Developing Fade Plans that Support Optimal Functioning

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Developing Fade Plans that Support Optimal Functioning Presented By Carroll Y Lytch, Psy.D,, MHA Based on the work of Janet Hull School Based Resource Teacher Anne Arundel County Public Schools Jhull@AACPS.org

Questions to ask before determining the need for Individual Supports Does the current Individual Support Plan meet the needs of the consumer? Are there goals/objectives to increase independence? Have all existing natural resources been utilized? Can the individuals needs be met in a group type service? Have you consulted with Specialized Consultative Services or the PDS Consulting Psychologist for suggestions and recommendations?

Decision Making Flowcharts Pose the following Questions: Is there a significant health, behavior or transition concern? Has the case manager or another objective individual on the team or that consults with the team observed the individual? What interventions/programs have been tried? What was the success? How long was the intervention attempted? What data was collected to assist in the decision making process? What specific health, behavior or transitional behaviors necessitate the need for the support service

Consider the positive and negative impacts of the assignment of individual supports: Negative consequences include: May create an unnatural and more restrictive environment Isolation from peers Dependence on staff Impact on peer interactions Failure to develop self-regulating behavior

Consider the positive and negative impacts of individual supports Positive outcomes include: Align to goals of independence Bridge the individual into a less restrictive environment Use of a Fade Plan can lead to increased independence by individual

Why Build Independence? Builds self-esteem esteem Motivates an individual to achieve Gives the individual a sense of purpose Support for long-term care providers Social acceptance Reduces stereotypic labels

Elements of a Fade Plan Includes background information on consumers strengths, needs, abilities and preferences Defines roles/responsibilities of staff members Fade plan should be included in the ISP The criteria for implementing fading should be tied specifically to goals/objectives from the ISP that support optimal independent functioning Describes support needed during: Transitions Work/Day Activity Behavior Self-help Describes fading plan hierarchy A specific number of episodes/instances of the behavior could be set as criteria

Fading Plan Hierarchy Most to least intrusive: Full physical Partial physical Verbal prompt Visual prompt Modeling Group staff member, employer, or family member prompt/cue

Guidelines for Effective Fading of Supports: The fading plan should be a gradual process that gives the individual time to adjust to the changes in supervision and enables the individual to experience the success they are achieving. The fading plan needs to be described in a step by step fashion that ends up with 1:1 supervision being discontinued. These should be small steps and designed by the team and psychologist to be successful. Criteria are identified for expanding or generalizing fading to other times and or places. Criteria for abandoning the fading plan or going back one step, etc. should also be specified. Plan should also include direction on where or on what step to resume the fading

Guidelines for an Effective Fade Plan In shaping behavior the goal is to reinforce close approximations of the desired behavior. Use primary reinforcement (ex: praise, recognition, enrichment of job or day activities) in conjunction with secondary reinforcement (additional staff, food, stickers, etc). All secondary reinforcers need to be faded over time After the individual masters a skill, discontinue using the secondary reinforcer Continue providing primary reinforcement when the individual exhibits the desired response/behavior Fading secondary reinforcement is needed to avoid Dependency on Secondary Reinforcer (Additional Staff)

What is the ultimate goal? The fading process is complete when the individual consistently responds correctly The goal is limited assistance from staff, employer or family member

Questions?