Look at Grandma! Joint visual attention over video chat during the COVID-19 pandemic.

Social interactions are crucial for many aspects of development. One developmentally important milestone is joint visual attention (JVA), or shared attention between child and adult on an object, person, or event. Adults support infants' development of JVA by structuring the input they receive, with the goal of infants learning to use JVA to communicate. When family members are separated from the infants in their lives, video chat sessions between children and distant relatives allow for shared back-and-forth turn taking interaction across the screen, but JVA is complicated by screen mediation. During video chat, when a participant is looking or pointing at the screen to something in the other person's environment, there is no line of sight that can be followed to their object of focus. Sensitive caregivers in the remote and local environment with the infant may be able to structure interactions to support infants in using JVA to communicate across screens. We observed naturalistic video chat interactions longitudinally from 50 triads (infant, co-viewing parent, remote grandmother). Longitudinal growth models showed that JVA rate changes with child age (4 to 20 months). Furthermore, grandmother sensitivity predicted JVA rate and infant attention. More complex sessions (sessions involving more people, those with a greater proportion of across-screen JVA, and those where infants initiated more of the JVA) resulted in lower amounts of JVA-per-minute, and evidence of family-level individual differences emerged in all models. We discuss the potential of video chat to enhance communication for separated families in the digital world.

Preschoolers ask questions about unknown words on video chat and in live interactions at similar rates.

The COVID-19 pandemic has led to a major increase in digital interactions in early experience. A crucial question, given expanding virtual platforms, is whether preschoolers' active word learning behaviors extend to their interactions over video chat. When not provided with sufficient information to link new words to meanings, preschoolers drive their word learning by asking questions. In person, 5-year-olds focus their questions on unknown words compared with known words, highlighting their active word learning. Here, we investigated whether preschoolers' question-asking over video chat differs from in-person question-asking. In the study, 5-year-olds were instructed to move toys in response to known and unknown verbs on a video conferencing call (i.e., Zoom). Consistent with in-person results, video chat participants (n = 18) asked more questions about unknown words than about known words. The rate of question-asking about words across video chat and in-person formats did not differ. Differences in the types of questions asked about words indicate, however, that although video chat does not hinder preschoolers' active word learning, the use of video chat may influence how preschoolers request information about words.

The challenge of screen mediated shared reading for children's learning and engagement.

Introduction: Screen mediated shared reading (SMSR), which involves an adult reading a child a book through video-chat, is a recent development in shared reading. In this study, we investigated whether, as in in-person shared reading, children could learn new words from SMSR, and whether having a physical copy of the book to follow along with impacted children's novel word retention and engagement in this setting. Method: Three- to 5-year-old participants (n = 34) were read an 8-page rhyming, "Meet the Friendly Monsters" story by a researcher over Zoom, via screen sharing an e-version of the story used in previous studies. Participants were randomly assigned to one of two conditions: SMSR with or without a paper copy of the book to follow along with. The session was recorded to measure children's engagement behaviors during the reading. Novel word learning from the story was measured with both a multiple choice identification test and a monster naming test, both administered immediately after the initial reading, then re-administered 10-14 days later. Engagement during the SMSR sessions was measured every 30-s on a scale of 1 (low engagement) to 5 (high engagement), and then averaged for each child. Results: Results show that children overall performed slightly above chance on novel monster name retention from the SMSR. However, retention was not as strong as seen in other in-person shared reading studies using the same story. Additionally, while children remembered monster names with equal efficacy regardless of condition and level of engagement, there were still qualitative differences in the reading sessions depending on whether children had their own paper copy of the book to follow along with - in general, the 'with book' condition appeared to increase the challenges posed to children's attention during SMSR, potentially making the word learning task more difficult. Discussion: The findings of this study have implications for how to approach shared reading with young children in new contexts with the use of emerging technology. We raise future research questions for a better understanding of best practices for screen mediated shared reading.

