WEBVTT 00:00:08.654 --> 00:00:12.313 Communication in work and educational settings 00:00:12.313 --> 00:00:20.698 How can communication with people with profound intellectual and multiple disabilities be successfully organized in work and educational settings? 00:00:20.706 --> 00:00:25.866 The responsibility for establishing interaction 00:00:25.866 --> 00:00:29.006 or communication lies largely 00:00:29.006 --> 00:00:32.625 lies with people without disabilities, 00:00:32.625 --> 00:00:35.766 at least initially, or at least to start with. 00:00:35.766 --> 00:00:39.126 So this arrangement of situations, 00:00:39.126 --> 00:00:40.486 as I said before, 00:00:40.486 --> 00:00:44.446 or even in this sensitivity and responsiveness, 00:00:44.446 --> 00:00:47.706 well, the signs are also different, much more subtle. 00:00:47.706 --> 00:00:49.366 So what can I pick up on 00:00:49.366 --> 00:00:52.246 to develop this into a dialogue? 00:00:52.246 --> 00:00:55.766 And there are also studies or a lot of knowledge on this, 00:00:55.766 --> 00:00:59.866 that we are also guided by intuition to a large extent, 00:00:59.866 --> 00:01:01.606 at least in early childhood. 00:01:01.606 --> 00:01:05.046 And that we orient ourselves, 00: 01:05.046 --> 00:01:06.546 for example, by common 00:01:06.546 --> 00:01:09.646 behaviors such as gestures or facial expressions 00:01:09.646 --> 00:01:11.226 or someone smiles 00:01:12.846 --> 00:01:16.630 or someone can perform actions and 00:01:16.630 --> 00:01:18.230 that's exactly that and that pulls 00:01:18.230 --> 00:01:19.750 then through all stages of life, 00:01:19.750 --> 00:01:21.770 so it becomes even more difficult 00:01:21.770 --> 00:01:23.290 the older people are, 00:01:23.290 --> 00:01:26.090 because in childhood you still have the child schema, 00:01:26.090 --> 00:01:29.230 which evokes this affection or 00:01:29.230 --> 00:01:32.490 which makes it easier, I think, 00:01:32.490 --> 00:01:33.870 to make contact, 00:01:33.870 --> 00:01:35.630 with adults it's different, 00:01:35.630 --> 00:01:37.230 because someone initially displays completely different, 00:01:37.230 --> 00:01:38.890 unusual behavior, 00:01:38,890 - -> 00:01:43,210 where you first have to adjust to it and then 00:01:43.778 --> 00:01:46.438 But still, the same approach is 00:01:46.438 --> 00:01:50.038 what the person offers me to develop into a dialogue. 00:01:50.038 --> 00:01:52.138 And that is also, 00:01:52.138 --> 00:01:53.738 that this is unconditional, 00:01:53.738 --> 00:01:57.538 meaning that it is possible with anyone. 00:01:57.638 --> 00:02:01.478 And that's just up to me, 00:02:01.478 --> 00:02:03.198 that I take advantage of these opportunities. 00:02:03.198 --> 00:02:05.638 So, unusual signs, 00:02:05.638 --> 00:02:08.997 subtle expressions and 00:02:08.997 --> 00:02:10.318 develop them into a dialogue. 00:02:11.426 --> 00:02:14.966 So there are two sides to the role of communication partner 00:02:14.966 --> 00:02:18.226 and that also has something to do with perspectives, 00:02:18.226 --> 00:02:21.246 that in the early days 00:02:21.246 --> 00:02:24.286 of supporting profound intellectual and multiple disabilities, 00:02:24.286 --> 00:02:25.446 there are quotes, 00:02:25.446 --> 00:02:28.046 for example, from Seeweinig or also from Fröhlich, 00:02:28.046 --> 00:02:30.486 that people were also described as individuals 00:02:30.486 --> 00:02:32.826 who are at best capable of 00:02:32.826 --> 00:02:35.086 responding to communicative offers. 