Last modified: 2014-04-03
Abstract
The Pervasive Development Disorders Laboratory is a multidisciplinary diagnostic service in the Psychology Institute of the University of Sao Paulo which purpose is the clinical study of Autism Spectrum Disorders (ASD). This is a complex neurodevelopmental condition with great impact on lifelong and prevalence around 1:110 births. Early diagnostic and intervention implies in a better prognosis. Between 2005 and 2012, 447 patients was referred from primary attention child services of Sao Paulo and others states. After medical and neuropsychological screening, it was proceeded the evaluation in accordance with the multiaxial system (DSM-IV-TR), using specific autism and developmental scales, neurological examination and neuropsychological tests. From the 447 assessment, 128 (28.6%) patients received diagnosis of ASD, in a ratio of 2,6 boys : 1 girl. The age varied between 2 and 42 years (average of 9,2 ± 6,3). The main complaints had been global development or language delay (12% and 11%, respectively), hyperactivity (10%), learning difficulties (10%), social deficits (11%) and behavioral problems (7%). Only 22.7% had ASD as initial hypothesis. There was intellectual disability and/or deficit in the adaptive behavior in 50% of cases. The main medical condition observed was epilepsy and previous prematurity. This survey evidences the lack of prepared services of child mental health for the accomplishment on the diagnosis of ASD and, over all, in an early age. Although they have come of primary health services, only less than one quarter of patients had the suspicion of ASD.
Keywords
References
American Psychiatry Association (APA). (2002). DSM-IV-TRtm - Manual Diagnóstico e Estatístico de Transtornos Mentais. Porto Alegre: Artmed.
Asperger, H. (1991). 'Autistic psychopathy' in childhood. In: U. Frith, Autism and Asperger syndrome (pp. 37-92). Cambridge, UK: Cambridge University Press.
Assumpção Jr, F., Gonçalves, J., Cuccolichio, S., Amorim, L., Rego, F., Gomes, C. et al. (2008). Escala de Avaliação de Traços Autísticos (ATA): segundo estudo de validade. Medicina de Reabilitação, 27(2), 41-44.
Assumpção Jr, F., Kuczynski, E., Gabriel, M. & Rocca, C. (1999). Escala de Avaliação de Traços Autísticos (ATA): validade e confiabilidade de uma escala para a detecção de condutas autísticas. Arquivos de Neuropsiquiatria, 57, pp. 23-29.
Baillargeon, R., Spelke, E. & Wassermann, S. (1985). Object permanence in 5-month-old infant. Cognition, 20, 191-208.
Ballabriga, M., Escudé, R.M.C. & Llaberia, E. (1994). Escala d'avaluació dels trests autistes (A.T.A.): validez y fiabilidad de una escala para el examen de las conductas autistes. Revista de Psiquiatria Infanto-Juvenil, 4, 254-263.
Baron-Cohen, S. (2008b). Autism and Asperger Syndrome. New York: Oxford University Press.
Baron-Cohen, S. (2004). Diferença Essencial: A verdade sobre o cérebro de homens e mulheres. Rio de Janeiro: Objetiva.
Baron-Cohen, S. (2002). The extreme male brain theory of autism. Trends in Cognitive Sciences, 6, 248-254.
Baron-Cohen, S. & Belmonte, M. K. (2005). Autism: a window onto the development of the social and the analytic brain. Annual Review of Neuroscience, 28, 109-126.
Baron-Cohen, S. & Hammer, J. (1997b). Parents of children with Asperger syndrome: what is the cognitive phenotype? Journal of Cognitive Neuroscience, 9(4), 548-554.
Baron-Cohen, S., Knickmeyer, R. & Belmonte, M. (2005). Sex differences in the brain: implications for explaining autism. Science , 310, 819-823.
Center for Disease Control and Prevention (CDC). (2012). Prevalence of Autism Spectrum Disorders — Autism and Developmental Disabilities Monitoring Network, 14 Sites, United States, 2008. MMWR Surveillance Summaries, 61 (3), 1-19
Fombonne, E. (2009). Epidemiology of Pervasive Developmental Disorders. Pediatric Research, 65, 591-598.
Fombonne, E. (1999). The epidemiology of autism: a review. Psychological Medicine, 29, 769-786.
Frith, U. (1991). Autism and Asperger Syndrome. Cambridge: Cambridge University Press.
Frith, U. (2004). Autismo. Hacia una explicación del enigma. Madrid: Alianza Editorial.
Frith, U., Morton, J. & Leslie, A. (1991). The cognitive basis of a biological disorder: autism. Trends in Neurosciences, 14(10), 433-438.
Kanner, L. (1943). Autistic disturbances of affective contact. Nervous Child, 2, 217-250.
Klin, A. (2006). Autismo e síndrome de Asperger. Revista Brasileira de Psiquiatria, 28(S), 3-11.
Pereira, A., Riesgo, R. & Wagner, M. B. (2008). Childhood autism: translation and validation of the Childhood Autism Rating Scale for use in Brazil. Jornal de Pediatria, 84(6), 487-494.
Wechsler, D. (2002). WISC-III: Escala de Inteligência Wechsler para Crianças. (1 ed.). (V. Figueiredo, Trad.) São Paulo: Casa do Psicólogo.
WHO. (1992). International Classification of Mental and Behavioural Disorders. ClinicalDescriptions and Diagnosis Guidelines. (10th ed (ICD-10) ed.). Geneva: World Health Organization.
Wing, L. (1981). Asperger syndrome: a clinical account. Psychological Medicine, 11, 115-129.