Please read the abstract in the section 00front of this document / Dissertation (MEd (Orthodidactics))--University of Pretoria, 2007. / Orthopaedic Surgery / unrestricted

Made available in DSpace on 2017-06-01T18:08:53Z (GMT). No. of bitstreams: 1 luiz_felipe_oliveira_andrade.pdf: 731813 bytes, checksum: f7b31cf46bfa3c538fd7c698bdc7c4e1 (MD5) Previous issue date: 2014-05-30 / It is evident nowadays the over-diagnosis of hyperactivity. Our survey in CAPSi (Center of Psychosocial Care of Children and Adolescents ) found the using of "imperative " or "imperative child " to name these children . The hyperactive functioning can be elucidated by psychoanalysis reading which highlights the various levels at which the imperative reaches the subject. This can be done by the adherence to the sub - line search: Limits, boundaries and addressments between mother and child of Nanette Zmeri Frej. As the Freudian Aufhebung movement presented by Frej (2003), the first boundary will structure the self as distinct from the object and the functions of Attention and Motricity (axes in the diagnosis of hyperactivity disorder). Another limit to this movement can be situated on the Oedipus Complex that interdicts the incest and regulates human relationships. This limit will also have influence on Attenction, Mobility and above all on the conduct, which could be transgressive. (Another diagnosis axe). These considerations have approached us the way professionals understand the CAPSi, a hyperactive child and its treatment. This approach was also possible through semi-structured interviews to professionals who work with children diagnosed asking these professionals about their concept about the problem and how they treat them.We found that hyperactivity of children deal with the problems of the first boundaries that distinguish the self from the external world and self-other as seen in the absence of addressment, since " they don t stop " and many of the hyperactivity and conduct disorders represent conflicts of children and adolescents with Oedipal Law, exemplified in the statements reported by professionals: " Teach me to be quiet ! " "to be obedient! " We identify in one hand the disciplinary interventions, expressed in "setting limits" to the children and on the other hand the CAPSi´s staff attempting to account for the constitutive limits of children, making a subject hypothesis to them and also considering their addressments to their Other. Finally, we note how important is the CAPSi not be guided through imperatives of productivity up to the point of forgetting the limits of their interventions and the need of interdisciplinary and territory networking performance otherwise the CAPSi could become hyperactive itself. / Partimos da evidência no discurso contemporâneo do excesso de diagnóstico de hiperatividade. Nossa pesquisa realizada em CAPSi (Centro de Atenção Psicossocial Infanto-Juvenil) constatou a utilização do termo Imperativo ou criança imperativa para nomear essas crianças. O funcionamento hiperativo pode se beneficiar da leitura da psicanálise, que destaca os diversos níveis em que o imperativo atinge o sujeito. Isto foi possível a partir de nossa adesão a sublinha de pesquisa Limites, fronteiras e endereçamentos entre mãe e criança de Nanette Zmeri Frej. Conforme o movimento da Aufhebung freudiana apresentado por Frej (2003), as primeiras fronteiras vão estruturar o eu como algo distinto do objeto e as funções da Atenção e da Motricidade (eixos no diagnóstico do transtorno da hiperatividade). Outro limite ao movimento pode ser situado no Complexo de Édipo que interdita o incesto e regula as relações humanas. Este limite também terá influência na Atenção, na Motricidade e, sobretudo na conduta, que pode ser transgressiva. (Forma outro eixo diagnóstico). Essas considerações contribuíram para nos aproximar do modo como os profissionais do CAPSi entendem uma criança hiperativa e seu tratamento. A aproximação se deu também através de entrevistas semi-estruturadas às profissionais que trabalham com as crianças que têm o diagnóstico pesquisado sobre a concepção que têm dessas crianças e o tratamento realizados com elas. Constatamos que a hiperatividade das crianças está relacionada aos problemas das primeiras fronteiras que distinguem o eu do mundo externo. Eu-outro como se vê em sua ausência de endereçamento, já que não param e que muito da hiperatividade e dos transtornos de conduta representam conflitos da criança e do adolescente com a Lei Edípica, exemplificados nas falas reportadas pelas profissionais: Me ensine a ficar quieto! A obedecer! Isso nos permite identificar que, ao lado das intervenções disciplinares, expressas no dar limites às crianças, as profissionais tentam dar conta dos limites constitutivos em suas intervenções, fazem hipóteses nas crianças de sujeito e consideram também os endereçamentos nas relações delas a seus Outros. Ao final, constatamos a importância do próprio CAPSi não ceder aos imperativos de produtividade e de esquecer dos limites de suas intervenções que precisa considerar a interdisciplinaridade e a atuação em Rede a fim de que ele próprio não fique hiperativo.

