PSYCHOANALYTIC POSITION AGAINST DOGMATISM APPLIED TO AUTISM

Some critics of psychoanalysis, who influence government agencies, and to whom the press gives a good welcome, repeatedly report untruths about the psychoanalytical care of autistic people in France and about the supposed scientificity in this domain of cognitive-behavioral therapies (CBT). It seems useful to recall here some essential data.

The cause of autism remains elusive. Its very nature is still debated. There is no gene or drug therapy. Yet it is often asserted that: “Autism Spectrum Disorders always have a neurological/biological cause.” This peremptory statement should be qualified: even if biology plays a causal role in autism, it can in no way predict the future of the autistic subject, its evolution being dependent on multiple factors. Moreover, even if studies of monozygotic twins, one of whom is autistic, seem to attest to a genetic causation of autism, they never reach a 100% concordance rate, which leaves an important part of enigma. According to a recent meta-analysis, the correspondence can vary between 64 and 91% (1). Moreover, it is established that the environment of two monozygous twins exerts a strong influence on the severity of their autism (2), and that the environment modifies the expression of genes (3). Many studies on the biological genesis of autism now lead to a heterogeneous, polygenic genetic determination with no gene key, which produces an accumulation of scattered data that nothing manages to assemble (3). In short, the scientific data currently available lead to the conclusion that the causes of autism are not neurobiological, but multifactorial, and that the development of the autistic subject is not fixed in his genes. The autistic person is a plastic subject for whom the mode of management has a decisive influence on their development. The debate today is about how to think about it, either by advocating methods that invite forging the model of the educator of autistic subject, or by considering that it is a matter of stimulating their development capacities. Cognitive-behavioural methods opt for the first approach, psychodynamic methods more or less inspired by psychoanalysis, developmental methods and methods focused on dyadic interventions such as PACT (Pediatric Autism Communication Therapy) choose the second.

It is readily stated that CBT would be “validated” and would “achieve a level of education and integration in society in the majority of cases”. However, in its 2012 recommendations, the High Health Authority (HAS) notes that no method of managing autism is scientifically validated. It recommends three: the ABA method and the Denver Developmental Program, which have a grade B designation of “scientific presumption” of effectiveness, while the TEACCH program has a grade C, referring to “a low level of evidence” (4). However, the recommendations of the High Health Authority, according to the Council of State, are now obsolete (5). They are doubly so, on the one hand, because the evaluations of the methods recommended in 2012 have since been strongly drawn down, on the other hand, because the methods that were said to be non-consensual (psychoanalysis and institutional psychotherapy), due to the lack of evaluations, can now point to some conclusive studies.

Research following the latest recommendations of the Haute Autorité de Santé converge to consider that the existing studies in favor of the effectiveness of the ABA method, the most common method for the managementof autism, are based on low levels of evidence. In England, this is the conclusion of the Institute for Health and Care Excellence (NICE) (6), confirmed in 2017 by government expertise (7); whereas in 2012 The Agency for Healthcare Research and Quality’s comprehensive review of the English-language scientific literature leads to the same conclusion (8). Even more recently, the U.S. Department of Defense has been trying to assess the appropriateness of its spending on the ABA. In 2019, he found that for 76% of children there was little or no change after 12 months of management; while 9% more had worsening symptoms (9). In 2020, no statistically significant correlation was found between the number of hours of ABA performed and the results obtained (9).

Quite revealing was the experiment carried out in France, from 2010, in 28 pilot institutions, benefiting from extremely favourable conditions, endowed with generous financial means, to confirm the still cited result of 47% of autistic children in school using the ABA method. After four years of intensive ABA practice among 578 autistic children, 19 went out to the “ordinary environment”, or 3.3%. Disappointed by these results, the French health authorities have endeavoured to keep confidential the report entitled “National Evaluation of Autism Experimental Structures” (11). However, it shows that the evidence on the ABA method is limited to quantifying improvements in cognition and certain behaviours, masking that in terms of clinically significant changes (adaptation, autonomy, socialization) his performance is mediocre.

