A criança e o adolescente com problemas do desenvolvimento no ambulatório de pediatria

OBJETIVO: revisar a literatura e os princípios básicos sobre o atendimento ambulatorial da criança e do adolescente com alterações no desenvolvimento, salientando os aspectos da prevenção, detecção e intervenção precoce, inclusão e reabilitação. FONTE DE DADOS: pesquisa nas bases de dados Medline, Lilacs, nas publicações de comitês científicos, de instituições para portadores de necessidades especiais e protocolos sobre assistência ambulatorial em centros de referência para crianças e adolescentes portadores de deficiências. SÍNTESE DOS DADOS: esta população-alvo apresenta, além dos problemas de saúde típicos de sua faixa etária, os relacionados à sua patologia de base, ou às conseqüências dessas. Este artigo traz ao pediatra as principais causas de distúrbios de desenvolvimento e as características de cada forma de deficiência, ressaltando os cuidados necessários na sua abordagem nos ambulatórios de pediatria. CONCLUSÕES: o censo brasileiro de 2000 aponta que 14,5% da população brasileira apresenta algum tipo de deficiência, posicionando os problemas de desenvolvimento como um dos mais prevalentes agravos da infância e da adolescência. Assim sendo, todo pediatra há que estar atento ao desenvolvimento das crianças e adolescentes e aos fatores que possam influir sobre ele. Do pediatra depende a prevenção, o diagnóstico precoce e o tratamento em tempo hábil, sendo insubstituível na coordenação da assistência multidisciplinar, bem como na inclusão desta clientela na assistência básica à saúde, fundamentais na definição do prognóstico e da qualidade de vida dos portadores de deficiências.

Radiographic study of dental anomalies in brazilian patients with neuropsychomotor disorders

The purposes of this study were to investigate radiographically the dental and maxillomandibular in patients with neuropsychomotor disorders and determine the role of panoramic radiographs for quantitative and qualitative analyses of dental alterations. A total of 322 panoramic radiographs from 190 males and 132 females aged 4 to 57 years were obtained from the files of the Center for Care to Patients with Special Needs (CAPE; Dental School, University of São Paulo) and subdivided into syndromes, special needs, neurological, neuromuscular or cerebral disorders, and sequels of diseases. 32% of dental alterations were in tooth position, with 69% of this group associated with tooth rotation. The mandible accounted for 54.62% of alterations. The male gender (55.85%) and the permanent dentition (78.7%) were most affected. Panoramic radiographs were proved to be well suited for quantitative evaluation of dental anomalies of epidemiological nature. Panoramic radiographs are important diagnostic resources when applied to patients with special needs because of the difficulty to place intraoral films and held them correctly positioned during the radiographic technique.

Aprendizados com a diferença em uma experiência de paternidade: do testemunho ao cuidado

This essay tells a singular experience of paternity, a parent's relationship to his daughter and learning of a child with special needs. This narrated experience has as an objective of the author's own narration of the transformations of this test, the theoretical features that marked his intellectual trajectory and limits them to express it. From this perspective, this essay seeks to give voice to this unique experience of caring with the goal of establishing a counterpoint with the discourse of inclusion and the specialized knowledge, with a view to a discursive event that produces a philosophical thinking and an apprenticeship with the difference that can promote the self-transformation of individuals who act in this field in their educational action.

Acessibilidade em Ambientes Informacionais Digitais

The current nature of World Wide Web (Web), which highlights the collaborative participation of users in some digital information environments, lead to development of guidelines with a focus on Inclusive Digital Information Architecture for a different audiences in multiples informational ambiences. This research proposes guidelines for a inclusive digital information environment, aiming to identify the elements of accessibility that allow the promotion of inclusion digital information, in order to highlight the references of the Architecture of Digital Information, the international recommendations and the structures representation of information (specially accessibility attributes), with the look of Information Science and New Technologies of Information and Communication. The thesis is as to the need to develop methodologies with guidelines that contemplate the elements of digital accessibility focused on the task of the user. The research problem is that actual methodologies and recommendations used for the development of digital information environments do not cover all the elements of accessibility with a focus on user needs. The proposition is to present, through a methodological approach (exploratory and descriptive), a theoretical-methodological proposal to promote elements of digital accessibility to the development of digital information environments, for users with or without special needs. The overall objective of this study is to contribute to the development of inclusive digital information environments, in perspective of union of theories, recommendations and technologies for the development of digital accessibility guidelines. In a theoretical dimension, the research covers a critical review of the specialized literature in the areas of Information Science and Computer Science and, in the applied part, the analysis and development of a proposal of guidelines for the architecture of a digital information environment with accessibility.

