The aim of this study was to examine the protruding school concept NPF-säkring at the public school Källbrinksskolan in Sweden. Pupils with neuropsychiatric disabilities are particularly at risk to not reach the goals of the education and to have high school absence, which can lead to social exclusion later in life. The school in this study are well-known through Swedish media and claim that they have a solution to the challenges the Swedish school system face today therefore they have formed their concept specifically to the pupils with neuropsychiatric disabilities. The aim of this study was to perform a case-study to examine what the concept implies, it’s main logics and how it affects the institution. Using triangulation while studying various documents connected to the school concept, as well as one observation at the school after school hours, five main logics of the school concept became distinguishable. The analysis were divided into two parts where the first part focus on the main logics of the concept analyzed through Universal design of learning as a theoretical perspective and the second part consists of the theory of the Institutions three pillars to understand the institutional function and its relation to its context of the society. As a conclusion it came apparent that the main logics consists of physical environment, flexible structure, relational approach, encouragement for students' self-determination and overall approach at the school. The institutional function of the concept is distinctly connected to the increased awareness regarding the consequences of neuropsychiatric disabilities throughout society and by developing a new school concept, the institution there-by question the traditional Swedish school-system.

Undersökningar visar att elever med funktionsnedsättning uppger att de trivs sämre i skolan, de upplever ofta högre krav och mer stress från skolarbetet än övriga elever. Arbetsterapi inom skolmiljö riktar sig mot att möjliggöra en stödjande miljö för individen. Syftet med studien var att undersöka och beskriva arbetsterapeuters erfarenheter av arbete i skolan för elever med ADHD och/eller autism. Metoden som författarna använde sig utav var en kvalitativ intervjustudie där deltagarna rekryterades med avsiktligt urval och snöbollsurval. Undersökningen bestod av intervjuer med åtta arbetsterapeuter som arbetar inom skola och habilitering i Sverige. Materialet analyserades enligt kvalitativ innehållsanalys och bygger på arbetsterapeuternas berättelser. Resultatet presenteras i tre kategorier: Utmaningar i skolmiljön, Interventioner samt Skolan som ny arena. Arbetsterapeuterna beskrev utmaningar som målgruppen upplevde i skolmiljö, vilka interventioner som användes samt deras uppfattningar av arbetsterapi i skolan. Slutsatsen är att det finns brist på kunskap om ADHD och autism i omgivningen i skolan. Det finns behov av arbetsterapi i skolan för elever med ADHD och/eller autism. En arbetsterapeut kan med sitt helhetsperspektiv arbeta för att främja aktivitet och delaktighet i skolan. / Studies shows that pupils with disabilities state that they experience a low level of wellbeing in school. Pupils with disabilities often experience higher demands and more stress from school tasks than other pupils. Occupational therapy within school environment is targeted at enabling a supportive environment for the individual. The purpose with this study was to investigate and describe occupational therapist´s experiences of work in school for pupils with ADHD and/or autism. The method that was used by the authors was a qualitative interview study. Participants were recruited by using purposive and snowball sampling. The study consisted of 8 occupational therapists who were working in school and habilitation in Sweden. The material was analyzed by using qualitative content analysis. The results are based on the occupational therapist´s point of view and are presented in three main categories, Challenges in the school environment, Interventions and School as a new arena. The occupational therapists describes challenges in school environment for the pupils, which interventions they were using in their work and their perceptions about occupational therapy in school. The conclusion is that there is a lack of knowledge about ADHD and autism in the surroundings at school. There is a need for occupational therapy in schools for pupils with ADHD and/or autism. An occupational therapist can work with their holistic perspective to promote activity and participation in the school.

