Cognitive processes in spatial mapping: Evidence from a developmental spatial deficit.

We report a case study of an adolescent girl (N.K.Y.) with a developmental deficit affecting spatial processing. In a simple spatial mapping task, N.K.Y. shows a striking dissociation: She succeeds in one variant of the experiment in which the stimuli are objects, but struggles in a structurally identical task with people as stimuli. We present evidence that this dissociation stems from a tendency to automatically adopt the spatial perspective of other people, but not objects-a phenomenon also observed in neurotypical individuals. When adopting another person's perspective, N.K.Y. imagines herself in the other's position, representing the other's left and right as if it were her own. N.K.Y.'s deficit in relating left-right information to her own body then disrupts her performance. Our results shed light on the nature of N.K.Y.'s deficit as well as the cognitive operations involved in spatial perspective taking.

When the Analytic Patient has Attention Deficit Hyperactivity Disorder.

Most analysts are now treating or can expect to treat adult patients with cognitive deficits such as attention deficit hyperactivity disorder (ADHD), based on the prevalence of this syndrome in children and its continuation into adulthood. ADHD is a cognitive disorder considered by nonanalytic and analytic writers to be a dysfunction of affect regulation and behavioral inhibition. Analysis deals with these issues, and most analytic theories address affect regulation. Manifestations of ADHD can mimic the clinical expression of intrapsychic conflict, in which the cognitive deficits are embedded. If these symptoms are interpreted primarily as transference resistances without acknowledging the cognitive contribution, the patient may experience a resurgence of feeling misunderstood and shamed, helpless and defective. Confusion in the countertransference is a hallmark of analyses in which cognitive deficits are intertwined with psychic conflict, sometimes leading the analyst to compartmentalize the cognitive and the conflictual and to miss aspects of the patient and the process. Appropriate action within the analytic frame may be needed to help the patient seek information, specialists, or coaches to deal with limitations in executive functioning. A variety of technical considerations and confusions in the countertransference are illustrated.

Estado nutricional de crianças e adolescentes com necessidades especiais e deficiências múltiplas

Nas décadas de 1970 e 1980, as referências de desenvolvimento começaram a serutilizadas para auxiliar nas avaliações de crescimento de crianças e adolescentes.Porém, as crianças com deficiência apresentam uma velocidade de desenvolvimentodiferente, não podendo ser avaliados pelos mesmos métodos. Nos dias de hoje, tem –se as referências de desenvolvimento da OMS, NCHS/CDC, para paralisia cerebral(PC) e Síndrome de Down (SD). Este estudo teve como objetivo analisar se asreferências de crescimento disponíveis podem ser utilizadas em crianças eadolescentes com necessidades especiais e deficiências múltiplas acompanhadas emuma Instituição Beneficente no Estado de São Paulo. Participaram do estudo 98crianças e adolescentes, de ambos os sexos, com idade entre 1 e 19 anos, comdiversas deficiências, sendo 70% com diagnóstico de PC. Quando avaliadosPeso/Idade na referência de Steven et al, 90,8% estavam com o peso adequado. Aavaliação de Peso/Comprimento apresenta referência para pessoas sem deficiência,com isso, a taxa de adequação do peso foi de 70% na referência de desenvolvimentoda OMS e 65% na da NCHS/CDC. Comprimento/Idade, mostrou que a referência dedesenvolvimento de Steven et al, 100% dos meninos e 97,36% das meninas estavamcom a estatura adequada. Quando avaliado o Indice de Massa Corporal/Idade,novamente a referência de Steven et al ser mais adequada, 96,66% dos participantesmeninos e 94,73% das participantes meninas estavam com o IMC em eutrofia. Podeseconcluir que, para essa população, mesmo com as deficiências múltiplas, asreferências que mais se adequaram foram as referências de desenvolvimento para pessoas portadoras de PC.

In the decades of 1970 and 1980, developmental referrals began to be used to helpevaluate the development of children and adolescents. However, handicappedindividuals exhibit different development rates and therefore, cannot be evaluated bythe same methods. Nowadays, there are WHO developmental references, NCHS/CDCand which are specific for CP and DS. This study aimed at analyze whether theavailable developmental references can be used for children and adolescents withspecial needs and multiple handicaps in a benevolent Institution in São Paulo. Thestudy counted on the participation of 98 children and adolescents of both sexesbetween 1 e 19 years of age, with various disabilities, of which 70% had a PCdiagnosis. Weight/age was evaluated, for Steven et al. showed that 90.8% wereadequate weight. The weight/length is referenced only for non-handicappedindividuals, therefore, the adequacy index is of 70% on WHO’s reference and 65% onthe NCHS/CDC reference. Length/Age showed that Steven et al. reference, 100% ofthe boys and 97.36% of the girls were adequate heights. When BMI/Age wasevaluated, once again the developmental reference for CP was more adequate, where96.66% of the boys and 94.73% of the girls were with the BMI in eutrophy. It can beconcluded that, for this population, even with multiple deficiencies, the most adequatereferences are those that are specific to individuals with CP.