title: [Schooling of patients exhibiting Autism Spectrum Disorders without mental retardation].
abstract: BACKGROUND
  Autism Spectrum Disorders belong to Pervasive Development Disorders. Although access to education is recommended by the French National High Authority for Health (HAS), the practice remains limited and the reasons for the low education rate of these children have still not been sufficiently explored in the literature.
  
  
  OBJECTIVE
  The main objective of this study was to analyze the links between Autism Spectrum Disorder without mental retardation, psychiatric comorbidity and education. The secondary objective was to analyze the cognitive and contextual factors that could limit educational inclusion.
  
  
  METHODS
  Eighty-three autistic patients (3-18years old; 73 males and 10 females) with childhood autism, atypical autism or Asperger's syndrome (criteria from the International Classification of Diseases-10) without mental retardation and in education were assessed at the Alpine Centre for Early Diagnosis of Autism. The sample included 45 subjects with childhood autism, 12 subjects with atypical autism and 26 subjects with Asperger's syndrome. The diagnosis was based on the Autism Diagnostic Interview Revised (ADI-R), in accordance with the recommendations of the HAS, the Autism Diagnostic Observation Schedule (ADOS) and the Wechsler Intelligence Scale for Children, 4th edition (WISC-IV).
  
  
  RESULTS
  Our results showed that childhood autism and atypical autism were mainly found in nursery and primary school, whereas Asperger's syndrome was mainly found in secondary school (Chi(2)=18.23; df=6; P<.006). Individuals with childhood autism and atypical autism were more likely to receive the support of a special educational assistant (Chi(2)=15.61; df=2; P<.000) and underwent a higher number of consultations and treatment episodes than those with Asperger's syndrome (Chi(2)=27.83; df=14; P<.015). The cognitive profiles obtained with the WISC-IV also differed: the Verbal Comprehension Index (VCI) and Working Memory Index (WMI) were higher for Asperger's syndrome than for childhood autism and atypical autism (respectively, F=23.11, P<.000; df=2; partial η(2)=.576 and F=8.06, P<.001; df=2; partial η(2)=.357). Linear regression showed that the VCI and Processing Speed Index (PSI) were inversely correlated to the number of hours spent with a special educational assistant: the lower these indexes, the greater the amount of time spent with a special educational assistant. No link was found between psychiatric comorbidity, type of psychological and psychiatric treatment, and education.
  
  
  CONCLUSIONS
  The use of special educational assistants seems to be linked to the diagnosis of Autism Spectrum Disorders and neuropsychological functioning, as assessed by WISC-IV, along a continuum that ranges from childhood autism (more needs and deficits) to atypical autism to Asperger's syndrome. The Verbal Comprehension Index (VCI) and the Processing Speed Index (PSI) could be used to evaluate the number of hours of support needed by children and to better target the deficits and specific needs of children without mental retardation who are in education. A study on a larger scale could help to more closely address the question of the cognitive abilities of children with Autism Spectrum Disorder without mental retardation, so as to better help them in their education.
authors.affiliation: Centre hospitalier Alpes Isère, 38120 Saint-Égrève, France; Université Joseph-Fourier, 38000 Grenoble, France.
authors.forename: D
authors.initials: D
authors.lastname: Grimm
authors.affiliation: Centre expert asperger, Cadipa, centre hospitalier Alpes-Isère, 3, rue de la Gare, 38120 Saint-Égrève, France.
authors.forename: B
authors.initials: B
authors.lastname: Assouline
authors.affiliation: Comité de soutien à la recherche, centre hospitalier Alpes-Isère, 3, rue de la Gare, 38120 Saint-Égrève, France. Electronic address: apiero@ch-alpes-isere.fr.
authors.forename: A
authors.initials: A
authors.lastname: Piero
mesh_terms: D000293:Adolescent; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis / Q000523:psychology* / Q000534:rehabilitation; D002675:Child, Preschool; D004495:Education of Persons with Intellectual Disabilities; D005260:Female; D005602:France; D006801:Humans; D016014:Linear Models; D008297:Male; D012574:Schools; D014888:Wechsler Scales / Q000706:statistics & numerical data
keywords: Asperger's syndrome; Autism; Autisme; Education; Mental retardation; Retard mental; School; Scolarité; Spectre autistique; Troubles envahissants du développement