Unit IV: Process of Rehabilitation
1. Habilitation & rehabilitation across the spectrum: concept & definition
2. Education for Work and Employment across the spectrum
3. Developing work skills and work behaviors
4. Work and Employment a. Home based b. Sheltered 32 c. Self & supported d. Open
5. Awareness of services & resources for ASD
1. Habilitation & rehabilitation across the spectrum: concept & definition
Although they work side-by-side, rehabilitation and habilitation mean two different things:
Habilitation refers to a process aimed at helping disabled people attain, keep or improve skills and functioning for daily living; its services include physical, occupational, and speech-language therapy, various treatments related to pain management, and audiology and other services that are offered in both hospital and outpatient locations.
Rehabilitation refers to regaining skills, abilities, or knowledge that may have been lost or compromised as a result of acquiring a disability or due to a change in one’s disability or circumstances.
As defined in the CRPD, Habilitation and Rehabilitation “enable persons with disabilities to attain and maintain maximum independence, full physical, mental, social, and vocational ability, and full inclusion and participation in all aspects of life.”
Without adequate habilitation and rehabilitation services, persons with disabilities may not be able to work, go to school, or participate in cultural, sports, or leisure activities. At the same time, barriers to other human rights can prevent persons with disabilities from claiming the right to habilitation and rehabilitation. Services may exist, but if there is not accessible transportation, many persons with disabilities will not receive the benefit of these services. If information about habilitation and rehabilitation services is not available in accessible formats, persons with certain disabilities may never know that they exist.
You might be more familiar with the term rehabilitation, which is related to habilitation. Habilitation, or Habilitative services, are health care services that help you keep, learn, or improve skills and functioning for daily living.
Examples include therapy for a child who isn’t walking or talking at the expected age.
These services may include:
*physical and occupational therapy,
*speech-language pathology, and
*other services for people with disabilities in a variety of inpatient and/or outpatient settings.
Day Habilitation services are habilitation services that may be provided to an individual regardless of his or her living environment, and regularly take place in a non-residential setting, separate from the individual’s private residence or other home.
As with Community Habilitation services, Day Habilitation services can assist individuals to acquire, retain or improve their self-help, socialization and adaptive skills, including communication, travel and other areas in adult education.
Activities and environments are designed to foster the development of skills and appropriate behavior, greater independence, community inclusion, relationship building, self-advocacy and informed choice. Additionally, individuals accessing day habilitation often contribute to their communities through volunteer work.
2. Education for Work and Employment across the spectrum
Transition has been defined in the Individuals with Disabilities Education Act (IDEA) 2004 as follows.
Transition services mean a coordinated set of activities for a student with a disability that:
IEPs for students aged 16 years and older must reflect specific transition planning. Some states (Virginia, Delaware, Rhode Island) have moved this to age 14. According to IDEA, the IEP must include a statement of
As noted earlier, individuals with ASD can work with proper supports. In fact there is a growing literature suggesting that individuals with ASD achieve many desirable outcomes when they are able to work independently in a community-based environment. Even so, individuals with ASD may require support to achieve these outcomes. This section describes supported employment for individuals with ASD and reviews some specialized vocational models that are reporting preliminary success.
Supported employment is an approach that helps individuals with ASD acquire, learn, and maintain competitive employment in a regular job for a competitive wage. Wehman and colleagues described such a program whereby individuals with ASD achieved and maintained employment in a suburban hospital in a variety of paraprofessional positions at a competitive wage. The Federal Register defines supported employment as “competitive employment in an integrated setting with ongoing support services for individuals with the most severe disabilities” (Federal Regulations Register, 2002).
Strengths observed in workers with ASD
Because of these strengths, many businesses are collaborating with disability-specific employment organizations to increase the employment of individuals with disabilities. Examples of these employment partnerships result in “real jobs for real pay” for individuals with ASD and other disabilities.
Customized Employment
Customized employment is a model that allows a person with ASD to negotiate a personalized job independently or through a job negotiator. The job coach frequently acts as the job negotiator. In one example of this model, a job coach met with the owner of a small coffee and sandwich shop in a college town to negotiate a job for a person with ASD. In this example, the job coach arranged for the individual to prepare vegetables for sandwiches, stock the drink cooler, and deliver orders within a 4-block radius of the store. These tasks did not comprise the typical job in this establishment, but did serve the needs of the business and the employment needs of this individual with ASD.
Self-Employment
In this model of supported employment, individuals with ASD have the opportunity to develop a community-based or home-based business that capitalizes on their personal strengths. Due to personal circumstances such as challenging behavior or intensity of support needs, individuals with ASD can develop their own business whereby they can define their job and the time they will devote to that job.
3. Developing work skills and work behaviors
There are so many skills needed to be successful in a job. Some of them are:
A person with autism might have a few of these skills, but struggle with others, making it difficult to get and sustain work. The key is to implicitly target these areas as early as possible so that your child has a foundation of social and organizational skills when it comes time to enter the work force.
1. Good communication skills are critical for helping you to work effectively, build solid relationships and prevent unnecessary misunderstandings.
