Pubmed du 02/04/20

jeudi 2 avril 2020

1. Abbeduto L, Berry-Kravis E, Sterling A, Sherman S, Edgin JO, McDuffie A, Hoffmann A, Hamilton D, Nelson M, Aschkenasy J, Thurman AJ. Correction to : Expressive language sampling as a source of outcome measures for treatment studies in fragile X syndrome : feasibility, practice effects, test-retest reliability, and construct validity. J Neurodev Disord. 2020 ; 12(1) : 11.

In the original publication of this article [1], the author name Leonard Abbeduto was misspelled as Leonardkk Abbeduto. The original article has been corrected.

Lien vers le texte intégral (Open Access ou abonnement)

2. Aravamudhan S, Awasthi S. Behavioral Interventions to Treat Speech Sound Disorders in Children With Autism. Behavior analysis in practice. 2020 ; 13(1) : 174-85.

Children with autism are at a higher risk of being affected by speech disorders and often require remedial intervention. Eikeseth and Nesset (Journal of Applied Behavior Analysis, 36(3), 325-337, 2003) used sufficient-response exemplar training of vocal imitation in conjunction with prompting, chaining, and shaping procedures to successfully teach 2 typically developing children to articulate several Norwegian words with blends. The present study extends and adapts these procedures to children with autism. Participants were TA, an 11-year-old boy, and KS, a 15-year-old girl, both with autism and speech sound disorders. For each participant, 3 sets of 10 words with specific blends in the initial position were targeted for training. Vocal imitation training with within-stimulus prompts was used for both participants. For KS, lip-tongue-teeth position prompts and chaining were added during the training of certain words. A multiple-baseline across-behaviors (word sets with target blends) design demonstrated improvement in the articulation of trained words and generalization of correct articulation to untrained words with both participants. The findings suggest that speech sound disorders in children with autism can be addressed with behavioral interventions.

Lien vers le texte intégral (Open Access ou abonnement)

3. Belisle J, Dixon MR, Alholai A, Ellenberger L, Stanley C, Galliford M. Teaching Children with Autism to Tact the Private Events of Others. Behavior analysis in practice. 2020 ; 13(1) : 169-73.

We evaluated the efficacy of a most-to-least intrusive error-correction/prompting procedure for teaching 3 children with autism to tact the private events of others through publicly accompanying stimuli. Participants did not reliably demonstrate correct tact responses to publicly observable stimuli that accompany common emotions reported by others (e.g., bandage = hurt) in baseline. Procedures were taken from the Promoting the Emergence of Advanced Knowledge Relational Training System : Direct Training Module (PEAK-DT) to aid in clinical replication, and training was introduced in a multiple-baseline design. Results showed that the procedures were efficacious in teaching this skill to each of the participants, and fast rates of acquisition were observed.

Lien vers le texte intégral (Open Access ou abonnement)

4. Blair BJ, Blanco S, Ikombo-Deguenon F, Belcastro A. Sex/Gender Phenotypes and the Diagnosis and Treatment of Autism Spectrum Disorder : Implications for Applied Behavior Analysts. Behavior analysis in practice. 2020 ; 13(1) : 263-9.

Research has consistently reported a higher rate of autism spectrum disorder (ASD) diagnoses in males than in females, but until recently, the impact of sex/gender differences has received little attention from applied behavior analysts. The underlying reasons for the difference in rates of diagnosis could be related to genetic or hormonal differences, sociocultural expectations of behavior based on sex/gender norms, or biases built into the assessment and observation of ASD symptoms. It is necessary to engage in further discussion and research in order to improve the treatment and quality of life of persons with ASD because misdiagnosis or late diagnosis can delay the start of early intervention and limit its proven benefits. Furthermore, differences in symptom presentation can impact interventions selected. We suggest that applied behavior analysts should be knowledgeable of these issues and the implications they may have on the field of applied behavior analysis in general.

Lien vers le texte intégral (Open Access ou abonnement)

5. De Simone R, Butera A, Armida M, Pezzola A, Boirivant M, Potenza RL, Ricceri L. Beneficial Effects of Fingolimod on Social Interaction, CNS and Peripheral Immune Response in the BTBR Mouse Model of Autism. Neuroscience. 2020.

