The Family Teaching Model: The Family Teaching Model: A Kansas Residential Model for Adults with A Kansas Residential Model for Adults with Intellectual Developmental Disabilities that Intellectual Developmental Disabilities that offers Eleven Desired Lifestyle Outcomesoffers Eleven Desired Lifestyle Outcomes

Diane Bannerman Juracek, Ph.D., BCBADiane Bannerman Juracek, Ph.D., BCBA

Community Living Opportunities, Inc.Community Living Opportunities, Inc.

CLO’s mission is to help adults and children with severe CLO’s mission is to help adults and children with severe developmental disabilities achieve personally satisfying developmental disabilities achieve personally satisfying

and fulfilling lifestyles in their own communities.and fulfilling lifestyles in their own communities.

CLO’s ServicesCLO’s Services Residential Options Residential Options Day Classes Day Classes Supported EmploymentSupported Employment Health Care Services: Clinics in Lenexa and Health Care Services: Clinics in Lenexa and

LawrenceLawrence Applied Behavior Analysis ConsultationApplied Behavior Analysis Consultation Positive Behavior SupportsPositive Behavior Supports Children’s Services Children’s Services Training, Evaluation and CertificationTraining, Evaluation and Certification Outreach ServicesOutreach Services Remote MonitoringRemote Monitoring Midnight FarmMidnight Farm

CLO 2012 DemographicsCLO 2012 Demographics 81 homes81 homes 214 individuals with intellectual developmental disabilities214 individuals with intellectual developmental disabilities ““Extremely satisfied” or “Satisfied” ratings from 91% of Extremely satisfied” or “Satisfied” ratings from 91% of

parents/guardians of those we serveparents/guardians of those we serve 230 adults served in day services in Douglas, Allen, and 230 adults served in day services in Douglas, Allen, and

Johnson CountiesJohnson Counties Virtual village opens, providing “Homelink” support to Virtual village opens, providing “Homelink” support to

promote independencepromote independence 115 individuals served in CLO wellness clinics and 115 individuals served in CLO wellness clinics and

occupational/physical therapy servicesoccupational/physical therapy services 330 children served in Children’s Network330 children served in Children’s Network

Early intensive behavioral interventionEarly intensive behavioral intervention Family and youth intervention Family and youth intervention Johnson County Montessori PreschoolJohnson County Montessori Preschool Northstar AcademyNorthstar Academy

Midnight FarmMidnight Farm 120 special-needs kids and adults in therapeutic riding120 special-needs kids and adults in therapeutic riding 40 special-needs kids in summer camps40 special-needs kids in summer camps 750 individuals from community on tours, field trips & special events750 individuals from community on tours, field trips & special events

Building the “Good Life”Building the “Good Life”

Timeline of HistoryTimeline of HistoryThe Teaching Family ModelThe Teaching Family Model

Teaching Family Model

1967 Lonnie and Elaine

Phillips/ Mont Wolf

1970 1st dissemination attempt – not successful

Consumer feedback important

1975 Boys Town

1977 Concerned Care

Jim Sherman and Jan Sheldon

1st adaptation for DD population

1981 DSNWK

1983 CLO

2001Tennesee Family Solutions

2004 California Community

Opportunities

Residential Service Models Residential Service Models at Community Living at Community Living Opportunities, Inc.Opportunities, Inc.

8 housemates 8 housemates Awake shift staff 24 hours a dayAwake shift staff 24 hours a day Funded by Medicaid as a Private Intermediate Care

Facilities for Adults with Mental Retardation (ICF/MR)

3 housemates3 housemates Living in an apartment or homeLiving in an apartment or home Awake shift staff 24 hours a dayAwake shift staff 24 hours a day Funded by Medicaid Home & Community Based Services

(HCBS) waivers for persons diagnosed with Developmental disabilities

Group Home

Individualized

Living

Residential Service Models Residential Service Models at Community Living at Community Living Opportunities, Inc.Opportunities, Inc.

