3. A beautiful light snow is falling and the misty tail of Christmas lights reflect into the
foggy air. I’m on my way to go shopping for gifts. The mall is filled with the rush of excited
people looking for just the right gift. Husbands and wives, mothers and daughters, fathers
and sons, are all out shopping with a purpose of giving. As I walk toward the food court I
notice two staff with a group of adults with developmental disabilities. The staff are seated
off to the side—essentially adult sitting a group. They were all just sitting looking off into
space. Nobody was eating or drinking anything and no one had any packages. The empty
void was evident and I did not need to be a mental health professional to feel the
disattachment. Something is missing!
…
The second generation of advocates in the developmental disabilities field is the
teenagers of the sixties (the first generation is of course parents of persons with disabilities).
Many of these advocates have some rebellious natures that may not have ever completely
left from the volatility of their youth. They assisted in spearheading many of the reforms for
persons with disabilities. They helped advocate disinstitutionization—and took it on the
chin with loud and even sometimes physical threats when group homes opened in
neighborhoods. I was there. I remember angry town hall meetings and the windows being
broken days before folks moved into their new home. I once even had my small Honda car
keyed (although I did have the poor judgment of driving a foreign car in the Flint, Michigan
area). However, eventually, enough neighbors supported the rights of persons with
disabilities to live in a community. At that time, it was like a civil rights movement.
3
4. When I saw some of the images of large institutions and the behavioral approaches used
it made me feel like I was liberating people from a house of horrors. I recall pictures of
young women dressed in nightgowns seated in bleak rooms in metal chairs looking crazy,
lost, and animal like. Parents were often told to instiutionized their children with mental
retardation in the nineteen forties and fifties and were told that it was the best thing for
them. And that advice came from doctors and mental health experts!
I did not see any of those horrors when I visited the Michigan institutions. Basically, I
visited twenty or thirty people before they were to move into the group homes I was helping
to develop. I saw clean rooms with ten beds in them, end tables, dressers, and personal
items. People lived in a segregated compound of the institution and worked in a sheltered
workshop making items that were sold in the community. I saw smiles and an overall
lifestyle and the institutions I observed did have caring staff and administrators. At that
time, it was generally a feeling that “I’m mentally retarded and this is where I belong and
where I am happy!”
Of course, that is not where persons with disabilities belonged; they have a right to live
life just like anyone. Moving people to their own group home from those settings was
exciting, liberating, and provided a great deal of satisfaction. I have a deep affection for
many of the people who really stuck their necks out during that time to advocate for persons
with disabilities. In Michigan, there was a core group of professionals who worked
tirelessly to provide homes for persons with developmental disabilities and most of them
are still working in the field. They literally moved mountains!
4
5. Fast forward to the local mall (in one of the top twenty most affluent counties in United
States) and I see four adults with half shaven faces and wrinkled, mismatched clothes and I
(now) think like a professional and a parent: I am not proud of what I am seeing. It is
December 2012 and (I’m thinking) is this where our efforts have taken us…? The surface
observation is that it takes a little time and trouble to get ready to go out. Clothes do not
iron themselves and nice clothes have to be purchased. Good healthy hygiene takes practice
and if need be—supervision. My wife, for example, often suggests different choices to me
along with other observations she has made over the years…so, then, obviously no one took
the time or trouble to assist the persons at the mall to look as good. They are just sitting
there with a sort of void look of nothing much happening. And really, I cannot think of any
excuse. It is forty years since those liberating days. It is simply not a good reflection that we
really know what we are doing in our efforts to provide supports to persons with
disabilities. It looks lame and sloppy.
I know we have the good intentions. I know we have passionate administrators,
management and staff who have given their heart and soul. I truly believe in inclusive
communities, positive behavioral supports, gentle teaching, community based curriculums,
home of our own, self determination, and freedom for persons with disabilities to make
their own choices and mistakes…, still, it does not change the general feel that too often the
performance of these initiatives is not good enough. And as a professional in the field, I
don’t think we need another internet class for direct care staff or another new slogan or to
rethink community supports …we need skilled and talented people just like any other field,
and people who know what to do and do it…and, like any profession, quality service is not
5
6. easy and takes practice, training, money and skills. But it is not a simple undertaking. It
takes time and trouble. It takes the right people at the right places at the right times.
6
7. Chapter One_
_______________________________
What’s the matter?
