AUCD Webinar: Pathways to Employment for Transition Aged Youth and Young Adults with Autism Spect

AUCD Webinar: Pathways to Employment for Transition Aged Youth and Young Adults with Autism Spect


Event ID: 3264509 Event Started: 5/18/2017
5:00:00 PM ———- Please stand by for realtime captions.>>Hello and welcome to Pathways to Employment
for Transition Aged Youth and Young Adults with Autism Spectrum Disorders a webinar hosted
by the ASD special interest group. My name is Sarah DeMaio and I am the program
manager for AUCD’s Maternal Child Health technical assistance team. We would like to thank you all for joining
us today. Before we begin I would like to address a
few just a couple issues then we will provide — I will provide a brief introduction for
our speaker Carol Schall. Following the presentation there will be time
for questions in the last 10 to 15 minutes of today’s webinar. Captions are available using the link posted
in the first comment in the chat log of the webinar consul. Because of the number of participants your
telephone lines will be on mute throughout the event. You can submit questions at any point during
the presentation via the chat box on your webinar console. You may send a chat to the whole audience
or to the presenter only. We will compile your questions at the webinar
and address them at the end. Please note that we may not be able to address
every question and may combine some questions. This entire webinar is being recorded and
will be available on the website following the webinar. The presentation slides are available as handouts
in the handout section of the console or on the event page on the website. There will be a short five question evaluation
survey at the close of the webinar. We invite you to provide feedback on the webinar
and provide suggestions for future topics. Please join me and welcoming today’s presenter. Doctor Carol Schall is the Co-director for
the Virginia Commonwealth University Center for excellence. They director of the Virginia autism research
center and the principal investigator in the development of the community-based functional
skills assessment for traditional aged use — a grant funded by autism speaks. She has over 30 years experience supporting
adolescents and adults with ASD and a future group home supervisor administrator researcher
and consultant. She provided positive and instructional technical
assistance for the project search plus ASD support program for the past eight years at
the University. She is also the research coordinator for this
project. Additionally, she has conducted — consulted
nationally and internationally on issues related to adolescents and young adults with ASD. I will now turn the microphone over.>>Good afternoon everyone and thank you for
inviting me to present on this topic. I know it is very timely and also very important. As the incidence of autism has risen over
the past many years and have that first wave of individuals identified in the 90s and early
2000 our aging to the point where they are ready for transition to adulthood, this topic
is becoming more and more important for educators and community service providers alike.>>Much of our research here has centered
around autism and we have several publications we have published describing the work we have
completed. Many of the citations are on the screen and
these are also located in the handout that is available to you through PDF. I post this for your information. If you would like further information on any
of these I would be happy to share with you as well as much as I am left with in the guidelines
of our publishing responsibilities. One of the pieces of research we did was to
look what is happening in high school. We completed this research back in 2014. What we found was that — are not receiving
the same kind of educational support that many of our youth with other disabilities
are receiving. In fact we found as a group that use with
ASD have the highest GPA of any other disability with in the disability category. Specifically use with ASD have — as their
overall transcript GPA. We also found interestingly that youth with
ASD have many more high school credits when they graduate compared to their peers without
disabilities and peers with other disabilities. What we found when looking at the type of
credit that those youth with ASD are accessing that exceed their peers without disabilities,
and other disabilities, we found that youth with ASD are taking more nonvocational, nonacademic
credit than any other disability group or individuals without disabilities. Credits in high school are divided into three
types. We have academic credits which we understand
pretty well to be reading and writing and arithmetic. That is English, mathematics, science, social
studies, those core academic modules that you are required to take throughout high school. We then have vocational credits and vocational
credits fall in the area of any kind of career and technical educational course you may take,
but they also fall into the area of marketing. My daughter just graduated from high school
last year and some of the courses that were available to her that fall into this vocational
area would be sports marketing or some other courses along the lines of selling or home
economics or what shop. There is the entire career and technical education
coursework available if you elect to go to that location for about half of your day for
you may study cosmetology or dental hygiene or some of the other career fields that you
may prepare for while in high school. Those are the vocational credits. This area of nonvocational and non-academic
falls into a couple of different categories some of which may be helpful for individuals
