The Cigna Group · NYSE:CI
The Cigna — Investor Presentation (April 2012)
53 slides from The Cigna's investor presentation, April 2012
Slide 1: Facilitating Independence for Individuals with Autism
Facilitating Independence for Individuals with Autism
Slide 2: Why is Independence so Important?
Why is Independence so Important?
Slide 3: How do I Facilitate Independence?
How do I Facilitate Independence?
Slide 4: Prompting, Structure, Behavior, Individualization, Generalization
•Prompting •Structure •Physical structure •Daily schedule •Work system •Visual structure •Behavior •Individualization •Generalization
Slide 5: Prompting Hierarchy least to most
Prompting Hierarchy least to most Independent –able to perform the task on his/her own with no prompts or assistance Visual- use a symbol (picture, words) to cue him/her into what they should be doing Indirect (Verbal or Nonverbal) – indicate that something is expected, but not tell him/her (e.g., “
Slide 6: Structure
Structure
Slide 7: Nordstrom's vs. Marshall's: Which environment is best for autism?
Nordstrom’s vs. Marshall’s Which environment is best for a person with Autism? Nordstrom’s Marshall’s
Slide 8: Structure Encourages Independence by
Structure Encourages Independence by: • Helping individuals with autism to UNDERSTAND • Helping individuals with autism to be CALM • Helping individuals with autism to LEARN BETTER • Structure is a form of BEHAVIOR MANAGEMENT
Slide 9: How do I Implement Structure?
How do I Implement Structure?
Slide 10: 4 Components
4 Components • Physical Structure • Individualized Daily Schedule • Individualized Work Systems • Visual Structure
Slide 11: Physical Structure
Physical Structure
Slide 12: Physical Structure: Clear Physical & Visual Boundaries
Clear Physical & Physical Structure Visual Boundaries Furniture Carpet & Flooring Color Coded Areas Labeling Area
Slide 13: Physical Structure: Minimize Visual & Auditory Distractions
Minimize Visual & Physical Structure Auditory Distractions Non-fluorescent lighting Simple wall decorations Keep distracting hanging/moving objects away from the line of sight of the client Sit facing the teacher and a wall to minimize distracting movements
Slide 14: Physical Structure: Develop Basic Teaching Areas
Develop Basic Physical Structure Teaching Areas Play Art Transition 1:1 Small Group Circle Bathroom Motor Snack/Lunc h Break Independent Area
Slide 15: Important Things to Remember
Important Things to Remember • Keep materials and areas consistent - don’t move them around • Keep preferred activities and materials out of sight • Minimize distractions - have only needed materials out • Keep it SIMPLE!
Slide 16: Individualized Daily Schedule
Individualized Daily Schedule
Slide 17: How many of you use a schedule?
• How many of you use a schedule? • What does your schedule look like? • How would you feel or cope if you lost your schedule?
Slide 18: A person with Autism MUST have a schedule
A person with Autism MUST have a schedule that is developmentally appropriate and individually designed to help them be INDEPENDENT, UNDERSTAND your expectations, BEHAVE APPROPRIATELY, and handle CHANGE.
Slide 19: Individualized Daily Schedule
Individualized Daily Schedule • MUST be EASY to UNDERSTAND • Daily Routine- What are we doing today? TELLS YOU WHERE TO GO • What sequence? Work then Play • Teaches Flexibility- Important to change the schedule so they learn to follow your routines, not theirs (e.g., RIGID behaviors)
Slide 20: Types of Schedules: Object Schedule
Object with Types of Schedules Object Key Adult as transition Left to Right Top to Bottom Can put icons next to the key to help them learn the icons
Slide 21: Types of Schedules: Photo Schedule
Photo Types of Schedules Schedule Photo is a close up of the activity. Taking photos that are clear of distraction is key.
Slide 22: Types of Schedules: Pictures with Words
Pictures with Types of Schedules Words Can be made with Mayor Johnson Symbols Hand drawings
Slide 23: Types of Schedules: Written Schedule
Written Types of Schedules Schedule Check off Word Lists On a Transition Strip Clip Board Binder Schedule Book
Slide 24: Individualization
Individualization • Type of schedule used • Length of schedule (transition, activity, first/then, part day, full day • Mobility and manipulation (carry, check off, portability) • Interest and motivation
Slide 25: Individualized Work Systems
Individualized Work Systems
Slide 26: Individualized Work Systems (IWS)
Individualized Work Systems (IWS) • Systematic way to understand information - TELLS YOU WHAT TO DO • Increases the ability to work independently • INDIVIDUALIZED - Top to bottom/left to right, matching (colors, shapes, numbers, letters), or written systems
Slide 27: Individualized Work Systems (IWS) Answers Questions
Individualized Work Systems (IWS) Answers 4 questions: •What work? •How much work? •Concept of finished? •What happens next?
