Uma revisão de revisões sobre o que tem sido feito para potencializar a aprendizagem de crianças e adolescentes com deficiência intelectual

Abstract

Background: Intellectual disability (ID) affects 1 to 3% of the pediatric population, and teaching these children basic living skills, as well as optimizing their mental capital — resulting in better adaptability —, is a challenge. There is no current consensus as to the most effective strategies, and the extant literature is broad but still uncertain. Objectives: This overview aims to compile the most useful information and strategies for intervening in the learning of intellectually disabled children and adolescents, aiding clinical practice, decision making, and family care. Methods: A research protocol has been registered on PROSPERO under the number CRD42020195913. We searched the databases Medline, Cochrane, Scopus, Web of Science, Lilacs, SciELO, ERIC, and PsycINFO to amass systematic reviews and meta-analyses published since the year 2000 which investigated the impacts of multiple types of interventions on the learning of the selected population. Methodological quality has been assessed using the AMSTAR-2 tool. Main results: 59 studies were selected after the full-text examination. Those were divided by outcome domains and subdivided by the type of intervention. Outcome’s domains were personal-social, fine motor-adaptive, gross motor, or language-related. Interventions were related to caregiving, education, medication and diet, physical therapy, and similar strategies, or technology. Authors’ conclusions: Recommendations were made for each outcome domain using the evidence gathered in the studies. The data shows benefits of: caregiver stimulation of specific skills with careful explanation of activities, corrective feedback and engaging in play-behavior; 35 education with systematic instruction (e.g., high probability command sequences), and embedded instruction, with the support of behavioral analysis strategies; specific motor interventions, encouraging sport practicing, physical activities and animal-assisted therapy; the use of augmentative and alternative communication, and technological devices for support learning. The overall low methodological quality of the studies is a limiting factor for most recommendations, and the successful implementation will also depend on caregivers’ training, participation, and socio-economic status.