| Literature DB >> 34792779 |
Elena Hoicka1, Burcu Soy Telli2, Eloise Prouten3, George Leckie4, William J Browne4, Gina Mireault5, Claire Fox6.
Abstract
We created a 20-item parent-report measure of humor development from 1 to 47 months: the Early Humor Survey (EHS). We developed the EHS with Study 1 (N = 219) using exploratory factor analysis, demonstrating the EHS works with 1- to 47-month-olds with excellent reliability and a strong correlation with age, showing its developmental trajectory. We replicated the EHS with Study 2 (N = 587), revealing a one-factor structure, showing excellent reliability, and replicating a strong correlation with age. Study 3 (N = 84) found the EHS correlated with a humor experiment, however it no longer correlated once age was accounted for, suggesting low convergent validity. Subsamples of parents from Studies 2 and 3 showed excellent inter-observer reliability between both parents, and good longitudinal stability after 6 months. Combining participants from all studies, we found the EHS is reliable across countries (Australia, United Kingdom, United States), parent education levels, and children's age groups. We charted expected humor development by age (in months), and the expected proportion of children who would appreciate each humor type by age (in months). Finally, we found no demographic differences (e.g., country: Australia, Canada, United Kingdom, United States; parents' education) in humor when pooling all data. The EHS is a valuable tool that will allow researchers to understand how humor: (1) emerges; and (2) affects other aspects of life, e.g., making friends, coping with stress, and creativity. The EHS is helpful for parents, early years educators, and children's media, as it systematically charts early humor development.Entities:
Keywords: Humor; Joke; Preschool; Survey; Toddler
Mesh:
Year: 2021 PMID: 34792779 PMCID: PMC9374637 DOI: 10.3758/s13428-021-01704-4
Source DB: PubMed Journal: Behav Res Methods ISSN: 1554-351X
Items; empirical sources for items; Spearman’s rho correlations between the final items and total scale (r); factor loadings for the exploratory factor analysis (EFA, Study 1), standardized regression weight means for the Bayesian confirmatory factor analysis (CFA, Study 2); and the ages (in months) at which 25, 50, and 75% of children are predicted to pass each item based on the logistic regressions of age on each item (see Study 5, Results). Where there are no ages under the percentiles, this indicates that by 47 months, fewer than that percentile (e.g., 50%) of children appreciated that type of humor. Numbers are in bold for the factor onto which the item loaded best. Items are ordered by age of emergence, based on the percentiles
| 9 | Hide & Reveal Games | Peekaboo/ hide & seek, including variations, e.g., hiding objects in bags and revealing them | (Addyman & Addyman, | .41 | – 0.10 | .16 | 1 | 1 | 1 | |
| 8 | Tickling | Tickling, including variations, e.g., using objects to tickle, e.g., stick or feather | (Addyman & Addyman, | .33 | – 0.15 | .25 | 1 | 1 | 1 | |
| 17 | Funny faces | Pulling/making silly faces, e.g., scrunching up face | (Angeleri & Airenti, | .46 | 0.04 | .38 | 1 | 1 | 8 | |
| 10 | Bodily humor | Strange body movements, e.g., head through legs, kicking legs in air | (Addyman & Addyman, | .59 | 0.30 | .29 | 1 | 1 | 10 | |
| 1 | Funny voices | Making strange voices (not just strange noises) | (Sroufe & Wunsch, | .42 | 0.13 | .41 | 1 | 1 | 17 | |
| 12 | Chasing | Chasing, including variations, e.g., making toys chase each other | (Hoicka & Akhtar, | .68 | 0.41 | .41 | 1 | 4 | 16 | |
