Patrick - Written by Ellen Condon
Patrick moved to Missoula in the spring of 2009. He lives in a large home with another young man who also has a label of autism, and is supported by a staff managed by AWARE, Inc. I had the opportunity to get to know Patrick and his support team when they asked for my assistance to create employment for him.
Patrick wasn't someone I could ask, "What would you like to do for work?" and get an informative answer. A question that abstract, if asked, probably wouldn't have gotten any response at all. Patrick's team members, including his family, didn't have a clear picture of what kind of job would work for him, either. Patrick had a few work experiences while he was in high school, performing cleaning and recycling. And at home he had enjoyed crushing soda cans and turning them in at the recycling center for money.
Patrick wasn't going to be "competitive" in employment, meaning that he wouldn't do well applying for job openings and being screened against other applicants and the demands of the position. However, we knew he could make a contribution to an employer if we could negotiate a position in a job site that was well-matched to his needs.
Our first step was to determine what a "well-matched job site" was for Patrick. I spent time with Patrick at his new home, getting familiar with his typical routine, observing him working on chores and academics. I talked to his parents and other people who knew him well. I learned the strategies that his support staff used to help him be successful during the day and I went on outings in the community with him and his staff. I was observing how he did things and what environments and activities were motivating to him and allowed him to be successful.
All of these activities were for the purpose of getting a clear picture of what the characteristics of a good job environment would look like for him. What type of interaction on the job site would be best? How would the tasks flow? What time of day would work best? What type of tasks would he be most successful at? Where would he be most motivated to work? What supports would need to be in place? I was not assessing or judging his performance to determine if he was "ready to work." I began with the assumption that everyone is ready to make a contribution and to work. What I needed to know was: under what conditions would he be at his best, most productive, motivated and engaged, and what contributions could he make to a prospective employer.
As I gathered stories and information and added my own observations, I summarized what I had learned in a document called the Vocational Profile. Patrick's family and his other team members (AWARE staff, his Developmental Disabilities case manager, and his Quality Improvement Specialist from the Developmental Disabilities Program) reviewed it and helped add or edit the information until it was an accurate representation of who Patrick was at his best.
Our next step was to meet as a team and consolidate the information from the Profile into a blueprint for the job that would be developed and negotiated on his behalf. The team agreed that the following conditions would most likely lead to Patrick's success:
· Begin working no earlier than 10 AM, for one hour, one day a week to start
· Work up to two hours, two days a week
· Perform a task for no more than 30 minutes, have a break, change tasks
· All tasks would have clear beginnings and endings
· Physical tasks that would involve pushing, pulling, lifting, and walking
· The job would be no more than 20 minutes from his home
· There would be minimal people traffic and a place with familiar people
· Noisy environments and children would be avoided
· Patrick would have his own working space - not too close to coworkers
· Avoid environments with costly, fragile materials and/or people
· The completion of the tasks didn't have a critical time frame (if he didn't get to a task during his shift, someone on another shift could do it)
We then talked about what things motivated Patrick...his interests. The team listed: water; trains; trucks and construction equipment; horses; recycling; bowling; and spicy hot, salty and sweet foods. He enjoys counting and being outside.
Before we could market him to an employer we also needed two additional things: a list of what he would contribute (his skills, experiences and attributes), and a list of tasks he could perform for the employer.
Below are what the team came up with for his contributions:
· He likes to be helpful
· Notices when things are out of place
· Likes things in their place
· Enjoys people and has an infectious smile
· Follows a schedule
· Enjoys being busy and engaged
And the tasks he could perform now or with training:
· Filling containers
· Loading or unloading shelves, trucks...
· Washing vehicles, carts, equipment
· Pouring liquids
The team then generated a list of employers where one of us had a contact. To be on the list of potential employers, the team members had to agree that the employment setting matched Patrick's ideal conditions, and might have a need for the contributions and tasks he could offer.
We decided to give Patrick a chance to have a few work experiences in a well-matched job and see how it went. His Developmental Disabilities case manger, Greg, approached Vocational Rehabilitation to request wages for Patrick during his work experience. She approved the request and this work experience would be considered a community-based work assessment for Patrick. We knew he wouldn't be competitive with other job seekers but we also knew that he could make a contribution in the work force. We needed his assessment to be completed in an environment that was individualized to him.
He began his work experience at a local horse stable in February 2010. We used all the information we had learned about him to try to set up the most success from day one. I had taken pictures of the tasks he would be doing at the barn, the horses, the people and the dog. I made a PowerPoint presentation for him that his support staff reviewed with him on the drive to his first day of work. We knew that Patrick does best in situations where he knows what is next, how long it will last, and where there aren't surprises. When the dog began barking at all of us as Patrick was touring around the barn, one of his staff was able to say, "Look Patrick, that's Budda. The dog from the pictures." It wasn't a surprise and we all kept walking! (There had been information in Patrick's files that said he disliked dogs. His parents clarified that he likes dogs, but not when they are noisy.)
When Patrick's team first talked about him working and earning money we also talked about the concern that he might not have any concept of money. It was decided that he would be paid in cash at the end of his first few shifts and he would spend his cash at a fast food restaurant on the way home from work. His mom had suggested this would be the most motivating way to use his wages initially. The icons of all the restaurant options were printed off (five in this rural town!) and laminated so Patrick could look at choices and decide where he wanted to go that day.
When he began work on day one he was informed that he was working for money that he could use to buy lunch on the way home. He looked over all of his choices, and picked a new one each shift until he tried all five. The picture of the restaurant was placed at the bottom of his picture checklist so he knew what he was working for and that he would go to the restaurant after he finished his work.
At the end of the assessment period the team had a longer list of tasks that Patrick could perform and we had confirmation that we were on target with most of the conditions that Patrick needed to be successful. He did show us that he could be much more flexible than we had expected at work.
He was hired at the stables and is paid minimum wage. He works two hours each Monday cleaning automatic waterers, raking the indoor arena, and filling the stalls with shavings. He also began a second paid job at another horse stable cleaning pens for two hours a day on Thursdays. The team's goal is to have one more community placement (paid or a volunteer position) by the end of the year.