AGI Support Tools For DSPs

The
items in this file include all AGI Curriculum Tools and Activities that
appear in the print publication of the training. Some unit numbers do
not match the module numbers for the AGI Online Course that you
have completed; however, all tools covered in the online course can be
found here, plus many additional materials developed for supporting
adults with autism. AGI wishes you all the best in your future support to
people with autism. You are making a difference!

Unit #1 History Learning Activity 1.1

Current Perceptions: ABCs What Would You Do?

Instructions: Using the video link provided in the training, view the ABC program, What Would You
Do? Reflecting on the video, consider the thoughts, feelings and behaviors of the players involved in
that particular situation. Pretend you were in a similar situation. Write down all the thoughts, feelings
and behaviors that you might take on.

Group activity:
Next, count off in 3s for discussion. For your group, consider the perspective of:

1: the other patrons in the restaurant
2: the parents of the person with autism
3: the person with autism

Keep in mind there are no right or wrong answers. This exercise is about self-discovery and professional
growth.

Thoughts Feelings Behaviors/Actions

Unit #1 History Learning Activity 1.2

Changing Perceptions: A Credo for Support

Instructions: Using the link provided in the training, view the video, A Credo for Support. Reflecting
on the video, consider the thoughts, feelings and behaviors of the players involved. Pretend you were in
a similar situation. Write down all the thoughts, feelings and behaviors that you might take on.

Did you experience any changes in your perspective about people with disabilities? If so, what were the
changes?

Do you feel viewing this video will affect the way you support people with disabilities in your daily work
setting? If so, how?

Group activity:
Next, count off in 2s for discussion. Share your thoughts and ideas:
1: Did you experience any changes in your perspective about people with disabilities? If so, what were
the changes?
2: Do you feel viewing this video will affect the way you support people with disabilities in your daily
work setting? If so, how?

Keep in mind there are no right or wrong answers. This exercise is about self-discovery and professional
growth.

Changes in My Perspective Changes I Want to Make in My Support

Unit #2 Person Centered Approach Handout 2.1

Preferences Chart

What Works What Doesnt Work


Interests Worksheet

Favorite Objects Hobbies Favorite Places Favorite People Favorite classes, Work Experiences
(collections) clubs, groups, (jobs, tasks, chores)
activities


Needs Chart

What Works What Doesnt Work

Unit #2 Person Centered Approach Learning Activity 2.1

Test Your Knowledge of Self-Advocacy

Used with permission of Valerie Paradiz, LLC

A. Short Answer (provide brief written answers)
1. Name at least two (2) areas residential/daily living settings in which a person with autism or a related condition can experience
enhanced quality of life by learning self-advocacy skills? Offer brief examples of each.
A.
B.

2. If you were aiming to support a person with autism or related condition in acquiring skill in self-advocacy, what indicators would you
look for to know whether your support has been effective?

B. Multiple Choice and True/False (circle your choice)
1. If a person with autism or another disability decides to tell someone about his/her diagnosis, this is called:
a. Ineffective self-advocacy
b. Self-disclosure
c. Effective self-advocacy
d. Full disclosure
e. b. and c.
f. None of the above

2. A non-speaking person with autism cannot learn to advocate for his/her needs and preferences.
a. True
b. False

3. Individuals who have severe behaviors cannot learn self-advocacy skills.
a. True
b. False

Unit #2 Person Centered Approach Learning Activity 2.1 (answer key)
Test Your Knowledge of Self-Advocacy: Answer Key

A. Short Answer (provide brief written answers)
1. Name at least two (2) areas residential/daily living settings in which a person with autism or a related condition can experience
enhanced quality of life by learning self-advocacy skills? Offer brief examples of each.
A. Advocating for sensory needs with regard to cooking/mealtimes (odors, tastes, etc.)
B. Advocating for social needs with regard to mealtimes (needs to speak less in order to be able to complete motor
planning with chewing, swallowing, etc.)

2. If you were aiming to support a person with autism or related condition in acquiring skill in self-advocacy, what indicators would you
look for to know whether your support has been effective?
Decreased anxiety
Decreased violent or aggressive behaviors
Generalization of skill to other areas outside the residence, such as in the community

B. Multiple Choice and True/False (circle your choice)
1. If a person with autism or another disability decides to tell someone about his/her diagnosis, this is called:
a. Ineffective self-advocacy
b. Self-disclosure
c. Effective self-advocacy
d. Full disclosure
e. b. and c.
f. None of the above

2. A non-speaking person with autism cannot learn to advocate for his/her needs and preferences.
a. True
b. False
3. Individuals who have severe behaviors cannot learn self-advocacy skills.
a. True
b. False

Unit #2 Person Centered Approach Learning Activity 2.2

The Learner Snapshot

Directions: Use the following information to create a Learner Snapshot. If information is missing or unclear be sure to
note it in your process. Be sure to clearly identify what information would be important to gather and how you would
go about obtaining that information. Include information for the following headings:
Name
Exceptionality
Family dynamics
Learns best
Special interests
Strengths
Challenges

Description: Martin is a 42 year-old man with ASD who lives in a residential placement setting. Martin is a kind,
gentle, and cooperative individual. He works in a factory assembling small mechanical parts. He responds well to
direct instruction techniques and is very organized. He enjoys gardening, puzzles, Celine Dion music, bird watching,
building birdhouses, and visits with his brother. He uses a language board to communicate because he has difficulty
with verbal expression. He has difficulty with almost any change in his routine and requires advance notice and
multiple opportunities to practice with any new experience. He can become upset in the face of confusion or when he
does not know what is happening or what is expected. He becomes upset in large crowds and busy chaotic
environments. He relies on visual schedules to help navigate his day. When upset, he can become despondent and
may rock or moan to soothe himself. Listening to music, going for a walk, or removing him from triggering situations
is helpful. Martin has Type I diabetes and is allergic to strawberries.

Unit #2 Person Centered Approach Learning Activity 2.2 (answer key)

The Learner Snapshot: Martin
Answer Key
Name: Martin M. 42 years old
Disabilities:
Autism-A disorder resulting in impairments in communication and social interaction, with markedly restricted patterns of
behavior and interests
Medical: Type I Diabetes- insulin dependent
Allergies: Strawberries
Family Dynamics: Martin is kind, cooperative, and gentle. He lives a residential facility. He is extremely fond of his brother and
looks forward to their weekly visits. He works at a local factory assembling small mechanical parts.
Learns Best: Martin is a visual learner. He learns well when tasks are modeled for him. He does well when clear, explicit
instructions are provided. He uses a language board to communicate with others.
Special Interests: Gardening, birds, Celine Dion music, puzzles, building birdhouses
Strengths: Gentle, polite, cooperative, responds well to direct instructions, enjoys a wide range of activities, responds well to
structure and is very organized.
Challenges: Functioning during unstructured activities, ambiguous situations or too many choices, poor problem solving skills,
adjusting to changes in routine or schedule, difficulty with new people
Things that upset: Changes to schedule or routine, loud noises, commotion or large crowds,
Signs of being upset: Rocks back and forth, stares out the window, whimpers or moans, rocks back and forth, despondence or
inactivity, rigidity
Motivators and preferences: Walking the grounds, listening to music, watching the Discovery channel, working on birdhouses,
visits with his brother
Calming/Soothing Techniques: Using soft gentle tones, listening to Celine Dion songs, removal from loud or chaotic
environments, taking a walk outdoors or in an area with limited noise and commotion
General modifications: Visual and sensory supports, providing clear directions, number steps to tasks, provide verbal and
visual instructions, use of calendar and daily schedule, use of language board, provide multiple opportunities to practice task or
skills, prepare one week in advance for changes in schedule or routine, limit choices.

Unit #3 Regulation Learning Activity 3.1

ISA Sensory Scan Pre-Teaching Worksheet
Learning the Sensory Systems
Used with permission by Valerie Paradiz, LLC

Instructions: Fill in the blanks below to learn more about the sensory systems, how they function and what you
are currently sensing in the environment through each system. The last image in the worksheet represents both
the vestibular and proprioceptive systems. An example key is provided following Homework 3.1.

Sensory Picture What is its name? How does it function? Do you sense anything in
this environment?

Unit #3 Regulation Homework 3.1


Instructions: Complete this form with an individual with autism by prompting him/her to self-report and/or by
your observations. The last image in the worksheet represents both the vestibular and proprioceptive systems. An
example key is provided on the next page.

this environment?

Unit #3 Regulation Learning Activity/Homework 3.1 (example key)


this environment?
Auditory To hear Air conditioner fan
Visual To see Fluorescent

lighting
Gustatory To taste Nothing in the

current

environment
Olfactory To smell Another

participants

perfume

Tactile To touch Texture of desk is

tacky
Vestibular All aspects of motor Difficulty sitting

& movement and for long periods in
Proprioceptive planning a chair

Sensory Dis-regulation
Using the behavior example provided by your instructor, complete the following worksheet. Consider the strategies for
supporting regulation covered in this unit when completing the section Possible Behavior Solution. An example key is
provided on the following page.

Sensory System/ Incoming Incoming Possible Behavior Solution
Situation Information Information
Too Big Too Small
Sight (Visual)

Smell (Olfactory)

Hearing (Auditory)

Taste (Oral Motor)

Touch (Tactile)

Proprioception

Vestibular

Unit #3 Regulation Learning Activity 3.2 (example key)
Sensory Dis-regulation

Too Big Too Small
Sight (Visual) Eyes water Rub eyes, ask for pain
and burn, reliever, use sunglasses,
Bright lights headache change or remove self
after 10 from bright lights
minutes,
everything
looks blurry
Smell (Olfactory)

Hearing (Auditory) Cant hear Remain silent, talk to
dinner only the person next to
Crowded companions you, ask for quieter
restaurant seating

Taste (Oral Motor)

Touch (Tactile)

Proprioception

Vestibular

Supporting an Individual in Sensory Regulation
Complete the following w worksheet with an individual you support in a residential setting or when integrating
into the community. This can be completed by self-report and/or observation on your part. Consider the
strategies for supporting regulation covered in this unit when completing the section Possible Behavior
Solution.

Too Big Too Small
Sight (Visual)

Smell (Olfactory)

Hearing (Auditory)

Taste (Oral Motor)

Touch (Tactile)

Proprioception

Vestibular


The ISA Sensory Scan Worksheet
Integrated Self-Advocacy ISA
Instructions: Complete the following worksheet, scanning the current environment you are in or in another
environment outside the training room.
My Personal Information & Scan Location
Your name: _________________________________________ Date: ________________________
Agency/program/work site/other: __________________________________________________________
Which room or environment will you be scanning? ____________________________________________
The ISA Sensory Scan

1. Auditory Scan: Pay attention to the sound in this environment. Which of the following apply to you? Fill in as many
details as you can in the Notes sections.
Background noise is distracting Difficulty with sudden or irregular noises
Notes: Notes:
Challenge with number or volume of voice(s) Other

Notes: Notes:
2. Visual Scan: Pay attention to what you see or how you see in this environment. Which of the following apply to
you? Fill in as many details as you can in the Notes sections.
Light in room is too bright or too dim Type of light is distracting or challenging
Notes: Notes:
Angle of light is difficult (from above, below, etc.) Difficulty reading in this environment
Notes: Notes:
Distracted by things hanging on the wall, on surfaces, Other

or in my peripheral vision Notes:
Notes:
3. Olfactory Scan (Smell): Pay attention to the smells in this environment. Which of the following apply to you? Fill in
as many details as you can in the Notes sections.
Smell from objects is distracting, challenging The general smell of the room is difficult
Notes: Notes:
Smell from person(s) is distracting, challenging Other
Notes: Notes:

4. Tactile Scan (Touch/Feel): Pay attention to your reaction to touch or to the things or people you
touch/feel in this environment. Which of the following apply to you? Fill in as many details as you can in the Notes
sections.
Generally cannot tolerate others touch/type of touch Challenges with how things or surfaces
Notes: feel to the touch (sticky, wet, rough, etc.)
Notes:
Sometimes dont feel pain the way others do Difficulty with the temperature or drafts
Notes: Notes:
5. Oral/Gustatory Scan: Pay attention to tastes or textures on your tongue in this environment. Which of the
following apply to you? Fill in as many details as you can in the Notes sections.
Difficulty with the texture or taste Challenges with mixed foods
of certain foods Notes:
Notes:
Other/Notes:
6. Vestibular Scan: Pay attention to how movement affects or doesnt affect you in this environment. Which of
the following apply to you? Fill in as many details as you can in the Notes sections.
Cannot sit for long periods of time Would like to spin in circles
Notes: Notes:
Motion in vehicles is disruptive/makes me feel Other

sick or confused Notes:
Notes:
7. Proprioceptive Scan: Pay attention to your experience of your body and the space around you. Which of the
following apply to you? Fill in as many details as you can in the notes sections.
Easily bump into others or the walls Need to rock, bounce, or press
Notes: against other things or people
Notes:
Trouble writing on paper (graphomotor) Difficulty using stairs or walking

Notes: down an incline
Notes:
Cannot sit for long periods of time Other

Notes: Notes:
My Top Three Environmental Needs: Choose up to three results from your Sensory Scan above. You will use
these to develop an Advocacy Plan in your Self-Advocacy Portfolio.
1.
2.
3.


Develop a Sensory Advocacy Plan
Used with Permission from Valerie Paradiz, LLC

Instructions: On the following page, youll find a Sensory Advocacy Plan Worksheet. Using the results of your
Sensory Scan in Learning Activity 3.3, choose one or more of your Top Environmental Needs, then complete the
planning sheet accordingly.

You will see that once the advocacy plan is completed, it should be implemented by you support in the residential
setting or out in the community. An assessment of how effective/useful the plan was can be found at the bottom
of the worksheet. If the score is 1, the plan can be revised and implemented again. If the score is 2, perhaps the
plan can be adjusted for optimal success. If the score is 3 the plan was successful on the first attempt!

Self-Advocacy Portfolio

Sensory Advocacy Plan

My top sensory need:
Need
What is my sensory goal?

(For example, do you need to make a request for a modification or for assistance of some kind?)
ISA Sensory Plan
Can I address my sensory needs independently without a script? If so how?

(For example, do you need spend less time in this environment, can you take breaks or do an activity that will help
structure your experience more?
Do I need an Advocacy Script? (If YES, complete the Advocacy Script worksheet)
Do I need someone to support me, a translator or mentor? If so, how?

(You might want to practice your plan first, ask someone to accompany you, or follow up with a mentor after you have
executed your Advocacy Plan.)
Ratings: How did it go?

1-Poorly
2- OK
3- Great
Valerie Paradiz, LLC 2012 Integrated Self Advocacy ISA ISA Social Scan

Exploring Autism Internet Modules
Visit the AIM (Autism Internet Modules) site at:
http://www.autisminternetmodules.org/
At this site, you can choose a module on visual supports or sensory differences to see video footage on
the implementation of various supports.
After completing the module of your choice, provide a list of 3-5 visual or sensory support ideas or
strategies you can try with individuals.
Complete this assignment prior to the Communication Unit #4, in which you will learn more about
aspects of visual supports.
Additionally, you will learn much more about implementing visual and sensory supports in the
Applications Unit #5 of this curriculum.
AIM Module Title: _________________________________________________
Type of Support How I Will Implement It Additional Notes

Unit #4 Communication Handout 4.1

Example Task Analysis: Steps for Washing Dishes
Rinse dishes and stack them on the
counter

Fill one side of sink with hot water

Add a squirt of dish liquid to the
water

Wash and rinse all glasses, placing
them in the rack on the counter

Wash and rinse all utensils, placing
them in the rack on the counter

Wash and rinse all plates and bowls,
placing them in the rack on the
counter

Wash and rinse all pots and pans,
placing them in the rack on the
counter

Empty the water from the sink,
rinsing away soap suds

Wipe water from the counter and
faucet area

Example Daily Schedule

8:00 AM Breakfast

8:30 AM Catch Bus

9:00 AM Day Program

12:00 PM Lunch

12:30 PM Catch Bus

1:00 PM Work

5:15 PM Catch Bus

6:00 PM Dinner

7:00 PM Wash Dishes

8:00 PM TV Time

10:00 PM Bed


Example Weekly Schedule

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Unit #4 Communication Learning Activity 4.1

Design a Visual Schedule to Support Communication
Instructions: Use Pias Learner Snapshot as a basis for developing a visual support that will facilitate communication for Pia,
who volunteers in the community. In addition, indicate how the support you develop will increase communication.
Name: Pia 51 year-old female
Disabilities: Autism: A disorder resulting in impairments in communication and social interaction, with markedly restricted
patterns of behavior and interests
Medical: Arthritis
Family Dynamics: Pia is quiet, shy and gentle. Her primary language is Filipino and her secondary language is English. Her
receptive language is quite good but she communicates infrequently using one or two words to express herself. She primarily
relies on a Picture Exchange Communication System (PECS, Bondy & Frost, 2011) binder that has been created for her. She
will often avoid communicating her needs and often waits until someone engages her. A timer and a written schedule are
helpful to her to anticipate possible needs or transition periods, such as meals, using the restroom, etc.
Learns Best: Pia functions well with written schedules. She does best when her own schedule is written in her language. She
thrives on a predictable routine. Timers have been helpful in alerting her when it is time to s use the restroom, get a drink, eat
lunch, etc.
Special Interests: Gardening, birds, flowers, crossword puzzles, reading (books in Filipino), listening to books on tape
(especially in Filipino), crochet
Strengths: Gentle, polite, cooperative, responds well to direct instructions, responds well to structure, level of independence
increases as structure and predictability increase
Challenges: Pia (a) struggles to communicate her wants and needs when in new settings; (b) often relies on prompts to
perform some basic functions, such as taking a bathroom break or stopping for lunch; (c) uses her PECS book in the
residential facility but seems hesitant to use it in other settings; (d) experiences difficulty transitioning from one setting to
the next due to her strong interests
Things that upset: Unfamiliar people, loud noises, commotion or large crowds
Signs of being upset: Despondence or inactivity, rigidity, confusion, inconsistency in schedule or routine
Motivators and preferences: Crochet, gardening, reading
Calming/Soothing Techniques: Using soft gentle tones, removal from loud or chaotic environments, calms with the sound
of running water, nature sounds CD
General modifications: Visual and sensory supports, providing clear directions, provide verbal and visual instructions, use of
calendar and daily schedule, use of PECS to communicate, provide communication in Filipino as much as possible
Reference: Bondy, A., & Frost, L. (2011). A pictures work: PECS and other visual communication in autism. Bethesda, MD:
Woodbine House.

