Community lifestyle influences feeding practices among Indonesian infants and young children.

OBJECTIVE: To analyze the feeding practices of malnourished infants and young children aged 6-24 months old in Bogor, West Java, Indonesia. METHOD: Fourteen mothers or caregivers who had malnourished infants and young children aged 6-24 months were interviewed, focusing on their feeding practices. Informants came from sub-districts in Bogor Regency, Indonesia, which had a higher incidence of malnutrition. The interview process was recorded. Verbatim transcripts of recorded interviews were analyzed using thematic analysis. RESULTS: Five major themes were identified: (1) Inappropriate practice of early initiation of breastfeeding, (2) Challenges in decision making to maintain breastfeeding, (3) Lack of complementary feeding practices, (4) Failing to follow feeding recommendations, and (5) Infant and young child feeding constraints. CONCLUSION: The feeding practice for malnourished infants and young children is not entirely based on the recommended standards. This situation is caused by several factors such as economic conditions, culture, parental knowledge, family and community health workers' support. Health workers need to provide comprehensive intervention for mothers and families intensively by taking into account the culture and conditions of the related family.

Children Exposed to Interparental Violence: A Study of Portuguese Children from 7-9 Years of Age / Niños expuestos a violencia interparental: un estudio de niños portugueses de 7 a 9 años

Abstract Introduction: Exposure to interparental violence is a type of child maltreatment linked to a higher risk of physical and mental health problems. This research considers the experiences of young Portuguese children exposed to interparental violence. The goal is to explore the associations between interparental conflict in children, their perceptions of conflict properties, threat, self-blame, and the relationship with their parents. Method: The research protocol was applied to 888 Portuguese children between 7 and 9 years of age, of whom 123 are victims of interparental violence. Results: The results showed that witnessing interparental conflict is positively correlated with children's self-blame and insight into conflict properties and negatively correlated with children's insight into the parent-child relationship. Conclusion: These results provide strong support for the hypothesis that witnessing interparental conflict is associated with adverse outcomes in young children. Findings highlight the importance of identifying children exposed

Resumen Introducción: La exposición a la violencia interparental es un tipo de maltrato infantil, y está relacionada con mayor riesgo de desarrollo de problemas de salud física y mental. Esta investigación analiza las experiencias de los niños portugueses expuestos a la violencia interparental. El objetivo es explorar la relación entre el conflicto interparental en los niños, sus percepciones sobre las propiedades del conflicto, la amenaza, la culpabilidad y la relación con sus padres. Método: Se ha aplicado el protocolo de investigación a 888 niños portugueses de entre 7 y 9 años, no víctimas (n = 765) y víctimas de la violencia interparental (n = 123). Resultados: Los resultados mostraron que presenciar el conflicto interparental está positivamente asociado a la percepción de culpabilidad de los niños y la percepción de las propiedades del conflicto y negativamente correlacionada con su percepción de la relación padre-hijo. Conclusión: Estos resultados soportan la hipótesis de que presenciar un conflicto interparental está asociado al desarrollo de problemas en niños pequeños. Los resultados destacan la importancia de identificar a los niños que han presenciado el conflicto interparental para desarrollar programas de intervención adecuados.

Measuring child-rearing goals for parents with young children: A scoping review.

This scoping review summarizes and consolidates the parenting goals for young children captured in existing parent-report measures, and the characteristics of studies that employed them. Five electronic databases were systematically searched to identify original studies that used a self-report measure for parenting goals during the child's first 5 years. Characteristics of the parenting goals measures and the studies that employed them were extracted and synthesized. A deductive approach was used to reduce the parenting goals items across instruments into representative domains. Fourteen original parenting goals measures and their modifications (i.e., 24 unique measures in total) were identified in 44 research articles from 41 original studies. Items from these measures were synthesized into 33 representative domains. Findings will inform the direction of future research and the development of a comprehensive measure of parenting goals for parents with young children that can be applied across cultures, economic backgrounds, informants, and parenting contexts.

Esta revisión exploratoria resume y consolida los objetivos de crianza para los niños pequeños captados en medidas de informes actuales de los padres, así como las características de los estudios que las utilizaron. Se hicieron búsquedas sistemáticas en cinco bases de datos electrónicas para encontrar estudios originales en los que se utilizó un instrumento de medición de autoinforme para los objetivos de crianza durante los primeros cinco años del niño. Se extrajeron y se combinaron las características de las mediciones de los objetivos de crianza y los estudios que las utilizaron. Se usó un método deductivo para reducir los ítems de los objetivos de crianza de los instrumentos en áreas representativas. Se identificaron catorce instrumentos de medición de objetivos de crianza originales y sus modificaciones (p. ej.: 24 instrumentos de medición únicos en total) en 44 artículos de investigación de 41 estudios originales. Los ítems de estos instrumentos de medición se combinaron en 33 áreas representativas. Los resultados indicarán el rumbo de investigaciones futuras y el desarrollo de un instrumento de medición completo de los objetivos de crianza para padres con niños pequeños que se pueda aplicar a diferentes culturales, situaciones económicas, informantes y contextos de crianza.

