The aim of this descriptive review was to elucidate how the literature describes how children of parents with mental illness experience and have knowledge about their parent’s illness. The aim was furthermore to describe how the children’s existence is affected, can be improved and why the children so often are invisible. Search through Medline (through PubMed) database and additional manual search was conducted. In total fourteen articles fulfilled the inclusion criteria and were reviewed. The chosen method for analysis was qualitative and the results are presented on the basis of different subjects that elucidated the questions at issue. The study shows that children of parents with mental disorder often takes responsibility for the parents disease, a disease that has to be kept a secret and often lead to social isolation for the children. The children often have poor knowledge of the parent’s illness. Due to different obstacles these children are difficult to identify and thereby also difficult to help. The children themselves have clear opinions of what kind of help they want, mainly economic and domestic support, conversational support and information. One of the authors’ conclusions is that new research needs to be done regarding Swedish conditions. / Syftet med denna deskriptiva litteraturstudie var att belysa hur litteraturen beskriver hur barn till föräldrar med psykisk sjukdom upplever och har kunskap om föräldrarnas sjukdom. Dessutom var syftet att beskriva hur barnens tillvaro påverkas, kan förbättras och varför barnen ofta är svåra att identifiera. Litteratursökningen genomfördes i databasen Medline (via PubMed) och kompletterades med manuell sökning. Fjorton artiklar som mötte inklusions-kriterierna granskades. Analysmetoden var kvalitativ och resultatet presenteras utifrån olika områden som belyser frågeställningarna. Studien visar att barnen till föräldrar med psykisk sjukdom ofta tar på sig ansvaret för förälderns sjukdom, en sjukdom som måste hållas hemlig och ofta leder till social isolering för barnen. Barnen har ofta dåliga kunskaper om förälderns sjukdom. På grund av olika hinder är dessa barn svåra att identifiera och därmed också svåra att ge stöd och hjälp. Barnen själva har tydliga uppfattningar om vilken hjälp de önskar, främst ekonomiskt stöd och hjälp i hushållet samt samtalsstöd och information. En slutsats författarna drar är att ny forskning behöver göras avseende svenska förhållanden.

Mémoire numérisé par la Division de la gestion de documents et des archives de l'Université de Montréal

The current research utilizes a multi-level analysis of historical, clinical, situational and neighbourhood factors to predict violence severity among persons with major mental illness. In addition, it draws on the typologies of offenders proposed by Moffitt (1993) and Hodgins and Janson (2002) to explore whether different predictors of violence severity exist for early-start, persistent offenders and late-start offenders. Finally, it compares early-start and late-start offenders with major mental illness to determine if differences exist in their criminal history, clinical presentation, motive for violence, crime-scene behaviours and neighbourhood backgrounds. A retrospective chart review of a mental health court support program in Toronto, Canada is utilized to explore the correlates of violence severity. Clinical charts and supplemental arrest records are content analyzed to extract data on arrestee/offender characteristics and on crime scene behaviours and tract-level data from the 2001 Canada Census is used to identify structural features of the neighbourhood environment of arrestees/offenders at the time of their arrest. Violence severity is measured using the Cormier-Lang System of Quantifying Criminal History (Quinsey, Harris, Rice, & Cormier, 1998). In total 1806 charts were reviewed and 245 subjects were subsequently included within the analyses. Using a variety of analytic techniques, the following results were obtained: 1) offense characteristics such as victim gender, victim-offender relationship, instrumental motive, and use of a weapon were the most robust predictors of violence severity while clinical factors such as diagnosis and comorbid clinical conditions were marginally significant predictors and historical factors such as previous violence and early-start offending were not significant predictors of violence severity; 2) context-specific measures accounted for more of the explained variation in violence severity than did individual-specific measures; 3) early-start and late-start offenders did differ with respect to history of violence, presence of a comorbid clinical condition such as a personality disorder or substance abuse and current life circumstances. Implications for theory refinement, clinical practice and program development are discussed and future avenues of research are considered.

