RESUMO
It cannot be assumed that the experience of having an autistic child is the same across countries since demographic and systemic factors are as diverse as the manifestation of ASD symptomatology. This study explores the lived experiences of 20 Venezuelan parents after receiving an autism diagnosis for their child. Applied thematic analysis was used to analyze parental attitudes, challenges in identifying their child's delay, access to diagnostic services, beliefs towards autism, professional evaluations, family support, and perceptions toward health and educational services for autistic children. Venezuelan parents reported a generalized lack of autism awareness, an unsupportive school system, and judgment from their extended family. Despite the universal health coverage in the country, Venezuelan parents commented on the scarcity of services, as well as the lengthy and costly processes to receive an ASD diagnosis. The results support previous research findings showing that socioeconomic factors influence how parents experience the process of obtaining an autism diagnosis for their children. For most Venezuelan parents, it might imply a long journey in which limited resources and knowledge about autism will determine its route and length. For parents, cultural values and spiritual and religious beliefs will serve as both coping mechanisms and barriers to accessing services.
Assuntos
Transtorno Autístico , Criança , Humanos , Transtorno Autístico/diagnóstico , Pais , Fatores Socioeconômicos , Instituições AcadêmicasRESUMO
Delayed diagnosis and a lack of adequate care for people with autism spectrum disorder (ASD) are related to worse outcomes and quality of life. This study aimed to identify the profile of service use, barriers to access care, and factors related to those barriers in Brazilian families with children with ASD. A total of 927 families with children with ASD (3-17 years) from five Brazilian regions completed an online version of the Caregivers Needs Survey. Results showed that the most used services were behavioral interventions and pharmacotherapy, while the most used professionals were neurologists, nutritionists, speech therapists, psychiatrists, psychologists, and pediatricians. The main barriers included waiting lists, costs, and the absence of services or treatment. Service use varied according to age, the region of residence, type of health care system used, and the parents/caregivers' education. Access to behavioral interventions was more frequent among users of the private system/health insurance and families whose caregivers had higher education. The absence of specialized services/treatments was less frequent among residents of state capitals and families whose caregivers had higher levels of education. This study highlights how families with children/adolescents with ASD in Brazil face significant barriers to access care related to sociodemographic factors.
RESUMO
Background: Many countries have developed health initiatives to protect those with disabilities and developmental concerns in the past few years. However, the needs of autistic individuals are still short of being fulfilled. Partially due to limited research expenditure, which would allow bridging the gap between evidence and practice, the long time it takes to implement passed laws, and the limited operationalization of inclusive policies. Objective: To quantitatively examine changes in the child's age at the time of caregiver's first developmental concerns and age of diagnosis of their autistic child across 5 years. Also, to address challenges experienced by caregivers (e.g., reported service barriers) and the work still needing to be done in Argentina based on caregivers' reports of their priorities (e.g., ensuring their child receives better services). Methods: Two independent samples of caregivers of autistic individuals were surveyed by the Red Espectro Autista Latinoamerica (REAL) in 2015 (n = 763) and the World Health Organization (WHO) in 2020 (n = 422). Similar items in both surveys were compared through descriptive inferential analysis and chi-square tests for categorical variables. Results: Compared to the 2015 sample, for the 2020 sample, more caregivers reported an earlier age of first concerns and an earlier age of a professional diagnosis. In the 2020 sample, more children diagnosed before the age of three had a doctor or a teacher noticing the first developmental concern. Also, in this sample, fewer caregivers reported service barriers (e.g., limited availability, waitlist, costs, etc.) and a need for better social support and better health services. However, rates of caregivers indicating a need for more rights for autistic individuals and greater protection of existing rights increased. There was no change in the reported rate of family members who stopped working to care for the autistic individual. For both samples, there was statistically significant differences in individual (physician, teacher, caregiver) noticing first developmental concern and the age of diagnosis, with the majority having a caregiver noticing the first concern. Conclusion: The 5 years that separate both samples show an improvement in developmental concerns being noticed, a decrease in age of diagnosis, and an improvement in several service areas such as community awareness. Also, caregivers reported fewer barriers to service accessibility, thus suggesting a positive impact stemming from changes in public policies, non-profit organizations' work through awareness campaigns, and advocates' strives toward greater awareness. Nonetheless, a similar proportion of family members reported ceasing working to care for autistic individuals and perceived that the fundamental rights of their autistic children needed to be protected. These results imply that despite better care pathways in Argentina, there are still gaps when attempting to meet the needs of autistic individuals and their families. The present study provides a meaningful understanding of existing gaps and help exemplify the perceived improvements when non-profit agencies and advocates promote increased rights and community awareness in addition to the established laws focusing on ASD.
