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OBJECTIVE: This study evaluated the receptive vocabulary of girls diagnosed with Rett Syndrome (RS) by employing eye-tracking technology and examined how these objective measures compared with parents' perceptions of their daughters' language abilities. METHOD: Fourteen girls with RS and eleven typically developing peers participated. Instruments included the Kerr Scale, a parental questionnaire on communication skills, the Peabody Picture Vocabulary Test - PPVT-4, and eye-tracking equipment. The PPVT-4's initial 12 cards, each displaying four images, were presented on screen for 5 s for the child's initial inspection. Subsequently, the same card was shown for 5 s with instructions to identify the picture matching the word, repeated three times in a randomized order. RESULTS: Eye-tracking assessments revealed that girls with RS with less severe symptoms, performed below typically developing peers with aged 3-4 years. The number of eye fixations emerged as a reliable metric for assessing their performance. A positive correlation was found between parental reports of their daughters' vocabulary knowledge and their ability to identify the correct stimulus, suggesting comprehension and active engagement in the testing process. CONCLUSION: This study presents a pioneering approach by combining parental perceptions with eye-tracking measures to assess receptive vocabulary in girls diagnosed with Rett Syndrome. Despite showing lower performance levels compared to significantly younger peers, the findings suggest that these individuals use less effectively eye contact as a mode of communication.
Subject(s)
Eye Movements , Parents , Rett Syndrome , Vocabulary , Humans , Rett Syndrome/physiopathology , Rett Syndrome/psychology , Female , Eye Movements/physiology , Child, Preschool , Parents/psychology , Child , Eye-Tracking Technology , Language Tests , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To evaluate the pattern of eye-gaze of preterm (PT), autism spectrum disorder (ASD) and neurotypical (Ty) children. METHODS: A cross-sectional study with eight preterm (born with ≤2000 g weight), nine ASD and five Ty male children, between six and nine years old, was performed. The eye gaze was evaluated presenting a board with a couple in social interaction, and a video with four children playing with blocks, projected in a screen computer, successively, evaluating the time that the children looked at each stimulus. RESULTS: Although all the groups focus on the central social figure with no significant differences, ASD presented significant differences in time fixation of the objects (p=0.021), while premature children fixated more time in the central social interaction than in the whole scene than typical children. CONCLUSIONS: Although this study found noteworthy differences in the eye-gaze patterns among the three groups, additional research with a more extensive participant pool is necessary to validate these preliminary results.
Subject(s)
Autism Spectrum Disorder , Fixation, Ocular , Infant, Premature , Social Behavior , Social Interaction , Infant, Premature/physiology , Infant, Premature/psychology , Autism Spectrum Disorder/physiopathology , Autism Spectrum Disorder/psychology , Humans , Male , Child , Cross-Sectional Studies , Eye-Tracking Technology , Eye Movements , Infant, NewbornABSTRACT
ABSTRACT Objective: To evaluate the pattern of eye-gaze of preterm (PT), autism spectrum disorder (ASD) and neurotypical (Ty) children. Methods: A cross-sectional study with eight preterm (born with ≤2000 g weight), nine ASD and five Ty male children, between six and nine years old, was performed. The eye gaze was evaluated presenting a board with a couple in social interaction, and a video with four children playing with blocks, projected in a screen computer, successively, evaluating the time that the children looked at each stimulus. Results: Although all the groups focus on the central social figure with no significant differences, ASD presented significant differences in time fixation of the objects (p=0.021), while premature children fixated more time in the central social interaction than in the whole scene than typical children. Conclusions: Although this study found noteworthy differences in the eye-gaze patterns among the three groups, additional research with a more extensive participant pool is necessary to validate these preliminary results.
RESUMO Objetivo: Avaliar o padrão de fixação visual de crianças nascidas prematuras (PT), com transtorno do espectro do autismo (TEA/ASD) e neurotípicas (Ty). Métodos: Estudo transversal incluindo oito meninos prematuros (nascidos com peso ≤2000 g), nove TEA e cinco Ty, com idade entre 6 e 9 anos. A varredura visual foi avaliada apresentando-se imagem de casal em interação social e vídeo com crianças brincando. A figura e o vídeo foram projetados em tela de computador, sucessivamente, sendo avaliado o tempo de fixação para cada estímulo. Resultados: Apesar de os três grupos de crianças focarem o olhar na figura social central sem diferenças significativas, crianças com TEA apresentaram diferenças significativas no tempo de fixação em objetos (p=0,021), enquanto prematuros fixaram o olhar mais tempo na interação social central do que na cena como um todo. Conclusões: Embora tenham sido notadas algumas diferenças significativas nos padrões de olhar para os três grupos, é necessário realizar mais pesquisas com uma amostra maior para confirmar esses resultados iniciais.
