Web Posted on: November 23, 1998

Implementing AT in a community-based adult development center

In January 1998, the Madge Gunn Training Initiative was implemented through private funding received by United Cerebral Palsy Associations, Inc. (UCPA). The purpose of this Training Initiative is to enhance and improve the knowledge and awareness of direct care staff working with adults with developmental disabilities. These staff were identified from day and residential program settings. The impact of this project will ultimately result in improved service delivery that will serve to empower consumers and improve the independence and quality of life of individuals with disabilities residing in these institutional settings.

For the purposes of this training and technical assistance, facility was identified in both Los Angeles, CA, and Miami, Fl. In total these two facilities serve in excess of 100 adults in varied day and residential programs. As well, through collaborative programs supported by each of these facilities, another 150 adults with disabilities are impacted. For the purposes of a mulidisciplinary approach, the following priorities were identified for training and technical assistance for direct care staff working with these adults:

• Augmentative and Alternative Communication (AAC)
• Computer Access
• Recreation and leisure activities
• Seating and Positioning
• Activities of Daily Living (ADL's)

For the purposes of this initiative it was noted that given this population of individuals with multiple disabilities, including cerebral palsy, significant and varied problems exist within each location. In addition to physical and cognitive limitations, the individuals residing in these facilities present with a significantly higher incidence of sensory impairment (i.e. visual, auditory, dual sensory) than their peers who are not physically and cognitively limited.

The literature supports that upwards to 80% of these individuals may experience visual impairments, while approximately 35% may present with hearing impairments1. The integration of AT into these environments is a readily achievable solution directed to increasing empowerment and improving quality of life issues for adults. Given this background, coupled with the complexion of this population, staff of these facilities are routinely supported in making efforts to augment and facilitate communication, motor skills and cognitive development.

The Goals and Mission of this project are to:

• Facilitate Team Building within each facility to improve program designs that enhance quality of life issues for all individuals within the facility;
• Establish Goals and Objectives that serve to increase personal empowerment of all individuals residing within the facility;
• Design Action Plans to promote a systematic process to identify technology and non-technology related solutions for enhancing social interactions and other quality of life issues for all individuals within the facility;
• Provide Inservice training to direct care and other facility staff;
• Provide Individual Consultation regarding specific problematic cases within each facility;
• Develop products for dissemination that will provide for duplication of these efforts within specified states,
• and throughout the nation. These products may include, but are not be limited to a Curriculum Guide and/or Videotapes (Before and After).

Since January, 1998, each facility has been provided a multidisciplinary consultation team for the purposes of increasing personal empowerment and enhancing the quality of life for the individual residing within that location. These teams are available for consultation to each facility, throughout an 18 month period. Each team is comprised of adults with developmental disabilities, direct care staff from day and residential programs, and professionals from the disciplines of Occupational Therapy, Physical Therapy, Rehabilitation Engineering, and/or Speech/Language Pathology. These teams work together within each facility to address personal empowerment and quality of life issues within one or more of the following topics areas:

• Seating and mobility
• Augmentative and Alternative Communication (AAC)
• Education, cognition and recreation/leisure
• Activities of Daily Living (ADL's)
• Technology-related assistance

In addition to the team identified above, training and technical assistance is also provided to parents, family members, caregivers, Advisory Board members, volunteer coordinators, program director, and nursing staff. The benefit to "blending" these teams will be to provide a picture from within, as well as from outside of the facility.

This amalgamation provides for a set of strategies and techniques that are proven best practices, and adjusted to the needs of the specific facility. These needs are based on specific individual needs for solutions to enhance personal empowerment and improve the quality of life for individuals within each facility.

This session will provide results and outcomes of the Madge Gunn Training Initiative. Over this 1 hour sessions, participants will become familiar with:

• training and technical support strategies to support direct care staff in the implementation of AT to increase the independence and quality of life of residents of a community-based adult development center.
• AT devices and strategies that increase the independence and quality of life of adults with developmental disabilities living in a community-based center. The AT devices that will be considered are those for seating, augmentative communication, as well as recreation and leisure.

It is widely known that many individuals with developmental disabilities are, and will continue to living in residential group homes. These individuals are primarily cared for by direct care staff who have very limited, if any, experience with assistive technology. Their primary role is to take care of a person's daily physical needs. They are typically paid a little more than minimum wage. This course will present tools and strategies to inspire and support direct care providers in the implementation of assistive technology for seating, augmentative communication, and recreation and leisure. By supporting the implementation of assistive technology, residents experience improved independence and quality of life.

This course is designed to provide administrators and professional support staff with strategies to include training and technical support for the implementation of assistive technology in their inservice or educational programs for direct care staff. Another goal is to demonstrate that by providing sufficient training and technical support to implement AT to direct care staff, the independence and quality of life for the residents will increase.

The content of this course will emphasize the consumer within this process. Those adults with developmental disabilities residing in community-based settings are often lacking in services from direct care staff with sufficient awareness and basic knowledge about AT. Strategies for increasing this knowledge and awareness in a practical format will be presented.

An overview and results/outcomes of the Madge Gunn Training Initiative will be provided. Various technologies to address seating and positioning, augmentative and alternative communication (AAC), environmental control, and control interfaces as they relate to recreation and leisure will also be addressed. Specifically, the role of the direct care staff and strategies to train and inspire direct care providers to support the implementation and follow-up of AT will be highlighted.

This course will include information about appropriate assistive technology and strategies for adults with developmental disabilities that were identified throughout the Madge Gunn Training Initiative, an 18 month collaborative research and development project. Tools and strategies for positioning, seating, control interface access, augmentative communication, recreation and leisure will be addressed.

Both dedicated and computer based solutions will be presented. As well, actual case studies will be presented and supported by video. A curriculum for use in the replication of this program for community based day and residential facilities serving adults with developmental disabilities will be presented and discussed.

Strategies to support the implementation of assistive technology will include team building in a facility to improve the program design and the development of action plans to promote a systematic process to identify solutions for enhancing social interactions and other quality of life issues for individuals within the facility.

Throughout this project, team members have been developing curriculum materials for use during inservice training, and videotaping within each facility. These materials will be made available during this session. As well, handouts will include a course outline, equipment list, and sample training outlines.

References:

1 Sobsey, D. & Wolf-Schein, E.G. (1991). Sensory Impairments. In F.P. Orelove & D. Sobsey (Eds.) Educating children with multiple disabilities: A transdisciplinary approach. (2nd Ed.) (pp. 199-254). Baltimore: Paul H. Brookes.