Protocolos de avaliação de comportamentos são frequentemente utilizados para fins de triagem do Transtorno do Espectro de Autismo (TEA) quando avaliações abrangentes se mostram impraticáveis. Esta pesquisa teve como objetivo geral avaliar evidências de sensibilidade para detecção de TEA do Child Behavior Checklist (CBCL/1.5-5), em crianças de dois a cinco anos de idade. Considerando que o CBCL apresenta apenas resultados preliminares de sensibilidade para detecção de TEA no Brasil, apesar de seu uso frequente em avaliação de crianças em serviços de saúde e em pesquisas no mundo todo, justifica-se o estudo de evidências de sensibilidade deste instrumento para o referido quadro, tendo por instrumento padrão ouro a Childhood Autism Rating Scale Brasil (CARS-BR). O CBCL/ 1.5-5 é um instrumento preenchido pelos pais (pai, mãe ou responsável pela criança) e a CARS é um inventário aplicado pelo pesquisador em forma de entrevista com os mesmos. A amostra foi composta por 114 crianças, distribuídas em três grupos: um grupo pesquisa formado por 46 crianças com diagnóstico de TEA, um grupo controle formado por 23 crianças com diagnóstico de Transtorno de Déficit de Atenção/ Hiperatividade (TDAH) e um segundo grupo controle composto por 45 crianças pré escolares com desenvolvimento típico. Foram realizadas uma análise de variância multivariada (MANOVA), uma análise univariada (ANOVA), uma análise de regressão logística com odds ratio (OR) e análise da curva ROC. Para uma análise qualitativa de discussão de caso, foi verificado em que medida aspectos singulares de quatro casos avaliados apresentam manifestações da tendência grupal. Para isso, foi utilizado um método de discussão de caso, realizado a partir de eixos teóricos extraídos da Avaliação Psicanalítica aos 3 anos (AP3), que são: o brincar e a fantasia; o corpo e sua imagem; manifestação diante das normas e posição frente à lei; a fala e a posição na linguagem. As análises estatísticas indicaram que as escalas em que foi possível verificar uma diferença quando comparados os três grupos foram Retraimento e Problemas invasivos do desenvolvimento do CBCL/1.5-5. A escala Reatividade emocional mostrou diferença quando comparado o grupo TEA com os dois grupos controle, mas não apresentou diferença na comparação dos grupos controle entre si. A análise da curva ROC indicou alta sensibilidade e especificidade para Reatividade emocional (85% e 82%), Retraimento (87% e 89%) e Problemas Invasivos do Desenvolvimento (91% e 96%) quando foram comparados o grupo com TEA e o grupo com desenvolvimento típico. E, ainda, indicou índices menores de sensibilidade e especificidade para Reatividade emocional (85% e 70%), Retraimento (74% e 70%) e Problemas Invasivos do Desenvolvimento (85% e 70%) quando foram comparados o grupo com TEA e o grupo com TDAH. As análises apontaram que o CBCL/ 1.5-5 pode ser utilizado para fins de rastreamento de TEA, indicando as escalas Reatividade emocional, Retraimento e Problemas Invasivos do Desenvolvimento como as variáveis preditoras mais significativas, ou seja, que apresentaram diferenças na comparação inter-grupos. As análises mostraram que há maiores índices de sensibilidade do CBCL/ 1.5-5 quando se comparou o grupo TEA e o grupo com desenvolvimento típico / Behavior evaluation protocols are often used to screen for Autism Spectrum Disorder (ASD) when broad evaluations seem to be unfeasible. The general objective of this investigation was to assess the sensitivity evidence for the detection of ASD of the Child Behavior Checklist (CBCL/1.5-5), in children aged between two and five years of age. Considering that CBCL only shows preliminary results of sensitivity for the detection of ASD in Brazil, despite its frequent use in childrens assessment in health services and in research around the world, the study of evidence for this instruments sensitivity is justified for the frame here mentioned, having as the golden standard instrument the Childhood Autism Rating Scale Brazil (CARS-BR). CBCL/ 1.5-5 is an instrument completed by the parents (father, mother or person in charge of the child) and CARS is an inventory applied by the researcher in the form of an interview with the same people. The sample was composed of 114 children distributed in three groups: one research group composed of 46 children diagnosed with ASD, a control group composed of 23 children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), and a second control group composed of 45 preschool children with typical development. A multivariate analysis of