Toddlers as social actors in early education / Los niños pequeños como actores sociales en la educación infantil temprana / Crianças como atores sociais na educação infantil

Abstract: This article focuses on interaction among young toddlers during their second year of life in a Swedish preschool, with the view of toddlers as social actors. The overall aim is to explore interaction, communication, and the creation of friendship between the young children during self-initiated play activities. Play is looked upon as a rich arena for observing toddler interaction. The theoretical framework for the study is phenomenology, the view of the child as a social person and a child-oriented perspective. This article will also address the important concepts of methodology and research ethics, in relation to an ethnographic early childhood study, intended to investigate toddler's life worlds. A close analysis of their worlds may reveal what was not visible before - like a kaleidoscope. Six one-year old girls and boys in a setting, in a total of 15 children, were the focus of this study's observations for nine months. Participatory methods, photos, field notes and video-recordings, were used for the data collection. The findings of the ethnographic study recognise theoretically the competence of the toddler as a social actor, the child as an active participant, and the strategic nonverbal and verbal actions of children to initiate friendship. Mutual awareness, joint attention, shared smiles, coordinated movements, as well as other types of synchronized actions are understood as parts of nonverbal elements in emerging friendship. The competencies of attunement, taking others' perspectives and turn-taking were found in play among the young toddlers.

Resumen: Este artículo se centra en la interacción entre los niños pequeños durante su segundo año de vida en un preescolar sueco, desde la perspectiva de los niños pequeños como actores sociales. El objetivo general es explorar la interacción, la comunicación y la creación de amistad entre los niños pequeños durante las actividades de juego iniciadas por ellos mismos. El juego se considera un campo rico para observar la interacción de los niños pequeños. El marco teórico para el estudio es la fenomenología, la visión del niño como una persona social y desde un enfoque centrado en el niño. Este artículo también abordará las categorías centrales de metodología y ética de la investigación, con relación al estudio etnográfico de la primera infancia, destinado a investigar los mundos de la vida de los niños pequeños. Un análisis detallado de sus mundos puede revelar -como un caleidoscopio- lo que antes no era visible. En un grupo de quince niños, se enfocó el estudio de seis niñas y niños de un año en el entorno preescolar mediante observaciones desarrolladas durante nueve meses. Para la recolección de datos se utilizaron métodos participativos, fotografías, notas de campo y grabaciones de video. Los hallazgos del estudio etnográfico reconocen teóricamente la competencia del niño pequeño como actor social, el niño como participante activo, y las acciones estratégicas no verbales y verbales de los niños para iniciar la amistad. La conciencia mutua, la atención conjunta, las sonrisas compartidas, los movimientos coordinados, así como otros tipos de acciones sincronizadas, se entienden como parte de elementos no verbales en la amistad emergente. Las competencias de sintonía, considerar las perspectivas de los demás y tomar turnos, fueron halladas en el juego entre los niños pequeños.

Resumo: Este artigo enfoca a interação entre crianças pequenas durante o segundo ano de vida em uma pré-escola sueca, com a visão das crianças como atores sociais. O objetivo geral é explorar a interação, a comunicação e a criação de amizade entre as crianças pequenas durante as atividades lúdicas autoiniciadas. As brincadeiras são vistas como uma arena rica para observar a interação das crianças. O referencial teórico do estudo é a fenomenologia, a visão da criança como pessoa social e uma perspectiva orientada para a criança. Este artigo também abordará os conceitos importantes de metodologia e ética em pesquisa, em relação a um estudo etnográfico da primeira infância, destinado a investigar o mundo da vida de crianças pequenas. Uma análise detalhada de seus mundos pode revelar o que não era visível antes - como um caleidoscópio. Em um grupo de quinze crianças, o estudo de seis meninas e meninos de um ano de idade no ambiente pré-escolar foi focado por meio de observações desenvolvidas ao longo de nove meses. Métodos participativos, fotos, notas de campo e gravações de vídeo, foram utilizados para a coleta de dados. Os resultados do estudo etnográfico reconhecem teoricamente a competência da criança como ator social; a criança como um participante ativo, e as ações não-verbais e verbais estratégicas das crianças para iniciar a amizade. Consciência mútua, atenção conjunta, sorrisos compartilhados, movimentos coordenados, bem como outros tipos de ações sincronizadas são entendidos como partes de elementos não-verbais na amizade emergente. As competências de sintonização, assumir a perspectiva dos outros e dar turnos foram encontradas em brincadeiras entre as crianças pequenas.

[Validation of a short food frequency questionnaire in small children]. / Validación de un cuestionario corto de frecuencia de consumo alimentario en niños pequeños.

INTRODUCTION: Introduction: validated food frequency questionnaires in children are scarce, mostly long, and only provide data about food consumption. Objectives: the aim of this study was to evaluate the reproducibility and validity of a short food frequency questionnaire that estimates energy, nutritional intake, and the frequency of food consumption in children aged between 3 and 6 years. Material and methods: in 49 children (57% boys), the reproducibility and validity of a frequency questionnaire with 41 items was assessed using Spearman's and intraclass correlations, both adjusted and not adjusted for energy. A 6-day record was used as a reference method. Results: reproducibility was high in food groups with correlations > 0.70 for most of them and between 0.5 and 0.7 for meat, fish, potatoes, sweets/soft drinks, and oil. For energy and nutrients correlations were > 0.9 and > 0.7, respectively. Validity was strong to moderate for foods with correlations > 0.7 (dairy and milk) and between 0.4 and 0.7 (sausages, eggs, yogur/cheese, vegetables and oil), and for nutrients with correlations > 0.5 (lipids, AGS, AGP, phosphorus, calcium, vitamin E and vitamin C) and between 0.3 and 0.5 (energy, starches, fiber, MUFA, cholesterol, sodium, magnesium, potassium, retinol, riboflavin, niacin, pantothenic acid, vitamin B6 and folates). All correlations were significant and increased after they had been adjusted for energy. Conclusions: the short food frequency questionnaire for children between 3 and 6 years old has high reproducibility and good validity with results that are as good as those of long food frequency questionnaires.

