Diese Dissertation basiert auf einer auf den Menschen bezogenen, multidimensionalen Betrachtung von Entwicklung. Sie soll empirisch Übereinstimmungen und Determinanten der Gesundheit von Kindern in Ländern mit niedrigem und mittlerem Einkommen analysieren. Der erste Essay – mit verfasst von Stephan Klasen - wendet bivariate Cluster Analyse an, um die Beziehung der Verbesserungen verschiedener Gesundheits- und Bildungsindikatoren der Millennium Development Goals (MDG) zu untersuchen. Die MDGs beinhalten Schlüsselaspekte des menschlichen Wohlbefindens und sollten daher eng miteinander verkoppelt sein. Trotz der substantiellen theoretischen Grundlage für enorme Synergien zwischen MDG Zielen, ist die empirische Heterogenität der Kopplung der Prozesse zwischen verschiedenen MDGs erheblich groß.  Die zentrale Fragestellung des ersten Essays dieser Dissertation ist daher, ob klare Gruppen eben jener Länder ausgemacht werden können, in denen derartige Synergien existieren (und in denen diese nicht existieren), und was die Zugehörigkeit in derartigen Gruppen treibt.   Unser Beitrag ist, den MDG Fortschritt durch Indikatoren relativer Leistung zu definieren. Diese bezeichnen die Änderungsrate, die die empirisch "erwartete" Änderungsrate bei gegebenen ursprünglichen Bedingungen übersteigt. Diese Maßnahme erlaubt es uns für den unterschiedlichen Grad an Ambition impliziert durch die MDGs bei Ländern mit unterschiedlichen Ausgangslagen zu kontrollieren und lässt uns im Grunde fragen ob Länder, die außerordentlichen Fortschritt bei der Erreichung von MDGs gemacht haben, von Synergien profitiert haben. Indem wir die Cluster Analyse auf diese Indikatoren der relativen Leistung in Bezug auf verschiedene MDG Indikatoren für Gesundheit und Bildung anwenden konnten wir jene Länder, in denen sich Indikatoren in die selbe Richtung ("gute" oder "schlechte" Performer) bewegten, von solchen Ländern unterscheiden, bei denen sich Indikatoren in unterschiedliche Richtungen ("partielle" Performer) bewegten. Unsere Ergebnisse legen nahe, dass Synergien existieren, diese jedoch nur bei einer eingeschränkten Gruppe von Ländern auftreten (die "guten" Performer, die mit Fortschritt einhergehen und die "schlechten" Performer, die mit Rückschritt einhergehen). Andererseits können wir zeigen, dass bei einer beträchtlichen Anzahl an Ländern Synergien schwach oder abwesend sind, was zu umgekehrten Bewegungen  im MDG Fortschritt bei mindestens einem oder zwei Paaren von nicht einkommensbezogenen MDG Indikatoren führt. Unsere Regressionsergebnisse zeigen, dass diese partielle Performance gut durch steigende Ungleichheit und niedrige institutionelle Qualität erklärt wird. Andererseits kann Wirtschaftswachstum, welches als die robusteste Determinante der Cluster-Zugehörigkeit erscheint, insbesondere gute von schlechten Performern unterscheiden. Der zweite Essay - in alleiniger Urheberschaft - analysiert die kurz- und langfristigen Determinanten von Errungenschaften bei der Gesundheit von Kindern unter Verwendung von Längsschnittsdaten aus Indonesien. Basierend auf dem analytischen Ansatz von Mosley und Chen (1984), werden insbesondere die Effekte einer Reihe von kindspezifischer, Haushalts- und Gemeindecharakteristika auf den Ernährungszustand von Kindern, gemessen in height-for age z-scores, betrachtet. Der besondere Beitrag dieser Studie ist die Verwendung von Paneldaten auf der Mikro-Ebene und einer Methodologie (dem Mundlak-Ansatz für fixe  Haushalteffekte), die  robuste und unverzerrte Schätzungen liefert. Desweiteren ermöglicht sie die Identificationkurz- und langfristiger Effekte unmittelbarer und sozioökonomischer Determinanten der Gesundheit von und trägt so zur bestehenden Literatur bei. Die Ergebnisse legen nahe, dass mütterliche Bildung einen positiven und langfristigen Einfluss auf die Gesundheit von Kindern hat. Dies zeigt sich teilweise in reproduktivem Verhalten und wird teilweise durch Praktiken im Umgang mit Kindern (d.h. Stillen) vermittelt. Andererseits zeigt sich kein langfristiger Effekt von Einkommen, obgleich temporäre Einkommenssteigerungen zu höheren Ausgaben und somit zu einer Verbessereung des