WEBVTT 00:00:08.324 --> 00:00:13.199 Behavioral problems – An educational perspective 00:00:13.581 --> 00:00:20.186 What are behavioral problems? 00:00:20.562 --> 00:00:22.742 First of all, I would like to say 00:00:22.742 --> 00:00:26.570 that behavioral problems are actually 00:00:26.570 --> 00:00: 28.250 I think it's important to realize that 00:00:28.250 --> 00:00:31.010 it's something that's good, 00:00:31.010 --> 00:00:32.490 if we basically assume 00:00:32,490 - -> 00:00:35,130 that it is sensible behavior, 00:00:35.130 --> 00:00:37.330 that it has a subjective meaning 00:00:37.330 --> 00:00:39.650 and that it is behavior 00:00:39.650 --> 00:00:40.870 that we are all familiar with. 00:00:40.870 --> 00:00:44.310 So it's not, so to speak, completely absurd, 00:00:44.310 --> 00:00:46.590 unimaginable behavior, 00:00:46.590 --> 00:00:47.310 but always something 00:00:47.310 --> 00:00:49.130 we are all familiar with, 00:00:49.130 --> 00:00:51.130 but which then, 00:00:51.130 --> 00:00:53.090 when we talk about behavioral problems, 00:00:53.090 --> 00:00:53.952 it differs in that 00:00:53.952 --> 00:00:56.252 it perhaps takes place with a particular intensity 00:00:56.252 --> 00:01:00.592 with particularly negative consequences 00:01:00.592 --> 00:01:04.352 or simply not appropriate to the situation. 00:01:04.352 --> 00:01:07.812 I have sometimes said and written that 00:01:07.812 --> 00:01:10.552 behavioral problems actually 00:01:10.552 --> 00:01:12.432 a kind of competence. 00:01:13.570 --> 00:01:15.910 Competence means 00:01:15.910 --> 00:01:17.690 that a person discovers, for example, 00:01:17.690 --> 00:01:19.070 that they can do something. 00:01:19.070 --> 00: 01:20.090 So let's say 00:01:20.090 --> 00:01:22.430 I'll take Volker again. 00:01:22.430 --> 00:01:23.530 Imagine 00:01:23.530 --> 00:01:26.690 you have a severe headache. 00:01:26.690 --> 00:01:29.902 And you are unable to 00:01:29.902 --> 00:01:31.742 communicate this to anyone. 00:01:31.742 --> 00:01:34.102 Maybe you're not even aware 00:01:34.102 --> 00:01:37.362 that your head hurts in that spot. 00:01:37.362 --> 00:01:38.662 You only notice it 00:01:38.662 --> 00:01:39.662 because something is wrong. 00:01:39.662 --> 00:01:40.982 And then you discover that 00:01:40.982 --> 00:01:43.522 when you hit yourself on the head with your fist, 00:01:43.522 --> 00:01:45.642 you can bear the pain more easily. 00:01:45.642 --> 00:01:47.222 This can be explained physiologically, 00:01:47,222 - -> 00:01:48,482 that it works. 00:01:48.482 --> 00:01:49.722 You discover that. 00:01:49.722 --> 00:01:51.762 So now you have developed a skill 00:01:51.762 --> 00:01:54.462 namely to manage these headaches, 00:01:54.462 --> 00:01:55.542 to deal with them. 00:01:58.018 --> 00:02:00.058 It's just a very strange, 00:02:00.058 --> 00:02:01.878 actually a double-edged skill. 00:02:01.878 --> 00:02:03.418 Because this skill, 00:02:03.418 --> 00:02:04.378 that is, the ability 00:02:04.378 --> 00:02:05.398 that you discovered, 00:02:05.398 --> 00:02:06.978 which you found on your own, 00:02:06.978 --> 00:02:08.258 never taught you again, 00:02:08.258 --> 00:02:10.318 is at the same time one that 00:02:10.318 --> 00:02:12.678 which is also causing you problems again. 00:02:12.678 --> 00:02:14.118 Because the headaches are 00:02:14.118 --> 00:02:15.498 of course not gone for good. 00:02:15.742 --> 00:02:18.690 And with this Volker, it was like this, 00:02:18.690 --> 00:02:19.270 he also, 00:02:19.270 --> 00:02:20.770 I think, damaged his ear, 00:02:20.770 --> 00:02:22.410 he couldn't hear anymore afterwards. 00:02:22.410 --> 00:02:24.570 Some people damage their eyes or other parts of their body. 00:02:24.570 --> 00:02:27.850 So it's a skill, 00:02:27.850 --> 00:02:30.090 but one that has very negative consequences. 00:02:30.734 --> 00:02:37.030 What is special about behavioral problems in people with profound intellectual and multiple disabilities? 00:02:37.378 --> 00:02:38.618 That was actually the question, 00:02:38.618 --> 00:02:39.738 what is special about 00:02:39.738 --> 00:02:43.158 people with profound intellectual and multiple disabilities 00:02:43.158 --> 00:02:44.618 about behavioral problems. 