natural supports for people with autism spectrum disorder

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Natural Supports for People with Autism Spectrum Disorder

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Natural Supports for People with Autism Spectrum Disorder. Griffin- Hammis Module Participants. Does anyone work with someone you don’t understand?. What do you do about that? Group Discussion. THE SOLUTION IS ALWAYS IN THE PROBLEM. Who better knows the expectations within the job…. - PowerPoint PPT Presentation

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Page 1: Natural Supports for People with Autism Spectrum Disorder

Natural Supports for People with Autism Spectrum Disorder

Page 2: Natural Supports for People with Autism Spectrum Disorder

Griffin-Hammis Module Participants

Page 3: Natural Supports for People with Autism Spectrum Disorder

Does anyone work with someone you don’t understand?

What do you do about that?Group Discussion

Page 4: Natural Supports for People with Autism Spectrum Disorder
Page 5: Natural Supports for People with Autism Spectrum Disorder

THE SOLUTION IS ALWAYS IN THE PROBLEM

Page 6: Natural Supports for People with Autism Spectrum Disorder

Who better knows the expectations within the job…

An outside person or a co-worker!

Page 7: Natural Supports for People with Autism Spectrum Disorder

Key Questions• What Are Natural Support?

• Why Would I Use Natural Supports?

• What is the Medium of Exchange for people who are “typical” to connect with people with ASD?

• Are you in, What do you need to know, and How do we keep you coming back

• (Recruitment, Training and Maintenance)

Page 8: Natural Supports for People with Autism Spectrum Disorder

Social Competency Research• Students with adequate social skills are

more likely to have positive outcomes, while significant social difficulties place the child at risk for developing later problem behaviors (Koegel, Koegel, & Surratt, 1992).

• Venter, Lord, and Schopler (1992) conducted a study of children with autism and found that social skills during childhood were strong predictors of adult adaptive functioning.

Page 9: Natural Supports for People with Autism Spectrum Disorder

Social Competency Research• Educational programming for students

with ASD should include goals for improving social skills with both adults and peers (National Research Council, 2001).

EBP – HAVE TO USE• Weiss and Harris (2001) refer to the

scarcity of research targeting social skill development in adolescents and older students.– Many interventions targeting social skills

development have inadequately addressed the social validity of outcomes.

Page 10: Natural Supports for People with Autism Spectrum Disorder

Social Competency Research• The more traditional approaches to teaching social

skills have not been highly effective as indicated in a meta analysis conducted by Bellini et al., (2007).

(BRIAN)• Many peer-mediated intervention programs are too

narrow in scope, such as the Circle of Friends approach, to produce significant long-term impact on participants.

• Efforts to successfully teach social skills to students with ASD can be undermined by problems with generalization to new settings, people, and materials (Parsons & Mitchell, 2002; Zager & Shamow, 2005).

Page 12: Natural Supports for People with Autism Spectrum Disorder

Social Competency and ASDResearch summarized by Rogers (2000) indicate a shift in the field of ASD, from:

Adult-Directed Instructional StrategiesTO

Peer-Mediated Interventions

Numerous studies have demonstrated theeffectiveness of peer-mediated strategies to

facilitate social interactions.

Page 13: Natural Supports for People with Autism Spectrum Disorder

Social Competency and ASD• The National Research Council report

(2001) recommended that students with ASD be taught skills in natural contexts.

• One suggestion is the use of multiple peers in various settings to improve generalization (Kamps et al., 1997; Kamps et al., 2002).

LEARN FROM DISLIKE

Page 18: Natural Supports for People with Autism Spectrum Disorder

History of the Autistic Program

1987 - Elementary

1990 - Middle School

1992 - High School

1993 - Pre-Primary Program

1994 – 2nd Elementary

1996 - Post High School Program 1999 – 2nd Middle School

Page 19: Natural Supports for People with Autism Spectrum Disorder

Full Continuum Concepts

• Break Card

• Modifications – Ed Strats

• Visual Supports

Page 23: Natural Supports for People with Autism Spectrum Disorder

Evolution of the Clarkston Autistic Program

Reverse Mainstream > > Moderated Behavior

Integration > > Behavioral Systems

Integration > > Academic Systems

Integration > > Socialization Systems

Reverse Mainstream > > Curriculum Makeover

Page 24: Natural Supports for People with Autism Spectrum Disorder

Evolution of the Clarkston Autistic ProgramReverse Mainstream > > Moderated BehaviorReverse Mainstream > > Curriculum Makeover

