Think of yourself less as a teacher
and more as a designer of meaningful experiences.
- Norman Eng
The purpose of day programming is to design meaningful experiences for the people in the program. This isn't always easy. It can be particularly challenging when someone has difficulty expressing how they're feeling, what their interests are, and how they would like to spend their time. These questions are usually best answered by people who know them well. When people know each other well we communicate through body language, gestures, eye contact, and a hundred other subtle cues that transmit our needs and preferences without using language. Sensitivity to these cues is one of the most important soft skills necessary to effectively provide support.
While so much of day programming relies on soft skills, there are important technical skills involved as well. Day programming is integrated into an individual's Individual Service Plan (ISP) along with all the other facets of their heath care. In turn, physical, occupational, and behavioral therapies may be integrated into day program activities. For this reason it is important that the goals and objectives of the individual are clearly stated, and that the appropriate data is collected to inform the ISP.
The ISP is developed to provide a clear understanding of a person’s needs and preferences, and to act as a guide for staff to deliver consistent, comprehensive care. As a part of that individual’s ISP, goals and objectives are developed that form the curriculum of the person’s day program. The day programming staff’s role, in collaboration with the Interdisciplinary Team responsible for developing the ISP, is to identify and define activities that maintain or increase mental and physical health, and support the person living their fullest life.
Those activities, which comprise the curriculum of the day program, will be different for each person. Each of the people we care for have their own needs and preferences that are address in their goals and objectives. Each person requires support in different areas, so their day program curriculum will be individualized. The development of the curriculum, the persons goals and objectives, can be aided by a formal design process.
The ENCORE Day Program design describes anticipated outcomes and training areas that are intended to be incorporated into the individual’s day program curriculum in support of the goals identified in the ISP. The anticipated and measurable program outcomes, and associated training areas, provide a foundation on which an individualized curriculum, based on the individuals needs and preferences, can be built.
ENCORE’s anticipated and measurable program outcomes are listed here. They will include maintaining the overall health and well-being for each consumer by:
· Maintaining or increasing independent living skills;
· Maintaining or increasing social skills;
· Maintaining or increasing recreational skills;
· Maintaining or increasing educational skills;
· Maintaining or increasing communication skills;
· Maintaining or increasing choice-making skills;
· Maintaining or increasing community access;
· Maintaining or increasing personal health.
The ENCORE’s program design also designates six training areas that support those outcomes:
1. Independent Living Skills: The goal of this area is to promote independence in activities of daily living (ADL’s). These activities my involve preparing meals, housekeeping, using the telephone, etc., and personal care such as dressing, bathing, using the restroom, teeth care, etc. (Occupational Therapist to consult).
2. Social Skills: The goal of this area is to promote increased social interactions in a variety of settings. These activities will involve interacting with others (e.g. communication skills, whether verbally or via alternative and augmentative communication). (Recreational Therapist to consult).
3. Recreational Skills: The goal of this area is to promote independence in recreational and leisure activities. This area includes activities of individual hobbies (e.g. such as writing, puzzles, sewing, knitting, etc.), participating in the arts (such as music, painting, visiting museums, etc.), becoming involved in group activities (such as bowling, bocce ball, etc.) and enjoying recreational pursuits in the community.
4. Educational Skills: The goal of this area is to promote life-long learning. This area involves academic pursuits (such as reading, writing, math, etc.), computer skills, (e-mail, games, searching the internet, etc.), and attending community adult education or community college classes, as appropriate. (Recreational Therapist to consult).
5. Community Access: The goal of this area is to promote independence and enjoyment in the use of public facilities and businesses. This area involves facilitating access to generic community activities such as shopping (including money management), use of public transportation (including route planning, use of passes and transfers), banking, and any other community facilities available locally, such as libraries. In addition, this area may include volunteer and/or paid work, and self-advocacy training (Occupational and Recreational Therapist to consult).
6. Personal Health: The goal of this area is to promote and maintain good health and mobility. This area involves activities that will maintain or increase the physical health of individuals, such as aerobic exercise, positioning, contracture care, continence care, and range of motion exercises, healthy eating, and any other activities unique to the individual’s condition necessary to maintain or increase health. (Physical Therapist, Occupational Therapist, and Dietician, to consult).
As we identify a person’s needs and preferences, we can use these anticipated outcomes and training areas to form goals and objectives. The goals and objectives are shaped by the stated outcomes and focused on each of the listed training areas. It is not necessary to address every outcome or training area in any one person’s day program curriculum. Some people may benefit by a Personal Health goal that incorporates range of motion exercises, others may benefit more from a focus on Recreational or Independent Living Skills.
The key to forming a meaningful curriculum is knowing the needs and preferences of that person being supported. The outcomes and training areas help to shape the curriculum but they do not determine what it should be, they are simply a tool that is helpful in building specific goals and objectives that best reflect the needs and preferences of the individual. The anticipated outcomes and training areas provide a foundation to build from, but each person’s needs and preferences determine which outcomes and training areas are selected.
In consideration of those needs and preferences, every attempt should be made to involve the person in the development of their own curriculum. As an adult, if you decided you wanted to learn a new skill, or practice a skill you’ve already developed, you would consider what activities would benefit you and choose from those that you preferred. The people we support should have the same opportunity to express their autonomy.
When a person is unable to easily express their own needs and preferences, members of the Interdisciplinary Team can support that effort. Physicians, therapists, family, friends, and other staff members can often provide meaningful insight. Often, however, some of the people who can best inform the specifics of a person's day program curriculum are the staff who spend the most time with the person being supported. If they have taken the time and effort to build a relationship with the person, they can support the person in voicing their own needs, or help communicate the needs and preferences they have identified through that relationship.
See the attached PDF for more information on writing meaningful goals and objectives.
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