A model of ongoing consultation was implemented in a community group home for 8 adults with severe and profound mental retardation. Two consultants, highly experienced in working with people with mental retardation and in the procedures used in group homes, taught staff members to use a token reinforcement system, to engage the adults in a variety of activities, and to improve the content and style of the staff members' interactions with the adults. The consultants taught skills to 9 staff members through brief mini-workshops, direct observation of the staff members' use of the skills during regular activities in the group home, and individual verbal feedback regarding a staff member's performance of the skills. Evaluation of the ongoing consultation process by the 2 consultants showed it to be effective in improving the performance of the staff members and in changing the behaviors of the adults who lived in the home. Continued implementation of the process, however, appeared to be necessary for the behavior changes of staff members to be maintained at high levels.
Paraprofessionals are increasingly being employed to provide direct care to children and adults who have behavioral deficits and excesses, such as those labeled developmentally disabled, mentally ill, or delinquent. Behavioral techniques, if effectively taught to paraprofessionals, offer ways of both teaching new skills to clients and reducing their undesirable behaviors. This article describes the methods that have been used to teach paraprofessionals to use behavioral techniques, how these skills can be maintained on the job, and the effects upon client behavior that result from this teaching of paraprofessionals. In addition, a system for teaching staff to implement and continue to use behavioral techniques is proposed.
Individuals with disabilities and seniors often lack the freedom to choose with whom they live and where they reside. Service options may involve moving consumers to large nursing facilities or other less-preferred settings rather than optimizing environmental supports in their own home or in less restrictive settings. Not only do adults usually enjoy greater choice when they live in their own homes relative to individuals living in congregate care or group home settings but independent and semi-independent settings are also associated with better outcomes and lower costs. Identifying variables that serve as barriers to independent living is especially important given estimates predicting that the numbers of seniors and individuals with disabilities will double in the next 20 years. This doubling will tax an already burdened and costly system of care. The present study queried consumers and other key stakeholders about potential barriers to independent living and their importance. Findings not only revealed a high degree of overlap between identified barriers and their importance ratings within groups but also showed clear differences in potential barriers across the groups assessed (individuals with disabilities and senior citizens).
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