Study of sleep and evaluation of sumatriptan and rizatriptan in the acute treatment of migraine in children and adolescents

Migraine is a common disease in children and adolescents, affecting roughly 10% of school-aged children. Recent studies have revealed an increasing incidence of childhood migraine, but migraine remains an underrecognized and undertreated condition in the pediatric population. Migraine attacks are painful and disabling and can affect a child´s life in many ways. Effective drug treatment is usually needed. The new migraine drugs, triptans, were introduced at the beginning of the 1990s and have since been shown to be very effective in the treatment of migraine attacks in adults. Although they are widely used in adults, the acute treatment of migraine in children and adolescents is still based on paracetamol and nonsteroidal anti-inflammatory drugs. Some children can control their attacks satisfactorily with simple analgesics, but at least one-third need more powerful treatments. When this thesis work commenced, hardly any information existed on the efficacy and safety of triptans in children. The study aim of the thesis was to identify more efficient treatments of migraine for children and adolescents by investigating the efficacy of sumatriptan nasal spray and oral rizatriptan compared with placebo in them. Sleep has an impact on migraine in many aspects. Despite the clinical relevance and common manifestation of sleep in the context of migraine in children, very little research data on the true frequency of sleep exist. As sleeping is so often related to childhood migraine, it can be a confounding factor in clinical drug trials of migraine treatments in children and adolescents. How the results of a sleeping child should be analyzed is under continual debate. The aim of the thesis was also to clarify this as well as to evaluate the frequency of sleeping during migraine attacks in children and factors affecting frequency. Both nasal sumatriptan and oral rizatriptan were effective (superior to placebo), and well tolerated in treatment of migraine attacks in children and adolescents aged 8-17 and 6-17 years, respectively. No serous adverse effects were observed. The results of this work suggest that nasal sumatriptan 20 mg and rizatriptan 10 mg can be effectively and safely used to treat migraine attacks in adolescents aged over 12 years if more effective drugs than NSAIDs are needed. No difference was observed in efficacy or safety of nasal sumatriptan and rizatriptan between children aged younger than 12 years and older children, but because the treated number of patients under 12 years is still small, more studies are needed before sumatriptan or rizatriptan can be recommended for use in this population. Sleeping during migraine attacks was very common, and most children at least occasionally slept during an attack. Falling asleep was especially common in children under eight years of age and during the first hour after the onset of attack. Children who were able to sleep soon after attack onset were more likely pain-free at two hours. Sleeping probably both improves recovery from a migraine attack and is a sign of headache relief. Falling asleep should be classified as a sign of headache relief in clinical drug trials when studying migraine treatments in children and adolescents.

Hospital-related fears and coping strategies in 4-6-year-old children

There is only little information available on the 4-6-year-old child s hospital-related fears, and on the coping with such fears, as expressed by the children themselves. However, previous data collected from parents and hospital personnel indicate that hospitalization is an anxiety-producing experience for young children. The purpose of this study was to describe the experience of hospital-related fears and the experience of coping with hospital-related fears of 4-6-year-old children. The aim of this study was to form a descriptive model of the subjective experience of hospital-related fears and coping strategies of 4-6-year old children. The data were collected by interviewing 4-6-year-old children from a hospital and kindergarten settings in Finland from 2004 to 2006. Ninety children were interviewed in order to describe the hospital-related fear and the experience of fear, and 89 to describe their coping with the fear and the experience of coping. The children were chosen through purposive sampling. The data were gathered by semi-structured interview, supported by pictures. The data about hospital-related fears and on strategies for coping with hospital-related fears were reviewed by qualitative and quantitative methods. The experience of hospital-related fears and coping with these fears were analyzed using Colaizzi s Method of Phenomenological Analysis. The results revealed that more than 90 % of the children said they were afraid of at least one thing in hospital. Most of the fears could be categorized as nursing interventions, fears of being a patient, and fears caused by the developmental stage of the child. Children interviewed in the hospital expressed substantially more fears than children interviewed in kindergarten. Children s meanings of hospital-related fears were placed into four main clusters: 1) insecurity, 2) injury, 3) helplessness, 4) and rejection. The results also showed that children have plenty of coping strategies, to deal with their fears, especially such strategies in which the children themselves play an active role. Most often mentioned coping strategies were 1) the presence of parents and other family members, 2) the help of the personnel, 3) positive images and humour, 4) play, and 5) the child s own safety toy. The children interviewed in the hospital mentioned statistically significantly more often play, positive imagination and humour as their coping strategy than children interviewed in kindergarten. The meaning of coping with hospital fears consisted of six clusters: pleasure, security, care, understanding the meaning of the situation participating, and protecting oneself. Being admitted to a hospital is an event which may increase the fears of a 4-6-year-old child. Children who have personal experience of being admitted to a hospital describe more fears than healthy children in kindergarten. For young children, hospital-related fear can be such a distressing experience that it reflects on their feelings of security and their behaviour. Children can sometimes find it difficult to admit their fear. Children need the help of adults to express their hospital-related fears, the objects of the fears, and to cope with the fears. Personnel should be aware of children s fears and support them in the use of coping strategies. In addition to the experiences of security and care, pre-school-aged children need active coping strategies that they can use themselves, regardless of the presence of the parents or nurses. Most of all, children need the possibility to play and experience pleasure. Children can also be taught coping strategies which give them an active, positive role.

