In this thesis, the theoretical introduction firstly reviews Asperger's syndrome using available scientific resources. Secondly, we discuss major impacts and parameters of the integration process in a general perspective. The empirical part is fosuced on two case studies describing integration of two students who were diagnosed with Asperger syndrome. Data collection was based on direct observation, interview, databases and information from experts. The results and conclusions shall help to improve pegagogical skills of teachers. Furthermore the thesis shall serve as a source of information and guideline for parents, for whom the sufficient education is very essential.

Le monde social est par essence fortement incertain, dans la mesure où les informations peuvent varier rapidement et de façon imprévisible, et il est essentiel de pouvoir s’y adapter. Les personnes avec autisme présentent souvent une intolérance au changement et une recherche d’immuabilité, associées à des difficultés dans le domaine de la prise de décision. Elles rapportent également que leurs difficultés sont amplifiées lorsque la prise de décision implique un changement de routine et lorsqu’elle fait entrer en jeu une composante sociale. Si la prise de décision dans un environnement social a été beaucoup explorée, l’influence de l’incertitude du contexte (c’est-à-dire d’un changement brutal des probabilités de survenue d’un événement) et son interaction avec la nature sociale de l’environnement n’ont jamais été étudiées dans le cadre de l’autisme. Cette thèse vise à mieux comprendre les spécificités du traitement du caractère imprévisible du contexte chez les personnes autistes de haut niveau (High-Functioning Autism : HFA) et avec un Syndrome d’Asperger (AS). La question posée ici est de savoir si c’est l’aspect social, ou bien l’aspect imprévisible, qui pose problème aux personnes avec autisme dans les interactions sociales. Nous avons fait l’hypothèse d’une altération du traitement du caractère imprévisible chez ces personnes, comparées à des sujets neurotypiques appariés, et nous souhaitions préciser l’influence de la nature sociale ou non-sociale de la source d’information sur cette altération. Dans la première étude, comportementale, de cette thèse, nous avons adapté une tâche de prise de décision de Behrens et al. (2007, 2008), comportant une condition stable et une condition instable (i.e. incertaine), cet aspect stable ou instable pouvant venir d’un indice social ou non-social. Cette première étude a permis de montrer que, dans notre tâche, les difficultés rencontrées par les personnes HFA/AS dans un environnement social tiennent plus à son caractère imprévisible qu’à son aspect social. A cela s’ajoute une difficulté globale à intégrer les indices contextuels dans la prise de décision. Notre deuxième étude, en IRM fonctionnelle, visait à identifier les régions cérébrales impliquées dans le traitement du caractère imprévisible du contexte, ainsi que l’effet de la nature sociale de l’environnement sur ce traitement, chez des personnes avec autisme. Cette seconde étude a montré que les personnes HFA/AS mobilisent moins le réseau attentionnel fronto-pariétal que les personnes neurotypiques dans un contexte incertain (qu’il soit social ou non). On observe également chez ces personnes une difficulté à réorienter l’attention lorsque les indices contextuels ne sont pas pertinents. Par ailleurs, dans un environnement social les personnes HFA/AS activent moins les aires du « cerveau social » que les personnes neurotypiques. La discussion établit un parallèle entre ces résultats et la littérature existante, et propose des perspectives en termes de prise en charge dans l’autisme / The social world is inherently very uncertain, as the information can change rapidly, unpredictably, and thus it is essential to be able to adapt. People with autism often show a resistance to change and a preference for sameness, associated with decision-making difficulties. They also report that their difficulties are augmented when the decision involves a change in the routine and when a social component is involved. While the decision-making in a social environment has been widely investigated, the influence of the uncertainty of the context (i.e. of a sudden change in the probability of occurrence of an event) and its interaction with the social nature of the environment has never been studied in the context of autism. This thesis aims to better understand how people with High-Functioning Autism (HFA) and Asperger's syndrome (AS) process an unpredictable context. The main question asked here is which of the social or unexpected aspects denote a problem for people with autism in social interactions. We hypothesized that processing of uncertainty is altered in HFA/AS people compared to matched controls, and we wanted to determine what is the influence of a social or a non-social source of information on this alteration. In the first study of this thesis (a behavioural study), we adapted a decision-making task from Behrens et al. (2007, 2008), which implies a stable and an unstable (i.e. uncertain) conditions. The stable or unstable aspect could derive from a social or a non-social cue. The study showed that in our task the difficulties faced by people with HFA/AS in a social environment are more linked to the uncertainty of the context than to its social aspect. HFA/AS participants also showed a global difficulty to integrate contextual cues in decisionmaking. The second study (a functional MRI study) aimed to identify brain regions involved in the uncertainty processing, as well as the effect of the social nature of the environment on this processing. We observed in HFA/AS participants a weaker engagement of the fronto-parietal attentional cerebral network in an unstable context (regardless whether the cue was social or non-social). We also observed in these participants a difficulty to redirect their attention when contextual cues were not relevant. Moreover, in a social environment people with HFA/AS activated less than controls brain areas belonging to the "social brain”. The discussion draws a parallel between these results and the literature, and opens to rehabilitation perspectives for people with autism

