Counseling

The support paradigm is substantially different from the deficit because it tries to provide the necessary help to achieve the life that one wants and can sustain. Thinking about supports allows identifying these people not only with what they lack but with what they can, could and will, and not intervene to supply a lack, but to provide from the environment, the help they need to live, as happens in the life of the conventional.

The key aspects of the support model are:

  • Ecological approach: behavior depends on assessing the discrepancy between a person's abilities and abilities and the adaptive skills and abilities required to function in a context.
    Influence of multiple factors: supports that improve individual functioning can be influenced by protective factors and idiosyncratic risk with respect to physical and psychological health, the environment and their demands and other related disabilities
    Nine areas of potential support to assess the skills-requirements discrepancy: human development, education and education, life at home, life in the community, employment, health and safety, behavioral area, social area and protection and defense.
    Intensity of support: For each of these nine support areas the intensity of the necessary support is determined
    Support functions: several functions that act reducing the discrepancy between the person and the requirements of the environment, and are: teaching, friendship, financial planning, help in employment, behavioral support, help in life at home, access to and use of the community, and help in relation to health
    Diversity of sources of support: either natural or based on services. In this sense, services should be considered as a type of support provided by agencies and / or professionals
    Desired personal outcomes through supports: include improving independence, relationships, contributions, participation in school and in the community, and personal well-being.

If you think about support and levels of support stop thinking about a dependent person for life in all aspects and go to think that this person requires some help in some fields for some time. A certain pathology can last a lifetime; The disability does not have to last so long.

A Support is a resource and / or strategy that fulfills 3 functions:

  1. Promotes the interests and goals of people with or without disabilities;
  2. It allows access to resources, information and relationships from work environments and integrated housing;
  3. It gives rise to an increase in their independence, their labor productivity, their community integration and their subjective satisfaction.

The origin of the supports is also variable. In the first instance, supports must come from family and friends (natural supports); after the general and free services; and, ultimately, specialized services. However, what we commonly see is that, once the person with ASD/NDD is identified, the supports are focused on the specialized services; Collaterally, generic services are used and natural supports are wasted. The nature of the support can be individual, institutional, technological or service.

 

The four intensities of the supports are:

  • Intermittent: sporadic provision, in the short term, at the request of the person or in case of unforeseen events, of low technical complexity. Support in the aspects "that are necessary". They are characterized by the episodic nature, the person does not always need the support / s, or are short-term supports that are needed during transitions from one stage of life to another (eg loss of employment or the appearance of a disease acute). When provided, the intensity of the intermittent supports may be high or low.
  • Limited: Provision of support regularly, for short periods or infrequently, requiring low cost in money and human resources and simple training. The supports are characterized by a constant intensity over time, or limited in time, but they are not intermittent in nature, they may require less assistance personnel and less cost than the more intense levels of support (eg short-term training for employment or transition supports during the period from school to adult stage).
  • Extensive: supports that last for years, of weekly frequency, that require direct professional participation or their frequent supervision, which usually exceed the possibilities of natural sources. Supports characterized by regular aids (eg daily) in at least some settings (such as at work or at home) and not limited in time (eg long-term support, or long-term support for life at home).
  • Generalized: lifelong supports, which require a high degree of specific training, which require high costs or a significant amount of highly trained personnel. Support characterized by its constancy and high intensity; provided in the different contexts; necessary for the survival of the person. Generalized supports usually involve more healthcare personnel and are more invasive than broad or limited support.

The precise determination of support levels requires considering several factors that influence their intensity. Likewise, the supports should not be removed abruptly; For its effectiveness to be evident, its installation, development and suspension require time. Its nature and origin must vary in tune with the different life moments of the person, which implies that they must be reviewed, rethink periodically.

Some typical areas of support are: human relationships; economic planning; labor assistance; behavioral support; help at home; access and use of the community.

In summary, supports are defined as: Resources and strategies that seek to promote the development, education, interests and personal well-being of a person and improve individual functioning.

