Desenvolvimento de crianças com TEA e treino de parentalidade positiva para seus cuidadores
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2022-03-29
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Universidade Estadual Paulista (Unesp)
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O Transtorno do Espectro Autista (TEA) pode resultar em atrasos no neurodesenvolvimento e tem como características prejuízos na comunicação social e nos padrões restritos de interesse e comportamentos. Entre as estratégias para reduzir prejuízos sociais e funcionais, estão os programas de intervenção para as crianças, como a Análise do Comportamento Aplicada (ABA), assim como de programas para pais. Visou-se neste estudo avaliar os efeitos: a) do programa ABA e a associação com um programa para cuidadores sobre o desenvolvimento de crianças com TEA e, b) do programa para cuidadores sobre as suas práticas educativas e crenças sobre cuidados e estimulação infantil. Participaram do estudo, 32 pais (16 mães e 16 pais) e 16 crianças, entre dois a cinco anos. Os genitores foram divididos randomicamente em dois grupos, Experimental (GE) e o Controle (GC). Inicialmente responderam ao Inventário de Estilos Parentais para Mães e Pais de Bebês (IEPMB) e a Escala de Crenças Parentais e Práticas de Cuidado na Primeira Infância (E-CPPC). O desenvolvimento das crianças foi avaliado com o Inventário Portage Operacionalizado e com o Verbal Behavior Milestones Assessment and Placement Program (VBMAPP). Após a avaliação todas as crianças foram submetidas ao programa ABA. Os pais do GE e do GC, participaram do Programa de Educação Positiva para Pais de Crianças em momentos distintos e a cada etapa uma nova avaliação foi feita com todos os instrumentos. Os dados obtidos foram organizados em quatro estudos. O Estudo 1 visou descrever e comparar práticas e crenças parentais, considerando o que fazem e o que acham importante fazer, sobre cuidados e estimulação de crianças com TEA, antes e depois do Programa para Pais. Os resultados da amostra toda apontaram que, no pré-teste, as mães apresentaram médias significativamente maiores de cuidados primários do que os pais. Após a intervenção, na comparação inter e intragrupos, observou-se médias significativamente maiores para GE após a intervenção. Mudanças significativas persistiram no follow-up para os dois grupos. No Estudo 2 pretendeu-se descrever e comparar os efeitos do programa para pais no relato das práticas educativas. Os resultados obtidos mostraram que as mães diferiram dos pais, antes da intervenção, apenas em abuso físico, mais frequentes entre elas. Tanto pais como mães do GE e do GC aumentaram significativamente as práticas positivas e diminuíram as negativas após a intervenção. Objetivou-se, no Estudo 3, descrever e comparar o desenvolvimento de crianças com TEA, quando expostas ao ABA e ao ABA associado ao programa de práticas positivas para os pais. As crianças apresentaram médias significativamente maiores em todas as áreas avaliadas, tanto comparando as duas linhas de base do GC, mostrando os efeitos favoráveis do ABA, como também após a participação dos pais no programa sobre parentalidade associado ao ABA. O Estudo 4 visou comparar o repertório verbal das crianças antes e depois do ABA e, também, quando associado à intervenção com os pais. Os resultados demostraram que o programa de educação positiva para os pais associado ao ABA ampliou o repertório verbal das crianças de ambos os grupos, em todas as habilidades verbais avaliadas. Conclui-se que pais e mães se beneficiaram do programa de práticas educativas positivas associado ao ABA, resultando em ampliação de repertório comportamental de seus filhos, ampliando as possibilidades de intervenções com essa população.