This study aimed to explore the underlying basis of the communication difficulties in children (between 5.0 and 7.11 years) with high functioning pervasive developmental disorder (HFPDD) (n=26), compared to children with specific language impairment (SLI) (n=26), and children with no history of developmental difficulty (NDD) (n=26). The study looked at: whether different profiles could be obtained for the groups on comprehensive batteries of communication, cognitive processing and theory of mind; which areas measured were best correlated; and which measures best differentiated the groups. Comprehensive communication and theory of mind batteries were devised and conducted. Cognitive processing was measured using the Cognitive Assessment System (CAS) (Naglieri and Das, 1997). Data was analysed using descriptive statistics, analysis of variance, the Kruskal-Wallis test, Bonferroni t tests, frequency distributions, Pearson correlation coefficients and discriminant function analyses. Kappa coefficients and analysis of variance measures were carried out on 23% of the rated data in order to establish inter-rater agreement and acceptable levels of agreement were reached. On the communication assessment, the HFPDD group experienced the most difficulty on the measures of understanding abstract vocabulary, understanding conversation, pronoun alternation, higher level semantics, narrative ability and pragmatic ability. In contrast, the SLI group experienced the most difficulty on the measures of expressive grammar and narrative clarity. On the cognitive processing assessment, the HFPDD group experienced marked difficulty in the areas of planning and attention, while the SLI group experienced significant difficulty in the areas of successive processing and less marked but still significant difficulty in the area of planning. Within the HFPDD group, a group with simultaneous processing markedly stronger than successive processing, a group with successive processing markedly stronger than simultaneous processing, and a group with simultaneous and successive processing occurring at a similar level, were identified. The HFPDD group experienced significant difficulty on all the measures of theory of mind, although a limited number of HFPDD subjects did not experience difficulty. The SLI group experienced significant difficulty on the two theory of mind measures that were more verbally loaded. Strong correlations were found between receptive language, expressive semantics, narrative ability, pragmatic ability, planning, attention and theory of mind; and between expressive grammar and successive processing. Pragmatic ability, narrative ability, planning, and certain of the theory of mind measures best appeared to discriminate the groups. A combined model of language, cognitive and theory of mind processing is proposed to explain the differences between the HFPDD and SLI groups.

This thesis examines language alignment in children with an autism spectrum disorder (ASD), a neurodevelopmental disorder characterised by impaired social understanding and poor communication skills. Alignment, the tendency for speakers to repeat one another's linguistic choices in conversation, promotes better communication and more satisfying interactions (cf. e.g., Fusaroli et al., 2012). By corollary, deficits in alignment may adversely affect both communicative and affective aspects of conversation. Across three studies, I consider whether ASD children's conversational deficits relate to disrupted patterns of alignment, and explore the mechanisms underlying this. In the first study, I adopt a corpus-based approach to show that syntactic alignment effects are observable in ASD children's ‘real-life' conversations, not just in an experimental context. The second study draws on research into the role of inhibitory control in communicative perspective-taking (Nilsen & Graham, 2009) to show that lexical alignment is not socially mediated in ASD. I develop this work in the third study, which highlights how, for ASD children, conversation can be compromised when lexical alignment is driven exclusively by priming mechanisms. Taken together, these studies advance our understanding of conversational deficits in ASD, and particularly how impaired social understanding affects ASD children's language processing in dialogue. I conclude that, while ASD children have intact alignment, reduced social understanding may prevent them from ‘diverging', which can be necessary to move a conversation forward (Healey, Purver, & Howes, 2014). More broadly, the thesis addresses questions of theoretical relevance to the study of alignment, by clarifying the contributions of unmediated (i.e., priming) and socially mediated (i.e., audience design) mechanisms to children's alignment behaviour, both in ASD and typical development.