The current research utilizes a multi-level analysis of historical, clinical, situational and neighbourhood factors to predict violence severity among persons with major mental illness. In addition, it draws on the typologies of offenders proposed by Moffitt (1993) and Hodgins and Janson (2002) to explore whether different predictors of violence severity exist for early-start, persistent offenders and late-start offenders. Finally, it compares early-start and late-start offenders with major mental illness to determine if differences exist in their criminal history, clinical presentation, motive for violence, crime-scene behaviours and neighbourhood backgrounds. A retrospective chart review of a mental health court support program in Toronto, Canada is utilized to explore the correlates of violence severity. Clinical charts and supplemental arrest records are content analyzed to extract data on arrestee/offender characteristics and on crime scene behaviours and tract-level data from the 2001 Canada Census is used to identify structural features of the neighbourhood environment of arrestees/offenders at the time of their arrest. Violence severity is measured using the Cormier-Lang System of Quantifying Criminal History (Quinsey, Harris, Rice, & Cormier, 1998). In total 1806 charts were reviewed and 245 subjects were subsequently included within the analyses. Using a variety of analytic techniques, the following results were obtained: 1) offense characteristics such as victim gender, victim-offender relationship, instrumental motive, and use of a weapon were the most robust predictors of violence severity while clinical factors such as diagnosis and comorbid clinical conditions were marginally significant predictors and historical factors such as previous violence and early-start offending were not significant predictors of violence severity; 2) context-specific measures accounted for more of the explained variation in violence severity than did individual-specific measures; 3) early-start and late-start offenders did differ with respect to history of violence, presence of a comorbid clinical condition such as a personality disorder or substance abuse and current life circumstances. Implications for theory refinement, clinical practice and program development are discussed and future avenues of research are considered.

O presente estudo tem como objetivo central analisar o conceito de deficiência intelectual e suas opções terminológicas, considerando como estas se instituem no contexto brasileiro. Buscou-se ainda refletir sobre os possíveis efeitos dessas alternativas conceituais e terminológicas quanto à avaliação inicial e ao encaminhamento aos serviços de apoio especializado em educação especial. A pesquisa, de cunho qualitativo, utiliza predominantemente o levantamento bibliográfico e a análise documental, além de discutir os indicadores educacionais vinculados às matrículas dos alunos público-alvo da educação especial. A base teórica de referência foi o pensamento sistêmico associado aos estudos do campo da educação especial. Essa perspectiva tende a favorecer uma análise baseada na busca de contextualização, valorizando os princípios da complexidade, instabilidade e intersubjetividade. A partir da análise, pode-se inferir que, historicamente, tem sido problematizadas as alternativas de nomeação da deficiência intelectual, sendo que tais alternativas produzem efeitos associados a sujeitos que podem ser identificados como integrantes do maior contingente dentre as pessoas com deficiência. Destaca-se a ação da Associação Americana de Deficiência Intelectual e Desenvolvimento (AAIDD) no que diz respeito à definição do conceito e dos processos de identificação e diagnóstico. A análise identifica que as alterações terminológicas coexistem com a manutenção de definição conceitual. Houve, ainda, uma busca de indicadores de matrículas associadas aos alunos inseridos na categoria de deficiência intelectual do Censo Escolar MEC/INEP no período de 2007 a 2014. Por meio desse levantamento, identificou-se um aumento expressivo das matrículas dos alunos inseridos na categoria de deficiência intelectual nos últimos anos. Em última análise, pode-se apontar que a responsabilidade pelo processo diagnóstico continua sendo dos profissionais da área clínica. Porém, recentemente as políticas de inclusão no Brasil introduziram, por meio da Nota técnica nº 4 de 2014, a valorização da ação dos profissionais