RESUMO
Abstract Introduction The COVID-19 lockdown has posed new challenges for individuals with autism spectrum disorder (ASD), including service suspension and reductions in support. Objective To explore the perspectives of caregivers on the impact of the COVID-19 lockdown on people with ASD in Mexico. Method 126 caregivers from Mexico completed a survey on the impact of lockdown on people with ASD. Results Suspension of at least one service was reported for 38.9% of subjects, with no significant association being found between symptom worsening and service administration modality. Discussion and conclusion Service suspension for people with ASD in Mexico has been a side effect of the pandemic, negatively impacting their behavior. Results indicate that certain services could be remotely maintained and provided to individuals with ASD in underserved areas.
Resumen Introducción El confinamiento debido a la pandemia por COVID-19 ha implicado nuevos desafíos para las personas con trastorno del espectro autista (TEA), incluyendo la suspensión de algunos servicios, y la disminución de los apoyos. Objetivo Explorar las perspectivas de los cuidadores acerca de las repercusiones del confinamiento por COVID-19 en las personas con TEA en México. Método 126 cuidadores residentes de México completaron una encuesta acerca del impacto del confinamiento en personas con TEA. Resultados Aunque el 38.9% de los participantes reportó la suspensión de al menos un servicio de salud tras el confinamiento, no hubo asociaciones significativas entre retroceso y modalidad de administración de los servicios. Discusión y conclusión La suspensión de servicios a las personas con TEA en México es uno de los efectos secundarios de la pandemia, y afecta negativamente su comportamiento. Los resultados indican que algunos tratamientos pudieran ser mantenidos remotamente y brindar servicios a personas con TEA en zonas de difícil acceso.
RESUMO
INTRODUCTION: People on the Autism Spectrum (AS) face multiple health, education, social, and economic pro blems. There is limited available information in Chile. OBJECTIVE: To describe the access and satisfac tion with health and education services, family and economic impact, stigma, and quality of life of people with AS and their families in Chile. SUBJECTS AND METHOD: Parents/caregivers of AS persons completed the Caregiver Needs Survey, developed by Autism Speaks, which includes demographic information, characteristics of AS persons (previously published), use of health and education servi ces, parents/caregivers' perceptions of satisfaction, impact, stigma, and quality of life. RESULTS: 291 caregivers (86% mothers) of 291 AS persons participated, 89% were male, aged 1-40 years (X:10.4 SD:6.1). Limited and unspecific access to health services is reported. 77% are regularly attending a standard or special school system. Families pay for over 60% of therapies/medical care and over 40% of specific educational support, and 25% report difficulties in accessing services. The family income is affected by resignation (35%) or reduced working hours (46%). Stigma is associated with possi ble discrimination and feelings of helplessness. The main priorities mentioned for a better quality of life are support for inclusive schooling, better adjustment at home, and improved socialization. CONCLUSIONS: This survey provides relevant information about the needs, barriers, and challenges of AS people in Chile and highlights the difficulties in accessing health services and the severe impact on family income. Feelings of stigma, discrimination, and helplessness are reported. Collaborative strategies are needed to improve the quality and access to services and to reduce the economic and mental health burden on the family.
Assuntos
Transtorno Autístico , Cuidadores , Cuidadores/psicologia , Chile , Feminino , Humanos , Masculino , Satisfação Pessoal , Qualidade de VidaRESUMO
BACKGROUND: Sex differences in symptom severity and adaptive function in children with ASD have been historically inconsistent and studies are predominantly from American- and European-residing populations. Alike, there is limited information on the complex interplay between sex, intelligence, adaptive function, and autism symptom severity; this is crucial to identify given their predictive value for health outcomes in autism AIM: This study aimed to identify sex differences in autism symptom severity and adaptive function in a sample of Venezuelan children. METHOD: One-hundred-and-three Venezuelan children ages 3-7 completed a comprehensive assessment for symptom severity, adaptive functioning, and intelligence. RESULTS: Sex differences were not present in any autism diagnostic domain or adaptive function.Symptom severity was not a significant predictor for adaptive function, which contrasts with studies sampling American children. CONCLUSION: This study corroborates other findings based on non-American children, where symptom severity was not a function of adaptive function. Awareness of the interplay of culture, sex-related standards, and autism symptomatology will result in better identification and diagnosis of autism regardless of sex or cultural background. What this paper adds? This paper aids the current literature on sex difference on both autism symptom severity and adaptive function. It also provides a snapshot of the relationship between symptom severity, adaptive function, and other psychological variables that influence the outcome of children with ASD.
Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , Transtorno Autístico/diagnóstico , Transtorno Autístico/epidemiologia , Criança , Pré-Escolar , Estudos Transversais , Demografia , Feminino , Humanos , Inteligência , MasculinoRESUMO
La pandemia de covid-19 y las medidas asociadas determinaron cambios profundos en los individuos con trastorno del espectro autista (TEA) y sus familias. Se busca explorar estos efectos a nivel de las emociones y comportamientos en esta población en Uruguay. Dentro de un estudio multicéntrico de ocho países de Latinoamérica, se utilizó la submuestra de Uruguay para analizar los cambios de los comportamientos exhibidos por los individuos con TEA sobre la base de género y edad. Entre los 269 cuidadores que completaron una encuesta anónima, el 43,9 % reportó mayores problemas de convivencia y el 75,4 % reportó retrocesos. El empeoramiento de los comportamientos externalizados fue mayor en el sexo masculino y de los internalizados, en los adolescentes de 13 a 18 años. Estos resultados deberían considerarse a la hora de tomar medidas que comprometen la continuidad educativa, apoyos terapéuticos y de asistencia a las familias con personas con TEA en Uruguay.
COVID-19 pandemic and its associated measures, determined pro-found changes in individuals with autism spectrum disorder (ASD) and their families. Authors explore consequences regarding emotions and behaviors in this population in Uruguay. Within a multicentric study of eight Latin American countries, changes in behaviors in individuals with ASD based on gender and age were analyzed in the Uruguayan sub-sample. Among the 269 caregivers who completed an anonymous survey, 43.9% reported greater problems in daily life and 75.4% reported setbacks. The worsening of externalizing behaviors was greater in males. The internalizing ones were higher in adolescents aged 13 to 18 years. These results should be considered when taking measures that compromise educational continuity, therapeutic supports and assistance to families with people with ASD in Uruguay.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adulto , Agressão/psicologia , Pandemias , Comportamento Problema/psicologia , Transtorno do Espectro Autista/psicologia , COVID-19/psicologia , COVID-19/epidemiologia , Fatores Socioeconômicos , Uruguai/epidemiologia , Epidemiologia Descritiva , Estudos Transversais , Inquéritos EpidemiológicosRESUMO
LAY ABSTRACT: Approximately 6 million individuals with autism spectrum disorder live in Latin America. In order to strengthen autism spectrum disorder research collaborations and awareness in the region, the Latin American Autism Spectrum Network (Red Espectro Autista Latinoamerica) was constituted in 2015, comprising researchers and clinicians from the following six countries: Brazil Argentina, Chile, Uruguay, Venezuela, and the Dominican Republic. This first multisite study from the Red Espectro Autista Latinoamerica network aims to describe the challenges and priorities to identify barriers to care and to map stigma among families of individuals with autism spectrum disorder living in Latin America. A total of 2942 caregivers from these six countries completed an online survey showing that the main priorities were greater community awareness and improvements in the educational system for individuals with autism spectrum disorder. In addition to that, the main barriers to care were related to lack of structure, mainly waiting lists (50.2%), high treatment costs (35.2%), and lack of specialized services (26.1%). Stigma experienced by families was frequent: one third reported feeling discriminated against and helpless for having a child with autism spectrum disorder. Also, 48.8% of the caregivers declared financial problems, 47.4% of them had to cut down work hours, and 35.5% had to leave their jobs because of their child's autism spectrum disorder. This is a pioneer study providing a description of the needs and challenges faced by families affected by autism spectrum disorder in Latin America, helping to build data-driven strategies at the national and regional levels.