La stimulation cérébrale profonde (SCP) est un outil thérapeutique pour le traitement chronique des symptômes de nombreuses maladies, notamment les troubles moteurs et les maladies psychiatriques réfractaires. Cependant, ses mécanismes d’action sont encore peu connus, notamment en ce qui concerne les effets à large échelle sur les réseaux fonctionnels cérébraux. Dans ce travail de thèse, nous avons développé l’imagerie par électroencéphalographie des réseaux corticaux modulés par la SCP au travers de trois études sur des pathologies différentes :• une étude sur les réseaux de l’inhibition motrice chez 12 patients ayant des troubles obsessionnels compulsifs, traités par stimulation de la partie associativo-limbique du noyau subthalamique (NST),• une étude sur les réseaux du contrôle des interférences émotionnelles chez 5 patients dépressifs sévères, traités par stimulation du cortex cingulaire subgénual,• une étude sur le contrôle des interférences émotionnelles chez 16 patients parkinsoniens, traités par stimulation de la partie motrice du NST et comparés à 16 sujets sains.Nous avons mis en place une méthodologie EEG commune reposant sur la correction des artefacts de stimulation, le calcul des potentiels évoqués cognitifs en condition de stimulation ON et OFF, la localisation de sources et la modélisation causale dynamique permettant d’étudier la connectivité des réseaux corticaux-sous-corticaux. La première étude nous a montré que la SCP du NST diminue les sorties efférentes des ganglions de la base vers le cortex frontal inférieur droit qui est une zone centrale de l’inhibition, concomitante d’une altération des performances à l’inhibition. La deuxième étude a déterminé que l’un des corrélats neuronaux de l’amélioration clinique par la SCP de la dépression serait une diminution de l’influence limbique sur le système visuel ventral (hyper-actifs chez ces patients). Cet effet était accompagné d’une augmentation par la SCP des marqueurs cardiaques de l’activité vagale (sous active chez ces patients à risques). Enfin, la troisième étude a mis en évidence un effet différent et opposé des traitements dopaminergiques et de la SCP du NST sur le contrôle de l’interférence émotionnelle chez les patients parkinsoniens. Ces trois études ont donc montré que l’utilisation de la reconstruction de sources et de la MDC en EEG permet de mettre en évidence les effets de la SCP sur le cerveau et de mieux comprendre comment ce traitement modifie les réseaux neuronaux fonctionnels. / Deep Brain Stimulation (DBS) is a chronic clinical tool used to treat symptoms from several diseases, as motor disorders and refractory psychiatric diseases. However, its mechanism are still not well known, especially its large scale effects on brain functional networks. In this PhD, we have developed electroencephalographic imaging of cortical networks modulated by DBS through three studies on different diseases:• the first study on motor inhibition networks in 12 patients with obsessive compulsive disorders, treated with DBS of the associativo-limbic region of the subthalamic nucleus (STN),• the second study on emotional interferences control in 5 severe depressive patients, treated by DBS of the subgenual cingulate cortex,• the last study on emotional interferences control in 16 parkinson’s patients, treated by DBS of the motor region of the STN and compared with 16 healthy subjects.We have used the same EEG methods based on artefact (from stimulation) correction, computation of the cognitive evoked potentials in ON and OFF DBS conditions, source localization and dynamic causal modeling to study cortical-subcortical networks. The first study has shown that STN DBS decreases efferent outputs from the basal ganglia to the right inferior frontal cortex which is a key node of inhibition, simultaneously with an alteration of inhibition performance. The second study has shown that one of the correlates of clinical improvement with DBS in depression would be a decrease of the limbic influence on the ventral visual system (hyperactive in those patients). This effect was concomitant with an increase of vagal activity cardiac indexes with DBS (hypoactive in those patients at risk). Finally, the last study has shown that dopaminergic treatment and STN DBS have different and opposed effects on the emotional interference control in parkinsonian patients. Therefore, these three studies have shown that EEG source reconstruction and DCM are efficient to study DBS effect on the brain and open a way to better understand how DBS modulates neural functional networks.

