For someone with an intellectual disability, any kind of transition or change can be extremely stressful. People with intellectual disabilities can feel vulnerable when faced with a new situation because it will take them out of the familiar. The familiar represents a successful safe haven of sorts to most of us. When we are faced with a significant (or, for some of us) a slight change, we begin to prepare ourselves in a variety of ways.
This article will outline a number of strategies that can be used to assist any individual with making a transition. These strategies are divided into three main sections:
- making the transition
When any type of change is anticipated we prepare ourselves in a variety of ways. For a job interview in an unknown location: we can rehearse possible responses to questions with a friend; we can look on a city map to find the location; we can decide ahead what clothes to wear, etc. Each of these preparatory steps help us to be more organized and, hopefully, more confident when we actually have our job interview.
Preparing an individual with an intellectual disability for change will certainly be a smoother process if preparatory steps are followed. The use of a variety of cues and aids generally assists in making transitions, whether large or small.
Consider the cues that might be used for a young adult about to leave home for an assisted living arrangement. Visual cues can include things like: brochures with photographs of the interior; polaroid photos taken by the individual and her family on a visit; calendars and schedules outlining daily or weekly routines; picture symbols to help organize clothing and possessions; name tags on fellow residents’ photos. Auditory cues can include the rehearsal of peoples’ names; practicing at home with an alarm clock to wake up independently; practicing with an egg timer to get dressed independently. The individual can also prepare with family by packing their own belongings; physically taking the transit route to get to the new residence; and taking part in some social activities at the residence prior to moving in. All of these cues are, in some way, assisting the individual to prepare, to be more comfortable when the moving day finally does come.
Essentially, preparing for change is the taking of any steps which will make the transition go as smoothly and successfully as possible.
We have discussed a rather large and potentially stressful change in a person’s life. However, many of these same types of cues may be used with a small transition. Some individuals may be so disrupted and upset by even a small change in their environment that they will need some kind of preparation. An individual who is comfortable with a predictable daily routine may need preparation to change a part of that routine.
For example, a child in a nursery program may need to move from one activity to another. Each time a new move or transition occurs, a number of cues can be used to help. The child may be given verbal warning paired with a visual cue that he will be moving to a new activity. Other children could be partnered with him to give another cue-when they move, he sees this and moves too. A portable schedule can be given to the child, using picture symbols to show what comes next. All of these ways of preparing an individual may help the transition to be successful.
During the actual transition, it is useful to repeat the various cues, including visual, auditory and physical. Now the cues are given in an immediate way, with the intent that the transition will happen. For the child moving from one activity to another at Nursery School, the instruction can be given, paired with physical guidance to help the individual complete the action. For the adult moving to a group home, the actual day will involve the carrying of favourite articles to a vehicle and physically getting into a vehicle to travel to the apartment. Again, the repetition of various cues will help the person to be more independent, comfortable and successful.
The final stage in making transitions involves the assessment of how the transition was made. Was the individual successful? Could some things be changed in preparation so that the transition goes more smoothly? Did the individual appear to respond better to some Cues than others? By asking these and other related questions, subsequent transitions can be made smoother for the individual. When the individual and others around him/her are asked how things went, a better picture will emerge on how to modify transitions in the future. This step is important because, ultimately, changes in routines and activities should become easier to deal with.
The ease with which we handle new and different situations is directly related to how many times we encounter new and different situations. The more we are successful with changes in our environment, the more relaxed we can be when faced with something completely new. We learn to generalize from one situation to another. Generalization occurs when we mentally assess a new situation and compare it to similar past experiences. We see the aspects that are the same, and we see those that are different. We use all of our past experiences to successfully manage this one.
When assisting an individual with an intellectual disability to make successful transitions, we need to build in opportunities for generalization to occur. Frequently, this will mean more practicing of skills across a number of different situations, and with a variety of people. Cues may be altered slightly, instructions may be changed, timing may be different. All of these should be planned based upon the observations made when the individual first made their transition.
Let’s review the three stages in making a successful transition. First, we must carefully prepare the individual for change by using as many cues as possible to let them know change is imminent. Second, we must use those cues again when actually making the transition. The more cues that facilitate independence with the transition, fostering self reliance, the better. Third, a review of what happened is critical to ensure that future transitions will be successful. It is especially important to look at the need for generalization at this stage, building up the experiences in a positive way, sot that change does not seem as difficult.