Autism Spectrum Disorders (ASD) are neurodevelopmental disorders characterized by social communication deficits and repetitive/stereotyped behaviours. We evaluated the effects of a chronic treatment with the immunomodulator drug Fingolimod (FTY720 - a non-selective Sphingosine 1-Phosphate Receptor ligand) in an ASD model, the BTBR T(+)tf/J (BTBR) mouse strain. In adult BTBR males, chronic FTY720 treatment (4weeks) increased social and vocal response during a male-female interaction and hippocampal expression of BDNF and Neuregulin 1, two trophic factors reduced in BTBR when compared to control C57 mice. FTY720 also re-established the expression of IL-1beta and MnSOD in the hippocampus, whereas it did not modify IL-6 mRNA content. In addition to its central effect, FTY720 modulated the activation state of peripheral macrophages in the BTBR model, both in basal conditions and after stimulation with an immune challenge. Furthermore, IL-6 mRNA colonic content of BTBR mice, reduced when compared with C57 mice, was normalized by chronic treatment with FTY720. Our study, while indicating FTY720 as a tool to attenuate relevant alterations of the BTBR neurobehavioural phenotype, emphasizes the importance of gut mucosal immune evaluation as an additional target that deserve to be investigated in preclinical studies of anti-inflammatory therapeutic approaches in ASD.

Lien vers le texte intégral (Open Access ou abonnement)

6. Fisher K, Robichaux C, Sauerland J, Stokes F. A nurses’ ethical commitment to people with intellectual and developmental disabilities. Nursing ethics. 2020 : 969733019900310.

Aim : This article explores the issues of knowledge deficits of healthcare professionals in meeting the needs of people with IDD throughout the life span, and to identify factors that contribute to these deficits. Although statistics vary due to census results and the presence of a "hidden population," approximately 1%-3% of the global population identify as living with an intellectual or developmental disability. People with intellectual or developmental disability experience health inequities and confront multiple barriers in society, often related to the stigma of intellectual or developmental disability. Disparities in care and service are attributed to a lack of knowledge and understanding among healthcare providers about people with intellectual or developmental disability, despite their increased risk for chronic health problems. The near absence of educational programs in nursing both nationally and internationally contributes to this significant knowledge deficit. In addition, ethical considerations between paternalistic beneficence and idealized autonomy have resulted in a lack of clear direction in working with a population that is often ignored or exploited. Nurses who view people with intellectual or developmental disability as vulnerable without assessing or acknowledging their capabilities may err toward paternalism in an effort to "first do no harm." Likewise, nurses who fail to recognize the challenges and limitations faced by people with intellectual or developmental disability may not provide sufficient protections for a vulnerable person. People with intellectual or developmental disability are not binary, but rather complex individuals with a myriad of presentations. This article seeks to encourage a well-informed model of nursing care. Through an ethical lens, this article explores the nurse’s ethical commitments in cases of victimization, access to care, decision making, and the provision of optimal end-of-life care for people with intellectual or developmental disability.

Lien vers le texte intégral (Open Access ou abonnement)

7. Gardner L, Campbell JM. Law Enforcement Officers’ Preparation for Calls Involving Autism : Prior Experiences and Response to Training. J Autism Dev Disord. 2020.

Highly publicized interactions between law enforcement officers (LEOs) and individuals with autism spectrum disorder (ASD) have raised questions about LEOs’ training related to ASD. In the present study, 157 LEOs participated in ASD-specific training and completed pretest and posttest surveys of autism knowledge, confidence, and self-monitoring. The majority of LEOs responded to calls involving someone with ASD in the last year, with 20% of these calls resulting in involuntary psychiatric hospitalization. LEO knowledge of ASD, self-confidence in responding to calls, and self-monitoring of performance increased from pretest to posttest. Compared to male counterparts, female officers were less likely to use force and handcuffs when responding to ASD-related calls. Female officers’ self-confidence increased significantly more than male officers.

Lien vers le texte intégral (Open Access ou abonnement)

8. Jager-Hyman S, Maddox BB, Crabbe SR, Mandell DS. Mental Health Clinicians’ Screening and Intervention Practices to Reduce Suicide Risk in Autistic Adolescents and Adults. J Autism Dev Disord. 2020.

