Programas de intervenções comportamentais e de desenvolvimento intensivas precoces para crianças com TEA: uma revisão de literatura
DOI:
https://doi.org/10.5902/1984686X41167Palavras-chave:
Autismo, Intervenção Precoce, Programas de IntervençãoResumo
Indivíduos diagnosticados com Transtorno do Espectro do Autismo (TEA) apresentam comprometimento qualitativo para interagir socialmente de forma recíproca, para discriminar o sentido social das experiências com outros e, por conseguinte, prejuízo significativo no processo de desenvolvimento de habilidades sociocomunicativas. Sinais de autismo podem ser identificados desde o primeiro ano de vida, o que representa possibilidade de iniciar intervenção precoce – sendo esta um importante preditor na recuperação funcional desse transtorno do neurodesenvolvimento. O objetivo do presente estudo é revisar, na literatura científica, procedimentos de intervenção comportamentais e de desenvolvimento intensivas e precoce, em crianças diagnosticadas com TEA, que revelem evidência de resultados. Foram pesquisadas cinco bases de dados internacionais, nas áreas de saúde e educação, como fontes da busca, quais sejam: a) Web of Science; b) Scopus; c) PsycInfo; d) Eric; e, e) BVS. A partir disso, foram selecionados 95 artigos a partir dos critérios de inclusão adotados e identificou-se que as principais áreas de desenvolvimento-alvos das intervenções são habilidades de comunicação, interação social e cognição; o tempo médio pode variar, contudo, a recomendação é de que haja intensidade de, no mínimo, 3 horas por dia; os contextos de intervenção variam e envolvem predominantemente ambientes clínicos ou domésticos, cujos agentes de intervenção são técnicos e pais. Quanto aos ingredientes ativos nos efeitos das intervenções, quanto mais nova a criança e mais alto for o QI, maior a probabilidade de desfechos favoráveis na intervenção; em relação aos principais indicadores de qualidade, os programas são avaliados a partir de ganhos nas habilidades cognitivas, de linguagem, adaptativas e sociais. Tais resultados podem ser convertidas em diretrizes na implementação de programas de intervenção precoce para crianças com autismo.
Downloads
Referências
ASSOCIAÇÃO AMERICANA DE PSIQUIATRIA - APA. (2014). DSM-5 - Manual Diagnóstico e Estatístico de Transtornos Mentais. Porto Alegre: ArtMed.
BARIL, Erika M.; HUMPHREYS, Betsy P. An Evaluation of the Research Evidence on the Early Start Denver Model. Journal of Early Intervention, Durham, v. 39, n. 4, p. 321–338, jul. 2017.
BEN-ITZCHAK, Ester; ZACHOR, Ditza A. Who benefits from early intervention in autism spectrum disorders? Research in Autism Spectrum Disorders. v. 5, n. 1, p. 345–350, 2011.
BOSA, Cleonice Alves. Autismo: intervenções psicoeducacionais. Revista Brasileira de Psiquiatria, São Paulo, v. 28(Supl I), p. S47-53, 2006. Dispnível em: http://www.scielo.br/pdf/rbp/v28s1/a07v28s1.pdf. Acesso em: 31 mar. 2020.
BOSA, Cleonice Alves; ZANON, Regina Basso. Bases teóricas do desenvolvimento pré-lingüístico: implicações para o diagnóstico precoce do autismo. In Autismo - Vivências e Caminhos. São Paulo: Blucher, 2016.
BRADSHAW, Jessica. et al. Feasibility and Effectiveness of Very Early Intervention for Infants At-Risk for Autism Spectrum Disorder: A Systematic Review. Journal of Autism and Developmental Disorders, v. 45, n. 3, p. 778–794, mar., 2015.
CANAL-BEDIA, Ricardo. et al. Programas de cribado y atención temprana en niños con trastornos del espectro autista. Revista Neurología, v. 58(Supl 1), 123–127, fev., 2014. Disponível em < http://www.neurologia.com/pdf/Web/58S01/blS01S123.pdf>. Acesso em: 30 jan. 2019
CANCINO, Miguel Higuera. Transtornos do desenvolvimento e da comunicação. Rio de Janeiro: WAK, 2013.
