Psychomotricity and Psychoneurology: introduction to the human psychomotor system (HPMS)
AbstractThis paper deals with the interactive relations between neurology, psychology, motricity according to an evolutionary point of view. The human psychomotor system (HPMS) which emerges from philogenetic and ontogenetic evolution, is based on symmetric and asymmetric structures, and functional units. These three units involve a specific neurological substratum corresponding to psychological functions and psychomotors factors. The first unit includes the functions which form the neurological substratum of psychomotor factors of tonicity and equilibrium. The second unit includes the functions responsible for the organization of psychomotor factors of laterality, body image and space-temporal structure. The third unit includes the psychological functions of planning, programming and regulation and also the organization of some neurological factors such as global and fine praxia. The constant interaction of these three units forms a work constellation which processes the motricity in an organization preliminary to its final product. According to these concepts, a psychomotor battery (PMB) has been developed. It consists of situations and tasks distributed among seven psychomotor factors (tonicity, equilibrium, laterality, body image, space-time structure, global and fine praxia). The battery was administered to 120 children. A large correlation was found between body image and fine and global praxias and between space-time structure and fine praxia. In conclusion, these data confirm the systemic and neuropsychological architecture of the psychomotor systems.
Anxieties and fears in old age
AbstractElderly people experience life through what they have been, what they are, and what they still expect to be and to fulfill. The path of existence, from its beginnings to prolonged longevity, flows along the path of multiple and varied experiences, which can have various meanings. Human beings carry in themselves the notion and the awareness of life and also the end of life. From the very beginning there is either the happy and satisfying awareness of feeling protected and believing that life follows a plan, or the anguishing and desperate insecurity of abandonment and disappearance. Life, in every instant, is not forgetful of itself, and doesn’t change its intrinsic semantic quality over time. Anguish that one is not aware of, may modify the way it is expressed and the cloths in which it appears, but it is fed by the same significant feelings in every era. Old age represents the historical continuity, the succession, the accumulation, the adaptation, the apposition, the correlation of events, strategies, modalities, experiences, and meanings given to events in the past. It corresponds also to peculiar problems and characteristics of the contingent life, in particular the risks of losing, the anxieties and the fears that are rekindled, and individual ways of expressing these internal states, which can also be of clinical interest. The research projects that have been conducted over a long period of time, and the specific and recent studies about elderly people and the current social community (in metropolitan areas in particular), in various residential contexts, have revealed many interesting points. The study was carried out with the use of a questionnaire, applied during a semi-structured interview. These studies have revealed that elderly people suffer from feelings of uneasiness, experience difficulties, anxieties, dread and fears. These feelings are associated with the perception of the future, of possible changes in the family and in the emotional sphere, with health and autonomy, loneliness and poverty, with the progressive increase of abominable news items given live on television or witnessed in person, that is often uncalled for and unexplained. A certain number of elderly people are afraid to live alone, forgotten by everyone. They are afraid of illness, pain and invalidity. They suffer from being in a state of economic precariousness that doesn’t allow them to sustain the possible therapies and the expensive, lengthy assistance services. They are afraid of mental decline, the incapacity to confront life’s last sacrifices, one more task, the last passages. They also sense the anxiety of an undesired epilogue in a resting home, expropriated of their privacy, that has been long defended, and of the freedom to organize and articulate for themselves how they will spend their days. They feel anguished about a possible abandonment, in particular when their health begins to decline. The prospective that the situation will become chronic worsens, and the ghost of extreme poverty comes to light next to their imposed loneliness. Many elderly people are afraid of the social environment. They are afraid to be attacked, isolated, cast out. They are afraid of being easy targets for practical jokes or acts of violence. These fears are also mediated by the frequent images and news items that are transmitted by the means of mass communication. The same residence, especially for elderly women, tends to lose its traditional protective, reassuring function. In addition to the violation of one’s home, the typical fears of the elderly of today, especially those that live in the big cities, seem to be the fear of aggression when on the street or when using public means of transportation. Some elderly people try to accept the modifications that the process of aging foresees and produces. At times the signs of the past are experienced with anxiety and suffering, especially when the body is invested with particular positive valences, such as the mediation of a particular type of relationship. The nearness to or the progression of old age stimulates a comprehensive confrontation with one’s existence. To make this confrontation the elderly person may refer back to the meanings of his past experiences, to the outlined plot of his life. He may also reflect on his relationship with immanence, the anguish and continuity that derive from this relationship, and the developments that this anguish and continuity could possibly have. The studies confirm that generally the elderly person is not afraid of the drawing near of the completion of his existence. Instead, he feels serene about his last appointment. Some people in this last phase of life express, nevertheless, dread and fear about death. Not all begin, proceed, and arrive at this destination in the same conditions. Personal history has traced a singular destiny for each one of us. This destiny is carried out in the mist of difficulties and facilitation, opportunities and hardships, losses and elaboration, uncertainties and acquisitions, between desire and the anguish of being. Old age harvests what has been sown and the peculiarity of past seasons. It spans the articulation of the whole journey. It reflects the nature of its solemn gait. It considers and weights its continuing path. It collects the antique and current anguishes, the soothed fears of the past and the evocation of those in the present, the ignition and the extinguishing of these fears, their predominance and their surrender. There are elderly people that lose track of themselves, yet still many others experience actively and with awareness the meaning of their existence and life’s end. A subtle relationship seems to exist between anguish and adaptation, fear and knowledge, subjectivity and experience, that sketches and unveils the countless faces of old age. Anxieties and fears in old age sometimes seem to express a difficult attempt to recall and, at times, to reconstruct the sensation of continuity and the value of the unitary dimension of existence.
