Olga Maria Bastos

Sexualidade e o adolescente com deficiência mental: uma revisão bibliográfica

Com o objetivo de discutir a sexualidade de adolescentes com deficiencia mental e as repercussoes familiares do adolescer, realizou-se uma revisao bibliografica a partir da base de dados da Bireme, analisando a producao de 1990 a 2003 sobre o tema. Os artigos mostram que os pais se deparam com novos desafios para a integracao social dos seus filhos com deficiencia mental quando estes chegam a adolescencia, especialmente com o despertar de sua sexualidade genital. Os trabalhos corroboram que os preconceitos no campo da sexualidade ainda estao presentes. Fica evidente o temor diante das manifestacoes sexuais desses adolescentes, como a masturbacao, e a dificuldade dos pais em lidar com a situacao. Pelo receio do abuso sexual e da gravidez decorrente, metodos contraceptivos, inclusive a esterilizacao, sao discutidos. A revisao da literatura indica, enfim, que o desenvolvimento da sexualidade se da igualmente nos adolescentes com e sem deficiencia, mas sao atribuidas representacoes distintas aos dois grupos. Conclui-se que a ampliacao do debate aos pais e adolescentes com deficiencia pode contribuir para que eles tenham uma vivencia da sexualidade com menos estigmas, menos exposta a riscos e, consequentemente, mais satisfatoria.

Diagnóstico situacional da violência contra crianças e adolescentes com deficiência em três instituições do Rio de Janeiro

We present a situational diagnostic about violence against children and adolescent with disability, which were done in three referenced institutions in Rio de Janeiro, from federal and municipal level and from the third sector, based in 53 case studies. This article considered a recent theoretical study of violence in the disability field and it demonstrates that this subject is embryonic in Brazil and Latin American. The relevance of this study is in the description we did of the diversity and richness of the recent forms of assistance in the disability field. It was analyzed how these institutions are being challenged to face violence and rights violation and to build protection strategies. Not only violence, but the poverty is another problem which is pointed out to these organizations. We concluded that when disability is associated to forms of violence and rights violation these institutions have developed social benefits and a social network in order to change disability people s quality of life. The central challenge is to promote change of cumulative disadvantages, to enhance capacities and to offer care and protection to disabled people and their families.

Family violence in a sample of children and adolescents with disabilities

This study aimed to identify and analyze the prevalence of physical and psychological family violence in a sample of children and adolescents with different categories of disabilities in a hospital in Rio de Janeiro, Brazil. This was a cross-sectional observational study based on application of the Parent-Child Conflict Tactics Scale in a sample of 270 parents or guardians. Prevalence was 83.7% for psychological aggression and 84.4% for physical maltreatment, while 96.5% of the children and adolescents with disabilities that suffered physical punishment were also victims of psychological aggression (p < 0.01) and 100% of those who suffered severe physical maltreatment also suffered psychological aggression (p = 0.01). Children and adolescents with disabilities showed increased risk of suffering family violence compared to those without disabilities. In conclusion, there is a need for greater awareness-raising and training of health teams for detection and notification of child abuse, and efforts should be made to support these families.O trabalho objetivou identificar e analisar a prevalencia da violencia familiar fisica e psicologica entre criancas e adolescentes com diferentes categorias de deficiencia em um hospital no Rio de Janeiro, Brasil. Estudo observacional, transversal realizado com aplicacao do instrumento Parent-Child Conflicts Tatics Scales numa amostra de 270 responsaveis. Mostrou-se a prevalencia de 83,7% para agressao psicologica e 84,4% para maus-tratos fisicos, e 96,5% das criancas e dos adolescentes com deficiencia que sofreram punicao corporal, tambem foram vitimas de agressao psicologica (p < 0,01), e todos os que sofreram maus-tratos fisicos graves sofreram agressao psicologica (p = 0,01). Criancas e adolescentes com deficiencia apresentam maior risco de sofrer violencia intrafamiliar do que aquelas sem deficiencia. Conclui-se haver necessidade de maior conscientizacao e capacitacao das equipes de saude em relacao a deteccao e notificacao dos casos de maus-tratos da populacao estudada e para as medidas de protecao, e esforcos devem ser feitos para apoiar essas familias.

