Resumen: Este estudio buscó evaluar los aportes de un entrenamiento parental híbrido realizado con ocho madres de niños preescolares con trastorno del espectro autista basado en la ciencia del análisis aplicado de la conducta para la reducción del estrés parental. Se llevó a cabo la construcción e implementación de un entrenamiento parental híbrido. Se dividió la muestra en grupo de tratamiento y control, y se realizaron comparaciones del nivel de estrés en el período pre/postintervención, así como el análisis de la práctica directa con el niño en un cara a cara con el grupo de tratamiento. Los resultados obtenidos demuestran que las madres del grupo de tratamiento reaccionaron positivamente a los videos y materiales presentados; sin embargo, no se observaron diferencias estadísticas significativas que sugieran una reducción en el nivel de estrés entre los dos grupos. Las limitaciones del estudio fueron el pequeño tamaño de la muestra y el hecho de que los niños de ambos grupos continuaron recibiendo tratamiento de terapia intensiva durante la implementación de la capacitación de los padres.

Resumo: Este estudo buscou avaliar as contribuições de um treinamento parental híbrido realizado com oito mães de crianças pré-escolares com transtorno do espectro do autismo baseado na ciência da análise do comportamento aplicada para a redução do estresse parental. Foi realizado a construção e implementação do treinamento parental híbrido. A amostra foi dividida em grupo tratamento e controle. Em termos de análise de dados, foram feitas comparações do nível de estresse no período pré/pós-intervenção, assim como a análise de uma prática direta com a criança de forma presencial com o grupo tratamento. Os resultados obtidos demonstraram que as mães do grupo tratamento reagiram positivamente com as vídeos e materiais apresentados. No entanto, não foi observado diferenças estatísticas significativas para sugerir a redução do nível de estresse entre os dois grupos. As limitações do estudo foram o tamanho reduzido da amostra e o fato das crianças de ambos os grupos continuarem recebendo o tratamento em terapia intensiva durante a aplicação do treinamento parental.

Abstract: This study sought to evaluate the contributions of a hybrid parental training carried out with eight mothers of preschool children with autism spectrum disorder, based on the science of applied behavioral analysis for reducing parental stress. The hybrid parental training was constructed and implemented by the researchers. The sample was divided into two groups: a Treatment Group and a Control Group. In the data analysis, comparisons were made of the levels of stress pre- and post-intervention and for the treatment group, direct practice with the child in a face-to-face environment was also analyzed. The results showed that the mothers in the treatment group reacted positively to the video and materials presented; however, no significant statistical differences were found that would suggest a reduction in stress levels between the two groups as a result of the training given. The limitations of the study were its small sample size and the fact that the children in both groups continued to receive intensive therapy treatment during the application of the parental training.

Abstract Introduction: Friendship positively influences human development. However, people with disabilities face difficulties in building and maintaining this bond. This study aims to explore and analyze the knowledge networks in the literature on friendship and disabilities from 2017 to 2022. Method: Using PRISMA criteria, the search was conducted in the Scopus and Web of Science databases. VOSviewer and Pajek software were used to construct and analyze the networks. Results: Sixty-eight articles were analyzed. The United States leads in publications, but the United Kingdom is more influential in the network. The main research areas are autism spectrum disorder, intellectual disability, social inclusion, social skills, and violence against people with disabilities. Influential documents address thematic analysis in psychology, and friendship among individuals with autism spectrum disorder and intellectual disability. Conclusions: Knowledge maps and network analysis help explore the literature, allowing an understanding of trends, the foundational intellectual structure, and scientific correlations.

