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• W302157424 abstract "Depuis longtemps, on a cru que la personne souffrant d’autisme avait une insensibilité ou une analgésie à la douleur. Or les études récentes montrent plutôt un mode d’expression différent face à la douleur en rapport avec les troubles de la communication, du schéma corporel et de certains troubles cognitifs. L’objectif de notre étude est d’évaluer la réactivité d’un enfant autiste à une stimulation légèrement douloureuse dans une situation standardisée où il est en relation duelle avec un adulte. Nous avons mené une étude prospective sur 40 enfants autistes suivis au service de pédopsychiatrie à l’hôpital militaire Avicenne Marrakech. Tous les sujets étaient soumis à un pincement au moyen d’une pince à linge camouflée par la paume de la main de l’examinateur. La réactivité à la douleur a été évaluée par la Grille d’Évaluation Douleur – Déficience intellectuelle (GED-DI). Tous les enfants ont réagi à la douleur, 57,5 % présentaient une douleur modérée à sévère et 42,5 % une douleur légère. L’évaluation de l’expression de la douleur selon les items de l’échelle GED-DI a montré que 95 % des enfants ont réagi par des réactions motrices, 90 % ont réagi par des productions vocales et seulement la moitié des enfants (55 %) ont présenté des expressions faciales. L’analyse du type des réactions motrices et vocales n’orientait pas vers la localisation de la douleur chez la quasi-totalité des enfants. Ces résultats sont en faveur d’une réactivité comportementale à la douleur chez les enfants autistes. It has long been believed that the person with autism had insensibility or analgesia pain. However, recent studies show a different mode of expression of pain associated with disorders of verbal and nonverbal communication, body schema and some cognitive impairment. The aim of our study was to evaluate the reactivity of an autistic child in a slightly painful stimulation in a standardized situation where there is a dual relationship with an adult. We conducted a study, in child and adolescent psychiatry service in Marrakech Avicenne military hospital, on 40 children with autism and mental retardation. The diagnosis of autism was established following a multidisciplinary assessment including placing scale ADIR (Autism Diagnostic Interview Revised) and ADOS (Autism Diagnostic Observation Schedule). Severity of autism was assessed by the scale CARS (Childhood Autism Rating Scale). All subjects were submitted to a pinch with a clothespin camouflaged by the palm of the hand of the examiner. The reactivity to pain was assessed by the NCCPC (Non-Communicating Children's Pain Checklist). Data analysis has objectified the following results: the average age of the children was 4.89 ± 1.04 years with a range of 3.5 years and 7 years. We find that 72.5% of children were male, all children have responded to pain, 57.5% had moderate to severe pain and 42.5% had mild pain. The evaluation of pain according to the severity of autism showed no correlation between the intensity of the pain and the severity of autism (P = 0.745). Another evaluation of the expression of pain according to the items of the NCCPC scores showed that 95% of children responded with motor responses, 90% responded with vocal productions, only half of the children (55%) presented facial expressions and 12, 5% of the children showed physiological indices. The analysis of the type of motor and vocal reactions was not moving toward pain in almost all children (removal or protection of the area of the body affected, the precise location of the painful area are almost absent in our sample). These results are in favor of a different mode of expression of pain in children with autism, the fine and gross motor assessment, voice, facial and physiological responses remains important for better detection of pain in children with autism." @default.
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• W302157424 date "2016-01-01" @default.
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• W302157424 title "Perception de la douleur chez les enfants autistes (étude prospective de 40 cas)" @default.
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