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Diretrizes de Atenção
1
Brasília – DF
2013
Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
MINISTÉRIO DA SAÚDE
Secretaria de Atenção à Saúde
© 2013 Ministério da Saúde. ĞƉĂƌƚĂŵĞŶƚŽĚĞĕƁĞƐWƌŽŐƌĂŵĄƟĐĂƐƐƚƌĂƚĠŐŝĐĂƐ
dŽĚŽƐŽƐĚŝƌĞŝƚŽƐƌĞƐĞƌǀĂĚŽƐ͘ƉĞƌŵŝƟĚĂĂƌĞƉƌŽĚƵĕĆŽƉĂƌĐŝĂůŽƵƚŽƚĂůĚĞƐƚĂŽďƌĂ͕ĚĞƐĚĞƋƵĞĐŝƚĂĚĂĂĨŽŶƚĞĞƋƵĞŶĆŽƐĞũĂƉĂƌĂǀĞŶĚĂ
ŽƵƋƵĂůƋƵĞƌĮŵĐŽŵĞƌĐŝĂů͘ƌĞƐƉŽŶƐĂďŝůŝĚĂĚĞƉĞůŽƐĚŝƌĞŝƚŽƐĂƵƚŽƌĂŝƐĚĞƚĞdžƚŽƐĞŝŵĂŐĞŶƐĚĞƐƚĂŽďƌĂĠĚĂĄƌĞĂƚĠĐŶŝĐĂ͘ĐŽůĞĕĆŽŝŶƐ-‐
ƟƚƵĐŝŽŶĂůĚŽDŝŶŝƐƚĠƌŝŽĚĂ^ĂƷĚĞƉŽĚĞƐĞƌĂĐĞƐƐĂĚĂ͕ŶĂşŶƚĞŐƌĂ͕ŶĂŝďůŝŽƚĞĐĂsŝƌƚƵĂůĞŵ^ĂƷĚĞĚŽDŝŶŝƐƚĠƌŝŽĚĂ^ĂƷĚĞ͗фŚƩƉ͗ͬͬǁǁǁ͘
ƐĂƵĚĞ͘ŐŽǀ͘ďƌͬďǀƐх͘
dŝƌĂŐĞŵ͗ϭǐĞĚŝĕĆŽʹϮϬϭϯʹϱϬϬĞdžĞŵƉůĂƌĞƐ
ElaboraĕĆŽ͕ĚŝƐƚƌŝďƵŝĕĆŽĞinformações Colaboradores
MINISTÉRIO DA SAÚDE ůĞŽŶŝĐĞůǀĞƐŽƐĂ
^ĞĐƌĞƚĂƌŝĂĚĞƚĞŶĕĆŽă^ĂƷĚĞ ĂŶŝĞůĂ&ĞƌŶĂŶĚĂDĂƌƋƵĞƐ
ĞƉĂƌƚĂŵĞŶƚŽĚĞĕƁĞƐWƌŽŐƌĂŵĄƟĐĂƐĞƐƚƌĂƚĠŐŝĐĂƐ &ĞƌŶĂŶĚĂWƌĂĚĂDĂĐŚĂĚŽ
ƌĞĂdĠĐŶŝĐĂĚĞ^ĂƷĚĞĚĂWĞƐƐŽĂĐŽŵĞĨŝĐŝġŶĐŝĂ :ĂĐLJWĞƌŝƐƐŝŶŽƚŽ
^&ͬ^Ƶů͕dƌĞĐŚŽϮ͕ĚŝİĐŝŽWƌĞŵŝƵŵ͕dŽƌƌĞϮ͕ďůŽĐŽ&͕ƚĠƌƌĞŽ͕ƐĂůĂϭϭ :ŽƐĠ^ĂůŽŵĆŽ^ĐŚǁĂƌƚnjŵĂŶ
W͗ϳϬϬϳϬͲϲϬϬʹƌĂƐşůŝĂͬ& DĂƌŝĂŵĠƌŝĐĂŽŝŵďƌĂĚĞŶĚƌĂĚĞ
Site:фǁǁǁ͘ƐĂƵĚĞ͘ŐŽǀ͘ďƌх DĂƌŝƐĂ&ƵƌŝĂ^ŝůǀĂ
E-‐mail: ƉĞƐƐŽĂĐŽŵĚĞĮĐŝĞŶĐŝĂΛƐĂƵĚĞ͘ŐŽǀ͘ďƌ ZŽŐĠƌŝŽ>ĞƌŶĞƌ
ZƵƚŚZĂŵĂůŚŽZƵŝǀŽWĂůůĂĚŝŶŽ
Coordenação ^ŝůǀŝĂDĂƌŝĂƌĐƵƌŝ
Diretrizes de Atenção
ĄƌŝŽ&ƌĞĚĞƌŝĐŽWĂƐĐŚĞ
sĞƌĂ>ƷĐŝĂ&ĞƌƌĞŝƌĂDĞŶĚĞƐ WƌŽũĞƚŽ'ƌĄĮĐŽĞĚŝĂŐƌĂŵĂĕĆŽ
ůŝƐƐŽŶ^ďƌĂŶĂ
Organização
Mariana Fernandes Campos Fotos
sĞƌĂ>ƷĐŝĂ&ĞƌƌĞŝƌĂDĞŶĚĞƐ ĐĞƌǀŽƌĞĂdĠĐŶŝĐĂĚĞ^ĂƷĚĞ
ĚĂWĞƐƐŽĂĐŽŵĞĨŝĐŝġŶĐŝĂ
Revisão Técnica͗
ĂƚĂůŽŐĂĕĆŽŶĂĨŽŶƚĞʹŽŽƌĚĞŶĂĕĆŽͲ'ĞƌĂůĚĞŽĐƵŵĞŶƚĂĕĆŽĞ/ŶĨŽƌŵĂĕĆŽʹĚŝƚŽƌĂD^ʹ
Títulos para indexação:
ŵŝŶŐůġƐ͗
ŵĞƐƉĂŶŚŽů͗
Brasília – DF
2013
2 3
Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
Prefácio
A ŽŶǀĞŶĕĆŽƐŽďƌĞŽƐŝƌĞŝƚŽƐĚĂWĞƐƐŽĂĐŽŵĞĮĐŝġŶĐŝĂ;Ez͕ϮϬϬϳͿ͕
ƉƌŽŵƵůŐĂĚĂƉĞůŽƐƚĂĚŽƌĂƐŝůĞŝƌŽƉĞůŽĚĞĐƌĞƚŽϲ͘ϵϰϵĞŵϮϱͬϬϴͬϬϵ͕
ƌĞƐƵůƚŽƵ ŶƵŵĂ ŵƵĚĂŶĕĂ ƉĂƌĂĚŝŐŵĄƟĐĂ ĚĂƐ ĐŽŶĚƵƚĂƐ ŽĨĞƌĞĐŝĚĂƐ ăƐ
WĞƐƐŽĂƐ ĐŽŵ ĞĮĐŝġŶĐŝĂ͕ ĞůĞŐĞŶĚŽ Ă ĂĐĞƐƐŝďŝůŝĚĂĚĞ ĐŽŵŽ ƉŽŶƚŽ
ĐĞŶƚƌĂůƉĂƌĂĂŐĂƌĂŶƟĂĚŽƐĚŝƌĞŝƚŽƐŝŶĚŝǀŝĚƵĂŝƐ͘ŽŶǀĞŶĕĆŽ͕ĞŵƐĞƵ
ĂƌƟŐŽ ϭǑ͕ ĂĮƌŵĂ ƋƵĞ Ă ƉĞƐƐŽĂ ĐŽŵ ĚĞĮĐŝġŶĐŝĂ Ġ ĂƋƵĞůĂ ƋƵĞ “ têm
ŝŵƉĞĚŝŵĞŶƚŽƐĚĞůŽŶŐŽƉƌĂnjŽ͕ĚĞŶĂƚƵƌĞnjĂİƐŝĐĂ͕ŵĞŶƚĂů͕ŝŶƚĞůĞĐƚƵĂů
ou sensorial, os quais, em interação com diversas barreiras, podem
ŽďƐƚƌƵŝƌƐƵĂƉĂƌƟĐŝƉĂĕĆŽƉůĞŶĂĞĞĨĞƟǀĂŶĂƐŽĐŝĞĚĂĚĞĞŵŝŐƵĂůĚĂĚĞ
de condições com as demais pessoas”.
ĞƐĚĞĞŶƚĆŽ͕ŽƐƚĂĚŽďƌĂƐŝůĞŝƌŽƚĞŵďƵƐĐĂĚŽ͕ƉŽƌŵĞŝŽĚĂĨŽƌŵƵůĂĕĆŽ
ĚĞ ƉŽůşƟĐĂƐ ƉƷďůŝĐĂƐ͕ ŐĂƌĂŶƟƌ Ă ĂƵƚŽŶŽŵŝĂ͖ Ă ĂŵƉůŝĂĕĆŽ ĚŽ ĂĐĞƐƐŽ
ă ƐĂƷĚĞ͖ ă ĞĚƵĐĂĕĆŽ͖ ĂŽ ƚƌĂďĂůŚŽ͕ ĞŶƚƌĞ ŽƵƚƌŽƐ͕ ĐŽŵ ŽďũĞƟǀŽ ĚĞ
ŵĞůŚŽƌĂƌ ĂƐ ĐŽŶĚŝĕƁĞƐ ĚĞ ǀŝĚĂ ĚĂƐ ƉĞƐƐŽĂƐ ĐŽŵ ĚĞĮĐŝġŶĐŝĂ͘ ŵ
ĚĞnjĞŵďƌŽĚĞϮϬϭϭĠůĂŶĕĂĚŽŽViver sem Limite: Plano Nacional de
ŝƌĞŝƚŽƐĚĂWĞƐƐŽĂĐŽŵĞĮĐŝġŶĐŝĂ;ĞĐƌĞƚŽϳ͘ϲϭϮĚĞϭϳͬϭϭͬϭϭͿĞ͕
ĐŽŵŽƉĂƌƚĞŝŶƚĞŐƌĂŶƚĞĚĞƐƚĞƉƌŽŐƌĂŵĂ͕ŽDŝŶŝƐƚĠƌŝŽĚĂ^ĂƷĚĞŝŶƐƟƚƵŝ
a ZĞĚĞĚĞƵŝĚĂĚŽƐă^ĂƷĚĞĚĂWĞƐƐŽĂĐŽŵĞĮĐŝġŶĐŝĂŶŽąŵďŝƚŽ
do SUS ;WŽƌƚĂƌŝĂ ϳϵϯ͕ ĚĞ ϮϰͬϬϰͬϭϮͿ͕ ĞƐƚĂďĞůĞĐĞŶĚŽ ĚŝƌĞƚƌŝnjĞƐ ƉĂƌĂ
Ž ĐƵŝĚĂĚŽ ăƐ ƉĞƐƐŽĂƐ ĐŽŵ ĚĞĮĐŝġŶĐŝĂ ƚĞŵƉŽƌĄƌŝĂ ŽƵ ƉĞƌŵĂŶĞŶƚĞ͖
ƉƌŽŐƌĞƐƐŝǀĂ͖ƌĞŐƌĞƐƐŝǀĂŽƵĞƐƚĄǀĞů͖ŝŶƚĞƌŵŝƚĞŶƚĞŽƵĐŽŶơŶƵĂ͘
4 5
Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
dĂŵďĠŵĞŵĐŽŶƐŽŶąŶĐŝĂĐŽŵĂŽŶǀĞŶĕĆŽƐŽďƌĞŽƐŝƌĞŝƚŽƐĚĂWĞƐƐŽĂ
ĐŽŵĞĮĐŝġŶĐŝĂ͕ŽŐŽǀĞƌŶŽďƌĂƐŝůĞŝƌŽŝŶƐƟƚƵŝĂWŽůşƟĐĂEĂĐŝŽŶĂůĚĞ
Proteção dos Direitos da Pessoa com Transtornos do Espectro do
ƵƟƐŵŽ ;>Ğŝ ϭϮ͘ϳϲϰ ĚĞ ϮϳͬϭϮͬϭϮͿ͕ ƐĞŶĚŽ ĞƐƚĂ ĐŽŶƐŝĚĞƌĂĚĂ WĞƐƐŽĂ
ĐŽŵĞĮĐŝġŶĐŝĂƉĂƌĂƚŽĚŽƐŽƐĞĨĞŝƚŽƐůĞŐĂŝƐ͘
Esta Diretriz Ġ Ƶŵ ĚŽƐ ƌĞƐƵůƚĂĚŽƐ ĚĂ ĐŽŶũƵŶĕĆŽ ĚĞ ĞƐĨŽƌĕŽƐ ĚĂ
ƐŽĐŝĞĚĂĚĞĐŝǀŝůĞĚŽŐŽǀĞƌŶŽďƌĂƐŝůĞŝƌŽ͘ŽŽƌĚĞŶĂĚŽƉĞůŽDŝŶŝƐƚĠƌŝŽĚĂ
^ĂƷĚĞ͕ƵŵŐƌƵƉŽĚĞƉĞƐƋƵŝƐĂĚŽƌĞƐĞĞƐƉĞĐŝĂůŝƐƚĂƐĞǀĄƌŝĂƐĞŶƟĚĂĚĞƐ͕
ĞůĂďŽƌŽƵ Ž ŵĂƚĞƌŝĂů ĂƋƵŝ ĂƉƌĞƐĞŶƚĂĚŽ͕ ŽĨĞƌĞĐĞŶĚŽ ŽƌŝĞŶƚĂĕƁĞƐ
ƌĞůĂƟǀĂƐ ĂŽ ĐƵŝĚĂĚŽ ă ƐĂƷĚĞ ĚĂƐ WĞƐƐŽĂƐ ĐŽŵ dƌĂŶƐƚŽƌŶŽƐ ĚŽ
ƐƉĞĐƚƌŽĚŽƵƟƐŵŽ͕ŶŽĐĂŵƉŽĚĂŚĂďŝůŝƚĂĕĆŽͬƌĞĂďŝůŝƚĂĕĆŽŶĂZĞĚĞ
ĚĞƵŝĚĂĚŽƐăWĞƐƐŽĂĐŽŵĞĮĐŝġŶĐŝĂ͘
sĂůĞ ĂŝŶĚĂ ƐĂůŝĞŶƚĂƌ ƋƵĞ ƉĂƌĂ ƋƵĞ Ă ĂƚĞŶĕĆŽ ŝŶƚĞŐƌĂů ă ƉĞƐƐŽĂ ĐŽŵ
ƚƌĂŶƐƚŽƌŶŽ ĚŽ ĞƐƉĞĐƚƌŽ ĚŽ ĂƵƟƐŵŽ ƐĞũĂ ĞĨĞƟǀĂ͕ ĂƐ ĂĕƁĞƐ ĂƋƵŝ
ĂŶƵŶĐŝĂĚĂƐĚĞǀĞŵĞƐƚĂƌĂƌƟĐƵůĂĚĂƐĂŽƵƚƌŽƐƉŽŶƚŽƐĚĞƚĞŶĕĆŽĚĂ
ZĞĚĞ^h^;ĂƚĞŶĕĆŽďĄƐŝĐĂ͕ĞƐƉĞĐŝĂůŝnjĂĚĂĞŚŽƐƉŝƚĂůĂƌͿ͕ďĞŵĐŽŵŽŽƐ
ƐĞƌǀŝĕŽƐĚĞƉƌŽƚĞĕĆŽƐŽĐŝĂů;ĐĞŶƚƌŽƐĚŝĂ͕ƌĞƐŝĚġŶĐŝĂƐŝŶĐůƵƐŝǀĂƐ͕Z^
ĞZ^Ϳ͕ĞĚĞĞĚƵĐĂĕĆŽ͘
6 7
Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
SUMÁRIO
1 OBJETIVO 10
2 METODOLOGIA 12
3 INTRODUÇÃO 14
4 INDICADORES DO DESENVOLVIMENTO E SINAIS DE ALERTA 20
5 INSTRUMENTOS DE RASTREAMENTO 30
6 COMPORTAMENTOS ATÍPICOS, REPETITIVOS E
ESTEREOTIPADOS COMO INDICADORES DA PRESENÇA DE TEA 33
7 DIRETRIZES DIAGNÓSTICAS DOS TEA 37
8 O MOMENTO DA NOTÍCIA DO DIAGNÓSTICO DE TEA 54
9 PROJETO TERAPÊUTICO SINGULAR: HABILITAÇÃO/
REABILITAÇÃO DA PESSOA COM TEA 57
10 APOIO E ACOLHIMENTO À FAMÍLIA DA PESSOA COM TEA 64
11 FLUXOGRAMA DE ACOMPANHAMENTO E ATENDIMENTO
DA PESSOA COM TEA NA REDE SUS 66
REFERÊNCIAS 69
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Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
1 Objetivo
10 11
Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
2 Metodologia
ĞůĂďŽƌĂĕĆŽ ĚĂƐ ŝƌĞƚƌŝnjĞƐ ĚĞ ƚĞŶĕĆŽ ă ZĞĂďŝůŝƚĂĕĆŽ ĚĂ WĞƐƐŽĂ
ĐŽŵ dƌĂŶƐƚŽƌŶŽƐ ĚŽ ƐƉĞĐƚƌŽ ĚŽ ƵƟƐŵŽ ĨŽŝ ƵŵĂ ĂĕĆŽ ĐŽŶũƵŶƚĂ
ĚĞ ƉƌŽĮƐƐŝŽŶĂŝƐ͕ ƉĞƐƋƵŝƐĂĚŽƌĞƐ Ğ ĞƐƉĞĐŝĂůŝƐƚĂƐ͕ ĐŽŵ ĞdžƉĞƌŝġŶĐŝĂ
ƌĞĐŽŶŚĞĐŝĚĂ Ğŵ ĚŝǀĞƌƐĂƐ ƉƌŽĮƐƐƁĞƐ ĚĂ ƐĂƷĚĞ Ğ ƉĞƌƚĞŶĐĞŶƚĞƐ Ă
^ŽĐŝĞĚĂĚĞƐ ŝĞŶơĮĐĂƐ Ğ WƌŽĮƐƐŝŽŶĂŝƐ͘ ƐƐĞ ŐƌƵƉŽ ĐŽŶƚŽƵ ƚĂŵďĠŵ
ĐŽŵƵŵƌĞƉƌĞƐĞŶƚĂŶƚĞĚĂƐŽĐŝĞĚĂĚĞĐŝǀŝů͘
12 13
Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
ƐŝŶĂŝƐĞƐŝŶƚŽŵĂƐĚĞƉĞŶĚĞŶĚŽĚĂĐůĂƐƐŝĮĐĂĕĆŽĚŝĂŐŶſƐƟĐĂĂĚŽƚĂĚĂĂ
ƉĂƌƟƌĚŽƐĚŽŝƐƐŝŶĂŝƐďĄƐŝĐŽƐĞƐƚĂďĞůĞĐŝĚŽƐƉŽƌ<ĂŶŶĞƌ͘
3 Introdução
K ĐŽŶĐĞŝƚŽ ĚŽ ƵƟƐŵŽ /ŶĨĂŶƟů ;/Ϳ͕ ƉŽƌƚĂŶƚŽ͕ ƐĞ ŵŽĚŝĮĐŽƵ ĚĞƐĚĞ
3.1 Histórico ƐƵĂ ĚĞƐĐƌŝĕĆŽ ŝŶŝĐŝĂů͕ ƉĂƐƐĂŶĚŽ Ă ƐĞƌ ĂŐƌƵƉĂĚŽ Ğŵ Ƶŵ ĐŽŶơŶƵŽ ĚĞ
ĐŽŶĚŝĕƁĞƐ ĐŽŵ ĂƐ ƋƵĂŝƐ ŐƵĂƌĚĂ ǀĄƌŝĂƐ ƐŝŵŝůĂƌŝĚĂĚĞƐ͕ ƋƵĞ ƉĂƐƐĂƌĂŵ
K ƚĞƌŵŽ ͞ĂƵƟƐŵŽ͟ ĨŽŝ ŝŶƚƌŽĚƵnjŝĚŽ ŶĂ ƉƐŝƋƵŝĂƚƌŝĂ ƉŽƌ WůŽƵůůĞƌ͕ Ğŵ
Ă ƐĞƌ ĚĞŶŽŵŝŶĂĚĂƐ ĚĞ dƌĂŶƐƚŽƌŶŽƐ 'ůŽďĂŝƐ ;ŽƵ /ŶǀĂƐŝǀŽƐͿ ĚŽ
ϭϵϬϲ͕ĐŽŵŽŝƚĞŵĚĞƐĐƌŝƟǀŽĚŽƐŝŶĂůĐůşŶŝĐŽĚĞŝƐŽůĂŵĞŶƚŽ;ĞŶĐĞŶĂĚŽ
ĞƐĞŶǀŽůǀŝŵĞŶƚŽ ;d'Ϳ͘ DĂŝƐ ƌĞĐĞŶƚĞŵĞŶƚĞ͕ ĚĞŶŽŵŝŶĂƌĂŵͲƐĞ ŽƐ
ƉĞůĂƌĞƉĞƟĕĆŽĚĂĂƵƚŽͲƌĞĨĞƌġŶĐŝĂͿĨƌĞƋƵĞŶƚĞĞŵĂůŐƵŶƐĐĂƐŽƐ͘
dƌĂŶƐƚŽƌŶŽƐĚŽƐƉĞĐƚƌŽĚŽƵƟƐŵŽ;dͿƉĂƌĂƐĞƌĞĨĞƌŝƌĂƵŵĂƉĂƌƚĞ
ĚŽƐd'͗ŽƵƟƐŵŽ͖Ă^şŶĚƌŽŵĞĚĞƐƉĞƌŐĞƌ͖ĞŽdƌĂŶƐƚŽƌŶŽ'ůŽďĂů
ŵ ϭϵϰϯ͕ <ĂŶŶĞƌ ƌĞĨŽƌŵƵůŽƵ Ž ƚĞƌŵŽ ĐŽŵŽ ĚŝƐƚƷƌďŝŽ ĂƵơƐƟĐŽ ĚŽ
ĚŽĞƐĞŶǀŽůǀŝŵĞŶƚŽƐĞŵKƵƚƌĂƐƉĞĐŝĮĐĂĕĆŽ͕ƉŽƌƚĂŶƚŽŶĆŽŝŶĐůƵŝŶĚŽ
ĐŽŶƚĂƚŽ ĂĨĞƟǀŽ͕ ĚĞƐĐƌĞǀĞŶĚŽ ƵŵĂ ƐşŶĚƌŽŵĞ ĐŽŵ Ž ŵĞƐŵŽ ƐŝŶĂů
^şŶĚƌŽŵĞĚĞZĞƩĞdƌĂŶƐƚŽƌŶŽĞƐŝŶƚĞŐƌĂƟǀŽĚĂ/ŶĨąŶĐŝĂ͘
ĐůşŶŝĐŽĚĞŝƐŽůĂŵĞŶƚŽ͕ĞŶƚĆŽŽďƐĞƌǀĂĚŽŶƵŵŐƌƵƉŽĚĞĐƌŝĂŶĕĂƐĐŽŵ
ŝĚĂĚĞƐǀĂƌŝĂŶĚŽĞŶƚƌĞϮĂŶŽƐĞϰŵĞƐĞƐĂϭϭĂŶŽƐ͘ůĞĂƉƌĞƐĞŶƚŽƵĂƐ
K ĂƵƟƐŵŽ Ġ ĐŽŶƐŝĚĞƌĂĚŽ ƵŵĂ ƐşŶĚƌŽŵĞ ŶĞƵƌŽƉƐŝƋƵŝĄƚƌŝĐĂ͘ ŵďŽƌĂ
ƐĞŐƵŝŶƚĞƐĐĂƌĂĐƚĞƌşƐƟĐĂƐ͕ĐŽŵŽƉĂƌƚĞĚŽƋƵĂĚƌŽĐůşŶŝĐŽƋƵĞũƵƐƟĮĐĂǀĂ
ƵŵĂĞƟŽůŽŐŝĂĞƐƉĞĐşĮĐĂŶĆŽƚĞŶŚĂƐŝĚŽŝĚĞŶƟĮĐĂĚĂ͕ĞƐƚƵĚŽƐƐƵŐĞƌĞŵ
ĂĚĞƚĞƌŵŝŶĂĕĆŽĚĞƵŵƚƌĂŶƐƚŽƌŶŽĚŽĚĞƐĞŶǀŽůǀŝŵĞŶƚŽ͗ϭͿĞdžƚƌĞŵĂ
ĂƉƌĞƐĞŶĕĂĚĞĂůŐƵŶƐĨĂƚŽƌĞƐŐĞŶĠƟĐŽƐĞŶĞƵƌŽďŝŽůſŐŝĐŽƐƋƵĞƉŽĚĞŵ
ĚŝĮĐƵůĚĂĚĞ ƉĂƌĂ ĞƐƚĂďĞůĞĐĞƌ ǀşŶĐƵůŽƐ ĐŽŵ ƉĞƐƐŽĂƐ ŽƵ ƐŝƚƵĂĕƁĞƐ͖
ĞƐƚĂƌ ĂƐƐŽĐŝĂĚŽƐ ĂŽ ĂƵƟƐŵŽ ;ĂŶŽŵĂůŝĂ ĂŶĂƚƀŵŝĐĂ ŽƵ ĮƐŝŽůſŐŝĐĂ
ϮͿ ĂƵƐġŶĐŝĂ ĚĞ ůŝŶŐƵĂŐĞŵ ŽƵ ŝŶĐĂƉĂĐŝĚĂĚĞ ŶŽ ƵƐŽ ƐŝŐŶŝĮĐĂƟǀŽ ĚĂ
ĚŽ ^E͖ ƉƌŽďůĞŵĂƐ ĐŽŶƐƟƚƵĐŝŽŶĂŝƐ ŝŶĂƚŽƐ͕ ƉƌĞĚĞƚĞƌŵŝŶĂĚŽƐ
ůŝŶŐƵĂŐĞŵ͖ ϯͿ ďŽĂ ŵĞŵſƌŝĂ ŵĞĐąŶŝĐĂ͖ ϰͿ ĞĐŽůĂůŝĂ1͖ ϱͿ ƌĞƉĞƟĕĆŽ ĚĞ
ďŝŽůŽŐŝĐĂŵĞŶƚĞͿ͘ &ĂƚŽƌĞƐ ĚĞ ƌŝƐĐŽ ƉƐŝĐŽƐƐŽĐŝĂŝƐ ƚĂŵďĠŵ ĨŽƌĂŵ
ƉƌŽŶŽŵĞƐ ƐĞŵ ƌĞǀĞƌƐĆŽ͖ ϲͿ ƌĞĐƵƐĂ ĚĞ ĐŽŵŝĚĂ͖ ϳͿ ƌĞĂĕĆŽ ĚĞ ŚŽƌƌŽƌ
ĂƐƐŽĐŝĂĚŽƐ͘ EĂƐ ĚŝĨĞƌĞŶƚĞƐ ĞdžƉƌĞƐƐƁĞƐ ĚŽ ƋƵĂĚƌŽ ĐůşŶŝĐŽ͕ ĚŝǀĞƌƐŽƐ
Ă ƌƵşĚŽƐ ĨŽƌƚĞƐ Ğ ŵŽǀŝŵĞŶƚŽƐ ďƌƵƐĐŽƐ͖ ϴͿ ƌĞƉĞƟĕĆŽ ĚĞ ĂƟƚƵĚĞƐ͖ ϵͿ
ƐŝŶĂŝƐĞƐŝŶƚŽŵĂƐƉŽĚĞŵĞƐƚĂƌŽƵŶĆŽƉƌĞƐĞŶƚĞƐ͕ŵĂƐĂƐĐĂƌĂĐƚĞƌşƐƟĐĂƐ
ŵĂŶŝƉƵůĂĕĆŽĚĞŽďũĞƚŽƐ͕ĚŽƟƉŽŝŶĐŽƌƉŽƌĂĕĆŽ͖ϭϬͿİƐŝĐŽŶŽƌŵĂů͖ϭϭͿ
ĚĞŝƐŽůĂŵĞŶƚŽĞŝŵƵƚĂďŝůŝĚĂĚĞĚĞĐŽŶĚƵƚĂƐĞƐƚĆŽƐĞŵƉƌĞƉƌĞƐĞŶƚĞƐ͘
ĨĂŵşůŝĂŶŽƌŵĂů͘
KƋƵĂĚƌŽ͕ŝŶŝĐŝĂůŵĞŶƚĞ͕ĨŽŝĐůĂƐƐŝĮĐĂĚŽŶŽŐƌƵƉŽĚĂƐƉƐŝĐŽƐĞƐŝŶĨĂŶƟƐ͘
