Como as dificuldades comportamentais e emocionais infantis, se não superadas neste período, podem estender-se ao longo do desenvolvimento, é de fundamental importância o investimento em estudos focados na avaliação e compreensão dos problemas de comportamento desta população, para, então, realizar um planejamento de intervenção adequado às suas necessidades. O presente trabalho tem como ponto de partida o reconhecimento da importância de múltiplas fontes de informações no processo de avaliação da criança, incluindo ela própria e o psicólogo clínico, para que haja o melhor atendimento psicológico. O objetivo desta pesquisa foi identificar a presença de problemas de comportamento em crianças a partir da avaliação de seus pais e do clínico, compreender os fatores de risco que possam estar associados a presença de tais dificuldades e analisar os níveis de concordância e discordância entre as avaliações realizadas pelas múltiplas fontes. Para tanto, foram realizadas entrevistas clínicas semiestruturadas (SCICA) com 25 crianças, de ambos os sexos e com idade entre sete e 11 anos, encaminhadas para atendimento em serviços de saúde mental, a fim de compará-las com as respostas dos pais/cuidador a um inventário de comportamentos infantis, o CBCL. Também foram coletadas informações sobre a presença de fatores de risco na família (Índice de Adversidade Familiar) e sobre os problemas de comportamento dos cuidadores que realizaram a avaliação (ASR). A SCICA mostrou-se um protocolo de entrevista válido para obtenção de observação comportamental e do relato da criança sobre seu funcionamento. A partir da análise dos resultados identificou-se que tanto os problemas observados pelos clínicos, quanto os reportados pela própria criança, apresentavam-se em taxas inferiores às relatadas pelos cuidadores. As dificuldades com agressividade e com ansiedade/depressão dos pais se mostraram um fator explicativo para as discrepâncias identificadas. As análises com os fatores de risco revelaram uma correlação positiva entre os escores no IAF e a presença de dificuldades internalizantes e total de problemas relatados pelas crianças. Considerando os fatores de risco isoladamente, observou-se que o fator presença de discórdia conjugal guardava relação com as dificuldades externalizantes e totais, enquanto o fator presença de psicopatologia na família estava relacionado às dificuldades internalizantes. Os dados sobre adversidade ambiental sugerem a importância de acompanhar os pais paralelamente ao trabalho da criança, dado que as condições de saúde mental na família e a presença de conflito marital apresentam uma relação intrínseca com as dificuldades infantis. A partir das análises de discordâncias observamos que a inclusão de forma sistematizada das diversas fontes mostrou-se relevante, pois, articuladamente ao relato dos pais, foi possível ir além da queixa declarada inicialmente e identificar outras áreas deficitárias do funcionamento das crianças avaliadas / The children\'s behavioral and emotional difficulties, if not overcome during childhood, may extend through the adult development, so it is extremely important to invest in studies focused on the evaluation and understanding of their behavioral problems to perform an intervention plan on these needs. One of the main concepts of this study is to recognize the importance of having multiple sources of information in the childs evaluation process (for instance, him/herself and the clinical psychologist) to have the best psychological care. The objective of this research was to identify the presence of behavioral problems in children based on their parents and clinical assessment, to analyze the risk factors that may be associated with these difficulties and to examine the levels of agreement and disagreement between the evaluations performed by multiple sources. To achieve that, we have compared the children\'s scores on a parentreport questionnaire, the CBCL, with semi-structured clinical interviews that were performed with 25 children referred for psychological care, of both genders and age range from 7 to 11 years old. We have also collected information about the presence of risk factors in the family (Rutter\'s Family Adversity Index) and about the presence of parents behavioral problems according to ASR. The SCICA proved to be a valid interview protocol to obtain behavioral observation and child\'s report about their functioning. From the analysis, we found that the problems noted by clinicians and reported by the child, were presented at rates lower than those reported by caregivers. An explanatory factor for the discrepancies found was parents´ aggression and anxiety/ depression problems. According to the analysis, Rutter\'s Family Adversity Index scores had a positive correlation with the presence of internalizing problems and total problems reported by children. Regarding the types of risk factors, it has been observed that the \"marital discordance\" factor was linked to the externalizing and total problems, while \"presence of psychopathology in the family\" factor was related to internalizing problems. Data on environmental adversity suggests the importance of instructing parents while the child´s treatment is being conducted, given that family mental health problems and the presence of marital conflict have a close relationship with the children\'s difficulties. From the identified discrepancies we can conclude that a systematic inclusion of the various sources is relevant, since the parental-report integrated with clinical psychologist perception and child\'s report allowed to go beyond the main complaint initially declared and identify other deficient areas of children functioning

