Diss. (sammanfattning) Uppsala : Uppsala universitet, 2006. / ISBN ej i pappersutskriften. Härtill 4 uppsatser.

Thesis (M.A.)--University of Nevada, Reno, 2004. / Includes bibliographical references. Online version available on the World Wide Web.

Autism prevalence studies have often relied on administrative prevalence or clinical diagnosis as case-identification strategies. We report the incidence of clinical diagnoses of autism spectrum disorders (ASD), versus research-identified autism among residents of Olmsted County, Minnesota, age =21 years, from 1976-1997. The incidence of clinically diagnosed ASD (with 95% CI) was 1.5 per 100,000 (0.0-3.7) in 1980-1983 and 33.1 (22.8-43.3) in 1995-1997, a 22.1-fold increase. In contrast, the incidence of research-identified autism increased from 5.5 (1.4-9.5) per 100,000 to 44.9 (32.9-56.9), an 8.2-fold increase. Only 46.8% of research-identified cases received a clinical diagnosis of ASD. These findings demonstrate the potential for misleading interpretation of results from epidemiologic studies that rely on clinical diagnosis of autism to identify cases.

Tema: No desenvolvimento típico há um movimento constante em direção à maior complexidade lingüística com o decorrer do tempo, mas esta evolução nem sempre é observada nos distúrbios de linguagem. Especificamente nos Transtornos do Espectro Autístico, os estudos têm apresentado resultados conflitantes a respeito da evolução lingüística. Objetivo: Caracterizar a linguagem oral de crianças autistas estudando as variáveis gramaticais, vocabulares e pragmáticas em três momentos distintos: avaliação inicial, após seis e após doze meses de terapia fonoaudiológica. Método: participaram desta pesquisa dez crianças do sexo masculino, com idades entre 2.7 e 11.2 anos. Todos foram diagnosticados por médicos como portadores de Transtornos do Espectro Autístico. Foram realizadas filmagens de 30 minutos de interação entre terapeuta e paciente, em três momentos diferentes (inicial, após 6 e 12 meses de terapia). De cada filmagem, foram transcritos os quinze minutos iniciais para análise do Perfil Funcional da Comunicação. Para a análise dos aspectos gramaticais foram transcritos cem segmentos de fala e estes também foram utilizados como corpus de análise dos aspectos vocabulares. Os dados foram analisados quanto à funcionalidade, aspectos gramaticais e vocabulares e foram comparados entre si longitudinalmente. Resultados: não houve diferença estatisticamente significativa nas variáveis entre os três momentos de coleta, exceto com relação ao número de segmentos frasais não contados em outras categorias. Foram encontradas diferenças significativas entre diferentes variáveis ao longo do período de coleta. Conclusão: as variáveis estudadas mostraram consistência no desempenho do grupo estudado / Language is a symbolic process that allows intra and inter-personal communication. Several authors consider it as an integrated system comprised of sub-systems that must work harmonically and interdependently. These functioning can be observed in normal development but not in cases of language disorder. Among them, the disorders of the autism spectrum (ASD) are complex conditions that include disorders in the areas of cognition and socialization, as well as communication. The unbalance among these areas has been described by many authors. Nevertheless there is no agreement whether it can be also observed among language components. The general purpose of this research was to study vocabulary, grammatical and pragmatic variables on the language of subjects with autism spectrum disorders on three different moments: language therapy onset, after six and twelve months. Subjects were ten individuals with diagnosis included in the Autism Spectrum Disorders (ASD) with ages varying between 2:7y. and 11:2y. (mean 7:2y.). All participants were of the male gender and had their diagnosis performed by psychiatrists according to the DSM-IV criteria. All were filmed at the start of weekly language therapy process (moment 1), after six months (moment 2) and twelve months latter (moment 3). The method used on the three studies includes the analysis of a spontaneous speech filmed samples of 30 minutes interaction sessions of each child and a language therapist. To the analysis of the pragmatic variables the first 15 minutes of each sample were transcribed. Data refer to number of communicative acts per minute, communicative means used, amount and type of communicative functions expressed, proportion of interpersonal communicative acts and occupation of the communicative context. To the vocabulary analysis the assessment identified psychological state terms (including