Proposta de adaptação dos Indicadores Clínicos de Risco para o Desenvolvimento Infantil (IRDI) para questionário para pais e sua aplicabilidade

Detalhes bibliográficos
Ano de defesa: 2013
Autor(a) principal: Machado, Fernanda Prada lattes
Orientador(a): Cunha, Maria Claudia
Banca de defesa: Não Informado pela instituição
Tipo de documento: Tese
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Pontifícia Universidade Católica de São Paulo
Programa de Pós-Graduação: Programa de Estudos Pós-Graduados em Fonoaudiologia
Departamento: Fonoaudiologia
País: BR
Palavras-chave em Português:
Palavras-chave em Inglês:
Área do conhecimento CNPq:
Link de acesso: https://tede2.pucsp.br/handle/handle/11951
Resumo: Autism Spectrum Disorders (ASD) are considered developmental disorders that appears in infancy. Early identification and diagnosis enable early intervention. The earlier the child can be identified and treated, the better the long-term outcome. Aim: to adapt the IRDI instrument to retrospective parent report for children from 3;0 to 7;0 years old, administer it in 2 groups and evaluate its sensitivity to screening ASD in comparison with CARS-BR (Brazilian version of Childhood Autism Rating Scale). Method: Participated on the study 72 subjects, parents of children aged from 2;11 to 7;7 years, divided into 2 groups: research group (RG) and control group (CG). The proposed IRDI modification into IRDI-questionnaire, transformed the 31 affirmations from the first into retrospective self-administered questions to parents, with responses in Likert scale. The IRDI-questionnaire was administered in the two groups and the CARS-BR was administered in the CG. The data were submitted to statistical analysis - the chi-square test and the comparison of means test, T-student were used to verify the homogeneity of the groups. For validity, the Pearson's correlation coefficient between IRDI-questionnaire and CARS-BR were performed. A ROC curve was plotted in order to identify the best cut-off point. Sensitivity, specificity and positive predictive value were calculated based on the cut-off point established. In order to study the agreement in IRDI-questionnaire, Kappa s correlation coefficient was calculated. Results: IRDI-questionnaire showed to be easy and quick to administer (average 15 minutes) and with low cost. The internal consistency analysis of the questions calculated by Cronbach s alpha coefficient obtained 0,89 as value. The comparison between the groups by the parents answers to the 31 questions, showed statistically significant difference in 16 questions, with p<0,05. IRDIquestionnaire and CRS-BR comparison by Spearman's correlation coefficient obtained r=0,42, positive correlation, statistically significant between the results of both instruments (p=0,011). The ROC curve plotted identified an area of 84,6%, good performance, statistically significant (p<0,001). The cut-off point established for IRDI-questionnaire indicated sensitivity of 88,9%, specificity of 63,9% and positive predictive value of 71%. Final remarks: we verified that most items of IRDI-questionnaire concerns the main ASD risc signs pointed out in literature. The sensitivity evaluation from the new instrument showed good rates (around 90%), assuring that most children with ASD were identified by IRDI-questionnaire