ABSTRACT
O artigo apresenta uma pesquisa de orientação psicanalítica sobre atendimentos educacionais/terapêuticos realizados na Educação Precoce, serviço educacional especializado oferecido pela Secretaria de Educação do Distrito Federal a crianças de zero a três anos e onze meses de idade, com atraso no desenvolvimento neuro-psicomotor. Neste estudo, duas crianças com Síndrome de Down foram observadas em atendimento. Os Indicadores Clínicos de Risco para o Desenvolvimento Infantil (IRDI) foram aplicados e as mães dos bebês foram entrevistadas. A finalidade do estudo e do presente artigo é salientar que determinadas intervenções educativas podem reproduzir junto aos pais o saber de especialistas advindos do discurso da ciência, o qual, em muitas circunstâncias, não só anula o saber parental como também eclipsa o lugar de sujeito da criança. O estudo destaca que a psicanálise pode apresentar-se como um aporte conceitual relevante para os profissionais que atuam na Educação Precoce e na Educação Infantil, pois os convoca à atitude de abertura à escuta, à fala e às observações das interações mãe-criança, de modo a localizar a posição que a criança ocupa na dinâmica materna e familiar, levando em conta a singularização dos pequenos sujeitos e subvertendo a lógica da padronização, da medicalização e da patologização.
El artículo presenta una investigación de orientación psicoanalítica sobre asistencia educativa/terapia realizada en educación temprana, servicio educativo especializado ofrecido por el Departamento de Educación del Distrito Federal - Brasil, a niños de 0 a 3 años y 11 meses de edad con retraso en el desarrollo. En este estudio dos niños con síndrome de Down, se aplicaron el protocolo IRDI o los indicadores clínicos de riesgo para el desarrollo infantil y se entrevistó a las madres de los bebés. El propósito del estudio es señalar que las intervenciones educativas también pueden reproducir con los padres el conocimiento de especialistas del discurso de la ciencia que, no solo anula el conocimiento de los padres, sino que también eclipsa la posición de sujeto del niño. El estudio destaca que el psicoanálisis puede presentarse como una contribución conceptual relevante para los profesionales que trabajan en la educación temprana, sino también en la educación de la primera infancia, ya que los llama a la actitud de apertura a la escucha, al habla y a las observaciones de las interacciones madre-hijo, de para ubicar la posición que ocupa el niño en la dinámica materna y familiar, teniendo en cuenta la singularización de los sujetos pequeños y subvirtiendo la lógica de estandarización, medicalización y patologización.
The article presents a psychoanalytic research about educational/therapeutic attendance, carried out at early Education, a specialized educational service offered by the Federal District Department of Education - Brazil, to children from 0 to 3 years and 11 months of age with neuropsychomotor developmental delay. In this study two children with Down syndrome were observed. The IRDI protocol or clinical indicators of risk for child development were applied and the mothers of the babies were interviewed. The purpose of this study is point out that Educational interventions can also reproduce with parents the knowledge of specialists from the discourse of science, which, in many circumstances, not only nullifies parental knowledge, but also eclipses the child's subject position. The study highlights that psychoanalysis can present itself as a relevant conceptual support for professionals who work in early education, because it calls them to the attitude of openness to listening, speech and observations of mother-child interactions in order to locate the place, the position that the child occupies in the maternal and family dynamics, taking into account the singularization of small subjects and subverting the logic of standardization, medicalization and pathologization.
Subject(s)
Humans , Female , Infant , Psychoanalysis , Down Syndrome , Early Intervention, Educational , Child Development , Clinical Protocols , Risk FactorsABSTRACT
Abstract Introduction: Although it is an essential component of the treatment of acute lymphoid leukemia in children, asparaginase causes adverse reactions that sometimes make it impossible to use it fully. Hypersensitivity reactions are the most frequent and may lead to early discontinuation of treatment. The present study aimed to investigate suspicions of adverse reactions during the infusion of asparaginase in a pediatric cohort. Methods: A retrospective observational study was carried out at a university pediatric institute in the state of Rio de Janeiro. Information regarding clinical features and characteristics of adverse reactions was collected from hospital medical records. Suspicions of adverse reactions were classified regarding causality and severity. Results: Seventy-three suspicions of adverse reactions were recorded during asparaginase infusion in 72 children in the study period. Allergic hypersensitivity reactions were suspected in 60.5% of the cases. Of these, 25% of the reactions occurred during induction and 61.1% in concomitant use with vincristine, findings that diverge from other studies. High-risk classification and younger age were considered risk factors for these reactions. A total of 72.4% of the reactions were classified as grade 1 or 2, which suggest that not all are related to antibody formation; this highlights the importance of differential diagnosis with other reactions, such as non-allergic hypersensitivity and hyperammonemia. Conclusion: The implementation of the differential diagnosis of reactions related to infusion of asparaginase with ammonia dosage and classification of the grade of reactions is crucial to facilitate the identification and proper management of each type of reaction.