Deze samenvatting omvat alle lessen van thema's uit de orthopedagogiek: handicap en ontwikkelingsstoornissen. Ook zijn er overal bijkomende notities aan toegevoegd.
THEMA’S UIT DE
ORTHOPEDAGOGIEK
HANDICAP EN ONTWIKKELINGSSTOORNISSEN
HANNE BOONS
1STE MASTER
2021-2022
,Inhoud
1 Autismespectrumstoornis: kwaliteitsvolle diagnostiek en interventies...............................................7
1.1 ASS kenmerken.............................................................................................................................7
1.1.1 Problemen in sociale communicatie en sociale interactie.....................................................7
1.1.2 Beperkte, repetitieve patronen van gedrag, belangstelling, activiteiten...............................7
1.2 Diagnostiek...................................................................................................................................7
1.2.1 Onderkennende, classificerende diagnostiek van ASS...........................................................8
1.2.2 Verklarende en handelingsgerichte diagnostiek..................................................................14
1.2.3 Diagnostiek in Vlaanderen: Aanbevelingen Taskforce Autisme, 2016.................................17
1.2.4 Van diagnostiek naar interventies.......................................................................................17
2 Communicatie bij mensen met verstandelijke beperking en/of autisme..........................................21
2.1 Waarom aandacht voor communicatie?.....................................................................................21
2.2 Een bijzondere doelgroep...........................................................................................................21
2.3 Ontwikkeling van communicatie.................................................................................................21
2.3.1 Intentionaliteit.....................................................................................................................22
2.3.2 Symboolvorming..................................................................................................................22
2.4 Communicatiemodel (Verpoorten, 1996)...................................................................................23
2.5 Functies van communicatie........................................................................................................23
2.5.1 Gedragsregulatie..................................................................................................................23
2.5.2 Sociale interactie.................................................................................................................23
2.5.3 Gedeelde aandacht..............................................................................................................23
2.6 Vormen van communicatie.........................................................................................................24
2.7 Niveaus van betekenisverlening.................................................................................................24
2.7.1 Sensatieniveau.....................................................................................................................24
2.7.2 Presentatieniveau................................................................................................................24
2.7.3 Representatieniveau............................................................................................................24
2.7.4 Metarepresentatieniveau....................................................................................................25
2.8 Ondersteuning op maat..............................................................................................................25
2.8.1 Ondersteunende communicatie (OC)..................................................................................26
3 Autismespectrumstoornis: neurodiversiteit......................................................................................31
3.1 Uitgangspunt: wat is autisme.....................................................................................................31
3.2 Terminologie en definities..........................................................................................................31
3.2.1 Neurodiversiteit...................................................................................................................31
3.2.2 Neurodiversiteitsparadigma................................................................................................31
3.2.3 Neurodiversiteitsbeweging..................................................................................................32
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, 3.2.4 Neurotypisch – neurodivergent...........................................................................................32
3.2.5 Intersectionaliteit................................................................................................................32
3.3 Neurodiversiteit in diagnostiek en interventies..........................................................................32
3.3.1 Kritische vragen...................................................................................................................32
3.3.2 Aan de slag...........................................................................................................................33
4 Analyse en aanpak van probleemgedrag bij mensen met verstandelijke en meervoudige
beperkingen.........................................................................................................................................35
4.1 Definitie en prevalentie..............................................................................................................35
4.1.1 Probleemgedrag..................................................................................................................35
4.1.2 Zelfverwondend gedrag.......................................................................................................35
4.1.3 Agressief/destructief gedrag................................................................................................36
4.1.4 Stereotiep/repetitief gedrag................................................................................................36
4.1.5 Ander probleemgedrag........................................................................................................36
4.1.6 Gevolgen probleemgedrag..................................................................................................36
4.1.7 Multifactoriële analyse van probleemgedrag......................................................................37
4.2 Analysekader + casus..................................................................................................................38
4.2.1 Gedrags- en emotionele problemen....................................................................................38
4.3 Interventies + casus....................................................................................................................53
4.3.1 Beeldvorming Luuk..............................................................................................................53
4.3.2 Beeldvorming Carla..............................................................................................................56
4.4 Multifactoriële analyse van probleemgedrag.............................................................................59
4.5 Interventies.................................................................................................................................60
4.5.1 Meta-analyse (groepsstudies)..............................................................................................60
4.5.2 Meta-analyse (single case studies)......................................................................................60
4.5.3 Medicatie.............................................................................................................................60
4.5.4 Gedragstherapeutische interventies....................................................................................61
4.5.5 Omgevingsgerichte interventies..........................................................................................61
4.5.6 Individugerichte interventies...............................................................................................63
4.5.7 Probleemgedrag: interventies.............................................................................................64
4.6 Casus Luuk – interventies...........................................................................................................64
4.7 Casus Carla..................................................................................................................................65
4.8 Voorbeelden examenvragen.......................................................................................................65
5 Sociale netwerken en sociale inclusie................................................................................................66
5.1 Wat?...........................................................................................................................................66
5.2 Belang sociale netwerken/inclusie.............................................................................................66
5.2.1 Vanuit personen met een beperking...................................................................................66
2
, 5.2.2 Kwaliteit en beleving............................................................................................................68
5.3 Beïnvloedende factoren van sociale netwerken en sociale inclusie...........................................69
5.4 Analyse en beeldvorming...........................................................................................................70
5.4.1 Analyse van netwerk: WAT..................................................................................................70
5.5 Analyse van netwerk: HOE..........................................................................................................70
5.5.1 Breder (onverwacht) netwerk (LUS)....................................................................................71
5.5.2 Inclusietoets.........................................................................................................................72
5.5.3 Dynamische persoonlijke netwerkverhalen.........................................................................72
5.6 Interventie..................................................................................................................................74
5.6.1 Interventies niveau inclusie.................................................................................................74
5.6.2 Interventies niveau sociale netwerkvorming.......................................................................75
5.6.3 Visie begeleiders (bevraging SPOND vzw)............................................................................77
5.6.4 Zijn de genoemde interventies en benaderingen effectief?................................................77
6 Persoons- en gezinsgericht werken bij mensen met een beperking..................................................78
6.1 Individu: kwaliteit van leven.......................................................................................................78
6.1.1 Quality of life – kwaliteit van leven......................................................................................78
6.1.2 Basisprincipes bij conceptualisering....................................................................................79
6.2 Persoonsgerichte planningsmethodieken...................................................................................81
6.2.1 Doelstellingen......................................................................................................................81
6.2.2 Diverse methodieken...........................................................................................................81
6.2.3 Kernprincipes van methoden...............................................................................................82
6.2.4 Procesverloop......................................................................................................................82
6.3 Review Ratti et al. (2016)............................................................................................................82
6.3.1 Verklaringen?.......................................................................................................................83
6.4 Samenleving: inclusie en volwaardig burgerschap.....................................................................83
6.4.1 Bredere context...................................................................................................................84
6.4.2 Kerncomponenten...............................................................................................................84
6.4.3 Basisprincipes bij conceptualisering....................................................................................84
7 Gezinsgericht werken........................................................................................................................85
7.1 Gezin: gezinskwaliteit van leven.................................................................................................85
7.2 Family Quality of Life – Kwaliteit van het Gezinsleven................................................................85
7.3 Basisprincipes bij conceptualisering...........................................................................................86
7.4 Gezinsgericht werken: principes.................................................................................................86
7.5 Gezinsgericht werken.................................................................................................................87
7.5.1 Interventie...........................................................................................................................89
7.5.2 Resultaten MM case studies................................................................................................89
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