VCU 
2/23/04
WEBCAST:  POSITIVE BEHAVIOR SUPPORTS
Presenter: DR. KATHERINE INGE
     
    
    >> DR. KATHERINE INGE: Hello and welcome to our live 
webcast today on positive behavioral support in the 
workplace.  We have a really big topic to cover today, 
and a very short period of time, so I don't really expect 
that you're going to become an expert in this topic in 
this short period of time.
    However, what I intend to do or hope to accomplish is 
give you a few strategies that you can think about when 
you go to work later today, or perhaps tomorrow, with the 
idea that you're going to be looking for additional 
assistance and resources. 
    I'd like to start and ask you to think about how you 
view people with disabilities.  Now, I think oftentimes 
we perhaps think of people with disabilities differently 
from ourselves and we think, "Well, they have challenging 
behaviors;" or "They have behaviors that perhaps you or I 
don't have."
    A couple of years ago, I found a very interesting 
handout that really made me think about how I thought 
about people with challenging behaviors, and what it did 
was it sort of compared our behaviors - perhaps, things 
that you and I do - versus things that an individual 
with a disability might do. 
    So let's look at some comparisons between how we view 
people with disabilities.
    Since we're thinking about this in the context of 
the workplace, I came up with some ideas that perhaps 
would apply to your job or mine. I'm asking you to 
think, "Well, let's think about ourselves.  We take a 
break.  But perhaps when we think about people with 
disabilities in the workplace, we might say that they are 
off task."
    Or perhaps we say, "We stand up for our opinions in 
the workplace," while someone else might have difficult 
challenges and they're considered non-compliant. 
    Perhaps we think we change our minds and they have 
short attention spans.  Or we might try to make friends 
in the workplace, while they have attention-seeking 
behaviors. 
    This particular handout made me stop and think, really 
related to how we might see people in general.  Now, 
think about yourself.  Most behaviors serve a purpose for 
you or for me.  I think most of us have interfering 
behaviors.  You might stop for a minute and think 
about yourself.  Think of some things that you might have 
done yesterday, the day before.  Did you take a break 
that was perhaps a little bit too long?  Did you get up 
from your desk or leave your workstation or perhaps go 
out to your car when you might have thought you should be 
working with a customer on his job site?
    Think about some of the things that you or I do, 
and then think about that in relationship to an 
individual with a disability.  Perhaps we're really more 
the same than we are different. 
    As we're thinking about people today, I think the 
other thing that we really get caught up in is really 
labeling people. I would really challenge you, if you 
don't remember anything else that I talk about today, 
please remember this when we're talking about supporting 
people who need extra support in the workplace.  Let's 
not say that they're non-compliant.  Let's not talk about 
people being withdrawn.  Let's refrain from saying that 
someone is uncooperative.  I think that you could 
probably think of a million things yourself, if you were 
sitting there, are labels that perhaps we have given to 
people who have really extra support needs.  And let's 
try to think about it from the perspective of extra 
support needs.
    Before we go on to another slide, I really would 
like to just comment a little bit more about how we think 
about behavior in the workplace.  Our behavior versus 
perhaps someone that we are supporting. 
    A real key concept for me is that you and I really 
know when we are perhaps doing something that we 
shouldn't be doing in the workplace.  Perhaps we realize 
when we've talked a little bit too long to a coworker or 
we realize we've stayed away from what we really were 
hoping to accomplish within a set period of 
time.  These are things that probably the individual with 
a disability is not aware of.  We know when we hear 
the boss' footsteps coming down the hall that perhaps we 
should suddenly get busy and look busy and get our books 
out or get whatever assignment or work task that 
we're trying to accomplish out so that the boss sees us 
busy instead of talking to our coworker at the water 
fountain.  I think this is something that we really need 
to think about when we are assisting the individuals in 
their workplaces.  We need to assist them in learning, 
really, that work culture, learning how to fit in, how to 
be socially appropriate within the workplace.  These are 
skills that they haven't really often typically learned.  
I think it's really, really important to consider. 
    The next thing that I think is really critical to 
consider is that all behaviors serve a function for us.  
