Collaboration. Great tomorrows begin today! Building effective transition teams for youth and young adults with Special Needs.

Transcription

1 Collaboration Building effective transition teams for youth and young adults with Special Needs. Great tomorrows begin today! 3 of 6 - Components of Teen Transition Planning Collaboration 3 of 6 - Components of Teen Transition Planning Pu(ng the Pieces Together We recognize that that there are blocks of expertise within our community. The challenge has been bringing all the blocks together to build a meaningful transition process. The Teen Transition Planning system endeavors to provide the framework for a coordinated transition process to better serve families and youth with special needs. Collaboration is the key to success! 1

2 Collabora9on! The Teen Transition Planning system helps to build transition aware communities, where all information sources, service providers, resources, and family support systems WORK TOGETHER towards a common vision... making it EASIER for families to get the services and supports they need. Collaborative Partners include but are not limited to: MCFD CLBC School Districts Community Service Providers Person Centred Planning Community Involvement (school, agencies) Best Practices Best Practices Youth and Family Involvement Identification and use of a Transition Coordinator Brainstorm Brainstorm: Think of words to describe the lives of people with disabilities Habilita9on Habilita9on involves teaching skills needed to live as independently as possible. Habilita9on is different from rehabilita9on as the individual may not have ever developed the skill. i.e. it was not lost and now being regained it was never part of the person s repertoire. It is the right of individuals with intellectual disabili9es to receive individualized service (habilita9on) that will give each of them a realis9c opportunity to lead a more useful and meaningful life. 2

3 Right to Choice Thinking Caps Balancing the right to habilita9on with the right to choose. Service providers open choose the client s habilita9ve goals, choose their work or day treatment se(ng, impose a daily schedule and regulate access to preferred ac9vi9es. Choices may promote habilita9on, but they may not reflect the client s preferences. Brainstorm: What are the advantages and disadvantages of empowering people with developmental disabili9es to exercise their personal liber9es? Two Sides of the Coin Respect for Choice Diagnosis Disability Disorder Disease Syndrome Illness Asset Resilience Talents Participation Ability Capacity Aptitude Consider respect for choice versus respect for person... Cambridge University forum 2010 if we help support the person with a milder disability to live independently we put them at greater risk... some might argue that the risk outweighs the choice... What about other factors: Smoking Over- ea9ng, ea9ng an unbalanced diet Casual sex 3

4 Social Role Valoriza9on Wolf Wolfensberger s Principle of NormalizaAon (1972) which he reformulated into Social Role ValorizaAon (Wolfensberger, 1983, 1995, 2000). Both are based on Social- Role Theory, which holds that people largely define themselves and others based on what roles they occupy. Wolfensberger believes that individuals with disabili9es have tradi9onally been allowed only marginal roles in society, leading to their devalua9on as individuals. Devalued people in society are open poor, rejected, treated inhumanely, not allowed opportuni9es, and even brutalized. His contribu9on - he was one of the first to suggest that society must provide more valued roles for people with disabili9es. Change How You Think! System- Centred Plan a lifetime of programs Offer a limited number of segregated program options Base on stereotypes about persons with disabilities Organized to please funders, regulators, policies and rules Person Centred Craft a desirable lifestyle Design an unlimited number of experiences Find new possibilities Focus on quality of life Emphasize dreams, desires, and meaningful experience Organize to respond to people Sec9on 1 What is Person Centred Planning? Person Centred Planning PCP is a way of listening to and learning from individuals with regards to what they would like to have or see in their lives. It assists people to think about what types of things they would like to have now as well as in the future It places the individuals family and friends at the forefront of helping to make those plans come into existence (O Brien 2004). 4