Les troubles du comportement sont fréquents chez les sujets âgés avec ou sans troubles cognitifs. En Afrique subsaharienne, très peu de données sont disponibles en population générale sur les troubles du comportement chez le sujet âgé et aucune n’a encore été réalisée en Afrique Centrale. L’objectif général de ce travail était de contribuer à une meilleure connaissance des troubles du comportement chez les sujets âgés en Afrique Centrale en République Centrafricaine et au Congo. Nos objectifs spécifiques étaient de : 1) décrire les troubles du comportement, leur gravité, leur retentissement, leurs facteurs associés et les symptômes associés aux démences ; 2) évaluer l’association entre les troubles du comportement et l’Apolipoprotéine E ε4 ; 3) évaluer l’association entre les troubles du comportement, la mortalité et le déclin cognitif. A partir des données des programmes EPIDEMCA et EPIDEMCA-FU, nous avons pu déterminer que la prévalence des troubles du comportement était de 63,7% (IC95% : 59,5-67,8). Le score médian global de gravité était de 9 [IQR : 6-12] et le score médian global de retentissement était de 7 [IQR : 4-10]. Vivre à Gamboma (zone rurale du Congo), l’audition normale et les liens amicaux étaient protecteurs des troubles du comportement. Le sexe féminin, la démence, la personnalité dépendante et le handicap physique ont été identifiés comme étant associés à la présence des troubles du comportement. Les idées délirantes, la dépression, l’apathie, la désinhibition et le comportement moteur aberrant étaient associés à la présence de démences dans notre étude. Dans nos travaux, les troubles du comportement n’étaient pas associés à l’Apolipoprotéine E ε4. Ces symptômes étaient associés à la mortalité des sujets âgés à deux ans mais pas au déclin cognitif. Ces résultats permettent une amélioration de la connaissance des troubles du comportement en Afrique Centrale et de nombreuses perspectives liées à leur prise en charge s’en dégagent. / Neuropsychiatric symptoms are common among older adults with or without cognitive disorders. In sub-Saharan Africa, few population-based studies are focused on these symptoms and to our knowledge no study was conducted in Central Africa. Our main objectivewas to improve the knowledge of neuropsychiatric symptoms in Central Africa (Central African Republic: CAR and Republic of Congo: ROC). Specifically we aimed at describing the neuropsychiatric symptoms, their severity, their distress and associated factors; 2) evaluating the association between neuropsychiatric symptoms and Apolipoprotein E ε4; 3) evaluating the association between neuropsychiatric symptoms, mortality and cognitive decline among older adults We performed the studies, using data from the EPIDEMCA and EPIDEMCA-FU programmes. The prevalence of neuropsychiatric symptoms was 63.7% (95%CI: 59.5-67.8).The overall median score of severity was 9 [IQR: 6-12] and the overall median score of distress was 7 [IQR: 4-10]. Living in Gamboma (rural ROC), normal hearing and having friends in the community were protective while female sex, dementia, dependent personality, and physical disability were risk factors for neuropsychiatric symptoms. Delusions, depression, apathy, disinhibition and aberrant motor behavior were specifically associated with dementia. We are not able to confirm the relationship between neuropsychiatric symptoms and Apolipoprotein E ε4. Neuropsychiatric symptoms were associated with mortality after two years of follow-up but not associated with cognitive decline. This thesis allowed us to improve the knowledge of behavioral disorders in Central Africa. Due to their burden among caregivers, a better management of these symptoms must be performed.

<p>The aim in the study is to search for a deeper understanding of how parents experience a neurological diagnose of the child and how this affects the parenthood. Parenthood was seen in a systemtheoretical perspective as a social construction. The narrative method was used in two lifestory parentinterviews. The analysis was made from parenthood. The result formed stories about parenthood with children having neuropsyciatric functional disability who even came to be a woman’s struggle. Two stories became central, one about righteousness and commonship and one against diagnosis and network. The struggle for support and understanding from the surrounding network was central. There was also a fight between the network and the parent of the authority to decide the child’s normality. The parent and child early experience a segregation in society based on diagnose. Parents experienced insecurity and difficulties regarding dose and sideeffects in medication the child. The networks reception was central for the acceptance of diagnosis and for keeping the parentcompetence. The public debate of inherent or environment created doubt and insecurity. In the stories there was a tendency that the struggle went beside the child and parenthood and instead became a struggle for righteousness against society.</p>

