Interac(ng	
  with	
  Each	
  Individual	
  	
  
with	
  Very	
  High	
  &	
  Complex	
  Needs:	
  	
  
Video	
  Interac(o...
Communica2ng	
  with	
  People	
  with	
  
Complex	
  Care	
  Needs…	
  
Can	
  Be	
  Difficult…	
  
•  Cogni2ve	
  impairment	
  
•  Vision	
  impairment	
  
•  Hearing	
  impairment	
  
•  Moveme...
…	
  For	
  Both	
  People	
  
•  May	
  not	
  know	
  other	
  ways	
  
to	
  communicate	
  
•  May	
  be	
  scared	
  ...
It	
  Can	
  Happen	
  
Today’s	
  Session	
  
•  Principles	
  
•  Processes	
  
•  Prac2ce	
  
•  Ques2ons	
  
Your	
  presenter	
  
•  Sheridan	
  Forster	
  
– Prac22oner	
  &	
  
supervisor	
  
•  Video	
  Interac2on	
  
Guidance	...
What	
  is	
  VIG?	
  
•  An	
  interven2on	
  the	
  works	
  towards	
  improving	
  
interac2ons	
  between	
  two	
  o...
VIG	
  In	
  3	
  Minutes	
  
10	
  
The	
  Scope	
  of	
  VIG	
  
Clients	
  
•  New	
  born	
  babies	
  and	
  parents	
  
•  Children	
  in	
  early	
  int...
Par2cipants	
  
•  Person	
  –	
  target	
  person	
  such	
  
as	
  child,	
  adult	
  with	
  
disability,	
  person	
  ...
Intersubjec2vity	
  
•  Sharing	
  minds	
  
•  Trevarthen,	
  Stern	
  
Key	
  terms	
  
Ini-a-ve	
   Recep-on	
  
DISCORDANT CYCLE!ATTUNED CYCLE!
YES ! NO!
Person receives
partner’s turn!
Person misses!
partner’s turn!
Partner receives!...
What	
  are	
  the	
  Principles	
  of	
  ARuned	
  
Interac2ons?	
  
•  Being	
  aRen2ve	
  
•  Encouraging	
  ini2a2ves	...
BEING	
  ATTENTIVE	
  
ENCOURAGING	
  
INITIATIVES	
  
RECEIVING	
  INITIATIVES	
  
ATTUNED	
  
INTERACTION	
  
GUIDING	
 ...
The	
  Steps	
  in	
  VIG	
  
CLIENT
Kennedy, H., Landor, M. & Todd,
L.(2011).Video Interaction
Guidance: a relationship-based
intervention to promote
a...
Compensa2ng	
  &	
  Ac2va2ng	
  
Compensa2ng	
  &	
  Ac2va2ng	
  
Prac2ce	
  
•  Adult	
  with	
  Down	
  
syndrome	
  and	
  demen2a	
  
•  Example	
  of	
  process	
  for	
  
Craig	
  an...
Beginning	
  Clip	
  
23	
  
1st	
  Shared	
  Review	
  
24	
  
2nd	
  Clip	
  
25	
  
Exploring	
  
26	
  
Working	
  Point	
  
27	
  
3	
  Weeks	
  Later	
  
28	
  
2nd	
  Shared	
  Review	
  
29	
  
2	
  Months	
  Later	
  
30	
  
3rd	
  Shared	
  Review	
  
31	
  
Last	
  Word	
  
32	
  
Adult	
  with	
  Down	
  Syndrome/Demen2a	
  
&	
  DSW	
  
•  Examining	
  the	
  effect	
  of	
  
VIG	
  on	
  interac2ons...
Results	
  
A	
  Context	
  For	
  Discussing	
  Prac2ce	
  Issues	
  
•  For	
  example,	
  use	
  of	
  
touch	
  in	
  interac2ons	...
A	
  Shik	
  to	
  Intersubjec2vity	
  
Time	
  1	
  “It’s	
  been	
  difficult	
  of	
  late	
  
because	
  she	
  really	
...
Apprecia2ng	
  Smaller	
  Things	
  
“my	
  problem	
  throughout	
  the	
  
whole	
  project	
  was	
  that	
  I	
  was	
...
Staying	
  in	
  the	
  Moment	
  
“I	
  need	
  to	
  spend	
  more	
  2me	
  
with	
  her,	
  be	
  more	
  pa2ent,	
  
...
Feeling	
  More	
  Confident	
  
When	
  asked	
  about	
  the	
  best	
  
part	
  of	
  the	
  process	
  one	
  
DSW	
  s...
Team	
  Prac2ces	
  
“encouragement,	
  receiving	
  
encouragement,	
  a	
  few	
  
encouraging	
  words,	
  oh	
  yes	
 ...
Conclusions	
  
•  Video	
  Interac2on	
  Guidance	
  has	
  much	
  to	
  offer	
  
speech	
  clinicians,	
  prac22oners	
...
42	
  
Ques2ons	
  and	
  comments	
  
Endpoints	
  
•  Image	
  credits	
  –	
  123rf	
  –	
  anatolymas	
  &	
  
johan2011	
  
•  www.videointerac2onguidance.n...
Being	
  a	
  VIG	
  prac22oner	
  
•  Associa2on	
  for	
  Video	
  
Interac2on	
  Guidance	
  UK	
  
–  Introductory	
  ...
Sheridan Forster - Speech Pathologist/ Researcher - Interacting with Each Individual with Very High & Complex Needs: Video...
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Sheridan Forster - Speech Pathologist/ Researcher - Interacting with Each Individual with Very High & Complex Needs: Video Interaction Guidance Supporting to Enhance Relationships

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Sheridan Forster delivered the presentation at the 2014 Younger People with very High & Complex Care Needs Conference.