00:02:35.810 --> 00:02:40.250 And this view has actually changed a lot 00:02:40.250 --> 00:02:41.710 and that's also a very important point, 00:02:41.710 --> 00:02:43.490 that it has changed, 00:02:43.490 --> 00:02:49.070 but it also shows that the opportunities 00:02:49.070 --> 00:02:51.450 that I can take advantage of, or an opportunity 00:02:51.450 --> 00:02:54.970 that someone gets for communication, for participation, 00:02:54.970 --> 00:02:57.490 that they are again in this perspective. 00:02:57.490 --> 00:02:59.970 So when I see someone like that, 00:02:59.970 --> 00:03:02.642 who wants to form a relationship 00:03:02.642 --> 00:03:04.402 and that they also want to express themselves, 00:03:04.402 --> 00:03:06.642 that there is a personality behind it 00:03:06.642 --> 00:03:13.402 and that these people also want social relationships 00:03:13.402 --> 00:03:15.202 or want to help shape them, 00:03:15.202 --> 00:03:18.842 then I approach a person in a completely different way. 00:03: 18.842 --> 00:03:21.282 And I perceive something completely different. 00:03:21.282 --> 00:03:23.782 And yes, that's exactly the point, 00:03:23.782 --> 00:03:26.882 that this initiative is actually more important 00:03:26.882 --> 00:03:29.062 than provoking this reaction. 00:03:29.062 --> 00:03:33.774 The person who, well, 00:03:33.774 --> 00:03:35.754 who might then be described as easy to care for, 00:03:35.754 --> 00:03:38.454 because they are easy to deal with, 00:03:38.454 --> 00:03:41.354 three alarm bells always go off in my head, 00:03:41.354 --> 00:03:43.854 because they are easier to handle than the child, 00:03:43.854 --> 00:03:46.514 who, so to speak, screams and starts hitting out 00:03:46.514 --> 00:03:51.454 when they can't follow something or when something is different, 00:03:51.454 --> 00:03:55.674 because it's important there, 00:03:55.674 --> 00:03:57.054 so they basically 00:03:57.054 --> 00:03:59.114 learned communicative helplessness, so to speak, 00:03:59.114 --> 00:04:01.074 it doesn't matter what I do, 00:04:01.698 --> 00:04:04.018 or I can't influence anything. 00:04:04.018 --> 00:04:05.718 And that's just a situation 00:04:05.718 --> 00:04:06.738 that you can, for example, 00:04:06.738 --> 00:04:09.358 through self-awareness, 00:04:09.358 --> 00:04:14.618 how important it is to make things predictable. 00:04:15.363 --> 00:04:23.948 What tasks arise in communication for employees in work and educational settings? 00:04:24.066 --> 00:04:25.586 Another thing is what I already mentioned 00:04:25.586 --> 00:04:27.846 with these documentaries, 00:04:27.846 --> 00:04:30.466 that you record experiential knowledge. 00:04:30.466 --> 00:04:31.806 And that can be 00:04:31.806 --> 00:04:34.606 in the form of autobiographies, for example, 00:04:34.606 --> 00:04:36.866 where you write things down, 00:04:36.866 --> 00:04:38.126 write down preferences. 00:04:38.126 --> 00:04:40.066 What does someone like, what does someone dislike? 00:04:40.066 --> 00:04:40.606 What do I do 00:04:40.606 --> 00:04:42.526 when someone is in a stressed state? 00:04:42. 526 --> 00:04:45.666 An extended form of this are dialogue books. 00:04:45.666 --> 00:04:46.706 I think that's really nice too. 00:04:46.706 --> 00:04:48.766 This is from the Spastic Aid Association in Berlin. 00:04:48.766 --> 00:04:49.666 They developed it, 00:04:50.210 --> 00:04:52.270 and they even recorded it on video, 00:04:52.270 --> 00:04:53.550 this is what it looks like, 00:04: 53.550 --> 00:04:54.990 if the person is doing well, 00:04:54.990 --> 00:04:55.630 this is what it looks like 00:04:55.630 --> 00:04:57.350 when the person is in pain. 00:04:57.350 --> 00:04:59.870 And that every new employee is, so to speak, 00:04:59.870 --> 00:05:04.290 and 00:05:04.290 --> 00:05:06.590 these books are then continued or 00:05:06.590 --> 00:05:10.270 or adapted. 