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Introduction Autism can be described as a mental disorder that displays social interactions and communication impairments as well as a restricted range of activities or interests. Since autism is different for each individual, possible treatments are challenging and should consider individual characteristics at all times. Interactions with peers, family, and teachers are challenging for those with autism as they usually lack behaviors such as eye contact, playing, and talking with other people. It is common to observe sensorial issues as hypersensitivity in these individuals. Patients may have visual, auditive, or even tactile dysfunctions. Dir/Floortime is a comprehensive model that gives theoretical support and methodological approach to lead to development focusing on the development of individual capacities for sensorial organization, motor planning, language, and many abilities that provide a development trail that will help individuals to achieve essential milestones to infants and adolescents. The DIR/Floortime is based on the development as a lifespan event, individual differences, and relationships established with peers and any other people in the child´s context. Objectives The aim of this study was to demonstrate that the DIR/Floortime is a comprehensive method of study and intervention since it matches all necessary characteristics to produce development. Methods It was performed a theoretic approach of both DIR/Floortime and Biological Theory of Human Development in search of basis in a contextualist theory to explain a practical method of intervention. Results Psychological theories about human development are important tools for understanding the way individuals interact with their context and produce changes in biopsychosocial characteristics. The Bioecological theory of Human Development is a contextualist theory that considers the interactions established between individuals through a model called PPCT, with their characteristics with people, objects, and symbols through interactions known as proximal processes, considered to be meaningful interactions, occurring frequently, through a long time. Conclusions The TBDH through the PPCT model can show that the DIR/Floortime presented itself as an efficient method for the treatment of autism since it considers the personal characteristics of the patients, especially their sensory and motor characteristics (Personal Characteristics such as Resource, Demand, and Force). This method has in significant interaction the most efficient way to produce development (equivalent to proximal Proximal Processes), takes into account the contexts where the developing individual attends, especially home, school and therapy, and has time as an essential factor for development to occur. Disclosure of Interest None Declared

Introduction Adolescence presents itself as a phase of life marked by rapid changes produced by different social contexts and in many cases, it can be configured in a stressful situation. The development of a psychosocial support network is of fundamental importance for adolescents to cope with the pressures of life in challenging situations. Many students, especially living in poor communities, face school problems especially because the curriculum fails to provide relevant knowledge to students in a way it can be meaningful and easier to be taught by teachers and learned by students. When students fail at school usually, they tend to blame themselves and as a result they may develop anxiety, social isolation and even depression. Objectives Through the Bioecological Theory of Human Development, we sought to understand the psychosocial support networks of adolescents, whether or not experiencing school problems, considering this to be a challenging event. Methods In this research it was used the Five Fields Map, an instrument that evaluated the psychosocial support network for adolescents. The students with and without school problems filled the map in the beginning of the year and then at the end of the same year while facing a school problem as repeating the whole year because of insufficient grades. Results The number of relationships between students facing and not facing school problems was not different, however, failing students had fewer relationships in the school-church Mesosystem, fewer relationships in the second and third levels in the first and second moments of data collection, and more relationships in level 5 in the second moment. School Home Church Public spaces Rel. Factor Rel. Factor Rel. Factor Rel. Factor Control Beginning 56 5,2 36 4,97 33 6,3 26 6,77 Control End 42 5,26 33 4,94 38 6,6 20 6,7 Total 98 5,23 69 4,97 71 6,45 46 6,74 School problem Beginning 57 5,52 39 5,36 10 6,3 15 5,26 School Problem End 45 5,4 31 5,67 10 6,3 10 5,6 Total 102 5,47 70 5,51 20 6,3 25 5,53 TOTAL 200 5,3 139 5,23 91 6,37 71 6,06 Conclusions Both group of students showed great strength of proximity in their psychosocial support networks, indicating that it provided sufficient support so that the outcome of the failure experience was positive. Disclosure of Interest None Declared

