Nonverbal Children Research Articles

Challenges in the assessment and management of pain in non-verbal autistic children: a case report of an osteochondroma revealed by self-aggressive behavior

Introduction: To highlight the challenges of identifying and managing pain in non-verbal autistic children through a case of osteochondroma revealed by self-aggressive behavior and to propose a structured diagnostic approach for these complex situations. Case description: We report the case of a 14-year-old girl with severe non-verbal autism spectrum disorder who developed a progressive increase in self-aggressive behavior over 20 months. The evaluation required an in-depth functional behavioral analysis and an adapted clinical examination, complemented by a radiological work-up. Behavioral analysis revealed that the function of the behavioral problems pointed towards an organic origin: an increase in behavior when moving around, a protective limping when dodging with an exacerbation in the evening. The assessment identified a femoral osteochondroma. The introduction of an alternative communication system with analgesic treatment led to an 80% reduction in self-aggressive behavior. Our observation highlights the difficulties in identifying pain in non-verbal ASD patients and the importance of a structured diagnostic approach. The development of alternative communication appears to be a key element in the assessment and management of pain. Conclusion: Pain management in non-verbal ASD patients requires particular vigilance and a systematic diagnostic approach. Early implementation of alternative communication tools is essential to optimize their assessment and treatment.

Development and Validation of a Tool to Assess Pain in Preverbal and Non-verbal Children with Cerebral Palsy: Cerebral Palsy Faces Pain Scale (CPFPS)

Development and Validation of a Tool to Assess Pain in Preverbal and Non-verbal Children with Cerebral Palsy: Cerebral Palsy Faces Pain Scale (CPFPS)

Caregivers' expectations of their non-verbal autistic children in rural KwaZulu-Natal.

Caregiver expectations have been shown to impact child outcomes. There is limited research regarding caregivers of non-verbal autistic children in rural South Africa. Autistic individuals form part of a larger environment, which they influence and which impacts them. Caregivers form part of this environment. This study aims to explore caregivers' expectations of communication, education, social implications and intervention for their non-verbal autistic child in rural KwaZulu-Natal (KZN). Bronfenbrenner's ecological and bioecological systems theory framed the study and allowed the child's interaction with their environment to be understood through the use of a qualitative study design via interviews. Eleven caregivers (pilot study:n= 1 and main study:n= 10) of non-verbal autistic children were selected and interviewed. Data were analysed thematically. Caregivers had varied expectations. Grandparents were often the primary caregivers (microsystem). Relationships within the mesosystem (caregiver and therapist) and caregiver's understanding affected their feelings and expectations that changed over time (chronosystem). Education was the predominant expectation. The study highlighted limited resources (schools) within the exosystem. Caregivers reported both support and judgement from their communities. There is a need for public awareness, caregiver counselling and autism support groups in rural KZN and more specialised education options in order to improve caregivers' expectations.Contribution:This study contributes to the limited literature in the field of autism in South Africa, more specifically the rural context and communication disorders.

Cognitive testing of the Children’s Palliative Outcome Scale (C-POS) with children, young people and their parents/carers

Background: The Children’s Palliative Outcome Scale (C-POS) is being developed using best methodological guidance on outcome measure development, This recommends cognitive testing, an established method of item improvement, prior to psychometric testing. Aim: To cognitively test C-POS within the target population to establish comprehensibility, comprehensiveness, relevance and acceptability. Design: Cross-sectional cognitive interview study following COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) methodology and Rothrock guidance on outcome measure development. Cognitive interviews were conducted using ‘think aloud’ and verbal probing techniques. Setting/participants: Children 5–⩽17 years old with life-limiting conditions and parents/carers of children with life-limiting conditions were recruited from 14 UK sites. Results: Forty-eight individuals participated (36 parents; 12 children) in cognitively testing the five versions of C-POS over two to seven rounds. Content and length were acceptable, and all questions were considered important. Refinements were made to parent/carer versions to be inclusive of non-verbal children such as changing ‘share’ to ‘express’ feelings; and ‘being able to ask questions’ to ‘having the appropriate information’. Changes to improve comprehensibility of items such as ‘living life to the fullest’ were also made. Parents reported that completing an outcome measure can be distressing but this is anticipated and that being asked is important. Conclusion: Cognitive interviewing has facilitated refinement of the C-POS, especially for non-verbal children who represent a large proportion of those with a life-limiting condition. This study has enhanced the face and content validity of the measure and provided preliminary evidence for acceptability for use in routine practice.

