Dissertação

Avaliação comportamental de crianças com Síndrome do Respirador Bucal

The Mouth Breathing Syndrome (MBS) causes physical and behavioral characteristics that interfere on the child’s quality of life. The Attention Deficit Hyperactivity Disorder (ADHD) may be related to mouth breathing in the individual, as well as to the presence of Sleep Disordered Breathing (SDB). Mo...

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Autor principal: CASTELO BRANCO, Marília Fontes de
Grau: Dissertação
Idioma: por
Publicado em: Universidade Federal do Pará 2014
Assuntos:
Acesso em linha: http://repositorio.ufpa.br/jspui/handle/2011/5704
Resumo:
The Mouth Breathing Syndrome (MBS) causes physical and behavioral characteristics that interfere on the child’s quality of life. The Attention Deficit Hyperactivity Disorder (ADHD) may be related to mouth breathing in the individual, as well as to the presence of Sleep Disordered Breathing (SDB). Moreover, studies indicate that adenotonsillectomy reduces the occurrence of behavior indicative of ADHD in patients with MBS, and produces significant improvement in SDB. Objectives: (a) characterize the sociodemographic condition and risk indicators of children diagnosed with MBS; (b) analyze behavioral patterns associated with ADHD and sleep habits of children diagnosed with MBS, observed before and after adenoidectomy, tonsillectomy or adenotonsillectomy. The participants were 44 children, of both genders, between two and 12 years of age, seen in the Otorhinolaryngology Department of a university hospital. The sample was also composed by these children’s caregivers and teachers. Data collection was accomplished through: (1) Application of the Child and Family Information Form and the Developmental and Medical History Form with caregivers, followed by the Child Behavior Checklist - Caregiver Version (CBCL) and the criteria for ADHD diagnosis from DSM-IV; (2) Application of the Teacher’s Report Form (TRF); (3) Application of the Sleep Habits Inventory for Preschool Children and Sleep Behavior Questionnaire, for schoolchildren; (4) Post-surgery Behavioral Evaluation, using the CBCL and the sleep inventories, two months after surgery; and (5) Follow-up interview. Mostly, the mouth breathers: a) were school children; b) were 7-9 years old; c) were female; d) their primary caregiver had completed High School; e) his/her family income was around one and two minimum wages; f) had an original family constitution; g) were at a moderate psychosocial risk. It was observed that most participants in this study went through a normal pregnancy, with no events that could cause harm, and their delivery was also performed appropriately, however, part of the mouth breathers in this sample was cyanotic during or immediately after delivery and presented respiratory problems during the first months. Regarding the baby's temper in the first year of life, most of them were hyperactive and had difficulty falling asleep and being kept busy. The majority of the mouth breathers’ developmental milestones in this study happened in a period within the typical patterns of child development. The most frequent health problems were: appetite problems; and sleep problems. A decrease in frequency of ADHD-related behaviors was observed after surgery in both preschoolers and school children, according to data from CBCL (p = 0.723). And most items in the Sleep Habits Inventory for Preschool Children had a reduction in the frequency of inappropriate habits and an increase in the frequency of appropriate behaviors. In the Sleep Behavior Questionnaire, applied to school children, it was seen that few had sleep problems in the post-surgery evaluation and most sleep problems were reduced in frequency. The greatest reductions occurred in moves a lot while sleeping and snores in his/her sleep (p = 1.000). The preventive multidisciplinary assessment of mouth breathing is suggested as well as the incorporation of a control group, composed by nasal breathers, in future studies.