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Onderzoeksliteratuur kinderen, scholen en covid-19: een jaar later

“Our perception of risk and prevalence is driven by stories, events, anecdotes, rather than data” – Steven Pinker

“If you succeed [in school], your life will be good. If you fail, your life is going to be much worse. You’re going to live shorter. You’re going to be poorer. That, of course, is in the back of your head when you start talking about closing schools” – Anders Tegnell

Hoewel niet evidence-based als interventie zijn wereldwijd in de meeste landen de scholen gesloten tijdens de pandemie. In Nederland sloten de scholen voor het eerst sinds de Tweede Wereldoorlog, eerst op 16 maart en op 15 december opnieuw. Data en onderzoek wijzen vanaf het begin in dezelfde richting: kinderen en scholen spelen een beperkte rol. Nu bijna een jaar later zijn er vele studies verschenen rond kinderen, school en covid-19. Een aantal studies op een rij.

2021

01. Lewis, S.J.J., Munro, A.P.S., Smith, G.D., Pollock, A.M. (2021). Closing schools is not evidence based and harms children. British Medical Journal, 23 February

“School closures have been implemented internationally with insufficient evidence for their role in minimising covid-19 transmission and insufficient consideration of the harms to children. (..) The UN convention on the rights of the child and the duty on the government to respect, protect and fulfil those rights have largely been overlooked.(..) In the absence of strong evidence for benefits of school closures, the precautionary principle would be to keep schools open to prevent catastrophic harms to children”

School photo created by freepik – www.freepik.com

02. Ingelbeen, B., Peckeu, L., Laga, M., et al. (2021) Reducing contacts to stop SARS-CoV-2 transmission during the second pandemic wave in Brussels, Belgium. Eurosurveillance, 18 februari

“Our findings confirm transmission among and from teenagers, with intergenerational transmission apparent following school opening. Nonetheless, their relative role was limited: transmission events from 10–19-year-olds to other age groups remained fewer than those from adults, and the proportion of cases among 10–19-year-olds did not significantly change after school reopening”

03. Folkhälsomyndigheten (2021) Covid-19 most common among health care groups. Onderzoek Zweedse gezondheidsautoriteiten naar beroepsgroepen en risico op infectie covid-19, 11 februari

“When it comes to school staff, according to the report, they generally do not have a higher risk of infection than people in other occupational groups who have contact with many people, for example service professions. They also have no increased risk of developing serious disease with covid-19”

04. Zimmerman, K., Akinboyo, I., Brookheart, M., et al. (2021) Incidence and Secondary Transmission of SARS-CoV-2 Infections in Schools. Pediatrics, 1 februari             

“We examined 11 school districts with nearly 100,000 students/staff open for 9 weeks of in-person instruction, tracking secondary transmission of SARS-CoV-2; within-school infections were extremely rare. (NB: no transmission from students to staff)”

05. RIVM, niet gepubliceerde studie (2021). Kinderen, school en COVID-19. Website RIVM (bijgewerkt: 25 februari)

“Vanaf 31 augustus 2020 tot en met 10 januari 2021 zijn ruim 390.000 mensen die werkzaam zijn in het onderwijs of kinderopvang getest. Van deze testen was 9% positief. Dit percentage is lager dan het totaal van 14% bij de ruim 3,7 miljoen volwassenen getest in de teststraten in deze periode”

06. The British Medical Journal (2021) Webinar Covid-19 and schools – known unknowns. BMJ, 28 januari

“Findings [from Scotland] have been reassuring for teachers, as there is now “strong evidence” that teachers are at a similar or lower risk of severe illness or dying from covid-19, than the general working age population, “and that finding persists when schools are open” 

07. Office for National Statistics (2021) Coronavirus (COVID-19) related deaths by occupation, England and Wales: deaths registered between 9 March and 28 December 2020. ONS, 25 januari

Deze studie in de media: Schraer, R. (2021) Covid: Teachers ‘not at higher risk’ of death than average. BBC Health, 25 januari

“Rates of death involving COVID-19 in men and women who worked as teaching and educational professionals, such as secondary school teachers, were not statistically significantly raised when compared with the rates seen in the population among those of the same age and sex”