I like to ask parents of persons with developmental disabilities how many seconds does
it take for them to know if a program (or supports) is good or bad. Or one step closer: How
long does it take to get a feeling if you would want your son or daughter here? The answer
I receive is that it only takes a few seconds. So then, based on what they see and feel they
can make a pretty fast determination, based on the fact that they have been involved in
Special Needs programs going on twenty years. They know and feel it!
It is perhaps not much different than when someone is taking a car trip and decides to
stop for lunch. One person sees an off the road diner that says “EAT” and the other
passengers say “I don’t know we better check it out” and then someone goes inside to
scout it out. The determination is basically on how clean, how organized, how friendly,
7
8. how well it smells, how nice it looks, how the crowd is dressed, do the staff look like they
know what they are doing, how good the furniture is…and if it does not pass this first
impression test they drive away. And really, in many cases, that is fair enough. People
have been in hundreds of diners and they get the idea pretty quickly.
Conversely, I have walked into many homes of my own, and vocational workshops,
community programs, supported employment and customized employment supports and
felt like saying “Come on, is this where we have ended up? Many of the programs look like
mini warehouses or church basements--unkempt, crummy furniture, bleak interior
decorating (like nobody cares or it is mismatched donated leftovers…), and people and
staff are standing around and frankly it does not look or smell like a home of your own (or
their brochure!) or an active teaching environment where persons are learning community
living skills. If I was driving by I would basically think the owners (administrators in this
place) don’t know what they are doing. It too often looks like a program structure that has
not grown in thirty or forty years…or beyond the look of a church basement. If I was the
parent I would not want my son or daughter there…disability or no disability.
Certainly, there are very good homes and supports out there, but enough falls into the
above description to be called out. I have defensive feelings about other people being
critical of my field, because I am part of the family and family members can say things
others cannot. Still, the point is we have some work to do! I have been at countless
meetings in people’s apartments (persons with developmental disabilities) and time after
time it looked depressing, friendless and lifeless. I could feel that it was home without any
8
9. active spirit. I didn’t hear anything about dinner parties, friendships, learning to invite
others to social events, going to buy things for the home, cool hobbies, or home
improvement projects--what I heard was very basic stuff that left me feeling that not much
is happening on a consistent basis.
I was an administrator for various support programs for over thirty years for persons
who lived with their families and for those who lived at group homes. I remember the
people who lived at home who do things together—with the assistance of their parents,
brothers or sisters in getting together after work or on the weekends. In thirty years I can
count on my fingers how many times that happened for the persons living in the
residential homes. There are various reasons—but it says something….
… our mission statements say we are nurturing,
facilitating, building self esteem, developing lives,
creating dreams and freedom……..
Folks in the field of mental health/developmental disabilities spend a great deal of time
and trouble on writing philosophical statements outlining why they are doing what they
are doing. Every year or two someone points out that a sentence or adjective does not
reflect proper respect to persons with disabilities and it is edited again and again. The
intentions are always laudable. The aim is to provide supports so persons with disabilities
9
10. are afforded all the opportunities of every citizen—life, liberty and the pursuit of
happiness.
I remember being at committee meetings of directors and social workers where we
would all be voicing our opinions on the new statements. When we were through with the
statement it was often such an ambiguous run on sentence, that I bet if everyone had to
actually sit down and write an essay on what it meant to them -- we would get an
embarrassing mish mash of conflicting responses! And after so many years of participating
in this I did get the feeling that we were creating a little club of persons who knew the
latest and sexy way to express ourselves. It was fun when I was a young administrator and
feeling important (if not a little arrogant) at those meetings, but after twenty odd years, a
certain sense of the folly of it all surfaced. Frankly, I think a nice, short clear statement
should suffice. Or as a Ben Franklin quote goes-- it is better to say well done …than well
said.
So… in my humble opinion, if we just do a good job our work will say everything for us.
It often plays like the old joke of the brochure of seemingly great holiday hotel with an
ocean view, but when you really get there is it not even close to the presentation. You can
only see the ocean from one corner of a window if you stand on your toes. What really
matters is the details of what we are doing (not the brochure) and how well we do it and,
of course, those details always take real talent to implement. Our efforts need to be
focused on a skilled effect and on how it gets accomplished.
10
11. And aren’t we wonderful…we work with the
disabled…
Sometimes when you mention that you work with persons with disabilities, people say
wow that really is so cool! They admire you and think you must be wonderful. It pulls the
heart strings and no additional explanation is often required. It is sort of like a small halo
goes over your head and no details are really expected.