00:05: 10.270 --> 00:05:11.830 Of course, not everything stays the same, 00:05:11.830 --> 00:05:13.630 so preferences also change 00:05:13.630 --> 00:05:15.610 or new ones can be developed. 00:05:15.610 --> 00:05:16.590 So, of course, they have to be 00:05:16.590 --> 00:05:18.230 continued and adapted. 00:05:19.074 --> 00:05:20.094 And it's helpful 00:05:20.094 --> 00:05:23.094 to have something like that for each individual, 00:05:23.094 --> 00:05:25. 274 that it also states exactly 00:05:25.274 --> 00:05:29.094 for example, rest period, stored in such and such a way, 00:05:29.094 --> 00:05:32.314 that it is documented visually and also, 00:05:32.314 --> 00:05:34.194 that you know what to look out for. 00:05:34.194 --> 00:05:36.474 And that simply brings 00:05:36.474 --> 00:05:38.774 or certain procedures are also defined, 00:05:38.774 --> 00:05:40.834 for example in personal hygiene. 00:05:40.834 --> 00:05:42.894 Because, as I said, this point, 00:05:42.894 --> 00: 05:45.634 even if everyone has the best motivation 00:05:45.634 --> 00:05:47.974 and long professional experience, 00:05:48. 226 --> 00:05:50.546 does a good job based on their motivation, 00:05:50.546 --> 00:05:52.126 it may be 00:05:52.126 --> 00:05:54.666 that for the person with a profound intellectual and multiple disability, 00:05:54.666 --> 00:05:57.406 that is experienced as a different situation, 00:05:57.406 --> 00:05:59.366 because the sequence is different, for example. 00:05:59.366 --> 00:06:02.446 And that can be avoided. 00:06:02.446 --> 00:06:05.366 It's always about building predictability and expectations 00:06:05.366 --> 00:06:08.646 and tools like this help a great deal with that. 00:06:08.646 --> 00:06:12.406 It's also important to exchange ideas, 00:06:12.406 --> 00:06:14.706 a kind of case conference, 00:06:14.706 --> 00:06:19.126 case conferences can be held in the clinic, 00:06:19.126 --> 00:06:20.546 we hold case conferences, for example, 00:06:20.546 --> 00:06:22.526 where communication is also a topic, 00:06:22.526 --> 00:06:24.386 so it's about patients 00:06:24.386 --> 00:06:26.926 who are regaining communication, 00:06:26.926 --> 00:06:29.266 i.e. those with the most severe brain damage 00:06:29.266 --> 00:06:32.586 for example, those in a persistent vegetative state, then waking up again, 00:06:32.586 --> 00:06:35.066 in the next phase, so to speak, and there 00:06:35.066 --> 00:06:36.146 it is also very important, for example, 00:06:36.146 --> 00:06:37.046 exchange ideas, 00:06:37.046 --> 00:06:38.526 what did you notice this week, 00:06:38.526 --> 00:06:40.906 was it nodding or is it more like closing your eyes 00:06:40.906 --> 00:06:42.806 or is it more like a handshake, so 00:06:43.554 --> 00:06:45.234 Then it's more about the form of yes, no, 00:06:45.234 --> 00:06:47.654 that's already the case with the other group, 00:06:47.654 --> 00:06:49.114 which we're talking about, nothing to expect. 00:06:49.114 --> 00:06:51.054 But you can just see how important it is 00:06:51.054 --> 00:06:53.014 that you then have a period of time, so to speak 00:06:53.014 --> 00:06:54.174 in one direction for a while. 00:06:54.174 --> 00:06:55.714 What I said earlier, 00:06:55.714 --> 00:06:57.074 is that you exchange ideas and then say, 00:06:57.074 --> 00:06:58.514 hey, if that works best, 00:06: 58.514 --> 00:07:00.734 then let's all try it out. 00:07:00.734 --> 00:07:02.234 Let's all go in the same direction. 00:07:02.234 --> 00:07:04.834 Then it will just become predictable and foreseeable again. 