Moreover, HAS has not considered the potential adverse effects of ABA. In 2018, it was found that 46% of autistic people who were exposed to this method in their childhood have post-traumatic stress disorder as an adult. In addition, the study found a positive statistical correlation between the severity of symptoms and the duration of exposure to ABA (12). The HAS neglects the ethical problems inherent in the practice of the ABA, in particular what many autistic people denounce (13), namely the violence inherent in it. Even after having more or less abandoned the punishments, it willingly provokes a return of it. A complaint lodged by a parent of autistic children treated at the Camus Centre in Villeneuve-d’Ascq, the pilot site of the ABA method, recalled the persistence of aversive techniques in certain institutions (14). This was confirmed by the court in dismissing the defamation suit brought against the complainant parent by the Director of the Centre (15).

Who believes that the French health authorities are favorable to psychoanalysis is undoubtedly poorly informed of the current struggles of psychologists against the decree of March 10, 2021; on the contrary, they tend, to take the recommendations of the HAS for legal constraints. It was necessary for the Court of Cassation to recall in 2018 that these recommendations “are intended only for the information of health personnel and the public” and “have no mandatory value” (16). The obsolescence of the 2012 autism recommendations in 2022 confirms the wisdom of this decision.

In addition, a member close to the government tried to ban psychoanalysis for autistic people in the name of the same recommendations that are now outdated. The national representation did not follow him in a project anyway inapplicable: the HAS notes that “the border between therapeutic and educational is sometimes artificial and unclear”. Among the various modes of intervention deployed to autistic children by institutional management with analytical reference never misses the internal or external schooling at the institution; how can we then rigorously assess the part that comes back to the psychoanalytical reference and the part that comes back to the pedagogical efforts? Not forgetting the results of the various workshops (swimming pool, horse riding, etc.) and the one still related to the implementation of rehabilitation techniques (speech language pathology, psychomotor skills, etc.)?

It should be recalled that institutional arrangements with psychoanalytic reference for autistic persons are inseparable from internal or external pedagogical and educational activities. They seek to promote the social integration of the child, so that inclusion in the ordinary school environment is always sought where possible, provided that it does not expose the child to abuse by other pupils because of his or her difference.

Day hospitals are not boarding schools, so that obviously their creation is not based on a desire to cut off autistic children from their parents, on the contrary they assume the beneficial character of keeping the child in his family, and in their practice they associate the parents with the management.

Of course, half a century ago, Bettelheim argued that parents could be the cause of their child’s autism, and he also explicitly stated the contrary(17), so that everyone can take what they want from their work. The detractors of psychoanalysis readily forget that he was not a psychoanalyst even if some psychoanalysis reviews made him welcome at the time. Those who have largely forged psychoanalytic apprehension of autism have clearly opposed parental guilt. Malher argued that the treatment of autism must go through the implementation of a mothering principle (18). Tustin rebelled against the thesis of harmful parents. As early as 1981, she stressed the need to be careful not to “systematically challenge nurturing care” (19). Against some malicious allegations, Lacan has never ruled on the causality of autism. In the current state of knowledge, this remains elusive.

The most common culpability practices of parents today are those of ABA practitioners, who claim that the child’s insufficient progress is due to a lack of parental involvement. The poignant testimony of Johanne Leduc is edifying in this regard (20).

What characterizes current French psychiatry is in no way its subservience to psychoanalysis, but a reduction in the relational and (re)structuring orientation of care, which is replaced by chemotherapy, including a strong comeback of electro-convulsive therapy, and a generalization of restraint practices. The principle of this degradation of psychiatric practice is the decline of the reference to psychoanalysis, the virtual denial of the psyche to the benefit of the whole brain and the medicalization of mental illness: they lead to disfavour of any knowledge of the patient with regard to his disorders, and a consequent neglect of his speech. It is not necessary to be a specialist in the history of psychiatry to make these observations. A magistrate, a controller of places of deprivation of liberty, Adeline Hazan, who took the time to inquire about the experience of caregivers, is quite able to indicate this. “Some department heads have “banned” psychoanalysis and institutional therapy,” she notes, but these approaches “place the caregiver in a supportive, not constrained relationship with the patient,” so that, she adds, “ the correlation between the abandonment of these therapeutic schools and the use of isolation and restraint should be assessed.” (21)

Packing is a marginal practice, of which it must be remembered that it precedes much the discovery of psychoanalysis, so that its links to it are tenuous, no doubt why in France most institutions that refer to psychoanalysis do not practice it. Nevertheless, there is evidence that, while not an autism therapy, it can help soothe some children (22).

