2/24/2017...(e.g., technology-based communication, social media, etc.), there will be a...

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Rethinking our Approach in

Schools and the Community:

Taking a Strengths Based

Approach to Fostering Language

and Social Development

Matt Braun, PhD, L/CCC-SLP

Speech Language Pathologist

Owner- Speech & Language Solutions, LLC

Introduction

• Who am I?

• Who are you?

• What are we doing here today?

Getting Started

To reiterate some of the common themes we’ve heard through the conference:

From the folks at Notre Dame (ACE)- Welcome, Serve, Celebrate

Create a culture of Inclusivity in our schools and communities (define communities)

This is a Journey….It takes time….but what are we doing to promote inclusivity in my school and community

Our Goal

Evaluate the evidence.

Evaluate our practice.

How can we make changes?

What’s our plan to make those changes?

See Handout

Overview

• Review Traditional Models of Practice

• Introduce Strengths Bases Practices

• Review theory and evidence for Strengths Based Practices

• How to apply strengths based practices in the classroom

• Questions/Comments/Discussion

Traditional approaches

Medical model and Subsequently, More Traditional Models of Practice

• Focusses on what is wrong, broken, or needs “fixing”

• In general physical health, something (a system, organ, bone, muscle, etc.) is

broken, hurt, weakened, etc.

• Moving in to more social sciences we’ve tried and tried to apply this same

model

• Speaking in this way suggests that the problem lies within the person and

implies that something is wrong or broken inferring there is something to fix

(Saleebey, 2009)

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Traditional vs. Strengths Based

Approaches to Care

• Traditional deficit based approaches aim to fix what is broken or support a disability.

• Professionals tend to over estimate the negative effects of disability conditions

• Systems are set up to foster deficit based approaches (e.g. DSM-V, ICD-10, 3rd

Party payers)

• Strengths based approaches aim to build on what already exists or enhance current abilities (or strengths)

The Evolution of Family Centered

Care and Strengths Based Practices

Traditional Medical Model

Focus on Deficits, Fix a Problem

Family Centered Care Movement, 1979

Healthy People (1990, 200, 2010, 2020)

Various National Organizations Adopt the idea of Family Centered Care

Not One Agreed Upon Definition of Family Centered Care

A General Consensus on Family

Centered Care• Respect for all team members (including families as team members)

• A focus on family strengths and resources

• Cultural competence

• A balanced and trusting relationship between providers and families

• Active partnering between families and team members

• Empowerment

• Services be differentiated, solutions focussed individualized, goal

oriented, and community focused

(American Occupational Therapy Association, 2010; American Speech-Language Hearing Association, 2008; Braun, Dunn & Tomchek, 2017; Christon & Meyers, 2015; Committee on Hospital Care & Institute for Patient and Family-Centered Care, 2003, 2012; National Center for Family Centered Care, 1989; Zajicek-Farber, Lotrecchiano, Long, & Farber, 2015)

Theory, Evidence, and Application

of Strengths Based Practices

• The Strengths Perspective (Saleebey, 2009)

• Positive Psychology (Seligman & Csikszentmihalyi, 2000)

• Neuro-diversity (Muzikar, 2016)

• Positive Deviance (Lindberg & Clancy, 2010)

Strengths Based Approaches are

more….

A framework

A philosophy

A way of thinking

A way of approaching our work

than an actual practice…..

Our practice becomes strengths based when we put the skills, abilities and existing resources of the people and families we serve at the center of our care-Rather than focusing on the disability or disability condition

Finding Bright Spots

• Be Solutions Focused rather than Problem Focused

“Even in failure, there is success”

Chip and Dan Heath

Switch: How to Change Things When Change is Hard

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Narrow Framing &

The Spotlight effect

• We often operate with just the information in front of us…..There’s

usually a much bigger picture

• Let’s ask questions, become better informed and widen the spotlight….

