Étude de cas : Intervention thérapeuthique utilisant les « intérêts particuliers » chez un enfant autiste avec agnosie visuelle

Bien que l'éducation spécialisée sous ses divers modes soit consensuellement reconnue comme l'abord privilégié des troubles envahissants du développement, il n'existe à ce jour que peu de travaux sur l'intervention rééducative chez les personnes autistes d'intelligence normale. Cet article présente l'intervention psychoéducative faite avec un jeune garçon autiste de trois ans dans un centre de jour pédopsychiatrique. L'intérêt de cette observation est double. Tout d'abord, cet enfant était porteur, en plus de son autisme, d'une affection de caractère exceptionnel, l'agnosie visuelle. D'autre part, ses « intérêts restreints » autistiques, c'est-à-dire les comportements d'attirance perceptive et de questionnement pour une classe d'objets particuliers ou un paramètre particulier de ces objets, ont été utilisés comme levier pour l'amener à améliorer ses capacités de communication et d'interactions sociales.Although special education under its diverse forms is consensually recognized as the priviliged area of pervasive developmental delay, there is little studies on re-education intervention for autistic persons of normal intelligence. This article presents a psychoeducative intervention with a three year old autistic boy in a pédopsychiatrie day care centre. The interest of this observation is double. On the one hand, this child, aside from autism, is carrier of an exceptional ailment: visual agnosia. On the other hand, his "restrictive autistic interest", namely perceptive attraction and his questioning of a particular class of objects or a particular parameter of these objects were used as lever to bring him to improve his capacities of communication and social interactions.Aunque la education especializada en sus diversas formas sea, de manera consensual, reconocida como el abordaje privilegiado de los desordenes invasores del desarrollo, hasta el momento solo existen pocos trabajos sobre la intervencion con las personas autistas de inteligencia normal. Este articulo présenta la intervencion sicoeducativa realizada con un nino autista de très afios en un centro de siquiatria infantil. El interés de esta observaciôn es doble. Primeramente, este nino era ademâs de su autismo portador de una afeccion de carâcter exepcional, la agnosia visual. En segundo lugar, los "intereses restringidos" autisitcos de este nino, es decir los comportamientos de atracciôn perceptiva y de interrogaciôn por una clase particular de objetos o un parâmetro particular de esos objetos, fueron utilizados como palanca para Ilevarlo a mejorar sus capacidades de comunicaciôn y de interacciones sociales

Le diagnostic des troubles envahissants du développement sans déficience et son impact sur l’obtention des services scolaires et sociaux au Québec

Les troubles envahissants du développement sans déficience constituent une nouvelle entité clinique comprenant les personnes autistes et porteuses d'un trouble envahissant non spécifié sans déficience, ainsi que les personnes porteuses d'un syndrome d'Asperger. Ce groupe est de distinction récente et encore problématique à plusieurs égards. Notre article fait le point sur les relations historiques, théoriques et cliniques que les troubles envahissants du développement sans déficience entretiennent avec les syndromes limitrophes. Nous montrons ensuite les conséquences de l'indétermination concernant ces patients sur les mesures d'assistance disponibles pour eux. Nous concluons sur l'utilité de considérer indépendamment le diagnostic, la description des signes, le niveau intellectuel et l'adaptation psychosociale dans les décisions éducatives et psychosociales concernant les troubles envahissants du développement sans déficience.Pervasive developmental disorders without mental retardation is a new clinical category including high-functioning autism, Asperger syndrome and pervasive developmental disorder non otherwise specified. Its recognition is recent and still problematic in many regards. This article reviews the historical, theoretical and clinical relations between pervasive developmental disorders without mental retardation and bordering disorders. The consequences of an inadequate diagnosis on measures of assistance for these patients is also investigated. The authors conclude on the necessity in considering, independently of the diagnosis, the description of symptoms, the intellectual level and the adaptative level in order to take the most appropriate educational and psychosocial decisions regarding pervasive developmental disorders without mental retardation.Los desordenes invasores del desarrollo sin deficiencia constituyen una nueva entidad clmica que comprende las personas autistas y portadoras de un desorden invasor no especificado sin deficiencia, asi que las personas portadoras de un síndrome de Asperger. Este grupo distinguido recientemente es aún problemático desde varios puntos de vista. Nuestro articulo de centra en las relaciones histôricas, teôricas y clinicas que los desordenes invasores del desarrollo mantienen con sindromes limítrofes. Mostramos en seguida las consecuencias de la indeterminación implicando estos patientes sobre las medidas de asistencia disponibles para estas personas. Concluimos en la utilidad de considerar independientemente el diagnóstico, la description de los signos, el nivel intelectual, y la adaptation sicosocial en las decisiones educativas y sicosociales que conciernen el desorden invasor del desarrollo sin deficiencia