Unit #4 Communication Homework 4.1

Construct a Visual Schedule for an Individual You Support
Using the examples in the PowerPoint slides for this and the Regulation unit, any of the examples the
instructor made available to you, and information from the AIM site, create a visual schedule that will
support a client.
NOTE: When this unit is presented the instructor will have a variety of actual visual schedules as
examples for you to see.
If you have not done so, make sure to complete Homework 3.1: Exploring Internet Modules from the
Regulation unit before completing this assignment.


Developing a Script from a Learner Snapshot

Instructions: On the pages that follow are five learner snapshots. Create a script that will facilitate the
communication of one of the adults in the list below. The learner snapshots focus on the following areas:
1. Martin M. Shopping
2. Jamilla Recreation
3. Liam Transportation
4. Pia Volunteering
5. Dom Faith-based

In addition, indicate how the support you develop will increase communication.

Unit #4 Communication Learning Activity 4.2 (continued)

Learner Snapshot #1: Shopping
Disabilities: Autism-A disorder resulting in impairments in communication and social interaction, with markedly restricted
Family Dynamics: Martin is kind, cooperative, and gentle. He lives a residential facility. He is extremely fond of his brother
and looks forward to their weekly visits. He works at a local factory assembling small mechanical parts.
Learns Best: Martin is a visual learner. He learns well when tasks are modeled for him. He does well when clear, explicit
instructions are provided. He uses a language board to communicate with others.
Strengths: Gentle, polite, cooperative, responds well to direct instructions, enjoys a wide range of activities, responds well to
structure and is very organized.
Challenges: Functioning during unstructured activities, ambiguous situations or too many choices, poor problem solving
skills, adjusting to changes in routine or schedule, difficulty with new people
Things that upset: Changes to schedule or routine, loud noises, commotion or large crowds
Signs of being upset: Rocks back and forth, stares out the window, whimpers or moans, rocks back and forth, despondence
or inactivity, rigidity
Motivators and preferences: Walking the grounds, listening to music, watching the Discovery channel, working on
birdhouses, visits with his brother
Calming/Soothing Techniques: Using soft gentle tones, listening to Celine Dion songs, removal from loud or chaotic
environments, taking a walk outdoors or in an area with limited noise and commotion
General modifications: Visual and sensory supports, providing clear directions, number steps to tasks, provide verbal and
visual instructions, use of calendar and daily schedule, use of language board, provide multiple opportunities to practice task
or skills, prepare one week in advance for changes in schedule or routine, limit choices


Learner Snapshot#2: Recreation
Name: Jamilla 23 year-old female
Medical: strong allergic reaction to peanuts and beestings (carries epi-pen)
Family Dynamics: Jamilla is kind and energetic. She is quite curious and exploratory. She has just recently been placed in a
residential living situation because her needs exceed that of which her mother can provide. Her family consists of her 2
parents and 2 younger siblings. Her mother visits daily and the entire family visits on Sundays.
Learns Best: Jamilla responds well to structure and explicit instructions. Visual supports and a variety of prompts are
necessary. Her daily schedule needs to be carefully planned and organized, as she gets bored easily with monotonous tasks
that do not involve movement. She enjoys physical activity and loves being outdoors. Boundary markers are helpful in
managing her curiosity and avoiding areas that may be dangerous.
Special Interests: Jamilla loves the outdoors and engaging in games and tasks that require movement. She loves bike riding
and hiking.
Strengths: Jamilla is very curious. She is friendly and energetic. She gets along well with others.
Challenges: Jamilla has the tendency to wander. She often does not understand her own boundaries and the precautions she
needs to take with regards to her allergies. Her receptive language skills are poor and she has troubling retaining information
for very long. She becomes interested and fixated on almost anything that catches her eye outdoors. She needs significant
structure and one on one support to assist her in new settings as well as for most tasks and activities.
Things that upset: Telling her no or redirecting her without replacement of a particular interest or activity, transitioning
between activities, stopping one activity and beginning another, too much commotion or activity (overstimulation)
Signs of being upset: Motor agitation, rapid shifts in mood and affect, rejecting alternative options, self injury (hitting head,
picking at skin on arms and face)
Motivators and preferences: Movement, physical activity/games, bike riding, visits with her mother, citrus fruit (oranges are
her favorite), blowing bubbles (use as distracter to transition from one activity to the next)
Calming/Soothing Techniques: Movement, push-ups, walks, use of a weighted blanket, use of a therapy ball
General modifications: Frequent reminders (countdowns to transitions), one on one assistance in less structure settings,
creating boundary markers, use timers to count down time left from one activity to the next.


Learner Snapshot#3: Transportation
Name: Liam 35 year-old male
Medical: Asthma (uses inhaler)
Family Dynamics: Liam is a motivated and driven man. He has lived in a residential setting for the past 18 years. He is verbal
but uses brief phrases to communicate. He struggles with receptive language and will sometimes indicate that he
understands when he does not. He works at the local animal shelter helping exercise dogs and clean kennels. He is quite
sensitive to certain odors and uses a medical grade mask, as needed. His parents visit him every Monday and take him out to
his favorite restaurant if he has met his weekly goal. (Liam has yet to miss his weekly goal).
Learns Best: Liam thrives on clear and explicit instruction. He needs models and multiple opportunities to practice with
corrective feedback in order to achieving mastery. Tasks need to be broken down by steps and rehearsed regularly. He also
requires gestural prompts, but does not like being told what to do. He responds well to verbal reinforcement (good job!) and
a check mark after every step completed successfully.
Special Interests: Dogs, working at the dog shelter, completing crossword puzzles, being helpful particularity if working with
his hands and back (breaking down boxes)
Strengths: Hard-worker, responds well verbal and visual forms of reinforcement, highly motivated, will try new things, eager
to please others, strong relationship with his family, dependable.
Challenges: Functioning during unstructured activities/tasks, can become over-stimulated by sounds and smells,
transitioning from one activity to the next, strives for perfection
Things that upset: Changes to schedule or routine, strong and unfamiliar odors
Signs of being upset: Rocks back and forth, whimpers or moans, rocks back and forth, becomes rigid, paces
Motivators and preferences: Work tasks that involved the use of his back and arms, crossword puzzles, Wii system games,
weekly dinners with his family, going to work at the dog shelter
Calming/Soothing Techniques: Using soft gentle tones, removal from loud or chaotic environments, engaging in physical
activity such as sweeping/mopping/shoveling, moving boxes, using his medical mask,
General modifications: Visual and sensory supports, providing clear directions, number steps to tasks, provide modeling and
multiple opportunities to practice, use of calendar and daily schedule, provide multiple opportunities to practice task or skills,
prepare one week in advance for changes in schedule or routine, limit choices.


Learner Snapshot#4: Volunteering
Medical: Arthritis
Family Dynamics: Pia is quiet, shy and gentle. Her primary language is Filipino and her secondary language is English. Her
receptive language is quiet good but she is communicates infrequently only using one or two words to express herself. She
primarily relies on a Picture Exchange Communication System (PECS, Bondy & Frost, 2011) binder that has been created for
her. She will often avoid communicating her needs and often wait until someone engages her as opposed to initiating. A
timer and a written schedule are helpful to her to anticipate possible needs or transition periods, such as meals and using the
restroom.
Learns Best: Pia functions well with written schedules. She does best when her own schedule is written in her language. She
thrives on a predictable routine. Timers have been helpful in alerting her when it is time to s use the restroom, get a drink, eat
lunch, etc.
Special Interests: Gardening, birds, flowers, crossword puzzles, reading (books in Filipino), listening to books on tape
(especially in Filipino), crochet
Strengths: Gentle, polite, cooperative, responds well to direct instructions, responds well to structure, level of independence
increases as structure and predictability increase
Challenges: She struggles to communicate her wants and needs when in new settings, she often relies on prompts to
perform some basic functions such as taking a bathroom break or stopping for lunch, she uses her PECS book in the
residential facility but seems hesitant to use it in other settings, difficulty transitioning from one setting to the next due to
fixated interests
Signs of being upset: despondence or inactivity, rigidity, confusion, inconsistency in schedule or routine
Calming/Soothing Techniques: Using soft gentle tones, removal from loud or chaotic environments, calms with the sound
of running water, nature sounds CD
calendar and daily schedule, use of PECS to communicate, provide communication in Filipino as much as possible
Reference: Bondy, A., & Frost, L. (2011). A pictures work: PECS and other visual communication in autism. Bethesda, MD:
Woodbine House.


Learner Snapshot#5: Faith-Based
Name: Dom 64 years old
Disabilities: Autism-A disorder resulting in impairments in communication and social interaction, with markedly restricted
patterns of behavior and interests; Generalized Anxiety Disorder- A mental disorder that is characterized by excessive worry
or fear
Medical: Asthma, Chronic constipation and stomach upset (takes medication to manage)
Allergies: Seasonal
Family Dynamics: Dom is a 64 year-old man with ASD. He is non-verbal but can read and write quite well. He has one sister
that visits 2 times a year. These visits are generally upsetting because of poor planning and preparedness as well as Doms
need for strict adherence to his schedule.
Learns Best: Dom thrives on structure and predictability within his daily routine. He relies heavily on his visual schedule and
can communicate using a speech-generating device. He is a visual learner and does well with new tasks when people show
him exactly what it is that he needs to do (modeling). He also requires gestural prompts.
Special Interests: Music (particularly gospel hymns), watching the dogs at the dog park (from a distance and will not
approach), putting together jigsaw puzzles, reading in his rocking chair, enjoys reading the newspaper from cover to cover
everyday
Strengths: Gentle, cooperative, understands and follows through with his routine with the necessary supports, picks up on
new tasks easily as long as there is a visual model, can take the bus independently
Challenges: Non-verbal, poor problem solving skills, adjusting to changes in routine or schedule, difficulty with new people,
general anxiety, needs things to be predictable to the minute, details of his schedule need to be written exactly.
Things that upset: Changes to schedule or routine, easily spooked (does not like things at his back), difficulty ending
activities
Signs of being upset: Yelling, crying, fidgeting
Motivators and preferences: Completing puzzles, Sudoku, walking the therapy dog, reading, going to mass
Calming/Soothing Techniques: Music, referring him to his schedule when there are changes, going to his rocking chair,
reading
calendar and daily schedule, limit choices.


Developing a Script for a Person You Support
Using the examples in the PowerPoint slides for this and the Regulation unit, any of the examples the instructor
made available to you, and information from the AIM site, create a script that will support a client.
NOTE: When this unit is presented the instructor will have a variety of actual scripts as examples for you to see.


Participant Query: What Does It Mean?
Kim is learning to cook supper for his family one night The familys in-home support worker is
per week. When his father, who supports him says, teaching Kims family how to support him in
Whats next?, Kim tends to respond by trying to learning new skills. The worker tells Kims
repeat the last step. father to try pointing to an item involved in
the next step.

Arial has begun attending services at the synagogue A former teacher, who provides Arial with
near her new apartment. She frequently spends part of transportation, explains to the Rabbi that Arial
the time pacing in the back of the sanctuary. gets restless and often paces as a way to stay
focused.

Ben tends to say all done whenever he is asked Bens house mate gives him a laminated card
whether he is done with a task. This is true whether he with the words work on the front and
is finished or not. done on the back. Ben flips the card to the
back when he finishes a task.


Supporting Communication as a Translator
Instructions: Think of an individual with whom you work. Identify a time when a communication mishap occurred.
Identify what information needed translation. Indicate who could have acted as a translator and how. Use this
information to complete the form below.
Brief Description of Individual

Description of Communication Mishap

Information That Required Translation

Potential Translator for the Situation

How Translated Information Could Be Shared with the Individual


Hidden Curriculum in Daily Life: My Hidden Curriculum Diary
Hidden curriculum items are often learned as the result of direct instruction. This instruction may occur
in daily life by using a one-a-day hidden curriculum calendar or something similar, or instruction may
occur after social error has occurred that involves a violation of the hidden curriculum.
This tool (refer to the following pages) provides you with one way to keep track of the hidden curriculum
items you learn. It is amazing how much you can learn over time and fun to review it from time to time.
You can also make your own Hidden Curriculum Diary electronically on your computer, iPad or other
device, if you prefer.
Make several copies of the tool. If you want you can hole punch the copies and put them into a ring
binder or staple them together to make your own diary. Feel free to make a cover for your diary if you
wish.
NOTE: Information solicited can be provided in many ways including, but not limited to:
Recording by handwriting onto a hard copy of My Hidden Curriculum Diary Tool

Recording by typing into the template of My Hidden Curriculum Diary Tool
Making a short audio or video of yourself telling the information solicited by My Hidden
Curriculum Diary Tool
Taking photos of each location where a hidden curriculum item became apparent to you and
then providing the solicited information by writing, typing or voice recording to go with each
photo. This is easily accomplished if you have cell phone, iPod or iPad capability.

Unit #4 Communication Learning Activity 4.4 (Diary Tool)

Date Hidden Curriculum Item Notes


Using My Hidden Curriculum Diary
Using the Diary Tool provided in Learning Activity 4.4, begin recording all the hidden curriculum you
observe for the next 24-48 hours as you go about your everyday life. Record at least 6-8 items.
For example, when checking out at the grocery store, even though you are in a hurry and would like to
load your items on the conveyor belt at the checkout to expedite the checkout process, you refrain from
rearranging the items belonging to the customer in front of you so as to be able to make room for your
items. The hidden curriculum item is:
When waiting to load your items on the conveyor belt at the grocery store checkout, it is considered a
social sin to rearrange another customers items so as to take up less space, thus making room for your
own items.
In the notes section of My Hidden Curriculum Diary you might record something about your experience
such as the fact that you were in a hurry and perhaps could have completed the checkout process faster
by shoving the other customers items closer to the cashier, but refrained from doing so.


Implications of Not Understanding the Hidden Curriculum
Have participants each take one of the following hidden curriculum items. You might cut the items apart, fold the
strips and have participants pick an item from the hat (or basket). Use as many items as you need for the number
of participants in your training.
Go around and have each participant tell one implication/possible impact for a client who does not understand
the hidden curriculum item.
Note: If there are a large number of participants this activity may be done in smaller groups with each group doing
the activity.
1. If a police officer asks you to come to the police station for questioning, you must go.
Ask for a lawyer. It is your legal right, and it is very important NOT to answer questions until a lawyer
representing you is present.
2. Most times you will have to wait beyond the scheduled time of a medical appointment. Plan on this and be
prepared to pass the time quietly.
3. Dont make threatening remarks in public. Even if you dont mean what you say, you could find yourself in
serious legal trouble if the remarks are taken seriously.
4. You may consider smoking to be a disgusting habit, but do not share this information with strangers you see
smoking. To smoke or not to smoke is a personal choice.
5. People do not send out used Christmas cards. If you are going to send out Christmas cards you must send new
ones. This is not the time to recycle.
6. Never joke about doing something illegal such as bombing a building or robbing a bank. You could be taken
seriously and, if so, find yourself in legal trouble.
7. If you do not know when to cheer at a sporting event, a good rule of thumb is to cheer when the crowd cheers
using the same words you hear others saying.
8. If you are ever in a situation where the police want to question you, it is your legal right to demand that an
attorney be present. It is the polices job to try to get you to answer questions. It is your job to ONLY say, I would
like an attorney. Then, wait until one arrives before saying anything more.
9. It is generally considered rude to comment on any unfavorable body smell such as sweat, but complimentary
to comment on favorable body smells such as perfume.

10. If you have leftover prescription pain pills that you no longer need to take, know that it is illegal to sell them to
anyone else even if someone asks to buy them from you.
11. Regardless of your own belief it is considerate to go along with a childs belief in Santa Claus as that is how the
child understands the spirit of Christmas giving. The child is not wrong even if he believes differently than you.
12. When using the self-scanner at a store checkout, if an item doesnt scan and you proceed to place it in your
shopping bag as if it had scanned, this is considered stealing.
13. Even though it is a commonly understood social courtesy not to pick your nose in public places, it is not your
place to inform a nose picker unless the nose picker is your child.
14. Most communities have time frames for how long before and after trash pickup you can leave your trash can
at the curb. You may be fined if you put your trash can out too early or leave it out too long after the trash has
been picked up.

