O armazenamento e/ou o acesso automático e preciso dos fatos aritméticos básicos da memória de longo prazo têm sido apontados como habilidades prejudicadas em crianças com dificuldades aritméticas e com Transtorno de Déficit de Atenção/Hiperatividade. Em vista disso, esse grupo de estudantes acaba por utilizar procedimentos de contagem mais imaturos do que seus pares sem dificuldades. O objetivo principal deste estudo é avaliar a eficácia de um programa de ensino de fatos básicos aditivos, como um recurso para a mudança de um procedimento baseado na contagem para outro apoiado na memória. Para alcançar essa meta, a pesquisa consta de dois estudos. O primeiro busca identificar e descrever os procedimentos de contagem e os processos de memória utilizados por um grupo de 28 estudantes, com idades entre 8 anos e 14 anos, com TDAH-D ou TDAH-C que participam do Programa de Transtornos de Déficit de Atenção/Hiperatividade (PRODAH/HCPA). Os resultados indicaram que os estudantes continuavam usando procedimentos de contagem considerados imaturos além da série esperada e que, dentre os processos de memória, a decomposição era o mais usado. Para o segundo estudo, foram convidadas a participar as crianças que utilizaram procedimentos de contagem no estudo 1. Dessa forma, o segundo estudo visa avaliar a eficácia de um modelo de intervenção pedagógica dirigida ao ensino de fatos básicos aditivos, como um recurso para o avanço nos procedimentos de contagem em 7 crianças com Transtorno de Déficit de Atenção/Hiperatividade com idade média de 9,8 anos. Trata-se de uma pesquisa experimental com ensaio clínico controlado randomizado, cego, em paralelo. Resultados demonstraram que o modelo de intervenção pedagógica testado é promissor para a mudança de um procedimento de contagem para um apoiado na memória. Os resultados sugerem que: 1) um programa de ensino cuidadosamente desenhado proporciona avanço para um processo de memória e 2) estudantes com TDAH necessitam de mais tempo de prática em um procedimento aliado a um ensino explícito. / The storage and/or automatic and accurate access of the basic facts of addition from the long term memory have been registered as impaired abilities in children with arithmetical difficulties and with Attention Deficit/Hyperactivity Disorder (ADHD). As a result, this group of students ultimately uses more immature counting procedures than their without difficulty peers. The aim of this study is to evaluate the effectiveness of a program for teaching basic facts of addition, as a resource for a procedure change, based on the counting to other procedure supported by memory. To achieve this goal, the research consists of two studies. The first one seeks to identify and describe the counting procedures and memory processes used by a group of 28 students, aged between 8 and 14 years, with ADHD-I or ADHD-C who participated in the Attention Deficit/Hyperactivity Disorder Program (PRODAH/HCPA). The results indicated that students still were using counting procedures considered immature beyond the expected series and that, among the memory processes, the decomposition was the most used one. For the second study, there were invited to participate children who used counting procedures of study 1. Thus, the second study aims to evaluate the effectiveness of a educational intervention model directed to the teaching of basic facts of addition, as a resource to the advancement in the counting procedures on 7 children with Attention Deficit/Hyperactivity Disorder with an average age of 9,8 years. This is an experimental research with randomized controlled clinical trial, blind, in parallel. The results showed that the tested educational intervention model is promising to change a counting procedure for one supported by memory. The results show that: 1) a carefully designed education program provides advance for a memory process and 2) students with ADHD need more practice time in a procedure, linked to a specific teaching.

