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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Médium: | doctoralThesis |
Jazyk: | por |
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Brasil
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On-line přístup: | https://repositorio.ufrn.br/jspui/handle/123456789/24491 |
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Shrnutí: | 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. |
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