ECOLOGICAL AND A CONTEXTUAL INTERVENTIONS IN BEHAVIORAL REHABILITATION OF A CHILD WITH CEREBRAL PALSY

This study aims to propose an intervention program based on the context to behavioral problems of a child with cerebral palsy. The study is related to the interventions developed during the year of 2013 in a specific group of SARAH Network of Neurorehabilitation Hospitals, the Fifth Dimension. It is based on contextual approach, taking the contributions of Urie Bronfenbrenner, Mark Ylvisaker & Timothy Feeney, and Lucia Braga. The case report is a type of scientific presentation that enable an important source of information about interventions made with specific populations. In clinical practice with children that present cerebral palsy the evidence relating cerebral injury and behavioral problems is recent. However common problems include conduct disorder, emotional disorder and higher frequency of hyperactivity. In this study behavioral problems are understood as deficits or behavioral excess that inhibit new reinforcement contingencies and difficult new behaviors that are important to the learning process. The Fifth Dimension program is an educational system in which social interaction is a means for generalizing information and a basis for the development of skills. It was originally created in Laboratory for Comparative Human Cognition at University of California by Michael Cole. In 2006, the program was adapted to the rehabilitation context in Brazil and developed by SARAH Network of Neurorehabilitation integrating the activities to children with cerebral palsy. In this research, the subject, a six year-old child, before integrating the program presented agitate behavior, impulsivity, lack of behavioral regulation and deficits in social skills. It was promoted interventions through playful activities that possibilitated functional analysis about behavioral problems, antecedent management to modificate behaviors, alternative behavioral models through peers interactions; behavioral self-regulation and adjustment in parental and social management. The results indicate improvement in social skills; reduction in frequency and intensity of behavioral problems and development in family and social participation.