Introduction

Research demonstrates that quality interventions designed to support young children’s socio-emotional learning (SEL) are associated with positive social, emotional, behavioral, and academic outcomes later in life (Domitrovich, et al., 2017; Jones & Bouffard, 2012). For young children exposed to high levels of risk or adversity, the development of SEL skills is crucial for building resiliency skills (Domitrovich, et al., 2017). Broadly, socio-emotional learning includes five interrelated areas of competence: self-awareness, self-management, social awareness, relationship skills, and responsible decision-making (Collaborative for Academic, Social & Emotional Learning, 2020). For young children, there is ample evidence in developmental literature that socio-emotional skills are associated with improved school performance, increased pro-social behavior and well-being, and a decline in anxiety and behavioral problems (Durlak, et al., 2011; Leerkes, et al., 2008; O'Conner, et al., 2017).

Given the role of SEL as part of young children’s healthy development, especially for those who have experienced adversity, Ahlan Simsim, a children’s educational television show produced in the Middle East, is focused on supporting children’s socio-emotional needs. Ahlan Simsim (AS) is an Arabic-language co-production from Sesame Workshop, the non-profit behind the children’s educational television show, Sesame Street (Carp, 2020). First broadcast in February 2020 across 20 countries via pan-Arab satellite channel MBC3, Ahlan Simsim, “Welcome Sesame” in Arabic, offers early learning to young children across the Middle East and North Africa. Ahlan Simsim represents one element of Ahlan Simsim, a humanitarian program in partnership between Sesame Workshop and the International Rescue Committee (IRC), made possible by support from the MacArthur Foundation, that reaches families affected by conflict and crisis in Iraq, Jordan, Lebanon, and Syria with the vital early learning that children need to thrive.

Informed by regional needs assessments, multiple rounds of formative research, and local expert advisories, each episode of Season 1 of AS focuses on a single emotion and two management strategies to build a foundation for a child’s emotional ABCs (Kohn et al., 2020, 2021) Emotions covered in Season 1 include anger, caring, fear, frustration, nervousness, determination, jealously, loneliness, and sadness, guided by Shaver, et al., 1987. Management strategies include counting to five, moving or drawing it out, belly breathing, making a plan, or asking an adult for help (Kohn et al., 2020). AS is produced primarily in Levantine Arabic and features characters speaking in Syrian, Jordanian, Iraqi, and Lebanese dialects. For expression of key curricular concepts, characters use vocabulary in Modern Standard Arabic.

Using findings from an encouragement design performance evaluation on Season 1 of Ahlan Simsim conducted with 473 families in Egypt, Lebanon, Saudi Arabia (KSA), and United Arab Emirates (UAE), this research study will provide evidence that families who regularly co-viewed Ahlan Simsim reported improved emotional vocabulary and increased emotion regulation among both children 4–6 years old and their parents, expanding on the literature on the importance of co-viewership for children’s learning to also include parents’ improved socio-emotional skills. The findings also show that learning extended beyond viewing individual episodes, as parents reported that watching AS sparked conversations at home about new emotional vocabulary, expressing feelings, and practicing coping techniques.

The Importance of Emotion Knowledge and Emotion Regulation in Children

As noted, the evidence identifies a strong link between children’s socio-emotional skills and an array of positive outcomes, from academic development, pro-social behavior, and mental health (O'Conner et al., 2017; Leerkes et al., 2008; Durlak et al., 2011; Domitrovich et al., 2017; Jones & Bouffard, 2012). The foundation of socio-emotional development is emotion vocabulary. The ability to label emotions has shown to be significantly related to cognitive performance and emotional control, as an understanding of emotions and emotional control has been shown to be more strongly linked to indicators of early social and academic processes, even more so than cognitive processes (Leerkes, et al., 2008; Ogren & Sandhofer, 2022). Emotion knowledge among preschoolers is also an important mediator in interpersonal relationships with peers and teachers, as well as a predictor of kindergarten achievement (Torresa et al., 2015).

