Addressing the Behavior Cusp Skills of Tolerating Routines Related to Health and Safety and Environmental Aversives

People with Intellectual and Developmental Disabilities (IDD) are at risk for a high rate of medical problems and regular trauma from daily care to prevent and treat health and safety issues. Those who need the highest level of care often have the least access to it and face challenges with communication with medical providers and toleration of preventative and reactive care. Additionally, they face social isolation and the loss of additional skills with a narrow range of reinforcing activities, which often grows narrower the older they get if these tolerating skills are not addressed proactively.

After a thorough discussion of the ethics involved, we present a practical, evidence-based ethical decision-making process for selecting and designing curriculum for desensitization targets depending on the type of social significance for the learner including skills necessary for current and future health and safety as well as skills necessary to expand leisure activities and increase community access and involvement.

Discussion topics include the process of designing an assessment that determines social significance with client assent is the first step, and subsequent curriculum design including treatment packages such as Calm Counts, Skills Based Treatment and Essential for Living.

Learning Objectives:

• Attendees will identify ethical issues regarding selection and process for teaching these skills.
• Attendees will learn to assess what skills would be behavior cusps for a specific learner based on their health needs and family culture.
• Attendees will learn how to determine the most effective and ethical treatment procedure for health and safety routines, given their client’s profile and needs.
• Attendees will become familiar with current forms of procedural technology and guidance on how to combine those within a desensitization program.
• Attendees will plan for care coordination with caregivers and providers.