This study sought to examine the relationships between the adult language input, as measured by quantity and quality, and the child’s language production in regards to quantity and quality, as well as their knowledge of basic concepts and vocabulary. LENA technology was used to audio-record the language environments of 26 preschool children with hearing loss over two days (weekday and weekend). This technology recorded up to 16 hours and analyzed the quantitative data associated with the adult word count (AWC), conversational turn count (CTC), and child vocalization count (CVC). Furthermore, one- hour meal times (30 minutes for the weekday/snack time and 30 minutes for the weekend/dinner time) was transcribed and coded for quality components of language defined as lexical diversity, syntactical complexity and clausal complexity. Additionally, the children were assessed on their knowledge of basic concepts through the Boehm Test of Basic Concepts (BTBC-3) and the Peabody Picture Vocabulary Test (PPVT-4). Results indicated that there was a relationship between the adult language input and the child language production, but only in regards to quantity of language. More specifically, the CTC during each day was related to the CVC for each day; in other words, the more interactions adults and children had during the day, the more likely the child vocalized. Interestingly, the statistical analysis revealed that quality of adult language input was not significantly related to the child language variables. However, significant differences between the teachers and caregivers were reported in regards to the quality of adult language input. These results suggest that the language input provided by adults in different environments (school versus home) is considerably different and warrants further investigation as how the potential influence on language outcomes of children with hearing loss.

In 2 experiments, I tested the effects of a behavioral momentum blending procedure on the accuracy of component and composite textual and spelling responses emitted by 11 preschool students with disabilities, including autism and speech and language delays, using multiple probe designs across participants. The participants were between 3 and 4 years old and were selected to participate because they were receiving reading instruction, but they emitted low numbers of correct textual responses to words comprised of previously mastered phoneme-grapheme correspondences. Dependent measures in the experiment included blending responses to novel text stimuli, composite vocal blending responses in which no textual stimuli were used, and spelling responses. In addition, in Experiment 2, I tested the effects of the procedure on the reinforcing properties of textual stimuli. Prior to the intervention, the participants were taught to textually respond to a set of known, regular words comprised of up to five phonemic sounds represented by corresponding graphemes at a target rate (number per min). During the behavioral momentum blending intervention, participants responded to these words that were presented in rapid succession by the experimenter, followed by the immediate presentation of novel words. The experimenter provided a vocal model of the component phonemes which was systematically faded during each phase of the intervention. Results for Experiment 1 showed increases in textual, spelling, and vocal blending responses for five participants. In addition, results indicated that the participants textually responded to novel words and emitted more composite textual responses, or responses without emitting the component sounds prior to textually responding, when composite blending was modeled at the beginning of the probe session. In Experiment 2, I altered the intervention procedure to require composite only responding as a final step in the instructional sequence. Six new preschool students were selected to participate, and the dependent measures were the same as Experiment 1; however, I also tested for the presence of conditioned reinforcement for observing print prior to and following BMBI. Results showed significant effects for four of the participants following up to two phases of intervention but were less significant for two of the participants. Additionally, results indicated the establishment of conditioned reinforcement for observing print for the participants who textually responded at criterion level. These findings are discussed with regard to the educational significance of blending as a prerequisite for textual responding and the importance of the speaker-as-own-listener verbal repertoire in learning to read phonetically.

