Italian journal of clinical and psychoeducational research

Scientific Committee: Michele Zappella
Periodicity: january, may, october

Vol. 16, n. 3, 2018

Table of Contents

Ambito internazionale

Hilde De Clercq

The importance of an ethical approach to autism

The following article is a transcript of the speech that Hilde De Clercq gave during the first plenary session of the 6th edition of the «Autismi» Convention, which took place in Rimini on May 4th-5th 2018. Her contribution focuses on the ethical approach to autism, a theory that aims to put emphasis on respect for neurodiversity, on the acknowledgement of different cognitive styles, on the strengths of people with autism rather than on problems, on difficulties and on attempts to medicalise the autism spectrum. Sensory issues and the functioning of senses in people with autism have great relevance here, as these aspects are seen as key to understanding such a condition. Another crucial aspect is the awareness that autism might be seen, and therefore tackled, as a different culture. The goal should thus be to work towards integration and inclusion, which will result in an improvement in the quality of life for people with autism.

Ambito clinico

Michele Zappella

The evolution of the concept of autism

The clinical picture of autism was described 130 years ago and it was given this name and described in detail by Leo Kanner in 1943. Following a period when a precocious dysfunction of the mother-child interaction was inappropriately considered the cause of autism by a number of professionals, in the Seventies studies conducted on twins showed that autism has a neurobiological, often genetic, basis. The myth of autism as a single incurable disease is devastating for families, can misguide professionals, and together with other socio-cultural and economic factors can support the present autism «epidemics» with high prevalence and overdiagnosis. In actual fact, autistic behaviours are present in different neurodevelopmental disorders, usually comorbid with other abnormal behaviour such as language disorders, ADHD, etc., and can have different evolutions, whether spontaneous or following specific treatments. An appropriate differential diagnosis with other syndromes and with clinical pictures where communication is difficult (dyspraxia disorders, language disorders, early onset Tourette syndrome, etc.) is very important for the health of young children.

Ambito clinico

Carlo Ricci Eleonora Mattei

The history of ABA in Italy: Between myths and false beliefs

This paper proposes disproving two false beliefs about the diffusion in Italy of Applied Behaviour Analysis (ABA) with particular reference to interventions on the Autistic Spectrum Disorders (ASD). The first one considers the ABA an innovative intervention which has only recently been included in the rehabilitation field; the second one believes that our country does not have a tradition of this type of intervention. We will show that ABA has a history of over half a century of clinical/rehabilitation practice supported by extensive evidence-based scientific research documentation despite being less widespread and often opposed in our country. Furthermore, the thesis that the history of ABA has evolved symmetrically both in Italy and the US is supported.

Ambito clinico

Maria Luisa Scattoni Giovanna Romano Antonella Costantino Francesco Nardocci Paolo Biasci Mattia Doria Rinaldo Missaglia Federica Zanetto Alberto Villani Susanna Mantovani

Building a child paediatric/neuropsychiatric network. The need for an agreement and objectives

Neurodevelopmental disorders require early diagnosis and prompt therapeutic intervention. Developmental checks, if properly implemented, may be a means of strategic monitoring, ensuring the application of sustainable early recognition strategies. On the 4th November 2017, the National Institute of Health, The Italian Society of Child and Adolescent Neuropsychiatry, with the Italian Federation of Paediatricians, the Cultural Association of Paediatricians, the Union of Family Paediatricians and the Italian Society of Paediatricians, reached an agreement as part of the «National observatory on the monitoring of autism spectrum disorders», in order to encourage the implementation of developmental checks and establish a formal link between paediatrics and child neuropsychiatry all over Italy. The education system is also crucial in a child’s first years and, thanks to the establishment of an integrated 0-6 system, it will now be possible to promote new, more robust professionalism and new local networks also between educators and health workers.

Ambito didattico

Paola Venuti

Autism at school: What should be done and why

In this paper we will investigate the theory and practice of the inclusion process of students with Autistic Spectrum Disorders in a class. We will describe key difficulties that may arise from neurodevelopment alterations. We will highlight behaviours and teaching methods which encourage the participation and inclusion in the class of students with ASDs. In particular, we will discuss the need of a careful observational setup in order to identify personal strengths and weaknesses and accordingly structure the class environment.

Ambito didattico

Lucio Cottini Claudia Munaro Chiara Dalla Vecchia Marialuisa Tonietto Anna Rita Attanasio

Learning to learn with the help of peers. Peer tutoring as a challenge for schools and other educational communities

In order to promote social and civil competences and active citizenship behaviour nationally and at a European and worldwide level, it is essential to create significant, cooperative, supportive learning environments for children, right from day one. Places where each individual can practically experiment with sharing, help and peer-to-peer support. The school is the chosen environment for children and pupils to actively and practically experiment with these values and become peer tutors/learning facilitators for their classmates with difficulties, disorders or disabilities. To this aim, peer tutoring seems a virtuous approach for encouraging inclusive environments where teachers, tutors and tutees can learn to offer a smile, lend a hand, and share space, materials and their time, in a structured setting which is supported by the families. Listening to each other, finding agreement and acting together, each person with their own peculiarities, from the shared perspective of promoting well-being in one’s learning/teaching context and in future society.