Integration > > Behavioral Systems

Integration > > Academic Systems

Integration > > Socialization Systems

Page 25: Natural Supports for People with Autism Spectrum Disorder

The LINK Program

• 1990 – 17 Study Hall Volunteers

• 2002 – 800 General Education Students 72 Students with ASD

• Utilizing the Most Appropriate Resource in Public

Education to Teach Social Skills to Students with ASD

Page 26: Natural Supports for People with Autism Spectrum Disorder

Post High School Video• Use to educate potential job

placement staff

• Assist parents in understanding ultimate goal of the program

• Creates common understanding about ASD and the workplace

Page 29: Natural Supports for People with Autism Spectrum Disorder

Goals for Students with ASD

Socialization Skills

Independent Skills

Page 30: Natural Supports for People with Autism Spectrum Disorder

Two Ways to Address A Socialization Deficit

• Utilize social skills curriculum to teach isolated social skills to students with autism spectrum disorder in specific settings and then practice isolated skills in a generalized setting.

• Teach general education students about autism spectrum disorder and specific information about students with autism spectrum disorder in their building. Develop tolerance and acceptance within the general education population. Students with autism spectrum disorder will then be able to practice social skills in all settings within the building gaining competency in natural environments.

Page 31: Natural Supports for People with Autism Spectrum Disorder

Peer to Peer Support ProgramsTeach general education students about Autism Spectrum Disorder and specificinformation about students with autism spectrum disorder in their building. Develop tolerance and acceptance within the generaleducation population. Students with autismspectrum disorder will then be able to practice social skills in all settings within the building gaining competency in natural environments.

Page 32: Natural Supports for People with Autism Spectrum Disorder

Medium of Exchange

How to connect the typical person to the person with ASD?

Page 33: Natural Supports for People with Autism Spectrum Disorder

Definition of Medium of Exchange

• The medium of exchange is any material, task, prop, interest area, etc. that connects a person with ASD to a typical person

• Typically the medium of exchange is something that does not require language for the connection or interaction to occur

Page 34: Natural Supports for People with Autism Spectrum Disorder

Medium of Exchange Material

Person with ASD Typical Person

Page 36: Natural Supports for People with Autism Spectrum Disorder

Examples of Medium of Exchange • Work Talk• After Work Activities• Encyclopedic Interests• Computer Interests and Related

Technology• Bowling and Other Leagues• WII• Intense Interests

Page 37: Natural Supports for People with Autism Spectrum Disorder

The STATE of MichiganMost Bowling Leagues

Page 38: Natural Supports for People with Autism Spectrum Disorder

What Connects You with Other People?

What are yourCharacteristics/

Interests?

What are CharacteristicsInterests of a Significant

Person in yourLife?

What is the Same?

Page 39: Natural Supports for People with Autism Spectrum Disorder

This is the Concept of Medium of Exchange

What it is for you is what it is for the person with ASD

Page 40: Natural Supports for People with Autism Spectrum Disorder

Connecting with Other People…

Isn’t That What This Is All About!

Page 42: Natural Supports for People with Autism Spectrum Disorder

AwakeningsMedium of Exchange

• Try to discover the interest areas of the people with ASD to develop mediums

• Motor Planning and Organization• Staff and Natural Supports may need to

initiate the medium in the environments for Person with ASD

• Staff and Natural Supports are excellent resources in developing new mediums

Page 43: Natural Supports for People with Autism Spectrum Disorder

Care for the Person

Respect for the Disability

Page 44: Natural Supports for People with Autism Spectrum Disorder

Natural Support Benefits to People with ASD

• Socialization Opportunities• Work Place Norms and Expectations• Independence• Larger Support Network• More Models of Work Tasks• Others Noticing Subtle Changes to the

Environment

Page 45: Natural Supports for People with Autism Spectrum Disorder

Peer to Peer BenefitsNatural Supports

• Organizational Skills• Problem Solving Skills• Connection to Employment• Diversity• Responsibility• Collaboration• Self Esteem

Page 46: Natural Supports for People with Autism Spectrum Disorder

Reciprocal Benefits1. Opportunities for learning in both populations.

