Learning and Memory Impairments With Attention-Deficit/Hyperactivity Disorder.

ADHD is a common chronic neurodevelopmental disorder and is characterized by persistent inattention, hyperactivity, impulsivity and are often accompanied by learning and memory impairment. Great evidence has shown that learning and memory impairment of ADHD plays an important role in its executive function deficits, which seriously affects the development of academic, cognitive and daily social skills and will cause a serious burden on families and society. With the increasing attention paid to learning and memory impairment in ADHD, relevant research is gradually increasing. In this article, we will present the current research results of learning and memory impairment in ADHD from the following aspects. Firstly, the animal models of ADHD, which display the core symptoms of ADHD as well as with learning and memory impairment. Secondly, the molecular mechanism of has explored, including some neurotransmitters, receptors, RNAs, etc. Thirdly, the susceptibility gene of ADHD related to the learning and impairment in order to have a more comprehensive understanding of the pathogenesis. Key words: Learning and memory, ADHD, Review.

Learning difficulties in school children: health and education professionals' perceptions.

OBJECTIVES: to understand health and education professionals' perceptions regarding children's learning difficulties in public schools. METHODS: qualitative research, of the participatory action type, linked to Paulo Freire's Research Itinerary. Forty-five professionals participated, through interviews and a Virtual Culture Circle. The analysis was developed through careful reading, reflection and interpretation of highlighted topics. RESULTS: professionals discussed the (in)visibility of learning difficulties, strategies and resources in the educational sector and the search for solutions in the health sector. It was found that the production of complaints related to school learning is attributed predominantly as an individual problem of children or their family, exempting the educational institution from this process. FINAL CONSIDERATIONS: greater investment in professional training and development policies is urgently needed to facilitate coordination between sectors, with a view to overcoming outdated pedagogical and health models.

Estimating the prevalence of Non-Verbal Learning Disability (NVLD) from the ABCD sample.

Non-Verbal Learning Disability (NVLD) is a neurodevelopmental disorder characterized by deficits in processing visuospatial information but with age-appropriate verbal skills. This cognitive profile has been hypothesized to be associated with atypical white matter, but at the present there is a lack of evidence for this hypothesis. Currently, the condition is not characterized within the main diagnostic systems, in part because no clear set of criteria for characterizing the disorder exists. This report is the first attempt to estimate NVLD prevalence, using two sets of diagnostic criteria, in a large sample of over 11,000 children who were selected without regards to problems of specific nature, either psychological, neurological, physical and/or social. Furthermore, it examined the association between the profile of cognitive abilities and aspects of whole-brain white matter measures in children with and without symptoms associated with NVLD. Participants were drawn from the Adolescent Brain Cognitive Development (ABCD) study, a 10-year longitudinal study of 11,876 children in the U.S. The data used in the present study were drawn from the initial testing point at which the children were 9-10 years old. Prevalence of NVLD based on two distinct sets of criteria, correlations between the measures used to create the criteria, correlations between criteria measures and measures of white matter integrity. The cognitive criteria included measures of visuospatial processing, reading, intelligence and social skills. By varying the cut-offs applied to social skills in conjunction with visuo-spatial difficulties, spared reading skills and intelligence scores, we calculated prevalence for two NVLD groups. White matter characteristics were measures of volume, fractional anisotropy and mean diffusivity. Based on the criteria used, the estimated prevalence of NVLD varied from 1 to 8%. Furthermore, children with NVLD showed a dissociation between measures of visuo-spatial processing not observed in non-NVLD children. At the neurological level, findings provide preliminary evidence of associations between the cognitive profile of NVLD and abnormalities in white matters tracts. The present study documents that exists, within this large non-selected sample, a proportion of youth who show evidence of NVLD. Given those results, it appears essential to establish the best diagnostic criteria, to improve the treatment options and quality of life for children with this disorder.

From classroom to life: Gender differences in the persistent effect of learning disabilities on adult depressive symptoms.