The Day Centre for Autism Spectrum Disorders of the ASP (Public Community Services Authority) in Catania carried out, for two school years, two different work-related learning projects with two secondary schools in the city. In the first project, the Day Centre asked the «Fermi-Eredia» Institute to have its students be part of the cast in an adaptation of the Wizard of Oz in the first year and Beauty and the Beast in the second, to be held in their theatre therapy workshop. The aim was to share all phases of the performance preparation, including acting, music, singing, set design, costumes and humanoid robotics (the little robot Nao had to be programmed to act) with the autistic teenagers of the Day Centre. In both cases the project ended with a performance open to the public, highlighting the true integration and inclusion of the two components in the project. In the other project it was the historical Lyceum «Cutelli» of Catania to invite the Day Centre to work on mediation projects between groups from the Lyceum, youths from the «Progetto Pallamica» (focusing on basketball), set up by the Association «Un futuro per l’Autismo Onlus» («A future for autism»), and the advanced technologies, robotics and augmented reality laboratory, active within the Day Centre for Autism Spectrum Disorders of the ASP in Catania. The results regarding participants’ perceptions and the various positive outcomes which were achieved and can be achieved are analysed.

Treating Autism Spectrum Disorders requires health workers, families and schools to share objectives and intervention strategies. Education is the primary treatment for autism and the involvement of natural educators (parents) and professional educators (teachers) is essential. This principle should also be applied in clinical pathways, which, due to the importance of education in treating autism, must also be educational. In Piedmont, the school plays an important role in the implementation of a regional clinical pathway for autism, which is divided into different phases. For children with autism attending nursery school, the phase of treatment defined as «integrated» involves the sharing of objectives and strategies in order to create an individual project. A web platform (Integrated Platform for Autism) has been set up to support this process, allowing the educational project of each child to be shared and information and resources for training to be uploaded to the network.

This article intends to demonstrate the importance of theatrical, artistic and cinematographic experiences in autism. In particular, the theatre-therapy proposals of Lerner (SDARI) and Solari (IDEAS) are analysed with the aim of valorising group psychotherapy with individuals with ASD, in order for them to improve their abilities in expressing the peer interactive competencies they require. These are, in fact, considered in the core of autism according to Laura Schreibman, especially if dealt with from a naturalistic perspective, as also highlighted in the Emotional Interactive Method, which is backed by important scientific research.

Ambito culturale-sociale

Cinzia Raffin

Challenges of adulthood: Not only work

The transition from adolescence to adulthood is marked, for all people, by critical discontinuities we must adapt to through processes of learning and change. There is homogeneity in the perception of what the discontinuities are for the neurotypical population: work, economic and housing autonomy, etc., but to think that also people with autism perceive the answers to such discontinuities as «priorities» in their life, can be an undue projection. In particular, we must emphasise the need for continuous and complete health care, which emerges from surveys where the stakeholders are involved but is often neglected in service planning and in research. The presentation will propose a wide-ranging reflection with respect to the discrepancy between real needs and system responses, also proposing a concrete tool capable of making it easier for people with Autism Spectrum Disorders to face procedures and medical examinations aimed at ensuring their right to prevention and to care.

Ambito culturale-sociale

Flavia Caretto Pietro Cirrincione

Words for describing autism. What terms should be used when you talk about autism and why?

This article takes many different contexts into consideration — the public context, the media, specialist literature, professional language, everyday language and the language of the people involved — in order to support the idea that the way you speak about autism determines inclusion or marginalisation. From a social point of view, it has a bearing on social and economic policies, and, from the point of view of those involved, it determines the way in which the issue is personally faced and the way people feel and behave in relation to their autism and others’ autism. We are putting forward a suggestion for the adoption of language which is acceptable, appropriate and respectful.

Ambito culturale-sociale

Gianluca Nicoletti

My story of intractable brains

As a journalist and father of an autistic child, Gianluca Nicoletti strives for the widespread culture of neurodiversity. Given the profound backwardness of Italy in the area of disability, it appears tough for a country incapable of making a distinction between obsolete approaches and scientific evidence to talk about autism on a uniform basis. No coincidence then that disunity and strife quite often persist among Italian families and associations. Hence, it is not simple to undermine those deep-rooted social biases that deliberately minimise the exact nature of autism, including its most troublesome aspects. In his three novels and a film, Nicoletti has presented his view on the issue of autism, often without the approval of those families of individuals with ASDs who deem his way of talking excessively aggressive and personal. He is currently working on the «Intractable Brains» concept for the dissemination and promotion of cognitive, behavioural, interpersonal, and thoughtful differences that dwell in endless progressions in every possible social environment.