Made available in DSpace on 2014-07-29T15:29:13Z (GMT). No. of bitstreams: 1 Dissertacao Karla C N de Carvalho.pdf: 1709963 bytes, checksum: d6262a77a98e3884046049ab5e97cc76 (MD5) Previous issue date: 2011-03-16 / Few studies have been conducted worldwide on Attention Deficit Disorder and Hyperactivity Disorder (ADHD) in rural communities and none in Brazil so far. This is the first prevalence research on the signs and symptoms of ADHD in children and adolescents who identify themselves as Kalunga, as well as one of the pioneers on this field specifically with African descendants in Brazil. Its overall objective was the investigation of the presence of signs and symptoms of ADHD in children and adolescents (from 6 to 18 years) who identify themselves as Kalunga, in Cavalcante- GO, Brazil. A total of 204 children and adolescents were assessed through the responses provided by their parents or guardians and their teacher during interviews using the Child Behavior Checklist for Ages 6-18 (CBCL/6-18) and the Teacher s Report Form for Ages 6-18 (TRF/6-18), respectively. Using the CBCL/6-18 and TRF/6-18, the signs and symptoms of ADHD were detected in 5.9% and 5,4% of the individuals assessed, whereas those of ADD were observed in 16.2% and 15.2% of them, respectively. Also, we detected that the prevalence of ADD in this study was higher than the national average, while the ADHD presented median prevalence compared with that of the world population. According to the evaluations of parents or guardians and teachers, the following estimated prevalences of comorbidities with signs and symptoms of ADHD were observed, respectively: 83% and 90% with oppositional defiant disorder; 41.6% and 45.4% with conduct disorder; 58.3% and 63.6% with anxiety disorders; 33.3% and 36.3% with affective disorders. In accordance with the evaluations of parents or guardians and teachers, the following estimated prevalences of comorbidities with signs and symptoms of ADHD were registered, respectively: 60.6% and 64% with oppositional defiant disorder; 54.5% and 58% with conduct disorder; 75.7% and 80.6% with anxiety disorders; 57.5% and 61.2% with affective disorders. We concluded that ADD exists in a culturally diverse population, the children and adolescents who identify themselves as Kalunga and who live in Cavalcante-GO, Brazil, presenting a high prevalence rate, with comorbidities commonly found in other populations of children from various cultures around the world. On the other hand, the signs and symptoms of ADHD in the present sample presented a prevalence that can be compared with that of the world population, also with comorbidities commonly found in studies performed in several parts of the world and some carried out in Brazil. / Poucos estudos foram realizados no mundo sobre Transtorno de Déficit de Atenção e Hiperatividade (TDAH) em comunidades rurais e nenhum no Brasil até o momento. Esta é a primeira pesquisa de prevalência de sinais e sintomas do TDAH em crianças e adolescentes que se identificam como Kalunga, bem como um dos pioneiros neste campo especificamente com negros no Brasil. Teve como objetivo geral investigar a presença dos sinais e sintomas do TDAH em crianças e adolescentes (de 6 a 18 anos) que se identificam como Kalunga, em Cavalcante- GO, Brasil. No total, 204 crianças e adolescentes foram avaliados por meio das respostas fornecidas pelos pais ou responsáveis e pelos professores durante entrevistas utilizando-se o Child Behavior Checklist for Ages 6-18 (CBCL/6-18) e o Teacher s Report Form for Ages 6-18 (TRF/6-18), respectivamente. Usando o CBCL/6-18 e do TRF/6-18, os sinais e sintomas do TDAH foram detectados em 5,9% e 5,4% dos indivíduos avaliados, enquanto os do TDA foram observados em 16,2% e 15,2% deles, respectivamente. Também se verificou que a prevalência do TDA neste estudo foi superior à média nacional, ao passo que a do TDAH foi mediana quando comparada com a da população mundial. De acordo com as avaliações dos pais ou responsáveis e dos professores, houve as seguintes prevalências estimadas de transtornos comórbidos com sinais e sintomas de TDAH, respectivamente: 83% e 90% de transtorno opositor desafiador; 41,6% e 45,4% de transtorno de conduta; 58,3% e 63,6% de transtornos de ansiedade; 33,3% e 36,3% de transtornos afetivos. Conforme as avaliações dos pais ou responsáveis e dos professores, foram registradas as seguintes prevalências estimadas de transtornos comórbidos com sinais e sintomas de TDA, respectivamente: 60,6% e 64% de transtorno opositor desafiador; 54,5% e 58% de transtorno de conduta; 75,7% e 80,6% de transtornos de ansiedade; 57,5% e 61,2% de transtornos afetivos. Constatou-se que o TDA existe em uma população culturalmente diversa, as crianças e adolescentes que se identificam como Kalunga residentes em Cavalcante-GO, com alta taxa de prevalência, tendo sido observadas as comorbidades habitualmente encontradas em outras populações de crianças das mais variadas culturas ao redor do mundo. Já os sinais e sintomas do TDAH nesta amostra tiveram prevalência equiparada à da população mundial, também com alta taxa de prevalência e igualmente apresentando ss comorbidades habitualmente encontradas em estudos conduzidos em várias partes do mundo e alguns realizados no Brasil.