Eernährungsstatus führen., Hierbei zeigt nur der Erwerb und die Verwendung von Vorleistungsgütern der Gesundheitsproduktion wie einer verbesserten Hygieneinfrastruktur einen ausgeprägten und signifikanten Einfluss auf die Gesundheit von Kindern. Insgesamt implizieren die Ergebnisse, dass eine Politik der Linderung von Einkommensarmut ergänzt durch Investitionen in grundlegende Gesundheitsinfrastruktur erheblich dazu beitragen, die Gesundheit von Kindern zu verbessern. Da der Zusammenhangzwischen der Bildung von Müttern, Praktiken der Kindesernährung und der Gesundheit von Kindern stark ausgeprägt ist, könnten auch Strategien, die die Qualität von Bildung erhöhen,  den Ernährungszustand von Kindern verbessern. Der dritte Essay - in alleiniger Urheberschaft - untersucht die Auswirkungen des Ernährungszustandes auf den Bildungserfolg. Dabei werden Paneldaten auf der Miko-Ebene aus Indonesien verwendet. Außerdem wird eine Spezifikation mit Mutter-Fixed Effects, die durch einen Instrumentalvariablen-Ansatz erweitert wird, verwendet um für mögliche Korrelationen zwischen verschiedenen Komponenten des Fehlerterms und der unabhängigen Variable zu kontrollieren. Wir nutzen Flächenbrände, die im Jahr 1997 in Inodensien zu einer Dürre führten, und Variation zwischen Geschwistern und identifizieren so den Effekt des Ernährungszustands in den frühen Lebensmonaten auf den späteren Bildungserfolg. Schätzungen zeigen, dass Gesundheitskapital (gemessen in height-for-age z-scores in der Kindheit) die Anzahl an abgeschlossenen Schuljahren und das Ergebnis bei kognitiven Testes signifikant positiv beeinflusst.  Dies impliziert, dass von einer politischen Perspektive aus Zielsetzungen im Bereich Schule und Ernährung nicht als rivalisierend betrachtet werden sollten, sondern eng miteinander verzahnt sind. Daher konkurrieren finanzielle Ressourcen, die der Kindesernährung gewidmet sind, nicht unbedingt mit solchen für Bildungszwecke. Im Gegensatz könnten sie - wie in diesem Essay beschrieben - als eine kosteneffizientere Art betrachtet werden, gegenwärtige und zukünftige sozio-ökonomische Entwicklung anzuheben.

Of all motor skills, manual reaching might be the one ability that matters most for infants’ perceptual, cognitive and social development. Reaching allows infants to learn about object properties, but also gives opportunities for socializing with others. The general aim of the present thesis was to study the importance of manual motor development in infancy from different perspectives; first, through examining stereopsis as a prerequisite for efficient reaching development, second, with regard to understanding others goal-directed reach actions by means of the mirror neuron system (MNS), and third, in relation to possible atypical development, with a specific focus on autism spectrum disorder (ASD). Study I shows that under monocular viewing conditions, infants at six, eight and 10 months of age perform slower and less accurate reaches. Longer times to object contact during monocular trials specifically imply that motor prediction is less effective when depth and distance information is compromised. Study II demonstrates that, by eight months of age, infants seem to have a MNS that functions in a similar manner to the adult MNS, thus activity can be registered over the motor cortex when infants simply observe an action they can master themselves. This activation is predictive, indicating anticipation of the goal of the observed reach. Study III indicates that infants at elevated familial risk for ASD present with reduced prospective motor control at 10 months of age. Compared to a low-risk control sample, high-risk infants perform reactive rather than predictive reach actions. Follow-up assessment at 36 months will show whether this measure can be used as a predictive diagnostic marker for ASD. The main contribution given by this work is the insight that it is important to take manual motor aspects into account when considering typical as well as atypical cognitive and social development, and in addition, that motor prediction is a key factor behind being able to timely execute and understand reaching actions.