Unit #5 Applications Learning Activity 5.1

Evidence-Based Strategies at Work

Instructions:
Create a list of all the supports in the appropriate columns on the activity sheet below.

Visual supports Sensory supports Positive reinforcement

Teaching/learning new Structure, routine, and If you are uncertain, list
skills predictability them here for group
discussion

Part Two: After completing
the lists, answer the
questions: What if these
supports were not available
to you? How would this
impact your ability to
manage? How would you
feel? How might you act?

Unit #5 Applications Learning Activity 5.1 (answer key)

Evidence-Based Strategies at Work
Answer Key

Directions:
Group 1-Create a list of all the supports in the appropriate columns on the activity sheet.

Visual Supports Sensory supports Positive reinforcement

Photographs Phone ringer Pay checks
Food labels Alarm clock Compliments
Written words Fire detector Activities
Calendars Clothing Food/desserts
Schedules Alarm systems
Picture symbols (refer to the reinforcement activity)
Planners
Recipe cards
Traffic signs
Teaching/learning new skills Structure, routine, and If you are uncertain, list them
predictability here for group discussion
Learning to drive Work schedule
Learning Yoga Mealtimes
Learning to cook or a Bus schedules
new recipe Store hours (hours of
Working an iPad operation)
Learning your new
camera
Part Two: After completing Information in this area is a reflection. Responses will vary.
the lists, answer the
questions: What if these
supports were not available
to you? How would this
impact your ability to
manage? How would you
feel? How might you act?


Create a Learner Snapshot for a Person You Support

Directions: Create a Learner Snapshot for one of the individuals you support.
You may use the format provided in the Activity Packet (next page) or create one of your own.
The Snapshot in any format should contain all the essential components:

Name
Exceptionality
Family dynamics
Learns best
Special interests
Strengths
Challenges

Develop a plan to (a) share the completed Snapshot with the individual you support, (b) add or
modify information gained from the individual, and (c) share with others who can benefit from
the Snapshot.

You will later use this information to develop an ISA Sensory Scan, ISA Social Scan, CAPS: 6-
Minute Brief, and related supports.

Unit #5 Applications Learning Activity 5.2 (continued)

Keep this information for later in unit when you develop an ISA Sensory Scan, ISA Social Scan, and a CAPS: 6-
Minute Brief.
The Learner Snapshot
Name

Exceptionality

Family Dynamics

Learns Best

Special Interests

Strengths

Challenges

Plan (Next Steps)
How and When To
Share with Individual

How To Add/Modify

How To Share with
Others (How to use the
Snapshot)


Create a Task Analysis

Directions: Create a task analysis. Be sure to clearly identify the target skill or behavior.
Dissect the components that make up the skill. Include information related to
prerequisite skills and learning opportunities.
Use the task analysis forms provided in this packet or select your own way to complete
the activity.

Task Analysis 1: Hand washing
Task Analysis 2: Washing clothes using a washing machine
Task Analysis 3: Going to the grocery store
Task Analysis 4: Ordering food at a fast food restaurant
Task Analysis 5: Taking the bus to work


Task Analysis
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.

Additional Aspects to Consider
Attention
What attentional skills will be needed in order to
attend to the task Visual/Auditory? How long?

Imitation
Will the person be imitating motor skills? Verbal
Skills? Multiple skills at the same time?

Environmental Tolerance
Where does the task occur and what are the
sensory aspects of that environment

Opportunity to Practice
Potential opportunities to practice the task


Task Analysis
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.

Additional Aspects to Consider
Attention
What attentional skills will be needed in order to
attend to the task Visual/Auditory? How long?

Imitation
Will the person be imitating motor skills? Verbal
Skills? Multiple skills at the same time?

Environmental Tolerance
Where does the task occur and what are the
sensory aspects of that environment

Opportunity to Practice
Potential opportunities to practice the task


Task Analysis General Answers

Directions: Create a task analysis. Be sure to clearly identify the target skill or behavior. Dissect the
components that make up the skill.

Group 1: Hand washing

Turn on water
Wet hands on all sides under water stream
Place one hand under soap dispenser
With the other hand, pump soap dispenser twice into hands
Rub palms of hands together vigorously for 10 seconds
Place one hand over the other and rub vigorously for 10 seconds
Switch hands, placing one hand over the other rubbing vigorously for 10 seconds
Place hands together with fingers open; gently rub in between fingers distributing soap around all
fingers
Rinse hands underwater until all soap is removed
Turn off water
Dry hands on towel

Group 2: Washing clothes using a washing machine

Place clothes in basin of washing machine
Measure detergent
Close lid
Pour detergent into washing machine
Turn dial to appropriate load setting
Turn dial to desired washing cycle
Push start button

Unit #5 Applications Learning Activity 5.3 (answer key, continued)

Group 3: Going to the grocery store

Make a list of desired items
Gather money and list
Drive to grocery store
Enter store
Get cart
Select items on list and place in cart
Proceed to checkout
Place items on grocery belt
Hand money to cashier
Get change and receipt
Leave store
Load items into car
Drive home
Unload groceries

Group 4: Ordering food at a fast food restaurant

Review menu
Decide on meal items
Get in line
Give order to employee
Pay for meal
Wait for meal to be prepare
Take bag and leave restaurant or find seat

Group 5: Taking the bus to work

Identify bus stop
Identify appropriate bus to work location
Proceed to bus stop
Wait for appropriate bus to arrive
Enter bus
Pay driver
Ride to work
Get off bus at work location


Prompting

Directions: Label each scenario according to the type of prompted depicted. When you have finished,
create your own scenario of each prompt using a different situation and context.
Modeling Visual Physical Gestural Verbal

A. _______________________You are teaching Pat to greet others. You have been working on it for a
couple weeks. Pats friend walks into the room. You say, Theres Ray. What do say to Ray?

B. ______________________When at the mall, Inga begins to look for the restroom. She approaches a
cashier in a department store and asks her where the ladies room is located. The cashier turns and point
behind her to the sign labeled Restrooms .

C. _______________________You are working on teaching your client the particular steps of a
structured work task. He completes steps 1-3, and then stops. You gently place his hand on the next
item.

D. _______________________Ben needs to return a library book. He places the book on the passenger
seat of his car the night before to serve as a reminder.

E. _______________________You are trying to teach Henry to fold a shirt. You decide that they best
way to teach this is to show him step by step by completing the task yourself and have him observe.


Prompting
General Answer Key

Directions: Label each scenario according to the type of prompted depicted. When you have
finished, create your own scenario of each prompt using a different situation and context.
Modeling Visual Physical Gestural Verbal

A. Verbal You are teaching Pat to greet others. You have been working on it for a couple
weeks. Pats friend walks into the room. You say, Theres Ray. What do say to Ray?

B. Gestural When at the mall, Inga begins to look for the restroom. She approaches a cashier
in a department store and asks her where the ladies room is located. The cashier turns and
point behind her to the sign labeled Restrooms .

C. Physical You are working on teaching your client the particular steps of a structured work
task. He completes steps 1-3, and then stops. You gently place his hand on the next item.

D. Visual Ben needs to return a library book. He places the book on the passenger seat of his
car the night before to serve as a reminder.

E. Modeling You are trying to teach Henry to fold a shirt. You decide that they best way to
teach this is to show him step by step by completing the task yourself and have him observe.


Fading Prompts

Directions: Consider one of the scenarios you or your group created for the previous prompting
activity.

Review the examples or scenarios that you created for the 1) Verbal Prompt, 2) Gestural
Prompt and 3) Physical Prompt.

Describe or create an example for each of these scenarios of how you might fade the prompt or
how you might modify or incorporate a more independent prompt.

Scenario Fading Strategies/Independent Prompt
Verbal:

Gestural:

Physical:


Modeling

Directions: Teach an individual how to greet someone using modeling (in the moment, not
video). Describe how you would complete the task 1) using verbal language and 2)
communicating non-verbally. Consider and identify natural and artificial cues and how you
would incorporate them into your teaching.

Group 1: Greeting someone you know. Group 3: Greeting someone you know in passing.
Group 2: Greeting someone you do not know. Group 4: Greeting someone you dont know in passing.

Verbal Non-Verbal Natural and Artificial Cues
Greeting
someone you
know

Greeting
someone you
do not know

Greeting
someone you
know in passing

Greeting
someone you
dont know in
passing


Modeling
General Answer Key

Directions: Teach an individual how to greet someone using in vivo modeling. Complete the
task using verbal language as well as how they would model the task without verbal language.
Consider and identify natural and artificial cues and how you would incorporate them into your
teaching.

Verbal Non-Verbal Natural and Artificial Cues
for Teaching
Greeting Scan environment for Scan environment for Teach attention to others
people you recognize. people that you recognize persons pace and facial
someone you Make Eye Contact Make Eye Contact expression. Do they appear
know Smile Smile to have time to talk?
Stop walking/slow down Stop walking Use of gestural cues to
Say, So good to see you Initiate a warm hand help the individual
shake, a hug (if a good recognize the opportunity
friend) or a fist pump of to greet.
Greeting Stop Stop Teach to use arms
Monitor personal space, not Monitor personal space, length to monitor
someone you too close. not too close. personal space
do not know Say, Hello, I do not think Smile Provide visual cue of
we have met. I am _____ Extend hand to shake allow person to identify
Extend hand to shake briefly who they are / their
briefly name.
Smile
Greeting Eye contact Eye contact Cue verbally or visually
Slow pace slightly Slow pace slightly that someone they have
someone you Smile Smile met is approachinggive
know in passing Wave Wave name.
Say, Hello __(name)__ Wave first and use the
name
Greeting Brief eye contact Brief eye contact Use signal that person is
Steady pace Steady pace a stranger to help him
someone you Slight smile Slight smile recall what steps to use.
dont know in Hi Slight head nod Model technique for
passing Keep moving Keep moving person using other
strangers while in an
unfamiliar group before
he tries the skill.


Reinforcement

Directions: Make a list of common reinforcers. Record them in the appropriate reinforcement
category.

Primary: Naturally occurring, no need to Activity: Engaging in an interest,
be taught occupation, hobby, pastime, etc.
Social: Social Contact or Interaction Material: Tangibles, Items


Reinforcement
General Answer Key

Directions: Make a list of common reinforcers. Record them in the appropriate reinforcement
category.

Primary Activity
Sleep Concerts
Food Parties
Air Sport activities
Sex Video games
Sleepovers
Shopping
Crafts
Vacations/day outings
Playing on the computer

Social Material
Compliments Books
Facial expressions of approval Music
Attention Movie tickets
Applause Clothes
Thumbs-up Shoes
Jewelry
Toys


Instructions: Complete the following Social Scan worksheet with an individual you support. You can
base the scan on self-report from the individual and/or observations you make.

The ISA Social Scan Worksheet

My Personal Information and Scan Location
Your name: Date:
College/Program/Employment Site:
Which social environment will you be scanning?
The Social Scan
1. People: Pay attention to the people in this situation. Which of the following apply? Fill in as many details as you
can in the Notes sections.
How many people are in this environment? If its a large number, give an estimate.
Number:
There are people I know here. Describe how this makes you feel.
Notes:
I do not know any of the people here. Describe how this makes you feel.
Notes:
Other.
Notes:
My comfort level with people in this setting is (circle one):

1 2 3 4
unbearable uncomfortable not a problem comfortable
2. Structure & Space: Pay attention to the structure of this situation and how people are distributed in space in
relation to you. Which of the following apply? Fill in as many details as you can in the Notes sections.
This is a formal or organized setting. People are seated in rows of chairs or at table(s) or desk(s).
Notes:
The setting is not formal or organized. People are moving about at will or standing/sitting in groups.
Notes:

I feel comfortable with the amount of space in relation to the number of people.
Notes:
I feel uncomfortable with the amount of space in relation to the number of people.
Notes:
Provide some details on your location in this setting, as well as your proximity to others.
Notes:
Other
Notes:
My comfort level with the structure of this setting is (circle one):

1 2 3 4
3. Content: Pay attention to the content of this social environment. Which of the following apply? Fill in as many
This is a formal lecture or class, one or more people are speaking to the others, who are listening.
The topic(s) being discussed is/are:
This is an informal setting, such as a party or other loosely organized social gathering.
People are talking about:
This is a very quiet setting. People are either whispering or not talking at all.
Notes:
I am not sure what the content of this setting is.

Notes:
My comfort level with the content of this setting is (circle one):

1 2 3 4
4. Expectations: Think about what might be expected of you in this environment. Which of the following apply? Fill
in as many details as you can in the Notes sections.
I am expected to participate with others in an organized activity.

Notes:
Participation in this situation is voluntary and not expected of me or others.

Notes:
I am not sure what is expected of me.

Notes:
I am expected to be quiet and listen in this setting.

Notes:
Other
Notes:
My comfort level with the expectations in this setting is (circle one):

1 2 3 4

5. Mood: Pay attention to the mood or the emotions of others in this setting. Which of the following apply? Fill in as
many details as you can in the Notes sections.
The mood is joyous or happy.

Notes:
The mood is somber or sad.

Notes:
The mood is focused or attentive. People are concentrating on something or someone.

Notes:
I am not sure what the mood is.

Notes:
Other
Notes:
My comfort level with the mood of this setting is (circle one):

1 2 3 4

6. Context Cues/Supports: Are there any context cues or supports in the environment that help you understand
what to do? Which of the following apply? Fill in as many details as you can in the Notes sections.
There are signs or other symbols that help me to navigate this environment.
Notes:
The way people are sitting, standing or organized help me to navigate this environment.
Notes:
I am not sure if there are context cues or supports in this environment.

Notes:
Other
Notes:
My comfort level with the context cues/supports this setting is (circle one):
1 2 3 4

My Social Tendencies
You will use the results of this questionnaire to create a Social Advocacy Plan.
1. Review your Social Scan. Which social aspects of this setting make you uncomfortable (score of 1 or 2)?
2. Which social aspects of this setting are you comfortable with (score of 3 or 4)?
The ISA Social Scan is used with permission of Valerie Paradiz, LLC.

Unit #5 Applications Homework 5.1

Develop a Social Advocacy Plan
Used with Permission from Valerie Paradiz, LLC

Instructions: On the following page, youll find a Social Advocacy Plan Worksheet. Using the
results of your Social Scan from Learning Activity 5.8, choose one or more social discomforts or
difficulties you wish to address with your advocacy plan. These would be items that you scored
1 or 2 on in the 1-4 scale of discomfort/comfort.

When supporting an individual:
Once the advocacy plan is completed, it should be implemented by the person in his/her
home/residential setting, or in the community. An assessment of how effective/useful the plan
was can be found at the bottom of the worksheet. If the score is 1-2, the plan can be revised
and implemented again. If the score is 3, perhaps the plan can be adjusted for optimal success.
If the score is 4 the plan was successful on the first attempt!

Self- Advocacy Portfolio
Social Advocacy Plan

My social discomforts and tendencies:
1.
2.
3.
Can I address my social needs on my own? If so how?

(For example, do you need spend less time in this environment, can you take breaks or do an activity
that will help structure your experience more?
1.
2.
3.
If I cant address my social needs on my own, what is my advocacy goal?

ISA Social Scan
1.
2.
3.
1. YES NO
2. YES NO
3. YES NO
Do I need someone to support me? If so, how?
(You might want to practice your plan first, ask someone to accompany you, or follow up with a mentor
after you have executed your Advocacy Plan.)
1. YES NO
2. YES NO
3. YES NO

1 2 3 4
Unbearable Uncomfortable Not a problem Comfortable!
Valerie Paradiz 2011 Integrated Self Advocacy ISA The ISA Social Scan for FBA/BIP


Identify the Sensory System

Directions: Read each scenario and identify the specific sensory system that is reflected in the specific
scenario.

Scenario Check the Sensory System(s) reflected in each Scenario
(some scenarios may include more than one)
Storm. Tactile (Touch) Auditory (Hearing)
One evening a thunderstorm results in the electricity going Vestibular (Balance) Visual (Sight)
out. In complete darkness Rachel is able to locate her Proprioceptive ( Body Gustatory (Taste)
nightstand and the flashlight inside. What sensory area is Awareness) Olfactory (Smell)
operating in this example?
Barber Shop Tactile (Touch) Auditory (Hearing)
Aaron hates having his haircut. He has become more Vestibular (Balance) Visual (Sight)
tolerant but he uses a stress ball to help him through the Proprioceptive (Body Gustatory (Taste)
process. What sensory systems do you recognize as Awareness) Olfactory (Smell)
sensitive and as part of the intervention?
Gas Leak Tactile (Touch) Auditory (Hearing)
Marcus comes home from work after a long day. He enters Vestibular (Balance) Visual (Sight)
his apartment and detects a gas leak. What sense is most Proprioceptive (Body Gustatory (Taste)
likely responsible for this discovery? Awareness) Olfactory (Smell)
Bus Ride Tactile (Touch) Auditory (Hearing)
Joe needs to ride the bus everyday to work, however, he Vestibular (Balance) Visual (Sight)
often becomes anxious and agitated. On the advice of his Proprioceptive (Body Gustatory (Taste)
co-worker, he now listens to music on his iPod. What type of Awareness) Olfactory (Smell)
sensory intervention is being used?
Biking Tactile (Touch) Auditory (Hearing)
Val is training for a bike race. The trails are comprised of Vestibular (Balance) Visual (Sight)
complex terrain, which involve steep hills and tight turns. Proprioceptive (Body Gustatory (Taste)
His ability to negotiate the positioning of his body according Awareness) Olfactory (Smell)
to the terrain refers to what sensory area?
The Workout Tactile (Touch) Auditory (Hearing)
Miriam has worked up quite a sweat at the gym. She Vestibular (Balance) Visual (Sight)
glances down at the elliptical machine and it reads :08. She Proprioceptive (Body Gustatory (Taste)
signs in relief knowing that her workout is almost complete. Awareness) Olfactory (Smell)
What sensory area is she using to make that determination?
Card Night Tactile (Touch) Auditory (Hearing)
Henry plays cards with a group of his friends each Friday. His Vestibular (Balance) Visual (Sight)
friend brings a new recipe to share with the group. The Proprioceptive (Body Gustatory (Taste)
others offer compliments and eat with delight. Henry takes Awareness) Olfactory (Smell)
one bite and immediately spits it into his napkin. His mouth
feels like it is on fire. What sense does this refer to?