Unmasking the Power of Play Through TUI Designs

Research on the potential benefits of technology for autistic children is an emergent field in Human-Computer Interaction (HCI), especially within the Child-Computer Interaction Community. At the same time, there are concerns about what these interventions and technologies are for and who benefits. We present a research and design approach for Tangible User Interfaces (TUIs) for minimally verbal to nonverbal autistic children following a neurodiversity narrative through three field studies developed and evaluated with three groups of children within a semi-structured scholastic environment between 2018 and 2021 in the UK. We discuss our insights for research and TUI designs in the context of social play for nonverbal autistic children and critically reflect on the methods and approaches we used. We do this to disrupt the normalisation agenda that subtly permeates the field of HCI and to direct designers’ attention toward supporting autistic ways of being in the world.

Child, family and professional views on valued communication outcomes for non-verbal children with neurodisability: A qualitative meta-synthesis.

There are many children with neurodisability who are unable to rely on speech to communicate and so use a range of augmentative and alternative communication (AAC) methods and strategies to get their message across. Current instruments designed to measure the outcomes of speech and language therapy interventions lack specific attention to communication outcomes that are valued by non-verbal children with neurodisability, their families and support networks. This qualitative meta-synthesis was conducted to identify valued communication outcomes to inform the next stage of developing a novel outcome measure. To systematically identify and synthesise the qualitative evidence about which communication outcomes non-verbal children with neurodisability, their family members, healthcare professionals and educators think are important to achieve, specifically which communication outcomes are most valued by: (1) non-verbal children with neurodisability; (2) parents or other family members of non-verbal children with neurodisability; and (3) professionals who work with non-verbal children with neurodisability. A systematic search of bibliographic databases and the grey literature was undertaken to identify qualitative studies that included evidence of views expressed by children, family members, healthcare professionals and educators on outcomes in relation to the communication of non-verbal children with neurodisability. All papers meeting the inclusion criteria were quality appraised using the Critical Appraisal Skills Programme Qualitative checklist, although none were excluded on this basis. The data synthesis involved organising coded data into descriptive themes which were then synthesised into analytical themes. We found 47 papers containing qualitative data meeting the inclusion criteria from research situated in 14 countries. The views of 35 children, 183 parents, six other family members, 42 healthcare professionals and 18 educators are represented in the review. The included studies contained very few data reported by children themselves; most data were provided by adults, especially parents. Three main analytical themes were identified: Experiences of communication and expectations; adapting to and acceptance of AAC; and becoming an autonomous communicator. This meta-synthesis brings together the limited qualitative research findings about what parents, professionals and children consider are important communication outcomes for non-verbal children with neurodisability. The synthesis identifies key gaps in our knowledge about the perspectives of children and their siblings. This synthesis will inform primary research to understand valued communication outcomes in this group, and ultimately the development of a patient-reported outcome measure (PROM) that can be used to demonstrate the effect of interventions, at both clinical and service levels. What is already known on the subject Studies of children with cerebral palsy and autism spectrum disorder indicate that at least 25% of children with these conditions are non-verbal. Studies on the health outcomes of children with neurodisability have identified that communication is rated as important by parents and health professionals. There is an evidence gap about which communication outcomes are important to non-verbal children, their families and the people who work with them. What this paper adds to the existing knowledge This is the first synthesis of data that relates to communication outcomes for non-verbal children with neurodisability. This qualitative meta-synthesis identifies from previous research studies the communication outcomes valued by children who are non-verbal, their parents or other family members, and the professionals who work with them. The findings will be used to shape further primary research and the development of a novel patient-reported communication outcome measure for non-verbal children with neurodisability. It is anticipated that this will be used by clinicians to measure the effect of their interventions. What are the practical and clinical implications of this work? Clinicians should reflect on parents' experiences of communication with their child before discussing potential outcomes with them. Gaining insight into the lived experience of communication for non-verbal children and their families will help healthcare professionals to understand which goals are important to them and why. Few studies have specifically asked which communication outcomes are important for non-verbal children with neurodisability. Further exploration is needed to determine which communication outcomes non-verbal children and their families would like to see included in outcome measures used by clinicians.

Language deficit in boys with autism spectrum disorder in relation to maternal reproductive health, endocrine disruptors, and delivery method.