Resumo Introdução: A amizade influencia positivamente o desenvolvimento humano. Todavia, pessoas com deficiencia enfrentam dificuldades para construir e manter esse vínculo. Este estudo objetiva explorar e analisar as redes de conhecimento da literatura sobre amizade e deficiencia de 2017 a 2022. Método: Utilizando critérios Prisma, a busca foi realizada nas bases de dados Scopus e Web of Science. Os softwares VOSviewer e Pajek foram usados para construir e analisar as redes. Resultados: Foram analisados 68 artigos. Os Estados Unidos lideram em publicaçoes, entretanto o Reino Unido é mais influente na rede. As principais investigaçoes na área sao: transtorno do espectro autista, deficiencia intelectual, inclusao social, habilidades sociais e violencia contra a pessoa com deficiencia. Documentos influentes abordam análise temática em psicologia, amizade de pessoas com transtorno do espectro autista e deficiencia intelectual. Conclusões: Os mapas de conhecimento e análise de redes ajudam a explorar a literatura, o que permite compreender tendencias, estrutura intelectual base e correlações científicas.

Abstract Objective This study aimed to investigate the prevalence of autism spectrum disorder and its possible correlations with clinical characteristics in patients with infantile epileptic spasms syndrome in a single center in Brazil. Methods This retrospective cross-sectional study examined 53 children with the diagnosis of infantile epileptic spasms syndrome prior to an autism spectrum disorder assessment. Participants were divided into two groups based on the presence or absence of autism spectrum disorder. Available variables (sex, medications, median age at onset of infantile epileptic spasms syndrome, and presence of comorbidities) were compared using Mann-Whitney U or chi-square tests. Results Among the included patients, 12 (23 %) were diagnosed with autism spectrum disorder, corresponding to a relative risk of 0.29 (95 % confidence interval 0.174-0.492). The age at the first seizure ranged from 3 to 15 months, with a mean of 6.65 months. This age significantly differed between participants with autism spectrum disorder (10.58 months) and those without (5.43 months), p<0.001. Conclusion Children with infantile epileptic spasms syndrome have a higher risk of being diagnosed with autism spectrum disorder. Later age of onset and period of spasm occurrence might be predisposing risk factors. Brazil crosssectional cross sectional 5 assessment sex, sex (sex medications comorbidities MannWhitney Mann Whitney chisquare chi square tests 1 23 (2 029 0 29 0.2 95 (9 0.1740.492. 01740492 0.174 0.492 . 174 492 0.174-0.492) months 665 6 65 6.6 10.58 1058 10 58 (10.5 5.43 543 43 (5.4 , p0001 p 001 p<0.001 factors 2 ( 02 0. 9 1740 0.1740.492 0174049 0174 0.17 0492 0.49 17 49 0.174-0.492 66 6. 10.5 105 (10. 5.4 54 4 (5. p000 00 p<0.00 0.1740.49 017404 017 0.1 049 0.4 0.174-0.49 10. (10 5. (5 p00 p<0.0 0.1740.4 01740 01 04 0.174-0.4 (1 p0 p<0. 0.1740. 0.174-0. p<0 0.1740 0.174-0 p< 0.174-

My enrolment at university was a significant milestone in my life. During my first three days as a student with autism spectrum disorder, I experienced both positive and negative situations at different campuses, including overcrowded lecture halls, residences, faculty houses, and interacting with other students. My literature review and theoretical interpretation are guided by historical institutionalism and Bakhtin's concept of "outsideness". These frameworks address how historical events shape the social, political, and economic behaviour of institutions in a system that treats new students who must adapt to the university's rules, regulations, and traditions as outsiders. The frameworks mentioned above were used to understand what I experienced during my first three days at university, which set the tone for the rest of my undergraduate education, punctuated by ableness, whiteness, masculinity, and fluctuating forms of support.

