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To contribute to the application of the Childhood Atopic Dermatitis Impact Scale (CADIS), 135 Italian parents of children with atopic dermatitis (AD) aged birth to 6 years completed: CADIS, Infants Dermatitis Quality of Life Index (IDQOL) or Children's Dermatology Life Quality Index (CDLQI), and Dermatitis Family Impact 10-item questionnaire (DFI). A subsample of 66 caregivers completed the CADIS again, 48 hours later. Disease severity was measured with the Severity Scoring of Atopic Dermatitis (SCORAD) index. Exploratory factor analyses almost replicated the general factor structure of the original CADIS, established on a US sample. However, some differences emerged, probably due to cultural differences. A reduced version of the original CADIS was also obtained, based on the exploratory factor analyses, to facilitate use in clinical settings. The original and the shorter versions were tested for reliability: overall Cronbach's α and test-retest reliability for the child- and parent-related scales were acceptable. Regarding concurrent validity, estimates showed the CADIS to correlate adequately with SCORAD, IDQOL-CDLQI, and DFI. Multiple comparison tests for discriminant validity revealed significant differences between extreme groups based on AD severity for all five domains of CADIS. The original CADIS showed adequate validity and reliability in Italy as well, and the shorter version showed promising psychometric properties.

Postnatal growth restriction and failure to thrive still remain a major problem in Extremely Low Birth Weight (ELBW) infants . The goal for the nutritional care of these infants is to achieve rate of growth similar to those of the fetus in utero at the equivalent gestational age. Human milk fortified remains the best food for all these preterms. Two groups of preterm of weight 580-1250 g and gestational age 23-32 wk, were fed with different protein intake in the human/maternal milk fortified ( 3,5 g Kg-1 per day and 4,8 g Kg-1 per day in the control and intervention group respectively).The feeding tolerance, intrahospital growth, neurological outcome and anthropometric data until 12 months of corrected age, were evaluated. The protein supplemented group (PSG) showed an intrahospital highter growth rate ( mostly in head circumference, p 0,02, and length growth, p 0,04) only in the preterms with 580-980 g and 23-30 wk. In the same preterms, Griffith Development Mental Score at 3 and 12 months corrected age showed higher score than in the control group in the Performance (p 0,04) and Hearing/Language (p 0,03) items. The auxological evaluation in the postdischarge period showed in the PSG group mean z-score values for length higher than those in the control group at 9 (p 0,04) months of corrected age.

Aim: Communication between the healthcare team and the parents in Neonatal Intensive Care Unit (NICU) is very important, and may affect both trust in medical team and the health of premature babies. The aim of this study is to confirm that a good relationship with families can be obtained if all the healthcare team adopts a good common communication scheme. Methods: We have implemented a communication strategy that works through three stages: (1) Training in Communication: a course about general problems with communication for medical and nursing staff. (2) Communicative Algorithm: various guidelines to follow during the most common scenarios in the NICU. (3) Communicative Case Sheet: a notebook used to record any problem or discomfort that occurs during communication. We applied the strategy for a 12 months trial period. Results: A Systemic Counselling Institute of Medical Psychology tested families' satisfaction at the end of the period. The test showed that in 75% of cases, satisfaction with communication was very good and in the remaining 25%, parents perceived communication as good, but improvable. Conclusion: In NICU, communication between the members of the team and the newborn's parents may be improved by specific tools

