RESUMO
This study focuses on the cross-cultural adaptation of the Emotional Outburst Questionnaire (EOQ) to Brazilian Portuguese and preliminarily assesses its predictive validity. The EOQ evaluates aspects of emotional outbursts (EO), including frequency, duration, intensity, types, associated behaviours, recovery time, triggers, and effectiveness of calming strategies. Two independent translators performed the translation, with subsequent synthesis and analysis revealing that only 33 items (24.81%) required revision. Among these, one item needed partial modification, and two needed total modification. The study demonstrated strong content validity and adaptation in terms of conceptual, idiomatic, and semantic aspects. The EOQ's predictive validity was assessed by analysing the interruption of mental health services in Brazil due to Covid-19 (T1) compared to when services resumed after social distancing measures were lifted (T2). Parents of 25 individuals with developmental disabilities (ASD, DS and ID), with a mean of 11 y/o, mostly male (76%), completed the EOQ. Service interruption during T1 led to increased frequency and duration of severe emotional outbursts reported by caregivers compared to T2 (frequency: p < .001; duration: p = 0.05). This suggests that the EOQ exhibits predictive validity and sensitivity to changes influenced by individual contexts. These findings highlight the EOQ's potential as an outcome measure for intervention development.
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Emoções , Transtornos do Humor , Humanos , Masculino , Feminino , Brasil , Psicometria , Pessoal Técnico de SaúdeRESUMO
The causal relationship between emotional outbursts and emotion dysregulation is proposed to be heterogeneous, but cultural influences have not been considered despite established cultural differences in emotional processes (e.g., increased motivation to suppress emotions in interdependent cultures). Responses to the Brazilian Portuguese version of the Emotional Outburst Questionnaire were collected from 327 caregivers of young people (6-25 years) with autism spectrum disorder, Down's syndrome, or intellectual disability. Responses were compared to a previous sample of 268 responses from the English version of the questionnaire. The latent factor structure of the contextual items was measurement invariant across both versions. The Brazilian responses were classified into three distinct clusters (Sensory Sensitivity; Perceived Safety; Perceived Unsafety) which considerably overlapped with the English clusters.
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Transtorno do Espectro Autista , Comparação Transcultural , Humanos , Adolescente , Emoções , Inquéritos e Questionários , Transtornos do Humor , BrasilRESUMO
Sleep problems are common in children and adolescents, particularly those with Neurodevelopmental Disorders. With the changes in daily habits resulting from the COVID-19 pandemic, we have analyzed sleep characteristics, during social isolation, in Brazilian children and adolescents aged between 4 and 12 years with Autism Spectrum Disorder (N = 267), Down Syndrome (N = 74), and typical development (N = 312). The ASD group presented with worse indicators of sleep habits in the Children's Sleep Habits Questionnaire (CSHQ-BR) and fell asleep later during the pandemic. The entire group started fall asleep and waking up later during the pandemic - as well as waking up more often during the night. These results may contribute to parental guidance and sleep habit-related interventions during and after the COVID-19 pandemic.
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OBJECTIVES: To translate to Brazilian Portuguese, culturally adapt and confirm the psychometric parameters of validity and reliability of the Children's Sleep Habits Questionnaire (CSHQ-BR) in children. METHODS: A sample of 314 typically developing children, 51% girls, mean age 7.12 years (SD = 2.04 years) were assessed, comprising 227 from São Paulo and 87 from the Amazon region. Translation, back translation, cultural adaptation, a pilot study and item review were carried out, yielding the final version of the CSHQ. Psychometric parameters were determined based on content validity coefficient (CVC), test-retest, internal consistency, evidence of convergent validity and internal structure. RESULTS: The final CVC for the scale was 0.88. Intraclass correlation was 0.98 for the overall questionnaire and ranged from 0.88 to 0.98 for subscales. CSHQ-BR internal consistency was α = 0.81 for the CSHQ-BR total score (95% CI) and from 0.51 to 0.75 for subscales. Exploratory factor analysis suggested a novel 4-factor structure. A positive correlation was found between the CSHQ and the Questionnaire on Sleep Behavior. Mean total CSHQ score in Brazilian children was 46.85 (SD = 9.43), and boys had a higher mean total score than girls, although not statistically significant. CONCLUSION: The CSHQ-BR exhibited satisfactory equivalence for the original English abbreviated form and the Brazilian Portuguese version, proving a useful sleep screening instrument for identifying sleep problems in Brazilian children aged 4-10 years.