Made available in DSpace on 2016-06-02T20:44:12Z (GMT). No. of bitstreams: 1 5126.pdf: 1687281 bytes, checksum: 393596b569cb3b9980b77e9f5435b36e (MD5) Previous issue date: 2013-02-28 / Financiadora de Estudos e Projetos / Literature has pointed to the importance of intergenerational relationships in families of children with and without disabilities. Once the familiar universe of a child goes beyond the interaction that he establishes with his mother, involving fathers, siblings, grandparents and other individuals, the focus of intergenerationality has contributed to the understanding of developmental processes and family adaptation in families of children with and without developmental abnormalities. Furthermore, studies indicate the need for greater understanding about the family s factors associated with stress reported by the elderly. The aim of this study was to identify the experiences of families of children with intellectual disabilities and typically developing children, about daily life, support practices and intergenerationality from the perspective of three generations - grandmothers, mothers and siblings. As the specific objectives we have: (1) assess the differences and similarities in patterns of intergenerational relationships and daily life of the two family groups represented, (2) identify the presence of stress in participant grandmothers. The study included 36 family members of 12 families of children with intellectual disabilities and typically developing children who were linked to public and / or philanthropic schools located in countryside of Sao Paulo - Brazil, who had older siblings and grandparents living in the same city. For data collection were used: 1) Identification questionnaire of the child and family, 2) Economic Classification Criterion Brazil (CCEB), 3) Semi-structured roadmap interviews for mothers, grandmothers and siblings of the children; 4) Inventory stress symptoms for adults (ISSL). The data obtained through the identification questionnaire, the CCEB and the ISSL were analyzed using descriptive statistics. The interviews were analyzed qualitatively using the technique of the Collective Subject Discourse. The main findings indicate that grandmothers of both family groups studied represent an important source of support for the family. Moreover, the intergenerational relationship between grandmothers and their older grandchildren presented as positive in the lives of all involved, with no significant differences between groups. However, in the case of families of children with disabilities, it was observed that the interaction between grandmothers and older grandchildren is increased with specific features of this reality, since the grandmothers seem to interfere more in the relationship between siblings than the grandmothers of typically developing children do. Furthermore, older siblings, in these families were identified as important support to their mothers and siblings with disabilities. About the stress experienced by the third generation, the results from the application of ISSL revealed that the majority of grandparents of children with disabilities are stressed, while only one grandmother of typically developing children showed symptoms of stress. It is argued about the contribution of intergenerational relationships in the development of all family members and is pointed up, in the case of grandmothers of children with disabilities, about the importance of considering them in the guidance and clarification about the issue of the child. It is emphasized on the importance of intergenerational studies and the need for education and health activities that promote and strength the intergenerational connections. / A literatura aponta para a importância dos relacionamentos intergeracionais em famílias de crianças com e sem deficiência. Uma vez que o universo familiar de uma criança vai muito além da interação que esta estabelece com sua mãe, envolvendo os pais, irmãos, avós e outros indivíduos, o enfoque da intergeracionalidade tem contribuído para a compreensão dos processos de desenvolvimento e adaptação familiar em famílias de crianças com e sem alterações no desenvolvimento. Além disso, estudos apontam sobre a necessidade de maior compreensão acerca dos fatores familiares associados ao estresse relatado por idosos. O objetivo do presente estudo foi identificar a experiência de famílias de crianças com deficiência intelectual e de crianças com desenvolvimento típico, acerca do cotidiano, das práticas de apoio e da intergeracionalidade, sob a ótica de três gerações avós, mães e irmãos. Como objetivos específicos, tem-se: (1) verificar diferenças e semelhanças nos padrões de relacionamento intergeracional e no cotidiano dos dois grupos familiares representados; (2) identificar a presença de estresse nas avós participantes. Participaram do estudo 36 familiares de 12 famílias de crianças com deficiência intelectual e desenvolvimento típico, que estavam vinculadas a escolas públicas e/ou filantrópicas localizadas em uma cidade do interior do estado de São Paulo, que tinham irmãos mais velhos e avós residindo na mesma cidade. Para coleta de dados foram utilizados: 1) Questionário de identificação da criança e da família; 2) Critério de Classificação Econômica Brasil (CCEB); 3) Roteiros de entrevistas semiestruturadas para mães, avós