Este estudo teve como objetivo avaliar o perfil comportamental e a competência social de crianças e adolescentes, filhos de mulheres com esquizofrenia, e compará-los com crianças da mesma faixa etária e sexo, filhos de mulheres sem transtorno mental grave. Para a avaliação das crianças e adolescentes foram utilizados o Inventário de Comportamentos para Infância e Adolescência (Child Behavior Checklist- CBCL) e o Inventário de Comportamentos Auto-Referidos para Adolescentes (Youth Self Report- YSR). Os filhos de mulheres com esquizofrenia apresentaram maior proporção de problemas de internalização e de problemas com o pensamento, principalmente para as crianças que moravam com a mãe com esquizofrenia, quando comparados a crianças e adolescentes do grupo comparativo com mães sem transtornos mentais / The objective of this study was to evaluate the behavior profile and social competence of children and adolescents of schizophrenic mothers, and compare it with children of the same age and gender of mothers without any severe mental disorder. To evaluate children and adolescents the Child Behavior Checklist (CBCL) and Youth Self Report (YSR) were used. The children of schizophrenic mothers had a higher proportion of internalizing problems and of thought problems, mostly for children living with their schizophrenic mothers, when compared to children and adolescents of mothers without any psychiatric disorder

A enurese é uma condição caracterizada pela perda de urina durante o sono, em crianças com mais de cinco anos sem outra condição clínica que explique os episódios. A enurese pode ser primária, no caso das crianças que nunca obtiveram controle prévio, ou secundária, em que a enurese cessou por pelo menos seis meses. Também é classificada como monossintomática, na ausência de sintomas diurnos do trato urinário inferior ou não-monossintomática, quando está associada a tais sintomas, como a urgência miccional. A enurese, cujas causas apresentam componentes hereditários ainda pouco claros, tem sua etiologia baseada na combinação de três fatores: a poliúria noturna ou a hiperatividade detrusora ligada á incapacidade de despertar em resposta aos sinais da bexiga cheia. Há tratamentos medicamentosos e psicológicos, sendo que a desmopressina, análogo sintético da vasopressina, que atua na poliúria noturna e o alarme, que atua na incapacidade de despertar, apresentam os níveis mais altos de recomendação e evidência. Embora tais tratamentos estejam consolidados, ainda não há total clareza sobre seus mecanismos de funcionamento e o porquê de não alcançarem todos os casos. Este trabalho teve como objetivo verificar se um conjunto de variáveis atuaria como moderador do resultado do tratamento com alarme, ou seja, em que medida influenciava, positiva ou negativamente, o desempenho dos participantes atendidos. As variáveis avaliadas foram: tipo de acompanhamento (presencial e à distância), frequência inicial de episódios, nível de problemas de comportamento, escolaridade dos pais, sexo e idade. Foram incluídos na amostra 61 crianças e adolescentes de 6 a 17 anos que receberam tratamento com alarme, sendo que 34 foram acompanhados à distância e 27 presencialmente. No total, 37 participantes obtiveram sucesso, caracterizado por 14 noites consecutivas sem episódios, num período de 28 semanas. Doze participantes não obtiveram sucesso e outros 12 desistiram. Caracterizaram-se como moderadoras do resultado do tratamento as seguintes variáveis: tipo de acompanhamento (grupo acompanhado à distância obteve mais sucessos), frequência inicial de episódios (participantes que obtiveram sucesso tinham menos episódios, em média, no início do tratamento) e nível de problemas de comportamento (participantes que não obtiveram sucesso tinham escores maiores de problemas de comportamento externalizantes). Os resultados indicam a efetividade do alarme e apontam para os aspectos que devem receber atenção do clínico ao administrar esse tipo de tratamento / Enuresis is a condition in which children of at least five years of age lose urine during sleep, without another clinical condition that could explain the wetting episodes. Enuresis may be primary, when the child has not obtained previous bladder control, or secondary, when such control was achieved for at least six months. It is also classified as monosymptomatic, when it is not associated with other lower urinary tract symptoms or non monosymptomatic, when these symptoms, such as urgency, are present. Enuresis etiology has unclear hereditary aspects. Its physiology is based on a combination of at least two of three malfunctioning systems: incapacity to wake in response to the full bladder signals plus nocturnal polyuria or detrusor hyperactivity. There are evidence based pharmacological and psychological treatments. Desmopressin, a synthetic version of hormone vasopressin that reduces nocturnal polyuria is the first line pharmacological treatment, whereas the alarm, which acts in the incapacity to wake is the first line psychological treatment. Both have the higher levels of evidence and recommendation by the specialized literature. However, the mechanisms underlying these treatments results and the reasons they are not successful with every enuretic children are not entirely clear. The objective of this work was to verify to what stand a series of variables are moderators of alarm treatment outcome. These variables were: type of support (face-to-face versus long distance), initial bedwetting frequency, behavior problems scores, level of parents education, gender and age. Sixty-one children with ages from 6 to 17 were included. All received full spectrum home training. Thirty-four received long distance support during treatment and 27 received face-to-face support. Success was defined by 14 consecutive dry nights within a 28 weeks treatment period. Success was obtained by 37 children, while 12 did not succeed and other 12 dropped out. Three variables were observed as moderators of treatment outcome: type of support (long distance had better results), initial bedwetting frequency (participants who succeeded had fewer initial wet nights) and behavior problem scores (participants who did not succeed had higher externalizing problems scores). Results indicate alarm effectiveness and aspects that should be focuses of attention when this kind of treatment is administered

