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SETTING TRANSITION GOALS FOR STUDENTS WITH SIGNIFICANT DISABILITIES
April 27, 2011Transition Center at West Bay
Warwick, Rhode Island
John KregelVirginia Commonwealth University
My Background
Teacher in the first classroom for students with Severe Disabilities in Lawrence Kansas
Eight years classroom teaching experience for students with severe disabilities
Professor in VCU’s intellectual and development disabilities programs teaching transition and behavior management
Research Director at VCU-RRTC since 1984
What are your expectations
for this morning’s discussion?
Our Learning Objectives
1. 1. Carefully review the expectations we have for our students.
2. 2. Reflect on our current curriculum decisions based on our experiences and expectations.
3. 3. Examine our formal transition planning process
4. 4. Share current approaches to teaching functional skills and making employment a reality for our students
What are our expectations for our students?
Health and SafetyIndependence and Self EsteemResidentialEducationEmployment Financial literacyCommunity ParticipationSocial Relationships
Health and Safety
1. Our expectations for our students include:
1. Life Expectancy2. Treatment for Chronic Conditions3. Access to Health Care4. Need for Assistive Technology5. What Else?
Independence and Self-Esteem
1. Our expectations for our students include:
1. Family Member2. Friend3. Neighbor4. Helper5. Member6. What Else?
Residential
1. Our expectations for our students include:
1. Avoiding medically based congregate care facilities
2. Living with families or relatives3. Stability of living arrangements4. Access to necessary supports
Education
1. Our expectations for our students include:
1. Dual Enrollment Models2. Supported Education Models3. When are these models
appropriate?
DUAL ENROLLMENT
Mixed/Hybrid Model
Students involved in social activities and/or academic classes with students without disabilities (for audit or credit)Participate in classes with other students with disabilities—such classes as life skills or transition programsEmployment experiences are offered both on and off campus (Hart et al 2005)
Hart et al., 2006
Substantially Separate
Students are on campus, but are in classes only with other students with disabilities Access to socializing with students without disabilities is part of the model
Employment experiences typically in pre-established employment settings on and off campus
Hart et al., 2006
Inclusive Individual Support Model
Students receive individualized services—educational coach, tutor, technology-in college classes, certificate programs and/or degree programs (for credit or audit) Not program based: courses are selected on students’ career goals and employment experiences (internships, apprenticeships, work-based learning) Interagency team w/student and family identify range of services and share costs Hart et al., 2006
Higher Education Opportunity Act (PL 110-315)
Enacted in 2008 Has provisions to improve access to
postsecondary ed for students with ID Language in legislation covers:
-Financial aid provisions -Creation of model demonstration program -Creation of coordinating center
George Mason University’sLIFE Program: Started in 2000
Provides inclusive university experience to further literacy skills and prepare for employment and independent living
Students commute or live on campus; Two-thirds attending LIFE Program are on campus
Receive certificate upon completion (4 yr program) Program developed for students with intellectual and
developmental disabilities
SUPPORTED EDUCATION
VCU ACE IT in COLLEGE
5 yr demo grant through US Dept of Education
Provides college education for students with intellectual disabilities (18-26 yrs)
21 credit, 30 month certificate program through School of Education
“Program of one” with inclusive core courses, electives and work experience
KATIE
Learns through discussion and small group activities in UNIV 101 class (i.e. volunteered to write group responses on the board for class)
With initial prompts from education coach, expresses thoughts and ideas about class readings (i.e. Book: Letters to a Young Teacher)
Expands her experiences through prompts from coach (i.e. participates in service learning, reads a story to children at her job in the university child development center).
Explores Google docs to get comments from education coach on assignments
Employment
1. Our expectations for our students include:
1. Competitive Employment First2. Employment Retention3. Employment Satisfaction4. Access to Employment Supports
Financial Literacy
1. Our expectations for our students include:
1. Money of my own2. Purchasing3. Saving4. Banking5. Financial Education6. Credit
TRANSITION ACTIVITIES LEADING TO FINANCIAL STABILITY
Individuals with disabilities often have very limited income and few, if any, assets.
As of March 2011, 13.4 million individuals were receiving disability benefits. Of those:
• 7.5 million received Title II benefits only, • 4.4 million received Supplemental
Security Income (SSI) only, and • 1.5 million received both SSI and Title II
benefits (SSA, March 31, 2011).
