{"id":606,"date":"2025-05-12T18:52:35","date_gmt":"2025-05-12T18:52:35","guid":{"rendered":"https:\/\/msbrazelton.wpenginepowered.com\/?page_id=606"},"modified":"2026-06-02T18:55:48","modified_gmt":"2026-06-02T18:55:48","slug":"how-infants-and-children-depend-upon-and-benefit-from-autonomic-emotional-connection-aec-with-their-mothers-and-why","status":"publish","type":"page","link":"https:\/\/brazeltoninstitute.childrenshospital.org\/pt\/nbi-community\/leaders-in-the-field\/how-infants-and-children-depend-upon-and-benefit-from-autonomic-emotional-connection-aec-with-their-mothers-and-why\/","title":{"rendered":"Como os lactentes e crian\u00e7as dependem da conex\u00e3o emocional aut\u00f4noma (AEC) com suas m\u00e3es e como isso os beneficia, e por qu\u00ea"},"content":{"rendered":"

Presentado por<\/em> Professor<\/em> Martha G. Welch<\/em><\/p>\n\n\n\n

Este webinar foi apresentado ao vivo na quarta-feira, 6 de dezembro de 2023, \u00e0s 16h (hor\u00e1rio do leste dos EUA). Gra\u00e7as \u00e0 gentileza do apresentador, est\u00e1 dispon\u00edvel uma grava\u00e7\u00e3o do webinar. Aqui.<\/a><\/em><\/p>\n\n\n\n

Neste webinar, irei primeiro analisar os resultados de dois ensaios cl\u00ednicos randomizados realizados em m\u00e3es e seus beb\u00eas prematuros, bem como em m\u00e3es e seus filhos em idade pr\u00e9-escolar, utilizando interven\u00e7\u00f5es que visam restaurar a conex\u00e3o emocional aut\u00f4noma (AEC) entre os dois grupos. Em segundo lugar, irei analisar uma nova teoria sobre mudan\u00e7as no ciclo de relaxamento e na teoria aut\u00f4noma das emo\u00e7\u00f5es que pode explicar as mudan\u00e7as significativas provocadas pelas interven\u00e7\u00f5es. Por fim, irei analisar uma nova ferramenta de avalia\u00e7\u00e3o, o Welch Emotional Connection Screen, que desenvolvemos para medir o comportamento associado aos sistemas nervoso aut\u00f4nomo da m\u00e3e e do filho.<\/p>\n\n\n\n

Para beb\u00eas prematuros, desenvolvemos e testamos a Interven\u00e7\u00e3o Familiar para Nutri\u00e7\u00e3o (FNI) para superar o estresse e a desregula\u00e7\u00e3o auton\u00f4mica da m\u00e3e e do beb\u00ea enquanto a dupla ainda estiver na UTI Neonatal. Nosso grupo do Columbia University Medical Center conduziu um estudo randomizado de FNI no Hospital Infantil de Nova York e uma replica\u00e7\u00e3o de estudo randomizado em v\u00e1rios locais em Nova York e no Texas Children\u2019s Hospital de San Antonio, comparando a FNI com o tratamento padr\u00e3o. A FNI incluiu aproximadamente seis semanas de intera\u00e7\u00f5es facilitadas entre m\u00e3e e beb\u00ea na UTI Neonatal, visando alcan\u00e7ar AEC entre m\u00e3e e beb\u00ea, uma constela\u00e7\u00e3o in\u00e9dita que descreve a rela\u00e7\u00e3o emocional m\u00e3e-beb\u00ea no n\u00edvel do sistema nervoso aut\u00f4nomo. Documentamos efeitos positivos significativos a curto e longo prazo da FNI no funcionamento neurocomportamental da inf\u00e2ncia, nas trajet\u00f3rias de desenvolvimento e na sa\u00fade aut\u00f4noma tanto da m\u00e3e quanto do beb\u00ea ao longo de cinco anos.<\/p>\n\n\n\n

