Novo transtorno, velho problema: a identificação do TDAH pelo olhar do professor

No presente trabalho analisamos os desdobramentos do processo de expansão do Transtorno de Déficit de Atenção e Hiperatividade (TDAH) no cenário educacional brasileiro. O TDAH, considerado atualmente o transtorno de desenvolvimento que mais acomete crianças em idade escolar, vem sofrendo constantes questionamentos no que se refere a sua validade diagnóstica. Caracterizado basicamente pela tríade sintomatológica desatençãohiperatividade-impulsividade, propusemos na pesquisa que o TDAH vem ocupando posição central na discussão sobre as leituras contemporâneas a respeito do fracasso escolar. Para compreender a associação entre TDAH e educação, mais especificamente a hipóteses sobre o fracasso escolar, realizamos um breve levantamento das definições dos sintomas, causas, tratamentos e história do transtorno conforme as edições do DSM. A exposição destes dados permitiu uma reflexão do TDAH como uma entidade complexa e multifatorial que apresenta uma diversidade de manifestações sintomáticas e variadas formas de tratamento. Procuramos demonstrar que essa diversidade de características não só permite que um número cada vez maior de indivíduos seja diagnosticado portador do transtorno como também abre caminho para intensos debates que questionam suas fronteiras flexíveis. Para dar visibilidade às discussões brasileiras, analisamos os materiais divulgados pela Associação Brasileira de Déficit de Atenção (ABDA) e pelo Fórum Sobre a Medicalização da Educação e da Sociedade, duas entidades que apresentam leituras opostas a respeito do conceito nosológico em questão. Demonstramos ainda como TDAH vem compondo discursos sobre os problemas de aprendizagem e indisciplina de crianças em idade escolar de uma escola estadual do município de Niterói, no Rio de Janeiro. Localizar o problema do fracasso escolar na biologia do indivíduo torna possível obliterar outros conflitos que se desencadeiam no ambiente escolar, mantendo como foco o objetivo disciplinador da escola. Os sintomas do TDAH se apresentam, portanto, fundamentalmente relacionados a problemas de desajuste escolar, o que promove um grande desafio aos professores. Esses profissionais recorrem cada vez mais às especialidades médicas relacionadas ao transtorno infantil a fim de buscar soluções para situações que enfrentam em sala de aula. Nesse contexto, a pesquisa de base empírica buscou verificar os sentidos que as professoras atribuem ao TDAH a partir das relações com os alunos em sala de aula. Através da coleta de dados composta por observação participante e entrevistas semiestruturadas aos professores e profissionais de saúde que ocupam o ambiente escolar pesquisado, visamos destacar a forma como se compõe os discursos acerca do TDAH neste ambiente, os quais apresentam diferenças em relação a intensidade da influência exercida pelo discurso médico formal.

Prevalência de má oclusão em crianças com idade escolar

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Medicina Dentária

Safe spaces and sense of identity: views and experiences of lesbian, gay and bisexual young people

Empirical data on the life experiences of contemporary school-age lesbian, gay and bisexual (LGB) young people in Britain remains somewhat sparse. This paper reports the preliminary findings of a study conducted at a recently-initiated LGB youth Summer School. To further an appreciation of issues of concern to today's LGB teenagers, in-depth interviews were conducted with 10 Summer School participants (five female and five male, aged 15-18 years). The aim was to elicit their views and experiences relating to their need for support such as that offered by the Summer School. Themes drawn from participants' interviews are presented. Key issues included: being positioned as different by their majority heterosexual peers; feelings of isolation and loneliness in their peer groups and families; difficulties in finding others like themselves for companionship; and the importance of meeting more LGB people of their own age.

Measles virus and classical Hodgkin lymphoma: no evidence for a direct association.

A proportion of Hodgkin lymphoma (HL) cases are causally associated with the Epstein-Barr virus (EBV) but the aetiology of the remaining cases remains obscure. Over the last 3 decades several studies have found an association between HL and measles virus (MV) including a recent cohort study describing the detection of MV antigens in Hodgkin and Reed-Sternberg cells, the tumour cells in HL. In the present study we looked at the relationship between history of MV infection and risk of developing HL in a population-based, case/control study of HL. In addition we used immunohistochemistry and RT-PCR to look for direct evidence of MV in HL biopsies. There was no significant difference in the proportion of cases reporting previous measles compared to controls in the entire data set or when young adults were considered separately. Using a robust immunohistochemical assay for MV infection, we failed to find evidence of MV in biopsies from 97 cases of HL and RT-PCR studies similarly gave negative results. This study therefore provides no evidence that MV is directly involved in the development of HL. However, when age at first reported MV infection was investigated, significant differences emerged with children infected before school-age having higher risk, especially of EBV-ve HL, when compared with children infected at older ages; the interpretation of these latter results is unclear.

