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Previous issue date: 2014-05-29 / The main goal of the present thesis was to explore the development and relationship between language and executive functions (EF), a topic of extreme relevance both for research and clinical practice. Given the scarcity of studies of the association between language and executive abilities in typically developing children, there is an absence of assessment instruments with norms for children of different ages and education levels. Verbal fluency (VF) tasks are some of the most commonly used tools in the neuropsychological assessment of linguistic and executive processing. As such, these tasks may be able to satisfy the research and clinical demands for a further understanding of these abilities in patients with Attention Deficit/Hyperactivity Disorder (ADHD), a highly prevalent condition in childhood. The relationship between EF and language in children with this disorder were examined through two empirical studies and a literature review. The first study assessed the impact of age and type of school in the performance of 6-to-12-year old children in unconstrained, phonemic and semantic VF tasks (abbreviated as UVF, PVF and SVF, respectively). A total of 378 participants (177 from private schools) with a mean age of 9.03 years (SD=1.91) completed the UVF task, while 403 children (186 from private schools) with a mean age of 9.12 years (SD=1.88) completed were administered the PVF task and 385 children (168 from private schools) with a mean age of 9.01 years (SD=1.86) completed the SVF task. The effect of age and type of school on children s VF performance was assessed using a Two-Way ANOVA, and group differences were investigated using Bonferroni post-hoc tests. Main effects of age and type of school were observed in UVF and PVF scores, while the interaction between these two variables had an effect on SVF. Overall, performance tended to improve with age, and was better in children who attended private schools than in those recruited from public institutions. The second study aimed to perform a review of studies addressing the clinical and/or neuropsychological assessment of linguistic and auditory processing (AP) in children with ADHD. The PubMed database was searched for articles published between 2000 and 2012 using the following keywords [language or linguistic] and [auditory processing or auditory perception] and [attention deficit or hyperactivity]. All abstracts returned were analyzed in parallel by two independent researchers, using a third reviewer for consensus. A total of 46.7% of the studies included in the reviewed focused on language assessment at word and sentence levels, while 33.33% investigated AP and 13.33% assessed both variables. Reading disorders were the most prevalent condition in the samples studied, and, interestingly, the assessments of language and AP were not conducted with the aim of achieving any specific neuropsychological goals. Lastly, the third study in this thesis assessed the impact of the intensity of symptoms of inattention and/or hyperactivity/impulsivity on language, AP, working memory (WM) and the EF of children with ADHD, as well as the relationships and interactions between these variables. Forty-four children with a diagnosis of ADHD took part in the study (33 from private schools, with a mean age of 9.07 years (SD = 1.71)). Correlation analysis was used to select variables for inclusion in a linear regression model. The following results were obtained from this investigation: (1) the intensity of inattention symptoms accounted for a significant portion of the variability reading and writing performance, especially phonological reading and spelling in a writing-to-dictation task; (2) the intensity of hyperactivity/impulsivity symptoms had a significant impact on children s EF (processing speed, cognitive flexibility and inhibitory control), corroborating other findings in the literature; (3) oral language and AP were associated with measures of EF and WM, suggesting that these components are interdependent, although the directionality of their relationship needs to be further explored. In conclusion, the present studies contributed to the understanding of relationships between language and EF in typical childhood development and in children with psychiatric disorders. These findings also have important implications for the neuropsychological assessment and rehabilitation of patients with ADHD. / A presente tese tem como eixo principal a avalia??o de fun??es cognitivas e suas interrela??es, como componentes lingu?sticos lexicais, sint?ticos e