Search

In neurotypical individuals, studies report that women have better communication, social, and emotional skills than men (Head et al., 2014). This parameter is thought to be due to more demanding educational expectations in women and early assimilation into their own gender (between 18 and 24 months) (Steensma et al., 2013). This phenomenon would also be found in female with autism spectrum disorder without intellectual disability (ASD WID), who would tend to camouflage their autistic traits, which would explain the under-diagnosis of autism in that gender (Hull et al., 2017). Using Annick Duchêne May-Carle's Implicit Management Protocol, the purpose of the study is twofold: first, we would like to identify if there are performance’s differences between females with ASD compared to neurotypical females and to ASD males; second, we tried to establish female profiles of implicit understanding in ASD WID. In order to do this, results of 25 ASD WID patients (15 males and 10 females) aged from 20 to 34 years have been compared to each other and to the results of 20 neurotypical individuals (10 males and 10 females). Statistically, our study did not demonstrate a significant superiority of implicit comprehension in ASD women. However, the descriptive data for ASD WID females showed a slight superiority in scores compared to ASD WID males.; Chez les personnes neurotypiques, les études rapportent que les femmes ont de meilleures capacités communicationnelles, sociales et émotionnelles que les hommes (Head et al., 2014). Ce paramètre serait dû à des attentes éducatives plus exigeantes chez la femme et une assimilation précoce à son propre genre (entre 18 et 24 mois) (Steensma et al., 2013). Ce phénomène se retrouverait aussi chez les femmes présentant un trouble du spectre de l’autisme sans déficience intellectuel (TSA SDI), qui auraient tendance à camoufler leurs traits autistiques, ce qui expliquerait le sous-diagnostic d’autisme féminin (Hull et al., 2017). Au moyen du protocole de la gestion de l’implicite d’Annick Duchêne May-Carle, l’objectif de l’étude est double : il consiste d’une part à identifier s’il y a des différences de performances entre les femmes TSA SDI comparativement aux performances des femmes neurotypiques et également comparativement aux performances des hommes TSA SDI, et d’autre part, à établir des profils féminins de la compréhension de l’implicite dans le TSA SDI. Pour ce faire, les résultats de 25 patients TSA SDI (15 hommes et 10 femmes) âgés de 20 à 34 ans ont été comparés entre eux ainsi qu’aux résultats de 20 individus neurotypiques (10 hommes et 10 femmes). Statistiquement, notre étude n’a pas permis de démontrer une supériorité significative de la compréhension de l’implicite chez la femme TSA SDI. En revanche, les données descriptives des femmes TSA SDI ont montré une légère supériorité de résultats par rapport aux hommes TSA SDI.

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder associating persistent communication and social interaction deficits with behaviors, interests or activities of a restricted and repetitive nature. The etiology of ASD is not yet fully understood but appears to be multifactorial, including both genetic and environmental factors. The concept of autism underwent a major evolution before arriving at the current definition in DSM-5. The diagnosis has two parts: a categorical from cut-off and differential diagnosis established from a specification of the category by dimensional variables (intelligence, language, associated diseases, adaptation). These two parts (categorical diagnosis and specifiers) are complementary but pose a certain number of practical problems in establishing the diagnosis in adulthood.Le trouble du spectre de l’autisme (TSA) est un trouble neurodéveloppemental associant des déficits persistants de la communication et des interactions sociales à des comportements, intérêts ou activités présentant un caractère restreint et répétitif. L’étiologie du TSA n’est pas complètement élucidée mais semble plurifactorielle, comportant des facteurs génétiques et environnementaux. La notion d’autisme a subi une évolution importante avant d’aboutir à l’actuelle définition dans le DSM-5. Le diagnostic comprend : a) un diagnostic catégoriel établi à partir de seuils et b) un diagnostic dimensionnel établi à partir de variables dimensionnelles (intelligence, langage, maladies associées, adaptation). Ces 2 parties sont complémentaires mais posent un certain nombre de problèmes pratiques à l’établissement du diagnostic à l’âge adulte.

This report presents the case of a young man of 24 years old with Asperger syndrome who ingest quantities of medication whose flecainide. Resume of his stay in intensive care unit, notably serious adverse effect which ventricular tachycardia with membrane stabilizing effect and lengthening of stay in intensive care unit. Study of literature of different take care already published, with notion of mid-term leaching of flecainide which were ingest days before, at different levels all over the world.

I met people with Asperger syndrome to explore their relationship to nature by collecting their testimony and conducting ethnographic surveys at the homes of two of them. From these testimonies and observations, I articulate my remarks around two central axes: if the importance of the sensoriality in their relationship with nature and environment is highlighted, a second axis emerges: that of stigmatization and experience of rejection, which would lead the people I met to turn to nature as a space freed from social norms., J’ai rencontré 24 personnes porteuses du syndrome d’Asperger afin d’explorer leur rapport à la nature en recueillant leurs témoignages et en réalisant des enquêtes ethnographiques au domicile de deux d’entre elles. À partir de ces témoignages et observations, j’articule mon propos autour de deux axes centraux : si l’importance de la sensorialité dans leur rapport à la nature et à l’environnement est mise en évidence, une deuxième problématique apparaît : la stigmatisation et un vécu de rejet qui inciteraient les personnes que j’ai rencontrées à se tourner vers la nature comme un espace libéré des normes sociales.

