Externalization of problems as a component of narrative therapy has been well defined by such authors as Epston and White, and Freedman and Combs. This study reflects the voices and experiences of 17 participants who engaged in an innovative externalization exercise combining sculpture and journaling over a period of 4 weeks. In an attempt to better understand the experience of the participants, the principal investigator also engaged in the exercise. Findings indicated that the intervention helped participants express emotions, increased their awareness of personal resources and agency, helped separate problems from self decreased symptoms and problem behaviors, and fostered a sense of empowerment. This study reveals the potential usefulness of physically externalizing problems and interacting with them deliberately over time. Such interventions may be useful components of narrative therapy or augmentations to brief therapy. They may help reach populations who have limited access to therapy services or who are reluctant to present for therapy.
RESUMENFundamentos: La importancia de la detección temprana del autismo mejora el pronóstico de niños con alteraciones en el desarrollo, en especial con trastornos del espectro autista (TEA). El objetivo de este trabajo es delimitar a qué edad surgen las primeras sospechas de un trastorno del espectro autista, a qué profesionales recurren las familias, la demora en confirmar el diagnóstico y la celeridad en la respuesta de los profesionales de la pediatría. Método:Estudio transversal retrospectivo llevado a cabo en la Comunidad Autónoma de Canarias durante el año 2010. Se solicitó la colaboración voluntaria de las asociaciones y familias que recibían tratamiento en centros especializados. Se recogieron 72 cuestionarios para familias de personas con autismo. Se realizó un análisis descriptivo de frecuencias mediante el programa estadístico SPSS Statistics 19.Resultados: En el 79% de los casos fue la propia familia quien tuvo las primeras sospechas de que algo no iba bien en el desarrollo de los niños, seguida de los profesionales de la educación (15%) y la sanidad (pediatras: 4% y psicólogos: 2%). El 69% recibieron el primer diagnós-tico durante los 3 primeros años, el 32% antes de los dos años. La demora diagnóstica se situó en 16 meses.Conclusiones: La mayoría de los padres de niños con TEA son conscientes de alteraciones en el desarrollo de sus hijos alrededor de los 18 meses. Se confirmó la tendencia a disminuir el tiempo de respuesta de los profesionales de la sanidad. Background: The importance of early detection in order to improve the prognosis of children with developmental disorders, especially autism spectrum disorders (ASD), has been widely proven, clearly followed by the corresponding intervention. The aim of this work is to define the age at which the first signs of an autism spectrum disorder show up, the professionals that families go to, as well as delays confirming a diagnosis and the celerity offered by paediatricians.Method: A transversal, retrospective study carried out in 2010 in the Canary Islands. The voluntary cooperation of family associations, and families that received treatment in specialized centres was requested. 72 "Questionnaires for families of people with autism" were gathered. A descriptive analysis of frequencies was carried out, using the statistics programme SPSS Statistics 19.Results: In 79% of the cases it was the family who first suspected there was something wrong with the children's development, followed by teachers (15%) and health care staff (pediatricians 4% and psychologists, 2%). 69% of the children were first diagnosed before turning 3 years of age, 32% of them were diagnosed even before turning two years of age. The delay regarding diagnosis in the Canary Islands circa 16 months. Conclusions:Most parents of children with ASD were aware of the developmental disorders that their children were experiencing at around 18 months of age. A tendency to a faster response time by health care professionals was confirmed.
Currently, it is our belief that autism is a neurodevelopmental disorder caused by a prenatal dysfunction of the Central Nervous System characterized by a series of observable symptoms the first three years of life. Psychologically speaking, the international community is in agreement regarding the fact that autism is understood as a disorder of intersubjectivity and social cognition. The speech and executive functions are affected. In addition, attentional difficulties (sustained and selective attention) are present, as well as learning and sensorial integration difficulties.The definition has been subject to conceptual changes and it is a difficult task to reach a consensus when it comes to agreeing upon a definition which includes the wide range of manifestations of autism. However, it is even more difficult to perform a diagnosis, as often ASDs overlap with other pathologies. For instance, with attentional deficit disorders, with or without hyperactivity (ADHD), with language disorders, obsessive-compulsive disorders (OCD), intellectual disabilities (ID) and different personality disorders, among others. An added problem is how symptom manifestation changes throughout life. It is essential to adopt an evolutionary perspective throughout the whole diagnosis process and take into account environmental factors (diverse treatment, family involvement…).As there is a lack of biological indicators which clearly indicate what autism really is, nowadays the diagnosis is clinical although interdisciplinary collaboration plays a significant role (neurologists, psychiatrists, psychologists, speech therapists and educators, among others) to successfully reach a diagnosis.On the one hand, we need to avail of efficient classification systems scientifically recognised, and on the other hand, specific assessment tools for people with ASD, standardised and scientifically validated and with specific procedures to apply them avoiding any differences based on the examiner.Keywords: Autism. Autism Spectrum Disorders. Pervasive Developmental Disorders. DSM-5. Diagnosis. NUEVAS FORMAS DE ABORDAJE DEL PROCESO DIAGNÓSTICO DEL TEA DESPUÉS DEL DSM-5 NEW WAYS TO APPROACH THE DIAGNOSIS PROCESS OF ASDS BASED ON DSM-5María del Sol Fortea Sevilla.Doctora y Profesora Asociada Laboral. María Olga Escandell Bermúdez. Doctora y profesora Titular de Universidad.José Juan Castro Sánchez. Doctor y profesor Titular de Universidad. RESUMEN Actualmente, estamos en condiciones de asegurar, que el autismo es un trastorno del neurodesarrollo causado por una disfunción prenatal del Sistema Nervioso Central que se caracteriza por una serie de síntomas observables en los tres primeros años de la vida. En el plano psicológico, la comunidad internacional está de acuerdo en que el autismo se entiende como un trastorno de la intersubjetividad y de la cognición social. Están afectados el lenguaje y las funciones ejecutivas. Además presentan dificultades atencionales (atención sostenida y selectiva), de aprendizaje y de integración sensorial.Si la defini...
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