Desenvolvimento de Crianças com Transtorno do Espectro Autista pelo Battelle developmental Inventory, 2nd Edition: um estudo comparativo com crianças típicas

Abstract

Human development is a continuous process of cumulative changes throughout the life cycle, that occurs according to the interaction between the organism and its environment. However, there are individuals who present a different developmental path, as the Autism Spectrum Disorder (ASD) people. Children with ASD have the development in nontypical evolutionary sequence, with areas and domains of development not integrated with each other. Considering the importance of development evaluation for the planning and monitoring of intervention for this population, in addition to the lack of assessment tools adapted for Brazil, the objective of this Master's Thesis was to analyze the viability of the Battelle Developmental Inventory 2nd Edition (BDI-2) to evaluate children with ASD and the adapted version of the Battelle Developmental Screening Test (BDIS-BR) for Brazil to screen the development of Brazilian children with autism from 24 to 59 months of age. Based on this objective, two studies were performed. The Study 1 was an integrative review of the literature of studies that adopted the Battelle Developmental Inventory 2nd Edition (BDI-2) with autistic children in order to discuss the suitability of this instrument for this population. Five databases were used to select 20 articles, which were analyzed by country and year of publication, design, sample size, study objectives, and authors' considerations on the use of BDI-2 with autistic children. Most of the studies were US-based which, adopting quantitative descriptive (n = 18) designs, used the BDI2 to investigate relations among developmental variables and the child's performance on the test. The authors considered the BDI-2 as an instrument with excellent level of internal consistency, acceptable test-retest reliability and good convergent validity and sensitivity to evaluate development milestones for screening and diagnosing specific populations. This review concluded that the BDI-2 is useful for evaluating the development of children with ASD, but studies about it are still necessary in Brazil. The objective of Study 2 was to analyze the viability of the adapted version of BDIS for Brazil, the BDIS-BR, comparing the performance of Brazilian children with ASD to children with typical development from 24 to 59 months of age, and evaluating the performance of ASD children in the BDIS-BR and their scores in the Childhood Autism Rating Scale (CARS). Statistical analyzes showed that there were significant differences between those two groups for the total score (M = 90.5 for the ASD group, M = 128 for the typical group), as well as for all BDIS-BR domains. Significant negative correlations between the scores of children with ASD on the CARS and their performance in the BDIS-BR were found for the total score (r = -0.438), and for the Adaptive (r = -0.537), and the Cognitive (r = -0.452) domains scores in the BDIS-BR. The findings of Study 2 suggest that the BDISBR is a viable evaluation tool for the screening the development of Brazilian children with ASD, since significant differences between groups of children with ASD and with typical development were found, such as the results of Study 1 and the original BDI-2 study had already confirmed. This viability of the BDIS-BR was also confirmed by the significant negative correlations found between the results of this instrument and the CARS. However, it is important to propose new studies with this assessment tool for different age groups, to confirm its potential using for the public and private´s health and educational systems in our country. It is concluded that the BDIS-BR is an unprecedented and appropriate tool for the screening and the monitoring ASD children development, with potential for using by health and education professionals, as well as researchers who study the development of atypical population