| 3 | Misusing objects | Strange actions with objects, e.g., use wrong end of spoon, put cup on head | (Dubois et al., | .71 | 0.40 | .42 | 1 | 8 | 17 | |
| 19 | Teasing | Teasing, e.g., offering an object and taking it away | (Howe et al., | .62 | 0.31 | .39 | 1 | 12 | 38 | |
| 18 | Showing hidden body parts | Showing normally hidden body parts, e.g., lifting shirt to reveal tummy; taking off clothes | (Reddy, | .62 | 0.38 | .45 | 1 | 15 | 31 | |
| 11 | Scaring others | Scaring people, e.g., jumping out at them, or yelling | (unpublished corpus from Hoicka & Akhtar, | .68 | 0.44 | .47 | 1 | 16 | 35 | |
| 15 | Acting like something else | Acting like something else, e.g., an animal, another person, etc. | (Addyman & Addyman, | .68 | 0.36 | .64 | 8 | 17 | 26 | |
| 5 | Taboo topics | Referring to gross things, e.g., poo, sneezing, smelly feet, etc. | (Addyman & Addyman, | .65 | 0.13 | .67 | 15 | 23 | 31 | |
| 6 | Mislabeling | Mislabeling objects/events, e.g., calling a car a banana; could be in song, or intentionally giving you the wrong answer | (Hoicka & Akhtar, | .73 | 0.02 | .62 | 22 | 29 | 36 | |
| 2 | Making fun | Making fun of others, e.g., calling someone a poopoohead | (Dubois et al., | .65 | 0.13 | .63 | 24 | 30 | 37 | |
| 7 | Aggressive humor | Aggressive acts, e.g., spitting out water, throwing things, pushing people, etc. | (Esseily et al., | .63 | 0.39 | .28 | 1 | 31 | ||
| 4 | Playing with concepts | Saying strange things/mixing up concepts/nonsense (e.g., dinosaurs eat the wall; cats have 5 legs, dogs say moo), including nonsense variations of knock-knock/why did the chicken cross the road jokes | (Dubois et al., | .73 | 0.01 | .60 | 24 | 31 | 37 | |
| 16 | Nonsense words | Inventing words, e.g., schmoogly | (Hoicka & Akhtar, | .66 | 0.00 | .56 | 28 | 35 | 42 | |
| 13 | Playing with social rules | Socially unacceptable situations, e.g., putting cat on dining table, saying naughty words, etc. | (Hoicka & Gattis, | .64 | 0.02 | .49 | 33 | 44 | ||
| 14 | Tricks | Playing tricks on people, e.g., putting salt in the sugar bowl | (unpublished corpus from Hoicka & Akhtar, | .32 | – 0.26 | .45 | 39 | |||
| 20 | Puns | Making puns, that is, jokes where words have double meanings, e.g., Why are fish so smart? Because they live in schools | (Dubois et al., | .52 | – 0.06 | .26 | ||||
| 21 | Funny noises (not included in final survey) | Making strange noises, e.g., raspberries, shrieks, sneeze sounds | (Addyman & Addyman, |
Power analyses for all analyses. Nreq is the minimum number of participants required. Nact is the actual number of participants in the sample for each analysis. For Study 5, analyses were a priori for Child Age, Child Gender, Parent Age, and EHS Version, but post hoc for other demographic variables as we could not predict the breakdown ahead of time
| Study 1: Survey Construction | EFA | 210 | 215 | 21 items; 10 participants per item (Tabachnick & Fidell, |
| Study 2: Survey Replication | CFA | 200 | 587 | Minimum 200 participants (Kline, |
| Study 3: Concurrent Validity | Correlation | 84 | 84 | Two-tailed medium correlation ( |
| Study 4: Inter-observer Reliability | Correlation | 29 | 39 | Two-tailed large correlation ( |
| Study 4: Longitudinal Stability | Correlation | 29 | 214 | Two-tailed large correlation ( |
| Study 5: EHS Version | Differential Item Functioning | 200/ group | ≥214/ group | Small effect size (based on simulations, corrections for multiple testing) (Belzak, |
