Martha Driessnack

What is the focus of your research? Give a brief overview. What questions are you trying to answer? What problems are you attempting to solve?

The focus of my research is the development of new approaches, techniques, and tools for use with children in research. Current approaches and tools used to access children’s voices and/or assess their experiences are primarily ‘hand-me-downs’, developed with and for adults and then made child-friendly by using simple vocabulary and visual prompts. The problem with this approach is that children are not adults. They think differently. They process new information differently and they organize and recall information differently. My focus is to capture these differences through the development of truly child-centered, rather than just child-friendly, approaches to data collection.

One child-centered approach I developed that appears to capture these differences is the Draw-and-Tell Conversation (DTC).The DTC integrates children’s drawings into the interview process, using the children’s drawings and associated narratives to direct the conversation, rather than adult-generated interview guides and probes.

The long term goal of my research program is to improve the accuracy and quality of data collected from children. Continuing use of adult hand-me-down approaches may, in contrast, produce information that is misleading or even dangerous to children.

What led to the development of interest in this topic?

I have been a pediatric nurse practitioner for over 30 years, working with children across the health care continuum. One of the things I noticed in practice was that young children often went unheard when it came to assessing them. Instead, health care providers deferred to parents and other adult observations for information about the child. Yet, when I engaged these children in conversation, I was consistently impressed with their ability to articulate their needs. Of particular concern to me were the discrepancies between what these children had to say and what their adult proxies reported. I remember thinking that somehow I was going to change this. Children should be seen, heard, and believed. I set it as my goal to get the world to pay attention to children.

Early on in practice I noticed that art appeared to be a natural medium for children to express themselves. During my doctoral studies, I minored in art therapy, and continued to pursue the integration of children’s drawings as a facilitator for conversation. I continue to use art, but I am also exploring other tools and approaches by actively engaging children as co-researchers.

What impact do you predict coming from this research? (on citizens, practice environment, educational opportunities, funding, etc.?)

The primary impact of this program of research is its potential to increase the accuracy and validity of information obtained from children in research and clinical practice. This ‘back to the future’ approach may not only open the door to the collection of more acurate, relevant, and actionable information from children, but also may open the door to improving child health care and outcomes across the health care continuum.

A secondary impact is refocusing research and researchers on children and childhood and the importance of both in our understanding of later health, disease risk, health literacy, and health behaviors.

How does the research integrate into education/practice/service?

In society, education, practice, and research, children are often viewed within the construct of ‘development’ – the linear, sequential, and normalized ‘process’ by which children become adults. This construct of children as human becomings, as opposed to human beings, has contributed to a worldview of children as simpler versions of adults. However, there is emerging evidence that we need to pay more attention to children’s early thinking. Children’s naïve theories of biology, psychology, and physics form the foundation and initial scaffolding for later learning. For example, a child’s naïve theory of biology typically forms between 7-10 years of age and once it is formed, it is resitant to change. So, later, when we struggle with adults who do not seem to comprehend their disease risk or needed preventive actions, it may be because the information they are now receiving conflict with their earlier naïve theories or models and are rejected.

Learning about children’s naïve theories, especially their naïve models of biology, which include disease causation and risk, has fueled my desire to move research efforts upstream to childhood. Rather than focusing health research solely on plucking individuals from the waters, I am interested in how and why those individuals, as children, fell in to begin with. I am hoping that moving the focus upstream will help change the prevailing view that children are small adults to the idea that adults are big children.