Information and support services for children aged 9 to 12 years. A mixed methods review
Systematic review
|Published
The purpose of this review was to synthesize Norwegian and international studies that can shed light on the wishes and needs for and experiences with information and sup-port services for children aged 9 to 12 years.
Key message
Children in Norway can reach out to various information and support services, without needing parental consent or referral from another service. To develop good services for children aged 9-12, it is important to acquire knowledge about the questions children in this age group want answers to, or help with, from people other than family and friends, as well as where and how they seek answers to these questions.
Our aim was to synthesise Norwegian and international studies that could shed light on the needs and wishes for information and support services among children aged 9-12. Both children's experiences and service providers' experiences with children's use or needs were included. We conducted a mixed methods systematic review, including studies published from 2015 to April 2024.
From the five included studies (three qualitative and two cross-sectional studies), we summarize that:
- Children who contacted support services were more often girls than boys.
- Children reached out to get information, to check what is okay or normal, to try out ways of talking about something, and/or to talk about and get confirmation of feelings.
- Children have a wide range of topics they are concerned about and seek contact for, including emotional difficulties, family relationships, social relationships, as well as violence and abuse.
The studies show that the age group 9-12 years is clearly represented among users of information and support services. However, no studies have asked the children about their experiences, needs, or wishes for these services. When (further) developing services, it is necessary to facilitate the evaluation of these services, also with data from children.
Summary
Introduction
Children aged 9-12 may have questions that they prefer are answered by someone other than family and friends. In Norway, various information and help services exist, which children can turn to without the need for a referral or consent from a guardian. What children aged 9-12 need information or help with, and where and how they turn to get help, are among the questions that are useful to know more about when services are to be established or further developed. The knowledge gained from this project will be used to develop good, quality-assured services in Norway, with the aim of informing, guiding and helping children in the target group.
Objective
The purpose of this review was to synthesize Norwegian and international studies that can shed light on the wishes and needs for and experiences with information and support services for children aged 9 to 12 years. Both children's own experiences and service providers' experiences with children's use or needs were included.
Method
We carried out a systematic review that included different types of study design, i.e., a mixed methods review. We chose this approach as we had a broad overarching objective and wanted to shed light on the topic from different perspectives, and we had sub-questions that could be answered with both qualitative and quantitative studies. Our inclusion criteria included: children aged 9-12 and service providers who provide information and support services to children aged 9-12; services designed to guide, give advice, help or information to children in the age group, without the need for adult consent or referral from another agency; and outcomes reported on the children's needs and wishes for and experiences with information/support services.
We performed an extensive literature search. The search for studies was for the period 2015 to April 2024 and included, among other things, the databases PsycINFO and Epistemonikos, searches in a number of Nordic science archives (Cristin, Idunn, VIVE, Diva, etc.) and a search in the OpenAlex data set. We also contacted all the Nordic services that are part of the Child Helpline International collaboration. Team members, with the help of machine learning functions, made independent assessments of the references’ titles and abstracts. Relevant full texts were screened by at least two team members for final inclusion. After retrieving data from the studies, we transformed quantitative data into qualitative descriptions and compiled the findings in an integrated synthesis. This part was carried out by one team member, checked by another, and then discussed by all team members.
Results
The literature searches yielded more than 10,000 references, while included studies were limited to five studies from Norway, Sweden, Finland, Belgium and Australia, of which three were qualitative studies and two were quantitative cross-sectional studies. One Norwegian study examined the school health service, one Swedish study looked social services at school, while the other three examined different variants of digital helplines. We considered two of the three qualitative studies to have moderate methodological limitations and the third to have large methodological limitations. We considered the two cross-sectional studies (prevalence studies) to have moderate and high risk of systematic bias. In the discussion, we have also referred to eleven Nordic studies that were identified in the search, but which had age groups that were wider than 9-12 years. Based on relevant Nordic contexts, these studies can contribute to supporting the knowledge base for the relevant services.
The overall aims of the studies were to investigate which children made contact, what they approached the services about, how they approached and how the services met the children or provided assistance. Our theme-based synthesis led us to four overarching themes: characteristics of the children, forms of contact, themes of contact, performance of the services. The main findings are:
- The sample in the studies had a somewhat wider age range than 9-12 years, but included age groups (or separate data) that were ca. 9-12 years. Girls were in the majority in the inquiries to the services (59-77% in four studies). No other characteristics, such as socio-economic background or ethnicity, were mentioned.
- In two studies, the forms of contact were physical meetings, and in the others digital via telephone calls, chat or e-mail. One study showed that two-thirds of children in the age group 5-12 chose to use the phone to contact the digital services.
- Two of the studies on digital helplines had a narrow thematic focus (inquiries related to sexuality or terror), while the other three studies covered all kinds of topics. One study on digital help services showed that children made contact about, e.g., emotional difficulties/mental health, family relationships, violence/abuse outside the family, social relationships and abuse/violence in the family, where violence and abuse made up almost 30 percent of the inquiries. A study from social services in Swedish schools found that the inquiries for 10-12 year-olds most often came from parents and concerned concerns about behaviour, neuropsychiatric symptoms and externalizing difficulties. In a small Norwegian study, the children made contact with the school nurse, often by presenting a physical pain as an introduction to raising various questions. The two latter studies had major methodological weaknesses and the knowledge about the physical services is spare.
- The way in which service providers respond to the children who make contact and what they offer were reported in all three studies dealing with digital help services and in the Swedish study from social services in schools. In the latter, the social workers reported the importance of building alliances with the children and helping the children through guidance, assessment, processing, treatment and crisis management. The Australian study measured changes in the service providers' time spent on the phone, chat, etc. The Belgian study found that the service providers emphasized informing and reassuring the children who approached them about terror-related concerns. The Finnish study stated that the service providers accepted the children's noisy inquiries which may seem provocative.
Discussion
With only five studies of different types of services from five different countries, we have limited information to answer what needs and wishes for information and support services children aged 9-12 have and what experiences they themselves or service providers have had the use of the services. It is also a limitation that none of the studies used children as informants.
From document studies and studies where service providers were informants, we observe some aspects that we assume are important. First, the findings show that boys approach less often. Furthermore, the findings indicate that the services must be able to handle a wide range of children's questions and needs. This also involves training service providers in a variety of topics for the areas of life and for issues related to the world situation. Based on our data, both service offers for physical meetings and digital services that are open to several forms of communication can be argued for, but we have no data basis for whether some are better than the others. Service providers' competence and communication skills are also touched upon in the studies. Even if some topics, such as anonymity for the service user and the services’ possibility of further referral, are mentioned to a rather small extent, these and other aspects that have not been studied, could have great importance for children 9-12 year olds who need information and none of the studies highlight questions related to the need for such services for the relevant age group, but we believe that the studies implicitly point to a need without being able to say anything conclusive about scope, structure or content.
This systematic overview indicates large gaps in the research about the needs, wishes and experiences of children aged 9-12 regarding information and support services. Despite the fact that such services are offered in many countries, and we have figures that indicate that 9–12-year-olds make up a not insignificant proportion of the users of the services, we found only five studies that shed light on this specific age group. Therefore, more studies are needed of both digital and physical services for children aged 9-12, differentiated by age, about their wishes and needs for services, including the wishes and needs of children who do not use the services, what promotes and inhibits children's use of such services, consequences when using the services and more.
Conclusion
Although information and support services are available for children aged 9-12, and there are indications that this age group is clearly represented among the users, there are no studies that have asked the children directly about their experiences or what needs and wishes they have for the services. In the (further) development of such services for this age group, we would recommend that practical arrangements are made for evaluation of the services – also with input from the children.