The INSERM report on psychotherapy (2004) aroused such criticism of its methodology that the Minister of Health, Dr Douste-Blazy, disavowed it. The conclu­sions supported a superiority of CBT over psychoanalytic therapies; and all previous and later meta-analyses agree on another result, the absence of any significant difference in the therapeutic efficacy of all bona fide therapies, regardless of their theoretical references (23, 24). Among these, the effectiveness of psychoanalysis and psychodynamic therapies is well established (25, 26).

The obsolescence of the HAS recommendations promulgated in 2012 is still due to its finding that there is a lack of studies on psychoanalytic interventions for autistic people, which led to the characterization of them as “non-consensual”. The lack of consensus focuses on the evaluation methodology. There is no shortage of evidence but it is in the form of case studies (27). The psychoanalytic approach consists in inventing a mode of management specific to the singularity of each autistic, which is why it lends itself difficult to the global evaluations of evidence-based medicine expected by the HAS. This method of assessment was the subject of a fine-tuning by Inserm (2007) (28) and a major challenge in psychology at the international level, particularly by the American Psychological Association (2005) (29).

Nevertheless, since 2012, several studies of psychodynamic approaches to autism, referred more or less to psycho­-analysis, have tried to fit into this evaluation mold, which is from the outset rather unfavourable to them, since it gives an advantage to observations of behaviours, to the detriment of the seizure of psychic mutations. Four studies: Thurin (30), Cornet (31), Touati (32), Garret-Cloanec (33) have demonstrated the effectiveness of psychodynamic methods in the management of autism. However, as is constantly observed for the evaluations of practice with autistic people, their methodology does not make it possible to reach a high level of proof guaranteeing scientific validation. Despite everything, they seem comparable to other studies that have been deemed sufficiently convincing to obtain expert agreement, or even a low level of proof. The first of them was even praised in 2014 by the KCE (Belgian equivalent of the HAS, in its recommendations for autism). These studies should be compared with the mediocrity of those with which the HAS was satisfied in 2012 concerning the ABA method.

What is more, in 2017, the heuristic potential of the psychoanalytic approach applied to autism was highlighted by the work of French researchers who made it possible to improve the early diagnosis of autism: they scientifically validated a screening grid based on the hypothesis of a discernible drive dysfunction from the first years. Their research is internationally recognized (34).

Contemporary psychoanalysis does not advocate to analyze the unconscious conflicts of the autistic subject, this model resulting from the treatment of neurotics is not appropriate. The psychoanalytic doctrine is not inflexible: some psychoanalysts seek to build the image of the body of the autistic subject (35); others favor the support of autistic objects and specific interests (36). The evolution of psychoanalytical theory has led to refine the differences between autism and child psychosis so as not to confuse them (37).



On the ground, we observe empirically a certain rapprochement, and mutual borrowing, between cognitive and psycho­analytic approaches to autism, cognition not being cut off from affects. The HAS report notes that in publications referring to ABA behavioral techniques, it is now recommended by its supporters themselves “to be attentive to the signals given by the child, to be receptive and reactive to them and to leave as far as possible the activities, desires and intentions of the child himself, rather than systematically imposing the learning of a decided behaviour without prior observation of the child’s personality” (38). Some proponents of structured pedagogical approaches now consider it appropriate to take into account and work with of the child’s centres of interest to which they attach an intense emotional investment. On the other hand, the reluctance of institutions oriented by psychoanalysis to use teaching methods adapted to the cognition of autistic people is also changing: they increasingly resort to the use of pictograms, the structuring of the environment, and individualized activities planning. The current evolution in institutions is towards more diversified integrative approaches, that seek to understand the difficulties of autistic people in terms of both the characteristics of their cognition and the specificity of their emotional life (39). The outrageous dogmatism of certain adversaries of psychoanalysis hinders a dialogue between different approaches to the detriment of improving the care of autistic people.