Asperger's syndrome symptoms in children, adolescents and young adults. Asperger syndrome (AS) is a neurodevelopemental disorder which is classified into autism- spectrums disorders (ASDs). AS is characterized by significant difficulties in social interaction and nonverbal communication, stereotyped and restricted patterns of behaviour, activities and interests. There is no clinically significant delay in cognitive development nor general delay in language. However, there are specific abnormalities such as literal interpretations, miscomprehension of nuance, unusually pedantic and formal speech. Clinical aspects are very heterogeneous and vary depending on age and psychiatric comorbidities. Among the associated disorders, Attention Deficit Hyperactivity Disorder, mood and anxiety disorders are commonly found. To identify these conditions and offer appropriate treatment, elevated vigilance is needed in clinical practice.Quand évoquer le syndrome d’asperger chez l’enfant, l’adolescent et le jeune adulte ? Le syndrome d’Asperger est un trouble neuro-développemental faisant partie de la grande famille des troubles du spectre de l’autisme. Les personnes ayant un syndrome d’Asperger ont des difficultés dans le domaine des interactions sociales, de la communication verbale et non verbale et peuvent avoir une bizarrerie comportementale avec des stéréotypies et des intérêts restreints. Ils n’ont pas de retard du langage et le développement cognitif n’est pas marqué par un retard global mais par des atteintes spécifiques dans certains domaines comme les fonctions exécutives. Les aspects cliniques sont très hétérogènes, ils varient en fonction de l’âge et des comorbidités psychiatriques. Parmi les troubles associés on retrouve fréquemment le trouble de déficit de l’attention avec ou sans hyperactivité. Une prise en charge précoce, multidisciplinaire et intégrative permet une meilleure qualité de vie et une diminution des complications psychiatriques telles que les troubles anxieux, la dépression et les conduites suicidaires.

En France, aucune étude n’a été publiée sur l’évolution socio professionnelles des patients présentant un syndrome d’Asperger (SA). Tous les jeunes adultes âgés de 18 à 30 ans, suivis dans un service de pédopsychiatrie pour un SA, ont été interrogés sur leur parcours socio professionnel et leur ressenti sur leur avenir. Trois questionnaires ont été utilisés : un questionnaire ad hoc analysant les données socio démographiques et l’expérience professionnelle, les questionnaires WHOQOL-Bref et COPSOQ.Sur 79 sujets inclus, 24 ont participé à l’étude avec un âge moyen de 22.2 ans (SD 3.4 ans) et un âge diagnostic moyen de 17.5 ans (SD 3.7 ans). La majorité (54 %) rapporte une comorbidité psychiatrique en particulier un trouble anxieux. La moitié d’entre eux déclare avoir au moins un niveau baccalauréat et bénéficier d’une expérience professionnelle. Seuls 6 sont en emploi lors de l’étude, les autres dépendent financièrement de leurs parents. Leur qualité de vie ressentie est significativement altérée par rapport à la population générale française, en particulier les domaines « santé psychologique » et « relations sociales », mais le travail reste perçu comme un élément d’épanouissement. Pour répondre aux difficultés, ils souhaitent un accompagnement personnalisé adapté au trouble autistique ainsi qu’une action en milieu professionnel.Ces résultats sont cohérents avec les données internationales. Des travaux restent à réaliser pour évaluer les facteurs d’intégration socioprofessionnelle, et notamment les actions à entreprendre par les professionnels de santé au travail auprès des équipes chargées de l’accompagnement de ces adultes.

The purpose of this paper is to examine the possible benefits to keep using the diagnosis of Asperger's syndrome. We first describe the evolution of this entity over time and within nomenclature bases such as the ICD- 10, the CFTMEA and the last versions of DSM. Then, we discuss more precisely the impact of the decision made in the DSM-5 to suppress the Asperger syndrome as a differentiated entity within the pervasive developmental disorders (PDD). This disorder chapter by the way also disappears and is replaced by Autism Spectrum Disorder (ASD). We present here three clinical cases encountered in an outpatient general child psychiatry clinic : 1 case was diagnosed as Asperger syndrome, 1 as infantile autism (early infantile autism) and 1 as another pervasive developmental disorder (psychotic disharmony). The objective was to expose the commonali ties and differences between these three entities. We conclude that keeping using the Asperger diagnosis is important for the clinical management of these clinical situations but also for the individual, his or her family and society at large.L’objet de cet article est de discuter du diagnostic de syndrome d’Asperger. Nous décrivons tout d’abord l’évolution de cette entité au fil du temps et des référentiels que sont l’ICD-10, la CFTMEA et les différents DSM. Nous parlons plus précisément des répercussions des décisions prises dans la nouvelle mouture du DSM-5 pour ce trouble en particulier, à savoir sa disparition en tant qu’entité différenciée au sein des troubles envahissants du développement (TED) dont le terme disparaît également au profit du concept de troubles du spectre autistique (TSA). Nous exposons 3 cas cliniques rencontrés en consultation de pédopsychiatrie générale : 1 cas diagnostiqué comme étant un syndrome d’Asperger, 1 cas d’autisme infantile (autisme infantile précoce) et 1 cas d’un autre trouble envahissant du développement (dysharmonie psychotique) afin d’exposer les points communs et les différences entre ces 3 entités. Nous insistons sur le fait de l’importance de poser ce diagnostic et de le reconnaître en tant qu’entité à part entière au niveau de notre clinique quotidienne non seulement pour la prise en charge de ces situations cliniques mais aussi et surtout pour l’individu, sa famille et la société.

