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Originally Processed With FOIA(s):
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MARKER
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administrative marker by the George Bush Presidential
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Record Group/Collection: Donated Historical Materials
Collection/Office of Origin: Frieden, Lex, Collection
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Disability Rights Organizations
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[TIRR] New Options Evaluations [1977-1978]
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SYSTEMS ASSESSMENT
OF THE
NEW OPTIONS PROJECT
D.G. Stuart, PhD
Consultant
November, 1977
working Working Draft
BACKGROUND
The New Options program is designed to serve individuals who
have had difficulty in adapaing to community living after
leaving hospital based rehabilitation programs. It offers
three interrelated types of experiences to its participants:
(1) It provides specific information about various aspects
of disability and community living; (2) it provides individual
counseling to assist in problem identification and personal
adjustment, and (3) it provides a series of experiences with
in community settings and with succe sfully functioning,
dhysically disabled people so that expectations about what
is possible are changed.
Part of the New OPtions program is an ongoing assessment effort
intended to moniter the effectiveness and efficiency of
The effectiveness and efficiency of hte New Options program
is monitered by an ongoing research effort. The major thrust
participant's
of this effort is to assess changes in 1 community functioning
which might be attributable to the program. This is done by
looking at comminity activity levels before and after entry
into the program. At the same time thereahas been an interest
in monitering the New Options system itself as it goes about
the ghat is, to look at how the program functions, what its
tratment philosophy is and how well the philosophy is expressed
in practice. The consultation project reported here was
this task.
commissioned to assist in finding ways to assess the performance
this assessment
defining what the program does and how to go about assessing
its internal functioning.
STRUCTURE
The New Option S program currently operates-on organized
which take Place over a Six week period,
into a series of modules. Each module deals with a specific
content area such as financial management, sexuality,
medical needs, and so on. Some modules are run by regular staff
members and others are run by community consultanats, that
is, physically disabled individuals from the community who
have speical knowledge or expereince to offer. Some modules
combine both staff and consultants as leaders. Each module
offers a series of experiences which-run-frem-leetures-t
such as lectures, group discussions, expert pamels, and
field trips and exercises. Some modules, such as medical or
fințancial plamning have a high information content while
others, such as mobility por social skills have a high
experiential component.
The program runs for six weeks and the time is usually quit-
closely scheduled. Many of the staff have expressed the feeling
that there is not enough time in the 6 weeks to do all that
tey ould like. It should be noted that free- ime for the
participants is considered and important part of hte program.
PROBLEM:
Several issues surfaced during the consultation. The first
was
issue centered on how to assess the ffCtiveness of hte
indiviudal modules. It quickly became apparent that this
was a more difficult problem that assessing the impact of the
which
pogram as a whole The total impact of the program can easily
as
be conceptulized in a pre-test, post-test desing which looks
at how parti cpants pay function before and after entry into
the program. Variables such as contacts with other people,
educational or vocational activity, number of different activities
performed, time away from home and SO forth make sense and
are relatively easy to measure. Attitudinal or self-concept
measures can likewise be obtained before and after the program.
It is not so easy however to break up the integrated whole
and look at the impact of the indiviudal modules on final outcome.
In fact, given the practical restrictions Practical restrictions
exper montally
Such as 104
prevent the program form manipulating the system by altering
a single module while holding other factors constrat. In fact,
it is difficult to hold the content of the modules constant
from one cycle of partiicpants to another because as the
character of the particia -of the and nedds of the participnat S
chngre a ) SO does the content of the program.
The interaction between the types of partii cpants entering
a
a
program cycle and the nture of fite program rassed several
other issues. The first was the difference between a criterion
performance model and an improvement based model. It was
clear that participants vary a great deal in their entry-level
skills and needs. It was not SO clear whether the program
was seeking
was defining a successful outcome in terms of a specific levw
1
of functioning or in terms of some amount of improvement over
the entry level abilities. A second, and more subtle issues,
concerned the way in which progam staff conceptualize the
functionng of the program. On the one hand there was a concern
that some specific items of infrmation be presented to the
participants. This was linked to a desire to create a
package of standardized package of module contents which
might be distributed to other rehabilitation programs. At
the same time there was a feeling that the program must
be indiviudalized to some extent. There was also a feeling
that much of the impact of the program might result from
the contact with the community consuttants and fieldtrips
changed expectations about what was possible for a disabled
person caused by contact wint the communiy-con successfully
rehabilitated community consultants, and rather than from
exposure to informatio specific information about disability.
The impo tance and role of the counseling was also not clear:
it
The couseling was considered important, but its place in
relation to the rest of hte program and ways of assessing its
uncartain
impact were less clear. Finally, the importance of free-time
and informal contacts with the staff members was raised.
It was genrally agreed that the availabilty of a tleast one
staff member for informal contacts with particiapnts was
desirable but no such staff role or time had been formally
role
designated. Instead this function had simply appeared as a
function of the personality of certian staff members and the
needs of the participants, but had never been formally acknowledged.
Discussion of why this role was importnat led to an increased
feeling that generalized, non specific contacts
awareness
led to anincreased feeling on the part of the consultant that
informal, non-specific contacts represented an importnat part
f what the New Options programs offers.
ALTERNATIVE MODELS
C
All of the above issues may be conceptualized under a genral
comparison of An educatinal, clinical and theraputic
community models of program functioning. The actual functioning
of the New Options program represents a mixture of these
approaches but it might prove useful to make the ramifications
of each model explicit.
S
(1) It appears that the module structure of the program derive&
form an educational orientation. The breakdown of the program
experience into content areas which are operated sperately
by staff or community consultants assumes a set of specialized
skill or body of knowledge which is to be transmitted in
each module (2) The clinical modle is represented by the
counsleing relationships offerd a by various staff members:
a
some around vocational needs, others around personal adjustmynt
and others around personal mobility or functional performance
(3)
needs. Finally, the theraputic community concept is expressed
in the modeling done by the community consultants, the
informal contacts with staff and consultants, and the field
trips to community settings where skills are tried out
and actual adjustment issues @raided.
The relative importnace of these three orientations in
the operation of the program is not clear. The program
has not been conceptualized in these terms but instead
grew
seemid-
grow into its present form on the basis of the
experiences of the staff in working with successful and
unsuccessfully rehabilitated people. Many of hte field
trips included in the modules were included because
community consultatns or staff had experienced difficulties
certain Settions
with these experiences in the past and had had to find ways
to overcome them. This kind of experiential-based concept
of what the program is all about is similar to that used
by action oritned agencies or programs such as the U S
Army, of medical schools and so on which attempt to provide
a series of hands-on experdinces which provide not only a
set of skills but an altered perception of personal functioning
and relationship with the world.
The mixture of models used in the operation of the program
has some strengths in that a variety of needs are being met.
The weakness has been that the-purpose-and- fu an understanding
of the purpose and functionng of hte program has been obscured.
Staff have been operating on a set of indiviudal, implicit
assumptions about the program . This had 5 been possible because
so many different functions are being performed, and each person
to
be
can find examples of what he believes is important somewhere
in the program. The difficulty has been that-there- in locating
inefficiencies or blank spots in the operation of the
$
sytem. From the consultants poim t of view, there was considerable
duplication across some of the modules and it also seemed
there were some important things going on that were not
who
given sufficient program recognition/ It seemed to me that
some parti epants were attending modules which would not be
helpful to them while HH suspected that there were needs that
were not being met. Most importnatly, it seeemd that the
Process
goal of indiviudalizing the program was not being adequately
met at the total po level of Aprogram level although it
was being dealt with in some of the indiviudal modules.
ASSESSMENT
The assessment of components of hte program program
was originally
to
functioning originally was focusedon the modules, An attempt
was made to providd an assessment system for each individual
module. It was quickly apparnet that the modules differed
condiderably in the mix of counseling, information and
experiential functions. The assessment of the information
content! was appraoched by asking staff membets to create
ture-false, multiple choice, or essay questions appropriate
for the module. It was discovered that the information content
changes from cycle to cycle however and it also became
apparent that the actual content had never formally been set
down but had "grown up" in the heads of those doing the module.
A second issue concerned whether it was the program or the
partiicpants that were to be assessed. In one sense, the progress
of the participants is a measure of the effectiveness of the
program, but module, but in another sense the only measure,
othe effectivenes of a module would be osme measure of its
claim
impact on the outcome criteria. It was agreed however that
the influence of indiviual modiles on final outcome could not
it was necessary
the
be assessed; this meant that what we wanted to measure was
participants'
anindividuals knowledge VAS or skills before and after going
as a measure of what the percind + the module does,
through a module. At the tine of this report the staff had
totally
still not agreed in whtehr this should be a criterion lave
ASSESSMENT
The assessment effort was originally focused on the module
structure and an attempt was made 60 create measurement
techniques for each module. It was clear, however, that
the impact of hte indiviudal modules on the final outcome
could not be measured; stead, the functioning of the modules
would have to be assessed in terms of knowledge and skills
the participants receive as they go through the system.
