Attention deficit-/hyperactivity disorder (ADHD) is a psychiatric condition that can affect both children and adults. It is characterised by behavioural and attention difficulties. Sleep deficits are a prominent characteristic of the disorder and some of the core symptoms of ADHD are known characteristics of sleep deprivation. The circadian clock is integral to determining the rhythm of the sleep/wake cycle. Furthermore the two main forms of pharmacological treatment for ADHD, namely the psychostimulant methylphenidate, and the non-stimulant atomoxetine, along with the targets of these drugs noradrenaline and dopamine, appear to both interact and be under the regulation of the circadian clock. This thesis aimed firstly to develop a non-invasive technique for the real time RT- PCR quantification of circadian clock gene expression in the human oral mucosa. Secondly to address how circadian clock functioning may be disturbed in adult ADHD via measurement of a number of molecular, endocrine and behavioural markers, for which real-time RT-PCR, ELISA and actigraphy techniques were employed. Thirdly to examine the effects of ADHD medication upon circadian clock protein expression in the rodent brain using immunohistochemistry methods. Here it is demonstrated that disturbances in the rhythmic secretion of endocrine factors that are key outputs and regulators of the master circadian pacemaker, the circadian clock gene expression of a peripheral oscillator and the actigraphic measures of circadian organization of gross behaviour are associated with adult ADHD. Furthermore, both atomoxetine and methylphenidate are shown to effect circadian clock protein expression. Collectively this data suggests a key role for the circadian clock not only in the pathophysiology of adult ADHD but also indicates a role for pharmacological treatments in the modulation of the circadian clock.

Attention deficit and hyperactivity disorder (ADHD) is characterised by a range of behaviours that include excessive motor activity and distractibility. Motor coordination problem is often a feature. It is therefore likely that motor control mechanisms are implicated in ADHD and then executive function associated with it. After a literature review on the correlation between cognition and movement (chapter 1), the novel VSWM (chapter 2) and sequential learning (chapter 3) tasks are introduced. Based on the typical Corsi tapping task, participants were instructed to either move their hand to the stimulus presented on the computer screen or tap the keyboard when they saw it, while trying to remember the location and order of the stimuli. The results suggest that movements deteriorate VSWM in both ADHD and control groups (chapter 2) while they had a tendency to improve learning performance in healthy but not ADHD participants (chapter 3). It was posited that the results from both tasks could have been influenced by differences in the ability to concentrate on the task and difficulty in controlling movements. Two other experiments were used to test this assumption and eliminate any confounds from the memory and learning tasks. The results from chapter 4, which looks at divided attention, indicate a significantly higher response rate in the ADHD compared to the healthy participants, while showing no significant deficit in fine motor but rather on the attentional control (chapter 5) in ADHD participants. These findings are summarised in chapter 6 and discussed in terms of 1) the relationship between movement and cognitive function, 2) the causation of the VSWM deficit in ADHD, and 3) the potential use these tasks may have in a clinical setting as an assessment tool or cognitive training program for people with ADHD.

