La scolarité des enfants atteints de troubles du spectre autistique sans déficit intellectuel (TSA SDI) est un sujet encore peu exploré en France.

L’objectif de cette étude était d’évaluer un certain nombre de facteurs cliniques et cognitifs qui peuvent être liés à la fonction de l’auxiliaire à la vie scolaire (AVS).

Quatre-vingt-trois patients autistes (3–18ans) sans retard mental ont été inclus au centre alpin de diagnostic précoce de l’autisme (Cadipa), centre ressources autisme Rhône-Alpes.

Nos résultats montrent que les autistes typiques et atypiques sont principalement retrouvés en maternelle et au primaire, ils bénéficient plus fréquemment d’une AVS et d’un plus grand nombre de prises en charge comparativement aux enfants porteurs du syndrome d’Asperger. Les profils cognitifs de la Wechsler Intelligence Scale for Children (WISC 4^e édition) sont également différents : l’indice de compréhension verbale (ICV) et l’indice de mémoire de travail (IMT) sont plus élevés chez les aspergers que chez les autistes typiques et atypiques. L’ICV et l’indice de vitesse de traitement (IVT) sont indirectement corrélés au nombre d’heures d’AVS.

Dans le milieu scolaire, la présence d’AVS semble associée au diagnostic principal et au fonctionnement neuropsychologique selon un continuum qui va de l’autisme typique (besoins et déficits plus importants) au syndrome d’Asperger. Aucun lien entre la comorbidité psychiatrique et la scolarité n’a été retrouvé.

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.

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.

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).

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 (Chi²=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 (Chi²=15.61; df=2; P<.000) and underwent a higher number of consultations and treatment episodes than those with Asperger's syndrome (Chi²=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 η²=.576 and F=8.06, P<.001; df=2; partial η²=.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.

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.