Le devenir des idées en pédopsychiatrie, à travers l’histoire de l’autisme

The history of autism can serve as a model for the understanding of the history of child psychiatry. One can observe the controversies between the inborn or acquired nature of the child psychic troubles, between the primacy of psychiatric care or education, between handicap or disease and about the specificity of the child psychopathology. The 19th century was dominated by the educational model. The goals were, first, to civilize wild children, then to develop by education the mind of idiotics, imbeciles, mentally retarded children, ranged on a one-dimension scale of intellectuel level. At the turn of the century, under the influence of psychoanalysis but also of a more humanistic conception of psychiatry, psychopathology has developed as a new approach, against the pessimistic view of heredity, giving birth to the new concept of infantile autism included in the more general frame of infantile psychosis and fostering the development of various forms of psychotherapy articulated with educative methods. After World War II, in France, the movement of “sector public child psychiatry” has represented a major trend in favor of social and psychological reintegration of abnormal children. Nowadays, parents have received some of psychodynamic theories as a way of making them responsible of their child pathology. They ask for a turn towards mere education and fight against the therapeutic methods. This backward movement may, by neglecting the need for care and therapy, hinder a regard for the emotional life of the child and be detrimental for his/her evolution. Under the pressure of the families exaction, the influence of drug industry, the financial shortage due to economic conditions, child psychiatry is in need of more historical knowledge in order to insure its transmission and its ethics.