{"id":9845,"date":"2012-04-01T18:22:15","date_gmt":"2012-04-01T16:22:15","guid":{"rendered":"http:\/\/www.lacanquotidien.fr\/blog\/?p=9845"},"modified":"2012-04-06T19:20:49","modified_gmt":"2012-04-06T17:20:49","slug":"lapproche-clinique-de-leo-kanner-serait-elle-consideree-comme-non-pertinente-aujourdhui","status":"publish","type":"post","link":"https:\/\/lacanquotidien.fr\/blog\/2012\/04\/lapproche-clinique-de-leo-kanner-serait-elle-consideree-comme-non-pertinente-aujourdhui\/","title":{"rendered":"L\u2019approche clinique de L\u00e9o Kanner serait-elle consid\u00e9r\u00e9e comme \u00ab non pertinente \u00bb aujourd\u2019hui ?"},"content":{"rendered":"

Autisme : l\u2019approche clinique de L\u00e9o Kanner <\/span><\/strong><\/h1>\n

serait-elle consid\u00e9r\u00e9e comme \u00ab\u00a0non pertinente\u00a0\u00bb aujourd\u2019hui\u00a0?<\/strong><\/span><\/h1>\n

Marco Mauas<\/strong><\/span><\/h2>\n

\"\"<\/a><\/p>\n

\n

Part I.<\/strong><\/p>\n

Une lecture du texte princeps sur l\u2019autisme de L\u00e9o Kanner1 <\/sup>\u00a0peut, encore de nos jours, surprendre. Il s\u2019agit de la description de 11 enfants. \u00ab\u00a0Each case merits\u2014\u00e9crit-t-il \u00e0 la troisi\u00e8me ligne\u2014a detailed consideration of its fascinating peculiarities.\u00a0\u00bb Les d\u00e9tails de sa consid\u00e9ration clinique sont d\u00e9licats.<\/p>\n

\u25aa D\u00e8s le premier cas, le cas de Donald (\u00e2g\u00e9 de 5 ans, \u00ab\u00a0Don\u00a0\u00bb), on peut distinguer le dit, r\u00e9p\u00e9titif, rituel, qui pourrait \u00eatre la cible, le leurre pour essayer des r\u00e9compenses et des ch\u00e2timents, appliqu\u00e9s au dire\u00a0:<\/strong><\/p>\n

\u00ab\u00a0He used the personal pronouns for the person he was quoting, even<\/span><\/em> imitating the intonantion.\u00a0\u00bb (soulign\u00e9 par MM).<\/p>\n

Un autre exemple\u00a0:<\/p>\n

\u00ab\u00a0The word \u00ab\u00a0yes\u00a0\u00bb for a long time meant that he wanted his father to put him up on his shoulder. This had a definite origin. His father, trying to teach him to say \u201cyes\u201d or \u201cno\u201d, once asked him, \u201cDo you want me to put you on my shoulder\u201d?<\/p>\n

\u201cDon expressed his agreement by repeating the question literally, echolalia-like. His father said, \u201cIf you want me to, say \u201cYes\u201d; if you don\u2019t want me to, say \u201cNo\u201d\u201d.<\/p>\n

\u201cDon said \u201cyes\u201d when asked. But thereafter<\/span><\/em> \u201cyes\u201d came to mean that he desired to be put up on his father\u2019s shoulder.\u201d (Soulign\u00e9 MM).<\/p>\n

