Disertacijoje tirtas vaizdo analizės metodu pagrįstos, trumpalaikės, nukreiptos į motinos ir kūdikio sąveiką, prieraišumo santykius koreguojančios intervencijos (VIPP, Juffer, Bakermans-Kranenburg, & Van IJzendoorn, 2008) poveikis motinų jautrumui kūdikio signalams bei kūdikių prieraišumo saugumui. Tiriamieji buvo (N = 54) nepakankamai jautrios kūdikio signalams, klinikinių sutrikimų neturinčios, viduriniosios klasės motinos ir kūdikiai. Motinos jautrumas kūdikio signalams buvo vertinamas klasikine Ainsworth skale pagal nufilmuotą motinos ir kūdikio laisvą žaidimą, o kūdikių prieraišumo saugumas vertintas Waters‘o „Prieraišumo Q-rūšiavimo metodika“ (stebint kūdikį ir motiną namuose). Ilgalaikį dalyvavimo korekcijos programoje poveikį vaikų elgesio sunkumams vertinome CBCL metodika. Nustatyta, kad dalyvavimas korekcijos programoje reikšmingai padidino motinų jautrumą kūdikių signalams, net kai buvo kontroliuojamas motinos amžius, išsilavinimas, kasdienis stresas, saviveiksmingumas, kūdikių lytis ir temperamentas. Kūdikių prieraišumo saugumas eksperimentinėje grupėje nepadidėjo, kai eksperimentinės grupės tiriamieji baigė dalyvauti programoje, lyginant su kontroline grupe. Aukštesniu ir žemesniu neigiamu emocionalumu pasižymintys kūdikiai gavo tiek pat naudos iš dalyvavimo programoje. Eksperimentinės, kontrolinės grupių ir pakankamai jautrių motinų vaikai patyrė panašiai tiek pat elgesio sunkumų dviejų metų amžiuje. Disertacijoje analizuojami veiksniai, susiję su motinų... [toliau žr. visą tekstą] / The randomized control trial examined the effects of a short-term, interaction focused and attachment-based video-feedback intervention (VIPP, Juffer, Bakermans-Kranenburg, & Van IJzendoorn, 2008) on mothers’ sensitive responsiveness and infant-mother attachment security in a sample (N = 54) of low sensitive, non-clinical, middle class Lithuanian mothers. Maternal sensitivity was assessed in a free play session with the Ainsworth sensitivity scale, and attachment security was observed using the Attachment Q sort for home observations. The long-term intervention effect on children behavior problems was assessed with CBCL. We found that the intervention mothers indeed significantly improved their sensitive responsiveness through participation in the intervention. VIPP enhanced maternal sensitive responsiveness even when maternal age, educational level, daily hassles, efficacy, infant gender, and infant negative and positive affect were controlled for. However, attachment security in the intervention group infants was not enhanced after the intervention, compared to the control infants, and the infants did not seem to differential susceptible to the increase in maternal sensitivity. Experimental, control groups children and sensitive mothers’ children experienced the same level of behavior problems at two years. Factors associated with maternal sensitivity and children behavior problems were analyzed.

Submitted by Aelson Maciera (aelsoncm@terra.com.br) on 2017-08-16T18:00:15Z No. of bitstreams: 1 TeseARLS.pdf: 1226089 bytes, checksum: f9b0f71fd6df402c4cbe47b4b483be8d (MD5) / Approved for entry into archive by Ronildo Prado (producaointelectual.bco@ufscar.br) on 2017-10-31T16:19:03Z (GMT) No. of bitstreams: 1 TeseARLS.pdf: 1226089 bytes, checksum: f9b0f71fd6df402c4cbe47b4b483be8d (MD5) / Approved for entry into archive by Ronildo Prado (producaointelectual.bco@ufscar.br) on 2017-10-31T16:19:13Z (GMT) No. of bitstreams: 1 TeseARLS.pdf: 1226089 bytes, checksum: f9b0f71fd6df402c4cbe47b4b483be8d (MD5) / Made available in DSpace on 2017-10-31T16:23:46Z (GMT). No. of bitstreams: 1 TeseARLS.pdf: 1226089 bytes, checksum: f9b0f71fd6df402c4cbe47b4b483be8d (MD5) Previous issue date: 2017-03-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / This research encompass two studies. The objectives of Study A composed by two steps: Stage 1- In the period of 10 years (2005 – 2014), identify and analyze theses and dissertations produced in Brazilian graduate program with objective of development proposal of Early Intervention Programs for children's development were identified and analyzed to seek main variables studied; and Stage 2: - The proposals of Early Intervention Programs developed that identified in previous stage were characterized and assessed. The Study B described evaluations of Early Intervention Programs after the event of researchers responsible for proposal and execution, as well as continuity of work after conclusion of research. The Study A based on data from the Theses and Dissertations Bank of Brazilian Digital Library (BDTD), whose search descriptors were: early attention, early stimulation, essential stimulation, child stimulation, child development stimulation, early intervention, development surveillance and screening of development. According to two independent judges with pre-defined criteria of inclusion and exclusion, this Study analyzed 25 cases integrally. In step 1, the protocol "Early Intervention Programs Characterization" (PIP) used to systematize information about participants, methodological considerations, intervention characteristics, studied variables, results, limitations and future studies, whose results indicated a predominance of indirect PIPs (13/25) that worked with training and formation of mediators. The presence of children in the PIP varied between forms of individual participation and groups. The mediators of the mixed intervention studies, who participated in PIP, along with children, were mainly parents / guardians. The categories of limitations and / or risks for development: Prevention, Risk and Disability, with a higher incidence of studies in category of Risks. Only one research used an equal control group design and follow-up evaluation was presented in three studies. Ten programs concurred with traditional paradigm and new paradigm, only one study presented characteristics of New Paradigm and the Family-Centered Model. The contexts in which interventions carried out were residences, kindergartens and university. Indirect interventions had a longer duration when compared to direct interventions. The target behaviors / abilities of intervention related to child development and parental and professional training. The results mostly evaluated as positive regardless of intervention type performed. Only three studies indicated non-effective results. 