2. Growth occurs in both populations.

3. Cost effective and productive.

Page 47: Natural Supports for People with Autism Spectrum Disorder

Questions or Concerns about Medium of Exchange

Determine a Medium of Exchanges for the Students You Work With

P.O.C. – 20 Minutes

Page 48: Natural Supports for People with Autism Spectrum Disorder

Recruitment of the Natural Supports

Do I Have to do This or Worse are You Going to Make Me Do This?

My Plate is Full and How Will this Help?

Page 49: Natural Supports for People with Autism Spectrum Disorder

Steps for Recruitment• Provide information about ASD and

specific people with ASD in the job to other people

• Provide interested volunteers the opportunity

• Organize and schedule the natural supports throughout the day

Page 50: Natural Supports for People with Autism Spectrum Disorder

Peer to Peer and Other Natural Supports Recruitment

• All People Make Great Supports

• After-Work Activities

• Management Involvement

• What can this help us with? Will this move me forward in the organization?

Page 51: Natural Supports for People with Autism Spectrum Disorder

How and Where Do You Find Natural Supports for People with

ASD?

Page 52: Natural Supports for People with Autism Spectrum Disorder

How and Where?Observation of Environment

Staff MeetingsParticipation in Peer to Peer Support

Programs During SchoolAsk for Volunteers

Find the Co-Workers Looking for a Challenge Get a Commitment Agreement

Page 53: Natural Supports for People with Autism Spectrum Disorder

Questions or Comments about Recruitment of Peers or Other

Natural Supports?

Where will your team recruit natural supports? POC – 15 Minutes

Page 54: Natural Supports for People with Autism Spectrum Disorder

Natural Supports Training

Page 55: Natural Supports for People with Autism Spectrum Disorder

Natural Supports Introductions

• Natural support’s name• Natural support’s hours of employment• Hobbies• Family members• Why they want to be a natural support

for people with ASD

Page 56: Natural Supports for People with Autism Spectrum Disorder

Group Discussion about Autism Spectrum Disorder

• Ask the natural supports what they know about Autism Spectrum Disorder

• Write ideas on the board• Engage natural supports in discussion

about ASD

Page 57: Natural Supports for People with Autism Spectrum Disorder

Information About ASD• Approximately 1 in 110• Rapidly Increasing in Numbers of Students• 4 times more common in males than

females• Cause is Unknown• You are born with autism spectrum disorder• You can’t catch it

Page 58: Natural Supports for People with Autism Spectrum Disorder

Autism and IdiosyncraticBehavior - Rain Man

• Over-reaction to changes of schedule

• Personal Property is Valued/Obsession

• Material Organization is more important than Object/Material

• May use idiosyncratic speech

Page 59: Natural Supports for People with Autism Spectrum Disorder

Characteristics of ASD• Social Skill Issues

• Communication

• Intense Interests and Repetitive Behavior

Page 60: Natural Supports for People with Autism Spectrum Disorder

Characteristics of ASDSocial Skill Issues

• Peer Relationships

• Sharing Information

• Misunderstanding of Social Situations

• Reciprocal Social Interactions

Page 61: Natural Supports for People with Autism Spectrum Disorder

Characteristics of ASDCommunication

• Verbal and Non-verbal

• Talk about Interests

• May not seem interested in what others are talking about

• May say inappropriate words

Page 62: Natural Supports for People with Autism Spectrum Disorder

Characteristics of ASD - Intense Interest and Repetitive Behaviors• Intense Interest in Certain Topic

Areas

• May Like to Do the Same Thing Over and Over

• May Like Things to Stay the Same – Difficult with Transition

Page 63: Natural Supports for People with Autism Spectrum Disorder

• Visual Supports• Communication Systems• Self Management Systems• Case Conference (Team Process)

Strategies that Work with People with ASD

Page 64: Natural Supports for People with Autism Spectrum Disorder

David’s Yes/No Communication System

Yes No

Page 65: Natural Supports for People with Autism Spectrum Disorder

Ryan’s Communication System

Food Drink Bathroom

More Help Other

Break Yes No

Page 66: Natural Supports for People with Autism Spectrum Disorder

Natural Supports and Case Conferences

• Weekly or Monthly Meetings

• Problem Solving Focus

• May Include the Person with ASD

• Teaching Support Strategies in the Case Conference that will Generalize to the Work Environment

