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The inappropriate use of electronic devices can affect the psychological and physical health of children and adolescents. Therefore, it is essential to accompany them and promote media literacy to ensure a healthy and responsible use of technology. On occasions that depend on a multifactorial complex, the inappropriate use of networks can trigger problematic consumption and seriously affect the lives of young people. In 2022, the World Health Organization recognized, through ICD-11, the addiction to video games and used the term "problematic use" for the Internet and social networks. This article attempts to update professionals on new trends in the consumption of social networks, video games, and online gambling platforms and their consequences on the psychophysical well-being of children and adolescents.

El uso inapropiado de dispositivos electrónicos puede afectar la salud psicofísica de niños y adolescentes. Por ello, es fundamental acompañarlos y fomentar la alfabetización mediática para garantizar un uso saludable y responsable de la tecnología. En ocasiones que dependen de un complejo multifactorial, el uso inadecuado de las redes puede desencadenar consumos problemáticos y afectar gravemente la vida de los jóvenes. En 2022, la Organización Mundial de la Salud reconoció, a través del CIE 11, la adicción a los videojuegos y utilizó el término "uso problemático" para internet y redes sociales. Este artículo intenta actualizar a los profesionales sobre las nuevas tendencias en el consumo de las redes sociales, los videojuegos, las plataformas de apuestas en línea y sus consecuencias en el bienestar psicofísico de los niños y adolescentes.

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BACKGROUND: The Confusion, Hubbub, and Order Scale (CHAOS in English Version) was originally developed in the USA by Matheny et al (Bringing order out of chaos: psychometric characteristics of the confusion, hubbub, and order scale. Journal of Applied Developmental Psychology 16(3):429-444, 1995) to measure chaos in the family environment, characterized by confusion, lack of routine, and organization. OBJECTIVE: To present evidence of content validity, internal structure validity, and validity based on relationships with external measures of an adapted version of the CHAOS into Brasilian Portuguese with adolescents sample in São Paulo - Brasil. METHOD: Study 1 involved the translation/back-translation and adaptation of the scale into Brazilian Portuguese [here named "Escala de Confusão, Alvoroço e Ordem no Sistema familiar" (CAOS)], assessed by 5 judges. In Study 2, we conducted an exploratory factor analyses (EFA) to determine the scale's factor structure (N = 180 adults). In Study 3, we carried out confirmatory factor analyses (CFA) to confirm the internal validity of the scale, along with complete structural equation modeling to explore convergent validity in another sample (N = 239 adolescents). RESULTS: The CAOS scale displayed content validity, and the EFA and CFA showed a unifactorial structure (with some scale adjustments) with an acceptable fit. The family chaos latent factor was associated with externalizing symptoms and perceived stress in adolescents. CONCLUSION: Overall, the Brazilian version of the scale presented evidence of construct, internal, and concurrent validity that indicate its usefulness in Brazil.

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Punishing, minimizing, ignoring, or becoming distressed when dealing with children's negative emotions may favor the emergence or worsen behavior problems during childhood. This study examined the effects of the intervention program Vivendo Emoções [Experiencing Emotions] on maternal reactions to children's emotions and children's internalizing and externalizing problems. Thirty-two mothers of children aged between three and eight participated and were assigned to an intervention (n = 16) or a comparison (n = 16) group. The intervention was implemented in eight sessions intended to promote the mothers' strategies to identify and regulate their children's negative emotions and enable the children to improve emotional competence. The mothers completed the CCNES to report their reactions to children's emotional expressions and the CBCL to report internalizing and externalizing problems on pretest and posttest. The results reveal that mothers in the intervention group reported fewer unsupportive reactions on posttest than mothers in the comparison group. This finding shows the potential of such interventions to decrease unsupportive maternal reactions. Additionally, children in the intervention group presented more frequent somatic complaints than those in the comparison group on posttest. A potential explanation is that the mothers were more prepared to encourage their children to report negative emotions associated with bodily sensations.