The prevalence of anxiety disorders has been recently estimated at 42 % in a population of adolescents with autism spectrum disorder without intellectual disability. This rate is more than two times higher than in adolescents without developmental disorders (around 20 %). Besides, according to recent studies, the quality of life of adolescents with ASD without mental retardation seems to be lower than adolescents with typical development. We guess that anxiety disorders may be responsible for a low quality of life in adolescents with ASD.The aim of this study was to describe the relationship between quality of life and anxiety disorders. The first objective was to determine if anxiety disorders are a risk factor for having a low quality of life in adolescents with ASD. The second objective was to confirm this link with another comparison using a control group of adolescents with an anxiety disorder but without ASD. Our hypothesis was that anxiety disorder is a risk factor to decrease the quality of life of adolescents with ASD.This research was a transversal descriptive and comparative study. Sixty-six adolescents aged between 11 and 18years old were included: 46 with ASD without mental retardation and 20 controls (with anxiety disorders without ASD). Among the ASD group, 20 patients were identified as having an anxiety disorder according to international classifications of mental diseases, and 26 adolescents had no psychiatric comorbidity. Quality of Life (QoL) was reported in five domains with the KIDSCREEN-27, for each patient in the three different groups. Diagnosis of anxiety disorders was assessed using the Kiddie-SADS-PL. The level of anxiety was measured with a self-report questionnaire (RC-MAS). We compared the anxiety rates and the QoL levels between the two groups of adolescents with ASD, one with anxiety disorders, the other without anxiety disorder. Comparisons were also made with QoL data from the general population.Quality of life in the two different groups of adolescents with ASD without mental retardation (with and without anxiety disorders) was significantly lower than in adolescents in the general population. Those rates were significantly lower in the group with ASD and anxiety disorders than in the group with ASD without anxiety disorders for the domain of "physical well-being" only. There was no significant difference between the groups regarding the four other domains of the Kidscreen-27. Moreover, there was no difference between adolescents with ASD and adolescents without ASD regarding the perceived level of anxiety.This study shows that anxiety disorders could be a risk factor for impairment of the "physical well-being" dimension of QoL in adolescents with ASD without intellectual disability. Results highlight the interest of a self-evaluation of anxiety level in a population of adolescents with ASD. Findings about self-report of QoL might be temper probably due to the insight difficulties that meet patients with ASD reported in literature review. Further research need to be done with larger samples of patients using self-evaluation coupled with hetero-evaluation such as parents' reports and clinicians' reports.

En plus de la triade de symptômes caractérisant l’autisme, ce trouble neurodévelopmental est associé à des particularités perceptives et motrices et, au niveau cérébral, par une connectivité atypique entre les différentes régions du cerveau. Au niveau anatomique, un des résultats les plus communs est la réduction du corps calleux. Toutefois, des effets directs de cette altération anatomique sur l’intégrité et l’efficacité du transfert interhémisphérique restent à être démontrés. Pour la présente thèse, trois différentes études investiguent différents aspects du traitement de l’information visuomotrice : le transfert interhémisphérique entre les régions bilatérales motrices et visuelles, la vitesse de traitement perceptif, et les habiletés motrices visuellement guidées. Dans la première étude, le paradigme visuomoteur de Poffenberger a été utilisé pour mesurer le temps de transfert interhémisphérique (TTIH). L’imagerie par résonnance magnétique fonctionnelle (IRMf) et structurale ainsi que l’imagerie de diffusion ont aussi été utilisées pour étudier les réseaux cérébraux impliqués dans la tâche de Poffenberger. Les autistes ont été comparés à un groupe d’individus à développement typique. La deuxième étude avait pour but d’investiguer la vitesse de traitement perceptif en autisme. Dans la troisième étude, deux tâches motrices (Purdue et Annett) ont été utilisées pour examiner la nature et l’importance des déficits moteurs. La tâche de Purdue inclut deux conditions bimanuelles utilisées comme indice additionnel d’intégration interhémisphérique. Dans les études 2 et 3, le groupe d’autistes a aussi été comparé à un groupe d’individus Asperger afin de voir si, et comment, les deux sous-groupes peuvent être distingués en ce qui concerne le traitement visuel et les déficits moteurs. Aucune différence entre les groupes n’a été observée en termes de TTIH. Les résultats de l’étude IRMf révèlent des différences d’activations corticales en lien avec la tâche de Poffenberger. Dans les groupes d’autistes et de typiques, l’efficacité de la communication interhémisphérique était associée à différentes portions du corps calleux (frontales/motrices chez les typiques, postérieures/visuelles chez les autistes). De façon globale, les résultats de cette étude démontrent un patron atypique de transfert interhémisphérique de l’information visuomotrice en autisme, reflétant un rôle plus important des mécanismes visuels dans le comportement sensorimoteur possiblement en lien avec une réorganisation cérébrale. Les résultats des études comportementales 2 et 3 indiquent que les autistes excellent dans la tâche mesurant la vitesse de traitement perceptif alors que les Asperger accomplissent la tâche à des niveaux similaires à ceux des typiques. La nature des déficits moteurs diffère aussi entre les deux sous-groupes; la dextérité et la coordination bimanuelle est affectée chez les individus Asperger mais pas chez les autistes, qui eux sont plus atteints au niveau de la rapidité unimanuelle. Les sous-groupes d’autistes et de syndrome d’Asperger sont caractérisés par des profils cognitifs différents dont les particularités perceptives et motrices font partie intégrante., In addition to the triad of symptoms characterizing autism, this neurodevelopmental condition is characterized by visual and motor atypicalities and, at the cerebral level, by atypical connectivity between the different brain areas. Anatomically, one of the most replicated finding is a reduction of the corpus callosum. However, evidence of a direct effect of the corpus callosum reductions on integrity and efficiency of interhemispheric transfer is lacking. Three different studies were designed to investigate different aspect of visuo-motor processing: interhemispheric transfer between bilateral motor and visual brain areas, perceptual processing speed, visually guided motor performance. In the first study, the visuo-motor Poffenberger paradigm was used to measure interhemispheric transfer time (IHTT). Structural and functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) were also used to study the brain networks involved in the Poffenberger task. Autistics were compared to typically developing individuals. The second study investigates whether perceptual processing speed (Inspection Time task) is atypical in autism. In the third study, two visually-guided motor tasks (the Purdue pegboard and Annett peg moving task) were used to verify the nature and magnitude of motor deficits. The Purdue task includes two bimanual conditions used as additional measures of interhemispheric communication integrity. Moreover, in studies 2 and 3, behavioral differences between autistic and Asperger individuals were investigated in order to see if and how the two subgroups can be distinguished in terms of perceptual processing and motor deficits. No group difference was observed in terms of IHTT. The fMRI results reveal a different pattern of cortical activations associated to the Poffenberger task. In the autism and typical groups, the efficiency of interhemispheric communication was associated with different portions of the corpus callosum (frontal/premotor in typicals, posterior/visual in autistics). These results demonstrate an atypical pattern of interhemispheric visuo-motor information transfer, possibly reflecting a more prominent role of visual mechanisms guiding sensorimotor behavior in autism, related to cerebral reorganizations. Results of the behavioral studies indicate that autistics have an excellent visual processing speed while Asperger individuals performed like typicals. Motor impairments also differed between the two subgroups; dexterity and bimanual coordination was impaired in Asperger individuals but not in autistics, who presented more difficulties in unimanual conditions. Autism and Asperger subgroups are characterized by different cognitive profiles in which visual processing and motor deficits are important factors.