Unit #5 Applications Learning Activity 5.9 (General answer key)

Identify the Sensory System
General Answer Key

Scenario Check the Sensory System(s) reflected in each Scenario
(some scenarios may include more than one)
Storm. Tactile (Touch) Auditory (Hearing)
One evening a thunderstorm results in the electricity going Vestibular (Balance) Visual (Sight)
out. In complete darkness Rachel is able to locate her Proprioceptive (Body Gustatory (Taste)
nightstand and the flashlight inside. What sensory area is Awareness) Olfactory (Smell)
operating in this example?
Barber Shop Tactile (Touch) Auditory (Hearing)
Aaron hates having his haircut. He has become more Vestibular (Balance) (possibly)
tolerant but he uses a stress ball to help him through the Proprioceptive (Body Visual (Sight)
process. What sensory systems do you recognize as Awareness) Gustatory (Taste)
Olfactory (Smell)
sensitive and as part of the intervention?
Gas Leak Tactile (Touch) Auditory (Hearing)
Marcus comes home from work after a long day. He enters Vestibular (Balance) Visual (Sight)
his apartment and detects a gas leak. What sense is most Proprioceptive (Body Gustatory (Taste)
likely responsible for this discovery? Awareness) Olfactory (Smell)
Bus Ride Tactile (Touch) Auditory (Hearing)
Joe needs to ride the bus everyday to work, however, he Vestibular (Balance) Visual (Sight)
often becomes anxious and agitated. On the advice of his Proprioceptive (Body Gustatory (Taste)
co-worker, he now listens to music on his iPod. What type of Awareness) Olfactory (Smell)
sensory intervention is being used?
Biking Tactile (Touch) Auditory (Hearing)
Val is training for a bike race. The trails are comprised of Vestibular (Balance) Visual (Sight)
complex terrain, which involve steep hills and tight turns. Proprioceptive (Body Gustatory (Taste)
His ability to negotiate the positioning of his body according Awareness) Olfactory (Smell)
to the terrain refers to what sensory area?
The Workout Tactile (Touch) Auditory (Hearing)
Miriam has worked up quite a sweat at the gym. She Vestibular (Balance) Visual (Sight)
glances down at the elliptical machine and it reads :08. She Proprioceptive (Body Gustatory (Taste)
signs in relief knowing that her workout is almost complete. Awareness) Olfactory (Smell)
What sensory area is she using to make that determination?
Card Night Tactile (Touch) Auditory (Hearing)
Henry plays cards with a group of his friends each Friday. His Vestibular (Balance) Visual (Sight)
friend brings a new recipe to share with the group. The Proprioceptive (Body Gustatory (Taste)
others offer compliments and eat with delight. Henry takes Awareness) Olfactory (Smell)
one bite and immediately spits it into his napkin. His mouth
feels like it is on fire. What sense does this refer to?


Natural Supports

Consider the scenario below. As a staff member, consider how you would use aspects of yourself and
structuring of the environment or schedule to serve as a natural support in this situation. Identify how
you would use the following to support Doug based on the information provided.
1. Premack Principle
2. Breaks
3. Customized tasks
4. Individuals working side by side

Case example: Doug is extremely eager to work at the woodshop. He is extremely skilled with
his hands and works tirelessly on the projects he creates. Recently, Doug was offered a job at
the local woodshop after his talents were recognized at a local community craft show. The
owner is very supportive of having Dougs help but cannot devote all of his time monitoring his
work. You are concerned because Doug has a tendency to become overwhelmed when he does
not understand what is required of him or if he is unable to complete a task. When
overwhelmed or frustrated, Doug engages in behaviors such as self-harm, yelling, rocking, and
crying. In addition, you are concerned that Doug will be late every morning because of his
refusal to complete his hygiene routine. As with most jobs, punctuality and good hygiene is a
requirement for the position.

Premack Principle

Breaks

Customized Tasks

Individuals working
side by side

Unit #5 Applications Learning Activity 5.10 (General answer key)

Natural Supports
General Answer Key

Consider the scenario below. As a staff member, consider how you would use aspects of yourself and
structuring of the environment or schedule to serve as a natural support in this situation. Identify how
you would use the following to support Doug based on the information provided.
1. Premack Principle
2. Breaks
3. Customized tasks
4. Individuals working side by side

Case example: Doug is extremely eager to work at the woodshop. He is extremely skilled with his
hands and works tirelessly on the projects he creates. Recently, Doug was offered a job at the local
woodshop after his talents were recognized at a local community craft show. The owner is very
supportive of having Dougs help but cannot devote all of his time monitoring his work. You are
concerned because Doug has a tendency to become overwhelmed when he does not understand what
is required of him or if he is unable to complete a task. When overwhelmed or frustrated, Doug engages
in behaviors such as self-harm, yelling, rocking, and crying. In addition, you are concerned that Doug
will be late every morning because of his refusal to complete his hygiene routine. As with most jobs,
punctuality and good hygiene is a requirement for the position.

Premack Principle Use to help move the morning routine along. First Shower Then Woodshop. Or First Get
Dressed, Then Breakfast (assuming Doug likes breakfast). Use visual support that has pictures of
him engaged in the workshop r breakfast as a visual reminder of what will happen next.
Breaks Place breaks proactively in his day to prevent getting too stressed or overwhelmed. Make these
frequent enough that he does not need to escalate before the break occurs. As he becomes more
comfortable, the breaks may not need to be as frequent or could be shortened.
Customized Tasks Provide specific directions of what he is to do at the woodshop. Give him a visual schedule that
breaks down the day with each activity. Provide an area that is set up with the specific materials he
needs. He can do the same tasks each day as part of his routines, which can add familiarity. When
new tasks are added, there is a routine in which to teach the new tasks. If there are tasks that are
more difficult, consider the use of a jig that helps Doug remember how to do the task. This might
be a visual model of how to construct an item in order or how many pieces needs to be compiled for
a woodshop project.
Individuals Select a co-worker that shows an interest in Doug to be a mentor. Facilitate interaction with co-
working side by worker and model how to communicate and socialize with Doug. Have the co-worker work close to
side where Dougs space is located so he is able to model how to do jobs. When Doug is unsure, he can
observe his mentor or possibly go to this person for a brief question. As Doug becomes more
comfortable and confident, he will likely not need as much support and will not become
overwhelmed as easily.
These are general ideas. Participants may have additional or creative ideas as well.


OCALI Self-Check

Instructions: Using the OCALI Self-Check provided on the following page, rate yourself
confidentially.

After completing the survey, select 2-3 items that you believe are your personal strength areas
and 2-3 items that you want to focus on and improve.

You may share your results if you wish; however, this is not meant as a group activity.

Characteristics and Qualities of an Effective Support
Person for Individuals with ASD: A Self-Check
High-quality support personnel have a specific set of beliefs and values and exhibit behaviors
consistent with these beliefs. These qualities, when actualized, can improve meaningful interactions,
facilitate positive behaviors, and promote self-confidence for individuals with ASD.
Rating Key
1: Almost never 2. Not very often 3: Sometimes 4: Usually 5: Almost always
(0-10% of the time) (10-30% of the time) (30-60% of the time) (60%-90% of the time) (90%-100% of the time)
Self-Check Questions: Beliefs and Values Rating
1. I believe that the individual that I support deserves the same level of dignity and 1 2 3 4 5
respect that I expect for myself.
2. I believe that the person I support has talent and potential regardless of diagnosis. 1 2 3 4 5
3. I show respect of the choices and preferences of the person/people I support by 1 2 3 4 5

attempting to honor those choice as much as possible.
4. I value the information and ideas that the person I support is sharing, offering, or 1 2 3 4 5
communicating to me.
5. I believe that when the person I support engages in what is often described as 1 2 3 4 5
behavior, he is trying to convey a message that he is unable to communicate in other
ways.
6. I believe in a positive support system and believe that using punishment is not 1 2 3 4 5
respectful and does not teach needed skills.
7. I believe that when the person I support experiences failures and engage in 1 2 3 4 5
challenging behaviors, the program has failed, not the person it is designed to support.
8. I understand that my role is to encourage, advocate for, and work alongside the 1 2 3 4 5
person/people I support and not to direct or manage.
9. As a support person, I do NOT have to be in control. 1 2 3 4 5
10. I believe that it is important for the person I support to connect socially and that she 1 2 3 4 5
wants to have friends but that she may not understand how to make the connections
or that others may misinterpret her attempts to do so.
Rating Key
1: Almost never 2. Not very often 3: Sometimes 4: Usually 5: Almost always
(0-10% of the time) (10-30% of the time) (30-60% of the time) (60%-90% of the time) (90%-100% of the time)
Self-Check Questions: Personal Actions Rating
11. I show dignity and respect to the individual I support. 1 2 3 4 5
12. I understand the underlying characteristics of ASD and use this knowledge to help me 1 2 3 4 5
create supports and to assist me in understanding behaviors that might occur.
13. I actively seek out ways to use or embed the persons interest, desires, and preferences 1 2 3 4 5
in daily activities.
14. I listen to and try to understand what the person I am supporting is communicating to 1 2 3 4 5
me.
15. I seek out opportunities and activities that the person I support can complete 1 2 3 4 5
independently.
16. I make available communication supports that the person I support can use to tell me 1 2 3 4 5
information or make requests.
17. I use/make available communication tools to ensure the person I support understands 1 2 3 4 5
what others are communicating.
18. I monitor and pace my language. I use clear, concrete language in an effort to 1 2 3 4 5
communicate clearly with the person/people I support.
19. I am comfortable being quiet and know that sometimes it is necessary. 1 2 3 4 5
20. I provide predictability in the daily schedule and in the environment. 1 2 3 4 5
21. I can wait patiently when someone is not ready to transition or needs more time, even 1 2 3 4 5
if it means that I must change my plans.
22. When a situation becomes difficult or the person I support is not successful, I change 1 2 3 4 5
the way I interact or change the way I am providing support.
23. I take into consideration sensory challenges and sensitivities when the person I support 1 2 3 4 5
seems upset, withdrawn, in pain or is exhibiting other unusual behavior.

Unit #5 Applications Learning Activity 5.12 (Shopping)

Case Studies: Shopping

Instructions: Work in small groups as instructed by the trainer. Use the 4 case studies and 4 blank
copies of the CAPS-6 Minute Brief provided in the pages that follow.

As a staff member, you have the responsibility of preparing Martin to go grocery shopping to purchase
a few items. Using the information you have from the Learner Snapshot provided, create plan for him
using the CAPS-6 Minute Brief.

Martin: Shopping
Disabilities: Autism-A disorder resulting in impairments in communication and social interaction,
with markedly restricted patterns of behavior and interests
Family Dynamics: Martin is kind, cooperative, and gentle. He lives a residential facility. He is extremely
fond of his brother and looks forward to their weekly visits. He works at a local factory assembling small
mechanical parts.
Learns Best: Martin is a visual learner. He learns well when tasks are modeled for him. He does well
when clear, explicit instructions are provided. He uses a language board to communicate with others.
Strengths: Gentle, polite, cooperative, responds well to direct instructions, enjoys a wide range of
activities, responds well to structure and is very organized.
Challenges: Functioning during unstructured activities, ambiguous situations or too many choices,
poor problem solving skills, adjusting to changes in routine or schedule, difficulty with new people
Things that upset: Changes to schedule or routine, loud noises, commotion or large crowds
Signs of being upset: Rocks back and forth, stares out the window, whimpers or moans, rocks back and
forth, despondence or inactivity, rigidity
Motivators and preferences: Walking the grounds, listening to music, watching the Discovery channel,
working on birdhouses, visits with his brother
Calming/Soothing Techniques: Using soft gentle tones, listening to Celine Dion songs, removal from
loud or chaotic environments, taking a walk outdoors or in an area with limited noise and commotion
General modifications: Visual and sensory supports, providing clear directions, number steps to tasks,
provide verbal and visual instructions, use of calendar and daily schedule, use of language board,
provide multiple opportunities to practice task or skills, prepare one week in advance for changes in
schedule or routine, limit choices

Unit #5 Applications Learning Activity 5.12 (Recreation)

Case Studies: Recreation

Instructions: As a staff member, you have the responsibility of preparing Jamilla for a picnic with a
group of same aged peers. Using the information you have from the Learner Snapshot provided, create
plan for her using the CAPS-6 Minute Brief.

Name: Jamilla 23 year-old female
Disabilities: Autism: A disorder resulting in impairments in communication and social interaction,
Medical: strong allergic reaction to peanuts and beestings (carries epi-pen)
Family Dynamics: Jamilla is kind and energetic. She is quite curious and exploratory. She has just
recently been placed in a residential living situation because her needs exceed that of which her mother
can provide. Her family consists of her 2 parents and 2 younger siblings. Her mother visits daily and the
entire family visits on Sundays.
Learns Best: Jamilla responds well to structure and explicit instructions. Visual supports and a variety
of prompts are necessary. Her daily schedule needs to be carefully planned and organized, as she gets
bored easily with monotonous tasks that do not involve movement. She enjoys physical activity and
loves being outdoors. Boundary markers are helpful in managing her curiosity and avoiding areas that
may be dangerous.
Special Interests: Jamilla loves the outdoors and engaging in games and tasks that require movement.
She loves bike riding and hiking.
Strengths: Jamilla is very curious. She is friendly and energetic. She gets along well with others.
Challenges: Jamilla has the tendency to wander. She often does not understand her own boundaries
and the precautions she needs to take with regards to her allergies. Her receptive language skills are
poor and she has troubling retaining information for very long. She becomes interested and fixated on
almost anything that catches her eye outdoors. She needs significant structure and one on one support
to assist her in new settings as well as for most tasks and activities.
Things that upset: Telling her no or redirecting her without replacement of a particular interest or
activity, transitioning between activities, stopping one activity and beginning another, too much
commotion or activity (overstimulation)
Signs of being upset: Motor agitation, rapid shifts in mood and affect, rejecting alternative options,
self injury (hitting head, picking at skin on arms and face)
Motivators and preferences: Movement, physical activity/games, bike riding, visits with her mother,
citrus fruit (oranges are her favorite), blowing bubbles (use as distracter to transition from one activity
to the next)
Calming/Soothing Techniques: Movement, push-ups, walks, use of a weighted blanket, use of a
therapy ball
General modifications: Frequent reminders (countdowns to transitions), one on one assistance in less
structure settings, creating boundary markers, use timers to count down time left from one activity to
the next.

Unit #5 Applications Learning Activity 5.12 (Transportation)

Case Studies: Transportation

Instructions: As a staff member, you have the responsibility of preparing Liam to begin to take the bus
to his job. He works at a dog shelter 3 days a week. Using the information you have from the Learner
Snapshot provided, create plan for her using the CAPS-6 Minute Brief.

Name: Liam 35 year-old male
Medical: Asthma (uses inhaler)
Family Dynamics: Liam is a motivated and driven man. He has lived in a residential setting for the past
18 years. He is verbal but uses brief phrases to communicate. He struggles with receptive language and
will sometimes indicate that he understands when he does not. He works at the local animal shelter
helping exercise dogs and clean kennels. He is quite sensitive to certain odors and uses a medical grade
mask, as needed. His parents visit him every Monday and take him out to his favorite restaurant if he
has met his weekly goal. (Liam has yet to miss his weekly goal).
Learns Best: Liam thrives on clear and explicit instruction. He needs models and multiple
opportunities to practice with corrective feedback in order to achieving mastery. Tasks need to be
broken down by steps and rehearsed regularly. He also requires gestural prompts, but does not like
being told what to do. He responds well to verbal reinforcement (good job!) and a check mark after
every step completed successfully.
Special Interests: Dogs, working at the dog shelter, completing crossword puzzles, being helpful
particularity if working with his hands and back (breaking down boxes)
Strengths: Hard-worker, responds well verbal and visual forms of reinforcement, highly motivated, will
try new things, eager to please others, strong relationship with his family, dependable.
Challenges: Functioning during unstructured activities/tasks, can become over-stimulated by sounds
and smells, transitioning from one activity to the next, strives for perfection
Things that upset: Changes to schedule or routine, strong and unfamiliar odors
Signs of being upset: Rocks back and forth, whimpers or moans, rocks back and forth, becomes rigid,
paces
Motivators and preferences: Work tasks that involved the use of his back and arms, crossword puzzles,
Wii system games, weekly dinners with his family, going to work at the dog shelter
Calming/Soothing Techniques: Using soft gentle tones, removal from loud or chaotic environments,
engaging in physical activity such as sweeping/mopping/shoveling, moving boxes, using his medical
mask,
General modifications: Visual and sensory supports, providing clear directions, number steps to tasks,
provide modeling and multiple opportunities to practice, use of calendar and daily schedule, provide
multiple opportunities to practice task or skills, prepare one week in advance for changes in schedule or
routine, limit choices.