desire, emotional, cognitive and physical) and designative terms (of action, natural and cultural entity, special and temporal localization, artifacts, names of body parts and persons). Grammatical variables referred to morphemes, grammatical classes, mean length of utterance in morphemes and words, unintelligible segments and non-categorized phrasal segments. To allow the discussion of data the research was subdivided in three studies. Study 1 assessed vocabulary, grammatical and pragmatic variables of the sample, characterizing the group performance along the studied period. Study 2 analyzed the associations between the types of variables along 12 months of language therapy. Study 3 investigated which of the variables predicted linguistic development after twelve months of language therapy. Statistical analysis showed that the item that better identified the changes that occurred during the twelve months of language therapy was the number of non-categorized phrasal segments. Generally the associations among variables were relatively uniform, showing consistent performance. The third study showed that some grammatical variables predicted pragmatic development while vocabulary variables predicted grammatical development. These findings highlighted the language peculiarities of the studied subjects

Tema: No desenvolvimento típico há um movimento constante em direção à maior complexidade lingüística com o decorrer do tempo, mas esta evolução nem sempre é observada nos distúrbios de linguagem. Especificamente nos Transtornos do Espectro Autístico, os estudos têm apresentado resultados conflitantes a respeito da evolução lingüística. Objetivo: Caracterizar a linguagem oral de crianças autistas estudando as variáveis gramaticais, vocabulares e pragmáticas em três momentos distintos: avaliação inicial, após seis e após doze meses de terapia fonoaudiológica. Método: participaram desta pesquisa dez crianças do sexo masculino, com idades entre 2.7 e 11.2 anos. Todos foram diagnosticados por médicos como portadores de Transtornos do Espectro Autístico. Foram realizadas filmagens de 30 minutos de interação entre terapeuta e paciente, em três momentos diferentes (inicial, após 6 e 12 meses de terapia). De cada filmagem, foram transcritos os quinze minutos iniciais para análise do Perfil Funcional da Comunicação. Para a análise dos aspectos gramaticais foram transcritos cem segmentos de fala e estes também foram utilizados como corpus de análise dos aspectos vocabulares. Os dados foram analisados quanto à funcionalidade, aspectos gramaticais e vocabulares e foram comparados entre si longitudinalmente. Resultados: não houve diferença estatisticamente significativa nas variáveis entre os três momentos de coleta, exceto com relação ao número de segmentos frasais não contados em outras categorias. Foram encontradas diferenças significativas entre diferentes variáveis ao longo do período de coleta. Conclusão: as variáveis estudadas mostraram consistência no desempenho do grupo estudado / Language is a symbolic process that allows intra and inter-personal communication. Several authors consider it as an integrated system comprised of sub-systems that must work harmonically and interdependently. These functioning can be observed in normal development but not in cases of language disorder. Among them, the disorders of the autism spectrum (ASD) are complex conditions that include disorders in the areas of cognition and socialization, as well as communication. The unbalance among these areas has been described by many authors. Nevertheless there is no agreement whether it can be also observed among language components. The general purpose of this research was to study vocabulary, grammatical and pragmatic variables on the language of subjects with autism spectrum disorders on three different moments: language therapy onset, after six and twelve months. Subjects were ten individuals with diagnosis included in the Autism Spectrum Disorders (ASD) with ages varying between 2:7y. and 11:2y. (mean 7:2y.). All participants were of the male gender and had their diagnosis performed by psychiatrists according to the DSM-IV criteria. All were filmed at the start of weekly language therapy process (moment 1), after six months (moment 2) and twelve months latter (moment 3). The method used on the three studies includes the analysis of a spontaneous speech filmed samples of 30 minutes interaction sessions of each child and a language therapist. To the analysis of the pragmatic variables the first 15 minutes of each sample were transcribed. Data refer to number of communicative acts per minute, communicative means used, amount and type of communicative functions expressed, proportion