e irmãos das crianças; 4) Inventário de sintomas de stress para adultos (ISSL). Os dados obtidos por meio do Questionário de identificação, do CCEB e do ISSL foram analisados por meio de estatística descritiva. As entrevistas foram analisadas qualitativamente por meio da técnica do Discurso do Sujeito Coletivo. Os principais resultados apontam que as avós de ambos os grupos representam importante fonte de apoio à família. Além disso, o relacionamento intergeracional entre as avós e seus netos mais velhos apresentou-se como positivo na vida de todos os envolvidos, não havendo diferenças marcantes entre os grupos. Contudo, no caso das famílias de crianças com deficiência, observou-se que a interação entre avós e netos mais velhos é acrescida de características específicas desta realidade, uma vez que as avós parecem interferir mais no relacionamento entre os irmãos do que o fazem as avós de crianças com desenvolvimento típico. Além disso, os irmãos mais velhos, nestas famílias, foram apontados como importante fonte de apoio às mães e aos irmãos com deficiência. Acerca do estresse vivenciado pela terceira geração, os resultados advindos da aplicação do ISSL revelaram que a maior parte das avós de crianças com deficiência encontra-se estressada, enquanto que apenas uma avó das crianças com desenvolvimento típico apresentou sintomas de estresse. Discute-se sobre a contribuição de relacionamentos intergeracionais no desenvolvimento de todos os membros da família e aponta-se, no caso das avós das famílias de crianças com deficiência, sobre a importância de considerá-las ao orientar e esclarecer sobre a problemática da criança. Ressalta-se para a importância de estudos intergeracionais e para a necessidade de ações de saúde e educação que promovam e fortaleçam os vínculos intergeracionais.

L’œuvre de Sylvie Germain, traversée par de nombreuses références mythiques et bibliques, invite à une lecture polyphonique du monde. Lieu privilégié pour interroger l’originaire, la famille, structurée par des liens complexes d’affiliation, de filiation et d’alliance, devient la scène où se jouent et se rejouent les drames individuels et collectifs, se fomentent les meurtres comme les lumineuses adoptions. Caisse de résonnance particulièrement sensible aux désastres du monde qui la traversent, elle fait parvenir, en sourdine ou en éclats, les flux et reflux généalogiques qui atteignent ses membres. À partir d’une étude approfondie des différentes figures familiales, ce travail explore les situations de violences primitives et les cheminements qui conduisent à la réconciliation du sujet avec son enfance et sa mémoire. / The work of Sylvie Germain is pervaded by numerous mythical and biblical references, which causes the reader to be immersed in a polyphonic process. It appears as a relevant field of study to raise questions related to both origin and family, equally structured by complex lineage bonds, lines of descent and alliances. It can become the stage on which individual and collective dramas are performed; murders are contrived under the appearance of luminous adoptions. The work of Sylvie Germain echoes the world’s disasters and leads the reader to perceive the ebb and flow of genealogy affecting all relatives in a dim or deafening manner. This study explores the situation of violence based on a thorough analysis of the status of the various family members and itinerary which enables the subject to come to terms with childhood and awakened memories.

Sibling relationships are dynamic within any family context and disabilities add a different and even more complex dimension to a family context. In addition, inclusion is a relatively new concept in South Africa, especially as an inclusive society. This means that it is challenging for a family that has children with disabilities to live and function in the greater society as children with disabilities have specialised needs and expectations. However, siblings of children with disabilities have their own needs and expectations as participating individuals within a family context and within society; therefore it is of relevance to be fully aware of their personal views, perceptions, understanding and challenges they are confronted with. The primary aim of this study was to gain a rich and in-depth understanding of how the disabilities of a child could impact on a non-disabled sibling. With the above mentioned taken into account, siblings of children with disabilities are faced with an array of unique challenges that may change as the siblings develop, therefore, this study focused on siblings who are in their middle childhood phase (six to twelve years old). Qualitative research methods were applied to gain an in-depth understanding of the children‘s experiences and views. The review of the literature provided the theoretical framework against which the qualitative research was conducted. Semi-structured interviews were constructed from the comprehensive literature review. Observations and documents were also used as research instruments to collect descriptive and supportive data. Interpretations were made from the data collected. The literature review exposed and recognised variances regarding sibling experiences about living with children with disabilities. Five information rich participants were interviewed. The findings of this