People with disabilities are considerably more likely to experience poverty relative to those without disabilities:
Poverty Status among SSA Beneficiaries 18-64
Type of BenefitPercentage in
PovertyNumber in
Poverty
SSI 72% 3,175,000
SSDI 31% 2,825,000
26
Current Federal Poverty Level
Federal Poverty Level (family of 1)$10,890
Two Times Federal Poverty Level
$21,780 Federal Poverty Level (family of 4)
$22,350
SSI and SSDI Benefits
The average SSI benefit of $533/month (January 2012) is only 59% of the federal poverty level for a family of one.
The average monthly SSDI payment is $1070 (2011) – only 118% of the federal poverty level for a family of one.
Material Hardship Indicators
Hardship with respect to consumption of material items necessary to meet basic needs
• Unable to meet expenses Unable to pay rent or mortgage Unable to pay utility bills Unable to get needed medical care Unable to get needed dental care Food insecurity (with or without hunger)
Hardship Prevalence Age 25-61Income Below the Poverty Level
HardshipIndicator
No Work Limitation
Work Limitation
Didn’t Get Medical Care
12% 21%
Food Insecurity with Hunger
8% 20%
Any of Six Hardships
45% 62%
50% of Individuals with Disabilities are “Unbanked”
Individuals who are unbanked have no access to financial services (services that include savings, credit, money transfer, insurance, or pensions) through any type of financial sector agency such as banks, non-bank financial institutions, financial cooperatives and credit unions, finance companies.
31
Defining Financial Stability
A concept that reflects each person’s employment and economic independence goals and takes into account his or her unique life circumstances and family situation. Financial stability encompasses:
An individual’s income and wealth in relation to his or her financial expenses, responsibilities, and desires;
An individual’s ability to manage his or her finances, and access the information and supports needed to make sound financial decisions and long-term financial plans; and
An individual’s ability to avoid lifelong poverty and dependence on disability benefits.
Community Participation
1. Our expectations for our students include:
1. Consumer2. Citizen3. Volunteer4. How do I get there?
Social Relationships
1. Our expectations for our students include:
1. Building friendships with individuals who are not caregivers
2. Residential stability to allow individuals to maintain friendships
Employment
Post 21 Transition:
What Do We Want?
Post 21 Transition:
What We Don’t Want…
Promising Practices and Service Delivery Models
with Businesses
Walgreens
Program Design
15 Distribution Centers Two new ones are in Anderson, S.C. ( 700
employees) and Windsor Conn. (300 employees)
Individuals with disabilities work at same productivity rate, receive same pay, and work side by side with other workers Commitment to hire at least 10% of
employees with disabilities in distributions center
Walmart
ARC of US & Walmart Foundation: School to Community Transition Project
ARC received 3year, 3 million dollar grant
Purpose of funding to identify & fund innovative & best practices in school-to-community transition services
Grants funded nationwide
Marriott: The Bridges Program
Bank of America
Bank of America- Card Center, Wilmington DE.
