Transition Planning and Intervention for Youth with Autism
VCU Autism Center for Excellence
August 14, 2012

Services provided by: Caption First, Inc.

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	>> EMILY HELMBOLDT: Hello, and welcome to the VCU Autism Center for Excellence webcast on transition planning and intervention for students with autism.  I'm Emily Helmboldt, and I'm a technical assistance coordinator with the ACE project at RRTC, VCU, and I'm pleased to be here with you today.  
	Some of the goals of the webcast, I would love for you to understand the critical status of employment for students and adults with autism.  We'll be talking about some employment rates.  Also, I'd like for you to understand the essential components of an effective transition plan.  Then finally, I'd like for you to have a framework of best practices and employment models for persons with autism.  
	I'd like to take a moment to thank people who have helped with this webcast.  The first person being Dr. Paul Wehman, the Director of the RRTC, for his assistance with some of the content of this webcast.  I'd also like to thank the Autism Center for Excellence, or ACE, training staff for all their hard work in the past year and a half in building a tremendous base, training opportunities for persons across the state to take advantage of at little to no cost.  I'd also like to thank Dr. Carol Schall, the Director of the technical assistance project for ACE, as well as Jennifer McDonough, the Assistant Director of Training for the RRTC for all their work in researching effective methods of employment for persons with ASD using the Project SEARCH model.  
	I'd also like to thank our funder, the Virginia Department of Education, without whom we would not be here today, so thank you very much.  
	So what happens to cute little children with autism?  There are many cute little children with autism these days, as you probably know.  We're getting much better at identifying them now.  We have better screening tools and evaluation tools and can look for markers of the disorder as early as 18 months.  In the near future, we probably have tools coming aboard that will detect as early as six months old.  
	We have had excellent evaluations further refined and validated within the past decade.  We are slowly but surely getting better at finding these kids and intervening early.  
	So when we determine a child has autism, what do we do?  Persons working with children with autism see the child as an individual who is unique in his or her interests, their abilities, motivations, and challenges.  And I'd like to emphasize the word "spectrum" here because children with autism spectrum disorder truly represent a continuum of interests, challenges, and strengths, and so we always need to keep that in mind when we're working with the children.  
	As a person who has worked with kids with autism before or a parent who has a child with autism, we know the easiest way to teach a skill of any kind is to key in on their likes and dislikes; right?  By and large, trying to totally eliminate obsessions, behavioral obsessions, like obsessions with string or fuzz or balls, it really gets you nowhere fast.  Instead, we need to celebrate their interests and use them as opportunities for joint attention and build upon them.  
	You can utilize reinforcement inventories on a daily basis to determine what is driving the child that day and what sparks their interest.  
	Observations.  Just watching a child, watching how they play, watching what they gravitate towards is a very effective way of determining what a child is interested in.  
	Exposure to many different types of toys and materials, demonstrating the use of those to the children, and allowing them to explore can really give you a better picture of what makes that child tick.  
	You see some edibles here.  We've got some candy, and we've got pretzels.  And we also have a computer.  All kids are different.  Some kids are highly motivated by edibles, and some kids are highly motivated by other things.  Computers can be very popular with the students with autism.  So what do we do next?  How do we discover where this child is with their academic skills, the communication abilities, and so on?  Where do we start teaching language and communication?  Well, we can use validated assessment tools.  There are many.  For example, the VB map, or the Able.  Those will chart the course for targeted interventions.  
	Best of all, we know what works.  We have an incredibly large empirical base of interventions that we know work for children with autism.  For example, discrete trial training, verbal behavior, reinforcement, functional behavioral assessment, and many more.  
	There are several autism centers across the country that have looked at interventions for children with autism.  They have measured which ones exhibit the scientific rigor needed to truly represent an evidence-based practice.  One of those centers, the National Professional Development Center on Autism Spectrum Disorders at UNC Chapel Hill, has looked at no less than 24 evidence-based practices as being truly evidence based or promising practice.  
	Most of those interventions were normed or researched with children, elementary school age.  