Aivojen jännitevasteiden rekisteröinti useaan äänen piirteeseen yhdellä mittauskerralla terveillä musiikkileikkikoulua käyvillä kaksivuotiailla

The early detection of hearing deficits is important to a child's development. However, examining small children with behavioural methods is often difficult. Research with ERPs (event-related potentials), recorded with EEG (electroencephalography), does not require attention or action from the child. Especially in children's ERP research, it is essential that the duration of a recording session is not too long. A new, faster optimum paradigm has been developed to record MMN (mismatch negativity), where ERPs to several sound features can be recorded in one recording session. This substantially shortens the time required for the experiment. So far, the new paradigm has been used in adult and school-aged children research. This study examines if MMN, LDN (late discriminative negativity) and P3a components can be recorded in two-year-olds with the new paradigm. The standard stimulus (p=0.50) was an 80 dB harmonic tone consisting of three harmonic frequencies (500 Hz, 1000 Hz and 1500 Hz) with a duration of 200 ms. The loudness deviants (p=0.067) were at a level of +6 dB or -6 dB compared to the standards. The frequency deviants (p=0.112) had a fundamental frequency of 550 or 454.4 Hz (small deviation), 625 or 400 Hz (medium deviation) or 750 or 333.3 Hz (large deviation). The duration deviants (p=0.112) had a duration of 175 ms (small deviation), 150 ms (medium deviation) or 100 ms (large deviation). The direction deviants (p=0.067) were presented from the left or right loudspeaker only. The gap deviant (p=0.067) included a 5-ms silent gap in the middle of the sound. Altogether 17 children participated in the experiment, of whom the data of 12 children was used in the analysis. ERP components were observed for all deviant types. The MMN was significant for duration and gap deviants. The LDN was significant for the large duration deviant and all other deviant types. No significant P3a was observed. These results indicate that the optimum paradigm can be used with two-year-olds. With this paradigm, data on several sound features can be recorded in a shorter time than with the previous paradigms used in ERP research.

"Sitte se menee koulus" : Eri kieli- ja kulttuuritaustaisen lapsen suomen kielen taito esiopetuksen päättövaiheessa

