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Adolescence and autism: A difficult, but not hopeless, combination

The challenges that autistic patients face become more pronounced during adolescence, a crucial period when many kinds of social behaviours are developed and when these individuals can become more keenly aware of their relationship difficulties.

A paper by Dr. Eric Fombonne, Head of the Division of Child Psychiatry at the McGill University Health Centre (MUHC), published in the November 2007 issue of the Journal of Autism and Developmental Disorders describes the effectiveness of social skills training groups for autistic adolescents.

"This study shows that the social and interpersonal skills of autistic adolescents can be improved, and we established that our method is efficient and does not require significant resources," said Dr. Fombonne.

Dr. Fombonne organized the first training group in 2002, with his colleagues Jack Strulovitch, social worker at the MUHC, and Vicki Tagalakis, therapist in psychiatry paediatrics at the MUHC. They wanted to address the needs of autistic adolescents who had no major delay in their language development or who were not cognitively challenged (high-functioning autism and Asperger syndrome). Since then the training groups have been running twice a year for 14 sessions, each group involving seven to eight adolescents aged an average of 14.6 years.

The major component of the sessions is role play, which allows the patients to simulate different social situations and create new friendships with other members of the group. Both the adolescents and their parents were asked to fill out peer-validated questionnaires so that researchers can evaluate progress. "These groups were created based uniquely on clinical approach, meaning without the same selection or limitation criteria inherent in research projects. The groups are therefore very representative of what can be done in a classic therapeutic setting," explained Dr. Fombonne.

The study results definitely back up this conclusion, as there was a discernible increase in patients' social skills over the course of the sessions, an improvement that was maintained outside the training groups. This last point proves that behaviour improvement in these patients is not solely tied to the hospital environment. The training has also helped some of the adolescents reduce problems with excessive irritability or sensitivity.

The McGill University Health Centre (MUHC) is a comprehensive academic health institution with an international reputation for excellence in clinical programs, research and teaching. The MUHC is a merger of five teaching hospitals affiliated with the Faculty of Medicine at McGill University--the Montreal Children's, Montreal General, Royal Victoria, and Montreal Neurological Hospitals, as well as the Montreal Chest Institute. Building on the tradition of medical leadership of the founding hospitals, the goal of the MUHC is to provide patient care based on the most advanced knowledge in the health care field, and to contribute to the development of new knowledge.

Isabelle Kling | MUHC
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