Submitted by SBI Biblioteca Digital (sbi.bibliotecadigital@puc-campinas.edu.br) on 2018-05-25T12:54:59Z No. of bitstreams: 1 HELLEN CRISTINA MACHADO.pdf: 2759283 bytes, checksum: 7d1d4cfacdb9375860b5e81d34dd63c2 (MD5) / Made available in DSpace on 2018-05-25T12:54:59Z (GMT). No. of bitstreams: 1 HELLEN CRISTINA MACHADO.pdf: 2759283 bytes, checksum: 7d1d4cfacdb9375860b5e81d34dd63c2 (MD5) Previous issue date: 2018-02-06 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / This is an exploratory-type qualitative research carried out with the researcher?s own group of students, composed of children aged from 4 to 5, and with a group of younger children, aged from 2 to 3, at the same school, regarding the relationship of these children with the children's literature based on the concept of Fruition Reading. The general purpose of our research was to analyze the potential of creation and literature fruition in the practice of "reading" literary books performed by the voice and hands of children in preschool education. From there, the following specific objectives were outlined: (i) to analyze the potential of a peer reading proposal for the practice of Fruition Reading; (ii) to analyze the potential of a peer reading proposal for the improvement and development of higher psychological functions and their use in relation to literature. The empirical material was produced through videotaped and audio-recorded observations of 42 situations in which the children were invited to "read" to their peers (from their own class and a class of younger children) and qualitatively analyzed, based on the concept of Fruition Reading and on the historical-cultural theory, with regard to mediation and the development of higher psychological functions. The empirical material analysis was carried out on the following axes and sub-axes: importance of mediation, subdivided into mediation by teacher-researcher and among peers; then the importance of the recurrence of the experiences, subdivided into the appropriation of reading practice and, finally, the sub-axis of higher highlighted psychological functions: memory and imagination. Based on these analyzes we could identify the potential of child creation in storytelling from the children's literary book; the children were able to creatively imagine and invent stories, going beyond the simple description of the book's static illustration; they not only built sophisticated storytelling strategies, but also assumed a behavior as "readers"; they encouraged and displayed an interest in and appreciation of the "readings" made by peers; from the "readings", they brought debates on issues they considered important and also felt at ease to express their feelings. It is expected that this research results contribute to the formation of teachers when thinking about reading practice without aiming for strict control of results, which aims to explore the taste of reading for pleasure among preschool children. / Trata-se de uma pesquisa qualitativa do tipo explorat?ria realizada com a turma de alunos da pr?pria pesquisadora, composta por crian?as de 4 a 5 anos de idade e com a turma de crian?as menores, com 2 e 3 anos, da mesma escola, referente ? rela??o destas com a literatura infantil a partir do conceito de Leitura Frui??o. O objetivo geral de nossa pesquisa foi analisar a potencialidade de cria??o e frui??o liter?ria na pr?tica de ?leitura? de livros liter?rios realizados pela voz e m?os de crian?as da Educa??o Infantil. A partir disso, foram delineados os seguintes objetivos espec?ficos: (i) analisar a potencialidade de proposta de leitura entre pares para a pr?tica de Leitura Frui??o; (ii) analisar a potencialidade de proposta de leitura entre pares para o aprimoramento e desenvolvimento de fun??es ps?quicas superiores e de seu uso nas rela??es com a literatura. O material emp?rico foi produzido atrav?s de observa??es com v?deofilmagens e grava??o em ?udio de 42 situa??es em que as crian?as foram convidadas a ?lerem? para seus pares (de sua pr?pria turma e de uma turma de crian?as menores) e analisado qualitativamente, com embasamento no conceito de Leitura Frui??o e na teoria Hist?rico-Cultural, no que diz respeito ? media??o e ao desenvolvimento de fun??es ps?quicas superiores. A an?lise do material emp?rico foi realizada nos seguintes eixos e sub-eixos: import?ncia da media??o, subdividido em media??o da professora-pesquisadora e entre pares; em seguida, a import?ncia da recorr?ncia das experi?ncias, subdividido em a apropria??o da pr?tica de leitura e, por fim, o sub-eixo fun??es ps?quicas superiores em destaque: mem?ria e imagina??o. Com essas an?lises pudemos identificar a potencialidade da cria??o infantil na conta??o de hist?rias a partir do livro liter?rio infantil; as crian?as mostraram-se capazes de imaginar e inventar hist?rias criativamente, indo al?m da simples descri??o da ilustra??o est?tica do livro; constru?ram estrat?gias sofisticadas de conta??o de hist?rias, bem como assumiram postura como ?leitoras?; incentivaram e demonstraram interesse e gosto pelas ?leituras? feitas pelos colegas; a partir das ?leituras?, trouxeram debates de assuntos considerados importantes para elas e tamb?m sentiram-se ? vontade para expressarem seus sentimentos. Desta pesquisa, se espera que seus resultados contribuam para a forma??o de professores quando pensada a pr?tica de leitura sem almejar o controle estrito de resultados, que visa explorar os sabores da leitura por deleite com crian?as da Educa??o Infantil.

