Habilitation

ITC

HABILITATIONTRAINING

DEPARTMENT OF ECONOMIC SECURITY

DIVISION OF DEVELOPMENTAL DISABILITIES

DISTRICT 1

Overview

Building Relationships Through Communication

Principles of Behavior Building

Potential Barriers to Teaching

Why Inappropriate Behaviors Occur

How Your Values Impact Others

Reinforcement

Behavior Building Overview

Habilitation Progress Note Walkthrough

Good Example of HAH Note


The individuals we work with not only need to learn new skills (how to brush their teeth, plan a nutritional meal, wash their clothes, etc.) but also need to develop more positive attitudes towards themselves and towards the people around them. They must learn to like themselves, develop a feeling of self-confidence. They need to know that someone likes and cares about them. They must feel successful and be able to say, "Hey, look what I did!" If they do not feel good about themselves, then teaching them new skills will seem to be nearly impossible.

The responsibility for helping the individuals we work with/for develop good feelings about themselves lies with the people who support them. "As a person who provides direct support," you can accomplish this responsibility by developing a positive relationship with the individual. To do this, you must say to the individual by your words and actions, “I like you”, “You are a worthwhile person", "I know you can do it".


We need to respect AND VALUE the individuals we work with. They have likes/dislikes, needs, wants, etc. just like anyone else. In order to identify these and help that person learn to fill them we must develop a relationship with that individual.

Remember--We are here to help "each person" develop their potential as an individual (i.e., we don't build products. We build relationships and relationships build people!!)


• When you are with the individuals, talk about what they can do, don't dwell on what they cannot do.

• What are their positive points?• What can you and the individual do to further develop these positive points?

CONCENTRATE ON THE INDIVIDUAL'S STRENGTHS:

• Praise the individuals for the good things they do. Do not assume they know what they are doing is correct. Praise builds self-confidence. The more things they know they can do, the more they will try. Don't forget to praise attempts even if they are not successful--praise the fact that they tried. Use the individual's name when praising him/her. Let them know it is they, as individuals, you are praising. When you praise someone base it on his/her likes. Likes are things a person chooses to do or have, that they are willing to work for, and will get obvious pleasure from (places, events, people, food, and objects).

PRAISE THE INDIVIDUALS:


• Some of the strongest communication we give is through our non-verbal actions, (eye

• contact, gestures, body language, looks, expressions and body contact). People will

• pick up on these things and act accordingly.• Are you warm, friendly, and interested?• Do you yell at the individual?• Do you look angry?• Are you afraid of the individual?• Do you look bored?

BE AWARE OF YOUR VERBAL AND NON-VERBAL ACTIONS


• How many times do you find yourself giving orders, saying, "Do this, Do that." or, maybe more frequently, "don't do that." Each time you do this, you are really telling someone they cannot do anything for him/herself and you are taking that person's control from them. No one can learn independence or self-confidence or trust if someone continually orders them around. It also takes away the opportunity to build relationships with people.

• Try saying, "Could you help me with this? "I think this is a good idea how about you?"

• Give choices whenever possible. Don't we all like to have some control over our own lives?

TREAT THE PERSON AS A PERSON:


Never talk about an individual in front of him/her as if he/she isn't there.

If you must discuss a person, involve him/her in the conversation with you.

Never talk about an individual's problems or shortcomings in front of other individuals present. Reserve any discussion for a time when others are not around or when the person can be involved in the discussion (problem solving)

Never talk about an individual's problems or shortcomings you work with/for to any person who is not professionally involved with that person.

U S E T H E S E T O O L S T O P O S I T I V E LY B U I L D R E L AT I O N S H I P S A N D Y O U M AY B E A M A Z E D AT

T H E O U T C O M E ! ! ! ! ! !

Principles of Behavior Building

• Behavior occurs all the time.• You influence a person's behavior, whether you realize it or not.• Every interaction is either therapeutic or not--you make the

difference.• Bonds and friendships develop from interactions with people.• The environment influences behavior 24 hours a day.• How you structure the environment determines whether it is

therapeutic.• At any given moment, there is a desired behavior to promote.• A person's needs are identifiable through his/her behavior.• There are constructive ways to respond to needs.• The individuals who receive services from the division have

preferences that may be different than staff preferences.• People can and do change/learn.

Potential Barriers to Teaching

• Colors should not be bland, boring or too busy.• Textures should have variety.• Furniture may be inappropriate (wrong size or height) or

inadequate (not enough support or run-down).• Inappropriate temperature (too hot or cold) may affect

alertness and agility.• Strong odors are a problem in any environment.• Cramped areas clutter and poor arrangement may limit activity.• Too bright or too dim light may interfere with an activity.• Confusing, complex, insufficient or large layouts are a problem.• Noise can interfere with hearing and concentration.• Other -- general ugliness, dirt, etc.

Why Inappropriate Behaviors Occur

If you observe a problem, ask yourself which of these might be the cause, then do something to POSITIVELY change the

situation.

• ATTENTION

• ANGER

• FRUSTRATION

• BOREDOM

ATTENTION

• Attention is the main cause of most problem behaviors. The person may be seeking attention from anyone (parents, staff, peers, etc.) Individuals who have lived in an institution have learned that the fastest way to get attention is to display an inappropriate behavior. If you think attention is the cause of the problem, you must:– Not attend to the behavior and redirect to another appropriate behavior; and– Give attention for anything positive the individual does. Teach him/her they will get

attention for appropriate things, not inappropriate. Do not allow the behavior to occur--i.e. give attention for positive things before he/she has to do something wrong to gain your attention.