The presented research aimed to identify prenatal factors involved in abnormal neurodevelopment and postnatal manifestation of an autistic phenotype in 107 boys (average age 4.31 ± 2.24 years). Their biological mothers were asked to fill out a comprehensive questionnaire about their reproductive health, infections during pregnancy, oral contraceptive intake before conception, and potential substance abuse before and during pregnancy as well as delivery and newborn information. The boys were subsequently diagnosed with autism spectrum disorder (ASD) using the combination of Autism Diagnostic Observation Schedule (ADOS-2) and Autism Diagnostic Interview - Revised (ADI-R). Based on the ADOS-2 module chosen during diagnosis, boys diagnosed with Module 1 can be classified as nonverbal or minimally verbal (N = 68), while those diagnosed using Module 3 are fully verbal (N = 39). According to our results, reproductive health related to the length of the menstrual cycle before pregnancy with the autistic child seems to play a role with regards to the severity of the disorder (P = 0.017) as well as the number of previous pregnancies (P = 0.026). Mothers of nonverbal children reported to have had a much shorter menstrual cycle (27.35 ± 6.60 days) than those with verbal children (30.14 ± 4.44 days) and reported more previous pregnancies (0.93 ± 1.07 vs. 0.51 ± 0.91), while not reporting the number of live births before they had the autistic child. Children who were later diagnosed as non-verbal had a longer delivery time (from 2 to 48 hours; on average 11.13 hours, SD = 9.49) than verbal ones (between 1 and 27 hours, which was on average 7.09 hours, SD = 8.91), P = 0.0182. Delivery method didn't play a role in this context, and neither did the type of conception (natural, insemination, etc.). Studying the involvement of prenatal factors in the etiology of autism based on the speech of the child seems to be a promising approach.

Lived Experiences of Parents Using Speech Therapy in Enhancing Communication Skills in Nonverbal Children with Autism Spectrum Disorder

Lived Experiences of Parents Using Speech Therapy in Enhancing Communication Skills in Nonverbal Children with Autism Spectrum Disorder

Facial Expressions as Behavioral Indicators for Assessing Pain using Machine Learning Models

Pain is a symptom of a condition or disease. Pain experienced in the body is verbally reported to a health care giver. Currently there is no objective way to measure physical pain or discomfort one may be feeling. And so consequently, there is no way for caregivers to adequately assess patients in pain who cannot verbalize it, such as non-verbal, adult patients and young children. Facial expressions may be used as a behavioral indicator for evidence of pain which can then be used to communicate a patient's distress and pain severity. These facial expressions can be recognized through jaw clenching, eyebrow raising, and eye squinting. Machine learning with vision based algorithms may differentiate these behavioral face-indicators and assess the pain levels of nonverbal patients. There have emerged many vision based methods for predicting pain from face images. This review summarizes the development of pain recognition from facial expressive images or videos, datasets available for research, an overview of vision based methods using conventional and deep learning, the current challenges and limitations, and scope for improvement in future.

“I Think She’s Forgiven Me”: Utilizing the Language of Play to Nurture Connection between a Nonverbal Child and Their Mother

The ability to communicate, to understand and share meaning, is a salient feature of human development, crucial for integration in, and acceptance by, the social group and for the emergence of a sense of selfhood. Human infants are primed to communicate through playful interaction from the moment of birth and play remains the primary mode of communication throughout childhood, accessible by all ages and abilities. Play is integral to the development of intersubjectivity on which all human connection depends, and which is vital to social acceptance and emotional wellbeing. This paper describes the way in which play represents a mode of metacommunication when a child is diagnosed with a serious illness or disability as a means of sharing meaning around healthcare experiences. A case example from the Japanese context illustrates the way in which the Health Play Specialist uses the language of play to nurture connection in a parent-child dyad living with a diagnosis of neurological impairment, reinforcing the need for wider recognition of the role of play as the universal language of childhood.

Language acquisition in Autism Spectrum Disorder: Strategies for early diagnosis and intervention – A review of literature

Autism Spectrum Disorder (ASD) is characterized as a neurodevelopmental disorder, with deficits in communication and social interaction with a defined diagnostic criteria. Although the main diagnosis is made by the pediatric neurologist and/or the psychiatrist, the clinician ability to refer children with a suspected condition, based on language differences to their neurotypical peers, is crucial for shortening the diagnosis time. Because it is a neurodevelopmental condition, the earlier the interventions, the better the responses and prognosis in development. In this literature review, we aim at an updated discussion about the role of ASD on the child brain, the language development differences in neurotypical and ASD children, the emerging early diagnosis technologies, and the early intervention therapies available for verbal and non-verbal ASD children’s, as well as adults, with a final focus on music therapy.