with autism and some that may not necessarily be helpful. These courses include music, art, physical
education and those general electives that people might access that are more of interest
or application. They also include learning resources and learning
support and life skills courses or social skills courses. When we further look at those nonacademic
and nonvocational courses, because the majority of extra courses fall into this category. We thought if they are taking social skills
or life skills, that would be a good match. In fact we found that life skills and social
skills are the smallest percentage of credits in this nonacademic, nonvocational area for
youth with ASD. Instead, the majority of the coursework they
are taking are in fine arts performing arts areas that do not necessarily turn into careers
for the future. What we concluded after looking at this is
that rather than taking life skills and social skills to adjuncts their high school education,
youth with ASD are actually taking courses that do not necessarily equal a career or
even preparation for a career. We concluded that youth with ASD have significant
potential going untapped during their high school. In short, we are giving them more nonacademic,
nonvocational courses than their peers without disabilities and we’re also keeping them in
high school longer and they have very high GPA, the highest of any group. If you were to look at this and I were to
describe a group of people were I said overall if we mashed them altogether they are getting
3.0 and doing very well in high school and staying in high school longer than anybody
else you may assume that this is a group of students who are ready to tackle the world
challenges and achieve success that we see a mismatch between the GPA — in short we
are not preparing them for their adult life. Instead, we are preparing them to continue
to do stuff that is fun rather than stuff that really challenges them or lose them to
the next stage. That is a real problem. As a result we find that youth with ASD are
unemployed and underemployed than individuals with other disabilities. — Depending on the study read and numbers
you look at but somewhere between 50% to 75% of youth with ASD are unemployed. We see really low rates of independent living. With most individuals with ASD continuing
to live with their parents well into adulthood . [ Inaudible ] has done a number of analysis
— a number of pieces of analysis on the national longitudinal transition survey and what he
has found his youth with ASD have the highest degree of disconnection of any other disability
it would be I am working or going to school or accessing some type of support services. That is how we measure connection in adulthood,
that you are going somewhere or seeing someone or doing something different during the day. Over 60% of with ASD have none of those activities,
no postsecondary education or work or support of any kind. That is the highest of any disability. Even as much as six years out from high school
we see as many as 40% continue to be disconnected with nothing happening during the third day. A lot of our with ASD are living at home,
hanging out in their parents basement, playing video games, and as educators and people who
care about individuals with ASD, we know that is something we do not want for them lifelong. In addition, because of that disconnection,
we see very low incidence of friendships and relationships outside the home. This a comes the real problem we think about
that transition. We also conceptualize work very much for that
young adult it is an organizing factor. If you think back to your transition from
school to adulthood whether that was from college or from high school, what you will
remember is your first friend in adulthood came from work. Your life was organized around your work. Your time you spent in engaged activities
was mainly around work. Work is a very important, very significant
organizing factor at that point for young adults with ASD. Yes, their failure to access it seems to be
the beginning of a cascade of their failure to access all kinds of things like the ability
to live independently in the ability to make relationships and maintain friendships outside
of their immediate circle.>>We have been working on how to stem this
type by looking at the pathway to employment. At this way point in our research we have
identified three solid ways we have evidence that lead to employment. Those freeways are on the screen in front
of you right now. They are internshiphttp://www.aucd.org/images2/promos/vouchers.jpgs,
supported employment, and customized employment. I will walk through each of these in that
order.>>The first bit of research that we have
been doing is in relationship to this provision of projects search — SEARCH for people with
ASD. SEARCH — at Cincinnati Children’s Hospital
in Cincinnati Ohio, and it is a project that allows for individuals with elemental disabilities
to access internships in nontraditional, large businesses in their final year of high school. We look at individuals between the ages of
18 and 22 when there eligibility expires. We look at internships in unpaid settings
at this point. If they are adults and they make a payment,
but we worked very closely to ensure that our internships meet the requirements of the
department of labor and qualify for internships. The first place as we have been working are
in hospitals, Cincinnati Children’s Hospital has also started with a hospital. The idea of using a hospital is not because
it is a hospital, but because hospitals are large businesses that end up being microcosms
of the community. Specifically every job you may find in the
community you will find in the hospital. That will be food service in a hospital. There will be sales and retail in a hospital. There is going to be a lot of stocking and
