Examining where to go: pediatric psychology trainees' perception of their graduate training in culture and diversity.

OBJECTIVE: Culture and diversity-related training is critical to the development of competent pediatric psychologists. Evaluation of training efforts have been conducted at the program level, yet evaluation of trainee experiences in culture and diversity-related training remains unassessed. This trainee-led study was the first formal assessment of pediatric psychology trainee experiences of culture and diversity-related training and the impact of training on their own cultural humility. METHODS: Study overview and a survey link was distributed across 2 listservs associated with the American Psychological Association (Division 53, Division 54) and sent directly to directors of graduate, internship, and fellowship training programs with a request to share with trainees. Surveys assessing integration of cultural training and trainee cultural humility were completed. Trainees also provided qualitative feedback regarding their multicultural training and development. RESULTS: Pediatric psychology trainees (N = 90) reported inconsistent integration of culture and diversity topics into their training. Of the 34 training areas assessed, 10 were perceived as thoroughly integrated into formal training by at least half of the respondents. Trainees often sought independent cultural training outside of their programs, and no relationship was detected between perceived integration of cultural training and trainee cultural competence. DISCUSSION: Results indicate room for improvement regarding integration of cultural training and a need to better understand driving forces behind trainees independently seeking training outside of their formal training programs. Moreover, understanding the aspects of training that are most contributory to trainee development is needed given that no relationship between training and development emerged in the current study.

A prática psicológica e a ludicidade na hospitalização pediátrica: relato de experiência / Psychological practice and playing in pediatric hospitalization: experience report / La práctica psicológica y la ludicidad en la hospitalización pediátrica: informe de experiencia

INTRODUÇÃO: A inserção da psicologia e o método lúdico de intervenção na esfera hospitalar surge para promover bem-estar frente às vivências das crianças em condição de internação. O enfrentamento de uma hospitalização no período da infância pode provocar impactos significativos do ponto de vista orgânico, psíquico e ambiental, por ser um momento de estruturação do indivíduo enquanto sujeito psíquico. OBJETIVO: Posto isso, o presente artigo objetiva refletir sobre a relação da família e da equipe de saúde com crianças hospitalizadas e a relevância da utilização dos recursos lúdicos, a partir de um relato de experiência de estagiários de um curso de graduação em psicologia. MÉTODO: Logo, trata-se de um relato de experiência, de abordagem qualitativa e de natureza descritiva, realizado de março de 2022 a junho de 2023, em uma Unidade Pediátrica de um Hospital Público Brasileiro. RESULTADOS E DISCUSSÃO: A partir disso, observaram-se na prática reações de estranhamento dos pacientes ao se depararem com a permanência no hospital, o adoecimento e os procedimentos das equipes multiprofissionais de saúde; bem como evidenciou-se a importância da transmissão das informações e do preparo verbal ante intervenções, visando a participação ativa do paciente em seu tratamento. Também observou-se a significância do uso de ferramentas lúdicas nas intervenções com as crianças, que facilitam a adaptação ao contexto e proporcionam âncora para estas elaborarem suas vivências. CONCLUSÃO: Portanto, conclui-se que a utilização de recursos lúdicos favorece o atendimento psicológico na infância e período de hospitalização.

INTRODUCTION: The integration of psychology and the playing method of intervention in the hospital setting emerges to promote wellbeing in the face of children's experiences during hospitalization. Confronting hospitalization during childhood can lead to significant impacts from organic, psychological, and environmental standpoints, as it represents a pivotal moment in the individual's psychological development. OBJECTIVE: With this in mind, the present article aims to reflect on the relationship between families and healthcare teams with hospitalized children and the relevance of using playful resources, based on an experience report from interns of an undergraduate psychology course. METHOD: Therefore, it constitutes an experiential account, employing a qualitative and descriptive approach, conducted from March 2022 to June 2023, in a Pediatric Unit of a Brazilian Public Hospital. RESULTS AND DISCUSSION: From this perspective, practical observations revealed patients' feelings of unfamiliarity upon facing hospital stays, illness, and procedures performed by multidisciplinary healthcare teams; as well as the significance of conveying information and verbal preparation before interventions was highlighted, aiming to actively involve the patient in their treatment. It was also observed the significance of using playful tools in interventions with children, which facilitates adaptation to the context and provides an anchor for them to elaborate on their experiences. CONCLUSION: Thus, it can be concluded that the use of playful resources enhances psychological care during childhood and the hospitalization period.

