Search

Age-related differences in visual search have been extensively studied using simple item arrays, showing an attentional decline. Little is known about how aging affects attentional guidance during search in more complex scenes. To study this issue, we analyzed eye-movement behavior in realistic scene search. We examined age-related differences in top-down guidance, manipulating target template specificity (picture vs. word cue) and target-scene semantic consistency (consistent vs. inconsistent), and in bottom-up guidance, manipulating perceptual salience (high vs. low) of targets and distractors. Compared to young adults (YA), older adults (OA) were overall slower, from the first saccade in the scene. They showed a smaller benefit of a specific target template, suggesting that precision of visual information in working memory may decrease with age. The benefit of semantic consistency did not depend on age, suggesting a preserved ability in OA to use knowledge about object occurrence in scenes. OA showed greater bottom-up search facilitation due to target's high salience, which may depend on reduced selection of low-salience stimuli. Attentional capture by distractors was greater in OA than YA, with respect to engagement (probability of distractor fixation), but only following a picture cue, and disengagement (fixation duration on distractors) in all conditions. Overall, our study shows that age-related differences in visual selection of targets and distractors depend on specific task demands in terms of top-down and bottom-up guidance. It also indicates that scene search difficulties in OA can be limited by cognitive and perceptual forms of environmental support. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Objective: Visual search is a crucial task in daily life, but in Alzheimer’s disease (AD) it has usually been investigated using simple arrays. Here, we used scenes depicting real environments and studied the time course of attentional guidance. Method: We analyzed eye-movement differences between mild AD patients and age-matched healthy controls during search. We examined top-down guidance, manipulating the target template (precise picture vs. word cue) and the target-scene semantic consistency (consistent vs. inconsistent), and bottom-up guidance, manipulating the perceptual salience (high vs. low) of targets and distractors. Results: During scene scanning, AD patients had longer search times, made more fixations before the first target fixation, and showed a greater probability of distractor selection, with longer distractor fixation. AD also led to longer target fixation. In patients and controls, picture cues and highly salient targets improved all search phases, whereas consistent targets only improved search initiation (first saccade). Moreover, top-down and bottom-up guidance interacted in initiation and scanning, and this did not differ between the two groups of participants. However, AD led to a smaller picture cue benefit in shortening distractor fixation and greater bottom-up search facilitation during scanning, where a high-salience target reduced the performance gap between patients and controls. Conclusions: Our study shows the importance of top-down and bottom-up guidance, and their integration, in improving search in AD patients. It suggests that precise target cues and, even more, highly salient targets may act as environmental supports that enhance attentional processing and search performance. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Nous avons la capacite de reconnaitre tres rapidement une scene visuelle, meme presentee un tres court instant. Cette capacite concerne le sens de la scene mais egalement l’emotion qu’elle vehicule. Cette revue critique presentera d’abord une synthese des principales recherches menees sur les traitements des contenus semantiques, puis sur les traitements des contenus emotionnels lors de la perception des scenes. Il s’agira de mieux comprendre comment ces informations sont selectionnees et representees, et comment elles influencent l’exploration visuelle, contribuant ainsi a la rapidite du traitement de la scene. Nous questionnerons ensuite les eventuelles interactions entre les traitements semantiques et emotionnels. Cette revue met en exergue l’importance des liens semantiques et emotionnels entre les differents constituants d’une scene et le caractere dynamique, integratif de la perception visuelle. Elle suggere egalement divers futurs axes de recherche.

Visual categorization improves when object-context associations in scenes are semantically consistent, thus predictable from schemas stored in long-term memory. However, it is unclear whether this is due to differences in early perceptual processing, in matching of memory representations or in later stages of response selection. We tested these three concurrent explanations across five experiments. At each trial, participants had to categorize a scene context and an object briefly presented within the same image (Experiment 1), or separately in simultaneous images (Experiments 2–5). We analyzed unilateral (Experiments 1, 3) and bilateral presentations (Experiments 2, 4, 5), and presentations on the screen’s horizontal midline (Experiments 1–2) and in the upper and lower visual fields (Experiments 3, 4). In all the experiments, we found a semantic consistency advantage for both context categorization and object categorization. This shows that the memory for object-context semantic associations is activated regardless of whether these two scene components are integrated in the same percept. Our study suggests that the facilitation effect of semantic consistency on categorization occurs at the stage of matching the percept with previous knowledge, supporting the object selection account and extending this framework to an object-context reciprocal influence on matching processes (object-context selection account).