감각통합을 활용한 몸짓상징중재가 무발화 아동의 몸짓상징과 발화 의사소통 기능에 미치는 효과

The purpose of this study is to investigate the effect of simplified manual sign intervention using sensory integration on communication using simplified manual sign and speech voluntarily in the initial communication function of nonverbal children. In the study, four nonverbal children aged 3 to 5 years were evaluated every time. The intervention was divided into introduction and development activities, and after the intervention, the evaluation was completed, and two simplified manual sign were divided into 1st and 2nd stages according to the 5 communication functions. Considering generalization, each communication function was evaluated by providing 10 opportunities for each simplified manual sign for communication (requiring, rejecting, answering, and naming) and one for greeting so that measurements were made in natural situations.
 As a result of the study, in simplified manual sign intervention using sensory integration, the simplified manual sign communication function was improved, and gradually used voluntary simplified manual sign to communicate. In the speech communication functions, individual differences were for each subject, but it showed improvement in children A and B, and vocalization appeared with simplified manual sign for the first time, and speech was gradually used as simplified manual sign and articulation increased. In this study, the challenge behavior of the subjects was reduced, improving attention concentration and creating an environment for communication, proving the effectiveness in communication using simplified manual sign and speech. This is meaningful that simplified manual sign intervention using sensory integration can serve as a foundation for creating manual signs and verbal communication.

The use of creative case studies to explore non-verbal and non-ambulant children and young people’s well-being

Background and purposeThe aim of this paper is to describe and critically analyse creative research methods, exploring how these can offer ways to enable non-verbal and non-ambulant children and young people with cerebral palsy, to express their views about their well-being. The context of this research explored their choices for recreational activities, seeking to understand how their level of participation impacted upon their well-being. MethodsA qualitative comparative case study design was chosen comprising of two interviews, using photographs and diaries to elicit discussion, supported by observations. These observations provided evidence of well-being indicators that were interpreted by the researcher, alongside their parents. Seven participants volunteered, aged nine to sixteen years. Data were analysed utilising Braun and Clark’s six stages. Firstly, each case’s data sources were coded, themes identified, then across cases comparisons, arriving at three final themes. Triangulation of data sources which made up each case, enhanced the trustworthiness in this study. ResultsObservations were key to providing insight into their well-being. Interpretation of this rich data, supported by their parents, revealed that the participants could self-advocate, as shown by their intentional behaviours, to choose their level of participation. DiscussionThe researcher’s ability to be creative in the data collection methods is original in physiotherapy. It was important to work in partnership with parents, to ensure the correct interpretation of their intentional behaviours from the observations. The diaries and photographs added a unique contribution to knowledge, which enabled the non-verbal participants inclusion, empowering them to express their well-being. Study registrationThis study is registered with the International Study + Clinical Trials Network Register (ISRCTN) Number:42717948. Contribution of paper•This creative approach to a qualitative case study design has offered a new way to explore the well-being of participants who would not be able to carry out a typical interview. In this case it was with non-verbal and non-ambulant children and young people with complex cerebral palsy. The data has illustrated how they can be empowered to indicate their well-being, as their own advocates. It is important this work continues to provide deeper insight into this under-reported group. Physiotherapists should consider how they can include other non-verbal populations in research.•Physiotherapists who work with non-verbal children and young people with complex disabilities, need to find a way to hear their voices. A creative qualitative case study design offers this flexibility and should be considered as an authentic method for data collection in future studies. Children and young people with complex disabilities deserve to see themselves represented in research.•Physiotherapists are unlikely to work alone to achieve advocacy on behalf of non-verbal populations. Teamwork with designers, illustrators and town planners can contribute to move this agenda forwards. This can then increase the choices and opportunities for disabled children to enhance their well-being.

Healthcare Experience of Pediatric Patients with Autism Spectrum Disorders in Saudi Arabia: A Cross-Sectional Study.

Children with autism spectrum disorder (ASD) face several challenges in the healthcare setting. This study defines the challenges experienced by children with autism in hospitals in Saudi Arabia. A cross-sectional study was conducted using a questionnaire for guardians of autistic children in outpatient clinics, autism support groups, and rehabilitation centers. A total of 199 participants were included. The medical procedures causing the most anxiety to children were injections and getting their blood drawn (68.3%), vital sign measurement (41.6%), and height and weight measurement (37.8%). Long waiting hours (44.1%), increased sensory stimuli (33.2%), and overcrowding of hospital staff (27.9%) were stress-inducing in the healthcare environment. The guardians recommended that loud noises (44.7%), crowdedness (41.2%), and long waiting hours (42.1%) be avoided. The nonverbal children experienced significantly higher levels (p < 0.001) of agitation, irritability, and outbursts during doctor visits than their verbal counterparts. The children with intellectual disabilities were more tense and unresponsive during doctor visits (33.3%) than their intellectually able counterparts, who more frequently were calm and responsive (44.9%) during visits. Most patients with ASD face hardships during hospital visits. Nonverbal patients and those with intellectual disabilities have a higher tendency for hospital setting anxiety-induced outbursts, which may be eased by avoiding loud noise and overcrowding.

