setting transition goals for students with significant disabilities

SETTING TRANSITION GOALS FOR STUDENTS WITH SIGNIFICANT DISABILITIES

April 27, 2011Transition Center at West Bay

Warwick, Rhode Island

John KregelVirginia Commonwealth University

My Background

Teacher in the first classroom for students with Severe Disabilities in Lawrence Kansas

Eight years classroom teaching experience for students with severe disabilities

Professor in VCU’s intellectual and development disabilities programs teaching transition and behavior management

Research Director at VCU-RRTC since 1984

What are your expectations for this morning’s discussion?

Our Learning Objectives

1. 1. Carefully review the expectations we have for our students.

2. 2. Reflect on our current curriculum decisions based on our experiences and expectations.

3. 3. Examine our formal transition planning process

4. 4. Share current approaches to teaching functional skills and making employment a reality for our students

What are our expectations for our students?

Health and SafetyIndependence and Self EsteemResidentialEducationEmployment Financial literacyCommunity ParticipationSocial Relationships

Health and Safety

1. Our expectations for our students include:

1. Life Expectancy2. Treatment for Chronic Conditions3. Access to Health Care4. Need for Assistive Technology5. What Else?

Independence and Self-Esteem

1. Our expectations for our students include:

1. Family Member2. Friend3. Neighbor4. Helper5. Member6. What Else?

Residential

1. Our expectations for our students include:

1. Avoiding medically based congregate care facilities

2. Living with families or relatives3. Stability of living arrangements4. Access to necessary supports

Education

1. Our expectations for our students include:

1. Dual Enrollment Models2. Supported Education Models3. When are these models

appropriate?

DUAL ENROLLMENT

Mixed/Hybrid Model

Students involved in social activities and/or academic classes with students without disabilities (for audit or credit)Participate in classes with other students with disabilities—such classes as life skills or transition programsEmployment experiences are offered both on and off campus (Hart et al 2005)

Hart et al., 2006

Substantially Separate

Students are on campus, but are in classes only with other students with disabilities Access to socializing with students without disabilities is part of the model

Employment experiences typically in pre-established employment settings on and off campus

Hart et al., 2006

Inclusive Individual Support Model

Students receive individualized services—educational coach, tutor, technology-in college classes, certificate programs and/or degree programs (for credit or audit) Not program based: courses are selected on students’ career goals and employment experiences (internships, apprenticeships, work-based learning) Interagency team w/student and family identify range of services and share costs Hart et al., 2006

Higher Education Opportunity Act (PL 110-315)

Enacted in 2008 Has provisions to improve access to

postsecondary ed for students with ID Language in legislation covers:

-Financial aid provisions -Creation of model demonstration program -Creation of coordinating center

George Mason University’sLIFE Program: Started in 2000

Provides inclusive university experience to further literacy skills and prepare for employment and independent living

Students commute or live on campus; Two-thirds attending LIFE Program are on campus

Receive certificate upon completion (4 yr program) Program developed for students with intellectual and

developmental disabilities

SUPPORTED EDUCATION

VCU ACE IT in COLLEGE

5 yr demo grant through US Dept of Education

Provides college education for students with intellectual disabilities (18-26 yrs)

21 credit, 30 month certificate program through School of Education

“Program of one” with inclusive core courses, electives and work experience

KATIE

Learns through discussion and small group activities in UNIV 101 class (i.e. volunteered to write group responses on the board for class)

With initial prompts from education coach, expresses thoughts and ideas about class readings (i.e. Book: Letters to a Young Teacher)

Expands her experiences through prompts from coach (i.e. participates in service learning, reads a story to children at her job in the university child development center).

Explores Google docs to get comments from education coach on assignments

Employment

1. Our expectations for our students include:

1. Competitive Employment First2. Employment Retention3. Employment Satisfaction4. Access to Employment Supports

Financial Literacy

1. Our expectations for our students include:

1. Money of my own2. Purchasing3. Saving4. Banking5. Financial Education6. Credit

TRANSITION ACTIVITIES LEADING TO FINANCIAL STABILITY

Individuals with disabilities often have very limited income and few, if any, assets.

As of March 2011, 13.4 million individuals were receiving disability benefits. Of those:

• 7.5 million received Title II benefits only, • 4.4 million received Supplemental

Security Income (SSI) only, and • 1.5 million received both SSI and Title II

benefits (SSA, March 31, 2011).

People with disabilities are considerably more likely to experience poverty relative to those without disabilities:

Poverty Status among SSA Beneficiaries 18-64

Type of Benefit Percentage in Poverty

Number in Poverty

SSI 72% 3,175,000

SSDI 31% 2,825,000

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Current Federal Poverty Level

Federal Poverty Level (family of 1)$10,890

Two Times Federal Poverty Level

$21,780 Federal Poverty Level (family of 4)

$22,350

SSI and SSDI Benefits

The average SSI benefit of $533/month (January 2012) is only 59% of the federal poverty level for a family of one.

The average monthly SSDI payment is $1070 (2011) – only 118% of the federal poverty level for a family of one.

