Le « child-therapist » évoque un enfant qui sacrifie son psychisme et ainsi son développement pour la survie du système familial. Cette thèse cherche à explorer son vécu et à mieux comprendre ce qu’il vit. A travers la méthode d’observation et une analyse utilisant la méthode d’IPA (Interpretational Phenomenological Analysis), je questionne son développement psychique, sa mentalisation et la colère latente qu’il peut ressentir envers ses parents. Cette recherche a révélé que certains child-therapists se développent à travers un conditionnement, c’est-à-dire à partir des tâtonnements vers des comportements désirés, ainsi que des comportements qui réduisent les tensions au sein de la famille. Aussi, en présence de ses parents, il démontre de fausses capacités de mentalisation. Enfin, sans exception, il porte une colère envers ses parents défaillants. Cette recherche a donc élucidé le fonctionnement mental du child-therapist. / The child-therapist speaks of a child who sacrifices his own psychical development for the survival of his or her family. This dissertation sets out to understand the mind of the child. Using the observational method and the IPA (Interpretational Phenomenological Analysis) to analyse the data,I set out to investigate his or her development, his or her mentalization capacities and a latent anger that he or she could harbour towards his or her parents. This research showed that the child develops through a form of conditioning. In addition, he or she exhibits false mentalization capacities, but only in the presence of his or her parents. Lastly, the child holds anger and resentment towards his parents that failed him or her. This study helped shed light on the mind of the child-therapist.

Constraint-induced movement therapy (CIMT) has been demonstrated to yield functional improvements for children with spastic hemiplegic cerebral palsy (CP); however, many studies have reported inconsistent findings with regards to the extent of the benefits observed following the intervention. This study sought to examine the effects of CIMT in the context of a day camp in this population; it also examined the child-therapist (C-T) interaction during the assessment sessions as a potential factor influencing the child’s scores on tests of motor performance. This interaction has not yet been formally measured in the literature, and may influence the perceived outcomes of CIMT. Motor Outcomes: Results demonstrated significant improvements in quality of use of the upper extremity following the intervention; the improvements were maintained at the 3-month follow-up. Analysis of each individual participant yielded additional information on clinically significant improvements. C-T Outcomes: Results demonstrated that the strength of the C-T interaction was significantly and positively correlated with the scores obtained by participants on motor assessments. The results of this study indicate that modified CIMT is effective in inducing lasting and meaningful changes in children with spastic hemiplegic CP. They also suggest that the C-T interaction may contribute to a participant’s performance during the assessment session, which may ultimately affect the perceived outcomes of CIMT. / UOIT

Children, growing up in this digital era incorporate technology into play, communication and learning. Therapists working with children endeavour to use mediums with which children are familiar and thus need to make a decision whether to include technology in or exclude technology from their therapeutic environments. This is no easy decision, in the midst of negative publicity regarding the role technology plays in children‘s lives. A deeper understanding of what encourages or discourages therapists from using technology as a therapeutic medium with children could guide practitioners in their decisions regarding the use of technology in therapy. The aim of this study was to explore and describe experiences of therapists using technology, as a therapeutic medium with children. A qualitative multiple case study design was used. Experiences were defined as the “active process" of reinterpreting the "physical, perceptual, affective and cognitive aspects" of being exposed to events to bring about a change in response options (McKnight & Sechrest, 2003:471). Data were collected by means of semi-structured interviews and visual data. Seven therapists participated in the research, selected by means of non-probability purposive sampling and snowball sampling. Collected data and reflective field notes were analysed thematically, using an inductive, interpretive approach, guided by a theoretical framework, the Theory of Reasoned Action (TRA). Findings indicated that all participants were aware that children find technology appealing, but participants who were older or psychodynamically orientated were less inclined to incorporate technology as a therapeutic medium. Participants who were experimental by nature used technology as a therapeutic medium with some caution. Experimentally inclined participants who had received training in using technology used technology not only as a therapeutic medium, but also more confidently as a play medium. Participants were deterred mainly by the uncertainty of the therapeutic value of technology, the lack of ethical guidelines regulating the use of technology in therapy and the concern that technology may interfere with the therapeutic process. Further research regarding parents’ and child-clients’ perspectives of using technology in therapy would perhaps reduce speculative perceptions. Research regarding therapists’ values and perceptions of technology as a therapeutic medium could guide stakeholders in their development of training programs and necessary ethical guidelines. / MA (Psychology), North-West University, Potchefstroom Campus, 2015