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ABSTRACT Objective: The aim of this study was to compare the social cognition profiles of male adults with ASD (n = 15), SCHZ (n = 16) and controls (n = 20). Change the second sentence of the abstract. Methods: A cross-sectional assessment of social cognition domains with emotional face perception with eye tracking was performed, and two IQ measures (Verbal IQ and Performance IQ) (Wechsler Adult Intelligence Scale), and the DSM-IV Structured Clinical Interview were applied. Results: There were no significant differences in terms of average performance in social cognition tests or eye tracking tasks between the ASD and SCHZ groups. However, both had lower performances in most cases when compared to the control group. In the social cognition tasks, individuals in the control group performed better than both clinical groups. Conclusion: Although differences were identified between individuals with ASD and SCHZ, it was not possible to determine patterns or to differentiate the clinical groups.
RESUMO Objetivo: O objetivo deste estudo foi comparar os perfis de cognição social de adultos do sexo masculino com TEA (n = 15), SCHZ (n = 16) e controles (n = 20). Métodos: Foram aplicadas uma avaliação transversal dos domínios de cognição social com percepção emocional com rastreamento ocular, duas medidas de QI (QI verbal e QI de desempenho) (Escala de Inteligência Adulta de Wechsler) e a Entrevista Clínica Estruturada DSM-IV. Resultados: Não houve diferenças significativas em termos de desempenho médio em testes de cognição social ou tarefas de rastreamento ocular entre os grupos ASD e SCHZ. No entanto, ambos tiveram desempenhos mais baixos na maioria dos casos, quando comparados ao grupo controle. Nas tarefas de cognição social, os indivíduos do grupo controle tiveram melhor desempenho do que ambos os grupos clínicos. Conclusão: Embora tenham sido identificadas diferenças entre indivíduos com TEA e SCHZ, não foi possível determinar padrões ou diferenciar os grupos clínicos.
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Introdução: Movimentos repetitivos associados a alterações de linguagem representam dois importantes sinais de alerta para os TEA (Transtornos do Espectro do Autismo). Ainda que, segundo pesquisas atuais, o atraso na aquisição da linguagem não faça parte do conjunto de características comumente observadas em crianças na primeira infância com Transtorno do Movimento Estereotipado (TME), a sua coocorrência pode ser mais comum do que se imagina, o que pode levar a diagnósticos falso positivo para os TEA. Objetivo: Caracterizar o processo desviante de aquisição da linguagem associado ao TME, buscando diferenciar das características específicas aos TEA. Método: A presente pesquisa apresenta o relato de caso de duas crianças, na faixa etária dos 30 aos 36 meses, com importante atraso na aquisição da fala associado à presença de movimentos estereotipados, com perfis considerados de risco para o autismo. Resultados: Na primeira avaliação as duas crianças apresentavam escore médio referente ao número de sinais de alerta para os TEA. Após intervenção de 6 meses, para diagnóstico diferencial, houve queda no número de sinais de risco, como remissão de alguns comportamentos característicos dos TEA, melhora na intensidade dos movimentos repetitivos e aumento do repertório de fala. Conclusão: Ainda que a presença de movimentos repetitivos ou estereotipadas seja um dos sinais clássicos dos TEA, mesmo que coocorra com outras alterações igualmente sugestivas a este diagnóstico, como o atraso na fala, para que o diagnóstico seja conclusivo, é necessária a observação da presença de outros sintomas que se manifestam de forma persistente ao longo do desenvolvimento.
Introduction: The repetitive movements associated with language disorders represent two important warning signs for ASD (Autism Spectrum Disorders). Even if, according to current research, the delay in language acquisition may not be part of the set of characteristics commonly observed in toddlers with Stereotyped Movement Disorder (SMD), this co-occurrence of language impairment and Stereotyped Movement Disorder may be more common than can be imagined, which leads to mistaken ASD diagnoses. Objective: To characterize the deviant language acquisition process associated with SMD, seeking to differentiate the specific characteristics of ASD. Method: This research presents a case report of two toddlers, aged 30 to 36 months, with an important delay in the acquisition and development of speech associated with the presence of stereotyped movements, with profiles considered at risk for autism. Results: The first assessment showed important results indicating ASD for both children. After a 6-month intervention, there was a decrease in the number of risk signs, such as remission of some behavior characteristic of ASD, improvement in the intensity of repetitive movements and increase of the speech repertoire. Conclusion: Although the presence of repetitive or stereotyped movements is one of the classic signs of ASD, even if it co-occurs with other disorders equally suggestive to this diagnosis, such as delayed speech, for a conclusive diagnosis it is necessary the observation of other symptoms that manifest themselves persistently throughout development.
