RESUMEN
PURPOSE: To study the impact of autism spectrum disorders (ASDs) on parental quality of life (QoL) at adolescence using the parental-developmental disorders-quality of life scale (Par-DD-QoL). METHODS: One hundred and fifty-two mothers of adolescents with ASD completed Par-DD-QoL. This scale assesses the following dimensions: emotional, daily disturbance and global QoL. This cross-sectional study uses a subset of data collected at the final time of a follow-up study (EpiTED cohort). RESULTS: A polytomic regression identified an increase in aberrant behavior scores as the major independent risk factor for parental QoL. The identified protective factors were the increase in daily living, communication and object cognition scores and a higher number of siblings. CONCLUSIONS: Those results suggest that there is a negative effect of externalizing behaviors and a protective effect of adaptive skills, communication and object cognition on parental QoL. Study limitations and implications are discussed.
Asunto(s)
Actividades Cotidianas , Trastornos Generalizados del Desarrollo Infantil/psicología , Relaciones Padres-Hijo , Padres/psicología , Calidad de Vida , Adaptación Psicológica , Adolescente , Trastornos Generalizados del Desarrollo Infantil/diagnóstico , Trastornos Generalizados del Desarrollo Infantil/epidemiología , Comorbilidad , Estudios Transversales , Epilepsia/diagnóstico , Epilepsia/epidemiología , Femenino , Estudios de Seguimiento , Francia/epidemiología , Humanos , Modelos Logísticos , Masculino , Trastornos Mentales/diagnóstico , Trastornos Mentales/epidemiología , Trastornos Mentales/psicología , Persona de Mediana Edad , Análisis Multivariante , Factores de Riesgo , Ajuste Social , Clase Social , Encuestas y CuestionariosRESUMEN
This study examines change in 152 children over an almost 10-year period (T1: 4.9 (± 1.3) years; T2: 8.1 (± 1.3) years; T3: 15(± 1.6) years) using a group-based, semi-parametric method in order to identify distinct developmental trajectories. Important deficits remain at adolescence in the adaptive abilities of children with Autism spectrum disorders, but changes in adaptive skills show two distinct growth rates. The univariate analysis reveals that low growth trajectories for both social and communication outcome are associated with the following characteristics at age 5: low cognitive and language skills, presence of epilepsy, and severity of autism. The multivariate analysis confirms that risk factors at age 5, were low language and severity of autism for both social and communication outcomes 10 years later, and that hours of early intervention was protective factor for communication.
Asunto(s)
Adaptación Psicológica , Trastornos Generalizados del Desarrollo Infantil/diagnóstico , Trastornos Generalizados del Desarrollo Infantil/psicología , Adolescente , Niño , Trastornos Generalizados del Desarrollo Infantil/epidemiología , Preescolar , Trastornos del Conocimiento/diagnóstico , Trastornos del Conocimiento/epidemiología , Trastornos del Conocimiento/psicología , Estudios de Cohortes , Comunicación , Comorbilidad , Epilepsia/diagnóstico , Epilepsia/epidemiología , Epilepsia/psicología , Femenino , Estudios de Seguimiento , Encuestas Epidemiológicas , Humanos , Trastornos del Desarrollo del Lenguaje/diagnóstico , Trastornos del Desarrollo del Lenguaje/epidemiología , Trastornos del Desarrollo del Lenguaje/psicología , Masculino , Análisis Multivariante , Apego a Objetos , Pronóstico , Ajuste Social , Estados UnidosRESUMEN
The study aims were to identify developmental trajectories of young children with autism and investigate their prognostic factors. The participants were 208 children, assessed first at the age of 5 years, followed longitudinally, and reassessed 3 years later. The children's clinical characteristics and the interventions received were recorded. The results indicated two distinct outcome groups with more stability than change. When changes did occur, they pertained to symptom severity (which decreased) and speech level and adaptive behavior (which improved). A logistic regression analysis pointed out two main risk factors (symptom severity and speech level) and two main protection factors (communication skills and person-related cognition). Surprisingly, the amount of intervention (in terms of number of hours) was not related to outcome.