International audience; The relationship between posttraumatic stress disorder (PTSD) and focal epilepsy is poorly understood. It has been hypothesized that there is a complex and reciprocal potential reinforcement of the symptoms of each condition. In this study, we investigated whether there are PTSD-specific brain changes in temporal lobe epilepsy (TLE). Brain fluorodeoxyglucose positron emission tomography (PET) metabolism was compared between controls and two groups of TLE patients: one group of 15 patients fulfilling the criteria for a potential diagnosis of PTSD (TLE-PTSD+), another group of 24 patients without a diagnosis of PTSD (TLE-PTSD-), and a group of 30 healthy control participants. We compared the differences in brain PET metabolism among these three groups, and we studied their correlations with interictal and peri-ictal scales of PTSD symptoms. TLE-PTSD+ patients showed more significant hypometabolism involving right temporal and right orbitofrontal cortex in comparison to TLE-PTSD- patients and healthy subjects. Moreover, degree of reduced metabolism in these brain areas correlated with interictal and peri-ictal PTSD questionnaire scores. PTSD in temporal epilepsy is associated with specific changes in neural networks, affecting limbic and paralimbic structures. This illustrates the close intertwining of epileptogenic and psychogenic processes in these patients

Visual search is a crucial, everyday activity that declines with ageing. Here, referring to the environmental support account, we hypothesised that semantic contextual associations between the target and the neighbouring objects (e.g., a teacup near a tea bag and a spoon), acting as external cues, may counteract this decline. Moreover, when searching for a target, viewers may encode information about the co-present distractor objects, by simply looking at them. In everyday life, where viewers often search for several targets within the same environment, such distractor objects may often become targets of future searches. Thus, we examined whether incidentally fixating a target during previous trials, when it was a distractor, may also modulate the impact of ageing on search performance. We used everyday object arrays on tables in a real room, where healthy young and older adults had to search sequentially for multiple objects across different trials within the same array. We showed that search was quicker (1) in young than older adults; (2) for targets surrounded by semantically associated objects than unassociated objects, but only in older adults; and (3) for incidentally fixated targets than for targets that were not fixated when they were distractors, with no differences between young and older adults. These results suggest that older viewers use both environmental support based on object semantic associations and object information incidentally encoded to enhance efficiency of real-world search, even in relatively simple environments. This reduces, but does not eliminate, search decline related to ageing.

Background Developmental dyslexia, a specific and long-lasting learning disorder that prevents children from becoming efficient and fluent readers, has a severe impact on academic learning and behavior and may compromise professional and social development. Most remediation studies are based on the explicit or implicit assumption that dyslexia results from a single cause related to either impaired phonological or visual-attentional processing or impaired cross-modal integration. Yet, recent studies show that dyslexia is multifactorial and that many dyslexics have underlying deficits in several domains. The originality of the current study is to test a remediation approach that trains skills in all three domains using different training methods that are tailored to an individual’s cognitive profile as part of a longitudinal intervention study. Methods This multicenter randomized crossover study will be conducted in three phases and will involve 120 dyslexic children between the ages of 8 and 13 years. The first phase serves as within-subject baseline period that lasts for 2 months. In this phase, all children undergo weekly speech-language therapy sessions without additional training at home (business-as-usual). During the second phase, all dyslexics receive three types of intensive interventions that last 2 month each: Phonological, visual-attentional, and cross-modal. The order of the first two interventions (phonological and visual-attentional) is swapped in two randomly assigned groups of 60 dyslexics each. This allows one to test the efficacy and additivity of each intervention (against baseline) and find out whether the order of delivery matters. During the third phase, the follow-up period, the intensive interventions are stopped, and all dyslexics will be tested after 2 months. Implementation fidelity will be assessed from the user data of the computerized intervention program and an “intention-to-treat” analysis will be performed on the children who quit the trial before the end. Discussion The main objective of this study is to assess whether the three types of intensive intervention (phase 2) improve reading skills compared to baseline (i.e., non-intensive intervention, phase 1). The secondary objectives are to evaluate the effectiveness of each intervention and to test the effects of order of delivery on reading intervention outcomes. Reading comprehension, spelling performance and reading disorder impact of dyslexic readers are assessed immediately before and after the multimodal intervention and 2 months post-intervention. Trial registration ClinicalTrials.gov, NCT04028310. Registered on July 18, 2019.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