00:07:04.834 --> 00:07:08.414 Another thing is what we often 00:07:08.414 --> 00:07:11.674 at the assisted communication counseling center, 00:07:13.954 --> 00:07:15.934 that it helps just by itself, 00:07:15.934 --> 00:07:19.054 when people from different areas 00:07:19.054 --> 00:07:21.814 and guided, 00:07:21.814 --> 00:07:24.154 namely via a questionnaire on communication, 00: 07:24.154 --> 00:07:26.654 simply exchange ideas about the skills 00:07:26.654 --> 00:07:28.254 that are perceived in everyday life 00:07:28.254 --> 00:07:31.654 or the means of expression 00:07:31.654 --> 00:07:35.054 that are perceived, or what is thought about, 00:07:35.054 --> 00:07:37.754 what the person understands, 00:07:37.754 --> 00:07:39.914 i.e. understanding situations or understanding language. 00:07:40.418 --> 00:07:43.478 And that alone often helps a lot, 00:07:43.478 --> 00:07:45.058 because it's done far too rarely, 00:07:45.058 --> 00:07:46.398 that everyone sits down together 00:07:46.398 --> 00:07:48.518 and just talk about it. 00:07:48.518 --> 00:07:50.758 And that also provides impetus 00:07:50.758 --> 00:07:53.298 to look at things differently 00:07:53.298 --> 00:07:55.518 or perhaps to develop ideas 00:07:55.518 --> 00:07:57.218 or to transfer something from one area 00:07:57.218 --> 00:07:59.798 to another. 00:08:00.708 --> 00:08:07.968 What concepts exist for communicating with people with profound intellectual and multiple disabilities? 00:08:08.578 --> 00:08:12.798 Yes, there are of course specific approaches, 00:08:12.798 --> 00:08:14.338 such as Intensive Interaction 00:08:14.338 --> 00:08:15.878 which I already mentioned, 00:08:15.878 --> 00:08:17.798 where there are studies showing 00:08:17.798 --> 00:08:19.338 that just ten minutes, 00:08:19.338 --> 00:08:20.878 so the problem is always that 00:08:20.878 --> 00:08:22.118 it's one-to-one, that it's one-on-one, 00:08:22.118 --> 00:08:24.498 so the beginnings of communication are 00:08:24.498 --> 00:08:25.418 one-on-one situations. 00:08:25.418 --> 00:08:27.138 That's just how it is. 00:08:27.138 --> 00:08:29.538 And that's when the killer argument usually comes up: 00:08:29.538 --> 00:08:30.738 we don't have time for that. 00:08:32.130 --> 00:08:34.610 But I think 00:08:34.610 --> 00:08:36.510 that you plan that in the same way 00:08:36.510 --> 00:08:38.169 as you plan other measures, 00:08:38.169 --> 00:08:41.830 you just plan these things too and allow ten minutes for them. 00:08:41.830 --> 00:08:44.790 So it doesn't have to be an hour, 00:08:44.790 --> 00:08:47.290 it doesn't have to be two or three hours, 00:08:47.290 --> 00:08:49.690 ten minutes or so is really enough. 00:08:49.690 --> 00:08:51.790 That's usually the attention span 00:08:51.790 --> 00:08:54.090 that is possible for these people, 00:08:54.090 --> 00:08:57.570 so they focus, so to speak, on engaging with an offer 00:08:57.570 --> 00:08:59.290 or they are usually very short. 00:08:59.290 --> 00:09:07.274 And yes, and then, so to speak, following that person, 00:09:07.274 --> 00:09:10.054 giving them answers, 00:09:10.054 --> 00:09:11.814 instead of expecting reactions, 00:09:11.814 --> 00:09:12.854 because you know 00:09:12.854 --> 00:09:14.974 that this brings significant progress, 00:09:14.974 --> 00:09:17.754 a change, that the signals become clearer 00:09:17.754 --> 00:09:19.494 or that they are used in a more targeted manner, 00:09:19.494 --> 00:09:21.234 if you do this over a longer period of time. 00:09:21.234 --> 00:09:23.714 So that this is really a very important 00:09:23.714 --> 00:09:25.934 point for the development of intentionality. 