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Increasing life skills for adolescents who havedevelopmental disabilities: a program developmentplanRenae C. SauterThe University of Toledo
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Increasing Life Skills 1
Increasing Life Skills for Adolescents who have Developmental Disabilities:
A Program Development Plan
Renae C. Sauter
Faculty Mentor: Melanie Criss,
Site Mentor: Maureen Kane Wineland, Ph.D., OTR/L
Department of Rehabilitation Sciences
Occupational Therapy Doctorate Program
The University of Toledo
May 2012
Note: This document describes a Capstone Dissemination project reflecting an individually planned experience conducted under faculty and site mentorship. The goal of the Capstone experience is to provide the occupational therapy doctoral student with a unique experience whereby he/she can demonstrate leadership and autonomous decision-making in preparation for enhanced future practice as an occupational therapist. As such, the Capstone Dissemination is not formal research.
Increasing Life Skills 2
Table of Contents
Introduction------------------------------------------------------------------------------------------------6
Definitions----------------------------------------------------------------------------------------6
Program Site--------------------------------------------------------------------------------------6
Program Needs-----------------------------------------------------------------------------------7
Demographics and Literature Review---------------------------------------------------------9
Model of Practice---------------------------------------------------------------------------------13
Federal Initiatives---------------------------------------------------------------------------------16
Objectives---------------------------------------------------------------------------------------------------18
Marketing and Recruitment-------------------------------------------------------------------------------19
Potential Participants------------------------------------------------------------------------------22
Inclusion Criteria ----------------------------------------------------------------------------23
Programming------------------------------------------------------------------------------------------------24
Literature for Programming----------------------------------------------------------------------24
Assessment-----------------------------------------------------------------------------------------26
Programming with Role Acquisition-----------------------------------------------------------27
Interventions---------------------------------------------------------------------------------------29
Program Outline-----------------------------------------------------------------------------------31
Direct and Indirect Services---------------------------------------------------------------------33
Documentation Systems--------------------------------------------------------------------------34
Program Discharge--------------------------------------------------------------------------------35
Budgeting and Staffing------------------------------------------------------------------------------------35
Personnel-------------------------------------------------------------------------------------------40
Increasing Life Skills 3
Funding Sources-----------------------------------------------------------------------------------40
Self-Sufficiency------------------------------------------------------------------------------------43
Program Evaluation-----------------------------------------------------------------------------------------44
Timeline------------------------------------------------------------------------------------------------------47
Letters of Support-------------------------------------------------------------------------------------------48
Reference-----------------------------------------------------------------------------------------------------49
Appendix A: Organizational Chart------------------------------------------------------------------------55
Appendix B: Self-Care Assessment-----------------------------------------------------------------------57
Appendix C: Home-Care Assessment--------------------------------------------------------------------61
Appendix D: Adolescent Autonomy Checklist----------------------------------------------------------66
Appendix E: Results from the Self-Care Assessment, Home-Care Assessment, and Adolescent
Autonomy Checklist-----------------------------------------------------------------------------------------72
Appendix F: Semi-Structured Interview and Answers-------------------------------------------------76
Appendix G: Living Independently Marketing Flyer---------------------------------------------------83
Appendix H: Living Independently Marketing Letter--------------------------------------------------85
Appendix I: Living Independently Assessment---------------------------------------------------------88
Appendix J: Living Independently Progress Note------------------------------------------------------98
Appendix K: Living Independently Evaluation Summary--------------------------------------------100
Appendix L: Living Independently Budgeting and Staffing Outline--------------------------------102
Appendix M: Living Independently Job Description--------------------------------------------------109
Appendix N: Living Independently Job Newspaper Advertisement--------------------------------112
Appendix O: Living Independently Program Evaluation---------------------------------------------114
Appendix P: Living Independently Timeline-----------------------------------------------------------116
Increasing Life Skills 4
Appendix Q: Living Independently Letter of Support------------------------------------------------119
Appendix R: Living Independently Additional Supporters ------------------------------------------121
Increasing Life Skills 5
Executive Summary
A needs assessment was conducted with the Maureen Kane-Wineland, an occupational
therapist at Rehab Dynamics along with multiple caregivers of adolescents who have
developmental disabilities. The needs assessment and literature review identified a clear need for
a life skills program for adolescents who have developmental disabilities.
The goal for the Living Independently program at Rehab Dynamics is to increase
independent living skills in occupations of daily living and instrumental occupations of daily
living among adolescents who have developmental disabilities. Objectives to measure the Living
Independently goal are to increase functional level in dressing, hygiene, cleaning, laundry, meal
preparation, shopping, emergency, and telephone skills from the beginning of the program, end
of the program, and to the four week follow-up.
The participants will be males and females that are between the ages of 12-18 years old.
All participants will have at least one type of developmental disability. Participants must have an
average of moderate assistance or less in the skill areas that are identified on the Living
Independently Assessment. Eight students will participate in the Living Independently program
held at Rehab Dynamics.
The seventeen week program will teach participants a variety of life skills. All sessions
will be occupationally based with an emphasis on hands-on learning. The levels of independence
will be measured by the caregivers completing the Living Independently Assessment with the
Functional Independence Measure scale. Caregivers will be asked to complete the assessment at
the start, end, and the four week follow-up. The occupational therapist will use the assessment to
measure any improvements in independent skills. The caregivers will also be asked to evaluate
the overall quality of the Living Independently Assessment through a questionnaire.
Increasing Life Skills 6
Introduction
The goal for the Living Independently program at Rehab Dynamics is to increase
independent living skills in occupations of daily living and instrumental occupations of daily
living among adolescents who have developmental disabilities.
Definitions
Independent living is defined as the control over one’s life, with the ability and
opportunity to make choices to perform everyday occupations (National Council for the
Dissemination, 2006).
Skills are observable, goal-directed actions that a person uses while performing
(Crepeau, Cohn, Schell, 2009).
Occupations of daily living (ODL’s) are defined as the tasks directed toward
taking care of one’s own body. These occupations facilitate basic survival and well-being
(American Occupational Therapy Association, 2008).
Instrumental occupations of daily living (IODL’s) are the occupations that support
daily living. Often IODL’s occur within the home or community and require more
complex interactions than the skills needed for ODL’s (American Occupational Therapy
Association, 2008).
Program Site
The Living Independently program will be conducted at Rehab Dynamics in Toledo,
Ohio. Rehab Dynamics is a well known pediatric setting that provides occupational, physical,
and speech-language services to children who have various types of developmental disabilities.
Rehab Dynamics provides services geared toward learning new skills and increasing
independence to approximately 250 children and their families who have developmental
Increasing Life Skills 7
disabilities. The mission of Rehab Dynamics is to guide children to be successful in their lives
and help family members by providing support and education (Rehab Dynamics, 2002). Please
see Appendix A for Rehab Dynamics staff organizational chart.
Rehab Dynamics is a private therapy practice but has associations with the Lucas County
Board of Mental Retardation and Developmental Disabilities, the Fetal Alcohol Diagnostic
Clinic through DOUBLE ARC, and Mary Immaculate School (Rehab Dynamics, 2002). Rehab
Dynamics provides services for clients with and without health insurance coverage as well as,
self-pay services. Rehab Dynamics utilized grant funding from several resources in order to
provide more services to individuals in the Northwest Ohio community.
Program Needs
A needs assessment was conducted to determine the needs for a life skills program. The
needs assessment consisted on a semi-structured interview, the Self-Care Assessment (see
Appendix B), Home-Care Assessment (see Appendix C), and the Adolescent Autonomy
Checklist (see Appendix D). Stakeholders involved in the needs assessment include; Maureen
Wineland, an occupational therapist at Rehab Dynamics; Tammy Lamb, a mother of an adult
with autism and the creator of Breaking Barriers; multiple caregivers of adolescents using Rehab
Dynamics services; HOPE Community Center staff and members; and the Lenawee Intermediate
School District special education teachers.
The semi-structured interview provided the opportunity to ask the stakeholders questions
and develop a baseline of the general needs for this population. The interviews left space to ask
additional questions as they arose in the conversation (Fazio, 2008). Interviews with the
caregivers were conducted in focus groups and in single person interviews. The focus groups
were a casual but productive interaction between the caregivers and interviewer to explain
Increasing Life Skills 8
experiences, attitudes, and views of the caregivers (Lehoux, Poland, & Daudelin, 2006). Two
focus groups with two sets of mothers were conducted while the children were participating in a
group therapy session. The focus groups with the caregivers were beneficial because the
caregivers were comfortable talking amongst other caregivers who have children with similar
disabilities. The caregivers opened up and shared stories about their personal experiences of
having a child with a developmental disability. Individualized interviews were conducted with
caregivers who were unable to attend the focus groups. These interviews were structured and ran
the same as the focus groups.
The Self-Care Assessment, Home-Care Assessment, and Adolescent Autonomy Checklist
were completed by the caregivers. The caregivers are the only stakeholders that could truly
answer the questions which ask about the specific occupational functions of the child in various
occupations. Other stakeholders were not as knowledgeable about the individual participant’s
ability to complete the identified skills. These assessments asked caregivers to check their child’s
level of mastery in tasks and to identify the level of motivation for addressing each task in the
life skills program. The assessments covered a detailed breakdown of occupations of daily living
and instrumental occupations of daily living. Using these assessments allowed parents to identify
a need for additional tasks that were not mentioned in the focus group. The focus groups and
assessments provided a thorough evaluation of the program needs.
Results from the needs assessment supported the need for a life skills program. All the
stakeholders were very knowledgeable about the functional status of the participants and were
able to provide accurate and detailed information. Caregivers identified their child as having a
variety of skills ranging from no basic skill, can complete the task with assistance, and can
complete the task independently. Although it was evident that each child had individualized
Increasing Life Skills 9
needs, the general need for a life skills program was apparent. Interviews with the HOPE staff
and members were also helpful in identifying an extensive variety of ODL’s and IODL’s that
needed to be addressed in a life skills program. Please see Appendix E for results from the Self-
Care Assessment, Home-Care Assessment, and Adolescent Autonomy Checklist. Also see
Appendix F for the semi-structured interview questions and answers.
Demographics and Literature Review
The diagnosis for developmental disabilities is a classification for an individual having
severe impairment or an absence in the process of human development (Brown, 2007). The
Developmental Disabilities Assistance and Bill of Rights Act Amendments of 2000 have defined
developmental disability as a disability occurring at 5 years of age and up to 22 years with
physical and/or mental impairments, limitations in major life activities (occupations), and
required assistance for a lifetime or for an extended duration of time (Brown, 2007). In the years
2006-2008, approximately 1 in 6 American children were reported as having a developmental
disability (Boyle, Boulet, Schieve, Cohen, Blumberg, Yeargin-Allsopp, Visser, & Kogan, 2011).
The prevalence for individuals diagnosed with a developmental disability increased from 12.84%
to 15.04% between the years of 1997 and 2008 (Boyle et al, 2011). Intellectual disabilities were
the most common type of developmental disability along with cerebral palsy, vision impairment,
hearing loss, and autism spectrum disorders (United States Department of Health and Human
Services, n.d.).
Often times, services dwindle for the adolescents who have disabilities. Generally,
toddlers and young children are provided with early intervention services. However, once in
school, therapists have large caseloads and discharge students if progress is inconsistent (Scott,
2001). When a child with a disability reaches adolescence, the occupational therapy services are
Increasing Life Skills 10
typically reduced or discontinued (Scott, 2001). Powell (1994) surveyed one hundred thirty six
Michigan school-based occupational therapists and found that the therapists provide more
services to preschool and elementary students compared to middle and high school students.
Approximately 35% of special education directors across the United States recommend their
school district to provide additional occupational therapy services for adolescents in transition
programming (Spencer, Emery, & Schneck, 2003). Inge (1995) proposed that occupational
therapists are not providing as much secondary transition services as expected.
Dr. Paul T. Shattuck noticed the high rates of adolescents and young adults who are no
longer receiving special supports (2011). In fact, Dr. Shattuck discovered 39.1 percent of youth
with autism were not provided with therapy, mental health, medical diagnostics, or case
management services (2011). Occupational therapy services should not be discharged when an
individual reaches a certain age or gradates from school; instead, occupational therapy services
can facilitate continued increases in independence and quality of life regardless of age (Winkle &
Cobb, 2010). A large majority of a lifespan is spent in adolescence and adulthood. Services
should be provided for the entire lifespan rather than primarily focusing on young children.
There are several barriers that exist for schools in providing life skill programming for
children with developmental disabilities. Kardos and White (2005) revealed the false belief that
transition programming is being provided by another faculty of the school, the lack of
understanding of occupational therapy by other transition team members, and the lack of funding
are the three most identified barriers to transition services. The lack of services and barriers in
schools for providing independent living skills for adolescents indicates the strong need for
additional private therapy providers to offer life skills programs.
Increasing Life Skills 11
A person who has a developmental disability may have problems with skills necessary to
live independently. The individual may have impairments in skills including: social skills,
education, employment, leisure, occupations of daily living, and instrumental occupations of
daily living (Rogers, 2010). Allowing adolescents to engage in meaningful programs can
increase his/her level of knowledge, skills and ability to apply skills to new situations (Kohler &
Field, 2003). Cronin (1996) reviewed the existing literature about the available life skills
programs for students who have learning disabilities. General outcomes were concluded that
students do not learn life skills on their own and require services to teach these skills (Cronin,
1996).
Benz, Lindstrom and Latta (1999) and Benz, Lindstrom, and Yovanoff (2000) reviewed a
Youth Transition Program (YTP) for adolescents who typically have poor academic, social and
independent living skills with little to no job experience. Interventions during the program
included: functional academics, vocational skills, personal and social skills, and independent
living skills (Benz et al., 1999; Benz et al., 2000). Overall, the participant’s active in the YTP
had higher rates of success in receiving a standard diploma, finding and maintaining a job, and
continuing education compared to the non-YTP students (Benz et al., 1999; Benz et al., 2000).