of interpersonal communicative acts and occupation of the communicative context. To the vocabulary analysis the assessment identified psychological state terms (including desire, emotional, cognitive and physical) and designative terms (of action, natural and cultural entity, special and temporal localization, artifacts, names of body parts and persons). Grammatical variables referred to morphemes, grammatical classes, mean length of utterance in morphemes and words, unintelligible segments and non-categorized phrasal segments. To allow the discussion of data the research was subdivided in three studies. Study 1 assessed vocabulary, grammatical and pragmatic variables of the sample, characterizing the group performance along the studied period. Study 2 analyzed the associations between the types of variables along 12 months of language therapy. Study 3 investigated which of the variables predicted linguistic development after twelve months of language therapy. Statistical analysis showed that the item that better identified the changes that occurred during the twelve months of language therapy was the number of non-categorized phrasal segments. Generally the associations among variables were relatively uniform, showing consistent performance. The third study showed that some grammatical variables predicted pragmatic development while vocabulary variables predicted grammatical development. These findings highlighted the language peculiarities of the studied subjects

Objetivo: Classificar crianças e adolescentes autistas segundo os critérios do Functional Communication Profile - Revised (FCP-R) e associar o seu resultado ao Perfil Funcional da Comunicação (PFC). Métodos: Foram selecionadas 50 crianças e adolescentes com idades entre 3 e 14 anos. As terapeutas desses indivíduos foram entrevistadas segundo o FCP-R e o PFC - Checklist e a avaliação do PFC foi realizada. Os sujeitos foram caracterizados e os dados associados a fim de verificar as possíveis interrelações. Resultados: O FCP-R identificou corretamente as dificuldades encontradas para os sujeitos, verificando os principais déficits nas áreas de comportamento, atenção/concentração, linguagem receptiva, linguagem expressiva e pragmática/social. Quando associado ao PFC e ao PFC-Checklist, podemos observar que o desempenho nestas áreas está diretamente associado ao desempenho na funcionalidade comunicativa - principalmente ao que se refere à interatividade e iniciativa comunicativa desses sujeitos. Discussão: Os dados obtidos concordam com os dados encontrados na literatura que evidenciam que os indivíduos autistas apresentam maiores dificuldades em relação ao comportamento, as habilidades de atenção e de concentração, às habilidades de linguagem e as habilidades pragmáticas e sociais, e observam ainda que quanto maior é esse prejuízo, maior é, também, a dificuldade em interagir. Conclusão: O uso de protocolos objetivos associados é de extrema importância para a prática clínica, o delineamento do atendimento terapêutico, a mensuração da evolução e para o desenvolvimento de pesquisas científicas. / Purpose: Classify children and adolescents with autism spectrum disorders (ASD) according to the criteria proposed by the Functional Communication Profile - Revised (FCP-R) and associate the results with the Functional Communicative Profile (FCP). Method: Subjects were 50 children and adolescents with ages varying from 3 to 14 years. The language therapists attending each of the subjects were interviewed to fill the FCP-R and the PFC-checklist (FCP-C) and the FCP was determined based on a video sample. The subjects were assessed and the results were compared in order to determine possible associations. Results: The FCP-R correctly identified the disorders presented by the subjects verifying the main deficits in the areas of behavior, attentiveness, receptive language, expressive language and pragmatic/social. When associated to the FCP and to the FCP-C it was possible to observe that the performance on these areas is directly associated to the communicative functionality especially in what refers to the subjects\' interactivity and communicative initiative. Discussion: Data obtained agree with studies that show evidence that ASD individuals have more communicative impairments than in the areas of behavior, attentiveness, language, and social and pragmatic abilities. It was also observed that more severe disorders are associated greater interaction inabilities. Conclusion: The combined use of different protocols is useful to the clinical practice, to the design of intervention programs, to the assessment of therapeutic results and to the development of scientific research.

