Outputs from our co-production workshop

The Neurodevelopmental Disorders Annual Seminar was held in Edinburgh this year. During the event, we held a workshop called Overcoming barriers to co-production with children and adults with neurodevelopmental disabilities.

Many researchers feel unprepared to co-produce research with people with neurodevelopmental disabilities, while still believing in the value of co-production. This workshop aimed to address this gap, by giving researchers an overview of the main challenges to co-production and how to overcome them.

We had three excellent speakers:

Dr Laura Crane, co-director of Centre for Research in Autism and Education (CRAE) at University College London. In her talk, she explained her journey into participatory research methods, how research about autistic people has changed in the last few years, challenges and solutions to co-production work.

You can see her presentation on our YouTube channel here https://www.youtube.com/watch?v=qMSrhVBn4sk&t=27s

Ailbhe Mckinney talking and Sarah O’Brien on the big screen giving her views during the discussion part of the workshop

Next, we had Sarah O’Brien, a PhD researcher at Kings College London. She talked about co-production from the perspective of conducting it as a facilitator but also being involved as an autistic and dyspraxic individual. She talks about what she learnt along the way. 

See her talk here: https://www.youtube.com/watch?v=ZaBizLjR0rI&t=346s

Finally, we had Emma Pauley, who is a parent and co-production advocate. She talked about being involved in genuine co-production and then, tokenistic co-production. She spoke about how it was easy for her to see the difference and how they made her feel. 

In the afternoon of the workshop, attendees (45 researchers in the area of neurodevelopmental conditions) discussed challenges and solutions to co-production across six themes: 1) Recruitment and Partnership building, 2) Payment, Expectations, and Trust, 3) Facilitation of co-production with adults, 4) Facilitation of co-production with children and adolescents, 5) Evaluation or 6) Dissemination and public engagement. 

Over July and August we will be posting two blog series summarising the outputs from this workshop: starting this week with the: ‘Insights from Researchers on Co-production blog series. and then, later in the summer Emma Pauley’s series ‘Insights from a Lived experience on Co-production blog series’

This workshop was funded by the University of Edinburgh College of Medicine and Veterinary Medicine Public Engagement Seed Fund through the Institutional Strategic Support Fund.

Update on EPIC activities

We have been a bit quiet on the EPIC blog of late as we have been very busy with a number of activities!

We are working hard on developing new booklets! These will be added to the collection of understanding ADHD and DCD and strategy booklets we have already posted on our website. Our new booklets will be suitable for all neurodivergent children. This means they will be suitable for children who have difficulties in their thinking, learning and wellbeing who have no diagnosis or multiple diagnoses or difficulties that go beyond a current diagnosis. Many children fall into these categories as waiting lists for assessments can be long and in our work we continually hear from parents and teachers about the need for information to help these children now while they are waiting on assessment and support.         

We have also recently received funding to make a video version for parents and teachers of the EPIC booklets highlighting the ways in which these children can be supported and we hope to release that on our website in late autumn.

From next week we will be posting a series of posts again for parents and teachers that describes recent research we have published about children’s understanding of ADHD and strategy use in the classroom, understanding the relationship between thinking processes and maths learning, and an overview of how ADHD stimulant medication works on thinking processes.  

From next week we will also be posting two interlinked series of blogs that relate to the importance of children with conditions, their families and those who care for them being involved as active decision makers in the process of research studies. These series’ will involve one directed to researchers ‘Insights from Researchers on Co-production blog series’ involving 4 blog posts written by PhD researcher Ailbhe McKinney on topics from evaluating involvement of the public in research to best practices in dissemination. A second series ‘Insights from a Lived experience on Co-production blog series’ involves 3 blog posts from Emma Pauley who has lived experience. She will cover the importance of families affected by disability in being at the heart of what is researched, informing how studies are carried out and how the researcher best reaches families with the findings.  We will also be launching our YouTube ‘EPIC’ channel with videos and presentations about research and advice for parents and teachers.

Myths around ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is often misunderstood. The myths that surround ADHD never seem to go away despite a huge amount of research into the causes, characteristics and treatments for ADHD. Most psychological disorders do have myths around them though – such as the image of all autistic children having amazing memories like the actor in the film ‘Rainman’. The myths surrounding ADHD may be in part have arisen by the name we have for the disorder i.e. ‘attention deficit’, and the fact that people tend to see behaviour first. In this blog post some of these myths will be addressed. Looking at these myths in relation to research evidence is important as without an accurate understanding of the difficulties children with ADHD show, it is very difficult to support these children effectively.