The ability for children to regulate their emotions is linked to children’s holistic development, as emotion regulation skills serve as a predictor for academic achievement, mental health problems, and behavioral problems later in life. For children transitioning from preschool to kindergarten, evidence has shown that emotional self-regulation was the domain most consistently related to academic performance (Barbarin, 2013). Further, a meta-analysis of studies assessing self-regulation in early childhood found that children’s emotion regulation skills were positively associated to math and literacy skills and negatively associated with depressive symptoms, aggression, criminal behavior, obesity, illicit drug use, and unemployment (Robson et al., 2020). Interestingly, despite the importance of emotion knowledge and emotion regulation to children’s growth, there is little research exploring the developmental relationship between these constructs (Lucas-Molina, et al., 2020). There is evidence to suggest that each is a prerequisite for the other, leading scholars advocate that emotion knowledge and emotion regulation are reciprocal skills, each supporting the acquisition of the other (Denham et al., 2012; Lucas-Molina, et al., 2020).

Parents contribute in significant ways to children’s emotion identification and regulation strategies. Evidence indicates that when a parent values teaching their child about emotions, there is a positive association with that child’s emotion knowledge (Denham & Kochanoff, 2002; van der Pol, et al., 2016). Furthering this, research also links parents’ support of their child’s emotion knowledge and improved child mental health symptoms. A study of an intervention focused on emotion knowledge for anxious preschoolers and their parents found improved emotion understanding skills, reduced anxiety symptoms for both parent and child, and improved parental confidence in their children’s ability to cope with anxiety (Fox, et al., 2012). Recent evidence continues to reinforce the link between emotion recognition and children’s mental health. A study of 249 American preschoolers found that when facing multiple adverse experiences, preschoolers with poor and moderate ability to recognize sad emotional intensity exhibited elevated depressive symptoms, and that sad emotion recognition may be a protective factor for depression in early childhood (Sudit et al., 2021).

The links to emotion knowledge and mental health are not inconsequential, particularly as the effects of COVID-19 globally have created a mental health crisis for children. A metanalysis of research exploring the impact of pandemics on children’s and adolescents’ mental health found that both groups are more likely to experience high rates of depression and anxiety during and after a pandemic (Meherali, et al., 2021). Evidence also shows that the effects of quarantines on children during previous incidents of disease containment measures, specifically social isolation and loneliness, increased the risk of depression between 0.25 and 9 years later (Loades, et al., 2020). Exacerbating the effects of isolation, school closures represent a loss of a daily routine and reduced access to critical services, like school meals, school health services, and provision of hygiene supplies. School closures also reduce the scope of the safety net for young children, reducing interactions with trusted adults and opportunities to identify child abuse or neglect (Viner, et al., 2022). Emerging evidence from the first wave of COVID-19 is confirming these assumptions. A review of data focused on mental health from 11 countries– Bangladesh, Brazil, Canada, China, India, Ireland, India, Japan, Turkey, United Kingdom, and United States – from February-July 2020 of children 0–19 years found 18% to 60% of children and adolescents scored above risk thresholds for distress, particularly anxiety and depressive symptoms. In a similar vein, likely due to school closures and a move to remote classrooms, studies that reported on child protection referrals found lower than expected number of referrals originating in schools (Viner, et al., 2022). Furthering these concerns, scholars have also warned that under COVID-19, these effects are likely to be even more severe for children experiencing developmental and intellectual delays (Patel, 2020). Given these initial findings, scholars have called for research to explore effective mental health strategies tailored to the needs of children, including the development and delivery of evidenced-based, age-appropriate programming to mitigate the effects of these adverse childhood experiences (Meherali et al., 2021).

Educational Mass Media as a Tool to Support Children’s Socio-Emotional Development

That mass media supports children’s learning at scale across a variety of educational outcomes is widely acknowledged (Associates for Community & Population Research, 2008; Cole & Lee, 2016; Mares & Pan, 2013; Fisch & Truglio, 2000; Borzekowski & Macha, 2010; Borzekowski, 2018; Borzekowski et al., 2019; Kennedy et al., 2022; Schmitt et al., 2000). Those effects are further enhanced when content is co-viewed with a parent or primary caregiver (Fisch, et al., 2008; Kibira & Jain, 2019; Meng et al., 2020; Morgenlander, 2010; Rasmussen, et al., 2016; Salomon, 1977). Despite this breadth and depth of evidence, there has been less of a focus on the association between mass media and young children’s socio-emotional skills building (Martins, 2015; Rasmussen, et al., 2016). A meta-analysis on the positive effects of television on children's social interactions found there were consistent positive effects for those who watched prosocial content relative to those who did not (Mares & Woodard, 2005). It should be noted, however, that while there is a general dearth in the literature on the link between mass media and prosocial behavior, this absence is even more pronounced in the Middle East and North Africa, as most literature has focused on North America, Europe, and Asia–Pacific (Mares & Woodard, 2005).

