Text of Interdisciplinary, Interagency Collaboration for Transition From Adolescence to Adulthood
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Interdisciplinary, Interagency Collaboration for Transition
From Adolescence to Adulthood
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Panelists Tony Antosh, Ed.D.; Director, Sherlock Center, Rhode
Island College Ilka Riddle, Ph.D; Associate Director, University of
Cincinnati UCEDD Margo Izzo, Ph.D.; Associate Director, Nisonger
Center, Ohio State University Olivia Raynor, Ph.D.; Director.
Tarjan Center, UCLA
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Agenda Introduction, Agenda, Objectives, Issue (Antosh)
Perspectives on Transition Healthcare (Riddle) Youth and Families
(Antosh, videoclips) Education, Employment, Postsecondary (Izzo)
Community Living (Antosh) Strategies for Interagency Collaboration
(Raynor) Small Group Discussion Large Group Discussion Wrap up and
Resources
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Transition Listening Session Sue Swenson Deputy Assistant
Secretary OSERS US Department of Education Tuesday, December 4
3:00-4:15 Gunston East
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Genesis of the Symposium AUCD Board of Directors wanted to
select one issue and use the breadth and depth of the network to
create a national focus on that issue. Interdisciplinary Practice
is one of the foundation concepts of the AUCD network. After
significant discussion, the Board focused on applying the concepts
of interdisciplinary, interagency collaboration to transition
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The Issue Youth with IDD should be able to expect
self-determined transitions with coordinated support from family,
community, professionals, and agencies. But they and their families
often experience very little coordination and collaboration from
the myriad of systems involved in the transition process
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Why Failure to support self-determination as a central element
of the person-centered process of transition
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Why Insufficient understanding of the role of culture in an
individual or familys concept or approach to transition
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Why The tendency for professionals within each realm of
transition (education, health, community living, employment, and
others) to use language that is not easily understood by other
professionals, youth with IDD, families, or other community
partners
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Why Neglecting to specifically explore how transition in the
different realms could/should be linked for maximizing success
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Self Determined Life Youth and Family Culture Perspectives
Education Health Employment Postsecondary Adult Supports Providers
Outcomes Competence Healthy Life Place to Live Paying Job
SocialNetwork Community
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Goals Promote an interdisciplinary, interagency approach to
transition Understand the language, methodology and practices
inherent in the different disciplines and perspectives Understand
the role of culture in transition Develop strategies for linking
disciplines and agencies Increased awareness of network
resources
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Perspectives on Transition
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Youth and Families
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I would like to live with my aunt who has provided me with the
care that no one else has been able to do. I plan to find a
part-time paying job. I would like to spend the rest of my days
going to the gym to keep up my health, doing recreational
activities in the community and being part of my social community.
I can only do these things if I have wheelchair transportation, a
job coach and a nurse to meet my medical needs. Quote from a letter
from a youth with IDD to an agency administrator
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I expected assistance in planning ways that my daughter could
function with support in various adult roles.I expected that the
various entities that were involved with her supportwould
collaborate together to design supports that would help her reach
her unique adult goals. I expected to have good, complete and
understandable information.I expected that supports would be
available in her own community in places of her choosing. What I
needed most was a guide. Quote from a mother
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Families want information and planning processes that are
clear, simple and individualized. Families and individuals want
choice and control their own voices primary in design of services
rather than decisions made arbitrarily by others.. want what any
family wants for their young adult. looking for the ways and means.
Quote from a community supports navigator
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Two Videos The Good and the Bad of Transition Kristen
Michael
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Youth and Family Practices Good, complete, understandable
information Focused transition planning Person-centered transition
planning Family/Community Support Navigators Self-Determination
Curriculum
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Healthcare Transition Ilka Riddle
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Health Care Transition is the purposeful, planned movement of
adolescents and young adults with chronic physical and medical
conditions from child- centered to adult-oriented health care
systems. Blum et al.,1993
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Health Care Transition is: patient-centered flexible responsive
continuous comprehensive coordinated AAP, AAFP, ACP, 2002
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Guidelines & Best Practices AAP, AAFP and ACP 2002
Consensus Statement: 6 First Steps to Successful Transition AAP,
AAFP and ACP 2011 Clinical Report: Health Care Transition Planning
Algorithm
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Best Practice: Learning Collaboratives Pilots Got Transition
Learning Collaboratives
(www.gottransition.org)www.gottransition.org Transition
Collaborations of Pediatric and Adult Practices/Systems
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Shared Management Approach to Transition Team/Partnership
Approach Active Participation Empowerment Self-Determination
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StageProfessionalParent Child/ Young Adult 1 (Child 6-11) Lead
responsibility Participates & Provides care Receives care 2
(Young Adolescent 12-14) Partner gives guidance & support
Partner guides & manages Participates in care & decision
making 3 (Adolescent 15-17) Consultant Supervisor shared decision
making Manager shared decision making 4 (Young Adult 18+)
ResourceConsultant Lead manages & supervises
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Data tell us that 40.0 % of all youth 12-17 years with special
health care needs receive the services necessary to make
appropriate transition to health care, work, independence National
Survey of Children with Special Health Care Needs, 2009/2010
Data
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Considerations People involved: Youth/Young Adults Family
Members/Guardians Pediatric care provider & specialists Adult
care provider & specialists (Others)
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Considerations Systems involved: Pediatric health care system
Adult health care system (Others (e.g. service system, education
system, etc.))