The content of the modules is based on simple face validity,
i.e., it is based on what the staff feels is important for
a disabled people person to know and know-ho those things he
should be able to do. Wehter or not disabled people do indeed
need the information or skills offered is more a matter of the
tion
definition of successful rehabilitan than it is of validation.
During the consultation, it became clear that there was
considerable agreement among the staff about the importance of
various parts of the program. Nevertheless, the consultant
had the feeling that the rationale for doing things the
activities was more covert than explicit. One of the goals
for the consultant, therefore, was to use the assessment
task to as a way to bring the thinking of the staff more
into the open so that it might be rationally structured.
^assessment or an improvement over entering level. The trend
seemed to be to create indiviudalized goals for participants
and to measure heir progress against these goals. This
mans that each participant would have a specified set of
fals for each module.
The modules differ considerably in the mix of counseling,
information and experiential activities And the assessment
techniques for each of these also differ. Information content
is conceptually the easiest to measure: staff were asked to
provide true-fälse, multiple choice or esay type questions
A
to cover the information content. One problem that arose
v
with thes however, was that the information cntent apparenty
shifts from cycle to cycle and has never been formally
written down for any module. It thus became clear that what
is taught in the modules depends to a great extent on the
current module leader rather than on some centralized planning
decisions. The isúe 5 of whther this was desirable or not
19
was not refolved $ during the consultation. There was discussion of
uisng videotape to standardize cerain presentaitons but this
awkward?
was felt to conflict with the Personal connect with 110/7/1196 community when consultants made
The experientital act ivities of amodkle
the presentations assessing
A seecnd second approach to the information content of a module
15
was to desing specific tasks such as creating a budget
in the financial module; or to listing list the important medical
information relevant to the particiapnat in the medical
module, (a list of these will be found iin the appendix)
provides a straightformont measure of
This work-sample approach seemed to be popular with the staff,
skills learned.
create
but some ierable work will be required to cractate
meaningful tasks and to find ways to grade them.
The counseling functions of certain modules proved to te
difficult to assess just as they are in other formats such
It seemed that
as psychotherapy or vocational counseling. It was finally agreed
what was impor tant about The Purpose of the counseling
that the staff expectation about wat was happening with
19
these types of functions was to increase awareness of the
goals +
participants the parti cpants awareness of, options. and
possibilities Given-this-it-see A kind of' goals clarification"
was seen as importat. Given this it was dicided to reccomende d
that participants list short term and long term goals
both
appropriate to the each module, before entering and just before
fininshing the module. The assumption here being that if
the module is effective 1 the number of goals seen as possible
will expand and goals will become more relaistic and detailed.
A part of this exercisw 0 would ten b to list the steps
include listing
necessary to obtain the goals. This listing task not only
functioning
serves the purpose of assessing the impact of the program
but provides the module leader with information about the
Participant's
participant that can be useful in planning the activities.
wcih will be useful to him
This assessment approach has asme obvious difficulties: it
is possible for instrace, that participants would simply learn
0
to fill out a cmplicated-looking set of goals without actually
becoming percosnally involved or committed to them. It is also
This
difficult to quantify the assessment of improvement. The only
response is that the expansion of e xpectations about what is
possible is difficult to measure, but for this program,
it seems importnat to make the attempt because so much of
what the prgram does seems to be dealing wiht this area
U
The experiential functions of the varios modules provide
another complex assessment task. The consultant found
genral 0 agreement among th staf theat the field-trips and
activities which occur on the field trips are a key part of
the program; but again, these had never been explicitely
written down. Instead, program Þeaders had created a series
of events, such as a trip to the ariport, which they felt
to be improtant based on their experience and k nowledge
aobut the adjustment of other physically disabled people.
Several anecdotal accounts of specific exercises desinged
made it
for a particular participant were offerd and it became
clear that many of these exercises occured to staff only
during the course of a module as they got to know the
needs of the participants better, Here again the
issue of a standardized, versus an indiviudalized program
was raised. Discussion with staff raised the possibility
a pool
that a $$1 gental set of experiential exercises could be
designed which would provide a pool of possiblélities
from which specific exercises would be drawn for each
indiiudal. Assesment of these exercises would then be made
on the basis of ratings by the staff and/or other participants
depending on the nature of hte exercise. Some exercises,
such as going into a store and buying something could simply
person
be rated as pass/fail depending on whether the son
succeeds or not while other might require a more complex
judgent Concerin g the "smoothness" or ease wiht which the person
functioned. Murry (19--) provides a model for such assessments
although the actual system Qwuld ahve to be specifically
tailored for the New Optns program. Note that, here again,
the effectivenss of e module is being assessed by measuring
whether of not the particiapnats are able to perform certian
specified tasks indiviudal assessment is part of the
program evalaution.
DISCUSSION AND RECOMMENDARIONS
After analyzing the New OPtions Program, the consultant felt
there remaned a number of ambiguities and unanswered questions
about the goals and functioning of the program. It was therefore
decided to have a staff retreat to explore this. Duin Some
of the issues that durfaced 5 during this meeting have alreasdy been
Even Cleared
be discussed. In general it became, clearer that a great deal
a
of importnce was attatched to the feeld exercises & and conta
the personal contacts partilcpants have with the communtiy
consultants and staff embrs. This was not to say that the
informtaion content of hte program was not chsidered important,
but for the consultant, at least, the it became clear that
there was a strong und lying feeling that what the program
0
ffers
IS
was offerging was a set of expere nces whihc allow the
participants to try out new ways of doing and thinking abut
h
A
things facilitated by seeing oters who have alredy successfully
achieved a fulfilling life-style. Within this framework, the
information &ontent and module structure provides the settin
exercises
a background for the field exeries One staff member
prased it as providien an "excuse" for the field exericeses
FOr instnace, the arirport trip was considered very importnant.
because it gets participants into a public setting, provides
tem with numerous mobility and interpersonal challanges
and lets them deal with a large organization. The lernaing
that goes in tin this situation far exceeds the specific
information gained about an airport.
Given this logic, the group came around to the idea that the
+ structure
B
should be
the core of the program was actually the set of experiences offered
rathet than the module structure. The consultant had already
the
inted out thate overlap in modules and had recommneded that
titles
several modules be combined under new heading. The idea
ing
that emerged however was to begin to structure the field
and to list
experiences
expereinces much more closely by lisitng those expeeirneces
that were considered essential along with the reasons they
why
&
of
were essential. This ld to the concept of creating a set pg
specific ogals for each participant based on WHEL each
field trip and to assess or his his performance in meeting these
the
goals. This meant that eh module structure would no longer
be followed, but instead the functions served by each module
0
wuld now be integrated around a set of field experiences.
i.e.,
The information content of the modules talks by experts,
panel discussions, and snall M gorup discussions would
be In add, two, these formats
continue to be a part of the prggram, but would now be seen
would be used much more consciously to prepare for field trips t
as preparing for or be part of the "debriefing" of field
to provide "debriefing" after the experiences.
trips.
The consultant felt this was a very crative solution. this The solution
offers an
m
min advantage being that it requires the staff to conceptualize
why they hazve been providing certan experiences and because
it albws a way to indiviudalize the program while retainint retaining
a group structure. This is achieved by taking the group on
only
a field trip ) but by haivng differnet goals and exercises
for participants within that structure.
It is recommended,
therefore, that the staff pursue this concept.
The evaluation effort techniques presented for the individual
modules can be easily transposed if a new experiential-based
design is used since all that is chanigng is the way in
which the program is conceptualized and goals set for the
participants. The evaluations recommendations are presented
in the appendix.
Another issue raisded in the retreat deserves special mentin.
It was noted that cerain staff members have been fulfilling
the
a special role This role consists of being available to
an
informal
participants on a very informal basis for discussions in the
hallways, while playing pool and so on. The infonmal nature
of these contacts often provides a way for participants to
n
apporach a sensitive or importat area in a casual, fashion-
low anxiety fashion. A person who might never make an appointment
for an interview, or knock on a door, might find himself
or
lorself
talking adbut something importnat / if it arises out of a
firendly conversation on some other topic. The importnace
of
0
of the opportunities for such inflrmal contacts sould be
stressed, The theraputic community approach model. makes much of such
as
contacts, and the New Options program has been prvviding
syhe services even though it has not bee specifically programmed.
