ABSTRACT
Paciente, 18 años, hijo único, pololeando. Antecedentes Psiquiátricos Familiares (+). Repitió 3 veces el 1ero básico. Aislamiento social e intereses restringidos desde la infancia. Derivado de Alter joven. Historia de larga data (>1 año) de mayor descuido de higiene personal, aislamiento social e irritabilidad. Hipótesis diagnóstica: TEA. Seguimiento con controles médicos, con terapeuta ocupacional y psicoterapia. Examen mental al inicio: Con escaso contacto visual. Pseudocontactado, hipomímico. Afecto con rango de expresividad emocional disminuido. Humor depresivo. Lenguaje lacónico, aprosódico. Al examen (6 meses después) destaca buen arreglo personal, contactado, establece contacto visual, tranquilo, adecuado, cooperador, eutímico, mímica facial acorde al relato, lenguaje bien articulado, con manierismos y estereotipias, prosodia alterada, pensamiento estructurado, con rigidez cognitiva y concreto.
Patient, 18 years old, only child, in love relationship. Family Psychiatric Background (+). He repeated 3 times the 1st basic course. Social isolation and restricted interests from childhood. Derived from Young Alter. Long history (> 1 year) of greater neglect of personal hygiene, social isolation and irritability. Diagnostic hypothesis: ASD. Follow-up with medical controls, occupational therapist and psychotherapy. Mental exam at the start: With little eye contact. Pseudocontact, hypomimic. Affect with decreased emotional expressiveness. Depressive mood. Laconic language, aprosodic.
Subject(s)
Humans , Male , Adolescent , Autism Spectrum Disorder/diagnosis , Autism Spectrum Disorder/physiopathology , Autism Spectrum Disorder/therapy , Asperger Syndrome/diagnosis , Asperger Syndrome/physiopathology , Asperger Syndrome/therapyABSTRACT
Se han propuesto tres aproximaciones que intentan explicar las peculiaridades del Síndrome de Asperger (SA): disfunción ejecutiva, pobre teoría de la mente o dificultades en la coherencia central. En 2005, Frith y Vignemont proponen una desconexión entre posiciones egocéntrica a alocéntrica, planteando una nueva línea de caracterización del SA. Objetivo: En el presente estudio se comparó el desempeño del tránsito entre posiciones egocéntrica y alocéntrica, en un grupo de cinco niños con SA. Método: El grupo estuvo conformado por 4 niños y 1 niña, con edad promedio de 10 años. Se realizó una valoración detallada a fin de confirmar el diagnóstico y se aplicaron subescalas de la Evaluación Neuropsicológica Infantil. Se reporta el análisis del desempeño en la subescala Habilidades Espaciales. Resultados: Se observa un desempeño dentro del rango promedio observando diferencias estadísticamente significativas entre subdominios que conforman la subescala (014<0.05 F friedman), así como en las respuestas correctas cuando utilizaron marcos de referencia alocéntricos y egocéntrico en tareas de comprensión (gl 2, 0.041<0.05 Q Cochran) y expresión (gl 2, 0.022<0.05 Q Cochran) derecha-izquierda. Conclusión: En el caso del SA, se observa predominio del uso de la posición egocéntrica. El desempeño alocéntrico de los participantes es más eficaz cuando establecen relaciones desde un objeto dinámico vs estático. Se destaca la importancia de realizar un diagnóstico meticuloso del SA, a fin de valorar si las peculiaridades observadas en cognición espacial han sido generalizadas erróneamente a otros Trastornos del Espectro Autista debido a un diagnóstico equivocado.
Asperger Syndrome (SA) has been explained by three approaches: executive dysfunction, impaired theory of mind and central coherence. In 2005, Frith and Vignemont suggest a new approach, based in disconnection between egocentric and allocentric stances. The present study aimed to compare performance´s group of five children with AS in egocentric-allocentric transit task. Four boys and a girl, whose average age was 10 years old, formed the group. A comprehensive assessment confirmed de AS diagnostic. Children were assessed with Evaluacion Neuropsicológica Infantil subtests, and we report the Spatial Abilities subtest analysis. Standard scores were obtained by the group in average values, but there were significant differences (014<0.05 F friedman) between subdomains assessed by Spatial Abilities subtest. We also found significant differences in egocentric-allocentric stances in spatial notion understanding task (gl 2,0.041<0.05 Q Cochran), and spatial notion expression task (gl 2, 0.022<0.05 Q Cochran). Conclusion: AS group prevail taking egocentric stance. Allocentric performance is commonly efficient if individuals take stance from dynamic than static object. We highlight the importance of an accurate and comprehensive assessment in AS diagnosis to avoid generalization of AS features to another Spectrum Autistic Disorders because of a mistaken AS diagnosis.
