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Summary Reader Orthopedagogy: Theories and Models
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A compact but complete summary of the reader belonging to the course Orthopedagogy: Theories and Models.
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Chapter 1 IntroductionProf-eds’ sensitivity to social values
The prof-ed seeks opportunities to optimize the development and health of clients. Clients
are children and older persons who in a community are considered to function cognitively
and emotionally as if they were children. Clients may also be persons who legally or in
practice function as educators of these children. Health is used as a super standard and
defined here as a state of complete physical, mental and social well-being and not merely
the absence of disease or infirmity. However, the notions of health and optimizing health
need to be substantiated in specific communities. Prof-eds tend to warrant some space for
traditions and consensus as a source for substantiating what is health, as long as this is not
putting the child’s health and well-being at risk.
A cultural-historical approach to educational challenges
Vygotsky and today’s scholars inspired by him suggest that the challenges met by prof-eds
should always be defined and approached from the perspective that society is not capable or
willing to invest in findings ways to equip functionally impaired persons with the tools needed
for conquering or compensating for the functional impairment. Other scholars will say that
this is a nonsensical approach, blaming always the environment and particularly the prof-eds
for clients’ problems. They would be right if this were an issue of guilt and legal liability, but
this is not what Vygotsky pointed at. Scholars like Vygotsky suggest that children or adults
who are incapable of understanding and regulating a functional impairment and its
consequences, cannot be held responsible for it. However, it remains the responsibility of
those who can and are held responsible to support the children and develop tools to improve
children’s fate. Vygotsky voices a call to take up the challenge to help and continue to seek
ways to alleviate the plight of clients in need.
The use of interpersonal relationships and tools is central to the way scholars in the cultural-
historical approach explain normative developmental processes as well as developmental
psychopathology and also use these relationships for preventing and remedying challenges.
At the same time they are keenly aware of the fact that the carriers of development are
physical and biological entities. This fits nicely with how prof-eds normally approach clients.
They primarily use interpersonal relationships and non-invasive tools to optimize clients’
well-being and development. If something is wrong with the physiological or neurological
functioning of a client they will seek to address this with interventions that try to induce a
form of social or socialized regulation of the physical or biological challenges and the
psychological consequences. For more invasive tools, prof-eds can refer their clients to their
medical colleagues.
Iatrogenic effects
Not everything done by a prof-ed is good or just. Actually, what clinicians do may even be
detrimental to clients’ health and well-being. Such negative consequences of pedagogical,
clinical acting are referred to as iatrogenic effects. Iatrogenic effects are likely to occur when
prof-eds willfully or unconsciously contribute to a client’s suboptimal functioning or
problematic well-being. Examples show that in such situations the prof-ed did not take the
responsibility to safeguard the client from negative health consequences. There are different
kinds of iatrogenic effects: reactive pathogenic effects, facilitative pathogenic effects,
contagion effects and restriction of learning opportunities.
, Reactive pathogenic effects
When clients come to or are referred to a prof-ed, they come with a question or problem that
is input to a diagnostic process, which can result in a label. Such labels and specifications
about the severity of the problems or challenges are needed to talk and write about the
problems. However, as a result of these labels, clients may be confronted with exclusion,
feelings of distress and negative health consequences. Some labels may also be
accompanied by a drug prescription, which can carry some risks. Labeling may also lead to
a referral to a special school, class, program or special attention in class and as such set
children apart. As a consequence the labelled children run a higher risk that peers will start
evading, rejecting or bullying them. Such effects are called reactive pathogenic effects:
negative effects that are due to reactions by others to clinical treatment or diagnoses and
labels that are the consequence.
Facilitative pathogenic effects
Next to reactive effects, the work of prof-eds may have facilitative pathogenic effects. Those
are directly related to diagnostics and treatments that are flawed, invalid or ineffective. When
diagnostics are invalid or incorrect, this is likely to result in the prescription of an unsuitable
intervention, a delay of the start of support or an adequate intervention. Such negative
effects may get worse when diagnostics is detached from clinical treatments and seen as a
separate independent activity with a value of its own; this is diagnostics for the files or for a
client who seeks reassurance. A prof-ed is supposed to work on behalf of children’s health
and development and a treatment should be seen as a prolonged opportunity to find out
more about the client asking whether or not the diagnosis should be qualified or specified
and whether or not the treatment should be adapted to the special needs of the client.
Contagion effects
Contagion effects refer to the interpersonal transmittance of particular characteristics. These
characteristics can be either positive or negative, but the notion of contagion is
predominantly used when negatively valued characteristics are at stake. Contagion effects
increase when children or adolescents characterized by either externalizing or internalizing
problems are brought together for their treatment and live together for several months or
longer. Such a treatment may have short term positive effects, but in the long run it will lead
to more problems, because peers spread and reinforce the negative characteristics amongst
each other.
Restriction of learning opportunities
Restriction of learning opportunities is at stake when children either on instigation of or with
the approval of a prof-ed are restrained from partaking in activities that are important for
children’s development or well-being. Because the students are assumed to have little
possibilities to develop competencies that would allow them to fulfill a socially valued task,
they are being taught only some basic skills. This is despicable, because the professionals
using this assumption confuse clients’ needs and interests with a low appreciation of the
particular skills in the wider community.
Prof-eds at work; opportunities, restraints and responsibilities
In recent years, it is getting increasingly complicated for prof-eds to effectively handle
complicated professional challenges, because the responsibility of prof-eds is not just
approached as an issue of competence and substantive challenge but also as an
engagement with activities and risks that involve liability in terms of being made guilty of and
having to financially compensate for damage incurred on clients and their representatives.
Educational institutions make this judicial aspect of their functioning salient and manageable
, by developing and using protocols. These are systems of rules that explain the correct
conduct and procedures to be followed in particular situations. They are a resource or
guidance for professionals when they have to make decisions and specify what quality
criteria have to be met and what professional efforts are warranted in specified educationally
challenging situations. Moreover, they specify how professionals are supposed to act in
order to avoid liability claims against either the professional or the institution represented.
Together with the increasing numbers of protocols, complaints are raised against them.
Professionals need protocols for reassurance and guidance, but also need room for
creativity and flexibility. Prof-eds should, whenever possible and justified, not feel restricted
by protocols in exploring and using new ways of finding solutions for clients’ problems.
Delegated authority and anticipation of approval
Prof-eds work with clients that depend on parents or specially appointed persons and
institutions who are formally responsible for them as long as they cannot handle the
responsibility themselves. This delegation of responsibility ends for most children in the
Netherlands when they reach the age of 18 years, with an exception for severely
handicapped persons and for criminals. Basic to the right to self-determination and personal
integrity is the notion that persons are closely engaged when it comes to decisions about
perspectives for their own development and treatments or interventions needed for realizing
these perspectives. This same legislature also specifies the restrictions of this right to self-
determination with respects to persons of whom it is evident or likely that they are
insufficiently capable of evaluating the quality of a perspective for development or to oversee
and weigh the risks involved in efforts to realize it. In this case, ‘anticipation of approval’ can
be used: force and obligations are justified as long as, in the long run, they benefit the
persons and community involved. In the situation of children who cannot stand up for
themselves, the use of the principle is linked to the assumption that eventually, through the
intervention of the professionals, a client’s education is successful. At that time, the client or
former client is assumed to be able to communicate that being engaged in the intervention
was a justified and good decision. This is risky because the assumed developmental
expectations may not be realized and the anticipated approval may not be validated.
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