Although vocational skills will not be covered in the life skills program, many of the skills
learned can crossover from employment to basic life skills. The YTP is a great example of the
need for a life skills program and the positive outcomes that can result.
Meal preparation is another important factor to consider with individuals who have
intellectual disabilities. Arnold-Reid, Schloss, and Alper (1997) discussed the importance of
meal planning for independent living. People with disabilities tend to have more health problems
and are more susceptible to eating disorders (Arnold-Reid, Schloss, & Alper, 1997). Teaching
Increasing Life Skills 12
meal planning introduces the individual to independent living skills, functional leisure, nutrition,
and financial management (Arnold-Reid, Schloss, & Alper, 1997). Results from the study found
that adolescents with intellectual impairments were able to plan a menu for three days, create a
shopping list, and select and purchase items at the store (Arnold-Reid, Schloss, & Alper, 1997).
Results also found that the participants were able to maintain the meal planning skills for a
minimum of two months (Arnold-Reid, Schloss, & Alper, 1997). This study demonstrates the
potential for independent living skills and the need for life skills experiences.
Smith and Belcher (1985) found that adults with autism can complete occupations with
fewer verbal prompting after repetitive practice. The participants had an increase in
independence in cleaning the sink, cooking spaghetti, face washing, hair combing, and teeth
brushing (Smith & Belcher, 1985). The conclusions from this study support the need for a life
skills program that gives participants the opportunity to practice each occupation with the
guidance of the therapist.
Skills such as grocery shopping should also be considered. Morse and Schuster (2000)
conducted a research study about teaching elementary students with moderate intellectual
disabilities how to shop for groceries. The students had the opportunity to shop in a real grocery
store and receive storyboard education about the process of shopping. Results found that during
the posttest, the six students who achieved criterion performed the steps of the task analysis with
90% to 100% accuracy (Morse & Schuster, 2000). Seven parents completed a post intervention
survey, five of the parents reported their child had an increased participation in grocery shopping
outside the classroom (Morse & Schuster, 2000). Overall, this study concluded that six students
learned how to purchase two items at the store, maintain the skills to shop for six weeks and
were able to generalize the skills to a different store (Morse & Schuster, 2000). Shopping at the
Increasing Life Skills 13
store requires many IODL skills. The students had to demonstrate competences in transportation,
money management and shopping for meal preparation. This study supports the Living
Independently program with the significant results in successful grocery shopping. Grocery
shopping is one example of an occupation that has many benefits. Developing a similar program
will educate the students on the skills required to shop along with many other IODL’s necessary
to live independently.
The presented literature supports the program goal by demonstrating evidence of
successful life skills programs geared toward increasing skills. The existing literature provides
confirmation that a young adult with a developmental disability can have an increase in skills for
occupations of daily living and instrumental occupations of daily living when receiving the
proper instructions. These articles can be used as a foundation for the program development plan
in order to reach the overall goal. The Living Independently program will focus on areas
identified in the needs assessment in order for each adolescent to live as independently as
possible. Using resources such as; articles, books, online resources, and other life skills programs
will assist in developing an occupationally enriched program.
Model of Practice
The Role Acquisition model developed by Ann Mosey (1986, Chap. 26) is a teaching
model that will complement the Living Independently program. This model emphasizes the
dynamic relationship between skills (task and interpersonal) and roles (family, ODL’s,
play/leisure, work, temporal adaptation) (Mosey, 1986, Chap. 26). Role Acquisition is used for
individuals who are experiencing difficulty transitioning between roles or who must engage in
their social role in a different manner (Mosey, 1986, Chap. 26).
Increasing Life Skills 14
Role Acquisition acknowledges that learning is a complex process (Mosey, 1986, Chap.
26). Learning involves individualized goals, an understanding of what is to be learned,
motivation, active participation, feedback, trial and error, repetition and an enriched environment
(Mosey, 1986, Chap. 26). There are key components of the Role Acquisition model that an
instructor must consider. These considerations include: 1) Engaging the student in active
participation to help with the development of skills, 2) conscious awareness of materials being
learned, 3) the use of realistic and symbolic learning experiences, and 4) the use of simulated and
natural situations (Mosey, 1986, Chap. 26). The therapist would want to use these considerations
to facilitate growth from conscious to unconscious or skill mastery.
Many of the learning principles established in the Role Acquisition model support the life
skills program. Active participation is an effective learning process to facilitate learning and
develop skills (Mosey, 1986, Chap. 26). All sessions in the life skills program will be hands-on
learning with the participants actively engaging in each occupation. Learning starts at the current
level and increases as the individual becomes more comfortable and skilled (Mosey, 1986, Chap.
26). The life skills program will start with simple skills and eventually combine the skills into a
more complex occupation. Repetition and practice aides in the learning process (Mosey, 1986,
Chap. 26). The teaching techniques of the Role Acquisition model are similar to the learning
styles identified in the needs assessment.
Role Acquisition focuses on mastering certain skills at a time. These skills are based on
what the adolescent and his/her parents want to master (Mosey, 1986, Chap. 26). The life skills
program will also consider the participants interests and attempt to assist the adolescent to reach
independence through those interests. Information about the interest was gathered through the
needs assessment and general discussions with the stakeholders or participant. However, some
Increasing Life Skills 15
life skills, such as housekeeping, will be included in the life skills program even if it is not the
participant’s most desired occupation.
While learning new skills, the participant must be conscious of what is being learned
before they can fully master the skills (Mosey, 1986, Chap. 26). The adolescent must also
receive feedback about his/her occupational performance (Mosey, 1986, Chap. 26). The Living
Independently program will include both the conscious learning and the feedback. Prior to the
occupation, the instructor will explain to the participant why they are completing the designated
occupation. The participant will be given feedback about their quality of performance and advice
for ways to improve.
Mosey (1986, Chap. 26) reviews the intervention process for ODL’s. She lists grooming,
cooking, homemaking, and community survival as an example. Mosey continues to state that
ODL’s can be taught within a group context, but it is important for each individual to be able to
perform the ODL’s independently (1986, Chap. 26). Learning ODL’s should be done in real life
situations that allow a hands-on experience (Mosey, 1986, Chap. 26). The therapist should break
down and sequence the tasks (Mosey, 1986, Chap. 26). The Living Independently program will
provide the most naturalistic environment by completing some of the ODL’s in the facility
bathroom and kitchen along with providing many opportunities for hands-on learning.
The long-term goal of Role Acquisition is geared toward the expected environment
(Mosey, 1986, Chap. 26). The overall focus for the life skills program is to increase independent
living skills. The skill areas identified in the Living Independently program are skills that are
identified by Mosey (1986, Chap. 26) and from the needs assessment that will help the individual
to become more independent. The life skills program will implement principles of learning to
Increasing Life Skills 16
provide opportunities for the participants to gain skills and possibly move to an expected
environment.
Federal Initiatives
Governmental efforts such as Healthy People 2020 and Individuals with Disabilities
Education Act (IDEA) have had an impact on the services provided to adolescents who have
developmental disabilities. Healthy People 2020 identified that 28,890 children and youth live in
congregate care residences. The target number is 26,001 children and youth with disabilities to
live in those settings (U.S. Department of Health and Human Services, 2010). The life skills
program can help reduce these numbers by teaching youth the skills necessary to live
independently. The 1997 reauthorization of IDEA was to ensure that students had free
appropriate public education (FAPE) with an emphasis for special education and related services;
including independent living to meet the needs of each student (U.S. Department of Education,
2007). In 2004 IDEA required transition services to be part of the student’s individualized
education plan (IEP) by the time the student is 16 years old (U.S. Department of Education,
2006). The goals of the IEP must have measurable postsecondary goals related to education,
employment and independent living skills. The transition services must help the students to reach
these goals (U.S. Department of Education, 2006). IDEA requires that students with special
needs are provided with services that (a) have an outcome-orientated process that supports post-
school activities (occupations), including independent living, (b) are directed toward the
individual student’s needs, interests, and preferences, and (c) contain instruction for related
services such as daily living skills (Kardos & White, 2005). The life skills program is compatible
with the focus for IDEA because these skills help with the transition process.
Increasing Life Skills 17
The Administration on Developmental Disabilities (ADD) through the U.S. Department
of Health and Human Services Administration for Children and Families is a strong federal
organization to promote the Independent Living program. The ADD promotes the
Developmental Disabilities Assistance and Bill of Rights Act of 2000 which was established to
assist individuals with developmental disabilities and their families to engage in community
supports, individualized supports, and additional supports to assist in self-determination,
independence, and inclusion in community life (Administration on Developmental Disabilities,
2011). ADD offers funding, monitoring, and policy regulation to developmental disabilities
programs Nationwide (Administration on Developmental Disabilities, 2011).
Another federal agency involved in providing independent living skills for individuals
with disabilities is the National Council on Independent Living (NCIL). The NCIL fosters equal
opportunities for people with disabilities to contribute in society through work, community, and
how he/she lives (National Council Independent Living, 2006). The NCIL is involved in the
legislative process to promote social changes, abolish disability-based discrimination and
barriers, and create more opportunities for individuals with disabilities (National Council
Independent Living, 2006). The NCIL has filed a bill to the Senate HELP Committee to create a
new Independent Living Administration (ILA). The ILA will promote America’s Independent
Living (IL) Program to the federal level (National Council Independent Living, 2011).
The World Health Organization (WHO) acknowledges the needs for individuals who
have disabilities and attempts to integrate these individuals into a universal human experience
(World Health Organization, 2011). One attempt to improve services to individuals with
disabilities is to include these students into educational programming (World Health
Organizations, 2011). WHO also works with the UN Department of Economic and Social Affairs
Increasing Life Skills 18
(UNDESA) to integrate individuals with mental health and disabilities into programs by
recognizing barriers and providing opportunities for the involvement in desired programming
(World Health Organizations, 2011). The Living Independently program is a type of service that
would be beneficial for these individuals with developmental disabilities or mental health.
Objectives
The goal for the Living Independently program at Rehab Dynamics is to increase
independent living skills in occupations of daily living and instrumental occupations of daily
living among adolescents who have developmental disabilities.
Participant will improve a minimum of one performance level in five or more basic
dressing skills on the Living Independently Assessment upon completion of the program.
Participant will improve a minimum of two performance levels in six or more grooming
and personal hygiene skills on the Living Independently Assessment upon completion of
the program.
Participant will improve a minimum of two performance levels in six or more cleaning
and house maintenance skills on the Living Independently Assessment upon completion
of the program.
Participant will improve a minimum of two performance levels in five or more laundry
skills on the Living Independently Assessment upon completion of the program.
Participant will improve a minimum of two performance levels in seven or more food
preparation skills on the Living Independently Assessment upon completion of the
program.
Participant will improve a minimum of two performance levels in three or more shopping
skills on the Living Independently Assessment upon completion of the program.
Increasing Life Skills 19
Participant will improve a minimum of one performance levels in three or more
emergency skills on the Living Independently Assessment upon completion of the
program.
Participant will improve a minimum of one performance levels in three or more
telephone skills on the Living Independently Assessment upon completion of the
program.
Marketing and Recruitment
Stakeholders approached in the marketing efforts would include caregivers of children
that receive services through Rehab Dynamics, local school directors, local special education
teachers and teaching aids, school Parent-Teacher Association’s (PTA), local pediatric
physicians, local pediatric therapy providers, Community Mental Health (CMH), Lucas County
Board of MR/DD, and additional organizations that provide services to individuals with
disabilities such as The Ability Center, Sunshine, and the Autism Society of Northwest Ohio
(ASNO). Each of these stakeholders would be sought out due to his/her relevance to the Living
Independently program. These stakeholders have some influence on the services that each
potential Living Independently participant receives. Marketing to a spectrum of pediatric and
disability services will spread the information about the Living Independently program and
potentially recruit more participants.
The Living Independently program will be discussed with caregivers of children aged 10
and older who are receiving services at Rehab Dynamics. The program is for adolescents age 12
and older, but informing the caregivers early will allow for the caregivers to make future therapy
plans. The caregivers will also be given a flyer (see Appendix G) describing the program as a
reminder after the initial conversation. In person discussions and flyers are the most appropriate
Increasing Life Skills 20
approach for marketing to caregivers because they are already at Rehab Dynamics with their
children and have an open relationship with the therapists. The Living Independently program
can be introduced and discussed while the caregivers are at the facility with their children. The
flyer reinforces the discussions and provides opportunities for caregivers to pass the flyer along
to other caregivers who have children that would benefit from the program.
A brief letter will be sent to the local school district directors and special education
teachers, CMH, pediatric physicians, pediatric therapy providers, Lucas County Board of
MR/DD, The Ability Center, and ASNO describing an overview of the Living Independently
program and contact information. The letter (see Appendix H) will contain a brief summary of
the life skills that will be addressed in the program as well as a brief review of existing literature
that identifies the benefits of a life skills program. A phone call to these stakeholders, especially
the school directors, physicians, therapy providers, and case managers at CMH will also be used
for further marketing purposes. A phone call establishes a rapport with these stakeholders and
allows dialogue and questions to be addressed. The phone call will summarize the goals of the
Living Independently program and contact information for future needs. These stakeholders are
very busy and receive a variety of mail. The phone call ensures that information about the
program was received and validates the therapist’s dedication to the program.
The special education teachers, at-risk teachers, PTA, and Community Mental Health will
also receive a flyer. The flyer will be eye-catching and provide a brief summary about the
available life skills program held at Rehab Dynamics. Contact information will also be provided
on the flyer for an opportunity to ask questions. These stakeholders will be able to pass the flyer
along to others service providers or recipients.