14 studies indicated limitations regarding both research design / procedure and intervention program. Questions raised for future research on methodology, such as longitudinal studies, extension of intervention, extension of sample searched and higher frequency of evaluations. Family demands related to parental / caregiver adherence to intervention programs, parents / child bonding and family / school relationship, and in professional context, knowledge about health surveillance and development surveillance was highlighted. In step 2, the protocol "Evaluation of Early Intervention Programs" (adapted from Mendes, 2010) used to analyze the programs within the community, family, child and intervention program, whose results indicated that community level, 14 studies did not indicate referral procedures, used voluntary or convenience samples. The eligibility criteria for PIPs quite diverse; 18 studies did not mention screening procedures for participation in program; information to families generally provided at beginning of program and it is also possible to inform that IPPs more directed to interests of researchers than to real needs of population. At the family level it can be verified that host interview and presentation the PIP were more frequent than actions that involved planning of support to families. At children's level, studies focused on social life and child autonomy. At PIP level, they showed more frequently performance of a single professional, without specific training; with activity plans that presented some information gaps such as: objectives, materials, teaching and registration procedures; few revisions in intervention proposals observed, with main concern in effectiveness of programs, whose evaluations based on non-standardized instruments. In the Step 1 results indicated that there was indirect predominance of PIPs (13/25) that worked with training, mediator development. The presence of children in PIP varied between individual forms participation and groups. Mediators of mixed intervention Studies, who participated in PIP, along with the children, were mainly the parents / guardians. Limitations and / or risks for development had been categorized: Prevention, Risk and Disability, with a higher incidence of studies in the category of Risks. Just one research used control group design and follow-up assessment presented by three Studies. Ten programs concomitantly met traditional paradigm and new paradigm, just one study presented characteristics of New Paradigm and the Family-Centered Model. The interventions carried out in residences, kindergartens and university. Indirect interventions had a longer duration when compared to direct interventions. The target behaviors / skills of intervention related to child development and parental and professional development. Independent of type of intervention performed, the results mostly evaluated as positive. Only three research indicated non-effective results. 14 studies indicated relative limitations to research design / procedure and intervention program. For future research, questions relating to methodology was highlighted, such as longitudinal studies, extension of intervention, extension of sample surveyed, higher frequency of evaluations. In family context, demands referred to participation of parents / caregivers in intervention programs, parents / child bond and family / school relationship, and in professional scope, knowledge about surveillance of development and health / education integration highlighted. Step 2 results indicated that in 14 studies there were no referral procedures in community analyzes level whose samples were voluntary or convenience; diversified eligibility criteria for PIPs; 18 studies no mention screening procedures for participation in the program; information had been provided in beginning of program for family; it is possible inform that PIPs more directed to researchers interests than real needs of population. In family level, it can verify that foster interview and PIP presentation were more frequent than actions with planning of support to families. In children's level, the studies focused on social life and children's autonomy. In PIP level emphasized more frequently performance of single professional, without specific qualification; activity plans with some gaps information such as: objectives, materials, teaching and registration procedures; few revisions in intervention proposals were observed, with main concern in effectiveness of programs, whose evaluations were based on non-standardized instruments. Study B analyzed posteriori assessment of researchers responsible for proposing and executing the Early Intervention Programs, as well as their continuity after their conclusion. Ten researchers answered a questionnaire with following topics: validity period, institutional support, concomitance between closure of research and program, and assessment of program regarding objectives / focus of intervention, screening procedures and evaluation procedures, family participation, engaged professionals, child development and results obtained vs expected. The results had been indicated that programs lasted up to 12 months; six of them had financial support; closure of the programs occurred concurrently in eight of them; it were positively evaluated by their proponents; it presented questions to be improved regarding theoretical reference, organization and planning of actions to be developed. It can indicate that research involving early intervention presented are important initiatives to deal to early stimulation in children with different risk factors and / or disabilities and producing knowledge in Brazilian context. / Esta pesquisa foi organizada em dois estudos. O Estudo A, composto por duas etapas, teve por objetivos: Etapa 1 - identificar e analisar, no período de 10 anos (2005-2014), as teses e dissertações produzidas em programas de pós-graduação brasileiros que tiveram o objetivo de desenvolver propostas de Programas de Intervenção Precoce para o desenvolvimento infantil buscando captar as principais variáveis estudadas e, Etapa 2 - caracterizar e avaliar as propostas de Programas de Intervenção Precoce desenvolvidas nas pesquisas identificadas na etapa anterior. O Estudo B objetivou