Explorando o papel do comportamento motor no diagnóstico precoce do transtorno do espectro do autismo em crianças com até 12 meses: revisão integrativa

Abstract

O Autism Spectrum Disorder (ASD) presents, within its complexity, a lack of specific biomarkers, thus posing challenges in diagnosis, primarily defined through clinical observation. Existing assessment tools are limited, generally proving useful only after the first year of life, thereby constraining early intervention efforts and the potential benefits within the developmental window. The objective of this study was to identify research utilizing motor behavior for early diagnosis of ASD in children up to 12 months old. This encompassed an integrative literature review, without language or date restrictions, utilizing PubMed and Lilacs databases, guided by the question: "What motor assessment instruments are being used for early autism diagnosis?" Discrepancies were discussed, and selected articles were categorized into two groups: assessment of movement complexity and evaluation of motor developmental milestones. Observational and/or experimental studies assessing autism risk in infants, with samples comprising infants up to twelve months of both sexes, were included, while literature reviews, incomplete studies, articles unavailable for full reading, and those lacking outcome variables were excluded. This process yielded 541 articles, with 485 excluded for not addressing ASD or focusing on populations above 12 months. Of the 56 articles read in their entirety, 52 were excluded for not addressing motor behavior, leaving four for final analysis: one case-control, one retrospective, and two longitudinal studies. These studies originated from North America (United States), Eastern Europe (Georgia), and Asia (Japan), published between 2008 and 2021. Two studies emphasized motor movement complexity—one using General Movements (GM) and another employing wearable sensors—while the other two investigated motor developmental milestones such as head control when pulling to sit and primitive reflexes. Across all analyzed articles, motor behavior was notably poorer in newborns with ASD.