[Oral language development in maltreated and foster children]. / Le développement du langage oral chez les enfants maltraités et placés.

Language disorders, which are still very poorly detected, are often present in abused children. While the consequences are well known and long-lasting, little is known about the development and specific characteristics of these children, depending on where they were placed, the type of abuse they suffered and the age at which they were placed. This finding led to a review of the literature aimed at better defining the state of knowledge on the subject, for the benefit of better detection and treatment.

Assessing the applicability and appropriateness of ChatGPT in answering clinical pharmacy questions.

OBJECTIVES: Clinical pharmacists rely on different scientific references to ensure appropriate, safe, and cost-effective drug use. Tools based on artificial intelligence (AI) such as ChatGPT (Generative Pre-trained Transformer) could offer valuable support. The objective of this study was to assess ChatGPT's capacity to correctly respond to clinical pharmacy questions asked by healthcare professionals in our university hospital. MATERIAL AND METHODS: ChatGPT's capacity to respond correctly to the last 100 consecutive questions recorded in our clinical pharmacy database was assessed. Questions were copied from our FileMaker Pro database and pasted into ChatGPT March 14 version online platform. The generated answers were then copied verbatim into an Excel file. Two blinded clinical pharmacists reviewed all the questions and the answers given by the software. In case of disagreements, a third blinded pharmacist intervened to decide. RESULTS: Documentation-related issues (n=36) and drug administration mode (n=30) were preponderantly recorded. Among 69 applicable questions, the rate of correct answers varied from 30 to 57.1% depending on questions type with a global rate of 44.9%. Regarding inappropriate answers (n=38), 20 were incorrect, 18 gave no answers and 8 were incomplete with 8 answers belonging to 2 different categories. No better answers than the pharmacists were observed. CONCLUSIONS: ChatGPT demonstrated a mitigated performance in answering clinical pharmacy questions. It should not replace human expertise as a high rate of inappropriate answers was highlighted. Future studies should focus on the optimization of ChatGPT for specific clinical pharmacy questions and explore the potential benefits and limitations of integrating this technology into clinical practice.

Development of a natural language processing model for deriving breast cancer quality indicators : A cross-sectional, multicenter study.

OBJECTIVES: Medico-administrative data are promising to automate the calculation of Healthcare Quality and Safety Indicators. Nevertheless, not all relevant indicators can be calculated with this data alone. Our feasibility study objective is to analyze 1) the availability of data sources; 2) the availability of each indicator elementary variables, and 3) to apply natural language processing to automatically retrieve such information. METHOD: We performed a multicenter cross-sectional observational feasibility study on the clinical data warehouse of Assistance Publique - Hôpitaux de Paris (AP-HP). We studied the management of breast cancer patients treated at AP-HP between January 2019 and June 2021, and the quality indicators published by the European Society of Breast Cancer Specialist, using claims data from the Programme de Médicalisation du Système d'Information (PMSI) and pathology reports. For each indicator, we calculated the number (%) of patients for whom all necessary data sources were available, and the number (%) of patients for whom all elementary variables were available in the sources, and for whom the related HQSI was computable. To extract useful data from the free text reports, we developed and validated dedicated rule-based algorithms, whose performance metrics were assessed with recall, precision, and f1-score. RESULTS: Out of 5785 female patients diagnosed with a breast cancer (60.9 years, IQR [50.0-71.9]), 5,147 (89.0%) had procedures related to breast cancer recorded in the PMSI, and 3732 (72.5%) had at least one surgery. Out of the 34 key indicators, 9 could be calculated with the PMSI alone, and 6 others became so using the data from pathology reports. Ten elementary variables were needed to calculate the 6 indicators combining the PMSI and pathology reports. The necessary sources were available for 58.8% to 94.6% of patients, depending on the indicators. The extraction algorithms developed had an average accuracy of 76.5% (min-max [32.7%-93.3%]), an average precision of 77.7% [10.0%-97.4%] and an average sensitivity of 71.6% [2.8% to 100.0%]. Once these algorithms applied, the variables needed to calculate the indicators were extracted for 2% to 88% of patients, depending on the indicators. DISCUSSION: The availability of medical reports in the electronic health records, of the elementary variables within the reports, and the performance of the extraction algorithms limit the population for which the indicators can be calculated. CONCLUSIONS: The automated calculation of quality indicators from electronic health records is a prospect that comes up against many practical obstacles.

Envisioning motherhood: Mental-state language in caregiving narratives across the perinatal period.

Nancy Suchman's work highlighted the fundamental role of maternal mentalization in maternal addiction, mental health, and caregiving challenges. In this study, we aimed to examine the role of mental-state language (MSL) as a measure of mentalization in prenatal and postnatal narratives and their sentiment in a sample of 91 primarily White mothers from the western United States, followed from the second trimester of pregnancy, through the third trimester, to 4 months postpartum. Specifically, we investigated the use of affective and cognitive MSL in prenatal narratives when mothers visualized caring for their baby and postnatal narratives when mothers compared their prenatal visualization to the current caregiving reality. Results indicated moderate consistency in MSL between the second and third trimesters, but prenatal and postnatal MSL was not significantly correlated. Across all time points, higher use of MSL was related to more positive sentiment, indicating an association between mentalization and positive caregiving representations across the perinatal period. Women used more affective than cognitive MSL in prenatal imagination of caregiving, but this pattern was reversed in their postpartum reflection. Implications on assessing parental mentalization prenatally and considering the relative dominance of affective and cognitive mentalizing are discussed while considering study limitations.

