Propiedades Psicométricas de la Escala de Evaluación Socioemocional Breve de Infantes y Niños (BITSEA) en una muestra de niños y niñas chilenos / Psychometric properties of the Brief Infant-Toddler Social and Emotional Assessment (BITSEA) in a sample of Chilean children

Introducción: La infancia temprana es una etapa crítica para la salud mental, por lo que es fundamental contar con herramientas eficaces para detectar tempranamente conductas infantiles relacionadas con psicopatología. Objetivo: Investigar las propiedades psicométricas de la Escala de Evaluación Socioemocional Breve de Infantes y Niños (BITSEA) en una muestra de infantes chilenos. Método: 289 padres de niños y niñas de entre 12 y 36 meses de edad completaron la BITSEA y el CBCL 1½-5. Resultados: Se encontró una confiabilidad aceptable para las puntuaciones de la subescala "problema socioemocional" (ω=0.84), y una confiabilidad baja para las puntuaciones de la subescala "competencia socioemocional" (ω=0.59). La estructura factorial fue adecuada y se observó una alta validez concurrente con otras escalas. El modelo confirmatorio mostró índices aceptables (CFI= 0.94; TLI= 0.94; SRMR= 0.07; RMSEA= 0.027). Conclusión: La BITSEA en esta muestra arrojó resultados similares a otros estudios, su aplicabilidad es prometedora para la detección temprana de problema socioemocional en la infancia temprana. Se sugiere continuar su estudio en muestra nacional representativa.

Introduction: Early childhood is a critical stage for mental health, and it is necessary to have effective tools for early detection of child behaviours related to psychopathology. Objective: to assess the psychometric properties of the Brief Infant and Toddler Social-Emotional Evaluation Scale (BITSEA) in a sample of Chilean children. Methods: 289 parents of infants and toddlers aged 12-36 months completed the BITSEA and the CBCL 1½-5. Results: Acceptable reliability was found for the "socioemotional problems" dimension (ω=0.84), and low reliability for the "socioemotional competence" subscale scores (ω=0.59). The factor structure was adequate and high concurrent validity with other scales was observed. The confirmatory model showed acceptable fit indices (CFI= 0.94; TLI= 0.94; SRMR= 0.07; RMSEA= 0.027). Conclusion: The BITSEA in this sample showed similar results to other studies, its applicability is promising for the early detection of socioemotional problems in early childhood. It is suggested to continue its study in a nationally representative sample.

Increased behavioural problems associated with corticosteroid use in children with nephrotic syndrome: a Southeast Asian perspective

INTRODUCTION@#The study was performed to determine the psychological problems in children with idiopathic nephrotic syndrome (INS) while they were on steroid therapy, as compared to healthy children.@*METHODS@#This prospective cohort study was conducted in a paediatric clinic of a tertiary hospital. Parents of the participants in the INS group and control group (comprising children without chronic illness) completed questionnaires using the Child Behavioural Checklist (CBCL). The CBCL measures a range of age-specific emotional and psychological problems, including internalising and externalising domains. Analyses of the CBCL scores between groups were done using Mann-Whitney U test.@*RESULTS@#A total of 140 children were recruited with an equal number in the INS and control groups. There was a significant difference in the mean total CBCL scores between the INS group and the control group, specifically in the withdrawal, somatic, anxious and aggressiveness subdomains. Similar findings were demonstrated in correlation between total psychological problems and corticosteroid dosage. In the INS group, steroid dose and cushingoid features were found to have a significant positive association with internalising psychological problems.@*CONCLUSION@#Children with INS on corticosteroid treatment showed an increase in internalising and externalising scores, as compared to healthy children.

Problemas comportamentales en la infancia: conceptualización, evaluación e impacto / Behavioral Problems during Childhood: conceptualization, evaluation and impact

Los problemas comportamentales en la infancia suponen todos aquellos comportamientos persistentes en los que se repiten conductas que no respetan las normas o las reglas sociales propias de la edad. La detección temprana de estas dificultades permite controlar en cierto modo la gravedad del asunto ya que, de no trabajarse sobre la sintomatología del niño, las posibilidades de desarrollar un trastorno mental severo son mayores. Así, la identificación y el diagnóstico de los problemas conductuales se ha vuelto una meta de gran significación para la disciplina psicológica. El objetivo de este estudio fue realizar una revisión de la literatura reciente para sistematizar la información referida a las diferentes conceptualizaciones teóricas que existen sobre los problemas comportamentales desde diversas escuelas psicológicas y las respuestas terapéuticas que ofrecen, identificar los instrumentos de medición validados para su evaluación en Argentina, y describir la importancia de su detección temprana y posibles áreas de incidencia(AU)

