Toward a Diagnostic Intervention Model for Fostering Harmonious Interactions between Deaf-Blind Children and Their Educators

Abstract

This article demonstrates the use of the Diagnostic Intervention Model in everyday practice and the effects of its application in a case study of Kris and his educator using individual coaching. The implications of the case for everyday practice are discussed.

Attachment representations and response to video-feedback intervention for professional caregivers

“…The changes in affective mutuality were also not The lower rate of confirmation indicates a more ''distant'' interactive style among caregivers with dismissing attachment representations, which might be explained from the general strategy to prevent exposure to negative affect in relationships (Kobak, Cole, Ferenz-Gillies, & Fleming, 1993;Roisman, 2006). However, for clients with visual and intellectual disabilities, confirmation of signals works as a constant reminder that a partner is available for engaging in interaction (Janssen et al, 2003b). In the long run, therefore, the quality of interaction with caregivers with dismissing attachment representations may continue to be relatively more at risk, despite the positive effects of the Contact intervention on the two other dimensions of interaction.…”

“…Such programs are especially important when persons with disabilities live in group homes, away from their parental attachment figures, have developed highly idiosyncratic, mostly nonverbal means to express their emotional needs, or display aversive behaviors that interfere with positive, harmonious interaction (Janssen, Riksen-Walraven, & Van Dijk, 2003b;Janssen, Schuengel, & Stolk, 2002;Schuengel et al, 2010). Most programs train staff in general skills for interacting with persons with intellectual or multiple disabilities (e.g., Maes, Lambrechts, Hostyn, & Petry, 2007).…”

“…Apparently, even caregivers with autonomous attachment representations needed interaction coaching to improve the rate of confirmation as well as the affective mutuality within the interaction. The difficulties that caregivers have in developing high quality interactions may be the result of the often subtle, idiosyncratic signal repertoire that persons with multiple disabilities may develop (Janssen, Schuengel, et al, 2002;Janssen et al, 2003b). These signals will be harder to read for some clients than for others.…”

Stress, Behavior, and Children and Youth Who are Deafblind

“…For a variety of reasons, children and youth who are deafblind with additional disabilities have been considered to be particularly vulnerable to toxic stress (Chess, Korn, & Fernandez, 1971;Janssen, Riksen-Walraven, & van Dijk, 2003;McInnis & Treffry, 1982). Communicative behaviors of children who are deafblind are often subtle and difficult to interpret, and as a result, such behaviors are often missed or misinterpreted.…”

“…Such perceived sudden changes in the environment, in the absence of resources to adjust to them, are likely to evoke stress responses (Janssen, Schuengel, et al, 2002). In addition, research has suggested that children who are deafblind are at increased risk for impaired attachment relationships due to a number of factors including frequent hospitalizations, lack of face-to-face eye contact, lack of joint attention, slow, difficult to read responses to caregiver initiations, and difficulties in regulation of arousal patterns (Janssen et al, 2003;Nelson et al, 2002;Nelson, van Dijk, Oster, & McDonnell, 2009;Rowland, 1984). Moreover, chronic stress in children who are deafblind has been thought to manifest itself in physical illness, self-abusive behaviors, and severe challenging behaviors (Janssen, Schuengel, et al, 2002).…”