In a workplace, it is polite to engage in "small talk"
Small talk is a short, casual conversation usually about fairly impersonal, everyday topics, such as:
· The weather
· Hobbies and interests
· Weekend plans / holiday plans
· News headlines / current affairs
Small talk may appear to be mundane or without purpose, however it actually plays a very important part in social interaction.
Here are some of the reasons why it is important to try to use small talk –
2. Social skill: In some ways, being sociable with the people you work with is very similar to being sociable with friends and family.
But in other ways, it’s very different.
It’s a good idea to learn some of the social dos and don’ts of the workplace so that you can fit in and feel comfortable with your co-workers.
The main challenges of people living with autism is understanding social rules. Social rules are the rules that apply to various social situations.
You have probably found them quite difficult, especially as the rules often change depending on where you are and who you are with. The workplace has its own set of social rules that you really need to know.
If someone is supporting you in the workplace, assisting you to understand the social rules of your particular workplace can be part of how they help you.
3. Organization skills: When faced with many different demands on your time at work, it is important to organise and prioritise the workload and effectively manage time.
When trying to adopt an organised approach to work tasks consider the following points.
Of all your work tasks (commitments).
Make a list of all your main activities to help you get an overview of the time you will need to set aside. This should make it easier for you to prioritise tasks.
About what is involved and how long will it take.
Break down your work tasks and be realistic as to the time you will need to set aside to complete them.
In order to effectively prioritise our time, consider the following questions:
Determine:
Once you have developed a clear idea of what your work tasks are you can start to make plans.
A timetable or action plan can be a useful resource to help you keep organised at work.
Establishing structure to your work day will help set the defined tasks for the day or week ahead.
Structure can be established by:
Ask yourself or your manager:
It is important that you take time to assess how effectively you are completing work tasks. You may need to re-assess timetables and action plans if work tasks are not being completed to schedule.
Some tips for managing time:
4. Hygiene: It's really important to look professional at work. But, it's not just important to look good in a workplace, you have to smell good too!
4. Work and Employment a. Home based b. Sheltered c. Self & supported d. Open
Employment should take advantage of the individual’s strengths and abilities. Temple Grandin, Ph.D., suggests that “jobs should have a well-defined goal or endpoint,” and that your “boss must recognize your social limitations.” She recommends that parents begin helping their children find jobs before they leave grade school, to prepare them with job skills and experience. The authors of A Parent’s Guide to Asperger Syndrome and High-Functioning Autism describe three types of employment possibilities: competitive, supported, and secure/sheltered.
· Competitive employment is the most independent, with no support offered in the work environment. Some people might be successful in careers that require focus on details but only limited social interaction with colleagues, such as computer sciences, research or library sciences. It could also help to ask for accommodations, such as a workspace without fluorescent lights, in order to feel more comfortable at work.
(Self-employment is also an option some people with ASD pursue. This requires strong motivation, but can be more flexible than working for a company.)
· In supported employment, a system of supports allows people with ASD to pursue paid employment in the community, sometimes as part of a mobile crew, other times individually in a job developed for them.
· In secure or sheltered employment, an individual is guaranteed a job in a facility-based setting. People in secure settings generally receive work skills and behavior training as well, while sheltered employment might not provide training that would allow for more independence.
Open employment means doing a job which can be done by any person. You do the same job as your co-workers and are paid the same wages. But you won’t be thrown in at the deep end! There is support available to help you find a job in open employment. You can be given assistance to learn a job, and adjustments can be made to help you work well.
5. Awareness of services & resources for ASD
Most state and federal agencies are just beginning to understand what it means to work with autisitic adults. As with schools, they are accustomed to finding appropriate jobs and support for people with intellectual or physical disabilities. Autism is neither. While agencies are doing their best to catch up with the needs of a fast-growing group of adults with both great abilities and great challenges, they're also struggling with bureaucracy and funding issues. As is often the case, it is sometimes up to parents and self-advocates to provide information, websites, and legal information to keep agencies up to date.
Some autistic adults know exactly what kind of work they want. Others are flexible, and others have no idea. But just like everyone else, adults with autism have both the responsibility and the right to direct their own lives. Even if a person has limited verbal skills, it's important to know that the work they are doing suits their interests, abilities, and sense of purpose.
To help determine an individual's best career choices, school counselors and agency personnel can use tools such as vocational and aptitude tests. A student's vision is then made part of the transition plan which, in turn, makes it easier to plan for training, internships, and vocational opportunities.
One of the hardest realities to face as the parent of a child with autism or an autistic self-advocate is that abilities are not always enough to get and keep a good job. A young adult with autism may be a brilliant mathematician, but if they can't generalize their skills to a needed function, such as accounting or statistics, there may be no job available. Other issues that can be serious obstacles to employment include:
Oddly enough, it can sometimes be easier to find a job placement for a nonverbal person with few sensory issues than for a talented techie who can't handle an office environment.
Understanding strengths and challenges are important to the transition and job search process. If you know what issues are likely to be a problem, you can advocate for training, internships, and "job carving" to create the right job match.
While it's great to imagine a young adult with autism getting a great job and keeping it for a lifetime, it's rare to see that kind of success without a great deal of preparation and support. It's possible to set your child (or yourself) up for success, but it takes planning and work. Usually the planning: