NAME:
James Cucek
D.O.B.:
ADDRESS:
DATE OF REPORT:
WRITTEN BY:
Director,
CIRCULATION: James Cucek; Linda and Stan Cucek; Brian Cucek; Kerry Lawson, CLBC; Lori Richardson CLBC
Proposal for
Applied Behavioural Analysis (ABA
Reason for Referral
Linda and Stan Cucek have been lobbying for intensive
An initial planning meeting was held at the Cucek home on
Convergence of Person Centered Support, Positive Behavioural Support, Applied Behavioural Analysis and the “Lovaas Program”
A research paper on the “Lovaas Program” was first published in 1987 (Lovaas, 1987). The program was designed for pre-school children with the underlying hypothesis that some young children with autism can “catch up” to their normal peers by first grade via an intensive program using the discrete trial format and a graduated three year curriculum (The Me Book, Lovaas 1981). The curriculum focuses on challenging behaviour in year 1, teaching expressive and early abstract language and interactive play with peers in year 2, followed by pre-academic skills in year 3. Other dimensions of the program included intensity of support (40 hours per week) and family involvement.
As James is a young adult, and is skilled in many areas including music and computers, a pre-determined, pre-school curriculum is not appropriate. Linda Cucek and Stan Cucek are dedicated advocates for James, and have expressed that they want what is “best for James.” Linda Cucek and Stan Cucek are skilled Internet users and have access to multiple sources of information. Linda and Stan astutely observed that James’ curriculum must be appropriate for his age and linked to a vision of a desirable future.
In many ways, Linda and Stan have been pioneers seeking and advocating for innovative, effective support for James. Fortunately, this particular juncture in research and practice for adults with autism and other developmental disabilities is most promising. Current research and practice for young adults with autism represents a blending of perspectives such as the Lovaas program, person centered support, contemporary applied behavioural analysis and positive behavioral support.
James is a complex and talented individual with diverse needs. These diverse needs are best served by creating a desirable vision of the future with James and his family, and designing services and supports that reflect his personal profile and hopes and dreams. It is therefore recommended that James’ intensive ABA program utilize a person centered planning approach to develop and individualize a curriculum that is referenced to his goals and dreams vs. utilizing a prescriptive curriculum designed for young children.
Person centered planning procedures reference curriculum
planning and goal setting to lifestyle domains and lifestyle quality.
Curricular domains include where James wishes to live, what type of career he
would like to pursue, with whom James would like to socialize etc. Desired
lifestyle outcomes include increased participation and presence in community
activities, increased competence in valued life routines, increased choice in
major and minor decisions, and increased respect within the community.
In order to teach James the necessary skills that he will
need to function more independently within his community, it is recommended
that the principles of applied behavioural analysis be incorporated in the form
of ecological inventory strategies and task analytic teaching.
Presently, James is on a number of medications to deal with
anxiety and challenging behaviour. Contemporary principles of applied
behavioural analysis are reflected in a process called functional assessment of
challenging behaviour and positive behavioural support. The goal of functional
assessment is to identify the communicative function or motivation of challenging
behaviour and to teach positive communication alternatives. Functional
assessment and positive behavioural support are recognized as essential
features of best practice autism support, and it is recommended that positive
behavioural support be implemented for James as an alternative or adjunct to
medications.
Vision of a Desirable Future for James
Linda, Stan and James have a similar vision of a desirable future. James expressed that he would like to live by the water, and Stan and Linda expressed that they would like to see James more independent and eventually move from the family home. James expressed that he would like to pursue a career in music and his dream is to play with the musical group ABBA. James also expressed that he would “like the pain to go away.” Stan and Linda feel that James’ medication for anxiety and behavioural control are causing him considerable pain and a priority goal expressed by the family is to have James free of medication.
The process of developing and operationalizing a person
centered plan for James will require several lifestyle planning meetings and
will involve coordinated efforts among family members, friends, agencies and
government officials.
Given that James is a young adult, CBI recommends that an
individualized
Necessary Supports to Operationalize Support Plan
James has graduated from high school and requires support
for a quality adult life in his community. This support includes career
planning, peer networks, and curriculum planning. Residential options,
vocational options, and appropriate support persons and agencies will also need
to be identified and coordinated. Funding will need to be clarified and
implemented.
Future Steps to Develop an Intensive Support Plan for James
(1) Cucek family and James to review CBI report and research citations and confirm that this is the route that they would like to pursue.
(2) Inform CLBC team of decision to move forward with the plan.
(3) If
decision is to move ahead with CBI support, then
(4) Once
funding is secured,
(5) Following
the assessment,
(6) In conjunction with the Cucek family and other team members, CBI will design, implement and monitor an individualized support plan
Sincerely,
Director,
References
Lovaas Program
Lovaas, O.,
Functioning in Young Autistic Children. Journal of Consulting and Clinical
Psychology, 55, 1, 3-9.
Lovaas, O.,
Pro-Ed. Austin Texas
Person Centered Planning and Support
Malette, P., Mirenda, P., Kandborg, T., Jones, P., Bunz, T., & Rogow, S. (1992). Application of a lifestyle development process for persons with severe intellectual disabilities: A case study report. Journal of the Association for Persons with Severe Handicaps, 17 (3), 179-191.
Mount, B.A., (1987). Personal futures planning: Finding
direction for change (Doctoral dissertation,
Mount, B., & Zwernik, K. (1988). It’s never too early,
it’s never too late (Publication No. 421-88-109).
O’Brien, J. (1987). A guide to life-style planning: Using The
Activities Catalog to integrate services and natural support systems. In B.
Wilcox & G.T. Bellamy, A comprehensive guide to The Activities Catalog:
An alternative curriculum for youth and adults with severe disabilities
(pp. 175-190).
Positive Behavioural Support
O’Neill,
R., Horner, R., Albin, R., Sprague, J.,
Storey, K., &