da área da educação como responsável pelo processo de identificação e avaliação inicial. Este último ponto, considerado como um elemento novo, ainda não tem sido alvo das pesquisas acadêmicas e, dessa forma não temos como problematizar seus efeitos. / The present study was aimed at analyzing the concept of intellectual disability, its terminological options, and how they are instituted in the Brazilian context. In addition, the study also reflected on the possible effects of these conceptual and terminological alternatives regarding initial assessment and referral to special education support services. The research was qualitative and predominantly used literature survey and document analysis, besides discussing educational indicators linked to special education students’ enrollment. Systems thinking associated with studies in the field of special education were used as theoretical framework. The perspective used in this study tends to favor analysis based on the search for contextualization, which values principles of complexity, instability and intersubjectivity. Through analysis, it was inferred that intellectual disability nomenclature alternatives have been historically problematized. Such alternatives produce effects associated to individuals who can be identified as members of the largest contingent among people with disabilities. Action by the American Association on Intellectual and Developmental Disabilities (AAIDD) regarding the definition of concept and processes of identification and diagnosis was highlighted. Analysis found that terminological changes coexist with conceptual definition maintenance. Moreover, there was also search for enrollment indicators associated to students inserted in the Intellectual Disability category of MEC/INEP’s School Census from 2007 to 2014. Through the School Census survey, a significant increase in the enrollment of students classified in the Intellectual Disability category was identified in recent years. Ultimately, it was pointed out that diagnosis responsibility remains with professionals in the clinical area. However, inclusion policies in Brazil have recently introduced the valorization of education professionals as responsible for identification and initial assessment through Technical Note No. 4 2014. The latter point, which is considered a new element, has not been the subject of academic research yet. Therefore, it is not possible to problematize its effects.

Introdução: os transtornos mentais freqüentemente têm início na infância e podem persistir até a idade adulta. Assim, transtornos mentais em crianças e adolescentes apresentam alta prevalência. Determinantes ambientais, genéticos, biológicos e comportamentais têm sido investigados na etiologia dos transtornos mentais. Objetivos: estudar a prevalência e a continuidade dos transtornos mentais no início da adolescência e os determinantes precoces para problemas de atenção e hiperatividade na mesma faixa etária. Métodos: realizaram-se dois estudos com delineamento prospectivo de coorte e um estudo transversal aninhado ao estudo longitudinal com duas fases: triagem e diagnóstico de saúde mental. Em 1993, todos os nascimentos hospitalares ocorridos na cidade de Pelotas foram monitorados (N = 5.249). Amostras destas crianças foram visitadas no primeiro e no quarto ano de vida. Em 2004-5, 4.452 (87,5% da coorte original) adolescentes e suas mães foram entrevistados. Neste seguimento, foram utilizados três instrumentos de coleta de dados sobre saúde mental. Inicialmente, 4.452 adolescentes e suas mães responderam ao Questionário de Capacidades e Dificuldades (SDQ) para avaliar problemas de saúde mental dos adolescentes. Os adolescentes com rastreamento positivo (na versão do SDQ das mães ou na de auto-preenchimento), mais uma amostra com rastreamento negativo, foram selecionados (juntamente com suas mães) para responderem à entrevista Levantamento sobre o Desenvolvimento e Bem-estar de Crianças e Adolescentes (DAWBA). Procedeu-se a uma nova visita domiciliar para uma entrevista com as mães de uma amostra de adolescentes (os mesmos avaliados aos 4 anos), utilizando o Inventário de Comportamentos da Infância e Adolescência (CBCL). Resultados: a prevalência de transtornos mentais no início da adolescência foi estimada em 10,8% (IC 95% 5,7-15,9%), sendo os grupos de transtornos mais prevalentes os do comportamento disruptivo, seguidos dos de ansiedade. Na reaplicação do CBCL após