Habilitation Planning for Adults with Disabilities

237 Pages·1990·3.585 MB·English

by  Robert L. Schalock, William E. Kiernan (auth.)

Disorders of Human Learning,
Behavior, and Communication
Ronald L. Taylor and Les Sternberg
Series Editors
Robert L. Schalock William E. Kiernan
Habilitation Planning
for Adults
with Disabilities
Springer-Verlag
New York Berlin Heidelberg
London Paris Tokyo Hong Kong
Robert L. Schalock, Hastings College and Mid-Nebraska Mental Retardation Ser
vices, Hastings, NE 68901, USA
William E. Kiernan, Boston Children's Hospital and Training and Research
Institute for Adults with Disabilities, Boston, MA 02115, USA
Series Editors: Ronald L. Taylor and Les Sternberg, Exceptional Student Educa
tion, Florida Atlantic University, Boca Raton, FL 33431-0991, USA
Library of Congress Cataloging-in-Publication Data
Schalock, Robert L.
Habilitation planning for adults with disabilities/Robert L. Schalock, William E.
Kiernan.
p. cm.-(Disorders of human learning, behavior, and communication)
Includes bibliographical references.
1. Developmentally disabled-Rehabilitation. 2. Developmentally disabled
Institutional care. I. Kiernan, William E., 1945-
II. Title. III. Series.
frV1570.S33 1990
362.1'968-dc20 89-26194
Printed on acid-free paper
© 1990 Springer-Verlag New York Inc.
Softcover reprint of the hardcover 1st edition 1990
All rights reserved. This work may not be translated or copied in whole or in part
without the written permission of the publisher (Springer-Verlag New York, Inc.,
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formation and retrieval, electronic adaptation, computer software, or by similar or
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The use of general descriptive names, trade names, trademarks, etc., in this pub
lication, even if the former are not especially identified, is not to be taken as a sign
that such names, as understood by the Trade Marks and Merchandise Marks Act,
may accordingly be used freely by anyone.
Typeset by Asco Trade Typesetting Ltd., Hong Kong.
9 8 7 6 5 4 3 2 1
ISBN-13:978-1-4612-7986-0 e-ISBN-13:978-1-4612-3372-5
DOl: 10.1007/978-1-4612-3372-5
Dedicated to the concept that people are people.
Preface
We have written this book primarily to present a comprehensive approach
to habilitation planning and service delivery for adults with disabilities. We
anticipate that our readership will be either students in special education,
rehabilitation counseling, human services or health administration, or
habilitation personnel in the areas of administration, assessment/training,
case management, or evaluation.
The book deals with adults with disabilities who are either in or entering
into the habilitation service system with increasing expectations and de
mands for services that are person-referenced and committed to the indi
vidual's independence, productivity, community integration, and quality of
life. Thus, we attempt throughout the book's 14 chapters to describe ha
bilitation practices that are responsive to both these expectations and the
current habilitation focus on integrated living, work, and recreationlleisure
opportunities.
We use two terms repeatedly that might need additional definition and
discussion. We define disability broadly as having its origins in a person's
early years. Thus, such disabilities attributable to the aging process,
trauma in later years, substance dependence and mental illness with onset
in adult years are not included in the scope of the book. We define habilita
tion as including a number of techniques and strategies that focus on the
individual and the environment. At the individual level, the techniques
involve assessment, training, and support based on the principle of person
environment analysis. At the program and larger state-federal system
levels, the strategies involve providing the opportunities for adults with
disabilities to access integrated living, work, and recreation environments
through which they can enhance their independence, productivity, social
belonging, and quality of life.
We hope and anticipate that the reader will be an active participant in
habilitation planning and service delivery. To that end, we present numer
ous case examples, planning documents, and evaluation techniques to
enhance your efficiency and effectiveness.
viii Preface
Writing this book has been both challenging and rewarding. We could
not have done it without the valuable insight gained from adults with dis
abilities, colleagues, and habilitation personnel from throughout the
country who have shared their hopes, dreams, experiences, and good will.
Special thanks also goes to Gloria Mills, who has provided deeply appre
ciated technical support.
Robert L. Schalock
William E. Kiernan
Hastings and Boston
Contents
Preface .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii
Section I: Adults with Disabilities and Their Habilitation 1
Environments .................................................. .
1 Developing a Mindset ............................................... 3
Trends Impacting Service Delivery ................................ 3
Basic Service Delivery Principles ....... . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Professional Standards ............................................ 6
Summary ........................................................ 7
2 Defining Adults with Disabilities ..................................... 8
Cognitive/Developmental Impairment ............................ 9
Sensory/Neurological Impairment ................................. 13
Physical Impairment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
EmotionallBehavioral Impairment ................................ 20
Summary ...... ....... ......... ........... ......... .............. 24
Additional Readings .............................................. 25
3 The Seven Major Life Activity Areas ................................ 26
Major Life Activity Areas ........................................ 27
Life Activity Area Assessment .................................... 30
The Pros and Cons of a Functional Definition . . . . . . . . . . . . . . . . . . . . . . 35
Summary ...... ................ ....... ........... ....... ......... 37
4 Environments and Life Activities .................................... 39
Life's Three Major Environments and Their Importance ........... 40
Environment Classification and Assessment . . . . . . . . . . . . . . . . . . . . . . . . 44
Environments and Quality of Life ................................. 47
Summary.............. ............. ............. ................ 49
x Contents
Section II: The Environments for Life Activities................. 51
5 The Living Environment ............................................ 53
Historical Trends in Community Living Programs .................. 54