Para crian\u00e7as em idade pr\u00e9-escolar, desenvolvemos e testamos o programa de prepara\u00e7\u00e3o emocional m\u00e3e-filho (MCEP), baseado no nosso novo mecanismo de aprendizagem do sistema nervoso aut\u00f4nomo. Tal como a FNI, o MCEP \u00e9 hipotetizado para condicionar o sistema nervoso aut\u00f4nomo da crian\u00e7a de forma a que este possa responder melhor aos desafios socioemocionais ao longo do desenvolvimento. Realizamos um ensaio cl\u00ednico randomizado com o MCEP, comparando um grupo de crian\u00e7as que recebiam um curr\u00edculo padr\u00e3o com um grupo de crian\u00e7as que recebiam um curr\u00edculo padr\u00e3o mais o MCEP. Observ\u00e1mos que as d\u00edades m\u00e3e-filho do MCEP apresentavam maior liga\u00e7\u00e3o emocional aos seis meses ap\u00f3s a interven\u00e7\u00e3o e que as crian\u00e7as do MCEP demonstraram um comportamento socioemocional mais positivo em casa e na sala de aula. Al\u00e9m disso, observ\u00e1mos que as crian\u00e7as do MCEP apresentavam uma melhor regula\u00e7\u00e3o auton\u00f4mica ap\u00f3s um estressor, medida por menores taxas de frequ\u00eancia card\u00edaca e aumento da arritmia sinusal de alta frequ\u00eancia (RSA) ou do t\u00f4nus vagal, com valores de tamanho do efeito significativos. Al\u00e9m disso, observamos correla\u00e7\u00f5es significativas, tamb\u00e9m com tamanhos de efeito elevados, entre as medidas auton\u00f4micas e os escores no Welch Emotional Connection Screen (WECS). Essas descobertas corroboram a conclus\u00e3o de que o MCEP teve um impacto positivo significativo na regula\u00e7\u00e3o auton\u00f4mica infantil em resposta ao estresse, o que se correlaciona com as avalia\u00e7\u00f5es comportamentais da conex\u00e3o emocional.<\/p>\n\n\n\n

Muitos estudos documentaram o profundo impacto que a rela\u00e7\u00e3o m\u00e3e-filho tem na sociabilidade e no comportamento da crian\u00e7a. No entanto, os mecanismos biol\u00f3gicos que regem essa rela\u00e7\u00e3o s\u00e3o pouco compreendidos. Para explicar o impacto profundo e de longo prazo de nossas interven\u00e7\u00f5es, desenvolvemos uma nova teoria aut\u00f4noma sobre emo\u00e7\u00f5es. Essa teoria exige uma nova interpreta\u00e7\u00e3o da biologia do desenvolvimento neonatal. Em resumo, acreditamos que o FNI conecta emocionalmente a m\u00e3e e o beb\u00ea ao reativar os reflexos socioemocionais aut\u00f4nimos e prim\u00e1rios da m\u00e3e e do beb\u00ea (ASRs). Esses reflexos se desenvolvem durante a gesta\u00e7\u00e3o. Isso ocorre por meio de condicionamento aut\u00f4nomo ou aprendizagem. Ap\u00f3s o nascimento, esses reflexos aprendidos garantem que os corpos da m\u00e3e e do beb\u00ea se atraem automaticamente, sem necessidade de pensamento. N\u00e3o se espera que nem o beb\u00ea nem a m\u00e3e \u201cse auto-regulem\u201d em suas respostas emocionais um com o outro ap\u00f3s o nascimento. Ambos s\u00e3o naturalmente capazes de \u201cco-regular\u201d a fisiologia aut\u00f4noma uns dos outros, a menos que isso seja interrompido, como acontece com o parto prematuro. Essa co-regula\u00e7\u00e3o pode ser restabelecida atrav\u00e9s de \u201ccondicionamento aut\u00f4nomo\u201d (sess\u00f5es de relaxamento FNI), que envolve a reeduca\u00e7\u00e3o dos reflexos internos dos \u00f3rg\u00e3os do corpo (cora\u00e7\u00e3o, pulm\u00f5es e trato gastrointestinal) para que reajam positivamente com o contato socioemocional pr\u00f3ximo. Acreditamos que o FNI modifica a resposta de defesa (ASR) de \u201cevitamento\u201d para \u201catra\u00e7\u00e3o\u201d quando a m\u00e3e expressa seus sentimentos e emo\u00e7\u00f5es mais profundas diretamente para seu beb\u00ea. Quando a m\u00e3e e o beb\u00ea conseguem se conectar emocionalmente nesse n\u00edvel fisiol\u00f3gico, descrevemos esse estado comportamental observ\u00e1vel como \u201cconex\u00e3o emocional aut\u00f4noma\u201d.<\/p>\n\n\n\n