O diagnóstico de Transtorno de Déficit de Atenção e Hiperatividade (TDAH) apresentou um expressivo crescimento durante a última década (LEGNANI et al., 2006), tornando-se o mais frequente dos transtornos psiquiátricos tratados em jovens (ROHDE et al., 2007). Dados epidemiológicos apontam para prevalência mundial de 4% a 10% entre crianças. Os desdobramentos dessa epidemia diagnóstica não são sem efeitos para a criança e seu corpo. Temos, do lado da família e da escola, uma criança tida como insuportável, que não para e que ninguém consegue controlar; via de regra, esta última não é escutada, mas julgada a partir de seus comportamentos. O desejo tanto do lado da escola como do da família é silenciar a criança e sua agitação. E a resposta a essa demanda vai ser encontrada junto ao saber médico-científico que, consoante à lógica do discurso capitalista de mercados, que tende a simplificar para gerir, tem uma resposta clara e objetiva: trata-se de um transtorno neurobiológico que deve ser tratado via medicação e terapia cognitivo-comportamental. Essa pesquisa tem como objetivo debater de forma crítica a homogeneização da criança sob o diagnóstico de TDAH no discurso médico-científico, trazendo rigor e formalizando a discussão, tanto no âmbito clínico, em que há uma redução do sujeito e seu sofrimento a processos neuroquímicos, como no campo político, no qual a articulação entre saber e poder, evidenciada pela medicalização da existência, permanece oculta sob o véu do discurso da neutralidade científica. A partir de recortes da experiência da clínica psicanalítica de orientação lacaniana com crianças procurou-se restaurar a complexidade da leitura da produção sintomática de um sujeito, articulando-a a um modo de gozo e ao desejo do Outro. Nesse sentido foi possível formalizar que se trata de sujeitos que, de modo singular, renunciam ao seu espaço e à apropriação/subjetivação de seu corpo para gozar e servir ao gozo ao Outro. Quando consideramos o eixo político, podemos pensar a medicalização do desvio como uma construção social que evidencia um momento singular da evolução da cultura e da função social da medicina, em que o aumento do poder médico sobre a regulação de condutas e comportamentos passa a ter uma função de normalização psíquica, constituindo um novo sintoma no laço social / The diagnosis of attention-deficit hyperactivity disorder (ADHD) has showed a significant growth over the last decade (LEGNANI et al., 2006), making it the most common psychiatric disorder treated in young people (ROHDE et al., 2007). Epidemiological data indicate a global prevalence of 4 % to 10 % among children. The consequences of this epidemic of diagnosis are not without effects on the children and their body. We have, on the side of the family and school, a child seen as \"unbearable,\" unstoppable and uncontrollable. By and large, these children are not heard, but judged from their behaviour. That which the school and the family desire is to mute this children and \"their agitation.\" And the answer to this demand will be found in the medical-scientific discourse which, in line with the logic of capitalist market discourse, which tends to simplify to manage, has a clear and objective answer: it is a neurobiological disorder that should be treated via medication and cognitive behavioural therapy. The present research aims to critically discuss the homogenization of the child under the ADHD diagnosis in the medicalscientific discourse, bringing rigor and formalizing the discussion both in the clinical setting, where the subject and his suffering are reduced to neurochemical processes, and in the political field, in which the relationship between knowledge and power, as evidenced by the medicalization of existence, remains hidden under the veil of the discourse of scientific neutrality. Based on the experience of clippings of Lacanian psychoanalytic clinical guidance with children, we sought to restore the complexity of reading a symptomatic production of a subject, linking it to a mode of enjoyment and desire of the Other. In this sense, it was possible to formalize that these subjects who, in a unique way, give up their space and the appropriation/subjectivization of their body to enjoy and serve the jouissance of the Other. In relation to the political axis, we can consider the medicalization of deviance as a social construct that reflects a unique moment in the evolution of culture and the social function of medicine, in which the increased medical power over the regulation of conduct and behaviour acquires a function of psychic standardization, thereby creating a new symptom in the social bond

