Análise do comportamento aplicada ao transtorno do espectro autista: as famílias usuárias, as normas técnicas e os serviços

Abstract

Autistic Spectrum Disorder (ASD) has a neurological basis and is characterized by deficits and excesses of motor, cognitive and affective responses. The subject diagnosed with this disorder has limitations in the relationship with people and objects, repetitive and stereotyped acts and disorders in language development, such as speech with echolalia. Such limitations are subject to change from constructive interactions learned in effective treatments, usually intensive and conducted by a specialized multidisciplinary team, often in Applied Behavior Analysis (ABA). Despite this, reports and research indicate that interventions in behavior analysis, even effective, can be ineffective if not done as they should; and inform that there is a shortage of clinics and organizations that offer it as part of specialized services. This is problematic under the bylaws which dictate those individuals with ASD are entitled to receive treatment with the required standards. Thus, the objective of this investigation was to describe relations between the level of reproduction of intertwined behavioral contingencies of demand for services for individuals with ASD, socioeconomic level and level of knowledge about ASD of the families of these individuals, users of these services. For this, the research was divided into two studies. Study 1 consisted of documentary research that raised the technical standards that prescribe the standards guaranteed for such care, and with such a prescription, it was possible to build a checklist for evaluating the standard in ABA-based services provided to people with ASD. In Study 2, this instrument had participants from the capital Vitória, in Espirito Santo, as respondents, including managers, professionals and persons responsible for the service users. Also, the characteristics of the clinics and the training of professionals were evaluated, in addition to the socioeconomic and demographic conditions of those responsible and their level of knowledge about the ASD, using a questionnaire and a scale. At the end, all collected data were interpreted, based on the average of the results. At the end of Study 1, it was possible to identify, in the normative documents, the absence of detailed descriptions of contingencies, which makes it difficult to apply and standardize the services provided based on the ABA. Therefore, there is an emergence of the creation of new normative documents, mainly Brazilian ones, with better description so that they can serve as a model for the professionals' behavior. Finally, in Study 2, the hypotheses were confirmed, which associated the level of knowledge of family members about the ASD to their socioeconomic status and how this could interfere with access to services based on the ABA. It is noteworthy that there is a need for greater depth on this topic and further research for this audience.