empirical investigation revealed that not all the siblings identified the same experiences as shared experiences of being siblings to children with disabilities. Therefore, it is recommended that the challenges these siblings are faced with should be taken into account since it has been revealed that there seems to be a need to support these siblings and their families. The whole family is a nested system interacting with each other, within the family system and with other systems beyond the family system, including the wider community and society. Thus, siblings need regular, understandable and updated information as they grow up, regarding the challenges the families are faced with, pertaining to the disabilities experienced, within this nested system. / Psychology of Education / M. Ed. (Guidance and Counseling)

Made available in DSpace on 2016-06-02T19:46:12Z (GMT). No. of bitstreams: 1 3066.pdf: 3447240 bytes, checksum: a21a8ddc4d41cf9f065cbdf1a92fadce (MD5) Previous issue date: 2010-03-01 / Financiadora de Estudos e Projetos / Group interventions may be a useful strategy for helping siblings of disabled children to cope with difficulties related to the special sibling. The purposes of the present study were: 1) to identify the main needs of older siblings of disabled children; 2) to prepare and implement one group intervention and 3) to identify changes in some aspects of the participants lives, such as interaction between the siblings, coping strategies and knowledge about the sibling s disability . Study participants were eight pre-adolescents and adolescents aged 10 to 15 years, divided into Group 1 (G1) and Group 2 (G2). Participants underwent three evaluations, at least one before the intervention and one after it. The instruments used were the Entrevista com Irmão de Indivíduo com Necessidades Especiais (Interview with Sibling of Disabled Individual), the Formulário de Irmãos (Sibling s Questionnaire) and the Inventário de Estresse e Enfrentamento (Stress and Coping Inventory), besides the Questionário de Satisfação com o Grupo de Apoio (Satisfaction of the Support Group Questionnaire), the last one were applied at the end of the intervention. The study also conducted interviews with the mothers of the participants. The intervention was conducted in nine sessions, once a week, lasting two hours each, first with the G1 and then with the G2. The data were analyzed descriptively and/or quantitatively, and the results were compared immediately before and immediately after the intervention. The comparison was done for each participant in order to obtain evidences of changes in aspects related with the session s themes. The results indicated that after the intervention there was an increase of knowledge about the siblings disability and related aspects; variation of the interaction levels between siblings and the kind of behaviors directed at them; variation in the stress levels and in the strategies used to deal with difficult situations related to his brother or sister, demonstrating the role of intervention that is modify some aspects of participants lives. This study draws attention to the importance of group interventions applied to this kind of population, appropriate to his age and his needs. / Intervenções em grupo podem ser uma estratégia útil para ajudar irmãos de crianças com necessidades especiais (NEs) a lidar com dificuldades relacionadas ao irmão especial. O presente estudo teve como objetivos: 1) identificar as principais necessidades de irmãos mais velhos de crianças com NEs; 2) elaborar e implementar uma intervenção em grupo; e 3) identificar mudanças em aspectos da vida dos participantes, como interação com o irmão especial, enfrentamento e informações sobre a deficiência do irmão. Participaram do estudo oito pré-adolescentes e adolescentes com idade entre 10 e 15 anos, divididos em Grupo 1 (G1) e Grupo 2 (G2). Os participantes passaram por três avaliações, sendo pelo menos uma antes da intervenção e uma depois. Os instrumentos aplicados foram a Entrevista com Irmão de Indivíduo com Necessidades Especiais, o Formulário de Irmãos e o Inventário de Estresse e Enfrentamento, além do Questionário de Satisfação com o Grupo de Apoio aplicado ao fim da intervenção. Entrevistas também foram realizadas com as mães dos participantes. A intervenção foi realizada em nove sessões, uma vez por semana, com duração de duas horas cada, primeiramente com o G1 e depois com o G2. Os dados obtidos foram analisados de forma descritiva e/ou quantitativa, e comparações entre os resultados imediatamente antes e imediatamente depois foram feitas para cada participante, a fim de obter indícios de mudanças nos aspectos trabalhados durante as sessões. Os resultados indicaram que após a intervenção houve um aumento de conhecimentos sobre a deficiência do irmão e aspectos relacionados; variabilidade em relação aos níveis de interação com os irmãos e aos tipos de comportamentos dirigidos a eles; variabilidade também quanto aos níveis de estresse e às estratégias utilizadas para enfrentar situações difíceis relacionadas ao irmão; demonstrando o papel da intervenção em modificar alguns aspectos da vida dos participantes. O presente estudo chama atenção para a importância de se realizar intervenções em grupos com essa população, adequadas à sua faixa etária e às suas necessidades.

