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Children's views of older people.

Worldwide demographic change means that the responsibility for an aging population will fall to younger generations. This narrative literature review comprises an international examination of what has been published about children's views of older people between 1980 and 2011. Sixty-nine academic articles were inductively analyzed, and the emerging themes were ageism, contact with older people, children's media, children's perceptions of older people, intergenerational studies, children's perceptions of older people's health conditions, and culture, ethnicity, and worldwide studies. Reports about children's views were influenced by research methods, the children's familiarity with whom they were being asked to describe, their prior relationships with grandparents and other significant older people, and their stage of development. Eighty percent of the articles were based on American research and were often guided by a concern about ageism. Although children adopt stereotypes, they do not appear to be ageist. Research needs to include a wider geographical and cultural spread of children, children's understandings of the lived experiences of older people, and an exploration of the effects of culture, faith, and socioeconomic status on children's views if it is to underpin effective education that equips the next generation to humanely support the older populations of the future.

Keywords: child voice, social interaction, intergenerational activities, multi-age grouping, stereotypes

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Traditionally, older people were venerated for their experience and wisdom. After the 1930s, however, attitudes began to change in many "Western" societies. The diminution in the social status of older people paralleled an increased focus on youth and was underpinned by economic, social, and political changes (Johnson, 1995). Phillipson (1991) explained how during the 1970s, the rise in oil prices, economic decline, raised unemployment, and high inflation led to older people being characterized as a burden on public finances. The study of older people emerged during the late 1970s and focused on the older person's deficits as measured against a biological or social "norm." Geriatrics identified medical problems, such as dementia, and gerontology identified social problems, such as loss, institutionalization, or loneliness. Defining any population in terms of deficits alone makes that population vulnerable to being blamed for wider social, political, or economic difficulties, thus fueling negative discrimination. It wasn't until the 1980s that the social model developed into one that focused on the structures of society and recognized that older people's experiences were often shaped by the wider physical and social environment over which, as individuals, they had little control (Phillipson, 1991; Townsend, Davidson, & Whitehead, 1988).

Today, as the world tentatively emerges from economic recession, concerns about the rising older population are evident. The United Nations (2002) reported that, across the more developed regions of the world, there are likely to be double the number of older people compared to children by 2050. According to the World Health Organization (WHO; 2011), the rising number of people older than age 65 years across the world is associated with an increased prevalence of major health issues, such as dementia, cardiovascular disease, and cancer. Consequently, health and social care costs could outstrip national infrastructures. By 2035, there will be 2.6 million more older people in the United Kingdom than younger (Office for National Statistics [ONS], 2012). Age UK (2011, 2012) described the care of older people as having reached a "financial breaking point," with 34% of individuals age 65 to 74 years and 48% older than age 75 having a limiting longstanding illness. The social and economic responsibility will fall to the younger generations, making intergenerational understanding and support an urgent issue. It is in this context that this article examines children's views of older people that, in turn, can help to inform children's education about older people and their needs.

Age Concern UK commissioned a recent European Social Survey with 55,000 people, age 15 years and older, across 28 European countries, finding that 44% of respondents thought that age discrimination, of young and old, is a serious problem (Abrams, Russell, Vauclair, & Swift, 2011). People older than age 70 years are attributed the lowest social status, as contributing little economically (57%) and being a burden on the health care services (49%). Compared to other age groups, older people are more likely to be described as friendly and having high moral standards but also as being incompetent. People's views of an age group are more positive the closer they are themselves to that age group. The survey suggested that the U.K. population is particularly concerned about not being prejudiced toward other age groups. Perhaps this can be partly explained by the findings from an earlier U.K. study in which 1,843 people age 16 and older were interviewed (Ray & Sharp, 2006). One in three replied that those older than age 70 were viewed as incompetent and incapable and that prejudice was higher than 5 years previously. Thirty-three percent felt that the demographic shift toward an older society would "make life worse." Neither the European nor U.K. surveys examined the views of children.

In England, teachers are being asked to create learning experiences that will enable children and young people to positively adapt to population changes due to factors such as immigration and the aging population. The English Framework for School Inspection (Office for Standards in Education in England, 2012b) stated that inspectors of mainstream schools and academies will consider the spiritual, moral, social, and cultural development of pupils at school. In response to concerns about bullying and prejudice-based language in schools (Office for Standards in Education in England, 2012c), teachers are expected to provide a wide range of opportunities to develop pupils' knowledge and understanding of diversity so that they can be helped to develop sufficient empathy for others. Lessons in personal, social, and health education (PSHE) and citizenship need to include learning about individual differences and diversity, and schools need to provide evidence that they support pupils with developing and maintaining healthy relationships within a range of social and cultural contexts, that they encourage pupils to respect equality within a diverse community, and that they tackle prejudice with vigor (Office for Standards in Education in England, 2012d). The citizenship curriculum (Department for Education [DfE], 2011a) includes enabling pupils to engage in discussions about rights, responsibilities, and democracy. Children and young people are encouraged to challenge injustice, inequalities, and discrimination and become active citizens who contribute to community cohesion and social justice. To be judged as outstanding, schools need to provide evidence that pupils are able to work constructively with others in exploring citizenship issues and that pupils participate in active citizenship (Office for Standards in Education in England, 2012a). This learning includes exploring relationships between younger and older generations.

