Validation d’une situation de stimulation suscitant des comportements stéréotypés et des intérêts restreints chez le jeune enfant autiste
Restricted interests and repetitive behaviours constitute one of the three core domains of symptoms required for an autism spectrum diagnosis. However, the detection of these behaviours in clinical practice remains limited by the lack of validated instruments designed to elicit these behaviours during clinical assessment. Moreover, a lack of clear operational definitions of target behaviours limits the generalisation of findings amongst studies and its application to clinical practice.      The aim of this thesis is to document the occurrence and quality of restricted interests and repetitive behaviours in young autistic children and to develop a validated stimulating play situation that can readily be use to elicit target behaviours in clinical assessments.   Preliminary steps documented the various restricted interests and repetitive behaviours as well as the objects likely to trigger these behaviours in children with autism using a questionnaire completed by experts in the field. The list of the most common behaviours was used to build the observational rating scale based on operational definitions of the restricted interests and repetitive behaviours. The main part of this study was to develop a stimulating play situation designed to elicit restricted interests and repetitive behaviours through exposure to specific objects previously identified as potential triggers. This situation documented, through detailed observation, restricted interests and repetitive behaviours most commonly found in autism during infancy. Validation of the stimulating play situation consisted in exposing twenty one (21) autistic experimental subjects and twenty four (24) typically developing control subjects, aged from 24 to 72 months, matched for chronological and developmental non-verbal age.  Results demonstrate sufficient sensitivity of  the stimulating play situation to accurately detect restricted interests and repetitive behaviours as well as objects of interest in children with autism. Autistic children differ from typically developing children on the amount and duration of restricted interests and repetitive behaviours, significantly for: hand flapping, hand and fingers posturing, hopping, putting finger in mouth, putting objects in mouth, putting object in movement, and visual exploration. Regarding which objects were explored, a greater proportion of autistic participants played with the hammer and balls toy and did so more frequently and for a longer period of time than typical children.   This study is the first to use a systematic observation protocol to document restricted interests and repetitive behaviours and objects of interest in autism during early childhood. This new instrument could ultimately be used in the identification of young autistic children as part of the diagnostic or screening assessment.
questionnaire autism coding system object of interest perceptual properties preschool-aged children questionnaire restricted interest and repetitive behaviour stimulating play situation