A common myth is that most or even all children with ADHD will grow out of their difficulties. Some children do of course show reduced symptoms with development but research has shown that the story of developmental changes in ADHD is complex. In one research study, children were followed up after a 4 year period and asked to complete a set of thinking tasks tapping memory, planning, attention flexibility and controlling responses.  On some of the tasks, such as on a long-term memory task where children had to remember patterns and later recognise them, the children caught up with their peers. On another task where children had to use a strategy to keep and update information in their ‘working memory’ they showed improvements with age but didn’t catch up to the levels of their peers. On other tasks, such as those assessing being able to keep information in memory over time there was evidence of continued difficulties. This research shows that the story of ‘growing out of ADHD’ is not a straightforward one.

Some statements you may have come across about ADHD might include ‘ADHD mainly affects behaviour’, ‘ADHD is a childhood condition’, and ‘attention difficulties explain the thinking (‘inattentive’) part of ADHD’. In fact these are myths in the specific sense. While many children with ADHD do have behavioural difficulties, thinking and learning difficulties are very common and often underlie behavioural difficulties that are seen. Obviously the name ‘attention deficit’ suggests that difficulties in attention explains the thinking part but in reality this accounts for only a small part of the difficulties. Research has shown that many of these children do not have a specific attention difficulty at all – at least in terms of how psychologists measure attention.

Children with ADHD often show difficulties in thinking strategically – what we refer to as ’executive functions’. The thinking difficulties associated with ADHD are much broader than executive functions too though. Children with ADHD often show memory difficulties including basic memory processes and not just the more strategic kind of memory associated with executive functions. Other difficulties or differences can include perception of time (and a range of aspects of timing), being able to self-regulate, having an aversion to delay, and being variable in responding.  

An important issue to emphasise is that children with ADHD differ from one another. We now know that many children with ADHD show difficulties in executive functions for example but not all do, and those that do can differ in the areas they have difficulty in. Some may have difficulties in ‘working memory’ (a mental workspace where we hold and organise information in our mind) and others with planning. Other children may have a difficulty in using their attention flexibly and/or being able to control their responses. Children with ADHD have different strengths and difficulties and it is important we understand these children on an individual basis for that reason. In our ‘Understanding ADHD’ booklet, we describe a range of these strengths and difficulties and in our linked Strategy booklet we outline ideas for how to support children with their particular set of difficulties.   

ADHD is often spoken about as a condition that occurs on its own. Most children with ADHD show difficulties in other areas. Often these will relate to a second or even third diagnosed condition but children with ADHD often show symptoms of another condition but do not meet criteria for a diagnosis. These symptoms may still impact their thinking, learning, behaviour and wellbeing though. These difficulties may include the sensory difficulties we would associate with autism, or fine or gross motor difficulties we would associate with dyspraxia/DCD. Children with ADHD are also more likely than their peers to show specific learning difficulties such as dyslexia. Understanding these common co-occurrences is critical to fully support a child with ADHD.

A few years back members of our team were involved in a large scale research priority exercise (called a James Lind Alliance exercise) with young people, their families and health and education practitioners across a range of areas of learning difficulty including ADHD. Several of the top questions families and professionals felt were a top priority for research focused on how do we optimally support these children for best outcomes. A huge part of tackling this question involves the need to dispel these common myths and to understand children with ADHD based on research evidence. This research, which shows that ADHD is associated with a wide range of difficulties and that children differ from one another in their specific profile of difficulties, highlights the importance of taking an individualised approach to supporting children with ADHD.

Visual photo credit: Photographer valentinrussanov via Getty images.

Thinking skills and literacy in children with ADHD

We have recently published systematic reviews about thinking skills and their relationship to difficulties in maths and literacy in children with ADHD. Today we will summarise the findings of the review that focused on literacy. So first of all, what is a ‘systematic review’? A systematic review is a summary of all of the literature that has been published on a specific topic. The authors make decisions before hand about criteria that the research studies must meet such as for example that the review will include children in primary school only or who have a confirmed diagnosis. The authors then comprehensively search all of the available literature with those criteria and arrive at a final set of studies to be included. In our literacy review, we also did what is called a ‘meta-analysis’ – this involves doing a statistical analysis on the data produced by the studies in the review that combines them. Both a systematic review and a meta-analysis are therefore important ways of putting together and understanding a research area that draws on as much robust studies as possible. The conclusions made then reflect the studies across that field rather than a conclusion that comes from a single study result.