Despite a remarkable need and demand for services, little is known about the family relationships of children with social competency disorders (SCD), defined in this study as children with Asperger’s Disorder and nonverbal learning disabilities (NVLD). Both children with Asperger’s Disorder and children with NVLD exhibit social skill deficits essential to building and maintaining relationships. These social competency impairments are thought to be related to similarities in their neuropsychological profiles. The low prevalence rates of these conditions and the neuropsychological and behavioral similarities supports the combination of Asperger’s Disorder and NVLD as a “social competency disorders” group for purposes of research. Attention deficit-hyperactivity disorders (ADHD) have been found to be highly comorbid in children with SCD, and were included in this study as clinical control group. The purpose of this study was to examine the relational functioning in the families of children with social competency deficits across different parts of the family system. It was hypothesized that the social competency deficits in children with SCD would result in significantly lower levels of relational functioning across the parent-child subsystem, parenting subsystem and whole family level of the family. Sixty-one children between the ages of 8-12 and their mothers participated in this study. Children were assigned to the SCD, ADHD or typically developing group based on pre-determined criteria. Self-report measures of interpersonal functioning in the parent-child relationship, strength of parenting alliance in the parental relationship and social support in the whole family were collected and compared across the three groups. As predicted, mothers of children with SCD reported significantly higher levels of dysfunction in the parent-child subsystem as compared to mothers of typically developing children; however, no significant differences in parent-child dysfunction were found between the SCD and the ADHD group. Contrary to the hypotheses proposed in this study, the SCD group showed no significant group differences on measures of parenting alliance and social support in the whole family. This study reveals the importance of intervention in the parent-child relationship in these families, and the need for additional research using longitudinal, multi-modal and multiple informant designs. / text

The prevalence of anxiety amongst children with Autism Spectrum Conditions (ASC) is reportedly considerably higher than the general population (Ozsivadjian & Knott, 2011). Research considering intervention for children with ASC and anxiety has predominantly been from a clinical perspective, with limited evidence based literature being found that explored the needs of these students in relation to anxiety within the mainstream secondary school educational context. Anxiety can increase during adolescence for children with ASC (White, Ollendick, Scahill, Oswald, & Albano, 2009) and many of the anxiety related worries of children with ASC have been found to be related to school (Ozsivadjian & Knott, 2011). However, there is a dearth of research regarding practical support within an educational setting that can be implemented by schools on a needs basis to support students with ASC and signs of anxiety. Four students with a diagnosis of an ASC who had presented with signs of anxiety were identified from mainstream secondary schools across one English local authority. A parent and an educational practitioner who worked with each student also participated. A qualitative multiple embedded case study design was utilised. Suitably differentiated methods for gaining this cohort of students’ views and engaging them in the research were employed. Data from semi-structured interviews and educational documentation were analysed for main themes using thematic analysis based upon Braun and Clarke's (2006) six phase model. The perceived needs and difficulties of anxious students with ASC and what is considered to be effective practice in supporting them within a mainstream secondary school setting are outlined. The study provides some understanding of the needs of students with ASC and how schools support management of their anxiety. The research intends to extend knowledge of the needs of these students and what works in effectively supporting these students within a mainstream secondary school setting.

Repetitive verbal patterns of speech are a trait associated with high-functioning autism (HFA). For some, this higher-order restricted, repetitive behavior impedes learning, social opportunities, and access to work environments. Despite emerging motivation for establishing social relationships, some individuals with HFA lack the behavioral prerequisites to establish meaningful relationships. The purpose of this study is to demonstrate the effectiveness of teaching interaction to decrease higher-order verbal restricted and repetitive behaviors (RRBs) for four adults with HFA. Through a multiple baseline design across participants, individuals were exposed to a function-based intervention (i.e., teaching interaction) that systematically taught and reinforced alternative communicative behaviors while interrupting repetitive speech with specific feedback. Teaching interaction effectively reduced RRBs and increased alternative conversation for all four participants. Three of the four participants elected to participate in post-intervention maintenance sessions that occurred in individualized naturalistic settings. Their conversation behaviors maintained with one participant receiving one booster session.

