ABSTRACT
Resumen Numerosos estudios han analizado la Teoría de la Mente (ToM) y el Funcionamiento Ejecutivo (FE) en población infantil. Sin embargo, los hallazgos respecto a esta asociación no son concluyentes al considerar las variaciones en el neurodesarrollo típico y alterado. Este estudio analizó la producción científica y evidencia empírica sobre la relación entre el desempeño en ToM y FE en niños y su incidencia en el desarrollo neurotípico (DT), el trastorno de déficit de atención e hiperactividad (TDAH) y el trastorno del espectro autista (TEA). La búsqueda documental se hizo en la Web of Science y se utilizó bibliometrix, Sci2 Tool y Gephi para los análisis. Los hallazgos indican que niños con TDAH presentan un menor desempeño en tareas de control inhibitorio que los niños con DT, y los niños con TEA presentan un déficit en ToM en comparación con los demás grupos. La memoria de trabajo y el control inhibitorio predijeron el rendimiento de niños con TDAH, TEA y DT en tareas de falsas creencias. Finalmente, se halló que la FE se correlaciona directamente con la ToM en niños con DT. Esto hallazgos son relevantes porque ayudan a comprender mejor los mecanismos cognitivo-sociales y neuropsicológicos vinculados al neurodesarrollo infantil.
Abstract Several studies have examined theory of mind (ToM) and executive functioning (EF) in children. However, the findings regarding this association are inconsistent when considering variations in typical and impaired neurodevelopment. This study analyzed the scientific production and empirical evidence on the relationship between ToM and EF performance in children and its incidence in neurotypical development (TD), attention deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). The document search was done in the Web of Science and bibliometrix, Sci2 Tool and Gephi were used for the analyses. The findings indicate that children with ADHD present lower performance in inhibitory control tasks than children with TD, and children with ASD present a deficit in ToM compared to the other groups. Working memory and inhibitory control predicted the performance of children with ADHD, ASD and TD in false belief tasks. Finally, EF was found to correlate directly with ToM in children with TD. These findings are relevant because they help to better understand the cognitive-social and neuropsychological mechanisms linked to child neurodevelopment.
ABSTRACT
The lack of specific pharmacological therapy for Autistic Spectrum Disorder (ASD) and its clinical heterogeneity demand efforts directed toward the identification of biomarkers to aid in diagnosis. Proteomics offers a new perspective for studying the altered proteins associated with autism spectrum disorders (ASD) and we have saliva as an easy-to-collect biological fluid with important biomolecules for investigating biomarkers in various diseases. In this sense, saliva could be used to identify potential biomarkers of ASD. In the current work, saliva samples were collected from children with different degrees of ASD and healthy children and proteomics approaches were applied to generate data on differentially expressed proteins between groups which will serve as a basis for future validation studies as protein markers. Data are available via ProteomeXchange with identifier PXD030065. As results, 132 proteins were present in 80% of the saliva pools of all analyzed groups. Twenty-five proteins were identified as overexpressed in the group of severe and mild/moderate ASD carriers, among which, eight were identified as potential biomarkers for ASD.
Subject(s)
Autism Spectrum Disorder , Proteomics , Autism Spectrum Disorder/diagnosis , Autism Spectrum Disorder/metabolism , Biomarkers/metabolism , Child , Humans , Saliva/metabolismABSTRACT
O artigo aborda os impasses vividos por um bebê com risco de autismo em seu processo de subjetivação. Estudos afirmam que há bebês que, muito precocemente, recusam-se a estabelecer trocas com o objeto materno, impossibilitando que a mãe entre em um estado de identificação com seu bebê, o que colocaria em pauta que o autismo infantil não se limitaria apenas a uma falha materna, mas se trataria de uma patologia multifatorial. Quais intervenções clínicas seriam necessárias para que a mãe e o bebê possam juntos (re)escrever uma nova narrativa psíquica? Haveria um tipo de intervenção e de manejo clínico específico nos casos de bebês com risco de autismo? E como a psicanálise contemporânea, fundamentada pela leitura da intersubjetividade, nos ajudaria na compreensão da clínica da intervenção precoce?
