O brincar para conhecer o desenvolvimento de crianças com implante coclear

This research analyses the development of children presented with profound deafness and benefited by the cochlear implant, discovery of great significance in hearing health. The work is based, theoretically, on Winnicott, and methodologically, in anamnesis data and playing on a set of ludic scenes, systematically organized. Ten pre-school children with implants, selected by hospital and homogenization eligibility criteria participate in this study encompassing interviews with parents and playful observation sessions with the children, besides Lynn´s Dolls Structured Game. In the children, the results show immaturity, regression to earlier stages of their development, dependency and behavioral disorders, in particular, those related to language, interrelationship and anxiety. In the parents, family disorientation, partly overcome. The children and family participating are assisted by a multidisciplinary health team, at the hospital where they are attended.

Future directions for doll play narrative research: a commentary

Past research into doll play narratives has been productive in elucidating children's inner experiences, their determinants, and their role in child behaviour problems. The current volume takes this work forward in several directions: first, it indicates the value of designing story stems and coding schemes to address more specific questions about the developmental process of specific syndromes. Second, contributions demonstrate the "added value" provided by children's narratives, over and above information derived from other sources. Third, this recent research enhances our understanding of the role of parental representations and states of mind in influencing children's narratives; how these may come to influence child functioning via co-constructed parent-child dialogues is an important area for future research. Finally, possibilities of extending the clinical utility of doll play narratives are explored.

Doll Play narratives about starting school in children of socially anxious mothers, and their relation to subsequent child school-based anxiety

Background: Child social anxiety is common, and predicts later emotional and academic impairment. Offspring of socially anxious mothers are at increased risk. It is important to establish whether individual vulnerability to disorder can be identified in young children. Method: The responses of 4.5 year-old children of mothers with social phobia (N = 62) and non-anxious mothers (N = 60) were compared, two months before school entry, using a Doll Play (DP) procedure focused on the social challenge of starting school. DP responses were examined in relation to teacher reports of anxious-depressed symptoms and social worries at the end of the child’s first school term. The role of earlier child behavioral inhibition and attachment, assessed at 14 months, was also considered. Results: Compared to children of non-anxious mothers, children of mothers with social phobia were significantly more likely to give anxiously negative responses in their school DP (OR = 2.57). In turn, negative DP predicted teacher reported anxious-depressed and social worry problems. There were no effects of infant behavioral inhibition or attachment. Conclusion: Vulnerability in young children at risk of anxiety can be identified using Doll Play narratives.

Procedural memory predicts social skills in persons with schizophrenia

Despite a growing number of studies that have investigated the relationship between neurocognition and psychosocial outcome in schizophrenia, no studies have looked at the relationship between procedural memory and social skills measures in schizophrenia. The goal of this study was to investigate whether procedural memory, often preserved in schizophrenia, could predict nonverbal social skills in chronic patients with schizophrenia. Fourteen outpatients with schizophrenia participated in our study. Procedural memory was evaluated using the Mirror Reading Test, and nonverbal and verbal social skills were evaluated using a structured role play test. As predicted, there was a significant positive correlation between the learning index of the Mirror Reading Test and nonverbal skills (Spearman ρ=0.559, p = 0.038), but not for verbal communication skills or processing skills. Although preliminary, these results provide the first evidence of an association between procedural memory and nonverbal social skills in patients with schizophrenia.

A Transdiagnostic Social Skills Intervention; Using a Structured Story to Teach Children How to Ask a Friend to Play

An (independent samples comparison) controlled study was conducted to assess the efficacy of a novel approach to social skills training for children in a local socialization group at Knippenberg, Patterson & Associates (KPA). The treatment condition involved the combination of a Structured Story (i.e., novel bibliotherapy technique for children with social skills deficits), and a behavioral rehearsal (or role-play) segment, where the children practiced the target social skill featured in the Structure Story. The control group did not receive the Structured Story nor the behavioral rehearsal. Children in both groups engaged in ten-minutes of free play that was videorecorded for later observation and scoring by the principal investigator. Two target behaviors were assessed; asking a friend to play, and duration of joint play between two or more peers. The results did not show significant differences for either target variable between the group that received the novel intervention and the control group. Limitations of the current study and implications for further research are discussed.