Subject(s)
Female , Child , Cognition , Self Concept , Social Perception , Space Perception , Asperger Syndrome/physiopathology , Asperger Syndrome/psychology , Neuropsychological TestsABSTRACT
OBJETIVO: Comparar o perfil pragmático das iniciativas de comunicação e o perfil bidimensional envolvendo os aspectos de iniciativa e responsividade. Além disso, buscou-se analisar os tipos mais comuns de resposta apresentadas pelos indivíduos pesquisados. MÉTODOS: Foram analisadas trinta gravações de terapia fonoaudiológica, nas quais as terapeutas interagiam com crianças do espectro do autismo (média de idade: 9 anos e 6 meses). As filmagens foram transcritas e os dados derivados foram analisados quanto ao número de atos comunicativos, à ocupação do espaço comunicativo e ao uso dos meios verbal, vocal e gestual nas iniciativas e no total de participações (iniciativas e respostas). As respostas apresentadas foram qualificadas como: não resposta, resposta adequada, resposta inadequada e resposta pragmaticamente inapropriada. RESULTADOS: Houve diferença na comparação entre as iniciativas e o total de participações no que concerne à ocupação do espaço comunicativo e no total de atos. Quanto às respostas, houve diferença no número de respostas adequadas. CONCLUSÃO: Os resultados evidenciaram a necessidade de considerar o perfil bidimensional de comunicação e ressaltaram a necessidade de qualificar as respostas a fim de discriminar as habilidades comunicativas da criança.
PURPOSE: To compare the pragmatic profile referring to the communicative initiatives and the bi-dimensional profile involving the aspects of initiative and responsivity. It also aimed to analyze the most common types of responses presented by the studied individuals. METHODS: Thirty recorded samples of interaction between speech-language therapist and children with autism spectrum disorders (mean age: 9 years and 6 months) sessions were analyzed. The samples were transcribed and data analyzed about number of communicative acts, occupation of the communicative space, use of communicative means (verbal, vocal and gestural) and total number of participations (initiatives and responses). The responses were qualified as "non-answer", "adequate answer", "inadequate answer" and "pragmatically inappropriate answer". RESULTS: Significant differences in the comparison of the numbers of initiatives and total participations and of occupation of communicative space and total number of communicative acts. There was also a significant difference in the number of "adequate answers". CONCLUSION: Results show the need to consider the bi-dimensional communicative profile and qualify the answers in order to determine the child's communication abilities.
Subject(s)
Adolescent , Child , Child, Preschool , Female , Humans , Male , Asperger Syndrome/physiopathology , Autistic Disorder/physiopathology , Communication , Language Tests , Language Development Disorders/physiopathology , Verbal Behavior/physiology , Videotape RecordingABSTRACT
Cerebral hemispheres functioning have been found to be abnormal in children with ASD. The role of lateralization in implicit and explicit motor learning has received little attention in ASD researches. The main goal of this study is investigating the differences between two hands implicit and explicit motor learning in children with ASD and typical matched group. In the present random clinical trial study, 30 boys with ASD aged 7-11 were compared with 32 typical matched boys. Typical group and the ASDs, which were screened with ASSQ, were selected from elementary schools in Najafabad [Isfahan, Iran]. Participants performed a serial reaction time task [10 blocks] with each hand in implicit and explicit group with random allocation. Learning comparison between two groups showed significant difference which means explicit learning deficit in the ASDs with right [p=0.009] and left hand [p=0.004]. Results also indicated no significant difference in implicit learning between ASDs and typical matched group in right [p=0.385] and left hand [p=0.18]. Hands differences also showed speeded right hand in implicit learning in children with ASD [p=0.028] while no differences was seen in explicit learning and typical children. Explicit learning of right and left hand was impaired in children with ASD while implicit learning of both hands maintained intact and a right hand preference in implicit motor learning was observed in children with ASD due to left striatal system abnormality
Subject(s)
