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Clinics in Developmental Medicine No. 18
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The Imitation of Gestures
j e a n Berges
A technique for studying the body schema and praxis of children three to six years of age
ΙΓΘΠΘ
cHlÛ ίβζίΐΐβ
Translated by Arthur H. Parmelee Jr. Preface by Professor J. de Ajuriaguerra with a Foreword by Richmond Paine
21s or $3
1965
Published by The Spastics Society Medical Education and Information Unit in Association with William Heinemann Medical Books Ltd. London
Test d'Imitation de Gestes' was first published by Masson et Cie, Paris, in 1963. Appendix 3 of the present edition is reproduced by kind permission of Editions Scientifiques et Psychotech niques, Issy-les-Moulineaux, Seine.
Printed in England by THE LAVENHAM PRESS LTD., Lavenham, Suffolk.
Foreword Drs. Berges and Lézine have done a real service to pediatricians and to neurolo gists who deal with children, in making available two sets of tests* of the imitation of gestures performed by the examiner. These tests have now been carefully standardized, and throughout the entire work there is evidence of accurate scientific thought of a type which is unfortunately not too usual in medical books. The drawings of the gestures to be imitated are clear, standards for scoring as 'pass' or 'fail' for each one are clearly set forth, and a simple practical method of notekeeping is furnished. One is glad to learn that 100 premature infants were also studied and it is particularly fortunate to be told of the range of their scores in comparison with children born at term. The authors also provide us with valuable information about the development of right-left orientation in children from 4 to 8 years of age. A slight majority could identify their own left hand and right leg at the age of 5 but the majority did not success fully identify right and left parts of the examiner on three separate re-trials until 8. Recognizing that right-left orientation is usually not well established until the age of 6, Dr. Berges and his colleague have given credit for imitation of the gestures in mirror image. Several points concerning the reproduction of gestures in mirror image raise important and fascinating theoretical questions. The authors observe that the most difficult gesture scheduled to be presented for the child's chronological age is the one most likely to be reproduced in non-mirror image, but that the patients with the largest number of non-mirror image responses were those who obtained the poorest overall scores. There appeared also to be a tendency to execute the most difficult move ments with the dominant upper extremity, in those tests which involve use of both upper limbs. When the children were asked to make the Opposite' gesture, reversed right for left, the possibility of mirror-image mimicry was eliminated. If children up to 6 years of age were asked to do this after a successful reproduction of the original gesture they usually did so again and subsequently reversed it, which can be interpreted as a reversibility of action but not of image. Older children immediately executed the reversed gesture without the intermediate stage of imitating it in its original form. It will be readily apparent on a little thought that the test of imitation of gestures requires a certain degree of visual acuity, perception of the gesture as a Gestalt, some concept of body image and of extracorporeal space (with directional orientation for the more difficult tests), a certain level of general intelligence, and finally praxis, motor power and co-ordination to reproduce the gesture. The tests draw on several areas of cerebral function which are often disproportionately or selectively depressed in the presence of organic encephalopathies. One would expect the tests to be especially difficult for children with 'minimal