	So these children that we work with and we know how to work with them, they don't stay children forever, and eventually, they do become adults, but first they become teenagers.  And what do we do then?  
	Two of the most important and critical areas that teenagers, middle school and high school students with ASD struggle with are communication skills and social skills.  The social environment in middle school and high school gets very complex, as you know.  Clicks form, dating, they're given more decisions, given more autonomy on campus and off campus, and all of this can be very overwhelming for our students, and they can cause depression and/or anxiety in a lot of cases.  
	Furthermore, how do we help these kids get ready for adulthood?  Whether that be college or work or even both?  
	All too often we see scenarios like this, age-inappropriate interventions for our students with autism in high school.  
	We also see this.  We see isolated or segregated workshops or center-based employment, where the student is placed after graduation, and they are never deemed ready enough to get out and be integrated into the workforce.  
	Or do we want to see this?  Underemployment, college educated students who are involved in jobs that are way beneath their skill set?  Do we want these facts to remain true?  Adults with autism have some of the highest unemployment rates of any demographic group.  Let's look at this number, 16.2%.  
	Well, you might think for yourself for an unemployment number, that's not all that bad.  Right?  The national average at this point in time, August of 2012, is about 8.2% for all persons of working age.  However, we're not talking about unemployment rate here.  We're talking about employment rate.  And this is for folks with disabilities, adults with disabilities.  
	Now, if we focus in on working-age adults with autism, unfortunately, that number drops even more, from 4.1% to 11.8%.  So you see, this does not paint a very strong picture of current employment trends for people with autism.  
	Or do we want this to remain true?  Adults with autism we know live longer at home with their parents than other groups of persons with disabilities.  They are more likely to end up in segregated sheltered workshop.  They are more likely to end up in day activity centers, where they may engage in tasks that are not meaningful for them and that are not geared toward helping them get an integrated position in the future.  
	We also know that adults with autism more often than not end up with case management only and do not get linked up with effective services.  And one of the saddest facts for me is that very few adults with autism report having more than one friend upon graduation from high school.  
	There's light at the end of the tunnel in regards to promising practices and helping students with autism prepare for adulthood.  
	There are sparse, yet conclusive, studies on what works for transition.  Research is steadily growing, and these practices are showing potential in effectiveness towards the outcomes that persons with autism desire.  
	So let's take a look at these.  Supported employment.  Where the job coach helps the person to explore what jobs they might like.  They assess their skills.  They help the person with job development.  Then they train the person on the job and fade back as the person becomes more competent on the job.  
	Person-centered planning, which is the process of looking at a person as an individual, looking at their likes and dislikes, helping their support team gather around the person using different tools that really help map out the person's life and where they want to go in the future.  And really can improve their quality of life.  
	Augmentative communication is very effective, helping folks that aren't able to communicate their wants and needs by utilizing either high-tech or low-tech devices.  It could be picture symbols.  It could be an iPad.  
	Social skills instruction is very much a growing field of support for students with autism.  Social skills is essential for helping a person with autism become truly integrated into the community.  
	Workspace design, looking at the person's area where they work and what improvements can be made so that the person is more comfortable and more able to focus on their job tasks.  Visual strategies.  By and large we know that persons with autism do very well with having visual cues, visual supports in place, in school and work and other places.  
	Personal digital devices.  We are in a wonderful age of technology now for persons with autism, where we can utilize iPads, iPods, iTouches to help the person organize their day, to help the person review task analysis for job skills, for job tasks.  These devices can also help walk a person through a social scenario where they may have trouble problem-solving what to do in certain situations.  
	And also positive behavioral supports, which is the combination or the collaboration of applied behavioral analysis with person-centered planning.  Can be quite effective in helping a person within their work environment.  
	Let me back up.  I'm going to redo positive behavioral support.  And positive behavioral supports, which is a collaboration between applied behavioral analysis and person-centered planning techniques, can be very helpful in supporting the person in their work environment.  
	Why is transition important?  There are some obvious things about transition that are very important.  We're trying to help the students leave school and become an adult.  There are many components that need to be considered for this, and when we consider what is the whole life of the student, what really is true integration in the community.  
