TDAH et TED-NAS (non autrement spécifique)
À la frontière du TDAH, face aux colères explosives, sans motif apparent,
devant des comportements souvent hermétiques, à une fabulation extrême avec
personnages hétéroclites qui se parlent peu, il y a une exploration digne de
mention, celle des troubles envahissants du développement, dits TED-NAS (non
autrement spécifiques).
Dans le manuel du DSM IV, il existe à peine 7 lignes (sur 850 pages) sur le
sujet, dans ce chapitre complexe, comme pour manifester l'intérêt d'un lieu de
passage, d'une pathologie réelle, même si discrète et toutefois bien présente et
bien capable de causer des dégâts.
C'est dire qu'il faut s'éloigner des classifications rigides, des causalités
fermées, comme supposer qu'il y a une génétique pour le TDAH, une autre pour
l'autisme, une autre pour la dépression, l'anxiété.
Depuis quelques années, des professionnels ont développé une expertise qui
tente au mieux de cerner la réciprocité affective, le besoin de l'autre, la
pertinence des réponses, dans un contexte donné.
L'ADOS
(Autism Diagnostic Observation Schedule) permet une
évaluation standardisée, à travers les âges, sur les niveaux de développement et
les capacités de langage. À cet exercice périlleux, l'expert doit être bien
formé, expérimenté, sans doute travaillé avec des pairs et à la fin, avoir un
bon jugement clinique.
http://portal.wpspublish.com/portal/page?_pageid=53,70384&_dad=portal&_schema=PORTAL
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Autism Diagnostic Observation Schedule
(ADOS)
by Catherine Lord, Ph.D., Michael Rutter, M.D., FRS, Pamela C. DiLavore,
Ph.D., and Susan Risi, Ph.D. |
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This semi-structured
assessment can be used to evaluate almost anyone suspected of
having autism--from toddlers to adults, from children with no
speech to adults who are verbally fluent. |
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The ADOS
consists of various activities that allow you to observe social
and communication behaviors related to the diagnosis of
pervasive developmental disorders. These activities provide
interesting, standard contexts in which interaction can occur. |
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The ADOS
consists of four modules, each requiring just 35 to 40 minutes
to administer. The individual being evaluated is given just one
module, depending on his or her expressive language level and
chronological age. Following guidance provided in the manual,
you select the appropriate module for each person. Module 1 is
used with children who do not consistently use phrase speech,
Module 2 with those who use phrase speech but are not verbally
fluent, Module 3 with fluent children, and Module 4 with fluent
adolescents and adults. The one group within the autism spectrum
that the ADOS does not address is nonverbal adolescents and
adults. |
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Modules 1
and 2 require you and the child to move around the room. Modules
3 and 4, both of which involve more conversation, can be
administered at a table. Activities included in Modules 1 and 3
are listed below: |
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Module
1 |
Module
3 |
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Free Play |
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Construction
Task |
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Response to Name |
Make-Believe
Play |
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Response to
Joint Attention |
Joint
Interactive Play |
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Bubble Play |
Demonstration
Task |
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Anticipation of
a Routine With Objects |
Description of a
Picture |
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Responsive
Social Smile |
Telling a Story
from a Book |
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Anticipation of
Social Routine |
Cartoons |
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Functional and
Symbolic Imitation |
Reporting a
Non-Routine Event/Conversation |
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Birthday Party |
Emotions |
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Snack |
Social
Difficulties/Annoyance |
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Break |
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Friends/Loneliness/Marriage |
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Creating a Story |
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These
activities provide a 30- to 45-minute observation period full of
opportunities for the examinee to exhibit behaviors relevant to
a diagnosis of autism or PDD. As you administer the ADOS, you
record your observations, then code them later and formulate a
diagnosis. Cut-off scores are provided for both the broader
diagnosis of PDD/atypical autism/autism spectrum, as well as the
traditional, narrower conceptualization of autism. |
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Offering standardized materials and ratings,
the ADOS gives you a measure of autism spectrum disorder that is
unaffected by language. Because it can be used with a wide range
of children and adults, it is a cost-effective addition to any
hospital, clinic, or school that serves individuals with
developmental disorders.
The ADOS/ADI-R/SCQ unlimited-use scoring CD allows you to
score all three of these important assessments using just one
computer scoring program. The CD provides all of the algorithm
scoring functions of the ADOS and ADI-R (use the standard paper-and-pencil
administrations for the ADOS (W-365A) and ADI-R (W-382A), and
then enter the responses into the computer program for rapid
scoring). For the SCQ, use the CD to quickly score paper-and-pencil
administrations using the PC Answer Sheet (W-381D or W-381E), or
take advantage of convenient onscreen administration. |
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Claude Jolicoeur
2007, ®