Introducción: Los movimientos repetitivos asociados con los cambios de lenguaje representa importantes señales de advertencia para los TEA (Trastornos del Espectro Autista). Aunque, según la investigación actual, el retraso en la adquisición del lenguaje no es parte del conjunto de características comúnmente observadas en niños en la primera infancia con trastorno de movimientos estereotipados, su coocurrencia puede ser más común de lo imaginado, lo que conduce a diagnósticos falsos positivos de TEA. Objetivo: Caracterizar el proceso de adquisición del lenguaje desviado asociado al Trastorno de Movimientos Estereotipados (TME), buscando diferenciar las características específicas de los TEA. Método: Esta investigación presenta el caso clínico de dos niños, de 30 a 36 meses, con un importante retraso en la adquisición y desarrollo del habla asociado a la presencia de movimientos estereotipados, con perfiles considerados en riesgo de autismo. Resultados: En la primera evaluación, los dos niños obtuvieron una puntuación media con respecto al número de señales de advertencia de TEA. Después de una intervención de 6 meses, diagnóstico diferencial, hubo una disminución en el número de signos de riesgo, como la remisión de algunos comportamientos característicos de los TEA, una mejora en la intensidad de los movimientos repetitivos y un aumento en el repertorio del habla. Conclusión: Si bien la presencia de movimientos repetitivos o estereotipados es uno de los signos clásicos de los TEA, aunque concurra con otros cambios igualmente sugestivos para este diagnóstico, como el retraso en el habla, para que el diagnóstico sea concluyente es necesaria la observación de la observación. otros síntomas que se manifiestan de forma persistente a lo largo del desarrollo.
Subject(s)
Humans , Male , Female , Child, Preschool , Stereotypic Movement Disorder/complications , Diagnosis, Differential , Language Development Disorders/complications , Evaluation of the Efficacy-Effectiveness of Interventions , Autism Spectrum Disorder/diagnosis , Autism Spectrum Disorder/etiologyABSTRACT
ABSTRACT Objective: Voluntary and automatic orienting of attention enable proper processing of environmental information. Few studies have assessed how this process varies during development in children with attention deficit hyperactivity disorder (ADHD). Methods: This study analyzed voluntary and automatic orienting in 30 children with ADHD and 30 age and sex matched controls (Control group-CG). Two experiments assessed voluntary and automatic orienting by recording reaction times (RT) to conditions in relation to temporal interval, spatial position, cue validity and age. The RT medians calculated for each condition and participant were analyzed using ANOVA to compare ADHD and CG. Results: Children with ADHD exhibited globally higher RT than the CG group. They also showed prejudices during the reorienting process and demonstrated adequate voluntary orienting for shorter intervals. In automatic task, there was no group interaction, expressing early facilitation, but not inhibition of return. Conclusion: These results identify correlations of ADHD and the children's age in relation to voluntary and automatic orienting of attention.
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Background: This study developed a photo and video database of 4-to-6-year-olds expressing the seven induced and posed universal emotions and a neutral expression. Children participated in photo and video sessions designed to elicit the emotions, and the resulting images were further assessed by independent judges in two rounds. Methods: In the first round, two independent judges (1 and 2), experts in the Facial Action Coding System, firstly analysed 3,668 emotions facial expressions stimuli from 132 children. Both judges reached 100% agreement regarding 1,985 stimuli (124 children), which were then selected for a second round of analysis between judges 3 and 4. Results: The result was 1,985 stimuli (51% of the photographs) were produced from 124 participants (55% girls). A Kappa index of 0.70 and an accuracy of 73% between experts were observed. Lower accuracy was found for emotional expression by 4-year-olds than 6-year-olds. Happiness, disgust and contempt had the highest agreement. After a sub-analysis evaluation of all four judges, 100% agreement was reached for 1,381 stimuli which compound the ChildEFES database with 124 participants (59% girls) and 51% induced photographs. The number of stimuli of each emotion were: 87 for neutrality, 363 for happiness, 170 for disgust, 104 for surprise, 152 for fear, 144 for sadness, 157 for anger 157, and 183 for contempt. Conclusions: The findings show that this photo and video database can facilitate research on the mechanisms involved in early childhood recognition of facial emotions in children, contributing to the understanding of facial emotion recognition deficits which characterise several neurodevelopmental and psychiatric disorders.
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This study examined the parents' journey in the search of a diagnosis of Autism Spectrum Disorder (ASD) for their child and it was accomplished in two stages. The Stage 1 included the analysis of 20 records of children diagnosed with ASD attended in a clinic (2015-2017). We verified that the symptoms had been noticed between ages 13-24 months by most parents; the most reported symptom was verbal communication delay and different neuropediatricians were suspicious of the diagnosis; the most performed treatment was speech therapy. The Stage 2 was implemented to complement the findings of stage 1 and to characterize the clinic (311 cases in total). In this sample, we verified that 65.5% of the children were diagnosed with ASD; the parents and a single neuropediatrician were responsible for the referral. Despite the early detection of changes and seeking help, the parents sometimes received guidance that the child's development matched the expected for the age.