Material Hardship Indicators

Hardship with respect to consumption of material items necessary to meet basic needs

• Unable to meet expenses Unable to pay rent or mortgage Unable to pay utility bills Unable to get needed medical care Unable to get needed dental care Food insecurity (with or without hunger)

Hardship Prevalence Age 25-61Income Below the Poverty Level

HardshipIndicator

No Work Limitation

Work Limitation

Didn’t Get Medical Care 12% 21%Food Insecurity with Hunger 8% 20%Any of Six Hardships 45% 62%

50% of Individuals with Disabilities are “Unbanked”

Individuals who are unbanked have no access to financial services (services that include savings, credit, money transfer, insurance, or pensions) through any type of financial sector agency such as banks, non-bank financial institutions, financial cooperatives and credit unions, finance companies.

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Defining Financial Stability

A concept that reflects each person’s employment and economic independence goals and takes into account his or her unique life circumstances and family situation. Financial stability encompasses:

An individual’s income and wealth in relation to his or her financial expenses, responsibilities, and desires;

An individual’s ability to manage his or her finances, and access the information and supports needed to make sound financial decisions and long-term financial plans; and

An individual’s ability to avoid lifelong poverty and dependence on disability benefits.

Community Participation

1. Our expectations for our students include:

1. Consumer2. Citizen3. Volunteer4. How do I get there?

Social Relationships

1. Our expectations for our students include:

1. Building friendships with individuals who are not caregivers

2. Residential stability to allow individuals to maintain friendships

Employment

Post 21 Transition:

What Do We Want?

Post 21 Transition:

What We Don’t Want…

Promising Practices and Service Delivery Models

with Businesses

Walgreens

Program Design

15 Distribution Centers Two new ones are in Anderson, S.C. ( 700

employees) and Windsor Conn. (300 employees)

Individuals with disabilities work at same productivity rate, receive same pay, and work side by side with other workers Commitment to hire at least 10% of

employees with disabilities in distributions center

Walmart

ARC of US & Walmart Foundation: School to Community Transition Project

ARC received 3year, 3 million dollar grant

Purpose of funding to identify & fund innovative & best practices in school-to-community transition services

Grants funded nationwide

Marriott: The Bridges Program

Bank of America

Bank of America- Card Center, Wilmington DE.

Has long history of employing individuals with cognitive disabilities

Has hired over 300 individuals with disabilities in Wilmington, DE and Bangor, ME

Bon Secours

Supported by NIDRR, US Dept of Education

V.C.U. Project Search Replication

Key Concepts Collaboration with business,

education, rehabilitation (VR) & DD Braided funding Immersion & impact Training in real work settings Low risk, low cost for business Hiring students who are “good fit” Goal of employment

School Day: Business Based

8:00 Employability Skills

9:00 Worksites11:30 Lunch 12:15 Worksites2:00 Review, Plan,

Journaling2:30 Depart

P.J. Coronary Unit

P.J.: Coronary Care Unit Duties

• Stock drawers & cabinets in patient rooms• Take out laundry baskets• Prepare rooms for next patient• Remove needle boxes when they are full• Make flow charts for each patient• Stock lab trays• Check refrigerator temperatures

Dan: Dietary & Nutrition

Dan: Dietary & Nutrition Duties

• Refill soda syrup• Break down boxes• Stock water bottles & soda• Wipe down tables• Take trash to dumpster

J.K.: Radiology

JK: Radiology Duties

• Clean & sterilize X-ray cassettes• Stock patient areas with linens• Travel to Radiology, ER, &

Outpatient Units to complete these duties

Alice: Pediatrics

Alice: Pediatrics Duties

• Make new patient packets • Stock supplies • Clean toys • Play with children• Deliver blankets, books & toys• Make name signs for patient doors

& printing pages to color• Help children with crafts

Kalyn

Ambulatory Surgery

Kalyn: Ambulatory Surgery Duties• Remove instruments from clean

baskets• Sort items• Identify instruments & place correct

items on tray

Internships

Employee Wellness Scanning employee’s documents

into the computer system Assembling masks for employees Filing

Supports Incredible 5 point scale card for

noise 5 minute scheduled break in

morning and afternoon Visual cue cards:

“what to do with your hands at work”

“I’m feeling sleepy” “I’m feeling sad I should…” “I need a break”

InternshipsDiabetes Treatment Center

Creating invitations/mailings for “Sugar Fest”

Data entry Bulletin Board prep and design for

“Sugar Fest”

Internship Supports 5 minute break “I’m feeling

sleepy” visual cue card

InternshipsGeneral Surgery

Stocking medical supplies, and linen in patient rooms

Refilling water for patients

Removing soiled linen from rooms

Internship Supports Behavior plan with

incentives – reviewed before & after each shift

Supply list with par levels

TRANSITION FROM SCHOOL TO ADULT EMPLOYMENT FOR YOUTH WITH DISABILITIES:WHERE ARE WE IN 2012?

Seamless Transition from School to Adulthood : Is There Such a Thing?

