Made available in DSpace on 2016-03-15T19:40:16Z (GMT). No. of bitstreams: 1 Daniel de Sousa Filho.pdf: 797124 bytes, checksum: b6136c0e2a983cf0eaad975c2f8445b7 (MD5) Previous issue date: 2014-02-06 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Background: Autism Spectrum Disorders (ASD) are developmental disorders characterized by qualitative impairment in reciprocal social interaction, language and communication and restricted, repetitive, and stereotyped patterns of behavior, interests, and activities and they are defined based on standardized clinical criteria as such those from international manuals as ICD and DSM, or based on clinical tools, mainly the semi-structured interviews, such as the Autism Diagnostic Interview- Revised (ADI-R), a recognized gold standard diagnostic tool for ASD. This interview was recently translated into brazilian Portuguese, and it was preliminarily validated for this language. However, this process has been occurred with a small sample in a specific state of Brazil. Besides, other validity evidences, as convergent validity were not explored in this study. Aim: The aim of this study was to investigate the Convergent Validity between the Brazilian version of the ADI-R and a screening tool Autism Behavior Checklist (ABC). Method: For this study, 20 parents or caregivers of children and teens diagnosed with ASD were recruited from the Presbyterian Mackenzie University ASD Clinic, and from the Federal of São Paulo State University Social Cognition Clinic. The children were submitted to a clinical multidisciplinary evaluation, and neuropsychological evaluation that also consisted on application of the ABC. Another researcher, a Child Psychiatrist with expertise on ASD was previously trained and allowed for conducting and codificating the ADI-R. Results: The age of the probands has ranged between 6 and 19 years old, 90% of them were male. The correlations between both the tools, using the Pearson coefficient were mostly positive, and they have ranged between average to high with statistical significance., considering the 3 mains domains of the ADI-R and the five main domains of the ABC. Conclusions: Evidence of convergent validity was found when comparing ADI-R results with ABC/ICA. / Introdução: Os Transtornos do Espectro do Autismo (TEA) são transtornos do desenvolvimento caracterizados por prejuízos qualitativos na interação social recíproca, comunicação e linguagem e pela presença de padrões de comportamentos estereotipados, restritos e repetitivos e sua caracterização se faz a partir de critérios clínicos definidos e padronizados por classificações internacionais como as da CID ou DSM ou por instrumentos, principalmente as entrevistas, como a Autism Diagnostic Interview-Revised (ADI-R), instrumento considerado pela literatura padrão-ouro para diagnóstico de TEA e que recentemente foi traduzido e preliminarmente validado para o português brasileiro. Entretanto, tal processo ocorreu com uma amostra reduzida e numa região específica do Brasil, assim como outras evidências de validade do instrumento tais como validade convergente não foram exploradas. Objetivo: Investigar evidências de validade de convergente entre a versão brasileira da entrevista diagnóstica ADI-R e os instrumento de triagem Inventário de Comportamentos Autísticos (ICA). Método: Foram selecionados 20 pais e/ou cuidadores de 20 sujeitos a partir da Clínica de TEA da Universidade Presbiteriana Mackenzie e da Universidade Federal de São Paulo. Os sujeitos foram submetidos à avaliação clínica multidisciplinar médica e neuropsicológica a qual incluía a aplicação do ICA. Um outro avaliador, psiquiatra da Infância e Adolescência com experiência em TEA e habilitado a aplicar a ADI-R foi responsável pela aplicação e codificação da entrevista. Resultados: A idade dos sujeitos variou de 6 a 19 anos, com média de 10,1. Desses, 90% eram do sexo masculino. Os coeficientes de correlação de Pearson entre os 3 domínios da ADI-R (comunicação, interação social e comportamentos restritos) entre si e destes com o e os do ICA (escrever todos), foram moderados e altos, positivos e a maioria com significância estatística. Conclusões: Evidências de Validade Convergente foram encontradas, comparando-se a ADI-R com o ABC/ICA.

