Foi realizado o estudo prospectivo de uma amostra da população portadora de Síndrome de Down que procurou o Departamento de Genética do Hospital Infantil Darcy Vargas,no período de 1959 a 1996. Dos 2816 portadores de Síndrome de Down que compareceram a este Serviço, neste período , a amostra estudada consistiu de 518 pacientes que mantiveram períodos de retomo ambulatorial conforme previsto pelo Protocolo de segmento clínico adotado. O objetivo do estudo foi caracterizar a incidência de colecistopatia litiásica em pacientes portadores de Síndrome de Down . Para desenvolver este estudo, após o diagnóstico citogenético e clínico da Síndrome de Down, procurou-se correlacionar faixa etária dos genitores, uso de anticoncepcionais e principalmente promover a utilização de exames subsidiários específicos que permitiram melhores condições diagnósticas e definição de mecanismos fisiopatológicos eventuais relacionados à colilitiase. Verificou-se a presença de cálculos de vesícula biliar em 27 pacientes ( 3,28%) comparando-se à incidência descrita na população como um todo (0,07%). Estes dados caracterizam a prevalência de cálculos de vesícula biliar em portadores de Síndrome de Down ( a distribuição das probabilidades da frequência de cálculo de vesícula biliar em Sindrome de Down está dentro do intervalo de 95%, entre 3,6% e 7,7%). As correlações realizadas vieram a excluir,na amostra estudada, algumas etiologias comumente descritas para colelitíase e provavelmente vincula o fenômeno da colelitíase a mecanismos fisioembriopatológicos ligados à hipotonia e estase do conteúdo da vesícula biliar( e/ou redução na velocidade do seu esvaziamento). Em consequência torna-se importante propor uma investigação rotineira para esta patologia, com ênfase nos mecanismos fisiopatológicos, prováveis responsáveis pela incidência aumentada na população com Síndrome de Down. / The purpose of this study has been the prospective analysis of the Down syndrome population received by the Genetic Department of \"Hospital Infantil Darcy Vargas\", in the period from 1959 to 1996. The Department has received 2816 Down Syndrome patients\' in this period, and this study has selected 518 patients, clinical and cytogenetically diagnosed, which were studied following the specific clinical protocol, in periodical evaluations. The incidence of cholelithiasis was verified and it has been analysed the possible relationships among this disease and parentaI age, contraceptive use and clinical features leading to the discussion of eventual aetiologic mechanisms causing gallstones. It was verified 27 patients affected by Down Syndrome and presenting cholelithiasis in the survey of 518 patients ( 3.28 %) compared to the frequency of 7/10000 in the non Down population ( 0.07% ). The statistical analysis has shown that the distribution of the frequency probabilities have been between 3.6% and 7.7%, These studies have verified that the aetiology of the gallstones in the Down syndrome patients could be related to the hypotonic characteristic of the patients, leading to cholestasis, It is very important the suggestion of routine evaluation for this pathology, related to the eventual aetiologic features.

Este estudo de cunho empírico e qualitativo, parte do princípio que, apesar da legislação existente em relação à inclusão escolar de alunos com deficiência mental, ainda ocorre a exclusão dos mesmos nas relações cotidianas que se estabelecem na escola. O objetivo destge trabalho é compreender como a atividade proposta pela terapia ocupacional pode interferir e modificar as relações estabelecidas em relação aos alunos com deficiência mental no ambiente escolar. Através do relato de uma experiência de intervenção realizada por estagiários de terapia ocupacional no horário do recreio de uma escola estadual de ensino fundamental da cidade de São Paulo, procuro verificar como a atividade proposta, a atividade lúdica, provoca possibilidades de encontro entre os alunos da classe especial e os outros alunos, propondo mudanças no processo de inserção escolar dos alunos com deficiência mental. Usando a teoria winnicottiana, proponho um determinado olhar para o ambiente escolar e a atividade como fazer criativo do individuo.A análise qualitativa da intervenção realizada vem apontar as dificuldades que o ambiente escolar apresenta ao estabelecer relações cotidianas de qualidade com o aluno com deficiência mental. Permeada por preconceitos e desconhecimento, as relações que se desenrolam no ambiente escolar reforçam, para o aluno com deficiência mental, o papel cristalizado no insucesso e no fracasso escolar, impossibilitando-o de re-significar sua ação como individuo criativo e saudável, perpetuando um padrão de relacionamento que impede o processo de uma real inclusão escolar. / This study which is of empirical and qualitative connotation starts on the principle that, besides the existing legislation regarding school inclusion of the mental handicapped students, their exclusion from day-to-day relations still occurs. The objective of this work is to comprehend how the activity proposed by Occupational Therapy can interfere and modify the established relations regarding the mental handicapped student in the school environment. Through the report of Occupational Therapy Trainees on an intervention experiment during break time in an elementary public school in São Paulo city, I look forward to verifying how the proposed activity, the ludic one, provokes gathering possibilities between the special class students and the others, proposing changes in the school inclusion process of the mental handicapped students. Using Winnicott's theory I propose a determined look at the school environment and at the activity as how to make creative individual. The qualitative analysis of the intervention made points out to the difficulties which the school environment shows as when it establishes day-to-day relations of quality with the mental handicapped student. Covered up by prejudism and lack of information, the relations developed in the school environment reinforce the unsuccessful and school failure cristalized role to the mental handicapped student unabling him (her) to remean his (her) action as a creative and healthy individual, perpetuating a relation pattern that blocks up the process of a real school inclusion.