00:02:44.618 --> 00:02:46.258 First of all, they display 00:02:46.258 --> 00:02:48.098 completely normal conspicuous behavior, 00:02:48.098 --> 00:02:49.918 which can also be found in others. 00:02:49.918 --> 00:02:54.418 But in order for behavioral problems 00:02:54.418 --> 00:02:56.438 represent a skill, 00:02:56.438 --> 00:02:59.458 they also require skills, 00:02:59.458 --> 00:03:01.178 they also require skills. 00:03:01.178 --> 00:03:01.958 For example 00:03:01.958 --> 00:03:04.098 a person with profound intellectual and multiple disabilities 00:03:04.098 --> 00:03:05.358 could not rob a bank. 00:03:05.474 --> 00:03:09.414 Certain prerequisites would be missing. 00:03:09.414 --> 00:03:12.194 That means they remain, so to speak, 00:03:12.194 --> 00:03:13.634 with the behavioral problems 00:03:13.634 --> 00:03:15.434 for which their skills are sufficient. 00:03:15.434 --> 00:03:16.854 And that would be 00:03:16.854 --> 00:03:18.714 for example, something like 00:03:18.714 --> 00:03:20.454 this self-harming behavior. 00:03:20.454 --> 00:03:22.254 That's something 00:03:22.254 --> 00:03:23.254 they have everything 00:03:23.254 --> 00:03:24.214 they need for it. 00:03:24.214 --> 00:03:26.354 Most of them can hit someone on the head if they're not too impaired. 00:03:26.354 --> 00:03:28.074 They have the tool with them, 00:03:28.074 --> 00:03:29.914 which is their own fist. 00:03:29.914 --> 00:03:30.894 their own fist. 00:03:30.894 --> 00:03:33.314 They don't need to know how to use tools. 00:03:33.314 --> 00:03:37.006 So that means 00:03:37.006 --> 00:03:37.606 it's, so to speak 00: 03:37.606 --> 00:03:39.346 the normal behavioral problems, 00:03:39.346 --> 00:03:40.366 the others show, 00:03:40.366 --> 00:03:42.286 but limited to those 00:03:42.286 --> 00:03:43.846 where their skills are sufficient. 00:03:43.846 --> 00:03:45.866 That's how I would put it, I think. 00:03:46.666 --> 00:03:53.048 How can behavioral problems in people with profound intellectual and multiple disabilities be explained? 00:03:53.314 --> 00:03:55.094 It is behavior 00:03:55.094 --> 00:03:57.314 that is essentially subjectively meaningful. 00:03:57.314 --> 00:03:57.814 That means 00:03:57.814 --> 00:03:59.114 what do I have to do now? 00:03:59.114 --> 00:04:00.374 I have to ask, 00:04:00.374 --> 00:04:02.794 what could this make sense in? 00:04:02.794 --> 00:04:05.154 And of course there is now no 00:04:05.154 --> 00:04:06.634 for all behavioral abnormalities 00:04:06.634 --> 00:04:08.554 a common meaning and therefore also 00:04:08.554 --> 00:04:09.914 not one explanation for all, 00:04:09.914 --> 00:04:13.394 but one must ask for the explanation 00:04:13.394 --> 00:04:14.774 against the individual background, 00:04:14.774 --> 00:04:17. 334 against the background of the individual life situation, 00:04:17.334 --> 00:04:18.053 the experiences 00:04:18.053 --> 00:04:20.613 that someone has had and, above all, the skills 00:04:20.613 --> 00:04:21.954 the educational opportunities 00:04:21.954 --> 00:04:22.454 they have had. 00:04:22.594 --> 00:04:24.414 That could train. 00:04:24.414 --> 00:04:26.934 For example, one can 00:04:26.934 --> 00:04:29.174 to find such explanations, 00:04:29.174 --> 00:04:31.834 do something like a behavioral analysis. 00:04:31.834 --> 00: 04:34.394 This is an attempt to 00:04:34.394 --> 00:04:36.674 observe people, 00:04:36.674 --> 00:04:38.514 to see what happens. 00:04:38.914 --> 00:04:41.094 In what situations do they actually do that, 00:04:41.094 --> 00:04:42.014 what they do? 00:04:42.014 --> 00:04:43.594 What happens before that? 00:04:43.594 --> 00:04:45.754 Are there, so to speak, triggering conditions, 00:04:45.754 --> 00:04:46. 994 that cause this? 00:04:46.994 --> 00:04:48.414 Are there conditions 00:04:48.414 --> 00:04:50.254 that are responsible for this, so to speak, 00:04:50.254 --> 00:04:52.454 that contribute to this? 00:04:52.454 --> 00:04:54.014 What are the subsequent conditions? 00:04:54.014 --> 00:04:55.414 So do you experience 00:04:55.414 --> 00:04:58.134 effects with your behavior, for example, 00:04:58.134 --> 00:05:00.254 that could be positive for you, 00:05:00.254 --> 00:05:02.434 such as getting attention? 