Lisa is now 15 years old, and the last several years have continued to be a rollercoaster for her family. They have had some intensive in-home therapy which they found marginally helpful, and Scott and Marsha have been attending couples therapy with a local therapist who charges on a sliding scale. They scarcely have the money to support the family, but they feel they need the support.
Lisa is in high school, and she is in Special Education classes for most of the day. While it is challenging to get an exact number owing to Lisa's difficulty with testing environments, it is thought that her FSIQ is around 70. Sometimes, however, Lisa demonstrates incredible insight and thought, but then, quick as that, it seems to disappear into her usual moodiness. Now that she is a teenager, her medications that had been helpful in the past have not been as helpful. Her parents have struggled to get her on medications that will benefit her with the changes brought on by puberty.
Scott and Marsha understand that there is a special school in a nearby town that offers to work with children like Lisa. They have considered selling their house to go live in a trailer in order to pay to send her there. They have heard that kids can be "turned around" at the facility and, while they have accepted Lisa's disability, there is a part of them both that wonders if Lisa could grow out of her autism. Even if they could send her for a year, they feel like it would be worth it.
* What is the Faison School for Autism? How much does it cost to attend and who typically pays the tuition? What kind of program does the school have for children with Autism?
* Describe the typical developmental milestones for a 15 year old girl.
* Write a narrative of how Scott and Marsha might have explained menstruation to Lisa.
* Describe three goals that might be found on Lisa's IEP at this point in her life. What transition goals might also be there?
DECISION POINT: Do the Penningtons sell their house and send Lisa to the school?
The Faison School for Autism is a non-profit organization founded in 1998 that provides education and services to children and families that have been struck with ASD. They have a three-way approach to teaching, "evidence based treatment, research, and community education". They provide services for children with Autism "from early intervention through school age and intensive programming for children and young adults diagnosed with an autism spectrum disorder". They also offer consultations, in-home support, after-school care, summer camps, transitional life skills, and community activities. They base their school upon the ABA format, or "applied behavior analysis". The cost to attend Faison is about $57,000 annually, and is paid by the parents or guardians, as insurance companies are unlikely to pay for it.
ReplyDeleteSources:
Richard Foster. Virginia Department of Behavioral Health and Developmental Services. Retrieved October 26, 2011, from www.dbhds.virginia.gov/documents/CFS/CFS-329AutismSpeech.pdf
The Faison School Home. Index. Retrieved October 26, 2011, from http://www.thefaisonschool.org/index.php
Marsha: Lisa, why don't you come with me upstairs? I want to talk to you about some girly stuff.
ReplyDeleteLisa follows
Marsha: There comes a time in every girl's life when they start to grow up and be a young lady. I want to talk to you about how you're starting to become a very lovely young lady.
Lisa: Okay, Mommy.
Marsha: As we get older, our bodies start to change. While this is nothing to be afraid of, and is completely normal, I want to go over a few of these changes with you so you can be on the lookout for them.
Lisa: Do you mean me getting taller?
Marsha: Exactly! This is one of the things to look for. You're certainly getting taller by the day! Soon you'll be even taller than me.
Lisa: And maybe even taller than Daddy?
Marsha: Maybe one day, yes. Some of the other changes are specific to us girls. We start to grow breasts and need to wear bras under our shirts. (Marsha shows Lisa one of her bras as an example and lets Lisa examine it.) Another change is we start to grow hair on our legs and in other private places too.
Lisa: What do you mean, "private places"?
Marsha: Well what I mean is, (gestures) here. These are all signs of you growing up and turning into a young lady! Eventually you will start to notice that your underwear might have some red stains in them from your private places.
Lisa gasps
Marsha: I'm telling you this so you won't worry when it does happen, because this is another sign that you're growing up!
Lisa: Really? What are the red marks from?
Marsha: The red marks are from inside of you. Sometimes when you get a cut or boo-boo, it starts to bleed and you cover it up with a band-aid. This is the same sort of thing. Every few weeks your body will think that you have a boo-boo inside you and starts to bleed. This is why we put these (shows her a pad) in our underwear.
Marsha proceeds to show Lisa how to properly place a pad in her underwear when she gets her period and how to dispose of used pads afterwards.
