Fé Kok
O impacto de comportamentos desadaptativos na qualidade de vida relacionada à saúde (QVRS) de crianças pré-escolares com Transtorno do Espectro Autista (TEA) é relativamente inexplorado. Este estudo pretende explorar a extensão da influência que diferentes tipos de comportamentos desadaptativos (internalizados, associais e externalizados) têm na QVRS neste grupo, quando características de contexto (idade, renda bruta mensal, tipo de moradia e duração diária do sono) e funcionamento adaptativo são controlados.
Escalas de comportamento independente revisadas (SIB-R) e questionários de características de antecedentes de 99 cuidadores de crianças com TEA que buscam tratamento no KK Women and Children's Hospital foram coletados. Eles foram usados para avaliar a gravidade dos comportamentos maladaptativos, o nível de funcionamento adaptativo e algumas características de antecedentes dessas crianças. A relação destes com a HRQOL psicossocial e física nessas crianças é avaliada com o Pediatric Quality of Life Inventory (PedsQL).
O transtorno do espectro autista (TEA) é um problema neurodesenvolvimental duradouro retratado por deficiências na conexão e correspondência social, e exemplos limitados e monótonos de conduta, exercícios ou interesses. A predominância do TEA dá a impressão de estar aumentando em todo o mundo, com o TEA avaliado influenciando cerca de 1 em cada 88 pessoas.
O problema da faixa de desequilíbrio químico é percebido como uma preocupação significativa de bem-estar geral devido ao seu estágio inicial, perseverança profundamente enraizada e níveis elevados de impedimento relacionado. Essa fraqueza é inferível não exclusivamente às manifestações centrais do TEA, mas adicionalmente ao escopo de condições coincidentes que as pessoas com TEA vivenciam regularmente, incluindo questões apaixonadas e sociais, descanso, cuidados e problemas alimentares, sensibilidades táteis, aprendizagem e deficiências acadêmicas, assim como bem-estar co-dismal e bem-estar psicológico analisam. Essas condições coincidentes podem ser de preocupação equivalente ou mais proeminente para tutores e educadores de jovens com TEA do que os destaques centrais do TEA e afetam significativamente a conduta dos executivos, a obtenção de aprendizagem e a melhoria das conexões sociais.
Práticas problemáticas (ou práticas mal-adaptativas, como são mencionadas neste artigo), descritas por práticas problemáticas, prejudiciais, enérgicas ou completamente monótonas, são comuns em crianças pequenas com TEA. Por exemplo, Dominick et al. descobriram que 32,7% das crianças com TEA apresentaram práticas enérgicas, incluindo bater,
kicking, gnawing, and squeezing others. More than seventy five
percent of these kids indicated forceful practices both at home and outside the home, and hostility was coordinated toward
more than one individual in 92% of cases. Self-damaging conduct, including head slamming, hitting oneself, and gnawing oneself, was available in very nearly 33% of youngsters with ASD. Besides, 70.9% of youngsters with ASD had encountered a time of serious hissy fits and, for 60% of these kids, fits of rage happened consistently and were a steady (as opposed to wordy) issue during the period in which they were available.
A few creators have noticed a solid negative connection between the capacity to impart and the commonness of maladaptive conduct in small kids with ASD. Self-damaging practices among kids with ASD have likewise been connected to their responsive and additionally expressive correspondence shortfalls. It follows that when treatment programs center around building up the small kid's relational abilities to the degree that they can fill in as viable substitution practices, a decrease in the maladaptive conduct may result.
Maladaptive practices are especially hazardous in bunch settings, for example, early intercession administrations, childcare administrations, and preschools, as they can be problematic to the learning system and posture critical difficulties to the kids with ASD themselves, their companions, and staff. Consequently, maladaptive practices are among the most regularly recognized hindrances to the incorporation of youngsters with ASD in bunch settings.
Further, when maladaptive practices become a built up part of a youngster's conduct collection, they are probably not going to diminish and, as indicated by Berg et al., will normally remain or decline without intercession. Whenever left untreated, these practices can fundamentally lessen a kid's social and instructive open doors by restricting their admittance to accessible medicines, learning exercises, communications with others, network encounters and, specifically, their capacity to progress to, and partake in, school programs. Notwithstanding negatively affecting kids with ASD themselves, various examinations have demonstrated that guardians' degree of mental trouble is related with the seriousness of their kid's maladaptive practices just as their ASD side effects.
Accordingly, early intercessions for little youngsters with ASD should consolidate the administration of maladaptive practices . Given the connection between maladaptive practices and deficiencies in correspondence and social abilities, it is significant that intercession approaches focus on these center shortages. Myers and Johnson contend that the essential objectives of intercession for kids with ASD ought to be to augment the youngster's practical autonomy and personal satisfaction by lessening the center manifestations of ASD; encourage improvement and learning; advance socialization; diminish maladaptive practices; teach and backing families. They propose that, notwithstanding focusing on correspondence and social abilities, contemporary extensive intercession approaches for ASD should focus on a decrease in troublesome or maladaptive conduct by utilizing observationally upheld systems, including useful conduct appraisal (FBA). FBA is "the way toward deciding the expectation a wrong conduct serves for acquiring an ideal result and supplanting that conduct with a more fitting one that achieves a similar objective".
The overall significance of early mediation for ASD is broadly perceived, and is upheld by examines indicating better results with prior treatment. Early intercession for ASD, particularly that initiating before the time of 3 years, brings about fundamentally improved results comparative with mediation starting further down the road. Early intercession in the principal long stretches of life offers the best potential for kids as mind pliancy is most noteworthy during this period, empowering the foundation and redesign of neuronal systems in light of natural incitement
Multiple Regression revealed that Maladaptive behaviors have greater impact on HRQOL than Adaptive skills and background characteristics. Asocial maladaptive behaviors have the most unique influence on HRQOL out of the three Maladaptive behaviors, suggesting difficulties in social interaction and communication manifested by children with ASD play the largest role in their HRQOL at this age. Adaptive skills have a smaller but still unique impact on HRQOL, while background characteristics are not significant.
The specific types of Asocial Maladaptive behavior and their impact of HRQOL in this age group can be further studied with ASD-specific scales like Social Responsive Scale (SRS) and Repetitive Behaviors Scale-Revised (RBS-R). More targeted behavioral intervention can be then developed to improve the quality of life amongst preschool children with ASD.
Biography:
F. Kok is a Fourth Year Medical Student at Lee Kong Chian School of Medicine, National Technological University, Singapore.S.P. Yeleswarapu is a Consultant at the Department of Children Development at KK Women’s and Children Hospital, Singapore. She is also an Adjunct Assistant Professor with Duke-NUS Medical School, Singapore.
32ª Conferência Internacional sobre Saúde Mental e Comportamental, 22 a 23 de abril de 2020
Citação do Resumo :
Faith Kok, Explorando o tipo de comportamentos desadaptativos com maior impacto na qualidade de vida em crianças pré-escolares com autismo, Congresso de Saúde Mental 2020, 32ª Conferência Internacional sobre Saúde Mental e Comportamental, 22 a 23 de abril de 2020
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