Diane Bannerman Juracek, Ph.D., BCBA Community Living Opportunities, Inc.

1. The Family Teaching Model: A Kansas Residential Model for Adults with Intellectual Developmental Disabilities that offers Eleven Desired Lifestyle Outcomes Diane Bannerman Juracek, Ph.D., BCBA Community Living Opportunities, Inc.

2. CLO’s mission is to help adults and children with severe developmental disabilities achieve personally satisfying and fulfilling lifestyles in their own communities.

3. CLO’s Services • Residential Options • Day Classes • Supported Employment • Health Care Services: Clinics in Lenexa and Lawrence • Applied Behavior Analysis Consultation • Positive Behavior Supports • Children’s Services • Training, Evaluation and Certification • Outreach Services • Remote Monitoring • Midnight Farm

6. CLO 2012 Demographics • 81 homes • 214 individuals with intellectual developmental disabilities • “Extremely satisfied” or “Satisfied” ratings from 91% of parents/guardians of those we serve • 230 adults served in day services in Douglas, Allen, and Johnson Counties • Virtual village opens, providing “Homelink” support to promote independence • 115 individuals served in CLO wellness clinics and occupational/physical therapy services • 330 children served in Children’s Network • Early intensive behavioral intervention • Family and youth intervention • Johnson County Montessori Preschool • Northstar Academy • Midnight Farm • 120 special-needs kids and adults in therapeutic riding • 40 special-needs kids in summer camps • 750 individuals from community on tours, field trips & special events

7. Building the “Good Life”

8. 1981 DSNWK 1975 Boys Town 1970 1st dissemination attempt – not successful Timeline of HistoryThe Teaching Family Model 2004 California Community Opportunities 1983 CLO Teaching Family Model 2001Tennesee Family Solutions 1977 Concerned Care Jim Sherman and Jan Sheldon 1st adaptation for DD population 1967 Lonnie and Elaine Phillips/ Mont Wolf Consumer feedback important

9. Individualized Living Group Home Residential Service Models at Community Living Opportunities, Inc. • 8 housemates • Awake shift staff 24 hours a day • Funded by Medicaid as a Private Intermediate Care Facilities for Adults with Mental Retardation (ICF/MR) • 3 housemates • Living in an apartment or home • Awake shift staff 24 hours a day • Funded by Medicaid Home & Community Based Services (HCBS) waivers for persons diagnosed with Developmental disabilities

10. Family Teaching Residential Service Models at Community Living Opportunities, Inc. • 3 or 4 housemates • A family teaching couple provides most of the support, lives next door and manages the home • Lives with a teacher without disabilities or a teaching family in the same home Both programs funded through Medicaid’s Home and Community-based Waiver for people with DD Extended Family Teaching

11. Family Teaching Model* Components*An adaptation of the Teaching Family Model (Phillips, Phillips, Fixsen, & Wolf, 1974) • Family Teachers in family style living environments • Individualized daily schedules • Teaching new skills • Systems for encouraging achievement • Positive relationships • Opportunities for choice and self determination • Ongoing teacher training and consultation • Teacher evaluation and certification

12. Family Teaching Model Component # 1 . . . Family Teachers in a Family Style Environment

13. Family Teachers in a Family Style Environment What better model to accomplish this than the Family Teaching Model?!

14. Family Teaching Model Component # 2 . . . Individualized Daily Schedules

15. Tom's Choice Kevin’s choice Library Library Library Library Work @ Recycling Center Work @ Recycling Center While John(family teacher)goes to gym Ed's Choice Swimming Swimming Swimming

16. Family Teaching Model Component # 3 . . . Teaching New Skills& Quality of Life Planning

17. Continuous Planned and Opportunity Teaching • Identification and purposeful teaching of skills: • that lead to independence and ability to navigate through their day with less or no assistance • that help the person served access highly preferred items, activities, experiences. . . • that limit or eliminate any rights issues (privacy, need to have someone assist them in making a phone call) • that lead to improved health & safety • Behavioral support • Eliminates or decreases challenging behavior that inhibits continued progress towards living a good quality of life

18. Reinforcing Desirable Behavior* • Initiate Positively • a. Use Active Listening Skills (e.g., eye contact, responsive facial expression & voice tone, active listening posture, gestures, verbal and non-verbal encouragement, and reflection) • b. Expression of Affection • (e.g., smile, greeting, joke, physical contact) • 2. Praise and Positive Consequence • (descriptive, immediate)

19. Teaching a New Skill* 1.Initiate positively a. Use active listening skills (eye contact, responsive facial expression and voice tone, body posture, and gestures). b. Elicit person’s involvement throughout the interaction c. Expression of affection (e.g., smile, greeting, joke, physical contact) 2. Name appropriate behavior 3.Rationale(e.g., positive consequence of engaging in the appropriate behavior) Ask or give 4. Demonstrate the steps 5.Practice(Use prompts with fading, if necessary) 6.Feedback a. Reinforce: descriptive praise, optional positive consequence b. corrective feedback if needed 7.Practice 8.Feedback a. descriptive praise, optional positive consequence b. corrective feedback if needed 9.Planwhen to use the behavior *Some steps may be deleted or shortened depending on the needs and learning style of the individual.