El trabajo de Nancy Suchman subrayó el papel fundamental de la mentalización maternal en la adicción materna, la salud mental y los retos de la prestación de cuidado. En este estudio, nos propusimos examinar el papel del lenguaje del estado mental como una medida de mentalización en las narrativas pre- y postnatales y su sentimiento en un grupo muestra de 91 madres primariamente blancas del oeste de los Estados Unidos, a quienes se les dio seguimiento a partir del segundo trimestre de embarazo, a través del tercer trimestre, hasta 4 meses después del parto. Específicamente, investigamos el uso de lenguaje del estado mental afectivo y cognitivo en las narrativas prenatales cuando las madres visualizaban el cuidado de su bebé, y las narrativas postnatales cuando las madres comparaban su visualización prenatal con la presente realidad de prestación de cuidado. Los resultados indicaron una consistencia moderada en el lenguaje del estado mental entre el segundo y tercer trimestres, pero el lenguaje del estado mental prenatal y postnatal no fue significativamente correlacionado. A los largo de todos los punto temporales, el más alto uso del lenguaje del estado mental se relacionó con un más positivo sentimiento, indicando así una asociación entre la mentalización y las representaciones positivas de la prestación de cuidado a lo largo del período perinatal. Las mujeres usaron más lenguaje del estado mental afectivo que cognitivo en la imaginación prenatal de la prestación de cuidado, pero este patrón se invirtió en sus reflexiones después del parto. Se discuten las implicaciones sobre el tener acceso a la mentalización del progenitor prenatalmente y considerar el relativo dominio del mentalizarse en lo afectivo y cognitivo, al tiempo que se consideran las limitaciones del estudio.

Le travail de Nancy Suchman a mis en lumière le rôle fondamental de la mentalisation maternelle dans l'addiction maternelle, la santé mentale et les défis de la prestation de soins. Dans cette étude nous nous sommes donné pour but d'examiner le rôle du langage d'état mental en tant que mesure de la mentalisation dans les narrations prénatales et postnatales et leur sentiment chez un échantillon de 91 mères dans l'ensemble blanches vivant dans l'ouest des Etats-Unis d'Amériques, et suivies du second trimestre de la grossesse, durant le troisième trimestre jusqu'à 4 mois après la naissance. Plus particulièrement nous nous sommes penchés sur l'utilisation du langage d'état mental affectif et cognitif dans des narrations prénatales lorsque les mères visualisaient les soins à leur bébé, et les narrations postnatales lorsque les mères comparaient leur visualisation prénatale à la réalité actuelle des soins au bébé. Les résultats ont indiqué une cohérence modérée dans le langage d'état mental entre les second et troisième trimestres mais le langage d'état mental prénatal et postnatal n'était pas significativement corrélé. Au travers de tous les points temporels l'utilisation plus grande de langage d'état mental était liée à un sentiment plus positif, indiquant un lien entre la mentalisation et les représentations positives des soins au travers de la période périnatale. Les femmes ont utilisé un langage d'état mentale plus affectif que cognitif dans l'imagination prénatale des soins, mais ce schéma était renversé dans leur réflexion postpartum. Les implications pour l'évaluation de la mentalisation parentale avant la naissance et pour la considération de la domination relative de la mentalisation affective et cognitive sont discutées, tout en considérant les limites de l'étude.

Aggressive behavior: A language to be understood.

Aggressive behaviors could be considered as a dynamic of communication, in which aggression is a language to be understood, to be deciphered by two protagonists : the aggressor coping with a stressful and threatening situation and the aggressed individual coping with an aggressive acting out. The following questions are addressed: (a) What does aggression mean to the aggressor, what does it mean to the aggressed individual? (b) What does the aggressor want or try to express, and why does he or she use this mode of expression and action over another? (c) How does the aggressed individual react, and what is the impact of his or her response on the aggressor? This article reviews studies on the definition of aggression, its measurement, its developmental role and its associated risk factors in children and adolescents. First, aggression in children and adolescents with typical and atypical development is examined based on a developmental approach, clinical case studies in child and adolescent psychiatry, and an empirical study on aggression in autism. Then, in light of these studies, the problem of violence among younger and younger children and adolescents, is discussed. Finally, taking together these studies and discussion, a model is proposed that accounts for factors involved in aggressive behaviors and for different possible levels of intervention. Physical and/or psychic threats generate stress and may therefore lead to offensive or defensive aggression. Stress has to be considered in its physiological dimension (biological stress responses) and psychological dimension (perceived stress). This model reveals a vicious circle: when the main response to aggression is repression, it may reinforce physical/psychic threats and stress perceived by the aggressor, and in turn aggressive behaviors. Intervention can occur at three levels: the stressful situation, the aggressor (perception of the stressful situation and his or her response), and the aggressed individual (perception of the aggression and his or her response). This model, like all models, is limited but it offers a discussion and perspectives to understand the different links that form the "chain of aggressive behavior" and the relationships between exposure to violence and expression of violence. The article concludes on the interest of a muldisciplinary approach to aggression integrating physiological, psychological and sociological dimensions.