Esta tese tem como objeto de estudo as relações iniciais entre Psicologia e Educação Especial, na área específica da deficiência mental. As primeiras escolas de Educação Especial na área de deficiência mental nasceram, no Brasil, no final do século XIX, anexas aos hospitais psiquiátricos, por iniciativa de médicos que atuavam nesses hospitais. No início do século XX, com as reformas educacionais vinculadas ao avanço da Psicologia como campo de conhecimento científico, as práticas em Educação e Educação Especial, no que tange à deficiência mental, passaram a ser embasadas nessa Psicologia nascente. Com uma abordagem funcionalista, as diferentes teorias psicológicas foram utilizadas para instrumentalizar os professores na prática pedagógica e esses conhecimentos assumiram a primazia do saber educacional especializado. Os testes psicológicos tornaram-se os instrumentos mais utilizados para o reconhecimento da deficiência. Impulsionada pelo movimento escolanovista e da higiene mental, a Psicologia desponta como área de conhecimento necessária à compreensão do educando e ao estabelecimento de critérios de normalidade-patologia-deficiência. O objetivo do presente trabalho é compreender como se deu a inserção da Psicologia como área de estudo e atuação profissional na educação da criança com deficiência mental no Brasil, nas décadas de 1900 a 1930. Para isso, o trabalho foi dividido em três etapas. Na primeira, busca-se construir alguns itinerários históricos de uma Psicologia na Educação Especial e para isso foi utilizada bibliografia específica da história da Educação Especial e da história da Psicologia no Brasil. Essa construção histórica revelou personagens que contribuíram decisivamente para as práticas psicológicas na área, como Helena Antipoff. Dessa forma, na segunda etapa do trabalho são apresentadas as ideias, percursos e propostas de Helena Antipoff na área da deficiência mental, bem como uma pesquisa de campo realizada no Instituto Pestalozzi de Belo Horizonte, instituição fundada pela própria Antipoff, em 1935, e que se revelou como síntese das ideias de uma Psicologia na Educação Especial vigentes no país. Esta pesquisa, de caráter documental, teve por fonte de dados os prontuários de dez crianças, alunos da Instituição durante a década de 1930 (1935-1939), período de sua fundação e quando a própria Antipoff era sua diretora. O procedimento para a coleta de dados foi construído no decorrer da pesquisa e a partir da entrevista com os psicólogos que trabalham atualmente na Instituição, os quais indicaram os documentos que estavam disponíveis sobre o período estudado. Além da análise geral desses prontuários, a pesquisa contém uma análise mais aprofundada de um único prontuário. O objetivo desta pesquisa foi o de compreender como se efetivou a prática psicológica na Educação Especial no período estudado. A terceira etapa apresenta uma análise histórico-crítica do que foram os primeiros passos da Psicologia na Educação Especial. A história revelou que as principais práticas da Psicologia com crianças consideradas deficientes mentais se basearam na psicometria e na psicomotricidade. A psicometria teve a função de reconhecer as crianças com deficiência mental no universo escolar e, por isso, a Educação Especial confundiu-se com políticas para a redução do fracasso escolar, do qual a escola pública era vítima. A psicomotricidade foi amplamente utilizada para o tratamento da criança anormal, uma vez que se considerava que a maturidade física e mental precedia a aprendizagem e o desenvolvimento intelectual. Sendo assim, a Psicologia acabou reproduzindo a ideologia liberal que sustentava o pensamento educacional brasileiro, constituindo práticas que atualmente consideramos como segregadoras e que atingiram