ELIZABETH PALACIOS - SPAIN
Crossroads and challenges of a contemporary clinic.

ANALIA WALD - ARGENTINE
Learning disabilities: psychoanalysis, complexity and interdisciplinary approach.
Summary
A clinical approach model is presented for children and young people with complex problems, connecting learning with affective experiences and social opportunities. We work with school and medical teams, and with rights protection agencies. The clinical orientation implies establishing hypotheses in each case about the singular modalities of the symbolization processes and the axes of meaning that configure the problems from the perspective of complexity.  In addition to clinical interventions, most of the cases require a combination of interventions for the expansion of symbolic potential, imaginative processes and the possibility of deployment in the social field.
 

NORBERTO GIGLIO - ARGENTINE
Pediatric consultations during preventive social isolation due to SAR-CoV 2 circulation

The mandatory preventive social isolation that was installed during the pandemic generated many changes in the daily routines of children, adolescents and their respective families. Thus, we have been able to observe an increase in the number of children and adolescents staying at home with the same people who live with them, and at the same time a significant loss of autonomy, of spaces for socialisation, and of the personal care and aesthetic conditions necessary to go out "into the outside world". The routines of kindergarten and school were interrupted, which led to serious difficulties in the processes of social development and school learning.  
In the context of this prolonged uniformity, there was also a change in family dynamics with a consequent impact on paediatric consultation. Many families stopped coming to the paediatric clinic for fear of contagion and uncertainty about the disease. Others only used the virtual consultation with all the difficulties that this type of consultation posed to paediatricians for the necessary and adequate physical examination of the patient. 
The main reasons for consultation were: accelerated weight gain, hand damage due to excessive use of electronic games, insomnia and increased irritability. It could also be observed that the use of masks, to prevent the spread of the virus, could be related in some infants to a slight delay in the appearance of an important developmental organiser: the appearance of the social smile. 
After a year and a half of living through a pandemic, our role as paediatricians allows us to make an interdisciplinary reflection on children and adolescents physical and psycho-emotional health, which will help us to make the best and most opportune decisions.