Éléments de diagnostic différentiel clinique entre le syndrome d’Asperger et la personnalité Schizoïde/Paranoïaque

Les personnes avec syndrome d’Asperger soumise à une hostilité objective développent des états de méfiance généralisée pouvant conduire à des actes hétéro-agressifs. Ceux-ci peuvent être confondus avec des syndromes de persécution entrant dans le cadre d’une personnalité schizoïde ou schizothymique. Ces deux entités posées sur l’axe 2 sont en effet des diagnostics différentiels du syndrome d’Asperger, du fait de leur caractère commun de permanence et de la présence d’atypie de la socialisation. À partir de deux cas cliniques, cet article propose une série de critères cognitifs (profile Wechsler), développementaux (chronologie des actes de violences), discursif (aspect qualitatif du discours rapportant les événements) permettant de faire le diagnostic différentiel d’une situation d’hostilité vis-à-vis de l’entourage. Les conséquences dans le support à apporter à ces personnes sont également exposées.Individuals with Asperger syndrome may, when exposed to hostility (e.g. bullying at school or at work), develop hostile ideas against their social environment, sometimes leading to aggression. These ideas and acts may be confounded with those arising from a persecutory state in schizoid or schizotypal personality, or even schizophrenia. These entities can be confounded with Asperger syndrome due to their permanent nature, and the presence of atypical social and emotional behaviours. This paper proposes cognitive (Wechsler profile), developmental (course of hostile behaviours), discursive (qualitative features of discourse reporting hostile thoughts), which may contribute to differential diagnosis in the presence of hostile thoughts and behaviours. Consequences for case management are also reported.Las personas con síndrome de Asperger sometidas a una hostilidad objetiva desarrollan los estados de desconfianza generalizada pudiendo conducir a actos hetero-agresivos. Éstos pueden ser confundidos con síndromes de persecución que entran en el marco de una personalidad esquizoide o esquizotimica. Estas dos entidades posadas en el axis 2 son en efecto los diagnósticos diferenciales del síndrome de Asperger, del hecho de su carácter común de permanencia y de la presencia de atipia de la socialización. A partir de 2 casos clínicos, este artículo propone una serie de criterios cognitivos (perfil Wechsler), de desarrollo (cronología de actos de violencia), discursivo (aspecto cualitativo del discurso que reporta los eventos) que permite realizar el diagnóstico diferencial de una situación de hostilidad frente al entorno. También se exponen las consecuencias del apoyo a aportar y a estas personas.As pessoas com síndrome de Asperger, submetidas a uma hostilidade objetiva, desenvolvem estados de desconfiança generalizada podendo levar a atos heteroagressivos. Estes estados podem ser confundidos com síndromes de perseguição entrando no quadro de uma personalidade esquizóide ou esquizotímica. Estas duas entidades colocadas no eixo 2 são, de fato, diagnósticos diferenciais da síndrome de Asperger, por causa de seu caráter comum de permanência e da presença de atipia da socialização. A partir de dois casos clínicos, este artigo propõe uma série de critérios cognitivos (perfil Wechsler), de desenvolvimento (cronologia dos atos de violência), discursivos (aspecto qualitativo do discurso sobre os acontecimentos) que permitem fazer o diagnóstico diferencial de uma situação de hostilidade em relação ao seu meio. São igualmente expostas as conseqüências do apoio a estas pessoas

Mimetic desire in autism spectrum disorder

International audienceMimetic desire (MD), the spontaneous propensity to pursue goals that others pursue, is a case of social influence that is believed to shape preferences. Autism spectrum disorder (ASD) is defined by both atypical interests and altered social interaction. We investigated whether MD is lower in adults with ASD compared to typically developed adults and whether MD correlates with social anhedonia and social judgment, two aspects of atypical social functioning in autism. Contrary to our hypotheses, MD was similarly present in both ASD and control groups. Anhedonia and social judgment differed between the ASD and control groups but did not correlate with MD. These results extend previous findings by suggesting that basic mechanisms of social influence are preserved in autism. The finding of intact MD in ASD stands against the intuitive idea that atypical interests stem from reduced social influence and indirectly favors the possibility that special interests might be selected for their intrinsic properties

The Level and Nature of Autistic Intelligence II: What about Asperger Syndrome?

