Article 9

Article 9 Class

$35.00
Article 9 Class
9.76666666667

Overall Satisfaction

10/10

    Content Quality

    10/10

      Presentation Quality

      10/10

        What makes this class awesome

        • Taught by Master/LEAD Instructors
        • Sets the tone of all service delivery
        • Practical strategies to increase effectiveness

        Things to consider

        • For programs operated, licensed, certified, supervised or financially supported by the Division, failure to comply with any part of this Article may be grounds for suspension or revocation of a license, for termination of contract, employment, or for any other applicable administrative or judicial remedy

        • What a great place to get your training. Staff is personable, training is far from being boring and the time goes by fast!

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          Time goes Fast!
          Rhoda
        • Took the Article 9 course last night and I was so impressed with Marnie! I would love to attend other courses she teaches if there is any.

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          I was so impressed with Marnie!
          Misty
        • I took article nine and attendant care through this company. Sabrina was such a wonderful instructor! I learned so much. I would definetly take training here again.

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          I would definetly take training here again.
          Erika
        • Took the prevention and support class with Estel today! The class was exceptionally taught and she made sure that all skills were understood. Will be back for other classes in the future! Thanks for making 8 hours move efficiently and leaving us with valuable knowledge gained!

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          Will be back for other classes in the future!
          Amanda
        • Took the prevention and support class today at the Chandler location and LOVED it!! I work nights and was not thrilled with having to function so early in the morning lol but the instructor Chris Garcia made it fun!! The day flew by and all of us students laughed the whole time.. He was great! And a cutie..

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          Took the prevention and support class today at the Chandler location and LOVED it!!
          Rae Ann

        ARTICLE 9 – MANAGING INAPPROPRIATE BEHAVIORS CURRICULUM

        (Each of the sections is further explained below)

        • Historical perspective of Article 9
        • What is Positive Behavior Support?
        • Guidelines for Confidentiality, Individual Rights and Abuse/Neglect
        • Positive Teaching Techniques and Strategies                    
        • Behavior Plans
        • Techniques/Programs Requiring Prior Review and Approval by
        • the Program Review Committee (PRC)
        • Training Requirements for People Implementing Behavior Plans
        • Prohibited Techniques
        •  Individual Support Plan Team
        • Distinguishing Between the PRC and HRC Committees
        • Reporting Emergency Measures 
        • Sanctions
        • Article 9 (The Law)

        HISTORICAL PERSPECTIVE OF ARTICLE 9

        In the mid 1980’s, the Arizona Division of Developmental Disabilities was in the midst of deinstitutionalization. At that time, there were three institutional facilities operating in the State. The Arizona Training Programs in Phoenix and in Tucson had already begun relocating individuals into community based services. The population at the Coolidge facility was also rapidly declining. Planning had begun for Arizona to use Medicaid funding to support individuals with developmental disabilities which included compliance with the regulations of the Federal program.

        The Division began to write administrative rules to restructure its practices to comply with the Federal program. Statutes on individual rights and behavioral methods were a significant part of this process and Article 9 was written to address both individual rights and the use of behavioral methods within DDD services.

        The field of Behavioral Science was experiencing a shift in values as well as practice; specifically, in application within the disability community. The long tradition of aversive therapy and punishment within the institutional culture came into question. Federal regulations prohibited certain behavioral procedures and required oversight of others.

        The Division drafted Article 9 in 1988 with representation from the advocacy community, particularly the ARC, the service providers across the State, people with disabilities and their families in order to meet Federal requirements.

        Article 9 has had a significant impact in improving quality of life for many individuals. The sense of community has become the focus as many people, who at one time resided within the confines of an institution, now experience the fulfillment of value as contributing community members. The role of the service provider has shifted, from one of controller, to partner in support of individuals.

        What is Positive Behavior Support?