Este estudo averiguou o percurso de pais em busca de diagnóstico de Transtorno do Espectro Autista (TEA) para seus filhos e foi realizado em duas fases. Na fase 1, foi realizada a análise de 20 prontuários de pessoas atendidas em uma clínica entre 2015-2017 e que receberam diagnóstico de TEA. Nessa amostra, constatou-se que a maioria dos pais percebeu os sintomas entre 13-24 meses; o sintoma mais relatado foi atraso na comunicação verbal; os profissionais que mais levantaram suspeita de TEA foram diferentes neuropediatras; o tratamento mais realizado foi o fonoaudiológico. Na fase 2, para complementar os achados da fase 1 e caracterizar a clínica, o banco de dados foi analisado (total de 311 casos). Nessa amostra, verificou-se que 65,5% dos casos tiveram diagnóstico de TEA; as origens da maioria dos encaminhamentos eram um único neuropediatra e os pais. Apesar de detectarem alterações em idades precoces e buscarem ajuda, os pais, algumas vezes, receberam orientações de que o desenvolvimento da criança estava adequado para a idade.
Este estudio determinó el recorrido de los padres en busca del diagnóstico del Trastorno del Espectro Autista (TEA). Se llevó a cabo en dos fases: 1) análisis de 20 registros médicos de personas atendidas en una clínica (2015-2017) y que recibieron diagnóstico del TEA. La mayoría de los padres percibieron los síntomas entre 13-24 meses; lo más reportado era retardo de lenguaje; profesionales que levantaron la sospecha del TEA fueron diversos neuropediatras; terapia del habla fue tratamiento más logrado; 2) para complementar los hallazgos de la fase 1 y caracterizar la clínica, se analizó su base de datos (total: 311 casos): 65,5% de los casos tenía el diagnóstico del TEA; origen de la mayoría de los referidos: un solo neuropediatra y padres. A pesar de detectar cambios en las edades tempranas y buscar ayuda, los padres a veces recibieron orientación que el desarrollo del niño era apropiado para la edad.
Subject(s)
Humans , Child, Preschool , Signs and Symptoms , Comparative Study , Child Development , Family Relations , Autism Spectrum Disorder , Health Services Accessibility , Autistic Disorder , Complementary Therapies , DiagnosisABSTRACT
Prematurity has been associated with Autism Spectrum Disorders (ASD), and the early diagnosis is relevant for this population. This study compares the frequency of positive screening for ASD signs using M-CHAT at 18-24 months (n = 60) and ABC questionnaires at 30-36 months (n = 58) of corrected age in toddlers born prematurely with birth weight < I500g and investigates ASD diagnosis in suspected cases. Toddlers screened positive were evaluated with a DSM-5 diagnostic protocol. 6.7% of toddlers screened positive for M-CHAT and 5.2% for ABC. ASD diagnosis was confirmed for 3.3% of children. An agreement between M-CHAT and ABC questionnaires was low (k = 0.241, p = 0.063). The frequency of suggestive signs of ASD detected by the M-CHAT and the ABC at different moments was similar, and the diagnosis rate of ASD was high. The screening at I8-24 month added to the screening at 30-36 months increased the frequency of positive screening for signs of ASD in preterm.
Prematuridade tem sido associada com Transtorno do Espectro do Autismo (TEA). Diagnóstico precoce é relevante para essa população. Este estudo comparou a frequência de rastreamento positivo para sinais de TEA utilizando os questionários M-CHAT aos 18-24 meses (n = 60) e ABC aos 30-36 meses (n = 58) de idade corrigida em prematuros nascidos com peso < 1.500 g e investigou diagnóstico de TEA nos casos suspeitos com protocolo diagnóstico seguindo DSM-5. Dos prematuros, 6,7% foram positivos para M-CHAT e 5,2% para ABC. Diagnóstico de TEA foi confirmado para 3,3% das crianças. Houve baixa concordância entre M-CHAT e ABC (k = 0,241, p = 0,063). A frequência de sinais sugestivos de TEA detectada pelos dois instrumentos em diferentes momentos foi similar; e a taxa de diagnóstico de TEA, alta. O rastreamento aos 18-24 meses, acrescido de rastreamento aos 30-36 meses, aumenta a frequência de rastreamento positivo para sinais de TEA em prematuros.
Prematuridad es asociada al Transtorno del Espectro del Autismo (TEA). Diagnóstico precoz es relevante para esta población. Este estudio comparó la frequen-cia de rastreo positivo para senales de TEA utilizando los questionários M-CHAT a los 18-24 meses (n = 60) y ABC a los 30-36 meses (n = 58) de edad corregida em prematuros nacidos com peso < 1.500 g, y averiguo diagnóstico de TEA em los casos sospe-chosos, con protocolo diagnóstico siguiendo DSM-5. 6,7% de los prematuros fueron positivos para M-CHAT y 5,2% para ABC. Diagnóstico de TEA fue confirmado en 3,3% de los prematuros. Hubo baja concordância entre M-CHAT y ABC (k = 0,241, p = 0,063). La frequencia de senales de TEA detectada por los dos instrumentos en diferentes momentos fue similar, y la tasa de diagnóstico de TEA fue alta. El rastreo a los 18-24 meses, sumado al rastreo a los 30-36 meses aumenta la frequência de rastreo positivo para senales de TEA en prematuros.
