Avaliação da eficácia de um arranjo de treinamento de ensino de análise funcional para cuidadores de crianças autistas
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Data
2024-04-25
Autores
Santos, Talyta Cristine de Assis
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Universidade Federal do Espírito Santo
Resumo
O Transtorno do Espectro Autista (TEA) é caracterizado por déficits na comunicação e na interação social, e por padrões de comportamentos repetitivos e restritos. A intervenção fundamentada na Análise do Comportamento Aplicada (ABA) apresenta evidências científicas no tratamento de crianças com TEA, mas nem sempre as famílias conseguem acesso após o diagnóstico, sendo importante considerar alternativas como o treinamento parental. Os comportamentos interferentes apresentados pela criança se constituem barreiras para seu desenvolvimento, podendo acarretar aos cuidadores aumento do estresse e diminuição da percepção de competência parental. Nesse contexto, as intervenções baseadas na função do comportamento apresentam resultados efetivos na redução dos excessos comportamentais. O protocolo IISCA – Interview Informed Synthesized Contingency Analysis é um método de manipulação sistemática das possíveis variáveis que mantêm o comportamento, sendo utilizado para identificar sua função de forma rápida e eficaz, permitindo o planejamento da intervenção com base na análise funcional dos comportamentos interferentes. Assim, o presente estudo teve como objetivo avaliar a eficácia de um arranjo de treinamento para capacitar cuidadores de crianças com TEA a identificar variáveis mantenedoras dos comportamentos interferentes de seus filhos, e descrever tais relações funcionais com acurácia, tornando-os mais preparados para manejá-lo. Utilizando como método o delineamento de sujeito único, com linha de base múltipla, o treinamento constituiu em três etapas, sendo elas: 1) apresentação da pesquisa e coleta de dados de linha de base, 2) ensino teórico sobre ABA e análise funcional, e 3) aplicação da entrevista de anamnese do Protocolo IISCA, questionário de pós-teste e questionário de validade social. As respostas foram analisadas de forma descritivas e categorizadas para verificar se os participantes conseguiram identificar as variáveis antecedentes e consequentes dos comportamentos de seus filhos. Os resultados apontaram ganhos significativos para as três participantes, que apresentaram desempenho de 40%, 0% e 50% na linha de base, e, no pós-teste, o desempenho aumentou para 100%, 60% e 80%, respectivamente, demonstrando melhora na habilidade das mães de identificarem as variáveis que mantêm o comportamento dos seus filhos. Os relatos destas cuidadoras apontaram as contribuições do treinamento, diminuindo o nível de estresse e aumentando o senso de competência parental. As participantes descreveram ainda, a importância do treinamento parental sobre análise funcional para que conseguissem realizar os manejos dos comportamentos de seus filhos de forma efetiva, garantindo maiores oportunidades de aprendizagem para a criança. Em estudos futuros, o número de encontros poderia ser reduzido com duração das sessões entre 1 hora e 1 hora e 30 minutos para assegurar o engajamento dos participantes, bem como inserir o follow-up para avaliar a persistência do aprendizado ao longo de um período mais extenso. Os resultados desta pesquisa apontam para a relevância de que os cuidadores saibam realizar uma análise funcional dos comportamentos interferentes de seus filhos com TEA, melhorando assim, sua capacidade de intervenção nas situações problema do dia a dia.
