Prevalence and nuances of challenging behaviors in autism spectrum disorder: a narrative review of implications for the Brazilian public health system

Authors

• Felipe Magalhães Lemos Universidade Federal de São Carlos, São Carlos, SP, Brasil https://orcid.org/0000-0001-5511-7423
• Claudio Almeida Sarilho Instituto de Neurociências e Autismo (INA),  São Paulo, SP, Brasil https://orcid.org/0000-0003-3882-2301

DOI:

https://doi.org/10.17058/vm6yzz55

Keywords:

Autism Spectrum Disorder, Challenging Behavior, Prevalence, sus

Abstract

Introduction: Challenging behaviors are highly prevalent in individuals with Autism Spectrum Disorder (ASD), affecting both individual and family well-being. Despite their clinical relevance, Brazilian data on the topic are scarce. Objective: To analyze the prevalence and manifestations of challenging behaviors in individuals with ASD, with emphasis on national data gaps and implications for the Brazilian Unified Health System (SUS). Method: Narrative review of the literature, using PubMed, Scopus, PsycINFO, and SciELO databases, with terms in Portuguese and English. Empirical studies, systematic reviews, and meta-analyses on the prevalence of challenging behaviors in ASD were included. Results: The most frequent behaviors include aggression, self-injury, stereotypy, elopement, pica, and feeding difficulties, with prevalence ranging from 23% to 94%. Self-injurious behavior is persistent and associated with intellectual disability. The lack of population-based studies in Brazil is a major limitation. Conclusion: Challenging behaviors should be a priority in public health. The absence of national data hinders service planning. Epidemiological studies and culturally adapted interventions are needed to improve SUS-based care.

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