        Positive Behavior Support (PBS) is an approach to helping people improve difficult behavior that is based on four things:

        • An Understanding that people (even caregivers) do not control others, but seek to support others in their own behavior change process;
        • A Belief that there is a reason behind most difficult behavior, that people with
        • difficult behavior should be treated with compassion and respect, and that they are entitled to lives of quality as well as effective services;
        • The Application of a large and growing body of knowledge about how to better
        • understand people and make humane changes in their lives that can reduce the occurrence of difficult behavior; and
        • A Conviction to continually move away from the threat and/or use of unpleasant events to manage behavior.

        The threat and/or use of unpleasant events minimizes the dignity of the other person, often provokes retaliation, and sometimes causes physical and emotional harm. One example involves overpowering someone and physically forcing him/her to do something he/she doesn’t want to do. If he doesn’t comply, he is forced and continues to be forced until he gives up fighting. A common and relatively minor example includes taking privileges away from a person when she misbehaves. However, even minor use of these approaches can be harmful in that it can take away from the dignity, autonomy, and sense of self-control of the other person. Equally important is that approaches like these that were once effective cease to work, caregivers tend to increase their level and intensity rather than decrease them. They may increase the length of time required in time-out, the amount of privileges taken away, or the tone of voice used.

        PBS involves a commitment to continually search for new ways to minimize the use of these events. This does not mean parents or caregivers should be judged harshly if they occasionally resort to yelling. We all fall back on patterns of care giving that have worked for us in the past, especially when we are challenged by difficult behavior. PBS simply means that we, as caregivers, recognize the times when we have resorted to these types of measures, and continually seek to find alternatives that we can use next time we’re challenged with similar behavior.

        WHY DO WE NEED POSITIVE BEHAVIOR SUPPORT?

        Many people with difficult behavior have been misunderstood and mistreated throughout our history. People with developmental disabilities, in particular, have been subject to a wide array of disrespectful, humiliating and even painful conditions in the name of “effective treatment”. In recent years, however, there has been a growing body of research that demonstrates that even the most challenging behaviors can improve with the help of one or more of the approaches outlined below. The combination of these is the field called Positive Behavior Support.

        This information was developed by the Arizona Positive Behavior Support project of the Institute for Human Development at Northern Arizona University, in collaboration with the Arizona Department of Economic Security, Division of Developmental Disabilities, June 2001.

         

        INDIVIDUAL RIGHTS;

        ABUSE AND NEGLECT; AND CONFIDENTIALITY

        All personally identifiable records, reports and information pertaining to individuals served by the Arizona Department of Economic Security (DES)/Division of Developmental Disabilities (DDD) are confidential.

        Access to individual records and information shall be limited to specifically designated persons.

        Personally identifiable information (including audio-visual reproductions) may not be released without prior written authorization from the legally responsible person, except as permitted by law, regulation or policy. (In all cases, employees should refer requests to their supervisor, DES/DDD support coordinator, or review DES rules [R6-6-105.A.] for specific exceptions.)

        DES/DDD District Human Rights Committees (HRC) may have access to records upon request.

        Health, safety and emergency personnel may have access as necessary to protect the health and/or safety of individuals.

        All individual records should be maintained in an orderly, secure manner.

         CONSENT

        The following three (3) conditions must be met for consent:

        1. The person signing must have the necessary information to make an informed choice when giving consent.
        1. The consent must be voluntary, without coercion involved.
        1. A person, who may need assistance in making an informed choice in granting consent, shall be able to seek advice, counsel or assistance from significant others in making informed choices and decisions concerning consent, without coercion involved.

        RIGHTS OF INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES

        Individuals with developmental disabilities have the same rights and privileges guaranteed to all citizens by the constitution and laws of the United States and the constitution and the laws of the State of Arizona.

