Avaliação de funcionalidade e qualidade de vida em crianças e adolescentes com transtorno do espectro autista.

Abstract

Autism Spectrum Disorder is a neurodevelopmental condition characterized by repetitive and stereotyped behavior, restricted interests, and impairment in social communication. The disorder manifests its symptoms in childhood and encompasses different levels of severity. It is a polymorphic condition, and psychiatric and neurological comorbidities are common. The multiple etiologies and pathogenesis of the disorder are not fully understood. It is known that genetic factors and gestational injuries are involved in the development of abnormal neural connectivity. The presence of symptoms in various areas of behavior unequivocally defines functional impairments. This study aimed to investigate the aspects of functionality in determining the quality of life of children and adolescents with Autism Spectrum Disorder. For this purpose, a scoping review was conducted to define the instruments capable of measuring the quality of life of the study population. Subsequently, an observational study with an analytical cross-sectional design was conducted, with a sample consisting of 52 individuals. The following instruments were used: Childhood Autism Rating Scale, Brazil's Economic Classification Criterion, Pediatric Quality of Life InventoryTM, and International Classification of Functioning. Descriptive analysis was performed through the frequency distribution of categorical variables. Continuous variables were described using numerical summaries, and distributions were evaluated

using the Kolmogorov-Smirnov test. Means or medians were compared using the t- test or Mann-Whitney test. Pearson's chi-square test and Fisher's exact test were used

to assess the association between response and explanatory variables. For multivariate analysis, three multiple logistic regression models were constructed, using backward variable selection. The final model included variables significant at the 5% level and those that contributed to the best fit of the models, as evaluated by the Hosmer-Lemeshow test. The Odds Ratio and its respective confidence interval were used as measures of association magnitude. As a result of the review, no specific and widely disseminated instruments were identified to assess quality of life in Autism Spectrum Disorder. The most cited instrument was the PedsQLTM 4.0, used in 67.57% of the studies. As a result of the empirical investigation, it was found that the majority of patients were male, with a mean age of 110.93 months. Statistical differences were found in the mean age for the psychosocial domain, with a higher mean age among those with low quality of life in this domain. Participants with mild and moderate autism

had 4.41 times (OR=4.41; CI: 1.32-14.75) higher odds of having high quality of life in the physical domain compared to those with severe autism. In the final model, each month younger in participant age correlated with 1% (OR=0.99; CI: 0.97-0.99) higher odds of having high quality of life in the psychosocial domain. It can be concluded that having mild and moderate autism, as well as being younger, were associated with better quality of life.