Made available in DSpace on 2016-06-02T19:44:09Z (GMT). No. of bitstreams: 1 3780.pdf: 1214270 bytes, checksum: 4336ee658818b83885395fa0b6be4b67 (MD5) Previous issue date: 2011-03-28 / Universidade Federal de Minas Gerais / Evaluation studies about social skills of children have shown that in general there is an impairment of social skills in learning disabilities, sensory disabilities and other conditions of special educational needs. However, there is a gap in the literature as to a broader comparison of social skills of a greater diversity of populations of children, including sensory disabilities, mental retardation, children with attention deficit hyperactivity disorder, autism, behavior problems, learning disabilities, among others. The paucity of comparative studies to evaluate children with different special needs has hindered the production of empirical knowledge about specific issues to each population. Moreover, the lack of comparative evaluation studies has been an obstacle to the identification of needs that might guide the goals of educational and therapeutic interventions in social skills among children with different developmental characteristics. This study aimed to fill part of this gap and its goals was: (a) to compare, based on teacher evaluation, the repertoire of social skills of children from 12 different groups of special educational needs among themselves and with the normative sample of the Social Skills Rating System- SSRS-BR (Autism, Hearing Impairment, Mild Mental Retard, Moderate Mental Retard, Visual Impairment, Phonological Disorder, Learning Disabilities, Giftedness and Talent, Externalizing Behavior Problems, Internalizing Behavior Problems, Internalizing and Externalizing Behavior Problems and Attention Deficit Hyperactivity Disorder), (b) identify resources and deficits in social skills from each of the 12 groups and (c) assess the degree of prediction of different special educational needs on the repertoire of social skills of the children. Teachers of 120 students in regular and special schools, aged between six and 14 years, from four states, responded to the SSRS-BR to assess the social skills of their students. The results showed that the special needs that had a lower frequency of social skills compared to the other were also the best predictor of deficits in this area, according to the regression analysis performed: ADHD, Autism, Internalizing and Externalizing Behavior Problems and Externalizing Behavior Problems. Furthermore, the groups that most often presented these skills were Gifted and Talented, Children with Visual Impairment and Mild Mental Retard. The comparative analysis identified resources and deficits in specific social skills to each of the 12 participating groups. The results were discussed in relation to the intervention needs of each population, providing possible educational and therapeutic implications. / Os estudos de avaliação de habilidades sociais de crianças tem mostrado que, em geral, existe um comprometimento de habilidades sociais na deficiência intelectual, deficiências sensoriais e outras categorias de necessidades educacionais especiais. Ha, entretanto, uma lacuna existente na literatura quanto a uma comparação mais ampla do repertorio social de uma diversidade maior de populações de crianças, que inclua, simultaneamente, deficiências sensoriais, deficiência intelectual, crianças com deficit de atenção e hiperatividade, autismo, problemas de comportamento, dificuldades de aprendizagem, dentre outros. A escassez de estudos comparativos de avaliação de crianças com diferentes condições que decorrem em necessidades especiais tem dificultado a produção de conhecimentos sobre questões empíricas próprias, especificas de cada população. Alem disso, a carência de estudos de avaliação comparativos tem sido um obstaculo para a identificação de necessidades que poderiam nortear os objetivos de intervenções educacionais e terapêuticas em habilidades sociais junto a crianças com diferentes características desenvolvimentais. O presente estudo visou suprir parte dessa lacuna, tendo como objetivos: (a) comparar, com base na avaliação do professor, o repertorio de habilidades sociais de crianças de 12 diferentes categorias de necessidades educacionais especiais, entre si e com a amostra normativa do Sistema de Avaliação de Habilidades Sociais SSRS-BR (Autismo, Deficiência Auditiva, Deficiência Intelectual Leve, Deficiência Intelectual Moderada, Deficiência Visual, Desvio Fonológico, Dificuldades de Aprendizagem, Dotação e Talento, Problemas de Comportamento Externalizantes, Problemas de Comportamento Internalizantes, Problemas de Comportamento Internalizantes e Externalizantes e Transtorno de Deficit de Atenção e Hiperatividade); (b) identificar recursos e déficits em habilidades sociais de cada um dos 12 grupos e (c) verificar o grau de predição das diferentes categorias de necessidades educacionais especiais sobre o repertorio de habilidades sociais das crianças. Participaram da pesquisa os professores de 120 estudantes de escolas regulares e especiais, com idades entre seis e 14 anos, de quatro estados brasileiros, que responderam ao SSRS-BR, avaliando as habilidades sociais de seus alunos. Os resultados apontaram que as categorias de necessidades especiais que apresentaram menor frequência de habilidades sociais em comparação as outras foram também as melhores preditoras de déficits nessa área, de acordo com as analises de regressão realizadas: TDAH, Autismo, Problemas de Comportamento Internalizantes e Externalizantes e Problemas de Comportamento Externalizantes. Por outro lado, os grupos com maior frequência dessas habilidades foram os de crianças Dotadas e Talentosas, com Deficiência Visual e Deficiência Intelectual Leve. As analises comparativas permitiram ainda identificar recursos e déficits em habilidades sociais especificas para cada um dos 12 grupos participantes. Os resultados foram discutidos tendo em vista as necessidades de intervenção de cada população, com possíveis implicações educacionais e terapêuticas.

