RESUMO
LAY ABSTRACT: In Ecuador, the low official estimate of the number of persons with autism spectrum disorder suggest that many children are not identified and are not receiving support. Screening tools are short parent-addressed questionnaires used to identify children that may be developing with autism. Their use is recommended, but their application can be perceived as challenging in paediatric routines. Some professionals prefer looking for autism-related behaviours in a child rather than using screening questionnaires. Although a short observation does not replace the use of validated screening questionnaires, tasks to guide the observation of autistic early signs can help professionals decide to screen or refer the family for assessment and early intervention. In this study, we tested observational tasks that could be adapted to the Ecuadorian paediatric contexts.
Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Criança , Humanos , Transtorno do Espectro Autista/diagnóstico , Equador , Estudos de Viabilidade , Transtorno Autístico/diagnóstico , Inquéritos e QuestionáriosRESUMO
Early identification of children with autism is necessary to support their social and communicative skills and cognitive, verbal, and adaptive development. Researchers have identified several barriers to early diagnosis. Data collected in low- and middle-income contexts-where the vast majority of children in the world live-is scarce. In Ecuador, as in many other countries, estimates are lower compared to the global prevalence. Health authorities estimate a prevalence of 0.28% (0.18%-0.41%) in children aged five years old or less. Based on the hypothesis that, as in many parts of the world, children in Ecuador are not routinely screened and that this situation may result from poor recognition of this condition, our objective was to identify potential obstacles to case identification in pediatric settings. Several barriers, consistent with those identified in other countries, were reported by 153 participants on a survey, including lack of time, lack of resources to refer, fear of unnecessarily alarming families, and lack of information to guide families with concerns. The vast majority of participants are aware of the need for a screening tool for autism detection but report a lack of knowledge of its formal application. Most of the barriers reported in this study could be overcome by educational programs tailored to professional needs in order to support the well-being of children with autism and their families.
RESUMO
The goal of this study was to examine the visual preference towards socially salient stimuli, using a low-cost eye-tracking device in a group of typically developing (TD) Ecuadorian preschoolers aged 11 to 60 months, from rural and urban areas, and from families with low to high socioeconomic status (SES). Series of original stimuli inspired by those used in Western experiments on the early detection of Autism Spectrum Disorder (ASD) were proposed in two eye-tracking tasks. Two types of movements (human vs. object) were presented in task 1, and dynamic speaking faces in task 2. Parental perceptions of the adaptability of the low-cost eye-tracking device used here were also investigated through a questionnaire. The analyses of mean fixation times showed a visual preference for human movements compared to moving objects whatever age, residency location or SES. In task 2, visual preference for the mouth's area compared to the eyes' area was observed in specific conditions, modulated by residency location and SES but not by age. The analyses of the parental perception indicated that the eye-tracking technique is well accepted. The findings suggest that these stimuli, along with the experimental procedure and low-cost eye-tracking device used in the present study may be a relevant tool that can be used in clinical settings as a contribution to the early identification of at-risk factors of ASD in low- and middle-income contexts.