Resumo O complexo da esclerose tuberosa (CET) é uma doença autossômica dominante caracterizada pelo desenvolvimento de hamartomas no sistema nervoso central, coração, pele, pulmões e rins e outras manifestações, incluindo convulsões, tubérculos corticais, linhas de migração radial, autismo e deficiência cognitiva. A doença está associada a variantes patogênicas nos genes TSC1 ou TSC2, resultando na hiperativação da via mTOR, um importante regulador do crescimento e metabolismo celular. Consequentemente, a hiperativação da via mTOR leva à proliferação anormal do tecido e ao desenvolvimento de tumores sólidos. O envolvimento renal no CET é caracterizado pelo desenvolvimento de lesões císticas, carcinoma de células renais e angiomiolipomas renais, que podem progredir e causar dor, sangramento e perda da função renal. Nos últimos anos, houve uma mudança notável na abordagem terapêutica do CET, especialmente no tratamento das manifestações renais. Os inibidores de mTOR surgiram como a principal opção terapêutica, enquanto intervenções cirúrgicas como nefrectomia e embolização são reservadas principalmente para complicações que não respondem ao tratamento clínico, como hemorragia renal grave. Esta revisão se concentra nas principais características clínicas do CET, nos mecanismos subjacentes ao envolvimento renal, nos recentes avanços na terapia para lesões renais e nas perspectivas futuras. (CET central coração pele convulsões corticais radial cognitiva TSC TSC2 celular Consequentemente sólidos císticas dor anos clínico grave futuras

Abstract Tuberous sclerosis complex (TSC) is an autosomal dominant disease characterized by the development of hamartomas in the central nervous system, heart, skin, lungs, and kidneys and other manifestations including seizures, cortical tubers, radial migration lines, autism and cognitive disability. The disease is associated with pathogenic variants in the TSC1 or TSC2 genes, resulting in the hyperactivation of the mTOR pathway, a key regulator of cell growth and metabolism. Consequently, the hyperactivation of the mTOR pathway leads to abnormal tissue proliferation and the development of solid tumors. Kidney involvement in TSC is characterized by the development of cystic lesions, renal cell carcinoma and renal angiomyolipomas, which may progress and cause pain, bleeding, and loss of kidney function. Over the past years, there has been a notable shift in the therapeutic approach to TSC, particularly in addressing renal manifestations. mTOR inhibitors have emerged as the primary therapeutic option, whereas surgical interventions like nephrectomy and embolization being reserved primarily for complications unresponsive to clinical treatment, such as severe renal hemorrhage. This review focuses on the main clinical characteristics of TSC, the mechanisms underlying kidney involvement, the recent advances in therapy for kidney lesions, and the future perspectives. (TSC system heart skin lungs seizures tubers lines disability genes metabolism Consequently tumors lesions angiomyolipomas pain bleeding function years option treatment hemorrhage perspectives

RESUMEN El desarrollo que alcance un infante con repercusión en el resto de su vida adulta, será resultado tanto, de la interacción de sus características biológicas y psicológicas, como de las experiencias que le ofrezca su medio social. De ahí que se afirme el carácter biopsicosocial de los seres humanos y que se valore la socialización desde las primeras edades, por lo positivo y estimulante en su desarrollo. Sin embargo, en ocasiones, esa interacción es limitada por disímiles factores, que pueden partir desde el propio individuo, poseedor de determinadas características que condicionan su interacción con el medio y la particularizan; de la familia como ente propiciador o represor de la misma; de la propia sociedad o comunidad que la favorezca, promueva o estimule. Tal es el caso de los niños con necesidades educativas especiales, neurodivergentes y en situación de discapacidad. En coherencia, se diseñó un proyecto comunitario contentivo de acciones que contribuyen a la socialización y la estimulación del desarrollo de niños neurodivergentes, con énfasis en aquellos diagnosticados con trastorno del espectro autista (TEA). Prevalecen en el estudio los métodos: revisión bibliográfica, análisis-síntesis, entrevistas y observación. Los resultados proyectan la satisfacción de necesidades educativas básicas para la inclusión socioeducativa.