Increasing Life Skills 21
Additional information about the Living Independently program will be posted on the
Rehab Dynamics website. The website can be accessed by anyone searching the internet for
adolescent resources. These marketing strategies are highly cost effective with few materials
needed. Aside from the website and personal conversations, the flyers and letters will only
require the cost of paper, printing, and mailing. The flyer will be clear and organized with the
appropriate amount of information necessary without overwhelming the reader. The flyers would
need to have color printing due to the font color and pictures, therefore costing more than
standard black and white printing. The letter will be brief and to the point. The necessary
amount of literature review and Living Independently information will provide the reader with
the exact amount of content to keep his/her attention. The letter will be professional looking and
printed on letterhead.
The marketing strategies identified are appropriate for each population. The letters are
sent to the local school faculty, Community Mental Health, pediatric physicians and therapy
providers because the individuals in these positions tend to have a higher level of education and a
busy schedule. The letter gives each individual the ability to read the letter when it best fits into
his/her schedule. The review of literature is mentioned within the letter to provide additional
evidence in order to convince the reader that the life skills program will be effective.
Informing the caregivers through conversation is appropriate because the caregivers have
an awareness of the program due to prior conversations during the needs assessment. They have
already been involved in the development of the program. Discussing the Living Independently
program with the caregivers gives the staff and families the opportunity to ask questions
immediately face-to-face. The caregivers demonstrated interest in the life skills program during
the needs assessment and would likely be eager to have more discussions.
Increasing Life Skills 22
The flyer will be used as a tool to spread the information about the Living Independently
program to others. The caregivers and service provides can pass the flyer to someone that would
benefit from the services. The flyer will be written using simple and direct language. It is
important not to assume the recipients of the flyer have an advanced reading and comprehensive
reading level. The flyer is used because a letter might be too time consuming or advanced and
lose the attention of the readers. The colorfulness of the flyer is a great attention grabber.
The marketing strategies cover a wide range of promotional mix. Each marketing strategy
provides enough information for the reader to have a clear understanding of the Living
Independently program with contact information for additional questions. The diversity in
marketing strategies matches the targeted population. Providing information to the local school
systems, PTA, Community Mental Health and other organizations increases the chances of the
program being spread through word of mouth. Word of mouth can increase program awareness
and potentially recruit more young adults who have developmental disabilities who are not
recipients of Rehab Dynamics services. Posting the information on the website gives other
people in the community the opportunity to learn about the program.
Potential Participants
The potential participants participating in the Living Independently program will be between
the ages of 12-18 years old. Both males and females will be participating in the program. All
participants must have at least one type of developmental disability. The program will be held in
Toledo, Ohio but participants from other locations are welcome. Even if living independently is
not the goal of the participant and caregiver, learning the skills in the program will decrease the
participant’s overall level of dependence on his/her family. Participating in the program may
give the caregivers more confidence and comfort allowing their child to be more independent in
Increasing Life Skills 23
the home. The Living Independently program will provide services to eight participants at one
time.
Inclusion Criteria
Inclusion criteria for the program include:
Males and females are invited to participate
Must be between the age of 12-18 years old
Participants will not be turned away due to their current living situation
Participants must have an average score of moderate assistance or less assistance in areas
identified on the Living Independently Assessment
Participants must have the motor skills and coordination to make purposeful movements
Participants must be able to follow at least one-step directions
Participants will not be turned away due to medical diagnosis. All types of developmental
disabilities are invited to participate
Participants living outside Lucas County will not be turned away
Participants will be requires to pay a small fee to participate in the program
The Living Independently program will describe the total number of participants, the number
of males and females, average age, current level of functional independence based off the Living
Independently Assessment, type and generalized description of the disability, the current living
situation, future plans for living environment, and any identified goals from the participant or
caregiver which deals with independence.
The recruiting process will begin at Rehab Dynamics. The therapist will discuss with the
current adolescents, soon to be adolescents and the caregivers about the program. The therapist
will tell the families information such as details about the program, the overall program goals,
Increasing Life Skills 24
and the dates and times of the program. Next the therapist will follow up with phone calls
received from interested caregivers. The therapist will call the families with details about the
program including a description of the life skills, the overall goal of increasing independence,
and the dates and times of the group. Potential participants and families will be invited to a mini
open house before the Living Independently program starts. The open house will give
opportunities for the families to meet the therapist and discuss the program. The open house will
give families insight about what to expect from the program by asking the participants to prepare
a light snack such as pretzels and a drink. During the recruitment process the therapist will
emphasize that the program is not geared toward having the participants move out of his/her
current living situation, but to increase skills to become more independent.
Programming
The programming will be directly related to the objectives. The objectives are to increase
skills in the ODL’s and IODL’s that are addressed during the program. The program will include
the tasks that are measured in the objectives identified on the Living Independently Assessment.
Literature for Programming
Creating a program is a multi-step process that takes time and dedication. Many factors
contribute to developing a program, and completing all the steps will provide the best service
possible. The Living Independently program has utilized program development techniques to
provide the most efficient program for adolescents who have developmental disabilities.
Pearson-Bethea (2001) states the first step to developing a program is to understand the
organizational structure of the facility. The organizational structure has been explored through
the organizational chart (see Appendix A) along with many discussions with the faculty at Rehab
Dynamics. The program must also support the mission of Rehab Dynamics (Pearson-Bethea,
Increasing Life Skills 25
2001) which is to guide children to be successful in their lives and help family members by
providing support and education (Rehab Dynamics, 2002). As previously mentioned, the Living
Independently program will reflect the mission of Rehab Dynamics by educating adolescents on
increasing independent living skills.
Existing literature that addresses a similar plan can assist in the creation of a new
program. The program should be supported by an evidence-based literature review that verifies
the need for a program (Robinson, Herz, & Brennan, 2009). The Living Independently program
is supported by various different types of life skills courses and studies. For example, the Youth
Transition Program (Benz, Lindstrom & Latta, 1999; Benz, Lindstrom, & Yovanoff, 2000) has
found positive outcomes related to teaching adolescents life skills. Other literature such as Steps
to Independence (Baker, Brightman, Blacher, Hinshaw, Heifetz, Murphy, 2009) has provided
resources for teaching life skills. A thorough review of the literature was conducted to confirm
the success of life skills programs.
A very crucial part of program development is the needs assessment. A needs assessment
must be completed in order to determine the need of the community (Robinson, Herz, &
Brennan, 2009). The needs assessment helps the programmer to discover the primary needs of
the population as well as common characteristics, concerns and goals of the participants
(Pearson-Bethea, 2001). The needs assessments were conducted via focus groups and semi-
structured interviews (Fazio, 2008). A thorough needs assessment was completed to ensure the
Living Independently program addresses the current needs of adolescents who have
developmental disabilities.
A strong support group is needed to assist with the development of a program (Robinson,
Herz, & Brennan, 2009). The Living Independently program has a large support group ranging
Increasing Life Skills 26
from University of Toledo faculty; Maureen Wineland, founder of Rehab Dynamics; staff at
Rehab Dynamics; staff at HOPE Community Center; and local caregivers in the Lucas County
area. All stakeholders have played an active role in identifying the need for life skills and
supporting the creation of the Living Independently program.
Marketing is another essential component to program development (Robinson, Herz, &
Brennan, 2009). The Living Independently program is marketed to a diverse variety of
stakeholders with the appropriate marketing materials. According to Robinson, Herz, and
Brennan (2009) stakeholders must have a good understanding of what the program will and will
not include. The letters, flyers and discussions assist with painting a clear picture of the program.
The marketing efforts will continue beyond the letter and flyer by inviting caregivers and
participants to attend a mini open house to learn more about the program.
The next components of program development; design and planning, preparation and
implementation, and program evaluation (Fazio, 2008), all take place after the needs assessment
and marketing. The Living Independently program has been designed based on the results from
the needs assessment and is ready to be implemented. The program will conclude with a program
evaluation asking for the caregivers and participants input about the quality of the program and
areas for improvement.
Assessment
The caregivers will be asked to complete the Living Independently Assessment
(see Appendix I) at the beginning, conclusion, and four week follow up of the program.
Caregivers will be asked to rate their child’s functional performance in various ODL’s and
IODL’s. Sections covered in the assessment include; dressing, hygiene, house maintenance,
laundry, food preparation, shopping, emergency, and telephone use. The Living Independently
Increasing Life Skills 27
Assessment is derived from a combination of the Self-Care Assessment, Home-Care Assessment
(Baker et al., 2009) and the Adolescent Autonomy Checklist (University of Washington, 1984-
1987). All three assessments were compared and combined to develop the Living Independently
Assessment in order to analyze the functional performance of adolescents. Collectively, the
assessments provided a more thorough evaluation tool than separately.
The seven point scale used in the Living Independently Assessment is from the
Functional Independence Measure (FIM) (Keith, Granger, Hamilton, & Sherwin, 1987). The
Living Independently Assessment has a description of the seven point scale on the first page. The
FIM scale will replace the typical scale provided for the Self-Care Assessment, Home-Care
Assessment, and the Adolescent Autonomy Checklist to account for sensitivity. In the original
form, the three assessments measure participants by; no basic skills, needs assistance, and can
complete independently. These measurements provide little opportunity for changes in the
overall score. Since a participant may increase skills and require significantly less assistance
without seeing progress on the existing scale, the seven point FIM scale will be implemented as
an alternative.
Programming with Role Acquisition
The Role Acquisition model was designed to help an individual who is experiencing a
role transition or is having difficulty completing roles in his/her current living situation (Mosey,
1986, Chap. 26). The participants in the Living Independently program are experiencing a shift
as he/she matures into adulthood. These participants are also experiencing a shift from having
services as a child to a reduction in the total amount of services available. As services for
adolescents decreases, these individuals are lacking the support needed and are experiencing a
hardship in completing social roles such as independent living skills.
Increasing Life Skills 28
The Role Acquisition model has a large focus on the learning process (Mosey, 1986,
Chap. 26). Many of the learning principles identified in the Role Acquisition model are
implemented in the Living Independently program. According to Mosey (1986) learning is
increased when the participant is able to learn at his/her current level and learn at a pace that is
comfortable. The Living Independently program provides a review session to allow each
participant to work at his/her own speed. The group addresses the topic as a whole, with the
opportunity to work individually during the review session. Parallel to Role Acquisition, the
Living Independently program also provides active participation with frequent reinforcements,
opportunities for trial and error, and repetition during the session and the review.
The Living Independently program also uses a variety of simulated and natural
interventions. Participants will practice using a simulated approach to develop the conscious
awareness of the task. When possible, the participants will move to the naturalist approach to
further develop skills and decrease overall level of attention necessary for the task (Mosey, 1986,
Chap. 26).
The Living Independently program focuses mainly on the role section of the Role
Acquisition. However, many of the skills are concurrently addressed throughout the program.
The task skills such as willingness to participate, ability to follow directions, use of tools, and
attend to detail (Mosey, 1986, Chap. 26) will all be challenged in the program. The participants
must develop the acceptance of engaging in the task and be able to follow along with the
therapist’s directions. The participant will have several opportunities to utilize tools and increase
the ability to notice details during sessions such as cleaning and meal preparation.
Mosey (1986, Chap. 26) states that ODL’s should be demonstrated before the participant
attempts to complete the task, and learning should start in a treatment center but follow up in the
Increasing Life Skills 29
community if possible. A majority of the sessions in the Living Independently program starts
with the therapist demonstrating how to complete the task. Unfortunately a majority of the
program will take place in Rehab Dynamics. However, the sessions will be taught in the natural
and appropriate rooms. The participants will have the Also, the opportunity to practice shopping
at a local grocery store.
Mosey (1986, Chap. 26) also states that the therapist should break down the steps for
each ODL and determine the proper sequencing. The steps can be taught through chaining or
successive approximation (Mosey, 1986, Chap. 26). Each of the life skills covered in the
program are broken down into small steps. Frequently, the recommendation to use backward
chaining is suggested if participants struggle with the task.
Interventions
The Living Independently program will be conducted at Rehab Dynamics. The program
will use a variety of spaces such as the gym, kitchen, craft room, and other rooms to keep the
attention of the participants. One shopping session will be completed at the local Kroger store to
provide the most naturalistic occupation. A variety of occupational forms and learning principles
will be used for the interventions to maximize the participants overall learning experience.
The use of groups is a beneficial approach to the occupational interventions. Groups work
together to reach a common goal, acquire new skills, and complete a task (Kielhofner, 2009).
Groups based on life skills such as meal preparation would be an effective teaching method. The
group would learn the skills together and be able to work as a team to problem solve and
complete the task. The participants would have to work together to identify what utensils are
required and the steps necessary to prepare the food.
Increasing Life Skills 30
Each session will start by “setting the stage” for learning (Baker et al., 2009). The
therapist will select the most appropriate room that is relevant to the topic and has few
distractions. The therapist will introduce the topic and discuss with the participants the
components of the task and reasons for learning the identified skill. Setting the stage is a
technique used to orient the participants and get them ready to learn.
Using a checklist or establishing a routine is a common learning approach used for
individuals who have disabilities (Baugher & Pyne, 2012). During the hygiene sessions,
participants will be asked to organize the steps of showering. The participants will be able to
keep the organized steps and use as a checklist for home when showering. Similarly, the
participants will be asked to put the steps of washing dishes in proper order. Each participant will
receive a copy of the correct dish sequence to follow at home.
Considering the student’s zone of proximal development is another effective approach to
the Living Independently program. The zone of proximal development is the distance between
the child’s current level of development and the possible level reached though independent
problem solving and the child’s potential (Kaplan, 2010). Mosey acknowledges that learning is
enhanced when the interventions start at the participants current level of functioning. The task
can become more challenging when the client feels comfortable (Mosey, 1986, Chap. 26). Using
this approach in the Living Independently program would allow each participant to advance in
skills at his or her individual level. The therapist would gage the participant’s current level of
development and determine his or her potential to complete tasks.
This approach is used frequently through the simulated practice and modified
occupations. When learning how to wash dishes, the participants are asked to simulate washing
the dish with the dish rag without the water. Once participants feel comfortable cleaning all
Increasing Life Skills 31
surfaces of the dish, the occupation increases the challenge by washing the dish in water.