A vulnerable group in society is people with ASD (autism spectrum disorders) or autism. This group seems to increase, mainly due to genetic factors but also environmental problems. Medical research has accelerated in the U.S. and Europe. The biggest problem for people with disabilities is the inability to communicate, both verbally and socially. Parallel communication is growing strongly, a technique that can help these people much, if only there were an adaptation to the needs. There are already technical communication aids developed for people with autism. But they do not seem to fit the target group's communication needs well enough. These aids are designed to handle a superficial communication and people with autism do not understand this type of communication at all. People with ASD would rather appreciate the deeper relationships that can support them on important issues, such as to clarify the context for them are hard to understand. E.g. "inside" and "beyond" could tell that there are a number of houses behind them closer to the houses. They need a different type of support and this support must be provided by close caregivers. Closely support by caregivers seems to be essential for successful development. In other words, they do not have the extensive list of contacts that are in their communication tool today. In my theses, I look primarily at the core needs behind the communication of people with autism. But I also present a design proposal in the form of some sketches on the basis of these needs. The reason for focusing on the analysis is that the majority of existing technical communication aids never seems to have questioned the basis for the decisions shaping the design, i.e. the real needs of the people with ASD. Too often wrong design decisions seem to be made mainly due to an incorrect analysis. Several functions ought to coincide in a single tool that can support the people with ASD to talk, think clearer thoughts, to reflect, formulate an opinion and dream. I would like them to reach deeper thoughts than was possible so far. The features are not new but the combination is. I count to seven features which I consider to be crucial for my result: “Emphasized transfer”, “transparency”, “structure à la Talking Mats”, “imaging”, “digital camera”, “the real meeting”, and “caregivers as important role models”. The communicators should be geographically close to each other and carry one’s own portable technical communication aids, their “BeAKKta”, the name of this design proposal. My result identifies needs of disabled people in their communication, and gives suggestions on how to respond to those needs by presenting different sketches from an analysis. The sketches show up a new design for this communication tool, both in terms of form and function. Lovisa, my daughter and her communication problem is the origin of the trials and she is also the one who gave me both insights and inspiration. / Personer med autism är en utsatt grupp i samhället – en grupp som tycks öka främst på grund av genetiska faktorer men också på grund av miljöfaktorer. Den medicinska forskningen intensifieras både i USA och i Europa. Det största problemet för dessa funktionshindrade handlar om en oförmåga att kommunicera, såväl verbalt som socialt. Parallellt utvecklas kommunikationstekniken starkt, en teknik som skulle kunna hjälpa dessa personer avsevärt om bara det fanns en anpassning till deras behov. Det finns ju visserligen redan tekniska kommunikationshjälpmedel utvecklade för personer med autism. Det är bara det att dessa fortfarande inte passar målgruppens behov av kommunikation särskilt väl. Hjälpmedlen är konstruerade att hantera en mer ytlig kommunikation, det vill säga en kommunikationsform som personer med autism inte använder, än mindre förstår sig på. De vill ofta istället ha en djupare relation som kan stötta dem i viktigare frågor. Det kan till exempel handla om att reda ut huruvida det finns ett ”inuti” och ett ”bortom”; att det finns många hus bortom dem som man kan se närmast. Att se stora sammanhang är nästintill obegripligt för dem. Här behövs verklig hjälp och stöttningen bör förmedlas av en nära vän. Den omfattande kontaktlista som nuvarande kommunikationshjälpmedel tillhandahåller, står alltså inte högt i kurs. I mitt magisterarbete tittar jag framför allt på de centrala behoven bakom kommunikationen