In the present study, there were differences in the changes in visual attention, facial expression, engagement/behaviour and intergenerational conversation in association with the interaction style of intergenerational program. Smiles, constructive behaviour and intergenarational conversation were significantly higher in the social-oriented IG programming group than the performance-based IG programming group, while the visual attention occured between the generations was significantly higher in the performance-based IG programming group than the social-oriented IG programming group.
Smiles were observed in both the performance-based and social-oriented IG programming groups in this study. The older adults smiled just as a result of looking at the children’s faces in the performance-based IG program, while laughter was also heard in the social-oriented IG program, when the older adult picked up a good card, achieved a successful string figure, created a funny face in Fuku-warai, or played paper, rock and scissors. In general, social smiles sometimes occur, but laughter often breaks out when an individual is really enjoying something.
Laughter and smiles are means of non-verbal communication that express interpersonal attitudes. Laughter and smiling are usually produced as messages of good will to others, signalling acceptance. Laughter is believed to have evolved in humans to express a secure and safe message to others [30]. A chain reaction of smiling is known to occur in mother-child interaction when the mother smiles in response to the infant’s smile as a positive feedback [31]. Smiles and laughter allow both children and older adults to feel secure and connected, and help build a positive relationship even in a short interaction. Previous studies reported that following interpersonal contact, older adults showed more positive attitudes toward younger people [16], and also desired a meaningful relationship with younger people [18].
Effective intergenerational programs provide opportunities to plan and reflect on experiences [37]. Although little development can be expected after the completion of a performance in the performance-based IG program, one activity may trigger various conversation topics in the social-oriented IG program as shown by the results of the present study. Active engagement is found to create more opportunities to find and share common interests during the time that older adults and children spent together [37]. In the present study, the constructive behaviour rate was very high (90%) in the social-oriented IG program, and both older adults and children engaged in conversation and enjoyed traditional play together. Both generation groups have much to give and learn through interaction; children have a zest for learning, while older adults have a lifetime of experience [19].
When older adults are given meaningful roles such as the opportunity to nurture and mentor children, their self-esteem increases [11] in association with feeling needed, valued, and a sense of self-worth [10], and older adults are reminded of their role in society. In the present study, older adults not only responded to children’s questions, but also shared knowledge with children by teaching the rules of games and passing on cultural traditions though play. Traditional games invite conversation. Since Karuta and Fuku-warai are often played around the New Year holiday, playing these games presents a good opportunity for the adults to explain the cultural traditions engaged in at New Year’s. The older adults also learned new ways to play from the children regarding the “Cat’s cradle” and “Action Songs.” An intergenerational program is only effective when it supports mutually beneficial interactions [38].
Visual attention is also a form of non-verbal communication [39, 40]. In the performance-based IG programming group, older adults looked at children throughout the 5-minute observation period. Although these performance-based IG programs are adopted in a number of day services, the goal of intergenerational interaction is difficult to achieve with only the quiet watching of a performance [41]. It is rather note-worthy that the visual attention occurred between the generations was 87.5% in the present social-oriented IG program.
Close interaction and repeated contact make self-disclosure and other friendship-developing mechanisms possible [42]. It is very difficult to interpret the present findings without knowing whether the older adults and children had regular opportunities to interact with each other. The children participating in this study had visited the day centre on a regular basis since April 2011, and they were thus familiar faces among the older adults at the time of the survey in the winter of 2011. This sense of intimacy may have contributed to the generation of smiles in the results.
Intergenerational programs have the great potential to promote health and well-being of older adults. Given the limited number of such programs at present, we need to develop new programs which attract the participation of both older adults and children, with natural smiling and laughter. There are a variety of potential interactions including the pairing of older adults with children. Since the interest taken by older adults in activities is affected by their experience and character [43], programs utilizing their unique capacities and experience are desirable. For example, an older adult who has been a farmer can be a teacher of horticultural activity, while those who have a good knowledge of plants can be guides for children’s outdoor activities and those who are good at drawing can teach children to draw.
It is important for facilitators to assess whether older adults communicate well with children in the program and to provide support. It is the role of facilitators to offer a program which draws out the strengths of both generations and to promote sustained attention and self-motivated involvement [37], while ensuring that older adults and children are always the main focus of the intergenerational program. Future plans for intergenerational programs should be more research-based, and the principles of contact theory (support from authority, common goals, cooperation, equal group status, and opportunity for friendship) are essential for intergenerational programs [41, 42]. Future research – practice interactions may generate successful programs.
Strengths and limitations
Since the present study was a cross-sectional research design to compare a single set of observations of different adults in intergenerational programs, the effect of continuity of the IG programs was not determined. In addition, the participants in the performance-based IG program and the social-oriented IG program were different, and thus the effect of subject characteristics (e.g., how to express one’s emotion) cannot be ruled out. To eliminate the effect of subject characteristics, the same persons should participate in both the performance-based and social-oriented IG programs in a cross-over research approach. Also, we need to determine whether the same effects can be expected for older adults with severe dementia and whether the contents of intergenerational programs involving elementary school or junior high school children should be the same as those involving preschool children aged 5 to 6. The present study was conducted in one facility with small number of subjects. Therefore we need to increase number of facilities and subjects and examine whether the same results are obtained. Also, randomization of subjects to different interaction-style programs is necessary.
Although data collection is often difficult using questionnaire surveys when the subjects are older adults or preschool children due to problems with the reliability and validity of the survey results, we overcame such difficulties with objective video observation in the present study. Facial expression changed for only a few seconds at a time, therefore it was difficult to observe all of the changes in a single interaction, however, repeated play enabled us to improve the accuracy of the data.