Efeitos de um programa de ensino em Análise do Comportamento Aplicada (ABA) sobre o desenvolvimento de crianças com Transtorno do Espectro Autista e a saúde emocional de seus pais
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2023-05-25
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Universidade Estadual Paulista (Unesp)
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Estudos sobre a saúde emocional de pais de crianças com Transtorno do Espectro Autista (TEA) estão em foco, dada a frequência do transtorno na população mundial. Intervenções que promovam o empoderamento parental frente ao diagnóstico e acerca dessa condição duradoura de seus filhos podem ser eficazes na redução de prejuízos na saúde emocional parental e contribuir para o desenvolvimento infantil. A presente tese foi dividida em três estudos. O Estudo 1 pretendeu apresentar uma revisão sistemática de literatura sobre os efeitos de programas de treinamento de pais no desenvolvimento de crianças com TEA. A busca foi realizada no Portal de Periódicos da CAPES considerando artigos em português e inglês, publicados entre 2016 e 2021 e a organização foi pautada no protocolo PRISMA. Dos 30 artigos incluídos, todos eram internacionais, com mais publicações em 2016 e 2020 e o delineamento mais frequente foi o de linha de base múltipla. A Análise do Comportamento Aplicada (ABA) foi o aporte teórico mais utilizado. Pais e mães compuseram a maior parte das amostras, ainda que nos grupos, o número de mães fosse superior. Efeitos promissores das intervenções foram apontados em 70% dos estudos, porém, nem sempre com significância sobre o repertório infantil. O Estudo 2 teve como objetivo descrever e comparar a saúde emocional de pais e mães de crianças com TEA e sua percepção sobre rede de apoio, relacionando-as. Participaram 11 pais e 24 mães de crianças com TEA. Foram coletados dados sociodemográficos, de Saúde Emocional (SE) por meio dos instrumentos PSS, IDATE e EBADEP-A e de percepção sobre a rede de apoio social por meio da EAS. Os resultados apontaram para uma SE materna mais fragilizada em comparação aos pais. Sobre a percepção de rede de apoio, foram observadas médias mais baixas para as mães em todas as dimensões investigadas. Esses achados enfatizam a necessidade de mais investigações e intervenções direcionadas à SE de pais de crianças com TEA. O Estudo 3 objetivou descrever e avaliar os efeitos de um programa de orientação para pais, baseado na ABA sobre a saúde emocional parental (relacionados ao estresse, a ansiedade e a depressão) e sobre o desenvolvimento geral e verbal de seus filhos com TEA. Participaram 12 mães e seis pais de crianças com TEA com idade entre um e quatro anos. Os dados de SE foram coletados por meio do PSS, IDATE e EBADEP-A e as medidas de desenvolvimento infantil a partir do IPO e do VB-MAPP. Os resultados apontaram que programas de treinamento de pais pautados em conteúdos exclusivamente relacionados ao TEA ou ao desenvolvimento infantil pode surtir pouco efeito ou mesmo gerar uma sobrecarga na SE parental. As mães da amostra demonstraram uma SE mais comprometida em relação aos pais, o que, consequentemente, pode ter impactado a percepção parental sobre o desenvolvimento da criança. Os pais também indicaram uma SE frágil, ainda que em menor intensidade. As intervenções ABA realizadas com a criança contribuíram para o desenvolvimento geral e verbal infantil. Conclui-se, portanto, que o treinamento de pais de crianças com TEA é uma alternativa viável para o desenvolvimento infantil, todavia, novos estudos devem priorizar a SE parental incluindo-a nas intervenções propostas a fim de que elas sejam efetivas para melhora na qualidade de vida dos pais e de seus filhos com TEA.