Bakgrund: Attention deficit hyperactivity disorder (ADHD) är en neuropsykiatrisk funktionsnedsättning som kännetecknas av hyperaktivitet, ouppmärksamhet och impulsivitet. När en person behöver vård på grund av sin neuropsykiatriska funktionsnedsättning upplever ofta de anhöriga en skuld och anklagar sig själva för att deras familjemedlem behöver vård. När anhöriga söker vård med en familjemedlem önskar de att de skall tas på allvar, bli lyssnade på samt få känna sig betydelsefulla. Syfte: Syftet är att undersöka hur anhöriga upplever mötet med vården när en familjemedlem har diagnosen ADHD. Metod: Studien har en kvalitativ ansats och har genomförts via intervjuer av nio anhöriga till familjemedlemmar med diagnosen ADHD. Analysen har skett via kvalitativ innehållsanalys. Resultat: I intervjuerna framkom att de anhöriga upplevde att sammanhang och kontinuitet saknades, att det rådde brist på viss kunskap vilket medförde stort ansvar för anhöriga. De anhöriga upplevde att det varierade i tillgången till stöd. Anhöriga upplevde även att vården inte såg hur hela familjen påverkades av att en familjemedlem hade ADHD och att det inte fokuserades på hela familjens vardagliga situation, utan mest på medicinering. Bemötandet från vårdpersonalen samt miljön runtomkring mötet var även av betydelse. Slutsats: Utifrån den inledande litteraturgenomgången och föreliggande studie kan författarna anta att vården borde anamma ett mer systemiskt förhållningssätt då de arbetar med dessa anhöriga och deras familjemedlem. Kunskap om familjefokuserad omvårdnad hos vårdpersonalen hade eventuellt varit till gagn under mötet för de anhöriga och deras familjemedlem med ADHD, för att vården skulle kunna uppfylla det behov av stöd som varje familjemedlem behöver. / Background: Attention deficit hyperactivity disorder (ADHD) is a neuropsychiatric disability characterized of hyperactivity, inattentive and impulsiveness. When a person with a neuropsychiatric disability need help from the healthcare, it´s common that relatives often feel a fault and judges themselves. The relatives desired that health professionals would listen and give the relatives a feeling of being important. Aim: The aim of this study where to examine how relatives experiences the meeting with healthcare when a family member has ADHD.   Method: This study has a qualitative starting point and are made with nine interviews of relatives with a family member with ADHD. The analyze has been done by qualitative content analysis. Result:  The relatives experienced that the healthcare where missing a point of context, continuity and lack of knowledge which result in a big responsibility for the relatives themselves. It was a variation of access to support and help from the healthcare according to the relatives. The relatives also experienced that the healthcare didn’t see the whole family and how the person with ADHD affected all the family members and their everyday life. Experiences of focus on medication instead of the family’s everyday life where described. The environment and treatment from the health professionals where important to. Conclusion: Based on the initial literature review and the present study, the authors can assume that healthcare should involve a more systematic approach when working with these relatives and their family members. Knowledge of family-focused nursing care staff might have benefited during the meeting of the relatives and their family members with ADHD, so that healthcare could meet the need for support of the whole family.