That is really key when we're looking at people in 
their workplaces, or even if we're working with 
individuals in other community environments, or even 
within our workshops, if you are working within a 
workshop setting, that there are possible functions of 
all behaviors so that let's look more closely at what 
really that is accomplishing for the individual.   
Typically, if we can find out what the individual is 
trying to say to us, then perhaps we can be more 
successful in supporting that person in integrated 
community environments.  The first thing that I 
really like to think about and to encourage you to think 
about is for those people who really don't have good 
communication skills, who really can't tell us what the 
problem is, what the concern is.
    Perhaps what we're seeing and what we might see as 
a challenge or an extra support need in the workplace is 
really the person trying to tell us something.
    Another issue is that for some people, these extra 
support needs or these challenges that we're seeing have 
really come to be a way that the person can control the 
environment, and perhaps it means that they're getting 
extra attention from coworkers and that's what's really 
creating the problem.  Perhaps you're not able to fade 
from the worksite, because the person is doing something 
that is seen as difficult and really, that's the person's 
way of controlling you and controlling the situation and 
maintaining your presence in the workplace.  That 
really feeds to our next point, which is really 
attention.  I would caution you to remember that for 
some people who have never had much attention, that even 
negative attention -- when we say "Please don't do that" 
or "Please go back to work" or "Please don't go do that," 
even negative attention can be perceived as positive for 
the individual who has those extra needs in the 
workplace.  I think that is really key or important to 
remember. 
    Before we move on from that slide, I really would also 
caution you to think about, if we go back to the point on 
communication, what perhaps the person might be trying to 
tell us. Which reminds me of a situation at one point 
where we had placed a young gentleman into a workplace. 
He tended to have extra support needs and almost from 
the first day of work, he began hitting his face.
    It would be very easy to jump to the conclusion 
that the person did not like that job.  It was early on, 
it was the first or second day. We thought, "Well, oh 
my goodness, we're going to have to do something about 
this, we've never seen this individual, you know, do this 
in the past."  But we stopped and we thought, "What is 
the function of this?  What, perhaps, could this 
individual be trying to tell us?"  And we stopped, we 
thought, we talked to his parent, his mother, and 
absolutely found out that the problem was that he had a 
severe toothache.
    Not all support needs are going to be solved in 
that simple a manner, or as in this case, a trip to the 
dentist. But, we really do need to think about what the 
person is trying to communicate to us when they are 
talking or displaying some of the challenging behaviors.
    Along that line, some other important 
things to consider really would be control.  In this 
situation, I don't really mean control that the person is 
displaying the difficult challenge related to trying to 
control the situation; but rather, we have given limited 
control to people with disabilities. Therefore, when 
we say "Congratulations, here is your job," and that 
individual has no input into what that job is, then we 
have really, I think, perhaps done a disservice. We 
have maybe set ourselves up for some challenges related 
to the fact that we haven't looked and seen what the 
interests of the person actually are, and really thinking 
about where that person can have some control around the 
situation.
    The other really important thing that I think we need 
to think about is relationships.  We're taking someone 
who perhaps has never been in the workplace before, and 
these are people that they have never met before. 
Really in the beginning, we may have some issues because 
there are no relationships between this individual, the 
supervisor, the coworker, and that, in and of itself, 
could create some concerns or issues.  We need to 
really focus on day one on how we're going to build those 
relationships and not put ourselves between the 
individual and the coworkers. 
    The next thing that I would really challenge you to 
think about is to think about really brainstorming with 
your coworkers when you have issues or concerns 
with a particular person and their support needs. Because, 
we can't accomplish all of these things ourselves. 
You might just be more successful if, in fact, you 
brainstorm with the person who is having the challenges 
and brainstorm with your coworkers yourself.
    The last point that you see on this particular slide 
is community access. Within the context of community 
access, I think it's very important to really evaluate 
what we're doing with people with disabilities.  
Unfortunately I think sometimes we limit 
community access to people, because we say they have 
challenges.  We don't let them go out in the 
community.  We maintain them in our segregated 
environments, being concerned really about what's going 
to happen within the community. 
