Home-visiting Parenting Programs to Improve Mother-Infant Interactions at Early Ages: A Systematic Review.

Objective: To systematically review studies examining the effects of home-visiting preventive parenting programs (HV-PPs) on improving the quality of mother-child interactions in early childhood. Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol, we identified 3,586 studies published between 2018 and 2022 by searching the following databases: PubMed, Web of Science, BVS/LILACS, SciELO, and PsycNET/PsycINFO. After applying the eligibility criteria, 17 articles were selected for review. Results: Most studies were conducted in high-income countries (53%) and the remainder were conducted in upper-middle-income countries, predominantly using a randomized controlled trial design and with strong methodological quality. The 17 studies applied 13 different HV-PPs, predominantly using video feedback, based on various dosages and schedules. Most studies (77%) showed significant positive effects on mother-child interactions by improving mainly positive maternal behaviors (e.g., sensitivity and responsiveness). Positive effects occurred independent of the study design, sample characteristics, measures, and constructs assessed. However, the findings suggest that the combination of fewer than six sessions, durations shorter than three months, and a very early start did not impact mother-child interactions, as expected. Few studies have explored negative maternal behaviors, children's behaviors, and dyadic interactions such as mutuality and synchrony. Conclusions: HV-PPs positively impacted mother-child interactions in early childhood despite the large heterogeneity across program designs, outcome measures, and overlapping constructs. Based on the results, we discuss the practical and economic implications of using parenting programs as a preventive approach.

Effectiveness of Sucrose Used Routinely for Pain Relief and Neonatal Clinical Risk in Preterm Infants: A Nonrandomized Study.

BACKGROUND: Preterm infants (PI) requiring the neonatal intensive care unit are exposed to early repetitive pain/distress. Little is known about how pain relief strategies interact with infants' clinical health status, such as severity of illness with pain responses. This study aimed to examine main and interactive effects of routine sucrose intervention and neonatal clinical risk (NCR) on biobehavioral pain reactivity-recovery in PI during painful blood collection procedures. METHODS: Very low birth weight PI (<1500 g; n=104) were assigned to low and high clinical risk groups, according to the Clinical Risk Index for Babies. Sucrose group (n=52) received sucrose solution (25%; 0.5 mL/kg) 2 minutes before the procedures and control group received standard care. Biobehavioral pain reactivity-recovery was assessed according to the Neonatal Facial Coding System, sleep-wake state scale, crying time, and heart rate at 5 phases (baseline, antisepsis, puncture (P), recovery-dressing, and recovery-resting [R]). Repeated measure ANOVA with mixed-design was performed considering pain assessment phases, intervention group, and NCR. RESULTS: Independent of NCR, sucrose presented main effect in decreasing neonates' facial activity pain responses and crying time, during P and R. Independent of NCR level or routine sucrose intervention, all neonates displayed activated state in P and decreased biobehavioral responses in R phase. Although no sucrose or NCR effects were observed on physiological reactivity, all neonates exhibited physiological recovery 10 minutes after P, reaching the same heart rate patterns as the baseline. CONCLUSIONS: Independent of NCR level, sucrose intervention for pain relief during acute painful procedures was effective to reduce pain intensity and increase biobehavioral regulation.

Study Protocol for the Preschooler Regulation of Emotional Stress (PRES) Procedure.

