ANÁLISE COMPARATIVA DA PRECOCIDADE DIAGNÓSTICA NO TRANSTORNO DO ESPECTRO AUTISTA: NÍVEIS DE SUPORTE E O IMPACTO DA PUBERDADE NA FALÊNCIA DOS MECANISMOS COMPENSATÓRIOS
DOI:
https://doi.org/10.22533/omij.v7i1.488Palavras-chave:
transtorno do espectro autista, camuflagem social, masking, burnout autista, diagnóstico tardio, adolescência, alto rendimento cognitivo.Resumo
O Transtorno do Espectro Autista (TEA) apresenta heterogeneidade clínica que gera trajetórias diagnósticas distintas conforme o nível de suporte. Nos níveis 2 e 3, sinais precoces e salientes precipitam avaliação especializada ainda na primeira infância. No Nível 1 com alto rendimento cognitivo, competências executivas preservadas sustentam camuflagem social (masking) que torna os défices nucleares clinicamente invisíveis, gerando subdiagnóstico sistemático. Esta revisão teórica integrativa examina os mecanismos neurobiológicos desse contraste, propõe o construto do Savantismo Estrutural Compensado (SEC) como hipótese de trabalho, e analisa a puberdade como janela crítica de vulnerabilidade para a falência desses mecanismos. Conclui-se pela necessidade de instrumentos de rastreio sensíveis ao mascaramento cognitivo.
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ABUALAIT, T.; ALABBAD, M.; KALEEM, I.; IMRAN, H.; KHAN, H.; KIYANI, M. M.; BASHIR, S. Autism Spectrum Disorder in Children: Early Signs and Therapeutic Interventions. Children, v. 11, n. 11, p. 1311, 2024. https://doi.org/10.3390/children11111311
ALAGHBAND-RAD, J.; HAJIKARIM-HAMEDANI, A.; MOTAMED, M. Camouflage and masking behavior in adult autism. Frontiers in Psychiatry, v. 14, p. 1108110, 2023. https://doi.org/10.3389/fpsyt.2023.1108110
AMERICAN PSYCHIATRIC ASSOCIATION. DSM-5-TR: Manual Diagnóstico e Estatístico de Transtornos Mentais. 5. ed., rev. Washington, D.C.: APA, 2022.
BARGIELA, S.; STEWARD, R.; MANDY, W. The experiences of late-diagnosed women with autism spectrum conditions. Journal of Autism and Developmental Disorders, v. 46, n. 10, p. 3281-3294, 2016. https://doi.org/10.1007/s10803-016-2872-8
BARON-COHEN, S. Autism: The empathizing-systemizing (E-S) theory. Annals of the New York Academy of Sciences, v. 1156, p. 68-80, 2009. https://doi.org/10.1111/j.1749-6632.2009.04467.x
CASSIDY, S.; BRADLEY, L.; SHAW, R.; BARON-COHEN, S. Risk markers for suicidality in autistic adults. Molecular Autism, v. 9, art. 42, 2018. https://doi.org/10.1186/s13229-018-0226-4
CASSIDY, S.; RODGERS, J. Understanding and prevention of suicide in autism. The Lancet Psychiatry, v. 4, n. 6, p. e11, 2017. https://doi.org/10.1016/S2215-0366(17)30162-1
COOK, J.; HULL, L.; CRANE, L.; MANDY, W. Camouflaging in autism: A systematic review. Clinical Psychology Review, v. 89, p. 102080, 2021. https://doi.org/10.1016/j.cpr.2021.102080
ESTES, A.; MUNSON, J.; ROGERS, S. J.; GREENSON, J.; WINTER, J.; DAWSON, G. Long-term outcomes of early intervention in 6-year-old children with autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry, v. 54, n. 7, p. 580-587, 2015. https://doi.org/10.1016/j.jaac.2015.04.005
EVANS, J. A.; KRUMREI-MANCUSO, E. J.; ROUSE, S. V. What You Are Hiding Could Be Hurting You: Autistic Masking in Relation to Mental Health, Interpersonal Trauma, Authenticity, and Self-Esteem. Autism in Adulthood, v. 6, n. 2, p. 230-240, 2024. https://doi.org/10.1089/aut.2022.0115