        A.R.S. 36-551.01 enumerates additional rights of those with developmental disabilities, including, but not limited to:

        •  Protection from physical, psychological, verbal or sexual abuse;
        •  Publicly supported educational services;
        •  Equal employment opportunities;
        •  Fair compensation for labor;
        •  Right to own, sell or lease property;
        •  Presumption of legal competency;
        •  Right to marry;
        •  Right to petition;
        •  Right to have placement evaluations;
        •  Right to a written plan of services and supports [Individual Support Plan (ISP) or
        • Individualized Family Service Plan (IFSP);
        •  Right to notes documenting progress on the plan;
        •  Right to participate in the planning process and placement decisions;
        •  Right to be free from unnecessary and excessive medications;
        •  Individuals in residential programs have the right to a humane and clean physical environment, the right to communication and visits and the right to personal property;
        •  Individuals in residential programs have the right to live in the least restrictive alternative.
        •  Right to withdraw from services;
        •  Right to be informed of their rights upon admission to services.

        ABUSE AND NEGLECT

        Abuse and/or neglect is prohibited in all services and programs operated or supported by DES/DDD and anyone so doing is subject to dismissal and prosecution. In addition, any person who mistreats an individual by any conduct, which is intimidating, degrading, or humiliating or who hits, kicks, pinches, slaps, pulls hair or improperly touches an individual shall be subject to dismissal and/or prosecution.

        Abusive Treatment:

        Abusive Treatment includes, but not limited to:

        1. Physical abuse by inflicting pain or injury to an individual. This includes hitting, kicking, pinching, slapping, pulling hair or any sexual abuse (including inappropriate touch).
        2. Emotional abuse which includes ridiculing or demeaning an individual, making derogatory remarks to an individual or cursing directed towards an individual.
        3. Programmatic abuse is the use of procedures or techniques, which are not part of the support/service plan or are prohibited.

        Neglect:

        Neglect means a pattern of conduct without the person’s informed consent resulting in deprivation of food, water, medication, medical services, shelter, cooling, heating, or other services necessary to maintain physical or mental health.

        It also includes:

        1. Intentional lack of attention to physical needs of the individual such as toileting, bathing, meals and safety.
        2. Intentional failure to report medical problems or changes in health condition to immediate supervisor or nurse.
        3. Sleeping on duty or abandoning work station (including leaving the individual unsupervised.)
        4. Intentional failure to carry out a prescribed treatment plan for the individual.

        If abuse or neglect of a DES/DDD eligible individual is suspected and/or observed, it must be reported immediately to the DES/DDD support coordinator, Department of Child Safety  (if the individual is under the age of 18) or Adult Protective Services (if the individual is 18 years or older), or law enforcement.

         

        Positive Teaching Techniques and Strategies

        Anyone can use the following positive teaching techniques and strategies. Paid caregivers (agency staff, individually contracted providers) will use the guidelines of the Individual’s Plan (Individual Support Plan or Individualized Family Service Plan) in applying these techniques and strategies.

        Active Listening is a technique used by those providing support to assure attention to and understanding of communication by the person they support. Methods can include stating what feelings are being expressed, repeating and/or paraphrasing what was said, asking questions to obtain the facts, and/or simply paying attention to and acknowledging the person assuring that the person’s communications are attended to, understood and taken seriously. Focus is on the person communicating, not the person listening.

        ExampleMaria is playing a video game. Maria starts yelling and slaps the television screen.

        The Direct Support Professional says, “Maria you seem mad.”

        Maria replies, “Dumb game.”

        The Direct Support Professional, “Is the game hard?”

        Maria says “Doesn’t work.”

        The Direct Support Professional, “The game doesn’t work the way you want it to.”

        Maria says, Not fun.”

        The Direct Support Professional,“You are not having fun with this game. What do you want to do?”

        Maria says, “Different game.”

        The Direct Support Professional, “You want to play a different game. What game is fun for you?”

        Maria goes to the cabinet and gets a different game. Maria and the Direct Support Professional, change the games. Maria plays the new game and starts laughing.

         

        Applied Behavior Analysis is a group of techniques and strategies based upon the principles of analyzing behavior that have been demonstrated to be effective through use and research. These can include chaining, fading, shaping, prompting, discreet trial, etc. *NOTE: These techniques cannot involve the use of force without approval of the planning team, the Program Review Committee and review of the Human Rights committee.