The review we are going to focus on today was on the topic of thinking skills and literacy. We chose to examine studies that focused on literacy broadly and not just reading as we know that young people with ADHD, their parents and teachers often make comments that difficulties lie beyond reading. This makes sense if you think about writing for example and the importance of planning in creating a story that has a beginning, middle and an end.

So what did our review and meta-analysis find? Using our criteria we ended up with a review that included 6 studies. The age of participants in the studies ranged from 6 to 16 years with an average age of 9. We found there was a fairly small set of studies conducted that met our criteria and had looked beyond reading to other aspects of literacy. Researchers mainly focused on ‘working memory’ (the mental workspace where you hold and organise information for a brief time), but some also looked at ‘inhibitory control’ (difficulty with avoiding distractors and generally controlling responses). Attention was also examined and several included measures of ‘processing speed’ (how long it takes to get something done). Surprisingly given our example above none of the studies had included a measurement of planning or broader organisation skills.

What did the review and analysis find then? We found a series of relationships between different aspects of literacy and thinking skills. Poorer working memory skills were linked to a wide range of aspects of literacy difficulties including word reading, reading comprehension (being able to understand what is being read), writing and spelling. What this means is that if a child has difficulties in working memory they are likely to need supports and strategies in place when doing tasks that involve literacy. Having difficulties in inhibitory control, which we know is a key characteristic of many children with ADHD, was related to poorer spelling. Attention was only examined in one study and was found to be associated with reading. Processing speed, or how long it takes to get something done, was not consistently linked to literacy, although may be relevant for writing. We concluded that much more research needs to be done on this important topic.

Understanding thinking difficulties and their relationship to literacy is really important in arriving at suitable supports and strategies for optimising literacy learning for children with ADHD. In our Strategy booklet we describe a range of techniques to encourage children to practice these thinking skills and strategies that can be used to help children engage optimally with their academic learning.

The full paper can be found here: https://bpspsychub.onlinelibrary.wiley.com/doi/epdf/10.1111/bjdp.12395

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Helping children with their thinking skills across settings

We have been blogging about EPIC over the last few weeks introducing the ideas behind our approach.  

Last time we blogged about two of the central foundations of EPIC –our approach being individualised and taking what is called a ‘transdiagnostic’ apporach. Today we are going to discuss the importance of embedding change across contexts.  

In order for activities to be most effective for children, it is best that they are carried out across the settings they spend time in. Using and practicing the strategies we have described in our Strategy booklet at home and at school can help to make them routine and a child’s go to.

An example is encouraging children to practice planning. Most children as they develop begin to naturally use methods to help them plan out tasks or activities. Some children with developmental difficulties forget to do this and it makes starting, staying on, and completing a task or activity difficult. In our ‘understanding’ booklets, we describe how parents and teachers caring for children with developmental difficulties can be aware of this thinking difficulty so they know they must encourage the child to put steps in place to help them complete tasks. They can also use external strategies like planners, diaries and mind-maps to help them think about and practice planning.

In the home, everyday toys like Lego and craft activities are excellent ways to promote planning. In our strategy booklet (e.g. page 38) we describe steps that can be taken to promote the use of planning like drawing out what you plan to make with Lego pieces and working out what pieces you will need before you start. Games like ‘Connect 4’ and ‘Guess Who’ can be used to remind children about the importance of planning by chatting through about how you plan your moves before you make them. Many craft activities are also useful. Children can be encouraged to think about the final goal, plan out their use of materials before starting, and break the tasks into steps or stages to help them stay on task and complete the goal. Baking, and cooking in general, with children is also an excellent way to model planning – ‘what are all the ingredients we need before we start?’. When we bake we can engage the child in breaking the task into steps and encourage them to work towards an end goal – the cupcakes coming out of the oven!

In school, there are many routine activities that lend themselves to planning. Doing a book or chapter review is a great way to encourage children to reflect and to break a story into parts.  Mind-maps are a visual way to organise thoughts and ideas. They have a focus in the middle with ideas or themes branching out from it. The branches can be used to represent relationships between ideas.  A mind-map can be used to plan out the writing of a story – in the middle could be ‘my story’ with the branches indicating ideas for the beginning, middle and end and of course this could be words or it could be pictures depending on the age and ability of the child.      