This article presents an exploratory study evaluating the impact of the program Employment Pact: Québec in full force (2008) aimed at the integration in the workforce of adults living with Autism Spectrum Disorder (ASD) or Asperger Syndrome (AS). This program is implemented in different regions in Québec. The evaluation takes into consideration working conditions, integration procedures, as well as receptivity of eventual employers. Results demonstrate that the working conditions for these individuals are relatively similar, however, the type and number of services offered, as well as the training of service agents vary from one centre to another.

The category of pervasive developmental disorders (PDD) without intellectual disability (including Asperger syndrome and high-functioning autism) has increased steadily among individuals since the 1980s. Although some symptoms may decrease with age, functional disability persists and is largely related to abnormalities in social interaction. Within the framework of PDD without intellectual disability, improving social skills appears to be a primary target for intervention programs. Despite a recent increase in the number of studies on this topic, few validated programs are yet available for clinical settings.We have developed an intervention targeting the improvement of social skills from the analysis of video sequences. The goal of this intervention is to promote communication within the group through sharing their interests and emotions, and to enhance the understanding of social situations. In order to assess the efficiency of this intervention, we have conducted a prospective, open, and uncontrolled study. First, it aimed at assessing the immediate effect of our intervention on a single social skill (communication) in an experimental situation (in the group) and in an ecological situations (family and school). Second, this study aimed at assessing the effects of this intervention on the subjects' social adjustment.This study included 16 individuals with high-functioning autism/Asperger syndrome. Participants were evaluated before and after a 6-month video-based training using measures of socio-communicative and adaptive skills.Results revealed a statistically significant increase in the communication skills not only in the group (15.5%), but also at home (13.7%) and at school (8.7%). The evaluation of socio-adaptive behavior indicates a statistically significant increase in communication (12%), family (7%) and social autonomy (8%), and leisure activities (8%).The communication and social adjustment scores obtained upon inclusion were low, despite low autistic intensity scores. However, the improvement at six months was significant for most studied variables. These results are consistent with our clinical findings and seem partly explained by the use of video supports as the mediator of exchanges within the group. However, because of some methodological limitations, the conclusions on the effects of the intervention should be nuanced.This type of intervention seems to be an interesting therapeutic indication for individuals with high-functioning autism/Asperger syndrome. The first results are encouraging, and all participants enjoyed attending the meetings. These conclusion elements encourage us to continue this intervention and to pursue further research by studying the impact on the individuals' quality of life.