It is recommended that The importnace of these activities
be noted and acknowledged by formally making it a part of the
program in temrs of someones a job description, along with
the apporpriate time and money commitments. Although it may
be argued that there is not anough available time for all
the prgrammed activities now felt to be desirable, the
activit function
relative importance of this, as oppossed to other options
should be debated by the staff.
In conclusion, the consultant feels that the great impact of
the New OPtons program rests on the variety of personal
with statt + consultants, and on the field
contacts and experiences offered to its participants Specific information
MAN
is seen as having a sean secondary role.
rathek than on the inflrmation about disability And/ It
is not always easy to separate information from experience however,
IN facts nor there is there may any not reson a to be do so. It is should importnat, however
b4 realized howover,
to relaize that the program probably cannot be packaged
in the form of a catalougze of information, but instead must
be described in terms of the ways in which the staff and
by describing
community consultants interact wihtthe participants; and, the
ways in which the many field experineces widen the horizons
of the participants. This also means that assesment 5 of the
measuring
program's functioning cannot be a simple matter of assessinf
recognize
information learned, but must take full cognizeneze of
the almost "subliminal" learkng Bing that goes on as a sperson
sees other disabled people coping effectively with the
agan
environment. Here gian it will prove difficult to seperate
out any specific experdince and say what its impact was,
instead it must be recognized that it $s the buildup of
a series of such experiences that produces the effect of
the program. If the module system is dropped then
it will no longerbe useful to think in terms of assessing the
impact of individual modules - instead the participants' success
in performing cert an an designated tasks can be asseseed measured along
ability
withetheir abilitity to expand their thinking about goals and
ways to meet those goals. This approach seems to me to
give the best representation of the way the program actually
functions in expaning the activities of its paticopants.
and enriching
APPENDIX
The following is a series of assessment techniques based on
the present module system. They-will Most will still be
applicable if the experiential-based system is used. In
general, participants should perform each assessment task
before and after completing the relevant module or experiences
)
and the amount of improvement noted. ///// A criterion
level of performance should be established by the staff.
If participants reach this level in the pre-test then there
is no point in having them go through the module or experience.
It should be npted that most of these tasks have simple
face validity for the outcome of a "rehabilitated" person.
These tasks are based on what the New Options staff believes
is important for a disabled person to know - whether they do
indeed need to know these things is open-te-questienn more
a matter of definition of successful rehabilitation or community
adjustment than it is of validation.
FINANCIAL MANAGEMENT
1. Make a complete, detailed budget based on expectations of
how you will be living a year from now. List all relevant
sources of income and expense. Also include a description
of all agencies or services which might be relevant to
your situtaion and how you go about contacting them.
Include long-range financial planning.
SCORING: This may be done on a pass/fail system or the module
leader may assigne a score based on his udgment of how
or her
complete the budget is. Arithmetic should be checked.
PROBLEM SOLVING
This module should be dropped and the techniques integrated
f
with other modules. It it is retained, then particiants may
be socred on whether they can list the steps in problem
solving.
SEXUALITY
Sections I and IV of the Derogatis Sexual Functioning
Inventory may be used for sexual attitudes. Questionnaires
from the TIRR Sexual workshop may also be relevant.
Specific items covereing the effects of SCI, stroke etc. on
e
sexual functioning may be crated by the module leader. A pool
of itwms should be crered for all disability groups and the
items specific for a particular participant would be drawn
from this pool.
People may be asked to give their expectations for how they
will be functionng sexulaly in the future (with who, how
often, how satisfied etc.) The module should have the effect
of rasing these expectations.
MEDICAL
1. List all the medical problems relevant to your disability
group, how you recognize them, what you do about them.
2n What plans would you make for receiving routine and
emergency medical care in your community?
The module leader should have a list of the relevant medical
problems for each disability group and score the responses
from this list. The scoring will naturally be based on the
material actually covered in the module.
VOCATIONAL
1.
List your short term and long term vocational goals. Give
the steps necessary to reach each goal along with the
anticipated obsticles and what you plan to do about them.
Scoring: Participants should be able to give a longer and
more resonable list of goals after the module and should
have a better understanding of the steps necessary to reach
ter ni goal (such as educational requirements). The module
leader will have to score the ask hisor on her judgment of how
complete and realistic the result is.
HOME MANAGEMENT, LIVING ARRANGEMENTS, LEISURE, MOBILITY
AND FUNCTIONAL SKILLS
modorite to
1. The specific information content of these modules is very low,
and form an assessment point of view they seem to be dealing
11
with very simial èssues of how well the person gets around,
manipulates his environment, makes use of resources and so
on. It would seem best to have the entering par icipants
to make a list of the areas of functioning that now give
them trouble (such as driving, manuvering wheelchair, cooking,
going to stores and so on). They can then list the goals
they have for the New Options program. There performance in
achieveing these goals can then be rated by the staff.
2.
Participants may be asked to list-the-sou describe the sources
or learning about
of information they would use in selecting equipment, and community
They should bo able to list
resources.
n the steps to use in visiting new settings or using Different forms of
transportation such as planes or buses.
behavioral
3.
The field trips will provide may n opportunities for rating the of the
participants performance. This assessment should be utilized
to decide if the module is working (and thus helping the
person). It will be necessary to avoid having the paricipant
feel anxious about having his performance rated. This can
opher
be handled through appropriate feedback and by minimizing
the obtrusiveness of the rating procedure.
ATTENDANT MANAGEMENT, SOCIAL SKILLS AND CONSUMER AFFAIRS
1.
These modules all deal with social skills and are similar to
Just presented
these immediatley preceding in that the purpose of the
moduls is to develop skills rather than knowledge. Performance
in these areas is best assessed by behavior ratings on the
field trips or by role playing. For instance, -hiring,--
interviewing, hiring and firing an aide can be role-played
C
uisng staff or real aides. Job interviews, social ocassions
and so on can be effectively modeled and ratings obtained.
Here again it will be important to minimize anxiety about
the rating process. It will probbaly be a good idea to
explain to all entering participants that evalution of the
effectiveness of the modules will be continuing. throughout
the program.
2.
Questions on the legal rights and responsibilities of
various disability groups may be created by the module
leader.
PROCEDURAL NOTE:
Many of the assessment techniques just outlined depend on
staff ratings of participant behavior. Such ratings are
motoriously subject to staff expectations, biases and
pre-judgments. This can best be minimized by creating
A
simple
standardized check-lists of the desired behaviors with
PASS/FAIL
SYSTEM will
very simple criteria for judging success or failure. Ideally probably
work BEST.
an observer who is not a staff member should make the ratinggs,
BM 1 The reality is that these types of ratings are difficult.
It should therfore be kept in mind that the purpose of this q.4
evaluations
exercise is to gather information for the staff to use in
on
deciding about the usefulness and effectiveness of the
for use by State
various parts of the program and only secondarily as a
demonstration of the programs effectiveness to a third party.
The demonstration of the programs worth will depend on the
overall pre and post measures obtained on community functioning.
PROCEDURAL NOTES:
Many of the assessment techniques just outlined include
staff ratings of participhat's behavior. Such ratings are
notoriously subject to rater expectations, biases and
pre-judgements. These are best minimized by using standardized
check lists and using very simple criteria of success.
The following system mgiht be used: (1) prepare a set of
desired behaviors for each participant based in his goals
for the 6 week period. This might include such tasks as
getting in and out of a car, curb-jumping, buying something
in a store, asking a stragner for directions, using a pay
phone and so on. Different lists might be used for the
(2)
different settngs visited on the field-trips. The simplest
rating to use would be whther the person does or does not
perform the tasks. This simple pass/fail system should be used
whenever possible. If a more compèex judgment is required
to rate degree of success, or the ease with which a person
performs the task, the smallest number of choice points
possible should be used.
It should be kept in mind that the purpose of these assessment
activities is to gather information on the usefulness and
effectiveness of various parts of the program for use by the
staff. This information can be used in future planning and
as, tool for assessing the progress of the participants. It
is ony-secondarily of only secondary importnace in convincing
some outside party of the effectiveness of the program since
this will be done primarily by the overall pre and post
the graduate's
measures Of, community performance, by the graduates. Nevertheless,
it is importnat to document what the program actually does,
i.e, what the participants actually experence, if the nature
of the program is to be made clear to outsiders. This
documentation has the added benefit of clarifying how the
system functions Bor the staff, so that they may more readily
determine if it is functioning as they would wish it to.
Some such assessment effort should be an ongoing part of
the project.
Nevertheless, the process measures advocated here provide
staff with a way to monitor he program's functioning And. .
and to think about what the rporam doez and what they want
ft to do. Some such effort should be an ongoing part of
the program.