Este artículo se propone abordar los impases experimentados por un bebé con riesgo autista en su proceso de subjetivación. Existen estudios sobre bebés que precozmente se niegan a establecer intercambios con el objeto materno, imposibilitando que la madre entre en identificación con él, poniendo sobre la mesa que el autismo infantil no se limitaría a una falla materna, sino que se trataría de una patología multifactorial. Se plantea, cuáles intervenciones clínicas son necesarias para que madre y bebé puedan (re)escribir una nueva narrativa psíquica, que posibilite un verdadero encuentro diádico. ¿Habría un tipo específico de intervención y manejo clínico en los bebés con riesgo de autismo? ¿Cómo el psicoanálisis contemporáneo, basado en la lectura de la intersubjetividad y de lo intrapsíquico, ayudaría a entender la clínica de la intervención precoz?
This article addresses the failures of a baby with a risk of autism to develop his subjectivation process. Recent studies show that some babies are not able to develop exchanges with their maternal object, which would show that children autism would not be limited to a failure of the mother to enter into a state of identification with her baby, but would be associated to a multifactorial pathology. In that respect, which clinical interventions would be necessary so that mother and baby can (re)write a new psychic narrative, enabling them to develop a genuine capability to meet together? Is there a type of clinical handling for babies with a risk of autism? How can contemporary psychoanalysis, with focus on intersubjectivity and inter-psychism, could help us to understand early intervention clinic?
Cet article aborde les entraves d'un bébé à risque autistique à développer son processus de subjectivation. Des études récentes montrent que certains bébés ne sont pas capables de développer des échanges avec leur objet maternel, ce qui montrerait que l'autisme infantile ne se limiterait pas seulement à un échec de la mère d'entrer dans un état d'identification avec son bébé, mais qu'il s'agirait d'une pathologie multifactorielle. Ainsi, quelles interventions cliniques seraient nécessaires pour que mère et bébé puissent (ré)écrire ensemble un nouveau récit psychique, qui leur permettrait de développer une véritable capacité à se rencontrer ? Y aurait-il un type de prise en charge clinique spécifique aux bébés à risque d'autisme? Comment la psychanalyse contemporaine, centrée sur l'intersubjectivité et l'inter-psychisme, peut nous aider à comprendre la clinique d'intervention précoce?
Subject(s)
Humans , Female , Infant , Psychoanalysis/methods , Autistic Disorder , Early Medical Intervention/methods , Disorders of Excessive Somnolence , Maternal Behavior/psychology , Psychology, Clinical , Psychomotor Performance , Object AttachmentABSTRACT
The administration requirements of the Autism Diagnostic Observation Schedule and the Autism Diagnostic Interview-Revised, widely used in high-income countries, make them less feasible for diagnosis of autism spectrum disorder in low- and middle-income countries. The flexible administration requirements of the Childhood Autism Rating Scale have resulted in its use in both high-income countries and low- and middle-income countries. This study examines the agreement between assessments using the Childhood Autism Rating Scale with those using the Autism Diagnostic Observation Schedule or Autism Diagnostic Observation Schedule, Second Edition and Autism Diagnostic Interview-Revised in Jamaica. Children aged 2-8 years (n = 149) diagnosed with autism by an experienced clinician using the Childhood Autism Rating Scale were re-evaluated using the Autism Diagnostic Observation Schedule and Autism Diagnostic Interview-Revised. The proportion diagnosed with autism spectrum disorder using the Autism Diagnostic Observation Schedule, Autism Diagnostic Observation Schedule, Second Edition, and Autism Diagnostic Interview-Revised was determined and mean domain scores compared using analysis of variance (ANOVA). The mean age was 64.4 (standard deviation = 21.6) months; the male:female ratio was 6:1. The diagnostic agreement of the Childhood Autism Rating Scale with the Autism Diagnostic Observation Schedule and Autism Diagnostic Observation Schedule, Second Edition was 100.0% and 98.0%, respectively. Agreement with the Autism Diagnostic Interview-Revised was 94.6%. Domain scores were highest for children with more severe symptoms (p < 0.01). Despite a high level of agreement of the Childhood Autism Rating Scale with the Autism Diagnostic Observation Schedule, Autism Diagnostic Observation Schedule, Second Edition, and Autism Diagnostic Interview-Revised, the Childhood Autism Rating Scale should be evaluated further with a broader range of autism spectrum disorder symptomatology, and by clinicians with varying experience before recommendation for use in low- and middle-income countries.