hos personer med autism. Men jag presenterar också ett designförslag i form av några enklare skisser med utgångspunkt i just dessa behov. Anledningen till att fokus ligger på analysskedet är att flertalet hittillsvarande tekniska kommunikationshjälpmedel aldrig tycks ha ifrågasatt grunden till de beslut som formar designen det vill säga behoven hos de funktionshindrade personerna. Alltför ofta tas fel designbeslut på grund av en grundlös analys. Flera funktioner sammanfogas här inom ett och samma hjälpmedel som kan stödja de funktionshindrade att tala, tänka klarare tankar, att reflektera, formulera sin åsikt och att drömma. Jag vill att de ska nå djupare tankar än vad som hittills varit möjligt. Funktionerna är identifierade men finns inte inom ett och samma hjälpmedel. Sju funktioner sammanfogas inom ett och samma hjälpmedel: ”Betonad överföring”, ”överblickbarhet”, ”struktur à la Talking Mats”, ”bildhantering”, ”digitalkamera”, ”reellt möte” samt ”närstående som viktiga förebilder”. Båda parter bör befinna sig geografiskt nära varandra och båda måste ha med sig sin egen ”BeAKKta”. Jag identifierar kommunikationsbehoven hos personer med autism och ger förslag på hur behoven skulle kunna mötas genom analys och skisser. Resultatet blir en ny design som sammanför tidigare förvisso identifierade funktioner, varav dock fåtalet utvecklats med tanke på den digitala tekniken. Lovisa, min dotter och hennes brist på kommunikationsförmåga, är upprinnelsen till mitt försök och det är också hon som givit mig både insikter och inspiration. / Phone number: 46709981048

The majority of children with ASC are educated within a mainstream secondary setting. The challenges within the new environment may lead to some children experiencing a breakdown in provision resulting in temporary or permanent exclusions. A gap in the literature highlights a need for research which seeks to understand the views and experiences of year 7 children with ASCs about theirtransition to mainstream secondary school. The research involved four year 7 children with ASC, from across three settings, who had recently transitioned from a mainstream primary school to a mainstream secondary school (without resource based provision). The views of their parents and teachers were also sought. A multiple-embedded case study design was employed involving four cases from across three school settings. This involved utilising a transition Q-sort and a semi-structured interview with four children and semi-structured interviews with six parents and three teachers. The data was analysed using content analysis and thematic analysis (Braun & Clarke, 2006). The findings highlight a need for individualised transition planning for the child with ASC; consideration of co-occurring difficulties and the importance of including the views of the child and parents in transition planning. The findings are discussed in relation to psychological theories and existing literature. The implications for future research, local authority policy, school staff, parents and educational psychologists are considered.

The main goal of this diploma thesis is the proposal to use agile development procedures of Scrum framework with UML modeling language applicable for creating websites of small scale. The emphasis is especially put on creating a practically usable type model of the websites. The theoretical part of the thesis has two main chapters. In the "Agile methodology" chapter are listed principles of agile approach to creating software. The next part of this chapter is focus on agile methodologies (Scrum, XP, ASD, FDD, DSDM, LD and Crystal). In the "UML" chapter is introduced modeling language UML and its principles. The next part of this chapter is focus on UML diagrams used in practical part of this thesis (use case diagram, class diagram, sequence diagram, activity diagram and deployment diagram). The practical part of this thesis focuses on the design type model for creating websites of small scale. The type model is based both on the theoretical part of this work and practical experience of the author. In the first part is introduced scheme of model, where is shown the mutual relationship of individual phases. In the next part of this chapter are discussed the individual phases where is used the principle of agile development framework Scrum and examples of use of the UML diagrams.

