Currently, there is no intervention model for autism spectrum disorder (ASD) that addresses all levels and factors of the International Classification of Functioning, Disability and Health (ICF, WHO). The most researched programs focus on naturalistic, developmental and behavioral approaches to socio-communication. Less attention has been paid to motor and environmental reactivity aspects (behavior/interest restriction and sensory reactivity). The evidence rationale for the Global Integration Method (MIG, “Método de Integração Global”), a model addressing sensorimotor reactivity in addition to socio-communication, is presented. MIG is an integrative, interdisciplinary, family-oriented intervention and naturalistic program that addresses all levels and moderating factors of ASD’s impact. MIG’s theoretical rationale is based on the predictive coding impairment and embodied cognition hypotheses. MIG incorporates both bottom-up (flexible therapeutic suit, social-motor synchronization) and top-down (schematic social information processing, narratives, imagery) strategies to promote the building and use of accurate, flexible and context-sensitive internal predictive models. MIG is based on the premises that predictive coding improves both socio-communication and environmental reactivity, and that the postural stabilization provided by the flexible therapeutic suit frees information processing resources for socio-cognitive learning. MIG builds on interdisciplinary, professionally and parentally mediated work based on behavioral principles of intensive training in a situated environment.
A educação inclusiva no Brasil é amparada por leis e políticas públicas. No entanto, ainda enfrenta grandes desafios. Entre eles estão a adaptação do currículo, as dificuldades específicas de aprendizagem, a formação de professores e a falta de apoio institucional. Este estudo usa uma abordagem qualitativa para analisar esses obstáculos. A pesquisa se baseia em revisão bibliográfica e análise de documentos oficiais. Também examina as principais abordagens pedagógicas adotadas no país. O artigo apresenta o programa TREINI na Escola (TnE) como uma proposta prática e baseada em evidências científicas. O TnE oferece um currículo funcional e adaptado, com foco em ensino explícito e atividades contextualizadas. O programa também fornece suporte a professores, por meio de formação continuada e materiais estruturados. Seu objetivo é promover a aprendizagem acadêmica, funcional e socioemocional de alunos com deficiência e transtornos do neurodesenvolvimento. Ao unir elementos de pedagogias tradicionais e modernas, o TnE busca tornar a inclusão mais efetiva. Ainda assim, o programa precisa ser testado em diferentes contextos e validado por pesquisas futuras.
Children with autism spectrum disorder (ASD) may experience impairments across all domains of the International Classification of Functioning, Disability, and Health. However, there is a scarcity of programs that integrate interventions encompassing all these domains. Objective: To investigate parents’ perception of performance and satisfaction with functional goals for children with ASD after intervention with the Global Integration Methods: This single-group quasi-experimental study involved a total of 98 participants aged 1.8 to 18.2 years who underwent a 3-month intervention, five times a week, for 3-4 h per day. The intervention involved functional task training in an environment inspired by the natural environment associated with the use of a flexible therapeutic suit. The primary outcome measure was the Canadian Occupational Performance Measure, administered before and after the intervention. Results: Ninety-five participants completed the study. Approximately 60% of participants showed improvements in performance and satisfaction that ranged from 1 to 9 points on the Canadian Occupational Performance Measure. The Global Integration Method program resulted in significant improvements in goal performance (p<0.001, d=0.80) and satisfaction (p<0.001, d=0.67). Most parents (81%) believed that the Global Integration Method incorporated aspects of family-professional collaboration and were satisfied (93%) with the intervention. Conclusion: In the perception of parents, the Global Integration Method demonstrated effectiveness in achieving functional goals for children with ASD and their families. Parents expressed satisfaction with the intervention and indicated that it incorporated elements of family-professional collaboration.
Scientific knowledge has advanced in the implementation of safe and beneficial interventions for children and adolescents with cerebral palsy (CP). Although the importance of interdisciplinary interventions that integrate all components of the International Classification of Functioning, Disability and Health (ICF) into family-centered practices is widely recognized, this approach is not yet widely adopted. Instead, many programs remain focused on isolated domains. This study presents the theoretical and methodological foundation of TREINI, an interdisciplinary and family-centered program developed for children and youth with CP and other neurodevelopmental disorders. TREINI incorporates intervention strategies that address all ICF domains. It is grounded in the biopsychosocial model of health and utilizes principles based on the best evidence in pediatric rehabilitation, including intensive training, task-oriented training, and a naturalistic learning environment. Unlike traditional rehabilitation approaches, the care provided by the TREINI program is delivered through an intensive and interdisciplinary approach, by a team working collaboratively in a single location. In addition to including evidence-based interventions, the TREINI program features two innovative components: the “City of Tomorrow”, a naturalistic learning environment, and the “TREINI Exoflex” therapeutic suit, specifically designed to address deficiencies in the body functions and structures of children with CP and other neurodevelopmental disorders. This program has been carefully designed to support the process of neurological re-education and rehabilitation for children and adolescents with neuropsychomotor developmental delays.
Background: Disorders in different levels of body representation (i.e., body schema, body structural description, and body image) are present in hemiplegic cerebral palsy (HCP). However, it remains unclear whether the body image develops from aspects of body schema and body structural description, and how this occurs in children with HCP.Objective and methods: In a cross-sectional study, we investigated 53 children with HCP (mean age about 10 years) and 204 typically developing (TD) control children to qualitatively evaluate whether and how body schema (related sensorimotor experiences) and body structural description (related visuospatial experiences) affect the development of children’s body image and whether this development is delayed through HCP. Graph analysis was used to create a lexical-semantic map of body representation from data of a semantic word fluency task.Results: Results indicated a similar qualitative pattern of influences of sensorimotor and visuospatial experiences on lexical-semantic knowledge of body parts, with a delayed developmental course in children with HCP compared to TD children.Conclusion: These findings suggest that children’s body image seemed to be influenced by body schema and body structural descriptions as indicated by poorer lexical-semantic knowledge of body parts in children with HCP due to missing physical experiences of the affected body parts. This might imply that “body talk” may beneficially complement physical therapy for children with HCP to promote body image development.