OTHER MEASURES
The following paper-and-pencil tests may be useful in
assessing attitude changes. They are more likey to be useful
in meas-uing the overall impact of the program than the
effects of individual modules.
1. Rotter's Internal-external locus of control scale:
Rotter, J.B. Generalized expectancies for internal versus
external control of reinforcement. Psychological Monographs,
1966,80 (lWhole No. 609).
29 twe-choice items
2. Cattel's 16PF
187 three-choice items, takes about 30 minutes. Easy to score
with independent factors. Gets at personal orientations and
attitudes towards the world and other people.
25.
3. Shostrum's Personal Orientation Inventory
Shostrum, E. EITS Manual for the Personal Orientation
Inventory. San Diego, California (92107) : Educational and
Industrial Testing Service, 1966, supplemented 1968.
150 two-choice items ge-ting at self-acutalization, self
acceptance and other reaated concepts. 30-45 minutes.
SYSTEMS ASSESSMENT OF THE NEW OPTIONS PROJECT
By D.G. Stuart, Ph.D.
Consultant
November, 1977
BACKGROUND
The New Options program is designed to serve individuals who have had diffi-
culty in adapting to community living after leaving hospital based rehabili-
tation programs. It offers three interrelated types of experiences to its
participants: (1) It provides specific information about various aspects
of disability and community living; (2) it provides individual counseling
to assist in problem identification and personal adjustment, and (3) it
provides a series of experiences in community settings and with successfully
functioning, physically disabled people so that expectations about what is
possible are changed.
The effectiveness of the New Options program is monitored by an ongoing research
effort. The major thrust of this effort is to assess changes in participant's
community functioning which might be attributable to the program. This is done
by looking at community activity levels before and after entry into the program.
At the same time there has been an interest in monitoring the New Options
system itself; that is, to look at how the program functions, what its treat-
ment philosophy is and how well the philosophy is expressed in practice. The
consultation project reported here was commissioned to assist in this task.
STRUCTURE
The New Options program is currently organized into a series of modules which
take place over a six week period. Each module deals with a specific content
area such as financial management, sexuality, medical needs, and so on. Some
modules are run by regular staff members and others are run by community con-
sultants, that is, physically disabled individuals from the community who have
special knowledge or experience to offer. Some modules combine both staff
and consultants as leaders. Each module offers a series of experiences such as
lectures, group discussions, expert panels, field trips, and exercises. Some
modules, such as medical or financial planning have a high information content
while others, such as mobility or social skills have a high experiential
component.
PROBLEM
Several issues surfaced during the consultation. The first was how to assess
the effectiveness of the individual modules. It quickly became apparent that
this was a more difficult problem than assessing the impact of the program as
a whole which can easily be conceptulized as a pre-test, post-test design
which looks at how participants function before and after entry into the
program. Variables such as contacts with other people, educational or voca-
tional activity, number of different activities performed, time away from
home and so forth make sense and are relatively easy to measure. Attitudinal
or self-concept measures can likewise be obtained before and after the program.
It is not so easy however, to break up the integrated whole and look at the
impact of the individual modules on final outcome. Practical restrictions
prevent experimentally manipulating the system such as by altering a single
module while holding other factors constant. In fact, it is difficult to hold
the content of the modules constant from one cycle of participants to another
because, as the character and needs of the participants change, SO does the
content of the program.
The interaction between the types of participants and the nature of the program
raised several other issues. The first was the difference between a criterion
performance model and an improvement based model. It was clear that partici-
-3-
pants vary a great deal in their entry-level skills and needs. It was not so
clear whether the program was defining a successful outcome in terms of a
specific level of functioning or in terms of some amount of improvement over
entry level abilities. A second, and more subtle issue, concerned the way
in which program staff conceptualize the functioning of the program. On the
one hand there was a concern that some specific items of information be pre-
sented to the participants. This was linked to a desire to create a stan-
dardized package of module contents which might be distributed to other
rehabilitation programs. At the same time, there was a feeling that the
program must be individualized to some extent. There was also a feeling
that much of the impact of the program results from changed expectations about
what is possible for a disabled person, caused by contact with the successfully
rehabilitated community consultants, rather than from exposure to specific
information about disability. The role of the counseling was also not clear:
it was considered important, but its place in relation to the rest of the
program and ways of assessing its impact were uncertain. Finally, the impor-
tance of free-time and informal contacts with the staff members was raised.
It was generally agreed that the availability of at least one staff member
for informal contacts with participants was desirable but no such staff role
or time had been formally designated. Instead this role had simply appeared
as a function of the personality of certain staff members and the needs of
the participants. Discussion of why this role was important led to an increased
awareness on the part of the consultant that informal, non-specific contacts
represent an important part of what the New Options program offers.
ALTERNATIVE MODELS
All of the above issues may be conceptualized under a general comparison of
educational, clinical, and theraputic community models of program func-
tioning. The actual functioning of the New Options program represents
a mixture of these approaches: (1) The module structure of the pro-
gram derives from an educational orientation. The:breakdöwn of the
program experience into content areas which are operated separately
by staff or community consultants assumes a specialized skill or body
of knowledge which is to be transmitted in each module. (2) The
clinical model is represented by the counseling relationships offered
by various staff members: some around vocational needs, others around
personal adjustment or functional performance needs. (3) Finally, the
theraputic community concept is expressed in the modeling done by the
community consultants, and the field trips to community settings where
skills are tried out and actual adjustment issues raised.
The relative importance of these three orientations is the operation
of the program is not clear. The program has not been conceptualized
in these terms but instead grew into its present form on the basis of
the experiences of the staff in working with successful and unsuccess-
fully rehabilitated people. Many of the field trips included in the
modules were included because community consultants or staff had exper-
ienced difficulties with certain settings in the past and had had to
find ways to overcome them. This experiential-based concept attempts
to provide a series of hands-on experiences which provide not only a
set of skills but an altered perception of personal functioning and re-
lationship with the world.
The mixture of models used in the operation of the program has some strengths
-5-
in that a variety of needs are being met. The weakness has been that an
understanding of the purpose and functioning of the program has been
obscured. Staff have been operating on a set of individual, implicit
assumptions about the program. This has been possible because so many
different functions are being performed. The difficulty hassbeen in
locating inefficiencies or blank spots in the operation of the system.
From the consultants point of view, there was considerable duplication
across some of the modules and there were some important things that were
not given sufficient program recognition. Most importantly, it seemed
that the goal of individualizing the process wassnot being adequately
met at the program level although it was being dealt with in some of the
individual modules.
ASSESSMENT
The assessment effort was originally focused on the module structure and
an attempt was made to create measurement techniques for each module. It
was clear, however, that the impact of the individual modules on the final
outcome could not be measured; instead, the functioning of the modules
would have to be assessed in terms of knowledge and skills the participants
receive as they go through the system. The content of the modules is
based on simple face validity, i.e., it is based on what the staff feels is
important for a disabled person to know and those things he should be
able to do. Whether or not disabled people do indeed need the information
or skills offered is more a matter of the definition of successful rehabi-
litation than it is of validation. During the consultation, it became clear
that there was considerable agreement among the staff about the importance
of various parts of the program. Nevertheless, the consultant had the feeling
-6-
that the rationale was more covert than explicit. One of the goals for
the consultant, therefore, was to use the assessment task to bring the
thinking of the staff more into the open, so that it might be rationally
structured.
The modules differ considerably in the mix of counseling, information and
experiential activities and the assessment techniques for each of these
also differ. Information content is conceptually the easiest to measure:
staff were asked to provide true-false, multiple choice or essay type
questions to cover the information content. A problem that arose with
this, however, was that the information content apparently shifts from
cycle to cycle and has never been formally written down for any module.
It thus became clear that what is taught in the modules depends to a great
extent on the current module leader rather than on some centralized planning
decisions. The issue of whether this is desirable or not was not resolved
during the consultation. There was discussion of using videotape to
standardize certain presentations but this was felt to conflict with the
personal contact obtained when community consultants made the presentations.
A second approach to assessing the information content of a module is to
design specific tasks such as creating a budget in the financial module;
or listing medical information relevant to the participant in the medical
module. This work-sample approach provides a straight forward measure
of skills learned.
-7-
The counseling functions of certain modules proved to be difficult to assess
just as they are in other formats such as psychotherapy or vocational
counseling. The purpose of the couseling is to increase the participants
awareness of goals and options. Given this, it was recommended that
participants list short and long term goals appropriate to each module
both before entering and just before finishing the module. The assumption
being, that if the module is effection, the number of goals seen as
possible will expand and goals will become more realistic and detailed.
