By Ruba Alkhalil, M.S., BCBA, LBA, Licensed/Supervising Behavior Analyst

2020 was a hard year for everyone, but it was an especially hard year for our agency, people supported, and their families. Zoom was used as a programming model in place of in-person services. This style of providing support services to people with ID/DD was a foreign idea to many agencies and families. After several months of virtual programming via Zoom, questions began to emerge:

  • How can we individualize our virtual programming?
  • Is this option good enough for those who require more support?
  • Does virtual programming provide them with meaningful activities and are they able to engage and participate in a large zoom session?

These questions motivated Community Support Supervisor, Margaret Moss at William F. May Day Services in the Bronx, to reach out to Licensed/Board Certified Behavior Analyst, Ruba Alkhalil, M.S.,  and to Behavior Intervention Specialist, Anna Jones, M.A. for assistance and guidance. Margaret, Ruba, and Anna shared the same drive and passion to improve support and service delivery. They started to plan for a group that would focus on the use of visual support, schedule, and structured activities for virtual programming to provide people supported with a meaningful, predictable and interactive experience based on the TEACCH model, an evidence-based approach that originated from the TEACCH® Autism Program at the University of North Carolina -Chapel Hill.

The elements of the TEACCH model were adapted to be used during the new virtual group. The candidates for this new group were people with ASD who require more support because of their limited communication and social skills. They relied on the use of visual presentations to prepare for lessons that would keep the people engaged along with the use of visual cue cards that would assist people in responding to questions and lessons. During morning greetings, each person will respond to how they are feeling by holding up one of two visuals either happy or sad. Other lessons presented followed a similar format of having two choices of visuals that each person will select from as their response. Each person received a folder with visual cards that pairs with lessons and activities presented, as well as bins of materials to work on hands-on tasks such as matching, sorting, completing sentences. Staff members also have similar folders of visuals so they can model the correct responses as needed. Moreover, the group’s schedule includes time for physical exercise, sensory/relaxation time, music, and arts & crafts activities. All these activities are displayed visually on the schedule so people anticipate them.

Crucial Staff Members

This virtual group would not have been possible without the daily implementation of Community Support Professionals, Vanessa Pinott and Robert Orofino, who welcomed the idea enthusiastically.  Since this group consisted of a smaller number of people supported and a highly structured schedule and activities with clear expectations, it was easier to get family members’ involvement when needed under the guidance of Vanessa and Robert. None of this would have been achieved without the leadership of Margaret, as she ensured that all required materials and activities were produced and delivered to people’s homes in a timely manner.

Currently, this group has six people supported and each person has an opportunity to participate in activities by either responding verbally or by holding up their visual cues, as well as completing their individualized hands-on tasks. Families of people supported are satisfied with this group as they saw the difference in engagement and support provided during prior virtual settings. The success of this group is evident by the engagement and the smiling faces of people supported as they participate in this group.  It is satisfying when we see people waiting to begin their virtual program day by having their folders of visuals and activity bins ready in front of them each morning. This has been a great experience and an example of individualizing support delivery and acknowledging that even with changes in the service delivery model, a cookie-cutter model is not the right fit for everyone!