Emotional health studies of parents of children with Autism Spectrum Disorder (ASD) are in focus, considering the frequency of this disorder in the global population. Interventions that promote parental empowerment in the face of diagnosis and about this lasting condition of their children can be effective in reducing parental emotional health impairments and contributing to child development. This thesis was divided into three studies. Study 1 consisted of a systematic literature review on the effects of parent training programs on the development of children with Autism Spectrum Disorder (ASD). The search was conducted on the CAPES Periodicals Portal considering articles in Portuguese and English, published between 2016 and 2021, and the organization was based on the PRISMA protocol. Of the 30 included articles, all were international, with more publications in 2016 and 2020, and the multiple baseline design was frequently used. Applied Behavior Analysis (ABA) was the most commonly used theoretical framework. Parents, particularly mothers, made up the majority of the samples. Promising effects of interventions were reported in 70% of studies, but not always with a significant impact on children's repertoire. Study 2 aimed to describe and compare the emotional health of parents of children with Autism Spectrum Disorder (ASD) and their perception of support networks. A total of 11 fathers and 24 mothers of children with ASD participated in the study, which collected data on emotional health using validated instruments such as the Perceived Stress Scale (PSS), State-Trait Anxiety Inventory (STAI), and Baptista Depression Scale (EBADEP-A). Additionally, variables related to social support networks were assessed through the use of the Social Support Scale (MOS-SSS), and sociodemographic information was also gathered. The results indicated a more fragile maternal emotional health compared to fathers. In terms of the perception of support networks, mothers showed lower scores across all investigated dimensions. These findings emphasize the need for further research and interventions focused on the emotional health of parents of children with ASD. Study 3 aimed to describe and evaluate the effects of a parent training ABA-based program on parental emotional health (related to stress, anxiety, and depression) and the development of their children with ASD. 12 mothers and 6 fathers of children with ASD, aged between one and four years old, participated in the study. The emotional health data were collected through PSS, STAI, and EBADEP-A instruments. Also, VB-MAPP and OPI instruments evaluated the child's development. The results indicated that parent training programs based solely on content related to ASD or child development may have little effect or even cause an overload in parental emotional health. The mothers in the sample demonstrated more compromised emotional health in relation to fathers, which consequently may have impacted parental perception of child development. Fathers also reported fragile emotional health, albeit to a lesser extent. ABA interventions carried out with the child contributed to overall and verbal child development. It is concluded that training parents of children with ASD is a viable alternative for child development. However, new studies should prioritize parental emotional health, including it in the proposed interventions to improve the quality of life for parents and their children with ASD.
Emotional health studies of parents of children with Autism Spectrum Disorder (ASD) are in focus, considering the frequency of this disorder in the global population. Interventions that promote parental empowerment in the face of diagnosis and about this lasting condition of their children can be effective in reducing parental emotional health impairments and contributing to child development. This thesis was divided into three studies. Study 1 consisted of a systematic literature review on the effects of parent training programs on the development of children with Autism Spectrum Disorder (ASD). The search was conducted on the CAPES Periodicals Portal considering articles in Portuguese and English, published between 2016 and 2021, and the organization was based on the PRISMA protocol. Of the 30 included articles, all were international, with more publications in 2016 and 2020, and the multiple baseline design was frequently used. Applied Behavior Analysis (ABA) was the most commonly used theoretical framework. Parents, particularly mothers, made up the majority of the samples. Promising effects of interventions were reported in 70% of studies, but not always with a significant impact on children's repertoire. Study 2 aimed to describe and compare the emotional health of parents of children with Autism Spectrum Disorder (ASD) and their perception of support networks. A total of 11 fathers and 24 mothers of children with ASD participated in the study, which collected data on emotional health using validated instruments such as the Perceived Stress Scale (PSS), State-Trait Anxiety Inventory (STAI), and Baptista Depression Scale (EBADEP-A). Additionally, variables related to social support networks were assessed through the use of the Social Support Scale (MOS-SSS), and sociodemographic information was also gathered. The results indicated a more fragile maternal emotional health compared to fathers. In terms of the perception of support networks, mothers showed lower scores across all investigated dimensions. These findings emphasize the need for further research and interventions focused on the emotional health of parents of children with ASD. Study 3 aimed to describe and evaluate the effects of a parent training ABA-based program on parental emotional health (related to stress, anxiety, and depression) and the development of their children with ASD. 12 mothers and 6 fathers of children with ASD, aged between one and four years old, participated in the study. The emotional health data were collected through PSS, STAI, and EBADEP-A instruments. Also, VB-MAPP and OPI instruments evaluated the child's development. The results indicated that parent training programs based solely on content related to ASD or child development may have little effect or even cause an overload in parental emotional health. The mothers in the sample demonstrated more compromised emotional health in relation to fathers, which consequently may have impacted parental perception of child development. Fathers also reported fragile emotional health, albeit to a lesser extent. ABA interventions carried out with the child contributed to overall and verbal child development. It is concluded that training parents of children with ASD is a viable alternative for child development. However, new studies should prioritize parental emotional health, including it in the proposed interventions to improve the quality of life for parents and their children with ASD.
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Palavras-chave
Transtorno do Espectro Autista, Saúde Emocional Parental, Orientação de Pais, Autism Spectrum Disorder, Parental Emotional Health, Parent Training