References

1. Beata Tick, Patrick Bolton, Franscesca Happé, Michael Rutter, Frühling Rijsdijk. Heritability of autism spectrum disorders: a meta-analysis of twin studies. Journal Child Psychology Psychiatry. 2016 May;57(5):585-95. doi: 10.1111/jcpp.12499.

2. Wright J. Early life experiences may shift severity of autism. Spectrum. 17 January 2020.
https://www.spectrumnews.org/conference-news/international-society-autism-research-2019/

3. Ansermet F. Giacobino A. Autisme à chacun son génome. Navarin. 2012.

4. Haute autorité de Santé. (HAS) Agence nationale de l’évaluation et de la qualité des établissements et services sociaux et médico-sociaux (Anesm). Autisme et autres troubles envahissants du développement : interventions éducatives et thérapeutiques coordonnées chez l’enfant et l’adolescent. Recommandations. Mars 2012 , p. 25.

5. Conseil d’État. Décision n° 428284 du 23 décembre 2020. ECLI:FR:CECHR:2020:
428284.20201223.

6. National Institute for Health and Excellence (NICE), UK. (2011). Autism spectrum disorder in under 19s: recognition, referral and diagnosis. Clinical guideline (CG128] https://www.nice.org.uk/guidance/cg128/chapter/Recommendations.

7. Guldberg Karen. Parsons Sarah. (2017) Scientific review of the ‘Benchmarking Autism Services Efficacy’ (BASE) report (2015). http://eprints.soton.ac.uk/id/eprint/417238

8. Agency for Healthcare Research and Quality (AHRQ). (2014) Therapies for children with autism spectrum disorders: Behavioral Interventions Update. https://effectivehealthcare.ahrq.gov/
topics/autism-update/clinician

9. The Department of Defense Comprehensive Autism. Care Demonstration. Quarterly Report to Congress. Second Quarter, Fiscal Year 2019.

10. The Department of Defense. Comprehensive Autism Care demonstration. Annual Report. 2020.

11. Cekoïa Conseil. Planète publique. Evaluation nationale des structures expérimentales Autisme. Caisse Nationale de Solidarité pour l’Autonomie. Rapport final. Février 2015.

12. Kupferstein H. Evidence of increased PTSD symptoms in autistics exposed to applied behavior analysis. Advances in Autism, 2018, vol 4, issue 1, 19-29. DOI 10.1108/AIA-08-2017-0016.

13. Dawson M. The Misbehavior of Behaviorists : Ethical Challenges to the Autism-ABA Industry. 2004. https://www.sentex.ca/~nexus23/naa_aba.html

14. Dufau S. À Lille, le procès d’une méthode de traitement d’enfants autistes. Médiapart.
2 Juillet 2012. www. mediapart.fr

15. Dufau S. Vinca Rivière et l’association Pas à Pas perdent leur procès face à Médiapart.
6 Mars 2015. www.mediapart.fr

16. Cour de cassation. Arrêt du 8 novembre 2018. ECLI:FR:CCASS:2018:C201377.

17. “It is not the maternal attitude that produces autism,” he writes, “but the child’s spontaneous reaction to it.” He adds, “It would be a big mistake to suggest that a parent wants to create something like autism in their child.” (Bettelheim B. La forteresse vide. Gallimard. Paris, 1969, pp.102–103).
« Ce n’est pas l’attitude maternelle qui produit l’autisme, écrit-il, mais la réaction spontanée de l’enfant à cette attitude » ; Il ajoute : « ce serait […] commettre une lourde erreur que de prétendre qu’un parent désire créer, chez son enfant, une chose comme l’autisme » (Bettelheim B. La forteresse vide. Gallimard. Paris. 1969, pp. 102-103).

