by As a psychiatrist and one of the leading specialists in France on autism spectrum disorder (ASD), Frédérique Bonnet-Brilhault He has dedicated his career to expanding the understanding of this neurodiversity, especially in childhood, both in the laboratory and in clinical patient care. Last November she participated in the EDAI Symposium held at CaixaForum Madrid and organized by EDAIentity specialized in neurodevelopment and child and youth mental health and that receives support from the Calls for Social Projects of the La Caixa Foundation.
-The concept of autism spectrum disorder (ASD) has changed over the years. Where are you currently at?
-We know that ASD is due to abnormal brain development during pregnancy and not to issues linked to education or the relationship with parents during childhood, as was thought for a long time. This is something that began to change in the 1980s. We also know that it is due to a combination of genetic and environmental factors. And that each individual will have a specific form of the disorder and a particular trajectory.
-And what is still left to understand this disorder?
-We have not yet been able to develop a pharmacological treatment, especially for the most severe cases. We also do not know how to diagnose autism through biological markers, so the only way is through observation and clinical evaluation. Currently, interventions are more focused on rehabilitation than on drugs, but I believe that in the future we will be able to find at least specific medications to treat specific symptoms. There are several projects already underway.
-His research focuses on the neurophysiological mechanisms of ASD. What progress have they made?
-We work on the identification of the neurophysiological processes that impact the child’s communication skills. We have shown that children with autism process the senses differently: hearing, sight and even touch. That is, their brain perceives the environment differently and, therefore, does not decode social information in the same way as others, such as a face, a look, a tone of voice… This prevents the next step at the level of social development. , which is more complex as it grows.
-And how is this knowledge transferred later in therapy?
-Knowing this we have been able to develop specific therapies through individual sessions in which different interventions are combined to precisely analyze the way in which the child looks at you, listens to you… Thus we can understand the way in which the child patient interprets the world and communicates more effectively with it. This is what we call synchronization at a social level.
-Once this synchronization is achieved, can the patient be helped to interpret the world around them?
-We know that different common social situations can be complicated for a child with ASD, such as being in a classroom with many other children, with noise and constant stimuli, so we prepare them for this with, for example, real videos of that class. Through the use of virtual reality we carry out a progressive immersion, so that they adapt. This way, when he goes to that class he will have more tools to interpret what is happening in his environment and it will be easier for him to manage it.
-It is estimated that about 1% of the population in Spain or France suffers from an autism spectrum disorder. Has the prevalence increased or is it diagnosed better now?
-It is a combination of factors. Diagnosis has improved a lot today, and many forms of autism are included, which is why we talk about the spectrum. This is one reason why the number of people considered to have some form of autism has increased, half of whom are adults. Although we cannot rule out that a small part of this increase is due to environmental issues.
-Is it true that it is more difficult to detect ASD in girls?
-You can observe typical autism in girls or women, but there are clinical forms of the disorder that are more difficult to detect, probably because the camouflage effect or their ability to adapt to their environment is greater. Also because there are traits that are socially more linked to women, for example, shyness. And it is also true that some diagnostic tools have been developed based on the male population.
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-What would you say to parents whose son or daughter has just been diagnosed with ASD?
-I would tell you that the initial diagnosis is a photo, but not fixed, but dynamic. This is the first step in defining the treatment that may work best for your child and will evolve from here. We have more and more boys and girls who follow a positive trajectory thanks to treatment.