discursivos, de fun??es executivas (FE) e de percep??o auditiva, no desenvolvimento t?pico e at?pico (Transtorno de D?ficit de Aten??o e Hiperatividade TDAH). Na medida em que as investiga??es sobre a interface entre componentes lingu?sticos e executivos em crian?as em desenvolvimento t?pico ainda s?o escassas, levanta-se a necessidade de ferramentas adaptadas e normatizadas para esta popula??o, considerando as vari?veis sociodemogr?ficas, como idade e escolaridade. Nesse contexto, destaca-se o paradigma da flu?ncia verbal (FV), sendo uma das tarefas mais utilizadas na avalia??o neuropsicol?gica das FE que contempla a an?lise do processamento lingu?stico e executivo. Este tema vem ao encontro da demanda cl?nica e de pesquisa sobre o entendimento destes construtos em associa??o com o quadro cl?nico de TDAH, que ? frequente na popula??o infantil. Foram desenvolvidos dois estudos emp?ricos e um de revis?o sistem?tica da literatura. O primeiro estudo investigou, preliminarmente, o impacto da idade e do tipo de escola no desempenho de crian?as de 6 a 12 anos em tarefas de flu?ncia verbal livre (FVL), fon?mico-ortogr?fica (FVF) e sem?ntica (FVS). Para responder as quest?es de pesquisa participaram da avalia??o da FVL, 378 participantes (177 de escolas privadas) com m?dia de idade de 9,03 anos (dp=1,91); da FVF, foram 403 crian?as (186 de escolas privadas) com idade m?dia de 9,12 (dp=1,88); e da FVS, 385 participantes (168 de escolas privadas) com idade m?dia de 9,01 anos (dp=1,86). O efeito da idade, do tipo de escola e intera??o foi analisado pelo teste Two-Way ANOVA e as diferen?as entre os grupos foram verificadas por an?lise post-hoc Bonferroni. Observaram-se efeitos principais da idade e do tipo de escola na FVL e FVF e intera??o entre os fatores na FVS. De modo geral, o desempenho melhora de acordo com o aumento da idade e as crian?as de escolas privadas tendem a apresentar melhores escores. O segundo estudo objetivou identificar na literatura pesquisas que investigaram o processamento lingu?stico e auditivo (PA) na avalia??o cl?nica e/ou neuropsicol?gica de crian?as/adolescentes com TDAH. Realizou-se uma busca na base de dados PubMed de 2000 a 2012 com keywords dos construtos [language or linguistic] e [auditory processing or auditory perception] e [attention deficit or hyperactivity]. Os abstracts foram analisados por double blind review com terceiro juiz para consenso. Os resultados mostraram que 46,67% dos estudos avaliaram a linguagem (n?vel da palavra e senten?a), 33,33% processamento auditivo (PA) e 13,33%, ambos. O transtorno de leitura foi a comorbidade mais prevalente e o desempenho lingu?stico e de PA n?o foram analisados nos estudos para fins neuropsicol?gicos espec?ficos. Por fim, o terceiro estudo analisou o impacto da intensidade de sintomas de desaten??o e/ou hiperatividade/impulsividade de crian?as com TDAH em desfechos de linguagem, PA, mem?ria de trabalho (MT), componentes das FE, e as suas rela??es e influ?ncias m?tuas. Participaram do estudo 44 crian?as com diagn?stico de TDAH (33 de escolas privadas, com idade m?dia de 9,07 anos (dp=1,71)). As vari?veis que se correlacionaram significativamente participaram no modelo de an?lise de regress?o linear. Concluiu-se, com dados preliminares, que: (1) a intensidade de sintomas de desaten??o explicou aspectos relacionados ? leitura e escrita, mais especificamente o processamento ortogr?fico em tarefa de ditado e a leitura por via fonol?gica; (2) a intensidade dos sintomas de hiperatividade/impulsividade apresentou maior impacto em subcomponentes das FE (velocidade de processamento, flexibilidade cognitiva e controle inibit?rio) das crian?as investigadas, estando de acordo com outras pesquisas j? realizadas e (3) o processamento de linguagem oral e do PA relacionam-se com as medidas de FE e de MT, sugerindo a interdepend?ncia entre esses componentes, embora a direcionalidade destas influ?ncias necessitem ser mais exploradas. Em suma, os estudos desenvolvidos contribu?ram para a reflex?o sobre rela??o entre a linguagem e as FE no desenvolvimento t?pico infantil, bem como, para o entendimento de suas manifesta??es cl?nicas e implica??es para avalia??o e reabilita??o neuropsicol?gica de indiv?duos com TDAH.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/893 |
| Date | 29 May 2014 |
| Creators | Prando, Mirella Liberatore |
| Contributors | Fonseca, Rochele Paz |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Psicologia, PUCRS, BR, Faculdade de Psicologia |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 2588426296948062698, 500, 600, 2599381623216554467 |
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