Le stress prénatal maternel (SPM) est un concept largement étudié et ce, autant par de méthodes objectives que subjectives. Certains chercheurs évaluent les symptômes d’anxiété et de dépression des femmes au cours de leur grossesse alors que d’autres préfèrent mesurer les niveaux de cortisol des femmes enceintes. Pour cette thèse, le SPM a été mesuré par deux méthodes différentes, soit l’exposition des femmes enceintes à une catastrophe naturelle et l’exposition des mêmes femmes enceintes à des événements de vie stressants plus courants. Puisqu’il est bien établi que ce type de stress engendre des répercussions négatives sur la femme enceinte ainsi que sur le développement de l’enfant, il est désormais d’intérêt d’accentuer les recherches sur les moyens qui permettent d’atténuer les conséquences d’un tel stress. Dans les études auprès des animaux, nous savons que les conditions de maternage ainsi que l'enrichissement environnemental semblent renverser les effets du SPM, mais nous ne savons pas si, chez les humains, un bon encadrement parental, c’est-à-dire un cadre structuré avec des règles prévisibles et consistantes, peut protéger les enfants des effets du SPM. L’objectif de cette thèse est donc d’augmenter notre compréhension sur l’effet protecteur de l’encadrement parental dans le développement d’enfants qui ont été exposés à différents types de SPM. Cet objectif pourra être atteint grâce à une collaboration internationale initiée par la Dre Suzanne King suite aux inondations qui se sont produites en 2008 dans l'état d'Iowa. Suite à la catastrophe, la Dre King est entrée en contact avec le Dr O’Hara afin d'évaluer la sévérité du stress dû aux inondations chez les femmes enceintes et pour déterminer les effets de ce stress sur leur enfant. Trois types de stress ont été évalués: le degré objectif de difficulté (p. ex., pertes financières), l'évaluation cognitive de la catastrophe en tant qu'expérience négative, neutre ou positive, et la détresse subjective causée par l'inondation (p. ex., symptômes de TSPT). Suite au recrutement des mères, les enfants de l'échantillon ont été évalués à l’âge de 2, 4, 5 et 7 ans. La présente thèse est composée de trois études. La première étude porte sur l’effet modérateur de l’encadrement parental sur les associations entre le SPM causé par les inondations d’Iowa et les problèmes comportementaux chez les enfants âgés de sept ans. Les résultats indiquent qu’un encadrement parental où la discipline est consistante protège les garçons qui ont été exposés au SPM objectif contre différents symptômes de problèmes internalisés et externalisés. La deuxième étude se penche également sur la question de l’effet protecteur de l’encadrement parental sur les associations entre le SPM et les problèmes comportementaux chez les enfants âgés de sept ans. Toutefois, cette étude s’est plutôt penchée sur l’influence du SPM lorsque celui-ci est causé par des événements de vie qui sont plus communs qu’un désastre naturel. De nouveau, les résultats de cette étude nous révèlent qu’un encadrement parental consistant joue le rôle de facteur de protection, chez les garçons qui ont été exposés au SPM causé par des événements de vie stressants, mais seulement en ce qui concerne les problèmes de comportement externalisés. La troisième étude vient reconsidérer l’effet protecteur de l’encadrement parental sur les liens entre le SPM et les problèmes comportementaux des enfants qui ont été exposés à un désastre naturel. Cependant, pour cette étude, les comportements des enfants n’ont pas été évalués par un questionnaire, mais plutôt par une méthode observationnelle (tâche de frustration). Toutefois, dans cette étude, il n’est ressorti aucun effet significatif de l’encadrement parental comme variable modératrice. En somme, nos résultats rapportent que l’implantation d’un cadre structuré et consistant peut venir pallier et même renverser les conséquences du SPM sur le comportement des garçons. / Prenatal maternal stress (PNMS) is a widely studied concept, both by objective and subjective methods. Some researchers assess women's symptoms of anxiety and depression during pregnancy, while others prefer to measure cortisol levels in pregnant women. For this thesis, PNMS was measured by two different methods: either exposure of pregnant women to a natural disaster, or exposure of these same pregnant women to more common stressful life events. Since it is well established that this type of stress has a negative impact on the pregnant woman as well as on the development of the unborn child, it is now of interest to increase research on ways to mitigate the consequences of such stress. In animal studies, we know that rearing conditions and environmental enrichment seem to reverse the effects of PNMS, but we do not know whether, in humans, good parental structure, that is, a structured framework with predictable and consistent rules, can protect children from the effects of PNMS. The aim of this thesis is, therefore, to increase understanding of the protective effect of parental structure in the development of children who have been exposed to different types of PNMS. This goal can be achieved through an international collaboration