Assuntos
Transtorno do Espectro Autista , Transtorno Autístico , Brasil , Criança , Acessibilidade aos Serviços de Saúde , Humanos , América Latina , VenezuelaRESUMO
Latino children are diagnosed with autism spectrum disorder later in life, usually with more severe symptoms, and lower IQs, compared with non-Latino children. Possible reasons for such disparities could be due to lower levels of parent education, lower socioeconomic status, limited knowledge of parents about autism spectrum disorder, and diminished health-care knowledge. The goal of the study was to describe the age of parental concerns and at first autism spectrum disorder diagnosis, and factors associated with age at the first diagnosis in a sample of Venezuelan children. Diagnostic and demographic data were collected from 103 children between 2 and 7 years of age. Although the mean age of first concerns was 17 months, the age of diagnosis varied from 53.03 months for the Pervasive Developmental Disorders-Not Otherwise specified group to 54.38 months for the autism group. Although parents were aware of developmental difficulties before the second year of life, their children were diagnosed 36 months later. In Latin cultures, behavior problems are usually attributed to poor parenting skills, so parents might take longer to seek professional help. A better understanding of cultural influences on age of diagnosis will translate to quicker use of services independent of ethnicity.
Assuntos
Transtorno do Espectro Autista/diagnóstico , Hispânico ou Latino/estatística & dados numéricos , Distribuição por Idade , Idade de Início , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pais , Fatores Socioeconômicos , VenezuelaRESUMO
El objetivo de la presente investigación que estuvo dirigido a determinar la frecuencia del trastorno por déficit de atención-hiperactividad [TDAH] en estudiantes universitarios. La muestra estuvo constituida por 411 estudiantes universitarios de ambos sexos, con edades comprendidas entre 17 y 47 años, cursantes entre el 1er y 5to semestre de la Escuela de Educación de la Universidad del Zulia de la ciudad de Maracaibo. Para la identificación de los casos probables se utilizó el cuestionario de cribado ASR-S v1.1 y el FASCT. Los universitarios con puntajes positivos en ambas escalas de tamizaje, se seleccionaron para ser evaluados con la M.I.N.I plus. Los resultados indicaron que la prevalencia estimada en estudiantes universitarios es de 4,8%, caracterizándose el predominio de síntomas de impulsividad-hiperactividad. La comorbilidad asociada al diagnóstico de TDAH en la muestra estudiada fue de 35%. El estimado de prevalencia de 4,35% debe ser considerado como un signo de alerta de la necesidad de diagnóstico y tratamiento para esta población.
The aim of this study was to estimate the frequency of the attention deficit/hyperactivity disorder in college students. The sample was constituted by 411 college students, ages between 17 and 47 years, attending the School of Education at the Universidad del Zulia, 1st thru 5th semester. The identification of probable cases was performed by using the ASR-S v1.1 and FASCT as screening instruments. For the second part of the diagnostic process, students with positive scores in both screening measures were selected to be interviewed using the M.I.N.I plus. Results indicated that the estimated prevalence of ADHD in college students is 4.8%, with a behavioral profile which suggests that hyperactivity-impulsivity symptoms were predominant in this sample. Comorbidity related to the ADHD diagnosis was 35%. A prevalence estimate of 4.35% should be considered as an alert sign for the need of diagnostic and treatment of this population.
Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Estudos Transversais , Prevalência , Estudantes , Inquéritos e Questionários , Universidades , Venezuela/epidemiologiaRESUMO
The aim of this study was to estimate the frequency of the attention deficit/hyperactivity disorder in college students. The sample was constituted by 411 college students, ages between 17 and 47 years, attending the School of Education at the Universidad del Zulia, 1st thru 5th semester. The identification of probable cases was performed by using the ASR-S v1.1 and FASCT as screening instruments. For the second part of the diagnostic process, students with positive scores in both screening measures were selected to be interviewed using the M.I.N.I plus. Results indicated that the estimated prevalence of ADHD in college students is 4.8%, with a behavioral profile which suggests that hyperactivity-impulsivity symptoms were predominant in this sample. Comorbidity related to the ADHD diagnosis was 35%. A prevalence estimate of 4.35% should be considered as an alert sign for the need of diagnostic and treatment of this population.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudantes , Inquéritos e Questionários , Universidades , Venezuela/epidemiologia , Adulto JovemRESUMO
According to the DSM-IV-TR, symptoms of inattention and hyperactivity are frequent in children with Autism Spectrum Disorders (ASD). This statement is supported by clinical observation and formal assessment. However, ASD diagnosis is still among the exclusion criteria for the Attention-Deficit/Hyperactivity Disorder (ADHD). Such exclusion generates controversy and questions regarding the need and benefits of maintaining or not these separations; so much so, that the proposed criteria for the DSM-V eliminate that exclusion condition. It is necessary a better understanding of the comorbidity between both entities in order to be able to have an appropriate sequence of the intervention goals. For that reason, if inattention and hyperactivity in individuals with ASD are considered as a representation of a comorbid diagnosis of ADHD, treatment plans for this group would be better adjusted and more likely to offer a real benefit in the outcome of their adaptive functioning.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtornos Globais do Desenvolvimento Infantil/complicações , Criança , HumanosRESUMO
De acuerdo al DSM-IV-TR los síntomas de falta de atención e hiperactividad son frecuentes entre los individuos con Trastornos del Espectro Autista (TEA). Estas aseveraciones están reflejadas en a observación clínica y la valoración formal. Sin embargo, el diagnóstico de TEA aún continúa dentro de los criterios de exclusión para el Trastorno por Déficit de Atención-Hiperactividad (TDAH). Dicha exclusión ha ocasionado controversia e interrogantes con respecto a la necesidad y el beneficio de mantener o no estas separaciones; tanto así, que los criterios propuestos para el DSM-V eliminan dicho criterio de exclusión. Es necesaria una clara comprensión de la comorbilidad entre ambas entidades para realizar una secuencia óptima y apropiada de los objetivos de la intervención. Es por esto, que si se considera la falta de atención e hiperactividad en individuos con un diagnóstico asociado de TEA como una representación de un diagnóstico comórbido de TDAH, los planes de tratamiento serán más apropiados y con mayor impacto en su funcionamiento adaptativo.
According to the DSM-IV-TR, symptoms of inattention and hyperactivity are frequent in children with Autism Spectrum Disorders (ASD). This statement is supported by clinical observation and formal assessment. However, ASD diagnosis is still among the exclusion criteria for the Attention-Deficit/Hyperactivity Disorder (ADHD). Such exclusion generates controversy and questions regarding the need and benefits of maintening or not these separations; so much so, that the proposed criteria for the DSM-V eliminate that exclusion condition. It is necessary a better understanding of the comorbidity between both entities in order to be able to have an appropriate sequence of the intervention goals. For that reason, if inattention and hyperactivity in individuals with ASD are considered as a representation of a comorbid diagnosis of ADHD, treatment plans for this group would be better adjusted and more likely to offer a real benefit in the outcome of their adaptive functioning.
Assuntos
Criança , Humanos , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Transtornos Globais do Desenvolvimento Infantil/complicaçõesRESUMO
OBJECTIVE: To analyze the clinical, neuroimaging characteristics and positivity of the acquaporin water channel (NMO-IgG) in pediatric patients with neuromyelitis optica (NMO). This disorder could have a variable clinical expression. To address such variability, the term NMO spectrum has been suggested. METHOD: We evaluated six pediatric patients, with a median age of 11 years at the time of the study, with the diagnosis of NMO by the Wingerchuck criteria. RESULTS: All the cases exhibited bilateral optic neuritis (ON). Four patients had abnormalities on brain MRI from the onset,although only three of them developed symptoms correlated to those lesions during the course of their disorder. NMO-IgG was positive in 80%. CONCLUSION: Optic neuropathy is the most impaired feature in NMO patients. Brain MRI lesions are not compatible with multiple sclerosis and positivity of the NMO-IgG are also present in NMO pediatric patients, confirming the heterogeneity in the expression of this disorder.