Page 67: Natural Supports for People with Autism Spectrum Disorder

Case Conference Information Sheet

• Each staff fills out the sheet at the beginning of the case conference

• The facilitator collects the sheets and determines if there are any patterns in the answers

• The information from the sheet generates the discussion using the board

Page 68: Natural Supports for People with Autism Spectrum Disorder

Case Conference Information Sheet You do not need to put your name on this sheet. This is an information sharing sheet used to enhance the information presented during this case conference Please answer the following questions as openly and honestly as possible. If you do not have an answer or if you have an answer but it is hard to put into words just do your best. 1. The best experience with (Student with ASD) this month is when ___________________________________________________ ___________________________________________________ 2. Something I wasn’t sure how to handle this month was ________ ____________________________________________________ 3. I was frustrated by (Student with ASD) this month when he/she ____________________________________________________ 4. The biggest accomplishment that (Student with ASD) made while I was supporting him/her was _____________________________ ____________________________________________________ 5. The biggest accomplishment that I have made being a (Peer to Peer Support) is ______________________________________ 6. Are you interested in continuing to be a (Peer to Peer Support) Yes No If yes, which student would you like to support________ 7. What three suggestions would you give to the (Peer to Peer Supports) supporting the (Student with ASD) ____________________________________________________ ____________________________________________________ ____________________________________________________ (Give the students directions about where to put the sheets when completed. Ensure confidentiality.)

Page 69: Natural Supports for People with Autism Spectrum Disorder

Case Conference Mechanics and Outcomes

• Utilize meeting mechanics – always use the board

• Positives – Concerns – Brainstorming• Information from the board is written on

the Case Conference information sheet• Copies are made for each staff member,

person with ASD, and parent or guardian if appropriate

Page 70: Natural Supports for People with Autism Spectrum Disorder

In an effort to keep the parents, staff and peers students informed of the effective strategies that work for (Student with ASD Name) had a case conference on (Date )

Some positive things discussed about (Student with ASD)were: _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________

Some concerns that were raised about (Student with ASD) were: _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________

_______________________________________________________ The action plan to resolve the concerns for (Student with ASD) is: _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________ _______________________________________________________

If you have any questions or concerns please contact caseload teacher _______________________ ______________________ (Staff Person’s Signature) (Date)

Page 71: Natural Supports for People with Autism Spectrum Disorder

Utilizing MRS and Transition Coordinators as Facilitators of Work Place Case Conferences

The Change Has to Happen

Page 72: Natural Supports for People with Autism Spectrum Disorder

Maintenance of the Peer to Peer and Natural Supports

Page 73: Natural Supports for People with Autism Spectrum Disorder

Have you ever volunteered for any organization?

What made you continue to stay with volunteering?

Group Discussion

Page 74: Natural Supports for People with Autism Spectrum Disorder

Natural Supports Maintenance

• Employee of the Month• Work Talk• After Work Celebrations• League Opportunities• Fantasy Football• Sports Pools• Lotto Pools

Page 75: Natural Supports for People with Autism Spectrum Disorder

People with ASD must be Approachable• Socially Appropriate Dress

-Barbie Boots-Jelly Bean Jogging Suit

• Behavioral Issues-Stereotypical Behaviors

• Social Issues– Picking Nose – Spitting

Page 76: Natural Supports for People with Autism Spectrum Disorder

The Network• Do the natural supports go beyond

the work environment?• Personality of the Person with ASD• Climate of the Employment

Community• Dan and the Casino• Ryan’s Party

Page 77: Natural Supports for People with Autism Spectrum Disorder

Develop an On-Line LINK Social Network

• Track Graduated LINKS• Allow Networking Between LINKS• Post Opportunities for Graduated LINKS by

RCN• Provide Parents List of Graduated LINKS

by RCN• Social Network will be Hosted by a Person

with ASD

Page 78: Natural Supports for People with Autism Spectrum Disorder

Imagine the Possibilities• Co-Workers Understanding of ASD• Community College Opportunities• University Opportunities• Semi-Independent and Independent Living

