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Updated: Apr 19, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
[Child protection network and the intersector implementation of the circle of security as alternatives to medication]
Ana Laura Martins M M Becker1, Paulo Haddad de Souza1, Mônica Martins de Oliveira1
1Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brasil.
Insights
A child
Area of Science:
- Pediatric behavioral health
- Child psychology
- Interdisciplinary care
Background:
- A 5-year-old child presented with severe aggressive behavior and recurrent death-themed speech.
- Initial treatment with sertraline and risperidone for depressive and behavioral disorders resulted in side effects and was discontinued.
- Standard interventions including therapy and psychiatric follow-up were ineffective.
Objectives:
To describe the clinical history of a child with aggressive behavior and recurring death-theme speech, and report the experience of the team of authors, who proposed an alternative to medication through the establishment of a protection network and the inter-sector implementation of the circle of security concept.
Case Description:
A 5-year-old child has a violent and aggressive behavior at the day-care. The child was diagnosed by the healthcare center with depressive disorder and behavioral disorder, and was medicated with sertraline and risperidone. Side effects were observed, and the medications were discontinued. Despite several actions, such as talks, teamwork, psychological and psychiatric follow-up, the child's behavior remained unchanged.
Remarks:
A unique therapeutic project was developed by Universidade Estadual de Campinas' Medical School students in order to establish a connection between the entities responsible for the child's care (daycare center, healthcare center, and family). Thus, the team was able to develop a basic care protection network. The implementation of the inter-sector circle of security, as well as the communication and cooperation among the teams, produced very favorable results in this case. This initiative was shown to be a feasible and effective alternative to the use of medication for this child.
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