Samoprocjena spremnosti specijalizanata pedijatrije za prepoznavanje odstupanja u ranom komunikacijskom razvoju

master's thesis

• Title (english): Self-assessment of pediatric residents ability to recognize difficulties in early communication development
• Author: Lucia Žudić
• Mentor: Maja Cepanec (mentor)
• Committee member: Maja Cepanec (predsjednik povjerenstva)
• Committee member: Sanja Šimleša (član povjerenstva)
• Committee member: Jasmina Ivšac Pavliša (član povjerenstva)
• Granter: University of Zagreb; Faculty of Education and Rehabilitation Sciences; Zagreb
• Defense date and country: 2022-06-06, Croatia
• Scientific / art field, discipline and subdiscipline: SOCIAL SCIENCES; Speech Therapy

Abstract

Rano prepoznavanje odstupanja u obilježjima komunikacije djece dobi 0-3 godine ključno
je uključivanje djece u programe rane intervencije, a onda i za ranu dijagnostiku ukoliko se to
pokaže potrebnim. Prema Nacionalnom okviru za probir i dijagnostiku poremećaja iz spektra
autizma u djece dobi 0-7 godina u RH (2018), preporuka je da primarni pedijatri provode prvi
korak probira na cijeloj populaciji djece u dobi od 18 mjeseci te drugi korak u dobi od 24 mjeseca
u one djece koja su na prvom koraku ostvarila pozitivan rezultat. Sukladno ishodu drugog koraka,
dijete se potencijalno upućuje na razvojnu procjenu odnosno specifičnu dijagnostiku poremećaja
iz spektra autizma (PSA).
Cilj istraživanja bio je utvrditi kako specijalizanti pedijatrije procjenjuju vlastitu spremnost za
prepoznavanje odstupanja u ranom komunikacijskom razvoju te kakvi su njihovi stavovi o
uključivanju primarnih pedijatara u sustav probira na PSA. Uzorak su činila 53 specijalizanta
pedijatrije različitih zdravstvenih ustanova u Republici Hrvatskoj, a ispunjavali su upitnik
osmišljen za potrebe ovog istraživanja. Sudionici su se većinom složili da bi primarni pedijatri
trebali znati prepoznati odstupanja u komunikaciji djece rane dobi i sudjelovati u probiru te da, s
obzirom na kontinuirano praćenje rasta i razvoja djece te čestu komunikaciju s roditeljima, imaju
dobre preduvjete za praćenje kliničkih pokazatelja sumnje na PSA. No, procjenjuju da im u
primarnim pedijatrijskim ambulantama nedostaju protokoli za sustavno praćenje tih kliničkih
pokazatelja sumnje na poremećaj te da imaju nedovoljno vremena. Izvijestili su kako bi tijekom
studijskog obrazovanja trebalo više vremena posvetiti sadržaju o obilježjima komunikacije djece
dobi 0-3 godine. Procjena dobi javljanja pojedinih miljokaza u domeni ranog komunikacijskog
razvoja pokazuje da su njihova znanja prilično neujednačena, te da uglavnom dob pojave
određenih ponašanja smještaju u kasnije razdoblje no kad se ona uistinu javljaju. Primjerice,
gotovo polovina sudionika (45%) navodi da bi izostanak pojave prve riječi tolerirali do dobi 24 ili
36 mjeseci, dok međunarodne smjernice sugeriraju dob od 16 mjeseci. Sukladno tome, smatraju
da im je potrebna dodatna edukacija o tipičnom razvoju te o odstupanjima i prepoznavanju istih.
Dobiveni rezultati potencijalno su važni za oblikovanje sustavne edukacije budućih pedijatara za
prepoznavanje odstupanja u obilježjima ranog komunikacijskog razvoja te smjernica za praćenje
kliničkih pokazatelja sumnje na poremećaj iz spektra autizma.

Abstract (english)

Early recognition of difficulties in communication development of children aged 0-3 years
is crucial for inclusion in early intervention programs and early diagnosis. According to the
National Framework for Screening and Diagnosis of Autism Spectrum Disorder in Children aged
0-7 in Croatia (2018), it is recommended that primary pediatricians perform the first step of
screening the entire population of children aged 18 months and the second step at 24 months in
those children who achieved a positive result in the first step. In accordance with the outcome of
the second step, the child would be potentially referred to a developmental assessment or specific
diagnostic protocol for Autism Spectrum Disorder (ASD).
The research was conducted to determine how pediatric residents assess their own ability to
recognize difficulties in early communication development and what are their views on the role of
primary pediatricians in the screening for ASD. 53 pediatric residents from various health care
institutions in Croatia participated in the research and they filled out a questionnaire designed for
this research. Participants mostly agree that primary pediatricians should be able to recognize
difficulties in early communication development and participate in the screening. Furthermore,
given the continuous monitoring of children's development and frequent communication with
parents, they have good preconditions for monitoring clinical indicators of suspected ASD.
However, they estimate that there is a lack of protocols in primary pediatric offices for systematic
monitoring of these clinical indicators. In addition, they reported that more time should be devoted
to the content on early communication development during their formal education. The assessment
of the age of occurrence of certain milestones in early communication development shows that
their knowledge is quite uneven, and that they generally place the occurrence of certain behaviors
in a later period than when they should actually occur. For example, almost half of the participants
(45%) state that would tolerate the absence of the first word until the age of 24 or 36 months, while
international guidelines suggest an age of 16 months for this milestone. Accordingly, they believe
that they need additional education on typical development, difficulties and their recognition.
The results are potentially important for developing systematic education of future pediatricians
on identifying difficulties in early communication development and guidelines for monitoring
clinical indicators of suspected ASD.

• Keywords: rani komunikacijski razvoj; poremećaj iz spektra autizma; pedijatri; rano prepoznavanje odstupanja; probir
• Keywords (english): early communication development; autism spectrum disorder; pediatricians; early recognition of difficulties; screening
• Language: croatian
• URN:NBN: urn:nbn:hr:158:100659
• Study programme: Title: Graduate study of Speech and Language Pathology; Study programme type: university; Study level: graduate; Academic / professional title: magistar/magistra logopedije (magistar/magistra logopedije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-09-01 13:23:08