Article

À propos du suivi psychanalytique d’un jeune enfant autiste dans un dispositif de soins au Japon

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Résumé Introduction Nous présentons la première étude de cas d’un enfant franco-japonais de moins de six ans résidant au Japon et recevant un traitement psychanalytique. Diagnostic L’enfant a présenté de nombreux symptômes altérant la communication et les relations sociales avant deux ans, tels qu’un retard de langage, des stéréotypies, une absence de contact visuel, un retrait relationnel, et a reçu le diagnostic d’autisme et de déficience intellectuelle. Intervention thérapeutique L’enfant et a été suivi depuis ses deux ans à une fréquence de deux séances de 45 minutes par semaine, associé aux interventions de deux volontaires qui ont assuré un rôle de soutien psychoéducatif. Apports de l’étude Nous détaillons la nature de son monde interne ainsi que la manière dont le contexte japonais et pandémique a limité ses progrès. L’étude de cas révèle la quasi-absence de prévention et de traitement de l’autisme, au Japon, pour les enfants d’âge préscolaire, ainsi que la difficulté des établissements homologués par l’Agence pour l’enseignement du français à l’étranger (AEFE) à accueillir les personnes avec autisme. D’un point de vue psychanalytique, l’étude de cas est une contribution originale s’appuyant sur le corpus théorico-clinique de l’école française menée par Geneviève Haag et la CIPPA, en contexte japonais. Conclusions Le Japon doit développer des actions de prévention des troubles du spectre autistique en formant les professionnels et en identifiant le risque chez les bébés dès l’âge de six mois. Un rapport sur l’accueil des personnes handicapées au sein des établissements homologués par l’AEFE est urgent et doit inclure les parents, y compris ceux des enfants qui ont été contraints à la déscolarisation. La durée du traitement des demandes à la MDPH est excessivement longue : dans le cas présent, aucune réponse après deux ans et une perte du dossier circulant entre les services consulaires et la MDPH. La prise en charge de l’autisme infantile précoce est globalement dominée depuis des décennies par les approches comportementales et psycho-éducatives. Elle doit aujourd’hui s’associer davantage à un questionnement sur le monde interne, des hypothèses et des outils développés par une école psychanalytique française encore trop méconnue sur le plan international, spécialement au Japon.

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