Do you have a child who is experiencing learning and/or behavioral challenges in their school and/or home environment, which is impeding their learning to potential, impacting their placement, or affecting their overall social and community activities?
Would you benefit from seeing demonstration of best practices within a virtual or live classroom environment while focusing upon a couple of specific learning and/or behavioral objectives?
School-Age programming includes both individual and group formats. Group formats will be driven by integrated needs such that individuals involved within the group are working on individualized yet complementary goals. Programming is informed through skill-based assessment and involves a combination of goal-directed tutoring, general skills teaching, and training specific to the identified academic, behavioral, and functional needs.
Such needs may be driven by current challenges impeding successful inclusion within academic, social, and community activities or placements. Materials and strategies shared as part of programming are encouraged to be shared among providers to best set up for success in use across a range of settings as applicable. The school-age program is comprised of three service options (i.e., parent/child dyad, individual services, group services) that caregivers or providers can select from:
- Parent & Child Interaction Consultation (i.e., parent/child dyad)
- Individual or group services and programming
- Setting-Based Consultation
- Web-Based Consultation
- Intensive (3-5 Day) Training Participation
- Pre-Employment Transition Services (Pre-ETS)
- Vocational Rehabilitation (VR) Services
Parent & Child Interaction Consultation (i.e., parent/child dyad):
Initial sessions will focus on skills and goal development to provide direction for future sessions. Sessions are structured to address the identified academic, behavioral, and/or functional goals of the child as well as caregiver goals for skills development. During sessions, HANDS trainers provide instruction as well as demonstrate strategies in practice with the child while the caregiver observes.
Caregivers, and participating providers when applicable, have opportunity to ask questions, practice skills with the child and receive feedback from the trainer in real time across both live and virtual settings. Improvements in skills of caregiver/provider and child lead to overall improvement in interactions and practical skills that can be used with increased ease in the natural environment, particularly when partnered with setting-based consultations to foster improved use, consistency and improvement across home, school and community settings. At times, multiple persons such as 2 caregivers, a caregiver and provider, or other may be engaged to best support use of strategies across persons and settings.
Example: A parent has a difficult time getting his son to complete homework after school. These difficulties typically result in refusal to complete the assigned work thus leading to missing work which affects grades and participation in routines at school as well as much angst within the home setting given that this is a daily issue. Sessions focus upon discussion and application of visual and physical structure concepts to help the caregivers set up an area that is most conducive for homework and eLearning as well as ways to work through behavior, how to adapt or support work completion, and ways to reinforce such accomplishments. Practical, proactive strategies for increasing support use across home and school settings are taught to increase opportunity for collaboration and consistency in use.
Individual or group services and programming:
Initial sessions will focus on skills assessment and goal development to provide direction for future sessions. Sessions are structured to address the identified academic, behavioral, and/or functional goals. Skills and interventions will be individualized but may be addressed in either an individual or group setting depending on the format that is best suited to target the prioritized goals at that time.
Individual Example: The child is needing additional skills training on basic living skills to foster increased independence within daily routines. He continues to need support in tying his shoes, zipping his jacket, being prepared for different activities, sufficiently washing his hands, and other soft skill areas, that are not addressed with the school setting and have been a challenge to structure and reinforce in the home setting. Specific skill areas to address are identified through assessment, goal setting and practice during sessions with a HANDS trainer and between sessions (e.g., homework practice) to allow for greater independence.
Group Example: Due to coursework the student must complete to meet diploma requirements, there is not enough time for her to meet with the optional social skills group organized by her school-based SLP or speech therapist. To foster increased social skills development and practice, she participates within small groups with up to 6 similar aged students with successive work on identified social skill areas allowing for learning and teaching a skill, application of the skill within the group and among simulated novel situations, generalization activities to encourage use within and between sessions and planning for implementation beyond the sessions through development and use of individual supports. Through such participation, she can explore, learn, and practice social communication strategies as well as topics tied to community participation, self-advocacy, and other key social skill areas with a group of other individuals working on the same or similar skills.
In addition to the 3 service options reflected above, a range of evaluation, consultation and participation options exist as follows:
An independent evaluation is inclusive of a records review, caregiver interview, and an observation to assist in identifying individual learning styles and current skills that will inform curriculum and behavioral planning.
Setting-based consultations can occur within home, community, or school-based settings. Individualized consultation may be considered for children with challenging behavior who are at high risk of a more restrictive placement, change in student status/placement, or for whom associated travel risks are high. Travel greater than 75 miles from the HANDS Center and/or reports are not included as part of the onsite hours and are included separately as desired or needed.