00:05:02.434 --> 00:05:06.374 So behavioral analysis can be a useful tool 00:05:06.896 --> 00:05:08.676 to find such explanations, 00:05:08.676 --> 00:05:10.096 to see 00:05:10.096 --> 00:05:11.296 what I am actually observing, 00:05:11.296 --> 00:05:12.516 what always happens beforehand, 00:05:12.516 --> 00:05:14.176 what always happens afterwards 00:05:14.176 --> 00:05:16.796 and could the explanation lie there, 00:05:16.796 --> 00:05:18.576 so that could be a key to it, 00:05: 18.576 --> 00:05:20.936 why it makes sense for this person now, 00:05:20.936 --> 00:05:24.016 because, for example, he wants to achieve this effect, 00:05:24,016 - -> 00:05:25,676 which I have now observed, 00:05:25.676 --> 00:05:27.836 that the behavior actually has. 00:05:27.836 --> 00:05:28.316 So, 00:05:30.210 --> 00:05:32.470 the conditions can be very different. 00:05:32.470 --> 00: 05:34.630 Of course, there are also conditions that 00:05:34.630 --> 00:05:38.810 explanations for conspicuous behavior, 00:05:38.810 --> 00:05:39.950 which lie in the fact 00:05:39.950 --> 00:05:42.390 that, for example, there were problems 00:05:42.390 --> 00:05:44.690 with attachment development, 00:05:44.690 --> 00:05:49.350 so that there are difficulties, 00:05:49.350 --> 00:05:52.070 to have positive expectations 00:05:52.070 --> 00:05:54.410 of relationships with other people. 00:05:54.410 --> 00:05:56.010 That might have something to do with, 00:05:56.010 --> 00:05:57.310 or maybe not, 00:05:57,310 - -> 00:05:58,350 but certainly something 00:05:58.350 --> 00:06:00.490 to do with the bonding experiences 00:06:00.490 --> 00:06:01.630 that someone has had. 00:06:01.630 --> 00:06:03.710 So that could be something 00:06:03.710 --> 00:06:05.590 that you might then also 00:06:05.590 --> 00:06:06.410 in behavioral analysis 00:06:06.410 --> 00:06:07.530 not necessarily find out, 00:06:07.530 --> 00:06:09.090 but what you should also keep in mind 00:06:09.090 --> 00:06:10.590 is that this may be an explanation 00:06:10.590 --> 00:06:13.270 why someone exhibits certain behaviors. 00:06:13.270 --> 00:06:16.710 Other areas of explanation that exist, 00: 06:16.710 --> 00:06:18.510 I'll go into a behavior 00:06:18.510 --> 00:06:20.550 that is common among severely disabled people, 00:06:20.792 --> 00:06:22.312 stereotypical behaviors. 00:06:22.312 --> 00:06:24.252 One might ask 00:06:24.252 --> 00:06:27.432 why someone makes certain movements all the time 00:06:27.432 --> 00:06:30.432 or why someone always spins a CD. 00:06:30.432 --> 00:06:35.272 And then you might come to the conclusion 00:06:35.272 --> 00:06:39.612 that he simply didn't have a chance 00:06:39.612 --> 00:06:43.252 the variety of movements and activities 00:06:43.252 --> 00:06:44.612 that exist, 00:06:44.612 --> 00:06:46.572 to develop and acquire. 00:06:46.572 --> 00:06:49.050 This may indeed be a lack of education, 00:06: 49.050 --> 00:06:51.610 no one has really shown them 00:06:51.610 --> 00:06:52.790 what you can do, 00:06:52.790 --> 00:06:54.590 how to move in an interesting way, 00:06:54.590 --> 00:06:57.150 how to trigger interesting effects. 00:06:57.150 --> 00:06:59.210 And then he always sticks with the one 00:06:59.210 --> 00:07:00.210 he has found, 00:07:00.210 --> 00:07:01.230 and he does that over and over again, 00:07:01.230 --> 00:07:02.970 and that then acts as a stereotype, 00:07:02.970 --> 00:07:05.390 at the same time inhibiting him 00:07:05.390 --> 00:07:06.770 in his further development. 00:07:06.770 --> 00:07:10.790 Or if you look at aggressive behavior, 00:07:10.790 --> 00:07:13.690 which I mentioned earlier, 00:07:13.690 --> 00:07:16.090 you can look for explanations 00:07:16.090 --> 00:07:19.650 that actually lie in these social effects. 