Despite the well-established link between adolescent learning disabilities (LD) and mental health, little is known about its long-term consequences. This study examines the relationship between adolescent LD and adult depressive symptoms, with a focus on gender differences and underlying mechanisms. Using a sibling sample from the National Longitudinal Study of Adolescent to Adult Health (N = 3,414), this study estimated sibling fixed effects models to account for unobserved family-level characteristics such as genes and early childhood family and social context. Sobel mediation analyses were conducted to examine social-psychological mechanisms, including the student-teacher relationship, the student-student relationship, and a sense of school belonging. LD in adolescence was positively associated with depressive symptoms in adulthood (b = 0.823, p < 0.05). This association remained robust when controlling for unobserved family-level confounders as well as educational attainment in adulthood. Gender-stratified models showed that only the association for women is statistically significant (b = 1.935, p < 0.05), and its magnitude is nearly three times that of the association for men. Sobel mediation tests indicate that a decline in a sense of school belonging mediates approximately 17% of the association between adolescent LD and adult depressive symptoms. This study's findings suggest that LD in adolescence is associated with an increase in depressive symptoms in adulthood, particularly in women, and a low sense of school belonging may be a potential mediator. Implementing interventions to improve the school integration of girls with LD could be an effective means of improving their long-term mental health.

Adapting the EQ-5D-3L for adults with mild to moderate learning disabilities.

BACKGROUND: Approximately 1.5 million adults in the UK have a learning disability. The difference between age at death for this group and the general population is 26 years for females and 22 years for males. The NHS Long Term Plan (January 2019) recognises learning disabilities as a clinical priority area. People with a learning disability are often excluded from research by design or lack of reasonable adjustments, and self-reported health status/health-related quality of life questionnaires such as the EQ-5D are often not appropriate for this population. Here, we systematically examine the EQ-5D-3L (its wording, content, and format) using qualitative methods to inform the adaption of the measure for use with adults with mild to moderate learning disabilities. METHODS: Think-aloud interviews with carers/advocates of learning-disabled adults were undertaken to explore the difficulties with completing the EQ-5D-3L. Alternative wording, language, structure, and images were developed using focus groups, stakeholder reference groups, and an expert panel. Data analysis followed a framework method. RESULTS: The dimensions and levels within the EQ-5D-3L were deemed appropriate for adults with mild to moderate learning disabilities. Consensus on wording, structure, and images was reached through an iterative process, and an adapted version of the EQ-5D-3L was finalised. CONCLUSION: The EQ-5D-3L adapted for adults with mild to moderate intellectual/learning disabilities can facilitate measurement of self-reported health status. Research is underway to assess the potential use of the adaptation for economic evaluation.

The development of number line estimation in children at risk of mathematics learning difficulties: A longitudinal study.

Children with mathematics learning difficulties (MLD) show poorer performance on the number line task, but how performance on this task relates to other mathematical skills is unclear. This study examined the association between performance on the number line task and mathematical skills during the first 2 years of school for children at risk of MLD. Children (N = 100; Mage = 83.63 months) were assessed on four occasions on the number line task and other mathematical skills (math fluency, numerical operations, and mathematical reasoning). Estimation patterns were analyzed based on the representational shift and proportional judgment accounts separately. More consistent longitudinal trends and stronger evidence for differences in mathematical skills based on estimation patterns were found within the representational shift account. Latent growth curve models showed accuracy on the number line task as a predictor of growth in some mathematical skills assessed. We discuss impacts of methodological limitations on the study of estimation patterns.

Disability Acceptance and Affirmation Among U.S. Adults With Learning Disabilities and ADHD.

Personal disability identity is a predictor of psychosocial functioning among adults with predominantly physical disabilities. In the present study, we examined personal disability identity in adults with learning disabilities (LD) and/or attention-deficit/hyperactivity disorder (ADHD). In samples of 541 adults with LD, 475 with ADHD, and 433 with comorbid LD and ADHD, we examined the structural validity of disability acceptance and disability affirmation scores and the association between these scores and anxiety/depression, life satisfaction, and general self-efficacy. Factor analyses supported a 4-item disability acceptance and 3-item disability affirmation scale in LD-only and ADHD-only samples. Among adults with LD or ADHD, disability affirmation was a meaningful predictor of life satisfaction, and disability acceptance predicted general self-efficacy. Disability identity attitudes are worthy of clinical and scholarly attention in adults with LD and ADHD, and adults with comorbid LD and ADHD may warrant special consideration in the personal disability identity literature.

Mental health and service use of parents with and without borderline intellectual functioning.