A child learns new things, creates social relationships and participates in play with the help of language. How can a child overcome these challenges if the surrounding language is not his mother tongue? The objective of learning a new language in the Pre-school education is an active bilingualism in all fields of the language. Theoretical context of the research rises from bilingualism, learning a language, language skills and evaluating them. Object of the research was to understand language skills of a child from a different linguistic and cultural background in the final stage of Pre-school education and to clarify how learning Finnish was supported during the Pre-school year. Answers to the research issues will be searched with the following questions: 1) What kind of language skills does a child from a different linguistic and cultural backgrounds have at the final stage of Pre-school education?, 1.1) What kind of listening comprehension skills?, 1.2) What kind of speech and vocabulary skills?, 1.3) What kind of structural skills?, 2) What kind of individual differences are there in language skills of children from different linguistic and cultural backgrounds?, and 3) How has a child from a different linguistic and cultural background been supported in learning Finnish during the Pre-school education? The view of language skills in this research is holistic even though it will be analysed in separate fields. The aim of this research is to form an overall impression of Finnish skills of the children participating in the research. Eight Pre-school-aged children with different linguistic and cultural backgrounds and their kindergarten teachers participated in this research. The children had taken part in Finnish activities for about three years. The research material consists of the test series (KITA), which evaluate children’s language skills – and of the questionnaire to the kindergarten teachers. The purpose of the questionnaire was to provide additional information on children’s language skills in Pre-school teaching situations and on supporting Finnish in Pre-school education. This research is qualitative and processing of the material is based on content analysis. According to the kindergarten teachers, the children’s social language skills were sufficient to cope in everyday life but children needed assistance with longer instructions. The same phenomenon could also be seen with the KITA tests – in which long and abstract instructions turned out to be difficult. Individual differences of the children were perceived in productivity skills, which were realised in fluent or influent speech. The children were supported in learning Finnish individually, in small-groups and in the activities of a whole group. ‘Finnish as the second language’ small-groups were the most common form of support in learning the language. The support at understanding activities was emphasized in whole group situations as well as in individual situations while assisting the child’s language skills. Generally, the children’s language skills were in the same level with developing basic language skills. The data of this research help to understand children’s language skills after three years of adopting Finnish. The results can be utilised in planning and evaluation of teaching another language.

Developmental, functional brain imaging and electrophysiological evidence of visual and auditory working memory

Intact function of working memory (WM) is essential for children and adults to cope with every day life. Children with deficits in WM mechanisms have learning difficulties that are often accompanied by behavioral problems. The neural processes subserving WM, and brain structures underlying this system, continue to develop during childhood till adolescence and young adulthood. With functional magnetic resonance imaging (fMRI) it is possible to investigate the organization and development of WM. The present thesis aimed to investigate, using behavioral and neuroimaging methods, whether mnemonic processing of spatial and nonspatial visual information is segregated in the developing and mature human brain. A further aim in this research was to investigate the organization and development of audiospatial and visuospatial information processing in WM. The behavioral results showed that spatial and nonspatial visual WM processing is segregated in the adult brain. The fMRI result in children suggested that memory load related processing of spatial and nonspatial visual information engages common cortical networks, whereas selective attention to either type of stimuli recruits partially segregated areas in the frontal, parietal and occipital cortices. Deactivation mechanisms that are important in the performance of WM tasks in adults are already operational in healthy school-aged children. Electrophysiological evidence suggested segregated mnemonic processing of visual and auditory location information. The results of the development of audiospatial and visuospatial WM demonstrate that WM performance improves with age, suggesting functional maturation of underlying cognitive processes and brain areas. The development of the performance of spatial WM tasks follows a different time course in boys and girls indicating a larger degree of immaturity in the male than female WM systems. Furthermore, the differences in mastering auditory and visual WM tasks may indicate that visual WM reaches functional maturity earlier than the corresponding auditory system. Spatial WM deficits may underlie some learning difficulties and behavioral problems related to impulsivity, difficulties in concentration, and hyperactivity. Alternatively, anxiety or depressive symptoms may affect WM function and the ability to concentrate, being thus the primary cause of poor academic achievement in children.

Linguistic and perceptual processing of communicative cues in Asperger Syndrome

Asperger Syndrome (AS) belongs to autism spectrum disorders where both verbal and non-verbal communication difficulties are at the core of the impairment. Social communication requires a complex use of affective, linguistic-cognitive and perceptual processes. In the four studies included in the current thesis, some of the linguistic and perceptual factors that are important for face-to-face communication were studied using behavioural methods. In all four studies the results obtained from individuals with AS were compared with typically developed age, gender and IQ matched controls. First, the language skills of school-aged children were characterized in detail with standardized tests that measured different aspects of receptive and expressive language (Study I). The children with AS were found to be worse than the controls in following complex verbal instructions. Next, the visual perception of facial expressions of emotion with varying degrees of visual detail was examined (Study II). Adults with AS were found to have impaired recognition of facial expressions on the basis of very low spatial frequencies which are important for processing global information. Following that, multisensory perception was investigated by looking at audiovisual speech perception (Studies III and IV). Adults with AS were found to perceive audiovisual speech qualitatively differently from typically developed adults, although both groups were equally accurate in recognizing auditory and visual speech presented alone. Finally, the effect of attention on audiovisual speech perception was studied by registering eye gaze behaviour (Study III) and by studying the voluntary control of visual attention (Study IV). The groups did not differ in eye gaze behaviour or in the voluntary control of visual attention. The results of the study series demonstrate that many factors underpinning face-to-face social communication are atypical in AS. In contrast with previous assumptions about intact language abilities, the current results show that children with AS have difficulties in understanding complex verbal instructions. Furthermore, the study makes clear that deviations in the perception of global features in faces expressing emotions as well as in the multisensory perception of speech are likely to harm face-to-face social communication.

