partnered and non-partnered men.

They found that, for all groups, military-related post-traumatic stress was associated with greater family distress and lower support from friends and acquaintances and that these difficulties were, in turn, associated with higher academic dysfunction.

Moreover, the effect of PTSD symptoms on academic dysfunction was strongest for partnered women compared to the other three groups and was due to a greater influence of family problems on partnered women’s academic adjustment.

Fredman and colleagues theorize partnered women’s tendencies to “tend and befriend” when under stress may make them especially susceptible to the negative impacts of relationship problems on other areas of their lives, including academic functioning.

“Partnered women who are already struggling with the effects of post-traumatic stress and its impact on their relationships may be working extra hard to manage those relationships, leaving less time and fewer emotional resources to devote to their studies,” according to Fredman.

Fredman would like to determine which aspects of student veterans’ close relationships are most closely associated with academic success or challenges and to develop and test interventions that simultaneously improve PTSD symptoms, interpersonal relationship adjustment and academic functioning.

“Our ultimate goal is to develop interventions that can be delivered during critical transitional periods, such as the college years, that can serve as a unique window of opportunity to help trauma survivors address these difficulties so that they can fully benefit from their education and lead happier and healthier lives,” said Fredman.

Source: Penn State/EurekAlert

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Scientists have identified a new genetic neurodevelopmental disease that can cause growth delays, seizures and learning problems in humans. Their findings are published in the journal eLife.

The disorder is caused by a recessive mutation in the gene CAMK2A, known for its role in regulating learning and memory in animals. The researchers believe that dysfunctional CAMK2 genes could be contributing to other neurological disorders as well, such as epilepsy and autism. The findings could open up potential new paths for treating these conditions.

“A significant number of children are born with growth delays, neurological defects and intellectual disabilities every year across the world,” said senior author Dr. Bruno Reversade, research director at the Institute of Medical Biology and Institute of Molecular and Cell Biology, A*STAR, Singapore, who supervised the study.

“While specific genetic mutations have been identified for some patients, the cause remains unknown in many cases. Identifying novel mutations would not only advance our understanding of neurological diseases in general, but would also help clinicians diagnose children with similar symptoms and/or carry out genetic testing for expecting parents.”

The research began when the scientists were made aware of a pair of young siblings who exhibited neurodevelopmental delay with frequent, unexplained seizures and convulsions. Although their bodies had developed normally, they had not gained the ability to walk or speak.

“We believed that the children had novel mutations in CAMK2A, and we wanted to see if this were true,” said Reversade.

A healthy, functioning CAMK2A protein consists of several subunits. Using a genomic method known as exome sequencing, the researchers discovered a single coding error influencing a key residue in the CAMK2A gene that prevents its subunits from assembling correctly.

Next, the scientists moved their research to the roundworm Caenorhabditis elegans, and noticed how this particular mutation disrupts the ability of CAMK2A to ensure proper neuronal communication and normal motor function. This suggests that this mutation is indeed the cause of the neurodevelopmental defects seen in the siblings.

According to the researchers, this new disorder may represent the first human disease caused by inherited mutations on both copies of the CAMK2A gene. In addition, another study published recently identified single-copy mutations on both CAMK2A and CAMK2B that led to intellectual disabilities as soon as the mutations occurred.

“We would like to bring these findings to the attention of those working in the area of pediatric genetics, such as clinicians and genetic counselors, as there are likely more undiagnosed children with similar symptoms who have mutations in their CAMK2A gene,” explains co-first author Dr. Franklin Zhong, research scientist in Reversade’s lab at A*STAR.

“Neuroscientists working to understand childhood brain development, neuronal function and memory formation also need to consider this new disease, since CAMK2A is associated with these processes. In future, it would be interesting to test whether restoring CAMK2A activity can bring therapeutic benefit to patients with this condition, as well as those with related neurological disorders.”