| Study 5: Age, Parent Education | Differential Item Functioning | 400 | 873-886 | Small effect size (based on simulations, corrections for multiple testing) (Belzak, |
| Study 5: Parent Education (Degree, No Degree); Country (UK, US) | Differential Item Functioning | 100/ group | ≥112/ group | Medium effect size (based on simulations, no corrections for multiple testing) (Belzak, |
| Study 5: Country (UK, Australia) | Differential Item Functioning | 25/ group | ≥30/ group | Large effect size (based on simulations, no corrections for multiple testing) (Belzak, |
| Study 5: Child Age, Parent Education, Country | KR(20) | 30 | 30-674 | Based on simulations, when first eigenvalue above 6 (Yurdugül, |
| Study 5: Child Age | Linear regression | 787 | 873-886 | Small effect size (Cohen’s |
| Study 5: Child Gender | ANCOVA | 394/groups | ≥434/ group | Small effect size (Cohen’s |
| Study 5: Childcare Hours, Income (UK) | Linear regression | 259 | 434-605 | Small to medium effect size (Cohen’s |
| Study 5: Parent Education (Degree, No Degree), Siblings, Multilingualism | ANCOVA | 130/ group | ≥ 142/ group | Small to medium effect size (Cohen’s |
| Study 5: Income (US) | Linear regression | 77 | 90 | Medium to large effect size (Cohen’s |
| Study 5: Parent Gender | ANCOVA | 39/group | ≥51/ group | Medium to large effect size (Cohen’s |
| Study 5: Country (Australia, Canada, UK, US) | ANOVA, and ANCOVA | 13/group | ≥16/ group | Large effect size (Cohen’s |
Participant information
| 219 | 587 | 84 | |
19;24 0;7–47;14 12;14 | 27;9 1;28–47;28 11;3 | 23;27 1;19–46,6 13;7 | |
| Female | 86 (39%) | 279 (48%) | 43 (51%) |
| Male | 132 (60%) | 307 (52%) | 41 (49%) |
| Not reported | 1 (0.5%) | 1 (0.2%) | 0 (0%) |
| Of Color | 27 (12%) | 51 (9%) | 5 (6%) |
| White | 186 (85%) | 531 (90%) | 78 (93%) |
| Not reported | 6 (3%) | 5 (1%) | 1 (1%) |
| Australia | 27 (12%) | 3 (0.5%) | 0 (0%) |
| Canada | 10 (5%) | 7 (1%) | 0 (0%) |
| United Kingdom | 111 (51%) | 481 (82%) | 84 (100%) |
| United States of America | 47 (21%) | 66 (11%) | 0 (0%) |
| Other | 22 (10%) | 24 (4%) | 0 (0%) |
| Not reported | 2 (1%) | 6 (1%) | 0 (0%) |
| English only | 167 (76%) | 466 (79%) | 63 (75%) |
| English and another language(s) | 43 (20%) | 85 (14%) | 13 (15%) |
| Other language only (monolingual) | 0 | 2 (0.3%) | 0 (0%) |
| Other languages only (multilingual) | 0 | 2 (0.3%) | 0 (0%) |
| English, parents did not report whether children were exposed to another language | 0 | 27 (5%) | 8 (10%) |
| Not reported | 9 (4%) | 4 (1%) | 0 (0%) |
| Yes | 75 (34%) | 278 (47%) | 36 (43%) |
| No | 141 (64%) | 281 (48%) | 40 (48%) |
| Not reported | 3 (1%) | 28 (5%) | 9 (11%) |
| 17.22 | 12.67 | ||
| 0–75 | 0–50 | ||
| 14.56 | 12.69 | ||
| Not reported | 218 | 60 | 7 |
| 33.22 | 33.75 | 34.20 | |
| 18–46 | 18–62 | 22–43 | |
| 4.60 | 4.99 | 4.20 | |
| Not reported | 1 | 33 | 7 |
| Female | 209 | 514 | 75 |
| (95%) | (88%) | (89%) | |
| Male | 8 | 41 | 2 |
| (4%) | (7%) | (2%) | |
| Not reported | 2 | 32 | 7 |
| (1%) | (5%) | (8%) | |
| 14 | 43 | 3 | |
| Of Color | (6%) 201 | (7%) 512 | (4%) 73 |
| White | (92%) 4 | (87%) 32 | (87%) 8 |
| Not reported | (2%) | (5%) | (10%) |
| High School | 26 | 66 | 15 |
| (12%) | (11%) | (18%) | |
| Community College | 9 | 27 | 0 |
| (4%) | (5%) | (0%) | |
| Undergraduate Degree | 64 | 212 | 37 |
| (29%) | (36%) | (44%) | |
| Postgraduate Degree | 116 | 272 | 32 |
| (53%) | (46%) | (38%) | |
| Not reported | 3 | 10 | 0 |
| (1%) | (2%) | (0%) |
*See Appendix Table 6 for a more detailed breakdown of ethnicity, as well as information on household income, and recruitment.
