Evidências de efetividade de uma capacitação de profissionais da saúde mental no uso da Autism Diagnostic Observational Schedule (ADOS)

• Autor(a) principal: Namur, Victor Santos
• Data de Publicação: 2019
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações do Mackenzie
• Texto Completo: http://dspace.mackenzie.br/handle/10899/22764
• topic: transtorno do espectro autista; capacitação; profissionais da saúde; validação; ADOS; CNPQ::CIENCIAS HUMANAS::PSICOLOGIA::PSICOLOGIA DO DESENVOLVIMENTO HUMANO

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder considered to be one of the most severe of child development, associated with significant losses of the adaptive functioning of the individual. Early identification of ASD signs is essential so that the child has access to evidence-based specialized interventions, resulting in improved prognosis and improved quality of life for the individual and his or her family. In Brazil, the diagnosis in the first years of life is hard to obtain due to factors such as the scarcity of specialized services, and lack of training of specialized professionals for evaluation and diagnosis. The objectives of this study were to evaluate the impact of a training in the use of the Brazilian version of the gold standard instrument Autism Diagnostic Observation Schedule (ADOS) by professionals of a tertiary mental health center (Centro de Atenção Integral à Saúde Mental (CAISM) - Vila Mariana), and verify evidences of the validity of the translation of the scale into Brazilian Portuguese. The study was conducted in four stages: (a) semantic equivalence analysis of the translated ADOS to Brazilian Portuguese in a previous study; (b) Training for CAISM professionals in the use of 4 ADOS modules delivered by senior professional; (c) individual applications and scorings of modules 1 and 3 of ADOS by CAISM professionals; (d) assessment of the impact of training course by verification of preliminary evidence of ADOS validity in Brazilian Portuguese based on semantic equivalence analysis and inter-rater reliability in the instrument scoring. The results of the translated version analysis indicated good equivalence between the terms of the original English version and the terms obtained in the back translation, as well as between the Portuguese terms of the first translation and those of the final version, and the data obtained on construct validity in criteria of clarity and objectivity demonstrated excellent preliminary results. The agreement coefficients (Kappa) between CAISM professionals and senior examiner in the score of two ADOS modules varied from 0.56 to 0.89 (Module 1), and 0.13 to 0.54 (Module 3). The results suggest that the agreement obtained was not attributed to chance, indicating that there was quality in the scoring that the experts attributed independently in their ADOS applications when corrected with the recodifications of the scoring made by the senior examiner. Finally, the results of the study allowed verification of indicators of professional training by identifying evidence of validity of the translated version of ADOS to Brazilian Portuguese. Nevertheless, it is important to emphasize the need for further studies to evaluate other psychometric properties for the validation of ADOS in Portuguese in Brazil, contributing to the future commercialization of this gold standard instrument in its official national version.