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Barriers/Issues: Youth/Young Adult Little involvement in
transition process Little knowledge about condition, health, health
issues, health management Late start to transition planning
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Barriers/Issues: Family Members Late start to transition
preparation Little knowledge about how to navigate the adult health
care system Little information about changes regarding eligibility
for services, changes to health care coverage and guardianship
issues
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Barriers/Issues: Pediatric Providers Little time for transition
care/coordination Lack of reimbursement for transition support
Difficulty letting go Difficulty identifying adult care providers
and specialists Little knowledge about community resources
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Barriers/Issues: Adult Providers Lack of training in congenital
and childhood onset medical conditions Lack of training in working
with patients with disabilities Lack of communication from
pediatric provider Low reimbursement rates for comprehensive care/
care coordination
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Strategies: Youth/Young Adult Active participation in health
care and transition preparation Making use of transition resources
and tools specific to youth Active participation in finding adult
health care provider and specialists
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Strategies: Family Members Early transition planning
Encourage/empower youth to participate Utilize transition
resources, tools and information specific to families Initiate
identification of adult providers Ask for portable and accessible
medical summary
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Strategies: Pediatric Providers Transition Policies &
Processes Transition Plan at age 12-14 and updates Provide
transition resources Initiate contact with adult providers
Communicate with adult providers Provide medical summary
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Strategies: Adult Providers Engage in transition process Learn
from young adult & family members Learn about congenital &
childhood onset medical conditions Communicate with pediatric
providers
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Recommendations Improved Health Care Provider Training
Inclusion of disability training in medical school curricula
Education about congenital/childhood onset medical conditions
Inclusion of practical experience/ transition care rotations,
etc.
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Recommendations Improved Collaboration and Dissemination of
Information Inter-agency/multi-agency/integrated collaborative
transition approach One comprehensive transition resource guide
that addresses all types of transition, distributed in all
systems
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Recommendations Increased evidence-base for successful health
care transition: Health outcomes data
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Resources Got Transition National Health Care Transition Center
www.gottransition.org www.gottransition.org Florida HATS
www.floridahats.org www.floridahats.org
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Transition to College and Careers Margo Vreeburg Izzo, PhD
Program Director of Transition Services Ohio State University
Nisonger Center [email protected]
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College & Career Ready Higher expectations of all
stakeholders 21 st Century Skills (CCS leading to CCR) Grades 8 12:
Transition-focused Curricula Grades 13 16: PSE Programs Technology
utilization Continue evidence-based policies/practices National
Secondary Transition TA Center Think College What Works
Clearinghouse 44
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Transition Requires Interagency Collaboration IDEA of 2004
requires schools to coordinate with other service systems (i.e. VR,
DD): IEP must include AATA, measurable postsecondary goals,
projected date for services (i.e. travel training, work experience)
If participating agencies fail to provide transition services, LEA
shall reconvene the IEP team to identify strategies to meet the
transition objectives (IDEA of 2004, (D)(1 - 6)
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Transition Requires Interdisciplinary Approaches Age
Appropriate Transition Assessments (AATA) Transition to
Career/Employment Transition to College/Postsecondary Education
Focus Common Core Standards on College and Career Readiness
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Transition Requires Interdisciplinary Approaches Special Ed,
Voc Ed, Gen Ed & Rehab/DD counselors collaborate to provide:
Career development & exploration Soft skills and employability
development Self-determination/self advocacy training Summer work
experiences Job training and placement Carter, Austin &
Trainer, 2011, Predictor of Postschool Employment Outcomes for
Young Adults with Severe Disabilities, Journal of Disability Policy
Studies, 1-14.
