Made available in DSpace on 2016-03-15T19:40:23Z (GMT). No. of bitstreams: 1 Rosane Lowenthal - DD2006.pdf: 382320 bytes, checksum: 6a6e97760e5bdab1aa3be863aa2c72ac (MD5) Previous issue date: 2006-09-12 / Universidade Federal de São Paulo / The literature has reported frequencies from 1% to 11% of pervasive developmental disorder (PDD) in Down s syndrome (DS). It is not clear, if the frequency of this co-occurrence is higher or lower than in other mental retardations. The aim of the study was to identify the comorbidity of autistic spectrum disorders in children and adolescents with DS from Curitiba Brasil. 205 parents of children and adolescents with DS, between 5 and 19 years-old were asked to complete the self-report Autism Screening Questionnaire (ASQ) and the family history questionnaire (provided by Prof. C. Gillberg). The frequency of PDD in the DS sample was 15.6%, with 5.58% of autism (8 males and 2 females) and 10.05% of PDD non autism (9 males and 9 females). This study showed a higher frequency of TID in SD, even though more studies are needed to answer if this frequency is higher than in other mental retardations. / Os trabalhos publicados na literatura mostram taxas de transtornos invasivos do desenvolvimento (TID) em pessoas com síndrome de Down (SD) entre 1 e 11%. Não está claro se a freqüência desta ocorrência é mais alta ou mais baixa que em outras deficiências intelectuais. O objetivo deste estudo é fazer um rastreamento de TID em crianças e adolescentes com SD que residem em Curitiba Brasil. 205 pais de crianças e adolescentes com SD, entre 5 e 19 anos, responderam o questionário para triagem de TID, Autism Screening Questionnaire (ASQ), e o questionário de histórico familiar (cedido pelo Dr. Gillberg). A freqüência de TID em SD encontrada neste trabalho foi de 15,6%, com 5,58% de autismo (8 meninos e 2 meninas) e 10,05% de TID sem autismo (9 meninos e 9 meninas). Esse trabalho encontrou uma alta freqüência de TID em SD, sendo necessários mais estudos para esclarecimento se essa freqüência é maior do que a encontrada em outras deficiências mentais.

De nombreuses recherches montrent aujourd’hui que des signes de psychopathologies peuvent être présents très tôt dans le développement de l’enfant. L’étude approfondie du développement précoce s’avère ainsi essentielle, dans un souci de prévention et de prise en charge précoce. La présente étude a pour objectif, d’une part, d’identifier des éléments du développement précoce de l’enfant pouvant nous alerter quant à un risque éventuel de développer un trouble du développement et, d’autre part, d’identifier des éléments spécifiques au développement précoce des enfants ultérieurement diagnostiqués avec Trouble Envahissant du Développement (TED) ou trouble du développement (autre que TED). Dans ce but, nous avons, dans un premier temps, évalué le développement socio-émotionnel et cognitif de vingt enfants entre 12 et 24 mois, en lien avec les signes d’autisme et de retrait relationnel. Pour ce faire, trois outils spécifiques ont été utilisés : la BECS (« Batterie d’Évaluation du développement Cognitif et Socio-émotionnel », Adrien, 2007), l’ADBB (« Alarme Détresse Bébé », Guédeney et Fermanian, 2001), et l’ECA-N (Échelle d’ « Évaluation des Comportements Autistiques- Nourrisson », Sauvage, 1988 ; Adrien, et al., 1989, 1992). Il apparaît quatre sous-groupes d’enfants, qui se distinguent par trois caractéristiques, identifiées comme étant les plus discriminantes : l’âge de développement, l’hétérogénéité du développement socio-émotionnel, et les signes d’autisme. Dans un second temps, 10 à 32 mois après, une évaluation diagnostique a été réalisée pour la moitié de notre population. Cette évaluation nous permet d’établir des trajectoires développementales spécifiques pour chacun de nos quatre sous-groupes. Il apparait que la présence et le nombre de critères développementaux (parmi les trois identifiés), ainsi que le type de critère(s) nous informeraient quant à la probabilité ou non de développer un trouble, ainsi que le type de trouble vers lequel pourrait se diriger le développement de l’enfant. Enfin, certains éléments du développement et du comportement précoce des enfants ultérieurement diagnostiqués avec Trouble Envahissant du Développement ou avec trouble du développement (autre que TED) apparaissent comme caractéristiques. / There is substantial evidence that signs of psychopathology may appear very early in child development. A comprehensive evaluation of the child early development seems to be essential in order to implement prevention and early intervention strategies. This study aims to identify some specific elements of early development that could alert of a potential risk of developmental disorder, as well as particular elements of the development of infants subsequently diagnosed with Pervasive Developmental Disorder (PDD) or with developmental disorder (other than PDD). In a first moment, we evaluated the cognitive and socio-emotional development, in particular signs of social withdrawal and of autism, of 20 infants between 12 and 24 months of age. Three specific tools were used: the SCEB (“Social Cognitive Evaluation Battery”, Adrien, 2007), the ADBB (« Alarm Distress Baby Scale », Guédeney et Fermanian, 2001), and the IBSE (« Infant Behavioral Summarized Evaluation » Sauvage, 1988; Adrien, et al., 1989, 1992). Four sub-groups of children were identified, distinguished by three characteristics appearing to be the most distinctive: developmental level, heterogeneity of socio-emotional development, and signs of autism. In a second stage, from 10 to 32 months later, a diagnostic evaluation was performed for half of our population. This evaluation enabled to establish specific developmental trajectories, for each of our four sub-groups. Results show that the presence and the number of developmental criteria (among the three identified), along with the type of criteria, in early development, might inform of the probability of developing (or not) a disorder, as well as the kind of disorder that could possibly be further developed. Furthermore, some of the data about the development and the behavior of infants subsequently diagnosed with Pervasive Developmental Disorder (PDD) or with developmental disorder seem to be characteristics.