And, because research shows that interventions that support SEL can increase all children’s acquisition of these skills, mass media focused on SEL outcomes has the potential to provide a greater overall public health benefit relative to those interventions that target only those immediately affected by trauma or adversity (Domitrovich et al., 2017). Relatedly, due to COVID-19 restrictions and ensuing lockdowns, mass media is playing a critical role in supporting children and their families (Yoshikawa et al., 2020). Citing work done on the psycho-social responses of children and their parents to pandemic disasters (Sprang & Silman, 2013), researchers and policy advocates are particularly concerned about the long-term psychological impact of COVID-19 on young children given the prolonged duration, concerns of infection, boredom, lack of routine, lack of in-person social engagement with peers, and family financial loss (Wang et al., 2020). These findings indicate that pandemic disasters and subsequent disease-containment responses may create a condition that families and children find traumatic. Mass media, thus, can play a critical role in supporting children’s socio-emotional development, as they make sense of the world around them in the face of the ongoing COVID pandemic.

Overview of Study Methodology

The following research questions informed the design of this study:

  • To what extent do children understand and apply Ahlan Simsim’s educational messaging focused on building emotion vocabulary and emotion management strategies?

  • To what extent do co-viewing parents and caregivers understand and apply Ahlan Simsim’s educational messaging focused on building emotion vocabulary and emotion management strategies for their own emotion management and regulation?

To conduct this study, Sesame Workshop, the creators of Ahlan Simsim, commissioned D3 Systems to lead data collection in partnership with on the ground research partners. We recruited 473 caregiver-child dyads across four countries in the Middle East within MBC3’s range– Egypt, Lebanon, Saudi Arabia (KSA), and United Arab Emirates (UAE) – to participate in an encouragement design performance evaluation of AS. In this study, parent and caregiver are used interchangeably. Caregiver is defined here as someone living in the same home and who regularly cares for and engages with the child.

Method and Data Analysis

Each week for four weeks, each household received a viewing packet, which included a set of 3–4 Season 1 AS episodes and a viewing diary survey. Research teams delivered episodes and surveys online in all countries except for Lebanon, where the research team delivered hard copies (USB/DVD) and paper surveys. Respondents viewed episodes and completed surveys throughout week. Surveys collected parents’ observational feedback of their child, as well as their personal feedback. Using a 5-point Likert scale, parents provided responses to statements regarding the episode just viewed based on their agreement with that statement. Open-ended questions sought out more feedback pertaining to the specific lessons of the episode viewed.

After week 1, families received new viewing packets and the research team collected the previous week’s packet. Where relevant, episodes weblinks were invalidated. In Lebanon, enumerators visited each household for physical collection. For online countries, the research team monitored completion via an online dashboard. Enumerators implemented callbacks to respondents late to view episodes or who did not provide sufficient answers. In Lebanon, quality control and monitoring occurred upon packet collection at the household.

At the end of the four-week viewing period and having viewed a total of 13 episodes, or half of the total episodes from Season 1, a sub-sample of caregivers participated in focus group discussions (FGDs) to provide additional insights, for a total of 6 focus groups per country. Questions during the focus group discussions focused more on the holistic body of content rather than specific episodes, as well additional feedback on observed changes in their child’s knowledge and behavior throughout the viewing timeframe. All participating caregivers in the focus groups received a cash honorarium immediately after completing participation in the FGD. Participating caregivers in Lebanon (Beirut), Saudi Arabia (Jeddah, Riyadh), and UAE (Dubai, Abu Dhabi) received USD100. Participating caregivers in Egypt (Cairo, Alexandria) received USD50. Caregivers commuted to their FGD location. All caregivers lived in the cities they were interviewed, so their commute did not vary significantly from normal travel times and distances they are accustomed to in the area. Most caregivers had a short distance to travel, and among those with longer commutes, no one traveled farther than 25 km to a FGD venue. The honorarium was set at the rates above to cover any necessary transportation costs as well as adequately compensate the caregiver for their time to participate in 90–120 minute FGD session.

