Résumé
Il existe actuellement un consensus quant à l’intérêt d’une intervention précoce spécialisée dans les troubles du spectre autistique (TSA) en termes de pronostic cognitif, social et émotionnel. Or, l’instauration d’une prise en charge précoce dépend de la précocité du diagnostic, et les cliniciens manquent d’outils fiables pour évaluer le risque autistique avant l’âge de deux ans. De plus, le caractère évolutif et hétérogène de cette affection la rend parfois difficile à appréhender. Ainsi, le dépistage précoce de l’autisme, bien qu’il soit un enjeu de santé publique, se heurte à de nombreuses difficultés et il existe toujours un important retard au diagnostic, source de souffrance pour les enfants et leur famille. Dans cet article, nous récapitulons les différents signes précoces de l’autisme auquel le clinicien doit prêter attention dès les premiers mois de vie. Nous discutons les différences de trajectoire évolutive pouvant conduire au tableau de trouble envahissant du développement (TED) constitué. Enfin, nous évoquons l’intérêt d’une mise en place d’un dépistage du risque autistique en population générale et les possibilités de prise en charge précoce.
Abstract
There is now consensus about the value of early intervention in autism spectrum disorders, in terms of prognosis, cognitive, social and emotional development. However, the introduction of early treatment depends on early diagnosis, and clinicians lack reliable tools for assessing the risk of autism before the age of two. Furthermore, the heterogeneity of this condition and the evolutionary profile make it difficult to diagnose early. Thus, early detection of autism, although it is a public health issue, faces many difficulties, and there is still a significant delay in diagnosis; a source of suffering for children and their families. In this paper, we summarize the various early signs of autism to which the clinician should be alert during the first months of a child’s life. We discuss the differences in evolutionary trajectory that may lead to pervasive developmental disorder. Finally, we propose establishing an autism screening programme in the general population and opportunities for early treatment.
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Bargiacchi, A. Les signes précoces de l’autisme. Psychiatr Sci Hum Neurosci 9, 19–30 (2011). https://doi.org/10.1007/s11836-010-0158-3
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DOI: https://doi.org/10.1007/s11836-010-0158-3