The 4th Annual Younger People with very High & Complex Care Needs Conference focused on topics such as report on Summer Foundation’s preliminary findings from NDIS Launch sites in Barwon & the Hunter Valley, identify policy & practice opportunities & barriers for YPINH that arise from the NDIS.

For more information about the event, please visit: http://www.informa.com.au/youngerpeopleconference14

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Sheridan Forster - Speech Pathologist/ Researcher - Interacting with Each Individual with Very High & Complex Needs: Video Interaction Guidance Supporting to Enhance Relationships

  1. 1. Interac(ng  with  Each  Individual     with  Very  High  &  Complex  Needs:     Video  Interac(on  Guidance     Support  &  Enhance  Rela(onships   Sheridan  Forster    
  2. 2. Communica2ng  with  People  with   Complex  Care  Needs…  
  3. 3. Can  Be  Difficult…   •  Cogni2ve  impairment   •  Vision  impairment   •  Hearing  impairment   •  Movement  impairments   •  Medica2on  side  effects   •  May  not  use  speech   •  May  not  understand  speech   •  May  not  be  mo2vated  to   interact  
  4. 4. …  For  Both  People   •  May  not  know  other  ways   to  communicate   •  May  be  scared  and  not   know  what  to  do   •  May  not  give  the  person   2me   •  May  be  in  a  culture  that   discourages  interac2ons   •  May  not  think  it’s  their   responsibility   •  May  be  2red  
  5. 5. It  Can  Happen  
  6. 6. Today’s  Session   •  Principles   •  Processes   •  Prac2ce   •  Ques2ons  
  7. 7. Your  presenter   •  Sheridan  Forster   – Prac22oner  &   supervisor   •  Video  Interac2on   Guidance  Australia   – With  Chris2na  Tuke   Flanders  &  Meredith   Prain  
  8. 8. What  is  VIG?   •  An  interven2on  the  works  towards  improving   interac2ons  between  two  or  more  people   •  Using  clips  of  videos  of  the  clients  doing  beRer   than  usual  interac2ons   •  And  a  guide  to  help  them  explore  how  to   con2nue  to  improve  the  interac2ons  
  9. 9. VIG  In  3  Minutes   10  
  10. 10. The  Scope  of  VIG   Clients   •  New  born  babies  and  parents   •  Children  in  early  interven2on  and   teachers/parents   •  Children  in  school  and  teachers   •  Children  with  disabili2es  and   children  at  risk  and  their  parents   •  Adults  with  disabili2es  and  support   workers   •  Students  and  clinical  educators   •  People  with  demen2a  and  their   caregivers   Prac--oners   •  Educa2onal  psychologists   •  Teachers   •  Social  workers   •  Child  health  workers   •  Speech  pathologists   •  Psychologists   •  Disability  support  workers   •  Occupa2onal  therapists  
  11. 11. Par2cipants   •  Person  –  target  person  such   as  child,  adult  with   disability,  person  in  aged   care   •  Partner  –interacts  with   target  person,  key  focus  of   VIG:  parent,  support   worker,  teacher  –  the   Person   •  Prac22oner  –  the  VIG   prac22oner  suppor2ng  the   process  
  12. 12. Intersubjec2vity   •  Sharing  minds   •  Trevarthen,  Stern  
  13. 13. Key  terms   Ini-a-ve   Recep-on  
  14. 14. DISCORDANT CYCLE!ATTUNED CYCLE! YES ! NO! Person receives partner’s turn! Person misses! partner’s turn! Partner receives! person’s initiative! Partner misses! person’s initiative! Adapted from: Kennedy, H., Landor, M. & Todd, L. (2011).Video Interaction Guidance: a relationship-based intervention to promote attunement, empathy and well- being London: JKP ! Does  The  Partner  Receive  Person’s   Ini2a2ve?  
  15. 15. What  are  the  Principles  of  ARuned   Interac2ons?   •  Being  aRen2ve   •  Encouraging  ini2a2ves   •  Receiving  ini2a2ves   •  Developing  aRuned  interac2ons   •  Guiding   •  Deepening  discussions  
  16. 16. BEING  ATTENTIVE   ENCOURAGING   INITIATIVES   RECEIVING  INITIATIVES   ATTUNED   INTERACTION   GUIDING            DEEPENING            DISCUSSION   Parentled 1. ! TOWARDS INTERSUBJECTIVITY! Pre-requisite for building attuned interactions 2.!  INTERSUBJECTIVITY!          The  core  of  aRuned              interac2ons   3.  ! MEDIATED  LEARNING!          Developing  the            aRuned  rela2onship     Building blocks for parent as care-giver Possible impact of each block for child as care- seeker Feels  love,  recognized   and  important   Knows  their  parents  are   interested  in  what  they  are   doing  and  their  wishes   Experiencing  being  received,   parent  commen2ng  on  what  they   are  doing  and  their  wishes   Enjoys  interac2ng  with  their   parent   Enjoys  being  helped  and  learning   from  their  parents   Is  helped  to  manage  difficult  situa2ons  or   learn  new  things   Kennedy, H., Landor, M. & Todd, L.(2011).Video Interaction Guidance: a relationship-based intervention to promote attunement, empathy and well- being London: JKP
