Detección temprana del autismo: profesionales implicados

Abstract

RESUMENFundamentos: La importancia de la detección temprana del autismo mejora el pronóstico de niños con alteraciones en el desarrollo, en especial con trastornos del espectro autista (TEA). El objetivo de este trabajo es delimitar a qué edad surgen las primeras sospechas de un trastorno del espectro autista, a qué profesionales recurren las familias, la demora en confirmar el diagnóstico y la celeridad en la respuesta de los profesionales de la pediatría. Método:Estudio transversal retrospectivo llevado a cabo en la Comunidad Autónoma de Canarias durante el año 2010. Se solicitó la colaboración voluntaria de las asociaciones y familias que recibían tratamiento en centros especializados. Se recogieron 72 cuestionarios para familias de personas con autismo. Se realizó un análisis descriptivo de frecuencias mediante el programa estadístico SPSS Statistics 19.Resultados: En el 79% de los casos fue la propia familia quien tuvo las primeras sospechas de que algo no iba bien en el desarrollo de los niños, seguida de los profesionales de la educación (15%) y la sanidad (pediatras: 4% y psicólogos: 2%). El 69% recibieron el primer diagnós-tico durante los 3 primeros años, el 32% antes de los dos años. La demora diagnóstica se situó en 16 meses.Conclusiones: La mayoría de los padres de niños con TEA son conscientes de alteraciones en el desarrollo de sus hijos alrededor de los 18 meses. Se confirmó la tendencia a disminuir el tiempo de respuesta de los profesionales de la sanidad. Background: The importance of early detection in order to improve the prognosis of children with developmental disorders, especially autism spectrum disorders (ASD), has been widely proven, clearly followed by the corresponding intervention. The aim of this work is to define the age at which the first signs of an autism spectrum disorder show up, the professionals that families go to, as well as delays confirming a diagnosis and the celerity offered by paediatricians.Method: A transversal, retrospective study carried out in 2010 in the Canary Islands. The voluntary cooperation of family associations, and families that received treatment in specialized centres was requested. 72 "Questionnaires for families of people with autism" were gathered. A descriptive analysis of frequencies was carried out, using the statistics programme SPSS Statistics 19.Results: In 79% of the cases it was the family who first suspected there was something wrong with the children's development, followed by teachers (15%) and health care staff (pediatricians 4% and psychologists, 2%). 69% of the children were first diagnosed before turning 3 years of age, 32% of them were diagnosed even before turning two years of age. The delay regarding diagnosis in the Canary Islands circa 16 months. Conclusions:Most parents of children with ASD were aware of the developmental disorders that their children were experiencing at around 18 months of age. A tendency to a faster response time by health care professionals was confirmed.

Parents seeking a diagnosis of Autism Spectrum Disorder for their child

“…De acordo com Visani e Rabello (2012), em 36,4% dos casos, a criança tinha 12 meses ou menos quando foram observados os primeiros sintomas; em 27,3%, 24 meses; e em 18,2%, 36 meses. No entanto, Fortea Sevilla, Escandell Bermúdez, & Castro Sánchez (2013) relatam que em 9% dos casos a suspeita de um Jucineide S. Xavier, Thais Marchiori, José Salomão Schwartzman desenvolvimento atípico se deu quando a criança tinha menos de 12 meses; 40%, entre 12 e 18 meses; 23%, entre os 24 e 36 meses e apenas 10%, após os 36 meses.…”

“…O diagnóstico de TEA deve ser realizado por uma equipe multidisciplinar, isto é, por uma equipe que possua profissionais com domínio tanto das fases do desenvolvimento típico quanto dos sintomas do transtorno (Fortea Sevilla et al, 2013;Larsen, 2015). Para Cortez Bellotti de Oliveira e Contreras ( 2007), Favero-Nunes e Santos (2010) e Zanon et al (2014), somado ao fato de que, muitas vezes, os profissionais que prestam assistência a crianças menores de três anos não recebem formação adequada e contínua, há carência de equipamentos de saúde especializados e, também, de equipes multidisciplinares que facilitariam a detecção dos sinais e sintomas do transtorno.…”

“…Para Cortez Bellotti de Oliveira e Contreras ( 2007), Favero-Nunes e Santos (2010) e Zanon et al (2014), somado ao fato de que, muitas vezes, os profissionais que prestam assistência a crianças menores de três anos não recebem formação adequada e contínua, há carência de equipamentos de saúde especializados e, também, de equipes multidisciplinares que facilitariam a detecção dos sinais e sintomas do transtorno. É recomendado, portanto, que os profissionais adotem escalas e testes para auxiliá-los na conclusão diagnóstica, pois profissionais não adequadamente capacitados geram atraso no diagnóstico, no planejamento da intervenção, nos serviços médicos e, também, educacionais -serviços aos quais a criança deve ter acesso (Fortea Sevilla et al, 2013).…”

Timing of Parents’ Concerns Related to Autism Spectrum Disorder and its Diagnosis: A Mediation Analysis

“…These signs and symptoms are present early in life and usually are detected by parents (Barbaro & Dissanayake, 2009; Guinchat et al, 2012). In Spain, parents are the first to see signs in up to 79 % of children with ASD at 18 months (Fortea-Sevilla, Escandell-Bermúdez, & Castro-Sánchez, 2013), but these early concerns are not specific to ASD.…”

“…The first signs of ASD generally become visible prior to 36 months of life (Guinchat et al, 2012); furthermore, some studies found that between 30–50% of early concerns related to ASD are expressed around 12 months of life, and 80–90% by 24 months (Volkmar, Chawarska, & Klin, 2008). In Spain, although parents may be aware of some signs early, often their child does not receive a diagnosis until 37 months of life (Díaz-Atienza, García-Pablos, & Martín-Romera, 2004; Salomone et al, 2016), and the time lag between early concerns and a formal ASD diagnosis is close to 13 months (Fortea-Sevilla et al, 2013).…”