The International Baccalaureate (2011) encourages students throughout the world to "become active, compassionate and lifelong learners who understand that other people, with their differences, can also be right" (p. 2). Cambridge and Simandiraki (2005) propose an interactive intergenerational learning framework for students studying for an International Baccalaureate diploma. It comprises experiential learning with older people and fits the creativity, action, service (CAS) component of the diploma. As the European Year for Active Ageing and Solidarity Between Generations (Europa, 2012) drew to a close, it was timely to carry out an international literature-based study that aimed to examine what is known about children's views of older people.

METHOD

A search was carried out between May 2011 and August 2011 for academic journal articles across 21 electronic databases: ASSIA, BioMed Central, British Education Index, British Humanities Index (BHI), British Nursing Index, CINAHL With Full Text (EBSCO), EBSCHO Host Electronic Journals Service, ERIC Educational Resources Information Center, Informaworld Journals, Ingenta Connect, Medline, Oxford Journals, PsychINFO, PubMed Central, SAGE Journals Online, ScienceDirect, Web of Knowledge, Wiley Online Library, Zetoc, Google, and Google Scholar. The inclusion criteria combined three search terms: children AND views/perceptions/attitudes/prejudice/ AND elderly people OR older people OR intergenerational. Articles were excluded if they were published before 1980 because the researchers noted that there were relatively few studies undertaken before 1980, the findings from these concerned children from more distant generations living in a different era, and 31 years was considered to be a reasonable time frame in which to identify changes in children's views that may have relevance today.

Sixty-nine articles were found, of which 55 emanated from American studies, eight from the United Kingdom, and one each from the Netherlands, Serbia, Australia, Israel, Taiwan, and Scandinavia. Eighty-six percent of the articles reported empirical studies, 7% were narrative literature reviews, one article reported a systematic literature review, and another was an editorial piece. The articles are listed in Table 1. The data were manually (i.e., without the use of computer software) and inductively analyzed as guided by a hermeneutic/interpretivist philosophy. This means that the research aimed to understand the meaning of social behavior and experience on all levels from personal to social and cultural. The researchers were interested in what the articles could reveal about children's experiences and thoughts and thereby gain insight (Buchanan, 1992; Hayes, 1994; Johnson, 1984). So as not to limit the range of perspectives that may arise from an investigation, hermeneutic/interpretive approaches, in contrast to positivist/empiricist ones, do not have preconceived ideas of what they are looking for (Scott, 1996). The process was one of interpreting and drawing conclusions (Moule & Goodman, 2009).

After both researchers had undertaken the literature search, each read one half of the articles in full, to gain an overview of the subject area. After sharing reflections, the first researcher read and annotated all the articles and made brief handwritten notes on each. The notes included type of study, age and gender of sample, aims, methods, key findings, and individual words or phrases or references to a page number. From this, she identified the initial 13 emerging themes. The second researcher agreed these themes were credible, meaning that she believed the themes to be a true representation of the literature (Moule & Goodman, 2009). Together, using the notes and discussion, and through the process of creating a coherent and credible narrative, the researchers merged the 13 themes into seven themes. This grouping is shown in Table 2. The seven themes were ageism, contact with older people, children's media, children's descriptions of older people, intergenerational studies, children's perceptions of older people's health conditions, culture, ethnicity, and worldwide studies.

FINDINGS

Ageism and the Evidence

Thirty-two articles were relevant to the theme of ageism and the evidence. Stereotypes are fixed, simplified characterizations of people that provide a quick coherent impression about the features, traits, attitudes, behaviors, orientations, or myths of another (Lichtenstein et al., 2005). Ageism concerns age-based discrimination (Abrams et al., 2011). In the context of older people, it implies stigma, negative attitudes, and prejudice toward older people (Blunk & Williams, 1997). Many articles were written because of a concern that stereotypes about older people tend to be ageist, at a time when older people are rapidly increasing in number and will need more care from the young than ever before (e.g., Aday, Rice, Sims, McDuffie, & Evans, 1996; Blunk & Williams, 1997; Kamenir, 1983; Kupetz, 1994; Nishi-Strattner & Myers, 1983; Rich, Myrick, & Campbell, 1983) and, more rarely, because people need to prepare themselves for older age (McGuire, 1993). Children begin to be able to accurately discriminate age from about age 6 or 7 years (Burke, 1982; Goldman & Goldman, 1981). The majority of children define "old" as older than age 60 years (Aday et al., 1996; Armstrong & McKechnie, 2003; Davidovic, Djordjevic, Erceg, Despotovic, & Milosevic, 2007; Lichtenstein et al., 2003, 2005).

