Transtornos hipercineticos : contribuições do trabalho de Vygotisky para reavaliar o significado do diagnostico

AUTOR(ES)
DATA DE PUBLICAÇÃO

1997

RESUMO

This dissertation critically discusses the diagnosis of "Hiperkinetic Disorders" (HD). The proposed analysis assumes the importance of exploring an indicial paradigm articulated with a microgenetic analytical procedure founded on Lev Vygotsky s historical-cultural perspective. An empirical study was undertaken, focusing on children with HD, diagnosed through rocedures based on current classificatory criteria,. in order to examine the significance of inattention, hyperactivity, and impulsivity symptoms, within instances of intersubjective and dialogical processes, during various activities in which the children were involved. The group of subjects consisted of eight children who were selected from 154 clinic referred youths aged 8 - 13 years (Child Psychiatry Department of a Medical School). The selection of the focused subjects was made according to the stringent diagnostic criteria provided by World Health Organization - ICD-10/for research. The microgenetic methodology implies a qualitative analysis and effects a shi:ft from the individual-centered diagnostic evaluation to an approach that privileges interpersonal relationships. Consequently, this methodology can indicate the ways by which the other (examiner, peers) plays a fundamental role in the child s actions by inducing situations that may or may not lead to behaviors characterized as a clinical condition or disorder. The findings indicate that the presence or absence of signs of HD symptoms depend on whether the child s abilities are already developed or in process of development, and, mainly, on the type of interaction established between the subject and the examiner or peer. This means that the signs defining HD are, in fact, a result of dialogical interchanges and share actions inherent to intersubjective processes; that is the behavioral abilities (attention span, self-regulation) can be promoted or triggered by certain peculiarities of the social interaction. The analyses allow for a conclusion that no isolated symptoms or group of behaviors can characterize per se a particular disorder or intrinsic biological deficit, and that .the behavioral disorder normally diagnosed as HD seems to harbor a series of distinct conditions under its current definition. The use of microgenetic analysis showed that this is a valuable research tool as well as a useful clinical tool in the field of Child Psychiatry, since it permits to identify subtle dynamic-causal processes of human behavior and resort to a single set of criteria, thus integrating diagnosis, prognosis, and treatment

ASSUNTO(S)

neuropsicologia psicologia infantil psiquiatria infantil

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