Arrangements• Social Opportunities• Community Opportunities

Page 79: Natural Supports for People with Autism Spectrum Disorder

To Date…Over 200 Formalized Peer to Peer Support Programs

In Michigan

Page 80: Natural Supports for People with Autism Spectrum Disorder

The Power of Natural Supports Summer 2012

Work Experience Student with ASDNatural Support

Page 81: Natural Supports for People with Autism Spectrum Disorder

Natural Supports – Two Powerful Forces that Affect the Success

1. Features of Naturalness – Gain Access

2. Individual Needs – Assure The Needs of the Individual are Met

Marc Gold & Associatesmarcgold.com

Page 82: Natural Supports for People with Autism Spectrum Disorder

7 Phase Sequence for Balancing Naturalness and Individual Needs

• Determine Natural Ways• Determine Natural Means• Identify Natural People• Facilitate Successful Performance• Support/Substitute for Natural People• Suggest More Effective Natural Means• Adapt/Modify Natural Ways

Marc Gold & Associatesmarcgold.com

Page 83: Natural Supports for People with Autism Spectrum Disorder

Determine Natural Ways• Methods of Performance for Targeted Job Tasks• Step by Step Procedures• The Culture of the Workplace• The Manner in Which Workers Interact• The Managerial Style of the Setting• All Other Natural Features which Describe the

Unique Characteristics of Performance and Behavior Desired by the Employer

Marc Gold & Associatesmarcgold.com

Page 84: Natural Supports for People with Autism Spectrum Disorder

This Phase is Crucial…

1. Information for New Employee to Fit In2. Easier for Supervisors and Co-Workers to

Provide Assistance and Troubleshoot Problems Due to the Similarity of Performance

Marc Gold & Associatesmarcgold.com

Page 85: Natural Supports for People with Autism Spectrum Disorder

Purpose of Socialization as an Instructional Variable

• Modeling

• Participation

• Social Learning Theory

Page 86: Natural Supports for People with Autism Spectrum Disorder

Social Learning TheoryAlbert Bandura

• Attention

• Retention

• Reproduction

• Motivation

Page 87: Natural Supports for People with Autism Spectrum Disorder

Determine Natural Means

1. Ask the Employer to Describe the Procedures Used

2. Observe Teachings Done by Employees in the Setting

3. Ask to be Taught How to Perform the Job Task by the Persons Who Would Naturally Assist the Jobs to be Performed

Marc Gold & Associatesmarcgold.com

Page 88: Natural Supports for People with Autism Spectrum Disorder

How Did You Learn How to Write an IEP?

Page 89: Natural Supports for People with Autism Spectrum Disorder

Identify Natural People

• Identify and Enlist the Natural People Who Typically Support New Employees to Perform Their Jobs

• Most Novel Aspect of the Natural Supports for Traditional Providers of Supported Employment Services

Marc Gold & Associatesmarcgold.com

Page 90: Natural Supports for People with Autism Spectrum Disorder

In the Past…Job Developers Often Promised Employers…

1. Job Trainers Would Provide all the Assistance Necessary for Successful Performance

2. They Would Have No Investment in the Initial Training or Support of the Employee

3. Job Trainers Would Act as an Interpreter for All the Information, Rules, Policies and Activities

4. This Role Placed the Job Coach Between the Employer and the Employee

Marc Gold & Associatesmarcgold.com

Page 91: Natural Supports for People with Autism Spectrum Disorder

Similar to Issues with the Over-reliance on the use of

Paraprofessionals in the SchoolsUnnatural dependence on

an adult not associated with the environment

Page 92: Natural Supports for People with Autism Spectrum Disorder

This Practice Resulted in Isolation of Supported

Employees in their Own Work Settings

Marc Gold & Associatesmarcgold.com

Page 93: Natural Supports for People with Autism Spectrum Disorder

Facilitate Successful Performance• Initial and Ongoing Assistance to the

Supported Employee• Job Developers(Facilitators) Must Now

Decide the Degree of Naturalness Which Will Be Used for Initial Training

• Strongly Suggested…Unless There Are Clear Indications to the Contrary, Natural Procedures Be Utilized Initially

Marc Gold & Associatesmarcgold.com

Page 94: Natural Supports for People with Autism Spectrum Disorder

Strong Rationale For the Job Developer (Facilitator) to Take Risk

Allow Natural Means a Chance to Be Effective

Marc Gold & Associatesmarcgold.com

Page 95: Natural Supports for People with Autism Spectrum Disorder

Dignity of Risk Robert Perske

The concept of “dignity of risk” is we allow our children, and ourselves, to make choices and the accompanying mistakes, failures… because this is how we learn. This is how we build

our self-esteem and self-worth. Our Dignity.