INTRODUCCIÓN: Introducción: los cuestionarios de frecuencia de consumo alimentario validados en la edad infantil son escasos, principalmente largos y solo aportan datos del consumo alimentario. Objetivos: nuestro objetivo fue evaluar la reproducibilidad y validez de un cuestionario de frecuencia corto que estimara la frecuencia del consumo de alimentos y la ingesta energética y nutricional en edades de 3 a 6 años. Material y métodos: en 49 niños y niñas (57% varones) se valoró la reproducibilidad y la validez de un cuestionario de frecuencia de 41 ítems mediante los coeficientes de correlación de Spearman e intraclase, ajustados y sin ajustar por la energía. Se usó como método de referencia un registro alimentario de 6 días. Resultados: se obtuvo una reproducibilidad elevada en los alimentos con correlaciones > 0,70 para la mayoría de alimentos, y entre 0,5 y 0,7 para carnes, pescados, patatas, dulces-refrescos y aceite; para la energía y los nutrientes, las correlaciones fueron > 0,9 y > 0,7, respectivamente. Se obtuvo una validez fuerte o moderada en los alimentos, con correlaciones > 0,7 para lácteos y leche, y entre 0,4 y 0,7 para embutidos, huevos, yogur/queso, verduras y aceite, y en los nutrientes, con correlaciones > 0,5 para lípidos, AGS, AGP, fósforo, calcio, vitamina E y vitamina C, y entre 0,3 y 0,5 para energía, almidones, fibra, AGMI, colesterol, sodio, magnesio, potasio, retinol, rivoflabina, niacina, ácido pantoténico, vitamina B6 y folatos. Las correlaciones fueron significativas y se incrementaron al ajustar la energía. Conclusiones: el cuestionario de frecuencia de consumo alimentario corto para niños de 3-6 años de edad resultó tener una reproducibilidad elevada y buena validez, con resultados tan buenos como los de un cuestionario largo.

Reproductive justice for incarcerated mothers and advocacy for their infants and young children.

The United States has seen unprecedented growth in the number of incarcerated women, most of whom are mothers with minor children. Major public health concerns relate to the reproductive health of women in prisons and jails and the well-being of their infants and young children. In the current article, we use a reproductive justice framework to examine the intersection of incarceration and maternal and child health. We review (a) current research on the reproductive health of incarcerated women, (b) characteristics and experiences of pregnant incarcerated women, (c) outcomes of infants and young children with incarcerated parents, (d) implications of research findings for policy and practice, and (e) the need for increased research, public education, and advocacy. We strongly recommend that correctional policies and practices be updated to address the common misconceptions and biases as well as the unique vulnerabilities and health needs of incarcerated women and their young children.

Estados Unidos ha visto un crecimiento sin precedentes en el número de mujeres encarceladas, la mayoría de las cuales son madres con niños menores. Mayores preocupaciones de salud pública conciernen a la salud reproductiva de mujeres en prisiones y cárceles y el bienestar de sus infantes y niños pequeños. En el presente artículo, usamos un marco de trabajo de justicia reproductiva para examinar la intersección del encarcelamiento y la salud materno-infantil. Revisamos 1) la investigación actual sobre la salud reproductiva de mujeres encarceladas, 2) las características y experiencias de mujeres embarazadas encarceladas, 3) lo que resulta de infantes y niños pequeños con progenitores encarcelados, 4) las implicaciones de los resultados de la investigación en cuanto a políticas y prácticas, y 5) la necesidad de aumentar la investigación, la educación pública y la defensoría. Recomendamos fuertemente que se actualicen las políticas y prácticas correccionales para incluir los conceptos erróneos y prejuicios acerca de mujeres encarceladas y sus niños pequeños, así como también sus distintivas vulnerabilidades y necesidades de salud.

Les Etats-Unis d'Amérique ont été les témoins d'une augmentation sans précédent dans le nombre de femmes incarcérées, la plupart étant des mères avec des enfants mineurs. De grands problèmes de santé publique sont liés à la santé reproductive des femmes en prison et au bien-être de leurs nourrissons et de leurs jeunes enfants. Dans cet article nous utilisons une structure de justice reproductive afin d'examiner l'intersection de l'incarcération et de la santé maternelle et de l'enfant. Nous passons en revue: 1) les recherches actuelles sur la santé reproductive des femmes incarcérées, 2) les caractéristiques et les expériences de femmes incarcérées enceintes, 3) les résultats de nourrissons et de jeunes enfants avec des parents incarcérés, 4) les implications des résulats de recherche pour les lois et la pratique, et 5) le besoin de plus de recherches, plus d'éducation publique, plus de promotion et défense. Nous recommandons fortement que les lois correctionnelles et les pratiques correctionnelles soient mises à jour afin de traiter et de faire face aux conceptions erronées et à la partialité communes, ainsi qu'aux vulnérabilités uniques et aux besoins de santé des femmes incarcérées et de leurs jeunes enfants.

SOCIOEMOTIONAL AND BEHAVIORAL PROBLEMS IN TODDLERS WITH LANGUAGE DELAY.

Toddlers with language delay are at risk for persistent developmental and behavioral difficulties; however, the association between socioemotional/behavior problems and language in young children is not well understood. This study explored socioemotional/behavior problems in a unique sample of toddlers with language delays using a measure developed explicitly for this age group. Toddlers identified by 18 months with receptive and expressive language delay (LD; n = 30) or typical development (TD; n = 61) were evaluated at 18 and 24 months of age using the Infant-Toddler Social and Emotional Assessment (ITSEA) and the Mullen Scales of Early Learning. Compared to toddlers who had TD, toddlers with LD had significantly more concerning scores at 18 and 24 months on all ITSEA domains. The rate of "clinical concern" on most domains was not high in either group, except that >60% of LD toddlers were in the clinical concern range on the Competence domain. Socioemotional/behavioral problems were dimensionally related to receptive and expressive language, with greater language delay associated with more concerning ITSEA scores. Socioemotional and behavioral problems are related to receptive and expressive language abilities in 18- and 24-month-olds, indicating the need for screening of both types of concerns in toddlers identified with potential language delays.