oito anos (aos 4 e 12 anos de idade), houve uma continuidade moderada da psicopatologia. Assim 31% das crianças com comportamento desviante aos 4 anos persistiam com esses comportamentos aos 12 anos. Os problemas de externalização aos 4 anos foram os que apresentaram maior estabilidade em 8 anos e, também, os principais preditores de diferentes desfechos em saúde mental. Os fatores de risco (coletados no nascimento e quarto ano) que permaneceram associados aos problemas de atenção e hiperatividade aos 12 anos foram: a) renda familiar; b) sexo masculino; c) tabagismo materno na gestação; d) transtorno psiquiátrico materno; e) problemas de comportamento e emocionais da criança. Conclusões: os resultados mostraram-se similares aos achados de estudos, brasileiros e internacionais, em relação às taxas de prevalências, aos padrões de psicopatologia mais freqüentes, à evolução, aos antecedentes comportamentais e aos fatores de risco dos transtornos mentais, apontando para a universalidade dos transtornos mentais entre diferentes culturas. Fatores ambientais, biológicos e psicológicos, presentes no início da vida, tiveram efeito de longo prazo em escores de desatenção e hiperatividade na adolescência, confirmando achados prévios de estudos de coortes de nascimentos. / Introduction: mental disorders often begin during childhood and may persist up to the adult age. In addition, their prevalence in children and adolescent is high. Environmental, genetics, biological and psychological determinants have been investigated in the etiology of mental disorder. Objectives: to study the prevalence and the continuity of mental disorders in the early adolescence, as well as early determinants for attention and hyperactivity problems at the same age range. Methods: two studies with a cohort prospective design were developed and a transversal study was nested into the longitudinal study with two phases: screening and diagnoses of mental disorder. In 1993, all the births which took place in hospitals in the city of Pelotas were monitored (N = 5,249). Samples of these children were visited in the first and fourth year of age. In 2004-5, 4,452 (87.5% of the original cohort) adolescents and their mothers were interviewed. In this follow-up, three instruments assessing the mental health of the adolescents were applied. Initially, 4,452 adolescents and their mothers answered to the Strenghs and Difficulties Questionnaire (SDQ) to evaluate problems of mental health of the adolescents. The adolescents with positive screening (in the SDQ of the mothers or self-report versions), and a sample of those with negative screening, were selected (as well as their mothers) to answer to the Development and Well-Being of Children and Adolescents Interview (DAWBA). A new home visit was proceeded for an interview with the mothers of a sample of adolescents (the same who had been evaluated at 4 years of age), using the Child and Adolescent Behavior CheckList (CBCL). Results: the prevalence of mental disorder in early adolescence was estimated in 10.8% (95%CI 5.7-15.9). The most prevalent disorders were the group of disruptive behavior disorders, followed by anxiety disorders. By the time CBCL was reapplied after eight years (at the ages of 4 and 12), there was a moderate continuity of psychopathology. Thus, 31% of the children with deviant behavior at 4 years of age kept their deviant scores at 12 years of age. The externalizing problems at 4 years of age were the ones with higher stability and, also, the main predictors of different outcomes in mental health at early adolescence. The factors (measured at birth and fourth year) which remained associated to the problems of attentional and hyperactivity at 12 years of age were: a) family income; b) male sex; c) maternal smoking during pregnancy; d) maternal psychiatric disorder; e) behavioral and emotional problems of the child. Conclusions: our findings were similar to those found in both Brazilian and international studies regarding the prevalence rate, the most frequent psychopathological pattern, the evolution, behavioral antecedents and risk factors of a mental disorder, indicating the universality of mental disorders among different cultures. Environmental, biological and psychological factors, which are present in the beginning of life, had a long-term effect in attention and hyperactivity problems at the adolescence, confirming previous findings in studies of birth cohort.