Page, Olivas, Driver, and Driver (1981), Gilbert and Ricketts (2008), and Dunne, Macdonald, and Kilpatrick (2008) are among many authors who cite a range of American studies from the 1970s to the 1990s (e.g., Chitwood & Bigner, 1980; Page et al., 1981) suggesting that children had developed well-defined negative attitudes toward older adults by age 8. Frequently cited are Isaacs and Bearison (1986) who used a questionnaire with 144 children and concluded that the 4-year-olds were not ageist, but the 6-year-olds were. The 8-year-old children had significantly higher levels of prejudice compared to 6-year-olds. The finding that children become more ageist with age was confirmed by a study that compared 4- and 5-year-olds in 1997 (Blunk & Williams, 1997). During these decades, older people anticipated that children would have negative attitudes toward them, and when studies found that children had positive attitudes toward older people, the authors appear to search for reasons that could have influenced the findings, as if disbelieving the data at face value (e.g., Nishi-Strattner & Myers, 1983).

In 2003, Armstrong and McKechnie reported that all but one of the 10-year-olds in their study liked talking to older people and demonstrated sensitivity toward their life experiences. Although there was evidence of stereotyping, there was no evidence of ageism. In 2005, Lichtenstein and colleagues, using a research method based on children's drawings, concluded that middle school children did not demonstrate stereotypical or ageist views about older people. The drawings were diverse and multidimensional. A study in Serbia showed that more children, with a mean age of 13, refuted the idea that old age is unattractive than agreed that it was (Davidovic et al., 2007). Dunne et al. (2008) identified 12 research instruments used to identify children's attitudes toward aging in their systematic review spanning 1995 to 1997. Burke (1982) noted that using a questionnaire and photoboard, a very common research method in the 1970s and 1980s, elicited more passive and negative descriptions compared to when the same young children were interviewed. Fillmer (1984) found that children described older people more favorably when attributing adjectives, but more negatively when asked to respond to questions. In 1986, Dobrosky and Bishop called for research methods to be broadened, arguing that, "Too often ... research results are, in part, simply reflections of the thought patterns of the researchers, patterns are 'built into' the research techniques themselves" (p. 438). It seems that contemporary studies are countering the findings of the older studies, suggesting that children are not as ageist as they were or as they were previously thought to be. Children's apparent decline in ageism could be related to the evolution of different and more diverse research methods, as well as to changing social values.

Contact With Older People

Twenty-nine articles discussed children's contact with older people. Children from across four countries identified older people as being most often family, neighbors, and friends (Armstrong & McKechnie, 2008; Bergman & Cybulski, 1980; Burke, 1982; Ivey, 2001; Seefeldt & Keawkungwal, 1985). The most familiar older people in children's lives are their grandparents (Aldous, 1995; Burke, 1982; Newman, Faux, & Larimer, 1997). Newman et al. (1997) found that grandparents are special to 9- and 10-year-olds. They are the people from whom children learn the most about being old. Attar-Schartz, Tan, and Buchanan (2009) explain that because parents often act as gatekeepers within these intergenerational exchanges, they can also shape children's attitudes. Grandparents can provide family connections for children living in families where other family ties have been severed (Chom, 2009). Pitcher (2009) examined the views of three generations in British families with adopted children. The grandparents were described in terms of giving practical support and as being "approving witnesses" to the new family unit. Burke (1982) found that among 5- and 6-year-olds, more than one half visited grandparents weekly to bimonthly and 60% lived within 80 miles, but contact with other older adults was quite rare. Aldous (1995) concluded, from a literature review of many studies, that younger grandparents had more contact with children than older ones, and that the greatest contact was with mothers' parents and specifically the maternal grandmother. A close relationship with grandparents seems to be associated with having a more positive attitude toward their own aging among preteenagers (McGuinn & Mosher-Ashley, 2002). Children's relationships with grandparents, or with other older adults, seem to be generalized to their views of "all old people" (Burke, 1982; McGuinn & Mosher-Ashley, 2002; Newman et al., 1997). For example, Bales' (2002) study of relationships focusing on the quality and opportunity of interactions, shared activities, support, and emotional closeness identified that the quality of the grandchildren's relationship with the older person was predictive of how positive their views were toward older people in general. It is noteworthy that it is common for researchers to introduce the idea of grandparents as a "way in" to asking children about their attitudes toward older people. Hoe and Davidson (2002) found that if children were primed with grandparent-related thoughts prior to an investigation, their views of older people were found to be more positive, compared to being primed with negative words.

Researchers noted how much societal structures can diminish contact between children and older people (Hagestad & Uhlenberg, 2005) and asked whether children have more positive attitudes toward older people if they have greater contact with them. Among studies investigating preschool and primary school-age children, some have found that having more contact with older people, including nonrelatives, is associated with more positive attitudes (Cartensen, Mason, & Caldwell, 1982; Caspi, 1984; Chitwood & Bigner, 1980), whereas others have found that the frequency of contact has no effect on children's attitudes (Kocamik & Ponzetti, 1986; Miller & Blacock, 1984; Nishi-Strattner & Myers, 1983). It appears that the key factor is familiarity. Children are more positive when asked about people they know rather than strangers (Burke, 1982; Kocamick & Ponzetti, 1986; Lichtenstein et al., 2005), and they prefer to interact with family members more than with outsiders (Zandi, Mirle, & Jarvis, 1990). In 1982, a group of older people, with a mean age of 72 years, acted as tutors to school-age children (Aday, Aday, Arnold, & Bendix, 1996) and one fourth of the children described their tutors as being "not old," despite, as we have seen "old" is usually perceived as over 60, indicating that familiarity challenges prior concepts of "an older person." Blunk and Williams (1997) researched 4- and 5-year-olds and found that the frequency of visits to their grandparents was not associated with their attitudes toward older people. McGuinn and Mosher-Ashley (2002) found that the closer the relationship children (average age of 12) had with their grandparents, the higher was their fear of other older adults. These studies agree with another carried out with 16- to 25-year-olds (Bousfield & Hutchison, 2010), in concluding that familiarity, and the quality of relationship, is a greater influence on children's attitudes than contact.

