(Rivista Internazionale - December 1998: The French Hospitaller Works Help Autistic Adults - 1/2)

Health

The French Hospitaller Works Help Autistic Adults

Sallanches. The Notre-Dame de Philerme - Casa Guelpa Longo - Centre. An autistic patient is assisted by the Order’s medical personnel.

Autism, a profound and permanent disability, is characterised by a considerable difficulty in achieving a normal communication with one’s own environment. "Autistic children suffer their environment without managing to organise it, to perceive what is socially congruous and to "arrange it" in objects perceived outside it. They live in a world of states in which there are neither subjects nor objects, nor actions of one on the other, nor even less exchanges"*. In France, autism affects 80,000 people and four or five children out of every 10,000 births. Males are affected four times more than females and the disorder shows onset before 30 months. There have been various hypotheses on the causes of autism over the last fifty years.
During the last twenty years the most frequent are based on the psychodynamic model, which considers that a child who is totally normal at birth can develop symptoms because of inadequate parental behaviour. However, over and above the search for the etiologic causes of autism, the essential problem is establishing what we, hospital workers, can offer both those who are affected by this disorder and their families. Because, sadly, no one yet can claim to cure autism, and autistic children become autistic adults: a third will remain mute and totally dependent, a third will have a limited language and partial autonomy, albeit with the need of almost constant assistance, and a third, finally, will develop some kind of language and a "good" autonomy which will enable them to work in "sheltered workshops", or even in restaurants or libraries and lead a semi-independent life (Laxer and Ritvo, 1983).

Sallanches. One of the activities of the Individualised Educational Project planned by multidisciplinary medical and paramedical personnel with contribution of parents.

Two tailor-made institutes
Today, French legislation for the disabled permits autistic children to be given a specific and adequate education. However, after the child grows up, there is a serious lack of suitable structures. Despite the existence of specialised institutes for the young and, from 1989, their insertion in integrated classes, nothing more is envisaged for autistic children when they reach 18 years of age. The only future for these "big children", whose progress can only occur slowly and in suitable surroundings, is the psychiatric hospital or at home with isolated and defenceless parents. This cruel absence of both public and private structures has prompted the French Hospitaller Works of the Order of Malta to assist, at the beginning of the Nineties, the most excluded of all. Since then, two residential centres have been established, with 12 and 14 places respectively. The first was inaugurated in Rochefort-sur-mer (Charente Maritime) in 1996, the second opened its doors in Sallanches (Haute Savoie) in 1997.
The architecture and functioning of both these structures have been carefully studied bearing in mind the specificity of the autistic person, whose three commonly recognised behavioural characteristics are the incapacity to develop social relationships, major deficits in language development and bizarre ways of responding to the environment, with gestural stereotypes and resistance to change.
In the majority of cases, autistic children also have a low intellectual quotient and their development, slower than that of other children, to a great extent continues after they have become adults. Over and above these common signs, what mainly characterises individuals affected by autism is their extreme heterogeneity, since the same symptoms are expressed in very different ways and with different levels of importance.

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