Diane Bannerman Juracek, Ph.D., BCBA Community Living Opportunities, Inc.
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Transcript of Diane Bannerman Juracek, Ph.D., BCBA Community Living Opportunities, Inc.
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The Family Teaching Model: The Family Teaching Model: A Kansas Residential Model for Adults with A Kansas Residential Model for Adults with Intellectual Developmental Disabilities that Intellectual Developmental Disabilities that offers Eleven Desired Lifestyle Outcomesoffers Eleven Desired Lifestyle Outcomes
Diane Bannerman Juracek, Ph.D., BCBADiane Bannerman Juracek, Ph.D., BCBA
Community Living Opportunities, Inc.Community Living Opportunities, Inc.
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CLO’s mission is to help adults and children with severe CLO’s mission is to help adults and children with severe developmental disabilities achieve personally satisfying developmental disabilities achieve personally satisfying
and fulfilling lifestyles in their own communities.and fulfilling lifestyles in their own communities.
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CLO’s ServicesCLO’s Services Residential Options Residential Options Day Classes Day Classes Supported EmploymentSupported Employment Health Care Services: Clinics in Lenexa and Health Care Services: Clinics in Lenexa and
LawrenceLawrence Applied Behavior Analysis ConsultationApplied Behavior Analysis Consultation Positive Behavior SupportsPositive Behavior Supports Children’s Services Children’s Services Training, Evaluation and CertificationTraining, Evaluation and Certification Outreach ServicesOutreach Services Remote MonitoringRemote Monitoring Midnight FarmMidnight Farm
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CLO 2012 DemographicsCLO 2012 Demographics 81 homes81 homes 214 individuals with intellectual developmental disabilities214 individuals with intellectual developmental disabilities ““Extremely satisfied” or “Satisfied” ratings from 91% of Extremely satisfied” or “Satisfied” ratings from 91% of
parents/guardians of those we serveparents/guardians of those we serve 230 adults served in day services in Douglas, Allen, and 230 adults served in day services in Douglas, Allen, and
Johnson CountiesJohnson Counties Virtual village opens, providing “Homelink” support to Virtual village opens, providing “Homelink” support to
promote independencepromote independence 115 individuals served in CLO wellness clinics and 115 individuals served in CLO wellness clinics and
occupational/physical therapy servicesoccupational/physical therapy services 330 children served in Children’s Network330 children served in Children’s Network
Early intensive behavioral interventionEarly intensive behavioral intervention Family and youth intervention Family and youth intervention Johnson County Montessori PreschoolJohnson County Montessori Preschool Northstar AcademyNorthstar Academy
Midnight FarmMidnight Farm 120 special-needs kids and adults in therapeutic riding120 special-needs kids and adults in therapeutic riding 40 special-needs kids in summer camps40 special-needs kids in summer camps 750 individuals from community on tours, field trips & special events750 individuals from community on tours, field trips & special events
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Building the “Good Life”Building the “Good Life”
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Timeline of HistoryTimeline of HistoryThe Teaching Family ModelThe Teaching Family Model
Teaching Family Model
1967 Lonnie and Elaine
Phillips/ Mont Wolf
1970 1st dissemination attempt – not successful
Consumer feedback important
1975 Boys Town
1977 Concerned Care
Jim Sherman and Jan Sheldon
1st adaptation for DD population
1981 DSNWK
1983 CLO
2001Tennesee Family Solutions
2004 California Community
Opportunities
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Residential Service Models Residential Service Models at Community Living at Community Living Opportunities, Inc.Opportunities, Inc.
8 housemates 8 housemates Awake shift staff 24 hours a dayAwake shift staff 24 hours a day Funded by Medicaid as a Private Intermediate Care
Facilities for Adults with Mental Retardation (ICF/MR)
3 housemates3 housemates Living in an apartment or homeLiving in an apartment or home Awake shift staff 24 hours a dayAwake shift staff 24 hours a day Funded by Medicaid Home & Community Based Services
(HCBS) waivers for persons diagnosed with Developmental disabilities
Group Home
Individualized
Living
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Residential Service Models Residential Service Models at Community Living at Community Living Opportunities, Inc.Opportunities, Inc.
3 or 4 housemates 3 or 4 housemates A family teaching couple provides A family teaching couple provides most of the support, lives next most of the support, lives next door and manages the homedoor and manages the home
Lives with a teacher without Lives with a teacher without disabilities or a teaching family in disabilities or a teaching family in the same homethe same home
Both programs funded through Medicaid’s Home and Both programs funded through Medicaid’s Home and Community-based Waiver for people with DDCommunity-based Waiver for people with DD
Family Teaching
Extended Family
Teaching
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Family Teaching Model* Family Teaching Model* ComponentsComponents
*An adaptation of the Teaching Family Model *An adaptation of the Teaching Family Model (Phillips, Phillips, Fixsen, & Wolf, 1974)(Phillips, Phillips, Fixsen, & Wolf, 1974)
Family Teachers in family style living Family Teachers in family style living environmentsenvironments
Individualized daily schedulesIndividualized daily schedules Teaching new skillsTeaching new skills Systems for encouraging achievementSystems for encouraging achievement Positive relationshipsPositive relationships Opportunities for choice and self determinationOpportunities for choice and self determination Ongoing teacher training and consultationOngoing teacher training and consultation Teacher evaluation and certificationTeacher evaluation and certification
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Family Teachers in a Family Teachers in a Family Style EnvironmentFamily Style Environment
Family Teaching Model Component # 1 . . .