Não há consenso entre os estudos quanto à associação entre a presença de problemas de comportamento e resultados piores no tratamento com alarme para enurese. O objetivo do presente estudo foi investigar a ocorrência de associações entre a presença de problemas de comportamento e os resultados do tratamento com alarme para enurese primária com acompanhamento semanal de um terapeuta. Os participantes foram 20 crianças com enurese primária, 13 do sexo masculino e 7, do sexo feminino, com idades entre seis e dez anos. Metade das crianças apresentava escores clínicos indicativos de problemas de comportamento segundo o Child Behavior Checklist. As oito crianças sem problemas de comportamento que concluíram o tratamento alcançaram o critério de sucesso inicial (14 noites secas consecutivas) e apenas duas desistiram. Das dez crianças com problemas de comportamento, somente metade atingiu o sucesso inicial, quatro desistiram e uma completou o período de tratamento e não obteve sucesso. Essas diferenças nos resultados finais não foram significativas em termos estatísticos. Também não foram encontradas diferenças significativas nas taxas de recaídas entre as crianças com e sem problemas de comportamento. Quatro das oito crianças sem problemas de comportamento que haviam alcançado o critério de sucesso inicial apresentaram recaídas e quatro conseguiram manter o controle noturno adquirido. Das cinco crianças com problemas de comportamento que alcançaram o sucesso inicial, três, apresentaram recaídas e duas, enquadraram-se no critério de sucesso continuado. A única diferença estatística encontrada entre os dois grupos de crianças foi no tempo de tratamento necessário para alcance do critério de sucesso inicial. Em 12 semanas de tratamento, a probabilidade de atingir o sucesso inicial foi de 86,11% para as crianças sem problemas de comportamento e de 10% para as crianças com problemas de comportamento; em 20 semanas, a probabilidade foi de 100% para as crianças sem problemas de comportamento e de 40% para as crianças com problemas de comportamento. Pode-se dizer, portanto, que, na amostra de crianças atendidas, os problemas de comportamento parecem ter ocasionado dificuldades para que progressos fossem alcançados no tratamento da enurese com alarme. Na maioria dos casos, entretanto, essas dificuldades não foram suficientes para que as crianças com problemas de comportamento apresentassem ao final do tratamento resultados significativamente diferentes das crianças sem problemas de comportamento. Esses resultados sugerem que as crianças com problemas de comportamento podem beneficiar-se do tratamento com alarme para enurese tanto quanto as crianças sem problemas de comportamento. Considerando o tempo necessário para o alcance do sucesso inicial, os resultados indicam que, provavelmente, as crianças com problemas de comportamento precisam mais de acompanhamento intensivo durante o tratamento com alarme para enurese do que as crianças sem problemas de comportamento. / There is no consensus among the studies regarding the association between behavior problems and worse outcomes in alarm treatment for enuresis. The aim of this study was to investigate the relationship between behavior problems and outcome in alarm treatment for primary enuresis with weekly sessions with a therapist. The participants were 20 children with primary enuresis, 13 boys and 7 girls, between the ages of six and ten. Half of these children presented clinical scores on the Child Behavior Checklist. Eight out of the 10 children without behavior problems who finished the treatment have achieved the criteria for initial success (14 consecutive dry nights) and two of them dropped out. Only half of the children with behavior problems attained initial success, four of them dropped out and one finished without success. These differences on the outcome were not statistically significant. There were also not found significant statistical differences in the occurrence of relapses rates between children with and without behavior problems. Four of the eight children without behavior problems who attained initial success have relapsed, and four have maintained the acquired nocturnal control. Three of the five children with behavior problems who achieved the initial success have relapsed and two of them satisfied the criteria for continued success. The only statistical difference found between the children groups was the time required to achieve initial success. In 12 weeks of treatment, the probability of attaining initial success was 86.11% for children without behavior problems and 10% for children with behavior problems; in 20 weeks, the probability was 100% for children without behavior problems, and 40% for the children with behavior problems. Therefore, it is possible to say that in that sample of children the behavior problems seemed to provide difficulties in achieving progresses in the alarm treatment for enuresis. On most of the cases, those difficulties were not enough to make the outcomes at the end of the treatment of children with behavior problems being statistically different from the children without behavior problems. These results suggest that children with behavior problems may benefit from alarm treatment as well as children without behavior problems. Considering the time required for achieving success, the results indicate that they probably need more intensive support during enuresis treatment with alarm than children without other problems.

