Mapeamento da intersetorialidade entre serviços educacionais e serviços de saúde mental públicos destinados a crianças e adolescentes com Transtorno do Espectro Autista na cidade de Niterói-RJ

• Autor(a) principal: Siqueira, Leni Porto Costa
• Data de Publicação: 2021
• Tipo de documento: Tese
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações do Mackenzie
• Texto Completo: https://dspace.mackenzie.br/handle/10899/28587
• topic: transtorno do espectro autista; pais; saúde mental; educação; intersetorialidade; CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA::SAUDE PUBLICA

Intersectoriality is one of the guidelines of Brazilian public policies in the care of people with Autistic Spectrum Disorder (ASD). The general objective of the study was to explore the educational and mental health services received by children and adolescents with ASD and to verify indicators of intersectoral actions between these services according to the report of professionals and parents in the city of Niterói, state of Rio de Janeiro (RJ). The study design was cross-sectional with a non-probabilistic sample. The municipal education network in the municipality has 49 EF I and II schools. In 2019, 45 schools had 203 students with ASD enrolled, of whom 123 (sample loss of 39.40%) were part of the study. The sample consisted of 118 parents of children and adolescents with ASD, the respective 49 teachers from the Specialized Educational Service (SES) and 24 professionals from public mental health services. The data collection instruments were i) Family socioeconomic classification form; ii ) Three versions of questionnaires for parents, SES teachers and mental health professionals to ascertain the use and types of educational and mental health services received by children and adolescents and indicators of intersectoral actions between these services according to the report professionals and parents; iii) Brazilian version of the Behavior Problems Inventory (BPI-01/Inventory of Behavioral Problems) to assess the frequency and severity of aggressive, self-aggressive and stereotypical behaviors. Data collection was carried out between 2019 and 2020 and adopted a face-to-face and online hybrid model, due to the COVID-19 Pandemic. Descriptive analyses and calculation of the Kappa coefficient of agreement were conducted to test agreement among informants to verify intersectoral actions between educational and mental health services. The main results showed a predominance of stereotypical behavior (mean = 25.24; SD = 19.51), 77.23% of children and adolescents use medication, with atypical antipsychotics being the most used (71.57%). The most frequent use of mental health services was once a week for most professionals in the individual (66.66%) and group (56.86%) modalities. It was found that 84.31% of mental health professionals mentioned the stimulation of socialization as the type of intervention most frequently offered, followed by stimulations aimed at social cognition skills and theory of mind (80.39%) and language and social communication. (82.35%). Of the total of 123 ESA teachers, 99.18% reported the stimulation of language skills, social communication, and the use of visual cues as pedagogical support strategies offered more frequently followed by stimulations aimed at socialization (96.74%) and daily life skills (91.05%). The comparison of the answers of the teachers of the SES with those of the health professionals about the school and the health service they receive showed that 73.98 of the teachers are unaware of the health service and 56.86% of the health professionals are unaware of the school. Regarding the integrated intervention actions between SES and health services, it was found that 35.29% of teachers and 41.17% of health professionals report that the SES teacher never contacted the health professional. The reverse contact (health professionals contacting SES teachers for integration actions) showed that 64.70% of teachers reported that they had never been contacted by health professionals and 47.17% of these professionals informed that they never contacted SES teachers. Kappa's coefficient of agreement revealed a statistically significant low agreement (K= 0.25, p= 0.01), between teachers and health professionals regarding not communicating for requests for guidance on child management. It is concluded that most of the services offered reported by the informants indicate that evidence-based interventions are used, but the intersectoral actions between these services are practically nonexistent in the municipality.