Assuntos
Transtornos do Sono-Vigília , Criança , Feminino , Masculino , Humanos , Psicometria , Brasil , Reprodutibilidade dos Testes , Transtornos do Sono-Vigília/diagnóstico , Projetos Piloto , Sono , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: This study addressed dance practice intertwining communication, functional independence and social behavior in autistic children and adolescents with all levels of need support. DESIGN: A pilot randomized clinical trial with seventy-two participants between 8 and 15 years old were assessed for eligibility. SETTING: Theater rehearsal room and mental health clinic. INTERVENTIONS: Dance group (n = 17) or control group (n = 19), 24 sessions, once a week, lasting 40 min. MAIN OUTCOME MEASURES: The Autism Behavior Checklist (ABC), Autistic Screening Questionnaire (ASQ), Childhood Autism Rate Scale (CARS), Functional Independence Measure (FIM), and World Health Organization Disability Assessment Schedule (WHODAS, version 2.0, to assess mothers' functioning) were applied at two time points: baseline and end-point. RESULTS: Differences between dance and control groups were significant at post-intervention for communication (mean difference: 1.31; 99.8%CI: 0.29, 2.32, p < 0.001, d = 0.93); social cognition (mean difference: 1.01; 99.8%CI: 0.13, 1.89, p < 0.001, d = 0.82); autistic behavior (mean difference: 11.82; 99.8%CI: 17.33, -6.31, p < 0.001, d = 1.45). CONCLUSIONS: In this preliminary study, the findings provide ways of communication and social interaction through dance practice by autistic children and adolescents with all levels of support needs. Research on neurodiversity is needed to understand its feasibility and the lifestyle appropriation.
Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Dança , Criança , Adolescente , Humanos , Transtorno Autístico/terapia , Projetos Piloto , ComunicaçãoRESUMO
This study analyzed the exposure of women engaged in prostitution in downtown São Paulo to COVID-19. This cross-sectional study had a convenience sample selected in May 2021. We interviewed 219, mostly black, middle-aged, poor women with comorbidities. Among them, 61 had shown COVID-19 symptoms, 23, tested positive for the disease, seven underwent hospitalization, and four reported post-COVID-19 complications. Only 26 (30.2%) had been vaccinated. In addition to gender, race, and class inequalities, these women suffer both from a higher risk of contracting COVID-19 due to their working conditions and from the subsequent worsening of that disease due to age and lack of vaccination.
Assuntos
COVID-19 , Brasil/epidemiologia , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , SARS-CoV-2 , Trabalho SexualRESUMO
Atypical attention has been reported in individuals with autism spectrum disorder (ASD) with studies pointing to an increase in attention deficit and hyperactivity disorder-like symptomatology. Individuals with ASD may also present academic difficulties and it is possible that they face a double-barrier for academic attainment from both core ASD symptomatology and from attention atypicalities, which are directly linked to academic performance. This raises the possibility that academic difficulties in ASD may benefit from cognitive training targeting attention. To test this possibility, we used the computerized progressive attentional training (CPAT) intervention in a double-blind, active control with follow-up intervention study in Brazil. The CPAT is a computerized attention training program that was recently piloted with schoolchildren with ASD in the UK. Twenty-six participants (8-14 years) with ASD in the São Paulo's ASD Reference Unit were assigned to either the CPAT (n = 14) or active control group (n = 12), which were matched at baseline. Two 45-min intervention sessions per week were conducted over a 2-month period. School performance, attention, fluid intelligence, and behavior were assessed before, immediately after and 3 months following the intervention. Significant group by time interactions show improvements in math, reading, writing and attention that were maintained at follow-up for the CPAT (but not the active control) group, while parents of children from both groups tended to report behavioral improvements. We conclude that attention training has the potential to reduce obstacles for academic attainment in ASD. Combined with the previous pilot study, the current results point to the generality of the approach, which leads to similar outcomes in different cultural and social contexts. LAY ABSTRACT: Attention difficulties tend to occur in ASD and are linked to academic performance. In this study, we demonstrate that school performance in math, reading and writing in children with ASD can improve following an intervention that trains basic attention skills (the CPAT intervention). The improvements we report are stable and were maintained 3-months following the intervention. This study, which was conducted in a public-health setting in Brazil, extends previous research in schools in the UK pointing to the cross-cultural and cross-settings efficacy of the intervention.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Espectro Autista , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Transtorno do Espectro Autista/complicações , Transtorno do Espectro Autista/terapia , Brasil , Criança , Humanos , Projetos Piloto , LeituraRESUMO
