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Packing therapy in children and adolescents with autism and serious behavioural problems
J.L. Goeb, F. Bonelli, R. Jardri, G. Kechid, A.Y. Lenfant, P. Delion.
Department of Child and Adolescent Psychiatry, University Hospital
Centre of Lille, Lille, France - European Psychiatry 2008;23(Suppl. 2):S405-S406
Packing therapy is a part of therapeutic approach for children and adolescents with autistic disorder, especially in
the case of self-injurious behaviour, and who do not respond to usual psychotropic drugs or who cannot tolerate them. This method consists in wrapping the patient with his under-clothes
several times a week, using towels previously wet in cold water. The patient is then wrapped with blankets to help the body warm up in a few minutes. Members of staff are always looking
after the patient and are carefully attentive to the quality of the relation with the patient who achieve a greater perception and integration
of his body, and a growing sense of containment.
Self-injurious behaviours have previously been related to pain reactivity in autism. The effectiveness of packing could rest on the mobilization of thermo-algic sensitivity. There is a short-circuit of thepainful sensations on which the child seems to focus his attention.
A sensation, to which the patient has become particularly dependent,is therefore replaced by another type of sensation, which uses the same neuro-physiological pathway.
As there is currently no scientific data available, a randomized,blind and controlled study (supported by the National Grant ‘‘Programme Hospitalier de Recherche Clinique PHRC 2007/1918’’) is taking place to confirm the effectiveness of packing in clinical practice. We have chosen the methodology used to verify the effectivenessof risperidone in children with autism suffering of severe behavioural disorders.
This study should help us specify the therapeutic indicationsof packing in autism.