Submitted by Suzana Dias (suzana.dias@famerp.br) on 2018-11-07T16:23:52Z No. of bitstreams: 1 JanainaPompeuTobias_dissert.pdf: 1609448 bytes, checksum: 77a1378cbc196f5b8cffee0485926cb0 (MD5) / Made available in DSpace on 2018-11-07T16:23:52Z (GMT). No. of bitstreams: 1 JanainaPompeuTobias_dissert.pdf: 1609448 bytes, checksum: 77a1378cbc196f5b8cffee0485926cb0 (MD5) Previous issue date: 2017-08-30 / Autistic Spectrum Disorder, in psychoanalytic metapsychology, is understood through its negativity, of which it wasn´t possible to structure the subject. The first logical time of the constitution is the Stage of the Mirror, which is possible through the external agents who fulfill the maternal and paternal functions, which in exercising their role, put in action the operations of alienation and separation. In the case of TEA there is an impossibility of alienation, the movement that fails is the incidence of the imaginary in the real, the imaginary investment of the Other in the baby is truncated. As Jerusalinsky writes(1999, p. 139): "autistic children are taken in the real of the object". And, according to Mannoni (1923/1989) the father-mother-child dynamics is put long before the baby is born, and it is fundamental to involve parents in the treatment of their children, because they resonate the unconscious conflicts of the parents. Objective: To analyze the effects of a psychoanalytic intervention with parents of children with TEA, seeking to understand and analyze the discursive position of these parents. Method: Longitudinal study of mixed character (quantitative and qualitative). Performed at the specialty outpatient clinic of a school hospital. Participants were 7 parents of children diagnosed with TEA, of both sexes. The research's outline corresponded to the pre-intervention evaluation performed through the completion of the instruments: Socio-demographic data sheet and perception of the symptomatology of TEA, evaluation Scale for infantil autism, Inventory of Symptoms of Stress for Adults of Lipp, quality of life Scale, Self-efficacy Scale and Zarit Caretaker Overload Scale. The intervention happened through a listening group, which happened in 8 meetings lasting 90 minutes. The closure of this procedure happened through the reapplication of the instruments with the parents. Results: It was obtained that 71.4% of the participants were women, with a mean age of 38 years, 85.7% married, 57.1% with complete high school and 42.9% inactive, who didn‟t work in any type of paid work. Through the nodal points analyzed, the speech of the parents was located in the discursive node stagnated in the autistic signifier, because the parents couldn´t see in their children anything beyond the symptoms, and the children were marked by the impossibility. The interventions were performed through the retrieval of the gaze for these children from discursive turns. The results on stress showed a decrease in the means of the stress phase and the physical and psychological symptoms, however, there was no statistical significance, as well as the self-efficacy scale. Regarding the quality of life, there was a significant comparison with the psychological and environmental domain. The parents, before the intervention, presented intense and slight overload after, 43% of the parents didn´t present overload. Conclusions: The whole process of searching for a diagnosis and treatment generates a demand in these parents for a specialized knowledge about childhood, but this can generate a imprisonment to the master's discourse. The Listening Group has brought the possibility of providing symbolic exits for these children through their position in the imaginary of the parents. / O Transtorno do Espectro Autista, na metapsicologia psicanalítica, é compreendido por meio de sua negatividade, do que não foi possível estruturar no sujeito. O primeiro tempo lógico da constituição é o Estádio do Espelho, possível por intermédio dos agentes externos cumpridores da função materna e paterna, que, ao exercerem seu papel, colocam em ação as operações de alienação e separação. No caso do TEA há uma impossibilidade quanto à alienação, pois o movimento que falha é a incidência do imaginário no real, o investimento imaginário do Outro no bebê é truncado. Como escreve Jerusalinsky (1999, p. 139): “as crianças autistas ficam tomadas no real do objeto”. E, conforme Mannoni (1923/1989), a dinâmica pai-mãe-filho está posta muito antes do nascimento do bebê, sendo fundamental abarcar os pais ao tratamento dos filhos, pois esses ressoam os conflitos inconscientes dos pais. Objetivo: Analisar os efeitos de uma intervenção psicanalítica com pais de crianças com TEA, buscando compreender e analisar a posição discursiva desses pais. Método: Estudo longitudinal, de caráter misto (quantitativo e qualitativo), realizado no ambulatório de especialidades de um hospital escola. Participaram 7 pais de crianças com o diagnóstico de TEA, de ambos os sexos. O delinear da pesquisa correspondeu à avaliação