Résumés
Résumé
Au Québec, les enfants d’âge préscolaire ayant un trouble du spectre de l’autisme (TSA) reçoivent des services d’intervention comportementale intensive (ICI) par le biais des établissements du réseau de la santé et des services sociaux. L’intensité et la précocité, ainsi que le recours à des stratégies d’intervention spécifiques découlant des principes de l’analyse appliquée du comportement caractérisent l’ICI. La sélection des stratégies les plus appropriées pour chaque enfant est une étape essentielle du processus d’intervention. Plusieurs éléments sont susceptibles d’influencer cette décision. Les caractéristiques individuelles des enfants et les priorités de leur famille en sont des exemples. Cette étude s’intéresse à la façon dont les équipes cliniques opèrent ce processus d’individualisation. Plus spécifiquement, elle vise une meilleure compréhension de la façon dont les dispensateurs de services réalisent cette étape de l’intervention et l’identification des facteurs pris en compte, dans le cadre de services offerts dans la communauté. Pour ce faire, un devis qualitatif est proposé. Dix superviseures cliniques de programmes ICI de trois établissements du réseau de services publics québécois ont partagé leur expérience dans le cadre d’entretiens. Les résultats suggèrent que la prise de décision concernant les stratégies à privilégier implique plusieurs facteurs, et ce, à différents niveaux. En effet, le discours des superviseures met d’abord l’accent sur l’enfant et sa famille. De plus, il intègre des facteurs contextuels plus larges, notamment les environnements disponibles et les personnes qui appliquent l’intervention. Les résultats soulèvent la question de la formation et du soutien à offrir aux équipes d’intervention afin de faciliter le processus d’individualisation de l’ICI.
Mots-clés :
- intervention comportementale intensive,
- stratégies d’intervention,
- planification,
- prise de décision,
- individualisation
Abstract
In Quebec, children aged 2 to 6 with autism spectrum disorder (ASD) have been receiving early intensive behavioral intervention (EIBI) services for more than 15 years. Different EIBI programs share certain characteristics, such as intensity and earliness, as well as the use of specific intervention strategies derived from the principles of Applied Behavior Analysis (ABA). Selecting the most appropriate intervention strategies, for each child, is therefore a crucial factor in the intervention process. Several components are likely to influence the decisions regarding the selection of the strategies, such as the individual characteristics of children and their families or parental priorities. Given the importance of individualizing interventions for young children with ASD, this study focuses on how clinical teams within EIBI services in the community are choosing focused interventions for each child and the factors that are considered. In order to accomplish this, a qualitative interview design was carried out with 10 clinical supervisors of EIBI programs in the context of public services. The results suggest that decision-making about the strategies to select involves several factors, at different levels. Indeed, the supervisors’ discourse highlights factors concerning child- and family-centered considerations. In addition, it incorporates broader contextual factors, including available environments and implementers. The results raise the question of the training and support to be offered to intervention teams in order to facilitate the process of individualizing the intervention.
Keywords:
- intensive behavioral intervention,
- intervention strategies,
- intervention planning,
- decision-making,
- individualization
Parties annexes
Bibliographie
- American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5e éd.). American Psychiatric Publishing.
- Arick, J., Loos, L., Falco, R., et Krug, D. (2004). The star program: Strategies for teaching based on autism research. PRO-ED.
- Baer, D. M. et Schwartz, I. S. (1991). If reliance on epidemiology were to become epidemic, we would need to assess its social validity. Journal of Applied Behavior Analysis, 24(2), 231-234. https://doi.org/10.1901/jaba.1991.24-231
- Baer, D., Wolf, M. et Risley, T. (1968). Some current dimensions of applied behavior analysis. Journal of Applied Behavior Analysis, 1, 91-97. https://www.doi.org/10.1901/jaba.1968.1-91
- Baribeau, C. et Royer, C. (2012). L’entretien individuel en recherche qualitative : usages et modes de présentation dans la Revue des sciences de l’éducation. Revue des sciences de l’éducation, 38 (1), 23–45. https://doi.org/10.7202/1016748ar
- Barton, E. E., Lawrence, K. et Deurloo, F. (2012). Individualizing intervention for young children with autism in preschool. Journal of Autism and Developmental Disorders, 42, 1205-1217. https://www.doi.org/10.1007/s10803-011-1195-z
- Blais, M. et Martineau, S. (2012). L’analyse inductive générale : description d’une démarche visant à donner un sens à des données brutes. Recherches qualitatives, 26(2), 1-18.