Introduction Adolescence can be seen as a fundamental stage of life for the construction of the subject, resulting from childhood experiences and decisive for adulthood. It is common stressors to appear during adolescence, due to the lack of necessary resources to deal with a stressful problem or event. In this way, the evaluation of a stressful situation by the adolescent is important, because from it he will develop coping strategies that will help him to deal with the problem. Stressful life experiences, whether important events or even common annoyances, threaten the adolescent’s well-being, in addition to being linked to mental health and behavior problems, both internalizing ones, such as isolation, somatic complaints and anxiety/depression, as well as externalizing factors such as breaking rules and aggressive behavior. Romantic relationships are related to a major source of stress in the lives of these young people when conflicts, jealousy, aggression and infidelity occur, and have a great impact on the mental health of the individuals involved. Breakups, for example, have been linked to the onset of clinical depression in adolescents. There are three categories of concern for adolescents: (a) related to achievements, such as success in school or opportunity for success in the future; (b) relationships with colleagues or family members; and (c) social problems such as the environment, poverty and unemployment. Objectives To identify and describe stressful life events in adolescents from public schools in a poor community in Brazil. Methods The study included 64 adolescents, boys (51.56%) and girls (48.43%), aged between 12 and 16 years old (average 13.76%). The Adolescent Perceived Events Scale (APES) was used, which consists of 90 items that correspond to events that may occur in the adolescent’s daily life. Results The most significant stressors for the adolescents in this study were those dealing with the death of close people, such as a friend (100%), a family member (96.29%) and a relative (94.73%). Also appearing as major stressors were “plans that did not work” (91.89%), use of alcohol or drugs by family members (87.5%), loss of a job by parents (75%), imprisonment of a family member (75%), fights with boyfriend or girlfriend (86.66%), breakup (75%) and concern about their own appearance (76.52%). Conclusions Events referring to interpersonal relationships were considered the greatest stressors, with percentages above 80%. The present study contributed to the understanding of adolescents’ perceptions of their life events. In this way, we can understand the relationship between stressors and the coping strategies. Furthermore, it allows the proposition of preventive intervention strategies in the school context. Disclosure of Interest None Declared

Introduction Children with Autism Spectrum Disorder (ASD) have a qualitative deficit in social interaction, engagement, and behavior. The DIR/Floortime model is one of the ways of intervention and is based on the child’s Functional Development, Individual differences, and Relationships. It aims to build the foundation for the social, emotional, and intellectual skills of children, instead of having the focus only on isolated behaviors. The model was developed by Stanley Greenspan and Serena Wieder in the United States and is the result of many years of observations and studies on child development since the 1950s. In the 1980s, they unified knowledge from several related studies on child development and mental health and recognized the importance of relationships and affection for learning. One of the considerations of the DIR/Floortime model on children with autism is the individual profile, that is, their individual differences (the I of the DIR). Each child has a unique way of perceiving the world (sight, sounds, touch) and responding to it. They may have difficulties in processing or responding to sensory information. Their individual differences need to be well known so that we can draw up a therapeutic plan to obtain the best developmental evolution. Objectives Recognize and analyze the individual differences of each child, so that the appropriate therapeutic plan can be traced for the development of their potential. Methods Participated in the study 63 children with ASD, 12 girls (19%) and 51 boys (81%). Global Development Assessment questionnaires were used, based on the FEDC and the FEAS scale of the DIR/Floortime. Results All 63 children presented sensory alterations such as proprioceptive, visual, and vestibular search or hyper-reactivity, directly impacting abilities such as visuospatial processing and motor planning. In addition, 85% of children have low body tone. Regarding the sensory need for visual search, presented by 86% of the children, as well as the vestibular (90%), a recommended therapeutic strategy is mapping the place, with fewer objects. The therapist needs to be in a fixed position and maintain a pleasant, lower tone of voice. The routine framework for motor and action planning, anticipating, and giving the necessary waiting time for the child to get organized. Motor circuits can also help to work with the tone, as well as with praxis. Conclusions The DIR/Floortime model aims to make the child develop the ability to interact meaningfully and connect with the outside world. The individual differences of the child need to be known so that this work can take place effectively and so that the therapist can better organize the therapy, providing the best development for the child. Disclosure of Interest None Declared