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Transition Requires Interdisciplinary Approaches Special
educators, OT & VR provide: Transition assessments Assistive
technology assessment/training Worksite analysis & job match
Job development & placement Worksite Jigs, Ergonomic
assessments, etc.
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Teach SD Transition Planning* The Model has 3 phases &
supports AATA Phase 1. What is my goal? What career do I want?
Phase 2. What is my plan? What action can I do today to prepare for
chosen career? Phase 3. What have I learned? Revise goals &
plans, as needed Model Developed by M. Wehmeyer & Palmer,
2003
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50 Age Appropriate Transition Assessment Interdisciplinary IEP
teams use AATA to: Develop realistic and meaningful goals Provide
information for present levels of academic achievement and
functional performance Learn about the individual student, his/her
strengths, needs, interests, preferences (SPIN) Connect IEP with
future plans Inform the Summary of Performance
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Curriculum-based AATA Begins in the classroom Facilitated by
special, general & CTE teachers Integrate AATA into core
courses - ELA Examples: Self-determination assessments/curricula
EnvisionIT 21 st century curriculum
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52 21 st Century Curricula EnvisionIT teaches students: Common
Core Standards (CCS) Information Tech Literacy How to build a
self-directed Transition Portfolio by matching their interests,
abilities, and personality to career goals. Izzo, M.V., Yurick, A,
Nagaraja, H.N. & Novak, J.A. (2010). Effects of a 21st century
curriculum on students information technology and transition
skills. Career Development for Exceptional Individuals, 33(2),
95-105
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53 Online Assessments The VARK Questionnaire
http://www.vark-learn.com/english/page.asp The Myers-Briggs
Personality Test http://www.personalitypathways.com/type_inventory.
htmlhttp://www.personalitypathways.com/type_inventory. html The
Princeton Review http://princetonreview.com/Careers.aspx
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Common Core Standards (CCS) & Transition Assessment
Princeton Review: After completing the Princeton Review students
will be able to analyze their Interest Color and list 4 occupations
to explore Core Standard: Reading Strand: Cite strong and thorough
textual evidence to support analysis of what the text says
explicitly as well as inferences drawn from the text, including
determining where the text leaves matters uncertain
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CCS and Transition Planning EnvisionIT Activities Students
develop and present their assessment results and transition plans
Students write an essay to describe their Princeton Review,
personality and VARK assessment results Common Core Standards (CCS)
Writing Strand 4 Produce clear and coherent writing in which the
development, organization, and style are appropriate to task,
purpose, and audience. Speaking and Listening Strand 2 & 5
Integrate multiple sources of information presented in diverse
formats and media.
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Transition Knowledge (TK) Gains Conclusion: Students in the
experimental group increased their performance significantly on the
Transition Knowledge test, as compared to the control group.
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Recommendations Plan self-directed PCP meetings (IEP, IPE, ISP)
that include college and career goals Raise expectations of service
providers & parents through cross-agency trainings Coordinate
variety of work experiences from age 14 (or earlier) until paid
employment is achieved
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Recommendation Using the Self-Directed IEP Research-to-Practice
Lesson Plan Starters To teach the Self-Directed IEP to students
with cognitive disabilities
http://www.nsttac.org/LessonPlanLibrary/ 1_and_8.pdf
http://www.nsttac.org/LessonPlanLibrary/ 1_and_8.pdf
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Recommendation TEACH SELF-ADVOCACY SKILLS Self-advocacy is
letting people (professors, teachers, employers) know what you need
to be successful Important skill for anybody (especially those with
disabilities) Critical for college and career success
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Recommendations Jointly plan with education, rehab and DD
personnel Establish paid integrated job and community activities
during the last years of school services Adopt Employment First
Policies Washington State Legislature passed Jobs by 21 Partnership
Project in 2007 Winsor, Burrterworth & Boone, 2011,
Intellectual and Developmental Disabilities, 49, 274- 284.
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State Success in Integrated Employment National Survey of State
IDD Agency Day and Employment Services 2010
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Transition to College 27 Projects implement: Interdisciplinary
approaches VR and DD coordination Enrollment in college classes
Employment experiences Self-determination Inclusive age-appropriate
settings Go to www.ThinkCollege.netwww.ThinkCollege.net
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Who Should Go To College?
http://www.youtube.com/watch?feature=pl
ayer_embedded&v=auIYOb_rptQhttp://www.youtube.com/watch?feature=pl
ayer_embedded&v=auIYOb_rptQ Over 200 colleges in over 30 states
are enrolling students with IDD See www.thinkcollege.net for more
infowww.thinkcollege.net
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OSUs TOPS Model Interdisciplinary Team Special Educators,
Occupational Therapists, Physical Therapists, Rehab Counselors,
Speech Language Therapists, Social Workers, Assistive Tech.