Unit #5 Applications Learning Activity 5.12 (Faith-Based)

Case Studies: Faith-Based

Instructions: As a staff member, you have the responsibility of supporting Dom who enjoys attending
daily mass at a local church. He also likes to pass the collection basket at church. Using the information
you have from the Learner Snapshot provided, create plan for him using the CAPS-6 Minute Brief.

Name: Dom 64 years old
Disabilities: Autism-A disorder resulting in impairments in communication and social interaction,
with markedly restricted patterns of behavior and interests; Generalized Anxiety Disorder- A mental
disorder that is characterized by excessive worry or fear
Medical: Asthma, Chronic constipation and stomach upset (takes medication to manage)
Allergies: Seasonal
Family Dynamics: Dom is a 64 year-old man with ASD. He is non-verbal but can read and write quite
well. He has one sister that visits 2 times a year. These visits are generally upsetting because of poor
planning and preparedness as well as Doms need for strict adherence to his schedule.
Learns Best: Dom thrives on structure and predictability within his daily routine. He relies heavily on
his visual schedule and can communicate using a speech-generating device. He is a visual learner and
does well with new tasks when people show him exactly what it is that he needs to do (modeling). He
also requires gestural prompts.
Special Interests: Music (particularly gospel hymns), watching the dogs at the dog park (from a
distance and will not approach), putting together jigsaw puzzles, reading in his rocking chair, enjoys
reading the newspaper from cover to cover everyday
Strengths: Gentle, cooperative, understands and follows through with his routine with the necessary
supports, picks up on new tasks easily as long as there is a visual model, can take the bus independently
Challenges: Non-verbal, poor problem solving skills, adjusting to changes in routine or schedule,
difficulty with new people, general anxiety, needs things to be predictable to the minute, details of his
schedule need to be written exactly.
Things that upset: Changes to schedule or routine, easily spooked (does not like things at his back),
difficulty ending activities
Signs of being upset: Yelling, crying, fidgeting
Motivators and preferences: Completing puzzles, Sudoku, walking the therapy dog, reading, going to
mass
Calming/Soothing Techniques: Music, referring him to his schedule when there are changes, going to
his rocking chair, reading
General modifications: Visual and sensory supports, providing clear directions, provide verbal and
visual instructions, use of calendar and daily schedule, limit choices.


Build a Portfolio for an Individual You Support

Directions: Refer to the individual you described in the Learner Snapshot you developed in
Learning Activity 5.2. Select one activity during the individuals day that you think could
benefit from additional structure.

Using the information from the Learner Snapshot you developed in Learning Activity 5.2
complete the following to create a portfolio of supports:

(a) ISA Sensory Scan and Sensory Advocacy Plan

(b) ISA Social Scan and Social Advocacy Plan
(c) CAPS: 6-Minute Brief

(d) Three supports, one of which must address regulation

Unit #5 Applications Learning Activity 5.13a


Instructions: Complete the following Sensory Scan worksheet with an individual you support. You can
Your name: __________________________________________ Date: ________________________
Agency/program/work site/other: _________________________________________________________
Which room or environment will you be scanning?____________________________________________

1. Auditory Scan: Pay attention to the sound in this environment. Which of the following apply to you?
Fill in as many details as you can in the Notes sections.
Notes: Notes:

Notes: Notes:
2. Visual Scan: Pay attention to what you see or how you see in this environment. Which of the
Notes: Notes:
Notes: Notes:

Notes:
3. Olfactory Scan (Smell): Pay attention to the smells in this environment. Which of the following
apply to you? Fill in as many details as you can in the Notes sections.
Notes: Notes:
Notes: Notes:

4. Tactile Scan (Touch/Feel): Pay attention to your reaction to touch or to the things or
people you touch/feel in this environment. Which of the following apply to you? Fill in as many

Notes:
Notes: Notes:
5. Oral/Gustatory Scan: Pay attention to tastes or textures on your tongue in this

environment. Which of the following apply to you? Fill in as many details as you can in the Notes
sections.
Notes:
Other/Notes:
6. Vestibular Scan: Pay attention to how movement affects or doesnt affect you in this
sections.
Notes: Notes:

Notes:
7. Proprioceptive Scan: Pay attention to your experience of your body and the space around
you. Which of the following apply to you? Fill in as many details as you can in the notes sections.

Notes:

Notes:

Notes: Notes:
My Top Three Environmental Needs: Choose up to three results from your Sensory Scan
above. You will use these to develop an Advocacy Plan in your Self-Advocacy Portfolio.
1.
2.
3.

Self-Advocacy Portfolio

Sensory Advocacy Plan

My top sensory need:
Need
What is my sensory goal?

ISA Sensory Plan
Can I address my sensory needs independently without a script? If so how?

(For example, do you need spend less time in this environment, can you take breaks or do an activity that will help
structure your experience more?
Do I need someone to support me, a translator or mentor? If so, how?

(You might want to practice your plan first, ask someone to accompany you, or follow up with a mentor after you have
executed your Advocacy Plan.)

1-Poorly
2- OK
3- Great
Valerie Paradiz, LLC 2012 Integrated Self Advocacy ISA ISA Social Scan

Unit #5 Applications Learning Activity 5.13b

Instructions: Complete the following Social Scan worksheet with an individual you support. You can


Your name: Date:
The Social Scan
Number:
Notes:
Notes:
Other.
Notes:

1 2 3 4
Notes:
Notes:

Notes:
Notes:
Notes:
Other
Notes:

1 2 3 4
Notes:

Notes:

1 2 3 4

Notes:

Notes:

Notes:

Notes:
Other
Notes:

1 2 3 4


Notes:

Notes:

Notes:

Notes:
Other
Notes:

1 2 3 4

Notes:
Notes:

Notes:
Other
Notes:
1 2 3 4

The ISA Social Scan is used with permission by Valerie Paradiz, LLC.

Self- Advocacy Portfolio
Social Advocacy Plan

My social discomforts and tendencies:
1.
2.
3.
Can I address my social needs on my own? If so how?

(For example, do you need spend less time in this environment, can you take breaks or do an activity
that will help structure your experience more?
1.
2.
3.
If I cant address my social needs on my own, what is my advocacy goal?

ISA Social Scan
1.
2.
3.
1. YES NO
2. YES NO
3. YES NO
Do I need someone to support me? If so, how?
(You might want to practice your plan first, ask someone to accompany you, or follow up with a mentor
after you have executed your Advocacy Plan.)
1. YES NO
2. YES NO
3. YES NO

1 2 3 4
Unbearable Uncomfortable Not a problem Comfortable!
Valerie Paradiz 2011 Integrated Self Advocacy ISA The ISA Social Scan for FBA/BIP

Unit #5 Applications Learning Activity 5.13c

Use the CAPS 6-Minute Brief form on the next page.

Comprehensive Autism Planning System (CAPS)
6-Minute Brief
Name: ________________________
Support Network Contact: Name: _______________ Phone: _________ Date: ________
Activity/Task/Job: ________________________________
Training Needs or Reinforcement to Social and Sensory/Biological Environmental Suggested

Supports for Skills of Include in Communication Considerations and Modifications and Natural Supports
this Activity/Task Activity/ Task Needs and Supports Supports Supports Used
Modified by Chris Filler with permission from:

Henry, S. A., & Myles, B. S. (2007). Integrating best practices throughout the students daily schedule: The Comprehensive Autism Planning System (CAPS)
for individuals with Asperger Syndrome, autism and related disabilities. Shawnee Mission, KS: Autism Asperger Publishing Company.

Unit #5 Applications Learning Activity 5.13d

Three Supports

*At least one support must address regulation.
Support What It Addresses Strategies/Implementation Notes

#1

#2

#3

Unit #6 Citizenship and Community Life Homework 6.1 (Employee)

Considering Focused Interests

Instructions: Read the brief description of Jose and answer the questions below.

Brief Description
Jose is 25 years old.
He loves baseball, especially sharing stats and historical facts with others.
The support workers in his group home sometimes ask him to not talk about baseball
all the time.
Jose has never been to a ball park because he cannot tolerate loud crowds
Jose visited a ball park in his city during off hours and participated in a tour of the park
with a small group of fans
Jose knew many facts about his home team, which made the tour guide and other
participants happy
Jose stayed after the tour of the ball park and swapped facts with the tour guide
The tour guide enjoyed Joses enthusiasm and attention to facts about the park

Questions to Answer
1. How might Joses passion for baseball lead to a job?

2. How can Joes interest in baseball be used to help him develop work skills?

3. What can group home staff do during the regular course of the day to help Joe develop
skills using his interest in baseball?

Unit #6 Citizenship and Community Life Activity 6.2 (Employee)

CAPS 6-Minute Brief: George

Instructions: Create a CAPS 6-Minute Brief for George that will help him start his day in a
positive manner and distress after work. Use the template on the following page. What types
of supports would you consider to help George start his day positively and de-stress at the end
of the day?

You may work alone or in a group
Brainstorm quickly as many ideas as possible.
Be prepared to review your ideas with the large group.

Brief Description:
George is a 30-year-old man with classic autism who lives in a group home with several
men
George has limited verbal ability, but does choose to use his words to communicate
He is a visual learner and people that know him realize that when given information visually
(such as pictures and simple words) he understands much better
George likes routine in his day and has difficulty when the routine is changed unexpectedly.
As far as things that he enjoys, George likes TV, especially shows that have to do with
trains, airplanes or any kind of transportation. In fact he is drawn to books, games, pictures
and other items or activities that include transportation.
George is relatively healthy. He has few ongoing health issues, except he can have trouble
maintaining his blood sugar level. It seems to drop quickly when he needs to eat and can
cause him to have headaches, become shaky and weak.
George works in the community 4 days a week in a small retail store
He does not mind going to work; he just has difficulty moving though the morning
activities at a pace that will allow him not to be rushed. When he is rushed, it throws his day
off and he has a more difficult day at work
The job is well suited to his skills and interest; however, even a normal day of social
interaction and mild sensory challenges can cause stress to build. Light and sounds seem to
especially cause sensory deregulation.
By the end of the day George has difficulty coping with even small issues



6-Minute Brief
Name: ________________________




Example of George CAPS 6-Minute Brief

Unit #6 Citizenship and Community Life Learning Activity 6.3 (Volunteer)

Volunteering in the Community

Instructions: Pia is a 51-year-old woman with ASD. She is very interested in flowers and gardening. The
local Chamber of Commerce is looking for assistance with planting and weeding. Use the information
provided to create a CAPS-6 Minute Brief. A template for the brief is provided on the following page.

Medical: Arthritis
Family Dynamics: Pia is quiet, shy and gentle. Her primary language is Filipino and her secondary
language is English. Her receptive language is quiet good but she is communicates infrequently only
using one or two words to express herself. She primarily relies on a Picture Exchange Communication
System (PECS, Bondy & Frost, 2011) binder that has been created for her. She will often avoid
communicating her needs and often wait until someone engages her as opposed to initiating. A timer
and a written schedule are helpful to her to anticipate possible needs or transition periods, such as
meals and using the restroom.
Learns Best: Pia functions well with written schedules. She does best when her own schedule is written
in her language. She thrives on a predictable routine. Timers have been helpful in alerting her when it is
time to s use the restroom, get a drink, eat lunch, etc.
Special Interests: Gardening, birds, flowers, crossword puzzles, reading (books in Filipino), listening to
books on tape (especially in Filipino), crochet
Strengths: Gentle, polite, cooperative, responds well to direct instructions, responds well to structure,
level of independence increases as structure and predictability increase
Challenges: She struggles to communicate her wants and needs when in new settings, she often relies
on prompts to perform some basic functions such as taking a bathroom break or stopping for lunch, she
uses her PECS book in the residential facility but seems hesitant to use it in other settings, difficulty
transitioning from one setting to the next due to fixated interests
Signs of being upset: despondence or inactivity, rigidity, confusion, inconsistency in schedule or
routine
Calming/Soothing Techniques: Using soft gentle tones, removal from loud or chaotic environments,
calms with the sound of running water, nature sounds CD
General modifications: Visual and sensory supports, providing clear directions, provide verbal and
visual instructions, use of calendar and daily schedule, use of PECS to communicate, provide
communication in Filipino as much as possible



6-Minute Brief
Name: ________________________




Example CAPS 6-Minute Brief
Pia: Volunteering

Comprehensive Autism Planning System (CAPS)- 6 Minute Brief
Name: Pia
Support Contact Name: Sam B. Phone: 614-555-5555 Date: 3/5/12
Activity/Task/Job: Volunteer work- Gardening

Training Needs Reinforcement to Social and Sensory/ Environmental Suggested
or Supports for Include in Communication Biological Modifications Natural Supports
this Activity or Task Needs and Considerations and Supports
Task/Activity Supports and Supports Used

-Provide -Gardening -Uses PECS -Arthritis -Use of timer -Identify and
written steps serves as a book (In hands and to signal recruit an
to each natural knees) bathroom and individual at
gardening reinforcement -Needs requires meal breaks Chamber to
task for Pia prompts for regular be her point
bathroom and breaks -Use person
-Use -Allow Pia to meal breaks (One break boundary
boundary take some every 45 markers to -Check-in on
markers to flowers back minutes) signal area Pia every 45
identify what to the that she minutes
to plant residence to should work
where assist with within -Require Pia
transitions to take a
-Any written -If upset, have bathroom
instructions her water break at least
should be flowers- the 1 time in a 3
reviewed sounds are hour period
ahead of time soothing
and possibly
translated
into Filipino

Unit #6 Citizenship and Community Life Learning Activity 6.4 (Consumer/Customer)

Consumer/Customer

Directions: Review the Consumer Role Issues or Concerns on the previous slide.
Understanding the Hidden Curriculums of different places of business and how this
may not be same
Being taken advantage of, seen as easy mark
Managing money/credit cards in stores
Dis-regulation and explaining need for assistance

In light of these issues and others discussed, what additional strategies/interventions could one
add to the staff Getting Ready Routines in relation to the role of the consumer/customer?

Consumer Role Concern Strategies/Interventions for Staff Getting Ready Routines
or Issue
1. Understanding the
Hidden Curriculums of
different business and
how may not be same
2. Being taken advantage
of, seen as easy mark

3. Managing money/credit
cards in stores

4. Dis-regulation and
explaining need for
assistance

5.

6.

Unit #6 Citizenship and Community Life Learning Activity 6.4 (Consumer/Customer)

Consumer/Customer
Answer Key

Directions: Review the Consumer Role Issues or Concerns on the previous slide.
Understanding the Hidden Curriculums of different places of business and how this may not
be same
Being taken advantage of, seen as easy mark
Managing money/credit cards in stores
Dis-regulation and explaining need for assistance

In light of these issues and others discussed, what additional strategies/interventions could one add to
the staff Getting Ready Routines in relation to the role of the consumer/customer?
Consumer Role Concern Strategies/Interventions for Staff Getting Ready Routines
or Issue
1. Understanding the 1. Social Narratives
Hidden Curriculums of 2. Video Narratives and Examples
different business and 3. Role Play
how may not be same
2. Being taken advantage 1. Rules for Relationship (strangers vs. close friends)
of, seen as easy mark 2. Social Instruction regarding trusting others
3. Possibly the use of a 5 Point Scale regarding how to react to others
3. Managing money/credit 1. Providing an organizational tool that holds items securely
cards in stores 2. Subtle cues to remind how to manage money
3. Role play/practice in home, then at a small familiar store and then

generalize

4. Dis-regulation and 1. Preplan where and how to de-stress in a community setting before the
explaining need for need.
assistance 2. Prime the person prior to entering the community location as to what
they can do

3. Cue cards to remember
4. Create, review and practice a 5 Point scale
5.
6.

Unit #6 Citizenship and Community Life Learning Activity 6.5 (Civic Role)

Civic Group Member
Directions:
1. Think about the community in which you provide support for individuals with autism and
others. Brainstorm all of the organizations that might be possible locations for membership
and work as a community person in a civic role. Write these on the worksheet.
2. Highlight 2 or 3 that you believe might be the most supportive groups for individuals with
ASD.
3. Explain briefly why these groups were at the top of your list.

Organizations For Membership And Work As A Community Person In A Civic Role
1. 2.
3. 4.
5. 6.
7. 8.
9. 10.
11. 12.
13. 14.
15. 16.
17. 18.
19. 20.
Top Two or Three Organizations for Explain the features of these organizations/reasons
Membership/Participation by Individuals with ASD these organization are your top choices.

Unit #6 Citizenship and Community Life Learning Activity 6.6 (Global Supports)

Additional Global Community Supports

Directions: What additional ideas do you have that would be ways for the residential support person to
participate in supporting the community to better include individuals with ASD?
Discuss these with your group or with another individual.
Record a few ideas below

Activities, Strategies and Actions that a Residential Support Person may use to Influence
General Community Awareness and Community Support of Individuals with ASD
1.

