Associação entre Competência Narrativa, Teoria da Mente e Funções Executivas em crianças com Transtorno do Espectro Autista
Data
2024-10-24
Autores
Nascimbeni, Renata Cristina Dias 
Orientadores
Perissinoto, Jacy
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
No Transtorno do Espectro do Autismo (TEA) são encontradas inabilidades heterogêneas na compreensão e na produção da narrativa, geralmente associadas à Teoria da Mente (ToM) e Funções Neuropsicológicas (FN). OBJETIVO: Investigar a influência das FN e da ToM na compreensão e na produção da narrativa oral em crianças com TEA comparadas à típicas. MÉTODOS: Participaram 35 crianças, de 7 a 10 anos e 11 meses, com diagnóstico de TEA (GTEA) comparados por idade e gênero a 35 crianças sem queixas no desenvolvimento (GT). Foram coletadas duas amostras de compreensão de narrativa oral e duas de elaboração de narrativa oral. Na atividade de compreensão, as crianças responderam a 8 perguntas após ouvirem cada texto. E na produção, elaboraram duas histórias apoiadas por sequencias de 4 e 5 imagens, analisadas a partir de crivo pré-definido. Estabeleceu-se variáveis com a proporção de elementos explícitos e implícitos para cada módulo. Para ToM, foram coletadas as Animações Frith-Happé e para FN aplicou-se Neupsilin-Inf. O vocabulário expressivo testado pelo TIN e o QI total medido pelo WISC-IV foram utilizados como covariáveis. Para as análises, descritivas e comparativas, entre GT e GTEA, das variáveis de compreensão e produção utilizou-se teste de qui-quadrado, t-student ou Mann-Whitney, e para as associações, o coeficiente de correlação de Spearman, posteriormente foram realizados modelos de regressões múltiplas com todos os participantes. RESULTADOS: Revelaram pior desempenho do GTEA em compreensão e produção da Narrativa, exceto para uma das histórias narradas. Controlando as covariáveis, QI e vocabulário expressivo, as associações entre compreensão de narrativas habilidades de ToM e FN, bem como de produção de narrativa e habilidades de ToM e FN, revelaram significâncias específicas para cada grupo, sendo mais frequentes e generalizadas no GTEA e as regressões, nem sempre positivas, confirmaram o papel determinante da ToM de mentalização para a compreensão e de percepções físicas para a produção. As FN de linguagem, controle inibitório e aritmética predisseram somente a produção da narrativa do GTEA, sendo que a última previu piores resultados. CONCLUSÕES: As hipóteses foram comprovadas quanto às características específicas da narrativa no TEA, revelando o papel preditor de ToM para compreensão de narrativa a partir de perguntas e a predição de ToM com percepções fisicas e de FN na produção de narrativa oral a partir de sequência de figuras.
In Autism Spectrum Disorder (ASD), heterogeneous disabilities in understanding and producing narratives are found, generally associated with Theory of Mind (ToM) and Neuropsychological Functions (NF). OBJECTIVE: To investigate the influence of NF and ToM in the comprehension and production of oral narrative in children with ASD compared to typical children. METHODS: Thirty-five children, aged 7 to 10 years and 11 months, diagnosed with ASD (GTEA) participated in the study, compared by age and gender to 35 children without developmental complaints (GT). Two samples of oral narrative comprehension and two samples of oral narrative elaboration were collected. In the comprehension activity, the children answered 8 questions after listening to each text. And in the production activity, they elaborated two stories supported by sequences of 4 and 5 images, analyzed from a pre-defined sieve. Variables were established with the proportion of explicit and implicit elements for each modality. The expressive vocabulary tested by the TIN and the total IQ measured by the WISC-IV were used as covariates. For ToM, the Frith-Happé Animations were collected and for FN, the Neupsilin-Inf was applied. For the descriptive and comparative analyses between GT and GTEA, of the comprehension and production variables, the chi-square, t-student or Mann-Whitney test were used, and for the associations, the Spearman correlation coefficient was used, later multiple regression models were conducted with all participants. RESULTS: They revealed worse performance of GTEA in comprehension and production of the Narrative, except for one of the narrated stories. Controlling for the covariates, IQ and expressive vocabulary, the associations between narrative comprehension and ToM and FN skills, as well as narrative production and ToM and FN skills, revealed specific patterns for each group, being more frequent and generalized in the GTEA. The regressions, not always positive, confirmed the determining role of ToM of mentalization for comprehension and of physical perceptions for production. The FN of language, inhibitory control and arithmetic predicted only the production of the GTEA narrative, with the latter predicting worse results. CONCLUSIONS: The hypotheses were confirmed regarding the specific characteristics of narrative in ASD, revealing the predictive role of ToM for narrative comprehension from questions and the prediction of ToM with physical perceptions and NF in the production of oral narrative from a sequence of figures.
In Autism Spectrum Disorder (ASD), heterogeneous disabilities in understanding and producing narratives are found, generally associated with Theory of Mind (ToM) and Neuropsychological Functions (NF). OBJECTIVE: To investigate the influence of NF and ToM in the comprehension and production of oral narrative in children with ASD compared to typical children. METHODS: Thirty-five children, aged 7 to 10 years and 11 months, diagnosed with ASD (GTEA) participated in the study, compared by age and gender to 35 children without developmental complaints (GT). Two samples of oral narrative comprehension and two samples of oral narrative elaboration were collected. In the comprehension activity, the children answered 8 questions after listening to each text. And in the production activity, they elaborated two stories supported by sequences of 4 and 5 images, analyzed from a pre-defined sieve. Variables were established with the proportion of explicit and implicit elements for each modality. The expressive vocabulary tested by the TIN and the total IQ measured by the WISC-IV were used as covariates. For ToM, the Frith-Happé Animations were collected and for FN, the Neupsilin-Inf was applied. For the descriptive and comparative analyses between GT and GTEA, of the comprehension and production variables, the chi-square, t-student or Mann-Whitney test were used, and for the associations, the Spearman correlation coefficient was used, later multiple regression models were conducted with all participants. RESULTS: They revealed worse performance of GTEA in comprehension and production of the Narrative, except for one of the narrated stories. Controlling for the covariates, IQ and expressive vocabulary, the associations between narrative comprehension and ToM and FN skills, as well as narrative production and ToM and FN skills, revealed specific patterns for each group, being more frequent and generalized in the GTEA. The regressions, not always positive, confirmed the determining role of ToM of mentalization for comprehension and of physical perceptions for production. The FN of language, inhibitory control and arithmetic predicted only the production of the GTEA narrative, with the latter predicting worse results. CONCLUSIONS: The hypotheses were confirmed regarding the specific characteristics of narrative in ASD, revealing the predictive role of ToM for narrative comprehension from questions and the prediction of ToM with physical perceptions and NF in the production of oral narrative from a sequence of figures.
Descrição
Citação
NASCIMBENI, Renata Cristina Dias. Associação entre Competência Narrativa, Teoria da Mente e Funções Executivas em crianças com Transtorno do Espectro Autista. 2024. 225 f. Tese (Doutorado em Fonoaudiologia) - Escola Paulista de Medicina, Universidade Federal de São Paulo (UNIFESP), São Paulo, 2024.