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2. Two-and-a-half year old girl. Reason for consultation: lack of weight gain and retarded speech development (says only three words). The child is irritable and aggressive. Maturation delay is suspected because of paternal sexual abuse on a single occasion referred in a pediatric consultation by the mother. Family history: parents have been separated since the girls birth. Paternal contact on only four occasions. The mother puts the girl's behavior down to this cause. General attitude: the girl responds to the therapist's instructions and seems calm and collaborative. From the moment projective games started, the mother sees that her daughter represents herself apart from the rest of the family group, she does not make a representation of her mother, and she places her baby sister as the main female figure. From the mother's discourse, it comes up that the girl is not a priority to her, that the girl makes her feel exhausted, and that she has to scold her all the time. In a moment of emotion, the mother perceives her daughter's sadness, who starts crying upon the therapists intervention. This enables the reframing of the problem as mother-daughter indifference. The mother was advised to share moments with her daughter without scolding nor repressing her. In the second interview (15 days later), the following changes were observed: the girl gained 400 g, says phrases using a large number of words, and is peaceful at home.

Projective games to evaluate the family

Games are offered following a specific order. The child is invited to put together the puzzles being offered. Then, based on the puzzle, the therapist prompts the child to play with his/her imagination, enabling him/her to use the same games in a projective fashion. Each puzzle will help to evaluate different aspects in relation to the child and the family dynamics.

The parent participates in the same games when being invited to think what part of the child's story calls his/her attention. In this way, the game is compared to the reality perceived by the adult.

The differences found between both realities, or the reasons that might account for what the child is telling, help to shed a light on the key aspects of the family dynamics.

In the first two puzzles, the therapist participates only by observing. As of the third puzzle, the therapist gets directly involved by guiding the child's plot.

The interrelation between all the games and parental interventions provide the keys for the therapist to pose the hypothesis.

The objective of this study was to identify, by early screening, one-month old infants with acholic or hypocholic stools for the early detection of biliary atresia and other causes of neonatal cholestasis. The study was essentially exploratory (observational, prospective, statistically underpowered and with no clinical intervention) and used a color card screening of all newborns attending the first month of life checkup from 1999 to 2002 in a public hospital in Argentina. Of 12 484 newborn infants, 4239 were examined at their first month of life checkup visit with the stool color card. Eighteen infants were identified with hypocholic stools, of whom only four were proven to have cholestasis. Although no case of biliary atresia was detected, screening by stool color cards proved useful for the detection of other causes of neonatal cholestasis. 2351a5e196