Children, growing up in this digital era incorporate technology into play, communication and learning. Therapists working with children endeavour to use mediums with which children are familiar and thus need to make a decision whether to include technology in or exclude technology from their therapeutic environments. This is no easy decision, in the midst of negative publicity regarding the role technology plays in children‘s lives. A deeper understanding of what encourages or discourages therapists from using technology as a therapeutic medium with children could guide practitioners in their decisions regarding the use of technology in therapy. The aim of this study was to explore and describe experiences of therapists using technology, as a therapeutic medium with children. A qualitative multiple case study design was used. Experiences were defined as the “active process" of reinterpreting the "physical, perceptual, affective and cognitive aspects" of being exposed to events to bring about a change in response options (McKnight & Sechrest, 2003:471). Data were collected by means of semi-structured interviews and visual data. Seven therapists participated in the research, selected by means of non-probability purposive sampling and snowball sampling. Collected data and reflective field notes were analysed thematically, using an inductive, interpretive approach, guided by a theoretical framework, the Theory of Reasoned Action (TRA). Findings indicated that all participants were aware that children find technology appealing, but participants who were older or psychodynamically orientated were less inclined to incorporate technology as a therapeutic medium. Participants who were experimental by nature used technology as a therapeutic medium with some caution. Experimentally inclined participants who had received training in using technology used technology not only as a therapeutic medium, but also more confidently as a play medium. Participants were deterred mainly by the uncertainty of the therapeutic value of technology, the lack of ethical guidelines regulating the use of technology in therapy and the concern that technology may interfere with the therapeutic process. Further research regarding parents’ and child-clients’ perspectives of using technology in therapy would perhaps reduce speculative perceptions. Research regarding therapists’ values and perceptions of technology as a therapeutic medium could guide stakeholders in their development of training programs and necessary ethical guidelines. / MA (Psychology), North-West University, Potchefstroom Campus, 2015

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Clinical and research practice in the context of Autism rapidly evolved in the last decades. Finer diagnostic procedures, evidence-based models of intervention and higher social inclusivity significantly improved the possibility for autistic children to participate in the fabric of social life. In terms of health best practices, gold-standard procedures still need to be improved, and bridging research and clinical practice still presents several challenges. From the clinical standpoint, the role of process variables, predictors, mechanisms, and timing of change still requires extensive investigation in order to explain response variability and design optimized interventions, tailored to individual needs and maximally effective. Observational techniques represent the elective research methods in child development, especially in clinical contexts, due to their non-invasiveness. However, they still suffer from limited objectivity and poor quantification. Further, their main disadvantage is that they are highly time-consuming and labor-intensive. The aim of this thesis was moving forward to promote translational research in clinical practice of Autism intervention with preschool children. At first, we tried to design and apply quantitative observational techniques to longitudinally study treatment response trajectories during developmental intervention. We tried to characterize different response profiles, and which baseline predictors were able to predict the response over time. Secondly, we investigated mechanisms of change. In particular, we focused on the role of the child-therapist interaction dynamics as a possible active mediator of the process of intervention, especially in the developmental framework that stresses the importance of interpersonal aspects. We also aimed at understanding whether certain time-windows during the intervention were particularly predictive of the response, as well as which specific interaction aspects played a role. Finally, to promote the translational application of observational methods and to improve objective quantification, we proposed and validated an Artificial Intelligence (AI) system to automate data annotation in unconstrained clinical contexts, remaining completely non-invasive and dealing with the specific noisy data that characterize them, for the analysis of the child-therapist acoustic interaction. This effort represents a base building block enabling to employ downstream computational techniques greatly reducing the need for human annotation that usually prevents the application of observational research to large amounts of data . We discuss our findings stressing the importance of assuming a developmental framework in Autism, the key role of the interpersonal experience also in the clinical context, the importance of focusing on trajectories of change and the important need to promote the acquisition of large amounts of quantitative data from the clinical contexts exploiting AI-based systems to assist clinicians, improving objectivity, enabling treatment monitoring, and producing precious data-driven knowledge on treatment efficacy.

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