MURAT EYÜBOĞLU, HÜSEYİN BURAK BAYKARA, DAMLA EYÜBOĞLU

Otizm spektrum bozukluğu olan çocukların sağlıklı gelişim gösteren kardeşlerinin psikososyal özellikler ve yaşam kalitesi açısından değerlendirilmesi

Amaç: Bu çalışmanın amacı, otizm spektrum bozukluğu (OSB) olan çocukların sağlıklı gelişim gösteren kardeşlerinin psikososyal özellikler ve yaşam kalitesi açısından yaş ve cinsiyet gibi sosyodemografik özellikleri bire bir eşleştirilmiş sağlıklı gelişim gösteren çocuklar ile karşılaştırmaktır. Yöntem: Çalışmaya DSM IV-TR'ye göre otistik bozukluk, Asperger bozukluğu ve yaygın gelişimsel bozukluk-başka türlü adlandırılamayan tanılı 41 hastanın sağlıklı gelişim gösteren 41 kardeşi ve ailesinde herhangi bir psikiyatrik bozukluk öyküsü olmayan ve sağlıklı gelişim gösteren 43 kontrol alındı. Çalışmaya katılan tüm çocuklar ile tanısal bir psikiyatrik görüşme yapılmıştır. Olgu ve kontrol grubuna Güçler Güçlükler Anketi, Çocuklar için Yaşam Kalitesi Ölçeği uygulanmıştır. Olgu ve kontrol grubundaki çocukların anne-babalarına Çocukluk Otizm Değerlendirme Ölçeği, Çocuklar için Yaşam Kalitesi Ölçeği Anne-Baba Formu, Güçler Güçlükler Anketi Anne-Baba Formu uygulanmıştır. Sonuçlar: Olgu grubunun Yaşam Kalitesi Ölçeği fiziksel sağlık toplam puanı, duygusal işlevsellik puanı, psikososyal sağlık toplam puanı ve ölçek toplam puanı ile Güçler Güçlükler Anketi prososyal davranış alt ölçek puanı anlamlı olarak daha düşüktü. Tartışma: OSB'li çocukların sağlıklı kardeşleri uluslararası tanı ölçütlerine göre herhangi bir psikiyatrik bozukluk ölçütünü karşılamasalar bile, bu çocukların duygusal ve fiziksel alanda kendilerini olumsuz değerlendirdikleri, anne-babaların da bu çocukların yaşadıkları zorlukların yeterince farkında olmadığı düşünülebilir.

Assessment of psychosocial features and quality of life of typically developing siblings of children who diagnosed with autism spectrum disorder

Objective: The aim of this study is to compare typically developing siblings of children, who were diagnosed with autism spectrum disorder (ASD), with typically developing children matched by sociodemographic characteristics, in terms of psychosocial features and quality of life. Methods: Forty-one typically developing siblings of 41 cases who diagnosed autistic disorder, Asperger disorder and pervasive developmental disorder-not otherwise specified according to DSM IV-TR and 43 controls of typically developing controls, who has no history of any psychiatric disorder in their family, were included. Psychiatric diagnostic interview were applied to all children who admitted to the study. Strengths and Difficulties Questionnaire and Pediatric Quality of Life Questionnaire were applied to case and control groups. Childhood Autism Rating Scale andPediatric Quality of Life Questionnaire-parent form and Strengths and Difficulties Questionnaire-parent form were applied to parent of case and control groups. Results: The physical health total scores, emotional functioning scores, psychosocial health total scores and total scores of Pediatric Quality of Life Questionnaire and prosocial subscale scores of Strengths and Difficulties Questionnaire were significantly lower in case group. Conclusion: It can be considered that even typically developing siblings of children who diagnosed with Autism Spectrum Disorder have no psychiatric diagnosis according to international diagnostic criteria, these children have negative self-evaluation in physical and social areas and their parents are not enough to be aware of difficulties that these children experienced.

