Tuesday, August 28, 2007

The State of Autism Science in France Could be Better

Just one more example of how bad science, hurts people.

Taken from: HHK online medical/health news:

"A French treatment for autistic children with psychiatric problems which involves wrapping the patient in cold, wet sheets from head to foot is undergoing a clinical trial for the first time, which critics hope will see an end to the controversial practice.

The treatment, known as "packing", involves wrapping a child in wet, refrigerated sheets in order to produce a feeling of bodily limitation and holding, before psychiatrically trained staff talk to the child about their feelings. Critics have called the procedure cruel, unproven and potentially dangerous, but its proponents say they have seen results.

Pierre Delion, is head of the child and adolescent psychiatry unit at Lille Regional University Hospital in northern France, and pioneered the technique, which has its roots in other envelopment or encasement therapies, for example those using mud or clay. He says that packing reinforces childrens' consciousness of their bodily limits, which in some psychiatric conditions becomes fragmented.

Delion says the technique is indicated for severely autistic children who self-harm; psychotic children; and, more rarely, children with anorexia. He has claimed that it often results in a disappearance of self-harming behaviour. The process was brought to France by a US psychiatrist, Michael Woodbury, where it was taken up by the psychoanalytic movement founded by Sigmund Freud, which wields strong influence in French psychiatry.

In developmental psychological theories, "holding" and the sense of the skin's limitations that it brings, is conceived as a key component of the infant's sense of itself and its relationship with its mother. However, this model has been subjected to recent challenges, most notably by the French National Consultative Ethics Committee for Health and Life Sciences, which published a report in 1996 stating that there was no evidence to substantiate psychoanalytic models of autism, nor that therapies based on this model were effective.

The authors were also concerned that, in France, childhood autism was classified as an infantile psychosis, rather than as the now internationally recognised description as a pervasive developmental disorder.At the the Pitié-Salpêtrière Hospital in Paris, where the neurologist Pierre Janet once developed an extensive classification system for psychological disorders, packing is used alongside specialised education and medication for some severely autistic and schizophrenic children.

David Cohen heads the child and psychiatry service at the hospital, and he views packing as a form of bodily mediation like massage, which relaxes the child while he receives psychotherapy. It combines, he says, the body and the image of the body, both of which are crucial to each other for psychological integrity. Experts are awaiting the results of the clinical trial, taking place at Lille, with interest."


Anonymous Anonymous said...

To think that France has the #1 health care system in the world according to the WHO. (I guess that proves autism is not a medical condition :)

7:12 PM  
Blogger Suzanne said...

uughghughgh (shudder) I know I'd hate it!

8:10 PM  
Blogger David N. Andrews M. Ed., C. P. S. E. said...


The French understand autism less well than the Finnish do!

11:08 PM  
Blogger Clara said...

Do you have a link to the original article? I'd like to read it in full.

This is unbelievable...another excuse for bullies to abuse those that can't defend themselves.

I doubt any NTs could enjoy this, much less ASD persons with sensory issues... :(


12:05 AM  
Blogger Maya M said...

In Bulgaria, some grandmothers use absolutely the same method to lower the temperature of a child having fever.
To my opinion, this makes more sense.
Has anybody measured the autistic children's temperature after the "treatment"?

12:13 AM  
Blogger ebohlman said...

That's good ole "attachment therapy", like the kind Candace Newmaker got.

5:03 AM  
Blogger VAB said...

The French are a bit unusual in their approach to psychological well being. It may be of some comfort that they do odd things to everyone who they think could use a mental tweak, and not just autistic people. About one third of the French population takes prescription psychoactive medication. There is also a fondness for homeopathy and all sort of smoke and mirrors nonsense, but it makes them feel good. As to whether or not the recipients like, it, you'd have to ask them, but just because we would not like it given our cultural loading, it does not necessarily follow that they do not.

12:04 PM  
Blogger Interverbal said...

Hi Susan,

Sorry, this story was passed on to me via email, so I don't have the link, nor did a brief Googling uncover it. When I do get the link I will post it in the article.

4:42 PM  
Blogger Interverbal said...

Hi Maya,

I have not heard if anyone takes the child's temperature. I would strongly suspect that they do, otherwise hypothermia would be a potential issue.

4:45 PM  
Blogger Interverbal said...

Hi vab,

Thanks for sharing the information on French psychology.

I was very interested when you said:

"As to whether or not the recipients like, it, you'd have to ask them, but just because we would not like it given our cultural loading, it does not necessarily follow that they do not."

I would like to comment on this point in that I agree that attempting to understand an action within the relevant cultural context has value. I also agree that we should not comment upon what a group of people want, unless we actually ask them.

However, I think it still possible to challenge the ethics of a treatment even if there is informed consent. For an example in the US there is a center that uses skin shock to decrease certain severe behaviors.This center makes it clear that many of the recipients of the shock agree to the treatmnet.

Also, while trying to understand culture is a valuable analysis, I fear that sometimes appealing to culture may become a fallacy of the special plead.

I can easily think of a number of practices common in other cultures, which I would strongly speak against, irregardless of the fact they emerge from another culure.

5:09 PM  
Anonymous Anonymous said...

full text is in the Lancet
You have to register to get full access. But registration is free.

4:27 AM  
Anonymous Anonymous said...

I'd just like to make a comment on the cultural context concerning the approach towards the treatment of autism in France. We all know (WHO) that autism is a neurobiological disorder of genetic origin and NOT a pychiatric illness - thus, autistic children should not be sent to psychiatric institutions where they do not receive appropiate therapy and stimulation using behavioral methods - ABA, Sonrise, Stanley Greenspan, TEACHH etc However the psychiatric lobby in France is very powerful and wealthy so the word 'autism' is never used in diagnosis thus justifying psychiatric treatment - children are not diagnosed early as pediatricians receive no training or info, GP's neither. Change in society starts at the top - strange that in the country of 'liberty, equality and fratenity' autistic children should be maltreated, left unattended to , families suffer and social security pays 400 Euros/half day/per child to ghettoize autistic kids in psychiatric institutions. Things are not set to change either as our head of state is too busy romping in bed with ex-model nymphos and has more 'pressing' preoccupations. THAT is cultural.

3:11 AM  

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