Disruptive behaviour disorders (DBDs) in children are among the most common referrals to mental health services and can lead to adverse psychosocial outcomes. There is consistent evidence that dysfunctional parenting, which has been associated with parental psychopathology, is a risk factor for the onset of these disorders. Yet, few studies have explored a wide range of parental pathology and parenting behaviours as well as perceptions of mental health and parenting of the parents of children with DBDs. This study, which took the form of a multiple case study, aimed to explore and describe the mental health and parenting of parents of pre-adolescent and adolescent children with DBDs. It also aimed to explore and describe parental perceptions of their own mental health and parenting and how (or if) they perceive their mental health as influencing their parenting. Purposive sampling was used to select participants and the sample size was determined through data saturation. Data was collected via the Millon Clinical Multiaxial Inventory and a semi-structured interview. Thematic content analysis and cross-case synthesis were used to analyse the data. The participants’ personality profiles indicated the presence of moderate to severe pathology including personality disorders and clinical disorders. Parenting themes that emerged included a number of dysfunctional parenting behaviours. The parents showed an awareness of their mental health and perceived it as influencing their parenting. This study emphasised the importance of exploring mental health and parenting interventions for parents of children with DBDs. The biggest limitations of this study was the small sample size.

Foundation phase teachers of an urban, primary school at which the researcher is presently teaching, often complain about the behaviour of learners. Learners are sent out of the classrooms almost everyday, which contravenes education policy. Some of the problems foundation phase teachers complain about are disobedience, fighting, aggression as well as stealing and un-cooperative behaviour. These teachers often send learners with behavioural difficulties out of classes, and then call in parents but this intervention does not result in any changes. Teachers seem not to understand the nature of behaviours and strategies of behaviour management. They resort to losing control, using corporal punishment and think of resigning. Successful management of behavioural difficulties in foundation phase classes is crucial for learner development. Learners are still young and it is their first year at school. They come from different homes and neighbourhoods. Their background often influences their behaviour. Some of foundation phase learners practice the unacceptable behaviour practiced at home or by neighbours not knowing that the behaviour is not acceptable at school. Foundation phase teachers therefore do not always understand learners with behavioural difficulties because of lack of understanding of the nature of the causes of behavioural difficulties as well as the lack of strategies in managing learners with behavioural difficulties. Against this background the purpose of this study is therefore to investigate, explore and describe the support needs of foundation phase teachers in managing behavioural difficulties. In this study the research was conducted in a qualitative research paradigm. The data collection methods were individual interviews and field notes from individual interviews, which were taken as supportive data. A literature survey on the nature and causes of behavioural difficulties as well as the support needs of teachers is discussed in section two. Data was analysed through the qualitative content analysis method. Four categories emerged which are types of behavioural difficulties, causes of behavioural difficulties as well teachers’ present behavioural management strategies and the support needs of foundation phase teachers. Summary of the findings, recommendations for the study as well as critical discussion of the findings is also stated. Recommendations for further research are then suggested. / Mrs. J.V. Fourie

