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| Helping Staff to Help Adults with Disabilities in the Community |
| Sunday, May 30, 2004 |
| 9:00 AM–10:20 AM |
| Beacon B |
| Area: DDA/CSE; Domain: Applied Research |
| Chair: Diane Bannerman Juracek (CLO; KU) |
| Discussant: Gregory S. MacDuff (Princeton Child Development Institute) |
| Abstract: Learning Objectives
Attendees will be able to describe three empirically supported strategies used to improve staff performance.
Attendees will be able to describe successful use of an in-home coaching/feedback system and a tangible reinforcement system to maintain staff implementation of responsibilities in supporting people with developmental disabilities.
Attendees will be able to describe a measurement system for reliably tracking both staff behaviors and the consumer outcomes. |
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| Staff Training Using the Consultation Process to Produce Positive Outcomes for People with Developmental Disabilities |
| JOLENE PETERSON (Community Living Opportunities, Inc.), Holly M. Sweeney (Community Living Opportunities, Inc.), Diane Bannerman Juracek (Community Living Opportunities, Inc.), Jamie D. Price (Community Living Opportunities, Inc.), Michael C. Strouse (Community Living Opportunities, Inc.), Jan B. Sheldon (University of Kansas), James A. Sherman (University of Kansas) |
| Abstract: The consultation process (Harchik, Sherman, Sheldon,& Strouse, 1992)was initiated in homes adapting the Teaching Family Model where 3-4 adults with profound mental retardation live adjacent to a family couple in a duplex setting. Behavioral consultants, with varying education and experience in working with adults with developmental disabilities, taught the family couple how to implement and construct environmental manipulations, individualized schedules, preferred activities, and opportunities for choice as preventive strategies to decrease targeted maladaptive behaviors. Some of the maladaptive behaviors included pica, self-injurious behavior, and aggression. A consultant instructed the family couple on the four preventive strategies using the consultation process, including mini-inservices, demonstrations, coaching, and direct observation and feedback. As a result of use of the consultation process with the family couples, preventative procedures were used more consistently and maladaptive behaviors decreased. Data show that each family couple demonstrated the preventive strategies 95% of the time or better over 90% of the observations. Inter-observer reliability conducted during 20% of the direct observations was over 85% in agreement. |
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| Pizza, Movies, or the Mall?: Using Gift Certificates to Improve and Maintain Staff Performance. |
| THOMAS J. HARVEY (May Institute), Alan E. Harchik (May Institute), Amy E. Clark (May Institute), Eric C. Lunden (May Institute), Thomas Stanton (May Institute) |
| Abstract: Managers and direct care staff who support adults with disabilities in community residential programs have a myriad of paperwork, teaching, and treatment responsibilities. In this paper, we present an evaluation of a positive reinforcement system used to increase and maintain staff's performance in these areas. Criteria were developed that corresponded to state regulations, May Institute standards and policies, and best practices in community services. These included implementation of treatment programs for reducing problem behaviors and for improving skill deficits, ensuring home and vehicle safety, medication administration, and management of resident personal money. Gift certificates were purchased from a variety of local establishments, such as supermarkets, gas stations, movie theatres, restaurants, and malls. At the end of each month, staff submitted the required information to program administrators. If the home's staff met predetermined criteria for three consecutive months, each staff member in the home received a gift certificate of his or her choice. Data showed that performance increased from a baseline of approximately 40% to over 90% for each home. Fluctuations in data often corresponded to changes in home management. |
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| Evolution of a Quality Improvement System in a Community Based Program for Individuals with Disabilities |
| MARIANNE ARRUDA (May Institute), Alan E. Harchik (May Institute), Eric C. Lunden (May Institute) |
| Abstract: Quality improvement systems, in order to be effective, must target important outcomes that are valuable to site managers and to agency administrators. In this paper, we describe the development of a quality improvement on-site observation and feedback system. Specifically, the system was developed with the involvement of site managers, quality improvement staff, and agency senior administrators. Target areas included resident engagement in activities, direct care staff's interactions and supervision, implementation of behavioral treatments and skill training, and status of medication and resident money systems. The system was continually reviewed and modified based upon findings and from feedback from all of these participants. This study was implemented across four programs of May Institute in four different geographic regions of New England. Approximately 10 sites within each program participated in this study. The program included baseline data collection, observation, feedback, praise, and correction plans. In baseline, most measures were at 50%-60%. Following the feedback, praise, and correction intervention, measures rose to 80%-90%. |
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