At administrator meetings there is always somebody passing out a poem or dramatic
statement about ways to feel about persons with disabilities and reminding us to not label
people…and, well, with a marching band in the background, that is fine, and can be both
invigorating and heartwarming, but really, after a hundred of these, at a thousand
meetings, I understand already! I sometimes wonder if they pass out poems regarding
how wonderful it is to be a doctor at hospital administrator meetings.
11
12. My thought is we cannot ride that horse forever (or at all). We are operating a business
that provides customer supports and if the supports are not any good they should be
called out. Programs can too often fall into a trap of presenting themselves as a saving the
world charity where the director has that halo over their head. They keep playing that card
at presentations and fund raising events sometimes to the point where their intentions to
help persons with disabilities completely overshadows the reality of what they are actually
doing and how well they are doing it. The sad truth is there are lots of donated dollars
going to adult sitting programs as well as very well run programs—all pulling at the
heartstrings of well intentioned persons who want to help people with disabilities.
A great restaurant must prove itself every second
from the first impression to the last. And that is how our
supports must be! The real action happens between
the people with the disabilities and the persons working
and supporting them—and if the quality of that
interaction is anything less than excellent then we are
falling short. We have to know what excellence means
in this field—and if you listen to parents you will know if
you are reaching the mark.
Do the faces of persons touring the program look like they are impressed or would they
drive by if they had a choice? When a parent is standing there in a big warehouse looking
at a day program or a lifeless home and the executive director is selling them the holiday
12
The adult service system is a business
and must be judged by the
implementation of the details not the
fact that they merely work with
persons with disabilities. And that
begs the questions if everyone involved
even knows what the details ought to
be…?
13. hotel—does the director really think everyone buys what he or she is saying? The director
says they receive community living skills in this room and then they practice sorting
hangers in the other room—five days a week, fifty two weeks a year, no vacation. Is this a
drive by? The adult service system is a business and must be judged by the
implementation of the details not the fact that they merely work with people with
disabilities. And that begs the questions if everyone involved even knows what the details
ought to be…?
Logging in the great Northwest…
Many years ago when I was just starting out in the field of mental health, I had a college
roommate who grew up in an Oregon lumber town. I had traveled to Oregon to begin
college and was living in the wonderful city of Eugene. We took a weekend to visit his
parents in western Oregon. My roommate’s dad was a logger as big as a hundred year old
oak tree with a massive belt buckle around his jeans. He told me a tall skinny kid like me
needs some real work. He told us to go chop up some fire wood and bellowed out “you’ll
have to use the two man cross cut saw” instead of the chainsaw…. . My friend and I cut
wood for an hour and then came in to have a grilled steak dinner and –“we drink Coors
beer here in Oregon” his dad boasted! And with his well calloused workingman’s hands,
13
14. he handed me a cold beer, he looked me straight in the eye and asked me what I am doing
in school.
I said I was thinking about majoring in Special Education and was working with kids with
mental retardation at the Pearl Buck Center in Eugene. I told him we helped the students
develop self esteem and to do stuff. Well, he said, while he retreated into his Coors and
said that was a good thing. But I knew it was a lily livered answer by a painfully immature
young man…and at that time, I could not do anything else but swallow that thought with
one of those defeated looks only an eighteen year old can muster.
Logging is an honorable profession. It takes years to learn the craft and a person has to
have a lot of natural skill. You have to build up strength and stamina just to do the job.
Moreover, there is years of learning the tools, how to use them, hold them, take care of
them, and safely use them. The details matter—all the way to how you lace your boots
because you cannot afford to do it the wrong way. It is truly a matter of life and death—
logging in Oregon.
Having said that, every seasoned logger can clearly answer the question: What do you
do? They can explain what they do, where they do it, how they do it, and the details and
details and years and years of learning behind every answer. This is how excellence
happens! And you really don’t need to ask them why….and frankly, you are much better
off if you don’t! And one thing for sure, it is a lousy feeling having to swallow a lousy
answer.
14
15. Apprenticeships exist for a good reason…so you
become really good at something!
The fact is most professional fields have this type (relating to the loggers…) of
disciplined nature. People who are good at what they do have gone through a long
apprenticeship, studied, received critical evaluation during their internship and they either
made it or didn’t. Not everyone can be a logger. In contrast, non-skilled fields do not
require long training periods—maybe two weeks to ten weeks and voila you are now a
paraprofessional!! The difference is in skilled trades the quality is evident: the loggers
know how to log (you cannot wake up one day and become a logger). And the reality is
most fields and businesses really cannot provide any real quality and impressive details
without experts doing the work.