5 Effectiveness of PCP The first longitudinal study examining the efficacy of PCP was completed in 2004 (Holburn et al) involving 19 youth from a group home with a control group of peers. Some finding included: 1. increase in the size of social networks (doubled) 2. greater chance of having active contact with family 3. increase in level of contact with friends 4. increase in the number and diversity of community based activities 5. increase in the hours per week of scheduled activities 6. greater chance of having more choice. Objectives of PCP To gather all the resources in the community available to people in helping them to make the most out of their lives. It does not ignore the disability; it shifts the emphasis to a search for capacity in the person among friends and family, in the community and among service workers. PCP promotes the focal person to set their own future goals and dreams while simultaneously encouraging family and friends etc., to support them (Cross et al, 1999) Effectiveness The effectiveness of the plan depends on a support group of people who know the person with a disability, and who facilitate learning by problem solving, building community and changing organizations. Transition Planning Transition planning is a partnership involving the youth with special needs, their family, local service providers, school personnel and government staff. Purpose of transition planning is to identify opportunities and experiences during the youth s school years that will help them better prepare for life as an adult (Johnson, et al, 2000). 5

6 Importance of Planning Allows the youth to review personal accomplishments and create an individualized vision of the future. Transition planning requires bringing social resources together with service resources. Social resources include: family, friends, school, networks of contacts and information. Service resources include: available funds, capacity of services agencies Section 2 Steps to Person Centred Planning? Steps of Person Centred Transition Planning 1 Building a Planning Team 2 Gather Information (PATH) 3 Develop the Transition Plan 4 Implement the Transition Plan 5 Update the Transition Plan Team Members The actual people on the team may change over time; however, there are consistent roles: Family parents/guardians and extended family Team Coordinator Youth Friends Facilitator Educators community organizations 6

7 Role of Transition Coordinator Provides organizational and administrative support for the team. Coordinates and schedules meetings Manages the paper work and maintains a transition file Keeps the planning sessions focused Monitors the progress Obtains commitment for follow- up actions and ensures that all participants are clear on the specific tasks/actions they are to undertake Coordinates the writing and implementation of the Transition Plan. Importance of the TC position The Transition Coordinator position is a key role. The TC is accountable and responsible for coordinating all aspects of the Transition Plan once it has been developed. The Transition Coordinator should be identified prior to the PATH process occurring. The Transition Coordinator may be the parent, a family friend or a paid external support. Role of the Youth Attend IEP and Transition Planning meetings Lead the transition meeting with support as required Share his/her personal preferences, interests, skills, goals and needs with the team (with support as needed). Ask questions and provide information to the team on various issues that he/she wants to address such as wellness, social, financial etc (with support as needed) Assume responsibility for working towards his/her goals and completing the tasks listed in the Transition Plan. Role of Facilitator Attend and contribute to IEP and Transition Planning meetings. Provide support services in community settings. Provide the you with cultural support and connection where possible. 7

8 Role of Parent/Guardian Attend IEP and Transition Meetings Prepare their son/daughter for participation Lead transition planning meetings where possible and desired. Provide insight into the background and values of the family. Share their child s and their own preferences, interests, skills, goals and needs. Focus the team s planning on the youth s and family s needs and goals. Provide opportunities for their son/daughter to learn and practice the foundation skills that support active participation in the planning process Provide information on the programs and support services that are accessed by and available to their son/daughter. Family Involvement Research shows that parental involvement increases success in transition planning (Rutherford & Turnbull, 1996). The extent and nature of involvement will vary depending on the capacity of the family, their abilities and availability. Most importantly, parents can share their child s dream and help them realize their vision. Role of School Personnel Attend the IEP and Transition planning meetings. Consult with the planning team on educational opportunities, graduation, assessments and the youth s progress and support needs. Help identify and analyze post secondary education opportunities Support an inclusive environment Provide instruction to the young person on skills required to support a successful transition IEP and Transition Planning In British Columbia, the Ministry of Education supports youth involvement in life planning. Completion of Planning 10 and a Graduation Portfolio are two requirements of the school system; introducing topics such as: health, financial planning and career planning. The IEP for students in Grade can be used to support goals identified as part of the Transition Plan. IEP s can play a key role in matching educational programs to post school goals. 8

9 Role of Friends and Advocates Attend the IEP and Transition Planning Meetings Share information on the youth s and family s preferences, interests, goals and needs. Assist and support the youth and his/her family as they discuss their needs and goals Focus the team s planning on the youth s and family s needs and goals. Provide informal home and community experiences and supports if possible. Team Work! The transition planning team encourages, facilitates and supports active participation of youth and their family and friends in the planning process. Active participation ensures that the planning goals and strategies are based on the aspirations, desires, and needs of the individual and his or her family- not merely on the services and placements that are available. Section 3 Person Centred Transition Planning Preparing for the PATH 1 Building a Planning Team 2 Gather Information (PATH) 3 Develop the Transition Plan 4 Implement the Transition Plan 5 Update the Transition Plan 9

