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Communication is Key to Building Functional Independence Skills in Adults with Autism

Over the past year, cities across the country have made great strides in creating an atmosphere where people with autism feel welcome and comfortable. Multiple cities have become certified autism-friendly cities, sports teams have designated certain nights as sensory-friendly events and autism advocates are beginning to find ways to create a community for people with autism.

In October 2018, First Place Arizona, a residential development built for adults with autism and other disabilities, opened in Phoenix (Reagor, 2018). Founder Denise Resnik said her 27-year-old autistic son was the inspiration the autism-friendly independent living community. Along with her son’s diagnosis more than 20 years ago, Resnik was told he would likely need to be institutionalized. Displeased with the conditions of the institutions she toured, Resnik began working on the concept that later became First Place Arizona.

William Killion, PhD

William Killion, PhD, BCBA

Vicky Westra, a business owner in Tampa, FL and head of the nonprofit Autism Shifts, took her autism advocacy one step further by developing a business that only employs autistic adults (Guzzo, 2018). Westra’s vision behind the business was two-fold: 1) She wanted to show the community that adults with autism are employable, and 2) She wanted to create a place for autistic adults to learn skills and emphasize the positive reinforcement that learning those skills creates.

While the approaches are different, Resnik and Westra are both working toward the same goal – helping adults with autism gain the functional independence and career-readiness skills necessary to live on their own. Through transition training, adults at the Phoenix residential facility are taught everything from how to cook and clean to proper business etiquette. In Tampa, Westra owns multiple businesses that hire only autistic adults so they can learn a number of different job skills.

Functional independence skills are necessary for daily living, learning how to communicate with people and for establishing quality of life. And it’s not just about behavior. Personal hygiene and self-care, for example, are the cornerstones of functional independence skills. For a person to be successful, they have to understand the basic skills of bathing, feeding and clothing themselves. These skills also include communication, decision making, personal safety, recreational play and vocational skills.

Neuro-typical individuals use these skills every day without thinking much about them, awakening on time, getting bathed, dressed, fed and out the door instinctually. But for many people with autism, those skills must be taught. If possible, the foundation for these skills should begin at childhood and be built on and added to as the individual moves closer to adulthood. It’s important to develop functional independence skills in order to foster the ability for an individual with autism to achieve greater independence as they advance through life (“Independent Living Skills,” 2018).

The residents of First Place Arizona are a great example of that concept. In order to live on their own, each person had to learn some kind of functional independence skills. Those skills could range from getting a job to getting ready for work to grocery shopping.

At Springbrook Autism Behavioral Health, we work to establish these types of skills in children and adolescents. We start by breaking down functional independence skills into several domains: adaptive behavior, emotional issues, behavioral issues, cognitive issues, sensory motor issues socialization and speech and language. The whole idea of success in adulthood is having a foundation of basic adaptive behavior. The F.I.S.H. (Functional Independence Skills Handbook) program focuses on that.

Adaptive, behavioral and socialization domains are the most important focus areas. Adaptive behavior is the most critical aspect for adulthood; it is the behavior that tells a person everything they have to do in order to get ready for their work day – wake up, shower, get dressed, eat breakfast, etc. The behavioral domain looks at the behavior in certain situations. For example, can an autistic person adapt their behavior to their work environment, control their emotions and keep their anxiety under control? Socialization is very important because effective communication is necessary when it comes to getting a job. You have to be able to effectively communicate to get a job – basic communication skills to build on as they grow into adults.

Teaching functional independence skills as soon as possible is important (Sarris, 2014). Regardless, it is never too late to begin teaching these skills, and it’s never too late for a child or adult to learn them. In one case study from Springbrook, we worked with patient who was nonverbal and on the autism spectrum who did not begin therapy until he was 33. Using the F.I.S.H. curriculum, we were able to break through speech barriers, and the patient learned to talk.

The key to teaching functional independence skills is giving a person with autism the tools to be successful long-term so we build on the skills they already have. For example, if a child needs assistance to put on his socks, work on that from start to finish – break the process down into several small steps – to help the child master the task. Teach the starting point even though he can already do it to give them a positive experience. Once the skill is mastered, he will see the pattern of reinforcement and learn about successful by doing something he can already do; Then, build on that success.

For adults with autism, the same ‘sock’ theory applies, but with a bigger project. Whatever the task is – getting a job application, finding an apartment, responding to a supervisor – break it down into small, measurable steps and teach each of those steps sequentially to put it all together into one event.

The key is to focus on developmentally appropriate tasks. For example, there is a section in the F.I.S.H. curriculum that covers employment skills and basic functional skills that are necessary to be fully independent. When looking at that section, we may cover concepts like getting a job application and filling it out, picking out color-coordinated clothes appropriate for work and how to respond to a supervisor’s request.

People with autism learn basic functional independence skills as children that create a crucial foundation for their lives. As they get older and learn more tasks, those skills are built upon and added to create a full set of living skills. Eventually, what starts as learning to put on socks or pick out clothes will lead to concepts like grocery shopping, putting away groceries and being able to cook basic meals.

We all want to feel a sense of independence, and people with autism are no different. When adults with autism can perform basic tasks, it helps with their self-esteem and self-image. Rather than seeing a dependent or handicapped individual, they see someone who can take care of himself. That feeling will, in turn, create a more positive outlook about how they approach the work world and social world, which is the ultimate goal we’re all trying to achieve.

At Springbrook Autism Behavioral Health, we work with your child to discover which treatments and therapies will have the best result. Our goal is to promote growth and independent living for every child, using the means that are most effective for each individual. Contact us today for a private consultation or to tour our campus.

About William Killion

Dr. Killion is a Board Certified Behavior Analyst and a Speech and Language Pathologist with 40-plus years of direct experience with individuals with developmental disabilities, including autism. After receiving his B.S. in Speech Pathology with a minor in Psychology, Dr. Killion went on to attain an M.Ed. in Special Education and a PhD in Developmental Psychology. He is the owner of ABA (Applied Behavioral Analysis), a practice that services many areas of the state, and has served as adjunct psychology professor and consultant to psychiatric and behavioral facilities for behavioral plans for children and adult with Autism and other developmental disabilities. He is a Board Certified Behavior Analyst (BCBA) at Springbrook. He is the author of the Functional Independence Skills Handbook or F.I.S.H. Developmental Program which is a curriculum for ABA used in 83 countries and translated into many languages. Dr. Killion is a frequent national speaker on ABA and how to address significant negative behaviors.

References

Guzzo, P. (2018, July 27). Food truck operated by adults with autism is ready to roll in Tampa. Tampa Bay Times.

Independent Living Skills. (2018). Retrieved from www.tbh.com/autism-therapy/independent-living-skills.

Reagor, C. (2018, September 21). New Phoenix apartments open for adults with autism. Arizona Republic.

Sarris, M. (2014, April 10). Daily Living Skills: A Key to Independence for People with Autism. Interactive Autism Network.

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