Slide 28: IWS (continued)
IWS (continued) • Experience shows that productivity increases when we have a way of knowing how much work we need to do and when it is finished. • The IWS clarifies the meaning of “finished” and the adult’s expectations.
Slide 29: Important Things to Remember
Important Things to Remember • ALL tasks in an IWS MUST be previously mastered (check for mastery FIRST). • THEN mastered work can be placed in IWS • Tasks must be done in order (change the order DAILY to prevent rigidity) • Must put items in “finished”
Slide 30: Types of Work Systems: Top to Bottom or Left to Right
Top to Bottom or Types of Work Systems Left to Right Complete activities in order and place in a finished box
Slide 31: Types of Work Systems: Matching
Matching Types of Work Systems Matches items (by color, shape, number, etc.) to matching work task item
Slide 32: Types of Work Systems: Written Work System
Written Work Types of Work Systems System Check off or cross out activities as they go
Slide 33: Types of Work Tasks: Self-Contained Tasks
Self- Types of Work Tasks Contained Tasks Everything needed for the task is in one container
Slide 34: Types of Work Tasks: Folder Tasks
Folder Types of Work Tasks Tasks Everything needed for the task is in one folder
Slide 35: Individualization
Individualization • Visual cues used • Concept of finished (finished container, back on shelf, check or mark off) • Mobility and manipulation (carry, check off, portability) • Interest and motivation
Slide 36: Visual Structure
Visual Structure
Slide 37: Visual Structure
Visual Structure • Visual Structure capitalizes on visual strengths, avoids deficits in auditory processing and tells the individual how to complete a task. § Visual Instructions § Visual Organization § Visual Clarity
Slide 38: Visual Instructions
Visually tells the Visual Instructions sequence to complete a task Materials define the task, cut out or picture jigs, picture instructions, written instructions, product samples
Slide 39: Visual Instructions (Self-Help Skills)
Visual Instructions (Self-Help Skills)
Slide 40: Visual Organization
Uses space and containers to organize Visual Organization materials and to limit the focus of attention. Container organizing (self- contained tasks), limiting the area & materials, segmenting and stabilizing
Slide 41: Visual Clarity
Engages individual’s Visual Clarity attention to relevant information Color coding, highlight- ing and labeling
Slide 42: When Behaviors Get in the Way of Independence
When Behaviors Get in the Way of Independence try the following: • Choice Boards (sensory activities, art activities, play activities, food/toy/song choices) • First/Then Strips • Token Boards • Finished Box
Slide 43: Types of Choice Boards
Types of Choice Boards Can be objects, outline drawings, pictures, pictures with words, or words
Slide 44: First/Then Strips
First/Then Strips Visually explains what the individual needs to do before a reward is given
Slide 45: Token Boards
Token Boards Earn tokens toward a pre- determined reward
Slide 46: Where Do I Start?
Where Do I Start?
Slide 47: What to look for
What to look for • Emerging/developmentally appropriate skills • Strengths • Functional skills • Parental/employer priorities • Interests- social/occupational • Learning style and work habits: • Distractibility/Attention Span • Motivation
Slide 48: Identify Ways to Individualize and Generalize Skills
Identify Ways to Individualize and Generalize Skills
Slide 49: Individualization
Individualization • Individualization is crucial!!! • No two systems should look exactly the same • Based on individual’s learning ability and preferences • Highly motivating if individualized properly
Slide 50: Generalization
Generalization The ability to demonstrate a skill in a variety of settings and with a variety of different people and materials.
Slide 51: Generalization
Generalization Once the individual learns the process of following directions and looking for visual cues at home, we transfer the visual systems to other environments (e.g., community, work, school)
Slide 52: Generalization
Generalization • We do NOT fade the structure over time, but blend it into their lives • We teach the individual how to look for information in different environments
Slide 53: Questions? Contact Information
Questions? Contact Information: Sharyn Kerr, PhD., BCBA-D [email protected] (714) 873 8565