Another example of this approach is the sweeping session. Participants are first asked to
demonstrate the proper hand positioning and sweeping motion without sweeping the floor. Next,
large pieces of crumpled newspaper are thrown on the floor to sweep. As the participant’s
comfort and competence level increases the size of the items to sweep decreases. In addition, the
review session provides additional opportunities for the participant to continue practicing the
skill at his/her level.
Choice is another important factor to consider. Giving participant’s choice in the life
skills program can increase overall participation. Mosey (1986, Chap. 26) found that the
participants overall motivation is very important in the learning process. Giving the participants
the ability to make a choice can increase their overall level of motivation. The meal preparation
area is a great opportunity for the participants to make choices. The therapist will give the
participants the opportunity to select the meal they would like to cook. The entire cooking
session will be based on what the participant wants in the attempt to increase his/her level of
participation.
Practice is another principle identified in the Living Independently program. The
participants will be able to repeat their practice on the skills during the session and review.
Having the opportunity to practice increases the chances of the participants exhibiting long-term
learning with carryover (Kaplan, 2010). This provides evidence that the students will be able to
perform the occupations even after the program has concluded. During the practice approach, the
therapist will want to consider the participants overall performance in daily occupations and
routines (Palisano, Snider, & Orlin, 2004). The therapist will use the progress notes to record
each participant’s performance during all sessions. The therapist will refer back to the progress
Increasing Life Skills 32
notes and address these skill areas during the review for further practice. Repetition and practice
is considered to be an effective technique to facilitate learning (Mosey, 1986, Chap. 26; Kotler &
Koenig, 2012)
Examples of practice would be during the telephone occupations. The therapist will
practice proper telephone manners with the participants. The participants will also practice
dialing the correct numbers on the phone and looking up different phone numbers from various
locations (phonebook, newspaper, menu, or internet). The therapist will give each participant the
opportunity to practice making a phone call to another participant in a separate room using two
phones. Each of these skills will be practiced multiple times until the participant feels
comfortable.
Program Outline
The Living Independently program is made up of several different sessions. Each ODL
and IODL is taught over consecutive sessions before the next skill is introduced. The Living
Independently program will meet twice a week for one and a half hours each session. The Living
Independently program will run for 17 consecutive weeks. The order of the sections is as
follows:
Safety section will meet for a total of four sessions
Telephone section will meet for a total of three sessions
Hygiene section will meet for a total of four sessions
Dressing section will meet for a total of two sessions
Cleaning section will meet for a total of five sessions
Laundry section will meet for a total of five sessions
Shopping section will meet for a total of four sessions
Increasing Life Skills 33
Meal preparation section will meet for a total of six sessions
The very last session of the program will be a party to celebrate the success of the
program
Each section has one review session at the conclusion of the section. The review session is
designed to provide an additional opportunity for participants to practice the occupation. The
therapist will have the progress notes to keep track of each participant’s performance in the skill
area. During the review session, the therapist will review the progress note and have each
participant practice the skill that needs the most improvement. Please see the separate Living
Independently binder for the Living Independently program.
Direct and Indirect Services
Direct services are the services the therapist provides to the participants while they are at
the Living Independently program (Fazio, 2008). These include the physical attendance during
the occupations, the assistance, feedback and suggestions, the group discussions, and the group
and individual interactions during the skill areas.
Indirect services for the Living Independently program include discussions before or after
the sessions with the caregivers. The therapist will provide suggestions and encouragement to the
caregivers about techniques for his/her child to practice at home. The therapist will emphasize
the importance of providing additional opportunities for the participants to practice skills outside
of Rehab Dynamics. The information discussed may be very beneficial for the caregivers and
offer support in the process of teaching his/her child to become more independent.
Writing progress notes and preparing for the review session will be another indirect
service. The therapist will write individualized progress notes at the conclusion of each session.
Increasing Life Skills 34
These progress notes will be used when preparing for the review session. The therapist will have
to decide which areas need more practice, according to the progress note.
Additional indirect services include the preparation and clean up for sessions. Some
sessions such as the meal preparation and hygiene require set-up before the participants arrive.
The therapist must purchase some of the food required for the meal preparation section. The
participants will have a scavenger hunt to find the steps of washing dishes. The therapist must
organize the scavenger hunt and hide the clues around the facility. The therapist will also have to
clean up the area by putting the equipment in the proper location.
Documentation System
Each participant will have his/her own folder that contains personal information about the
Living Independently program. The folders will be stored in a locked filing cabinet in the front
office when the therapist is not using them. The Living Independently Assessment that was
completed by the caregiver at the beginning, conclusion and four week follow-up of the program
will be in the chart. The therapist will also have individualized goals for each participant based
on results from the Living Independently Assessment in the chart. The folder will also contain
the progress notes (see Appendix J) that are written after each session. The therapist observes the
participant engaging in the ODL’s and IODL’s and summarizes the quality of performance, level
of assistance needed, and progress toward each goal pertaining to that life skill. The progress
notes will be analyzed prior to the review session to determine what skills each participant needs
extra practice. Lastly, an evaluation summary (see Appendix K) will be in the folder. The
evaluation summary is used for the therapist to document each participant’s progression
throughout the entire Living Independently program. The summary will identity which goals
Increasing Life Skills 35
were and were not met, areas of improvements, areas that need additional practice, and
recommendations for the future.
Program Discharge
All participants will be discharged from the Living Independently program at the
conclusion of the 17 week course. At that time the therapist will complete an evaluation
summary (see Appendix K) about the participant’s overall occupational performance. The
therapist will suggest the participant returns to the program again if the therapist believes that
he/she has potential for more improvement in independent living skills.
Budgeting and Staffing
Please see Appendix L for budgeting and staffing outline. The occupational therapist
(OT) and certified occupational therapy assistant (COTA) personnel hired must be certified by
the National Board for Certification in Occupational Therapy (NBCOT) and licensed in the State
of Ohio. The OT will be hired to facilitate the life skills program 5 hours each week during the
17 week program. The OT will also be allotted 1 week to prepare for the program and 1 week to
analyze the four week follow-up information from the caregivers. The COTA will be hired to
assist for 3 hours a week during the 17 weeks for programming. The Living Independently
program will be held on Tuesday and Thursday afternoons for one and a half hours each session.
The OT will be responsible for the preparation for each session, instructing the participants about
the specific life skill being taught, clean-up after sessions, writing a progress note for each
participant, and discussing progress and strategies to use at home to facilitate independence with
caregivers before or after sessions. The therapist will have one hour each session for the
preparation, clean-up and discussions. The sessions do not require a great deal of preparation or
clean-up in which the participants cannot assist in completing. The COTA will be available to
Increasing Life Skills 36
assist with facilitating the group and provide an opportunity for the therapist to document
throughout the session to reduce the amount of documentation after the participants have left the
program. The extra hour each session will be sufficient amount of time for the OT.
The average hourly wage for an occupational therapist in the state of Ohio earns
approximately $31 per hour (American Occupational Therapy Association, 2010). The therapist
will be working a total of 95 hours during the program. Therefore, the occupational therapist will
be paid $2,945. No fringe benefits will be offered for this part-time position. The average hourly
wage for a certified occupational therapy assistant in the state of Ohio earns approximately
$20.50 per hour (American Occupational Therapy Association, 2010). The COTA will be
working a total of 51 hours during the program and will be paid $1,045.50. No fringe benefits
will be offered for this part-time position.
The Living Independently program will require some basic essentials. The computer,
printer, ink, and paper will all be used for the marketing efforts, printing the Living
Independently Assessments, and to create the documents for note writing. The stamps and
envelopes will be used to send out the marketing tools to various stakeholders. The 3-ring
binders will be used as the folder that contains information about each participant. The folders
will be stored in the locked filing cabinet in the front office. The dry-erase board will be used
frequently during the Living Independently program for the therapist to write notes for all
participants to see. Rehab Dynamics has multiple landline phones and a phone provider. There
are two working phones that can be used for the telephone sessions. Rehab Dynamics is willing
to cover the cost of the phones and phone line.
The grooming section will cover basic life skills such as washing hands, managing finger
nails, washing hair, using a mirror, washing face, brushing teeth, managing hair, and applying
Increasing Life Skills 37
deodorant. The liquid and bar soap will be used during the hand washing and showering
sessions. The participants should practice using the type of soap that is used at home. Hand soap
may be too harsh for the face; therefore, participants will practice washing his/her face with
simple face wash. For sanitary purposes and opportunities to practice, each participant will have
his/her own finger nail clipper and nail file to use. The participants will practice squeezing the
proper amount of shampoo out of a typical shampoo bottle. The shampoo does not have to be a
certain brand but should be a full sized bottle for a realistic practice. The participants will use the
mirror to practice spot checking self in the mirror. One mirror can be shared between two
participants. Using handheld mirrors ensures that all participants have the chance to use the
mirror in an environment which is not distracting. The mirrors in the bathroom would be too
distracting and interrupt the group dynamics.
Each participant is being taught about the importance of not sharing hair brushes or
toothbrushes. Each participant will have his/her own toothbrush and hair comb to practice using.
The individual brushes are more sanitary and prevent spreading germs. Only one tube of
toothpaste is needed among the group. The toothpaste can be any brand but should be standard
sized to practice squeezing the toothpaste. In addition, the program only needs one roll of the
dental floss and mouthwash. The participants can get him/her a piece of dental floss and put
some mouthwash into a small solo cup. Lastly, the deodorant should also be for each individual
for sanitary reasons. Deodorant does not need any adjustments in squeezing or manipulation
based on size, therefore, travel sized deodorant can be used to decrease overall cost. It is
important to note that special products may need to be purchased due to allergies.
The dressing sessions are relatively inexpensive with many in-kind costs. The program
will purchase one package of calf-high and knee-high socks. Each participant will only need one
Increasing Life Skills 38
sock to practice putting on socks. Rehab Dynamics will split the cost for button-up shirts and
jackets. The shirts will be used to practice buttoning actual clothes and the jacket will allow for
participants to practice zipping. Rehab Dynamics has four of both the button-up shirt and jacket.
Rehab Dynamics is also able to cut the cost for the cleaning sessions. Rehab Dynamics is
willing to provide the brooms, vacuum, and garbage cans. Each participant will have the
opportunity to practice using a standard flat kitchen broom, push broom, and a vacuum. One can
of shaving cream is needed to practice the proper motions for cleaning. Participants will practice
using a spray bottle filled with water before using a spray bottle filled with cleaner solution. All
participants should have a spray bottle to keep the attention and focus during the session. One
bottle of all purpose cleaner and window cleaner will be a sufficient amount of cleaning supplies.
Each participant will practice removing and replacing a garbage bag in the garbage can. A
garbage bag for each participant will provide opportunity to practice opening the garbage bag
and maneuvering the bag into the can. Rehab Dynamics has all dishes, dish rack, and wash cloths
for washing dishes. The program will need to purchase the dish soap.
Practicing making the bed is a common need identified on the needs assessment.
Purchasing a twin sized air mattress gives the opportunity to practice making the bed. The size of
the air mattress is realistic to a bed but can be easily deflated and stored. A regular mattress is
more costly and consumes more space while not being used. One set of sheets and one pillow
will be needed to practice making the bed. The fabric and pattern on the sheets is irrelevant to the
program.
Laundry skills are another area that was commonly mentioned during the needs
assessment. Rehab Dynamics is able to cut the cost by providing various clothing items to wash
and hang on hangers. Rehab Dynamics currently does not have a washing machine or a dryer and
Increasing Life Skills 39
the program will require the purchase of a washer and dryer. Although washers and dryers may
vary among style, participants can learn the basics at Rehab Dynamics and continue practice at
home. The washer and dryer will give participants a naturalistic experience instead of simulated
occupations. The program will also need to purchase the laundry detergent and fabric softener
sheets for washing and drying clothes. One package of tubular, wire, plastic, and wood hangers
will also be purchased. Participants will learn the different styles of hangers and in what
situations each type of hanger should be used.
Participants will practice basic shopping skills. Food items of various densities will be
purchased for participants to practice bagging groceries. The participants will also construct a
shopping list based on items that are needed at Rehab Dynamics. The group will meet at a local
grocery store and purchase the items on the list. The staff at Rehab Dynamics will pre-approve
the list, and cover the cost of the items purchased.
The meal preparation sessions will require a stovetop oven, various kitchen appliances,
utensils, and food. Rehab Dynamics has most of the appliances and utensils that are required.
The Living Independently program will require the purchase of a stovetop oven. Currently,
Rehab Dynamics only has a toaster oven. Participants will be learning the basics of cooking on a
stovetop and in the oven. An electric stovetop oven will be purchased for the group. The group
will be learning how to make basic sandwiches, prepare fruit, cook microwave foods, cook in the
oven, and make an entire meal. The program is providing $100 to cover the cost of all meal
preparation food items to be purchased.
Lastly, the program will conclude with a party. The group is allowing $40 to throw the
party. The $40 will include some decorations and food.
Increasing Life Skills 40
Rehab Dynamics will not charge the Living Independently program a fee for space or
utilities that are being used.
Each participant will have a participation fee of $40. The small fee is to reduce the
overall cost of the program. Rehab Dynamics is willing to work with the families to create
payment plans if families cannot afford the $40 at one time.
Personnel
The occupational therapist and certified occupational therapist assistant must be certified by the
National Board for Certification in Occupational Therapy (NBCOT) and licensed in the State of
Ohio. The occupational therapy practitioners will be preferred, but not mandated, to have at least
one year of experience working with adolescents who have intellectual or developmental
disabilities. Please see Appendix M for job description. The personnel positions will be enlisted
in the Toledo Blade Newspaper Please see Appendix N for advertisement.