Efficacy of a Digital Mental Health Biopsychosocial Transdiagnostic Intervention With or Without Therapist Assistance for Adults With Anxiety and Depression: Adaptive Randomized Controlled Trial.

BACKGROUND: Digital mental health (DMH) interventions incorporating elements that adapt to the evolving needs of consumers have the potential to further our understanding of the optimal intensity of therapist assistance and inform stepped-care models. OBJECTIVE: The primary objective was to compare the efficacy of a transdiagnostic biopsychosocial DMH program, with or without therapist assistance for adults with subthreshold symptoms or a diagnosis of anxiety or depression. METHODS: In a randomized adaptive clinical trial design, all participants had access to the DMH program, with eligibility to have their program augmented with therapist assistance determined by program engagement or symptom severity. Participants who met stepped-care criteria were randomized to have their treatment program augmented with either low-intensity (10 min/week of video chat support for 7 weeks) or high-intensity (50 min/week of video chat support for 7 weeks) therapist assistance. A total of 103 participants (mean age 34.17, SD 10.50 years) were assessed before (week 0), during (weeks 3 and 6), and after the intervention (week 9) and at the 3-month follow-up (week 21). The effects of 3 treatment conditions (DMH program only, DMH program+low-intensity therapist assistance, and DMH program+high-intensity therapist assistance) on changes in the 2 primary outcomes of anxiety (7-item Generalized Anxiety Disorder Scale [GAD-7]) and depression (9-item Patient Health Questionnaire [PHQ-9]) were assessed using the Cohen d, reliable change index, and mixed-effects linear regression analyses. RESULTS: There were no substantial differences in the outcome measures among intervention conditions. However, there were significant time effect changes in most outcomes over time. All 3 intervention conditions demonstrated strong and significant treatment effect changes in GAD-7 and PHQ-9 scores, with absolute Cohen d values ranging from 0.82 to 1.79 (all P<.05). The mixed-effects models revealed that, in the Life Flex program-only condition at week 3, mean GAD-7 and PHQ-9 scores significantly decreased from baseline by 3.54 and 4.38 (all P<.001), respectively. At weeks 6, 9, and 21, GAD-7 and PHQ-9 scores significantly decreased from baseline by at least 6 and 7 points (all P<.001), respectively. Nonresponders at week 3 who were stepped up to therapist assistance increased program engagement and treatment response. At the postintervention time point and 3-month follow-up, 67% (44/65) and 69% (34/49) of the participants, respectively, no longer met diagnostic criteria for anxiety or depression. CONCLUSIONS: The findings highlight that early detection of low engagement and non-treatment response presents an opportunity to effectively intervene by incorporating an adaptive design. Although the study findings indicate that therapist assistance was no more effective than the DMH intervention program alone for reducing symptoms of anxiety or depression, the data highlight the potential influence of participant selection bias and participant preferences within stepped-care treatment models. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12620000422921; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378317&isReview=true. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/45040.

Evaluation of Various Support Intensities of Digital Mental Health Treatment for Reducing Anxiety and Depression in Adults: Protocol for a Mixed Methods, Adaptive, Randomized Clinical Trial.