Autistic individuals experience elevated risk for suicide ideation, attempts, and deaths. Little is known about how clinicians assess risk or intervene with suicidal autistic individuals. We surveyed 121 clinicians about use of suicide prevention practices with autistic and non-autistic clients. Clinicians reported greater self-efficacy in screening for suicide risk among non-autistic clients (p = 0.01). There were no statistically significant differences in whether they used standardized screening measures or in their reported normative pressure or attitudes towards screening. Clinicians reported similar rates of use of Safety Planning, an evidence-based suicide-prevention strategy, across groups, but greater acceptability for non-autistic clients (p < 0.001). These findings have implications for strategies to increase clinicians’ adoption of these tools for autistic individuals.

Lien vers le texte intégral (Open Access ou abonnement)

9. Jannati A, Block G, Ryan MA, Kaye HL, Kayarian FB, Bashir S, Oberman LM, Pascual-Leone A, Rotenberg A. Continuous Theta-Burst Stimulation in Children With High-Functioning Autism Spectrum Disorder and Typically Developing Children. Frontiers in integrative neuroscience. 2020 ; 14 : 13.

Objectives : A neurophysiologic biomarker for autism spectrum disorder (ASD) is highly desirable and can improve diagnosis, monitoring, and assessment of therapeutic response among children with ASD. We investigated the utility of continuous theta-burst stimulation (cTBS) applied to the motor cortex (M1) as a biomarker for children and adolescents with high-functioning (HF) ASD compared to their age- and gender-matched typically developing (TD) controls. We also compared the developmental trajectory of long-term depression- (LTD-) like plasticity in the two groups. Finally, we explored the influence of a common brain-derived neurotrophic factor (BDNF) polymorphism on cTBS aftereffects in a subset of the ASD group. Methods : Twenty-nine children and adolescents (age range 10-16) in ASD (n = 11) and TD (n = 18) groups underwent M1 cTBS. Changes in MEP amplitude at 5-60 min post-cTBS and their cumulative measures in each group were calculated. We also assessed the relationship between age and maximum cTBS-induced MEP suppression (DeltaMEPMax) in each group. Finally, we compared cTBS aftereffects in BDNF Val/Val (n = 4) and Val/Met (n = 4) ASD participants. Results : Cumulative cTBS aftereffects were significantly more facilitatory in the ASD group than in the TD group (P FDR’s < 0.03). DeltaMEPMax was negatively correlated with age in the ASD group (r = -0.67, P = 0.025), but not in the TD group (r = -0.12, P = 0.65). Cumulative cTBS aftereffects were not significantly different between the two BDNF subgroups (P-values > 0.18). Conclusions : The results support the utility of cTBS measures of cortical plasticity as a biomarker for children and adolescents with HF-ASD and an aberrant developmental trajectory of LTD-like plasticity in ASD.

Lien vers le texte intégral (Open Access ou abonnement)

10. Jungade S. Manual physical therapy as a novel treatment modality for Autism spectrum disorder - A pilot study. Journal of complementary & integrative medicine. 2020.

Background Autism spectrum disorders (ASDs) fall under neurodevelopmental disorders and are characterized by impaired social interaction and communication, restricted interests, and repetitive behaviors. The current available treatments aim at functional rehabilitation with resultant partial improvement in few and the persistent handicap in rest of them. Manual physical therapy or manual manipulation therapy has the basis in structural rehabilitation of the patient and has been proposed to act by both peripheral and central mechanisms. Case presentation To study improvement in different components of ASD by manual physical therapy, the therapy comprised of soft tissue therapy, in the form of myofascial release (MFR) of deep fascia of leg and foot muscles. The child with ASD, treated by manual physical therapy had global improvement in all the deficits. Conclusions This is probably first case of autism reported to have almost complete symptom resolution, with any single form of treatment and this form of therapy holds promise in integrative and holistic management of the patient.

Lien vers le texte intégral (Open Access ou abonnement)

11. Kumari D, Sciascia N, Usdin K. Small Molecules Targeting H3K9 Methylation Prevent Silencing of Reactivated FMR1 Alleles in Fragile X Syndrome Patient Derived Cells. Genes. 2020 ; 11(4).