	Our students with autism face great challenges when they leave school and face adult services and programs.  Through leaving the education environment, which is a mandated environment, and they are entering into a world of eligibility and funding-based services.  So far too often our students do not receive the same amount of support or the same intensity of support when they leave school.  So planning early is critical.  Planning through the IEP process is essential.  And all of this will ensure the person truly does achieve a whole life.  
	On that note, let's review six considerations for a successful transition plan.  
	Number 1, employment and vocational competency.  We know that real work for real pay during school increases capacity and competence, helping the students get out and try jobs, getting their feet wet with learning different skills on the job, and also participating in opportunities where they get paid for their work can really help the students learn what the work world is all about.  
	Capitalize on positive attributes.  When we think about how we get jobs or what jobs are attractive to us, we think about our strings and we think about our skill set, and that's what we gravitate towards.  Students with autism are no different.  
	We also need to consider shelter workshops and day activity center as not being an option.  We need to think about integrated employment and meaningful activities the person is interested in and that will help them increase their independent over time.  
	The second consideration is participating in the community.  For example, residential choices might be living in a community apartment, a small group home, or other options.  And all these are possible for students and young adults with autism with the right support.  We know this.  We know they can learn how to live independently.  We know folks can learn how to get along with other people and have better social skills.  
	Students need experience in learning how to participate in a community, utilizing naturalistic environments, training in the actual situation.  These components are essential for students to really achieve that whole life.  
	Getting around in the community.  We know that our students with autism or our students with developmental disabilities have a lack of transportation options and affordable transportation options, and this can be a major source of isolation for these young adults.  So we need to think early about this.  We need to think about how do we help the student plan for getting around when they graduate?  Can we teach them to navigate in the community?
Can we help them to utilize public transportation?  Can we help them network with coworkers or costudents in higher ed opportunities so that they can get a ride to campus or they can get a ride to the job?  Can we help the student utilize their technology so that they can walk around within their city without getting lost?  All these are possible skills to teach.  
	The fourth thing is financial literacy.  This is a complex component of transition, and it does take a while to work on these and put the pieces together for the student to truly be financially independent.  
	First of all, we need to think about helping the person manage their benefits and maximizing work incentives.  There are benefits counselors that are available to consult with and help the student to achieve this.  The student needs to understand how to deal with a bank account, how to keep track of a bank account, how to use an ATM.  The student needs to learn how to utilize a calculator and have basic math skills.  
	The fifth component here is building social competence.  A socially competent person makes everyone more comfortable.  When we have folks with autism who are isolated or segregated, they don't have the opportunities to Mr. These skills.  So really, again, that community integration, whether it be in school, at home, through the work, really can aid the person in having these practice opportunities to build their social confidence.  
	And last but not least, self-esteem and having fun.  So taking care of mental hygiene is what I call this, feeling good about appearance.  We know that teenagers and young adults -- especially teenagers -- can feel awkward with their new bodies and the way they look.  Students with autism are no different.  We need to help them with taking care of themselves and feeling good about their appearance.  Self-esteem is important for friendships, for success on the job, for community participation.  So we need to keep this in mind.  Leisure activities to help the student figure out what they like to do in their leisure time, hobbies, sports, that kind of thing.  We need to really consider that and help the students achieve some of those goals.  
	So let's get down to the nitty-gritty here and think about what steps are needed to get a person integrated into the community and adult life.  How can we help them do that?  What skills can be taught in the community?  What should be on the IEP?  Remember those six domains we just touched on.  These are essential.  This is the foundation for the transition IEP.  
	The first one is an employment goal.  This may include integrated or supported employment.  Helping the students to understand that they can have a career, that they can choose different employment options is critical, and getting this early on the transition IEP is important to start working on those skills that will lead them to those jobs.  
	A second consideration is vocational or technical training.  This might include an apprenticeship.  Does the student want to have an opportunity to be shadowed or mentored by someone in the job position?  For example, an electrician or computer programmer.  Does the student have a higher education goal?  Are they interested in college?  Are they interested in community college or university?  