Estudo da acessibilidade aplicado a rodoviária de Aparecida-SP

The aim of this study was to develop a case study of road Aparecida, where it noticed a large movement of people with disabilities who use the road, bound for the city's churches. Another objective was to compare the minimum dimensions established by law, with the dimensions of the spaces (slope of ramps, wide sidewalks, etc.) on the road of Aparecida. Starting from this fact, a study was done on the architectural barriers faced by people with special needs and disabled. It was also made a field survey in order to know the opinion of the users about the accessibility of pregnant elderly and disabled in the road. Technical visits were also made in order to detect sites with access problems with special needs. Also were proposed guidelines for renovation of the building where the road works

Análise e reflexão sobre a educação especial inclusiva em Maringá/BR e em Guadalajara /ES

The purpose of this study is to know the route of Special Education in different contexts, the city of Maringa/Brazil and Guadalajara/Spain and analyze the bases underlying the organization, structure and operation of this mode of education having as starting point the process inclusive school. This investigation is based on the theoretical and methodological principles of the historical-cultural notion by Vygotsky. He argues that the existence of fundamental principles underlying the development of children with disabilities. If, on the one hand, the disability imposes limitations on the individual, hindering its development, on the other, just by causing difficulties, enables the movement to compensate, increasing the development of other capabilities. The deficit itself is less. Therefore, it is a field research carried out by means of observations, literature search and document analysis in early childhood education institutions visited in the cities mentioned above. The results showed that there are peculiarities of its path, organization and functioning of Special Education in each of the contexts analyzed. Referentemente the inclusive education movement, it is clear that Spain is a precursor of this process therefore has the right conditions in different ways to conduct the service children with special needs, and on the other hand, schools have the resources and specialized materials they need. While in Brazil the operationalization of these measures occurs more slowly. Thus, we can say that this process of inclusive education does not happen in a linear fashion within mainstream schools and so little action in the different forms of special education in two contexts analyzed.

Escolarização de alunos com altas habilidades/superdotação: um apoio virtual

According to current legislation, is part of the Target of Special Education, students with high abilities/giftedness (HA/G). However, it appears that there are few studies on efficiency and effectiveness of diverse pedagogical practice for students with these characteristics. With increasing globalization, are multiplied opportunities for transnational education programs and educational services, particularly through the Internet, increasing the need for information services and accreditation of institutions and educational programs. This study aims to: a) develop a website containing information on high abilities/giftedness; b) evaluate the design of teachers on applicability of the site; c) analyze the contributions posted on the site. Therefore, it was available to the participants of this research produced site. Consisted on the site, among other information, those relating to HA/G indicators. Was sent a questionnaire via the Internet, with nine closed questions and two open, to 2000 teachers, registered in the database Improvement Course in Educational Practices Inclusive conducted by UNESP, under the coordination of Prof. Dr. Vera Lucia Messias Fialho Capellini. Data were considering frequency responses. For the treatment we used the Google Docs. As result Program Observed how teachers are lacking this subject deserves further Top depth. Concerning the site he was Considered by the participants as a support tool to the teacher, Which helps to identify and recognition of Individuals with HA/G and contributes to information, training and practical pedagogical way. This, is expected to Contribute to the dissemination of this issue in society as well as the Possibility of Minimizing the myths about this population, since such myths exist due to the lack of information

O cuidador de paciente com neoplasia cerebral maligna primária: os desafios do cuidado

