1.Introduction



Since the early 1970's, researchers have sought to utilise computers to elicit information in situations where paper-based questionnaires were previously used. Research has shown that subjects are likely to respond more truthfully to computer-based questionnaires than paper ones [Evans & Miller, 1969] [Johnson & Williams, 1977] [Koson et al, 1970]. This can be attributed to many factors, but the user-interface is undoubtedly the most significant. It seems that it is in some way easier to respond to a computer, perhaps less embarrassing, than to a real person.

Notwithstanding these encouraging results, early attempts at computer systems for the elicitation of information simply took a questionnaire and "put it onto a computer". Users were asked to read text which posed a series of questions and were invited to type their answers, or use the keyboard to select from a list of alternatives. Such interfaces were inflexible, unforgiving and uninteresting; three major sins in interface design. However, with the state of development of computer hardware at the time they were at the limit of what was achievable. As more computing power became available to developers, these systems were enhanced with features such as graphical interfaces, coloured backgrounds and multiple fonts, but the same basic questionnaire approach has still prevailed.

This thesis describes a software package aimed primarily at children, for the elicitation of information about feelings, places and people. The package attempts to make more imaginative use of the power and flexibility available in modern computer systems, and the techniques and observations which go to make up the field of human-computer interaction. The intention was not only to utilise the positive effect of computer-based systems referred to above, but also to include extensive use of graphics and sound to capture the child's interest. Beyond even this, the goal was to go beyond the traditional questionnaire approach, and allow an interaction between a child and computer more closely approximating to an interview. This demands minimisation of text-based communication, and enabling children to express themselves using more flexible, yet simple to use, alternatives.


1.1 History of The Project


In 1988, Dr. Rachel Calam, who was working at Alder Hey Children's hospital in Liverpool, was involved in interviewing a child that she suspected had been the victim of sexual abuse. The child in question was keeping quiet about something, and Dr. Calam was trying to find some way to lower the barrier to communication. At about the same time, Dr. Calam had borrowed a Macintosh Plus computer to use at home, and had noticed how easily her children had taken to using it. Dr. Calam thought that if there was a computer system which used Macintosh graphics to represent personal and family circumstances, such a tool might help the child to disclose information about abuse, and overcome the barriers to communication that occur when an adult interviews them.

Over the duration of the project there has occurred a significant growth in multimedia software designed for children for leisure and educational purposes - the so called "edutainment" packages. The aim in this project was to produce something more serious, something that would find out about the lives of children, and how they may be suffering from distress or harm. The initial goal was to produce a package which would help in the disclosure of child sexual abuse, but as the project progressed and the tools that were produced showed more widespread applicability, the aims widened, to include any area where ascertaining the feelings of children about people, places and events was of major importance.


In the case of this project, when interviewing a child the whole raison d'etre of this package was to give the child tools which were simple and easily understood, yet could provide the flexibility to identify and describe people, events, places and emotions. In order to do this, metaphors used in the design of this interface were based upon things that children would have come across, such as scrapbooks, comic strips and comic book characters. Some aspects of the basic methods of interacting with the Macintosh were suited to the task, and others required simplifying from Apple's original Macintosh interface in order to make interaction easier. Hence a number of adaptations were made, and new methods of interacting with the package were developed. At the same time, some areas of the study human-computer interaction were examined, and the lessons learned were applied to the design and implementation of the various modules of the package.

An important aspect of the package is that it is not intended to replace the skilled interviewer, but should act as another "tool" available to them. The package is designed to help develop a triadic relationship between child, computer and interviewer (see figure 1.1). Child and interviewer sit side-by-side in front of the computer, with the child operating the various modules of the package, and the interviewer able to offer advice and assistance when necessary. The interviewer can ask the child questions relating to items that have arisen during the interview, but since they are not face to face in a classic interview situation, the flow of information is easier, and the major axis of communication is seen to be between child and computer.


fig. 1.1 The triadic relationship - interviewer/child/computer.



The package underwent continuous development in the light of user-feedback. A number of the tools which were produced underwent significant changes as a result of user-testing, and new ideas also came about as a result of upgrades to the operating system of the Macintosh. As new facilities became available some of them were incorporated into the package (e.g. QuickTime - see Appendix B.11). The stages of development are summarised in figure 1.2. Ideas were conceived and developed into modules which were then tested on pilot groups. The results of the pilot studies then led either to new ideas, or to the refinement of the existing ones. Occasionally, ideas had to be discarded, even if they had undergone a number of refinements.


fig. 1.2 Stages of production of the package.

1.2 Overview of The Thesis



The next chapter summarises the psychological aspects of the assessment of pain, and of interviewing, and specifically the interviewing technique used by the team at Liverpool. Chapter three continues the examination of background material by examining some of the current work being carried out in the area of human-computer interaction. Chapter four examines the design of the computer-based interviewing aide which is the subject of this thesis, and how the various modules of it relates to the non-computer-based interview. Some of the early changes to the package are also detailed. Chapter five reports on results from trials of some of the program modules with children. Chapter six discusses improvements that have already been implemented, and chapter seven looks at possible future enhancements, and the conclusions gathered from the project.

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