O que se desvela com a rotação do espelho? Da formação do eu à sensação do desejo do Outro / What is unveiled by rotating the mirror? From the formation of the I to the sensation of the Other's desire / Que dévoile-t-on en tournant le miroir? De la formation du Je à la sensation du désir de l'Autre / ¿Qué se desvela con la rotación del espejo? De la formación del yo a la sensación del deseo del Otro

Com base no esquema óptico, proposto por Lacan para identificar a formação do eu na constituição do sujeito, esta pesquisa teórico-clínica levanta a seguinte hipótese: a rotação do espelho plano desvela a fragilidade do eu. O espelho plano introduz, na formação do eu, a alteridade que parte da concepção do Outro em Lacan. Como Freud já havia conceituado, o eu é uma superfície advinda do investimento libidinal a partir da relação do infans com o Outro, substituindo-se à experiência original do corpo despedaçado. Todavia, tal despedaçamento não desaparece no engodo produzido nessa substituição, e quando se desvela, pode lançar o sujeito na angústia. Nossa vinheta clínica visa provocar a discussão que o percurso teórico advindo dessa questão suscita: quando a angústia — como sensação do desejo do Outro —, emerge para, o sujeito espatifando a imagem; ou melho, como diz nosso jovem sujeito, "espaguetificando" o eu.

Resumos Based on Lacan's optical scheme, proposed to identify the formation of the I in the constitution of the subject, this theoretical-clinical research posits that by rotating the plane mirror one reveals the fragility of the I. The plane mirror introduces, in the formation of the self, the alterity emerging from Lacan's conception of the Other. As already conceptualized by Freud, the I is a surface that emerges from the libidinal investment in the infans' relation with the Other, replacing the original experience of the fragmented body. However, such fragmentation does not disappear in this illusional substitution, which, when unveiled, can cast the subject into anguish. Our clinical vignette aims to discuss the theoretical path arising from this question: when anguish — as a sensation of the Other's desire — emerges for the subject, shattering the image; or better, as our young subject puts it, "spaghettifying" the I.

S'appuyant sur le schéma optique de Lacan, proposé pour identifier la formation du Je dans la constitution du sujet, cette recherche théorico-clinique postule qu'en faisant tourner le miroir plan on révèle la fragilité du Je. Le miroir plan introduit, dans la formation du Je, l'altérité issue de la conception de l'Autre chez Lacan. Comme déjà conceptualisé par Freud, le Je est une surface qui émerge de l'investissement libidinal de la relation du nourrisson avec l'Autre, remplaçant l'expérience originelle du corps fragmenté. Cependant, cette fragmentation ne disparaît pas dans cette substitution illusoire qui, lorsqu'elle est dévoilé, peut plonger le sujet dans l'angoisse. Notre vignette clinique vise à discuter la piste théorique qui en découle: lorsque l'angoisse — en tant que sensation du désir de l'Autre — surgit pour le sujet, faisant éclater l'image ; ou plutôt, comme le dit notre jeune sujet, en « spaghettifiant ¼ le Jr.

A partir del esquema óptico, propuesto por Lacan para identificar la formación del yo en la constitución del sujeto, esta investigación teórico-clínica plantea la siguiente hipótesis: la rotación del espejo plano revela la fragilidad del yo. El espejo plano introduce, en la formación del yo, la alteridad que proviene de la concepción del Otro en Lacan. Como ya lo había conceptualizado Freud, el yo es una superficie que surge de la investidura libidinal de la relación del infans con el Otro, sustituyendo la experiencia original del cuerpo despedazado. Sin embargo, este despedazamiento no desaparece en el engaño producido en esta sustitución, y, cuando se desvela, puede lanzar el sujeto en la angustia. Nuestra viñeta clínica pretende provocar la discusión que el camino teórico que surge de esta cuestión suscita: cuando la angustia —como sensación del deseo del Otro — emerge para el sujeto despedazando la imagen; o más bien, como dice nuestro joven sujeto, "espaguetizando" el yo.

[Phasic disorders and aphasia in geriatrics]. / Troubles phasiques et aphasie en gériatrie.

Aphasia, resulting from a brain lesion, leads to a partial or total loss of language in the elderly. By affecting communication abilities, it has repercussions on the life of the subject and his family. There are two types of aphasia. The roles of the caregiver and the speech therapist are in all cases essential. Depending on the communication difficulties encountered by the patient, specific supports can be recommended.

[Semantic analysis of online conversations on lung cancer: The WE-Lung research]. / Analyse sémantique de conversations sur le web portant sur le cancer du poumon : étude Web Ethnography-Lung.

