Resumo A orientação a práticas parentais visa modificar o contexto no qual as crianças estão inseridas como forma de potencializar mudanças em seu comportamento. Esse artigo descreve uma intervenção breve de sete encontros em modalidade individual. O programa teve como finalidades principais auxiliar os cuidadores a identificar e estimular comportamentos adequados em seus filhos; ensinar novos comportamentos; incentivar a autonomia das crianças; encontrar abordagens não-agressivas para lidar com maus comportamentos; e auxiliar na organização da rotina. Como metodologia, realizou-se a descrição de três casos, exemplificando as estratégias adotadas em cada um. A análise dos casos permitiu o delineamento de características comuns entre as práticas parentais dos pais ou cuidadores. Os casos relatados neste estudo evidenciam que as famílias utilizam punição corporal, apresentam dificuldade de empatizar com a criança, possuem um estilo parental autoritário e expectativas incompatíveis com a idade das crianças. Além disso, a infância dos pais ou cuidadores apresentou forte influência no desenvolvimento de suas práticas parentais. A sobrecarga na figura materna também ficou evidente nos casos de famílias intactas. Por fim, a intervenção pode estabelecer um contato inicial da família com um serviço de psicologia, incentivando contato posterior com serviços que possam atender às demais dificuldades. A partir dos resultados examinados, conclui-se que a intervenção breve apresentou resultados positivos na mudança das relações familiares. Porém, o estudo precisa estabelecer uma medição quantitativa antes e depois da intervenção, além de uma sessão de seguimento para verificar se as mudanças são de longo prazo.
RESUMOEste estudo apresenta o processo de construção e evidências de validade de conteúdo da Escala de Funcionamento Adaptativo para a Deficiência Intelectual (EFA-DI). A EFA-DI foi elaborada a fim de avaliar o funcionamento adaptativo em crianças e adolescentes entre 7 e 15 anos por meio de relato parental, para auxiliar no diagnóstico de Deficiência Intelectual. O processo envolveu cinco etapas: fundamentação teórica; estabelecimento das dimensões e construção dos itens da versão preliminar; análise dos itens por quatro juízes especialistas; análise semântica dos itens pela população-alvo; e estudo piloto. Em sua versão final, 52 itens integram a EFA-DI. Estudos já estão em andamento para finalizar o procedimento de construção da EFA-DI, bem como para investigar suas evidências de validade, fidedignidade e normas de interpretação. Espera-se que a escala contribua às áreas de avaliação psicológica e desenvolvimento infantil no contexto brasileiro. Palavras-chave: funcionamento adaptativo; deficiência intelectual; avaliação; construção de testes. ABSTRACT -Development of the Adaptive Functioning Scale for Intellectual Disability (EFA-DI) and Evidence of Content ValidityThis study presents the process of development of the Adaptive Functioning Scale for Intellectual Disability (AFS-ID) and evidence of its content validity. The AFS-ID was conceived to assess the adaptive functioning of children and adolescents, aged between 7 and 15 years, through parental reports, covering Conceptual, Social and Practical domains. The development process involved five steps: designation of the theoretical framework; definition of the dimensions and development of the preliminary version; analysis of the items by four experts; semantic analysis of the items by the target population; and a pilot study. The final version consisted of 52 items. Studies are already in progress to finish the construction of the EFA-DI and to investigate its evidence of validity, reliability and norms of interpretation. We expect that the AFS-ID will contribute to the psychological assessment of childhood development in the Brazilian context.
Intellectual disability (ID) is a developmental disorder characterized by deficits in intellectual functioning and adaptive behavior. The fifth edition of the Diagnostic and statistical manual of mental disorders (DSM-5) defines adaptive functioning as a severity measure of ID. The availability of tests in the international context to assess this construct has increased in recent years. In Brazil, however, non-systematic assessment of adaptive functioning, such as through observation and interviews, still predominates. The Escala de Funcionamento Adaptativo para Deficiência Intelectual EFA-DI [Adaptive Functioning Scale for Intellectual Disabilities] is a new instrument developed in Brazil to assess the adaptive functioning of 7- to 15-year-old children and support the diagnosis of ID. This study’s objectives were to investigate evidence of validity related to the EFA-DI’s internal structure, criterion validity, and reliability. The psychometric analyses involved two statistical modeling types, confirmatory factor analysis (CFA) and item response theory analysis (IRT). These results highlight the EFA-DI scale’s strong psychometric properties and support its use as a parental report measure of young children’s adaptive functioning. Future studies will be conducted to develop norms of interpretation for the EFA-DI. This study is expected to contribute to the fields of psychological assessment and child development in Brazil.
Intellectual disability (ID) represents limitations in intellectual functioning and in adaptive behavior that originate before 22 years of age. Adaptive behavior is a set of conceptual, social, and practical skills that have been learned and are performed by people in their daily lives. Early intervention, followed by continuous and focused adaptive behavior, can increase the quality of life and improve ID presentation. This systematic review and meta-analysis aim to investigate adaptive behavior interventions for children and adolescents with ID and to analyze their effectiveness. We used Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Statement guidelines. The 20 identified studies vary in terms of participant characteristics and type and duration of interventions. We performed the meta-analysis by examining the differences in the standardized mean or mean differences. Heterogeneity was tested using the I² test. The meta-analysis results indicate a lack of general consensus in the field of ID studies regarding interventions for adaptive behavior. This does not imply that there are insufficient foundations for the construct or the interventions, just a lack of evidence and consensus for using a specific intervention protocol. In subgroup sensitivity analysis, ABA-based interventions showed significant improvement in the experimental group's adaptive behavior compared to the control group. The findings provide information for researchers and practitioners, highlighting areas that need future research and offering implications for practice.
IntroductionFamily psycho-education is an essential part of the treatment for people with severe mental illness (SMI), however this relevant intervention is underutilized. Shortened variations of family psycho-education have been described in attempts to make it more attractive, efficient, and feasible.Objectives/aimsConsidering the lack of manualized intervention for families in Brazil, our study comes up with a proposal to implement and to evaluate the feasibility of brief family psycho-education program (BFPP) during inpatient psychiatric treatment.MethodsAn extensive review using a combination of the words: “family psychoeducation”; “severe mental illness”; “schizophrenia”; “bipolar disorder” was conducted in PubMed/Medline with the aim to select reports of multifamily group psycho-educational programs. Studies involving adults with severe mental illness published until March 2016 were included.ResultsAfter the review of literature and meeting with experts in SMI, the BFPP was developed collaboratively by bipolar disorders’ team at Hospital de Clínicas de Porto Alegre (HCPA). The standard BFPP consists of four sessions: (1) causes, symptoms, course, prognosis and stigma of severe mental disorder; (2) treatment; (3) community resources, communication skills and importance of healthy and regular habits; and (4) problem-solving strategies: preventing relapses and establishing plans for crisis. Each session will occur weekly, lasting 90 min, with 8–12 caregivers. The patients did not attend the group.ConclusionWe purposed a standard, brief, cheap and simple intervention to apply. We believe that BFPP is highly suitable for caregivers of patients with SMI. We hope that this program demonstrates feasibility among participants and become a useful and effective intervention.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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