Developed by

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Disability Training
Module 5 Providing Intensive Services to People
with Disabilities

• Developed by
• Karen N. Hoopes
• Disability Program Navigator
• Tri-County Workforce Center

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Module 5 Providing Intensive Services to Youth

• Learning Objectives
• Recognize the red flags that may indicate a
  hidden disability
• Understand how a disability can affect a clients
  ability to follow through
• Learn to plan ahead to avoid pitfalls and
  encourage success
• Learn to identify and provide needed
  accommodations
• Learn to navigate the special education maze

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Hidden Disabilities

• Of the 6 million youth in special education
  almost half have learning disabilities.
• High percentage of high school drop outs, prison
  inmates, and welfare recipients have either been
  diagnosed with specific learning disabilities or
  have similar histories of significant
  difficulties in school.
• Research suggests that a large percentage (50 to
  80) of people in WFC programs focused on
  literacy have hidden disabilities.

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Essential to Understand

• Types of disabilities
• How to identify the red flags
• Screening process connecting to formal
  diagnosis through referrals
• Providing accommodations
• How to coach provide support services to
  clients

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Types of Hidden DisabilitiesMost Common Types

• Mental Health or Emotional Disorders
• Depressive Disorders
• Anxiety Disorders
• Conduct Disorder
• Chemical Dependence
• Specific Learning Disabilities
• ADD/ADHD

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DepressionSigns Symptoms

• Depressed mood
• Irritability
• Difficulty enjoying normally pleasurable
  activities
• Over eating or lack of appetite
• Difficulty sleeping at night or wanting to sleep
  during the day
• Low energy
• Physical slowness or agitation
• Low self esteem
• Difficulty concentrating
• Recurrent thoughts of death or suicide.
  (thoughts, plan, means)
• Untreated can make education or career planning
  difficult

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AnxietySigns Symptoms

• 6 months or more of exaggerated worry and tension
  that is
• Unfounded
• More severe than normal anxiety
• Pessimistic
• Possible physical symptoms
• insomnia
• eating problems
• headaches
• social anxieties

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Conduct DisorderSigns Symptoms

• Behavioral and emotional problems
• Difficulty following rules
• Behave in a socially unacceptable way
• Aggression to people and animals
• Destruction of property
• Deceitfulness
• Stealing

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Chemical DependenceSigns Symptoms

• Use of any chemical substance, legal or illegal
  that creates behavioral or health problems or
  both
• Referral to substance abuse treatment facility
  needed
• Interferes with assessment
• May smell alcohol on breath or other signs of
  poor health

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Specific Learning Disabilities

• Dyscalculia
• Dysgraphia
• Dyslexia
• Dyspraxia
• Auditory Perceptual Deficit
• Visual Perceptual Deficit

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DyscalculiaSigns Symptoms

• Shows difficulty understanding concepts of place,
  value and quantity, number lines, positive and
  negative value, carrying and borrowing.
• Has difficulty understanding and doing word
  problems
• Has difficulty sequencing information or events
• Exhibits difficulty using steps involved in math
  operations.
• Shows difficulty understanding fractions.
• Is challenged making change and handling money
• Displays difficulty recognizing patterns when
  adding, subtracting, multiplying or dividing
• Has difficulty putting language to math processes
• Has difficulty understanding concepts related to
  time such as days, weeks, months, seasons,
  quarters, etc.
• Exhibits difficult organizing problems on the
  page, keeping numbers lined up, following through
  on long division

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DyscalculiaMathematical Disability

• Strategies
• Allow use of calculators and scratch pad for math
  computations
• Use diagrams and draw math concepts
• Suggest peer assistance
• Suggest use of graph paper
• Suggest use of colored pencils to differentiate
  problems
• Draw pictures of word problems
• Use mneumonic devices to learn steps of a math
  concept.
• Schedule computer time for the student for drill
  and practice.