INTRODUCTION: Today, patients with lung cancer and their relatives can easily search information on the Internet and express themselves online. METHODS: Within this web-ethnographic research, we found, based on 246 search terms related to lung cancer, and collected, a sample of 136 online conversations that were published between January 2004 and September 2018, including 1220 messages by 762 authors. RESULTS: The authors of messages, many of them close relatives of patients (35%), share their experience (34%). Seven areas of worrying concern, each of them prominent in 10 to 24% of the corpus, can be grouped under three headings: accepting the disease in order for the patient or their caregiver to fight it ("decide on the prognosis", "managing the treatments", "stopping the progression"), conjuring fate ("naming the guilty ones", "conjuring powerlessness"), asserting resilience ("adopt the right attitude" and "telling one's story in order to survive"). The question of time - disrupted, lost, to be caught up with or controlled - runs through all the issues. DISCUSSION: The patients' and caregivers' concerns go beyond the pace of medical treatment and beyond death. Their mental representations of the disease influence their adherence to the care pathway. Welcoming them in our care and dialogue goes hand in hand with personalized treatment.

The Effects of Prenatal Diagnosis on the Interaction of the Mother-Infant Dyad: A Longitudinal Study of Prenatal Care in the First Year of Life.

Introduction: Mother-child interactions during the first years of life have a significant impact on the emotional and cognitive development of the child. In this work, we study how a prenatal diagnosis of malformation may affect maternal representations and the quality of these early interactions. To this end, we conducted a longitudinal observational study of mother-child interactions from the gestational stage until the baby completed 12 months of age. Participants and Methods: We recruited 250 pregnant women from a local university hospital. Among them, 50 mother-infant dyads participated in all stages of the study. The study group consisted of 25 pregnant women with fetuses with some structural alteration and the control group consisted of 25 pregnant women with fetuses without structural anomalies. We collected obstetric and socio demographic data and pregnancy outcomes. Anxiety and depressive state data were collected using the COVI and Raskin Scales. We video-recorded the mother-infant interactions during several stages, including when the child was a newborn and when the child was 2, 4, 6, 9, and 12 months of age. The quality of the mother infant interactions were measured using the Coding Interactive Behavior (CIB). The interactive moments recorded on video was composed of three different activities, each one lasting appoximately 3 min, which included (1) Free Interaction, where the mother was instructed to interact "as usual" without any toy, (2) Toy Interaction, where the mother and baby played with a puppv, and (3) Song Interaction, where the mother and baby interacted while the mother sang the "Happy Birthday" song. Results: In the gestational phase, there was a significant difference between the groups with respect to anxiety and depression scores, which were significantly higher for the study group. In the postnatal phase, we found significant differences between the groups with respect to CIB scales after the child completed 6 months of age: the study group presented significantly higher values of Maternal Sensitivity at 6 months of age, of Baby Involvement at 9 and 12 months of age, and of Dyadic Reciprocity at 6, 9, and 12 months of age, while the control group presented significantly higher values of Withdrawal of the Baby at 6 months of age, and of Dyadic Negative States at 6 and 9 months of age. Conclusion: The support offered by the study favored the mother-infant bond and had a positive effect on the quality of interaction during the first year of life, despite the presence of prenatal diagnosis.

L'avènement de l'espace chez le jeune enfant / The onset of space in young children / O advento do espaço na criança pequena / El advenimiento del espacio en el la primera infancia

Cette étude examine les conditions de l'avènement de l'espace chez les jeunes enfants. Dans ce but, on procède à une relecture attentive de l'analyse du fort-da par Sigmund Freud, montrant comment ce jeu, inventé spontanément par un enfant de 18 mois, témoigne précisément l'articulation entre le langage, l'espace et l'émergence du désir. Nous nous appuierons également sur plusieurs remarques de Jacques Lacan à ce sujet.

Este estudo tem como objetivo questionar as condições do advento do espaço em crianças pequenas. Para isso, faremos uma releitura da análise que Sigmund Freud fez do fort-da, a fim de mostrar como esse jogo espontaneamente inventado por uma criança de um ano e meio atesta precisamente a articulação entre a linguagem, o espaço e o advento do desejo. Nós vamos assentar com diversos comentários de Jacques Lacan sobre o assunto.

This study investigates how the notion of space emerge in young children. To do so, it carries out a careful re-reading of Sigmund Freud's analysis of the "fort-da," showing how this game, spontaneously invented by an 18-month-old child, precisely indicates the articulation between language, space, and the emergence of desire. The discussion also borrows from several remarks made by Jacques Lacan on the topic.

Este estudio se propone interrogar las condiciones del advenimiento del espacio en la primera infancia. Para ello, se presenta el análisis de Sigmund Freud sobre el fort-da, con el fin de mostrar cómo este juego inventado espontáneamente por un niño de un año y medio atestigua precisamente la articulación entre el lenguaje, el espacio y el advenimiento del deseo. También se utilizan varios comentarios de Jacques Lacan sobre este tema.