Castigar, minimizar, ignorar o manifestar malestar ante la expresión de emociones negativas de los niños puede favorecer la aparición o el empeoramiento de problemas de comportamiento en la infancia. Este estudio examinó los efectos del programa de intervención Viviendo Emociones, focado en la socialización emocional de los niños, en las reacciones maternas a las emociones y en los problemas internalizantes y externalizantes de los niños. Participaron 32 madres de niños entre tres y ocho años, divididas en los grupos intervención (n = 16) y comparación (n = 16). El Viviendo Emociones se realizó en ocho sesiones y busca promover estrategias para identificar y regular las emociones negativas expresadas por los niños para que ellos amplíen su competencia emocional. En el pre-test y post-test, las madres respondieron el CCNES para reportar sus reacciones ante las expresiones emocionales de sus hijos y el CBCL para reportar problemas internalizantes y externalizantes. Los resultados revelaron que las madres en el grupo de intervención reportaron menos reacciones de no apoyo que las madres en el grupo comparación en el post-test. Ese hallazgo resalta el potencial de intervenciones de esta naturaleza para reducir las reacciones maternas de no apoyo. Adicionalmente, los niños del grupo intervención presentaron más quejas somáticas que los niños del grupo comparación en el post-test. Una explicación potencial es que las madres estaban más preparadas para alentar a los niños a reportar emociones negativas asociadas a sensaciones corporales.

Punir, minimizar, ignorar ou manifestar desconforto diante da expressão de emoções negativas dos filhos pode favorecer o surgimento ou agravamento dos problemas de comportamento na infância. Este estudo examinou os efeitos do programa de intervenção, Vivendo Emoções, com foco na socialização emocional infantil, sobre as reações maternas às emoções dos filhos e os problemas internalizantes e externalizantes das crianças. Participaram 32 mães de crianças entre três e oito anos, divididas em grupo intervenção (n = 16) e comparação (n = 16). O Vivendo Emoções foi realizado em oito sessões e busca promover estratégias para identificação e regulação das emoções negativas expressas pelos filhos de forma que a criança amplie sua competência emocional. No pré-teste e no pós-teste, as mães responderam a CCNES para informar suas reações às expressões emocionais nos filhos e o CBCL para relatar problemas internalizantes e externalizantes. Os resultados revelaram que as mães do grupo intervenção relataram menos reações não apoiadoras do que as mães do grupo comparação no pós-teste. Esse achado evidencia o potencial de intervenções dessa natureza para reduzir reações maternas não apoiadoras. Adicionalmente, as crianças do grupo intervenção apresentaram mais queixas somáticas do que as crianças do grupo comparação no pós-teste. Uma explicação potencial é que as mães estivessem mais preparadas para encorajar as crianças a relatar emoções negativas associadas a sensações corporais.

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ABSTRACT OBJECTIVE: To describe the frequency of behavioral problems and the internal consistency of the parent version of the Strengths and Difficulties Questionnaire (SDQ-P) in Amazonian preschool children during the covid-19 pandemic. METHODS: Data from the Maternal and Child Health and Nutrition in Acre (MINA-Brazil) study, a population-based birth cohort in the Western Brazilian Amazon, were used. The SDQ-P was applied in 2021 at the five-year follow-up visit to parents or caregivers of 695 children (49.4% of which were girls). This instrument is a short behavioral screening questionnaire composed of 25 items reorganized into five subscales: emotional symptoms, conduct problems, hyperactivity/inattention, peer relationship problems, and prosocial behavior. Cases of behavioral problems were defined according to the original SDQ cut-offs based on United Kingdom norms. Moreover, cut off points were estimated based on the SDQ-P percentile results of our study sample. Internal consistency was assessed by calculating Cronbach's alpha coefficient and McDonald's omega for each scale. RESULTS: According to the cut-offs based on our studied population distribution, 10% of all children had high or very high total difficulty scores, whereas it was almost twice when the original SDQ cut-offs based on United Kingdom norms, were applied (18%). Differences were also observed in the other scales. Compared to girls, boys showed higher means of externalizing problem and lower means of prosocial behavior. The five-factor model showed a moderate internal consistency of the items for all scales (0.60 ≤ α ≤ 0.40), except for total difficulty scores, which it considered substantial (α > 0.61). CONCLUSIONS: Our results support the usefulness of SDQ in our study population and reinforce the need for strategies and policy development for mental health care in early life in the Amazon.

