Staff training and Deafblindness

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Staff training and Deafblindness

• The Challenge of Communication

Zaragoza, March 28 2008 Prof. dr. Marleen Janssen
University of Groningen
Viataal-Sint-Michielsgestel
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Communication as a challenge

• Communication
• Transmission of meaning by the use of
  utterances which are perceived and interpreted by
  the communication partner ( Janssen, 2003 to
  Bjerkan, 1996)
• Dialogue mutual creation of meaning (DbI
  CN, 2007)

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Communication as a challenge

• Deafblind from birth on
• Assessing cognitive and communicative
  potentials
• 
  
  (Lenderink, 1907)

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Deafblindness - What does it mean?
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World of nearby senses

• Bodily experiences and exploration
• Building up bodily impressions and concepts
• as basis for commmunicative expressions
• Film Arjan and the horse - booklet 1

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Communication- What do you mean?

• Misunderstandings or assymmetries in
  dialogue
• World of touch and bodily emotional
  expressions
• Risc on emotional and behavioral problems

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What do you mean?

• Negotiation of meaning
• Tactile communication
• Film Hot Choclat Booklet 1

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• Quality of Communication
• Quality of Life

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Deafblindness

• What does it mean for staff training?
• Insights
• Skills
• Attitudes

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Work DBI Communication Network

• Implementation Project series handbooks with
  video
• Danish Resource Centre and Viataal
• Communication and Congenital Deafblindness
• I. Congenital Deafblindness and
  Intervention
• II. Contact and Social interaction
• III. Meaning making
• IV. Transition to Cultural Language

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Good practice

• practice based evidence

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Staff training

• Insights and Knowledge
• Processes of development and learning
• Deafblindness
• Individual assessment and intervention
• Interaction and communication

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Staff training

• Skills and competencies
• Willing and skilled in interacting
• Interacting on terms of the person with DB
• Able to be involved in varied relationships
• Collaboration within multipdisciplinary network

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Staff training

• Attitudes and conditions for learning
• Take the perspective of the person with DB
• Focus on bodily expressions and meaning
  potentials
• Many different ways of communication from
  bodylanguage to fluent
• sign language
• Use of touch, smell and tast require more time
  and more mental activity
• Adding language while matching attention and
  thinking and action

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Core principles of intervention

• Development as all human beings
• Fundamental processes in communication
• Specific deafblind knowledge
• Individual level life history individual
  competencies
• Role of parents and families essential

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Core principles of intervention

• Natural learning
• Creating an natural learning environment
• Reciprocal togetherness
• Togetherness is co-created
• Dynamic creation in routines and rituals
• Emotional involvement
• Dialogue co-regulating, negotiating and sharing
  meanings
• Transactional model aimed at positive snowball
  effects

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Core principles of intervention

• Holistic approach
• Look for the potentials in the person
• Nearby senses included in learning situations
• Multimodal approach
• Bodily gestures created in experiences is basis
  of communication
• Deafblind Services must have life long
  perspective

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Communication partners and coach

• Working in networks
• Role of communication coach/consultant
• Video analysis of communication
• Assessment and intervention cycli

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Communication coach

• Directing and supervising partners
• Working with video-analysis
• Systematic approach
• Formulating clear intervention aims
• Implementing intervention
• Evaluating intervention
• Formulating new aims

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Evidence based practice

• Diagnostic Intervention Model
• Developed on basis of three intervention
  studies with 13 persons with DB and 44 educators
  (parents, teachers and caregivers)
• 
  (Janssen, 2003 2006)

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Home interaction coaching - case Rolf

• Interaction
• Process in which two individuals influence
  each other by exchanging behaviors or utterances
• 
  (Janssen, 2003 to Bjerkan, 1996)

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Core characteristics of harmonious interactions

• 1. Mutual attention
• 2. Being in tune with each other
• 3. Adequate emotional regulation

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Diagnostic Intervention Model