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DysgraphiaSigns Symptoms

• May have illegible printing and cursive writing
  (despite appropriate time and attention given the
  task)
• Shows inconsistencies mixtures of print and
  cursive, upper and lower case, or irregular
  sizes, shapes or slant of letters
• Has unfinished words or letters, omitted words
• Inconsistent spacing between words and letters
• Exhibits strange wrist, body or paper position
• Has cramped or unusual grip/may complain of sore
  hand
• Has difficulty pre-visualizing letter formation
• Copying or writing is slow or labored
• Shows poor spatial planning on paper
• Has great difficulty thinking and writing at the
  same time

I wenT to t he Sto R e
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DysgraphiaStrategies

• Suggest use of word processor and or assistive
  technology
• Avoid chastising for sloppy, careless work
• Ask them to present any assignments orally
  instead of in writing, or accept alternative
  formats such as tape recordings.
• Allow use of tape recorder for workshops or 11
  sessions
• Provide notes, outlines or lists instead of
  requiring the client to take notes. This will
  reduce the amount of writing required
• When writing will benefit from the use of wide
  rule paper or graph paper
• Suggest the use of pencil grips and / or
  specifically designed writing aids
• Provide alternatives to written assignments
  (video-taped reports, audio taped reports)
• In 11 sessions do not try to speak while they
  are writing

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DyslexiaSigns Symptoms
He and there went to the store
b d p d

• Reads slowly and painfully
• Experiences decoding errors, especially with the
  order of letters
• Shows wide disparity between listening
  comprehension and reading comprehension of some
  text
• Has trouble with spelling
• May have difficulty with handwriting
• Exhibits difficulty recalling known words
• Has difficulty with written language
• May experience difficulty with math computations
• Decoding real words is better than nonsense words
• Substitutes one small slight word for another a,
  I, he, the there was

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DyslexiaStrategies

• Provide a quiet area for activities like reading,
  testing, and answering comprehension questions
• Use books and handouts with large print and big
  spaces between lines
• Provide a copy of lists or instructions from 11
  sessions.
• Encourage the use of Wynn Wizard or Wordsmith for
  writing and reading.
• Suggest the trial use of a Reading Pen.
• Allow alternative forms (wider spaces)
• Present material in small units

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Attention Deficit DisorderSigns Symptoms

• Inattention
• Hyperactivity (with or without)
• Impulsivity
• Co-Occurring disorders
• Tourette Syndrome (small percentage)
• Oppositional Defiant Disorder (1/3 to ½)
• Conduct Disorder (20 to 40)
• Anxiety
• Depression
• Bipolar Disorder

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ADD/ADHDSigns Symptoms

• Fails to give close attention to details or makes
  careless mistakes
• May have poorly formed letters or words or messy
  writing
• Has difficulty sustaining attention in tasks or
  activities
• Does not follow through on instructions and fails
  to finish tasks
• Avoids or strongly dislikes tasks that require
  sustained mental effort.
• Forgetful in daily activities
• Has difficulty organizing tasks and activities
• Loses things necessary for tasks or activities
• Shows difficulty engaging in leisure activities
  quietly
• Acts as if driven by a motor and cannot remain
  still
• Blurts out answers to questions before the
  questions have been completed, often interrupts
  others.

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ADHDStrategies

• Encourage the use of personal organizers,
  calendars and alarms.
• If distractions in the office setting, move 11
  to a quiet office or conference room.
• Ensure the client writes down action items.
• Use of white noise to block out background
  noise.
• Provide simple instructions, no more than three
  items at a time, or provide lists of actions.
• Encourage the use of a stress ball in 11
  sessions

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DyspraxiaSigns and Symptoms

• Problems with messages from the brain being
  properly transmitted to the body
• Have difficulty with the muscles being able to
  coordinate well together
• May cause speech problems
• Poor posture
• Poor sense of directions
• Difficulty with actions such as throwing and
  catching

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Auditory Perceptual DeficitSigns and Symptoms

• Difficulty receiving accurate information from
  the sense of hearing
• No problem with hearing, but in how brain
  interprets what they hear
• May have problems with understanding and
  remembering oral instructions
• May have problems differentiating between similar
  sounds or hearing one sound over a background
  noise

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Auditory Perceptual DeficitStrategies

• Provide instructions in written form as well as
  orally.
• Reduce the background noise, and meet 11 in an
  office or quiet space.

