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Samenvatting autisme en ontregeld gedrag
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Deze samenvatting is een combinatie van het boek 'Autisme en probleemgedrag' en van de lessen van Wilfried Peeters. Het bevat de hoofdstukken 1 + 3 tem 7.
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florevanmiert
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2023 –2024
Samenvatting
ASS EN ONTREGELD GEDRAG
FLORE VAN MIERT
,1
,Inhoudsopgave
1 Inleinding...................................................................................................................... 6
2 Omschrijving: wat is probleemgedrag (en wat niet)?.......................................................7
2.1 Definitie.......................................................................................................................................... 7
2.1.1 Moeilijkheden bij het omschrijven van probleemgedrag..........................................................7
2.1.2 Criteria voor probleemgedrag.................................................................................................. 7
2.2 Uitingsvorm.................................................................................................................................... 8
2.2.1 Typisch autistisch probleemgedrag?........................................................................................ 8
2.2.2 Gedragsproblemen en emotionele problemen.........................................................................8
2.3 Aard................................................................................................................................................ 9
2.3.1 Primair, secundair en comorbide probleemgedrag...................................................................9
2.3.2 Belang.................................................................................................................................... 10
2.3.3 Nuancering............................................................................................................................. 10
2.4 Verloop......................................................................................................................................... 11
3 Visie: probleemgedrag als stressventiel en oplossingsstrategie.....................................11
3.1 Uitgangspunt: probleemgedrag is zinvol......................................................................................11
3.2 Betekenis: probleemgedrag als stressventiel...............................................................................11
3.3 Functie: probleemgedrag als oplossingsstrategie.........................................................................11
3.4 Besluit: probleemgedrag is communicatie....................................................................................11
4 Ontstaan: een werkmodel over probleemgedrag...........................................................12
4.1 Stressoren.................................................................................................................................... 12
4.1.1 Omgevingsstressoren............................................................................................................ 12
4.1.2 Interne stressoren.................................................................................................................. 13
4.2 Verwerkingsmogelijkheden........................................................................................................... 13
4.3 Probleemgedrag........................................................................................................................... 15
4.4 Ongewenste leereffecten.............................................................................................................. 15
4.4.1 Heftige en emotionele reacties van de omgeving..................................................................15
4.4.2 Bekrachtiging......................................................................................................................... 17
4.4.3 Perseveratie........................................................................................................................... 18
4.4.4 Ontbreken van remmende mechanismen..............................................................................18
5 Beeldvorming: probleemgedrag in kaart brengen..........................................................19
5.1 Stap 1: Informatie verzamelen en analyseren..............................................................................19
5.1.1 Betekenis- en functieanalyse: ABC......................................................................................... 19
5.1.2 Ijsbergmodel: de binnenkant.................................................................................................. 20
5.1.3 Oplossingsgericht kijken: oplossingen, krachten en uitzonderingen......................................20
5.1.4 Synthese: geïntegreerde informatieverzameling en -analyse................................................21
2
, 5.2 Stap 2: hypothesen formuleren.................................................................................................... 21
5.3 Stap 3: hypothesen ordenen in werkmodel..................................................................................21
6 Aanpak: belangrijke principes......................................................................................22
6.1 Overzicht van behandelmodellen................................................................................................. 22
6.1.1 Autismespecifieke behandelmodellen....................................................................................22
6.1.2 Algemene behandelmodellen.................................................................................................23
6.1.3 Alternatieve behandelingen................................................................................................... 23
6.2 Uitgangspunten............................................................................................................................ 23
6.2.1 Verantwoordelijkheid bij de begeleider..................................................................................23
6.2.2 Afstemming tussen kind en omgeving...................................................................................25
6.2.3 Aanpak op maat..................................................................................................................... 25
6.2.4 Oog voor de betekenis en functie van probleemgedrag.........................................................25
6.2.5 Aandacht voor de totale persoon........................................................................................... 25
6.2.6 Krachten van persoon en omgeving benutten........................................................................26
6.2.7 Beperkingen van het kind accepteren....................................................................................26
6.2.8 Samenwerken met de context...............................................................................................26
6.3 Basisprincipe: het ijsbergmodel.................................................................................................... 26
6.4 Voorwaarden................................................................................................................................ 27
6.4.1 Is er een probleem?............................................................................................................... 27
6.4.2 Willen de betrokkenen het ontregelde gedrag (nu) aanpakken?............................................27
6.5 Behandelverloop: cyclus van planmatig handelen........................................................................28
7 Aanpak: een stappenplan voor de praktijk....................................................................29
7.1 Stap 1: neem lichamelijke ongemakken en pijn weg....................................................................29
7.2 Stap 2: pas de omgeving aan....................................................................................................... 30
7.2.1 Wat is een autismevriendelijke omgeving?............................................................................30
7.2.2 Welke omgevingsaanpassing is nodig?..................................................................................32
7.2.3 Verduidelijken........................................................................................................................ 32
7.2.4 Prikkelaanbod aanpassen....................................................................................................... 34
7.2.5 Eisenpakket aanpassen.......................................................................................................... 35
7.3 Stap 3: bevorder het gewenste gedrag........................................................................................36
7.3.1 Weet het kind wat hij of zij moet doen?.................................................................................36
7.3.2 Beheerst het kind de gewenste vaardigheid?.........................................................................39
7.3.3 Waarom zou het kind moeite doen?.......................................................................................40
7.4 Stap 4: verminder het probleemgedrag........................................................................................ 42
7.4.1 Verduidelijken........................................................................................................................ 42
7.4.2 Voorkomen............................................................................................................................. 42
7.4.3 Uitdoven................................................................................................................................. 44
7.4.4 Straffen.................................................................................................................................. 44
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