The aim of this article is to introduce a symposium I attended during my bachelor degree. This symposium, named CIALA which means « Colloque Inter-régional Autisme Limousin-Auvergne » took place during the 23rd March 2019. The main goal of this journey was to discuss the access to health for people with Autism Spectrum Disorder (ASD). In order to deal with it, different protagonists were present, especially Djéa Saravane and Martine Hennequin, two recognized professionals in their field of action. To present them quickly, Mrs Hennequin is a university professor and a dental surgeon specialized in the specifics of oral care with a public of autistic people. Regarding Mr Saravane, this hospital practitioner specialized in the treatment of pain has created the first Regional center for pain and somatic care in mental health, autism, multiple disabilities and rare genetic diseases. This innovative establishment, inaugurated in 2013 and based in Etampes, welcomes patients suffering from mental pathology while getting involved in the medical research of treatment of somatic pain for people with neurodevelopmental disorders.
This conference day begins with Doctor Saravane’s intervention that deals with somatic pain and autism. He starts his presentation by describing the fact that nowadays, one person out of one hundred is diagnosed with ASD. Thus, the care concerning this disorder represents a major public health issue. Nevertheless, according to him there is a clear lack of epidemiological data concerning the understanding of pain and its treatment for people with autism, that can lead to some misunderstanding in the medical field. Indeed, a third of people with autism do not have access to language and it can represent a real issue for them to express their feelings, their thoughts, their pains… Accordingly, sometimes this lack of expression can lead them to have big temper tantrums due to somatic pains. In order to illustrate his comments, Doctor Saravane gives the example of a young child on the spectrum addressed to his center after seeing several professionals for his increasingly recurring temper tantrums. The young boy’s mother explained that during his moments of decompensation nothing could calm him down, sometimes he was hitting his face violently with his hands and was screaming a lot. After a meticulous examination, Doctor Saravane had a new explanation, which has never been investigated until now : the young boy had cavities on his teeth which were painful for him so much so that it was causing these tantrums. In this respect, he received dental treatment and his decompensation attacks disappeared. Hereafter that, this example is a way to defend and generalize the idea that each person with autism must be considered as a unique human being that will express his somatic pain in his own way, particularly if he doesn’t have access to our language. Thus, any unusual behavior should be carefully studied without being directly considered as a typical symptom of autism. On Doctor Saravane’s mind, there are different ways to improve our knowledge of somatic pains for people with ASD. On the one hand, he announces that it is vital to pay special attention to every nonverbal communication clues. For instance, it can include compulsive scratching of an area, refusal to eat, repetitive behavior in a specific situation… On the other hand, he gives us some landmarks by explaining that the presence of aggressiveness, self-harm, screams, sleeping troubles and/or violent explosions represent risk factors that must be spotted and explored because they can reveal underlying disorders like sleep and digestive disorders or epileptic crises. On top of that, he finishes his presentation by quickly introduce a French measurement scale named “Echelle Simplifiée d’évaluation de la Douleur chez les personnes Dyscommunicantes avec troubles du spectre de l’Autisme”. The aim of this tool, created in his center in Etampes, is to objectify a potential acute pain of somatic origin by specific observations of the subject’s behavior in multiple situations.
After the presentation of Doctor Saravane, it was the turn of Doctor Hennequin to give her speech. During it, she describes the fact that medical care can represent a touchy topic when it deals with autism because all cares perceived as invasive (dental cares, blood tests…) represent a major difficulty for them. Thus, it can lead, as Dr Saravane expounded, to some carelessness. Concerning oral care, Doctor Hennequin explains that there are different ways to take care of people on the spectrum. First of all, visual pedagogy must be the preferred solution. As an example, before the appointment it is recommended to read books with the child about the profession of dentist in order to prepare and sensitize him to the context of the firm, dentist’s tools… Secondly, this awareness can consist in gradually expose the child to the dentist’s office during several meetings. Finally, it exists other controversial methods like the wrapping method where the child is physically restrained during the care and the method of conscious sedation during which analgesic and sedative products are given to calm the child.
To put it in a nutshell, as far as I am concerned this conference was really interesting and enriching in the way that it deals with some major stakes in the field of psychological support for people with autism, that is to say the recognition and care of somatic pains. According to the law of the 11 February 2005, access to healthcare must be free and equal for all citizens, it represents a fundamental need that must be relieved for every human being. Nowadays it is necessary to facilitate the understanding of people with autism in order to respect their right to the access to healthcare. For example, the Picture Exchange Communication System (PECS) is a non-verbal system of communication where the person with ASD uses pictograms in order to be understood. According to scientific literature, the use of this non-verbal system of communication increases the verbal and understanding skills of the person with autism in a meaningful way (Hauss, 2016 ; Mondillon, 2018). Thus, it can represent a possible way for us to understand their needs and to improve their somatic and psychological health care, with the aim of providing an equal access to healthcare for all.
Words I have learned :
A symposium → un colloque
Carelessness → négligences, manque de soin
Firm → cabinet
Relieve → soulager
Acute → Aigu
With the aim of → dans le but de
Bibliographic references :
Hauss, M. (2016). Apport de la technique PECS (Picture Exchange Communication System) dans la prise en charge bucco-dentaire de l’enfant atteint d’ASD (Autism Spectrum Disorder)
Mondillon, L. (2018). Comment les personnes autistes peuvent-elles communiquer ? – Enseignement Licence 3 Psychologie
Saravane, D. & Hennequin, M. (2019). Les phénomènes douloureux chez la personne TSA, utopie ou réalité ? – Colloque Inter-Régional de l’autisme Auvergne et Limousin
Law of the 11th february 2005 → https://www.hassante.fr/upload/docs/application/pdf/201803/lettre_de_cadrage_besoins_en_sante_des_personnes_handicapees_101011.pdf
Written by Ilhyana Derradj