RESUMO OBJETIVO: Descrever a frequência de problemas de comportamento e a consistência interna da versão para os pais do Questionário de Capacidades e Dificuldades (SDQ-P) em crianças pré-escolares da Amazônia durante a pandemia de covid-19. MÉTODOS: Foram utilizados dados do estudo de saúde e nutrição Materno-Infantil no Acre (MINA-Brasil), uma coorte de nascimentos de base populacional na Amazônia Ocidental Brasileira. O SDQ-P foi aplicado aos pais e cuidadores em 2021 na visita de acompanhamento de cinco anos de 695 crianças (49,4% das quais eram meninas). Esse instrumento é um breve questionário de rastreamento comportamental composto por 25 itens reorganizados em cinco subescalas: sintomas emocionais, problemas de conduta, hiperatividade/desatenção, problemas de relacionamento com colegas e comportamento pró-social. Os casos de problemas de comportamento foram definidos de acordo com os pontos de corte originais do SDQ, baseados nas normas do Reino Unido. Além disso, os pontos de corte foram estimados com base nos percentis dos resultados do SDQ-P da amostra do nosso estudo. A consistência interna foi avaliada pelo cálculo do coeficiente alfa de Cronbach e ômega de McDonald para cada escala. RESULTADOS: De acordo com os pontos de corte baseados na distribuição da população estudada, 10% de todas as crianças apresentaram escores totais de dificuldade elevados ou muito elevados, o que quase dobrou quando os pontos de corte originais do SDQ, baseados nas normas do Reino Unido, foram utilizados (18%). Este estudo também encontrou diferenças nas demais escalas. Comparados às meninas, os meninos apresentaram maiores médias de problemas de externalização e menores médias de comportamento pró-social. O modelo de cinco fatores apresentou consistência interna dos itens moderada para todas as escalas (0,60 ≤ α ≤ 0,40), exceto para a escala de pontuação total de dificuldades, a qual foi considerada substancial (α > 0,61). CONCLUSÕES: Nossos resultados apoiam a utilidade do SDQ em nossa população de estudo e reforçam a necessidade de estratégias e desenvolvimento de políticas para o cuidado em saúde mental no início da vida na Amazônia.

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OBJECTIVE: To assess the relation between leisure screen time and emotional and behavioral problems in Spanish children aged 4-14 years. STUDY DESIGN: This cross-sectional study used a representative sample of children aged 4-14 years included in the 2017 Spanish National Health Survey (n = 4073). Emotional and behavioral problems of children were assessed through the parent-report Strengths and Difficulties Questionnaire. Daily leisure screen time in minutes was categorized as 0-59, 60-119, 120-179, and ≥180. We calculated adjusted prevalence ratios (aPR) and their 95% CIs of being at risk of developing emotional and behavioral problems. Associations were adjusted for potential confounding variables. RESULTS: Children spending 180 minutes or more of daily leisure screen time compared with children spending less than 1 hour were more likely to be at risk of developing emotional and behavioral problems: aPR≥180: 2.19 (95% CI 1.53-3.14), emotional symptomology: aPR≥180: 2.09 (95% CI 1.37-3.18), conduct problems aPR≥180: 1.85 (95% CI 1.34-2.54), peer problems aPR≥180: 1.78 (95% CI 1.15-2.75), and to behave less prosocially: aPR≥180: 2.20 (95% CI 1.43-3.37). CONCLUSIONS: We have found significant associations between daily leisure screen time and emotional and behavioral problems in Spanish children between 6 and 14 years of age. However, these findings should be confirmed in cohort studies, so institutions might consider including screen time as a new risk factor for children.

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Introducción: El consumo de sustancias psicoactivas en jóvenes colombianos es considerado un problema de salud pública, debido a su prevalencia ascendente. Los estudios al respecto han indicado la existencia de una asociación con patrones conductuales que llevan a la alteración del rendimiento académico y el surgimiento de problemas disciplinarios. Objetivos: Identificar la asociación entre el consumo de sustancias psicoactivas y la presencia de problemas disciplinarios y de rendimiento académico en adolescentes colombianos. Materiales y métodos: Estudio transversal analítico. Se incluyeron 80.018 adolescentes escolares. Se indagó sobre la presencia de problemas disciplinarios y de rendimiento académico, así como consumo de sustancias psicoactivas durante los últimos 12 meses. Se describieron las frecuencias de los problemas académicos o disciplinarios con el consumo de cada una de las sustancias psicoactivas. Se estimaron asociaciones por medio de modelos de regresión logística binaria, y todos los análisis fueron ajustados por el factor de expansión. Resultados: Se registró que el 44% de los adolescentes reportaron problemas académicos, y el 20%, problemas disciplinarios. Entre las sustancias con mayor fuerza de asociación, frente a problemas disciplinarios, se mencionaron: cocaína (OR=3,18; IC95%=2,75- 3,69); marihuana (OR=2,93; IC95%=2,68-3,20); inhalables (OR=2,80; IC95%=2,40-3,28). Frente a problemas académicos, mostraron asociación la marihuana (OR=2,39; IC95%=2,18-2,61), el dick (OR=2,24; IC95%=1,88- 2,66) y los inhalables (OR=2,11; IC95%=1,80-2,48). Conclusiones: El consumo de sustancias psicoactivas estuvo relacionado con la presencia de problemas académicos y disciplinarios.