As contingências verbais promovidas pelo ambiente da educação infantil são importantes para que crianças pré-escolares desenvolvam seus repertórios verbais. Estudos indicam que a leitura compartilhada de histórias (LCH) tem efeitos significativos no desenvolvimento desses repertórios, principalmente quando associada a estratégias de ensino explícito de vocabulário. Porém, muitos educadores não têm conhecimento sobre essas estratégias e sobre como ocorre a aprendizagem a partir da LCH. Este trabalho, composto por três estudos, teve dois objetivos gerais: identificar as principais estratégias de LCH empregadas para o ensino explícito de palavras a crianças pré-escolares, estudadas pela literatura; e elaborar e implementar duas intervenções: uma delas voltada diretamente para crianças pré-escolares, e outra para professoras da Educação Infantil, ambas focadas no ensino de palavras por meio da leitura compartilhada de histórias. O Estudo 1 consistiu em uma revisão integrativa das estratégias de LCH testadas como prática de ensino publicadas em diferentes bases de dados entre 2006 e 2016. Foram analisados 13 artigos e foi possível identificar que todas as estratégias analisadas foram correlacionadas positivamente com ganhos por parte das crianças em diversas habilidades linguísticas. O Estudo 2 teve como objetivo testar os efeitos cumulativos do uso de estratégias de ensino de palavras a partir de sessões de LCH na aprendizagem de palavras por crianças pré-escolares. Foram realizadas três sessões de leitura compartilhada de uma mesma história e uma sessão composta por uma atividade complementar sobre as palavras da história lida, em uma classe de 13 crianças de 4 a 5 anos. Em cada sessão foi implementada uma estratégia de ensino de substantivos e verbos: Destacar a palavra-alvo, Explicar o significado da palavra-alvo, Iniciar conversas sobre a palavra-alvo e Atividades Complementares. Foi possível identificar ganhos significativos (p<0,05) das crianças em tarefas de emparelhamento ao modelo para substantivos e ganhos muito significativos (p<0,01) nas tarefas de nomeação tanto para substantivos quanto para verbos, na comparação entre medidas de pré e pós-teste. O Estudo 3 testou os efeitos de um programa de desenvolvimento profissional sobre estratégias de ensino de palavras a partir de LCH no uso dessas estratégias por parte de três professoras (medida primária) e na aprendizagem de palavras por parte das crianças, alunas dessas professoras (medida secundária). O programa de desenvolvimento profissional foi composto por um workshop sobre estratégias de ensino de palavras a partir de LCH e sessões de consultoria colaborativa, testados em um delineamento de linha de base múltipla. Foi possível identificar um aumento no uso de estratégias por parte das professoras após o workshop, além de manutenção e aumento desse uso durante os períodos Atividade de Contação de História e Atividades Complementares, respectivamente, após a implementação das sessões de consultoria colaborativa. Verificou-se, também, ganhos muito significativos (p>0,01) por parte das crianças nas tarefas de emparelhamento e definição de palavras. Além disso, as sessões de consultoria colaborativa permitiram a identificação de problemas vivenciados pelas professoras que influenciam, tanto em atividades cotidianas em sala de aula, quanto nas atividades propostas por esse estudo. O conjunto dos estudos confirmou a eficácia da LCH para ensino de repertórios verbais a crianças e apontou a necessidade de desenvolvimento de mais intervenções voltadas para professores nessa área / Verbal contingencies, promoted by early childhood education, and are important for preschool children to develop their verbal repertoires. Studies indicate that shared book reading (SBR) has a significant effect in developing there repertoires, especially when associated with explicit vocabulary teaching strategies. However, many educators have no knowledge about those strategies or about how SBR can promote learning processes. This research, composed by three studies, has two general purposes: to identify the main vocabulary-teaching strategies used during SBR with preschool children studied by the literature; and develop and implement two interventions: one applied to preschool children, and the other applied to early childhood educators, focused on vocabulary-teaching through SBR. Study 1 consisted in an integrative review of strategies used in SBR activities, tested as a teaching practice, published in different