Introduction Childhood family income is a powerful predictor of academic achievement and mental health. Here, we ask whether children living in poverty–those whose family incomes are not sufficient to meet their material needs–who beat the odds by succeeding academically are subsequently either protected from, or more at risk for, internalizing disorders. Prior research indicates that children in poverty with better academic performance and more depressive symptomatology tend to have higher temporal coupling between lateral frontoparietal network (LFPN; supports executive functions) and Default Mode Network (DMN; supports internally-directed thought) than lower-performing children in poverty, in direct contrast to the pattern observed for children above poverty. Thus, an open question is whether this pattern of connectivity adaptive for children in poverty has maladaptive long-term consequences, particularly for mental health. Objectives In this pre-registered study, we analyzed concurrent data from 8,091 children (1,307 in poverty) in the ABCD study at baseline (ages 9-10y). We performed linear mixed effects models to investigate whether both higher LFPN-DMN connectivity and grades are linked to more internalizing symptoms concurrently, and whether this differs for children above and below poverty. Methods We performed linear mixed effects models to investigate whether both higher LFPN-DMN connectivity and grades are linked to more internalizing symptoms concurrently, and whether this differs for children above and below poverty. Results We found that higher grades were associated with fewer internalizing symptoms for both children above and below poverty; this association was stronger for children below poverty. In addition, LFPN-DMN connectivity showed a significant negative correlation with internalizing symptoms at this age. However, when looking at internalizing symptoms separately - that is, anxiety/depression, withdrawal/depression, and somatic symptoms - we found that higher LFPN-DMN connectivity for children below poverty was associated with higher withdrawal/depression symptoms, but fewer somatic symptoms, pointing to a dissociation in what pattern of brain connectivity is most adaptive for the development of internalizing symptoms vs. physical health. These somatic symptoms highlight potential maladaptive consequences of resilience for children growing up in unequal structural conditions. Conclusions This research has important implications for supporting children in poverty by illuminating mechanisms for, and potential maladaptive consequences of, their resilience in academic contexts. Disclosure of Interest None Declared

Abstract Background The aim of this study was to assess barriers and facilitators in the pathways toward specialist care for eating disorders (EDs). Methods Eleven ED services located in seven European countries recruited patients with an ED. Clinicians administered an adapted version of the World Health Organization “Encounter Form,” a standardized tool to assess the pathways to care. The unadjusted overall time needed to access the ED unit was described using the Kaplan–Meier curve. Results Four-hundred-nine patients were recruited. The median time between the onset of the current ED episode and the access to a specialized ED care was 2 years. Most of the participants did not directly access the specialist ED unit: primary “points of access” to care were mental health professionals and general practitioners. The involvement of different health professionals in the pathway, seeking help for general psychiatric symptoms, and lack of support from family members were associated with delayed access to ED units. Conclusions Educational programs aiming to promote early diagnosis and treatment for EDs should pay particular attention to general practitioners, in addition to mental health professionals, and family members to increase awareness of these illnesses and of their treatment initiation process.

Introduction An infectious disease such as COVID-19 can have a great impact on mental health due to the fear of contracting it as well as the social isolation itself due to the containment measures. Such events are considered stressors, as they can be perceived as threatening or challenging, and can have cumulative effects that are harmful to mental health. Along with this scenario, anxiety can occur in association with stress, and it is defined as extreme concern and somatic symptoms that generate tension, hindering the proper functioning and development of basic life functions. In people with Autism Spectrum Disorder (ASD) and their families, such events can occur more intensely, as changing routine and adapting to different activities are usually challenging. The study examined stress, anxiety and coping strategies during the pandemic. Objectives To analyze stressful events, anxiety and coping strategies in caregivers of children and adolescents with ASD and typical development. Methods Forty caregivers of children and adolescents with ASD and 40 of typically developing participated in the study. The assessment instruments used were: 1. RSQ COVID-19; 2. Semi-structured interview; 3. State–Trait Anxiety Inventory for Adults. For statistical analysis, analysis of variance (ANOVA) or chi-square were used. Results Caregivers of children and adolescents with ASD showed greater stress and anxiety, in addition to using less adaptive coping strategies. Conclusions There is a great need to welcome families of children and adolescents with ASD, helping to develop coping or coping strategies. Disclosure No significant relationships.

Introduction During a public health crisis, preventive measures are essential. However, to make them effective, all citizens must be engaged. Objectives To analyse the differential role of individual and contextual variables in the adherence to public health recommendations. Methods 1376 adults (70.5% female; mean age=35.55±14.27) completed a survey between September/2020 and May/2021 with: Adherence Scale to the Recommendations during COVID-19 (ASR-COVID19; evaluates three dimensions of adherence), Fear of Covid-19 Scale (FC19S) and Toronto and Coimbra Prosocial Behaviour Questionnaire (ProBeQ; assesses empathy and altruism). Results Adherence did not differ between individuals with or without personal or family history of COVID-19 infection. ASR-COVID19 and all dimensions were positively correlated to ProBeQ’s altruism and empathy (from r=.32 to r=.54); FCV19S correlated positively to total adherence score and house sanitation (from r=.18 to r=.26; all p