Subject(s)
Autism Spectrum Disorder/diagnosis , Developing Countries , Poverty , Analysis of Variance , Child , Child, Preschool , Female , Humans , Jamaica , MaleABSTRACT
O acompanhamento terapêutico é um importante instrumento de tratamento cuja atuação envolve a circulação do acompanhado entre os espaços sociais, promovendo a reflexão quanto aos saberes instituídos e as práticas cristalizadas acerca do acompanhado e de seu modo de relacionar-se com o mundo. Nesta perspectiva apresentamos um recorte de um caso de uma criança com diagnóstico de autismo, com objetivo de descrever as contribuições do acompanhamento terapêutico ao tratamento do autismo. Especificamente buscou descrever como se deu a sustentação do laço social a partir da constituição de um vínculo terapêutico e do manejo elaborado para instituir uma presença de forma planejada. (AU)
Therapeutic accompaniment is an important treatment instrument whose action involves the movement of the accompanying person between social spaces, promoting the reflection on the instituted knowledge and the crystallized practices about the accompanying person and its way of relating to the world. In this perspective, we present a clipping of acase of a child diagnosed with autism, with the purpose of describing the contributions of the therapeutic accompaniment to the treatment of autism. Specifically, it sought to describe how the social bond wassustained through the constitution of a therapeutic link and the elaborate management to institute a presence in a planned way. (AU)
Subject(s)
Humans , Child , Autistic Disorder , Child , Object Attachment , Patient Escort ServiceABSTRACT
Introducción: las alteraciones en la función ejecutiva, especialmente en flexibilidad cognoscitiva, planeación,control inhibitorio y memoria de trabajo constituyen un elemento cardinal dentro las manifestaciones deltrastorno del espectro autista (TEA).Objetivo: el objetivo de este trabajo fue evaluar el desempeño de las pruebas de función ejecutiva en unapoblación de pacientes con trastorno del espectro autista (TEA).Materiales y métodos: se realizó un estudio observacional en niños de una institución de rehabilitación. Seevaluó el desempeño en las subpruebas de la evaluación neuropsicológica infantil, el puntaje de CARS (ChildhoodAutism Rating Scale) y otras variables, mediante un análisis de correlación de Spearman. El estudio fueaprobado por el Comité de Ética en Investigación y se obtuvo consentimiento de los padres.Resultados: se evaluaron ocho niños con edad promedio de 8,9 años (6,1-13,7) y puntaje CARS entre 32 y 46.Se encontró mejor desempeño en habilidades gráficas y menor fluidez gráfica y verbal y de flexibilidad cognitiva.La edad tuvo correlación directa con el puntaje en memoria de trabajo y con la capacidad de planeación.Un puntaje de CARS alto se correlacionó con bajo rendimiento en flexibilidad cognitiva, memoria de trabajoy fluidez gráfica no semántica.Conclusión: los niños con TEA son susceptibles de presentar alteraciones significativas en tareas relacionadascon las funciones ejecutivas, lo que puede explicar la tendencia a la perseveración, incapacidad de cambio decriterio y conductas estereotipadas. Esta disfunción se correlaciona con la severidad del autismo y varía segúnla edad. Aunque esta alteración no es un fenómeno que se presente exclusivamente en el TEA, constituye unelemento a tener en cuenta al momento de evaluar estos niños.