CAREGIVER'S DEPRESSIVE SYMPTOMS AND YOUNG CHILDREN'S SOCIOEMOTIONAL DEVELOPMENT DELAYS: A CROSS-SECTIONAL STUDY IN POOR RURAL AREAS OF CHINA.

Poverty and its associated factors put people at risk for depression. The aims of this study were to describe the prevalence of depressive symptoms (DS) of primary caregivers and socioemotional development (SED) delays of young children in poor rural areas of China, and to explore the association between them. Cross-sectional data of 2,664 children aged 3 to 35 months and their primary caregivers were used for analysis. Characteristics of the child, caregiver, and family were collected through face-to-face caregiver interviews. DS were assessed by the Zung Self-Rating Depression Scale (W.W. Zung, 1965, as cited in World Health Organization, ), and SED was evaluated by the Ages and Stage Questionnaires: Social-Emotional (J. Squires, D. Bricker, & L. Potter, 1997). The χ2 test, stratification analysis, and logistic regression analyses were used to explore the association. Among the caregivers, 40.3% (95% confidence interval [CI] [38.4, 42.1]), reported DS. Caregivers who were male, older and ethnic minorities as well as had a low level of education, a low family income, or more children were more likely to have DS. Of the children, 24.4% (95% CI [22.8, 26.0]) were recognized with SED delays. Older children displayed more delays than did younger children, but no significant differences between males and females were found. SED delays were significantly associated with mother outmigrating, male caregivers, older age, ethnic minorities, and low education or families with a single parent, low-income, and having more children. Caregivers having DS, odds ratio (OR) = 2.40, 95% CI [1.99, 2.88], was a significant predictor of increased odds of SED delays; other factors were single-parent family, OR = 1.99, 95% CI [1.37, 2.89], inadequate care, OR = 1.69, 95% CI [1.30, 2.21], physical punishment, OR = 1.61, 95% CI [1.33, 1.95], ethnic minorities, OR = 1.41, 95% CI [1.17, 1.71], and child age in months, OR = 1.03, 95% CI [1.02, 1.04], according to the logistic regression analysis. DS are prevalent among caregivers with young children in poor rural areas. Interventions to improve the mental health of caregivers and their parenting behaviors are needed to improve children's SED.

THE QUALITY OF FATHER-CHILD ROUGH-AND-TUMBLE PLAY AND TODDLERS' AGGRESSIVE BEHAVIOR IN CHINA.

The purpose of this study was to explore the influence of the quality of early father-child rough-and-tumble play (RTP) on toddler aggressive behaviors and more fully understand how child, mother, and father characteristics were associated with higher quality father-child RTP among contemporary urban Chinese families. Participants included 42 families in Changsha, China. Play observations of fathers and their children were coded for RTP quality. The specific RTP quality of father-child reciprocity of dominance was associated with fewer toddler aggressive behaviors, as rated by both fathers and mothers. Mothers' democratic parenting attitudes were associated with higher quality father-child RTP. These findings suggest that higher quality father-child RTP may be one way in which some fathers influence children's expression of aggressive behaviors, and the quality of father-child RTP may be influenced by the broader family, social, and cultural contexts.

ASSESSING PARENTING IN THE CONTEXT OF REUNIFICATION OF INFANTS/TODDLERS AND THEIR FAMILIES: HOW TO FACE THE CHALLENGES?

Since a substantial portion of infants and toddlers reenter care after reunification, the question of whether family reunification is feasible needs to be answered very cautiously. How parenting is assessed is of major importance in answering this question, but the quality of these assessments is often poor. With an eye to improving current practice, we conducted an integrative review, in which we analyzed the challenges related to the assessment of parenting vis-à-vis reunification and linked relevant knowledge from research with significant know-how from practice. The challenges appear to be embedded in the struggle to define (especially good enough) parenting and the complex context of child protection. As an answer to the challenges, the integrative review resulted in a framework of four key components required for sufficient parenting-assessment practice: (a) the use and development of expertise; and (b) providing families aiming for reunification with an intervention that is intensive, (c) flexible, and (d) organized as teamwork. Providing families with such an intervention gives them the opportunity to make substantial changes in their parenting and helps professionals assess the capacity of parents to grow to an acceptable level of caretaking for their child. Further implications for research and practice are discussed.

USING THE PARENT-INFANT RELATIONSHIP GLOBAL ASSESSMENT SCALE TO IDENTIFY CAREGIVER-INFANT/TODDLER DYADS WITH ABUSIVE RELATIONSHIP PATTERNS IN SIX EUROPEAN COUNTRIES.

The study examined whether the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, Revised Edition (DC: 0-3R; ZERO TO THREE, 2005) Parent-Infant Relationship Global Assessment Scale (PIR-GAS) is applicable to six European countries and contributes to the identification of caregiver-infant/toddler dyads with abusive relationship patterns. The sample consisted of 115 dyads with children's ages ranging from 1 to 47 months. Sixty-four dyads were recruited from community settings without known violence problems, and 51 dyads were recruited from clinical settings and already had been identified with violence problems or as being at risk for violence problems. To classify the dyads on the PIR-GAS categories, caregiver-child interactions were video-recorded and coded with observational scales appropriate for child age. To test whether the PIR-GAS allows for reliable identification of dyads with abusive relationship patterns, PIR-GAS ratings were compared with scores on the the International Society for the Prevention of Child Abuse and Neglect's (ISPCAN) Child Abuse Screening Tool-Parental Version (ICAST-P; D.K. Runyan et al., ), a questionnaire measuring abusive parental disciplinary practices. It was found that PIR-GAS ratings differentiated between the general and the clinical sample, and the dyads with abusive patterns of relationship were identified by both the PIR-GAS and the ICAST-P. Interrater reliability for the PIR-GAS ranged from moderate to excellent. The value of a broader use of tools such as the DC: 0-3R to promote early identification of families at risk for infant and toddler abuse and neglect is discussed.