Behavioral problems in childhood involve all those persistent actions in which activities that do not respect the norms or social rules of the age are repeated. Early detection of these problems makes it possible to control the severity of the problem to a certain extent. If the child's symptoms are not elaborated, the chances of developing a severe mental disorder are greater. Thus, the identification and diagnosis of behavioral problems has become a goal of great significance for the psychological discipline. The objective of this article was to carry out a review of the recent literature to systematize the information referring to the different theoretical conceptualizations that exist on behavioral problems from various psychological schools and the therapeutic responses they offer. Also,to identify the measurement instruments validated for their evaluation in Argentina and describe the importance of its early detection and possible areas of incidence(AU)

Ateneo General de la Residencia de Psicopedagogía: Niños pequeños: construyendo caminos hacia grandes pasos / General Athenaeum of the Psychopedagogical Residence: Little childrens: Building Pathways to Big Steps

Ateneo centrado en el abordaje en niños pequeños en la práctica de la Unidad de Salud Mental del Hospital de Niños Ricardo Gutiérrez, de la Ciudad de Buenos Aires. En una primera parte del texto, se describen algunos conceptos centrales en relación a la clínica con niños pequeños, y a la complejidad de la primera infancia. En un segundo momento, se profundiza en aspectos que se consideran fundamentales al realizar una evaluación. Por último, se abordan los modos de intervenir propios del Equipo de Psicopedagogía de esta Unidad.

Programas de fortalecimiento de prácticas parentales: un aporte a la prevención de conductas externalizantes en preescolares / Training programs in parental skills: a contribution to the prevention of the development of externalizing behaviors in preschool children

Resumen: La presencia de conductas externalizantes en la infancia tiene importantes grados de continuidad temporal futura, y es un factor de riesgo de fracaso y abandono escolar, de conductas delictuales, abuso y dependencia de sustancias, de conductas suicidas y de otros trastornos psicopatológicos del desarrollo. En esta revisión se analizan los principales aspectos relacionados con los programas de fortalecimiento de prácticas parentales como dispositivos útiles en el marco de estrategias multicomponentes de trabajo preventivo. La evidencia ha demostrado que la intervención dirigida a madres y padres es crucial en la modificación de problemas de conducta en niños/as, siendo el entrenamiento en habilidades parentales una de las estrategias mejor estudiadas y consideradas de mayor calidad al momento de prevenir el desarrollo de conductas externalizantes.

Abstract: The presence of externalizing behaviors in childhood has significant degrees of future self-continuity and is a risk factor for school failure and drop-out, criminal behavior, substance abuse and depen dence, suicidal behaviors and other developmental psychopathological disorders. In this review, the main aspects related to parental practices strengthening programs are analyzed as useful instruments in the context of multi-component preventive work strategies. The evidence has shown that interven tion aimed at mothers and fathers is crucial in the modification of behavioral problems in children, where training in parental skills is one of the most studied strategies and considered of higher quality when preventing the development of externalizing behaviors.

Emotional and behavioral problems: a school-based study in southern Brazil / Problemas emocionais e comportamentais: um estudo de base escolar no sul do Brasil

Abstract Introduction Mental health assessment in childhood needs to be carried out within a broader context that includes different factors. Objective To assess the prevalence of emotional and behavioral problems in schoolchildren and associated factors. Method A cross-sectional study was conducted with a school-based sample at 20 schools selected by systematic random sampling. Participants consisted of children aged 7-8 year old and their parents or primary caregivers. The Strengths and Difficulties Questionnaire (SDQ) was used to screen for the presence of emotional and behavioral problems in children. Results A total of 596 dyads were evaluated. The prevalence of emotional and behavioral problems was 30.0% among boys and 28.2% among girls. Hyperactivity/inattention were more prevalent among boys (p=0.015). Belonging to economically disadvantaged strata increased the likelihood of emotional and behavioral problems among schoolchildren by 71% (p=0.001), while having parents or caregivers with mental disorder increased by 2.2 times that probability (p<0.001). Conclusion: Our findings showed a high prevalence of emotional and behavioral problems among schoolchildren, as well as the influence of economic conditions and of the mental health of parents and caregivers on child mental health.