Étant donné que le bilinguisme et le multilinguisme sont la norme plutôt que l’exception, plusieurs enfants, y inclus plusieurs enfants ayant un trouble du spectre de l’autisme (TSA) sont élevés dans des contextes bilingues. Cependant, il y a actuellement peu de recherche examinant le développement langagier d’enfants ayant été exposés à deux langues, de la petite enfance à l’âge scolaire. Cette thèse a pour objectif d’examiner l’influence du bilinguisme sur le développement d’habiletés langagières d’enfants bilingues ayant un développement neurotypique à l’âge scolaire, ainsi que chez leurs pairs ayant un TSA. Cet objectif est atteint par l’entremise de trois manuscrits. Le premier manuscrit est une revue de la littérature dans le cadre de laquelle nous avons examiné le développement langagier d’enfants bilingues ayant un DN d’enfants ayant d’autres troubles de développement et finalement d’enfants ayant un TSA. Cette revue révéla que, tout comme leurs pairs ayant un DN, les enfants ayant un TSA peuvent devenir des locuteurs bilingues, et que le bilinguisme n’est pas néfaste à leur développement langagier. Cependant, certaines limites dans la littérature existante ont aussi été révélées. Dans un premier temps, la majorité des études publiées ont examiné les habiletés langagières d’enfants bilingues d’âge préscolaire. Toutefois, peu d’études ont examiné leur développement langagier une fois qu’ils atteignent l’âge scolaire, et ce, tant chez les enfants ayant un DN que chez les enfants ayant un TSA. Par ailleurs, peu d’études ont comparé les capacités langagières d’enfants ayant un TSA à celles de leurs pairs bilingues ayant un DN et aucune étude n’a comparé leurs capacités langagières à celles de leurs pairs unilingues ayant un DN. Les résultats qui découlent de cette revue ont menés à deux études expérimentales examinant l’influence du bilinguisme sur le développement langagier chez les enfants d’âge scolaire ayant un DN, ainsi que chez leurs pairs ayant un TSA. Notre revue de littérature suggère que l’exposition langagière pourrait jouer un rôle déterminant vis-à-vis les capacités langagières d’enfants bilingues. Le second manuscrit a donc comme objectif d’examiner la relation entre le développement langagier d’enfants étant des bilingues simultanés (exposés à leurs deux langues avant l’âge de trois ans) d’âge scolaire, et la quantité d’exposition langagière reçue dans chacune de leurs langues (le français et l’anglais). Globalement, nos résultats ont démontré une interaction entre la quantité d’exposition à l’anglais et la performance sur certaines mesures de langage expressif, mais pas avec les mesures de langage réceptif en anglais. En français, aucune interaction entre la quantité d’exposition au français et les performances sur les différentes mesures langagières n’a été trouvée. Ces différences sont potentiellement dues à des différences dans les montants d’exposition au français et à l’anglais, mais d’autres explications sont aussi discutées. De plus, les résultats suggèrent qu’en ayant approximativement 20% de leur exposition à une langue, ces enfants bilingues peuvent obtenir des scores dans la tranche moyenne sur toutes les mesures langagières. Par ailleurs, les enfants qui se servent de leurs deux langues tous les jours semblent nécessiter un moins grand pourcentage d’exposition pour développer des capacités langagières dans la moyenne. Ces résultats pourraient être expliqués par le transfert positif et une amélioration des capacités métalinguistiques plus généralement. Ce type d’amélioration pourrait permettre aux enfants qui se servent de leurs deux langues tous les jours de développer de meilleures capacités d’acquisition langagière. Les résultats de la revue de littérature ont aussi démontré que peu est connu en ce qui a trait aux capacités langagières d’enfants bilingues ayant un TSA lorsqu’ils atteignent l’âge scolaire. Conséquemment, pour le troisième manuscrit j’ai complété une étude pilote ayant comme objectif d’examiner si trois enfants bilingues simultanés d’âge scolaire et ayant un TSA (sans trouble de langage ou de déficiences intellectuelles) pouvaient atteindre des niveaux d’habiletés langagières semblables à celles de leurs pairs unilingues ayant un TSA. J’ai aussi cherché à savoir si ces trois enfants bilingues ayant un TSA pouvaient atteindre des seuils langagiers semblables à ceux de 19 pairs bilingues et 12 pairs unilingues ayant tous un DN. Les résultats ont démontré que ces bilingues simultanés ayant un TSA ont eu des performances semblables à celles de leurs pairs unilingues ayant un TSA sur des mesures langagières normées. Ils ont aussi eu des performances semblables à celles de leurs pairs bilingues et unilingues ayant un DN. L’ensemble de ces résultats démontrent que les enfants bilingues simultanés d’âge scolaire avec et sans TSA peuvent atteindre des niveaux d’habiletés langagières semblables à ceux de leurs pairs unilingues, du moins, dans une de leurs langues, sinon dans les deux. Bien que les bilingues ne sont pas deux unilingues en une seule personne, les résultats de nos recherches concordent avec ceux de recherches