Laterality in normal and retarded development.
AbstractIn developmental research, the issue about left laterality constitutes a “puzzle” of complex solution with regard to both the causes and the consequences. What is the real incidence on cognitive abilities and on personality? Is nonright laterality really connected to dislexia or other learning disabilities? Is it right to interfere to modify laterality? This paper summarizes the main empirical evidences on this topic - often in contrast -, focusing on laterality in mentally disabled subjects that, as reported in literature, are mainly left lateralized. Methodological issues, with regards to the evaluation of laterality, are then addressed. First of all, laterality can be categorized only arbitrarily, starting from a continuum that should be pointed out using proper formulae. It is necessary to distinguish handedness from over-all laterality that involves other modalities (foot, eye, ear). For what concerns assessment instruments, they should be distinguished in self report surveys - that can be sparely used with children or mentally retarded subjects - and direct observations of behavior. The first empirical study presented by the authors concerns the relationship between laterality and cognitive abilities in a large representative sample extrapolated from Sicilian schools population. The sample includes 393 students attending the 1st and 5th elementary classes. Evaluation of laterality has been made using 12 tests involving 4 modalities (hand, foot, eye, ear) to deduce a quantitative index of lateralization. Simultaneously, psychometric tests concerning left-right orientation, attention-concentration, perception and visuo-motor memory, verbal memory and semantic ability (Span and Vocabulary), and linguistic comprehension have been administered. Finally, MT reading test and mathematics tests were administered as achievement tests. Teachers’ intermediate and final marks have also been considered. Results show a 5% of left lateralized students in both 1st and 5th grade. Differences between sex, age and modality preferences are discussed. Except for few cases (attention and vocabulary in 1st grade, left-right orientation in 5th grade), lateralized students do not show better performances in cognitive and achievement tests than those with mixed or ambiguous lateralization. A specific study has been conducted with a sample of 48 subjects (28 females and 20 males) with mild (n=10), moderate (n=23) and severe (n=15) mental retardation. Ages ranged from 7 to 18 years. In mentally retarded subjects, there is a larger amount of left lateralized subjects than in normal. This refers, above all, to left handedness males: almost 1/3 of males with mental retardation is left handedness, while there is only an 8% of left handed subjects in the whole sample (in females the percentage is definitely lower). If all the modalities are considered, the percentage of mixed lateralization is very high (above 40%), but it is very low (almost zero) if only handedness is considered. In conclusion, mixed or ambiguous lateralization, in normal subjects, seems a developmental feature without any connection with cognitive or learning disability. In subjects with mental retardation, the marked differences connected with gender should be carefully examined taking care of cerebral pathology and his hemispheric localization. Besides, it should be interesting to study lateralization of persons with mental retardation from the life-span point of view and to verify if, as in normal subjects, there is a consolidation of preferences in adults and elderly.
Behavior Analysis and mental retardation: what can behavioral psychology offer today to the psychology of handicap.
AbstractThe main purpose of this paper is to clarify and to characterize more precisely what the analysis of behavior is. First of all behavior analysis is not synonymous of behaviorism and coincides only partially with it : certainly much few with behaviorism that many identify in Pavlov and Watson. The analysis of behavior is the psychological science that comes from behavioristic philosophy and presents its own characteristics for as concerns theoretical principles, methodological options, basic and applied research, technology. The analysis of behavior is an approach that could be described in functional terms. Functional means, first of all, that behavior is more interested in psychological functions than structures; functional means, moreover, that it addresses the processes that take place in the interaction between a human being and the environment not as two separate entities, but as a unique and mutual moment of this functional relationship. Despite of the fact that many people think that behaviorism consists of the objective and exclusive study of behavior, behavior analysis shows paradoxically little interest toward behavior itself, since is not behavior in topographical and descriptive sense that interests behavior analysts but its function or "purpose." This means to take into account all variables that act into a definite field: setting events, antecedent stimuli, responses, consequences. Among them, a key concept is that of class of behaviors. Classes of behavior could vary for width and complexity. A basic class of behaviors, of great width and complexity, is rule governed behavior or instructed behavior: every time a child is asked through a verbal instruction to learn or do anything we are in front of rule governed behavior. At the light of this general analysis of human nature and behavior some applications are discussed in the field of the mental handicap.
