Accommodated living is a systematic approach to arranging the help needed for people with autism to live a regular adult life and avoid institutionalization. It supplies modifications, adaptations, supports, and services, enabling people with autism to exercise their right to a life of responsible citizenship. Since autism is a distinct lifelong neurological disorder, an ongoing, coordinated system of skilled support is necessary. The organizations and persons who provide accommodated living services must have a good, current understanding of the autism syndrome and a commitment to the values of personal dignity, self-determination, growth, and inclusion.
Specific accommodations and supports will depend on a person's characteristics, strengths, deficits, and sensori-motor requirements. The conditions of his or her particular household, workplace, and community also need to be carefully considered. Adapting the environment to a person's sensory differences, for example, may involve reducing noise or using ear plugs. Motor differences may be accommodated through coaching and prompting to complete household or work tasks. Social guidance and vocational supports may enable the person to participate more fully in work and community life. Adaptive equipment may enable a non-speaking person to communicate.
Accommodations also afford the opportunity to develop strengths, pursue interests, and gain skills. In addition to publicly and privately financed services, help may be provided informally by family, neighbors, and co-workers. To be effective, all accommodations must be personally tailored to an individual's needs and preferences.
- Fosters individual choice and control.
- Promotes integration and inclusion.
- Enables personal development.
- Addresses individual needs for support.
- Compensates for motor and sensory differences.
- Adapts the household and work environments.
- Facilitates communication, through the use of augmentative and assistive means where appropriate.
- Strengthens self-care and self-management skills.
- Encourages appropriate adult behavior.
- Provides long-term consistency and stability.
PROVIDER IMPLEMENTATION OF ACCOMMODATED LIVING
ELEMENTS FOR SUCCESS
1. COMMITMENT AND PRINCIPLES.
A clear commitment to the principles of Accommodated Living (see previous page) at the highest provider management level. These principles also include:
- The services approach is “help to do” rather than “do for.”
- People with autism continue to learn and develop new skills throughout their life span.
- Consistency, structure, predictability, and stability are necessary in the lives of people with autism.
2. NEED FOR A PLAN.
- Services are guided by an individual plan, which reflects the social, employment, recreational, domestic skills, medical needs, spiritual and educational interests of the individual in the most integrated setting.
- Each individual plan must be clear, detailed and understood by direct staff. The plan is developed annually by a support team, which consists of the person with autism, individuals who know the person well, e.g. parents, siblings, friends, and key employees of the service provider, e.g. service director, program manager, behavior specialist, direct staff.
3. MONITORING THE PLAN.
The person’s support team meets on a regular basis (every 3 months or more if needed) to monitor progress versus the plan and to make changes if necessary. Information must be shared in order for the plan to be monitored and carried forward.
4. NEED FOR A COMMUNICATION SYSTEM FOR PERSONS WITH AUTISM.
Effective communication for most people with autism is difficult. Many are either non-verbal or lack reciprocal language skills; many lack cognitive skills; social interaction is a hallmark of autism. Sensori-motor problems in autism often are not taken into account, as well as behavioral problems that may well develop if communication is not effective. Each individual plan must take include an effective way to communicate.
5. NEED FOR BEHAVIORAL CONSULTANT.
A behavioral consultant is necessary to manage the behavior aspects of the plan. The consultant incorporates behavior items into the plan and trains staff in changes as being achieved through techniques incorporated into everyday living rather than through the medical model of a certain number of hours of therapy.
6. NEED FOR A HOUSE TEAM.
When two or more people live in the same household, a house team is necessary to deal with issues that affect all of the residents. The team consists of parents or others close to the individuals and key employees of the service provider.
7. PROVIDER COMMUNICATION SYSTEM.
An effective communication system needs to be in place to ensure that those involved with providing services from the highest management position through to the direct staff are informed of all that they need to know to do their jobs effectively day to day, hour to hour. Staff meetings should be regularly scheduled.
8. NEED FOR PROVIDER TRAINING.
An organization that aspires to provide services to people with autism under the principles of Accommodated Living must develop a pervasive culture. This culture is achieved through training and experience. All levels involved with providing services need training to develop an understanding of autism. Direct staff need ongoing training to acquire and consolidate the skills necessary to provide the required services. Key items include:
- What is autism and how does it challenge adults?
- Staff commitment and roles to maintaining a prosthetic environment with structure and consistency.
- How to identify implications of autism’s challenge for giving support to individuals.
- How to coach, cue, teach with gesture, simple short phrases, and written schedules.
- How to recognize first signs of anxiety, frustration, and distress and implement plans before behavior escalates to a crisis situation.
- How to redirect/intervene when individual’s behaviors are inappropriate.
- How to problem solve.
- How to function as a team.