Validity Evidence of the Autistic Spectrum Disorder Behavior Scale / Evidências de Validade da Escala de Comportamentos do Transtorno do Espectro Autista / Validez de la Escala de Comportamiento del Trastorno del Espectro Autista

Abstract Screening instruments to detect symptoms of Autistic Spectrum Disorder (ASD) in the school setting are still needed. The study aimed to develop the Autistic Spectrum Disorder Behavior Scale (ASD-BS) according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). The scale consists of 31 items, divided into communication; social interactions; restrictive, repetitive and ritual behaviors; and other indicators. The content validity included five expert judges and a pilot sample with 29 children between six and 12 years old. The results were shown to be adequate, all items reached agreement rates above 80% and Kappa of 0.84. Exploratory statistical analyzes showed Cronbach's alpha equal to 0.78, sensitivity values ranging from 86 to 93% and specificity from 34 to 100%. ASD-BS is of quick implementation, uses the teacher as an informant and contributes to psychological assessment.

Resumo Instrumentos de rastreio para detectar sintomas do Transtorno do Espectro Autista (TEA) no contexto escolar ainda são necessários. O estudo teve por objetivo a construção da Escala de Comportamentos do Transtorno do Espectro Autista (EC-TEA) de acordo com os critérios do Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM-V). A escala é composta por 31 itens, divididos em comunicação; interações sociais; comportamentos restritivos, repetitivos e rituais; e outros indicadores. A validade de conteúdo contou com cinco juízes especialistas e amostra piloto com 29 crianças entre seis e 12 anos. Os resultados se mostraram adequados, todos os itens alcançaram índices de concordâncias acima de 80% e Kappa de 0,84. As análises estatísticas exploratórias demonstraram Alfa de Cronbach igual a 0,78, valores de sensibilidade variando de 86 a 93% e especificidade de 34 a 100%. EC-TEA é de rápida aplicação, utiliza o professor como informante e contribui com a avaliação psicológica.

Resumen Aún se necesitan instrumentos de cribado para detectar los síntomas del trastorno del espectro autista (TEA) en el contexto escolar. Este estudio tuvo como objetivo construir la Escala de Comportamiento del Trastorno del Espectro Autista (EC-TEA) según los criterios del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM-V). La escala consta de 31 ítems, divididos en comunicación; interacciones sociales; conductas restrictivas, repetitivas y rituales; y otros indicadores. La validez de contenido incluyó a cinco jueces expertos y la muestra piloto con 29 niños de entre 6 y 12 años de edad. Los resultados demostraron ser adecuados, todos los ítems alcanzaron tasas de acuerdo superiores al 80% y el Kappa de 0,84. Los análisis estadísticos exploratorios mostraron un alfa de Cronbach igual a 0,78, valores de sensibilidad que oscilan entre el 86% y el 93% y una especificidad del 34% al 100%. EC-TEA se aplica rápidamente, utiliza al profesor como informante y contribuye a la evaluación psicológica.

Instrumentos de avaliação no Transtorno do Espectro Autista: uma revisão sistemática / Assessment tools for Autism Spectrum Disorder: a systematic review / Herramientas de evaluación del Trastorno del Espectro Autista: una revisión sistemática

Este trabalho procurou revisar sistematicamente a literatura científica acerca dos instrumentos validados no Brasil para a caracterização do Transtorno do Espectro Autista (TEA), segundo relato de responsáveis e/ou cuidadores. Realizou-se busca nas bases de dados: Embase, PubMed, Scopus e BVS, obtendo oito artigos publicados entre 2009 e março de 2019. Utilizou-se o protocolo PRISMA e dois juízes verificaram, de forma independente, procedimentos de seleção e extração de artigos. Constatou-se variação nos estudos identificados quanto à amostra, etapas seguidas na validação dos instrumentos, resultados estatísticos obtidos e submissão ao SATEPSI. Embora os instrumentos apresentem evidências de validade, estão disponíveis apenas em trabalhos científicos. Considerando os aspectos psicométricos e as diretrizes do Conselho Federal de Psicologia, não foi identificado um instrumento diagnóstico específico para o TEA disponível ao profissional psicólogo no Brasil, evidenciando uma situação crítica para a prática clínica nessa área. AU