There is a television show called the “Shark Tank,” with seasoned business experts
evaluating whether or not they will invest in a new business. Having watched the show a
hundred times, I have never seen them invest in a business where the owner was not
really doing the work and that the owner’s expert touch was not evident in every detail.
Otherwise, the “Stark Tank” investors would say “forget it. It’s doomed! Quality will suffer
irrevocably and the business will eventually fail!”
15
16. A good restaurant that you would want to eat in just does not happen on its own. The
owners must have a clear vision, expert skills, and know how to make it happen. Skills take
time to learn and develop. You simply cannot hire someone who likes the idea of logging
and give them anything that requires skill to do. They have years of learning first and have
to earn the right do the job. My question: Why can’t the adult service system be a skilled
profession? If mental health professionals think, in fact, it is, then is it really operated that
way? I believe it too often falls short. Way short. I don’t think the “Stark Tank” group
would invest…not because they don’t warm up to the ideals but because the business
execution is not there.
I am not saying that unskilled means no skills. Perhaps the label unskilled does a
disservice to persons without formal training. But if a field uses paraprofessionals—then
where are the professionals? Are the professionals supervising from an office off site?
Twenty feet away? Come in once a week? Are they writing about how things should be
run from University Centers? What happens when a field virtually runs on the talent of
just paraprofessionals?
A logging crew cannot operate with just the new guys or the unskilled labor. A great
restaurant cannot operate with just the inexperienced staff. The job would not get done
that way. The professionals have to be there and really be doing the work for excellence to
happen. A restaurant owner cannot just invest in expensive kitchen equipment and expect
great food---they must hire great cooks!! So what are we getting at….?
16
17. What a difference a teacher makes!
Perhaps the closest to what we do in the adult service system is Special Education.
Special Education has professional teachers who really do the job. The teachers are
assisted by paraprofessionals but the teachers are creating curriculum (engaging persons
in meaningful activities for six hours per day every day!!) and they are completely involved
in the action. For example, in a typical Special Education classroom, there may be one
professionally trained teacher and one or two paraprofessionals to nine to ten students.
The teacher is the one developing and planning the curriculum and the paraprofessionals
assist. The major costs of the school system are investing in the talent of the teachers—
because they (their talent and passion for their craft) make all the difference.
The fact is, the teacher is the professional and does not require layers and layers of
supervision. She or he knows what to do. And in a great classroom it is always evident—
and a parent can know it and feel it. The details impress and that is what adds up to
excellence. And the fact is when you walk into a great classroom—with real talent and real
attention to details—you can see it, touch it, and hear it. Remember, in contrast, how
some substitute teachers would create a winging it atmosphere and nothing much
happened on those days?
…
17
18. I had a great professor at Wayne State University, Detroit, who had been a dean,
division leader, written extensively, consulted at the highest levels and presented
(keynoted) many major conferences, named Dr. Leonard Kaplan. He could have limited his
teaching to doctoral candidates and graduate classes. But instead, he insisted on teaching
a class for incoming students into the College of Education. He wanted to teach the first
year students! I remember his steadfast emphasis on the entry level students learning
what teaching meant. He spoke of having a strong understanding of cognition (thinking
processes, learning, memory, and how it applies to actual instruction) and the science of
designing instructional curriculum. And, of course, being an expert in the domain (what
you are teaching!). This was part of the definition of excellence in teaching. He told us it
was an honor to be our instructor and it was a responsibility he practiced by continuing to
study, continuing to teach to the youngest of education students, planning every lesson,
completing an evaluation of every lesson and changing as needs changed.
One of his favorite stories was he would not want anyone ever taking out his appendix
that did not get an “A” in appendix removal…. Why should our field be any different he
asked? Do we have that rigorously academic and honorable approach in the adult service
delivery system? And why not?? According to Dr. Kaplan, every field, every work
endeavor, every business, has in fact a curriculum. It is not isolated to education. Dr.
Kaplan related that every business, not just the field of education, is dependent of the
quality of teaching within their field. And the quality of that effort is directly related to
whether or not excellence is present.
18
19. I’m going to Disney World!
When you go to Disneyworld and walk through one of their hotels, the cleaning staff is
trained to look up and smile and say hello. And as you go through the Magic Kingdom you
notice all the staff cleaning and smiling—making sure the guests have a wonderful time.
Likewise, at the Home Depot near my house the staff does the same thing. I should say
that many of the staff at Home Depot, before they were working at Home Depot, may
have been contractors and skilled tradesmen. The paint department, for example, has
someone who has been in the painting business for years. Typically, they really do know
their stuff.