Children's Media

Twelve articles related to the theme of children's media. In addition to the family, the media is recognized as a powerful force for learning about older people (Newman et al., 1997). There have been a number of examinations of child-oriented electronic and print-based media representations of older people in America. Over the last 30 years, the frequency of older people represented across the media has been consistently much lower than their relative proportion of the population (Bishop & Krause, 1984; Swan, 1995; Vasil & Wass, 1993). The exceptions are within family-oriented television, where they appear with greater frequency (Dail, 1988), and Disney animated films, where older characters have steadily risen to about 3.8 per film (Robinson, Callister, Magoffin, & Moore, 2007). Qualitative analysis shows that older characters tend to be peripheral, rather than characters that are central to the plot (Bishop & Krause, 1984; Robinson & Anderson, 2006; Vasil & Wass, 1993). During the 1970s and early 1980s, their portrayal was mainly negative (Bishop & Krause, 1984; Dellman-Jenkins & Yang, 1997; Vasil & Wass, 1993) but has become much more positive since (Beland & Mills, 2001; Dail, 1988; Dellman-Jenkins & Yang, 1997; Robinson & Anderson, 2006) with the exception of Saturday morning television cartoons, which were still overwhelmingly negative during the 1990s (Swan, 1995). Negative depictions of older people include loss of capacity, losing power, unattractive, needing help, foolish, eccentric, unsuccessful, lacking common sense, helpless, an object of ridicule, sexually neutral, evil, sinister, incompetent, grumpy, passive, angry, senile, crazy, villainous, and not respected. Positive depictions include healthy, clean, friendly, happy, good, caring, not lonely, independent, happy, wise, and understanding (Bishop & Krause, 1984; Dellman-Jenkins & Yang, 1997; T. Robinson & Anderson, 2006; Robinson et al., 2007; Swan, 1995; Vasil & Wass, 1993). Having a disability does not detract from these otherwise positive portrayals (Beland & Mills, 2001), and there is evidence that negative stereotypes of older people in advertising are becoming culturally unacceptable in America (Robinson, Gustafson, & Popovich, 2008).

Children's Descriptions of Older People

Twenty-six articles provided information relevant to understanding children's descriptions of older people. Children's reported descriptions of older people are influenced by the research methods, research context, the children's familiarity with who they are being asked to describe, prior relationships with grandparents or other significant older people, the media, and their stage of development. Given an open-ended question, most young children focus on describing an older person's physical appearance; older ones, from about age 10, will consider more psychological and behavioral attributes (Dobrosky & Bishop, 1986). This is what one would expect in line with their cognitive development (Hoe & Davidson, 2002). Many of children's physical descriptions have remained stable over time: wrinkles, grey hair, false teeth (Page et al., 1981); deterioration of skin, bones, posture, hearing, sight, smell, eating, and mobility (Goldman & Goldman, 1981); grey hair, no hair, wrinkles, quavering voices, funny nails (Ivey, 2001); bald/less hair, short hair or buns, wearing a hat, wrinkles, glasses, walking aid, male facial hair, hearing aids, sensible flat shoes/slippers (Falchikov, 1990); wrinkles, grey hair, bald (Lichtenstein et al., 2003). Dobrosky and Bishop (1986) suggested that children have stereotypes about older people based on primarily physical characteristics. If they do, then it is proposed that such stereotypes are coming from adults. Bishop and Krause (1984) chose to use the following criteria for identifying the old people represented in the cartoons that they analyzed: wrinkled skin, white hair, cracking voice, and stooped posture. Such descriptions also have a biological reality. Today, children's descriptions are generally positive, but reflect reality when describing older people as less active, weak, and slow (Lynott & Merola, 2007).

Older studies of younger children being asked to describe the behavioral/psychosocial aspects of older people through a heavily structured research method produced negative findings: not friendly (Chitwood & Bigner, 1980); senility and forgetfulness, poor concentration, reduced powers of thinking, moodiness, bad temper, impatience, inability to cope with stress and "keep up with the times," slower to understand (Goldman & Goldman, 1981); lonely, not busy (Burke, 1982); helpless, unwanted, weird, scary, lonely, sad, and no one cares about you (Marks, Newman, & Onawola, 1985). More recent studies and/or those with open or diverse research methods tend to produce more positive findings: wisdom, confidence, patience, friendliness, helpful, kind (Goldman & Goldman, 1981); behavioral descriptions more positive than negative (Dobrosky & Bishop, 1986); take time to teach children, cuddle, read stories, happy times, like to be with (Ivey, 2001); sensitive to older people's life experiences and fairly positive overall (Armstrong & McKechnie, 2003). Studies that ask about older people who are known to the children also produce more positive findings: grandparents are nice, they talk to and play games with children, they laugh together (Burke, 1982); trusted friend, funny, wise, kind, intelligent (Ellis & Granville, 1999).