The knowledge and strategies children gain from these activities can upskill them in new scenarios they encounter where planning skills and aids can be beneficial. Although our posts are often especially useful for children with developmental difficulties these skills are important for all children and we encourage a whole class or family approach when using them at school or at home.

In the next few weeks, we are going to blog about research evidence on children with developmental difficulties starting with a piece on ‘myths around ADHD’ and then a post about stimulant medication and ADHD. Academics write about their research in journals that are often not accessible to the very people who would gain most from hearing about the research. Over the next few weeks we will blog about some of this research in a style that is suitable for all people. It is very important to us that parents, teachers and all those caring and working for children with developmental difficulties have information to hand that can help them understand a child’s condition or difficulties but also that helps them to offer opportunities and strategies for the children they care for.  

We hope you find our booklets useful. Do please contact us with any feedback you have! 

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Taking an individualised approach when helping a child with developmental difficulties

The EPIC intervention and use of associated materials aims to facilitate optimal thinking, learning, and wellbeing in children and young people. Today we are going to cover a further aspect of EPIC: taking what is called an ‘individualised transdiagnostic’ approach.

The EPIC approach is individualised. It is important that psychoeducation and strategies are based on a child’s strengths and difficulties and not assumptions about their diagnosis. As we have mentioned before research has shown that not all children with ‘Attention’ Deficit Hyperactivity Disorder actually have an attention difficulty. They may act distracted because of a difficulty in memory for example. We need to look beyond the diagnosis because as the saying goes ‘if you have met one child with ADHD you have met just one child with ADHD’. We know from decades of research that children with the same diagnosis can ‘look’ very different to one another. An example is ’executive functions’ – which are thinking processes we engage to organise ourselves and to help us to achieve goals. There are different types of executive functions. Memory – especially using strategies or organising your memory is one example. Another example is being able to use your attention flexibly – for example in moving easily and flexibly from one part of a task or an activity to another. These seem very different – but both are part of the concept of executive functions. Some children with ADHD have a difficulty in one of those processes, some the other, some both, and some actually neither of them. This means we need to be careful about making assumptions of what a child’s thinking difficulties will be, based on the label a child has. The label is a guide but we need to ask further questions about what it is for that child that distracts them – attention, memory, sensory processing or something else? See our booklets for more information on this.      

Many children with a particular developmental condition show difficulties associated with another. Even if a second condition has not been diagnosed, a child may still show difficulties associated with a different disorder that are making life difficult for them. A common example is a child with ADHD showing sensory processing difficulties we normally associate with autism or dyspraxia/DCD symptoms or diagnosis. A child with ADHD may act distracted and can’t focus and of course it would look very much like an ‘attention’ difficulty. Actually though the child may have sensory processing difficulties and they are distracted by particular noises that occur in the classroom or at home. It is important we take an individualised approach and assess what the specific difficulties are that an individual child is experiencing. Our booklets detail lots of ideas and activities as to how to identify what the underlying difficulty might be. Our strategy book describes ways then that these difficulties can be helped.  

We hope you find our booklets useful. Do please contact us with any feedback you have! 

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Personalisation

We have published free downloadable materials for parents and teachers to help with thinking and learning in children and young people especially for children with developmental difficulties. Yesterday we blogged about a key feature of EPIC – multiple areas of difficulty and we wrote about our play, game and activity based focus.   Today we are going to cover personalisation and will also write about active learning.

At the heart of EPIC is personalisation. How can we best engage children to improve their thinking learning and wellbeing? We advocate using the items that are personal to a child such as toys they play with or items they collect. We have for example used nerf guns to help children learn high frequency words! A parent or teacher could write out a series of words for example ‘th’words – the, they, there, them – put them up on a door and ask the child shoot at them on calling each word out! Children who love lego can be easily engaged in maths by using lego to represent numbers with coloured pieces used to represent ‘chunks’ or groups of information. We include many more examples in the Strategy booklet.   

A child’s active participation in their learning is critical for all children but especially important for children with developmental difficulties. It is important the child ‘does’ the activity in addition to listening to information. In our strategy booklets we detail examples like this that many teachers routinely use in this way such as ‘rainbow writing’ and ‘stepped writing’. When we conducted interviews and workshops with teachers as part of the development of EPIC, teachers described the range of strategies they use and we found lots were being commonly used by all but some teachers used strategies that others weren’t using. We were able to document them in our booklets to ensure that teachers can learn from other teachers’ effective use of strategies.  Of course parents can also use these strategies to help with their child’s thinking and learning.    