ABSTRACT The development that an infant achieves with repercussions on the rest of his or her adult life will be the result of both the interaction of her biological and psychological characteristics and the experiences that her social environment offers her. Hence, the biopsychosocial character of human beings is affirmed and socialization is valued from the earliest ages, due to its positive and stimulating development. However, sometimes, this interaction is limited by dissimilar factors, which can come from the individual himself, who possesses certain characteristics that condition his interaction with the environment and make it particular; of the family as an entity that promotes or represses it; of the society or community itself that favors, promotes or stimulates it. This is the case of children with special educational needs, neurodivergents and those with disabilities. In coherence, a community project was designed containing actions that contribute to the socialization and stimulation of the development of neurodivergent children, with emphasis on those diagnosed with autism spectrum disorder (ASD). The methods prevail in the study: bibliographic review, analysis- synthesis, interviews and observation. The results project the satisfaction of basic educational needs for socio-educational inclusion.

ABSTRACT This article responds to the need to design specific innovative strategies for students with Autism Spectrum Disorders, as well as implement effective interventions aimed at developing logical mathematical reasoning, so important for their development in daily life. Taking this into account, the general objective was to propose a didactic strategy for the development of logical mathematical reasoning in a student with Autism Spectrum Disorders. The research is descriptive, methodological and field where theoretical and empirical methods are combined. The proposed teaching strategy is characterized by its inclusive and contextualized nature by taking into account the particularities of the environment where the student operates and their individual potential, which facilitated the learning process, as well as greater interest and motivation. The analysis of the results after the application in practice was carried out through a case study where it was possible to verify the strengthening of logical mathematical thinking in the student from greater motivation, being able to relate and identify clearly and quickly the numbers from one to ten, using their symbolic representations, as well as improving their behavior among other advances.

RESUMEN El presente artículo responde a la necesidad de diseñar estrategias innovadoras específicas para los estudiantes con Trastornos del Espectro Autista, así como ejecutar intervenciones efectivas dirigidas a desarrollar el razonamiento lógico matemático, tan importante para su desenvolvimiento en la vida diaria. Teniendo en cuenta ello el objetivo general fue proponer una estrategia didáctica para el desarrollo del razonamiento lógico matemático en un estudiante con Trastornos de Espectro Autista. La investigación fue de tipo descriptiva, metodológica y de campo donde se combinaron métodos teóricos y empíricos. La estrategia didáctica propuesta se caracteriza por su carácter inclusivo y contextualizado al tener en cuenta las particularidades del entorno donde se desenvuelve el estudiante y sus potencialidades individuales, lo cual facilitó el proceso de aprendizaje, así como un mayor interés y motivación. El análisis de los resultados luego de la aplicación en la práctica se realizó mediante un estudio de caso donde se pudo constatar el fortalecimiento del pensamiento lógico matemático en el estudiante a partir de una mayor estimulación siendo capaz de relacionar e identificar con claridad y precisión los números del uno al diez, utilizando sus representaciones simbólicas, así como mejorar su comportamiento, comunicación y tiempo de concentración en la actividad, entre otros avances.

ABSTRACT Physical Education has proven to be an effective tool to develop physical and mental conditions in human beings. However, even the proposals in favor of making inclusive education a reality for students with autism spectrum disorder do not achieve the globally expected levels. That is why, the objective of this work is to design a system of inclusive games for the development of motor coordination in students with autism spectrum disorder, in the Physical Education class. To achieve this purpose, the survey, the pedagogical test and observation were used as fundamental methods at the empirical level. The results of the diagnosis point to poor knowledge on the part of Physical Education teachers about the treatment of students with this disorder, so it is proceed to the task of developing a system of games for the development of motor coordination that gradually incorporated them into socialization in the group, and a pertinent evaluative system where superior results could be seen quantitatively and qualitatively.

