Using storybooks as a rehabilitation technique for poor socio-emotional skills

Objective: The main aim of this study was to determine how children best learn about emotions. This knowledge will aid the development of a socio-emotional rehabilitation program for children with traumatic brain injury (TBI), so a secondary aim was to understand how children with TBI gain emotional knowledge. Although the involvement of TBI children was exploratory in nature, it was hypothesised that all children would learn more about emotions when information was presented verbally, rather than pictorially.

Method: A total of 76 children (50-80 months) participated in this study. Typically developing children (n = 59) were recruited from local Hobart primary schools and children with TBI (n = 17) were recruited from the Royal Hobart Hospital (RHH). Parents were contacted if their child presented to the emergency room with a head injury between January 2009 and September 2011. A storybook was developed to assess children’s understanding of facts and emotions. Children were either shown the verbal (n = 35) or pictorial (n = 41) story, and required to answer factual and emotion-based questions about events in the story. Children were also administered the Peabody Picture Vocabulary Test (PPVT-III) to covary for receptive language skills.

Results: A mixed ANCOVA (2x2x2) was conducted. There was no significant main or interaction effect for group, however a significant interaction effect was apparent between question type and PPVT-III, F(1,71) = 4.52, p < .05, ƞ² = .06 as well as question type and story type, F(1,71) = 4.39, p < .05, ƞ² = .06. the means indicated that children’s performance on factual questions did not differ between story types, whereas children’s performance on emotion questions increased significantly when they were given the words-only version of the story book as opposed to the pictures-only version.

Conclusion: The results suggest that regardless of TBI history, children learn more about a storybook’s emotional content from the verbal narration as opposed to the pictures. This indicates that socio-emotional rehabilitation programs for children with TBI should focus on teaching children about emotions by using words to describe contextual information rather than pictures.