Visuaalis-spatiaalisten työmuistivalmiuksien yhteys (esi)matemaattisiin taitoihin ja merkitys osana matemaattisilta taidoiltaan heikkojen lasten ja nuorten kognitiivista profiilia

Tämän itsenäisistä osatutkimuksista koostuvan tutkimussarjan tavoitteena oli pyrkiä täydentämään kuvaa matemaattisilta taidoiltaan heikkojen lasten ja nuorten tiedonkäsittelyvalmiuksista selvittämällä, ovatko visuaalis-spatiaaliset työmuistivalmiudet yhteydessä matemaattiseen suoriutumiseen. Teoreettinen viitekehys rakentui Baddeleyn (1986, 1997) kolmikomponenttimallin ympärille. Työmuistikäsitys oli kuitenkin esikuvaansa laajempi sisällyttäen visuaalis-spatiaaliseen työmuistiin Cornoldin ja Vecchin (2003) termein sekä passiiviset varastotoiminnot että aktiiviset prosessointitoiminnot. Yhteyksiä työmuistin ja matemaattisten taitojen välillä tarkasteltiin viiden eri osatutkimuksen avulla. Kaksi ensimmäistä keskittyivät alle kouluikäisten lukukäsitteen hallinnan ja visuaalis-spatiaalisten työmuistivalmiuksen tutkimiseen ja kolme jälkimmäistä peruskoulun yhdeksäsluokkalaisten matemaattisten taitojen ja visuaalis-spatiaalisten työmuistitaitojen välisten yhteyksien selvittämiseen. Tutkimussarjan avulla pyrittiin selvittämään, ovatko visuaalis-spatiaaliset työmuistivalmiudet yhteydessä matemaattiseen suoriutumiseen sekä esi- että yläkouluiässä (osatutkimukset I, II, III, IV, V), onko yhteys spesifi rajoittuen tiettyjen visuaalis-spatiaalisten valmiuksien ja matemaattisen suoriutumisen välille vai onko se yleinen koskien matemaattisia taitoja ja koko visuaalis-spatiaalista työmuistia (osatutkimukset I, II, III, IV, V) tai työmuistia laajemmin (osatutkimukset II, III) sekä onko yhteys työmuistispesifi vai selitettävissä älykkyyden kaltaisella yleisellä päättelykapasiteetilla (osatutkimukset I, II, IV). Tutkimussarjan tulokset osoittavat, että kyky säilyttää ja käsitellä hetkellisesti visuaalis-spatiaalista informaatiota on yhteydessä matemaattiseen suoriutumiseen eikä yhteyttä voida selittää yksinomaan joustavalla älykkyydellä. Suoriutuminen visuaalis-spatiaalista työmuistia mittaavissa tehtävissä on yhteydessä sekä alle kouluikäisten esimatemaattisten taitojen hallintaan että peruskoulun yhdeksäsluokkalaisten matematiikan taitoihin. Matemaattisilta taidoiltaan heikkojen lasten ja nuorten visuaalis-spatiaalisten työmuistiresurssien heikkoudet vaikuttavat kuitenkin olevan sangen spesifejä rajoittuen tietyntyyppisissä muistitehtävissä vaadittaviin valmiuksiin; kaikissa visuaalis-spatiaalisen työmuistin valmiuksia mittaavissa tehtävissä suoriutuminen ei ole yhteydessä matemaattisiin taitoihin. Työmuistivalmiuksissa ilmenevät erot sekä alle kouluikäisten että kouluikäisten matemaattisilta taidoiltaan heikkojen ja normaalisuoriutujien välillä näyttävät olevan kuitenkin jossain määrin yhteydessä kielellisiin taitoihin viitaten vaikeuksien tietynlaiseen kasautumiseen; niillä matemaattisesti heikoilla, joilla on myös kielellisiä vaikeuksia, on keskimäärin laajemmat työmuistiheikkoudet. Osalla matematiikassa heikosti suoriutuvista on näin ollen selvästi keskimääräistä heikommat visuaalis-spatiaaliset työmuistivalmiudet, ja tämä heikkous saattaa olla yksi mahdollinen syy tai vaikeuksia lisäävä tekijä heikon matemaattisen suoriutumisen taustalla. Visuaalis-spatiaalisen työmuistin heikkous merkitsee konkreettisesti vähemmän mentaalista prosessointitilaa, joka rajoittaa oppimista ja suoritustilanteita. Tiedonkäsittelyvalmiuksien heikkous liittyy nimenomaan oppimisnopeuteen, ei asioiden opittavuuteen sinänsä. Mikäli oppimisympäristö ottaa huomioon valmiuksien rajallisuuden, työmuistiheikkoudet eivät todennäköisesti estä asioiden oppimista sinänsä. Avainsanat: Työmuisti, visuaalis-spatiaalinen työmuisti, matemaattiset taidot, lukukäsite, matematiikan oppimisvaikeudet

