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Supporting Adults with ASD in the Workplace Using Positive Behavior
Support
How to Put the Pieces to the Puzzle Together
Presented by: Emily Helmboldt, LPC, Virginia Department of Behavioral Health and
Developmental Services
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Our Session’s Agenda:I. Housekeeping-Cells on vibe,
breaks, etcII. A little about meIII. A LOT about ya’llIV. Autism Disorder primerV. Intro to VCU Career LinksVI. Positive Behavior Supports in the
workplace
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“If you’ve met 1 person with Autism…
You’ve met 1 person with Autism”
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A Snapshot of Autism Spectrum Disorder
A Neurobiological Disorder-
-prenatal brain dysfunctionneural pathwayschemical structure/balancesuneven growth patterns
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Causes of ASD??
Complex, much is unknown
Genetic components (several genes involved)Physiological components (gastointestinal disorders, sensory)Environmental components (teratagens)Note: NO factors in the psychological environment cause ASD!
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It’s time to play…
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RulesTake out sheet of paper- Take out penTake 1 minute to notice all the types of stimuli you are aware ofWrite down a list of what you sensed
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Areas of focus-
Severe delays in language development Severe delays in understanding social relationships Inconsistent Patterns of sensory responses Uneven patterns of intellectual functioning Marked restriction of activity and interests.
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To Do List:
Learn normal patterns of speechLearn to communicateLearn how to relate to people, objects & events
“Similar to persons who have had a stroke”
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Priority
communication and socialization
communication and socialization
communication and socialization !!
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Behavioral SymptomsSocial Interaction• Non-verbal social
communication• Peer Relationships• Social Reciprocity
Patterns of Behavior• Activities• Interests• Rituals
Communication• Ability to
Speak• Symbolic
Language• Pragmatic
Communication
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Secondary Characteristics
Behavior Challenges and Mental Health
Diagnoses Sensory Sensitivities
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“That’s a lot of negatives…Where’s the light at the end of
the tunnel?”
Loyal employeesA lot of Persons w/ASD like repetitionAttentive to detailOrganizedBenefit from the SAME positive outcomes from employment that you and I benefit from…
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ASD Career Links
Purpose of the study:Conduct evidence-based research on vocational rehabilitation service models for individuals with Autism Spectrum DisordersExamine the impact of intensive community-based work experiences on the employment outcomes of young adults with ASD
Project Search
Randomized Controlled Trial
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ASD Career LinksNational Institute on Disability and Rehabilitation Research (NIDRR) VCU – Rehabilitation Research & Training CenterResearch related to Vocational Rehabilitation Models for Individuals with ASDPartners:
Virginia Department of Rehabilitative Services (DRS)Henrico County Public SchoolsThe Faison School for AutismBon Secours Richmond Health SystemCincinnati Children’s Hospital
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Credit goes to…Dr. Carol Schall, VARC, Va Commonwealth UniversityJennifer McDonough, RRTC/VCUDr. Paul Wehman, RRTC/VCURichard Kriner, Dept of Rehab Services
** Erin Reihle, Project SEARCHFor more information about Project SEARCH at Cincinnati Children's, please contact [email protected] or call 513-636-2516.
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Project SearchSenior year transition programIn large business – microcosm community
HospitalLarge bank centerGovernment center
Classroom time, 1 hour in am, 45 minutes in pmRest of day – internships in business
3 rotations across year, ~10 wks each
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Business Model
Single point contracts and contactsInterns, not volunteersCreate need in businessTalk about potential employment at every evaluationWork on match between intern and internship
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Collaboration
Rehabilitative Services – Provides job coachingSchool – Provides teacher and instructional assistantFamily – Provides information and receives support during transitionUniversity – Provides consultation in best practice and behavior support
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Schall, C. M. (2010). Positive behavior support: Supporting adults with autism spectrum disorders in
the workplace. Journal of Vocational Rehabilitation, 32.
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Challenges of PBS at Work
Visible and public contextSupports are co-workers and supervisorPressure to performFewer trained staffLack of access to PBS servicesContextual fit
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The PBS Process
FBAPerson Centered PlanningIndirect Assessment
Identify and Define the BehaviorInterview TeamReview History
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The PBS Process
Direct AssessmentObserve in Environment where Behavior Occur and Do not Occur
Hypothesis DevelopmentWhen (Antecedent)Intern will (behavior)In Order to (function)
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The Competing Behavior Model
Antecedent
Problem Behavior
Function of Behavior Achieved
Replacement Behavior
Function of Behavior Achieved
Desired Behavior
Enhanced and Natural
Reinforcement
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Example:Intern touches women while talking to them, either on shoulders or tries to hug them.List problem behavior?List replacement behavior?List desired behavior?