<p>The purpose with this study is to describe what individual pupils with neuropsychiatric disorders, such as Asperger syndrome and ADHD (Attention Deficit/Hyperactivity Disorder), think of their time in the nine-year compulsory school. The intention is to, from a social and spatial point of view elucidate their experiences, on the basis of their specific needs and the commission and the curriculum of the compulsory school.</p><p>This study have a qualitative approach where I on two occasions have talked to three upper secondary school pupils with neuropsychiatric disorders about their time in the compulsory school. The work method for this study is life stories, a kind of interview that allows the pupils to speak more freely, and where the definitive question formulation appears gradually.</p><p>The result shows that the pupils in many ways experience that they have been misunderstood by both teachers and other pupils, first and foremost regarding teachers not having enough knowledge about how people with Asperger syndrome think and acts. In addition, all three have experiences of being bullied. At the same time the result shows that special adjustments to the pupils’ specific needs works and is a good thing, if they are based upon knowledge and understanding.</p><p>The conclusion is that genuine knowledge about neuropsychiatric disorders and the will to understand among the teachers is very important, and that adjustments of resources, demands and conditions is a good thing, and many times necessary. Many teachers do not have the adequate knowledge and the support to the students is inadequate. A proper, comprehensive and correct diagnosis is important to create knowledge of the specific individual needs.</p> / <p>Syftet med studien är att beskriva hur enskilda elever med neuropsykiatriska funktionsnedsättningar, i första hand Aspergers syndrom och ADHD (Attention Deficit/Hyperactivity Disorder), har upplevt sin tid i det obligatoriska skolväsendet. Avsikten är att ur ett socialt och ett rumsligt perspektiv belysa hur de upplevt sin skoltid, utifrån de specifika behoven och skolans uppdrag enligt Lpo94.</p><p>Studien har en kvalitativ ansats där jag vid två tillfällen samtalat med tre ungdomar i gymnasieåldern med diagnostiserade neuropsykiatriska funktionsnedsättningar om deras grundskoletid. Den metod som använts för genomförandet av studien är livsberättelse, en form av intervju som tillåter den intervjuade att berätta mer fritt, och där de definitiva frågeställningarna infinner sig efter hand.</p><p>Resultatet visar att eleverna på många sätt upplever att de blivit missförstådda av både lärare och andra elever, framför allt handlar det om att lärare inte haft tillräcklig kunskap om hur elever med Aspergers syndrom tänker och fungerar. Alla tre upplever dessutom att de varit utsatta för mobbing. Samtidigt visar resultatet att särskilda lösningar och anpassningar efter elevens specifika behov är bra och fungerar, om de bygger på kunskap och förståelse.</p><p>Slutsatser blir att gedigen kunskap om neuropsykiatriska funktionsnedsättningar och vilja till förståelse hos personalen är mycket viktigt, och att anpassningar av resurser, krav och villkor är bra och ofta nödvändigt. Många lärare saknar tillräcklig kunskap och stödet till eleverna är bristfälligt. En ordentlig, fullständig och korrekt diagnostisering är viktigt för att skapa kunskap om de specifika individuella behoven.</p>

The aim in the study is to search for a deeper understanding of how parents experience a neurological diagnose of the child and how this affects the parenthood. Parenthood was seen in a systemtheoretical perspective as a social construction. The narrative method was used in two lifestory parentinterviews. The analysis was made from parenthood. The result formed stories about parenthood with children having neuropsyciatric functional disability who even came to be a woman’s struggle. Two stories became central, one about righteousness and commonship and one against diagnosis and network. The struggle for support and understanding from the surrounding network was central. There was also a fight between the network and the parent of the authority to decide the child’s normality. The parent and child early experience a segregation in society based on diagnose. Parents experienced insecurity and difficulties regarding dose and sideeffects in medication the child. The networks reception was central for the acceptance of diagnosis and for keeping the parentcompetence. The public debate of inherent or environment created doubt and insecurity. In the stories there was a tendency that the struggle went beside the child and parenthood and instead became a struggle for righteousness against society.