variance (MANOVA) was carried out, as well as a one-way analysis of variance (ANOVA), an analysis of logistic regression with odds ratio (OR) and a ROC curve analysis. For a qualitative analysis of case discussion, the study verified the extent to which the unique aspects of four cases evaluated presented manifestations of group tendencies. In order for this to be achieved, the method of case discussion was used, from the theoretical axes of Psychoanalytical Evaluation at the age of 3 (PE3), which are: playing and fantasy, the body and its image; expression in face of norms and position regarding the law; speech and the position in language. Statistical analyses indicated that the scales in which it was possible to verify a difference when the three groups were compared were: Withdrawn and Pervasive developmental problems of CBCL/1.5-5. The scale of Emotionally reactive showed difference when the ASD group was compared to the two control groups, but showed no difference when the other control groups were compared amongst themselves. ROC Curve analysis indicated high sensitivity and specificity to Emotionally reactive (85% e 82%), Withdrawn (87% and 89%) and Pervasive developmental problems (91% and 96%) when the ASD group was compared to the typical development group. Moreover, it indicated lower indices of sensitivity and specificity to Emotionally reactive (85% and 70%), Withdrawn (74% and 70%) and Pervasive developmental problems (85% and 70%) when the ASD group was compared to the ADHD group. Analyses suggest that CBCL/ 1.5-5 can be used for screening of ASD, indicating the scales of Emotionally reactive, Withdrawn and Pervasive developmental problems as the most significant predicting variables, namely those that present the difference in comparison with intergroups. Analyses also show that there was greater sensitivity of CBCL/ 1.5-5 when the ASD group was compared to the control group of typical development

Protocolos de avaliação de comportamentos são frequentemente utilizados para fins de triagem do Transtorno do Espectro de Autismo (TEA) quando avaliações abrangentes se mostram impraticáveis. Esta pesquisa teve como objetivo geral avaliar evidências de sensibilidade para detecção de TEA do Child Behavior Checklist (CBCL/1.5-5), em crianças de dois a cinco anos de idade. Considerando que o CBCL apresenta apenas resultados preliminares de sensibilidade para detecção de TEA no Brasil, apesar de seu uso frequente em avaliação de crianças em serviços de saúde e em pesquisas no mundo todo, justifica-se o estudo de evidências de sensibilidade deste instrumento para o referido quadro, tendo por instrumento padrão ouro a Childhood Autism Rating Scale Brasil (CARS-BR). O CBCL/ 1.5-5 é um instrumento preenchido pelos pais (pai, mãe ou responsável pela criança) e a CARS é um inventário aplicado pelo pesquisador em forma de entrevista com os mesmos. A amostra foi composta por 114 crianças, distribuídas em três grupos: um grupo pesquisa formado por 46 crianças com diagnóstico de TEA, um grupo controle formado por 23 crianças com diagnóstico de Transtorno de Déficit de Atenção/ Hiperatividade (TDAH) e um segundo grupo controle composto por 45 crianças pré escolares com desenvolvimento típico. Foram realizadas uma análise de variância multivariada (MANOVA), uma análise univariada (ANOVA), uma análise de regressão logística com odds ratio (OR) e análise da curva ROC. Para uma análise qualitativa de discussão de caso, foi verificado em que medida aspectos singulares de quatro casos avaliados apresentam manifestações da tendência grupal. Para isso, foi utilizado um método de discussão de caso, realizado a partir de eixos teóricos extraídos da Avaliação Psicanalítica aos 3 anos (AP3), que são: o brincar e a fantasia; o corpo e sua imagem; manifestação diante das normas e posição frente à lei; a fala e a posição na linguagem. As análises estatísticas indicaram que as escalas em que foi possível verificar uma diferença quando comparados os três grupos foram Retraimento e Problemas invasivos do desenvolvimento do CBCL/1.5-5. A escala Reatividade emocional mostrou diferença quando comparado o grupo TEA com os dois grupos controle, mas não apresentou diferença na comparação dos grupos controle entre si. A análise da curva ROC indicou alta sensibilidade e especificidade para Reatividade emocional (85% e 82%), Retraimento (87% e 89%) e Problemas Invasivos do Desenvolvimento (91% e 96%) quando foram comparados o grupo com TEA e o grupo com desenvolvimento típico. E, ainda, indicou índices menores