La atención temprana en los trastornos del espectro autista (TEA) / Early intervention in autism spectrum disorders (ASD)

En el presente artículo abordamos la intervención temprana en niñas y niños de 0 a 6 años con trastorno del espectro autista (TEA). A pesar de que la atención temprana es una disciplina bastante reciente, actualmente hay algunas evidencias sobre cómo trabajar y qué principios deben guiar dicha intervención. En nuestro caso nos centraremos en los principios que deben guiar la atención temprana a la hora de intervenir con niños y niñas con rasgos del trastorno de espectro autista. Es innegable la importancia que tiene la detección precoz de cualquier trastorno del desarrollo -y por ende del TEA- para la intervención temprana con los menores y sus familias. Una intervención temprana constituye un importante predictor en la recuperación funcional de estos menores, lo cual, unido a la creciente incidencia y prevalencia de estos trastornos, hace de nuestro objeto de estudio un tema creciente de gran interés científico y teórico

In this paper we will address early intervention in children with autism spectrum disorders (ASD) in ages ranging from birth to six years old. Early intervention is a very recent matter, but today we have some evidences about how to deal with it and the principles that must guide early intervention in children with autism spectrum disorders. The importance of early detection is undeniable in all developmental disorders in children with ASD as well, for an early intervention with children and their families. An early intervention is a very important predictor of functional recovery. Along with the growing incidence and prevalence of this kind of disorders, this makes our field of study a matter of increasing scientific and theoretical interest

Procesos atencionales en pacientes escolares con TDAH / Attention processes in school-age patients with ADHD

El Trastorno por Déficit de Atención e Hiperactividad (TDAH) es una patología compleja y heterogénea. Su sintomatología discurre por ámbitos epistemológicamente diferentes: biológicos, cognitivos, conductuales, impulsivos y contextuales entre los más relevantes. En su diagnóstico clínico no podemos obviar el análisis de esta amplitud disciplinar, y cuando se hace caemos en el sobre o infradiagnóstico. Se debe perfilar con rigor, como se está haciendo por muchos investigadores, desde la definición criterial al modo de evaluación. Objetivo: en este trabajo se pretende, en una muestra de 50 sujetos, indagar en algunas variables atencionales (atención sostenida, dividida y selectiva) que están significativamente dañadas en este trastorno y que en este aspecto pueden aportar más datos complementarios para un diagnóstico clínico más acertado y sistemático. Resultados: podemos observar en los resultados que no son muchas las diferencias encontradas entre los grupos, y esto es precisamente lo que lleva a confusión en la mayoría de los casos. Conclusiones: la revisión de los criterios junto a una evaluación neuropsicológica más potente y refinada puede ser el camino para perfilar y establecer, desde la clínica, una mayor precisión en los grupos de esta compleja patología

Attention deficit hyperactivity disorder (ADHD) is a complex and heterogeneous pathology. Its symptoms encompass different epistemological fields of study such as biological, cognitive, behavioral, impulsive and contextual amongst the most relevant ones. Since it is easy to fall into over or underdiagnosis, a multidisciplinary approach is needed for the clinical diagnosis. It must be designed with rigor, as it is considered by many researchers, from the criterial definition to the means of assessment. Aim: the aim of this study, with a sample of 50 patients, is to investigate about some attentional variables (sustained, divided and selective attention) which are significantly impaired in this disorder and can contribute to providing complementary data in order to obtain a more systematic and pertinent diagnosis. Results: the results establish that it is hard to find many differences between the groups, which is precisely misleading in most cases. Conclusions: the revision of the criteria alongside a refined and stronger neuropsychological assessment may be the way to become clear and establish a greater precision, in clinical settings, within the groups of this complex pathology

Neuropsychiatric symptoms and intelligence quotient in autosomal dominant Segawa disease.

Segawa disease is a rare dystonia due to autosomal dominant guanosine triphosphate cyclohydrolase I (adGTPCH) deficiency, affecting dopamine and serotonin biosynthesis. Recently, the clinical phenotype was expanded to include psychiatric manifestations, such as depression, anxiety, obsessive-compulsive disorder, and sleep disturbances. Although cognitive and neuropsychiatric symptoms may be attributable to dopamine deficiency in the prefrontal cortex and frontostriatal circuitry, intelligence is considered normal in Segawa disease. Our aim was to investigate neuropsychiatric symptoms and intelligence quotients (IQ) in a series of individuals with adGTPCH deficiency. The assessment included a structured clinical interview following the DSM-IV-TR's guidelines, Beck's Depression Inventory, the State-Trait Anxiety Inventory, the Maudsley Obsessive-Compulsive Questionnaire, the Barratt Impulsiveness Scale-11 (BIS-11), the Oviedo Sleep Questionnaire, the Pittsburgh Sleep Quality Index, and the Wechsler Adult Intelligence Scale-Third Edition. Equivalent tests were applied to pediatric patients as appropriate for their age group. Fourteen patients with adGTPCH deficiency were evaluated (seven adult and seven pediatric patients). Depression, anxiety, and obsessive-compulsive symptoms were not more common than expected in the general population. However, the seven adults showed impulsivity in the BIS-11; nine individuals had an IQ in the range of borderline intellectual functioning to mild mental retardation, and sleep disturbances were found in four individuals. We found no differences between these results and the motor impairment. In conclusion, our findings would suggest that cognitive impairment, and impulsivity in adults, may be associated with Segawa disease.