amplamente as crianças das classes populares, as quais foram encaminhadas para o atendimento educacional especializado / This thesis aims to study the initial relations between psychology and special education in the specific area of mental retardation. The first special education schools in the area of mental retardation in Brazil began at the end of the 19th century, annexed to psychiatric hospitals as an initiative of doctors who worked in these hospitals. In the beginning of the 20th century, the educational reforms associated with the advance of psychology as a field of scientific knowledge, practices in education and special education, concerning mental retardation, became based on the emergent psychology. With a functionalist approach, different psychological approaches were used to instrumentalize the teachers in the pedagogic practice and this knowledge occupied the primacy of specialized educational knowledge. Psychological tests became the most utilized instruments for identification of retardation. Driven by the escolanovista and mental hygiene movements, psychology appears as an essential area of knowledge in order to comprehend the student and to establish normality-pathology-retardation criteria. The objective of this work is to understand how psychology became included as a study and professional area in educating children with mental retardation in Brazil between 1900 and 1930. Thus, the work was divided into three steps. The first step aims to construct some historical itineraries of psychology in special education and uses specific bibliographical material on the history of special education and psychology in Brazil. This historical construction revealed individuals who decisively contributed to psychological practice in this area, such as Helena Antipoff. In this way, in the second step, Helena Antipoff\'s ideas, trajectories and proposals in the area of mental retardation, as well as a field research conducted at the Pestalozzi Institute in Belo Horizonte, an institution founded by Antipoff in 1935, and which proved to be a synthesis of ideas of inclusion of psychology in special education in the country. This research was documental and the data source were the medical files of ten children who were students at the institute in the 1930s (1935-1940), its foundation period and when Antipoff herself was the director. The data gathering procedure was developed throughout the research and from the interviews with psychologists who currently work at the institute, and who indicated available documents about the studied period. Apart from the general analysis of these medical files, the research contains a more in-depth analysis of a single file. The objective of this research was to understand how psychological practice established itself in special education during the studied period. Finally, the work presents a historical-critical analysis of the initial stages of psychology in special education. History revealed that the main psychological practices with children considered to be mentally retarded were based on psychometry and psychomotricity. Psychometry had the role of identifying children with mental retardation in the school environment, thus special education was confused for policies to reduce failures in the school, and public schools were victims. Psychomotricity was widely used to treat abnormal children since physical and mental maturity was believed to precede learning and intellectual development. Therefore, psychology ended up reproducing a liberal ideology that supported the Brazilian educational vision, leading to practices that we currently consider to be segregationist and which caught up with children of the popular classes, who were referred for specialized education