BACKGROUND: People with borderline intellectual functioning (BIF) encounter greater social adversities than the general population and have an increased prevalence of mental illness. However, little is known about the socio-demographic characteristics and mental health of parents with BIF. METHODS: A secondary data analysis of the Adult Psychiatric Morbidity Survey 2014 was conducted. Logistic regression models were fitted to compare differences in socio-demographic, mental health and service-use characteristics between parents and non-parents with and without BIF, and to investigate if the relationship between parent status and mental health outcomes was modified by BIF status, sex, and employment. RESULTS: Data from 6872 participants was analyzed; 69.1% were parents. BIF parents had higher odds of common mental disorder, severe mental illness, post-traumatic stress disorder, self-harm/suicide and were more likely to see their General Practitioner (GP) and to receive mental health treatment than non-BIF parents. BIF parents did not have a higher prevalence of mental health problems than BIF non-parents. Being a parent, after adjusting for BIF status and other confounders, was associated with increased odds of having a common mental disorder, visits to see a GP and treatment for mental health. Female parents had higher odds of treatment for mental health problems. CONCLUSIONS: Being a parent is associated with elevated rates of common mental disorders. There is a higher burden of mental health problems and service use in people with BIF. A greater provision of specialist support services including ascertainment is indicated for this group.

Assessment of Specific Learning Disabilities and Intellectual Disabilities.

We review literature related to the assessment and identification of Specific Learning Disabilities (SLD) and Intellectual Disabilities (ID). SLD and ID are the only two disorders requiring psychometric test performance for identification within the group of neurodevelopmental disorders in Diagnostic and Statistical Manual - 5. SLD and ID are considered exclusionary of one another, but the processes for assessment and identification of each disorder vary. There is controversy about the identification and assessment methods for SLD, with little consensus. Unlike ID, SLD is weakly related to full-scale IQ, and there is insufficient evidence that the routine assessment of IQ or cognitive skills adds value to SLD identification and treatment. We have proposed a hybrid method based on the assessment of low achievement with norm-referenced tests, instructional response, and other disorders and contextual factors that may be comorbid or contraindicative of SLD. In contrast to SLD, there is strong consensus for a three-prong definition for the identification and assessment of ID: (a) significantly subaverage IQ, (b) adaptive behavior deficits that interfere with independent living in the community, and (c) age of onset in the developmental period. For both SLD and ID, we identify areas of controversy and best practices for identification and assessment.

Trajectory assessments of cognitive, visuospatial, and academic profile in nonverbal learning disability (visuospatial developmental disorder).

Substantial progress has been made in defining children with nonverbal learning disability (NLD), but longitudinal studies are still lacking. To start filling this gap, we examined changes in general cognitive functioning, visuo-constructive skills, and academic profiles in a group of children with NLD, also taking into account any internalizing and externalizing symptom as transdiagnostic features. A total of 30 participants (24 boys) diagnosed with NLD were tested twice, with a three-year gap between the two assessments (T1: at age 8-13; T2: at 11-16), on their cognitive profile, visuospatial abilities, and academic performance (i.e., reading, writing and arithmetic abilities). At T2, any internalizing and externalizing symptom was also investigated. Statistically significant differences emerged between the two assessments in terms of the WISC-IV Perceptual Reasoning Index (PRI), handwriting speed and arithmetical fact retrieval. The NLD profile seems to be characterized by a relative stability in its core features during a child's development, as regards both weaknesses (i.e., visuospatial processing) and strengths (i.e., verbal abilities). The presence of internalizing and externalizing symptoms also suggested the importance to analyze transdiagnostic features rather than only sharp boundaries between conditions.

Subtypes of mathematical learning disability and their antecedents: A cognitive diagnostic approach.

Using cognitive diagnostic modeling (CDM), this study identified subtypes of mathematics learning disability (MLD) based on children's numerical skills and examined the language and spatial precursors of these subtypes. Participants were 99 MLD children and 420 low achievers identified from 1839 Finnish children (966 boys) who were followed from preschool (age 6) to fourth grade (2007-2011). Five subtypes were identified: the arithmetic fluency deficit only subtype, the counting deficit subtype, the pervasive deficit subtype, the symbolic deficit subtype, and the counting and concept deficit subtype. Different subtypes depended on different constellations of language and spatial deficits. Findings highlight the effectiveness of CDM in identifying MLD subtypes and underscore the importance of understanding the specific deficits and antecedents of the subtypes.

