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http://www.codas.periodikos.com.br/article/doi/10.1590/2317-1782/e20240306en
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Original Article

Early symptoms of autism spectrum disorders and association with Brazilian children's development and behavior

Rafaela Silva Moreira; Marina Aguiar Pires Guimarães; Lívia de Castro Magalhães; Janaina Matos Moreira; Claudia Regina Lindgren Alves

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Abstract

ABSTRACT: Purpose: to examine the association between the early autism spectrum disorder (ASD) signs and developmental and behavioral performance of Brazilian children aged 18 to 34 months.

Methods: A cross-sectional study with 221 children recruited at public healthcare and early education services. Early symptoms of ASD were screened using the Parental Observations of Social Interaction (POSI). Children's development and behavior were examined using the Ages and Stages Questionnaires (ASQ-3) and Survey of Well-being of Young Children (SWYC-BR). The results of children at risk for ASD were compared to the no-risk ones using Chi-square and t-test.

Results: The overall frequency of children at risk for ASD (POSI-positive screening) was 33% and did not differ across children's age range and gender. Children at risk for ASD showed worse socio-emotional behaviors (p=0.004) and lower scores for overall development (p=0.0001), communication (p=0.0007), fine motor (p=0.04), and personal-social domains (p=0.01). Differences between groups varied according to children's age and across developmental/behavioral domains and were more evident in older children. Children aged 30 to 34 months presented significant differences in overall development (p=0.001), behavior (p=0.004), and the personal-social domains (p=0.03).

Conclusions: The frequency of children at risk for ASD was higher than described in the literature. Also, the development and behavior of children at risk for ASD were significantly different from their peers and compatible with the presentation of ASD in young children. Our findings reinforce the need for systematic and holistic surveillance of child development during well-being visits to improve ASD early detection.

Keywords

Autism Spectrum Disorder, Infants, Child Development, Behavior, Screening

Referências

1 American Psychiatric Association. American Psychiatric Association: Diagnostic and Statistiscal Manual of Mental Disorders. 5th ed. Washington: American Psychiatric Publising; 2013. 970 p.

2 Li YA, Chen ZJ, Li XD, Gu MH, Xia N, Gong C, et al. Epidemiology of autism spectrum disorders: global burden of disease 2019 and bibliometric analysis of risk factors. Front Pediatr. 2022;10:972809. http://doi.org/10.3389/fped.2022.972809. PMid:36545666.

3 Marlow M, Servili C, Tomlinson M. A review of screening tools for the identification of autism spectrum disorders and developmental delay in infants and young children: recommendations for use in low- and middle-income countries. Autism Res. 2019;12(2):176-99. http://doi.org/10.1002/aur.2033. PMid:30707000.

4 Maenner MJ, Shaw KA, Bakian AV, Bilder DA, Durkin MS, Esler A, et al. Prevalence and Characteristics of Autism Spectrum Disorder Among Children Aged 8 Years: Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2018. MMWR Surveill Summ. 2021;70(11):1-16. http://doi.org/10.15585/mmwr.ss7011a1. PMid:34855725.

5 Shaw KA, Bilder DA, McArthur D, Williams AR, Amoakohene E, Bakian AV, et al. Early Identification of Autism Spectrum Disorder Among Children Aged 4 Years: Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020. MMWR Surveill Summ. 2023;72(1):3-16. http://doi.org/10.15585/mmwr.ss7201a1. PMid:36952289.

6 Oner O, Munir KM. Modified Checklist for Autism in Toddlers Revised (MCHAT-R/F) in an urban metropolitan sample of young children in Turkey. J Autism Dev Disord. 2019;50(9):3312-9. http://doi.org/10.1007/s10803-019-04160-4. PMid:31414260.

7 Hoang VM, Le TV, Chu TTQ, Le BN, Duong MD, Thanh NM, et al. Prevalence of autism spectrum disorders and their relation to selected socio-demographic factors among children aged 18-30 months in northern Vietnam, 2017. Int J Ment Health Syst. 2019;13:29. http://doi.org/10.1186/s13033-019-0285-8. PMid:31168317.

8 Gomes PTM, Lima LHL, Bueno MKG, Araújo LA, Souza NM. Autism in Brazil: a systematic review of family challenges and coping strategies. J Pediatr. 2015;91(2):111-21.https://doi.org/10.1016/j.jped.2014.08.009.