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Visual Perceptual DeficitSigns Symptoms

• Difficulty receiving and or processing accurate
  information from the sense of sight
• Might have a problem picking out an object from a
  background of other objects
• May have difficulty seeing things in the correct
  order

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Visual Perceptual DeficitStrategies

• Consider alternative formats for assignments such
  as oral exams and oral assignments
• Avoid using forms with lines or dimensional
  patterns. Keep it simple.
• Do not have client face a window with vertical or
  horizontal blinds, face them in the opposite
  direction.
• If wallpaper or design of office is a busy
  graphic design, move to an office without
  patterns.

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Accommodations for Deficits in Reading

• Use of Wynn Wizard or Wordsmith for reading and
  writing.
• Use of a reading pen
• Books on tape
• Tape-recorded directives, messages, materials
• Colored Mylar templates for reading and scanning

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Accommodations for Deficits in Writing

• Allow use of personal computers/laptop computers
• Voice output software that highlights and reads
  via a speech synthesizer what has been keyed into
  the computer Wynn Wizard and Wordsmith
• Voice input software that recognizes the users
  voice and changes it to text on the computer
  screen
• Locator dots for identification of
  letters/numbers on the keyboard
• Word processing software
• Spell checking software/electronic spell checkers
• Software with highlighting capabilities
• Grammar checking software
• Word prediction software
• Form producing software that computerizes order
  forms, claim forms, applications, credit
  histories, equation and formula fields.

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Accommodations for Deficits in Organizational
Skills, Memory, and Time Management

• Day planners
• Electronic organizers/schedulers
• Software organizers with/without highlighting
  capabilities
• LCD watches, data bank watches, timers, counters,
  and alarms
• Use of electronic email for memory deficits

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Accommodations for Deficits in Managing Physical
Environment

• Room enclosures/cubicles to reduce auditory and
  visual distractions
• A private office space
• Use of White Noise by using a sound
  soother/environmental sound machine
• Use of colored files
• Mapping of the workspace/office

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When Greeting Meeting Customers

• Does the person have difficulty hearing you? Does
  s/he turn one ear toward you or ask you to repeat
  yourself multiple times?
• Does the client look confused when you give
  information?
• Does the client write everything down or ask you
  to write down information?
• Does the client appear to have difficulty
  reading, writing, or understanding simple forms?

Things to Watch For
Hidden Disability?

• Does the client appear unusually distracted?
• Does the client look disheveled or have poor
  hygiene?
• Does the client appear to miss important social
  cues?
• Does the client exhibit bizarre or unusual
  behavior?

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Working with People Hidden Disabilities

• General
  Guidelines
• Avoid being judgmental, do not personalize the
  clients response
• Be patient, listen carefully, and observe
  behavior, making notes
• Speak at a moderate pace, look for confusion or
  understanding.
• Ask the client to repeat his understanding of
  what you have said.
• Stop, ask, and listen to what works best for the
  client.
• Provide any needed accommodations based on known
  disability or apparent struggles.
• Be willing to have the hard conversations, and
  make the needed referrals, especially regarding
  addressing mental health issues

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The Special EducationMaze

• In Jefferson County, CO
• Unique terminology
• Eligibility Process
• Responsibility of school district and post
  secondary schools
• Teaching students self advocacy

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School DistrictResponsibilities

• Under Individuals with Disabilities Education Act
  (IDEA) school districts are required to provide
  students with disabilities an appropriate and
  free education
• School is responsible for identifying a problem
• School is responsible for testing and evaluation,
  and paying for that testing.
• School is responsible for developing a plan (IEP)

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Post-Secondary SchoolResponsibilities

• School has no obligation to provide a free
  education.
• Obligation to document a disability is the
  responsibility of the student, not the school
• Student must furnish medical records to provide
  proof of disability and needed accommodations
• The school is not responsible for testing to
  document a disability, and is under no obligation
  to pay for testing
• The student must first request an accommodation,
  before the school has an obligation to respond.
• The student must pay for any needed testing if
  alternative funding can not be found

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Special Education in Jefferson County Terms
Definitions

• Exceptional Student Services (ESS) Special
  Education
• Physical Disability (PD) PD
• Significantly Limited Intellectual Capacity
  (SLIC) MR/DD
• Significantly Identifiable Emotional Disorder
  (SIED) ED
• Perceptual Communication Disorder (PC) Learning
  Disability (LD)
• Speech/Language Disability S/L
• Hearing Disability
• Vision Disability
• Multiple Disability

