Fernandes Vanessa Pacini Inaba
Prefeitura Municipal de Sumaré - Sumaré (SP), Brazil.
Rev Paul Pediatr. 2024 Nov 29;43:e2024106. doi: 10.1590/1984-0462/2025/43/2024106. eCollection 2024.
Learning disability leads to school dropout and low self-esteem in childhood, low socioeconomic status, increased criminality, and incarceration in adulthood. Pediatricians are key professionals who can diagnose and prevent this. The objective of the study was the early detection and reference of children with learning disabilities as identified by their schoolteachers.
The protocol included: specific anamnesis with parents; Snellen test; audiometry and central auditory processing test; referral to speech therapists, ophthalmologists, otorhinolaryngologists, psychiatrists, psychologists, and neurologists if necessary; validated screening tests to evaluate literacy and mathematics reasoning skills; and development of a report for parents and teachers on the suspected diagnosis, professional referral, and curricular adjustments.
A total of 15 patients were evaluated in 1 year, with a mean age of 10.3 years, median school fourth grade, and mostly males (80%). The time for final report delivery was 6.4 months. Visual impairment was identified in 35.7% and central auditory processing impairment in 100% of patients. For writing and reading skills, seven children had below average and two children had average scores; for mathematics skills, five had below average, one average, and one higher score. Six children were illiterate and were suspected of having autism spectrum disorder, attention-deficit hyperactivity disorder, oppositional defiant disorder, intelligence disability, or borderline intelligence coefficient.
A specific protocol helped to identify sensory organ impairments and psychological and psychiatric conditions, quantify school hardship, and provide a report with a suspected diagnosis and referral for treatment of learning disabilities. Larger population studies and a control group are necessary to validate this protocol.
学习障碍会导致儿童期辍学和自卑、社会经济地位低下、成年后犯罪率上升及被监禁。儿科医生是能够诊断和预防此病的关键专业人员。本研究的目的是早期发现并转诊由学校教师识别出的有学习障碍的儿童。
方案包括:与家长进行详细问诊;斯内伦视力测试;听力测定及中枢听觉处理测试;必要时转诊至言语治疗师、眼科医生、耳鼻喉科医生、精神科医生、心理学家和神经科医生;采用经过验证的筛查测试评估读写能力和数学推理能力;为家长和教师编写一份关于疑似诊断、专业转诊及课程调整的报告。
1年内共评估了15例患者,平均年龄10.3岁,就读于四年级,大多数为男性(80%)。最终报告交付时间为6.4个月。35.7%的患者存在视力障碍,100%的患者存在中枢听觉处理障碍。在读写能力方面,7名儿童得分低于平均水平,2名儿童得分处于平均水平;在数学能力方面,5名儿童得分低于平均水平,1名儿童得分处于平均水平,1名儿童得分较高。6名儿童为文盲,疑似患有自闭症谱系障碍、注意力缺陷多动障碍、对立违抗障碍、智力残疾或边缘智力系数。
一项特定方案有助于识别感觉器官障碍以及心理和精神状况,量化学业困难,并提供一份包含疑似诊断及学习障碍治疗转诊建议的报告。需要更大规模的人群研究和一个对照组来验证该方案。