Étude de l’appropriation de l’orthographe française langue seconde/étrangère d’élèves arabophones du secondaire en Égypte

La présente recherche vise à décrire le développement orthographique des élèves arabophones de 1re année du secondaire en Égypte au début de l’apprentissage du français langue étrangère. Les recherches égyptiennes qui concernent le français écrit se sont préoccupées des erreurs grammaticales commises par les élèves. À notre connaissance, il n’existe pas d’études relatives à l’appropriation de l’orthographe française menée auprès de ces élèves. Afin de combler ce vide, nous avons souhaité apporter un éclairage sur les compétences orthographiques des élèves en essayant d’éclairer la documentation de ces compétences en français écrit par la mise en relation avec celle de jeunes enfants arabophones qui apprennent le français L2 au préscolaire lors de leur séjour au Québec. Afin d’atteindre nos objectifs, nous avons soumis 30 élèves arabophones du secondaire à une épreuve d’orthographes approchées à quatre reprises. Celle-ci s’est déroulée dans le cadre d’un entretien semi-structuré individuel dans lequel les élèves ont été invités à produire des mots et une phrase. L’analyse descriptive et statistique de la production écrite des sujets a permis d’observer trois types de préoccupations écrites : visuographiques, phonologiques et orthographiques. D’autre part, leurs écrits ont témoigné d’un transfert langagier de l’arabe L1 et de l’anglais LE, qui était parfois positif, d’autres fois négatif. Les résultats ont, enfin, révélé que les élèves ont utilisé trois stratégies, lexicale, phonologique et analogique, lors de leurs productions. En outre, une étude de cas multiples exploratoire avec quatre enfants arabophones du préscolaire au Québec a été effectuée. Ces derniers ont été individuellement invités à produire des mots et une phrase en français et en arabe. De manière exploratoire, nous avons mis en relation l’appropriation de l’écrit des élèves du secondaire et celle des enfants du préscolaire en français et en arabe, ce qui nous a permis de vérifier l’effet de l’âge sur le développement orthographique et sur le transfert langagier chez les apprenants. Les résultats obtenus indiquent que la performance écrite des élèves du secondaire était significativement plus réussie que celle des enfants du préscolaire et que les premiers étaient les plus susceptibles de produire un transfert langagier. Ainsi, l’âge de l’apprenant peut avoir un impact sur l’appropriation de l’écrit ainsi que sur le transfert langagier en français langue seconde/étrangère. Finalement, au-delà de son apport scientifique et pratique, la présente recherche propose des pistes de recherches futures.

The dynamics of threat, fear and intentionality in the conduct disorders: longitudinal findings in the children of women with post-natal depression

This paper considers how environmental threat may contribute to the child's use of avoidant strategies to regulate negative emotions, and how this may interact with high emotional reactivity to create vulnerability to conduct disorder symptoms. We report a study based on the hypothesis that interpreting others' behaviours in terms of their motives and emotions - using the intentional stance - promotes effective social action, but may lead to fear in threatful situations, and that inhibiting the intentional stance may reduce fear but promote conduct disorder symptoms. We assessed 5-year-olds' use of the intentional stance with an intentionality scale, contrasting high and low threat doll play scenarios. In a sample of 47 children of mothers with post-natal depression ( PND) and 35 controls, children rated as securely attached with their mothers at the age of 18 months were better able to preserve the intentional stance than insecure children in high threat scenarios, but not in low threat scenarios. Girls had higher intentionality scores than boys across all scenarios. Only intentionality in the high threat scenario was associated with teacher-rated conduct disorder symptoms, and only in the children of women with PND. Intentionality mediated the associations between attachment security and gender and conduct disorder symptoms in the PND group.