In fragile X syndrome (FXS), expansion of a CGG repeat tract in the 5’-untranslated region of the FMR1 gene to >200 repeats causes transcriptional silencing by inducing heterochromatin formation. Understanding the mechanism of FMR1 silencing is important as gene reactivation is a potential treatment approach for FXS. To date, only the DNA demethylating drug 5-azadeoxycytidine (AZA) has proved effective at gene reactivation ; however, this drug is toxic. The repressive H3K9 methylation mark is enriched on the FMR1 gene in FXS patient cells and is thus a potential druggable target. However, its contribution to the silencing process is unclear. Here, we studied the effect of small molecule inhibitors of H3K9 methylation on FMR1 expression in FXS patient cells. Chaetocin showed a small effect on FMR1 gene reactivation and a synergistic effect on FMR1 mRNA levels when used in combination with AZA. Additionally, chaetocin, BIX01294 and 3-Deazaneplanocin A (DZNep) were able to significantly delay the re-silencing of AZA-reactivated FMR1 alleles. These data are consistent with the idea that H3K9 methylation precedes DNA methylation and that removal of DNA methylation is necessary to see the optimal effect of histone methyl-transferase (HMT) inhibitors on FMR1 gene expression. Nonetheless, our data also show that drugs targeting repressive H3K9 methylation marks are able to produce sustained reactivation of the FMR1 gene after a single dose of AZA.

Lien vers le texte intégral (Open Access ou abonnement)

12. LaLonde KB, Jones S, West L, Santman C. An Evaluation of a Game-Based Treatment Package on Intraverbals in Young Children with Autism. Behavior analysis in practice. 2020 ; 13(1) : 152-7.

The purpose of the current study was to evaluate a game-based treatment package on the acquisition of intraverbals in young children with autism. The treatment package was composed of using a listener response training game (i.e., bingo), providing verbal praise that contained the label for the listener response, and modeling a pretend play action related to the answer. During posttreatment probes, participants vocally answered wh- questions without any supplementary stimuli present and maintained responses during follow-up probes.

Lien vers le texte intégral (Open Access ou abonnement)

13. Leaf JB, Cihon JH, Ferguson JL, Milne CM, Leaf R, McEachin J. Advances in Our Understanding of Behavioral Intervention : 1980 to 2020 for Individuals Diagnosed with Autism Spectrum Disorder. J Autism Dev Disord. 2020.

There are three branches of science of behavior analysis [i.e., experimental analysis of behavior, behavior analysis, and applied behavior analysis (ABA)]. ABA can be defined as a systematic approach to understanding behavior of social interest. For the past 40 plus years, researchers have evaluated ABA and ABA based procedures (e.g., behavioral intervention) as they relate to individuals diagnosed with autism spectrum disorder (ASD) and have implemented behavioral intervention in clinical settings for individuals diagnosed with ASD. In this paper, we discuss some of the pivotal contributions in the field of ABA in research and clinical practice. Additionally, we provide recommendations for the science and clinical practice of behavioral intervention in the next 40 years.

Lien vers le texte intégral (Open Access ou abonnement)

14. Liu H, Zimmerman AW, Singh K, Connors SL, Diggins E, Stephenson KK, Dinkova-Kostova AT, Fahey JW. Biomarker Exploration in Human Peripheral Blood Mononuclear Cells for Monitoring Sulforaphane Treatment Responses in Autism Spectrum Disorder. Sci Rep. 2020 ; 10(1) : 5822.

Autism Spectrum Disorder (ASD) is one of the most common neurodevelopmental disorders with no drugs treating the core symptoms and no validated biomarkers for clinical use. The multi-functional phytochemical sulforaphane affects many of the biochemical abnormalities associated with ASD. We investigated potential molecular markers from three ASD-associated physiological pathways that can be affected by sulforaphane : redox metabolism/oxidative stress ; heat shock response ; and immune dysregulation/inflammation, in peripheral blood mononuclear cells (PBMCs) from healthy donors and patients with ASD. We first analyzed the mRNA levels of selected molecular markers in response to sulforaphane ex vivo treatment in PBMCs from healthy donors by real-time quantitative PCR. All of the tested markers showed quantifiability, accuracy and reproducibility. We then compared the expression levels of those markers in PBMCs taken from ASD patients in response to orally-delivered sulforaphane. The mRNA levels of cytoprotective enzymes (NQO1, HO-1, AKR1C1), and heat shock proteins (HSP27 and HSP70), increased. Conversely, mRNA levels of pro-inflammatory markers (IL-6, IL-1beta, COX-2 and TNF-alpha) decreased. Individually none is sufficiently specific or sensitive, but when grouped by function as two panels, these biomarkers show promise for monitoring pharmacodynamic responses to sulforaphane in both healthy and autistic humans, and providing guidance for biomedical interventions.