00:07:19.650 --> 00:07:22.050 So the aggressive behavior can often 00:07:22.050 --> 00:07:23.810 be explained by this, 00:07:23,810 - -> 00:07:26,190 that it is a good way to 00:07:26.190 --> 00:07:26.930 ensure that 00:07:26.930 --> 00:07:28.210 that you are noticed, 00:07:28.210 --> 00:07:29.350 that you are not overlooked, 00:07:29.350 --> 00:07:30.490 that you are appreciated, 00:07:30.490 --> 00:07:32.790 that you can perhaps also stand strong, 00:07:32.790 --> 00:07:34.390 that you can feel strong, 00:07:34.390 --> 00:07:36.430 even when others are afraid of everything, 00:07:36.430 --> 00:07:38.130 when others shy away. 00:07:38.130 --> 00:07:41.810 So then the explanation would also be there, 00:07:41.810 --> 00:07:42.530 the effects 00:07:42.530 --> 00:07:44.610 that I can achieve with it 00:07:45.506 --> 00:07:48.266 make sense to me, and that's why I exhibit that behavior. 00:07:48.266 --> 00:07:52.166 So there are many different clusters of conditions, so to speak 00:07:52.166 --> 00:07:54.386 and you have to look closely to 00:07:54.386 --> 00:07:55.426 form hypotheses 00:07:55.426 --> 00:07:58.206 about the area in which such an explanation might lie. 00:07:59.040 --> 00:08:05.170 What impact do behavioral problems have on the lives of people with profound intellectual and multiple disabilities? 00:08:05.314 --> 00: 08:08.234 If you look at 00:08:08.234 --> 00:08:09.714 what effects this has, 00:08:09.714 --> 00:08:10.534 then first of all, 22 4 00:08:10.534 --> 00:08:13.314 it's probably an attempt to 00:08:13.314 --> 00:08:17.194 overcome problems or satisfy needs, 00:08:17.194 --> 00:08:20.474 but this double-edged sword, 00:08:20.474 --> 00:08:22.074 which I have already mentioned, 00:08:22.074 --> 00:08:22.974 means that 00:08:22.974 --> 00:08:25.894 that it usually also has another, 00:08:25.894 --> 00:08:27.494 completely opposite effect. 00:08:27.494 --> 00:08:29.834 So I actually want to be noticed, 00:08:29.834 --> 00:08:32.034 perhaps through my aggressive behavior, 00:08:32.034 --> 00:08:33.394 and thus initially achieve 00:08:33.394 --> 00:08:34.573 that I get attention. 00:08:34.573 --> 00:08:36.134 People come, jump, 00:08:36.134 --> 00:08:37.774 engage with me, 00:08:37.774 --> 00:08:40.554 but at the same time they no longer want 00:08:40.554 --> 00:08:41.894 to deal with me. 00:08:42.722 --> 00:08:45.042 It actually causes even greater exclusion. 00:08:45.042 --> 00:08:47.522 It limits opportunities for participation 00:08:47.522 --> 00:08:48.742 much, much more. 00:08:48.742 --> 00:08:51.482 So ultimately, it contributes 00:08:51.482 --> 00: 08:52.402 if you will, 00:08:52.402 --> 00:08:53.522 to disability. 00:08:53.522 --> 00:08:55.942 If impaired participation is actually 00:08:55.942 --> 00:08:58.502 the core of the disability according to the ICF, 00:08:58.502 --> 00:09:01.102 then the effect of conspicuous behavior is actually 00:09:01.102 --> 00:09:04.262 is usually an even greater impediment 00:09:04.262 --> 00:09:05.262 to participation. 00:09:05.954 --> 00:09:12.720 What concepts do you consider helpful with regard to people with profound intellectual and multiple disabilities and behavioral problems? 00:09:12.720 --> 00:09:14.126 Here, too, it is impossible to say 00:09:14.126 --> 00:09:15.146 there is a concept, 00:09:15.146 --> 00:09:19.226 but here too, the starting point must simply be 00:09:19.226 --> 00:09:20.466 first of all to look at 00:09:20.466 --> 00:09:24.046 what probably makes the subjective sense 00:09:24.046 --> 00:09:25.866 of this behavior for the person. 00:09:25.866 --> 00:09:29.586 So what can he achieve with it, 00:09:29.586 --> 00:09:30.926 what can he achieve with it, 00:09:30.926 --> 00:09:32.386 what competence, 00:09:32.386 --> 00:09:33.606 that he may lack, 00:09:33.606 --> 00:09:34.666 he replaces with it. 00:09:34.666 --> 00:09:37.766 And depending on that, I then have to decide 00:09:37.766 --> 00:09:40.866 what educational support I can offer him, 00:09:40.866 --> 00:09:42.286 what concepts I might also apply. 00:09:42.286 --> 00:09:44.702 So let's take another example. 00:09:44.702 --> 00:09:46.322 I said earlier that 00:09:46.322 --> 00:09:48.402 a person can hardly express themselves, 00:09:48.402 --> 00:09:49.462 make themselves understood, 00:09:49.462 --> 00:09:52.062 perhaps only hint at their behavior, 00:09:52.062 --> 00:09:54.082 whether they like something or not. 00:09:54.082 --> 00:09:57.382 If such a person now has needs, 00:09:57.382 --> 00:10:01.762 for example, for closeness, for attention 00:10:01.762 --> 00:10:03.362 or even for a yogurt 00:10:03.362 --> 00:10:04.202 or who knows what, 00:10:04.202 --> 00:10:07.022 for a meaningful occupation, 00:10:07.022 --> 00:10:10.622 then he actually has two options. 