RESTORING SAFETY: AN ATTACHMENT-BASED APPROACH TO CLINICAL WORK WITH A TRAUMATIZED TODDLER.

This clinical case study explores the integration of infancy research, brain development, attachment theory, and models of infant-parent/child-parent psychotherapy to address the needs of abused and neglected young children placed in foster or adoptive homes. Traumatized children employ defensive strategies to survive when there is no "good enough" caregiver (D.W. Winnicott, 1953, p. 94), and helping professionals can provide therapeutic experiences to develop or restore a child's sense of safety. With the case example of Anthony and his foster/adoptive parents, I illustrate how to manage and contain a traumatized child's terror, rage, and grief through therapeutic sessions with the parent and child together, and supportive parental guidance. I promote attention to the child's ability to self-integrate and to regulate his own affect, and encourages secure-base parental responses that facilitate a child's shift toward secure attachment behavior.

O sofrimento da criança pequena maltratada e seus pais / The suffering of the young child mistreated and his parents / El sufrimiento del niño pequeño maltratado y sus padres

As estatísticas francesas mostram que um grande número de maus-tratos dirigidos a crianças de 0 a 3 anos passa despercebido por causa da negação dos pais. Os laços das crianças dessa idade ainda são tão psiquicamente alienados a seus pais que elas não conseguem expressar seu próprio sofrimento. Nos pais abusadores, a relembrança de sua própria infância não os deixa diferenciarem-se de suas crianças. Esse laço pais-criança, estruturado a partir da identificação projetiva patológica, implica um dispositivo clínico especial para o tratamento pais - criança. Esse dispositivo singular possibilita diferenciar a criança real dessa relação alienante. Isso será ilustrado por meio de um caso clínico.(AU)

The french statistics show the extent of the mistreament of children aged from 0 to 3 years that often goes unnoticed due to the denial of the parents, which contaminates them. The link between parents and children of that age still is so physically alienating that they cannot express their own suffering. For the mistreating parents, the reviral of their own childhood experiences cannot allow them to differentiate themselves from their child. This parent-child link, built from the mechanism of projective and pathological identification, implicates on a singular therapeutic device for the treatment parents-child. This singular device allows differentiate the real child from that alienating relation. This will be illustrated through one clinical case.(AU)

Las estadísticas francesas muestran la importancia de los fenómenos de abuso en niños de 0-3 años que pasan desapercibidos debido a la negación de los padres, negación que los contaminan. Los lazos de los niños de esta edad aún son tan psíquicamente alienados a sus padres que no pueden expresar su propio sufrimiento. En los padres abusadores, el recuerdo de su propia infancia no los permite diferenciarse de sus hijos. Este vínculo padre - niño, estructurado desde la identificación proyectiva patológica, implica en un dispositivo clínico especial para el tratamiento de padres - niño. Este dispositivo único permite diferenciar el ninõ real de esta relación alienante. Esto será ilustrado por medio de un caso clínico.(AU)

O sofrimento da criança pequena maltratada e seus pais / The suffering of the young child mistreated and his parents / El sufrimiento del niño pequeño maltratado y sus padres

As estatísticas francesas mostram que um grande número de maus-tratos dirigidos a crianças de 0 a 3 anos passa despercebido por causa da negação dos pais. Os laços das crianças dessa idade ainda são tão psiquicamente alienados a seus pais que elas não conseguem expressar seu próprio sofrimento. Nos pais abusadores, a relembrança de sua própria infância não os deixa diferenciarem-se de suas crianças. Esse laço pais-criança, estruturado a partir da identificação projetiva patológica, implica um dispositivo clínico especial para o tratamento pais - criança. Esse dispositivo singular possibilita diferenciar a criança real dessa relação alienante. Isso será ilustrado por meio de um caso clínico.

The french statistics show the extent of the mistreament of children aged from 0 to 3 years that often goes unnoticed due to the denial of the parents, which contaminates them. The link between parents and children of that age still is so physically alienating that they cannot express their own suffering. For the mistreating parents, the reviral of their own childhood experiences cannot allow them to differentiate themselves from their child. This parent-child link, built from the mechanism of projective and pathological identification, implicates on a singular therapeutic device for the treatment parents-child. This singular device allows differentiate the real child from that alienating relation. This will be illustrated through one clinical case.

Las estadísticas francesas muestran la importancia de los fenómenos de abuso en niños de 0-3 años que pasan desapercibidos debido a la negación de los padres, negación que los contaminan. Los lazos de los niños de esta edad aún son tan psíquicamente alienados a sus padres que no pueden expresar su propio sufrimiento. En los padres abusadores, el recuerdo de su propia infancia no los permite diferenciarse de sus hijos. Este vínculo padre - niño, estructurado desde la identificación proyectiva patológica, implica en un dispositivo clínico especial para el tratamiento de padres - niño. Este dispositivo único permite diferenciar el ninõ real de esta relación alienante. Esto será ilustrado por medio de un caso clínico.