9 Hyman SL, Levy SE, Myers SM, Kuo DZ, Apkon S, Davidson LF, et al. Identification, evaluation, and management of children with autism spectrum disorder. Pediatrics. 2020;145(1):145. http://doi.org/10.1542/peds.2019-3447.

10 Salisbury LA, Nyce JD, Hannum CD, Sheldrick RC, Perrin EC. Sensitivity and specificity of 2 autism screeners among referred children between 16 and 48 months of age. J Dev Behav Pediatr. 2018;39(3):254-8. http://doi.org/10.1097/DBP.0000000000000537. PMid:29570569.

11 Sheldrick RC, Maye MP, Carter AS. Age at first identification of autism spectrum disorder: an analysis of two US surveys. J Am Acad Child Adolesc Psychiatry. 2017;56(4):313-20. http://doi.org/10.1016/j.jaac.2017.01.012. PMid:28335875.

12 Ribeiro SHB, de Paula CS, Bordini D, Mari JJ, Caetano SC. Barriers to early identification of autism in Brazil. Rev Bras Psiquiatr. 2017;39(4):352-4. http://doi.org/10.1590/1516-4446-2016-2141. PMid:28977067.

13 Gabbay-Dizdar N, Ilan M, Meiri G, Faroy M, Michaelovski A, Flusser H, et al. Early diagnosis of autism in the community is associated with marked improvement in social symptoms within 1–2 years. Autism. 2022;26(6):1353-63. http://doi.org/10.1177/13623613211049011. PMid:34623179.

14 Sicherman N, Charite J, Eyal G, Janecka M, Loewenstein G, Law K, et al. Clinical signs associated with earlier diagnosis of children with autism Spectrum disorder. BMC Pediatr. 2021;21(1):1-14. http://doi.org/10.1186/s12887-021-02551-0. PMid:33632186.

15 Arastoo S, Abdullah MM, Youssef J, Guo Y, Schuck SEB, Goldberg WA, et al. The relative utility of concurrent sources of information for diagnosis of autism spectrum disorder in early childhood. Front Pediatr. 2020;8:1-7. http://doi.org/10.3389/fped.2020.00486. PMid:33014922.

16 Lipkin PH, Macias MM, Norwood KW Jr, Brei TJ, Davidson LF, Davis BE, et al. Promoting optimal development: identifying infants and young children with developmental disorders through developmental surveillance and screening. Pediatrics. 2020;145(1):145. http://doi.org/10.1542/peds.2019-3449. PMid:31843861.

17 Brentani H, Polanczyk GV, Miguel EC. Brazil and Autism. In: Volkmar FR, editors. Encyclopedia of autism spectrum disorders. Cham: Springer International Publishing; 2021. p. 734-44. http://doi.org/10.1007/978-3-319-91280-6_102021.

18 Girianelli VR, Tomazelli J, da Silva CMFP, Fernandes CS. Early diagnosis of autism and other developmental disorders, Brazil, 2013-2019. Rev Saude Publica. 2023;57:21. PMid:37075404.

19 Sukiennik R, Marchezan J, Scornavacca F. Challenges on diagnoses and assessments related to autism spectrum disorder in Brazil: a systematic review. Front Neurol. 2022;12:598073. http://doi.org/10.3389/fneur.2021.598073. PMid:35126275.

20 Backes B, Monego BG, Bosa CA, Bandeira DR. Psychometric properties of assessment instruments for autism spectrum disorder: a systematic review of Brazilian studies. J Bras Psiquiatr. 2014;63(2):154-64. http://doi.org/10.1590/0047-2085000000020.

21 Paula CS, Fombonne E, Gadia C, Tuchman R, Rosanoff M. Autism in Brazil: perspectives from science and society. Rev da Assoc Médica Bras. 2011;57(1):2-5. PMid:21390445.

22 Smith NJ, Sheldrick RC, Perrin EC. An abbreviated screening instrument for autism spectrum disorders. Infant Ment Health J. 2013;34(2):149-55. http://doi.org/10.1002/imhj.21356.

23 Robins DL, Casagrande K, Barton M, Chen CM, Dumont-Mathieu T, Fein D. Validation of the modified checklist for autism in toddlers, revised with follow-up (M-CHAT-R/F). Pediatrics. 2014;133(1):37-45. http://doi.org/10.1542/peds.2013-1813. PMid:24366990.

24 Perrin E, Sheldrick C, Visco Z, Mattern K. The survey of well-being of young children (SWYC): user's manual. Boston: Tufts Medical Center; 2016. 157 p.