BACKGROUND: Autism Spectrum Disorder (ASD) is characterized by impairments in social interaction, restricted and repetitive behaviour, interests or activities. Difficulties in a broad spectrum of cognitive skills is often present, including attentional processes and nonverbal intelligence, which might be related to academic difficulties. AIMS: In this study, the association between attentional skills and nonverbal intelligence to school performance of children with ASD was assessed. METHODS AND PROCEDURES: 32 children/adolescents between 8-14 years old, who attended a treatment unit linked to the public health system of São Paulo-Brazil participated in the study. The following instruments were utilized: Cancellation Attention Test; Raven's Coloured Progressive Matrices; and School Performance Test. OUTCOMES AND RESULTS: After correlation analysis, statistically significant associations were found between attention and nonverbal intelligence with school performance. Regression analysis showed that attention drives school performance irrespective of nonverbal intelligence. CONCLUSIONS AND IMPLICATIONS: Results evidence the link between attention and school performance in ASD, suggesting that attentional mechanisms may be a promising route to follow in the design of interventions for school improvement of children and adolescents with ASD.
Assuntos
Transtorno do Espectro Autista , Adolescente , Atenção , Brasil , Criança , Humanos , Inteligência , Saúde Pública , Instituições AcadêmicasRESUMO
INTRODUCTION: Most children/adolescents with disability live in low and middle-income countries and, worldwide, they are more likely to have mental health problems and achieve worse academic performance compared to those with typical development. OBJECTIVE: To assess whether Brazilian children/adolescents with four types of disabilities are more likely to have psychiatric disorders and educational deficits than children/adolescents with typical development. METHOD: A multicenter cross-sectional study involving a school-based probabilistic sample of second to sixth graders (N = 1,674) from public schools in four Brazilian regions. The four types of disabilities (intellectual, visual, hearing, and motor) were assessed using the Ten Questions Questionnaire. Psychiatric disorders were measured with the Schedule for Affective Disorders/Schizophrenia for School-Age Children (K-SADS-PL), and academic performance was evaluated using the Teste de Desempenho Acadêmico - TDE (the academic performance test). RESULTS: A logistic regression model with cluster-robust errors identified the following statistically significant associations with three of the four types of disability (the exception was hearing). Intellectual disability was associated with anxiety (p < 0.01), depression (p < 0.01), attention deficit hyperactivity disorder (ADHD) (p < 0.001), school failure (p < 0.01), and poor academic performance (p < 0.01). Visual disability was associated with depression (p < 0.01). Motor disability was marginally associated with ADHD (p = 0.08). CONCLUSIONS: Presence of disabilities (intellectual, visual, and motor) in children/adolescents was associated with psychiatric disorders, school failure, and academic performance. It is therefore important to identify presence of disabilities and plan and deliver specific interventions and specialized educational care for the needs presented by these children/adolescents. This is particularly important in low and middle-income countries, where these disabilities are frequent among children/adolescents.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Pessoas com Deficiência , Transtornos Motores , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Criança , Estudos Transversais , Escolaridade , HumanosRESUMO
OBJECTIVE: To translate into Portuguese, back-translate, culturally adapt and validate a screening instrument for pervasive developmental disorder, the Autism Screening Questionnaire, for use in Brazil. METHOD: A sample of 120 patients was selected based on three groups of 40: patients with a clinical diagnosis of pervasive developmental disorder, Down syndrome, or other psychiatric disorders. The self-administered questionnaire was applied to the patients' legal guardians. Psychometric measures of the final version of the translated questionnaire were tested. RESULTS: The score of 15 had sensitivity of 92.5% and specificity of 95.5% as a cut-off point for the diagnosis of pervasive developmental disorder. Internal validity for a total of 40 questions was 0.895 for alpha and 0.896 for KR-20, ranging from 0.6 to 0.8 for both coefficients. Test and retest reliability values showed strong agreement for most questions. CONCLUSIONS: The final version of this instrument, translated into Portuguese and adapted to the Brazilian culture, had satisfactory measurement properties, suggesting preliminary validation proprieties. It was an easy-to-apply, useful tool for the diagnostic screening of individuals with pervasive developmental disorder.