         

        Chaining is a technique that breaks a task into smaller steps where each step acts as a prompt for the next step. Support giver assistance is faded from the steps of the task that the person masters first. Assistance can be faded from the first steps (forward chaining), the last steps (backward chaining) or middle steps (global chaining) of the task.

        ExampleCarlos is learning to brush his teeth, but he shows frustration trying to remember everything. The support giver breaks down the task into steps, such as picking up the toothbrush, wetting the brush, putting toothpaste on the brush, etc. The support giver begins by focusing on Carlos picking up the brush. When this is mastered, the focus changes to the next step.

         

        Cues/Prompts are signals to engage in behavior. These signals can be those that naturally occur in the environment and those that are provided by support givers. The prompts provided by support givers can include gestures, visual cues, verbal instructions or information, auditory cues, physical guidance, tactile cues and rarely scent cues. These are also known as discriminative stimuli. (see also “Modeling”)

        ExampleThe meal has just finished. Jesse is learning to clean the table after dinner. The support giver prompts Jesse by handing him a cloth and asking him to clean the table.

         

        Differential Reinforcement is planned reinforcement of specific desirable behaviors, while not reinforcing other behaviors. Support givers actively encourage positive behavior using reinforcement and minimize reinforcement for undesired behavior.

        ExampleWhen Abdulah and Hakeem sit together and play a game quietly, their mother sits with them and plays the game. She tells them she enjoys being with them. Later when Abdulah and Hakeem are arguing over who has more marbles, their mom goes into the kitchen to do the dishes and does not talk to them.

         

        Discrimination Training is teaching a person to behave differently based upon the situation and environment.

        ExamplesDon indiscriminately masturbates. Instead of trying to stop the behavior, Don is taught how to select an appropriate time and place such as a private time in his bathroom or bedroom. And Sam greets everyone with a hug, whether he knows them or not. Sam is taught to stop and ask himself the questions, “Do I know this person’s first and last name?” “Do I see this person every day?” to help him identify if this person is a stranger and to change how he greets the person.

         

        Environmental Manipulation is also known as “environmental support”, “environmental change” and “environmental engineering”. This is creating environments that will make it more likely that the person will succeed. It can include setting up the environment to facilitate better learning, “avoiding” or “removing temptation”, and elimination of environmental extremes and stressors (such as temperature, light, sound, contaminants, altitude, social groupings, etc.)

        Examples: Joe cries every time his mother prepares a meal making a stressful situation for both Joe and his mother. After some observation, it is determined that Joe’s crying seems to happen when his mother leaves his sight. The living room sofa blocks Joe’s view of his mother. The furniture is rearranged so Joe can see his mother. His crying stops and he is able to play in the living room while his mother prepares meals.

        And Jaime and Jean sit across from each other at a table to do activities. Materials for activities lay on the table between them. They fight over the materials. The person supporting them sets up an additional activity area at another table. Jaime and Jean now have their individual materials at separate tables, and there is no fighting.

         

        Fading of Cues/Prompts is a teaching technique that gradually reduces or withdraws the amount of assistance given to an individual. This involves actively assuring that “natural” environmental prompts are taught and gradually replace those provided by the support giver. (see also “Generalization Training” and “Graduated Guidance”)

        Example:  Guillermo is learning to get up in the morning and get out of bed. A support giver has been coming in and waking Guillermo up and telling him to get out of bed. An alarm clock is purchased and set to ring in the mornings. The support giver comes in and tells Guillermo that the alarm clock going off means it is time to get up. As time goes on the support giver talks less and lets the alarm clock ring longer. Finally the support giver stops going in to awaken Guillermo and Guillermo gets up when the alarm clock goes off.

         

        Generalization Training is a strategy or series of strategies to teach the person to display the behavior in all circumstances or situations where the behavior would normally or naturally occur.

        Example:  Sally cannot tell the difference between the men’s restroom and the women’s restroom. Support givers teach her all of the symbols and words to be able to tell the difference in all situations. And Joshua is taught to zip his pants immediately every time that he puts them on and/or pulls them up regardless of where he is. In this way, Joshua always has his pants appropriately zipped in every circumstance.

