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Living the Good Life: Adult Community Living in the Family Teaching Model

Living the Good Life: Adult Community Living in the Family Teaching Model. Diane Bannerman Juracek, Ph.D., BCBA Community Living Opportunities, Inc.

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Living the Good Life: Adult Community Living in the Family Teaching Model

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  1. Living the Good Life: Adult Community Living in the Family Teaching Model Diane Bannerman Juracek, Ph.D., BCBA Community Living Opportunities, Inc.

  2. CLO’s mission is to help adults and children with severe developmental disabilities achieve personally satisfying and fulfilling lifestyles in their own communities.

  3. CLO’s Services • Residential Options • Day Classes • Supported Employment • Health Care Services: Clinics in Lenexa and Lawrence • Applied Behavior Analysis Consultation • Positive Behavior Supports • Children’s Services • Training, Evaluation and Certification • Outreach Services • Remote Monitoring • Midnight Farm

  4. Midnight Farm 6 miles south of Eudora • 2 Extended Family Teaching Homes (Each housing a family and 1 or 2 people with developmental disabilities) • Multipurpose facility: with meeting lodge, bunkhouse, equestrian facility/arena, barn, staff for horses and other animals • Summer Day Camps for children with autism: 6-18 • Equestrian program

  5. In 2008, CLO serves approximately 465 adults & children 269 Adults with developmental disabilities (DD) • 196 Adults with DD in residential services • 73 Adults with DD in only day services and/or Targeted Case Management 105 children with autism or other developmental disabilities in Children’s Services 82 children served in our Montessori Preschool 9 at-risk families in Family and Youth Intervention program

  6. Building the “Good Life”

  7. Individualized Living Group Home Residential Service Models at Community Living Opportunities, Inc. • 8 housemates • Awake shift staff 24 hours a day • Funded by Medicaid as a Private Intermediate Care Facilities for Adults with Mental Retardation (ICF/MR) • 3 housemates • Living in an apartment or home • Awake shift staff 24 hours a day • Funded by Medicaid Home & Community Based Services (HCBS) waivers for persons diagnosed with Developmental disabilities

  8. This just isn’t working!

  9. Family Teaching Residential Service Models at Community Living Opportunities, Inc. • 3 or 4 housemates • A family teaching couple provides most of the support, lives next door and manages the home • Lives with a teacher without disabilities or a teaching family in the same home Both programs funded through Medicaid’s Home and Community-based Waiver for people with DD Extended Family Teaching

  10. Number of People Across CLO Residential Models 2008

  11. Family Teaching Model* Components*An adaptation of the Teaching Family Model (Phillips, Phillips, Fixsen, & Wolf, 1974) • Family Teachers in family style living environments • Individualized daily schedules • Teaching new skills • Systems for encouraging achievement • Positive relationships • Opportunities for choice and self determination • Ongoing teacher training and consultation • Teacher evaluation and certification

  12. Tom's Choice Kevin’s choice Library Library Library Library Work @ Recycling Center Work @ Recycling Center While John(family teacher)goes to gym Ed's Choice Swimming Swimming Swimming

  13. Reinforcing Desirable Behavior* • Initiate Positively • a. Use Active Listening Skills (e.g., eye contact, responsive facial expression & voice tone, active listening posture, gestures, verbal and non-verbal encouragement, and reflection) • b. Expression of Affection • (e.g., smile, greeting, joke, physical contact) • 2. Praise and Positive Consequence • (descriptive, immediate) • *Some steps may be deleted or shortened depending on the needs and learning style of the individual.

  14. Teaching a New Skill* 1.Initiate positively a. Use active listening skills (eye contact, responsive facial expression and voice tone, body posture, and gestures). b. Elicit person’s involvement throughout the interaction c. Expression of affection (e.g., smile, greeting, joke, physical contact) 2. Name appropriate behavior 3.Rationale(e.g., positive consequence of engaging in the appropriate behavior) Ask or give 4. Demonstrate the steps 5.Practice(Use prompts with fading, if necessary) 6.Feedback a. Reinforce: descriptive praise, optional positive consequence b. corrective feedback if needed 7.Practice 8.Feedback a. descriptive praise, optional positive consequence b. corrective feedback if needed 9.Planwhen to use the behavior *Some steps may be deleted or shortened depending on the needs and learning style of the individual.