Assuntos
Transtorno Autístico/diagnóstico , Transtornos Globais do Desenvolvimento Infantil/diagnóstico , Comparação Transcultural , Programas de Rastreamento , Inquéritos e Questionários/normas , Análise de Variância , Transtorno Autístico/psicologia , Brasil , Criança , Transtornos Globais do Desenvolvimento Infantil/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Métodos Epidemiológicos , Feminino , Humanos , Idioma , Masculino , Psicometria , TraduçãoRESUMO
OBJECTIVES: To translate and back-translate the Autism Diagnostic Observation Schedule (ADOS) into Brazilian Portuguese, to assess its cross-cultural semantic equivalence, and to verify indicators of quality of the final version by analyzing the inter-rater reliability of the ADOS scores. METHODS: This study had three stages: 1) translation and back-translation; 2) semantic equivalence analysis; and 3) pre-test to verify the agreement between mental health specialists and an ADOS senior examiner regarding the scoring procedure. Authorization to translate and carry out the cultural adaptation of the instrument was first obtained from the Western Psychological Services, publishers of the instrument. RESULTS: The main preliminary results pointed to good equivalence between the original English version and the final version and the Brazilian version following the cultural adaptation process. Some semantic differences were found between the original version and the back-translation into English, but they did not interfere with the first translation into Portuguese or into the final version. One of the limitations of the study was the small sample size; for that reason, the inter-rater reliability of the ADOS scores between the specialists and the senior examiner using the kappa coefficient was adequate for 7 out of 10 areas. CONCLUSIONS: We conclude that the creation of an official Brazilian version of ADOS will help to strengthen clinical and scientific research into ASD, and deter the use of other unauthorized versions of ADOS in the country.
Assuntos
Transtorno Autístico/diagnóstico , Semântica , Brasil , Comparação Transcultural , Humanos , Idioma , Variações Dependentes do Observador , Portugal , Psicometria , Reprodutibilidade dos Testes , TraduçõesRESUMO
The frequencies of pervasive developmental disorder (PDD) in Down's syndrome (DS) have been reported from 1% to 11%. However, it is not clear if the frequency of this co-occurrence is higher or lower than in other mental retardations. We study a large sample of DS population, finding a PDD frequency of 15.6%, with 5.58% of autism (eight males and two females) and 10.05% of PDD non autism (nine males and nine females. The meaning of this frequency is discussed.
Assuntos
Transtornos Globais do Desenvolvimento Infantil/epidemiologia , Síndrome de Down/epidemiologia , Adulto , Criança , Feminino , Humanos , Masculino , PrevalênciaRESUMO
Este estudo investigou a relação entre hábitos de sono e indicadores de saúde mental na infância relatados por cuidadores, além de buscar evidências de validade e precisão da adaptação para o Brasil do Children's Sleep Habits Questionnaire (CSHQ). Participaram 60 crianças, entre 4 e 10 anos, de uma escola pública da região central de São Paulo, em 2019. A média geral no CSHQ-BR foi 49,08. Não houve diferenças de sexo nos escores do CSHQ e do Strengths and Difficulties Questionnaire (SDQ). Houve correlações positivas e significativas entre o CSHQ e o SDQ, especificamente entre dificuldades, parassonias e distúrbios respiratórios do sono com problemas emocionais e hiperatividade. Hábitos de sono explicaram 23% da variância no SDQ. O coeficiente alfa de Cronbach do CSHQ-BR foi 0,75, indicando consistência interna adequada. Esses achados apontam evidências de validade e precisão do CSHQ-BR. Hábitos de sono estão associados a indicadores de problemas emocionais e comportamentais.