Neurodevelopmental and respiratory follow-up results at 7 years for children from the United Kingdom and Ireland enrolled in a randomized trial of early and late postnatal corticosteroid treatment, systemic and inhaled (the Open Study of Early Corticosteroid Treatment)

The goals were to compare early school-age neurodevelopmental and respiratory outcomes for children who were treated with either early (15 days) postnatal corticosteroid therapy and to compare systemic dexamethasone treatment with inhaled budesonide treatment.

Korean Parental Beliefs About ELT From the Perspective of Teachers

In South Korea, as in many other parts of the world, children begin learning English when they are very young. Korean parents want their children to learn English as quickly as possible and often make heavy financial and other investments in their children’s English language education. English language teachers of school-age learners in Korea often feel pressure and in some cases criticism from parents regarding English language instruction. This article reports the results of a study designed to begin examining the perceptions that Korean parents hold regarding English language instruction. It illustrates how some of their beliefs reflect the latest language teaching research, whereas others are more indicative of traditional Korean belief systems, educational approaches, and methodologies.

The neurodevelopmental progress of infants less than 33 weeks into adolescence

Background: Several studies have shown an increased incidence of neurodevelopmental impairment in very preterm survivors at school age compared with controls.

Aim: To compare findings in the same cohort at 8 years and 15 years.

Methods: A total of 151 of the 224 eligible infants born before 33 weeks of gestation from 1979 to 1982, and who were living in the UK, were assessed at 8 and 15 years. Items common to both assessments were compared to evaluate changes in neurodevelopmental function. The assessment included a structured neurological examination, psychometric tests using the WISC-R (in subjects born in 1981-82), a test of visuomotor integration (Beery), and a school questionnaire.

Results: There was a significant increase in the proportion of subjects classified as impaired with disability from 11% at 8 to 22% at 14-15 years of age. The proportion of subjects classified as impaired without disability increased from 16% at 8 to 26% at 14-15 years of age. Full scale IQ decreased from 104 to 95 from childhood to adolescence, and more adolescents (24%) were requiring extra educational provision than they had at the age of 8 years (15%).

Conclusion: Results indicate that between the ages of 8 and 15 years in this cohort of very preterm survivors there is an apparent deterioration in neurodevelopmental outcome category, cognitive function, and extra educational support. It is not clear whether this represents a genuine deterioration in neurocognitive function or whether it represents the expression of pre-existing cerebral pathology in an increasingly complex environment.

Trends in the use of psychotropic medications among adolescents, 1994 to 2001

Objectives: Few psychotropic medications are approved for use among children younger than 18 years. Yet previous studies have shown an increase in the use of psychotropic medications among school-age children and adolescents. Most previous studies examined data only up to 1997; therefore, the results predate any impact of changing federal policies and newly marketed medications. This study examined trends in the prescription of psychotropic medications to adolescents aged 14 to 18 years in office-based care in the United States from 1994 to 2001. Methods: Data from the National Ambulatory Medical Care Survey (NAMCS) were used to determine visit rates and prescribing patterns from 1994 to 2001 for psychotropics that were prescribed in office-based treatment settings to adolescents aged 14 to 18 years. Rates of visits that resulted in a prescription for psychotropic medication were calculated for two-year periods. Analyses were conducted by type of medication, gender, and the prescribing physician's specialty. Results: Rates of visits that resulted in a psychotropic prescription increased from 3.4 percent in 1994-1995 to 8.3 percent in 2000-2001. These trends were evident for males and females. The average annual growth rates for psychotropic prescriptions were much higher after 1999. Trends were also significant across drug classes. By 2001, one out of ten office visits by adolescent males resulted in a prescription for a psychotropic medication. Conclusions: Average annual growth rates for the prescription of psychotropics to adolescents increased from 1994 to 2001, with especially rapid acceleration after 1999. This increase may be associated with changing thresholds of diagnosis and treatment, availability of new medications, and changes in federal regulatory policies concerning promotion of medications by the pharmaceutical industry.

Magnetoencephalography reveals slowing of resting peak oscillatory frequency in children born very preterm

Resting cortical activity is characterized by a distinct spectral peak in the alpha frequency range. Slowing of this oscillatory peak toward the upper theta-band has been associated with a variety of neurological and neuropsychiatric conditions and has been attributed to altered thalamocortical dynamics. Children born very preterm exhibit altered development of thalamocortical systems. To test the hypothesis that peak oscillatory frequency is slowed in children born very preterm, we recorded resting magnetoencephalography (MEG) from school age children born very preterm (= 32 wk gestation) without major intellectual or neurological impairment and age-matched full-term controls. Very preterm children exhibit a slowing of peak frequency toward the theta-band over bilateral frontal cortex, together with reduced alpha-band power over bilateral frontal and temporal cortex, suggesting that mildly dysrhythmic thalamocortical interactions may contribute to altered spontaneous cortical activity in children born very preterm.