The goal of the current paper is to review the literature on the relationships between perceived control and episodic memory throughout adulthood. More specifically, three major questions are pursued: (1) Are higher levels of perceived control related to better memory performance? (2) Is the relationship between perceived control and memory similar or different as a function of age? (3) Does perceived control moderate memory decline? Although there is a great deal of evidence that perceived control and episodic memory are positively related in adulthood, the current review showed that very few studies have investigated whether age moderated this relationship. Moreover, only a limited number of studies have explored the role of perceived control in memory decline, and the results are inconsistent. We suggest some avenues for future research that could help understand by which mechanisms, and under what circumstances, perceived control and episodic memory are related across the lifespan.

Many studies provided the existence of attentional bias in individuals with post-traumatic stress-symptom (PTSS) or students with anxiety. However, results remain unclear concerning the type of alteration (vigilance or disengagement) and specificity of attentional bias (for negative information or trauma-related information). To address these issues, 131 students completed a visual search task with a lexical decision component and clinical scales (for PTSS and anxiety). Attentional bias (vigilance and disengagement) and word valences (neutral words, negative words and trauma-related words) were controlled. Three groups were distinguished: no symptom, PTSS and anxious groups. No symptom group was characterized by facilitation in the attentional treatment for negative information. PTSS group presented a disengagement bias for negative and trauma-related information. When anxiety symptoms were associated with PTSS, in this group, it led to difficulties in vigilance. The anxious group showed difficulties only for negative words in vigilance. These data suggest that sub-clinical PTSS and anxiety symptoms altered differently information processing. These findings highlight the need for research on trauma populations and anxiety, and to pursue studies on comorbidity in PTSS.

"Impairments in emotional information processing are frequently reported in attention deficit hyperactivity disorder (ADHD) at a voluntary, explicit level (e.g., emotion recognition) and at an involuntary, implicit level (e.g., emotional interference). Most of previous studies have used faces with emotional expressions, rarely examining other important sources of information usually co-occurring with faces in our every day experience. Here, we examined how the emotional content of an entire visual scene depicting real-world environments and situations is processed in ADHD. We systematically reviewed in PubMed, SCOPUS and ScienceDirect, using the PRISMA guidelines, empirical studies published in English until March 2019, about processing of visual scenes, with or without emotional content, in children and adolescents with ADHD. We included 17 studies among the 154 initially identified. Fifteen used scenes with emotional content (which was task-relevant in seven and irrelevant in eight studies) and two used scenes without emotional content. Even though the interpretation of the results differed according to the theoretical model of emotions of the study and the presence of comorbidity, differences in scene information processing between ADHD and typically developing children and adolescents were reported in all but one study. ADHD children and adolescents show difficulties in the processing of emotional information conveyed by visual scenes, which may stem from a stronger bottom-up impact of emotional stimuli in ADHD, increasing the emotional experience, and from core deficits of the disorder, decreasing the overall processing of the scene".

International audience; Anxiety and depression in epilepsy are strongly documented but post-traumatic stress disorder (PTSD) is underestimated and poorly known. We studied the links between psycho-traumagenic events (TE), onset of epilepsy, and severity of PTSD symptoms in patients with epilepsy. The study included 54 patients with epilepsy and 61 controls. We used validated questionnaires to screen for anxiety, depression, and PTSD symptoms and we conducted an interview to measure the prevalence of TE. We developed an original exploratory questionnaire to assess the presence of PTSD during interictal and peri-ictal periods. The results show that patients reported more exposure to a TE and presented significantly more severe PTSD symptoms than controls. Seventy-eight percent of patients (vs. 52% of controls) had been exposed to a TE, and 26% (vs. 7%) had a score above the diagnostic threshold of the PTSD scale. In addition, 18.6% of patients reported that their epilepsy began at the same time as they began to experience PTSD symptoms following a TE. Patients with high PTSD scores (above the threshold, n = 14) reported significantly more depression symptoms than patients without PTSD and reported PTSD symptoms both during the ictal and peri-ictal periods. Within the whole group of patients, anxiety (72%) and depression (33%) symptoms significantly correlated with PTSD symptoms reported by the scale. This study shows that patients with epilepsy have increased prevalence of self-reported PTSD symptoms. We describe the clinical picture specific to patients with epilepsy, which may include classical PTSD symptoms but also specific peri-ictal symptoms.