BACKGROUND: Anxiety and depression are leading causes of disease worldwide, requiring timely access to evidence-based treatment. Digital mental health (dMH) interventions increase accessibility to evidence-based psychological services delivered in a variety of web-based formats (eg, self-help and therapist-assisted interventions). Robust and rigorous studies of adaptive web-based intervention designs are scarce. No identified randomized clinical trial has investigated the efficacy of a 2-stage adaptive design, whereby the program-only condition or no support dMH treatment program is augmented by either low or high therapist assistance, if a participant does not improve or engage in the program-only condition. OBJECTIVE: The primary objective is to assess whether low or high therapist-assisted support delivered via video chat is more effective in reducing anxiety and depressive symptoms compared with a dMH program-only condition. The secondary objective is to evaluate the role of motivation; self-efficacy; and preferences in participant engagement, adherence, and clinical outcomes (anxiety and depression symptoms) among the 3 treatment conditions (program only, low-intensity therapist assistance, and high-intensity therapist assistance). A mixed methods analysis of factors affecting participant attrition, participant reasons for nonengagement and withdrawal, and therapist training and implementation of dMH interventions will be completed. Qualitative data regarding participant and therapist experiences and satisfaction with video chat assessment and treatment will also be analyzed. METHODS: Australian adults (N=137) with symptoms or a diagnosis of anxiety or depression will be screened for eligibility and given access to the 8-module Life Flex dMH treatment program. On day 15, participants who meet the augmentation criteria will be stepped up via block randomization to receive therapist assistance delivered via video chat for either 10 minutes (low intensity) or 50 minutes (high intensity) per week. This adaptive trial will implement a mixed methods design, with outcomes assessed before the intervention (week 0), during the intervention (weeks 3 and 6), after the intervention (week 9), and at the 3-month follow-up (week 21). RESULTS: The primary outcome measures are for anxiety (Generalized Anxiety Disorder-7) and depression severity (Patient Health Questionnaire-9). Measures of working alliance, health status, health resources, preferences, self-efficacy, and motivation will be used for secondary outcomes. Qualitative methods will be used to explore participant and therapist experiences of video chat assessment and treatment, participant reasons for withdrawal and nonengagement, and therapist training and implementation experiences. Data collection commenced in November 2020 and was completed at the end of March 2022. CONCLUSIONS: This is the first mixed methods adaptive trial to explore the comparative efficacy of different intensity levels of self-help and a therapist-assisted dMH intervention program delivered via video chat for adults with anxiety or depression. Anticipated results may have implications for the implementation of dMH interventions. TRIAL REGISTRATION: Australian and New Zealand Clinical Trials Registry 12620000422921; https://tinyurl.com/t9cyu372. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/45040.

A Medical Assistive Robot for Telehealth Care During the COVID-19 Pandemic: Development and Usability Study in an Isolation Ward.

BACKGROUND: The COVID-19 pandemic is affecting the mental and emotional well-being of patients, family members, and health care workers. Patients in the isolation ward may have psychological problems due to long-term hospitalization, the development of the epidemic, and the inability to see their families. A medical assistive robot (MAR), acting as an intermediary of communication, can be deployed to address these mental pressures. OBJECTIVE: CareDo, a MAR with telepresence and teleoperation functions, was developed in this work for remote health care. The aim of this study was to investigate its practical performance in the isolation ward during the pandemic. METHODS: Two systems were integrated into the CareDo robot. For the telepresence system, a web real-time communications solution is used for the multiuser chat system and a convolutional neural network is used for expression recognition. For the teleoperation system, an incremental motion mapping method is used for operating the robot remotely. A clinical trial of this system was conducted at First Affiliated Hospital, Zhejiang University. RESULTS: During the clinical trials, tasks such as video chatting, emotion detection, and medical supplies delivery were performed via the CareDo robot. Seven voice commands were set for performing system wakeup, video chatting, and system exiting. Durations from 1 to 3 seconds of common commands were set to improve voice command detection. The facial expression was recorded 152 times for a patient in 1 day for the psychological intervention. The recognition accuracy reached 95% and 92.8% for happy and neutral expressions, respectively. CONCLUSIONS: Patients and health care workers can use this MAR in the isolation ward for telehealth care during the COVID-19 pandemic. This can be a useful approach to break the chains of virus transmission and can also be an effective way to conduct remote psychological intervention.