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Infant, Premature , Diagnosis , Autism Spectrum Disorder , Infant, Low Birth Weight , Child , Child Development , Surveys and QuestionnairesABSTRACT
O objetivo do estudo foi avaliar a concordância entre múltiplos informantes sobre problemas de comportamento externalizantes e internalizantes de adolescentes entre 11 e 16 anos encaminhados para avaliação diagnóstica com queixas de desatenção e/ou hiperatividade. A amostra foi composta por 24 pais, 24 professores e 24 adolescentes que responderam aos questionários CBCL/6-18, TRF/6-18 e YSR/11-18, respectivamente, completando um total de 72 participantes. Em média, os pais reportaram mais problemas que os demais, o que levou a um maior número de casos na faixa clínica dos instrumentos. Os índices de concordância quanto à classificação dos problemas na faixa normal ou clínica dos instrumentos variaram de k=0,333 a k=0,120 e as correlações Q entre os pares de instrumentos variaram de 0,715 a 0,804, semelhantes às encontradas em trabalhos com amostras populacionais. As implicações para o diagnóstico clínico são discutidas tendo como base a importância da avaliação feita por múltiplos informantes para conhecer os comportamentos dos adolescentes com queixas de saúde mental em diferentes contextos e assim elaborar diagnósticos mais precisos e planejar intervenções mais adequadas.
The objective of this study was to verify the agreement rates among multiple informants regarding internalizing and externalizing behavioral problems in adolescents between 11 and 16 years old referred for diagnostic assessment with complaints of inattention and/or hyperactivity. The sample was composed by 24 parents, 24 teachers and 24 youths that filled the forms CBCL/6-18, TRF/6-18 and YSR/11/18, respectively, completing a total of 72 participants. On average, parents reported more problems than other informants for all problem-scales, which led to a greater number of cases identified in the clinical range of the form. Agreement indexes for classification of problems in normal vs. clinical range ranged from k=0.333 to k=0.120. Q Correlations for items ratings by pair of forms ranged from 0.715 to 0.804, similar to those found in other population sample studies. The implications for clinical diagnosis are discussed based on the important of multiple informants' assessment to understand adolescents' behaviors with mental health complaints in different contexts, to elaborate more accurate diagnoses and to plan appropriate interventions.
El objetivo de este estudio fue verificar los índices de concordancia entre múltiples informantes sobre problemas de conducta externalizantes e internalizantes de adolescentes entre 11 y 16 años llevados por los padres para evaluación diagnóstica por quejas de falta de atención y/o hiperactividad. La muestra del estudio fue compuesta por 24 padres, 24 profesores y 24 jóvenes (completando un total de 72 participantes) que llenaron los formularios CBCL/6-18, TRF/6-18 y YSR/11-18. En la media los padres reportaron más problemas que los otros informantes, lo que llevó a un mayor número de casos identificados en el rango clínico de los instrumentos. Los índices de concordancia de la clasificación de los problemas en el rango normal o clínico de los instrumentos variaron de k=0,333 a k=0,120 y las correlaciones Q entre los pares de instrumentos variaron de 0,715 a 0,804, datos que fueron semejantes a los encontrados en trabajos con muestras poblacionales. Las implicaciones para el diagnóstico clínico son discutidas teniendo como base la importancia de la evaluación hecha por informantes múltiples para conocer las conductas de los adolescentes con quejas de salud mental en diferentes contextos y así elaborar diagnósticos más precisos y planificar intervenciones más adecuadas.
