Introdução: Os maus tratos na infância e adolescência são considerados um problema de saúde pública devido a alta prevalência no Brasil e no mundo. A exposição a maus tratos está associada a alterações no desenvolvimento cognitivo, porém, há uma escassez de estudos brasileiros que investiguem o tema. Objetivos: Comparar o funcionamento neuropsicológico de adolescentes com e sem histórico de maus tratos, bem como estudar as relações entre essas vivências, desempenho neuropsicológico e sintomas psiquiátricos relacionados a impulsividade, oposição, hiperatividade e desatenção. Método: Cento e oito adolescentes foram selecionados em dois programas de atendimento a população em situação de vulnerabilidade e/ou risco social de São Paulo (SP). De acordo com a pontuação do Questionário de Traumas na Infância (QUESI), foram classificados em três grupos: GMT1 (grupo de maus tratos leves, n=35), GMT2 (grupo de maus tratos moderado a grave, n=19) e GC (grupo de comparação, n=54). Os adolescentes passaram por avaliação neuropsicológica com o foco na investigação de funções relacionadas a percepção visual e spam atencional (primeira unidade funcional), processamento e armazenamento de informações (segunda unidade funcional) e funcionamento executivo (terceira unidade funcional). Foram utilizadas escalas para avaliação psiquiátrica (K-SADS-PL) e investigação de sintomas de impulsividade, hiperatividade, desatenção e oposição (BIS-1, SNAP-IV). Os resultados obtidos nos grupos foram comparados com o controle estatístico de variáveis sociais (dificuldades socioeconômicas, escolaridade e abrigamento) e clínicas (transtornos psiquiátricos internalizantes e externalizantes, uso de medicação psiquiátrica e quociente intelectual estimado- QI). Por fim, foram feitas associações entre exposição a maus tratos, funcionamento neuropsicológico e sintomas psiquiátricos. Resultados: Os GMTs (grupos de maus tratos) apresentaram pior funcionamento intelectual em relação ao GC, sendo que o pior desempenho foi encontrado no GMT2 (p< 0,001). Medidas menores de QI estiveram associadas a prejuízo nas três unidades funcionais (p<= 0,049) e a mais sintomas de hiperatividade e desatenção (p <= 0,008). Foi encontrado pior desempenho dos GMTs nos testes para avaliação de segunda unidade funcional (p<= 0,001), porém, não foram encontradas diferenças entre os grupos na primeira e terceira unidades. Apesar disso, os testes de correlação indicaram que o aumento das pontuações no QUESI estava associado à piora do desempenho em todas as unidades funcionais (p<= 0,046). Os GMTs apresentaram maior impulsividade e oposição (p<= 0,008) e, quanto maior a pontuação no QUESI, maior a presença de sintomas de impulsividade, oposição, sintomas isolados de desatenção e sintomas mistos de desatenção e hiperatividade (p<= 0,006). Conclusão: Os resultados obtidos corroboram a associação entre exposição a maus tratos e dificuldades cognitivas e psiquiátricas. Os dados obtidos poderão contribuir para o planejamento de políticas públicas voltadas tanto à prevenção quanto para o tratamento de patologias associadas ao desenvolvimento neurobiológico alterado de crianças e adolescentes que crescem em condições adversas. / Introduction: Maltreatment experiences in childhood and adolescence are considered a public health problem due to high prevalence in Brazil and worldwide. The exposure to maltreatment is associated with changes in cognitive development; however, there is a shortage of Brazilian research that investigates this topic. Objectives: Comparison of neuropsychological functioning of adolescents with and without maltreatment history, as well as the research of relationships between these experiences, neuropsychological performance, and psychiatric symptoms relating to impulsivity, opposition, hyperactivity, and inattention. Methods: One hundred and eight adolescents were selected from two assistance programs for people in vulnerability and social risk situation in the city of Sao Paulo (SP). According to the Childhood Trauma Questionnaire (CTQ), three groups were classified: GMT1 Group (Mild Maltreatment, n = 35), GMT2 (group of moderate to severe maltreatment, n = 19) and GC (comparison group, n = 54). The adolescents underwent neuropsychological evaluation with a focus on the investigation of functions related to visual perception and attention spam (first functional unit), processing and retention of information (second functional unit) and executive functioning (third functional unit). Scales were used for psychiatric assessment (K-SADS-PL) and investigation of impulsivity, hyperactivity, inattention, and opposition