[Psychosocial rehabilitation applied to children]

Based on a developmental approach, psychosocial rehabilitation (PSR) for children assumes that a combination of factors points to problems and, as for adults, focuses on recovery. It does not depend solely on the child but on a process involving supportive adults. Recovery in children supports the hope of the parents and builds a new form of parenthood to cope with the child's disability. To optimize psychosocial abilities of a child with a neurodevelopmental disorder (NDD), a personalized assessment and early interventions are needed. Promoting parental skills is the key to preventing additional disabilities. Several stakeholders (education system, healthcare, social services, family support, child protection services) must be involved for inclusion and psychosocial risk management. Three psychological theories emphasized developmental needs which depend on chronological age, environmental context, and the brain's inhibitory capacity. A fourth theory suggests the need for a cultural-eco-social approach. For adults supporting a child with an NDD, psychoeducational approaches include therapeutic education; and peer support will foster empowerment. The recent presence of family peer caregivers included within the healthcare teams provides parents with complementary and different support, bringing hope. Through regional platforms, PSR brings together neuropsychologists, nurses, rehabilitation and socio-educational professionals, and school or work integration managers. The principles of a PSR day hospital for adults are well known, but specifications for the organization of child and adolescent PSR day hospitalization are needed. Day care programs need to use validated interventions whose effectiveness should be assessed. They must promote school inclusion and the autonomy of both parents and children. Psychoeducation and therapeutic patient education (TPE) sessions are applied. A neurocognitive assessment of pre- and post-treatment determines and assesses the objectives of the intervention. The interventions consist of workshops focusing on social skills, executive functions, and emotional regulation. A psychosocial intervention plan is developed collaboratively with the parents, and a review of the objectives is annually conducted. To conclude, psychosocial rehabilitation for children is not yet consensual, and its effectiveness still needs to be evaluated. It is a demanding model due to the assessments it requires, their repetition, and the need of parental support that must foster empowerment. The approaches take into account advances in scientific knowledge of children's cognitive development. These approaches must evolve rapidly and be highly personalized. They are aimed at both parents and healthcare partners. As with adults, health policy must promote the use of psychosocial rehabilitation and encourage the training of professionals in this area.