Inledning: Den neuropsykiatriska funktionsnedsättningen ADHD (engelsk förkortning för Attention Deficit Hyperactivity Disorder) drabbar både barn och vuxna. Orsaken till ADHD är okänd men sannolikt sker en hämmad transmission av dopamin och noradrenalin i hjärnan. Tillståndet ger symptom som uppmärksamhetsproblem, hyperaktivitet och impulsivitet till den grad att den drabbades vardagsliv ofta berörs och livskvaliteten påverkas negativt. Behandlingen innefattar läkemedelsbehandling och icke-farmakologiska åtgärder som t.ex. kognitiv beteendeterapi. Förstahandsvalet av läkemedel är centralstimulerande metylfenidat och antalet användare i Sverige år 2014 var över 73 000 individer. Andrahandsvalet är atomoxetin, ett icke centralstimulerande läkemedel med ca 14 100 användare år 2014 i Sverige. De exakta verkningsmekanismerna hos läkemedlen vid ADHD är okända. Effekterna av dessa läkemedel bedöms som otillräckliga när det gäller kontinuerlig långtidsbehandling i perioder över sex månader. Syfte: Denna studie riktades mot att undersöka de kända effekterna av långtidsbehandling med metylfenidat och atomoxetin, hos både vuxna och barn med diagnostiserad ADHD. Metod: Via PubMed gjordes litteratursökning med ämnesrelaterade sökord. Inklusionskriterierna var att studierna skulle vara utförda på människor under minst sex månaders tid och att presentationen skulle vara på engelska. Registerbaserade studier sorterades bort så att kliniska prövningar och öppna studier återstod. Tio artiklar är inkluderade i studien. Resultat: De tio artiklarna visade sammantaget att långtidseffekterna för både metylfenidat och atomoxetin var signifikant bättre än för placebo. Studielängderna varierade mellan sex månader och fyra år. Studierna kring metylfenidat utfördes med sammanlagt över 900 studiedeltagare och visade att läkemedlet hade effekt på kärnsymptom, emotionella symptom och svårighetsgraden på sjukdomen. Effekter på dessa områden redovisades också för atomoxetin och baserades på sex studier utförda med sammanlagt över 3 250 studiedeltagare. I en jämförande studie redovisades signifikant effekt på livskvaliteten för båda läkemedlen. Både metylfenidat och atomoxetin visade sig förbättra livskvaliteten när den var allvarligt negativt påverkad. Varken metylfenidat eller atomoxetin visade nedsatt terapeutisk verkan efter långtidsbehandling. Typ A-biverkningar av noradrenerg karaktär rapporterades fler gånger i grupperna som fått aktiva läkemedel jämfört med grupperna som fått placebo. Diskussion och slutsats: Resultatet i denna studie baseras på många olika skattningsskalor och för alla skalor visas effekt till fördel för läkemedel jämfört med placebo, vilket tyder på likheter mellan skattningsskalorna. De effekter som syntes vid långtidsbehandling med metylfenidat och atomoxetin överensstämmer med de resultat som redovisats i tidigare studier, både för de under kortare tidsperioder och de med långtidsbehandling. På grund av att det råder brist på långtidsstudier stöder resultatet i denna studie rekommendationen att läkemedelsbehandling vid ADHD ska omvärderas minst en gång per år, med anledning av att endast fyra av de tio inkluderade studierna hade studielängder på mer än ett år. Eftersom många blir långtidsanvändare av läkemedel finns det fortsatt stort behov av studier som sträcker sig över flera år.