Subject(s)
Psychology, Adolescent , Attention Deficit Disorder with Hyperactivity , Diagnostic Techniques and ProceduresABSTRACT
Entre 20% e 30% dos indivíduos encaminhados com suspeita diagnóstica de autismo para avaliação por equipes multidisciplinares, têm o diagnóstico descartado. Entre os casos positivos, 15% a 20% apresentam comorbidades genéticas e/ou ambientais. Entre setembro de 2011 e dezembro de 2014, foram avaliados 151 escolares da rede municipal de ensino de Barueri (SP) com o objetivo de validar a suspeita diagnóstica de transtorno global do desenvolvimento e investigar comorbidades genéticas e ambientais. Avaliação: anamnese perinatal, crescimento e desenvolvimento, histórico de saúde, comorbidades (anoxia perinatal, prematuridade, infecções e defeitos congênitos, síndromes genéticas, deficiência intelectual, epilepsia); escalas de triagem Inventário de Comportamentos Autísticos (Autism Behavior Checklist – ABC) e Questionário de Avaliação de Autismo (Autism Screening Questionnaire – ASQ). O método utilizado foi o de estudo de caso com a documentação disponível. Os principais resultados alcançados foram a exclusão do diagnóstico de TEA em 44 crianças (30%). Dentre os alunos com TEA, 22 (21%) apresentaram diversas comorbidades de causas genéticas e ambientais. Conclusões: 1. o diagnóstico de autismo registrado pelas escolas deve ser validado; 2. equipes acadêmicas interdisciplinares podem efetuar parcerias com sistemas educacionais; 3. protocolos clínicos básicos e disponíveis em nosso meio são eficazes tanto para validar o diagnóstico como para conhecer melhor o perfil cognitivo‑comportamental e as condições gerais de saúde dos alunos com autismo.
Among 20‑30% of patients with suspected autism referred for evaluation by multidisciplinary teams, have the diagnosed discarded and 15 to 20% have genetic and / or environmental comorbidities. From September 2011 to December 2014, through 15 task forces, physicians and neuropsychologists evaluated 151 children enrolled in municipal schools in the city of Barueri, São Paulo. Evaluation: perinatal history, growth and developmental milestones, health history, perinatal anoxia, prematurity, infection and birth defects, genetic syndromes, intellectual disability and epilepsy were recorded. Screening scales used were Autism Behavior Checklist (ABC) and the Autism Screening Questionnaire (ASQ). The main results were the exclusion of ASD diagnosis in 44 children (30%). Among ASD students 22 (21%) had several comorbidities of genetic and environmental causes. Conclusions: 1. the diagnosis of autism should be validated; 2. interdisciplinary academic teams with expertise in evaluation can make partnerships with educational systems and develop appropriate methods for this purpose; 3. basic and clinical protocols available in Brazil are effective both to validate the diagnosis and to better know the general health and cognitive‑behavioral of the students with autism.
Entre 20% e 30% de los individuos encaminados con sospecha diagnóstica de autismo para evaluación por equipos multidisciplinares tienen diagnóstico descartado. Entre los casos positivos, 15% a 20% presentan comorbidades genéticas y/o ambientales. Entre septiembre de 2011 a diciembre de 2014, fueron evaluados 151 escolares de una red municipal de enseñanza de Barueri, São Paulo. Evaluación: anamnesis perinatal, crecimiento y desarrollo, histórico de salud, comorbilidades (anoxia perinatal, prematuridad, infecciones y defectos congénitos, síndromes genéticos, deficiencia intelectual, epilepsia); escalas de despistaje Inventario de Conductas Autísticas (Autism Behavior Checklist – ABC) y Cuestionario de Evaluación de Autismo (Autism Screening Questionnaire – ASQ). Los principales resultados fueron la exclusión del diagnóstico de TEA en 44 niños (30%). Entre los estudiantes con TEA, 22 (21%) tuvieran varias comorbidades de causas genéticas e ambientales. Conclusiones: 1. el diagnóstico de autismo registrado por las escuelas debe ser validado; 2. equipos académicos interdisciplinares pueden efectuar colaboraciones con sistemas educacionales; 3. protocolos clínicos básicos y disponibles en nuestro medio son eficaces tanto para validar el diagnóstico como para conocer mejor las condiciones generales de salud y cognoscitivo‑conductuales de los alumnos con autismo.
Subject(s)
Humans , Male , Child, Preschool , Child , Adolescent , Adult , Autistic Disorder , Comorbidity , Child , Education, Special , DiagnosisABSTRACT
OBJECTIVE: To compare visual fixation at social stimuli in Rett syndrome (RT) and autism spectrum disorders (ASD) patients. METHOD: Visual fixation at social stimuli was analyzed in 14 RS female patients (age range 4-30 years), 11 ASD male patients (age range 4-20 years), and 17 children with typical development (TD). Patients were exposed to three different pictures (two of human faces and one with social and non-social stimuli) presented for 8 seconds each on the screen of a computer attached to an eye-tracker equipment. RESULTS: Percentage of visual fixation at social stimuli was significantly higher in the RS group compared to ASD and even to TD groups. CONCLUSION: Visual fixation at social stimuli seems to be one more endophenotype making RS to be very different from ASD.
Subject(s)
Child Development Disorders, Pervasive/physiopathology , Eye/physiopathology , Fixation, Ocular/physiology , Rett Syndrome/physiopathology , Visual Perception/physiology , Adolescent , Adult , Age Factors , Analysis of Variance , Child , Child, Preschool , Face , Female , Humans , Male , Pilot Projects , Social Perception , Time Factors , Young AdultABSTRACT
This study evaluates the impact in the stability and management of the marriage of parents of a child with Down or Rett Syndrome. Morbidity of the syndromes and the marital status of the couples before and after the birth of the affected children were considered variables. The divorce rate in families with Down syndrome was 10%, similar to the Brazilian rate population. In Rett Syndrome, the divorce rate was significantly higher, 23.5%. The higher morbidity of Rett Syndrome, and the moment of diagnosis could be relevant factors for the increased divorce rate related to this syndrome.