Patients with primary malignant brain tumor endure several motor and cognitive dysfunctions, demanding the presence of a caregiver even more because the time necessary for their assistance increases considerably. Usually this task is performed by a family relative, whose activities include taking care of the patient’s personal hygiene, escorting them to medical appointments, managing their money and performing their housework. All of this overwhelms the caregiver both physical and psychologically. This bibliographic research intends to analyze the role in which a caregiver plays in the quality of life of those kinds of patients, the complications of such task, the caregivers’ needs and the daily life of those terminal patients. It was used CAPES, PubMed and Google Academic databases for researching articles related to family caregivers who assisted adult patients with primary malignant brain tumor. The study concluded that being a caregiver of patients in such conditions harms one’s quality of life, with consequences such as stress, insomnia, financial problems and lack of social support. Theirs needs include: having someone to talk to about the matter, attending programs for reducing stress and increasing their knowledge about the disease. In advanced phases of the condition, the patient shows great mobility problems, aphasia and regular seizures, which end up overwhelming the caregiver. The level of quality of life found was above other types of cancer’s caregivers. Therefore, they represent a group with special needs, which should be especially handled by health professionals.

Dental care for cerebral palsy patients using auxiliary resources to inhibit pathological tonic reflexes

Cerebral paralysis is a chronic illness that affects the central nervous system. In this article the author describes the techniques used at CAOE (Odontological Center for Assistance to patients with special needs) to restraint CP patients during dental treatment, because they present some pathological reflexes which interfere in their odontological assistance. Also it shows how to perform a special physical restraint and how to keep the mouth open by using simple tools including a homemade one. All the devices used during the dental treatment in cerebral palsy patients, such as the physical restraint with bands or sheet to wrap them up, cylindrical pad or cushion made of a soft material, or simple tools including a homemade one to keep the mouth open are usually and safely used in CAOE. All these simple devices are necessary, because there are no available funds for the acquisition of expensive material or equipment. Despite of a shortage of resources we can easily and efficiently assist these patients.

Programa multidisciplinar para promoção da saúde envolvendo atividade física supervisionada: ações do PAFIPNES na atenção à saúde de mulheres em uma Unidade Básica de Saúde de São José do Rio Pardo-SP

The Physical Activity Program for Persons with Special Needs (PAFIPNES) is a extension project developed since 2002, and operates in secondary care to the health of obese, diabetic and hypertensive women. This offer exercise programs supervised by physical education professionals, together with a multidisciplinary health team that works in a Health Basic Unit of São José do Rio Pardo/SP. Their actions included interventions to improve general health status and stimulate the adoption of a more active lifestyle. In addition, the PAFIPNES serves as an internship site for scholars of Physical Education can acquire knowledge and skills that enable them to act on basic health care of patients with Non Communicable Diseases, as mentioned above.

Programa de equoterapia: intervenção com um praticante com deficiência visual

The hippotherapy is a therapeutic and educational method that uses the horse within an interdisciplinary approach in the areas of health, education and riding, seeking the biopsychosocial development of people with disabilities and/or special needs. The method generates the practitioner positive effects, such as physical, social and psychological benefits. The goal of this study was to investigate alterations with a practitioner with visual impairment during their participation in a hippotherapy program. The study is characterized by a qualitative and descriptive research, in the form of case study. Data were collected through interviews with the mother of the practitioner and filming, photographs and systematic observation of the sessions. Improvements were found in the behavior of practicing at home, and there was progress in motor performance, and self-confidence generated by the domain horse. It is concluded that the hippotherapy program generated physical, psychological and social benefits to the practitioner.

Rotinas familiares de crianças com necessidades especiais em família adotiva

Objetivou-se descrever as rotinas de três famílias, que adotaram crianças com necessidades especiais, que tinham conhecimento prévio dessa condição infantil. Utilizou-se o método de Estudo de Casos Múltiplos. Os dados foram obtidos por meio de Entrevista Semiestruturada (ES), do Inventário de Rotina (IR) e do Diário de Campo (DC). Quanto às semelhanças entre os grupos familiares, identificou-se que são comuns as atividades de alimentação/higiene, descanso e lazer, envolvendo a participação dos pais, irmãs e babás, geralmente nos ambientes domésticos da família. Observou-se diferenças importantes nos padrões de atividades, companhias e ambientes onde as rotinas ocorriam. Conclui-se que as variações nas rotinas estão relacionadas às particularidades de cada criança, à estrutura e nível socioeconômico de cada família participante.

