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Journal 02/08

1. Le fonctionnement déficitaire, évolution de l’autisme infantile
2. Habiletés alphabètes nécessaires à l’autonomie chez les personnes qui ont des incapacités intellectuelles: synthèse de trois études
3. The issue of professional exhaustion (burnout) is evolving

 Le fonctionnement déficitaire, évolution de l’autisme infantile

Prof. Francisco Palacio Espasa,
Chef de service et Professeur
ordinaire de Psychiatrie de
l’enfant et l’adolescent,
HUG - Université de Genève                                   

We will try to illustrate the different theoretical types of deficitary evolution. These evolutions, with slight variations, may be divided into 3 types of characteristic profiles. The essential aspects are:

Profile of type I : autism to narcissistic personality
Profile of type II : autism to schizoid personality
Profile of type III : autism to deficit

Our therapeutic work with psychotic children enables us to qualify deficitary functioning as « mutulating simplfication » of the psychid and mental life. It is characteristic of the evolution of deficitary fonctioning beginning in autism.

This type of functioning can be found, on a less severe scale, in all other psychological evolutions : psychotic, borderline and narcissistic.

The systematic study of the narcissistic dimention of the personality, recently published with Juan Manzano, enabled us to describe two narcissistic forms of functioning that constitute the extremes of a continuum defining these two forms : at one end narcissistic and at the other end, objectal (linked to reality).

The most severe polarity is persecutory narcissism also referred to as destructive narcissism (Rosenfeld, 1977) that constitutes prevelent narcissism in psychotic and borderline functioning. This mechanism largely utilizes the deficitary functioning and the attacks against the psychic life in order to deny the depressive anxiety due to the loss of an object. This mechanism has to deny the differentiation of the idealized objects. In the most schizoid forms, the narcissistic fantacies of fusion with the idealized objects are very cryptic, that is to say, not very apparent on the mental level.

At the end of the contimuum, closer to the neurotic evolution, we find the manic narcissism whose paradigm the manic defenses. In this sense the manic narcissistic functioning in the Oedipus Complex allows the child to deny the differences between generations as well as not realizing the exclusion from the relation between the parental couple. This subtle denial mechanism allows the child to claim him/herself as partner of one of the parents and the rival of the other.

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 Habiletés alphabètes nécessaires à l’autonomie chez les personnes qui ont des incapacités intellectuelles : synthèse de trois études

Sahar El Shourbagi

M.A. en culture d’enfance
Ph. D. en psychopédagogie

Chargée de cours en adaptation
scolaire et assistante d’enseignement:
Université de Montréal, département
de psychopédagogie et d’andragogie,
Groupe DÉFI Apprentissage

Agente de recherche, Université
de Montréal, Centre d’études ethniques
des universités montréalaises.

Activités professionnelles actuelles
Chercheure Post doctorante : Université
du Québec à Montréal, Département de
communication sociale et publique,
groupe de recherche Médias et santé

Jacques Langevin

M.A. Orthopédagogie
Ph. D. Psychologie cognitive

Expériences et activités
professionnelles actuelles

Professeur titulaire, Université de
Montréal, Département de psychopédagogie
et d’andragogie, Codirecteur du Groupe
DÉFI Apprentissage

Most intellectually disabled people remain illiterate despite fifteen years of education (Duchesne, 1999). This situation can strangle the autonomy and the social participation of the disabled people. Questionable pedagogic goals are partially to blame for this situation. Hence, the focus of this study is not to identify the desirable literacy skills (the capacity to realize activities which require the control of the writer code’s basic skills as reading, writing and calculation) but to identify the needs of necessary literacy skills in order to achieve functional autonomy and support social participation for those people.

At the beginning, we have clarified some concepts related to this study such as: autonomy, social participation, literacy and literacy skills.

Then, we have used three needs assessment methods to ascertain the necessary literacy skills required to achieve functional autonomy and the social participation:

First study (2005)

  1. Indicators approach (approche par indicateurs): Dever’s community life taxonomy goals (1988), was analyzed by three experts in order to point out the goals that required literacy skills. This list of goals was then submitted to other (eight) judges who identified the nature of the literacy skills required. This approach revealed a list of 15 literacy skills.

Actual studies

  1. Discussion group (groupe de discussion): we discussed literacy skills with eight
    mildly intellectually disabled adults (four of them are illetracy). They also provided feedback on the results obtained by the analysis of the taxonomy of community living skills in the indicators approach. This method added 4 literacy skills to the list of the indicators approach.
  2. The Delphi technique (technique Delphi): Seven experts expressed their opinions regarding required literacy skills; meanwhile they validated the results of the two previous methods stated above. The Delphi technique added six literacy skills to the list of the two others methods. Finally we established a final list of required literacy skills that contains 25 literacy skills.

The combined results of these three methods reveals that essential literacy skills include primarily the elementary skills of reading and writing of common words and simple phrases, as well as basic numeracy, and time and money management skills.

In conclusion, the study reveals that more this people gain those literacy skills, less they are dependant to others. These results may also contribute to an overall revision of the curriculum proposed for the intellectually disabled students.

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 The issue of professional exhaustion (burnout) is evolving

Dr. Ennio Cocco
Adjoint Médical Psychiatre
Fondation “Institution de Lavigny”
Route du Vignoble
CH - 1175 – Lavigny


The issue of professional exhaustion (burnout) is evolving

At the time when the problem was first pointed out, in the middle of the seventies, professional burnout only concerned the so-called helping professions (health professionals, teachers, social workers and so on).

During the nineties there has been a remarkable acceleration of the introduction of business principles into the hospitals and, prospectively, into the health, and even social, establishment.

It seems therefore legitimate to reconsider empirically the burnout in the light of these changes, which could influence this phenomenon up to the point of modifying its physiognomy, and moreover to do so asking a preliminary question: are the health professionals still more exposed to the problems of work exhaustion than other categories of workers?

In the present work we propose a study aiming at seeing whether the more or less pervasive introduction of a medical paradigm plays a role in the socio-educational institutions for people with learning disabilities at the level of the origin of burnout, in the sense of protecting the professionals, or rather exposing them more to it. 


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