京都大学 / 新制・課程博士 / 博士(医学) / 甲第24483号 / 医博第4925号 / 新制||医||1063(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 西浦 博, 教授 今中 雄一, 教授 滝田 順子 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

This study examined the costs of pervasive developmental disorder (PDD) treatment in a large healthcare organization. When compared to individual therapy and mixed therapy, family therapy had significantly fewer sessions, fewer episodes of care, and better cost-effectiveness. Individual therapy had significantly shorter treatment length than mixed therapy. There were no differences in treatment length or number of episodes by license, but dropout and cost-effectiveness were significantly different. Medical doctors had the highest dropout and best cost-effectiveness, while Marriage and Family Therapists had the lowest dropout and Masters of Social Work had the poorest cost-effectiveness. Children had significantly higher dropout than other age groups. An autism diagnosis was associated with fewer sessions but additional episodes of care when compared to PDD. Having a comorbid diagnosis is associated with longer treatment length but slightly fewer episodes of care. A regression model to predict number of episodes of care by intensity of treatment, provider type, and modality, intensity of treatment explained only 6% of the variance.

Background: Parents of children with developmental disorders (DD) or disabilities report greater parenting stress than parents of typically developing children. To minimise this stress, stressful factors need to be known and stress needs to be recognised early. The present cross-sectional study aims to systematically assess and compare parenting stress in families of children with various types of disabilities. In addition, the assessment of parenting stress by attending paediatricians will be evaluated. Methods: We surveyed 611 parents about their parenting stress at the Children's Development Center (CDC). Three questionnaires, including the German versions of the Parenting Stress Index (PSI) and Impact on Family Scale (IOFS), were used to evaluate parenting stress. Furthermore, attending paediatricians assessed of the child's type of disability and their perception of parenting stress in a separate questionnaire. Results: Fifty-five percent of all parents reported stress at a clinically relevant level, 65% in the child domain and 39% in the parent domain of the PSI. Parenting stress differed significantly across diagnostic categories (p < 0.01) and was associated with childhood disability related issues of behaviour, sleep or feeding issues. Parenting stress was often underestimated by the paediatricians, especially when the children had disabilities perceived as less severe. In one-third of parents with clinically relevant total stress, paediatricians reported low stress levels. Parent-reported financial problems, social isolation, and partnership conflicts were not suspected by paediatricians in ≥85% of cases. Conclusions: Clinically relevant parenting stress was found more often than in comparable studies. An assessment of parenting stress by paediatricians may be complicated by time constraints in medical appointments, the mainly child-centred consultation, or restricted expression of parents' stress. Paediatricians should move from a purely child-centred to a holistic, family-centred approach to treatment. Routine screening of parenting stress using standardised questionnaires could be helpful to identify affected families.