Regardez a gauche, maintenant regardez a droite, puis a gauche, a droite... C’est en substance ce qui est demande au participant dans la condition experimentale d’interet d’une etude qui explore les effets de series de mouvements oculaires saccadiques horizontaux (MOH) sur la performance cognitive, mnesique principalement. Des series breves (environ 30 secondes) de MOH precedant une tâche de memoire episodique semblent ameliorer la performance mnesique, en particulier chez les sujets fortement droitiers. Mais les quelques travaux menes selon ce devis general n’ont pas permis a ce jour de conclure, tantot montrant un effet positif des MOH sur la performance mnesique, et plus particulierement sur la recuperation en memoire episodique verbale, tantot echouant a mettre en evidence cet effet. Parce que la question de savoir si et comment les MOH peuvent moduler l’efficience cognitive nous parait d’un interet indeniable et sur le plan theorique et sur le plan clinique, nous nous proposons de faire le point. L’article presente les elements essentiels sur les bases cerebrales des saccades, un schema d’experience classique, les principaux resultats de la litterature et les differentes hypotheses en presence concernant les mecanismes cerebraux et cognitifs sous-jacents, encore tres preliminaires. Cette synthese souligne qu’il convient de suspendre notre jugement : les travaux encore peu nombreux, menes dans un nombre restreint d’equipes, n’ont pas produit de resultat robuste et seulement esquisse une comprehension des mecanismes d’action. Nous presenterons une demarche de recherche de type « collaboration contradictoire » qui nous a paru particulierement pertinente dans ce contexte. Enfin, comme il nous a semble indispensable de prendre en consideration les connexions entre cet axe de recherche sur les effets des mouvements oculaires sur le fonctionnement cognitif et cerebral et les etudes nombreuses sur l’efficacite des approches psychotherapeutiques qui utilisent ces mouvements, nous proposerons quelques considerations sur l’approche therapeutique par Eye Movement Desensitization and Reprocessing (EMDR).

International audience; Many instrumental activities of daily living (IADLs), like cooking and managing finances and medications, involve finding efficiently and in a timely manner one or several objects within complex environments. They may thus be disrupted by visual search deficits. These deficits, present in Alzheimer’s disease (AD) from its early stages, arise from impairments in multiple attentional and memory mechanisms. A growing body of research on visual search in AD has examined several factors underlying search impairments in simple arrays. Little is known about how AD patients search in real-world scenes and in real settings, and about how such impairments affect patients’ functional autonomy. Here, we review studies on visuospatial attention and visual search in AD. We then consider why analysis of patients’ oculomotor behavior is promising to improve understanding of the specific search deficits in AD, and of their role in impairing IADL performance. We also highlight why paradigms developed in research on real-world scenes and real settings in healthy individuals are valuable to investigate visual search in AD. Finally, we indicate future research directions that may offer new insights to improve visual search abilities and autonomy in AD patients.

International audience; The present study investigated the nature and specificity of the gestural deficit in children with developmental coordination disorder (DCD). Performance of children with DCD is compared with that of typically developing children across tasks and conditions that allow exploring distinct levels hypothesized by adult models of praxis processing. These models generally involve a conceptual system and a production system. Within this theoretical framework, the study analyzed the extent to which the gestural difficulties of children with DCD are related to a deficit of the production system. Considering the heterogeneity of deficits consistently reported in DCD, we also examined whether gestural difficulties of children with DCD could imply impairments on other cognitive functions (executive functions, visual-perceptual, and visuospatial functions). Thirty children with DCD were compared to 30 typically developing children. The DCD group exhibited a deficit in most of the gesture production tasks (with the exception of representational intransitive ones), with impaired visuospatial skills. When controlling for a measure of visuospatial skill, differences between groups remained significant only for representational transitive gestures. This dysfunction could neither be related to a semantic deficit, nor to an impairment of sensorimotor knowledge. Therefore, if the contribution of a visuospatial dysfunction allows discussing the specificity of gestural deficit, this does not appear to explain the overall gestural deficit. We suggest an explanation of the finding within the assumption of a production-system deficit.