A distinctively uneven profile of intelligence is a feature of the autistic spectrum. Within the spectrum, Asperger individuals differ from autistics in their early speech development and in being less likely to be characterized by visuospatial peaks. While different specific strengths characterize different autistic spectrum subgroups, all such peaks of ability have been interpreted as deficits: isolated, aberrant, and irreconcilable with real human intelligence. This view has recently been challenged by findings of autistic strengths in performance on Raven's Progressive Matrices (RPM), an important marker of general and fluid intelligence. We investigated whether these findings extend to Asperger syndrome, an autistic spectrum subgroup characterized by verbal peaks of ability, and whether the cognitive mechanisms underlying autistic and Asperger RPM performance differ. Thirty-two Asperger adults displayed a significant advantage on RPM over Wechsler Full-Scale and Performance scores relative to their typical controls, while in 25 Asperger children an RPM advantage was found over Wechsler Performance scores only. As previously found with autistics, Asperger children and adults achieved RPM scores at a level reflecting their Wechsler peaks of ability. Therefore, strengths in RPM performance span the autistic spectrum and imply a common mechanism advantageously applied to different facets of cognition. Autistic spectrum intelligence is atypical, but also genuine, general, and underestimated

Intérêts spécifiques dans l'autisme avec et sans retard de langage : l'importance des intérêts spécifiques perceptifs versus thématiques.

To explore whether autistic adults with versus without speech delay also differ in the perceptual vs thematic nature of their specific interests.Groupe de contact FNRS Psycholinguistique et Neurolinguistiqu

Increased Sensitivity to Mirror Symmetry in Autism

Can autistic people see the forest for the trees? Ongoing uncertainty about the integrity and role of global processing in autism gives special importance to the question of how autistic individuals group local stimulus attributes into meaningful spatial patterns. We investigated visual grouping in autism by measuring sensitivity to mirror symmetry, a highly-salient perceptual image attribute preceding object recognition. Autistic and non-autistic individuals were asked to detect mirror symmetry oriented along vertical, oblique, and horizontal axes. Both groups performed best when the axis was vertical, but across all randomly-presented axis orientations, autistics were significantly more sensitive to symmetry than non-autistics. We suggest that under some circumstances, autistic individuals can take advantage of parallel access to local and global information. In other words, autistics may sometimes see the forest and the trees, and may therefore extract from noisy environments genuine regularities which elude non-autistic observers

Novel VPS13B Mutations in Three Large Pakistani Cohen Syndrome Families Suggests a Baloch Variant with Autistic-Like Features.

BackgroundCohen Syndrome (COH1) is a rare autosomal recessive disorder, principally identified by ocular, neural and muscular deficits. We identified three large consanguineous Pakistani families with intellectual disability and in some cases with autistic traits.MethodsClinical assessments were performed in order to allow comparison of clinical features with other VPS13B mutations. Homozygosity mapping followed by whole exome sequencing and Sanger sequencing strategies were used to identify disease-related mutations.ResultsWe identified two novel homozygous deletion mutations in VPS13B, firstly a 1 bp deletion, NM_017890.4:c.6879delT; p.Phe2293Leufs*24, and secondly a deletion of exons 37-40, which co-segregate with affected status. In addition to COH1-related traits, autistic features were reported in a number of family members, contrasting with the "friendly" demeanour often associated with COH1. The c.6879delT mutation is present in two families from different regions of the country, but both from the Baloch sub-ethnic group, and with a shared haplotype, indicating a founder effect among the Baloch population.ConclusionWe suspect that the c.6879delT mutation may be a common cause of COH1 and similar phenotypes among the Baloch population. Additionally, most of the individuals with the c.6879delT mutation in these two families also present with autistic like traits, and suggests that this variant may lead to a distinct autistic-like COH1 subgroup

Postural Hypo-Reactivity in Autism is Contingent on Development and Visual Environment: A Fully Immersive Virtual Reality Study

Although atypical motor behaviors have been associated with autism, investigations regarding their possible origins are scarce. This study assessed the visual and vestibular components involved in atypical postural reactivity in autism. Postural reactivity and stability were measured for younger (12–15 years) and older (16–33 years) autistic participants in response to a virtual tunnel oscillating at different frequencies. At the highest oscillation frequency, younger autistic participants showed significantly less instability compared to younger typically-developing participants; no such group differences were evidenced for older participants. Additionally, no significant differences in postural behavior were found between all 4 groups when presented with static or without visual information. Results confirm that postural hypo-reactivity to visual information is present in autism, but is contingent on both visual environment and development