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Behavior InterventionPrevent Behavior • Alter the antecedents to prevent the problem
behavior from occurring
Teach• Teach replacement behaviors that serve the same
function as the problem behavior
Respond• Respond differently to the problem behavior by
removing the reinforcer and reinforce the replacement behavior
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From Student to Employee…Andrew: Goals:• Increase Independence :Computer, Agenda, Schedule• Writing: draft a letter, subject-verb agreement, vocabulary and sentence
development• Reading Comprehension: use of best words, comprehension to 4 th grade
level, understand simple sentences• Message Delivery: remember a verbal message and relay it with
accuracy (without getting distracted)• Phone Calls: Introduce himself, state purpose of the call, ask a question
Fred: Goals:• Practical Math: visual recognition and identification of
fractions, counting mixed money• Functional Reading: identify information presented in real-life
materials• Vocational Skills: sorting, matching, work speed, following a
task list to completion
Environment: School, CBI, community based employment sites (7 hours per week)
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AndrewAutism
Communication challengesSocial interaction patternsPatterns of behaviorSensory sensitivities
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Andrew: Materials ManagementDuties:
Use computer board & wandCount the white labeled items Pull materials from the stockroomLoad his cartDeliver stock to assigned departments
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Andrew’s FBA
Identify and Define Behavior Challenges
DartingPushing through peopleLaying on ground (in parking lot)
Interview previous school teamChanges in routine
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Andrew’s FBA
Observe behavior using ABC recording
Rushed through transition from computer or other desired activity to an unexpected activityForgetting important items at home
Employee orientation pinAcademy Awards Book
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Andrew’s FBA
Develop HypothesisWhen Andrew forgets items that are important to him, he will pace flapping his hands, dart away from his area, plop on the ground and refuse to move in order to express his distress and anxietyWhen Andrew is rushed to change activities from a desired activity to a less desired activity he will pace, flap, and dart in order to escape being rushed and transitioningWhen corrected, Andrew will pace and walk away in order to avoid correction
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Andrew’s PBS Plan
PreventWork on match between job and Andrew’s strengthsDesign visual supports to assist Andrew in understanding schedule for the day-iTouchProvide warnings before transitionsHave double sets of important objects
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Andrew’s PBS Plan
TeachTeach accepting correction
RespondTrain co-workers and supervisor about Andrew’s disability
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Andrew: Central Sterilization
Identify instruments using scannerPrint labels and place on packsPackage instruments in correct packs Peel packaging instruments in heat sealers
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Adam“High Functioning” Autism
Requires structured work dayWorks best with guysA few behavior challenges related to social interaction errorsSensory Issues
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Adam: Radiology
Duties:Clean & sterilize X-ray cassettesStock patient areas with linensTravel to Radiology, ER, and Outpatient Units to complete these duties
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Adam’s FBA
Identify and Define Behavior Challenges
Touching OthersRubbing Others
Interview previous school teamHe likes to hug and rub shoulders, it’s so sweet!
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Adam’s FBA
Observe behavior using ABC recording
When in close proximity to preferred female staffWhen attempting to interact with others and ‘at a loss for words’
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Adam’s FBA
Develop HypothesisWhen Adam is in close proximity to preferred female staff, Adam will rub their shoulders and offer to rub their feet, in order to gain positive attention and sensory feedbackWhen Adam wants to maintain interaction with others, but has run out of things to say, he will put his hands on his co-workers shoulder in order to maintain contact
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Adam’s PBS Plan
PreventWork on match between job and Adam’s desire for positive interaction
TeachTeach Adam to ‘be professional’
Hands to selfNo touching or rubbing others
Teach communication starters
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Adam’s PBS Plan
RespondTeach co-workers and supervisor about Adam’s disabilityTeach co-workers to say “be professional”
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Adam: Engineering
Team assignmentsAssist with repairs/maintenance across campus
Remove pipesAssemble equipment
Identify and change light bulbsChange ceiling tilesClean air vents
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Adam – Infection Control
Clean, restock, and collect ‘not needed items’ from isolation carts on every floor of the hospital
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ASD Supports At Work
Match – Capitalize on StrengthsCommunication Supports
Direct, Clear, Concise, Written
Social Skills InstructionSocial Skills Important in that EnvironmentLook out for work place bullies
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ASD Supports At Work
Environmental Design and Supports
Build routineDevelop distraction limited work stationProvide visual cues and information
Behavior ChallengesSort through the details to try to get the person’s perspectivePrevent the problemTeach new skillsSelf Management
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For more information…http://www.vcu-autism.org/
PBS info: www.apbs.org www.AAIDD.org
