Comment devrions-nous soutenir les enfants autistes ?

Association caritative britannique National Autistic Society (NAS) defines autism as a lifelong developmental disability that affects how people perceive the world and interact with others.

"Children on the autism spectrum see, hear, feel and experience the world in a different way from other people, particularly in terms of how they communicate, and experience and interact with the sensory world around them," says Carol Povey, director of the NAS Centre for Autism.

Le fait que la plupart des parents connaissent - ou connaissent quelqu'un - un enfant autiste témoigne non seulement de la prévalence de la condition (environ 700 000 personnes au Royaume-Uni, plus de 1 sur 100, sont sur the autism spectrum) but also to increased awareness around characteristics, diagnosis and treatment.

The autism spectrum

Toutes les personnes autistes partagent certaines difficultés, mais être autiste affecte les gens de différentes manières. Certaines peuvent avoir des troubles d'apprentissage associés, des problèmes de santé mentale ou des conditions connexes telles que trouble du déficit de l'attention avec hyperactivité (ADHD).

The autism spectrum also encompasses Asperger's syndrome, which affects people of average or above average intelligence, who may still have specific learning difficulties such as understanding and processing language.

"Asperger's syndrome isn't separate from autism - it's all part of the same condition," explains Povey. "The term is often used to describe the more able end of the autistic spectrum."

How is an autistic child diagnosed?

Until a child reaches 7 years of age, the behavioural indicators that denote autism and other autistic spectrum disorders (ASDs), such as ADHD, tend to overlap. For this reason, a diagnosis is sometimes not made until then.

However, most children on the autism spectrum display characteristics from the age of 3 years.

"We would expect to see some signs in those very early years, when children are developing their social and interactive skills, and their language is developing," says Povey.

"Doctors look at how the child interacts with other people - whether they are playing with other children and are able to take part in give-and-take games, whether they seek comfort from others, and whether they are able to make reciprocal friendships.

"They also look at the child's linguistic ability and reciprocal social communication (ability to respond appropriately to social cues from others), including broader facial expressions, tone of voice, receptive and expressive language, and eye contact.

"There may also be issues around repetitive behaviour and routine. Autistic children are often highly focused on certain activities and become distressed when things change.

"Finally, and this is a relatively new understanding, children on the autism spectrum may have very different sensory sensitivities to their peers. They may be over- or under-sensitive to light and touch, become distressed by everyday noises, or even find the texture of certain clothes and foods challenging."

Impact on academic performance

Within the school curriculum, children on the autism spectrum can struggle with comprehension, due to literal thinking and missing the subtleties that different situations provide. In the playground, a pupil may not understand the rules of a game, or require time on their own to 'de-stress' before returning to the classroom. A designated quiet area that they know they can retreat to is often useful.

However, with structured, informed support from classroom teachers, teaching assistants (TAs) and special educational needs (SEN) practitioners, large numbers of children on the autism spectrum learn to successfully navigate the school environment - and even excel academically.

"SEN support ranges from adaptations and targets being put into place up to roughly the equivalent of 13 hours of 1:1 support from a TA," explains Amy O'Donovan, assistant headteacher and SEN leader at a primary school in Surrey.

"Other children may have an Education Health and Care Plan that legally states the specific level of support required to meet their identified needs.

"It is important that all staff receive ASD training and know what strategies they can put in place.

"These include visual aids such as timetables to support understanding and the use of technology to support recording of work, as many ASD children struggle with the physical task of handwriting. Support to understand and teach social skills through comic strip conversations and social stories can also be hugely beneficial."

What is Ritalin® used for?

Povey est prompt à corriger une idée reçue courante selon laquelle des médicaments tels que Ritalin® peut être utilisé pour traiter l'autisme.

"Institut national pour l'excellence en santé et en soins Les directives de la NICE stipulent que des médicaments tels que le Ritalin® ne devraient pas être utilisés pour « traiter » les caractéristiques fondamentales de l'autisme", dit-elle. "Il n'existe aucune intervention pharmaceutique soutenue par des preuves de recherche qui ait démontré un changement de l'autisme. Si un enfant reçoit quelque chose comme le Ritalin®, c'est généralement pour traiter des conditions associées telles que le TDAH.

"Clinicians have to be very careful in their use of medication because it may affect autistic children differently."

Home strategies and support

What strategies can parents with autistic children put in place at home?

"Allowing children time to unwind with a favourite activity after school can help," says O’Donovan. "Other tips include visual timetables and schedules outlining routines at home, and warnings when these change; social stories to help children manage situations such as going out for dinner; and the use of visual aids such as photos of the clothes they need to put on in the order in which they should put them on.

"Il est également utile que les parents participent à des groupes de soutien ou Cygnet training pour partager des conseils et des stratégies entre eux et se soutenir mutuellement."

"Parents often feel isolated, but knowing other families in the same situation can be immensely supportive," agrees Povey. "NAS has branches across the UK where families get help, support and information.

"The families who are the most successful at raising children on the autistic spectrum are the ones where family bonds are really strong and the autistic child is a valued member of the family.

"So it is about getting to know your child and appreciating their strengths as well as their difficulties. We have moved away from seeing autism as a medical condition and much more as a different way of being - one that is just as valuable."