Repeated apneas are associated with severe hypoxemia that may ultimately lead to loss of consciousness in some breath-hold divers. Despite increasing number of practitioners, the relationship between apnea-induced hypoxia and neurocognitive functions is still poorly understood in the sport of free diving. To shed light onto this phenomenon, we examined the impact of long-term breath-hold diving training on attentional processing, short-term memory, and long-term mnesic and executive functions. Thirty-six men matched for age, height, and weight were separated into the following 3 groups: (i) 12 elite breath-hold divers (EBHD), mean static apnea best time 371 s, 105 months mean apnea experience; (ii) 12 novice breath-hold divers, mean best time 243 s, 8.75 months mean apnea experience; and (iii) 12 physical education students with no breath-hold diving experience; all of these participants performed varied written and computerized neuropsychological tasks. Compared with the 2 other groups, the EBHD group was slower to complete the interference card during a Stroop test (F[1,33]= 4.70, p < 0.05), and presented more errors on the interference card (F[1,33]= 2.96, p < 0.05) and a lower total interference score (F[1,33]= 5.64, p < 0.05). The time to complete the interference card test was positively correlated with maximal static apnea duration (r = 0.73, p < 0.05) and the number of years of breath-hold diving training (r = 0.79, p < 0.001). These findings suggest that breath-hold diving training over several years may cause mild, but persistent, short-term memory impairments.

Just like all the others specific learning disorders, dyspraxia is a key issue for public health and school performance. “Developmental dyspraxia” qualifies specific disturbances of gesture, i.e. the ability to produce a finalized action (goal-directed movement) and to use the objects [1] , [2] . Even if dyspraxia was described for decades, the value of the concept for diagnosis raises some debates in the international literature. Since 1994, a consensus has been established on the diagnostic entity of Developmental Coordination Disorder (DCD) to describe all children who exhibit developmental deficits of “motor coordination”. Beyond the usual debate of terminology, both the theoretical and the clinical definitions of the gestural dysfunctions in children remain insufficient in various respects. This communication provides a review of current controversies regarding the field of dyspraxia and DCD. Understanding the two entities of dyspraxia and DCD proves problematic, both when defining the concepts of praxis/motor coordination and when providing a theoretical analysis of the deficits they cover. More specifically, we aim at exploring the arguments supporting the hypothesis of a specific deficit in praxis development. We discuss the respective contributions of different impairment levels highlighted by studies of developmental gestural impairment (e.g. knowledge, executive functions, perceptive abilities…). Such a deconstruction of the concept of a specific deficit in praxis development argues in favor of an analysis that does not confuse gestural problems with other deficits made apparent through gesture.

Perceiving one’s own functioning as determined by one’s own actions and behaviors would be one of the key factors of successful cognitive aging. Perceived control would lead to sustained efforts to maintain a high level of cognitive performance despite advancing age, which would predict a positive evolution of cognitive abilities over time. Currently, many studies show that people with higher levels of sense of control have better memory performance than people who believe that events are beyond their control. Nevertheless, there is still a lack of empirical support concerning the hypothesis of a differential preservation of memory abilities as a function of levels of perceived control. Through three experimental studies and the validation of a new scale evaluating memory control beliefs, this thesis aimed to determine whether perceived control could make a positive contribution to memory aging and to identify the mechanisms that may explain the relationship between perceived control and episodic memory at different ages. Overall, our studies do not support the hypothesis that higher perceived control would moderate age-related differences in episodic memory. However, our work suggests that individuals, especially the older ones, who perceive their memory as controllable obtain better performance during memory tasks than those who perceive their memory as uncontrollable through greater and more efficient use of resource-demanding cognitive strategies.; La perception pour un individu que son fonctionnement est déterminé par ses propres actions et comportements serait l’un des facteurs clés d’un vieillissement cognitif réussi. Cette perception de contrôle conduirait à fournir des efforts soutenus pour rester performant sur le plan cognitif en dépit de l'avancée en âge, ce qui contribuerait au maintien de bonnes habiletés cognitives au fil du temps. Aujourd’hui, de nombreux travaux mettent en évidence que les personnes avec un fort sentiment de contrôle obtiennent de meilleures performances dans les tâches de mémoire épisodique que les autres. Néanmoins, l’hypothèse d’une préservation différentielle des capacités de mémoire épisodique en fonction du niveau de contrôle perçu manque encore de soutien empirique. A travers trois études expérimentales et la validation d’une nouvelle échelle de contrôle perçu spécifique à la mémoire, la présente thèse visait à déterminer si le contrôle perçu pouvait jouer un rôle positif dans l’évolution de la mémoire épisodique au fil de l’âge adulte puis à identifier les mécanismes explicatifs de la relation entre le contrôle perçu et la mémoire épisodique à différents âges de la vie adulte. Dans l’ensemble, nos études ne permettent pas de valider l’hypothèse selon laquelle un contrôle perçu plus élevé atténuerait les différences liées à l’âge en mémoire épisodique. En revanche, nos résultats suggèrent que les personnes, et en particulier les plus âgées, qui perçoivent leur mémoire comme contrôlable obtiennent de meilleures performances de mémoire épisodique que les autres grâce à une plus grande utilisation et à une exécution plus efficace de stratégies cognitives coûteuses en termes de ressources au cours de la tâche.