Resumo Introdução A avaliação da saúde mental na infância necessita ser realizada dentro de um contexto amplo que considere os diferentes fatores envolvidos. Objetivo Verificar a prevalência de problemas emocionais e comportamentais em escolares, bem como fatores associados. Método Estudo transversal, com amostra de base escolar em que foram selecionadas 20 escolas por amostragem aleatória sistemática. Participaram crianças com 7-8 anos e seus pais ou principais cuidadores. A presença de problemas emocionais e comportamentais nas crianças foi rastreada pelo Strengths and Difficulties Questionnaire (SDQ). Resultados Foram avaliadas 596 díades. A prevalência de problemas emocionais e comportamentais foi de 30,0% entre os meninos e 28,2% entre as meninas. Sintomas de hiperatividade/desatenção foram mais prevalentes entre meninos (p=0,015). Pertencer a camadas menos favorecidas economicamente aumentou em 71% a probabilidade de problemas emocionais e comportamentais entre os escolares (p=0,001), enquanto ter pais ou cuidadores com transtorno mental aumentou 2,2 vezes tal probabilidade (p<0,001). Conclusões: Nossos achados demonstram a elevada prevalência de problemas emocionais e comportamentais entre escolares, bem como a influência das condições econômicas e da saúde mental de pais e cuidadores sobre a saúde mental infantil.

Perfil de desregulación definido mediante el instrumento Child Behavior Checklist en preescolares / Dysregulation profile defined by Child Behavior Checklist in a sample of preschool children

INTRODUCCIÓN: El perfil de desregulación (PD) es una entidad clínica de interés en el área infantojuvenil, puesto que se asocia a psicopatología futura. El PD se define a partir del instrumento Child Beha vior Checklist (CBCL), combinando síntomas internalizantes (ansiedad/depresión) y externalizantes (agresividad, problemas de atención). OBJETIVO: Estudiar la frecuencia del perfil de PD por CBCL en una muestra de preescolares chilenos. PACIENTES Y MÉTODO: Se aplicó una encuesta sociodemográfica y Cuestionario CBCL 1% - 5 a cuidadores de niños entre 30 y 48 meses de edad, en una muestra representativa nacional de usuarios de red pública. Se estimó la frecuencia utilizando el método de Kim y colaboradores y se realizó un modelo explicativo mediante regresión logística binaria del PD utilizando variables del cuidador, del niño y del contexto. RESULTADOS: La muestra fue de 1429 pre escolares y sus cuidadores. La frecuencia de PD fue de 11,6% (IC 95% 9,9-13,5%). Las variables que permiten predecir el PD en un 88,6% fueron: Síntomas depresivos actuales en el cuidador principal (OR: 2,24; IC95%: 1,37-3,67); Número de eventos vitales estresantes vividos por el cuidador principal (p = 0,005); Número de elementos disponibles para estimulación en el hogar (p = 0,001); Número de enfermedades crónicas del niño (p = 0,006). CONCLUSIONES: PD tiene una frecuencia alta en preesco lares, lo que implica una carga en salud mental relevante, apuntando a la necesidad de intervenciones en esta área, además de seguimiento longitudinal de esta subpoblación.

INTRODUCTION: The dysregulation profile (DP) is a relevant clinical entity in the children and ado lescent area since its association with future psychopathology. DP is defined by the Child Behavior Checklist (CBCL), combining internalizing symptoms (anxiety/depression) and externalizing ones (aggressiveness, attention problems). OBJECTIVES: To study the frequency of CBCL-DP in a sample of Chilean preschoolers. PATIENTS AND METHOD: A sociodemographic survey and CBCL 1.5-5 was applied to caregivers of children aged 30 to 48 months in a national representative sample of public health system users. Frequency was estimated using the Kim et al. method and an explanatory model was made using binary logistic regression of DP using the child, caregiver, and contextual variables. RESULTS: The sample size was n = 1,429 preschool children and their caregivers. The frequency of DP was 11.6% (95% CI 9.9-13.5%). The variables that allow to classify DP in 88.6% of cases were: current depressive symptoms in the main caregiver (OR: 2.24; 95% CI 1.37-3.67); number of stressful events experienced by the main caregiver (p = 0.005); number of available elements for child development stimulation in the home (p = 0.001); number of chronic diseases of the child (p = 0.006). CONCLUSIONS: DP has a high frequency in preschoolers, which implies a relevant mental health burden. This finding points to the need for interventions in this area and also longitudinal monitoring of this subgroup.

