ObjectivesCommunity-based early autism intervention programs in Geneva, Switzerland, converted their in-person services to a telehealth format during the COVID-19 home confinement period. The current study was aimed at measuring the engagement and satisfaction of service providers and caregivers as they experienced telehealth services for the first time and at monitoring child progress.MethodsForty-five families from diverse backgrounds and their 45 service providers had daily videoconferencing sessions of primarily parent-mediated intervention. Satisfaction questionnaires were completed at three time points over a 2-month period. Session frequency and program participation were recorded. Caregiver and service provider’s answers were compared. Results were also analyzed by family annual income. Child progress was monitored using the Early Start Denver Model Curriculum Checklist.ResultsCaregivers and service providers maintained high levels of participation and satisfaction throughout the telehealth service period and appreciated how the telehealth format allowed them to meet more frequently. Lower-income families tended to be more unanimously positive about the services when compared with mid- and high-income families. We found significant group differences in service providers’ and caregivers’ perceptions of each other’s comfort level with the remote sessions. Child progress followed a pattern of continued significant improvement across most developmental domains during the telehealth service period.ConclusionsThese findings underscore the potential of telehealth as a promising and appreciated approach for delivering intensive early autism interventions in community settings. Further research is needed to determine optimal session frequency for remote parent-mediated intervention and to determine ways to make telehealth services more accessible for low-income families.

Psychotic disorders are one of the main causes of chronic disability in young people. An at-risk mental state (ARMS) is represented by subclinical symptoms that precede the first episode of psychosis (FEP). The PsyYoung project aims to optimize the detection of an ARMS while reducing unnecessary psychiatric treatments. It investigates the effects of service changes on the referrals and outcomes of young people with ARMS or a FEP. Six psychiatric outpatient clinics in three cantons (Basel-Stadt, Vaud, and Geneva) participated in the project. They passed through an implementation phase including service changes and the adaptation of a standardized stepped care model for diagnosis and assessment, in addition to measures for increasing the awareness, networking and training of local professionals. All participating cantons had entered the implementation phase. By March 2023, there were 619 referrals to participating sites. A total of 163 patients (37% FEP and 31% ARMS) and 15 close relatives had participated in individual longitudinal assessments, and 26 patients participated in qualitative interviews. This national collaborative project addresses the issue of early intervention for emerging psychoses, and creates spaces for fruitful reflections and collaboration in Switzerland. The ultimate aim of PsyYoung is to harmonize clinical practices in early intervention of psychosis on a national level.

Si les enfants adoptés souffrent pour la plupart de difficultés cognitives, le surinvestissement des parents adoptifs, souvent nourri par un fantasme de réparation, permet, dans bon nombre de situations, une récupération des capacités intellectuelles. Dans ce texte, je vais étudier la situation clinique d’un enfant adopté présentant un trouble de comportement et d’hyperactivité, supposé à haut potentiel par ses parents. L’idéalisation parentale de leur enfant élu, focalisée sur ses capacités de réflexion et sa maturité semblerait, d’une part, aider à entretenir ces troubles dans une boucle rétroactive et, d’autre part, à scotomiser les traumatismes vécus par leur enfant. Dans le cas de cet enfant et de sa famille, les questions des origines et celle du savoir semblent s’être mêlées puis emmêlées sans solution.

Emotional prosody results from the dynamic variation of language’s acoustic non-verbal aspects that allow people to convey and recognize emotions. The goal of this paper is to understand how this recognition develops from childhood to adolescence. We also aim to investigate how the ability to perceive multiple emotions in the voice matures over time. We tested 133 children and adolescents, aged between 6 and 17 years old, exposed to 4 kinds of linguistically meaningless emotional (anger, fear, happiness, and sadness) and neutral stimuli. Participants were asked to judge the type and intensity of perceived emotion on continuous scales, without a forced choice task. As predicted, a general linear mixed model analysis revealed a significant interaction effect between age and emotion. The ability to recognize emotions significantly increased with age for both emotional and neutral vocalizations. Girls recognized anger better than boys, who instead confused fear with neutral prosody more than girls. Across all ages, only marginally significant differences were found between anger, happiness, and neutral compared to sadness, which was more difficult to recognize. Finally, as age increased, participants were significantly more likely to attribute multiple emotions to emotional prosody, showing that the representation of emotional content becomes increasingly complex. The ability to identify basic emotions in prosody from linguistically meaningless stimuli develops from childhood to adolescence. Interestingly, this maturation was not only evidenced in the accuracy of emotion detection, but also in a complexification of emotion attribution in prosody.

Jasmine, a member of American high society, finds herself suddenly pennyless after her husband is involved in several fraudulent financial transactions. Desperate, she seeks refuge with her sister who lives in a disadvantaged environment and tries to rebuild her life as best she can. She does not adapt well to her loss of status and struggles to reconstruct herself and move forward.