A part of this exercise would include listing the steps necessary to obtain
the goals. This listing task not only serves the purpose of assessing
the functioning of the program but provides the module leader with infor-
mation that can be useful in planninggthe participant's activities.
The experiential functions of the various modules provide another complex
assessment task. The consultant found general agreement among the staff
that the field trips and activities which occur on the field trips are
a key part of the program; but again, these had never been explicitly
written down. Instead, program leaders had created a series of events, such
as a trip to the airport, which they felt to be important based on their
experience and knowledge about the adjustment of physically disabled people.
Several anecdotal accounts of exercises designed for a particular partici-
pant made it clear that many of these exercises occured to staff during the
course of a module, as they got to know the needs of the participants better.
Here again the issue of a standardized, versus an individualized program was
raised. Discussion with staff raised the possibility that a pool of exper-
iential exercises could be designed from which specific exercises would be
drawn for each individual. Assessment of these exercises would then be made
-8-
on the basis of ratings by the staff and/or other participants depending
on the nature of the exercise. Some exercises, such as going into a
store and buying something could simply be rated as pass/fail depending
on whether the person: succeeds or not, while others might require a more
complex judgment concerning the "smoothness" or ease with which the
person functioned.
DISCUSSION AND RECOMMENDATIONS
After analyzing the New Options Program, there remained a number of ambigui-
ties and unanswered questions about the goals and functioning of the program.
It was therefore decided to have a staff retreat to explore that. Some
of the issues that surfaced during this meeting have already been discussed.
In general, a great deal of importance was attached to the field exercises
and the personal contacts participants have with community consultants
and staff. This was not to say that the information content of the program
was not considered important: but for the consultant, at least, there was
a strong feeling that what the program offers is a set of experiences
which allow participants to try new ways of doing and thinking about things;
facilitated by seeing others who have already achieved a fulfilling life-
style. Within this framework, the information content and module structure
providesna background for the field exercises.
Given this logic, the core and structure of the program should be the set
of experiences offered rather than the module structure. The consultant
had already pointed out the overlap in modules and had recommended that
several modules be combined under new titles. The idea that emerged however,
-9-
was to begin structuring the field experiences much more closely and to
list those experiences that were considered essential along with the
reasons why they were essential. This led to the concept of creating
a set of specific goals for each part icipant on each field trip, and to
assess his or her performance in meeting these goals. This meänt that
the functions served by each module would now be integrated around a set
of field experiences. The information content of the modules i.e., talks
by experts, panel discussions, and small group discussions would continue
to be a part of the program. In addition, these formats would be used
much more consciously to prépare for field trips and to provide "debriefing"
after the experiences. This solution offers an advantage in that it
requires the staff to conceptualize why they have been providing certain
experiences and because it allows a way to individualize the program while
retaining a group structure. This is achieved by notionly taking the group
on a field trip, but by having different goals and exercises for partici-
pants within that structure.
Another issue raised in the retreat deserves special mention. It was noted
that certain staff members have been fulfilling the special role of being
available to participants on an informal basis for discussions in the hall-
ways, while playing pool and so on. The informal nature of these contacts
often provides a way for participants to approach a sensitive or important
area in a casual, low anxiety fashion. A person who might never make an
appointment for aniinterview, or knock on a door, might find himself or
herself talking about something important, if it arises out of a friendly
conversation on some other topic. The importance of such informal contacts
should be stressed, as it is in the theraputic community model. It is
-10-
recommended that the importance of these activities be acknowledged by
formally making it a part of the program in terms of a job description,
along with the appropriate time and money commitments.
In conclusion, the consultant feels that the great impact of the New Options
program rests on the variety of personal contacts with staff and consultants,
and on the field experiences offered to its participants.. Specific infor-
mation is seen as having a secondary role. It is not always easy to
separate information from experience. In fact, there may not be any reason
to do so. It should be realized however, that the program probably cannot
be packaged in the form of a catalogue of information, but instead must
be described in terms of the ways in which the staff and community consul-
tants interact with the participants, and by describing the ways in which
the many field experiences widen the horizons of the participants. This
also means that assessment of the program's functioning cannot be a simple
matter of measuring information learned, but must recognize the learning
that goes on as a person sees other disabled people coping effectively with
the environment. Here again it will prove difficult to separate out any
specific experiences and say what its impact was. Instead, it must be re-
cognized that it is the buildup of a series of such experiences that produces
the effect of the program. If the module system is dropped, then it will no
longer be useful to think in terms of assessing the impact of individual modules -
instead the participants' súccess in performing certain designated tasks can
be measured along with their ability to expand their thinking about goals and
ways to meet those goals. This approach seems to me to give the best repre-
sentation of the way the program actually functions in expanding and enriching
the activities of its participants.
APPENDIX
The following is a series of assessment techniques based on the present module
system. Most will still be applicable if the experiential-based system is
used. In general, participants should perform each assessment task before and
after completing the relevant module or experiences, and the amount of im-
provement noted. A criterion level of performance should be established by
the staff. If participants reach this level in the pre-test then there is
no point in having them go through the module or experience.
FINANCIAL MANAGEMENT
1. Make a complete, detailed budget based on expectations of how you will be
living a year from now. List all relevant sources of income and expense.
Also include a description of all agencies or services which might be
relevant to your situation and how you go about contacting them. Include
long-range financial planning.
SCORING: This may be done on a pass/fail system or the module leader may
assign a score based on his or her judgment of how complete the budget is.
Arithmetic should be checked.
PROBLEM SOLVING
This module should be dropped and the techniques integrated with other modules.
If it is retained, then participants may be scored on whether they can list the
steps in problem solving.
SEXUALITY
Sections I and IV of the Derogatis Sexual Functioning Inventory may be used for
sexual attitudes. Questionnaires from the TIRR Sexual Workshop may also be
relevant.
Specific items covering the effects of SCI, stroke, etc. on sexual functioning
may be created by the module leader. A pool of items should be created for all
disability groups and the items specific for a particular participant would be
drawn from this pool.
People may be asked to give their expectations for how they will be functioning
sexually in the future (with who, how often, how satisfied, etc.). The module
should have the effect of raising these expectations.
MEDICAL
1. List all the medical problems relevant to your disability group, how you
recognize them, what you do about them.
2. What plans would you make for receiving routine and emergency medical care
in your community?
The module leader should have a list of the relevant medical problems for each
disability group and score the responses from this list. The scoring will
naturally be based on the material actually covered in the module.
VOCATIONAL
1. List your short term and long term vocational goals. Give the steps
necessary to reach each goal along with the anticipated obstacles and
what you plan to do about them.
SCORING: Participants should be able to give a longer and more reasonable
list of goals after the module and should have a better understanding of
the steps necessary to reach their goal (such as educational requirements).
The module leader will have to score the task on his or her judgment of
how complete and realistic the result is.
HOME MANAGEMENT, LIVING ARRANGEMENTS, LEISURE, MOBILITY, AND FUNCTIONAL SKILLS
1. The specific information content of these modules is moderate to low,
and from an assessment point of view they seem to be dealing with very
similar issues of how well the person gets around, manipulates his en-
vironment, makes use of resources and so on. It would seem best to have
the entering participants make a list of the areas of functioning that
now give them trouble (such as driving, manuvering wheelchair, cooking,
going to stores and so on). They can then list the goals they have for
the New Options program. Their performance in achieving these goals can
then be rated by the staff.
2. Participants may be asked to describe the sources of information they would
use in selecting equipment, or learning about community resources. They
should be able to list the steps to use in visiting new settings or using
different forms of transportation such as planes or buses.
3. The field trips will provide many opportunities for behavioral ratings of
the participants' performance. This assessment should be utilized to decide
if the module is working (and thus helping the person). It will be necessary
to avoid having the participant feel anxious about having his or her per-
formance rated. This can be handled through appropriate feedback and by
minimizing the obtrusiveness of the rating procedure.
ATTENDANT MANAGEMENT, SOCIAL SKILLS, AND CONSUMER AFFAIRS
1. These modules all deal with social skills and are similar to these just
presented in that the purpose of the modules is to develop skills rather
than knowledge. Performance in these areas is best assessed by behavior
ratings on the field trips or by role playing. For instance, interviewing,
hiring and firing an aide can be role-played using staff or real aides.
Job interviews, social occasions, and so on can be effectively modeled and
ratings obtained. Here again, it will be important to minimize anxiety
about the rating process. It will probably be a good idea to explain to
all entering participants that evalution of the effectiveness of the modules
will be continuing throughout the program.
2. Questions on the legal rights and responsibilities of various disability
groups may be created by the module leader.