Stimulant drugs often have a profound calming effect on overactive and inattentive behaviors in children with attention deficit-hyperactivity disorder (ADHD), but only approximately 75 per cent of these children respond favorably to this treatment (Barkley, 1977). Discrimination of "responding" and "non-responding" groups on the basis of demographic, neurophysiological, or behavioral variables would be beneficial both for clinical (elimination of drug trial) and theoretical (description of subtypes) reasons. Previous researchers have identified many promising predictor variables, but relationships between predictor and criterion variables have generally been modest (although statistically significant) in size, and criterion variables have been poorly delineated. In addition, few multivariate investigations have been reported which take into account the relative predictive weight of these variables. The present study evaluated the multivariate relationship between several predictor variables and response to medication in 336 ADHD children, as measured through both rating scales and longer-term outcome measures. Multiple regression analyses revealed that measures of inattention and overactivity were the best predictors of response to a double-blind stimulant medication trial, as determined through parent and teacher rating scales. For cases in which rating scale data were not available, discriminant function analyses for "yes" versus "no" responders were also carried out, indicating results similar to those above. These relationships were highly significant but have limited clinical utility. Demographic variables were generally unsuccessful at prediction of medication response. Additional findings indicated that the results of the clinical trial (as determined by parent and teacher behavioral ratings) were not strongly related to ultimate placement on medication. Further exploration of this issue is called for. / Graduate

Resumo: Neste trabalho investigamos, por meio de aplicação das Provas Operatórias de Conservação de Quantidades Continuas e Descontinuas do Exame Clinico de Piaget, estruturas cognitivas de 50 crianças, das quais 25 pacientes com idades de 7 a 14 anos com TDAH, seguidos no Ambulatório de Neurologia Infantil da UNESP - Botucatu, e 25 crianças na mesma faixa etária, não TDAH para controle. A equipe multiprofissional avaliou os sujeitos que apresentaram nível intelectual esperado para a faixa etária... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: This work investigated, through the application of the Operational Tests of Conservation of Continuous and Discontinuous Quantity of Piaget's Clinical Examination, cognitive strutures of 50 children, 25 of them were ADHD patients whose ages ranged between 7 and 14, followed up in the Pediatric Neurology Clinic of UNESP (São Paulo's State University) - Botucatu campus, and the other 25 children, non-ADHD, belonging to the same age group, composed the control group. The subjects were assessed by a multiprofessional team and the intellectual level they presented was expected according to the age group... (Complete abstract, access undermentioned eletronic address) / Orientador: Tamara Beres Lederer Goldberg / Coorientador: Niura Aparecida Ribeiro de Moura Padula / Banca: Simone Aparecida Capellini / Banca: Patrícia Abreu Pinheiro Crenitte / Mestre

Made available in DSpace on 2014-06-11T19:28:01Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-01-30Bitstream added on 2014-06-13T18:32:26Z : No. of bitstreams: 1 campos_lga_me_botfm.pdf: 1198269 bytes, checksum: 2d010ec2d7b52fe2fcdd51442bcb5e10 (MD5) / Neste trabalho investigamos, por meio de aplicação das Provas Operatórias de Conservação de Quantidades Continuas e Descontinuas do Exame Clinico de Piaget, estruturas cognitivas de 50 crianças, das quais 25 pacientes com idades de 7 a 14 anos com TDAH, seguidos no Ambulatório de Neurologia Infantil da UNESP - Botucatu, e 25 crianças na mesma faixa etária, não TDAH para controle. A equipe multiprofissional avaliou os sujeitos que apresentaram nível intelectual esperado para a faixa etária... / This work investigated, through the application of the Operational Tests of Conservation of Continuous and Discontinuous Quantity of Piaget's Clinical Examination, cognitive strutures of 50 children, 25 of them were ADHD patients whose ages ranged between 7 and 14, followed up in the Pediatric Neurology Clinic of UNESP (São Paulo's State University) - Botucatu campus, and the other 25 children, non-ADHD, belonging to the same age group, composed the control group. The subjects were assessed by a multiprofessional team and the intellectual level they presented was expected according to the age group... (Complete abstract, access undermentioned eletronic address)