de sensibilidade e especificidade para Reatividade emocional (85% e 70%), Retraimento (74% e 70%) e Problemas Invasivos do Desenvolvimento (85% e 70%) quando foram comparados o grupo com TEA e o grupo com TDAH. As análises apontaram que o CBCL/ 1.5-5 pode ser utilizado para fins de rastreamento de TEA, indicando as escalas Reatividade emocional, Retraimento e Problemas Invasivos do Desenvolvimento como as variáveis preditoras mais significativas, ou seja, que apresentaram diferenças na comparação inter-grupos. As análises mostraram que há maiores índices de sensibilidade do CBCL/ 1.5-5 quando se comparou o grupo TEA e o grupo com desenvolvimento típico / Behavior evaluation protocols are often used to screen for Autism Spectrum Disorder (ASD) when broad evaluations seem to be unfeasible. The general objective of this investigation was to assess the sensitivity evidence for the detection of ASD of the Child Behavior Checklist (CBCL/1.5-5), in children aged between two and five years of age. Considering that CBCL only shows preliminary results of sensitivity for the detection of ASD in Brazil, despite its frequent use in childrens assessment in health services and in research around the world, the study of evidence for this instruments sensitivity is justified for the frame here mentioned, having as the golden standard instrument the Childhood Autism Rating Scale Brazil (CARS-BR). CBCL/ 1.5-5 is an instrument completed by the parents (father, mother or person in charge of the child) and CARS is an inventory applied by the researcher in the form of an interview with the same people. The sample was composed of 114 children distributed in three groups: one research group composed of 46 children diagnosed with ASD, a control group composed of 23 children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD), and a second control group composed of 45 preschool children with typical development. A multivariate analysis of variance (MANOVA) was carried out, as well as a one-way analysis of variance (ANOVA), an analysis of logistic regression with odds ratio (OR) and a ROC curve analysis. For a qualitative analysis of case discussion, the study verified the extent to which the unique aspects of four cases evaluated presented manifestations of group tendencies. In order for this to be achieved, the method of case discussion was used, from the theoretical axes of Psychoanalytical Evaluation at the age of 3 (PE3), which are: playing and fantasy, the body and its image; expression in face of norms and position regarding the law; speech and the position in language. Statistical analyses indicated that the scales in which it was possible to verify a difference when the three groups were compared were: Withdrawn and Pervasive developmental problems of CBCL/1.5-5. The scale of Emotionally reactive showed difference when the ASD group was compared to the two control groups, but showed no difference when the other control groups were compared amongst themselves. ROC Curve analysis indicated high sensitivity and specificity to Emotionally reactive (85% e 82%), Withdrawn (87% and 89%) and Pervasive developmental problems (91% and 96%) when the ASD group was compared to the typical development group. Moreover, it indicated lower indices of sensitivity and specificity to Emotionally reactive (85% and 70%), Withdrawn (74% and 70%) and Pervasive developmental problems (85% and 70%) when the ASD group was compared to the ADHD group. Analyses suggest that CBCL/ 1.5-5 can be used for screening of ASD, indicating the scales of Emotionally reactive, Withdrawn and Pervasive developmental problems as the most significant predicting variables, namely those that present the difference in comparison with intergroups. Analyses also show that there was greater sensitivity of CBCL/ 1.5-5 when the ASD group was compared to the control group of typical development

