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Rick's pre-plan

Name: Rick Date: February 10, 2011 Completed By: sister
Skills Challenges Accommodations

Expressive Communication:

Preferred method(s)
Body proximity
Eye contact
Guttural sounds
Some written words (prompted)
Selecting and exchanging photos
Great memory
Little initiation Unfamiliar people may not notice/understand his attempts to communicate Verbal prompts (OK, go ahead, show me) Observe carefully for subtle changes in body posture, eye gaze, sounds and facial expression Have photos available
Questioning
If he is unsure will come right up to your face, use intense eye contact and may make a noise Rick requests but doesn’t have a consistent way to question
Can appear threatening
Use verbal and visual explanations
Indicating yes/no
Walks away for no
Smiles for yes
May make a guttural noise for yes
Difficult for people who don’t know Rick to interpret his responses Rick wants to please people so he may go along with things that aren’t his choice Allow him to walk away when no is his answer
Choice Making
Can print some words when cued with “Tell me what you want” Rick can choose from a visual display of words or pictures If presented in a linear way he just chooses them in sequence Rick prints a phrase beginning with “I want”
On a bad day someone else may need to print the “I want” Present the pictures in a random scatter on the table
Unique words or phrases with a specific meaning
None at present except if he is upset his sounds are louder and more “sing-songy”
Non-verbal communication
This is Rick’s primary and most constant form of communication
Writing ability
Rick can print at least 500 words but not without prompting and usually related to requests or labelling in response to a picture Needs to carry writing tools since he no longer uses an electronic device Needs to practice this skill regularly

Receptive Communication:

Understanding instructions
Rick responds well to verbal instructions when he is calm When upset Rick’s comprehension decreases Repeat an instruction, break a sequence into smaller steps Allow him time to complete the request
Understanding questions
Rick’s receptive communication is good Rick may understand but it is difficult for him to demonstrate that by responding in a timely fashion Allowing him time and offering multiple options to allow him to respond (writing, photos, body language)
Choice making
Can select from a variety of pictures Ensure the presentation is random
Reading ability
Rick has a large sight vocabulary Random selection of words can be used to make choices
Rick appears to have a very finely tuned ability to read others’ intentions He makes quick decisions about who he does and doesn’t like He responds well to people he likes and who are comfortable with him
Reaction to others talking about you (him/her)
If Rick is in the room address him directly, don’t talk about him as though he isn’t there Rick has a great memory Rick may shut down if negative things are being said about him Focus on positives and be very careful when addressing something that may be a challenge If you say you’re going to do something be sure to follow through

Self-Regulation

General disposition
Rick is a generally a happy and easy-going person When he is not feeling well or can’t express something that is upsetting him Pay attention if he lies down during the day (other than his nap) or looks pale
What calms/coping strategies
Evening baths
Afternoon naps (30 minutes)
Sawing wood
Going for a walk
Sweeping
Sitting by the fire
Rick needs someone with him to engage in some of these calming activities May occasionally need a verbal reminder to choose a calming activity Someone needs to run his bath
What upsets
Being rushed
Not being included unless it is his choice
Someone else touching or using Rick’s special
items
Someone else sitting on the fireplace bench or using Rick’s afghan or pillow Ask Rick for permission first before touching his things
Reactions when upset
Vocalizations get louder
Pacing
Shutting down and falling asleep
If Rick gets too upset he can’t self-calm In intense situations make suggestions of ways he can calm himself
If he is under-stimulated he needs a suggestion about ways to be active
Things to avoid
Talking about Rick rather than to him
Excluding Rick
If people are sitting and chatting Rick needs a way to participate Make sure Rick has a role – serving food, taking coats, tending the fire and has his photos/words available if he wants to join in
Essential routines
Housecoat ritual
Fire ritual
Needs to wear a hat
Daily nap and bath
Table must be properly set for meals and grace said
A bathtub isn’t available A hot tub is an acceptable substitute
Warning if a change has to occur
Preparation for change/transitions
Rick is becoming a lot more flexible
With a day’s warning Rick can adapt most of his routine
Someone needs to take time to sit quietly with him and explain what will happen

Social

Greetings – others and yourself
Rick will shake hands, he will accept hugs but does not initiate them
He greets others only when prompted
Will walk past people without acknowledging them Provide a verbal prompt
Conversational rules
May get up and walk away when someone is speaking to him Have a sense of humour about this
Comfort in groups
Because he doesn’t talk Rick needs a role but groups of people don’t bother him as long as he has the option to leave
Safe person
Rick needs someone who is familiar with him to help interpret his responses for others Making sure someone is with Rick who knows him well If Rick wants to take a walk there needs to be someone available to go with him
Food at social gatherings
Rick’s rule is that when a group of people get together there must be food and beverages
People must use coasters
Involve Rick in food preparation, serving and clean up

Sensory

Movement needs
Rick must have the freedom to get up and move If Rick doesn’t move frequently he will lose interest or fall asleep
If Rick is bored he will start to rock
He needs a verbal cue such as, “Do you hear music?” to help him stop
Ability to sit
See above
Favorite items
Fire bench Nothing in particular that he would choose to have at the meeting
Room location and set-up
At his family home – in the living room and sun room No one can sit on his bench or the hearth of the fireplace – otherwise he’s not fussy
General rules to follow
Talk to him
Use napkins and coasters
Rick needs the opportunity to get up and do something about every 10 minutes
Ask Rick to help you
Photo albums and scrapbooks will definitely engage him Explain that kitchen clean up will only happen once the meeting is finished

Explanation of PDP

The night before the meeting, explain to Rick that people he knows will be getting together to talk about good things related to his life and that it will be like a party for him Tell him names and provide pictures of everyone who will take part Tell him about what food is planned and how he will help with that
Tell him when the meeting will happen in terms of his daily routine
Additional suggestions for the actual planning session:
  • Ask everyone to bring a picture of and story about things they have done with Rick
  • Use a storytelling format
  • MAPS or Paths format probably won’t interest him
  • Avoid reference to nightmares
  • Include his sister in BC by speaker phone if she can’t be present
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