O estresse durante o desenvolvimento está associado com diversas desordens neurocomportamentais, que podem persistir ao longo da vida. A hiperatividade é um dos transtornos comportamentais que, com maior frequência, observa-se em humanos submetidos ao estresse precoce. Esse transtorno pode ser a manifestação clínica predominante, ou mesclar-se com déficit de atenção, impulsividade e retardo da aprendizagem, constituindo o Transtorno de Déficit de Atenção e Hiperatividade (TDAH), com número de casos diagnosticados em ascensão. Diversos protocolos experimentais utilizam a separação materna (SM) de roedores neonatos para mimetizar as consequências do estresse precoce em humanos. Esta predileção por roedores recém-nascidos se deve à sua equivalência aproximada com fetos humanos no terceiro trimestre da gestação em termos de neurodesenvolvimento, quando ocorre o maior crescimento do Sistema Nervoso Central fetal. Neste trabalho, camundongos suíços neonatos foram submetidos a sessões diárias de isolamento com separação materna, entre o 2 e o 10 dias de vida pós-natal (PN2 a PN10), variando-se a temperatura de isolamento dos filhotes, que permaneciam sem aquecimento (na temperatura do biotério, entre 22 e 25C) ou eram mantidos aquecidos a 37C durante essas sessões. Portanto, foram três grupos experimentais: isolamento aquecido com SM; isolamento não aquecido com SM; e controle. Os animais do grupo controle foram pesados em PN2 e PN10 e, prontamente, devolvidos às progenitoras. Todos os animais foram desmamados e sexados em PN21, não sendo perturbados até a realização dos testes neurocomportamentais, a partir de PN30, que incluíram os Testes de Campo Aberto e de Esquiva Inibitória. Num segundo estudo, foram realizadas dosagens séricas da corticosterona basal e dos hormônios tireoidianos nos três grupos experimentais, em PN6, PN10 e PN30. Finalmente, num terceiro estudo, camundongos do grupo controle e do grupo submetido ao isolamento não aquecido com SM foram tratados com vimpocetina (20g/kg), um neuroprotetor potencial, ou com veículo (Dimetilsulfóxido), a fim de avaliar os efeitos da vimpocetina na atividade locomotora. O 1 estudo demonstrou que a temperatura foi um fator crítico para a manifestação de hiperatividade locomotora no Teste do Campo Aberto, que ocorreu, somente, nos animais do grupo submetido ao isolamento não aquecido. Adicionalmente, não houve diferenças entre os grupos experimentais no Teste da Esquiva Inibitória, quanto à memória e à aprendizagem. O 2 estudo demonstrou que a temperatura do isolamento influenciou os níveis da corticosterona basal e dos hormônios tireoidianos em PN10 e em PN30. No 3 estudo, a vimpocetina reduziu a hiperatividade locomotora no grupo de animais submetidos ao isolamento não aquecido com SM. De todo o exposto, conclui-se que o isolamento com SM de camundongos suíços neonatos à temperatura de 22 a 25C aumentou a atividade locomotora nesses animais, e que a vimpocetina foi capaz de atenuar esse comportamento, sem aumento da mortalidade. Finalmente, considerando-se o maior risco de desenvolvimento do TDAH em crianças e adolescentes com históricos de prematuridade, levanta-se a hipótese de que o estresse térmico pelo frio seja um dos fatores envolvidos na fisiopatogenia da hiperatividade nesses casos. / The stress during development is associated with several neurobehavioral disorders that can persist into postnatal life. Hyperactivity is one of these disorders that is frequently observed in humans early exposed to the early stress. This disorder may be the predominant clinical manifestation, or merge itself with attention deficit, impulsivity and impaired learning, composing the Attention Deficit Hyperactivity Disorder (ADHD), with the number of diagnosed cases on the rise. Several experimental protocols use maternal separation (MS) of newborn rodents to mimic the effects of early life stress in humans. This predilection for newborn rodents is due to its approximate equivalence with human fetuses at the 3rd trimester of pregnancy in terms of neurodevelopment, when there is the greatest growth of the fetal Central Nervous System (CNS). This work was carried out in three separate studies. In the first study, Swiss mice underwent daily sessions of isolation with maternal separation between the 2nd day of postnatal life (PN2) to PN10, varying the isolation temperature of the puppies, that were kept without heating (with the room temperature between 22 and 25 C) or heated at 37 C during these sessions. Therefore, we had three groups: warmed isolation with MS; unheated isolation with MS; and control. Control group animals were weighed in PN2 and PN10 and promptly returned to its progenitors. All animals were weaned and sexed in PN21 and were tested from PN30 in the Open Field and Inhibitory Passive Avoidance. In a second study, serum basal corticosterone and thyroid hormones were measured in the three experimental groups at PN6, PN10 and PN30. Finally, in a third study, mice from the control group and the group unheated isolation with MS were treated with Vinpocetine (20g / kg), a drug with potential neuroprotective effects, or vehicle (dimethylsulfoxide), in order to evaluate the effects of Vinpocetine on locomotor activity. The 1st study showed that the temperature was critical for the manifestation of locomotor hyperactivity in the Open Field Test, since it took place only in the group submitted to the unheated isolation. There were no differences among groups in the Inhibitory Avoidance Test concerning to memory and learning. The 2nd study showed that the temperature during isolation influenced significantly the levels of basal corticosterone and thyroid hormones in PN10 and PN30. In the 3rd study, Vinpocetine reduced the locomotor hyperactivity in animals submitted to the unheated isolation. Our results suggest that the temperature during neonatal isolation is an important factor to manifestation of neuroendocrine disorders caused by early stress in mice, and that Vinpocetine was able to mitigate them, without increasing mortality. Finally, considering that many cases of hyperactivity in human children are related to prematurity, raises the hypothesis that thermal stress by cold is one of the factors involved in the pathogenesis of hyperactivity in these cases.

