Objectives: Very preterm (VP) birth refers to an early stressful event putting children at heightened risk for behavioral and emotional difficulties. However, it remains unknown whether early emotional difficulties persist later in childhood and, importantly, whether the severity of the perinatal stress moderates this link.

Methods: 36 VP children and 23 full-term born (FT) children participated in an 11 year-long study. Perinatal stress was assessed at birth with the Perinatal Risk Inventory (PERI groups: low PERI: 100% of FT vs. 44% of VP children; high PERI: 56% of VP children). Early emotional problems were reported by mothers at 18 months in the behavioral and emotional disorders subscale (BE) of the Symptom Checklist. Later emotional problems at 11 years of age were reported by mothers through the internalizing problems (IP) subscale of the Child Behavior Checklist.

Results: First, examining whether the severity of perinatal stress affects IP, a t-test indicated significant differences between the low (M=51.92, SD=8.43) and high (M=59.60, SD=11.64) PERI groups (t(55)=-2.865, p=.006). Second, we correlated BE at 18 months with IP at 11 years and found a significant link in the high PERI group (r=.618, p=.004) but not in the low PERI group (r=.015, p=.933). Last, controlling for socio-economic status and intelligence quotient, we performed a regression analysis predicting child IP at 11 years by group (VP vs. FT), PERI groups (high vs. low), and BE at 18 months (main effects), as well as the interaction term of BE at 18 months with either group and PERI groups. This regression model significantly explained 36% of the variance in child IP at 11 years, F(7,52)=3.68, p=.003, R2change=.140. Specifically, the interaction between BE at 18 months and PERI groups refers to a significant predictor of later IP. Further analyses revealed that BE at 18 months marginally predicted children’s IP at 11 years only in the high PERI group (β=.418, p=.063), but not in the low PERI group (β =-.048, p=.801).

Conclusion: Prematurity affects children’s emotional abilities. Importantly, the link between emotional problems in early and later childhood is moderated by the severity of the perinatal stress. In particular, children who are born with more complications, experience more stress in the perinatal period, and are more likely to sustain their early emotional difficulties later in childhood.

Introduction:
Studying early interaction is essential for understanding development and psychopathology. Automatic computational methods offer the possibility to analyse social signals through behaviours of several partners simultaneously and dynamically.
The aim of the current study was to show the validity of the aforementioned automatic method by comparing our methods with the well-validate Coding Interactive Behavior (CIB) in neglected dyads.
Methods:
20 dyads of mothers and their 13-36 months old infants were videotaped during mother-infant interaction including 10 extremely high risk and 10 low risk dyads using both 2D and 3D sensors. From 2D+3D data and 3D space reconstruction, we extracted individual parameters (Quantity of movement and Motion activity ratio for each partner) and dyadic parameters related to the dynamics of partners heads distance (Contribution to heads distance), to the focus of mutual engagement (% of time spent face to face, or oriented to the task), and to the dynamics of motion activity (Synchrony ratio, Overlap ratio, Pause ratio). Features are compared with blind global rating of the interaction by expert coders using the Coding Interactive Behavior (CIB).
Results:
We found that individual and dyadic parameters of 2D+3D motion features perfectly correlates with rated CIB maternal composite scores (maternal sensitivity, mother limit setting and mother intrusiveness) and CIB dyadic composite scores (dyadic reciprocity/synchrony and dyadic negative status).
Conclusions:
Our method may present a low-cost methodology that can employ artificial technology to detect meaningful features of human interactions and may have implications for studying dyadic behaviours in psychiatry.
Learning Objectives:
Combining both clinical rating scales and computerized methods with this promising method may enable a continuum of time-scale from a summary of entire interactions to second-by-second dynamics and have implications in early child psychiatry concerning development of parent- child interactions.