symptoms (SNAP-IV, BIS-11). Results obtained in these groups were compared with statistical control of social variables (socioeconomic, school level, and shelter), and clinical variables (internalizing and externalizing psychiatric disorders, use of psychiatric medication, and estimated intellectual quotient - IQ). Lastly, associations between exposure to maltreatment, neuropsychological functioning and psychiatric symptoms were made. Results: The GMT (maltreatment groups) had a worse intellectual functioning compared to GC, while the worst performance was found in GMT2 (p < 0.001). Lower IQ measures were associated to impairment on the three functional units (p<= 0.049) and to more symptoms of inattention and hyperactivity (p <= 0.008). Worse performance on tests for evaluation of the second functional unit (p<= 0.001) was found for GMT, but no differences were found between the groups on the first and third units. Nevertheless, the correlation tests indicated that the increase in CTQ scores was associated to worse performance in all of the functional units (p<= 0,046). The GMT presented higher impulsivity and opposition (p<= 0,008) and the higher the CTQ score the more symptoms of impulsivity, opposition, isolated symptoms of inattention, and mixed symptoms of inattention and hyperactivity (p<= 0,006). Conclusion: The results confirm the negative association between exposure to maltreatment and psychiatric and cognitive difficulties. The data obtained will contribute to the planning of public policies for both prevention and treatment of diseases associated to altered neurobiological development of children and adolescents who grow up in adverse conditions.

No description available.

1 online resource (xii, 171 leaves) : illustrations (chiefly color), color graphs / ADHD negatively impacts academic performance, and the traditional classroom setting conflicts with the symptoms of ADHD. This research examined the potential of teaching through play and peer-teaching as alternative teaching methods to improve the mathematical performance of Grade 1 children with symptoms of ADHD; by answering, would adapting teaching methods to include teaching through play and/or peer-teaching, in the South African classroom, improve the mathematical performance of children with symptoms of ADHD? A pre-test-post-test control group design was employed in this comparative experimental study. Participants were purposively selected then randomly assigned to one of three intervention groups. An eight-week intervention was implemented as teaching through play or peer-teaching. Pre-test and post-test scores were analysed using a dependent t-test, a Wilcoxon Signed Rank test, and a Kruskal Wallis test. Teaching through play and peer-teaching have the potential to improve the mathematical performance of Grade 1 children with symptoms of ADHD. Special precautions were taken in the process of minor research participants, adhering to the ethical principles of beneficence and non-maleficence, justice, and autonomy. / Psychology / M. Sc. (Psychology (Research Consultation))

Les symptômes du TDAH et l’addiction aux jeux vidéo semblent partager une relation bidirectionnelle que nous avons voulu explorer davantage en présentant un état des connaissances actuelles de la littérature puis une étude sous forme d’article actuellement soumis. L' étude TDAH et usage addictif des jeux vidéo chez les enfants a pour objectifs de mieux comprendre la relation constatée en clinique et dans la littérature scientifique entre l’usage/addiction aux jeux vidéo et le TDAH chez les enfants de 4 à 12 ans : en comparant les modalités d'utilisation des jeux vidéo (temps de jeu, score de dépendance et utilisation par âge) entre des enfants TDAH et des enfants sans TDAH; en examinant les associations entre l’addiction aux jeux vidéo et les symptômes du TDAH; en explorant l’impact du genre dans l'utilisation des jeux vidéo et le type de jeux vidéo joués par les enfants. L’étude comprend 280 enfants, 135 d’un groupe clinique et 145 d’un groupe communautaire.L’étude est transversale, multicentrique (CHU Sainte-Justine et CIUSSS NIM), exploratoire, descriptive et ouverte. La méthodologie consiste en la passation de 3 questionnaires remplis par l’un des parents en une fois : questionnaire socio-démographique avec des spécifications concernant l’usage des jeux vidéo et des questions sur l’usage des parents et leur perception; Strenghs and Difficulties Questionnaire (SDQ); et le questionnaire sur l’attention et l’ordinateur (QUATTORD). Notre étude souligne la vulnérabilité des enfants TDAH pour l’usage excessif des