• In doing so, we’ll find the bright spots…

Chip and Dan Heath

Decisive: How to Make Better Choices in Life and Work

Applying Strengths Based

Practices

• Focus on positive

• Focus on strengths

• Shifting the starting point from what is wrong to where we are, what

exists, and how to build on it.

• What is wrong is still good information, but in many instances, goes

without stating.

Strengths Based Practices….

• Do not end in identifying strengths and positive

attributes

• Providers must go beyond simply reframing problems

and finding strengths.

• Identify resources that support the use and application

of identified strengths when challenges arise

See Tables Handout

Traditional Practice Models Strengths Based Practice Models

Focus/Emphasis A person’s vulnerabilities, deficit and/or problem situation; must identify a cause to work towards an outcome

A person’s strengths, capacities, abilities and surrounding resources; forward focussed

Attitude/Perspective Families require expert help to solve problems; Providers and systems are the primary source of growth and change.

All families have resources; Problem situations create opportunities for families to uncover those resources and realize potential. Growth and change comes from the individual and families

Provider and Family Roles One directional relationship; Professionals hold the expertise and knowledge to solve problems

Two directional relationship; Both families and providers bring expertise to the table

Environment/Context Emphasizes a diagnosis or problem condition as starting point of service

Emphasizes each families’ individual strengths, unique situation and culture as starting point of service

(Bransford, 2011; Early and GlenMaye, 2000; Saleebey, 2009; Weick, Rapp, Sullivan, & Kisthardt, 1989)

What people with autism are

saying

Temple Grandin

John Elder Robison

Michael John Carley

Daniel Tammet

Stephen Shore

Jesse Sperstein

Zosia Zaks

What Parents are Saying:

Ron Suskind

Roy Richard Grinker

Applying this Idea

Examples of individuals who have used strengths and interests to build unique opportunities for work.

• Emma: Master Shredder

https://open.abc.net.au/explore/103775

• Embrace the Shake- Phil Hansen

https://www.ted.com/talks/phil_hansen_embrace_the_shake

• Gregory Blackstock- https://www.brainpickings.org/2011/12/02/blackstocks-collections/

• Rising Tide Car Wash-

http://risingtidecarwash.com/



https://www.brainpickings.org/2011/12/02/blackstocks-collections/


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Harnessing strengths and interests

“Consider the preferences of the individual with ASD as being equally important to the use of an evidence-based intervention. Provide individuals the opportunity to choose their peers, activities, and environments as the foundation for successful focused intervention approaches.”

(Stump, Dunn & Tomchek, 2017)


“Consider a person’s sensory preferences as an essential

prerequisite to all learning situations, but especially during

activities that include social interaction. By taking steps to

minimize sensory-based challenges, families, educators, and

service providers may provide more comfortable contexts for

social interaction.”



“Obtain feedback from individuals with ASD about social intervention

practices. Such information would prove useful to the educational,

research, and service provider communities and direct practices related to

explicit social skills training, naturalistic and guided intervention

approaches, and family and self-initiated supports. Perhaps a more

comprehensive review of existing qualitative research about social

interventions is a first step toward increasing attention to individuals’ social

experiences.”



“Increase the value of conclusions from traditional quantitative research by

incorporating more “real world” evaluation. For example, Pragmatic

Clinical Trials (PCTs) allow researchers to measure the effectiveness of a

therapy practice during normal, daily routines (MacPherson, 2004). Such

hybrid methodology may provide the most efficient path to finding truly

effective approaches for teaching something as dynamic as strategies for

socializing. As the world of social interaction continues to rapidly evolve

(e.g., technology-based communication, social media, etc.), there will be a

corresponding, ongoing demand for new and effective approaches to social

intervention.”


Strategies

• Consider where STRENGTHS and INTERESTS intersect

• Connecting children to content by INTERESTS

• Connecting children to others through SHARED INTERESTS

• Using INTERESTS, STRENGTHS, and ABILITIES to build

skills in deficit areas


http://projectkeepitreal.com/stephen-shore


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Strategies

• CHILD LED learning in concert with adult led learning

• Tapping all areas of learning (MULTISENSORY approach to

learning)

• Teaching and re-teaching

• Peer buddy system for support, friends, and learning.