This study investigated the relationship between sleep habits and mental health indicators in childhood reported by caregivers, in addition to seeking evidence of validity and reliability of the Children Sleep Habits Questionnaire (CSHQ), Brazilian version (CSHQ-BR). Sixty children participated, between 4 and 10 years old, from a public school in the central region of São Paulo, in 2019. The overall mean of the CSHQ-BR score was 49.08. There were no differences between sex in the CSHQ and the Strengths and Difficulties Questionnaire (SDQ) scores. Positive and significant correlations were observed between the CSHQ and the SDQ, specifically between difficulties, parasomnias, sleep-disordered breathing with emotional problems, and hyperactivity. Sleep problems explain 23% of the variance of the SDQ scores. The Cronbach's Alpha Coefficient was 0.75, indicating adequate internal consistency. These findings point to evidence of the validity and accuracy of the CSHQ-BR. Sleep habits are associated with indi-cators of emotional and behavioral problems
Se investigó la relación entre hábitos de sueño y indicadores de salud mental infantil reportados por cuidadores, además de buscar evidencia de validez y precisión de la adaptación del Cuestionario de Hábitos de Sueño Infantil (CSHQ) para Brasil. En 2019 participaron 60 niños de 4 a 10 años de una escuela pública de la región central de São Paulo. El promedio general en el CSHQ-BR fue 49,08. No hubo diferencias de género en las puntuaciones del CSHQ y del Cuestionario de Fortalezas y Dificultades (SDQ). Hubo correlaciones positivas y significativas entre CSHQ y SDQ, específicamente entre dificultades, parasomnias y trastornos respiratorios del sueño con problemas emocionales e hiperactividad. Hábitos de sueño explicaron 23% de la variación en el SDQ. El coeficiente alfa de Cronbach de CSHQ-BR fue 0,75, indicando una consistencia interna adecuada. Estos hallazgos apuntan evidencia de validez y precisión del CSHQ-BR. Hábitos de sueño están asociados con indicadores de problemas emocionales y de comportamiento.
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Humanos , Masculino , Feminino , Pré-Escolar , Criança , Sono , Criança , Saúde Mental , Transtornos Respiratórios , Síndromes da Apneia do Sono , Inquéritos e QuestionáriosRESUMO
ABSTRACT This study analyzed the exposure of women engaged in prostitution in downtown São Paulo to COVID-19. This cross-sectional study had a convenience sample selected in May 2021. We interviewed 219, mostly black, middle-aged, poor women with comorbidities. Among them, 61 had shown COVID-19 symptoms, 23, tested positive for the disease, seven underwent hospitalization, and four reported post-COVID-19 complications. Only 26 (30.2%) had been vaccinated. In addition to gender, race, and class inequalities, these women suffer both from a higher risk of contracting COVID-19 due to their working conditions and from the subsequent worsening of that disease due to age and lack of vaccination.
RESUMO Esta pesquisa analisou a exposição de mulheres em situação de prostituição no centro de São Paulo à covid-19. Este estudo transversal contou com amostra de conveniência selecionada em maio de 2021. Entrevistou-se 219 mulheres majoritariamente negras, de meia idade, pobres e com comorbidades. Dentre essas mulheres, 61 tiveram sintomas de covid-19, 23 com teste positivo,7 foram internadas e 4 relataram complicações pós-covid-19. Somente 26 (30,2%) haviam sido vacinadas. Além das desigualdades de gênero, raça e classe, essas mulheres são expostas a um maior risco de contraírem covid-19, devido às condições de trabalho e por apresentarem doença grave relacionada à idade e falta de vacinação.
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Humanos , Feminino , Pessoa de Meia-Idade , COVID-19 , Trabalho Sexual , Brasil/epidemiologia , Estudos Transversais , SARS-CoV-2RESUMO
Abstract Introduction Most children/adolescents with disability live in low and middle-income countries and, worldwide, they are more likely to have mental health problems and achieve worse academic performance compared to those with typical development. Objective To assess whether Brazilian children/adolescents with four types of disabilities are more likely to have psychiatric disorders and educational deficits than children/adolescents with typical development. Method A multicenter cross-sectional study involving a school-based probabilistic sample of second to sixth graders (N = 1,674) from public schools in four Brazilian regions. The four types of disabilities (intellectual, visual, hearing, and motor) were assessed using the Ten Questions Questionnaire. Psychiatric disorders were measured with the Schedule for Affective Disorders/Schizophrenia for School-Age Children (K-SADS-PL), and academic performance was evaluated using the Teste de Desempenho Acadêmico - TDE (the academic performance test). Results A logistic regression model with cluster-robust errors identified the following statistically significant associations with three of the four types of disability (the exception was hearing). Intellectual disability was associated with anxiety (p < 0.01), depression (p < 0.01), attention deficit hyperactivity disorder (ADHD) (p < 0.001), school failure (p < 0.01), and poor academic performance (p < 0.01). Visual disability was associated with depression (p < 0.01). Motor disability was marginally associated with ADHD (p = 0.08). Conclusions Presence of disabilities (intellectual, visual, and motor) in children/adolescents was associated with psychiatric disorders, school failure, and academic performance. It is therefore important to identify presence of disabilities and plan and deliver specific interventions and specialized educational care for the needs presented by these children/adolescents. This is particularly important in low and middle-income countries, where these disabilities are frequent among children/adolescents.