Intergenerational Studies

Five articles discussed intergenerational studies. Intergenerational studies consider how the behaviors of one generation can affect the development and self-esteem of another (Schindlmayr, 2006). Alcock, Camic, Berker, Haridi, and Raven (2011) suggest that the development of healthy attitudes between young and old is dependent upon the opportunity for intergenerational interactions and the quality of these interactions. Both are decreased in societies that are becoming increasingly age segregated. Studies that investigate intergenerational views can, themselves, bring people together (Chom, 2009).

Studies have examined what happens when older people are brought into school settings. Ellis and Granville (1999) found this experience to be perceived as enjoyable, mutually beneficial, and as adding value to the children's learning. Hall and Batey (2008) found that children's ideas about aging were also influenced by such interactions. Children's attitudes to older people might improve when they are involved in the classroom, but Chom (2009) cautions that this might be because they expect the older adults to help them.

Children's Perceptions of Older People's Health Conditions

Seven articles discussed children's perceptions of older people's health conditions. Goldman and Goldman (1981) asked American, English, and Australian children about the causes of aging and their answers revealed the dominance of a biological decline model characterized by loss. For example, the children spoke of the body being worn out and worn down, perhaps through the loss of friends, too much alcohol and smoking, being tired and needing new parts, getting disease of the heart or lungs, or strokes. Middle school American children rarely associated old age with health conditions (Lichtenstein et al., 2003). Out of 2,476 children, only 4.6% mentioned diseases, and these included arthritis, osteoporosis, diabetes, cancer, heart problems, blood pressure problems, and back pain. Six percent mentioned being ill or taking medications and 5.7% mentioned sensory problems, usually related to hearing or vision. In another study, middle school children were asked to draw a picture of a typical older person and to write responses to a series of questions about the person's age, activities, feelings, thoughts, and so forth. The 1,944 drawings, accompanied by words, note the following: diseases or medication (6.4%), arthritis or back problems (5%), osteoporosis (7.8%), weakness (21.7%), trouble with walking (9.9%), a wheelchair (6.4%), a cane or crutch (33.5%), glasses (28%). When describing older people, apart from "weakness," the health conditions of older people are not prominent in children's thinking.

For the older generation, who face the risks of illness and hardship, relationships with younger generations can be instrumental in maintaining their health--for example, through the younger generations' access to technological advancement and knowledge (Costanzo & Hoy, 2007). Children's reactions to older people are more likely to be negative when faced with someone who has a health condition that includes personality changes (Newman et al., 1997). Myers, Epperson, and Taylor (1989) found that children with grandparents who had Alzheimer's disease had less positive perceptions of grandparents in general, though they held positive views of the elderly in general. McGregor, Copestake, and Wood (2000) discuss the concept of the "intergenerational bargain" associated with the transfer of family resources through the generations. When a grandparent has a long-term health condition, parents and grandparents are preoccupied with the health issue. In the context of limited health or social care provided by the state, the result is often a significant drain on the family resources, which reduces the resources available for the next generation. In turn, this "family debt" influences children's perceptions of older people, and the perceptions of each successive generation.

Culture, Ethnicity, and Worldwide Studies

Twenty-two articles discussed the influence of culture, ethnicity, or international studies. Out of these, four studies discussed ethnicity. Mitchell, Wilson, Revicki, and Parker (1985) found no differences between American Black and White children in their perceptions of older people. Zandi et al. (1990) compared Indians born and raised in America with other Americans and found that both rated older people quite positively. The Indian children cited more behavioral/lifestyle answers, such as walking more slowly, whereas the American children provided more affective/feelings based answers, such as older people being nice. Slaughter-Defoe, Kuehne, and Straker (1992) found similarities between White American and White Canadian children's attitudes toward older people and noted that African American children had more positive attitudes than White American children. Researchers comparing nationalities include Seefeldt (1984), who found that Alaskan children's attitudes toward older people were more negative compared to children based on mainland United States, Paraguay, or Australia, but that their overall concepts of older people and many of their specific attitudes were similar. Another study found similarities between Thai and American children, except more Thai children described older people as "older" and "healthier" and more American children cited "more wonderful" and "more friendly" (Seefeldt & Keawkungwal, 1985). Davidson, Luo, and Fulton (2008) found that younger children, age 6 and 7, were more likely to use stereotypes when describing older people compared to slightly older children, age 9 to 11, in China and America. In 1981, Goldman and Goldman noted that English children were more negative overall and less likely to mention psychological descriptions of older people compared to Australian, American, and Swedish children.