\u201cThereafter\u2026came to mean\u201d, c\u2019est le temps subjectif du cas \u00ab\u00a0D\u00a0\u00bb, dans la description clinique de Kanner. C\u2019est un \u00ab\u00a0thereafter\u00a0\u00bb tr\u00e8s diff\u00e9rent du \u00ab\u00a0avant\u00a0\u00bb et du \u00ab\u00a0apr\u00e8s\u00a0\u00bb de l\u2019\u00e9valuation des r\u00e9sultats des approches, cliniques ou autres, de ce qu\u2019on appelle \u00ab\u00a0autisme\u00a0\u00bb. Je veux seulement remarquer que le \u00ab\u00a0But thereafter came to mean\u2026\u00a0\u00bb peut-\u00eatre facilement consid\u00e9r\u00e9\u00a0 comme \u00ab\u00a0non pertinent\u00a0\u00bb, puisque le d\u00e9sir du clinicien, Kanner en ce cas, se limite \u00e0 signaler, sans juger. <\/strong>C\u2019est seulement signal\u00e9. L\u2019accent sur le dire barre l\u2019attention sur le \u00ab\u00a0after\u00a0\u00bb souhait\u00e9, par une approche autre, plus guid\u00e9e par le \u00ab\u00a0carrot-stick\u00bb que par la clinique.<\/p>\n

\u00a0<\/strong><\/p>\n

\u25aa Le second enfant est le cas Frederick (\u00e2g\u00e9 de 6 ans). Une phrase de Kanner\u00a0:<\/p>\n

\u00ab\u00a0The most striking feature in his behavior was the difference in his reactions to objects and to people. Objects absorbed him easily and he showed good attention and perseverance in playing with them. He seemed to regard people as unwelcome intruders whom he paid as little attention as they would permit<\/span><\/em>.\u201d (Soulign\u00e9 par MM)<\/p>\n

\u201cAs they would permit\u201d c\u2019est l\u2019espace du dire, c\u2019est une condition, ouverte, du cas Frederick dans la description de Kanner. Dans la m\u00e9thode ABA, on cherche \u00e0 capter l\u2019attention de l\u2019enfant comme une cible. La condition clinique temporalis\u00e9e par le conditionnel,\u00a0\u00ab\u00a0as they would permit\u00a0\u00bb, c\u2019est-\u00e0-dire une variable gr\u00e2ce \u00e0 laquelle on peut \u00e9couter et lire le dire de l\u2019enfant, peut \u00eatre consid\u00e9r\u00e9e comme \u00ab\u00a0non pertinente\u00a0\u00bb. C\u2019est une mesure subjective, intime, de l\u2019enfant, qui est retourn\u00e9e comme un gant en une mesure de l\u2019efficacit\u00e9. <\/strong>\u00ab\u00a0We won\u2019t permit, with carrot or stick.\u00bb. Disparition du \u00ab\u00a0as\u00a0\u00bb (\u00ab\u00a0dans la mesure subjective de\u2026\u00a0\u00bb), de l\u2019espace de l\u2019\u00e9cout\u00e9 et de la conversation.<\/p>\n

\u25aa Voyons le troisi\u00e8me enfant. Richard M. Deux ponctuations cliniques de Kanner :<\/p>\n

\u00ab\u00a0When started for the examination room, he screamed and made a great fuss, but once he yielded he went along willingly.\u201d<\/p>\n

Ici je noterai que le \u201cyielded\u201d (c\u00e9der) n\u2019est pas ce qui int\u00e9resse l\u2019\u0153il du clinicien, il est m\u00eame secondaire. Une fois qu\u2019il c\u00e8de sur ce \u00ab\u00a0great fuss\u00a0\u00bb, on trouve le \u00ab\u00a0willingly\u00a0\u00bb, c\u2019est-\u00e0-dire que le sujet n\u2019\u00e9tait pas l\u00e0. C\u00e9der n\u2019est pas forc\u00e9ment un indicateur tellement pr\u00e9cis de \u00ab\u00a0avant-apr\u00e8s\u00a0\u00bb.<\/p>\n

La d\u00e9couverte de ce qu\u2019on appelle aujourd\u2019hui \u00ab\u00a0autisme\u00a0\u00bb est le r\u00e9sultat d\u2019une mani\u00e8re de proc\u00e9der, de noter, de ponctuer, d\u2019\u00e9couter, qui serait consid\u00e9r\u00e9e peut \u00eatre aujourd\u2019hui comme \u00ab\u00a0non pertinente\u00a0\u00bb. <\/strong><\/p>\n