The treatment of ASD / ODD is not different from that of any other disability and is a function of the differential and potential diagnosis of each individual. A good psychopedagogical diagnosis will determine the needs and potential of each person, the necessary resources to enable educational aids according to the person, the family and the rest of the environment. What is involved is to make a general programming that allows to develop the capabilities of the person as well as the necessary attention to provide educational aids that allow him to live in the world of others facilitating his understanding and the relationship with him and the others people

 

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As it says The functional model of self-determination (Wehmeyer, 1999, 2003), to promote the teaching of self-determined behavior, three fundamental axes are proposed

  • Increase capacity
  • Offer opportunities
  • Give the necessary supports.

Self-determined behavior reflects the interaction between the capacities of individuals, the opportunities that the environment offers them and the supports they receive. Capabilities can not be expressed without opportunities for it, but opportunities without adequate capabilities are wasted. That's where the supports come in, to overcome the limitations in some capacity and give a good account of the opportunities.

The capacities and opportunities influence each other through the perception that the individual has of himself. Since beliefs are influenced by the attitudes of others towards us, it is important to generate and transmit attitudes of respect and possibility to people with ASD / NDD. We must teach these people to acquire the different components of self-determined behavior, with a special emphasis on those abilities that, given their condition, may present greater difficulties, such as: communication skills (as we are interdetermined beings, we must teach them skills negotiation and flexibility, since you can not always do what you want), understanding of emotions, theory of mind skills, social skills and the development of executive functions ...

We must give opportunities for people with ASD / NDD to make choices, express opinions, explore potential options, take appropriate risks, learn from the consequences, have time for oneself and develop autonomy, skills, an adequate concept of themselves, etc. ... to create all those opportunities, we must create a rich lifestyle and a supportive social context (Bambara, Cole and Koger, 1998). It is important to bet on natural supports, develop strategies so that we can use personal resources (family, friends ...) and the equipment of the community.

The most important supports that people with ASD / NDD may need in a specific way are: the design of significant and psychologically accessible environments, the teaching of alternative communication systems, as well as receiving information in advance and what has been done (Peeters, 1997).

The professionals are at the service of these people to help them build the lives they want, we will travel the road with them, we help them overcome some of their limitations, but they are the ones who show us the way, the ones who tell us where they want to go to go.

These personalized intervention plans are carried out in order to support people with disabilities in order to live the life they want to live. Depending on the dreams and goals of each one, we will teach them the skills and give them the necessary support to achieve them. The work model proposed by the AAMR (1992) and continued by the AAIDD proposes four steps to achieve this objective:

  1. Identify the relevant areas of support. Based on the person's abilities and abilities, the environmental demands of their habitual living environments are analyzed and the areas are established (human development, education and education, life in the home, life in the community, employment, health and safety). , behavioral, social, and protection and defense) in which the person needs support.
  2. Identify support activities for each area, based on the interests and preferences of the person, without forgetting that we program for people to achieve better futures, so we must choose together with the person and family, activities and contexts thinking in those in which the person either participates or is very likely to do so.
  3. Evaluate the intensity of the supports, that is, establish the function that the supports will fulfill, the source (natural or service-based supports) in charge of providing them and the intensity that will require, depending on the frequency, the duration of the daily support and the type of support required.
  4. Write the individualized support plan, with the ultimate goal of achieving personal results desired by the person, within the 5 main areas: independence, relationships, contributions, participation in school and in the community, and personal well-being.

 

The autonomy programs that are developed for the personal development of people with ASD / NDD revolve around the following centers of interest:

New Tabs / Accordion element

Communication

Communication is the ability to understand and express information through:

  • Symbolic behaviors (spoken word, written word, graphic symbols, signed language, sign system)
  • Non-symbolic behaviors (facial expression and body movement) (A.A.M.R. 1999). If we want people with PDDs to increase their quality of life, it is necessary, either through augmentative or alternative systems, to increase their level of understanding and expression through symbolic behaviors and / or non-symbolic behaviors that allow them to:
    • Express wishes: Understand and express feelings, needs and desires. Encourage spaces and times for communication, send appropriate messages to the recipients for an adequate understanding, interpreting verbal and non-verbal languages. Know the expressiveness and gestures.
    • Give and receive referential information.
    • Make requests.
    • Converse.
    • Etc.

