Berit Björkman

Children’s voices – Differentiating a child perspective from a child’s perspective

Abstract Objective: The aim of this paper was to discuss differences between having a child perspective and taking the child’s perspective based on the problem being investigated. Methods: Conceptual paper based on narrative review. Results: The child’s perspective in research concerning children that need additional support are important. The difference between having a child perspective and taking the child’s perspective in conjunction with the need to know children’s opinions has been discussed in the literature. From an ideological perspective the difference between the two perspectives seems self-evident, but the perspectives might be better seen as different ends on a continuum solely from an adult’s view of children to solely the perspective of children themselves. Depending on the research question, the design of the study may benefit from taking either perspective. In this article, we discuss the difference between the perspectives based on the problem being investigated, children’s capacity to express opinions, environmental adaptations and the degree of interpretation needed to understand children’s opinions. Conclusion: The examples provided indicate that children’s opinions can be regarded in most research, although to different degrees.

Perioperative and anesthesia guidelines for children with autism : A nationwide survey from Sweden

Objective: The overall aim of this study was to describe the current set of guidelines for the preparation and care for children with autism spectrum disorder (ASD) in the perioperative setting across Sweden and explore the content of these guidelines in detail. Method: An online questionnaire was distributed to the chairpersons of all anesthesia departments (n = 68) and pediatric departments (n = 38) throughout Sweden. Follow-up phone calls were made to those departments that did not return the questionnaire. The presence of guidelines was analyzed through descriptive statistics. These guidelines and comments on routines used in these departments were analyzed inspired by conventional content analysis. Results: Seven of the 68 anesthesia departments and none of the 38 pediatric departments across Sweden have guidelines for preparing and/or administering care to children with ASD within the perioperative setting. From the guidelines and routines used, 3 categories emerge: “lacking the necessary conditions,” “no extra considerations needed,” and “care with specific consideration for children with ASD.” These 3 categories span a continuum in the care. In the first category, the anesthesia induction could result in the child with ASD being physically restrained. In the last category, the entire encounter with the health care service would be adapted to the specific needs of the child. Conclusion: There is a lack of evidence-based guidelines specifically designed to meet the needs of children with ASD in the preoperative period in Sweden. Further research is needed to understand if children with ASD would benefit from evidence-based guidelines.

Will it Hurt? Verbal Interaction between Child and Radiographer during Radiographic Examination

This study investigated the nature of verbal interactions between child, parent and radiographer and the extent to which it varied as a function of the childs age. The participants were 20 female radiographers and 32 children (3-15 years) examined for acute injuries. The verbal interactions during the examination were video recorded and analyzed using the Roter Interaction Analysis System (RIAS). Results indicated that 80% of the verbal interaction was accounted for by the radiographer, 17% by the child and 3% by the parent. The distribution of utterances varied with regard to childrens age.

Peri-radiographic guidelines for children with autism spectrum disorder: a nationwide survey in Sweden

OBJECTIVE This study aimed to investigate the prevalence of guidelines and routines used nationwide when children with autism spectrum disorder (ASD) are taken care of and examined in a radiology department during a peri-radiographic process. METHOD A nationwide survey was compiled and distributed to 94 radiology departments throughout Sweden, i.e. those performing more than 100 000 radiographic examinations annually. The survey was designed as a web questionnaire with seven questions on possible guidelines and/or routines for the departments when preparing and taking care of children with ASD in conjunction with a radiographic procedure. The data were scrutinized, using descriptive statistics. RESULTS In total, 86 radiology departments responded to the survey (response rate 92%). Of those departments, 40 did not examine children with ASD. None of the departments included in the study had existing guidelines underpinning the routines when preparing and performing radiographic examinations for children diagnosed with ASD. A few departments (n = 8) would set aside more time for the procedure if it were known in advance that the child to be examined had been diagnosed with ASD. Also, some departments (n = 7) had radiographers who were more experienced in the care of children who would be appointed to perform examinations for children with ASD. CONCLUSION It is suggested that guidelines should be developed in order to increase interaction in a supportive way and decrease anxiety during the peri-radiographic process with children with ASD.

Management of children with Autism Spectrum Disorder in the anesthesia and radiographic context

Objective: As a primary objective, this study purports to develop guidelines to better care for children with autism spectrum disorder (ASD), particularly regarding these childrens preparation for anesthesia and radiologic procedures. Methods: Using a Delphi method with an online distribution of questionnaire, guidelines for caring for children with ASD were created. Twenty-one participants were included in the expert panel. These participants were working with children with ASD in several anesthesia and radiology departments in Sweden. A list of items was created from a previous survey and the literature. In the first round, the items with <60% agreement were discarded. Items were merged, and a new list was created. Two more similar rounds were performed. In the last 2 rounds, 21 participants responded, and 80% agreement was considered to be consensus. Results: The final guidelines consisted of 14 items and a checklist of 16 factors. The 5 areas covered by the items and the checklist were as follows: planning involving parents/guardians, features in the environment, and use of time, communication, and the health care professionals. The organization was important in making it possible for the health care professional to care for the individual child according to the childs needs. It was important to involve the parents/guardians to obtain knowledge about the functioning of the child. Conclusion: A caring encounter involving a child with ASD in the anesthesia and radiology contexts requires advance planning, catered specifically to the individual needs of each child. To accomplish this, general knowledge regarding ASD and ASDs particular manifestation in the child entrusted to their care is required from the health care workers. The organization needs to have structures in place to facilitate this process.