1. The Family Teaching Model: A Kansas Residential Model for Adults with Intellectual Developmental Disabilities that offers Eleven Desired Lifestyle Outcomes 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. 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 Residential Options Day Classes Day Classes Supported Employment Supported Employment Health Care Services: Clinics in Lenexa and Lawrence Health Care Services: Clinics in Lenexa and Lawrence Applied Behavior Analysis Consultation Applied Behavior Analysis Consultation Positive Behavior Supports Positive Behavior Supports Children’s Services Children’s Services Training, Evaluation and Certification Training, Evaluation and Certification Outreach Services Outreach Services Remote Monitoring Remote Monitoring Midnight Farm Midnight Farm

6. CLO 2012 Demographics 81 homes 81 homes 214 individuals with intellectual developmental disabilities 214 individuals with intellectual developmental disabilities “Extremely satisfied” or “Satisfied” ratings from 91% of parents/guardians of those we serve “Extremely satisfied” or “Satisfied” ratings from 91% of parents/guardians of those we serve 230 adults served in day services in Douglas, Allen, and Johnson Counties 230 adults served in day services in Douglas, Allen, and Johnson Counties Virtual village opens, providing “Homelink” support to promote independence Virtual village opens, providing “Homelink” support to promote independence 115 individuals served in CLO wellness clinics and occupational/physical therapy services 115 individuals served in CLO wellness clinics and occupational/physical therapy services 330 children served in Children’s Network 330 children served in Children’s Network Early intensive behavioral intervention Early intensive behavioral intervention Family and youth intervention Family and youth intervention Johnson County Montessori Preschool Johnson County Montessori Preschool Northstar Academy Northstar Academy Midnight Farm Midnight Farm 120 special-needs kids and adults in therapeutic riding 120 special-needs kids and adults in therapeutic riding 40 special-needs kids in summer camps 40 special-needs kids in summer camps 750 individuals from community on tours, field trips & special events 750 individuals from community on tours, field trips & special events

7. Building the “Good Life”

8. Timeline of History The Teaching Family Model Teaching Family Model 1967 Lonnie and Elaine Phillips/ Mont Wolf 1970 1 st dissemination attempt – not successful Consumer feedback important 1975 Boys Town 1977 Concerned Care Jim Sherman and Jan Sheldon 1 st adaptation for DD population 1981 DSNWK 1983 CLO 2001Tennesee Family Solutions 2004 California Community Opportunities

9. 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 Group Home Individualized Living

10. 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 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 Family Teaching Extended Family Teaching

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

12. Family Teachers in a Family Style Environment Family Teaching Model Component # 1...

13. What better model to accomplish this than the Family Teaching Model?! Family Teachers in a Family Style Environment

14. Individualized Daily Schedules Family Teaching Model Component # 2...

15. Libra ry Tom's Choice Work @ Recycling Center Libra ry Ed's Choice Swimming Work @ Recycling CenterThursEdKevinTom 7:00 AM AM Routine* AM Routine *(bath routine) Sally (Family Teacher) goes jogging AM Routine* 7:30 AM 8:00 AM MedsMedsMeds 8:30 AM Wait for City Bus R & R 9:00 AM 10:00 AM 11:00 AM 12:00 PM Lunch (*Lunch routine) Lunch 1:00 PM 2:00 PM 3:00 PM 4:00 PM 4:30 PM Meds Meds Meds/ Dinner Prep Routine* Meds Meds 5:00 PM Dinner/ Chores 5:30 PM 6:00 PM 6:30 PM 7:00 PM Sally (family teacher) takes Katie (daughter) to Girl Scouts Sally (family teacher) takes Katie (daughter) to Girl Scouts Hobby Choice Hobby Choice Check mail and choice of Activity Check mail and choice of Activity 7:30 PM Snack Snack Routine* Snack 8:00 PM Meds/ PM Routine* to recycling center to 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 Library Kevin’s choice

16. Teaching New Skills & Quality of Life Planning Family Teaching Model Component # 3...

17. Continuous Planned and Opportunity Teaching Identification and purposeful teaching of skills: Identification and purposeful teaching of skills: that lead to independence and ability to navigate through their day with less or no assistance that lead to independence and ability to navigate through their day with less or no assistance that help the person served access highly preferred items, activities, experiences... that help the person served access highly preferred items, activities, experiences... that limit or eliminate any rights issues (privacy, need to have someone assist them in making a phone call) that limit or eliminate any rights issues (privacy, need to have someone assist them in making a phone call) that lead to improved health & safety that lead to improved health & safety Behavioral support Behavioral support Eliminates or decreases challenging behavior that inhibits continued progress towards living a good quality of life Eliminates or decreases challenging behavior that inhibits continued progress towards living a good quality of life

18. Reinforcing Desirable Behavior* 1.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)

19. 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. Plan when to use the behavior *Some steps may be deleted or shortened depending on the needs and learning style of the individual.