Background The impact of atopic dermatitis (AD) on children's quality of life (QoL) in US and European countries is relatively well known, though rarely evaluated in the Italian population. Moreover, the association between child age and QoL has not been enough investigated, even though few studies detected a worse QoL in youngest AD children. The aim of the study was to evaluate the QoL in an Italian sample of atopic children and their families, also exploring a possible association with child age. Methods 60 AD children aged between 1-12 years and their mothers completed specific QoL questionnaires (IDQoL/CDLQI, DFI) and a clinician completed a measure of AD severity (SCORAD). Results AD severity (Objective SCORAD) significantly correlated with QoL measures. Severe AD children showed higher IDQoL/CDLQI and DFI scores compared to mild and moderate AD groups (P = 0.006 and P < 0.0005, respectively), but only DFI scores differed in these last two conditions (P = 0.014). DFI scores negatively correlated with children's age (P = 0.046), but did not differ when considering child age ranges. Multiple linear regression analyses revealed a significant association between Objective SCORAD and QoL measures. Conclusions A strong association between severe AD and poor QoL, both in children and mothers, was found in the Italian sample, in line with the international literature. Family's QoL scores were sensitively related to AD severity, more than the child's QoL, emphasising that the disease has a deep impact on the family. A significant association between age and QoL was only partially found and needs further investigation.

Aim : The goal of this study is to verify whether the Locomotor quotient of Griffiths Mental Development Scales (GMDS) can be considered a useful tool of screening for neurological disabilities in conjunction with objective tests. We explored whether there exists an association between the specialized medical examination and the GMDS Locomotor score at 6 and 12 months, and subsequently if it is possible to identify predictive factors at the birth of motor disability development. Materials and Methods : The sample includes 35 children born before the 32 nd gestational week with a birth weight less than 1500 g. The neurological examination was performed by an experienced physician using the criteria outlined by Milani-Comparetti and Amiel-Tison, while infant level of development was assessed using GMDS. Results : Significant correlation was found between the medical diagnosis and the GMDS at 6 and 12 months. The intraventricular hemorrhage of III-IV degree and periventricular leukomalacia were confirmed to be predictive risk factors for the development of motor disability. Conclusion: Locomotor quotient of GMDS could be used in conjunction with the standard neurological assessment to screen for motor disabilities.

In children older than 2 years, hypercalciuria is the most common metabolic cause of renal stones. In infants, its prevalence is not well established. Since 1990, we observed five infants in whom renal stones or microcalculi were diagnosed between the age of 5 and 19 months. One of them was lost to follow up. In the present report, we describe the four patients who underwent metabolic evaluation and in whom idiopathic hypercalciuria (IH) was diagnosed. We conclude that IH is a frequent cause of microcalculi and renal stones in infants, and a screen for this condition is warranted in this age group.

El estudio explora, en el parto prematuro, la relación entre el estrés de los padres, la percepción maternal del temperamento del niño y el nivel de desarrollo del niño. Para la evaluación de una muestra de 78 niños prematuros a los 3 meses exactos de edad, en comparación con 73 nacidos a término, se han usado: Parenting Stress Index-Short Form (PSI-SF), para el estrés parental; cuestionarios italianos para el temperamento (QUIT, 1-12 meses), para el temperamento; las escalas de desarrollo mental de Griffiths (GMDS; 0-2 años), para el desarrollo del niño. Los resultados muestran que las madres de prematuro experimentan un estrés paternal significativamente mayor y sienten una reducción de la actividad motora en sus hijos, que tienen un menor nivel de desarrollo en la escala de Oído-Lenguaje, performance y cociente general. Los predictores significativos de estrés materno son los siguientes: nacimiento pre término, disminución en el desarrollo locomotor y personal-social y la percepción materna de una alta emocionalidad positiva y una baja emocionalidad negativa. El nacimiento prematuro tiene un profundo impacto estresante en las madres, agravado por la percepción de la disparidad entre las exigencias de la atención neonatal y los recursos disponibles

Background and aim of the study: Extrauterine growth restriction and failure to thrive remain a major problem in Extremely Low Birth Weight infants. Nutritional support in preterm babies has the objective to improve the achieve rate of growth similar to those of the fetus in utero at the equivalent gestational age. The aim of the study was to evaluate feeding tolerance, intrahospital growth, neurological outcome and anthropometric data until 24 months of corrected age (mca) from different protein intake assumed by preterm babies

