Browsing by Author "Paiva Gomes, M"
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- A Perturbação do Espetro do Autismo na Primeira Infância: O Modelo do Centro de Estudos do Bebé e da Criança de Avaliação Diagnóstica e Intervenção TerapêuticaPublication . Martins Halpern, C; Caldeira da Silva, P; Costa, D; Nascimento, MJ; Mesquita Reis, J; Martins, MT; Pinto Ferreira, B; Santos, I; Carvalho, L; Paiva Gomes, M; Martins, M; Pimentel, MJ; Lopes, P; Silva, P; Rapazote, R; Catarino, S; Aires Pereira, S; Pereira, S; Afonso, SIntroduction: The Centro de Estudos do Bebé e da Criança in Hospital Dona Estefânia has organized a multidisciplinary model for children under three with suspected autism spectrum disorder, thus implementing the recent guidelines established by the Directorate General for Health. The aim of this study is to describe this model and case series. Material and methods: A retrospective descriptive study of observed children with suspected ASD. They were observed according to the model of the Centro de Estudos do Bebé e da Criança and DC:0-5TM classification, between January 2018 and September 2019. Results: The study included 178 children. The average age at the initial assessment was 27 months. From the total sample, 116 children concluded the diagnostic sessions (axis I): Autism Spectrum Disorder/Early Atypical (36%), Developmental Language Disorder (18%), Other (19%). Factors of axes II, III, IV and V of DC:0-5TM were determinant for clinical diagnosis in 26%. Discussion: Of 116 children, 36% were diagnosed with Autism Spectrum Disorder. This highlights the diagnostic challenge posed by neurodevelopmental disorders in early infancy. The sample shows that the characteristics of the relationship with the caregiver (axis II), presence of physical conditions (axis III), psycho-social stressors (axis IV) and developmental trajectory (axis V) have a significant clinical impact. In the future, the initial assessment should take place well before the age of 27 months because of the impact on prognosis. Conclusion: This model is a pioneering approach in Portugal. It promotes a common approach of Child and Adolescent Psychiatry and Neuropediatrics/Developmental Pediatrics in early infancy. Moreover, it increases the diagnostic acuity of Autism Spectrum Disorders and early therapeutic intervention.
- A Perturbação do Espetro do Autismo na Primeira Infância: O Modelo do Centro de Estudos do Bebé e da Criança de Avaliação Diagnóstica e Intervenção TerapêuticaPublication . Halpern, CM; Caldeira da Silva, P; Costa, D; Nascimento, MJ; Mesquita Reis, J; Martins, MT; Pinto Ferreira, B; Santos, I; Carvalho, L; Paiva Gomes, M; Martins, M; Pimentel, MJ; Lopes, P; Silva, P; Rapazote, R; Catarino, S; Aires Pereira, S; Pereira, S; Afonso, SIntroduction: The Centro de Estudos do Bebé e da Criança in Hospital Dona Estefânia has organized a multidisciplinary model for children under three with suspected autism spectrum disorder, thus implementing the recent guidelines established by the Directorate General for Health. The aim of this study is to describe this model and case series. Material and methods: A retrospective descriptive study of observed children with suspected ASD. They were observed according to the model of the Centro de Estudos do Bebé e da Criança and DC:0-5TM classification, between January 2018 and September 2019. Results: The study included 178 children. The average age at the initial assessment was 27 months. From the total sample, 116 children concluded the diagnostic sessions (axis I): Autism Spectrum Disorder/Early Atypical (36%), Developmental Language Disorder (18%), Other (19%). Factors of axes II, III, IV and V of DC:0-5TM were determinant for clinical diagnosis in 26%. Discussion: Of 116 children, 36% were diagnosed with Autism Spectrum Disorder. This highlights the diagnostic challenge posed by neurodevelopmental disorders in early infancy. The sample shows that the characteristics of the relationship with the caregiver (axis II), presence of physical conditions (axis III), psycho-social stressors (axis IV) and developmental trajectory (axis V) have a significant clinical impact. In the future, the initial assessment should take place well before the age of 27 months because of the impact on prognosis. Conclusion: This model is a pioneering approach in Portugal. It promotes a common approach of Child and Adolescent Psychiatry and Neuropediatrics/Developmental Pediatrics in early infancy. Moreover, it increases the diagnostic acuity of Autism Spectrum Disorders and early therapeutic intervention.
- Porque é que Ele Anda Assim? Marcha em Pontas e Perfil SensorialPublication . Pires, S; Costa, C; Martins, MT; Pereira, S; Martins Halpern, C; Neiva, S; Paiva Gomes, M; Caldeira da Silva, PA marcha em pontas (MP) define-se pela ausência de contacto do calcanhar com o solo na fase inicial da marcha, podendo ser normal durante a aprendizagem motora, associar-se a diferentes patologias ou ser idiopática (MPI). A abordagem terapêutica é variada, passando por um tratamento conservador ou interventivo. Encontra-se frequentemente a MP em crianças com perturbação do espectro do autismo (PEA), discutindo-se a hipótese de poder estar associada a perturbações do processamento sensorial (PPS). Este trabalho descreve um caso clínico ilustrativo de MP e PPS numa criança com PEA, com apresentação prévia de uma revisão da literatura sobre o tema. Tem sido descrito por alguns autores que crianças com MP parecem apresentar alterações sensoriais subtis, nomeadamente procura vestibular, procura propriocetiva e hipersensibilidade táctil. A criança apresentada, de 4 anos e 9 meses, do sexo masculino, tinha diagnóstico de PEA e apresentava MP. Os resultados do Sensory Profile MeasurePreschool revelaram uma hiperresponsividade táctil, procura sensorial nos domínios propriocetivo e vestibular, associadamente a dificuldades na ideação e planeamento motor (práxis). Parece haver uma relação entre a ocorrência de MP e PPS, contudo, os dados disponíveis são escassos, com diversas imitações. Encontrando-se uma associação consistente, poderá apostar-se com maior segurança no tratamento conservador, nomeadamente na Terapia Ocupacional com abordagem de integração sensorial.