Introduction: The consumption of psychoactive substances in Colombian youth is considered a public health problem, due to its prevalence and rising characteristics. Studies of the prevalence of drug use in this population indicate the presence of an association with behavioral patterns that lead to an alteration in academic performance and disciplinary problems. Objective: To identify the association between the consumption of psychoactive substances and the presence of academic or disciplinary problems in Colombian adolescents. Materials and methods: This is an analytical cross-sectional study. 80,018 adolescents enrolled in school were included. It was investigated whether the adolescent had academic or disciplinary per- formance problems, as well as consumption of psychoactive substances during the last 12 months. A description was made of the frequencies of academic or disciplinary problems with the consumption of each of these psychoactive substances. Associations were estimated using binary logistic regression models, and all analyzes were adjusted for the expansion factor. Results: There was a prevalence of 44% for academic problems and 20% for disciplinary problems. Among the substances with the greatest strength of association with disciplinary problems was cocaine (OR=3,18; IC95%=2.75-3.69), marihuana (OR=2,93; IC95%=2.68-3.20) and inhalants (OR=2,80; IC95%=2,40-3.28) and related to academic problems was marijuana (OR=2,39; IC95=2,18-2.61). dick (OR=2,24; IC95%=1.88-2.66) e inhalants (OR=2,11; IC95%=1,80-2.48). Conclusions: The use of psychoactive substances is related to the presence of academic and disciplinary problems.

Introdução: O uso de substâncias psicoativas em jovens colombianos é considerado um problema de saúde pública, devido à sua crescente prevalência. Estudos indicaram a existência de uma associação com padrões de comportamento que levam à alteração do desempenho académico e ao surgimento de problemas disciplinares. Objetivos: Identificar a associação entre o consumo de substâncias psicoativas e a presença de problemas disciplinares e de desempenho académico em adolescentes colombianos. Materiais e métodos: Estudo analítico de corte transversal. Foi incluído um total de 80.018 adolescentes em idade escolar. Inquirimos sobre a presença de problemas disciplinares e de desempenho académico, bem como o consumo de substâncias psicoativas durante os últimos 12 meses. Foram descritas as frequências dos problemas académicos ou disciplinares com a utilização de cada uma das substâncias psicoativas. As associações foram estimadas utilizando modelos de regressão logística binária, e todas as análises foram ajustadas para o fator de expansão. Resultados: 44% dos adolescentes relataram problemas académicos e 20% relataram problemas dis ciplinares. Entre as substâncias com maior associação a problemas disciplinares estavam: cocaína (OR= 3,18; IC95% = 2,75-3,69); canábis (OR = 2,93; IC95% = 2,68-3,20); inalantes (OR = 2,80; IC95%CI= 2,40-3,28). Para problemas académicos, o canábis (OR = 2,39, IC95% = 2,18-2,61), o Dick (OR =2,24, IC95% = 1,88-2,66) e inalantes (OR = 2,11, IC95% = 1,80-2,48) foram associados. Conclusões: O uso de substâncias psicoativas estava relacionado com a presença de problemas académicos e disciplinares.

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INTRODUCTION: To support the development of practices and guidelines that might help to reduce adverse events related to human factors, we aimed to study the response and perception by members of a cardiovascular surgery team of various error-driven or adverse features that might arise in the operating room (OR). METHODS: A previously validated Disruptions in Surgery Index (DiSI) questionnaire was completed by individuals working together in a cardiovascular surgical unit. Results were submitted to reliability analysis by calculating the Cronbach's alpha coefficient. Non-parametric Kruskal-Wallis test and Dunn's post-test were performed to estimate differences in perceptions of adverse events or outcomes between the groups (surgeons, nurses, anesthesiologists, and technicians). P<0.05 was considered statistically significant. RESULTS: Cronbach's alpha reliability coefficients showed consistency within the recommended range for all disruption types assessed in DiSI: an individual's skill (0.85), OR environment (0.88), communication (0.81), situational awareness (0.92), patient-related disruption (0.89), team cohesion (0.83), and organizational disruption (0.83). Nurses (27.4%) demonstrated significantly higher perception of disruptions than surgeons (25.4%), anesthetists (23.3%), and technicians (23.0%) (P=0.005). Study participants were more observant of their colleagues' disruptive behaviors than their own (P=0.0001). CONCLUSION: Our results revealed that there is a tendency among participants to hold a positive self-perception position. DiSI appears to be a reliable and useful tool to assess surgical disruptions in cardiovascular OR teams, identifying negative features that might imperil teamwork and safety in the OR. And human factors training interventions are available to develop team skills and improve safety and efficiency in the cardiovascular OR.

