Hide messageView More

Crisis Services

ASERT does not offer crisis services through our Resource Center. If you or someone you love is experiencing mental health distress or thoughts of suicide please call or text 988 for support.

Quick links: MyODP ASDNext AidInPA PhillyAP

Spotlight On: Person-Centered Projects

Overview

These resources focus on different aspects of Person-Centered planning, and include take away points and lessons learned from various ASERT projects over the years. Topics include: self-advocacy, case conceptualization and using data visualizations (graphs).

Self-Advocacy

Overview

Self-advocacy can be a challenge for individuals with autism because it requires social initiation and social interaction, as well as perspective taking and effective communication skills. However, all of these skills can be mastered with practice!Autism is considered an “invisible disability” meaning that you can’t tell that a person has a disability just by looking at them. For individuals with invisible disabilities, the ability to self-advocate is very important, because it’s less likely people will automatically offer accommodations or modifications. Individuals must speak up for themselves to explain and ask for what they need.

What is self advocacy and why is it important?

Generally speaking, self-advocacy means:

  • Speaking up for yourself
  • Making your own decisions
  • Knowing your rights and responsibilities
  • Problem solving
  • Reaching out to others when you need help and friendship
  • Learning about self-determination

So that individuals have the knowledge necessary to succeed and are given the chance to participate in decisions that are being made about their life. Self-advocacy involves:

  • Self-awareness
  • Considering others’ perspectives
  • Knowing what to request
  • Providing details

Components of self-advocacy

Self-awareness

In order to effectively self-advocate, an individual needs to know themselves well. This includes knowing areas of strengths and weaknesses, as well as accommodations to help them be successful.

Consider others’ perspective

Requests for accommodations will be more successful if individuals consider the perspectives of others and the overall environment or situation. For example, if music is playing loudly in a restaurant, request a quieter area to sit, rather than ask for all the music to be turned off.

Know what to request

It’s important for a self-advocate to know what accommodations they need to be successful. Understanding what reasonable accommodations would be most beneficial to them is important for a self-advocate.

Providing details

People may be more willing to cooperate, if they have an understanding about why the request is being made. Noting some specific things that interfere with or enhance success, can avoid confusion and increase understanding.

Helping Others Self-Advocate

Helping Others Self-Advocate

  • Help the individual recognize accommodations or modifications that they use, or have used in the past,to be successful across social, home and school or work life.Assist the individual to develop phrases that describe the accommodations, and practice communicating them to others.
  • Start by working with the individual’s preferences on how to self-advocate.While in person advocacy may be best, some individuals will be more comfortable with email or written requests at first. This practice can help to build confidence for later situations that may occur in-person.
  • Offer choices and provide support with problem-solving,focusing on multiple possible solutions. Some individuals struggle with self-advocacy because they have a difficult time envisioning alternatives that may be helpful to them to request.
  • Allow and support the individual to speak for themselves. This may become especially important to practice in adolescence and young adulthood. It may help to role-play or write down what they want to say in advance.As much as possible, support the individual to persist, rather than stepping in to repair the communication if it is not ideal the first time.
  • Encourage persistence and discourage fear of failure. Self-advocacy does not always result in getting exactly what they request, but that doesn’t mean it doesn’t work or that it’s wrong to ask. Some settings and people will be more open to accepting accommodations, but making the request and starting the conversation can help the individual build confidence and may also help spread awareness to others.

Case Conceptualization

Background

In the 2011 Pennsylvania Autism Needs Assessment, 85% of individuals with Autism Spectrum Disorder (ASD) reported having a co-occurring mental health disorder. Having anxiety and/or depression along with ASD is the rule rather than the exception. Various issues bring people to treatment, but they are often only the tip of the iceberg. When people seek therapy for issues in their lives, therapists often first answering the what. John is a 20-year-old with ASD, anxiety,
and depression. However, that is only the first step in treatment; what we are often more interested in is the why. Why does John have difficulty making friends? Why does he lose his temper so easily? Why does John not want to leave his room? Why does John seem sad all the time?

The issues that people bring to therapy can be thought of as ingredients that are in search of a recipe. The case conceptualization is the recipe; it is the story of why we do what we do. Often times, therapists have several places they can start in therapy: Which issue does the individual list as the most important for them to change? Which issue interferes most with this person’s quality of life? Should I treat multiple issues one at a time or all at once? If I chose to start with one, is there a particular order that I should go in?

Steps to Complete

A good case conceptualization will answer these questions and provide a road map for treatment. The following are the steps to complete a case conceptualization:

Step 1

Collect information from multiple sources: clinical interviews, self- and other-report questionnaires, self-monitoring data (e.g., daily behavior or mood tracking), and reports from family members and other treatment providers.

Step 2

Develop a comprehensive list of and triggers for the current presenting problems.

Step 3

Draft working hypotheses about reasons as to why this issues are happening using a specific theory (e.g., ABA, cognitive behavioral) and then personalize the hypotheses using the experiences of that particular person.

Step 4

Start interventions guided by hypotheses.

Step 5

Monitor – are things changing as expected?

Step 6

Revise hypotheses as needed

Writing Case Conceptualizations

Case conceptualizations can either be written out as a narrative in as little as a one to two paragraphs or can be visualized in a chart. It is important to be collaborative and person centered throughout this process relaying on the individual’s input about what is important and how things may be interrelated. Sharing a case conceptualization with a client can be a powerful therapeutic tool and can be adapted for all levels of ASD and intellectual impairment.

