Investigação de aspectos neuropsicológicos e acadêmicos em crianças e adolescentes sobreviventes de leucemia linfoide aguda - LLA

Acute lymphoblastic leukemia (ALL) is the most common type of cancer among children and adolescents. The sophistication of the diagnostic and therapeutic processes has promoted an increase in survival and reduction of relapse of the disease. The inclusion of prophylactic CNS therapy, performed th...

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主要作者: Gomes, Ediana Rosselly de Oliveira
其他作者: Pires, Izabel Augusta Hazin
格式: doctoralThesis
語言:por
出版: Brasil
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在線閱讀:https://repositorio.ufrn.br/jspui/handle/123456789/24491
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總結:Acute lymphoblastic leukemia (ALL) is the most common type of cancer among children and adolescents. The sophistication of the diagnostic and therapeutic processes has promoted an increase in survival and reduction of relapse of the disease. The inclusion of prophylactic CNS therapy, performed through chemotherapy and/or radiotherapy, has been identified as essential for therapeutic success, but it seems to be related to the emergence of late neuropsychological effects in about 30% of survivors. Studies suggest that changes in specific cognitive domains contribute to the decline of intellectual functioning and academic difficulties presented by this clinical population. The main objective of the present study was to investigate the neuropsychological and academic aspects of children and adolescents who survived ALL. The research was divided into four studies: 1) The intellectual functioning of children and adolescents diagnosed with ALL; 2) Attention and executive functions in pediatric survivors of ALL; 3) Translation and adaptation of the Deasy-Spinetta Behavioral Questionnaire (DSBQ); 4) Investigation of academic aspects in children and adolescents diagnosed with ALL. 26 children and adolescents surviving ALL who underwent chemotherapy (clinical group), 26 healthy children and adolescents (control group), 26 parents and 46 teachers took part in this study. The neuropsychological evaluation protocol included the following domains: intellectual functioning, attention, memory, executive functions, academic abilities and behavioral aspects. The results were analyzed by descriptive and inferential statistical tools. In study 1, the clinical group performed significantly lower than the control group. Maternal low schooling was associated with lower performance in verbal, nonverbal and global intellectual functioning. The younger age at diagnosis was correlated with low verbal domain, global intellectual capacity and working memory, and the latter was also associated with longer treatment completion time. Study 2 evidenced significantly lower performance of the clinical group in attention and executive functions, especially in the subgroup of children diagnosed before the age of five. The results of study 3 suggested that the DSBQ has an apparent or face validity, being a readily usable instrument. In study 4 the clinical group presented lower results in arithmetic, text comprehension and storage processes, learning evolution and information retrieval. Specific difficulties of school functioning were associated predominantly with the child's lower age at diagnosis. It is hoped that the knowledge produced by this study may contribute to the development of programs aimed at the reinsertion of the school and the elaboration of public policies for this clinical population, as well as the accomplishment of future studies in neuropsychology of development and learning.