organizing materials, what of taking care of the grounds. A hospital ends up being a really nice place
to host an internship site for a number of students, because you are going to be able
to access a number of different types of jobs that would also exist [ Inaudible ]. As we
began to work with individuals with autism, we knew that we were looking for specific
specific types of jobs that are repetitive in nature, but a high level of repetition. Not the same thing over and over again. Not a 37 or four step, but sometimes 80 or
90 or 100 step test. For example, one of the internships we have
taken advantage of wriggling is the maintenance of durable medical equipment. This would include IV poles and monitors,
blood oxygen monitors, the pediatric intensive care unit and newborn intensive care unit
they frequently have very extensive materials. There is a tool called a giraffe that is actually
a baby incubator with a heating lamp on top. That is almost in 80 step breakdown sterilize,
clear the data and rebuilds medical equipment that requires a great degree of focus. These internships, what we look for our true
work. When we are looking at an internship, we are
looking for work that does not qualify as volunteering. Hospitals have a tremendous amount of volunteer
opportunities as well but we do not take advantage of those because the difference between an
internship and a volunteer opportunity is the difference between a potential employee
and a really nice person with nothing else to do. We do not want our interns to be viewed as
a really nice person with nothing else to do. And said we want the business to view them
as potential employees and to ask them to do some work and consider them if they have
openings in employment. We are working with real jobs and providing
support. The nice thing about these internships is
the support on the internship is provided by a job coach while the person still has
educational support. There is also a teacher on site providing
classroom instruction and work social skills, work behaviors, and overall work knowledge
skills and abilities. We will see that the individual has someone
who is paid from a job coach perspective to meet that individuals needs.>>They also have an on-site mentor and that
is an employee of the this is where they are complete an internship who is responsible
for following them and teaching them what is required for them to be successful. It is always an educational purpose that leads
to an internship, and this in turn does not replace an employee, but in fact might actually
[ Inaudible ] the business a little bit. If it is taking that employee mentor some
time to teach the potential employee, the intern their job, but that is going to take
away from the business. The purpose of the internship is to learn
job skills that will make them successful and marketable and that open job market. I have video and I am going to step outside
of my presentation I will switch over to the video because I want to make sure you can
see it well and this is the best way to go about that.>>Stephanie works in the endoscopy department
of one of her main responsibilities is to help with room turnover preparing stretchers
after a patient leaves, sanitizing it and redressing it for the next patient to come
through. She also prepares patients [ Inaudible ] when
they are complete. [ Inaudible ]>>One of the internships was
in the endoscopy department. She was the first in turn we ever had in the
endoscopy department. We had approached them several times over
the years and when we first approached them they were hesitant because of the environment
in their department and lack of exposure and understanding of working with individuals
with disabilities, particularly autism. They initially said they would really prefer
not to work with us. They do not think it was a suitable environment. Over the years we continued to stop in and
check in and see if they were ready for us this time and we got to speak with one manager
he said I have seen a lot of your guys around the hospital ends they are doing things I
didn’t think someone with autism would be able to do. She was concerned about the sights and sounds
and smells that would be in the endoscopy department so [ Inaudible ] be able to work
with different smells and sounds and be able to take them seriously. You may want to cut this, but one of the things
we actually did was we downloaded and out that made different sounds and we played it
in the classroom and we were playing the pretty loudly to see who would respond and he was
responding appropriately to the inappropriate sounds we were playing in the room. Once endoscopy decided they were open to working
with us they asked us to come down and we toured the department with them and started
to identify some different tasks that needed to get done. Some of them were getting done regularly,
but they were being done by nurses who were being pulled from providing patient care. Smack –>>What Stephanie was dumped there
it was very successful. It took education and job coach support. Stephanie is a wonderful worker. She entered project search with a lot of natural
skills to be a good worker. She is organized and enjoys things clean,
she follows instructions very well however she does have an on makes of this made it
difficult for her coworkers to know how to interact with her. A lot of the teaching we did was not necessarily
for Stephanie to teach her how to do her job, but to teach her coworkers how to interact
with her.>>Her coworkers with sometimes provide Stephanie
with instructions for different job responsibilities and she would repeat them and not demonstrate
to them that she was understanding. We’ve really had to work with the department