3 or 4 housemates 3 or 4 housemates A family teaching couple provides A family teaching couple provides most of the support, lives next most of the support, lives next door and manages the homedoor and manages the home

Lives with a teacher without Lives with a teacher without disabilities or a teaching family in disabilities or a teaching family in the same homethe same home

Both programs funded through Medicaid’s Home and Both programs funded through Medicaid’s Home and Community-based Waiver for people with DDCommunity-based Waiver for people with DD

Family Teaching

Extended Family

Teaching

Family Teaching Model* Family Teaching Model* ComponentsComponents

*An adaptation of the Teaching Family Model *An adaptation of the Teaching Family Model (Phillips, Phillips, Fixsen, & Wolf, 1974)(Phillips, Phillips, Fixsen, & Wolf, 1974)

Family Teachers in family style living Family Teachers in family style living environmentsenvironments

Individualized daily schedulesIndividualized daily schedules Teaching new skillsTeaching new skills Systems for encouraging achievementSystems for encouraging achievement Positive relationshipsPositive relationships Opportunities for choice and self determinationOpportunities for choice and self determination Ongoing teacher training and consultationOngoing teacher training and consultation Teacher evaluation and certificationTeacher evaluation and certification

Family Teachers in a Family Teachers in a Family Style EnvironmentFamily Style Environment

Family Teaching Model Component # 1 . . .

What better model to accomplish this than the Family Teaching Model?!

Family Teachers in a Family Style Environment

Individualized Daily Individualized Daily SchedulesSchedules

Family Teaching Model Component # 2 . . .

Library

Tom's Choice

Work @ Recycling Center

Library

Ed's Choice

Swimming Swimming Swimming

Work @ Recycling Center

ThurThurss EdEd Kevin Kevin TomTom

7:00 7:00 AMAM

AM Routine*AM Routine* AM Routine *(bath routine)AM Routine *(bath routine)Sally Sally (Family Teacher)(Family Teacher) goes goes

joggingjoggingAM Routine*AM Routine*7:30 7:30

AMAM

8:00 8:00 AMAM MedsMeds MedsMeds MedsMeds

8:30 8:30 AMAM Wait for City BusWait for City Bus R & R R & R R & R R & R

9:00 9:00 AMAM

10:00 10:00 AMAM

11:00 11:00 AMAM

12:00 12:00 PMPM Lunch (*Lunch routine)Lunch (*Lunch routine) LunchLunch

1:00 1:00 PMPM      

2:00 2:00 PMPM

3:00 3:00 PMPM

4:00 4:00 PMPM

4:30 4:30 PMPM MedsMeds Meds/ Dinner Prep Routine*Meds/ Dinner Prep Routine* MedsMeds

5:00 5:00 PMPM Dinner/ ChoresDinner/ Chores Dinner/ ChoresDinner/ Chores Dinner/ ChoresDinner/ Chores

5:30 5:30 PMPM

6:00 6:00 PMPM

6:30 6:30 PMPM

7:00 7:00 PMPM

Sally (family teacher) takes Sally (family teacher) takes Katie (daughter) to Girl Katie (daughter) to Girl

Scouts Scouts   Hobby ChoiceHobby Choice   Check mail and choice of ActivityCheck mail and choice of Activity

7:30 7:30 PMPM SnackSnack Snack Routine*Snack Routine* SnackSnack

8:00 8:00 PMPM Meds/ PM Routine*Meds/ PM Routine* Meds/ PM Routine*Meds/ PM Routine* Meds/ PM Routine*Meds/ PM Routine*

  

to recycling centerto recycling center

Walk High School Track*Walk High School Track*   Walk at High School Track Walk at High School Track While John (family teacher) goes to gym

LibraryLibraryKevin’s choice

Teaching New SkillsTeaching New Skills& Quality of Life Planning& Quality of Life Planning

Family Teaching Model Component # 3 . . .

