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2018/2019 La Santé Mentale Des Nourrissons Institut De Formation Communautaire 2018/2019 La santé mentale des nourrissons Institut de formation communautaire - Séance 10 - Compréhension des troubles courants de la petite enfance Cette séance est conçue pour offrir un aperçu général des troubles de santé mentale et de développement des nourrissons et de la petite enfance. Bien que seules des cliniciens accrédités tels que des médecins sont autorisés à formuler un diagnostic, la compréhension des troubles les plus courants de la santé mentale et du développement des nourrissons et de la petite enfance peut rehausser aider un praticien à cerner l’état de développement d’un enfant et la façon dont il peut s’écarter d’un développement typique. Cela peut ensuite influencer les types de programmes, d’expériences et d’attentes qui existeront dans les environnements de soins et d’apprentissage pour la petite enfance. Objectifs d’apprentissage 1. Comprendre les préoccupations courantes en matière de santé mentale et de développement des nourrissons et de la petite enfance. 2. Comprendre comment des ressources et des outils tels que DC 0-3 peuvent modifier la prestation de services. 3. Mieux comprendre comment le diagnostic d’un enfant peut être utilisé pour créer des services et des programmes de soins individualisés. Conférencier : Greg Lubimiv, M.S.W., superviseur CACPT Né à Winnipeg, au Manitoba, Greg Lubimiv détient un baccalauréat en travail social de l’Université Laurentienne et une maîtrise en travail social de l’Université de Toronto. Il a oeuvré comme travailleur social dans les Territoires du Nord-Ouest, comme superviseur du bien-être des enfants dans le nord de l’Ontario et, depuis 1981, il est le directeur exécutif du Phoenix Centre, un centre de santé mentale des enfants dans l’est de l’Ontario. Le Phoenix Centre est un organisme dynamique et innovateur bien connu qui a mis sur pied plusieurs programmes populaires tels que le Friends and Neighbours Club Puppet Program et le Rethink Group Program destinés aux jeunes à haut risque et à leurs parents. Greg a développé une expertise dans les domaines du travail familial, de la thérapie par le jeu et des interventions créatives au cours de ses années de travail auprès des enfants et des familles. En 1988, il a obtenu une certification comme thérapeute par le jeu auprès des enfants et superviseur-thérapeute par le jeu de la Canadian Association of Enfant and Play Therapy. Il a depuis développé toute une série d’ateliers dans le domaine de la thérapie clinique et de la thérapie par le jeu. Greg dirige également Transitions, une organisation de pratique privée qui offre une grande variété de services de consultation et de formation liés à la santé mentale et à des questions organisationnelles et communautaires. Le travail de Greg a été reconnu par un certain nombre de prix dont le prix Liz Manson Award (Ontario, 2006), une mention élogieuse du commandant de base (Petawawa, 2007), le prix Monica Herbert Award (CACPT - Canada, 2002). Greg est aussi l’auteur d’un certain nombre de publications, dont deux livres, Wings for Our Children, qui porte sur les éléments essentiels permettant de devenir un thérapeute par le jeu et My Sister Is An Angeline, un livre pour enfants traitant du décès d’un membre de la fratrie. 2018/2019 La santé mentale des Séance 10 nourrissons : Institut de formation communautaire Enjeux, défis et stratégies Greg Lubimiv M.S.W.: C.A.C.P.T.-S [email protected] www.greglubimiv.com Des révisions importantes ont donné lieu à des changements majeurs dans les domaines suivants : - Classification des troubles de la petite enfance - Organisation par catégorie . Troubles . Troubles d’élimination neurodéveloppementaux . Troubles de l’éveil et du . Troubles dépressifs sommeil . Troubles anxieux . Troubles perturbateurs, impulsifs et . Troubles obsessionnels comportementaux compulsifs et connexes . Troubles de la . Troubles relatifs à un communication traumatisme ou au stress . Troubles dissociatifs . Troubles alimentaires Compréhension des troubles courants de la petite enfance_ Greg Lubimiv 1 2018/2019 La santé mentale des Séance 10 nourrissons : Institut de formation communautaire . Trouble de déficience intellectuelle . Trouble du spectre autistique* . Trouble d’alcoolisation fœtale . Trouble du déficit de l’attention/hyperactivité . Troubles moteurs . Traumatisme cérébral . Trouble de la communication, de la parole et du langage Les TSA comprennent désormais : . Le syndrome d’Asperger . Le trouble désintégratif de l’enfance . Le trouble envahissant du développement non spécifié Les troubles du spectre autistique (TSA) désignent : . un spectre de troubles touchant des personnes qui ont des problèmes de communication et d'interactions sociales ainsi que des cycles comportementaux restreints et répétitifs. Les enfants recevant un diagnostic de TSA peuvent être en mesure de fonctionner dans certains domaines du quotidien, alors que d’autres peuvent avoir un fonctionnement très limité. Compréhension des troubles courants de la petite enfance_ Greg Lubimiv 2 2018/2019 La santé mentale des Séance 10 nourrissons : Institut de formation communautaire Les TSA sont caractérisés par : 1. Des déficiences de communication sociale et d'interaction avec les autres. 