on having them provide instruction, pause, and have her repeated and also that written
instruction she response much better to. We ended up writing a social story for Stephanie. She does very well with social stories to
learn how to handle particular situations and on top of that we also contacted her mom
because family support, we have found is extremely important and the more support we have at
home if we put a plan into place at work to let the family now often they can reiterate
and reinforce their end as well.>>I think Stephanie’s story is a really good
one, because it demonstrates Stephanie as a person who had had significant impact in
the area of communication for her disability and how she was able to learn to work in an
environment that required a lot of different tasks that require a high degree of detail. You saw her resetting a patient they, setting
patient belonging banks, setting up beds, moving beds in and out of areas, and this
was all work that nurses completed, but Stephanie is now completing that work and is hired by
the hospital in making — I think now she is making over $10 an hour. She has been employed now for over four years,
and her department was her work and she was working there as well. What we found through this, and this was a
randomized controlled trial were we had in equal control — our control group members
dropped at a higher rate than our treatment group members so there were some differences
however our statistical program adjusted for that. What we found was that at baseline, no one
was employed. They were still at — in high school. At graduation, 74% of the youth in the treatment
group were employed and 90% three months after high school, 87% maintained employment at
12 months after high school. Compare that to the control group where employment
outcomes were at 6% at graduation and Fremont Pass high school and only 12% at 12 months
past high school. The idea that these youth have this experience
prior to graduating is very important. These internships not only demonstrates that
the youth has the ability to work, but in some ways we bypass some of the aspects of
job findings that are very typical. For example, someone like Stephanie would
have extreme difficulty in a [ Inaudible ] situation where she did not know the individuals who
were talking to her and they did not know her. They might ask her a question like, where
have you worked before and she would answer with — worked hard, yes. That is the kind of answer she would give. In an interview you really were not see what
Stephanie is capable of doing, but it is only when you see her work for a little while and
that she develops a resume with a number of different internships on them that you see
that she really is very valuable to an employment organization. There is something surprising that we found
about our control group. Again, our treatment group is — our control
group is the dark blue line with the squares. We measured the entity of support that the
students required to complete everyday tasks. What we found is that our treatment group
started in a similar place as our control group. There is no statistical difference between
their support needs starting out. In fact our treatment group was slightly — requires
more support behaviorally and medically. Yet by the end of 12 months after graduation,
we see that our treatment group support needs continue to decrease and it is trending downward
for as our control group support needs remain fairly similar with a slight trend upward. This finding is the first suggestion that
it is possible that work could actually be therapeutic for youth with autism. This I think is a very important finding out
of the study and we are continuing to look at the question. Is work itself a therapeutic intervention
for Young adults with ASD?>>The next area I want to talk about in terms
of a pathway to employment is supported employment. Supported employment is a structured way that
we work with individuals to assist them in finding employment. In addition to our projects SEARCH work we
have done research with our employment agency . Here at VCU we have a mentorship the provides
rehabilitative services to individuals with autism. We use supported employment in a structured
way and major way to assist youth with ASD in acquiring employment.>>I have another video for you to see in
this time — a young woman who is very interesting and delightful.>>Ellen was in project SEARCH in 2010 and
2011 and she has been employed as a nurse hospital since the summer of 2011.>>When Ellen was in project SEARCH her internships
with employee wellness, the foundation and with diabetes treatment center. Each of the jobs that highlighted her skills
were clerical type tasks that we were to the hospital to find offices where we were able
to do paperwork and data entry.>>Scan all the documents of what we have
done for two months.>>Ellen showed us she really excelled in
these areas. She does very well when she has a structured
routine and when she is working independently and when she is in a quiet space. Ellen has a tendency to talk to herself while
she is working and throughout her day she does a lot of scripting and her voice can
increase in volume so it is better for her and for others for her to be in a more quiet
environment.>>The job that Ellen has now is with employee
wellness and she strides in this job because it is structured and routine she comes in
each morning and her job is to do scanning. It may seem Monday but it is an important
job for the hospital and it provides her with comfort to work through her routine. There were times when asked her to do things
that were not a part of her routine and the unexpected change can be really challenging
