Basic principles

1. Early intensive intervention

Early intensive intervention takes account of the cerebral plasticity of the child and the quasi-absence of added handicaps. The aim is threefold: to improve the possibility of limiting the disorganising effect of the handicap on development; to encourage the setting up of appropriate processes; and to inhibit the appearance of secondary handicaps. It is observable to various degrees that the difficulty of being aware of the outside world – because of the difficulties allied to the integration of information arising from the senses, disturbances between the perceived and the emotional structures, the impossibility of setting up communicative exchanges, and of understanding and replying to external appeals – encourages the autistic child to be isolated from the outside world and from relationships.

Through early intensive procedure, we hope that:

– the child will benefit as soon as possible from an early specific educative procedure from the very first observable symptoms.

– the number of sessions and the quality of the support will be high during the first years of infancy, so as to enable qualitative changes in the areas of communication, reciprocal social exchanges, and enrichment of the repertoire of interest.

– In view of the premature nature of the procedure, our programme takes into consideration the global nature of the child within its family environment.

2. Processes integrated within the significant contents

Cognitive education models have the particularity of being centred on processes rather than on the contents. The cognitive education programme for the autistic child also aims at connecting contents with processes in order to encourage the setting up of learning operations that make sense. This integration is essential because it goes in the direction of useful acquisitions in adapting the child, and also increases the likelihood of these being applied in daily life. The strongly activated processes are those to be found at the base of language, structures that enable the operation of learning functions, such as observation, imitation, visual contact, selective attention, emotional regulation, mental processing, direction of aims and logical thought. The approach is directive or semi-directive in order to reduce risks of schematic functions that are ill-adapted to thinking and favour spontaneous approaches by the child. A progressive blurring is set up during each conduct.

3. Active participation of the parents

During the period of early childhood, the first participants to introduce the necessary experiences for the affective development of the child are the parents, and there is no question whatsoever of removing this role from them and breaking this fundamental rule of development. Their participation is indispensable, and it is apposite that the cognitive education programme presents itself as a tool for mediation between the child and its parents. It strives, at the same time, to deliver the tools to the child and to the family, in order to enable them to establish reciprocal and suitable communicative exchanges. The active participation of the parents enables them to obtain practical information, support and advice, in order to be better prepared for responding to the needs of their child. The programme also affords them the opportunity to discuss, express their opinion, mention their concerns and to act as participants and partners in the procedural project.

4. Emotional availability

The common origins of the emotions and the intelligence require these mental processes described as cognitive and these qualities termed emotional to be united (Greenspan 1998). Too frequently moved into the background and generally ignored by the cognitive models, emotions form the powerful vectors of mental organisation that are capable of orienting or blocking the entire mental activity.

Several authors (Adrien, 1996; Bernstein; Shapiro and Herzig, 1993; Dawson and Lewy, 1989; Greenspan 1998; Trevarthen, 1989) have emphasized a basic deficit of emotional expression and regulation in autism. This abnormal emotional action can prevent the autistic child from benefiting from interpersonal reciprocal exchanges, limit its possibility of learning by cooperation, provoke an alteration in the development of certain cognitive functions and impede the production of its spontaneous actions. The appearance of autistic symptoms can therefore be explained, in the first place, by the absence of these indispensable emotional experiences.

The cognitive education programme shares the opinion that emotions are at the base of learning, and that they play a fundamental role in the organisation and development of thought. The activation and regulation of the emotions are necessary, even if they are not sufficient for explaining the disturbed development of intelligence.

The aim of the procedural programme is therefore the observation, consideration and stimulation of the emotions by employing the spontaneous intentions of the child, the state of emotional availability, and the regulation and release of charged emotions. The parent – privileged and indispensable party – plays a decisive role in attaining this objective.

5. Learning to communicate

Learning to communicate is very characteristic of the approach. This principle concerns one of the central elements of autism i.e. the impossibility or difficulty, generally speaking, of entering into contact with others (and the environment). The communicative aspects are taken into consideration very early and continually stimulated. We shall observe the need to work on exchanges in the relationship of a child with two adults, in order to inculcate circles of communication and active language, and to utilise the emotional channel for establishing the first productions and maintenance of language. In addition, we shall ensure, whenever it proves necessary, to avoid focussing too early on verbal language, but rather on the global system of communication, and to employ a progressive communication that includes expression by gesture, the use of objects, pictures or pictograms in order to assist communication.

6. Piloting of conduct

This concerns the principle of the “child pilot”, in which the therapist adopts the secondary but indispensable role of “co-pilot”. This secondary position of the adult is not allied in any way to non-directivity. Quite to the contrary, it favours the orientation of the mental processes that are appropriate for the current action.

The approach enables the maintenance of an elementary level of functioning of the child’s mental activity that is favourable the development of intelligence. The support is adjusted according to the conduct. This work requires a good knowledge of the processes involved in learning and the direct observation of the child’s spontaneous approaches.

7. Conduct appropriate to the goals

This principle is defined by the importance for the child to employ, as far as possible, conduct in harmony with the goals. For this, the adult ensures that the goal is mentally processed by the child he is accompanying in its approaches, and orients or reorients it towards the goal, and supports the appropriate conduct. This may involve assistance in the acceptance of information, support in the participation and maintenance of the regard, being watchful of the attention directed towards relevant elements of the task, and encouraging the regulation and organisation of the actions. The final aim is the employment of conduct that is appropriate for the attainment of a goal.