Humans , Male , Child , Asperger Syndrome/physiopathology , Learning , Child , Cerebrum/pathology , Hand/physiopathologyABSTRACT
Indivíduos com transtornos psiquiátricos podem apresentar distúrbios perceptuais, de atenção e memória, questionando-se a presença de perdas auditivas periféricas e/ou centrais. Assim, o objetivo deste trabalho é descrever os resultados obtidos nas avaliações audiológica e eletrofisiológica, verificando a ocorrência de alterações auditivas periféricas e/ou centrais nesta população. Casuística e Métodos: Foram avaliados 20 indivíduos com autismo e síndrome de Asperger, e 20 indivíduos em desenvolvimento típico, entre oito e 19 anos. Resultados: Todos os indivíduos apresentaram resultados normais na avaliação audiológica. No PEATE, 50% dos indivíduos com autismo e 30% com síndrome de Asperger apresentaram alterações, havendo diferença estatisticamente significante na análise dos dados quantitativos em ambos os grupos. Em todos os grupos verificaram-se alterações no PEAML e P300. No PEAML, não houve diferençaestatisticamente significante entre os grupos na análise dos dados quantitativos e qualitativos. No P300, observou-se diferença estatisticamente significante quando comparados os grupos controle e síndrome de Asperger na análise dos dados quantitativos. Conclusão: Verificou-se grande ocorrência de alterações nos potenciais evocados auditivos em crianças autistas e com síndrome de Asperger, embora em algumas análises realizadas não tenha sido constatada diferença estatisticamente significante. Enfatiza-se a importância da investigação minuciosa da função auditiva em indivíduos com transtornos psiquiátricos.
Individuals with psychiatric disorders can present perception, attention and memory deficits, raising doubts about peripheral and/or central hearing loss. Thus, the aim of this study is to describe the audiological and electrophysiological results of individuals with psychiatric disorders, looking for peripheral and/or central auditory disorders. Methods: 20 individuals with autism and Asperger syndrome and 20 individuals without psychiatric disorders from eight to 19 years of age, were submitted to audiological and electrophysiological evaluation. Results: No alterations were observed on the audiological evaluation in all the individuals. In ABR, 50% of individuals with autism and 30% with Asperger syndrome presented alterations. Significant statistical differences were observed between the groups in the quantitative analysis. All groups presented alterations in AMLR and P300. In AMLR, no significant statistical differences were observed between the groups in the qualitative and quantitative analyses. In the P300, we noticed significant statistical differences between Asperger and control groups in the quantitative analysis. Conclusions: A high occurrence of alterations in auditory evoked potentials was seen in children with psychiatric disorders, although in some analysis it was observed a non-statistically significant difference when comparing study and control groups. We stress the need for a more careful investigation of the auditory function in this population.
Subject(s)
Adolescent , Child , Female , Humans , Male , Young Adult , Asperger Syndrome/physiopathology , Auditory Perceptual Disorders/physiopathology , Autistic Disorder/physiopathology , /physiology , Evoked Potentials, Auditory, Brain Stem/physiology , Audiometry, Pure-Tone , Case-Control Studies , Reaction Time/physiology , Young AdultABSTRACT
With the aim of analyzing which complementary tests are relevant in the diagnostic evaluation of individuals with pervasive developmental disorders, a protocol of clinical and laboratory evaluation was applied in 103 outpatients. The protocol included chromosomal analysis, screening for inborn errors of metabolism, cytogenetic and molecular study of the FRAXA, FRAXE, and FRAXF mutations, EEG, SPECT, and magnetic resonance imaging study. Eighty-four subjects concluded the complementary tests and were classified either as having autism, atypical autism or Asperger syndrome according to the DSM-IV criteria. Sixteen individuals, all bellonging to the two autistic groups, presented genetic or enviromental factors that may have lead to the behavioral disorders, showing the importance of diagnostic evaluation in this group of conditions. Neuroimaging and EEG findings were non-specific and occurred in similar proportion among the groups, being considered of relative low significance in the diagnostic evaluation of individuals with pervasive developmental disorders