Bergman and Cybulksi (1980) compared children of European origin, Yeminite/Tunisian, and Christian Arabs who all lived in the same geographical area. The children viewed older people not so much as formal transmitters of skills, but rather the agencies of socialization through relationships that are instrumental (practical help), affectational (sources of love, affection, and strength), and transmitters of cultural values and models of personal behavior. The European children saw older people as "bearers of national values," which included a love for Israel; the Yeminite/Tunisians emphasized that older people were about "sharing subsistence and keeping the family alive"; the Christian Arab children focused on older people being "role models and active participants in their lives." In Taiwan, Huang (2011) studied textbooks used in local elementary schools and found very few older people--all in roles such as fishing, walking, and gardening, described by the author as being "unproductive." Okoye and Obikeze (2005) reported that Nigerian youth perceived older people as being sickly, behaving like children, and not being open in their communication. They noted that the greater stereotyping was more prevalent among the less educated young people. Across the studies that examine ethnicity, nationality, and culture, there are more similarities than differences, but the relative importance of the differences are hard to judge with so few articles, and would benefit from wider study.

Eighty percent of the articles reviewed for this review were based entirely on studies carried out on Americans living within American culture. This is explained by the rise of "Gray Power" in America and Canada during the 1970s, which led to the predominance of academic articles and journals specializing in old age in America (Goldman & Goldman, 1981). Children's perceptions of older people may differ across the world and across ethnic groups, cultures, and time, and there is evidence that children's perceptions also might vary across socioeconomic status (Dobrosky & Bishop, 1986; Gilbert & Ricketts, 2008), gender according to the child (Armstrong & McKechnie, 2003; Burke, 1982; Falchikov, 1990; Fillmer, 1984; Goldman & Goldman, 1981; McGuinn & Mosher-Ashley, 2002; Mitchell et al., 1985), and the gender of the older person (Aldous, 1995; Chitwood & Bigner, 1980; Dail, 1988; Dellman-Jenkins & Yang, 1997; Falchikov, 1990; Middlecamp & Gross, 1993; Mitchell et al., 1985). Much more research, and more outside of America, is needed.

DISCUSSION

The review concurs that, like young and older adults (Abrams et al., 2011), children's own age influences their perceptions of what is old age. It concludes that research methods used to explore children's views should avoid being too structured by the researcher, so that the children's responses can be more valid. The methods and the analysis of the results need to take into account the children's cognitive stage of development.

Stereotypes are categorizations; they are neither positive nor negative in themselves. Their strength is that they help people to navigate the social world, but their weakness is that they do not reveal the whole truth and, once embraced, they are difficult to dislodge (Bishop & Krause, 1984). So if children come to think of an older person as inactive, they will tend to perceive them that way, regardless of reality (Swan, 1995). This review suggests that children's views of older people are stereotyped, but not ageist. Their stereotypes of the wrinkled, grey-haired person are rooted in biological reality and in adults' stereotypes. It could be argued that adults might have stereotypes about what they think are children's attitudes toward older people based on a narrative about ageism in America from 40 years ago. Since that time, there have been positive changes in child-oriented media and research methods, out of which has come a more positive picture as well as a greater understanding of the factors that influence children's attitudes toward older people. The evidence from this review suggests that many children have not yet formed the age-based discrimination that is recorded among young and older adults (Abrams et al., 2011). The review also found that familiarity is a stronger determining influence on children's attitudes toward older people than just contact. The more familiar they are, generally, the more positive is their attitude. Baumeister and Bushman (2011) explained that repeat exposure to a person tends to promote familiarity and a more positive attitude, but the addition of positive feelings emerging from shared experiences will promote a liking of another. This endorses the use of intergenerational face-to-face activities between children and older people, such as cooking, crafts, oral history, music making, and gardening, whereby children can see older people as empathic, knowledgeable, and skilled.

The findings from this review that children do not appear to be ageist is reassuring, as children will increasingly find themselves contributing, as part of a family or part of a local community, to the health and well-being of older people, many of whom will not be in full health (DfE, 2011b; WHO, 2011). In this context, it is noteworthy that only seven studies emerged in this review that reported on children's perceptions of older people's health conditions. Mental disorders, including depression and dementia, are most prevalent among older people (Mental Health Foundation, 2007), and the number of people living with dementia in the United Kingdom is likely to double over the next three decades (Department of Health, 2009). Newman et al.'s (1997) article suggests that children may feel more negative toward someone whose health condition has led to a personality change. Education may have a role in developing children's understanding of common health conditions among older people and helping children to develop the skills required to enable them to cope with the special communication challenges that this can present. This review did not uncover any publications discussing the introduction of this topic into children's education, possibly reflecting international drivers for schools to move away from adopting medical deficit models, which historically excluded pupils with health or learning needs from mainstream education, and toward social models of inclusion for all children (DfES, 2002; United Nations Educational, Scientific and Cultural Organization, 2009). Robinson and Summers (2012) demonstrated that a total rejection of the medical model can have negative consequences for children with serious illness in schools whose needs are not being adequately met; similarly, it might have negative consequences in terms of equipping children to deal with older people who have challenging health or communication issues. Both models have a place. Within England, for example, an introduction to some common health problems, such as arthritis or dementia, could contribute to school inspection criteria for personal, social, and health education (PSHE) and citizenship lessons (Office for Standards in Education in England, 2012d; DfE, 2011b).