A violência intrafamiliar e o adolescente que vive com HIV/AIDS por transmissão vertical: análise dos fatores de proteção e de vulnerabilidade

The scope of this study was to analyze protection and vulnerability factors in physical and psychological domestic violence among adolescents infected with HIV/AIDS through vertical transmission. This group is especially susceptible as they have vulnerability factors such as chronic disease, orphanhood with consequent change of caregivers and impaired body image. The research was conducted in a public hospital. The first stage used the Parent Child Conflict Tactics and the Degree of Psychological Violence Scale to determine what domestic violence occurred. In the second qualitative stage, the adolescents who scored the most or the least for violence in the quantitative instrument were interviewed. The questionnaires and the interviews revealed a high prevalence of physical and psychological violence and abusive domestic dynamics, thereby corroborating the extant literature. In view of the consequences of this kind of violence, it is essential that the health professional should be able to identify violent situations and recognize vulnerability factors and to promote protection factors against ill-treatment.

Sexualidade e deficiência intelectual: narrativas de pais de adolescentes

Pelo senso comum, adolescentes com deficiencia intelectual tem a sexualidade exacerbada ou sao assexuados. Para conhecer como vivenciam as manifestacoes sexuais de seus filhos, entrevistamos 14 pais de adolescentes com essa deficiencia. A analise das narrativas obtidas foi baseada em autores da antropologia. Nelas, observaram-se os preconceitos e o desconhecimento sobre o tema, bem como a reproducao da ideologia de genero da nossa sociedade. Nas narrativas dos pais de adolescentes do sexo masculino, a masturbacao, a relacao sexual e o medo de abuso sexual foram destaques, enquanto nas dos pais das adolescentes privilegiaram-se como tema as mudancas corporais e tambem o receio de que fossem abusadas sexualmente. A inadequacao entre desenvolvimento fisico e um comportamento sexual considerado socialmente improprio tambem foi alvo de narrativas. Aponta-se a necessidade de ampliacao do debate com os adolescentes, seus pais e diversos setores da sociedade para minimizar os preconceitos em relacao a sexualidade das pessoas com deficiencia intelectual, propiciando a garantia de seus direitos sexuais.

Violence prevention and health promotion

The article fits well with the recommendations of the Brazilian Policy of Reduction of Morbidity/Mortality by Accidents and Violence, which introduced the issue of violence in connection with health promotion. The expansion of the issue of violence, now related to a national public policy, is an important strategy in the attempt to reduce impairments resulting from violence in its different forms. The focus of the article, providing insight into the scenarios that allow for understanding the association between poverty, disability and violence, make it of huge importance. It also adds to the to the prescriptions for reducing maltreatment against people with disabilities.

Diretrizes para a saúde da criança: o desenvolvimento da linguagem em foco

Language disorders impact on child overall development. Policy directives for the child guide on ways to follow up child development for greater efficiency and effectiveness. The aim of this paper was to identify the policies positions of the proposals on the attention to language problems in the child health field. From a documental research, national and international guidelines were reviewed in order to identify actors, objectives, contexts, motivations, arguments, justifications and proposals regarding the follow of child development and child language. We performed a critical analysis in order to explain these positions and place on discussion the arguments that support them. The results point out to consensual aspects that place the problems of child development as vulnerabilities producers. Language problems cross the boundaries of political, scientific and social matters. These issues are challenges to interdisciplinary and intersectoral work and guide the need to promote the most effective responses of public policy for people requiring language support. The link of this discussion with the concepts of life cycle and human development for achieving full citizenship requires further deepening.