Being a therapist is being a scientist; we must follow the scientific method to guide treatment. When therapists feel as if they do not know what to do next or feel as if they are chasing symptoms and the newest crisis, these are signs of needing to revisit the case conceptualization.

For more information on case conceptualizations using a cognitive-behavioral framework, see Friedberg et al. (2009), Friedberg & McClure (2002), Kuyken, Padesky, & Dudley (2009), Persons (2008), and Beck (1995).

Example Case Conceptualization

Presenting Problem

Presenting problem: irritability and verbal aggression in 20-year-old male with ASD
Data from multiple sources: moderate ASD, moderate irritability, severe social anxiety and depression, low motivation, low community participation in important activities

Specific Issues

Problem list includes: moderate ASD, anger, social anxiety, depression, increased daytime sleeping, no same-age friendships/romantic relationships
Triggers: drastic decrease in community involvement following high school graduation, loss of BHRS services, closest friend recently moved out of state, recent family stressors

Hypotheses and Interventions

  • Recent stressors within family and significant issues within family dynamics leading to increased isolation in bedroom.
    Family therapy, referral for caregivers for individual therapy to target mental health issues.
    Monitor irritability and family stressors; expect it to decrease with increased social activity outside of the home

 

  • Frustration intolerance related to ending a preferred activities and low motivation.
    Individual therapy with exposures for frustration tolerance, behavioral therapy
    for parents.
    Monitor irritability and family stressors; expect it to decrease with increased social activity outside of the home

 

  • Escape behavior in response to social situations where he perceives others as being critical and rejecting.Individual therapy with exposures to social situations, Cognitive restructuring
    Monitor anxiety; expect it to increase with increase social activity and introduce exposures as needed

 

  • Belief that he is incompetent and a failure following high school graduation leading to decreased interest in social interactions.Individual therapy with behavioral activation targeting important community activities, Cognitive restructuringIncrease community engagement in self-reported important activities to improve motivation and mood
    Monitor anxiety; expect it to increase with increase social activity and introduce exposures as neededMonitor irritability and family stressors; expect it to decrease with increased social activity outside of the home

Tips for Data Visualizations

Why Visualize Data?

Data is easier to interpret when put into a visual form where multiple data points can be summarized and relationships and trends can be easily determined. When designing a visualization strategy, remember that the goal is to make the message more apparent.

Consider this example: One of Joe’s goals is to increase time in the community, so his team tracks the number of trips he takes in the community.

Visualizing the data readily allows the team to see that there is an increasing trend of community outings as the week progresses with Mondays being the low point and Saturdays being the high point. This trend is not apparent from a data table.

  • Data is easier to understand when put in a visual form
  • Bar graphs and line graphs are easiest to interpret for people
  • Often less is more for data visualization
  • Know your audience to determine the best format to show your data

Making the Most of Data Visualizations

In general, less is more for data visualizations as it makes them easier to understand and interpret. Including too many variables on one graph can make things complicated and difficult to understand. The aim is to include as much information as you can , while keeping the design as simple as possible.

Joe and his team decide the amount of time he spends in the community each day is as important as the number of trips he takes. The previous line graph does not show how much time he was in the community, only the number of trips. You could create a second graph that showed the number of minutes he was in the community each day, or find a way to incorporate both factors into one graph.

 

By switching to a bar graph the team can graph the number of trips on the horizontal axis and color code the bars to represent the amount of time he spends in the community. Now two points of data are being represented, allowing the team to evaluate his community outings more effectively. For example, as a result of this data visualization, Joe and his team may decide to revise his community plan for Sundays, as four outings occur but he is spending less than 60 minutes in the community. Mondays are also a concern as he’s only gone into the community once on those days and for less than an hour. On the opposite side,the team may want to look more closely at Thursdays as he’s only gone out twice those days, but is in the community for more than 2 hours. There may be opportunities there that can be used to increase his access to activities on other days.

Points to Remember

  • Bar graphs are easiest for most people to interpret.
  • Line graphs are helpful for showing small changes over time.
  • Make sure the visualizations are well labeled so people can understand what is being represented. This includes units of measurement.
  • Determine the appropriate amount of data to visualize. Showing an entire year’s worth of data may create a lot of “noise” which may make it difficult to understand small changes that occurred during that time, for example, what happened after a new community support plan was implemented. However, there may be situations where showing a larger data set is helpful, such as wanting to see the change in sleep since starting a new medication 6 months ago.
  • Well-designed data visualizations should “speak for themselves”. If you are finding that you need to explain your graphs, you may need to put more effort into how you set up and label the visualization.

Rate this resource

Thank you for rating this resource!

Other downloads

Name Description Type File
Person-Centered Planning Self-Advocacy pdf Download file: Person-Centered Planning
Person-Centered Planning Helping Others Self Advocate pdf Download file: Person-Centered Planning
Person-Centered Planning Case Conceptualization pdf Download file: Person-Centered Planning
Person-Centered Planning Creating Effective Data Visualizations pdf Download file: Person-Centered Planning

This information was developed by the Autism Services, Education, Resources, and Training Collaborative (ASERT). For more information, please contact ASERT at 877-231-4244 or info@PAautism.org. ASERT is funded by the Bureau of Supports for Autism and Special Populations, PA Department of Human Services.