00:10:10.622 --> 00:10:12.302 One would be 00:10:13.474 --> 00:10:16.194 to take his needs back, 00:10:16.194 --> 00:10:18.034 then that leads to 00:10:18.034 --> 00:10:21.414 depressive behavior or helplessness. 00:10:21.414 --> 00:10:24.374 Something that is also important 00:10:24.374 --> 00:10:25.734 in conspicuous behavior, 00:10:25.734 --> 00:10:27.674 which is often overlooked. 00:10:27.674 --> 00:10:30.914 We sometimes talk about challenging behavior. 00:10:30.914 --> 00:10:31.534 That means 00:10:31.534 --> 00:10:33.434 we tend to focus only on the behavior 00:10:33.434 --> 00:10:35.214 that really challenges us. 00:10:35.214 --> 00:10:37.214 If someone is sitting quietly in the corner doing nothing, 00:10:37.214 --> 00:10:40.254 then that doesn't challenge us very much. 00:10:41.538 --> 00:10:42.738 That's the one option 00:10:42.738 --> 00:10:43.298 he has 00:10:43.298 --> 00:10:46.578 if he finds communication difficult. 00:10:46.578 --> 00:10:47.138 The other is 00:10:47.138 --> 00:10:49.398 that he acts out, 00:10:49.398 --> 00:10:50.898 that he does something, 00:10:50.898 --> 00:10:51.998 develops aggression, 00:10:51.998 --> 00:10:54.178 breaks things, pushes others, 00:10:54.178 --> 00:10:57.018 kicks them in the leg, or does other things 00:10:57.018 --> 00:10:59.498 to compensate for 00:10:59.498 --> 00:11:01.038 what he lacks in communication. 00:11:01.038 --> 00:11:03.778 If I now make an analysis, 00:11:03.778 --> 00:11:06.578 that could be the reason 00:11:06.578 --> 00:11:09.298 why he has now developed his aggression, 00:11:09.890 --> 00:11:11.610 or even self-harming behavior, 00:11:11,610 - -> 00:11:12,330 which can also result from 00:11:12.330 --> 00:11:14.570 such unmet needs. 00:11:14.570 --> 00:11:18.650 Then the concept of choice is 00:11:18.650 --> 00:11:19.770 that I take care of 00:11:19.770 --> 00:11:21.630 how can this person 00:11:21.630 --> 00:11:23.550 expand their communication options. 00:11:23.550 --> 00:11:25.410 That means it starts with 00:11:25.410 --> 00:11:31.430 that I first respond to the signals 00:11:31.430 --> 00:11:33.210 that can be understood communicatively. 00:11:33.210 --> 00:11:33.610 That means 00:11:33.610 --> 00:11:35.550 I have to perceive the person, 00:11:35.550 --> 00:11:38.670 listen to them, look at them, and see 00:11:38.670 --> 00:11:39.746 what they might be expressing, 00:11:39.746 --> 00:11:42.166 including through their behavior. 00:11:42.166 --> 00:11:44.106 Sometimes the conspicuous behavior itself 00:11:44.106 --> 00:11:46.466 gives clues as to what it was all about. 00:11:46.466 --> 00:11:48.406 If you look at Volker again from the beginning, 00:11:48.406 --> 00:11:49.446 when he hits his ears, 00:11:49.446 --> 00:11:50.886 then it could just be 00:11:50.886 --> 00:11:52.326 that he has earache. 00:11:52.326 --> 00:11:57.166 Enable communication, 00:11:57.166 --> 00:11:59.466 then support all the possibilities, 00:11:59.466 --> 00:12:00.586 Use communication. 00:12:03.202 --> 00:12:05.502 I can think of other things 00:12:05.502 --> 00:12:07.162 when I have an impression 00:12:07.162 --> 00:12:08.522 when I come to the conclusion 00:12:08.522 --> 00:12:11.202 that someone is displaying stereotypical, 00:12:11.202 --> 00: 12:12.722 monotonous behavior, 00:12:12.722 --> 00:12:16.402 simply because he has found too few opportunities to 00:12:16.402 --> 00:12:19.242 how he can move well, 00:12:19.242 --> 00:12:21.062 how he can make interesting movements, 00:12:21.062 --> 00:12:24.302 how he can do something interesting, 00:12:24.302 --> 00:12:27.822 then I just have to make suggestions to him. 00:12:27,822 - -> 00:12:30,682 You can offer basic stimulation, 00:12:30.682 --> 00:12:31.162 there are a 00:12:31.184 --> 00:12:32.024 whole lot of 00:12:32.024 --> 00:12:35.404 where people can discover 00:12:35.404 --> 00:12:36.884 oh, that feels good, 00:12:36.884 --> 00:12:38.964 I see something that sparkles 00: 12:38.964 --> 00:12:41.424 and I can influence all of that myself 00:12:41.424 --> 00:12:42.664 and there are sounds 00:12:42.664 --> 00:12:43.724 that I can create. 