Identificação precoce do Transtorno do Espectro Autista por meio da Puericultura em uma Unidade Básica de Saúde

• Autor(a) principal: Murari, Silvia Cristiane
• Data de Publicação: 2014
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da PUC_SP
• Texto Completo: https://tede2.pucsp.br/handle/handle/16725
• topic: Análise do comportamento; Serviço Público de Saúde; Vigilância do desenvolvimento; Identificação precoce do Transtorno do Espectro Autista; Autismo; Behavior analysis; Public Health Service; Monitoring of development; Early identification of Autism Spectrum Disorder; Autism; CNPQ::CIENCIAS HUMANAS::PSICOLOGIA::PSICOLOGIA EXPERIMENTAL

The Autism Spectrum Disorder (ASD) is a developmental disorder of unknown etiology. The variables determining the severity of the autism like symptoms are linked to the child's life history, the child's health issues, and other environmental aspects. The lifelong effects of the autism on the child's development are related to the early detection of signs of autism and to the time of outset of clinical treatment. Primary health care professionals (i.e., pediatricians, nurses, and nursing assistants) are the first professionals to have contact with the infant. The purpose of this study was to investigate whether a child's development monitoring program in the public health care system, such as in the services provided in the Basic Health Units (BHU), constitutes an appropriate strategy for the early identification of ASD. In order to determine the feasibility of a child's development monitoring program, were assessed (a) the guidelines for professional practice in the healthcare system related to the childcare services; (b) the correlation between the professional guidelines and the protocols for measurement of children's development; (c) the types of medical records available on the child's development of 45 children between 15 days to 24 months old (i.e., symptoms reported, data on the child's social, psychomotor and language development); (d) the information on professional training and knowledge about autism of one pediatrician, one nurse and five nursing assistants; (e) video recordings of the professional's interaction with the children during the assessment conducted by a pediatrician, two nurses and seven nursing assistants, and the direct observation of child's behaviours concerning to autism like symptoms during the health care assessment. These evaluations were based on guidelines concerning to the early identification of autism available in the literature. The preliminary outcome of the study suggests that the services provided at the UBS setting may constitute an opportunity for early detection of autism. However, it is necessary to improve the child's development assessment existing protocols and professional practices. The recommended improvements should include several changes. First, the implementation of new guidelines for health care professionals concerning to the assessment of social and language development. Second, the improvement of the data collection tools used by the professionals in order to promote the easy visualization of early signs of autism through the identification of the presence or absence of typical developmental milestones and the possible presence of atypical developmental characteristics concerning to the early signs of autism. Third, the implementation of professional training on direct observation of children's behavior and children's development assessment, and implementation of information gathering protocols concerning to the parent's knowledge about the child's development, as well on provision of guidance on how parents can better participate in the identification of developmental deficits that may indicate the presence of autism