18. Malher M. Psychose infantile [1968] Payot. Paris. 1973.

19. Tustin F. Les états autistiques chez l’enfant.[1981] Seuil. Paris. 1986, p. 32.

20. Leduc J. La souffrance des envahis. Troubles envahissants du développement et autisme. Beliveau .Québec. Canada. 2012.

21. Hazan A. Contrôleur général des lieux de privation de liberté. Isolement et contention dans les établissements de santé mentale. Dalloz. Paris. 2016, p. 86.

22. Chamak B. Packing : quand des parents témoignent. Neuropsychiatrie de l’enfant et de l’adolescent. Elsevier Masson, 2020, 68, pp. 339 - 346. 
10.1016/j.neurenf.2020.08.001. Hal-03493678

23. Maleval J-C. Les étonnantes mystifications de la psychothérapie autoritaire. Navarin. Paris. 2012.

24. Wampold, B. E. et al. In pursuit of truth. A critical examination of meta analyses of cognitive behavior therapy. Psychotherapy Research, 2017, 27 (1), 14-32.

25. Leuzinger-Bohleber M., Stuhr U., Rüger B., Beutel M. How to study the quality
of psychoanalytic treatments and their long-term effects on patients well-being : a representative, multi-perspective follow-up study. International Journal of Psychoanalysis, 2003, 84,
pp. 263-290.

26. Leichsenring F. Rabung S. Long-term efficacy of psychodynamic psychotherapy. Journal of American Medical Association. 2008, 300 (13), pp. 1551-1565.

27. Bouyssou-Gaucher C. Louange, l’enfant du placard. Psychothérapie psychanalytique d’un enfant autiste. Penta Editions. 2019.

28. Bréchot, C., Danion, J. M., Falissard, B., Widlöcher, D., Thurin, J. M., Cohen, D.,
Kovess, V. Méthodologie de l’évaluation en psychiatrie et en santé mentale. Colloque Inserm du 30 mai 2007. Pour la Recherche. 2007, 54, 1-12.

29. American Psychological Association. Evidence-based practice in psychology. APA Presidential Task Force on Evidence-Based Practice. Am Psychol, 2006, 61(4), 271-285. doi:10.1037/0003-066X.61.4.271

30. Thurin J-M. Thurin M. Cohen D. Falissard B. Approches psychothérapeutiques de l’autisme. Résultats préliminaires de 50 études intensives de cas. Neuropsychiatrie de l’enfance et de l’adolescence. 2014 (62), pp. 102-118.

31. Cornet J-P, Vanheule S. Evaluation de la prise en charge institutionnelle d’enfants atteints d’un trouble envahissant du développement. Evolution psychiatrique. 2017, 82, 3, pp. 687-702.

32. Touati. B. Mercier A. Tull L. Autisme : évaluation des diagnostics et des traitements dans un intersecteur de pédopsychiatrie. La psychiatrie de l’enfant. 2016/1 (Vol. 59), pp. 225-290.

33. Garret-Gloanec N. Péré M. Squillante M. Roos-Weil F. Ferrand L. Pernel A-S. Apter G. Evaluation clinique des pratiques intégratives dans les troubles du spectre autistique (EPIGRAM) : méthodologie, population à l’inclusion et satisfaction des familles à 12 mois. Neuropsychiatrie de l’enfance et de l’adolescence. 2021, 69, 1, pp. 20-31.

34. Olliac B, Crespin G, Laznik M-C, Cherif Idrissi El Ganouni O, Sarradet J-L, Bauby C, et al. Infant and dyadic assessment in early community-based screening for autism spectrum disorder with the PREAUT grid. PLoS ONE, 2017, 12 (12): e0188831. https://doi.org/10.1371/journal. Pone.018883

35. Haag G. Le Moi corporel. Autisme et développement. PUF. Paris. 2018.

36. Laurent E. La bataille de l’autisme. Navarin. Paris. 2012.

37. Maleval J-C. La différence autistique. Presses universitaires de Vincennes. 2021.

38. Haute Autorité de Santé. (HAS). Agence nationale de l’évaluation et de la qualité des établissements et services sociaux et médico-sociaux. (Anesm). Autisme et autres troubles envahissants du développement : interventions éducatives et thérapeutiques coordonnées chez l’enfant et l’adolescent. Recommandations. Mars 2012, p. 49.