This paper sought to systematically review the scientific literature related to instruments validated in Brazil for the characterization of Autism Spectrum Disorder (ASD), according to reports of parents and/or caregivers. The following databases were searched: Embase, PubMed, Scopus and VHL. Eight articles were published between 2009 and March 2019. The PRISMA protocol was used and two judges independently verified the article selection and inclusion procedures. There were variations in the studies identified regarding the sample, the steps followed in the validation of the instruments, the statistical results obtained and the submission to SATEPSI. Although the instruments present evidence of validity, they are only available in scientific papers. Considering the psychometric aspects and the guidelines of the Federal Council of Psychology, no specific diagnostic instrument for ASD was identified as being available to the professional psychologist in Brazil, demonstrating a critical situation for the clinical practice in this area. AU

Este trabajo buscó revisar sistemáticamente la literatura científica con respecto a instrumentos validados en Brasil para la caracterización del Trastorno del Espectro Autista (TEA), según informes de tutores y/o cuidadores. Las búsquedas fueron realizadas en las siguientes bases de datos: Embase, PubMed, Scopus y BVS, resultando en ocho artículos publicados entre 2009 y marzo de 2019. Se utilizó el protocolo PRISMA y dos jueces verificaron de forma independiente los procedimientos de selección y extracción de artículos. Se constató variación en los estudios identificados con respecto a la muestra, las etapas seguidas en la validación de los instrumentos, los resultados estadísticos obtenidos y el envío al SATEPSI. Aunque los instrumentos presentan evidencias de validez, solo están disponibles en artículos científicos. Teniendo en cuenta los aspectos psicométricos y las pautas del Consejo Federal de Psicología, no se identificó ningún instrumento de diagnóstico específico para el TEA disponible para el psicólogo profesional en Brasil, lo que muestra una situación crítica para la práctica clínica en esta área. AU

Genetic diversity and antimicrobial resistance profile of Enterococcus faecalis isolated from broilers with vertebral osteomyelitis in Southeast Brazil.

Vertebral osteomyelitis (VO) is a worldwide emerging disease that affects broilers. Recently, the isolation of Enterococcus faecalis in cases of the disease has been described. This study aimed at determining the genetic diversity and antimicrobial resistance profile of 12 E. faecalis strains isolated from broilers with VO. Strains were isolated from nine flocks from six farms in a high-density poultry production area in Southeast Brazil and were evaluated using multilocus sequence typing and phylogenetic analysis. Antimicrobial susceptibility tests and PCR were performed to detect antimicrobial resistance genes. E. faecalis isolates belonged to different sequence types (ST), six of which (ST49, ST100, ST116, ST202, ST249, and ST300) have been previously described. Strains ST708 and ST709 were newly identified in this study. Strain ST49 was most frequently isolated (50% of the flocks) from the analysed VO cases. No phylogenetic or phylogeographic relationship was found among the strains. The VO isolated E. faecalis strains showed highest resistance to aminoglycosides, mainly gentamicin (40%), but were highly susceptible to vancomycin (10%). Aminoglycoside resistance genes were detected in seven E. faecalis strains, and AAC6'-APH2″ genes were most frequently detected. The results showed that E. faecalis strains isolated from recently reported VO cases were highly diverse genetically. The diversity of genotypes in circulation in the analysed flocks, without apparent relationship among them, raises questions on aetiopathogenesis of the disease in broilers and evolutionary aspects of E. faecalis.

Vertebral osteomyelitis associated with single and mixed bacterial infection in broilers.

Vertebral osteomyelitis (VO) is a worldwide emerging disease that affects broilers. The objective of this study was to determine the frequency and aetiology of VO in broilers in a highly productive broiler region. For this, 608 broilers with locomotory problems were analysed from 18 farms. Clinical signs were recorded, necropsy was performed and samples were collected from vertebral bodies with gross changes for molecular and histopathological analysis and for bacterial isolation. From broilers with locomotory changes, 5.1% (31/608) had VO and, of these, 93.5% were 40 days old or older and 89.7% were males. The birds with VO presented varying degrees of limited mobility and this was related to the level of compression to the spinal cord. Bacterial species of the genus Enterococcus (DNA detected in 53.6%) were the aetiological agents involved in most VO cases. Enterococcus faecalis was detected most frequently (35.7%), but Enterococcus hirae was also present in some lesions (7.1%). Escherichia coli was detected in 35.7% of vertebral lesions and co-infection with E. faecalis was confirmed in 7.1% cases. Staphylococcus aureus was involved in 14.3% of the cases, being 7.1% in co-infection with Enterococcus spp. or E. hirae. Our study has indicated that, in Brazil, VO in broilers may not be caused by a single infectious agent and has a lower frequency than recently reported in other countries. This study suggests that there are geographical differences between Brazil and other countries concerning the frequency and aetiology of VO.