2. Des comportements, intérêts et activités restreints et répétitifs. Les deux caractéristiques ci-dessus sont indispensables pour un diagnostic de TSA. Sans comportement restrictif et répétitif, le diagnostic deviendrait un trouble de la communication sociale. Aux É.-U., les estimations sont passées de 1 sur 88 à 1 sur 68 enfants (augmentation de 30 %). Cela correspond aux données canadiennes. Un rapport de la base de données épidémiologiques nationale pour l’étude de l’autisme au Canada publié en 2012 révélait une augmentation du nombre de diagnostics d’autisme à l’Île-du-Prince-Édouard, à Terre- Neuve-et-Labrador et dans le sud-est de l’Ontario. Les augmentations variaient de 39 à 204 %, en fonction de la région et du groupe d’âge. Elle concerne tous les groupes d'origine raciale, ethnique et socio- économique. 4,5 fois plus courant chez les garçons (1 garçon sur 42 contre 1 fille sur 189) . Un débat relatif à la cause de l’augmentation est en cours, et de nombreux chercheurs constatent que l’élargissement de la définition, l’amélioration de la formation et la précision des diagnostic en sont probablement à l’origine. Aucune conclusion n’a encore été tirée. 46 % des enfants ayant actuellement un diagnostic de TSA ont un QI moyen ou supérieur à la moyenne. De récentes études canadiennes et des É.-U. ont fait l’étonnante révélation que les enfants de groupes socio- économiques inférieurs ont des taux de diagnostic inférieurs – l’hypothèse très probable est que ces groupes ont accès à moins de services de dépistage et de traitement de l’autisme. L’étude canadienne, par exemple, indiquait qu’environ un enfant sur 100 reçoit un diagnostic de TSA, mais les médecins pensent que cela ne signifie pas que moins d’enfants ont un trouble qu’aux États-Unis. Compréhension des troubles courants de la petite enfance_ Greg Lubimiv 3 2018/2019 La santé mentale des Séance 10 nourrissons : Institut de formation communautaire . Les recherches étasuniennes et canadiennes indiquent que l’âge moyen du diagnostic de TSA est environ 4 ans et demi, bien qu’il existe des tests fiables permettant de détecter les troubles dès l’âge de 2ans. Les experts indiquent que les diagnostics précoces permettent d'apporter des traitements plus intensifs plus tôt, ce qui permet d’atténuer les symptômes des TSA.. Jeu inhabituel avec des jouets ou objets. Routines et préoccupation rigides avec routines et rituels. Difficultés de transition (associées au besoin de routine) . Le trouble de traitement sensoriel, qui est un problème de traitement des stimulations sensorielles comme le son, le toucher et le mouvement peuvent entraîner une hypersensibilité aux stimuli sensoriels. Problèmes de régulation des humeurs (souvent la colère ou l’anxiété) . Capacité à suivre les règles et lois, ainsi qu'une bonne compréhension de ce qui dépend des règles et lois (Baron-Cohen, 2003). Capacité à se concentrer sur les objets plutôt que les personnes, ce qui aide certaines personnes atteintes du TSA à très bien réussir dans des domaines tels que la science, l’ingénierie, l'informatique. De plus, de nombreuses personnes du TSA ont des intérêts dans d’autres domaines tels que les arts, la musique, le théâtre, et les sciences sociales, entre autres. Capacité d’attention prolongée, même sur des tâches que d’autres personnes trouveraient ennuyeuses ou vaines. Capacité à rester objectif, et ne pas être affecté par la « pression des pairs » ou l’opinion des autres (p. ex. les enfants sur le spectre des troubles autistiques sont bien moins influencés par les pairs en matière de mode ou de pression pour essayer les drogues) Compréhension des troubles courants de la petite enfance_ Greg Lubimiv 4 2018/2019 La santé mentale des Séance 10 nourrissons : Institut de formation communautaire . Mémoire visuelle. De nombreuses personnes ont une mémoire visuelle exceptionnelle (voir « photographique », c’est-à-dire, une capacité à se souvenir de ce qu’ils ont vu). Ces fortes compétences de visualisation (la capacité à prendre des photos mentales) peuvent être utiles en ingénierie, conception et autres domaines visuels. Mémoire auditive et verbale. Plutôt qu’une mémoire visuelle cependant, de nombreuses personnes ayant le syndrome d’Asperger peuvent avoir une mémoire auditive exceptionnelle (c.-à-d. retenir ce qu’ils entendent). De fortes compétences verbales peuvent aider de futurs professionnels tels que des écrivains, éditeurs, guides touristiques ou conférenciers... De fortes compétences « analytiques » ou de raisonnement logique, qui peuvent être utiles en comptabilité, ingénierie et informatique... Connaissance approfondie des domaines d'intérêts, ce qui peut les aider à devenir des experts dans leur domaine d'intérêt. Forte éthique de travail . Interventions relatives aux compétences sociales et aux compétences de vie . Interventions fondées sur le langage et la communication . Interventions sensorielles et motrices .
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