Les aléas du suivi orthophonique chez l’adolescent avec autisme : les facteurs influençant sa (non) mise en œuvre

Abstract

ObjectiveThis exploratory qualitative study aims to identify factors influencing orientation, access to speech therapy professionals and its maintenance in adolescents with autism. This was carried out by questioning them about their perceptions of the place and objectives of speech therapy concerning teenagers with autism spectrum disorders in a context where adolescents struggle to benefit from it. Sample and MethodEight child psychiatry professionals including four child psychiatrists, three speech therapists and a psychomotor-therapist took part. These semi-structured interviews have been analyzed using the Interpretative Phenomenological Analysis (IPA). ResultsThe perception of adolescents with ASD as carriers of severe behavioral disorders and unlikely to be e subject to significant clinical changes has an unfavorable influence on the indication for speech therapy at this age. In addition, the management of the shortages in speech therapy is done to the detriment of adolescents in order to prioritize the youngest. Speech therapy follow-ups are experienced as cumbersome with a lack of specific assessments and speech therapy tools for this age. DiscussionCommunication disorders are insufficiently assessed by prescribing professionals who have a more vague representation of the specificities of speech therapy work at this age. In the current situation of speech therapy shortage, speech therapists are torn between the desire to continue to follow an adolescent, whose development potential is not always perceived, and the moral and clinical obligation to take care of toddlers who are generally prioritized. ConclusionThese results reveal the need for more specific speech therapy assessments and tools for adolescents with autism to better target their communication needs and offer more appropriate care. Precise training on the issue of ASD in adolescence would make it possible to consider the diversity of needs and presentations of disorders at this age. Speech therapy monitoring of adolescents with autism raises questions about possible changes in the practice of speech therapy.