PROCEDURAL NOTES:
Many of the assessment techniques just outlined include staff ratings of parti-
cipant's behavior. Such ratings are notoriously subject to rater expectations,
biases and pre-judgments: These are best minimized by using standardized
check lists and using very simple criteria of success. The following system
might be used: (1) prepare a set of desired behaviors for each participant
based in his goals for the six week period. This might include such tasks as
getting in and out of a car, curb-jumping, buying something in a store, asking
a stranger for directions, using a pay phone and so on. Different lists might
be used for the different settings visited on the field trips. (2) The
simplest rating to use would be whether the person does or does not perform
the tasks. This simple pass/fail system should be used whenever possible.
If a more complex judgment is required to rate degree of success, or the ease
with which a person performs the task, the smallest number of choice points
possible should be used.
It should be kept in mind that the purpose of these assessment activities is
to gather information on the usefulness and effectiveness of various parts of
the program for use by the staff. This information can be used in future
planning and as a tool for assessing the progress of the participants. It
is of only secondary importance in convincing some outside party of the effec-
tiveness of the program since this will be done primarily by the overall pre
and post measures of the graduate's community performance. Nevertheless,
it is important to document what the program actually does, i.e., what the
participants actually experience, if the nature of the program is to be made
clear to outsiders. This documentation has the added benefit of clarifying
how the system functions for the staff, so that they may more readily determine
if it is functioning as they would wish it to. Some such assessment effort
should be an ongoing part of the project.
OTHER MEASURES
The following paper-and-pencil tests may be useful in assessing attitude changes.
They are more likely to be useful in measuring the overall impact of the program
than the effects of individual modules.
1. Rotter's Internal-external locus of control scale:
Rotter, J.B. Generalized expectancies for internal versus external
control of reinforcement. Psychological Monographs, 1966, 80 (1Whole
No. 609).
29 two-choice items
2. Cattel's 16PF
187 three-choice items, takes about 30 minutes. Easy to score with
independent factors. Gets at personal orientations and attitudes
towards the world and other people.
3. Shostrum's Personal Orientation Inventory
Shostrum, E. EITS Manual for the Personal Orientation Inventory.
San Diego, California (92107): Educational and Industrial Testing
Service, 1966, supplemented 1968.
150 two-choice items getting at self-acutalization, self acceptance
and other related concepts. 30-45 minutes
NEW OPTIONS RESEARCH DOCUMENT - 2/1/78
INDEPENDENT LIVING SKILLS EVALUATION
Item Pool
By
Lex Frieden
Texas Institute for Rehabilitation and Research
The following questions are designed to represent a variety oh specific, dis-
crete problems which are typical of those encountered by disabled persons who
are trying to be independent. Responses elicited by these questions individual-
ly or in select groups may indicate the relative degree of behavioral
independence which severely disabled individuals are likely to manifest.
Responses which seem to indicate the highest level of competence or ability
to function satis factorly in an independent, non-institutional living
arrangement are those which are :
1. solution oriented
2. express alternative approaches
3. clear and discrete steps
4. reflect pragmatic judgement
5. logically organized
6. introspective
7. explicitly stated
8. demonstrate relevant subject knowledge
9. behavioral or action oriented
10. imaginative
This research instrument was developed by the New Options Transitional Project
under grants from the Rehabilitation Services Administration, DHEW, and is
intended to be used exclusively for research purposes. Various methods of
scaling or scoring this instrument are presently being investigated. Reli-
ability and validity studies will be undertaken soon. Any judgements about
the validity of this instrument at the present time would be conjecture.
Cooperative use and future development of the items in this pool for research
purposes is invited. Correspondence should be addressed to the author at
New Options, 105 Drew, Houston, Texas, 77006.
LF/asm
NEW OPTIONS INDEPENDENT LIVING SKILLS EVALUATION
INSTRUCTIONS:
Answer the following questions as though you are a severely physically disabled
person who must depend upon a wheelchair for basic mobility, and as though you
require the assistance of an attendant in dressing, undressing, trans ferring,
and other personal care activities.
1. If you were going to hire an attendant how would you find one?
2. If someone applied to be your attendant, how would you describe his/her job
duties?
3. When interviewing a prospective attendant, what questions would you ask?
4. If your prospective attendant gave you the name of someone who would re-
commend him/her, what questions would you ask this reference person?
5. How much and how often would you pay your attendant?
6. what would you do if your attendant was always late for work?
7. would you expect your attendant to know how to assist you or would you prefer
to train him/her yourself? (explain why)
8. Do you have any legal responsibilities such as social security taxes or in-
surance to pay when hiring an attendant and what are they?
9. For what reasons would you fire your attendant?
10. How would you tell your attendant that he or she was being fired?
11. What would you do if your attendant had a car accident on his/her way to work
and was unable to get there?
-2-
12. What agencies or programs might help you pay for an attendant?
13. What are the advantages and disadvantages of sharing your attendant with
other disabled people?
14. If you needed to go to the grocery store which was two blocks away from your
home, how would you get there and back?
15. If you could afford to buy a van or a car, which would you get and why?
16. If you bought a van, what adaptations would you add?
17. If you needed to go to school which was ten miles away from your home, how
would you get there?
18. If you needed to go 2000 miles away from home on a business trip, how would
you get there?
19. What special arrangements would you need to make in order to travel by (a) bus,
(b) train, or (c) airplane?
20. If you were in another city 2000 miles away from home and your wheelchair got
a flat tire, what would you do?
21. If you went to an airline ticket counter to purchase a ticket and the agent
said it was against the rules for you to fly, what would you do?
22. What agencies or programs might help you find and pay for transportation to
get back and forth from your work or school to home?
23. What agencies and programs might help you find and pay for transportation to
get back and forth from your hospital or rehabilitation center to your home?
-3-
24. If you were stuck inside a van by yourself and the automatic lift would not
work, what would you do?
25. If someone invited you to a restaurant which you knew had steps, what would
you say or do?
26. If someone invited you to a movie and you did not know if it was accessible,
what would you do?
27. If you found it necessary to use the bathroom while dining at a friend's
house discovered the bathroom door was too narrow, what would you do?
28. What companies rent cars with hand controls, where are they available, and
how much do they cost?
29. How does a person who uses hand controls get a driver's license and what
special restrictions will they have?
30. How would you get from your wheelchair to your seat when boarding a train,
plane, or bus?
31. How do you check-the bearings on your wheelchair and how often should
you do it?
32. Are there reasons why you should or should not oil the wheels on your chair?
33. Where would you find information about various kinds of driving aids such as
hand controls, lifts, raised roofs, etc.?
34. What rules does the vocational rehabilitation agency go. by when deciding whether
or not to help you buy equipment?
-4-
35. What steps should you take when planning to visit a shopping center where
you have never been before?
36. What would you do if you went to a sporting event at a large arena and they
told you you would have to buy the most expensive seat in the house because
you were disabled?
37. If you were treating someone to dinner at a fine restaurant, and the waiter
brought the bill to your guest, what would you say or do?
38. If you needed a tape recorder to help you take notes in a class at school
and your instructor asked you not to record his lectures, what would you
say or do?
39. If your bowels began to move unexpectedly during the middle of a class period
at school, what would you do?
40. If you were trying to transfer from your car to your wheelchair by yourself
and your chair rolled back out of reach, what would you do?
41. What sporting activities do people in wheelchairs participate in?
42. What passive recreational (leisure) activities do people in wheelchair parti-
cipate in?
43. What special accommodations exist in some parks and recreational areas for
persons with disabilities?
44. By what methods might you. get from your wheelchair into a swimming pool and
back out?
45. What musical instruments do persons in wheelchairs play?
-5-
46. What great historical figures were handicapped?
47. What are the advantages and disadvantages of living with a group of persons
who are also disabled?
48. What questions would you ask when shopping for an apartment?
49. How many inches wide must a door be in order to accommodate your wheelchair?
50. What is the approximate turning radius of your wheelchair?
51. What agencies or programs might assist you in paying rent?
52. How does one apply for Section 8 Rent Subsidy Payments?
53. What program or programs pay more money for you to live in a nursing
home then they do for you to live by yourself?
54. What special accommodations would you like to have in your bathroom?
55. What special-accommodations would you like to have in your kitchen?
56. How many inches high must a table or cabinet be for your knees to fit under?
57. why or why not would you want your attendant to be your friend as well as
your helper?
58. How can you protect your lap from being burned when cooking?
-6-
59. What questions should you be prepared to answer on a job interview?
60. What questions should you ask your prospective employer?
61. What would you do if you discovered that you were being underpaid because
you were handicapped?