	Continuing education or adult education.  Might include a technical education goal.  So the team might consider looking at resources for a private technical school, of which there are many these days, or a public technical school.  
	Number five, the residential goal, is very important for the family and the student to be thinking about what is life going to look like for the student after they graduate and on into adulthood.  Do the students want to live with the parents?  Are the parents okay with that?  Or does the student want to be independent, own their own apartment or home?  All these things need to be considered, need to be included in this plan, and need to be worked on early as well.  
	So let's breeze through these next few ones here.  Transportation/mobility goal, a very important IEP component to consider how is the student going to get to and from work?  How are they going to get around when they need to get to campus or get their shopping done?  
	We need to consider their financial picture.  Do they need SSI?  Do we need to help them get that type of assistance?  Those kind of things.  
	Number 8 is a self-determination goal.  We need to look at what are the resources to help this student become more autonomous and have more control over their life, to be able to advocate for themselves better, in high school and also into adulthood.
	Number 9 is social competence, again, going back to the social skills, looking at how can we help the student be more comfortable in social situations?  Be more knowledgeable in social situations?  So that they can network at work, they can make friends, and they can be better integrated into their community.  
	Number 10 is a health and safety goal.  Does the student have health issues that need to be considered?  Do they have diabetes and have a difficult time managing that?  Do they have behaviors that might be unsafe, and do we need to help them learn how to manage those behaviors?  
	Some things to keep in mind with transition, the whole process, not just the actual transition IEP.  Plan early, assess early.  We talk about helping students at the age of 14 start to plan for their transition.  However, a colleague of mine once said the conversation needs to take place in kindergarten.  And although that may seem laughable, it is absolutely true, maybe not for the child, but for the parents.  The parents need to think about what life is going to be like when they life high school, and what do they see their child doing?  They need to think about the services and support their child might need.  Folks on the support team need to help the parents become more knowledgeable about such supports and services, as well as funding opportunities for their child with autism.  
	We need to look at complete team participation in the process, the transition process.  We can't just have education staff at the table with the parents and students for a transition IEP.  We have to incorporate and invite the adult services support team to the table.  We need to look at the vocational rehab counselors.  We need to look at benefits counselors, case managers from the local community services board or human service agency, and also other folks that might help with utilizing funding resources for the family.  These people need to be at the table at these early discussions.  
	We need to look at functional skills for the students.  What are the skills that they may not have worked on that much in school thus far that they absolutely need to learn to become more independent?  And experience, experience, experience.  I can't say that enough.  The more opportunities we can give these kids to try out jobs and to have community-based instruction and to have opportunities with leisure skills in the community the better.  
	Life skills training works.  How should these life skills be taught?  
	Applied behavioral analysis and a portfolio of skills context.  Let me explain that a little bit.  As you probably know, ABA has a wealth of research in its effectiveness on a continuum of ages, disability groups, populations, and treatment environments.  The actual ABA methods used are critical.  Teaching should be in natural environments when we're in high school.  We should be utilizing the current levels of performance of the student.  Programs should be set up to teach functional skills utilizing the ABA model.  
	When we talk about a portfolio, we are talking about a performance assessment where we are looking at the student's ability to apply the knowledge and actually demonstrate the knowledge they have attained thus far.  We are not looking at skill acquisition, per se.  We are looking more at where is the student now at demonstrating all these skills we have tried to teach them?  
	An example of a portfolio might be actual video of a student performing a task.  It can be actual examples of a student's work that can be shown to a variety of support persons or a potential supervisor during an interview.  
	Where should we teach these skills?  Again, in naturalistic environments.  Teaching those skills in businesses, in shopping malls -- which aren't so popular anymore.  Maybe shopping strip malls.  Community colleges.  We teach on the bus.  We teach on the street corner, the community rec center, and other places.  
	Students with autism have difficulty in generalizing from one environment to another, an acquired skill, so getting out in natural environments truly can be an effective way for the student to understand and to practice that skill.  