A systematic review and meta-analysis of factors influencing ImPACT concussion testing in high school and collegiate athletes with self-reported ADHD and/or LD.

OBJECTIVE: Sport concussion is a common injury, and athletes with attention-deficit/hyperactivity disorder (ADHD) and/or learning disorder (LD) are at increased risk and require specialized attention in clinical settings. Although systematic reviews of the relationship between ADHD/LD and concussion are reported in the literature, these reviews do not include quantitative syntheses. Additionally, no reviews have focused on the most commonly utilized concussion assessment, Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). The current review provides an update of sport concussion assessment in athletes with ADHD and/or LD from 2000 to 2021 on these topics: baseline and postconcussion performance on ImPACT, baseline and postconcussion symptom reporting using the Postconcussion Symptom Scale, invalid baseline classification on ImPACT, and self-reported history of concussion. METHOD: Meta-analyses were conducted on baseline ImPACT performance, symptom reporting, invalid baseline classification, and concussion rates. Thirty-four studies were included in systematic review and 19 were included in meta-analyses. RESULTS: Decreased baseline performance was found for athletes with ADHD (trivial to small effects), LD (small-to-medium effects), and ADHD/LD (small-to-medium effects). Increased baseline symptom reporting was found for athletes with ADHD (small effect). Increased odds of invalid baseline performance (trivial effect) and self-reported concussion history (small effect) were found in ADHD. CONCLUSIONS: These results provide the first quantitative synthesis of the literature in this area. It is recommended that future research further examines these topics in athletes with LD and co-occurring ADHD/LD (given the focus on ADHD), as well as the effects that all of these conditions may have on concussion recovery and return-to-play decision-making. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Sensitivity and Specificity of the ImPACT Neurocognitive Test in Collegiate Athletes and US Military Service Academy Cadets with ADHD and/or LD: Findings from the NCAA-DoD CARE Consortium.

BACKGROUND AND OBJECTIVE: Computer-based neurocognitive tests are widely used in sport-related concussion management, but the performance of these tests is not well understood in the participant population with attention-deficit/hyperactivity disorder (ADHD) and/or learning disorder (LD). This research estimates the sensitivity and specificity performance of the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) computer-based neurocognitive test in identifying concussion in this population. METHODS: Study participants consisted of collegiate university athletes and military service academy cadets from the National Collegiate Athletic Association-Department of Defense CARE Consortium who completed the ImPACT test between 2014 and 2021. Participants who self-identified as belonging to one of the subgroups of interest (ADHD with or without LD [ADHD:LD+/-], LD with or without ADHD [LD:ADHD+/-], ADHD and/or LD [ADHD a/o LD]) and completed a baseline (1874 ADHD:LD+/-, 779 LD:ADHD+/-, 2338 ADHD a/o LD) or 24-48 h post-concussion (175 ADHD:LD+/-, 77 LD:ADHD+/-, 216 ADHD a/o LD) ImPACT assessment were included. Sensitivity and specificity were calculated using a normative data method and three machine learning classification methods: logistic regression, classification and regression tree, and random forest. RESULTS: Using the four methods, participants with ADHD:LD+/- had sensitivities that ranged from 0.474 to 0.697, and specificities that ranged from 0.538 to 0.686. Participants with LD:ADHD+/- had sensitivities that ranged from 0.455 to 0.688, and specificities that ranged from 0.456 to 0.588. For participants with ADHD a/o LD, sensitivities ranged from 0.542 to 0.755, and specificities ranged from 0.451 to 0.724. CONCLUSIONS: For all subgroups and analytical methods, the results illustrate sensitivity and specificity values below typically accepted levels indicative of clinical utility. These findings support that using ImPACT alone may be insufficient to inform concussion diagnoses and encourages the use of a multi-dimensional concussion assessment.

