Translation and preliminary validation of the Brazilian family resources scale in a sample of parents of children with congenital Zika virus syndrome.

PURPOSE: Family-centered rehabilitative care optimizes outcomes for children with significant developmental disabilities. Family-centered services involve assessing family resources that promote positive developmental outcomes for children. Little is known regarding family resources in the context of caring for a child with developmental disabilities in Brazil due to an absence of validated measures. This study describes the translation and cultural adaptation of the Family Resource Scale and explored the measurement quality of the resulting measure (the Brazilian-Family Resource Scale, or B-FRS). METHODS: A rigorous serial translation process that emphasized linguistic accuracy as well as cultural adaptation was utilized. The resulting 27-item B-FRS was theoretically related and reflected the contextual intent of the original measure. RESULTS: A four-factor scoring approach yielded acceptable internal consistency estimates for the subscales and total scale score. Overall, low levels of family resources were reported by caregivers of children with Congenital Zika Syndrome. Low family resources were associated with parental depressive and stress-related symptoms. CONCLUSION: Confirmatory factor analysis of the B-FRS in a larger sample is recommended. Practitioners in Brazil should broadly consider family needs and resources to provide family-centered care that is effective for the child and engages the family in a way that highlights their strengths and promotes positive developmental trajectories.

Anxiety and depression among caregivers of young children with Congenital Zika Syndrome in Brazil.

PURPOSE: To examine the psychological well-being of primary caregivers of infants and toddlers with Congenital Zika Syndrome (CZS), and the roles of family resources, parenting stress, and coping strategies in caregivers' adaptation. MATERIALS AND METHODS: Family caregivers (N = 50) of children with CZS who were receiving treatment at a rehabilitation hospital in Recife, Brazil participated a cross-sectional survey study. Caregivers completed measures of anxiety and depression, coping strategies, family resources, and parenting stress. RESULTS: Mild to severe symptoms of depression were identified in 40% of caregivers and were a more prominent concern than symptoms of anxiety. Fewer family resources and high levels of parenting stress were significantly associated with both anxiety and depression. The association between parenting stress and depression was moderated by coping, such that parenting stress was associated with higher caregiver depression at low but not high levels of coping strategy use. CONCLUSIONS: Practitioners in Brazil should consider the role of family coping and resources as important resilience promoting factors in the development of new programs designed to promote psychological adaptation in caregivers to children with CZS. It is recommended that caregiver mental health support services be integrated into existing early intervention programs targeting children with CZS.Implications for RehabilitationParents and other primary caregivers are encouraged to take an active role in the care and developmental monitoring of children born with CZS, but their ability to provide care may be compromised by difficulties in psychological adaptation.Moderate and severe symptoms of depression were more prominent in caregivers than moderate and severe symptoms of anxiety (20% versus 6%, respectively).Practitioners should include assessment of coping strategies, parenting stress and family resources conjointly with evaluation of symptoms of depression and anxiety as part of routine CZS family evaluations.A useful approach for caregivers in Brazil may be to more fully integrate caregiver mental health support services into existing early intervention programs for children with CZS.

O desenvolvimento da comunicação no início da vida: estabelecimento, extensão e abreviação / The development of communication in the early life: establishment extension and abbreviation

Este trabalho apresenta uma proposta de análise e compreensão do processo de desenvolvimento da comunicação mãe-bebê. Dois pressupostos básicos fundamentam esta proposta. Um primeiro implica na inclusão do tempo como constitutivo da dinâmica da comunicação, concebida como um processo de mudança do qual emergem novos níveis de organização. O outro, assume que o desenvolvimento humano se dá em um contexto sociocultural, cuja participação se concretiza através da história de construção deste desenvolvimento. A partir do estudo de múltiplos casos, investigados longitudinalmente através de registros semanais em vídeo das interações mãe-bebê durante os oito primeiros meses de vida do bebê, são propostos três conceitos: estabelecimento, extensão e abreviação. Estes conceitos descrevem as formas dialógicas ou interacionais assumidas pela comunicação nesta faixa etária. Discute-se que o desenvolvimento da dinâmica da comunicação se caracteriza por um constante jogo entre aspectos determinados e indeterminados de um sistema que constrói novos elementos comunicativos como significados partilhados.(AU)

This paper presents a proposal for analysis and understanding of the mother-infant communication development. Two assumptions form the proposal basis. First, inclusion of the time as an essential part of the communication dynamic, conceived as a process of change when new leveis of the organization emerge. Second, integration of human development in the social-cultural context, actualized through the history of the communication development construction. Based on multiple case studies, longitudinally investigated through weekly videotaped mother-infant interactions during the first eight months of the infant's life, three concepts are proposed: establishment, extension and abbreviation. These concepts describe the dialogical or interactional formats assumed by communication for this age range. Finally, the characteristic communication dynamics is discussed as a constant interplay between deterministic and indeterministic aspects of the system that constructs new communicative elements as shared meanings.(AU)