Page 96: Natural Supports for People with Autism Spectrum Disorder

A Reasonable Trade-Off…

To Accept the Lessened Performance Through Naturalness

Over That Available Through Powerful Training Procedures

Marc Gold & Associatesmarcgold.com

Page 97: Natural Supports for People with Autism Spectrum Disorder

So Why Would This Be So Difficult…

Page 98: Natural Supports for People with Autism Spectrum Disorder

Constraints to the Initial Use of Naturalness • Job Developer and Employment Facilitator

are Different People• Impact of the Employee’s Disability

Requires the Facilitator to Model Effective Techniques for the Natural Supporters

• Fragile Situations in Relation to Employer’s Low Expectations of Success

• Modifications to Job Sites and/or Job Stations

Marc Gold & Associatesmarcgold.com

Page 99: Natural Supports for People with Autism Spectrum Disorder

Support/Substitute for Natural People• Demonstrate a More Powerful Technique• Negotiate a Time for Discussion and

Feedback with the Natural Supporter (Case Conferences)

• Offer Training Formally and Informally (Awareness of ASD)• Shadow the Natural Support and Offer On-

Going FeedbackMarc Gold & Associatesmarcgold.com

Page 100: Natural Supports for People with Autism Spectrum Disorder

Suggest More Effective Natural Means• Reconsideration of the Natural Means Used

by Employers to Teach and Motivate Employees to Perform Their Jobs

• Teaching Style of One Co-Worker May Differ Significantly from Another and Further Yet from a Supervisor

• Consideration…Various Strategies Which Seem to be Working and Who Uses Them

• Specific Suggestions to Specific Natural Supports…Each Different

Marc Gold & Associatesmarcgold.com

Page 101: Natural Supports for People with Autism Spectrum Disorder

Again…How Did You Learn How to Write an IEP?

Think about it…IEP’s are written differently in different districts and

ISD’s. Why?

Page 102: Natural Supports for People with Autism Spectrum Disorder

Adapt/Modify Natural Ways• Decisions of Adapting, Modifying or

Negotiating for Flexibility in the Natural Ways the Work Place Operates

• Considered Last Because They Are Often the Most Consistent and Unchanging Features of the Work Places

Marc Gold & Associatesmarcgold.com

Page 103: Natural Supports for People with Autism Spectrum Disorder

Job Analysis Process in Supported Employment is a…

Human Service Activity Designed to Assist Facilitators To:

Marc Gold & Associatesmarcgold.com

Page 104: Natural Supports for People with Autism Spectrum Disorder

1. Organize the Information to be Performed by the Supported Employee

2. Recognize the Natural Ways, Means and People Used by the Employer to Typically Perform and Teach the Job

3. Develop a Plan for Balancing the Natural Features of Support Available at the Job Site

4. Form Relationships Necessary to Accomplish the 7 Phase Sequence

Marc Gold & Associatesmarcgold.com

Page 105: Natural Supports for People with Autism Spectrum Disorder

Job Analysis Begins…

After the Employer Has Given Approval for the Job to Begin and Before the Supported Employee

Begins to WorkMarc Gold & Associatesmarcgold.com

Page 106: Natural Supports for People with Autism Spectrum Disorder

Why Would A Job Analysis Be Performed By A Human

Service Provider?

At This Time, The Funding and Responsibility for the Provision of These Supports Rest with Human

Service AgenciesMarc Gold & Associatesmarcgold.com

Page 107: Natural Supports for People with Autism Spectrum Disorder

Summary• Medium of Exchange• Recruitment• Training • Maintenance• Staff Responsibility• Development of a Natural Support

System

Page 108: Natural Supports for People with Autism Spectrum Disorder

Activities and Profile of Change

Page 109: Natural Supports for People with Autism Spectrum Disorder

Thank You!

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