MPM / Oliver Tambo Institute of Governance and Policy Studies

PhD (Psychology) / Department of Psychology. / Attention Deficit Hyperactivity Disorder (ADHD) is the most common diagnosed neurocognitive behavioural developmental disorder among school going–age children. ADHD in most instances is found to comorbid with internalising disorders such as anxiety and depression, therefore causing impairment on behaviour, emotions, academic, social and many areas of functioning. The existence of comorbid internalising disorders complicates the presentation of ADHD symptoms than if it was pure ADHD. The aim of the study was to explore the comorbidity of internalising disorders and ADHD symptoms. The study investigated whether children with ADHD have more symptoms of anxiety and depression than children without ADHD. The study went further to investigate whether children with ADHD have low self-esteem than children without ADHD. Also, that internalising comorbidities (anxiety and depression) are more prevalent in girls than in boys who have more externalising comorbidities which are Oppositional Defiant Disorder (ODD) and Conduct Disorder (CD) and anger issues. The null hypotheses further showed that, children with ADHD do not have more symptoms of anxiety and depression than children without ADHD. Moreover, children with ADHD have no lower self-esteem than children without ADHD. Also, internalising disorders (anxiety and depression) are not prevalent in girls than in boys who do not exhibit more externalising disorders which are Oppositional Defiant Disorder (ODD), Conduct Disorder (CD) and anger issues. The study was conducted in Lepelle-Nkumpi Municipality in Lebowakgomo sub circuit. A total of 250 children (94 boys and 156 girls, aged 6 – 12) who were purposively selected participated in the study. A total of 125 clinically diagnosed ADHD were matched to 125 control group for age and gender. Participants were assessed on a battery consisting of Parent/Teacher Disruptive Behavioural Rating Scale (DBD), which was used to assess the presence and degree of ADHD- related symptoms (inattention and hyperactive/ impulsive); Oppositional Defiant Disorder and Conduct Disorder and Beck Youth Inventory Second Edition (BYI II), which was used to assess emotional and psychological issues that children experience. ADHD scores obtained on the DBD scale were correlated with scores obtained on BYI II scale. The study only focused on learners from primary schools in Lepelle-Nkumpi in Lebowakgomo sub circuit. In this research study, children who were reported to have a history of neurological problems such as head injurie, epilepsy, cerebral palsy or severe psychiatric disorders were excluded from the study. The results were analysed using the analysis of variance (ANOVA) and post hoc benferoni analysis to determine the significant difference within ADHD subtypes. Results of the study showed that children with ADHD had comorbid internalising disorders (anxiety and depression) when compared to their neurotypical group. Both boys and girls with a clinical diagnosis of ADHD showed symptoms of anxiety and depression. More symptoms of anxiety and depression were observed within the ADHD-HI, ADHD-PI and ADHD-C subtypes. Comorbid internalising disorders (anxiety and depression) were also associated with impairments with ADHD symptom, in particular inattention. Children with ADHD also showed more symptoms of low self-esteem when compared to their neurotypical group. Both boys and girls showed significant difference level of low self-esteem in all ADHD subtypes (ADHD-HI, ADHD-PI and ADHD-PI). The results further revealed that both boys and girls equally showed symptoms of comorbid internalising disorders (anxiety and depression), whereas girls showed significantly more symptoms of externalising comorbidities such as ODD, CD and anger issues. In conclusion, the findings suggest that the comorbidity of internalising disorders in a clinically diagnosed child with ADHD worsens or complicates the child’s expected normal functioning unlike when the child was presenting with only ADHD. The results further suggest that a child with clinical diagnosis has double impairment as a result of many impairments which are occurring at the same time. Moreover, the existence of externalising comorbidities which are salient in girls with ADHD may require proper screening and assessment. / NRF