39. Landman P. Ribas D. Ce que les psychanalystes apportent aux personnes autistes. Erès. 2021.

Scientific referents

Ansermet F. Professeur émérite à l’Université de Genève et de Lausanne, précédemment chef de service de psychiatrie d’enfants et d’adolescents aux Hôpitaux Universitaires de Genève et directeur du Département de psychiatrie de l’Université de Genève. Membre du Comité Consultatif National d’Éthique à Paris (2013-2021), vice-président de la Fondation Agalma à Genève. Auteur de Autisme, à chacun son génome, Navarin, 2012. (en collaboration avec A. Giacobino).

Bonnet F. Professeur à l’Université Rennes 1. Faculté de médecine.

Botbol M. Professeur émérite de Psychiatrie Infanto-Juvénile. Université de Bretagne occidentale.

De Halleux B. Administrateur délégué et ex-directeur thérapeutique de l’Antenne 110. Centre de rééducation recevant des enfants présentant un trouble du spectre autistique (Bruxelles).

Fouchet P. Professeur de psychologie clinique et de psychopathologie à l’Université Libre de Bruxelles, co-auteur du rapport d’expertise rédigé pour le Gouvernement belge sous l’intitulé « Avis du Conseil Supérieur d’Hygiène – Psychothérapies: Définitions, pratiques, conditions d’agrément » (2005) et de ses annexes portant sur « Les psychothérapies d’orientation psychanalytiques: Validation scientifique et efficacité reconnue » (Ph. Fouchet et P. De Neuter, 2005).

Brenner L.S. (Ph.D.) Chercheur à l’Université psychanalytique internationale de Berlin et au Hans Kilian und Lotte Kölher Centrum (KKC) de la Ruhr Universität Bochum (Allemagne). Auteur de The Autistic Subject : On the Threshold of Language (Springer, 2020)

Gintz C. Psychiatre. Mère d’un jeune homme autiste. Secrétaire du RAAHP (Rassemblement pour une Approche des Autismes Humaniste et Plurielle). Grenoble.

Golse B. Professeur émérite de Psychiatrie de l’enfant et de l’adolescent à l’Université Paris-Cité. Fondateur de l’Institut Contemporain de l’Enfance. Président de l’Association Européenne de Psychopathologie de l’Enfant et de l’Adolescent . Président de la Coordination Internationale entre Psychothérapeutes Psychanalystes s’occupant de personnes autistes et membres associés (CIPPA). Auteur de Mon combat pour les enfants autistes (Odile Jacob, 2013).

Gorini L. Psychiatre. Cheffe de pôle. Psychiatrie infanto-juvénile 93102. EPS de Ville-Evrard.

Grollier M. Professeur de psychologie clinique. Université Rennes 2. Coordinateur du programme Européen IREAMS sur l’Inclusion Raisonnée des Enfants Autistes en Milieu Scolaire. ERASMUS+ (2019-2022) Auteur de Autisme et schizophrénie. Des histoires entremêlées, des réponses variées. (PUR, 2022)

Holvoet D. Directeur du Courtil (Institut Médico-Pédagogique de Leers). Enseignant dans le 3è Cycle de formation en psychothérapie à l’ULB (Bruxelles), Membre du Conseil Fédéral des Soins en Santé Mentale belge.

Laïa S. Professeur à l’Instituto de Psicanalise e Saude Mental de Minas Gerais (Brésil). Auteur de O que é o autismo, hoje ? (2018) (en collaboration avec E. Alvangera).

Landman P. Pédosychiatre. Président du Conseil scientifique d’AEVE. Président de Stop DSM. Co-auteur de Ce que les psychanalystes apportent aux personnes autistes (Erès, 2021).

Langelez K. Coordinatrice clinique des Ateliers du 94. Entreprise de travail adapté. La Louvière. Belgique.