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Physical Disability (PD)

• A chronic health problem or sustained illness
  requiring continual monitoring, intervention
  and/or specialized programming
• Condition interferes with mobility, attention,
  coordination, communication, and other activities
• May include students with Spina Bifida, Cerebral
  Palsy, ADD/ADHD, Autism, Traumatic Brain Injury
  (TBI)

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Significantly Limited Intellectual Capacity (SLIC)

• Limited intellectual capacity or ability which
  usually originates in the developmental period
  and exists concurrently with an impairment in
  adaptive behavior
• May include students with Downs Syndrome or
  Fetal Alcohol Syndrome

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Significantly Identifiable Emotional Disability
(SIED)

• Student displays an inability to build or
  maintain interpersonal relationships which
  significantly interferes with social development
• Poorly developed adaptive behaviors and social
  skills that result in a students inability to
  meet environmental demands and to assume
  responsibility for his/her own and others
  welfare.
• May include students with Clinical Depression,
  diagnosed mental illnesses, Bipolar disorder, etc.

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Perceptual or Communicative Disability (PC)

• A disorder in the psychological process which
  affects language and learning.
• Consists of discrepancy between estimated
  intellectual potential and the actual level of
  student performance
• Poor achievement in the following areas
• Pre-reading and/or reading skills
• Reading Comprehension
• Written language
• Math comprehension, application or concept
  retention

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Speech-Language Disability (S/L)

• Difficulties in functional communication
• Delayed language development
• Articulation problems
• Problems with fluency or voice
• Problems to the degree that it interferes with
  oral and/or written communication in academic
  and social interactions in a students primary
  language

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Hearing Disability

• Deficiency in hearing sensitivity that, even with
  amplification, limits the students ability to
  recognize pure tones or speech
• May result in
• Language delays
• Poor academic achievement
• Inattention
• Impairment of speech articulation, voice, and/or
  fluency

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Vision Disability

• A deficiency in visual acuity where even with the
  use of lenses or corrective devices, a student
  has
• restricted visual field
• acuity no better than 20/70
• exhibits a limited ability to move about safely
  in the environment

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Multiple Disability

• A combination of impairments that create a
  multiplicity of needs.
• Student must be identified as having a
  significant limited intellectual capacity as well
  as an additional disability
• - or-
• Be deaf and blind

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ESS Eligibility Process

• Teacher becomes aware that student is not
  performing to level expected
• Teacher intervenes to devise strategies, meets
  with parent
• Review periodically with parent, if intervention
  not effective, recommend testing eligibility
  determination for ESS
• Testing proceeds
• psychological testing
• social history
• academic testing

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Initial Staffing

• Once testing complete an initial staffing held
• Professionals present results of testing with
  recommendation for ESS services or not.
• Participants are teacher, ESS teacher, parent,
  school psychologist or social worker
• The case manager (primary provider) takes the
  lead in creating the Individual Education Plan
  (IEP) if needed
• IEP reviewed 1x year

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Testing Evaluation

• Psychological Evaluation
• IQ Test (WISC or WAIS-III)
• Social Evaluation
• Social history
• Academic / Education Evaluation
• Woodcock / Johnson Test

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IEP A Real Example

• Contact Information
• Present level of cognitive functioning (IQ test)
• Present level of educational functioning
• Present level of emotional and adaptive behavior
  functioning
• Present level of physical/motor physical health
  functioning
• Present level of communication functioning
• Present level of transition/life skills career
  transition
• Student profile
• Priority of needs
• Determination of Eligibility
• Goals Objectives

Whats in an IEP?
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Transitioning Youth

• From school to post-secondary school
• From school to work
• From jail to school or work

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Transition to Post-Secondary SchoolWorking with
Transitioning Youth

• Teach the student about his or her rights under
  the law
• Teach the student to advocate for him/her self to
  receive an accommodation for his/her disability
• Inform the student that the school has a right to
  ask for specific documentation of the disability
  before providing an accommodation.
• IEP or Section 504 plan not adequate to document
  disability
• Records must be 3 years or less old in most cases
• School has no obligation to pay for testing
• Vocational Rehabilitation can provide assessment
  and diagnosis. DU provides assessment services on
  a sliding scale.