62. What agencies or programs are available to assist you in finding a job?
63. How much money can you earn without losing your social security benefits?
64. What is the maximum amount of SSI (supplemental security income) you can
receive?
65. What information would you put on emergency medical cards?
66. What plans would you make for receiving emergency medical care in your
community?
67. Suppose you notice that one of your ankles is extremely swollen, what
would you do?
68. What would you do if you discovered at 10:00 at night that your temperature
was 100 degrees?
69. What would you do if you saw blood in your urine?
70. How long does it take to get a bed sore?
-7-
71. What would you tell someone who you wanted to date about your disability?
72. How can you find out if you are sexually sterile?
73. Which birth control method helps protect against VD?
74. How is sex important to you?
75. How does your disability affect your ability to function sexually?
76. How much income per month do you need to have in order to live independently?
77. What major expenses do persons who live independently have?
78. What possible sources of income are available to you?
79. If you needed personal or psychological counseling, what places might you
go for help?
80. What would you do if your vocational rehabilitation counselor planned to
stop providing services to you?
81. What would you do if your social security check was two weeks past due and
you needed the money?
82. If your attendant stole some of your medication, what would you say or do?
lex:
some thoughts about the Indep Living shills Eval.
There are some really good questions
w here, and d can think if several
useful purposes this could fill.
l would give some thought to
I
the overall balance of subject
areas - -some seem over-replesented
based on my view of what's impor-
tant', and others seem under-
represented
2
how would this he scored 0)
evaluated? (d think different
methods would we acceptable
the material (or.)
depending on what we use
3
D think it would we useful to
go through and ash what
each question would tell us- -
ie what inferences would we
draw hom various responses?
This may lead us to levise
the valance of behavioral
UD. informational questions.
4
This istrivial leut I don't under-
stand the structure of the
I's and 212, then lettles, etc
d think this would we gredt to use as
a format to mompt open-ended,
anthopological-s style vitervious
I'll let it would he similar to
the critical vicidents thing ui this
respect.
she like to talk c you further
Allth
NEW OPTIONS RESEARCH DOCUMENT - 2/1/78
INDEPENDENT LIVING SKILLS EVALUATION
Item Pool
By
Lex Frieden
Texas Institute for Rehabilitation and Research
The following questions are designed to represent a variety oh specific, dis-
crete problems which are typical of those encountered by disabled persons who
are trying to be independent. Responses elicited by these questions individual-
ly or in select groups may indicate the relative degree of behavioral
independence which severely disabled individuals are likely to manifest.
Responses which seem to indicate the highest level of competence or ability
to function satis factorly in an independent, non-institutional living
arrangement are those which are :
1. solution oriented
2. express alternative approaches
3. clear and discrete steps
4. reflect pragmatic judgement
5. logically organized
6. introspective
7. explicitly stated
8. demonstrate relevant subject knowledge
9. behavioral or action oriented
10. imaginative
This research instrument was developed by the New Options Transitional Project
under grants from the Rehabilitation Services Administration, DHEW, and is
intended to be used exclusively for research purposes. Various methods of
scaling or scoring this instrument are presently being investigated. Reli-
ability and validity studies will be undertaken soon. Any judgements about
the validity of this instrument at the present time would be conjecture.
Cooperative use and future development of the items in this pool for research
purposes is invited. Correspondence should be addressed to the author at
New Options, 105 Drew, Houston, Texas, 77006.
LF/asm
NEW OPTIONS RESEARCH DOCUMENT - 2/1/78
INDEPENDENT LIVING SKILLS EVALUATION
Item Pool
By
Lex Frieden
Texas Institute for Rehabilitation and Research
The following questions are designed to represent a variety oh specific, dis-
crete problems which are typical of those encountered by disabled persons who
are trying to be independent. Responses elicited by these questions individual-
ly or in select groups may indicate the relative degree of behavioral
independence which severely disabled individuals are likely to manifest.
Responses which seem to indicate the highest level of competence or ability
to function satis factorly in an independent, non-institutional living
arrangement are those which are :
1. solution oriented
2. express alternative approaches
3. clear and discrete steps
4. reflect pragmatic judgement
5. logically organized
6. introspective
7. explicitly stated
8. demonstrate relevant subject knowledge
9. behavioral or action oriented
10. imaginative
This research instrument was developed by the New Options Transitional Project
under grants from the Rehabilitation Services Administration, DHEW, and is
intended to be used exclusively for research purposes. Various methods of
scaling or scoring this instrument are presently being investigated. Reli-
ability and validity studies will be undertaken soon. Any judgements about
the validity of this instrument at the present time would be conjecture.
Cooperative use and future development of the items in this pool for research
purposes is invited. Correspondence should be addressed to the author at
New Options, 105 Drew, Houston, Texas, 77006.
LF/asm
NEW OPTIONS INDEPENDENT LIVING SKILLS EVALUATION
1. Suppose you are a severely physically disabled person who required the
assistance of an attendant in dressing, undressing, and other personal care
activities.
a. If you were going to hire an attendant where would you look or
advertise for one?
b. If someone applied to be your attendant, how would you describe
his/her job duties?
C. When interviewing a prospective attendant, what questions would
you ask?
d. If your prospective attendant gave you the name of someone who would
recommend him/her, what questions would you ask this reference person?
e. How much and how often would you pay your attendant?
6. What would you do if your attendant was always late for work?
-2-
g. would you expect your attendant to know how to assist you or would
you prefer to train him/her yourself? (explain why)
h. Do you have any legal responsibilities such as social security taxes
or insurance to pay when hiring an attendant?
i. For what reasons would you fire your attendant?
j. How would you explain to your attendant that he or she was béing
fired?
k. What would you do if your attendant had a car accident on his/her way
to work and was unable to get there?
l. what agencies or programs might help you pay for an attendant?
m. What are the advantages and disadvantages of sharing your attendant
with other disabled people.
2. Suppose you are a severely physically disabled person to who must depend upon
a wheelchair for basic mobility and finds it difficult to trans fer without assistance.
a. If you needed to go to the grocery store which was two blocks
away from your home, how would you get there and back?
b. If you could afford to buy a van or a car, which would you get and why?
-4-
C. If you bought a van, how would you fix it up?
d. If you needed to go to school which was ten miles away from your
home, how would you get there?
e. If you needed to go 2000 miles away from home on a business trip,
how would you get there?
6. what special arrangements would you need to make in order to travel
by (a) bus, (b) train, or (c) airplane?
-5- -
g. If you were in another city 2000 miles away from your home and your
wheelchair got a flat tire, what would you do?
h. If you went to an airline ticket counter to purchase a ticket and
the agent said it was against the rules for you to fly, what would
you do?
i. What agencies or programs might help you find and pay for transportation
to get back and forth from your work or school to home?
j. what agencies and programs might help you find and pay for transportation
to get back and forth from your hospital or rehabilitation center to
your home?
-6-
k. What would you do if the welded joints on your wheelchair frame
broke?
l. If you were stuck inside a van by yourself and the automatic lift
would not work, what would you do?
m. If s omeone invited you to a restaurant which you knew had steps,
what would you say or do?
n. If someone invited you to a movie and you did not know if it was
accessible, what would you do?
-7-
0. If you found it necessary to use the bathroom while dining at
a friend's house and discovered the bathroom door was too narrow,
what would you do?
p. What companies rent cars with hand controls, where are they
available, and how much do they cost?
9. How does a person who uses hand controls get a driver's license and
what special restrictions will they have?
-8- - 8
r. How would you get from your wheelchair to your seat when boarding
a train, plain, or bus?
S., How often do you need to check the bearings on your wheelchair?
t. Are there reasons why you should or should not oil the wheels on
your chair?
u. Where all would you expect to find information about various kinds
of driving aids such as hand controls, lifts, raised roofs, etc.?
-9-
V. What rules does the vocational rehabilitation agency go by when
deciding whether or not to help you buy equipment?
w. What steps should you take when planning to visit a shopping center
where you have never been before?
X. what would you do if you went to a sporting event at a large arena
and they told you you would have to buy the most expensive seat in
the house because you were disabled?
y. If you were treating someone to dinner at a fine restaurant, and
the waiter brought the bill to your guest, what would you say or do?
z. If you needed a tape recorder to help you take notes in a class at
school and your instructor asked you not to record his lectures,
what would you say or do?
aa. If your bowels began to move unexpectedly during the middle of a class
period at school, what would you do?
-11-
bb. If you were trying to transfer from your car to your wheelchair
by yourself and your chair rolled back out of reach, what would
you do?
cc. What active sport like basketball do people in wheelchairs parti-
cipate in?
dd. What passive competitive activities like playing cards do people in
wheelchairs participate in?
ee. What special accommodations exist in some parks and recreational
areas for persons in wheelchairs?