Marital separation and types of difficulties observed in the children: an empirical contribution
AbstractThis study deals with the consequences that a separation has on members of the nuclear family. It is based on a review of the Italian and non-Italian researchs on the topic of the cluster of variables that purposefully induce adaptive and non-adaptive modifications in parents and in their children. The authors have focused their attention on the effect that an adequate re-elaboration of the separation by the couple has on the psychological, emotional, and social adaptation of the children. On the contrary, conflicted dynamics of the couple that extend over a period longer than normal, and the consequences that these conflicts implicate (feelings of loss, inadequacy, etc.), don’t allow the children to have good emotional equilibrium. In particular, the process of individualization and separation, a basic element of growth, is blocked. Two sample groups have been used in this study, matched by size, education level, profession, and years of marriage. The subjects come from various areas of Sicily. Two research instruments were used: 1) The Symbolic Drawing of Family life, devised by Gilli et al. (1989), was administered to all the family members; 2) a semi-structured interview (freely adapted from a tool structured by Dell’Antonio, was administered to the parents, to study some problematic areas: a) decisional process, b) evaluation of the effects of separation on the children c) sharing of parenting d) educational criteria and life-style e) willingness and evaluation of change. The results of the research highlighted some observations that stimulate further clinical and psychological inquiry. The importance of a good re-elaboration of the separation in the family structure, founded on the willingness of the parents to reconstruct a satisfying vital experience, and also a willingness to share the parenting function, has become evident. In particular, the research shows how the parents’ tendency to project their own suffering onto the children does not allow the children to elaborate the situation personally. Instead, it induces controlled emotional states, adult-type behaviors, etc. Particular relationships between a child and his separated parent, that can disrupt the process of individualization in both of them, were observed. These conclusions suggest the need to use specific diagnostic-clinical research and intervention tools. The results of the research also seems to indicate that specific forms of counseling and assistance to the families could be useful in helping them understand the events of the family crisis, the implications of these events, that can change and evolve, negatively or positively, over time.
Lexical competence and learning to read: a longitudinal study
AbstractIn line with nowadays research guidelines in the field of neuropsychology and psycholinguistics which focus their attention on written language and on single words, this study attempts to analise the complex relationship between lexical competence and learning to read. According to a longitudinal plan of research, we have first evaluated lexical competence on grammar, nouns, verbs, adverbs, adjectives in 104 children attending the last year of primary school and showing the same sociocultural background. In the second phase of our research, carried out during the following school year, lexical and reading abilities have been evaluated again. The data obtained underlines a bidirectional relationship between the two variables. Differences have to be found on what concerns the qualitative and quantitative aspects linked to lexical competence compared to the process of comprehension and decodification linked to reading.
Rehabilitative outcome in children coma. Research on 17 cases at the Rehabilitation Center Astri-Arico in Milan
AbstractThis study concerns the outcome and rehabilitation of infantile coma, taking into consideration the outcome with regards to the self-sufficiency and autonomy reached by the patient at least four years after the event and also evaluating the different factors influencing that outcome. The rehabilitative therapy is valued according to its precocity, intensity, globality and duration, labeling it on the basis of these criteria as appropriate or inappropriate. Following the rehabilitative therapy is compared to the outcome of the patients. The study is based on 17 children, whose age ranges from 10 months to 10 years, and who had suffered a post-traumatic or a post-anoxic coma lasting from one to 147 days. These children have been observed three times during the follow-up period: one year, two years and at least four years after the event. This study reveals that the recovery in post-comatose children is very long since at least four years from the event are needed, while a certain level of autonomy is usually late (requires at least two years from the event). Furthermore the main problem encountered after at least four years is psychological in more than half of the cases. The factors that have been shown to have the major influence on the outcome in terms of self-sufficiency and autonomy are: psychological problems, motor deficits, neuropsychological deficits and family environment. As to rehabilitative therapy, the emphasis must be put on its decisive importance for the patient's outcome. It must also be noticed that the quality of this therapy is fundamental since, in order to give a good result, it must be characterized by precocity, intensity, globality and duration. In particular, it can be seen that following each follow-up control, self-sufficiency and autonomy of the patients treated in an appropriate way is always superior compared to patients not treated in an appropriate way.
