This thesis examines the significance of the study of art, specifically discipline-based art education, for behaviorally disordered public school students. A brief description of the distinctions between art education and art therapy is given and appropriate terms are defined. A discussion of the labels that constitute behavioral disorders and the general educational needs of that population is included. General benefits of art instruction for behaviorally disordered (BD) students are explored with the intention of demonstrating how a discipline-based art program can specifically enhance those benefits. A sample discipline-based drawing lesson adapted for behaviorally disordered students follows.

The purpose of this study was to delineate the differences between the types of behavioral management techniques used by teachers of students with emotional/behavioral disorders.

This dissertation has explored the origins of the field of Behavioral Disorders via a qualitative approach. In order to collect data, interviews were conducted with respondents who were selected via purposeful sampling. All respondents have had a significant impact on the field of special education as evidenced by scholarship and leadership throughout their careers. Data analysis of the interview transcriptions was accomplished through the utilization of computer software. The data indicated six areas/topics that were seen among respondents as being significant to the development of the field of Behavioral Disorders.

This study examines the impact of issues of loss on adolescents. It was hypothesized that adolescents who experienced incidents of loss which were not adequately supported or processed to the point of resolution are much more likely to exhibit more angry and defiant behaviors than those who did not have such life experiences. Three instruments were used to identify loss and related impact. The first is the Interview Process, designed to identify issues of loss and screen for problematic behavior. This tool is used to qualify the participant for the study, and to designate which study group the participant will be assigned. The Family Constellation Exercise is an experiential assessment tool that exemplifies how emotionally close or distant the participant feels in relation to his or her nuclear family members. The Minnesota Multiphasic Personality Assessment - Adolescent version (MMPI-A) is used to identify behaviors and thought patterns associated with anger and defiance.The study was able to conclude that there is a strong potential for unresolved loss to negatively impact an adolescent. The study also discovered that many teenagers who do not exhibit angry or defiant behaviors have also experienced loss, yet do not act out anger. Suggestions are made as to why this is so, and implications for future research are made.

Nesta dissertação, procuramos compreender os sentidos e significados que os profissionais de serviços de saúde e de assistência social de um município do interior paulista têm acerca dos transtornos de comportamento em crianças e adolescentes. Para tanto, foi realizado um estudo qualitativo em dois serviços de saúde e 2 conselhos tutelares de um município do interior paulista. Participaram do estudo 13 profissionais. A coleta de dados foi realizada através de uma entrevista semiestruturada realizada em local escolhido pelos participantes. Para a organização e tratamento dos dados foi utilizada a técnica de análise de conteúdo de Bardin, que nos permitiu construir três categorias temáticas: \"Transtornos de comportamento: que comportamento é esse?\" \"Transtornos de comportamento: como se desenvolvem?\" \"Ações (des)articuladas entre os setores saúde e assistência no atendimento à crianças e adolescentes com transtorno de comportamento\". Verificamos que o conhecimento acerca da aplicabilidade diagnóstica dos transtornos de comportamento não é clara para os profissionais de nosso estudo, o que acaba dificultando a identificação e o encaminhamento dessas crianças e adolescentes aos serviços de saúde mental e assistência social. Para os profissionais de nosso estudo, os principais fatores de risco atribuídos ao desenvolvimento dos transtornos de comportamento em crianças e adolescentes são aqueles que ocorrem nas relações entre as crianças e seus familiares, como a violência doméstica, a desestruturação familiar, a falta de afeto e as práticas educativas, fatores que podem inclusive potencializar ou não a predisposição genética da criança ou adolescente a desenvolver transtornos de comportamento. Já os fatores macrossociais, como as condições sociais e culturais, a ação do estado e as características da sociedade nas quais vivem as crianças e adolescentes são pormenorizados como colaboradores para o desenvolvimento de transtornos de comportamento pelos profissionais de nosso estudo. Por fim, constatamos que as ações de prevenção à violência juvenil e de atendimento à crianças e adolescentes com transtornos de comportamento dos profissionais de nosso estudo não atendem às diretrizes e normas estabelecidas pela OMS e pelas políticas nacionais de prevenção à violência no que diz respeito ao trabalho integrado e intersetorial, no desenvolvimento de ações preventivas, na consolidação do atendimento pré-hospitalar sistematizado, hierarquizado e subsidiado por práticas baseadas em evidências e na capacitação adequada dos recursos humanos / In this dissertation, we seek to understand the senses and meanings that the professionals working in health and social welfare services from a city of the countryside of São Paulo have about behavior disorders in children and teenagers. For this purpose, we performed a qualitative study in two health services and two guardianship councils from a city in the countryside of São Paulo. This study was attended by 13 professionals. Data collection took place by means of semi-structured interviews held in a place chosen by the participants. In order to organize and treat data, we used the Bardin\'s content analysis technique, which enabled us to draw up three thematic categories: \"Behavior disorders: what behavior is this?\" \"Behavior disorders: how do they develop?\" \"(Dis) articulated actions between the health and social welfare sectors in meeting the demands of children and teenagers with behavior disorders\". We have found that the knowledge about the diagnostic applicability of behavior disorders is not clear to the professionals who took part in our study, which ends up hindering the identification and referral of these children and teenagers to mental health and social welfare services. According to the professionals who attended our study, the main risk factors blamed on the development of behavior disorders in children and teenagers are those that occur in relationships between children and their relatives, such as domestic violence, family breakdown, lack of affection and educational practices, which are factors that may or may not increase the genetic predisposition of the child or teenager to develop behavior disorders. Conversely, macro-social factors, such as social and cultural conditions, state action, and the characteristics of the society where children and teenagers live are specified as collaborators for the development of behavior disorders by the professionals of our study. Lastly, we have noted that the actions to prevent youth violence and to meet the demands of children and teenagers with behavior disorders carried out by the professionals of our study do not comply with the guidelines and standards established by the WHO and the national policies on violence prevention with respect to the integrated and intersectoral work, development of preventive actions, consolidation of a systematized prehospital care, i.e., hierarchized and subsidized by evidence-based practices, and appropriate training of human resources

