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O que há de sensorial nas perturbações do espetro do autismo? : revisão bibliográfica
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Segundo a literatura médica, 69-100% das crianças com Perturbações do Espetro do Autismo apresentam padrões atípicos de modulação sensorial. Os défices na integração sensorial são frequentemente as primeiras manifestações que os pais destas crianças referem. Ao longo dos tempos, as classificações diagnósticas têm subvalorizado o domínio sensorial das Perturbações do Espetro do Autismo, no entanto, no DSM-5 este passou a ser um critério de diagnóstico. Tal inclusão é reforçada pelo papel das alterações sensoriais no desenvolvimento de estereotipias motoras e comportamentais e pelo seu impacto nas capacidades sociais, de comunicação e de atenção em crianças com Perturbações do Espetro do Autismo.
Considerando a heterogeneidade das manifestações clínicas de Perturbações do Espetro do Autismo, os sinais/sintomas de hipo e de hiperresponsividade nos sete sistemas sensoriais apresentam valor diagnóstico na identificação precoce e enquanto possíveis biomarcadores de Perturbações do Espetro do Autismo. Contudo, nenhum destes demonstra evidência científica significativa no presente.
Crianças com Perturbações da Regulação do Processamento Sensorial apresentam um risco superior para défices de desenvolvimento, sensoriais, motores, emocionais e comportamentais, logo é necessário estabelecer um diagnóstico diferencial entre estas e Perturbações do Espetro do Autismo. Tal está patente na DC:0-5, através da classificação das Perturbações da Regulação do Processamento Sensorial como diagnóstico de exclusão.
A abordagem das crianças com Perturbações do Espetro do Autismo implica a avaliação da componente sensorial, embora os instrumentos sejam escassos. Estas crianças beneficiam de intervenções multidisciplinares, no entanto o papel da terapia de integração sensorial é pouco consistente, por agora.
According to the medical literature, 69-100% of children with Autism Spectrum Disorders have atypical patterns of sensorial modulation. Deficits in sensorial integration are often the first manifestations that parents of these children report. Over time, diagnostic classifications have underestimated the sensorial domain of Autism Spectrum Disorders, but in DSM-5 this has become a diagnostic criterion. Such inclusion is reinforced by the role of sensorial changes in the development of motor and behavioural stereotypes and by their impact on social, communication and attention capacities in children with Autism Spectrum Disorders. Considering the heterogeneity of clinical manifestations of Autism Spectrum Disorders, the signs/symptoms of hypo and hyperresponsiveness in the seven sensorial systems present diagnostic value in the early identification and as possible biomarkers of Autism Spectrum Disorders. However, none of these demonstrate significant scientific evidence at present. Children with Regulation Disorders of Sensory Processing present a higher risk for developmental, sensorial, motor, emotional and behavioural deficits, so it is necessary to establish a differential diagnosis between these and Autism Spectrum Disorders. This is shown in DC:0-5, through classification of Regulation Disorders of Sensory Processing as a diagnosis of exclusion. The approach of children with Autism Spectrum Disorders involves the evaluation of the sensorial component, although the instruments have been scarce. These children benefit from multidisciplinary interventions, however the role of sensory integration therapy is inconsistent for now.
According to the medical literature, 69-100% of children with Autism Spectrum Disorders have atypical patterns of sensorial modulation. Deficits in sensorial integration are often the first manifestations that parents of these children report. Over time, diagnostic classifications have underestimated the sensorial domain of Autism Spectrum Disorders, but in DSM-5 this has become a diagnostic criterion. Such inclusion is reinforced by the role of sensorial changes in the development of motor and behavioural stereotypes and by their impact on social, communication and attention capacities in children with Autism Spectrum Disorders. Considering the heterogeneity of clinical manifestations of Autism Spectrum Disorders, the signs/symptoms of hypo and hyperresponsiveness in the seven sensorial systems present diagnostic value in the early identification and as possible biomarkers of Autism Spectrum Disorders. However, none of these demonstrate significant scientific evidence at present. Children with Regulation Disorders of Sensory Processing present a higher risk for developmental, sensorial, motor, emotional and behavioural deficits, so it is necessary to establish a differential diagnosis between these and Autism Spectrum Disorders. This is shown in DC:0-5, through classification of Regulation Disorders of Sensory Processing as a diagnosis of exclusion. The approach of children with Autism Spectrum Disorders involves the evaluation of the sensorial component, although the instruments have been scarce. These children benefit from multidisciplinary interventions, however the role of sensory integration therapy is inconsistent for now.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2018
Palavras-chave
Perturbações do espetro do autismo Perturbações da regulação do processamento sensorial Manifestações sensoriais atípicas Idade pediátrica Pediatria