- Boutin, G. (2018). L’entretien de recherche qualitatif : Théorie et pratique (2e éd.). Presses de l’Université du Québec.
- Cappe, É., Bailly, F., Paquet, A. et Dionne, C. (2016). Les services offerts au Québec aux jeunes enfants présentant un trouble du spectre de l’autisme : description du programme d’Intervention Comportementale Intensive (ICI) par des professionnels impliqués dans sa mise en oeuvre. A.N.A.E., 142, 1-11.
- Carter, S. I. (2010). The social validity manual: A guide to subjective evaluation of behavior interventions in applied behavior analysis (1ère éd.). Elsevier.
- Charlop M. H., Lang R. et Rispoli M. (2018) Play and social skills for children with autism spectrum disorder (1ère éd). Springer, Cham.
- Dionne, C., Joly, J., Paquet, A., Rousseau, M. et Rivard, M. (2016). Organizations’ choices when implementing an early intensive behavioral intervention program (EIBI). Education Sciences and Society, 2, 150-171. https://ojs.francoangeli.it/_ojs/index.php/ess/article/view/3934
- Dunst, C. J. (1997). Conceptual and empirical foundations of family-centered practice. Dans R. Illback, C. T. Cobb, & H. M. Joseph, Jr. (dir.), Integrated services for children and families: Opportunities for psychological practice (p. 75-91). American Psychological Association. https://doi.org/10.1037/10236-004
- Eikeseth, S. (2017). Additional treatment parameters and issues requiring study: Early intensive behavioral intervention (EIBI). Dans J. Matson (dir.), Handbook of Treatments for Autism Spectrum Disorder (p. 209-230). Springer International Publishing.
- Girard, S., Dugas, C. et Dionne, C. (2019). La transition vers la maternelle des enfants ayant un trouble du spectre de l’autisme : une revue narrative. Revue francophone de la déficience intellectuelle, 29, 76-87. https://www.doi.org/10.7202/1066867ar
- Klintwall L. et Eikeseth S. (2014) Early and intensive behavioral intervention (EIBI) in autism. Dans V. Patel, V. Preedy et C. Martin (eds.), Comprehensive Guide to Autism (p.117-137). Springer. https://doi.org/10.1007/978-1-4614-4788-7_129
- Lang, R., Hancock, T. B. et Singh, N. N. (2016) Early Intervention for Young Children with Autism Spectrum Disorder (1ère éd., p. 1-14). Springer International Publishing.
- Leaf, R. B. et McEachin J. (2016) “The Lovaas Model: Love It or Hate It, But First Understand It”. Dans R. Romanczyk R. et J. McEachin (dir.), Comprehensive Models of Autism Spectrum Disorder Treatment. (1ère éd., p. 7-43). Springer International Publishing.
- Leaf, R. B. et McEachin, J. J. (1999). A work in progress: Behavior management strategies and a curriculum for intensive behavioral treatment of autism. Different Roads to Learning.
- Leaf, J. B., Leaf, R., McEachin, J., Taubman, M., Ala’i-Rosales, S., Ross, R. K., Smith, T. et Weiss, M.J. (2016). Applied behavior analysis is a science and, Therefore, Progressive. Journal of Autism and Developmental Disorders, 46(2), 720-731. https://www.doi.org/10.1007/s10803- 015-2591-6
- Levy, A. et Perry, A. (2008). Transition of children with autism from intensive behavioural intervention programs into the school system. Journal on Developmental Disabilities, 14(1), 1-10.