The point is all these staff people are not at the top (or the bottom!) of the pay scale
but still have a clear, concrete idea what they are suppose to do. If you ask them they can
give you a learned statement that has a verb and a noun, and there are professionals on
staff, where the action is happening, and providing direct customer service. The store
looks clean, organized, and the staff is dressed well and very responsive to customers.
They make clear eye contact and ask if you need help and will drop what they are doing to
walk you to your item. Auburn Hills, Michigan Home Depot store does good work! I drive
in and stay and shop. Now I generalize this spirit to the adult service delivery field and
wonder if the same customer service ethic exists?
19
20. You can buy a new boxed set curriculum to go…
but go where?
I have walked into day programs for adults with developmental disabilities where
people are seated around tables not really doing anything. The staff, though trained
through the mental health system and in-services, clearly did not know what to do.
Despite a curriculum that they were supposed to follow, they were doing things like
providing Martin Luther King lectures (on Martin Luther King Day) to persons in the severe
and profound range of cognitive impairment. Or, they had a box of teaching materials that
they would use with ten or so things to do (for 200 days a year!). Or, they were doing
puzzles or a small crafts or handouts for second graders from a teaching store. Any
discriminating parent or a professional from another field that demands excellence would
question whether a coherent plan was being executed. It is like they have substitute
teacher every day.
Basically, they were using old materials. Bored staff. Bored curriculum. They had boxed
sets of curriculum materials that meant nothing. You did not need to scratch the surface
very hard to see that there was not much planning going on—the staff was often just
“winging it.” Some staff, of course, is natural teachers and did pretty well but the lack of
knowledge was clear (and any real Special Education teacher would be rolling their eyes…).
It is not that the adult program should be a school and have a school curriculum…it is
simply clear that many adult programs do not have a comprehensible grasp what they are
20
21. supposed to be doing. The intention is there to help and care about persons with
disabilities but the specific details regarding what their job is and what they are really
suppose to do all day—is clearly not!
According to Dr. Leonard Kaplan, curriculum is always evolving and always takes time,
study, new learning, mastery of subject matter, and mastery of learning styles of the
learner. The difference between someone who is prepared everyday and someone who
isn’t --is everything. Night and day! It is the difference between an actor who knows all
their lines and one who did not study their lines at all.
If I was a parent of one of these persons attending these programs I would be thinking
that they don’t have a clue who they are teaching and what to do. Now, for most of the
interactions I have seen the caring and love are usually evident, no one was neglected and
everyone was safe. And, of course, there is a value in that. It could be defined as very good
adult sitting. There is a strong tendency to be nice here and not hurt anyone’s feelings
because after all they are working with persons who require supports. But still…
And beyond that, it is like the restaurant that you would pass. The walls were white,
bland, a lack of coordinated decorating, cheap furniture, old TV’s and old out of date
teaching materials. The staff looks bored and is going through the motions and it does not
feel like an active, vibrant teaching environment. It is like having people who don’t know
how to design a curriculum or implement one—trying to wing it every day on a shoe string
21
22. budget. They are not teachers—yet they are hired with the same expectations. It almost
always looks the same, a semi organized free for all, to varying degrees.
I am using the term “teaching” and while I am not suggesting that we create an adult
school or try to be adult Special Education, I do suggest that much of what we do in adult
service delivery is teaching and does require a curriculum. A curriculum is not just a text of
adult service supports of objectives and teaching examples or a box set of materials. It is
an evolving plan of what, where, when and how we do things…implemented by someone
who has developed the skills and crafted a career.
Several definitions of curriculum exist depending on teacher training models. Yet, for
practical purposes in can be summarized as the what, when, where, who, why and how of
education:
1. What to teach (this consists of math, science, physical education, technology,
history, specific work skills, community skills, self help skills, social studies,
vocational skills, recreational social skills, cooking skills…. Each domain then can be
broken into teachable sub sets. Math—can consists of using money and rounding
concepts while in the community or paying for household expenses; or it can be
using a tape measure for home projects. Each difficult step is then adapted so the
person can actually learn and use the skills).
2. When to teach – (can consist of knowing when is the best time to present certain
concepts where the learner can best grasp, process and remember…it is a matter
of timing, speed of presentations, and determining when is the most meaningful
time to teach that encourages a connection to real life. It takes time and careful
planning is deciding how often to teach skills so they are useful and are aimed at
making life enjoyable).