Estudio de caso de narrativas infantiles en videollamadas: Aportes al análisis de interacciones mediadas por tecnología / Case study of children's narratives in videochats: contributions to the analysis of technology-mediated interactions

Resumen El aislamiento social preventivo y obligatorio por la pandemia del SARS-CoV-2 condujo a las familias a buscar alternativas para mantener el vínculo con sus parientes no convivientes. Una de ellas fue la videollamada, cuyo carácter audiovisual habilita nuevas maneras de comunicación (Ames et al., 2010; Ballagas et al., 2009; McClure y Barr, 2017) que podrían modificar las interacciones en las que adultos/as y niños/as participan y colaboran en la construcción de distintos tipos de discursos. La narración constituye una de las primeras y más relevantes formas de discurso en la infancia que permite reconstruir y comunicar la propia experiencia. En este trabajo se realizó un análisis de caso de 31 narrativas que tuvieron lugar en cinco videollamadas en las que participaban una misma niña residente de la Ciudad de Buenos Aires y sus familiares, pertenecientes al corpus "Contextos naturales de interacción en los hogares en los que los/as niños/as usan tempranamente tecnología"[1], a fin de caracterizar las interacciones que contribuyen a la configuración de las narrativas infantiles en contextos mediados por tecnología. Los resultados mostraron una mayor presencia de narrativas personales y de futuro, frente a pocas de ficción; mientras que estas últimas fueron en su totalidad autorreguladas, la cantidad de narrativas hetero y autorreguladas fue similar para los otros dos tipos de narrativas. Se identificaron distintas estrategias a las que, en el marco de videollamadas, la niña recurrió para participar en la construcción de narrativas.

Abstract The preventive and compulsory social isolation established in Argentina due to the SARS-CoV-2 pandemic led families to look for alternatives to maintain the bond and communicate with their non-cohabitant relatives. One of these alternatives was the use of videochat. Videochat enables new ways of audiovisual communication (Ames et al., 2010; Ballagas et al., 2009; McClure & Barr, 2017) that could affect the interactions in which adults and children collaborate in the construction of different types of discourses. Narratives are one of the first and most relevant forms of discourse, it allows for the reconstruction and communication of one's experience and is one of the ways in which thought is configured. In this work, a case study was conducted of the narratives produced during videochat conversations of a four-year-old girl with non-cohabiting relatives. The aim was to characterize the interactions that help in the configuration of children's narratives during technology-mediated situations. The research question were: (a) how do technology-mediated interactions allow the child to narrate about past and future events and to create fictional narratives?; (b) how does the child participate in the construction of those narrative in the context of these technology-mediated situations? Five videos of videochat interaction belonging to a single four year old girl were selected from the corpus "Contextos naturales de interacción en los hogares en los que los/as niños/as usan tempranamente tecnología". This corpus gathers different technology-mediated interactions collected during daily activities in the home of children aged 0 to 6 years. First, 31 narratives in which the girl participated were identified. Subsequently, used the constant comparative method was used (Strauss & Corbin, 1998) as well as analysis tools developed within the framework of interactive sociolinguistics (Gumperz, 1982, 1984); also, concepts developed in previous research (Arrúe et al., 2014; Labov, 1972; Rosemberg et al., 2010; Stein et al., 2020) were heuristically recovered to answer the research questions. Of the 31 narratives produced in the interactions, 14 were related to personal experience, 13 were of future events, and 4 were fiction narratives. Regarding the posed questions, results showed that children do in fact create personal, future and fictional narratives in technology-mediated interactions with adults. Technology also enables children to decide how much they want to participate in interactions: they can lead the narrative, or they can back off to a yes-or-no answer kind of participation. The child relies on the possibility to share visual information, beyond audio, to provide both events and context information. This interactive and multimodal aspect of videochats was also found to enable the girl to turn to present adults both to scaffold her narrative production and to resolve doubts about unknown words. Even though there are methodological limitations to this study, this first approach to narratives in technology-mediated interactions shows the richness that this type of interaction can have for the development of children's language.

Barriers to Accessing Video-Based Telehealth Appointments at a Community Veterinary Clinic During the COVID-19 Pandemic.