2.

3.

4.

5.

Unit #6 Citizenship and Community Life Learning Activity 6.7a (Advocate)

Advocacy and Self-Advocacy

Instructions: Interview your partner regarding their experience in advocacy. Inquire and record
information about 2 instances:

(1) where he or she had to advocate on their own behalf and

(2) when he or she advocated on behalf of someone else or a particular issue.

Be sure to get details related to:
when and where they had to advocate
why they felt they had to advocate
how they felt before, during, and after the process
how they went about the process
how successful they were and what they would do differently in the future.

Now proceed to Learning Activity 6.7b on the next page.

Unit #6 Citizenship and Community Life Learning Activity 6.7b (Advocate)

Your Self-Advocacy Experience and Supporting the Emerging Self-Advocate

Instructions: Next, consider your self-advocacy experience from 6.2a above.
Can you break the experience down into the three steps? Have you ever supported an
individual in advocating for him or herself? Can you recognize the steps from that experience
too?

Self-Advocacy Steps Your Experience
1. Self-Awareness

2. Disclosure & Advocacy Plan

3. Implementation

Unit #6 Citizenship and Community Life Homework 6.1 (Advocate)

Supporting Self-Advocacy

Instructions: Go back to the ISA Sensory Scan or the ISA Social Scan that you completed
in units 3-5 (with a person you support). Choose one item of sensory or social need, preference
or discomfort that was identified in a Scan, and support the individual in creating an advocacy
plan. Use the chart below to map out the three steps of the plan.

Self-Advocacy Steps Your Experience
1. Self-Awareness

2. Disclosure & Advocacy Plan

3. Implementation

Unit #7 Sexuality Learning Activity 7.1

Myths and Truths

1. In small groups, discuss statements the statements below. What is true? What is not? Why do you
think people may believe those statements that are false? Make a few notes on this worksheet if you
like.

2. In the large group, provide feedback on your small group discussion about either agreement or
disagreement with statements.

Statements to Consider

Autistic adults are not interested in sex

Autistic adults are hyper-sexual

Autistic adults do not have the capacity to participate in sexual behavior

Autistic adults are not motivated enough to engage in romantic and sexual activity

Autistic adults are not able to experience emotional and physical intimacy

Autistic adults are all heterosexual


Understanding Concepts of Public and Private

Instructions: Discuss the following questions in a small group or simply consider these to yourself.
Make notes to help you add to the group discussion that will follow.

1. What specific requirements of your support role could require close physical or visual contact and
possibly increase confusion about privacy?

2. Do you, or did you, ever feel uncomfortable or concerned?


Supporting Self Determination

1. How do you support an individual's ability to be self-determined?

In his/her daily life?

In his/her social life?

In community participation?

2. Brainstorm additional ways in which you could extend your support.


Social Competence: Defining Normal

If normal is defined as what is expected, and if you do not know
what is expected, you could be making mistakes and never realize it!

Consider this statement for a minute. Next, work in small groups or in pairs and discuss the following
questions. Use the worksheet for notes to share in the large group.

1. Discuss a time when this may have applied to you.
2. How did you feel when you finally realized this?
3. Did anyone help you or did you just need to figure it out?
4. What would you have liked to happen instead?

Question Notes
1.Discuss a time when this may have
applied to you.

2.How did you feel when you finally
realized this?

3. Did anyone help you or did you just
need to figure it out?

4. What would you have liked to happen
instead?


Task Analysis for Social Competence
Part 1

1. Select one of the following scenarios.
2. Complete a task analysis of the situation.
3. Include the specific steps and the knowledge required to successfully navigate the situation

Scenario One: Eating in a restaurant with friends
Scenario Two: Watching a movie in a theater with friend(s)
Scenario Three: Asking someone for a date for the first time

1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.

Unit #7 Sexuality Handout 7.1

Social Narrative on Kissing

KISSING - When one person's lips touch another persons lips. Kissing is something people like
to do when they have feelings for each other. It is basically when people press their lips
together. More can be done in kissing, such as the use of tongue. The feelings that are present
when people kiss can be different every time. I suggest that if you want to kiss a girl, you
prepare yourself and go over the situation first in your mind. If you and the person you want to
kiss are together as a dating couple, then it is probably appropriate. If you are not together, it is
inappropriate to kiss if the person doesn't feel the same way. You can never just go up to
someone and kiss without warning, because not only is that scary to the person you kissed, it is
also socially unacceptable. In fact, it can be illegal because it can be seen as harassment.

Asperger Download: A Guide to Help Teenage Males with Asperger Syndrome
Trouble-Shoot Life's Challenges by Josie and Damian Santomauro


Task Analysis
Part 2

1. Select one or two steps from the list of steps that you identified for Learning Activity 7.5.

2. Write the step(s) here:

3. Outline, describe, or sketch a visual tool or support that can be used to teach or support the
individual to be successful in learning and using the skills necessary to complete the step.

Unit #7 Sexuality Handout 7.2a

CAPS 6-Minute Brief
Case Study: Sarah

Sarah is a young woman diagnosed with high functioning (HF) autism. She has recently been
introduced to Paul, another HF individual with ASD. Paul and Sarah have had several
conversations and enjoy each others company in brief meetings in the community. Paul has
asked Sarah on a date to a video arcade facility where he and a group of individuals with ASD
meet and play games and have snacks or a meal. Sarah has never been out with this group or
with Paul. The group includes two facilitators that accompany the group, however only sit in
the snack bar to be available if any of the group should need them for help. Sarah is nervous
about the date but wants to go. Her support team would like to create a 6-Minute CAPS to
provide to the group facilitators to help them support Sarah to be successful.

6-Minute Brief

Name: ___Sarah_________________________________________________________________________________________________________________________________________________________________
Support Network Contact: Name: ___Josie________________________ Phone: ____234-3456__________________________ Date:__July 9, 2012_________________________________

Activity/Task/Job: ___Date with Paul _______________________________________________________________________________________________________________________________________

Supports for Skills Include in Communication Considerations and Modifications and Natural Supports
of this Activity/Task Activity/ Task Needs and Supports Supports Supports Used
- Sarah needs to learn - 5 Point Scale to help - Sarah can become - Taking a break to - Supports will be the
how to read and - Sarah is very teach and remind Sarah easily overwhelmed leave the group facilitators.
respond to social motivated for this different levels of in a situation such as overwhelming
situations that could date to be a success! relationships. Have the arcade. Especially situation. - They are available at
become unsafe or be available for support with the social the snack bar area
considered staff to use with Sarah demands of the date. throughout the
inappropriate for the Use 5-point scale to evening. Sarah needs
level of relationship - Reviewing public vs. cue her to take a to know these ladies
(i.e. acquaintance vs. private behaviors for break. Break will be and how to find them.
close friend or boy- the date. Include on 5 to excuse herself to
friend) Point Scale the restroom, or to sit - Have facilitator
at the snack bar and periodically scan /
get a drink, or take a walk the arcade for
brief walk outside. Sarah. Use the 5 Point
Scale cues discreetly
should it appear
Sarah needs help
remembering how to
react to situation or
she appears to need
break.

Unit #7 Sexuality Handout 7.2b

CAPS 6-Minute Brief
Case Study: TJ

TJ, a young man diagnosed with classic autism, plans to attend a swim party at the community
fitness facility with a group of his neurotypical peers. He has been to the facility numerous
times and knows some of the staff, but does not know this group of peers. TJs support staff
knows he is very excited to meet new people, but realizes he has great difficulty remembering
how to approach others, how to read situations, and how to regulate his interactions in social
situations. His support team would like to prepare a 6-Minute CAPS for TJ to help him and
support staff at the party to make it a successful event for TJ.

6-Minute Brief

Name: ________TJ______________________________________________________________________________________________________________________

Support Network Contact: Name: ___Carrie_______________________ Phone: _675-3421____________ Date: _ July 1, 2012_______

Activity/Task/Job: _____Swim Party_________________________________________________________________________________________________

Training Needs or Reinforcement Social and Sensory/Biological Environmental Suggested
Supports for Skills to Communication Considerations and Modifications and Natural Supports
of this Activity/Task Include in Needs and Supports Supports Supports Used
Activity/ Task
- Home staff to review - Water is a great - None needed at this - Staff at facility that
- TJ needs to learn - Built into the the public private rules sensory support for time. Environment is is familiar with TJ
and remember how situation. TJ is for changing to swim TJ. Being in water or naturally calming include Mary C. and
to approach other very reinforced by attire, restroom, locker the whirlpool will when using the water Jon R.
(Example: people he the positive room, etc. Cue words for assist him to calm. as a sensory These staff are willing
has just met, friends, interaction he staff at facility is Public break/sensory to use the
people working in the receives when he or Private regulator relationship circles
facility, etc.) and how is successful and public private
to do this in a way - Levels of relationships cues to help TJ be
that is expected for will be reviewed with successful at the
the relationship and visual of circles with party.
situation. outer rings being those
he needs to keep more
formal and close rings
being more informal. Will
carry the visual reminder
with him. Staff at facility
will be given a copy to
help remind him should
they observe TJ making
social mistakes

Unit #8 Safety Learning Activity 8.1

Prepare for Encounters with First Responders

Instructions: Returning to the triad of characteristics you learned about in Unit 1, imagine a
police officer arrives at the home or residence where you support an adult with autism. The
officer asks to question the individual, who was reported by a neighbor. The neighbor spotted
the individualrunning across the front lawn, carrying something and yelling. The neighbor
ran outside to identify the person and discovered that one of his garden gnomes was missing
from the front porch. He thinks the individual stole the gnome.

Considering the triad of characteristics, how would you support the individual while he/she is
being questioned by the police officer? Categorize your supports according to the triad of
characteristics in the chart provided below.

Characteristics Support
Difficulty with Social
Interaction

Impairment in Verbal and
Nonverbal Communication

Restricted and Repetitive
Behavior and Interests

1

Unit #8 Safety Handout 8.1

Individualized Medical Document
A Preview

The Individualized Medical Document will be covered more comprehensively in unit 9. You will
find a copy on the following page. This document summarizes for first responders and medical
staff essential information for emergencies, visits to the doctors office or hospitalization.
Categories included are:

1. Support Contacts
2. Communication Needs and Differences
3. Sensory Needs and Differences
4. Social Needs and Differences
5. Motor/Physical Needs and Differences
6. Behavioral Needs
7. Other Needs
8. Medications
9. Allergies

In unit 9, you will participate in a Learning Activity based upon the Individualized Medical
Document.
2
INDIVIDUALIZED MEDICAL DOCUMENT
NAME: _____________________________________ DATE: __________
SUPPORT CONTACTS
DIAGNOSES
COMMUNICATION
SENSORY
SOCIAL
MOTOR/PHYSICAL
BEHAVIOR
OTHER
MEDICATIONS
ALLERGIES

Unit #8 Safety Homework 8.1

Fire and Burn Prevention at Home

View the Safe Signals video produced by the Ohio State University Medical Center. The URL
to the video is:

http://www.youtube.com/watch?v=20qG5ojW4z0

After viewing the video, how do you feel can you increase fire and burn prevention for an
individual in the setting where you provide support? Create or provide 1) an example of a
sensory support, 2) an example of a visual support, 3) an example of a communication support
and 4) one task analysis.

1. Sensory Support

2. Visual Support

3. Communication Support

4. Task Analysis
3

Unit #9 Health and Wellness Handout 9.1


A full template for creating an Individualized Medical Document, as discussed in this unit, can
be found in the pages that follow.

INDIVIDUALIZED MEDICAL DOCUMENT
NAME: _____________________________________ DATE: __________
SUPPORT CONTACTS
DIAGNOSES
COMMUNICATION
SENSORY
SOCIAL
MOTOR/PHYSICAL
BEHAVIOR
OTHER
MEDICATIONS
ALLERGIES

Unit #9 Health and Wellness Learning Activity 9.1

Fitness as Routine

1. On your own, list all the fitness activities you have participated in during the past 6 months.

How many are routine?
How many are incidental?

2. Work in small groups and brainstorm a variety of activities that promote fitness, based on
the personal list you have developed.

3. Use the Internet to identify fitness opportunities in your community.

Categorize by type of activity
List agency, address, phone, website, cost for participation
Add pictures if possible

4. Identify fitness activities from this list that the people you support may be interested in
doing. Add additional fitness activities to the list that may be related to interests of the people
you work with. Be creative! For example, a person who enjoys animals may offer to regularly
walk a neighbors dog.

Agency Address Phone Web Site Cost to Comments
Name participate

Unit #9 Health and Wellness Learning Activity 9.2a

Using ISA Sensory and Social Scans in Fitness Contexts
1. Divide into small groups with an assigned context.
2. Use the ISA Sensory Scan and the ISA Social Scan to identify possible sensory issues in
that context, and document these issues in Table 1. Scans are available on the following
pages.
3. Share your findings with the other groups.
4. Discuss and list strategies in Table 2 to address some of the identified issues
Table 1
Context The ISA Sensory Scan The ISA Social Scan

Hiking trail in the woods
Public pool
Community health club
with exercise equipment
Ropes course on a college
campus
Outdoor basketball court
in a public park
Indoor track at the local
YMCA
Community yoga class

Table 2
Context Sensory Strategies Social Strategies
Hiking trail in the woods
Public pool
Community health club
with exercise equipment
Ropes course on a college
campus
Outdoor basketball court
in a public park
Indoor track at the local
YMCA
Community yoga class

Unit #9 Health and Wellness Learning Activity 9.2a

Your name: __________________________________________ Date: ________________________
Agency/program/work site/other: _________________________________________________________
Which room or environment will you be scanning?____________________________________________

1. Auditory Scan: Pay attention to the sound in this environment. Which of the following apply to you?
Fill in as many details as you can in the Notes sections.
Notes: Notes:

Notes: Notes:
2. Visual Scan: Pay attention to what you see or how you see in this environment. Which of the
Notes: Notes:
Notes: Notes:

Notes:
3. Olfactory Scan (Smell): Pay attention to the smells in this environment. Which of the following
apply to you? Fill in as many details as you can in the Notes sections.
Notes: Notes:
Notes: Notes:

4. Tactile Scan (Touch/Feel): Pay attention to your reaction to touch or to the things or
people you touch/feel in this environment. Which of the following apply to you? Fill in as many

Notes:
Notes: Notes:
5. Oral/Gustatory Scan: Pay attention to tastes or textures on your tongue in this

sections.
Notes:
Other/Notes:
6. Vestibular Scan: Pay attention to how movement affects or doesnt affect you in this
sections.
Notes: Notes:

Notes:
7. Proprioceptive Scan: Pay attention to your experience of your body and the space around
you. Which of the following apply to you? Fill in as many details as you can in the notes sections.

Notes:

Notes:

Notes: Notes:
My Top Three Environmental Needs: Choose up to three results from your Sensory Scan
above. You will use these to develop an Advocacy Plan in your Self-Advocacy Portfolio.
1. 2. 3.

Unit #9 Health and Wellness Learning Activity 9.2b


Your name: Date:
The Social Scan
Number:
Notes:
Notes:
Other.
Notes:

1 2 3 4
Notes:
Notes:
Notes:
Notes:

Notes:
Other
Notes:

1 2 3 4
Notes:

Notes:

1 2 3 4

Notes:

Notes:

Notes:

Notes:
Other
Notes:

1 2 3 4

Notes:

Notes:

Notes:

Notes:
Other
Notes:

1 2 3 4

Notes:
Notes:

Notes:
Other
Notes:
1 2 3 4


The ISA Social Scan is used with permission by Valerie Paradiz, LLC.

Unit #9 Health and Wellness Homework 9.1

Fitness as a Routine: Expanded Resource List

Please take some more time to expand upon the fitness resource list that you created in the
learning activity. Use the internet to continue identifying fitness opportunities in your
community. When creating your list use this template as a guide and adapt as needed. Please
make sure you complete your list with the following information:
Categorize by type of activity
List agency, address, phone, website
Find the cost for participation
Include pictures from the various program activities if possible
Label all pictures with the name of the program/activity, if attached separately

Agency Address Phone Web Site Cost to Comments Picture
Name participate


Adding Fruits and Veggies

During meal preparation in the setting where you support an individual, choose 2 items from
the list below to incorporate into planning, cooking and/or eating the meal. Use a visual of the
Healthy Eating Plate to discuss or model serving proportions (50% of the plate).

1. Add fruits in your cereals or pancakes
2. Add vegetables into scrambled eggs or into hash browns
3. Eat fruits and vegetables for snacks
4. Add sliced vegetables on sandwiches
5. Add fruits and vegetables in the salad
6. Place a whole bowl of fruits on the table
7. Eat more than one variety of veggies at dinner
8. Make a smoothie with fruits for snack
9. Add fruits in all desserts
10. Use a salad plate for dinner (the bigger the plate, the more food we pile on to fill the
space)
11. Use a dinner plate for salad (by using larger plates will are more inclined to serve bigger
portions of salad)


Connecting through Cooking

After viewing the video, Connecting through Cooking, plan to make applesauce or another
simple and cheap recipe with the individual(s) you support. Emphasize community
participation and delegate tasks to individual strengths. Prepare and offer supports as needed.
Complete the survey below to help you prepare for a successful time.

1. Do I need to provide a task analysis?
2. Do I need to offer visual supports?
3. Do I need to provide communication supports?
4. Are there movement and motor planning issues that need to be addressed?
5. Are there sensory concerns that can be resolved?