Behavioral Inhibition (BI; Kagan et al., 1987) is an early temperamental trait characterized by fear, wariness and reticence when the child is confronting with novelty. BI represents a relevant precursor of impaired outcomes in childhood and adolescence, specifically anxiety problems (Clauss et al., 2012). Traditionally, BI is described as a unitary construct characterized by wariness towards both social (i.e., unfamiliar adults) and non-social (i.e., new objects) stimuli. Recently, some authors (Kertes et al., 2009; Dyson et al., 2011) argued that social and non-social BI are relatively independent, with different psychopathological correlates. The aims of this study were: (1) to explore whether social aspects of BI were related or independent from non-social aspects in preschoolers, both cross-sectionally and longitudinally; (2) to investigate whether children with social or non-social BI, compared to their non-inhibited peers, showed a higher risk for internalizing difficulties, specifically anxiety problems. A sample of 45 children (aged 4 years) and their teachers were recruited from kindergartens in Bologna. Social and non-social features of BI were assessed through LAB-TAB (Goldsmith et al., 1999) in 2 repeated assessments during a scholastic year. Teachers completed the Children’s Behavior Questionnaire (CBQSF:Putnam & Rothbart,2006) for the assessment of temperamental traits and the Child Behavior Checklist (CBCL 1.5/5yrs: Achenbach,2004) for child internalizing problems. Main results: Social and non-social aspects of BI resulted to be highly correlated (p

Introduction: Postnatal depression has been widely recognized as a risk factor for women’s health and infant development, especially in traumatic experiences like preterm birth (Vigod et al., 2010; Neri et al., 2015). While the literature has widely investigated the consequences of postnatal depression on preterm babies’ mothers, less is known about paternal depression. The aims of the study were: to compare levels of depressive symptoms between preterm and full-term infants’ mothers and fathers; to study the influence of parental depression on infant development during infant’s first year of life. Materials and methods: 192 parents (99 mothers; 93 fathers) were recruited in the NICU of Bufalini hospital, Cesena (Italy) (preterm group-PT), while 165 families (88 mothers; 77 fathers) were recruited at antenatal classes at the same hospital (full-term group-FT). The total sample included 357 families. At 3 months of infant corrected age, mothers and fathers completed the Edinburgh Postnatal Depression Scale-EPDS (Cox et al., 1987) and a form regarding sociodemographic, obstetric and infant clinical data. The level of infant development was assessed by Griffiths Mental Development Scales-GMDS (Griffiths, 1996). Results: Data analyses are in progress. The levels of depressive symptoms were always significantly higher in mothers when compared to fathers (p=0,009). According to group status, PT parents were significantly more depressed than FT group (p=0,05) at 3 months of infant corrected age, while no differences emerged at 9 and 12 months. Conclusions: Results confirm how preterm birth represent a risk factor for postnatal depression, especially in mothers and in the first months after childbirth. Early diagnosis can help to plan supportive, preventive interventions in the neonatal period.

Introduction: Nutrition has always represented a problematic area for preterm children and their mothers, with more concerns for children born very and extremely preterm. However, literature lacks of studies that explore mother-child feeding interactions after the first year postpartum. Aims of the study: The present study investigates the quality of mother-child feeding interactions in Extremely Low Birth Weight (ELBW), Very Low Birth Weight (VLBW) and Full-Term (FT) dyads at 18 months of age of the child. The role of the child’s cognitive development and behavior is also evaluated as additional measure. Material and methods: The sample includes 60 children and their mothers recruited from the province of Cesena (Italy): 15 ELBW (gestational age (GA) 37 weeks; BW >2500 grams). Exclusion criteria were: child’s cerebral damage or chromosomal abnormality, parental psychiatric history and poor knowledge of Italian. At 18 months, 20 minutes of mother-child interaction during feeding were videotaped and later coded according to the Italian version of the Feeding Scale (SVIA). The child’s development was assessed trough the Griffith Scale and mothers completed the Child Behavior Check List as a measure of the child’s behavior. Results: ELBW dyads showed poorer feeding interactions than VLBW and FT dyads, displaying more maternal negative affect, higher interactional conflict and less dyadic reciprocity during the meal. No differences were found between VLBW and FT group. Moreover, no significant differences were found for the child’s cognitive development and behavior among groups. Conclusions: Among the population of preterm children, ELBW children seem to be at higher risk to experience more difficult and conflictual feeding interactions with their mother. Further longitudinal research should explore the long-term impact of these interactions on the child’s eating behavior.

