Desenvolvimento psicológico e transtorno de déficit de atenção e hiperatividade (TDAH): a construção do pensamento operatório / Psychological development and Attention Deficit Hyperactitity Disorder (ADHD): the construction of operational thinking

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

Attention Deficit Hyperactivity Disorder (ADHD) is one of the most prevalent disorders in childhood and adolescence. Recent research shows that, at least from a cognitive level, there are important differences in the development of children with ADHD when compared with children without any psychiatric diagnosis. This work aims to contribute to the field of research on ADHD, seeking a more dynamic understanding of this disorder, surpassing the descriptive level of symptoms, incorporating aspects of Developmental Psychology. We believe that Piaget´s theory about the psychological development, the process of transition from pre-operative stage to concrete operative stage of development, is important for the theoretical understanding of this disorder, especially the construction of the operative notion of time. The general hypothesis was that children with ADHD present deficits in the development of operational concepts, such as conservation, reversibility and temporal seizure. Sixty two children, aged 6 to 12 years, were interviewed, and subdivided into two groups: a clinical sample of children diagnosed with ADHD (n = 32) and a sample composed by children without diagnosis (control group, n = 30). The clinical sample was divided between children who made use of methylphenidate, and children non-medicated, in order to see if the medication did some influence on the children´s performance in piagetian tasks. For the composition of groups, the K-SADS-PL was utilized, prepared according to the DSM-IV criteria. To assess the levels of inattention and hyperactivity, the parents and / or guardians answered two questionnaires: Conners´ Abbreviated Parents Rating Scale, and the Child Behavior Checklist (CBCL). According to the Piaget´s clinical interview, the following tasks were applied: Conservation of discrete quantities; Change of criteria - dichotomy; the tasks Succession of Events Perceived; Simultaneity, and The time of the action and the internal duration. Results show statistically significant differences between the performance of children from different groups, for piagetians tasks as a whole (p <0001) and, when analyzed separately, for the tasks Conservation of Discrete Quantities (p = 0003), Simultaneity, (p = 0004), and The time of the action and the internal duration. (p <0001). Children with ADHD showed a tendency to take their responses classified at levels lower than expected when compared to the control group. Regarding the use of methylphenidate in the clinical sample, there was no significant difference between groups. Although necessary of treatment, methylphenidate has not be sufficient to enhance the cognitive development of children with ADHD, overcoming the deficits observed. These findings support the hypothesis of deficits in the acquisition of concepts operative in children with ADHD. This calls for new thinking about the ADHD, considering alternatives for interventions that consider the deficits observed, surpassing the drug treatment.

ASSUNTO(S)

desenvolvimento infantil transtorno de falta de atenção com hiperatividade childhood development provas piagetianas psicogênese piagetian tasks cognitive processes psychogenesis attention deficit disorder with hyperactivity processos cognitivos

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