- Landa R. J. (2018) Efficacy of early interventions for infants and young children with, and at risk for, autism spectrum disorders. International Review of Psychiatry, 30(1), 25-39. https://doi.org/10.1080/09540261.2018.1432574
- Lovaas, O. I. (2003). Teaching individuals with developmental delays: Basic intervention techniques. PRO-ED.
- Makrygianni, M. K. et Reed, P. (2010). A meta-analytic review of the effectiveness of behavioural early intervention programs for children with autistic spectrum disorders. Research in Autism Spectrum Disorders, 4, 577-593. https://www.doi.org/10.1016/j.rasd.2010.01.014
- Maurice, G. Green et Luce, S. C. (Eds.). (1996). Behavioral intervention for young children with autism: A manual for parents and professionals. PRO-ED.
- McGrew, J., Ruble, L. A. et Smith, I. M. (2016). Autism spectrum Disorder and Evidence-Based Practice in Psychology. Clinical Psychology Science and Practice, 23(3), 239-255. https://www.doi.org/10.1111/cps p.12160
- Ministère de la Santé et des Services sociaux. (2003). Un geste porteur d’avenir. Des services aux personnes présentant un trouble envahissant du développement, à leur famille et à leurs proches (publication no 02-820-01). https://publications.msss.gouv.qc.ca/msss/document-000837/
- Ministère de la Santé et des Services sociaux. (2017). Plan d’action sur le Trouble du Spectre de l’Autisme 2017-2022 : Des actions structurantes pour les personnes et leur famille (publication no 16-824-06W). Récupéré de https://publications.msss.gouv.qc.ca/msss/document-001828/
- Odom, S., Hume, K., Boyd, B. et Stabel, A. (2012). Moving beyond the intensive behavior treatment versus eclectic dichotomy: Evidence-based and individualized programs for learners with ASD. Behavior Modification, 36(3), 270-297. https://www.doi.org/10.1177/01454 45512444595
- Odom, S. L., Boyd, B., Hall, L. et Hume, K. (2010). Evaluation of comprehensive treatment models for individuals with autism spectrum disorders. Journal of Autism and Developmental Disorders, 40, 425-436. https://www.doi.org/10.1007/s10803 -009-0825-1
- Paillé, P. et Mucchielli, A. (2016). L’analyse qualitative en sciences humaines et sociales (4e éd., p. 235-312). Armand Colin.
- Paquet, A., Dionne, C., Joly, J., Rousseau, M. et Rivard, M. (2017). Supervision of Large-Scale Community-Based Early Intensive Behavioural Intervention Programs in Quebec: Description of Practices. Journal on Developmental Disabilities, 23(1), 54-63.
- Rivard, M., Millau, M., Mello, C., Clément, C., Mejia-Cardenas, C., Boulé, M. et Magnan, C. (2020). Immigrant families of children with autism disorder’s perceptions of early intensive behavioral intervention services. Journal on Developmental and Physical Disabilities. https://doi.org/10.1007/s10882-020-09764-8
- Roll-Pettersson, L., Olsson, I. et Ala’i-Rosales, S. (2016). Bridging the research to practice gap: A case study approach to understanding EIBI supports and barriers in Swedish preschools. International Electronic Journal of Elementary Education, 9(2), 317–336.
- Romanczyk, R. G. et Gillis, J. M. (2011). Continuum-based model of behavioral treatment for children with autism: A multi-factor and multi-dimensional perspective. Dans E. A. Mayville et J. A. Mulick (dir.), Behavioral Foundations of Effective Autism Treatment (p. 201-216). Sloan.
- Sandall, S. R., Hemmeter, M. L., Smith, B. J. et McLean, M. E. (2005). DEC recommended practices: A comprehensive guide for practical application in early intervention/early childhood special education. Division for Early Childhood (DEC), Council of Exceptional Children.