EĂ ƚĞŶƚĂƟǀĂ ĚĞ ĚŝĨĞƌĞŶĐŝĂĕĆŽ ĚĂ ĞƐƋƵŝnjŽĨƌĞŶŝĂ ĚĞ ŝŶşĐŝŽ ƉƌĞĐŽĐĞ͕
ŵϭϵϱϲ͕ĞůĞĞůĞŐĞĚŽŝƐƐŝŶĂŝƐĐŽŵŽďĄƐŝĐŽƐƉĂƌĂĂŝĚĞŶƟĮĐĂĕĆŽĚŽ
ƉƌĞǀĂůĞĐĞƵŽĐŽŶĐĞŝƚŽĚĞƋƵĞŽƐƐŝŶĂŝƐĞƐŝŶƚŽŵĂƐĚĞǀĞŵƐƵƌŐŝƌĂŶƚĞƐ
ƋƵĂĚƌŽ͗ŽŝƐŽůĂŵĞŶƚŽĞĂŝŵƵƚĂďŝůŝĚĂĚĞĞĐŽŶĮƌŵĂĂŶĂƚƵƌĞnjĂŝŶĂƚĂ
ĚŽƐϬϯĂŶŽƐĚĞŝĚĂĚĞ͕ĞŽƐƚƌġƐƉƌŝŶĐŝƉĂŝƐŐƌƵƉŽƐĚĞĐĂƌĂĐƚĞƌşƐƟĐĂƐ
ĚŽĚŝƐƚƷƌďŝŽ͘KƋƵĂĚƌŽĚŽĂƵƟƐŵŽƉĂƐƐŽƵ͕ĚĞƐĚĞĞŶƚĆŽ͕ĂƐĞƌƌĞĨĞƌŝĚŽ
ƐĆŽ͗ ƉƌŽďůĞŵĂƐ ĐŽŵ Ă ůŝŶŐƵĂŐĞŵ͖ ƉƌŽďůĞŵĂƐ ŶĂ ŝŶƚĞƌĂĕĆŽ ƐŽĐŝĂů͖ Ğ
ƉŽƌ ĚŝĨĞƌĞŶƚĞƐ ĚĞŶŽŵŝŶĂĕƁĞƐ͕ ƚĞŶĚŽ ƐŝĚŽ ĚĞƐĐƌŝƚŽ ƉŽƌ ĚŝĨĞƌĞŶƚĞƐ
ƉƌŽďůĞŵĂƐŶŽƌĞƉĞƌƚſƌŝŽĚĞĐŽŵƉŽƌƚĂŵĞŶƚŽƐ;ƌĞƐƚƌŝƚŽĞƌĞƉĞƟƟǀŽͿ͕
1 Genericamente, a ecolalia se caracteriza pela repetição sistemática de
palavras ou sílabas do enunciado do interlocutor. ŽƋƵĞŝŶĐůƵŝĂůƚĞƌĂĕƁĞƐŶŽƐƉĂĚƌƁĞƐĚŽƐŵŽǀŝŵĞŶƚŽƐ͘
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^ĞŶĚŽ ĂƐƐŝŵ͕ ĚƵĂƐ ƋƵĞƐƚƁĞƐ ƚŽƌŶĂƌĂŵͲƐĞ ĞǀŝĚĞŶƚĞƐ͗ Ă ŝŵƉŽƌƚąŶĐŝĂ EŽ ƌĂƐŝů͕ ŽƐ ĞƐƚƵĚŽƐ ĞƉŝĚĞŵŝŽůſŐŝĐŽƐ ƐĆŽ ĞƐĐĂƐƐŽƐ͘ EŽ WƌŝŵĞŝƌŽ
ĚĂ ĚĞƚĞĐĕĆŽ ƉƌĞĐŽĐĞ Ğ Ă ŶĞĐĞƐƐŝĚĂĚĞ ĚŽ ĚŝĂŐŶſƐƟĐŽ ĚŝĨĞƌĞŶĐŝĂů͘ ŶĐŽŶƚƌŽƌĂƐŝůĞŝƌŽƉĂƌĂWĞƐƋƵŝƐĂĞŵƵƟƐŵŽ;WͲŚƩƉ͗ͬͬǁǁǁϲ͘
ƉƌŝŵĞŝƌĂƐĞƌĞĨĞƌĞĂƵŵĂŵĞůŚŽƌĚĞĮŶŝĕĆŽĚĞƐŝŶĂŝƐ͕ŽƵĂŝŶĚĂ͕ĂƵŵĂ ƵĨƌŐƐ͘ďƌͬĞďƉĂϮϬϭϬͬͿ͕&ŽŵďŽŶŶĞ;ϮϬϭϬͿĞƐƟŵŽƵƵŵĂƉƌĞǀĂůġŶĐŝĂĚĞ
ƉŽƐƐŝďŝůŝĚĂĚĞ ĚĞ ŝĚĞŶƟĮĐĂĕĆŽ ĚŽƐ ŵĞƐŵŽƐ ŶŽ ƉĞƌşŽĚŽ Ğŵ ƋƵĞ Ă ĂƉƌŽdžŝŵĂĚĂŵĞŶƚĞϱϬϬŵŝůƉĞƐƐŽĂƐĐŽŵĂƵƟƐŵŽĞŵąŵďŝƚŽŶĂĐŝŽŶĂů͕
ĐŽŵƵŶŝĐĂĕĆŽĞĞdžƉƌĞƐƐĆŽŝŶĚŝǀŝĚƵĂůĞƐŽĐŝĂůĐŽŵĞĕĂŵĂƐĞŵŽůĚĂƌ͗ ďĂƐĞĂŶĚŽͲƐĞŶŽĞŶƐŽĚĞϮϬϬϬ͘ĞŶƚƌĞŽƐƉŽƵĐŽƐĞƐƚƵĚŽƐƌĞĂůŝnjĂĚŽƐ͕
ƉƌŝŵĞŝƌŽƐ ŵĞƐĞƐ ĚĞ ǀŝĚĂ͘ EĞƐƐĞ ƉŽŶƚŽ ǀĂůĞ ƵŵĂ ŽďƐĞƌǀĂĕĆŽ͗ Ă ŚĄ Ƶŵ ƉŝůŽƚŽ ;Ğ WĂƵůĂ͕ ZŝďĞŝƌŽ͕ &ŽŵďŽŶŶĞ Ğ DĞƌĐĂĚĂŶƚĞ͕ ϮϬϭϭͿ
ŝŵƉŽƌƚąŶĐŝĂĂƚƌŝďƵşĚĂăĚŝŵĞŶƐĆŽŝŶƚĞůĞĐƚƵĂůƐĞĚĄĞŵĚĞƚƌŝŵĞŶƚŽĚŽ ƌĞĂůŝnjĂĚŽ Ğŵ ƵŵĂ ĐŝĚĂĚĞ ďƌĂƐŝůĞŝƌĂ͕ ƋƵĞ ĂƉŽŶƚŽƵ ƵŵĂ ƉƌĞǀĂůġŶĐŝĂ
ĞƐƚƵĚŽĚĂůŝŶŐƵĂŐĞŵĚĞƐƐĂƐƉĞƐƐŽĂƐ͕ƋƵĞĂƉĂƌĞĐĞĚĞĨŽƌŵĂŐĞŶĠƌŝĐĂ ĚĞ ĂƉƌŽdžŝŵĂĚĂŵĞŶƚĞ Ϭ͕ϯй ĚĞ ƉĞƐƐŽĂƐ ĐŽŵ ƚƌĂŶƐƚŽƌŶŽƐ ŐůŽďĂŝƐ
ŶŽƐĂƉŽŶƚĂŵĞŶƚŽƐƐŽďƌĞĐŽŵƵŶŝĐĂĕĆŽ͕ƉƌŝǀŝůĞŐŝĂĚĂƉĂƌĂĚĞƐĐƌĞǀĞƌŽ ĚŽ ĚĞƐĞŶǀŽůǀŝŵĞŶƚŽ͘ Ğ ĂĐŽƌĚŽ ĐŽŵ ŽƐ ƉƌſƉƌŝŽƐ ĂƵƚŽƌĞƐ͕ ĚĂĚĂ Ă
ƐŝŶƚŽŵĂďĄƐŝĐŽĚŽŝƐŽůĂŵĞŶƚŽ͘WŽƌƚĂŶƚŽ͕ĨĂnjͲƐĞŶĞĐĞƐƐĄƌŝĂĂĚĞĮŶŝĕĆŽ ƉŽƵĐĂ ĂďƌĂŶŐġŶĐŝĂ ĚĂ ƉĞƐƋƵŝƐĂ͕ ŶĆŽ ĞdžŝƐƚĞŵ ĂŝŶĚĂ ĞƐƟŵĂƟǀĂƐ ĚĞ
ĚĞ ŝŶĚŝĐĂĚŽƌĞƐ ĚĞ ƌŝƐĐŽ ƉĂƌĂ Ž ƋƵĂĚƌŽ͕ Ğŵ ǀĄƌŝĂƐ ĚŝŵĞŶƐƁĞƐ͘ ƉƌĞǀĂůġŶĐŝĂĐŽŶĮĄǀĞŝƐĞŵŶŽƐƐŽƉĂşƐ͘
ƐĞŐƵŶĚĂ ƋƵĞƐƚĆŽ ƐĞ ƌĞĨĞƌĞ ă ĐŽŶƐƚƌƵĕĆŽ ĚĞ ƉƌŽƚŽĐŽůŽƐ ĞĐŽŶƀŵŝĐŽƐ
Ğ ĞĮĐŝĞŶƚĞƐ ĚĞ ĚŝĂŐŶſƐƟĐŽ Ğ ƚƌĂƚĂŵĞŶƚŽ͕ ƐĞƉĂƌĂŶĚŽ ŽƐ ĐĂƐŽƐ
ĚĞ ƚƌĂŶƐƚŽƌŶŽƐ ĚŽ ĞƐƉĞĐƚƌŽ ĚŽ ĂƵƟƐŵŽ ĚĞ Ƶŵ ƋƵĂĚƌŽ ŐĞƌĂů ĚŽƐ
ƚƌĂŶƐƚŽƌŶŽƐĚŽĚĞƐĞŶǀŽůǀŝŵĞŶƚŽ͕ĐŽŵŽŵĞĚŝĚĂĚĞĂũƵƐƚĞăƌĞĚĞĚĞ
3.3 Classificação e descrição
ĐƵŝĚĂĚŽƐăƐĂƷĚĞŶĞƐƐĞƐĐĂƐŽƐ͘
KƐ ƐŝƐƚĞŵĂƐ ŝŶƚĞƌŶĂĐŝŽŶĂůŵĞŶƚĞ ƵƟůŝnjĂĚŽƐ ŶĂ ĐůĂƐƐŝĮĐĂĕĆŽ ĚĞƐƐĞ
ƋƵĂĚƌŽ ƐĆŽ Ž ſĚŝŐŽ /ŶƚĞƌŶĂĐŝŽŶĂů ĚĂƐ ŽĞŶĕĂƐ Ğ WƌŽďůĞŵĂƐ
ZĞůĂĐŝŽŶĂĚŽƐ ă ^ĂƷĚĞ ;/ͲϭϬͿ Ğ Ž ſĚŝŐŽ /ŶƚĞƌŶĂĐŝŽŶĂů ĚĞ
3.2 Epidemiologia &ƵŶĐŝŽŶĂůŝĚĂĚĞƐ;/&Ϳ͘
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ŽĂƵƟƐŵŽĂơƉŝĐŽ;&ϴϰͲϭͿ͕ x ƵŝĚĂĚŽWĞƐƐŽĂů
ĂƐşŶĚƌŽŵĞĚĞZĞƩ;&ϴϰͲϮͿ͕ x sŝĚĂŽŵĠƐƟĐĂ
ĂƐşŶĚƌŽŵĞĚĞƐƉĞŐĞƌ;&ϴϰͲϱͿ͕ x ZĞůĂĕƁĞƐĞ/ŶƚĞƌĂĕƁĞƐ/ŶƚĞƌƉĞƐƐŽĂŝƐ
ŽdƌĂŶƐƚŽƌŶŽĚĞƐŝŶƚĞŐƌĂƟǀŽĚĂ/ŶĨĂŶĐŝĂ;&ϴϰͲϯͿĞ x ƌĞĂƐWƌŝŶĐŝƉĂŝƐĚĂsŝĚĂ
ŽdƌĂŶƐƚŽƌŶŽ'ĞƌĂůĚŽĚĞƐĞŶǀŽůǀŝŵĞŶƚŽŶĆŽĞƐƉĞĐŝĮĐĂĚŽ;&ϴϰͲϵͿ͘ x sŝĚĂŽŵƵŶŝƚĄƌŝĂ͕^ŽĐŝĂůĞşǀŝĐĂ
EŽƚĞͲƐĞ ƋƵĞ͕ ŶĞƐƐĂ ŵĞƐŵĂ ƐƵďƉĂƌƚĞ͕ ƐĞ ĂůŽĐĂŵ͗ ƉƌŽďůĞŵĂƐ ŶŽ /& ƉĞƌŵŝƚĞ Ă ŝĚĞŶƟĮĐĂĕĆŽ ĚĞ ĨĂĐŝůŝƚĂĚŽƌĞƐ Ğ ďĂƌƌĞŝƌĂƐ ĚĞŶƚƌĞ ŽƐ
ĚĞƐĞŶǀŽůǀŝŵĞŶƚŽ ĚĞ ĨĂůĂ Ğ ůŝŶŐƵĂŐĞŵ ;&ͲϴϬͿ͖ ŶŽ ĚĞƐĞŶǀŽůǀŝŵĞŶƚŽ &ĂƚŽƌĞƐ ŵďŝĞŶƚĂŝƐ ;İƐŝĐŽ͕ ƐŽĐŝĂů Ğ ĚĞ ĂƟƚƵĚĞͿ ƉĞĐƵůŝĂƌĞƐ Ă ĐĂĚĂ
ĚĂƐ ŚĂďŝůŝĚĂĚĞƐ ĞƐĐŽůĂƌĞƐ ;&ͲϴϭͿ͖ Ğ ŶŽ ĚĞƐĞŶǀŽůǀŝŵĞŶƚŽ ŵŽƚŽƌ ƉĞƐƐŽĂĞŵĚŝĨĞƌĞŶƚĞƐŵŽŵĞŶƚŽƐĚĂǀŝĚĂ͗
;&ͲϴϮͿ͕ ĐŽŵƉŽŶĚŽ ƵŵĂ ĐůĂƐƐŝĮĐĂĕĆŽ ŐĞƌĂů ĚŽƐ ƉƌŽďůĞŵĂƐ ĚŽ
desenvolvimento. x WƌŽĚƵƚŽƐĞdĞĐŶŽůŽŐŝĂ;Ğdž͗͘ŵĞĚŝĐĂŵĞŶƚŽƐ͖ƉƌſƚĞƐĞƐͿ
x dĂƌĞĨĂƐĞĞŵĂŶĚĂƐ'ĞƌĂŝƐ
x ŽŵƵŶŝĐĂĕĆŽ
x DŽďŝůŝĚĂĚĞ
18 19
Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
4 Indicadores do desenvolvimento e
sinais de alerta
ŝĚĞŶƟĮĐĂĕĆŽĚĞƐŝŶĂŝƐŝŶŝĐŝĂŝƐĚĞƉƌŽďůĞŵĂƐƉŽƐƐŝďŝůŝƚĂĂŝŶƐƚĂƵƌĂĕĆŽ
ŝŵĞĚŝĂƚĂĚĞŝŶƚĞƌǀĞŶĕƁĞƐĞdžƚƌĞŵĂŵĞŶƚĞŝŵƉŽƌƚĂŶƚĞƐ͕ƵŵĂǀĞnjƋƵĞŽƐ
ƌĞƐƵůƚĂĚŽƐƉŽƐŝƟǀŽƐĞŵƌĞƐƉŽƐƚĂĂƚĞƌĂƉŝĂƐƐĆŽƚĆŽŵĂŝƐƐŝŐŶŝĮĐĂƟǀŽƐ
ƋƵĂŶƚŽ ŵĂŝƐ ƉƌĞĐŽĐĞŵĞŶƚĞ ŝŶƐƟƚƵşĚŽƐ͘ ŵĂŝŽƌ ƉůĂƐƟĐŝĚĂĚĞ ĚĂƐ
ĞƐƚƌƵƚƵƌĂƐ ĂŶĄƚŽŵŽͲĮƐŝŽůſŐŝĐĂƐ ĚŽ ĐĠƌĞďƌŽ ŶŽƐ ƉƌŝŵĞŝƌŽƐ ĂŶŽƐ ĚĞ
ǀŝĚĂ͕ ďĞŵ ĐŽŵŽ Ž ƉĂƉĞů ĨƵŶĚĂŵĞŶƚĂů ĚĂƐ ĞdžƉĞƌŝġŶĐŝĂƐ ĚĞ ǀŝĚĂ ĚĞ
Ƶŵ ďĞďġ͕ ƉĂƌĂ Ž ĨƵŶĐŝŽŶĂŵĞŶƚŽ ĚĂƐ ĐŽŶĞdžƁĞƐ ŶĞƵƌŽŶĂŝƐ Ğ ƉĂƌĂ Ă
ĐŽŶƐƟƚƵŝĕĆŽƉƐŝĐŽƐƐŽĐŝĂů͕ƚŽƌŶĂŵĞƐƚĞƉĞƌşŽĚŽƵŵŵŽŵĞŶƚŽƐĞŶƐşǀĞů
Ğ ƉƌŝǀŝůĞŐŝĂĚŽ ƉĂƌĂ ŝŶƚĞƌǀĞŶĕƁĞƐ͘ ƐƐŝŵ͕ ĂƐ ŝŶƚĞƌǀĞŶĕƁĞƐ ƉƌĞĐŽĐĞƐ
ĞŵĐĂƐŽƐĚĞdƚġŵŵĂŝŽƌĞĮĐĄĐŝĂĞĐŽŶƚĞŵƉůĂŵŵĂŝŽƌĞĐŽŶŽŵŝĂ͕
ĚĞǀĞŶĚŽƐĞƌƉƌŝǀŝůĞŐŝĂĚĂƐƉĞůŽƐƉƌŽĮƐƐŝŽŶĂŝƐ͘
,ĄƵŵĂŶĞĐĞƐƐŝĚĂĚĞĐƌĞƐĐĞŶƚĞĚĞƉŽƐƐŝďŝůŝƚĂƌĂŝĚĞŶƟĮĐĂĕĆŽƉƌĞĐŽĐĞ
ĚĞƐƐĞƋƵĂĚƌŽĐůşŶŝĐŽƉĂƌĂƋƵĞĐƌŝĂŶĕĂƐĐŽŵdƉŽƐƐĂŵƚĞƌĂĐĞƐƐŽ
Ă ĂĕƁĞƐ Ğ ƉƌŽŐƌĂŵĂƐ ĚĞ ŝŶƚĞƌǀĞŶĕĆŽ Ž ƋƵĂŶƚŽ ĂŶƚĞƐ͘ ^ĂďĞͲƐĞ ƋƵĞ
ŵĂŶŝĨĞƐƚĂĕƁĞƐĚŽƋƵĂĚƌŽƐŝŶƚŽŵĂƚŽůſŐŝĐŽĚĞǀĞŵĞƐƚĂƌƉƌĞƐĞŶƚĞƐĂƚĠ
ŽƐ ƚƌġƐ ĂŶŽƐ ĚĞ ŝĚĂĚĞ ĚĂ ĐƌŝĂŶĕĂ͕ ĨĂƚŽƌ ƋƵĞ ĨĂǀŽƌĞĐĞ Ž ĚŝĂŐŶſƐƟĐŽ
ƉƌĞĐŽĐĞ͘
20 21
Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
ƐƐŝŵ͕ ŝŶǀĞŶƚĄƌŝŽƐ ĚĞ ĚĞƐĞŶǀŽůǀŝŵĞŶƚŽ ĚĂƐ ĐŽŵƉĞƚġŶĐŝĂƐ Ğ /ŶĚŝĐĂĚŽƌĞƐĚŽĞƐĞŶǀŽůǀŝŵĞŶƚŽ Sinais de Alerta para
ŚĂďŝůŝĚĂĚĞƐ͕ĞĚĞƐŝŶĂŝƐĚĞĂůĞƌƚĂƉĂƌĂƉƌŽďůĞŵĂƐƐĆŽƵŵŝŵƉŽƌƚĂŶƚĞ /ŶĨĂŶƟů TEA
WŽƌǀŽůƚĂĚŽƐϯŵĞƐĞƐĚĞŝĚĂĚĞĐƌŝĂŶĕĂƐ ƌŝĂŶĕĂĐŽŵdƉŽĚĞ
ŵĂƚĞƌŝĂů ƉĂƌĂ ŝŶƐƚƌƵŵĞŶƚĂůŝnjĂƌ ĂƐ ĞƋƵŝƉĞƐ ĚĞ ƐĂƷĚĞ ŶĂ ƚĂƌĞĨĂ ĚĞ ƉĂƐƐĂŵĂĂĐŽŵƉĂŶŚĂƌĞĂďƵƐĐĂƌŽŽůŚĂƌ ŶĆŽĨĂnjĞƌŝƐƚŽŽƵĨĂnjĞƌ
ŝĚĞŶƟĮĐĂĕĆŽĚĞƐƐĞƐĐĂƐŽƐ͘ /ŶƚĞƌĂĕĆŽ ĚĞƐĞƵĐƵŝĚĂĚŽƌ͘ ĐŽŵĨƌĞƋƵġŶĐŝĂŵĞŶŽƌ͘
ŵƚŽƌŶŽĚŽƐϲŵĞƐĞƐĚĞŝĚĂĚĞĠƉŽƐƐşǀĞů
^ŽĐŝĂů ƌŝĂŶĕĂĐŽŵdƉŽĚĞ
ŽďƐĞƌǀĂƌƋƵĞĂƐĐƌŝĂŶĕĂƐƉƌĞƐƚĂŵŵĂŝƐ
ƉƌĞƐƚĂƌŵĂŝƐĂƚĞŶĕĆŽ
ŝŵƉŽƌƚĂŶƚĞŽďƐĞƌǀĂƌŶĆŽƐŽŵĞŶƚĞĂƉƌĞƐĞŶĕĂŽƵĂƵƐġŶĐŝĂĚĞƵŵĂ ĂƚĞŶĕĆŽĞŵƉĞƐƐŽĂƐĚŽƋƵĞĞŵŽďũĞƚŽƐ
ĞŵŽďũĞƚŽƐ͘
ŽƵďƌŝŶƋƵĞĚŽƐ͘
ĐŽŵƉĞƚġŶĐŝĂ ĞͬŽƵ ŚĂďŝůŝĚĂĚĞ͕ ŵĂƐ ƐƵĂ ƋƵĂůŝĚĂĚĞ Ğ ĨƌĞƋƵġŶĐŝĂ ŶŽƐ ĞƐĚĞŽĐŽŵĞĕŽ͕ĂĐƌŝĂŶĕĂƉĂƌĞĐĞƚĞƌ ƌŝĂŶĕĂĐŽŵdƉŽĚĞ
ĂƚĞŶĕĆŽă;ŵĞůŽĚŝĂĚĂͿĨĂůĂŚƵŵĂŶĂ͘ƉſƐ ŝŐŶŽƌĂƌŽƵĂƉƌĞƐĞŶƚĂƌ
ĐŽŶƚĞdžƚŽƐĚĞǀŝĚĂĚĂƐƉĞƐƐŽĂƐ͘ŶƚƌĞŽƐƉƌŝŶĐŝƉĂŝƐĂƐƉĞĐƚŽƐĂƐĞƌĞŵ ŽƐϯŵĞƐĞƐ͕ĞůĂũĄŝĚĞŶƟĮĐĂĂĨĂůĂĚĞƐĞƵ ƉŽƵĐĂƌĞƐƉŽƐƚĂĂŽƐ
ĐƵŝĚĂĚŽƌ͕ŵŽƐƚƌĂŶĚŽƌĞĂĕƁĞƐĐŽƌƉŽƌĂŝƐ͘
ŽďƐĞƌǀĂĚŽƐ͕ĚĞƐƚĂĐĂŵŽƐ͗ WĂƌĂƐŽŶƐĂŵďŝĞŶƚĂŝƐ͕ĂƉƌĞƐĞŶƚĂ ƐŽŶƐĚĞĨĂůĂ͘
ĞdžƉƌĞƐƐƁĞƐ͕ƉŽƌĞdžĞŵƉůŽ͕ĚĞ͞ƐƵƐƚŽͬ͟
ĐŚŽƌŽͬƚƌĞŵŽƌ͘
ĞƐĚĞŽĐŽŵĞĕŽ͕ĂĐƌŝĂŶĕĂĂƉƌĞƐĞŶƚĂ ƌŝĂŶĕĂ ĐŽŵ d ƉŽĚĞ
ďĂůďƵĐŝŽŝŶƚĞŶƐŽĞŝŶĚŝƐĐƌŝŵŝŶĂĚŽ͕ďĞŵ ƚĞŶĚĞƌĂŽƐŝůġŶĐŝŽĞͬŽƵ
ĐŽŵŽŐƌŝƚŽƐĂůĞĂƚſƌŝŽƐ͕ĚĞǀŽůƵŵĞĞ ĂŐƌŝƚŽƐĂůĞĂƚſƌŝŽƐ͘
ŝŶƚĞŶƐŝĚĂĚĞǀĂƌŝĂĚŽƐ͕ŶĂƉƌĞƐĞŶĕĂŽƵ
ŶĂĂƵƐġŶĐŝĂĚŽĐƵŝĚĂĚŽƌ͘WŽƌǀŽůƚĂĚŽƐ
ĞϬĂϲDĞƐĞƐ
>ŝŶŐƵĂŐĞŵ ϲŵĞƐĞƐ͕ĐŽŵĞĕĂƵŵĂĚŝƐĐƌŝŵŝŶĂĕĆŽ
ŶĞƐƚĂƐƉƌŽĚƵĕƁĞƐƐŽŶŽƌĂƐ͕ƋƵĞƚĞŶĚĞŵĂ
ĂƉĂƌĞĐĞƌƉƌŝŶĐŝƉĂůŵĞŶƚĞŶĂƉƌĞƐĞŶĕĂĚŽ
ĐƵŝĚĂĚŽƌ͘
EŽŝŶŝĐŝŽ͕ŽĐŚŽƌŽĠŝŶĚŝƐĐƌŝŵŝŶĂĚŽ͘ ƌŝĂŶĕĂĐŽŵdƉŽĚĞ
WŽƌǀŽůƚĂĚŽƐϯŵĞƐĞƐ͕ŚĄŽŝŶşĐŝŽĚĞ ƚĞƌƵŵĐŚŽƌŽŝŶĚŝƐƟŶƚŽ
ĚŝĨĞƌĞŶƚĞƐĨŽƌŵĂƚĂĕƁĞƐĚĞĐŚŽƌŽ͗ĐŚŽƌŽ ŶĂƐĚŝĨĞƌĞŶƚĞƐ
ĚĞĨŽŵĞ͕ĚĞďŝƌƌĂ͕ĞƚĐ͘ƐƚĞƐĨŽƌŵĂƚŽƐ ŽĐĂƐŝƁĞƐ͕ĞƉŽĚĞƚĞƌ
ĚŝĨĞƌĞŶƚĞƐĞƐƚĆŽůŝŐĂĚŽƐĂŽŵŽŵĞŶƚŽĞͬ ĨƌĞƋƵĞŶƚĞƐĐƌŝƐĞƐĚĞ
ŽƵĂƵŵĞƐƚĂĚŽĚĞĚĞƐĐŽŶĨŽƌƚŽ͘ ĐŚŽƌŽĚƵƌĂĚŽƵƌŽ͕ƐĞŵ
ůŝŐĂĕĆŽĂƉĂƌĞŶƚĞĂ
ĞǀĞŶƚŽŽƵƉĞƐƐŽĂ͘
ƵƐġŶĐŝĂŽƵ
ƐĐƌŝĂŶĕĂƐŽůŚĂŵƉĂƌĂŽŽďũĞƚŽĞŽ raridade desses
ƌŝŶĐĂĚĞŝƌĂƐ ĞdžƉůŽƌĂŵĚĞĚŝĨĞƌĞŶƚĞƐĨŽƌŵĂƐ;ƐĂĐŽĚĞŵ͕ ĐŽŵƉŽƌƚĂŵĞŶƚŽƐ
ĂƟƌĂŵ͕ďĂƚĞŵĞĞƚĐ͘Ϳ ĞdžƉůŽƌĂƚſƌŝŽƐƉŽĚĞƐĞƌ
ƵŵŝŶĚŝĐĂĚŽƌĚĞd͘
ĂŵĂŵĞŶƚĂĕĆŽĠƵŵŵŽŵĞŶƚŽ ƌŝĂŶĕĂĐŽŵdƉŽĚĞ
ƉƌŝǀŝůĞŐŝĂĚŽĚĞĂƚĞŶĕĆŽƉŽƌƉĂƌƚĞĚĂ ĂƉƌĞƐĞŶƚĂƌĚŝĮĐƵůĚĂĚĞƐ
ůŝŵĞŶƚĂĕĆŽ
ĐƌŝĂŶĕĂĂŽƐŐĞƐƚŽƐ͕ĞdžƉƌĞƐƐƁĞƐĨĂĐŝĂŝƐĞ ŶĞƐƚĞƐĂƐƉĞĐƚŽƐ͘
ĨĂůĂĚĞƐĞƵĐƵŝĚĂĚŽƌ͘
22 23
Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
/ŶĚŝĐĂĚŽƌĞƐĚŽĞƐĞŶǀŽůǀŝŵĞŶƚŽ
/ŶĚŝĐĂĚŽƌĞƐĚŽĞƐĞŶǀŽůǀŝŵĞŶƚŽ Sinais de Alerta para TEA
Sinais de Alerta para TEA /ŶĨĂŶƟů
/ŶĨĂŶƟů ŽƐϭϱͲϭϴŵĞƐĞƐĂƐĐƌŝĂŶĕĂƐĂƉŽŶƚĂŵ
ĂƵƐġŶĐŝĂŽƵƌĂƌŝĚĂĚĞ
;ĐŽŵŽĚĞĚŽŝŶĚŝĐĂĚŽƌͿƉĂƌĂŵŽƐƚƌĂƌ
/ŶƚĞƌĂĕĆŽ^ŽĐŝĂů
ŽŵĞĕĂŵĂĂƉƌĞƐĞŶƚĂƌĐŽŵƉŽƌƚĂŵĞŶƚŽƐ ƌŝĂŶĕĂƐĐŽŵdƉŽĚĞŵ ĚĞƐƚĞŐĞƐƚŽĚĞĂƚĞŶĕĆŽ
ĐŽŝƐĂƐƋƵĞĚĞƐƉĞƌƚĂŵĂƐƵĂĐƵƌŝŽƐŝĚĂĚĞ͘
/ŶƚĞƌĂĕĆŽ ĂŶƚĞĐŝƉĂƚſƌŝŽƐ;Ğdž͗ĞƐƚĞŶĚĞƌŽƐďƌĂĕŽƐĞ ĂƉƌĞƐĞŶƚĂƌĚŝĮĐƵůĚĂĚĞƐ ĐŽŵƉĂƌƟůŚĂŵĞŶƚŽƉŽĚĞƐĞƌƵŵ
'ĞƌĂůŵĞŶƚĞ͕ŽŐĞƐƚŽĠĂĐŽŵƉĂŶŚĂĚŽ
^ŽĐŝĂů ĨĂnjĞƌĐŽŶƚĂƚŽǀŝƐƵĂůƉĂƌĂ͞ƉĞĚŝƌ͟ĐŽůŽͿĞ ŶĞƐƐĞƐĐŽŵƉŽƌƚĂŵĞŶƚŽƐ͘ ĚŽƐƉƌŝŶĐŝƉĂŝƐŝŶĚŝĐĂĚŽƌĞƐĚĞ
ƉŽƌĐŽŶƚĂƚŽǀŝƐƵĂůĞ͕ăƐǀĞnjĞƐ͕ƐŽƌƌŝƐŽƐĞ
ŝŵŝƚĂƟǀŽƐ;ƉŽƌĞdžĞŵƉůŽ͗ŐĞƐƚŽĚĞďĞŝũŽͿ͘ TEA.