initiated by Dr. Suzanne King following the 2008 floods in the state of Iowa. Following the disaster, Dr. King contacted Dr. O'Hara to assess the severity of flood stress in pregnant women and to determine the effects of this stress on their children. Following the recruitment of mothers, the children in the sample were assessed at the ages of 2, 4, 5 and 7 years. This thesis consists of three studies. The first study examines the moderating effect of parental structure on the associations between PNMS caused by a natural disaster and behavioural problems in the Iowa Flood Study children at age 7 years as reported by their mothers. The results indicate that consistent parenting protects boys who have been exposed to PNMS from various symptoms of internalizing and externalizing problems. The second study also examines the issue of the protective effect of parental structure on associations between PNMS and behavioural problems, as reported by their mothers, in the Iowa Flood Study seven-year-olds. However, this study looked at the influence of PNMS when it is caused by life events that are more common than a natural disaster while controlling for the severity of their flood exposure. Again, the results of this study reveal that consistent parenting plays the role of a protective factor in boys who have been exposed to PNMS caused by stressful life events, but only with regard to externalizing behaviour. The third study reconsiders the protective effect of parental structure on the links between PNMS and behavioral problems of children who have been exposed to a natural disaster. However, for this study, children's behaviors were not assessed by a questionnaire, but rather by an observational method (task of frustration). However, the limitations of this study did not allow us to observe the effects of parental structure. In summary, our results show that the implementation of a structured and consistent framework can overcome, and even reverse, the consequences of PNMS on boys' behaviour.

Hintergrund. - Internationale Studien zeigen, dass die Maßnahmen zur Eindämmung der COVID-19-Pandemie verstärkt zu psychischen Auffälligkeiten bei Kindern und Jugendlichen führen können. Insgesamt gibt es zu diesem Themenbereich viele Studienaktivitäten, jedoch nur wenige repräsentative Untersuchungen für Deutschland. - Ziel der Arbeit. Es soll untersucht werden, welchen Einfluss die COVID-19-Pandemie auf die psychische Gesundheit von Kindern und Jugendlichen in Deutschland nimmt und welche Risiko- und protektive Faktoren für das mentale Wohlbefinden während der Pandemie existieren. Im Anschluss wird ein EU-weites Projekt skizziert, welches die psychische Gesundheit von SchülerInnen durch ein Schulungsprogramm für Lehrkräfte und andere PädagogInnen fördern will. - Methoden. Unter Nutzung der Literaturdatenbanken PubMed und Medline fand eine unsystematische Literaturrecherche im Sinne eines narrativen Reviews statt. Die in dieser Arbeit einbezogenen Studien wurden anhand ihres thematisch passenden Abstracts ausgewählt. - Ergebnisse. Die Zahl der Kinder, die psychische Auffälligkeiten oder Verhaltensstörungen zeigen, stieg rapide an. Vor allem die soziale Isolation, Ängste und Unsicherheit, sowie Konflikte innerhalb der Familie aufgrund von Überforderung oder finanziellen Sorgen führen zu einer Verschlechterung der psychischen Situation von Kindern und Jugendlichen. Die Folgen sind depressive Verstimmungen, Verhaltensauffälligkeiten und psychosomatische Beschwerden. Schlussfolgerung. Die Auswirkungen der COVID-19-Pandemie auf die psychische Gesundheit von Kindern und Jugendlichen dürfen nicht unterschätzt werden. Auch in den kommenden Jahren ist ein besonderer Unterstützungsbedarf gefordert. / Background. International studies show that measures to contain the COVID-19 pandemic can lead to increasedmental health problems in children and adolescents. Overall, there are many study activities on this topic, but only a few representative studies for Germany. - Objectives. The impact of the COVID-19 pandemic on the mental health of children and adolescents in Germany will be investigated, as well as the risk and protective factors for mental well-being during the pandemic. Subsequently, an EU-wide project will be outlined, which aims to promote the mental health of students through a training programfor teachers and other educators. - Methods. Using literature databases PubMed andMedline, an unsystematic literature search was carried out in the sense of a narrative review. The studies included in this work were selected based on their thematically appropriate abstract. - Results. The number of children showing mental or behavioral problems increased rapidly. Above all, social isolation, fears and insecurity, as well as conflicts within the family due to excessive demands or financial worries, lead to a deterioration in the psychological situation of children and young people. The consequences are depressive moods, behavioral problems and psychosomatic complaints. - Conclusion. The impact of the COVID-19 pandemic on the mental health of children and adolescents should not be underestimated. There will also be a special need for support in the coming years.