Data presented in this research study aggregates strongly agreed and agreed frequencies, unless otherwise noted. This data is complemented by qualitative focus group responses. A coding scheme was developed to code qualitative data from the open-ended diary questions and the focus groups discussions. Codes included child-level appeal, child-level relevance, child-level comprehension, child-level application, parent-level appeal, parent-level relevance, parent-level comprehension, and parent-level application. A field supervisor reviewed all coding outputs to ensure consistency in application. All qualitative data was transcribed in Arabic and translated into English prior to coding.

Sample

For each country, we sampled from two cities, except for Lebanon which included only Beirut. Additional demographic quotas by country included religion and refugee status in Lebanon and local/expatriate resident status in KSA and UAE. In Egypt and Lebanon, the research team recruited families via conventional door-to-door sampling. In Saudi Arabia and UAE, intercept sampling was the preferred method for recruitment, as daytime household visits with women are often restricted given the household’s customs, limiting effectiveness of door-to-door sampling.

Table 1 includes a breakdown of the sample by country, city, gender, religion, local/expat status, and host/displaced status, as relevant. Of note, all recruited expatriate participants spoke Arabic in their homes.

Table 1 Sample breakdown, by country
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All homes had a child between 4 and 6 years old, with a slight over index among 6-year-old children (37%). There was an even distribution among girls (51%) and boys (49%) among select children. For adults, nearly all caregivers were the select child’s mothers (96%). The majority caregivers were between the age of 25 and 34 (57%), with 37% between the age of 35 and 44. Most caregivers have a university education, except in Lebanon, where most have achieved a high school education. Differences in education between UAE, Egypt, and KSA (university) and Lebanon (secondary) can be attributed to the mode of the interview. Lebanon was the only country to use paper instruments/hard copy episodes, making accessibility for lower resource households, correlated to lower education, more accessible.

Show Receptivity Among Selected Geographies

Among the selected countries, we first measured show receptivity and engagement, a critical entry point in the pathway to support knowledge and behavior change through media (Borzekowski et al., 2019; Brunick, et al., 2016; Lauricella et al., 2011). The selected countries represent a diverse spectrum of socio-political contexts and Arabic dialects, as well as key markets within MBC3’s reach footprint. These locations were complemented by Lebanon, a target country for media and community engagement for the Ahlan Simsim program. Despite this vast diversity, on average across the four countries, 94% of caregivers reported that Ahlan Simsim was appealing. Eighty-four percent of parents reported that their child could relate to AS content and 83% reported that AS made their child laugh. Further, data from these countries indicates that the appeal of AS increases over time. Across the 4 weeks, on average caregivers who strongly agreed that their child will want re-watch AS more than they want to re-watch other shows increased from 54% to 63%.

Data on receptivity indicated variations in linguistic preferences, the majority of which mirrored the diversity of Arabic dialects across the Middle East and North Africa and the complexity associated with the language choice for a pan-Arab television show.Footnote 1 Unsurprisingly, reception of the show’s dialect was most positive in Lebanon with both Lebanese nationals and displaced Syrians. In Egypt, though participants indicated they had a difficult time understanding the dialects, they noted it became easier to understand as they got used to the accents, with parents even referencing Arabic language learning as one of Ahlan Simsim’s lessons. Similarly, though parents in KSA had the fewest complaints about language and dialect used in the show, some KSA caregivers did express interest in showing a version of Ahlan Simsim to their children in English or Modern Standard Arabic.

Responses to the dialect in the UAE were the most varied. Though native Emiratis did not express concerns about their child’s understanding of the Arabic dialects used in the episodes, they did note that there were no Emirati accents and would like to see that in the future to improve their children’s comprehension. On the other hand, some expatriate families noted that their children had trouble understanding the Arabic and requested an English version of the show. Despite this, several participants shared that they were happy the episodes are in Arabic so that their children will become better at the language, as diverse Arabic dialects are representative of their realities.

Based on these collective set of data on receptivity of AS, particularly when considering the diversity of the region relative to a show designed for a specific population within that region, the appeal, relevance, and acceptability of dialect of AS is consistent, an important benchmark for assessing the impact of its educational content across the geographies.