During recent years, fictions featuring a character with Asperger syndrome have been increasingly produced in literature, cinema and TV. Thus, the public has gradually discovered the existence of this specific category of autism spectrum, which is far removed from old popular representations of autistic disorders, often associated with mental retardation.To describe the reactions generated by these characters in order to identify their major functions and also to try to explain their recent increase in fictions.First, we explored international publications concerning this topic. A group of experienced clinicians systematically examined works of fiction produced between 2000 and 2010 that included a character with Asperger syndrome. More than 30 productions have been identified and analyzed using a method adapted from focus group.Over 30 productions have been recorded and analyzed. The reactions generated by these characters are described. They range from fascination to empathy; if these heroes sometimes induce laughter (because of comedy situations), they also lead us to question our vision of the world and ask ourselves about notions such as difference, normality and tolerance. We illustrate this phenomenon with examples from literature, cinema or television.Four hypotheses are proposed trying to explain the recent multiplication of these fictional characters with Asperger syndrome. The first puts forward authors' informative and educational motivations, these authors being aware of this issue. The second is supported by the "hero" concept, which has evolved gradually into the figures of the scientific world and the so-called "Geek" community. The third hypothesis, a metaphorical one, considers these heroes as symbols of a future society: a hyper systematized society, devoid of empathy, as if to warn of a risk of evolution of humanity toward a generalized mental blindness. The fourth and last hypothesis explores the personal resonance, supported by identification mechanisms.The dissemination of such fictional characters and their specific characteristics helps make Asperger syndrome a cultural component of our modern society. Such a wide distribution, supported or even promoted by associations, could contribute to better information and therefore to greater acceptance of these persons who frequently experience releases and harassment. Whatever the fate of Asperger syndrome in future classifications, the multiplication and the success of fictional productions demonstrate a growing and probably irreversible enrollment in popular culture.

Objectif: Aucun outil n’est disponible en France pour le dépistage des troubles du spectre de l’autisme sans déficience intellectuelle (« Autisme de Haut Niveau » ou Syndrome d’Asperger, ici nommés « TED SDI »). L’utilisation de test de dépistage par des cliniciens « de première ligne » permettrait de mieux détecter les enfants susceptibles d’avoir de tels troubles et d’améliorer leur prise en charge. Au Royaume-Uni, 3 questionnaires ont été évalués : Quotient du spectre de l’autisme (AQ), Quotient d’empathie (EQ), et Quotient de systématisation (SQ). Nous avons traduit ces 3 questionnaires et proposons leur méthode d’évaluation en France auprès d’adolescents TED SDI et d’adolescents témoins.Méthode. La traduction du questionnaire en français a nécessité deux traductions simultanées, deux rétro-traductions et deux réunions d’harmonisation. Il s’agit d’une étude transversale comparant les scores obtenus avec les trois questionnaires AQ, EQ et SQ remplis par les parents de 4 groupes d’adolescents : 100 adolescents TED SDI (50 avec QI ≥ 85 et 50 avec 70 ≤ QI < 85), 50 adolescents ayant un autre trouble psychiatrique (TP), et 200 adolescents témoins (T).Résultats. Au total, 580 questionnaires ont été envoyés à 40 centres recruteurs en date du 28/02/2010 et 277 questionnaires ont été reçus : TED SDI : 70 (70 %) ; TP : 25 (50 %) et T : 182 (91 %). Dans le groupe témoin, 92 filles (moyenne 14,4 ± 1,7 ans) et 66 garçons (14,5 ± 1,7 ans) ont été enregistrés avec des données validées et saisies. Dans le groupe TED SDI, 4 filles (14,3 ± 2,4 ans) et 42 garçons (14,5 ± 1,7 ans) ont été recrutés. Une fille (81) et 6 garçons (72,2 ± 7,7) ont un QI compris entre 70 et 85 et 3 filles (95,3 ± 4,2) et 36 garçons (102,9 ± 12) ont un QI supérieur à 85. Dans le groupe TP, 9 filles (15,9 ± 1,7 ans) et 4 garçons (15,8 ± 1,9 ans) ont été recrutés.Conclusion. L’objectif de cette étude est de mettre à disposition en français les questionnaires AQ, EQ et SQ pour les cliniciens francophones. Cette étude permettra d’évaluer avec rigueur l’intérêt du questionnaire AQ pour le dépistage des TED SDI chez les adolescents.

Autism is a neurodevelopmental disorder characterized by a deficit of language and communication both associated with a restricted repertoire of activities and interests. The current prevalence of autistic disorder stricto sensu is estimated at 1/500 whereas autism spectrum disorders (ASD) increases up to 1/150 to 1/200. Mental deficiency (MD) and epilepsy are present in numerous autistic individuals. Consequently, autism is as a major public health issue. Autism was first considered as a non biological disease; however various rational approaches for analysing epidemiological data suggested the possibility of the influence of genetic factors. In 2003, this hypothesis was clearly illustrated by the characterization of genetic mutations transmitted through a mendelian manner. Subsequently, the glutamate synapse appeared as a preferential causal target in autism because the identified genes encoded proteins present in this structure. Strikingly, the findings that an identical genetic dysfunction of the synapse might also explain some MD suggested the possibility of a genetic comorbidity between these neurodevelopmental conditions. To date, various identified genes are considered indifferently as "autism" or "MD" genes. The characterization of mutations in the NLGN4X gene in patients with Asperger syndrome, autism without MD, or MD without autism, was the first example. It appears that a genetic continuum between ASD on one hand, and between autism and MD on the other hand, is present. Consequently, it is likely that genes already involved in MD will be found mutated in autistic patients and will represent future target for finding new factors in autism.