descrever as avaliações dos Programas de Intervenção Precoce a posteriori dos pesquisadores responsáveis pela proposição e execução, bem como a continuidade do trabalho após a conclusão da pesquisa. O Estudo A teve como fonte de dados o Banco da Biblioteca Brasileira Digital de Teses e Dissertações (BDTD), cujos descritores de busca foram: atenção precoce, estimulação precoce, estimulação essencial, estimulação infantil, estimulação do desenvolvimento infantil, intervenção precoce, vigilância do desenvolvimento e triagem do desenvolvimento. A seleção dos estudos foi realizada por dois juízes independentes de acordo com critérios de inclusão e exclusão pré-definidos, chegando a um total de 25 estudos analisados na íntegra. Na Etapa 1 foi utilizado o protocolo “Caracterização dos Programas de Intervenção Precoce” (PIP) com o objetivo de sistematizar informações referentes aos participantes, considerações metodológicas, características da intervenção, variáveis estudadas, resultados, limitações e futuros estudos, cujos resultados indicaram um predomínio de PIP indiretos (13/25) que trabalharam com a capacitação e formação de mediadores. A presença das crianças nos PIP variou entre as formas de participação individual e grupos. Os mediadores dos estudos com intervenção mista que participaram dos PIP, juntamente com as crianças, foram principalmente os pais/responsáveis. As limitações e/ou riscos para o desenvolvimento foram categorizadas em: Prevenção, Risco e Deficiências, havendo uma maior incidência de estudos na categoria de Riscos. Apenas uma pesquisa empregou delineamento com grupo controle equivalente e a avaliação de follow-up foi apresentada em três estudos. Dez programas atendiam concomitantemente ao paradigma tradicional e novo paradigma, apenas um estudo apresentou características do Novo Paradigma e do Modelo centrado na família. Os contextos nos quais as intervenções se realizaram foram residências, creches e universidade. As intervenções indiretas apresentaram uma duração maior quando comparadas às diretas. As habilidades/comportamentos alvo da intervenção estavam relacionadas ao desenvolvimento infantil e a capacitação parental e profissional. Os resultados foram majoritariamente avaliados como positivo independentemente do tipo de intervenção realizada. Apenas três estudos indicaram resultados não efetivos. 14 estudos indicaram limitações relativas tanto ao delineamento/procedimento da pesquisa quanto ao programa de intervenção. Foram assinaladas questões para futuras pesquisas relativas à metodologia, como, por exemplo, estudos longitudinais, extensão da intervenção, ampliação da amostra pesquisada e maior frequência das avaliações. As demandas no âmbito familiar se referiram a adesão de pais/cuidadores aos programas de intervenção, vínculo pais/criança e relação família/escola e, no âmbito profissional, destacaram-se o conhecimento sobre vigilância do desenvolvimento e integração saúde/educação. Na Etapa 2 foi empregado o protocolo “Avaliação dos Programas de Intervenção Precoce” para análise dos programas no âmbito da comunidade, família, criança e programa de intervenção, cujos resultados indicaram que, no nível da comunidade, 14 estudos não indicaram procedimentos de encaminhamentos, utilizaram amostras voluntárias ou de conveniência. Os critérios de elegibilidade para os PIP foram bastante diversificados; 18 estudos não fizeram menção aos procedimentos de triagem para a participação no programa; as informações às famílias eram fornecidas em geral no início do programa e, é possível, também, informar que os PIP foram mais voltados aos interesses dos pesquisadores do que às reais necessidades da população. No nível da família pode-se verificar que a entrevista de acolhimento e apresentação do PIP foram mais frequentes do que ações que envolviam planejamento de apoio às famílias. No nível das crianças, os estudos focaram a vida social e autonomia infantil. No nível dos PIP evidenciaram mais frequentemente a atuação de um único profissional, sem formação específica; com planos de atividades que apresentavam algumas lacunas de informações como: objetivos, materiais, procedimentos de ensino e de registro; foram observadas poucas revisões nas propostas de intervenção, com principal preocupação na eficácia dos programas, cujas avaliações foram baseadas em instrumentos não padronizados. Do Estudo B participaram 10 pesquisadores que responderam a um questionário que continha os seguintes tópicos: período de vigência, apoio institucional, concomitância entre o encerramento da pesquisa e do programa, e avaliação do programa quanto a objetivos/foco da intervenção, procedimentos de triagem e de avaliação, participação da família, profissionais envolvidos, desenvolvimento da criança e resultados obtidos x esperados. Os resultados indicaram que: os programas duraram até 12 meses; seis deles tiveram apoio financeiro; o encerramento dos programas aconteceu de forma concomitante em oito deles; foram avaliados positivamente por seus proponentes; apresentaram questões a serem aprimoradas quanto ao referencial teórico, a organização e planejamento das ações a serem desenvolvidas. Pode-se indicar que as pesquisas envolvendo intervenção precoce apresentadas aqui são iniciativas importantes em lidar com a estimulação precoce em crianças com diferentes fatores de risco e/ou deficiências e produzir conhecimentos no contexto brasileiro. / CAPES: 23211504

