Psychomotor Therapist Research Articles

À propos d’un cas pédiatrique de diplégie spastique : évaluations et élaboration d’un projet thérapeutique à court et moyen terme

We report a case of cerebral palsy, following premature birth, in a young girl presenting with spastic diplegia. At age 8years, she benefited from a complete and in depth clinical evaluation, including two major aspects: motor functions and neuropsychology, without forgetting pediatric data. This assessment was based on the “factorial evaluation”, as proposed by G. Tardieu and further developed by Mr Le Métayer. Such an evaluation was performed by a multidisciplinary team including a physiotherapist, a psychomotor therapist, a speech therapist and a psychologist, under supervision of the pediatrician in charge of the reeducational day center. Systematic evaluation led to organize a consistent therapeutic plan of care given previous major surgery, the orthopedic issues was the first concern and we described specificity of motor cares of the child at several levels: orthopedic devices, kinesitherapy, oral and topic treatment of spasticiy and previous surgical interventions. On the other hand, we emphasized on the need to consider visuospatial and orthoptic problems, as well as psychosocial considerations and their impact on the efficiency of reeduction and functional outcome. The ultimate goal of the reeduction is to provide to this child all necessary tools in order to maximize her autonomy level throughout her life.

Importance of holding: Play and exchanges between child psychiatrist, psychomotor therapist and the dyad

Importance of holding: Play and exchanges between child psychiatrist, psychomotor therapist and the dyad

P01-360 - Autism and violence

IntroductionAutism is a disorder of the overall development and early onset before the age of 3 years, characterized by a deviant functioning and / or delayed in three areas: social interaction, verbal and nonverbal behavior.The child may be aggressive, either to himself or to others. Communication difficulties hamper the social control of the aggression that is often disproportionate and can frighten the family.In this work we are interested in the management of aggression for the autistic children.Aimsidentify ways of managing aggressive behavior for autistic childrenMethodself-administered questionnaires provided to educators, psychologists, psychomotor therapists, working at Mohamed VI national center for handicapped people.Results43.3% of our sample exhibits behavioral problems which are « auto ou hétéroagressifs. We noted a male predominance. Precipitating factors were identified in 30% of cases and are mainly represented by the situations of failure and the changes in the environment of the autistic child. The management of aggressive behavior is based on several methods including the use of medications and behavioral approach.ConclusionThe behavioral disorders are common among autistic children and are a major problem that families face. The aggressive management of the crisis is often difficult, and management remains uncodified.

L’évaluation des soins en psychomotricité : la thérapie psychomotrice basée sur les preuves versus la psychomotricité relationnelle

The effectiveness of treatments for psychomotor disorders is becoming an important preoccupation in the field of clinical psychology. This article discusses the emergence of evidence-based psychomotor therapy. This therapeutic approach aims at reducing psychomotor disorders by practicing activities that specifically target underdeveloped perceptual-motor skills. Indeed, specific deficits are identified, and then addressed through careful assessment of these skills, by norm-referenced and standardized measures. Full scale randomized controlled studies of psychomotor techniques are lacking and the emergence of evidence-based psychomotor therapy is difficult. There are several reasons for this, not the least of which is the opposition of many psychomotor therapists. Indeed, many psychomotor therapists have negative attitudes concerning the idea that psychomotor interventions may be evaluated in terms of their benefits and effects, their theoretical movement has been labelled the “relational psychomotor therapy”. However, in the present health care climate, it is not sufficient to suggest that an interventionist approach is appropriate; solid evidence must be provided demonstrating the effectiveness of that approach. Further effort is needed to provide detailed treatment descriptions and experimental studies that involve at least one randomized control group of an acceptable size. In the future, such studies may inform the search for the most effective interventions and may guide treatment selection in clinical care of psychomotor disorders. The development of evidence-based psychomotor therapy should stimulate the use of available knowledge and the use of appropriate instruments for diagnosis, assessment, and treatment of psychomotor disorders.

Enjeux actuels de l’évaluation psychologique dans la clinique de l’enfant et de l’adolescent : vers une approche intégrée de la psychopathologie

This article will discuss different theoretical approaches and methods of data collection in view of the psychological assessment of children and adolescents. There are generally two different approaches; one being the single case study using a subjective method and the second consisting of clinical interviews and psychological tests using the objective method. In our opinion, psychological assessments should rely on two main axes. The first should be based on an updated knowledge of psychopathology, integrating new models and scientific findings with the methodology of Evidence Based Medicine (EBM). The second axis should be concerned with the psychological assessment combining subjective and objective methods. For example, the use of standardized tools such as scales or projective tests is essential to understand the interaction between multiple clinical variables influencing child psychopathology as well as to understand family and social interactions. The diversity of risk factors (e.g. family, personality, social, biological factors, etc.), implicated in mental illness shows the multi-dimensional aspects of psychopathology. Different theoretical approaches have been developed to study psycho-pathological mechanisms (neuro-psychology, psychoanalysis, biological psychiatry approaches, etc.). Therefore an integrative approach of psychopathology using different models and factors is needed to understand psychiatric disorders. A thorough psychological assessment is essential to the comprehension of mental illness in children and adolescents and is the first step to tailor treatments to individual needs. In order to answer these objectives, psychological assessments must be multi-modal, multi-disciplinary and multi-source: - Multi-disciplinary: For a better clinical assessment, psychologists and psychiatrists will need information from other professionals such as speech therapists, psychomotor therapists, neurologists… - Multi-modal: This aspect is crucial in clinical assessment. It characterizes all tools that clinicians will use in their assessment practice: Psychological tests, clinical interviews or clinical scales. - Multi-source: A comprehensive assessment of child and adolescent psychopathology includes assessments of different informants and sources (family, teachers…). These different approaches will be discussed in the perspective of the actual stakes of psychological assessment in children and adolescents. Developing integrative assessment approaches seems to be a promising field for the future in mental health services, allowing the tailoring of specific therapeutics for each child.