First described in 1944 by Hans Asperger, Asperger syndrome (AS) is now considered in international diagnostic classifications as one of the pervasive developmental disorders (PDD) or autism spectrum disorders (ASD). The main symptoms of AS are severe impairment in social interaction and communication, and restricted interests, without significant delay in cognitive and language development. Its prevalence is not clearly established but might be around 0.26 per 1000. Symptoms of high-functioning autism (HFA), which is not an official diagnostic category, are quite similar. Children and adolescents with AS or HFA mostly have a social skills deficit, in connection with a lack of understanding concerning the rules governing social interactions. This deficit often leads to social isolation and peer rejection, which can alter their quality of life. Their lack of social skills can also have effects on success at school or work, integration among peers and mental health. According to recent guidelines of the French national authority for health (Haute autorité de santé, HAS) about the special needs of persons with PDD, professionals have to develop evidence-based interventions, emphasizing social interactions and participation, as described by the international classification of functioning, disability and health (ICF): social and professional participation as well as participation in leisure activities, clubs and societies, etc.To explore the studies that give evidence of the value of these social skills training groups, to review the methods and programs worked out in these groups, and to highlight the best general operating principles to be adopted and combined.Systematic searches of electronic databases, journals, and reference lists identified 12 studies published since 1984, involving social competence group interventions, led by psychotherapists who were trained in cognitive behavioral therapies (CBT), for children and adolescents from 6 to 18years old with a diagnosis of AS or HFA.According to these 12 studies, these interventions are useful and significantly effective. Adaptation of their contents and educational means to how children and adolescents with AS function is necessary to facilitate learning and decrease anxiety. Concerning the groups' setting, most of these studies insist on the value of working with a small number of participants and creating a friendly, predictable and structured environment (even the progress of the sessions itself has to be structured). The programs' contents should ally didactic teaching and training exercises, which should be diverse and adapted to the objectives. The techniques usually applied in CBT (role plays, modeling, problem-solving strategies, etc.), must be completed with strategies known to be appropriate for children and adolescents with ASD, such as social scenarios.Although new studies are necessary to assess the generalization and long-term efficacy of such approaches, this review confirms the advantages of the main methods of social skills training groups for children and adolescents with AS. It opens up perspectives to developing new programs of social skills training groups, integrating various approaches, dimensions and objectives, working on a long-term basis.

This study investigated the cognitive skills in pervasive developmental disorders (PDD).Two groups of children participated in this study, 39 individuals with autism and 18 individuals with Asperger syndrome. Each participant was assessed by the Wechsler scales: WPPSI-III, WISC-III or WISC-IV.Children with Asperger syndrome have VIQ more than PIQ and the children with autism have VIQ less than PIQ. The performances in "block design" task vary according to the cognitive level and not according to the PDD type. The high-functioning autistic children show high performance in "block design" task. Children with Asperger syndrome revealed impairments in the "understanding of social situations" task.Individuals with autism have a verbal intelligence quotient lower than individuals with an Asperger syndrome. Several hypotheses have tried to explain verbal differences between children with autism and Asperger syndrome. A first hypothesis proposed a developmental convergence between these two groups. A second hypothesis suggested that communication and social interaction impairments could be implicated in verbal skills. A third hypothesis supported that individuals with Asperger syndrome could develop a specific cognitive style. Children with autism have spatial and perceptive capacities better than verbal capacities. These performances could be interpreted as the expression of a specific cognitive style based on the visual analysis of the detail.The low-functioning children with autism have a cognitive profile with PIQ more than VIQ and high skills in spatial organization. The high-level children with autism have a cognitive profile with PIQ more than VIQ and high skills in spatial abstraction. Children with Asperger syndrome have a profile VIQ more than PIQ profile, they are particularly good in verbal learning notably vocabulary.

Autism is a neurodevelopmental disorder characterized by a deficit of language and communication both associated with a restricted repertoire of activities and interests. The current prevalence of autistic disorder stricto sensu is estimated at 1/500 whereas autism spectrum disorders (ASD) increases up to 1/150 to 1/200. Mental deficiency (MD) and epilepsy are present in numerous autistic individuals. Consequently, autism is as a major public health issue. Autism was first considered as a non biological disease; however various rational approaches for analysing epidemiological data suggested the possibility of the influence of genetic factors. In 2003, this hypothesis was clearly illustrated by the characterization of genetic mutations transmitted through a mendelian manner. Subsequently, the glutamate synapse appeared as a preferential causal target in autism because the identified genes encoded proteins present in this structure. Strikingly, the findings that an identical genetic dysfunction of the synapse might also explain some MD suggested the possibility of a genetic comorbidity between these neurodevelopmental conditions. To date, various identified genes are considered indifferently as "autism" or "MD" genes. The characterization of mutations in the NLGN4X gene in patients with Asperger syndrome, autism without MD, or MD without autism, was the first example. It appears that a genetic continuum between ASD on one hand, and between autism and MD on the other hand, is present. Consequently, it is likely that genes already involved in MD will be found mutated in autistic patients and will represent future target for finding new factors in autism.

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.

