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Assessing the Coherence of Parents' Short Narratives Regarding their Child Using the Five-Minute Speech Sample Procedure

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What makes a child a 'competent' child?

Amanda van Rooyen¹, Tineke Water, Shayne Rasmussen

¹School of Clinical, Sciences, Auckland University of Technology, AUT North Shore Campus, Private Bag 92006, Auckland, 1142, New Zealand. amandahopevanrooyen@gmail.com.

The New Zealand Medical Journal

|February 26, 2016

Summary

Child competence is dynamic, not age-dependent, influencing healthcare decisions. Assessing competency in New Zealand children requires considering individual factors and navigating complex legal interpretations for informed consent.

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Area of Science:

Medical Ethics
Child Health Law
Pediatric Psychology

Background:

Child competence is crucial for informed consent in healthcare.
A child's perceived competence affects their participation in health decisions.
Healthcare professionals are responsible for assessing child competence.

Purpose of the Study:

To explore the definition and assessment of 'competency' in children under 16.
To examine the dynamic nature of child competence beyond age.
To address the complexities in New Zealand legislation regarding child consent to healthcare.

Main Methods:

Literature review of New Zealand health legislation and policy.
Analysis of the Health and Disability Commissioner's statements on child consent.
Discussion of factors influencing child competence.

Main Results:

Child competence is a dynamic attribute influenced by experiences, attributes, relationships, and context, not solely age.
No single validated tool exists for assessing competence in New Zealand children.
Interpretations of New Zealand law (Care of Children Act 2004, Code of Health and Disability Services Consumers' Rights 1996) regarding child consent are unclear.

Conclusions:

Defining and deciding child competency is complex and requires a nuanced approach.
Further clarification of legal frameworks is needed to support healthcare professionals in assessing child competence.
Individualized assessment considering developmental, contextual, and legal factors is essential for ethical healthcare practice involving children.