Orientador: Paulo Dalgalarrondo / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-19T03:00:44Z (GMT). No. of bitstreams: 1 Pegoraro_LuizFernandoLonguim_M.pdf: 2266541 bytes, checksum: 79f7b25b4b175b872cd3d424776438f6 (MD5) Previous issue date: 2011 / Resumo: As síndromes genéticas de Williams (SW), do X-Frágil (SXF) e de Prader-Willi (SPW) apresentam déficit cognitivo geral que varia do grau leve ao moderado. Apesar de compartilharem rebaixamento da inteligência como um todo, prejuízos e potencialidades em habilidades cognitivas específicas dessas síndromes são amplamente descritos na literatura internacional, mas não tão enfaticamente no Brasil. Este estudo teve por objetivo investigar, descrever e comparar o perfil cognitivo de crianças e adolescentes com SW, SXF e SPW. Trinta e quatro crianças e adolescentes de seis a 16 anos, de ambos os sexos, com diagnóstico confirmado para a SW (n = 10), a SXF (n = 13) e a SPW (n = 11), pacientes dos ambulatórios de Psiquiatria da Criança ou Adolescente e/ou Genética Geral II do Hospital de Clínicas (HC) da Unicamp participaram deste estudo. Os sujeitos foram avaliados em suas funções cognitivas por meio da Escala de Inteligência Wechsler para Crianças (WISC-III). Dados sócio-culturais, exames citogenéticos e os sintomas e diagnósticos psiquiátricos associados aos participantes foram coletados nos prontuários médicos e também por meio de entrevistas com os responsáveis por cada criança ou adolescente. O QI total (QIT), o QI verbal (QIV), o QI de execução (QIE) e os escores ponderados de cada subteste da escala WISC-III, assim como os dados pessoais dos sujeitos de pesquisa, foram transpostos para o software estatístico SPSS, versão 17 para Windows. Não foram encontradas diferenças significativas em relação à idade, à classe social e ao tipo de escola que cada participante freqüenta entre as três síndromes. Por outro lado, houve diferença significativa quanto ao gênero dos participantes (p < 0,05). Foram encontradas diferenças significativas em relação ao QIV, aos subtestes verbais Informação, Vocabulário, Compreensão e em relação aos subtestes de execução Cubos e Armar Objetos. O teste post hoc de comparações múltiplas de Dunn (? = 0,05) apontou um escore significativamente superior nos subtestes de linguagem verbal e no QIV para o grupo com SW e um escore significativamente superior nos subtestes visuo-espaciais para o grupo com SPW. Estes resultados dão suporte à noção do perfil cognitivo específico para estas síndromes genéticas, constituído por "picos e vales" de rendimento, apesar do déficit intelectual geral destas condições, contrariando a concepção do fator g em crianças e adolescentes com SW, SXF e SPW / Abstract: Genetic syndromes such as Williams (WS), Fragile X (FXS) and Prader-Willi syndrome (PWS) present general cognitive impairment ranging from mild to moderate. Despite sharing a diminishment of intelligence as a whole, strengths and weakness in specific cognitive abilities of each syndrome are well described in international literature, but not so emphatically in Brazil. This study aimed to investigate, describe and compare the cognitive profile of children and adolescents with WS, FXS and PWS. Thirty-four children and adolescents, aged between 6 and 16, of both genders, with a confirmed diagnosis of either WS (n = 10), FXS (n = 13) or PWS (n = 11), from the outpatient clinics of Child and Adolescent Psychiatry or from the General Genetics II clinic, located at the Hospital das Clinicas (HC), participated in this study. The subjects cognitive functions were evaluated using the Wechsler Intelligence Scale for Children (WISC-III). Socio-cultural, cytogenetic tests and associated psychiatric symptoms and diagnoses were collected from the participants medical records and through interviews with those responsible for each child or adolescent. The Full-Scale IQ (FSIQ), Verbal IQ (VIQ), Performance IQ of (PIQ) and the standard scores of each subtest in the WISC-III scale, as well as the personal data of research subjects, were entered in version 17 of the SPSS statistical software for Windows. No significant differences were found between the three syndromes regarding age, social class or the type of school (private or public) each participant attends. On the other hand, there were significant differences in gender of the participants (p <0.05). Significant differences were found with respect to VIQ, and the verbal subtests Information, Vocabulary and Comprehension, and also in relation to the performance subtests Block Design and Object Assembly. The Dunn's multiple comparison test showed a significantly higher score on the verbal subtests and VIQ for the group with WS and a significantly higher score on the visuospatial subtests for the group with PWS. These results support the notion that there are specific cognitive profiles for these genetic syndromes, consisting of "peaks and valleys" in performance, despite the general intellectual deficit of these conditions, contrary to the g factor concept in children and adolescents with WS, FXS and PWS / Mestrado / Saude da Criança e do Adolescente / Mestre em Ciências