antécédentes et démontrent que le bilinguisme n’est pas néfaste pour le développement langagier oral d’enfants d’âge scolaire ayant un DN ou ayant un TSA. / Since bilingualism and multilingualism are the norm rather than the exception, many children, including children with autism spectrum disorder (ASD), live in bilingual or minority-language households. However, little research has examined the language development of school-aged children who have been exposed to two languages since early childhood, and fewer still have examined bilingual school-aged children with ASD. In this thesis, I examine the influence of bilingualism on language development in both school-aged ND children and in their peers with ASD. This objective will be achieved through the three manuscripts making up this thesis. For the first manuscript, we completed a review of the literature in which we examined the language development of ND bilingual children, of bilingual children with various developmental disorders, and of bilingual children with ASD. This review revealed that, as with neurotypically developing (ND) children, children with ASD can become bilingual speakers, and that bilingualism is not detrimental to their language development. Our review also revealed some of the limits of the existing literature. First, the majority of existing studies had examined bilingual language development in preschool-aged children with and without ASD, but had not examined the language development of these bilingual children once they reached school age. Second, few studies had compared the language abilities of bilingual children with ASD to those of their ND bilingual peers, and at time of publication, none had compared them to those of ND monolingual children. The results from this review lead to two studies examining the influence of bilingualism on language development in school-aged ND children and in children with ASD. Our review of the literature suggested that language exposure may play an important role in determining bilingual children’s language ability. However, little was known about its influence in school-aged children. Therefore, for the second manuscript, I examined whether there was a relationship between language development and the amount of language exposure that ND simultaneous bilinguals (i.e. children having been exposed to both languages before the age of three years) received in each of their languages (French and English). I found a relationship between lifetime exposure to English and performances on some English-language expressive language measure, but not on receptive language measures. In French, no relationship between the amount of exposure to French and performances on any of the French-language measures was found. These differences in findings could be due to differences in language exposure ranges across both languages but other potential explanations are also discussed. Findings also show that when receiving 20% of their exposure to a language, most children were able to obtain scores within the average range on the language measures. Moreover, children who were exposed to both of their languages on a daily basis often had stronger performances on language measures than children who did not receive daily exposure to both of their languages. I hypothesized that positive transfer and improved metalinguistic abilities more generally may have contributed to improved language learning abilities in children who used both of their languages on a daily basis. Findings from the literature review also revealed that little was known about the language abilities of bilingual children with ASD once they reached school-age. With that in mind, the third manuscript reports on a pilot study that examined whether three simultaneous bilingual school-aged children with ASD (without a comorbid language disorder or an intellectual disability) could achieve language levels similar to those of their two French-monolingual peers with ASD. I also explored whether these bilingual children with ASD could reach language proficiency levels similar to those of their 19 ND simultaneous bilingual peers, in both of their languages (French and English), and whether they had similar abilities to those of their 12 ND French-monolingual peers. I found that the simultaneous bilingual children with ASD performed similarly on standardized language measures to their two monolingual peers with ASD, in both of their languages. They also had similar performances to those of their ND bilingual peers, as well as to those of their ND monolingual peers. Overall, these findings reveal that ND school-aged simultaneous bilinguals and their simultaneous bilingual peers with ASD (without a language disorder or intellectual disability) can achieve language proficiency levels similar to those of their monolingual peers, in at least one, if not both of their languages. While bilingual children are not two monolinguals within one child, our findings are similar to previous findings and show that bilingualism does not appear to impede the language development of school-aged ND bilingual children and bilingual children with ASD.