databases between 2006 and 2016. We analyzed 13 articles and identified that all strategies analyzed were positively correlated with gains in several language skills. The Study 2 aimed to test the cumulative effects in the use of word teaching strategies through SBR in word learning by preschool children. Three sessions of SBR of the same story, and one session of one complementary activity about words found in the story were implemented in a class of 13 children, from 4 to 5 years old. In each session, one teaching strategy was implemented to teach nouns and verbs: \"Highlight the target word\", \"Explain the target word\", \"Start conversations about the target word\" and \"Complementary Activities\". Significant gains (p <0.05) in matching to sample tasks for substantive and more significant gains (p <0.01) in naming tasks, between pre-test and post-test measures were identified . Study 3 tested the effects of a professional development program of word teaching strategies through SBR in measures of strategies use by three educators (primary measure) and in word learning by children in their class (secondary measure). The Professional development program was composed by a workshop about word teaching strategies trough SBR and collaborative consulting sessions, tested in a multiple baseline design. We identified a raise in strategies use by all the teachers after the workshop, and also a maintenance and a increase of this use in Telling Story Activity and Complementary Activities periods, respectively, after the implementation of collaborative consulting sessions. Significant gains (p>0,01) in childrens matching to sample and definition tasks performances were also observed. Moreover, collaborative consulting sessions allowed the identification of problems experienced by those educators that had influence, not only in everyday activities, but also activities proposed by this study. This set of studies confirm the efficacy of SBR in teaching verbal repertoires to children and pointed out the necessity of developing more interventions for educators in this area

SUMMARY: Graduation theses titled - Development and Application of the health and wellbeing promotion in preschool children - describes preparation, application and evaluation of a project which focuses on health and healthy lifestyle promotion in preschool aged children by using specific physical exercises and activities focused on health. The Project has been applied in a Preschool facility with a specific group of children and its content was adapted by the Preschool's official curriculum.

A presença de doenças e desordens bucais pode produzir um impacto na qualidade de vida de crianças pré-escolares e de seus pais, influenciando na saúde oral e bem-estar geral destas pessoas. Além disso, os fatores socioeconômicos podem confundir esta associação e, no entanto, isso ainda não tem sido testado nesta idade. O objetivo deste estudo foi avaliar o impacto da Cárie Precoce na Infância (CPI), Traumatismos Dentários (TD) e Tipos de Maloclusão Anterior (TMA) na Qualidade de Vida Relacionada à Saúde Bucal (QVRSB) de crianças entre 2 e 5 anos de idade e de seus pais, ajustados por fatores socioeconômicos, bem como, avaliar a presença destas condições clínicas bucais em associação a estes mesmos fatores. Pais de 260 crianças responderam ao Early Childhood Oral Health Impact Scale (ECOHIS) (06 domínios) sobre suas percepções em relação à QVRSB de seus filhos e suas condições socioeconômicas. Dois examinadores calibrados (Kappa=0,8 para CPI; 0,9 para TD e 1,0 para TMA) avaliaram a gravidade da CPI através do índice ceo-d (WHO, 1997) e as crianças foram categorizadas em: 0=livres de cárie; 1-5 =baixa gravidade; 6=alta gravidade. Os TD foram avaliados de acordo com a Classificação de Andreasen e Andreasen (1994) e as maloclusões de acordo com a presença de dois TMA, mordida aberta anterior e sobresaliência maior que 4 mm. A QVRSB foi mensurada através dos escores por domínios e total do ECOHIS. A regressão de Poisson foi realizada para associação dos fatores com QVRSB. Crianças mais velhas tiveram risco significativamente maior de desenvolver CPI, enquanto que ser menina, possuir renda familiar mensal mais alta e ter mães mais velhas, e que trabalham fora do lar, foram fatores de proteção para CPI (p<0,05). Nenhuma das condições socioeconômicas foi estatisticamente associada aos TD e TMA (p>0,05). Nos 6 domínios e no escore total do ECOHIS, a gravidade da CPI apresentou impacto negativo na QVRSB (p<0,001). Os