Detailed breakdown of ethnicity of children and parents across studies, as well as income and recruitment information
| 219 | 587 | 84 | |
| Black | 2 (1%) | 6 (1%) | 0 (0%) |
| East Asian | 1 (0.5%) | 3 (0.5%) | 0 (0%) |
| Hispanic | 1 (0.5%) | 0 (0%) | 0 (0%) |
| Pacific Islander | 0 (0%) | 1 (0.2%) | 0 (0%) |
| South Asian | 3 (1%) | 6 (1%) | 0 (0%) |
| West Indian | 0 (0%) | 1 (0.2%) | 0 (0%) |
| White | 186 (85%) | 531 (90%) | 78 (93%) |
| Of Mixed Ethnicity | 8 (4%) | 17 (3%) | 5 (6%) |
| Other (not specified) | 12 (5%) | 17 (3%) | 0 (0%) |
| Not reported | 6 (3%) | 5 (1%) | 1 (1%) |
2 (1%) | 7 (1%) | 1 (1%) | |
4 (2%) | 8 (1%) | 0 (0%) | |
3 (1%) | 5 (1%) | 0 (0%) | |
0 (0%) | 1 (0.2%) | 0 (0%) | |
201 (92%) | 512 (87%) | 73 (87%) | |
0 (0%) | 8 (1%) | 2 (2%) | |
5 (2%) | 14 (2%) | 0 (0%) | |
4 (2%) | 32 (5%) | 8 (10%) | |
Australia: | 18 $122,500 AUD $40,000–$240,000 $55,020 | ||
| Canada: | 7 | 5 | |
$150,000 CAD $60,000–200,000 $49,051 | $100,000 $50,000–160,000 $40,927 | ||
United Kingdom: | 76 £54,000 GBP £13,000–£150,000 £28,462 | 285 £50,000 £6,000–£750,000 £51,713 | 75 £53,000 £12,000–£120,000 £23,051 |
| United States of America: | |||
| 36 | 56 | ||
| $154,000 USD | $125,000 | ||
| $15,000–$350,000 | $20,000–$250,000 | ||
| $74,119 | $61,042 | ||
219 (100%) | 455 (78%) | 0 (0%) | |
| University of Sheffield Cognitive Development Lab | 0 (0%) | 123 (21%) | 84 (100%) |
| PASE Early Years Labs | 0 (0%) | 9 (2%) | 0 (0%) |
Questions for the Preliminary EHS and the EHS. Question block 1 was used in the Preliminary EHS only. Question block 2 was used in both the Preliminary EHS and the EHS. The Preliminary EHS used incremental questioning, while the EHS used Yes/No questions. Questions with letters are contingent on their route items, e.g., question 2a is asked only if the parent responds “Yes” to question 2. Questions with Roman numerals are contingent on their route items, e.g., question 12a(i) is asked only if the parent responds “Yes” to question 12a.
| 1 | Does your child laugh? |
| 2 | Does your child appreciate humor? (It could be verbal or physical, e.g., silly faces) |
| 2a | When was the last time your child appreciated humor? |
| 3 | Does your child intentionally produce humor (could be physical or verbal, e.g., silly faces; you might not get the humor) |
| 3a | When did your child last intentionally produce humor? (It may or may not have been humorous to you). |
| Instructions - Preliminary EHS | Types of Jokes: We will now ask questions about specific types of jokes your child may enjoy. When we ask if your child copies jokes, we mean making the exact same joke (or at least trying to). For instance, if they put a sock on their head after watching someone else do so. When we ask if your child invents jokes, we mean do they make jokes that (as far as you know) they have never seen anyone else do. Please choose the answers that best describe your child. |
| Preliminary EHS Question Structure*: | |
| a | Has your child ever seen anyone make this type of joke? |
| a(i) | Has your child ever found it funny when others produced this type of joke? |
| b** | Has your child ever tried to make this type of joke? |
| b(i) | Has your child ever correctly copied this type of joke from others? |
| b(ii) | Has your child ever invented this type of joke correctly him/herself? |
| Instructions - EHS | For the following, tick Yes if your child finds it funny when others make this joke type and/or makes this joke type him/herself to be funny. |
| J1 | Making strange voices (not just strange noises) |
| J2 | Making fun of others, e.g., calling someone a poopoohead |
| J3 | Strange actions with objects, e.g., use wrong end of spoon, put cup on head |
| J4 | Saying strange things/mixing up concepts/nonsense (e.g., dinosaurs eat the wall; cats have 5 legs, dogs say moo), including nonsense variations of knock-knock/why did the chicken cross the road jokes |