ǀŽĐĂůŝnjĂĕƁĞƐ;ƐŽŶƐͿ͘ŽŝŶǀĠƐĚĞĂƉŽŶƚĂƌ
ƌŝĂŶĕĂƐĐŽŵd ĞůĂƐƉŽĚĞŵ͞ŵŽƐƚƌĂƌ͟ĂƐĐŽŝƐĂƐĚĞŽƵƚƌĂ
ŚŽƌŽďĂƐƚĂŶƚĞĚŝĨĞƌĞŶĐŝĂĚŽĞŐƌŝƚŽƐ ƉŽĚĞŵŐƌŝƚĂƌŵƵŝƚŽ ĨŽƌŵĂ;Ğdž͗ĐŽůŽĐĂŶĚŽͲĂƐŶŽĐŽůŽĚĂƉĞƐƐŽĂ
ŵĞŶŽƐĂůĞĂƚſƌŝŽƐ͘ ĞŵĂŶƚĞƌƐĞƵĐŚŽƌŽ ŽƵĞŵĨƌĞŶƚĞĂŽƐƐĞƵƐŽůŚŽƐͿ͘
^ƵƌŐĞŵĂƐƉƌŝŵĞŝƌĂƐƉĂůĂǀƌĂƐ;Ğŵ
ŝŶĚŝĨĞƌĞŶĐŝĂĚŽ͕ĐƌŝĂŶĚŽ ƌŝĂŶĕĂƐĐŽŵdƉŽĚĞŵ
ƌĞƉĞƟĕĆŽͿĞ͕ƉŽƌǀŽůƚĂĚŽϭϴoŵġƐ͕ŽƐ
ƵŵĂĚŝĮĐƵůĚĂĚĞƉĂƌĂƐĞƵ ŶĆŽĂƉƌĞƐĞŶƚĂƌĂƐƉƌŝŵĞŝƌĂƐ
ƉƌŝŵĞŝƌŽƐĞƐďŽĕŽƐĚĞĨƌĂƐĞƐ;ĞŵƌĞƉĞƟĕĆŽ
ĐƵŝĚĂĚŽƌĞŶƚĞŶĚĞƌƐƵĂƐ ƉĂůĂǀƌĂƐŶĞƐƚĂĨĂŝdžĂĚĞŝĚĂĚĞ͘
ĂĨĂůĂĚĞŽƵƚƌĂƐƉĞƐƐŽĂƐͿ͘
ŶĞĐĞƐƐŝĚĂĚĞƐ͘
ĐƌŝĂŶĕĂĚĞƐĞŶǀŽůǀĞŵĂŝƐĂŵƉůĂŵĞŶƚĞ ƌŝĂŶĕĂƐĐŽŵdƉŽĚĞŵŶĆŽ
ƌŝĂŶĕĂƐĐŽŵd
ĂůďƵĐŝŽƐĞĚŝĨĞƌĞŶĐŝĂŶĚŽ͖ƌŝƐĂĚĂƐĞ ĂĨĂůĂ͕ĐŽŵƵŵƵƐŽŐƌĂĚĂƟǀĂŵĞŶƚĞŵĂŝƐ ĂƉƌĞƐĞŶƚĂƌĞƐƚĞĚĞƐĐŽůĂŵĞŶƚŽͬ
ƚĞŶĚĞŵĂŽƐŝůġŶĐŝŽĞĂ
sorrisos. ĂƉƌŽƉƌŝĂĚŽĚŽǀŽĐĂďƵůĄƌŝŽĞĚĂŐƌĂŵĄƟĐĂ͘ ƐƵĂĨĂůĂƉŽĚĞƉĂƌĞĐĞƌŵƵŝƚŽ
ŶĆŽŵĂŶŝĨĞƐƚĂƌĂŵƉůĂƐ
,ĄƵŵƉƌŽŐƌĞƐƐŝǀŽĚĞƐĐŽůĂŵĞŶƚŽĚĞƵƐŽƐ ĂĚĞƋƵĂĚĂ͕ŵĂƐƉŽƌƋƵĞĞƐƚĄĞŵ
ĞdžƉƌĞƐƐƁĞƐĨĂĐŝĂŝƐĐŽŵ
͞ĐŽŶŐĞůĂĚŽƐ͟;ƐŝƚƵĂĕƁĞƐĚŽĐŽƟĚŝĂŶŽ ƌĞƉĞƟĕĆŽ͕ƐĞŵĂƵƚŽŶŽŵŝĂ͘
ƐŝŐŶŝĮĐĂĚŽ͘
ŵƵŝƚŽƌĞƉĞƟĚĂƐͿƉĂƌĂƵŵŵŽǀŝŵĞŶƚŽŵĂŝƐ
ƚĞŶĕĆŽĂĐŽŶǀŽĐĂĕƁĞƐ;ƉƌĞƐƚĂĂƚĞŶĕĆŽ ƌŝĂŶĕĂƐĐŽŵdƚĞŶĚĞŵ
ĞϲĂϭϮDĞƐĞƐ
ĞϭϮĂϭϴDĞƐĞƐ
ůŝǀƌĞŶĂĨĂůĂ͘
ăĨĂůĂŵĂƚĞƌŶĂŽƵĚŽĐƵŝĚĂĚŽƌĞ ĂŶĆŽĂŐŝƌĐŽŵŽƐĞ
>ŝŶŐƵĂŐĞŵ
>ŝŶŐƵĂŐĞŵ
ĐŽŵĞĕĂĂĂŐŝƌĐŽŵŽƐĞ͞ĐŽŶǀĞƌƐĂƐƐĞ͕͟ ĐŽŶǀĞƌƐĂƐƐĞŵ͘ ĐŽŵƉƌĞĞŶƐĆŽǀĂŝƚĂŵďĠŵƐĂŝŶĚŽĚĂƐ ƌŝĂŶĕĂƐĐŽŵdŵŽƐƚƌĂŵ
ƌĞƐƉŽŶĚĞŶĚŽĐŽŵŐƌŝƚŽƐ͕ďĂůďƵĐŝŽƐ͕ ƐŝƚƵĂĕƁĞƐĐŽƟĚŝĂŶĂŵĞŶƚĞƌĞƉĞƟĚĂƐĞƐĞ ĚŝĮĐƵůĚĂĚĞĞŵĂŵƉůŝĂƌƐƵĂ
ŵŽǀŝŵĞŶƚŽƐĐŽƌƉŽƌĂŝƐͿ͘ ĂŵƉůŝĂŶĚŽƉĂƌĂĚŝĨĞƌĞŶƚĞƐĐŽŶƚĞdžƚŽƐ͘ ĐŽŵƉƌĞĞŶƐĆŽĚĞƐŝƚƵĂĕƁĞƐ
novas.
ƌŝĂŶĕĂƐĐŽŵdƉŽĚĞŵ ĐŽŵƵŶŝĐĂĕĆŽĠ͕ĞŵŐĞƌĂů͕ĂĐŽŵƉĂŶŚĂĚĂ ƌŝĂŶĕĂƐĐŽŵdƚĞŶĚĞŵĂ
ĐƌŝĂŶĕĂĐŽŵĞĕĂĂĂƚĞŶĚĞƌĂŽƐĞƌ ƉŽƌĞdžƉƌĞƐƐƁĞƐĨĂĐŝĂŝƐƋƵĞƌĞŇĞƚĞŵ ĂƉƌĞƐĞŶƚĂƌŵĞŶŽƐǀĂƌŝĂĕƁĞƐ
ŝŐŶŽƌĂƌŽƵƌĞĂŐŝƌĂƉĞŶĂƐ
ĐŚĂŵĂĚĂƉĞůŽŶŽŵĞ͘ ŽĞƐƚĂĚŽĞŵŽĐŝŽŶĂůĚĂƐĐƌŝĂŶĕĂƐ;Ğdž͗ ŶĂĞdžƉƌĞƐƐĆŽĨĂĐŝĂůĂŽƐĞ
ĂƉſƐŝŶƐŝƐƚġŶĐŝĂŽƵƚŽƋƵĞ͘
ƌŝĂŶĕĂƐĐŽŵdƉŽĚĞŵ ĂƌƌĞŐĂůĂƌŽƐŽůŚŽƐĞĮdžĂƌŽŽůŚĂƌŶŽ ĐŽŵƵŶŝĐĂƌĞŵ͕ĂŶĆŽƐĞƌĂůĞŐƌŝĂͬ
ŽŵĞĕĂĂƌĞƉĞƟƌŐĞƐƚŽƐĚĞĂĐĞŶŽƐ͕ ĂĚƵůƚŽƉĂƌĂĞdžƉƌĞƐƐĂƌƐƵƌƉƌĞƐĂ͕ŽƵĞŶƚĆŽ ĞdžĐŝƚĂĕĆŽ͕ƌĂŝǀĂŽƵĨƌƵƐƚƌĂĕĆŽ͘
ŶĆŽƌĞƉĞƟƌŐĞƐƚŽƐ
ƉĂůŵĂƐ͕ŵŽƐƚƌĂƌĂůşŶŐƵĂ͕ĚĂƌďĞŝũŽ͕ĞƚĐ͘ ĐŽŶƐƚƌĂŶŐŝŵĞŶƚŽ͕͞ǀĞƌŐŽŶŚĂ͟Ϳ͘
;ŵĂŶƵĂŝƐĞͬŽƵĐŽƌƉŽƌĂŝƐͿ
ĨƌĞŶƚĞĂƵŵĂƐŽůŝĐŝƚĂĕĆŽ ĐƌŝĂŶĕĂĐŽŵdƚĞŶĚĞĂ
ŽƐϭϮŵĞƐĞƐĂďƌŝŶĐĂĚĞŝƌĂĞdžƉůŽƌĂƚſƌŝĂ
ŽƵƉŽĚĞƉĂƐƐĂƌĂƌĞƉĞƟͲ ĞdžƉůŽƌĂƌŵĞŶŽƐŽďũĞƚŽƐĞ͕
ĠĂŵƉůĂĞǀĂƌŝĂĚĂ͘ĐƌŝĂŶĕĂŐŽƐƚĂĚĞ
ůŽƐĨŽƌĂĚŽĐŽŶƚĞdžƚŽ͕ ŵƵŝƚĂƐǀĞnjĞƐ͕ĮdžĂͲƐĞĞŵ
ĚĞƐĐŽďƌŝƌŽƐĚŝĨĞƌĞŶƚĞƐĂƚƌŝďƵƚŽƐ;ƚĞdžƚƵƌĂ͕
ĂůŐƵŵĂƐĚĞƐƵĂƐƉĂƌƚĞƐ͕ƐĞŵ
ƌŝŶĐĂĚĞŝƌĂƐ
aleatoriamente. ĐŚĞŝƌŽ͕ĞƚĐ͘ͿĞĨƵŶĕƁĞƐĚŽƐŽďũĞƚŽƐ;ƐŽŶƐ͕
ĐƌŝĂŶĕĂĐŽŵd ĞdžƉůŽƌĂƌĂƐĨƵŶĕƁĞƐ;Ğdž͗͘
ŽŵĞĕĂŵĂƐďƌŝŶĐĂĚĞŝƌĂƐƐŽĐŝĂŝƐ;ĐŽŵŽ ůƵnjĞƐ͕ŵŽǀŝŵĞŶƚŽƐ͕ĞƚĐ͘Ϳ͘
ƉŽĚĞƉƌĞĐŝƐĂƌĚĞŵƵŝƚĂ ƉĂƐƐĂƌŵĂŝƐƚĞŵƉŽŐŝƌĂŶĚŽĂ
ďƌŝŶĐĂƌĚĞĞƐĐŽŶĚĞͲĞƐĐŽŶĚĞͿ͕ĂĐƌŝĂŶĕĂ ƌŽĚĂĚĞƵŵĐĂƌƌŝŶŚŽĚŽƋƵĞ
ƌŝŶĐĂĚĞŝƌĂƐ ŝŶƐŝƐƚġŶĐŝĂĚŽĂĚƵůƚŽ
ƉĂƐƐĂĂƉƌŽĐƵƌĂƌŽĐŽŶƚĂƚŽǀŝƐƵĂůƉĂƌĂ ĞŵƉƵƌƌĂŶĚŽͲŽͿ͘
ƉĂƌĂƐĞĞŶŐĂũĂƌŶĂƐ
ŵĂŶƵƚĞŶĕĆŽĚĂŝŶƚĞƌĂĕĆŽ KũŽŐŽĚĞĨĂnjͲĚĞͲĐŽŶƚĂĞŵĞƌŐĞƉŽƌǀŽůƚĂ
ďƌŝŶĐĂĚĞŝƌĂƐ͘ ŵŐĞƌĂů͕ŝƐƐŽŶĆŽŽĐŽƌƌĞŶŽ
WĞƌşŽĚŽŝŵƉŽƌƚĂŶƚĞƉŽƌƋƵĞƐĞƌĆŽ ƌŝĂŶĕĂƐĐŽŵd ĚŽƐϭϱŵĞƐĞƐĞĚĞǀĞĞƐƚĂƌƉƌĞƐĞŶƚĞĚĞ
TEA.
ŝŶƚƌŽĚƵnjŝĚŽƐƚĞdžƚƵƌĂƐĞƐĂďŽƌĞƐ ƉŽĚĞŵƚĞƌƌĞƐŝƐƚġŶĐŝĂĂ ĨŽƌŵĂŵĂŝƐĐůĂƌĂĂŽƐϭϴŵĞƐĞƐĚĞŝĚĂĚĞ͘
ůŝŵĞŶƚĂĕĆŽ
24 25
ƉĂƌĐĞŝƌŽͿ͘
WŽƌǀŽůƚĂĚŽϮϰŵĞƐĞƐ͗ƐƵƌŐĞŵŽƐ
Ministério Diretrizes de Atenção à Reabilitação da Pessoa
͞ĞƌƌŽƐ͕͟ŵŽƐƚƌĂŶĚŽŽĚĞƐĐŽůĂŵĞŶƚŽ
da Saúde com Transtornos do Espectro do Autismo (TEA)
ŐĞƌĂůĚŽƉƌŽĐĞƐƐŽĚĞƌĞƉĞƟĕĆŽĚĂĨĂůĂ
ƌŝĂŶĕĂĐŽŵdƚĞŶĚĞŵĂ
ĚŽŽƵƚƌŽ͕ĞŵĚŝƌĞĕĆŽĂƵŵĂĨĂůĂŵĂŝƐ
ĞĐŽůĂůŝĂ͘
ĂƵƚƀŶŽŵĂ͕ŵĞƐŵŽƋƵĞƐĞŵĚŽŵşŶŝŽ
/ŶĚŝĐĂĚŽƌĞƐĚŽĞƐĞŶǀŽůǀŝŵĞŶƚŽ ;ĐŽŶƟŶƵĂĕĆŽͿ ĚĂƐƌĞŐƌĂƐĞĐŽŶǀĞŶĕƁĞƐ;WŽƌŝƐƐŽ
Sinais de Alerta para TEA ĂƉĂƌĞĐĞŵŽƐ͞ĞƌƌŽƐ͟Ϳ͘
/ŶĨĂŶƟů
,ĄŝŶƚĞƌĞƐƐĞĞŵƉĞŐĂƌŽďũĞƚŽƐ ƌŝĂŶĕĂƐĐŽŵdƉŽĚĞŵŶĆŽ KƐŐĞƐƚŽƐĐŽŵĞĕĂŵĂƐĞƌĂŵƉůĂŵĞŶƚĞ ƌŝĂŶĕĂƐĐŽŵdĐŽƐƚƵŵĂŵ
ŽĨĞƌĞĐŝĚŽƐƉĞůŽƐĞƵƉĂƌĐĞŝƌŽĐƵŝĚĂĚŽƌ͘ ƐĞŝŶƚĞƌĞƐƐĂƌĞŶĆŽƚĞŶƚĂƌƉĞŐĂƌ ƵƐĂĚŽƐŶĂĐŽŵƵŶŝĐĂĕĆŽ͘ ƵƟůŝnjĂƌŵĞŶŽƐŐĞƐƚŽƐĞͬŽƵ
>ŝŶŐƵĂŐĞŵ
KůŚĂŵƉĂƌĂŽŽďũĞƚŽĞƉĂƌĂƋƵĞŵŽ ŽďũĞƚŽƐĞƐƚĞŶĚŝĚŽƐƉŽƌƉĞƐƐŽĂƐ ĂƵƟůŝnjĄͲůŽƐĂůĞĂƚŽƌŝĂŵĞŶƚĞ͘
ŽĨĞƌĞĐĞ͘ ŽƵĨĂnjġͲůŽƐŽŵĞŶƚĞĂƉſƐŵƵŝƚĂ ZĞƐƉŽƐƚĂƐŐĞƐƚƵĂŝƐ͕ĐŽŵŽ
ŝŶƐŝƐƚġŶĐŝĂ͘ ĂĐĞŶĂƌĐŽŵĂĐĂďĞĕĂƉĂƌĂ
͞Ɛŝŵ͟Ğ͞ŶĆŽ͕͟ƚĂŵďĠŵƉŽĚĞŵ
ĐƌŝĂŶĕĂũĄƐĞŐƵĞŽĂƉŽŶƚĂƌŽƵŽ ƌŝĂŶĕĂƐĐŽŵdƉŽĚĞŵŶĆŽ ĞƐƚĂƌĂƵƐĞŶƚĞƐŶĞƐƐĂƐĐƌŝĂŶĕĂƐ
ŽůŚĂƌĚŽŽƵƚƌŽ͕ĞŵǀĄƌŝĂƐƐŝƚƵĂĕƁĞƐ͘ ƐĞŐƵŝƌŽĂƉŽŶƚĂƌŽƵŽŽůŚĂƌĚŽƐ ĞŶƚƌĞŽƐϭϴĞϮϰŵĞƐĞƐ͘
ŽƵƚƌŽƐ͖ƉŽĚĞŵŶĆŽŽůŚĂƌƉĂƌĂŽ
/ŶƚĞƌĂĕĆŽ^ŽĐŝĂů
WŽƌǀŽůƚĂĚĞϭϴŵĞƐĞƐ͕ďĞďġƐ
ĂůǀŽŽƵŽůŚĂƌĂƉĞŶĂƐƉĂƌĂŽĚĞĚŽ ĐƌŝĂŶĕĂĐŽŵdƉŽĚĞĮĐĂƌ
ĐŽƐƚƵŵĂŵƌĞƉƌŽĚƵnjŝƌŽĐŽƟĚŝĂŶŽƉŽƌ
ĚĞƋƵĞŵĞƐƚĄĂƉŽŶƚĂŶĚŽ͘ůĠŵ ĮdžĂĚĂĞŵĂůŐƵŵĂƚƌŝďƵƚŽ
ŵĞŝŽĚĞƵŵďƌŝŶƋƵĞĚŽŽƵďƌŝŶĐĂĚĞŝƌĂ͖
ĚŝƐƐŽ͕ŶĆŽĂůƚĞƌŶĂƐĞƵŽůŚĂƌĞŶƚƌĞ ĚŽŽďũĞƚŽ͕ĐŽŵŽĂƌŽĚĂƋƵĞ
ĚĞƐĐŽďƌĞŵĂĨƵŶĕĆŽƐŽĐŝĂůĚŽƐ
ĂƉĞƐƐŽĂƋƵĞĂƉŽŶƚĂĞŽŽďũĞƚŽ ŐŝƌĂŽƵƵŵĂƐĂůŝġŶĐŝĂĞŵƋƵĞ
ďƌŝŶƋƵĞĚŽƐ͘;Ğdž͗͘ĨĂnjĞƌŽĂŶŝŵĂůnjŝŶŚŽ
ƋƵĞĞƐƚĄƐĞŶĚŽĂƉŽŶƚĂĚŽ͘ ƉĂƐƐĂŽƐĚĞĚŽƐ͕ŶĆŽďƌŝŶĐĂŶĚŽ
ƌŝŶĐĂĚĞŝƌĂƐ
͞ĂŶĚĂƌ͟ĞƉƌŽĚƵnjŝƌƐŽŶƐͿ
ĂƉƌŽƉƌŝĂĚĂŵĞŶƚĞĐŽŵŽƋƵĞŽ
ĞϭϴĂϮϰDĞƐĞƐ
ĞϭϴĂϮϰDĞƐĞƐ
ůŝŵĞŶƚĂĕĆŽ
ĚŽŽƵƚƌŽ͕ĞŵĚŝƌĞĕĆŽĂƵŵĂĨĂůĂŵĂŝƐ ƐſůŝĚŽƐͬƐĞŵŝͲƐſůŝĚŽƐ͕ĨƌŝŽƐͬƋƵĞŶƚĞƐͬ de alimento mantendo por
ĂƵƚƀŶŽŵĂ͕ŵĞƐŵŽƋƵĞƐĞŵĚŽŵşŶŝŽ ŵŽƌŶŽƐ͕ĚŽĐĞƐͬƐĂůŐĂĚŽƐͬĂŵĂƌŐŽƐ͖ ĞdžĞŵƉůŽ͕ĂƚĞdžƚƵƌĂ͕ĂĐŽƌ͕
ĚĂƐƌĞŐƌĂƐĞĐŽŶǀĞŶĕƁĞƐ;WŽƌŝƐƐŽ ǀĂƌŝĂĚŽƐĞŵƋƵĂŶƟĚĂĚĞ͖ŽĨĞƌĞĐŝĚŽƐ ĂĐŽŶƐŝƐƚġŶĐŝĂ͕ĞƚĐ͘WŽĚĞŵ͕
ĂƉĂƌĞĐĞŵŽƐ͞ĞƌƌŽƐ͟Ϳ͘ ĞŵǀŝŐşůŝĂ͕ĨŽƌĂĚĂƐŝƚƵĂĕĆŽĚĞĐƌŝĂŶĕĂ ƐŽďƌĞƚƵĚŽ͕ƌĞƐŝƐƟƌĂƉĂƌƟĐŝƉĂƌ
ĚĞŝƚĂĚĂŽƵŶŽĐŽůŽ͖ϯͿĐŽŵĞĕĂĂ ĚĂĐĞŶĂĂůŝŵĞŶƚĂƌ͘
ƌŝĂŶĕĂƐĐŽŵdĐŽƐƚƵŵĂŵ ŝŶƚƌŽĚƵĕĆŽĚĂĐĞŶĂĂůŝŵĞŶƚĂƌ͗ŵĞƐĂͬ
ƵƟůŝnjĂƌŵĞŶŽƐŐĞƐƚŽƐĞͬŽƵ;ĐŽŶƟŶƵĂ͘͘͘Ϳ ĐĂĚĞŝƌĂͬƵƚĞŶƐşůŝŽƐ;ƉƌĂƚŽ͕ƚĂůŚĞƌĞƐ͕
ĂƵƟůŝnjĄͲůŽƐĂůĞĂƚŽƌŝĂŵĞŶƚĞ͘ ĐŽƉŽͿĞĂŝŶƚĞƌĂĕĆŽĨĂŵŝůŝĂƌͬƐŽĐŝĂů͘
KƐŐĞƐƚŽƐĐŽŵĞĕĂŵĂƐĞƌĂŵƉůĂŵĞŶƚĞ ZĞƐƉŽƐƚĂƐŐĞƐƚƵĂŝƐ͕ĐŽŵŽĂĐĞŶĂƌ
ƵƐĂĚŽƐŶĂĐŽŵƵŶŝĐĂĕĆŽ͘ ĐŽŵĂĐĂďĞĕĂƉĂƌĂ͞Ɛŝŵ͟Ğ͞ŶĆŽ͕͟
ƚĂŵďĠŵƉŽĚĞŵĞƐƚĂƌĂƵƐĞŶƚĞƐ
ŶĞƐƐĂƐĐƌŝĂŶĕĂƐĞŶƚƌĞŽƐϭϴĞϮϰ
meses.