Introduction The COVID-19 crisis has generated an increasing stress throughout the population. Objectives To develop and validate the Adherence Scale to the Recommendations for Mental Health during the COVID-19 pandemic from the Portuguese General Directorate of Health (GDH) (ASR-MH-COVID19). Methods The items content was based on the GDH guides for the prevention of mental health and psychosocial well-being of the general population during the COVID-19 outbreak. After content and facial validity analysis, the preliminary version of the ASR-MH-COVID19 (8 items to be answered on a Likert scale) was completed by 413 individuals (69.2% female; mean age=31.02±14,272), in September-December 2020 (Sample1) and then by 967 (70.9% female; mean age=34.02±14,272), in February-May 2021 (Sample2). Sample1 was randomly divided in two sub-samples. Sample1A was used for exploratory factor analysis/EFA and Sample1B for confirmatory factor analysis/CFA; CFA was then replicated with Sample2. The online surveys also included the Adherence Scale to the Recommendations of Portuguese GDH to minimize the impact of COVID-19 (ASR-COVID-19; Pereira et al. 2020). Results CFAs were informed by EFA and showed that the unidimensional model presented acceptable-good fit indexes (Sample1B: χ2/df=2.747; RMSEA=.0980, p

Introduction COVID-19 is a respiratory disease and its main symptoms are fever, dry cough and difficulty breathing. It spread to several countries, which led the World Health Organization to decree, on March 11, 2020, a pandemic state that deeply affected Brazil. Due to the impossibility of leaving the house, the routine of children with autism was changed. Children in Autism Spectrum Disorder (ASD) have a qualitative deficit in social interaction. Clinical and daily observations reinforce several scientific studies that defend the importance of maintaining a routine as stable as possible for people with ASD, without this stability they may become emotionally disorganized, feel discomfort or even irritability. Objectives Investigate the impact caused by social distancing on the development of children and adolescents with autism. Methods An online questionnaire based on the DIR/Floortime basic map of emotional functional capacity development was distributed in Brazil from April to May, 2020. The results were analyzed using SPSS software. Results Results obtained from 122 questionnaires showed that after 30 days of quarantine 20% of children no longer had the characteristic of being able to remain calm and organized for at least 2 minutes; 11% no longer initiates interactions with their parents; 27% demonstrated more protests and anger than before the social distancing; 18% demonstrated more emotions such as anger, fear and intimacy, 28% began to understand their limits and 12% of the children are using greater facial expression during the social distancing. Conclusions This study brings results that can help to understand the processes in a child with autism.

Introduction Individuals with CLP may present communication disorders, velopharyngeal dysfunction, dento-occlusal changes and hearing losses. Adolescents with CLP usually show greater impairment of communication. Such characteristics combined with the malformed face can impact psychosocial functioning and increase the risk of psychological difficulties. Life-stressing experiences from CLP to life events typical of adolescence, may threaten the well-being of the adolescent, and are linked to mental health and behavioral problems. Objectives To verify the coping of adolescents with CLP through a descriptive cross - sectional study. Methods Fifteen adolescents with CLP participated in the study. To evaluate them it was used the Coping scale (Lees, 2007), for the verification of coping in the families proposed by Motivational Theory of Coping. The analysis of the coping of adolescents with CLP considered two adverse contexts, namely “birth with fissure” and “have your secret told by a friend ”. Results In relation to the evaluation of the psychological needs of relationship, competence and autonomy faced the “birth with fissure” indicates that teens with fissures do not perceive this stressor as a threat to their basic psychological needs. Conclusions The adolescents with CLP who participated in the study feel more interested (perception of the challenge) in dealing with the stressor relative to the fissure than in dealing with the betrayal of a friend, who reveals a secret of his to other people. Disclosure No significant relationships.