While previous studies have found that a preterm (PT) birth leads to a higher risk for numerous adverse outcomes, including neurodevelopmental and behavioural problems, few, if any, have investigated the consistency of conceivable behavioural problems over time. The aim of this study was to investigate the existence and the stability of behavioural problems from four to eight years of age in a group of 18 children born PT without diagnosed neurological or developmental morbidity, in comparison to a group of 19 children born full term (FT). Additionally, the effects of gestational age (GA) as well as possible associations between behavioural problems and cognitive ability were investigated. Also, differences related to parents’ level of education were observed. Behavioural problems were evaluated with Child Behavior Checklist (CBCL) and cognitive ability was assessed at eight years of age by using Wechsler Intelligence Scale for Children (WISC-IV). Results showed significant differences between the groups regarding cognitive ability where children born PT had lower scores. Contrary to most previous findings, no evident differences between the two groups regarding amount of behavioural problems were found. Children born PT increased in amount of anxiety problems from four to eight years of age, while children born FT decreased, and a lower GA was related to increasing oppositional defiant problems. Generally, the mothers of children born PT had a lower level of education than those of the FT group. Thus, interpretations with caution due to the relatively small number of participants, these initial findings reveal the need for further prospective follow-up studies on the relationship between birth status and the change of behaviour problems in relation to both inter- and intra-effectors over time. / Tidigare forskning har visat att en för tidig födsel leder till en ökad risk för ett antal ofördelaktiga utfall, inklusive neuroutvecklingsrelaterade svårigheter och beteendeproblem. Få studier, om några, har undersökt stabiliteten av potentiella beteendeproblem över tid. Syftet med denna studie var att undersöka förekomst och stabilitet av beteendeproblematik mellan fyra till åtta års ålder i en grupp bestående av 18 barn födda för tidigt, utan neurologiska eller utvecklingsrelaterade störningar, jämfört med 19 barn födda fullgångna. Vidare undersöktes effekten av gestationsålder samt möjliga associationer mellan beteendeproblem och kognitiv förmåga. Skillnader i föräldrarnas utbildningsnivå mellan grupperna undersöktes också. Beteendeproblem skattades med Child Behavior Checklist (CBCL) och kognitiv förmåga bedömdes vid åtta års ålder med hjälp av Wechsler Intelligence Scale for Children (WISC-IV). Resultaten visade signifikanta skillnader mellan grupperna gällande kognitiv förmåga, där barn födda för tidigt hade lägre poäng. I motsats till vad flera tidigare studier funnit så visade vår studie inga signifikanta skillnader mellan grupperna gällande omfattning av beteendeproblem. Barn födda för tidigt uppvisade en ökning av ångestproblem från fyra till åtta års ålder medan barn fullgånget födda uppvisade en minskning, och lägre gestationsålder korrelerade med ökade trotsproblem. Generellt sett så hade mödrar till barn födda förtidigt en lägre utbildningsnivå än de i den fullgångna gruppen. Med försiktiga tolkningar på grund av det relativt låga antalet deltagare visar resultaten ett behov av vidare uppföljningsstudier av sambanden mellan födelsestatus och förändringen av beteendeproblem i relation till både inter- och intra-påverkande faktorer. / The relation between sensory-motor, behaviour functioning and brain development in preterm born children

There is limited research on the effects of antibiotic use during pregnancy on neurodevelopmental outcomes of offspring in early childhood. The aim of this study was to investigate associations between antibiotic use during early pregnancy and neurodevelopmental outcomes, both behavioral and cognitive, in the offspring during early childhood. This thesis examined a longitudinal study of 570 mother-child pairs where prenatal exposures and at least one neurodevelopment outcome assessment were recorded. An interview was conducted with mothers on average one year after delivery to collect information on prenatal exposures. Neurodevelopmental outcomes were assessed between the ages 5–11 years using the cognitive-based outcomes of Peabody Picture Vocabulary Test (PPVT-III) and the Beery-Buktenica Test of Visual Motor Integration-Fifth Edition (VMI-5) and behavioral-based outcomes of the Child Behavior Checklist (CBCL) and Teacher Report Form (TRF). Adjusted mean differences (adjMD) in outcome measures were calculated between mothers reporting antibiotics use and mothers reporting treated infections. Antibiotic use during pregnancy was not significantly associated with the two cognitive measures but was associated with increased total behavioral problems reported by mothers (adjMD: 2.60; CI: 0.50, 4.69) and teachers (adjMD 2.60; 95% CI 0.44, 4.76). Overall, antibiotics use during pregnancy was not associated with differences in childhood cognition but may be associated with greater behavior problems.