Subject(s)
Divorce/statistics & numerical data , Down Syndrome , Rett Syndrome , Adolescent , Brazil , Family Health , Female , Humans , Male , Young AdultABSTRACT
Objective To compare visual fixation at social stimuli in Rett syndrome (RT) and autism spectrum disorders (ASD) patients. Method Visual fixation at social stimuli was analyzed in 14 RS female patients (age range 4-30 years), 11 ASD male patients (age range 4-20 years), and 17 children with typical development (TD). Patients were exposed to three different pictures (two of human faces and one with social and non-social stimuli) presented for 8 seconds each on the screen of a computer attached to an eye-tracker equipment. Results Percentage of visual fixation at social stimuli was significantly higher in the RS group compared to ASD and even to TD groups. Conclusion Visual fixation at social stimuli seems to be one more endophenotype making RS to be very different from ASD. .
Objetivo Comparar a fixação visual em estímulos sociais em pacientes com síndrome de Rett (SR) e com transtornos do espectro do autismo (TEA). Método Fixação visual em estímulos sociais foi analisada em 14 pacientes do sexo feminino com SR (idades entre 4 e 30 anos), 11 pacientes do sexo masculino com TEA (idades entre 4 e 20 anos), e 17 crianças do sexo feminino com desenvolvimento típico (DT). Os participantes foram expostos a três figuras diferentes (duas figuras de faces humanas e uma figura contendo estímulo social e não social) apresentadas por 8 segundos cada uma no monitor de um computador acoplado a um equipamento de rastreamento de olhar. Resultados A porcentagem de fixação visual em estímulos sociais foi significativamente maior no grupo SR do que no grupo TEA e mesmo no grupo DT. Conclusão A fixação visual em estímulos sociais parece ser mais um dos endofenótipos que esclarecem as diferenças entre SR e TEA. .
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Young Adult , Child Development Disorders, Pervasive/physiopathology , Eye/physiopathology , Fixation, Ocular/physiology , Rett Syndrome/physiopathology , Visual Perception/physiology , Age Factors , Analysis of Variance , Face , Pilot Projects , Social Perception , Time FactorsABSTRACT
This study evaluates the impact in the stability and management of the marriage of parents of a child with Down or Rett Syndrome. Morbidity of the syndromes and the marital status of the couples before and after the birth of the affected children were considered variables. The divorce rate in families with Down syndrome was 10%, similar to the Brazilian rate population. In Rett Syndrome, the divorce rate was significantly higher, 23.5%. The higher morbidity of Rett Syndrome, and the moment of diagnosis could be relevant factors for the increased divorce rate related to this syndrome.
Este estudo buscou avaliar o impacto do nascimento de uma criança com Síndrome de Down ou Rett na estabilidade e manutenção do casamento. As variáveis consideradas foram a morbidade das síndromes e o estado marital dos casais antes e após o nascimento das crianças afetadas. A taxa de divórcio nas famílias com síndrome de Down foi de 10%, semelhante a da população brasileira. Para a Síndrome de Rett, a taxa de divórcio encontrada foi significativamente maior, 23,5%. Considera-se que tanto a maior morbidade da síndrome de Rett, bem como o momento do diagnóstico podem ser fatores relevantes para aumento de taxa de divórcio associada a esta síndrome.
Subject(s)
Humans , Male , Female , Adolescent , Young Adult , Divorce/statistics & numerical data , Rett Syndrome , Down Syndrome , Brazil , Family HealthABSTRACT
Este artigo apresenta um protocolo desenvolvido para a investigação de sinais de desatenção e hiperatividade em crianças e adolescentes, sob os aspectos comportamentais, neuropsicológicos e clínicos. A primeira fase é uma triagem telefônica. Na sequência, a avaliação é composta por uma triagem presencial, com preenchimento de um inventário comportamental (BPM) e realização de testes neuropsicológicos (QI estimado pelo Wisc-III e Test-CPT-II). Caso haja indicadores de desatenção e hiperatividade, o participante passa para terceira fase, na qual se concluem os instrumentos neuropsicológicos, que são aplicados a múltiplos informantes inventários de avaliação comportamental da plataforma Aseba. Após a realização dessa bateria, é feita uma avaliação com neurologista infantil. Nas devolutivas, os casos são encaminhados para acompanhamentos diversos em função dos sinais relatados. Abordagens multiprofissionais e de múltiplos informantes trazem maior clareza na identificação dos sinais compatíveis com o TDAH e aumentam os critérios de especificidade quanto à indicação de ações de intervenção.