	So I'd like to shift gears a little bit at this point in time and talk to you guy as little bit about some promising models of employment models, but also higher education models and service delivery practices for students with autism.  
	First we are going to touch on the Project SEARCH model.  You have probably heard of Project SEARCH, but if you haven't, this is a very comprehensive employment model that came out of the Cincinnati Children's Medical Hospital.  It was created by Erin Riehle, who was a nurse within that hospital.  Currently there are over 140 project search sites across the country.  Here at VCU, at the Autism Center for Excellence, we have a Project SEARCH replication project, and it's called the DRRP, which stands for Disability Rehabilitation Research Project, and it is supported through the National Institute on Disability research and rehabilitation, which is NIDRR, and the U.S. Department of Education.  
	Our project within ACE is looking at three different variables.  What we are concerned about and interested in are employment status upon completion of the program for these students.  We are looking at the wages of these students.  What rethis making when they finish this program?  And also how many hours are they working when they finish the project SEARCH?  
	So the key concepts of Project SEARCH.  The first one is collaboration with business, education, rehabilitation or voc rehab, and developmental disability services.  Again, this is a comprehensive model where the business that's interested in employing and working with these group of students gets together with the education staff from that area, teachers, special education -- let me back up.  
	Some of the key concepts of the Project SEARCH model are collaboration with businesses, education, voc rehab, and developmental disability services.  Again, this is a comprehensive model that truly brings to the table representatives from these various entities.  
	The businesses will work with the education staff, who will work with the rehabilitation staff and the developmental disability staff.  Really, this collaboration is the true essence of Project SEARCH and how it's been so successful.  
	Related to that is the funding.  The funding is off theed coming from different sources, braided, and utilized in different ways to help the students.  
	This is a model of immersion and impact where the students are located within the business.  The classroom is in the work site.  The students engage in internships, where they practice the job skills within the business throughout the day.  So it's training in real work settings.  These students are not sitting in a workshop somewhere practicing.  They're actually doing the positions.  They are learning as they go, learning on the job.  
	This is a low-risk model and low cost for businesses.  The students are supported by the teachers and the job coaches within the work site.  And the students are supported until they know their job very well and can be faded off from support.  
	At the end of the internship, the expectation is the students will get jobs if, indeed, the jobs have been good fits for them.  So the ultimate goal is employment for these students after the internships have finished.  
	So let's look at a typical school day for a Project SEARCH participant.  At 8:00, they will come into the business site and work on employability skills, depending upon where their internship is.  They might work on different skills.  At 9:00, they go out to their work site, and they engage in the work, they learn their jobs, and they practice right there on the work site.  
	They'll have lunch, they'll go back to the work sites.  Then what's really nice is at the end of the day, they will reconvene for a review of the day, they're look at their work plans, how they did for that day.  They'll participate in journaling, where they will record how the day went, how they did with their job tasks, anything new that they learned, anything else that they'd like to work on the next day, and also how did they do with managing their behaviors if that was an issue for the student.  And at 2:30 they depart the work site.  
	Some of the instructional strategies used on the Project SEARCH site are task analysis forward and backward chaining.  Differential reinforcement of other behavior or incompatible behavior.  Behavioral rehearsal.  So actually having the student practice the skill that they are trying to learn.  Applications of technology.  Again, going back to some of the wonderful resources we have these days, iTouches or iPods or different things like that that can help the student throughout their workday in a variety of ways.  
	They also utilize alphabetizing.  They have behavior plans with incentives if the student does need a behavior plan.  They are reviewed before and after each shift for the student.  This really guarantees that that student has ownership of the behavioral goals they are working on, in addition to an awareness of how they're going to help themselves to self-regulate, to manage their behaviors and their emotional states.  
	Another support is the five-point scale.  It's a visual cue.  It's a very effective tool that can be used for a variety of behaviors, including voice regulation, anger regulation, education levels, and so on.  And we'll see an example of that in a future slide.  