Nesta tese objetivamos analisar a compreensão de professoras de escolas públicas sobre o Transtorno de Déficit de Atenção e Hiperatividade (TDAH) e as suas práticas pedagógicas, junto a alunos com esta necessidade especial. Os esforços compilados no presente estudo nasceram da nossa prática profissional, num processo de múltiplas experiências e observações em ambientes escolares onde atuamos diretamente, somados a carência de profissionais habilitados sobre a temática, na área da Educação. Por isso, buscamos compreender como os professores têm trabalhado pedagogicamente com seus alunos com TDAH. Apesar dos muitos cursos de formação docente, os nossos professores têm poucas oportunidades de conhecer melhor o TDAH, em especial no Estado da Paraíba, onde este tema não é suficientemente discutido. O TDAH tem como principal característica a ausência de auto controle ocasionada por fatores orgânicos. Neste trabalho trouxemos a discussão sobre o TDAH, desde seus conceitos às práticas de interação apresentadas por diferentes autores. Realizamos uma pesquisa nas escolas do município de João Pessoa, junto a oito professoras, que tinham tido alunos com TDAH em suas classes, as quais responderam às questões em uma entrevista semiestruturada. Seis entre as oito professoras entrevistadas haviam concluído curso superior, no entanto, nenhuma delas realizou curso na área da Educação Especial ou para lidar com pessoas com TDAH. Os relatos dessas professoras revelaram que o trabalho com as crianças com TDAH, em geral, não diferia dos demais alunos da classe. Contudo, algumas professoras mostraram uma certa flexibilidade, como por exemplo, oferecendo outras atividades para as crianças com TDAH, quando esses alunos conseguiam concluir suas tarefas com mais rapidez. Foi verificado que o aluno com TDAH chegava à sala de aula sem nenhum suporte profissional, com exceção do esperado trabalho do professor. Conforme constatamos, poucas professoras tinham conhecimento prévio de que seu aluno possuía diagnóstico do TDAH. No entanto, isso não motivou as professoras ou a escola a buscar subsídios para que o aluno com TDAH fosse direcionado adequadamente. Para Benczik e Bromberg (2003), a presença de professores compreensivos, que colaborem com a criança, é imperativo para o desenvolvimento do potencial do aluno com TDAH. Como discutido, este transtorno envolve três tipos: o desatento, o hiperativo e o impulsivo. Isto nos levou a perceber que as atividades precisariam ser mais especificas, pois cada tipo de TDAH apresenta peculiaridades diferenciadas, ou seja, que cada um deles apresenta necessidades educacionais especiais específicas que demandam atendimento diferenciado. É relevante, portanto, que sejam realizados estudos que pontuem e trabalhem cada tipo de TDAH enfatizando suas especificidades visando um melhor desenvolvimento acadêmico e social destes alunos. / In this thesis we had as objective to analyze the understanding of public school teachers about the Attention Deficit Hyperactivity Disorder (ADHD) as well as their pedagogical practices with students with this special need. The efforts for the present study raised from our professional practice, in a process of multiple experiences and observations in school settings where we worked, added to the lack of professionals specialized in this theme among the area of Education. Therefore, we seek to understand how teachers have been working pedagogically with their students with ADHD. In spite of many teacher formation courses, our teachers have few opportunities to know more about the ADHD, especially in the State of Paraiba, where this theme is not sufficiently discussed. In this work we brought the discussion about ADHD, from its concept to the interaction practices presented by different authors. We undertook a research in schools of the City of Joao Pessoa, with eight teachers who had in their classes, students with ADHD, who answered questions in a semi-structured interview. Six among the eight teachers interviewed had concluded higher education, however, none had done any courses in the area of Special Education or geared to deal with persons with ADHD. The reports of these teachers showed that the work with ADHD children, in general, was not different that with the other students of the class. But some teachers showed a certain flexibility, for example, offering other activities for children with ADHD when these students were able to finish their tasks more quickly. It was verified that the student with ADHD arrived at the classroom without any professional support, with the exception of the expected work of the teacher. As we were able to notice, few teachers had previous knowledge that the student had ADHD diagnosis. However, this fact was not enough to motivate them or the school to search for subsidies in order for the student with ADHD to be adequately directed. For Benczik and Bromberg (2003), the presence of understanding teachers who collaborate with the child, is very important for the students with a ADHD potential development. As discussed, this disorder involves three types: non attentive, the hyperactive, and the impulsive. This lead us to perceive that the activities should be more specific, since each type of ADHD presents different peculiarities, that is, each one of them presents specific educational special needs that demand differential treatment. It is relevant, therefore, that be undertaken studies that focus and work each ADHD type, with emphasis in their specificities in order to achieve a better academic and social development for this students.

