Transition/Adulthood Program (14 years – adulthood)

Are you working through transition goals at school or with a service provider? Is your son or daughter ready to begin or have they been working on vocational and community living skills?

Are there social, communication, learning and/or behavioral challenges in their setting which is impeding their progress or may be barriers to achieving their potential in working towards education, employment, independent living, or community participation goal areas?

Would you benefit from seeing demonstration of best practices within a classroom environment and vocational setting targeted towards specific vocational, functional, community living, learning and/or behavioral objectives?

The Transition/Adulthood Program consists of individual and group formats whereby each format allows for focus on identified or specified skill areas necessary for successful transition into college, employment, and community settings. Training content involves consideration of strengths that can serve to engage and help individuals excel with necessary attention to areas of challenge that may impede such transitions. Group formats will be driven by integrated needs such that individuals involved within the group are working on individualized yet complementary goals. 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 Transition/Adulthood Program is comprised of three service options (i.e., parent/child dyad, individual services, group services) that caregivers or providers can select from:

Caregiver & Individual Interaction Consultation:

Initial sessions will focus on skills and goal development to provide direction for future sessions. Sessions are structured to address the identified skill areas related to independent living, community participation, employment, education, and training.

During sessions, HANDS trainers provide instruction as well as demonstrate strategies in practice with the individual while the caregiver observes. Caregivers, and participating providers when applicable, then have opportunities to ask questions, practice skills with the individual, and receive feedback from the trainer in real time.

Improved skills of both caregiver and individual lead to improved interactions and practical skills that can be used with greater ease in the natural environment, particularly when partnered with setting-based consultations to foster improved use and improvement across all applicable settings (e.g., home, school, work, community). 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: An individual may have difficulty understanding vocabulary in job applications, job descriptions or pre-boarding videos for positions. This challenge has affected their ability to effectively structure their resume or vision statement which impacts their access to volunteer or work opportunities and overall employability.

HANDS trainers will assess current vocabulary skills and approaches to determining the meaning of novel vocabulary, teach and discuss strategies for approaching unfamiliar vocabulary and fields of interest, and apply such strategies to simulated activities. Trainers will model and coach caregivers and/or providers, provide opportunities for practice and feedback on strategy use, and provide supports for further practice and use in the natural settings between sessions.

Other proactive and skills teaching strategies that support effective use and extension of the skills will be taught and discussed to ensure the greatest change of practical use across home, school, work, and other community contexts.

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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 skills necessary for successful transition to college, employment, and community settings. Identified skills and interventions will be individualized but may be addressed in either an individual or group setting depending on the format best able to target the prioritized goals at that time.

Individual Example: An individual is going to live in a dorm for college, but he has an extremely difficult time with organization, time management and scheduling related to grocery shopping, cooking, laundry, dishes, etc. Specific skills and strategies to address would be identified through assessment, goal setting and practice during sessions with a HANDS trainer and between sessions (e.g., homework practice) to address identified skills and develop supports for the individual to allow for independence and success in the dorm.

Group Example: A small group of no more than 6 peers work together on emotional regulation and self-care across a series of sessions allowing for successive teaching, application, generalization, and individualization of skills to situations that are common to the group. Adaptations to materials and activities are individualized based on the particular needs of group members (e.g., settings or situations used, language appropriate to age group, communication or response options, visual cues/supports) to best support each person’s ability to understand, express and engage with peers among the group.

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Trial Work Experiences:

A variety of job training and exploration opportunities are available (e.g., HANDS in Autism® Center, Riley Hospital for Children, IU School of Medicine/IUPUI campus departments) as part of the HANDSmade™ program. Applicable fit and/or placements will be decided following initial record review, interview, observation, and assessment of the individual’s interests and preferences as well as suitability for other options (e.g., Pre-ETS, VR services). During the trial work experience, assessment will guide supports and level of coaching needed to ensure mastery of skills.

Example: An adult is looking to further explore areas of interest after having lost a full-time position and then having had difficulty finding a position that best fits his areas of interest and skill. A HANDS trainer reviews records and completes initial assessment and interview to determine specific placements that will be best suited to further explore his abilities, capabilities, and capacity to perform in realistic work situations in an integrated employment setting. As an essential part of the trial work experiences, HANDS trainer(s) will work with him to reflect and encourage personal assessment or appraisal during and between sessions (e.g., homework) to ensure applicable recommendations and findings are generated to further inform the individual’s career pathway.

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In addition to the 3 service options reflected above, a range of evaluation, consultation and participation options exist as follows:

Evaluation:

An independent evaluation is inclusive of a records review, caregiver interview, and observation to assist in identifying individual learning styles and current skills that will inform curriculum and programming.

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Setting-Based Consultation:

Setting-based consultations can occur within home, work, community, or school-based settings. Individualized consultation may be considered for individuals with challenging behavior who are at high risk of a more restrictive placement, change in status/placement, at risk of losing a job, 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: Community-based consultation may be requested for an individual who is at risk of losing access to his current service and vocational placements due to difficulties transitioning between settings (e.g., riding the bus/van, engaging with different shift supervisors, adjusting to changes within community/leisure areas). 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 across applicable settings (e.g., home, vehicle, work, community).

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Web-Based Consultation:

Web-based consultation provides virtual support that is not limited by setting or area. 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 business is working to improve their inclusive practices to offer greater partnership and training opportunities for both current staff as well as interested community partners. A HANDS trainer connects during a scheduled time convenient to full team discussion or that will allow for interactive discussion of current practices, opportunities, and challenges. This provides a time to share perspectives on or visibility of the team, setting, and applicable materials to inform discussion and recommendations.

The HANDS trainer is able to effectively mentor the team and provide coaching aligned with recommendations as well as potentially inform adaptations and additions to materials, trainings, and other strategies that will assist the team as well as the potential partners in applying the practices and strategies iteratively working towards greater inclusion and success.

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Intensive (3-5 Day) Training Participation:

Among transition-focused trainings and workshops, such as the 3-Day Transition & Vocational Programming Workshop, individuals may have opportunity to participate as scheduled throughout the year. During these intensive trainings, individuals engage in a range of activities in both individual and group formats while working with adult training participants (e.g., teachers, daycare providers, therapists, 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 training experience.

Example: An individual participating in a training will work with an adult participant during daily living, vocational or academic activities appropriate to their level and skill. The individual will also interact with participants in group activities such as a discussion group or game-based activity with participants focused on appropriate prompting and praise while individuals work to improve spontaneous and reciprocal communication skills. While not working with participants, individuals will participate in various individual, one on one and group work and leisure activities with the HANDS trainers and other participants.

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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.

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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 postsecondary 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.