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Abstract Introduction: To support the development of practices and guidelines that might help to reduce adverse events related to human factors, we aimed to study the response and perception by members of a cardiovascular surgery team of various error-driven or adverse features that might arise in the operating room (OR). Methods: A previously validated Disruptions in Surgery Index (DiSI) questionnaire was completed by individuals working together in a cardiovascular surgical unit. Results were submitted to reliability analysis by calculating the Cronbach's alpha coefficient. Non-parametric Kruskal-Wallis test and Dunn's post-test were performed to estimate differences in perceptions of adverse events or outcomes between the groups (surgeons, nurses, anesthesiologists, and technicians). P<0.05 was considered statistically significant. Results: Cronbach's alpha reliability coefficients showed consistency within the recommended range for all disruption types assessed in DiSI: an individual's skill (0.85), OR environment (0.88), communication (0.81), situational awareness (0.92), patient-related disruption (0.89), team cohesion (0.83), and organizational disruption (0.83). Nurses (27.4%) demonstrated significantly higher perception of disruptions than surgeons (25.4%), anesthetists (23.3%), and technicians (23.0%) (P=0.005). Study participants were more observant of their colleagues' disruptive behaviors than their own (P=0.0001). Conclusion: Our results revealed that there is a tendency among participants to hold a positive self-perception position. DiSI appears to be a reliable and useful tool to assess surgical disruptions in cardiovascular OR teams, identifying negative features that might imperil teamwork and safety in the OR. And human factors training interventions are available to develop team skills and improve safety and efficiency in the cardiovascular OR.

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ABSTRACT BACKGROUND: In a literate society, linguistic/arithmetic performance is highly valued. Based on defined risk factors, strategies for promotion of better performance can be developed. OBJECTIVE: To ascertain the risk and protective factors relating to development of language and arithmetic. DESIGN AND SETTING: Observational comparative cross-sectional study at a public elementary school in Ribeirão Preto (SP), Brazil. METHODS: A total of 66 children (41% females) attending first to fifth grades participated in this study. They were divided into two groups: G1, children classified as presenting language or arithmetic deficits; G2, average performance. Language (oral and written) and arithmetic skills were assessed through standardized tests. Variables relating to social skills, home environment resources and behavioral problems were assessed through standardized scales. Data on other variables (pre, peri and postnatal complications, maternal variables and others) were collected through interviews. The logistic regression technique with LASSO was used (α = 0.05). RESULTS: Teenage pregnancy and consumption of psychoactive substances during pregnancy or complications during pregnancy were risk factors for performance regarding arithmetic and language. Higher schooling level for the mother was a protective factor in the development of arithmetic and language. Being female and having a history of otitis were risk factors for language. Altered social skills (responsibility and civility) and complaints of inattention were risk factor for arithmetic. Adequate linguistic development was a protective factor for the development of arithmetic. CONCLUSION: The risk/protective factors included variables relating to the gestational period, mother's age when pregnant, mother's schooling, social skills, behavior and development issues.

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Abstract The objective of this study was to describe and compare mothers' and teachers' reports concerning their educational social skills and negative practices and children's behavioral problems and social skills. The mothers and teachers of 81 children participated in this study. The children were assigned to four groups depending on whether they presented problems exclusively at home, school, in both, or none of these contexts. Valid instruments measured educational practices and child behavior. The results show that: (a) mothers and teachers agreed that children with problems in both contexts presented the highest level of impairment; (b) the mothers more frequently reported skills such as affection, adopted negative practices, and identified problem behaviors; (c) the teachers reported more skills such as limit setting. The conclusion is that teachers' and mothers' practices differ, and such information can guide preventive programs and interventions.

Resumo Objetivou-se descrever e comparar avaliações de mães e professores quanto às suas habilidades sociais educativas, práticas negativas e problemas de comportamento e de habilidades sociais das crianças. Participaram mães e professores de 81 crianças, distribuídas em 4 subgrupos quanto à presença/ausência de dificuldades na família e na escola. Aplicou-se instrumentos validados para mensurar práticas educativas e comportamentos infantis. Verificou-se que: (a) crianças com problemas nos dois ambientes apresentaram mais comprometimento para mães e professores; (b) as mães referiram mais habilidades (afeto), usaram mais práticas negativas e identificaram mais problemas de comportamento; (c) os professores referiram mais habilidades para estabelecer limites. Conclui-se que práticas de mães e professores diferem e tais dados podem nortear programas de prevenção e intervenção.