Objective: To assess veterinary needs of clients with low socioeconomic status during the COVID-19 pandemic, to explore the impact of the pandemic on marginalized communities, and to understand perceptions regarding barriers and incentives of telehealth appointments as a method to increase care access. Sample: 205 active Community Veterinary Medicine Clinic clients at Tufts at Tech Community Veterinary Clinic in Worcester, MA. Procedures: This cross-sectional study used a survey-based method to assess veterinary needs of clients with low socioeconomic status during the COVID-19 pandemic. The survey measured client perceptions regarding potential barriers and incentives of telehealth appointments. Participants were randomly sampled from a list of active clients and completed the survey either by email or over the phone. The survey was available in both English and Spanish. Clients who completed the questionnaire received credit for a free examination. Results: A total of 205 clients submitted survey responses. Factors affecting access to veterinary care were impacted by the COVID-19 pandemic. Access to reliable internet in the home was reported by 87% (n = 177) of participants. Digital access was correlated with education when controlling for race, income, age, and gender. Education was predictive of comfort with using video-chat (χ2 = 65, df = 24, p ≤ 0.01) and of whether or not clients reported need for assistance for using video-chat (χ2 = 52, df = 18, p ≤ 0.01). Patient education level was significantly predictive of wanting to use telehealth for at least one type of appointment (p ≤ 0.05). Conclusions and Clinical Relevance: The findings indicate that implementing telehealth services at this Community Medicine Clinic is feasible for much of the active clientele and offers a new avenue to provide veterinary care during times of social distancing restrictions and beyond.

Virtual auscultation course via video chat in times of COVID-19 improves cardiac auscultation skills compared to literature self-study in third-year medical students: a prospective randomized controlled cross-over study.

Background: Cardiac auscultation is a core clinical skill taught in medical school. Due to contact restrictions during the SARS-CoV-2 pandemic, interaction with patients was very limited. Therefore, a peer-to-peer virtual case-based auscultation course via video conference was established. Methods: A randomized controlled cross-over study was conducted to evaluate whether participation in a virtual auscultation course could improve heart auscultation skills in 3rd-year medical students. A total of sixty medical students were randomly assigned to either the experimental or control group after informed consent was obtained. Due to no-shows, 55 students participated. Depending on allocation, students attended three ninety-minute courses in intervals of one week in a different order: a virtual case-based auscultation course held via video chat, literature self-study, and an on-site course using a high-fidelity auscultation simulator (SAM II). The study's primary endpoint was the performance of the two groups at the simulator after participating in the virtual auscultation course or literature self-study. To evaluate their auscultation skills, students participated in five assessments using the same six pathologies: stenosis and regurgitation of the aortic and mitral valve, ventricular septal defect, and patent ductus arteriosus. Moreover, participants rated their satisfaction with each course and provided a self-assessment of competence. Results: Compared to literature self-study, participation in the virtual auscultation course led to a significantly improved description of heart murmurs at the auscultation simulator with regard to the presence in systole and diastole, low- and high-pitched sounds, and volume dynamics. There was no significant difference between the groups in diagnostic accuracy and identification of the point of maximal intensity. After the virtual course, students showed higher satisfaction rates and a higher increase in self-assessed competence compared to participants who engaged in literature self-study. Conclusions: For the first time, this study demonstrates that a case-based virtual auscultation course can improve aspects of cardiac auscultation skills on a simulator. This may facilitate the further acquisition of an essential clinical skill, even when contact restrictions will be lifted.

Implications of video chat use for young children's learning and social-emotional development: Learning words, taking turns, and fostering familial relationships.