In 2 experiments, I analyzed relations between the presence of Bidirectional Naming (BiN) and the establishment of arbitrary and non-arbitrary relational responses. In Experiment I, I analyzed the presence and strength of correlations between Bidirectional Naming and the establishment of derived relations for 31 preschool students. For Bidirectional Naming, the participants’ responses to both familiar and unfamiliar stimuli were measured; familiar stimuli were defined as spoken and visual stimuli that may be commonly present in the participants’ environment, while unfamiliar stimuli were contrived spoken and visual stimuli that were not customarily present in the participants’ environment. For relational responses, a non-arbitrary relation was defined as a relation that can be made based on the formal characteristics of the stimuli, while an arbitrary relation would be based on verbally mediated contextual cues. Data from this experiment showed there was an overall positive correlation between the demonstration of Bidirectional Naming and the establishment of derived relations, r = .847, p < .001. Moreover, there was a strong positive correlation between Bidirectional Naming with unfamiliar stimuli and arbitrarily derived relations, r = .823, p < .001. In Experiment II, I studied the establishment of arbitrary visual-visual and auditory-visual relations for 18 preschool students. The participants were split into 3 equal groups based on their degree of Bidirectional Naming; the groups consisted of 6 participants that demonstrated Bidirectional Naming, 6 participants that demonstrated Unidirectional Naming (UniN), and 6 participants that demonstrated a low degree of Bidirectional Naming. A comparison of the mean correct responses, between experimental groups, showed a significant difference for auditory-visual relations, F(2,15) = 36.63, p < .001, as well as visual-visual relations, F(2,15) = 4.11, p = .038. These data suggest that simpler (i.e., auditory-visual) derived relations are present with Unidirectional Naming; however, the joining of the listener and speaker repertoires (i.e., Bidirectional Naming) may be necessary for the development of more complex (i.e., visual-visual) derived relations. The results of these experiments suggest strong associations between the incidental acquisition of words and the incidental acquisition of language relations. The results also provide more evidence for how the establishment of Bidirectional Naming may lead to an individual learning at accelerated rates and in new ways.

De nos jours, la construction en bă, en tant que structure particulière et fréquente à l’oral et à l’écrit en chinois mandarin moderne, est souvent un sujet à polémique dans les analyses sémantico-syntaxiques ; les études sur son emploi chez les enfants sont plutôt rares. Partant de cette réalité, en m’appuyant sur la description détaillée de son emploi chez des enfants préscolaires âgés de plus de 05 ;06, et en combinant analyse quantitative et analyse qualitative, j’ai réussi non seulement à faire un « état des lieux » plus actualisé sur son emploi chez ces enfants, mais aussi à expliquer ses spécificités linguistiques à travers son acquisition, qui sont les deux objectifs principaux de cette thèse. Convaincu par son efficacité et l’absence de contrainte qu’elle impose à l’enfant, j’ai pratiqué la dictée à l’adulte tout au long de mon expérimentation, ce qui m’a permis de constituer mon propre corpus longitudinal, constitué d’enregistrements audio et vidéo de plus de 72 heures. Cette thèse permet, de ce fait, de dégager des paramètres opérants pour évaluer la bonne maîtrise de cette structure à l’oral, de discerner des caractéristiques acquisitionnelles facilitant son apprentissage et son enseignement, mais encore de mettre en évidence que, malgré le fait que les enfants maîtrisent la plupart des structures du syntagme verbal de cette construction avant leur scolarisation, son acquisition se poursuit après à l’école. Les analyses syntaxiques confirment que, même si divers facteurs peuvent influencer son emploi, les enfants l’utilisent essentiellement en raison de contraintes syntaxiques imposées par la langue chinoise, ce qui prouve bien que la construction en bă n’a pas encore acquis un sémantisme distinct et qu’elle est toujours en relation étroite avec l’ordre S.-V.-O., l’ordre canonique du chinois. / Nowadays, the bă construction, as a particular but frequent structure in spoken and written modern Mandarin Chinese, is still a controversial subject in semantico-syntactic analysis; the studies on children’s acquisition of this structure are even rare. With this reality in mind, based on the detailed description of its use by over 05;06 years old preschool children, and combining quantitative and qualitative analysis, I not only have updated the knowledge of its use by children, but also have explained its linguistic properties through how it has been acquired. These are also the two main objectives of this thesis. Convinced by its effectiveness and the absence of experimental constraint for children, I practiced the “dictée à l’adulte” (dictation to adult) throughout all my experimentation in China, which allowed me to build up my own longitudinal corpus including audio and video recordings of more than 72 hours. This thesis permit to identify effective parameters to evaluate the level of its mastery in children’s spoken language, to discern acquisitionnal features which could improve its teaching and facilitate children’s learning, and to highlight that despite the fact that children master most of the predicative structure likely to be used in this construction before entering school, its acquisition will continue during their education at primary school. Syntactic analysis confirms that while many factors could influence its use, the children use it mainly for the syntactic constraints imposed by the Chinese language. This fact proves that the bă construction has not yet acquired a distinct meaning and it is still closely related to the order S-V-O, the canonical order of Mandarin Chinese.