The effect of cleft lip on socio-emotional functioning in school-aged children

Background: Children with cleft lip are known to be at raised risk for socio-emotional difficulties, but the nature of these problems and their causes are incompletely understood; longitudinal studies are required that include comprehensive assessment of child functioning, and consideration of developmental mechanisms. Method: Children with cleft lip (with and without cleft palate) (N = 93) and controls (N = 77), previously studied through infancy, were followed up at 7 years, and their socio-emotional functioning assessed using teacher and maternal reports, observations of social interactions, and child social representations (doll play). Direct and moderating effects of infant attachment and current parenting were investigated, as was the role of child communication difficulties and attractiveness. Results: Children with clefts had raised rates of teacher-reported social problems, and anxious and withdrawn-depressed behaviour; direct observations and child representations also revealed difficulties in social relationships. Child communication problems largely accounted for these effects, especially in children with cleft palate as well as cleft lip. Insecure attachment contributed to risk in both index and control groups, and a poorer current parenting environment exacerbated the difficulties of those with clefts. Conclusions: Children with clefts are at raised risk for socio-emotional difficulties in the school years; clinical interventions should focus on communication problems and supporting parenting; specific interventions around the transition to school may be required. More generally, the findings reflect the importance of communication skills for children’s peer relations.

The representation of fathers by children of depressed mothers: refining the meaning of parentification in high-risk samples

Background: Children’s representations of mothers in doll-play are associated with child adjustment. Despite the importance of fathers for children’s adjustment, especially in the context of maternal psychopathology, few studies have considered children’s representations of their fathers. Method: We examined the portrayal of fathers by 5-year-old children of depressed (N = 55) and non-depressed (N = 39) mothers in a doll-play procedure concerning family experience. Results: Children gave equal prominence in their play to mothers and fathers. Representations of fathers were unrelated to maternal mood, but were associated with parental conflict. Representations of child care for the father that was unreciprocated predicted poor child adjustment in school, but only in children exposed to maternal postnatal depression. Conclusions: It may be clinically useful to consider children’s distinctive representations of their mother and father; but the concept of parentification in relation to risk and resilience effects requires refinement.

Socially anxious mothers’ narratives to their children, and their relation to child representations and adjustment

Anxious mothers’ parenting, particularly transfer of threat information, has been considered important in their children’s risk for social anxiety disorder (SAnxD), and maternal narratives concerning potential social threat could elucidate this contribution. Maternal narratives to their pre-school 4-5 year-old children, via a picture book about starting school, were assessed in socially anxious (N=73), and non-anxious (N=63) mothers. Child representations of school were assessed via Doll Play (DP). After one school term, mothers (CBCL) and teachers (TRF) reported on child internalizing problems, and child SAnxD was assessed via maternal interview. Relations between these variables, infant behavioral inhibition, and attachment, were examined. Socially anxious mothers showed more negative (higher threat attribution), and less supportive (lower encouragement) narratives, than controls, and their children’s DP representations, SAnxD and CBCL scores were more adverse. High narrative threat predicted child SAnxD; lower encouragement predicted negative child CBCL scores and, particularly for behaviorally inhibited children, TRF scores and DP representations. In securely attached children, CBCL scores and risk for SAnxD were affected by maternal anxiety and threat attributions, respectively. Low encouragement mediated the effects of maternal anxiety on child DP representations, and CBCL scores. Maternal narratives are affected by social anxiety, and contribute to adverse child outcome.

Influência da tecnologia educacional na avaliação do conhecimento de portadores de hepatite C crônica sobre sua doença e aderência ao tratamento antiviral

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

The test-retest reliability of the child-initiated pretend play assessment

OBJECTIVE: The purpose of this study is to establish the test–retest reliability of the Child-Initiated Pretend Play Assessment (ChIPPA) (Stagnitti, 2002a; Stagnitti, Unsworth, & Rodger, 2000).