CARON, Valérie; BÉRUBÉ, Annie; PAQUET, Annie. Implementation evaluation of early intensive behavioral intervention programs for children with autism spectrum disorders: A systematic review of studies in the last decade. Evaluation and Program Planning, Canadá, v. 62, p. 1–8, jun., 2017.
COLOMBI, Costanza et al. Implementation of the Early Start Denver Model in an Italian community. Autism, Itália, v. 22, n. 2, p. 126–133, out., 2016.
CONTALDO, Annarita. et al. The social effect of “being imitated” in children with autism spectrum disorder. Frontiers in Psychology, v.7, mai., 2016.
D’ELIA, Lidia. et al. A Longitudinal Study of the Teacch Program in Different Settings: The Potential Benefits of Low Intensity Intervention in Preschool Children with Autism Spectrum Disorder. Journal of Autism and Developmental Disorders, v. 44, n. 3, p. 615–626, mar., 2014.
DABABNAH, Sarah; PARISH, Susan L. Feasibility of an empirically based program for parents of preschoolers with autism spectrum disorder. Autism, v. 20, n. 1, p. 85–95, fev., 2015.
DAWSON, Geraldine. et al. Early Behavioral Intervention Is Associated With Normalized Brain Activity in Young Children With Autism. Journal of the American Academy of Child & Adolescent Psychiatry, EUA, v. 51 n.11, p. 1150–1159, nov., 2012.
DEL SOL FORTEA, María; ESCANDELL, Maria Olga; CASTRO, José Juan. Assessment of the efficacy of a program to improve the social communication and behavior of young children with autism spectrum disorders. Revista de Investigacion En Logopedia, Espanha, v.5, n. 2, p. 167–185, 2015. Disponível em: https://www.scopus.com/inward/record.uri?eid=2-s2.0-84948738941&partnerID=40&md5=dde631b1a38a0a4157c60dcec7d5081b. Acesso em: 31 mar. 2020
EAPEN, Valsamma; ČRNČEC, Rudi; WALTER, Amelia. Clinical outcomes of an early intervention program for preschool children with Autism Spectrum Disorder in a community group setting. BMC Pediatrics, v. 13 n. 3, p. 1–9, jan., 2013.
EIKESETH, Svein. Outcome of comprehensive psycho-educational interventions for young children with autism. Research in Developmental Disabilities, v. 30 n. 1, p. 158–178. fev., 2009.
EIKESETH, Svein. et al. Outcome for children with autism receiving early and intensive behavioral intervention in mainstream preschool and kindergarten settings. Research in Autism Spectrum Disorders, v. 6, n. 2, p. 829–835, jun., 2012.
ELDEVIK, Sigmund. et al. Meta-Analysis of Early Intensive Behavioral Intervention for Children With Autism. Journal of Clinical Child & Adolescent Psychology, v., 38, n. 3, p. 439–450, 2009.
ESTES, Annette. et al. The impact of parent-delivered intervention on parents of very young children with autism. Journal of Autism and Developmental Disorders, v. 44, n. 2, jul., 2013.
FREITAG, Christine M. et al. The Frankfurt early intervention early intervention program FFIP for preschool aged children with autism spectrum disorder: a pilot study. Journal of Neural Transmission, v. 119, n. 9, 1011–1021, 2012.
HERBRECHT, Evelyn. et al. Become Related: FIAS, an Intensive Early Intervention for Young Children with Autism Spectrum Disorders. Psychopathology, Suíça, v. 48, n. 3, p. 162–172, 2015.
HOWARD, Jane S. et al. A comparison of intensive behavior analytic and eclectic treatments for young children with autism. Research in Developmental Disabilities, v. 26, n. 4, p. 359–383, 2005.
HOWARD, Jane S. et al. Comparison of behavior analytic and eclectic early interventions for young children with autism after three years. Research in Developmental Disabilities, EUA, v. 35, n. 12, p. 3326–3344, dez., 2014.
HOWLIN, Patricia; MAGIATI, Iliana; CHARMAN, Tony. Systematic Review of Early Intensive Behavioral Interventions for Children With Autism. American Journal on Intellectual and Developmental Disabilities, Londres, v. 114, n. 1, p. 23–41, jan., 2009.