Introduction: executive function disturbances, especially in cognitive flexibility planning, inhibitory control and working memory constitute a cardinal element within the manifestations of autism spectrum disorder (ASD).Objective: the aim of this research was to evaluate the performance of executive function tests in children with ASD.Materials and methods: an observational study was conducted in children attending a rehabilitation institution. An analysis between the performance of the Childhood Neuropsychological assessment subtests, scores of CARS (Childhood Autism Rating Scale) and other variables was performed by a Spearman correlation test. The study was approved by the Institutional Ethics Committee and parental consent was obtained.Results: we evaluated eight children with a mean age of 8.9 years (min: 6.1, max: 13.7) and CARS score between 32 and 46. Better performance was found in graphical abilities, less in graphical and verbal fluency and in cognitive flexibility. Age was directly correlated with scores on working memory and planning. A high CARS score was correlated with poor performance on cognitive flexibility, working memory and non-semantic graphic fluency.Conclusion: children with ASD are prone to show disturbances in executive functions related tasks which may explain the inflexible adherence to routines, the persistence of stereotypical behaviors and the perseveration observed in ASD patients. This dysfunction correlates with the severity of autism and varies with age. Although this condition is not present exclusively in ASD, it is a factor to consider when evaluating children with autism.
Subject(s)
Humans , Autistic DisorderABSTRACT
As patologias autísticas são complexas e requerem uma atenção especifica para cada criança. Na organização que preside os tratamentos, a Psicoterapia Institucional tem uma grande importância devido à sua larga experiência com as psicopatologias graves como o autismo e a psicose. No projeto terapêutico da criança, a implicação e o papel dos pais são determinantes para sua orientação e indispensáveis para dar-lhe sentido. Contudo, por razões distintas, alguns pais podem desenvolver sentimentos negativos frente aos profissionais, que devem ser considerados.(AU)
Autistic disorders are complex and require a specific treatment for each child. For the organization that presides over the care, Institutional Psychotherapy movement is important because of its vast experience with severe psychopathology, such as autism and psychosis. In the treatments proposed to the child, the place of parents is crucial in terms of guidance and essential to reassign sense. However, for various reasons, some parents may develop negative feelings in the presence of professionals that should be considered.(AU)
Las patologías del autismo son complejas y se necesitan de una atención específica para cada niño. En la organización que ofrece atención, es importante el movimiento de la Psicoterapía Institucional debido a su larga experiencia con las psicopatologías graves, tales como el autismo y las psicosis. En los tratamientos propuestos al niño, el lugar de los padres resulta crucial en términos de orientación y es indispensable por reasignarles sentido. Sin embargo, por muchas razones, algunos padres pueden desarrollar, en los profesionales, sentimientos negativos que deben considerarse.(AU)
Subject(s)
Autistic Disorder/psychology , Parents/psychology , Child PsychiatryABSTRACT
As patologias autísticas são complexas e requerem uma atenção especifica para cada criança. Na organização que preside os tratamentos, a Psicoterapia Institucional tem uma grande importância devido à sua larga experiência com as psicopatologias graves como o autismo e a psicose. No projeto terapêutico da criança, a implicação e o papel dos pais são determinantes para sua orientação e indispensáveis para dar-lhe sentido. Contudo, por razões distintas, alguns pais podem desenvolver sentimentos negativos frente aos profissionais, que devem ser considerados.
Autistic disorders are complex and require a specific treatment for each child. For the organization that presides over the care, Institutional Psychotherapy movement is important because of its vast experience with severe psychopathology, such as autism and psychosis. In the treatments proposed to the child, the place of parents is crucial in terms of guidance and essential to reassign sense. However, for various reasons, some parents may develop negative feelings in the presence of professionals that should be considered.
Las patologías del autismo son complejas y se necesitan de una atención específica para cada niño. En la organización que ofrece atención, es importante el movimiento de la Psicoterapía Institucional debido a su larga experiencia con las psicopatologías graves, tales como el autismo y las psicosis. En los tratamientos propuestos al niño, el lugar de los padres resulta crucial en términos de orientación y es indispensable por reasignarles sentido. Sin embargo, por muchas razones, algunos padres pueden desarrollar, en los profesionales, sentimientos negativos que deben considerarse.
Subject(s)
Child Psychiatry , Parents/psychology , Autistic Disorder/psychologyABSTRACT
No presente artigo é realizada uma discussão sobre autismo infantil, enfatizando sua epidemiologia, etiologia, patogênese, manifestações clínicas, diagnóstico e tratamento.