Social Skills

Those skills related to social exchanges that are maintained with other people in the social environment. The quality of life of people with PDDs depends on their having skills that allow them:

  • Start, maintain and end the interaction with others.
  • Understand and respond to different social situations.
  • Recognize feelings.
  • Regulate your own behavior
  • Make and maintain friendships
  • Respond to the demands of others.
  • Show adequate social behavior
  • Respect and comply with laws and social norms.
  • Etc.

Self-regulation

It refers to the set of skills that have to do with: seek help when necessary, choose, solve problems, initiate activities appropriate to the situation, finish the necessary or required tasks ... Above all, it is about fostering in people with PDDs the ability to choose, by learning functional skills, from external support as necessary.

Self-regulation is one of the fundamental pillars on which the quality of life of people with disabilities is based. The programs whose objective is self-regulation are set as goals that people with disabilities reach:

  • Realize your objectives.
  • Choose among several things.
  • Have autonomy.
  • Decide on aspects related to your own life.
  • Participate in decision making.
  • Etc.

Functional academic skills

We refer to cognitive skills and those skills that require school learning, which have direct application in personal life (writing, reading, practical use of the calculation ...). It is not about reaching certain academic levels, but rather acquiring functional academic skills that allow you to access and enjoy an independent life, an essential requirement to talk about quality of life in people with PDDs. From this point of view, aspects such as:

  • The application of mathematical knowledge necessary to use money properly.
  • Comprehensive reading of texts, symbols and / or images.
  • Writing from a functional point of view.
  • The spatial and temporal orientation; necessary then, for example, for the proper handling of the watch.
  • Etc.

Home life

The quality of life of people with PDDs happens because during their adult life they can access, like any other person, to live outside the family home, as long as they possess or can acquire the necessary personal and social skills to benefit from this experience. It can develop well in sheltered floors or supervised floors. The first, the sheltered floors, are designed for people who have some autonomy but require the continued presence of support staff, to organize, plan, energize ... The second, supervised floors, are for people who have a sufficient degree of autonomy so as not to need the continued presence of support staff.

The skills developed during this type of program have to do with:

  • The care of clothes.
  • Housework.
  • Preparation and preparation of meals.
  • Daily planning
  • The security in the home.
  • Etc.

Health and security

The concept of health covers the whole set of skills related to the maintenance of one's health: to eat healthily, to maintain an adequate hygiene, to recognize when one is sick, to prevent accidents, to follow the rules of use of public spaces, to have knowledge of road safety education, have an affective-sexual education ... for all this, autonomy programs are developed where people with ASD / NDD are given the precise skills to improve their quality of life, this is directly related to the person with disability, as far as health is concerned, she was equipped with the necessary skills to detect the symptoms, prevent, treat and do the adequate follow-up of the pathology as well as seek the necessary health resources. But in addition to health, the issue of safety is taken into account, since providing the necessary strategies to identify and resolve the main situations of danger would considerably increase the quality of life of the person with ASD / NDD

Use of existing services in the community

It is about providing people with TGDs with the skills related to the adequate use of community resources, such as: public transport, shopping in stores, enjoyment of recreational areas, attendance at different shows.

The availability of these skills significantly influences the improvement of the quality of life since it offers possibilities to be able to choose according to preferences or needs, to develop personally, to improve leisure time and free time, etc. And above all it allows the person with disabilities to be included socially.
The social inclusion or what is the same, the involvement in the community, does not lead exclusively to the use of services, but also implies that the person with disabilities is related and participate actively and satisfactorily in the life of the community , feeling a full member.

The learning of social skills and respect for the rules of coexistence are what will give the index of interaction and inclusion in the community and, of course, the degree of independence that can reach the person within their environment. Therefore, it is essential to provide people with PDDs and people with disabilities in general with the necessary skills to:

  • Adequately use the administrative services of the community.
  • Properly use community health services.
  • Move autonomously well by himself or using the services of the community.
  • Use community services for personal development, leisure and free time ...
  • Etc.

Personal care

It includes the skills related to cleanliness, food, clothing, hygiene and personal appearance. The inclusion of people with PDDs is facilitated if it is accompanied by a careful external appearance. To do this, we must develop autonomy programs whose objectives are:

  • Carry out proper hygiene and personal hygiene.
  • To eat healthy.
  • Take care of the external image.
  • Properly perform the dress and undress.
  • Have privacy
  • Etc.