Estudo observacional que descreve e analisa a ocorrencia dos comportamentos de agressao e brincadeira turbulenta em criancas psicoticas. Os ss sao 11 criancas, com idade entre 7 e 11 anos, de ambos os sexos, com diagnostico de psicose, frequentando instituicoes especializadas. Realiza 5 sessoes de observacao com cada crianca em situacao ludica, com duracao de 10 minutos cada, no local em que normalmente desenvolvem atividades recreativas. Utiliza contribuicoes da antropologia e da psicanalise na articulacao dos resultados. Verifica que os meninos interagem mais que as meninas; que entre as meninas e mais frequente a brincadeira turbulenta do que a agressao, ocorrendo o inverso com os meninos; ha modos preferenciais para a agressao (fisica) e para a brincadeira turbulenta. Constata oposicoes entre os dois comportamentos, tanto para padroes quanto para frequencia, cuja analise demonstra existir uma estrutura interna aos dois comportamentos, sugerindo uma relacao dialetica entre o simbolo e a imagem. Demonstra, parcialmente, a hipotese de que ha um predominio de linguagem iconica na psicose e que no interior dessa o comportamento se estrutura tal como essa linguagem, numa dialetica de ausencia e presenca e numa oposicao entre seus significantes comportamentais / Eleven children between de ages of seven and eleven diagnosed as psycotic were the subjects of na observational study. The research was looking for descriptions and ocurrences of the aggressive behavior and rough-and-tumble play. They were observed at two specialized institution. To the criteria of Blurton-Jones (1967) for rough -and-tumble new ones were added and also context variables were taken into account. Methodological problems linked to the question of the description in ethology and psychiatry were discussed as also the nosology tradition involved. Anthropological and psychoanalytical contributions were used on the articulation of results. It was verified that in general boys interact more than girls. Girls rough-and-tumble was more frequent than aggression. In the case of boys this differences did not appear. Boys are more aggressive than girls. Individual differences were great. There were preferential forms of aggression (physical) and of rough-and-tumble different for each sex. Oppositions shown between one and another behavior were found which refer to motor patterns and occurrences. This opposition was analysed to demonstrate an internal structure to both behavior which leads us to believe that a dialectical relationship exists between the symbol and the image. From this it suggested that behavior has the same structure as a language.