pré-intervenção realizada através do preenchimento dos instrumentos: Ficha sobre dados sócio-demográficos e percepção da sintomatologia do TEA, Escala de avaliação para autismo infantil, Inventário de Sintomas de Stress para Adultos de Lipp, Escala de qualidade de vida, Escala de Auto-eficácia e Escala de Sobrecarga do Cuidador de Zarit. A intervenção sucedeu por meio de um grupo de escuta, que aconteceu em 8 encontros com duração de 90 minutos. O encerramento desse procedimento aconteceu por meio da reaplicação dos instrumentos com os pais. Resultados: Obteve-se que 71,4% dos participantes eram mulheres, com média de idade de 38 anos, 85,7% casados, 57,1% com o ensino médio completo e 42,9% inativos, que não atuavam em nenhum tipo de trabalho remunerado. Por meio dos pontos nodais analisados, localizou-se no discurso dos pais o nó discursivo estagnado no significante autista, pois os pais não conseguiam ver em seus filhos nada para além dos sintomas, estando os filhos marcados pela impossibilidade. As intervenções foram efetuadas por meio do resgate do olhar para essas crianças a partir de giros discursivos. Os resultados quanto ao estresse revelaram diminuição das médias da fase do estresse e dos sintomas físicos e psicológicos, porém não houve significância estatística relativa no que tange à escala de auto-eficácia. Já em relação à qualidade de vida, houve significância com a comparação no domínio psicológico e ambiental. Os pais, antes da intervenção, apresentaram sobrecarga intensa e ligeira, após 43% dos pais passaram a não apresentar sobrecarga. Conclusões: Todo o processo de busca por um diagnóstico e tratamentos gera uma demanda nesses pais por um saber especializado sobre a infância, porém isso pode gerar um aprisionamento ao discurso do mestre. O Grupo de Escuta trouxe a possibilidade de proporcionar saídas simbólicas para essas crianças através de sua posição no imaginário dos pais.

MSc Occupational Therapy, Faculty of Health Sciences, University of the Witwatersrand, 2009 / An increase in the prevalence of ASD has led to increased demands on service provision. This questionnaire-based, descriptive study aimed to explore service use and experiences of health and education service delivery by caregivers and their children with ASD in Johannesburg. The sample size was 39. Comparisons were drawn between the experiences of the participants accessing the private and public service sectors. Children were diagnosed at an average age of 4 years; 2 years after the first symptoms were noted by their caregivers. Families accessed a mean of 3 institutions and 6 professionals in seeking diagnosis and treatment. No specific referral patterns could be established. Challenges to service access identified by caregivers included: logistical problems, lack of professional knowledge and experience, poor parental coping and insight, and lack of community support. Solutions identified by the caregivers included: marketing, training, better referral procedures, and establishment of educational facilities.

<p>Autism är ett livslångt handikapp som ställer stora krav på familj, skola, sjukvård samt övriga personer som på olika sätt kommer i kontakt med dessa barn. Pedagoger och vårdare behöver medvetandegöras om sina föreställningar eftersom dessa styr bemötandet. Målet för behandlingen är målmedveten träning eftersom förmåga till social inlevelseförmåga mer eller mindre saknas hos såväl barn som vuxna med autism.</p><p>Syftet med litteraturstudien var att belysa metoder som fanns för att främja utvecklingen av barn med autism, samt vilken påverkan dessa metoder hade på barn- vårdarrelationen.</p><p>Litteraturstudien var en granskning och en sammanställning av ett specificerat forskningsområde/ämne. Resultatet visade på att vårdare som använt sig av specialpedagogik i hemmet upplevde att relationen till barnen förbättrades. Genom att familjerna erbjöds undervisning om olika metoder för specialpedagogik påverkades barnen med autism på olika positiva sätt. Vårdarna rapporterade minskad stress, ökad trygghet samt förbättrad kommunikationsförmåga hos barnen. Andra positiva resultat var förbättrad social interaktion, ökad förmåga att visa empati, bättre konversationsteknik, ökad förmåga till generalisering, samt minskade negativa beteenden som aggression och självdestruktivitet. Specialpedagogik i hemmet innebar att en positiv inlärningssituation skapades i barnets kontext. Familjen fick därmed tillgång till metoder som motverkade negativa beteendemönster och som främjade barnets utveckling, samspel och interaktion. Metoderna skulle med fördel kunna användas av vårdpersonal i olika situationer, lärare, samt av övriga som på olika sätt kommer i kontakt med barn med autism.