O reforço escolar: "Não sou bom de escola, sou bom de coração" / School Tutoring: "I'm not good at school, I'm good at heart" / El Refuerzo Escolar: "No soy bueno de escuela, soy bueno de corazón"

A pesquisa apresentada neste artigo identificou significações atribuídas por estudantes do ensino fundamental ao processo de reforço escolar. A partir da perspectiva teórica da Psicologia Sócio-histórica, conceitos fundamentais da constituição psicológica da criança no período escolar foram elencados. Com o referencial teórico foi criado um roteiro de entrevista, aplicado a estudantes de escolas particulares de São Paulo, sendo que este artigo traz uma das análises realizadas, com foco em um estudante. As respostas dos estudantes geraram uma análise qualitativa, utilizando o referencial teórico dos Núcleos de Significação, procedimento de análise elaborado por Aguiar e Ozella. A análise da entrevista de Caio trouxe significações a respeito do aluno que precisa de reforço escolar como sinônimo de "mau aluno", contribuindo para a adoção de mecanismos de defesa por Caio, alimentados por sentimentos de exclusão, monotonia e cansaço com o ambiente escolar. A partir das informações encontradas, os adultos envolvidos com a criança podem reestruturar e orientar de forma diferente o processo de reforço escolar, visando à diminuição ou eliminação dos sentimentos de exclusão e desvalorização que o processo pode gerar. (AU)

The research presented in this article identified meanings attributed by elementary school students to the process of school tutoring. From the theoretical perspective of Socio-Historical Psychology, fundamental concepts of the psychological constitution of the child in the school period were listed. With the theoretical reference, an interview script was created, applied to students from private schools in São Paulo, and this article brings one of the analyses carried out with a student. The students' answers generated a qualitative analysis, using the theoretical reference of the Nuclei of Meaning core, an analysis procedure developed by Aguiar and Ozella. The analysis of Caio's interview brought up meanings about the student who needs tutoring as a synonym of "bad student", contributing to the adoption of defense mechanisms by Caio, fed by feelings of exclusion, monotony and tiredness with the school environment. From the information found, the adults involved with the child can restructure and orient the process of school tutoring in a different way, aiming at reducing or eliminating the feelings of exclusion and devaluation that the process can generate. (AU)

La investigación presentada en este artículo identificó significaciones atribuidas por estudiantes de la enseñanza fundamental al proceso de refuerzo escolar. A partir de la perspectiva teórica de la Psicología Socio-Histórica conceptos fundamentales de la constitución psicológica del niño en el período escolar fueron enumerados. Con la referencia teórica, se creó un guión de entrevista, aplicado a estudiantes de escuelas públicas de São Paulo, y este artículo trae uno de los análisis realizados, con um estudiante. Las respuestas de los alumnos generaron un análisis cualitativo, utilizando el marco teórico de los Núcleos de Significado, un procedimiento de análisis desarrollado por Aguiar y Ozella. El análisis de la entrevista de Caio aportó significados sobre el alumno que necesita refuerzo escolar como sinónimo de "mal alumno", contribuyendo a la adopción de mecanismos de defensa por parte de Caio, alimentados por sentimientos de exclusión, monotonía y cansancio con el ambiente escolar. A partir de las informaciones encontradas los adultos involucrados con el niño pueden reestructurar y orientar de forma diferente el proceso de refuerzo escolar, buscando la disminución o eliminación de los sentimientos de exclusión y devaluación que el proceso puede generar. (AU)

Aggressive behaviour of psychiatric patients with mild and borderline intellectual disabilities in general mental health care.