We hope you find our booklets useful. Do please contact us with any feedback you have! 

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Multiple areas of difficulty and neurodevelopmental conditions

The EPIC intervention and use of associated materials aims to facilitate optimal learning, behaviour, wellbeing and mental health in children and young people. We recently blogged about strategies paired to areas of difficulty.   Today we are going to cover a further key aspect of our approach: targeting multiple areas of difficulty.

Children with neurodevelopmental difficulties most often show multiple thinking difficulties. It is a myth for example that children with ADHD just have a difficulty with attention. Indeed research has shown that many children with ADHD do not have an ‘attention’ difficulty at all. Many children with neurodevelopmental conditions show difficulties in being able to hold and organise information in memory, in automatically using strategies when they are needed, and in other areas like organisation and planning. Some children act distracted not because of a thinking difficulty but because they have sensory processing difficulties and of course classrooms can be noisy places. We emphasise identifying as many of the areas of difficulty a child has and undertaking psychoeducation and using strategies across these components.

How best can we engage children to understand their difficulties and to practice ways to overcome them? EPIC takes a play, game and activity based approach to achieve this. Games that are available routinely in homes like connect 4, snakes and ladders and guess who can be used to identify a child’s thinking difficulties and to practice ways of overcoming them – see our Strategy booklet for examples.  Routine household items can also be used as featured in our ‘tea towel’ memory game and ideas around baking and crafting.  See the booklets for more information on these strategies.

We will post about more of the EPIC underlying principles over the next few weeks. We hope you find our booklets useful. Do please contact us with any feedback you have! 

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Strategies to help with thinking skills

A central part of the EPIC approach is the use of psychoeducation and pairing of that knowledge with suitable strategies for facilitating optimal thinking, learning and wellbeing.

Once the child, parent and/or teacher are aware of a child’s difficulties, strategies can then be paired to difficulties to meet an individual child’s needs. In our Strategy booklet, we detail many examples of games and activities that can help with a child’s awareness of their thinking difficulties and easy tips and tools they can use to overcome them. Our current booklet has been developed for teachers but is also suitable for at home use by parents. In our next phase of EPIC we plan to co-produce a strategy booklet specifically for parents working with parents to do so. All of our work has evolved from what is called a ‘co-production’ model – working with children and young people, parents, teachers and clinicians to ensure our research priorities, practices, language use and materials are directed by those that will use them.

The strategies we detail include those that involve internal thinking strategies and external aids. Internal thinking strategies include for example ‘chunking’ which involves grouping or listing things based on similarity. If a child has to hold in mind a series of numbers they could chunk them into something meaningful – 1045 – my brother is 10 and my Dad is 45. Chunking in reading can help to not overwhelm a child with a long piece of text. Seeing the text as broken up into meaningful parts can also help with understanding.

Another technique to help memory is use of ‘mental imagery’. This is when a child creates an image in their mind to make things more vivid. It can also be used to remember to connect different bits of information. If a child for example is writing a paragraph that has to include a child, a dog and an ice-cream they could picture themselves holding an ice-cream and the dog takes a lick!

External strategies can also be useful such as the use of diaries or planners. These can help to reduce information that has to be remembered but also to plan out tasks and divide into steps. A mini-whiteboard can be a particularly useful tool for children with thinking difficulties. The use of ‘mind-maps’ can also help with planning and organising information meaningfully. A mind-map is a diagram or picture where information can be grouped and it can be linked. Colour and images can be used to help organise and display information.

Please see our booklets for more information on these strategies. We will post about more of the EPIC underlying principles over the next few weeks. We hope you find our booklets useful. Do please contact us with any feedback you have! 

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How can researchers encourage teaching professionals to get involved in research?

This blog post is pitched to researchers and how best to encourage teachers and other education professionals to get involved in research. The work described in this post was funded by a Wellcome Trust, University of Edinburgh, Institutional Strategic Support Fund award.