Background: Emotional stress regulation (ESR) rapidly develops during the first months of age and includes different behavioral strategies which largely contribute to children's behavioral and emotional adjustment later in life. The assessment of ESR during the first years of life is critical to identify preschool children who are at developmental risk. Although ESR is generally included in larger temperament batteries [e.g., the Laboratory Temperament Assessment Battery (Lab-TAB)], there is no standardized observational procedure to specifically assess and measure ESR in preschool aged children. Aim: Here, we describe the development of an observational procedure to assess ESR in preschool aged children [i.e., the Preschooler Regulation of Emotional Stress (PRES) Procedure] and the related coding system. Methods: Four Lab-TAB emotional stress episodes (i.e., the Stranger, the Perfect Circle, the Missing Sticker, and the Transparent Box) have been selected. Independent coders developed a list of ESR codes resulting in two general indexes (i.e., active engagement and stress level) and five specific indexes (i.e., anger, control, fear, inhibition, sadness). Finally, specific actions have been planned to assess the validity and the coding system reliability of PRES procedure. Ethics and Dissemination: The study has been approved by the Ethical Committee of the Scientific Institute IRCCS Eugenio Medea, Bosisio Parini (Italy). The PRES validation and reliability assessment as well as its use with healthy and at-risk populations of preschool children will be object of future scientific publications and international conference presentations.

Neuropsychological outcome of children with traumatic brain injury and its association with late magnetic resonance imaging findings: A cohort study.

OBJECTIVES: To evaluate neuropsychological outcome after traumatic brain injury (TBI) and its association with trauma severity and late magnetic resonance imaging (MRI) findings. METHODS: Prospective cohort study of patients with TBI admitted to the paediatric intensive care unit over 5 years. Trauma severity was determined by Glasgow Coma Scale (GCS), neurological outcome by King's Outcome Scale for Childhood Head Injury (KOSCHI) and neuropsychological outcome by Wechsler Intelligence Scale for Children - Fourth Edition. RESULTS: Twenty-five children (median age 6 years at trauma) were included. Patients were divided into Disability (DIS)(n = 10) and Good Recovery (GR)(n = 15) groups. Initial GCS score was not significantly different in both groups (median 6 vs. 10; p = 0.34). DIS group had lower values ​​of working memory index (WMI)(median 74 vs. 94; p = 0.004), perceptual reasoning index (PRI)(75 vs. 96; p = 0.03), verbal comprehension index (VCI)(65 vs. 84; p = 0.02), processing speed index (PSI)(74 vs. 97; p = 0.01) and full-scale intelligence quotient (FSIQ)(65 vs. 87; p = 0.008). In the GR group, 60% of patients had normal or minimally altered MRI versus 10% of patients in the DIS group (p = 0.018). Fractional anisotropy positively correlated with WMI(r = 0.65; p = 0.005), PRI(r = 0.52; p = 0.03) and FSIQ(r = 0.50; p = 0.04). CONCLUSIONS: Neuropsychological impairment was observed in 40% of children who suffered a TBI and was associated with late MRI abnormalities.

Neonatal pain and developmental outcomes in children born preterm: a systematic review.

BACKGROUND: Neonates cared for in neonatal intensive care units are exposed to many painful and stressful procedures that, cumulatively, could impact later neurodevelopmental outcomes. However, a systematic analysis of these effects is yet to be reported. OBJECTIVES: The aim of this research was to review empirical studies examining the association between early neonatal pain experiences of preterm infants and the subsequent developmental outcomes of these children across different ages. METHODS: The literature search was performed using the PubMed, PsycINFO, Lilacs, and SciELO databases and included the following key words: "pain," "preterm," and "development." In addition, a complementary search was performed in online journals that published pain and developmental studies to ensure all of the target studies had been found. The data were extracted according to predefined inclusion and exclusion criteria. RESULTS: Thirteen studies were analyzed. In infants born extremely preterm (gestational age ≤29 wk) greater numbers of painful procedures were associated with delayed postnatal growth, with poor early neurodevelopment, high cortical activation, and with altered brain development. In toddlers born very preterm (gestational age ≤32 wk) biobehavioral pain reactivity-recovery scores were associated with negative affectivity temperament. Furthermore, greater numbers of neonatal painful experiences were associated with a poor quality of cognitive and motor development at 1 year of age and changes in cortical rhythmicity and cortical thickness in children at 7 years of age. CONCLUSIONS: For infants born preterm, neonatal pain-related stress was associated with alterations in both early and in later developmental outcomes. Few longitudinal studies examined the impact of neonatal pain in the long-term development of children born preterm.