Make sure everyone involved with the preparation has an opportunity to eat the final result,
preferably as a community together at the table.

Unit #9 Health and Wellness Handouts 9.2 and 9.3

CAPS 6-Minute Brief
Examples for Health and Wellness

On the following pages youll find two CAPS 6-Minute Brief Examples

1) Health: Medical Appointment
2) Wellness: Community Exercise

Unit #9 Health and Wellness Learning Activity 9.3

CAPS 6-Minute Brief
Combining Health, Wellness and Nutrition

Instructions: Juan is a 35-year-old man with ASD. He has significant sensory challenges and his
communication is limited. His food interests are narrow, and he is very routine-oriented.
Physically, is underweight and there are concerns regarding nutritional deficits. What
strategies could you implement to encourage and expand Juans diet? Consider sensory, social,
communication, and environmental interventions and supports.

Using the template provided on the following page, create a six-minute brief to outline these
supports.


Developing a Personalized Cookbook

Many individuals on the autism spectrum struggle with specific dietary restrictions that can make meal
preparation and enjoyment of meals a challenge (with or without support from staff/family). A useful
tool for those with food allergies or other conditions requiring special diets can be an personalized
cookbook. The first step in creating a rewarding cookbook is to meet not only the dietary needs of the
individual but to also factor in skill level, preferences, food dislikes, including sensory issues. The
Nutrition Survey Form provided on the following page can help you get started.

Once youve completed the survey, you can begin to collect recipes that match the needs and
preferences of the individual. These can be found easily in cookbooks or online at such web sites as
www.epicurous.com , www.allrecipes.com, or www.food.com. You can also develop recipes from
scratch if youre an experienced cook.

As you compile the recipes for the personalized cookbook, focus on simple recipes that highlight an
easy technique. For example, if you teach an individual the method for cooking a chicken breast, they
can customize it by adding flavors they like and incorporate it into different recipes. When they feel
satisfied with the recipe it can lead to a boost in confidence. Once they get used to making it they can
feel more comfortable in the kitchen, too.

In the following pages, youll see a case study of George, an individual who has high cholesterol. In this
instance, recipes are included in his personalized cookbook that boost fiber content by increasing the
amount of vegetables while reducing the amount of saturated fats from animal products. Also,
recommendations for pairing main dishes with vegetable side dishes to encourage a balanced meal are
included in the cookbook. One of Georges goals is to avoid dairy and red meat, so recipes focus on fish
and chicken as sources of animal protein and include vegetarian protein options as well.

Sometimes it can be useful to rework preexisting recipes to fit an individuals needs. Some recipes only
needed a little change to adjust difficulty level or serving size, while others require more substantial
changes and substitutions of ingredients. It is important to build a recipe book that tailors to the
individuals specific needs. In this case study, George cooks only for himself. Thus, the recipes are in
portion sizes for a single person.

If possible, take a moment to go through the cookbook with the individual to make sure the layout and
instructions are understood.

Be sure to prepare ingredients lists and shopping lists that make it easy for the individual to prepare for
going to the grocery store (with our without support from staff/family). Templates for these are also
provided on the following pages.

Unit #9 Health and Wellness Homework 9.4a

Nutrition Survey Form
Used with Permission by Kelcey Ryan

Complete the following survey based upon self-reported responses by the individual or by
observation of eating habits, preferences and health concerns.

Are there any nutritional needs/goals (weight loss, gluten free, vegetarian, low sodium etc.)
that you wish to address?
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

Do you have any allergies?
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

Please list favorite foods, genres, snacks and/or brand preferences:
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________

Foods you dislike:
_______________________________________________________________________________
_______________________________________________________________________________

Are you open to trying new foods, including genres, fruits or vegetables (provided that they are
not foods you dislike/have an allergy to)?
_______________________________________________________________________________

Unit #9 Health and Wellness Homework 9.4b

Create a Shopping List

After you have compiled a personalized cookbook, create a shopping list that covers items for enough
meals for 1-3 days. Use the template below, categorizing items into staples (which might not need to be
purchased each time the individual shops) and specific items for recipes that arent staple items. This
list can be further refined by marking in the staples section whether that item needs to be purchased on
this trip to the grocery store (yes/no box). You can reproduce this list each time the individual goes
shopping, or transfer it to an erasable white board in the kitchen area. See the following page for an
example shopping list.

Staples Yes No Specific Items Notes

Example Shopping List

Staples Yes No Specific Items Notes
Olive oil X
Salt X
Salmon pound
Onions 2
Lettuce 1 head
Green beans pound
Pancake mix X
Maple syrup X
Butter X
Bacon 1 package
Mayonnaise X
Canned tuna 2 cans

Unit #10 Supporting Transportation Handout 10.1

CAPS 6-Minute Brief
Supporting Transportation: Jon

An example CAPS 6-Minute Brief to support Jon (as shown in the case study in this unit) can be
found on the following page.

Comprehensive Autism Planning System (CAPS)- 6 Minute Brief
Name: Jon
Support Contact Name: Sam B. Phone: 614-555-5555 Date: 3/5/12
Activity/Task/Job: Riding the Subway

Training Needs Reinforcement to Social and Sensory/ Environmental Suggested
or Supports for Include in Communication Biological Modifications Natural Supports
this Activity or Task Needs and Considerations and Supports
Task/Activity Supports and Supports Used

-Create -Arriving at -Written -Ride subway -Script to -Book to read
written script work with low script at off-peak identify on subway
to identify anxiety and time medical and when he
medical ready to work condition and arrives at
condition and -Sit instead request to sit work early
request to sit standing on down
down the subway

-Identify book
to read on the
subway

Unit #10 Supporting Transportation Learning Activity 10.1

Planning Transportation Advocacy
Sensory Self-Advocacy
Used with permission from Valerie Paradiz, LLC

Instructions: You will be using the following tools for this exercise:

1.The ISA Sensory Scan for Transportation
2.My Transportation Advocacy Plan
3.My Advocacy Script

ISA Sensory Scan for Transportation:

1.Consider a transportation setting you have been in and complete a Sensory Scan worksheet
(see the following pages). Settings may involve public transportation or private transportation.
The scan is based upon memory of the event, or upon anticipation of an event (such as getting
to work next week, traveling somewhere by plane, etc.)

2. Transportation Advocacy Plan:

Based upon the results of the scan you have completed, develop an Advocacy Plan, using the
form on the following pages.

3. If your Advocacy Plan requires requesting an accommodation or asking someone for
assistance, turn to the Advocacy Script worksheet on the following pages to create a script to
go with your Advocacy Plan.

4. After completing the ISA Sensory Scan planning series, how might you support an
individual with his/her transportation needs using these tools?

Note: All ISA transportation are used with permission by Valerie Paradiz, LLC. Materials are
presented here primarily in text format. For those who require more visual supports, this can serve
as a starting point for developing advocacy plans and scripts that may or may not involve
language and/or printed text, and might include video, photographic or other types of visual
supports such as cartooning, line drawings, sketches, etc.

The ISA Sensory Scan for Transportation
This worksheet is part of AGI Comprehensive Residential/Daily Living Curriculum. Complete this worksheet with an individual you support through
self-report and/or observation. Then, use the data from this worksheet to make a Transportation Advocacy Plan.
Your name: _________________________________________________________ Date: ______________________________
Program/School: _________________________________________________________________________________________
Which transportation environment will you be scanning? __________________________________________________________

*Note that you can scan specific places, such as inside the transportation vehicle you are taking (bus, subway, light rail, etc.) or outside
the vehicle at a waiting area, such as a bus or subway stop.
1. Auditory Scan: Pay attention to the sound in this environment. Which of the following apply to you? Fill in as many

Notes: Notes:

Notes: Notes:
My auditory comfort level in this setting is (circle one):

1 2 3 4
2. Visual Scan: Pay attention to what you see or how you see in this environment. Which of the following apply
to you? Fill in as many details as you can in the Notes sections.
Light in this environment is too bright or too dim Type of light is distracting or challenging
Notes: Notes:
Angle of light is difficult (from above, below, etc.) Difficulty decoding signs or other visual cues in this
Notes: environment
Notes:
Distracted by things/lights on the wall, on surfaces, Other

Notes:
My visual comfort level in this setting is (circle one):

1 2 3 4
3. Olfactory Scan (Smell): Pay attention to the smells in this environment. Which of the following apply to you? Fill
Smell from objects is distracting, challenging The general smell of the environment is difficult
Notes: Notes:

Notes: Notes:
My olfactory comfort level in this setting is (circle one):

1 2 3 4
Valerie Paradiz, PhD for Autistic Global Initiative 1

4. Tactile Scan (Touch/Feel): Pay attention to your reaction to touch or to the things or people you
touch/feel in this environment. Which of the following apply to you? Fill in as many details as you can in the Notes
sections.
Notes:
Notes: Notes:
My tactile comfort level in this setting is (circle one):

1 2 3 4
5. Vestibular & Proprioceptive (V&P) Scan: Pay attention to how movement and/or the sensation of
your body in the space around you affects or doesnt affect you in this environment. Which of the
Cannot sit for long periods of time Motion in vehicles is disruptive/makes me feel
sick or confused
Notes:
Easily bump into others or the walls/aisles Need to rock, bounce, or press
Notes:
Difficulty using stairs or walking down an incline Other

Notes: Notes:
My V&P comfort level in this setting is (circle one):

1 2 3 4
My Sensory Needs/Tendencies
You will use the results of this questionnaire to create a Transportation Advocacy Plan.
1. Review your Sensory Scan. Which sensory aspects of this transportation setting make you uncomfortable (score of 1 or 2)?
2. Which sensory aspects of this transportation setting are you comfortable with (score of 3 or 4)?
Next, complete a Transportation Advocacy Plan that addresses the items you listed in #1 above.

Integrated Self Advocacy ISA
My Transportation Advocacy Plan
Using the data you collected on your Sensory or Social Scan worksheet, devise an advocacy plan for yourself that will address your sensory or social discomforts or needs. If you need to make
a script to complete your plan, use the Advocacy Script Worksheet. After you have implemented your plan, rate how it went. This form can be completed via self-report and/or observation.
My top Sensory or Social What is my advocacy goal? How will I advocate for myself? Do I need someone to support me, such Implement and
Needs Briefly describe what you wish to as a translator or mentor? If so, how? rate your plan.
Refer to the ISA Sensory accomplish with your advocacy plan. Can I address my sensory or social
and Social Scans and needs independently? If so how? You might want to practice your plan first, How did it go?
record items you scored 1 ask someone to accompany you, or follow
or 2 on below. Or, do I need to develop an up with a mentor after you have executed
advocacy script to make a request your Advocacy Plan.
for an accommodation or other

assistance? If so, complete an
Advocacy Script Worksheet as part
of this Advocacy Plan.
Need 1: 1 poorly
2 OK
3 great
Need 2: 1 poorly
2 Ok
3 great
Need 3: 1 poorly
2 ok
3 great
Valerie Paradiz, PhD for Autistic Global Initiative

ED SELF ADV
R AT OC
EG AC
NT
Y
I ISA Transportation Advocacy Script Worksheet
Your name: ____________________________________________ Date: ____________________________
My Advocacy Goal, Need or Preference
This worksheet is part of the AGI Residential/Daily Living Curriculum. Briefly describe the advocacy goal, need,
or preference for which youll be creating a script. This can be provided in writing below, or it can be developed
in other formats, depending upon your mode of functional communication (AAC device, image based
information, such as photographs or drawings, video, etc.)
Analyze the Context Indicate Your Answers
LOCATION:
Where will you be using this script? What is the
environment like? Public, private? Will you need to
request privacy to implement your script?
WHO?
Who will you be sharing your script with? Is it one
person or more than one person?
DISCLOSURE:
Do you feel you need to self-disclose to reach your
advocacy goal? If you do, will you make a full or partial
disclosure?
OUTCOME:
What outcome do you hope to achieve? What will you
do if the outcome is different from what you expected?
SUPPORT:
Will you ask a translator, mentor or support person to be
present when you use your advocacy script? Will you
ask that person to follow up with you after you have
attempted advocating with your script?
ADDITIONAL CONSIDERATIONS:
Add any additional information that isnt covered above
yet is important to using your script.

Illustrate or Write the Script
Use the space provided below (or in an alternative format that works best for you) to illustrate and/or write your advocacy script. Be sure to
write the words and/or include the images (photos, drawings, etc.) you will use when you advocate for your need or preference.

Unit #10 Supporting Transportation Homework 10.1

Planning Transportation Advocacy
Social Self-Advocacy

Instructions: You will be using the following tools for this exercise:

1.The ISA Social Scan for Transportation
2.My Transportation Advocacy Plan
3.My Advocacy Script

ISA Social Scan for Transportation:

1.Consider a transportation setting you have been in and complete a Social Scan worksheet
(see the following pages). Settings may involve public transportation or private transportation.
The scan is based upon memory of the event, or upon anticipation of an event (such as getting
to work next week, traveling somewhere by plane, etc.)

2. Transportation Advocacy Plan:

Based upon the results of the scan you have completed, develop an Advocacy Plan, using the
form on the following pages.

3. If your Advocacy Plan requires requesting an accommodation or asking someone for
assistance, turn to the Advocacy Script worksheet on the following pages to create a script to
go with your Advocacy Plan.

4. After completing the ISA Social Scan planning series, how might you support an individual
with his/her transportation needs using these tools?

Note: All ISA transportation are used with permission by Valerie Paradiz, LLC. Materials are
presented here primarily in text format. For those who require more visual supports, this can serve
as a starting point for developing advocacy plans and scripts that may or may not involve
language and/or printed text, and might include video, photographic or other types of visual
supports such as cartooning, line drawings, sketches, etc.

ISA Social Scan for Public Transportation
This worksheet is part of AGI Comprehensive Residential/Daily Living Curriculum. Complete this worksheet with an individual you support through
self-report and/or observation. Then, use the data from this worksheet to make a Transportation Advocacy Plan.
Your name: _________________________________________________________ Date: ______________________________
Program/School: _________________________________________________________________________________________
Which transportation environment will you be scanning? __________________________________________________________

*Note that you can scan specific places, such as inside the transportation vehicle you are taking (bus, subway, light rail, car, etc.) or
outside the vehicle at a waiting area, such as a bus or subway stop.
1. People: Pay attention to the other passengers and the transportation worker(s) in this setting. Which of the following apply? Fill in
How many passengers are in this setting? If its a large number, give an estimate. Describe how the number of passengers
makes you feel.
Notes:
There are no other passengers in this transportation setting. Describe how this makes you feel.
Notes:
There are passengers I know well here. Describe how this makes you feel.
Notes:
There are passengers I recognize but dont know well here. Describe how this makes you feel.
Notes:
I do not know any of the other passengers here. Describe how this makes you feel.
Notes:
The transportation worker (driver, ticket taker, etc.) is in the area and I am able to communicate with him/her if I need to. Describe
how this makes you feel.
Notes:
I know the transportation worker well. Describe how this makes you feel.
Notes:
I recognize the transportation worker but dont know him/her well. Describe how this makes you feel.
Notes:
Other
Notes:

1 2 3 4
2. Structure & Space: In this transportation setting, pay attention to the structure of the situation. Which of the following apply? Fill in
This is a reserved seat setting.

Notes:
This is an unreserved seat setting.

Notes:
This setting has seating for individuals with disabilities.

Notes:
I am able to locate a seat. I am able to make my way there without assistance.

Notes:

I am not able to locate a seat and/or not able to make my way there without assistance.
Notes:
I feel uncomfortable with the number of people in relation to my location in this setting
Notes:
I feel comfortable with the number of people in relation to my location in this setting.
Notes:
I feel uncomfortable with my location in this setting.

Notes:
I am comfortable with my location in this setting.

Notes:
Other
Notes:

1 2 3 4
3. Content: Pay attention to the content of this transportation environment. Which of the following apply? Fill in as many details as
you can in the Notes sections.
Passengers are interacting with one another.

Notes:
Passengers are not interacting with one another.

Notes:
Sometimes the transportation worker is interacting with one or more passengers.

Notes:
The transportation worker is not interacting with the passengers.

Notes:

Notes:

1 2 3 4
4. Expectations: In this transportation setting, think about what might be expected of you by other passengers or by the
transportation worker. Which of the following apply? Fill in as many details as you can in the Notes sections.
I am expected to be quiet in this setting.

Notes:
I am expected to let the transportation worker know when I need to get off the vehicle.
Notes:

Notes:
Other
Notes:

1 2 3 4


5a. Mood (Transportation): Pay attention to the mood or the emotions of the transportation worker in this setting. Which of the
following apply? Fill in as many details as you can in the Notes sections.
The transportation worker is friendly.

Notes:
The transportation worker is busy or focused on his/her work.

Notes:
The transportation worker is brusque or cranky.

Notes:
The transportation worker is calm.

Notes:
I am not sure what the transportation workers mood is.

Notes:
Other
Notes:

1 2 3 4

5b. Mood (general/other passengers): Pay attention to the mood or the emotions of other passengers in this setting. Fill in as many
One or more passengers are friendly.

Notes:
One or more passengers are busy or focused.

Notes:
One or more people are brusque or cranky.

Note:
One or more passengers are calm.

Notes:
I am not sure what the general mood is.