Le trouble du spectre de l’autisme (TSA) est défini par l’atteinte de deux domaines: une diminution de la réciprocité sociale et une inflexibilité comportementale. Il n'existe pas de test diagnostique ni de mesure des mécanismes impliqués. En population adulte TSA, l’utilisation d’un jeu d’interaction dynamique, dyadique et intégratif présentant alternativement un contexte social ou non social, a permis d’obtenir un phénotype computationnel de la réciprocité sociale révélant une insensibilité au type de contexte, une utilisation de stratégie spécifique à ce groupe et une variation de performance dépendante de la sophistication de l’adversaire. Cette étude vise à étendre cette compréhension de la réciprocité sociale en population TSA pédiatrique et de la distinguer d'éléments psychopathologiques comme l'anxiété ou les symptômes de TDAH, parfois associés ou confondus avec des symptômes autistiques. L’analyse des données de performance des participants au jeu a permis de valider son utilisation en population pédiatrique, en répliquant l’impact du type d’algorithme sur la performance des participants. Une approche dimensionnelle utilisant des outils standardisés et permettant la quantification de la sévérité des symptômes autistiques, TDAH et troubles anxieux, a permis de spécifier l’impact des symptômes autistiques et anxieux sur la performance des participants contre un algorithme de type ToM d’ordre 0. Cette étude est une étape dans la compréhension des mécanismes impliqués dans l'interaction sociale au cours du développement, et dans la capacité à les mesurer. Des analyses computationnelles complémentaires permettront d’affiner ce phénotype computationnel en apportant des précisions quant aux stratégies utilisées pendant le jeu et à la flexibilité des participants à varier dans leur utilisation. / Autism Spectrum Disorder (ASD) is defined by two main domains of impairment: decreased social reciprocity and behavioural inflexibility. There is no diagnostic test or measurement of the mechanisms involved. A study with ASD adults used a dynamic, dyadic and integrative interaction game which alternately presents a social or non-social context, it resulted in a computational phenotype of social reciprocity revealing insensitivity to the type of context, a use of strategy specific to this group and a variation in performance depending on the opponent’s sophistication. This study aims to extend this understanding of social reciprocity in the pediatric ASD population and to distinguish psychopathological symptoms such as anxiety or ADHD symptoms, which are sometimes associated or confused with autistic symptoms. Analysis of the participants’ performance data validated its use in the pediatric population by replicating the impact of the algorithm on the participants’ performance. A dimensional approach using standardized tools and allowing the quantification of the autistic, ADHD and anxiety disorders symptoms’ severity, permits the emphasis of the impact of autistic and anxious symptoms on participants’ performance against a ToM-0 agent. This study is a step in the understanding of the mechanisms developed in social interaction during development and in the ability to measure them. Complementary computational analyzes will help refine this computational phenotype by giving more details about the strategies used during the game and the participants' flexibility to vary in their use.

Autism Spectrum Disorder is an increasingly common developmental disability. Students diagnosed with ASD can be challenging to incorporate into mainstream classrooms due to a lack of understanding and negative attitudes of neurotypical peers towards those students. This thesis aims to address the problem in a unit plan centered on the use of young adult literature with a main protagonist on the Spectrum in the English Language Arts classroom. Specifically, it argues the use of such texts in conjunction with a literature circles unit in providing better understanding and greater acceptance of students with ASD. The unit and lesson plans were written to reflect how Vygotsky’s Zone of Proximal Development, Bishop’s windows, doors, and mirrors , and the texts students read can influence their thinking and behavior. Using goodreads and local ELA book lists, I selected four YAL texts which portrayed the main character with ASD as they go about their daily lives. These texts were then incorporated into the twenty-lesson unit plan which aims at supporting positive attitudes and acceptance of neurotypical students towards their peers with ASD.

