As fourth of July approaches, I think about Independence and its meaning. Growing up with what I thought were overly protective parents, independence seemed to be equal to freedom. I pictured myself traveling around the world with nothing but a backpack and a smile. I could even feel the wind blowing on my cheeks, as I walked through exotic places. A few years later, independence meant being able to afford a living without getting myself deep in debt. As I started to work with people with disabilities, independence took a whole new meaning. Being able to use the bathroom by yourself could be all the independence some people seek.
From the first day of treatment we need to think about independence, we need to program independence, and we need to support independence. In my work with people with developmental disabilities, unfortunately, I have seen many cases of providers teaching shapes and colors to kids who are still in diapers, can’t feed themselves, or change their own clothes. In my work with adults with behavioral health needs I have seen medication adherence being enforced rather than supported.
When we prescribe an intervention, we need to think about its long term impact on the client’s life. Let’s first teach skills that will keep the individual safe, then move towards skills that will enrich their lives. For example, all behaviors associated with bathroom use are important for an individual to learn and be independent, as they minimize the opportunities for abuse. I have recently met a 20-year-old with autism who can identify shapes, colors, and letters but can’t wipe herself after using the bathroom! I am not saying that she should not have learned the shapes, colors and letters; I am saying that learning to be fully independent in the bathroom will aid in keeping her safe, and that should be priority.
As providers, it is our responsibility to make sure that the skills we choose to work on will lead to an independent, least restrictive life. Here are some things to keep in mind when choosing a skill to work on, so we can all celebrate an “independence day”:
- Is it essential for safety?
- Is it a pre-requisite to teach a safety-related skill?
- Will it enhance communication ability?
- Will it enhance community participation?
- Is it an essential skill for community living?
- Will it develop assertiveness?
- Will it enhance interaction with peers?
- Am I choosing this skill just because I know how to teach it?
- If this is a life-enrichment skill, have I considered all of the other client’s needs?
What have been your experiences teaching independence? Do you feel that independence is something hard to teach? Comment below to let me know how you have helped foster independence or if you have found challenges along the way.