Inledning: En prematur födsel framkallar ofta en kris i en familj, syskon blir oftast inte tillräckligt sedda i samband med att ett barn föds mycket för tidigt. Syftet med denna studie var att undersöka syskons och föräldrars upplevelse med ett särskilt fokus på syskonens upplevelse av att få ett extremt för tidigt fött syskon d.v.s. född v 28 och tidigare med en födelsevikt under ett kilo - v < 28 < 1000 g. Frågeställningarna i undersökningen fokuserade på förväntningar på att få ett syskon, vad som präglade tiden på neonatalavdelningen för föräldrar och syskon och hur har familjen föräldrar och syskon påverkats av att få ett extremt för tidigt fött barn. En kvalitativ metod valdes, studien bygger på fyra semistrukturerade intervjuer med syskon i åldrarna tio till femton år och fem kvalitativa föräldraenkäter. Resultatet min studie överensstämmer med vad tidigare forskning kommit fram till inom flera områden. Den neonatala tiden präglades av många känslor alltifrån stark förtvivlan till glädje och lycka. En tid som kom att innefatta mycket av oro för såväl syskon som föräldrar. Starka konfliktkänslor väcktes hos föräldrarna av att inte räcka till för både hemmavarande syskon och för det prematurfödda barnet. Separation och en splittrad familj upplevdes av alla respondenter. Syskonen beskriver en stark avsaknad utav sin mamma. Vardagen för familjerna blev kaotisk, stressig och rörig med lite tid för återhämtning. Diskussion: Flera studier påvisar, sårbarhet av att syskon inte tillräckligt uppmärksammas i samband med en prematur födsel. Vidare forskning inom området utifrån ett familjeperspektiv behövs. Med hänsyn till familjemedlemmars olika behov att hantera och bearbeta, en ofta traumatisk upplevelse som av att få ett mycket förtidigt fött barn. / Introduction A premature birth often provoke a crisis in the family, siblings are often not sufficiently taken in connection with a child is born very prematurely. The purpose of this study was to investigate the siblings and parents 'experience with a particular focus on the siblings' experience of getting an extremely premature siblings, that is, Born rows 28 and earlier with a birth weight under one kilogram - v <28 <1000 g. The questions in the survey focused on expectations about getting a sibling, what marked time in the neonatal unit, and how the family can be affected by getting an extremely prematurely given birth. A qualitative method was chosen, the study is based on four semi-structured interviews with siblings between the ages of ten to fifteen years and five qualitative parental questionnaires. The results my study correspond well with earlier research findings. The neonatal period was characterized by many emotions from strong despair to joy and happiness. A time that was to include a lot of concern for both siblings and parents. Strong conflicting emotions aroused in the parents by not being good enough for both at home and siblings of the prematurely born child. Separation and a broken family experienced by all respondents. Siblings describe a strong absence out of her mother. Everyday life for the families became chaotic, stressful and chaotic with little time for recovery. Discussion several studies demonstrate the vulnerability of the siblings are not sufficiently addressed in the context of a premature birth. Further research in this area from a family perspective is needed. With regard to the family members of the need to manage and process, an often traumatic experience of getting a very premature baby.

Compared to other children, children with Autism Spectrum Disorder (ASD) are known to engage less in joint attention - the sharing of attention between two individuals toward a common object or event. Joint attention behaviors - for example gaze following, alternating gaze, and pointing - play an important role in early development, as they provide a foundation for learning and social interaction. Study I and Study II focused on infant siblings of children with ASD. These infants, often termed high risk (HR) infants, have an increased probability of receiving a later ASD diagnosis. Studying them therefore allows for the detection of early signs of ASD. Live eye tracking was used to investigate different joint attention behaviors at 10 months of age. Study I showed that omitting the head movement that usually accompany experimenters’ eye gaze shifts in similar designs reduced gaze following performance in the HR group, but not in a group of infants at low risk (LR) for ASD. HR infants may thus be less sensitive to eye information, or may need more salient cues in order to follow gaze optimally. Study II focused on the infants’ tendency to initiate joint attention by alternating their gaze between a person and an event. LR infants engaged more in alternating gaze than HR infants, and less alternating gaze in infancy was associated with more ASD symptoms at 18 months. This relation remained when controlling for visual disengagement and general social interest in infancy. Study III explored the role of joint attention later in development, by investigating the microstructure of the looking behaviors of autistic and typically developing children (~6 years old). The results indicated that seeing somebody look at an object influenced the processing of that object less in autistic children than in the typically developing controls. Both groups followed gaze effectively, suggesting that differences in joint attention at this age may be subtle, but detectable with eye tracking technology. Together, the studies contribute to our understanding of the role that joint attention atypicalities play both in the early development of infants at risk for ASD, and later in the development of children with a confirmed diagnosis.

