ABSTRACT
The treatment of children with pervasive developmental disorders (PDD) has not been systematically assessed in French day-care units. In this prospective study, 11 children with a diagnosis of PDD were followed up for 2years in a day-care unit in the Marseille university hospital. The treatment they received is based on an initial assessment by the "Centre Ressources Autisme" (CRA PACA) and further included a continued observation of the child and an assessment of the child's abilities and needs. This treatment used various therapeutic approaches 10h weekly and also included parental counseling and coordinated work with schools. Treatment in our day-care unit can be categorized as eclectic, non-intensive therapy. It is based on methods such as TEACCH (Treatment and Education of Autistic and related Communication handicapped Children), Floor Time Play, speech and language therapy, developmental therapy, and psychotherapy. International studies on intensive behavioral therapies suggest that this treatment is superior to non-behavioral and/or non-intensive treatment. They suggest its efficiency is due both to the nature of the treatment (behavioral) and to its intensity (more than 25h a week). In this study, the CRA diagnosed children using the ADI and ADOS. The 11 children (mean age, 3years 5months) were tested twice, with the Vineland and CARS scales. The first assessment was on admission to the day hospital and the second was 2years later. The results showed developmental progress with a mean increase of 13.5 months at the Vineland Scale, and a decrease of the autism severity score on the CARS. The treatment presented here proves to be efficient; if compared to similar results in international studies, we obtained better results than their eclectic intensive or non-intensive treatment comparison group.
Subject(s)
Child Development Disorders, Pervasive/therapy , Parents , Autistic Disorder/therapy , Child Development Disorders, Pervasive/diagnosis , Child Development Disorders, Pervasive/psychology , Child, Preschool , Cognitive Behavioral Therapy/methods , Day Care, Medical/methods , Female , Follow-Up Studies , Hospitals, University , Humans , Male , Parents/education , Personality Assessment , Program Evaluation , Prospective Studies , Speech Therapy/methodsABSTRACT
Early onset (pediatric) bipolar disorders are still an issue of much controversy due to several clinical particularities of the thymic episodes at this age. To date, there is indeed no consensus regarding the prevalence of bipolar disorders before puberty. Diagnosis criteria in children and young adolescents remain thus elusive. The purpose of this review is to provide an overview of this issue. The idea of continuity, from childhood to adulthood, in bipolar disorders also raises important questions regarding predictive factors of bipolar disorders in adults. Studies on the childhood of bipolar adults, as well as studies on the children of bipolar parents will be reviewed, in an attempt to identify the psychopathological substrates of bipolar disorders.
Subject(s)
Bipolar Disorder/diagnosis , Adolescent , Adult , Bipolar Disorder/epidemiology , Bipolar Disorder/genetics , Bipolar Disorder/psychology , Child , Cross-Sectional Studies , Diagnosis, Differential , Humans , Psychopathology , Risk FactorsABSTRACT
OBJECTIVE: To determine developmental communication profiles in young autistic children with mental retardation. METHODS: A group of 19 autistic children (mean age=43 months) were matched with a group of 11 mentally retarded children (mean age=39 months) on mental age (17,6 months). All of these children were without speech (less than 5 words of vocabulary). Communication skills were assessed with the Guidetti-Tourrette scales (ECSP), French adaptation of the Seibert-Hogan scales. RESULTS: Autistic children displayed a much lower score than mentally retarded children in the 3 functions of early social communication (behavior regulation, social interaction and joint attention). The developmental communication profiles was the same in the 2 groups. DISCUSSION: The results showed evidence of distortion in autistic children development: they displayed important deficits in communication skills, in comparison with cognitive skills. Autistic children mainly displayed requesting gestures: they used adults to help them to reach a goal, instead of regarding them as social partners. However, young children who have mental age less than 18 months mainly use the same functions of communication, with or without autistic trouble. CONCLUSIONS: There is a same developmental sequence in communication skills in young children, with or without autistic trouble.