Seconde ponctuation clinique de Kanner que je veux souligner. \u00ab\u00a0The mother felt that she was no longer capable of handling him, and he was placed in a foster home near Annapolis with a woman who had shown a remarkable talent for dealing with difficult children. Recently, this woman heard him say clearly his first intelligible words: \u201cGood night\u201d \u201c.<\/p>\n

On peut longuement discuter la pertinence de ce que veut dire \u201ca remarkable talent for dealing with difficult children\u201d. Mais c\u2019est cette femme qui \u00e9couta et aussi put transmettre \u00ab\u00a0for the record\u00a0\u00bb les premiers mots intelligibles. Il est \u00e9galement remarquable que ces mots constituent aussi la fin de la description du cas Richard M. Good night, Richard.<\/p>\n

\u25aa Le cas n\u00b04, Paul G, (\u00e2g\u00e9 de 5 ans), nous apprend <\/strong>comment, lorsque le clinicien s\u2019int\u00e9resse au pass\u00e9, dans les deux sens, du \u00ab\u00a0pas forcement utile\u00a0\u00bb et aussi du \u00ab\u00a0temps pass\u00e9\u00a0\u00bb, il ouvre quelquefois la porte \u00e0 la relation, pas du tout claire, avec l\u2019angoisse et le corps. Cette relation peut \u00eatre consid\u00e9r\u00e9e comme \u00ab\u00a0non pertinente\u00a0\u00bb si on centre l\u2019int\u00e9r\u00eat juste un peu trop sur le \u00ab\u00a0avant-apr\u00e8s\u00a0\u00bb, car ainsi on pourrait risquer de laisser une partie importante de la vie symptomatique de l\u2019enfant hors conversation. <\/strong>Je cite un passage de Kanner\u00a0:<\/p>\n

\u00ab\u00a0He got hold of a pair of scissors and patiently and skilfully cut a sheet of paper into small bits, singing the phrase \u00ab\u00a0Cutting paper\u00a0\u00bb, many times. He helped himself to a toy engine, ran around the room holding it up high and and singing over and over again, \u201cThe engine is flying\u201d. While these utterances, made always with the same inflection, were clearly connected with his actions, he ejaculated others that could not be linked up with immediate situations. These are a few examples: \u201cThe people in the hotel\u201d; \u201cDid you hurt your leg?\u201d; \u201cCandy is all gone, candy is empty\u201d; \u201cYou\u2019ll fall off the bicycle and bump your head.\u201d However, some of these exclamations could be definitely traced to previous experiences. He was in the habit of saying almost every day, \u201cDon\u2019t throw the dog off the balcony.\u201d His mother recalled that he had said those words to him about a toy dog while they were still in England. At the sight of a saucepan he would invariably exclaim, \u201cPeten-eater.\u201d The mother remembered that this particular association had begun when he was 2 years old and she happened to drop a saucepan while reciting to him the nursery rhyme about \u201cPeter, Peter, pumpkin eater.\u201d Reproductions of warnings of bodily injury constituted a major portion of his utterances.\u201d<\/p>\n

Ici, on voit comment la m\u00e9thode du \u201ccarrot-stick\u201d \u00e9carte nettement toute chance d\u2019accompagner l\u2019enfant, quand bien m\u00eame quelquefois, \u00e9tant \u00e0 ce point condition de possibilit\u00e9 de ces m\u00e9thodes, lalangue ou le langage fait prise sur le corps. C\u2019est l\u2019avertissement, le signe de la blessure corporelle, ce qui est not\u00e9 par le clinicien.<\/strong><\/p>\n

 <\/p>\n

\n
\n<\/div>\n

1http:\/\/www.autismtruths.org\/pdf\/Autistic%20Disturbances%20of%20Affective%20Contact%20-%20Leo%20Kanner.pdf<\/a><\/sup><\/p>\n

\n
\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Autisme : l\u2019approche clinique de L\u00e9o Kanner serait-elle consid\u00e9r\u00e9e comme \u00ab\u00a0non pertinente\u00a0\u00bb aujourd\u2019hui\u00a0? Marco Mauas <\/p>\n

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