Les preuves scientifiques

 

 

 Les données concernant l’autisme infantile sont maintenant parfaitement claires.

 

Les enfants autistes ont besoin de soins efficaces fondés sur des preuves qui leur permettent une scolarisation en milieu habituel. L'élément qui choque le plus les étrangers réside en ce que 80% des autistes ne soient pas scolarisés en France et que nombre de familles doivent emmener leurs enfants en Belgique pour avoir enfin des soins conformes à l’état des connaissances scientifiques.

Or il existe 27 études, trois méta-analyses et des recommandations publiées par des agences officielles : françaises, américaines, anglaises et espagnoles qui affirment que les seules méthodes ayant prouvé leur capacité à atteindre cet objectif dans environ 50% des cas sont des méthodes comportementales et cognitives. Aucune autre méthode n’a jusqu'à présent fait preuve de son efficacité (cf. références).

Bien entendu, cet état des lieux est provisoire et devra être révisé en fonction du progrès des connaissances scientifiques. Pour cela, plus de recherches sont nécessaires, sans exclusivité théorique,  à la fois sur les facteurs biologiques et psychosociaux sous-jacents aux troubles, et sur l’amélioration et l’évaluation des approches psychothérapiques et éducatives.

 

Références

  • Anderson, S. R., Avery, D. L., DiPietro, E.K., Edwards, G. L., and Christian, W.P. (1987). Intensive home-based early intervention with autistic children. Education and Treatment of Children, 10(4), 352-366.

  • Bibby, P., Eiseseth, S., Martin, N. T., Mudford, O. C. and Reeves, D. (2001). Progress and outcomes for children with autism receiving parent-managed intensive interventions. Res Dev Disabil, 22, 425-447.

  • Birnbrauer, J. S., and Leach, D. J. (1993). The Murdoch early intervention program after 2 years. Behaviour Change, 10(2), 63-74.

  • Cohen, H., Amerine-Dickens, M., & Smith, T. (2006). Early intensive behavioral treatment: replication of the UCLA model in a community setting. J Dev Behav Pediatr, 27(2 Suppl), S145-55.

  • Dawson, G., Rogers, S., Munson, J., Smith, M., Winter, J., Greenson, J. et al. (2010). Randomized, controlled trial of an intervention for toddlers with autism: the Early Start Denver Model. Pediatrics, 125(1), e17-23.

  • Eikeseth, S. (2009). Outcome of comprehensive psycho-educational interventions for young children with autism. Res Dev Disabil, 30(1), 158-178.

  • Eikeseth, S., Smith, T., Jahr, E., & Eldevik, S. (2002). Intensive behavioral treatment at school for 4- to 7-year-old children with autism. A 1-year comparison controlled study. Behav Modif, 26(1), 49-68.

  • Eikeseth, S., Smith, T., Jahr, E., & Eldevik, S. (2007). Outcome for children with autism who began intensive behavioral treatment between ages 4 and 7: a comparison controlled study. Behav Modif, 31(3), 264-278.

  • Eldevik, S., Eikeseth, S., Jahr, E., & Smith, T. (2006). Effects of low-intensity behavioral treatment for children with autism and mental retardation. J Autism Dev Disord, 36(2), 211-224.

  • Fenski.EC, Zelenski.S, Krantz, P. J., & McClannahan, L. E. (1985). Age at intervention and treatment outcome for autistic children in a comprehensive intervention program. Analysis and Intervention in Developmental Disabilities, 5, 7-31.

  • Handleman, J. S., Harris, S. L., Celiberti, D., Lilleheleht, E., & Tomcheck, L. (1991). Developmental changes in preschool children with autism and normally developing peers. Infant and Toddler Intervention, 1, 137-143.

  • Harris, S. L., Handleman, J. S., Gordon, R., Kristoff, B., and Fuentes, F. (1991). Changes in cognitive and language functioning of preschool children with autism. J Autism Dev Disord, 21(3), 281-290.