08. O’Leary, S.T. (2021) To Spread or Not to Spread SARS-CoV-2—Is That the Question? JAMA Pediatrics, 22 januari

“With this large seroprevalence study demonstrating yet again what we have suspected for several months, the answer to that question could not be clearer: we must prioritize the reopening of childcare facilities and elementary schools to full time, in-person learning without exception”

09. Tönshoff  B, Müller B., Elling R, et al. (2021) Prevalence of SARS-CoV-2 infection in children and their parents in southwest Germany. JAMA Pediatrics, januari 22

“The low seroprevalence of SARS-CoV-2 antibodies in young children in this study may indicate that they do not play a key role in SARS-CoV-2 spreading during the current pandemic”

10. Somekh, I., Shohat, T., Keinan-Boker, L., et al. (2021). Reopening Schools and the Dynamics of SARS-CoV-2 Infections in Israel: A Nationwide Study. Clinical Infectious Diseases, 18 januari

“This analysis does not support a major role of school reopening in the resurgence of the COVID-19 curve in Israel. Easing restrictions on large scale gatherings was the major influence on this resurgence”

11. Centers for Disease Prevention and Control (2021) COVID-19 Trends Among Persons Aged 0–24 Years — United States, March 1–December 12, 2020. CDC, 13 januari

“As of December 7, nearly two thirds (62.0%) of U.S. kindergarten through grade 12 (K–12) school districts offered either full or partial (hybrid with virtual) in-person learning. Despite this level of in-person learning, reports to CDC of outbreaks within K–12 schools have been limited, and as of the week beginning December 6, aggregate COVID-19 incidence among the general population in counties where K–12 schools offer in-person education (401.2 per 100,000) was similar to that in counties offering only virtual/online education (418.2 per 100,000)”

Deze studie in de media: Cortez, M.F. (2021) Covid-19 Outbreaks Aren’t Driven by In-Person Classes, CDC Says. Bloomberg, 13 januari

12. Brandal, L.T., Ofitserova, T.S. Meijerink, H., et al. (2021) Minimal transmission of SARS-CoV-2 from paediatric COVID-19 cases in primary schools, Norway, August to November 2020. Eurosurveillance, 7 januari

“This prospective study shows that transmission of SARS-CoV-2 from children under 14 years of age was minimal in primary schools in Oslo and Viken, the two Norwegian counties with the highest COVID-19 incidence and in which 35% of the Norwegian population resides”

13. Ludvigsson, J.F., Engerström, L., Nordenhäll, C., Larsson, E. (2021) Open Schools, Covid-19, and Child and Teacher Morbidity in Sweden. The New England Journal of Medicine, 6 januari

Despite Sweden’s having kept schools and preschools open, we found a low incidence of severe Covid-19 among schoolchildren and children of preschool age during the SARS-CoV-2 pandemic. Among the 1.95 million children who were 1 to 16 years of age, 15 children had Covid-19, MIS-C, or both conditions and were admitted to an ICU, which is equal to 1 child in 130,000.

2020

14. Ulyte, A., Radtke, T., Abela, I., A., et al. (2020) Clustering and longitudinal change in SARS-CoV-2 seroprevalence in 2 school-children: prospective cohort study of 55 schools in Switzerland. medRxiv, 22 december

“Under a regimen of open schools with some preventive measures in place since August, clustering of seropositive cases occurred in very few classes and not across entire schools despite a clear increase in seropositive children during a period of high 68 transmission of SARS-CoV-2”

15. European Centre for Disease Prevention and Control (2020) COVID-19 in children and the role of school settings in transmission – first update. ECDC, 23 december

“There is a general consensus that the decision to close schools to control the COVID-19 pandemic should be used as a last resort. The negative physical, mental health and educational impact of proactive school closures on children, as well as the economic impact on society more broadly, would likely outweigh the benefits.(..) Educational staff and adults within the school setting are generally not seen to be at a higher risk of infection than other occupations”

16. Prahley, L. (2020) Exclusive: Kids catch and spread coronavirus half as much as adults, Iceland study confirms. National Geographic, 10 december

“This 40,000-person study found that children under 15 were about half as likely as adults to be infected, and only half as likely as adults to transmit the virus to others. Almost all the coronavirus transmissions to children came from adults”

17. Larosa, E., Djuric, O., Cassinadri, M., et al. (2020). Secondary transmission of COVID-19 in preschool and school settings in northern Italy after their reopening in September 2020: a population-based study. Eurosurveillance, 10 december

