ABSTRACT
O objetivo do estudo foi avaliar a concordância entre múltiplos informantes sobre problemas de comportamento externalizantes e internalizantes de adolescentes entre 11 e 16 anos encaminhados para avaliação diagnóstica com queixas de desatenção e/ou hiperatividade. A amostra foi composta por 24 pais, 24 professores e 24 adolescentes que responderam aos questionários CBCL/6-18, TRF/6-18 e YSR/11-18, respectivamente, completando um total de 72 participantes. Em média, os pais reportaram mais problemas que os demais, o que levou a um maior número de casos na faixa clínica dos instrumentos. Os índices de concordância quanto à classificação dos problemas na faixa normal ou clínica dos instrumentos variaram de k=0,333 a k=0,120 e as correlações Q entre os pares de instrumentos variaram de 0,715 a 0,804, semelhantes às encontradas em trabalhos com amostras populacionais. As implicações para o diagnóstico clínico são discutidas tendo como base a importância da avaliação feita por múltiplos informantes para conhecer os comportamentos dos adolescentes com queixas de saúde mental em diferentes contextos e assim elaborar diagnósticos mais precisos e planejar intervenções mais adequadas.
The objective of this study was to verify the agreement rates among multiple informants regarding internalizing and externalizing behavioral problems in adolescents between 11 and 16 years old referred for diagnostic assessment with complaints of inattention and/or hyperactivity. The sample was composed by 24 parents, 24 teachers and 24 youths that filled the forms CBCL/6-18, TRF/6-18 and YSR/11/18, respectively, completing a total of 72 participants. On average, parents reported more problems than other informants for all problem-scales, which led to a greater number of cases identified in the clinical range of the form. Agreement indexes for classification of problems in normal vs. clinical range ranged from k=0.333 to k=0.120. Q Correlations for items ratings by pair of forms ranged from 0.715 to 0.804, similar to those found in other population sample studies. The implications for clinical diagnosis are discussed based on the important of multiple informants' assessment to understand adolescents' behaviors with mental health complaints in different contexts, to elaborate more accurate diagnoses and to plan appropriate interventions.
El objetivo de este estudio fue verificar los índices de concordancia entre múltiples informantes sobre problemas de conducta externalizantes e internalizantes de adolescentes entre 11 y 16 años llevados por los padres para evaluación diagnóstica por quejas de falta de atención y/o hiperactividad. La muestra del estudio fue compuesta por 24 padres, 24 profesores y 24 jóvenes (completando un total de 72 participantes) que llenaron los formularios CBCL/6-18, TRF/6-18 y YSR/11-18. En la media los padres reportaron más problemas que los otros informantes, lo que llevó a un mayor número de casos identificados en el rango clínico de los instrumentos. Los índices de concordancia de la clasificación de los problemas en el rango normal o clínico de los instrumentos variaron de k=0,333 a k=0,120 y las correlaciones Q entre los pares de instrumentos variaron de 0,715 a 0,804, datos que fueron semejantes a los encontrados en trabajos con muestras poblacionales. Las implicaciones para el diagnóstico clínico son discutidas teniendo como base la importancia de la evaluación hecha por informantes múltiples para conocer las conductas de los adolescentes con quejas de salud mental en diferentes contextos y así elaborar diagnósticos más precisos y planificar intervenciones más adecuadas.
Subject(s)
Psychology, Adolescent , Attention Deficit Disorder with Hyperactivity , Diagnostic Techniques and ProceduresABSTRACT
Este artigo apresenta um protocolo desenvolvido para a investigação de sinais de desatenção e hiperatividade em crianças e adolescentes, sob os aspectos comportamentais, neuropsicológicos e clínicos. A primeira fase é uma triagem telefônica. Na sequência, a avaliação é composta por uma triagem presencial, com preenchimento de um inventário comportamental (BPM) e realização de testes neuropsicológicos (QI estimado pelo Wisc-III e Test-CPT-II). Caso haja indicadores de desatenção e hiperatividade, o participante passa para terceira fase, na qual se concluem os instrumentos neuropsicológicos, que são aplicados a múltiplos informantes inventários de avaliação comportamental da plataforma Aseba. Após a realização dessa bateria, é feita uma avaliação com neurologista infantil. Nas devolutivas, os casos são encaminhados para acompanhamentos diversos em função dos sinais relatados. Abordagens multiprofissionais e de múltiplos informantes trazem maior clareza na identificação dos sinais compatíveis com o TDAH e aumentam os critérios de especificidade quanto à indicação de ações de intervenção.