Ämnet neuropsykiatriska funktionsnedsättningar valdes eftersom det är aktuellt inom skolans värld. Tidigare forskning har visat att lärares kompetens inom området ofta brister och att den svenska skolan inte alltid lyckas i att vara en skola för alla. Syftet med arbetet var att undersöka nio lärares erfarenhet gällande inkludering av elever med neuropsykiatriska diagnoser. Frågeställningarna var: Vilken kompetens har lärarna för att kunna inkludera diagnosticerade elever i sin undervisning och på vilka sätt har de erhållit den? Vilka möjligheter och hinder upplever lärarna att det finns i arbetet med inkludering av diagnosticerade elever? På vilka sätt anpassar lärarna sin undervisning för att elever med neuropsykiatrisk diagnos ska uppnå kursmålen? Kvalitativa intervjuer av nio informanter har utgjort metoden. Huvudresultatet har visat att lärare ansett sig sakna kunskap om NPF när de börjat jobba, de har erhållit kompetensen de besitter idag genom arbetet med elever som har en neuropsykiatrisk diagnos. En möjlighet lärarna upplever med att dessa elever inkluderas är att skolan blir en representant för hur samhället ser ut. Hinder kan vara ramfaktorer, främst tidsbrist. Anpassning av undervisning kan ske genom strukturerade lektioner med korta instruktioner, förlängd provtid och anpassade uppgifter. Undervisningen för elever med neuropsykiatriska funktionsnedsättningar skulle kunna förbättras genom att lärare får en större kunskap inom området och att de ges fler resurser, främst i form av tid och mindre klasser. / The topic of neuropsychiatric diagnoses was chosen because it is very current within the school today. Former research has shown that the competence of teachers very often tends to fail and the Swedish school does not succeed in being a school for everybody. The purpose of this thesis was to investigate nine teachers’ experience of inclusion of students with neuropsychiatric diagnoses. The problems were: What capability do the teachers have to include students with a diagnosis in their education and in what ways have they received it? What possibilities and what obstacles do the teachers believe there are with inclusion of students with diagnoses? In which ways do the teachers adjust their education in order to make the students with neuropsychiatric diagnoses achieve the goals of the curriculum? Qualitative interviews with nine informants have constituted the method. The main result has shown that the teachers have found themselves without knowledge within the neuropsychiatric area when they began their career, they have received the competence they possess today by working with students with neuropsychiatric diagnoses. Pros with inclusion of these students is that the school should be a representative of society as it really is, obstacles with inclusion may be lack of time and too large classes. Adjustment of the education might be done by structured classes with short instructions, extended time when writing tests and adjusted tasks. The conclusion is that teachers don’t get any education within this topic; instead they have to learn by themselves by trial and error. The education for students with neuropsychiatric diagnoses could improve by educating teachers and giving them better resources like time and smaller classes.

No description available.

The purpose of our study was to identify and present experiences encountered by parents with a child with diagnosis. Those narratives are made open for the public. Data has been collected through ten interviews with parents having children with a diagnosis. These interviews have also been complemented by interviews with one child and one youth. The parents and the children who have been interviewed, all have their own stories and experiences of how it is to live with a diagnosis in the family and for all families there are different diagnosis. Some of the families have had the diagnosis confirmed, and some are living with overlapping diagnosis, everything dependent on the symptoms picture of the child. A qualitative research method has been used using semi structured interviews. The interviews have been analysed using a narrative method, which in our case resulted in nine different stories. The narrative way of doing analysis in this study has been chosen, as the purpose of the study has been to make the different narratives public. The narratives are tied to the following theories: normality, stigmatization, categorization and economic motives. This study concludes, based on the family interviews, that there is no strong correlation to support any firm conclusion due to different experienced in all cases. However, one result which is evident in all cases is that the families are continuously struggling to get help in school, to get special support from society.