TD não mostraram impacto negativo na QVRSB no escore total do ECOHIS, mas foi encontrada associação significante no domínio de auto-imagem e interação social no que diz respeito às lesões nos tecidos periodontais e alterações de cor. Os TMA não mostraram impacto negativo na QVRSB (p>0,05). Quanto maior a idade da criança, maior a aglomeração na casa, menor renda familiar e se a mãe trabalha fora do lar, maior o impacto negativo na QVRSB (p<0,05). O modelo multivariado ajustado mostrou que a alta gravidade da CPI (RR=3,81; IC95%= 2,66 - 5,46; p<0,001) está associada ao maior impacto negativo na QVRSB, sendo a alta renda familiar um fator de proteção (RR=0,93; IC95% 0,87 - 0,99; p<0,001). A gravidade da CPI apresenta um impacto negativo na QVRSB de crianças pré-escolares e de seus pais, enquanto que os TD e TMA não apresentam. As famílias de alta renda familiar relataram uma melhor QVRSB independentemente da presença de doenças e desordens bucais. / The presence of oral diseases and disorders can produce an impact on quality of life of preschool children and their parents, affecting their oral health and well-being. However, socioeconomic factors could confound this association, but it has not been yet tested at this age. The aim of this study was to assess the impact of Early Childhood Caries (ECC), Traumatic Dental Injuries (TDI) and Anterior Malocclusions Traits (AMT) on the oral health-related quality of life (OHRQoL) of children between 2 and 5 years of age and their parents adjusted by socioeconomic factors, and also to assess the presence of these oral clinical conditions in association to socioeconomic factors. Parents of 260 children answered the Early Childhood Oral Health Impact Scale (ECOHIS) (6 domains) on their perception of the childrens OHRQoL and socioeconomic conditions. Two calibrated dentists (Kappa=0.8 for ECC; 0.9 for TDI and 1.0 for AMT) examined the severity of ECC according to dmf-t index (WHO, 1997) and children were categorize in: 0= caries free; 1-5= low severity; 6= high severity. TDI were examined according to Andreasen e Andreasen (1994) classification and malocclusions according to the presence of two AMT, anterior open bite and overjet greater than 4mm. OHRQoL was measured through ECOHIS domain and total scores and Poisson regression was used to associate the different factors to the outcome. Older children had significantly greater risk of developing caries, and girls were at less risk. A greater family income, older mothers, and if the mothers work away from home were also significantly protective factors for dental caries (p<0.05). None of the socioeconomic conditions were statistically associated to TDI or AMT (p>0.05). In each domain and overall ECOHIS scores, the severity of ECC showed a negative impact on OHRQoL (p<0.001). TDI did not show a negative impact on OHRQoL in the overall ECOHIS score, but significant association was found in the self-image/social interaction domain for injuries to the periodontal tissues and discoloration. AMT did not show a negative impact on OHRQoL nor in each domain (p>0.05). The increase in the childs age, higher household crowding, lower family income and mother working out of home were significantly associated with OHRQoL (p<0.05). The multivariate adjusted model showed that the high severity of ECC (RR=3.81; 95% CI= 2.66, 5.46; p<0.001) was associated to greater negative impact on OHRQoL, while high family income was a protective factor for OHRQoL (RR=0.93; 95% CI= 0.87, 0.99; p<0.001). The severity of ECC presents a negative impact on the OHRQoL of preschool children and their parents, whereas TDI and AMT do not. Families with higher income report better OHRQoL at this age, independent of presence of oral diseases and disorders.

The purpose of this study was to examine temporal resolution in normal-hearing preschool children. Word recognition was evaluated in quiet and in spectrally identical continuous and interrupted noise at signal-to-noise ratios (S/Ns) of 10, 0, and −10dB−10dB−10dB. Sixteen children 4to5years4to5years4to5yearsof age and eight adults participated. Performance decreased with decreasing S/N. At poorer S/Ns, participants demonstrated superior performance or a release from masking in the interrupted noise. Adults performed better than children, yet the release from masking was equivalent. Collectively these findings are consistent with the notion that preschool children suffer from poorer processing efficiency rather than temporal resolution per se.