La première partie de ce travail vise à étudier les effets de la présence vocale maternelle, chant et la parole, sur l'état clinique de l'enfant prématuré, évalué en termes de paramètres physiologiques (fréquence cardiaque, oxygénation du sang et événements critiques) et sur son état comportemental. Dans cette partie on observe donc la mère comme sujet actif et stimulant, par rapport à un bébé prématuré qui, à travers des indices comportementaux et physiologiques, montre bénéficier de la stimulation directe de la voix de la mère. La comparaison des périodes avec et sans stimulation vocale maternelle révèle un plus haut niveau de saturation en oxygène et la fréquence cardiaque et significativement moins d'événements critiques négatives (p <0,0001) lorsque la mère parle et chante. Une connexion renouvelé à la voix de la mère peut être une expérience importante et significative pour les enfants prématurés. L'exposition à la parole et au chant de la mère montre des effets bénéfiques précoces importantes sur l'état physiologique du bébé, tels que les niveaux de saturation en oxygène, le nombre d'événements critiques et la prévalence de l'état d'alerte calme. Ces résultats ont des implications pour les interventions en USIN, encourageant l'interaction maternelle avec leurs nouveau-nés prématurés médicalement stables.La deuxième partie inverse le point de vue, visant à évaluer les effets du comportement de l'enfant sur la mère qui chante et parle: on évalue la capacité de l'enfant à être un partenaire actif dans ces première proto-interactions en vis à vis. On analyse en termes acoustiques les effets du comportement du nouveau-né sur la voix maternelle directe. La voix de la mère présente des caractéristiques spécifiques en termes de minimum de fréquence fondamentale (F0min) pendant les 5 secondes qui précèdent les réactions positives des nouveau-nés. Les mères ont élevé la hauteur de leur voix en présence d'un comportement positif de l'enfant, en particulier dans la communication parlée. En outre, la variance de la F0 (F0sd), augmente en particulier dans la langue maternelle, lorsque l'enfant ouvre les yeux. Ces résultats suggèrent que les comportements positifs des prématurés nés hospitalisés, dans le contexte des interactions, peuvent évoquer, dans les mères des formes précoces de attachement, mesurée par l'augmentation des caractéristiques du parler-bébé. En particulier, le F0min a un rôle crucial pour détecter la réactivité émotionnelle de la mère au cours des interactions vocales. Dans la dernière partie, enfin, on analyse dans le détail quelques épisodes de régulation réciproque dans la dyade mère-enfant: une hypothèse hasardeuse. Il s’agit de trouver, dans une relation dyadique profondément compromise, les traces de syntonisations affectives, des imitations amodales, des épisodes d’ajustement mutuel, de désengagements suite aux stimulations excessives. Nous avons analysé trois situations différentes dans lesquelles les mères et les nouveau-nés prématurés interagissent. Les trois séquences présentent (a) un cas de imitation intermodale, où la mère accompagne par la voix et du visage imitation changement postural du nouveau-né; (b) une séquence interactive dans laquelle on peut identifier un moment d’échange du regard entre les deux partenaires, qui est interrompue et réglementé par le bébé prématuré. La troisième microanalyse (c) vise à montrer les caractéristiques acoustiques d'une interaction vocale entre l’adulte (père et mère) et le nouveau-né prématuré. / This thesis investigated the effects, the responsiveness, the characteristics of maternal voice speaking and singing to preterm infants in NICU.In Study 1 we investigated the effects of live maternal speaking and singing on physiological parameters of preterm infants in the NICU and to test the hypothesis that vocal stimulation can have differential effects on preterm infants at a behavioural level.Methods: Eighteen mothers spoke and sang to their medically stable preterm infants in their incubators over 6 days, between 1 and 2 pm. Heart rate (HR), oxygen saturation (OxSat), number of critical events (hypoxemia, bradycardia and apnoea) and change in behavioural state were measured.Results: Comparisons of periods with and without maternal vocal stimulation revealed significantly greater oxygen saturation level and heart rate and significantly fewer negative critical events (p < 0.0001) when the mother was speaking and singing. Unexpected findings were the comparable effects of maternal talk and singing on infant physiological parameters and the differential ones on infant behavioural state.Conclusion: A renewed connection to the mother’s voice can be an important and significant experience for preterm infants. Exposure to maternal speech and singing shows significant early beneficial effects on physiological state, such as oxygen saturation levels, number of critical events and prevalence of calm alert state. These findings have implications for NICU interventions, encouraging maternal interaction with their medically stable preterm infants. In Study 2 we aimed (1) to examine qualitative change in maternal infant-directed singing and speaking, prior to a positive behaviour display by the preterm infants (i.e. eye opening and lip-corner raising), (2) to analyse the effects of the two behaviours on concomitant acoustic characteristics of maternal infant-directed vocal communication (IDVC), (3) to determine whether changes in maternal voice quality persist after the infant’s positive behavioural display.Methods: Participants included 10 mothers who were asked, on different occasions, to speak and sing to their medically stable infants in incubators, 128 vocalization extracts were examined. Results: The maternal voice shows specific characteristics in terms of fundamental frequency minimum (F0min) during the 5 seconds before the positive reactions of newborns. Mothers raised their pitch in presence of infant’s positive behaviour, especially during the speaking stimulation, reinforcing the higher pitched ID speech. Moreover, the variance of the F0 (F0sd), increases in particular in the maternal speaking, when the infant opens the eyes. Conclusions: These findings suggest that the preterm hospitalized infants’ positive displays, in the context of interactions, can evoke in mothers early forms of attachment, measured by the increase of the characteristics of Infant Directed Speech. In particular the F0min has a crucial role for detecting maternal emotional responsiveness in contingent vocal interactions. In the third part we aimed to analyse, with qualitative methods, the interaction between mothers and preterm infants. We will analyse three different situations in which mothers and preterm infants interact. The three sequences will present (a) a case of intermodal imitation, where the mother accompanies through voice and facial imitation postural change of the newborn; (b) an interactive sequence in which we can identify a moment of eye contact between the two partners, which is interrupted and regulated by the premature baby. The third microanalysis (c) aims to show the acoustical features of a vocal interaction bertween adults (mother and father) and their preterm infants.