    I'd really like to share with you an example here 
around community access and around really community 
expectations, what people within the community 
perhaps are more tolerant sometimes than maybe you or I 
are of the individual's challenges.  This reminds me 
of a young man that we worked with a couple of years ago 
who was working in a mall.  His job was negotiated 
for him. What he did was he actually cleaned the 
entrances to the mall, washed the windows, and he had a 
number of those windows to wash.  He'd go from area to 
area to area. 
    This particular job was very well suited to this 
gentleman. He really liked to move around, so he 
had some great distances that he could move from one 
window to another. And, he liked to push his cart around. 
These were sort of positive things about this 
particular position. 
    He also really liked to sing.  And when I say "sing," 
I perhaps mean that he liked to make loud noises as he 
moved through the mall and pushed his cart.  He had 
learned his job, and he was pretty successful with it. 
Part of his day he was there just with his coworkers, 
and the mall workers who were really familiar with him 
and would greet him. And, he would interact with them.   
Part of his day really was after the mall had opened.  
I remember this particular day when there was going 
to be an antique show in the mall.  That was a kind 
of interesting plus for me.  I'm thinking, "Well, perhaps 
today would be a good day to go and visit Michael."   
I should comment today I'm using people's names but these 
are not really their names.  These are pretty much 
made-up names to protect the confidentiality of 
the individuals.  I thought, "Well, today would be a 
good day, and I'm a little concerned about all these 
antique dealers that are setting up in the mall."   
Perhaps Michael, with his fast pace of pushing his cart 
through the mall, and he's used to having pretty much free 
rein, that that could be a problem.
    I went out to the mall that day. I happened to 
be standing over behind a potted plant that was a rather 
large potted plant.  Any of you who are employment 
specialists probably could really relate to my story 
about standing behind somewhere so that the individual 
couldn't see you.  Occasionally when I start 
thinking very seriously, I'll get a frown on my face, and 
I might look like I'm very concerned. So here I am, 
you can sort of see this picture.  I'm standing behind 
this potted plant. I've probably got a frown on my 
face. One of the antique dealers is setting up her 
space. She sees me over here behind the potted plant 
where Michael can't see me, by the way.  He happens 
to be singing very loudly, and pushing his cart rather 
fiercely. I'm thinking, "Should I intervene?   
Is he going to hit anything?  
Should I go over there to him?"  I had this look 
on my face, I'm sure.  And the antique dealer is watching 
me, not necessarily Michael, my, quote-unquote, 
challenging behaviors and perhaps my support needs. 
The antique dealer came over to me and tapped me on the 
shoulder and said, "Dear, you really don't have to worry.  
He's not going to do anything.  He's just singing."
    I really give you that story because I think, 
some of you who have heard me talk before may know, 
that it's actually one of my favorite stories. We 
probably sometimes put barriers in the way of people when 
the community may perhaps be a lot more forgiving and a 
lot less demanding than you or I perhaps are.
    I would really challenge you to think about that 
when we are perhaps withholding community access from 
people that we are working with. 
    Saying that, I would like to say, "Are we part of 
the problem or are we the solution?"
    What I'd like for you to really consider as we're 
looking at this particular slide is, "What have we done in 
relationship to the job match?"  We've already talked on 
the whole idea of making sure that the job matches the 
person's interests and abilities, even though the 
individual may have more intensive support needs than 
someone else.  Have we really thought about what that 
person's support needs are when we do that job match?   
I remember a young woman who really talked a lot. 
When I say "talked a lot," she really had, I guess, 
nonstop vocalizations. A lot of it was sort of 
nonsensical. Really the key to working with her in 
her situation was finding a workplace, obviously, that 
didn't require her to remain silent.
    That's really key.  What are the support needs?  
Can we find a job site that will match those support 
needs? 
    When I say "have we set the person up to fail," it 
would be to go back to my example of the young woman who 
talked all the time, if we put her into an 
environment that needed her to remain quiet most of her 
workday.  Another example might be the individual who has 
very colorful language or let's be very blunt, uses 
a lot of obscene language.  Certainly we wouldn't put 
that individual within a workplace where that might be a 
problem. Hopefully we could match the individual to a 
worksite that would be more appropriate where, perhaps, 
even the coworkers have colorful language such as within 
a construction site. 
    Those are things that we need to think about 
when we're discussing are we part of the problem or are 
we the solution. 