• Purpose
• Fostering harmonious interactions
• Intervention pinciples
• Improving insights and skills of the partners
  to
• a) Recognize individual behaviors and
  utterances
• b) Attune own behavior to those of the person
  with DB
• c) Adapt the interaction context
• Intervention protocol
• 1) Determination of the question
• 2) Clarification of the question
• 3) Interaction analysis
• 4) Implementation of the intervention
• 5) Evaluation

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Interaction analysis

• Intervention aims in terms of core categories
  of
• interactive behavior
• a) initiatives
• b) confirmation
• c) answers
• d) turns
• e) attention
• f) intensity
• g) affective involvement

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Definitions

• Initiatives starting an interaction or raising
  something new as part of a reaction
• Confirmation clear acknowledgement that an
  initiative has been noticed and recognized
• Answers approving or disapproving reaction to an
  utteracne of teh partner
• Turns turn-taking or becoming the actor, and
  turn-giving or allowing the otehr to become the
  actor
• Attention focus on the partner, content of
  interaction, people or objects within the
  interaction context

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Definitions

• Intensity for educators waiting while the
  persoen with DB regulates the intensity for
  person with DB
• via for example turning head away, laying
  hand on the hand of the educators, but also via
  for example self- abusive or aggressive behaviors
• Affective involvement mutual sharing of emotions
• 
  (Janssen et al., 2003 2006)

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Determination of the questions

• 1. How can Rolf feel better understood?
• 2. How can I react more adequately during
• interaction?
• 3. How can I improve reciprocity in
  interaction?

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Clarification of the questions

• a) Characteristics of Rolf
• b) Characteristics of physical and social
  environment
• c) Determination of the type of coaching

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Interaction analysis

• a) Individual behaviors and utterances
• b) Interaction characteristics
• c) Interaction context
• d) Intervention aims

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Intervention aim 1

• Rolf feels better understood
• less often regulation of intensity
• more often approving answers
• less often disapproving answers
• more often affective involvement

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Intervention aim 2

• Mother can react effectively
• confirms more often

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Intervention aim 3

• Mother can improve reciprocity in interaction
• less often initiatives
• simultaneous turns shorter
• more often affective involvement

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Case Rolf

• Implementation of the intervention
• Evaluation

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Effects Rolf feels better understood
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Effects Mother reacts more effectively
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Effects Mother improves reciprocity
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Effects Affective involvement
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Diagnostic Intervention Model

• applicable for
• individual coaching
• team coaching
• home settings
• school settings
• residential settings
• other target groups

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Education of educators and coaches

• Managers and organisation must support this way
  of working
• Certified basic training for educators
• Certified training for communication coaches
  (1.5 year)
• Coach is not a separate profession
• Viataal- Sint-Michielsgestel, The Netherlands
• Academic course Interaction coaching CONTACT
  at University of Groningen

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Skills in daily communication

• Film fragments
• Implementation project
• Communication and Congenital Deafblindness
• viataal_at_viataalshop.nl

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Literature

• Series Communication and Congenital
  Deafblindness
• I. Congenital Deafblindness and the core
  principles of intervention (Inger Rodbroe
  Marleen Janssen, 2006)
• II. Contact and Social Interaction (Marleen
  Janssen Inger Rodbroe, 2007)
• Sint-Michielsgestel, Viataal_at_viataalshop.nl
  
• Janssen, M.J., Riksen-Walraven, M. Van Dijk, J.
  (2003a). Toward a Diagnostic Intervention Model
  for fostering harmonious interactions between
  deafblind children and their educators.
• Janssen, M.J., Riksen-Walraven, M. Van Dijk, J
  (2003b). CONTACT Effects of an intervention
  program to foster harmonious interactions.
  Journal of Visual Impairment and Blindness, 97,
  197-229.
• Janssen, M.J., Riksen-Walraven, M. Van Dijk, J.
  (2006).Applying the Diagnostic Intervention Model
  for Fostering Harmonious interactions. A case
  study. Journal of Visual Impairment and
  Blindness, 100, 91-105.

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Thank you for your attention