Introdução: os transtornos mentais freqüentemente têm início na infância e podem persistir até a idade adulta. Assim, transtornos mentais em crianças e adolescentes apresentam alta prevalência. Determinantes ambientais, genéticos, biológicos e comportamentais têm sido investigados na etiologia dos transtornos mentais. Objetivos: estudar a prevalência e a continuidade dos transtornos mentais no início da adolescência e os determinantes precoces para problemas de atenção e hiperatividade na mesma faixa etária. Métodos: realizaram-se dois estudos com delineamento prospectivo de coorte e um estudo transversal aninhado ao estudo longitudinal com duas fases: triagem e diagnóstico de saúde mental. Em 1993, todos os nascimentos hospitalares ocorridos na cidade de Pelotas foram monitorados (N = 5.249). Amostras destas crianças foram visitadas no primeiro e no quarto ano de vida. Em 2004-5, 4.452 (87,5% da coorte original) adolescentes e suas mães foram entrevistados. Neste seguimento, foram utilizados três instrumentos de coleta de dados sobre saúde mental. Inicialmente, 4.452 adolescentes e suas mães responderam ao Questionário de Capacidades e Dificuldades (SDQ) para avaliar problemas de saúde mental dos adolescentes. Os adolescentes com rastreamento positivo (na versão do SDQ das mães ou na de auto-preenchimento), mais uma amostra com rastreamento negativo, foram selecionados (juntamente com suas mães) para responderem à entrevista Levantamento sobre o Desenvolvimento e Bem-estar de Crianças e Adolescentes (DAWBA). Procedeu-se a uma nova visita domiciliar para uma entrevista com as mães de uma amostra de adolescentes (os mesmos avaliados aos 4 anos), utilizando o Inventário de Comportamentos da Infância e Adolescência (CBCL). Resultados: a prevalência de transtornos mentais no início da adolescência foi estimada em 10,8% (IC 95% 5,7-15,9%), sendo os grupos de transtornos mais prevalentes os do comportamento disruptivo, seguidos dos de ansiedade. Na reaplicação do CBCL após oito anos (aos 4 e 12 anos de idade), houve uma continuidade moderada da psicopatologia. Assim 31% das crianças com comportamento desviante aos 4 anos persistiam com esses comportamentos aos 12 anos. Os problemas de externalização aos 4 anos foram os que apresentaram maior estabilidade em 8 anos e, também, os principais preditores de diferentes desfechos em saúde mental. Os fatores de risco (coletados no nascimento e quarto ano) que permaneceram associados aos problemas de atenção e hiperatividade aos 12 anos foram: a) renda familiar; b) sexo masculino; c) tabagismo materno na gestação; d) transtorno psiquiátrico materno; e) problemas de comportamento e emocionais da criança. Conclusões: os resultados mostraram-se similares aos achados de estudos, brasileiros e internacionais, em relação às taxas de prevalências, aos padrões de psicopatologia mais freqüentes, à evolução, aos antecedentes comportamentais e aos fatores de risco dos transtornos mentais, apontando para a universalidade dos transtornos mentais entre diferentes culturas. Fatores ambientais, biológicos e psicológicos, presentes no início da vida, tiveram efeito de longo prazo em escores de desatenção e hiperatividade na adolescência, confirmando achados prévios de estudos de coortes de nascimentos. / Introduction: mental disorders often begin during childhood and may persist up to the adult age. In addition, their prevalence in children and adolescent is high. Environmental, genetics, biological and psychological determinants have been investigated in the etiology of mental disorder. Objectives: to study the prevalence and the continuity of mental disorders in the early adolescence, as well as early determinants for attention and hyperactivity problems at the same age range. Methods: two studies with a cohort prospective design were developed and a transversal study was nested into the longitudinal study with two phases: screening and diagnoses of mental disorder. In 1993, all the births which took place in hospitals in the city of Pelotas were monitored (N = 5,249). Samples of these children were visited in the first and fourth year of age. In 2004-5, 4,452 (87.5% of the original cohort) adolescents and their mothers were interviewed. In this follow-up, three instruments assessing the mental health of the adolescents were applied. Initially, 4,452 adolescents and their mothers answered to the Strenghs and Difficulties Questionnaire (SDQ) to evaluate problems of mental health of the adolescents. The adolescents with positive screening (in the SDQ of the mothers or self-report versions), and a sample of those with negative screening, were selected (as well as their mothers) to answer to the Development and Well-Being of Children and Adolescents Interview (DAWBA). A new home visit was proceeded for an interview with the mothers of a sample of adolescents (the same who