Transtorno do déficit de atenção e hiperatividade : conhecimento dos professores, adaptação e evidências de validade da escala kadds e características diagnósticas em crianças

Abstract

Studies carried out in several countries point to the teachers' lack of knowledge about Attention Deficit Hyperactivity Disorder (ADHD), an increase in prevalence in children and adolescents and, at the same time, an increase in erroneous diagnoses. For these reasons, the present doctoral thesis aims to assess the level of knowledge of public-school teachers in Rondônia about Attention Deficit Hyperactivity Disorder (ADHD) and to assess the characteristics of ADHD diagnoses performed in children. To this end, five studies were developed, one theoretical and four empirical - presented in the format of articles. The first article presents the result of a systematic literature review that aimed to assess the level of knowledge of basic education teachers about ADHD. A total of 22 studies were selected and the results indicate that teachers have a low level of knowledge and, in rare cases, only average about ADHD. The second article presents the adaptation of the Knowledge of Attention Deficit Disorders Scale (KADDS) to the Portuguese language, in Brazil. As a result of this study, we present the Knowledge of Attention Deficit Disorders Scale - Brazil (KADDS-Br) to be applied to Brazilian teachers. The third article investigated aspects of validity of KADDS-Br in a sample of 202 teachers in 18 municipalities, investigating its psychometric properties and internal consistency in the three subscales: general characteristics, symptoms/diagnosis, and treatment. The results indicated factor loads ranging from 0.33 to 0.87 and the adjustment indices were estimated CFI = (0.954), TLI = (0.951), RMSEA = (0.039) and the estimated reliability measures of Cronbach's alpha = 0.90, Omega = 0.80 and Avevar = 0,40. This study corroborated the construct's validity and reliability of the scale. The fourth article assessed the level of knowledge of teachers in Rondônia using KADDS-Br as an instrument. The responses to the items indicated knowledge about ADHD in 52.67% of the participants, with satisfactory knowledge about the domains evaluated in the subscales: general characteristics (46.45%), symptoms/diagnosis (69.54%) and treatment (48, 95%). Study five evaluated the characteristics of ADHD diagnoses performed in children. The neurology specialty was responsible for 75.63% of ADHD diagnoses and 66.6% of the reports/diagnosis do not inform the adopted protocol, tests or exams performed. In 39.9% of cases, children had comorbidities and the most prescribed medication was Methylphenidate Hydrochloride (Ritalin) in 55.9% of cases. Clinical diagnoses fulfill their role in identifying ADHD disorder, but there is an urgent need to improve the quality of the information contained in the reports/diagnosis. The results of this thesis: (1) provide an instrument to assess teachers' knowledge about ADHD in our environment; (2) identify important gaps in teachers' knowledge about the characteristics, symptoms and treatment options for ADHD; and (3) reveal limitations in establishing the diagnosis of ADHD among students in public schools in Rondônia.