This article presents a protocol developed for the investigation of signs of inattention and hyperactivity in children and adolescents, considering the behavioral, neuropsychological and clinical aspects. The first stage is a telephone triage. Further, the assessment consists of a face-to-face screening in which a behavioral inventory (BPM) is filled, and neuropsychological tests (IQ estimated by the Wisc-III and CPT-II Test) are performed. If there are indicators of inattention and hyperactivity the participant passes to the third stage. This stage is composed by complete neuropsychological instruments and inventories of behavioral assessment by multiple informants from Aseba approach. After this battery is finished, an evaluation with a pediatric neurologist occurs. When the feedbacks are given, the cases are addressed to diverse follow-ups according to the signals reported. Multidisciplinary and multiple informants’ approaches bring greater clarity in identifying ADHD compatible signs, and also increase the specificity criteria to intervention actions indication.
Este artículo presenta un protocolo desarrollado para la investigación de señales de desatención e hiperactividad en niños y adolescentes sobre aspectos conductuales, neuropsicológicos y clínicos. La primera fase es una entrevista telefónica. En la secuencia la evaluación es compuesta por una entrevista de despistaje presencial en la que es completado un inventario conductual (BPM) y son realizados testes neuropsicológicos (QI estimado por el Wisc-III y el Test-CPT-II). Caso existan indicadores de desatención e hiperactividad el participante pasa para la tercera fase. En la misma son concluidos los instrumentos neuropsicológicos y son aplicados a múltiplos informantes inventarios de evaluación conductual de la plataforma Aseba. Después de la realización de esa batería, es conducida una evaluación con un neurólogo infantil. En las devolutivas, los casos son encaminados para diversos acompañamientos en función de las señales relatadas. Enfoques multiprofesionales y de múltiplos informantes traen mayor clareza en la identificación de los señales compatibles con el TDAH y aumentan los criterios de especificidad cuanto a la indicación de acciones de intervención.
Subject(s)
Humans , Male , Female , Child , Adolescent , Attention Deficit Disorder with Hyperactivity , Comprehensive Health Care , Neuropsychology , Signs and Symptoms , Behavior , Sensitivity and Specificity , Decision Making , Growth and Development , Neuropsychological TestsABSTRACT
Selective attention directs cognitive resources to relevant objects or events through either voluntary (top-down) or automatic (bottom-up) control. This paper analyzes voluntary and automatic orienting of attention during childhood development. Seventy-four children (6 to 10 years old) were asked to press a key in response to a visual target presented in a previously oriented position (voluntary orienting; Experiment 1) or after a peripheral unpredictable cue (automatic orienting; Experiment 2). A systematic reduction of reaction times was observed in older children in both experiments. For automatic orienting in Experiment 2, reaction times were shorter in the ipsilateral condition than in the contralateral condition. However, for older children, the differences in reaction times between these conditions decreased. This may be attributable to the appearance of Inhibition of Return as a result of the maturation of the attentional system derived from childhood development, which contributes to more effective exploration of the environment.
Subject(s)
Humans , Male , Female , Child , Attention , Photic Stimulation , Reaction Time , Child DevelopmentABSTRACT
Selective attention directs cognitive resources to relevant objects or events through either voluntary (top-down) or automatic (bottom-up) control. This paper analyzes voluntary and automatic orienting of attention during childhood development. Seventy-four children (6 to 10 years old) were asked to press a key in response to a visual target presented in a previously oriented position (voluntary orienting; Experiment 1) or after a peripheral unpredictable cue (automatic orienting; Experiment 2). A systematic reduction of reaction times was observed in older children in both experiments. For automatic orienting in Experiment 2, reaction times were shorter in the ipsilateral condition than in the contralateral condition. However, for older children, the differences in reaction times between these conditions decreased. This may be attributable to the appearance of Inhibition of Return as a result of the maturation of the attentional system derived from childhood development, which contributes to more effective exploration of the environment.(AU)