Two Pronged Peer Buddy Approach

1. Peer buddy in social- a coach/mentor

2. Peer buddy in academics and organization-

a wing man of sorts.

Lots of Talking…..

But who’s Walking?

• Effective Professional Development

• What’s Your Plan?

• How will you measure and adjust?

See Handout

Temple Grandin

“I’m certainly not saying we shouldn’t work on

deficits. But the focus on deficits is so intense and so

automatic that people lose sight of the strengths…If

even the experts can’t stop thinking about what’s

wrong, how can anyone expect the families who are

dealing with autism to think any differently?”

• “…When it comes to a child with a disability, doctors and educators, and parents too, can easily spend too much time on what the child

cannot do, meanwhile not noticing what he can do. We can be so busy

dealing with what is absent that we ignore what is right before our eyes.

It’s often difficult to understand that what we need to make visible is

not darkness but light...”

Roy Richard GrinkerUnstrange Mindsp.280

Are we Helping, Fixing or Serving?

“Helping, fixing, and serving represent three different ways

of seeing life. When you help, you see life as weak. When you

fix, you see life as broken. When you serve, you see life as

whole. Fixing and helping may be the work of the ego, and

service the work of the soul.”

- Rachel Naomi Remen

Rethinking our Approach in Schools and the Community: Taking a Strengths Based Approach to Fostering Language and Social Development- Presentation at the FIRE Inclusive Education Conference, Kansas City, MO, February 24, 2017

STRENGTHS BASED APPROACHES IN MY PRACTICE

Rate Each Statement according

to our 1 – 5 rating scale

1=10% or less 2=25% 3=50% 4=75% 5=90% or more

My current rating

My plan to increase the visibility of this

strategy with all the people/ families/

units I serve

1. I recognize that regardless of life situation, EVERY person/family/ unit is capable

and has resources to support their own development

2. I can write down at least 5 strengths of every person/ family/ unit I serve

3. I am confident that no matter what a person/family/ unit indicates as their

interests and priorities, I can find ways to support them within those areas

4. I know every person/family/ unit’s daily life routines and have a record of how

they spend their time

5. After I complete an evaluation, I can write down at least 5 strengths of every

person/family/ unit I serve

6. My goals explicitly address the person’s participation in THEIR everyday life

7. All my plans harness strengths of the person/family/ unit, with no attention to

the “weaknesses”

8. I spend intervention time supporting people/families/ units to identify their

strengths

9. I identify the ‘uber’ strengths* of the person/family/ unit to support them to

recognize their unique identity and potential contributions of ‘uber’ strengths

(Dunn, W., 2016)


OUR GOAL Evaluate the Evidence and What is NEW

Evaluate my Practice

What Changes Can I make?

How Can I make these Changes?


Presentation Bibliography

American Occupational Therapy Association. (2010). AOTA Practice Advisory on Occupational Therapy in Early Intervention. Retrieved from http://www.aota.org/Practitioners-Section/Children-and-Youth/Browse/EI/Practice-Advisory-OT-EI.aspx?FT=.pdf

American Psyciatric Association. (2013). Diagnostic and statistical manual of mental disorders (5 th ed.). Washington, DC: Author.

American Speech-Language Hearing Association. (2008). Roles and responsibilities of speech-language pathologists in early intervention: technical report [Technical Report]. Retrieved from http://www.asha.org/policy/TR2008-00290.htm

Bransford, C. L. (2011). Reconciling Paternalism and Empowerment in Clinical Practice: An Intersubjective Perspective. Social Work, 56(1), 33-41.

Braun, M, Dunn, W. & Tomchek, S. (2017a). A Pilot Study on Professional Documentation: Do We Write from a Strengths Perspective? American Journal of Speech-Language Pathology. In Press.