“Transmission within the schools of Reggio Emilia province, northern Italy, occurred in a non-negligible number of cases, particularly in the age group 10–18 years, i.e. in middle and high schools, while no secondary cases were detected in pre-school children, only one case in primary school and no secondary cases among teachers and staff”

18. Ismail, S.A., Saliba, C., Bernal, J.L., et al. (2020) SARS-CoV-2 infection and transmission in educational settings: a prospective, cross-sectional analysis of infection clusters and outbreaks in England. The Lancet Infectious diseases, 8 december

“SARS-CoV-2 infections and outbreaks were uncommon in educational settings during the summer half-term in England. The strong association with regional COVID-19 incidence emphasises the importance of controlling community transmission to protect educational settings. Interventions should focus on reducing transmission in and among staff”

19. Bismarck-Osten, C. von., Borusyak,K., Schönberg., U. (2020) The Role of Schools in Transmission of the SARS-CoV-2 Virus: Quasi-Experimental Evidence from Germany.  Centre for Research and Analysis of Migration Department of Economics – University College London, 20 november

“Leveraging a difference-in-differences design with staggered adoption, we show that neither the summer closures nor the closures in the fall have had any significant containing effect on the spread of SARS-CoV-2 among children or any spill-over effect on older generations. We also do not find any evidence that the return to school at full capacity after the summer holidays increased infections among children or adults. Instead, we find the number of children infected increased during the last weeks of the summer holiday and decreased in the first weeks after schools reopen”

20. Christakis, D., et al. (2020) Estimation of US Children’s Educational Attainment and Years of Life Lost Associated With Primary School Closures During the Coronavirus Disease 2019 Pandemic.  JAMA, 12 november

“These findings suggest that the decision to close US public primary schools in the early months of 2020 may be associated with a decrease in life expectancy for US children”

21. Viner, R.M., Mytton, O.T., is Bonell, C. (2020) Susceptibility to and transmission of COVID-19 amongst children and adolescents compared with adults: a systematic review and meta-analysis. JAMA, 25 september 

“In this meta-analysis, there is preliminary evidence that children and adolescents have lower susceptibility to SARS-CoV-2, with an odds ratio of 0.56 for being an infected contact compared with adults. There is weak evidence that children and adolescents play a lesser role than adults in transmission of SARS-CoV-2 at a population level. This study provides no information on the infectivity of children”

22. Ludvigsson, J.F. (2020) The first eight months of Sweden’s COVID‐19 strategy and the key actions and actors that were involved. Acta Paediatrica, 20 september

“Sweden’s response was less invasive than many other countries, with no general lockdown. It focused on mitigation: slowing, but not stopping, the pandemic. Physical distancing was recommended in public spaces, but mandatory in bars, restaurants and at events. Visits to nursing facilities were banned. Kindergartens and schools for children up to 16 stayed open, but closed for older children for three months. There were no enforced quarantines for infected households or geographical regions, and facemasks were not recommended outside health care”

23. Ehrhardt J, Ekinci A, Krehl H., et al. (2020). Transmission of SARS-CoV-2 in children aged 0 to 19 years in childcare facilities and schools after their reopening in May 2020, Baden-Württemberg, Germany. Eus Surveillance, 10 september

“Our investigation suggests that child-to-child transmission in schools and childcare facilities is uncommon and not the primary cause of SARS-CoV-2 infection in children”

24. Japan’s Ministry of Education, Culture, Sports, Science and Technology (2020) Education in Japan beyond the crisis of COVID-19 -Leave No One Behind. MEXT, september

‘In the period from June 1, when schools began to fully reopen, to July 31, 242 out of 12 million students in 35,874 schools were reported to have been infected”

25. Macartney, K., Quinn, H.E., Pillsbury, E.J., et al. (2020) Transmission of SARS-CoV-2 in Australian educational settings: a prospective cohort study. The Lancet Child and Adolescent Health, 3 augustus

“SARS-CoV-2 transmission rates were low in NSW educational settings during the first COVID-19 epidemic wave, consistent with mild infrequent disease in the 1·8 million child population. With effective case-contact testing and epidemic management strategies and associated small numbers of attendances while infected, children and teachers did not contribute significantly to COVID-19 transmission via attendance in educational settings”