10 PATH Determining the long term goals and dreams for the individual with special needs requires a planning process. This training program encourages families to utilize a planning tool called PATH Planning Alternative Tomorrows with Hope. The PATH becomes the foundational tool for the transition plan encompassing school, community and family life goals based on the dreams of the youth with special needs. PATH PATH is a person centred planning tool developed by Jack Pearpoint and Marsha Forest in PATH planning tool provides a visual representation of a person s hopes and dreams and then systematically develops the process to enrol team members to support the youth to achieve their goals. PATH Process The PATH is coordinated by two people the PATH Facilitator and the Graphic Recorder. The youth that the PATH is for, is called the pathfinder. The Pathfinder should invite his/her team to attend the PATH. The PATH should be approached as a celebration. Steps to the PATH There are 8 steps to the PATH 1. The North Star 2. Positive and Possible Goals 3. The Now 4. Enrolling Team Members 5. Getting Stronger 6. The Next Year 7. The Next 6 Months 8. Committing to First Steps 10

11 The PATH is supported by a PATH Facilitator and a Graphic Recorder PATH Facilitator/ Graphic Recorder The role of PATH Facilitator and Graphic Recorder is a short term duty. They will facilitate the PATH on the day of the mee9ng. They do not need to be ongoing members of the teen s transi9on team. This role must be fulfilled by someone with training (part of this training). However, facilita9ng a PATH requires significant prac9ce; therefore, this role is open taken on by community organiza9ons, schools and businesses that specialize in providing PATH services. PATH Graphic Preparation The youth and family should be prepared to share their dreams of the future setting aside fears and preconceived notions of what s doable in Person Centred Planning, move away from the limits of Service Centred Planning! Time should be spent with the youth prior to the PATH to gather information that will assist the team to support the youth in the PATH process. The Transition Coordinator will facilitate the completion of Youth and Family Profiles as well as providing a framework for discussion of hopes and dreams. 11

12 Create a Profile Prior to the PATH, create a profile that includes your interests, abilities, likes, dislikes, achievements and needs. Ask questions such as: What are my strengths and interests? What are my likes and dislikes? What are my accomplishments? How do I communicate with people? What services and/or supports do I currently use? What services and/or supports do I need? TABLE 2: Youth Profile Preparation For some youth, the concept of pretending and verbalizing what they are imagining is very challenging. It is important to prepare the youth ahead of the PATH meeting and talk about their strengths, interests and accomplishments. At the PATH, the youth can then be supported to refer back to their list and goals for the future can be produced. TABLE 3 Preparing for the North Star 12

13 Section 4 The PATH 1. The Dream (North Star) Remember this is the youth s dream team members should not criticise the youth s dream. All team members may contribute to the dream with the approval of the youth with special needs. Don t limit the dream! The North Star The North Star is the key to the entire process. The North Star is: The vision Out of the ordinary The dream The seed of the future for the person The hope The future What drives the pathfinder to get up in the morning. NOTE Any image can be used to represent the vision for the teen, so if the star does not resonate, choose a different image 13

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15 The Fear Sometimes it is helpful to think about what you don t want for the youth as a means of thinking about what you do want. Spending some time examining the fear can sometimes be a powerful way to generate ideas for the dream, so don t shy away from this technique. Domains to consider in the Dream! The PATH Facilitator will probe to insure that each of the domains is considered during the PATH process: Life Skills & Adaptive Skills Education Family & Friends Health Housing Employment Leisure / Culture/ Spiritual 2. Vision of a Possible Future Our sense of the goal The dream provides orientation, however it is not the goal. Goals must be positive and possible! The vision of a possible future is completed by having the person look backwards and describing successes as if they have already happened. The youth should think about what he/she could accomplish 2-5 years in the future. The team determines the time frame. NOTE: This section is written in past tense!! PATH participants should write as if its happened 15