Validity and reliability assessment of the Brazilian version of the faces pain scale-revised

The Faces Pain Scale-Revised (FPS-R) is among the most commonly used measures of pain intensity in clinical and research settings. Little evidence exists about the Brazilian version of this scale. The purpose of the present study was to examine the validity and reliability of the Brazilian version of the FPS-R. The sample comprised 214 children, 6 to 10 years of age. In the first phase of the study, the children ranked the faces of the FPS-R according to pain intensity, and the faces were presented in all possible pair combinations (content validity). All six faces were correctly ranked by 47% of the younger children (6 to 7 years old) and 52% of the older children (8 to 10 years old). With regard to paired combinations, all of the pairs were correctly placed by 63% of the younger children and 67% of the older children. In the second phase, the children rated recalled experiences of pain using both the Brazilian version of the FPS-R and Coloured Analogue Scale (CAS; convergent validity). The children were retested 4 weeks later (test-retest reliability). The degree of agreement between the FPS-R and CAS was moderate, with a Kendall's tau-b (τ) of .49 (p < .01). The test-retest reliability coefficient was τ = .52 (p < .01). This study provides evidence of the validity and reliability of the FPS-R as a pain intensity measurement for use in Brazilian samples.

Validity and reliability assessment of the Brazilian version of the Faces Pain Scale-Revised

The Faces Pain Scale-Revised (FPS-R) is among the most commonly used measures of pain intensity in clinical and research settings. Little evidence exists about the Brazilian version of this scale. The purpose of the present study was to examine the validity and reliability of the Brazilian version of the FPS-R. The sample comprised 214 children, 6 to 10 years of age. In the first phase of the study, the children ranked the faces of the FPS-R according to pain intensity, and the faces were presented in all possible pair combinations (content validity). All six faces were correctly ranked by 47% of the younger children (6 to 7 years old) and 52% of the older children (8 to 10 years old). With regard to paired combinations, all of the pairs were correctly placed by 63% of the younger children and 67% of the older children. In the second phase, the children rated recalled experiences of pain using both the Brazilian version of the FPS-R and Coloured Analogue Scale (CAS; convergent validity). The children were retested 4 weeks later (test-retest reliability). The degree of agreement between the FPS-R and CAS was moderate, with a Kendall's tau-b (τ) of .49 (p < .01). The test-retest reliability coefficient was τ = .52 (p < .01). This study provides evidence of the validity and reliability of the FPS-R as a pain intensity measurement for use in Brazilian samples.(AU)

Avaliação assistida: uma abordagem promissora na avaliação cognitiva de crianças / Assisted assessment: a promising approach in the children's cognitive assessment

O presente trabalho tem por finalidade apresentar uma abordagem de avaliação cognitiva de crianças, que tem se revelado promissora na área de diagnóstico psicológico, denominada avaliação assistida. Na primeira parte, será apresentada sua fundamentação teórica, definição e principais características; na segunda parte, serão descritos alguns procedimentos de avaliação assistida; na terceira parte, serão sintetizadas contribuições de pesquisas na área de avaliação cognitiva assistida em situação de resolução de problemas de perguntas de busca de informação ("constraint- seeking questions") e finalizando, serão realizadas considerações sobre as implicações para a avaliação psicológica, sua aplicabilidade e limites.(AU)

The present paper aims to present an approach of children's cognitive assessment, that has revealed to be promising in the psychological assessment area, called assisted assessment. In the first part, it will be presented the theoretical foundation, defmition, and principal characteristics; in the second part, it will be described some assisted assessment procedures; in the third part, it will be synthesized research contributions in the cognitive assisted assessment area in problem solving situations with constraint - seeking questions and finally it will be carried out considerations about implications to psychological assessment, its applicability and limitations.(AU)