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Student Rights Under the LawPost-Secondary

• The student is not required to disclose a
  disability, but must if an accommodation is being
  requested.
• The school must provide access to the same
  programs and services that it provides to other
  students without disabilities.
• The school is required by law to provide a
  reasonable accommodation if the student requests
  it.
• The accommodation for the disability must be
  effective and not cause undue hardship on the
  school
• The school cannot charge extra fees for the
  accommodation
• The school does not have to provide an
  accommodation that would be for personal use.

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Self Advocacy in Post Secondary SchoolsCoach
Your Youth

• You are responsible for making the accommodation
  request.
• Determine the school official responsible for ADA
  compliance, and understand the procedures used
  for asking for accommodation
• Ask a school official
• Research college catalogues and brochures
• Get your medical documentation ready.
• Communicate the accommodations you need (be
  specific) to the appropriate school official.
• Follow school procedures
• Must be done as early as possible in the semester
  to give the school time to comply
• Be willing to re-negotiate if needed

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Rights in the WorkplaceCoach Your Youth

• You are under no obligation to disclose your
  disability unless you want an accommodation.
• Employers cannot ask you if you have a disability
  in the pre-offer phase.
• Best not to disclose a disability until the
  post-offer phase
• Employers with 15 employees must by law provide
  a reasonable accommodation as long as it does not
  cause undue hardship on the employer
• Employers are under no obligation to hire you if
  you are not qualified for the job.
• Employers do not have to remove a core
  responsibility of the job to accommodate you
• Employers have a right to ask for and review your
  medical or other records that document that you
  have a disability in the post offer phase if you
  are asking for an accommodation.
• Employers are required to keep your medical
  information confidential, and can not tell other
  employees that you are receiving an
  accommodation.
• Employers are under no obligation to give you the
  accommodation you ask for as long as they offer
  an effective alternative.
• Employers cannot charge you for the accommodation

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Self Advocacy in the WorkplaceCoach Your Youth

• Research company procedure for requesting
  accommodations
• Know the specific accommodations you need
• Get your medical records together and be prepared
  to share them with your employer
• Use the employers procedure to request
  accommodations
• Explain the modifications you need to be
  productive
• Participate with the employer in coming up with a
  solution that works for both of you.
• Work with SWAP

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Disability IncomeFinancial Support During
Transition

• Social Security Disability Insurance (SSDI)
• Supplemental Social Security (SSI)
• Plan for Achieving Self Support (PASS)
• Earned Income and Other Exclusions
• Section 1619(b) of Social Security Act

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Social Security AdministrationOverview

• Local office
• Claims/Applications
• Issue social security cards
• Reviews
• BPAO Office (Benefits Planners Assistance
  Outreach)
• 6 Benefits Planners in State
• Provide assistance to clients in determining the
  effect of working on benefits and other services
• Pass Cadre Plan for Achieving Self Sufficiency
• Administer PASS program
• 3 in local area
• AWIC Area Work Incentive Coordinator
• Handles high profile disability work issue cases
• Coordinates public outreach on work incentives
• Coordinates and oversees training on SSAs
  employment support programs for all personnel at
  local social security offices
• Monitors the disability work issue workloads in
  their respective area

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Social Security Income

• SSDI
• Not a needs based program, entitlement
• Cash benefits for workers with disabilities who
  have a record of earnings (FICA)
• SSI
• Supplemental Social Security
• Needs based, less than 2,000 per month in total
  resources

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PASS Program

• PASS Plan to Achieve Self Support
• Eligibility receiving SSI or could qualify for
  SSI
• Set aside disability income for expenses related
  to finding work
• Eligible expenses may include education,
  vocational training, or starting a business as
  long as the expenses are related to achieving the
  work goal
• Income put in PASS not counted when determining
  the initial and continuing eligibility for SSI.

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Earned Income Exclusion

• Protects the ability of transition aged youth to
  work and have earnings through work based
  learning programs that are integrated into
  educational programs
• Keep benefits

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Section 1619(b)

• Allows an individual with disabilities who is
  collecting social security to continue to receive
  Medicaid if
• Earned income is too high to qualify for SSI
• Earned income is too low to be able to afford
  Medicaid

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Test Your Disability IQ
Test Your Disability IQ
Written Examination
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Summarize Your Learning
What did you learn today?