Stratégies d’évaluation des troubles d’utilisation d’objets

A substantial proportion of patients with brain damage and neurodegenerative diseases misuse common tools. However, this neuropsychological syndrome affecting everyday life is relatively unexplored in the field of experimental and clinical neuropsychology. Little is known about long-term evolution and specific evaluation and/or rehabilitation. This is partially due to the lack of an integrative theoretical framework taking into account all cognitive processes underlying gesture orientation, object selection, or action sequencing. Indeed, apraxia of tool use goes far beyond the traditional, obsolete distinction between ideational apraxia and ideomotor apraxia. This is a complex symptomatology requiring a conceptual and clinical differential analysis. After a brief overview of the theoretical principles underpinning our evaluation method, the purpose of this article is to describe the various types of tests that are required to exhaustively assess tool use disorders. We will then focus on tool use assessment: types of objects, basic knowledge related to them, presentation modalities, action planning. A case study is presented to illustrate how our analysis works