In Chapter One, a systematic literature review was conducted to analyze intervention studies that measured student- teacher relationships (STR). STR are important for all students (Burchinal, Peisner-Feinberg, Pianta, & Howes, 2002; Hughes, Luo, Kwok, & Loyd, 2008; Pianta & Stuhlman, 2004). Students who have positive relationships that include high levels of closeness with their teachers have better academic, behavioral, and social emotional outcomes (Mihalas, Morse, Allsopp, & McHatton, 2009; Roorda, Koomen, Spilt & Oort, 2011). In addition, students who have relationships with their teacher that are high in conflict are more likely to demonstrate negative behavior, social skills and academic achievement (Murray & Greenberg, 2001; Pianta & Stuhlman, 2004). Fourteen intervention studies were synthesized in this systematic literature review to identify strategies that can be used in the classroom to improve STR. Ten strategies were represented in two or more studies that had a positive impact on STR: (a) specific praise and positive feedback, (b) direct student intervention, (c) de-escalation by ignoring or redirecting, (d) increased one-to-one time, (e) helping students change their representational models, (f) adjusting the teachers representational models, (g) tangible reinforcement, (I) parent involvement, and (j) morning meetings. One intervention in Chapter One that improved STR was dialogue journaling (DJ). DJ is an ongoing, personal, and interactive written conversation between the teacher and student. Previous research suggests that DJ has the potential to help students and teachers improve their relationships as they develop a personal connection that is mutually respectful. DJ also has the potential to reduce students’ disruptive behavior, improve their interactions with the teacher, and enhance their writing skills. In Chapter Two, a multiple baseline across participants single-case design study was conducted to examine the relationship between DJ and disruptive behavior, teacher praise, writing length, writing quality, and STR with four middle school students with emotional and behavior disorders in a therapeutic school. Students responded to journal prompts or wrote to a topic of their choosing during baseline and maintenance. During intervention, students and teachers corresponded in writing through the dialogue journals. A functional relation was found between DJ and disruptive behavior, but not between DJ and teacher praise, STR or writing skills. However, there was an effect demonstrated between DJ and writing length for two students. In addition, three of the four students reported an increased perception of teacher-student relationships. Students and teachers expressed satisfaction with the intervention. Limitations and future directions are discussed.

No description available.

M.Ed. / This study investigates parents' conception of their children who have been diagnosed with Attention-Deficit/Hyperactivity Disorder (AD/HD). The view being to describe and explain their conception and to lay down principles for the implementation of parental guidance. The rationale for this study is derived from the researcher's experiences that parents' emotions, experiences and points of view are seldom taken into account in the multidisciplinary intervention process regarding children with AD/HD. Parents are the primary educators of their children, therefore it is important to involve the parents in the intervention process. For the involvement to be of optimal value, therapists need to have an understanding of the conceptions of these parents regarding children with AD/HD. Therapists who know where the parents are, and what their emotions and experiences are, find themselves in a better position to provide relevant parental guidance in an empathetic manner. This study presents a framework of theory in which AD/HD is clearly explicated. The experiences and needs of parents of children with AD/HD and the role of parental guidance is discussed. The focus then shifts to therapy and parental guidance from a constructivistic perspective. In the constructivistic view the therapist is the facilitator of change and this has implications for the goal of therapy and the therapeutic relationship. Parental guidance from a constructivistic perspective is recommended as an alternative way of involving parents (with their emotions, experiences and conceptions) in the process of helping children with AD/HD. The framework of theory is followed by a chapter on the design of the research, substantiating the choice of format and methods of data collection and analysis. The data is reported in the final chapter. Examples of raw data from transcriptions and sketches are presented. Finally, the consolidated data is interpreted. The most significant findings of this study are that parents of children with AD/HD experience their educational task as problematic, that these parents don't receive any form of (structured) parental guidance and/or support and that they experience a great need for the latter. iv This study proposes that a parental guidance program should be implemented in order to meet the needs of the parents of children with AD/HD and to provide them with the necessary support. Five implications for the implementation of such a program are discussed. The study concludes with the thought that children with AD/HD who live in a happy and supportive family unit, have a far better chance to reach their full potential and to be successful in life than those who don't. It is therefore important to assist parents in the provision of such an environment.

Developing effective literacy skill has become an increasingly critical skill in today's information age. Students with emotional/behavioral disorders (E/BD) routinely lack these skills and are not being taught how to read effectively. The field of special education needs more comprehensive and specific information about how to most effectively teach reading skills to students with E/BD. When reading interventions are conducted using student with E/BD, the interventions are generally drawn from the LD field. The assumption is that the reading interventions that have worked with students with LD will work equally well with the E/BD population. This study performed a meta-analysis to examine whether reading interventions are equally effective on the E/BD and LD populations. In addition, it will examine whether the instruction mode (e. g., peer, self, or teacher directed), gender, or grade group affects the success of the intervention. The meta-analysis found that the reading interventions for both disability groups had high effect sizes. In addition, neither disability group, teaching method, gender, nor grades were predictive of the variance in the effect size. These results indicate that reading programs that have been designed for students with LD are also effective for students with E/BD and furthermore, reading programs can improve the academic achievement of students with behavioral disorders. Recommendations for teacher training and future research are given based on these results.