16 3. Describe the Now Grounding the PATH process by providing a description of where the youth is now. There will be tension between the goals and the current situation. This tension is what provides the energy to move forward. Examining the feelings evoked by this tension is important to the process. Describing the Now Describe where the youth and family is now. Include support services available, skills, finances all applicable potential barriers should be considered. Describe what the present is like? Use feeling words as well as identifying needs. Describe now versus the image of success in the future. 16

17 4. Enrol Support The youth with special needs will need to enrol support from others to fulfil their goals! Enrolling a team member is more than just exchanging favours, it means honouring a shared commitment. This step allows recognition of those people with whom the pathfinder wants to build a shared commitment through work. This section may evolve over time team members may have to be researched. Preparation Prior to the PATH, review the process by talking about people that the youth wants to have in their life to help them. These people may or may not be attending the PATH, but if the youth feels they are important to fulfilling an aspect of their dream, they should be approached. If you do not have all the team members needed, the transition coordinator can support the youth and family to enrol others. 5. Get Stronger This section is about the youth looking after himself/herself to make sure they are able to work towards their goals. What do you need to get strong and stay strong? This step seeks to determine the following: What knowledge do you need? What skills do you need to develop? What relationships do you need to maintain? How can you stay healthy and well as you work towards creating what you want? Getting Stronger Getting stronger is not about steps to goal attainment its about looking after the youth with special needs and their family so that they can move through the PATH process. There will be successes and defeats the family and the youth need to be strong to keep moving forward. In the getting stronger section consider rest, respite, relaxation, journaling 17

18 6. Charting Action (strategies) a year from now This step looks at what to do over the next year. Goals are briefly reviewed while thinking about the next year identify important steps that need to take place. Each as goal should be considered, the team may decide to wait with regards to some aspects, but this should be a conscious decision. 7. Next Steps a 6 months from now This step looks at what to do over the next 6 months. Goals are briefly reviewed while thinking about the next year identify important steps that need to take place. Each as goal should be considered, the team may decide to wait with regards to some aspects, but this should be a conscious decision. 8. First Steps This section summarizes the work to be done in the next few months! Specify who will do what and by when! This section is often information gathering and recruitment of team members! 18

19 Tracking the Goals TASK CHECKLIST AGE (Grade 9 & 10) PATH GOALS Person Responsible Due Date Check When Completed Prepare and Plan Tracking the Goals TASK CHECKLIST AGE (Grade 11 & 12) PATH GOALS Person Responsible Due Date Check When Completed TASK CHECKLIST AGE (Grade 9 & 10) PLAN & PREPARE Apply for a Social Insurance Number: ( Obtain a birth certificate Participate in the school- directed Grade 10 Planning course to learn about planning for education and career transitions, financial planning, and decision - making skills. Work with your family to make a long- term financial plan that will help you transition to adulthood. Person Responsible Due Date Check When Completed 19

20 Prepare and Plan Tracking the Goals TASK CHECKLIST AGE (Grade 11 & 12) PLAN & PREPARE 6 Months before you turn 18 years old apply for your Person with Disability Benefits (PWD)? NOTE: If you re currently receiving At Home Medical Benefits and you re applying for PWD: upon initial phone call to the Ministry of Housing & Social Development Office (MHSD), inform the worker of this. Discuss the process of applying for medical supplies with the worker at MHSD. TASK CHECKLIST AGE 18 & 19 PATH GOALS Person Responsible Due Date Check When Completed Make arrangements to visit agencies in your community that can offer day program opportunities, supported employment or volunteer opportunities. Open a bank account, if you haven't already done so and obtain an ATM card. Apply for a British Columbia Identification Card (B.C. I.D. Card). Prepare and Plan Committing to First Steps TASK CHECKLIST AGE 18 & 19 PREPARE AND PLAN With your family and school, determine whether or not you are eligible to attend an additional year of school. If you are eligible for the CLBC Adult Community Living Services take your transition plan to the CLBC office and request the assistance of a Coordinator to review your plan which will then be submitted to the Quality Service Office to determine if requested CLBC funded supports are approved. Establish strong connections in your community by volunteering and by exploring recreational, social and cultural opportunities. Complete a personal portfolio of work and volunteer experience, such as your Graduation Transitions. Ask your family, your lawyer, financial planner and/or transition coordinator to help you understand adult guardianship and will and estate planning. For youth who will not be actively participating or directing their health care and other life decisions, consider preparing a Representation Agreement for when the youth turns 19 years of age). Person Responsible Due Date Check When Completed This is the last step of the PATH process. This step involves moving from thinking into action! Try to identify barriers to taking the first steps. Ask for commitments! NOTE You may invite people to sign the PATH to show their commitment 20