O objetivo do presente estudo foi avaliar a magnitude da redução nos parâmetros de cárie após a inclusão da avaliação da atividade e investigar a associação dos fatores socioeconômicos e biológicos com o status de atividade das lesões de cárie em pré-escolares brasileiros. A pesquisa foi realizada em Santa Maria, Brasil, durante a Campanha Nacional de Multivacinação Infantil, e 639 crianças com idade entre 12 meses e 59 meses foram incluídas. Quinze examinadores avaliaram as crianças utilizando o International Caries Detection and Assessment System (ICDAS) e um critério adicional para avaliação da atividade das lesões. Um questionário estruturado foi aplicado aos responsáveis da criança para coletar informações relacionadas às características demográficas, socioeconômicas e biológicas. A média de dentes e superfícies cariadas e a prevalência de cárie foram calculadas inicialmente nos diferentes pontos de corte do ICDAS. A avaliação da atividade foi realizada, e as lesões inativas foram consideradas como hígidas na segunda análise. Posteriormente, os mesmos parâmetros de cárie, nos mesmos pontos de corte do ICDAS, foram recalculados. A redução nos parâmetros de cárie após a inclusão da atividade e o número de crianças que precisavam ser avaliadas com a finalidade de mudar sua classificação de cariada para hígida foram também calculados. Além disso, análise de regressão de Poisson foi realizada para avaliar a associação entre as variáveis independentes e 7 desfechos que incluíam o número de lesões de cárie não-cavitadas (ativas, inativas e total), o número de lesões de cárie cavitadas (ativas, inativas e total) e todas as lesões. A maioria das lesões foi classificada como ativa, principalmente nos limiares de cavidade. Quando a atividade foi considerada, os valores dos parâmetros de cárie diminuíram. Esse decréscimo foi mais evidente nos limiares de lesões de cárie não-cavitadas. O número de crianças que precisavam ser avaliadas para mudar sua classificação de cariada para hígida foi menor que 20 quando todas as lesões foram consideradas; entretanto, esse valor aumentou para aproximadamente 100 quando somente as lesões cavitadas foram consideradas. As variáveis independentes estudadas foram associadas similarmente com os diferentes desfechos independente do status de atividade das lesões. Idade da criança e presença de placa bacteriana foram associadas significativamente com os desfechos relacionados às lesões de cárie não-cavitadas. Algumas variáveis socioeconômicas foram significativamente associadas com o número de lesões de cárie cavitadas, independente do status de atividade das lesões. Portanto, pode-se concluir que inclusão da avaliação da atividade em pesquisas epidemiológicas relacionadas à cárie dentária tem pouco impacto sobre os parâmetros de cárie considerando ambas as lesões de cárie cavitadas e não-cavitadas, e a avaliação da atividade da doença não é vantajosa para identificar os fatores de risco no contexto de saúde pública. / This study aimed to evaluate the magnitude of the reduction in caries parameters after inclusion of dental caries activity assessment and to investigate the strength of association of socioeconomic and biological factors with dental caries lesions activity status in Brazilian preschool children. The survey was carried out in Santa Maria, Brazil, during the National Childrens Vaccination Day, and 639 children aged from 12 months to 59 months were included. Fifteen examiners assessed the children based on the International Caries Detection and Assessment System (ICDAS) and an additional lesion activity assessment criterion. A structured questionnaire was answered by each childs guardian to collect information about demographic, socioeconomic and biological characteristics.The mean of decayed surfaces (d-s), the mean of decayed teeth (d-t), caries prevalence, and 95% confidence intervals were calculated, initially by classifying all lesions using the various thresholds defined by the ICDAS. Caries activity status was then evaluated, and inactive lesions were classified as sound in the second analysis; subsequently, the same caries parameters, at the same thresholds, were recalculated. The reduction in caries parameters and the number of children needed to be assessed in order to change their classification from decayed to sound were also calculated. Furthermore, multivariate Poisson regression analyses using a hierarchical approach was performed to evaluate the association between several independent variables and seven outcomes including number of non-cavitated caries lesions (active, inactive and total), number of cavitated caries lesions (active, inactive and total) and all lesions. The majority of lesions were classified as active, mainly at cavitated thresholds. When activity was considered, values of all caries parameters decreased. This decrease was more evident at non-cavitated thresholds. The number of children requiring assessment in order to change their classification from decayed to sound was less than 20 considering all lesions, but this value increased to approximately 100 when we included only cavitated lesions. The explanatory variables studied were similarly associated with the different outcomes, independently of the caries lesions activity status. Childs age and presence of bacterial plaque were statistically significant associated with non-cavitated caries lesions outcomes. Some socioeconomic variables were statistically significant associated with number of cavitated caries lesions, independently of their activity status. In conclusion, the inclusion of activity assessment in caries epidemiological surveys has little impact on dental caries parameters considering both non-cavitated and cavitated lesions and caries activity assessment is not advantageous to identify risk groups in a public health context.

