Dados do Trabalho

Título

THE IMPACT OF THE PANDEMIC ON THE OUTPATIENT FOLLOW-UP OF PATIENTS WITH SCHOOL DIFFICULTIES

Introdução

The COVID-19 pandemic has had an impact on learning and the difficulty in accessing medical care has aggravated pre-existing conditions such as learning disabilities (LD) and neurodevelopmental disorders (NDD).

Objetivo

The aim of this study is to outline the clinical profile of patients before and after the pandemic and their adherence to the outpatient clinic for school difficulties, in the post-pandemic period, among children and adolescents diagnosed with LD and NDD.

Método

This is a retrospective cross-sectional descriptive study, used as a scientific initiation project approved by the CEP under CAAE 34383220.9.0000.5558. Identification was made of non-syndromic patients with LD and NDD, with a history of at least 3 ambulatory consultations between 2014 and 2020. The following aspects were assessed: age, gender, diagnosis, length of pre-pandemic follow-up and follow-up resumption after the pandemic (from 2022 onwards).

Resultados

298 patients with a diagnosis of LD and/or non-syndromic NDD were identified, of which only 117 met the inclusion criteria. The average age was 12.7 years and 69.8% were boys. ADHD was the most prevalent isolated disorder (28%), followed by autism spectrum disorder (13%). The association of LD and ADHD was observed in 13%, with dyslexia being the most prevalent LD (15%). The average pre-pandemic follow-up time was 2.27 years (min = 6 months; max = 7 years). Around 51% continued to be followed up in the post-pandemic period. Of these, almost 70% had their therapy readjusted (increased or added to) because other comorbidities had been identified, such as major depressive disorder (MDD) in 24%, generalized anxiety disorder (GAD) in 19% and binge eating disorder (BED) in 10%.

Conclusão

In the pre-pandemic period, the main diagnoses were LD and NDD and the pandemic had a negative impact on adherence to outpatient follow-up. Just over half returned for assessment after the pandemic, with the addition of other diagnoses such as GAD, BED and MDD and the need for therapeutic adjustments. Quarantine, bereavement, difficulty in accessing multidisciplinary care, family stress, screen abuse are some factors that may explain the low adherence to post-pandemic follow-up and the negative impact on behavior and the learning process.

Referências

1) Colvin MK, Reesman J, Glen T. Reforming learning disorder diagnosis following COVID-19 educational disruption. Nat Rev Psychol. 2022;1:251–252.

2) Colvin MKM, Reesman J, Glen T. O impacto da interrupção educacional relacionada à COVID-19 em crianças e adolescentes: um resumo de dados provisório e comentário sobre dez considerações para a prática neuropsicológica. Clin Neuropsicol. 2022;36:45–71.

3) Kawaoka N, Ohashi K, Fukuhara S, Miyachi T, Asai T, Imaeda M. Impacto do fechamento de escolas devido à COVID-19 em crianças com transtornos do neurodesenvolvimento no Japão. Jornal de Autismo e Transtornos do Desenvolvimento. 2021

4) Breaux R, Dvorsky MR, Marsh NP, Green CD, Cash AR, Shroff DM. Impacto prospectivo de COVID-19 no funcionamento da saúde mental em adolescentes com e sem TDAH: papel protetor das habilidades de regulação emocional. Jornal de Psiquiatria e Psiquiatria Infantil. 2021;62:1132–1139.

Palavras Chave

Learning Disabilities; Neurodevelopment; COVID-19 Pandemic