Parents of young children use video chat differently than other screen media, paralleling expert recommendations (e.g., American Academy of Pediatrics Council on Communications and Media, 2016), which suggest that video chat, unlike other screen media, is acceptable for use by children under 18 months. Video chat is unique among screen media in that it permits contingent (time-sensitive and content-sensitive) social interactions. Contingent social interactions take place between a child and a partner (dyadic), with objects (triadic), and with multiple others (multi-party configurations), which critically underpin development in multiple domains. First, we review how contingent social interaction may underlie video chat's advantages in two domains: for learning (specifically learning new words) and for social-emotional development (specifically taking turns and fostering familial relationships). Second, we describe constraints on video chat use and how using chat with an active adult (co-viewing) may mitigate some of its limitations. Finally, we suggest future research directions that will clarify the potential advantages and impediments to the use of video chat by young children. This article is categorized under: Linguistics > Language Acquisition Psychology > Learning Cognitive Biology > Social Development.

Frequency of contact with friends and relatives via internet and psychosocial factors in middle-aged and older adults during the COVID-19 pandemic. Findings from the German Ageing Survey.

OBJECTIVES: Previous studies have examined the association between frequency of contact with friends and relatives via internet and psychosocial factors (in terms of loneliness, life satisfaction and depressive symptoms). However, far less is known about such a link during the COVID-19 pandemic, particularly based on nationally representative samples. Therefore, the aim of this study was to examine this association among middle-aged/older adults. METHODS/DESIGN: Data were taken from the short survey of the German Ageing Survey (June/July 2020, 3134 individuals in the analytical sample). The De Jong Gierveld scale was used to quantify loneliness, the Satisfaction with Life Scale was used to quantify life satisfaction and the 10-item version of the Center for Epidemiological Studies-Depression was used to quantify depressive symptoms. RESULTS: Regressions showed that-compared to daily users-less frequent users of the internet for contact with friends and relatives reported increased loneliness, lower life satisfaction and more depressive symptoms. With regard to covariates, better psychosocial factors were associated with medium education (compared to low education), living with partner in the same household (compared to singles), better self-rated health, and favourable COVID-19 factors (in terms of decreased feeling that the Corona crisis is a threat for oneself, not having an infection with the coronavirus and an increased feeling that you can influence an infection with the coronavirus yourself). CONCLUSIONS: Data suggest that individuals with a high frequency of contact with friends and relatives via internet reported better psychosocial factors. Future research in other cultural settings are required.

Telecollaboration in gerontology service learning: Addressing isolation & loneliness in a pandemic.

Social isolation and loneliness present significant challenges for the mental and physical health of older adults. Social distancing, mask wearing, and other precautions necessitated by the COVID-19 pandemic add to these challenges. This article details a telecollaborative service-learning project to engage older adults online and provide applied experiences for students. From March through October 2020, 54 students from Social Work (Master, Bachelor), the College of Osteopathic Medicine (COM; DO), and Occupational Therapy (Master) provided telephone support and Zoom™ based programming for older adults affiliated with the University of New England. Creative offerings were piloted weekly and debriefed on Friday afternoons in the spring, leading to more structured 8-week schedules in summer and fall. Peer-to-peer support took place between older adults with experience in video meetings and those willing to learn. Bidirectional and intergenerational benefits were noted as older adults and students navigated the exigencies of the pandemic and learned important lessons with and from each other to advance knowledge and improve quality of life.

Children's language abilities predict success in remote communication contexts.

Remote communicative contexts are part of everyday social, familial, and academic interactions for the modern child. We investigated the ability of second-graders to engage in remote discourse, and we determined whether language ability, theory of mind, and shy temperament predicted their success. Fifty 7-to-9-year-old monolingual English speakers with a wide range of language abilities participated in standardized testing and an expository discourse task in which they taught two adults to solve the Tower of London, one in an audiovisual condition to simulate video chat and a second in an audio-only condition to simulate phone communication. The discourse was scored with a rubric of 15 items deemed relevant to the explanation. Children included 27% to 87% of the items, with more items communicated via gesture than spoken word in both conditions. Gesture scores and spoken scores were highly correlated. Children specified more rubric items overall in the audio condition and more rubric items in the spoken modality when in the audio condition than the audiovisual condition. Performance in both conditions was positively associated with scores on independent measures of language ability. There was no relationship between performance and theory of mind, shy temperament, ability to solve the Tower of London, age, or sex. We conclude that 7-to-9-year-olds adjust the modality and content of their message to suit their remote partner's needs, but their success in remote discourse contexts varies significantly from individual to individual. Children with below-average language skills are at risk for functional impairments in remote communication.

