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ICF/MR FOCUSED TRAINING
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ICF/MR FOCUSED TRAINING
Henry
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ICF/MR FOCUSED TRAINING
MAJOR MOVEMENT DISORDERS
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ICF/MR FOCUSED TRAINING
BAD REPUTATIONS
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ICF/MR FOCUSED TRAINING
CREATIVE COMMUNICATION STYLES
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ICF/MR FOCUSED TRAINING
MEDICALLY FRAGILE
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TRADITIONAL PERSPECTIVES
This person is disabledThe disability is a problemThis problem needs to be fixedSpecial people are needed to fix it It can only be fixed in special places It needs to go to one of those special places
to be fixed It can only come back when it is fixed
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FORM VS. FUNCTION
Function = the purpose of the behavior, service, objective, etc.
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FORM VS. FUNCTION
Form = the way we do it
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ICF/MR FOCUSED TRAINING
“The most critical deficiency in typical assessment is the emphasis on teaching skills of a specific form
rather than focusing on training relevant behavior.”
(Campbell and Bricker)
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MORE HELPFUL ASSUMPTIONS
Autonomy and Independences Individuality Love and Acceptance Stability and Continuity Continuous Growth and Learning Community Status Protection of Rights and Personal Interests
ALL PEOPLE SHARE THE SAME BASIC NEEDS:
People with disabilities do not have qualitatively different needs.
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ICF/MR FOCUSED TRAINING
“The description of the disability is relevant only to the extent that the condition complicates the fulfillment of the above-mentioned needs. What people with disabilities do not have in common is the independent ability and means to create conditions, situations and experiences to meet all of their basic needs.”
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FOCUSING ON WHAT THE PERSON CANNOT DO
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ICF/MR FOCUSED TRAINING
Assuming Unlimited Time For Learning
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ICF/MR FOCUSED TRAINING
Eradicating Functional Behavior (Functional Communication)
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ICF/MR FOCUSED TRAINING
Too sick Too retarded
Labeling the person as Incapable of Change, e.g.
Too crazy Too worthless
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CRITICAL DIMENSION OF ASSESSMENT
Underlying functions critical to performance of more complex forms of behavior
Useful in analyzing obstacles to development
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ICF/MR FOCUSED TRAINING
Thriving
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ICF/MR FOCUSED TRAINING
Motor Quantitave—how much does the
person move?
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ICF/MR FOCUSED TRAINING
Motor Qualitative—How well does the
person move?
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ICF/MR FOCUSED TRAINING
Oral Motor Function
Eating
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ICF/MR FOCUSED TRAINING
Oral Motor Function
Vocalizing
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ICF/MR FOCUSED TRAINING
MobilityHow does person get
from one place to
another?
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ICF/MR FOCUSED TRAINING
Sensory Status
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ICF/MR FOCUSED TRAINING
Visual Status
What can this guy see?
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ICF/MR FOCUSED TRAINING
Auditory Status
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ICF/MR FOCUSED TRAINING
Muscle tone & movement affect smell & taste
Taste requires smell Open mouth affects
both
Smell/Taste
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ICF/MR FOCUSED TRAINING
Joint sense Place in space Righting reactions Movement causes
pain
Tactile/Proprioceptive
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ICF/MR FOCUSED TRAINING
How the person uses hands Hand development takes many months Sensory preparation
Manipulative
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ICF/MR FOCUSED TRAINING
Response to possible enforcers
Consequence Preference
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ICF/MR FOCUSED TRAINING
Primary circular reactive Object permanence
Use of Objects
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ICF/MR FOCUSED TRAINING
Willingness to cooperate
Creative communication used so you will “buzz off”
Compliance
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ICF/MR FOCUSED TRAINING
Knowing things continue to exist Indicates “readiness” for symbols
Object Permanence
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ICF/MR FOCUSED TRAINING
Seeking interaction with others Range of behaviors used to control social
environment
Social Responsiveness
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ICF/MR FOCUSED TRAINING
Imitates movement sequence modeled by others
Motor Imitation
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ICF/MR FOCUSED TRAINING
Imitates sounds or parts ofsounds initiated by others
Vocal Imitation
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Top Ten Approaches for Functional Assessment
1. Discover the Person
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Top Ten Approaches for Functional Assessment
2. Evaluate from more than one point of view.
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Top Ten Approaches for Functional Assessment
3. Are skills present in different places (Grandma’s Law).
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Top Ten Approaches for Functional Assessment
4. What supports are needed to do valued things?
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Top Ten Approaches for Functional Assessment
5. Make sure they don’t already have it.
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Top Ten Approaches for Functional Assessment
6. Identify splinter skills and fill in the blanks.
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Top Ten Approaches for Functional Assessment
7. Discover how (not if) the person controls environment.
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Top Ten Approaches for Functional Assessment
8. Identify developmental obstacles.
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Top Ten Approaches for Functional Assessment
9. Find the passionate relationship in the person’s life.
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Top Ten Approaches for Functional Assessment
10. Ask: If the person can’t do it, will we have to hire someone todo it for him/her?
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Basic Guides for Helping
1. Pass the Dead Person’s Test, e.g. “If a dead person can do it, it’s not an objective!” e.g. tolerating side lying.
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Basic Guides for Helping
2. Real Life, e.g. What would an able-bodied person of the same age and sex be doing?
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Basic Guides for Helping
3. Pay attention to the antecedents in the A-B-C (antecedent-behavior-consequence).
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Basic Guides for Helping
4. Demystify Clinical Skills-a person who implements clinical interventions must be directly trained, and supervised. And clinician must be accessible for change.
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Basic Guides for Helping
5. Make everyday activities therapeutic rather than doses of treatment, e.g. 15 seconds X 10 X per day.
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Basic Guides for Helping
6. If immediate results not apparent, problem is probably with the program and not the person.
“It’s difficult to give a person a choice of what she wants for breakfast if the
only word she knows is eggs!”
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Activity: Some of JJ’s Goals @ 40
1. Given a well aligned left sidelying position JJ ill breathe deeply for 60-90 seconds X 4 times per day.
2. JJ will eat a full meal in 30 minutes or less using active lip closure to pull food from a spoon.
3. JJ will consume 240 cc of thickened fluid X 5 times per day in 30 minutes or less using an independent consecutive swallow.
4. JJ will indicate choices of food, clothing, activities using a yes/no response 5 X/day.
5. JJ will participate in 2 off site activities of his choice per week.
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Activity: Some of JJ’s Goals @ 60
1. JJ will use a motorized chair to participate in a senior program.
2. JJ will use an augmentative communication device to participate in recreation programs at the senior center.
3. JJ will make personal functional choices during 3 community outings per week—(e.g. food, brands of personal products.
4. JJ will choose from a range of menu items for 3 meals a day.
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Activity: Goals for JJ
Using JJ’s goals @ 40, determine when, where, and how you might implement each goal.
Using each of JJ’s goals @ 60, write objectives and/or strategies for either a money management program, or a self-administration of drugs program.