for her.>>When at work which was to be his?>>>>Ellen has an iPod with her every day
at work. She keeps it on her desk. One of the things is the background of her
screen is what we call the incredible five-point scale, and one of her challenges is keeping
her voice volume appropriate for the workplace services and there’s a reminder to her of
where her boy should be while it worked.>>Now talking. Quiet.>>It also comes into play when we are providing
her with instruction, because opposed to telling her you are being too loud, we ask her and
so question like what color should we be at or where are we depending on what the situation
is, her employer is also aware of this and would give her the same cues.>>Yes, it is okay now.>>It seems that so much of what is going
on in the day is providing employers and coworkers with really simple instruction to educate
them on the best ways to work with a specific person with autism.>>Yet again, Ellen provides a really good
example of someone who continues to require intervention through supported employment. In fact she began to see a little bit of an
incident that could have turned into a bit of a louder tantrum with Ellen. She was wearing a microphone which was a change
in her routine and it was difficult for her to tolerate that so she negotiated it would
not be five more minutes, but three more minutes and shortly after that she was able to take
the microphone off. We’re working with individuals through supported
employment we fill out a job seeker profile and with Ellen we knew we had to match her
to a quiet environment. The more noise present in the environment
that were she would escalate. We also identified several strengths for her
within the area of paperwork and in the area of data entry and general office skill. We then developed a number of different opportunities,
not only for her to shadow and tour, but for her to also demonstrate some of her skills
by working in the and firemen. We worked on interviews, and interviews with
Ellen were kind of interesting yet again. She does have — she struggled a little bit
with the interview process, but we were able to also demonstrate the work she had done
her internships and that helped as well.>>On the site job-training and for individuals
with ASD we start at a very high 100% of the time on-the-job support and we remain there
until the person has mastered the skills necessary for them to be successful at that job, but
we also maintain long-term support. The long-term support allow us to go back
in, and for someone like Ellen we absolutely do have to go back in, especially if there
are going to be changes in her job, if the people with whom she works regularly change,
or even when there’s for example she works in an area of the hospital where there is
a suite of offices, and they were having construction and redoing some offices and we found it necessary
to go back in and provide increased support during that time. One of the advantages of supported employment
as you can go back in and provide more intensive intervention and then stayed out again. This is another example of a gun man who received
supported employment, and he is now a part-time spot assistant where he is working in an area
where he is doing a lot of sorting, washing, and drying laundry, folding laundry [ Inaudible
] and he works on a dishwasher. He has been employed for over a year and he
perceives long-term support plus on-the-job support. That is another aspect that is really important
in that is that we work with coworkers and supervisors to be able to provide support
on the job as well.>>It is interesting to note that while our
youth with ASD require quite a bit of support with employment they are also very successful
when the employer begins to implement the support. In fact, employers have reported to us that
they begin to use some of those same techniques with other employees. It turns out that the support we use for folks
with autism are good for more than just people with autism. We find that the job coaches we work with
to require special information to support individuals with autism. I think this is an important aspect of the
research we are completing. Specifically that we need our job coaches
to understand ASD understand that when she is becoming frustrating and getting louder
there is an underlying problem that exists and we have to find out what that is. In the video clip you saw, you saw that Ellen
began to get loud about having to wear the microphone and understanding that when she
says I want to wear it for five more minutes, she doesn’t mean she wants to wear for five
more minutes, that is actually part of the negotiation. We need people to understand autism and the
communication and the social skills and difficulties that exist with the disorder. We also need our job coaches understand a
list of evidence-based practices, that includes receiving behavioral support and behavioral
consultation on a regular basis. A lot of our youth have difficult behaviors
or behaviors may come up in unexpected or unusual situations. We need our job coaches to know when to reach
out before things — we want our job coaches understand how to use reinforcements, how
to take data and — and we really wanted to understand functions
of behavior because we do not want them to assume that — displaying behavior that is
problematic to them and we need our job coaches to understand the status and aspect of work
that I think those of us who have worked in schools — we need that building — we need
that to build trust with the job coach. We need the business, employees, employers
and coworkers — when they call a job coach because they are struggling with an individual
at work they are not going to see the individual in trouble, but instead they are going to