Cette recherche porte sur l’impact et la caractérisation des difficultés socio-affectives dans l’anorexie mentale (AM). Les difficultés intéroceptives et introspectives, telles qu’appréhendées par des mesures d’alexithymie, pourraient être liées à la sévérité des tableaux cliniques des AM et impacter non seulement leur état somatique mais également leur fonctionnement interpersonnel. Par ailleurs l’alexithymie et l’évitement social sont des déficits retrouvés dans les troubles du spectre autistique. L’Institut de Psychiatrie de Londres a d’ailleurs proposé un modèle mettant en cause un partage d’endophénotypes entre ces troubles et l’anorexie mentale qui rendrait compte de leur chevauchement phénotypique. Le manque de flexibilité et de cohérence centrale font l’objet d’une littérature grandissante et semblent bien être commun aux deux pathologies. Des difficultés socio-affectives communes sont aussi discutées, mais encore peu étudiées. Un axe de notre travail a été d’étudier les liens entre l’alexithymie, les facteurs cliniques (e.g âge de début, durée d’évolution, nombre de rechutes, évolution de l’état globlal) et l’anxiété sociale en prenant en compte d’éventuels facteurs de confusion mis en cause dans la littérature (état nutritionnel,, affects anxio-dépressifs). Le deuxième axe de notre travail a porté sur la caractérisation du chevauchement existant entre les troubles du spectre autistique et l’anorexie mentale en comparant les profils socio-affectifs d‘anorexiques et de personnes atteintes du syndrome d’Asperger. Pour répondre au premier axe de recherche, nous avons réalisé deux études : une 1ère auprès de 60 patientes ; une 2ème auprès de 213 patients. Les sujets des deux études étaient des patients hospitalisés pour un épisode d’anorexie dans une unité spécialisée dans la prise en charge des troubles des conduites alimentaires. La première étude a porté sur une population homogène d’adolescentes anorexiques, malades depuis moins de 3 ans et toutes hospitalisées dans le même centre parisien. La participation à la deuxième étude a été proposée à tous les patients âgés de 13 à 65 ans hospitalisés pour un épisode d’anorexie au sein de 11 services spécialisés en France. Pour les deux études, nous avons utilisé les scores à des instruments psychométriques mesurant l’alexithymie (TAS-20 ou BVAQ), la symptomatologie alimentaire (EDI, ou EDE-Q et EAT) et les affects anxio-dépressifs (SCL-90 ou HAD). L’état global des patients, l’anxiété et l’évitement social ont été évalués lors d’entretiens semi-structurés (respectivement Morgan et Russell, LSAS). De ces deux études, il ressort que l’alexithymie semble jouer un rôle péjorant, non seulement sur les symptômes alimentaires, mais également sur l’évitement social. L’impact de l’alexithymie existe au-delà de l’effet de l’état nutritionnel et des affects dysphoriques. Le fonctionnement alexithymique semble par ailleurs influencer négativement l’évolution de l’état clinique des personnes ayant nécessité une hospitalisation pour anorexie mentale dans une unité spécialisée. Pour répondre à notre deuxième axe de recherche, nous avons réalisé une étude psychométrique comparative auprès de 15 personnes présentant un Syndrome d’Asperger, 15 anorexiques et deux groupes de témoins appariés à chaque groupe clinique. Nous avons utilisé des entretiens semi-structurés pour confirmer les diagnostics du Syndrome d’Asperger et d’AM (ADOS et MINI). Les participants ont complété des échelles d’alexithymie (BVAQ), de traits autistiques (AQ), d’empathie (IRI, EQ), de dépression (BDI) ainsi que de symptomatologie alimentaire (EAT). Cette étude comparative montre que les anorexiques se rapprochent des personnes souffrant du Syndrome d’Asperger en ce qui concerne l’alexithymie et certains traits autistiques, notamment cognitifs. (...) / This work concerns the impact and the nature of socio-affective difficulties in Anorexia Nervosa (AN). Interoceptive and introspective difficulties, as apprehended by measures of alexithymia, could be linked to the severity of clinical profiles among AN patients, and have an impact not only on their somatic state but also on their interpersonal functioning.Alongside, alexithymia and social avoidance are deficits that are encountered in disorders in the autistic spectrum. The London Institute of Psychiatry has indeed proposed a model involving shared endophenotypes between these disorders and AN, thus concluding to a phenotype overlap. The lack of flexibility and central coherence among these patients are issues that are being increasingly broached in the literature, and these features do indeed appear common to both pathologies. Socio-affective difficulties are also widely discussed in this respect, but as yet there have been few studies. Our first line of research was the study of the links between alexithymia, clinical factors (such as age at onset, duration of illness, number of relapses, evolution of global state), and social anxiety, taking into account any possible confounders highlighted in the literature (nutritional state, anxious-depressive affects). The second line of research was an exploration of the overlap between disorders in the autism spectrum and AN, by way of a comparison of the socio-affective profiles of AN patients and patients with Asperger's syndrome. To address the first line of research two studies were conducted. The first involved 60 female patients, and the second included 213 male and female patients. The patients in both of these studies were hospitalised for an episode of anorexia in units specialised in the care of eating disorders. The first study explored a homogenous population of anorexic adolescent girls with an illness duration of three years or more, all hospitalised in the same facility in Paris. Participation in the second study was proposed to all patents aged between 13 and 65 years hospitalised for an episode of anorexia across 11 specialised units in France. For both studies the scores used were derived from psychometric measures of alexithymia (TAS-20 or BVAQ), eating disorder symptoms (EDI or EDE-Q and EAT), and anxious-depressive affects (SCL-90 or HAD). Global state, anxiety and social avoidance were assessed in the course of semi-structured interviews (GOAS and LSAS respectively). From these studies it emerged that alexithymia appears to have an aggravating role, not only on eating symptoms, but also on social avoidance. The impact of alexithymia extends beyond that of the nutritional state and dysphoric affects. Alexithymic functioning also appears to have a negative impact on the evolution of clinical state among individuals having required hospitalisation in a unit specialised in AN. To explore the second line of research we performed a comparative psychometric study on 15 individuals presenting Asperger's syndrome, 15 anorexic patients, and two control groups matched to the two clinical groups. Semi-structured interviews were used to confirm the diagnoses of Asperger's Syndrome and AN (ADOS and MINI). The participants completed the scales for alexithymia (BVAQ), autistic traits (AQ), empathy (IRI,EQ), depression (BDI) and eating symptoms (EAT). This comparative study showed that AN subjects exhibited similarities with Asperger subjects for alexithymia and certain autistic traits, in particular cognitive. In contrast, important differences were observed for social skills, with anorexics exhibiting more empathy and greater concern for others that the patients with a disorder in the autism spectrum. From a clinical point of view in the field of the care of AN, this research shows the value of developing new approaches centred on the recognition of emotional states and the improvement of social skills. (...)