Inclusão do portador de necessidades especiais no ensino regular: revisão da literatura

OBJETIVOS: Analisar criticamente a inclusão do portador de necessidades especiais no ensino regular brasileiro, considerando aspectos sociais e jurídicos, por meio de revisão de literatura. ESTRATÉGIA DE PESQUISA: A pesquisa bibliográfica foi conduzida em bases de dados de acesso público: LILACS, SciELO, Portal Cochrane e IUSDATA, sendo esta última da Biblioteca da Faculdade de Direito da Universidade de São Paulo, considerando todos os artigos publicados até o mês de dezembro de 2010. Como estratégia de busca foram utilizados os seguintes termos livres: educação inclusiva, educação especial, proposta inclusiva e portador de necessidades especiais. CRITÉRIOS DE SELEÇÃO: Durante a busca, foram avaliados e selecionados apenas os estudos cujo resumo ou corpo do artigo tivesse relação com o objetivo proposto. ANÁLISE DE DADOS : Os artigos potencialmente relevantes para a revisão foram apresentados em uma ficha protocolar contendo critérios de elegibilidade do estudo, métodos utilizados, características do grupo de artigos analisado, tipo de intervenção realizada e resultados obtidos no estudo. Os artigos classificados como opinião de especialistas, apesar de apresentarem baixo nível de evidência científica, foram incluídos no trabalho, pois são frequentemente encontrados na literatura sobre o assunto. RESULTADOS: Foram encontrados 1.399 artigos, e após leitura dos resumos foram selecionados 120 artigos potencialmente relevantes considerando-se o objetivo da pesquisa. Destes, 67 artigos foram citados em mais de uma base de dados, o que resultou em 53 artigos para serem lidos na íntegra. Após a leitura dos 53 artigos, foram excluídos 15 que não se enquadravam nos critérios de inclusão. Desta forma, 38 estudos foram incluídos e analisados. CONCLUSÃO: Após a análise crítica da literatura da área conclui-se que, até o momento, de maneira geral, a escola recebe, mas há muito a percorrer para incluir os alunos portadores de necessidades especiais, embora o país possua o escopo da inclusão. Assim, faz-se necessário o estabelecimento de diretrizes e ações políticas visando uma inclusão efetiva.

Caratterizzazione della flora microbica orale in diverse categorie di pazienti sindromici in età evolutiva.

La salute orale dei soggetti affetti da patologie sistemiche responsabili di disabilità fisiche e/o psichiche, in particolare in età evolutiva, è un obiettivo da perseguire di primaria importanza al fine di migliorare la qualità della vita del bambino e garantirgli un buon inserimento nel contesto sociale. Ricerche sperimentali e cliniche hanno individuato i momenti eziopatogenetici delle diverse problematiche che si riscontrano a carico del cavo orale, con una frequenza superiore nei pazienti disabili rispetto alla restante popolazione, attribuendo ai batteri formanti la placca e a quelli con la capacità di indurre un danno parodontale un ruolo chiave. Diversi sono stati i protocolli di prevenzione e terapia proposti nel tempo, costruiti proprio in relazione all’età del soggetto ed alla tipologia della disabilità; tuttavia risulta di fondamentale importanza chiarire il complesso rapporto tra la popolazione microbica orale e l'ospite nello stato di malattia. In un contesto del genere, intento del lavoro di ricerca è proprio quello di portare a termine un progetto di bonifica dentaria su un gruppo di pazienti in età compresa tra i 2 e i 17 anni, affetti da patologie sistemiche e patologie del cavo orale, sulla base di un profilo microbiologico, a partire da tamponi salivari e prelievi parodontali. Stilando il profilo microbiologico del “gruppo campione” e confrontandolo con quello di un gruppo di pazienti di controllo, lo studio si propone di riuscire a delineare i miglioramenti, qualora ci fossero, post terapia odontostomatologica e di riuscire a trovare una base microbiologica alle patologie extra -orali annesse.