00:12:43.724 --> 00:12:45.884 So the interaction with things, 00:12:45.884 --> 00:12:47.384 creating effects, 00:12:47.384 --> 00:12:50.444 you can learn that, and that would be the measure, so to speak, 00:12:50.444 --> 00:12:51.824 I would take, 00:12:51.824 --> 00:12:53.554 if I come to a conclusion, 00:12:53.554 --> 00:12:55.714 there is a problem, so to speak, 00:12:55.714 --> 00:12:56.494 that this person 00:12:56.494 --> 00:12:59.434 is trying to cope with this stereotypical behavior. 00:12:59.434 --> 00:13:00.494 You can't say 00:13:00.494 --> 00:13:02.314 that this is a concept that helps 00:13:02.314 --> 00:13:04.254 with profound intellectual and multiple disabilities and behavioral problems, 00:13:04.254 --> 00:13:06.014 but you have to do what 00:13:06.014 --> 00:13:10.554 corresponds, so to speak, to the subjective meaning, 00:13:10.554 --> 00:13:13.034 which I have identified, 00:13:13.034 --> 00:13:15.254 where I have formed my hypothesis about it 00: 13:15.254 --> 00:13:16.694 and then I'll see 00:13:16.694 --> 00:13:17.914 if it helps, 00:13:17. 914 --> 00:13:20.154 then I can also test the hypotheses with it. 00:13:20. 166 --> 00:13:27.186 What challenges do employees face when dealing with people with profound intellectual and multiple disabilities and behavioral problems? 00:13:27.458 --> 00:13:31.858 It is certainly a particular challenge 00:13:31.858 --> 00:13:33.838 with people with profound intellectual and multiple disabilities, 00:13:33.838 --> 00:13:36.989 that the employees who accompany people 00:13:36.989 --> 00:13:39.818 are able, for example 00:13:39.818 --> 00:13:41.098 in the area of communication 00:13:41.098 --> 00:13:45.118 to perceive the very basic things, 00:13:45.118 --> 00:13:46.638 to see them and also to use them. 00:13:46.638 --> 00:13:49.138 That means, for example, 00:13:49.138 --> 00:13:51.498 for example, to have an idea 00:13:51.498 --> 00:13:54.318 when someone is lashing out angrily, 00:13:54.318 --> 00:13:58.038 what could be recognized in this, 00:13:58.038 --> 00:14:00.398 what kind of support this person needs, 00:14:00.398 --> 00:14:01.598 support they need. 00:14:01.598 --> 00:14:03.458 So to be able to identify that. 00:14:04.098 --> 00:14:07.858 What are the simple, 00:14:07.858 --> 00:14:09.598 basic means of communication 00:14:09.598 --> 00:14:10.898 that parents 00:14:10.898 --> 00:14:12.558 already use with their infants 00:14:12.558 --> 00:14:14.738 in intuitive parenting, 00:14:14.738 --> 00:14:17.318 can I do something similar? 00:14:17.318 --> 00:14:21.098 How can I get the answers to the role, 00:14:21.098 --> 00:14:24.298 especially when dealing with people with profound intellectual and multiple disabilities, 00:14:24.298 --> 00:14:25.778 so that they understand 00:14:25.778 --> 00:14:27.158 I express something, 00:14:27.158 --> 00:14:28.958 I do something or say 00:14:28.958 --> 00:14:30.438 something, and there is someone 00:14:30.438 --> 00:14:31.518 who understands that. 00:14:32.130 --> 00:14:33.790 Or at least tries to understand it, 00:14:33.790 --> 00:14:38.710 so there's a kind of interplay in the action. 00:14:38.710 --> 00:14:40.670 And then he suddenly feels like 00:14:40.670 --> 00:14:4 2.270 express something again. 00:14:42.270 --> 00:14:46.210 And that's how the motivation to communicate arises. 00:14:46.210 --> 00:14:48.770 So that's definitely a very central area, 00:14:48.770 --> 00:14:53.110 the ability to 00:14:53.110 --> 00:14:56.230 communicative processes in a very basic way. 00:14:56.230 --> 00:14:56.990 There is, 00:14:56.990 --> 00:14:59.110 and that is also a challenge, 00:14:59.110 --> 00:15:00.950 I believe, for the employees, 00:15:00.950 --> 00:15:02.722 in such areas. 