Autism in France

Launch of autism strategy in 2018.

The history of autism in France is marked by the strong influence of psychoanalysis, and by the persistence of institutionalization practices that violate the fundamental rights of autistic people. According to estimates at the end of 2016, 0.7 to 1% of the French population has an autism spectrum disorder, most of which is undiagnosed, leading to varying degrees of disability.

Before the first intervention and medical definition initiatives, autistic people – often likened to idiots or, in the image of Victor of Aveyron, "wild children" – were probably very marginalized and victims of serious violence. The first steps were taken in the 1950s, notably by Professor Roger Misès, who set up day hospitals and devised the French classification of mental disorders in children and adolescents (CFTMEA – classification française des troubles mentaux de l'enfant et de l'adolescent). Interest in autism grew following the publication of Bruno Bettelheim's The Empty Fortress (1967) and his lectures in France in the 1970s. The first government measures in this area were taken in the 1990s by Simone Veil. At the beginning of the 21st century, the French psychiatric approach – which equated autism with a mental illness caused by poor parenting, and advocated placement in a specialized institution – was challenged by parents' associations, who referred the matter to the Council of Europe, because of the social exclusion it led to for autistic children, and the blame placed on parents by the medical profession. This led to autism being classified as a disability, and to the introduction of new measures via four "Autism Plans" in the years 2000 and 2010. These led to creating an Autism Resource Centre in each region of France. The old classification of autism as a psychosis is gradually being abandoned in favor of the concept of autism spectrum disorder (ASD), which is present in international classifications and takes account of the contribution of neuroscience and the development of individuals in society. The Autism Plans recommend increasing school enrolment rates for children, as well as employment for adults. However, in a report to be published in March 2019, the ONU is calling on France to embark on a genuine policy of deinstitutionalization.

The team at the CHRU in Tours was a pioneer in the study of autism, thanks in particular to the work of Gilbert Lelord and, more recently, Catherine Barthélémy. Thomas Bourgeron and Laurent Mottron, who work in Quebec, are also among the French researchers whose work is internationally recognized. Parents of autistic children have spoken out in public debates or autobiographies, including Olivia Cattan, Danièle Langloys, and Francis Perrin. More recently, autistic people such as Josef Schovanec have spoken out in support of neurodiversity in the face of the medical model. Associations that have historically been active in this field include Autisme France, Sésame Autisme and Association for research into autism and the prevention of maladjustment in France (ARAPI – Association pour la recherche sur l'autisme et la prévention des inadaptations).

The treatment of autism in France is a source of much tension, particularly on the question of intervention, which pits supporters of a behavioral approach, represented by parents associations and certain cognitivist scientists, against those who use a psychoanalytical frame of reference, and the movement for the rights of autistic people. Specifically French practices, such as the frequent use of the word "autistic" as an insult and the overmedication with neuroleptics, are a source of exclusion and suffering for the people concerned, who are affected by numerous social difficulties such as dropping out of school and unemployment. Recent research recommends building on the specific interests of people with autism to promote an inclusive society.