JANSSON, Birgitta Spjut. et al. Children who screen positive for autism at 2.5 years and receive early intervention: A prospective naturalistic 2-year outcome study. Neuropsychiatric Disease and Treatment, v. 12, p. 2255–2263, nov., 2016.
KRISHNAN, Raman. et al. The effectiveness of an intensive, parent mediated, multi-component, early intervention for children with autism. Journal of Indian Association for Child & Adolescent Mental Health, v. 12, n. 3, p. 230–252, 2016.
LAMPREIA, Carolina. A perspectiva desenvolvimentista para a intervenção precoce no autismo. Estudos de Psicologia, Campinas, v. 24, n. 1, p. 105–114, 2007.
MACDONALD, Rebecca. et al. Assessing progress and outcome of early intensive behavioral intervention for toddlers with autism. Research in Developmental Disabilities, v. 35, n. 12, p. 3632–3644, dez., 2014.
MAHONEY, Gerald; SOLOMON, Richard. Mechanism of Developmental Change in the PLAY Project Home Consultation Program: Evidence from a Randomized Control Trial. Journal of Autism and Developmental Disorders, v. 46, n. 5, p. 1860–1871, jan., 2016.
MAKRYGIANNI, Maria K.; REED, Phill. A meta-analytic review of the effectiveness of behavioural early intervention programs for children with Autistic Spectrum Disorders. Research in Autism Spectrum Disorders, v. 4, n. 4, p. 577–593, out., 2010.
MARQUES, Daniela Fernandes; BOSA, Cleonice Alves. Protocolo de Avaliação de Crianças com Autismo: Evidências de Validade de Critério. Psicologia: Teoria e Pesquisa, Brasília, v. 31, n. 1, p. 43–51, mar., 2015.
MARTOS-PÉREZ, Juan; LLORENTE-COMÍ, María. Tratamiento de los trastornos del espectro autista: unión entre la comprensión y la práctica en la evidencia. Revista de Neurología, v. 57(Supl 1), s185–s191, 2013. Disponível em: http://centroalgoritmus.com/pdfs/articulos-autismo-general/union-entre-comprension-tratamientos.pdf. Acesso em: 31 mar. 2020.
MCCONACHIE, Helen; OONO, Inalegwo. Cochrane in context: Parent-mediated early intervention for young children with autism spectrum disorders (ASD). Evidence-Based Child Health: A Cochrane Review Journal, v. 8, n. 6, p. 2483–2485, 2013.
MOINÁR, Claire; ELDEVIK, Sigmund. Behavioral intervention for preschool children with autism – outcome of parent-based Intervention. Z Kinder Jugendpsychiatr Psychother, v. 45, n. 3, p. 181–191, set., 2016.
NAIR, M. K. C. et al. CDC Kerala 9: Effectiveness of Low Intensity Home Based Early Intervention for Autism Spectrum Disorder in India. Indian Journal of Pediatrics, v. 81, n. 2, p. 115–119, 2014.
NAIR, M. K. C. et al. CDC Kerala 8: Effectiveness of a Clinic Based, Low Intensity, Early Intervention for Children with Autism Spectrum Disorder in India: A Naturalistic Observational Study. Indian Journal of Pediatrics, v. 81. n. 2, p. 110–114, 2014.
NARZISI, Antonio. et al. Non-Pharmacological Treatments in Autism Spectrum Disorders: An Overview on Early Interventions for Pre-Schoolers. Current Clinical Pharmacology, v. 9, n. 1, p. 17–26, 2014.
OONO, Inalegwu P.; HONEY, Emma J.; MCCONACHIE, Hellen. Parent-mediated early intervention for young children with autism spectrum disorders (ASD). Evidence-Based Child Health, v. 8 n. 6, p. 2380–2479, nov., 2013.
OZONOFF, Sally. et al. A prospective study of the emergence of early behavioral signs of autism. Journal of the American Academy of Child and Adolescent Psychiatry, EUA, v. 49, n. 3, p. 256-66.e1–2, mar., 2010.