00:15:02.722 --> 00:15:05.962 Behavioral problems are often 00:15:05.962 --> 00:15:08.822 also behaviors that are risky, 00:15:08.822 --> 00:15:10.042 not only for the people themselves, 00:15:10.042 --> 00:15:10.982 if they injure themselves, 00:15:10.982 --> 00:15:12.882 but also for employees. 00:15:12.882 --> 00:15:16.002 This means that you also need 00:15:16.002 --> 00:15:19.322 the competence, for example, of someone who 00:15:19.322 --> 00:15:20.822 what is known as de-escalation. 00:15:20.822 --> 00:15:21.982 There are courses for this, 00:15:21.982 --> 00:15:23.642 quite a lot of them now, 00:15:23.642 --> 00:15:25.682 de-escalation training courses. 00:15:25.682 --> 00:15:28.602 Basically, it's about 00:15:28.602 --> 00:15:31.662 protecting someone from themselves 00:15:31.662 --> 00:15:33.322 and protecting others from them, 00:15:33.322 --> 00:15:35.802 but in a way 00:15:35.802 --> 00:15:38.762 that preserves the dignity of all involved. 00:15:38.762 --> 00:15:40.702 That means that as someone who 00:15: 40.702 --> 00:15:42.362 who is now calming him down, 00:15:42.362 --> 00:15:44.082 not beating him up, 00:15:44.082 --> 00:15:46 .842 so don't treat him with contempt now, 00:15:46.842 --> 00:15:48.922 but maintain his dignity, 00:15:48.922 --> 00:15:50.182 mine too, 00:15:50.182 --> 00:15:51.822 and that I maintain communication 00:15:51.822 --> 00:15:54.662 in this process, 00:15:54.662 --> 00:15:57.502 so that I calm him down, 00:15:57.502 --> 00:15:59.484 but that he is not 00:15:59.484 --> 00:16:01.084 or 00:16:01.084 --> 00:16:03.584 maybe even beaten 00:16:03.584 --> 00:16:04.484 or something else. 00:16:04.484 --> 00:16:06.044 So that's also important, 00:16:06.044 --> 00:16:08.364 to acquire such skills. 00:16:08.364 --> 00:16:10.824 How can I deal with such truly risky, 00:16:10.824 --> 00:16:12.864 difficult situations 00:16:12.864 --> 00:16:13.764 in a way 00:16:13.764 --> 00:16:17.804 that allows me to maintain my own dignity as an educator, 00:16:17.804 --> 00:16:20.044 that allows me to maintain communication 00:16:20.044 --> 00:16:21.844 and where, above all, I keep an open mind 00:16:22.242 --> 00:16:24.062 about what 00:16:24.062 --> 00:16:25.642 what this person needs from me. 00:16:25.642 --> 00:16:27.282 What they need first and foremost is not 00:16:27.282 --> 00:16:30.062 me to hold him down or push him to the ground, 00:16:30.062 --> 00:16:32.922 but he also tells me 00:16:32.922 --> 00:16:34.642 through this difficult behavior, 00:16:34.642 --> 00:16:36.542 what his needs are, 00:16:36.542 --> 00:16:38.142 what kind of support he needs, 00:16:38.142 --> 00:16:40.402 so that I always have that in mind. 00:16:40.402 --> 00:16:41.242 So I believe 00:16:41.242 --> 00:16:45.822 that this is also a very central qualification 00:16:45.822 --> 00:16:47.942 that you need in this field. 00:16:47.942 --> 00:16:52.286 And finally, a high level of teamwork skills, 00:16:52.286 --> 00:16:53.226 that is also, 00:16:53.226 --> 00:16:54.646 I believe, important. 00:16:54.646 --> 00:16:58.046 So the ability to 00:16:58.046 --> 00:17:01.886 work with others, 00:17:01.886 --> 00:17:02.886 to coordinate, 00:17:02.886 --> 00:17:03.886 so to speak, not 00:17:03.886 --> 00:17:07.246 to stop communicating with colleagues, 00:17:07.246 --> 00:17:10.006 everyone does their own thing, 00:17:10.006 --> 00:17:11.306 communicate, 00:17:11.306 --> 00:17:13.626 also do all these processes together, 00:17:13.626 --> 00:17:15.086 which can or should take place in this behavioral analysis 00:17:15.086 --> 00:17:17.498 for example, 00:17:17.498 --> 00:17:19.298 that is, to discuss 00:17:19.298 --> 00:17:20.778 why is this person like this, 00:17:20.778 --> 00:17:21.917 what can they actually do, 00:17:21.917 --> 00:17:23.818 what are their possibilities, 00:17:23.818 --> 00:17:25.377 what are their needs, 00:17:25.377 --> 00:17:29.018 what could make sense 00:17:29.018 --> 00:17:30.898 or suggest the meaning for what 00:17:30.898 --> 00:17:32.658 what he does that you don't like so much 00:17:32.658 --> 00:17:34.558 and what we can do together. 00:17:34.558 --> 00:17:38.398 Cooperation with parents and so on, of course. 00:17:38.398 --> 00:17:40.978 So cooperative skills are, 00:17:40.978 --> 00:17:42.758 I believe, are also very important. 