ƌŝŶĐĂĚĞŝƌĂƐ
ĐƌŝĂŶĕĂĐŽŵdƉŽĚĞĮĐĂƌ
26 27
WŽƌǀŽůƚĂĚĞϭϴŵĞƐĞƐ͕ďĞďġƐ
26 ĐŽƐƚƵŵĂŵƌĞƉƌŽĚƵnjŝƌŽĐŽƟĚŝĂŶŽƉŽƌ
ŵĞŝŽĚĞƵŵďƌŝŶƋƵĞĚŽŽƵďƌŝŶĐĂĚĞŝƌĂ͖
ĮdžĂĚĂĞŵĂůŐƵŵĂƚƌŝďƵƚŽ
ĚŽŽďũĞƚŽ͕ĐŽŵŽĂƌŽĚĂƋƵĞ 27
ŐŝƌĂŽƵƵŵĂƐĂůŝġŶĐŝĂĞŵƋƵĞ
ĚĞƐĐŽďƌĞŵĂĨƵŶĕĆŽƐŽĐŝĂůĚŽƐ
;ĞŵƌĞƉĞƟĕĆŽͿ͘:ĄĨĂnjĚŝƐƟŶĕĆŽĚĞƚĞŵƉŽ
ĞϮϰ
ƌŝĂŶĕĂƐĐŽŵdƉŽĚĞŵ
;ƉĂƐƐĂĚŽ͕ƉƌĞƐĞŶƚĞ͕ĨƵƚƵƌŽͿ͖ĚĞŐġŶĞƌŽ
Ministério Diretrizes de AtençãoƚĞŶĚĞƌăĞĐŽůĂůŝĂ͖ĚŝƐƟŶĕĆŽĚĞ
à Reabilitação da Pessoa
da Saúde
;ŵĂƐĐƵůŝŶŽ͕ĨĞŵŝŶŝŶŽͿ͖ĞĚĞŶƷŵĞƌŽ;ƐŝŶŐƵůĂƌ͕
com Transtornos do Espectro do Autismo (TEA)
ŐġŶĞƌŽ͕ŶƷŵĞƌŽĞƚĞŵƉŽŶĆŽ
ƉůƵƌĂůͿ͕ƋƵĂƐĞƐĞŵƉƌĞĂĚĞƋƵĂĚĂƐ;ƐĞŵƉƌĞĞŵ
ĂĐŽŶƚĞĐĞ͖ĐĂŶƚŽƐĞǀĞƌƐŽƐƐſ
ĐŽŶƚĞdžƚŽĚĞĚŝĄůŽŐŽͿ͘WƌŽĚƵnjĂŵĂŝŽƌƉĂƌƚĞĚŽƐ
ĞŵƌĞƉĞƟĕĆŽĂůĞĂƚſƌŝĂ͕ŶĆŽ
ƐŽŶƐĚĂůşŶŐƵĂ͕ŵĂƐƉŽĚĞĂƉƌĞƐĞŶƚĂƌ͞ĞƌƌŽƐ͖͟Ă
;ĐŽŶƟŶƵĂĕĆŽͿ ͞ĐŽŶǀĞƌƐĂŵ͟ĐŽŵŽĂĚƵůƚŽ͘
ĨĂůĂƚĞŵƵŵĂŵĞůŽĚŝĂďĞŵŝŶĨĂŶƟůĂŝŶĚĂ͖ǀŽnj
ŐĞƌĂůŵĞŶƚĞŵĂŝƐĂŐƵĚŝnjĂĚĂ͘
/ŶĚŝĐĂĚŽƌĞƐĚŽĞƐĞŶǀŽůǀŝŵĞŶƚŽ ĐƌŝĂŶĕĂ͕ŶĂƐďƌŝŶĐĂĚĞŝƌĂƐ͕ƵƐĂƵŵŽďũĞƚŽ ƌŝĂŶĕĂƐĐŽŵdƌĂƌĂŵĞŶƚĞ
Sinais de Alerta para TEA ͞ĮŶŐŝŶĚŽ͟ƋƵĞĠŽƵƚƌŽ;ƵŵďůŽĐŽĚĞŵĂĚĞŝƌĂ ĂƉƌĞƐĞŶƚĂŵĞƐƚĞƟƉŽĚĞ
/ŶĨĂŶƟů
ƉŽĚĞƐĞƌƵŵĐĂƌƌŝŶŚŽ͕ƵŵĂĐĂŶĞƚĂƉŽĚĞƐĞƌƵŵ ďƌŝŶĐĂĚĞŝƌĂŽƵŽĨĂnjĞŵĚĞ
KƐŐĞƐƚŽƐ;ŽůŚĂƌ͕ĂƉŽŶƚĂƌ͕ĞƚĐ͘ͿƐĆŽ ĂǀŝĆŽ͕ĞƚĐ͘Ϳ͘ĐƌŝĂŶĕĂďƌŝŶĐĂŝŵŝƚĂŶĚŽŽƐƉĂƉĠŝƐ ĨŽƌŵĂďĂƐƚĂŶƚĞƌĞƉĞƟƟǀĂĞ
KƐŐĞƐƚŽƐĞĐŽŵĞŶƚĄƌŝŽƐĞŵ
ĂĐŽŵƉĂŶŚĂĚŽƐƉĞůŽŝŶƚĞŶƐŽĂƵŵĞŶƚŽŶĂ ĚŽƐĂĚƵůƚŽƐ;ĚĞ͞ĐĂƐŝŶŚĂ͕͟ĚĞ͞ŵĠĚŝĐŽ͕͟ĞƚĐ͘Ϳ͕ ƉŽƵĐŽĐƌŝĂƟǀĂ͘
/ŶƚĞƌĂĕĆŽ^ŽĐŝĂů
ƌĞƐƉŽƐƚĂĂŽĂĚƵůƚŽƚĞŶĚĞŵ
ĐĂƉĂĐŝĚĂĚĞĚĞĐŽŵĞŶƚĂƌĞͬŽƵƉĞƌŐƵŶƚĂƌ ĐŽŶƐƚƌƵŝŶĚŽĐĞŶĂƐŽƵĞƐƚſƌŝĂƐ͘ůĂƉƌſƉƌŝĂŽƵ
ĂĂƉĂƌĞĐĞƌŝƐŽůĂĚĂŵĞŶƚĞŽƵ
ƐŽďƌĞŽƐŽďũĞƚŽƐĞƐŝƚƵĂĕƁĞƐƋƵĞĞƐƚĆŽ ƐĞƵƐďŽŶĞĐŽƐƐĆŽŽƐ͞ƉĞƌƐŽŶĂŐĞŶƐ͘͟
ĂƉſƐŵƵŝƚĂŝŶƐŝƐƚġŶĐŝĂ͘Ɛ
ƐĞŶĚŽĐŽŵƉĂƌƟůŚĂĚĂƐ͘ŝŶŝĐŝĂƟǀĂĚĂĐƌŝĂŶĕĂ
ŝŶŝĐŝĂƟǀĂƐƐĆŽƌĂƌĂƐ͕ƐĞŶĚŽƵŵ ĐƌŝĂŶĕĂŐŽƐƚĂĚĞďƌŝŶĐĂƌƉĞƌƚŽĚĞŽƵƚƌĂƐ ĂƵƐġŶĐŝĂĚĞƐƐĂƐĂĕƁĞƐ
ĞŵĂƉŽŶƚĂƌ͕ŵŽƐƚƌĂƌĞĚĂƌŽďũĞƚŽƐƉĂƌĂ
ƌŝŶĐĂĚĞŝƌĂƐ
ĚŽƐƉƌŝŶĐŝƉĂŝƐƐŝŶĂŝƐĚĞĂůĞƌƚĂ ĐƌŝĂŶĕĂƐ;ĂŝŶĚĂƋƵĞŶĆŽŶĞĐĞƐƐĂƌŝĂŵĞŶƚĞ ƉŽĚĞŝŶĚŝĐĂƌƐŝŶĂŝƐĚĞd͖
ĐŽŵƉĂƌƟůŚĄͲůŽƐĐŽŵŽĂĚƵůƚŽĂƵŵĞŶƚĂĞŵ
de TEA. ĐŽŵĞůĂƐͿĞĚĞŵŽŶƐƚƌĂŵŝŶƚĞƌĞƐƐĞƉŽƌĞůĂƐ ĂƐĐƌŝĂŶĕĂƐƉŽĚĞŵƐĞĂĨĂƐƚĂƌ͕
ĨƌĞƋƵġŶĐŝĂ͘
;ĂƉƌŽdžŝŵĂƌͲƐĞ͕ƚŽĐĂƌĞƐĞĚĞŝdžĂƌƚŽĐĂƌ͕ĞƚĐ͘Ϳ͘ ŝŐŶŽƌĂƌŽƵůŝŵŝƚĂƌͲƐĞĂ
ĨĂůĂĞƐƚĄŵĂŝƐĚĞƐĞŶǀŽůǀŝĚĂ͕ŵĂƐĂŝŶĚĂ ƌŝĂŶĕĂƐĐŽŵdƉŽĚĞŵƚĞƌ ŽďƐĞƌǀĂƌďƌĞǀĞŵĞŶƚĞŽƵƚƌĂƐ
ŚĄƌĞƉĞƟĕĆŽĚĂĨĂůĂĚŽĂĚƵůƚŽĞŵǀĄƌŝĂƐ ƌĞƉĞƟĕĆŽĚĂĨĂůĂĚĂŽƵƚƌĂ ĐƌŝĂŶĕĂƐăĚŝƐƚąŶĐŝĂ͘
ŽĐĂƐŝƁĞƐ͕ĐŽŵƵƟůŝnjĂĕĆŽĚĞŶƚƌŽĚĂƐŝƚƵĂĕĆŽĚĞ ƉĞƐƐŽĂƐĞŵƌĞůĂĕĆŽĐŽŵĂ
ĐŽŵƵŶŝĐĂĕĆŽ͘ ƐŝƚƵĂĕĆŽĚĞĐŽŵƵŶŝĐĂĕĆŽ͘ ŽƐϯϲŵĞƐĞƐĂƐĐƌŝĂŶĕĂƐŐŽƐƚĂŵĚĞƉƌŽƉŽƌͬ ƌŝĂŶĕĂƐĐŽŵd͕ƋƵĂŶĚŽ
ĞŶŐĂũĂƌͲƐĞĞŵďƌŝŶĐĂĚĞŝƌĂƐĐŽŵŽƵƚƌĂƐĚĂ ĂĐĞŝƚĂŵƉĂƌƟĐŝƉĂƌĚĂƐ
ƌŝĂŶĕĂƐĐŽŵdƉŽĚĞŵ ŵĞƐŵĂĨĂŝdžĂĚĞŝĚĂĚĞ͘ ďƌŝŶĐĂĚĞŝƌĂƐĐŽŵŽƵƚƌĂƐ
ŽŵĞĕĂĂĐŽŶƚĂƌƉĞƋƵĞŶĂƐĞƐƚſƌŝĂƐ͖ĂƌĞůĂƚĂƌ
ĂƉƌĞƐĞŶƚĂƌĚŝĮĐƵůĚĂĚĞƐŽƵ ĐƌŝĂŶĕĂƐ͕ĞŵŐĞƌĂů͕ƚġŵ
ĞǀĞŶƚŽƐƉƌſdžŝŵŽƐũĄĂĐŽŶƚĞĐŝĚŽƐ͖ĂĐŽŵĞŶƚĂƌ
ĚĞƐŝŶƚĞƌĞƐƐĞĞŵŶĂƌƌĂƟǀĂƐ ĚŝĮĐƵůĚĂĚĞƐĞŵĞŶƚĞŶĚġͲůĂƐ͘
ƐŽďƌĞĞǀĞŶƚŽƐĨƵƚƵƌŽƐ͕ƐĞŵƉƌĞĞŵƐŝƚƵĂĕƁĞƐĚĞ
ƌĞĨĞƌĞŶƚĞƐĂŽĐŽƟĚŝĂŶŽ͘
ĚŝĄůŽŐŽ;ĐŽŵŽĂĚƵůƚŽƐƵƐƚĞŶƚĂŶĚŽŽĚŝƐĐƵƌƐŽͿ͘ ƌŝĂŶĕĂƐĐŽŵdƉŽĚĞŵƚĞƌ
WŽĚĞŵƌĞƉĞƟƌĨƌĂŐŵĞŶƚŽƐĚĞ ĐƌŝĂŶĕĂũĄƉĂƌƟĐŝƉĂĚĂƐĐĞŶĂƐĂůŝŵĞŶƚĂƌĞƐ
ĞϮϰĂϯϲDĞƐĞƐ
ƌĞůĂƚŽƐͬŶĂƌƌĂƟǀĂƐ͕ŝŶĐůƵƐŝǀĞ ĚŝĮĐƵůĚĂĚĞĐŽŵĞƐƚĞĞƐƋƵĞŵĂ
ĐŽƟĚŝĂŶĂƐ͗ĐĂĨĠĚĂŵĂŶŚĆͬĂůŵŽĕŽͬũĂŶƚĂƌ͖Ġ
ĚĞĚŝĄůŽŐŽƐ͕ĞŵƌĞƉĞƟĕĆŽĞ ĂůŝŵĞŶƚĂƌ͗ƉĞƌŵĂŶĞĐĞƌŶĂ
ĐĂƉĂnjĚĞĞƐƚĂďĞůĞĐĞƌƐĞƉĂƌĂĕĆŽĚŽƐĂůŝŵĞŶƚŽƐ
ŝŶĚĞƉĞŶĚĞŶƚĞĚĂƉĂƌƟĐŝƉĂĕĆŽ ŵĂŵĂĚĞŝƌĂ͖ĂƉƌĞƐĞŶƚĂƌƌĞĐƵƐĂ
ƉĞůŽƟƉŽĚĞƌĞĨĞŝĕĆŽŽƵƐŝƚƵĂĕĆŽ;ĐŽŵŝĚĂ
>ŝŶŐƵĂŐĞŵ
ĚĂŽƵƚƌĂƉĞƐƐŽĂ͘ ĂůŝŵĞŶƚĂƌ͖ŶĆŽƉĂƌƟĐŝƉĂƌĚĂƐ
ĚĞůĂŶĐŚĞͬĨĞƐƚĂͬĂůŵŽĕŽĚĞĚŽŵŝŶŐŽ͕ĞƚĐ͘Ϳ͖
ĐĞŶĂƐĂůŝŵĞŶƚĂƌĞƐ͖ŶĆŽƐĞ
ůŝŵĞŶƚĂĕĆŽ
ĂŶƚĂĞƉŽĚĞƌĞĐŝƚĂƌƵŵĂĞƐƚƌŽĨĞĚĞǀĞƌƐŝŶŚŽƐ ŝŶşĐŝŽĚŽŵĂŶƵƐĞŝŽĂĚĞƋƵĂĚŽĚŽƐƚĂůŚĞƌĞƐ͖
ƌŝĂŶĕĂƐĐŽŵdƉŽĚĞŵ ĂĚĞƋƵĂƌĂŽƐ͞ŚŽƌĄƌŝŽƐ͟ĚĞ
;ĞŵƌĞƉĞƟĕĆŽͿ͘:ĄĨĂnjĚŝƐƟŶĕĆŽĚĞƚĞŵƉŽ ĂůŝŵĞŶƚĂĕĆŽĐŽŶƟĚĂĂŽůŽŶŐŽĚŽĚŝĂ;ƌĞƟƌĂĚĂ
ƚĞŶĚĞƌăĞĐŽůĂůŝĂ͖ĚŝƐƟŶĕĆŽĚĞ ĂůŝŵĞŶƚĂĕĆŽ͖ƉŽĚĞƋƵĞƌĞƌ
;ƉĂƐƐĂĚŽ͕ƉƌĞƐĞŶƚĞ͕ĨƵƚƵƌŽͿ͖ĚĞŐġŶĞƌŽ ĚĂƐŵĂŵĂĚĞŝƌĂƐŶŽƚƵƌŶĂƐͿ͘
ŐġŶĞƌŽ͕ŶƷŵĞƌŽĞƚĞŵƉŽŶĆŽ ĐŽŵĞƌĂƋƵĂůƋƵĞƌŚŽƌĂĞ
;ŵĂƐĐƵůŝŶŽ͕ĨĞŵŝŶŝŶŽͿ͖ĞĚĞŶƷŵĞƌŽ;ƐŝŶŐƵůĂƌ͕
ĂĐŽŶƚĞĐĞ͖ĐĂŶƚŽƐĞǀĞƌƐŽƐƐſ ǀĄƌŝŽƐƟƉŽƐĚĞĂůŝŵĞŶƚŽĂŽ
ƉůƵƌĂůͿ͕ƋƵĂƐĞƐĞŵƉƌĞĂĚĞƋƵĂĚĂƐ;ƐĞŵƉƌĞĞŵ
ĞŵƌĞƉĞƟĕĆŽĂůĞĂƚſƌŝĂ͕ŶĆŽ ŵĞƐŵŽƚĞŵƉŽ͖ƉŽĚĞƉĂƐƐĂƌ
ĐŽŶƚĞdžƚŽĚĞĚŝĄůŽŐŽͿ͘WƌŽĚƵnjĂŵĂŝŽƌƉĂƌƚĞĚŽƐ
͞ĐŽŶǀĞƌƐĂŵ͟ĐŽŵŽĂĚƵůƚŽ͘ ƉŽƌůŽŶŐŽƐƉĞƌşŽĚŽƐƐĞŵ
ƐŽŶƐĚĂůşŶŐƵĂ͕ŵĂƐƉŽĚĞĂƉƌĞƐĞŶƚĂƌ͞ĞƌƌŽƐ͖͟Ă
ĨĂůĂƚĞŵƵŵĂŵĞůŽĚŝĂďĞŵŝŶĨĂŶƟůĂŝŶĚĂ͖ǀŽnj ĐŽŵĞƌ͖ƉŽĚĞƐſĐŽŵĞƌƋƵĂŶĚŽ
ŐĞƌĂůŵĞŶƚĞŵĂŝƐĂŐƵĚŝnjĂĚĂ͘ ĂĐŽŵŝĚĂĠĚĂĚĂŶĂďŽĐĂŽƵƐſ
ĐƌŝĂŶĕĂ͕ŶĂƐďƌŝŶĐĂĚĞŝƌĂƐ͕ƵƐĂƵŵŽďũĞƚŽ ĐŽŵĞƌƐŽnjŝŶŚĂ͕ĞƚĐ͘
͞ĮŶŐŝŶĚŽ͟ƋƵĞĠŽƵƚƌŽ;ƵŵďůŽĐŽĚĞŵĂĚĞŝƌĂ ƌŝĂŶĕĂƐĐŽŵdƌĂƌĂŵĞŶƚĞ
;ĐŽŶƟŶƵĂ͘͘͘Ϳ
ƉŽĚĞƐĞƌƵŵĐĂƌƌŝŶŚŽ͕ƵŵĂĐĂŶĞƚĂƉŽĚĞƐĞƌƵŵ ĂƉƌĞƐĞŶƚĂŵĞƐƚĞƟƉŽĚĞ
ĂǀŝĆŽ͕ĞƚĐ͘Ϳ͘ĐƌŝĂŶĕĂďƌŝŶĐĂŝŵŝƚĂŶĚŽŽƐƉĂƉĠŝƐ ďƌŝŶĐĂĚĞŝƌĂŽƵŽĨĂnjĞŵĚĞ
ĚŽƐĂĚƵůƚŽƐ;ĚĞ͞ĐĂƐŝŶŚĂ͕͟ĚĞ͞ŵĠĚŝĐŽ͕͟ĞƚĐ͘Ϳ͕ ĨŽƌŵĂďĂƐƚĂŶƚĞƌĞƉĞƟƟǀĂĞ
ĐŽŶƐƚƌƵŝŶĚŽĐĞŶĂƐŽƵĞƐƚſƌŝĂƐ͘ůĂƉƌſƉƌŝĂŽƵ ƉŽƵĐŽĐƌŝĂƟǀĂ͘
ƐĞƵƐďŽŶĞĐŽƐƐĆŽŽƐ͞ƉĞƌƐŽŶĂŐĞŶƐ͘͟
ĂƵƐġŶĐŝĂ ĚĞƐƐĂƐ ĂĕƁĞƐ
ĐƌŝĂŶĕĂŐŽƐƚĂĚĞďƌŝŶĐĂƌƉĞƌƚŽĚĞŽƵƚƌĂƐ ƉŽĚĞ ŝŶĚŝĐĂƌ ƐŝŶĂŝƐ ĚĞ d͖
28 ĐƌŝĂŶĕĂƐ;ĂŝŶĚĂƋƵĞŶĆŽŶĞĐĞƐƐĂƌŝĂŵĞŶƚĞ
ĐŽŵĞůĂƐͿĞĚĞŵŽŶƐƚƌĂŵŝŶƚĞƌĞƐƐĞƉŽƌĞůĂƐ
ĂƐ ĐƌŝĂŶĕĂƐ ƉŽĚĞŵ ƐĞ ĂĨĂƐƚĂƌ͕
ŝŐŶŽƌĂƌŽƵůŝŵŝƚĂƌͲƐĞĂŽďƐĞƌǀĂƌ 29
;ĂƉƌŽdžŝŵĂƌͲƐĞ͕ƚŽĐĂƌĞƐĞĚĞŝdžĂƌƚŽĐĂƌ͕ĞƚĐ͘Ϳ ďƌĞǀĞŵĞŶƚĞ ŽƵƚƌĂƐ ĐƌŝĂŶĕĂƐ ă
Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
5 Instrumentos de Rastreamento ĞŶƚƌĞ ŽƐ ŝŶƐƚƌƵŵĞŶƚŽƐ ĚĞ ƵƐŽ ůŝǀƌĞ ƉĂƌĂ ƌĂƐƚƌĞĂŵĞŶƚŽͬƚƌŝĂŐĞŵ ĚĞ
ŝŶĚŝĐĂĚŽƌĞƐĐůşŶŝĐŽƐĚĞĂůƚĞƌĂĕƁĞƐĚĞĚĞƐĞŶǀŽůǀŝŵĞŶƚŽ͕ƚĞŵŽƐ͗
5.1 – Instrumentos de uso livre2 para o
Rastreamento/Triagem de Indicadores de xIRDI (Indicadores Clínicos de Risco para o Desenvolvimento
Desenvolvimento Infantil e dos TEA /ŶĨĂŶƟůͿ͗ĠŝŶƐƚƌƵŵĞŶƚŽĚĞŽďƐĞƌǀĂĕĆŽĞŝŶƋƵĠƌŝƚŽƋƵĞƉŽĚĞƐĞƌ
ƵƐĂĚŽŶŽƌĂƐƚƌĞĂŵĞŶƚŽĚŽĚĞƐĞŶǀŽůǀŝŵĞŶƚŽ͘ƌŝĂĚŽĞǀĂůŝĚĂĚŽ
K ĚŝĂŐŶſƐƟĐŽ ĚŽ d ƉĞƌŵĂŶĞĐĞ ĞƐƐĞŶĐŝĂůŵĞŶƚĞ ĐůşŶŝĐŽ Ğ Ġ ĨĞŝƚŽ ƉŽƌ Ƶŵ ŐƌƵƉŽ ĚĞ ĞƐƉĞĐŝĂůŝƐƚĂƐ ďƌĂƐŝůĞŝƌŽƐ Ġ ĚĞ ƵƐŽ ůŝǀƌĞ ƉĞůŽƐ
Ă ƉĂƌƟƌ ĚĞ ŽďƐĞƌǀĂĕƁĞƐ ĚĂ ĐƌŝĂŶĕĂ Ğ ĞŶƚƌĞǀŝƐƚĂƐ ĐŽŵ ƉĂŝƐ ĞͬŽƵ ƉƌŽĮƐƐŝŽŶĂŝƐĚĂƐĂƷĚĞ͘ĐŽŵƉŽƐƚŽƉŽƌϯϭŝŶĚŝĐĂĚŽƌĞƐĚĞďŽŵ
ĐƵŝĚĂĚŽƌĞƐ͕ŽƋƵĞƚŽƌŶĂŽƵƐŽĚĞĞƐĐĂůĂƐĞŝŶƐƚƌƵŵĞŶƚŽƐĚĞƚƌŝĂŐĞŵĞ ĚĞƐĞŶǀŽůǀŝŵĞŶƚŽĚŽǀşŶĐƵůŽĚŽďĞďġĐŽŵŽƐƉĂŝƐ͕ĚŝƐƚƌŝďƵşĚŽƐĞŵ
ĂǀĂůŝĂĕĆŽƉĂĚƌŽŶŝnjĂĚŽƐƵŵĂŶĞĐĞƐƐŝĚĂĚĞ͘ ϰĨĂŝdžĂƐĞƚĄƌŝĂƐĚĞϬĂϭϴŵĞƐĞƐ͕ƉĂƌĂĂŽďƐĞƌǀĂĕĆŽĞƉĞƌŐƵŶƚĂƐ
ĚŝƌŝŐŝĚĂƐăĚşĂĚĞŵĆĞ;ŽƵĐƵŝĚĂĚŽƌͿͲďĞďġ͘KƉŽƐƐşǀĞůƌŝƐĐŽƉĂƌĂ
ĞŶƚƌĞŽƐŝŶƐƚƌƵŵĞŶƚŽƐĚĞƚƌŝĂŐĞŵĞĚĞĂǀĂůŝĂĕĆŽĚŽd͕ĠƉƌĞĐŝƐŽ ĚĞƐĞŶǀŽůǀŝŵĞŶƚŽ ĚĞĐŽƌƌĞ ĚĞ ŝŶĚŝĐĂĚŽƌĞƐ ĞƐƚĂƌĞŵ ĂƵƐĞŶƚĞƐ͘
ƌĞĐŽŶŚĞĐĞƌ Ğ ĚŝĨĞƌĞŶĐŝĂƌ ƋƵĞ ĂůŐƵŶƐ ĚĞƐƐĞƐ ƐĆŽ ƉĂƌĂ ŝĚĞŶƟĮĐĂĕĆŽ͕ ;<hW&ZĞƚ͘Ăů͕͘ϮϬϬϵ͕>ZEZ͕ϮϬϭϭͿ