21 Section 5 Person Centred Transition Planning 1 Building a Planning Team Following the PATH 2 Gather Information (PATH) 3 Develop the Transition Plan 4 Implement the Transition Plan 5 Update the Transition Plan Pu(ng Goals into Ac9on The PATH is the key to determining goals for the youth with special needs. Once the PATH is completed, the positive and possible goals are translated into yearly goals and recorded in Section 4 of the binder. Some people become complacent at this point, but it is critical to keep pushing forward and activate the goals. The key to successful activation will be calling on members of the transition team and also finding other blocks of expertise! The school will likely be your first collaborative partner through the bridging some of the PATH goals into the IEP. Developing the Plan The PATH provides the foundation for the Transition Plan. Each team member involved on the team will have committed to First Steps. The Transition Plan does not need to be one document! The areas of the plan appropriate to the School Personnel (for which they committed) will become part of the student s IEP. Bridge Your Transition Plan to the School s IEP 21

22 Transi9on Goals in the IEP The Ministry of Education acknowledges that goals specific to transitioning should be included in youth with special needs IEP s in Grades Since school staff should be a part of the transition team, this link to the IEP flows naturally from the PATH process. Transi9on Goals The Ministry of Educa9on (2011) states that if the student is preparing for transi9on beyond school, the following considera9ons are important: o input from the family and student regarding needs, preferences, interests and concerns (part of the PATH); o key support people or agencies that will be part of the student s life in the next se(ng; o opportuni9es for the student to explore/experience new se(ngs in advance of the transi9on; o the connec9on of the family to service agencies, if relevant; and o exposure to voca9onal experiences prior to leaving school Transition Plan The goals not accounted for in the IEP should be included in a Transition Plan. The Transition Coordinator is responsible for producing the Transition Plan. The Transition Plan will include goals to be completed by the family and community based organizations. The Transition Coordinator will store a summary of the PATH and the IEP in the Transition Planning binder. Contents of the Plan Just like an IEP, each long term goal will refer to the several short term goals. The short term goal will identify the person responsible and the time by which it was to be completed. The Transition Coordinator, together with the family and youth monitor the progress of the Transition Plan to insure that goals are being met. If barrier arise, the Transition Coordinator will support the family and youth to identify and enrol new supports. 22

23 Transition Plan Transition Plan Section 6 Domains Domains to consider in the Dream! The PATH Facilitator will probe to insure that each of the domains is considered during the PATH process: Life Skills & Adaptive Skills Education Family & Friends Health Housing Employment Leisure / Culture/ Spiritual 23

24 Housing Where is the youth going to live? Are they going to live alone or with a room mate or significant other? Does the youth need support for daily living? If so, how much could the support needs be decreased through teaching? Is the youth going to transition to a provincially funding living arrangement? Legal and Financial Representation Agreements Wills Trusts Discretionary/non- discretionary Public Guardianship Persons with Disabilities funding (PWD) Registered Disability Savings Plan (RDSP) Binder Each section acts as storage a place to COLLECT the information that you will need to accomplish your plan. Each domain has the following subsections: Define Context: This will help you understand what the domain is all about. What kinds of issues, challenges, goals, and resources are usually addressed in this domain. Experts and Guides: This space is provided to help you learn about the types of professionals who might be of help to you, and where to find them. You can also use this section to store contact information about those important people as you collect it over time. Common Assessment Tools: This section describes many common tools unique to this domain that may be used to help define the plan. Reports from these assessments or other documents can be stored here. Curriculum and Programs: This section is where you will gather resource or support information or specific programming that is designed to help teach the skills and accomplish the goals specified in this domain. Sample Context Define Context: In this section, Life Skills and Adaptive Skills means all of the vital skills that an individual will need to be able to live happily and successfully through the various ages and stages. For children and teens, life stills may focus on self- care tasks such as dressing, basic personal hygiene, making friends, managing emotions, etc. As teens approach adulthood, other skills necessary for independence become important: learning to cope with anger, learning to plan (think) ahead, have self- discipline in studies or work, learning to be on time, managing finances, scheduling time, using public transportation, etc. 24