Não há consenso entre os estudos quanto à associação entre a presença de problemas de comportamento e resultados piores no tratamento com alarme para enurese. O objetivo do presente estudo foi investigar a ocorrência de associações entre a presença de problemas de comportamento e os resultados do tratamento com alarme para enurese primária com acompanhamento semanal de um terapeuta. Os participantes foram 20 crianças com enurese primária, 13 do sexo masculino e 7, do sexo feminino, com idades entre seis e dez anos. Metade das crianças apresentava escores clínicos indicativos de problemas de comportamento segundo o Child Behavior Checklist. As oito crianças sem problemas de comportamento que concluíram o tratamento alcançaram o critério de sucesso inicial (14 noites secas consecutivas) e apenas duas desistiram. Das dez crianças com problemas de comportamento, somente metade atingiu o sucesso inicial, quatro desistiram e uma completou o período de tratamento e não obteve sucesso. Essas diferenças nos resultados finais não foram significativas em termos estatísticos. Também não foram encontradas diferenças significativas nas taxas de recaídas entre as crianças com e sem problemas de comportamento. Quatro das oito crianças sem problemas de comportamento que haviam alcançado o critério de sucesso inicial apresentaram recaídas e quatro conseguiram manter o controle noturno adquirido. Das cinco crianças com problemas de comportamento que alcançaram o sucesso inicial, três, apresentaram recaídas e duas, enquadraram-se no critério de sucesso continuado. A única diferença estatística encontrada entre os dois grupos de crianças foi no tempo de tratamento necessário para alcance do critério de sucesso inicial. Em 12 semanas de tratamento, a probabilidade de atingir o sucesso inicial foi de 86,11% para as crianças sem problemas de comportamento e de 10% para as crianças com problemas de comportamento; em 20 semanas, a probabilidade foi de 100% para as crianças sem problemas de comportamento e de 40% para as crianças com problemas de comportamento. Pode-se dizer, portanto, que, na amostra de crianças atendidas, os problemas de comportamento parecem ter ocasionado dificuldades para que progressos fossem alcançados no tratamento da enurese com alarme. Na maioria dos casos, entretanto, essas dificuldades não foram suficientes para que as crianças com problemas de comportamento apresentassem ao final do tratamento resultados significativamente diferentes das crianças sem problemas de comportamento. Esses resultados sugerem que as crianças com problemas de comportamento podem beneficiar-se do tratamento com alarme para enurese tanto quanto as crianças sem problemas de comportamento. Considerando o tempo necessário para o alcance do sucesso inicial, os resultados indicam que, provavelmente, as crianças com problemas de comportamento precisam mais de acompanhamento intensivo durante o tratamento com alarme para enurese do que as crianças sem problemas de comportamento. / There is no consensus among the studies regarding the association between behavior problems and worse outcomes in alarm treatment for enuresis. The aim of this study was to investigate the relationship between behavior problems and outcome in alarm treatment for primary enuresis with weekly sessions with a therapist. The participants were 20 children with primary enuresis, 13 boys and 7 girls, between the ages of six and ten. Half of these children presented clinical scores on the Child Behavior Checklist. Eight out of the 10 children without behavior problems who finished the treatment have achieved the criteria for initial success (14 consecutive dry nights) and two of them dropped out. Only half of the children with behavior problems attained initial success, four of them dropped out and one finished without success. These differences on the outcome were not statistically significant. There were also not found significant statistical differences in the occurrence of relapses rates between children with and without behavior problems. Four of the eight children without behavior problems who attained initial success have relapsed, and four have maintained the acquired nocturnal control. Three of the five children with behavior problems who achieved the initial success have relapsed and two of them satisfied the criteria for continued success. The only statistical difference found between the children groups was the time required to achieve initial success. In 12 weeks of treatment, the probability of attaining initial success was 86.11% for children without behavior problems and 10% for children with behavior problems; in 20 weeks, the probability was 100% for children without behavior problems, and 40% for the children with behavior problems. Therefore, it is possible to say that in that sample of children the behavior problems seemed to provide difficulties in achieving progresses in the alarm treatment for enuresis. On most of the cases, those difficulties were not enough to make the outcomes at the end of the treatment of children with behavior problems being statistically different from the children without behavior problems. These results suggest that children with behavior problems may benefit from alarm treatment as well as children without behavior problems. Considering the time required for achieving success, the results indicate that they probably need more intensive support during enuresis treatment with alarm than children without other problems.