RESUMO
OBJECTIVE: To evaluate the impact of a training program on autism spectrum disorder (ASD) identification offered to Brazilian health professionals. METHODS: Twenty-two primary care providers participated in five 3-hour weekly training sessions. RESULTS: The trained providers significantly improved their ASD knowledge after training in comparison with pre-training (mean score, 6.73 vs. 9.18, p < 0.01). Clinical practice also changed: 4 months after the training program, the providers had referred six times as many suspected cases of ASD to a specialized mental health service in comparison with the previous 4 months. CONCLUSION: This pilot training model seems a promising, feasible, and inexpensive way to improve early identification of ASD in the primary care system.
Assuntos
Transtornos Globais do Desenvolvimento Infantil/diagnóstico , Pessoal de Saúde/educação , Atenção Primária à Saúde , Adulto , Criança , Pré-Escolar , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Pediatria/educação , Projetos Piloto , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Inquéritos e Questionários , Fatores de TempoRESUMO
Abstract Cognition in individuals with Autism Spectrum Disorder (ASD) shows large variability. Nonverbal tests can be more suitable for cognitive assessment in this group. We investigated cognitive abilities in ASD using the SON-R 6-40 Nonverbal Intelligence Test. A total of 37 individuals with ASD (AG) aged 6-24 years participated. Cognitive assessment of the AG was done using the SON-R 6-40 and performance compared with the standardized sample which served as the control group (CG). Results showed lower subtest scores in the AG than in the CG. Approximately 84% of the AG had intellectual disability according to IQ scores. Individuals with preserved speech in the AG had higher IQ scores than patients without preserved speech. There was no relationship between intelligence and ASD symptom severity as reported by families.
Resumo A cognição de indivíduos com Transtorno do Espectro Autista (TEA) apresenta grande variabilidade. Testes não-verbais podem ser mais adequados para avaliação cognitiva desta população. Investigou-se as habilidades cognitivas de indivíduos com TEA a partir do desempenho no Teste não verbal de inteligência SON-R 6-40. Participaram 37 indivíduos com TEA (GTEA) entre 6 e 24 anos, cujo desempenho no SON-R 6-40 foi comparado ao da amostra normativa do instrumento (GC). Houve pior desempenho do GTEA em todos os subtestes, com diferença significativa em relação ao GC. Quase 84% do GTEA apresentou QI compatível com deficiência intelectual. Aqueles com fala preservada apresentaram desempenho superior ao grupo não-verbal. Não houve relação entre inteligência e gravidade dos sintomas conforme relato das famílias.
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Abstract Objectives: To translate and back-translate the Autism Diagnostic Observation Schedule (ADOS) into Brazilian Portuguese, to assess its cross-cultural semantic equivalence, and to verify indicators of quality of the final version by analyzing the inter-rater reliability of the ADOS scores. Methods: This study had three stages: 1) translation and back-translation; 2) semantic equivalence analysis; and 3) pre-test to verify the agreement between mental health specialists and an ADOS senior examiner regarding the scoring procedure. Authorization to translate and carry out the cultural adaptation of the instrument was first obtained from the Western Psychological Services, publishers of the instrument. Results: The main preliminary results pointed to good equivalence between the original English version and the final version and the Brazilian version following the cultural adaptation process. Some semantic differences were found between the original version and the back-translation into English, but they did not interfere with the first translation into Portuguese or into the final version. One of the limitations of the study was the small sample size; for that reason, the inter-rater reliability of the ADOS scores between the specialists and the senior examiner using the kappa coefficient was adequate for 7 out of 10 areas. Conclusions: We conclude that the creation of an official Brazilian version of ADOS will help to strengthen clinical and scientific research into ASD, and deter the use of other unauthorized versions of ADOS in the country.