The diploma thesis follows the bachelor thesis "School and Counselling Trajectory of a Child with Asperger's Syndrome", where the experience of children with this diagnosis and their parents with school attendance was described. This time it is viewed from the perspective of primary school teachers who have experience with a pupil with Asperger's syndrome. For data collecting a semi-structured interviews about Asperger's syndrome were used and a qualitative method was chosen. Based on the analysis of the results, the following areas were found: "how it all started", what it means to have a pupil with Asperger's syndrome in the classroom, conflicts, what helps, experiencing inclusion of a child with Asperger's syndrome by his class teacher, "…so one wonders, if it's worth it". The results most often included the individuality of the child and the lack of time and space on the part of teachers in meeting the individual needs of included children, the importance of support from the teaching assistant and also the importance of cooperation with the child's family. The work also includes the theoretical definition of the inclusion of pupils with Asperger's syndrome into regular primary school. KEYWORDS Asperger's syndrome, teachers, primary school, experience, autism spectrum disorders

With a dramatic increase in the prevalence of students with autism spectrum disorders (ASD), including those with high-functioning autism and Asperger's syndrome, educators are challenged to meet the educational needs of a complex and widely diverse group of exceptional learners. The focus of this research was to gain insight into the experiences of the graduated student with autism and his/her parent(s) during the student's time in public school. This study had three research questions: 1) What were the lived experiences of students with ASD who graduated from an urban public high school in the southeast United States?; 2) What were the lived experiences of the parents of the graduated students with ASD?; and, 3) Were there common themes between the graduated students' lived experiences and the parent's lived experiences? Five graduated students and their parents were interviewed in this qualitative, phenomenological study. Explicitation of the interview data identified three themes for the graduated student group: a) challenges with learning due to having an ASD; b) difficulty making friends; and, c) involvement in their educational process. Four themes were present in the parent group: a) challenges with learning due to having an ASD; b) difficulty making friends; c) establishment of a relationship with the school; and, d) preparation for post-secondary experiences. The graduated student group agreed with the parent group on 16 of the 20 interview questions. Responses for each graduated student were compared to the responses of his/her own parent(s). Recommendations were made for future research.