         

        Graduated Guidance is a teaching technique that starts with the guidance necessary to support or assist the person in completing a task and gradually provides less assistance as the person gains or demonstrates greater competence. This usually refers to the use of physical assistance.

        ExampleTaylor is learning to scoop food with a spoon. After the support giver has handed the spoon to Taylor and told Taylor to pick up the spoon, Taylor has still not responded. The support giver then physically guides Taylor’s hand to the spoon. When Taylor’s hand touches the spoon her fingers close around the spoon and she starts to lift the spoon. The support giver withdraws her hand from Taylor and allows Taylor to complete the motion.

         

        Incidental Teaching involves using the “teachable moment”. Those who support individuals use normally occurring situations as well as random and unplanned occurrences to provide “on the spot” learning opportunities to individuals. Sometimes this is “learner lead” with the support giver expanding upon the individual’s lead or interest.

        ExampleWhile Tyler and a support giver are traveling to the ice cream shop, the vehicle they are in gets a flat tire. The support giver uses this as an opportunity to teach about getting safely off of the road, staying calm in a crisis and using tools to change the tire.

         

        Modeling is demonstrating the desired behavior to be imitated. (see also “Cues/Prompts”)

        Example:  Alma is learning to fold clothes. The person supporting Alma sits next to her and also folds clothes or folds clothes while Alma watches.

         

        Redirection is a technique where the person is instructed to a different area, activity, choice or focus in order to interrupt the current behavior, and then problem solving to address the reason for the behavior, and/or training the acceptable replacement behavior follows. This technique is best used when a functional alternative behavior has been identified. Simply changing locations, circumstances, or attention may not address the underlying cause of the behavior. It may continue in the different situation or happen again after a short delay.

        Example:  Alberto is getting tired of feeding the birds on the back porch. He throws down the bag of seeds. The support giver noticed that prior to this Alberto was looking at the swing, the back gate and the door to the house. The support giver starts a conversation with Alberto. The support giver asks if he would like to sit down on the swing, go for a walk or go back in the house. Alberto goes to the swing, sits on it and begins to swing.

         

        Reinforcement is any event/item that immediately follows a behavior which increases the likelihood of the behavior occurring again. Reinforcing events/items can include a wide variety of objects, activities, interactions, occurrences or tokens/symbols.

        ExampleHan takes his plate to the kitchen and washes it. The support giver smiles and tells Han, “Thank you for washing your plate. Good job.” (It is important to be specific about what is being praised.) In the future, Han repeats the behavior more frequently.

         

        Relaxation Training can involve a number of different strategies to help a person remain calm or use self calming techniques in situations that otherwise produce stress and anxiety. Training can include biofeedback, desensitization, breath control, guided imagery, orderly muscle tension and relaxation, meditation, scripted “self talk”, etc.

        Example:  Dina becomes very anxious when she sees and/or hears thunderstorms. Dina is taught to close her eyes and take 3 slow deep breaths whenever she is aware of a thunderstorm.

         

        Shaping is a procedure during which support givers reinforce in a planned sequence closer and closer steps to learning a skill. At first the support giver would reinforce any response that even resembles the desired behavior. After that response is occurring with regularity, the support giver requires that the response be a little closer to the desired behavior before providing reinforcement. This continues until the individual is then displaying the desired behavior.

        Example: Andrè is expected to sit with his classmates at story time.

        Currently Andrè wanders around the room. Whenever Andrè comes within 3 feet of his chair the teacher praises Andrè. Soon Andrè starts hovering around his chair; then the teacher only praises Andrè when he actually touches his chair. Andrè starts touching his chair all the time, then the teacher only praises André when his leg touches the chair. Eventually Andrè will sit in his chair in order to have the teacher praise him.

