Use of Methodological Critiques in Understanding effects of trauma on childrenIntroduction – Visual methodologies are a qualitative approach to psychological research. It is an overarching name for various methods such as drawing, art, mapping and photography elicitation. A relatively recent shift in child development research has encouraged the emergence of visual methodologies in research: on its own or paired with more traditional methods (GroundwaterSmith, Dockett and Bottrell, 2015). Providing a deeper understanding to quantitative results, visual methodologies consist of a variety of visual techniques to allow freedom in interpretation of a research question (Glaw, 2017). FURTHER INFO NEEDED ON WHAT VISUAL METHODOLOGIES CONSIST OF.This critical review will outline the rising use of visual methodologies in mixed methods and qualitative research within child development context; in this instance, research upon effects of trauma on children; reflection upon the incident and further emotional impacts by visual methods of photography and drawings. Method ApplicationIn the simplest of terms, visual methodologies are a collection of research tools that are used to interpret and understand images (Glaw et al., 2017). Through a process of theme framework, coding, interview elicitation and narrative research (Padros, 2011) visual methodologies are analysed very differently from quantitative experiments. Although seemingly more flexible than quantifiable data extraction, many approaches to analysis of visual methods involve creating a framework and identifying themes amongst the data, in a qualitative approach. An example of use of framework in photo elicitation involves asking participants about their approach to producing the image, the image itself and how the image is related to the participant (Guillemin, 2004). Dependent upon the study, researchers may use inductive or deductive methods in order to analyse participant data. Figure 1: Example models of inductive and deductive category development respectively (extracted from Mayring, 2000) When using alternative visual methods such as drawings, coding may also be used as an analytic tool (Onuc et al., 2009). Coding the presence of certain objects, or how something is depicted, can be used to generate quantitative data which can then be analysed numerically.When utilising qualitative methods, it is important that context of the research is considered. Often, more traditional methods are used within a laboratory setting, allowing for control of any extraneous variables. When analysing the resultant data from visual methodologies, reflexivity is key and researchers must recognise their role within the process of producing the data; for example, any assistance given to participants when using equipment (Radley, 2010). Additionally, honest identification of any contradictions made within the context surrounding the data and the data, or participants’ perceptions within the data. Overview of Methodological Strengths and WeaknessesVisual methodologies provide a fresh perspective, and a voice for those who struggle with articulating language, such as young children (Guillemin, 2004). Further to this, many aspects of experiences in which visual methodologies are aiming to research, such as trauma or pain, are difficult to express in single words, and therefore visual tools help to paint the experience with richer data. Adults are non-representative of children’s experiences (Punch, 2002) ; a study researching child’s pain experiences suggested that neither parents’ nor nurses’ assessment of child’s pain corresponded to the pain reported by children themselves (Kortesluoma and Nikkonen, 2004).Visual methodologies allow for a participant to self-reflect without the contractual limitations of structured questionnaires. The traditional researcher/participant dynamic is altered through the increased control of the participant in context of research. Participants are able to regulate the content of their data to an extent, and researchers are able to use this data to introduce topics into elicitation, allowing for flexibility in data analysis. Using visual research lends itself to participants for whom language is a potential barrier. Feelings, attitudes and tones can be conveyed more accurately and is not self-reporting is not solely relied upon. This is useful for research involving young children. Furthermore, the context of data can be monitored, proving visual research results can be more ecologically valid than lab-based settings. As visual methodologies increase in popularity, weaknesses are identified. As aforementioned, the researchers role differs, therefore it is vital that researchers monitor their influence (unintentional or otherwise) in participants’ data results (Punch, 2002) Rapport between participant and researcher is beneficial for collecting the richest data; this may mean that data collection can be more time consuming than more traditional qualitative methods. During research, obstacles can be present. Equipment needed for visual research can be expensive, and difficult to transport for field research. Additionally, further ethical concerns can arise, such as consent for photography in children, and being able to capture footage in controlled areas, such as developing countries. Photography in Child Trauma StudiesPrimarily used in anthropological research to study native cultures, photography is an emerging research tool used to gain data through the eyes of an individual or group; in this instance, children. There are several theoretical paradigms that can be used when conducting research with photography; what