	So let's look at an actual project search student.  This student's name is Paul.  It's not his real name, but that's the name we are using here.  I've known Paul for a number of years prior to his Project SEARCH placement, and when I found out that he was involved in Project SEARCH, I was very excited because one thing that I always had tried to advocate for Paul was for him to have experience in the work site and to have a good job coach.  So this is a very exciting story for me.  
	To help Paul transform from a student to employee, there were some goals that he needed to work on.  One was practical math, where it was, in particular, the visual recognition and identification of fractions, which was very relevant to his job tasks.  He also needed to get a little bit better at counting mixed money, change and dollar bills, that kind of thing, so that he could navigate through leisure -- or excuse me -- so he could navigate through break time and lunch time, buying food and drinks, that kind of thing on the work site.  
	He also had to work on his functional reading.  In particular, identifying information that was relevant to his job tasks, to be able to read some of the books put together so he could understand which order they should be in and to understand when he was given a work assignment.  
	He also needed some practice with vocational skills, such as sorting materials, matching, and work speed.  Paul has a tendency to be a perfectionist, and he really takes his time to be meticulous with his tasks.  However, on the work site, he needed to speed up just a little bit to become more productive.  And he also needed some assistance with task list so he could complete his work.  
	The environments where Paul was supported was at school, the community-based instruction, and employment site.  
	So let's look at Paul's strengths, of which he has many.  He has an excellent work ethic.  This guy is a loyal worker.  He wants to come to work.  He wants to please people.  He wants to do a good job for his supervisor.  He likes to hear that he's done a good job.  He is a very good asset to the company.  He is able to understand new concepts and catch on pretty quickly.  
	Paul does have some challenges that he works on.  Because of his perfectionistic traits, he has difficulty accepting criticism.  I think a lot of us experience that.  We really need to help him understanding not to take criticism personally but to see it as a way to do his job better and learn.  
	Ehen Paul would get agitated, he has a history of cursing, and he also has a history of some intense anger outbursts that could include aggression.  So those behaviors don't bode well on the work site, and Paul was very motivated to work on these.  Which he has done a beautiful job with.  
	Some of the supports, intensive social skills training so he could understand what people are saying to him and what they mean and where they are coming from, other people's perspectives, so he is less likely to see things as being critical, so he can actually learn from them instead.  
	Check-in and check-out procedure with his job coach, where in the morning he would talk to his job coach about how he's feeling about specific things, and we'll look at his list in just a minute.  
	And at the end of the day, how did his day go, and how were his emotions during the day?  Did he have difficulty controlling his emotions?  Did he get upset or agitated or anxious?  And how did he handle that?  
	Another practical support is a think sheet, and we will look that in a minute, and he also utilized a level plan.  
	Let's check out the think sheet.  If you can see this, I think it's pretty clear.  This is a really unique, very simple tool that can be utilized for a lot of students.  So basically, if a situation occurred on the job site where Paul had difficulty with maybe he had a conflict with a coworker or got upset with something his boss said to him, and maybe he didn't handle himself as professionally as he knew he should, he might process later utilizing -- he might process later utilizing this behavior think sheet.  
	You can see at the top, "I was not," then these squares here have different options for him to check and then review.  One is respecting personal space.  The other one is using professional language.  The symbol right there is listening with the little ear on it.  The other one where we see a police cap is following rules.  And then there's a blank space to write in something else that might have been pertinent for that episode.  
	So what he could do is check these off and write down how was he not respecting the person's personal space?  For example, did he touch the person when he got agitated?  Was he using professional language?  He could mark down here that he cursed and so on for these different options.  
	And at the end he has the ability to write down a narrative of the incident, what happened before the incident occurred, what made him upset, how did he act, how did the person respond to how he acted, and how did it end?  
	Then he has the opportunity to think about what he could do next time.  For example, you see on here where the hands are, it says keep my hands to myself.  That might be an option for him.  In this particular occurrence, he needed to use professional language next time and think about that.  He needed to respect personal space.  And he needed to use flexible thinking.  That's a biggie for a lot of our students with autism is the ability to adapt to a new situation or deal with confrontational or conflict to think out of the box and to come up with a productive way to handle a situation.  At the bottom, Paul is able to brainstorm about what to do next time if a same or similar situation arises.  That's a great tool.  