Intimate partner violence during pregnancy and behavioral problems in children and adolescents: a meta-analysis / Violência por parceiro íntimo na gravidez e problemas comportamentais de crianças e adolescentes: uma metanálise

Abstract Objective: To evaluate the association of intimate partner violence during the gestational period and the development of externalizing and internalizing behavioral problems in children and adolescents. Source of data: A meta-analysis of cohort and case-control studies was performed, using studies selected from electronic databases. Eligible studies included women who experienced intimate partner violence during pregnancy and their children's behavioral problems. These problems encompass two groups: externalizing problems (expressed by hyperactivity, aggressive and challenging behavior, and delinquency) and internalizing problems (represented by depressive moods, anxiety, and somatic symptoms). The risk of bias was assessed by the Newcastle-Ottawa Quality Assessment Scale (NOS) and the quality of evidence by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE). RevMan 5.3 software was used for the meta-analysis. Data synthesis: Of the 687 eligible articles, only seven met all inclusion criteria and consisted of 12,250 mother/child pairs. The age range of the assessed children varied from 10 months to 16 years. The odds of internalizing problems in children exposed to prenatal violence were two-fold higher (OR = 2.10, 95% CI: 1.17-3.76) and that of externalizing problems were 1.9-fold higher (95% CI: 1.28-2.83), when compared to children of unexposed mothers. Conclusion: The results of this study are consistent with the hypothesis that women's exposure to intimate partner violence during pregnancy may be associated with behavioral problems of their children, emphasizing the need for greater understanding about the vulnerability of children to adversity in early ages.

Resumo Objetivo: Avaliar a associação da violência por parceiro íntimo durante o período gestacional e o desenvolvimento de problemas comportamentais externalizantes e internalizantes de crianças e adolescentes. Fontes dos dados: Foi realizada metanálise de estudos de coorte e caso‐controle, selecionados em bases de dados eletrônicas. Os estudos elegíveis incluíram: mulheres que sofreram violência pelo parceiro íntimo durante a gravidez e problemas comportamentais de seus filhos. Esses problemas englobam dois grupos: os problemas externalizantes (que se expressam por hiperatividade, comportamento agressivo e desafiante e delinquência) e os internalizantes (representados por humor depressivo, ansiedade e sintomas somáticos). O risco de viés foi avaliado pela Newcastle‐Ottawa Quality Assessment Scale (NOS) e a qualidade da evidência pelo "Grading of Recommendations, Assessment, Development and Evaluation (GRADE)". O software RevMan 5.3 foi usado para a metanálise. Síntese dos dados: Dos 687 artigos elegíveis, apenas sete apresentaram todos os critérios de inclusão e formaram 12.250 pares de mães e filhos. A faixa etária das crianças analisadas variou de 10 meses a 16 anos. A chance de problemas internalizantes das crianças, expostas à violência pré‐natal, foi duas vezes maior (OR = 2,10; IC 95%: 1,17‐3,76) e de problemas externalizantes, foi 1,90 vezes maior (IC 95%: 1,28‐2,83), quando comparada com filhos de mães não expostas. Conclusão: Os resultados deste estudo são consistentes com a hipótese que a exposição da mulher a violência por parceiro íntimo na gestação pode estar associada a problemas comportamentais dos filhos, destacando a necessidade de maior compreensão sobre vulnerabilidade das crianças a adversidades precoces.

Can parenting practices predict externalizing behavior problems among children with hearing impairment?

Objective: To identify possible differences in the level of externalizing behavior problems among children with and without hearing impairment and determine whether any relationship exists between this type of problem and parenting practices. Methods: The Behavior Assessment System for Children was used to evaluate externalizing variables in a sample of 118 boys and girls divided into two matched groups: 59 with hearing disorders and 59 normal-hearing controls. Results: Significant between-group differences were found in hyperactivity, behavioral problems, and externalizing problems, but not in aggression. Significant differences were also found in various aspects of parenting styles. A model for predicting externalizing behavior problems was constructed, achieving a predicted explained variance of 50%. Conclusion: Significant differences do exist between adaptation levels in children with and without hearing impairment. Parenting style also plays an important role.

Dimensions of youth psychopathy differentially predict concurrent pro- and antisocial behavior

Objective: To investigate the unique contribution of narcissism and impulsivity, in addition to callous-unemotional (CU) traits, in explaining concurrent prosocial and antisocial behavior. Method: Two hundred and forty-nine schoolchildren (53% female; age 9-12 years) completed the self-report Strengths and Difficulties Questionnaire (SDQ) and the Antisocial Process Screening Device (APSD). Two statistical models were tested, predicting conduct problems (CP) and prosocial behavior (PB). In the first one, CU traits and gender were entered into the equation. The second model added narcissism and impulsivity. Results: Gender, narcissism and impulsivity, but not CU, were statistically significant predictors of CP in the second model (F3,226 = 45.07, p < 0.001, R2 = 43.7%; betas: gender = -0.20, narcissism = 0.29, impulsivity = 0.36, CU = 0.06). PB was significantly predicted by all domains except gender (F3,226 = 42.57, p < 0.001, R2 = 42.4%; betas: gender = 0.08, narcissism = -0.16, impulsivity = -0.23, CU = -0.41). Conclusion: Our results confirmed that CU traits refer to a distinct manifestation of psychopathy in youth, but we also found that narcissism and impulsivity are equally important when predicting CP. Previous reports of sex differences on APSD and SDQ domains were also corroborated.