Has long history of employing individuals with cognitive disabilities
Has hired over 300 individuals with disabilities in Wilmington, DE and Bangor, ME
Bon Secours
Supported by NIDRR, US Dept of Education
V.C.U. Project Search Replication
Key Concepts Collaboration with business,
education, rehabilitation (VR) & DD Braided funding Immersion & impact Training in real work settings Low risk, low cost for business Hiring students who are “good fit” Goal of employment
School Day: Business Based
8:00 Employability Skills
9:00 Worksites11:30 Lunch 12:15 Worksites2:00 Review, Plan,
Journaling2:30 Depart
P.J. Coronary Unit
P.J.: Coronary Care Unit Duties
• Stock drawers & cabinets in patient rooms• Take out laundry baskets• Prepare rooms for next patient• Remove needle boxes when they are full• Make flow charts for each patient• Stock lab trays• Check refrigerator temperatures
Dan: Dietary & Nutrition
Dan: Dietary & Nutrition Duties
• Refill soda syrup• Break down boxes• Stock water bottles & soda• Wipe down tables• Take trash to dumpster
J.K.: Radiology
JK: Radiology Duties
• Clean & sterilize X-ray cassettes• Stock patient areas with linens• Travel to Radiology, ER, &
Outpatient Units to complete these duties
Alice: Pediatrics
Alice: Pediatrics Duties
• Make new patient packets • Stock supplies • Clean toys • Play with children• Deliver blankets, books & toys• Make name signs for patient doors
& printing pages to color• Help children with crafts
Kalyn
Ambulatory Surgery
Kalyn: Ambulatory Surgery Duties
• Remove instruments from clean baskets
• Sort items• Identify instruments & place correct
items on tray
Internships
Employee Wellness Scanning employee’s documents
into the computer system Assembling masks for employees Filing
Supports Incredible 5 point scale card for
noise 5 minute scheduled break in
morning and afternoon Visual cue cards:
“what to do with your hands at work”
“I’m feeling sleepy” “I’m feeling sad I should…” “I need a break”
InternshipsDiabetes Treatment Center
Creating invitations/mailings for “Sugar Fest”
Data entry Bulletin Board prep and design for
“Sugar Fest”
Internship Supports 5 minute break “I’m feeling
sleepy” visual cue card
InternshipsGeneral Surgery
Stocking medical supplies, and linen in patient rooms
Refilling water for patients
Removing soiled linen from rooms
Internship Supports Behavior plan with
incentives – reviewed before & after each shift
Supply list with par levels
TRANSITION FROM SCHOOL TO ADULT EMPLOYMENT FOR YOUTH WITH DISABILITIES:WHERE ARE WE IN 2012?
Seamless Transition from School to Adulthood : Is There Such a Thing?
Pervasive Unemployment and Underemployment
Need for Renewed Emphasis on Work
Since 80’s research has shown youth with disabilities who participated in work experiences, especially paid work, while in secondary school are significantly more likely to hold jobs after they exit school than those who do not (regardless of disability, or need for accommodation or support)Hazazi, Gordon and Roe, 1985,Benz, Yovanoff, & Doren, 1997,NLTS 2 2006
Transition and IDEA
Amendments of 1997 IDEA eliminated separation between Individual Transition Plan and IEP"Implicit in this requirement is the national policy.....that publically supported education for students with disabilities should culminate in postschool employment and independent living”
When Will Competitive
Employment Be the First Choice?
Wehman 2012
EFFICACY OF TRANSITION PLANNING:
WHAT DOES THE RESEARCH TELL US?
31 studies reviewed involving 859 youth
Not enough studies have sufficient methodological design (Cobb and Alwell 2009) Cobb & Alwell, 2009
Findings
•Too little, too late•Lack of active participation by
students/families•Perception of poor post 21
outcomes by families and teachers
Findings from Qualitative Metasynthesis of Transition Planning
Transition more of a promise than reality Uneven transition expertise, low levels of
parent/student involvement Influence of families and extended families on
career choices and job acquisition Restrictive views on post-school outcomes Lack of cognitive clarity and systematic instruction Lack of respect and understanding by some teachers
Source: NSTTAC
Lack of Career GoalsReview 399 IEP’s (16 to 22 yrs) revealed two thirds did not address or provided inadequate detail for mandated transition goal areas Most lacked career planning and indicated disconnect between an individual’s career interests and type of work experiences they participated in
Powers et al., 2005
EFFICACY OF LIFE SKILLS50 studies reviewed involving 482 youth
Alwell & Cobb, 2009
Findings
Strong support for life skills training and
positive transition related outcomes
Importance of Transition
Need to understand how transition relates to a whole life: living, working, and participating
in the community Great challenge when leave school
and face adult service systems and programs
Planning through a transition IEP is essential
Types of Transitions that Lead to a Whole Life
No perfect way to perfect life; are ways to help get there
Family and culture
Appetite to grow
Plan and supports
Many require more supports than those without disability
MAKING TRANSITION
A REALITY
COMMUNITY-BASED TRAINING AND EMPLOYMENT
WHAT skills should be taught in the community?
What should be on the IEP?
Transition IEPs
1. Employment Goal (may include integrated employment and supported employment)
2. Vocational/Technical Training Goal (may include apprenticeship, work-force training)
3. Higher Education Goal
Transition IEPs (continued)
4. Continuing and Adult Education, Career/Technical Education Goal (may include public or private technical school)
5. Residential Goal
Transition IEPs (continued)
6. Transportation/Mobility Goal
7. Financial/Income Needs Goal
8. Self-Determination Goal
9. Social Competence Goal
10. Health/Safety Goal
(Transition IEPs Wehman & Wittig, 2009, PRO-ED)
Life Skills Training Works!
