Uno sguardo al neurosviluppo raggiunto ai due anni d’età

Abstract

When a psychological disorder appears in a child, even a mild disorder, early diagnosis is essential in order to provide a timely and appropriate intervention that can improve, both, the child’s symptoms and development. Early identification can prevent consequences of differing levels, in the short and long term, and in the individual, in his or her family, and in society as a whole. Hence the importance of paediatrician’s point of view and clinical know-how in identifying potential disorders early, but also the parents’ views. It is therefore important to actively involve parents upon initial diagnosis. In this regard, within the NASCITA Project, a study branch aimed at building a shared, active approach between parents, paediatricians and neuropsychiatrists/psychologists was activated for the age 2-year health assessments (wellchild visits) phase. Three tests were used: the M-CHAT-R (Modified Checklist for Autism in Toddlers, Revised) to evaluate language, social skills, behaviour, sensory areas; the PSI-SF (Parenting Stress Index –Short Form) to verify the degree of discrepancy perceived by the parent between the child’s requests and his or her ability to deal with them adequately; the DERS (Difficulties in Emotion Regulation Scale) to highlight the difficulties of each parent in recognising, interpreting, and managing their emotions. The tests were given to 380 parents (142 couples, 215 mothers and 23 fathers) by 45 family paediatricians during the wellchild visit held at two years of age. In all, 33 children (9%) resulted at risk, with a score of ≥3, 1 of whom was found to be at high risk. For 64 children (16.8%) at least one of the parents tested positive for PSI-SF and for 19 (5%) children at least one parent tested positive with the DERS. After combining the results obtained from the three tests and the clinical evaluation, and assessing the child’s condition with respect to those results, the pediatrician can provide the parents with a concise description of what emerged and provide a summarised report for the specialist. Such an effort leads to timely, shared communication within the parentpaediatrician-neuropsychiatrist triad that includes specificity of intervention and that can contribute to the effectiveness of the response.