Da origem à criação: o aparecimento do sujeito como aquele que c@nta / Del origen a la creación: la aparición del sujeto como quien c@nta / From origin to creation: the appearance of the subject as the one who sings / De l'origine à la création: l'apparition du sujet comme celui qui chante

O sujeito se constitui na rede de significantes, construída diante dos afetos que circundam a sua relação com o Outro. Parte dessa afetação é promovida pela musicalidade que caracteriza a fala materna, que tanto promove simbolizações às enunciações do bebê como também embala o real de seu corpo nas ressonâncias da sua dimensão vocal. Fascínio que integra gozo e sentido, convocando-o à linguagem. Nessa perspectiva, o presente artigo remete a uma pesquisa qualitativa, condizente a uma revisão narrativa de literatura, que tem como principal objetivo compreender como as vocalizações do Outro influenciam a forma em que o sujeito conduz a sua fala, demonstrando que a entrada na linguagem acontece frente ao desejo do Outro e que, assim, o sujeito ao falar também goza, por incorporar tal desejo em sua prosódia

El sujeto se constituye en la red de significantes, construida frente a los afectos que envuelven su relación con el Otro. Parte de esta afectación es promovida por la musicalidad que caracteriza el habla de la madre, que al mismo tiempo promueve simbolizaciones a los enunciados del bebé, pero también empaqueta lo real de su cuerpo en las resonancias de su dimensión vocal. Fascinación que integra goce y sentido, convocándolo al lenguaje. En esta perspectiva, el presente artículo se refiere a una investigación cualitativa, consistente con una revisión de la literatura narrativa, cuyo principal objetivo es comprender cómo las vocalizaciones del Otro influyen en la forma en que el sujeto conduce su discurso, demostrando que la entrada en el lenguaje ocurre frente al deseo del Otro y así, el sujeto al hablar también goza, por incorporar tal deseo en su prosodia

The subject is constituted in the net of signifiers, built on the affections that surround his relationship with the Other. Part of this affectation is promoted by the musicality that characterizes the mother's speech, which promotes both symbolizations to the baby's utterances, as well as nourish the real of her body in the resonances of her vocal dimension. Fascination that integrates jouissance and meaning, summoning it to language. In this perspective, the present article refers to a qualitative research, consistent with a narrative literature review, whose main objective is to understand how the vocalizations of the Other influence the way in which the subject conducts his speech, demonstrating that the entry into language happens in front of the Other's desire and thus, the subject when speaking also enjoys, for incorporating such desire in his prosody

Le sujet se constitue dans le réseau des signifiants, construit face aux affections qui entourent sa relation à l'Autre. Une partie de cette affectation est favorisée par la musicalité qui caractérise le discours de la mère, qui à la fois promeut des symbolisations dans les énoncés du bébé, et emballe également le réel de son corps dans les résonances de sa dimension vocale. Fascination qui intègre jouissance et sens, l'invoquant au langage. Dans cette perspective, le présent article se réfère à une recherche qualitative, cohérente avecune revue de la littérature narrative, dont l'objectif principal est de comprendre comment les vocalisations de l'Autre influencent la manière dont le sujet conduit sa parole, démontrant que l'entrée dans le langage se fait devant le désir de l'Autre et donc, le sujet parlant jouit aussi, d'incorporer ce désir dans sa prosodie

Fracassos na aquisição: os cantos da fala na relação corpo e linguagem / Fallos en la adquisición del lenguaje: preguntas sobre la relación entre cuerpo y lenguaje / Failures in language acquisition/incorporation: concerns about the relationship between body and language / Les échecs dans l'acquisition du langage: questions sur le rapport entre corps et langage

Este trabalho parte de inquietações acerca do atendimento de uma criança, na Clínica de Linguagem, cuja mãe solicitou um diagnóstico diferencial entre Apraxia de Fala na Infância e Transtorno do Espectro Autista. Discute-se a contradição entre a indecidibilidade diagnóstica e a suposta universalidade destas categorias. O objetivo é propor um diagnóstico de linguagem que leve em consideração não somente as inusitadas produções orais de uma criança, mas seu modo de relação à fala do outro e à própria. Utilizou-se como método a discussão de um caso clínico, cujo diagnóstico de linguagem era indicativo de fracassos na inscrição significante no corpo. A intervenção foi realizada sobre o efeito da fala da criança no outro que, à deriva, ficava preso ao espelhamento do gesto motor, impossibilitado de a ele atribuir valor linguístico

Este trabajo es fruto de la preocupación por el tratamiento de un niño, realizada desde la perspectiva de la Clínica del Lenguaje. La madre trajo el niño con la solicitud del diagnóstico diferencial entre Apraxia del Habla en la Infancia y Trastorno del Espectro Autista. Señaló la contradicción entre la entificación y la fijeza de estas categorías y lo que aparece enmascarado bajo la apariencia de indecidibilidad diagnóstica. Propongo articular las inusuales producciones orales del niño con gestos corporales. El diagnóstico del lenguaje, indicativo de fallas en la inscripción del lenguaje en el cuerpo, implicó una intervención sobre el efecto del habla del niño sobre el otro, quien, a la deriva, quedó atrapado en el reflejo del gesto motor e incapaz de atribuirle valor linguístico