The review also highlighted the need for more research outside of America, as only 20% of the articles were non-American. The European Social Survey (Abrams et al., 2011) showed that among young and older adults there are differing attitudes toward older people in different countries. Romanians were the least likely, and the Norwegians the most likely, to view the older than age 70 as friendly. The Hungarians were the most likely to view this population as the most competent and the Polish the least. Migration, including a border-free single market within the European Union, has led to a diverse child population within many schools (Council of Europe, 2001), and it is likely that these children bring with them differing attitudes toward older people. Approaches to health, health care (Campbell-Hall et al., 2010; Seale, 2001), and elder abuse (WHO, 2002) are culturally and socioeconomically determined. Children's education has a role to play in fostering learning about differences between individuals, challenging assumptions, respecting different views, and promoting healthy relationships across communities (DfE, 2011b; Office for Standards in Education in England, 2012d). Such education needs to be informed by research into children's views about older people within a wide variety of countries and settings comprising multi-cultural populations of children.

Limitations

This literature review was limited by the number and types of databases used, which may not have captured the whole picture. In particular, the authors are aware that many articles published on intergenerational studies may include useful information, but the search terms, focusing on children's views, only found five articles. The review's findings were based on those emanating from articles published in academic journals and exclude findings from wider sources, such as reports produced by organizations, websites, media, and unpublished papers. The findings are also based on secondary, rather than primary data, which makes this article an interpretation of other interpretations based on a diverse range of methods and child populations. The rigor of the research would have been improved if both researchers had read, annotated, and made notes on all the articles independently, and then checked to see if they agreed on the emergent initial themes. Equally, using a coding system is recognized as a way to increase rigor and reduced bias. This was not used by the researchers, because it can also leave out subtle nuances in what people say, and these can be very relevant. Together, these factors compromise validity. To try to address this, the researchers took note of the methods and samples and avoided simply taking the authors' conclusions at face value. In the light of these limitations, it is recognized that these findings represent an incomplete picture, but one to which further research could add through a wider systematic review.

CONCLUSIONS

During the 1970s, the difficult social and economic climate helped to fuel negative views of older people in terms of deficits and being a burden to society. These views were reflected in the media at the time. Many studies, published from the 1970s to the 1990s, demonstrate the adult authors' concerns about ageism by referring to it within the contextualization of their articles, and the review's finding that the design and analysis of some studies also seemed to be influenced by a presumption of ageism by the authors. The articles of the 1970s and early 1980s tend to present the children's views of older age in terms of deficits, such as loss and decline, compared to more recent articles. In 2010, in the midst of a world recession, social epidemiologists defined the older population's health as being biologically and psychologically shaped by the accumulation of their life experiences that are, in turn, strongly influenced by unequal wider social influences over which they have no control (Marmot, 2010). It is a model that is attracting worldwide interest not only because it seeks to improve quality of life for the individual, but also because it promotes equity and, through that, a way of controlling spiraling health and social care costs. The children of the 21st century, perhaps influenced by strong social inclusion and equity agendas that focus on "the structural" rather than "the individual," rarely view older people in terms of health deficits, preferring more holistic and generally more positive characteristics compared to the past. These findings support the idea that wider societal influences can influence social constructs of older people and, in various ways, these can influence children's views.

Research needs to extend beyond assessing the thoughts and attitudes of children in relation to older people. If the younger generation are going to adequately support the expanding older generation, they will need an empathic understanding of older people's needs and experiences. Research needs to turn to studies that examine children's understandings of the lived experience of being an older person, which includes children's perceptions of older people's quality of life, their health and well-being, and their histories, culture, and personhood. The research needs to be based on a far wider geographical and cultural spread of children. In addition to examining intergenerational relationships, it needs to examine children's views of older people where there are differences of culture, faith, and socioeconomic status. This broader research base is needed to guide the development of effective education to meet goals such as challenging injustice and discrimination, respecting individual differences, and supporting social inclusion. Such education needs to be evaluated and reported upon. In this way, we can support children toward the complex and highly challenging task of participating constructively in a society that adequately cares for its older generations in ways that are ethical and humane.

DOI: 10.1080/02568543.2014.912995

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Sally Robinson and Lioba Howatson-Jones

Canterbury Christ Church University Canterbury, United Kingdom

Submitted July 13, 2012; accepted September 26, 2013.

Address correspondence to Dr. Sally Robinson, Department of Health, Wellbeing and Family, Canterbury Christ Church University, Canterbury, Kent CT1 1QU, United Kingdom. E-mail: sally.robinson@canterbury.ac.uk
TABLE 1
The 69 Papers Reporting on Children's Views of Older People

Adam, J. E. (1992). The effect of an intergenerational program on
children's attitudes and the well being of nursing home residents
(Unpublished doctoral dissertation), PACE University.