    When we're really looking at supporting people in the 
workplace, I would really obviously challenge you to 
think about positive supports versus negative 
consequences.  Unfortunately I still hear, when I 
talk to employment specialists who are working with 
people with more intensive support needs, things like, 
"Well, if they don't do their job, then they won't get 
access to something."  There might be a very subtle 
difference here in flipping this around and thinking 
about giving access to things when people really are 
positive, when they interact well with the environment.  
But if we're constantly thinking about negative 
consequences, then I'm not sure we're going to be very 
successful.
    The other side of that is that if we think we're going 
to eliminate behaviors, typically what happens is that if 
you or I were to go into the workplace, we could work 
very hard and perhaps we could eliminate the challenge. 
But if you or I are the person that does that, then once 
we're gone, the person is probably going to go right back 
to what they were doing before that we perceived as being 
the support need. 
    Another really good point to think about is 
that you or I, as the employment specialist, really can't 
be the ones that always implement these things  
or strategies that we're going to talk about 
in a few minutes. Primarily the individual needs 
to learn positive behaviors or strategies so that he or 
she can manage the situation. The coworkers also need 
to have tips and strategies on how to assist the 
individual into fitting in that workplace.
    Those are really, really key things to think about.  
If you go for the negative consequence approach, I 
think what often happens -- and if you have children, you 
could probably think about this from that perspective -- 
is the person who does the punishing is typically going 
to be the person that gets avoided.  Think about that 
if you are thinking about using negative consequences in 
the workplace.  Obviously, it's not really socially 
appropriate, to begin with.
    [Next is] one of the old tried and true 
strategies that we might take a look at when we are 
trying to figure out what the person's support needs are 
within the workplace. Those of you who have been 
around for a while, like I have, might have heard of just 
this idea. Do an ABC analysis of what's going on. 
Essentially what we're trying to do is find out 
within the "A" part of this analysis, what happens before 
the individual perhaps does this behavior, that we have 
determined is an extra support need for the individual.
    What happens before?  Is there a trigger in the 
workplace that really -- I don't want to say causes the 
situation, but in some ways, perhaps, that's as good a 
word as any to think about what happens before.
    I would really challenge you to think about what 
the person really does. This goes back to my earlier 
slide, where I asked you not to think about the person 
being non-compliant or the person being withdrawn because 
that doesn't really tell us what the person is doing.  I 
want to really know what the person's doing.  Is the 
person sitting down on the floor and refusing to get up?  
Is the person going to the break room and staying there 
for 30, 40 minutes at a time, and refusing to come out 
and do the tasks?  I want to know exactly what it is that 
the person does.  Can we tell, is there anything 
consistent about what happens before?  Then really 
thinking about what happens after that behavior occurs.  
Because, sometimes it might be what happens after, that is 
maintaining this particular support need, as well as 
what's happening before. 
    Those are really, I think, things that we can take 
some initial data, probably not the best choice of 
words. But, we can do some observation and get some 
beginning ideas about what the support needs are of the 
person. 
    The next thing that I would like to 
challenge you to think about within the whole context of 
really trying to identify what the support need of the 
person is -- we've really already touched on being 
specific about what it is -- is there any particular time 
of day that this occurs?  How do the coworkers react?  
How do you react, for that matter?  Is there a specific 
location within this workplace where the particular 
challenge or support needs occur?  Because all of those 
things can really give you some ideas about how you can 
go about supporting this individual and being more 
successful.
    Another thing that you might want to think about -- 
and this somewhat goes back to what we've already talked 
about related to our ABC analysis -- are there specific 
situations or conditions within that workplace that the 
particular challenge occurs so that we can really look 
at that.  I would say that sometimes we can be 
more successful, really, about changing what's going on 
in the workplace, perhaps, than we can be about changing 
what the person is doing.  Really targeting what's
going on around the person, and those things can really 
give us a great deal of success.