Autism Spectrum Disorder (ASD) results in neurodevelopmental delays and is characterized by impairments in social communication and restricted patterns of interest and behaviors. Among the strategies to reduce social and functional impairments are stimulation programs for children, such as Applied Behavior Analysis (ABA), as well as programs for parents. This study aimed to evaluate the effects: a) of the ABA program and its associated with a program for caregivers on the development of children with ASD and, b) of the program for caregivers on their educational practices and beliefs about child care and stimulation. The study included 32 fathers (16 mothers and 16 fathers) and 16 children, aged between two and five years. The parents were randomly divided into two groups, Experimental (EG) and Control (CG). Initially, they responded to the Parenting Styles Inventory for Mothers and Fathers of Babies (IEPMB) and the Parental Beliefs and Early Childhood Care Practices Scale (E-CPPC). Children's development was assessed using the Operationalized Portage Inventory and the Verbal Behavior Milestones Assessment and Placement Program (VBMAPP). After the evaluation, all children were submitted to the ABA program. The parents of the EG and the CG participated in the Positive Education Program for Parents of Children at different times and at each stage a new assessment was made with all the instruments. The data obtained were organized into four studies. Study 1 aimed to describe and compare parenting practices and beliefs, considering what they do and what they think is important to do, about care and stimulation of children with ASD, before and after the Parents Program. The results of the entire sample showed that, in the pre-test, mothers had significantly higher means of primary care than fathers. After the intervention, in the inter- and intra-group comparison, significantly higher means were observed for EG after the intervention. Significant changes persisted at follow-up for both groups. In Study 2, we intended to describe and compare the effects of the program for parents in the reporting of educational practices. The results obtained showed that the mothers differed from the fathers, before the intervention, only in physical abuse, which was more frequent among them. Both EG and CG fathers and mothers significantly increased positive practices and decreased negative ones after the intervention. The aim of Study 3 was to describe and compare the development of children with ASD when exposed to ABA and ABA associated with the program of positive parenting practices. Children had significantly higher averages in all areas evaluated, both comparing the two CG baselines, showing the favorable effects of ABA, and also after parents' participation in the ABA-associated parenting program. Study 4 aimed to compare the children's verbal repertoire before and after ABA and also when associated with the intervention with the parents. The results showed that the positive education program for parents associated with ABA expanded the verbal repertoire of children in both groups, in all verbal skills evaluated. It is concluded that fathers and mothers benefited from the program of positive educational practices associated with ABA, resulting in an expansion of their children's behavioral repertoire, expanding the possibilities of interventions with this population.
Autism Spectrum Disorder (ASD) results in neurodevelopmental delays and is characterized by impairments in social communication and restricted patterns of interest and behaviors. Among the strategies to reduce social and functional impairments are stimulation programs for children, such as Applied Behavior Analysis (ABA), as well as programs for parents. This study aimed to evaluate the effects: a) of the ABA program and its associated with a program for caregivers on the development of children with ASD and, b) of the program for caregivers on their educational practices and beliefs about child care and stimulation. The study included 32 fathers (16 mothers and 16 fathers) and 16 children, aged between two and five years. The parents were randomly divided into two groups, Experimental (EG) and Control (CG). Initially, they responded to the Parenting Styles Inventory for Mothers and Fathers of Babies (IEPMB) and the Parental Beliefs and Early Childhood Care Practices Scale (E-CPPC). Children's development was assessed using the Operationalized Portage Inventory and the Verbal Behavior Milestones Assessment and Placement Program (VBMAPP). After the evaluation, all children were submitted to the ABA program. The parents of the EG and the CG participated in the Positive Education Program for Parents of Children at different times and at each stage a new assessment was made with all the instruments. The data obtained were organized into four studies. Study 1 aimed to describe and compare parenting practices and beliefs, considering what they do and what they think is important to do, about care and stimulation of children with ASD, before and after the Parents Program. The results of the entire sample showed that, in the pre-test, mothers had significantly higher means of primary care than fathers. After the intervention, in the inter- and intra-group comparison, significantly higher means were observed for EG after the intervention. Significant changes persisted at follow-up for both groups. In Study 2, we intended to describe and compare the effects of the program for parents in the reporting of educational practices. The results obtained showed that the mothers differed from the fathers, before the intervention, only in physical abuse, which was more frequent among them. Both EG and CG fathers and mothers significantly increased positive practices and decreased negative ones after the intervention. The aim of Study 3 was to describe and compare the development of children with ASD when exposed to ABA and ABA associated with the program of positive parenting practices. Children had significantly higher averages in all areas evaluated, both comparing the two CG baselines, showing the favorable effects of ABA, and also after parents' participation in the ABA-associated parenting program. Study 4 aimed to compare the children's verbal repertoire before and after ABA and also when associated with the intervention with the parents. The results showed that the positive education program for parents associated with ABA expanded the verbal repertoire of children in both groups, in all verbal skills evaluated. It is concluded that fathers and mothers benefited from the program of positive educational practices associated with ABA, resulting in an expansion of their children's behavioral repertoire, expanding the possibilities of interventions with this population.
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Transtorno do Espectro Autista, Crianças - Desenvolvimento, Crianças - Conduta, Educação especial - Participação dos pais, Treino parental, Análise do comportamento aplicada, Desenvolvimento infantil, Child development, Parental involvement in children's education, ASDs (Autism spectrum disorders), Applied behavior analysis