Findings

Findings of this study are presented along the following categories: child-level findings on comprehension and application of episode content, and parent-level findings on comprehension and application of episode content.

Comprehension and Application of Episode Content, Children

Parents across all geographies reported that that the AS episodes supported children’s socio-emotional learning. On average, 87% of parents reported that the episodes taught their child new emotion vocabulary words, and 83% of parents agreed that their children were applying the management strategies learned to help them manage their emotions (Fig. 1). While the findings were positive on average and across all geographies, parents in UAE reported the highest rate of agreement to these statements. Parents in KSA, on average, had the lowest rates of agreement to these statements.

Fig. 1
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Comprehension and application of AS lessons among children, by country

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Through both the surveys and focus group discussions, parents provided additional specificity on observed changes in their children’s knowledge and application of the show’s lessons. As one KSA mother of a 6-year-old son explained, her son referenced two strategies he learned to help his fear of the doctor: “He said needles and doctors aren't scary and if I ever feel scared, I'll do like Jad, I'll draw and count to 5.” Relatedly, and reinforcing the importance of co-viewing with a parent, a 5-year-old girl from Egypt asked her mother to remind her of the show’s lessons to manage big feelings: “When I feel upset mommy, remind me to do belly breathing.”

When looking further within Lebanon specifically, and analyzing survey data from Syrian refugees, the findings reveal overwhelming rates of agreement. In reporting on whether the episodes taught their children new emotion vocabulary words, 96% of Syrian parents agreed to this statement. In applying this new knowledge, 92% of Syrian parents agreed that their child had applied the lessons taught in the episodes. As a 23-year-old Syrian mother of a 6-year-old daughter explained, “She learned new things about feeling nervous and how to breathe from the stomach.”

There were variations in comprehension of Ahlan Simsim’s lessons by age. Because the target age for Ahlan Simsim’s content developmentally is children 5–6 years old, some parents of 4-year-old children reported that they had to explain the emotions to their children and felt that the concepts are better suited for older children. Relatedly, the viewing diary surveys revealed some variation by age on comprehension and application of AS’s educational content. Compared to parents of 5 and 6-year-old children, parents of 4-year-old children reported slightly lower agreement on episodes’ ability to teach their child new emotion vocabulary words and application of the episode’s lesson to manage emotions. On average, 88% of parents of 5- and 6-year-old children agreed that episodes taught their children new emotion vocabulary words, with only 83% of parents of 4-year-old children agreeing to this statement. For application of lessons taught in the show to help manage emotions, 85% of parents of 5- and 6-year-old children agreed to this statement, compared to only 79% of parents of 4-year-old children.

Comprehension and Application of Episode Content for Parents of Young Children

Although Ahlan Simsim is designed for young children, parents reported that the AS episodes also taught them the same lessons of emotion vocabulary and management strategies (Fig. 2). On average, 79% of parents reported that watching AS taught them new emotion vocabulary words and 85% of parents reported that the lessons from AS helped them manage their own emotions. As with child-facing statements, though agreement to these statements was high across all geographies, parents in UAE reported the highest rates of agreement relative to parents in KSA, who reported the lowest rates of agreement.

Fig. 2
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Comprehension and application of AS lessons among parents, by country

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Based on parent responses, watching AS episodes provided a springboard for parents and children to continue these discussions and apply the episode learnings to their personal experiences. Through both viewing diaries and focus group discussions, parents reported that AS episodes sparked conversations at home about new emotional vocabulary, expressing feelings, and practicing coping techniques. A 30-year-old mother in Lebanon who viewed the episodes with her 5-year-old son explained how watching the show generated post-viewing conversations about the meaning of loneliness: “After he finished watching, he asked me about the meaning of loneliness, and after we talked, he went to get a paper and start drawing like Abu’l Fihem asked Jad to do.” Parents also provided examples of how the lessons in the show helped them navigate difficult situations with children in their family. For example, a 32-year-old mother in KSA recalled a story of the show’s lessons helping resolve a conflict between her 6-year-old son and his nephew: “When my kid was fighting with his nephew because of a toy, I told him to breathe and relax. Then he smiled and gave him the toy.” Ultimately, parents found that the show helped their children learn lessons they have struggled to teach. A 36-year-old Lebanese mother shared that, “They made it simple for my child to learn the ideas and concepts that he had difficulty learning from me.”