ABSTRACT Background: Recent literature suggests preschool children regardless of income, age, ethnicity, and gender are subject to future cardiometabolic risk. Dietary intake, when analyzed can indicate diversity and lack of meeting adequate nutrient standards. A combination of anthropometric and blood analysis with dietary intake assessment can provide practitioners the knowledge for adequate early nutrition intervention and education. Objectives: This descriptive, cross-sectional study describes the relationship between dietary intake and cardiometabolic indicators in preschool children. There is also a comparison of mean subject values and referenced national standards. Study Sample: Four hundred seventy-one preschool children, between the ages of three and five, and parents were recruited via the Head Start program in seven different rural schools in Northeast Florida. Each parent was provided an Individual Dietary Diversity Score questionnaire. Children underwent blood sampling from a finger prick to assess lipids, glucose, hemoglobin and hematocrit. Body measurements including height, weight, waist circumference, sagittal abdominal diameter, and blood pressure were taken. Statistical Analysis: Variables of interest were uploaded into SPSS software for quantitative analysis. Means and standard deviations were calculated for the continuous variables and frequencies and percent were calculated for the categorical variables. One-way analysis of variance was used to assess the relationship between the cardiometabolic variables as dependent variables and the dichotomous explanatory variables. One-sample t-tests were used to compare the mean values of the cardiometabolic variables with national standards by age and gender. Results: Of the 471 subjects, 86 assessed via one-way ANOVA showed that lower diversity scores were significantly associated with lower blood triglycerides and higher hemoglobin (n = 137) and hematocrit % (n = 65) levels. Higher 100% fruit juice consumption was significantly associated with lower triglyceride levels. A higher intake of fresh vegetables was significantly associated with lower waist circumference and lower sagittal abdominal diameter. A higher soda consumption was significantly associated with greater waist circumference, greater sagittal abdominal diameter and higher triglyceride levels. When the cardiometabolic parameters in the study sample were compared with national standards, it was found that the height of study subjects was shorter (cm) than national standards for males and females. Waist circumference of 4 and 5-year-old males was smaller (cm) than national standards, BMI of 4-year-old females was lower than national standards, blood pressure in both male and female subject age groups was higher (mmHg) than national standards, and hematocrit % in both males and females was a higher percentage than national standards. Conclusion: This study does support the belief that a diet with a higher intake of fresh vegetables, fruits and 100% fruit juice and a lower consumption of sugary beverages such as soda promotes a decrease in body composition, specifically measurements of adiposity around the abdominal area. Lowering abdominal adiposity decreases cardiometabolic risk.

<p>Fizička aktivnost u velikoj meri može pozitivno uticati na zdravstveni status i psihosocijalno stanje, pa je glavni cilj istraživanja bio usmeren na analizu fizičke aktivnosti pred&scaron;kolske dece. Teorijski deo rada obuhvata sve &scaron;to je bitno za razumevanje postavljene teme, dok je empirijski deo podeljen na četiri dela. U prvom delu su izloženi rezultati dobijeni anketom i dnevnikom aktivnosti koje su popunjavali roditelji, a analizirana je dečja aktivnost radnim danima i vikendom. Drugi deo se odnosi na obim kretne aktivnosti dece tokom boravka u vrtiću, gde je statističkom obradom podataka utvrđeno kakav je obim kretne aktivnosti dečaka i devojčica i od čega zavisi. U okviru plana i programa koji se sprovodi u pred&scaron;kolskoj ustanovi, predviđeno je da se upražnjavaju usmerene aktivnosti s motoričkim sadržajem, &scaron;to je analizirano u trećem i četvrtom delu (trajanje, struktura i sadržaj aktivnosti, kao i motorička&nbsp; angažovanost dece na aktivnostima).</p> / <p>Physical activity can have a positive impact on the health status and psychosocial condition; therefore the main aim of this research was focused on the analysis of physical activities of preschool children. The theoretical part of the study includes all important matters essential for understanding the subject, while the empirical part is divided into four sections. The first section presents the results obtained from a questionnaire and a diary of activities completed by parents, and it analyzes the children&#39;s activity on weekdays and weekends. The second section relates to the extent of motor activity of children during their stay in the kindergarten. The statistical analysis in this section shows the scope of motor activity of boys and girls and what it depends on. According to the plan implemented in preschool institution, it is expected to have directed activities with motor content. This part is analyzed in the third and fourth section (duration, structure and content of activities as well as motor<br />involvement of children in activities).</p>