Lo Wing-sze. / One booklet (14 p. : col. ill. ; 21 cm.) mounted on leaf 156. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (leaves 100-113). / Abstracts in English and Chinese; questionnaires also in Chinese. / Acknowledgements --- p.ii / Abstract --- p.iii / Abstract (Chinese Version) --- p.v / Publications / Table of Contents --- p.viii / List of Figures --- p.xiii / List of Tables --- p.xv / List of Abbreviations --- p.xviii / Chapter Chapter One: --- Introduction / Chapter 1.1 --- Childhood obesity trends and measurement in Hong Kong and Elsewhere in the recent decade --- p.1 / Chapter 1.2 --- Health consequences of childhood obesity --- p.3 / Chapter 1.3 --- Determinants of childhood obesity --- p.4 / Physical inactivity --- p.4 / High-fat diet --- p.5 / Chapter 1.4 --- Parental eating attitudes on family food environments --- p.6 / Home food purchasing and availability --- p.6 / Family meal frequency and location --- p.7 / Child feeding practices- the food and eating rules --- p.8 / Chapter 1.5 --- The relationship of socioeconomic status and obesity --- p.8 / The economic status of households in Hong Kong --- p.10 / Chapter 1.6 --- Targeting children aged three and four years --- p.12 / Chapter 1.7 --- Conceptual framework and study objectives --- p.13 / Chapter Chapter Two: --- Survey Design / Chapter 2.1 --- Sample design and subject recruitment --- p.15 / Chapter 2.2 --- Survey methods --- p.17 / Anthropometric measurement --- p.17 / Lifestyle questionnaire --- p.18 / Three-day 24-hour dietary intake recall --- p.20 / Chapter 2.3 --- Data management and analysis methods --- p.23 / Anthropometric measurements --- p.23 / Lifestyle questionnaire --- p.24 / Three-day 24-hour dietary intake recall --- p.24 / Socioeconomic status (SES) of the subjects (Households) --- p.25 / Chapter 2.4 --- Ethics --- p.25 / Chapter Chapter Three: --- Results / Chapter 3.1 --- Responses to various components of the survey --- p.26 / Chapter 3.2 --- Socioeconomic status and related characteristics of the households --- p.28 / Chapter 3.3 --- Characteristics of the preschooler and their carers --- p.34 / Preschooler s weight status --- p.34 / Preschooler s growth --- p.35 / Other characteristicsof the preschoolers --- p.37 / Chapter 3.4 --- Home food purchasing and its determinants --- p.40 / Chapter 3.5 --- Family meal frequency and location --- p.43 / Chapter 3.6 --- Preschoolers' meal preparation activities --- p.48 / Chapter 3.7 --- Food and eating rules and mealtime activities --- p.50 / Chapter 3.8 --- Child's sedentary activities patterns and parental perceptions --- p.53 / Chapter 3.9 --- "Parental perceptions of preschooler's height and weight, and eating habits" --- p.57 / Chapter 3.10 --- Nutrient intakes of the preschoolers --- p.59 / Chapter 3.11 --- Food consumption patterns of the preschoolers --- p.63 / Chapter 3.12 --- Meal and snack patterns of the preschoolers --- p.67 / Chapter 3.13 --- Main contribution of food sub-groups to energy and various nutrient intakes for preschoolers --- p.69 / Chapter 3.14 --- Intakes of energy and various nutrients from foods eaten at home and outside home --- p.72 / Chapter 3.15 --- "Associations of parental feeding practices, preschoolers' nutrient intakes and physical activity patterns with childhood overweight and obesity" --- p.75 / Parental feeding practices and attitudes toward healthy eating by preschoolers'weight status --- p.75 / Activity patterns of the preschoolers by weight status --- p.76 / Energy and various nutrient intakes of the preschoolers by weight status --- p.77 / Chapter Chapter Four: --- Discussion / Chapter 4.1 --- Childhood obesity rate by SES group --- p.80 / Chapter 4.2 --- Characteristics of the preschoolers and the households --- p.81 / Chapter 4.3 --- High SES families dined together less frequently than their low SES counterparts --- p.84 / Chapter 4.4 --- Preferences of family members as an influential factor in purchasing fruits and vegetables --- p.86 / Chapter 4.5 --- Encouraging healthy food shopping practices with the preschoolers --- p.87 / Chapter 4.6 --- Food and eating rules imposed by parents may influence preschooler's eating habits and nutrient intakes --- p.88 / Chapter 4.7 --- Preschooler's sedentary activities patterns --- p.89 / Chapter 4.8 --- Incorrect parental perceptions of preschooler's weight --- p.91 / Chapter 4.9 --- Nutrient intakes of the preschoolers overall --- p.91 / Chapter 4.10 --- Comparing the nutrient intakes of the preschoolers with another study carried out in 2000 --- p.93 / Chapter 4.11 --- Parental/preschooler association on fruit and vegetable consumption --- p.94 / Chapter 4.12 --- Main contributors of food sub-groups to energy and various nutrient intakes for the preschoolers by SES group --- p.95 / Chapter 4.13 --- "Differences in family food environments, feeding practices, eating habits and nutrient intakes of preschoolers by maternal education level and mother's employment status" --- p.95 / Chapter 4.14 --- Strengths and limitations of the study --- p.96 / Chapter Chapter Five: --- Conclusions and Recommendations --- p.99 / References --- p.100 / Appendices / Chapter A1 --- Invitation letter to principals (English version) --- p.114 / Chapter A2 --- Invitation letter to principals (Chinese version) --- p.117 / Chapter B --- Summary of the background information of the participating schools --- p.120 / Chapter C1 --- Consent form and letter to parent(s) or guardian(s) (English version) --- p.121 / Chapter C2 --- Consent form and letter to parent(s) or guardian(s) (Chinese version) --- p.123 / Chapter D --- Paper fans with food and physical activity pyramid pictures --- p.125 / Chapter E --- Health report --- p.126 / Chapter F1 --- Lifestyle questionnaire (English version) --- p.127 / Chapter F2 --- Lifestyle questionnaire (Chinese version) --- p.136 / Chapter G1 --- 24-hour dietary recall forms (English version) --- p.144 / Chapter G2 --- 24-hour dietary recall forms (Chinese version) --- p.150 / Chapter H --- Food photo booklet --- p.156 / Chapter I1 --- Table: Households receiving social benefits by paternal occupations (p<0.001) --- p.157 / Chapter I2 --- Table: Summaries some of the characteristics of the surveyed preschoolers by gender and altogether --- p.158 / Chapter I3a --- Table: Preschooler's parents' age --- p.159 / Chapter I3b --- Table: Parents age by SES --- p.159 / Chapter I4 --- Table: Factors considered by interviewee when buying food items --- p.160 / Chapter I5 --- Table: Cost as a factor of buying queried food items by SES income group --- p.161 / Chapter I6 --- Table: Frequencies of eating out or having takeaway meals in/from different types of caterers by SES group --- p.162 / Chapter I7 --- Type of utensils used to feed the preschoolers by SES group --- p.162 / Chapter I8 --- Preschoolers' activities during dinner by SES group --- p.163 / Chapter I9 --- "Proportion of interviewees with adequate fruit, vegetable, and both fruit and vegetable intakes per day by SES group" --- p.163

O objetivo do presente estudo foi avaliar a magnitude da redução nos parâmetros de cárie após a inclusão da avaliação da atividade e investigar a associação dos fatores socioeconômicos e biológicos com o status de atividade das lesões de cárie em pré-escolares brasileiros. A pesquisa foi realizada em Santa Maria, Brasil, durante a Campanha Nacional de Multivacinação Infantil, e 639 crianças com idade entre 12 meses e 59 meses foram incluídas. Quinze examinadores avaliaram as crianças utilizando o International Caries Detection and Assessment System (ICDAS) e um critério adicional para avaliação da atividade das lesões. Um questionário estruturado foi aplicado aos responsáveis da criança para coletar informações relacionadas às características demográficas, socioeconômicas e biológicas. A média de dentes e superfícies cariadas e a prevalência de cárie foram calculadas inicialmente nos diferentes pontos de corte do ICDAS. A avaliação da atividade foi realizada, e as lesões inativas foram consideradas como hígidas na segunda análise. Posteriormente, os mesmos parâmetros de cárie, nos mesmos pontos de corte do ICDAS, foram recalculados. A redução nos parâmetros de cárie após a inclusão da atividade e o número de crianças que precisavam ser avaliadas com a finalidade de mudar sua classificação de cariada para hígida foram também calculados. Além disso, análise de regressão de Poisson foi realizada para avaliar a associação entre as variáveis independentes e 7 desfechos que incluíam o número de lesões de cárie não-cavitadas (ativas, inativas