Perceiving one’s own functioning as determined by one’s own actions and behaviors would be one of the key factors of successful cognitive aging. Perceived control would lead to sustained efforts to maintain a high level of cognitive performance despite advancing age, which would predict a positive evolution of cognitive abilities over time. Currently, many studies show that people with higher levels of sense of control have better memory performance than people who believe that events are beyond their control. Nevertheless, there is still a lack of empirical support concerning the hypothesis of a differential preservation of memory abilities as a function of levels of perceived control. Through three experimental studies and the validation of a new scale evaluating memory control beliefs, this thesis aimed to determine whether perceived control could make a positive contribution to memory aging and to identify the mechanisms that may explain the relationship between perceived control and episodic memory at different ages. Overall, our studies do not support the hypothesis that higher perceived control would moderate age-related differences in episodic memory. However, our work suggests that individuals, especially the older ones, who perceive their memory as controllable obtain better performance during memory tasks than those who perceive their memory as uncontrollable through greater and more efficient use of resource-demanding cognitive strategies.; La perception pour un individu que son fonctionnement est déterminé par ses propres actions et comportements serait l’un des facteurs clés d’un vieillissement cognitif réussi. Cette perception de contrôle conduirait à fournir des efforts soutenus pour rester performant sur le plan cognitif en dépit de l'avancée en âge, ce qui contribuerait au maintien de bonnes habiletés cognitives au fil du temps. Aujourd’hui, de nombreux travaux mettent en évidence que les personnes avec un fort sentiment de contrôle obtiennent de meilleures performances dans les tâches de mémoire épisodique que les autres. Néanmoins, l’hypothèse d’une préservation différentielle des capacités de mémoire épisodique en fonction du niveau de contrôle perçu manque encore de soutien empirique. A travers trois études expérimentales et la validation d’une nouvelle échelle de contrôle perçu spécifique à la mémoire, la présente thèse visait à déterminer si le contrôle perçu pouvait jouer un rôle positif dans l’évolution de la mémoire épisodique au fil de l’âge adulte puis à identifier les mécanismes explicatifs de la relation entre le contrôle perçu et la mémoire épisodique à différents âges de la vie adulte. Dans l’ensemble, nos études ne permettent pas de valider l’hypothèse selon laquelle un contrôle perçu plus élevé atténuerait les différences liées à l’âge en mémoire épisodique. En revanche, nos résultats suggèrent que les personnes, et en particulier les plus âgées, qui perçoivent leur mémoire comme contrôlable obtiennent de meilleures performances de mémoire épisodique que les autres grâce à une plus grande utilisation et à une exécution plus efficace de stratégies cognitives coûteuses en termes de ressources au cours de la tâche.