get assistance and the employee, the person — we need the job coach —
around autism and autism specific to the individual they are supporting. — Lease and
flexible about how people work Ashwini to make sure we have the right match when finding
a place for individuals with autism. If I can say one thing about helping individuals
with autism gain employment is that we want to match the person to the right set of skills
and the right social environment that will make the best match for individuals with autism. I have a short video clip we found that many
of our youth transition into adulthood and gaining employment to best with a modified
job description. So much of what we do in this world is social
and that includes a social component so we find it necessary to build jobs that have
less social interaction associated with them. That is how we customize employment to meet
the needs of the individual. For this example, I am going to show you a
little bit about Damien who today it happens to be Damien’s birthday so it is a good day
to tell Damien’s story.>>[ Indiscernible – low volume ]>>Damien
had an internship in the inpatient pharmacy. He was responsible for checking all of the
drugs that are individually packed and checking the expiration dates. He also was responsible for cleaning shelves
and keeping it organized in the department. This is something that they often needed a
tech to do, but it was not getting done as frequently as it probably should have been.>>[ Indiscernible – low volume ]>>This
turned into a job, because as the internship was coming to a close, the department was
willing to see how they could continue without having him there to complete this job for
them because it really is critical. As the job involved in addition to checking
expiration dates, Damien also learned how to read doctrine and learn how to make deliveries
to the outpatient infusion center. This came about because Damien was getting
done with his work quickly and he have a lot of energy and that energy was being released
in the department which was causing a distraction to his coworkers. He has a tendency to — he was actually getting
on coworkers computers and finding things to fill his own time with which were not productive
and distracting to the department. His supervisors wanted to continue have him
working there so they contacted us to see what we could do to continue to use his assets
but also help out the department. That is how the deliveries started. The outpatient infusion center is attached
to the hospital and this is where patients are going to receive chemotherapy and other
cancer treatments.>>[ Indiscernible – low volume ]>>By the
door?>>[ Indiscernible – low volume ]>>It is
okay to speak in a regular volume we just cannot shout. Does that make sense?>>No. Not make sense.>>When we are at work.>>I keep the volume down. I keep the voice down.>>And your body?>>Keep my body still. I not by the door.>>[ Indiscernible – low volume ]>>At the
time, a volunteer was responsible for making the deliveries to the outpatient infusion
center from the pharmacy or if the volunteer was not there, went of the pharmacists or
text had to do it. It was not done on a certain schedule in patients
were having to wait several hours to get the treatment. The inpatient pharmacy and outpatient infusion
center decided to collaborate and create this job for Damien the that he was helping their
department run more efficiently and to provide better care for the patients waiting for treatment.>>[ Indiscernible – low volume ]>>I work
in the pharmacy. [ Indiscernible – low volume ]>>Damien has
been working for almost 5 years and we do continue to provide him with social support
at work. At this point we are no longer implementing
a monitoring plan and working on it together for my times throughout the day. His apartment has been trained on how to enforce
the rules and Damien is at the point now where he has written his own plan and he knows what
the expectations are and it is written clearly for him.>>[ Indiscernible – low volume ]>>[ Captioners
transitioning ]>>Additional support than they always call us and
we come and provided immediate assistance.>>Damien’s story shows customized employments
at its best. He front dates medications in the pharmacy. There is probably 1 million different medications
and that was a really good job for him at first. He keeps really engaged. We found that he was running out of things
to do early on any needed to move a lot more. And we added in the task of delivering the
medications to the chemo and non-chemo unit. Infusion unit. Those tasks were not being done on a regular
basis and patients were having to wait. So consequently that is the true marriage
of a nice customized employment. We have a individual who has specific needs
around a particular kind of job and we have a business with specific needs around that
job being done. Marrying those two together and that’s how
you get a good customized employment situation. And for Damien is really perfect. He gets to move a lot through the hospital. Continue organizing medications and also get
to work in an environment where they absolutely love him. My coworker Jen stopped in my office this
morning and show me a picture of him and the unit was throwing him a birthday party. Because today is his birthday. And they made sure–and he made sure that
they knew today with his birthday. A really good example of how we put together
jobs to meet individual needs and business needs at the same time. So out of all this research we found that
the individuals with autism can work with integrated employment. The majority of the individuals are working
part-time but they are making wages with peers in similar positions and maintaining those