    I'd really like to -- perhaps you can tell already 
that I like to tell stories -- but I'd really like for you 
to think about the whole issue of can you identify a 
specific time of day that the situation occurs. This 
reminds me of a time that an employment specialist came 
to me and said, "Well, I don't think this particular job 
site is going to work out because the person is getting 
food and eating food out of the trash can.  I really 
can't think of how we're going to stop this.  You know, 
I've tried taking it away from her."  Now, think about 
that, if the person said to you, "I've tried taking it 
away from her."  That should send a little red flag up in 
your mind to think about whether it is attention that the 
individual is looking for.  Really, when you're 
looking at some of these things, I'm kind of asking you 
to be a detective, to put your thinking cap on, and to 
look really within the context. -- I'm kind of 
digressing from my story there. 
    The first thing that I thought about when we 
sat down to brainstorm the situation together, my first 
question was, is there any specific time of day that this 
is occurring?
   When he looked at it, and he stopped and 
thought -- and that's the employment specialist in this 
situation -- he said, "Well, as a matter of fact, yes, 
it's almost pretty consistently first thing in the 
morning."
    When we explored this, we found out that the 
person was not eating any breakfast.  Again, I'm giving 
you a simple story. You may be sitting there thinking 
to yourself, "Well, all of these examples are really 
simple."  But, I would also say that sometimes it's the 
simple things that we tend to overlook when it comes to 
the specific needs of people in their workplaces. So 
please, don't overlook some of those simple things.
    In this situation, it happened to be so simple as 
encouraging the person and the group home to ensure that 
the individual got to eat something prior to leaving for 
work. 
    Going along some of these lines, let's stop and think 
a little bit more about what the functions of the 
behavior is for the individual.  This functional 
analysis really is written pretty extensively about in a 
book that was written by Meyer and Evans. I'll have 
that resource for you posted online so perhaps you can 
explore it a little bit further.  When they talked 
about what is the function of the behavior, what they 
really asked us to do is to describe exactly what's 
happened.  I've already sort of challenged you to 
think about exactly what is going on, as opposed to sort 
of using value-laden statements about it. Then they 
suggest that you really stop and think about really 
putting that thinking cap on again. What hypothesis or 
alternative explanation could we have around why, 
perhaps, this person is displaying this particular 
support need?
    Once you come up with that hypothesis or alternative 
explanation, what they suggest that you do is to really 
test that by, again, manipulating the environment.  Maybe 
"manipulating" is not exactly the best choice of words in 
this particular discussion, but rearranging, perhaps, 
would be a better way of looking at it.  What can we do 
that perhaps would assist the individual in being more 
successful.  Let's look at that really more from an 
example perspective, so that maybe it will make a 
little more sense to you. 
    In order to do that, we're going to look at it from 
the perspective of a young gentleman who was working at a 
Pizza Hut.  This particular Pizza Hut was very 
supportive. The individual's job task had been 
negotiated for him. He was  
scrubbing pizza pans, filling condiment containers, and 
putting away supplies around the kitchen, once the 
coworkers were done with them.  In this particular 
situation, very specifically what the support need was 
was that the individual would scream and run out the back 
door of the Pizza Hut and sit on the curb and refuse to 
get up.  That was his particular support need that we 
needed to address or consider. 
    In looking at this you might think, "Well, I 
can't imagine that there would be an employer that would 
allow someone to scream and run out the back door and sit 
on the curb."  However, again, I would say that  
the employer in this situation was very supportive and 
did want this particular individual to be successful.   
The first thing that we did in this particular situation 
was really to start brainstorming as a group what the 
support need of this individual was, what really perhaps 
are some of the reasons or alternative explanations. 
    In this particular situation, I think it would be 
very easy to say, "Well, we're going to throw up our 
hands. We're going to say this is not a good job match.  
I guess we're just going to have to quit the job."   
In fact, I would say to you that's what the employment 
specialist said.  "I really can't encourage him to get up 
off the curb once he sits down. I've tried talking to 
him. I've tried reasoning with him, and he just won't get 
up."
    I would say to you that typically this kind of 
tug of war situation is really not going to do you any 
good. Perhaps that would be my first tip when I'm 
thinking about working with an individual who has 
this type of support need.  It's not going to help you 
any.  The more you talk, sometimes, the more resistant 
the person could get to be. So I'd say, "Well, 
let's stop and think for a minute.  Is it a good job 
match?  The individual really had expressed some interest 
in working at the Pizza Hut."  Perhaps we thought, 
"Well, maybe it's something within the situation that the 
individual is trying to tell us."  I have a long 
laundry list of things that you were just looking at on 
the slide.
