Thesis (MEdPsych)--University of Stellenbosch, 2003. / ENGLISH ABSTRACT: This study was undertaken with the view to explore the experiences of tutors of children with the dual diagnosis of Autism and Down syndrome during the implementation of an Applied Behaviour Analysis support programme The parents of the children willingly participated in a research project of the Department of Educational Psychology and Specialized Education at the University of Stellenbosch. A private individual funded the project. The aim of the project was to evaluate the effectiveness of an Applied Behavior Analysis support programme over a period of 26 weeks on an individual that has Autism. The programme impacted the daily lives of the tutors. The question soon arose as to how the intensive contact between tutor and the child would be experienced by the tutor. A literature review was conducted to obtain a perspective of research done in this field. I fulfilled the dual role of researcher and trainee educational psychologist. The social contructivist framework was chosen as the preferred educational psychological framework from which to approach the study, while the participatory action research paradigm lent itself to describe the individual experiences of the tutors. The experiences were gathered from interviews, observations, video material, journals and reflections. The research report describes a variety of possible experiences the tutor underwent and the repercussions thereof. Suggestions were made as to how adaptations to the programme could serve to expand the training of educational psychologists and tutors. / AFRIKAANSE OPSOMMING: Hierdie studie is onderneem om die belewenisse van tutors van kinders met die dubbel diagnose van Outisme en Down sindroom tydens 'n Toegepaste Gedragsmodifikasie Analise program te ondersoek. Die ouers van die kinders het vrywilliglik deelgeneem aan 'n navorsingsprojek van die Departement Opvoedkunde en Spesialiseringsonderwys van die Universiteit van Stellenbosch. Fondse vir die projek is van 'n privaat persoon ontvang. Die doel van die projek was om die effektiwiteit van die program oor 'n tydperk van 26 weke te evalueer. Die tutors se daaglikse lewe is deur die program beïnvloed en die vraag het ontstaan hoe die intensiewe kontak tussen kind en tutor deur die tutor beleef sou word. 'n Literatuurstudie is onderneem om inligting oor bestaande navorsing in te win. Ek het tydens die projek die rol van beide navorser en opvoedkundige sielkundige in opleiding vervul. Die sosiaal konstruktiwistiese raamwerk is bespreek as 'n sinvolle opvoedkundige sielkundige raamwerk, terwyl die deelnemende aktiewe navorsingsparadigma homself daartoe leen om die belewenisse van die tutors te beskryf. Die belewenisse is ingesamel deur middel van onderhoude, observasie en video materiaal, 'n joernaal en refleksies. Hierdie navorsingsprojek beskryf 'n verskeidenheid van die moontlike belewenisse van die tutors sowel as die moontlike nagevolge daarvan. Voorstelle oor moontlike aanpassings in die program word gemaak om sodoende die opleiding van tutors sowel as opvoedkundige sielkundiges in opleiding te verbeter.

My study arose in the context of an intervention programme aimed at the development of a child with autism’s communication and social interaction skills. The approach I take is a social constructionist one in which language is considered to be constructive and constitutive of social and psychological reality. This orientation challenges the assumptions of a western psychiatric approach that emphasizes the impairment and deficits associated with autism. The participants of the study are a 6-year-old boy diagnosed with Pervasive Developmental Disorder (Autistic Spectrum), and his mother, father, sister and a volunteer on the intervention programme. The discourse analytic method of conversation analysis is employed as a means of elucidating the collaborative mechanisms employed by both the child and his co-participants in making sense of one another. The specific aims of the study are to closely examine the communicative behaviour and interactive styles of the child and his coparticipants, their implications for communicative success (co-ordinated interaction) or breakdown (discordant interaction), and the implications for how the child is positioned within the discourse in relation to his co-participants. My constructions of the data suggested that a playful, activity-based interactive style constituted by non-verbal turns, affection and short, simple utterances enhance mutual participation and the accomplishment of co-ordinated interaction. Barney’s co-participants sometimes tend to dominate interaction and frequently employ a strategy of repetitive questioning, which functions to direct and constrain the interaction and results in the child’s withdrawal and discordant interaction. This tendency to withdraw, however, seems to function as a means by which the child is able to actively resist positioning by others, and thus constitutes himself in a position of greater power. Furthermore, his use of the pronoun ‘I’ and collaborative negotiation of the words yours and mine suggest the active co-construction and positioning of himself as a separate person in relation to his co-participants. This research informs intervention efforts and encourages the co-participants to reflect on how interaction is co-constructed between themselves and the child.