Habilidades y conocimientos constitutivos de la alfabetización temprana: Semejanzas y diferencias según el entorno social y las oportunidades educativas / Early literacy skills: Similarities and differences caused by social environment and school opportunities

Dada la relevancia del desarrollo temprano de los conocimientos o habilidades considerados precursores de la alfabetización, resulta fundamental, para la elaboración de propuestas pedagógicas, identificar aquellos aspectos en los que es necesario focalizar dichas propuestas. En este sentido, el estudio que se informa abordó la incidencia del medio en las habilidades tempranas de lectura y escritura en tres grupos de niños de diferente procedencia socioeconómica (niveles socioeconómicos medio urbano, bajo urbano y bajo rural). Los niños respondieron a 11 pruebas que evalúan las siguientes variables precursoras de la alfabetización: Habilidades de procesamiento fonológico, Conocimiento de las correspondencias, Habilidades de discriminación visual de letras y palabras, Habilidad de lectura de palabras en contexto, Capacidad de reconocimiento de acciones de lectura y escritura, Formas tempranas de escritura, Conocimiento de lenguaje técnico y Manejo de libro. Los resultados obtenidos señalan que existen diferencias entre los grupos en las tareas implicadas en el reconocimiento de lenguaje técnico, en las de conciencia fonológica y en las formas de escritura. Sin embargo, no se hallaron diferencias entre los niños de los distintos sectores socioeconómicos evaluados en las tareas de discriminación, manejo de libro y reconocimiento de acciones de lectura y escritura. En concordancia con el modelo evolutivo de Nelson (2007), los grupos muestran un desempeño similar en conocimientos que responden a procesos perceptivos básicos y difieren en aquellos que la investigación ha demostrado que requieren de la intervención de un adulto alfabetizado.(AU)

Due to the fact that early literacy skills are crucial for reading and writing learning process, it is important to identify them in order to design teaching activities. Most of the former literacy studies have been carried out with middle class children and show that reading and writing learning process begins very early at home. The rate and the way reading and writing are developed is highly related with parents educational level and the kind and frequency of the literacy activities they propose. There are differences between social groups with regard to these activities that may cause knowledge differences at early age that may explain reading and writing learning process failure in low income children. From a developmental perspective there have been numerous studies focused mainly on literacy learning before formal teaching of reading and writing in school. These researches tempt to explore and describe the concepts, knowledge, skills and early actions of reading and writing as well as the social context where these developments occur. In the framework of these observations, the aim of the present study was to compare early reading and writing skills in three groups of children from different socioeconomic environment. From theoretical and methodological point of view we have take in account a cognitive psychology perspective to explore those variables considered early literacy skills such as phonological awareness, early writing skills among others as well as we have adopted as teaching and learning process framework Vigotskys zone of proximal development as well as Bruners scaffolding. The groups were described according to different variables such us age (measured up to May, 30th), sex and socioeconomic level. In order to measure the last variable, parents education level and job were considered according Sartú (1992) occupational scale. Using this variables three groups were selected: Group A was formed by 20 children mean age 5.5-year-olds from middle urban income families who attended a public kindergarten school situated in a middle class neighborhood. Group B was formed by 19 kids mean age 5.3-year-olds from low income families who attended to a public kindergarten school in a low income urban neighborhood. Group C was formed by 17 children mean age 5.3-year-olds who attended a public kindergarten school from a low rural income area. Kids were assessed with 11 tasks: Phonological awareness, Letter-sound correspondences, Differences between letters, Words from pictures, Reading words in context, Recognition of writing and reading activities, Early reading and writing performance, Technical vocabulary knowledge, proper usage of books was tested. The results of this study provides empirical information on the early literacy pattern of learning process of Spanish-speaking children as well as differences in knowledge and skills involved in this process between children from different socioeconomic groups. Differences between the three groups were observed in technical vocabulary knowledge and phonological awareness tasks performance. There were no differences between socioeconomically groups in distinguishing letters and words from pictures, recognizing writing and reading activities and proper using of books. According to Nelson (2007), children have a similar performance in those activities based on basic cognitive skills and differ in the ones that involve adults instruction. The similar performances of the groups tested seems to indicate that the knowledge involved in early literacy process is develop in a sequence characterized by an emerging knowledge about writing in the social environment. The fact that children did not grasp a complete competence in one knowledge before reaching it in other later ability shows that literacy acquisition is characterized by an overlapping development of different abilities and knowledge.(AU)

Habilidades y conocimientos constitutivos de la alfabetización temprana: Semejanzas y diferencias según el entorno social y las oportunidades educativas / Early literacy skills: Similarities and differences caused by social environment and school opportunities

Dada la relevancia del desarrollo temprano de los conocimientos o habilidades considerados precursores de la alfabetización, resulta fundamental, para la elaboración de propuestas pedagógicas, identificar aquellos aspectos en los que es necesario focalizar dichas propuestas. En este sentido, el estudio que se informa abordó la incidencia del medio en las habilidades tempranas de lectura y escritura en tres grupos de niños de diferente procedencia socioeconómica (niveles socioeconómicos medio urbano, bajo urbano y bajo rural). Los niños respondieron a 11 pruebas que evalúan las siguientes variables precursoras de la alfabetización: Habilidades de procesamiento fonológico, Conocimiento de las correspondencias, Habilidades de discriminación visual de letras y palabras, Habilidad de lectura de palabras en contexto, Capacidad de reconocimiento de acciones de lectura y escritura, Formas tempranas de escritura, Conocimiento de lenguaje técnico y Manejo de libro. Los resultados obtenidos señalan que existen diferencias entre los grupos en las tareas implicadas en el reconocimiento de lenguaje técnico, en las de conciencia fonológica y en las formas de escritura. Sin embargo, no se hallaron diferencias entre los niños de los distintos sectores socioeconómicos evaluados en las tareas de discriminación, manejo de libro y reconocimiento de acciones de lectura y escritura. En concordancia con el modelo evolutivo de Nelson (2007), los grupos muestran un desempeño similar en conocimientos que responden a procesos perceptivos básicos y difieren en aquellos que la investigación ha demostrado que requieren de la intervención de un adulto alfabetizado.