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Objective: To determine the prevalence of childhood emotional and behavioral problems and examine their associations with cesarean delivery. Methods: Our sample consisted of 8,900 preschoolers from 35 kindergartens in four cities in East China. Parents completed the Strengths and Difficulties Questionnaire (SDQ) and provided other information. Children's emotional and behavioral problems were assessed using five subscales of the SDQ. Mode of delivery was classified as vaginal or cesarean section (CS); in sub-analyses, we divided CS into elective or emergency delivery. Logistic regression was used to examine associations. Results: A total of 1,209 (13.6%) children had a total SDQ score within abnormal range; 25.5% had peer problems within abnormal range, 9.0% had abnormal emotional symptoms, 13.9% had abnormal conduct problems, 18.9% had abnormal hyperactivity problems, and 16.2% were rated abnormal in pro-social behavior. Overall, 67.3% of the children who participated were delivered by CS. In fully adjusted analysis, CS was significantly associated with abnormal total SDQ score (OR = 1.27; 95%CI 1.10-1.46; p < 0.05) and pro-social behavior (OR = 1.27; 95%CI 1.12-1.45; p < 0.0001). No significant association was found between CS and risk of having conduct problems (OR 1.13; 95%CI 0.98-1.29), peer problems (OR 1.11; 95%CI 0.99-1.24), hyperactivity (OR 1.02; 95%CI 0.91-1.15), or emotional problems (OR 1.06; 95%CI 0.90-1.24). Conclusion: In this sample, CS was associated with risk of behavioral problems, but not with emotional problems. Further research is needed to better understand these associations.

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Using a sample of 193 Mexican American adolescents (M age at Wave 1 = 14) and three waves of data over two years, this study longitudinally examined the effects of parent-youth acculturation differences, relative to no differences, on parent-adolescent relationship quality and youth problem behavior. We examined parent-youth differences in overall acculturation, Mexican acculturation, and American acculturation. We differentiated between cases in which the adolescent was more acculturated than the parent and cases in which the parent was more acculturated than the adolescent. Adolescents were more commonly similar to their parents than different. Where differences existed, adolescents were not uniformly more American than their parents, no type of difference was associated with parent-adolescent relationship quality, and no type of difference in overall acculturation was associated with youth problem behavior. One type of difference by dimension (adolescent had less Mexican acculturation than mother) was associated with less risk of problem behavior.

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ABSTRACT: Introduction: Childhood depression is a disease that is becoming more frequent. Few reports address parental perception of children depressive symptoms, and these studies have not been carried out in community samples. Objective: To evaluate the correlation and agreement of depressive symptoms in school-age children, and their parent's perception about emotional and conduct abnormalities. Method: A transversal study was performed in 284 children who filled a Children Depression Inventory. One of their parents filled a Strengths and Difficulty Questionnaire, and correlation between scores and subcomponent scores were assessed. Agreement between presence of depressive symptoms in children and their parent's perception of abnormal emotional and/or conduct reports was also obtained. Results: 47 children were identified with depressive symptoms. We found moderate correlation between scores. We did not find agreement between the presence of depressive symptoms in the children and the report of emotional and conduct abnormalities by parents. Discussion and conclusion: There is a modest correlation between depressive symptom severity and parental perception of abnormal emotions and/or behaviors. We found no evidence of agreement between these domains in our study, which suggests that parents fail to perceive negative emotions or conducts as depressive symptoms in their children. Parental reports should be addressed by healthcare workers, and their emotional significance should be interpreted. An intentional search of depressive symptomatology in children should be a priority.