xv, 244 p. A print copy of this thesis is available through the UO Libraries. Search the library catalog for the location and call number. / Incorporation of a mental health focus into Early Intervention/Early Childhood Special Education (EI/ECSE) services is considered critical by many professionals due to the vulnerability of young children with disabilities to developing behavior problems, mental health disorders, and to experiencing maltreatment. This qualitative research study investigated ways personnel in EI/ECSE agencies in Oregon are addressing the mental health needs of the children and families they serve. How mental health is conceptualized by EI/ECSE providers, how well prepared providers are in addressing the needs, what kinds of strategies are used to serve children and families, and how adequately EI/ECSE families and children are served by the mental health system were explored. The study was divided into two parts, which included a state-wide study of 14 EI/ECSE agencies in five regions in Oregon, and an in-depth study of one EI/ECSE agency that has employed a mental health consultant. State-wide agencies were mainly located in rural parts of the state, although two education service districts in metropolitan areas were included. The perspectives of 10 mental health providers from community mental health centers were also collected. The most salient issues that surfaced in the state-wide study included the focus of EI/ECSE concern on behavioral and mental health problems in children ages three through five and strategies for related behavior management in classroom settings, the importance of collaboration with community agencies, and a desire for increased partnership with mental health. Interviews with both EI/ECSE and mental health agencies revealed problems in the mental health system including training of therapists in working with very young children, gaps in services for children who were not Medicaid-eligible and in services for parents with their own psychological issues, and in the capacity to serve all of the children who were referred. The in-depth study focused on one EI/ECSE agency that was developing staff competence in relationship-based work with families through support from a mental health consultant employed by the agency. Salient issues included funding for a mental health consultant in an educational agency, development of mental health services for early childhood through community collaboration, and supporting staff through reflective supervision. / Adviser: Jane Squires

[pt] Intervenções na primeira infância pautadas na promoção da parentalidade em famílias de baixa renda possuem o potencial de aumentar o desenvolvimento infantil, diminuindo assim os riscos sociais provenientes do baixo nível socioeconômico. O presente estudo investigou a viabilidade técnica para implementação do programa de intervenção Leitura Desde o Berço em uma Creche Municipal da região Metropolitana do Rio de Janeiro, e a capacidade deste programa em gerar aumento no desenvolvimento cognitivo e da linguagem de crianças entre 24 e 42 meses de idade. Participaram 16 díades cuidador-criança matriculadas no Centro Municipal de Educação Infantil em Seropédica/RJ. Os resultados mostraram que o programa Leitura Desde o Berço possui qualidade de recursos e técnicas, porém, houve baixa adesão da instituição de Educação Infantil e dos cuidadores, assim como o programa não produziu aumento das habilidades cognitivas e de linguagem das crianças. Dessa forma, sugere-se a implementação de políticas públicas em educação e saúde voltadas para o desenvolvimento infantil no currículo educacional dos Municípios, para que programas de intervenção possam ser incluídos em creches e escolas e investigações dos seus efeitos em fases mais avançadas do desenvolvimento infantil possam ser realizadas. / [en] Early childhood interventions based on the promotion of parenting in low-income families have the potential of increasing the childhood development, therefore lowing the social risks from the low socio-economic status. This study investigated the technical viability for implementation of the intervention program Leitura Desde o Berço in a Municipal Nursery in the Metropolitan Region of Rio de Janeiro and the capacity of this program to produce an increase in cognitive and language development in children of 24-42 months of age. Sixteen caregiver-child dyads that were enrolled at the Municipal Center for Early Childhood Education in Seropédica/RJ participated in this study. The results showed that the program Leitura Desde o Berço presents quality of resources and techniques, however, there has been little involvement of the institution and caregivers, such as the program did not increase children s cognitive and language skills. Thus, we suggest the implementation of public policies in education and health aimed at childhood development in the educational curriculum of the municipalities, so that intervention programs can be included in nurseries and schools and investigations on their effects in later stages of child development can be carried out.

