Participate to the MAX!
How we can help increase participation and inclusion for people with profound intellectual and multiple disabilities
By Mandy Williams
Too often we miss the obvious. With the best of intentions and a rush of enthusiasm to try the latest gadgets and most recent fads we create activities and spaces that do not demonstrate any positive improvement in the person’s interest to engage in activities, their environment or with others.
Why is this so?
The most important factor in supporting a person with profound intellectual and multiple disabilities (PIMD) is the relationship between that person and the people who support them. The term “dynamic improvisation” is often used to describe the role of the support person. Their role is to observe and try to understand and positively influence moment-by-moment the person’s attempts to interact with people, an activity or their environment. A relationship built on trust is important to reduce the person’s anxiety and to open their responsiveness to opportunities for participation and inclusion in ways that are meaningful to them.
Here are 5 tips for supporting people with PIMD:
1. Hang out with the person. Allow time for people with PIMD initiate and to respond. “You are the best piece of multi-sensory equipment around. You are the most flexible, adaptable, responsive, and interesting piece of equipment!”
2. Activities need to be relevant to the person. Think about what the person does every day. Walking down the hallway, sharing a meal or having a relaxing time watching TV – these experiences all provide opportunities for interaction with others, activities or the environment. Start by considering each step of the activity and how you might support the person to be more engaged in ways that are meaningful to them.
3. Sensory experiences can lead to learning if they are provided in context. Sensory experiences need to be tailored to match the person’s sensory responsiveness. An Occupational Therapist skilled in Sensory Processing Disorders can help assess and make recommendations regarding individualized sensory-focused strategies that support positive interactions, participation and inclusion.
The person with PIMD communicates their expressions of likes and dislikes through their behavior. Reflect on how, when, where and why they exhibit their like and dislike behaviours to inform the development of the support plan
4. Provide Consistency of Support. Ensure the level and type of support the person requires to participate in everyday activities is recorded in an accessible format and made accessible for the support team (family/staff). Engage support staff, family and the person with PIMD in defining the support required. It will form a baseline for assessing the effectiveness (outcomes) of the support provided (input).The person with PIMD communicates their expressions of likes and dislikes through their behavior. Reflect on how, when, where and why they exhibit their like and dislike behaviours to inform the development of the support plan.
5. Routines and repetition give the person with PIMD a sense of reliability and predictability. They will learn to anticipate what is about to happen and how they can engage in the process. Through anticipation anxiety diminishes promoting a sense of positive well being and openness to learning.
So, there you have it…my top 5 tips for supporting someone with PIMD to actively participate to the MAX.
If you are interested in finding out more or attending some training in this and many more topics, check out CIRC’s training calendar, or call us on (03)9843 2000 to discuss your needs.
Forster, S. (2008). Hanging Out Program: Interaction for People at Risk of Isolation.
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