INTRODUCCIÓN: La inserción de la psicología y el método lúdico de intervención en el ámbito hospitalario surge con el propósito de promover el bienestar frente a las experiencias de los niños en condiciones de hospitalización. Enfrentar la hospitalización durante la infancia puede generar impactos significativos desde un punto de vista orgánico, psicológico y ambiental, ya que representa un momento de estructuración del individuo como sujeto psíquico. OBJETIVO: En este sentido, el presente artículo tiene como objetivo reflexionar sobre la relación de la familia y el equipo de salud con niños hospitalizados y la relevancia de utilizar recursos lúdicos, a partir de un relato de experiencia de practicantes de un curso de grado en psicología. MÉTODO: Por lo tanto, se trata de un informe de experiencia con enfoque cualitativo y de naturaleza descriptiva, llevado a cabo desde marzo de 2022 hasta junio de 2023 en una Unidad Pediátrica de un Hospital Público Brasileño. RESULTADOS Y DISCUSIÓN: A partir de esto, se observaron reacciones de desconcierto por parte de los pacientes al enfrentar la permanencia en el hospital, la enfermedad y los procedimientos realizados por los equipos de salud multidisciplinarios; así como también se resaltó la importancia de la transmisión de información y la preparación verbal antes de las intervenciones, con el objetivo de involucrar activamente al paciente en su tratamiento. También se observó la importancia del uso de herramientas lúdicas en las intervenciones con niños, ya que facilitan la adaptación al contexto y brindan un punto de referencia para que estos niños elaboren sus experiencias. CONCLUSIÓN: Por lo tanto, se concluye que el uso de recursos lúdicos favorece la atención psicológica durante la infancia y el período de hospitalización.

The Role of Pediatric Psychologists in Critical Care: Lessons Learned and Future Directions in Integrating Mental Health Care Into PICUs.

Pediatric psychologists are essential staff in the PICU. Their role in caring for critically ill children aligns with clinical practice guidelines for the mental health care needs of this population of patients. This article highlights the role of pediatric psychology in the PICU through illustrative case examples. We discuss lessons learned and future directions for the development and provision of mental health services in PICUs. We address relevant ways for critical care providers to understand the importance of evidence-based psychological care and advocate for the inclusion of psychologists on multidisciplinary PICU teams. As the critical care field continues to focus on an improved understanding of post-intensive care syndrome in pediatrics and the psychological needs of critical care patients, it will be important to consider the vital roles of psychologists and to advocate for improved integration of mental health care in PICUs.

William E. Pelham Jr. (1948-2023).

William ("Bill") E. Pelham Jr. was a renowned clinical child psychologist who specialized in the assessment and treatment of children with attention-deficit/hyperactivity disorder (ADHD). Bill was born in 1948 in Atlanta, Georgia, to William E. Pelham Sr. and Kittie Copeland Kay, the eldest of four brothers. Bill is most well-known for the development, study, and advocacy of psychosocial treatments for children with ADHD. While at Florida State University in the 1980s, he developed a comprehensive summer treatment program designed to improve family and classroom functioning, strengthen peer relationships, and boost academic achievement. Bill built the case for the behavioral treatment of ADHD over nearly 50 years of programmatic research. Bill was a leader in the field of clinical child psychology. Bill passed away on October 21, 2023, after a brief illness. He is survived by his wife of 33 years Maureen, son William E. Pelham III, and daughter Caroline. His legacy will live on in their work to support children with ADHD and their families. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Commentary: Integrative, multi-level explanatory models are needed to understand recent trends in sex, gender, and internalizing conditions, reflections on Keyes and Platt (2023).