This paper is due to concerns on the treatment of a child from the perspective of the Language Clinic. The mother brought the child with the request for the differential diagnosis between Speech Apraxia in Childhood and Autistic Spectrum Disorder. On the article, I highlight the contradiction between the entification and fixity of these categories and what appears masked under the semblance of diagnostic undecidability. I propose to articulate the child's unusual oral productions with bodily gestures. The language diagnosis, indicative of failures in the language inscription in the body, implied an intervention on the effect of the child's speech on the other, who, adrift, was trapped in the mirroring of the motor gesture and unable to attribute linguistic value to it

Ce travail est le résultat de préoccupations concernant le traitement, à la Clinique du Langage, d'un enfant amené para sa mère avec une demande de diagnostic différentiel entre l'Apraxie de la Parole chez l'enfant et Trouble du Spectre Autistique. Dans ce contexte, je souligne la contradiction entre l'éntification et la fixité de ces catégories et ce qui apparaît masqué sous un semblant d'indécidabilité du diagnostic. Je propose d'articuler les productions orales inhabituelles de l'enfant avec des gestes corporels. Le diagnostic du langage, révélateur de défaillances de l'inscription significant dans le corps, impliquait une intervention sur l'effet de la parole de l'enfant sur l'autre, qui, à la dérive, était piégé dans le miroir du geste moteur et incapable de lui attribuer une valeur linguistique

Águas paradas, um rio que corre: a linguagem das tormentas / Still waters, a river that runs: the language of the tempests / Aguas tranquilas, un río que corre: el lenguaje de las tormentas / Des eaux calmes, une rivière qui coule: le langage des tempêtes

Neste ensaio autoral, a experiência de descobrir e habitar uma linguagem inusitada e aberta a ressonâncias emocionais na clínica psicanalítica é apresentada em diferentes camadas textuais. O estilo da prosa poética convida à experiência de aproximação com a alteridade, emulando-se no próprio ato da leitura o objeto que se apresenta analiticamente como uma linguagem de reconhecimento.

In this authorial essay, the experience of discovering and inhabiting an unusual language open to emotional resonances in the psychoanalytic clinical practice is presented in different textual layers. The poetic prose style invites the experience of approximation with otherness, emulating in the very act of reading the object that presents itself analytically as a language of recognition.

En este ensayo de autor, la experiencia de descubrir y habitar un lenguaje inusual abierto a resonancias emocionales en la práctica clínica psicoanalítica se presenta en diferentes capas textuales. El estilo de la prosa poética invita a la experiencia de aproximación con la alteridad, emulando en el acto mismo de leer el objeto que se presenta analíticamente como un lenguaje de reconocimiento.

Dans cet essai d'auteur, l'expérience de découvrir et d'habiter un langage inhabituel ouvert aux résonances émotionnelles dans la clinique psychanalytique est présentée dans différentes couches textuelles. Le style de la prose poétique invite à l'expérience du rapprochement avec l'altérité, émulant dans l'acte même de lire l'objet qui se présente analytiquement comme un langage de reconnaissance.

Estatuto do sujeito na clínica dos autismos / Statute of the subject in the autism clinic / Statut du sujet dans la clinique de l'autisme

Este artigo objetiva indicar a particularidade psicanalítica ao apostar no sujeito na clínica dos autistas.Sustenta que os autistas não estão em condição deficitária. Problematiza a existência do Outro no campo da subjetividade dos autistas recorrendo as indicações do ato inaugural de Rosine Lefort em propor a estutura autística. Busca no suplemento as teses de Lefort por Jean-Claude Maleval as hipóteses que os autistas recorrerem ao uso do objeto autístico, do duplo real e do Outro de síntese como recursos para lidar com a presença da alteridade

This article aims to indicate the psychoanalytic particularity when betting on the subject in the autistic clinic. It sustains that autistic people do not display a deficient condition. It problematizes the existence of the Other in the field of autistic subjectivity, employing the indications of Rosine Lefort's inaugural act in proposing the autistic structure. It seeks the hypotheses that autistic people resort to the use of the autistic object, the double real and the Other of synthesis as resources to deal with the presence of alterity in Lefort's theses by Jean-Claude Maleval in the supplement

Cet texte vise à indiquer la particularité psychanalytique lors qu'elle garantit le sujet dans la clinique de l'autisme. Il défend que les personnes autistes ne sont pas dans un état deficient. À partir des indications de l'acte inaugural de Rosine Lefort qui propose la structure autistique, il problématise l'existence de l'Autre dans le domaine de la subjectivité autistique. Dans les suppléments des thèses de Lefort, l'article travaille à partir de hypothèses de Jean-Claude Maleval selon lesquelles les personnes autistes utilisent l'objet autistique, le double réel et l'Autre de synthèse comme ressources pour faire face à la présence de l'alterité

Lisez, parlez, chantez : la promotion de l'alphabétisation précoce dans le milieu de la santé.