FARLEY, M. A.; McMAHON, W. M.; FOMBONNE, E.; JENSON, W. R.; MILLER, J.; GARDNER, M.; COON, H. Twenty-year outcome for individuals with autism and average or near-average cognitive abilities. Autism Research, v. 2, n. 2, p. 109-118, 2009. https://doi.org/10.1002/aur.69
GESCHWIND, D. H.; LEVITT, P. Autism spectrum disorders: Developmental disconnection syndromes. Current Opinion in Neurobiology, v. 17, n. 1, p. 103-111, 2007. https://doi.org/10.1016/j.conb.2007.01.009
GOTHAM, K.; PICKLES, A.; LORD, C. Trajectories of autism severity in children using standardized ADOS scores. Pediatrics, v. 130, n. 5, p. e1278-e1284, 2012. https://doi.org/10.1542/peds.2011-3668
HAPPE, F.; FRITH, U. Annual Research Review: Looking back to look forward. Journal of Child Psychology and Psychiatry, v. 61, n. 3, p. 218-232, 2020. https://doi.org/10.1111/jcpp.13176
HULL, L.; MANDY, W.; LAI, M.-C.; BARON-COHEN, S.; ALLISON, C.; SMITH, P.; PETRIDES, K. V. Development and Validation of the Camouflaging Autistic Traits Questionnaire (CAT-Q). Journal of Autism and Developmental Disorders, v. 49, n. 3, p. 819-833, 2019. https://doi.org/10.1007/s10803-018-3792-6
HULL, L.; LEVY, L.; LAI, M.-C.; PETRIDES, K. V.; BARON-COHEN, S.; ALLISON, C.; SMITH, P.; MANDY, W. Is social camouflaging associated with anxiety and depression in autistic adults? Molecular Autism, v. 12, art. 13, 2021. https://doi.org/10.1186/s13229-021-00421-7
JUST, M. A.; KELLER, T. A.; MALAVE, V. L.; KANA, R. K.; VARMA, S. Autism as a neural systems disorder: A theory of frontal-posterior underconnectivity. Neuroscience and Biobehavioral Reviews, v. 36, n. 4, p. 1292-1313, 2012. https://doi.org/10.1016/j.neubiorev.2012.02.007
KHUDIAKOVA, V.; RUSSELL, E.; SOWDEN-CARVALHO, S.; SURTEES, A. D. R. A systematic review and meta-analysis of mental health outcomes associated with camouflaging in autistic people. Research in Autism Spectrum Disorders, v. 118, p. 102492, 2024. https://doi.org/10.1016/j.rasd.2024.102492
KLEIN, J.; KRAHN, R.; HOWE, S.; LEWIS, J.; McMORRIS, C.; MACOUN, S. A systematic review of social camouflaging in autistic adults and youth: Implications and theory. Development and Psychopathology, v. 37, p. 1320-1334, 2025. https://doi.org/10.1017/S0954579424001159
LAI, M.-C.; BARON-COHEN, S. Identifying the lost generation of adults with autism spectrum conditions. The Lancet Psychiatry, v. 2, n. 11, p. 1013-1027, 2015. https://doi.org/10.1016/S2215-0366(15)00277-5
LAI, M.-C.; KASSEE, C.; BESNEY, R.; BONATO, S.; HULL, L.; MANDY, W.; SZATMARI, P.; AMEIS, S. H. Prevalence of co-occurring mental health diagnoses in the autism population: A systematic review and meta-analysis. The Lancet Psychiatry, v. 6, n. 10, p. 819-829, 2020. https://doi.org/10.1016/S2215-0366(19)30289-5
LEEDHAM, A.; THOMPSON, A. R.; SMITH, R.; FREETH, M. 'I was exhausted trying to figure it out': The experiences of autistic women diagnosed in adulthood. Autism, v. 24, n. 1, p. 135-146, 2020. https://doi.org/10.1177/1362361319853442
LIMA, J. P. P.; MATOS, J. P. C.; FONSECA, L. S.; TRISTAO, M. E. A. M. A. Relevancia do diagnostico precoce do transtorno do espectro autista em criancas. LUMEN ET VIRTUS, v. 16, n. 48, p. 5696-5704, 2025. https://doi.org/10.56238/levv16n48-084
