STROUD COURT COMMUNITY TRUST POLICY & PROCEDURE FILE POLICY DOCUMENT ELECTRONIC VERSION POLICY ON PROMOTING INDEPENDENCE This document is based on work undertaken by Jacqui Ashton Smith, Head Teacher at the Helen Allison School, Longfield Road, Meopham, Kent, DA13 0EW. Stroud Court Community Trust is grateful for the support and assistance given in developing this policy and the permissions granted to use the material. Chris Atkins, Executive Director, Stroud Court Community Trust, October 2004, revised October 2012 Policy Statement: Policy on Promoting Independence At Stroud Court, we believe it is important to empower clients through the provision of advocacy and the development and promotion of self-help and life skills. It is essential that clients be given planned opportunities to acquire independence in order to develop self-esteem and confidence. At Stroud Court we do this through assessment and target setting within individualised care plans. Opportunities are given for these experiences to be generalised and consolidated. Clients are given frequent opportunities to achieve at their own level with minimal support. When new experiences are being planned, the least intrusive support necessary is used and gradually withdrawn as the individual becomes more familiar with the particular activity. At all times we are aware of the characteristics of autistic spectrum disorders, in particular the triad of impairments (Wing & Gould 1979) and how these characteristics impact on the individual in their everyday life experiences. Autistic Spectrum Disorders and Independence People with an autistic spectrum disorder often have difficulties in understanding social situations and may have impaired self-awareness making it difficult to function without support (Wing 1996, Jordan 1999, Peeters & Gillberg 1999). Additional impaired thought processing, poor fine and gross motor skills and sensory issues can also make achieving independence problematic (Baron-Cohen & Bolton 1993, Frith 1989, Attwood 1998). See the SCCT Policy on the Development of Social Understanding for further details on this aspect. It is necessary to be respectful of sensory difficulties, fears, phobias and anxieties that may have an impact on the development of skills that promote independence (Bogdashina 2003). It is acknowledged that this may be particularly prevalent when working on personal hygiene, eating and other self-help skills and accessing the community. The characteristic impairments associated with the condition can make social skills and community inclusion/presence especially complex for our clients. Individuals with an autistic spectrum disorder may experience low levels of awareness of danger (Morgan 1996, Jordan 1999, Peeters 1997). Consequently, clients need access to processes for checking whether a situation has any hazards. These safeguards are clearly outlined in the Stroud Court Risk Policy and Procedure available in any Policy and Procedure File (policy document 34) and all staff are required to read and understand this. Staff are required to assess, plan, evaluate CD version Independence Policy Page 1 of 5 rev. Oct. ‘12 STROUD COURT COMMUNITY TRUST POLICY & PROCEDURE FILE POLICY DOCUMENT ELECTRONIC VERSION POLICY ON PROMOTING INDEPENDENCE and review situations and activities that allow clients to be increasingly independent within a responsible risk-taking framework. It is acknowledged that people with an autistic spectrum disorder can learn a skill in a particular way within a particular environment and then find it difficult to adapt and transfer this skill to a different setting (Jordan 1999, Morgan 1996). Accordingly, through the development of advocacy, self-help and life skills, clients are encouraged to experience as wide a range of environments and settings as practical. Independence is a specific area detailed within all client plans that provides information and approaches to use in order to promote independence for that particular individual. This area of development permeates all activities within the service – staff are expected to encourage clients to participate in all daily living activities appropriate to their ability and potential and it through this that a generalisation of skills across time and environments is experienced. Staff are expected to be fully aware of, and actively address the independence targets in a consistent manner and staff deployment recognises and takes account of the need for consistency and continuity of approach. Community based education is used to develop independence skills and covers a range of situations and opportunities including self-help and self-care, skill acquisition and development, leisure, clubs, holidays away, etc. Clients are encouraged to access college courses and staff support will seek to be the least restrictive appropriate for that individual. In doing this, independence is maximised and lifeexperiences move more towards those experienced by all members of society. Promoting Independence The following section gives a range of examples illustrating the strategies we use to develop and promote independence. Initial assessment On admission to Stroud Court Community Trust, information is gathered from home, previous services and outside agencies. A team of senior staff will then carry out the initial assessments to highlight the individual’s strengths and needs. From the information that is collected, approaches that are based on participation, choice and independence will be used. The assessment includes sections on: o o o o Service Requirements Core Skills Independence Skills Leisure Skills Vocational Skills Communication Social Behaviour Sensory Profile Autism Profile Social Interaction Communication CD version Independence Policy Page 2 of 5 rev. Oct. ‘12 STROUD COURT COMMUNITY TRUST POLICY & PROCEDURE FILE POLICY DOCUMENT ELECTRONIC VERSION POLICY ON PROMOTING INDEPENDENCE o Repetitive/Stereotyped Behaviour Behaviour Profile Aggression Unsocial Motivation Other From this assessment, the initial