Specialist Pilot Sites Ohio State UniversityUniversity of
ToledoThree Replication Sites Services Planned Through Transition
AssessmentPerson-Centered PlanningAcademic Advising
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TOPS: Student Experiences Inclusive Postsecondary Campus
Experience Self- Determination Health, Wellness Independent Living
skills Enroll/Audit College Courses Project SEARCH Internships
Residential Campus Experiences Individualized Supports Peer
SupportMentoringFamily SupportEducational/Job Coaching E-Portfolio
Each student exits the program with an e-portfolio that documents
academic employment and independent living skills through digital
pictures, video and documents.
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Project SEARCH Internships Provides internships leading to
employment Engages employers, community partners, employment
service providers to meet workforce needs of businesses and job
seekers Youth learn job tasks at no expense to employer Goal is
EMPLOYMENT! For more information: http://www.projectsearch.us/
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Dental Clinic Assistant
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Mentoring on OSUs Campus
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Technology Recommendations Promotes age appropriate supports
Navigation around work/college setting Organization and schedule
prompts Provides a means to express interests/skills using digital
resumes and application materials Promotes access to academic and
work content Sample digital story
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Transition: A Bridge to Inclusion in Society
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Community Living
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A Place to Live 599,152 (58%) people with ID/DD received
publicly funded supports while living in the home of a family
member 122,088 (12%) while living in homes of their own 40,967 (4)
while living in host family or foster care setting 276,460 (26%)
people with ID/DD lived in congregate care settings 57% of those
lived with six or fewer people. Most of the growth in services in
the last half century has been to support people living in their
own or a family home. Family and Individual Needs for Disability
Supports
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A Place to Live
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More than half of the family caregivers thought the ideal
residential setting was somewhere other than these family home
Family and Individual Needs for Disability Supports
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Time in the Community 80-90% have participated in community
activities in the past month 50% have exercised 50% participated in
a religious service, 40% usually feel lonely 30% have ever gone to
a self-advocacy meeting NCI Consumer Report
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Time with Others How Time Was Spent During Three Days
Individual Only 56.0% Housemate 21.2% Agency Staff 19.5%
Day/Workmate 2.4% Family Community Friend 0.8% Someone else 0.1%
Community Acquaintance 0.1%
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Getting There
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Transportation Resources
http://www.projectaction.org/Initiatives/YouthTransportation.aspx
Mobility Options in Your Community. A resource mapping tool to help
you analyze the accessible transportation resources in your
community Building a Transportation Education Continuum. An
activity to assist educators to build transportation education
activities across multiple tiers. Building Awareness in Accessible
Transportation: Transit Assessment Guide for Students, Families and
Educators. A tool for students, families, and educators who would
like to increase their understanding of transit systems and how
people with disabilities use public transportation.Building
Awareness in Accessible Transportation: Transit Assessment Guide
for Students, Families and Educators
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Initiating Activities Who Initiated Activities During Three
Days Individual 71.6% Agency Staff 27.4% Family Community Friend
0.4% Housemate 0.4% Someone else 0.1% Day/Workmate 0.1%
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Making Decisions
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Summary Transition Planning should include: Where to Live How
to Get There Community Activity Leisure and Recreation Building a
Social Network Making Decisions
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Interagency Collaboration and Coordination Interagency
Collaboration and Coordination
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IDEA Transition Planning The IEP must include for each student
beginning at age 16 (or younger, if determined appropriate by the
IEP team) a statement of needed transition services for the
student, including, if appropriate a statement of interagency
responsibilities or any needed linkages. 34 CFR 300.347(b)(2)
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Transition Barriers for Students and Families Accessing needed
services Navigating adult services No coordination amongst multiple
agencies Lack of sufficient information/awareness Insufficient
preparation of students for work US Government Accountability
Office (2012), Better federal coordination could lessen challenges
in the transition from high school
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Interagency Teams Three groups typically served by interagency
teams that vary by setting, roles and responsibilities (State level
agencies) Developing cross- agency policies to facilitate
transition (Regional/local district personnel)Developing procedures
and guidelines at district level (Individual level) Working with
individual students at IEP meeting or other interagency
meetings
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The CA Postsecondary Education Interagency Workgroup The Tarjan
Center, a University Center for Excellence in Developmental
Disabilities established a workgroup consisting of public agencies
representing rehabilitation, developmental disabilities services,
education, and community colleges in partnership with the State
Council on Developmental Disabilities and the California Health
Incentives Improvement Project to address needed changes to improve
access and participation in postsecondary education.