26. Folkhälsomyndigheten (2020) Covid-19 in schoolchildren – A comparison between Finland and Sweden. Zweedse gezondheidsautoriteit, 7 juli

“In conclusion, closure or not of schools has had little if any impact on the number of laboratory confirmed cases in school aged children in Finland and Sweden”

28. Lavezzo, E. Franchin, C. Ciavarella, G., et al. (2020). Suppression of a SARS-CoV-2 outbreak in the Italian municipality of Vo. Nature, 30 juni (updated 15 januari 2021)

“Recent studies have found that the clinical progression of infection in children is generally milder than in adults. We found that none of the children under 10 years of age who took part in the study tested positive for SARS-CoV-2 infection at either survey, despite at least 13 of them living together with infected family members. This agrees with a recent study conducted in Iceland and is particularly intriguing given the very high observed odds ratio for adults to become infected when living together with family members who are positive for SARS-CoV-2”

29. Yung CF, Kam KQ, Nadua KD, Chong CY, Tan NWH, Li J, et al. (2020). Novel coronavirus 2019 transmission risk in educational settings. Clinical Infectious Diseases, 25 juni

“Our investigations, especially in preschools, could not detect SARS-CoV-2 transmission despite screening of symptomatic and asymptomatic children. The data suggest that children are not the primary drivers of SARS-CoV-2 transmission in schools and could help inform exit strategies for lifting of lockdowns”

30. Gudbjartsson, D.F., Helgason, A., Jonsson, H., et al. (2020). Spread of SARS-CoV-2 in the Icelandic Population. The New England Journal of Medicine, 11 juni

“In a population-based study in Iceland, children under 10 years of age and females had a lower incidence of SARS-CoV-2 infection than adolescents or adults and males”

31. Heavey, L., Casey, G., Kelly.,  C, Kelly,  D.,  McDarby, G. (2020). No evidence of secondary transmission of COVID-19 from children attending school in Ireland, 2020. Eurosurveillance, 28 mei

“The results moreover echo the experience of other countries, where children are not emerging as considerable drivers of transmission of COVID-19. (…) These findings suggest that schools are not a high risk setting for transmission of COVID-19 between pupils or between staff and pupils”

32. Ludvigsson, J.F. Children are unlikely to be the main drivers of the COVID‐19 pandemic – a systematic review. Acta Paediatrica, 19 mei

“Children accounted for a small fraction of COVID‐19 cases and mostly had social contacts with peers or parents, rather than older people at risk of severe disease. Data on viral loads were scarce, but indicated that children may have lower levels than adults, partly because they often have fewer symptoms, and this should decrease the transmission risk. Household transmission studies showed that children were rarely the index case and case studies suggested that children with COVID‐19 seldom caused outbreaks”

33. Munro, A.P.S., Saul, N. (2020) Children are not COVID-19 super spreaders: time to go back to school. The British Medical Journal, 5 mei 2020

“At the current time, children do not appear to be super spreaders. (..) Governments worldwide should allow all children back to school regardless of comorbidities”

34. Thors, V., S. (2020) Iceland’s data on the infectivity of children cross-infection risk. European Association of Paediatrics, april

“Furthermore, we could also deduct that none of the 1800 cases were infected by a child < 10 years of age whereas infections from adults to children were quite common. With this knowledge in mind, there has been no closure of schools nor day-care centres although they have been running on a limited power also due to staff issues”

Studies naar het effect van schoolsluitingen

  1. Walsh S, Chowdhury A, Russell S, et al. (2021) Do school closures reduce community transmission of COVID-19? A systematic review of observational studies. medRxiv, 4 januari

“Three studies, including the two at lowest risk of bias, reported no impact of school closures on SARS-CoV-2 transmission; whilst the other seven reported protective effects. Effect sizes ranged from no association to substantial and important reductions in community transmission”

2. Haug, N., Geyrhofer, L., Londei, A., et al. (2020) Ranking the effectiveness of worldwide COVID-19 government interventions. Nature Human Behaviour, 16 november

“We showed that the most effective measures include closing and restricting most places where people gather in smaller or larger numbers for extended periods of time (businesses, bars, schools and so on). However, we also find several highly effective measures that are less intrusive”

NB: Er is geen onderzoek gedaan naar ‘schoolsluitingen’. Dat alle onderwijsinstellingen (inclusief universiteiten) onder één noemer gebracht worden is een beperking van deze studie.

