Foi Kok
L’impact des comportements inadaptés sur la qualité de vie liée à la santé (QVLS) des enfants d’âge préscolaire atteints de troubles du spectre autistique (TSA) est relativement peu étudié. Cette étude vise à explorer l’étendue de l’influence que différents types de comportements inadaptés (intériorisés, asociaux et extériorisés) ont sur la QVLS dans ce groupe, lorsque les caractéristiques de base (âge, revenu mensuel brut, type de logement et durée quotidienne du sommeil) et le fonctionnement adaptatif sont contrôlés.
Des questionnaires sur les caractéristiques de base et les échelles de comportement indépendant révisées (SIB-R) ont été recueillis auprès de 99 soignants d'enfants atteints de TSA qui demandaient un traitement à l'hôpital pour femmes et enfants KK. Ces questionnaires ont été utilisés pour évaluer la gravité des comportements inadaptés, le niveau de fonctionnement adaptatif et quelques caractéristiques de base de ces enfants. La relation entre ces éléments et la qualité de vie psychosociale et physique de ces enfants est évaluée à l'aide de l'inventaire de la qualité de vie pédiatrique (PedsQL).
Le trouble du spectre autistique (TSA) est un trouble neurodéveloppemental chronique caractérisé par des troubles des relations sociales et de la communication, ainsi que par des comportements, des activités ou des intérêts limités et mornes. La prévalence du TSA semble augmenter dans le monde entier, le TSA touchant environ 1 personne sur 88.
Le trouble du spectre de l'équilibre chimique est perçu comme un problème de santé général important en raison de son stade initial, de sa persistance profondément enracinée et des niveaux élevés d'entraves associées. Cette faiblesse est imputable non seulement aux manifestations centrales du TSA, mais également à l'étendue des troubles concomitants que les personnes atteintes de TSA rencontrent régulièrement, notamment les troubles émotionnels et sociaux, les troubles du sommeil, des soins et de l'alimentation, les sensibilités tactiles, les troubles d'apprentissage et scolaires, ainsi que les troubles concomitants de la santé mentale et du bien-être. Ces troubles concomitants peuvent être une préoccupation égale ou plus importante pour les parents et les éducateurs d'enfants atteints de TSA que les manifestations centrales du TSA, et affectent considérablement la gestion du comportement, l'apprentissage et le développement des relations sociales.
Les pratiques problématiques (ou pratiques inadaptées comme on les appelle dans cet article), décrites comme des pratiques gênantes, dommageables, violentes ou tout à fait mornes, sont courantes chez les jeunes enfants atteints de TSA. Par exemple, Dominick et al. ont découvert que 32,7 % des enfants atteints de TSA présentaient des pratiques violentes, notamment des coups,
kicking, gnawing, and squeezing others. More than seventy five
percent of these kids indicated forceful practices both at home and outside the home, and hostility was coordinated toward
more than one individual in 92% of cases. Self-damaging conduct, including head slamming, hitting oneself, and gnawing oneself, was available in very nearly 33% of youngsters with ASD. Besides, 70.9% of youngsters with ASD had encountered a time of serious hissy fits and, for 60% of these kids, fits of rage happened consistently and were a steady (as opposed to wordy) issue during the period in which they were available.
A few creators have noticed a solid negative connection between the capacity to impart and the commonness of maladaptive conduct in small kids with ASD. Self-damaging practices among kids with ASD have likewise been connected to their responsive and additionally expressive correspondence shortfalls. It follows that when treatment programs center around building up the small kid's relational abilities to the degree that they can fill in as viable substitution practices, a decrease in the maladaptive conduct may result.
Maladaptive practices are especially hazardous in bunch settings, for example, early intercession administrations, childcare administrations, and preschools, as they can be problematic to the learning system and posture critical difficulties to the kids with ASD themselves, their companions, and staff. Consequently, maladaptive practices are among the most regularly recognized hindrances to the incorporation of youngsters with ASD in bunch settings.
Further, when maladaptive practices become a built up part of a youngster's conduct collection, they are probably not going to diminish and, as indicated by Berg et al., will normally remain or decline without intercession. Whenever left untreated, these practices can fundamentally lessen a kid's social and instructive open doors by restricting their admittance to accessible medicines, learning exercises, communications with others, network encounters and, specifically, their capacity to progress to, and partake in, school programs. Notwithstanding negatively affecting kids with ASD themselves, various examinations have demonstrated that guardians' degree of mental trouble is related with the seriousness of their kid's maladaptive practices just as their ASD side effects.
Accordingly, early intercessions for little youngsters with ASD should consolidate the administration of maladaptive practices . Given the connection between maladaptive practices and deficiencies in correspondence and social abilities, it is significant that intercession approaches focus on these center shortages. Myers and Johnson contend that the essential objectives of intercession for kids with ASD ought to be to augment the youngster's practical autonomy and personal satisfaction by lessening the center manifestations of ASD; encourage improvement and learning; advance socialization; diminish maladaptive practices; teach and backing families. They propose that, notwithstanding focusing on correspondence and social abilities, contemporary extensive intercession approaches for ASD should focus on a decrease in troublesome or maladaptive conduct by utilizing observationally upheld systems, including useful conduct appraisal (FBA). FBA is "the way toward deciding the expectation a wrong conduct serves for acquiring an ideal result and supplanting that conduct with a more fitting one that achieves a similar objective".
The overall significance of early mediation for ASD is broadly perceived, and is upheld by examines indicating better results with prior treatment. Early intercession for ASD, particularly that initiating before the time of 3 years, brings about fundamentally improved results comparative with mediation starting further down the road. Early intercession in the principal long stretches of life offers the best potential for kids as mind pliancy is most noteworthy during this period, empowering the foundation and redesign of neuronal systems in light of natural incitement
Multiple Regression revealed that Maladaptive behaviors have greater impact on HRQOL than Adaptive skills and background characteristics. Asocial maladaptive behaviors have the most unique influence on HRQOL out of the three Maladaptive behaviors, suggesting difficulties in social interaction and communication manifested by children with ASD play the largest role in their HRQOL at this age. Adaptive skills have a smaller but still unique impact on HRQOL, while background characteristics are not significant.
The specific types of Asocial Maladaptive behavior and their impact of HRQOL in this age group can be further studied with ASD-specific scales like Social Responsive Scale (SRS) and Repetitive Behaviors Scale-Revised (RBS-R). More targeted behavioral intervention can be then developed to improve the quality of life amongst preschool children with ASD.
Biography:
F. Kok is a Fourth Year Medical Student at Lee Kong Chian School of Medicine, National Technological University, Singapore.S.P. Yeleswarapu is a Consultant at the Department of Children Development at KK Women’s and Children Hospital, Singapore. She is also an Adjunct Assistant Professor with Duke-NUS Medical School, Singapore.
32e Conférence internationale sur la santé mentale et comportementale, 22-23 avril 2020
Résumé Citation :
Faith Kok, Exploration du type de comportements inadaptés ayant le plus d'impact sur la qualité de vie des enfants d'âge préscolaire atteints d'autisme, Congrès sur la santé mentale 2020, 32e Conférence internationale sur la santé mentale et comportementale, 22-23 avril 2020
English 
Spanish 
Chinese 
Russian 
German 
Japanese 
Portuguese 
Hindi