e total), o número de lesões de cárie cavitadas (ativas, inativas e total) e todas as lesões. A maioria das lesões foi classificada como ativa, principalmente nos limiares de cavidade. Quando a atividade foi considerada, os valores dos parâmetros de cárie diminuíram. Esse decréscimo foi mais evidente nos limiares de lesões de cárie não-cavitadas. O número de crianças que precisavam ser avaliadas para mudar sua classificação de cariada para hígida foi menor que 20 quando todas as lesões foram consideradas; entretanto, esse valor aumentou para aproximadamente 100 quando somente as lesões cavitadas foram consideradas. As variáveis independentes estudadas foram associadas similarmente com os diferentes desfechos independente do status de atividade das lesões. Idade da criança e presença de placa bacteriana foram associadas significativamente com os desfechos relacionados às lesões de cárie não-cavitadas. Algumas variáveis socioeconômicas foram significativamente associadas com o número de lesões de cárie cavitadas, independente do status de atividade das lesões. Portanto, pode-se concluir que inclusão da avaliação da atividade em pesquisas epidemiológicas relacionadas à cárie dentária tem pouco impacto sobre os parâmetros de cárie considerando ambas as lesões de cárie cavitadas e não-cavitadas, e a avaliação da atividade da doença não é vantajosa para identificar os fatores de risco no contexto de saúde pública. / This study aimed to evaluate the magnitude of the reduction in caries parameters after inclusion of dental caries activity assessment and to investigate the strength of association of socioeconomic and biological factors with dental caries lesions activity status in Brazilian preschool children. The survey was carried out in Santa Maria, Brazil, during the National Childrens Vaccination Day, and 639 children aged from 12 months to 59 months were included. Fifteen examiners assessed the children based on the International Caries Detection and Assessment System (ICDAS) and an additional lesion activity assessment criterion. A structured questionnaire was answered by each childs guardian to collect information about demographic, socioeconomic and biological characteristics.The mean of decayed surfaces (d-s), the mean of decayed teeth (d-t), caries prevalence, and 95% confidence intervals were calculated, initially by classifying all lesions using the various thresholds defined by the ICDAS. Caries activity status was then evaluated, and inactive lesions were classified as sound in the second analysis; subsequently, the same caries parameters, at the same thresholds, were recalculated. The reduction in caries parameters and the number of children needed to be assessed in order to change their classification from decayed to sound were also calculated. Furthermore, multivariate Poisson regression analyses using a hierarchical approach was performed to evaluate the association between several independent variables and seven outcomes including number of non-cavitated caries lesions (active, inactive and total), number of cavitated caries lesions (active, inactive and total) and all lesions. The majority of lesions were classified as active, mainly at cavitated thresholds. When activity was considered, values of all caries parameters decreased. This decrease was more evident at non-cavitated thresholds. The number of children requiring assessment in order to change their classification from decayed to sound was less than 20 considering all lesions, but this value increased to approximately 100 when we included only cavitated lesions. The explanatory variables studied were similarly associated with the different outcomes, independently of the caries lesions activity status. Childs age and presence of bacterial plaque were statistically significant associated with non-cavitated caries lesions outcomes. Some socioeconomic variables were statistically significant associated with number of cavitated caries lesions, independently of their activity status. In conclusion, the inclusion of activity assessment in caries epidemiological surveys has little impact on dental caries parameters considering both non-cavitated and cavitated lesions and caries activity assessment is not advantageous to identify risk groups in a public health context.