had been evaluated at 4 years of age), using the Child and Adolescent Behavior CheckList (CBCL). Results: the prevalence of mental disorder in early adolescence was estimated in 10.8% (95%CI 5.7-15.9). The most prevalent disorders were the group of disruptive behavior disorders, followed by anxiety disorders. By the time CBCL was reapplied after eight years (at the ages of 4 and 12), there was a moderate continuity of psychopathology. Thus, 31% of the children with deviant behavior at 4 years of age kept their deviant scores at 12 years of age. The externalizing problems at 4 years of age were the ones with higher stability and, also, the main predictors of different outcomes in mental health at early adolescence. The factors (measured at birth and fourth year) which remained associated to the problems of attentional and hyperactivity at 12 years of age were: a) family income; b) male sex; c) maternal smoking during pregnancy; d) maternal psychiatric disorder; e) behavioral and emotional problems of the child. Conclusions: our findings were similar to those found in both Brazilian and international studies regarding the prevalence rate, the most frequent psychopathological pattern, the evolution, behavioral antecedents and risk factors of a mental disorder, indicating the universality of mental disorders among different cultures. Environmental, biological and psychological factors, which are present in the beginning of life, had a long-term effect in attention and hyperactivity problems at the adolescence, confirming previous findings in studies of birth cohort.

250 000 enfants sont impliqués dans les dispositifs de l'Aide Sociale à l'Enfance ; 135 000 sont placés. Ils devraient présenter des taux élevés de troubles mentaux car la raison principale qui conduit au placement, le dysfonctionnement familial sévère et durable, est aussi un facteur de risque largement reconnu au développement de la plupart des troubles mentaux survenant dans l'enfance. Les rares études d'épidémiologie pédopsychiatrique réalisées auprès de cette population spécifique et repérable dans quelques pays anglo-saxons et germaniques, affirment effectivement des taux dépassant volontiers les 50%. Ces enfants sont paradoxalement peu pris en charge par les dispositifs de pédopsychiatrie, car la place des parents, ici défaillants, y est en général essentielle et l'articulation entre les professionnels des champs socio-éducatif et médico-psychologique est médiocre. Le contact avec les services de pédopsychiatrie se fait volontiers par les urgences en situation de crise comportementale. Après avoir décrit l'histoire de la « protection de l'enfance » et de la pédopsychiatrie, notamment leur construction concomitante et entremêlée à partir du 19ème siècle, nous analysons les points favorisant et défavorisant leur rencontre. Nous envisageons aussi les possibilités et les freins à la recherche scientifique en milieu socio-éducatif. Nous présentons ensuite les résultats de deux études menées auprès d'adolescents placés en foyers du département des Bouches-du-Rhône : une étude de prévalence des troubles mentaux et une étude de leur Qualité de la Vie et des liens de ces valeurs avec les troubles mentaux. / 250 000 children and adolescents are involved in the child welfare system in France. 135 000 are living in « out-of-home care ». These children should have high rates of mental disorders because the severe familial dysfonction which drive them in these social institutions is a wellknown risk factor for the main mental disorders too. Prevalence studies of mental disorders among this very specific population are rares and have been held in anglo-saxon or germanics countries. They show mental disorders rates above 50%. However, their access to regular mental services is weak, because of failing parents and the poverty of the partnerships between social workers and child mental health professionals. These adolescents often meet child psychiatry through emergency during a behavioral crisis. We describe, in a first part, the history of child welfare system and of the child psychiatry, in particular through their co-construction since the 19th century. We analyze the elements influencing their partnerships. We examine too the difficulties to organize scientific research in the field of the child welfare. We presents, then, the results of two studies among adolescents living in residential group homes in the county of Bouches-du-Rhône (France) : a prevalence of mental disorders study and a Quality of Life study including the links between these values and the mental disorders. Results show mental disorders rates five times more frequents than in general population, and much more among girls, with specific psychopathologic profiles and an irregular expression of mental health needs degrading the screening. These data are the first in France.