Child labor and severe functioning difficulties and disability in Mexican children and adolescents 5-17 years of age / Trabajo infantil y dificultades severas de funcionamiento y discapacidad en niños y adolescentes mexicanos de 5-17 años

Abstract: Objective: To describe the characteristics of Mexican children and adolescents 5-17 years with severe functioning difficulties and disability and explore their participation in child labor. Materials and methods: Using data from the National Survey of Boys, Girls and Women in Mexico 2015 we estimated prevalence of functioning difficulties and disability and used logistic regression to explore the association between this condition and child labor. Results: While 11.2% of Mexicans 5-17 years-old has severe functioning difficulties or disability, 13.4% work. The functioning difficulty and disability domains with the highest prevalence are experiencing anxiety (5.4%) and depression (1.5%) daily. Children and adolescents with severe functioning difficulties and disability are 70% more likely to do child labor [OR=1.7, 95%CI:1.2,2.4]. Educational lag doubles the likelihood of doing child labor [OR=2.2, 95%CI:1.5,3.3]. Conclusions: Guaranteeing educational opportunities and respect for the rights of children with severe functioning difficulties and disability is essential to achieve development of their full potential.

Resumen: Objetivo: Describir la población mexicana de 5-17 años con problemas severos de funcionamiento y discapacidad y explorar su realización de trabajo infantil. Material y métodos: Basado en la Encuesta Nacional de Niños, Niñas y Mujeres 2015, se estimaron prevalencias de problemas de funcionamiento y discapacidad y se exploró la relación con el trabajo infantil en un modelo de regresión logística. Resultados: El 11.2% de los mexicanos de 5-17 años tiene dificultades severas de funcionamiento o discapacidad y 13.4% realiza trabajo infantil. Los ámbitos con la mayor prevalencia fueron ansiedad (5.4%) y depresión (1.5%) experimentadas diariamente. Niños y adolescentes con problemas severos de funcionamiento o discapacidad tienen 70% más posibilidades de realizar trabajo infantil [RM=1.7, IC95%:1.2,2.4]. El rezago educativo duplica las posibilidades de realizar trabajo infantil [RM=2.2, IC95%:1.5,3.3]. Conclusiones: Es imprescindible garantizar oportunidades educativas y respeto a los derechos de la población infantil con problemas de funcionamiento y discapacidad para lograr su desarrollo integral.

Inventario de Conductas Infantiles en preescolares: propiedades psicométricas del Inventario de Conductas Infantiles (CBCL/1. 5-5) y del informe del cuidador/educador (C-TRF) en preescolares chilenos / Psychometric properties of the Child Behavior Checklist and the caregiver /teacher report form in Chilean preschoolers

El Inventario de Conductas Infantiles 1.5-5 años (CBCL/1.5-5 por su acrónimo en inglés) y el informe del cuidador/educador (C-TRF por su acrónimo en inglés), son de los instrumentos más ampliamente reconocidos internacionalmente para evaluar conductas desadaptativas que pueden afectan el desarrollo presente y futuro de niños y niñas preescolares. Se evaluó el comportamiento psicométrico de ambos instrumentos en una muestra diversa socioeconómicamente de 550 preescolares chilenos. En general, ambos mostraron un comportamiento psicométrico análogo al obtenido con estudios en otras sociedades. Los análisis factoriales confirmatorios mostraron un ajuste adecuado del modelo bifactorial original. Sin embargo, en el CBCL/1.5-5 los puntajes obtenidos son más altos que en la mayoría de los países y, comparativamente, en ambos instrumentos, se observó un mayor efecto de género. Se analizan los hallazgos obtenidos, y se dan sugerencias normativas y conceptuales para el empleo de ambos instrumentos en niños y niñas preescolares en nuestro país.

The child Behavior checklist/1.5-5 and the caregiver/teacher report Form are one of the most widely internationally recognized instruments to evaluate desadaptative behaviors which may affect the current and future development of preschool children. The psychometric behavior of both instruments was evaluated in a socioeconomically diverse sample of 550 chilean preschool children. In general, it was observed an analog behavior of both compared to the one obtained with studies in other societies. The confirmatory factor analysis showed a suitable adjustment of the original bifactor model. However, in the CBCL, the scores obtained are higher than in most of the countries and, comparatively, in both instruments, a greater effect of gender was observed. The findings obtained are analyzed and, normative and conceptual suggestions are given for the use of both instruments in preschool children in our country.