RESUMEN: Introducción: La prevalencia de la depresión infantil está al alza. Pocos estudios han evaluado la percepción parental de los síntomas depresivos en niños, y los que se han realizado no han sido replicados en la comunidad. Objetivo: Evaluar la correlación y la concordancia entre los síntomas depresivos en niños de edad escolar con la percepción de sus padres sobre problemas emocionales y conductas anormales. Método: Se realizó un estudio transversal en 284 niños que contestaron el Inventario de Depresión Infantil y se compararon los puntajes con el Cuestionario de Fortalezas y Dificultades que llenó uno de los padres. Se evaluó la correlación entre los puntajes totales y por sub-escalas, así como la concordancia entre la presencia de puntajes sugestivos de depresión infantil y la percepción parental de emociones y conductas anormales. Resultados: 47 niños fueron identificados con puntajes indicativos de sintomatología depresiva. Encontramos correlación moderada entre los puntajes de las escalas. No encontramos concordancia entre la presencia de síntomas depresivos y el reporte parental de emociones o conductas anormales. Discusión y conclusión: Existe correlación entre la severidad de los síntomas depresivos y la percepción parental de emociones y conductas anormales. No encontramos concordancia entre ambas mediciones, lo cual sugiere que los padres fallan al identificar las conductas y emociones anormales de sus hijos como los síntomas depresivos. Los reportes de los padres deben ser tomados en cuenta y ser interpretados por el personal de salud. La búsqueda intencionada de síntomas depresivos en niños debe ser parte fundamental del proceso de cuidado de esta población.

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Experimental conditions similar to those described by Lieving and Lattal (2003) were used within two experiments to evaluate the resurgence of mands with humans. Two mands from the same operant class were trained with three participants with developmental disabilities during Experiment 1 and with two participants with developmental disabilities and a history of problem behavior during Experiment 2. The two mands were then placed on extinction. Both persisted, but showed different response strength during extinction. The mand with the weaker response strength was targeted for additional functional communication training and the alternative mand was placed on extinction. Following steady levels of occurrence of the targeted mand and no occurrences of the alternative mand, both mands were placed on extinction again. At least one instance of resurgence of the alternative mand occurred with every participant and resurgence of problem behavior occurred for both participants during Experiment 2.

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This study explores the monitoring process longitudinally among a sample of rural early adolescents and addresses two research questions (1) Does maternal knowledge mediate the relationship between three aspects of the parental monitoring process and adolescent problem behavior: active parent monitoring efforts, youth disclosure, and parental supervision? (2) Are these meditational pathways moderated by the affective quality of the parent-child relationship? Parent efforts to monitor youth and youth disclosure in the Fall of Grade 6 predicted substance use and delinquency in Grade 8. These relations were mediated by increases in maternal knowledge assessed in the Spring of Grade 6, suggesting that the protective effects of these constructs are partially indirect. Supervision was not significantly related to maternal knowledge or problem behavior. Parent efforts to monitor were more strongly related to maternal knowledge in families with high levels of positive affect than in families with low levels of positive affect.

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A harmonia nas relações familiares tem um impacto positivo para todos os seus membros e, em especial, para o desenvolvimento da competência social da criança. Com base nos conhecimentos científicos atuais, a proposta deste artigo é examinar os critérios de qualidade necessários aos programas de apoio psicossocial que visam intervir junto às famílias, no intuito de diminuir os problemas de comportamento das crianças e melhorar sua competência social. Os programas abordados nesse artigo são Incredible Years, High Scope e Fast Track (Estados Unidos), ELEM e Fluppy (Canadá). Constata-se que as intervenções familiares com base nesses conhecimentos atendem a altos padrões de eficácia e ética. Porém, conclui-se que pesquisadores e profissionais ainda encontram obstáculos em protocolos onde a baixa coerência entre a avaliação e a intervenção pode comprometer a qualidade do apoio oferecido às famílias numa perspectiva de saúde pública.

Harmony in family relationships has a positive impact on all its members and especially on the development of the social competence of the child. Based on current scientific knowledge, the scope of this article is to examine the quality criteria required for psychosocial support programs aimed at intervening together with families in order to reduce the behavioral problems of children and enhance their social competence. The programs discussed in this article are Incredible Years, High Scope and Fast Track (United States), ELEM and Fluppy (Canada). It is revealed that family interventions based on this knowledge meet high standards of efficacy and ethics. However, the conclusion reached is that researchers and professionals still face obstacles in protocols where the low coherence between assessment and intervention may compromise the quality of support offered to families from a public health perspective.