25 Myers SM, Challman TD. Autism spectrum disorder. In: Voigt RG, Macias SM, Tapia CD. Developmental and behavioral pediatrics - section on developmental and behavioral pediatrics. 2nd ed. Washington, D.C.: American Academy of Pediatrics; 2018. p. 406-76. http://doi.org/10.1542/9781610021357-19.

26 Hardy S, Haisley L, Manning C, Fein D. Can screening with the ages and stages questionnaire detect autism? J Dev Behav Pediatr. 2015;36(7):536-43. http://doi.org/10.1097/DBP.0000000000000201. PMid:26348972.

27 Losapio MF, Siquara GM, Lampreia C, Lazaro CP, Ponde MP. Translation into Brazilian Portuguese and validation of the M-CHAT-R/F scale for early screening of autism spectrum disorder. Rev Paul Pediatr. 2023;41:e2021262. http://doi.org/10.1590/1984-0462/2023/41/2021262. PMid:35830165.

28 Moreira RS, Magalhães LDC, Siqueira CM, Alves CRL. Cross-cultural adaptation of the child development surveillance instrument “Survey of Wellbeing of Young Children (SWYC)” in the Brazilian context. J Hum Growth Dev. 2019;29:28-38. http://doi.org/10.7322/jhgd.145001.

29 Sheldrick RC, Frenette E, Vera JD, Mackie TI, Martinez-Pedraza F, Hoch N, et al. What drives detection and diagnosis of autism spectrum disorder? looking under the hood of a multi-stage screening process in early intervention. J Autism Dev Disord. 2019;49(6):2304-19. http://doi.org/10.1007/s10803-019-03913-5. PMid:30726534.

30 ABEP: Associação Brasileira de Empresas de Pesquisa. Critério Brasil e Alterações na aplicação do Critério Brasil, válidas a partir de 16/04/2018. São Paulo: ABEP; 2018.

31 Jane Squires DB. Ages & Stages Questionnaires. In: Squires J, Twombly E, Bricker D, Potter LW. ASQ-3TM user's guide. 3rd ed. Baltimore: Brookes Publishing; 2009. 170 p.

32 Filgueiras A, Pires P, Maissonette S, Landeira-fernandez J. Early Human Development Psychometric properties of the Brazilian-adapted version of the Ages and Stages Questionnaire in public child daycare centers. Early Hum Dev. 2013;89(8):561-76. http://doi.org/10.1016/j.earlhumdev.2013.02.005. PMid:23507472.

33 Sheldrick RC, Henson BS, Merchant S, Neger EN, Murphy JM, Perrin EC. The Preschool Pediatric Symptom Checklist (PPSC): development and initial validation of a new social/emotional screening instrument. Acad Pediatr. 2012;12(5):456-67. http://doi.org/10.1016/j.acap.2012.06.008. PMid:22921494.

34 Paula CS, Ribeiro SH, Fombonne E, Mercadante MT. Brief report: Prevalence of pervasive developmental disorder in Brazil: a pilot study. J Autism Dev Disord. 2011;41(12):1738-42. http://doi.org/10.1007/s10803-011-1200-6. PMid:21337063.

35 Zaqueu LCC, Teixeira MCTV, Alckmin-Carvalho F, Paula CS. Associações entre sinais precoces de autismo, atenção compartilhada e atrasos no desenvolvimento infantil. Psicol, Teor Pesqui. 2015;31(3):293-302. http://doi.org/10.1590/0102-37722015032243293302.

36 Chiarotti F, Venerosi A. Epidemiology of autism spectrum disorders: a review of worldwide prevalence estimates since 2014. Brain Sci. 2020;10(5):274. http://doi.org/10.3390/brainsci10050274. PMid:32370097.

37 Li L, Pasco G, Ali JB, Johnson MH, Jones EJH, Charman T. Associations between early language, motor abilities, and later autism traits in infants with typical and elevated likelihood of autism. Autism Res. 2023;16(11):2184-97. http://doi.org/10.1002/aur.3023. PMid:37698295.

38 Sacrey LAR, Zwaigenbaum L, Bryson S, Brian J, Smith IM, Roberts W, et al. Can Parents’ concerns predict autism spectrum disorder? A prospective study of high-risk siblings from 6 to 36 months of age. J Am Acad Child Adolesc Psychiatry. 2015;54(6):470-8. http://doi.org/10.1016/j.jaac.2015.03.014. PMid:26004662.
 


Submetido em:
26/09/2024

Aceito em:
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