1. “Promoting Interdependence; Spreading Self-Determination” Capacity-Building for Students with Disabilities School In-service

2. Independence vs. Interdependence Traditional notion of independence is that “assistance is considered a deficit.” Interdependence recognizes that assistance with certain tasks is necessary for complete autonomy. (from: About a Lifecourse Approach, CanChild website) WE ALL NEED SUPPORT!

3. Interdependence and Capacity Interdependence emphasizes capacity as the ultimate goal instead of independence. Capacity is the actual ability to perform a task whether this requires assistance from another person or not. Capacity must be seen as a lifespan approach.

4. Interdependence – Sample Goals Within one year, Leon will use his rolling walker to walk 300 ft. from the auditorium to the classroom, verbally requesting appropriate assistance to hold open the door to exit auditorium. Success will be measured by Leon’s ability to arrive on time in homeroom after weekly auditorium assembly 3 times a week, in a 3 week period per teacher, or paraprofessional report. Within one year, Faygie will be able to make regular appointments with her wheelchair clinic for follow-up equipment care. Success will be measured by Faygie’s ability to convey the appointment date, location, and contact person’s name and number to therapist, parent or teacher.

5. What Does a Student Need to Be Interdependent? 1.Self-Determination 2. Social Support

6. 1. Self-Determination ability to set goals and act on them ability to make choices/decisions requires self-awareness, self-monitoring know how to apply strengths know how to compensate for limitations

7. Elements of Self-Determination Skills –Choice-making –Problem-solving –Decision-making –Goal-setting and attainment –Self-regulation (self-observation, self-evaluation & self-reinforcement ) –Self-advocacy and leadership Attitude –Perceptions of control –Self-efficacy –Self-awareness and self-knowledge

8. Developing Self-Determination Encourage: –participation in class/school activities that include planning, organization, research and presentation –taking on leadership roles –allow students to set & plan to attain their own goals –teach students to monitor their own progress and modify actions as needed –participation in IEP meetings –school-based services must be student-directed Modeling, role-playing, feedback, direct instruction http://www.nsttac.org/ebp/EBPractices/TeachingSelfDetermination SkillsGP.aspx

9. Self-Determination Skills Develop Throughout a Person’s Lifespan Choice-making Problem-solving Goal-setting & attainment with adult assistance Self-regulation Goal setting & attainment with less adult assistance Decision-making with adult assistance Self-advocacy Better self-awareness and self-knowledge Better perception of control & efficacy Decision-making All elements are coming together AGE2-56-89-11 12 & up

10. Developing Self-Determination Studies have shown direct correlation between self-determination skills and a student with disability’s capacity to succeed in school and in transitioning to an adult life. This includes employment and independent living. http://nasetalliance.org/youthdev/research.htm http://www.nsttac.org/ebp/student_development.aspx

11. 2. Social Support Participation in societal roles, by definition, cannot be done in isolation Interaction with others is essential A disabled individual may require more support; therefore he/she (or the family/caregiver) must know how to advocate for him/herself

12. Developing Social Support join clubs, support groups, activity groups train student, parents and caregivers on: –concept of interdependence and capacity, as early in life as possible –advocating for student’s needs (self-advocacy) –allowing student to perform to his/her optimal level; then, if needed, assist the student to augment his/her effort. involve the community

13. Implications to PT Promoting self-determination requires a change from: Student-focused PT Services  Student-directed PT Services

14. Student-Directed PT Service

15. TOTAL Therapy Activities

16. The Balance of Capacity

17. For: -students with milder disability -tasks that are easy

18. The Balance of Capacity For: -students with more severe disability -tasks that are more difficult

19. Implications for OTs/PTs Collaborative Consultation An essential role of OTs and PTs working in the schools is collaborative consultation with other school staff and parents/guardians. This may or may not require OT/PT services to be mandated on the IEP. Therapists may participate in transition planning as needed.

20. Implications for OTs/PTs Treatment Options: 1.Remediation of student’s body structure/ function, skills and behaviors. –e.g. strengthening, stretching, exercises –Includes activities done in therapy room –Requires that student demonstrates potential for change and readiness for acquiring new skills –Typically, more appropriate for younger children

21. Implications for OTs/PTs Treatment Options: 2. Compensation of task and environment –e.g. wheelchair, slant board, specialized seating –Includes activities and materials incorporated into classroom/school routine that are implemented in collaboration with teacher, paraprofessional or other school staff –Pros: Immediate independence (or decreased dependence on others) Improved self-esteem Less pull-out from peers & class activity Less direct one-on-one time

22. Implications for OTs/PTs Treatment Options: 3. Teaching student and parent/guardian how to seek assistance (self-advocacy skills) –Ability to identify person(s) that can assist –Ability to explain how the person can assist –Students with more severe disabilities would require more assistance from parent/guardian to advocate for their needs

23. Implications for the School Community School staff needs to know the concepts of interdependence, capacity & self-determination –Allowing students to participate in the IEP process including setting goals and determining assistance & accommodations needed. –Teaching student self-advocacy skills instead of providing students with assistance before they even ask for it Teaching “how to fish” vs. “giving the fish” –Allowing student to perform to his/her optimal level; then, if needed, assist the student to augment his/her effort.

24. Implications for the School Community Encourage student participation and leadership roles in class, school and after-school activities and in IEP meetings PT services may be provided via different methods including: –integration of sessions into actual class/school activities –collaborative consultation with teachers and other school staff –participation in transition planning as needed

25. Implication for Parents Child should be provided with opportunities to develop self-determination: –Participate in community clubs, activity groups –Allow children to make choices and decisions; and to learn consequences from these choices and decisions –Chores reinforce the notion of interdependence (e.g. family members help each other). Have children choose a task they can help in –Allowing child to perform to his/her optimal level; then, if needed, assist the child to augment his/her effort. Encourage child to advocate for self.