Para medir o comportamento associado ao estado aut\u00f4nomo, criamos o Welch Emotional Connection Screen (WECS). O WECS foi validado em uma amostra de beb\u00eas prematuros no nosso primeiro estudo com FNI, mostrando correla\u00e7\u00e3o entre a conex\u00e3o emocional e o estado fisiol\u00f3gico, medido pelo t\u00f4nus vagal. Al\u00e9m disso, o WECS foi utilizado em uma popula\u00e7\u00e3o de beb\u00eas de termo, onde o WECS de 4 meses predizia o comportamento dos beb\u00eas de 3 anos na Crian\u00e7a Checklist de Comportamento. Em seguida, na popula\u00e7\u00e3o pr\u00e9-escolar, validamos o Universal WECS ou uWECS em espanhol. Como o original Welch Emotional Connection Screen (English oWECS) apresentava dificuldades para falantes de ingl\u00eas em concordar com as palavras utilizadas para descrever a conex\u00e3o emocional, e como o oWECS se mostrou dif\u00edcil de traduzir para muitos idiomas, traduzimos-o para o instrumento universal WECS (uWECS). Usando uma linguagem clara e expl\u00edcita, traduzimos o oWECS em ingl\u00eas para um novo instrumento universal, o uWECS. Neste estudo, realizamos dois objetivos: estabelecer a validade concomitante do uWECS comparando os escores obtidos com o uWECS espanhol codificado por codificadores nativos de l\u00edngua espanhola com os escores obtidos com o uWECS espanhol codificado por codificadores bilingues de l\u00edngua espanhola secund\u00e1ria; e estabelecer a validade relacionada a crit\u00e9rios demonstrando que o uWECS mede com precis\u00e3o o constructo subjacente da conex\u00e3o emocional aut\u00f4noma (AEC).<\/p>\n\n\n\n

\"\"<\/figure>
\n

Martha G. Welch, MD, DFAPA<\/strong> \u00c9 professora de Psiquiatria na \u00e1rea de Pediatria e em Patologia e Biologia Celular no Irving Medical Center (CUIMC) da Universidade Columbia, em Nova York. \u00c9 Diplomada pela American Board of Psychiatry and Neurology e membro distinguida da Associa\u00e7\u00e3o Psiqui\u00e1trica Americana. Atualmente, ela \u00e9 cofundadora do Programa Martha Welch Legacy em Pediatria no CUIMC. Anteriormente, a Dra. Welch fundou e coordenou a Iniciativa BrainGut em Patologia e Biologia Celular e o Programa de Ci\u00eancias da Nutri\u00e7\u00e3o no Departamento de Pediatria, onde realizou pesquisas b\u00e1sicas e cl\u00ednicas voltadas \u00e0 elucida\u00e7\u00e3o dos mecanismos da co-regula\u00e7\u00e3o auton\u00f4mica entre m\u00e3e e filho e entre m\u00e3e e filho, al\u00e9m de desenvolver um tratamento para transtornos emocionais, comportamentais e de desenvolvimento e um desenvolvimento ideal centrado na co-regula\u00e7\u00e3o emocional entre m\u00e3e e filho. A Dra. Welch dedicou 50 anos \u00e0 medicina, dos quais os primeiros 25 anos foram dedicados ao tratamento da sa\u00fade relacional entre m\u00e3e e filho e \u00e0 inova\u00e7\u00e3o em um tratamento para transtornos emocionais, comportamentais e de desenvolvimento, al\u00e9m de um desenvolvimento ideal centrado na co-regula\u00e7\u00e3o emocional entre m\u00e3e e filho. Nos \u00faltimos 25 anos, a Dra. Welch realizou pesquisas pioneiras em \u00e1reas moleculares, animais e humanas na Universidade de Columbia. Ela foi investigadora principal em numerosas pesquisas controladas randomizadas que testaram sua teoria de mudan\u00e7a do ciclo de relaxamento entre m\u00e3es e seus beb\u00eas pr\u00e9-termos e entre m\u00e3es e seus filhos em idade pr\u00e9-escolar. O trabalho da Dra. Welch em diversas \u00e1reas da disciplina cient\u00edfica levou ao desenvolvimento de uma nova teoria aut\u00f4noma das emo\u00e7\u00f5es, que prop\u00f5e uma maneira fundamentalmente nova de visualizar e medir o comportamento emocional atrav\u00e9s do Welch Emotional Connection Screen (WECS). Recentemente, a Dra. Welch e sua equipe fundaram o Martha G. Welch Center for Emotional Connection (emotionalconnection.org) para oferecer ajuda direta a fam\u00edlias com crian\u00e7as de zero a cinco anos.<\/p>\n<\/div><\/div>","protected":false},"excerpt":{"rendered":"

Presented by Professor Martha G. 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