This study aimed to explore the underlying basis of the communication difficulties in children (between 5.0 and 7.11 years) with high functioning pervasive developmental disorder (HFPDD) (n=26), compared to children with specific language impairment (SLI) (n=26), and children with no history of developmental difficulty (NDD) (n=26). The study looked at: whether different profiles could be obtained for the groups on comprehensive batteries of communication, cognitive processing and theory of mind; which areas measured were best correlated; and which measures best differentiated the groups. Comprehensive communication and theory of mind batteries were devised and conducted. Cognitive processing was measured using the Cognitive Assessment System (CAS) (Naglieri and Das, 1997). Data was analysed using descriptive statistics, analysis of variance, the Kruskal-Wallis test, Bonferroni t tests, frequency distributions, Pearson correlation coefficients and discriminant function analyses. Kappa coefficients and analysis of variance measures were carried out on 23% of the rated data in order to establish inter-rater agreement and acceptable levels of agreement were reached. On the communication assessment, the HFPDD group experienced the most difficulty on the measures of understanding abstract vocabulary, understanding conversation, pronoun alternation, higher level semantics, narrative ability and pragmatic ability. In contrast, the SLI group experienced the most difficulty on the measures of expressive grammar and narrative clarity. On the cognitive processing assessment, the HFPDD group experienced marked difficulty in the areas of planning and attention, while the SLI group experienced significant difficulty in the areas of successive processing and less marked but still significant difficulty in the area of planning. Within the HFPDD group, a group with simultaneous processing markedly stronger than successive processing, a group with successive processing markedly stronger than simultaneous processing, and a group with simultaneous and successive processing occurring at a similar level, were identified. The HFPDD group experienced significant difficulty on all the measures of theory of mind, although a limited number of HFPDD subjects did not experience difficulty. The SLI group experienced significant difficulty on the two theory of mind measures that were more verbally loaded. Strong correlations were found between receptive language, expressive semantics, narrative ability, pragmatic ability, planning, attention and theory of mind; and between expressive grammar and successive processing. Pragmatic ability, narrative ability, planning, and certain of the theory of mind measures best appeared to discriminate the groups. A combined model of language, cognitive and theory of mind processing is proposed to explain the differences between the HFPDD and SLI groups.

