Notes On Active Treatment For Individual With Special Needs

Active treatment is the term often used to describe the process of teaching independent living skillsto people.

Expected outcome- to promote maximum independence and supporthing the person’s goals.

Teachable moments – teaching opportunity

Active teaching includes specialized and generalized training as well as services and supports that assist a person to acquire the skills and behavior necessary to function with as much self-determination and independence as possible.

Priority areas for the person are:
-personal care
-vocational and leisure skills

These skills allow people to be more independent and can support their personal goals.

Active teaching can also prevent or slow down the regression in current functional skills.

Active teaching is based on the premise that all people, regardless of severity of their disability, grow and develop throughout their live.

An assessment is an evaluation of someone’s current abilities or level of skill and interests.

When the term “assessment” is used, it can mean, ether:
– a formal assessment, which uses one of a number of different formats, or…
-an informal assessment, which may simply be reports from the person served, staff, family and others, based on observations of the person.

The Plan
Each person you work with has an individual plan.
This plan may be called an:
– Individual Program Plan (IPP)
– Individual Support Plan (ISP)
– Individual Habilitation Plan (IHP)
-Person Centered Plan (PCP)
– Some other name
This plan includes skills the person is developing. There is no single format for a person’s plan. The skills are written as goals with clearly defined expected outcomes. The plan may also designate the priority in which goals and objectives will be addressed. It defines specific recommendations to accomplish each goal and objective. With independence as a primary goal, the plan gives direction to the support staff in guiding an individual to work toward and achieve their maximum potential. The plan should be written in a way that helps the person achieve a more independent life and reflects the interest and outcomes they desire in life.

To be more effective, active teaching should be happening all the time and occurring in all areas of life. In active teaching the person shoul be an active participant.

The person should do for themselves as much as possible, with staff providing only the minimal support that allows the person to be successful.

Active teaching must be consistently implemented, not only formally, but also informally, as the need arise and the opportunities present themselves throughout the day.

Formal goals collect data and are in the written plan.

Data is written documentation and it identifies if there is progress in meeting the objective.

Informal goals don’t necessarily collect data. However, they still need to be implemented.

A plan often includes goals for activities of daily living (ADL’s), vocational, leisure, communication, self-administration of medication, money management, etc..

Skills in these areas allow for maximum independence and can and should help a person achieve their personal goals.

Implementation and Intervention Strategies
Implementation stategies detail how staff will assist the person in acquiring new skills and also build on existing skills.

Intervention strategies describe what staff will do to support the individual for each objective established.

Teaching Strategy
Praise and other means of positive reinforcement are an essential part of teaching new skills while at the same time strengthening existing ones.

Active teaching plans support each individual to reach their maximum potential.

In a teaching strategy the individual is encouraged to do a skill independently. The support staff then provides assistance with prompts or cues as necessary to help the person complete the task.

The cue or prompt level may look something like this:
1- natural
2- gestural
3- verbal
4- modeling
5- physical prompt

The natural cue comes from the environment and is also called the independent level. At this level the individual does the skill or task with out any prompting from support staff.

If an idividual cannot accomplish a task or skill at the naural cue level, the next cue given is a Gesture. For example, an individual may not initiate picking up an object. However, if the support staff points to the object to be picked up and the person picks up the object, that person did the task at the gestural prompt level.

Verbal cue…for example, you would say “Geroge, please pick up the spoon.” If George picked up the spoon, he met the task at the verbal cue

Modelling cue…staff will show or model the expected behavior by picking up the desired object.

Physical prompt…follows the modelling cue if more support is needed. This is where support staff provides brief hand over hand assistance in order for the individual to complete the skill. When physical prompting is used it should serve to convey information through direct movements. A physical prompt should never be used to overpower or manipulate someone. It should be used when the staff person and person supported are working together and coordinating movements. For example, the spoon is on the table. Staff supports George’s hand in their hand and guides it over to the spoon.

If an individual needs more assistance than physical prompt, they probably require total assistance.

Total assistance is when support staff completes the task for the person instead of the person completing the task.

Always begin by giving the person the opportunity to initiate the task or skill. This promotes independence. Proceed to each prompt level as needed in order to help the person complete the task. This approach provides the opportunity to achieve success at any level. It also uses a variety of techniques and allows for a variety of individual learning styles.

Building Blocks of Goals
-Goals are written up to one year.
-Goals should be realistic and attainable.
-For every goal there is an objective.

An objective is a “stepping stone” toward meeting the long term goal.
-objectives are usually written 3-6 months.

Individuals should take an active role in establishing their goals and objectives.

In order to construct a good objective you need to be familiar wtih its building blocks.

There are (3) three parts to every good objective
1. Observable behavior- part of the objective that states the specific desired action. It should be a single target behavior, specific and measurable.
Example: brush teet
                    eat with a fork
                    grasp an object
                   maintain eye contact
2. Condition – second part of the objective and it answers the question”under what circumstances or in what situations does this behavior happen?”
The condition wil describe something that will be provided by staff.
Example: verbal cue
                     physical prompt
                     hand over han assistance
3. Criteria – part of the objective that states the measure of success.-for five consecutive days
                                                                                                                                         -three out of six opportunities
                                                                                                                                         -each morning for seven days
                                                                                                                                         -nine out of ten attempts
If an individual is not meeting a goal or objective after an extended period of time, it needs to be reassessed.

Carefully think through why the person isn’t meeting the objective.

Sometimes the person reaches a plateau or is interested in developing another skill.

Sometimes the approach needs to be changed.

A revised plan is then developed and implemented.

Individualized Program Plans must be consistently monitored and revised as necessary.

In an ICF/MR, the Qualified Mental Retardation Professional (QMRP) oversees this process.

The QMRP may be a social worker, psychologist, RN, etc..

An important part of the active treatment plan is gathering data to document the individual’s progress.

Data also measures the success and effectiveness of the plan.

Documentation (taking and recordingof data) is done on all formal objectives.

The data (documentation) form is the record of progress.

Documentation is the crucial part of the active teaching process.

When an individual completes the objective, documentation of progress takes place.

Each support staff person is responsible for documenting the progress of individuals at the intervals listed on the plan.

People with developmental disabilities experience barriers to learning.

Guidelines for Teaching Strategies
1. The approach must be clearly written so everyone will implement it in exactly the same manner.
2. Objective should be worked on and the approach followed as opportunities arise.
3. Prompts should be simple, clear, and easy to understand.
4. Physical disabilities may eliminate a prompt level (e.g., gesture cue for someone who can’t see, verbal prompt for someone who can’t hear).
5. The approach should contain full instructions (i.e., instruction on the following of prompts, offering the least level of assistance, method of reinforcement, and when data will be collected).
6. Objectives cannot be written at the total assist level. If you do not anticipate success at any higher level, this would not be a priority skill area.
7. All steps of the approach must be followed in the correct order so that the individual has the opportunity to succeed with the lowest level of staff intervention.

Main Points of Active Teaching:
1. Talk to and listen to the people you support.
2. “Teach” versus “do.”
3. Focus on the individual’s interests, needs and preferences.


About the Author: Nicetas Juanillo

Writing makes me happy away from home. My website is where you can find my tips about lifestyle, health and other issues. I also have books on my site that you can read to know more

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