Family Child Care Homes (FCCHs) are the second largest provider of non-relative care in the U.S. However, despite providing care for nearly 1.9 million children under the age of 5, little is known about the physical activity levels of children attending FCCHs. This dissertation sought to provide new information with regards to physical activity in children attending FCCHs. The purpose of the first study was to objectively measure physical activity in children attending FCCHs. 114 children (60 boys and 54 girls) 3.7 �� 1.1 years of age from 47 FCCHs wore an ActiGraph GT1M accelerometer for the duration of child care attendance during a randomly selected week. Counts were classified as sedentary (SED), light (LPA), or moderate-to-vigorous (MVPA) using the cut-points developed by Pate et al. (2006). Total physical activity was calculated by summing time spent in LPA and MVPA. Non-wear time was estimated by summing the number of consecutive zero counts accumulated in strings of 10 minutes or longer. Children were included in the analyses if they had 2 or more monitoring days in which wear time was ���75% of the attendance time. On average, children accumulated 25.9 �� 5.7 min of SED, 10.1 �� 4.2 min of MVPA, and 34.1 �� 5.7 min of total physical activity per hour of attendance. Further analysis revealed that among healthy weight children, 4 year-olds exhibited significantly lower levels of SED and significantly higher levels of MVPA and total physical activity than 2- and 3- year-olds. Among 4-year-olds, overweight and obese children exhibited significantly higher levels of SED and significantly lower levels of MVPA and total PHYSICAL ACTIVITY than healthy weight counterparts. The results from this study indicated that preschool-aged children attending FCCHs are mostly sedentary and accumulate low levels of MVPA during the child care day. The purpose of the second study was to assess the validity of two proxy report instruments designed to measure physical activity in children attending FCCHs. Valid self-report measures are needed for large scale intervention studies and/or population-based surveillance studies in which more burdensome objective measures are not feasible. In Year 1 of the study, FCCH Providers (N=37) completed the Burdette parent proxy report, modified for the family child care setting, for 107 children aged 3.4 �� 1.2 years. In Year 2, 42 Providers completed the Harro parent and teacher proxy report, modified for the family child care setting, for 131 children aged 3.8 �� 1.3 years. Both proxy-reports were assessed for validity using objectively measured physical activity as a criterion measure (accelerometry). Significant positive correlations were observed between scores from the modified Burdette proxy report and objectively measured total physical activity (r = 0.31, p < 0.01) and MVPA (r = 0.33, p < 0.01). Across levels of Provider-reported activity, both total physical activity and MVPA increased significantly in a linear dose-response fashion. Provider-reported MVPA scores from modified Harro proxy report were not associated with objectively measured physical activity. These findings suggested that the modified Burdette proxy report may be a useful measurement tool in larger-scale physical activity studies involving FCCHs in which objective measures, such as direct observation or accelerometry, are not practical. The purpose of the third study was to evaluate the effects of two strategies to increase the use of portable play equipment in FCCHs ��� a community-based train-the-trainer physical activity intervention (INT), and the same trainer-the-trainer intervention supplemented with monthly emails promoting the use of portable play equipment (INT+). We hypothesized that Providers completing the standard train-the-trainer intervention would report significantly greater portable play equipment use than Providers completing the food allergy control training (CON). We further hypothesized that Providers completing the supplementary email intervention would report significantly greater portable play equipment use than Providers completing standard train-the-trainer intervention or the food allergy control training. A total of 50 FCCH Providers from Marion, Linn, Benton, Washington, and Lane County, Oregon were randomized to the INT or CON conditions. Twelve Providers from Lincoln County were assigned to the (INT+). The type, variety, and frequency of portable play equipment use was measured by means of self-report via a checklist and two items from the previously validated NAP-SACC Self-Assessment instrument. FCCH Providers who completed the INT reported significantly greater use of portable play equipment than Providers completing the CON training. However, portable play equipment use among Providers completing the INT+ was not significantly different from that reported by Providers in the INT or CON. Notably, neither intervention had a significant impact on the amount or variety of portable play equipment. The results showed that a comprehensive trainer-the-trainer intervention to increase physical activity in FCCHs could successfully increase the use of portable play equipment in the home. However, supplementing the intervention with monthly emails encouraging the use of PPE was not effective. / Graduation date: 2013