</p> / <p>Autism is a life-long handicap with great demands on all that are involved with children with this disorder. Teachers and parents need to become conscious of their own convictions as these are crucial to the way they approach the child. The aim of the therapy is to establish a goal-oriented training programme, since the ability for empathy in social behaviour is more or less absent in both children and adults with autism. The aim of the study of literature on this subject was to highlight existing methods to stimulate the development of children with autism, as well as the results these methods had on the child-parent relationship. The study of literature was established within a specified area of research. The result demonstrated that parents using remedial teaching methods within the family environment experienced a better relationship with the children. By giving the families access to different remedial teaching methods, the children with autism were affected in various positive ways. Those in charge of the children reported diminished stress symtoms, an increased feeling of security, and an improved ability of communication in the children. Other positive results were improved social interactions, improved ability to show empathy, better conversational techniques, improved ability to generalise a subject, as well as less aggressive and self-destructive behaviour. Remedial teaching methods within the family environment meant that a positive learning situation was created within the context of the child. In this way, families were given methods that lessened negative behavioural patterns and that promoted the development of interaction in the child. These remedial methods could well be used by all categories of nurses, teachers, and others who may encounter children with autism.</p>

Autism är ett livslångt handikapp som ställer stora krav på familj, skola, sjukvård samt övriga personer som på olika sätt kommer i kontakt med dessa barn. Pedagoger och vårdare behöver medvetandegöras om sina föreställningar eftersom dessa styr bemötandet. Målet för behandlingen är målmedveten träning eftersom förmåga till social inlevelseförmåga mer eller mindre saknas hos såväl barn som vuxna med autism. Syftet med litteraturstudien var att belysa metoder som fanns för att främja utvecklingen av barn med autism, samt vilken påverkan dessa metoder hade på barn- vårdarrelationen. Litteraturstudien var en granskning och en sammanställning av ett specificerat forskningsområde/ämne. Resultatet visade på att vårdare som använt sig av specialpedagogik i hemmet upplevde att relationen till barnen förbättrades. Genom att familjerna erbjöds undervisning om olika metoder för specialpedagogik påverkades barnen med autism på olika positiva sätt. Vårdarna rapporterade minskad stress, ökad trygghet samt förbättrad kommunikationsförmåga hos barnen. Andra positiva resultat var förbättrad social interaktion, ökad förmåga att visa empati, bättre konversationsteknik, ökad förmåga till generalisering, samt minskade negativa beteenden som aggression och självdestruktivitet. Specialpedagogik i hemmet innebar att en positiv inlärningssituation skapades i barnets kontext. Familjen fick därmed tillgång till metoder som motverkade negativa beteendemönster och som främjade barnets utveckling, samspel och interaktion. Metoderna skulle med fördel kunna användas av vårdpersonal i olika situationer, lärare, samt av övriga som på olika sätt kommer i kontakt med barn med autism. / Autism is a life-long handicap with great demands on all that are involved with children with this disorder. Teachers and parents need to become conscious of their own convictions as these are crucial to the way they approach the child. The aim of the therapy is to establish a goal-oriented training programme, since the ability for empathy in social behaviour is more or less absent in both children and adults with autism. The aim of the study of literature on this subject was to highlight existing methods to stimulate the development of children with autism, as well as the results these methods had on the child-parent relationship. The study of literature was established within a specified area of research. The result demonstrated that parents using remedial teaching methods within the family environment experienced a better relationship with the children. By giving the families access to different remedial teaching methods, the children with autism were affected in various positive ways. Those in charge of the children reported diminished stress symtoms, an increased feeling of security, and an improved ability of communication in the children. Other positive results were improved social interactions, improved ability to show empathy, better conversational techniques, improved ability to generalise a subject, as well as less aggressive and self-destructive behaviour. Remedial teaching methods within the family environment meant that a positive learning situation was created within the context of the child. In this way, families were given methods that lessened negative behavioural patterns and that promoted the development of interaction in the child. These remedial methods could well be used by all categories of nurses, teachers, and others who may encounter children with autism.