Funding Sources
The Living Independently program will be grant funded to reduce the overall cost for
families. Insurance companies will not be billed for the Living Independently program due to the
variety of insurance and coverage. Instead, the program will be funded with a small fee from the
families and grants. Three potential funding sources are; the Stranahan Foundation, Reinberger
Foundation, and May and Stanly Smith Charitable Trust.
The goal of the Stranahan Foundation is to help people become independent and
responsible citizens (Stranahan Foundation, 2010). The Stranahan Foundation supports nonprofit
organizations that have reliable leadership and programs that are effective in meeting the current
needs of the community (Stranahan Foundation, 2010). Proposals should identify a plan to meet
the current needs in a unique approach, use of community resources, support from the
Increasing Life Skills 41
community, measurable results, and a plan to continue financial support (Stranahan Foundation,
2010). The Living Independently program is a great match to receive a grant from the Stranahan
Foundation. Both goals from the Stranahan Foundation and Living Independently program focus
on increasing independence. The Living Independently program meets the current needs of the
community as identified from the needs assessment. The program provides a variety of
interesting educational approaches and is a unique service for adolescents. The community is
largely involved in the program, with stakeholders throughout the community supporting the
program and community members participating in the program. The success from the program
will be evident with the Living Independently Assessment administered at the beginning,
conclusion, and four week follow-up. Lastly, the plan is for the program is to reduce the total
cost and will not require much funding in the future.
The Stranahan Foundation prefers programs that fall within the five priority areas of
interest: education, physical and mental health, ecological well-being, arts/culture, and human
services (Stranahan Foundation, 2010). The Living Independently program falls into the
education area by providing an alternative educational opportunity. The life skills program also
falls under the category of human services. The Foundation is committed to strengthening the
community by helping disadvantaged individuals with the ability to; access services that meet
basic needs, have opportunities to engage in community life, and achieve self-sufficiency and
contribute to the community (Stranahan Foundation, 2010). The life skills program teaches basic
life skills in order for each participant to become active in the community.
All applicants applying for a grant must be a nonprofit organization as defined in Section
501. To apply for a grant from the Stranahan Foundation, all applicants must submit a letter of
inquiry. Letters of inquiry should be sent via the e-grant system; stranahan.egrant.net. The
Increasing Life Skills 42
applicant can submit the full proposal after the letter of inquiry is reviewed and approved
(Stranahan Foundation, 2010). The deadline date to submit a letter of inquiry is May 1, 2012 and
November 1, 2012 (Stranahan Foundation, 2010). The Foundation website did not identify a
floor or ceiling amount of money for funding.
Another local funding source would be the Reinberger Foundation. The Reinberger
Foundation is dedicated to improving quality of life for all individuals. The Foundation supports
programs that include one of the areas of arts, education, human service-health, and human
services-other (Reinberger Foundation, n.d.). The Living Independently program would qualify
under the human services-other category, where child and Youth programming are listed. The
Living Independently program will assist the adolescent population by providing services that
increase independent living which could increase overall quality of life.
The Reinberger Foundation will accept applications from non-profit organizations,
preferably from the Northeast Ohio or greater-Columbus area. Applicants for the human
services-other grants must submit a letter of inquiry by September 1. Letters of inquiry are
limited to two pages. Letters of inquiry should be mailed to 30000 Chagrin Blvd., #300
Cleveland, OH 44124. The letter of inquiry will be reviewed and the applicants will be notified
within one month for a request for a full proposal or a decline. The deadline for the full proposal
is November 1. The Foundation website does not identify a ceiling or floor amount of money
granted (Reinberger Foundation, n.d.).
The May and Stanley Smith Charitable Trust is dedicated in providing opportunities for
children, youth, elderly, people with disabilities or who are critically ill, and disadvantaged
adults and families (Adminitrust LLC, 2012). The opportunities for these populations are geared
toward improving overall quality of life, the promotion of self-sufficiency and assistance in
Increasing Life Skills 43
reaching one’s highest potential (Adminitrust LLC, 2012). The Trust grants funding to
organizations that provide direct services to individuals in the effort to make a long-term
difference in the life of each person served (Adminitrust LLC, 2012). In the area of children and
youth, the Trust is devoted to promote healthy development and future independence for all
children (Adminitrust LLC, 2012). The goal of the Living Independently program is to educate
the students about the skills necessary to live independently. The May and Stanley Smith
Charitable Trust is highly interested in programs that encourage independent living situations by
providing educational, physical, and life skills programs for individuals who have disabilities or
are critically ill (Adminitrust LLC, 2012). The content in the life skills program matches
perfectly with the values and interests of the May and Stanley Smith Charitable Trust.
Independent living and achieving one’s highest potential is the overall goal for the Living
Independently program and the May and Stanley Smith Charitable Trust.
The May and Stanley Smith Charitable Trust does not have a limit on amount of money
being requested. Applicants can submit a letter of inquiry at anytime throughout the year. A
deadline will be determined if the applicant is asked to submit a full proposal. Prior to submitting
the letter of inquiry, the website provides an eligibility quiz for applicants to complete to
determine if their request matches the criteria for the Trust. The application process in a two-
stage process: the online letter of inquiry and the full proposal. Staff reviews the letter of inquiry
and determines if the applicant should submit the full proposal (Adminitrust LLC, 2012).
Applicants will be notified within a month of submitting the letter of inquiry. If the review board
accepts the letter of inquiry the applicant will be asked to submit the full proposal. Applications
are accepted based on the potential for success, capacity of the requesting organization,
compliance to the application guidelines, and appropriateness of the proposal to May and Stanley
Increasing Life Skills 44
Smith Charitable Trust’s mission. The entire application process takes between four to six
months (Adminitrust LLC, 2012).
Self-Sufficiency
The Living Independently program will be able to maintain self-sufficiency beyond the
first year. The total cost to run the program will decrease after the first session. The expensive
equipment such as the washer, dryer, and stovetop oven can be reused and will not have to be
purchased again. The Living Independently program does not have a long expense list to run
each session. The total cost for personnel can also be reduced. After the program has been
successful, the program will be able to hire new personnel. The certified occupational therapist
assistance (COTA) can take over the program and run the sessions. Rehab Dynamics will be able
to pay the COTA less money than the occupational therapist. A group assistant without any type
of certification can assist the COTA during the group. Rehab Dynamics has many students
completing school assignments. The program will also be able to utilize the students to assist
with the class, which would eliminate the cost of a group assistant. The overall cost of the
program will decrease the following years.
Program Evaluation
Caregivers will be asked to complete the Living Independently Assessment at the start of
the program, end of the program, and four weeks after the program. The Living Independently
Assessment will measure the participant’s performance level using the seven point scale from the
FIM. Caregivers will score their child’s level of independence in dressing, grooming,
cleaning/house maintenance, laundry, food preparation, shopping, emergency, and telephone use.
The therapist will compare the answers from the beginning, end, and follow up assessments to
Increasing Life Skills 45
determine if the participant showed any progress. The therapist will be able to determine if the
objectives were met based on the score of each of the life skills.
The objectives are geared to measure an increase in each skill category. The objectives
account for all independence levels and allow each participant to progress at his/her own pace.
The participants do not need to become completely independent in order to meet the objectives.
Each objective identifies the performance level to be achieved in each skill category for a certain
amount of skills. For example, the dressing category states that the participant will improve a
minimum of one performance level in five or more dressing skills. If one participant is scored as
needing moderate assistance for putting on socks, starting a zipper, buttoning, putting on a front
open shirt, and selecting clothes appropriate for the weather at the beginning of the program and
at the end of the program the participant is able to complete these tasks with minimal assistance,
the participant met the objective. However, if the participant still required moderate assistance in
four of the five skills, the objective would not be met. At the same time, if a participant was
scored to need supervision in the same five skill areas at the beginning of the program and is able
to complete the skills with modified assistance, that participant also met the objective. Each
participant is able to meet the objectives regardless of performance compared to one another.
The therapist must compare the results from the assessment at the start, conclusion, and four
week follow-up to determine if the objectives were met.
Prior to starting an occupation, the therapist will discuss with the participants the purpose
and intentions for each occupation. The therapist will summarize the discussion and ask all
participants if they understand the occupation. The therapist and COTA will facilitate each
session and provide opportunities for each participant to attempt the occupation. The OT and
COTA will evaluate the performance through observations and document the participant’s
Increasing Life Skills 46
performance on the progress note. The therapist will compare the performance to the answers on
the Living Independently Assessment and decide if the participant needs further practice. Further
practice will be determined based on performance and progression toward each objective. This
process will be repeated for each life skill category.
The caregivers play a key component in the evaluation process. Each caregiver will be
asked to evaluate his/her child at the beginning, end, and four week follow-up. The therapist will
also meet with the caregivers frequently to discuss progress and any potential concerns. The
therapist will reassure that the caregivers and the therapist both agree on the progress and
objectives. In addition to the Living Independently Assessment, the caregivers will also be asked
to complete a Living Independently Program Evaluation (see Appendix O). The evaluation will
be a survey that contains questions regarding usefulness of discussions and suggestions provided
by the therapist, the overall quality of the program, and how the program could improve. The
surveys will be mailed out by the office staff, three weeks after the program has ended. The
surveys will contain a pre-stamped envelope for the caregiver to return the survey. The
caregivers will be asked to return the survey within one week. The therapist will inform
caregivers about the survey during the last week of the program.
The evaluation methods to evaluate the participant’s progress and caregiver’s satisfaction
are achievable and will provide a thorough evaluation of the program. The Living Independently
Assessment and caregiver survey will be an effective way to conduct a summative evaluation of
the program. The therapist will also formatively evaluate the program by observing the
participant’s performance throughout the course of the program. The therapist will have the
opportunity to work one-on-one with all participants during each of the life skills. The therapist
will watch the participant’s overall performance and monitor his/her progress. The therapist will
Increasing Life Skills 47
also communicate with the caregivers about the participant’s progress. The therapist will make
any necessary changes to the rest of the program based on the observations and conversations
with the participants and caregivers. If major discrepancies are found between the results on the
Living Independently Assessment and the therapist observations, the therapist will use the results
on the Living Independently Assessment for consistency and true occupational performance at
home.
Timeline
The timeline of responsibilities for the occupational therapist is available in Appendix P.
The therapist will start the program by conducting a needs assessment, marketing, recruiting
participants, printing the forms, facilitating the open house, asking caregivers to complete the
Living Independently Assessment, and creating individualized goals for each participant. The
therapist will have to purchase the non-perishable items at the beginning of the program. The
therapist will also be responsible for shopping for more supplies as the program progresses into
sessions that require a shopping experience or food.
The therapist will be responsible for communicating with the caregivers, facilitating the
biweekly life skills classes, writing progress notes, observing the participants, and making
adjustments as needed throughout the entire program. The therapist must be active in these steps
to ensure the best quality of education and program thoroughness. The therapist is responsible
for overseeing the entire program process.
The therapist will also be responsible for asking the caregivers to complete the Living
Independently Assessment and analyzing the results. The therapist will have to compare the
results from the assessment at the beginning, end, and four week follow-up. The therapist will
also have to evaluate each participant’s performance at the conclusion of the program. The
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therapist will review the results from the caregivers on the Living Independently Program
Evaluation (see Appendix O).
Letter of Support
A letter of support will be signed by Maureen Kane-Wineland, the co-owner of Rehab
Dynamics (see Appendix Q). The letter will contain a brief summary about the needs for the
program and predicted program outcomes. Please see Appendix R for a list of additional
stakeholders who would be able to write letters of support for the Living Independently program.
The letters would be from staff, caregivers, disability advocates, and other key stakeholders that
support the program. The letters will be available to provide evidence for potential participant
families, community members or funding sources about the quality of the program. Letters of
support will be printed on letter head if applicable.
Increasing Life Skills 49
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Appendix A
Organizational Chart
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Appendix A
Rehab Dynamics Organizational Chart
Office Manager
Jill Delbrocco
Assistant Office Staff
Lauren Danko
Physical Therapy
Michelle Lemon
Megan Gicote
Occupational Therapy
Brynn Barga
Lynn Campbell
Alysia Kusner
Danielle Nelson
Brooke Paulski
Howard Luebke
Eric Polz
Speech Language Pathology
Marianne Briggs
Kim Long
Lauren Wright
Felicity Strause
Co-Owners
Ann Nagle & Maureen Kane-Wineland
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Appendix B
Self-Care Assessment
The Self-Care Assessment was created by Baker, B.L. & Brightman, A.J. (2009) in Steps to independence: Teaching everyday skills to children with special needs.
The Assessment is available for public access to download from the publishing website http://www.brookespublishing.com/steps/
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Appendix B
Self-Care Assessment
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Appendix C
Home-Care Assessment
The Home-Care Assessment was created by Baker, B.L. & Brightman, A.J. (2009) in Steps to independence: Teaching everyday skills to children with special needs.