Braun, M., Dunn, W., & Tomchek, S. (2017b). Strengths Based Practices: Barriers to Implementation and Action Steps for Moving Forward. Manuscript in preparation.

Christon, L. M., & Myers, B. J. (2015). Family-centered care practices in a multidisciplinary sample of pediatric professionals providing autism spectrum disorder services in the United States. Research in Autism Spectrum Disorders, 20, 47-57.

Committee on Hospital Care, & Institute for Patient and Family-Centered Care. (2003). Family-centered care and the pediatrician's role. Pediatrics, 112(3), 691-697.

Committee on Hospital Care, & Institute for Patient and Family-Centered Care. (2012). Patient- and Family-Centered Care and the Pediatrician's Role. Pediatrics. doi: 10.1542/peds.2011-3084

Dunn, W. (2016). Focus on Strengths: Imagine the Possibilities. Presentation

Early, T. J., & GlenMaye, L. F. (2000). Valuing Families: Social Work Practice with Families from a Strengths Perspective. Social Work, 45(2), 118.

Grandin, T., & Panek, R. (2013). The autistic brain: Thinking across the spectrum. Houghton Mifflin Harcourt.

Grinker, R. R. (2008). Unstrange minds: Remapping the world of autism. Basic Books.

Heath, C., & Heath, D. (2013). Decisive: How to make better choices in life and work. New York: Random House.

Heath, C., & Heath, D. (2010). Switch: How to change when change is hard. New York: Broadway Books.

Lindberg, C., & Clancy, T. R. (2010). Positive Deviance: An Elegant Solution to a Complex Problem. Journal of Nursing Administration, 40(4), 150-153 110.1097/NNA.1090b1013e3181d1040e1039.

Muzikar, D. (2016). Neurodiversity: A person, a perspective, a movement? Retrieved from: http://the-art-of-autism.com/neurodiverse-a-person-a-perspective-a-movement/.

National Center for Family Centered Care. (1989). Family-centered care for children with special health care needs. Retrieved from http://www.neserve.org/maconsortium/pdf/Medical%20Home/Family_Centered_Care.pdf

Saleebey, D. (2009). The strengths perspective in social work practice (5th ed.). Boston, MA: Allyn and Bacon.

Seligman, M. E. P., & Csikszentmihalyi, M. (2000). Positive Psychology: an introduction. American Psychologist, 55, 5-14.

Stump, K., Dunn, W., & Tomchek, S. (2016) Social interaction and autism: Autobiographical listerature as evidence. Mansucript in Preparation.

Weick, A., Rapp, C., Sullivan, W. P., & Kisthardt, W. (1989). A Strengths Perspective for Social Work Practice. Social Work, 34(4), 350.

Zajicek-Farber, M. L., Lotrecchiano, G. R., Long, T. M., & Farber, J. M. (2015). Parental Perceptions of Family Centered Care in Medical Homes of Children with Neurodevelopmental Disabilities. Maternal and Child Health Journal, 19(8), 1744-1755. doi: 10.1007/s10995-015-1688-z


Additional Reads (Not all inclusive, but some of the best reads in my opinion)

Armstrong, T. (2011). The power of neurodiversity: Unleashing the advantages of your differently wired

brain. Da Capo Press.

Carley, M. J. (2008). Asperger’s from the Inside Out. New York: Perigree.

Carley, M. J. (2016). Unemployed on the Autism Spectrum: How to Cope Productively with the Effects of

Unemployment and Jobhunt with Confidence. Jessica Kingsley Publishers.

Dunn, W. (2007). Living sensationally: Understanding your senses. Jessica Kingsley Publishers.

Gaus, V. L. (2011). Living well on the spectrum: How to use your strengths to meet the challenges of

Asperger syndrome/high-functioning autism. Guilford Press.

Grandin, T., & Panek, R. (2013). The autistic brain: Thinking across the spectrum. Houghton Mifflin

Harcourt.