3. Where to teach – (this consists of deciding how to bridge the connection between
real life and the classroom or community, it can include bringing in real materials
from the community into the classroom, home, program or going directly into the
community--all to really use the leaned skills in their most natural setting …really
relating that old adage of "I will never use this" and demonstrating that "yes you do
and here is how"…Most of us do not spend all day community-based, we are in a
building. It is a matter of how meaningful the experience is where you are).
4. Who are you teaching – (this consists of a clear understanding the learning process
in each learner, especially in special education, making sure the use of language is
22
23. clear, the presentation of new concepts is either chucked creatively, or is visual,
tactile, reintroduced in several diverse approaches, practiced enough-all to be
sensitive to the learner's ability to process and apply information—to use the skills
to make life better and meaningful. And, of course, a firm sense of what works for
what level of cognitive impairment).
5. Why are you teaching – (this consists t of a philosophical perspective regarding
what is to be accomplished by providing an education, where is the student going
after their education, what are they doing at the vocational program or in the
home? Making the most of what each person has and learning to explore their
imagination to the fullest and having the learner continue to learn and experience
new people, places and things… to have challenges and try new activities in real life
settings)!
6. How to teach – (this consists of the actual approach to teaching material, lecturing,
reading handouts, interactive learning with diverse materials, how to practice-what
is practice? How to break down the concepts of new materials, a combination of
when, where, and use of accommodations for different learners and that the
science of adaptations is a major component of what working with persons with
disabilities).
The above definition of curriculum is daunting at best. Still, it relates to fact that a
teacher is more than the person standing in front of students talking and pointing to the
next chapter to read. Or, related to adult service programs, staff ought to be more than
adult sitters. Teachers create an evolving, living curriculum and bring it alive for people.
…
A curriculum is something that a trained professional (a teacher) develops every
minute, hour, day, week, month and year. It is always improving and evolving. It takes
training to use materials and put them together, much the same way the logger takes
years in learning his craft. A pre-packaged curriculum does not really work for the very
diverse learners we have in the adult service system—at a work site, home environment or
program. Plus, it is a science itself to decide what to teach and what is meaningful to each
23
24. person. In other words, a top down boxed set of teaching activities handed to
paraprofessionals (and then told to do this) is not an active curriculum. Instead—it is
usually embarrassing and ineffectual, like a movie where none of the actors ever
rehearsed their lines, or a restaurant that hired cooks who cannot cook. Again, skilled
professions are characterized by attention to details in planning and study. And if it is not
a skilled effort that we are doing in the adult delivery system… what is it?
…and you find anything you want in the want
ads…
A visit to the want ads across the nation tells the story. Typically, there are tons of
positions open for direct care staff at both vocational and residential programs. A recent
ad that I saw requested that the person be “at least eighteen years old; must assist clients
with hygiene and physical and emotional needs and individual chores, implement assigned
goals consistent with a person-centered plan, monitor growth, document daily occurrences
and promote self esteem”.
24
25. Now I could just stop there and assume anyone with experience in customer service
would identify that ad is not much more than what is expected from a baby sitter (at
about the same hourly pay). But it evokes a deeper concern, which is this: I am not sure
that the people writing these ads have any idea what to do and what they are really
looking for. What do they really mean by a “person centered plan?” How does such a plan
affect what the worker is expected to accomplish on a daily and hourly basis?”
It is not so much that the provider (or director of the not for profit) of these services is
operating a five or ten million dollar agency and that the most important position in the
company is (or should be) the person actually providing the real services --and they must
be at least eighteen years old and have gone through twenty hours of state training and
that they must promote self- esteem in the clients (one wonders how they measure that
on a job evaluation?), it reflects a whole sense that the field itself promotes an adult
sitting expectation.
If the training requested is not any more that the babysitting classes offered through
city education departments and the ads for babysitting and direct care staff are similar,
then what other conclusion can be drawn? This is 2013 and what are the advocates,
developmental disabilities University professors and mental health administrators asking
parents to endorse?
Conversely, I have read ads for direct care staff that go the complete other direction—
but with the same outcome. The ads are highly specific to designing curriculum and
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26. include esoteric terms that would be included on a master’s level special education
teacher’s job description. But the catch—the same catch as the above callow ad, the
person must be at least eighteen, high school education (some college preferred) and pass
a drug test. The writer of these ads really wants something for nothing—and usually you
don’t quite get that in real life. I would not think that they have ever got an applicant that
fits the description for their ten dollars per hour. Or, in everyday language “who are you
kidding”? The answer is of course no one-- if anyone is really paying this close attention—
other than the parents of persons receiving the services and wondering what they can do.