         

        Token Economies can be used with anyone as long as they do not require a person to earn basic necessities such as clothing, food and shelter and/or things that already belong to them, including money. Token economies are reward systems where tokens (symbols) are given for positive behavior, saved and exchanged for items of larger value. Token symbols can be poker chips, stars on a chart, stickers, checks on a calendar, or any other symbolic item.

        ExampleJasmin really likes music CDs, however rewarding Jasmin with a music CD every day that she completes all of her house chores is not realistic or practical. A system is set up for her to accumulate tokens (stars on a calendar) and when she has twenty tokens she will get a new music CD (that is not purchased with her money).

        Voluntary Time Out is a procedure where the individual chooses to go to an area away from others to allow time and space to deal with stressors in the environment or feelings that can lead to difficult behavior. Those supporting the individual can suggest and/or encourage the individual to use time out, but the individual ultimately chooses whether s/he separates him/herself and for how long that will be.

        Example:  Simone comes home from day activities and starts yelling at those supporting her at home. One of the persons at her home suggests that she go to her room and relax for a few minutes. Simone goes to her room, lies on her bed for a few minutes and then comes back into the living room and calmly talks to others.

        BEHAVIOR PLANS

         

        When does an individual need a behavior plan?

        The team must write a plan:

        For anyone prescribed a behavior modifying medication (except if living in their own or family home); or upon team decision to use any technique that requires approval, which includes any of the following:

        • techniques that require the use of force,
        • programs involving the use of response cost,
        • programs which might infringe upon the rights of the individual
        • protective devices used to prevent self injury.

        The team may consider developing a plan when the individual is displaying an inappropriate behavior that interferes with the individual’s learning or participation in his/her community or places the individual or others at risk of harm.

        The team must meet and consider writing a behavior plan when an emergency measure is used two or more times in a 30 day period or with any identifiable pattern.

         

        If a Behavior Plan needs to be developed:

         

        1.  Describe the target behavior (inappropriate/interfering behavior) in specific terms – label and define.

        2. Collect baseline data:

        • Who, what, when, how often.
        • Antecedents (what happened before the target behavior).
        • Precursors (what is the person doing before the target behavior)
        • Describe what the Target Behavior looks like.
        • Consequences (what happens after the target behavior).

        3. Examine the individual’s environment to determine any issues that may be contributing to the inappropriate behaviors. This may include but not be limited to looking at: space, privacy, health, communication skills, relationships, and ability to make choices.

        4. Look for the purpose/meaning/function of the target behavior – “why” is the individual displaying this behavior.

        5. Determine the Alternative Behavior that will replace (or be incompatible with) the target behavior and how that alternative behavior will be taught:

        • Write an alternative outcome to be taught.
        • List the strategy to teach the alternative outcome.
        • Include the reinforcement schedule.
        • How will data be collected (mini-strategy for each antecedent behavior noted.
        • What will be done if the target behavior occurs.
        •  List the name and/or title of the person who will train the staff who will be implementing the behavior plan and the name and/or title of the person who will monitor the implementation of the behavior plan on-site twice a month.
        • The responsible person’s signature and approval must be attained prior to implementation and review of the plan by the Program Review Committee.

        Once the team writes a Behavior Plan and agrees to it:

        The team needs to submit it for approval to the Program Review Committee and to the Human Rights Committee for review.

         

        TECHNIQUES/PROGRAMS REQUIRING PRIOR REVIEW AND APPROVAL BY THE PROGRAM REVIEW COMMITTEE (PRC)

         

        R6-6-903. Program Review Committee

        The ISP team shall submit to the PRC and Human Rights Committee for review any behavior plan, which includes:

        1. Techniques that require the use of force.

        • Forced Compliance
        • Forced Exclusion Time Out
        • The use of contingent observation, if force is required. d. Logical consequences, if force is used.