Designing a blended learning model for primary school language learning

In Finland, there is a desperate need for flexible, reliable and functional multi-e-learning settings for pupils aged 11-13. Southern Finland has several ongoing e-learning projects, but none that develop a multiple setting, with learning and teaching occurring between more than two schools. In 2006, internet connections were not broadband and data transfer was mainly audio data. Connections and technical problems occurred, which were an obstacle to multi-e-learning. Internet connections today enable web-based learning in major parts of
Lapland and by 2015, broadband will reach even the remotest villages up north. Therefore, it is important to research the possibilities of multi-e-learning and to build collaborative, learner-centred, versatile network models for primary school-aged pupils. The resulting model will facilitate distance learning to extend education to rural, sparsely populated areas, and it will give a model of using mobile devices in language portfolios. This will promote regional equality and prevent exclusion. Working with portfolios provides the opportunity to develop mobility from a pedagogical point of view. It is important to study the pros and cons of mobile devices in producing artefacts on portfolios in e-learning and language learning settings.
The current study represents a design-based research approach. The design research approach includes two important aspects concerning the current research: ‘a teacher as researcher’ aspect, which means there is the possibility to be strongly involved in developing processes and an obstacle-aspect, which means that problems while developing, are seen as a
promoter in evolving the designed model, as apposed to negative results.

Designing a blended learning model for primary school language learning

In Finland, there is a desperate need for flexible, reliable and functional multi-e-learning settings for pupils aged 11-13. Southern Finland has several ongoing e-learning projects, but none that develop a multiple setting, with learning and teaching occurring between more than two schools. In 2006, internet connections were not broadband and data transfer was mainly audio data. Connections and technical problems occurred, which were an obstacle to multi-e-learning. Internet connections today enable web-based learning in major parts of Lapland and by 2015, broadband will reach even the remotest villages up north. Therefore, it is important to research the possibilities of multi-e-learning and to build collaborative, learner-centred, versatile network models for primary school-aged pupils. The resulting model will facilitate distance learning to extend education to rural, sparsely populated areas, and it will give a model of using mobile devices in language portfolios. This will promote regional equality and prevent exclusion. Working with portfolios provides the opportunity to develop mobility from a pedagogical point of view. It is important to study the pros and cons of mobile devices in producing artefacts on portfolios in e-learning and language learning settings. The current study represents a design-based research approach. The design research approach includes two important aspects concerning the current research: ‘a teacher as researcher’ aspect, which means there is the possibility to be strongly involved in developing processes and an obstacle-aspect, which means that problems while developing, are seen as a promoter in evolving the designed model, as apposed to negative results.