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CA Postsecondary Education Interagency Workgroup Participants
John Kimura, Jeff Reil and Susan Mathers, California Department of
Rehabilitation Denyse Curtright, Don Braeger, Rick Ingram, Victoria
King, Department of Developmental Services Carol Risley, State
Council on Developmental Disabilities Scott Berenson,& Scott
Valverde, California Community Colleges Chancellors Office Dr.
Catherine Campisi & Rachel Stewart, California Health
Incentives and Improvement Project* Jill Larson, Dr. Dan Boomer,
California Department of Education Carolyn Nunes, Director of
Special Education, San Diego Office of Education Dr. Olivia Raynor
& Wilbert Francis, Tarjan Center at UCLA Dr. Kathleen Rice,
Facilitator *Funder
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How We Created an Engaged and Committed Group Developed
relationships, mutual understanding and trust among diverse
partners; Assessed the environment for change; Attended to the
priorities and context under which each agency operated Identified
assets and barriers and developed an actionable plan for our work
Affirmed individual and agencys commitment to improve outcomes for
youth with developmental disabilities Built a sense of purpose,
hopefulness and commitment to the work
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Step 1: Map Each Agencys Initiatives that Support Students with
ID and ASD Raynor, O., Campisi, C & Francis, W. (2012),
Pathways to PSE for Students with ID & Autism
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Raynor et al., 2012
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Step 2: Create an Interagency Matrix ( Raynor et al, 2012)
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Step 3: Utilize Case Studies to Identify Supports, Strengths
& Gaps Identified key issues and unmet needs Services each
agency provided in response to student needs Regulations policies
or local practices that created available services, prevented them
from being provided or could have been employed but were not Who
else needed to be involved? If the system worked well, what would
have happened?
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Example: Reflection Discussions What are you pleased to see?
What is most surprising? What is concerning to you? What else is
possible? For your agency? For collaboration between agencies? What
is the collective meaning of this work for students with
intellectual disabilities or autism? What needs to happen with this
information? What does this mean for this group What needs to
happen next? Who else needs to be involved? How?
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Step 4: Deepen the Learning of Each Agency About One Another
What are the top 3 priorities of your agency? What receives the
most attention, resources, etc.? What is your agency held
accountable for? Where does this accountability originate (e.g.
legislation, funding sources)? Where does attention to people with
ID and ASD in pursuing PSE fit in with those priorities and
accountability expectations? Which of your agencys programmatic
efforts or initiatives are truly working to specifically support
people with ID and ASD in pursuing PSE? How many people with ID and
ASD are utilizing these services? Are these numbers representative
of the ID and ASD population? How do you know they are successful?
Looking at the Chart mapping the current legislative authority and
core functions (Step 1 above) or the Agency Interaction Matrix
(Step 2 above), what other questions would help you learn about the
work of this agency?
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Reviewing the Steps Deciding to Collaborate The Invitation
Creating a Shared Understanding of Each of the Partners, their
Individual Roles and Responsibilities Creating a Shared
Understanding of How Each Agency Might Work Together Utilize Case
Examples to Surface Barriers and Unmet Needs Deepening
Understanding of Systems Barriers through Learning
Conversations
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Pathways to PSE for Students with ID and Autism: An Interagency
Guide 23 + 16-22 6-15 Birth - 5 Knowledge and Skills Required
Information Provided to or by Individuals with ID & Families
Primary Actions Primary Role Agency Plans
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Youth Ages 6-15 Raynor et al., 2012
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Key Learning It is critical to start early to lay the
foundation (life experiences, role models, mentors, examples of
success) for college and a career. There is a need to raise
expectations across the board i.e., parents, self advocates,
agencies, and schools, that individuals with ID/ASD will achieve
success in their lives and careers. Perceived authority and
decision making influences the interpretation of policies, planning
and service provision at a state and local level. Context is
critical. During the course of our work, new barriers and
opportunities for collaboration emerged.
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Group Exercise
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Question to Consider: If the system worked well, what
could/should happen to support this students self-determination and
success? What could education do? What could the DD system do? What
could VR do? Which agency is responsible for coordinating the
health care needs? What could they do? Who else needed to be
involved?
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Discuss the Following Record Your Best Ideas: What are the key
transition issues? In your experience with transition, what needs
are typically not met? What are the barriers to meeting those
needs? What surprised you about your discussion? What was new
information? What recommendations would you suggest to make
transition a more collaborative process? What strategies would you
use?