Continuous Planned and Continuous Planned and Opportunity TeachingOpportunity Teaching

Identification and purposeful teaching of skills:Identification and purposeful teaching of skills: that lead to independence and ability to navigate that lead to independence and ability to navigate

through their day with less or no assistancethrough their day with less or no assistance that help the person served access highly preferred that help the person served access highly preferred

items, activities, experiences. . . items, activities, experiences. . . that limit or eliminate any rights issues (privacy, that limit or eliminate any rights issues (privacy,

need to have someone assist them in making a need to have someone assist them in making a phone call)phone call)

that lead to improved health & safety that lead to improved health & safety Behavioral supportBehavioral support

Eliminates or decreases challenging behavior that Eliminates or decreases challenging behavior that inhibits continued progress towards living a good inhibits continued progress towards living a good quality of lifequality of life

Reinforcing Desirable Behavior*

1. Initiate Positivelya. Use Active Listening Skills (e.g., eye contact, responsive facial expression & voice tone, active listening posture, gestures, verbal and non-verbal encouragement, and reflection)b. Expression of Affection(e.g., smile, greeting, joke, physical contact)

2. Praise and Positive Consequence (descriptive, immediate)

Teaching a New Skill* 1. Initiate positivelya. Use active listening skills (eye contact, responsive facial expression and voice tone, body posture, and gestures).b. Elicit person’s involvement throughout the interactionc. Expression of affection (e.g., smile, greeting, joke, physical contact)

2. Name appropriate behavior

3. Rationale (e.g., positive consequence of engaging in the appropriate behavior) Ask or give

4. Demonstrate the steps

5. Practice (Use prompts with fading, if necessary)

6. Feedback a. Reinforce: descriptive praise, optional positive consequence b. corrective feedback if needed

7. Practice

8. Feedback a. descriptive praise, optional positive consequence b. corrective feedback if needed

9. Plan when to use the behavior *Some steps may be deleted or shortened depending on the needs and learning style of the individual .

Systems for Systems for Encouraging Encouraging

AchievementAchievement

Family Teaching Model Component # 4 . . .

FormalFormal

Positive RelationshipsPositive Relationships Motivation Systems – monetary, Motivation Systems – monetary,

points, tangibles, etc. . .points, tangibles, etc. . . Behavioral Contracting Behavioral Contracting Premack Principle – eat dinner to get Premack Principle – eat dinner to get

your dessert. . . your dessert. . . Staff reinforcement and recognition Staff reinforcement and recognition

programsprograms

or Informal

Positive RelationshipsPositive Relationships

Family Teaching Model Component # 5 . . .

Opportunities for Choice Opportunities for Choice and Self Determinationand Self Determination

Family Teaching Model Component # 6 . . .

Making choices freelyMaking choices freely Having control in areas important to Having control in areas important to

youyou Being part of decisions that affect youBeing part of decisions that affect you Knowing how to make a choiceKnowing how to make a choice Feeling free to make a choiceFeeling free to make a choice Having predictable events in your Having predictable events in your

day/weekday/week

What does Self-Determination mean?

Ongoing Teacher Ongoing Teacher Training and EvaluationTraining and Evaluation

Family Teaching Model Component # 7 . . .

The Coaching ProcessThe Coaching Process(Sherman J., Harchik A., Strouse, M,)(Sherman J., Harchik A., Strouse, M,)

Mini-Inservice Learn about a topic

Demonstration Someone shows you how

Coaching You practice with shaping

Observation & Feedback Systematic, ongoing formal and informal

Train to Generalization You practice in a natural setting until you master the skill

Reinforce to Maintenance You now use the skill as a matter of course

Teacher Evaluation & Teacher Evaluation & CertificationCertification

Family Teaching Model Component # 8 . . .

The Community Living Research and Development Project

at theUniversity of Kansas

  Family Teacher Certification Program

 Providing Certification of

Family Teachers employed byCommunity Living Opportunities, Inc.who exhibit exemplary teaching and

implement Community Living Opportunities' Family Teaching Model for Adults with

Developmental Disabilities

Community Living Opportunities Community Living Opportunities

Expected OutcomesExpected Outcomes for Persons Served for Persons Served

Pleasant and Safe SurroundingsPleasant and Safe SurroundingsObservance of Legal and Personal RightsObservance of Legal and Personal Rights

Positive Relationships with OthersPositive Relationships with OthersLiving Healthy LifestylesLiving Healthy Lifestyles

Opportunities for Choice and ControlOpportunities for Choice and ControlEffective Learning Opportunities Effective Learning Opportunities

High Level of Participation in Daily High Level of Participation in Daily ExperiencesExperiences