Assuntos
Encefalopatias/patologia , Imunoglobulina G/sangue , Mielite Transversa/patologia , Neuromielite Óptica/patologia , Adolescente , Encéfalo/patologia , Encefalopatias/imunologia , Criança , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Mielite Transversa/imunologia , Neuromielite Óptica/imunologiaRESUMO
OBJECTIVE: To analyze the clinical, neuroimaging characteristics and positivity of the acquaporin water channel (NMO-IgG) in pediatric patients with neuromyelitis optica (NMO). This disorder could have a variable clinical expression. To address such variability, the term NMO spectrum has been suggested. METHOD: We evaluated six pediatric patients, with a median age of 11 years at the time of the study, with the diagnosis of NMO by the Wingerchuck criteria. RESULTS: All the cases exhibited bilateral optic neuritis (ON). Four patients had abnormalities on brain MRI from the onset,although only three of them developed symptoms correlated to those lesions during the course of their disorder. NMO-IgG was positive in 80 percent. CONCLUSION: Optic neuropathy is the most impaired feature in NMO patients. Brain MRI lesions are not compatible with multiple sclerosis and positivity of the NMO-IgG are also present in NMO pediatric patients, confirming the heterogeneity in the expression of this disorder.
OBJETIVO: Analizar las características clínicas y de neuroimagen, y la positividad del canal de agua acuaporin (NMO-IgG) en pacientes pediátricos con neuromielitis óptica (NMO). Este trastorno puede tener una expresión clínica variable. El término espectro de NMO ha sido propuesto para poder incluir la variabilidad. METODO: Evaluamos seis pacientes pediátricos, con una mediana de edad de 11 años al momento del estudio, con el diagnóstico de NMO de acuerdo a los criterios de Wingerchuck. RESULTADOS: Todos los casos exhibían neuritis óptica bilateral (ON). Cuatro pacientes tuvieron anormalidades en la RM cerebral desde el inicio, aunque solo tres de ellos desarrollaron síntomas relacionados con las lesiones durante el curso de la enfermedad. NMO-IgG fue positiva en el 80 por ciento. CONCLUSIÓN: Neuropatía óptica es la característica mayormente observada en los pacientes con NMO. Lesiones cerebrales en la RM cerebral no compatibles con esclerosis multiple y positividad de la NMO-IgG están también presentes en los pacientes pediátricos con NMO; lo cual confirma la heterogeneidad en la expresión clínica de este trastorno.
Assuntos
Adolescente , Criança , Feminino , Humanos , Masculino , Encefalopatias/patologia , Imunoglobulina G/sangue , Mielite Transversa/patologia , Neuromielite Óptica/patologia , Encefalopatias/imunologia , Encéfalo/patologia , Imageamento por Ressonância Magnética , Mielite Transversa/imunologia , Neuromielite Óptica/imunologiaAssuntos
Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Comparação Transcultural , Países em Desenvolvimento , Metilfenidato/uso terapêutico , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Região do Caribe , Criança , Pré-Escolar , Feminino , Humanos , América Latina , Masculino , Avaliação das Necessidades , Encaminhamento e ConsultaRESUMO
The study aims to determine the prevalence of autism spectrum disorders (ASDs) for children receiving services in Maracaibo County, Venezuela. Children aged 3-9 with diagnosis of any ASD were recruited. We ascertained area, referral process, and definitions of ASD for each patient. A total of 430 children were identified, and 76.5 percent were boys. Prevalences were 1.7 per 1000 for all ASD, 1.1 per 1000 for autism, and 0.6 per 1000 for PDD-NOS and Asperger syndrome combined. These prevalences are lower than current reports in the literature. Differences in case-finding methods, diagnostic criteria, and lack of awareness in the general population may have influenced the number of cases identified. An ASD prevalence of 1.7 per 1000 should alert the health and education authorities to the need to reassess the services available for children with these disorders and their families.