Introduction Children in Autism Spectrum Disorder (ASD) have a qualitative deficit in social interaction. The DIR/Floortime (Stanley Greenspan and Serena Wieder) is based on the Child’s Functional Development, Individual Differences and Relationships (D for development, I for individuality or individual differences and R for relationship), aiming at building the foundations for social, emotional and intellectual skills of children. Objectives To determine the results of 18 months DIR/Floortime™ parent training for an additional benefit in encouraging children with ASD climbing the developmental “ladder”. Methods The participants are 15 children with ASD aged between 2 and 6 years-old. The follow-up occurs in two private DIR Floortime Model service centers in Brazil. Protocols: Functional Emotional Assessment Scale – FEAS and Functional Emotional Developmental Questionnaire – FEDQ. The participants were followed-up one on one every four months. Results At the first month of assessment the children showed lack of self regulation, social interaction and engagement with their parents in a symbolic, sensory and motor play setting. At the following evaluations, they showed increase of social interaction and engagement in the same play setting. Besides the high affect of the parents during the play time promoted a two way purpose communication and behavioral organization. Conclusions Children showed a good development of functional and emotional capacities during the study period, demonstrating the effectiveness of the DIR/Floortime model in the intervention.

Introduction In the midst of a global pandemic with a rising death toll, the children´s mental health can be easily overlooked in the country’s response. But this overlook would have devastating consequences for years to come. Objectives The objective of this research is to compare children’s physical and mental development before, during and after the situation of social isolation caused by the pandemic of COVID-19. Methods The parents/guardians of 100 children aged between 0 and 5 years and 11 months old were asked to answer questions based on the ASQ-3 (Ages and Stages Questionnaire III), containing questions related to Communication, Gross Motor, Fine Motor, Problem Solving, and Personal-Social and ASQ- SE (Ages and Stages Questionnaires Social-Emotional) addressing issues of self-regulation, compliance, social-communication, adaptive functioning, autonomy, and affect. In addition, behavioral issues related to children’s mental health will be included, such as: aggressiveness, insomnia, lack of appetite, apathy, sadness, tiredness, lack of interest, hyperactivity, manias, tantrum, morning among others. Child development data will be collected before and during quarantine / isolation and later, in a second stage, after the end of social isolation. Results The data will be analyzed in order to characterize child behavior before, during and after the period of social isolation, correlating the different areas of child development, especially mental health. Conclusions As argued, socially isolated children are at increased risk of health problems in adulthood. Furthermore, studies on social isolation have demonstrated that a lack of social relationships negatively impacts the development of the brain’s structure. Disclosure No significant relationships.

Introduction Bipolar Disorder (BD) is a severe recurrent disorder with a complex biogenetic and psychosocial etiology. The immune system cytokines in interaction with the CNS play a role in the pathophysiology. Objectives To compare inflammatory cytokines between BD patients and controls during the manic episode; additionally, compare these cytokines with psychiatric symptoms and cognitive performance during follow-up. Methods We recruited 25 BD patients in mania with paired controls. We measured baseline IL-2, IL-4, IL-8, IL-10, GM-CSG, TNF- α, and TNF- γ in plasma. We used U-Mann-Whitney for group comparison and Spearman correlation between sub-group follow-up assessments and cytokines. Results We found a significant difference in IL-6 between subjects and controls (figure 1). During the follow-up, we found a correlation with psychiatric symptoms, cognition, and cytokines during manic episodes (Table 1). Table 1. Follow-up Correlation with cytokines during a manic episode. BD follow-up N=8 Cytokine MADRS BPRS SCIP-S WMT-SCIP-S PST-SCIP-S IL-10 (-) Rho=-.957 (p=

Introduction When parents discover that their child has hearing loss, a new reality presents itself with frustration, a huge amount of work as special care, therapies, exams, etc. Adapting to this new situation is a huge challenge to the development of both parents and children who receive this diagnosis. Objectives This study investigated how Brazilian parents of children diagnosed with hearing loss dealt with this situation from diagnosis to the present day. Methods In this study it was used the Bioecological Theory of Human Development, which considers the development of both parents and children over time. Two meetings were conducted using a focal group technique, with questions related to the diagnosis and how they faced the situation, prejudice, care of other siblings, etc. Results Most parents discovered the diagnosis of hearing loss of their children right after birth. Only one mother said she did not care about the diagnosis of hearing loss while most reported having suffered a lot and glimpsed a life of difficulties. Even knowing the limitations imposed by the condition of the children, no one considered hearing loss as a sickness. Parents reported that the child suffered bullying because of difficulties in speaking and most parents say they worry about their children’s school life. Conclusions Parenting kids with hearing impairment is challenging, and involves dealing with prejudice, fear of future, long-term therapies and high costs. Nevertheless parents make great efforts to provide a good environment minimizing the risks of having such condition.