RESUMO A Educação Física tem se mostrado uma ferramenta eficaz para desenvolver as condições físicas e mentais do ser humano. No entanto, mesmo as propostas a favor de tornar a educação inclusiva uma realidade para alunos com perturbação do espectro do autismo não atingem os níveis globalmente esperados. Por isso o objetivo deste trabalho é desenhar um sistema de jogos inclusivos para o desenvolvimento da coordenação motora em alunos com transtorno do espectro do autismo, na aula de Educação Física. Para atingir este propósito, o inquérito, o teste pedagógico e a observação foram utilizados como métodos fundamentais a nível empírico. Os resultados do diagnóstico apontam para pouco conhecimento por parte dos professores de Educação Física sobre o tratamento dos alunos com esse transtorno, por isso passam à tarefa de desenvolver um sistema de jogos para o desenvolvimento da coordenação motora que os incorpore gradativamente à socialização em o grupo, e um sistema avaliativo pertinente onde resultados superiores pudessem ser vistos quantitativa e qualitativamente.

RESUMEN La Educación Física ha demostrado ser una herramienta eficaz para desarrollar condiciones físicas y mentales en el ser humano. Sin embargo, aún las propuestas a favor de hacer realidad la educación inclusiva en estudiantes con trastorno del espectro autista no logra los niveles mundialmente esperados. Es por ello que en esta obra se plantea como objetivo diseñar un sistema de juegos inclusivos para el desarrollo de la coordinación motriz en estudiantes con trastorno del espectro autista, en la clase de Educación Física. Para lograr este propósito se emplearon como métodos fundamentales del nivel empírico la encuesta, la prueba pedagógica y la observación. Los resultados del diagnóstico apuntan a un deficiente conocimiento por parte de los docentes de Educación Física sobre el tratamiento de los estudiantes con este trastorno, por lo que se procede a la tarea de elaborar un sistema de juegos para el desarrollo de la coordinación motriz que gradualmente los incorpore a la socialización en el grupo, y un sistema evaluativo pertinente donde se pudieron apreciar resultados superiores cuantitativa y cualitativamente.

Abstract We compared anaphora processing and the ability to integrate spatial information into a situation model during reading among college students with autism spectrum disorder (ASD) (N=20) and typically developing (TD) students (N=22). We designed 24 narrative texts divided into two conditions: (1) anaphoric referent spatially associated with the main character and (2) anaphoric referent spatially dissociated. We analyzed different measures of eye movement during reading using eye-tracking technology. Mixed model analysis revealed significant differences in the group effect, the condition effect, and the interaction between the group and condition for various measures and areas of interest in the text. The results showed a facilitating effect in the anaphoric processing of the associated condition, specifically for the group with TD. However, this effect was not seen in people with ASD. Finally, we discuss the results regarding the higher prevalence of perceptual organization problems and difficulties to integrate information in a situation model during reading for people with ASD.

Resumen Comparamos el procesamiento de anáforas y la capacidad de integrar información espacial en un modelo de situación durante la lectura entre estudiantes universitarios dentro del trastorno del espectro autista (TEA) (N=20) y estudiantes con desarrollo típico (DT) (N=22). Diseñamos 24 textos narrativos divididos en dos condiciones: (1) referente anafórico espacialmente asociado al personaje principal y (2) referente anafórico espacialmente disociado. Analizamos diferentes medidas de movimiento ocular durante la lectura utilizando tecnología de eye-tracking. El análisis de modelos mixtos reveló diferencias significativas en el efecto de grupo, el efecto de condición y la interacción entre el grupo y la condición de varias medidas y áreas de interés en el texto. Los resultados mostraron un efecto facilitador en el procesamiento anafórico de la condición asociada, específicamente, para el grupo con DT. Sin embargo, este efecto no se observó en personas con TEA. Por último, discutimos los resultados en torno a la mayor prevalencia de problemas de organización perceptiva y dificultades para integrar información en un modelo de situación durante la lectura para personas con TEA.