Asunto(s)
Trastorno Autístico/terapia , Desarrollo Infantil , Trastorno Autístico/psicología , Preescolar , Femenino , Humanos , Desarrollo del Lenguaje , Modelos Logísticos , Estudios Longitudinales , Masculino , Oportunidad Relativa , Pruebas Psicológicas , Gestión de Riesgos , Resultado del TratamientoRESUMEN
The purpose of the present article was to assess the available literature concerning pain and autism. First, authors summarized the published articles on pain reactivity in people with autism. Second, the hypotheses envisaged to explain the presence of expressive particularities in people with autism spectrum disorders were reviewed; these included endogenous opioid excess theory, sensorial abnormalities and sociocommunicative deficit. Finally, the present review dealt with the tools available to assess and manage pain in people with autism. In conclusion, the authors revealed the need for more research to obtain more consensual data and provided some recommendations in this domain that were under exploited by the scientific community. From a clinical point of view, more knowledge about pain in people with autism should enable the development of specific assessment tools and, consequently, better pain management in daily care.
Asunto(s)
Trastorno Autístico/complicaciones , Dolor , Humanos , Dolor/complicaciones , Dolor/diagnóstico , Manejo del DolorRESUMEN
BACKGROUND: Adherence in severe asthma is a difficult health problem. Although psychosocial factors may be responsible for non-adherence, few longitudinal studies have investigated their link with adherence, with most studies having focused on pharmacology. METHODS: Sixty patients with severe asthma were recruited. Adherence was electronically monitored using peak flow measurements at entry and after 1 year of follow-up. Eysenck's Personality Inventory, Rotter's Locus of Control (LOC), and health control beliefs were all studied. Multiple logistic regression (MLR) was used for risk calculations. RESULTS: Initially, subjects with poor adherence had an external LOC (P=.001) and a high extraversion score (P=.003) compared to those with good adherence. The lie score was high in all patients. Nocturnal awakenings were highly significantly correlated with poor adherence (P=.006). After 1 year, patient adherence, extraversion, and neuroticism remained unchanged. The LOC changed in subjects with poor adherence, showing a less "external" orientation (P=.007). The health parameters were better at the end of the study. By MLR analysis, externality, extraversion, and low social desirability were associated with poor adherence. Patients with poor adherence had a greater probability of nocturnal symptoms. CONCLUSION: No specific personality type was associated with lack of adherence in the present study, but a high extraversion score, a low social desirability score, and a high level of externality were all predictors of poor adherence.
Asunto(s)
Asma/psicología , Control Interno-Externo , Cooperación del Paciente/psicología , Personalidad , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Distribución de Chi-Cuadrado , Femenino , Humanos , Modelos Logísticos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Oportunidad Relativa , Ápice del Flujo Espiratorio , Índice de Severidad de la Enfermedad , Encuestas y CuestionariosRESUMEN
BACKGROUND: Children with an intellectual disability (ID) are sometimes unable to verbalize and describe their painful experience; therefore family members and health carers can assess the intensity of the pain only from the behaviour exhibited by the children. AIM AND METHOD: The purpose of this descriptive and exploratory study was to examine the behavioural pain expression in 30 children with ID aged from 5 to 18 years in a surgical context. Children were matched with 30 typically developing children of the same chronological age and 30 typically developing children of the same developmental age. RESULTS: The results showed the influence of the level of expressive communication on the pain expression. Children who were able to verbalize their pain exhibited a normative pain expression with behavioural traits similar to those of typically developing children of the same developmental age. Children who were unable to verbalize their pain produced particular pain expressions with behavioural traits that were atypical and without a communicative goal. CONCLUSION: Pain expression modalities are extremely different between children able to verbalize their pain and those unable to do so. This study confirmed the necessity to take into account the particularities of each child with ID in order to individualize the pain management and avoid misdiagnosis and the under treating of pain in non verbal children.
Asunto(s)
Comunicación , Discapacidad Intelectual/psicología , Dolor/psicología , Adolescente , Niño , Preescolar , Humanos , Selección de Paciente , Estadísticas no ParamétricasRESUMEN
The purpose of this study was to examine the development and construction of vocal and verbal expression of postoperative pain in young children with limited linguistic abilities. The main objective was to highlight specific pain vocalizations, which may lead to easy and quick detection and assessment of postoperative pain relative to the age of the suffering child. Forty-seven children aged 1 to 6 years were observed during two periods of surgical hospitalization: a preoperative and a postoperative period. The results showed that there was a significant relation between their age and the types of vocalization they expressed during the postoperative period. Regarding the development in relation to certain contexts, a minor modification seems to be concerned not with the type but with the frequency of the items of vocalizations. The study confirms earlier observations and clinical experience that an efficient and reliable assessment of pain in infants and young children necessitates taking several factors into account, such as the developmental age of the children, and especially a consideration of the whole spectrum of pain markers present in the child's behavior and captured by the assessment tools.