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What better model to accomplish this than the Family Teaching Model?!
Family Teachers in a Family Style Environment
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Individualized Daily Individualized Daily SchedulesSchedules
Family Teaching Model Component # 2 . . .
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Library
Tom's Choice
Work @ Recycling Center
Library
Ed's Choice
Swimming Swimming Swimming
Work @ Recycling Center
ThurThurss EdEd Kevin Kevin TomTom
7:00 7:00 AMAM
AM Routine*AM Routine* AM Routine *(bath routine)AM Routine *(bath routine)Sally Sally (Family Teacher)(Family Teacher) goes goes
joggingjoggingAM Routine*AM Routine*7:30 7:30
AMAM
8:00 8:00 AMAM MedsMeds MedsMeds MedsMeds
8:30 8:30 AMAM Wait for City BusWait for City Bus R & R R & R R & R R & R
9:00 9:00 AMAM
10:00 10:00 AMAM
11:00 11:00 AMAM
12:00 12:00 PMPM Lunch (*Lunch routine)Lunch (*Lunch routine) LunchLunch
1:00 1:00 PMPM
2:00 2:00 PMPM
3:00 3:00 PMPM
4:00 4:00 PMPM
4:30 4:30 PMPM MedsMeds Meds/ Dinner Prep Routine*Meds/ Dinner Prep Routine* MedsMeds
5:00 5:00 PMPM Dinner/ ChoresDinner/ Chores Dinner/ ChoresDinner/ Chores Dinner/ ChoresDinner/ Chores
5:30 5:30 PMPM
6:00 6:00 PMPM
6:30 6:30 PMPM
7:00 7:00 PMPM
Sally (family teacher) takes Sally (family teacher) takes Katie (daughter) to Girl Katie (daughter) to Girl
Scouts Scouts Hobby ChoiceHobby Choice Check mail and choice of ActivityCheck mail and choice of Activity
7:30 7:30 PMPM SnackSnack Snack Routine*Snack Routine* SnackSnack
8:00 8:00 PMPM Meds/ PM Routine*Meds/ PM Routine* Meds/ PM Routine*Meds/ PM Routine* Meds/ PM Routine*Meds/ PM Routine*
to recycling centerto recycling center
Walk High School Track*Walk High School Track* Walk at High School Track Walk at High School Track While John (family teacher) goes to gym
LibraryLibraryKevin’s choice
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Teaching New SkillsTeaching New Skills& Quality of Life Planning& Quality of Life Planning
Family Teaching Model Component # 3 . . .
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Continuous Planned and Continuous Planned and Opportunity TeachingOpportunity Teaching
Identification and purposeful teaching of skills:Identification and purposeful teaching of skills: that lead to independence and ability to navigate that lead to independence and ability to navigate
through their day with less or no assistancethrough their day with less or no assistance that help the person served access highly preferred that help the person served access highly preferred
items, activities, experiences. . . items, activities, experiences. . . that limit or eliminate any rights issues (privacy, that limit or eliminate any rights issues (privacy,
need to have someone assist them in making a need to have someone assist them in making a phone call)phone call)
that lead to improved health & safety that lead to improved health & safety Behavioral supportBehavioral support
Eliminates or decreases challenging behavior that Eliminates or decreases challenging behavior that inhibits continued progress towards living a good inhibits continued progress towards living a good quality of lifequality of life
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Reinforcing Desirable Behavior*
1. Initiate Positivelya. 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)
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Teaching a New Skill* 1. Initiate positivelya. Use active listening skills (eye contact, responsive facial expression and voice tone, body posture, and gestures).b. Elicit person’s involvement throughout the interactionc. 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. Plan when to use the behavior *Some steps may be deleted or shortened depending on the needs and learning style of the individual .
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Systems for Systems for Encouraging Encouraging
AchievementAchievement
Family Teaching Model Component # 4 . . .
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FormalFormal
Positive RelationshipsPositive Relationships Motivation Systems – monetary, Motivation Systems – monetary,
points, tangibles, etc. . .points, tangibles, etc. . . Behavioral Contracting Behavioral Contracting Premack Principle – eat dinner to get Premack Principle – eat dinner to get
your dessert. . . your dessert. . . Staff reinforcement and recognition Staff reinforcement and recognition
programsprograms
or Informal
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Positive RelationshipsPositive Relationships
Family Teaching Model Component # 5 . . .
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Opportunities for Choice Opportunities for Choice and Self Determinationand Self Determination
Family Teaching Model Component # 6 . . .
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Making choices freelyMaking choices freely Having control in areas important to Having control in areas important to
youyou Being part of decisions that affect youBeing part of decisions that affect you Knowing how to make a choiceKnowing how to make a choice Feeling free to make a choiceFeeling free to make a choice Having predictable events in your Having predictable events in your
day/weekday/week
What does Self-Determination mean?