A qualitative study was undertaken to develop an understanding of the social welfare services rendered to street children and to ascertain how these social welfare services can be enhanced from the perspective of service providers employed by NGOs in Pretoria. An explorative, descriptive and contextual research design was utilised. The researcher used purposive and non-probability sampling methods to draw the sample. Semi-structured interviews were used to collect information from nine service providers working with street children. Data were analysed according to the framework provided by Tesch (in Creswell, 2009). Data was verified using Guba‘s model (in Krefting, 1991).The study highlights challenges faced by NGOs in providing social welfare services to street children. The study provides a critical analysis of some of the key social welfare service challenges that need to be addressed to ensure effective and sustainable delivery of social welfare services. how these social welfare services can be enhanced from the perspective of service providers employed by NGOs in Pretoria. An explorative, descriptive and contextual research design was utilised. The researcher used purposive and non-probability sampling methods to draw the sample. Semi-structured interviews were used to collect information from nine service providers working with street children. Data were analysed according to the framework provided by Tesch (in Creswell, 2009). Data was verified using Guba‘s model (in Krefting, 1991).The study highlights challenges faced by NGOs in providing social welfare services to street children. The study provides a critical analysis of some of the key social welfare service challenges that need to be addressed to ensure effective and sustainable delivery of social welfare services. the social welfare services rendered to street children and to ascertain how these social welfare services can be enhanced from the perspective of service providers employed by NGOs in Pretoria. An explorative, descriptive and contextual research design was utilised. The researcher used purposive and non-probability sampling methods to draw the sample. Semi-structured interviews were used to collect information from nine service providers working with street children. Data were analysed according to the framework provided by Tesch (in Creswell, 2009). Data was verified using Guba‘s model (in Krefting, 1991).The study highlights challenges faced by NGOs in providing social welfare services to street children. The study provides a critical analysis of some of the key social welfare service challenges that need to be addressed to ensure effective and sustainable delivery of social welfare services. / Social Work / MA (Social Work)

[pt] Segundo a abordagem desenvolvimentista, as falhas inatas na capacidade de conexão afetiva das crianças autistas prejudicam o seu engajamento nas interações sociais, ocasionando dificuldades em todo o seu desenvolvimento. Intervenções precoces com base nesta abordagem focalizam as dificuldades iniciais do transtorno autista, de modo a saná-las ou amenizá-las e assim fazer com que as crianças autistas se desenvolvam o mais tipicamente possível. O presente trabalho teve como objetivo a construção de um programa de intervenção precoce que favorecesse o desenvolvimento dos comportamentos do desenvolvimento infantil típico em crianças recém-diagnosticadas autistas, através do fomento da conexão afetiva destas crianças nas interações sociais. Os participantes foram cinco crianças recém-diagnosticadas autistas, entre os três e quatro anos de idade no início da intervenção, e os seus respectivos cuidadores. O programa consistiu em desenvolver a conexão afetiva, seis tipos de interações sociais com as suas variações e vinte e cinco comportamentos do desenvolvimento infantil típico nas crianças atendidas. Estas interações e comportamentos basearam-se nos trabalhos de Brazelton e Cramer, 1990; Carpenter, Nagell e Tomasello, 1998; García-Perez, Lee e Hobson, 1997; Klinger e Dawson, 1992; Leslie, 1987; Maestro et al, 2001; Osterling e Dawson, 1994; Tomasello, 2003 e Wainwright e Fein,1996. O programa mostrou-se eficaz por conseguir desenvolver a conexão afetiva, interações sociais e comportamentos em todos os participantes, embora o grau desta conexão, que variou em cada criança atendida, influenciou o modo como estas interações e comportamentos apareceram no desenvolvimento de cada uma delas. / [en] According to the developmental approach a deficit in the capacity of affectively engaging with others is basic to autism and its impairments in social engagement and developmental deficits. Developmental-based early interventions have targeted this innate deficit in order to minimize developmental deficits and to promote typical behaviors in children with autism and related disorders. The aim of this study was to design an intervention program to promote typical behaviors in early diagnosed autistic children through the support of affective engagement during social interaction. Participants were five 3-4-year-old children recently diagnosed autistic and their caregivers. The program targeted the development of affective engagement, six varieties of social interaction situation and twenty-five typical behaviors. Social interaction situations and typical behaviors were based upon previous work by Brazelton and Cramer, 1990; Carpenter, Nagell and Tomasello, 1998; García-Perez, Lee and Hobson, 1997; Klinger and Dawson, 1992; Leslie, 1987; Maestro et al, 2001; Osterling and Dawson, 1994; Tomasello, 2003 and Wainwright and Fein, 1996. Results showed that the program succeeded in developing affective engagement, social interaction and typical behaviors in every children. Nonetheless, social interaction and typical behaviors could differ among children depending on their degree of affective engagement.

This diploma thesis deals with the issues of a family of a newborn with a developmental risk. The theoretic part deals with the most common problems endangering the healthy development of a newborn, also with family and the process of coping with the crisis. Further on, it deals with possibilities of family support during their stay in hospital and also after the baby has been discharged into home care, using the support of non-health care groups. The objective of the diploma thesis was to detect possibilities of psycho-social support for the family of a newborn with a developmental risk. The thesis answers questions of, how parents feel in this situation after the birth of their child, during its stay in hospital and subsequently after the discharge into home care, what kind of support services they use to help them manage this period. Further on it deals with questions of whether the information of support options is sufficient and whether this support system works from the parent?s perspective.This diploma thesis was processed on a basis of qualitative survey results. The questioning method of half-format with parents was used and the method of document summary analysis. The investigated samples were parents of ten children treated in The Developmental Care Unit of Neonatology ward in the hospital of České Budějovice a.s. During the hospitalization of the child, it is important, that the medical team communicates openly, gives well timed and clear information and allows direct involvement in the child care. The outcome of this investigation points out the important role of the partner, family and friends as the main source of support. Also sharing feelings and needs with other parents is rand as a considerable source of support. However, the mothers especially, miss this sharing opportunity after their baby has been discharged into home care. Another interesting outcome is the absence of a psychologist, who specializes in newborn matters as an important source of support for parents. The survey shows, how important the psychosocial support is for parents, not just during hospitalization, but also after the discharge of their baby. Whereas they feel that the healthcare service is adequate, they especially miss the psychosocial support after the discharge from hospital. This is especially true of families of babies with developmental risk, without any serious health problem. Listed subjects could be used by professionals dealing with care of newborn with developmental risk, who provide complex care for families of the children with perinatal condition. Therefore, specialized psychological help should be an evident part of the care provided. The hypothesis were determined on the basis of qualitative survey results, which could be verified by further investigation:Hypothesis 1: For mothers of a newborn with developmental risk it is important to get help in the framework of supporting parental groups.Hypothesis 2: After the discharge of their child into home care, parents would appreciate psychosocial support in the framework of outpatient service.