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common behavioural disturbances in school children. The aims of this thesis were to explore the association of ADHD with recurrent health complaints and bullying behaviour in children in grade four, and to evaluate whether it is possible to predict ADHD in grade four by screening before or at school entry. Cohort study in a population of 577 fourth graders (10-year-olds) in Sigtuna, a municipality in Stockholm County. All children were screened for attention and behaviour problems by parents and teachers in fourth grade. In a second step children with high scores underwent further clinical and cognitive assessments. Information about health complaints and bullying was collected from the children themselves in a classroom questionnaire. Hypotheses were tested in multivariate analyses with adjustment for sex and parental education. Screening with developmental indicators and Conners scale from routine child health services was performed. Sensitivity, specificity and positive predictive value for being diagnosed with ADHD in fourth grade was calculated. Recurrent abdominal pain, sleeping problems, and tiredness were associated with ADHD (adjusted relative risks: 2.2 [1.4-3.4], 1.7 [1.1-2.7], and 2.7 [1.7-4.1] respectively). ADHD was associated with bullying others students (adjusted odds ratios; 3.8 [95% C.I.: 2.0-7.2]) as well as being bullied (often 10.8 [4.0-29.0] and sometimes 2.9 [1.5-5.7]). The predictive value of developmental deviations for ADHD was no more than 20% and 50% when combining a Conner score of at least 10 from both parents and teachers. This thesis demonstrates a connection between ADHD in one as well as two settings (home and school), health complaints, and bullying in school children. Treatment strategies for ADHD need to include an effective evaluation and treatment of health complaints and effective interventions for bullying. Evaluation of ADHD should be considered in children with recurrent health complaints and in children involved in bullying. Screening does not identify children who are diagnosed with ADHD in grade four with a high degree of selectivity. It may be more important for schools to have an effective strategy for identifying and dealing with children who develop ADHD when these problems evolve, rather than before school entry.

La presente ricerca nasce da una domanda di un territorio specifico che si è interrogato relativamente ai problemi emotivo-comportamentali dei bambini in età prescolare Tale richiesta ci ha sollecitato da un punto di vista teorico a porre l’attenzione da un lato, sul significato “clinico” dei problemi emotivo-comportamentali dei bambini, dall’altro sul processo di assessment e in particolar modo sulla prospettiva multi-informant . Tale prospettiva è stata nello specifico oggetto di riflessione e indagine empirica soprattutto nel primo studio dove si sono considerate con particolare attenzione le discrepanze tra gli informant e il loro possibile significato. La domanda di ricerca iniziale si è quindi ampliata fino ad affrontare l’individuazione dei fattori protettivi e di rischio nello sviluppo psicologico dei bambini in età prescolare. A questo proposito il secondo studio propone un modello multifattoriale per la comprensione delle problematiche emotivo-comportamentali dei bambini che tiene conto di aspetti individuali e di aspetti relazionali, familiari in primo luogo. Infine, il terzo studio vede l’utilizzo del modello teorico proposto nei i primi due studi su di un campione di genitori che si sono rivolti a un servizio territoriale arrivando a identificare gli elementi del modello che discriminano famiglie considerate normali da quelle definibili come cliniche. / This research developed from a need to answer specific questions about emotional-behavioral problems in preschool children. From a theoretical point of view, this need forced one to focus on the “clinical” meaning of emotional-behavioral problems in pre-school children and their assessment processes, especially from a multi-informant perspective. Particularly, this perspective was a topic of interest in an empirical investigation in the first study, where discrepancies between informants and their possible perceptions were considered with particular attention. The initial research question was expanded to deal with the identification of risk and protective factors in the psychological development of preschool children. On this regard, the second study proposed a multi-factorial model to understand the emotional and behavioral problems of children which took into account individual and relational aspects, including especially the family. Finally, the third study considered the use of a theoretical model proposed in the first two studies with a sample of parents who turned for help to social services to identify from the model critical elements that discriminated families which could be considered functional from those defined as clinical.