RESUMEN El proceso de socialización del niño autista es fundamental para su desarrollo como individuo. El propósito de la investigación fue analizar dentro de este proceso, la relación del capital cultural incorporado en las familias acerca de diferentes trastornos que marcan el autismo y el desarrollo social del niño. Es un estudio triangular donde se utilizaron técnicas cualitativas y cuantitativas. Los resultados indican que las diferentes dimensiones del autismo incorporadas en el capital cultural de las familias, son elementos que intervienen a través de acciones adecuadas en el desarrollo positivo de la socialización del niño autista.

ABSTRACT The socialization process of the autistic child is fundamental for his development as an individual. The purpose of the research was to analyze within this process, the relationship of the cultural capital incorporated in the families about different disorders that mark autism and the social development of the child. It is a triangular study where qualitative and quantitative techniques were used. The results indicate that the different dimensions of autism incorporated in the cultural capital of families are elements that intervene through appropriate actions in the positive development of the autistic child's socialization.

ABSTRACT: One of the groups that is currently benefiting from a more inclusive educational response in Spain is students with Autism Spectrum Disorder (ASD). This fact has allowed them to enjoy schooling in ordinary centers, like their peers and, at the same time, to receive a highly adapted educational response in which the work of specialized support has a very relevant weight. This article analyzes the role of specialized support in educational centers from an applied perspective, but without forgetting the importance of decisions regarding educational policies as facilitators of this process. The questions presented are the result of an investigation carried out through the study of multiple cases. Qualitative information collection techniques have been used, among which documentary analysis, observations and interviews stand out, and also of a quantitative nature, through the application of 2014 questionnaires constructed ad-hoc to the members of the educational community. Although the data presented is limited to the Early Childhood Education stage and initially to students with ASD, we understand that, knowing how the centers organize specialized supports from an inclusive perspective, can help other centers move forward in the unfinished process of inclusive education.

RESUMEN: Uno de los colectivos que, en la actualidad, se está beneficiando de una respuesta educativa más inclusiva en España es el alumnado con Trastorno del Espectro del Autismo (TEA). Este hecho les ha permitido disfrutar de una escolarización en centros ordinarios, al igual que sus iguales, y a la vez a recibir una respuesta educativa altamente adaptada en la que el trabajo de los apoyos especializados tiene un peso muy relevante. Este artículo analiza el papel de los apoyos especializados en los centros educativos desde una mirada aplicada, pero sin olvidar la importancia de las decisiones en materia de políticas educativas como facilitadoras de este proceso. Los resultados que se exponen son fruto de una investigación realizada a través de un estudio de casos múltiples. Se han utilizado técnicas de recogida de información cualitativa, entre las que destacan el análisis documental, observaciones y entrevistas, y también de naturaleza cuantitativa, mediante la aplicación de 2014 cuestionarios construidos ad-hoc a los miembros de la Comunidad educativa. Aunque los datos que se presentan se circunscriben a la etapa de Educación Infantil y se centran en el alumnado con TEA, entendemos que conocer cómo los centros que organizan los apoyos especializados, desde una perspectiva inclusiva, puede ayudar a otros centros a avanzar en el inconcluso proceso de la educación inclusiva.

Abstract The occurrence of seizures is frequent during the neonatal period due to the functional immaturity of the brain.The presence of these seizures may lead to a diagnosis of neonatal epilepsy, which is usually as sociated with structural alterations of the brain during neurodevelopment. Approximately 50% of people with active epilepsy have at least one comorbid medical di sorder, and the existence of a comorbid process changes the course of the epilepsy. The presence of neurologic disorders preceding the onset of epilepsy indicates that underlying neurobiological alterations may indepen dently cause the predisposition to epilepsy and comor bid processes. In this review we describe the structural and functional brain processes underlying the onset of neonatal epilepsy and its comorbidities.