A enurese é uma condição caracterizada pela perda de urina durante o sono, em crianças com mais de cinco anos sem outra condição clínica que explique os episódios. A enurese pode ser primária, no caso das crianças que nunca obtiveram controle prévio, ou secundária, em que a enurese cessou por pelo menos seis meses. Também é classificada como monossintomática, na ausência de sintomas diurnos do trato urinário inferior ou não-monossintomática, quando está associada a tais sintomas, como a urgência miccional. A enurese, cujas causas apresentam componentes hereditários ainda pouco claros, tem sua etiologia baseada na combinação de três fatores: a poliúria noturna ou a hiperatividade detrusora ligada á incapacidade de despertar em resposta aos sinais da bexiga cheia. Há tratamentos medicamentosos e psicológicos, sendo que a desmopressina, análogo sintético da vasopressina, que atua na poliúria noturna e o alarme, que atua na incapacidade de despertar, apresentam os níveis mais altos de recomendação e evidência. Embora tais tratamentos estejam consolidados, ainda não há total clareza sobre seus mecanismos de funcionamento e o porquê de não alcançarem todos os casos. Este trabalho teve como objetivo verificar se um conjunto de variáveis atuaria como moderador do resultado do tratamento com alarme, ou seja, em que medida influenciava, positiva ou negativamente, o desempenho dos participantes atendidos. As variáveis avaliadas foram: tipo de acompanhamento (presencial e à distância), frequência inicial de episódios, nível de problemas de comportamento, escolaridade dos pais, sexo e idade. Foram incluídos na amostra 61 crianças e adolescentes de 6 a 17 anos que receberam tratamento com alarme, sendo que 34 foram acompanhados à distância e 27 presencialmente. No total, 37 participantes obtiveram sucesso, caracterizado por 14 noites consecutivas sem episódios, num período de 28 semanas. Doze participantes não obtiveram sucesso e outros 12 desistiram. Caracterizaram-se como moderadoras do resultado do tratamento as seguintes variáveis: tipo de acompanhamento (grupo acompanhado à distância obteve mais sucessos), frequência inicial de episódios (participantes que obtiveram sucesso tinham menos episódios, em média, no início do tratamento) e nível de problemas de comportamento (participantes que não obtiveram sucesso tinham escores maiores de problemas de comportamento externalizantes). Os resultados indicam a efetividade do alarme e apontam para os aspectos que devem receber atenção do clínico ao administrar esse tipo de tratamento / Enuresis is a condition in which children of at least five years of age lose urine during sleep, without another clinical condition that could explain the wetting episodes. Enuresis may be primary, when the child has not obtained previous bladder control, or secondary, when such control was achieved for at least six months. It is also classified as monosymptomatic, when it is not associated with other lower urinary tract symptoms or non monosymptomatic, when these symptoms, such as urgency, are present. Enuresis etiology has unclear hereditary aspects. Its physiology is based on a combination of at least two of three malfunctioning systems: incapacity to wake in response to the full bladder signals plus nocturnal polyuria or detrusor hyperactivity. There are evidence based pharmacological and psychological treatments. Desmopressin, a synthetic version of hormone vasopressin that reduces nocturnal polyuria is the first line pharmacological treatment, whereas the alarm, which acts in the incapacity to wake is the first line psychological treatment. Both have the higher levels of evidence and recommendation by the specialized literature. However, the mechanisms underlying these treatments results and the reasons they are not successful with every enuretic children are not entirely clear. The objective of this work was to verify to what stand a series of variables are moderators of alarm treatment outcome. These variables were: type of support (face-to-face versus long distance), initial bedwetting frequency, behavior problems scores, level of parents education, gender and age. Sixty-one children with ages from 6 to 17 were included. All received full spectrum home training. Thirty-four received long distance support during treatment and 27 received face-to-face support. Success was defined by 14 consecutive dry nights within a 28 weeks treatment period. Success was obtained by 37 children, while 12 did not succeed and other 12 dropped out. Three variables were observed as moderators of treatment outcome: type of support (long distance had better results), initial bedwetting frequency (participants who succeeded had fewer initial wet nights) and behavior problem scores (participants who did not succeed had higher externalizing problems scores). Results indicate alarm effectiveness and aspects that should be focuses of attention when this kind of treatment is administered