Asunto(s)
Conducta Infantil/psicología , Comunicación , Llanto/psicología , Dolor Postoperatorio/psicología , Conducta Verbal , Factores de Edad , Actitud Frente a la Salud , Distribución de Chi-Cuadrado , Niño , Desarrollo Infantil , Lenguaje Infantil , Preescolar , Femenino , Humanos , Masculino , Evaluación en Enfermería/métodos , Investigación Metodológica en Enfermería , Dimensión del Dolor/métodos , Dimensión del Dolor/enfermería , Dimensión del Dolor/psicología , Dolor Postoperatorio/diagnóstico , Cuidados Posoperatorios/psicología , Cuidados Preoperatorios/psicología , Psicología Infantil , SemánticaRESUMEN
This longitudinal study assessed multidisciplinary data on 219 children with autistic spectrum disorders from the median age of 5 (Time 1) to 8 years old (Time 2). The evolution of psychological and adaptive data was subjected to cluster analysis. Four clinically meaningful clusters emerged. The first group (21%) demonstrated the most important psychological transformations between the two times of the research. The second group (24%) made progress but less than group 1. The third and biggest group (30%) kept the same developmental slope. The fourth group (25%) showed no significant evolution between the two times of the research. This study highlights important differences among children with autism and the necessity of using a developmental view when considering the autistic syndrome.
Asunto(s)
Trastorno Autístico/psicología , Adaptación Psicológica , Niño , Preescolar , Femenino , Humanos , Estudios Longitudinales , Masculino , Destreza Motora , Desempeño Psicomotor , Factores de TiempoRESUMEN
Whereas a growing interest in the development of attentional flexibility (AF) and in perseverative behavior, being one marker of this component, exists in neuropsychological studies and in the domain of developmental psychopathology (e.g., PKU, infantile schizophrenia, autism and Parkinson's disease) (Pennington & Ozonoff, 1996; Stahl & Pry, 2002), only a few studies have concerned themselves with this subject in normal children. It is thus of interest to add more empirical data to the existing literature in this domain. Therefore, the aim of our study was to explore the development of AF and of perseverative errors in young preschool children with normal development, aged 1.5 to 6 years. Using set-shifting tasks of increasing difficulty level, three age groups were compared with respect to their AF skills. Results show a developmental factor underlying AF, with different levels of this form becoming more and more complex with age, ranging from a rudimentary visual form to a complex representational form of flexibility. Overall, few perseverative errors occurred and they decreased with age. Results are discussed from a developmental and neuropsychological perspective.
Asunto(s)
Atención/fisiología , Desarrollo Infantil , Cognición/fisiología , Factores de Edad , Niño , Desarrollo Infantil/fisiología , Preescolar , Femenino , Lóbulo Frontal/fisiología , Humanos , Lactante , Masculino , Recuerdo Mental/fisiología , Pruebas Neuropsicológicas , Proyectos Piloto , Percepción Espacial , Estadísticas no Paramétricas , Percepción Visual/fisiologíaRESUMEN
Autism is now thought to be present right from birth. Although usually not officially diagnosed until after the child's second birthday, parents often report disturbances before then. The age of detection of disturbances varies and may be linked to differences in the severity of the autism and its associated retardation. This study evaluates the developmental characteristics of 193 children with pervasive developmental disorder, using the same standard procedures for all subjects. Our goal was to determine the relationship between age of parental recognition of disturbances and disorder severity. The results indicated mainly a link between early abnormalities, associated medical condition and severity measured on cognitive tests. They suggest systematic screening for signs of autism in very young children.
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Trastorno Autístico/diagnóstico , Reconocimiento en Psicología , Factores de Edad , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Pruebas Psicológicas , Índice de Severidad de la Enfermedad , Encuestas y CuestionariosRESUMEN
Executive function deficits in autism have been consistently found in many studies, using a wide range of measures, but usually involving older children and adults and those of higher IQ. The interpretation of executive function deficits is difficult because the concept itself is poorly defined (inhibition of prepotent responses, set-shifting, action planning etc.). Analyses have focused mainly on the attention participants pay to physical entities (object handling and problem solving) rather than social ones. The present study investigated whether these two types of attention are linked in autistic development. Fifteen children with autism (mean mental age = 24 months) were compared to 21 normally developing children (mean mental age = 25 months). A strong correlation was found between joint attention and set-shifting in the typically developing children but not those with autism. The results are discussed from a psychopathological perspective on development.