Thiago da Silva Gusmão Cardoso

Cognitive and behavioral effects of obstructive sleep apnea syndrome in children: a systematic literature review

Obstructive sleep apnea syndrome (OSA) is a common respiratory sleep disorder in children that is believed to adversely affect both quality of life and cognition. The purpose of the present systematic review was to obtain evidence of the impact of OSA on childrens cognitive/behavioral abilities from primary studies published in MEDLINE/PubMed, LILACS, SciELO, ISI Web of Science, and PsycINFO databases from 2002 to 2016. Of the 649 articles found, only 34 met the eligibility criteria: studies that evaluated cognition, behavior, and/or academic achievement of children meeting clinical criteria for OSA to compare their data to those of healthy controls or normative data, provided that the samples did not present conditions that might affect cognition/behavior irrespective of OSA. The few selected articles with low risk of bias (levels of evidence I and II) showed that OSA childrens intellectual abilities may be impaired but remain within the normal range. Which specific cognitive ability drives this impairment is unclear, as there was insufficient evidence of deficits in language, memory, attention, executive functions, and academic performance, due to low levels of evidence, conflicting findings, and/or heterogeneity of tasks and cognitive abilities tapped by the measures used to assess these domains. To determine why this is so, future studies must test OSA patients using measures that allow for fractionated higher- and lower-order cognitive abilities based on accepted cognitive neuropsychology models.

Prevenção e remediação das dificuldades de aprendizagem: adaptação do modelo de resposta à intervenção em uma amostra brasileira

O objetivo deste estudo foi adaptar e colocar em pratica no contexto brasileiro um dos modelos mais aceitos de prevencao e remediacao das dificuldades de aprendizagem, a resposta a intervencao (RTI). A pesquisa foi realizada em duas etapas: i) adaptacao e implementacao da camada 1, intervencao coletiva instrucional, na qual participaram duas professoras de primeiro ano do ensino fundamental que aplicaram a RTI em sala de aula; ii) desenvolvimento e implementacao da camada 2, intervencao no grupo-alvo que permaneceu com desempenho abaixo da media no estudo 1. Participaram dez criancas e a intervencao ocorreu tres vezes por semana, com duracao de cerca de quarenta minutos cada. Todas as atividades tiveram como foco estrategias pedagogicas e interventivas baseadas nas habilidades cognitivas relacionadas a leitura. Os resultados do presente estudo mostram que esse pode ser um modelo adequado ao contexto brasileiro, sendo uma alternativa para avaliar e intervir nas necessidades dos alunos.