• Remember– For someone who has learned to get attention for-negative, inappropriate, behaviors

in the past, these will increase while you begin to ignore the inappropriate behavior, and continue to ignore and re-teach him/her that they will get attention only for appropriate things they do. If attention for appropriate things is not given now, then ignoring will not work!! Ignoring will not work alone; it must be used with attention!!!! Everyone involved with the person must follow this for it to work.

ANGER

• Many individuals do not know how to appropriately express their anger, resulting in inappropriate behaviors. If you decide anger is the cause of the behavior:– Determine why the person is angry, with whom, with what. – Look at the whole situation, can you change it?– Teach the person appropriate expressions of anger.

FRUSTRATION

• Frustration results when a person tries to do something he/she cannot do. If you think this is the cause of the inappropriate behavior:

– Praise the person for all their attempts.– If the task is too hard, go to an easier one or break it down into

smaller, easier steps.– Reassure him/her frequently that they can do it.– When frustration appears to be building -- have them do

something different for a while.

Boredom

• What does boredom look like? • When you decide boredom is the reason

– Try to change the activity before boredom sets in. – Offer interesting, age appropriate activities -- have him/her tell

you what they want to do.– Don't get into the rut of always doing the same things.

Dealing with inappropriate behaviors is something that will occur over and over again until the individual has

meaningful choices of alternative behaviors in which to choose from.

How Your Values Impact Others

• We all place our judgments onto others. Therefore, a person’s behavior may be getting them what it is they need or want in the only way they know how to get it.

• We then judge them as inappropriate or appropriate.– Your judgments are based on:

• You’re personal values.• Your limited knowledge of the situation.• Your emotional state.

• In order to more effectively work with another person, you need to put your values/judgments to the side.

Reinforcement

• Something a person wants and is willing to work for.

What is a reinforcer?

• Material – Something tangible that the person can hold or touch.• Privileges and Activities - Above and beyond normal or routine.• Social - Carried with you all the time i.e.; smile, verbal praise, high five etc. • Token – Something given that can be exchanged for something else.

What are the four types of reinforcers?

• Ask the person.• Ask others who know the person best.• Observe the person.• Observe another person who is similar.• Premack Principle (Grandma’s Rule) – borders on bribery.• Reinforcement Sampling – try all ideas to learn what works

What are the six ways you can use to choose reinforcers?

Reinforcement

• Use the person’s name.• Give immediately and consistently.• Give contingent on the behavior you want to increase.• Be the right size and amount.• The person must want it.• Must not be harmful to the person.• Something we have a right to and can easily control.• Edibles (food) must be paired with social praise and faded when

appropriate.• Be specific in your praise.• Use a variety of reinforcers.• Be consistent with the person’s diet, medication, medical, conditionals,

and disability.

What are the rules in delivering reinforcers?


• ANTECEDENTS– Describe what is going on before a behavior occurs.– Look at:

• Who was interacting with the person and how?• What was said and number of times said?• Where and when the incident occurred?• Did the person have a bad cold, fever, etc.?• Did the person get only three hours sleep last night?• Did the person just return from a trip?• Did the person have his/her medications changed?• Did the person have a favorite possession broken or stolen?• Did the person start a new program?• Is the person receiving supports from someone new?• Did the person have a close friend move to a new home or place?• Etc…


PRECURSOR BEHAVIOR

CONSEQUENCES (After the behavior)

DOCUMENTATION

EVALUATE

FOLLOW UP


PRINT YOUR FIRST AND LAST NAME

THIS IS THE AMOUNT OF HAH HOURS YOU CAN PROVIDE IN A

MONTH

PRINT THE CURRENT MONTH/YEAR

THIS IS THE KEY TO HOW WE SCORE OUR

CONSUMER BASED ON HOW WELL THEY

PERFORMED THE HAH GOAL


THE DAY OF THE MONTH IS

REPRESENTED IN THE TOP CELL AND IN THE

BOTTOM CELL YOU WILL WRITE IN HOW MANY

HOUR OF HAH YOU PROVIDED FOR THE DAY

ADD UP THE HOURS AND PUT THE TOTAL AT

THE END AND THE TOTAL HOURS NEED TO MATCH THE ALLOTTED

HOURS.


THIS IS WERE THE HABILITATION GOAL

WILL BE WRITTEN OUT AND THE NUMBER OF GOALS WILL DEPEND ON THE CONSUMER AND THEIR NEEDS

THE DAY OF THE MONTH IS

REPRESENTED IN THE TOP CELL AND IN THE

BOTTOM CELL YOU WILL WRITE IN THE SCORE

YOU GAVE YOUR CONSUMER FOR THAT

HAH GOAL

IMPORTANT

YOU MUST FILL IN MEANINGFULL AND

ACCURATE DATA

*THIS IS WHAT DDD IS GOING TO REVIEW SO

DO NOT WRITE THE SAME COMMENTS

EVERY MONTH


YOU MUST SIGN AND DATE

Example of a Good HAH Note

Habilitation

Business

Transcript of Habilitation