jeux vidéo et les conséquences sur leur symptomatologie. Associées à ces résultats, nous avons procédé à des analyses complémentaires sur les caractéristiques de la population, et l’usage et perception des jeux vidéo chez les parents. Ces données semblent corroborer l’idée d’une relation multifactorielle à l’origine des comportements d’addiction aux jeux vidéo. / ADHD symptoms and video game addiction seem to share a two-way relationship that we intended to explore further by describing the current state of knowledge of the literature and conducting a study presented in the form of a currently submitted article. The objectives of this project are to better understand the relationship between video game use / addiction and ADHD in children aged 4 to 12: by comparing the methods of using video games (playtime, dependence score and use by age) between ADHD children and children without ADHD; examining the associations between video game addiction and ADHD symptoms; exploring the impact of gender in the use of video games and the type of video games played by children. The study is transversal, multicentric (CHU Sainte-Justine and CIUSSS NIM), exploratory, descriptive and open. The methodology consists of taking 3 questionnaires completed by one of the parents at once: socio-demographic questionnaire with specifications concerning the use of video games and questions on the use of parents and their perception; Strengths and Difficulties Questionnaire (SDQ); and the Attention and Computer Questionnaire (QUATTORD). Our study highlights the vulnerability of ADHD children to excessive use of video games and the consequences on their symptoms. Associated with these results, we carried out additional analyzes on the characteristics of the population, and the use and perception of video games among parents. Our data seem to support the idea of a multifactorial relationship at the root of video game addiction behaviors.

Introduction : Le trouble du déficit de l’attention avec ou sans hyperactivité (TDAH) est un trouble neurodéveloppemental caractérisé par l'inattention et/ou l'hyperactivité-impulsivité. Le TDAH est un trouble fréquent qui affecte environ 5% à 8% des enfants et des adolescents, et 4% des adultes. Les lignes directrices recommandent un traitement pharmacologique comme traitement de première intention pour le TDAH chez l'adulte. Bien que rare, il y a une augmentation constante de l'utilisation des médicaments pour le TDAH chez les adultes, y compris les femmes en âge de procréer et durant la grossesse. Ils représentent donc une exposition aux médicaments de plus en plus fréquente. Le TDAH non traité a un impact sur le bien-être ainsi que sur la santé psychosociale de la femme. D’ailleurs, il est associé à d’importants problèmes professionnels, interpersonnels et psychosociaux. Les préoccupations concernant l'exposition in utero aux médicaments pour traiter le TDAH reposent principalement sur l'impact que ces derniers peuvent avoir sur le fœtus. Objectifs : Cette thèse comprend trois volets de recherche liés à l’utilisation des médicaments psychostimulants et non stimulants dans le traitement du TDAH durant la grossesse. Le premier volet de recherche vise à décrire la prévalence d'utilisation, les dosages et les déterminants de l'utilisation des différents médicaments dans le traitement du TDAH chez les femmes enceintes. Le second volet de recherche consiste à évaluer l’association entre l’utilisation de médicaments pour le TDAH chez la femme enceinte et le risque de TDAH chez l’enfant. Le troisième volet de recherche est subdivisé en deux parties. La première partie visant à déterminer l'association entre l'exposition aux médicaments pour le TDAH au premier trimestre et le risque de malformations congénitales majeures (MCMs). La seconde partie consiste à évaluer l'impact du biais de sélection dans les études pharmacoépidémiologiques périnatales en utilisant des cohortes d’étude basée sur différents critères d’éligibilité. Méthodologie : Le programme de recherche est basé sur les données de la Cohorte des grossesses du Québec (CGQ). Dans le premier volet de cette thèse, nous avons effectué une étude de cohorte longitudinale chez les femmes couvertes par le régime d'assurance médicaments de la RAMQ de 1998 à 2015 pour identifier la prévalence et les déterminants de l’utilisation des médicaments pour le TDAH. Les déterminants de l'utilisation des médicaments pour le TDAH durant la grossesse ont été estimés avec des équations d'estimation généralisées. Dans le second volet nous avons utilisé un devis d’étude de cohorte pour mesurer le risque de survenue de