A mother’s sensitivity in responding to her infant’s signals, forms the basis of secure attachment and is protective of later mental health. Video Interaction Guidance (VIG) is a strengths based intervention using moments from a video of parent-infant interaction observed and reflected on, which enhances parental sensitive responsiveness to their infant and also supports parents’ self-awareness. The aim is to evaluate the effects of an early attachment focused intervention for parents of very preterm infants born <32 weeks GA, in the NICU.
Methods: A pragmatic randomised controlled trial in a level III NICU with preterm infants born <32 weeks’ GA and their parents. The Preterm Infant-Parent Programme for Attachment (PIPPA) is a 3 session therapeutic intervention of reflective discussion, observation of infant cues and 1 VIG session. Primary outcome: maternal sensitivity measured by the CARE-Index at 9 months CA. Secondary outcomes: Infant social-emotional problems on the Ages and Stages Questionnaire – SE. Intention to treat analysis of data of first twin is presented as primary analysis.
Results: Eighty mothers, of 98 infants, consented andwere randomly allocated to intervention and control groups. There were no differences between the groups in socioeconomic status (p<0.356) in mean birth weight (p=0.97) or gestational age (0.79). Mothers in the intervention group had attained a higher level of education than mothers in the control group (p<0.008). Subsequent analyses were adjusted accordingly. Primary Outcome: There was no statistically significant difference between the intervention and control groups in maternal sensitivity at 9 months CA. Secondary outcomes: Infants receiving the intervention had lower self-regulation problems at 12 months CA (p=0.05). Infants whose mothers had received the VIG session, had significantly fewer communication problems (p<0.002).The intervention effect was moderated by ethnicity.
Discussion and Conclusions: This brief attachment focused intervention using VIG with parents of preterm infants showed improved social-emotional outcomes at 12 months CA, while no significant effect was found on maternal sensitivity, adjusting for maternal education. Integrating and evaluating interventions such as this in the NICU can enhance social-emotional and mental health outcomes of preterm infants.

A CLINICAL TRIAL TO EVALUATE THE COMPARATIVE EFFICACY OF COGNIUM SYRUP WITH STANDARD BEHAVIOURAL THERAPY VIS-À-VIS STANDARD BEHAVIOURAL THERAPY ALONE IN CHILDREN WITH ATTENTION-DEFICIT HYPERACTIVITY DISORDER (ADHD)
Dr. Vijay Warad, Dr. Milind Patil
ABSTRACT
An open label, comparative, 16 week study was conducted to evaluate the efficacy of Cognium syrup, a poly herbal formulation, on children between 6 – 14 years of age group with attention-deficit hyperactivity disorder (ADHD). A total of 76 children were enrolled as per the DSM IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) criteria for ADHD. Enrolled patients were divided in two groups. Group A received Cognium syrup along with behavioral therapy and Group B was on behavioral therapy only. Both the treatment groups were comparable in terms of the baseline scores. The statistical analysis was carried out in only 60 children as remaining were dropped from the study. Treatment with Cognium syrup led to uniform improvement in all parameters. The total symptom score (TSS) decreased in 96.6% of patients in group A compared to 46.6% in group B. The average performance score for functional impairment decreased in 80% patients in group A and in group B by 36.66%. The well tolerated Cognium syrup demonstrated significant improvement in ADHD symptoms inattention, impulsiveness and hyperactivity in intervention group, indicating a promise for ADHD children.

La famille d'un enfant ou d'un adolescent joue un rôle de premier plan dans son développement. Celui-ci est certes le patient du clinicien, mais il est aussi la plupart du temps le patient "désigné" de sa famille (index patient). Prendre en compte le système familial représente ainsi un levier de compréhension et un potentiel de changement inestimables pour le thérapeute.
Les auteurs aborderont quelques procédés cliniques pertinents dans l'approche du système familial pour le pédopsychiatre, aussi bien pour élucider une problématique au retentissement individuel que pour s'appuyer sur les ressources représentées par les membres de la famille, en vue d'un changement clinique. Deux cas cliniques illustreront les idées et les méthodes cliniques exposées.

Transition: Der Wandel von Mustern der Interaktion in Familie und Schulklasse durch systemische Interventionen. Ein sehr erfolgreiches Modell vor allem bei komplizierten und mehrschichtigen Problemen. Mit dem Hintergrund einer bindungstheoretischen und behavioralen Logik werden funktionierende Wechselwirkung beobachtet und verstärkt. So finden Erwachsene Zugänge zu Kindern und Jugendlichen, die als schwierig, speziell oder fremdartig empfunden werden, um diese Kinder passgenauer zu fördern. Es sind lebensweltorientierte Ansätze aus der aufsuchenden (mobilen) Familientherapie.