Theory of mind deficit can be used to explain social and communication impairments that define the autism spectrum disorder. Theory of mind is the ability to attribute mental states to self and others in order to understand and predict behavior. It involves the distinction between the real world and mental representations of the world. Several studies established that high functioning autistic individuals and individuals with Asperger syndrome (ASP) tend to be as proficient as controls in understanding first order false belief tasks. In contrast, they still lag behind their typical peers in understanding second order false belief tasks or more advanced tasks of theory of mind (e.g., Baron-Cohen, 1993). Most of these studies focus on the adult population and it seems particularly interesting to investigate whether children with ASP would present the same pattern of strengths and deficits as adults. In our research, children with ASP were tested in an advanced task of theory of mind based on a visual presentation of comic strips and in a more traditional assessment of false belief understanding: the Smarties test.Two experimental groups participated in this study: a group of 16 high functioning children and adolescents with autism or with Asperger syndrome (ASP) and a group of 16 typically developing children matched on gender and age (CONT). The task was designed to assess the ability of children with ASP to infer the mental state of others. Stimuli were 26 different comic strips depicting a short story. Each comic strip was composed of three pictures and was shown on the upper half of the screen. Then three pictures numbered 1 to 3 showing possible outcomes of the scenario were superimposed on the bottom half of the screen. Only one of these three pictures represented a plausible conclusion to the scenario. This experiment contained two conditions: A Character intention (CI) condition and a Physical causality (PC) condition. The comic strips in the CI condition involved one character whose intentions had to be inferred by the subject in order to choose the correct picture. Comic strips in PC condition only required to understand physical causalities. Subjects were asked to watch the comic strip attentively and then they were required to make a choice between the three story endings by pressing the corresponding keyboard button. Both answers and response times were recorded. Additionally, all participants were enrolled in the classical false belief (Smarties) task.Comic strips: An ANOVA [2 groups (CONT/ASP) x 2 conditions (CI/PC)] was performed on the number of correct responses. Neither the Group nor the Condition factor was significant (p0.05). In contrast, the interaction Group x Condition reached significance level [F(1-30)=4.3, p0.05)]. Further analysis revealed that performance of the ASP group was significantly higher in the CP (M=10.8, SD=2.5) than in the CI (M=9.8, SD=2) condition [t (1-14)=2.9, p0.001)], whereas there was no condition difference in the control group (p0.05). False belief: all ASP participants succeeded in the task.Our data clearly demonstrated that children and adolescents with Asperger syndrome or high functioning autism exhibited an impairment in understanding the intention of others. In the comic strip task, children with ASP have more difficulties in the character's intention condition than in the physical causality condition. This impairment is not imputable to a deficit in taking into account the context (Weack Central Coherence theory) since they performed as well as controls in the physical causality condition which also required the processing of the whole scene. In contrast, all children with ASP succeeded at the false belief task. These contradictory findings suggest that, although testing theory of mind, the two tasks do not tap similar mechanisms. It is possible that the use of verbal material in the false belief task improved performance of the ASP children who are known to present particular strengths in this domain. Another possible explanation that needs further testing would be that the level of complexity differs between the two tasks.

We are interested in the production of lexical-semantic approximations in first vs in second language acquisition. We specifically examine the production of second language learners in comparison with that of autistic children and of persons with Asperger Syndrome which begin learning a second language. To do so, we adopt two scientific avenues of research: the cross-linguistic way and the transpathological way (in both a linguistic and psycholinguistic dimension). Our protocol gives us the opportunity to prove the presence of similar semantic approximations in several languages: Japanese, Vietnamese, Medumba, Russian, Polish, German...Thus, we are in the position to prove the robustness of “lexicalsemantic approximations” as a basic cognitive component in the way that different types of speakers handle lexicalisation processes, whether they are pathological or not.; Notre étude s'intéresse à la production d'énoncés de type métaphorique, dans une double voie : langue première (L1) vs langue seconde (L2) et cela dans le développement normal et dans le cadre des TED (Syndrome d'Asperger et autisme de haut niveau).Notre projet propose une mise en synergie novatrice en associant deux voies de recherche souvent coupées l'une de l'autre : la voie translinguistique et la voie transpathologique. Il s'agit d'étudier, avec un éclairage essentiellement linguistique mais aussi psycholinguistique les formes linguistiques qui manifestent la capacité à saisir la ressemblance entre des phénomènes et plus précisément des actions.

We are interested in the production of lexical-semantic approximations in first vs in second language acquisition. We specifically examine the production of second language learners in comparison with that of autistic children and of persons with Asperger Syndrome which begin learning a second language. To do so, we adopt two scientific avenues of research: the cross-linguistic way and the transpathological way (in both a linguistic and psycholinguistic dimension). Our protocol gives us the opportunity to prove the presence of similar semantic approximations in several languages: Japanese, Vietnamese, Medumba, Russian, Polish, German...Thus, we are in the position to prove the robustness of “lexicalsemantic approximations” as a basic cognitive component in the way that different types of speakers handle lexicalisation processes, whether they are pathological or not.; Notre étude s'intéresse à la production d'énoncés de type métaphorique, dans une double voie : langue première (L1) vs langue seconde (L2) et cela dans le développement normal et dans le cadre des TED (Syndrome d'Asperger et autisme de haut niveau).Notre projet propose une mise en synergie novatrice en associant deux voies de recherche souvent coupées l'une de l'autre : la voie translinguistique et la voie transpathologique. Il s'agit d'étudier, avec un éclairage essentiellement linguistique mais aussi psycholinguistique les formes linguistiques qui manifestent la capacité à saisir la ressemblance entre des phénomènes et plus précisément des actions.