    We looked at saying, "Does he need to take a break?  
Is this task too simple or is it too complex?"  I'm 
not really saying in this situation that it's both of 
those things. Although perhaps the individual does have 
different work tasks, and some of them are too complex and 
the individual doesn't know how to perform those tasks; 
versus them being too simple, and the person perhaps is 
bored, and the job isn't challenging enough. 
   We need to determine, does the individual know the 
expectations of the job, does the individual know how to 
perform the job? In this situation, is it perhaps 
that the environment is too loud?  I know of other 
situations, not in this particular situation, where the 
environment simply was too loud. In combination with 
some of the other support needs of this individual, the 
volume level of the environment only created anxiety. 
Then the individual would leave the workstation. In 
that situation perhaps a pair of earplugs might be 
helpful.
    Did the person in this situation feel that they were 
isolated?  Did we not work in enough 
relationship-building activities with the coworkers?  And 
in some situations, I think we put people in jobs where 
they don't understand initially that they're working, and 
they're going to earn money. Quite frankly if you 
took me out of one environment and put me in the other, 
and I didn't understand that I was going to earn money 
for what I was doing, and it was really hard, and you're 
increasing demands on me, asking for me to do 
more and more work, and I don't understand what I'm 
getting out of it, then perhaps any of us would have 
extra support needs in those situations.  I would ask 
that you think about that as well. 
    Once we looked at all of those things that it might 
be that this particular individual was having 
difficulties with, perhaps what we needed to think about 
was working in a way for the individual to communicate 
that he needed to take a break.  Perhaps what he was 
doing when he was running out the back door of the Pizza 
Hut was that he was trying to tell us that he'd
had enough. He needed to take a break. 
    Perhaps we didn't have enough for him to do there. 
That we needed to alternate some of his preferred tasks 
within that workplace with some of his less preferred 
tasks. That we were pretty aware that some of his 
less preferred tasks was actually standing at the sink 
for excessively long periods of time. 
    Looking at changing the instructions so that we 
know that the individual understands, again, what the 
expectations are.  Does he need more structure to this 
job?  And finally, facilitating relationships in the 
workplace. 
    I think it's important, again, within the context of 
this individual, to view him from a capacity view. Because, 
if we have, as the employment specialist, gotten 
emotionally involved. Or, [if we] look at it from the 
perspective of that it's our fault, or the 
workplace's fault, or John's fault, 
that this is occurring, if we get emotionally caught up 
in this, and we stop viewing John from a positive 
perspective, then I'd say we're probably going to have 
less chance of being successful with him.
    If we look at him from a capacity viewpoint, we 
perhaps could say that he knows how to get what he wants. 
We also know that he likes the Pizza Hut. One 
thing that we had learned about him was that he was very 
particular about things being orderly.  If we looked 
critically after we had sort of looked at our function 
tests, we might perhaps could say to ourselves, "Well, 
this wasn't a very orderly environment. He likes 
things that are very neat and very organized."
    Some other things that we found out about him when we 
started doing our sort of hypothesis building is that he 
really didn't like a lot of verbal directions. 
The employment specialist was going outside 
and verbally encouraging him to get up.  That was just 
escalating the situation as opposed to calming him down.  
He had never earned a paycheck before, so again that 
didn't make any sense to him.  As I've already mentioned, 
the job site was not very structured. The other thing 
was that he tended to get very frustrated when he didn't 
understand what was expected of him.
    Again, the whole issue of him leaving the 
workplace and going out back was when he got frustrated.
    What was done to assist this individual was really 
to try to place some order into the environment and to 
give him some control over that order.  Basically 
what was accomplished was that we gave him some ways to 
self-monitor his work tasks.  He was given a sort of 
picture job duty sequence that he could check off as he 
finished a work task.  He was also given a small index 
card that had a circle drawn on it and really divided up 
into slices, if you wanted to call it slices. One 
of the things that we found out within this particular 
workplace was that coworkers were able to take pizza home 
with them that was left at the end of the day off of the 
buffet. What we did was really try to associate 
with John's check card, that he managed himself,  
an association between initially that if he 
worked, he could check the work task off on his job duty 
schedule, giving him some order within the 
workplace. Then he could sort of keep count of how 
many slices of pizza that he was going to get to take 
home at the end of the day. 