Resumo Objetivos: Traduzir e retrotraduzir a Autism Diagnostic Observation Schedule (ADOS) para a língua portuguesa do Brasil, verificar sua equivalência semântica transcultural e verificar indicadores de qualidade da versão final analisando a confiabilidade interavaliadores na pontuação da ADOS. Métodos: O estudo teve três etapas: 1) tradução e retrotradução; 2) análise de equivalência semântica; e 3) pré-teste para verificar a concordância entre especialistas em saúde mental e um examinador sênior em relação ao procedimento de pontuação. A realização do estudo foi feita com a autorização da Western Psychological Services, distribuidor oficial do instrumento. Resultados: Os principais resultados preliminares indicaram uma boa equivalência entre a versão original em inglês e a versão brasileira após o processo de adaptação cultural. Algumas diferenças semânticas foram encontradas entre a versão original e a retrotradução, mas que não interferiram na primeira tradução para o português nem na versão final. Uma das limitações do estudo foi o tamanho amostral pequeno; em razão disso, a confiabilidade interavaliadores entre as pontuações da ADOS dadas pelos especialistas e pelo examinador sênior utilizando o coeficiente kappa foi adequada para 7 das 10 áreas. Conclusão: Conclui-se que, com a versão brasileira da ADOS, oficializa-se uma versão única da escala em português, fortalecendo os campos clínicos e científicos de pesquisa em TEA e impedindo que no país sejam utilizadas outras versões não autorizadas da ADOS.
Assuntos
Humanos , Semântica , Transtorno Autístico/diagnóstico , Portugal , Psicometria , Traduções , Brasil , Variações Dependentes do Observador , Comparação Transcultural , Reprodutibilidade dos Testes , IdiomaRESUMO
Primary care professionals are usually the first ones to detect symptomns of autism. We have developed and evaluated an educational model via a combined telehealth and face-to-face approach to handle autism spectrum disorders (ASD) and child mental health. The training comprised two modules involving distance-learning and face-to-face teaching environments. A total of 150 healthcare professionals - 75 doctors and 75 nurses - from five Brazilian cities were trained. Videos about ASD and child mental health were developed for the distance-learning module. The face-toface module was based on training regarding "Mental health communication skills for child and adolescent primary care." The professionals were evaluated before and after training utilizing a specific knowledge questionnaire and surveys on Knowledge, Attitude, and Practice (KAP). Knowledge acquisition, practice, and attitude improved significantly after training (p < 0.01). Our results indicated that the use of interactive tele-education to train professionals in primary care is feasible and effective.
Os primeiros sintomas de transtorno do espectro autista (TEA) são detectados por profissionais da atenção básica. O objetivo deste estudo foi desenvolver e avaliar um modelo de treinamento via telemedicina e workshop presencial sobre TEA e saúde mental infantil para médicos e enfermeiros da atenção básica. Participaram do treinamento 150 profissionais de cinco cidades brasileiras. No módulo a distância, foram desenvolvidos vídeos sobre TEA e os principais transtornos da infância, e no presencial foi baseado no treinamento "Técnicas de comunicação para lidar com saúde mental de crianças e adolescentes na atenção primaria". Os profissionais foram avaliados antes e depois da capacitação com questionários específicos de conhecimento e o Questionário de conhecimento, atitudes e prática (CAP). Os resultados apontaram a aquisição de conhecimento, atitudes e prática tanto pelos médicos quanto pelos enfermeiros. Os resultados deste estudo mostram que o treinamento de profissionais da atenção básica é factível e efetiva.
Los profesionales que detectan los primeros síntomas de trastorno del espectro autista son los profesionales de la atención básica. Desarrollamos y evaluamos un modelo de educación vía tele-salude y taller presencial sobre TEA y salud mental infantil para médicos y enfermeros de la atención básica. 150 profesionales de 5 ciudades brasileñas participaron en el entrenamiento. Para el módulo a distancia se desarrollaron vídeos sobre TEA y los principales trastornos de la infancia. El módulo presencial se basó en el entrenamiento "Técnicas de comunicación para lidiar con la salud mental de niños y adolescentes en la atención primaria". Los profesionales fueron evaluados antes y después de la capacitación con Cuestionario Específicos de Conocimiento y el Cuestionario de conocimiento, actitudes, práctica (CAP). Los resultados apuntaron que hubo adquisición de conocimiento, actitud y práctica tanto por los médicos y por los enfermeros. Los resultados muestran que el uso de tele-educación interactiva para la capacitación es factible y efectiva.