20. Systems for Encouraging Achievement Family Teaching Model Component # 4...

21. Formal Positive Relationships Positive Relationships Motivation Systems – monetary, points, tangibles, etc... Motivation Systems – monetary, points, tangibles, etc... Behavioral Contracting Behavioral Contracting Premack Principle – eat dinner to get your dessert... Premack Principle – eat dinner to get your dessert... Staff reinforcement and recognition programs Staff reinforcement and recognition programs or Informal

22. Positive Relationships Family Teaching Model Component # 5...

25. Opportunities for Choice and Self Determination Family Teaching Model Component # 6...

26. Making choices freely Making choices freely Having control in areas important to you Having control in areas important to you Being part of decisions that affect you Being part of decisions that affect you Knowing how to make a choice Knowing how to make a choice Feeling free to make a choice Feeling free to make a choice Having predictable events in your day/week Having predictable events in your day/week What does Self-Determination mean?

27. Ongoing Teacher Training and Evaluation Family Teaching Model Component # 7...

28. The Coaching Process (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

29. Teacher Evaluation & Certification Family Teaching Model Component # 8...

30. The Community Living Research and Development Project at the University of Kansas Family Teacher Certification Program Providing Certification of Family Teachers employed by Community Living Opportunities, Inc. who exhibit exemplary teaching and implement Community Living Opportunities' Family Teaching Model for Adults with Developmental Disabilities

31. Community Living Opportunities Expected Outcomes for Persons Served Pleasant and Safe Surroundings Observance of Legal and Personal Rights Positive Relationships with Others Living Healthy Lifestyles Opportunities for Choice and Control Effective Learning Opportunities High Level of Participation in Daily Experiences Community Involvement Effective Communication Pleasant Social Environment Satisfied Consumers

32. 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 $$

35. …but there’s more… our latest community living model…VIRTUAL VILLAGE Fewer staff Fewer staff CLO’ Homelink central site monitoring, as needed: audio, video, sensors, devices - in every 2-bedroom apartment CLO’ Homelink central site monitoring, as needed: audio, video, sensors, devices - in every 2-bedroom apartment Rigorous teaching and progress assessment on independent living skills Rigorous teaching and progress assessment on independent living skills Daily schedules Daily schedules Classes: problemsolving, roommate conference, home safety…. Classes: problemsolving, roommate conference, home safety…. Jobs Jobs Community Inclusion (3 rd places) Community Inclusion (3 rd places) Motivation Point economy system (with daily trips to point exchange store) Motivation Point economy system (with daily trips to point exchange store) Self-government – to minimize staff control/increase control and responsibility for the men and women Self-government – to minimize staff control/increase control and responsibility for the men and women Health ticklers Health ticklers Learning to take medications independently Learning to take medications independently

39. Factors Influencing “Living the Good Life” Fewer number of individuals living in a home in the community Fewer number of individuals living in a home in the community Either “Family teachers” providing support or “teaching staff” as opposed to shift-staff Either “Family teachers” providing support or “teaching staff” as opposed to shift-staff Implementation of Family Teaching Model Components Implementation of Family Teaching Model Components family style or roommate living environments family style or roommate living environments Community inclusion Community inclusion Individualized daily schedules Individualized daily schedules Teaching rights, communication, and other skills Teaching rights, communication, and other skills Systems for encouraging achievement Systems for encouraging achievement Positive relationships Positive relationships Opportunities for choice and self determination Opportunities for choice and self determination Ongoing teacher training and consultation Ongoing teacher training and consultation Teacher evaluation and certification Teacher evaluation and certification

40. Midnight Farm CLO's Midnight Farm provides year round therapeutic horseback riding lessons to children and adults of all abilities. We have a great time with our summer camps. And any given weekday you can find our day service men and women out working in the greenhouse or creating something in the pottery barn! www.midnight-farm.org

45. Community Living Opportunities Expected Outcomes for Persons Served Pleasant and Safe Surroundings Observance of Legal and Personal Rights Positive Relationships with Others Living Healthy Lifestyles Opportunities for Choice and Control Effective Learning Opportunities High Level of Participation in Daily Experiences Community Involvement Effective Communication Pleasant Social Environment Satisfied Consumers

46. 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 dianebannermanjuracek@clokansas.org dianebannermanjuracek@clokansas.org