Severe disability

The obvious handicap is the name for an impairment of all people in all his daily life and habits due to complex impairment of many skills of this man. As a rule, all possibilities of experience and expression, i.e. emotional , cognitive , physical , social and communication skills, are affected.

So it is not a single impairment (commonly known as a handicap ) such as mental or physical impairment , but accumulated impairments. This means that different impairments mutually condition, intensify and / or cause each other, which ultimately leads to severe disability. It is therefore not possible to assign it to one of the common guiding symptoms (such as mental, physical or various sensory disabilities ), because this would not do justice to the character of the complexity of the impairment and the holistic nature of the individual .

definition

In 1982, Ursula Haupt and Andreas D. Fröhlich understood the following under severe disability, as opposed to severe disability :

"Severely disabled children are physically handicapped children who have extreme developmental impairments in all main areas of development (psychomotor, emotional, communicative, social, cognitive). They are children

which - even on the ground - cannot yet move on their own
who cannot yet use their hands specifically to eat alone, to play constructively, to doodle, to design
who cannot yet communicate with spoken language
whose perception is still limited to the immediate area and who are not yet able to imitate what they have seen and heard
whose reaction and processing options relate at best to what has been directly experienced, but for which even the simplest abstractions (e.g. recognition of objects in pictures) are not yet possible
who at most react to contact offers from adult caregivers who are not yet able to establish relationships with other children and therefore have to be addressed individually over and over again
whose movement impairment is so pronounced that they are dependent on adult help for all everyday activities, for dressing and undressing, personal hygiene, eating, locomotion, communication, for satisfying emotional and social needs, for stimulation and occupation "(Haupt and Fröhlich, 1982 ).

Hans-Jürgen Pitsch (2003) briefly describes the positions of Manfred Thalhammer and the staff of his previous school, how severe and severe disabilities are distinguished:

Pragmatic college agreement

heavy:	Whose behavior cannot be controlled from a distance through verbal cues.
most difficult:	Targeted movements are only possible with physical assistance (e.g. leading)

Thalhammer

heavy:	"expressive" mentally handicapped people
most difficult:	"impressive" mentally handicapped people

Otto Speck and Theodor Thesing / Michael Vogt combine both forms according to Hans-Jürgen Pitsch (2003).

causes

The emergence of the so-called severe disability - which can happen in the pre- , peri- and postnatal period (at any age , e.g. due to accidents ) - can only be referred to the known causes of the various impairments, which are cumulative to the severe disability lead, be referred to: The causes can therefore be chromosomal , genetic , neurological and / or traumatic in nature.

advancement

People with severe disabilities need

Physical near
- to be able to have direct experience,
- to perceive other people.
other people
- which bring them closer to the environment in the simplest possible way,
- which enable them to move around and change their position,
- who they understand even without language and who reliably provide and care for them.

From such a deficit-oriented definition approach, the perspective of a competence-oriented approach developed. One arrives at the representation of their abilities:

“You perceive other people through skin and body contact.
You can gain direct experience with your body and evaluate it.
You experience yourself, people and things in an immediate emotional state.
They use their entire physicality to express and communicate ”(Fröhlich, 1993).

The causes of the most severe disability cannot be precisely determined based on current medical knowledge.

“Rather, you have to orientate yourself towards the generally known causes of disabilities. This means that the entire range of genetic, chromosomal, metabolic, neurological and traumatic causes must be included. This applies to the prenatal period, perinatal period and the postpartum period. In addition, harmful events can lead to severe disabilities at any age ”(Fröhlich, 1991). It is a combination of several circumstances and not just a specific decisive cause. For Georg Feuser , in addition to medical factors, social influences also play a decisive role. In summary, he sees the most severe disability as an expression of the appropriation of the world within processes of change between the organic requirements of the individual and the social conditions (cf. Feuser, 1979). The promotion of severely disabled people is based on the special needs of these:

“They need a lot of physical closeness in order to have direct experiences
they need physical closeness in order to be able to perceive other people
they need the teacher / therapist who brings them closer to the environment in the simplest possible way
They need the educator / therapist who enables them to move around and change their position
they need someone who understands them without language and who takes care of them reliably ”(Fröhlich, 1991).

Haupt sees the following as one way of promoting:

“(...) development-analogous support occurs in the awareness that analogy is not equality. Severely disabled students are not infants, are not toddlers. The development of severely disabled children shows analogies to the development of non-disabled children and other possibilities for creative solutions to life energy in the networked organism for communication, interaction and learning ”(Haupt, 1996).

The orientation towards basic needs can be done in connection with the offer of content-related, elementary learning goals, such as within the framework of the basic action stories according to Goudarzi , the "more meaningful" stories according to Fornefeld or with offers from the Basal Theater.

literature

Feuser, Georg: Severely disabled people in the school for the mentally handicapped . In: Dittmann, Werner; Klöpfer, Siegfried; Ruoff, Elsbeth (ed.): On the problem of educational support for severely disabled children and young people . Rheinstetten 1979, p. 27
Fischer, Erhard: Pedagogy for the most severe disability . In: Hansen, Gerd; Stein, Roland (ed.): Compendium special education. Bad Heilbrunn: Klinkhardt 2006, pp. 305-318
Fornefeld, Barbara: more sense® stories - telling - experiencing - understanding. Concept tape. Publishing a self-determined life. Düsseldorf 2013
Fröhlich, Andreas: Basal stimulation . Düsseldorf 1991, pp. 11, 12, 14
Fröhlich, Andreas: Living spaces - lifelong dreams . In: Fröhlich, Andreas (Hrsg.): Living spaces: Promotion and life support of severely disabled people in Europe . Lucerne 1993, p. 12
Goudarzi, Nicol: Basale action stories - stories of experiences for people with severe disabilities . Karlsruhe: by Loeper Literaturverlag 2015
Goudarzi, Nicol: Basale Action Stories. A trip around the world. New stories for people with severe disabilities . Karlsruhe: by Loeper Literaturverlag 2017
Hannich, Hans-Joachim: Relationship and interaction with the unconscious . In: Bienstein, Christel; Fröhlich, Andreas (Ed.): Unconscious: a challenge for relatives, nurses and doctors . Düsseldorf 1994, p. 54
Haupt, Ursula; Fröhlich, Andreas: Development support for severely disabled children . Mainz 1982, p. 22f.
Haupt, Ursula: Learning to understand disabled children . Düsseldorf 1996, p. 126
Pitsch, Hans Jürgen: "Lessons" with severely disabled people - problems with planning and implementation. In: Klauß, Theo; Lamers, Wolfgang (Hrsg.): All children teach everything ... Basics of pedagogy for people with severe and multiple disabilities . Heidelberg 2003, pp. 183-195