00:17:42.940 --> 00:17:49.620 What is helpful for employees when dealing with severe disabilities and behavioral problems? 00:17:50.082 --> 00:17:50.802 What they need, 00:17:50.802 --> 00:17:52.282 is, of course, the opportunity to 00:17:52.282 --> 00:17:55.102 acquire such qualifications, 00:17:55.102 --> 00:17:56.262 to get hold of them. 00:17:56.262 --> 00:17:57.782 That's not necessarily 00:17:57.782 --> 00:18:01.062 an integral part of the training programs. 00:18:01.062 --> 00:18:03.322 That's the topic of behavioral problems. 00:18:03.322 --> 00:18:06.922 We asked teachers about this. 00:18:06.922 --> 00:18:08.902 The vast majority say 00:18:08.902 --> 00:18:10.362 we actually learned far too little 00:18:10.362 --> 00:18:11.622 or nothing at all 00:18:11.622 --> 00:18:13.862 about what you can actually do 00:18:13.862 --> 00:18:14.882 how to understand them, 00:18:14.882 --> 00:18:16.102 how to deal with people. 00:18:16.102 --> 00:18:18.622 That's the first thing, 00:18:18.622 --> 00:18:19.382 I think, important, 00:18:19.382 --> 00:18:20.869 that you look at, so to speak, 00:18:20.869 --> 00:18:23.250 what qualification opportunities are available, 00:18:23.250 --> 00:18:24.830 that, for example, 00:18:24.830 --> 00:18:28.730 as the facility manager, you also encourage people 00:18:28.730 --> 00:18:31.190 and support them in taking advantage of such opportunities 00:18:31.190 --> 00:18:33.270 or even educational days 00:18:33.270 --> 00:18:34.390 or something like that. 00:18:34.390 --> 00:18:35.370 So I think the qualification 00:18:35.370 --> 00:18:37.290 I think is important. 00:18:37.290 --> 00:18:40.550 I think things like that are important, 00:18:40.550 --> 00:18:41.410 such as 00:18:41.410 --> 00:18:43.030 I mentioned teamwork, 00:18:43.030 --> 00:18:45.310 such as supervision. 00:18:45.634 --> 00:18:50.314 such as regular team consultations based on partnership. 00:18:50.314 --> 00:18:51.434 That means 00:18:51.434 --> 00:18:53.774 there must be the possibility 00:18:53.774 --> 00:18:56.394 to deal with the very special stresses 00:18:56.394 --> 00:18:57.694 that result from this, 00:18:57.694 --> 00:19:00.734 that people can behave very conspicuously, 00:19:00.734 --> 00:19:03.054 that they may seem unpredictable, 00:19:03.054 --> 00:19:04.706 that they do things 00:19:04.706 --> 00:19:05.866 that you don't expect, 00:19:05.866 --> 00:19:07.206 that you're not prepared for. 00:19:07.206 --> 00:19:08.726 Or that you also have such difficulty 00:19:08.726 --> 00:19:09.506 understanding them. 00:19:09.506 --> 00:19:12.586 Or that you realize 00:19:12.586 --> 00:19:13.706 I reject him too, 00:19:13.706 --> 00:19:15.706 because that's how he is. 00:19:15.706 --> 00:19:16.826 I said earlier that 00:19:16.826 --> 00:19:18.906 Behavioral problems have an exclusionary effect. 00:19:18.906 --> 00:19:20.706 If that's the effect it has, 00:19:20.706 --> 00:19:23.506 then it also has an effect on employees, 00:19:23.506 --> 00:19:25.306 in that aggression 00:19:25.306 --> 00:19:26.786 towards these people, 00:19:26.786 --> 00:19:27.806 rejection arises. 00:19:28.450 --> 00:19:30.310 So you have to be able to deal with these things. 00:19:30.310 --> 00:19:30.630 That means 00:19:30.630 --> 00:19:31.790 you need the opportunity to 00:19:31.790 --> 00:19:34.250 talk about it in a team or 00:19:34.250 --> 00:19:37.990 work on it in supervision. 00:19:39.042 --> 00:19:43.130 So, appropriate qualifications, 00:19:43.130 --> 00:19:44.850 also these de-escalation things, 00:19:44.850 --> 00:19:46.130 you have to have the opportunity to 00:19:46.130 --> 00:19:47.730 to do that. 00:19:47.730 --> 00:19:48.490 I think 00:19:48.490 --> 00:19:49.710 it's also important 00:19:49.710 --> 00:19:55.030 to be well positioned conceptually as a service, 00:19:55.030 --> 00:19:56.010 as an institution. 00:19:56.674 --> 00:19:57.414 That means 00:19:57.414 --> 00:20:01.414 that there is also clarity for the employees. 00:20:01.414 --> 00:20:02.814 For example, 00:20:02.814 --> 00:20:04.394 what is my role, 00:20:04.394 --> 00:20:06.314 my relationship with such people.