Aday, R. H., Aday, K. L., Arnold, J. L. & Bendix, S. L. (1996).
Changing children's perceptions of the elderly: The effects of
intergenerational contact. Gerontology and Geriatrics Education,
16(3), 37-51.

Aday, R. H., Rice, C., Sims, C., McDuffie, W., & Evans, E. (1996).
Changing children's attitudes toward the elderly: the longitudinal
effects of an intergenerational partners program. Journal of
Research in Childhood Education, 10(2), 143-151.

Aldous, J. (1995). New views of grandparents in intergenerational
context. Journal of Family Issues, 16(1), 104-122.

Alcock, C. L., Camic, P. M., Berker, C., Haridi, C., & Raven, R.
(2011). Intergenerational practice in the community: A focused
ethnographic evaluation. Journal of Community and Applied Social
Psychology, 21, 419-432.

Armstrong, L., & McKechnie, K. (2003). Intergenerational
communication: Fundamental but under exploited theory for speech
and language therapy with older people. International Journal of
Language and Communication Disorders, 38(1), 13-29.

Attar-Schwartz, S., Tan, J. P., & Buchanan, A. (2009). Adolescents'
perspectives on relationships with grandparents: The contribution
of adolescent, grandparent and parent-grandparent relationship
variables. Children and Youth Services Review, 31(9), 1057-1066.

Bales, S. S. (2002). The relation between the
grandparent-grandchild bond and children's views of themselves and
grandparents. Dissertation Abstracts International Section A:
Humanities and Social Sciences, 63(5A), 1705-1706.

Beland, R. M., & Mills, T. L. (2001). Positive portrayal of
grandparents in current children's literature. Journal of Family
Issues, 22(5), 639-651.

Bergman, S., & Cybulski, O. (1980). School children's attitudes
toward learning from older people: A case study in Israel.
Educational Gerontology: An International Quarterly, 5, 259-272.

Bishop, J. M., & Krause, D. R. (1984). Depictions of aging and old
age on Saturday morning television. Gerontologist, 24(1), 91-94.

Blunk, E. M., & William, S. W. (1997). The effect of curriculum on
preschool children's perceptions of the elderly. Educational
Gerontology, 23, 233-241.

Bousfield, C. & Hutchison, P. (2010). Contact, anxiety, and young
people's attitudes and behavioural intentions towards the elderly.
Educational Gerontology, 36, 451-466.

Buchanan, D. R. (1992). An uneasy alliance: combining qualitative
and quantitative research methods. Health Education Quarterly,
79(1), 117-135.

Burke, J. (1982). Young children's attitudes and perceptions of
older adults. International Journal of Aging and Human Development,
14(3), 205-221.

Cambridge, J., & Simandirak, A. (2005). Interactive
intergenerational learning project. Final report. Bath, England:
University of Bath, International Baccalaureate Research Unit.
Retrieved from www.ibo.org/research/programme development

Cartensen, L., Mason, S. E., & Caldwell, E. C. (1982). Children's
attitudes toward the elderly: An intergenerational technique for
change. Educational Gerontology, 8, 291-301.

Caspi, A. (1984). Contact hypothesis and inter-age attitudes: A
field study of cross-age contact. Social Psychology Quarterly,
47(1), 74-80.

Chatard, A., & Selimbegovic, L. (2008). The intergenerational
transmission of social dominance: A three generation study.
European Journal of Personality, 22(6), 541-551.

Chitwood, D. G., & Bigner, J. J. (1980). Young children's
perceptions of old people. Home Economics Research Journal, 8(5),
369-373.

Chom, D. C. (2009). Children's attitudes and classroom interaction
in an intergenerational education program. Educational Gerontology,
35(5), 453-164.

Costanzo, P. R., & Hoy, M. B. (2007). Intergenerational relations:
Themes, prospects and possibilities. Journal of Social Issues,
63(4), 885-902.

Dail, P. W. (1988). Prime-time television portrayals of older
adults in the context of family life. The Gerontologist, 28,
700-706.

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TABLE 2
Grouping Initial Themes Into Seven Themes (N = Number of Papers)

Initial Themes                      Seven Themes

How old is old, who are older       Ageism (n = 32)
  people? (n = 9)
When does ageism occur? (n = 13)
Qualities of older people
  (stereotypes, simple negative/
  positive attitudes (n = 10)
Contact (relationship between       Contact with older people
  contact and attitudes               (n = 29)
  towards older people) (n = 13)
Grandparents (n = 12)
Types of relationships
  with older people (n = 4)
Portrayal of older people           Children's media (n = 12)
  in media, books, TV (n = 12)
Qualities of older people           Children's descriptions of older
  (what they are like) (n = 26)       people (n = 26)
Intergenerational studies (n = 5)   Intergenerational studies (n = 5)
Perceptions of older people's       Children's perceptions of older
  illness/health (n = 7)              people's health
                                      conditions (n = 1)
Gender differences                  Culture, ethnicity and
  (boys and girls) (n = 7)            world-wide studies (n = 22)
Gender of older people (n = 8)
Cultural differences (n = 12)
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