Revista Internacional de Salud Mental y Psiquiatría

Exploración del tipo de conductas desadaptativas con mayor impacto en la calidad de vida de niños en edad preescolar con autismo

Fe Kok

El impacto de las conductas desadaptativas en la calidad de vida relacionada con la salud (CVRS) de los niños en edad preescolar con trastorno del espectro autista (TEA) es relativamente inexplorado. Este estudio pretende explorar el grado de influencia que tienen los diferentes tipos de conductas desadaptativas (internalizadas, asociales y externalizadas) en la CVRS de este grupo, cuando se controlan las características de fondo (edad, ingresos mensuales brutos, tipo de vivienda y duración diaria del sueño) y el funcionamiento adaptativo.

Se recopilaron las Escalas de conducta independiente revisadas (SIB-R) y los cuestionarios de características de antecedentes de 99 cuidadores de niños con TEA que buscaban tratamiento en el Hospital de Mujeres y Niños KK. Estos se utilizaron para evaluar la gravedad de las conductas desadaptativas, el nivel de funcionamiento adaptativo y algunas características de antecedentes de estos niños. La relación de estos con la calidad de vida relacionada con la salud psicosocial y física en estos niños se evalúa con el Inventario de calidad de vida pediátrica (PedsQL).

El trastorno del espectro autista (TEA) es un problema crónico del desarrollo neurológico que se caracteriza por discapacidades en la comunicación y la comunicación social, y patrones de conducta, actividades o intereses limitados y aburridos. La prevalencia del TEA parece estar aumentando en todo el mundo, ya que se estima que afecta a aproximadamente 1 de cada 88 personas.

El trastorno del espectro autista se considera un problema de salud general importante debido a su etapa inicial, su persistencia arraigada y los altos niveles de discapacidad asociada. Esta debilidad se debe no solo a las manifestaciones centrales del TEA, sino también a la variedad de trastornos coincidentes que las personas con TEA experimentan a menudo, incluidos los trastornos emocionales y sociales, el sueño, los trastornos de atención y de alimentación, las sensibilidades táctiles, los retrasos en el aprendizaje y los trastornos académicos, así como la evaluación simultánea de la salud mental y la salud mental. Estos trastornos coincidentes pueden ser de igual o mayor importancia para los padres y educadores de niños con TEA que los trastornos centrales del TEA, y afectan significativamente el control de la conducta, la adquisición del aprendizaje y el desarrollo de las relaciones sociales.

Las conductas problemáticas (o conductas desadaptativas, como se las denomina en este artículo), descritas como conductas problemáticas, dañinas, agresivas o totalmente deprimentes, son comunes en los niños pequeños con TEA. Por ejemplo, Dominick et al. descubrieron que el 32,7 % de los niños con TEA mostraban conductas agresivas, como golpear,

 

kicking, gnawing, and squeezing others. More than seventy five
percent of these kids indicated forceful practices both at home and outside the home, and hostility was coordinated toward
more than one individual in 92% of cases. Self-damaging conduct, including head slamming, hitting oneself, and gnawing oneself, was available in very nearly 33% of youngsters with ASD. Besides, 70.9% of youngsters with ASD had encountered a time of serious hissy fits and, for 60% of these kids, fits of rage happened consistently and were a steady (as opposed to wordy) issue during the period in which they were available.

A few creators have noticed a solid negative connection between the capacity to impart and the commonness of maladaptive conduct in small kids with ASD. Self-damaging practices among kids with ASD have likewise been connected to their responsive and additionally expressive correspondence shortfalls. It follows that when treatment programs center around building up the small kid's relational abilities to the degree that they can fill in as viable substitution practices, a decrease in the maladaptive conduct may result.

Maladaptive practices are especially hazardous in bunch settings, for example, early intercession administrations, childcare administrations, and preschools, as they can be problematic to the learning system and posture critical difficulties to the kids with ASD themselves, their companions, and staff. Consequently, maladaptive practices are among the most regularly recognized hindrances to the incorporation of youngsters with ASD in bunch settings.

Further, when maladaptive practices become a built up part of a youngster's conduct collection, they are probably not going to diminish and, as indicated by Berg et al., will normally remain or decline without intercession. Whenever left untreated, these practices can fundamentally lessen a kid's social and instructive open doors by restricting their admittance to accessible medicines, learning exercises, communications with others, network encounters and, specifically, their capacity to progress to, and partake in, school programs. Notwithstanding negatively affecting kids with ASD themselves, various examinations have demonstrated that guardians' degree of mental trouble is related with the seriousness of their kid's maladaptive practices just as their ASD side effects.

Accordingly, early intercessions for little youngsters with ASD should consolidate the administration of maladaptive practices . Given the connection between maladaptive practices and deficiencies in correspondence and social abilities, it is significant that intercession approaches focus on these center shortages. Myers and Johnson contend that the essential objectives of intercession for kids with ASD ought to be to augment the youngster's practical autonomy and personal satisfaction by lessening the center manifestations of ASD; encourage improvement and learning; advance socialization; diminish maladaptive practices; teach and backing families. They propose that, notwithstanding focusing on correspondence and social abilities, contemporary extensive intercession approaches for ASD should focus on a decrease in troublesome or maladaptive conduct by utilizing observationally upheld systems, including useful conduct appraisal (FBA). FBA is "the way toward deciding the expectation a wrong conduct serves for acquiring an ideal result and supplanting that conduct with a more fitting one that achieves a similar objective".

The overall significance of early mediation for ASD is broadly perceived, and is upheld by examines indicating better results with prior treatment. Early intercession for ASD, particularly that initiating before the time of 3 years, brings about fundamentally improved results comparative with mediation starting further down the road. Early intercession in the principal long stretches of life offers the best potential for kids as mind pliancy is most noteworthy during this period, empowering the foundation and redesign of neuronal systems in light of natural incitement

Multiple Regression revealed that Maladaptive behaviors have greater impact on HRQOL than Adaptive skills and background characteristics. Asocial maladaptive behaviors have the most unique influence on HRQOL out of the three Maladaptive behaviors, suggesting difficulties in social interaction and communication manifested by children with ASD play the largest role in their HRQOL at this age. Adaptive skills have a smaller but still unique impact on HRQOL, while background characteristics are not significant.

The specific types of Asocial Maladaptive behavior and their impact of HRQOL in this age group can be further studied with ASD-specific scales like Social Responsive Scale (SRS) and Repetitive Behaviors Scale-Revised (RBS-R). More targeted behavioral intervention can be then developed to improve the quality of life amongst preschool children with ASD.

Biography:

F. Kok is a Fourth Year Medical Student at Lee Kong Chian School of Medicine, National Technological University, Singapore.S.P. Yeleswarapu is a Consultant at the Department of Children Development at KK Women’s and Children Hospital, Singapore. She is also an Adjunct Assistant Professor with Duke-NUS Medical School, Singapore.

32.ª Conferencia Internacional sobre Salud Mental y Conductual, 22 y 23 de abril de 2020

Cita abstracta :

Faith Kok, Exploración del tipo de conductas desadaptativas con mayor impacto en la calidad de vida de niños en edad preescolar con autismo, Congreso de Salud Mental 2020, 32.ª Conferencia Internacional sobre Salud Mental y Conductual, 22 y 23 de abril de 2020