Keyes' and Platt's (The Journal of Child Psychology and Psychiatry, 2023) review provides much-needed systematic evidence about why internalizing symptoms have increased and it clarifies the role of novel risk factors. The findings highlight that multiple factors at multiple levels are responsible for this phenomenon, many with small effects, within a complex interplay that is rarely well captured. As new insights emerge across disciplines, an important step is to renew efforts to integrate them to understand how internalizing symptoms develop for different people.

Do school and equality education characteristics influence young children's understanding of sex/gender constancy?

In many cognitive developmental studies, young children ( < 6 years) fail to understand that changing the appearance of a person, object, or animal does not change its underlying reality. They appear to believe that a cat wearing a dog mask is genuinely a dog (appearance/reality distinction) and that a boy wearing a dress is genuinely a girl (sex/gender constancy). These skills may be affected by various influences: testing methods, training on the constancy of biological traits, child's or sibling's diagnosis of gender dysphoria, and child's diagnosis of autism. This study aimed to partially replicate the study of Arthur et al. (Journal of Experimental Child Psychology, 2009, Vol. 104, pp. 427-446) showing that experimental lessons emphasizing the constancy or otherwise of biological traits affected appearance/reality and sex/gender constancy performance. The study examined the influence of school lessons with content on sex/gender stereotyping and pro/anti constancy on the performance of young English children (mean age = 5;6 [years;months]; N = 58) on appearance/reality and sex/gender constancy tasks. Children performed above chance on sex/gender stability (change over time) but performed below chance on sex/gender constancy and appearance/reality tasks (change due to superficial alterations). These scores are comparable to those in nearly all previous studies. Children's scores were not influenced by school lesson content, although not all schools provided content. Conclusions are drawn about the effect of lesson content, which may be too diffuse and long term to affect performance. The level of children's performance and what this means in absolute terms about children's understanding of sex/gender stereotypes and the possibility of a child changing sex/gender is also discussed.

A fase terminal do filho com câncer: percepções dos profissionais hospitalares / The terminal phase of children with cancer: perceptions of hospital professionals / La fase terminal del hijo con cáncer: percepciones de los profesionales del hospital

O confronto com o câncer de um filho e a percepção da sua morte como inevitável dão lugar a experiências parentais relevantes para a pesquisa científica. Este estudo teve como objetivo investigar, por meio da percepção dos profissionais hospitalares, o modo como os pais experienciam a fase terminal e fim de vida do filho com câncer para melhor compreender os processos psicoemocionais experienciados por esses pais diante da cronicidade da doença e da morte do filho. No sentido de alcançar esse objetivo, realizou-se um estudo qualitativo de tipo fenomenológico envolvendo 17 profissionais de dois hospitais portugueses de referência em oncologia pediátrica. Os dados foram recolhidos com recurso a um guia de entrevista semiestruturada. Na percepção dos profissionais hospitalares, os resultados evidenciam que esses pais experienciam múltiplas dificuldades e preocupações na fase terminal da doença do filho e no pós-morte, bem como um sofrimento extremo e desestruturação biopsicossocial e espiritual na família. O conhecimento aprofundado da fenomenologia desses processos é essencial para o desenho e a implementação de intervenções emocionais, cognitivas, comportamentais e sociais mais ajustadas às dificuldades e preocupações parentais vividas no fim de vida e pós-morte.(AU)

Coping with children's cancer and the perception of their inevitable death give rise to parental experiences that are important to study. This study aimed to investigate, based on hospital professionals' perspectives, how parents experience the terminal phase and end of life of their children suffering from cancer to better understand the psycho-emotional processes these parents experienced in face of the chronicity of the disease and their children's death. To achieve this objective, a qualitative phenomenological study was carried out involving 17 professionals of two Portuguese hospitals that are reference in pediatric oncology. Data were collected using a semi-structured interview guide. From the perspective of hospital professionals, results show that these parents experience multiple difficulties and concerns in the terminal phase of their children's disease and postmortem, as well as the extreme suffering and biopsychosocial and spiritual disruption of the family. A deeper understanding of the phenomenology of these processes is essential to design and implement better adjusted emotional, cognitive, behavioral, and social interventions aimed at the parental difficulties and concerns experienced at the end of life and after death.(AU)