Principles for Community Living Programs ........................ 56
The Components of a Community Living Program ................. 60
Summary ........................................................ 66
6 The Work Environment ............................................. 67
The Evolution of Employment Services ........................... 68
Principles for Employment Service Programs ...................... 70
The Components of an Employment Program ..................... 72
Summary...... ............... ..... ........ ..... ..... ............ 81
7 Recreation and Leisure from a Wellness Perspective ................. 83
Program Principles ................................................ 85
Program Components ............................................ 88
Person-Referenced Outcomes .................................... 93
Summary........... ............... ......... ..... ......... ... .... 93
Additional Readings .............................................. 94
8 Refocusing on the Whole Person ..................................... 95
Life-Style Planning ................................................ 96
Assessing Life Experiences ....................................... 98
Developing Life Aim Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Individual Habilitation Plan ....................................... 107
Person-Referenced Outcomes .................................... 109
Summary ........................................................ 111
Section III: Habilitation Strategies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113
9 Personal Growth Within Life Activities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115
Program Principles................................................ 116
Develop Behavioral Skill Instructional Techniques. . . . . . . . . . . . . . . . . 119
Adapt Tasks and Environments ................................... 124
Teach Problem-Solving/Decision Making .......................... 130
Addressing Problem Behaviors in Growth-Producing Ways ........ 133
Summary ........................................................ 138
Additional Readings .............................................. 139
10 Program Change Strategies ......................................... 141
Program-Environment Analysis ................................. 142
Staff Functions and Competencies ................................. 145
Systems Interface ................................................. 148
Quality of Life ................................................... 150
Summary ........................................................ 158
Additional Readings .............................................. 159
Contents xi
11 Societal Philosophies Affecting Habilitation Strategies................ 160
Normalization. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
Advocacy ......................................................... 162
Public Laws ....................................................... 164
Least Restrictive Environment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Summary ........................................................ 174
Additional Readings .............................................. 175
Section IV: Management and Evaluation. . . . . . . . . . . . . . . . . . . . . . . . 177
12 Program Principles and Their Management. . . . . . . . . . . . . . . . . . . . . . . . . . . 179
Program Principles ................................................ 181
Accountability Dimensions ........................................ 182
Monitoring Critical Performance Indicators ....................... 184
Practical Management Skills ....................................... 186
Summary ........................................................ 187
Additional Readings .............................................. 188
13 Evaluation of Habilitation Services .................................. 189
Outcome Analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191
Process Analysis .................................................. 194
Impact Analysis ................................................... 198
Summary ........................................................ 202
Additional Readings .............................................. 203
Section V: The Future . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 205
14 The Power of Mindsets .............................................. 207
Current and Future Trends ....................................... 207
The Individual ................................................... 212
The Program ..................................................... 212
The System ...................................................... 216
Summary ........................................................ 217
Section VI: References......................................... 219
Index............................................................ 229
Section I
Adults with Disabilities and Their
Habilitation Environments
Anyone reading this book is undoubtedly interested in human services,
and more specifically in planning habilitation services for adults with dis
abilities. Our experiences with students and program personnel in special
education, rehabilitation counseling, human services, and health adminis
tration suggest that our readers will have a number of questions about this
population including the following:
• Who are adults with disabilities?
• What are their strengths and weaknesses?
• What mindset or frame of reference do I use in working with these per-
sons?
• What goals should I have for them?
• What skill or behavioral areas do I focus?
• What services should I plan, and in which habilitation environments can
those services be provided?
Our purpose in the book's first section is to answer these questions and
thereby get you off on the correct foot in your habilitation planning efforts
on behalf of adults with disabilities. Chapter 1 begins our efforts by discus
sing the three goals that currently guide services for adults with disabilities:
to increase a person's independence, productivity, and integration into the
community. Thereafter, we stress the importance of developing a mindset
that reflects your sensitivity to these goals plus a number of current trends,
service delivery principles, and professional standards that have an impact
on service delivery to adults with disabilities.
In Chapter 2 we present our working definition of adults with disabili
ties. The three primary criteria related to that working definition include
(1) disabilities attributable to a mental or physical impairment, or a com
bination of mental and physical impairment, (2) resulting in substantial
functional limitations in three or more major life activity areas, and (3)
reflecting the person's need for potentially long-term, individually planned
and coordinated habilitation services. After discussing this definition, we