This is exactly how we get the holiday hotel that cannot live up to its brochure. I am sure
the whole business would be laughed out of the Stark Tank!
Let’s hire who?
It is instructive to look at the requirements of regular education teachers in teaching
secondary special needs students. The items below are the essential and basic
components in an introductory Special Education class:
Basic terms, concepts and laws that define Special Education
• A history of how services became to exist and the salient issues regarding supports
• Definitions of who receives services.
• Working with parents
• Working effectively with paraprofessionals in Special Education
26
27. • How are supports organized, physical organization, routines, whole class instruction, and small group
instruction, one on one instruction…?
• Evaluating the learner and instructional materials
• Use of technology in instructional setting and providing supports
• Selecting what to teach with a systems approach to assessment in multiple settings
• Developing instructional accommodations for students with moderate, severe or multiple disabilities
• Making accommodations with students with visual and hearing impairments
• Making accommodations with students with orthopedic impairments
• Understanding and working with students with autism including communication accommodations
• Understanding speech problems and making accommodations for students with speech problems
• Knowing what are the learning needs within multiple setting for students with learning and behavioral
needs and creating necessary accommodations
• What are the social and emotional needs of students with disabilities and creating necessary
accommodations
• How to accommodate students with ADHD and creating accommodations
• What are the needs of students who are culturally diverse
• How to make assessments and contribute in creating individual plans of service and create meaningful
lives
• How do you create a everyday curriculum: what pre-skills (if any) what selecting and sequencing
examples to use; deciding rate of instruction; providing opportunities in multiple settings and
appropriate time for review and practice
• What subject matter and content is appropriate for students with special needs
• How to create written and oral communication skills within an overall curriculum
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28. • Understanding the learning strategies for students with severe, moderate, and mild cognitive
impairments and how to accommodate curriculum accordingly
• What are examples of successful learning strategies and how to use them
• Creating instructional environments conductive to learning
• Understanding and demonstrating positive behavioral approaches
• Using direct instructional approaches; using technology; adaptive technology; arranging stimulation
activities; developing peer tutoring supports in multiple settings
The above is a rather cursory list of skills required in an introduction to students with
special needs class for regular education teachers. And like any 101 course, it gives an
overall wide sweep of the field. The remaining years of study and practice take each sub-
subject and break it down into more specific knowledge sets. The objective is that after
several years of classes, internships and critical evaluation in designing curriculum,
teaching and working with special needs students—a person has the tools to begin their
craft.
Given this extensive knowledge base, I get uneasy with efforts that promote more pay
for paraprofessionals in the adult service system—with the underlying premise that an
increase in pay by a dollar an hour will improve supports. My belief is that it will not. After
being in the field for thirty years I simply see very little evidence that our field understands
the above concepts very well, at the administrative, management and paraprofessional
level. The problem is-- it is clear that the something missing is really someone is missing!
The person who has learned this craft!
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29. … The best supports and programs just don’t
happen…
Again and again, to be excellent at selecting what to teach takes time, practice, study
and evaluation—something a non-skilled person would of course not do well. We have
talented university professors in Special Education who have written very good books on
the adult service system. These texts have checklists and surveys that are designed to help
select meaningful things to teach, and many great suggestions for providing supports to
adults with developmental disabilities. The professors who have written on the adult
service delivery system most likely spend twenty years or longer reading and studying the
writing of key professionals—then owned the material and created their own material.
The problem is that this is a professional field. You cannot just read a new book
(however great it is) just once and then run a great program. A person cannot read an
anatomy book a couple of times and then proceed to do surgery. It takes time to learn,
study, go through an appropriate apprenticeship (perhaps like a teacher for five years) and
then you begin to become skilled. In fact, if you ask most teachers how long it took for
them to run their classroom well, they often will say three or four years (or more).
Beginning teachers spend many nights crafting their lesson plans, studying teaching
materials, evaluating their performance, changing the curriculum as they learn by trial and
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30. error. They spend almost as much time preparing as teaching. And frankly, I don’t see
paraprofessionals in this field really capable of performing these tasks. It is not because
they are not talented people. They do not have the training or the appropriate background
to do what we are really asking them to do. If you look at the job description of a
paraprofessional in the adult service system you will see a watered down version of what a
Special Education teacher does. That is not how excellence happens; it is how mediocrity is
achieved. It is how winging it is achieved.