ŽƵƚƌŽƐ ƉĂƌĂ ĚŝĂŐŶſƐƟĐŽ͕ ƉĂƌĂ ŝĚĞŶƟĮĐĂƌ ĂůǀŽƐ ĚĞ ŝŶƚĞƌǀĞŶĕĆŽ Ğ
ŵŽŶŝƚŽƌĂƌŽƐƐŝŶƚŽŵĂƐĂŽůŽŶŐŽĚŽƚĞŵƉŽ͘ ĞŶƚƌĞŽƐ ŝŶƐƚƌƵŵĞŶƚŽƐ ĚĞ ƌĂƐƚƌĞĂŵĞŶƚŽͬƚƌŝĂŐĞŵĚĞ ŝŶĚŝĐĂĚŽƌĞƐĚŽƐ
dĂĚĂƉƚĂĚŽƐĞǀĂůŝĚĂĚŽƐŶŽƌĂƐŝů͕ĂƉĞŶĂƐŽDͲ,dĠĚĞƵƐŽůŝǀƌĞ͗
ŝŵƉŽƌƚĂŶƚĞ ƐĂůŝĞŶƚĂƌ ƋƵĞ ŚĄ ŝŶƐƚƌƵŵĞŶƚŽƐ ĚĞ ƌĂƐƚƌĞĂŵĞŶƚŽͬ
ƚƌŝĂŐĞŵƋƵĞƉŽĚĞŵƐĞƌĂƉůŝĐĂĚŽƐƉŽƌƉƌŽĮƐƐŝŽŶĂŝƐĚĞĚŝǀĞƌƐĂƐĄƌĞĂƐ͕ x DͲŚĂƚ ;DŽĚŝĮĞĚ ŚĞĐŬůŝƐƚ ĨŽƌ ƵƟƐŵ ŝŶ dŽĚĚůĞƌƐ Ġ Ƶŵ
ƉĂƌĂƐĞƌŽŵĂŝƐĂďƌĂŶŐĞŶƚĞƉŽƐƐşǀĞů͘/ŶƐƚƌƵŵĞŶƚŽƐĚĞƌĂƐƚƌĞĂŵĞŶƚŽ ƋƵĞƐƟŽŶĄƌŝŽĐŽŵϮϯŝƚĞŶƐ͕ƵƐĂĚŽĐŽŵŽƚƌŝĂŐĞŵĚĞd͘WŽĚĞƐĞƌ
ƐĆŽ ĂƋƵĞůĞƐ ƋƵĞ͕ Ğŵ ůŝŶŚĂƐ ŐĞƌĂŝƐ͕ ĚĞƚĞĐƚĂŵ ƐŝŶƚŽŵĂƐ ƌĞůĂƟǀŽƐ ĂŽ ĂƉůŝĐĂĚŽƉŽƌƋƵĂůƋƵĞƌƉƌŽĮƐƐŝŽŶĂůĚĞƐĂƷĚĞ͘ŽŵŽŵĞŶĐŝŽŶĂĚŽ͕
ĞƐƉĞĐƚƌŽ͕ŵĂƐŶĆŽ͞ĨĞĐŚĂŵ͟ĚŝĂŐŶſƐƟĐŽ͘ ĠĐŽŵƉŽƐƚŽƉŽƌϮϯƉĞƌŐƵŶƚĂƐƉĂƌĂƉĂŝƐĚĞĐƌŝĂŶĕĂƐĚĞϭϴĂϮϰ
ŵĞƐĞƐ͕ĐŽŵƌĞƐƉŽƐƚĂƐ͞Ɛŝŵ͟ŽƵ͞ŶĆŽ͕͟ƋƵĞŝŶĚŝĐĂŵĂƉƌĞƐĞŶĕĂĚĞ
sĂůĞ ĚĞƐƚĂĐĂƌ ƋƵĞ ƚĂŝƐ ŝŶƐƚƌƵŵĞŶƚŽƐ ĨŽƌŶĞĐĞŵ ŝŶĨŽƌŵĂĕƁĞƐ ƋƵĞ ĐŽŵƉŽƌƚĂŵĞŶƚŽƐĐŽŶŚĞĐŝĚŽƐĐŽŵŽƐŝŶĂŝƐƉƌĞĐŽĐĞƐĚĞd͘/ŶĐůƵŝ
ůĞǀĂŶƚĂŵ Ă ƐƵƐƉĞŝƚĂ ĚŽ ĚŝĂŐŶſƐƟĐŽ͕ ƐĞŶĚŽ ŶĞĐĞƐƐĄƌŝŽ Ž ĚĞǀŝĚŽ ŝƚĞŶƐ ƌĞůĂĐŝŽŶĂĚŽƐ ĂŽƐ ŝŶƚĞƌĞƐƐĞƐ ĚĂ ĐƌŝĂŶĕĂ ŶŽ ĞŶŐĂũĂŵĞŶƚŽ
ĞŶĐĂŵŝŶŚĂŵĞŶƚŽ ƉĂƌĂ ƋƵĞ Ž ĚŝĂŐŶſƐƟĐŽ ƉƌŽƉƌŝĂŵĞŶƚĞ ĚŝƚŽ ƐĞũĂ ƐŽĐŝĂů͖ ŚĂďŝůŝĚĂĚĞ ĚĞ ŵĂŶƚĞƌ Ž ĐŽŶƚĂƚŽ ǀŝƐƵĂů͖ ŝŵŝƚĂĕĆŽ͖
ƌĞĂůŝnjĂĚŽƉŽƌƉƌŽĮƐƐŝŽŶĂůƚƌĞŝŶĂĚŽĞĐĂƉĂĐŝƚĂĚŽƉĂƌĂŝƐƐŽ͘EŽĐĂƐŽ ďƌŝŶĐĂĚĞŝƌĂ ƌĞƉĞƟƟǀĂ Ğ ĚĞ ͞ĨĂnjͲĚĞͲĐŽŶƚĂ͖͟ Ğ Ž ƵƐŽ ĚŽ ĐŽŶƚĂƚŽ
ĚŽƐ dƌĂŶƐƚŽƌŶŽƐ ĚŽ ƐƉĞĐƚƌŽ ĚŽ ƵƟƐŵŽ͕ ƌĞĐŽŵĞŶĚĂͲƐĞ ƋƵĞ ƐĞũĂ ǀŝƐƵĂů Ğ ĚĞ ŐĞƐƚŽƐ ƉĂƌĂ ĚŝƌĞĐŝŽŶĂƌ ĂƚĞŶĕĆŽ ƐŽĐŝĂů ĚŽ ƉĂƌĐĞŝƌŽ
ƌĞĂůŝnjĂĚŽĚŝĂŐŶſƐƟĐŽĚŝĨĞƌĞŶĐŝĂů͘ ŽƵƉĂƌĂƉĞĚŝƌĂũƵĚĂ;>K^W/KĞWKE͕ϮϬϬϴ͖^dZKͲ^Kh͕
2 Foram incluídos apenas instrumentos cuja situação de uso livre de direitos ϮϬϭϭͿtZ/',dWKh>/EͲhK/^͕ϮϬϭϭͿ͘
autorais foi mencionada na publicação original e/ou na versão brasileira.
30 31
Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
6.1 – Motores
x ĚŝĮĐƵůĚĂĚĞĚĞƐĞĂŶŝŶŚĂƌŶŽĐŽůŽĚŽƐĐƵŝĚĂĚŽƌĞƐŽƵĞdžƚƌĞŵĂ
ƉĂƐƐŝǀŝĚĂĚĞ ŶŽ ĐŽŶƚĂƚŽ ĐŽƌƉŽƌĂů͖ ĞdžƚƌĞŵĂ ƐĞŶƐŝďŝůŝĚĂĚĞ Ğŵ
ŵŽŵĞŶƚŽƐĚĞĚĞƐĐŽŶĨŽƌƚŽ;Ğdž͗͘ĚŽƌͿ͖
x ĚŝƐƐŝŵĞƚƌŝĂƐŶĂŵŽƚƌŝĐŝĚĂĚĞ͕ƚĂŝƐĐŽŵŽ͗ŵĂŝŽƌŵŽǀŝŵĞŶƚĂĕĆŽ
ĚŽƐŵĞŵďƌŽƐĚĞƵŵůĂĚŽĚŽĐŽƌƉŽ͖ĚŝĮĐƵůĚĂĚĞƐĚĞƌŽůĂŵĞŶƚŽ
ŶĂ ŝĚĂĚĞ ĞƐƉĞƌĂĚĂ͖ ŵŽǀŝŵĞŶƚŽƐ ĐŽƌƉŽƌĂŝƐ Ğŵ ďůŽĐŽ Ğ ŶĆŽ
32 33
Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
x ŝŶƐŝƐƚġŶĐŝĂ ǀŝƐƵĂů Ğŵ ŽďũĞƚŽƐ ƋƵĞ ƚġŵ ůƵnjĞƐ ƋƵĞ ƉŝƐĐĂŵ ĞͬŽƵ x Ă ƉĞƌĚĂ ĚĞ ŚĂďŝůŝĚĂĚĞƐ ƉƌĞǀŝĂŵĞŶƚĞ ĂĚƋƵŝƌŝĚĂƐ ĚĞǀĞ ƐĞƌ
ĞŵŝƚĞŵďĂƌƵůŚŽƐ͕ďĞŵĐŽŵŽŶĂƐƉĂƌƚĞƐƋƵĞŐŝƌĂŵ;ǀĞŶƟůĂĚŽƌĞƐ͕ ƐĞŵƉƌĞĞŶĐĂƌĂĚĂĐŽŵŽƐŝŶĂůĚĞŝŵƉŽƌƚąŶĐŝĂ͘ůŐƵŵĂƐĐƌŝĂŶĕĂƐ
ŵĄƋƵŝŶĂƐ͕ĞƚĐ͘Ϳ͖ ĐŽŵdĚĞŝdžĂŵĚĞĨĂůĂƌĞƉĞƌĚĞŵĐĞƌƚĂƐŚĂďŝůŝĚĂĚĞƐƐŽĐŝĂŝƐ
ũĄ ĂĚƋƵŝƌŝĚĂƐ ƉŽƌ ǀŽůƚĂ ĚŽƐ ϭϮͲϮϰ ŵĞƐĞƐ͘ ƉĞƌĚĂ ƉŽĚĞ ƐĞƌ
x ŝŶƐŝƐƚġŶĐŝĂƚĄƟů͗ƉŽĚĞŵƉĞƌŵĂŶĞĐĞƌƉŽƌŵƵŝƚŽƚĞŵƉŽƉĂƐƐĂŶĚŽĂ
ŐƌĂĚƵĂů ŽƵ ĂƉĂƌĞŶƚĞŵĞŶƚĞ ƐƷďŝƚĂ͘ ĂƐŽ ŝƐƐŽ ƐĞũĂ ŽďƐĞƌǀĂĚŽ
ŵĆŽƐŽďƌĞƵŵĂĚĞƚĞƌŵŝŶĂĚĂƚĞdžƚƵƌĂ͘
ĞŵƵŵĂĐƌŝĂŶĕĂ͕ĂŽůĂĚŽĚĞŽƵƚƌŽƐƉŽƐƐşǀĞŝƐƐŝŶĂŝƐ͕ĂŚŝƉſƚĞƐĞ
ĚĞ ǁƵŵ d ĚĞǀĞ ƐĞƌ ĂǀĞŶƚĂĚĂ͕ ƐĞŵ͕ ŶŽ ĞŶƚĂŶƚŽ͕ ĞdžĐůƵŝƌ
6.3 - Rotinas
ŽƵƚƌĂƐ ƉŽƐƐŝďŝůŝĚĂĚĞƐ ĚŝĂŐŶſƐƟĐĂƐ ;ƉŽƌ ĞdžĞŵƉůŽ͕ ĚŽĞŶĕĂƐ
x ƚĞŶĚġŶĐŝĂĂƌŽƟŶĂƐƌŝƚƵĂůŝnjĂĚĂƐĞƌşŐŝĚĂƐ͖ ƉƌŽŐƌĞƐƐŝǀĂƐͿ͘
34 35
Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
^ĞŐƵĞĂďĂŝdžŽ͕ƵŵŵŽĚĞůŽƐŝŶƚĠƟĐŽĚĞĂƐƉĞĐƚŽƐĂƐĞƌĞŵŝŶǀĞƐƟŐĂĚŽƐ
ƉĞůĂƐĞƋƵŝƉĞƐ͕ƉƌŽƉŽƐƚŽƉŽƌK^;ϭϵϵϴͿĞĂŵƉůŝĂĚĂƉŽƌ&ZEE^
;ϮϬϬϬͿ͖WZ/^^/EKdK;ϮϬϬϰͿĞDZYh^;ϮϬϭϬͿ͕ĞƋƵĞƉŽĚĞŽƌŝĞŶƚĂƌ
ŽƐƉƌŽĮƐƐŝŽŶĂŝƐĚĂƐĂƷĚĞ͘
ůĠŵĚŽƐĚĂĚŽƐƋƵĞũĄĐŽŶƐƚĂŵŶŽƉƌŽŶƚƵĄƌŝŽĠŝŵƉŽƌƚĂŶƚĞƌĞŐŝƐƚƌĂƌ
ŽƐ ƟƉŽƐ ĚĞ ĂƚĞŶĚŝŵĞŶƚŽƐ ;ĚĂƚĂ ĚĞ ŝŶşĐŝŽ͕ ĨƌĞƋƵġŶĐŝĂ͕ ĞƚĐ͘Ϳ Ğ ŽďƚĞƌ
ŝŶĨŽƌŵĂĕƁĞƐƐŽďƌĞ͗
x ,ŝƐƚſƌŝĂĚĞƉƌŽďůĞŵĂƐĚĞĚĞƐĞŶǀŽůǀŝŵĞŶƚŽĚŽƐƉĂŝƐ͕ŝƌŵĆŽƐ
Ğ ŽƵƚƌŽƐ ĨĂŵŝůŝĂƌĞƐ ;ĚĞƐĞŶǀŽůǀŝŵĞŶƚŽ İƐŝĐŽ͕ ƉƌŽďůĞŵĂƐ
ĞŵŽĐŝŽŶĂŝƐ͕ƉƌŽďůĞŵĂƐĚĞĂƉƌĞŶĚŝnjĂŐĞŵŶĂĞƐĐŽůĂʹůĞŝƚƵƌĂͬ
ĞƐĐƌŝƚĂͿĞƐĞŚŽƵǀĞŶĞĐĞƐƐŝĚĂĚĞĚĞƚƌĂƚĂŵĞŶƚŽ͘
x YƵĂŶĚŽ ƐƵƌŐŝƌĂŵ ŽƐ ƉƌŝŵĞŝƌŽƐ ƐŝŶƚŽŵĂƐ Ğ Ğŵ ƋƵĞ ĄƌĞĂ ĚŽ
36 37
Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
38 39
Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
ƐŝŵƉůĞƐĞƐŝŵƵůƚąŶĞĂƐ;ĐŚƵƚĂƌďŽůĂĚĞǀŽůƚĂĞŶƋƵĂŶƚŽĚĞƐůŽĐĂ
ĐĂƌƌŝŶŚŽƐŶĂĂƌĞŝĂ͖ĞƚĐ͘Ϳ͍ ϳ͘Ϯ͘ϱĨĞƟǀŝĚĂĚĞ
ϳ͘Ϯ͘ϯ͘ϰ ŶŐĂũĂͲƐĞ Ğŵ ďƌŝŶĐĂĚĞŝƌĂƐ͕ ŵĂƐ ƐŽŵĞŶƚĞ ĂƋƵĞůĂƐ ĞŶ-‐
ǀŽůǀĞŶĚŽŽƐŽďũĞƚŽƐĚĞƉƌĞŽĐƵƉĂĕƁĞƐĐŝƌĐƵŶƐĐƌŝƚĂƐ;ĞƐƚĞƌĞŽƟ-‐ ϳ͘Ϯ͘ϱ͘ϭŵƋƵĞŝĚĂĚĞŽĐŽƌƌĞƌĂŵŽƐƉƌŝŵĞŝƌŽƐƐŽƌƌŝƐŽƐ͍
ƉĂĚĂƐͿ͍ ϳ͘Ϯ͘ϱ͘ϮƉƌĞƐĞŶƚŽƵŽƌŝĞŶƚĂĕĆŽĚĂĐĂďĞĕĂƉĂƌĂĂĨĂĐĞĚŽĂĚƵůƚŽ
ϳ͘Ϯ͘ϯ͘ϱWƌĞĨĞƌĞďƌŝŶĐĂĚĞŝƌĂƐĞŵĚƵƉůĂƐĂŐƌƵƉŽƐ;ĐŽŶƐŝĚĞƌĂƌĂ ƋƵĂŶĚŽĞƐƚĞĨĂůĂǀĂͬďƌŝŶĐĂǀĂĐŽŵĞůĂ;ďĞďġͿ͍
ŝĚĂĚĞͿ͍ ϳ͘Ϯ͘ϱ͘ϯ,ĄƐŽƌƌŝƐŽĞƐƉŽŶƚąŶĞŽĂƉĞƐƐŽĂƐĨĂŵŝůŝĂƌĞƐ;ƌĞŐŝƐƚƌĂƌƐĞ
ϳ͘Ϯ͘ϯ͘ϲ&ŝĐĂŝŶƚĞŶƐĂŵĞŶƚĞĂŶƐŝŽƐŽŶĂƉƌĞƐĞŶĕĂĚĞƉĞƐƐŽĂƐƋƵĞ ĠƌĞƐƚƌŝƚŽĂŽƐƉĂŝƐͿ
ŶĆŽƐĞũĂŵĨĂŵŝůŝĂƌĞƐ;ĚŝƐƟŶŐƵŝƌĂŶƐŝĞĚĂĚĞĚĞƟŵŝĚĞnjʹďĂŝdžĂƌ ϳ͘Ϯ͘ϱ͘ϰ,ĄƐŽƌƌŝƐŽĞƐƉŽŶƚąŶĞŽĂƉĞƐƐŽĂƐƋƵĞŶĆŽƐĞũĂŵĨĂŵŝ-‐
ŽƐŽůŚŽƐ͕ĞƐĐŽŶĚĞƌŽƌŽƐƚŽ͕ĞƚĐ͘Ϳ͍ ůŝĂƌĞƐ͍
ϳ͘Ϯ͘ϯ͘ϳ/ŐŶŽƌĂͬĞǀŝƚĂĚĞĨŽƌŵĂƉĞƌƐŝƐƚĞŶƚĞŽĐŽŶƚĂƚŽĐŽŵƉĞƐƐŽ-‐ ϳ͘Ϯ͘ϱ͘ϱ,ĄǀĂƌŝĂĕĆŽŶĂĞdžƉƌĞƐƐĆŽĨĂĐŝĂů;ĐŽŶƚĞŶƚĂŵĞŶƚŽ͕ĨƌƵƐ-‐
ĂƐŶĆŽĨĂŵŝůŝĂƌĞƐ͍ ƚƌĂĕĆŽ͕ƐƵƌƉƌĞƐĂ͕ĐŽŶƐƚƌĂŶŐŝŵĞŶƚŽ͕ĞƚĐ͘Ϳ͍
ϳ͘Ϯ͘ϯ͘ϴ ŵƉƵƌƌĂͬĂŐƌŝĚĞ ;ĐŽŵƉŽŶĞŶƚĞ İƐŝĐŽͿ ĚĞ ĨŽƌŵĂ ƉĞƌƐŝƐ-‐ ϳ͘Ϯ͘ϱ͘ϲ ,Ą ĞdžƉƌĞƐƐĆŽ ĞŵŽĐŝŽŶĂů ĂƉƌŽƉƌŝĂĚĂ ĂŽ ĐŽŶƚĞdžƚŽ ;Ğdž͗͘
ƚĞŶƚĞ͍ ƐŽƌƌŝƐŽĐŽĞƌĞŶƚĞĐŽŵĂƐŝƚƵĂĕĆŽͿ͍
ϳ͘Ϯ͘ϯ͘ϵ,ĄĨĂůƚĂĚĞŝŶŝďŝĕĆŽ;ĐŽŵƵŵĞŵĐƌŝĂŶĕĂƐƉĞƋƵĞŶĂƐͿĞŵ ϳ͘Ϯ͘ϱ͘ϳŽŵƉĂƌƟůŚĂĂƟǀŝĚĂĚĞƐƉƌĂnjĞƌŽƐĂƐĐŽŵŽƐŽƵƚƌŽƐ͍
ƌĞůĂĕĆŽĂƉĞƐƐŽĂƐĞƐƚƌĂŶŚĂƐ͍ ϳ͘Ϯ͘ϱ͘ϴ ĞŵŽŶƐƚƌĂ ƉƌĞŽĐƵƉĂĕĆŽ ƐĞ ŽƐ ƉĂŝƐͬĐƵŝĚĂĚŽƌĞƐ ĞƐƚĆŽ
ϳ͘Ϯ͘ϯ͘ϭϬ,ĄǀĂƌŝĂĕĆŽŶĂƌĞƐƉŽƐƚĂĐŽŶĨŽƌŵĞŽĐŽŶƚĞdžƚŽĞĂƉĞƐ-‐ ƚƌŝƐƚĞƐŽƵĚŽĞŶƚĞƐͬŵĂĐŚƵĐĂĚŽƐ͍
ƐŽĂ͍
7.2.6 Brincadeira
7.2.4 Comportamentos de Apego
ϳ͘Ϯ͘ϲ͘ϭ /ŶǀĞƐƟŐĂƌĂƋƵĂůŝĚĂĚĞĚĂďƌŝŶĐĂĚĞŝƌĂ͗ĨƌĞƋƵġŶĐŝĂ͕ŝŶ-‐
ϳ͘Ϯ͘ϰ͘ϭĞŵŽŶƐƚƌĂƉƌĞŽĐƵƉĂĕĆŽƋƵĂŶĚŽƐĞƉĂƌĂĚĂĚŽƐƉĂŝƐŽƵ
ƚĞŶƐŝĚĂĚĞ͕ǀĂƌŝĞĚĂĚĞĚĞĐŽŶƚĞdžƚŽƐĞƚſƉŝĐŽƐ͘^ĞĂďƌŝŶĐĂĚĞŝƌĂ
ĐƵŝĚĂĚŽƌĞƐ͍
ĨŽƌƌĞƉĞƟƟǀĂĞĞƐƚĞƌĞŽƟƉĂĚĂ͕ŝŶǀĞƐƟŐĂƌĂƌĞƐŝƐƚġŶĐŝĂăŝŶƚĞƌ-‐
ϳ͘Ϯ͘ϰ͘Ϯ ^Žƌƌŝ ŽƵ ŵŽƐƚƌĂ ĞdžĐŝƚĂĕĆŽ ĐŽŵ Ž ƌĞƚŽƌŶŽ ĚŽƐ ƉĂŝƐ ŽƵ
ƌƵƉĕĆŽĚĂŵĞƐŵĂ͘
ĐƵŝĚĂĚŽƌĞƐĂƉſƐƐĞƉĂƌĂĕƁĞƐ͍
ϳ͘Ϯ͘ϲ͘Ϯ YƵĂŝƐƐĆŽŽƐďƌŝŶƋƵĞĚŽƐĞĂƟǀŝĚĂĚĞƐĨĂǀŽƌŝƚĂƐ͍
ϳ͘Ϯ͘ϰ͘ϯƵƐĐĂĂũƵĚĂĚŽƐƉĂŝƐŽƵĐƵŝĚĂĚŽƌĞƐƋƵĂŶĚŽŵĂĐŚƵĐĂ-‐
ϳ͘Ϯ͘ϲ͘ϯƉƌĞƐĞŶƚĂďƌŝŶĐĂĚĞŝƌĂĚĞĨĂnjͲĚĞͲĐŽŶƚĂ;ĨĂnjĞƌĞƐƚŽƌŝŶŚĂƐ
ĚĂ͍
ĐŽŵŽƐďƌŝŶƋƵĞĚŽƐ͖ƵŵďŽŶĞĐŽĐŽŶǀĞƌƐĂƌĐŽŵŽŽƵƚƌŽ͖ƵƐĂƌ
ϳ͘Ϯ͘ϰ͘ϰ ŚĞĐĂ Ă ƉƌĞƐĞŶĕĂ ĚŽƐ ƉĂŝƐ ŽƵ ĐƵŝĚĂĚŽƌĞƐ Ğŵ ůƵŐĂƌĞƐ
ƵŵŽďũĞƚŽƉĂƌĂƌĞƉƌĞƐĞŶƚĂƌŽƵƚƌŽͿ
ĞƐƚƌĂŶŚŽƐ͍
ϳ͘Ϯ͘ϲ͘ϰ ůŝŶŚĂ ŽƵ ĞŵƉŝůŚĂ ŽďũĞƚŽƐ ƐĞŵ ĂƉĂƌĞŶƚĞ ĨƵŶĕĆŽ ŶĂ
40 41
Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
ϳ͘Ϯ͘ϳ ŽŵƉŽƌƚĂŵĞŶƚŽƐƌĞƉĞƟƟǀŽƐĞĞƐƚĞƌĞŽƟƉĂĚŽƐ
ϳ͘Ϯ͘ϳ͘ϭDĂŶĞŝƌŝƐŵŽƐĞDŽǀŝŵĞŶƚŽƐŽŵƉůĞdžŽƐĚŽŽƌƉŽ;ƌĞ-‐
7.3 Observação Direta do Comportamento
