RESUMEN

Children growing up in institutions lack a stable relationship-essential for development. A significant proportion of them have disorganised attachment, which is associated with negative outcomes. Therefore, interventions aimed at improving attachment security are needed. We conducted a case series study (involving five participants aged 8-11 years) in a newly established psychosocial rehabilitation daycare centre to describe the changes in attachment security and mental health of institutionalised children after one year of attendance. The intervention consisted of individualised care focusing on staff building a trusting relationship with participants using the principles of Trust-Based Relational Intervention® (TBRI). Measures such as the Child Attachment Interview, SDQ, CBCL6/18, TRF6/18, and clinical interviews were used to follow change. The descriptive data of five participants are presented. All five children improved in mental health, and for two participants, organisation of attachment changed. Three children experienced relational ruptures. The findings suggest that psychosocial interventions that focus on building trusting relationships may be beneficial in institutionalised children. For these children, given their life history, it can be damaging to experience repeated breakdowns. Thus, the practical implication is that any new relationship for them with an adult should be established after an assessment of whether the relationship can be sustained.

RESUMEN

AIM: This study aimed: (i) to identify and compare the prevalence of temporomandibular disorders (TMDs) and oral parafunctions among children living in child-protection institutions (CLCPI) with children living with their parents (CLWP); (ii) to determine whether or not there is an association between oral parafunctions and TMDs; and (iii) to examine the possible impact of stress on TMDs. STUDY DESIGN: The study was conducted on a total of 385 children who were divided into two groups: the CLCPI group (n = 184); and the CLWP group (control, n = 201). All children 8-18 years of age and living in protective-care facilities in Kocaeli, Turkey, were included in this study in the CLCPI group. The CLWP control group comprised children of the same age as those in the CLCPI group, but those in the CLWP group were living with their families and were randomly selected from one primary school, one elementary school and one high school in Kocaeli, Turkey. Each child in the study completed a questionnaire and underwent a clinical examination. RESULTS: The overall prevalence of TMDs and oral parafunctions were higher in the CLCPI group than in the CLWP group (P < 0.05). The vast majority of participants reported at least one parafunction (CLCPI, n = 97.3%; CLWP, n = 93%). Problems related to family or friends were higher in the CLCPI group, whereas problems related to school lessons were higher in the CLWP group (P < 0.05). In both groups, positive associations were found between signs and symptoms of TMDs, oral parafunctions and stressful life events. CONCLUSION: The prevalence of signs and symptoms of TMDs and oral parafunctions differed significantly between CLCPI and CLWP groups, with children of the CLCPI group found to be significantly more prone to TMDs and oral parafunctions than children of the CLWP group.

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RESUMEN

O desenvolvimento infantil é um processo de mudanças relacionado com a idade e influenciado pelo ambiente em que a criança vive. Desta maneira, o objetivo é verificar o a prevalência de atraso do desenvolvimento neuropsicomotor (DNPM) em pré-escolares. Procedimentos: tratou-se de um estudo transversal analítico realizado em três abrigos e uma escola particular da Zona Leste de São Paulo-SP, na qual participaram 81 crianças. Aplicou-se um questionário aos responsáveis pelas crianças participantes e para avaliar o desenvolvimento neuropsicomotor das crianças foi utilizado o Teste Denver II. Os resultados revelaram a prevalência de atraso no DNPM em crianças institucionalizadas (31,6 por cento), p=0,06. A linguagem foi a área mais freqüentemente afetada nas crianças com suspeita de atraso. Em relação ao suporte familiar e condições ambientais não houve diferenças estatisticamente significantes nas crianças institucionalizadas. Verificou-se que os resultados não significativos talvez sejam conseqüência da relação de apego que as crianças institucionalizadas adquirem entre si e da convivência com um maior número de crianças. Conclusão: o presente estudo não encontrou diferenças estatisticamente significativas no desenvolvimento neuropsicomotor de crianças institucionalizadas e não-institucionalizadas, porém houve maior prevalência de suspeita de atraso nas crianças institucionalizadas.(AU)

The child development is a process of age-related changes and influenced by the environment where the child lives. This way, the goal is to determine the prevalence of delay development neuropsychomotor in preschool children. Procedures: this was an analytical cross-sectional study performed in three shelters and a private school in the East zone of São Paulo-SP, attended 81 children. A questionnaire was applied to children participating and to evaluate the development neuropsychomotor of children was used testing Denver II. The results revealed the prevalence of late DNPM institutionalised children (31.6 percent), p = 0.06. The language was the area most often affected in children with suspected delays. In relation to the support of family and environmental conditions there were statistically significant differences in institutionalised children. The insignificant results may be a consequence of the relationship of attachment that institutionalized children acquire each other and co-existence with a greater number of children. Conclusion: this study found no statistically significant differences in the development of institutionalized children neuropsicomotor and non-institutionalized, but there were higher prevalence of suspected delay in institutionalised children.(AU)

RESUMEN

O desenvolvimento infantil é um processo de mudanças relacionado com a idade e influenciado pelo ambiente em que a criança vive. Desta maneira, o objetivo é verificar o a prevalência de atraso do desenvolvimento neuropsicomotor (DNPM) em pré-escolares. Procedimentos: tratou-se de um estudo transversal analítico realizado em três abrigos e uma escola particular da Zona Leste de São Paulo-SP, na qual participaram 81 crianças. Aplicou-se um questionário aos responsáveis pelas crianças participantes e para avaliar o desenvolvimento neuropsicomotor das crianças foi utilizado o Teste Denver II. Os resultados revelaram a prevalência de atraso no DNPM em crianças institucionalizadas (31,6 por cento), p=0,06. A linguagem foi a área mais freqüentemente afetada nas crianças com suspeita de atraso. Em relação ao suporte familiar e condições ambientais não houve diferenças estatisticamente significantes nas crianças institucionalizadas. Verificou-se que os resultados não significativos talvez sejam conseqüência da relação de apego que as crianças institucionalizadas adquirem entre si e da convivência com um maior número de crianças. Conclusão: o presente estudo não encontrou diferenças estatisticamente significativas no desenvolvimento neuropsicomotor de crianças institucionalizadas e não-institucionalizadas, porém houve maior prevalência de suspeita de atraso nas crianças institucionalizadas

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