Using Storybooks to Teach Children About Illness Transmission and Promote Adaptive Health Behavior – A Pilot Study

Learning about germs in a global pandemic: Children’s knowledge and avoidance of contagious illness before and after COVID-19

“…Although most parents reported discussing contagion with their children, only 59% of parents reported that their children had a strong understanding of how to avoid illness (mean confidence rating = 3.7, SD = 0.98), and merely 5% of parents believed their child would actually behave in ways that would keep them from exposure (e.g., avoid playing with a sick friend; mean confidence rating = 2.1, SD = 1.24). Children's avoidance behavior might be supported by increased understanding of the causal mechanisms of transmission, given that research shows that interventions emphasizing causal mechanisms of contagion support adaptive behavior, whereas educational interventions focusing on risk/preventative measures do not impact knowledge or behavior (Au et al, 2008;Blacker & LoBue, 2016;Conrad et al, 2020). The disconnect between knowledge and adaptive behavior might be due to the fact that parents' reports of discussions with their children centered around risk prevention strategies only, rather than biological explanations or causal mechanisms of illness transmission.…”

“…Previous research has demonstrated that while understanding causal mechanisms of contagion may be important for promoting adaptive avoidance behavior, very few preschoolers have acquired this knowledge (Blacker & LoBue, 2016;Conrad et al, 2020). Additionally, little is known about how parents discuss contagious illness with their young children.…”

“…However, despite the fact that children do not seem to have sophisticated causal knowledge about illness transmission until the age of 7 or 8, children may be capable of learning causal biological theories at much earlier ages. Indeed, even preschool-aged children demonstrate an understanding of causal relationships across various domains, demonstrating the potential for training (Blacker & LoBue, 2016;Bonawitz, Fischer, & Schulz, 2012;Bonawitz et al, 2019;Coley, 2012;Conrad et al, 2020;Daubert et al, 2020;Flavell, et al 1995;Gelman & Wellman, 1991;Gopnik & Meltzoff, 1997;Inagaki & Hatano, 1993;Kalish, 1996;Perner, 1991;Schulz, Bonawitz, & Griffiths, 2007;Shultz, 1982;Spelke, Breinlinger, Macomber, & Jacobson, 1992). Further, one recent study even showed that children as young as five can learn about a topic as complex as natural selection by providing them with causal information in an informal picture book interaction (Kelemen, Emmons, Schillaci, & Ganea, 2014).…”

“…Indeed, past research has demonstrated that children's knowledge, attitudes, and beliefs about disgust and illness are influenced by those of their parents (Sigelman et al, 1993;Sigelman et al, 1995;Stevenson et al, 2010;Toyama, 2016). Recently, researchers have advocated using explanation-based instruction to teach complex counterintuitive concepts to young children (Conrad et al, 2020;Keleman, 2019;Kelemen et al, 2014;Myant & Williams, 2008). Findings from such research suggest that causal knowledge about illness transmission might be an important mechanism that leads to healthy behavior in preschool-aged children, and that even 3-to 5-yearolds can learn a causal explanation for illness transmission from a simple informal learning experience (Conrad et al, 2020).…”

“…However, research suggests that causal knowledge of how illnesses are spread can be a potential mechanism that might underlie the development of disease-avoidant behavior (Siegal, Fadda, & Overton, 2011). More specifically, two studies have now demonstrated that children who have a more sophisticated causal understanding of illness transmission are more likely to avoid proximity to a sick person and contact with a contaminated object (Blacker & LoBue, 2016;Conrad et al, 2020). Thus, examining whether and how younger, preschool-aged children acquire causal knowledge of illness transmission in a way that relates to their adaptive avoidance of contamination is an important topic for research.…”