Snoring and sleep apnea in children

Snoring is a primary and major clinical symptom of upper airway obstruction during sleep. Sleep-disordered breathing ranges from primary snoring to significant partial upper airway obstruction, and obstructive sleep apnea. Adult snoring and obstructive sleep apnea have been extensively studied, whereas less is known about these disorders in children. Snoring and more severe obstructive sleep apnea have been shown to have a harmful effect on the neurobehavioral development of children, but the mechanisms of this effect remains unknown. Furthermore, the correlation of this effect to objective sleep study parameters remains poor. This study evaluated the prevalence of snoring in preschool-aged children in Finland. Host and environmental risk factors, and neurobehavioral and neurocognitive symptoms of children suffering from snoring or obstructive sleep apnea were also investigated. The feasibility of acoustic rhinometry in young children was assessed. The prevalence and risk factors of snoring (I) were evaluated by a questionnaire. The random sample included 2100 children aged 1-6 years living in Helsinki. All 3- to 6-year-old children whose parents reported their child to snore always, often, or sometimes were categorized as snorers, and invited to participate to the clinical study (II-IV). Non-snoring children whose parents were willing to participate in the clinical study were invited to serve as controls. Children underwent a clinical ear-nose-throat examination. Emotional, behavioral, and cognitive performances were evaluated by Child Behavioral Checklist (CBCL), Wechsler Preschool and Primary Scale of Intelligence (WPPSI-R) and NEPSY-A Developmental Neuropsychological Assessment (NEPSY). Nasal volume was measured by acoustic rhinometry, and nasal resistance by rhinomanometry. Lateral and posteroanterior cephalometry were performed. A standard overnight ambulatory polysomnography was performed in the home environment. Twenty-six healthy children were tested in order to assess the feasibility of acoustic rhinometry in young children (V). Snoring was common in children; 6.3% of children snored always or often, whereas 81.3% snored never or occasionally. No differences were apparent between snorers and non-snorers regarding age, or gender. Pediatric snoring was associated with recurrent upper respiratory infections, otitis media, and allergic rhinitis. Exposure to parental tobacco smoke, especially maternal smoking, was more common among snorers. Rhinitis was more common among children who exposured to tobacco smoke. Overnight polysomnography (PSG) was performed on 87 children; 74% showed no signs of significant upper airway obstruction during sleep. Three children had obstructive apnea/hypopnea index (OAHI) greater than 5/h. Age, gender, or a previous adenoidectomy or tonsillectomy did not correlate with OAHI, whereas tonsillar size did correlate with OAHI. Relative body weight and obesity correlated with none of the PSG parameters. In cephalometry, no clear differences or correlations were found in PSG parameters or between snorers and non-snorers. No correlations were observed between acoustic rhinometry, rhinomanometry, and PSG parameters. Psychiatric symptoms were more frequent in the snoring group than in the nonsnoring group. In particular, anxious and depressed symptoms were more prevalent in the snoring group. Snoring children frequently scored lower in language functions. However, PSG parameters correlated poorly with neurocognitive test results in these children. This study and previous studies indicate that snoring without episodes of obstructive apnea or SpO2 desaturations may cause impairment in behavioral and neurocognitive functions. The mechanism of action remains unknown. Exposure to parental tobacco smoke is more common among snorers than non-snorers, emphasizing the importance of a smoke-free environment. Children tolerated acoustic rhinometry measurements well.

Kuka kasvattaa, kuka opettaa? : Genealoginen tutkimus perheen ja koulun välisen kasvatusvastuun politiikasta