Objectif : De nombreuses études ont montré l’efficacité de la thérapie du langage par contrainte induite (CIAT) pour la prise en charge de patients aphasiques chroniques. Cette thérapie se caractérise par la pratique massive et l’utilisation exclusive du langage oral autour d’un jeu de langage. L’objectif de notre étude est de montrer la faisabilité de la CIAT en phase subaiguë et son impact sur les habiletés langagières et communicationnelles.Méthodologie : La CIAT aménagée en intensité et en contrainte est appliquée 2 à 3 heures par jour pendant 2 semaines, soit en individuel, soit en groupe, à 4 patients aphasiques non fluents à moins d’un an d’un AVC ischémique gauche. Les évaluations pré et post-thérapeutique combinent des mesures standards de langage oral et des mesures plus spécifiques pour l’anomie et la communication, enrichies par des observations de séances.Résultats : Les 4 patients ont suivi avec succès le programme de la CIAT. Les résultats montrent une amélioration globale de l’évaluation du langage oral après la CIAT avec plus particulièrement des gains significatifs sur le versant de la désignation et de la dénomination. Une évolution qualitative des habiletés communicationnelles est relevée tout au long de la thérapie avec notamment une progression des interactions. Les patients ont témoigné d’un ressenti positif du traitement.Conclusion : Les résultats de notre travail suggèrent l’application bénéfique de la CIAT en phase subaiguë avec quelques modifications. Au vu de la taille de notre échantillon, d’autres études doivent venir confirmer ces données.

In France, several controversies about the psychoanalytical cares of autism have resulted in a proposed law dated October 2016 forbidding all kind of psychoanalytical practices and obliging therapists to apply the ABA method as the preferential way of taking care of autism spectrum disorders. The aim of these thesis is to help align these divisions through the modelling of the therapeutic mediations based on a neuroscientific and psychoanalytical approach. We hypothesized that the symbolization processes (semantical and metaphorical recategorizations) supported by the transference relationship improve autism spectrum disorders through an increasingly complex elaboration of the Real. After having brought to light a Freudian epistemological break which causes the repression of the psychoanalysis’ neuroscientific origins, we have reinitiated dialogue with neurosciences. Thus we have introduced the autism spectrum disorder as a neurodevelopmental locked-in syndrome caused by an unique adaptation of the neural network of the Ego (dynamic core) under crippling conditions caused by this neurodevelopmental disorder. The therapeutic mediations enable us to highlight the fact that the symbolization process in creative process depended on the simultaneous activation of neural network used by language and art, facilitating the synaptic strengthening between the representations of the two areas, what allows the patient to communicate his painful experience through an artistic/metaphorical language. The repeated expression of his experiences would allow reorganizing of the dynamic core of the Ego into a non-pathological way. Finally, five therapeutic mediations allow us to argue that it is possible to integrate the subjectivity into structured and theoretically motivated interventions, proposing a real means of evaluating their efficiency without affecting the quality of the care., En France, les nombreuses polémiques au sujet de la prise en charge psychanalytique de l’autisme se sont conclues sur une proposition de résolution totalitaire soumise en octobre 2016 à l’Assemblée nationale visant à interdire les pratiques psychanalytiques sous toutes leurs formes et à imposer la méthode ABA comme prise en charge de l’autisme. La présente thèse vise à dépasser ces clivages à l’aide d’une modélisation des médiations thérapeutiques à partir d’une approche neuroscientifique et psychanalytique. Nous faisons l’hypothèse que les processus de symbolisation (recatégorisations sémantiques et métaphoriques), appuyés par la relation transférentielle, favorisent l’amélioration des troubles autistiques grâce à une mise en forme du Réel de plus en plus complexe. Après avoir mis en évidence une rupture épistémologique freudienne ayant provoqué un refoulement des origines neuroscientifiques de la psychanalyse, nous avons renoué le dialogue avec les neurosciences en présentant l’autisme comme une forme de Locked-in syndrom neurodéveloppemental provoquée par une adaptation singulière du réseau neuronal du Moi (noyau dynamique) face à des conditions invalidantes issues des troubles autistiques. Les médiations thérapeutiques nous ont ainsi permis de mettre en évidence que les processus de symbolisation propres à la création dépendaient de l’activation simultanée des réseaux neuronaux partagés par le langage et l’art, facilitant le renforcement synaptique entre les représentations de ces deux domaines, ce qui permettrait au patient d’exprimer ses expériences difficiles dans un registre artistique/métaphorique. L’expression répétée de ces expériences favoriserait ainsi une réorganisation non-pathologique du noyau dynamique moïque du sujet. Finalement, cinq thérapies médiatisées nous ont permis de soutenir qu’il est possible d’intégrer la subjectivité dans des interventions structurées et motivées théoriquement, tout en proposant de véritables moyens pour évaluer leur efficacité, sans pour autant affecter la qualité de la prise en charge.