The study was conducted to determine the current status and employment needs for therapeutic recreation personnel in selected agencies in the state of Texas. The study provided the first definitive information on therapeutic recreation manpower needs on a state-wide basis. The study determined the status of therapeutic recreation personnel and assisted in identifying projected training needs in the state of Texas. A survey was mailed to 114 Texas Department of Mental Health and Mental Retardation and parks and recreation agencies. Information was requested concerning General Agency Information, Recreation Services, Current Employment, Current Therapeutic Recreation Personnel, Projected Employment and Bilingual Employees and Client information.

Nous proposons à travers ce travail de thèse une analyse théorico-clinique en contexte écologique de la problématique des personnes adultes, sujettes au syndrome de l'autisme avec retard mental profond associé, accompagnées en structure médico-sociale, qui constituent une population spécifique du fait de la sévérité particulière de leur handicap et de la grande difficulté pour autrui à accéder à leur subjectivité. Suivant une double démarche éthique et épistémologique, nous avons élaboré de manière complémentaire une modélisation théorique compréhensive de la cognition de ces sujets, basé sur leur singularité développementale, et une méthode d'investigation de leur vécu et fonctionnement sur plusieurs niveaux, adaptée à la complexité de leur problématique et de leur cadre de vie. Suite à cinq études de cas et l'exemple d'une intervention systémique psycho-éducative, nous présentons une synthèse des facteurs susceptibles de contribuer à la situation de handicap de ces sujets. / We propose through this work of thesis a theoretical and clinical analysis in ecological context of the issue of the adult people, prone to the syndrome of autism with severe mental retardation, cared for within medico-social structures. These subjects constitute a specific population, because of the particular severity of their disabilities and of the great difficulty for others of reaching their subjectivity. According to a double ethical and epistemological approach, we worked out in a complementary way an understanding theoretical modeling of the cognition of these subjects, based on their developmental singularity, and a method of investigation of their experience and functioning, on several levels, adapted to the complexity of their issue and to their living environment. Following five case studies and an example of a psycho-educational systemic intervention, we present a synthesis of the factors likely to contribute to the disability situation of these subjects.

This diploma thesis deals with respite service and issues with providing respite services to parents of children and adults with autism and mental retardation. The opening chapters focus on autistic spectrum disorder in combination with mental retardation and potential challenging behaviour. This work describes therapeutic process for persons with autism and mental retardation and it also describes the issues with providing social service to these persons. This thesis focuses mainly on respite services. The empirical part describes the availability of respite services for families with autistic person and mental retardation in the Czech Republic.

The purpose of this study was to explore the nature and content of the social policy of "normalization" in community based services which have been used to meet the needs of deinstitutionalized mentally retarded adults. In the process it was hoped that data would be obtained to aid decision makers in planning community services for retarded adults. The study was directed to examine the relationship between the levels of normalization in services which had been provided for retarded adults who were discharged from the Provincial institution for mental retardation - Woodlands - under the medical administration of retardation services as well as after the assumption of same responsibility by the Ministry of Human Resources. These administrations represented the medical and the social systems of service delivery. "Normalization" had been adopted as "policy" soon after the transfer of responsibilities by the Ministries. Three areas of concern were examined: Levels of normalization of services; needs of subjects; and normalization as policy. These areas had been central to public discussion of retardation issues in British Columbia. In order to examine the three areas, normalization was defined in the Greater Vancouver Area of study using the explicit judgement of citizens and the implicit judgement of professionals. From their judgements, a criteria for measuring normalization was developed and used in scoring individual services according to the special features of those services. A total of seven service areas were scored: Residential, Social, Medical, Recreational, Educational, Psychological and Vocational. The needs of subjects were identified from institutional records and scored. Five service characteristics were further examined for normalization. These were the nature, type, name, location and degree of integration. An integrated framework for policy analysis as well as empirical results were then used to analyse findings. The study showed that community services were essentially deviant in orientation; that level of normalization were about the same for each five year period of study; that services were inadequate in meeting needs; that there was lack of coordination in delivery of services] and that "normalization" was a principle rather than a policy of the Provincial Government. Implications for policy development as well as areas for further research have been suggested. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

No description available.

Thesis (M. A. (Psychology)) -- University of Limpopo, 2016 / The aim of this study was to determine the psychological experiences of family caregivers of children with an intellectual disability. The study was conducted along the lines of an exploratory sequential mixed-method design. Firstly, 15 family caregivers were purposively sampled as participants. They described their experiences of caring for children with a formal diagnosis of mild intellectual disability. The research question, which was used as a “grand-tour” question, was: “What are the psychological experiences of family caregivers of children with an intellectual disability?” Themes that emerged included the following: understanding intellectual disability; disclosure of the disability as a result of schooling difficulties; reaction to the disclosure of the disability; challenging behaviour of the child’s integration into the family system, unemployment and financial strains due to the child’s condition and community reaction; social support and stigmatisation. In the quantitative aspect of the study, the researcher used a close-ended questionnaire to collect data from one hundred self-declared primary family caregivers (one per household) of children with an intellectual disability. Results of regression analysis indicated that psychological wellbeing as measured by the Psychological General Well Being Index and its dimensions was predicted mainly by psychological stress and family support. Significant other support and support from friends only predicted life satisfaction. Policy recommendations are advanced based on the findings of the study.