FAMILIES AND SCHOOLS AND THE POLITICS OF RESPONSIBILITIES - a genealogical study on family and school as carers and educators of the child population in modern society This study aims to uncover the politics behind such discourses in the media which have claimed the family to be totally responsible for children and which ignore the various responsibilities accorded to the state in matters concerning the child population. Using Max Weber s and Michael Mann s theorizing on the history of power relationships, feminist social history on patriarchy and Foucauldian power analytic concept of dispositif the study traces two competing child policies which have influenced the historical formation of modern generational order in Western societies. One of them is based on the interests of the hegemonic bourgeois elite and the other on the interests of the non-elite population, which were expressed during the phase of building the welfare state in Finland in the 1960 1980 s. The central strategies of the bourgeois child policy are 1) to construct the childhood years as a time for preparation and formation of the individual according to the interests of the elite, 2) to construct the family as the sole site of holistic care and responsibility of children in society, and 3) compulsory schooling of children of the non-elite population in state organized schools. To implement these strategies the elite uses strategically patriarchal cultural formations/dispositifs in modernized versions. The result has been the formation of a sexually divided and hierarchical order of care and education, where, on the one hand, there is the less important feminine care of children done by mothers at home and, on the other, the real education of the school, where children are made the object of authoritarian shaping and where the needs and the personal experiences of the child are ignored. The welfare order of care and education is based on the ethos of welfare society, where the state and the families are seen to share the responsibility for the child population. In this vein, families and schools are seen as partners who both have a caring attitude to children s welfare and learning. The study shows that discourses and terminology in the mainstream educational policy texts in Finland create a chaotic linguistic game which makes it difficult to have a rational discussion about the roles of family and school in the holistic care and education of children. This has opened the door to political discourses where familist interpretations of the question of responsibility are claimed to be based on law.

Tyttöjen kesken : Monikulttuurisuus ja sukupuolten tasa-arvo nuorisotyössä.

Among Girls Youth Work, Multiculturalism and Gender Equality Finland s increasingly multicultural society concerns younger generations in a very particular manner. Starting already in pre-school kindergartens, children from different cultural backgrounds share their everyday existence. The focus of this study is Finland s increasingly multicultural society that has challenged youth work professionals in particular and made them rethink questions related to content, basic values and goals of youth work. These reconsiderations include the following essential questions: which of these pedagogic principles are defined as Finnish, and under what kinds of circumstances would the youth workers be ready to negotiate about them. These questions, which are related to multiculturalism, are then linked to the girls position, status and gender equality. The research examines how gender equality is articulated in relation to multiculturalism and vice versa, in what contexts youth work-related questions are negoatiated in, and how these negotiations then relate to gender issues. The present study combines theoretical concepts and debates from both post-colonial and youth research, and has benefited greatly from previous research which has examined the everyday lives of young people with multicultural backgrounds and conceptualised the different meanings of age, ethnicity, culture and gender. Neither multiculturalism nor gender equality is, however, taken as a given concept in this study; rather the research focuses on how youth workers understand and define these concepts and how they are used. The emphasis has been on monitoring the varying consequences of different understandings and definitions in terms of everyday work and practices. The goal of this study has been to find typical ways of conceptualising multiculturalism, gender equality and the role of girls in the context of youth work. The focus of the research is not just the youth workers different views but also the notions of the girls themselves. These are then further analysed by examining the ways the girls negotiate their agency. Examples of how the girls agency is defined and the different forms of agency that are offered to the girls within the context of leisure time activities and youth work have been sought. The kind of agency the girls then assume is also examined. The data in this research is comprised of interviews with young people with multicultural backgrounds (n=39), youth workers (n=42) and of ethnographic fieldwork (2003 2005). The fieldwork concentrated on following different types of youth work activities that were targeted at girls with migrant backgrounds. These were organized both by selected municipalities and NGOs. The research shows that various questions related to multicultural issues have enhanced the visibility of gender equality in the field of youth work. The identification of gender-based inequality is especially closely linked to the position of girls from migrant backgrounds. These girls are a source of particular worry and the aim of the many activity groups for migrant girls is to educate them so that they can become equal Finnish citizens . The youth work itself is seen as gender-neutral and equality based. Equality in this context is defined as a purely quantitative concept, and the solution to any possible inequalities is thus the exact same treatment for everyone . The girls themselves seem mainly confused by the role that is offered to them. They would need a voice and the possibility to have an impact on the planning of youth work activities. They want to have their views heard. The role of the victim assigned to them is very confining and makes it difficult to act. At the same time the research shows how gender-sensitive youth work is seen to mean youth work with girls. Gender-sensitive work with boys is not really done or is done very little, even if many of the interviewees are of the opinion that the true materialization of gender equality would require boys to be taken into account too. The principle of gender equality should be shared by the entire youth work profession. Keywords Youth work, equality, multiculturalism, gender sensitivity, agency, girls, young people, sexuality