Méthode de prise en charge globale non médicamenteuse des patients déments institutionnalisés

Over the last decades many approaches have been developed to manage cognitive and behavioral disturbances in dementia. The present work describes a global intervention program carried out with moderately to severely demented institutionalized patients. The aims of the intervention program are to stimulate and maintain the preserved abilities of demented patients in a supportive context, to decrease the behavioral disturbance and to avoid burnout of care-unit staff. This intervention combines different means: psychosocial care (validation therapy, social interaction), cognitive stimulation (memory and verbal training), and motor and sensitive stimulation. The global intervention program requires a special trained team composed of a supervisor, six aid-nurses, an occupational therapist, a speech therapist, a psychomotor therapist and a psychologist. The team cared for the patients five days per week over a three-month period. Assessments were conducted before and after the intervention program to measure the benefit. Positive effects were shown for cognitive abilities, nutritional problems and staff burnout. However, due to the small sample size for this study, more research is needed to verify the effectiveness of this global intervention program, particularly the implications for nutrition. This global intervention combined with pharmacological treatment seems to be useful for managing psychological and behavioral disorders of institutionalized demented patients.

Departamento de Psicología del Hospital Central de la FF.AA.

The Psychology Department as such, has been progressively consolidated into six well differentiated Services, both in its specialized functions and tasks, as well as in relation to the numerous users it assists. According to the Internal Management System (SIG), it depends directly on the Technical Direction of the Central Hospital of the Armed Forces. It is made up of 27 psychologists, 2 psychomotor therapists, 1 teacher specialized in learning difficulties, 1 speech therapist. The Professional Staff carries out clinical assistance work with outpatients, inpatients and their families. This includes patient management, clinical evaluation, intervention, follow-up, etc., together with the prerogatives of consultation (inter-consultation) with other hospital services, psychoprophylaxis, staff training, program evaluation and planning, etc., as well as research, scientific activities, and the development of new technologies, as well as research, scientific activities (athenaeums, supervision, etc.), are complemented with additional work for the evaluation of the applied tests, elaboration of reports, use of the computer program, team and service meetings, interviews with professionals, support for admission to the Military School, activities of the Chiefs, coordination with various extra-hospital institutions, transfers, intra- and extra-hospital training, etc. In June 2000, the Department participated in the Disaster Plan and from then on was included in it. In July 2000, the Medical Psychology and Rehabilitation Services added 35 monthly polyclinics for the admission of its special patient population. In the month of August, the Department started 24-hour on-call duty from Monday to Sunday.

Relation of early neuromotor and cranial signs with neuropsychological outcome at 4 years

The persistence and predictive value at 3–5 years of age of three signs detected within the first 18 months of life were investigated: phasic stretch reflex in one or both gastrocnemius muscles, imbalance in passive axial tone with an excess of dorsal extension, and a ridge on the squamous sutures. Phasic stretch reflex and at least one of the other signs were found in 14 children during repeated assessments within the first 18 months. The progress of these children was compared with that of 14 matched controls who had repeatedly normal neurological assessments during the first 18 months in the same clinic in Paris. At the age 3–5 years all the children were then assessed blindly by the second author from a pediatric neurological viewpoint and by two psychologists and two psychomotor therapists as well. The parents of the affected children reported significantly more problems in motor/praxis skills, language development and attention. Abnormal neurological signs were also significantly more frequent than in the controls. Suboptimal cognition did not reach significance. The neurological inclusion criteria were still present at 3–5 years old in 86% (vs. respectively 100% and 93% during the first 18 months of life) of this small group of children, while the cranial suture sign was still present in only 28% (vs. 64%). Findings of these three signs during the first 18 months of life may help in predicting long-term neurobehavioral or long-term neuropsychological problems.

Communication: What happens during the First Encounter between Patient and Physiotherapist?

First encounters between patients and physiotherapists have been video-taped and analysed as part of a research-project. Emphasis was on both functional assessment and patterns of interaction. Three groups of physiotherapists participated; manual therapists, psychomotor therapists, and district physiotherapists. The three groups used different approaches when examining their patients. Thus they conveyed different messages of content, roles, and relationships. Commonly, communication is discussed and analysed separately from diagnostic and therapeutic activity. Rejecting such separation, it is argued that it is important to highlight the way in which physiotherapists relate to their patients through their professional actions. The focus in this article is the implicit communication in the physiotherapist's examination. For physiotherapists, as for doctors, the body is the basis of their work. It is emphasized that it is especially important to discuss the body in connection with implicit communication.