Patients with Asperger syndrome are often diagnosed late or are wrongly considered to have schizophrenia. Misdiagnosing Asperger syndrome creates serious problems by preventing effective therapy. Several clinical signs described in Asperger syndrome could also be considered as clinical signs of schizophrenia, including impaired social interactions, disabilities in communication, restricted interests, and delusions of persecution. A number of clinical features may facilitate the differential diagnosis: younger age at onset, family history of pervasive developmental disorder, recurring conversations on the same topic, pragmatic aspects of language use, oddities of intonation and pitch, lack of imagination, and incomprehension of social rules are more characteristic of Asperger syndrome. Accurate distinction between Asperger syndrome and schizophrenia would make it possible to offer more treatment appropriate to the patient's functioning.

Current evaluations used by occupational therapists to assess and treat feeding problems derive mainly from the domain of dysphagia. The purpose of this article is to familiarize the reader with tools used, in research, for children with pervasive developmental disorders (PDD) and to determine if any of these meet the needs of occupational therapists. The following data bases were searched: Medline, CINAHL, HAPI and PsyINFO, using the terms pervasive developmental disorder, autism, Asperger syndrome, pervasive developmental disorder not otherwise specified, eating behavior, eating disorder, food preference, food selectivity, feeding disorders, picky eater and child. All articles published between 1980 and 2006 (n=27) were reviewed. A total of 20 studies met our selection criteria. Assessment methods are compared using the Disability Creation Model (DCP). The DCP is the Quebec alternative to the International Classification of Functioning, Disability and Health (ICF). None of the evaluation tools reviewed met all factors that may influence eating in children with PDD. Implications for research and practice in occupational therapy are discussed.

Although Asperger syndrome is described by international classifications as a category of pervasive developmental disorder (PDD), its validity as a specific entity distinct from autistic disorders remains controversial. The syndrome, first described by Hans Asperger, could not be distinguished from high functioning autism (onset, symptoms, outcome...). However, international classifications propose a distinction between the two syndromes based on a delayed onset, the absence of speech delay, the presence of motor disorders and a better outcome in Asperger syndrome. This categorical differentiation is not confirmed by current studies and in the absence of biological markers, no clinical, neuropsychological or epidemiological criteria makes it possible to distinguish high functioning autism from Asperger syndrome. From a clinical perspective, it is nevertheless of interest to isolate Asperger syndrome from other autistic disorders to propose specific assessment and therapy.

Asperger syndrome is a pervasive developmental disorder included lately in the international classifications.We report the observations of four children presenting this syndrome. For every patient, we collected antecedents and psychomotor development; we made neuropsychological assessment and video recording. Three patients underwent an EEG and one a cerebral MRI.These patients were between ten- and sixteen-year old. The neuropsychological assessment showed a heterogeneous intellectual functioning with three times out of four a dissociation between high verbal level and low non-verbal level. Their language appeared sophisticated, apragmatic, their comprehension was inflexible. The mean age at diagnosis was ten years. They showed a sociability and autonomy improvement but they were conscious of their difference and suffered from it.Our four cases allow to present Asperger syndrome, slightly known in France. Collaborative studies and genetic studies are necessary to improve the knowledge of this syndrome.

La plus récente version du Manuel diagnostique et statistique des troubles mentaux de l'American Psychiatrie Association (DSM-IV; APA, 1994) distingue à l'intérieur des troubles envahissants du développement, cinq sous-groupes : a) le trouble autistique ; b) le syndrome de Rett ; c) le trouble désintégratif de l'enfance ; d) le syndrome d'Asperger et e) le trouble envahissant du développement non spécifié. Le diagnostic des différents sous-groupes demeure toutefois difficile à établir, particulièrement pour le trouble autistique et le syndrome d'Asperger car peu de caractéristiques distinguent ces deux syndromes. Le présent article expose les critères diagnostiques de l'autisme puis ceux du syndrome d'Asperger afin d'illustrer les similitudes et les différences entre les deux syndromes., The American Psychiatric Association's last version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; APA, 1994) identifies within pervasive developmental disorders five subgroups: (a) autistic disorder; (b) Rett's disorder; (c) childhood disintegrative disorder; (d) Asperger's disorder and (e) pervasive developmental disorder not otherwise specified. However, the diagnosis of the different sub-groups is difficult to establish, particularly between autistic disorder and Asperger's disorder. This article exposes the diagnostic criteria of autism and Asperger's syndrome in order to illustrate the similarities and differences between the two disorders., La mas reciente version del Manual diagnôstico y estadistico de los desôrdenes mentales de la Asociaciôn americana de siquiatrïa (DSM-IV ; APA, 1994) distingue cinco sub-grupos al interior de los desôrdenes invasores del desarrollo : a) el desorden autistico; b) el sindrome de Rett; c) el desorden desintegrador de la infancia; d) el sindrome de Asperger y e) el sindrome invasor no especificado del desarrollo. El diagnôstico de los diferentes sub-grupos queda sin embargo, difïcil de establecer, particularmente el del desorden autistico y el del desorden de Asperger puesto que pocas caracterîsticas distinguen estos dos desôrdenes. Este articulo expone los criterios diagnosticos del autismo y los del sindrome de Asperger para ilustrar las semejanzas y las diferencias entre los dos desôrdenes.