There is a tendency for children who display unacceptable behaviour to be described as having Attention Deficit-Hyperactivity Disorder when the actual reason for the child’s diagnosis may simply be affective factors, another disorder or simply misbehaviour. ADHD is the most commonly diagnosed child disorder affecting 3-5% of all school age children. The aim was to investigate the prevalence of Attention Deficit-Hyperactivity Disorder in a sample of Foundation Phase children at an Inclusive ex Model C Preparatory School in the South Metro, Western Cape, by uncovering the criteria that are used by their teachers to suggest a possible Attention Deficit-Hyperactivity Disorder in a child for a referral to a parent, therapist or professional. This study used a phenomenology design making use of interpretations, meanings and an individual’s opinions regarding the teacher’s criteria, which relate to the diagnosis of ADHD. It required a qualitative analysis with the emphasis on observation, interviews and document analysis. A verbal Interview consisting of questions which were taped and transcribed, as well as an observation, and completion of a Connors Form of the selected children was completed by the teachers. Ten class teachers were interviewed and seven children from Grades one, two and three were observed. A model from Creswell was used, in order to identify the units of meaning relating to the prevalence of ADHD amongst learners in the South Metro District. The findings include lack of understanding of ADHD amongst teachers, subjectivity in the diagnosis of learners with ADHD, factors influencing the diagnosis of ADHD, criteria necessary to identify ADHD and stereotyping differences. / Inclusive Education / M. Ed. (Inclusive Education)

Much has been said and written over recent years about Attention-Deficit/Hyperactivity Disorder. There is a certain amount of confusion as to what exactly the condition constitutes and controversy continues to rage regarding treatment. A significant number of children appear to be affected. Previously, parents and teachers ·were blamed for failing to discipline effectively. Often, the difficulties remained undiagnosed and untreated. Thanks to the wisdom of so many experts who have generously shared their knowledge and considerable expertise, there is an increased awareness of ADHD. Although there is no cure, there are ways to manage the difficulties. However, early diagnosis and intervention is critical. Since many different symptoms are associated with the disorder, a multi-modal treatment plan has been found to lead to a better outcome. For the purpose of this study, a multi-modal programme was planned to address the needs of a small group of children with ADHD and their parents. The intention was to empower the parents, within a supportive group environment, by providing them with knowledge about the disorder and guidelines for managing the difficult behaviour. In addition, an attempt was made to change the negative behaviour patterns of the children through the medium of story-telling. It was hoped that by reducing the levels of parental stress, parents would be more competent to cope with their educational demands, so that their children could be guided more positively towards adulthood. The results of the programme were positive. Teachers and parents reported better behaviour by the children. The parents' stress levels were reduced. The parents expressed greater understanding about the disorder and a hopefulness that they could better manage their children. They felt they had benefitted from the advice given by other parents who were facing similar challenges. However, they felt that a short-term programme was insufficient to address all their needs and they expressed a need for ongoing support. In view of the chronicity of the disorder and the constantly changing needs of the child on his journey towards adulthood, cognisance was taken of the fact that longterm intervention is essential. / Psychology of Education / D.Ed. (Psychology of Education)

Much has been said and written over recent years about Attention-Deficit/Hyperactivity Disorder. There is a certain amount of confusion as to what exactly the condition constitutes and controversy continues to rage regarding treatment. A significant number of children appear to be affected. Previously, parents and teachers ·were blamed for failing to discipline effectively. Often, the difficulties remained undiagnosed and untreated. Thanks to the wisdom of so many experts who have generously shared their knowledge and considerable expertise, there is an increased awareness of ADHD. Although there is no cure, there are ways to manage the difficulties. However, early diagnosis and intervention is critical. Since many different symptoms are associated with the disorder, a multi-modal treatment plan has been found to lead to a better outcome. For the purpose of this study, a multi-modal programme was planned to address the needs of a small group of children with ADHD and their parents. The intention was to empower the parents, within a supportive group environment, by providing them with knowledge about the disorder and guidelines for managing the difficult behaviour. In addition, an attempt was made to change the negative behaviour patterns of the children through the medium of story-telling. It was hoped that by reducing the levels of parental stress, parents would be more competent to cope with their educational demands, so that their children could be guided more positively towards adulthood. The results of the programme were positive. Teachers and parents reported better behaviour by the children. The parents' stress levels were reduced. The parents expressed greater understanding about the disorder and a hopefulness that they could better manage their children. They felt they had benefitted from the advice given by other parents who were facing similar challenges. However, they felt that a short-term programme was insufficient to address all their needs and they expressed a need for ongoing support. In view of the chronicity of the disorder and the constantly changing needs of the child on his journey towards adulthood, cognisance was taken of the fact that longterm intervention is essential. / Psychology of Education / D.Ed. (Psychology of Education)