Resumen La aparición de convulsiones es frecuente durante el periodo neonatal debido a las características de inma durez funcional del cerebro es este periodo. La aparición de estas convulsiones puede llevar a un diagnóstico de epilepsia neonatal, que suele estar asociado a alteracio nes estructurales del cerebro durante el neurodesarrollo. Aproximadamente el 50% de las personas con epilepsia activa padecen al menos un trastorno médico comórbi do, y esto hace que cambie la evolución de la epilepsia. La presencia de trastornos neurológicos que preceden a la aparición de la epilepsia indica que alteraciones es tructurales y/o funcionales del cerebro subyacentes pue den ser causa de la predisposición a padecer epilepsia y de los procesos comórbidos de manera independiente. En esta revisión describimos los procesos cerebrales estructurales y funcionales que subyacen a la aparición de epilepsia neonatal y sus comorbilidades.

Abstract Introduction : Autism Spectrum Disorder (ASD) is a neurodevelopmental condition which traditional as sessment procedures encounter certain limitations. The current ASD research field is exploring and endorsing innovative methods to assess the disorder early on, based on the automatic detection of biomarkers. How ever, many of these procedures lack ecological validity in their measurements. In this context, virtual reality (VR) shows promise for objectively recording biosignals while users experience ecological situations. Methods : This study outlines a novel and playful VR procedure for the early assessment of ASD, relying on multimodal biosignal recording. During a VR experience featuring 12 virtual scenes, eye gaze, motor skills, elec trodermal activity and behavioural performance were measured in 39 children with ASD and 42 control peers. Machine learning models were developed to identify digital biomarkers and classify autism. Results : Biosignals reported varied performance in detecting ASD, while the combined model resulting from the combination of specific-biosignal models demon strated the ability to identify ASD with an accuracy of 83% (SD = 3%) and an AUC of 0.91 (SD = 0.04). Discussion : This screening tool may support ASD diagnosis by reinforcing the outcomes of traditional assessment procedures.

Resumen Introducción : El Trastorno del Espectro Autista (TEA) es un trastorno del neurodesarrollo, y sus procedimien tos tradicionales de evaluación encuentran ciertas li mitaciones. El actual campo de investigación sobre TEA está explorando y respaldando métodos innovadores para evaluar el trastorno tempranamente, basándose en la detección automática de biomarcadores. Sin embargo, muchos de estos procedimientos carecen de validez ecológica en sus mediciones. En este contexto, la reali dad virtual (RV) presenta un prometedor potencial para registrar objetivamente bioseñales mientras los usuarios experimentan situaciones ecológicas. Métodos : Este estudio describe un novedoso y lúdi co procedimiento de RV para la evaluación temprana del TEA, basado en la grabación multimodal de bio señales. Durante una experiencia de RV con 12 esce nas virtuales, se midieron la mirada, las habilidades motoras, la actividad electrodermal y el rendimiento conductual en 39 niños con TEA y 42 compañeros de control. Se desarrollaron modelos de aprendizaje automático para identificar biomarcadores digitales y clasificar el autismo. Resultados : Las bioseñales reportaron un rendimien to variado en la detección del TEA, mientras que el modelo resultante de la combinación de los modelos de las bioseñales demostró la capacidad de identificar el TEA con una precisión del 83% (DE = 3%) y un AUC de 0.91 (DE = 0.04). Discusión : Esta herramienta de detección pue de respaldar el diagnóstico del TEA al reforzar los resultados de los procedimientos tradicionales de evaluación.

Abstract Autism Spectrum Disorders (ASD) and Attention Defi cit Hyperactivity Disorders (ADHD) are Neurodevelop mental Disorders (ND) that frequently coexist together and have etiological, biological, and clinical factors in common. The comorbidity of both neurodevelopmental disorders is associated with a delay or lack of ASD di agnosis and the development of perceptual, emotional, cognitive and behavioral alterations related to Emotional Dysregulation (ED) is common. When both TN are not diagnosed in childhood, they frequently receive wrong diagnoses at later ages, the most frequent being Border line Personality Disorder (BPD). The clinical presentation of the association of ASD and ADHD, the association with ED, differentiation of BPD, and evaluation and intervention are here analyzed. The comorbidity ASD, ADHD, ED is a more severe disorder associated to polypharmacology and hospital admissions.

