Approches visant à améliorer les soins de santé mentale pour les enfants et les jeunes autistes : une revue systématique et une méta-analyse

Titre original en anglais : Approaches to improving mental health care for autistic children and young people: a systematic review and meta-analysis

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Pemovska, T., Loizou, S., Appleton, R., Spain, D., Stefanidou, T., Kular, A., Cooper, R., Greenburgh, A., Griffiths, J., Barnett, P., Foye, U., Baldwin, H., Minchin, M., Brady, G., Saunders, K. R. K., Ahmed, N., Jackson, R., Olive, R. R., Parker, J.,..., & Johnson, S. (2024). Approaches to improving mental health care for autistic children and young people: a systematic review and meta-analysis. Psychological Medicine, 54(10), 2313-2343. https://doi.org/10.1017/s0033291724001089

Date de publication: 17/05/2024 Ajout dans AutiHub: 06/07/2026 Type: Article Langue de l’article: Anglais
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Auteurs

Auteur·ices des publications
31
Auteur·ices de la publication identifié·es comme autistes
1 / 31 (3,2 %)
  1. Tamara Pemovska
  2. Sofia Loizou
  3. Rebecca Appleton
  4. Debbie Spain
  5. Theodora Stefanidou
  6. Ariana Kular
  7. Ruth Cooper
  8. Anna Greenburgh
  9. Jessica Griffiths
  10. Phoebe Barnett
  11. Una Foye
  1. Helen Baldwin
  2. Matilda Minchin
  3. Gráinne Brady
  4. Katherine R. K. Saunders
  5. Nafiso Ahmed
  6. Robin Jackson
  7. Rachel Rowan Olive
  8. Jennie Parker
  9. Amanda Timmerman *
  10. Suzi J. Sapiets
  11. Eva Driskell
  1. Beverley Chipp
  2. Bethany Parsons
  3. Vasiliki Totsika
  4. Will Mandy
  5. Richard Pender
  6. Philippa Clery
  7. Brynmor Lloyd‐Evans
  8. Alan Simpson
  9. Sonia Johnson

Résumé

Les enfants et les jeunes autistes (CYP) rencontrent des difficultés de santé mentale, mais font face à de nombreux obstacles pour accéder aux soins de santé mentale et en bénéficier. Il est nécessaire d'explorer les stratégies de soins de santé mentale destinées aux CYP autistes afin d'orienter la pratique clinique et les recherches futures et de soutenir leurs besoins en santé mentale. Notre objectif était d'identifier les stratégies utilisées pour améliorer les soins de santé mentale destinés aux CYP autistes et d'examiner les données concernant leur acceptabilité, leur faisabilité et leur efficacité. Une revue systématique et une méta-analyse ont été réalisées. Tous les plans d'étude rapportant des résultats d'acceptabilité ou de faisabilité et les études quantitatives empiriques rapportant des résultats d'efficacité pour des stratégies testées dans le cadre des soins de santé mentale étaient admissibles. Nous avons réalisé une synthèse narrative et des méta-analyses distinctes selon l'informateur (auto-évaluation, parent et clinicien). Cinquante-sept articles ont été inclus, la plupart examinant des interventions fondées sur la thérapie cognitivo-comportementale (TCC) pour l'anxiété, et plusieurs explorant des stratégies au niveau des services, telles que des outils de dépistage de l'autisme, la formation des cliniciens et des adaptations relatives à l'organisation des services. La plupart des articles décrivaient l'implication des aidants dans la thérapie et rapportaient des adaptations de la communication et du contenu de l'intervention ; quelques-uns rapportaient des ajustements environnementaux. Dans les méta-analyses, les résultats rapportés par les parents et les cliniciens, mais non les résultats auto-rapportés, ont montré avec un niveau de certitude modéré que la TCC pour l'anxiété était un traitement efficace, comparativement à toute condition de comparaison, pour réduire les symptômes d'anxiété chez les personnes autistes. Le niveau de certitude des données relatives à l'efficacité, synthétisées de manière narrative, allait de faible à modéré. Les données relatives à la faisabilité et à l'acceptabilité tendaient à être positives. Nombre des stratégies identifiées sont des ajustements simples et raisonnables qui peuvent être mis en œuvre dans les services afin d'améliorer les soins de santé mentale destinés aux personnes autistes. Des lacunes notables dans la recherche persistent toutefois.

Autistic children and young people (CYP) experience mental health difficulties but face many barriers to accessing and benefiting from mental health care. There is a need to explore strategies in mental health care for autistic CYP to guide clinical practice and future research and support their mental health needs. Our aim was to identify strategies used to improve mental health care for autistic CYP and examine evidence on their acceptability, feasibility, and effectiveness. A systematic review and meta-analysis were carried out. All study designs reporting acceptability/feasibility outcomes and empirical quantitative studies reporting effectiveness outcomes for strategies tested within mental health care were eligible. We conducted a narrative synthesis and separate meta-analyses by informant (self, parent, and clinician). Fifty-seven papers were included, with most investigating cognitive behavioral therapy (CBT)-based interventions for anxiety and several exploring service-level strategies, such as autism screening tools, clinician training, and adaptations regarding organization of services. Most papers described caregiver involvement in therapy and reported adaptations to communication and intervention content; a few reported environmental adjustments. In the meta-analyses, parent- and clinician-reported outcomes, but not self-reported outcomes, showed with moderate certainty that CBT for anxiety was an effective treatment compared to any comparison condition in reducing anxiety symptoms in autistic individuals. The certainty of evidence for effectiveness, synthesized narratively, ranged from low to moderate. Evidence for feasibility and acceptability tended to be positive. Many identified strategies are simple, reasonable adjustments that can be implemented in services to enhance mental health care for autistic individuals. Notable research gaps persist, however.

Bibliographie citée par cette référence

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Vue d’ensemble de l’inclusion dans la bibliographie

Ces indicateurs décrivent la bibliographie citée importée pour cette publication. Les métriques de références citées utilisent le total des références citées comme dénominateur. Les métriques d’auteurices cité·es indiquent si elles utilisent toutes les occurrences d’auteurices cité·es ou seulement les occurrences rattachées à des auteurices déjà intégré·es à la base de données AutiHub. Ils utilisent les rattachements mis en cache entre les auteurices cité·es et les auteurices intégré·es à la base de données AutiHub. Dernier calcul : 16/08/2026 11:31.

Références citées
127
Nombre total de références citées intégrées pour cette publication.
Références citées avec un·e auteur·ice identifié·e comme autiste
5 / 127 (3,9 %)
Occurrences d’auteur·ices cité·es identifié·es comme autistes
13 / 768 (1,7 %)
Parmi les occurrences rattachées à des auteurices intégré·es à la base de données AutiHub : 13 / 199 (6,5 %). Auteurices cité·es distinct·es identifié·es comme autistes : 13 / 630 (2,1 %).
Occurrences citées rattachées à la base AutiHub
199 / 768 (25,9 %)
Auteurices cité·es distinct·es rattaché·es : 144 / 630 (22,9 %)
Occurrences rattachées, non identifiées comme autistes
186 / 199 (93,5 %)
Parmi les seules occurrences rattachées. Sur l’ensemble des occurrences d’auteurices cité·es : 186 / 768 (24,2 %). Auteurices cité·es distinct·es rattaché·es, non identifié·es comme autistes : 131 / 144 (91,0 %).
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