The study of the loss of a sibling in mainstream bereavement literature has been largely neglected in psychology. This sentiment has often, and still continues, to be expressed by those outside and within the psychological field. The focus in the childhood bereavement literature has been on the loss of a parent and, in adulthood, on the loss of a child or of a spouse. Despite the growing interest in sibling loss in more recent times (since the 1980s), more specifically in childhood and adolescent sibling loss, in reality bereaved siblings remain ‘forgotten’ and even marginalised. The present study concerned the experience of the loss of a brother or sister in young adulthood, an area that has been largely neglected. The phenomenon was explored using a qualitative approach and employing the empirical phenomenological psychological research method as articulated by Amedeo Giorgi. In-depth interviews with three research participants who were asked to describe their experience of the loss of their sibling were used to gather the data. The emphasis was on discovery, on allowing the siblings to speak for themselves by posing an open-ended question rather than focusing on isolated aspects of the loss experience. The general psychological structure revealed that the experience of the loss of a brother or sister evolves over time and cannot meaningfully be understood as an event that can be contained within a specified moment in time. The experience is a fundamentally relational and paradoxical phenomenon and is reflective of the context in which it occurs. With the loss, the sibling's whole world changes in a very radical way. It is a triple loss: the loss of the brother or sister, the loss of the family unit and the 'loss' of the parents as the siblings had known them. Initially bereaved siblings put aside their grief in an attempt to protect parents and significant others. A conspiracy of silence evolves which conceals their pain and as they continue with life as ‘normal’ there is a deceptive belief of ‘coping well’, of personal stability. Yet internally the bereaved sibling struggles with intense emotions and a lonely struggle ensues. The lack of acknowledgement of the sibling’s grief by others compounds the sense of isolation and alienation and he/she begins to feel like an “implicated alien”, a participant-spectator; part-of and also apart-from the grief situation. Finding a safe space to grieve is critical to bereaved siblings and when this is possible they are able to let go of their deep emotions and grieve the loss of their brother or sister. The loss of a sibling is the experience of losing various parts of the self and needing to reclaim and reintegrate self. The main contribution of this study can be described as providing insights concerning the complex, multi-layered and multi-dimensional process of this loss experience to clinicians and others who care for bereaved siblings. Where the extant psychoanalytic and object relations literature is willing to concede that a sibling relationship exists, screened behind parental relationships, the present study reveals that siblings have a unique relationship of their own and that the loss of this relationship demands radical mourning. This study also reveals that death in the family is a fundamentally relational experience. The loss of a sibling and the loss of a child frequently overlap and tumble into each other and it is difficult to know for whom the sibling is grieving at any particular moment. Thus, grief over the loss of a brother or sister cannot be reduced to a purely intra-psychic or psycho-social process. The fact that sibling grief is not visible, does not mean that it does not exist. Clinicians and caregivers need to be aware of the existential chaos, the trauma, and the ambiguous and paradoxical nature of the sorrow experienced by a sibling-who-loses-a-sibling. Future research into the loss of a brother or sister beyond young and middle adulthood, an area that has also largely been neglected, would constitute an important contribution to the psychology of siblings and of sibling loss/bereavement throughout the life cycle. Also significant would be the exploration of what happens in the sibling group following the loss of one of their members. / Thesis (PhD (Psychotherapy))--University of Pretoria, 2007. / Psychology / unrestricted

Cette recherche ancrée principalement sur une approche systémique, propose d’évaluer l’impact de la déficience intellectuelle d’un enfant sur son environnement familial et en particulier sur ses frères et sœurs. Le handicap d’un enfant ne touche pas uniquement celui qui en est atteint, mais constitue une information signifiante pour le système familial qui va modifier ses interactions en fonction d’elle. Nous nous intéressons, dans cette étude, au vécu subjectif des frères et sœurs, âgés entre 6 et 12 ans, d’enfants porteurs de déficience intellectuelle. Nous avons réalisé une étude comparative entre un groupe expérimental composé de 27 familles et 34 frères et sœurs confrontés à la déficience intellectuelle et un groupe témoin composé de 19 familles et de 24 frères