St Christopher’s School and Children’s Home (Bristol) Policy on Promoting Independence Ratified by Trustees August 2015 Review date August 2016 Introduction Our pupils and young adults have severe and complex learning difficulties; some also have mobility problems, all have language and communication difficulties and many are diagnosed with autistic spectrum disorders (ASD). Because of this our pupils and young adults can be highly dependent on external support to fulfil their needs. As a result, privacy can be hard to obtain in most aspects of their daily lives. Teaching them to become more independent will give them more control over their lives, create more opportunities for privacy, lead to better quality of life, prepare them for their life beyond St Christopher’s and enhance their ability to make their own choices now and in the future. At St Christopher’s our work is based on the understanding that beyond their disabilities, each young person has personal qualities and interests that they wish to express and develop. High expectations from all staff, providing young people with activities that are appropriate to their age and interests and valuing each one as an individual for the special qualities they bring, all enable them to gain in independence and self-esteem. People with autistic spectrum disorder (ASD) have difficulties in understanding social situations and have poor self-awareness making it difficult to function in school, home and community environments without support. Additional difficulties in thought processing, communication, poor fine and/or gross motor skills and sensory processing can also make achieving independence problematic. We believe it is important to empower our young people through the teaching of selfhelp and life skills. It is essential that they be given planned opportunities to acquire independence in order to develop self-esteem and confidence throughout life. This is done through assessment and target setting as well as general awareness of “doing with”, rather than “doing for” provided by 1:1staff support in both House and school. OM 4. Promoting Independence Policy File 2 Page 1 Young people are given frequent opportunities to achieve at their own level of ability with or without minimal adult support and opportunities are given for this learning to be generalised and consolidated. It is necessary to be respectful of sensory difficulties, fears, phobias and anxieties that may impinge on the teaching of skills that promote independence. It is acknowledged that this may be particularly prevalent when working on toileting and eating skills or accessing the community. Pupils' independence encompasses: Occupying themselves with independent activities Carrying out daily tasks with minimal support Self- help tasks e.g. eating, drinking, personal care, dressing, going to the toilet Moderating their own behaviours Able to generalise skills e.g. in a different setting, with different people etc. Making choices, including food and drinks at meal times, snacks, etc Setting the pace of non-independent activities Communicating needs Ability to be alone Initiating communication/activity Influencing / controlling their own environment Receiving ‘payment’ for work experience and using money to pay for shopping of chosen items Becoming more independent enhances the young person’s quality of life! Curriculum Context Promoting Independence comes under the extended curriculum area of Personal, Social and Health Education (PSHE). This area of the curriculum is seen as the main focus of the “waking day curriculum”. It permeates all activities, both within the school and Houses, to ensure that there is a generalisation of skills across environments, as this is a crucial element in the development of independence. (See policy on PSHE). We use P Levels to formally assess pupils' levels of ability set targets accordingly. All pupils have Individual Education Plan (IEP) or Individual Learning Plan (ILP) targets and methods for working towards in school and in the residential setting to ensure OM 4. Promoting Independence Policy File 2 Page 2 consistency and continuity. Parents receive copies of IEP/ILPs, so that when possible new skills could be transferred and maintained at home. There is emphasis on developing independence in ways that are appropriate to young people’s age. Progression is built into the development of independence through appropriate target setting by gradual reduction of adult direction, increased subtlety of structure and prompts, direct teaching situations, increased opportunities within and external to St Christopher’s, and structured opportunities to develop and practice decision making and problem solving skills. Young people with severe and complex learning difficulties have low levels of (and many have no) awareness of danger. Staff are required to plan situations that allow young people to be increasingly independent without a risk to their safety and well being. There are general risk assessments for various situations and waking day curriculum activities. In addition to those, individual pupils’ risk assessments are completed as required. These will also take into account the nature of an autistic spectrum disorder and how this has impacted on the individual .e.g. fears, phobias, etc. Main Area of Focus Depending on their abilities and skills pupils are encouraged to take an active part in the daily life of the Houses and school. The main areas of focus in the Houses are dressing, toileting, mealtimes, personal hygiene, care of the environment, use of public amenities and road safety. There are joint targets for personal and social development - mainly developing social interaction - and these are agreed on by the key care staff and teacher. The IEPs are broken down into long term and short term targets to enable the pupils to achieve the long term targets in smaller steps. The IEPs are assessed weekly and formally evaluated every six months. Opportunities to Generalise Skills People with autism have difficulties in generalising skills learned in one context to another, therefore any programme that develops pupils' independence skills includes opportunities to practice these skills in a range of contexts. The ”waking day” curriculum is very conducive to enabling pupils to transfer skills within a variety of environments, e.g. a pupil working on a specific eating skill in their residential House will transfer this skill into other situations such as snack time in the class room or when going to a café with their carer. Pupils who develop specific self-help skills e.g. fastening a zip, are then given the chance to practice these skills with a range of zips and garments. OM 4. Promoting Independence Policy File 2 Page 3 Visual Prompts The use of carefully designed and individualised visual cues is central to enabling pupils to understand the task presented to them. In addition to clarifying tasks, visual cues act as an unobtrusive prompt to pupils. Visual picture or photo sequences (work systems) support the young person to carry out a task with minimal or no staff help, thus increasing their independence. In some classrooms pupils have independent work-stations where they can learn to complete tasks independently with minimal disruption. The emphasis would then be on completing a familiar