Community InvolvementCommunity InvolvementEffective CommunicationEffective Communication

Pleasant Social EnvironmentPleasant Social EnvironmentSatisfied ConsumersSatisfied Consumers

Family Teaching Model Certification• FTM Pre-service Workshop • Shadow Training• Program Specific Orientation• 12 Coaching Lessons • 90 Day Evaluation• More Coaching Lessons based on Outcome

QEs• Family Teaching Model Workshop• Pre-evaluation meeting for First Private• 6 mos. after hire: First Private

Evaluation • Quality at a Glance Evals • Pre-evaluation meeting for Certification

Evaluation • 12 mos. After hire: Certification

Evaluation

Certification Celebration and $$

……but there’s more… our latest but there’s more… our latest community living model…VIRTUAL community living model…VIRTUAL

VILLAGEVILLAGE Fewer staffFewer staff CLO’ Homelink central site monitoring, as needed: audio, video, CLO’ Homelink central site monitoring, as needed: audio, video,

sensors, devices - in every 2-bedroom apartmentsensors, devices - in every 2-bedroom apartment Rigorous teaching and progress assessment on independent living Rigorous teaching and progress assessment on independent living

skillsskills Daily schedules Daily schedules Classes: problemsolving, roommate conference, home safety…. Classes: problemsolving, roommate conference, home safety…. JobsJobs Community Inclusion (3Community Inclusion (3rdrd places) places) Motivation Point economy system (with daily trips to point exchange Motivation Point economy system (with daily trips to point exchange

store)store) Self-government – to minimize staff control/increase control and Self-government – to minimize staff control/increase control and

responsibility for the men and womenresponsibility for the men and women Health ticklersHealth ticklers Learning to take medications independentlyLearning to take medications independently

Factors Influencing Factors Influencing “Living the Good Life”“Living the Good Life”

Fewer number of individuals living in a home in the Fewer number of individuals living in a home in the communitycommunity

Either “Family teachers” providing support or “teaching Either “Family teachers” providing support or “teaching staff” as opposed to shift-staffstaff” as opposed to shift-staff

Implementation of Family Teaching Model ComponentsImplementation of Family Teaching Model Components family style or roommate living environmentsfamily style or roommate living environments Community inclusionCommunity inclusion Individualized daily schedulesIndividualized daily schedules Teaching rights, communication, and other skillsTeaching rights, communication, and other skills Systems for encouraging achievementSystems for encouraging achievement Positive relationshipsPositive relationships Opportunities for choice and self determinationOpportunities for choice and self determination Ongoing teacher training and consultationOngoing teacher training and consultation Teacher evaluation and certificationTeacher evaluation and certification

Midnight FarmMidnight FarmCLO's Midnight Farm provides year round CLO's Midnight Farm provides year round therapeutic horseback riding lessons to therapeutic horseback riding lessons to

children and adults of all abilities. We have a children and adults of all abilities. We have a great time with our summer camps. And any great time with our summer camps. And any given weekday you can find our day service given weekday you can find our day service

men and women out working in the men and women out working in the greenhouse or creating something in the greenhouse or creating something in the

pottery barn!pottery barn!www.midnight-farm.orgwww.midnight-farm.org

Community Living Opportunities Community Living Opportunities

Expected OutcomesExpected Outcomes for Persons Served for Persons Served

Pleasant and Safe SurroundingsPleasant and Safe SurroundingsObservance of Legal and Personal RightsObservance of Legal and Personal Rights

Positive Relationships with OthersPositive Relationships with OthersLiving Healthy LifestylesLiving Healthy Lifestyles

Opportunities for Choice and ControlOpportunities for Choice and ControlEffective Learning Opportunities Effective Learning Opportunities

High Level of Participation in Daily High Level of Participation in Daily ExperiencesExperiences

Community InvolvementCommunity InvolvementEffective CommunicationEffective Communication

Pleasant Social EnvironmentPleasant Social EnvironmentSatisfied ConsumersSatisfied Consumers

Thank you for your time and interest.

Please feel free to contact me for further information: 785-218-9358

Diane Bannerman Juracek, Ph.D, BCBA dianebannermanjuracek@clokansas.org