Le présent document de principes aidera les dispensateurs de soins à évaluer l'alphabétisation précoce dans les familles et à leur donner des conseils, et ce, dans presque tous les contextes d'exercice. On y définit les habiletés d'alphabétisation émergente, y compris l'apprentissage précoce du langage et des récits oraux, et on y explore les bienfaits de la lecture, de la parole et de la chanson auprès des nourrissons et des tout-petits, tant pour eux que pour les adultes qui en sont responsables. La lecture partagée au coucher et d'autres habitudes liées au langage ont un effet positif sur la santé familiale, relationnelle et socioaffective. L'exposition précoce à la langue parlée à la maison peut contribuer à l'alphabétisation dans les autres langues auxquelles l'enfant pourrait être exposé. On y trouve enfin des recommandations particulières pour les cliniciens qui conseillent les familles en matière d'alphabétisation précoce.

[From learning reflective awareness to using screens]. / De l'apprentissage d'une conscience réflexive à l'utilisation des écrans.

The emergence of new technologies in our rapidly changing society has significantly changed the way people live. Children of all ages are surrounded daily by a multitude of screens, such as television, computers, video games, smartphones and digital tablets. In the face of this influx, the aim is to bring children to adopt a reflective consciousness, teaching them to question and relate to reality what they see when they watch a DVD or a programme broadcast on television.

Objective odor analysis of incidentally emitted compounds using the Langage des Nez® method: application to the industrial zone of Le Havre.

Environmental odor studies are usually done using two approaches: nuisance impact assessment and source identification. The latter may be done using chemical analysis or sensory analysis. While sensory analyses offer many advantages, they also face the main obstacle: odor nature description still uses conventional methods based on subjective evocations as odor descriptors. This makes the sensory method ineffective especially when the expected outcome is the source identification in the context of an industrial accident. This work wants to fulfill this gap proposing to build an objective database including the odor nature description of selected potentially emitted compounds using a promising approach: the Langage des Nez® (LdN). Using definite odorous compounds as odor referents, this work provides the odor nature description of 44 compounds, reported as potential incidentally released chemical compounds in the industrial zone of Le Havre. The city of Le Havre, France, was chosen as a model due to a history of odorous emissions of industrial origins. A trained panel described the odor of each compound using up to three referents of the LdN referents collection and attributed a score to each referent. A data analysis method was developed based on the frequency of citation of the referents and the attributed scores allowing the categorization of each compound in three types of consensus categories. The data analysis results showed that around 80% of compounds were described with a good consensus, showing the LdN as a well-adapted lexicon. This study does not point to any correlation between the chemical structures of the compounds of interest and their relative referents. When compared to conventional methods, LdN revealed a more objective and precise approach. The proposed experimental method and the results provided in this work offer the first insight for time-efficient approaches to objectively describe environmental odors, especially potentially emitted odors during incidents. This work may be supplemented by abatement and mixture effect investigations for a complete understanding of odor dispersion.

Recordar, repetir e criar na clínica psicanalítica: do lero-lero à pancada de arrepio / Remember, repeat and create in the psychoanalytic clinic: from "lero-lero" to strong emotion / Recordar, repetir y crear en la clínica psicanalítica: del lero-lero al golpe de escalofrío / Rappeler, répéter et créer dans la clinique psychanalytique: du blablabla àu coup de frisson

O objetivo deste trabalho é propor reflexões, baseadas na teoria, na experiência clínica e na arte, sobre as profundas alterações que a técnica psicanalítica vem sofrendo, principalmente a partir da teoria das transformações, de Bion. Ampliada a regra fundamental de Freud, a experiência emocional ganha destaque na apreensão da dupla psicanalítica e mobiliza a necessidade de se aproximar do criar como fator essencial na construção de uma linguagem que coloque analista e analisando em comunhão. A linguagem de emoção passa a ser produto dessa criação e responde, quando exitosa, a questões práticas que nos desafiam em toda sessão analítica: O que falar? Para que falar? Quando falar? Como falar?

The purpose of this work is to propose reflections, based on theory, clinical experience and art, on the profound changes that the psychoanalytic technique has been suffering, mainly, from the "Theory of Transformations", by Bion. Having broadened "Freud's fundamental rule", the emotional experience is highlighted in the psychoanalytic concern and mobilizes the need to approach creation as an essential factor in the construction of a language that brings analyst and analyzing together. The "language of emotion" becomes the product of this creation and responds, when successful, to the practical issues that challenge us throughout the analytical session: what to say? what to talk about? when to speak ?, how to speak?...

El objetivo de este trabajo es proponer reflexiones, basadas en la teoría, en la experiencia clínica y en el arte, sobre las profundas alteraciones que la técnica psicoanalítica viene sufriendo, principalmente, a partir de la "Teoría de las Transformaciones", de Bion. Ampliada la "regla fundamental" de Freud, la experiencia emocional se destaca en la aprehensión del doble psicoanalítico y moviliza la necesidad de acercarse al crear como factor esencial en la construcción de un lenguaje que coloque analista y analizando en comunión. El "lenguaje de emoción" pasa a ser producto de esa creación y responde, cuando es exitoso, a cuestiones prácticas que nos desafían en toda la sesión analítica: ¿qué hablar ?, para qué hablar?, ¿cuándo hablar ?, ¿cómo hablar?...