| J5 | Referring to gross things, e.g., poo, sneezing, smelly feet, etc. |
| J6 | Mislabeling objects/events, e.g., calling a car a banana; could be in song, or intentionally giving you the wrong answer |
| J7 | Aggressive acts, e.g., spitting out water, throwing things, pushing people, etc. |
| J8 | Tickling, including variations, e.g., using objects to tickle, e.g., stick or feather |
| J9 | Peekaboo/ hide & seek, including variations, e.g., hiding objects in bags and revealing them |
| J10 | Strange body movements, e.g., head through legs, kicking legs in air |
| J11 | Scaring people, e.g., jumping out at them, or yelling |
| J12 | Chasing, including variations, e.g., making toys chase each other |
| J13 | Socially unacceptable situations, e.g., putting cat on dining table, saying naughty words, etc. |
| J14 | Playing tricks on people, e.g., putting salt in the sugar bowl |
| J15 | Acting like something else, e.g., an animal, another person, etc. |
| J16 | Inventing words, e.g., schmoogly |
| J17 | Pulling/making silly faces, e.g., scrunching up face |
| J18 | Showing normally hidden body parts, e.g., lifting shirt to reveal tummy; taking off clothes |
| J19 | Teasing, e.g., offering an object and taking it away |
| J20 | Making puns, that is, jokes where words have double meanings, e.g., Why are fish so smart? Because they live in schools |
| J21ʈ | Making strange noises, e.g., raspberries, shrieks, sneeze sounds |
*Question structure used for questions J1–J21 of the Preliminary EHS. **Contingent on answering “Yes” to question 3 of the General Humor Questions. ʈQuestion included in the Preliminary EHS only.
Fig. 1Predicted age curves for laughter, humor appreciation, and humor production
Fig. 2Scree plot for (A) Sample 1, and (B) random data, for parallel analysis
Actions for the lab experiment
| Humor type | Joke | Control | Materials |
|---|---|---|---|
| Funny noises | Makes a monkey squawk three times | Hums, ‘twinkle twinkle little star’ tune to child | Toy monkey |
| Peekaboo | Quickly hides face behind hands and shows face, saying, “boo!” | Waves at child | |
| Tickling | Tickles teddy bear’s tummy and says, ‘tickle, tickle, tickle!’ | Cuddles teddy bear | Teddy bear |
| Funny faces | Pulls mouth to sides with fingers and sticks out tongue | Scratches face | |
| Bodily humor | Humorously waggles arms | Claps hands | |
| Misusing objects | Puts glove on foot | Puts glove on hand | Glove |
| Chasing | Makes a toy pig chase a toy cow and says, “I’m gonna get you!” | Makes a toy pig and toy cow walk side by side and says, “We’re going for a walk!” | Toy pig, toy cow |
| Funny voices | Speaks in a humorous high voice to say, “The dog is crossing the road” | Uses a normal voice to say, “The dog is crossing the road” | Toy dog |
| Acting like something else | Gets down on all fours, mimicking a dog, and says, ‘Woof! Woof!’ | Walks around the room and says, “I like walking!” | |
| Teasing | Teases by offering and withdrawing a feather ball toy from parent | Offers to give feather ball toy to parent. Lets parent take the toy. | Feather ball toy |
| Scaring others | Yells, “boo!” at parent while their back is turned. Parent reacts scared | Says, “Hello!” to parent | |
| Showing body parts | Lifts top of doll and shows stomach, says, ‘Look! Her tummy!’ | Covers doll over with small towel and says, ‘Look, a blanket!’ | Doll, doll top, small towel |
| Taboo topics | Smells the doll’s bum and says, “Ewww! It’s smelly!” | Holds doll out in front of them, looks at doll and says, “I like this doll!” | Doll |
| Mislabeling | Holds a hat and says, “This is a sheep!” | Holds a toy sheep and says, “This is a sheep!” | Hat, toy sheep |
| Aggressive humor | Parent builds a tower using toy blocks, and then the experimenter knocks it over. Parent looks surprised | Builds a tower using blocks | Blocks |
