Association for Behavior Analysis International

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31st Annual Convention; Chicago, IL; 2005

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Symposium #301
Perfecting the “Two-Step”: Supporting Staff in Providing Quality Lifestyles for Persons with Severe Disabilities
Monday, May 30, 2005
9:00 AM–10:20 AM
Stevens 2 (Lower Level)
Area: DDA; Domain: Service Delivery
Chair: Jamie D. Price (Community Living Opportunities, Inc.)
Discussant: Michael C. Strouse (Community Living Opportunities, Inc.)
CE Instructor: Diane Bannerman Juracek, Ph.D.
Abstract: In the context of his chapter entitled “Get a Life” (Koegel, Koegel & Dunlap, 1996), Todd Risley discussed the importance of “durable dance partners” for people with developmental disabilities. “Durable dance partners” are long-term, reliable support providers who build positive relationships, provide consistent treatment, and facilitate a high quality of life for those they support. This symposium describes three studies that show how these partnerships can be facilitated to produce positive outcomes for persons served. The first presentation examines how the satisfaction of people with severe disabilities can be assessed and how positive outcomes can be produced by increasing the satisfaction of live-in care providers through the use of a family “Quality of Life Plan”. The second presentation compares teacher interactions, person served rates of engagement, problem behavior, and preferred activities across two different models of day services. Finally, the third presentation focuses on the challenge of supporting staff implementation of a rigorous behavior support plan to address extreme self-injury and parasuicidal behavior.
 
Joy of the “Dance”: Increasing Quality of Life for People with Disabilities and Their Support Providers
DIANE BANNERMAN JURACEK (Community Living Opportunities, Inc.), Holly M. Sweeney (Community Living Opportunities, Inc.), Jamie D. Price (Community Living Opportunities, Inc.), Christina M. Holt (Community Living Opportunities, Inc.), Tammy Rystrom (Community Living Opportunities, Inc.), Michael C. Strouse (Community Living Opportunities, Inc.), Jan B. Sheldon (University of Kansas), James A. Sherman (University of Kansas)
Abstract: Service providers are continually challenged to offer high quality community residential services for people with severe and multiple developmental disabilities. Low pay, lackluster staff satisfaction, and high turnover hinder efforts to provide consistent treatment and build long-term relationships between staff and persons served. In this study, low levels of live-in staff satisfaction (averaging 3.7 on a 1-5 scale where 1 is not at all satisfied and 5 is very satisfied) led to the development and implementation of a “Quality of Life Plan” (QLP) for live-in couples. Satisfaction ratings and other outcomes, (e.g., engagement in high priority family activities) were measured to assess the effects of the QLP. Additionally, a Quality of life satisfaction survey was used to assess person served satisfaction and other outcomes, such as the number of visits to a favorite community venue.
 
Dosie-Doe All Day: Comparing Staff and Person-served Outcomes Across Two-Day Service Models
JAMES PARA-CREMER (Community Living Opportunities, Inc.), Diane Bannerman Juracek (Community Living Opportunities, Inc.), Mahin L. Para-Cremer (Community Living Opportunities, Inc.), Holly M. Sweeney (Community Living Opportunities, Inc.), Michael C. Strouse (Community Living Opportunities, Inc.), James A. Sherman (University of Kansas), Jan B. Sheldon (University of Kansas)
Abstract: Provision of day services that are engaging and preferred by persons with severe developmental disabilities is a challenge. This study compares teacher interactions and consumer rates of engagement, problem behavior, and preferred activities across two different models of day service. The first model is a center-based model where vocational, leisure, and learning activities are based in a large building with large groups of consumers. The second model provides similar valued day activities with a smaller group of consumers in a smaller community-based setting. Both models include individualized daily schedules and community outings. A consultation process (Harchik, Sherman, Sheldon, & Strouse, 1992), including an inservice, coaching in the natural setting, and a lottery reward system were used to teach staff to actively engage consumers in their scheduled activities. Pilot data show that the consultation process paired with a lottery incentive system resulted in an increase in the average number of correctly completed steps from 60% to 97%. Additional data, including teacher and consumer satisfaction ratings will be presented.
 
Supporting Staff in the Treatment of Severe Self Injurious/Parasuicidal Behavior: Behavioral and PRN Medication Interventions
CHRISTINE M. MAGEE (The May Institute), James M. Sperry (The May Institute)
Abstract: The following is a data-based case study in the treatment of serious self-injurious/parasuicidal behavior using psychiatric hospitalizations as a measure. The participant is a 38 year old male with a diagnosis of Mild Mental Retardation, Depression with Psychotic Features, and Borderline Personality Disorder. The participant has a long history of self-injury/parasuicdal behavior resulting in the need for medical attention and psychiatric hospitalization. The behavior was effectively managed in a more restrictive residential setting for a number of years with no hospitalizations. The participant’s stability was jeopardized upon moving to a less restrictive setting and the need for psychiatric hospitalization reoccurred. Efforts to return the participant to the more restrictive setting proved ineffective and after a life threatening episode of the behavior the use of PRN medication became necessary to assure the participant’s safety in the residential setting. In addition, staff required specialized support to provide this individualized community based programming. Ongoing staff performance as well as access to the PRN medication are closely monitored and has resulted in a decrease in the frequency of severe self-injurious/parasuicidal behavior and psychiatric hospitalization.
 

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