<p>Grav språkstörning hos barn kan orsaka beteendeproblem. För barn med primärt grava språksvårigheter finns specialskola att tillgå, så kallad språkskola. Syftet med föreliggande studie var att mäta beteende hos barn på språkskola med hjälp av föräldraenkäten Child Behavior Checklist, CBCL, samt Child Health Questionnaire, CHQ, för att utesluta hälsopåverkan på svarsresultaten.</p><p>En specifik språkskola valdes ut och målsmännen till barnen kontaktades. Elva av dessa godkände deltagande i studien. Barnen var i åldrarna 6:11 till 15:5 år. Svaren från enkäterna sammanställdes, analyserades och jämfördes med normaldata. Problemområden och dess underkategorier som redovisades var inåtagerande och utåtagerande beteende samt en blandad kategori innehållande bland annat social problematik.  Resultatet redovisades deskriptivt.</p><p>Resultatet i föreliggande studie visade att fem barn av elva överskred normvärdet av totalpoängen i CBCL. Vissa av barnen föreföll ha social problematik samt uppmärksamhetssvårigheter. Ingen generell beteendemässig problematik kunde dock påvisas.</p>

Grav språkstörning hos barn kan orsaka beteendeproblem. För barn med primärt grava språksvårigheter finns specialskola att tillgå, så kallad språkskola. Syftet med föreliggande studie var att mäta beteende hos barn på språkskola med hjälp av föräldraenkäten Child Behavior Checklist, CBCL, samt Child Health Questionnaire, CHQ, för att utesluta hälsopåverkan på svarsresultaten. En specifik språkskola valdes ut och målsmännen till barnen kontaktades. Elva av dessa godkände deltagande i studien. Barnen var i åldrarna 6:11 till 15:5 år. Svaren från enkäterna sammanställdes, analyserades och jämfördes med normaldata. Problemområden och dess underkategorier som redovisades var inåtagerande och utåtagerande beteende samt en blandad kategori innehållande bland annat social problematik.  Resultatet redovisades deskriptivt. Resultatet i föreliggande studie visade att fem barn av elva överskred normvärdet av totalpoängen i CBCL. Vissa av barnen föreföll ha social problematik samt uppmärksamhetssvårigheter. Ingen generell beteendemässig problematik kunde dock påvisas.

Résumé: Une recension portant sur 50 ans de recherche sur les routines familiales révèle, entre autres, leur impact sur la santé et l'adaptation psychosociale, tant des parents que des enfants (Fiese et al., 2002). Peu d'informations sur la pratique des routines familiales de la population québécoise sont disponibles. Par le fait même, le profil des relations entre les routines pratiquées par les familles québécoises et d'autres facteurs familiaux et individuels est peu connu. Les routines familiales ont un rôle de médiation dans le cas de plusieurs phénomènes pouvant toucher les membres d'une famille (Kwok et al., 2006; Guidubaldi et al., 1986; Hawkins, 1997; Haugland, 2005; Greening et al., 2007). Les données de cette recherche ont été collectées auprès de 125 dyades mère-enfant provenant de 93 familles. Les enfants (69 filles et 56 garçons) étaient âgés de 5 à 12 ans. Des hypothèses ont été vérifiées afin de prédire la pratique des routines familiales, le stress parental ainsi que l'adaptation de l'enfant. Les routines familiales ont été mesurées selon leur fréquence et l'importance accordée avec le FR1, le niveau de stress parental avec 11SP et l'adaptation de l'enfant avec le CBCL. Les analyses de régression multiple hiérarchique révèlent que les routines familiales sont prédites par le niveau de scolarité de la mère et elles prédisent elles-mêmes !es compétences de l'enfant. Le niveau de stress parental de la mère est quant à lui prédit par la présence de troubles externalisés et un faible niveau de compétences chez son enfant mais également par le SSÉ familial et l'évitement dans le style d'attachement maternel. f.a fréquence des routines familiales, le niveau de scolarité de la mère ainsi qu'un faible stress parental permettent de prédire les compétences de l'enfant. Les variables prédictrices des difficultés d'adaptation de l'enfant sont le stress parental et le SSÉ familial. De plus, des analyses complémentaires montrent que les routines familiales n'ont pas de rôle de modération entre les variables à l'étude. Par ailleurs, les analyses mettent en lumière le rôle médiateur des routines entre la scolarité de la