et sœurs sur la nature de la relation fraternelle (proximité, conflits, rivalité), la fonctionnalité de la typologie familiale (« équilibrée », « moyennement équilibrée » ou « extrême »), le sentiment d’intégration sociale (en famille, dans les collectivités et parmi les pairs) et le degré de dépression. La variable indépendante est la présence ou non d’un enfant porteur d’une déficience intellectuelle dans la famille. Nous souhaitons ainsi montrer l’impact de la présence d’un enfant porteur d’une déficience intellectuelle dans la famille. Nous avons également procédé à une étude corrélationnelle entre les variables retenues (nature de la relation fraternelle, fonctionnalité de la typologie familiale, sentiment d’intégration sociale et degré de dépression) afin d’identifier les facteurs de risques et de protection pour ces fratries. Les résultats obtenus indiquent que peu de différences existent entre ces familles sur les variables retenues. Seules deux modalités de la relation fraternelle sont significativement différentes entre les deux groupes. Les frères et sœurs d’enfants atteints de déficience intellectuelle évaluent leurs relations comme moins proches et également moins conflictuelles avec l’enfant déficient intellectuel .D’autre part, l’étude corrélationnelle montre que la typologie familiale et la proximité fraternelle ne sont corrélées à aucune autre variable. Le sentiment d’intégration sociale dans les trois domaines de la collectivité, de la famille et des pairs est, quant à lui, corrélé négativement, pour les deux groupes, à la rivalité dans la relation fraternelle ainsi qu’au degré de dépression. Une corrélation positive significative est établie uniquement pour le groupe témoin entre le degré de dépression et les conflits dans la fratrie. Ainsi, l’étude comparative permet de montrer que les fratries et les familles confrontées à la déficience intellectuelle ne sont pas différentes des autres sauf sur la nature de la relation fraternelle. D’autre part, le modèle explicatif établi par l’étude corrélationnelle permet d’identifier l’importance de la rivalité fraternelle et du sentiment d’intégration sociale pour le bien-être des frères et sœurs. Enfin, ces constats permettent de contribuer à une réflexion sur les applications cliniques de cette recherche. / The present study, predominantly using a family systems approach, aimed to estimate the impact of a child's intellectual disability on the family environment, and specifically on brothers and sisters. A child's disability does not simply affect himself, but is also a significant factor for the family system, where interactions will be altered in response to this information.This study explored the subjective experience of brothers and sisters, aged between 6 and 12 years old, of intellectually disabled children.A comparative study was conducted of an experimental group made up of 27 families and 34 brothers and sisters faced with the intellectual disability of a sibling, and a control group made up of 19 families and 24 brothers and sisters, on the kind of sibling relationships (closeness, conflict, rivalry), typology of family functioning, (« balanced », « moderate » or « extreme »), feeling of social integration (in the family, in the community and within peer groups) and degree of depression. The independant variable was the presence or absence of an intellectually disabled child in the family. This study, therefore, sought to illustrate the impact of having a intellectually disabled child in the family. A correlational study was conjointly carried out on the different variables (kind of sibling relationships, typology of family functioning, feeling of social integration, degree of depression) in order to pinpoint risk and protection factors for siblings. Results indicated little difference between the families on these variables. Only two kinds of sibling relationships were significantly different in the two groups. Brothers and sisters of intellectually disabled children evaluated their relationships as being less close and also less conflictual with their intellectually disabled sibling. Furthermore, the correlational study also showed that family typology and sibling closeness were not correlated with any other variable. As for children's feeling of social integration for the three areas of community, family and peers, this was found to be negatively correlated for both groups with rivalry in sibling relationships as well as with the degree of depression. A significant positive correlation was established only for the control group, between the degree of depression and sibling conflicts. Thus, the comparative study illustrates that siblings and families faced with the intellectual disability of a child are no different from others except for the kind of sibling relationships. Furthermore the explicative model established by the correlational study illustrates the importance of sibling rivalry and of the feeling of social integration for the psychological well-being of brothers and sisters. These findings help to generate further discussion of the clinical applications of this research.