O objetivo do presente estudo foi conhecer a prevalência da dor de dente e fatores associados na população de crianças de 3 e 4 anos de idade, residentes na região oeste do município de São Paulo, SP. A dor de dente foi associada à prevalência da cárie dentária, necessidade de tratamento, condições socioeconômicas e o impacto na Qualidade de Vida Relacionada à Saúde Bucal (QVRSB) das crianças. Para isso foi realizado um estudo epidemiológico transversal de saúde bucal, no mês de novembro de 2014. A amostra de 485 crianças foi determinada pela fórmula de Kirkwood (1988). Os dados sobre a presença de dor de dente, prevalência e gravidade de cárie dentária, necessidade de tratamento, aspectos socioeconômicos e de qualidade de vida da criança e dos pais foram coletados durante o dia de Campanha Nacional de Multivacinação Infantil. As crianças foram selecionadas de forma sistemática na fila de vacinação. O Termo de Consentimento Livre e Esclarecido foi assinado pelos responsáveis legais dos participantes. Agentes comunitários treinados coletaram dados sobre a presença de dor de dente por cárie dentária utilizando a versão brasileira do Dental Discomfort Questionnaire (DDQ-B), dados socioeconômicos e dados de qualidade de vida pela versão brasileira do Early Childhood Oral Health Impact Scale (B-ECOHIS). Posteriormente, as crianças foram examinadas em consultórios odontológicos de 15 Unidades Básicas de Saúde (UBSs) por 15 cirurgiões-dentistas treinados e calibrados para o diagnóstico de cárie dentária pelos indíces ceo-d e para coletar as necessidades de tratamento pelos critérios da Organização Mundial da Saúde. Os dados foram analisados estatisticamente utilizando regressão de Poisson com variância robusta (IC 95%) para associar o desfecho do escore total do DDQ-B com prevalência de cárie dentária, necessidade de tratamento e condições socioeconômicas. Como análise complementar foi feita a associação do desfecho qualidade de vida com a presença de dor de dente. Na população estudada foi encontrada uma prevalência de dor de dente de 11,8% considerado o ponto de corte maior ou igual a 3 no escore total do DDQ-B e foi associada com a presença de cárie dentária (RTR=1,85; p<0.001). A média ± desvio padrão do DDQ-B total da amostra foi 0,81 ± 1,46. Dentre as necessidades de tratamento, a necessidade de tratamento pulpar com restauração foi a única necessidade de tratamento associada à dor de dente (RTR = 2,81; p < 0,001). As condições socioeconômicas não foram associadas com a dor de dente (p> 0,05). Adicionalmente, a baixa gravidade (ceo-d entre 1 e 5) e a alta gravidade de cárie dentária (ceo-d >=6), tanto quanto os maiores níveis de dor, foram associados a uma pior QVRSB em pré-escolares e suas famílias (RTR= 3,86, p<0,001; RTR= 9,17, p<0,001 e RTR=1,38, p<0,001, respectivamente). Portanto, na população estudada, a dor de dente é associada a presença de cárie dentária, necessidade de tratamento pulpar com restauração, e pior QVRSB em pré-escolares e suas famílias. / The aim of this study was to assess the prevalence of dental pain and associated factors in preschool children 3-4 years old, living in the western district of São Paulo City, Brazil. Dental pain was associated with prevalence of dental caries, treatment needs, socioeconomic status and the impact on the Oral Health-Related Quality of Life (OHRQoL) in preschool children. In November 2014, a cross-sectional epidemiological study of dental caries was carried on. Representative sample of 485 children was calculated by Kirkwood formula (1988). Data on dental pain prevalence, caries prevalence and severity, dental treatment needs, socioeconomic status and impact on OHRQoL were collected during the Children´s Multivaccination National Campaign Day. Children were selected systematically in the vaccination queue. The Informed Consent was signed by the participant´s parents. Trained external interviewer collected data on dental pain related to caries using the Brazilian version of Dental Discomfort Questionnaire (DDQ-B), data on socioeconomic status, and data on quality of life using the Brazilian version of Early Childhood Oral Health Impact Scale (B-ECOHIS) . After that, the children were examined in dental units of the 15 health centers, by 15 trained dentists. Dental caries was assessed according to the dmf-t criteria. The codes and criteria for dental treatment needs were those based on the WHO manual. Data analyses were performed using Poisson regression (95% CI) to associate the total DDQ-B scores to dental caries prevalence, treatment needs and socioeconomic conditions. A complementary analysis assessed the association between dental pain and impact on quality of life. In the population studied, the prevalence of dental pain was 11.8%, considering the cut-off point greater than or equal to 3 in the total DDQ-B score and it was associated with caries prevalence (RR = 1.85; p <0.001). The mean ± standard deviation of total DDQ-B was 0.81 ± 1.46. Regarding dental treatment needs, the need for pulp treatment with restoration was the only treatment need associated with dental pain (RR = 2.81, p <0.001). Socioeconomic factors were not associated to dental pain (p> 0.05). In addition, the low (dmf-t between 1 and 5 ) and high caries severity (dmft >=6), as the highest pain levels; were associated with a worse OHRQoL in preschool children and their families (RR= 3.86, p<0.001; RR= 9.17, p<0.001 e RR=1.38, p<0.001, respectively). Therefore, in this population, dental pain was associated with caries prevalence, need for pulp treatment with restoration, and a worse oral health-related quality of life in preschool children and their families.

Speech Disorders Resource Guide for Preschool Children provides detailed information about assessment, analysis and intervention methods pertaining to childhood speech disorders. Also covers intervention outcomes and treatment efficacy. A concise, easy-to-use format makes it an ideal clinical resource tool for students and clinicians. / https://dc.etsu.edu/etsu_books/1181/thumbnail.jpg

Young children in the United States are widely using technology at ages 3 and 4, but to date there are no well documented participatory design methods for including this age group in the development of technologies. A few attempts at using methods designed for older children were unsuccessful. To address this gap in methods, this research developed Play-based Design, a novel participatory design method inspired by make-believe play in the style of Tools of the Mind, an evidence-based preschool curriculum. Play-based Design first sets the context for play and design through stories. It then enables children to plan play by selecting roles and contribute their ideas as they act and speak during make-believe play activities in which they interact with other children, voice agents, adult facilitators, and generic props. This research includes four sets of design sessions with 3-4 year old children. The first provided the design of StoryCarnival a web-based app to set up Tools of the Mind style play. The second set of design sessions led my research team through the development of voice agents to support Tools of the Mind style play as it happens. These two sets of sessions provided inspiration and insight for using StoryCarnival combined with voice agents to support design activities for technologies with physical and social components. The last two sets of sessions gave me an opportunity to understand whether Play-based Design could be applied to obtain design requirements from children for technology unrelated to make-believe play by focusing on obtaining ideas for Internet-of-Things applications in the home. The research presented in this dissertation required an interdisciplinary journey through child development theories, storytelling for children, graphic design, qualitative methods, software development, and related approaches from the literature. Participant observations, group discussions, and video analysis were used to collect and analyze data. Results from the last two sets of design sessions focused on obtaining ideas for Internet-of-Things technologies to provide evidence that Play-based Design can enable 3-4 year old children to contribute their ideas to the design of technologies. More specifically, in this dissertation, I provide supporting evidence for my thesis statement: “When applied to participatory design sessions with young children, Play-based Design can: (1) allow young children to express their ideas through make-believe play, which is a developmentally appropriate activity; (2) enable children to act out design ideas or verbally express them by conversing with researchers or voice agents; (3) support fluid communication between adult researchers and children; and (4) inform the design of technologies that facilitate activities that have social and physical components (e.g. tangible user interfaces, voice agents, IoT).”