is becoming more prevalent in the psychology field is taking a constructivist approach to photography as a data source (Poveda et al., 2018) understanding that they embody the individual’s views, bias’, culture and any other influences. Auto photography tasks participants with taking photographs of their environment and utilising the actual photographs as research data. The aim is to capture the world through participants’ eyes with succeeding knowledge production. Allowing children access to a camera may allow them to communicate without verbal limits and without the constraints of self-reporting. Some children may find themselves unable to articulate how they feel; particularly children pre secondary, and this may allow them to convey a tone, atmosphere or feeling without the worry of misinterpretation. A child does not need to have a vast understanding of language to participate in studies using this tool.Photographs can be used as a resource within themselves, or as a tool in photo elicitation (Edmondson et al., 2018) to encourage further discussion upon the topic of the photographs, often used in health and trauma research. Photovoice, originally developed by Wang and Burris (1997) involves using commentary and is often used with older children. Participants are tasked with accompanying photos with a commentary – what it means and how it relates to the topic, for example. Although often used in a social context, Photovoice is becoming increasingly popular to understand how trauma impacts, not only children, but the community in which they live in from their perspective. An interesting example of this implementation is the use of Photovoice in Sierra Leone, understanding the impact war has had on former child soldiers (Denov et al., 2012). Although logistical issues arose, such as maintaining resources in difficult living conditions, Photovoice allowed a collection of rich data from the participants’ views themselves and became a useful tool in encouraging further discussion upon sensitive topics. Drawings in Child Trauma Studies-Drawings are a popular qualitative research tool for experiences of children within a health setting as an addition to any interviews or focus groups. In a study based in an Argentinian Children Hospital, chronically ill children were asked to draw diagnosis and treatment scenes, in order to research upon their perceptions of medical treatments (Johnson et al., 2013). The aim of the study was to subjectively explore the relevant adults, events and issues that contributed as difficulties to accessing and adhering to treatment. Figure 1 : Drawing of a room where lumbar puncture is performed (Felipe, 11 years, receiving treatment for Leukemia) (Padros, 2011)Initially, some older child participants were reluctant to draw, deeming it not socially acceptable at their age. The study conveyed benefits of combining drawings with interviews. The interviews helped to discuss and clarify features of the children’s drawings, whilst the drawings became raw data. Based on aforementioned theory framework of narrative research, the study provided results that conveyed a very different experience of oncology departments and illness for children, as opposed to their parents. This supports the notion that although shared experiences, children are affected differently from traumatic experiences (Punch, 2002) and visual methods are useful in exploring this. Children’s drawings of humans are increasingly seen as an indication of their emotional state. A recent study further looked at how the emotional state of a child post trauma affects their drawings, suggesting that children suffering from trauma tend to create darker coloured pictures (Oncu et al., 2009). It is therefore important to look not only at the content of the drawing, but the context it is in drawn in and potentially, the style in which it is drawn to explore the extent to which trauma has affected the child. Comparison of other research toolsA major issue with visual methodologies is lack of data on cognitive and biological changes following trauma. Alternative research tools explore how trauma impacts developing brains. Eye tracking can be used to produce quantitative data on how children process (ie faces) and how the development may differ if exposed to trauma in early childhood, for example, children tend to have less attentional control when exposed to trauma (Schoorl et al., 2014). Brain imaging techniques such as fMRI and EEG allow for biological changes within the brain to be monitored. This can help to identify developmental changes, and differences between typically developing children. Alternate qualitative methods may produce similar data output, however interviews and focus groups are usually conducted differently, usually more structured and led by adults and may be intimidating to children, as questions may be more direct in nature. Impact of Mixed Methods- Utilising a mixed methods study design will provide the richest data. One of the most useful ways to utilise visual methodologies in reflection of trauma impact on children, is to accompany it with biological and cognitive testing. In this respect, a range of psychological underpinnings can be examined, and this helps to create a vast knowledge base and reflect on how this has impacted children on a biological, cognitive and emotional level. Conclusion – Allowing a mix of qualitative and quantitative methods in childhood trauma studies provides the most contextual data. Although there remains limitations to visual methodologies, it is clear that in childhood studies, it allows the voice of the child to remain heard.