Un nombre croissant d’études indique que les interventions musicales (IMs) ont des effets bénéfiques sur les enfants et adolescents atteints d’un trouble du spectre de l’autisme (TSA). À ce jour, aucune revue systématique utilisant une approche méta-analytique n’a investigué l’efficacité des IMs sur trois des symptômes prédominants du TSA, soit le fonctionnement social, les comportements mal-adaptés et le langage. Dans ce mémoire, tous les 17 articles scientifiques comparant les IMs à des interventions non-musicales (INMs) ont été décrits systématiquement et évalués selon les lignes directrices de CONSORT. Onze études répondaient aux critères d’inclusion des présentes méta-analyses, chacune rapportant des mesures d’évaluations longitudinales ou d’évaluations pendant les sessions. Les résultats des méta-analyses ont démontré un bénéfice des IMs chez le TSA, particulièrement pour les mesures des comportements sociaux mal-adaptés. Une comparaison entre les IMs et les INMs indiquait un avantage pour les IMs comparément aux INMs en ce qui concerne les comportements sociaux, mais aucun avantage pour les comportements mal-adaptés non-sociaux et le langage. La revue systématique a révélé des lacunes méthodologiques des études évaluées, telles que des tailles d’échantillons restreintes, des durées et intensités d’interventions limitées, un manque d’information à propos des échantillons et des critères d’appariement, puis le biais d’attrition. La combinaison de cette revue systématique et des méta-analyses a permis une mise à jour de l’évaluation des preuves de l’efficacité des IMs pour les jeunes ayant un TSA, ainsi que de donner des recommandations aux chercheurs et cliniciens afin d’améliorer la pratique dans ce domaine. / There is considerable interest in using music interventions (MIs) to address core impairments present in children and adolescents with autism spectrum disorder (ASD). An increasing number of studies suggest that MIs have positive outcomes in this population, but no systematic review employing meta-analysis to date has investigated the efficacy of MIs across three of the predominant symptoms in ASD, specifically social functioning, maladaptive behaviors and language impairments. In this thesis, all available peer-reviewed studies (n = 17) comparing active MIs to non-music interventions (NMIs) were systematically summarized and evaluated using quality assessment based on the CONSORT statement. Eleven studies fulfilled inclusion criteria for meta-analysis, which differentiated between within-session and longitudinal outcomes. The quantitative analyses results supported the effectiveness of MI in ASD, and particularly for measures sensitive to social maladaptive behaviors. Comparing between MI and NMI, the results were generally suggestive of benefits of MI over NMI for social outcomes, but did not find benefits for non-social maladaptive behaviors or language outcomes. The systematic review revealed important methodological issues present in these studies, such as small sample sizes, restricted durations and intensities of interventions, missing sample information and matching criteria, and attrition bias. Together, the combined systematic review and meta-analyses provided an up-to-date evaluation of the evidence for MI’s benefits in ASD children and provide key recommendations for future clinical interventions and research about best practice in the domain.

Les Troubles du Spectre de l'Autisme (TSA) sont devenus une priorité nationale et internationale en matière de santé publique. À ce titre, de nombreux outils et différents types de prises en charge sont proposés avec plus ou moins de résultats pour les personnes qui en sont atteintes. C'est pourquoi, les dernières recommandations de la Haute Autorité de Santé (HAS, 2012) ainsi que le plan gouvernemental autisme 2013-2017 insistent sur l'importance de mener des études objectives concernant l'évolution et les prises en charge des personnes porteuses de TSA. Cette recherche qui comprend 2 études distinctes, vise à (1) objectiver l'efficacité d'un dispositif innovant d'intervention développementale en milieu ordinaire pour les personnes porteuses de TSA (le programme IDDEES : Intervention - Développement - Domicile - Ecole - Entreprise - Supervision) et à (2) démontrer le bénéfice de l'utilisation de nouvelles technologies (applications LearnEnjoy) associées à ce programme sur la dysrégulation fonctionnelle et les comportements restreints et répétitifs. Les participants de l'étude 1 sont des enfants âgés de 1 à 9 ans, ayant un TSA et bénéficiant tous du programme IDDEES (N = 51 enfants). Le diagnostic a été établi sur la base des critères du DSM-5 (APA, 2013) et de l'échelle d'évaluation quantitative, la CARS (Schopler, Reichler & Renner, 1988). Les enfants sont évalués à 3 temps différents (10 mois d'intervalle) sur le plan développemental (PEP-3, Schopler, Lansing, & Reichler, 2010 ; EDEI-R, Perron-Borelli, 1996 ; etc.) et comportemental (CARS, Schopler, et al., 1988). La population de l'étude 2 est constituée de 31 enfants et adolescents âgés de 3 ans à 17 ans et de 9 adultes âgés de 17 à 38 ans, bénéficiant du programme IDDEES et de l'utilisation des applications LearnEnjoy dans leur programme de remédiation. Tous les 3 mois durant 2 ans, les accompagnants de ces personnes cotent des échelles permettant d'analyser l'évolution de leur dysrégulation (GRAM, Adrien, 1996) et de leurs comportements répétitifs et restreints (EC2R, Bourreau, Gomot, Roux et Barthélémy, 2009). Les résultats de la 1ère étude mettent en évidence une évolution des âges de développement et une diminution de la symptomatologie autistique des personnes bénéficiant du programme IDDEES, indépendamment de l'âge réel et de l'intensité du trouble autistique au début de l'étude. Les résultats de la seconde, montrent que les personnes bénéficiant à la fois du programme IDDEES et des applications LearnEnjoy, après un temps d'adaptation nécessaire, parviennent à se réguler de mieux en mieux au fil des mois. De plus, leur comportements restreints et répétitifs et leur résistance au changement diminuent au profit d'une plus grande souplesse cognitive. Le programme IDDEES qui tient compte du développement atypique et du fonctionnement dysrégulé et si particulier des personnes avec TSA, constitue ainsi une bonne méthode pour favoriser leur développement et leur adaptation à l'environnement physique et social. Pour les professionnels respectueux de l'éthique et soucieux d'améliorer la qualité de vie de ces personnes, il est indispensable de proposer des interventions de qualité et reconnues comme telles. / Autism Spectrum Disorders (ASD) became a national and international public health priority. As such, many tools and different types of care are offered with varying degrees of success for those affected. That's why the latest recommendations of the High Authority for Health (HAS, 2012) and the governmental plan for autism 2013-2017 stress the importance of conducting objective studies on the evolution and care of people Carriers. This research, which includes 2 separate studies, aims to (1) objectify the effectiveness of an innovative device for developmental intervention in a standard environment for persons with ASD (Program' IDHSFS : Intervention-Development-Home-School-Firm-Supervision) and (2) show the benefit of using of new technologies (LearnEnjoy' applications) associated to this program on functional dyregulation and their repetitive and restricted behaviours. Participants of study 1, are children aged 1-9 years with ASD and all with Program' IDHSFS  (N = 51 children). The diagnosis was based on DSM-5 criteria (APA, 2013) and the quantitative assessment scale, CARS (Schopler, Reichler & Renner, 1988). Children were assessed at 3 different times (10 months apart), developmental evaluation (PEP-3, Schopler, Lansing, & Reichler, 2010, EDEI-R, Perron-Borelli) and behavioral evaluation (CARS, Schopler, & al, 1988). The study 2 population is constituted of 31 children and teenagers aged 3 to 17 years and 9 adults aged 17 to 38 years, benefiting from the Program' IDHSFS and the use of LearnEnjoy' applications in their weekly socio-cognitive rehabilitation sessions. Every three months, for 2 years, expert in autism coaches of these people established some scales allowing to analyze the evolution of their activity's regulation (RAMG, Adrien, 1996) and their repetitive and restricted behaviours. (EC2R, Bourreau, Gomot, Roux and Barthélémy, 2009). The results of the first study shows an evolution of the developmental ages and a decrease in the autistic symptomatology of people benefiting from the IDDEES program, regardless of the real age and intensity of the autistic disorder at the start of the study. The results of the second, show that people benefiting from both the Program' IDHSFS and the LearnEnjoy' applications, after a necessary period of adaptation, manage to regulate better and better over the months. Moreover, their repetitive and restricted behaviours, and their resistance to change decreases in favor of greater mental flexibility. The IDDEES program, which takes into account the atypical development and the dysregulated functioning of people with ASD, is a good method for their development and adaptation to the physical and social environment. For professionals who respect ethical standards and are keen to improve the quality of life of these people, it is essential to offer high-quality and recognized interventions.

No description available.