Autism Spectrum Disorder (ASD) is characterized by deficits in communication and social interactions, as well as by repetitive and restrictive behavior patterns. Based on Applied Behavior Analysis (ABA), intervention presents scientific evidence for the treatment of children with ASD. However, not all families can access this treatment after receiving a child's diagnosis, thus it is important to consider alternatives, such as parent training. Interfering behaviors displayed by a child with ASD can be seen as obstacles for the child's development, just as possibly leading to higher stress for caretakers and decreasing their perception of parental competence. In this context, interventions based on the function of behavior display effective results in reducing excessive behaviors. The IISCA (Interview Informed Synthesized Contingency Analysis) protocol is a method of systematic manipulation of the possible variables that maintain behaviors; it is used to promptly and efficiently identify its functions, allowing planning for the intervention based on the functional analysis of interfering behaviors. The objective of the present study is to assess the efficiency of training caretakers of children with ASD to identify variables that sustain their child's interfering behaviors, as well as to accurately describe functional relationships, so caretakers are more prepared to manage these behaviors. By applying the single subject research design with multiple baselines, training consists of 3 steps: 1) introduction to the research and collection of baseline data, 2) theoretical instruction on ABA and functional analysis, and 3) performing anamnesis according to the IISCA Protocol, Post-Test questionnaire and social validity questionnaire. The responses were analyzed descriptively and categorized to verify whether the participants were able to identify the antecedent and consequent variables of their children's behaviors. The results indicate significant gains for all 3 participants as they had rated their performances at 40%, 0%, and 50% at the baseline, but, afterwards, during the Post-Test, reported performance enhancements of 100%, 60%, and 80%, respectively, illustrating that mothers have improved their abilities to identify the variables that maintain their children's behaviors. The reports given by the caretakers suggest that training had positive contributions, decreasing their stress levels and increasing their sense of parental competence. Furthermore, the participants described the importance of parent training on functional analysis in order to be able to effectively manage a child's behaviors, ensuring better learning opportunities for children with ASD. For future studies, we suggest a reduced number of meetings, featuring sessions ranging from 1 hour to 1 hour and 30 minutes to assure that participants are engaged, as well as adding a follow-up meeting to evaluate the endurance of training through a longer time period. The results of this research indicate that it is highly relevant for caretakers to effectively perform functional analysis of the interfering behaviors of their child with ASD and, therefore, improve their abilities to intervene daily in problematic situations.
Autism Spectrum Disorder (ASD) is characterized by deficits in communication and social interactions, as well as by repetitive and restrictive behavior patterns. Based on Applied Behavior Analysis (ABA), intervention presents scientific evidence for the treatment of children with ASD. However, not all families can access this treatment after receiving a child's diagnosis, thus it is important to consider alternatives, such as parent training. Interfering behaviors displayed by a child with ASD can be seen as obstacles for the child's development, just as possibly leading to higher stress for caretakers and decreasing their perception of parental competence. In this context, interventions based on the function of behavior display effective results in reducing excessive behaviors. The IISCA (Interview Informed Synthesized Contingency Analysis) protocol is a method of systematic manipulation of the possible variables that maintain behaviors; it is used to promptly and efficiently identify its functions, allowing planning for the intervention based on the functional analysis of interfering behaviors. The objective of the present study is to assess the efficiency of training caretakers of children with ASD to identify variables that sustain their child's interfering behaviors, as well as to accurately describe functional relationships, so caretakers are more prepared to manage these behaviors. By applying the single subject research design with multiple baselines, training consists of 3 steps: 1) introduction to the research and collection of baseline data, 2) theoretical instruction on ABA and functional analysis, and 3) performing anamnesis according to the IISCA Protocol, Post-Test questionnaire and social validity questionnaire. The responses were analyzed descriptively and categorized to verify whether the participants were able to identify the antecedent and consequent variables of their children's behaviors. The results indicate significant gains for all 3 participants as they had rated their performances at 40%, 0%, and 50% at the baseline, but, afterwards, during the Post-Test, reported performance enhancements of 100%, 60%, and 80%, respectively, illustrating that mothers have improved their abilities to identify the variables that maintain their children's behaviors. The reports given by the caretakers suggest that training had positive contributions, decreasing their stress levels and increasing their sense of parental competence. Furthermore, the participants described the importance of parent training on functional analysis in order to be able to effectively manage a child's behaviors, ensuring better learning opportunities for children with ASD. For future studies, we suggest a reduced number of meetings, featuring sessions ranging from 1 hour to 1 hour and 30 minutes to assure that participants are engaged, as well as adding a follow-up meeting to evaluate the endurance of training through a longer time period. The results of this research indicate that it is highly relevant for caretakers to effectively perform functional analysis of the interfering behaviors of their child with ASD and, therefore, improve their abilities to intervene daily in problematic situations.
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Treinamento parental , Protocolo IISCA , Treino de habilidades comportamentais (BST)