Durante os primeiros meses de vida, o bebê mostra um intenso interesse para olhar e ser olhado, porém quando isso não acontece e sua mãe não se dá conta desse fato, podemos considerar este como sendo um sinal de risco de autismo (Laznik, 2004). Assim, a clínica com bebês propõe um tratamento de crianças desde o momento em que aparecem os primeiros elementos indicativos de sofrimento psíquico. Dessa forma, o olhar dos pais é de fundamental importância na intervenção clínica precoce, que visa à saúde mental na primeira infância e suas repercussões para a vida posterior. Nesse sentido é que este estudo foi desenvolvido, a partir de nossas atividades clínicas, com bebês que apresentam algum sofrimento psíquico, realizadas nos grupos pais-bebês do CAPSi Centro Campinense de Intervenção Precoce, na cidade de Campina Grande PB, tendo como objetivo geral analisar o lugar no qual esses pais se colocam face a adoção de um bebê com sinais indicativos de autismo. Como objetivos específicos, ele se propõe: investigar como esse bebê é falado por seus pais, uma vez que o olhar pode ser um efeito da palavra, e também pretendemos articular os aspectos que levaram à adoção e aos sinais indicativos de autismo. Seu fundamento teórico consiste na psicanálise, tendo como eixo condutor de nossas leituras as obras de Freud e Lacan e de seus discípulos cujos trabalhos versam sobre constituição do sujeito e a clínica precoce de crianças com risco de autismo ou com dificuldades no estabelecimento do laço pais-bebês. Realizamos um estudo de caso para ilustrar a questão do olhar dos pais, enfatizando de que lugar o bebê é olhado, em que ponto do esquema óptico de Lacan os seus pais estão situados. Também discutimos questões relacionadas à adoção, maternidade e paternidade. Os dados relacionados foram coletados por meio de entrevistas realizadas com a mãe, o pai e duas profissionais que atendem o referido bebê, além da consulta ao prontuário.

Made available in DSpace on 2017-06-01T18:08:54Z (GMT). No. of bitstreams: 1 vivian_batista_carvalho.pdf: 766478 bytes, checksum: 7c68517d03dd8ae3d811cc6cc7bc38c1 (MD5) Previous issue date: 2014-05-23 / During the first months of life, a baby shows an intense interest in looking and being looked at, but when it does not happen and the mother does not realize this fact, we can consider it as a sign of risk of autism (Laznik, 2004). Thus the clinic with babies proposes a treatment of children since the moment that the first elements that indicate psychological distress appear. This way, the gaze of the parents is crucial in early clinical intervention, which aims to mental health in early childhood and its implications for later life. This study was developed in this direction, starting from our clinical activities, with babies who have some psychological distress, realized in parents-babies groups at CAPSi Early Intervention Center of Campina Grande state of Paraiba. Our general goal was to analyze the place in which these parents put themselves face the adoption of a baby with indicative signs of autism. As specific goals, we proposed: to investigate how this baby is spoken by their parents, since the gaze may be an effect of the word, and we also intended to articulate the issues that led to the adoption and to the signs of autism. We took as basis for our work the psychoanalytic theoretical reference, having as the primary driver of our readings the literary work of Freud and Lacan. We also emphasized texts of other authors that talk about the constitution of the subject and the early clinical intervention for children at risk of autism or facing difficulties in establishing the parent-infant bond. A case study was conducted to illustrate the issue of the parents‟ gaze, emphasizing from which place the baby is seen, at which point of Lacan's optical scheme their parents are located. We also discussed issues related to adoption, motherhood and fatherhood. Related data were collected through interviews with the mother, the father and two professionals who provide care to the baby, besides consulting the patient records. / Durante os primeiros meses de vida, o bebê mostra um intenso interesse para olhar e ser olhado, porém quando isso não acontece e sua mãe não se dá conta desse fato, podemos considerar este como sendo um sinal de risco de autismo (Laznik, 2004). Assim, a clínica com bebês propõe um tratamento de crianças desde o momento em que aparecem os primeiros elementos indicativos de sofrimento psíquico. Dessa forma, o olhar dos pais é de fundamental importância na intervenção clínica precoce, que visa à saúde mental na primeira infância e suas repercussões para a vida posterior. Nesse sentido é que este estudo foi desenvolvido, a partir de nossas atividades clínicas, com bebês que apresentam algum sofrimento psíquico, realizadas nos grupos pais-bebês do CAPSi Centro Campinense de Intervenção Precoce, na cidade de Campina Grande PB, tendo como objetivo geral analisar o lugar no qual esses pais se colocam face a adoção de um bebê com sinais indicativos de autismo. Como objetivos específicos, ele se propõe: investigar como esse bebê é falado por seus pais, uma vez que o olhar pode ser um efeito da palavra, e também pretendemos articular os aspectos que levaram à adoção e aos sinais indicativos de autismo. Seu fundamento teórico consiste na psicanálise, tendo como eixo condutor de nossas leituras as obras de Freud e Lacan e de seus discípulos cujos trabalhos versam sobre constituição do sujeito e a clínica precoce de crianças com risco de autismo ou com dificuldades no estabelecimento do laço pais-bebês. Realizamos um estudo de caso para ilustrar a questão do olhar dos pais, enfatizando de que lugar o bebê é olhado, em que ponto do esquema óptico de Lacan os seus pais estão situados. Também discutimos questões relacionadas à adoção, maternidade e paternidade. Os dados relacionados foram coletados por meio de entrevistas realizadas com a mãe, o pai e duas profissionais que atendem o referido bebê, além da consulta ao prontuário.