	An essential component for this, lastly, is for him to be able to remediate a relationship, to be able to go back and repair the relationship.  In this case, he apologized to the person that he got angry towards, and he apologized and he explained where he was coming from, and this is essential for Paul to build that social repertoire.  
	Here's an example of a five-point scale.  This is a really neat, simple tool to use.  Again, it can be used for not only voice regulation, but it can be used for emotional regulation, stress, all those good things.  
	So let's look closer at Paul’s here.  Number one represents Paul in a very good mood, happy-go-lucky, low stress, everything is going fine.  To number three represents getting a little anxious, getting a little upset, a little stressed.  Then all the way to five, as you can see, that little face there shows someone who is very angry and in the red zone because it's colored red.  
	And so below that is a chart where we have listed out the different parts of his job and where he might actually get upset.  For example, the first one is a supervisor gives me feedback or constructive criticism, and so at the end of the day, Paul goes back and reviews this chart and checks off how these things made him feel that day.  On this particular day, it kind of made him feel both.  You'll see number one and number two are checked off.  So in other words, he by and large is okay with the criticism or the feedback that his supervisor gave him, probably a couple of occasions he got a little bit upset about it, but really nothing too unmanageable.  
	If we move down to the second one, it says someone or something interrupts me while I’m working.  He doesn't like to be interrupted.  So on this particular occasion, it did make him fairly frustrated.  
	So this is just a great way for him to go back and review how he felt that day and to again help him manage those self-regulation skills.  
	So let's look at what Paul actually does at the hospital.  He works in the Ricoh or the print shop, where he engaging in delivering mail.  He also meters the mail as it comes in, and as you see here, he is involved in binding some kind of a booklet.  So he works with a variety of technology and also a variety of equipment that he's had to be trained on, and he is doing an excellent job on this site.  
	Let's review one more transition example.  This is not her actual picture, and this is not her actual name, but we're going to go with this young adult by the name of Melissa.  She has asperser’s syndrome, someone I worked with in the past.  What I’d like to do is talk about the process we went through for transition planning.  
	Melissa came from a household where her mother always expected her to work one day.  She had high expectations for Melissa, and Melissa grew up believing that she could work and she could go to college one day.  
	So that conversation started early in their home.  Some of the school supports she received was lots of community-based instruction.  She was able to participate in some situational assessments where she tried out different jobs and volunteer activities, which were essential for her to get her feet wet in the different skills that she might be interested in.  And for also -- and also for persons supporting her to understand where she might need extra supports and extra training.  
	The team also participated in a person-centered plan where they looked at Melissa’s life, where she came from, where she grew up, where she went to school, relationship map, like who is involved in her life as far as friends, family, staff, and the community.  
	And what we found out from that process is that she was very interested in getting a job, and at some point in time, she wanted to go to college as well, but she really was excited to get a job because she had been hanging out at a thrift store and really liked this place.  She loved looking at the new clothes that came in.  She got -- she befriended the supervisor or the owner of the thrift shop.  And so she really became a regular person there.  
	So the person-centered plan bridged adult and educational services together.  Again, going back to the process of the transition planning, helping get the vocational rehab staff at the table, helping to get persons who know of funding sources to the table, very important in this process.  
	We also utilized historians, in other words, family members, older teachers came to the table for the person-centered planning process.  And they are able to shed light on some strengths of Melissa’s, some areas where she had struggled in the past, and some effective supports that worked with Melissa.  
	This process, like other person-centered planning processes, highly visual.  It was graphic.  It was informative.  And it was experiential.  We had everybody sitting together as we drew the graphs and the pictures and we talked about what are her dreams and we looked at who is in her life to help her get to the goals she wants to achieve.  
	So the outcomes through this process, the IEP goals on her transition IEP included getting better at accepting directions and feedback.  Again, like Paul, she was a perfectionist.  She did not want to make a mistake.  Very difficult time when she would make a mistake or when her supervisor had to -- and job coach had to help her with doing things a different way.  She also had to work on her personal hygiene.  Sometimes she might forget a couple of steps in her hygiene routine, so we really had to help her with a task analysis and a checklist so she -- when she was grooming herself in the morning, she would get all of the steps completed.  