Due to the fact that early literacy skills are crucial for reading and writing learning process, it is important to identify them in order to design teaching activities. Most of the former literacy studies have been carried out with middle class children and show that reading and writing learning process begins very early at home. The rate and the way reading and writing are developed is highly related with parents educational level and the kind and frequency of the literacy activities they propose. There are differences between social groups with regard to these activities that may cause knowledge differences at early age that may explain reading and writing learning process failure in low income children. From a developmental perspective there have been numerous studies focused mainly on literacy learning before formal teaching of reading and writing in school. These researches tempt to explore and describe the concepts, knowledge, skills and early actions of reading and writing as well as the social context where these developments occur. In the framework of these observations, the aim of the present study was to compare early reading and writing skills in three groups of children from different socioeconomic environment. From theoretical and methodological point of view we have take in account a cognitive psychology perspective to explore those variables considered early literacy skills such as phonological awareness, early writing skills among others as well as we have adopted as teaching and learning process framework Vigotsky's zone of proximal development as well as Bruner's scaffolding. The groups were described according to different variables such us age (measured up to May, 30th), sex and socioeconomic level. In order to measure the last variable, parents education level and job were considered according Sartú (1992) occupational scale. Using this variables three groups were selected: Group A was formed by 20 children mean age 5.5-year-olds from middle urban income families who attended a public kindergarten school situated in a middle class neighborhood. Group B was formed by 19 kids mean age 5.3-year-olds from low income families who attended to a public kindergarten school in a low income urban neighborhood. Group C was formed by 17 children mean age 5.3-year-olds who attended a public kindergarten school from a low rural income area. Kids were assessed with 11 tasks: Phonological awareness, Letter-sound correspondences, Differences between letters, Words from pictures, Reading words in context, Recognition of writing and reading activities, Early reading and writing performance, Technical vocabulary knowledge, proper usage of books was tested. The results of this study provides empirical information on the early literacy pattern of learning process of Spanish-speaking children as well as differences in knowledge and skills involved in this process between children from different socioeconomic groups. Differences between the three groups were observed in technical vocabulary knowledge and phonological awareness tasks performance. There were no differences between socioeconomically groups in distinguishing letters and words from pictures, recognizing writing and reading activities and proper using of books. According to Nelson (2007), children have a similar performance in those activities based on basic cognitive skills and differ in the ones that involve adult's instruction. The similar performances of the groups tested seems to indicate that the knowledge involved in early literacy process is develop in a sequence characterized by an emerging knowledge about writing in the social environment. The fact that children did not grasp a complete competence in one knowledge before reaching it in other later ability shows that literacy acquisition is characterized by an overlapping development of different abilities and knowledge.

Asociación entre el índice de predicción de asma y el óxido nítrico exhalado en niños pequeños con sibilancias recurrentes / Association between the Asthma Predictive Index and levels of exhaled nitric oxide in infants ans toddlers with recurrent wheezing

Introducción. Es difícil identificar de manera temprana qué niños con sibilancias recurrentes desarrollarán asma en el futuro. El índice predictor de asma (API) es un cuestionario basado en parámetros clínicos y de laboratorio aplicado para este fin. La medición de la fracción exhalada de óxido nítrico (FE NO) se utiliza como un marcador de inflamación eosinofílica en las vías aéreas de los pacientes asmáticos. Objetivo. Determinar la asociación entre el índice predictor de asma y los valores de FE NO en menores de 3 años con sibilancias recurrentes. Materiales y métodos. Estudio observacional de corte transversal. Se incluyeron niños menores de 36 meses con tres o más episodios de obstrucción bronquial en el último año sin tratamiento previo con corticosteroides inhalados o antagonistas de los receptores de leucotrienos. Después de obtener los datos clínicos, se realizó la determinación de FE NO mediante un analizador de quimioluminiscencia mientras el paciente respiraba a volumen corriente (técnica on line). Resultados. Se incluyeron 52 niños de entre 5 y 36 meses de edad. Los pacientes con un índice (+) constituyeron el 60% de la población y presentaron valores de FE NO más elevados que los niños con un índice (-), mediana (rango) 13,5 (0,7 a 31) contra 5,6 (0,1 a 20,8) ppb, respectivamente (p <0,01). Se observó FE NO elevado (>8 ppb) en el 74% de los niños con API (+) y en el 26% de los niños con API (-) (p <0,01). Conclusiones. En el presente estudio se encontró una asociación entre los niveles elevados de óxido nítrico exhalado y un índice predictor de asma positivo en niños menores de 3 años con sibilancias recurrentes.