mère et les compétences de l'enfant. Ces résultats doivent être pris en compte par les intervenants psychosociaux puisque les routines familiales sont des pratiques faciles d'enseignement aux familles et ayant une portée significative sur le bien-être des enfants et de la mère dans l'exercice de son rôle. // Abstract: A review covering 50 years of research on family routines demonstrated their impacts on health and psychosocial adjustment among both parents and children (Fiese et al., 2002). However, there is little information available concerning the practice of family routines in Quebec, thus the relationships between the routines that Quebec families practice and other family and individual factors remain poorly understood. Family routines play a mediating role in many experiences that may affect family members (Kwok et al., 2006; Guidubaldi et al., 1986; Hawkins, 1997; Haugland, 2005; Greening et al., 2007). For this study, data were collected from 125 mother-child dyads in 93 families. The children (69 girls and 56 boys) were between 5 and 12 years old. Hypotheses were tested to predict the family routines, parental stress and adaptation of the child. Family routines were measured by frequency and the importance given with the IRF, the level of parenting stress with PSI and the adaptation of the child with the CBCL. The hierarchical multiple regression analyzes revealed that family routines are predicted by the level of maternal education and that they predict the skills of the child. The level of parental stress of the mother is in turn predicted by the presence of externalizing problems and low levels of skills in her child but also by family SES and avoidance in the style of maternal attachment. The frequency of family routines, the level of maternal education and low parental stress predict the skills of the child. The predictors of adjustment problems in children are parenting stress and SES. Bivariate and multivariate analyzes were performed and the results show that family routines play a mediating role between the mother's education and the child's skills. These results should be taken into account by social and mental health workers, because family routines can be easily taught to families and have significant impacts on the well-being of children and of mothers as they try to fulfill their role.

Background: Research has shown that attachment has a powerful impact on the developing brain of a child (Lieberman, 2004). Prevention focusing on the earliest signs of mental illness has the greatest potential for decreasing the risk of mental issues in later life (Ammitzbell et al., 2016). Purpose: The purpose of this project was to train nurses working at the Easter Seals Blake Foundation Nurse Family Partnership Program on the Child Behavior Checklist. The study focused on identification of children who are at risk of mental health problems, largely based on attachment problems, and provide early interventions. Design: The initial step of this study consisted of training home visiting Nurses working at a Nurse Family Partnership Program site in Pima County on the Child Behavior Checklist. The Child Behavior Checklist was meant to be implemented into the program as a secondary mental health screening tool if a child who was 18- or 24-months old was found to be “at-risk” using the Ages and Stages Questionnaire-Social and Emotional Tool. The Child Behavior Checklist, served as a more detailed screening tool if a child was found “at-risk.” Results: During this project, a training on the Child Behavior Checklist was performed. Seven nurses participated in the initial survey, which assessed their thoughts on the current protocols at the Nurse Family Partnership Program. Then their client charts were reviewed to determine if the Child Behavior Checklist was utilized. Lastly, a post survey was sent out to inquire about their thoughts and potential for implementing the Child Behavior Checklist. Implications: From the post survey, it was determined that most nurses thought the Child Behavior Checklist is a great, detailed tool to use if a child is found to be “at-risk.” However, most nurses also stated they did not need to use it due to lack of children having an “at-risk” score using the Ages and Stages Questionnaire-Social and Emotional tool.

