A hundred people took part on November 26 in the first interprofessional day of the Coordination and Orientation Platform, Neurodevelopmental Disorders of Vaucluse (PCO-TND 84), created in March. This new device of the regional health agency (ARS) Paca is carried by the center of early medico-social action (CAMSP) of the hospital center of Avignon. It accompanies some 160 children domiciled in the department.

“Our mission is aimed at children from 0 to 6 years of age who show warning signs of neurodevelopmental disorders but for whom there is no diagnosis yet”, explains Rebecca Perez, coordinating neuropsychologist. For example, if parents are worried about a delay in language, motor skills, learning or relationships with others in their child, they can consult a doctor, who will now be able to refer them to BCP.

“We can remunerate liberal professionals who do not fall within the framework of reimbursement of care by Social Security so that there is no remainder to be borne by families”, continues Rebecca Perez. “The goal is to facilitate access to care because very often the financial issue is a brake,” she adds. About forty occupational therapists, psychologists and psychomotor therapists have already been agreed with the PCO, which can pay them “early intervention packages”.

“We would have support within more court deadlines than in structures such as CMPPs or CMPEAs (medico-psycho-pedagogical centers for children and adolescents, editor’s note) where there is a one to two-year wait”, adds Sandrine Del Aguila, childcare worker, manager, coordinator. “You can’t leave children at that age with evolving brains without care. The earlier we act, the better the prognosis,” she adds.

According to their prevalence (5 to 10%), neurodevelopmental disorders represent 350 new cases per year in the Vaucluse. L’ARS Paca finances the core team of the PCO-TND 84 to the tune of €200,000 per year. The latter will soon be joined by social assistance which will be able to help families to compile an MDPH file (Departmental House of Disabled People) and finance the continuation of care via the education allowance for disabled children (AEEH) if necessary.

2,500 children supported in the region

In Paca, 2,500 children were accompanied by the six BCP of the region – one per department –, the first of which was created in the Var in 2019. In the Bouches-du-Rhône, a second is in the process of starting up at the Aix-Pertuis intermunicipal hospital center, like that supported by the Valvert hospital center in Marseille. “We are starting to see the fruits and the effectiveness of this system”, welcomes Sandrine Bonjardini, regional referent for autism and neurodevelopmental disorders at ARS Paca.

In the Vaucluse, the majority of files (38%) are sought by doctors from Maternal and Child Protection (PMI), ahead of general practitioners (20%) and pediatricians (17%). “PMI doctors free up time to meet families, do initial check-ups for children, refer them to PCO and participate in coordination because this is a priority for inclusive education”, underlines Dr Isabelle Chomy, doctor head-PMI. “The particularity of the PMI is that it intervenes early, from pregnancy, including at home and it sees 90% of school children for the health check-up at school for 3-4 year olds”, continues- she.

In her area, Morières-lès-Avignon, Le Pontet, Vedène and Saint-Saturnin-lès-Avignon, Dr. Catherine Curutchet, a PMI doctor, is already monitoring around twenty children. “We are appointed referring doctor, which is very time-consuming,” she explains. “We are supposed to accompany the child until the end of his journey, until he is 7 years old, whereas we are authorized to take care of children from 0 to 6 years old. As such, she must make medical prescriptions, check regularly with families to find out where they are and participate in multidisciplinary consultation meetings (RCP).

These RCPs are organized every six months knowing that the duration of the coordinated care course is one year, renewable for one year. “It is essential for professionals to be able to discuss among themselves, think together and settle in terms of the diagnosis and the care of these children. This makes it possible to define priorities and to have the same discourse vis-à-vis the parents”, underlines Dr Sylvie Lamoureux, neuropediatrician, head of pediatric services at the Avignon hospital and coordinating doctor of the PCO-TND 84. “If we help them early, the projection into adulthood will be different and will strongly condition their autonomy,” she discovered.