Orientation for ODP Service Providers - Amazon S3 › palms-awss3...2018/09/18 · Orientation for...

Orientation for ODP Service Providers Person-Centered Practices: Webcast #3

Music only.

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This webcast includes spoken narration.

To adjust the volume, use the controls at the bottom of the screen. While viewing this webcast, there is a pause and reverse button that can be used throughout the presentation.

The written version of the narration appears to the right of the screen.

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Certificates of Achievement will be available to all staff of Direct Care Provider Agencies and Supports Coordination Organizations after completing all course requirements.

Please view and then save or print your certificate in order to receive credit for this course.

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Hello, my name is Frank Schweigert from The Columbus Organization. This is the third webcast in a course of six webcasts developed on the topic of Person‐Centered Practices for all newly hired service provider staff including managers, supervisors, Direct Support Professionals, Supports Coordinators, buildings and ground staff, and administrative support staff.

This training content is offered by the Office of Developmental Programs to meet the General Orientation training requirements specific to the topic areas identified in the 55 PA Code 6100 Regulations.

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In this webcast we will focus on recognizing and supporting the different ways people communicate their thoughts and feelings and the importance of understanding how they communicate with both words and behavior. We will also discuss the important steps that can be taken to acknowledge a person’s attempts to communicate, even when they are not easily understood.

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Think about a time when you came home with some very happy news. A good friend got engaged or announced her pregnancy. You got the job assignment or a promotion you were hoping for. Or maybe you won $100 on a scratch‐off lottery ticket or got to eat lunch at a favorite restaurant.

You didn’t say one word but your housemate, spouse, child, or parent said, “Did something good happen today?” How did they know without any words passing between you, that you were happy? In addition to a smile or a laugh, go beyond the obvious and identify something unique that you did to show your happiness. In other words, when you did THIS, it meant you were happy.

Write down your responses in the text box. When you are ready, click the submit button to continue.

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Your example shows us that communication can be sent and received (expressed and understood) without words. In fact, that is more often what happens.

Research tells us that only seven percent of communication is expressed using words.

Thirty‐eight percent of our communication is expressed through our tone of voice, rate of speech, and use of pauses. This is also referred to as para‐verbal communication. It’s not the actual words we use but how we say those words.

Fifty‐five percent of our communication is expressed non‐verbally though our facial expressions, gestures, posture, and sounds that are not words.

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Let me give you an example of the use of verbal, para‐verbal, and non‐verbal communication.

A teenager comes home from high school and you ask ‐ “How are you?”

These teenagers say – “I’m fine.”

And these teenagers say – “I’m fine.”

And this guy doesn’t answer.

Who do you believe and why?

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To fully understand what people are communicating we need to not just listen to the words, but also how the words are said and how the actions match or don’t match those words.

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If all of us communicate with words and actions, then let’s think about how and why this is important for people with developmental disabilities.

Some people with disabilities that you know probably communicate using words. Some people may use sign language or assistive technology to help them communicate. Other people may have few or limited words and phrases that they use in their communication. When you don’t have words, your actions are the only way to communicate how you feel and what you need.

For those people that do not use words to communicate, it is critically important to understand the way they express themselves through their actions.

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People tell us what they want, what they don’t want, and what is important to them with both their words and actions. But sometimes what they may say and what they may do doesn't match up.

For example: I can say that I love riding my bike, but every time I have an opportunity to go for a bike ride, I find a reason not to go. My words and actions don’t match.

If you wanted to find out why my words and actions didn’t match, what would you do? You might find out the reasons by asking me questions that would explain the mismatch between my words and actions. This could shed light on what is really important to me: it isn’t really about bike riding at all but maybe I love to tinker with my bike in the garage or that the seat on my bike is uncomfortable.

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Has there been a time where your words didn’t match your behavior? Have you said you were fine even when you had a bad day? Have you said you liked doing something when you really wanted to do something else?

What are some reasons that your words and your actions don’t always match?

Write down your responses in the text box. When you are ready, click the submit button to continue.

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What you communicate and how you communicate is based on the relationships you have with the people in your life. How well do they know you? How much do you trust them to listen, to hear, and to act on what they hear? Think about the reasons you wrote down on the previous slide. Were any of the reasons related to your relationship with the person you were communicating with?