(Alwell & Cobb, 2009)
HOW should these skills be taught?
Applied Behavior Analysis (ABA) in a portfolio of skills context
(Wehman, Schall & Smith, 2009)
Discrete Trials vs. Portfolio Based Activity Training
I. Person Centered Planning to Inform IEP Development and Transition Planning
Transition Planning
II. Implementation of Communication, Social Skill, and Self Determination Curriculum and Interventions across the Curriculum
Transition Planning
III. Implementation of Organizational and Academic Supports to Achieve desired Transition Outcomes
Transition Planning
IV. Implementation of Self Monitoring and Behavioral Supports to Mitigate Barriers to Desired Transition Outcomes
Transition Planning
V. Implementation of Family Support to Increase Consistency of Supports Across Home to School
Transition Planning
VI. Implementation of Community Based Career Development Curriculum to Increase Career Planning and Development
Transition Planning
Cutting Edge Transition Issues
Employment Before Exit Policy
(Rusch & Braddock, 2004)
(Wehman et al, 2002; 2006b, 2012)
No More Subminimum
Wages!
APSE Board Statement, July, 2009
Access to Benefits
Social Security and Other Benefits
Age 18 RedeterminationStudent Earned Income Exclusion
Section 301
Medicaid/Waiver Eligibility Wehman, 2006a
Functional Curriculum vs
Literacy Based Curriculum
(Wehman and Kregel 2011; Bouck, 2008)
Long Term Support: Who Will Pay?
Long Term Funding: The Bane of Transition
Long Term Funding Policy for Extended Employment and
Independent Living
(see Certo et al., 2008)
Greater Early On Transition Planning with Student, Family and Self-
Determination
Transition Research: What Do We Need to Know?
School Based We need to know the EFFECTS (not relationships)
of different service delivery models on post school employment/education outcomes.
Specifically: Does inclusive education in high school lead to
greater likelihood of successful postsecondary education?
Do functional curriculum/life skills taught in "community immersion" settings lead to successful postsecondary employment?
www.worksupport.comwww.vcu-ntc.org
Virginia Commonwealth University
Reference ListAgran, M. and Hughes, C. (2008). Students' opinions regarding their Individualized Education Program
involvement. Career Development for Exceptional Individuals, 31(2), 69-76.
Alwell, M. and Cobb, B. (2009). Functional life skills curricular interventions for youth with disabilities: A systematic review. Career Development for Exceptional Individuals, Aug 32, 82 - 93.
Analysis of 2007-2008 state annual performance reports for indicator 13. National Secondary Transition Technical Assistance Center. Retrieved October 22, 2009, from www.nsttac.org/indicator13/StatePerformanceReportSummary2009.pdf
APSE statement on subminimum wage. (July, 2009). Available from www.apse.org
Benz, R.B., Yovanoff, P., and Doren, B. (1997). School-to-work components that predict post-school success for students with and without disabilities. Exceptional Children, 63, 151-165.
Bond, G.R. (2004). Supported employment: evidence for an evidence-based practice. Psychiatr Rehabil J 27, 345–359.
Bond, G., McHugo, G., Becker, D, Rapp, C. and Whitley, R. (2008). Fidelity of supported employment: Lessons learned from the National Evidence-Based Practice project. Psychiatr Rehabil J, 31(4), 300-305.
Bouck, E. C. (2008). Factors impacting the enactment of functional curriculum in self contained cross categorical programs. Education and Training in Developmental Disabilities, 43(3), 294-310.
Braddock, D., Hemp, R., and Rizzolo, M.C. (2008). The state of the states in developmental disabilities, seventh edition, 2008. Washington, DC: American Association on Intellectual and Developmental Disabilities.
Reference List
Certo, N. J., Luecking, R., Murphy, S., Courey, S. and Belanger, D. (2008). Seamless transition and long-term support for individuals with severe intellectual disabilities. Research and Practice for Persons with Severe Disabilities, 33(3), 85-95.