La violencia familiar y el niño y/o adolescente con discapacidad

This study aimed to identify and analyze the prevalence of physical and psychological family violence in a sample of children and adolescents with different categories of disabilities in a hospital in Rio de Janeiro, Brazil. This was a cross-sectional observational study based on application of the Parent-Child Conflict Tactics Scale in a sample of 270 parents or guardians. Prevalence was 83.7% for psychological aggression and 84.4% for physical maltreatment, while 96.5% of the children and adolescents with disabilities that suffered physical punishment were also victims of psychological aggression (p < 0.01) and 100% of those who suffered severe physical maltreatment also suffered psychological aggression (p = 0.01). Children and adolescents with disabilities showed increased risk of suffering family violence compared to those without disabilities. In conclusion, there is a need for greater awareness-raising and training of health teams for detection and notification of child abuse, and efforts should be made to support these families.O trabalho objetivou identificar e analisar a prevalencia da violencia familiar fisica e psicologica entre criancas e adolescentes com diferentes categorias de deficiencia em um hospital no Rio de Janeiro, Brasil. Estudo observacional, transversal realizado com aplicacao do instrumento Parent-Child Conflicts Tatics Scales numa amostra de 270 responsaveis. Mostrou-se a prevalencia de 83,7% para agressao psicologica e 84,4% para maus-tratos fisicos, e 96,5% das criancas e dos adolescentes com deficiencia que sofreram punicao corporal, tambem foram vitimas de agressao psicologica (p < 0,01), e todos os que sofreram maus-tratos fisicos graves sofreram agressao psicologica (p = 0,01). Criancas e adolescentes com deficiencia apresentam maior risco de sofrer violencia intrafamiliar do que aquelas sem deficiencia. Conclui-se haver necessidade de maior conscientizacao e capacitacao das equipes de saude em relacao a deteccao e notificacao dos casos de maus-tratos da populacao estudada e para as medidas de protecao, e esforcos devem ser feitos para apoiar essas familias.

A violência familiar e a criança e o adolescente com deficiências

This study aimed to identify and analyze the prevalence of physical and psychological family violence in a sample of children and adolescents with different categories of disabilities in a hospital in Rio de Janeiro, Brazil. This was a cross-sectional observational study based on application of the Parent-Child Conflict Tactics Scale in a sample of 270 parents or guardians. Prevalence was 83.7% for psychological aggression and 84.4% for physical maltreatment, while 96.5% of the children and adolescents with disabilities that suffered physical punishment were also victims of psychological aggression (p < 0.01) and 100% of those who suffered severe physical maltreatment also suffered psychological aggression (p = 0.01). Children and adolescents with disabilities showed increased risk of suffering family violence compared to those without disabilities. In conclusion, there is a need for greater awareness-raising and training of health teams for detection and notification of child abuse, and efforts should be made to support these families.O trabalho objetivou identificar e analisar a prevalencia da violencia familiar fisica e psicologica entre criancas e adolescentes com diferentes categorias de deficiencia em um hospital no Rio de Janeiro, Brasil. Estudo observacional, transversal realizado com aplicacao do instrumento Parent-Child Conflicts Tatics Scales numa amostra de 270 responsaveis. Mostrou-se a prevalencia de 83,7% para agressao psicologica e 84,4% para maus-tratos fisicos, e 96,5% das criancas e dos adolescentes com deficiencia que sofreram punicao corporal, tambem foram vitimas de agressao psicologica (p < 0,01), e todos os que sofreram maus-tratos fisicos graves sofreram agressao psicologica (p = 0,01). Criancas e adolescentes com deficiencia apresentam maior risco de sofrer violencia intrafamiliar do que aquelas sem deficiencia. Conclui-se haver necessidade de maior conscientizacao e capacitacao das equipes de saude em relacao a deteccao e notificacao dos casos de maus-tratos da populacao estudada e para as medidas de protecao, e esforcos devem ser feitos para apoiar essas familias.