Isolating findings for Syrian refugees in Lebanon, data reveal similar levels of agreement. More than 90% of Syrian parents reported that the episodes made them laugh and that the content was relatable to their family’s lives. More notably, 86% of Syrian parents reported that the episodes taught them new emotion vocabulary words. In addition, 87% of Syrian parents reported that they apply the strategies used in Ahlan Simsim episodes to manage their own emotions.

Limitations of the Study and Lessons Learned

The evaluation of Season 1 of Ahlan Simsim includes several limitations and resulting lessons learned. Due to the design of the study, the findings represented here are not causal, nor do they include direct child assessment. Instead, the findings rely on parent report of observed knowledge and behavior changes related to viewing Ahlan Simsim. Future iterations of this design could include collection of child-level data, possibly through drawings or video diaries, to complement parent diaries and provide a more robust analysis.

In addition, because of the focus on encourage-to-view, a minimum dose threshold was difficult to implement with fidelity. An ideal dose scenario constitutes daily viewing of an episode. Because this study implemented a more naturalistic design – viewing at home rather than viewing in a controlled environment like a school or community center – dose thresholds and exposure to content are challenging to determine beyond parent report but should be established as part of the recruitment screening process.

Finally, to ensure our sampling was inclusive of the diverse region included in the study, determining the appropriate delivery platform was challenging. In KSA and UAE, smartphone ownership is very high at 97% (Deloitte and Touche (M.E.) 2019). In Egypt, while mobile phone ownership is also high, around 95%, internet access is just over 50% (Arab Republic of Egypt., 2020). In Lebanon, 86% of adults own a smartphone (Silver, et al., 2019). Among displaced Syrians in Lebanon, it is not clear the proportion who have access to the Internet and/or a smartphone, but UNHCR estimates that refugees are half as likely than the general population to own an Internet-capable phone (UNHCR, 2016). Thus, this study could not rely on online platforms to collect back-end data across all regions. Further, back-end data would only provide data by episode rather than by household. Future versions of this study should consider provision of tablets to all participating families for use during the evaluation period to help track household level data and create a more equitable delivery mechanism across diverse populations.

Conclusion

Given the evidence linking socio-emotional skill building, school performance, pro-social behavior, reduced feelings of anxiety, and the mitigation of the negative effects of adverse childhood experiences (Britto, et al., 2016; Shonkoff, 2012), these findings provide continued insight on the ways in which educational media for children can support children’s holistic healthy development. When viewed through the lens of the immediate and still unknown long-term impacts of COVID-19 on children’s mental health and well-being, there is an increased need and potential for mass media to mitigate the likely long-term effects of restricted movement and school closures globally (Yoshikawa, et al., 2020). This further underscores the need to understand the ways in which educational children’s television can support children’s learning and developmental needs.

The findings from the evaluation of Season 1 of Ahlan Simsim demonstrate that the show is supporting both young children and their parents’ emotional vocabulary and emotion management strategies. While designed to support children in living in Jordan, Lebanon, Iraq, and Syria displaced and affected by the Syrian civil war, the show reaches children across the Middle East and North Africa through its pan-Arab broadcaster. The findings here suggest that the format and approach to engagement and learning in Ahlan Simsim is resonating with families in the region and serving a clear need in building the foundations of children’s socio-emotional skills through the emotional ABCs. Moreover, AS is serving as a springboard for families to continue these conversations beyond viewing, further strengthening the show’s educational goals.

The results of this study of AS add to the literature on mass media’s capacity to support children’s learning at scale, as well as the added benefit of co-viewership with a parent or primary caregiver. The results presented here expand on the empirical benefits of co-viewership, suggesting that the benefit of co-viewing also provides parents with important learning opportunities for their own socio-emotional development through accessible, engaging, informal mass media engagement. This skill development in parents can support both their personal resilience, as well as their children’s socio-emotional development. This learning is clear across the distinct socio-political contexts and linguistic landscapes of the region, as demonstrated here with the diverse geographies represented. Future research is needed to demonstrate causal effects of this co-viewership, but the initial findings here suggest that co-viewing children’s educational mass media benefits both child and parent socio-emotional learning outcomes.