	She also needed assistance staying organized.  She would sometimes go off on tangents in her workplace, and she needed to be -- she needed to be brought back to stay on task.  
	She needed to communicate break needs.  She needed to recognize when she was getting anxious or agitated and to be able to ask her supervisor or her job coach for a break.  
	And so again, she loves thrift stores.  She ended up working at a local thrift store.  She knows lots of regular customers.  They come in and look for her and ask for her.  Some of the job tasks she engages in is she sorts the new items.  She loves this the best.  It's like Christmas for her when someone brings in a batch of new clothes because she can sort through them and check them out and see if there's anything she would like, but also she really likes the -- she's interested in the clothes and likes to talk to customers about the new items they've gotten in.  
	She hangs up the clothing.  She inspects the items for disrepair or cleanliness.  She tags items, and she stocks the racks and the shelves.  
	So that was Melissa.  So we've looked at the project search model.  We've looked at Melissa, which is an example of a customized employment model, where she was able to engage in job discovery, where she was able to try out different jobs, and her support persons were able to really key in on what her interests are and her strengths.  
	There's also another model called self-employment, which really fits under the customized employment heading.  Self-employment is where a person with autism or other developmental disability basically starts their own business.  The support team helps them to identify what they're interested in, brainstorms a product or a process that they might be able to engage in on a regular basis, and really helps the person to start their own business in something they're interested in.  
	Another resource I’d like to demonstrate to you is called the I’m determined project.  We talked a little while ago about the importance of self-determination, self-esteem for these kids.  And this is a great tool that I have heard several divisions across the state of Virginia utilize.  What this is is basically it's a collaborative project between the Virginia department of education and the technical training and assistance centers at jams Madison university and other regional t/tacs across our state.  This project has the goal of involvement of students in the IEP process, helping students to become more self-directed and become better self-advocates, and it also helps them to integrate and incorporate some of their self-determination goals into their transition IEP.  
	This is the website for the I’m determined project.  
	A couple of post secondary education or higher education resources are right here.  One is going-to-college.org, and this is under the RRTC's website, and this is a wonderful resource for students with autism or developmental disabilities or other developmental disabilities when they're thinking about higher education choices.  
	The second one here is -- are the ace website.  In particular, this is a research study, which is geared toward collecting information for current students who have autism who are in higher education, looking at what supports they're receiving, looking at their areas of need.  And the third resource I’d like to bring to you today is called the ace it in college project, and that is a collaborative project between the VCU RRTC and the VCU partnership for people with disabilities.  And this is a project where students with autism spectrum disorders, neurological disabilities, physical disabilities, or traumatic brain injury can receive individualized supports on their way to obtaining a certificate through the university.  
	So this is the website that will get you a lot more information on this project, but it's a really interesting project that's going on right now.  
	And for the final slide, these two websites, the Virginia autism center dot org is the autism center for excellence website, and on that website you'll find a wealth of information on not only what our project is doing, technical assistance, also our research project, but you'll also be able to take advantage of a variety of training opportunities at little to no cost for you.  Many of these training opportunities can be asynchronous and can be synced with your schedule so you don't have to take them at a certain time.  
	We also have other webcasts like this one that you're watching now archived from the past, and we're going to have future webcasts on a monthly basis, so you can check out our website to get more information on what's upcoming.  
	The second website here is the research rehab and training center at VCU website called worksupport.com.  In addition, this website has quite a bit of resources for training opportunities, for employment instruction for persons with disabilities, for innovative models for employment for persons with disabilities, and a variety of other resources.  
	Well, I hope you've enjoyed this webcast on transition planning and intervention.  It's been my pleasure to talk to you for the past hour regarding this subject matter.  If you have any more questions, feel free to join our discussion board, or you can join in the chat room and engage in the discussion and send me an email.  Thank you very much.  

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