Des agents heureux du progrès. L'éducation morale des parents dans le traitement de l'autisme en France / Happy agents of progress. The moral education of parents in the treatment of autism in France. (original) (raw)

2023, Mathias Winter, PhD defense, Medical anthropology, December 15, ENS Lyon

Happy agents of progress. The moral education of parents in the treatment of autism in France. This thesis examines contemporary changes in child psychiatry in France, through an anthropological study of the treatment of autism spectrum disorders (ASD). It aims to analyze why the moral enhancement of parents is a central and emblematic aspect of therapeutic 'modernity' in the field of ASD. Its methodology combines epistemological history and the ethnography of professional practices. The research focused, on the one hand, on the formation of a globalized cultural frame of reference based on the categories of autism, ASD and Asperger's syndrome, and on its initial reception by French child psychiatry. This first line of research is based on the study of American, British and French psychiatric literature and documents from the second half of the twentieth century. Secondly, an ethnographic study was carried out between April 2016 and September 2019 in several hospital and medico-social care facilities for autistic children and/or their parents. The results are presented in four chapters. The first proposes a genealogy of autism as a cultural frame of reference, linked to an ideal of scientific and social progress. This frame is characterized by three main social uses: an epidemiological categorization of primary socialization, a special pedagogy approach of secondary socialization, and a moral and social mobilization in the perspective of a political epistemology of affects. The second chapter examines the structuring of French child psychiatry around the category of child psychosis from the 1960s to the 1980s, with the aim of elucidating the epistemological and moral obstacles that conditioned the first reception of globalized autism in France. This reception is analyzed in the context of an in-depth study of an international symposium held in Paris in 1985, which marked the start of the 'autism battle' in France. The third chapter focuses on 'therapeutic education' programs which are currently becoming widespread as essential components of autism care, and shows how these programs meet the two-fold objective of repairing and improving the moral and social status of parents. Finally, the fourth chapter examines the principles and implementation of two 'developmental' therapeutic interventions (Early Start Denver Model and Preschool Autism Communication Therapy), both of which involve parents as agents of the child's social development. Both interventions confront professionals with the paradox of attempting to technically modify parental ways of interacting with the child, without affecting their spontaneity. In the context of these interventions, the association between the meticulous objectification of the child's progress and the emotional management of parents makes it possible to characterize a moral economy of efficiency in which the parents are ideally instituted as happy agents of progress. Keywords : Epistemological history ; France ; Medical anthropology ; Child psychiatry ; Autism spectrum disorders ; Moral education ; Progress.