00:09:25.934 --> 00:09:27.574 And I think 00:09:27.574 --> 00:09:29.874 that should simply be planned for and also taken into account, 00:09:29.874 --> 00:09:32.134 that these small talk sequences, 00:09:32.134 --> 00:09:33.274 there's another program, 00:09:33.274 --> 00:09:35.214 called the Hanging Out Program, 00:09:35.214 --> 00:09:37.154 which is also along these lines. 00:09:37.154 --> 00:09:39.014 There's often this thing, 00:09:39.014 --> 00:09:40.614 what do I do all day then 00:09:40.614 --> 00:09:42.154 or what do we offer? 00:09:42.154 --> 00:09:44.374 Yes, maybe you don't have to do that much. 00:09:44.374 --> 00:09:47.034 Maybe it just makes sense to 00:09:47.034 --> 00:09:49.654 get 100 percent involved with this person 00:09:49.654 --> 00:09:50.814 and just see 00:09:50.814 --> 00:09:52.494 what develops from such a situation. 00:09:52.494 --> 00:09:54.854 Or maybe even film it on video 00:09:54.854 --> 00:09:58.186 and then see what a whisper, 00:09:58.186 --> 00:10:00.686 what a touch does, and then to take that up again, 00:10:00.686 --> 00:10: 03.306 expand it and also not knowing 00:10:03.306 --> 00:10:04.146 where it's going, 00:10:04.146 --> 00:10:05.866 not expecting anything specific, 00:10:05.866 --> 00:10:07.586 but having this openness, 00:10:07.586 --> 00:10:10.986 that communication takes place in dialogue and 00:10:10.986 --> 00:10:13.766 interactive exchange 00:10:13.766 --> 00:10:15.146 and that in these ten minutes 00:10:15.146 --> 00:10:17.306 we have equal roles. 00:10:17.306 --> 00:10:20.186 Or maybe even the role of leadership 00:10:20.186 --> 00:10:23.246 even more to this other person. 00:10:24.034 --> 00:10:26.014 As I said, openness, patience, 00:10:26.014 --> 00:10:27.914 so this whole thing of getting involved in 00:10:27.914 --> 00:10:30.794 these unusual forms of communication, 00:10:30.794 --> 00:10:32.914 sensitivity, responsiveness, 00:10:32.914 --> 00:10:34.014 can also be learned. 00:10:34.014 --> 00:10:35.754 There are school programs 00:10:35.754 --> 00:10:37.134 that teach you 00:10:37.134 --> 00:10:39.874 to look more closely and become more sensitive 00:10:39.874 --> 00:10:41.254 to these subtle signals 00:10:41.254 --> 00:10:42.434 and that you can also learn 00:10:42.434 --> 00:10:45.494 to broaden your scope of interpretation 00:10:45.494 --> 00:10:47.934 or to consider interpretations at all. 00:10:47.934 --> 00:10:49.214 So it's not just that 00:10: 49.214 --> 00:10:50.794 that it's intuitive, so 00:10:51.202 --> 00:10:52.782 It doesn't have to remain intuitive, 00:10:52.782 --> 00:10:54.922 but you can also acquire skills 00:10:54.922 --> 00:10:56.442 and teach these skills. 00:10:56.848 --> 00:11:05.248 00:10:56.848 --> 00:11:05.248 What can communication support look like in work and educational settings? 00:11:05.378 --> 00:11:07.858 Regarding assistive communication, 00:11:07.858 --> 00:11:11.538 because that also plays a role. 00:11:11.538 --> 00:11:13.378 So when we talk about communication, 00:11:13.378 --> 00:11:15.018 I haven't talked about it yet, 00:11:15.018 --> 00:11:17.158 I mean communication with aids. 00:11:17.158 --> 00:11:19.318 And I think that in terms of 00:11:19.318 --> 00:11:21.538 aided communication or 00:11:21.538 --> 00: 11:23.678 assisted communication, 00:11:23.678 --> 00:11:25.638 if defined narrowly, 00:11:25.638 --> 00:11:26.598 perhaps only 00:11:26.598 --> 00:11:28.798 defined as assisted communication, 00:11:28.798 --> 00:11:31.438 I just think that there are also many errors. 00:11:31.938 --> 00:11:34.438 On the one hand, there are many errors in practice 00:11:34.438 --> 00:11:36.878 or many things are done that one assumes 00:11:36.878 --> 00:11:38.358 would promote communication, 00:11:38.358 --> 00:11:40.198 but which should be critically questioned. 