positions long-term. We have seen all of those individuals who
work for a period of time, we have seen the number of hours they work each year in crease
overtime. They get raises, benefits, to the degree that
they are eligible for those benefits. And so we have been able to find on characteristic
places for individuals to work, they are really enriching for them. In this next part, I want to talk a little
bit more about how we do this and that should take a little bit of time and I will be able
to take some questions. We really, mindfully teach work skills that
really have more to do with social behavioral interaction. So, our guys learned the task that they need
to complete very quickly. However, they struggle more with the social
aspect of work. Like, going to lunch and finishing lunch and
getting back to work. Following a task with transitioning between
tasks independently. Interacting with the public and coworkers. Staying on task at work. We also see that they needed a lot of behavioral
skills. All of us need counter frustration at work. So they need to learn how to manage frustration,
how to know what to talk about at work versus what you might talk about at home. How do–what to do during break time. And a number of different ways we describe
professional behavior. The main way we do this is through the electronic
and paper and pencil support. So this is a screenshot of a Opp–iPod or
iPhone schedule to help someone not only address their needs in terms of what they should be
doing it various times. But also how they should be going about it. For example this is double check decision
and check your schedule. That is a way to remind folks what they need
to do. This would be a support we would use for someone. This is a example of the same kind of thing
as paper and pencil. This is a morning routine for somebody who
is struggling with how to start their morning. We also work with folks around appropriate
lunch time choices. Again this is a real problem for a lot of
our youth who are transitioning for high school. A wide array of potential once Tice–lunch
choices. I take a small salad, I have sodas on Fridays
only, because that makes sense and we work with folks how to manage their choices as
it relates to lunch time. We have some folks who do not read. And so we have found a free app called story
kit. This app was developed for parents to develop
stories for their children who don’t read yet. And so the app story kit will read a book
to you and you can input Xers and it. We use that exact tool to develop schedules
for individuals. This is a free tool. It is called story kit. And so you can see this for one of our young
men and it has exactly what he needs to do for stocking linen and when he is stocking
a room. So it will read his schedule to him and he
will follow the schedule and have it read to him and have the pictures of him doing
his schedule displayed at the same time. We also use the work task on the iPod or the
iPhone, we like to use free apps because our folks don’t have a lot of money to buy expensive
apps. This is a example of a picture and word schedule
and then we have just picture schedule themselves. We find that a lot of our folks need to understand
how to make decisions at work and we try to make those from the complex to easy. This is a very complex decision-making tool
that we use for someone who is learning to file. So there are a number of decision points along
the way. This is more simple for someone whose task
was to clean the lactation room. With a young man, he had to learn that if
the Doyle–door was closed that he could not go in and if it was open he could go in. It was very difficult for him. He really needed a lot of support to understand
that it was okay to move on and come back later. This is a interesting way that we build the
schedule for someone had task that they need to do once a day. Task that they need to do once in the morning
and tasks that they do in the morning and the afternoon. So we color-coded the task and they could
be done in any order. And so as he was working through the day and
he came across a blue tab and it was checked out, that meant that he didn’t have to do
it again. If the came across a red tab it needed to
tap onto checks. And that green checks were as often as they
needed to be done. So as he moved through the day if he came
through a red tab and it was already checked off, he did not need to do it again. It is a way to help him organize. In a job he can do any of those tasks a those
points. We have another, this was a way that we helped
an employer give instruction to a young man who had difficulty receiving verbal instruction
and keeping track of it and also becoming a little oppositional when he was presented
with a new task. So we created a list of various aspects of
his work that he might be asked to do and that he could keep track of completing those
tests. I’m going to skip through some of these because
I want to get to some of your questions. So again, we go and do a lot of self monitoring. This is how we do role-play and we practice
social skills. These are the steps to following instructions
and we actually follow those and practice them with individuals to help them understand
the expectations of their employer. You have seen the incredible five-point scale. We use this for how to calm yourself down
and what to do if you are frustrated, there are a number of individualized plan that we
build. What is work appropriate hygiene is a struggle
so we work with that. A man who had a flood of anxiety and we had
him write them down and erase them and say goodbye worries. For another WebCam. For right now I want to stop and
find out what questions you might have.

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