Made available in DSpace on 2016-03-15T19:40:01Z (GMT). No. of bitstreams: 1 Fernanda Orsati.pdf: 1711676 bytes, checksum: 67a1af29a9c15a0b260226b0599ab6af (MD5) Previous issue date: 2007-02-09 / Fundo Mackenzie de Pesquisa / Autism is part of a spectrum of the Pervasive Developmental Disorders (PDD). It is characterized by deficits in social interaction, communication and behavior. The diagnosis is based on clinical assessment and behavior observation. New methods have been developed and studied for more precise diagnosis. Among these methods are PET scan, histological, neuropsychological and eye movements markers. Combining some of these methods, such as the neuropsychological assessment of executive functions and eye movement, correlations can establish with neurobiological bases and this way contribute to more precise interventions. The objective is to assess executive functions and correlate them to eye movements abnormalities in PDD participants. METHOD: 10 PDD children and adolescents, mean age 11,9 (SD=3,22)matched with 10 children and adolescents with typical development. The WISC III was used to assess intelligence, Trail Making, Rey Complex Figure and Hanoi Tower were used to assesse the executive functions. The eye movements parameters were assessed with Predictive Saccade Task (SP), Anti-Saccade (AS), Pursuit Eye Movement, and Face Tracking. RESULTS: Significant differences were found between General IQ, Executive IQ, part B of Trail Making Test, memory drawing after 3 and 30 minutes in the Complex Figure Test and the Hanoi Tower. Differences between groups were found in the eye tracking tasks: accuracy and latency in the SP Task; errors followed by correct saccades in the AS Task; numbers of pursuit eye movements and number of fixations on the eye region in faces with eye present or absent in the Face Tracking Task. Significant correlations were also found between measures of IQ, executive functions and eye tracking. DISCUSSION and CONCLUSIONS: A profile of neuropsychological deficits correlated to eye tracking patterns has been found. This profile is characterized by: difficulties on voluntary attention regulation, response inhibition, planning, response initiation and cognitive flexibility; and preserved viso-construction ability. The executive function impairments reflect on the social behavior regulation. The description of the executive profile can contribute to more efficient interventions. / O autismo está inserido dentro dos Transtornos Invasivos do Desenvolvimento (TID) sendo caracterizado por uma tríade de comprometimentos que atinge a interação social, comunicação e comportamento. Atualmente o diagnóstico é realizado por observação e relatos comportamentais sem que haja um marcador biológico único para caracterizá-lo. Novas possibilidades de determinar esse marcador preciso vêm sendo amplamente discutidas na literatura tais como: achados de ressonância magnética funcional, histológicos, neuropsicológicos e de movimento ocular. Desta maneira, a avaliação de funções executivas e de anormalidades do movimento ocular são meios de investigação das bases de funcionamento neubiológico e contribuem para maior precisão no desenvolvimento de intervenções nesse distúrbio. O presente trabalho objetiva avaliar as Habilidades Executivas e correlacioná-las ao movimento ocular em crianças e adolescentes com TID. MÉTODO: Foram avaliadas 10 crianças e jovens com TID, com idade média de 11,9 (DP=3,22), pareados por idade e sexo com 10 crianças e jovens com desenvolvimento típico. Avaliou-se a inteligência através do WISC III; as Habilidades Executivas através do Trail Making, Figura Complexa de Rey e Torre de Hanói. As habilidades de rastreamento ocular foram avaliadas através das Tarefas de Sacada Preditiva (SP), Anti-Sacada (AS), Acompanhamento e Rastreamento de Faces. RESULTADOS: Observa-se diferenças significativas de desempenho entre grupos no QI Geral, QI de Execução, no Trail Making parte B, na reprodução de Memória com 3 e 30 minutos da Figura Complexa de Rey e na execução da Torre de Hanói. Observam-se diferenças também nas provas de rastreamento ocular: nos acertos, erros e latência para a Tarefa SP; nos erros seguidos de acerto para a Tarefa AS; no número de sacadas intermediárias para a Tarefa de Acompanhamento e no número de fixações na região dos olhos entre faces com Olhos Presentes e Ocultados no Rastreamento de Faces. Foram também encontradas correlações significativas entre índices de QI, resultados de FE e medidas de movimentos oculares. DISCUSSÃO e CONCLUSÕES: Encontrou-se um perfil de alterações neuropsicológicas nos indivíduos pesquisados que se correlaciona aos padrões de movimento ocular. Esse padrão comum é delineado por uma falta de regulação da atenção voluntária, dificuldade em inibir um comportamento e direcioná-lo ao objetivo proposto na tarefa, alteração no planejamento de ação, dificuldade para iniciação de resposta, dificuldade na flexibilidade cognitiva; e habilidade de visuo-construção preservada. As alterações em habilidades executivas refletem nas relações sociais do indivíduo com o meio e com outras pessoas. A determinação desse perfil de dificuldades pode contribuir para o desenvolvimento de intervenções mais eficazes para essa população.

Made available in DSpace on 2016-03-15T19:40:26Z (GMT). No. of bitstreams: 1 Margareth Neves Montenegro.pdf: 2385940 bytes, checksum: 95807f736efbb6507397bac474f53096 (MD5) Previous issue date: 2007-09-06 / Fundo Mackenzie de Pesquisa / Initial Social Communication comprehends skills that appear in early infancy. Among which, Social Orienting (SO) and Joint Attention (JA) have proven to be good predictors of the development of sociability. The impairment of such functions has been strongly associated with the diagnosis of Pervasive Developmental Disorders (PDD). The present study has assessed the initial social communication skills (Social Orienting and Joint Attention) in children from 2 to 4 years old with typical development (n=19) and in children from 3 to 7 years old with Pervasive Developmental Disorder (n=17) paired by mental age. For the assessment the study has developed the PAISC - (Protocol of Assessment of Initial Social Communication). The results from the trials of the protocol have demonstrated that children with Pervasive Developmental Disorder have shown significantly worst performance in the Social Orienting and Joint Attention behaviors if compared to the children with typical development. Among the behaviors, the one that better distinguished children with Pervasive Developmental Disorder from the children with typical development was the Initial Joint Attention. The PAISC protocol allows detecting changes in the development of social communication in the first year of life, being an instrument for the early diagnosis and employment of intervention programs in the cases of Pervasive Developmental Disorders. / Comunicação Social Inicial compreende habilidades que surgem cedo no primeiro ano de vida. Entre essas habilidades, Orientação Social (OS) e Atenção Compartilhada (AC) têm se mostrado bons preditores do desenvolvimento da sociabilidade. Prejuízos nessas funções têm sido fortemente associados com o diagnóstico de Transtorno Invasivo do Desenvolvimento (TID). O presente estudo avaliou as habilidades da comunicação social inicial (OS e AC) em crianças com desenvolvimento típico de 2 a 4 anos (n=19) e em crianças com TID de 3 a 7 anos (n=17) pareadas pela idade mental. Para a avaliação o estudo desenvolveu o Protocolo de Avaliação da Comunicação Social Inicial PACSI. Os resultados obtidos nas provas do protocolo demonstraram que as crianças com TID apresentaram performance significativamente pior nos comportamentos de OS e AC, comparadas às crianças com desenvolvimento típico. Entre os comportamentos o que melhor discriminou crianças com TID das crianças com desenvolvimento típico foi o de Iniciação de Atenção Compartilhada. O protocolo PACSI permite detectar alterações no desenvolvimento da comunicação social no primeiro ano de vida, sendo um instrumento para o diagnóstico precoce e estabelecimento de programas de intervenção nos casos de Transtornos Invasivos do Desenvolvimento.