Administering interventions through schools is a promising strategy for improving the wellbeing and learning of children with mental health problems or neurodevelopmental diagnoses, like attention deficit hyperactivity disorder (ADHD), autism, dyspraxia/Developmental coordination disorder (DCD), dyslexia or for children who are born preterm. For these interventions to be developed and tested, the involvement of teachers, head teachers, teaching assistants, pupil support officers, guidance counsellors, and other education professionals are essential. Yet, these stakeholders are often stretched thinly and often turn down research as they are worried it will take up too much time with few gains. How can researchers motivate and encourage teachers and other education professionals to get involved in research?

We held a ‘Knowledge Exchange’ workshop with primary school teachers to understand why teachers choose to take part in research and how we can encourage more to do so. The workshop also included an update on our research findings and some myth busting around ADHD, making it a knowledge exchange workshop with mutual benefit. Their insights are organised by theme below:

  1. Pointing out that involvement can be a part of Continued Professional Development

Researchers can remind teaching professionals that their involvement in research can be a part of their continued professional development. For example, the General Teaching Council for Scotland encourages teachers to take part in Professional Learning such as online learning, professional dialogue with colleagues, critical analysis of reading, masters courses, or attending conferences. Research engagement also counts as professional learning.  Researchers can point out that teachers can log their research participation in their professional learning records. Teachers are guided by the Professional Standards when selecting learning opportunities. Researchers can highlight that their research is in line with the professional standards and therefore teachers can appropriately log it as their professional learning. For example, one teacher in our workshop mentioned learning about strategies for helping children with ADHD (the focus of the research project they were involved in with us) was in line with the social justice and professional commitment section of the Professional Standards. For more information see the General Teaching Council for Scotland’s page on Professional Learning.

  • Sharing new strategies for problem solving in the classroom

Teachers mentioned that they were more likely to take part in research if it is likely to directly benefit their classroom, for example in helping them develop new strategies for teaching children.  All teachers mentioned the main reason they took part in our research study was because a child in their class had the developmental diagnosis (ADHD) we were researching in that particular project, and they wanted to improve the strategies they use with them. However, they recognised that the strategies could be used to help children with other neurodevelopmental conditions or children struggling for any reason (e.g. mental health difficulties, problems at home). One in five children have a neurodevelopmental condition and so it is likely that a teacher will have a pupil in their class who needs extra support. Yet, there is little formal training on teaching neurodivergent children. Even in some school communities where there is a focus on improving outcomes for children with neurodevelopmental conditions, they often focus primarily on autism forgetting other disabilities, our workshop teachers pointed out. Therefore our particular focus in the research project we had engaged with them – ADHD, a condition associated with a lot of myths and uncertainties, attracted the teachers to take part. Researchers can remind teachers of the direct impact taking part in research may have on their understanding of their pupils, their teaching practice, or their approach to dealing with problems in the classroom.

  • Being flexible and transparent with timing

Teachers mentioned the main reason they would not take part in future research was being asked during a busy time of the year. Some teachers shared they were initially hesitant to take part because they were worried it would take up too much time. The start and end of term were highlighted as particularly inconvenient times. It is important to point out the teachers are not just concerned about time flexibility for their own schedules but often do not want their pupil’s routine to be disrupted or miss a certain lesson. For example, the idea of a researcher only being available at one time meaning the child missed P.E./gym class was not attractive to participation.

Teachers mentioned it was helpful that our research team was flexible with timing, offered a lot of time slots, and generally worked around the teachers’ schedule. Online meetings and workshops offer convenience in eliminating travel time, but it was also mentioned that face-to-face work is more meaningful. Following completion, teachers said that it was not as time consuming as they thought it would be. Researchers should mention in their initial email to teachers exactly how much time it will take up, offer flexible timing, and aim to contact them at less busy times of the term.

  • Explaining the wider implications of the research

Teachers were pleasantly surprised to learn that this research taking place across schools in Edinburgh would be published in international journals, shared around the world at conferences, and had the potential to help many more children in the future. Researchers can mention the impact of a project and the long-term implications of the teachers’ contributions. In this way, instilling a sense of pride, well-deserved in any case, facilitates motivation to take part. Teachers also mentioned it was empowering to be asked for their view throughout the research as opposed to being a passive party in the process. Explaining to teachers that their contributions will ultimately improve the research (in our case the design of an intervention) by making it more accessible and feasible for other teachers is another point to highlight if applicable.  

At the onset of the recruitment, researchers can cover these points when explaining the project in their initial email or phone call.  We believe that highlighting and considering the above points when developing a partnership with teaching professionals will result in a symbiotic relationship conducive to research.

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