Étude du développement cognitif et socio-émotionnel, et de la régulation de l'activité d'enfants ayant le double diagnostic de trisomie 21 et d'autisme

Abstract : Context. In France, Autism Spectrum Disorder (ASD) is still rarely identified in children with Down's syndrome (DS). However, specific autism diagnostic instruments have shown good sensitivity for detecting ASD in this population. DS is a genetic disease associated with mental retardation and with social, communicative and behavioural impairment making difficult the dual diagnosis. However, a lot of children with DS also present TSA. The lack of diagnosis deprives young children of an early and appropriate behavioural and developmental support. Objective. This study aimed (1) to provide evidence of specific features in the cognitive and socio-emotional development and activity regulation functioning of young children with a dual diagnosis and (2) to identify specificities compared to children with DS and children with TSA. This research also aimed to sensitize professionals to the recognition of this developmental psychopathology (dual diagnosis). This included encourage better identification of autism at an early age in children with DS, and to determine an appropriate support to their specific needs, focusing on cognitive and social development and activity regulation. Method. Participants: They were volunteers recruited in institutions and family associations. Three groups of children, matched in their developmental age, were compared: (i) 18 children with a dual diagnosis, (ii) 25 children with DS and (iii) 21 children with ASD. Their developmental level is included in the 4 to 24 months' age period. Tools: To diagnose autism, we used Dianostic and Statiscal Manual of mental disorders -fifth edition- (DSM-5, APA, 2013) and Childhood Autism Rating Scale (CARS, Schopler, Reichler & Daly, 1980). Cognitive and socio-emotional development assessed by means of the Socio-emotional and Cognitive Evaluation Battery (SCEB). Cognitive and emotional activities regulation assessed by Regulation Disorders Evaluation Grid (RDEG, Adrien,1996), the Coding and scoring grid for other-regulation and self-regulation (Nader-Grosbois, 2000) and the Emotion Regulation Checklist (Shields & Cicchetti,1997). Procedure: Parents were signed informed consent forms before the developmental and behavioural assessment of children. Results. We revealed the existence of specific developmental profiles among children with dual diagnosis of DS and ASD, and large variability inter- and intra-individual in the development and emotional regulation of children with developmental disorders: DS with TSA / DS without TSA / TSA. Conclusion. A better knowledge of the developmental and regulation functioning characteristics of children with dual diagnosis of DS and ASD allows to propose personalized support and to increase awareness among professionals to to the importance of early recognition this dual diagnosis. It seems justified to diagnose ASD in young children with DS and consider it a primary disorder, in order to offer them a more adapted intervention.
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Anne-Emmanuelle Krieger. Étude du développement cognitif et socio-émotionnel, et de la régulation de l'activité d'enfants ayant le double diagnostic de trisomie 21 et d'autisme. Psychologie. Université Sorbonne Paris Cité, 2016. Français. ⟨NNT : 2016USPCB209⟩. ⟨tel-02021027⟩

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