Algemene kritiek: “International modelling studies which estimate that school closures have a meaningful effect on reducing transmission rates are all confounded by the near simultaneous introduction of multiple interventions (including lockdowns, curfews, closures of bars and restaurants). Moreover, they do not account for indirect effects of school closures which prevent parents from working outside the home” – Alisdair Munroe, kinderarts en Clinical Research Fellow Paediatric Infectious Diseases – University Hospital Southampton


Voor een uitgebreid literatuuroverzicht kinderen en covid-19, en regelmatige updates, ism UK Royal College of Paediatrics and Child Health:

Boast A, Munro A, Goldstein H. An evidence summary of Paediatric COVID-19 literature. Don’t Forget the Bubbles, 2021

‘Help de kinderen’

OPINIE Noordhollands Dagblad | Nederland telt 2,5 miljoen schoolgaande kinderen en ruim 1,2 miljoen studenten, maar een handvol virologen, microbiologen en artsen domineren het coronabeleid. Dat wreekt zich. Kinderen lijken vooral nog te worden beschouwd als wandelende ziektekiemen, kinderen worden verantwoordelijk gehouden voor ziekte en dood van oma’s en opa’s, leerkrachten en docenten, hun scholen zijn bovenal levensgevaarlijke kweekvijvers voor het virus. Een microscopische kokervisie brengt de jongste generatie in gevaar. Voor een breder perspectief is de inbreng van pedagogen en gedragswetenschappers in het coronadebat dringend noodzakelijk.

De terugkeer van kinderen in de basisschool na de tweede schoolsluiting is uitgelopen op een heuse militaire operatie in vredestijd. Consensus tot voor kort: een goed en veilig pedagogisch klimaat is belangrijk voor het welbevinden en een gezonde ontwikkeling van kinderen. De huidige dreiging van testhysterie en verplichte quarantaines is voor kleuters en schoolkinderen een ideale voedingsbodem voor nodeloze schuld- en angstgevoelens. Een mondkapjesadvies voor groep 7 en 8 (zonder wetenschappelijke evidentie), afstandsregels, gemaskerde ouders buiten op het schoolplein, dit alles roept een angstcultuur in het leven die het pedagogisch klimaat in school als leefomgeving ernstig onder druk zet. Een plek waar angst regeert en kinderen primair behandeld worden als potentiële ziekteverspreiders is geen geschikte leeromgeving voor kinderen. Voor veel ouders hebben scholen nu een grens overschreden. Ook in het onderwijsveld zelf klinkt verzet.


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Jongeren zijn het kind van de coronarekening

OPINIE | In 1989 zag het Verdrag inzake de Rechten van het kind het levenslicht. Artikel 3: “Bij alle maatregelen die kinderen betreffen dient het belang van het kind voorop te staan.” Het is verbijsterend hoe snel in 2020 de rechten van kinderen wereldwijd overboord zijn gegaan. Met desastreuze gevolgen. Ook in Nederland.

In een land hier niet ver vandaan hebben kinderen tijdens de coronacrisis nog geen dag school gemist, kinderen die aan sport doen zijn er nog geen training of competitiewedstrijd bij ingeschoten. Geen sprookje, maar: Zweden – niet toevallig ook het land van Ellen Key, de invloedrijke Zweedse pedagoge die in 1900 de Eeuw van het Kind uitriep.

Sport is belangrijk voor de gezondheid van kinderen


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Tweede golf van angst in het onderwijs

OPINIE | Door een onnodige schoolsluiting – niet gebaseerd op wetenschappelijke bevindingen en tegen het advies van het RIVM – waren kinderen en jongeren maandenlang aangewezen  op inferieur noodonderwijs. Dit terwijl geen enkel handboek Epidemiologie van Infectieziekten het sluiten van scholen als effectieve maatregel aanbeveelt. Nu klinkt de roep om scholen te sluiten opnieuw en dreigt een tweede golf van angst het onderwijs te overspoelen. Maar het leeuwendeel van wetenschappelijk en epidemiologisch onderzoek laat zien dat voor kinderen en jongeren de gezondheidsrisico’s minimaal zijn, en de rol van scholen bij de verspreiding van covid-19 beperkt is. Om met pedagoog Micha de Winter te spreken: jongeren hebben hoop en optimisme nodig. Voorkomen moet worden dat de jongste generatie opnieuw de dupe wordt van disproportionele angst.

