Psychopharmacological and behavioural interventions are used to treat challenging behaviours (e.g., self-injury, aggression, stereotypy, bizarre vocalizations) in individuals with intellectual disability (ID), often in combination. However, little is known about the behavioural mechanisms underlying psychopharmacological treatment. Establishing a better understanding of these mechanisms could contribute to improving treatment efficacy. For this study, I conducted repeated functional analyses using single-subject experimental designs to assess the impact of naturally varying dosages of psychotropic medications on behaviour function. Four individuals with ID who engaged in challenging behaviour and were undergoing psychotropic medication changes participated. Medication impact across two topographies for one participant, and three topographies for another participant were assessed, for a total of seven cases. For Analysis 1, I calculated standardized mean differences between baseline and final drug administration phases to estimate the overall effect of medication. I used this information to examine whether response rate following drug administration was related to response rate during baseline, referred to as rate-dependency. Rate-dependency was not observed. Analysis 2 explored the relation between psychotropic medications and behaviour function identified through functional analyses. Challenging behaviour was the dependent variable, while functional analysis conditions and psychotropic medication level served as independent variables. The latter was a quasi-experimental variable given participants’ psychiatric team prescribed changes independent of the researchers. Behaviour function correspondence, defined as no function change after a medication manipulation, was observed across 14 of the 21 medication manipulations (67%). / October 2015

Introdução: A dor lombar (DL) é um sintoma comum que acomete pessoas de todas as idades. Em 2015, a prevalência pontual global de DL limitante de atividade foi de 7,3%, implicando que 540 milhões de pessoas foram afetadas a qualquer momento neste período. É a principal causa mundial de anos perdidos por incapacidade e as consequências a ela vinculadas, estão crescendo junto com o aumento e o envelhecimento da população. Objetivo: Mensurar a prevalência de dor lombar e avaliar a intensidade da dor e o nível de incapacidade funcional em idosos residentes da cidade de Manaus, Amazonas. Método: Participaram do estudo 700 idosos, de ambos os gêneros, residentes na área urbana de Manaus. Os desfechos primários foram: prevalência de dor lombar pontual e nos últimos 365 dias, intensidade da dor (Escala Numérica de Dor) e incapacidade funcional (Questionário de Incapacidade de Rolland Morris) e os desfechos secundários: nível de atividade física (International Physical Activity Questionnaire - short version), Índice de Massa Corpórea (IMC), doenças autorreferidas, anos de estudo, renda individual, classificação da saúde e nível emocional. A coleta de dados ocorreu no período de julho de 2016 a julho de 2017. O nível de significância estabelecido foi de 5%. Resultados: A prevalência de DL pontual foi de 42,4%; (IC 95% 38,2-46,6%) e a prevalência nos últimos 365 dias 93,7%; (IC 95% 91,3-95,6%). A média da intensidade da dor foi 6,17 ± 2,14 (moderada) e a incapacidade funcional com escore ³14 pontos (incapacidade grave) esteve presente em 31,6% dos idosos com DL. Nos desfechos secundários foi encontrada diferença estatisticamente significante entre os idosos na intensidade da DL e incapacidade funcional respectivamente nos desfechos gênero (p = 0,039; p = 0,001), IMC (p = 0,048; p = 0,000), classificação da saúde (p = < 0,000; p = <0,000) e nível emocional (p = 0,007; p = < 0,000). O desfecho anos de estudo (p = 0,001) foi estaticamente significante na intensidade da dor e os desfechos nível de atividade física (p = 0,000) e hipertensão arterial (p = 0,032) no nível de incapacidade funcional. Conclusão: Nossos resultados demonstram que a prevalência de dor lombar pontual e nos últimos 365 dias foi alta entre os idosos, a intensidade de dor foi moderada para ambos os gêneros e o escore geral de incapacidade funcional foi classificado como incapacidade moderada. O estudo também apontou que existe associação entre os fatores clínicos e sociais com a incapacidade funcional e intensidade de dor nos idosos com dor lombar / Introduction: Low back pain (LBP) is a common symptom which affects people of all ages. In 2015, the global punctual prevalence of activity-limiting LBP was 7.3%, involved that 540 million were affected the any one time in this period. Is the worldwide cause principal of last years for disability and your consequences are growing together with increase and population ageing the population. Objective: To measure the prevalence of low back pain and to evaluate the intensity pain and the level of disability functional in the elderly residents in the Manaus city, Amazonas. Methods: Seven hundred elderly, both genders, residents in the urban area of Manaus. The primary outcomes were: LBP prevalence punctual and the last 365 days, intensity pain (Numerical Range Scale Pain), and disability functional (Rolland Morris Disability Questionnaire). The second outcomes were: physical activity level (International Physical Activity Questionnaire - short version), Body Mass Index (BMI), self-reported diseases, years of study, individual income, health classification and emotional level. The data collection occurred between July 2016 and July 2017. The level of significance was established in 5%. Results: The punctual prevalence of LBP was 42.4% (CI 95% 38.2-46.6%) and the last 365 days 93.7% (CI 95% 91.3-95.6%). The intensity pain mean was 6.17±2.14 (moderate) and disability functional score with ³ 14 points (disability serious) was present in 31.6% elderly with LBP. In the outcomes was found significance difference between elderly intensity pain and disability functional respectively in the outcomes genders (p = 0.039; p = 0.001), BMI (p= 0.048; p = 0.000), health classification (p = 0.000; p = < 0.001), emotional level (p = 0.007; p = < 0.000). The outcome years of study (p = 0.001) was significance difference in the intensity pain and outcomes physical activity level (p = 0.000) and high blood pressure (p = 0.032) in the disability functional level. Conclusion: Our results provide the punctual and the 365 last days low back pain prevalence was high between elderly, the intensity pain was moderate in between genders and total score disability functional was moderate classified. The also study point that association occurred amongst clinical and social factors with the intensity pain and disability functional in elderly with low back pain

This thesis focuses on functional assessments, visual stimulation and on offers of Centres for Early Intervention that provide services in the area of visual perception for children in early and preschool age. The goal of the thesis is to analyze interviews with workers in these centres on options and services in the area of visual aid that these centres provide for families and their children with disabilities. The first four chapters deal with theoretical background in the area of functional assessments of vision, visual stimulation and description of the group of children in early and preschool age with visual and multiple disabilities. Last but not least, these chapters also deal with organizations that provide early intervention services, their structure, composition of personnel and range of offered services. The content of the fifth chapter is a qualitative research investigation. The data were collected through interviews with instructors of visual stimulation and with an early intervention assistant. Analysis of these interviews then became basis for the subsequent definition of commendable suggestions for good practise.