Assuntos

RESUMO

Functional analysis (Iwata, Dorsey, Slifer, Bauman, & Richman, 1982/1994) is a robust approach to identifying function-based interventions for problem behavior, including self-injury, aggression, and destruction. Such interventions, however, may be difficult for untrained caregivers to implement with fidelity in natural environments. Further research is needed to identify simple antecedent strategies for promoting appropriate behavior among children with significant problem behavior. The purpose of the current study was to utilize a concurrent schedules arrangement to identify conditions under which two children with autism spectrum disorder (ASD) and developmental delays who engaged in problem behaviors would choose to complete academic tasks to earn access to preferred items. In both cases, problem behaviors were shown to be sensitive to reinforcement in the forms of escape from task demands and access to preferred items. A concurrent operant arrangement in which the participants could choose to complete work tasks to earn access to preferred activities, or to take a break without demands or preferred items, was implemented. The schedule requirements in the demand component were systematically increased across opportunities, while the amount and type of reinforcement was kept constant. The results show, at the lowest levels of task demands, both participants allocated more opportunities to the work option. At higher levels, however, both participants allocated a majority of their choices to the break option. Despite the absence of preferred items in the break component, no instances of problem behavior were observed following selection of the break option. This indicates that this type of analysis could be used to identify conditions for compliance among individuals who engage in escape- or multiply-maintained problem behaviors, without the need to provoke or reinforce problem behavior. Limitations of the current study and recommendations for future research are discussed.

El análisis funcional (Iwata, Dorsey, Slifer, Bauman, & Richman, 1982/1994) es una aproximación robusta para identificar intervenciones basadas en la función para la conducta problemática, incluyendo la autolesión, agresión y destrucción. Tales intervenciones, no obstante, pueden ser difíciles de implementar fidedignamente en escenarios naturales por cuidadores no entrenados. Se requiere más investigación para identificar estrategias antecedentes simples para promover la conducta apropiada entre niños con problemas significativos de conducta. El propósito del presente estudio fue utilizar un arreglo de programas concurrentes para identificar las condiciones bajo las cuales dos niños con trastorno del espectro autista (ASD, por sus siglas en inglés) y retraso en el desarrollo que emitían conducta problemática escogerían completar tareas académicas para ganar acceso a ítems preferidos. En ambos casos, las conductas problemáticas fueron sensibles al reforzamiento consistente en escape de las demandas de la tarea y en acceso a ítems preferidos. Se implementó un arreglo de programas concurrentes en el que los participantes podían escoger entre completar una tarea académica para ganar acceso a ítems preferidos o tomar un descanso sin demandas y sin ítems preferidos. Los requisitos del programa en el componente de demanda fueron incrementados sistemáticamente a través de las oportunidades de elección, mientras que el tipo y cantidad de reforzamiento se mantuvo constante. Los resultados mostraron que en el nivel más bajo de demandas, ambos participantes prefirieron la opción de trabajo. A niveles de demanda más altos, no obstante, ambos participantes eligieron la opción de tomar un descanso. A pesar de la ausencia de ítems preferidos en el componente de descanso, no se observaron instancias de conducta problemática después de esta opción. Esto indicó que este tipo de análisis puede ser usado para identificar condiciones que conducen a la obediencia entre individuos cuya conducta problemática se mantiene por escape o bien por múltiples reforzadores, sin la necesidad de provocar o reforzar la conducta problemática. Se discuten las limitaciones del presente estudio y se ofrecen recomendaciones para futura investigación.

RESUMO

Functional assessment, and function-based treatments, are the gold standard for the treatment of problem behavior. Historically, these assessment and treatment evaluations have been conducted in austere clinical settings to increase internal validity. While prioritizing internal validity is critical in the initial stages of a treatment evaluation, if there is not an eventual shift to prioritizing the external or social validity of the treatment it may inevitably fail in the natural environment. The purpose of this case example is to outline a socially valid approach to the assessment and treatment of problem behavior that ensures individuals' and their families' lives benefit in meaningful ways. More specifically, this case-example will outline a method of prioritizing social validity to identify treatment goals, conduct functional analysis, evaluate and generalize treatment, and implement caregiver training.

La evaluación funcional y los tratamientos funcionales son el estándar de oro para el tratamiento de la conducta problemática. Históricamente, esas evaluaciones y tratamientos se han conducido en escenarios clínicos austeros para aumentar la validez interna. Si bien el priorizar la validez interna es crítico en las etapas iniciales de la evaluación de un tratamiento, si eventualmente no hay un cambio para priorizar la validez externa o social del tratamiento, éste puede fallar en un escenario natural. El propósito del ejemplo de caso que se presenta en este trabajo es mostrar una aproximación válida para la evaluación y tratamiento de conducta problemática que asegura que las vidas de los individuos y de sus familias se beneficien de forma significativa. Más específicamente, el ejemplo de caso que se presenta mostrará un método para identificar las metas del tratamiento priorizando la validez social, para conducir un análisis funcional, evaluar y generalizar el tratamiento y entrenar al cuidador.