Remédiation cognitive et fonctionnement scolaire chez les enfants avec trouble du spectre autistique

Abstract

IntroductionAutism Spectrum Disorder (ASD) is known to be associated with Cognitive impairment, especially executive dysfunction. Cognitive Remediation Therapy (CRT) is a rehabilitation method aiming to produce improvement in cognitive processes by teaching information processing strategies through guided mental exercises. CRT has been used in patients with schizophrenia. Taking into account the overlap between ASD and schizophrenia, we aimed in this study to examine the effectiveness of CRT for cognitive flexibility, inhibition and school results in children with ASD. MethodsChildren meeting the Diagnostic and Statistical Manual for Mental Disorders (DSM-5) criteria for ASD were recruited from a clinical population at the Child and Adolescent Psychiatry Department in Razi University Hospital, Manouba, Tunisia. The CRT program was conducted at the rate of one session per week of 45minutes each. The outcome measures were cognitive flexibility (by the mean of phonemic and semantic fluency), inhibition (using either Hayling Sentence Completion Task or Colors and Animals Attention Test [CAAT]), and school performance (assessed by school results). These outcomes were measured at baseline and one week after completion of the treatment. ResultsOf the 25 patients included, 16 achieved assessments tests after CRT, thus constituting our final sample. Their average age was 10.87 years. The average number of the performed sessions was 22.38. For semantic fluency, the mean score in “animals” category was 13.94 before CRT and 17 after it (P=0.045). Concerning the “clothes” category, the mean score increased from 10.47 to 12 after completion of the program. As for phonemic fluency scores, patients displayed significant improvement (P=0.032). Patients committed more repetitive and intrusive errors, an increase significant only on the “clothes” category. After achievement of the CRT program, a significant improvement was also shown on school results (P=0.001). Concerning inhibition tests, patients showed no significant improvement. ConclusionThe findings provide support for the effectiveness of CRT for enhancing executive functions in children and adolescents with ASD. Further studies are required to examine the durability of CRT effects in these children.