Consultas terapêuticas familiares no tratamento do comportamento agressivo em crianças / Therapeutic family consultations in the treatment of agressive behavior in children

Relato de estudo no qual foi aplicado o modelo consultas terapêuticas familiares (CTF) no tratamento de famílias de crianças agressivas. Esse modelo foi desenvolvido pelas autoras com base nos trabalhos de R.Benenzon, em musicoterapia, e D. Winnicott, em consultas terapêuticas. Participaram seis famílias, comas quais foram realizadas entrevista inicial (EI), hora interativa (HI) e sessão com os cuidadores (SC), em unidades ambulatoriais. Em alguns casos, houve observações na escola (OEs). As EIs, HIs, OEs e SCs foram registradas por escrito, e as HIs foram gravadas em aúdio e vídeo. A análise constatou, nas crianças, diminuição dos comportamentos agressivos relacionados aos sentimentos de insegurança e desconfiança em relação aos cuidadores. Havendo adesão dos principais cuidadores, o modelo mostrou seviável e fecundo

Household task demands for quiet and focused behavior facilitate performance by ADHD youth / Demandas de tarefas domésticas por comportamento quieto e focado facilitam o desempenho de jovens com TDAH

ABSTRACT This study evaluated the associations among symptoms of attention-deficit/hyperactivity disorder (ADHD) and of oppositional defiant disorder (ODD) in children and adolescents’ performance in household tasks and assistance provided by caregivers. Parents of children from 6 to 14 years old with ADHD (n = 67) were interviewed with the Children Helping Out: Responsibilities, Expectations, and Supports (CHORES) instrument. Significant correlations were found between symptoms of ODD and assistance in self-care tasks (r = −0.31; p = 0.01); symptoms of hyperactivity correlated with assistance in self-care (r = −0.30, p = 0.01); and family-care (r = −0.25, p = 0.04) tasks. Age was directly associated with the number of tasks performed by children and inversely related to the assistance provided by caregivers. A greater number of ODD symptoms resulted in more household assistance from caregivers. Characteristics of ODD symptoms, such as disobedience and hostility in the face of authority, may limit these children in accessing household tasks by their own initiative, requiring assistance from caregivers.

RESUMO Este estudo avaliou transversalmente a correlação entre sintomas de transtorno de déficit de atenção e hiperatividade (TDAH) e de oposição com desempenho de crianças e adolescentes nas tarefas domésticas e assistência disponibilizada pelos cuidadores. Pais de crianças e adolescentes com TDAH (n = 67), de 6 a 14 anos, foram entrevistados com o children helping out: responsibilities, expectations and supports (CHORES). Foram encontradas correlações significativas entre sintomas de oposição e assistência em cuidado próprio (r = -0,31; p = 0,01) e de hiperatividade com assistência em cuidado próprio (r = -0,30, p = 0,01) e em cuidado familiar (r = -0,25, p = 0,04). Idade está diretamente correlacionada ao número de tarefas desempenhadas pela criança e inversamente associada à assistência disponibilizada pelos cuidadores. Maior número de sintomas de oposição resultou em maior assistência disponibilizada. Características dos sintomas de oposição, como a desobediência e hostilidade frente às autoridades, são limitantes para que essas crianças acessem as tarefas por iniciativa própria, demandando maior assistência dos cuidadores.

Prevalence of behavior problems and associated factors in preschool children from the city of Salvador, state of Bahia, Brazil

Objective: To identify the prevalence of internalizing and externalizing behavior problems among preschoolers from the city of Salvador, state of Bahia, Brazil, and their associations with maternal mental health and family characteristics. Methods: This was a cross-sectional study of 349 children aged 49 to 72 months, randomly selected from 20,000 households representing the range of socioeconomic and environmental conditions in Salvador. In 1999, we assessed sociodemographic variables and family environment characteristics. In 2001, we used the Child Behavior Checklist to measure and describe the frequencies of behavior problems. We conducted bivariate and multivariate analysis to estimate associations between family and maternal factors and prevalence of behavior problems. Results: The overall prevalence of behavior problems was 23.5%. The prevalence of internalizing problems was 9.7%, and that of externalizing problems, 25.2%. Behavior problems were associated with several maternal mental health variables, namely: presence of at least one psychiatric diagnosis (odds radio [OR] 3.01, 95%CI 1.75-5.18), anxiety disorder (OR 2.06, 95%CI 1.20-3.46), affective disorder (OR 2.10, 95%CI 1.21-3.65), and mental health disorders due to use of psychoactive substances (OR 2.31, 95%CI 1.18-4.55). Conclusion: The observed prevalence of child behavior problems fell within the range reported in previous studies. Maternal mental health is an important risk factor for behavior problems in preschool-aged children.