The aim of this study was to investigate the associations and differences regarding behaviour- and emotional problems and physical activity (PA) in early school-age children born preterm in comparison to children born full term. The sample consisted of 131 children at age 6-9 (mean age 7.8, including 54 % girls). The participants were divided into four groups depending on weeks of gestational age (GA): extremely preterm (EPT; 22-27 weeks), very preterm (VPT; 28-33 weeks), moderate preterm (MPT; 34-37 weeks) and the control group born at full term (FT; 38-42 weeks). The data were received from parent’s ratings on the questionnaire Child Behaviour Checklist (CBCL). The result showed that children born EPT were rated as having significantly more symptoms of depression, ADHD and conduct disorders, compared to the children born VPT, MPT and FT. The children born EPT also participated more in individual sports rather than team sports and in particular for those children with high ratings on ADHD Scale and Oppositional Defiant Scale. In conclusion, children born EPT seem to have more symptoms on behavioural and emotional problems and therefore more attention is needed to define appropriate interventions for this group to prevent and treat these problems. Even though PA didn’t manifestly decrease with lower GA in this sample it’s likely that bigger differences will show when the children grow older and more investigations are needed to examine the impact of PA among children born PT. / Syftet med denna studie var att undersöka relationer mellan beteende och emotionella problem samt fysisk aktivitet i tidig skolålder hos prematura barn i jämförelse med fullgångna barn. Urvalet bestod av 131 barn i åldern 6–9 (medelvärde 7.8, inklusive 54 % flickor). Deltagarna blev indelade i fyra grupper beroende på gestationsålder: extremt prematura (22–27 veckor), mycket prematura (28–33 veckor), måttligt prematura (34–37 veckor) och kontrollgruppen som bestod av fullgångna barn (38–42 veckor). Datamaterialet inhämtades från föräldrarnas skattningar på enkäten Child Behaviour Checklist (CBCL). Resultaten visade att barn som fötts extremt prematurt skattades ha signifikant mer symtom av depression, ADHD och uppförandestörning jämfört med mycket och måttligt prematura samt fullgångna barn. Barnen som fötts extremt prematurt utövade även mer individuella idrotter och mindre lagidrotter, vilket var speciellt tydligt för barn med höga skattningar på skalorna ADHD och trotssyndrom. Sammanfattningsvis har barn födda extremt prematurt mer emotionella och beteendemässiga problem jämfört barn med längre gestationsålder, och utifrån det behövs mer fokus på att utforma lämpliga interventioner för att förebygga och behandla dessa problem. Även om fysisk aktivitet inte visade sig minska med lägre gestationsålder i vårt urval är det troligt att större skillnader kommer visa sig när barnen blir äldre och vidare undersökningar krävs för att avgöra hur fysisk aktivitet kan tänkas påverka utfallen för prematura barn.

O consumo de álcool durante a gestação tem sido associado a alterações no desenvolvimento físico, neurológico e comportamental da criança, sendo que muitas das consequências sobre o desenvolvimento infantil apresentam ampla variação em extensão e gravidade. Os efeitos podem variar desde uma relativa normalidade até a morte perinatal e Síndrome Fetal do Álcool (SFA). No presente estudo foi avaliado o desenvolvimento cognitivo de crianças em idade escolar em relação ao padrão de consumo de álcool materno. Foram avaliadas oitenta e seis crianças de 8 a 9 anos de idade cujas mães (N = 449) haviam sido entrevistadas em 2001 durante o terceiro trimestre de gestação sobre o padrão de consumo de álcool e outras substâncias psicoativas, em um serviço obstétrico municipal da rede pública. Para avaliação cognitiva do grupo de crianças na idade escolar foi utilizada a Escala de Maturidade Mental Columbia (EMMC). O grupo constituído pelas mães ou cuidadores respondeu a um questionário sobre as condições sociodemográficas, saúde geral, e uso materno de álcool durante a gestação e recente. Foi realizada uma anamnese sobre o desenvolvimento neuropsicomotor e condições clínicas pregressas e atuais da criança. Foi utilizado o Child Behavior Checklist (CBCL 6-18 anos) para a identificação de problemas de saúde mental na infância. Resultados mostram que, em relação à avaliação cognitiva das crianças, o RPI (resultado padrão por idade) variou de 64 a 134, com valor médio de 99,95 (± 16,01) e mediana de 103. Associação estatisticamente significativa foi observada entre os escores de RPI acima de 99,95 e maior idade materna e maior peso ao nascimento (p = 0,01 e 0,05 respectivamente). Diferença significativa também foi observada em relação ao número de filhos. Crianças com famílias com três ou mais filhos apresentaram RPI médio de 106,4 versus RPI de 99,10 para aquelas com famílias com menos de três filhos (P=0.04). Separando a amostra por gênero, observamos escores médios menores na Escala de Maturidade Mental Columbia em meninos filhos de mães que