Example: School-based consultation may be requested for an individual with a history of poor attendance and intermittently high-level behavior that emerges when he is in school given the current providers difficulty in increasing regular attendance and challenge in addressing behavioral concerns. Direct observation and assessment of the current setting by a HANDS trainer may be recommended to provide information and supports necessary for planning, providing, and/or training interventions for ultimate use by caregivers and teams in the school environment. Additional collaboration and/or discussion can occur to train systems or protocols for eventual use and integration by other caregivers and provider teams across settings.
Web-based consultation provides virtual support that is not limited by setting or location. Consultation among caregivers, service providers or provider teams, can assist in the planning and/or support of initial or ongoing assessment, training, and practice related to the use of evidence-based strategies, collaboration, and use of available local and state resources with success. Consultation is coordinated for up to an hour each time and may occur across single or multiple, hourly occasions. No review of records is involved in this consultation and coordination occurs to ensure individuals or teams can effectively engage for the duration with all activities occurring during scheduled times. Video or web conference capabilities are required for effective consultation.
Example: A provider team is working to improve their collaboration with families and other partner agencies to foster improved use of strategies (e.g., schedules, visual supports, differential reinforcement) across settings for the individuals they serve. A HANDS trainer joins during a scheduled time convenient to full team discussion with suggestion to the team to have questions in hand as well as any sample materials that may be or have been used to allow for reference as part of the discussion. The HANDS trainer discusses the current students and partners to gain additional perspective while learning more about the strategies used, collaboration avenues that have been attempted or considered, resources sought and options to try that may be feasible for the various parties involved. Efforts are made to facilitate a proactive, team discussion in working towards implementation of the collaboration strategies moving forward.
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Intensive (3-5 Day) Training Participation:
For school-aged individuals, students may have opportunity to participate in the HANDS in Autism® intensive (3-5 day) trainings as scheduled throughout the year. During these workshops, students engage in a range of activities in both individual and group formats while working with adult training participants (e.g., teachers, job coaches, instructional assistants, therapists, administrators, etc.) who are learning to apply evidence-based strategies and concepts such as schedules, prompting practice, data collection, social skills teaching and other activities as part of their experience in the HANDS training.
Example: A student participating in a training will work with an adult participant across a range of functional skill, academic and social activities appropriate to their level and skill. The student will interact with participants in both individual and group activities to allow opportunity for the adult participants to practice a range of strategies such as prompting, praise, and data collection within daily living tasks, academics, art, games, and other age appropriate activities. While not working with participants, the child will participate in various individual, one on one and group work and leisure activities with the HANDS trainers and other student participants.
For students 14 years of age and older, additional service options may be available as follows:
Pre-Employment Transition Services (Pre-ETS)
HANDS in Autism® has been available for and delivering statewide Pre-ETS services since becoming a Pre-ETS service provider in 2017. Service options available through HANDS span the 5 Pre-ETS service categories (i.e., job exploration counseling, counseling on post-secondary opportunities, workplace readiness training, work-based learning experiences, self-advocacy skills) with the service type being matched to the individual student, family/caregiver and setting needs and preferences or interests with services types noted as follows:
- Individual services – Services include one to one work with a HANDS trainer(s) specific to individual goal areas. Individuals may have work to complete between sessions with scheduled times to check in with HANDS trainers on a weekly or biweekly basis based upon expressed availability and/or need.
- Small group sessions – Small groups, comprised of up to 6 individuals, will center around monthly topics. Groups will be conducted across up to 4 sessions with individuals being expected to attend one session a week across a series of 3-4 weeks.
- Internships – Internships provide meaningful opportunities to engage within live or simulated work-based learning activities across up to 52 sessions or a 10-month period. Internships are facilitated through the HANDSmade™ program, a collaborative partnership between Riley Hospital for Children at IU Health, IUPUI, IU School of Medicine, and the HANDS in Autism® Center.
- Multi-day sessions – Individuals and parents/caregivers can express interest in participating within 3-day sessions that provide focused opportunity to learn, apply, and implement skills or areas noted for that session.