Notes:
Other
Notes:

1 2 3 4

6. Context Cues/Supports: In this setting, are there any context cues or supports in the environment that help you understand what
to do? Which of the following apply? Fill in as many details as you can in the Notes sections.
There are people here who can help me understand the social situation (such as an interpreter or mentor).
Notes:
There are cues to help me understand how the space is organized or to help me complete tasks.
Notes:
There are cues to help me understand the type of situation to expect or the type of event(s) that will occur.
Notes:
People are acting in a way that helps me know the mood or that helps me know how to act.
Notes:
There are cues in the environment that indicate the expectations or that help me know what to do.
Notes:

Notes:
Other
Notes:
1 2 3 4

You will use the results of this questionnaire to create a Transportation Advocacy Plan.
1. Review your Social Scan. Which social aspects of this transportation setting make you uncomfortable (score of 1 or 2)?
2. Which social aspects of this transportation setting are you comfortable with (score of 3 or 4)?
Next, complete a Transportation Advocacy Plan that addresses the items you listed in #1 above.


Integrated Self Advocacy ISA
Using the data you collected on your Sensory or Social Scan worksheet, devise an advocacy plan for yourself that will address your sensory or social discomforts or needs. If you need to make
a script to complete your plan, use the Advocacy Script Worksheet. After you have implemented your plan, rate how it went. This form can be completed via self-report and/or observation.
My top Sensory or Social What is my advocacy goal? How will I advocate for myself? Do I need someone to support me, such Implement and
Needs Briefly describe what you wish to as a translator or mentor? If so, how? rate your plan.
Refer to the ISA Sensory accomplish with your advocacy plan. Can I address my sensory or social
and Social Scans and needs independently? If so how? You might want to practice your plan first, How did it go?
record items you scored 1 ask someone to accompany you, or follow
or 2 on below. Or, do I need to develop an up with a mentor after you have executed
advocacy script to make a request your Advocacy Plan.
for an accommodation or other

assistance? If so, complete an
Advocacy Script Worksheet as part
of this Advocacy Plan.
Need 1: 1 poorly
2 OK
3 great
Need 2: 1 poorly
2 Ok
3 great
Need 3: 1 poorly
2 ok
3 great
Valerie Paradiz, PhD for Autistic Global Initiative

ED SELF ADV
R AT OC
EG AC
NT
Y
I ISA Transportation Advocacy Script Worksheet
Your name: ____________________________________________ Date: ____________________________
My Advocacy Goal, Need or Preference
This worksheet is part of the AGI Residential/Daily Living Curriculum. Briefly describe the advocacy goal, need,
or preference for which youll be creating a script. This can be provided in writing below, or it can be developed
in other formats, depending upon your mode of functional communication (AAC device, image based
information, such as photographs or drawings, video, etc.)
Analyze the Context Indicate Your Answers
LOCATION:
Where will you be using this script? What is the
environment like? Public, private? Will you need to
request privacy to implement your script?
WHO?
Who will you be sharing your script with? Is it one
person or more than one person?
DISCLOSURE:
Do you feel you need to self-disclose to reach your
advocacy goal? If you do, will you make a full or partial
disclosure?
OUTCOME:
What outcome do you hope to achieve? What will you
do if the outcome is different from what you expected?
SUPPORT:
Will you ask a translator, mentor or support person to be
present when you use your advocacy script? Will you
ask that person to follow up with you after you have
attempted advocating with your script?
ADDITIONAL CONSIDERATIONS:
Add any additional information that isnt covered above
yet is important to using your script.

Illustrate or Write the Script
Use the space provided below (or in an alternative format that works best for you) to illustrate and/or write your advocacy script. Be sure to
write the words and/or include the images (photos, drawings, etc.) you will use when you advocate for your need or preference.


Experience Transit: Taking a Trip

See the following pages for instructions and worksheets for Homework 10.2.


Experience Transit: Taking a Trip
Now its time to do your homework! Take a bus or train trip in your community that would be
similar to a trip for which public transportation would be needed. Select a destination for your
trip either to school, work, or a community event or activity (such as to the store or a holiday
celebration). You may want to take a camera and/or take notes about your journey and to capture
landmarks and notable items along the route. This experience can help you teach others about
traveling independently. Here are the steps that should comprise your trip:
Before you Travel
1) During class, use the internet to find the transit system (A bus or train system) that is
closest to the residence at which you work.
What is the Name of this Transit System? ________________________________
2) On the transit system website, locate the schedule and plan your route. Consider the
following before you travel:
a. What time you have to be at a designated place such as a worksite or school.
_________________________________________
b. What time would you have to leave to ensure you get to the stop on time?
____________________________________________________
c. What kinds of things will you look for on the route to determine its accessibility?
____________________________________________________
d. What factors will help you determine whether your path to the transit stop is safe?
__________________________________________________________
e. When the vehicle approaches, how will you know you are boarding the correct
vehicle?
____________________________________________________________
f. What will you need to pay your fare (e.g., correct change, smart card)?
_____________________________________________________________
2
During your Travel - Traveling on the Vehicle
3). When you board the vehicle (bus or train), how do you pay your fare?
___________________________________________________________
4). What factors influenced your decision regarding where to sit?
___________________________________________________________
5). Were there rules regarding how you should act on the vehicle? How did you learn about these
rules?
Did you eat/drink _____________
Did you yell or play loud music _________
6). How did you know where you should get off of the vehicle?
______________________________________________________________
7). How did you let the driver know where you wanted to get off?
_____________________________________________________________
Back in Classroom
If you are working in a group, share your thoughts and have a discussion with your classmates
regarding:
If you are studying independently, write down the answers to the following:
What surprised you about the trip?
What was the most difficult or challenging part of the trip?
How did your experience help you understand how to help others travel independently?

Unit #10 Supporting Transportation Additional Activities

The following pages contain additional transportation related activities developed by Easter
Seals Project ACTION. You or your team may consider continuing your professional
development by implementing some of these additional tools with/for individuals you support.

Mobility Options for an Individual
This tool will help you think about the various transportation options that might be
available to an individual and includes a chart on which you can record information
about the transportation needs of an individual.
1) Use the information you learned from your exploration of transportation options
through How to Find a Ride (learning activity 10.1) and you recorded on the Mobility
Options for the Community Chart (learning activity 10.2).
2) Before you begin thinking about the transportation needs of a particular individual,
review the completed Mobility Options for an Individual Chart provided as an
example.
3) Use the blank Mobility Options for an Individual Chart to record information about the
specific transportation needs of an individual.
Directions for Using the Chart
The chart has five columns. What follows is a brief description of the information
intended for each column.
Column 1: Providers
The name of each transportation provider who offers service that is usable by
the person needing the trip.
Column 2: Vehicle/Service Access:

A determination regarding whether the person can use the providers service
o If the person needs a lift or ramp, does the provider offer that service;
o If the person needs assistance in identifying when the destination has
been reached, does the provider offer that level of service;
o If the person needs assistance to and from the door of their origin or
destination, does the provider offer this level of service;
o If it is necessary to travel several blocks in order to reach the pick-up
point for the transportation, can the person navigate this trip.
Column 3: Eligibility
Is this person eligible for the service being offered?
Column 4: Availability
Is this option available when and where the person needs it?
Column 5: Cost/Fare
Is the cost of this trip reasonable for the person who needs it?
Review the Sample Mobility Options for an Individual chart to gain a better
understanding of the use of the chart. Then use the blank chart to start recording
information pertinent to a specific person.
Sample Chart - Mobility Options for an Individual
Name: Joe Smith
Vehicle/Service
Providers Eligibility Availability Cost/Fare
Access
Yes/can ride for free Yes/for going to and

Metro Transit using paratransit from work
Yes/for familiar trips pass No/for evening trips Yes/Free
Yes/for limited
Metro Access Yes/for trips to weekend trips Yes/$1.00 per trip is
unfamiliar places Yes No/for evening trips very reasonable
Yes/reasonable for
Yellow Cab Yes/does not need short trips on an
an accessible vehicle Yes Yes/any trip occasional basis
County Senior Bus

No/not eligible
Yes/Group home has

Easter Seals Vans an agreement with Rarely/due to work
Yes ES schedule Yes/free
Good Faith Church

Van No/Does not attend
this church
Volunteer Veterans
Association
No/Not eligible
Mobility Options for an Individual
Name: ______________________________
Vehicle/Service
Providers Eligibility Availability Cost/Fare
Access
Easter Seals Project ACTION is funded through a cooperative agreement with the U.S.
Department of Transportation, Federal Transit Administration, and is administered by
Easter Seals, Inc. This document is disseminated under the sponsorship of ESPA in the
interest of information exchange. Neither Easter Seals nor the U.S. DOT, FTA assumes
liability for its contents or use thereof.
Mobility Options for the Community
This tool will help you think about the various transportation options that might be
available in a community and includes a chart on which you can record information
about transportation services, and their characteristics.
1) Use the information you learned from your exploration of transportation options
through How to Find a Ride (learning activity 10.1).
2) Before you begin thinking about the various transportation options and their
characteristics in a community, review the completed Mobility Options for the
Community Chart provided as an example.
3) Use the blank Mobility Options for the Community Chart to record information about
the characteristics of transportation services across your community.
Directions to use the Mobility Options for the Community Chart

The chart has five columns. What follows is a brief description of the information
intended for each column.
Column 1: Providers
The name of each transportation provider you find who offers some level of
service to the community.
Column 2: Vehicle Access:

The percentage of vehicles that are accessible to people with disabilities, (e.g., lifts,
ramps, securements for mobility devices, audible/visual information about route and
stops).
Column 3: Eligibility
Who is eligible to use the service;
Often restricted to a particular population such as 65 and older, people using
particular service programs, etc.
Column 4: Availability
When is the service available;
Where does it go?
Column 5: Cost/Fare
An estimate of the cost of a ride for a single trip.
Review the Sample Mobility Options for the Community chart to gain a better
understanding of the use of the chart. Then use the blank chart to start recording
information pertinent to your community.
Sample Mobility Options for the Community
Providers Vehicle Access Eligibility Availability Cost/Fare
5:00 AM 7:30 PM
Mon/Fri
10:00 AM 4:30 PM
weekends
Metro Transit For specific routes in
100% Everyone the county $.50 - $1.50
5:30 AM 7:30 PM
Mon/Fri
10:00 AM 4:30 PM
People with weekends
Metro Access disabilities unable to Anywhere within the
100% use Metro Transit county $1.00
Based on length of
Yellow Cab 24 hours/7 days a trip
0% General public week Average cost $12.00
County Senior Bus 10:00 AM 7:00 PM

50% People 65 and older Mon/Sat $2.50
Priority for People
receiving ES
services
Remaining seats
available to people in 8:00 AM 5:00 PM
Easter Seals Vans partner disability Mon/Fri
100% programs No weekends Free
People attending
Good Faith Church services and
Van activities of the Before and after
0% church scheduled events Free
Volunteer Veterans
Association Veterans with
50% disabilities On demand Free
Mobility Options for the Community
Providers Vehicle Access Eligibility Availability Cost/Fare
Easter Seals Project ACTION is funded through a cooperative agreement with the U.S.
Department of Transportation, Federal Transit Administration, and is administered by
Easter Seals, Inc. This document is disseminated under the sponsorship of ESPA in the
interest of information exchange. Neither Easter Seals nor the U.S. DOT, FTA assumes
liability for its contents or use thereof.
Transportation Choices
Using a Bus Schedule Peer to Peer Activity
Sharon needs to get to work at the Paradise Valley Mall at 11:00 a.m. She lives on 35th
Avenue and wants to make sure she gets to work on time. What time should she pick
up her bus?
Sharon needs to get back home by 6:00 p.m. to meet with her speech pathologist. But
first she needs to stop at the pharmacy to pick up a prescription. Her pharmacy is
located at Thunderbird at 7th street. What time should Sharon leave her job to get home
in time?
Group Activity: With a colleague, discuss what factors were important in determining
which bus Sharon should use to get to work and back on time.
Self study: Make notes regarding what factors were important in determining which bus
Sharon should use to get to work and back on time.
WEEKDAY EASTBOUND SCHEDULE

(Schedule times in bold print indicate P.M. times.)
THUNDER- THUNDER- THUNDER- THUNDER- THUNDER- CACTUS 32ND ST THUNDER- PARADISE

BIRD AT ASU BIRD AT BIRD AT BIRD AT BIRD AT AT CAVE AT BIRD AT VALLEY
67TH AVE WEST 43RD AVE 35TH AVE 19TH AVE 7TH ST CREEK CACTUS 40TH ST MALL
800 809 811 815 823 830 836 841 848 855
830 839 841 845 853 900 906 911 918 925
900 909 911 915 923 930 936 941 948 955
930 939 941 945 953 1000 1006 1011 1018 1025
1000 1009 1011 1015 1023 1030 1036 1041 1048 1055
1030 1039 1041 1045 1053 1100 1106 1111 1118 1125
1100 1109 1111 1115 1123 1130 1136 1141 1148 1155
100 109 111 115 123 130 136 141 148 155
300 309 311 315 323 330 336 341 348 355
400 409 411 415 423 430 436 441 448 455
430 439 441 445 453 500 506 511 518 525
600 609 611 615 623 630 636 641 648 655
WEEKDAY WESTBOUND SCHEDULE
(Schedule times in bold print indicate P.M. times.)
PARADISE THUNDER- 32ND ST CACTUS AT THUNDER- THUNDER- THUNDER- THUNDER- THUNDER-

VALLEY BIRD AT AT CAVE BIRD AT BIRD AT BIRD AT BIRD AT ASU BIRD AT
MALL 40TH ST CACTUS CREEK 7TH ST 19TH AVE 35TH AVE 43RD AVE WEST 67TH AVE
800 807 814 819 825 832 840 844 846 855
830 837 844 849 855 902 910 914 916 925
900 907 914 919 925 932 940 944 946 955
930 937 944 949 955 1002 1010 1014 1016 1025
1000 1007 1014 1019 1025 1032 1040 1044 1046 1055
1030 1037 1044 1049 1055 1102 1110 1114 1116 1125
1100 1107 1114 1119 1125 1132 1140 1144 1146 1155
1200 1207 1214 1219 1225 1232 1240 1244 1246 1255
130 137 144 149 155 1002 110 114 116 125
230 237 244 249 255 202 210 214 216 225
300 307 314 319 325 332 340 344 346 355
330 337 344 349 355 402 410 414 416 425
500 507 514 519 525 532 540 544 546 555
600 607 614 619 625 632 640 644 646 655

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Test Your Knowledge of Self-Advocacy

Test Your Knowledge of Self-Advocacy: Answer Key

Auditory To hear Air conditioner fan

Visual To see Fluorescent

Gustatory To taste Nothing in the

Olfactory To smell Another

Tactile To touch Texture of desk is

Vestibular All aspects of motor Difficulty sitting

Sensory System/ Incoming Incoming Possible Behavior Solution

Supporting an Individual in Sensory Regulation

My Personal Information & Scan Location

Your name: _________________________________________ Date: ________________________

Agency/program/work site/other: __________________________________________________________

Which room or environment will you be scanning? ____________________________________________

The ISA Sensory Scan

Challenge with number or volume of voice(s) Other

Distracted by things hanging on the wall, on surfaces, Other

Motion in vehicles is disruptive/makes me feel Other

Trouble writing on paper (graphomotor) Difficulty using stairs or walking

Cannot sit for long periods of time Other

Sensory Advocacy Plan

What is my sensory goal?

Can I address my sensory needs independently without a script? If so how?

Do I need someone to support me, a translator or mentor? If so, how?

Ratings: How did it go?

Exploring Autism Internet Modules

Visit the AIM (Autism Internet Modules) site at:

AIM Module Title: _________________________________________________

Type of Support How I Will Implement It Additional Notes

Unit #4 Communication Handout 4.2

Name: Pia 51 year-old female

Motivators and preferences: Crochet, gardening, reading

Name: Martin M. 42 years old

Medical: Type I Diabetes- insulin dependent

Name: Jamilla 23 year-old female

Medical: strong allergic reaction to peanuts and beestings (carries epi-pen)

Name: Liam 35 year-old male

Medical: Asthma (uses inhaler)

Name: Pia 51 year-old female

Motivators and preferences: Crochet, gardening, reading

Learner Snapshot#5: Faith-Based

Name: Dom 64 years old

Signs of being upset: Yelling, crying, fidgeting

Developing a Script for a Person You Support

Participant Query: What Does It Mean?

Brief Description of Individual

Hidden Curriculum in Daily Life: My Hidden Curriculum Diary

Recording by handwriting onto a hard copy of My Hidden Curriculum Diary Tool

Date Hidden Curriculum Item Notes

Implications of Not Understanding the Hidden Curriculum

Unit #4 Communication Learning Activity 4.5 (continued)

Modeling Visual Physical Gestural Verbal

Modeling Visual Physical Gestural Verbal

Social: Social Contact or Interaction Material: Tangibles, Items

The ISA Social Scan Worksheet

Your name: Date:

Which social environment will you be scanning?

The Social Scan

My comfort level with people in this setting is (circle one):

My comfort level with the structure of this setting is (circle one):

I am not sure what the content of this setting is.

My comfort level with the content of this setting is (circle one):

Your name: _________________ Date:

Your name: __________________ Date:

Support Network Contact: Name: ___________ Phone: _ Date: ____