ƉĞƟĕĆŽĚĞŵŽǀŝŵĞŶƚŽƐƐĞŵĂƉĂƌĞŶƚĞĨƵŶĕĆŽ͕ƉƌŝŶĐŝƉĂůŵĞŶƚĞ
7.3.1 – Interação social, linguagem e comunicação
ĞŵŵŽǀŝŵĞŶƚŽƐĚĞĞƐƚƌĞƐƐĞŽƵĞdžĐŝƚĂĕĆŽͿ͗
ϳ͘Ϯ͘ϳ͘Ϯ,ĄŵŽǀŝŵĞŶƚŽƐĚĂƐŵĆŽƐƉĞƌƚŽĚŽƌŽƐƚŽ͍
ϳ͘ϯ͘ϭ͘ϭͲƚĞŶĕĆŽŽŵƉĂƌƟůŚĂĚĂ
ϳ͘Ϯ͘ϳ͘ϯ,ĄŵŽǀŝŵĞŶƚŽƐĚŽƐĚĞĚŽƐĞŵĆŽƐũƵŶƚŽĂŽĐŽƌƉŽ͍
ϳ͘Ϯ͘ϳ͘ϰ,ĄďĂůĂŶĕŽĚŽĐŽƌƉŽ͍ x KďƐĞƌǀĂƌƐĞƚĞŶƚĂĚŝƌŝŐŝƌĂĂƚĞŶĕĆŽĚŽĞdžĂŵŝŶĂĚŽƌƉĂƌĂ
ϳ͘Ϯ͘ϳ͘ϱ,ĄŵŽǀŝŵĞŶƚŽƐĚŽƐďƌĂĕŽƐ;ŇĂƉƉŝŶŐͿ͍ ďƌŝŶƋƵĞĚŽƐͬĞǀĞŶƚŽƐ ĚĞ ŝŶƚĞƌĞƐƐĞ ƉƌſƉƌŝŽ͕ ĚĞ ĨŽƌŵĂ
ĞƐƉŽŶƚąŶĞĂ͘WŽĚĞƐĞƌŵĂŶŝĨĞƐƚĂĚŽƉŽƌŵĞŝŽĚĞŐĞƐƚŽƐ
7.2.8 Sensibilidade Sensorial: ;ŵŽƐƚƌĂƌ͕ ĂƉŽŶƚĂƌ͕ ƚƌĂnjĞƌ ŽďũĞƚŽƐ ƉĂƌĂ Ž ƉĂƌĐĞŝƌŽͿ ĞͬŽƵ
42 43
Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
ǀĞƌďĂůŝnjĂĕƁĞƐ;ĐŽŵĞŶƚĄƌŝŽƐƐŽďƌĞĂƐƉƌŽƉƌŝĞĚĂĚĞƐİƐŝĐĂƐ x /ŵŝƚĂĕĆŽŵŽƚŽƌĂŽƵ͞ƐŽĐŝĂů͟ĞƐƚĆŽƉƌĞƐĞŶƚĞƐ͍
ĚŽƐ ŽďũĞƚŽƐͬĞǀĞŶƚŽƐ͖ ƉĞƌŐƵŶƚĂƐ ƉĂƌĂ ĞƐĐůĂƌĞĐŝŵĞŶƚŽ x KďƐĞƌǀĂƌƐĞƌĞƉƌŽĚƵnjŽƐŐĞƐƚŽƐŽƵĂƟǀŝĚĂĚĞƐŝŶŝĐŝĂĚĂƐ
ĚĞ ĚƷǀŝĚĂƐ ŽƵ ŽďƚĞŶĕĆŽ ĚĞ ŝŶĨŽƌŵĂĕĆŽ Ğŵ ƌĞůĂĕĆŽ Ă ƉĞůŽ ĞdžĂŵŝŶĂĚŽƌ ĞĐŽŵ ƋƵĞ ĨƌĞƋƵġŶĐŝĂ ŝƐƐŽ ŽĐŽƌƌĞ͖ƐĞ
ĞƐƚĞƐŽďũĞƚŽƐͬĞǀĞŶƚŽƐ͕ƉŽƌĐƵƌŝŽƐŝĚĂĚĞͿ͘EŽĐĂƐŽĚĞƐƐĞ ĐĂŶƚĂŽƵĚĂŶĕĂ͘
ĐŽŵƉŽƌƚĂŵĞŶƚŽ ĞƐƚĂƌ ƉƌĞƐĞŶƚĞ͕ ĚĞǀĞͲƐĞ ĐŽŶƐŝĚĞƌĂƌ Ž
ĐŽŵƉŽƌƚĂŵĞŶƚŽ ĐŽŽƌĚĞŶĂĚŽ ĐŽŵ Ž ŽůŚĂƌ͘ ůĠŵ ĚŝƐƐŽ͕ 7.3.1.4 -‐ Sorriso
ŽďƐĞƌǀĂƌƐĞŽĐŽŵƉŽƌƚĂŵĞŶƚŽĚĞĂƚĞŶĕĆŽĐŽŵƉĂƌƟůŚĂĚĂ
ĂƉĂƌĞĐĞĞŵƵŵĂǀĂƌŝĞĚĂĚĞĚĞƐŝƚƵĂĕƁĞƐŽƵƐŽŵĞŶƚĞĞŵ
x EĞƐƚĞ ŝƚĞŵ ĚĞǀĞͲƐĞ ŽďƐĞƌǀĂƌ ƐĞ ĂƉƌĞƐĞŶƚĂ ƐŽƌƌŝƐŽ
ĚŝƌŝŐŝĚŽ ĂŽ ŽƵƚƌŽ Ğ ĐŽŵ ŵŽƟǀŽ ĂƉĂƌĞŶƚĞ͖ ƐĞ Ă ĚŝƌĞĕĆŽ
ĂƟǀŝĚĂĚĞƐƌĞƉĞƟƟǀĂƐ;ĞƐƚĞƌĞŽƟƉĂĚĂƐͿ͘
ĚŽƐŽƌƌŝƐŽĠĚŝĨƵƐĂĞƐĞŵŵŽƟǀŽŝĚĞŶƟĮĐĄǀĞů͕ŽƵƐĞŶĆŽ
x KďƐĞƌǀĂƌ ƚĂŵďĠŵ ƐĞ ƐĞŐƵĞ ŽƐ ŐĞƐƚŽƐ ŝŶĚŝĐĂƟǀŽƐ ĚĞ
ƐŽƌƌŝ͘ ŽŶƐŝĚĞƌĂƌ ƚĂŵďĠŵ ƐĞ Ž ƐŽƌƌŝƐŽ Ġ ĂĐŽŵƉĂŶŚĂĚŽ
ŽƵƚƌĂƐƉĞƐƐŽĂƐ͗ŽůŚĂƉĂƌĂŽŶĚĞĞƐƚĞƐĞƐƚĆŽŽůŚĂŶĚŽ͕ĞƚĐ͘
ƉĞůŽŽůŚĂƌĞĂĚĞƋƵĂĚŽĂŽĐŽŶƚĞdžƚŽƐŽĐŝĂů͘
EĆŽ ŝŶĐůƵŝ ĨĂnjĞƌ ŐĞƐƚŽƐ ŽƵ ĨĂůĂƌ ƉĂƌĂ ƉĞĚŝƌ ĂũƵĚĂ ;ƉĂƌĂ
ĂůĐĂŶĕĂƌŽƵĨĂnjĞƌĨƵŶĐŝŽŶĂƌƵŵďƌŝŶƋƵĞĚŽ͕ĞƚĐ͘Ϳ͘
ϳ͘ϯ͘ϭ͘ϱ Ͳ KƵƚƌĂƐ džƉƌĞƐƐƁĞƐ ĨĞƟǀĂƐ /ĚĞŶƟĮĐĄǀĞŝƐ ƉĞůŽ
Observador
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Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
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Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
ĚĂǀĂƌŝĂĕĆŽŵĞůſĚŝĐĂĚĂŽƵƚƌĂƉĞƐƐŽĂĠŵŽƟǀĂĚŽƌĂĚĂ ƐĞƌĞĂůŝnjĂĚĂĚĞĨŽƌŵĂĞƐƚĞƌĞŽƟƉĂĚĂ;Ğdž͗͘ŝŶƚĞƌĞƐƐĞƉĞůŽ
ĂƚĞŶĕĆŽĚĂƉĞƐƐŽĂĐŽŵd͘ ŵŽǀŝŵĞŶƚŽ ĚŽƐ ŽďũĞƚŽƐ͕ ƉŽƌ ƉĂƌƚĞƐ Ğ ŶĆŽ ƉĞůŽ ŽďũĞƚŽ
ŝŶƚĞŝƌŽ͕ĂƟǀŝĚĂĚĞƌĞƉĞƟƟǀĂͲĂůŝŶŚĂƌ͕ŐŝƌĂƌŽďũĞƚŽƐ͕ƐĞŵ
x ŽŶƐŝĚĞƌĞ ĂŝŶĚĂ Ž ǀŽĐĂďƵůĄƌŝŽ ĚĞ ƌĞĐĞƉĕĆŽ Ğ ĚĞ ĨƵŶĕĆŽĂƉĂƌĞŶƚĞͿ͘
ĞdžƉƌĞƐƐĆŽ͖ Ă ĐŽŵƉůĞdžŝĚĂĚĞ ŐƌĂŵĂƟĐĂů ĚĞ ƌĞĐĞƉĕĆŽ Ğ
ĞdžƉƌĞƐƐĆŽ͖ĞĐĂƌĂĐƚĞƌşƐƟĐĂƐĨŽŶŽůſŐŝĐĂƐ͘ 7.3.2.2 -‐ Brincadeira Funcional
x KďƐĞƌǀĞ ƐĞ ƌĞĐŽŶŚĞĐĞ ůĞƚƌĂƐ͕ ƉĂůĂǀƌĂƐ͕ ĨƌĂƐĞƐ ĞͬŽƵ x ďƌŝŶĐĂĚĞŝƌĂ ĨƵŶĐŝŽŶĂů ƌĞĨĞƌĞͲƐĞ ă ŵĂŶŝƉƵůĂĕĆŽ ĚĞ
ŶƷŵĞƌŽƐ ƐĞŵ ƚĞƌ ƐŝĚŽ ĨŽƌŵĂůŵĞŶƚĞ ĞŶƐŝŶĂĚŽ ;ĂŶƚĞƌŝŽƌ ŽďũĞƚŽƐͬďƌŝŶƋƵĞĚŽƐŶĆŽĂƉĞŶĂƐĐŽŵĮŶƐĞdžƉůŽƌĂƚſƌŝŽƐ͕
ĂŽƐ ϰĂŶŽƐͿ Ğ͕ ĞƐƉĞĐŝĂůŵĞŶƚĞ͕ ƐĞ ŵŽƐƚƌĂ ĐŽŵƉƌĞĞŶƐĆŽ ŵĂƐĚĞĂĐŽƌĚŽĐŽŵƐƵĂƐĨƵŶĕƁĞƐ;Ğdž͗͘ĂĐŝŽŶĂƌďƌŝŶƋƵĞĚŽƐ
ĚĞƐƚĞƟƉŽĚĞůĞŝƚƵƌĂ͘ ŵƵƐŝĐĂŝƐ͕ĨĂnjĞƌĞŶĐĂŝdžĞƐ͕ũŽŐŽƐĚĞĐŽŶƐƚƌƵĕĆŽ͕ĞƚĐ͘Ϳ͘
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Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
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Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
ĂƵƚŽĞŚĞƚĞƌŽĂŐƌĞƐƐŝǀŽƐ͕ŽƐƌŝƐĐŽƐƋƵĞĞƐƚĞƐĂƉƌĞƐĞŶƚĂŵ͕
ďĞŵĐŽŵŽĨŽƌŵĂƐĚĞƚƌĂƚĂŵĞŶƚŽĞŐĞƌĞŶĐŝĂŵĞŶƚŽĚŽƐ
ŵĞƐŵŽƐ͕ ĚĞǀĞŵ ƐĞƌ ĞdžƚĞŶƐŝǀĂŵĞŶƚĞ ĚŝƐĐƵƟĚĂƐ ƉĞůĂ
ĞƋƵŝƉĞ ĚĞ ƚƌĂďĂůŚŽ͘ DĂƐ ŶĆŽ ƐĆŽ ĂƉĞŶĂƐ ŽƐ ĞdžĐĞƐƐŽƐ
ĐŽŵƉŽƌƚĂŵĞŶƚĂŝƐ ƋƵĞ ĐŽůŽĐĂŵ Ž ŝŶĚŝǀşĚƵŽ Ğŵ ƌŝƐĐŽ͘
ĠĮĐŝƚƐŶĂƐĄƌĞĂƐĚĞĐŽŵƵŶŝĐĂĕĆŽ͕ĂƵƚŽĐƵŝĚĂĚŽƐĞĂƵƚŽ
ƉƌĞƐĞƌǀĂĕĆŽƚĂŵďĠŵƉŽĚĞŵƐĞƌĐƌşƟĐŽƐ͘
7.3.5 – Comorbidades
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ĨĂŵşůŝĂ͕ĞƋƵĞŝŵƉƁĞĐƵŝĚĂĚŽƐĞƌŽƟŶĂƐĚŝĨĞƌĞŶĐŝĂĚĂƐ͘ŝŐƵĂůŵĞŶƚĞ
8 O Momento da Notícia do Diagnóstico ŝŵƉŽƌƚĂŶƚĞĞƐĐůĂƌĞĐĞƌƋƵĞŽƐĐƵŝĚĂĚŽƐƐĞƌĆŽĐŽŵƉĂƌƟůŚĂĚŽƐĞŶƚƌĞĂ
de TEA ĞƋƵŝƉĞƉƌŽĮƐƐŝŽŶĂůƌĞƐƉŽŶƐĄǀĞůƉĞůŽƚƌĂƚĂŵĞŶƚŽĞĂĨĂŵşůŝĂ͘KƵƐĞũĂ͕
ĠŝŵƉŽƌƚĂŶƚĞĨĂnjġͲůĂŶŽƚĂƌƋƵĞŶĆŽĞƐƚĂƌĄƐŽnjŝŶŚĂŶĞƐƐĞƉƌŽĐĞƐƐŽ͕Ğ
K ŵŽŵĞŶƚŽ ĚĂ ŶŽơĐŝĂ ĚŽ ĚŝĂŐŶſƐƟĐŽ ĚĞǀĞ ƐĞƌ ĐƵŝĚĂĚŽƐĂŵĞŶƚĞ
ƋƵĞƚĞƌĄƌĞƐƉĞŝƚĂĚĂƐƵĂĂƵƚŽŶŽŵŝĂŶĂƚŽŵĂĚĂĚĂƐĚĞĐŝƐƁĞƐ͘
ƉƌĞƉĂƌĂĚŽ͕ ƉŽŝƐ ƐĞƌĄ ŵƵŝƚŽ ƐŽĨƌŝĚŽ ƉĂƌĂ ĨĂŵşůŝĂ Ğ ƚĞƌĄ ŝŵƉĂĐƚŽ Ğŵ
ƐƵĂĨƵƚƵƌĂĂĚĞƐĆŽĂŽƚƌĂƚĂŵĞŶƚŽ͘
ĂƉƌĞƐĞŶƚĂĕĆŽĚŽĚŝĂŐŶſƐƟĐŽĚĞǀĞƐĞƌĐŽŵƉůĞŵĞŶƚĂĚĂƉĞůĂƐƵŐĞƐƚĆŽ
ĚĞ ƚƌĂƚĂŵĞŶƚŽ͕ ŝŶĐůƵŝŶĚŽ ƚŽĚĂƐ ĂƐ ĂƟǀŝĚĂĚĞƐ ƐƵŐĞƌŝĚĂƐ ŶŽ ƉƌŽũĞƚŽ
ƚĞƌĂƉġƵƟĐŽ ƐŝŶŐƵůĂƌ͘ K ĞŶĐĂŵŝŶŚĂŵĞŶƚŽ ƉĂƌĂ ŽƐ ƉƌŽĮƐƐŝŽŶĂŝƐ͕ ƋƵĞ
ĞƐƚĂƌĆŽĞŶǀŽůǀŝĚŽƐŶŽĂƚĞŶĚŝŵĞŶƚŽĚŽĐĂƐŽ͕ĚĞǀĞƐĞƌĨĞŝƚŽĚĞŵŽĚŽ
ŽďũĞƟǀŽ Ğ ŝŵĞĚŝĂƚŽ͕ ƌĞƐƉĞŝƚĂŶĚŽ͕ Ġ ĐůĂƌŽ͕ Ž ƚĞŵƉŽ ŶĞĐĞƐƐĄƌŝŽ ƉĂƌĂ
ĐĂĚĂĨĂŵşůŝĂĞůĂďŽƌĂƌĂŶŽǀĂƐŝƚƵĂĕĆŽ͘
ŝŵƉŽƌƚĂŶƚĞĞƐĐůĂƌĞĐĞƌƋƵĞŽƋƵĂĚƌŽĚŽĂƵƟƐŵŽĠƵŵĂ͞ƐşŶĚƌŽŵĞ͕͟
ƋƵĞƐŝŐŶŝĮĐĂ͞ƵŵĐŽŶũƵŶƚŽĚĞƐŝŶĂŝƐĐůşŶŝĐŽƐ͖͟ĐŽŶũƵŶƚŽƋƵĞĚĞĮŶĞƵŵĂ
ĐĞƌƚĂĐŽŶĚŝĕĆŽĚĞǀŝĚĂĚŝĨĞƌĞŶƚĞĚĂƋƵĞůĂĂƚĠĞŶƚĆŽĞdžƉĞƌŝŵĞŶƚĂĚĂƉĞůĂ
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da Saúde com Transtornos do Espectro do Autismo (TEA)
ŽĨĞƌƚĂĚĞƚƌĂƚĂŵĞŶƚŽ͕ŶŽƐƉŽŶƚŽƐĚĞĂƚĞŶĕĆŽĚĂZĞĚĞĚĞƵŝĚĂĚŽƐ
ă ^ĂƷĚĞ ĚĂ WĞƐƐŽĂ ĐŽŵ ĞĮĐŝġŶĐŝĂ͕ ĐŽŶƐƟƚƵŝ ƵŵĂ ŝŵƉŽƌƚĂŶƚĞ
ĞƐƚƌĂƚĠŐŝĂ ŶĂ ĂƚĞŶĕĆŽ ăƐ ƉĞƐƐŽĂƐ ĐŽŵ ƚƌĂŶƐƚŽƌŶŽƐ ĚŽ ĞƐƉĞĐƚƌŽ
ĚŽ ĂƵƟƐŵŽ͕ ƵŵĂ ǀĞnj ƋƵĞ ƚĂů ĐŽŶĚŝĕĆŽ ŝŵƉůŝĐĂ Ğŵ ĂůƚĞƌĂĕƁĞƐ ĚĞ
ůŝŶŐƵĂŐĞŵĞĚĞƐŽĐŝĂďŝůŝĚĂĚĞƋƵĞĂĨĞƚĂŵĚŝƌĞƚĂŵĞŶƚĞʹĐŽŵŵĂŝŽƌŽƵ
ŵĞŶŽƌŝŶƚĞŶƐŝĚĂĚĞʹŐƌĂŶĚĞƉĂƌƚĞĚŽƐĐĂƐŽƐ͕ůŝŵŝƚĂŶĚŽĐĂƉĂĐŝĚĂĚĞƐ
ĨƵŶĐŝŽŶĂŝƐŶŽĐƵŝĚĂĚŽĚĞƐŝĞŶĂƐŝŶƚĞƌĂĕƁĞƐƐŽĐŝĂŝƐ͕ŽƋƵĞĚĞŵĂŶĚĂ
ĐƵŝĚĂĚŽƐ ĞƐƉĞĐşĮĐŽƐ Ğ ƐŝŶŐƵůĂƌĞƐ ĚĞ ŚĂďŝůŝƚĂĕĆŽ Ğ ƌĞĂďŝůŝƚĂĕĆŽ3 ao
ůŽŶŐŽĚĂƐĚŝĨĞƌĞŶƚĞƐĨĂƐĞƐĚĂǀŝĚĂ͘
KƉƌŽũĞƚŽƚĞƌĂƉġƵƟĐŽĂƐĞƌĚĞƐĞŶǀŽůǀŝĚŽĚĞǀĞƌĞƐƵůƚĂƌĚŽĚŝĂŐŶſƐƟĐŽ
ĞůĂďŽƌĂĚŽ͖ĚĂƐƐƵŐĞƐƚƁĞƐĚĂĞƋƵŝƉĞ͖ĞĚĂƐĚĞĐŝƐƁĞƐĚĂĨĂŵşůŝĂ͘dŽĚŽ
ƉƌŽũĞƚŽ ƚĞƌĂƉġƵƟĐŽ͕ ƉŽƌƚĂŶƚŽ͕ ƐĞƌĄ ŝŶĚŝǀŝĚƵĂůŝnjĂĚŽ Ğ ĚĞǀĞ ĂƚĞŶĚĞƌ
ăƐŶĞĐĞƐƐŝĚĂĚĞƐ͕ĚĞŵĂŶĚĂƐĞŝŶƚĞƌĞƐƐĞƐĚĞĐĂĚĂƉĂĐŝĞŶƚĞĞĚĞƐĞƵƐ
ĨĂŵŝůŝĂƌĞƐ͘
3 Conforme o documento base para gestores e trabalhadores do SUS
(Ministério da Saúde, Secretaria de Atenção à Saúde, Núcleo Técnico da Política
Nacional de Humanização, 4a Ed., 2008), habilitar é tornar hábil, no sentido da destreza/
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p PDUFDGR SRU VXDV H[SHULrQFLDV R HQWRUQR GH IHQ{PHQRV UHODo}HV H FRQGLo}HV
históricas, neste sentido, sempre muda. Então, a noção de reabilitar é relativamente
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aplica.