- Schertz, H., Baker, C., Hurwitz, S. et Benner, L. (2011). Principles of early intervention reflected in toddler research in autism spectrum disorders. Topics in Early Childhood Special Education, 31(1). 4-21. https://www.doi.org/10.1177/0271121410382460
- Schreibman, L., Dawson, G., Stahmer, A. C., Landa, R., Rogers, S. J., McGee, G. G., Kasari, C., Ingersoll, B., P. Kaiser, A., Bruinsma, Y., McNerney, E., Wetherby, A. et Halladay, A. (2015). Naturalistic developmental behavioral interventions: Empirically validated treatments for autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(8), 2411-2428. https://www.doi.org/10.1007/s10803-015-2407-8
- Shepley, C. et Grisham-Brown, J. (2019). Applied behavior analysis in early childhood education: An overview of policies, research, blended practices, and the curriculum rramework. Behavior Analysis in Practice, 12, 235–246. https://doi.org/10.1007/s40617-018-0236-x
- Stahmer, A. C., Schreibman, L. et Cunningham, A. B. (2011). Toward a technology of treatment individualization for young children with autism spectrum disorders. Brain research, 1380, 229- 239. https://www.doi.org/10.1016/j.brainr es.2010.09.043
- Steinbrenner, J. R., Hume, K., Odom, S. L., Morin, K. L., Nowell, S. W., Tomaszewski, B., ... & Savage, M. N. (2020). Evidence-Based Practices for Children, Youth, and Young Adults with Autism. FPG Child Development Institute.
- Thompson, T. (2011). Individualized autism intervention for young children: Blending discrete trial and naturalistic approaches. Brookes Publishing Co.
- Tomasello, N. M., Manning, A. R. et Dulmus, C. N. (2010) Family-centered early intervention for infants and toddlers with disabilities. Journal of Family Social Work, 13(2), 163-172. https://www.doi.org/10.1080/10522150903503010
- Turnbull, A. P., Turnbull, R., Erwin, E. J., Soodak, L. C. et Shogren, K. A. (2011). Families, professionals, and exceptionality: Positive outcomes through partnerships and trust (6e éd.). Pearson.
- Vivanti, G. (2017). Individualizing and combining treatments in autism spectrum disorder: Four elements for a theory-driven research agenda. Current Directions in Psychological Science, 26(2), 114–119. https://www.doi.org/10.11 77/0963721416680262
- Vivanti G. et Pellecchia M. (2020) Applied behavior analytic approaches to early intervention for children with autism. Dans G. Vivanti, K., Bottema-Beutel et L. Turner-Brown (dir.), Clinical Guide to Early Interventions for Children with Autism. Springer, Cham.
- Waligorska, A., Kucharczyk, S., Waligorski, M., Kuncewicz-Sosnowska, K., Kalisz, K. et Odom, S. L. (2019). National Professional Development Center on Autism Spectrum Disorders (NPDC) model - an integrated model of evidence-based practices for autism spectrum disorder. Psychiatria Polska, 53(4), 753-770. https://www.doi.org/10.12740/PP/99163
- White, C. (2006). The social play record: A toolkit for assessing and developing social play from infancy to adolescence. Jessica Kingsley Publishers.
- Wolf, M. M. (1978). Social validity: The case for subjective measurement or how applied behavior analysis is finding its heart. Journal of applied behavior analysis, 11(2), 203-214. https://doi.org/10.1901/jaba.1978.11-203
- Wong, C., Odom, S. L., Hume, K. Cox, A. W., Fettig, A., Kucharczyk, S., Brock, M. E., Plavnick, J. B., Fleury, V. P. et Schultz, T. R. (2013). Evidence-based practices for children, youth, and young adults with Autism Spectrum Disorder. The University of North Carolina, Frank Porter Graham Child Development Institute, Autism Evidence-Based Practice Review Group. https://www.researchgate.net/publication/340952880_Evidence-Based_Practices_for_Children_Youth_and_Young_Adults_with_Autism
- Zachor, D. A. et Ben-Itzchak, E. (2017). Variables affecting outcome of early intervention in autism spectrum disorder. Journal of Pediatric Neurology, 15(03), 129-133. https://www.doi.org/10.1055/s-0037-1601444
10.7202/1016748ar