Language batteries used to assess the skills of elderly individuals, such as naming and semantic verbal fluency, present some limitations in differentiating healthy controls from patients with amnestic mild cognitive impairment (a-MCI). Deficits in narrative discourse occur early in dementia caused by Alzheimer's disease (AD), and the narrative discourse abilities of a-MCI patients are poorly documented. The present study sought to propose and evaluate parameters for investigating narrative discourse in these populations. After a pilot study of 30 healthy subjects who served as a preliminary investigation of macro- and micro-linguistic aspects, 77 individuals (patients with AD and a-MCI and a control group) were evaluated. The experimental task required the participants to narrate a story based on a sequence of actions visually presented. The Control and AD groups differed in all parameters except narrative time and the total number of words recalled. The a-MCI group displayed mild discursive difficulties that were characterized as an intermediate stage between the Control and AD groups' performances. The a-MCI and Control groups differed from the AD group with respect to global coherence, discourse type and referential cohesion. The a-MCI and AD groups were similar to one another but differed from the Control group with respect to the type of words recalled, the repetition of words in the same sentence, the narrative structure and the inclusion of irrelevant propositions in the narrative. The narrative parameter that best distinguished the three groups was the speech effectiveness index. The proposed task was able to reveal differences between healthy controls and groups with cognitive decline. According to our findings, patients with a-MCI already present narrative deficits that are characterized by mild discursive difficulties that are less severe than those found in patients with AD.
This systematic review sought to assess the impact of child maltreatment on cognitive functioning. Seventeen papers from Medline, PsycINFO, Embase and Amed (1995-2011) databases were analyzed based on inclusion/exclusion criteria. The studies have shown that maltreatment during childhood has deleterious effects on cognitive functioning. Overall, adults or children/teenagers exposed to abuse during childhood performed poorly on tasks meant to assess verbal episodic memory, working memory, attention, and executive functions. We conclude that child maltreatment is a risk factor for short and long-term development due to potential adverse effects on cognitive functioning. ResumoEste estudo buscou investigar os efeitos da exposição a maus-tratos sobre o funcionamento cognitivo através do método de revisão sistemática da literatura. Pelos bancos de dados Medline, PsycINFO, Embase e Amed (1995-2011), a partir de critérios de inclusão/exclusão, foram recuperados e analisados 17 trabalhos.Os estudos mostraram que há um efeito deletério de experiências de maus-tratos na infância no funcionamento cognitivo. De maneira geral, adultos ou crianças/adolescentes que sofreram maus-tratos na infância demonstraram um perfi l cognitivo inferior em tarefas que examinaram memória verbal episódica, memória de trabalho, atenção e componentes das funções executivas. Conclui-se que maus-tratos sofridos na infância constituem fatores de risco para o desenvolvimento, tanto a curto quanto a longo-prazo, pois podem acarretar prejuízos cognitivos. Palavras-chave: Maus tratos, funcionamento cognitivo, memória, funções executivas.
An innovative program focused on the promotion of parent-child reading aloud resulted in benefits to parent-child interactions and to child language and cognitive development that were greater than those provided by educational child care alone. This promising approach merits further evaluation at scale.
ResumoO objetivo deste estudo é apresentar o processo de desenvolvimento e validação de conteúdo do Instrumento de Avaliação Neuropsicológica Breve Infantil NEUPSILIN-INF, que avalia, de modo breve, componentes de oito funções neuropsicológicas em crianças em idade escolar: orientação, atenção, percepção visual, memória, habilidades aritméticas, linguagem, habilidades visuoconstrutivas e funções executivas. O processo envolveu: 1) análise do instrumento original NEUPSILIN e definição das funções e tarefas a serem adaptadas para avaliação neuropsicológica infantil; 2) desenvolvimento de novas tarefas consideradas fundamentais para a avaliação na infância; 3) estudo piloto 1 com a versão preliminar do instrumento; 4) análise de juízes especialistas; 5) estudos piloto 2 e 3, nova reformulação de tarefas do instrumento e elaboração de sua versão final. O instrumento apresentou adequada validade aparente e de conteúdo. Palavras-chave: Criança, Testes neuropsicológicos, Neuropsicologia, Cognição, Psicometria. Development of the Child Brief Neuropsychological Assessment Battery NEUPSILIN-INF AbstractThe aim of this study is to present the development process and content validation of Child Brief Neuropsychological Assessment Battery NEUPSILIN-INF, which briefly assesses the components of eight neuropsychological functions in school-aged children: orientation, attention, visual perception, memory, arithmetic abilities, language, visuoconstructive abilities and executive functions. The process comprised: 1) the analysis of the original NEUPSILIN instrument and definition of the functions and tasks to be adapted for the child neuropsychological assessment; 2) the development of new tasks considered as fundamental for the assessment in children; 3) pilot study 1 with the preliminary version of the instrument; 4) analysis by specialist judges; 5) pilot studies 2 and 3, new reformulation of the instrument's tasks and preparation of its final version. The instrument presented appropriate face and content validity.
The aim of this study was to assess the effect of family socioeconomic status (SES) and parental education on non-verbal IQ and on the processing of oral and written language, working memory, verbal memory and executive functions in children from different age ranges. A total of 419 Brazilian children aged 6-12 years old, attending public and private schools from Porto Alegre, RS participated in the study. Structural equation analyzes revealed that in the general model (for all ages), the SES contributed to cognitive performance -IQ, verbal memory, working memory, oral and written language and executive functions (28, 19, 36, 28 and 25 %, respectively). SES had stronger effects on younger children (up to nine years old), in most cognitive tasks examined. Probably, after this age, a combination of factors such as schooling, living in other social environments, among others, may mitigate the effects of family socioeconomic status.
TEMA: um instrumento de avaliação de déficits comunicativos após lesão de hemisfério direito: Bateria Montreal de Avaliação da Comunicação, versão brasileira adaptada do instrumento original canadense Protocole Montréal d'Évaluation de la Communication. Ferramentas de avaliação dos déficits discursivos, pragmáticos, léxico-semânticos e prosódicos são necessárias para o diagnóstico dos distúrbios da comunicação presentes em aproximadamente 50% dos indivíduos lesados de hemisfério direito. O quadro comunicativo após acometimento desse lado do cérebro vem sendo estudado sistematicamente há apenas duas décadas. OBJETIVO: apresentar a Bateria Montreal de Avaliação da Comunicação aos fonoaudiólogos brasileiros. CONCLUSÃO: o instrumento apresentado mostra-se uma ferramenta clínica útil no exame das habilidades lingüísticas e comunicativas relacionadas a quatro processamentos: discursivo, pragmático-inferencial, léxico-semântico e prosódico. Está normatizado, validado e sua fidedignidade foi confirmada. Embora tenha sido construído e adaptado para o exame dos distúrbios comunicativos em pacientes lesados de hemisfério direito, também pode auxiliar na investigação de seqüelas na comunicação em quadros de traumatismo crânio-encefálico, demência, lesões frontais bilaterais, lesões de hemisfério esquerdo, psicopatologias como a esquizofrenia, entre outros.
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