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da Saúde com Transtornos do Espectro do Autismo (TEA)
ĞƐĐŽůŚĂ ĚŽ ŵĠƚŽĚŽ Ă ƐĞƌ ƵƟůŝnjĂĚŽ ŶŽ ƚƌĂƚĂŵĞŶƚŽ͕ ďĞŵ ĐŽŵŽ Ă ĨĂƚŽƌĞƐĂĚŝĐŝŽŶĂŝƐĚĞǀĞŵƐĞƌĐŽŶƐŝĚĞƌĂĚŽƐ͘WƌŝŵĞŝƌŽ͕ĂĚĞŵĂŶĚĂƉŽƌ
ĂǀĂůŝĂĕĆŽƉĞƌŝſĚŝĐĂĚĞƐƵĂĞĮĐĄĐŝĂĚĞǀĞŵƐĞƌĨĞŝƚĂƐĚĞŵŽĚŽĐŽŶũƵŶƚŽ ĞƐƐĞƟƉŽĚĞƐĞƌǀŝĕŽƚĞŵĂƵŵĞŶƚĂĚŽŶŽŵƵŶĚŽĞŽŵĞƐŵŽĠĞƐƉĞƌĂĚŽ
ĞŶƚƌĞ Ă ĞƋƵŝƉĞ Ğ Ă ĨĂŵşůŝĂ ĚŽ ƉĂĐŝĞŶƚĞ͕ ŐĂƌĂŶƟŶĚŽ ŝŶĨŽƌŵĂĕĆŽ ĂƋƵŝŶŽƌĂƐŝů͘ŝŶĚĂƋƵĞĂŝŶƚĞƌǀĞŶĕƁĞƐƉƌĞĐŽĐĞƐĞŝŶƚĞŶƐŝǀĂƐƚƌĂŐĂŵ
ĂĚĞƋƵĂĚĂ ƋƵĂŶƚŽ ĂŽ ĂůĐĂŶĐĞ Ğ ĂŽƐ ďĞŶĞİĐŝŽƐ ĚŽ ƚƌĂƚĂŵĞŶƚŽ͕ ďĞŵ ŝŵĞŶƐŽƐ ŐĂŶŚŽƐ ƉĂƌĂ Ž ŝŶĚŝǀşĚƵŽ ĐŽŵ d Ğ ƐƵĂƐ ĨĂŵşůŝĂƐ͕ ŵƵŝƚĂƐ
ĐŽŵŽĨĂǀŽƌĞĐĞŶĚŽĂŝŵƉůŝĐĂĕĆŽĞĂĐŽƌƌĞƐƉŽŶƐĂďŝůŝĚĂĚĞŶŽƉƌŽĐĞƐƐŽ ĚĂĚŝĮĐƵůĚĂĚĞƐǀŝǀŝĚĂƐƉŽƌĞƐƐĞƐŝŶĚŝǀşĚƵŽƐƵůƚƌĂƉĂƐƐĂŵŽƐĂŶŽƐĚĂ
ĚĞĐƵŝĚĂĚŽăƐĂƷĚĞ͘ ŝŶĨąŶĐŝĂĞĚĂũƵǀĞŶƚƵĚĞ͘ŶĞĐĞƐƐŝĚĂĚĞƉŽƌƐĞƌǀŝĕŽƐĞĐƵŝĚĂĚŽƐƉŽĚĞ͕
ƉŽƌƚĂŶƚŽ͕ƐĞĞƐƚĞŶĚĞƌĚƵƌĂŶƚĞƚŽĚĂĂǀŝĚĂĚŽŝŶĚŝǀşĚƵŽ͘EŽĐĂƐŽĚŽ
ĂǀĂůŝĂĕĆŽƐŝƐƚĞŵĄƟĐĂĚŽƉƌŽĐĞƐƐŽĚĞŚĂďŝůŝƚĂĕĆŽͬƌĞĂďŝůŝƚĂĕĆŽĚĞǀĞ ĂĚƵůƚŽ ŽƵ ŝĚŽƐŽ ĐŽŵ d ʹ Ƶŵ ƉŽƵĐŽ ĚŝĨĞƌĞŶƚĞ ĚŽ ƋƵĞ ŽĐŽƌƌĞ ŶĂ
ƐĞƌƉĂƵƚĂĚĂƉĞůĂŵĞůŚŽƌĂĞƉĞůĂĂŵƉůŝĂĕĆŽĚĂƐĐĂƉĂĐŝĚĂĚĞƐĨƵŶĐŝŽŶĂŝƐ ŝŶƚĞƌǀĞŶĕĆŽƉƌĞĐŽĐĞĞŶĂĞĚƵĐĂĕĆŽŝŶĨĂŶƟů͕ŽŶĚĞŚĄŵƵŝƚĂġŶĨĂƐĞŶŽ
ĚŽŝŶĚŝǀşĚƵŽĞŵǀĄƌŝŽƐŶşǀĞŝƐĞĂŽůŽŶŐŽĚŽƚĞŵƉŽ͕ƉŽƌĞdžĞŵƉůŽ͗ŶĂ ĚĞƐĞŶǀŽůǀŝŵĞŶƚŽĚĞŚĂďŝůŝĚĂĚĞƐĚĞďĂƐĞŽƵƉƌĠͲƌĞƋƵŝƐŝƚŽƐʹŽĨŽĐŽ
ƉĂƌƟĐŝƉĂĕĆŽĞŶŽĚĞƐĞŵƉĞŶŚŽĞŵĂƟǀŝĚĂĚĞƐƐŽĐŝĂŝƐĐŽƟĚŝĂŶĂƐ͖ŶĂ ĚŽĂƚĞŶĚŝŵĞŶƚŽĚĞǀĞƐĞǀŽůƚĂƌăŝŶƚĞŐƌĂĕĆŽĞĂĐĞƐƐŽĂŽƐƐĞƌǀŝĕŽƐ͕ă
ĂƵƚŽŶŽŵŝĂ ƉĂƌĂ ŵŽďŝůŝĚĂĚĞ͖ ŶĂ ĐĂƉĂĐŝĚĂĚĞ ĚĞ ĂƵƚŽĐƵŝĚĂĚŽ Ğ ĚĞ ĐŽŵƵŶŝĚĂĚĞ͕ăŝŶƐĞƌĕĆŽŶŽŵĞƌĐĂĚŽĚĞƚƌĂďĂůŚŽ͕ĂŽůĂnjĞƌ͘ġŶĨĂƐĞ
ƚƌĂďĂůŚŽ͖ ŶĂ ĂŵƉůŝĂĕĆŽ ĚŽ ƵƐŽ ĚĞ ƌĞĐƵƌƐŽƐ ƉĞƐƐŽĂŝƐ Ğ ƐŽĐŝĂŝƐ͖ ŶĂ ŶĞƐƐĂƐ ĚŝŵĞŶƐƁĞƐ ŶĆŽ ĞdžĐůƵŝ Ă ĐŽŶƟŶƵŝĚĂĚĞ ĚŽ ƚƌĂďĂůŚŽ ƉĂƌĂ ƋƵĞ
ƋƵĂůŝĚĂĚĞĚĞǀŝĚĂĞŶĂĐŽŵƵŶŝĐĂĕĆŽ͘ŵƐşŶƚĞƐĞ͕ŽƐŐĂŶŚŽƐĨƵŶĐŝŽŶĂŝƐ ŽƐĂĚƵůƚŽƐĐŽŵdƉŽƐƐĂŵĐƵŝĚĂƌĚĞƐƵĂƐĂƷĚĞƉĞƐƐŽĂů͕ĂƉƌŝŵŽƌĂƌ
ƐĆŽŝŶĚŝĐĂĚŽƌĞƐĐĞŶƚƌĂŝƐŶĂĂǀĂůŝĂĕĆŽĚĂĞĮĐĄĐŝĂĚŽƚƌĂƚĂŵĞŶƚŽ͘ ŚĂďŝůŝĚĂĚĞƐ ĨƵŶĐŝŽŶĂŝƐ Ğ ĚĞ ĂƵƚŽĐƵŝĚĂĚŽ͕ ďĞŵ ĐŽŵŽ ŝŶƚĞŶƐŝĮĐĂƌ
ƐƵĂƐ ƉŽƐƐŝďŝůŝĚĂĚĞƐ ĚĞ ĐŽŵƵŶŝĐĂĕĆŽ Ğ ĂŵƉůŝĂƌ ƐĞƵ ƌĞƉĞƌƚſƌŝŽ ĚĞ
KƚƌĂƚĂŵĞŶƚŽĚĞǀĞƐĞƌĞƐƚĂďĞůĞĐŝĚŽĚĞŵŽĚŽĂĐŽůŚĞĚŽƌĞŚƵŵĂŶŝnjĂĚŽ͕
ĐŽŵƉŽƌƚĂŵĞŶƚŽƐƐŽĐŝĂŝƐ͘
ĐŽŶƐŝĚĞƌĂŶĚŽŽĞƐƚĂĚŽĞŵŽĐŝŽŶĂůĚĂƉĞƐƐŽĂĐŽŵdĞƐĞƵƐĨĂŵŝůŝĂƌĞƐ͕
ĚŝƌĞĐŝŽŶĂŶĚŽƐƵĂƐĂĕƁĞƐĂŽĚĞƐĞŶǀŽůǀŝŵĞŶƚŽĚĞĨƵŶĐŝŽŶĂůŝĚĂĚĞƐĞă WĂƌĂŽƉůĂŶĞũĂŵĞŶƚŽ͕ƐĞůĞĕĆŽĚĞŽďũĞƟǀŽƐĞŝŶƚĞƌǀĞŶĕĆŽĞŵĐĂĚĂƵŵĂ
ĐŽŵƉĞŶƐĂĕĆŽ ĚĞ ůŝŵŝƚĂĕƁĞƐ ĨƵŶĐŝŽŶĂŝƐ͕ ĐŽŵŽ ƚĂŵďĠŵ ă ƉƌĞǀĞŶĕĆŽ ĚĞƐƐĂƐ ĄƌĞĂƐ͕ ĂƐ ĞƋƵŝƉĞƐ ƉƌŽĮƐƐŝŽŶĂŝƐ ĚĞǀĞŵ ĐŽŶƐŝĚĞƌĂƌ ĂŽ ŵĞŶŽƐ
ŽƵ ƌĞƚĂƌĚŽ ĚĞ ƉŽƐƐşǀĞů ĚĞƚĞƌŝŽƌĂĕĆŽ ĚĂƐ ĐĂƉĂĐŝĚĂĚĞƐ ĨƵŶĐŝŽŶĂŝƐ͕ ŽƐƐĞŐƵŝŶƚĞƐĂƐƉĞĐƚŽƐ͗;ĂͿƉƌĞĨĞƌġŶĐŝĂƐŝŶĚŝǀŝĚƵĂŝƐ͕;ďͿĚĞƐĞŵƉĞŶŚŽ
ƉŽƌ ŵĞŝŽ ĚĞ ƉƌŽĐĞƐƐŽƐ ĚĞ ŚĂďŝůŝƚĂĕĆŽ Ğ ƌĞĂďŝůŝƚĂĕĆŽ ĨŽĐĂĚŽƐ ŶŽ ŝŶĚŝǀŝĚƵĂů͕ ;ĐͿ ƚŽůĞƌąŶĐŝĂ Ğ ƌĞƐŝƐƚġŶĐŝĂ ă ĚĞŵĂŶĚĂ ĚĂ ĂƟǀŝĚĂĚĞ
ĂĐŽŵƉĂŶŚĂŵĞŶƚŽ ŵĠĚŝĐŽ Ğ ŶŽ ĚĞ ŽƵƚƌŽƐ ƉƌŽĮƐƐŝŽŶĂŝƐ ĚĞ ƐĂƷĚĞ ƉƌŽƉŽƐƚĂ͕;ĚͿƌŝƐĐŽƐĂŽƉƌſƉƌŝŽŝŶĚŝǀşĚƵŽŽƵŽƵƚƌŽƐ͘
ĞŶǀŽůǀŝĚŽƐ ĐŽŵ ĂƐ ĚŝŵĞŶƐƁĞƐ ĐŽŵƉŽƌƚĂŵĞŶƚĂŝƐ͕ ĞŵŽĐŝŽŶĂŝƐ͕
ĐŽŐŶŝƟǀĂƐĞĚĞůŝŶŐƵĂŐĞŵ;ŽƌĂů͕ĞƐĐƌŝƚĂĞŶĆŽͲǀĞƌďĂůͿ͕ƉŽŝƐĞƐƚĂƐƐĆŽ hŵďŽŵ ĞŶƚĞŶĚŝŵĞŶƚŽ ĚĂƐ ƉƌĞĨĞƌġŶĐŝĂƐ ŝŶĚŝǀŝĚƵĂŝƐ ĚŽ ĂĚƵůƚŽ ĐŽŵ
ĚŝŵĞŶƐƁĞƐďĄƐŝĐĂƐăĐŝƌĐƵůĂĕĆŽĞĂƉĞƌƚĞŶĕĂƐŽĐŝĂůĚĂƐƉĞƐƐŽĂƐĐŽŵ d͕ ŶĂƐ ĚŝǀĞƌƐĂƐ ĄƌĞĂƐ ĚĂ ǀŝĚĂ͕ ƉĞƌŵŝƟƌĄ ƋƵĞ Ă ĞƋƵŝƉĞ ƐĞůĞĐŝŽŶĞ
dŶĂƐŽĐŝĞĚĂĚĞ͘ ŽďũĞƟǀŽƐƐŽĐŝĂŝƐ͕ĚĞůĂnjĞƌĞƚƌĂďĂůŚŽĂĚĞƋƵĂĚŽƐĂƉĞƐƐŽĂĂƚĞŶĚŝĚĂ͘
EŽ ĐŽŶƚĞdžƚŽ ĚŽ ĂƚĞŶĚŝŵĞŶƚŽ ĂŽ ĂĚƵůƚŽ Ğ ŝĚŽƐŽ ĐŽŵ d͕ ĂůŐƵŶƐ EŽĐĂƐŽĚŽĂĚƵůƚŽ͕ĂĞdžƉƌĞƐƐĆŽ͞ĚĞƐĞŵƉĞŶŚŽŝŶĚŝǀŝĚƵĂů͟ƵƐĂĚĂĂƋƵŝ
58 59
Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
ƌĞĨĞƌĞͲƐĞ ăƐ ŚĂďŝůŝĚĂĚĞƐ ƉƌĞƐĞŶƚĞƐ Ğ ĂŽ ŶşǀĞů ĚĞ ĂũƵĚĂ ŶĞĐĞƐƐĄƌŝŽƐ ƉŽƌƐƵĂǀĞnj͕ĚĞǀĞĂƉƌĞŶĚĞƌĂĞŶƚĞŶĚĞƌĞĂĐŽůŚĞƌŽƐĨĂƚŽƐƉĂƌĂĂůĠŵ
ƉĂƌĂƋƵĞŽŝŶĚŝǀşĚƵŽƉĂƌƟĐŝƉĞĚĂƐĂƟǀŝĚĂĚĞƐƉƌŽƉŽƐƚĂƐĞŵƐƵĂǀŝĚĂ͘ ĚĂƋƵŝůŽ ƋƵĞ Ġ ƌĞůĂƚĂĚŽ͘ WŽƌ ĞdžĞŵƉůŽ͗ ƐĞ Ƶŵ ŝŶĚŝǀşĚƵŽ ƋƵĞ ŶĆŽ
ŝŵƉŽƌƚĂŶƚĞƋƵĞƐĞƚĞŶŚĂĞŵŵĞŶƚĞƋƵĞŽĨĂƚŽĚĞƐĞƚƌĂƚĂƌĚĞƵŵ ĐŽŶƐĞŐƵĞ ƐĞ ĐŽŵƵŶŝĐĂƌ͕ ƉŽĚĞ Ğdžŝďŝƌ ĐŽŵƉŽƌƚĂŵĞŶƚŽ ĂƵƚŽͲůĞƐŝǀŽ
ĂĚƵůƚŽ͕ ŶĆŽ ƐŝŐŶŝĮĐĂ ƋƵĞ ŶĆŽ ŚĂũĂ ĂƉƌĞŶĚŝnjĂŐĞŵ͘ KƵ ƐĞũĂ͕ Ƶŵ ĚŽƐ ƉĞƌƐŝƐƚĞŶƚĞĚŝƌŝŐŝĚŽăƌĞŐŝĆŽĚŽƌŽƐƚŽ͘ĞƋƵŝƉĞƚĞƌĄƋƵĞĚĞƐĞŶǀŽůǀĞƌ
ŽďũĞƟǀŽƐ ĨƵŶĚĂŵĞŶƚĂŝƐ ĚŽ ĂƚĞŶĚŝŵĞŶƚŽ͕ ŵĞƐŵŽ ĚƵƌĂŶƚĞ Ă ǀŝĚĂ ĨŽƌŵĂƐŽďũĞƟǀĂƐĚĞŵĞĚŝƌĂŽĐŽƌƌġŶĐŝĂĞŽƐƉŽƐƐşǀĞŝƐĞĨĞŝƚŽƐĚĞƐƐĞ
ĂĚƵůƚĂ͕ĠŽĚĞŚĂďŝůŝƚĂƌŽŝŶĚŝǀşĚƵŽƉĂƌĂƉĂƌƟĐŝƉĂƌĚĞŵŽĚŽĂƟǀŽĞ ĐŽŵƉŽƌƚĂŵĞŶƚŽ͘DĞĚŝĚĂƐĚĞĨƌĞƋƵġŶĐŝĂ͕ƉŽƌĐĞŶƚĂŐĞŵĚĞŽĐŽƌƌġŶĐŝĂ͕
ŝŶĚĞƉĞŶĚĞŶƚĞ ĚĂƐ ĂƟǀŝĚĂĚĞƐ ƋƵĞ ƐĆŽ ĂƉƌĞƐĞŶƚĂĚĂƐ͘ ŽŶŚĞĐĞƌ ƐĞƵ ĞƚĐ͕͘ƐĆŽďĂƐƚĂŶƚĞƷƚĞŝƐŶĞƐƐĞƐĞŶƟĚŽ͘ŵĂůŐƵŶƐĐĂƐŽƐ͕ƚĂŝƐŵĞĚŝĚĂƐ
ĚĞƐĞŵƉĞŶŚŽŝŶĚĞƉĞŶĚĞŶƚĞĞŵĚŝǀĞƌƐĂƐĄƌĞĂƐ͕ƉĞƌŵŝƚĞƋƵĞĂĞƋƵŝƉĞ ƐĞƌĆŽĂƷŶŝĐĂĨŽƌŵĂĚĞƐĞĂǀĂůŝĂƌƌŝƐĐŽƐ͘
ƉůĂŶĞũĞĞƐƚƌĂƚĠŐŝĂƐƉĂƌĂŵĞůŚŽƌĂƌĞƐƐĞĚĞƐĞŵƉĞŶŚŽĞƌĞĚƵnjŝƌ͕ŐƌĂĚƵĂů
ĞƐŝƐƚĞŵĂƟĐĂŵĞŶƚĞ͕ŽŶşǀĞůĚĞĂũƵĚĂƋƵĞĠŶĞĐĞƐƐĄƌŝŽ͘ ĞƐƐĞŶĐŝĂůƋƵĞĂĚĞĮŶŝĕĆŽĚŽƉƌŽũĞƚŽƚĞƌĂƉġƵƟĐŽĚĂƐƉĞƐƐŽĂƐĐŽŵ
dƌĂŶƐƚŽƌŶŽƐ ĚŽ ƐƉĞĐƚƌŽ ĚŽ ƵƟƐŵŽ ůĞǀĞ Ğŵ ĐŽŶƚĂ ĂƐ ĚŝĨĞƌĞŶƚĞƐ
KƵƚƌĂĄƌĞĂĐƌşƟĐĂŶĂǀŝĚĂĚŽĂĚƵůƚŽĐŽŵd͕ƋƵĞĂĨĞƚĂƉƌŝŶĐŝƉĂůŵĞŶƚĞ ƐŝƚƵĂĕƁĞƐĐůşŶŝĐĂƐĞŶǀŽůǀŝĚĂƐŶŽƐƚƌĂŶƐƚŽƌŶŽĚŽĞƐƉĞĐƚƌŽĚŽĂƵƟƐŵŽ͘
ƐƵĂƐ ĐŚĂŶĐĞƐ ĚĞ ŝŶƐĞƌĕĆŽ ŶŽ ŵĞƌĐĂĚŽ ĚĞ ƚƌĂďĂůŚŽ Ğ ŶĂ ǀŝĚĂ KƵ ƐĞũĂ͕ Ġ ŶĞĐĞƐƐĄƌŝŽ ĚŝƐƟŶŐƵŝƌ Ğ ƚĞƌ Ă ĐĂƉĂĐŝĚĂĚĞ ĚĞ ƌĞƐƉŽŶĚĞƌ
ĐŽŵƵŶŝƚĄƌŝĂ͕ ƌĞĨĞƌĞͲƐĞ Ă ƐƵĂ ƚŽůĞƌąŶĐŝĂ ĂƐ ĚĞŵĂŶĚĂƐ ĂƉƌĞƐĞŶƚĂĚĂƐ͘ ƚĂŶƚŽ ăƐ ĚĞŵĂŶĚĂƐ ĚĞ ŚĂďŝůŝƚĂĕĆŽͬƌĞĂďŝůŝƚĂĕĆŽ ĚĞ ĚƵƌĂĕĆŽ ůŝŵŝƚĂĚĂ
^ĞũĂŵ ĞƐƐĂƐ ĚĞŵĂŶĚĂƐ ĚĞ ƚƌĂďĂůŚŽ ;ŝ͘Ğ͘ ƋƵĂŶƟĚĂĚĞ ŽƵ ƚĞŵƉŽ ĚĞ ;ĂƟŶŐŝŵĞŶƚŽĚĞŶşǀĞŝƐƐĂƟƐĨĂƚſƌŝŽƐĚĞĨƵŶĐŝŽŶĂůŝĚĂĚĞĞƐŽĐŝĂďŝůŝĚĂĚĞ
ĂƟǀŝĚĂĚĞͿ͕ ŽƵ ĚĞŵĂŶĚĂƐ ƐŽĐŝĂŝƐ ;ŝ͘Ğ͘ ƉƌĞƐĞŶĕĂ ĚĞ ƉĞƐƐŽĂƐ͕ ƌƵşĚŽƐ͕ ƉŽƌƉĂƌƚĞĚŽƐƉĂĐŝĞŶƚĞƐ͕ĞǀŝƚĂŶĚŽŵĂŶƚĞƌĞƐƐĂƐƉĞƐƐŽĂƐĐŽŵŽƵƐƵĄƌŝŽƐ
ŝŶƚĞƌĂĕƁĞƐͿ͘ WŽƌ ŝƐƐŽ͕ Ġ ŝŵƉŽƌƚĂŶƚĞ ƋƵĞ ƐĞ ĐŽŶŚĞĕĂ ƋƵĂŶƚŽ ĐĂĚĂ ƉĞƌŵĂŶĞŶƚĞƐĚŽƐƐĞƌǀŝĕŽƐͿ͕ƋƵĂŶƚŽĂŽĞƐƚĂďĞůĞĐŝŵĞŶƚŽĚĞƉƌŽĐĞƐƐŽƐ
ŝŶĚŝǀşĚƵŽ ĐŽŶƐĞŐƵĞ ƚŽůĞƌĂƌ Ğ ĚĞƐĞŵƉĞŶŚĂƌ Ă ĐĂĚĂ ŵŽŵĞŶƚŽ ĚŽ ĚĞ ĐƵŝĚĂĚŽ ăƋƵĞůĞƐ ƵƐƵĄƌŝŽƐ ƋƵĞ ŶĞĐĞƐƐŝƚĂŵ ĚĞ ĂĐŽŵƉĂŶŚĂŵĞŶƚŽ
ĂƚĞŶĚŝŵĞŶƚŽ͘ WŽƌ ĞdžĞŵƉůŽ͗ Ġ ƉŽƐƐşǀĞů ƋƵĞ Ƶŵ ũŽǀĞŵ ĂĚƵůƚŽ ĐŽŵ ĐŽŶơŶƵŽĞƉƌŽůŽŶŐĂĚŽ͘
d ĞŶƚƌĞ ŶĂ ƌĞĚĞ ĚĞ ƐĞƌǀŝĕŽƐ ƐĞŶĚŽ ĐŽŵƉůĞƚĂŵĞŶƚĞ ĐĂƉĂnj ĚĞ
ĚĞƐĞŵƉĞŶŚĂƌ ďĞŵ ĐĞƌƚĂƐ ĂƟǀŝĚĂĚĞƐ ĚĞ ƚƌĂďĂůŚŽ͕ ƉŽƌĠŵ ĂƉƌĞƐĞŶƚĞ ŽŵĞƐŵŽƚĞŵƉŽ͕ĂůĠŵĚŽƐƉƌŽĐĞƐƐŽƐĚĞĐƵŝĚĂĚŽăƐĂƷĚĞŶŽąŵďŝƚŽ
ĚŝĮĐƵůĚĂĚĞƐĞŵƉĞƌŵĂŶĞĐĞƌĞŶŐĂũĂĚŽĚƵƌĂŶƚĞƉĞƌşŽĚŽƐŵĂŝƐůŽŶŐŽƐ͘ ĚĂ ĂƚĞŶĕĆŽ ĞƐƉĞĐŝĂůŝnjĂĚĂ͕ ƋƵĞ ǀŝƐĂŵ ƌĞƐƉŽŶĚĞƌ ăƐ ĞƐƉĞĐŝĮĐŝĚĂĚĞƐ
EĞƐƐĞ ĐĂƐŽ͕ ƐƵĂ ƚŽůĞƌąŶĐŝĂ ĂŽ ĞŶŐĂũĂŵĞŶƚŽ ƉŽĚĞ ƐĞƌ ĂƵŵĞŶƚĂĚĂ ĐůşŶŝĐĂƐ͕ Ġ ŝŵƉŽƌƚĂŶƚĞ ƌĞƐƐĂůƚĂƌ ƋƵĞ ŽƐ ƐĞƌǀŝĕŽƐ ĚĞ ƐĂƷĚĞ ĚĞǀĞŵ
ŐƌĂĚĂƟǀĂŵĞŶƚĞ͕ ĚĞ ŵŽĚŽ ƋƵĞ ĞůĞ ƉŽƐƐĂ͕ ĞǀĞŶƚƵĂůŵĞŶƚĞ͕ ĂůĐĂŶĕĂƌ ĨƵŶĐŝŽŶĂƌ Ğŵ ƌĞĚĞ͕ ĞƐƚĂŶĚŽ ƉƌĞƉĂƌĂĚŽƐ ƉĂƌĂ ĂĐŽůŚĞƌ Ğ ƌĞƐƉŽŶĚĞƌ
ŶşǀĞŝƐĐŽŵƉĞƟƟǀŽƐĚĞĚĞƐĞŵƉĞŶŚŽ͘ ăƐŶĞĐĞƐƐŝĚĂĚĞƐŐĞƌĂŝƐĚĞƐĂƷĚĞĚĂƐƉĞƐƐŽĂƐĐŽŵd͕ŽƋƵĞŝŶĐůƵŝ
Ž ĂĐŽŵƉĂŶŚĂŵĞŶƚŽ ;ďĄƐŝĐŽ Ğ ĞƐƉĞĐŝĂůŝnjĂĚŽͿ ƚĂŶƚŽ ĚĂ ĞƋƵŝƉĞ ĚĞ
KŝŶĚŝǀşĚƵŽƋƵĞŶĆŽĐŽŶƐĞŐƵĞĐŽŵƵŶŝĐĂƌĚŽƌ͕ŽƵĚĞƐĐƌĞǀĞƌĞƐƚĂĚŽƐ ŚĂďŝůŝƚĂĕĆŽͬƌĞĂďŝůŝƚĂĕĆŽ͕ ƋƵĂŶƚŽ ŵĠĚŝĐŽ͕ ŽĚŽŶƚŽůſŐŝĐŽ Ğ ĚĂ ƐĂƷĚĞ
ŝŶƚĞƌŶŽƐ͕ ĚĞƉĞŶĚĞƌĄ ĚĂ ŚĂďŝůŝĚĂĚĞ ĚĂƋƵĞůĞƐ Ă ƐĞƵ ƌĞĚŽƌ ƉĂƌĂ Ž ŵĞŶƚĂů͕ƐĞŵƉƌĞƋƵĞƐĞĮnjĞƌŶĞĐĞƐƐĄƌŝŽ͘
ĚŝĂŐŶſƐƟĐŽ Ğ ƚƌĂƚĂŵĞŶƚŽ ĚĞ ƚŽĚŽ ƟƉŽ ĚĞ ĚĞƐĐŽŶĨŽƌƚŽ͘ ĞƋƵŝƉĞ͕
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ƚĂŵďĠŵĚĞĞdžƚƌĞŵĂŝŵƉŽƌƚąŶĐŝĂƋƵĞŽƐĐƵŝĚĂĚŽƐăƐĂƷĚĞĚĂƉĞƐƐŽĂ