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Ongoing Teacher Ongoing Teacher Training and EvaluationTraining and Evaluation
Family Teaching Model Component # 7 . . .
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The Coaching ProcessThe Coaching Process(Sherman J., Harchik A., Strouse, M,)(Sherman J., Harchik A., Strouse, M,)
Mini-Inservice Learn about a topic
Demonstration Someone shows you how
Coaching You practice with shaping
Observation & Feedback Systematic, ongoing formal and informal
Train to Generalization You practice in a natural setting until you master the skill
Reinforce to Maintenance You now use the skill as a matter of course
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Teacher Evaluation & Teacher Evaluation & CertificationCertification
Family Teaching Model Component # 8 . . .
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The Community Living Research and Development Project
at theUniversity of Kansas
Family Teacher Certification Program
Providing 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
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Community Living Opportunities Community Living Opportunities
Expected OutcomesExpected Outcomes for Persons Served for Persons Served
Pleasant and Safe SurroundingsPleasant and Safe SurroundingsObservance of Legal and Personal RightsObservance of Legal and Personal Rights
Positive Relationships with OthersPositive Relationships with OthersLiving Healthy LifestylesLiving Healthy Lifestyles
Opportunities for Choice and ControlOpportunities for Choice and ControlEffective Learning Opportunities Effective Learning Opportunities
High Level of Participation in Daily High Level of Participation in Daily ExperiencesExperiences
Community InvolvementCommunity InvolvementEffective CommunicationEffective Communication
Pleasant Social EnvironmentPleasant Social EnvironmentSatisfied ConsumersSatisfied Consumers
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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 $$
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……but there’s more… our latest but there’s more… our latest community living model…VIRTUAL community living model…VIRTUAL
VILLAGEVILLAGE Fewer staffFewer staff CLO’ Homelink central site monitoring, as needed: audio, video, CLO’ Homelink central site monitoring, as needed: audio, video,
sensors, devices - in every 2-bedroom apartmentsensors, devices - in every 2-bedroom apartment Rigorous teaching and progress assessment on independent living Rigorous teaching and progress assessment on independent living
skillsskills Daily schedules Daily schedules Classes: problemsolving, roommate conference, home safety…. Classes: problemsolving, roommate conference, home safety…. JobsJobs Community Inclusion (3Community Inclusion (3rdrd places) places) Motivation Point economy system (with daily trips to point exchange Motivation Point economy system (with daily trips to point exchange
store)store) Self-government – to minimize staff control/increase control and Self-government – to minimize staff control/increase control and
responsibility for the men and womenresponsibility for the men and women Health ticklersHealth ticklers Learning to take medications independentlyLearning to take medications independently
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Factors Influencing Factors Influencing “Living the Good Life”“Living the Good Life”
Fewer number of individuals living in a home in the Fewer number of individuals living in a home in the communitycommunity
Either “Family teachers” providing support or “teaching Either “Family teachers” providing support or “teaching staff” as opposed to shift-staffstaff” as opposed to shift-staff
Implementation of Family Teaching Model ComponentsImplementation of Family Teaching Model Components family style or roommate living environmentsfamily style or roommate living environments Community inclusionCommunity inclusion Individualized daily schedulesIndividualized daily schedules Teaching rights, communication, and other skillsTeaching rights, communication, and other skills Systems for encouraging achievementSystems for encouraging achievement Positive relationshipsPositive relationships Opportunities for choice and self determinationOpportunities for choice and self determination Ongoing teacher training and consultationOngoing teacher training and consultation Teacher evaluation and certificationTeacher evaluation and certification
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Midnight FarmMidnight FarmCLO's Midnight Farm provides year round CLO's Midnight Farm provides year round therapeutic horseback riding lessons to therapeutic horseback riding lessons to
children and adults of all abilities. We have a children and adults of all abilities. We have a great time with our summer camps. And any great time with our summer camps. And any given weekday you can find our day service given weekday you can find our day service
men and women out working in the men and women out working in the greenhouse or creating something in the greenhouse or creating something in the
pottery barn!pottery barn!www.midnight-farm.orgwww.midnight-farm.org
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Community Living Opportunities Community Living Opportunities
Expected OutcomesExpected Outcomes for Persons Served for Persons Served
Pleasant and Safe SurroundingsPleasant and Safe SurroundingsObservance of Legal and Personal RightsObservance of Legal and Personal Rights
Positive Relationships with OthersPositive Relationships with OthersLiving Healthy LifestylesLiving Healthy Lifestyles
Opportunities for Choice and ControlOpportunities for Choice and ControlEffective Learning Opportunities Effective Learning Opportunities
High Level of Participation in Daily High Level of Participation in Daily ExperiencesExperiences
Community InvolvementCommunity InvolvementEffective CommunicationEffective Communication
Pleasant Social EnvironmentPleasant Social EnvironmentSatisfied ConsumersSatisfied Consumers
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Thank you for your time and interest.
Please feel free to contact me for further information: 785-218-9358
Diane Bannerman Juracek, Ph.D, BCBA [email protected]
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