Video chat usage and the Big Five in women during the COVID-19 pandemic.

As the COVID-19 pandemic has led to an exchange of face-to-face interactions for virtual meetings across many circumstances, research is needed to understand how individuals differentially respond to the increase in video chatting. The current study evaluated how the Big Five traits were associated with video chat usage, such as use of video chat services prior to and following the beginning of the pandemic, contexts in which participants used these services (i.e. social, family, work/school), and whether people engaged in appearance comparison when video chatting. Participants were recruited through Prolific and responded to a cross-sectional online survey (n = 438; M age  = 31.3; 100% women) assessing video chat usage and the Big Five personality traits. Higher extraversion was associated with greater video chat usage prior to and following the beginning of the pandemic, while neuroticism predicted more frequent video chat appearance comparisons when accounting for age and the other Big Five traits. Findings are discussed regarding the implications of these associations, as well as future research opportunities to extend current findings.

Virtual auscultation course for medical students via video chat in times of COVID-19.

Introduction: Auscultation skills are among the basic techniques to be learned in medical school. Such skills are achieved through supervised examination of patients often supported by simulator-based learning. The emergence of COVID-19 has disrupted and continues to hinder hands-on on-site medical training on a global scale. Project description: An effective virtual auscultation course was established in times of contact restrictions due to COVID-19 at the Medical Faculty of the Heinrich Heine University Düsseldorf. The interactive case-based webinar was designed to improve listening techniques, description and interpretation of auscultation findings in an off-site context. Clinical cases with pre-recorded auscultation sounds and additional case-based diagnostics were presented. The course focused on common heart murmurs including aortic and mitral valve stenosis and regurgitation as well as congenital heart defects (ventricular septal defect and patent ductus arteriosus). Results: The course was well received by the students and assessed as being useful and instructive. Assessment of learning effects, such as detection of pathological findings before and after training, is ongoing as part of a subsequent trial. Conclusion: Virtual interactive learning using a sound simulation lesson with clinical case presentations via video chat can well be used as a supplement to practical auscultation training. This learning format could also play a useful role in the curriculum of medical studies once contact restrictions are revoked.

Preschoolers Benefit Equally From Video Chat, Pseudo-Contingent Video, and Live Book Reading: Implications for Storytime During the Coronavirus Pandemic and Beyond.

During the unprecedented coronavirus disease (COVID-19) crisis, virtual education activities have become more prevalent than ever. One activity that many families have incorporated into their routines while at home is virtual storytime, with teachers, grandparents, and other remote adults reading books to children over video chat. The current study asks how dialogic reading over video chat compares to more traditional forms of book reading in promoting story comprehension and vocabulary learning. Fifty-eight 4-year-olds (M age = 52.7, SD = 4.04, 31 girls) were randomly assigned to one of three conditions (Video chat, Live, and Prerecorded). Across conditions, children were read the same narrative storybook by a female experimenter who used the same 10 scripted dialogic reading prompts during book reading. In the Video chat (n = 21) and Live conditions (n = 18), the experimenter gave the scripted prompts and interacted naturally and contingently, responding in a timely, relevant manner to children's behaviors. In the Prerecorded condition (n = 19), children viewed a video of an experimenter reading the book. The Prerecorded condition was pseudo-contingent; the reader posed questions and paused for a set period of time as if to wait for a child's response. After reading, children completed measures of vocabulary and comprehension. Results revealed no differences between conditions across six different outcome measures, suggesting that children comprehended and learned from the story similarly across book formats. Further, children in the three experimental conditions scored significantly higher on measures than children in a fourth condition (control) who had never read the book, confirming that children learned from the three different book formats. However, children were more responsive to the prompts in the Live and Video chat conditions than the Prerecorded condition, suggesting that children recognized that these interactions were contingent with their responses, a feature that was lacking in the Prerecorded condition. Results indicate that children can comprehend books over video chat, suggesting that this technology is a viable option for reading to children, especially during the current pandemic.

