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Evaluation of Social Cognition in Children with Autism Spectrum Disorders: Instruments in the Clinical Context. a Systematic Review
Autism spectrum disorders (ASD), characterized as an early disorder of social interactions, stand out as the central feature to define this condition. The understanding of the difficulties in social interaction in ASDs requires a broad and integrating vision of these difficulties, which includes various socio-cognitive skills necessary to achieve satisfactory social interactions.
Several authors have proposed this approach is possible from the concept of social cognition (SC) . From neurocognitive studies to clinical reality, there are methodological and practical gaps in the application of valid instruments for the systematic evaluation of SC in clinical contexts.
Objectives:
General: Identify, analyze and synthesize the available evidence on tools that can be applied in clinical contexts for the systematic evaluation of SC of children with ASD.
Specific: a) describe the main characteristics of the identified instruments; b) describe the subfactors or dimensions of the SC evaluated by each instrument; e) perform an analysis of its applicability in clinical contexts; d) make suggestions or contributions to providers that work with children with ASD regarding these instruments.
Methods:
A search and systematic review of the literature with SC measurement instruments in ASD children was carried out, following the PRISMA guidelines and recommendations (Moher et al., 2015). In the design phase, a systematic review protocol was carried out (not registered).
The eligibility criteria were: original studies, published in peer-reviewed journals until 2017, where the participants included children with ASD evaluated with SC instruments. The SC instruments were applied in clinical contexts or are susceptible to be applied in those contexts . In addition, they should have evidence of its validity in children with ASD.
The search was made in June 2018 and was carried out in three sources of information: Web of Sciencie (Core Collection), Scopus and PubMed. The data was exported through the bibliographic manager EndNoteX8. The process of selecting the studies followed the PRISMA recommendations (Moher et al., 2015).
Results:
292 articles were identified. After the identification, screening and eligibility procedures, 17 articles were included in the analysis.
The sample includes n = 2024 participants. The average age of the sample was 9.65 years. Four of the articles included exclusively TEA children in the sample, without making comparisons with other conditions.
The main characteristics of 22 instruments were identified and reported. 16/22 of the identified instruments, evaluate some dimension of Theory of Mind (ToM). The most commonly used SC measurement instrument was the "Reading the Mind in the Eyes" Test -Child Version (RMET-ChildVersion) (Table 1.)
Conclusions:
The present review gives the specialists in child development, evidence for the systematic evaluation of CS in children with ASD.
Although the SC includes the interaction of diverse cognitive abilities, most of the instruments studied evaluate the TdM dimension exclusively.
Only one of the instruments identified has a validated version in Spanish, which suggests guidelines for future research in Spanish-speaking countries.