Como as dificuldades comportamentais e emocionais infantis, se não superadas neste período, podem estender-se ao longo do desenvolvimento, é de fundamental importância o investimento em estudos focados na avaliação e compreensão dos problemas de comportamento desta população, para, então, realizar um planejamento de intervenção adequado às suas necessidades. O presente trabalho tem como ponto de partida o reconhecimento da importância de múltiplas fontes de informações no processo de avaliação da criança, incluindo ela própria e o psicólogo clínico, para que haja o melhor atendimento psicológico. O objetivo desta pesquisa foi identificar a presença de problemas de comportamento em crianças a partir da avaliação de seus pais e do clínico, compreender os fatores de risco que possam estar associados a presença de tais dificuldades e analisar os níveis de concordância e discordância entre as avaliações realizadas pelas múltiplas fontes. Para tanto, foram realizadas entrevistas clínicas semiestruturadas (SCICA) com 25 crianças, de ambos os sexos e com idade entre sete e 11 anos, encaminhadas para atendimento em serviços de saúde mental, a fim de compará-las com as respostas dos pais/cuidador a um inventário de comportamentos infantis, o CBCL. Também foram coletadas informações sobre a presença de fatores de risco na família (Índice de Adversidade Familiar) e sobre os problemas de comportamento dos cuidadores que realizaram a avaliação (ASR). A SCICA mostrou-se um protocolo de entrevista válido para obtenção de observação comportamental e do relato da criança sobre seu funcionamento. A partir da análise dos resultados identificou-se que tanto os problemas observados pelos clínicos, quanto os reportados pela própria criança, apresentavam-se em taxas inferiores às relatadas pelos cuidadores. As dificuldades com agressividade e com ansiedade/depressão dos pais se mostraram um fator explicativo para as discrepâncias identificadas. As análises com os fatores de risco revelaram uma correlação positiva entre os escores no IAF e a presença de dificuldades internalizantes e total de problemas relatados pelas crianças. Considerando os fatores de risco isoladamente, observou-se que o fator presença de discórdia conjugal guardava relação com as dificuldades externalizantes e totais, enquanto o fator presença de psicopatologia na família estava relacionado às dificuldades internalizantes. Os dados sobre adversidade ambiental sugerem a importância de acompanhar os pais paralelamente ao trabalho da criança, dado que as condições de saúde mental na família e a presença de conflito marital apresentam uma relação intrínseca com as dificuldades infantis. A partir das análises de discordâncias observamos que a inclusão de forma sistematizada das diversas fontes mostrou-se relevante, pois, articuladamente ao relato dos pais, foi possível ir além da queixa declarada inicialmente e identificar outras áreas deficitárias do funcionamento das crianças avaliadas / The children\'s behavioral and emotional difficulties, if not overcome during childhood, may extend through the adult development, so it is extremely important to invest in studies focused on the evaluation and understanding of their behavioral problems to perform an intervention plan on these needs. One of the main concepts of this study is to recognize the importance of having multiple sources of information in the childs evaluation process (for instance, him/herself and the clinical psychologist) to have the best psychological care. The objective of this research was to identify the presence of behavioral problems in children based on their parents and clinical assessment, to analyze the risk factors that may be associated with these difficulties and to examine the levels of agreement and disagreement between the evaluations performed by multiple sources. To achieve that, we have compared the children\'s scores on a parentreport questionnaire, the CBCL, with semi-structured clinical interviews that were performed with 25 children referred for psychological care, of both genders and age range from 7 to 11 years old. We have also collected information about the presence of risk factors in the family (Rutter\'s Family Adversity Index) and about the presence of parents behavioral problems according to ASR. The SCICA proved to be a valid interview protocol to obtain behavioral observation and child\'s report about their functioning. From the analysis, we found that the problems noted by clinicians and reported by the child, were presented at rates lower than those reported by caregivers. An explanatory factor for the discrepancies found was parents´ aggression and anxiety/ depression problems. According to the analysis, Rutter\'s Family Adversity Index scores had a positive correlation with the presence of internalizing problems and total problems reported by children. Regarding the types of risk factors, it has been observed that the \"marital discordance\" factor was linked to the externalizing and total problems, while \"presence of psychopathology in the family\" factor was related to internalizing problems. Data on environmental adversity suggests the importance of instructing parents while the child´s treatment is being conducted, given that family mental health problems and the presence of marital conflict have a close relationship with the children\'s difficulties. From the identified discrepancies we can conclude that a systematic inclusion of the various sources is relevant, since the parental-report integrated with clinical psychologist perception and child\'s report allowed to go beyond the main complaint initially declared and identify other deficient areas of children functioning

Challenging behaviors are considered predictors of poor outcomes and children with Autism Spectrum Disorder (ASD) are at increased risk for such behaviors. There is limited research on how the functions of such behaviors and intervention strategies aimed at reducing them may differ by context. Using a researcher-designed survey, this study examined parents’ and teachers’ descriptions of the function of, and strategies for, challenging behaviors among children with and without ASD. A total of 488 respondents completed the survey, including 251 (51.5%) teachers and 237 (48.5%) parents. The participants were recruited in person and via social networking using snowballing and word-of-mouth. The study findings revealed that while both parents and teachers frequently identified avoidance/escape and attention-seeking as functions of challenging behaviors for children with and without ASD, there were some differences in their reports. Most notably, for children with ASD, 28% of parents reported children’s use of challenging behaviors to get attention at home whereas 2% reported this function at school, while 72% of the teachers indicated children’s use of challenging behaviors to seek attention at school and only 10% reported this function at home. The two most common intervention strategies identified by both teachers and parents were reinforcing positive effortful behavior and providing positive attention such as praise and acknowledgement. These finding are critical as they show the differences in the opinions towards the use of challenging behaviors in the home and school settings as reported by parents and teachers and inform future intervention efforts aimed at addressing challenging behaviors in varying contexts.