Hintergrund: Psychische Auffälligkeiten beginnen häufig im Kindesalter und können in psychische Störungen münden. Vorhandene Präventionsangebote werden trotz Wirksamkeit nur spärlich in Anspruch genommen. Ziel war zu prüfen, inwiefern durch die Etablierung einer Versorgungskette Risikokinder frühzeitig identifiziert und Präventionsmaßnahmen zugewiesen werden können, sowie inwieweit indikative Präventionsprogramme schlussendlich in Anspruch genommen werden. - Methoden: In einer prospektiven Implementationsstudie wurde während der regulären U9- bis U11-Gesundheitsuntersuchungen (Altersbereich: 5–10 Jahre) der „Strengths and Difficulties Questionnaire“ als Screeninginstrument an Familien ausgegeben. Diese erhielten von ihren Kinderärzt*innen unmittelbar eine Ergebnisrückmeldung und im Falle von grenzwertig auffälligen emotionalen oder Verhaltensproblemen eine Empfehlung für ein indikatives Präventionsprogramm. Vor Programmteilnahme fand im Vorgespräch eine Indikationsprüfung statt. - Ergebnisse: Im Raum Dresden beteiligten sich n = 46 (38,7 %) Kinderärzt*innen am Projekt. In n = 28 Kinderarztpraxen nahmen n = 3231 (86,4 %) Familien am Screening teil, n = 864 (26,7 %) Kinder, deren Familien eine Ergebnisrückmeldung erhielten, bekamen eine Präventionsempfehlung. Zur Präventionsprogrammteilnahme meldeten sich n = 118/864 (13,7 %) Familien selbstständig. n = 215/624 (35,5 %) zeigten Interesse nach projektinitiierter Kontaktaufnahme. Über andere Zugangswege kamen n = 139 Teilnahmeanfragen. n = 337 (n = 461; über alle Zugangswege) Vorgespräche wurden geführt. Schließlich nahmen n = 237 (n = 337) Kinder ein indikatives Präventionsprogramm in Anspruch. - Schlussfolgerung: Eine Ausweitung der Vorsorgeuntersuchung auf psychische Auffälligkeiten ist umsetzbar, nützlich und erfährt breite Akzeptanz. Um eine Versorgungskette einzurichten, sollte eine Angebotsstruktur etabliert werden, um damit die Zuweisung zu und Inanspruchnahme von Präventionsmaßnahmen zu ermöglichen. / Background: Mental health problems usually have their onset in childhood. Undiagnosed, they may progress into mental disorders. Despite their effectiveness, existing preventive programs have been rarely used. We aimed to examine to what extent the establishment of a care chain can identify children at high risk at an early stage and assign them to preventive interventions. In addition, prevention program participation was assessed. - Methods: In a prospective implementation study, the Strengths and Difficulties Questionnaire was administered as a screening instrument to families during regular pediatric health examinations (U9–U11, child age 5–10 years). Families received feedback directly from the pediatrician, and in the case of borderline abnormal emotional or behavioral problems, a recommendation for an indicative prevention program. Program indication was additionally determined in an entry examination prior to program participation. - Results: In the area of Dresden (Germany), n = 46 (38.7%) pediatricians participated in the project. In n = 28 pediatric practices, n = 3231 (86.4%) families participated in the screening and n = 864 (26.7%) children received a prevention recommendation. Of the families, n = 118/864 (13.7%) self-registered for the prevention programs, n = 215/624 (35.5%) showed interest after being contacted by the study teamn. Through other pathways, n = 139 families requested participation. Clinical evaluation interviews to assess prevention indication were conducted in n = 337 children (n = 461; via all entry pathways). Finally, n = 237 (n = 337) children participated in an indicated prevention program. - Conclusion: Expanding screening to mental health problems during regular health checkups is feasible, useful, and widely accepted. In order to implement a care chain, a supply structure should be established to enable referral to and uptake of preventive interventions.