task without any support, rather than on learning a new skill. Learning Routines and Rules Routines are established with clear transition symbols, to enable pupils to understand what is expected of them, for example when going to the swimming pool, using a towel as a signal it is time to go. (For more details please refer to Policy on Provision for Specific Needs of Pupils with Autism Spectrum Disorders). Giving Pupils Strategies to Structure their own Life A wide variety of strategies are used to structure pupils' working environment and promote pupils’ taking responsibility for organisation of work and materials. These strategies include: Use of structured teaching principles: visual schedules, work systems Workstations Familiar daily routines/ chores in the House/class room e.g. laying the table Opportunities for making choices throughout the waking day e.g. menu choices, activities Communication and Social Interaction Communication is taught throughout St Christopher’s day with a strong emphasis on pupils taking initiative to communicate. The Picture Exchange Communication System (PECS) enables pupils to initiate requests e.g. choosing what clothes they want to wear, or leisure activities. A range of other visual and audio supports are available and introduced to pupils, as appropriate. (Please refer to policy on Language and Communication). Intensive Interaction enables pupils to gain an initial sense of how two-way interactions work. DIR Floor-time principles are gradually being introduced to care and teaching OM 4. Promoting Independence Policy File 2 Page 4 staff. These give a developmental, person-centred framework for teaching children and young people how to engage in social interaction. Essential Approaches and Attitudes to be Used by Staff to Promote Pupils' Independence: Work with the pupil in an empowering mode: Every activity that a supportive adult does with a child or young person is potentially on a range of ‘empowering' through to 'disempowering'. Have the mind-set of working 'with' them rather than 'doing for' them. Where the task is unavoidably 'doing for' e.g. giving a hand massage, putting on a hoist harness, pushing a swing, give them opportunities to set the pace, e.g. are you ready?; do you want some more? Create opportunities for the young person to take the initiative (e.g. PECS work). Sometimes the best use of 1:1 staffing is to attentively stand back. Always ask yourself - could they be doing some of this themselves? e. g. lifting foot for shoe on, pushing through a sleeve, etc. It is important to recognise that preferences might change over time. Therefore, adults supporting a child or young person must not assume that once a preference/choice has been made this will be static. The child or young person must be given opportunities to confirm their preferences/choices on a regular basis. Be mindful of every physical or verbal prompt or support given: OM Think of ultimately making yourself redundant. Any prompting which becomes part of a learnt process will ideally, at some stage in the future, need to be phased out, so think carefully before introducing them. Physical prompting (for a hand activity) to start as far away from the hand as possible i.e. upper arm, elbow, lower arm then finally (if all else fails) hand over hand. As the young person masters the activity, you can phase out support backwards, i.e. from full support to light support. Verbal prompting to be as short, simple and consistent as possible. Compare e.g. 'hold' (a one key word instruction) with "hold the ball and put it in the bucket" (a 4- 5 key word instruction). Once an instruction is given don't change the language e.g. don't change "hold" to "pick it up, reach out, take it". Do not inadvertently create dependence. 4. Promoting Independence Policy File 2 Page 5 Support young people’s ability to succeed: Success breeds confidence, good self-esteem, motivation, independence. Stress, fear, anxiety can be paralysing. The supporter's good relationship with the young person and the young person’s ability to make sense of their immediate environment and to moderate their own behaviours are all vital for their sense of inner security, safety and trust. Working with the methods that St Christopher’s staff are trained in, such as Intensive Interaction are a key component of this relationship building enabling you to be with the young person, in the moment, meeting them where they are at, and then guiding them to new experiences and success. In tasks that may require two members of staff to support a pupil, one person will take the lead, and the other will be a silent support. This ensures clarity for the young person and supporting staff and the relationship is not jeopardised. For many young people receiving, processing and acting on sensory stimulation is impaired. Sensory Integration therapy and ‘sensory diet’ activities (offered by the occupational therapist) are also helpful in reducing stress. These approaches can be helpful in enabling the young person to accept a range of sensory stimulation without feeling overwhelmed, confused or out of control. We need to ensure/be aware of not overloading with a variety of sense perceptions i.e. using one sensory channel at a time. Proactive Behaviour Guidelines and agreed responses should help the person to regulate their own behaviours where possible and reduce dependence on intervention. OM Give the young person time to engage, remembering that they have to become aware of the stimulus, register what it means, organise themselves mentally and physically to respond and then respond. Be thoughtful of unnecessary praise. Mainly let the activity be the reward where possible (i.e. the switch produces music, the touch-screen produces an animation, the item dropped in a bucket makes a noise, the guitar strummed plays music) so the young person does not become too dependent on social praise for motivation and self-esteem. Make activities engaging by modelling or working alongside, to help the young person to want to do the task. Tap into subjects/activities that individuals are naturally interested in. These will motivate them to engage in new activities/learn new skills. 4. Promoting Independence Policy File 2 Page 6 OM Encourage their ability to anticipate i.e. supporting a task by breaking it up into a repetitive sequence of steps and inviting the young person to complete it in order to facilitate independent completion e.g. reach, hold, in, next; reach, hold, in, next. Use the principle of backward-chaining, i.e. for a task which involves several stages, let the young person see you do the first stages and help them to succeed with the last stage; they then get the reward of the job completed. Then help them to do the penultimate stage AND the last stage, etc until they finally learn the first stage of the task. Make the environment supportive of independent success - reduce distractions and sensory clutter e.g. work area visually uncluttered, physically uncluttered, minimal noise disturbance. Ensure the level of challenge of the task matches the young person’s level of ability, and can even extend it when appropriate. Support receptive and expressive communication e.g. PECS, visual schedules, photo cards, symbols, objects of reference, Makaton signing. 4. Promoting Independence Policy File 2 Page 7