I have see many case managers, support coordinators and program directors who are
looking at blank computer screens trying to develop “meaningful” objectives that are
billable. Really? I know this sounds like a broken record but it takes study, time, practice,
critical evaluation, and knowledge of good materials on selecting meaningful things to
teach (consistent with customized employment; freedom, choices, age appropriate,
community based…) and most social workers or occupational therapists did not go
through that type of training. And what we get is what we have-- an inconsistent adult
service delivery system with different versions of winging it everywhere you go.
In fact, the persons designing the objectives are usually not the persons doing the
teaching…so they are not learning via trial and error nor evaluating the results. They
develop the objectives and they tell the paraprofessionals to just do it or observe for a few
minutes and ask the paraprofessional how it is going. My best guess is that Dr. Kaplan
would think this is an ineffective approach, if not a dishonorable effort. I cannot think of
another field that has the most talented persons simply stop in, present an approach and
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31. leave their report and have the staff complete it. How can an effective business run that
way?
Many states have State Developmental Disabilities Councils and University Institutes,
where they have developed internet training programs, presented customized
employment approaches, community based activities and gentle teaching methods and
fund statewide training projects for staff charged
with teaching persons with developmental
disabilities. And still, it is very clear in these
states, that the staff, management and
administration in adult services delivery
programs, after say the last twenty five years,
too often cannot answer my friend’s dad
question much better than I did at eighteen.
They still seem to not grasp the old (and true)
chestnut “what a difference a teacher makes”
and that it applies to the service delivery system.
We simply have most of the talent circling
around the field—writing about it, facilitating the
funding of the system, completing the paperwork
for the system, and dealing with the human
resource issues of entry level staff, designing on-line required in-services, advocating for
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We have too many
disillusioned parents completely
frustrated with the
implementation of supports for
people with developmental
disabilities. The field itself tends
to grow and evolve externally
through its advocacy but
internally it has not grown much
where the action really occurs.
32. the rights…but not enough talent where it really counts…where the action is! And the
outcome is-- restaurants that you would not want to go to if given more choices.
We have too many disillusioned parents completely frustrated with the implementation
of supports for people with developmental disabilities. The field itself tends to grow and
evolve externally through its advocacy but internally it has not grown much where the
action really occurs.
What is missing?
There are many parts that are in place and intelligent professionals surrounding the
action. Yet, it is the quality of the direct teaching that makes all the difference…. It does
not matter if the program is community based or at a job site, or at a home of your own, a
group home or apartment or supported employment… it is always the teacher (or person
trained in a similar manner) that makes all the difference. Day in and day out, many
people with cognitive impairments do require support to get everything planned and
accomplished for an enriching life style. There has to be talent behind the results. I do not
mean hand over hand but a teacher (paid like a teacher!!) directing the action. Otherwise
…it generally does not get done at a quality level that would pass the “I am proud of this”
test…period.
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33. The absence of a very skilled teacher in any teaching environment basically puts the
teaching on “getting by” mode or doing “busy work” or “mop up”. This even happens
when the regular instructor is gone in a typical regular education classroom and a
substitute is in charge. The regular teacher has a relationship with the material, knows
where the students are, and has complete ownership of that teaching environment. If you
put (for illustrative purposes) her teaching paraprofessionals in charge, the drop off in
quality would not be simply slight–it would be more like falling off a steep cliff? It is not
the same without the real thing in charge.
The idea that since the complexity of a teaching curriculum for special needs people is
not very challenging (in comparison to people without a cognitive disability) and therefore
there is no need for that same level of talent is a faulty concept. And, if that is accepted,
then off the cliff into the free fall the whole field goes. The business then takes on a
“getting by” with what we have mode, or “come on there are no funds for trained
teachers –are you kidding?” Yet, there are funds to start new initiatives, supported
employment placements, home of our own programs, new quality control, elaborate
layers of administration and case management positions—all designed to watch over the
programs but not actually do them. And again, money is always an issue but not the whole
issue….
A professional who takes complete ownership of the teaching environment and
command of the material will grow and evolve with an intelligent and innovative grasp of
the material. As a result, there may be less need for so many fly by positions because the
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34. most important persons (and best paid!) with the adult service systems would change
from directors, support coordinators, rights officers, area directors, quality control
inspectors –to the teachers (whatever the positions are called). Otherwise, what exists is
thirty years of new concepts and initiatives implemented on an inconsistent basis with
embarrassing and disappointing results.
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