In Zweden bleven scholen voor kinderen tot 16 jaar open – foto: http://www.sweden.se


De schade voor kinderen is niet te overzien. “school is niet alleen een omgeving waar een virus zich kan verspreiden, maar ook een belangrijk onderdeel van de gezondheid van jonge mensen. Als je faalt op school, dan ben je later in je leven slechter af. Je leeft korter, je zult armer zijn. Dat speelt allemaal mee.” Was getekend: Anders Tegnell.

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Mondkapjes af in het onderwijs

OPINIE | Homo sapiens is een meester in het bezweren van angst met rituelen. In de donkere Middeleeuwen spijkerden mensen knoflook boven de deur tegen vampiers. Op de Mongoolse steppen laten ouders – ingegeven door de hogere kindersterfte onder jongens – de haren van hun pasgeboren zoons lang groeien, opdat boze geesten ze voor meisjes aanzien. In Nederland anno 2020 zoekt circa één op de vijf middelbare scholen hun heil in mondkapjes voor leerlingen, uit angst voor covid-19. Zonder wetenschappelijke evidentie, zonder noodzaak. Opnieuw offert het onderwijs kinderen op het altaar van disproportionele angst.

Mondkapjes af in het onderwijs (foto: www.freepik.com)


De boodschap van het RIVM na een zonnige zomervakantie is helder: de scholen kunnen gewoon open. Zonder mondkapjes. Na de onnodige schoolsluiting slaat het onderwijs wederom een advies van het RIVM in de wind. Onomwonden stelt RIVM-hoofdwetenschapper Jaap van Dissel namens  het OMT in een persconferentie over mondkapjes (29 juli): ‘het wetenschappelijk bewijs ontbreekt domweg’. Conclusie: in dubio, abstine (bij twijfel, grijp dan niet in). ‘Natuurlijk kunnen mensen mondkapjes dragen, maar ze kunnen niet zeggen dat het een ‘evidence-based’ beslissing is aldus de Britse epidemioloog en hoogleraar Evidence-Based Medicine Carl Heneghan (Universiteit van Oxford).

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Onderwijs vergeet kinderen

OPINIE | Wereldwijd zijn er relatief weinig kinderen gemeld met covid-19. Feit. In maart was al bekend dat kinderen een ondergeschikte rol spelen bij de verspreiding. Toch sloten de scholen op 16 maart hun deuren in de paniek die volgde toen de Wereldgezondheidsorganisatie (WHO) de wereldwijde uitbraak als pandemie bestempelde.

Emoties

De schoolsluiting was niet gebaseerd op wetenschappelijke inzichten, en tegen het advies van het RIVM. Hoogopgelopen emoties maakten dat het onderwijs haar pedagogische opdracht uit het oog heeft verloren. Ook nu nog is in geen beroepsgroep ongerustheid zo wijdverspreid als in het onderwijs. 

Foto Richard Brocken (via Noordhollands Dagblad)


Aanvankelijk was de paniek voor een deel te begrijpen. Te midden van de overdadige media-aandacht was (en is) het moeilijk onderscheid te maken tussen experts met feiten en experts met meningen. Of tussen trends en anekdotes. Maar al snel kwam de kinderopvang tot de conclusie dat sluiting niet te verdedigen was.

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Een pleidooi voor evolutionaire pedagogiek

The trouble is that most research on parenting will not help you in the slightest because it doesn’t control for genetic factors

Brian Boutwell

 

Charles Darwin was niet alleen een natuurwetenschapper die voor opschudding zorgde met het intellectuele dynamiet van de evolutietheorie. Hij was ook een oplettende ouder. Vanaf de geboorte van zijn eerste zoon William Erasmus in 1839 hield hij een dagboek bij van diens ontwikkeling. Darwin observeerde vol verwondering de aangeboren zoek- en zuigreflexen en het werpgedrag van zijn zoon. Anderhalve eeuw later wordt de maakbaarheid van het kind schromelijk overschat en de opvoeding overdreven geproblematiseerd. Juist pedagogen zouden op basis van evolutietheoretische en gedragsgenetische bevindingen meer tegenwicht moeten bieden aan het alomtegenwoordige dogma van het kind als onbeschreven blad.

 

Screenshot PIP

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