Think about a time when you first met someone. Maybe it was someone you wanted to date. Maybe it was someone you thought might become a new friend. Maybe it was a co‐worker. During that time when you were just getting to know each other, did your words always match your feelings? Or maybe did you agree to go to a restaurant or event that wasn’t a particular favorite of yours because you wanted the person to like you?

Some time later, when you both got to know each other better and some trust was built in the relationship, would you be more likely to suggest something more to your liking or just say no thanks? Your willingness to match your words with your feelings is because of the trust that has been built in your relationship.

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Trust is also built through your experiences with the person over time. Experiences where they really listened to you and you listened to them. Where you got to know each other and responded to each other’s needs and preferences.

For many people with developmental disabilities, their life experiences may include having had people in their lives that didn’t listen to what their words or actions said. Maybe one or more of the people supporting him or her didn’t always respond to their needs and preferences in the way they would have preferred. Maybe the person had experienced trauma because their words or actions were not listened to or as a result of abuse or neglect. As a result of these past experiences, the person may not trust that what they say now will be respected. Without trust and respect, words and actions may continue to be different until that trust is built.

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There can also be times where medical or psychological conditions can cause our words and behaviors to not match.

Think of someone you know that in the past has really enjoyed going to concerts or to an amusement park with you and their words and actions both support that. Now imagine that you have an extra ticket to the amusement park and offer the ticket to that same friend and she simply says no thanks. Her words don’t match her actions. Does that mean that she no longer likes going to amusement parks? Maybe. Or maybe there is another reason.

Maybe she is just getting over the flu and is not up to all the walking and excitement. Maybe she is struggling with some sadness after the loss of a close relative who used to take her to the amusement park and she is not quite ready to go back.

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Understanding a person’s communication (both with words and actions) will guide us in developing person‐centered supports. We will be able to provide supports that promote the things that give value and meaning to their life, and match it with supports that can help keep the person healthy and safe.

Through our experiences in understanding behavior as a form of communication and building trust, we can recognize how the person tells us they want to be supported so that the person is in control.

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Knowing how a person communicates pain, discomfort, and distress is extremely important. This is true for everyone, but especially true for a person who does not use words. Here’s a very shortened story about a woman named Cheron that will help explain why.

Cheron is a very easy‐going person who suddenly started to bite her hand. She does not use words to communicate. When this started to happen, the staff that support her tried to figure it out; but everyone was stumped. Because she was hurting herself, a doctor prescribed a medication to help her to calm down, but it didn’t work. As a matter of fact, a few days later Cheron was biting herself more often. Finally, someone suggested – maybe she’s in pain. Maybe something is hurting her. Thankfully, the staff jumped right on that idea and soon found out she had an abscessed tooth. The tooth was removed and she was fine and back to her old self almost immediately and she no longer needed the calming medication.

Everyone understanding how Cheron communicates pain is key to making sure that those who support her now and in the future will know at least one of the behaviors she may use to communicate when she is in distress or discomfort.

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Sometimes what the person communicates with their words and actions can be very clear. But at other times, due to lack of trust or difficulty understanding what the person is communicating with behavior (like Cheron), we need to do that detective work to figure out what is being communicated.

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One way to organize what we learn about how a person communicates is to think about it in four steps.

* What are the words or actions of the person? (What is the person saying or doing?)

* What do I think it means? What do I think they are trying to say?

* What is happening around the person or to the person that might contribute to their action? And then…

* How should I respond to what the person is communicating?

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Let’s talk about the second question for a moment. “What do I think it means?”

There may be times when the meaning of a behavior is not easily understood. Initially we may have to use what we and others already know about the person and their actions to make a best guess as to the meaning of the behavior. We can then test our response based on that guess and see if it is helpful to the person. This is referred to as “Respectful Guessing.”

If our guess is right and our actions are helpful, the person will know you have listened and you are building trust.

If our guess is wrong or our response is not helpful, we have still learned something and the person will see you are trying to understand them and trust can still be built.

So let’s see how this works for Rhonda.