Grinker, R. R. (2008). Unstrange minds: Remapping the world of autism. Basic Books.

Prizant, B. M., & Fields-Meyer, T. (2015). Uniquely human: A different way of seeing autism. Simon and

Schuster.

Robison, J. E. (2011). Be different: Adventures of a free-range Aspergian. Doubleday Canada.

Robison, J. E. (2008). Look me in the eye: My life with Asperger's. Random House.

Saperstein, J. A. (2010). Atypical: Life with Asperger's in 20 1/3 chapters. Penguin.

Shore, S. M. (2003). Beyond the wall: Personal experiences with autism and Asperger syndrome. AAPC

Publishing.

Silberman, S. (2015). Neurotribes: The legacy of autism and the future of neurodiversity. Penguin.

Suskind, R. (2016). Life, animated: A story of sidekicks, heroes, and autism. Disney Electronic Content.

Tammet, D. (2007). Born on a blue day: Inside the extraordinary mind of an autistic savant. Simon and

Schuster.

Zaks, Z. (2006). Life and love: Positive strategies for autistic adults. AAPC Publishing.

Other Web Resources










Comparison of Major Underlying Assumptions of Deficit Based and Strengths Based Models

Traditional Practice Models Strengths Based Practice Models

Focus/Emphasis A person’s vulnerabilities, deficit and/or problem situation; must identify a cause to work towards an outcome

A person’s strengths, capacities, abilities and surrounding resources; forward focussed

Attitude/Perspective Families require expert help to solve problems; Providers and systems are the primary source of growth and change.

All families have resources; Problem situations create opportunities for families to uncover those resources and realize potential. Growth and change comes from the individual and families

Provider and Family Roles One directional relationship; Professionals hold the expertise and knowledge to solve problems

Two directional relationship; Both families and providers bring expertise to the table

Environment/Context Emphasizes a diagnosis or problem condition as starting point of service

Emphasizes each families’ individual strengths, unique situation and culture as starting point of service

(Bransford, 2011; Early and GlenMaye, 2000; Saleebey, 2009; Weick, Rapp, Sullivan, & Kisthardt, 1989)

From: (Braun, Dunn & Tomcheck, 2017b)


Case Example: Consider the family of a child with an autism spectrum disorder.

In Deficit Based Models In Strengths Based Models

The provider enters the provider-family relationship with preconceived ideas of what the family needs.

The provider enters the provider-family relationship with an understanding of autism spectrum disorders and the impact this can have on families.

The provider begins by gathering information about parental concerns, the child’s challenges and what the child does well.

The provider begins by having the family tell their story, inquiring about child and family strengths and the families’ hopes and desires for their child.

The provider may or may not complete formal testing to compare the child to other same age peers. Based on this comparison to the general or typically developing child, the provider develops a treatment plan.

The provider may use formal or informal assessments to gather information about the child’s abilities and strengths. Based on assessments and family input, the provider-family team generates goals and targets that help the family work toward desired outcomes.

Treatment programs may include toys or activities specifically designed to promote development and are chosen by the provider. Treatment activities may take place in a clinic setting, a therapy room at school, in the child’s home or in classrooms.

Therapeutic programs will include a variety of activities aimed at creating meaningful experiences for the child and family. Treatment materials will include existing resources to which the family already has access (e.g. toys in the home, the child’s favorite cup or plate). Treatment activities will take place in settings that are natural to the child and family.

The provider takes the lead on therapeutic activities and gathers data throughout during treatment activities.

The family takes the lead in therapeutic activities and the provider is more of a coach, a guide or resource to the family.

Data is used to track progress toward goals based on “normal” development.

Together, the family and the provider monitor progress toward desired outcomes.

Once the child has met all of his goals, he is either discharged from therapy or the provider develops new goals based on the next level normal development.

Once the family decides they are comfortable and have the necessary skills to continue to promote the child’s development, the provider phases out of the therapeutic relationship.

(Braun, Dunn & Tomcheck, 2017b).

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