  • Harris, S. L., Handleman, J. S., Kristoff, B., Bass, L., & Gordon, R. (1990). Changes in language development among autistic and peer children in segregated and integrated preschool settings. J Autism Dev Disord, 20(1), 23-31.

  • Hastings, R. P., & Symes, M. D. (2002). Early intensive behavioral intervention for children with autism: parental therapeutic self-efficacy. Res Dev Disabil, 23(5), 332-341.

  • Howard, J. S., Sparkman, C. R., Cohen, H. G., Green, G., & Stanislaw, H. (2005). A comparison of intensive behavior analytic and eclectic treatments for young children with autism. Res Dev Disabil, 26(4), 359-383.

  • Lovaas, O. I. (1987). Behavioral treatment and normal educational and intellectual functioning in young autistic children. J Consult Clin Psychol, 55(1), 3-9.

  • Lovaas, O. I., Koegel, R. L., Simmons, J. Q., & Long, J. (1973). Some generalization and follow-up measures on autistic children in behavior therapy. Journal of Applied Behavior Analysis, 6, 131-166.

  • Magiati, I., Charman, T., & Howlin, P. (2007). A two-year prospective follow-up study of community-based early intensive behavioural intervention and specialist nursery provision for children with autism spectrum disorders. J Child Psychol Psychiatry, 48(8), 803-812.

  • McEachin, J. J., Smith, T., & Lovaas, O. I. (1993). Long-term outcome for children with autism who received early intensive behavioral treatment. Am J Ment Retard, 97(4), 359-72; discussion 373-91.

  • Perry, A., et al. (2008). Effectiveness of Intensive Behavioral Intervention in a large, community based program. Research in Autism Spectrum Disorders 2, 621-642.

  • Remington, B., Hastings, R. P., Kovshoff, H., degli Espinosa, F., Jahr, E., Brown, T. et al. (2007). Early intensive behavioral intervention: outcomes for children with autism and their parents after two years. Am J Ment Retard, 112(6), 418-438.

  • Sallows, G. O., & Graupner, T. D. (2005). Intensive behavioral treatment for children with autism: four-year outcome and predictors. Am J Ment Retard, 110(6), 417-438.

  • Sheinkopf, S. J., & Siegel, B. (1998). Home-based behavioral treatment of young children with autism. J Autism Dev Disord, 28(1), 15-23.

  • Smith, T., Buch, G. A., & Gamby, T. E. (2000). Parent-directed, intensive early intervention for children with pervasive developmental disorder. Res Dev Disabil, 21(4), 297-309.

  • Smith, T., Eikeseth, S., Klevstrand, M., & Lovaas, O. I. (1997). Intensive behavioral treatment for preschoolers with severe mental retardation and pervasive developmental disorder. Am J Ment Retard, 102(3), 238-249.

  • Smith, T., Groen, A. D., & Wynn, J. W. (2000). Randomized trial of intensive early intervention for children with pervasive developmental disorder. Am J Ment Retard, 105(4), 269-285.

  • Weiss, M. J. (1999). Differential rates of skill acquisition and outcomes of early intensive behavioral intervention for autism. Behavioral Interventions, 14, 3-22.

Meta analyses

  • Spreckley M, Boyd R  (2009) Efficacy of Applied Behavioral Intervention in Preschool Children with Autism for Improving Cognitive, Language, and Adaptive Behavior: A Systematic Review and Meta-analysis, J Pediatr, 154:338-44.

  • Ortega JVR (2010) Applied behavior analytic intervention for autism in early childhood: Meta-analysis, meta-regression and dose–response meta-analysis of multiple outcomes, Clinical Psychology Review 30, 387–399.

  • Diggle TTJ, McConachie HHR. Parent-mediated early intervention for young children with autism spectrum disorder. Cochrane Database of Systematic Reviews 2002, Issue 2. Art. No.: CD003496. DOI: 10.1002/14651858.CD003496.

 

 

Sources : Collectif du 7 janvier

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