LIVINGSTON, L. A.; COLVERT, E.; BOLTON, P.; HAPPE, F. Good social skills despite poor theory of mind: Exploring compensation in autism spectrum disorder. Journal of Child Psychology and Psychiatry, v. 60, n. 1, p. 102-110, 2019. https://doi.org/10.1111/jcpp.12889
MANDY, W. Social camouflaging in autism: Is it time to lose the mask? Autism, v. 23, n. 8, p. 1879-1881, 2019. https://doi.org/10.1177/1362361319878559
McQUAID, G. A.; LEE, N. R.; WALLACE, G. L. Camouflaging in autism spectrum disorder: Examining the roles of sex, gender identity, and diagnostic timing. Autism, v. 26, n. 2, p. 552-559, 2022. https://doi.org/10.1177/13623613211042131
PEREIRA DA SILVA, A.; AGRELA RODRIGUES, F. de A. Luta ou Fuga no Espectro Autista. Revista Internacional de Ciencias Sociales, v. 4, n. 2, p. e726, 2025. https://doi.org/10.57188/RICSO.2025.726
RAYMAKER, D. M.; TEO, A. R.; STECKLER, N. A.; LENTZ, B.; SCHARER, M.; DELOS SANTOS, A.; KAPP, S. K.; HUNTER, M.; JOYCE, A.; NICOLAIDIS, C. Having All of Your Internal Resources Exhausted Beyond Measure and Being Left with No Clean-Up Crew: Defining Autistic Burnout. Autism in Adulthood, v. 2, n. 2, p. 132-143, 2020. https://doi.org/10.1089/aut.2019.0079
RODRIGUES, F. de A. A. O Savantismo Estrutural Compensado (SEC). Open Minds International Journal, v. 7, p. 1-13, 2026. https://doi.org/10.5281/zenodo.1845834
RODRIGUES, F. de A. A.; LIMA, M. A. B. Difficulties in the social interaction of autistic individuals: A neuroscientific perspective. International Journal of Health Science. [no prelo]. 2025.
RODRIGUES, F. de A. A.; NUNES, F. da S. Correlation between giftedness and autism: An evolutionary and neurodevelopmental model. International Journal of Health Science. [no prelo]. 2025.
SUPEKAR, K.; UDDIN, L. Q.; KHOUZAM, A.; PHILLIPS, J.; GAILLARD, W. D.; KENWORTHY, L. E.; YERYS, B. E.; VAIDYA, C. J.; MENON, V. Brain hyperconnectivity in children with autism and its links to social deficits. Cell Reports, v. 5, n. 3, p. 738-747, 2013. https://doi.org/10.1016/j.celrep.2013.10.001
THOMAS, M. S. C.; ANNAZ, D.; ANSARI, D.; SCERIF, G.; JARROLD, C.; KARMILOFF-SMITH, A. Using developmental trajectories to understand developmental disorders. Journal of Speech, Language, and Hearing Research, v. 52, n. 2, p. 336-358, 2011.
TORRACO, R. J. Writing integrative literature reviews: Guidelines and examples. Human Resource Development Review, v. 4, n. 3, p. 356-367, 2005. https://doi.org/10.1177/1534484305278283
UDDIN, L. Q.; SUPEKAR, K.; MENON, V. Reconceptualizing functional brain connectivity in autism from a developmental perspective. Frontiers in Human Neuroscience, v. 7, p. 458, 2013. https://doi.org/10.3389/fnhum.2013.00458
WHITTEMORE, R.; KNAFL, K. The integrative review: Updated methodology. Journal of Advanced Nursing, v. 52, n. 5, p. 546-553, 2005. https://doi.org/10.1111/j.1365-2648.2005.03621.x
ZWAIGENBAUM, L.; BAUMAN, M. L.; CHOUEIRI, R.; KASARI, C.; CARTER, A.; GRANPEESHEH, D.; MAILLOUX, Z.; SMITH ROLEY, S.; WAGNER, S.; FEIN, D.; PIERCE, K.; BUIE, T.; DAVIS, P. A.; NEWSCHAFFER, C.; ROBINS, D.; WETHERBY, A.; STONE, W. L.; YIRMIYA, N.; ESTES, A.; HANSEN, R. L.; McPARTLAND, J. C.; NATOWICZ, M. R. Early intervention for children with autism spectrum disorder under 3 years of age. Pediatrics, v. 136, suppl. 1, p. S60-S81, 2019. https://doi.org/10.1542/peds.2014-3667E
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