Background: The two most common neuropsychiatric disabilities are attention deficithyperactivity disorder (ADHD) and autism spectrum disorder (ASD). Functional impairmentsentail some difficulties for the child that affects the family situation such as interaction withother people and learning and memory difficulties. Aim: The aim of this study was to illuminate the family's experience of living with childrenwho have a neuropsychiatric disability. Method: A qualitative approach was used for this literature based study. The CINAHL and PubMed databases were used to search for scientific articles. Through systematic searches we found ten articles and these were analyzed using Friberg's five-step method. Results: The result is presented on the basis of three themes: An everyday battle, Experiences of understanding and support from the outside world and Family life in light and darkness. It shows that it was a daily struggle for family members in their daily lives. The parents experienced a lack of understanding from the outside world and received limited support. Several parents felt socially isolated and alone. Their daily situation ended up in strong emotions. Conclusion: This study provides an understanding of how family members experience their everyday situation with the child with neuropsychiatric disability. The family relationship was affected in one way or another and it was important for family members to receive support. The nurse has an important responsibility to provide the support and care that family members need to avoid suffering.

M.A. (Psychology) / Please refer to full text to view abstract

M.Ed. (Education and Learning Support) / This study focused on the design, implementation and reflection of the development of a workshop for educators with regards to understanding and effectively managing learners with Attention Deficit Hyperactivity Disorder (ADHD) in their classrooms. This study was done in an action research framework in four specific stages, (a) the educators role, (b) educators knowledge about teaching, (c) teaching practices, and (d) reflective practices. Data was collected from a video recording of the workshop on ADHD, an informal focus group assessment questionnaire, and collection of participant's artifacts of the activities during the workshop. Educators who were engaged in the stages of action research during the workshop were provided with theory, strategies, and a checklists on ADHD. This structure assisted educators through the process of becoming knowledgeable, effective, and reflective managers of learners with ADHD.

M.A. (Clinical Psychology) / The purpose of this study was to determine whether children who are diagnosed as having Attention Deficit Disorder (ADHD), and Geschwind's syndrome, show a tendency to greater allergic responsivity manifesting in a greater sensitivity to specific foods than a control group. In order to test out these predictions, it had to be assessed whether these children displayed differential sensitivity to the food groups of sugar, dairy products and artificial flavouring and colouring. It was also necessary to establish whether these children will show a decrease in levels of activity contingent upon withdrawal of a foodstuff to which a differential sensitivity has been demonstrated. The subjects participating in this study were rated on a Conners Rating Scale to assess the degree of hyperactive behaviour, by both parents and teachers over a six week period. The overall pattern of results indicated that children with a combined diagnosis of ADHD and Geschwind's syndrome would show a greater behavioural responsivity to certain foodstuffs, and contingent upon their withdrawal, show a significant decrease in hyperactive behaviour. It is proposed that the study be repeated utilising a larger sample.

Ph.D. (Psychology) / Attention deficit disorder, or its theoretical antecedent minimal brain dysfunction, has been the subject of numerous investigations as to the nature and cause of this disturbance that so often affects children. Although the findings of these studies appear to be equivocal as regards the precise cause of the condition, there are numerous indications in the literature that there might indeed be a neurological, albeit a "soft" neurological basis or cause, for this disturbance. A study was performed to test the hypothesis that minimal brain dysfunction indeed has its basis in higher cortical dysfunctions as assessed within the context of neuropsychological investigations. In order to perform the study, two measures of neuropsychological functioning, the Luria-Nebraska neuropsychological investigation for children and the Majovski determination of higher cortical functions in children and adolescents were subjected to a determination of its validity within the South African context. Subsequently these tests were applied to two groups of children with organic brain damage, a group of children diagnosed as having minimal brain dysfunction, a group of children with emotional disturbance, and a group of normal children. The two groups of organically brain damaged children consisted of a group of children with predominantly left hemispheric brain damage and a group of children with predominantly right hemispheric brain damage. It was postulated that children with minimal brain dysfunction would show less higher cortical dysfunction than the two groups of children with organic brain damage, but more higher cortical dysfunction than the normal children, and the children with emotional disturbance. The validation procedure indicated that both measures of neuropsychological functioning have adequate validity in terms...