PAYNTER, Jessica M. et al. Brief Report: An Evaluation of an Australian Autism-Specific, Early Intervention Programme. International Journal of Special Education, v. 30, n. 2, p. 13–19, 2015.
PERERA, Hemamali. et al. Outcome of home-based early intervention for autism in Sri Lanka: Follow-up of a cohort and comparison with a nonintervention group. BioMed Research International, p. 2–7, jun., 2016.
PETERS-SCHEFFER, Nienke. et al. A meta-analytic study on the effectiveness of comprehensive ABA-based early intervention programs for children with Autism Spectrum Disorders. Research in Autism Spectrum Disorders, v. 5, n. 1, p. 60–69, jan., 2011.
REED, Phil. et al. Evaluation of the Barnet Early Autism Model (BEAM) teaching intervention programme in a ‘real world’ setting. Research in Autism Spectrum Disorders, UK, v. 7, n. 6, p. 631–638, jun., 2013.
REICHOW, Brian. et al. Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD) (Review) Early intensive behavioral intervention (EIBI) for young children with autism spectrum disorders (ASD). Wiley Publishers, EUA, n. 10, p. 2–4, out., 2012.
REICHOW, Brian; WOLERY, Mark. Comprehensive Synthesis of Early Intensive Behavioral Interventions for Young Children with Autism Based on the UCLA Young Autism Project Model. Journal of Autism and Developmental Disorders, v. 39, n. 1, p. 23–41, jan., 2009.
RIVARD, Mélina; TERROUX, Amélie; MERCIER, Céline. Effectiveness of early behavioral intervention in public and mainstream settings: The case of preschool-age children with autism spectrum disorders. Research in Autism Spectrum Disorders, v. 8, n. 9, p. 1031–1043, set., 2014.
ROBERTS, Jacqueline. et al. A randomised controlled trial of two early intervention programs for young children with autism: Centre-based with parent program and home-based. Research in Autism Spectrum Disorders, v. 5, n. 4, p. 1553–1566, out., 2011.
ROGERS, Sally J.; VISMARA, Laurie. A. Evidence-Based Comprehensive Treatments for Early Autism. Journal of Clinical Child and Adolescent Psychology, v. 37, n. 1, p. 8–38, jan., 2008.
ROGERS, Sally J. et al. Effects of a Brief Early Start Denver Model (ESDM)–Based Parent Intervention on Toddlers at Risk for Autism Spectrum Disorders: A Randomized Controlled Trial. Journal of the American Academy of Child & Adolescent Psychiatry, v. 51, n. 10, p. 1052–1065, out., 2012.
ROGERS, Sally J.; DAWSON, Geraldine. Intervenção Precoce em Crianças com Autismo: Modelo Denver para a promoção da linguagem, da aprendizagem e da socialização. Lisboa: Lidel, 2014.
RYBERG, Kayce. H. Evidence for the Implementation of the Early Start Denver Model for Young Children With Autism Spectrum Disorder. Journal of the American Psychiatric Nurses Association, v. 21, n. 5, p. 327–337, out., 2015.
SÁNCHEZ-RAYA, Araceli. et al. La atención temprana en los trastornos del espectro autista (TEA). Psicologia Educativa, Espanha, v. 21, n. 1, p. 55–63, jun. 2015.
SALVADÓ-SALVADÓ, Berta. et al. Modelos de intervención global en personas con trastorno del espectro autista. Revista de Neurología, v. 54, n. 1, p. 63–71, 2012. Disponível em <http://dugi-doc.udg.edu/bitstream/handle/10256/12558/025355.pdf?sequence=1>. Acesso em 31 mar. 2020.
SHANNON, Robin Adair. A Clinical Translation of the Article Titled “Evidence for the Implementation of the Early Start Denver Model for Young Children With Autism Spectrum Disorder.” Journal of the American Psychiatric Nurses Association, EUA, v. 21, n. 5, p. 338–342, out., 2015.
SMITH, Tristram; KLORMAN, Rafael; MRUZEK, Daniel W. Predicting Outcome of Community-Based Early Intensive Behavioral Intervention for Children with Autism. Journal of Abnormal Child Psychology, v. 43, n. 7, p. 1271–1282, out., 2015.