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1. Van Engeland H, Buitelaar JK. Autism spectrum Disorders. Rutter M, Bishop DVM, Pine DS, Scott S, Stevenson J, Taylor E, Thapar A (Eds.), Rutter's Child and Adolescent Psychiatry, fifth ed., Massachusetts: Blackwell Publishing, 2008, p.759-781
2. Fombonne E. Epidemiology of pervasive developmental disorders. Pediatr Res 2009; 65:591- 598.
3. Bryson SE. Epidemiology of autism: Overview and issues outstanding. Cohen DJ, Volkmar FR (eds.), Handbook of Autism and Pervasive Developmental Disorders, second ed., New York: Wiley, 1997, p.41-46.
4. Fombonne E. Is autism getting commoner? Br J Psychiatry 2008; 193:59.
5. Kim YS, Leventhal BL, Koh YJ, Fombonne E, Laska E, Lim EC, et al. Prevalence of autism spectrum disorders in a total population sample. Am J Psychiatry 2011; 168:904-912.
6. Yeargin-Allsopp M, Rice C, Karapurkar T, Doernberg N, Boyle C, Murphy C. Prevalence of autism in a US metropolitan area. JAMA 2003; 289:49- 55.
7. Dunn J. Annotation: sibling influences on childhood development. J Child Psychol Psychiatry 1988; 29:119-127.
8. Dunn J,McGuire S.Sibling and peer relationship in childhood. J Child Psychol Psychiatry 1992; 33:67-105.
9. Stoneman Z, Brody GH. Sibling Relationships in the family context. Z Stoneman, P Waldman (Eds.), The Effects of Mental Retardation, Disability and Illness on Sibling Relationships: Research Issues and Challenges, Baltimore, New York: Paul H. Brookes Publishing, 1993, p.3-30.
10. Brody GH, Stoneman Z. Contextual issues in the study of sibling socialization. JJ Gallagher, PM Vietze (Eds.), Families of Handicapped Persons: Research, Programs and Policy Issues, Baltimore, New York: Paul H. Brookes Publishing, 1986, p.197-217.
11. Powell TH, Gallagher PA. Brothers and Sisters: a Special Part of Exceptional Families. Second ed., Baltimore, New York: Paul H. Brookes Pub., 1993. 12. Rodrigue JR, Geffken GR, Morgan SB. Per-ceived competence and behavioral adjustment of siblings of children with autism. J Autism Dev Disord 1993; 23:665-674.
13. Ross P, Cuskelly M. Adjustment, sibling problems and coping strategies of brothers and sisters of children with autistic spectrum disorder. J Intellect Dev Disabil 2006; 31:77-86.
14. Meadan H, Stoner JB, Angell ME. Review of literature related to social, emotional, and behavioral adjustment of siblings of individuals with autism spectrum disorders. J Dev Phys Disabil 2010; 22:83-100.
15. Giallo R, Gavidia-Payne S. Child, parent and family factors as predictors of adjustment for siblings of children with a disability. J Intellect Disabil Res 2006; 50:937-948.
16. Toth K, Dawson G, Meltzoff AN, Greenson J, Fein D.Early social, imitation, play, and language abilities of young non-autistic siblings of children with autism. J Autism Dev Disord 2007; 37:145- 157.
17. Hastings RP. Longitudinal relationships between sibling behavioral adjustment and behavior problems of children with developmental disabilities. J Autism Dev Disord 2007; 37:1485-1492.
18. Verte´ S, Roeyers H, Buysse A. Behavioural problems, social competence and self-concept in siblings of children with autism. Child Care Health Dev 2003; 29:193-205.
19. Macks RJ, Reeve RE. The adjustment of nondisabled siblings of children with autism. J Autism Dev Disord 2007; 37:1060-1067.
20. Mates TE. Siblings of autistic children: Their adjustment and performance at home and in school. J Autism Dev Disord 1990; 20:545-553.
21. Tomeny TS, Barry TD, Bader SH. Are typicallydeveloping siblings of children with an autism spectrum disorder at risk for behavioral, emotional, and social maladjustment? Res Autism Spectr Disord 2012; 6: 508-518
22. Howlin P. Living with impairment: the effects on children of having an autistic sibling. Child Care Health Dev 1988; 14:395-408.
23. Marciano AR, Scheuer CI. Quality of life in siblings of autistic patients. Rev Bras Psiquiatr 2005; 27:67-69.
24. Kaufman J, Birmaher B, Brent D, Rao U, Flynn C, Moreci P et al. Schedule for affective disorders and schizophrenia for schoolage children-present and lifetime version (K-SADS-PL): Initial reliability and validity data. Journal American Academy of Child and Adolescent Psychiatry 1997; 36:980- 988.
26. Varni JW, Seid M, Rode CA. The Peds QLTM: The measurement model for the pediatric quality of life inventory. Med Care 1999; 37: 126-139
27. Çakın Memik N, Ağaoğlu B, Coşkun A, Üneri ÖŞ, Karakaya I. Çocuklar için yaşam kalitesi ölçeğinin 13-18 yaş ergen formunun geçerlik ve güvenirliği. Türk Psikiyatri Dergisi 2007; 18: 353-63
28. Goodman R. The Strengths and Difficulties Questionnaire: A research note. J Child Psychol Psychiatry 1997; 38:581-586.
30. Schopler E, Reichler RJ, Rochen Renner B. The Childhood Autism Rating Scale (CARS), On birinci baskı, Western Psychological Services, 2007
31. İncekaş S. Çocukluk Otizmini Derecelendirme Ölçeği Geçerlik ve Güvenirlik Çalışması. Yayımlanmamış Uzmanlık Tezi, İzmir, Dokuz Eylül Üniversitesi Tıp Fakültesi Çocuk ve Ergen Ruh Sağlığı ve Hastalıkları Anabilim Dalı, 2009.
32. Constantino JN, Lajonchere C, Lutz M, Gray T, Abbacchi A, McKenna K et al. Autistic social ımpairment in the siblings of children with pervasive developmental disorders. Am J Psychiatry 2006; 163:294-296.
33. Fisman S, Wolf L, Ellison D, Freeman T. A longitudinal study of siblings of children with chronic disabilities. Can J Psychiatry 2000; 45:369-375.
34. Hastings RP. Brief report: Behavioral adjustment of siblings of children with autism. J Autism Dev Disord 2003; 33:99-104.
35. Knott F, Lewis C, Williams T. Sibling interaction of children with learning disabilities: A compari-son of autism and Down's syndome. J Child Psychol Psychiatry 1995; 36:965-976.
36. Kaminsky L, Dewey D. Psychosocial adjustment in siblings of children with autism. J Child Psychol Psychiatry 2002; 43:225-232.
37. Petalas MA, Hastings RP, Nash S, Hall LM, Joannidi H, Dowey A. Psychological adjustment and sibling relationships in siblings of children with Autism Spectrum Disorders: environmental stressors and the broad autism phenotype. Res Autism Spectr Disord 2012; 6:546-555.
38. Vieira CB, Fernandes FD. Quality of life of siblings of children included in the autism spectrum. Codas 2013; 25:120-127.
39. Georgiades S, Szatmari P, Zwaigenbaum L. Prospective study of autistic-like traits in unaf-fected siblings of probands with autism spectrum disorder. JAMA Psychiatry 2013; 70:42-48.