Psychoanalysis in the treatment of autism: why is France a cultural outlier?

"Survival classes for a neurotypical world": What French autistic adults want and need after receiving an autism diagnosis

LAY ABSTRACT

Adults receiving an autism diagnosis might not react the same depending on their countries or cultures. We also know that autistic people are rarely asked what they think would be best for them following this diagnosis. In this study, we asked 12 French autistic adults about their experiences of receiving an autism diagnosis as well as what they thought might be useful afterwards. Overall, we found that some experiences were similar to experiences related by English or American participants, but some were specific to the French culture, suggesting that such research should expand into new territories and cultures, especially non-European ones. Our participants also had quite a few ideas as to what would be useful for people in the same situation. Some of the suggestions can be put into action by peers and professionals alike, while others are wishes relating to how our participants would like society to behave toward them and people like them, for example. This article allows for a better comprehension of how cultural differences can impact the experience of receiving an autism diagnosis as an adult and provides some insight into what these adults want and desire following such a diagnosis.

The prevalence of autism spectrum disorder traits and diagnosis in adults and young people with personality disorders: A systematic review

OBJECTIVES

Autism spectrum disorders and personality disorders are spectrum conditions with shared clinical features. Despite similarities, previous attempts to synthesise literature on co-existing prevalence and shared traits have employed a unidirectional focus, assessing personality characteristics of individuals with an autism spectrum disorder diagnosis. Here, we assess the prevalence of autism spectrum disorder diagnosis and/or traits among persons diagnosed with a personality disorder.

METHODS

We systematically reviewed the English-language literature following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, according to a pre-registered protocol (PROSPERO: CRD 42021264106). Peer-reviewed quantitative studies reporting the prevalence of autism spectrum disorder diagnosis or traits in persons with an established personality disorder diagnosis were included. Studies were critically appraised using the Appraisal tool for Cross-Sectional Studies.

RESULTS

Fifteen studies were identified, including 72,902 participants (median: 48, interquartile range: 30-77). Diagnoses included borderline, schizotypal and obsessive-compulsive personality disorders, and cohorts with unspecified personality disorder diagnoses. There was significant heterogeneity in diagnostic methodology and assessment tools used. We identified preliminary evidence of an increased prevalence of co-existing autism spectrum disorder diagnosis and traits among those diagnosed with a personality disorder, although significant limitations of the literature were identified.

CONCLUSION

Our research suggests clinicians should consider conducting a careful developmental assessment when assessing service-users with possible or confirmed personality disorder. Future research directions may include larger studies featuring clinical control groups, an exploration of shared and differentiating behavioural-cognitive features of the two conditions, and investigation into potentially shared aetiological factors. Research investigating demographic factors that may contribute to potential diagnostic overshadowing would also be welcomed.

Evaluation of teachers' knowledge and attitudes regarding the school inclusion of autistic children: Validation of a brief assessment toolkit

BACKGROUND

Teachers' level of knowledge regarding autism and their attitudes towards inclusion are major levers for the successful schooling of autistic students. However, there are currently insufficient validated tools for evaluating these two concepts among teachers that are adapted to the French context and to the constraints of the classroom setting.

AIMS

This study was designed to test both the validity of The Autism Knowledge Screening Scale (AKSS) and of the Autism Attitude Scale for Teachers (AAST) among French teachers.

SAMPLE

Our final sample consisted of 307 French teachers (50.5% primary school teachers and 49.5% secondary school teachers).

METHODS

First, confirmatory factor analyses were conducted to test the two initial factor structures and an exploratory factor analysis was conducted regarding the AKSS. Second, criterion validity was assessed for each of the two scales.

RESULTS

Concerning knowledge of autism, a two-factor model (8 items) explaining 53% of the variance was observed. The first factor represented knowledge about aetiology and the second represented knowledge about symptoms. Concerning attitudes towards autism, a one-factor model (14 items) exhibited good model fit (χ² /df = 1.71, RMSEA = .048, AGFI = .979, SRMR = .068, CFI = .987, NNFI = .984). As expected, participants who were specialized teachers, had training, and a high degree of contact with autism had more knowledge (regarding aetiology but not regarding symptoms) and more positive attitudes.

CONCLUSIONS

This study validated two quick-to-use tools for making an initial diagnosis of teachers' knowledge and attitudes regarding the school inclusion of autistic children. The use of these tools could help to fine-tune the content of training programs for teachers and test their efficacy, particularly in France where the inclusion of autistic children is still far from international standards.