avoiding hitches in the get -along - aucd home · 2009. 11. 5. · fugue state, dizziness,...

Avoiding Hitches in the Get -Along

A Prescription for Successful Transition

Jan MossCenter for Learning and Leadership

Jennifer Graduated and Transitioned

High SchoolVotechnical School

Moving to AptSupported Employment

Job developmentEmployment

Remaining Employed Health Services Transition

Transition Scores

Hitches in the get-along

Jennifer has been employed for over 17 years at Mercy Health Center, receives natural supports in work place

Children with special healthcare needs frequently experience emotional and physical health problems that could be addressed more effectively if their healthcare providers had adequate knowledge and resources available.Ann Cutler, MD

Avoiding Hitches in the Get Along

Alert - Newsletter of The Department of Disability and Human Development

Oops! Jason Graduated Hitches in transition prevented get-along

Health Transition was not achieved

High School supported transition job ended with graduation

Vocational Rehabilitation resources and supports were insufficient, Ticket-to-Work failed

Hitches for Jason included (but were not limited to):Speed talking and agitationBiting or head butting self, boss, co-worker, (innocent passers by)Rashes, itching, picking, hivesRocking, moaning, clucking, clickingTics, twitches, grunts, growlsInappropriate gestures, pacingAnxiety, panic attacks, seizures:

absence, atonic, tonic-clonic, myoclonic, simple, partial, complexBouts of cursing, hissing, sniffingSuicidal thoughts …continued

Health Transition did not occur for Jason Side effects of Administering Employment without Health Considerations hitched him up

could include (but are not limited to):Refusal to move (statuating)Throwing self to floor or pavement Uncontrolled diaherria, flatulence (pugh-ugh)Refusal to leave the restroomRefusal to speak, refusal to quietSleeplessness, wakefulnessFugue state, dizziness, drowsiness, lethargyConfusion, feeling faint/ light headedClothing removal: stripping, streaking and Loss of appetite

Side effects can offset economic and social rewards by…creating poor health status and

Increased health care costsLost Quality of Life

Side effects when Administering Employment without Health Considerations

Side effects indicate real problems

Jason Considerations

Creating a Successful Job Match

The Employment Support Indicators

Identify supports necessary to:

• transition into adult health services• find job preference and trial experiences• get along with co-workers and supervisory

personnel • stay focused on the job • change work assignment • evaluate quality of work• continue to work

Employment Support IndicatorsCommunication: combination of words and pictures, assistive, Interpreter

or translation services

Reading Affect: can read affect of others and respond appropriately, does not consistently read and interpret affect; understands own affect and how others might react

Interpersonal Skills: cues to interpret personal space (self and others) supports to understand language pragmatics (what is appropriate to say to whom, when and where.), voice modulation cues

Handling Criticism/Stress: accepts criticism can change behavior, able to ask questions, get clarification and understand criticism, will need clarification to see the forest for the trees

Body Clock: peak work performance, functions best in the morning, mid-morning, afternoon, evening

Endurance: requires frequent breaks, hourly breaks, able to self determine when a break is needed or required

Employment Support IndicatorsDecision making/Problem solving : help to identify options and

impact of choice making, rules and structure to minimize decision making

Adapting to Change: rigid routine is preferred, flexible routine, advance notice and explanation

Time Awareness: understanding of time, need cuesIndependent Work Rate: slow, average, sometimes fast (may need to be supported with volume of work…under-employed… or rush-to-finish… quality control lost)Reinforcement: paycheck provides sufficient reinforcement, other

positive aspects of work are more importantTransportation: means, method, cost, self-arranged, must be supported in arrangements, private, public, dependable sourceEmergency arrangements: who, what ,when, where, how