Expanded options are accessible for students who are able to attend or engage in services onsite at the HANDS in Autism® Center located on the campuses of the IU School of Medicine, IUPUI, IU Health, and Riley Hospital for Children at IU Health; however, virtual and onsite options are amenable to students accessing services remotely or in other regional areas within Indiana. Students interested in Pre-ETS participation must meet applicable eligibility criteria (i.e., 14-22 years of age with a documented disability and enrollment in a training or educational program). For additional information related to Pre-ETS, visit https://www.in.gov/fssa/ddrs/5474.htm.
Vocational Rehabilitation (VR) Services
HANDS in Autism® operates as a VR provider with services provided to assist those between transition and adult ages in engaging successfully in a number of settings and contexts inclusive of but not limited to work, job preparation and readiness, post‐secondary preparation and readiness, as well as community‐based support needed to prepare for work and post‐secondary goals. HANDS in Autism® also provides a forum for professionals to actively observe, shadow and receive mentoring in evidence‐based practices for supporting, teaching, and advocating for inclusion of disabilities in post-secondary education as well as employment settings and worksite life.
HANDS provides a demonstration site for active training and mentoring not only of the special individual but also of caregivers and employers for increased awareness, understanding and effective implementation both within and outside of employment and post‐secondary settings.
Services accessible through HANDS in Autism® as a VR provider include:
Diagnostic evaluation – Evaluations could involve a multi-visit process over a period of time with the intent to verify or determine applicable diagnoses for eligibility determination and consideration in relationship to vocational and post‐secondary support services. Evaluation will include a review of records, interview, assessment and observation, and report development. Evaluation may involve assessment of academic, cognitive, developmental, functional, and applicable areas of functioning as requested and appropriate for informing vocational and post‐secondary services.
Work evaluation – Work evaluations occur onsite at the HANDS in Autism® Center and affiliated locations on the IUPUI, IU School of Medicine, and IU Health campuses. Evaluations could involve a multi-visit process over a period of time pending authorization from VR and may require supplementation based on individual needs or extended time need for evaluation. Evaluations may include any combination of the following as appropriate to the reason for referral:
- Record review, interview, and observation to identify job readiness, interests, vocational and functional skills, and individual learning styles and work habits important to individualized and improved postsecondary education and/or job placements and programming,
- Assessments of college/job preparedness for specific skills,
- Identifying appropriate accommodations and strategies needed for school/on the job success,
- Assessment of skills to determine success more effectively through naturalistic observation and trial school/work experience opportunities,
- Shadow and/or trial of various work contexts and options to determine potential for success, to identify accommodations and/or modifications necessary for success and to assure alignment with interests, skills, and supports needed for success
Work skills training – Work skills training can include a combination of both virtual and onsite experiences at the HANDS in Autism® Center and affiliated locations on the IUPUI, IU School of Medicine, and IU Health campuses. Work skills building will likely involve an extended process that could take multiple sessions over a period of time. Skills training systematically fosters development and application of skills related to social, communication, self‐advocacy, self‐monitoring, hygiene, and other such skills necessary for successful transition into and/or maintenance of educational placement/employment. Skills intervention will be goal‐directed and time‐limited, tracked with data‐driven strategies and with a focus on the training of skills related to job/community readiness and preparedness in individual and/or group contexts.
Community-based support – Community-based support involves offsite services that are completed within work, community, home, or school‐based settings whereby the HANDS trainer provides a combination of evaluation, direct services, and/or consultation related to community employment, competitive employment, post‐secondary and other training environments to inform, support, train and address the individualized needs of a particular client who is at risk of losing or failing to access employment or student status or for those clients whom display associated travel risks in that more intensive community‐based services are warranted. Sample strategies and/or outcomes of such support may involve the following activities or topical areas:
- Set up work‐related spaces that proactively support client work styles and task‐ related needs
- Set up data systems for behavior, vocational and functional skills
- Conduct FBAs for effective behavior planning
- Facilitate the development of behavior plans
- Conduct informal assessments focused upon skills and work habits that inform the learning plan, ongoing data collection, and programming
- Direct work in training systems and implementing protocols for eventual use and integration by other caregivers
- Develop training materials and supports to support necessary areas of skills teaching and development for work and post‐secondary training and readiness
- Facilitate team collaboration and caregiver engagement
- Other as determined with the individual’s team
Individuals or providers interested in VR provider services through HANDS in Autism® must meet applicable VR eligibility criteria and can work collaboratively with HANDS trainers and the respective VR contact to determine the best fit among services as well as navigating the needed referral and authorization steps. For additional information about VR and VR services, visit https://www.in.gov/fssa/ddrs/2636.htm.