Questo breve eBook passa in rassegna gli studi e le ragioni della validità della scala Griffiths per 0-2 anni, anche alla luce delle ricerche condotte in Italia, e presenta uno studio di applicazione del test su un campione di nati pretermine, uno dei target cui lo strumento è più sensibile.

Negli studi sullo sviluppo infantile, la tematica della religiosità è stata poco affrontata, anche se, a partire dal 2000, è stata oggetto di un crescente interesse. La genesi del sentimento religioso fu presa in considerazione da Freud in molte sue opere, a partire naturalmente dal punto di vista di una scienziato che aveva “fede” nella ragione, anche se riteneva che la maturità emozionale dell’individuo e della società si fondasse sui legami emotivi costruiti attraverso relazioni ed identificazioni. Il contributo “che la considerazione psicoanalitica può offrire alla soluzione del problema religioso” (Freud, 1927, tr.it.1978, p.453) è la connessione con il bisogno del bambino e poi dell’adulto di ricevere protezione rispetto ai dolorosi sentimenti della debolezza e fragilità del vivere, nonostante i progressi della civiltà, ma “chi umilmente si rassegna alla parte insignificante dell’uomo nel vasto mondo, costui è davvero irreligioso nel più vero significato della parola” (Freud, op.cit. p. 463).

La gioco terapia focale consente di mettere in risalto le caratteristiche dell’autonomia nel rapporto con il cibo e con i contenuti evacuativi. Essa si basa infatti su un punto di partenza organizzato che permette al bambino di esprimere la motivazione a fare da solo in una condotta autoregolata e che, contemporaneamente, sviluppa l’alleanza con i genitori e l’integrazione del gruppo familiare. Offre pertanto un nuovo sistema di riferimento, così da favorire nel bambino un comportamento adeguato alle reali esigenze del suo sviluppo.

Introduction: the goal of this chapter was to examine the possible advantages of precocious tale reading to premature infants. Methods: a picture book in native family language was given to newborn’s parents after the admission in NICU and suggested to be read to their baby every time they would think possible and useful. On discharge home the same book followed the family. A questionnaire regarding liking of reading activity was administered and completed by parents, 6-12 months after their infant’s discharge. At 18 months of infant correct age, the level of infant hearing and language development was assesed by Griffiths Mental Development Scale. Results: Overall both in NICU and after discharge, parents stated they liked reading to infant and that it helped them feel closer to their babies. 64.5% of parents in NICU and 39.2% after discharge read every day to the infant. In the first assessment, the Likert scale in the first two items (“reading helps both, we parents and our neonate” and “it makes us closer”), showed a score higher in families with very low birth weight infants (VLBW) than in those with low birth weight infants (LBW), (Fisher F (1,124) = 10.31; p=.002; F (1,123) = 16.23; p