I objectif de ce travail est de proposer des réflexions basées sur la théorie, l'expérience clinique et l'art, concernant les profonds changements que la technique psychanalytique subit récemment, principalement depuis la «Théorie des Transformations¼ de Bion. En élargissant la «règle fondamentale¼ de Freud, l'expérience émotionnelle prend de l'importance dans l'appréhension du duo psychanalytique et mobilise la nécessité de s'approcher de la création en tant que facteur essentiel dans la construction d'un langage qui met l'analyste et l'analysant en communion. Le «langage de l'émotion¼ devient un produit de cette création et répond, en cas de succès, aux questions pratiques qui nous défient en toute session analytique : de quoi parler ? Pourquoi parler ? quand parler ? Comment parler ? ...

O estruturalismo na obra de Jacques Lacan: um retorno a questão da linguagem / Structuralism in Jacques Lacan's work: returning to the question of language / Estructuralismo en el trabajo de Jacques Lacan: un regreso a la cuestión del lenguaje / Le structuralisme dans l´oeuvre de Jacques Lacan: un retour á la question du langage

Este artigo busca analisar as contribuições do movimento estruturalista para o avanço da psicanálise lacaniana. Para isso, apresentamos um breve histórico sobre as origens desse pensamento e suas principais filiações. Tanto a antropologia de Lévi-Strauss quanto a linguística de Jakobson possibilitaram que Lacan realizasse o seu projeto freudiano atravessado por uma nova forma de produzir ciência. No entanto, destacamos que a relação de Lacan com a linguística saussuriana teve um impacto singular para os rumos da psicanálise. Lacan encontrou na linguística estrutural uma possibilidade de trazer a psicanálise de volta para o seu campo específico - o da linguagem. Desse modo, o estruturalismo ocupa um lugar importante na história da psicanálise, fato este que tentamos demonstrar nesse trabalho.

This article analyzes the contributions of the structuralist movement to the advance of Lacanian psychoanalysis. The study presents a brief history of the structuralism and its main affiliations. Both Lévi-Strauss's anthropology and Jakobson's linguistics enabled Lacan to carry out his Freudian project characterized by a new way of producing science. However, the study highlights that Lacan's relationship with Saussurian linguistics had a unique impact on the direction of psychoanalysis. Lacan found in structural linguistics a possibility of bringing psychoanalysis back to its specific field - language. Thus, structuralism occupies an important place in the history of psychoanalysis, a fact that we try to demonstrate in this work.

Este artículo analiza las contribuciones del movimiento estructuralista al avance del psicoanálisis lacaniana. Para esto, presentamos una breve historia sobre los orígenes de este pensamiento y sus principales afiliaciones. Tanto la antropología de Lévi-Strauss como la lingüística de Jakobson le permitieron a Lacan realizar su proyecto freudiano atravesado por una nueva forma de producir ciencia. Sin embargo, destacamos que la relación de Lacan con la lingüística saussuriana tuvo un impacto único en la dirección del psicoanálisis. Lacan encontró en la lingüística estructural la posibilidad de devolver el psicoanálisis a su campo específico: el del lenguaje. Así, el estructuralismo ocupa un lugar importante en la historia del psicoanálisis, un hecho que intentamos demostrar en este trabajo.

Cet article cherche à analyser les contributions du mouvement structuraliste pour le développement de la psychanalyse lacanienne. Pour ce faire, nous présentons un bref historique des origines de cette pensée et ses filiations plus importantes. Aussi bien l'anthropologie de Lévi-Strauss que la linguistique de Jakobson ont permis à Lacan de réaliser son projet freudien coupé par une nouvelle façon de produire de la science. Nous signalons, cependant, que le rapport de Lacan avec la linguistique saussurienne a frappé, particulièrement, la marche de la psychanalyse. Lacan a trouvé, dans la linguistique structurelle, une possibilité de faire revenir la psychanalyse à son domaine spécifique, celui du langage. Ainsi, le structuralisme occupe une place importante dans l'histoire de la psychanalyse, un fait que nous essayons de démontrer dans cet ouvrage.

Questionnaire Sémantique de Québec (QueSQ). Développement, validation et normalisation.

The main objective of this study was to present the development, validation and normalization of the Quebec Semantic Questionnaire (QueSQ). The QueSQ is a 12-item questionnaire designed for the rapid screening of semantic disorders. Psycholinguistic parameters that can influence performance, such as the nature of semantic features and superordinate semantic categories, were taken into account during its development. Psychometric qualities of QueSQ were demonstrated during the validation process. QueSQ normative data were established on the basis of age and level of education, from a sample of 100 Franco-Quebecers aged 50 years and over.

L'objectif principal de cet article est de présenter le développement, la validation et la normalisation du Questionnaire Sémantique de Québec (QueSQ). Le QueSQ est un questionnaire comportant 12 items, permettant le dépistage rapide des troubles sémantiques. Il a été conçu en tenant compte des paramètres psycholinguistiques pouvant influencer la performance, soit la nature des traits sémantiques et la catégorie sémantique superordonnée. L'étude de validation a permis de mettre en évidence certaines des qualités psychométriques du QueSQ. Les données normatives du QueSQ, établies en fonction de l'âge et du niveau de scolarité, ont été obtenues auprès de 100 personnes franco-québécoises âgées de 50 ans et plus.