    What also was accomplished within the 
situation was that it set up a relationship between the 
coworkers and with John in helping him really keep track 
of what he was going to get to take home at the end of 
the day. 
    The other feature of this that we wanted to look 
at was taking a break. Let's look a little bit 
more closely at that around what to do, should he still
[become frustrated] even after we had put into place 
his self-management strategies.
    We wanted to redirect him whenever possible.  We 
didn't want to get into those situations where I talked 
about really getting into a tug of war with him, so this 
particular person you could really read his body language 
and tell when he was getting a little agitated.  
In that situation, what we did and what the coworkers 
learned to do was redirect him to take a brief break.  
They would say, "John, do you need to take a brief 
break?"  [They would] redirect him when they noticed that 
his body language meant that he was becoming frustrated. 
    We've already addressed a little bit the whole idea of 
remaining neutral.  Again, not getting into a tug of war 
with him, and avoiding backing yourself into a corner and 
being consistent with what you're trying to accomplish.  
Does this mean that the first day that we put the 
test card in place with him that he was successful?  
Well, no, it didn't.  It was a gradual change.  He had to 
learn how to really self-manage the things that had been 
a support need for him in the past.  Between the 
employment specialist, the coworker, and John, being 
consistent and working through the situation, he 
did, over the course of a couple of weeks, 
learn how to use his self-management strategy to either 
change the work task he was doing or to take a brief 
break. 
    Initially, when he became agitated, the employment 
specialist allowed him to go out back.  Then, after one 
minute, she would go back and say, "I see you need to 
take a break.  Let's take a minute break." Then she 
would leave.  She would stop getting into that tug of war 
that I mentioned before.
    He quickly learned that there was no attention 
for sitting out on the curb. In this particular 
situation, he was not someone who ran away so there 
wasn't a real critical safety issue. He really quickly 
pretty much learned that the attention was inside the 
Pizza Hut, and not outside.
    Between his sort of self-management procedures and 
the discontinuing of getting attention for that behavior, 
he became pretty successful pretty quickly. 
    I'd like to see if we have time for one more quick 
example.  This particular young woman really had a 
lot of things going for her.  But she had come from a 
workplace where there weren't many, I guess, 
expectations placed on her.  She's extremely 
social. She was a very steady worker. She had sort of 
displayed that she wanted to have a job at a restaurant 
based on some situational assessments that we had done 
with her. 
    The job task that was really structured for her, I 
guess negotiated for her, was rolling silverware at a 
restaurant.  She very quickly learned how to do that 
particular work task. What she didn't learn how to do 
very quickly was that she wasn't rolling silverware very 
quickly.
    Within this context, I mentioned that the job  
was negotiated for her from the perspective 
that the employment specialist, in addressing the manager 
of this particular restaurant and exploring some of the 
things that weren't really getting done to the employer's 
needs. [The negotiated job] was really that the table staff 
or the wait staff often would run out of silverware, so this 
particular job was negotiated for Jessica.
    There really wasn't a production standard in this 
situation, because it was a negotiated job. But if you 
look at the information here, and these are  
random observation periods across the day, 
we see that she's really not rolling silverware very 
quickly, if you say that these are 10-minute intervals. 
At her very best, she's rolling 10 pieces of 
silverware within a 10-minute period of time.  I think we 
all can realize that's what going on.
    Within this particular situation, some of the 
challenges were that she was getting up from her 
workstation and wandering around the restaurant to talk 
to the wait staff.  Obviously, that would not be 
perceived as a very good thing to do while the wait staff 
is trying to work on tables.  She would ask people for 
assistance.  She would go get more supplies when she 
really didn't need more supplies.  Those were just some 
of the things that she was doing within this particular 
situation. 