Atypical clinical presentation and management of urinary stone disease in non-verbal non-ambulatory children

Management of kidney stones primarily depends on various factors such as the presence of urinary tract obstruction, pain, stone size, location, impact on renal function, and the existence of infection. Renal colic is the classic presentation of an obstructive kidney stone. However, in this study, we present a cohort of non-verbal non-ambulatory (NVNA) patients who exhibit a distinct and uncommon presentation of kidney stones due to their medical conditions. Information about kidney stone disease in this gropup of complex pediatric patients is, scarce and their associated risk factors are not well understood. Therefore, we aim to summarize the clinical presentation, and management challenges in this unique group of NVNA patients to identify potential variables for prospective studies. A retrospective chart review was completed for all NVNA patients seen at the pediatric multidisciplinary kidney stone clinic between July 2020 to August 2022. Demographic variables, clinical presentation data, metabolic evaluation, radiological imaging, and surgical management was included for analysis. A total of 224 pediatric patients were referred to the multidisciplinary stone clinic. Of those, 27 were identified to be NVNA. The most common primary diagnosis was Cerebral Palsy followed by Lennox-Gastaut syndrome. Average age at first kidney stone presentation was 11.5 years±5.7 years. An obstructing stone was diagnosed in 18 (66%) patients, 4 (22.2%) of these presented with sepsis. Average stone burden was 9.2mm (±5.8mm). Of the obstructing stones, 13 (72%) were in the kidney. All patients with an obstructing stone underwent surgical management with retrograde endoscopic approach. Metabolic 24-h-urine analysis was completed in 24 (89%) patients. 17 (62%) had an elevated urine density, 15 (55%) demonstrated calcium oxalate supersaturation, 12 (44%) met criteria for acidosis, and 7 (26%) had significant hypocitraturia. NVNA patients represent a unique cohort whose clinical presentation is atypical. Limited ability to express symptoms makes early detection difficult to recognize. Twenty two percent of patients present with sepsis as their first manifestation of an acutely obstructing kidney stone. Pain is subjectively interpreted by caregivers and is an uncommon symptom. Our cohort demonstrates common risk factors for stones including propensity for chronic dehydration, slow urinary tract transit, ineffective bladder emptying, G-tube feeding, and lithogenic medications. NVNA pediatric patients have atypical kidney stone clinical presentation. Awareness of this unique group of patients should support future collaborative studies to focus on understanding these atypical presentations and reflect on improving management.

A kaleidoscope of well-being to authentically represent the voices of children and young people with complex cerebral palsy: a case study series

Purpose This paper authentically represents the voices of non-verbal children with cerebral palsy using a case study design. Policy suggests that children should have the right to play and leisure opportunities, however non-verbal children with cerebral palsy have fewer choices. Additionally, children with communication, learning and mobility limitations are usually excluded from research. The aim of this research was to capture the voices of non-verbal children by exploring their well-being impact in terms of their experiences and choices about their level of participation in recreational activities. Methods A qualitative case series study included interviews, observations, photographs and diaries. Where possible, the diaries were completed by both caregivers and children. Data were analysed thematically, and the lens of positioning theory applied. Results Seven children aged nine to sixteen years participated. The findings showed how equipment, people and environments enabled or hindered the children’s participation. The children also advocated as champions for their own well-being. Positioning theory was applied across the data and was adapted offering a way to better understand the children’s well-being responses. Conclusion The findings demonstrate how these children were able to self-advocate, demonstrating their well-being by their intentional behaviours from their level of participation in a recreational activity.

Recognizing a Peritonsillar Abscess in Pediatric Patients.