Pervasive Unemployment and Underemployment

Need for Renewed Emphasis on Work

Since 80’s research has shown youth with disabilities who participated in work experiences, especially paid work, while in secondary school are significantly more likely to hold jobs after they exit school than those who do not (regardless of disability, or need for accommodation or support)Hazazi, Gordon and Roe, 1985,Benz, Yovanoff, & Doren, 1997,NLTS 2 2006

Transition and IDEA

Amendments of 1997 IDEA eliminated separation between Individual Transition Plan and IEP"Implicit in this requirement is the national policy.....that publically supported education for students with disabilities should culminate in postschool employment and independent living”

When Will Competitive

Employment Be the First Choice?

Wehman 2012

EFFICACY OF TRANSITION PLANNING:

WHAT DOES THE RESEARCH TELL US?31 studies reviewed involving 859 youthNot enough studies have sufficient methodological design (Cobb and Alwell 2009) Cobb & Alwell, 2009

Findings

•Too little, too late•Lack of active participation by

students/families•Perception of poor post 21

outcomes by families and teachers

Findings from Qualitative Metasynthesis of Transition Planning

Transition more of a promise than reality Uneven transition expertise, low levels of

parent/student involvement Influence of families and extended families on

career choices and job acquisition Restrictive views on post-school outcomes Lack of cognitive clarity and systematic instruction Lack of respect and understanding by some teachers

Source: NSTTAC

Lack of Career GoalsReview 399 IEP’s (16 to 22 yrs) revealed two thirds did not address or provided inadequate detail for mandated transition goal areas Most lacked career planning and indicated disconnect between an individual’s career interests and type of work experiences they participated in

Powers et al., 2005

EFFICACY OF LIFE SKILLS50 studies reviewed involving 482 youth

Alwell & Cobb, 2009

Findings

Strong support for life skills training and

positive transition related outcomes

Importance of Transition

Need to understand how transition relates to a whole life: living, working, and participating

in the community Great challenge when leave school

and face adult service systems and programs

Planning through a transition IEP is essential

Types of Transitions that Lead to a Whole Life

No perfect way to perfect life; are ways to help get there

Family and culture Appetite to grow Plan and supports Many require more supports

than those without disability

MAKING TRANSITION A REALITY

COMMUNITY-BASED TRAINING AND EMPLOYMENT

WHAT skills should be taught in the community?

What should be on the IEP?

Transition IEPs

1. Employment Goal (may include integrated employment and supported employment)

2. Vocational/Technical Training Goal (may include apprenticeship, work-force training)

3. Higher Education Goal

Transition IEPs (continued)

4. Continuing and Adult Education, Career/Technical Education Goal (may include public or private technical school)

5. Residential Goal

Transition IEPs (continued)

6. Transportation/Mobility Goal

7. Financial/Income Needs Goal

8. Self-Determination Goal

9. Social Competence Goal

10. Health/Safety Goal(Transition IEPs Wehman & Wittig, 2009, PRO-ED)

Life Skills Training Works!

(Alwell & Cobb, 2009)

HOW should these skills be taught?

Applied Behavior Analysis (ABA) in a portfolio of skills context

(Wehman, Schall & Smith, 2009)

Discrete Trials vs. Portfolio Based Activity Training

I. Person Centered Planning to Inform IEP Development and Transition Planning

Transition Planning

II. Implementation of Communication, Social Skill, and Self Determination Curriculum and Interventions across the Curriculum

Transition Planning

III. Implementation of Organizational and Academic Supports to Achieve desired Transition Outcomes

Transition Planning

IV. Implementation of Self Monitoring and Behavioral Supports to Mitigate Barriers to Desired Transition Outcomes

Transition Planning

V. Implementation of Family Support to Increase Consistency of Supports Across Home to School

Transition Planning

VI. Implementation of Community Based Career Development Curriculum to Increase Career Planning and Development

Transition Planning

Cutting Edge Transition Issues

Employment Before Exit Policy

(Rusch & Braddock, 2004)(Wehman et al, 2002; 2006b, 2012)

No More Subminimum

Wages!APSE Board Statement, July, 2009

Access to BenefitsSocial Security and Other Benefits

Age 18 RedeterminationStudent Earned Income Exclusion

Section 301

Medicaid/Waiver Eligibility Wehman, 2006a

Functional Curriculum vs

Literacy Based Curriculum

(Wehman and Kregel 2011; Bouck, 2008)

Long Term Support: Who Will Pay?

Long Term Funding: The Bane of Transition

Long Term Funding Policy for Extended Employment and

Independent Living

(see Certo et al., 2008)

Greater Early On Transition Planning with Student, Family and Self-

Determination

Transition Research: What Do We Need to Know?

School Based We need to know the EFFECTS (not relationships)

of different service delivery models on post school employment/education outcomes.

Specifically: Does inclusive education in high school lead to

greater likelihood of successful postsecondary education?

Do functional curriculum/life skills taught in "community immersion" settings lead to successful postsecondary employment?

www.worksupport.comwww.vcu-ntc.org

Virginia Commonwealth University

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