TDAH chez l’enfant à la suite de l’exposition in utero aux médicaments pour le TDAH. Une analyse de survie pour modéliser le temps à la survenue de l’événement a d’abord été menée. Par la suite, pour prendre en compte les facteurs intrafamiliaux invariants non mesurés dans le premier modèle d’analyse, nous avons évalué le risque de TDAH chez l’enfant par l’intermédiaire d’une analyse de type « siblings ». Dans le troisième volet, nous nous sommes intéressés à l’aspect épidémiologique et méthodologique des études périnatales antérieures dans l’évaluation du risque de malformations congénitales majeures. Compte tenu des limites méthodologiques relatives aux études antérieures, nous avons effectué une étude de cohorte incluant tous les enfants singletons nés à terme, les mortinaissances et les avortements induits et planifiés afin d’évaluer le risque de malformations congénitales majeures et l'impact d'un biais de sélection potentiel dans les études pharmacoépidémiologiques périnatales. Résultats : Les résultats du projet 1 ont démontré que la prévalence de l'utilisation de médicaments pour le TDAH chez les femmes enceintes au Québec a augmenté de façon significative entre 1998 et 2015. Les résultats du projet 2 ont permis de constater que l'exposition in utero aux médicaments pour le TDAH n'était pas associée à un risque accru de TDAH chez les enfants. Nos analyses combinant la régression de Cox et l’analyse de type « sibling » suggèrent que l'association est due à des facteurs environnementaux génétiques et/ou familiaux. Finalement, les résultats du projet 3 ont démontré que l'utilisation de médicaments pour le TDAH au cours du premier trimestre augmente le risque de MCMs de 29% chez les nouveau-nés, en particulier de malformations cardiaques. La définition des critères d'inclusion n'expliquerait pas l'ampleur du risque de MCM associé à l'utilisation de médicaments pour le TDAH. Conclusion : Ce programme de recherche dresse un portrait global de l’usage et des risques des traitements pharmacologiques spécifiques au TDAH chez les femmes enceintes au Québec. L’usage des médicaments psychostimulants et non stimulants dans le traitement du TDAH durant la grossesse augmente significativement au fil du temps. L’exposition in utero aux médicaments pour traiter le TDAH ne serait pas associée à un risque accru de TDAH chez les enfants. De ce fait, l'association est très probablement due à des facteurs environnementaux génétiques et/ou familiaux. Bien que les conséquences fœtales de l'exposition prénatale restent à déterminer, l’utilisation de ces médicaments dans le traitement du TDAH au cours du premier trimestre augmente le risque de malformations congénitales majeures chez le nouveau-né. Ainsi, ces informations sont importantes dans l’évaluation des stratégies de traitement du TDAH chez les femmes enceintes. / Introduction: Attention deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention and/or hyperactivity-impulsivity. ADHD is a common disorder that affects about 5% to 8% of children and adolescents, and 4% of adults. Guidelines recommend pharmacological treatment as the first-line treatment for adult ADHD to manage symptoms and impairments. Although rare, the use of these drugs in adults, including women of childbearing age, has increased significantly. They therefore represent an increasingly frequent exposure to these drugs during pregnancy. Untreated ADHD has an impact on the well-being as well as on the psychosocial health of women. Moreover, it is associated with important professional, interpersonal and psychosocial problems. Concerns about in utero exposure to ADHD drugs are based primarily on the impact they may have on the fetus. Objectives: This thesis includes three research projects related to the use of psychostimulant and nonstimulant drugs in the treatment of ADHD during pregnancy. The first project of the research aims is to describe the prevalence of use, the dosages and the determinants of the use of the different drugs in the treatment of ADHD in pregnant women. The second project of the research is to assess the association between the use of ADHD drugs in pregnant women and the risk of ADHD in children. The third research project is subdivided into two parts. The first part aims to determine the association between exposure to ADHD drugs in the first trimester and the risk of major congenital malformations. The second part consists of evaluating the impact of selection bias in perinatal pharmacoepidemiologic studies using study cohorts based on different eligibility criteria. Methodology: The research program is based on data from the