individual programme is designed. Individual programmes Using information gained from assessments, observations and history, individual programmes are tailored to meet the wishes, aspirations and needs of the individual; for example a client may have a programme that develops road crossing skills or helps them overcome anxieties experienced in social environments. It is important that tasks are achievable and a stepped approach to the development and maintenance of skills is used. Communication systems One of the basic enabling components to promote independence through the participation and involvement of clients is an effective communication system the lack of which is a fundamental indicator of an autistic spectrum disorder. Stroud Court operates an augmentative communication system based on the “Total Communication” approach to enable users, wherever possible, to express themselves and take an active role in decisions that may have an effect on their life. At all times we will seek to engage clients in all aspects of the service they receive at Stroud Court, although this may vary according to the strengths and wishes of individuals. Central to our work is the identification and use of appropriate communication systems for clients – these are individualised and wherever possible make full use of any existing systems clients may employ. Learning routines and rules Routines and patterns are established with clear transition and anchor points to enable clients to understand and predict daily life. For example; moving to a different location for activities, using specific environments for specific functions, collecting coats and shoes to indicate an outing, setting table places in preparation for a meal. Where appropriate, “rules” are given to the clients in order to give them clear guidelines of how to behave in specific situations – this may take the form of “social stories” or “comic strip conversations” (Gray 1994). Opportunities to generalise skills Built into any programme that develops clients’ independence skills is the opportunity to practice these skills in a range of differing contexts. For example, it is not assumed that a client working on a specific eating skill can repeat this in other situations. This client may then be taken on visits to a range of eating establishments - giving the individual the scope to generalise this aspect of independence. Clients who develop specific self-help skills - for example fastening a zip - are then given the chance to practice this skill with a range of zips and garments. CD version Independence Policy Page 3 of 5 rev. Oct. ‘12 STROUD COURT COMMUNITY TRUST POLICY & PROCEDURE FILE POLICY DOCUMENT ELECTRONIC VERSION POLICY ON PROMOTING INDEPENDENCE Giving clients strategies to structure their own life A wide variety of strategies are used to structure clients’ environment and promote individuals taking responsibility for the organisation of activities. These strategies include: o Communication systems o Individual programmes o “Speak up for Yourself” sessions (self advocacy) o Opportunities to choose activities (college, holidays, leisure pursuits, home based activities) o Flexible and responsive staff support o Provision of 1-1 staff support o Where appropriate, client self-assessment and progress reporting Responsible Risk Taking The general duty of care owed to all clients is acknowledged within the context of the responsibilities the Trust also has to provide for the development of clients in its broadest sense. In assessing and managing risks, the Trust is mindful of the need to provide a safe and secure environment for clients, but will do so in the least restrictive and limiting manner in order to promote independence wherever possible. References Attwood, T. (1998) Asperger’s Syndrome – A Guide for Parents and Professionals, London/New York: Jessica Kingsley Baron-Cohen, S. & Bolton, P. (1993) Autism: the facts, Oxford, Oxford University Press Bogdashina, O. (2003) Sensory Perceptual Issues in Autism and Asperger Syndrome: Different Sensory Experiences - Different Perceptual Worlds, London/New York: Jessica Kingsley Frith, U. (1989) Autism: Explaining the Enigma, Oxford: Blackwell Gray, C. (1994) The New Social Story Book, Arlington: Future Horizons Jordan, R. (1999) Autistic Spectrum Disorders – An Introductory Handbook for Practitioners, London, David Fulton Publishers Morgan, H. (1996) Adults with Autism, Cambridge: Cambridge University Press Peeters, T. (1997) Autism – From theoretical understanding to educational intervention, London: Whurr Publishers Peeters, T. & Gillberg, C. (1999) Autism: Medical and Educational Aspects, London: Whurr Publishers CD version Independence Policy Page 4 of 5 rev. Oct. ‘12 STROUD COURT COMMUNITY TRUST POLICY & PROCEDURE FILE POLICY DOCUMENT ELECTRONIC VERSION POLICY ON PROMOTING INDEPENDENCE Wing, L. (1996) The Autistic Spectrum: A guide for parents and professionals, London, Constable Wing, L. and Gould, J. (1979) “Severe impairments of social interaction and associated abnormalities in children: epidemiology and classification”, Journal of Autism and Childhood Schizophrenia, 9, 11 – 29. Training All new staff will be required to read this document as part of their induction process. In house training is arranged annually and all relevant staff will be expected to attend as necessary. Breaches of this Policy Any breach of this policy will be taken very seriously by the Trust and, depending on the specific circumstances of the case, may result in disciplinary action being taken up to and including summary dismissal in accordance with the SCCT Disciplinary Procedure. Distribution and Review This policy statement will be provided to every member and employee of Stroud Court Community Trust at appointment or staff induction, and be explained in full. The service management will review this document annually or as circumstances dictate. Reviewed: October 2012 Signed: Name: Chris Atkins Position: Executive Director CD version Independence Policy Page 5 of 5 rev. Oct. ‘12