It is difficult to make an early identification of which children with recurrent wheezing will develop asthma in the following years. The Asthma Predictive Index (API) is a questionnaire based on clinical and laboratory parameters used for this end. The measurement of fractional exhaled nitric oxide (FE NO) has been used as a marker of eosinophilic airway infammation in asthma patients. Objective. To determine the association between the Asthma Predictive Index and FE NO levels in children younger than 3 years old with recurrent wheezing. Materials and methods. Observational, cross sectional study. Children younger than 36 months old with 3 or more episodes of bronchial obstruction in the past year who were inhaled corticosteroid-naive or leukotriene receptor antagonist-naive were included. After recording clinical data, FE NO was measured by a chemiluminescence analyzer during tidal breathing (online method). Results. A total of 52 children aged 5-36 months old were included. Patients with a positive API accounted for 60% of the population and had higher levels of FE NO than those with a negative API, with a median (range) of 13.5 ppb (0.7-31) versus 5.6 ppb (0.1-20.8), respectively (p <0.01). A high FE NO (>8 ppb) was observed in 74% of children with a positive API and in 26% of those with a negative API (p <0.01). Conclusions. This study found an association between high levels of exhaled nitric oxide and a positive Asthma Predictive Index in children younger than 3 years old with recurrent wheezing.

Asociación entre el índice de predicción de asma y el óxido nítrico exhalado en niños pequeños con sibilancias recurrentes / Association between the Asthma Predictive Index and levels of exhaled nitric oxide in infants ans toddlers with recurrent wheezing

Introducción. Es difícil identificar de manera temprana qué niños con sibilancias recurrentes desarrollarán asma en el futuro. El índice predictor de asma (API) es un cuestionario basado en parámetros clínicos y de laboratorio aplicado para este fin. La medición de la fracción exhalada de óxido nítrico (FE NO) se utiliza como un marcador de inflamación eosinofílica en las vías aéreas de los pacientes asmáticos. Objetivo. Determinar la asociación entre el índice predictor de asma y los valores de FE NO en menores de 3 años con sibilancias recurrentes. Materiales y métodos. Estudio observacional de corte transversal. Se incluyeron niños menores de 36 meses con tres o más episodios de obstrucción bronquial en el último año sin tratamiento previo con corticosteroides inhalados o antagonistas de los receptores de leucotrienos. Después de obtener los datos clínicos, se realizó la determinación de FE NO mediante un analizador de quimioluminiscencia mientras el paciente respiraba a volumen corriente (técnica on line). Resultados. Se incluyeron 52 niños de entre 5 y 36 meses de edad. Los pacientes con un índice (+) constituyeron el 60% de la población y presentaron valores de FE NO más elevados que los niños con un índice (-), mediana (rango) 13,5 (0,7 a 31) contra 5,6 (0,1 a 20,8) ppb, respectivamente (p <0,01). Se observó FE NO elevado (>8 ppb) en el 74% de los niños con API (+) y en el 26% de los niños con API (-) (p <0,01). Conclusiones. En el presente estudio se encontró una asociación entre los niveles elevados de óxido nítrico exhalado y un índice predictor de asma positivo en niños menores de 3 años con sibilancias recurrentes.(AU)

It is difficult to make an early identification of which children with recurrent wheezing will develop asthma in the following years. The Asthma Predictive Index (API) is a questionnaire based on clinical and laboratory parameters used for this end. The measurement of fractional exhaled nitric oxide (FE NO) has been used as a marker of eosinophilic airway infammation in asthma patients. Objective. To determine the association between the Asthma Predictive Index and FE NO levels in children younger than 3 years old with recurrent wheezing. Materials and methods. Observational, cross sectional study. Children younger than 36 months old with 3 or more episodes of bronchial obstruction in the past year who were inhaled corticosteroid-naive or leukotriene receptor antagonist-naive were included. After recording clinical data, FE NO was measured by a chemiluminescence analyzer during tidal breathing (online method). Results. A total of 52 children aged 5-36 months old were included. Patients with a positive API accounted for 60% of the population and had higher levels of FE NO than those with a negative API, with a median (range) of 13.5 ppb (0.7-31) versus 5.6 ppb (0.1-20.8), respectively (p <0.01). A high FE NO (>8 ppb) was observed in 74% of children with a positive API and in 26% of those with a negative API (p <0.01). Conclusions. This study found an association between high levels of exhaled nitric oxide and a positive Asthma Predictive Index in children younger than 3 years old with recurrent wheezing.(AU)

Evaluación nutricional de niños de 10 a 14 meses de edad / Nutrition assessment related to children aged 10 to 14 months

El objetivo de la investigación fue realizar la evaluación nutricional de un grupo de niños con edades entre 10 y 14 meses, residentes en Ciudad de La Habana. MÉTODOS. Las variables analizadas fueron la edad decimal, peso, longitud supina e ingestión de energía y macronutrientes. Los índices antropométricos peso para la edad, talla para la edad y peso para la talla se compararon con los valores nacionales e internacionales de referencia. Las encuestas dietéticas fueron analizadas en el programa CERES. RESULTADOS. La mayoría de los individuos fueron normales para los tres índices antropométricos, y aunque las niñas presentaron una ligera tendencia a la obesidad, no existieron diferencias significativas entre hembras y varones. El 87,5 por ciento presentó ingestión excesiva de proteínas y la contribución de los macronutrientes a la energía fue desequilibrada. CONCLUSIONES. Se comprobó que la mayoría de los niños son normales desde el punto de vista antropométrico y que existe un patrón dietético inadecuado(AU)

The aim of this research was the carrying out of a nutrition assessment of a group of children aged from 10 to 14 months, in Ciudad de la Habana. METHODS: Variables analyzed included decimal age, weight, supine length and energy and macronutrients consumption. Anthropometric rates for age-weight, age-height and height-weight were compared with reference national and international values. Dietetic surveys were analyzed in CERES program. RESULTS: Most of subjects were normal for the three anthropometric rates, and although girls had a slight trend to obesity, there were not significant differences between both sexes. The 87,5 percent showed an excessive consumption of proteins and contribution of macronutrients to energy was unstable. CONCLUSIONS: Was proved that most of children are normal from the anthropometric point of view, and that there is an inappropriate dietetic patternç(AU)