““Promoting Interdependence; Promoting Interdependence; Spreading Self-Determination”Spreading Self-Determination”

Capacity-Building for Students with DisabilitiesCapacity-Building for Students with DisabilitiesSchool In-serviceSchool In-service

Independence vs. Interdependence

• Traditional notion of independence is that “assistance is considered a deficit.”

• Interdependence recognizes that assistance with certain tasks is necessary for complete autonomy. (from: About a Lifecourse Approach, CanChild website)

• WE ALL NEED SUPPORT!

Interdependence and Capacity

• Interdependence emphasizes capacity as the ultimate goal instead of independence.

• Capacity is the actual ability to perform a task whether this requires assistance from another person or not.

• Capacity must be seen as a lifespan approach.

Interdependence – Sample Goals

• Within one year, Leon will use his rolling walker to walk 300 ft. from the auditorium to the classroom, verbally requesting appropriate assistance to hold open the door to exit auditorium. Success will be measured by Leon’s ability to arrive on time in homeroom after weekly auditorium assembly 3 times a week, in a 3 week period per teacher, or paraprofessional report.

• Within one year, Faygie will be able to make regular appointments with her wheelchair clinic for follow-up equipment care. Success will be measured by Faygie’s ability to convey the appointment date, location, and contact person’s name and number to therapist, parent or teacher.

What Does a Student Need to Be Interdependent?

1. Self-Determination

2. Social Support

1. Self-Determination

• ability to set goals and act on them• ability to make choices/decisions• requires self-awareness, self-monitoring• know how to apply strengths• know how to compensate for limitations

Elements of Self-Determination

• Skills– Choice-making– Problem-solving– Decision-making– Goal-setting and attainment– Self-regulation (self-observation, self-evaluation &

self-reinforcement )– Self-advocacy and leadership

• Attitude– Perceptions of control– Self-efficacy– Self-awareness and self-knowledge

Developing Self-Determination

• Encourage: – participation in class/school activities that include

planning, organization, research and presentation– taking on leadership roles– allow students to set & plan to attain their own goals– teach students to monitor their own progress and modify

actions as needed– participation in IEP meetings– school-based services must be student-directed

• Modeling, role-playing, feedback, direct instruction

• http://www.nsttac.org/ebp/EBPractices/TeachingSelfDeterminationSkillsGP.aspx

Self-Determination Skills Develop Throughout a Person’s Lifespan

Choice-making

Problem-solving Goal-setting & attainment with adult assistance Self-regulation

Goal setting & attainment with less adult assistance Decision-making with adult assistance Self-advocacy Better self-awareness and self-knowledge Better perception of control & efficacy

Decision-making All elements are coming together

AGEAGE

2-52-5

6-86-8

9-119-11

12 & up12 & up

Developing Self-Determination

Studies have shown direct correlation between self-determination skills and a student with disability’s capacity to succeed in school and in transitioning to an adult life. This includes employment and independent living.

http://nasetalliance.org/youthdev/research.htm

http://www.nsttac.org/ebp/student_development.aspx

2. Social Support

• Participation in societal roles, by definition, cannot be done in isolation

• Interaction with others is essential• A disabled individual may require more support;

therefore he/she (or the family/caregiver) must know how to advocate for him/herself

Developing Social Support

• join clubs, support groups, activity groups

• train student, parents and caregivers on: – concept of interdependence and capacity, as

early in life as possible– advocating for student’s needs (self-advocacy)– allowing student to perform to his/her optimal

level; then, if needed, assist the student to augment his/her effort.

• involve the community

Implications to PT

• Promoting self-determination requires a change from:

Student-focused

PT Services

Student-directed

PT Services

Student-Directed PT Service

TOTAL Therapy Activities

The Balance of Capacity

The Balance of Capacity

For:-students with milder disability-tasks that are easy

The Balance of Capacity

For:-students with more severe disability-tasks that are more difficult

Implications for OTs/PTs

Collaborative Consultation• An essential role of OTs and PTs working in

the schools is collaborative consultation with other school staff and parents/guardians.

• This may or may not require OT/PT services to be mandated on the IEP.

• Therapists may participate in transition planning as needed.

Implications for OTs/PTs

Treatment Options:

1.Remediation of student’s body structure/ function, skills and behaviors.– e.g. strengthening, stretching, exercises– Includes activities done in therapy room– Requires that student demonstrates potential for

change and readiness for acquiring new skills– Typically, more appropriate for younger children

Implications for OTs/PTs

Treatment Options:

2. Compensation of task and environment– e.g. wheelchair, slant board, specialized seating– Includes activities and materials incorporated into

classroom/school routine that are implemented in collaboration with teacher, paraprofessional or other school staff

– Pros:• Immediate independence

(or decreased dependence on others)• Improved self-esteem• Less pull-out from peers & class activity• Less direct one-on-one time

Implications for OTs/PTs

Treatment Options:

3. Teaching student and parent/guardian how to seek assistance (self-advocacy skills)– Ability to identify person(s) that can assist– Ability to explain how the person can assist– Students with more severe disabilities would

require more assistance from parent/guardian to advocate for their needs

Implications for the School Community

• School staff needs to know the concepts of interdependence, capacity & self-determination

– Allowing students to participate in the IEP process including setting goals and determining assistance & accommodations needed.

– Teaching student self-advocacy skills instead of providing students with assistance before they even ask for it

• Teaching “how to fish” vs. “giving the fish”

– Allowing student to perform to his/her optimal level; then, if needed, assist the student to augment his/her effort.

Implications for the School Community

• Encourage student participation and leadership roles in class, school and after-school activities and in IEP meetings

• PT services may be provided via different methods including:– integration of sessions into actual class/school

activities– collaborative consultation with teachers and other

school staff – participation in transition planning as needed

Implication for Parents

• Child should be provided with opportunities to develop self-determination:– Participate in community clubs, activity groups– Allow children to make choices and decisions; and to

learn consequences from these choices and decisions– Chores reinforce the notion of interdependence (e.g.

family members help each other). Have children choose a task they can help in

– Allowing child to perform to his/her optimal level; then, if needed, assist the child to augment his/her effort. Encourage child to advocate for self.