METHOD: The first author rated 38 preschool children ages 4 and 5 years (4 with developmental delay and 34 typically developing) on the ChIPPA. The ChIPPA employs conventional play materials and unstructured play materials to assess three qualities of a child's play ability: elaborateness of play action, ability to substitute objects during play, and the child's need to imitate the modelled actions of the examiner. The ChIPPA was administered twice, at a 2-week interval, to each participant.

RESULTS: Test–retest intraclass correlation coefficients (ICCs) (Type 2,1) calculated for each of the three elaborate play measures ranged from .73 to .84. A test–retest ICC of .56 was obtained for object substitution with unstructured play materials. The test–retest ICC obtained for the combined score for unstructured and conventional play materials was .57. Percentage agreement figures ranging from 63.2% to 84.2% were obtained on test–retest of the object substitution with conventional toys and imitated actions measures. There was no significant difference between test and retest scores for these measures based on a Wilcoxon Matched Pairs Signed-Ranks Test (Wilcoxon Sign Test).

CONCLUSION: Elaborate play scores, object substitution with conventional toys score, and imitation scores on the ChIPPA showed stability over time. Object substitution scores using unstructured materials were the least stable play measures and appeared to be related to the child's play themes. Since play is the primary occupation of children, it is essential that therapists have a reliable measure of play behavior. The test–retest reliability results from the ChIPPA provide evidence that this assessment produces a stable measure of play behavior that can then guide therapists when planning intervention strategies for children.

Play, language and social skills of children attending a play-based curriculum school and a traditionally structured classroom curriculum school in low socioeconomic areas

Aim and method: A comparison study of four six-year-old children attending a school with a play-based curriculum and a school with a traditionally structured classroom from low socioeconomic areas was conducted in Victoria, Australia. Children’s play,
language and social skills were measured in February and again in August. At baseline assessment there was a combined sample of 31 children (mean age 5.5 years, SD 0.35 years; 13 females and 18 males). At follow-up there was a combined sample of 26
children (mean age 5.9 years, SD 0.35 years; 10 females, 16 males).
Results: There was no significant difference between the school groups in play, language, social skills, age and sex at baseline assessment. Compared to norms on a standardised assessment, all the children were beginning school with delayed play ability. At follow-up assessment, children at the play-based curriculum school had made significant gains in all areas assessed (p values ranged from 0.000 to 0.05). Children at the school with the traditional structured classroom had made significant positive gains in use of symbols in play (p < 0.05) and semantic language (p < 0.05). At follow-up, there were significant differences between schools in elaborate play (p < 0.000), semantic language (p < 0.000), narrative language (p < 0.01) and social connection (p < 0.01), with children in the play-based curriculum school having significantly higher scores in play, narrative language and language and lower scores in social disconnection.
Implications: Children from low SES areas begin school at risk of failure as skills in play, language and social skills are delayed. The school experience increases children’s skills, with children in the play-based curriculum showing significant improvements in all areas assessed. It is argued that a play-based curriculum meets children’s developmental and learning needs more effectively. More research is needed to replicate these results.

The Contribution of Structured Activity and Deliberate Play to the Development of Expert Perceptual and Decision-Making Skill

The developmental histories of 32 players in the Australian Football League (AFL), independently classified as either expert or less skilled in their perceptual and decision- making skills, were collected through a structured interview process and their year-on-year involvement in structured and deliberate play activities retrospectively determined. Despite being drawn from the same elite level of competition, the expert decision-makers differed from the less skilled in having accrued, during their developing years, more hours of experience in structured activities of all types, in structured activities in invasion-type sports, in invasion-type deliberate play, and in invasion activities from sports other than Australian football. Accumulated hours invested in invasion-type activities differentiated between the groups, suggesting that it is the amount of invasion-type activity that is experienced and not necessarily intent (skill development or fun) or specificity that facilitates the development of perceptual and decision-making expertise in this team sport.