Source: eLife

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A Scandinavian study suggests the risk for diabetes is influenced by the home environment and especially by your partner. Danish researchers from the University of Copenhagen and Aarhus University have found a connection between the BMI of one spouse and the other spouse’s risk of developing type 2 diabetes.

Prevention of diabetes is a major public health goal as the disease has serious complications, some of which may have developed by the time the disease is detected. Investigators discovered the risk of diabetes is shared among the entire household, not just one partner.

In the new study, researcher’s examined data from 3,649 men and 3,478 women from the English Longitudinal Study of Aging in the UK. They found men had a greater chance of developing diabetes dependent upon their wife’s body mass index. BMI is a measure of body fat based on height and weight that applies to adult men and women.

“We have discovered that you can predict a person’s risk of developing type 2 diabetes based on his or her partner’s BMI. This means that you can tell whether a person has a heightened risk or not on the basis of the partner’s BMI,” said Dr. Jannie Nielsen, first author of the study.

The study appears in the scientific journal Diabetologia.

On a global scale, 422 million adults have diabetes, according to the World Health Organization. And it is estimated 1,5 million deaths are caused by the disease. According to the CDC, more than 100 million U.S. adults are now living with diabetes or prediabetes. Specifically, as of 2015, 30.3 million Americans – 9.4 percent of the U.S. population – have diabetes.

Prior studies have shown that spouses are often similar in terms of body weight, among other things because people often marry someone similar to themselves and often share dietary and exercise habits when living together.

In the current study, researchers examined whether the heightened risk of developing type 2 diabetes of an obese woman, for example, was merely a result of her own body weight, or if other factors influenced development of the disease.

This examination led the researchers to find a difference between the two sexes.

“If we adjusted for the women’s own weight, they did not have a heightened risk of developing type 2 diabetes as a result of their husband’s BMI. But even when we adjusted for the weight in men, they had a heightened risk,” Nielsen said.

A man whose wife had a BMI of 30 kg/m2 had a 21 percent higher risk of developing diabetes than men whose wives had a BMI of 25 kg/m2, regardless of the man’s own BMI.

The researchers have not examined why only the men still had a heightened risk after own weight adjustment. They do have a theory, though, which involves who is in charge of the household.

“We believe it is because women generally decide what we eat at home. That is, women have greater influence on their spouse’s dietary habits than men do,” Nielsen said. She cited a U.S. study which showed that women more often than men are responsible for doing the household’s cooking and shopping.

Diabetes can cause complications and serious sequelae such as damage to the heart, kidneys and eyes. According to the Danish Diabetes Association, 35 percent experience complications by the time they are diagnosed with diabetes. Therefore, early detection is vital.

“The earlier a disease is detected, the higher the potential for successful prevention and treatment. We know that type 2 diabetes can be prevented or postponed, reducing the number of years that patients have to live with the disease. Just as related complications can be postponed through early detection,” Nielsen said.

If type 2 diabetes is detected at an early stage, medical treatment can be postponed, and instead the patient can begin with lifestyle changes such as eating a healthy diet and getting more physical exercise.

Based on the study, Nielsen believes that early detection of type 2 diabetes can be improved if we change our approach to the disease.

“Our approach to type 2 diabetes should not focus on the individual, but instead on, for example, the entire household. If a woman has a heightened risk, there is a strong probability that it is shared by her husband.

“We know that men are less inclined to go to the doctor. So if a woman comes to her physician with risk factors for type 2 diabetes, the physician should therefore perhaps ask her to bring her husband next time,” Nielsen said.

Source: University of Copenhagen

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Suicide rates among whites have traditionally been higher than for blacks in the United States. However, a new study shows that the racial differences in suicide rates may be age-specific. The findings, published in JAMA Pediatrics, reveal that suicide rates for black children aged 5-12 are approximately double than that for white children of similar ages.