Clark, H. B., and Unruh, D. K. (2009). Transition of youth and young adult with emotional or behavioral difficulties: An evidence-supported handbook. Baltimore: Brookes Publishing.
Cobb, B. R and Alwell, M. (2009). Transition planning/coordinating interventions for youth with disabilities: A Systematic Review. Career Development for Exceptional Individuals, 32(2) 70-81.
Flannery, K.B., Slovic, R., Benz, M.R., and Levine, E. (2007). Priorities and changing practices: Vocational rehabilitation and community colleges improving workforce development programs for people with disabilities. Journal of Vocational Rehabilitation, 27, 141-151.
Hart, D., Grigal, M., Sax, C., Martinez, D., & Will, M. (2006). Postsecondary education options for students with intellectual disabilities. Research to Practice, 45, 1- 4.
Hartwig, R. and Sitlington, P.L. (2008). Employer perspectives on high school diploma options for adolescents with disabilities. Journal of Disability Policy Studies, 19(1), 5- 14.
Hughes, C., Washington, B. H., and Brown, G. L. (2008). Supporting students in the transition from school to adult life. In Rusch, F. R. (Ed.). Beyond high school: Preparing Adolescents for Tomorrow’s Challenges (2nd Ed.). Upper Saddle River, New Jersey, Pearson.
Institute for Community Inclusion: Supported employment closures. Retrieved October 22, 2009, from http://www.statedata.info
Reference ListNational Longitudinal Transition Study 2. Retrieved October 22, 2009, from
http://www.nlts2.org/data_tables/index.html
Ottomanelli, L.,Bradshaw, L.D., and Cipher, D.J. (2009). Employment and Vocational Rehabilitation Services use among veterans with Spinal Cord Injury. Journal of Vocational Rehabilitation, 31(1), 39-43.
Powers, K. M., Gil-Kashiwabara, E., Greenen, S. J., Powers, L. E., Balandran, J., and Palmer, C. (2005). Mandates and effective transition planning practices reflected in IEPs. Career Development for Exceptional Individuals, 28(1), 47-59.
Revell, G., Smith, F., and Inge, K. (2009). Report: An analysis of self-employment outcomes within the Federal/State Vocational Rehabilitation System. Journal of Vocational Rehabilitation, 31(1), 11-18.
Rusch, F.R. & Braddock, D. (2004). Adult day programs versus supported employment (1988-2002): Spending and service practices of mental retardation and developmental disabilities state agencies. Research and Practice for Persons with Severe Disabilities, 29, 237-242.
Test, D. W., Fowler, C.H., Richter, S.M., White, J., Mazzotti, V., Walker, A.R., Kohler, P. and Kortering (2009). Evidence-based practices in secondary transition. Career Development for Exceptional Individuals, 32(2),115-128.
The young and the jobless. (2009). The Wall Street Journal, October 3, page A12.
What works transition research synthesis National Secondary Transition Technical Assistance Center. Retrieved October 22, 2009, from http://www.nsttac.org/ebp/what_works.aspx
Reference List
Wehman, P. (1981). Competitive employment: New horizons for severely disabled individuals. Baltimore: Paul H. Brookes Publishing Co.
Wehman, P. (2002). A new era: Revitalizing Special Education for children and their families. Focus on Autism and Other Developmental Disabilities, 17(4), 194-197.
Wehman, P. (2006a). Integrated employment: If not now, when? If not us, who? Research and Practice for Persons with Severe Intellectual Disabilities, 31, 122-126.
Wehman, P. (2006b). Life Beyond the Classroom: Transition Strategies for Young People With Disabilities. Baltimore, Md.: Paul H. Brookes Publishing Co.
Wehman, P., Revell,G., and Brooke, V. (2003). Competitive employment: Has it become the "First Choice" Yet? Journal of Disability Policy Studies, 14(3), 163-173.
Wehman, P., Targett, P., West, M., & Kregel, J. (2005). Productive work and employment for persons with Traumatic Brain Injury: What have we learned after 20 years? Journal of Head Trauma Rehabilitation, 20(2), 115-127.
Wehmeyer, M.L., Parent, W., Lattimore, J., Obremski, S., Poston, D., & Rousso, H. (in press). Promoting self-determination and self-directed employment planning for people with disabilities. Journal of Social Work in Disability and Rehabilitation.