ĐŽŵd͕ĂŽůŽŶŐŽĚĂǀŝĚĂ͕ĞƐƚĞũĂŵĂƌƟĐƵůĂĚŽƐƚĂŵďĠŵăƐĂĕƁĞƐĞ
ƉƌŽŐƌĂŵĂƐ ŶŽ ąŵďŝƚŽ ĚĂ ƉƌŽƚĞĕĆŽ ƐŽĐŝĂů͕ ĞĚƵĐĂĕĆŽ͕ ůĂnjĞƌ͕ ĐƵůƚƵƌĂ
ĞƚƌĂďĂůŚŽ͕ǀŝƐĂŶĚŽŽĐƵŝĚĂĚŽŝŶƚĞŐƌĂůĞŽŵĄdžŝŵŽĚĞĂƵƚŽŶŽŵŝĂĞ
ŝŶĚĞƉĞŶĚġŶĐŝĂŶĂƐĂƟǀŝĚĂĚĞƐĚĂǀŝĚĂĐŽƟĚŝĂŶĂ͘
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da Saúde com Transtornos do Espectro do Autismo (TEA)
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Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
11 Fluxograma de Acompanhamento
e Atendimento da Pessoa com TEA na
REDE SUS
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da Saúde com Transtornos do Espectro do Autismo (TEA)
14. ĞŶƚĞƌƐĨŽƌŝƐĞĂƐĞŽŶƚƌŽůĂŶĚWƌĞǀĞŶƟŽŶ;ϮϬϬϳͿ͘Prevalence 23. &ŽŵďŽŶŶĞ͕ ͘ ;ϮϬϭϬ͕ ƉƌŝůͿ͘ ƉŝĚĞŵŝŽůŽŐLJ ŽĨ ĂƵƟƐŵ͘ WĂƉĞƌ
ŽĨ ĂƵƟƐŵ ƐƉĞĐƚƌƵŵ ĚŝƐŽƌĚĞƌƐ͗ ĂƵƟƐŵ ĂŶĚ ĚĞǀĞůŽƉŵĞŶƚĂů ƉƌĞƐĞŶƚĞĚ Ăƚ ƚŚĞ ϭǑ͘ ŶĐŽŶƚƌŽ ƌĂƐůĞŝƌŽ ƉĂƌĂ WĞƐƋƵŝƐĂ Ğŵ
ĚŝƐĂďŝůŝƟĞƐŵŽŶŝƚŽƌŝŶŐŶĞƚǁŽƌŬ͘ZĞƚƌŝĞǀĞĚŝŶƵŐƵƐƚ͕ϵ͕ϮϬϭϬ͕ ƵƟƐŵŽ͕WŽƌƚŽůĞŐƌĞ͕ZŝŽ'ƌĂŶĚĞĚŽ^Ƶů͕ƌĂƐŝů͘
ĨƌŽŵŚƩƉ͗ͬͬǁǁǁ͘ĐĚĐ͘ŐŽǀͬŵŵǁƌͬŝŶĚƐƐͺϮϬϬϳ͘Śƚŵů͘ 24. ,ŽīŵĂŶ͕͕͘͘^ǁĞĞŶĞLJ͕͘W͕͘,ŽĚŐĞ͕͕͘>ŽƉĞnjͲtĂŐŶĞƌ͕D͘͘
15. ŽLJůĞ1 Θ DĐŽƵŐůĞ ΏϮ :͕ WŚĂƌŵĂĐŽƚŚĞƌĂƉLJ ƚŽ ĐŽŶƚƌŽů Θ>ŽŽŶĞLJ͕>͘;ϮϬϬϵͿ͘WĂƌĞŶƟŶŐ^ƚƌĞƐƐĂŶĚůŽƐĞŶĞƐƐDŽƚŚĞƌƐ
ďĞŚĂǀŝŽƌĂůƐLJŵƉƚŽŵƐŝŶĐŚŝůĚƌĞŶǁŝƚŚĂƵƟƐŵ͕džƉĞƌƚKƉŝŶŝŽŶ ŽĨ dLJƉŝĐĂůůLJ ĞǀĞůŽƉŝŶŐ ŚŝůĚƌĞŶ ĂŶĚ DŽƚŚĞƌƐ ŽĨ ŚŝůĚƌĞŶ
ŝŶWŚĂƌŵĂĐŽƚŚĞƌĂƉLJ͕ϮϬϭϮ͕sŽů͘ϭϯ͕EŽ͘ϭϭ͕ϭϲϭϱͲϭϲϮϵ͘ tŝƚŚ ƵƟƐŵ͘ &ŽĐƵƐ KŶ ƵƟƐŵ ŶĚ KƚŚĞƌ ĞǀĞůŽƉŵĞŶƚĂů
16. ŽǁĚ͕͖͘ZŝŶĞŚĂƌƚ͕E͘ΘDĐ'ŝŶůĞLJ͕:͘;ϮϬϭϬͿ͘DŽƚŽƌĨƵŶĐƟŽŶ ŝƐĂďŝůŝƟĞƐ͕Ϯϰ;ϯͿ͕ϭϳϴͲϭϴϳ͘
ŝŶĐŚŝůĚƌĞŶǁŝƚŚĂƵƟƐŵ͗ǁŚLJŝƐƚŚŝƐƌĞůĞǀĂŶƚƚŽƉƐLJĐŚŽůŽŐŝƐƚƐ͍ Ϯϱ͘ <ŽŐĂŶ D͕ ůƵŵďĞƌŐ ^:͕ ^ĐŚŝĞǀĞ >͕ ŽLJůĞ ͕ WĞƌƌŝŶ :D͕
ůŝŶŝĐĂůWƐLJĐŚŽůŽŐŝƐƚ͕ϭϰ;ϯͿ͘ 'ŚĂŶĚŽƵƌZDĞƚĂů͘WƌĞǀĂůĞŶĐĞŽĨƉĂƌĞŶƚͲƌĞƉŽƌƚĞĚĚŝĂŐŶŽƐŝƐ
17. ƐƉŽƐŝƚŽ͕'͖sĞŶƵƟ͕W͖͘DĂĞƐƚƌŽ͕^͘ΘDƵƌĂƚŽƌŝ͕&͘;ϮϬϬϵͿŶ ŽĨ ĂƵƟƐŵ ƐƉĞĐƚƌƵŵ ĚŝƐŽƌĚĞƌ ĂŵŽŶŐ ĐŚŝůĚƌĞŶ ŝŶ ƚŚĞ h^͘
ĞdžƉůŽƌĂƟŽŶŽĨƐLJŵŵĞƚƌLJŝŶĞĂƌůLJĂƵƟƐŵƐƉĞĐƚƌƵŵĚŝƐŽƌĚĞƌƐ͗ WĞĚŝĂƚƌŝĐƐϮϬϬϵ͖ϭϯϵϱͲϭϰϬϯ͘
ĂŶĂůLJƐŝƐŽĨůLJŝŶŐ͘ƌĂŝŶΘĞǀĞůƉŵĞŶƚ͕;ϯϭͿ͕ϭϯϭͲϭϮϴ͘ Ϯϲ͘ <ƵƉĨĞƌ͕DD͕͘:ĞƌƵƐĂůŝŶƐŬLJ͕E͕͘ĞƌŶĂƌĚŝŶŽ͕>D&͕͘tĂŶĚĞƌůĞLJ͕
18. ƐƉŽƐŝƚŽ͕ '͖ sĞŶƵƟ͕ W͖͘ ƉŝĐĞůůĂ͕ &͘ Θ DƵƌĂƚŽƌŝ͕ &͘ ;ϮϬϭϭͿ ͕͘ ZŽĐŚĂ͕ W^͕͘ DŽůŝŶĂ͕ ^͕͘ Ğƚ Ăů͘ ;ϮϬϭϬͿ͘ WƌĞĚŝĐƟǀĞ
ŶĂůLJƐŝƐŽƐƵŶƐƵƉƉŽƌƚĞĚŐĂŝƚŝŶƚŽĚĚůĞƌƐǁŝƚŚĂƵƟƐŵ͘ƌĂŝŶΘ ǀĂůƵĞ ŽĨ ĐůŝŶŝĐĂů ƌŝƐŬ ŝŶĚŝĐĂƚŽƌƐ ŝŶ ĐŚŝůĚ ĚĞǀĞůŽƉŵĞŶƚ͗ ĮŶĂů
ĞǀĞůƉŵĞŶƚ͕;ϯϯͿ͕ϯϲϳͲϯϳϯ͘ ƌĞƐƵůƚƐ ŽĨ Ă ƐƚƵĚLJ ďĂƐĞĚ ŽŶ ƉƐLJĐŚŽĂŶĂůLJƟĐ ƚŚĞŽƌLJ͘ ZĞǀŝƐƚĂ
19. &ĞƌŶĂŶĚĞƐ͕ & DͲǀĂůŝĂĕĆŽ WƌĂŐŵĄƟĐĂ͘ /E ŶĚƌĂĚĞ Z&͕ >ĂƟŶŽĂŵĞƌŝĐĂŶĂ ĚĞ WƐŝĐŽƉĂƚŽůŽŐŝĂ &ƵŶĚĂŵĞŶƚĂů͕ ǀ͘ ϭϯ͕ ϯϭͲ
ĞĮͲ>ŽƉĞƐD͕&ĞƌŶĂŶĚĞƐ&D͕tĞƌƚnjŶĞƌ,&͘&tʹdĞƐƚĞ ϱϮ͘
ĚĞ>ŝŶŐƵĂŐĞŵ/ŶĨĂŶƟů͗ŶĂƐĄƌĞĂƐĚĞ&ŽŶŽůŽŐŝĂ͕sŽĐĂďƵůĄƌŝŽ͕ Ϯϳ͘ >ĞƌŶĞƌ͕ Z͘ ;ϮϬϭϭͿ͘ /ŶĚŝĐĂĚŽƌĞƐ ĐůşŶŝĐŽƐ ĚĞ ƌŝƐĐŽ ƉĂƌĂ Ž
&ůƵġŶĐŝĂĞWƌĂŐŵĄƟĐĂ͘^ĆŽWĂƵůŽ͗WƌſͲ&ŽŶŽ͖ϮϬϬϬ͘ ĚĞƐĞŶǀŽůǀŝŵĞŶƚŽ ŝŶĨĂŶƟů͗ ǀĞƌŝĮĐĂĕĆŽ ĚĂ ĐĂƉĂĐŝĚĂĚĞ
20. &ŽŵďŽŶŶĞ ͘ ƉŝĚĞŵŝŽůŽŐLJ ŽĨ ĂƵƟƐƟĐ ĚŝƐŽƌĚĞƌ ĂŶĚ ŽƚŚĞƌ ĚŝƐĐƌŝŵŝŶĂƟǀĂĞŶƚƌĞĂƵƟƐŵŽ͕ƌĞƚĂƌĚŽŵĞŶƚĂůĞŶŽƌŵĂůŝĚĂĚĞ͘
ƉĞƌǀĂƐŝǀĞ ĚĞǀĞůŽƉŵĞŶƚĂů ĚŝƐŽƌĚĞƌƐ͘ : ůŝŶ WƐLJĐŚŝĂƚƌ ϮϬϬϲ͖ dĞƐĞ;>ŝǀƌĞͲŽĐġŶĐŝĂͿʹ/ŶƐƟƚƵƚŽĚĞWƐŝĐŽůŽŐŝĂ͘hŶŝǀĞƌƐŝĚĂĚĞ
ϲϳ;ϭϮͿ͗ϮϬϬϯͿ͘ ĚĞ^ĆŽWĂƵůŽ͘^ĆŽWĂƵůŽ͕ƌĂƐŝů͘
21. &ŽŵďŽŶŶĞ͕ ͘ ;ϮϬϬϵͿ͘ ƉŝĚĞŵŝŽůŽŐLJ ŽĨ ƉĞƌǀĂƐŝǀĞ Ϯϴ͘ <ƵƉĨĞƌ͕ DD͕͘ :ĞƌƵƐĂůŝŶƐŬLJ͕ E͕͘ ĞƌŶĂƌĚŝŶŽ͕ >D&͕͘
developmental disorders. WĞĚŝĂƚƌŝĐZĞƐĞĂƌĐŚ͕ϲϱ;ϲͿ͕ϱϵϭͲϱϵϴ͘ tĂŶĚĞƌůĞLJ͕ ͕͘ ZŽĐŚĂ͕ W^͕͘ ^ĂůĞƐ͕ >DD͕͘ Ğƚ Ăů͘ ;ϮϬϬϵͿ͘
22. &ŽŵďŽŶŶĞ͕ ͘ ;ϮϬϬϵͿ͘ ƉŝĚĞŵŝŽůŽŐLJ ŽĨ ƉĞƌǀĂƐŝǀĞ WƌĞĚŝĐƟǀĞǀĂůƵĞŽĨƌŝƐŬƐŝŐŶĂůƐĨŽƌƚŚĞĐŚŝůĚĚĞǀĞůŽƉŵĞŶƚ͗Ă
developmental disorders. WĞĚŝĂƚƌŝĐZĞƐĞĂƌĐŚ͕ϲϱ;ϲͿ͕ϱϵϭͲϱϵϴ͘ ƉƐLJĐŚŽĂŶĂůLJƟĐĂůƐƚƵĚLJ͘>ĂƟŶŵĞƌŝĐĂŶ:ŽƵƌŶĂůŽĨ&ƵŶĚĂŵĞŶƚĂů
WƐLJĐŚŽƉĂƚŚŽůŽŐLJŽŶůŝŶĞ͕ǀ͘ϲ͕ϰϴͲϲϴ͘
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Ϯϵ͘ <ƵƉĨĞƌ͕ DD͕͘ :ĞƌƵƐĂůŝŶƐŬLJ͕ E͕͘ ĞƌŶĂƌĚŝŶŽ͕ >D&͕͘ ϯϲ͘ DĂƌƋƵĞƐ͕ ͘&͘ ;ϮϬϭϬͿ͘ ƉƌŝŵŽƌĂŵĞŶƚŽ Ğ ĞǀŝĚġŶĐŝĂƐ ĚĞ ǀĂůŝĚĂĚĞ
tĂŶĚĞƌůĞLJ͕ ͕͘ ZŽĐŚĂ͕ W^͕͘ DŽůŝŶĂ͕ ^͕͘ Ğƚ Ăů͘ ;ϮϬϭϬͿ͘ ĚŽ ƉƌŽƚŽĐŽůŽ ĚĞ ŽďƐĞƌǀĂĕĆŽ ƉĂƌĂ ĐƌŝĂŶĕĂƐ ĐŽŵ ƐƵƐƉĞŝƚĂ ĚĞ
WƌĞĚŝĐƟǀĞ ǀĂůƵĞ ŽĨ ĐůŝŶŝĐĂů ƌŝƐŬ ŝŶĚŝĐĂƚŽƌƐ ŝŶ ĐŚŝůĚ ƚƌĂŶƐƚŽƌŶŽƐĚŽĞƐƉĞĐƚƌŽĂƵƟƐƚĂ͗hŵĞƐƚƵĚŽƉƌĞůŝŵŝŶĂƌ͘ŝƐƐĞƌƚĂĕĆŽ
ĚĞǀĞůŽƉŵĞŶƚ͗ĮŶĂůƌĞƐƵůƚƐŽĨĂƐƚƵĚLJďĂƐĞĚŽŶƉƐLJĐŚŽĂŶĂůLJƟĐ ĚĞDĞƐƚƌĂĚŽ͘hŶŝǀĞƌƐŝĚĂĚĞ&ĞĚĞƌĂůĚŽZŝŽ'ƌĂŶĚĞĚŽ^Ƶů͘
ƚŚĞŽƌLJ͘ ZĞǀŝƐƚĂ >ĂƟŶŽĂŵĞƌŝĐĂŶĂ ĚĞ WƐŝĐŽƉĂƚŽůŽŐŝĂ ϯϳ͘ EĞǁƐĐŚĂīĞƌ͕͘:͕͘ƌŽĞŶ͕>͕͘͘ĂŶŝĞůƐ͕:͕͘'ŝĂƌĞůůŝ͕͕͘'ƌĞƚŚĞƌ͕:͘
&ƵŶĚĂŵĞŶƚĂů͕ǀ͘ϭϯ͕ϯϭͲϱϮ͘ <͕͘>ĞǀLJ͕^͕͘͘DĂŶĚĞůů͕͘^͕͘DŝůůĞƌ͕>͕͘͘WŝŶƚŽͲDĂƌƟŶ͕:͕͘ZĞĂǀĞŶ͕
30. >ĞƌŶĞƌ͕Z͘/ŶĚŝĐĂĚŽƌĞƐĐůşŶŝĐŽƐĚĞƌŝƐĐŽƉĂƌĂŽĚĞƐĞŶǀŽůǀŝŵĞŶƚŽ :͕͘ ZĞLJŶŽůĚƐ͕ ͘ D͕͘ ZŝĐĞ͕ ͘ ͕͘ ^ĐŚĞŶĚĞů͕ ͕͘ Θ tŝŶĚŚĂŵ͕ '͘ ͘
ŝŶĨĂŶƟůͲ/Z/͗ǀĞƌŝĮĐĂĕĆŽĚĂĐĂƉĂĐŝĚĂĚĞĚŝƐĐƌŝŵŝŶĂƟǀĂĞŶƚƌĞ ;ϮϬϬϳͿ͘dŚĞĞƉŝĚĞŵŝŽůŽŐLJŽĨĂƵƟƐŵƐƉĞĐƚƌƵŵĚŝƐŽƌĚĞƌƐ͘Annual
ĂƵƟƐŵŽ͕ ƌĞƚĂƌĚŽ ŵĞŶƚĂů Ğ ŶŽƌŵĂůŝĚĂĚĞ͘ >ŝǀƌĞͲĚŽĐġŶĐŝĂ ZĞǀŝĞǁŽĨWƵďůŝĐ,ĞĂůƚŚ͕Ϯϴ͕ϮϯϱͲϮϱϴ͘
;/ŶƐƟƚƵƚŽĚĞWƐŝĐŽůŽŐŝĂͿͲhŶŝǀĞƌƐŝĚĂĚĞĚĞ^ĆŽWĂƵůŽ͕ϮϬϭϭ͘ ϯϴ͘ WĂƵůĂ͕ ͘ ^͕͘ ZŝďĞŝƌŽ͕ ^͘ ,͕͘ &ŽŵďŽŶŶĞ͕ ͕͘ Θ DĞƌĐĂĚĂŶƚĞ͕ D͘ d͘
31. >ŽƌĚ Θ ZƵƩĞƌ D͕ ƵƟƐŵ ĂŶĚ WĞƌǀĂƐŝǀĞ ĞǀĞůŽƉŵĞŶƚĂů ;ϮϬϭϭͿ͘ ƌŝĞĨ ƌĞƉŽƌƚ͗ WƌĞǀĂůĞŶĐĞŽĨ WĞƌǀĂƐŝǀĞ ĞǀĞůŽƉŵĞŶƚĂů
rd
ŝƐŽƌĚĞƌƐ͕ŝŶŚŝůĚĂŶĚĚŽůĞƐĐĞŶƚWƐLJĐŚŝĂƚƌLJ͕ϯ ĞĚ;ĚZƵƩĞƌ ŝƐŽƌĚĞƌŝŶƌĂnjŝů͗ƉŝůŽƚƐƚƵĚLJ͘:ŽƵƌŶĂůŽĨƵƟƐŵĂŶĚĞǀĞůŽŵĞŶƚĂů
D͕ dĂLJůŽƌ ĂŶĚ ,ĞƌƐŽǀ >͕ ůĂŬǁĞůů ^ĐŝĞŶƟĮĐ WƵďůŝĐĂƟŽŶƐ ŝƐŽƌĚĞƌƐ͕ϰϭ;ϭϮͿ͕ϭϳϯϴͲϭϳϰϮ͘
KdžĨŽƌĚ͕ϭϵϵϰ͕ϱϲϵͲϱϵϯ͘ ϯϵ͘ ZŝĐĞ͕͘;ϮϬϬϳͿ͘WƌĞǀĂůĞŶĐĞŽĨĂƵƟƐŵƐƉĞĐƚƌƵŵĚŝƐŽƌĚĞƌƐͲĂƵƟƐŵ
32. >ŽƐĂƉŝŽ͕ D&͕ WŽŶĚĞ͕ DW͘ dƌĂĚƵĕĆŽ ƉĂƌĂ Ž ƉŽƌƚƵŐƵġƐ ĚĂ ĂŶĚ ĚĞǀĞůŽƉŵĞŶƚĂů ĚŝƐĂďŝůŝƟĞƐ ŵŽŶŝƚŽƌŝŶŐ ŶĞƚǁŽƌŬ͕ ϭϰ ƐŝƚĞƐ͕
ĞƐĐĂůĂDͲ,dƉĂƌĂƌĂƐƚƌĞĂŵĞŶƚŽƉƌĞĐŽĐĞĚĞĂƵƟƐŵŽ͘ZĞǀ͘ hŶŝƚĞĚ^ƚĂƚĞƐŽĨŵĞƌŝĐĂ͕ϮϬϬϮ͘DŽƌďŝĚŝƚLJĂŶĚDŽƌƚĂůŝƚLJtĞĞŬůLJ
ƉƐŝƋƵŝĂƚƌ͘ZŝŽ'Ě͘^Ƶů͕WŽƌƚŽůĞŐƌĞ͕ǀ͘ϯϬ͕Ŷ͘ϯ͕ĚĞnj͘ϮϬϬϴ͘ ZĞƉŽƌƚ͕ϱϲ͕ϭϮͲϮϴ͘
33. DĂĐĞƌŵŽƩ^͕tŝůůŝĂŵƐ<͕ZŝĚůĞLJ'͕',ůĂƐƐŽŶ͘ĂŶĚtƌĂLJ:͘ 40. WĞƌŝƐƐŝŶŽƚŽ͕:͘ ŝĂŐŶſƐƟĐŽ ĚĞ ůŝŶŐƵĂŐĞŵ Ğŵ ĐƌŝĂŶĕĂƐ ĐŽŵ
dŚĞƉƌĞǀĂůĞŶĐĞŽĨĂƵƟƐŵŝŶƵƐƚƌĂůŝĂ͘ĂŶŝƚďĞĞƐƚĂďůŝƐŚĞĚ ƚƌĂŶƐƚŽƌŶŽƐĚŽĞƐƉĞĐƚƌŽĂƵơƐƟĐŽ/Ŷ͗dƌĂƚĂĚŽĚĞ&ŽŶŽĂƵĚŝŽůŽŐŝĂ
ĨƌŽŵĞdžŝƐƟŶŐĚĂƚĂ͍ƵƟƐŵĚǀŝƐŽƌŽĂƌĚŽŶƵƟƐŵ^ƉĞĐƚƌƵŵ ĞĚ͘^ĆŽWĂƵůŽͲ^W͗ZŽĐĂ͕ϮϬϬϰ͕Ɖ͘ϵϯϯͲϵϰϬ͘
ŝƐŽƌĚĞƌƐ͕ϮϬϬϳ 41. ZŝƚǀŽZ͕&ƌĞĞŵĂŶ:͕WŝŐƌĞĞW͕DĂƐŽŶͲƌŽƚŚĞƐ͕:ŽƌĚĞ>͕:ĞŶƐŽŶ
34. DĂĞƐƚƌŽ͕^͖͘DƵƌĂƚŽƌŝ͕&͖͘ĂǀĂůůĂƌŽ͕D͕͖WĞĐŝŶŝ͕͖͘ĞƐĂƌŝ͕͖͘ tZĞƚĂů͘dŚĞh>ͲhŶŝǀĞƌƐŝƚLJŽĨhƚĂŚĞƉŝĚĞŵŝĐƐƵƌǀĞLJŽĨĂƵƟƐŵ͗
WĂnjŝĞŶƚĞ͕ ͖͘ ^ƚĞƌŶ͕ ͖͘ 'ŽůƐĞ͕ Θ WĂůĂĐŝŽͲƐƉĂƐĂ͕ &͘ ;ϮϬϬϱͿ WƌĞǀĂůĞŶĐĞ͘:WƐLJĐŚŝĂƚƌϭϵϴϵ͖ϭϰϲ;ϮͿ͗ϭϵϰͲϵͿ͘
,ŽǁzŽƵŶŐŚŝůĚƌĞŶdƌĞĂƚKďũĞĐƚƐĂŶĚWĞŽƉůĞ͗ŶŵƉŝƌŝĐĂů 42. ZŽŐĞƌƐ ^: ĂŶĚ sŝƐŵĂƌĂ > ǀŝĚĞŶĐĞͲĂƐĞĚ ŽŵƉƌĞŚĞŶƐŝǀĞ
^ƚƵĚLJŽĨƚŚĞ&ŝƌƐƚzĞĂƌŽĨ>ŝĨĞŝŶƵƟƐŵŚŝůĚWƐLJĐŚŝĂƚƌLJĂŶĚ dƌĞĂƚŵĞŶƚƐĨŽƌĂƌůLJƵƟƐŵ͘:ůŝŶŚŝůĚΘĚŽůWƐLJĐŚŽůŽŐLJ͕ϮϬϬϴ͕
,ƵŵĂŶĞǀĞůŽƉŵĞŶƚ͕sŽů͘ϯϱ;ϰͿ͕ϯϴϯͲϯϵϲ͘ ϯϳ;ϭͿ͕ϴʹϯϴ
ϯϱ͘ DĂƌƋƵĞƐ͘&͕͘ΘŽƐĂ͕͘͘;ƐƵďŵĞƟĚŽͿ͘ƵƟƐŵŽ͗sĂůŝĚĂĕĆŽ 43. ZƵƩĞƌ͕D͘>͘;ϮϬϭϭͿ͘WƌŽŐƌĞƐƐŝŶƵŶĚĞƌƐƚĂŶĚŝŶŐĂƵƟƐŵ͗ϮϬϬϳͲϮϬϭϬ͘
ƉƌĞůŝŵŝŶĂƌ ĚĞ Ƶŵ ƉƌŽƚŽĐŽůŽ ĐůşŶŝĐŽ ĚĞ ŽďƐĞƌǀĂĕĆŽ ĚŽ :ŽƵƌŶĂůŽĨƵƟƐŵĂŶĚǀĞůŽƉŵĞŶƚĂůŝƐŽƌĚĞƌƐ͕ϰϭ;ϰͿ͕ϯϵϱͲϰϬϰ͘
ĐŽŵƉŽƌƚĂŵĞŶƚŽ͘WƐŝĐŽůŽŐŝĂ͗dĞŽƌŝĂĞWĞƐƋƵŝƐĂ͘
72 73
Ministério Diretrizes de Atenção à Reabilitação da Pessoa
da Saúde com Transtornos do Espectro do Autismo (TEA)
74 75
Ministério
da Saúde
76