“Our findings provide further evidence of a significant age-related racial disparity in childhood suicide rates and rebut the long-held perception that suicide rates are uniformly higher in whites than blacks in the United States,” said lead author Dr. Jeff Bridge, director of the Center for Suicide Prevention and Research at Nationwide Children’s Hospital in Columbus, Ohio.

“The large age-related racial difference in suicide rates did not change during the study period, suggesting that this disparity is not explained by recent events such as the economic recession.”

Among teens, the trend reverses back to the national average: In young people aged 13-17 years, suicide is roughly 50 percent lower in black children than in white children.

For the study, the researchers pulled data for cases in which suicide was listed as the underlying cause of death among persons aged 5-17 years from 2001-2015 from the Web-based Injury Statistics Query and Reporting System (WISQARSTM) of the Centers for Disease Control and Prevention.

The data shows that between the years 2001-2015, among ages 5 to 17, there were 1,661 suicide deaths in black youths and 13,341 suicide deaths in white youths. During this time period, the overall suicide rate was about 42 percent lower in black youth (1.26 per 100,000) than in white youth (2.16 per 100,000).

However, age significantly affected this racial difference, as shown when suicide rates among 5- to 12-year-olds and 13- to 17-year-olds were evaluated.

“It is important not to lose sight that very young children of all races are at risk of suicide,” said Dr. Joel Greenhouse, a co-author of the study and professor of statistics and data science at Carnegie Mellon University. “Descriptive studies like this are important for identifying trends in suicide rates. However, they leave open the question as to why there are differences.”

“It is also important to note that the homicide rate for black youths aged 13-17 is between five to seven times greater than for white youths and may indeed be a competing risk for suicide in this age group. This is a question that we are continuing to investigate,” said Greenhouse.

Source: Carnegie Mellon University

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In a new Spanish study, researchers discovered that when young children (ages 4 to 7) were asked to create spontaneous drawings of plants, they demonstrated a clear understanding of the interdependent relationship between plants and animals.

According to the researchers, this suggests that concepts related to biology, the environment and sustainability can be easily incorporated into early education classrooms.

Throughout the last five years, the researchers from the University of the Basque Country have been investigating the extent of young children’s knowledge about the environment by studying their spontaneous drawings.

The researchers point out that the drawings of young children are closely linked to their thoughts and feelings. Therefore, analyzing such drawings is considered a valuable method for studying their conceptual development.

The research was conducted with 328 children (162 girls and 166 boys) at six schools (five in Bizkaia, and one in Burgos). Three of the schools are located in urban areas with more than 75,000 inhabitants and the rest are located in rural areas with a population of less than 6,000.

In the classroom, with the help of a puppet, the children were told that the puppet did not know anything about the plant world, so it was suggested to them that they could use their drawings to explain to the puppet what plants are. Each child was given 10 crayons.

In 15 minutes or less, each child expressed his/her way of understanding plant reality, first through drawing and then through coloring. The children were not given any indication or additional explanation about plants, animals or the interactions between them.

When the drawings were analyzed, the researchers found that the children correctly associated the animal world with the plant world. For example, they depicted animals eating plants and also identified and distinguished between living beings and inert objects such as the sun, clouds or vehicles.

In addition, the older the children were, the more frequently they drew animals and plants in an interdependent relationship.

Thus, the findings show that in the early years of education, children are already capable of distinguishing between fundamental biological concepts that pave the way towards understanding natural phenomena. Therefore, teaching concepts relating to biology or sustainability could be incorporated into pre-kindergarten and early primary education.

“By way of conclusion, it can be said that the evidence we provide is consistent with the assumption that by the age of eight children start to understand the interdependence between living beings in ecosystems,” said José Domingo Villarroel, researcher at the Faculty of Education in Bilbao.

“This circumstance is an opportunity for them to reflect on the ecological connections between living beings, including human beings. It is an educational aim that, without doubt, should exert a significant impact on environmental thinking.”

Source: University of the Basque Country

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