Lien vers le texte intégral (Open Access ou abonnement)

15. O’Connor MT, Belisle J, Stanley CR, Dixon MR. Establishing Multiple-Control Responding of Children with Autism to People and Emotions in Context by Utilizing Derived Stimulus Relations. Behavior analysis in practice. 2020 ; 13(1) : 192-6.

This study evaluated the efficacy of a set of procedures in evoking responding under multiple stimulus control (identifying emotions when provided a person and context) in a match-to-sample arrangement. Three participants with autism achieved a mastery criterion following direct training of the target relations, and two of the participants additionally demonstrated derived relations without direct training (identifying people when provided an emotion and context). Corrective procedures were effective in promoting the emergence of derived relations for the third participant. These data suggest that incorporating derived stimulus relation training and testing procedures may have utility for clinical interventions in children with autism.

Lien vers le texte intégral (Open Access ou abonnement)

16. Ozdemir M, Ilgin C, Karavus M, Hidiroglu S, Luleci NE, Ay NP, Sarioz A, Save D. Adaptation of the Knowledge about Childhood Autism among Health Workers (KCAHW) Questionnaire : Turkish version. Northern clinics of Istanbul. 2020 ; 7(1) : 40-8.

OBJECTIVE : Many checklists and scales have been developed to diagnose the autism spectrum disorder in childhood. However, self-applied questionnaires/scales that can be filled out by health professionals for assessing their knowledge and consciousness of this disorder are still limited. The Knowledge about Childhood Autism among Health Workers self-administered survey was developed by Bakare et al. in 2008. This survey was recruited by many study groups in developing countries. In these countries, knowledge regarding childhood autism is inadequate within community healthcare professionals. METHODS : In our study, the agreed-upon Turkish version of the questionnaire was distributed to the 61 primary care physicians working in Maltepe District of Istanbul Province for the adaptation and validation. RESULTS : The internal consistency coefficient (Kuder-Richarson coefficient of reliability-KR20) of the measurements attained from the Turkish version of the questionnaire was 0.70. The split- half reliability analysis demonstrated that the Guttman Split-half value was 0.84. According to the principal factor analysis of the tetrachoric correlation matrix, the three factors with the highest Eigenvalues were associated with (i) Relatively easy clinical observations, (ii) the signs which require a longer observation time and detailed anamnesis, and (iii) the signs, which require detailed examination and observation. The factors explained cumulatively 65.98% of the total variance. CONCLUSION : The findings obtained in this study showed that the adapted questionnaire addressed in the scope of this study is a valid measure for Turkish society.

Lien vers le texte intégral (Open Access ou abonnement)

17. Sanchez MJ, Constantino JN. Expediting clinician assessment in the diagnosis of autism spectrum disorder. Dev Med Child Neurol. 2020.

AIM : To investigate a novel observational rating protocol designed to expedite clinical diagnosis of autism spectrum disorder (ASD). METHOD : Two hundred and forty patients referred to a tertiary autism center (median age 8y 9mo, 2y 6mo-34y 8mo ; 188 males, 52 females) were rated using an adaptation of the Childhood Autism Rating Scale, Second Edition (CARS-2) based exclusively on patient observation (CARS-2(obs) ). Scores were compared to expert diagnosis of ASD, parent-reported Social Responsiveness Scale, Second Edition (SRS-2) and, in a selected subset of patients, the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2). RESULTS : CARS-2(obs) distinguished patients with a clinical diagnosis of ASD from those with non-ASD neuropsychiatric disorders (mean score=18 vs 11.7, p<0.001). Severity ratings on the CARS-2(obs) correlated with the ADOS-2 (r=0.68, rho=0.64) and SRS-2 (r=0.31, rho=0.32). A CARS-2(obs) cutoff point equal to or greater than 16 demonstrated 95.8% specificity and 62.3% sensitivity in discriminating individuals with ASD from individuals without ASD. INTERPRETATION : The CARS-2(obs) allows the rapid acquisition of quantitative ratings of autistic severity by direct observation. Coupled with parent/teacher-reported symptoms and developmental history, the measure may contribute to a low-cost diagnostic paradigm in clinical and public health settings, where positive results might help reduce delays in diagnosis, and negative results could prompt further specialty assessment. What this paper adds The Childhood Autism Rating Scale, Second Edition based on patient observation distinguished individuals with versus without autism spectrum disorder (ASD). A score equal to or greater than 16 on this assessment showed high specificity for a diagnosis of ASD.