Submitted by Izabel Franco (izabel-franco@ufscar.br) on 2016-09-19T12:17:15Z No. of bitstreams: 1 DissAB.pdf: 1469709 bytes, checksum: 4e3a475885c84908531d17d4a30fec4e (MD5) / Approved for entry into archive by Marina Freitas (marinapf@ufscar.br) on 2016-09-20T13:49:19Z (GMT) No. of bitstreams: 1 DissAB.pdf: 1469709 bytes, checksum: 4e3a475885c84908531d17d4a30fec4e (MD5) / Approved for entry into archive by Marina Freitas (marinapf@ufscar.br) on 2016-09-20T13:49:27Z (GMT) No. of bitstreams: 1 DissAB.pdf: 1469709 bytes, checksum: 4e3a475885c84908531d17d4a30fec4e (MD5) / Made available in DSpace on 2016-09-20T13:49:34Z (GMT). No. of bitstreams: 1 DissAB.pdf: 1469709 bytes, checksum: 4e3a475885c84908531d17d4a30fec4e (MD5) Previous issue date: 2014-06-27 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / In Brazilian context, the official guideline recommends that Early Stimulation have the purpose of providing the development of children with special needs. In the use of the institutions, this practice involves different types of professionals and of guided acquirements to children with risk to their development. The diversity of practices makes it relevant to describe the performance of the professionals that work in Early Stimulation programs as a way of enabling the improvement of the work carried out, aiming the harmonization of concepts, guidelines and practices. In this research, the purpose was to describe the performance of 13 professionals experienced in working at early stimulation programs, in three institutions, and to analyze the relationships established by these professionals between their professional practice and the knowledge acquired during graduation course. For this purpose, an exploratory study was carried out, whose data collection consisted of semistructured interviews with the abovementioned professionals and the collection of the institutions’ data through consults to the coordination and to the available documents. Regarding the results, the interviewed professionals conceived early stimulation as the provision of opportunities to the child’s development; and/or support to the Family or the prevention of risk for the development. The professionals considered it important for a good service in the early stimulation program the professional involvement and/or specific working conditions and/or partnership with the family. Regarding the difficulties faced in carrying out the work, the reports were focused on the lack of familiar participation/involvement, the inadequacy of work conditions and the work with the child itself. Regarding the preparation/training that the Higher Education Institution (HEI) offered for the work in early stimulation program, eight interviewed professionals informed that the graduation course offered the training on the Early Stimulation; however, half of them related that this training was inadequate/superficial. From the thirteen professionals, five declared that the HEI did not offer preparation/training to work with early stimulation. From all the professionals, tem considered that the HEI could have offered better training, even those that offered some; from those tem, five declared that there should be better articulation between theory and practice. / No contexto brasileiro, a diretriz oficial preconiza que a Estimulação Precoce tem por finalidade propiciar o desenvolvimento de crianças com necessidades especiais. Na prática das instituições, esse serviço requer diferentes tipos de profissionais e de saberes orientados também para as crianças com risco para o desenvolvimento. A diversidade de serviços torna relevante caracterizar a atuação dos profissionais nos programas de Estimulação Precoce, como forma de possibilitar a compreensão do trabalho realizado, visando a compatibilização dos conceitos, diretrizes e práticas. Nesta pesquisa, visou-se caracterizar a atuação de 13 profissionais, com experiência de trabalho em programas de Estimulação Precoce, em três instituições, e analisar as relações que os profissionais estabeleciam entre a sua atuação profissional e a formação recebida durante a graduação. Para tanto, foi realizado um estudo exploratório cuja coleta de dados consistiu na realização de entrevistas semiestruturadas com os referidos profissionais e coleta de dados das instituições por meio de consulta à coordenação e aos documentos disponíveis. Com relação aos resultados, os entrevistados concebiam a Estimulação Precoce como oferecimento de oportunidades para o desenvolvimento da criança; e/ou suporte à família ou prevenção de risco para o desenvolvimento. Os profissionais consideravam importante para um bom atendimento, no programa de Estimulação Precoce, o envolvimento profissional e/ou condições específicas de trabalho e/ou parceria com a família. Quanto às dificuldades enfrentadas, os relatos referiramse à falta de participação/envolvimento familiar; à insuficiência das condições de trabalho e às atividades específicas com a criança. Sobre o preparo/formação que a Instituição de Ensino Superior (IES) ofereceu para a atuação na Estimulação Precoce, oito entrevistados informaram que o curso de graduação forneceu formação a respeito da Estimulação Precoce, porém a metade desses profissionais relatou que essa formação foi insuficiente/superficial e cinco afirmaram que a IES não preparou/formou para atuar na Estimulação Precoce. Do total de profissionais, dez consideraram que a IES poderia ter proporcionado melhor formação, mesmo aquelas que ofereceram alguma formação; destes dez, cinco afirmaram que deveria ter maior articulação entre teoria e prática.