Quebec Pregnancy Cohort (QPC). In the first project of this thesis, we carried out a longitudinal cohort study among women covered by the RAMQ drug insurance plan from 1998 to 2015 to describe the prevalence and identify the determinants of the use of ADHD medication. The determinants of ADHD medication use during pregnancy were estimated with generalized estimation equations. In the second project, we used a cohort study design to measure the risk of ADHD in children following in utero exposure to ADHD medications. A survival analysis to model the time of onset of the event was first performed. Subsequently, to take into account the invariant intrafamily factors not measured in the first model, we assessed the risk of ADHD in children with a sibling design. In the third project, we looked at the epidemiological and methodological aspect of previous perinatal studies in assessing the risk of major congenital malformations. Given the methodological limitations of previous studies, we performed a cohort study including all singletons born at term, stillbirths and induced/planned abortions in order to assess the risk of major congenital malformations and the impact of a potential selection bias in perinatal pharmacoepidemiologic studies. Results: The results of the first project demonstrated that the prevalence of ADHD medication use among pregnant women in Quebec increased significantly between 1998 and 2015. The results of the second project showed that exposure in utero medication for ADHD was not associated with an increased risk of ADHD in children. Our method of analysis combining Cox regression and sibling analysis suggests that the association is due to genetic and/or familial environmental factors. Finally, the results of the third project demonstrated that the use of ADHD medication during the first trimester increases the risk of MCMs by 29% in live-born singletons, especially heart defects. The definition of the inclusion criteria would not explain the magnitude of the risk of MCM associated with the use of medications for ADHD. Conclusion: This research program provides a comprehensive portrait of the use and risks of pharmacological treatments specific to ADHD in pregnant women in Quebec. The use of psychostimulant and nonstimulant medications in the treatment of ADHD during pregnancy increases significantly over time. In utero exposure to medications to treat ADHD is not believed to be associated with an increased risk of ADHD in children. Therefore, the association is most likely due to genetic and/or familial environmental factors. Although the fetal consequences of prenatal exposure remain to be determined, the use of these medications in the treatment of ADHD in the first trimester increases the risk of major congenital malformations in the infant. Thus, this information is important in evaluating treatment strategies for ADHD in pregnant women.

Mindfulness meditation programs, benefits, and outcomes were examined through research previously conducted and published by professionals within five differing disciplines: health and wellness, psychology, elementary education, exceptional education, and medicine. The goal was to find common themes within the differing disciplines in order to gather information about the effectiveness of a mindfulness meditation program to be used in an elementary classroom. In this thesis, the chapter of Health and Wellness is a review of literature that tells the benefits found within meditators, which are not found within non-meditators. The chapter of Psychology explains the social-emotional needs of students, the causes of stress and anxieties amongst students, and the benefits that meditation provides in order to counter the negative effects of stress, anxiety, poverty, etc. The chapter of Elementary Education reviews research literature on the existing mindfulness meditation programs within the United States. This chapter also describes the implementation of such a program in an elementary school, as well as the documented data of the outcomes of the programs. The chapter of Exceptional Education is a review of the research literature on the benefits mindfulness meditation has on students with exceptionalities, such as specific learning disabilities, attention deficit hyperactivity disorder, and autism spectrum disorder. The chapter of Medicine is a retelling of previously published scholarly articles that list the neurological benefits of meditation, and also references the negative side effects to the currently prescribed medications that are being used in the treatment of ADHD.

No description available.

Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are two frequently co-occurring neurodevelopmental conditions that share certain symptomatology, including social difficulties. This presents practitioners with challenging (differential) diagnostic considerations, particularly in clinically more complex cases with co-occurring ASD and ADHD. Therefore, the primary aim of the current study was to apply a data-driven machine learning approach (support vector machine) to determine whether and which items from the best-practice clinical instruments for diagnosing ASD (ADOS, ADI-R) would best differentiate between four groups of individuals referred to specialized ASD clinics (i.e., ASD, ADHD, ASD + ADHD, ND = no diagnosis). We found that a subset of five features from both ADOS (clinical observation) and ADI-R (parental interview) reliably differentiated between ASD groups (ASD & ASD + ADHD) and non-ASD groups (ADHD & ND), and these features corresponded to the social-communication but also restrictive and repetitive behavior domains. In conclusion, the results of the current study support the idea that detecting ASD in individuals with suspected signs of the diagnosis, including those with co-occurring ADHD, is possible with considerably fewer items relative to the original ADOS/2 and ADI-R algorithms (i.e., 92% item reduction) while preserving relatively high diagnostic accuracy. Clinical implications and study limitations are discussed.

Text in Afrikaans with a summary in Afrikaans and English / The motivation for this study was to use animal-assisted therapy to the advantage of the child with Fetal Alcohol Syndrome. The purpose of this study was to describe the use of therapeutic horse riding in Gestalt therapy and its influence on the awareness levels of the child with Fetal Alcohol Syndrome that present with Attention deficit/Hyperactivity disorder. For the purpose of this study a quantitative research approach with a descriptive nature was used. Semi-structured interviews were used to compile information about a single child in a therapeutic milieu. This information was combined with information gathered from the literature to compile guidelines for the counsellor. In this study horse riding was effectively combined with Gestalt play therapy to enhance the awareness levels of the child with Fetal Alcohol Syndrome. / Die motivering van hierdie ondersoek was om diergefasiliteerde terapie tot voordeel van die kind met Fetale Alkohol Sindroom te benut. Die doel van die studie was om die benutting van terapeutiese perdry in Gestaltspelterapie en die invloed daarvan op die bewustheidsvlakke van die kind met Fetale Alkohol Sindroom wat met Aandagafleibaarheid/hiperaktiwiteitsindroom presenteer te beskryf. Vir die doel van hierdie studie is kwalitatiewe navorsing met 'n beskrywende aard benut. Semi-gestruktureerde onderhoude is gebruik om inligting in te samel rakende 'n enkele kind in 'n terapeutiese milieu. Hierdie inligting is gekombineer met die inligting uit die literatuur ten einde riglyne vir die berader op te stel. In hierdie studie is perdry effektief by Gestaltspelterapie geintegreer om die kind met Fetale Alkohol Sindroom se bewustheidsvlakke te verhoog. / Practical Theology / M.Diac. (Play Therapy)

Text in Afrikaans with a summary in Afrikaans and English / The motivation for this study was to use animal-assisted therapy to the advantage of the child with Fetal Alcohol Syndrome. The purpose of this study was to describe the use of therapeutic horse riding in Gestalt therapy and its influence on the awareness levels of the child with Fetal Alcohol Syndrome that present with Attention deficit/Hyperactivity disorder. For the purpose of this study a quantitative research approach with a descriptive nature was used. Semi-structured interviews were used to compile information about a single child in a therapeutic milieu. This information was combined with information gathered from the literature to compile guidelines for the counsellor. In this study horse riding was effectively combined with Gestalt play therapy to enhance the awareness levels of the child with Fetal Alcohol Syndrome. / Die motivering van hierdie ondersoek was om diergefasiliteerde terapie tot voordeel van die kind met Fetale Alkohol Sindroom te benut. Die doel van die studie was om die benutting van terapeutiese perdry in Gestaltspelterapie en die invloed daarvan op die bewustheidsvlakke van die kind met Fetale Alkohol Sindroom wat met Aandagafleibaarheid/hiperaktiwiteitsindroom presenteer te beskryf. Vir die doel van hierdie studie is kwalitatiewe navorsing met 'n beskrywende aard benut. Semi-gestruktureerde onderhoude is gebruik om inligting in te samel rakende 'n enkele kind in 'n terapeutiese milieu. Hierdie inligting is gekombineer met die inligting uit die literatuur ten einde riglyne vir die berader op te stel. In hierdie studie is perdry effektief by Gestaltspelterapie geintegreer om die kind met Fetale Alkohol Sindroom se bewustheidsvlakke te verhoog. / Philosophy, Practical and Systematic Theology / M.Diac. (Play Therapy)