| Making fun | Drops straws on parent’s head. Parent looks surprised | Puts a hat on the parent’s head | Straws, hat |
| Playing with concepts | Holds a toy horse and says, “The horse goes Quack! Quack Quack!” | Holds a toy horse and says, “The horse goes neigh! Neigh!” | Toy horse |
| Nonsense words | Holds a spoon and says, “This is a schmoogly” | Holds a spoon and says, “This is a spoon” | Spoon |
| Playing with social rules | Leans back and puts feet on table | Holds a book and puts it on the table | Table, book |
| Tricks | Says to parent, “I’ve got you a nice gift!” Hands gift to parent, waits for parent to open gift to reveal crumpled paper inside. Parent looks disappointed. | Says to parent, “I’ve got you a nice gift!” E hands gift to parent, waits for parent to open gift to reveal a toy plane inside. Parent looks happy. | Crumpled paper, toy plane |
| Puns | Says, “Why are teddy bears never hungry? Because they’re always stuffed!” | Says, “Why are teddy bears never hungry? Because they eat a lot!” |
Fig. 3Mean humor appreciation/production scores for the EHS and joke and control trials in the humor experiment for Study 3. Error bars represent 95% confidence intervals (N = 84)
Spearman’s rho correlations between humor lab tasks and the total humor lab score (i.e., total number of trials for which children laughed at a joke, or copied a joke while smiling or laughing). *p < .05
| Hide & Reveal Games | .758* |
| Tickling | .760* |
| Funny faces | .520* |
| Bodily humor | .730* |
| Misusing objects | .702* |
| Chasing | .775* |
| Funny voices | .811* |
| Acting like something else | .778* |
| Teasing | .705* |
| Scaring others | .881* |
| Showing body parts | .758* |
| Taboo topics | .788* |
| Mislabeling | .637* |
| Aggressive humor | .817* |
| Making fun | .754* |
| Playing with concepts | .691* |
| Nonsense words | .461* |
| Playing with social rules | .713* |
| Tricks | .703* |
| Puns | .384* |
Differential item functioning for EHS Version (Preliminary, Final), Child Age, Parent Education, and Country. ΔR2 are Zumbo–Thomas effect sizes. Significant p values are .0025 for EHS Version and Child Age, to account for Bonferroni corrections. Significant p values are .05 for Parent Education and Countries to account due to smaller sample sizes (Belzak, 2020). NA = Not Applicable, as p values were not significant
| 9 | Hide & Reveal Games | 0.157 | 0.069 | 0.653 | |||||||
| 8 | Tickling | 0.862 | 0.411 | ||||||||
| 17 | Funny faces | 0.209 | 0.941 | 0.755 | 0.997 | ||||||
| 10 | Bodily humor | 0.015 | 0.504 | 0.795 | 0.428 | ||||||
| 1 | Funny voices | 0.063 | 0.003 | 0.638 | 0.312 | 0.547 | |||||
| 12 | Chasing | 0.171 | |||||||||
| 3 | Misusing objects | 0.532 | 0.927 | ||||||||
| 19 | Teasing | 0.144 | 0.301 | 0.244 | 0.473 | ||||||
| 18 | Showing hidden body parts | 0.086 | 0.569 | 0.109 | |||||||
| 11 | Scaring others | 0.141 | 0.635 | 0.121 | |||||||
| 15 | Acting like something else | 0.203 | 0.908 | 0.110 | 0.801 | 0.613 | |||||
| 5 | Taboo topics | 0.011 | 0.003 | 0.632 | 0.457 | 0.226 | |||||
| 6 | Mislabeling | 0.685 | 0.150 | 0.875 | |||||||
| 2 | Making fun | 0.003 | 0.388 | 0.284 | |||||||
| 7 | Aggressive humor | 0.007 | 0.775 | 0.696 | 0.808 | ||||||
| 4 | Playing with concepts | 0.859 | 0.201 | 0.66 | |||||||
| 16 | Nonsense words | 0.018 | 0.706 | 0.093 | |||||||
| 13 | Playing with social rules | 0.157 | 0.679 | 0.389 | 0.224 | 0.653 | |||||
| 14 | Tricks | 0.439 | 0.709 | 0.178 | |||||||
| 20 | Puns | 0.185 | 0.503 | 0.182 | |||||||
Fig. 4Age curves for each item. Items are grouped in the order of age of emergence by percentiles (see Table 1). Participants included all children from Studies 2 and 3, N = 671
Fig. 5Predicted EHS scores by month, with 95% confidence intervals (CI). While the lower CI is below 0 at 7 months, and the upper CI is above 20 from 34 months, we limited the graph to the range of scores possible on the EHS