RationaleTransition in psychiatry refers to the period where young people transit from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). Discontinuity of care during this period is well-documented but little is known about provisions and transition characteristics and policies across Switzerland. The aim of this article is to describe the architecture of public mental health providers in Switzerland and compare it to EU countries.MethodTwo mapping surveys, developed previously for European countries, were adapted and sent to cantonal experts: the adapted European CAMHS Mapping Questionnaire (ECM-Q) assessing the architecture and functioning of CAMHS and the adapted Standardized Assessment Tool for Mental Health Transition (SATMeHT) to map CAMHS-AMHS interface.ResultsData were gathered from six cantons. Activity data and transition policies were comparable between Swiss regions and European countries. The percentage of young people below 19 years who were in care was above 2% in every responding canton with a higher proportion of boys than girls for patients <12 years of age. The transition occurred at the age of 18 years, civil majority, in each canton, and between 0 and 24% (3/7) and 25% and 49% (4/7) of young people were expected to transition. One canton (1/7) benefitted from written guidelines, at the CAMHS level only, regarding transition but none had guidelines for mapping CAMHS/AMHS interface even at the regional level.ConclusionDespite the availability of resources and even if the possibilities of access to care are on average higher than in many European countries, issues regarding transition remain comparable in six Swiss cantons when compared to Europe. Meaning that beyond resources, it is the coordination between services that needs to be worked on. Importantly, implementing those changes would not require investing financial resources but rather working on the coordination between existing teams.

In response to a Covid-19 period of home-confinement, autism early intervention programs in Geneva, Switzerland, converted their in-person services to a telehealth format. Forty-five families received daily videoconferencing sessions of primarily parent-implemented intervention. Questionnaires were completed at three time points. Child progress was monitored using the Early Start Denver Model Curriculum Checklist. Parents maintained high levels of participation and satisfaction, regardless of socio-economic or cultural background, with the majority reporting an improvement in their use of intervention techniques. Child progress followed a pattern of continued significant improvement across most developmental domains. Findings suggest that a more frequent dosage of parent-implemented intervention than typically studied is not only feasible, but appreciated by caregivers, especially when delivered via the time-saving videoconferencing format.

Abstract Background: Emotional prosody is the result of the dynamic variation of acoustical non-verbal aspects of language that allow people to convey and recognize emotions. Understanding how this recognition develops during childhood to adolescence is the goal of the present paper. We also aim to test the maturation of the ability to perceive mixed emotions in voice. Methods: We tested 133 children and adolescents, aged between 6 and 17 years old, exposed to 4 kinds of emotional (anger, fear, happiness, and sadness) and neutral linguistic meaningless stimuli. Participants were asked to judge the type and degree of perceived emotion on continuous scales. Results: By means of a general linear mixed model analysis, as predicted, a significant interaction between age and emotion was found. The ability to recognize emotions significantly increased with age for all emotional and neutral vocalizations. Girls recognized anger better than boys, who instead confused fear with neutral prosody more than girls did. Across all ages, only marginally significant differences were found between anger, happiness, and neutral versus sadness, which was more difficult to recognize. Finally, as age increased, participants were significantly more likely to attribute mixed emotions to emotional prosody, showing the progressive complexification of the emotional content representation that young adults perceived in emotional prosody. Conclusions: The ability to identify basic emotions from linguistically meaningless stimuli develops from childhood to adolescence. Interestingly, this maturation was not only evidenced in the accuracy of emotion detection, but also in a complexification of emotion attribution in prosody.

En psychiatrie, la transition désigne le passage des services de soins pour enfants et adolescents aux services pour adultes. Cela se produit vers l’âge de 18 ans (majorité civile) dans la plupart des pays du monde. Bien qu’il soit indéniable que les besoins des enfants soient différents de ceux des adultes, cette barrière artificielle de l’âge chronologique pose des problèmes pour une continuité optimale des soins. La croissance n’est, en effet, pas uniforme dans le temps et l’âge développemental ainsi que la maturation cérébrale jouent un rôle crucial dans l’autonomisation des individus. Ceci impacte alors la transition qui peut ainsi être sous optimale et conduire à une discontinuité thérapeutique, lors du passage d’un service à l’autre. Ces jeunes, dépourvus de soins, reviennent parfois des années plus tard dans des situations plus chroniques que s’ils avaient eu une continuité thérapeutique. Il semble urgent de changer les politiques et d’adapter les soins psychiatriques aux nouvelles découvertes sur le développement du cerveau qui se poursuit tout au long de la vie plutôt que de se focaliser uniquement sur un âge chronologique. Cette adaptation contribuerait à diminuer les déficits de soins.