  17. 17. The  Steps  in  VIG  
  18. 18. CLIENT Kennedy, H., Landor, M. & Todd, L.(2011).Video Interaction Guidance: a relationship-based intervention to promote attunement, empathy and well- being London: JKP
  19. 19. Compensa2ng  &  Ac2va2ng  
  20. 20. Compensa2ng  &  Ac2va2ng  
  21. 21. Prac2ce   •  Adult  with  Down   syndrome  and  demen2a   •  Example  of  process  for   Craig  and  Luke   – Concern  re:  depression   – Difficult  to  engage  
  22. 22. Beginning  Clip   23  
  23. 23. 1st  Shared  Review   24  
  24. 24. 2nd  Clip   25  
  25. 25. Exploring   26  
  26. 26. Working  Point   27  
  27. 27. 3  Weeks  Later   28  
  28. 28. 2nd  Shared  Review   29  
  29. 29. 2  Months  Later   30  
  30. 30. 3rd  Shared  Review   31  
  31. 31. Last  Word   32  
  32. 32. Adult  with  Down  Syndrome/Demen2a   &  DSW   •  Examining  the  effect  of   VIG  on  interac2ons   •  Qualita2ve   •  5  DSWs  &  1  woman  with   DS/D  (mid-­‐stage)  
  33. 33. Results  
  34. 34. A  Context  For  Discussing  Prac2ce  Issues   •  For  example,  use  of   touch  in  interac2ons   •  Ability  to  describe  why   they  do  what  they  do  
  35. 35. A  Shik  to  Intersubjec2vity   Time  1  “It’s  been  difficult  of  late   because  she  really  has  gone   downhill  with  the  demen2a   part”  and  then  gave  further   explana2on  of  the  behavioural   difficul2es  and  deteriora2on.     Time  2  “Well,  just  I  muck  around   with  her  when  I  do  her  toes,  and   I  say,  this  liRle  piggy,  so  just   having  games  with  her”,  followed   by  a  descrip2on  of  the  skill   deteriora2on.    
  36. 36. Apprecia2ng  Smaller  Things   “my  problem  throughout  the   whole  project  was  that  I  was   looking  for  far  too  much....  I   was  always  looking  for  too   much.  Every  2me  you  went  to   the  next  video,  I  was  trying  for   a  great  response,  not  just  the   liRle  responses.  So  I’ve  really   got  to  retrain  myself  to   understand  that  even  those   liRle  responses  are  successes.”  
  37. 37. Staying  in  the  Moment   “I  need  to  spend  more  2me   with  her,  be  more  pa2ent,   wait  for  her  to  respond,  and   par2cularly,  try  and  stay  in  the   moment  as  well.  So  if  Mary’s   showing  being  quite   responsive  to  something,  just   try  and  stay  in  that  moment.   By  staying  on  the  subject  and   not  moving  on,  you  do   some2mes  get  some  really   special  moments”.    
  38. 38. Feeling  More  Confident   When  asked  about  the  best   part  of  the  process  one   DSW  said,  “Certainly  not   seeing  myself  on  video.  I   think  that  was  awkward….   The  best  part  is  seeing  we   actually  do  –  we  are  all   actually  doing  the  right   thing  by  Mary.  It  was  fairly   confirming.”  
  39. 39. Team  Prac2ces   “encouragement,  receiving   encouragement,  a  few   encouraging  words,  oh  yes   you  were  very  pa2ent   there  and  you  made  her   feel  at  ease,  something  like   that,  that  was  very  posi2ve   for  me”  
  40. 40. Conclusions   •  Video  Interac2on  Guidance  has  much  to  offer   speech  clinicians,  prac22oners  &  families   •  There  is  growing  evidence  of  it’s  effec2veness   •  VIG  may  help  us  to  be  beRer  communicators  
  41. 41. 42  
  42. 42. Ques2ons  and  comments  
  43. 43. Endpoints   •  Image  credits  –  123rf  –  anatolymas  &   johan2011   •  www.videointerac2onguidance.net  
  44. 44. Being  a  VIG  prac22oner   •  Associa2on  for  Video   Interac2on  Guidance  UK   –  Introductory  training  course   (2  days)   –  Stage  1  –  supervised   prac2ce  (6  mths  +)   –  Stage  2  –  supervised   prac2ce  (6  mths  +)   –  Stage  3  –  supervised   prac2ce  (6  mths  +)   –  Supervisor  training  

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