25 Experts and Guides Common Assessment Tools Implementing the Plan Once the planning is done, the team has to be careful not to lose momentum! Maintaining the commitment of a group of people over time is one of the most challenging requirements of the planning process. The Transition Coordinator can help with this phase by checking in periodically with the team and inviting people to work together towards the vision. Curriculum and Programs Once assessments are completed, goals are set and individualized curriculum and programs should be developed to support the client s learning (school and transi9on coordinators). Those curriculum and programs should be stored in the binder within the appropriate domain. The school may be able to help with some of the goals, but it is likely that other supports will be required. 25

26 Baseline It is important to have a baseline skill level for the child prior to choosing new skills the baseline allows you to set SMART IEP goals. To set a realistic achievable goal you must know where to begin. To determine baseline for a child s performance standardized and curriculum based assessments may be used. Complexity of Skill Development There is no such thing as a simple skill! It is critical to identify pre- requisite skills and to teach each skill component. The skill deficit must be identified prior to identifying long term and short term goals. Ex. John will obtain a paid part- time job at the library shelving books by Shelving books requires being able to alphabetize and order by decimals (basic skills). It also requires the ability stay on task for 4 hours, follow receptive instructions, adjust ones behaviour in response to others, transition between activities etc. It also requires appropriate dress, hygiene, social skills for breaks etc. SMART Goals Specific: written in clear, unambiguous language Measurable: allow student achievement to be described, assessed and evaluated Achievable and action- oriented: are realistic for the student and written in terms of what the student will do Realistic and relevant: are meaningful for the student, focused on positive and achievable changes Time- limited: can be accomplished within a specific period Person Centred Transition Planning 1 Building a Planning Team 2 Gather Information (PATH) 3 Develop the Transition Plan 4 Implement the Transition Plan 5 Update the Transition Plan 26

27 Implementing the Plan Once the planning is done, the team has to be careful not to lose momentum! Maintaining the commitment of a group of people over time is one of the most challenging requirements of the planning process. The Transition Coordinator can help with this phase by checking in periodically with the team and inviting people to work together towards the vision. Curriculum and Programs Once assessments are completed, goals are set and individualized curriculum and programs should be developed to support the client s learning (school and transi9on coordinators). Those curriculum and programs should be stored in the binder within the appropriate domain. The school may be able to help with some of the goals, but it is likely that other supports will be required. Teaching Programs Teaching Programs 27

28 Teaching Programs Person Centred Transition Planning 1 Building a Planning Team 2 Gather Information (PATH) 3 Develop the Transition Plan 4 Implement the Transition Plan 5 Update the Transition Plan Updating the Plan The Transition Plan should be updated annually since the short term goals are for one year (and to coincide with IEP development). New annual goals should be selected from the PATH process and the process for enrolling and initiating goals should be re- introduced. The North Star and the Positive and Possible goals should continue to be the catalyst for the annual goal setting. Section 7 The Hub 28

29 Why Collaborate When you complete the PATH process you will likely have a need for expertise from other people not currently on your transition team. Finding these experts, and recruiting them from within your community to JOIN your transition team will greatly strengthen your team, and assist in maximizing the potential of the youth with special needs to meet all the goals outlined in the PATH. How to Collaborate Find others with like needs by reaching out to others who are going through the same process. The Teen Transi9on Planning website: teentransiaonplanning.ca is the first place to look for links to agencies, parent groups and online resources. This resource is updated regularly with ideas and links provided by others in the community. Click the drop down box for your community and check out the resources listed there. Make recommenda9ons, use the contacts provided and contact others through the blog for ideas. The Hub! Putting the Pieces Together We recognize that that there are blocks of expertise within our community. The challenge has been bringing all the blocks together to build a meaningful transition process. The Teen Transition Planning system endeavors to provide the framework for a coordinated transition process to better serve families and youth with special needs. Collaboration is the key to success! 29

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