        2. Programs that might infringe upon the rights of the individual.

        • Exclusion from activities within the daily routine.
        • Restitution – Payment for repairs/replacement for property damage, etc.
        • Reinforcement procedures that require the individual to earn basic necessities or personal possessions.
        • Giving up a reinforcer that has already been earned as a consequence to a behavior that occurred after earning the reinforcer.
        • Limitations, some examples are:
          • cigarettes
          •  access to the community
          • soda or coffee
          •  phone privileges, if individual uses phone excessively
          •  access to food and basic necessities

        3. The  use  of  behavior  modifying  medications.  (Note:  Except  when  an individual is living in his/her own home or family home.)

        The utilization of behavior modifying medication, as ordered by a physician, as part of the treatment strategy to address/manage behavioral issues.

        Notes:

         Prior review by PRC is not required for situations where the prescribing physician orders behavior-modifying medications to accomplish a specific “one time” medical or dental procedure.

         The planning team must convene and initiate development of a plan within 30 days of the start of behavior modifying medications.

         Within 90 days, the planning team should have the plan completed and forwarded to the Program Review Committee for review.

        4. Protective devices used to prevent an individual from sustaining injury as a result of his/her self-injurious behavior.

        Protective devices that are utilized as a consequence to a behavior to prevent and/or minimize injury from incidents of self-abusive behavior, such as helmets, arm wraps, straps, etc.

         

        TRAINING REQUIREMENTS FOR PEOPLE IMPLEMENTING BEHAVIOR PLANS

         

        R6-9-906. Training

        Any person who is involved in the use of a behavior plan shall be trained by the Division or trained by an instructor approved by the Division prior to such involvement.

        Initial Training shall cover at a minimum:

        1. Provisions of law related to:
        • Interventions, particularly this Article and 42 CFR 483.450 (October 1, 1992)
        • Rights of individuals with developmental disabilities
        • Confidentiality
        • Abuse and Neglect

        2. Intervention techniques, treatment and services, particularly addressing the risks and side effects that may adversely affect the individual.

        3. The development, implementation and monitoring of a person specific behavior plans.

        4. A general orientation to:

        •  Division goals with respect to the provision of services to individuals with developmental disabilities.
        • Related policies and instructions of the Division.

         

        With respect to the use of techniques, the Rule indicates training shall include hands-on or practical experience conducted by instructors approved by the Division, and who have experience in the actual use of the interventions as opposed to administrative responsibility for such use. The Rule also indicates “physical management techniques shall only be used by those persons specifically trained in their use”.

        The Rule, and associated Department of Economic Security, Division of Developmental Disabilities policies and procedures, licensing and/or certification requirements indicate that:

        Any person providing direct services to individuals who have the potential to exhibit inappropriate behaviors, which may require physical management and control, receive training in the use of interventions. The intervention training should include hands-on or practical experience conducted by an instructor approved by the Division, using a curriculum approved by the Division, and who have experience in the actual use of interventions as opposed to administrative responsibility for such use.

        Currently, the intervention training recognized to meet this training requirement is “Prevention and Support”. All other forms of physical intervention training must be reviewed and approved by the Division to ensure compliance with this rule, the associated policies and procedures of the Division.

        All persons using emergency physical intervention techniques shall:

        1. Have successfully completed a course in the use of those emergency physical intervention techniques.
        2. Receive instruction in emergency physical intervention techniques only from an instructor certified and/or approved by Department.
        3. Be re-certified in emergency physical intervention techniques periodically as determined by the Division of Developmental Disabilities or determined by their supervisor.

        Any person providing direct service to an individual whose program involves the utilization of behavior modifying medications shall receive training that includes:

        1. An overview of drug use, interactions and contraindications;
        1. A discussion of planned reductions in the use of such medications and clinical rationale for continued use;
        1. Identification of side effects of the use of behavior modifying medications including, but not limited to, Tardive Dyskinesia; and
        1. Instruction in methods for reporting results of medication use.

        The Division shall provide all persons serving on a Program Review Committee   (PRC) and Human Rights Committee   (HRC), training and information relative to the Division and Department rules and procedures, and contemporary practices in behavior treatment.

        In addition to initial training, the Division shall ensure that training is available as necessary to maintain currency in knowledge and recent technical trends related to intervention trends related to intervention for the management of inappropriate behavior