O presente estudo tem como objetivo central analisar o conceito de deficiência intelectual e suas opções terminológicas, considerando como estas se instituem no contexto brasileiro. Buscou-se ainda refletir sobre os possíveis efeitos dessas alternativas conceituais e terminológicas quanto à avaliação inicial e ao encaminhamento aos serviços de apoio especializado em educação especial. A pesquisa, de cunho qualitativo, utiliza predominantemente o levantamento bibliográfico e a análise documental, além de discutir os indicadores educacionais vinculados às matrículas dos alunos público-alvo da educação especial. A base teórica de referência foi o pensamento sistêmico associado aos estudos do campo da educação especial. Essa perspectiva tende a favorecer uma análise baseada na busca de contextualização, valorizando os princípios da complexidade, instabilidade e intersubjetividade. A partir da análise, pode-se inferir que, historicamente, tem sido problematizadas as alternativas de nomeação da deficiência intelectual, sendo que tais alternativas produzem efeitos associados a sujeitos que podem ser identificados como integrantes do maior contingente dentre as pessoas com deficiência. Destaca-se a ação da Associação Americana de Deficiência Intelectual e Desenvolvimento (AAIDD) no que diz respeito à definição do conceito e dos processos de identificação e diagnóstico. A análise identifica que as alterações terminológicas coexistem com a manutenção de definição conceitual. Houve, ainda, uma busca de indicadores de matrículas associadas aos alunos inseridos na categoria de deficiência intelectual do Censo Escolar MEC/INEP no período de 2007 a 2014. Por meio desse levantamento, identificou-se um aumento expressivo das matrículas dos alunos inseridos na categoria de deficiência intelectual nos últimos anos. Em última análise, pode-se apontar que a responsabilidade pelo processo diagnóstico continua sendo dos profissionais da área clínica. Porém, recentemente as políticas de inclusão no Brasil introduziram, por meio da Nota técnica nº 4 de 2014, a valorização da ação dos profissionais da área da educação como responsável pelo processo de identificação e avaliação inicial. Este último ponto, considerado como um elemento novo, ainda não tem sido alvo das pesquisas acadêmicas e, dessa forma não temos como problematizar seus efeitos. / The present study was aimed at analyzing the concept of intellectual disability, its terminological options, and how they are instituted in the Brazilian context. In addition, the study also reflected on the possible effects of these conceptual and terminological alternatives regarding initial assessment and referral to special education support services. The research was qualitative and predominantly used literature survey and document analysis, besides discussing educational indicators linked to special education students’ enrollment. Systems thinking associated with studies in the field of special education were used as theoretical framework. The perspective used in this study tends to favor analysis based on the search for contextualization, which values principles of complexity, instability and intersubjectivity. Through analysis, it was inferred that intellectual disability nomenclature alternatives have been historically problematized. Such alternatives produce effects associated to individuals who can be identified as members of the largest contingent among people with disabilities. Action by the American Association on Intellectual and Developmental Disabilities (AAIDD) regarding the definition of concept and processes of identification and diagnosis was highlighted. Analysis found that terminological changes coexist with conceptual definition maintenance. Moreover, there was also search for enrollment indicators associated to students inserted in the Intellectual Disability category of MEC/INEP’s School Census from 2007 to 2014. Through the School Census survey, a significant increase in the enrollment of students classified in the Intellectual Disability category was identified in recent years. Ultimately, it was pointed out that diagnosis responsibility remains with professionals in the clinical area. However, inclusion policies in Brazil have recently introduced the valorization of education professionals as responsible for identification and initial assessment through Technical Note No. 4 2014. The latter point, which is considered a new element, has not been the subject of academic research yet. Therefore, it is not possible to problematize its effects.