    The first thing that we really thought we needed to do 
for her was really give her some kind of idea about the 
expectation or what she needed to accomplish within this 
particular task. We gave her a standard of that she 
needed to roll a minimum of 10 pieces of silverware in a 
5-minute period of time.  You'll notice that this is 
a little bit more stringent than the guidelines of 
what she was doing previously. I would also caution 
you when you're trying to work through some of these 
programs that you don't place unrealistic expectations on 
people.  It perhaps would have been unrealistic for us in 
this particular situation to have said, "Okay, you're 
only rolling 10 pieces in 10 minutes. Now I want you 
to run 25 pieces in 5 minutes."  Again, if 
you go back to some of my earlier thoughts about setting 
people up to fail, that probably would have been setting 
her up to fail in this particular situation. 
    What we wanted to do, though, was try to look at the 
work supplies that she used. Their napkins came in 
packs of 50. As we looked at this and we thought about 
it from a time perspective, if she did 5 pieces in 10 
minutes, and we asked her to pretty much do one pack of 50 
napkins in a 25-minute period of time, and we talked to 
the employer about this. The employer was pretty 
satisfied with that particular scenario. 
    Within the context of that, again, what we wanted to 
do was really help her to learn how to manage some of 
these concerns or support needs as opposed to it being 
always the employment specialist.  In this 
particular situation, we knew that some of it was for 
attention from the coworkers and
the employment specialist, so we also felt that she 
really -- when we did some of that alternative 
explanation -- didn't understand the 
expectations that she needed to roll silverware quickly.  
We gave her a timer that had a mark on it for 5 
minutes.  We put some small strips of tape on 
the table in front of her. Ten pieces representing the 10 
pieces that she needed to roll in the 5-minute period of 
time.  She rolled a piece of silverware. She placed it on 
a piece of tape.  The clock is ticking.  She knows that 
when she finishes, what she wants to do is fill up all of 
those pieces of tape before the bell goes off on the 
timer.  Then she gets to check it off on her production 
card.
    If, within that 25-minute period of time, she's 
done this for five times in a row, then the coworker 
comes by, checks her work, says, "Great job, Jessica, 
come on up to the front and we'll greet customers."  
You'll probably guess what restaurant this is without my 
saying.  The restaurant that has a greeter at the front 
door.  She essentially got to go after she 
finished a pack of 50 napkins in 25 minutes up to 
the front door for 10 minutes with her coworker greeting 
customers as they came into the restaurant. 
    A good example of a -- I don't want to call 
silverware a non-preferred activity -- but clearly the 
preferred activity was working with her coworker at the 
front door greeting customers. 
    Really, within the context of that, thinking about 
working in that relationship again, and also working with 
the individual to manage the situation himself or 
herself, so that you as the employment specialist are not 
always doing that.  So making sure that you are involving 
the coworker in any kind of support plans that you are 
coming up with, as well as thinking about, from the very 
first day that you implement any kind of strategy, in 
trying to support a person in the workplace is your first 
and foremost thought should always be, "How am I going to 
get myself out that front door?" Because, the whole goal is 
for the person to be successful with the natural supports 
of those coworkers in that workplace.  Be sure that 
you're not working yourself as part of the program when 
you are designing or addressing any of these concerns. 
    I'd really like to make some closing comments
as we leave today, because unfortunately I think we 
probably could spend all day together talking. Certainly I 
know that you probably still have many, many more 
questions. But some of the things that I would like to 
leave you with is to brainstorm with your coworkers.  
Even brainstorm obviously with the coworkers in the 
workplace.  Involve that person.  The other thing that I 
would suggest to you is to learn from your mistakes.  I 
would really say that in some situations, I have learned 
as much from some mistakes I've made, and 
hopefully could carry some of those things on to 
brainstorming in a new situation or a new scenario. 
    One final funny story. I remember one time an 
employment specialist calling me up on the phone and 
saying, "I've been in the closet for the last 30 minutes 
because I couldn't get out." I thought to myself, 
"Well, I guess you'll never go first into the closet 
again."  I'm not trying to make light of the situation, 
but trying to cue you in to learning from your mistakes.
    In closing, just really trying to encourage you to 
include the customer always in the choices and include 
that individual in learning how to control the situation 
as opposed to having to display some type of challenge to 
get your attention or to control the situation.  I'd like to 
encourage you to join me in the chatroom and perhaps we 
could talk about some of these scenarios or situations, 
or perhaps some of you might have some things that you 
could share with us related to positive supports in the 
workplace.  Thanks a lot. 
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