Psychological intervention with parents of young Prader Willi according to a group technique derived from Balint method
AbstractThe article unfolds in three parts : the first part deals with the physical and psychological characteristics of P.Ws and with the most important results of psychological research, in the second part the A.A. describe how they have arrived at a particular method of intervention for the treatment and prevention of P.W.'s emotional disturbances: the third part focuses on the results obtained with this intervention. In the first part P.W. syndrome, discovered by the Swiss physicians Prader and Willi in 1956 , whose genetic origin has been found out only recently, is described both in its physical features ( dysmorphism, hyperphagia leading to obesity, hypogonadism , short stature ), and in its psychological aspects (mental retardation, behavioral alteration and a tendency to develop psychic disturbance ) that contribute to make PWs' life particularity difficult. The A.A. then refer to the main conclusion elicited in the second and last International congress on PW syndrome (Oslo 1995) where many papers were focused on PW's emotional vulnerability that can be responsible of serious psychic diseases. They point out how the findings of an American research confirm results obtained from a follow-up investigation in the Endocrinologica Center of Infancy and Adolescence of Milan : they show that family relantionships are of primary importance in worsening or improving the potential emotional disturbances of these subjects. The second part deals with a multifocal psychological program with PW adolescents and in particular with the choice of an intervention with their parents since in the above mentioned investigation their relationships with PW boys and girls had been found relevant to the latter's emotional state. The A.A. describe how the methods of intervening with the adults taking care of children and adolescents with psychological problems has changed in the time. Until about ten years ago, according to an epistemological trend common in the time, psychologists and psychiatrists used to transmit the data elicited from their assessments to parents, teachers and medical staff, basing on the assumption that knowledge of the case, and the indications that followed, could induce these people to behave in ways adequate to soave the child's problem. This method was proved unsuccessful in most cases while it became more and more evident that it was important to understand the relationships between the young and the adults, above ali in their emotional connotations, and that most problems depended on their interactive and dynamic aspects. It was understood that it was necessary that the adult should investigate and discuss his own reactions to improve the relationship with the problematic child. This conclusion lead to the necessity to find methods different from the previous ones. The A.A. explain how this urge made them join the Milano Balint group where they were trained as Balint leaders. They have studied for fifteen years its applications with parents of children affected with psychological problems. The third part focuses on the characteristics of the group of PWs' parents. During the sessions of the groups that took place in the last five years it became evident that PWs' psychic disharmony, emotional vulnerability, lacking control of impulsivity and compulsive behaviour were responsible for parents' intense emotional reactions ( refusal or hostility towards their children or depression and a sentiment of powerlessness). It was understood that sharing problems and difficulties with the other parents constitues a relevant group support that made parents able to communicate even their most painful experiences. The discussion in each session, of a situation referring to the relationship of a parent with a child was found to promote better insights: in many cases parents succeeded in becoming aware of attitudes and feelings active at a deep level but denied to consciousness. Six young PW out of eight, whose parents had attended this program for at least three years, improved in their emotional state. In particular, a girl who suffered from psychotic cryses and serious school maladjustment, became better and better until she reached a steady positive emotional state. The girl's improvements followed gradual changes in her mother as the latter, within the group, learned to recognize her aggressivity towards her daughter and to understand that most of the girl's misbehaviours were due to PWs' strong compulsion towards food.
Autistic Behavior Assessment Scale (SVA): validity, reliability, effectiveness
AbstractThe most used clinical instruments for the evaluation of autistic behavior are considered before the SVA (Scheda di Valutazione di comportamenti Autistici - autistic behavior assessment scale) is presented. The SVA scale was elaborated to make easier an early identification of the autistic syndrome. The reliability was verified applying the scale to 10 children with autism by 3 different psychologists. The ability to measure autistic behaviors was verified applying the scale to 30 subjects with autism, 30 subjects with mental retardation, 30 subjects without mental retardation. The effectiveness was verified applying the SVA scale together with the CARS scale to 30 subjects with autism. Results are satisfactory and could be supposed that the SVA scale is a good diagnostic instrument for the autistic disorder.
Visual perception in mental retardation. From experimental psychology to clinical neuropsychology.
AbstractResearches on visual perception in mental retardation, have followed a peculiar evolution. From the second half of this Century until the end of the Seventies there was a large amount of general experimental researches on newborns and children. After that period, researches and papers published in that field were less numerous. In this paper the current situation is described and a possible interpretation of the phenomenon is proposed according to the most recent neuropsychological researches. The use of the neuropsychological approach in developmental age and in mental retardation is still a very debated question, but it moved the research field from the “laboratory” to the subject daily life. The possibility to use neuropsychological approach in both research and clinical work for visual perception in mental retardation is discussed outlining the consequent theoretical, methodological, and practical changes.