20. Family Teaching Model Component # 4 . . . Systems for Encouraging Achievement

21. Informal Formal or • Positive Relationships • Motivation Systems – monetary, points, tangibles, etc. . . • Behavioral Contracting • Premack Principle – eat dinner to get your dessert. . . • Staff reinforcement and recognition programs

22. Family Teaching Model Component # 5 . . . Positive Relationships

25. Family Teaching Model Component # 6 . . . Opportunities for Choice and Self Determination

26. What does Self-Determination mean? • Making choices freely • Having control in areas important to you • Being part of decisions that affect you • Knowing how to make a choice • Feeling free to make a choice • Having predictable events in your day/week

27. Family Teaching Model Component # 7 . . . Ongoing Teacher Training and Evaluation

28. The Coaching Process(Sherman J., Harchik A., Strouse, M,)

29. Family Teaching Model Component # 8 . . . Teacher Evaluation & Certification

30. The Community Living Research and Development Projectat theUniversity of KansasFamilyTeacher Certification ProgramProviding Certification of Family Teachers employed byCommunity Living Opportunities, Inc.who exhibit exemplary teaching and implement Community Living Opportunities' Family Teaching Model for Adults with Developmental Disabilities

31. Community Living Opportunities Expected Outcomes for Persons ServedPleasant and Safe SurroundingsObservance of Legal and Personal RightsPositive Relationships with OthersLiving Healthy LifestylesOpportunities for Choice and ControlEffective Learning Opportunities High Level of Participation in Daily ExperiencesCommunity InvolvementEffective CommunicationPleasant Social EnvironmentSatisfied Consumers

32. Family Teaching Model Certification • FTM Pre-service Workshop • Shadow Training • Program Specific Orientation • 12 Coaching Lessons • 90 Day Evaluation • More Coaching Lessons based on Outcome QEs • Family Teaching Model Workshop • Pre-evaluation meeting for First Private • 6 mos. after hire: First Private Evaluation • Quality at a Glance Evals • Pre-evaluation meeting for Certification Evaluation • 12 mos. After hire: Certification Evaluation Certification Celebration and $$

35. …but there’s more… our latest community living model…VIRTUAL VILLAGE • Fewer staff • CLO’ Homelink central site monitoring, as needed: audio, video, sensors, devices - in every 2-bedroom apartment • Rigorous teaching and progress assessment on independent living skills • Daily schedules • Classes: problemsolving, roommate conference, home safety…. • Jobs • Community Inclusion (3rd places) • Motivation Point economy system (with daily trips to point exchange store) • Self-government – to minimize staff control/increase control and responsibility for the men and women • Health ticklers • Learning to take medications independently

39. Factors Influencing “Living the Good Life” • Fewer number of individuals living in a home in the community • Either “Family teachers” providing support or “teaching staff” as opposed to shift-staff • Implementation of Family Teaching Model Components • family style or roommate living environments • Community inclusion • Individualized daily schedules • Teaching rights, communication, and other skills • Systems for encouraging achievement • Positive relationships • Opportunities for choice and self determination • Ongoing teacher training and consultation • Teacher evaluation and certification

40. Midnight FarmCLO's Midnight Farm provides year round therapeutic horseback riding lessons to children and adults of all abilities. We have a great time with our summer camps. And any given weekday you can find our day service men and women out working in the greenhouse or creating something in the pottery barn!www.midnight-farm.org

45. Community Living Opportunities Expected Outcomes for Persons ServedPleasant and Safe SurroundingsObservance of Legal and Personal RightsPositive Relationships with OthersLiving Healthy LifestylesOpportunities for Choice and ControlEffective Learning Opportunities High Level of Participation in Daily ExperiencesCommunity InvolvementEffective CommunicationPleasant Social EnvironmentSatisfied Consumers

46. Thank you for your time and interest. Please feel free to contact me for further information: 785-218-9358 Diane Bannerman Juracek, Ph.D, BCBA dianebannermanjuracek@clokansas.org