00:11:40.198 --> 00:11:42.818 And on the other hand, there is very detailed knowledge 00:11:42.818 --> 00:11:44.078 which we are not yet utilizing at all. 00:11:44.078 --> 00:11:47.558 And I think there is still a lot of potential there, 00:11:47.558 --> 00:11:48.678 even in adulthood, 00:11:48.678 --> 00:11:52.718 what can be promoted and, above all, how it can be promoted. 00:11:52.738 --> 00:11:58.898 And one mistake, for example, is 00:11:58.898 --> 00:12:01.478 that the focus is often placed 00:12:02.018 --> 00:12:04.878 on this concrete experience 00:12:04.878 --> 00:12:07.718 of cause and effect or self-efficacy. 00:12:07.718 --> 00:12:12.078 So I press a button and then 00: 12:12.078 --> 00:12:15.178 the blender starts up, or when cooking, for example, or 00:12:15.178 --> 00:12:18.658 the shredder in the paper workshop or something like that. 00:12:18.658 --> 00:12:22.558 And that's certainly an important experience, 00:12:22.558 --> 00:12:24.858 so do it, but it's questionable 00:12:24.858 --> 00:12:26.458 whether communication develops as a result. 00:12:27.330 --> 00:12:28.690 Or at least develops further. 00:12:28.690 --> 00:12:31.090 And then you also have to look at 00:12:31.090 --> 00:12:32.730 in the case of profound intellectual and multiple disability, how close, 00:12: 32.730 --> 00:12:34.650 so whether the connection can be made at all, 00:12:34.650 --> 00:12:38.030 if the blender is one meter away 00:12:38.030 --> 00:12:39.230 or two meters away. 00:12:39.230 --> 00:12:40.730 So that is also questionable, 00:12:40.730 --> 00:12:44.410 whether pressing the button 00:12:44.410 --> 00:12:47.530 whether this can be experienced in context at all. 00:12:47.530 --> 00: 12:48.430 or whether 00:12:48.430 --> 00:12:51.190 things closer to the body are easier to experience. 00:12:51.190 --> 00:12:56.394 And what we know is that 00:12:56.394 --> 00:13:00.474 these social-interactional or emotional aspects 00:13:00.474 --> 00:13:02.974 that they can also be experienced with the aids, 00:13:02.974 --> 00:13:04.734s o use aids, 00:13: 04.734 --> 00:13:11.074 to demand social interactions, so to speak 00:13:11.074 --> 00:13:13.374 or to summon a person. 00:13:13.374 --> 00:13:17.354 Or, for example, something like, 00:13:17.354 --> 00:13:21.154 playing a physical game, so 00:13:21.698 --> 00:13:23.538 okay, I would have to rethink that for adults, 00:13:23.538 --> 00:13:25.478 but with children it's relatively easy, 00:13:25.478 --> 00:13: 26.818 you can play tickling games or 00:13:26.818 --> 00:13:28.618 recite verses and then press 00:13:28.618 --> 00:13:31. 138 press a button like that again and repeat it again. 00:13:31.138 --> 00:13:34.898 So that the person is turned into a toy, so to speak 00:13:34.898 --> 00:13:36.998 and not mechanically always 00:13:36.998 --> 00:13:38.138 the same reaction, 00:13:38.138 --> 00:13:39.018 that also has the advantage 00:13:39.018 --> 00:13:40.278 that I can introduce emotional aspects 00:13:40.278 --> 00:13:41.918 or variations. 00:13:41.918 --> 00:13:43.958 And that also has something to do 00:13:43.958 --> 00:13:46.518 with experiencing the joy of interaction. 00:13:46.518 --> 00:13:51.411 And that is more than just this concrete cause-and-effect experience 00:13:53.538 --> 00:13:56.998 then it is also the case that 00:13:56.998 --> 00:14:02.858 a very, very important aspect, 00:14:02.858 --> 00:14:08.018 in order to bring about development, so to speak 00:14:08.018 --> 00:14:12.078 towards intentionality with such connections 00:14:12.078 --> 00:14:13.958 between button and then something happens, 00:14:13.958 --> 00:14:15.058 is one aspect, 00:14:15.058 --> 00:14:17.278 that the child itself can independently 00:14:17.278 --> 00:14:20.458 operate this button or sensor. 