El enfrentamiento del cáncer de un hijo y la percepción de su muerte como inevitable dan lugar a experiencias parentales importantes que deben ser estudiadas. Este estudio pretende identificar desde la percepción de los profesionales del hospital cómo los padres viven la fase terminal y el final de la vida de su hijo con cáncer con el fin de comprender mejor los procesos psicoemocionales que viven estos padres ante la cronicidad de la enfermedad y la muerte de su hijo. Para ello, se realizó un estudio cualitativo, con enfoque fenomenológico, en el que participaron 17 profesionales de dos hospitales portugueses de referencia en oncología pediátrica. Para recoger los datos se aplicó un guion de entrevista semiestructurada. En cuanto a la percepción de los profesionales del hospital, estos padres experimentaron múltiples dificultades y preocupaciones en la fase terminal de la enfermedad de su hijo y postmuerte, así como un sufrimiento extremo y una desestructuración biopsicosocial y espiritual en la familia. El conocimiento en profundidad de la fenomenología de estos procesos es esencial para elaborar e implementar intervenciones emocionales, cognitivas, conductuales y sociales más acordes a las dificultades y preocupaciones parentales que se experimentan al final de la vida y la postmuerte.(AU)

Promoción de la salud afectiva-sexual en primera infancia, contexto de cuido y educativo en Costa Rica. Una revisión crítica / Affective-sexual health promotion in early childhood: critical review in the context of childcare and education in Costa Rica

Resumen La presente revisión describe investigaciones sobre el desarrollo afectivo-sexual en primera infancia en el ámbito preescolar y de cuido; éstas se analizan desde el marco normativo y operativo en el cual se sustenta la educación sobre este tema en Costa Rica. Dicha revisión se realizó con 4 bases de datos internacionales y se sustentó en estudios empíricos y de revisión. Los estudios hallados apuntan a una diversidad de procesos a tomar en cuenta. Algunos de éstos se relacionan con el desarrollo de vínculos seguros y confiables, el uso de terminología genital desde temprana edad, abordajes asertivos de las manifestaciones afectivas-sexuales de infantes, así como a contemplar los aspectos culturales y socio-históricos. A nivel nacional se encuentra que existe un amplio marco normativo que respalda la comprensión integral del desarrollo afectivo-sexual para su abordaje. Sin embargo, se observa que en el programa nacional de preescolar, se prioriza el riesgo al abuso sexual. Además en este se devela una visión moralista por edades, considerando que los genitales deben nombrarse sólo en los últimos niveles de preescolar y no cuando se conocen las partes del cuerpo en los niveles iniciales. Desde un enfoque de promoción de la salud sexual en el ámbito de cuido y educativo nacional, aquí se propone una visión más amplia que tiene plenamente en cuenta las complejidades en torno a los determinantes sociales del desarrollo afectivo sexual. Por lo que se requiere una actualización del programa de preescolar, acompañado de formación continua para el personal y las familias de infantes.

Abstract This critical review describes research on affective and sexual development in early childhood in preschool and childcare settings. Studies are analyzed from the point of view of the regulatory and operational frameworks on which education on this topic in Costa Rica is based. The review was carried out using 4 international databases, examining empirical studies and review studies. Costa Rica has put in place a broad national-level policy framework that supports a comprehensive understanding of affective-sexual development from infancy. However, implementation of the policy in the national preschool program does not always meet the framework's standards. We find that the risk of sexual abuse tends to be prioritized in early sexual-affective education. Sexual-affective development is often addressed from a moralistic standpoint, advising for instance that the genitals should be named only in the last levels of preschool and not when the other parts of the body are first named. From a health-promotional perspective on national childcare and early education, we here propose a broader view that takes fully into account the complexities around the social determinants of sexual-affective development. We conclude that an update of the preschool program is required, accompanied by continuous training for staff and families of infants.