Submitted by Regina Correa (rehecorrea@gmail.com) on 2016-09-26T14:03:00Z No. of bitstreams: 1 DissMGM.pdf: 2144965 bytes, checksum: 356a93562613810a808bc41438e7a3ef (MD5) / Approved for entry into archive by Marina Freitas (marinapf@ufscar.br) on 2016-09-27T19:25:28Z (GMT) No. of bitstreams: 1 DissMGM.pdf: 2144965 bytes, checksum: 356a93562613810a808bc41438e7a3ef (MD5) / Approved for entry into archive by Marina Freitas (marinapf@ufscar.br) on 2016-09-27T19:25:35Z (GMT) No. of bitstreams: 1 DissMGM.pdf: 2144965 bytes, checksum: 356a93562613810a808bc41438e7a3ef (MD5) / Made available in DSpace on 2016-09-27T19:25:43Z (GMT). No. of bitstreams: 1 DissMGM.pdf: 2144965 bytes, checksum: 356a93562613810a808bc41438e7a3ef (MD5) Previous issue date: 2016-02-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Motor development is a process of changes in motor behavior over time, due to an interaction of systems within the organism, the environment and tasks. The presence of risk factors, such as prematurity, may influence motor development, including the control of head movements. In this context, some strategies may prevent delay in the acquisition of head control, which is required for more complex abilities. Postural manipulation may be a strategy to improve head control in preterm infants, as it is known that postural manipulation may facilitate more mature head movements in full-term infants between birth and four months of age. Objective: To assess the influence of postural manipulation on head movements in full-term and late preterm infants at 5-6 months of corrected age. Method: Thirty eight infants (22 full-term infants and 16 late preterm infants, born at 34-36 weeks gestation) were assessed in a infant chair once in three experimental conditions: a) unsupported supine, b) supported supine (small pillow as an external support), and c) supported reclined at an angle of 20 degrees (small pillow). To elicit head movements, a black and white smiley face card was manually moved from side to side in the infant’s visual field for two minutes in each posture. A two-way repeated measures ANOVA was conducted to compare the groups and conditions (p <0.05). Results: We found that body orientation or external support influenced the control of head movement however in a different way than expected, possibly because at these ages infants have acquired strength and control enough for the task even in the most demanding postures at neuromotor and biomechanical level. No difference was observed between the experimental conditions for most variables, however, the use of support promoted more controlled movements. There was a difference for the desaceleration index (F [1.44]= 4.741; p=0.01), which the preterm infants presented higher values than full-term infants in supported supine position (p=0,012). Moreover, for the preterm infants, they presented higher values in the supported supine compared to the unsupported supine, and supported reclined (p = 0.007 and p = 0.003 , respectively). Conclusion:. We suggest the external support of the head promoted more controlled head movements in preterm infants. These findings suggested posture manipulation may be an early intervention strategy for infants at risk for developmental delay. / O desenvolvimento motor é um processo de mudanças no comportamento motor ao longo do tempo, que resulta da interação do indivíduo com o ambiente e a tarefa. Assim, a presença de fatores de risco, como a prematuridade, influencia o controle do movimento de cabeça. Neste contexto, estratégias podem prevenir o atraso na aquisição do controle deste segmento, a qual é pré-requisito para habilidades mais complexas. A mudança na orientação corporal pode ser uma estratégia, pois foi favorável em lactentes de termo do nascimento ao quarto mês por propiciar movimentos de cabeça com padrão mais maduro. Objetivo: Verificar a influência da orientação corporal nos movimentos de cabeça em lactentes a termo e pré-termo tardios aos 5-6 meses de idade. Método: Foi realizada avaliação cinemática do movimento de cabeça com 38 lactentes (22 a termo e 16 pré-termo tardios, nascidos entre 34 e 36 semanas e 6 dias de idade gestacional) nas orientações: supino, supino com suporte de cabeça e reclinado com suporte. Um cartão de estimulação visual foi movido manualmente no plano frontal por 2 minutos em cada postura, a fim de eliciar o movimento de cabeça. Estatística: Os dados foram analisados por meio da análise de variância (ANOVA) para medidas repetidas, com nível de significância de p≤0.05. Resultados: O presente estudo verificou que, nas condições de nascimento a termo e prétermo tardio, a orientação corporal ou o suporte externo exerceram influências no controle do movimento da cabeça de forma divergente da esperada, possivelmente porque nessas idades os lactentes já adquiriram força e controle o suficiente para a execução da tarefa mesmo em posturas mais exigentes a nível neuromotor e biomecânico. Não foi observada diferença entre as condições experimentais para a maior parte das variáveis, entretanto, o uso do suporte favoreceu a execução de movimentos mais controlados e com padrão mais maduro, sendo que houve diferença para o índice de desaceleração (F [1,44]= 4,741; p=0,01), no qual os pré-termo apresentaram maior valor que os a termo na postura supino com suporte (p=0,012). Além disso, para os pré-termo, foi observado maiores valores na postura supino com suporte que na sem suporte e reclinado com suporte (p = 0,007 e p = 0,003, respectivamente). Conclusão: Sugere-se que o uso do suporte de cabeça promoveu movimentos de cabeça mais controlados, evidenciando seu possível uso enquanto estratégia de intervenção precoce para lactentes com fatores de risco ou com alteração no desenvolvimento neurosensoriomotor.