Altered long-range alpha-band synchronization during visual short-term memory retention in children born very preterm

Children born very preterm, even when intelligence is broadly normal, often experience selective difficulties in executive function and visual-spatial processing. Development of structural cortical connectivity is known to be altered in this group, and functional magnetic resonance imaging (fMRI) evidence indicates that very preterm children recruit different patterns of functional connectivity between cortical regions during cognition. Synchronization of neural oscillations across brain areas has been proposed as a mechanism for dynamically assigning functional coupling to support perceptual and cognitive processing, but little is known about what role oscillatory synchronization may play in the altered neurocognitive development of very preterm children. To investigate this, we recorded magnetoencephalographic (MEG) activity while 7-8 year old children born very preterm and age-matched full-term controls performed a visual short-term memory task. Very preterm children exhibited reduced long-range synchronization in the alpha-band during visual short-term memory retention, indicating that cortical alpha rhythms may play a critical role in altered patterns functional connectivity expressed by this population during cognitive and perceptual processing. Long-range alpha-band synchronization was also correlated with task performance and visual-perceptual ability within the very preterm group, indicating that altered alpha oscillatory mechanisms mediating transient functional integration between cortical regions may be relevant to selective problems in neurocognitive development in this vulnerable population at school age.

Extremely premature (<or = 800 g) schoolchildren:multiple areas of hidden disability

To examine the functional abilities of extremely low birthweight (ELBW, <or = 800 g) children at school age compared with full term children.

Validation of night blindness reports among children and women in a vitamin A deficient population in rural Tanzania.

OBJECTIVE: This study validates different definitions of reported night blindness (XN) in a vitamin A deficient African population with no local term for XN. DESIGN: Case-control study with follow-up after treatment. SETTING: Eight primary schools and health centres in rural Tanzania. SUBJECTS: A total of 1214 participants were screened for reported XN and other eye signs of xerophthalmia: 461 children aged 24-71 months, 562 primary school-age children and 191 pregnant or breast-feeding women. All 152 cases of reported XN were selected for the validation study and group matched with 321 controls who did not complain of XN. XN reports were validated against serum retinol concentrations and pupillary dark adaptation measurements in cases and controls. INTERVENTION: All children and women who reported XN or had other signs of active xerophthalmia were treated with vitamin A and followed up 3-4 weeks later. Half of the untreated control group who had their serum retinol examined in the baseline examination were also followed up. RESULTS: The overall prevalence of reported XN was 12.5%. At baseline, mean pupillary threshold (-1.52 vs -1.55 log cd/m(2), P=0.501) and median serum retinol concentrations (0.95 vs 0.93 micromol/l, P=0.734) were not significantly different in cases and controls either overall or in each population group. More restricted case definitions reduced the prevalence of reported XN to 5.5% (P<0.001), but there was still no significant difference between cases and controls although the results were in the expected direction. After treatment, the median serum retinol concentration improved significantly only in the most deficient group, the young children. Dark adaptation improved in all the subgroups but the difference was only significant for young children and primary school-age children when the restricted case definitions were used. CONCLUSIONS: XN reports are a poor indicator of vitamin A deficiency in this population. SPONSORSHIP: Task Force Sight and Life, Basel, Switzerland.

Prática Pedagógica em Educação de Infância : consciência fonológica e desenvolvimento de competências orais e escritas

Relatório de estágio para a obtenção do grau de Mestre em Educação Pré-escolar e 1º Ciclo do Ensino Básico. Orientadora: Maria Leonor Simões dos Santos .Coorientadora: Marta Andreia de Sousa Jacinto Uva

Do challenge, task experience or computer familiarity influence the learning of historical chronology from virtual environments in 8–9 year old children?

Studies examined the potential use of Virtual Environments (VEs) in teaching historical chronology to 127 children of primary school age (8–9 years). The use of passive fly-through VEs had been found, in an earlier study, to be disadvantageous with this age group when tested for their subsequent ability to place displayed sequential events in correct chronological order. All VEs in the present studies included active challenge, previously shown to enhance learning in older participants. Primary school children in the UK (all frequent computer users) were tested using UK historical materials, but no significant effect was found between three conditions (Paper, PowerPoint and VE) with minimal pre-training. However, excellent (error free) learning occurred when children were allowed greater exploration prior to training in the VE. In Ukraine, with children having much less computer familiarity, training in a VE (depicting Ukrainian history) produced better learning compared to PowerPoint, but no better than in a Paper condition. The results confirmed the benefit of using challenge in a VE with primary age children, but only with adequate prior familiarisation with the medium. Familiarity may reduce working memory load and increase children’s spatial memory capacity for acquiring sequential temporal-spatial information from virtual displays. Keywords: timeline, chronographics

O Papel do educador enquanto promotor de comportamentos de autorregulação das crianças

Relatório da Prática Profissional Supervisionada Mestrado em Educação Pré-Escolar