Submitted by Ana Carla Almeida (ana.almeida@ucsal.br) on 2016-09-27T18:00:10Z No. of bitstreams: 1 DISSERTAÇÃO.pdf: 3127752 bytes, checksum: bf61ab94c26ce1b4298f77c7923b48ce (MD5) / Approved for entry into archive by Maria Emília Carvalho Ribeiro (maria.ribeiro@ucsal.br) on 2016-09-30T22:28:15Z (GMT) No. of bitstreams: 1 DISSERTAÇÃO.pdf: 3127752 bytes, checksum: bf61ab94c26ce1b4298f77c7923b48ce (MD5) / Made available in DSpace on 2016-09-30T22:28:15Z (GMT). No. of bitstreams: 1 DISSERTAÇÃO.pdf: 3127752 bytes, checksum: bf61ab94c26ce1b4298f77c7923b48ce (MD5) Previous issue date: 2015-01-26 / O trabalho que se segue propõe uma reflexão acerca dos direitos conferidos aos indivíduos com transtorno mental que praticam uma infração penal. A pesquisa foi realizada com viés transdisciplinar e procura investigar de que maneira a justiça prevê penalidades a essas pessoas e sua aplicabilidade. No Brasil, pessoas com doença mental ou desenvolvimento mental incompleto ou retardado têm sido autoras de crimes consumados ou tentados. Em muitos casos, os crimes são praticados contra familiares ou pessoas mais próximas, sem motivo aparente. Sob um olhar mais apurado, percebe-se que a violência cometida se traduz em um apelo por ajuda ou um pedido de socorro. Quando os seus crimes são levados ao conhecimento da Justiça e é constatada a sua inimputabilidade, o sujeito que o cometeu é isento de pena, sendo-lhe aplicada a medida de segurança, que consiste em internação em Hospital de Custódia e Tratamento Psiquiátrico (HCTP) para tratamento. Desse modo, busca-se entender o fenômeno da loucura sob a perspectiva da reforma psiquiátrica, o que exige um levantamento acerca da legislação atinente ao tema, considerando aspectos jurídicos, políticos, sociais e culturais da questão, sem os quais não se pode compreender as mudanças de comportamento e de olhar que se estabeleceram ao longo dos anos. O presente trabalho tem por objetivo fazer uma análise do direito fundamental social à saúde e à convivência familiar, assegurados pelo Estado, às pessoas que sofrem de transtornos mentais e que, nessa condição, cometem delitos. Nesses casos, lhes é aplicada medida de segurança, seja de internação em Hospital de Custódia e Tratamento Psiquiátrico (HCTP) ou tratamento ambulatorial, casos em que o crime é punível com reclusão ou com detenção, respectivamente. / The work that follows proposes a reflection on the rights of individuals with mental disorders who practice a criminal offense. The survey was conducted with transdisciplinary bias and investigates how the justice provides penalties for these people and their applicability . In Brazil , people with mental illness or incomplete or retarded mental development have been authors of completed or attempted crimes. In many cases, crimes are committed against family members or people close for no apparent reason. Under a closer look, one realizes that committed violence translates into a cry for help or a cry for help. When their crimes are brought to the attention of Justice and is found its unaccountability, the guy who committed it is exempt from punishment and shall be applied to security measures, consisting of admission to Hospital Custody and Psychiatric Treatment (CPTH) for treatment. Thus, we seek to understand the phenomenon of madness from the perspective of psychiatric reform , which requires a survey about the relevant legislation to the subject, considering legal, political, social and cultural issue, without which one can not understand the behavioral changes and look that settled over the years . This study aims to analyze the fundamental social right to health and family life, guaranteed by the state, people suffering from mental disorders and that, as such, commit crimes. In such cases, they are a security measure applied, is admission to the Hospital of Custody and Psychiatric Treatment (CPTH) or outpatient treatment, where the crime is punishable by imprisonment or detention, respectively.