declararam cor mulata ou negra (p = 0,02), que fizeram uso em dias de qualquer quantidade de álcool na gestação maior que a média (p = 0.01) e também naqueles em que as mães usaram três ou mais doses de álcool por ocasião durante a gestação acima da média (p < 0.0001). Não foram observadas diferenças significativas para as outras variáveis analisadas. Em relação aos problemas de comportamento quando avaliados pelo CBCL, diferenças significativas foram observadas em relação ao uso de álcool durante a gestação no 2º, 3º trimestres e uso nos três trimestres com dados do GESTA-ÁLCOOL (p = 0,05, p = 0,01 e p = 0,02 respectivamente) e no 1º trimestre da gestação (p = 0,05), uso de qualquer quantidade de álcool em dias acima da média (p = 0,01), uso de três ou mais doses por ocasião acima da média (p = 0,05) com dados do INFANTO-ÁLCOOL. Foram observadas também diferenças significativas em relação ao uso atual de tabaco (p = 0,006), religião (p = 0,03) e escores médios de RPI da Escala de Maturidade Mental Columbia (p = 0,002) e escores de RPI um desvio-padrão abaixo da média (p = 0,03). Não foram observadas diferenças de média para nenhuma das outras variáveis analisadas. O uso leve/moderado de álcool na gestação esteve associado ao menor desempenho cognitivo e problemas comportamentais totais, especialmente em meninos. Estudos controlados com um número maior de casos e a introdução de marcadores biológicos de exposição ao álcool na gestação são necessários, a fim de possibilitar uma detecção precoce dos efeitos adversos, uma melhor compreensão da gravidade e da extensão dos danos no desenvolvimento cognitivo e identificação de funções cognitivas específicas que possam ser mais afetadas pela exposição pré-natal ao álcool, propiciando uma intervenção precoce nos possíveis déficits encontrados. / Prenatal alcohol exposure has been associated to problems in physical, neurological and behavioral child development and many of the consequences on childhood development show a wide range in extension and severity. The effects can vary from relative normality to perinatal death and fetal alcohol syndrome (FAS). In this study we analyzed the cognitive development of children at school age regarding to the maternal alcohol consumption at pregnancy. We evaluated eighty six children from eight to nine years old whose mothers (N = 449) have been interviewed in 2001 during the third trimester of pregnancy about the alcohol and other psychoactives substances pattern consumption, in a public obstetric hospital. Children cognitive status was assessed using the Columbia Mental Maturity Scale (CMMS). The group composed by mothers or caretakers answered a questionnaire about socio-demographic data, general health, prenatal and recent alcohol use. A brief anamnesis on neuropsychomotor development and previous and recent clinical conditions was made. The Child Behavior Checklist (CBCL 6-18 years) was used to identify mental health disorders in childhood. Regarding to the children cognitive evaluation results showed that the ADS (age deviation scores) range from 64 to 134, with a mean value of 99.95 (± 16.01) e median of 103. Statistical significant association was found between RPI scores above 99.95 and older maternal age and birth weight (p = 0.01, p = 0.05 respectively). Analyzing the sample in relation to gender, we observed lower scores in Columbia Mental Maturity Scale in boys whose mothers declared color mulatto or black (p = 0.02), used in days any quantity of alcohol during pregnancy higher than average (p = 0.01) and also in those boys whose mothers used three or more doses of alcohol per occasion during pregnancy above average (p < 0.0001). No significant differences were observed for other variables analyzed. Significant differences were observed in relation to total behavior problems, when evaluated by CBCL, and alcohol use during gestation in 2nd, 3rd trimesters and use in all three trimesters with prospective data (p = 0.05, p = 0.01 and p = 0.02 respectively) and in 1º trimester of pregnancy (p = 0.05), use of any quantity of alcohol in days above average (p = 0.01), use of three or more doses per occasion above average (p = 0.05) with retrospective data. Significant differences were also observed in relation to recent tobacco use (p = 0.006), religion (p = 0.03), mean scores of RPI in Columbia Mental Maturity Scale (p = 0.002) and scores of RPI one standard deviation below the mean (p = 0.03). No differences were observed for other variables analyzed. Our findings suggest that, up to now, low/moderate alcohol use in gestation was associated to lower cognitive performance and total behavior problems, especially in boys. More controlled studies using a larger number of subjects and the introduction of biological markers of alcohol exposure in pregnancy are necessary in order to detect the adverse effects, to understand the extension of damages in cognitive development and to identify specific cognitive functions that could be more affected by prenatal alcohol exposure, contributing for development of early interventions.