CHAPTER 4 90 enabling them to understand and apply words in more complex situations (Blank, 2001). This influences the information obtained during an interview. The level of (non)verbal communication children can use in a more or less complex situation and the interview style of the professional can both be classified in ‘stages’. The communication level of the child is classified by Oskam and Scheres (2016) into three levels with each two stages (situation, signal or symbol level). Blank (2001) developed a model with four types of abstraction in interview style with different sorts of questions (Figure 1). Whether children communicate at a given time or under given circumstances at a situation, signal or symbol level depends on their cognitive ability (ability to reason and act independently), and the socio-emotional level (extent to which a child can oversee and handle situations). An interviewer can influence the ability of the child to communicate by formulating a question in a certain manner or using materials such as pictures which aids the child to give information. For instance, “what-happens usually-when” types of questions are asked to gain information or script knowledge of children (Docherty & Sandelowski, 1999). An interviewer should match the interviewing style and question form to the communication abilities of the child. For children with a disability in health care, many different interview techniques and supportive tools are available to yield the experiences of their daily occupations, for example the use of Augmentative and Alternative Communication (AAC), such as Talking Mats® (Lindenschot et al., 2021; Murphy & Cameron, 2006), the use of stimulus material (Punch, 2002) or the auto-driven photo elicitation interview (Croghan et al., 2008; Phelan & Kinsella). Several of these have been used in a study of Lindenschot et al. (2020) in children with mitochondrial disorder aged between 6 and 18 years, who had variable communicative, cognitive and physical disabilities. To gain insight in the experiences of activities, children were asked “what they do”, “how they perform and experience these activities”, and “what their wants and needs are”. Each child was approached with a different method, adapted to their capacities, justified by Kelly (2007) who argues that the flexible nature of qualitative research allows room for creative and responsive methodological approaches for consulting children. The aim of this study is to get insight in which interview techniques and interviewer skills are helpful to uncover the perspectives of children with a developmental disorder.
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