Metodologias participativas em pesquisa com crianças: abordagens criativas e inovadoras / Metodologías de investigación participativa con niños: enfoques creativos e innovadores / Participatory methodologies in research with children: creative and innovative approaches

RESUMO Objetivo Relatar a experiência da utilização de metodologias participativas em pesquisa com crianças. Métodos Relato de experiência com abordagem qualitativa, realizado com crianças entre seis e onze anos de uma escola municipal, em Pelotas, e do Centro de Atenção Psicossocial Infantojuvenil, em São Lourenço do Sul, ambos municípios do Estado do Rio Grande do Sul. A coleta de dados foi baseada em registros feitos em diários de campo e observação, realizada de abril a julho de 2016. Resultados O relato apontou que o Photovoice promoveu a motivação entre o grupo e elevou a autoestima e a autoconfiança das crianças. O Mapa dos Cinco Campos possibilitou às crianças expressar sentimentos por intermédio do jogo. Conclusão Compreende-se que o Photovoice e o Mapa dos Cinco Campos são instrumentos que viabilizam novas abordagens metodológicas nas pesquisas com crianças, facilitando a construção das propostas de atividades que visam processos inovadores e criativos de pesquisa em saúde/enfermagem.

RESUMEN Objetivo Presentar la experiencia de usar enfoques participativos en la investigación con niños. Métodos Informe de experiencia con un enfoque cualitativo, realizado con niños de entre seis y once años, de una escuela municipal en Pelotas y en el Cuidado de Niños y Jóvenes Centro Psicosocial, en São Lourenço do Sul, ambos municipios de Rio Grande do Sul. La recogida de datos se basa en los registros realizados en diarios de campo y observación, de abril a julio de 2016. Resultados el informe señaló que la Fotovoz promueve la motivación entre el grupo, el aumento de la autoestima, autoconfianza de los niños. El Mapa de cinco campos y ayudan a los niños a expresar sus sentimientos por medio del juego. Conclusión Se entiende que el Fotovoz y mapa de cinco campos son herramientas que permiten los nuevos enfoques metodológicos de la investigación con los niños, lo que facilita la construcción de las actividades propuestas dirigidas a los procesos creativos e innovadores de la investigación en salud/enfermería.

ABSTRACT Objective To describe the use of participatory methodologies in research with children. Methods Experience report with a qualitative approach, conducted with children between six and eleven years of age, from a municipal school in Pelotas and in the Psychosocial Children and Youth Care Center, in São Lourenço do Sul, both municipalities of the Rio Grande do Sul State. Data collection was based on records made in field and observation diaries, held from April to July 2016. Results The report pointed out that the Photovoice promoted motivation in the group, in addition to increasing the self-esteem and self-confidence of children. The Five Field Map made it possible to help children express feelings through the game. Conclusion Photovoice and the Five Field Map are seen as tools that enable new methodological approaches in research with children, facilitating the construction of the proposed activities aimed at innovative and creative research processes in health/nursing.

Behavior problems and social competence in Brazilian children with specific language impairment

Abstract This study aimed to investigate the behavior and social profile of Brazilian children with specific language impairment (SLI) and explore whether the severity of language deficits was associated with behavioral problems and low social competence. Twenty-four children with SLI aged from 6 to 11 years who showed substantial expressive language problems and were receiving speech-language therapy were assessed through the Child Behavior Checklist (CBCL). Children with SLI showed high rates of behavioral problems and low levels of social competence. With the exception of two subscales ("somatic" and "rule breaker"), the percentage of children with SLI at risk of behavioral problems was significantly higher than the same proportion in the general population; and almost all children with SLI (95.2 %) demonstrated problems with social competence. The severity of language deficits was associated with the risk of behavioral problems according to only one criterion. No associations were found between the severity of language problems and social competence. The study provides cross-cultural evidence to support the existence of behavior problems and reduced social competence in children with SLI. Our findings point to the need of using a combination of measures to classify the severity of language problems rather than a single dimension. (AU)

Possible benefit of consolidation therapy with high-dose cytarabine on overall survival of adults with non-promyelocytic acute myeloid leukemia