Sources:
Wrobel, M. Taking Care of Myself: A Hygiene ... - Mary Wrobel - Google Books. Google Books. Retrieved October 26, 2011, from http://books.google.com/books?id=N2NFGdzMSSwC&pg=PA153&lpg=PA153&dq=autism+hygene+menstruation&source=web&ots=uyrFVA04qO&sig=MSW3gVtTZEHa0qdR4Esb3HrmW-U#v=onepage&q&f=false
Three goals that might be on Lisa’s IEP would address social-emotional skills, social understanding skills, and self-advocacy. Lisa would also start to have transition goals listed in her IEP that addressed the issues of independent and daily living skills and career awareness and employment. The first goal addressing social-emotional skills would work to increase Lisa’s ability to control her “moodiness” and express her emotions about her stressful home environment.
ReplyDeleteGoal 1: “Lisa will increase social-emotional skills” by identifying emotional states and adopting meaningful ways of expressing emotional states.
Objectives:
a. Lisa “will identify various emotional states” and “will state what would be an appropriate response to a particular emotional state 4/5 opportunities to do so.”
Lisa “will state why a person might be feeling a particular emotion 4/5 opportunities to do so.
Lisa “will state why she might be feeling a particular emotion 4/5 opportunities to do so.”1
Lisa will discuss home or social issues (through the use of conversation or social stories) with a counselor 3 days a week for 15 minutes.
The next goal will help Lisa’s interactions with her peers, her family, and her future interactions or relationships.
Goal 2: “Lisa will develop social understanding skills” through learning to cooperate with peers, developing effective interaction with peers, understanding safety in social environments, and realizing acceptable social behaviors.
Objectives:
Lisa “will work cooperatively with peers in small group settings (ie. Share materials, allow peers to share different thoughts)” and “wait her turn 4/5 opportunities to do so.”
“Lisa will appropriately acknowledge an interaction initiated by others by giving an appropriate response, either verbal or non-verbal” and also understand “the relationship between her verbalizations and actions/effect on others.” 1
Lisa will evaluate social situations and social skills and the consequences of failing to act socially sound in many situations (ie: Lisa will be able to describe what happens if she hits a store clerk that is out of the product Lisa desires)
“Lisa will increase safety awareness” in school, home, and community environments
Lisa “will identify appropriate social rules and codes of conduct for various social situations 3/5 opportunities to do so.”1
The third goal addresses Lisa’s ability to be her own advocate.
Goal 3: “Student will demonstrate self-advocacy skills in order to communicate learning style, academic and behavioral needs.
Objectives:
a. Lisa, with assistance of a teacher/paraeducator/counselor, will “complete a learning style inventory and be able to describe learning style.” 2
b. Lisa “will communicate to others the strengths and weaknesses of learning style.” 2
c. Lisa will participate in self-determination of her IEP accommodations and goals.
d. Lisa will help the Special Educator in the preparation of a powerpoint presentation detailing background information about herself (likes, dislikes), her IEP, and her future aspirations
e. Lisa will evaluate her own behaviors and their impact on her learning.
f. Lisa will improve her learning with her teacher’s criticism.
g. Lisa will accept praise for her successes.
h. Lisa “will communicate with teachers to seek help, clarify instructions or requirements of academic tasks, and make them aware of accommodations.” 2
i. Lisa will “face academic and social situations positively and appropriately and discuss feelings regarding these situations.”2
Lisa’s IEP would address the following transition goal. A goal for independent/daily living skills has been established so Lisa can begin to recognize what she will be responsible for when she leaves high school.
Goal 4: Lisa “will acquire the necessary daily living skills to allow for independent functioning in a variety of environments (home, vocational and community).”
ReplyDeleteObjectives:
a. Lisa “will maintain well-groomed appearance and proper hygiene.”
b. Lisa “will identify personal medical management needs (prescription, over-the-counter medicine, directions and safety of use).” 2
c. Lisa will be educated about “the need for regular exercise and proper diet to maintain healthy bodies.” 2
d. Lisa “will identify steps necessary to ensure a safe environment, such as obtaining appropriate assistance during emergencies, dealing with strangers, having appropriate ID and knowing when and how to use it.” 2
e. Lisa will demonstrate an understanding of appropriate dress for school, work, church, home, sports, and other situations.
f. Lisa will “maintain a clean bedroom.” 2
g. Lisa will have a daily schedule and keep a calendar of events and to-dos.
h. Lisa will begin to pack/prepare her own meals with minimal parental guidance.
The last goal deals with Career Awareness/Employment. This goal is made so that Lisa can become a productive part of society and find the support she will need.