PURPOSE: Little is known about the associations between mild intellectual disability (MID), borderline intellectual functioning (BIF) and aggressive behaviour in general mental health care. The study aims to establish the association between aggressive behaviour and MID/BIF, analysing patient characteristics and diagnoses. METHOD: 1174 out of 1565 consecutive in-and outpatients were screened for MID/BIF with the Screener for Intelligence and Learning Disabilities (SCIL) in general mental health care in The Netherlands. During treatment, aggressive behaviour was assessed with the Staff Observation Aggression Scale-Revised (SOAS-R). We calculated odds ratios and performed a logistic and poisson regression to calculate the associations of MID/ BIF, patient characteristics and diagnoses with the probability of aggression. RESULTS: Forty-one percent of participating patients were screened positive for MID/BIF. Patients with assumed MID/BIF showed significantly more aggression at the patient and sample level (odds ratio (OR) of 2.50 for aggression and 2.52 for engaging in outwardly directed physical aggression). The proportion of patients engaging in 2-5 repeated aggression incidents was higher in assumed MID (OR = 3.01, 95% CI 1.82-4.95) and MID/BIF (OR = 4.20, 95% CI 2.45-7.22). Logistic regression showed that patients who screened positive for BIF (OR 2,0 95% CL 1.26-3.17), MID (OR 2.89, 95% CI 1.87-4.46), had a bipolar disorder (OR 3.07, 95% CI 1.79-5.28), schizophrenia (OR 2.75, 95% CI 1.80-4.19), and younger age (OR 1.69, 95% CI 1.15-2.50), were more likely to have engaged in any aggression. Poisson regression underlined these findings, showing a SCIL of 15 and below (ß = 0.61, p<0.001) was related to more incidents. CONCLUSIONS: We found an increased risk for aggression and physical aggression in patients with assumed MID/BIF. We recommend screening for intellectual functioning at the start of treatment and using measures to prevent and manage aggressive behaviour that fits patients with MID/BIF.

The structure, profile, and diagnostic significance of intelligence in children with ADHD are impressively similar to those of children with a specific learning disorder.

This study examines the structure, profile, and diagnostic significance of intelligence in a group of 948 children diagnosed with attention deficit/hyperactivity disorder (ADHD) assessed with the WISC-IV and compared with children with specific learning disorders (SLDs) and with typically developing children. Based on four indexes, the WISC-IV configuration found in TD resulted applicable to ADHD, but with generally lower loadings on g. The Perceptual Reasoning and Verbal Comprehension indexes not only had higher loadings compared to the other two indexes but also represented the relative strengths of children with ADHD, as previously observed for children with SLD. In fact, the WISC pattern could be successfully used for discriminating between ADHD and TD, but not between ADHD and SLD. The latter result was not due to a co-occurrence of a learning disorder because the presence or absence of an associated diagnosis of SLD negligibly affected the pattern observed in ADHD. We concluded that the characteristics of intelligence in children with ADHD can be relevant for assessing this disorder, and that ADHD and SLDs share largely similar underlying cognitive features.

Adults with learning disabilities want loving relationships, but may need support.

The studyMcCarthy M, Bates C, Elson N, Hunt S, Milne-Skillman, Forrester-Jones R. 'Love makes me feel good inside and my heart is fixed': What adults with intellectual disabilities have to say about love and relationships. J Appl Res Intellect Disabil 2021;00:1-11.To read the full NIHR Alert, go to: https://evidence.nihr.ac.uk/alert/romantic-relationships-adults-with-learning-disabilities/.

Promoting academic success in college students with ADHD and LD: A systematic literature review to identify intervention targets.

Objective: College students with attention-deficit/hyperactivity disorder (ADHD) and/or a learning disorder (LD) are at higher risk for not attaining a bachelor's degree. The purpose is to identify the predictors of academic success in college for students with ADHD and/or LD using a systematic review of the literature. Method: Academic Search Premier, Education Full Text, Education Source, Education Resources Information Center, Teacher Reference Center, PsycINFO, PsycArticles, and Primary Search and relevant journals were searched using PRISMA guidelines. Studies were screened based on the following inclusion criteria: college students with ADHD and/or LD, student characteristics as predictors, and GPA and/or retention as outcomes. Results: Twenty-one studies were included (20 quantitative studies and 1 randomized control trial). Academic regulation, academic self-efficacy, emotional regulation, ADHD symptoms, and academic and social integration predicted college success. Conclusion: Incorporating these components into interventions with students with ADHD and/or LD may enhance their success in college.

The Effects of Data-based Instruction (DBI) for Students with Learning Difficulties in Korea: A Single-subject Meta-analysis.