This article presents a protocol developed for the investigation of signs of inattention and hyperactivity in children and adolescents, considering the behavioral, neuropsychological and clinical aspects. The first stage is a telephone triage. Further, the assessment consists of a face-to-face screening in which a behavioral inventory (BPM) is filled, and neuropsychological tests (IQ estimated by the Wisc-III and CPT-II Test) are performed. If there are indicators of inattention and hyperactivity the participant passes to the third stage. This stage is composed by complete neuropsychological instruments and inventories of behavioral assessment by multiple informants from Aseba approach. After this battery is finished, an evaluation with a pediatric neurologist occurs. When the feedbacks are given, the cases are addressed to diverse follow-ups according to the signals reported. Multidisciplinary and multiple informants’ approaches bring greater clarity in identifying ADHD compatible signs, and also increase the specificity criteria to intervention actions indication.
Este artículo presenta un protocolo desarrollado para la investigación de señales de desatención e hiperactividad en niños y adolescentes sobre aspectos conductuales, neuropsicológicos y clínicos. La primera fase es una entrevista telefónica. En la secuencia la evaluación es compuesta por una entrevista de despistaje presencial en la que es completado un inventario conductual (BPM) y son realizados testes neuropsicológicos (QI estimado por el Wisc-III y el Test-CPT-II). Caso existan indicadores de desatención e hiperactividad el participante pasa para la tercera fase. En la misma son concluidos los instrumentos neuropsicológicos y son aplicados a múltiplos informantes inventarios de evaluación conductual de la plataforma Aseba. Después de la realización de esa batería, es conducida una evaluación con un neurólogo infantil. En las devolutivas, los casos son encaminados para diversos acompañamientos en función de las señales relatadas. Enfoques multiprofesionales y de múltiplos informantes traen mayor clareza en la identificación de los señales compatibles con el TDAH y aumentan los criterios de especificidad cuanto a la indicación de acciones de intervención.
Subject(s)
Humans , Male , Female , Child , Adolescent , Attention Deficit Disorder with Hyperactivity , Comprehensive Health Care , Neuropsychology , Signs and Symptoms , Behavior , Sensitivity and Specificity , Decision Making , Growth and Development , Neuropsychological TestsABSTRACT
Objective To evaluate the theory of mind in autism spectrum disorders (ASD) and control individuals by applying the Strange Stories test that was translated and adapted to the Portuguese language. Method Twenty-eight children with ASD and 56 controls who were all male and aged between 6 and 12 years participated in the study. Results There were significant differences between the median scores of the groups for each of the 12 stories of the test and for the sum total of all the median scores. The median scores for all stories were significantly greater in the control group than those in the experimental group (children with ASD). In addition, the protocol had excellent internal consistency. Conclusion The theory of mind skills assessed with the Strange Stories test indicated alterations in children with ASD compared with children in the control group. .
Objetivo Avaliação de habilidades de Teoria da Mente em indivíduos com Transtornos do Espectro do Autismo (TEA) e indivíduos-controle, com a aplicação do teste Strange Stories , traduzido e adaptado para a Língua Portuguesa. Método Participaram do estudo 28 crianças com TEA e 56 crianças-controle, todas do sexo masculino e na faixa etária entre seis e 12 anos. Resultados Foram observadas diferenças significativas entre os escores médios dos grupos em cada uma das 12 histórias do teste e na soma dos escores de todas as histórias. Os escores médios registrados para todas as histórias foram significativamente maiores no grupo-controle do que no grupo experimental (crianças com TEA). Observou-se ótima consistência interna do protocolo. Conclusão As habilidades de Teoria da Mente avaliadas pelo teste Strange Stories se mostraram alteradas no grupo de crianças com TEA quando comparadas às crianças do grupo-controle. .
Subject(s)
Child , Humans , Male , Child Development Disorders, Pervasive/physiopathology , Neuropsychological Tests , Theory of Mind/physiology , Age Factors , Analysis of Variance , Case-Control Studies , Child Development Disorders, Pervasive/diagnosis , Interpersonal Relations , Reference Values , Reproducibility of Results , Social Perception , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To evaluate the theory of mind in autism spectrum disorders (ASD) and control individuals by applying the Strange Stories test that was translated and adapted to the Portuguese language. METHOD: Twenty-eight children with ASD and 56 controls who were all male and aged between 6 and 12 years participated in the study. RESULTS: There were significant differences between the median scores of the groups for each of the 12 stories of the test and for the sum total of all the median scores. The median scores for all stories were significantly greater in the control group than those in the experimental group (children with ASD). In addition, the protocol had excellent internal consistency. CONCLUSION: The theory of mind skills assessed with the Strange Stories test indicated alterations in children with ASD compared with children in the control group.