A partir da leitura de pesquisas que envolvem o ensino de língua(gem), oral ou escrita, e as práticas docentes voltadas para este fim, inferimos que, ainda hoje, o trabalho com a linguagem, muitas vezes, é realizado de forma limitada, reducionista, como se aprender a língua fosse uma questão de codificar e decodificar um alfabeto. Escola e professores ainda se encontram presos ao que é determinado pelo livro didático ou por apostilas, muito utilizadas, atualmente, cujas atividades enfatizam o preenchimento de lacunas e a repetição do sentido dos textos lidos. Isso faz com que muitos professores, voltados aos materiais didáticos, não trabalhem com a língua(gem) de maneira a proporcionar ao sujeito-aluno usar a escrita para manifestar opiniões, sentimentos e sentidos que o afetam. Neste trabalho, objetivamos analisar as produções textuais de alunos do Ensino Fundamental, discursivizados como hiperativos ou com dificuldade de aprendizagem, a fim de investigar como estes alunos usam a escrita para colocar em curso os sentidos com os quais eles se identificam acerca do tema trabalhado. Isso significa que investigamos a relação entre escrita e subjetividade. A nosso ver, essa relação deve ser estudada, já que a língua é usada pelas crianças para falar o mundo e sobre ele; então, surge aqui, a necessidade de aprofundar nossos estudos sobre como a linguagem escrita é utilizada pelos alunos para escreverem acerca de suas vivências. Além disso, observaremos como se dá a constituição da identidade do sujeito, na/pela linguagem. Os sujeitos da pesquisa são alunos que frequentam o 4º e o 5º ano do Ensino Fundamental, na cidade de Ribeirão Preto SP, alunos com idade entre nove e dez anos e que foram considerados pelas professoras dos anos anteriores como alunos que apresentavam dificuldade para a leitura e a escrita, ou, considerados hiperativos. Nosso corpus é constituído pelos textos escritos por estes sujeitos acerca do tema família. A professora das turmas conduziu as aulas em que os textos foram escritos pelas crianças e nos informou sobre como se deram as condições de produção discursivas. Para a realização da coleta de dados, a professora leu, interpretou e discutiu com os alunos os seguintes textos: um poema (Infância - Drummond) e uma música (Família- Titãs), que falavam sobre o tema proposto (família) e as crianças deveriam utilizá-los como arquivo para a escrita de sua produção textual. Como resultado, as análises apontam que a autoria se instala nos textos analisados, o que contraria a formação discursiva dominante sobre os alunos considerados hiperativos ou com dificuldade de aprendizagem de leitura e escrita. Os sujeitos assumem a responsabilidade pelo dizer, marcando um posicionamento em relação ao objeto discursivo, controlando os possíveis pontos de fuga do sentido e os mecanismos internos do texto, mostrando que, mesmos os alunos considerados pela escola como alunos com dificuldades de aprendizagem, ou com hiperatividade são capazes de escrever textos que apresentam coesão e coerência, e desta forma, conseguem posicionar-se como autores de seus textos, sustentando o seu dizer por meio de escritos nos quais eles inscrevem subjetividades. / From the reading of research involving language teaching (gem), oral or written, and teaching practices geared towards this end, we infer that, today, work with language, it is often performed in a limited way, reductionist, as if learning the language was a matter of encoding and decoding an alphabet. School and teachers are still stuck with what is determined by the textbook or handouts, widely used today, whose activities emphasize fill gaps and repetition of the meaning of the texts read. This causes many teachers, teaching materials geared to not work with the language (gem) in order to provide the subject-student use writing to express opinions, feelings and senses that affect it. Here we analyze the textual productions of elementary school students, called as hyperactive or learning disability in order to investigate how these students use writing to get underway senses with which they identify on the subject worked. This means that we investigate the relationship between writing and subjectivity. In our view, this relationship should be studied, since the language is used by children to the world and talk about it, so here comes the need to deepen our studies of how written language is used by students to write about their experiences. Moreover, if we look at how the constitution gives the subject\'s identity in / through language. The research subjects are students in the 4th and 5th year of elementary school in the city of Ribeirão Preto - SP, pupils aged between nine and ten years and who were considered by teachers in previous years as students who had difficulty reading and writing, or considered hyperactive. Our corpus consists of texts written by these guys on the theme \"family.