Assuntos
Transtorno Autístico/epidemiologia , Síndrome de Asperger/diagnóstico , Síndrome de Asperger/epidemiologia , Transtorno Autístico/diagnóstico , Criança , Transtornos Globais do Desenvolvimento Infantil/diagnóstico , Transtornos Globais do Desenvolvimento Infantil/epidemiologia , Pré-Escolar , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Prevalência , Venezuela/epidemiologiaRESUMO
Diferentes estudios que comparan varones y hembras diagnosticados con Trastorno por Déficit de Atención-Hiperactividad (TDAH) no han sido concluyentes. En general estos estudios reportan que los varones son más hiperactivos y presentan mayor cantidad de problemas de conducta; mientras que las hembras presentan mayor cantidad de problemas cognoscitivos y de aprendizaje. El objetivo de este estudio estuvo dirigido a obtener información acerca de la caracterización del TDAH dependiendo del género. Se recolectaron datos demográficos, escalas de puntuación de padres y profesores, y cociente intelectual de 169 niños (123 varones, 46 hembras), con edades comprendidas entre 4 y 13 años, con diagnóstico de TDAH. La batería de evaluación incluyó las Escalas de Conners-Revisadas para padres y profesores, la versión abreviada de Escala Wechsler para Niños-III edición (WISC-III) y para Pre-Escolares-Revisada (WPPSI-R), medidas de aprovechamiento académico, historia de desarrollo, y el Inventario de Entrevistas Diagnósticas para Niños-IV Versión Padres (DISC-IV. P) Los resultados indicaron ausencia de diferencias significativas entre géneros para ninguna de las variables estudiadas, varones y hembras con TDAH obtuvieron puntuaciones equivalentes en las diferentes medidas de conductuales y cognoscitivas. Los resultados presentados describen homogeneidad de síntomas, características demográficas y funcionamiento neuropsicológico para niños de ambos géneros con diagnóstico de TDAH, sugiriendo un síndrome con los mismos criterios e independiente del género.
Assuntos
Masculino , Humanos , Feminino , Criança , Transtorno do Deficit de Atenção com Hiperatividade , Identidade de Gênero , Neurologia , Pediatria , VenezuelaRESUMO
Results from studies comparing boys and girls diagnosed as having Attention Deficit-Hyperactivity Disorder (ADHD) have been non conclusive. In general, the results of such studies report boys as being more hyperactive and presenting more conduct problems, and girls as having more cognitive and learning problems. The aim of this study was to collect information about the characterization of the disorder depending on the gender. 169 children (123 males, 46 females), between 4 and 13 years of age with ADHD were studied. The assessment battery included Conners' rating scales-Revised for parents and teachers, short forms of the Wechsler Intelligence Scale for Children-Third Edition (WISC-III) and Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R), academic achievement measures, developmental history and the Diagnostic Interview Schedule for Children-IV Version-Parents (DISC-IV). The results indicated the lack of significant differences between genders for the studied variables, ADHD boys and girls scored alike in the various behavioral and cognitive measures. The results presented describe homogeneity in the symptoms, demographic characteristics and neuropsychological functioning for children of both genders; suggesting a syndrome with the same criteria and independent of the gender.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Fatores Sexuais , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/psicologia , Criança , Pré-Escolar , Escolaridade , Feminino , Humanos , Testes de Inteligência , Deficiências da Aprendizagem/epidemiologia , Deficiências da Aprendizagem/etiologia , Deficiências da Aprendizagem/psicologia , Masculino , Testes Neuropsicológicos , Pais/psicologia , Inventário de Personalidade , Índice de Gravidade de Doença , Fatores Socioeconômicos , Venezuela/epidemiologiaRESUMO
Multiple sclerosis (MS) is an autoimmune disease caused by the destruction of the myelin layer and the nervous fibers, and secondary by a progressive neuronal damage. It is characterized by episodes of demyelination disseminated in time and space in different areas of the white matter of the CNS which includes periventricular region, spinal cord, brain stem, cerebellum and optical nerve. Due to the confusing differential diagnosis of MS in children with other demyelinating diseases such as ADEM, it is important to reach this diagnosis when there is proof of white matter lesions disseminated in time and space that cannot be explained by any other mechanisms or pathologies. The goal of this paper is to review the diagnostic parameters used for MS in the pediatric age, the dilemmas regarding the validity of diagnostic criteria, clinical manifestations, differentiation of other demyelinating diseases, and the diagnostic process. MS although infrequent, is a valid diagnosis among the spectrum of childhood inflammatory demyelinating diseases. The clinical presentation might be indistinguishable from a multifocal acute disseminated encephalopathy or could be presented with just focal signs. A reasonable clinical judgment and the practice of laboratory tests confirm or rule out the diagnosis. It is not possible to differentiate between ADEM and MS in a first episode, nor by the clinical, the CSF, neither the neuroimaging. There are still needed consensus criteria both clinical and laboratory test. There are many question still to be answered using prospective studies, and standardized clinical measures that will allow the delimitation of the demographic, neurological, and neuropsychological aspects of the MS and other form of acquired demyelinating diseases in children.