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People who know Rhonda describe her as: * Loving * Adaptable * Patient and tolerant * A good listener * Knows what she wants and * Outspoken

Rhonda does not communicate with words, but because the people who support her know many of her non‐verbal communications, she is able to communicate more effectively and they are able to more effectively support her.

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This is part of a chart her staff use to document some of what they have learned about how Rhonda communicates. Depending on your role, you may see something similar for the people you or your agency supports.

Let’s look at the first row. Rhonda’s supporters noticed that at times she would lock the wheels of her wheelchair. Their guess was that she did not want to go wherever her staff were taking her, and they should try to figure out why she doesn’t want to go there and where she would prefer to go. When we understand what Rhonda is communicating through her behavior, she feels heard and is happier, the people supporting Rhonda are happier, and trust is built.

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Let’s look at a couple more rows. When Rhonda has stopped eating, she will look at you and pull down her napkin. The people supporting her have learned that when she looks at you and pulls down her napkin she is saying she’s done with the meal and ready for you to help her take care of her dishes and any leftovers. If Rhonda is listened to, and her communication is understood, all is good. But…

If you don’t recognize or respond to her communication, she’ll take care of it herself, in a way that should encourage you to listen and respond better the next time.

Everyone benefits from listening and responding to what Rhonda is telling us. Rhonda’s quality of life is enhanced and our relationship with her is strengthened when we understand and respond to what she is telling us. That is what Rhonda is communicating in the second row of this chart.

Using a Communication Chart like this has an important second benefit for Rhonda and all new staff like you. Recording and understanding behavior helps us to make sure that when there are changes in caregivers, this information is not lost and what has already been learned can be shared with any new caregivers.

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So you might be saying to yourself “I’m new. I don’t know anyone yet to have built trusting relationships. I don’t know if their words will match their actions or if they use words at all. So how should I talk to them?”

Maybe in your job you won’t be providing direct support but you will see people your agency supports in the hall or the breakroom, or in the office and you may have the opportunity to talk to them.

That’s OK. You are new to the person as well. They don’t know you either. They don’t know how you communicate or if you will understand them.

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When you get down to the basics, it is no different than what you might say or do for someone without a disability.

If Sabrina tries to say something to you, but you don’t quite understand her, you look for those non‐verbal cues that may help you to understand her. Don’t be afraid to say you didn’t understand what she said. Sabrina probably knows people sometimes have a hard time understanding her. She will appreciate your efforts to understand her and she may try again or she may find someone who can help you to understand her.

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The risk for a person with a developmental disability who does not communicate with words or whose speech is difficult to understand is that you may think that they have nothing important to say or to contribute. The best thing you can do, even when you may not initially know how the person communicates or understand their communication style, is to recognize and value their efforts to communicate with you.

Just like you, people with developmental disabilities want to be recognized and appreciated by the people in their life. Just like you, they want to make connections and develop relationships based on understanding, respect, and trust.

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When you see Janice in the hall or in the office, recognize her presence. Say Hi!

When you enter the building with Maggie, appreciate her sense of style and compliment her on her outfit.

When Garrett comes into the breakroom, acknowledge his wave and wave back.

If Albert requests something that you are not able to help him with, respect the request and his need to be heard. Help him to find someone that can help him.

These simple actions demonstrate that you respect the person and their attempt to communicate with you. These are the first critical steps in building trust and understanding.

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And lastly, understanding how a person communicates is not about changing the individual.

It’s about listening to what the person says with words and without words and respecting what they say.

Understanding communication is about learning from the person and those who know the person, so that we can listen and respond respectfully and effectively.

When we know what the person is telling us and how to respond, the work of the people providing support is more helpful and appreciated. When we understand what a person is communicating, they will feel understood, respected, and valued.

Understanding communication makes for a better day for everyone.

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This concludes the third webcast on Orientation to ODP Service Providers: Person‐Centered Practices. Please be sure to watch all six webcasts and complete all course requirements in order to obtain your Certificate of Achievement and training credit.

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This webcast has been developed and produced by the Pennsylvania Department of Human Services, Office of Developmental Programs in partnership with The Columbus Organization.

Thank you for participating in this lesson.

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Orientation for ODP Service Providers - Amazon S3 › palms-awss3...2018/09/18 · Orientation for...

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