Resumen Los Trastornos del Espectro Autista (TEA) y los Tras tornos por Déficit de Atención Hiperactividad (TDAH) son Trastornos del Neurodesarrollo (TN) que coexisten frecuentemente y que tienen factores etiológicos, bio lógicos, clínicos en común. La comorbilidad de ambos TN se asocia a un retraso en el diagnóstico del TEA o un diagnóstico que nunca llegan a recibir y es frecuente el desarrollo de alteraciones perceptivas, emocionales, cognitivas y conductuales relacionadas con la Desregu lación Emocional (DE). Cuando ambos TN no son diag nosticados en infancia, frecuentemente reciben diag nósticos equivocados en edades más tardías, siendo el más frecuente el Trastorno Límite de Personalidad (TLP). Se analiza la presentación clínica de la asociación del TEA y el TDAH, la asociación con DE, diferenciación del TLP y evaluación e intervención. La comorbilidad TEA, TDAH, DE, es un trastorno más severo, asociado a poli farmacología y a ingresos hospi talarios.

Abstract With the upsurge of community uptake in popula tion-based early screening for autism, the main obstacle to increasing access to early treatment and intervention services is the extremely limited access to high quality diagnosis, specifically the shortage of expert clinicians. Diagnostic evaluation models deployed by academic cen ters of excellence, which typically require the investment of 6-10 hours by specialized multidisciplinary teams, is not a viable solution to the vast needs of communities, resulting in parents’ “diagnostic odysseys” and delays, often of several years, for treatment, interventions and supports. Biomarker-based objective procedures for early diagnosis and assessment of autism are now available, clinically validated, and cleared for broad implementa tion by the US Food and Drug Administration (FDA). They are intended to increase access while maintaining high quality. Such solutions, however, will require change in entrenched models of diagnostic care, and aggressive prioritization of the needs of the community at large. If these innovations are successful, the number of children diagnosed in the first three years of life will double or triple. This will, in turn, require much greater inves tments in resources for treatment, including massive workforce training of providers capable of delivering community-viable caregiver-mediated interventions, and of early educators capable of serving autistic children in therapeutic inclusive preschool settings.

Resumen Con el aumento de la aceptación comunitaria de la detección temprana del autismo basada en la pobla ción, el principal obstáculo para aumentar el acceso al tratamiento temprano y a los servicios de intervención es el acceso extremadamente limitado a un diagnóstico de alta calidad, específicamente la escasez de médicos expertos. Los modelos de evaluación diagnóstica imple mentados por centros académicos de excelencia, que normalmente requieren la inversión de 6 a 10 horas por parte de equipos multidisciplinarios especializados, no son una solución viable para las vastas necesidades de las comunidades, lo que resulta en “odiseas diagnósti cas” y retrasos, a menudo de gran importancia, para los padres varios años, para tratamiento, intervenciones y apoyos. Los procedimientos objetivos basados en bio marcadores para el diagnóstico temprano y la evaluación del autismo ya están disponibles, clínicamente validados y aprobados para su amplia implementación por la Ad ministración de Alimentos y Medicamentos de EE. UU. (FDA). Su objetivo es aumentar el acceso manteniendo una alta calidad. Sin embargo, tales soluciones requeri rán cambios en los modelos arraigados de atención de diagnóstico y una priorización agresiva de las necesida des de la comunidad en general. Si estas innovaciones tienen éxito, el número de niños diagnosticados en los primeros tres años de vida se duplicará o triplicará. 51 Esto, a su vez, requerirá inversiones mucho mayores en recursos para el tratamiento, incluida la capacitación masiva de la fuerza laboral de proveedores capaces de brindar intervenciones comunitarias viables mediadas por cuidadores, y de educadores tempranos capaces de atender a niños autistas en entornos preescolares terapéuticos inclusivos.