Lien vers le texte intégral (Open Access ou abonnement)

18. Thomas EM, DeBar RM, Vladescu JC, Townsend DB. A Comparison of Video Modeling and Video Prompting by Adolescents with ASD. Behavior analysis in practice. 2020 ; 13(1) : 40-52.

Video-based instruction has been effective in teaching a range of skills, including functional living skills, to individuals with autism spectrum disorder. Few studies have compared the efficacy and efficiency across video modality-specifically, comparing video modeling to video prompting. Consequently, practitioners have little empirical guidance when selecting between procedural variations of video-based instruction. Using an adaptive alternating-treatments design with a baseline, we evaluated the comparative effectiveness of point-of-view video modeling and video prompting on the percentage of meal preparation tasks completed correctly and on-task behavior with 4 adolescents with autism spectrum disorder. We found video modeling to be effective and efficient in the acquisition of meal preparation skills across 3 of the 4 participants. Across participants, video prompting resulted in more errors than video modeling did. Skills generalized to an untrained location and were maintained at a 3-week follow-up. Stakeholders reported procedures, goals, and outcomes as socially valid.

Lien vers le texte intégral (Open Access ou abonnement)

19. Westby C. Screen Time and Children with Autism Spectrum Disorder. Folia phoniatrica et logopaedica : official organ of the International Association of Logopedics and Phoniatrics (IALP). 2020 : 1-8.

BACKGROUND : Research is increasingly raising concerns regarding the negative consequences of children’s use of screens. SUMMARY : This article reviews the literature on the benefits and risks of screen time with attention to explaining possible reasons that children with autism are more at risk for the negative effects of screen time. Based on the science of learning literature, a framework for choosing appropriate digital media for children with autism is described. The 3-component framework considers the characteristics of the child, the context in which digital media are used, and the content of the media. Key Message : Using the framework, the speech-language pathologist will be better able to select appropriate digital media content for children with autism that is engaging (while not being distracting), encourages the child to be actively involved with the media, is meaningful in the child’s life, and incorporates social interactions with others.

Lien vers le texte intégral (Open Access ou abonnement)

20. Williams H, Stanley CR, Belisle J, Dixon MR. Evaluating the Emergence of the Transformation of Stimulus Function through Representational Drawing in Children with Autism. Behavior analysis in practice. 2020 ; 13(1) : 186-91.

The present study aimed to evaluate the utility of representational drawing as an alternative to selection-based responses for evaluating the emergence of the transformation of stimulus function. Two children with autism were initially taught relations among pictures, arbitrary symbols, and arbitrary words. Nonreinforced tests were also conducted to evaluate the possibility of a transformation of stimulus function across stimuli when presented with a generative drawing task. The results suggested that both participants responded at high accuracy following initial training and also were able to transform the functions of these training stimuli such that novel drawings that were never reinforced actually emerged under extinction conditions. These data add to the body of literature supporting the utility of exposing children with autism to applied behavior-analytic interventions that incorporate derived relational responding as a target operant, and this generalized operant also is capable of a transformation of stimulus function.

Lien vers le texte intégral (Open Access ou abonnement)


Accès direct au catalogue en ligne !

Vous pouvez accéder directement au catalogue en ligne du centre de documentation du CRA Rhône-Alpes en cliquant sur l’image ci-dessous :

Cliquez pour consulter le catalogue

Formations pour les Familles et les Proches

le détail des programmes de formation à l’attention des familles et des proches de personnes avec TSA est disponible en cliquant sur l’image ci-dessous.

Formation pour les Aidants Familiaux {JPEG}

Sensibilisation à l’usage des tablettes au CRA !

Toutes les informations concernant les sensibilisations du CRA aux tablettes numériques en cliquant sur l’image ci-dessous :

1-Formation à l’état des connaissances de l’autisme

Plus d’information sur la formation gratuite que dispense le CRA en cliquant sur l’image ci-dessous :

Formation à l'état des connaissances de l'autisme {JPEG}

4-Accéder au Livret Autisme Auvergne Rhône-Alpes (LAARA)

Prenez connaissance du Livret Autisme Auvergne Rhône-Alpes, projet de répertoire régional des structures médico-sociales. En cliquant sur l’image ci-dessous :

Cliquer pour accéder au LAARA