Cognitive Disability Strategy Interview
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. What would you like to do?
Please share a job situation in workplace relationships that was challenging for you? How did you overcome the challenge?
- While supervising at the PAAGH I was presented with the concern of people smoking outside the group home door. It set a bad example for the youth and was against hospital policy. The issue wasn’t enforcing it, the issue was finding a way to keep the relationships enforcing a policy after recently
- becoming supervisor. Because it seemed to be happening very quickly I felt as though
- I got more resistance than I was expecting. It was from the people I expected. I reminded myself that it’s not personal and that it was not only my concern. If I was to go through the same experience, I would have brought it forward slower and gotten input rather than just my own thoughts of what needed to happen.
Describe a mistake you made
dealing with coworker/manager. How did you rectify the situation? What did you
- At the PAAGH there was a coworker who consistently antagonized the
- youth. The youth would typically leave the facility or go to their room angry
- for the rest of the night. I had an issue with this and since this wasn’t a
- full time staff the plan which was discussed by full time staff was for staff
- to just to take the lead in those situations. When I saw this I didn’t talk to
- him about it as I felt it wasn’t my role. One day it escalated to the point
- where he took off his glasses and wanted the youth to hit him. I stepped in and
- the situation was deescalated, but I felt as though there was a lot I could
- have done differently. Our policy for
- communicating the coworker concerns is to address it with that individual. It
- was my responsibility if I was on shift. I should have communicated this with
- my coworkers as well to develop a consistent plan.
Overview of experience with
children, young adults, and their families with Cognitive Disabilities.
Skill teaching programs
Assessments of needs -
Behavioral and developmental
- Camp Thunderbird, Child Protection, PAAGH, and Mental Health.
- While working at the group home I trained Therapeutic Crisis Intervention which
- teaches behavioral support techniques for ages 5 - 18.
- Working at Camp Thunderbird I was able to learn that people with
- the same diagnosis have varying needs. On the front line I learned that each
- individual has varying needs as well as strengths. During Child Protection I
- had the opportunity to work with one family in particular who both had low IQ
- and diagnosed MR. Behaviorally, there were no concerns but the question was
- whether they met a developmentally appropriate level to care for newborn. After
- parenting assessments and parenting classes it was apparent that they did not
- have the ability to care for their child on their own. However, with extended
- family in the home and using community supports such as a parental support
- worker from NCC the child was eventually returned to their care with continued
- support. The plan isn't to put the child at risk, but modifying to keep the
- child safe with other family members while giving the parents as much
- responsibility as they can manage.
Experience working collaboratively with other service providers, organizations and agencies.
- Since working at Child Protection I have always had to work with
- NGO's and government agencies.
- Examples would be NCC, group homes, working with Mental Health,
- and First Nations Bands and ICFS'.
- Currently I work within the schools and sometimes it can be
- difficult with two different mandates and expectations. Being able to work with
- the schools rather than IN or FOR the schools has been difficult, but I have
- found that respect, professionalism, and most importantly, boundary setting has
- been my savior.
Experience direct treatment
strategies / behavior support plans for individuals who exhibit challenging
- It would vary dependent on
- the developmental/cognitive ability of the child. Reactive strategies would
- include ensuring immediate safety from harm to others through directive
- statements, distraction, moving the child to a temporary safe environment.
- Proactive plans could include discussions about triggers, cues (like the
- “smile/frown” card), or a placement of support workers.
- Some recent strategies I
- have learned about are deep muscle stimulation so things like periodic massages
- or weighted blankets.
- The different settings
- would have to be taken into consideration. Are the same behaviors being seen at
- home as well as school? Where are the behaviors not being seen?
Experience in direct treatment strategies / counseling techniques
a. Counseling - Psychosocial (for parents)
b. CBT - Kids
d. Reality Therapy
Experience in delivery of assessments and/or behavioral measurements
- Functional behavioral
- analysis – CAFAS
- Objective recording of
- behaviors – In order to get relevant data, it’s important to get information
- from the client as well as the individuals involved in their lives. The desire
- to please the therapist can sometimes lead to clients stating they are doing
- better than they really are.
What is your experience in training?
Formally, I am a certified trainer of TCI, where Mark McDougal and I, trained group homes and their workers in behavioral management techniques.
Informally, it feels like every day at Mental Health is a training day, especially working in the schools. Almost daily I expect I give Psychoeducational information to staff, parents, or youth.
What is your experience with cognitive disabilities individuals?
- I have had years of direct
- care experience for individuals with MCI (Mild cognitive impairment) like
- Alzheimer’s and the onset of Dementia at the nursing home where I worked and
- volunteered doing things like feeding, talking, and doing recreational
- activities; to acute cognitive disabilities like MR, autism, aspergers, and
- FASD, ADHD directly at Camp Thunderbird, Mentorship, and the Group Home and as
- a case manager in Child Protection, at the Group home, and currently at Mental
- Health. I have been working with a young
- man with Asperger’s and our plan was to reduce outbursts and increase social
- skills. I have already experienced the frustrations of having the schools being
- resistant to accommodating for individuals with Cog Dis. My experience has been
- that rapport building, similar to any other case planning, is a key element for
- positive growth. For example, this young man and I have an agreement that we
- spend the first 15 minutes talking about his improvements and change and the
- rest of the appointment talking about his passions, Writing and Anime. Even
- with 15 minutes, we have challenged his beliefs on CBT, goals and how to
- achieve them, and hygiene and self care (coming in without deodorant).
- I have a young man who has
- had an assessment which places him with an IQ between 50 -70. I have learned
- that long term case planning is not effective and have come to terms with the
- fact that he may require continued, intermittent therapy, to manage his
- continued “roller coaster” like life. The best service I can provide for him is
- advocacy for environmental changes, self regulation skills, and opportunity for debriefing.
What do you know about Cognitive Disabilities?
Autism - Qualitative impairment of social functioning, communication issues, and repetitive behaviors.
- Asperger's - Communication does not
- necessarily need to be impaired, but they share the social and repetitive
- traits of an Autistic individual. An individual with Asperger's could be high functioning
- in certain aspects such as math.
MR - Low IQ (Below 70) and adaptive functioning impairments
Exposure to Alcohol during pregnancy
· Growth impairments
· Facial characteristics
· Brain domains are effected
· What will I see?
· Predominantly Hyperactivity
o Socially inappropriate
o Legal issues
· Predominantly Inattentive
o Zoning out
- o Appears to not be listening / disrespectful
- . Mixed
Describe the process of person centered
a. Including the person/family in the planning
b. Support decision making
c. Ensuring quality of life
d. Wrap around
e. MAPS / PATHS - planning tools
Describe the process involved in the design
of intervention strategies directed at challenging behaviors.
a. Assessment of the environment, interactions, testing, observation, file review, and interviews
b. Develop a hypothesis
c. Develop a strategy
e. Monitor and evaluate
What ethical guidelines are important in
assessment and design of behavior support?
b. Focus on behavior prevention
c. Quality of life
d. Onus on the environment
e. Positive not punitive
g. Strengths based
How do you design an approach for families
with a high needs behavioral child?
a. Include the family
b. Something that is appropriate for them
c. Hands on demonstration
Naked kid scenario
- a. Functional assessment on environment
- analysis, interactional analysis, date keeping, review file history, interview with school and family
b. Create a planning team
c. Development of strategies
d. Development of reactive strategies to keep people safe
What would you like to do?
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