00:14:20.458 --> 00:14:22.298 And it is quite clear, however, 00:14:22.298 --> 00:14:23.438 that the literature says 00:14:23.906 --> 00:14:26.946 the prerequisite for a child to show learning success 00:14:26.946 --> 00:14:28.526 is this independent activity. 00:14:28.526 --> 00:14:30.226 So the motivation, 00:14:30.226 --> 00:14:32.246 so you need, so to speak, 00:14:32.246 --> 00:14:34.306 so you need an effect 00:14:34.306 --> 00:14:35.306 that is motivating, 00: 14:35.306 --> 00:14:36.606 but you need 00:14:36.606 --> 00:14:39.886 to encourage the child to be active, 00:14:39.886 --> 00:14:41.806 it has to be, so to speak, inside, 00:14:41.806 --> 00:14:44.946 be implementable by itself. 00:14:44.946 --> 00:14:46.126 I can't teach that. 00:14:46.126 --> 00:14:47.666 And teaching would be, 00:14:47.666 --> 00:14:48.986 I take the hand and guide the hand. 00:14:48.986 --> 00:14:51.286 And that's not how the child learns 00:14:51.970 --> 00:14:53.930 what intentionality is. 00:14:53.930 --> 00:14:54.930 It may then learn to 00:14:54.930 --> 00:14:56.330 requests to press the button, 00:14:56.330 --> 00:14:59.890 but not in the sense that I am the one causing something to happen here. 00:14:59.890 --> 00:15:04.070 So this repetition and that, 00:15:04.070 --> 00:15:05.370 which leads to international behavior, 00:15:05.370 --> 00:15:06.050 that only works 00:15:06.050 --> 00:15:11.270 if the action can be carried out independently and self-determined. 00:15:11.270 --> 00:15:13.950 And it's also important to understand 00:15:13.950 --> 00:15:16.230 we are also talking about 00:15:16.230 --> 00:15:19.490 basic support or simple communication aids, 00: 15:19.842 --> 00:15:25.622 I think that in itself is misleading, 00:15:25.622 --> 00:15:27.822 that this support would be simple, 00:15:27.822 --> 00:15:29.222 because it's actually, 00:15:29.222 --> 00:15:30.762 you have to think it through much more carefully. 00:15:30.762 --> 00:15:33.562 And there are a few good examples of this, 00:15:33.562 --> 00:15:34.802 for example from Kvantic, 00:15:34.802 --> 00:15:36.742 who describes this example of the boy 00:15:36.742 --> 00:15:39.442 who spent over half a year learning to play the piano, 00:15:39.442 --> 00:15:42.102 he could press the keys, but he was blind. 00:15:42.102 --> 00:15:44.402 And then in the end they found out 00:15:44.402 --> 00:15:45.782 what his favorite music was, 00:15:45.782 --> 00:15:46.962 by repeatedly 00:15:46.962 --> 00:15:50.366 varying it and offering different things 00:15:50.366 --> 00:15:52.166 and seeing if he has a preference. 00:15:52.166 --> 00:15:53.886 And those are processes 00:15:53.886 --> 00:15:56.486 that require very detailed planning 00:15:56.486 --> 00:15:58.866 as well as patience and perseverance 30600:15:58.866 --> 00:16:00.306 and, above all, documentation. 00:16:00.306 --> 00:16:02.746 So, what is the child doing today? 00:16:02.746 --> 00:16:05.046 Or Lilleniesen's small room, 00:16:05.046 --> 00:16:05.986 that's the same thing. 