Neuropsychiatrie de l''Enfance et de l''Adolescence最新文献

Introduction

Aim of study

Results

Conclusion

Objective

The aim of the study presented here is to compare the activity of two neurodevelopmental disorders coordination and orientation platforms (PCO–TND) set up at different times in the history of this system (implemented in 2019). Two studies were conducted: A comparative cross-sectional study of the first 101 screening booklets recorded on both platforms, and a longitudinal study based on data from the Finistère PCO comparing the contents of the booklets of the first 101 children addressed to the PCO with those of the 101 booklets recorded exactly one year later. The questions we aimed to answer are as follows: did the activity of the Vendée PCOs implanted one year later benefit from feedback from the first implanted PCOs? What points of similarity were revealed from a cross-sectional comparison of the activity of these two platforms? What points of dissimilarity? A longitudinal comparison of the activity of the Finistère PCO revealed what changes had taken place over time in terms of the characteristics of the children addressed and the types of referring doctors?

Method

The same data collection tool was used at the Finistère and Vendée PCOs. It consisted of a Google form file which recorded the characteristics of the addressed child (age, sex), his/her other high-risk TND factors, particular instinctual, sensory and emotional behaviors, TND warning signs, the suspected disorder(s) justifying referral to the platform, and the assessments prescribed.

Results

The age of addressed children tended to fall within the length of time the platform had been in operation. The type of referring doctor varied according to the territory in which the PCO was located. A quarter of the children referred to the two platforms were thought to have an overall developmental delay (motor skills, language and cognition). Sleep disorders and “exaggerated intolerance to change” were identified in around 25 % of children referred to the two PCOs. The longitudinal study carried out on the Finistère PCO revealed an evolution in the quantitative and qualitative characteristics of the activity in the direction of greater compliance with the original objectives of the system.

Discussion–Conclusion

Once this screening system has found its place in the host region, at-risk children can be identified earlier and their care provided more promptly which would improve their prognosis. Over time, first-line doctors will become more familiar with the booklet and with TND symptoms and will therefore be better able to identify them, which in turn increases the rate of referral of at-risk children to the platform.

The specificities of the current clinical practice demand a constant reflection regarding the symbolizing and containing potential of our therapeutic settings as a means to support families whose backgrounds are often marked by traumatic migratory experiences. Clinicians need to modify traditional therapeutic settings in order to culturally, socially and intrapsychically permit injured families to adhere to the proposed clinical interventions. As a way of better responding to the demands of those families, both in terms of time and content, we have set up a parent/child space. This multi-disciplinary observation place enables us to elaborate about the child's care, but it also constitutes a first therapeutic space that supports the institutional transfer which is often weakened by the traumatic impact of the history of the families we receive at the CMP. Inspired by Françoise Dolto's Maison Verte, this space encourages the parents’ involvement in their child's development, by enhancing their investment in the institution and in their child. The aim is to provide a more individualized support so that children can regain a subjective position, and their parents can be heard and supported in their suffering while dealing with their child's disorders and disorganization.

Access to parenthood is not always easy, and various difficulties can sometimes emerge. Often underdiagnosed, these peri- and post-partum disorders have a major impact on the quality of early interactions. Prevention and fast care are fundamental. In Nancy, France, a mobile perinatal psychiatry team (EMPPer) was created in September 2021 with the aim of “reaching out” to these vulnerable populations with care access difficulties. A clinical case combining precariousness, migration, maternal psychopathological disorders, baby's psycho-affective and psychomotor development trouble is exposed. This article aims to present the multidisciplinary network intervention of EMPPer.

Introduction

In France, to benefit from appropriate medical, social and educational care, children with autism spectrum disorders must obtain a referral from the Maison Départementale des Personnes Handicapées (MDPH), and these notifications must then be implemented. In French Guiana, social and territorial inequalities in health are omnipresent. However, there are no data on the care of adolescents with Autism Spectrum Disorder in French Guiana.

Aim and methodology

The aim of the project was to explore the educational and medico-social pathways of children included in Guiana's autism spectrum disorder register since 2016 (who were living in Guiana in 2016 and whose ASD had been diagnosed before their 8th birthday) by means of a telephone interview and data collection at the MDPH. We included 52 young people aged 11 to 18, including 40 families contacted by telephone. The results obtained through the variables collected show that, despite a diagnosis made before the age of 8, only 29 young people (out of 47 completed) benefit from medical, social and educational care that coincides with the recommendations of the current Commission des droits et de l’autonomie des personnes handicapées (CDAPH).

Results

Of the 52 young people monitored, at least nine – or 17.3% – were not receiving any form of education. Thirty one young people were receiving medical, social, health and/or educational care at the time of the survey, compared with 16 who were not receiving any, mainly because they had been on a waiting list for an average of five years. In addition, 34% said they were not satisfied with the overall care their child received, mainly because of staff shortages.

Conclusion

In conclusion, in French Guiana, there is a significant gap between what is recommended to parents for their teenage child's care and what is actually possible.

Objective

The aim of this study was to identify the content of the stereotype of a child with a diagnosis of attention deficit disorder with or without hyperactivity (ADHD) among French neuropsychologists, and then to identify the factors associated with a stereotyped representation of ADHD.

Method

An online survey was conducted in France among 88 neuropsychologists working with children diagnosed with ADHD. Stereotypes were identified using differential semantic scales. In line with the Stereotype Content model, seven “competence” stereotypes and seven “warmth” stereotypes were assessed. Individual factors potentially associated with stereotyping included categorical and continuum beliefs, beliefs in high quality of life opportunities, feelings of professional usefulness, perceived general similarities and perceived specific similarities. Sociodemographic factors were also collected.

Results

Compared with neurotypical children, participants perceived children with an ADHD diagnosis as having more difficulty concentrating, being less competent at controlling their emotions, more extroverted, more irritable, more insolent, less competent at maintaining friendly relationships, less competent academically, more competent at sports, more warm-hearted and more arrogant. The more the participants perceived themselves to be similar to children with a diagnosis of ADHD, the fewer stereotypes they themselves reported. Neuropsychologists with the fewest years of experience, the most frequent contact with children diagnosed with ADHD and working in private practice reported a more stereotyped view of ADHD.

Conclusion

Even though neuropsychologists play an important role in supporting children with ADHD, many stereotypes can be found in their representation of the children they work with. These stereotypes are discussed, along with anti-stigma solution.