Revisão sistemática e avaliação metodológica de intervenções analítico-comportamentais para o enfraquecimento de estereotipia em indivíduos com autismo, publicadas nos últimos 15 anos

Abstract

The occurrence of stereotypy is one of the criteria for Autism Spectrum Disorder diagnosis. The stereotypy is frequent and intense in autistic individuals and may cause academic and social damage. Various areas of knowledge, including behavior analysis, have tried to develop strategies to weaken stereotypy of autistic individuals. This study aimed to develop a systematic review and methodological evaluation of studies that used analytical-behavioral interventions for weakening motor and vocal stereotypy in autistic individuals published between 1999 and 2013. The studies from this period were selected by PubMed, Medline, PsycINFO and Lilacs bibliographic indexes. It were analyzed 36 articles. The results indicated that 106 authors developed procedures applied with 73 participants between 03 and 49 years old. The use of single subject design was unanimous in the different studies analyzed. Studies evaluating the agreement between observers had high levels of concordance. The procedures most used to weaken stereotypy were environmental enrichment matched stimulation and procedure of interruption and redirection of response (RIRD), however, several procedures were used, for example, procedures of self-management, self-recording, the response blocking, response cost, overcorrection, visual cues, differential reinforcement, verbal reprimands, replacement of edible consequences, functional communication training, verbal operant training, and others. Although results varied between participants, it was shown that weakening the stereotypy is possible by most of the procedures used in the studies reviewed. The 28 studies that evaluated the function of stereotypy and the 03 studies that did not made the functional analysis assessment considered that stereotypy was automatically reinforced. The authors of 03 studies considered that stereotypy was maintained by socially mediated consequences, beyond the sensory consequences. This review pointed methodological weaknesses in the reviewed studies: lack of stability of the measurements made, and lack of generalization and follow-up tests