In adults with non-promyelocytic acute myeloid leukemia (AML), high-dose cytarabine consolidation therapy has been shown to influence survival in selected patients, although the appropriate doses and schemes have not been defined. We evaluated survival after calculating the actual dose of cytarabine that patients received for consolidation therapy and divided them into 3 groups according to dose. We conducted a single-center, retrospective study involving 311 non-promyelocytic AML patients with a median age of 36 years (16-79 years) who received curative treatment between 1978 and 2007. The 131 patients who received cytarabine consolidation were assigned to study groups by their cytarabine dose protocol. Group 1 (n=69) received <1.5 g/m2 every 12 h on 3 alternate days for up to 4 cycles. The remaining patients received high-dose cytarabine (≥1.5 g/m2 every 12 h on 3 alternate days for up to 4 cycles). The actual dose received during the entire consolidation period in these patients was calculated, allowing us to divide these patients into 2 additional groups. Group 2 (n=27) received an intermediate-high-dose (<27 g/m2), and group 3 (n=35) received a very-high-dose (≥27 g/m2). Among the 311 patients receiving curative treatment, the 5-year survival rate was 20.2% (63 patients). The cytarabine consolidation dose was an independent determinant of survival in multivariate analysis; age, karyotype, induction protocol, French-American-British classification, and de novo leukemia were not. Comparisons showed that the risk of death was higher in the intermediate-high-dose group 2 (hazard ratio [HR]=4.51; 95% confidence interval [CI]: 1.81-11.21) and the low-dose group 1 (HR=4.43; 95% CI: 1.97-9.96) than in the very-high-dose group 3, with no significant difference between those two groups. Our findings indicated that very-high-dose cytarabine during consolidation in adults with non-promyelocytic AML may improve survival.

Mental health of children and adolescents with epilepsy: analysis of clinical and neuropsichological aspects / Saúde mental de crianças e adolescentes com epilepsia: análise de fatores clínicos e neuropsicológicos

Epilepsy compromises the development of cognitive and social skills and represents a risk of psychiatric comorbidity. Objective: To compare psychopathological symptoms in children with epilepsy and in a healthy group, and to correlate the results with neuropsychological and clinical variables. Method: Forty five children with idiopathic epilepsy and sixty five healthy controls underwent neuropsychological evaluation and their caregivers replied to a psychopathology questionnaire (Child Behavior Checklist – CBCL). Results: There were significant differences in CBCL, with poorer results showed mainly by patients with epilepsy. There was no significant association between any psychopathological symptom and disease duration or amount of antiepileptic drugs used. There was positive correlation between intelligence quocient and CBCL on items such as sluggish cognitive tempo, aggressive behavior, attention problems and activities and a negative relation between academic achievement, conduct and rule-breaking behavior. Conclusion: Children with epilepsy had the worse results in the psychopathology evaluation. Certain psychopathological variables are related to the cognitive profile, with no relation to clinical variables. .

A epilepsia compromete o desenvolvimento de habilidades cognitivas e sociais e representa um risco para comorbidade psiquiátrica. Objetivo: Comparar sintomas psicopatológicos em crianças com epilepsia e um grupo saudável, e correlacionar os resultados com variáveis neuropsicológicas e clínicas. Método: Quarenta e cinco crianças com epilepsia idiopática e sessenta e cinco controles saudáveis foram submetidos à avaliação neuropsicológica e seus cuidadores responderam a um questionário de psicopatologia (Child Behavior Checklist – CBCL). Resultados: Houve diferenças significativas no CBCL, com piores resultados principalmente para pacientes com epilepsia. Não houve associação significativa entre os resultados e duração da doença ou número de drogas antiepilépticas. Houve relação positiva entre quociente de inteligência e CBCL em itens como tempo cognitivo lento, comportamento agressivo, problemas de atenção e atividades e uma relação negativa entre o desempenho acadêmico e conduta e comportamento de quebras de regra. Conclusão: Crianças com epilepsia apresentaram piores resultados em psicopatologia, com certas variáveis psicopatológicas relacionadas ao perfil cognitivo, mas sem relação com variáveis clínicas. .

Indicadores emocionales del DFH y su relación con los motivos de consulta psicológica en niños / Emotional indicators of the HFD and its relation with the psychological reasons for consultation in children

Los Indicadores emocionales (IEs) del Dibujo de la Figura Humana postulados por Koppitz (1968), son ampliamente utilizados en los ámbitos clínicos y educativos en nuestro país para la exploración psicológica de población infantil. Estos indicadores brindan información acerca de las ansiedades, actitudes y preocupaciones de los niños (Koppitz, 1984). En el presente estudio se evalúan estos IEs en los gráficos de niños de entre 6 y 12 años que asisten a consulta psicológica en los ámbitos públicos y privados, con el objeto de relevar si se evidencia relación con los motivos de consulta más frecuentes en esta franja etaria. Del análisis de los resultados se verifica que la presencia de algunos IEs se observa con más frecuencia en niños con dificultades en el aprendizaje y problemas de conducta.