Corrigendum: Let's Chat: On-Screen Social Responsiveness Is Not Sufficient to Support Toddlers' Word Learning From Video.

[This corrects the article DOI: 10.3389/fpsyg.2018.02195.].

When Representation Becomes Reality: Interactive Digital Media and Symbolic Development.

One challenge of using an interesting object such as a scale model as a symbol for something else is children's deep interest in the object itself. Attending to the model (the symbol) as a toy, children do not use information about where in the model a tiny dog is hiding to mentally represent where a larger dog is hiding in the full-sized room (the referent). Young children use pictures in this way because they are relatively uninteresting as objects. Today, interactive images on touchscreens function as virtual objects on which to act and which respond to the user's actions. In this chapter, we examine how interactive symbolic media (e.g., touchscreens, video chat, augmented reality) might affect children's symbolic development and the way that psychologists think about representational objects. Young children's learning about and from interactive media may depend upon adults scaffolding children's use of these new cultural tools.

Let's Chat: On-Screen Social Responsiveness Is Not Sufficient to Support Toddlers' Word Learning From Video.

Joint engagement with a speaker is one cue children may use to establish that an interaction is relevant to them and worthy of attention. People on pre-recorded video cannot engage contingently with a viewer in shared experiences, possibly leading to deficits in learning from video relative to learning from responsive face-to-face encounters. One hundred and thirty two toddlers (24 and 30 months old) were offered referential social cues disambiguating a novel word's meaning in one of four conditions: responsive live (a speaker was present and engaged with children); unresponsive video (a speaker on video looked at the camera and smiled at scripted times); unresponsive live (although present, the speaker behaved as she did on the unresponsive video), and responsive video (a speaker on closed-circuit video engaged with children, as in video chat). Children of both ages reliably learned the word in the responsive live condition, and older children (30 months) learned in the unresponsive live condition. Neither group learned in the responsive or unresponsive video conditions. The results show that the addition of communicative social cues to the video presentation via video chat was not sufficient to support learning in this case. Rather, toddlers' transfer and generalization of words presented on video chat may depend on other contextual factors, such as co-viewers who scaffold their learning. Live, responsive video as implemented in this and prior studies is compared, with implications for the use of video chat via the Internet with young children.

Co-viewing supports toddlers' word learning from contingent and noncontingent video.

Social cues are one way young children determine that a situation is pedagogical in nature-containing information to be learned and generalized. However, some social cues (e.g., contingent gaze and responsiveness) are missing from prerecorded video, a potential reason why toddlers' language learning from video can be inefficient compared with their learning directly from a person. This study explored two methods for supporting children's word learning from video by adding social-communicative cues. A sample of 88 30-month-olds began their participation with a video training phase. In one manipulation, an on-screen actress responded contingently to children through a live video feed (similar to Skype or FaceTime "video chat") or appeared in a prerecorded demonstration. In the other manipulation, parents either modeled responsiveness to the actress's on-screen bids for participation or sat out of their children's view. Children then viewed a labeling demonstration on video, and their knowledge of the label was tested with three-dimensional objects. Results indicated that both on-screen contingency and parent modeling increased children's engagement with the actress during training. However, only parent modeling increased children's subsequent word learning, perhaps by revealing the symbolic (representational) intentions underlying this video. This study highlights the importance of adult co-viewing in helping toddlers to interpret communicative cues from video.