Data-based instruction (DBI) is an ongoing process to utilize students' data for determining when and how to intensify intervention. It is an educational approach that is suggested as effective to enhance achievements of struggling learners, particularly for those who did not respond to intensive intervention in usual ways. In Korea, DBI was introduced and applied for students with learning difficulties especially since 2000 when the first Korea curriculum-based measurement (CBM) was developed as the name of Basic Academic Skills Assessment. Despite a number of studies accumulated since then, there has been a lack of research that examined the level of evidence-based practice (EBP) of DBI research. Thus, the present study sought to synthesize the DBI research so far in Korea by analyzing the effectiveness of DBI for school-aged students with learning difficulties via meta-analysis and evaluating the quality of the research. In this study, a total of 32 single-subject design studies were used. Multilevel meta-analysis revealed that the mean effect size of DBI was statistically significant (B = 1.34) and there was significant variance across participants in effect sizes. The results from the conditional model showed that exceptionality type, the number of sessions, and the length of each session were significantly accountable for the variability of effect sizes. In addition, the results of the qualitative analysis revealed the acceptable quality of the overall DBI research with some limitations. Based on these findings, implications and study limitations were discussed.

Queixa escolar: uma análise dos encaminhamentos de alunos aos serviços de saúde / School complaint: an analysis of the referrals of students to health services / Queja escolar: un análisis de los encaminamientos de alumnos a los servicios de salud

Fundamentada na perspectiva da psicologia escolar e educacional crítica, a presente pesquisa, realizada em um município baiano, objetivou conhecer as concepções de educadores e psicólogos sobre o encaminhamento das crianças com queixa escolar para serviços de saúde e investigar as modalidades de atendimento a esse fenômeno. De caráter qualitativo e exploratório, foi realizada uma entrevista semiestruturada, aplicada de forma individual, totalizando 12 participantes, cujas respostas foram organizadas em categorias temáticas relacionadas aos objetivos da pesquisa. Nas entrevistas, prevaleceu a concepção de que questões de ordem educacional e também familiares/sociais justificam os problemas de escolarização das crianças, cujo encaminhamento aos serviços de saúde tem sido a alternativa possível, mas não a ideal para avaliação e intervenção. Espera-se que os referidos achados suscitem novos estudos sobre o tema investigado, especialmente no município em questão, que favoreça o fortalecimento dos pressupostos da psicologia escolar/educacional crítica no meio acadêmico. Ressalta-se ainda a necessidade de fomentar essa discussão de forma intersetorial na rede municipal de educação e saúde, problematizando a compreensão e atendimento às queixas escolares, e que se possam produzir práticas psicológicas e educativas críticas e emancipadoras.

Deemed on the Psychology Schooling and Education perspective, this study was carried out in a city located in Bahia. The Study aimed to understand the conceptions of the Psycologists and Educators about the routing of children with scholar complain to health services and this study also purposed to assess the treatment models related to this phenomenon. From a qualitative and exploratory nature, semi structered interviews were conceded individually with 12 subjects, whose responses were organized into thematical categories related to the objectives of the present research. The data from interviews showed that a comprehension concept about educational and social/family issues justifies the children scholarization problems and the routing to health devices is seen as a possible alternative although this isn't the best evaluation nor intervention. It is expected that the data found here might entail other studies about the problem that was investigated on this paper and it's also expected that this study strenghs the Psychology Schooling and Education assumptions at academic level. It is necessary to emphasize the need to promote this discussion intersectorally in the municipal network, problematizing the understanding and attendance to scholar complain in order to promote, critical and emancipatory pschological practices.

Fundada en la perspectiva de la psicología educativa/escolar crítica, la presente investigación, realizada en una ciudad de Bahia, objetivó conocer las concepciones de educadores y psicólogos sobre el encaminamiento de los niños con queja escolar para servicios de salud e investigar las modalidades de atención a ese fenómeno. De carácter cualitativo y exploratorio, se realizaron encuestas con educadoras y psicólogas, totalizando 12 participantes cuyas respuestas fueron organizadas en categorías temáticas relacionadas a los objetivos de la investigación. En las entrevistas, prevaleció la concepción de que cuestiones de orden educacional y también familiares/sociales justifican los problemas de escolarización de los niños, cuyo encaminamiento a los servicios de salud ha sido la alternativa posible, pero no la ideal para evaluación e intervención. Se espera que estos hallazgos susciten nuevos estudios sobre el tema investigado, especialmente en el municipio en cuestión, que favorezca el fortalecimiento de los presupuestos de la psicología escolar / educativa crítica en el medio académico. Se resalta la necesidad de fomentar esa discusión de forma intersectorial en las escuelas públicas municipales, problematizando la comprensión y atención a las quejas escolares, y que se puedan producir prácticas psicológicas y educativas críticas y emancipadoras.