A peritonsillar abscess (PTA) is a localized collection of pus in the peritonsillar space, between the palatine tonsillar capsule and the superior pharyngeal constrictor muscle (G. Gupta & R. McDowell, 2022). It is the most commonly occurring abscess in the head and neck region. Patient presentation usually includes odynophagia, unilateral otalgia, trismus, and voice changes. Managing a pediatric patient may be challenging, as children may not be able to describe their history of illness and symptoms. The management of a PTA can also differ between pediatric and adult patients (S. Ahmed Ali et al., 2018). It is important for practitioners to consider all aspects when providing treatment. This article describes the encounter and individualized treatment plan of an 11-year-old nonverbal autistic child who presented with fever, decreased oral intake, and left neck swelling. It also provides a general overview of PTAs and procedural steps to perform drainage through needle aspiration and incision and drainage.

Reduction in Behavior Problems with Increase in Communication Skills Through Augmentative and Alternative Communication among Special Needs Children

Cerebral Palsy is one of the most prevalent physical handicaps in children. Sensory-motor problems such as communication and cognitive impairment are major symptoms of cerebral palsy. In Pakistan, lack of interventions for cerebral palsy children exists due to low health budget. Consequently, CP children are facing difficulty in having the treatment. The present study aims to implement an augmentative and alternative communication (AAC) approach among nonverbal children with cerebral palsy living in Pakistan. Past research evidence has revealed the co-morbidity of communication problems with behavioral issues among cerebral palsy children. Keeping in view, the present study also aims to examine the behavioral issues of nonverbal children with cerebral palsy. For the said purpose, a pilot study employed the interventional research design (pre and post assessment) which was conducted in Pakistan. 10 nonverbal cerebral palsy children were selected from three different special needs centers by using non-probability sampling technique. Repeated measures, pre and post assessment t-test analysis was conducted to assess the impact of augmentative and alternative communication (AAC) intervention on the communication skills and behavioral problems of the participants. The results showed that AAC intervention has significantly improved the communication skills (t = -11.09, P < .001) and reduced the behavioral problems (t = 2.55, P <.005) of the participants which were nonverbal children with cerebral palsy. Thematic analysis on the open-ended questions from Pragmatic profile reported that participants have started to enjoy indoor and outdoor activities. After the intervention, significant improvement in communication has been observed in participants when they present needs/desire. Thus, this study recommends that implementation of AAC on cerebral palsy population would be effective in improving communication skills and reducing their behavioral problems.

The Influence of Vestibular Input on the Responses of Children with Autism Spectrum Disorder Using Picture Exchange Communication to Request

ABSTRACT Vestibular input (VI) activities are linked with skill learning, engagement, and communication. This study investigated the influence of VI activities on the responses of non-verbal children with autism spectrum disorders (CWASD) when prompted to request a reinforcer using picture exchange communication. A single subject alternating treatment design was implemented. Three participants were selected from a classroom supporting non-verbal CWASD. Baseline data points were collected over a 1-week period followed by treatment phase where three data points were collected over a 4-week period. Participants engaged in VI activities or a control activity prior to a picture exchange communication activity. Data were documented by a professional panel. Data analysis included visual and statistical analyses. Participants’ responses increased significantly after receiving VI. An immediate effect was identified. This finding holds value for educators and therapists aiming to increase the consistency and pace of responding and skill learning in CWASD. Participants responded differently to the two treatments. The findings hold value for therapists and educators to support responsiveness and skill learning to aid communication in CWASD. Interdisciplinary collaboration between occupational therapists and speech-language pathologists is highlighted.

Estudo comparativo da aplicação por telefone e presencial da entrevista de triagem por telefone de sintomas do espectro autista (PSI-TEA)

ABSTRACT Objective: Describe reliabilities evidence of the Phone Screening Interview (PSI), a telephone screening interview for autism spectrum disorder (ASD) symptoms, capable of investigating mild to moderate ASD symptoms. Moreover, the PSI also works for verbal and non-verbal children and is consistent with the DSM-5 diagnostic criteria. Methods: An interview was performed with sixty-eight parents of children between 2 and 15 years old attended by the Psychiatry Ambulatory of Santa Casa de Misericórdia do Rio de Janeiro through the PSI in person and by telephone. Results: No significant differences in comparison between averages of the total score of the face-to-face and telephone applications were observed. The agreement analysis between the items indicated three items with lower values, leading to the modification of some questions, culminating in a new interview version for further studies. Given the disagreement in the values found, the order of application of the interviews seems to not impact the results, demonstrating strong correlations between both interviews, even with a different order of application. Aiming to facilitate the use of the scale by different examiners, the interobserver reliability was investigated, which did not show significant differences in the means. Conclusion: The study suggests that the telephone interview can be used similarly to the face-to-face interview, by different evaluators, with no impact on its efficiency in detecting ASD symptoms.