  15. The Community Living Research and Development Projectat theUniversity of KansasFamilyTeacher Certification ProgramProviding Certification of Family Teachers employed byCommunity Living Opportunities, Inc.who exhibit exemplary teaching and implement Community Living Opportunities' Family Teaching Model for Adults with Developmental Disabilities

  16. Community Living Opportunities Expected Outcomes for Persons ServedPleasant and Safe SurroundingsObservance of Legal and Personal RightsPositive Relationships with OthersLiving Healthy LifestylesOpportunities for Choice and ControlEffective Learning Opportunities High Level of Participation in Daily ExperiencesCommunity InvolvementEffective CommunicationPleasant Social EnvironmentSatisfied Consumers

  17. Family Teaching Model Certification • FTM Pre-service Workshop • Shadow Training • Program Specific Orientation • 12 Coaching Lessons • 90 Day Evaluation • More Coaching Lessons based on Outcome QEs • Family Teaching Model Workshop • Pre-evaluation meeting for First Private • 6 mos. after hire: First Private Evaluation • Quality at a Glance Evals • Pre-evaluation meeting for Certification Evaluation • 12 mos. After hire: Certification Evaluation Certification Celebration and $$

  18. Benefits of theFamily Teaching Model&Extended Family Teaching Model

  19. Community Living Opportunities Expected Outcomes for Persons ServedPleasant and Safe SurroundingsObservance of Legal and Personal RightsPositive Relationships with OthersLiving Healthy LifestylesOpportunities for Choice and ControlEffective Learning Opportunities High Level of Participation in Daily ExperiencesCommunity InvolvementEffective CommunicationPleasant Social EnvironmentSatisfied Consumers

  20. CLO Average Number of People Per Home Across years Number

  21. Percent Staff Turnover Across Direct Support Positions CLO - 2008 Percent

  22. Average Parent Guardian Satisfaction with CLO Community Living Models April and October 2008 Sent 464 Received 176 (38%) Number of Persons Served 196 Rating Scale 6=Very Satisfied 5=Satisfied 4=Slightly Satisfied 3=Slightly Dissatisfied 2=Dissatisfied 1=Very Dissatisfied

  23. Average Teacher SatisfactionCLO - 2008 RatingScale 6=Very Satisfied 5=Satisfied 4=Slightly Satisfied 3=Slightly Dissatisfied 2=Dissatisfied 1=Very Dissatisfied

  24. Average Number of Persons-served per Teacher Across Residential ModelsCLO - 2008 Number

  25. Average Number of People Per Home Across years Number

  26. Living the Good Life:A Retrospective Analysis of challenging Behaviors and Health Indicators for Individuals Across Residential Models James Sherman and Jan Sheldon (University of Kansas) Michael Strouse, JAMIE PRICE, DIANE BANNERMAN JURACEK, and HOLLY M. SWEENEY (Community Living Opportunities, Inc.)

  27. Case Study – Brad Description Brad is a 43 year old man with Autism and visual impairments. He loves going to musicals, playing Uno, spending holidays and special occasions with his family. He is described as being a good friend and brother, routine oriented, having a good sense of humor and an excellent memory. Residential Living History 1991 – Group Home 1996 – Family Teaching Home 2003 – Extended Family Teaching Home with a family.

  28. Extended Family Family Teaching Group Home Brad Screaming and Biting Others

  29. Case Study – Troy Description Troy is a 23 year old male with Autism. He is described as being very affectionate, honest, having a good work ethic, a quick learner and having a great sense of humor. Residential Living History 2001 – Family Teaching Home 2003 – Extended Family Teaching Home with a family.

  30. Extended Family Family Teaching TroyCrying, Swearing, Yelling and Physical Aggression

  31. Family Teaching Extended Family Individualized Living BobPhysical Aggression FTM ILP EFT

  32. Family Teaching Extended Family Individualized Living BobVerbal Aggression FTM ILP EFT

  33. BobPsychotropic Medication

  34. BobSeizures and Anticonvulsant Medication

  35. Factors Influencing “Living the Good Life” • Fewer number of individuals living in a home • Durable Dance Partners (shift staffing vs. families providing care) • Implementation of Family Teaching Model Components • Family Teachers in family style living environments • Individualized daily schedules • Teaching new skills • Systems for encouraging achievement • Positive relationships • Opportunities for choice and self determination • Ongoing teacher training and consultation • Teacher evaluation and certification

  36. Thank you for your time and interest. Please feel free to contact me for further information: Diane Bannerman Juracek, Ph.D. dianebannermanjuracek@clokansas.org

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