The Assessment is available for public access to download from the publishing website http://www.brookespublishing.com/steps/
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Appendix C
Home-Care Assessment
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Appendix D
Adolescent Autonomy Checklist
The Adolescent Autonomy Checklist was developed by the Youth in Transition Project (1984-1987) at the University of Washington Division of Adolescent Medicine. The checklist is based on a Model developed by the Children's Rehabilitation Center at the University of Virginia. The checklist can be found and downloaded at http://www.aacpp.com/pdf/parents/English/Teens/Adolescent-Autonomy-Checklist.pdf
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Appendix D
Adolescent Autonomy Checklist
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Appendix E
Results from Self-Care Assessment, Home-Care Assessment, and
Adolescent Autonomy Checklist
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Appendix E
Results from Self-Care Assessment, Home-Care Assessment, and
Adolescent Autonomy Checklist
Dressing
Tie shoes Put on socks
Start a zipper Buttons
Put on front-button shirt
Laundry
Fold clothes Hang clothes
Wears clothes that are clean and pressed Clothes that fit
Clothes that match Clothes appropriate to weather
Appropriate to social occasion
Grooming/hygiene
Shaving Combs and brushes hair
Use tissue Take care of eyeglasses or contacts
Uses toilet paper and toilet Washes and rinses hair
Take bath or shower with soap and washcloth Brushes teeth and uses mouthwash
Uses a mirror to spot-check appearance Trims fingernails/toenails
Wipes food/dirt off clothes and face
Health Care
Gets enough sleep Identify cold symptoms
Cleaning
Puts things away Empties baskets and puts out trash
Sweeps Dusts
Vacuum Washes windows or mirrors
Mops floor Cleans sink
Cleans toilet Cleans stove
Cleans oven Washes and dried dishes, pots, and pans
Loads dishwasher properly Shovels snow
Laundry
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Separates machine from hand washables Separates dry cleaning from washables
Separates clean from dirty clothes Separates light from dark clothes
Washes items by hand Hangs items on clothesline
Properly loads washing machine Measures soap
Uses dryer Hangs clothes neatly
Folds clothes neatly Puts clothes away appropriately
Iron clothes as needed
Food Preparation
Puts groceries away Sets table
Clears table Prepares cold breakfast
Makes sandwich Cooks prepared foods
Prepares hot breakfast Uses oven
Fixes salads and desserts Helps plan and prepare meals
Cooks main dish Cooks complete meal
Stores leftover foods Identified and discards spoiled foods
Uses toaster Uses mixer/blender
Uses can opener Uses measuring utensils
Familiarity with content of packaged foods
Replacing used items
Replacing burned-out light bulb Replaces toilet paper roll
Replace bar of soap in bathroom Replace trash liners
Routine adjustments and maintenance
Adjust thermostat Secures the residence
Makes bed Changes bed
Clean room Feeds and waters house plant
Know tool safety
Non-routine repairs
Hangs a picture Stops continuously running toilet
Unclogs toilet or sink Glues broken items
Unjams toaster
Emergency
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Plan fire exits and emergency procedures Use a fire extinguisher
Know where extra key is located
Personal skills
Uses phone Manage personal grooming
Health care skills
Know height, weight, and birthday Know health emergency telephone numbers
Discuss role in health maintenance
Community skills
Get around city (pedestrian skills) Use public transportation
Leisure time skills
Invite a friend over
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Appendix F
Semi-Structured Interview and Answers
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Appendix F
Semi-Structured Interview and Answers
Semi-Structured Interview with Maureen Wineland
What are the interests of the participants?
Quite variable based on age and ability. Hard to give any one answer many video games. Some
like DVD’s, jokes, and video games.
How do the participants learn best?
Again there is no one best way. Many need multiple ways modeling demonstrations one on one
instructions visual schedules
What occupations do the participants struggle with the most? A home? At school?
Most that I am concerned with fall between cracks as can dress do shower etc and function, but
not good at self independence things like making a meal, shopping for food, ordering at
restaurant, getting things out to prepare a meal of knowing what they need, following multi step
directions without lots of help, participating with peers without getting mad
Which occupations are the most important for the participants to master?
Independent living skills or at least skills that would allow them to do some of the things that
they need to be more independent from parent. Possibly be able to get themselves dinner. Shop
and get food they need, or work with peers to complete a task. Are the participants able to get a
job and be able to follow the directions without getting distracted or wondering off
Are there any specific services/programming you'd like to see provided for the
participants?
I don't know how to provide programming that meet these needs and get it covered by insurance
or how to meet needs when they are so diverse and it would take so much staff. Social
participation is one part that we have tried to address and we try to incorporate more tasks where
they have to plan, organize, work with peers to make meal or food and I have tried to set up
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some work tasks to help one participant get ready for a simple job but what else can we do in the
clinic setting to help with these goals
What is the current level of independence of the participants and where would you like to
see them function independently?
Highly variable. Some are competent in many areas and are more independent, while others need
much more help
Are there any triggers or situations that cause a behavior?
Kid specific. People touching them, being in their space, too many directions, winning and
losing, not getting the attention they seek
What is the best way to manage behaviors?
Same as above varies kid by kid. We tend to use 1-2-3 magic strategies
Semi-structured Interview with Caregivers at Rehab Dynamics
What are some of the interests of your child?
Common interests of the adolescents at Rehab Dynamics include computers, watching tv,
playing video games, swimming, reading, electronics, animals, and role playing.
How does your child learn best?
Rehab dynamic participants learn best with:
Visual aids
Providing rewards and punishments
Prompting
Breaking tasks down into steps
Schedules
Time frame for tasks
What tasks have you noticed your child is having the most difficulties completing? At
school? At home?
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Social skills- screening words, determining appropriate/inappropriate words and times to
speak, blurting out, perseverance of topics, interrupting, listening skills, peer interactions,
small talk, phone skills
Anger management
Money management- counting, Dollar up, understanding change
Shopping- finding items in store, creating a list, recognizing items, using cart,
Kitchen skills
Following directions
Manners
Laundry- sorting, folding, vocabulary/supplies
Cleaning- entire surface
Hygiene- brushing hair, finger/toe nail maintenance
Safety at home, steps before and after calling 911
Exercise and health
Knot tie- garbage bags, shoes
Light kitchen skills- cutting apples, cleaning grapes, making toast, preparing bowl of
cereal, spreading butter, using microwave
What level of independence does your child have now, and where would you like them to
be?
The boys discussed in this needs assessment live at home. The parents predict the boys to live in
a group home or independent if possible.
What are the occupations you think are the most important for your child to master?
Parents feel their child should master safety skills, manners, social skills, light kitchen skills,
basic life skills.
What type of programs/services would you like to see implemented for your child?
Life skills
Cooking
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Safety
Cleaning skills
Social skills training.
Is there anything that causes reactions/behaviors for your child?
One participant is afraid of flies and has a severe reaction.
What types of behavior management techniques do you us to address your child’s
behaviors?
Remind participant that the fly won’t hurt him, or remove him from area
Are there any precautions to know when working with your child?
Food allergies- dairy and gluten
Semi-Structured Interview and Focus Groups with HOPE members, staff and LISD staff
What are some of the interests of your participants?
Common interested include: watching TV, reading, going for walks, completing puzzles, basic
adult education, social clubs/activities, socializing, sports and recreation, comic books, karaoke,
music, food, volunteering
How do your participants learn best?
Participants learn best with:
Hands-on tasks
Handouts/notes
Providing step by step directions
Visual aids
Optimal engagement in sessions
Repetition
Interactive
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What tasks have you noticed your participants are having the most difficulties completing?
At work? At home?
Common themes of occupations include:
Fine motor skills- coin manipulation, folding paper, opening containers,
Fast food restaurant skills- filling cup, getting condiments and napkins, throwing away
food, tray manipulation, menu reading, money transaction
Hair management- brushing, washing, drying, styling
Money management, coin manipulation, coin counting, paying bills, cashing checks
Cooking, microwave skills
Shopping, store orientation, community skills, transportation
Ironing, folding, hanging, sorting, washing, and putting clothes away
Donning coats, fasteners, zippers
Following directions
Cleaning- dishes, clearing table, dusting, vacuuming, garbage liners,
Shaving
What level of independence do your participants have now, and where would you like them
to be?
HOPE members live in variety of settings including; home with family, group home, or living
independent with and without staff checking in occasionally. Some independence is limited due
to the restrictions in group home policies. Majority of HOPE members are fairly independent in
basic self-care. Some members have potential to increase level of independence but will most
likely continue to need assistance/supervision. However, HOPE staff does not wish to promote
HOPE members to move out of current living situation.
What are the occupations you think are the most important for your participants to
master?
Task initiation and motivation to complete occupation
Money management for monthly allowance, outings, and special events
Basic life skills
Increasing Life Skills 82
Emergency skills
Social awareness
Safety
Navigate transportation.
What type of programs/services would you like to see implemented for your participants?
HOPE members and staff expressed desire for cooking, shopping, community safety, money
management, independent living skills,
Is there anything that causes reactions/behaviors for your participants?
No real behavior issues that would interfere with programs
What types of behavior management techniques do you us to address your participant’s
behaviors?
Seek assistance from HOPE staff
Are there any precautions to know when working with your participants?
Seizures, diabetic, weight lifting restrictions
Increasing Life Skills 83
Appendix G
Living Independently Marketing Flyer
Increasing Life Skills 84
Are you a caregiver seeking help
to teach your child life skills?
Living Independently A life skills program for adolescents who have
developmental disabilities
The Living Independently program is a group-based series
designed to increase independence in the following areas:
Dressing
Hygiene
Laundry
Housekeeping
Meal preparation
Telephone skills
Shopping
Emergency
For more information please call
Renae Sauter: (517) 902-6158
Living Independently program will be held at Rehab Dynamics
3160 Central Park West Drive, Toledo, Ohio 43617
Increasing Life Skills 85
Appendix H
Living Independently Marketing Letter
Increasing Life Skills 86
Appendix H
Living Independently Marketing Letter
Renae Sauter Rehab Dynamics 3160 Central Park West Drive Toledo, Ohio 43617 419-841-1840 To whom this may concern: This letter is to inform you about a new program available for adolescents who have developmental disabilities. The Living Independently program is a series of sessions that teach adolescents various types of life skills. A certified occupational therapist will be facilitating each session at Rehab Dynamics.
As literature shows, adolescents have fewer services and therapy opportunities available through the school and community as caseloads increase. School therapists often have large caseloads and frequently discharge adolescent students if progress is inconsistent (Scott, 2001). Dr. Paul T. Shattuck, a national expert on disabilities, has discovered that 39.1 percent of youth with autism were not provided with therapy, mental health, medical diagnostics, or case management services (2011). Winkle and Cobb (2010) identify that occupational therapy services can continue increasing independence and quality of life regardless of age. Life skills programs have been proved effective for individuals with disabilities. A Youth Transition Program has been implemented in Minnesota which has fostered significant independent living skills for the participants. Research has proved that an individual with a disability can learn and sustain skills. Life skills such as meal preparation, grooming, and shopping have all proven successful when given an opportunity to learn (Arnold-Reid, Schloss, & Alper, 1997; Smith & Belcher, 1985; Morse & Schuster, 2000). The Living Independently program is designed to provide an opportunity for adolescents who have developmental disabilities the chance to learn life skills. The program is a group-based approach that will meet during after school hours. Please pass this information about the program to families you think would benefit from this opportunity. If you have any questions or comments, please do not hesitate to call me at 419-841-1840. I am available Monday thru Friday 9:00am-5:00pm. Thank you for your time and I look forward to hearing from you. Sincerely, Renae Sauter, OTD/S Please see attached page for list of references mentioned within this letter.
Increasing Life Skills 87
References
Arnold-Reid, G.S., Schloss, P.J., & Alper, S. (1997). Teaching meal planning to youth with
mental retardation in natural settings. Remedial and Special Education, 18, 166-173.
Morse, T.E., & Schuster, J.W. (2000). Teaching elementary students with moderate intellectual
disabilities how to shop for groceries. Exceptional Children, 66, 273-288.
Scott, J. (2001). Occupational therapy for adolescents with autism. Developmental Disabilities
Special Interest Section Quarterly, 24, 1-3.
Shattuck, P., (2011, February 24). Adults with autism and their families often left without help
after high school [Web log post]. Retrieved from http://blog.autismspeaks.org/tag/dr-
paul-t-shattuck/
Smith, M.D., & Belcher, R. (1985). Teaching life skills to adults disabled by autism. Journal of
Autism and Developmental Disorders, 15, 163-175.
Winkle, M.Y. & Cobb, A.L., (2010). Plotting next steps: Transitions for adults with
developmental disabilities. OT Practice, 13-16.
Increasing Life Skills 88
Appendix I
Living Independently Assessment
Increasing Life Skills 89
Appendix I
Living Independently Assessment
For each of the skills identified in this assessment evaluate your child’s level of independence according to the scale below:
Scale measurements according to the Functional Independence Measure (FIM)
Total Assistance- Subject contributes less than 25% of the effort or is unable to do the task
Maximal Assistance- Subject provides less than half of the effort 25% to 49% of the task Moderate Assistance- Subject performs half or more than half (50-75%) of the task Minimal Assistance- Subject requires incidental hands-on only and performed greater
than 75% of the task Supervision or Setup- Subject requires only standby assistance or verbal prompting or
help with setup Modified Independence- Subject requires the use of a device but no physical help Complete Independence- Subject is fully independent
(Functional Independence Measure, n.d.)
Increasing Life Skills 90
SKILLS
Act
ivit
y D
oes
Not
Occ
ur
Com
plet
e A
ssis
tanc
e P
rovi
ded
Max
imal
A
ssis
tanc
e P
rovi
ded
Mod
erat
e A
ssis
tanc
e P
rovi
ded
Min
imal
A
ssis
tanc
e P
rovi
ded
Sup
ervi
sion
or
Set
up P
rovi
ded
Mod
ifie
d In
depe
nden
ce
Com
plet
e In
depe
nden
ce
Basic Dressing
Puts on underpants
Puts on undershirt
Puts on socks
Puts on pants
Puts on pullover shirt, sweater
Puts on front-button shirt, blouse
Takes off pullover shirt, sweater
Pulls zipper up/down (if started)
Threads a belt
Starts a zipper
Buttons
Fastens snaps, hooks
Ties shoes
Puts on a slip
Puts on a bra (if appropriate)
Puts on nylons/pantyhose (if appropriate)
Ties a necktie (if appropriate)
Wears clothes that are clean and presses
Selects clothes that fit
Increasing Life Skills 91
Act
ivit
y D
oes
Not
Occ
ur
Com
plet
e A
ssis
tanc
e P
rovi
ded
Max
imal
A
ssis
tanc
e P
rovi
ded
Mod
erat
e A
ssis
tanc
e P
rovi
ded
Min
imal
A
ssis
tanc
e P
rovi
ded
Sup
ervi
sion
or
Set
up P
rovi
ded
Mod
ifie
d In
depe
nden
ce
Com
plet
e In
depe
nden
ce
Selects clothes that match
Selects age-appropriate clothes
Selects clothes appropriate to weather
Selects clothes appropriate to social occasion
Grooming and Personal Hygiene
Uses toilet and toilet paper
Washes and dries hands
Washes and dries face
Takes bath or shower, with soap and washcloth
Uses deodorant
Washes and rinses hair
Brushes teeth and uses mouthwash
Cleans ears
Shaves (if appropriate)
Applies makeup (if appropriate)
Combs and brushes hair
Uses a mirror to spot-check appearance
Trims fingernails/toenails
Uses aftershave/perfume
Increasing Life Skills 92
Act
ivit
y D
oes
Not
Occ
ur
Com
plet
e A
ssis
tanc
e P
rovi
ded
Max
imal
A
ssis
tanc
e P
rovi
ded
Mod
erat
e A
ssis
tanc
e P
rovi
ded
Min
imal
A
ssis
tanc
e P
rovi
ded
Sup
ervi
sion
or
Set
up P
rovi
ded
Mod
ifie
d In
depe
nden
ce
Com
plet
e In
depe
nden
ce
Uses a handkerchief/tissue
Takes care of eyeglasses or contact
lenses (if appropriate)
Wipes food/dirt off clothes
Uses tampons or sanitary napkins (if
appropriate) and disposes of them properly
Cleaning/ house maintenance
Puts things away
Empties baskets and puts out trash
Replaces trash liners
Sweeps
Dusts
Vacuums
Washes windows or mirrors
Mops floor
Cleans sink
Cleans toilet
Cleans stove
Cleans oven
Washes and dries dishes, pots, and pans
Increasing Life Skills 93
Act
ivit
y D
oes
Not
Occ
ur
Com
plet
e A
ssis
tanc
e P
rovi
ded
Max
imal
A
ssis
tanc
e P
rovi
ded
Mod
erat
e A
ssis
tanc
e P
rovi
ded
Min
imal
A
ssis
tanc
e P
rovi
ded
Sup
ervi
sion
or
Set
up P
rovi
ded
Mod
ifie
d In
depe
nden
ce
Com
plet
e In
depe
nden
ce
Loads dishwasher properly (if appropriate)
Changes linens
Makes bed
Replaces burned-out light bulb
Replaces toilet paper roll or bar of soap in bathroom
Replaces batteries in toy, radio, or flashlight
Replaces vacuum cleaner bag
Laundry
Puts dirty clothes in hamper
Separates machine from hand washables
Separates dry cleaning from washables
Separates clean from dirty clothes
Separates light from dark clothes
Washes items by hand
Hangs items on clothesline
Properly loads washing machine (knows what setting to use)
Measures soap
Increasing Life Skills 94
Act
ivit
y D
oes
Not
Occ
ur
Com
plet
e A
ssis
tanc
e P
rovi
ded
Max
imal
A
ssis
tanc
e P
rovi
ded
Mod
erat
e A
ssis
tanc
e P
rovi
ded
Min
imal
A
ssis
tanc
e P
rovi
ded
Sup
ervi
sion
or
Set
up P
rovi
ded
Mod
ifie
d In
depe
nden
ce
Com
plet
e In
depe
nden
ce
Uses dryer
Hangs up clothes neatly
Folds clothes neatly
Puts clothing away appropriately
Irons clothing as needed
Food Preparation
Helps plan meals
Puts groceries away
Sets table
Clears table
Follows recipe
Gets snack
Prepares cold breakfast
Makes sandwich (no mixing, no cooking)
Cooks prepared foods
Prepares hot breakfasts
Uses microwave (sets for setting/times correctly)
Uses oven (sets for temperature/times correctly)
Fixes salads and desserts
Increasing Life Skills 95
A
ctiv
ity
Doe
s N
ot O
ccur
Com
plet
e A
ssis
tanc
e P
rovi
ded
Max
imal
A
ssis
tanc
e P
rovi
ded
Mod
erat
e A
ssis
tanc
e P
rovi
ded
Min
imal
A
ssis
tanc
e P
rovi
ded
Sup
ervi
sion
or
Set
up P
rovi
ded
Mod
ifie
d In
depe
nden
ce
Com
plet
e In
depe
nden
ce
Cooks main dish
Cooks complete meal
Finds/replaces food and utensils in designated areas
Identifies canned or boxed food by labels
Stores leftover foods
Identifies and discards spoiled foods
Identifies and uses utensils and appliances:
Toaster
Blender
Can opener
Ice cream scoop
Uses spatula
Uses measuring utensils
Shopping
Creates a shopping list
Locate areas in store (produce, toiletries, toys)
Use shopping cart or basket
Finds/selects item
Increasing Life Skills 96
A
ctiv
ity
Doe
s N
ot O
ccur
Com
plet
e A
ssis
tanc
e P
rovi
ded
Max
imal
A
ssis
tanc
e P
rovi
ded
Mod
erat
e A
ssis
tanc
e P
rovi
ded
Min
imal
A
ssis
tanc
e P
rovi
ded
Sup
ervi
sion
or
Set
up P
rovi
ded
Mod
ifie
d In
depe
nden
ce
Com
plet
e In
depe
nden
ce
Places items on conveyer belt
Places items In bags
Loads and unloads items in car
Puts items away
Emergency
Plan fire exits and emergency
Know where candles and flashlights are stored
Know how to use a fire extinguisher
Know community emergency procedures
Know where extra house key is located
Know procedure for 911
Know emergency contacts
Know personal information (address, phone number)
Recognize household hazards
Telephone use
Locating numbers (phone book, newspaper, menu)
Dialing correct number
Increasing Life Skills 97
Act
ivit
y D
oes
N
ot O
ccur
Com
plet
e A
ssis
tanc
e P
rovi
ded
Max
imal
A
ssis
tanc
e P
rovi
ded
Mod
erat
e A
ssis
tanc
e P
rovi
ded
Min
imal
A
ssis
tanc
e P
rovi
ded
Sup
ervi
sion
or
Set
up P
rovi
ded
Mod
ifie
d In
depe
nden
ce
Com
plet
e In
depe
nden
ce
Leaving a message
Taking a message
Maintain phone conversation
Increasing Life Skills 98
Appendix J
Living Independently Progress Note
Increasing Life Skills 99
Appendix J
Living Independently Progress Note
Student: _____________________________________ Date: ___________________
Life skill session: ______________________________________________________________
Progression toward individualized goal(s) for life skill: ______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Overall occupational performance and type of assistance provided:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Areas to review:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Signature: _______________________________________________ Date: ________________
Increasing Life Skills 100
Appendix K
Living Independently Evaluation Summary
Increasing Life Skills 101
Appendix K
Living Independently Evaluation Summary
Student: _________________________________________
Individualized goal(s): Met?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Areas of improvement:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Areas to keep practicing:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Recommendations for future:
______________________________________________________________________________
______________________________________________________________________________
Signature: _________________________________________________ Date: ______________
Increasing Life Skills 102
Appendix L
Living Independently Budgeting and Staffing Outline
Increasing Life Skills 103
Appendix L
Living Independently Budgeting and Staffing Outline
The budget estimates the overall cost for the 17 week Living Independently program. Personnel
Position Hours per week Salary from Grant Money
Total
Program Occupational Therapist
5 $2,945.00 $2,945.00
Program Occupational Therapist Assistant
3 $1, 045.50 $1,045.50
Subtotal: $3,990.50
Program Supplies and Equipment Item Description of
Items Quantity Cost per Item Total Cost
First aid kit Travel 195 piece all purpose first
aid kit
1 kit $11.88 $11.88
Blank paper Package of blank computer paper
1 package $3.49 $3.49
Black and white ink
Printer ink cartridge
1 cartridge $21.99 $21.99
Colored ink Printer colored ink cartridge
1 cartridge $24.98 $24.98
Pretzel Large bag of pretzels for open
house
1 large bag $1.69 $1.69
Stamps Standard mailing stamps
1 booklet $8.80 $8.80
Envelops Standard letter size envelopes
1 box (25 count) $3.99 $3.99
Folder 3 ring binder to use as a chart for
participants
1 folder per participant (8 folders total)
$3.99 $31.92
Construction paper
Package of construction
paper. Various colors
1 package of 50 sheets
$2.79 $2.79
Dry-erase board 4’ X3’ standard white dry erase
board
1 board $131.99 $131.99
Dry-erase markers and
Kit of four markers, spray,
1 kit $7.00 $7.00
Increasing Life Skills 104
cleaner and eraser Liquid hand soap Liquid hand soap
from traditional bottle
1 bottle $2.49 $2.49
Bar hand soap Bar of traditional hand soap
1 bar $1.09 $1.09
Nail clippers Fingernail clippers
1 per participant (8)
$1.99 $15.92
Nail file Nail file with smooth and rough sides
1 pack (8 count) $2.74 $2.74
Solo cups Plain paper cups (3 ounces)
1 pack (100 count)
$4.19 $4.19
Alcohol wipes Individually wrapped
cleaning pads
1 box (100 count)
$16.99 $16.99
Shampoo Standard sized bottle. Any brand
1 bottle $2.74 $2.74
Hand-help mirror Small mirror with frame
around edges of mirror
4 $11.99 $47.96
Milk Half gallon of milk. Can be soy
for dairy allergies
1 half gallon $1.99 $1.99
Paper towel Standard paper towel roll
1 roll $1.98 $1.98
Face wash Generic face wash. Liquid of foam for general
cleaning
1 bottle $4.97 $4.97
Toothbrush Adult medium bristles.
1 per participant (8). 2 four packs
$3.69 $7.38
toothpaste Average sized tube. Any brand
1 tube $2.49 $2.49
Dental floss Floss from roll. Not in stick form
1 roll $1.00 $1.00
Mouthwash Safe mouth wash for adolescents
1 bottle $4.59 $4.59
Hair comb Combination packs to provide
diversity of combs
1 package (10 count)
$7.49 $7.49
Hair brush Typical hair brush. Handle
5 $2.99 $14.95
Increasing Life Skills 105
and tipped bristles
Deodorant Travel sized generic
deodorant
1 per participant (8)
$1.00 $8.00
Socks Calf height socks. Any color
2 packages of 6 count calf socks
$4.99 $9.98
Socks Knee high socks. Any color
2 packages of 6 count tube socks
$6.99 $6.99
Button up shirts Shirts that button up the front with
large buttons
1 per participant (4 shirts)
$9.49 $37.96
Zip up jacket Lightweight sweatshirt or
jacket with front zipper
1 per participant (4 jackets)
$14.00 $56.00
Shaving cream Unscented shaving cream
1 bottle $1.99 $1.99
Spray bottles Plastic spray bottle
8 bottles $1.00 $8.00
Cleaning bucket Plastic 1 gallon bucket with
handle
1 $7.78 $7.78
All- purpose cleaner and
window cleaner
Cleaner that is safe for contact
1 bottle each (2) $2.99 $5.98
Bed sheets Set of twin sized bed sheets
1 set $16.99 $16.99
Pillow Average sized bed pillow
1 $6.99 $6.99
Air mattress Twin sized inflatable mattress
1 $29.99 $29.99
Garbage bags Kitchen sized 1 box (30 count) $7.79 $7.79 Washing machine
Top loader washing machine
1 $379.99
$379.99
Drying machine Front loader dryer
1 $373.99 $373.99
Laundry detergent
32 load bottle 1 bottle $12.99 $12.99
Fabric softener sheets
50 sheet box 1 box $5.79 $5.79
Hangers Tubular, wire, wood, plastic
1 pack each $2.29 $9.16
Supplies for shopping
Bread, chips, bags of apples,
2 of each $15.00 $30.00
Increasing Life Skills 106
practice box of cereal, four cans of food
Food items for meal preparation
Bread, fruit, meat, microwave
meal, etc
1 each $100.00 $50.00
Stovetop oven Electric stovetop oven
1 $399.99 $399.99
Supplies for party
Party at conclusion of
program
1 party $40.00 $40.00
Subtotal: $1,949.82
*In-kind Program Supplies and Equipment Item Description of
Items Quantity Cost per Item Total Cost
Pens Basic ballpoint pen
10 In-kind $1.00
In-kind $1.00
Printer Black/White and colored printing
1 In-kind $179.99
In-kind $179.99
Printing The therapist will be able to use the
computer and printer to print the template for
copies
Up to 20 pages total
In-kind $0.10
In-kind $2.00
Paint Bottle of tempera paint. Washable.