La letteratura internazionale degli ultimi decenni ha ben documentato le conseguenze negative che depressione e ansia nella madre, in epoca prenatale, possono indurre sullo stato materno nel periodo post partum e sul successivo sviluppo del bambino (Brand, Brennan, 2009) In particolare, un crescente interesse è stato rivolto ad uno specifico aspetto della sintomatologia ansiosa, le ansie specifiche alla gravidanza (Pregnancy Related Anxieties, PRA), indicate tra i più importanti predittori di esiti negativi nello sviluppo del bambino (Dunkel Schetter, Tanner, 2012). Il presente studio si propone di valutare nel periodo prenatale la prevalenza di sintomatologia ansiosa, depressiva e la fenomenologia delle PRA, non ancora adeguatamente indagate nel contesto italiano. Durante i corsi di accompagnamento al parto organizzati dal Consultorio Familiare AUSL di Cesena (FC), sono state reclutate 140 donne al terzo trimestre di gravidanza (nazionalità italiana, in prevalenza primipare, coniugate e di istruzione medio-alta). Le gestanti hanno compilato: STAI-Y (Spielberger et al., 1983) per la valutazione della sintomatologia ansiosa di stato e tratto, l’EPDS (Cox et al., 1987) per la rilevazione della sintomatologia depressiva e il PRAQ-R (Huizink et al., 2004), per indagare la presenza di ansie specifiche alla gravidanza (es. parto, aspetto fisico). L’analisi statistica dei dati è in corso ed i principali risultati saranno presentati al congresso. BIBLIOGRAFIA Brand, S.R., Brennan, P.A. (2009), Impact of antenatal and postpartum maternal mental illness: how are the children?. Clinical Obstetrics and Gynecology, 52, 441-455. Cox, J.L., Holden, J.M., Sagovsky, R. (1987), Detection of postnatal depression: development of the 10 item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782-786. Dunkel Schetter, C.,Tanner L. (2012), Anxiety, depression and stress in pregnancy: implication for mothers, children, research, and practice. Current Opinion of Psychiatry, 25, 141-148. Huizink, A.C., Mulder, E.J.H., de Medina, P.G.R., Visser, G.H.A., Buitelaar, J.K. (2004), Is pregnancy anxiety a distinctive syndrome?. Early Human Development, 79, 91-91.

La genitorialità, come processo psichico attraverso il quale un uomo e una donna diventano genitori, si fonda su una dimensione temporale e spaziale, che contiene la rappresentazione di un figlio e di sé come madre e padre, rappresentazione in continua costruzione e ricostruzione, che tiene conto del presente, della progettualità, ma che si riallaccia, in una modalità dinamica e trasformativa, ad aree intra ed interpsichiche più antiche, connesse all’immagine dei propri genitori, al ricordo del rapporto con loro. I legami affettivi, fondamenta dei meccanismi intersoggettivi e dei meccanismi di mentalizzazione, sono soggetti a continue trasformazioni e spesso a rotture traumatiche, fra le quali la più devastante è la perdita di un figlio. La morte di un figlio disgrega in modo catastrofico gli schemi mentali personali e familiari: il mondo emotivo è pervaso da tristezza, solitudine destrutturante e insensata, ottundimento emotivo o rabbia, senso di colpa; le aree vitali vengono depauperate e devitalizzate; l’affaticamento cronico e la depressione congelano apparentemente la sofferenza.

Introduction: Prematurity is a very traumatic experience for both infant and his/her parents. Important consequences regard the infant’s survival and the risks for long-term developmental, cognitive, emotional and behavioral problems; at the same time, the premature birth is associated to parents’ worries, fears, concerns and negative affective states relative to the survival of the baby. Perinatal depression has been detected in about 50% of preterm babies’ mothers, a percentage which is higher than the one found in the general population (Brandon et al., 2011). At 6 months of corrected age, these levels tend to decrease to 20% and remain stable up to 2 years (Miles et al., 2007; Poehlmann et al., 2012), representing a relevant risk for the development of the preterm child, up to 3 years (Singer et al., 1999). Objectives and methods: The project aims at evaluating prevalence and course of postnatal depressive symptoms and comorbid anxious symptomatology in preterm babies’ mothers at relevant moments of infant development: 3, 9 and 12 months of infant’s corrected age. Analyses will be carried on comparing three groups of mothers differentiated by: 1) Preterm delivery of a baby weighing less than 1500 grams (Very Low Birth Weight); 2) Preterm delivery of a baby weighing less than 1000 grams (Extremely Low Birth Weight); 3) Term delivery of a healthy baby. At every step of the project, mothers will complete the Edinburgh Postnatal Depression Scale (Cox et al., 1987), Parenting-Stress Index (Abidin, 1995), Penn State Worry Questionnaire (Meyer et al. 1990), Social interaction and Anxiety Scale (Mattick, Clarke, 1998). Besides, the level of child development will be assessed using the Griffiths Mental Development Scales (Griffiths, 1996).