The aim of this study was to investigate the possibility to combine the Ericksonian method with sandplay therapy to support a child with aggression as developmental disturbances. The aforementioned was executed by examinig a case study in which a youth that showed agression was supported by the Ericksonian method to sandplay therapy. This study was motivated by many years of interaction by the researcher with children that showed emotional developmental disturbances and where these developmental disturbances delayed the attainment of their full potensial. / Dissertation (MEd (Educational Psychology))--University of Pretoria, 2007. / Educational Psychology / unrestricted

AFRIKAANS: Die doel van hierdie studie is om te verken of die Ericksoniaanse terapiebenadering met sandspelterapie gekombineer kan word om kinders en adolessente wat depressiewe gedrag toon, te ondersteun. Die studie is uitgevoer deur middel van gevallestudies waar kinders en adolessente wat depressiewe gedrag toon, ondersteun is deur middel van die Ericksoniaanse benadering tot sandspelterapie. Die motivering vir hierdie studie hou verband met jarelange interaksie met kinders wat emosionele ontwikkelingsteurnisse ervaar het wat beperkend was met betrekking tot die bereiking van hul volle potensiaal. Ek wou dus ondersoek instel na die moontlikheid om die Ericksoniaanse terapie-benadering met sandspelterapie te kombineer in die behandeling van kinders en adolessente wat depressiewe gedrag toon. My navorsing was daarop gerig om ‘n moontlike kennisbydrae te lewer tot die gebruik van die gekombineerde benadering met kinders en adolessente wat depressie as ontwikkelingsteurnis ervaar. ‘n Teoretiese raamwerk is gebruik wat uit verskillende teorieë bestaan het as 'n lens waardeur ek data geanaliseer en interpreteer het. Die ekologiese teorie, sisteemteorie en transteoretiese model is tydens die studie as teoretiese raamwerk bespreek. ‘n Intervensiestudie gekombineer met ‘n gevalstudie as navorsingsontwerp is tydens my studie gebruik. Ek het kwalitatiewe datainsamelingstegnieke in die onderhawige studie geïmplementeer ten einde die navorsingsprobleem en bevindinge deurtastend te ondersoek en te beskryf. Die data-analisestrategieë wat in die studie geïmlementeer was, berus op Creswell (2003) en Creswell (2005) se benaderings (Sien bl. 109). In antwoord op my primêre navorsingsvraag, het ek tot die gevolgtrekking gekom dat die Ericksoniaanse benadering in kombinasie met sandspelterapie wel van waarde mag wees vir sommige kinders en adolessente wat depressie as ontwikkelingsteurnis ervaar. / ENGLISH: The aim of this study was to investigate the possibility of combining the Ericksonian method with sandplay therapy to support children and adolescents with depression as developmental disorder. The aforementioned was executed by examining case studies in which children and adolescents that showed depression was supported by the Ericksonian method to sandplay therapy. This study was motivated by the researcher’s interaction with children that showed emotional developmental disorders and where these developmental disorders delayed the attainment of their potential. One of the reasons for my research was the potential contribution of knowledge towards the use of the combined method with children and adolescents whom experience depression as developmental disorder. The echological theory, systems theory and trans-theoretical model was used as theoretical framework for my study. I made use of an intervention study combined with a case study during the research. In order to investigate and describe the research problem and findings I implemented qualitative data-collection strategies. / Thesis (PhD)--University of Pretoria, 2011. / Educational Psychology / unrestricted