Any color
1 bottle $1.29 $1.29
Crayons Box of 24 crayons to use
during occupations
1 box In-kind $1.50
In-kind $1.50
Chalk Box of plain white chalk
1 box In-kind $1.29
In-kind $1.29
Tape Invisible clear tape
1 roll In-kind $1.39
In-kind $1.39
Masking tape Roll of masking tape
1 roll In-kind $3.99
In-kind $3.99
Glue Elmer’s glue 4 tubes In-kind $1.50
In-kind $6.00
Scissors Safety scissors 8 pair In-kind $1.00
In-kind $8.00
Phonebook Phonebook with yellow and white
pages
8 books In-kind $0.00
In-kind $0.00
Newspaper, Information that 1 per participant In-kind In-kind
Increasing Life Skills 107
menu, flyers contains a phone number
(8 minimum) $2.99 $2.99
Hand towels Standard sized hand towel. Any
color
1 per participant (8 minimum)
In-kind $2.79
In-kind $22.32
Wash cloth Standard sized wash cloth. Any
color
1 per participant (8 minimum). 2
Four packs
In-kind $4.99
In-kind $9.98
Body towel Standard body towel. Any color
1 towel In-kind $4.99
In-kind $4.99
Button up shirts Shirts that button up the front with
large buttons
1 per participant (4 shirts)
In-kind $9.49
In-kind $37.96
Zip up jacket Lightweight sweatshirt or
jacket with front zipper
1 per participant (4 jackets)
In-kind $14.00
In-kind $56.00
Blanket Twin sized blanket
1 In-kind $12.99
In-kind $12.99
Broom (indoor) Standard flat kitchen broom
1 In-kind $9.99
In-kind $9.99
Broom (outdoor) Standard push broom
1 In-kind $14.99
In-kind $14.99
Vacuum Standard push vacuum
1 In-kind $119.96
In-kind $119.96
Trashcans Small trashcans 2 In-kind $6.97
In-kind $6.97
Dish towels Towels to wash and dry dishes
2 each In-kind $2.99
In-kind $11.96
Dish rack Rack to hold dishes
1 In-kind $3.79
In-kind $3.79
Dish soap Dawn dish soap 1 bottle In-kind $3.49
In-kind $3.49
Dishes Set of plastic dishes
8 In-kind $6.00
In-kind $48.00
Clothing items Shirts, socks, pants, etc
1 laundry basket full
In-kind $50.00
In-kind $50.00
Laundry basket Plastic standard sized basket
3 In-kind $4.49
In-kind $13.47
Rags Pieces of cloth that can be used
for cleaning purposed
10 In-kind $0.00
In-kind $0.00
Supplies that are on shopping list
Items that are needed at Rehab
Dynamics
1 each In-kind $30.00
In-kind $30.00
Increasing Life Skills 108
Kitchen appliances and
utensils
Various appliances and utensils that are used for basic
cooking
1 each In-kind $200.00
In-kind $200.00
In-kind Subtotal: $866.30
Other *In-kind Supplies and Equipment Item Description of
Items Quantity Cost per Item Total Cost
Working landline phone
Phone for students to send and receive calls
2 phones In-kind $100.00
In-kind $100.00
Computer with internet access
Computer with internet browsing
software
1 In-kind $679.99
In-kind $679.99
Filing Cabinet Locked cabinet to contain
student’s folders
1 In-kind $59.99
In-kind $59.99
Chalkboard Chalkboard for cleaning and writing notes
1 In-kind $69.99
In-kind $69.99
Space payment Cost to pay for building
1 In-kind $400.00
In-kind $400.00
Utilities Heat, lights, water, electricity
1 In-kind $250.00
In-kind $250.00
Subtotal: $1,556.97 Other In-kind Subtotal: $866.30 Total In-kind cost: $2,423.27
Participation Fee Item Quantity Cost per Item Total Cost
Participation fee 8 $40 $320 Total Cost $5,620.32 * Rehab Dynamics is willing to provide in-kind support for the Living Independently program.
Increasing Life Skills 109
Appendix M
Living Independently Job Description
Increasing Life Skills 110
Appendix M
Living Independently Job Description: Occupational Therapist
Employed by the Rehab Dynamics Living Independently program
Position Title: Occupational Therapist, Living Independently program Professional Requirements:
1. Current registration as an occupational therapist by NBCOT 2. Current license to practice occupational therapy in the State of Ohio 3. A Bachelors, Masters, or Doctorate degree in occupational therapy 4. Prior work with adolescents who have developmental disabilities preferred, but not
required Responsible to: Executive Directors; Maureen Kane-Wineland, Ph.D., OTR/L and Ann Nagle, P.T. Position Summary: The occupational therapist will facilitate the Living Independently program at Rehab Dynamics. The occupational therapist will instruct and educate adolescents who have developmental disabilities, ages 12-18 years-old about life skills. The occupational therapist will also oversee the certified occupational therapist assistant. Performance Requirements:
Assist in the recruitment process Ask caregivers to complete the Living Independently Assessment Score and interpret results from assessment, develop needs list for each student, write
individualized goals Communicate with caregivers about participants’ progress and helpful suggestions for the
home Write progress notes and complete evaluation summary for each student Send program evaluations to caregivers Facilitate weekly life skills sessions two times a week for one and one half hour each
session Accept other duties as needed
Working Conditions:
Work at Rehab Dynamics Walking, sitting, standing, bending, twisting, lifting, pushing, and carrying Interactions with other staff, caregivers, participants, and other stakeholders
Physical Requirements: Must be able to tolerate simple repetitive arm motions, have adequate vision, and proper body mechanics to complete all responsibilities of the Living Independently program.
Increasing Life Skills 111
Appendix M
Living Independently Job Description: Certified Occupational Therapist Assistant
Employed by the Rehab Dynamics Living Independently program
Position Title: Certified Occupational Therapist Assistant, Living Independently program Professional Requirements:
5. Current registration as an occupational therapist by NBCOT 6. Current license to practice occupational therapy in the State of Ohio 7. An Associate’s degree in occupational therapy assistant 8. Prior work with adolescents who have developmental disabilities preferred, but not
required Responsible to: Occupational Therapist facilitating group Position Summary: The certified occupational therapist assistant will help with the Living Independently program at Rehab Dynamics. The certified occupational therapist assistant will aid the occupation therapist in teaching life skills to adolescents ages 12-18 who have developmental disabilities. Performance Requirements:
Communicate with the occupational therapist about the program and teaching strategies Communicate with caregivers about participants’ progress and helpful suggestions for the
home Assist with set-up, clean-up, and facilitation of session Write progress notes with occupational therapist approval Accept other duties as needed
Working Conditions:
Work at Rehab Dynamics Walking, sitting, standing, bending, twisting, lifting, pushing, and carrying Interactions with staff, caregivers, participants, and other stakeholders
Physical Requirements: Must be able to tolerate simple repetitive arm motions, have adequate vision, and proper body mechanics to complete all responsibilities of the Living Independently program.
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Appendix N
Living Independently Job Newspaper Advertisement
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Appendix N
Living Independently Occupational Therapist and
Certified Occupational Therapist Assistant
Newspaper advertisement
Occupational Therapist Part-time
Occupational therapist needed to facilitate the Living Independently program at Rehab Dynamics in Toledo, OH. This grant funded program teaches adolescents ages 12-18 who have developmental disabilities life skills to increase levels of independence. The occupational therapist must be certified by NBCOT, licensed to work in the State of Ohio, and a have Bachelor’s, Master’s or Doctorate degree in occupational therapy. Please call Renae Sauter at 419-841-1840 for more information.
Certified Occupational Therapist Assistant Part-time
Certified occupational therapist assistant is needed to assist with the Living Independently program at Rehab Dynamics in Toledo, OH. This grant funded program teaches adolescents ages 12-18 who have developmental disabilities life skills to increase levels of independence. The certified occupational therapist assistant must be certified by NBCOT, licensed to work in the State of Ohio, and have an Associate’s degree in occupational therapy assistant. Please call Renae Sauter at 419-841-1840 for more information.
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Appendix O
Living Independently Program Evaluation
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Appendix O
Living Independently Program Evaluation
Please return this survey to Rehab Dynamics within one week of receiving the survey! Please answer the follow questions regarding the Living Independently program. 1= strongly Disagree, 2= Disagree, 3=Agree, 4= Strongly Agree, 5= N/A 1 2 3 4 5 Comments 1. My child enjoyed the program
2. The life skills were presented in a logical order
3. The life skills were relevant to my child’s individual needs
4. The Living Independently program was helpful for my child
5. I have noticed an increase in skills from my child
6. I incorporated some of the Living Independently program at home
8. The occupational therapist was professional and knowledgeable about the Living Independently content
9. The occupational therapist provided useful suggestions for home
10. My discussions with the therapist were very helpful
10. The overall quality of the Living Independently program was good
What life skills did you see the most improvement in your child’s performance? ____________________________________________________________________________________________________________________________________________________________ In what areas did you notice little or no change in the child’s performance? ____________________________________________________________________________________________________________________________________________________________ How could the program improve? ____________________________________________________________________________________________________________________________________________________________ Signature:______________________________________________ Date:_____________
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Appendix P
Living Independently Timeline
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Appendix P
Living Independently Timeline
Task Week 1 2 3 4 5 6 7 8 9 10 Conduct needs assessment
X
Market to stakeholders
X
Recruit program participants
X
Print out documentation forms
X
Purchase supplies
X
Ask caregivers to complete Living Independently Assessment
X
Create goals for each participant
X
Invites families and facilitate open house
X
Conduct biweekly life skills sessions
X X X X X X X X X
Write progress notes about student performance and progress toward goals
X X X X X X X X x
Observe student performance and make necessary adjustments
X X X X X X X X X
Communicate with caregivers
X X X X X X X X X X
Evaluate participant’s progress
Program evaluation
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Task Week 11 12 13 14 15 16 17 18 19
Conduct needs assessment
Market to stakeholders
Recruit program participants
Print out documentation forms
X X X
Purchase supplies
Ask caregivers to complete Living Independently Assessment
X X
Create goals for each participant
X
Invites families and facilitate open house
Conduct biweekly life skills sessions
X X X X X X X X
Write progress notes about student performance and progress toward goals
X X X X X X X X
Observe student performance and make necessary adjustments
X X X X X X X X
Communicate with caregivers
X X X X X X X X
Program evaluation
X
Complete evaluation form for each participant
X
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Appendix Q
Living Independently Letter of Support
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Appendix Q
Living Independently Letter of Support
Rehab Dynamics 3160 Central Park West Drive Toledo, Ohio 43617 April 6, 2012 Renae Sauter Living Independently Coordinator The University of Toledo Judith Herb College of Education, Health Science, and Human Service Toledo, OH 43606
Dear Miss Sauter,
I am writing this letter to show my support and enthusiasm for the Living Independently program. I am an occupational therapist and the co-owner of Rehab Dynamics. I have discovered the need for adolescent services and am looking forward to the day when adolescents are provided with the proper programming that fits their unique needs. I have been an occupational therapist working with youth for many years; and have grown to notice the need for additional life skills training into adolescent years. Many of the adolescents receiving services at the facility need assistance with basic daily occupations and are very reliant on caregivers. I have noticed the trend that caregivers tend to complete many life skills for their child which leaves little opportunity for the child to learn how to help themselves. This life style can lead to a lifetime of dependence with little independence. The Living Independently program will give the adolescents the opportunity to learn and improve skills that would allow them to be become more independent. Improvements in life skills could ultimately lead to more independent living. I believe some of the adolescents have the potential to become less dependent of family and possibly live independently. I strongly think the goal of the Living Independently program is reachable and would be a great benefit to all of the adolescents. The Living Independently program is exactly what the youth needs to experience. Each individual adolescent and family would benefit greatly from this program. I strongly hope that you will recognize the impact this program can have for the adolescents and families. Sincerely, Maureen Kane-Wineland Occupational Therapy and co-owner of Rehab Dynamics
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Appendix R
Living Independently Additional Supporters
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Appendix R
Living Independently Additional Supporters 1) Maureen Kane-Wineland, Occupational Therapist and Co-Owner of Rehab Dynamics
Mrs. Kane-Wineland provides treatment to various pediatric clients. She is very knowledgeable about the need for a life skills program and would be a key stakeholder for recruiting participants. Caregivers are very familiar with Mrs. Kane-Wineland and will be comfortable allowing their child to participate in the program. She is also willing to provide assistance and guidance in facilitating the Living Independently program. Mrs. Kane-Wineland 3160 Central Park West Drive Toledo, Ohio 43617 (419) 841-1840
2) Lynn Campbell, Occupational Therapist Mrs. Campbell is another occupational therapist that works at Rehab Dynamics. Mrs. Campbell has taken an active role in assisting with providing resources for the Living Independently program. Mrs. Campbell has also discovered the need for services for the adolescent population. The caregivers feel comfortable around Mrs. Campbell would take comfort in Mrs. Campbell’s confidence in the Living Independently program. Lynn Campbell 3160 Central Park West Drive Toledo, Ohio 43617 (419) 841-1840
3) Marianne Mader, Community Supports and Services Mrs. Mader is the Senior Director responsible for Community Supports and Services at the Lucas County Board Developmental Disabilities. The Board of DD is dedicated to assisting individuals with developmental disabilities to be self-determined and successful in the community. Mrs. Mader is responsible for managing the Community Supports and Services which contains transitioning into adulthood. Mrs. Mader would support the program and become a means for marketing the program. Marianne Mader (419) 380-4000
4) Kay Treanor, Ohio Developmental Disabilities Council Mrs. Treanor is on the Children and Health Committee through the Ohio Developmental Disabilities Council. The Children and Health Committee assist children and young adults who have developmental disabilities to live, work, and be included in the community. Mrs. Treanor would support the concept behind the Living Independently program as another resource in Ohio. Kay Treanor 899 East Broad Street, Suite 203 Columbus, OH 43205
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(614) 466-5205 5) Tammy Lamb, Breaking Barriers
Mrs. Lamb is a local stakeholder and has a 30 year-old son who has autism. Mrs. Lamb has shared her frustration in finding services for her son when he was in his adolescent years. Mrs. Lamb has created a funding source called Breaking Barriers to provide small financial assistance for individuals who have developmental disabilities. Mrs. Lamb is a strong supporter of the Living Independently program and may be willing to provide financial assistance to families to pay for the program. Tammy Lamb (734) 847-2203
6) Mark Armstrong, Community Connections Coordinator Mr. Armstrong is the Community Connections Coordinator at the Ability Center of Greater Toledo. The Ability Center assist individuals with disabilities to live, work, and socialize within the accessible community. Mr. Armstrong is the resource that informed individuals of program available in the community. Mr. Armstrong would be a supporter of the Living Independently program and would assist in the recruiting process. Mark Armstrong 5605 Monroe Street Sylvania, OH 43560 (419) 885-5733
7) Kathy B., Parent
Mrs. B is a grandparent of an 11 year-old girl who has autism. Mrs. B has been seeking resources for her granddaughter. She is greatly appreciative of any resources available and strongly supports the development of new program that provide services to adolescents. Mrs. B has shown great enthusiasm about her granddaughter participating in the Living Independently program. Kathy B can be contacted through Rehab Dynamics 3160 Central Park West Drive Toledo, Ohio 43617 (419) 841-1840
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