Laurent E. Ancien Président de l’association mondiale de psychanalyse. Auteur de La bataille de l’autisme (Navarin, 2012).

Leguil F. Psychiatre. Ancien praticien hospitalier à l’Hôpital Sainte-Anne (Paris).

Lucchelli J.P. Psychiatre. Médecin chef au Pôle de santé mentale à l’Hôpital du Jura bernois (Suisse). Auteur de Autisme. Quelle place pour la psychanalyse ? (Michelle, 2018)

Maleval J-C. Professeur émérite de psychologie clinique. Université Rennes 2. Auteur de L’autiste et sa voix (Seuil, 2009) et de La différence autistique (PUV, 2021).

Poblome G. Directeur thérapeutique de l’Antenne 110. Centre de rééducation recevant des enfants présentant un trouble du spectre autistique (Bruxelles).

Pozzetti R. Professeur de psychologie. Université de Insubria. Varese. Italy, et LUDeS Campus Lugano. Suisse.

Rabeyron T. Professeur de psychologie clinique à l’Université de Lorraine (Nancy). Directeur du Laboratoire Interpsy. Membre Junior de l’Institut Universitaire de France.

Ruiz Acero I. Coordinateur du centre de recherche sur l’autisme à la Section Clinique de Barcelone de l’Institut du champ freudien. Fondateur de l’association TEAdir de parents de personnes autistes et directeur de ses espaces thérapeutiques. Co-auteur de No Todo sobre el autismo (Gredos, 2013) et compilateur d’Evidencia cientifica y autismo. Una Burbuja de certidumbre (Gredos, 2021).

Rouillon J-P. Directeur de Centre thérapeutique et de Recherche de Nonette. (France).

Svolos T. MD. Professor of Psychiatry. Associate Dean for Strategy and Accreditation. Creighton University School of Medicine (Omaha, Nebraska, and Phoenix, Arizona, United States of America)

Thurin J-M. Psychiatre. Docteur ès Sciences Cognitives. Chercheur associé CESP/Inserm U 1018, Equipe psychiatrie du développement. Université Paris-Saclay. Responsable pédagogique D.U. Psychothérapies : des théories aux partqiues. Coordinateur du Réseau de recherches fondées sur les pratiques psychothérapiques. Fédération française de psychiatrie. Ecole de psychosomatique. Society for Psychothepay research

Vanderveken Y. Directeur thérapeutique au Courtil (Institut Médico-Pédagogique de Leers). Directeur du Centre d’Etudes et de Recherches sur l’Autisme.

Vanier A. Professeur honoraire à l’Université Paris Cité. Ancien Psychiatre des hôpitaux.

Vanheule S. Professeur de psychologie clinique à l’Université de Gand (Belgique). Auteur d’une étude sur l’évaluation de la prise en charge institutionnelle d’enfants atteints d’un trouble envahissant du développement (Evolution psychiatrique, 2017).

Vidal J-M. Chercheur au CNRS. Auteur de Autismes, une approche anthropologique, la question du tiers. (PUF, 2020).

Vives J-M. Professeur de psychologie clinique et pathologique. Université Côte d’Azur. Nice. Auteur de Autisme et médiation. Bricoler une solution pour chacun. (Arkhé, 2020), (en collaboration avec Orrado I.)

Tendlarz S. Professeure. Chaire de Clinique de l’autisme et psychoses de l’enfance. Faculté de Psychologie. Université de Buenos Aires. Responsable du Département autisme et psychoses de l’enfance. Institut Clinique de Buenos Aires. Professeur de l’UNSAM et de l’UNC. Auteure de Clinique de l’autisme et de la psychose dans l’enfance (Buenos Aires, 2016); Qu’est ce que c’est l’autisme ? Enfance et psychanalyse (Buenos Aires, 2013).

Contacts :

Landman Patrick patrlandm0909 gmail.com

Leguil François fleguil orange.fr

Maleval J-C. jean.claude.maleval gmail.com

Les trois initiateurs de la brochure remercient le CERA (Centres d’études et de Recherches sur l’Autisme pour son aide et son appui logistique.