“Goal 5: Student will complete a series of activities in order to prepare him/her to transition to competitive or supported employment.” 2
Objectives:
a. Lisa will complete “a series of formal and/or informal vocational assessment activities:
a. Career Interest Inventory
b. Parent Interview
c. Values/Maturity Inventory” 2
b. Lisa will “identify attitudes and behaviors necessary for job success.” 2
c. Lisa “will meet with adult service representatives to initiate referral process” and then “will meet with adult service representatives at least two times per school year to prepare for transition.” 2
d. Lisa will have a shadowing experience while being accompanied by a company’s appointed vocational mentor
e. Lisa will develop her “goals related to employment, postsecondary education and training, independent living, and community participation.”2
f. Lisa will take a home economics class with the assistance of a one-on-one paraeducator.
Links for reference:
1 Educational Service Agency No. 7. (1999) Examples of IEP Goals and Objectives Suggestions For Students With Autism. CESA #7 Special Education Services index. Retrieved October 24, 2011, from http://www.specialed.us/autism/05/g_o.htmlTop of FormBottom of Form
2 State Department of Education -Bureau of Special Education. (2006, November 3). Writing Transition Goals and Objectives. Connecticut State Department of Education. Retrieved October 24, 2011, from www.sde.ct.gov/sde/lib/sde/PDF/DEPS/Special/Transition_GO.pdf
We don't think the Penningtons should give up their house to send Lisa to the Faison school. We think it will create more financial hardships on the entire family and possibly create a negative tension between Lisa and her brother out of jealousy. As an alternative, they could consider selling their house and moving to a small apartment in Fairfax County, where the school system has implemented an ABA system into their schools for Autistic children. Despite there being a higher cost of living in Fairfax county and could create some sacrifices in leaving what they know, it would allow for a free public education for Lisa that would be almost as good, if not better than what she would receive at Faison and allow for the family to "start fresh".
ReplyDeleteA 15 year old girl typically starts to understand who “she is”, her “unique” personality, her “opinions,” and the meaningfulness of her friendships. Emotional and social development includes: an interest in boys, developing “intimate relationships”, conflict with parents, and “more independence from parents.” 1 Unfortunately, girls may also “feel a lot of sadness or depression.” 1 Girls feel “grief at the passing of their childhood and some anxiety about the approaching challenges of adulthood” which is the cause of “some occasional moodiness.” 2 Girls feel “stormy and painful” about separation from their parents and attempt to “challenge/irritate” their parents (mostly mom). 2 Social development also includes “close friendships” among girls. Cognitive and educational (learning) development includes: “more defined work habits”, “more concern about future school and work plans,” and providing rationale for “their own choices” (like right or wrong). 1 Teenagers do not like criticisms.
ReplyDeleteAt this age, girls are introduced to many risky behaviors. Girls may be exposed to drugs, alcohol, sex, violence. Girls at this age are also beginning to drive. A 15 year olds physical development needs to focus on “enough sleep and exercise, and to eat healthy, balanced meals.” 1 Also, girls should make “better choices about the foods she eats, promote healthy weight, and give family members time to talk with each other.” 1 Since Lisa is now 15 years old, she has reached the teenage years. Lisa should be starting to menstruate any day, considering that “most girls will be physically mature by now, and most will have completed puberty.” 1 Lisa may have “concerns about her body size, shape, or weight.” 1 Lisa should have begun to or already developed “breasts and fat deposits around their hips and thighs” and “pubic hair”. 2 Lisa, like other 15 year old girls, is undergoing rapid development. Lisa’s well-being, self-image, and self-regulation should be consistently monitored at this time.
ReplyDeleteLink for reference:
1CDC - Child Development, Adolescence (9-11 years old) - NCBDDD. (2011, September 9). Centers for Disease Control and Prevention. Retrieved October 24, 2011, from http://www.cdc.gov/ncbddd/childdevelopment/positiveparenting/adolescence2.html
2 Child and Youth Health. (2009, September 15). Parenting and Child Health - Health Topics - Child development: 12-15 years. CYH Home - Home. Retrieved October 25, 2011, from http://www.cyh.com/HealthTopics/HealthTopicDetails.aspx?p=114&np=122&id=1866
Questions from Group 3:
ReplyDelete1. Since individuals with Autism generally have a hard time with change, do you think that moving Lisa to a new school and a new home would cause her to act out more?
2. Since Lisa’s parents are having a hard time finding a medication that works, what other therapies could they try to help Lisa?