SOLOMON, Richard. et al. PLAY Project Home Consultation Intervention Program for Young Children With Autism Spectrum Disorders: A Randomized Controlled Trial. Journal of Developmental and Behavioral Pediatrics, v. 35, n. 8, p. 475–485, out., 2014.
STAHMER, Aubyn. C. The basic structure of community early intervention programs for children with autism: Provider descriptions. Journal of Autism and Developmental Disorders, v. 37, n. 7, p. 1344–1354, ago., 2007.
STRAIN, Phillip. S.; SCHWARTZ, Ilene S.; BARTON, Erin. Providing Interventions for Young Children With Autism Spectrum Disorders. Journal of Early Intervention, v. 33, n. 4, p. 321–332, jan., 2012.
TOMASELLO, Michael. Origens culturais da aquisição do conhecimento humano. São Paulo: Martins Fontes, 2003.
TOMASELLO, Michael. Origins of human communication. Massachussetts: The MIT Press, 2008.
TOMASELLO, Michael. et al. Understanding and sharing intentions: the origins of cultural cognition. Behavioral and Brain Sciences, v. 8, n. 5, p. 675–735, 2005.
TONGE, Bruce. et al. A review of evidence-based early intervention for behavioural problems in children with autism spectrum disorder. Current Opinion in Psychiatry, v. 27, n. 2, p. 158–165, jan., 2014.
VIRUÉS-ORTEGA, Javier. Applied behavior analytic intervention for autism in early childhood: Meta-analysis, meta-regression and dose–response meta-analysis of multiple outcomes. Clinical Psychology Review, Espanha, v. 30, n. 4, p. 387–399, jun., 2010.
VIVANTI, Giacomo; DISSANAYAKE, Cheryl. Outcome for Children Receiving the Early Start Denver Model Before and After 48 Months. Journal of Autism and Developmental Disorders, v. 46, n. 7, p. 2441–2449, jul., 2016.
VIVANTI, Giacomo. et al. Effectiveness and Feasibility of the Early Start Denver Model Implemented in a Group-Based Community Childcare Setting. Journal of Autism and Developmental Disorders, EUA, v. 44, n. 12, p. 3140–3153, dez., 2014.
WARREN, Zachary. et al. A Systematic Review of Early Intensive Intervention for Autism Spectrum Disorders. Pediatrics, v. 127, n. 5, p. e1303–e1311, mai., 2011.
XU, Yun. A Pilot Study of a Culturally Adapted Early Intervention for Young Children With Autism Spectrum Disorders in China. Journal of Early Intervention, China, v. 40, n. 1, p. 52–68, dez., 2017.
ZANON, Regina Basso; BACKES, Bárbara; BOSA, Cleonice Alves. Diferenças conceituais entre resposta e iniciativa de atenção compartilhada. Revista Psicologia: Teoria e Prática, São Paulo, v. 17, n. 2, p. 78–90, ago., 2015.
ZANON, Regina Basso; BACKES, Bárbara; BOSA, Cleonice Alves. Diagnóstico do autismo: relação entre fatores contextuais, familiares e da criança. Revista Psicologia: Teoria e Prática, São Paulo, v. 19, n. 1, p. 152–163, abr., 2017.
ZWAIGENBAUM, Lonnie. et al. Early Intervention for Children With Autism Spectrum Disorder Under 3 Years of Age: Recommendations for Practice and Research. Pediatrics, v. 136(Supplement), p. S60–S81, out., 2015.
Publicado
Como Citar
Edição
Seção
Licença
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)
DECLARAÇÃO DE ORIGINALIDADE E DIREITOS AUTORAIS
Declaramos o artigo a ser submetido para avaliação na Revista Educação Especial (UFSM) é original e inédito, assim como não foi enviado para qualquer outra publicação, como um todo ou uma fração.
Também reconhecemos que a submissão dos originais à Revista Educação Especial (UFSM) implica na transferência de direitos autorais para publicação digital na revista. Em caso de incumprimento, o infrator receberá sanções e penalidades previstas pela Lei Brasileira de Proteção de Direitos Autorais (n. 9610, de 19/02/98).