00:16:05.986 --> 00:16:08.286 So it's not about an activity, 00:16:08.286 --> 00:16:09.686 we're doing this now, 00:16:09.686 --> 00:16:14.486 but when I set learning goals, so to speak, 00:16:14.486 --> 00:16:16.546 then I have to have a plan behind it 00:16:16.546 --> 00:16:17.666 and then I also have to 00:16:18.018 --> 00:16:18.898 document 00:16:18.898 --> 00:16:22.498 what the child is doing and think about it, 00:16:22.498 --> 00:16:24.578 what the next step is or what 00:16:24.578 --> 00:16:26.778 tell me now or what to vary. 00:16:26.778 --> 00:16:28.898 And vary it in such a way 00:16:28.898 --> 00:16:30.778 that it remains recognizable, 00:16:30.778 --> 00:16:32.438 but that it is still something new. 00:16:32.438 --> 00:16:36.098 Yes, then I think it's also very important 00:16:36.158 --> 00:16:39.758 not to be tempted 00:16:39.758 --> 00:16:43.518 to promote communication exclusively 00:16:43.518 --> 00:16:47.278 in therapy or support situations, 00:16:48.226 --> 00:16:50.626 but to be mindful 00:16:50.626 --> 00:16:52.226 for all these aspects, 00:16:52.226 --> 00:16:55.406 predictability, groin marks, responding, and so on, 00:16:55.406 --> 00:16:57.586 into everyday life. 00:16:58.026 --> 00:17:03.466 And as negative examples, I have, for example, 00:17:03.466 --> 00:17:07.726 that you pay attention to time rhythms, for example. 00:17:07.726 --> 00:17:11.326 I don't think that makes any sense at all. 00:17:11.326 --> 00:17:13.606 Or it's impossible for people to reconcile, 00:17:14.146 --> 00:17:16.705 if, for example, they are rushed in the morning 00:17:16.705 --> 00:17:20.665 to be cared for and then have 00:17:20.665 --> 00:17:22.986 have an hour of basal stimulation. 00:17:22.986 --> 00:17:26.126 So these are such contradictory experiences 00:17:26.126 --> 00:17:35.506 even in terms of physical contact, 00:17:35.506 --> 00:17:39.386 that it's impossible to reconcile. 00:17:39.386 --> 00:17:41.146 And it's exactly the same, 00:17:41.146 --> 00:17:43.746 it may also be that you 00:17:44.418 --> 00:17:46.578 planned an offer in the workshop, 00:17:46.578 --> 00:17:50.998 for example, you do something with textiles 00:17:50.998 --> 00:17:55.378 or felt or something like that, elementarization, that kind of offer. 00:17:55.378 --> 00:17:57.398 And then it turns out 00:17:57.398 --> 00:18:00.718 that the person needs to be changed first, 00:18:00.718 --> 00:18:02.158 so the diaper needs to be changed. 00:18:02,158 And then there are two options. 00:18:04,758 One option is to do it quickly, 00:18:06.518 --> 00:18:07.578 but with adults it doesn't work 00:18:07.578 --> 00:18:08.578 as quickly as it does with children. 00:18:08.578 --> 00:18:09.958 With children, there is more of a tendency to 00:18:09.958 --> 00:18:11.118 do it quickly, 00:18:11.118 --> 00:18:13.558 so that you still have time for this offer. 00:18:14.018 --> 00:18:15.798 Or the second decision is simply 00:18:15.798 --> 00:18:16.798 that you say, okay, 00:18:16.798 --> 00:18:20.378 then I'll go out now and take this half hour, 00:18:20.378 --> 00:18:21.538 which I had actually planned for 00:18:21.538 --> 00:18:23.158 the offer and do some promotional care there, 00:18:23.158 --> 00:18:24.458 where I take the time 00:18:24.458 --> 00:18:28.718 to let people do things at their own pace, to include them, 00:18:28.718 --> 00:18:33.618 perhaps also using it for a kind of body language dialogue, 00:18:33.618 --> 00:18:36.658 implementing the rituals in between, 00:18:36.658 --> 00:18:39.758 implementing the agreements and so on. 00:18:40.194 --> 00:18:41.254 Then I have someone afterwards 00:18:41.254 --> 00:18:42.074 who is relaxed, 00:18:42.074 --> 00:18:45.114 who has experienced half an hour of self-efficacy 00:18:45.114 --> 00:18:48.994 and then continues through the day, so to speak. 00:18:48.994 --> 00:18:50.714 And in the other case, I might have someone 00:18:50.714 --> 00:18:53.434 who goes into the situation stressed 00:18:53.434 --> 00:18:55.934 and then doesn't benefit from it, so to speak.