\" The teacher led the class lessons in which the texts were written by the children and informed us about how you got the discursive production conditions. To collect the data, the teacher read, interpreted and discussed with students the following texts: a poem (Childhood - Drummond) and a song (Family-Titans), who spoke on the proposed topic (family) and children should use them as a file for writing textual production. As a result, the analyzes indicate that the authorship settles in the texts analyzed, which contradicts the dominant discursive formation on students considered hyperactive or learning difficulty reading and writing. Individuals take responsibility for say, marking a position on the discursive object, controlling the possible effect of the vanishing points and the internal mechanisms of the text, showing that these students considered by the school as students with learning difficulties, or hyperactivity are able to write texts that show cohesion and consistency, and thus can position themselves as authors of their texts, supporting their say through writings in which they inscribed subjectivities.

M.Tech. / This research was conducted to determine the efficacy of Choresan (R36) ® on children with “Specific Learning Disabilities”. Choresan (R36) ® is a complex homoeopathic formulation indicated for use in mild nervous disorders, physical restlessness, tics and spasms and muscular twitching (Dr. Reckeweg and Co. GMBH, 2009). Choresan (R36)® contains a combination of homoeopathic remedies that lend to usage for the symptomology associated with Specific Learning Disabilities. Specific Learning Disabilities are defined as a group of basic psychological processes which affect the understanding and use of language (written and spoken). Individuals present with an inability to learn as well as restlessness or hyperactivity (Webb, 2008). The management of Specific Learning Disabilities is two fold, namely education and scheduled drugs. The use of antipsychotic and stimulant drugs have problematic long term efficacy with adverse side effects (Matson and Neal, 2009). This study was conducted to determine if homoeopathic medicine may be able to suggest a safer, side effect free alternative.

D.Ed. / The practice regarding the diagnosing and therapeuterising, with Ritalin, of children with ADHD (Attention Deficit Hyperactivity Disorder) is inadequate. There is in general practice little, if any, signs of holistic interactive co-operation amongst practitioners regarding diagnosing and therapeuterising, with Ritalin, exceptions excluded. The practice situation reflects a rather fragmented image, unscientific practises regarding diagnostic and therapeutic instruments and procedures, ignorance and incompleteness. The rational why this study was undertaken is because of the researcher's experience of the overwhelming inadequacy of this practice. The aim of this research was to develop, validate and describe standards for the holistic interactive management of the practice of diagnosing of the child \Vith ADHD and his/her therapy, with Ritalin. These standards can contribute towards improvement of the total practice, that is improvement of aid rendering to this child in order to optimise his/her functioning accordingly. In order to reach this aim, a research method was followed whereby an intensive literature study, multiple case studies and a questionnaire survey regarding a variety of professional practitioners and parents, was introduced in order to obtain data from the practice situation. Data was continuously qualitatively analised within the parameters of a theoretically grounded conceptual framework. These analyses eventually culminated in the description of concept standards and revised concept standards which were submitted to five domain experts for validation. The final standards which were determined through a process of a reasonable high level of consensus amongst these experts, is described in two official languages, namely Afrikaans and English. The final standards reflect the need from practice, namely holistic interactive management of the procedures of diagnosis and therapy, with Ritalin, of the child with ADHD.