-12-
66. By what methods might you get from your wheelchair into a swimming
pool and back out?
gg. what musical instruments do persons in wheelchairs play?
hh. What great historical figures were handicapped?
ii. what are the advantages and disadvantages of living with a
group of persons who are also disabled?
jj. What questions would you ask when shopping for an apartment?
kk. How many inches wide must a door be in order to accomodate your
wheelchair?
ll. What is the approximate turning radiús of your wheelchair?
mm. what agencies or programs might assist you in paying rent?
nn. How does one apply for Section 8 Grant Subsidy Payments?
-14-
00. What program or programs pay more money for you to live in a nursing
home then they do for you to live by yourself?
pp. what special accommodations would you like to have in your bathroom?
99. what special accommodations would you like to have in your kitchen?
rr. How many inches high must a table or cabinet be for your knees
to fit under?
-15-
ss. Why or why not would you want your attendant to be your friend
as well as your helper?
tt. How can you protect your lap from being burned when cooking?
ии. What questions should you be prepared to answer on a job interview?
VV. What questions should you ask your prospective employer?
-16-
ww. What would you do if you discovered that you were being underpayed
because you were handicapped?
XX. What agencies or programs are available to assist you in finding
a job?
yy. How much money can you earn without losing your social security
benefits?
zz. What is the maximum amount of SSI (supplemental security income)
you can receive?
-17-
aaa. What information would you put on emergency medical cards?
bbb. What plans would you make for receiving emergency medical care
in your community?
ccc. Suppose you notice that one of your ankles is extremely swollen,
what would you do?
ddd. What would you do if you discovered at 10:00 at night that your
temperature was 100 degrees?
-18-
eee. What would you do if you say blood in your urine?
666. How long does it take to get a bed sore?
ggg. what would you tell someone who you wanted to date about your
disability?
hhh. How can you find out if you are sexually sterile?
-19-
iii. which birth control method helps protect against VD?
jjj. How is sex important to you?
kkk. How does your disability effect your ability to function
sexually?
lll. How much income per month do you need to have in order to live
independently?
-20-
mmm. What major expenses do persons who live independently have?
nnn. what possible sources of income are available to you?
000. If you needed personal or psychological counseling, what places
might you go for help?
ppp. How can you find out what your social security benefits are?
-21-
999. What would you do if your vocational rehabilitation counselor
planned to stop providing services to you?
rrr. What would you do if your social security check was two weeks past
due and you needed the money?
sss. If your attendant stole some of your medication, what would you say
or do?
ttt. what can you do to help get laws passed to make life more normal
for handicapped individuals?
-22-
иии. What reasons might you have for living in a nursing home?
VVV. How can handicapped citizens assure that public facilities,
goods, and services are made accessible to them in the future?
www. Why are organizations or coalitions of handicapped people
important?
xxx. Why is location an important variable to consider when choosing
a living arrangement?
LF/asm
10/4/77
must Depend upon a
(mobility and that you
wheelchoir for basic
NEW OPTIONS INDEPENDENT LIVING SKILLS EVALUATION
dustructions HX : transferrings
as though S
Suppose you are a severely physically disabled person who required the
assistance of an attendant in dressing, undressing, and other personal care
activities.
a. If you were going to hire an attendant where how would would you look you find or one
advertise for one?
2 b. If s omeone applied to be your attendant, how would you describe
his/her job duties?
3 C. When interviewing a prospective attendant, what questions would
you ask?
the
d. If your prospective attendant gave you the name of someone who would
recommend him/her, what questions would you ask this reference person?
answer
e. How much and how often would you pay your attendant?
6. what would you do if your attendant was always late for work?
Expaned
(whei
g. would you expect your attendant to know how to assist you or would
you prefer to train him/her yourself? (explain why)
How would goutrain your attendant to
h. Do you have any legal responsibilities such as social security taxes
or insurance to pay when hiring an attendant?
(How) and what are they ?
Where would you fend out about these sibelated rasion-
i. For what reasons would you fire your attendant?
j. How would you explain tell to your attendant that he or she was being
fired?
k. what would you do if your attendant had a car accident on his/her way
to work and was unable to get there?
what would you do of your atterdant didn't come
orcall and you had all appt that morning
l. what agencies or programs might help you pay for an attendant?
m. what are the advantages and disadvantages of sharing your attendant
with other disabled people.
2.
Suppose you are a severely physically disabled person to who must depend upon
a wheelchair for basic mobility and finds it difficult to trans fer without assistance.
a. If you needed to go to the grocery store which was two blocks
away from your home, how would you get there and back?
8
b. If you could afford to buy a van or a car, which would you get and why?
-4-
C. If you bought a van, how would you fix it up? odd? where
what adaptations would you
would act them
Endalled
d. If you needed to go to school which was ten miles away from your
home, how would you get there?
e. If you needed to go 2000 miles away from home on a business trip,
how would you get there?
6. What special arrangements would you need to make in order to travel
by (a) bus, (b) train, or (c) airplane?
-5-
g. If you were in another city 2000 miles away from your home and your
wheelchair got a flat tire, what would you do?
h. If you went to an airline ticket counter to purchase a ticket and
the agent said it was against the rules for you to fly, what would
you do?
i. what agencies or programs might help you find and pay for transportation
to get back and forth from your work or school to home?
j. What agencies and programs might help you find and pay for transportation
to get back and forth from your hospital or rehabilitation center to
your home?
-6-
k. what would you do if the welded joints on your wheelchair frame
broke?
If you were stuck inside a van by yourself and the automatic lift
would not work, what would you do?
m.
If s omeone invited you to a restaurant which you knew had steps,
what would you say or do?
it.
If someone invited you to a movie and you did not know if it was
accessible, what would you do?
-7-
O.
Q
If you found it necessary to use the bathroom while dining at
a friend's house and discovered the bathroom door was too narrow,
what would you do?
8
p.
what companies rent cars with hand controls, where are they
available, and how much do they cost?
f5.
9.
How does a person who uses hand controls get a driver's license and
what special restrictions will they have?
-8-
Lr. How would you get from your wheelchair to your seat when boarding
of a train, plain, ne or bus?
Rs How or ften do you need to check the bearings on your wheelchairt
you
and how + often should
do HOW do you wheel bearnings ?
A
Are there reasons why you should or should not oil the wheels on
your chair?
a. where all would you expect to find information about various kinds
of driving aids such as hand controls, lifts, raised roofs, etc. ?
-9-
V.
What rules does the vocational rehabilitation agency go by when
deciding whether or not to help you buy equipment?
w. What steps should you take when planning to visit a shopping center
where you have never been before?
X.
What would you do if you went to a sporting event at a large arena
and they told you you would have to buy the most expensive seat in
the house because you were disabled?
y. If you were treating someone to dinner at a fine restaurant, and
the waiter brought the bill to your guest, what would you say. or do?
Z. If you needed a tape recorder to help you take notes in a class at
school and your instructor asked you not to record his lectures,
what would you say or do?
aa. If your bowels began to move unexpectedly during the middle of a class
period at school, what would you do?
-11-
bb. If you were trying to trans fer from your car to your wheelchair
by yourself and your chair rolled back out of reach, what would
you do?
CC. what active sport people in wheelchairs parti-
noting like basketball activities do
cipate in?
Insecrectional (bssure)
dd. What passive competitive activities like playing cards do people in
wheelchairs participate in?
ee. what special accommodations exist in some parks and recreational
areas for persons ons in whee c desibilities
-12-
66. By what methods might you get from your wheelchair into a swimming
pool and back out?
1 gg. What musical instruments do persons in wheelchairs play?
L
hh. what great historical figures were handicapped?
ii. what are the advantages and disadvantages of living with a
group of persons who are also disabled?
-13-
jj. What questions would you ask when shopping for an apartment?
kk. How many inches wide must a door be in order to accomodate your
wheelchair?
ll. What is the approximate (turning radius of your wheelchair?
mm. What agencies or programs might assist you in paying rent?
nn. How does one apply for Section 8 Grant Rout Subsidy Payments?
-14-
00. What program or programs pay more money for you to live in a nursing
home then they do for you to live by yourself?
pp. what special accommodations would you like to have in your bathroom?
99. what special accommodations would you like to have in your kitchen?
rr. How many inches high must a table or cabinet be for your knees
to fit under?
15-
ss. Why or why not would you want your attendant to be your friend
as well as your helper?
tt. How can you protect your lap from being burned when cooking?
uu. what questions should you be prepared to answer on a job interview?
VV. what questions should you ask your prospective employer?
-16-
ww. what would you do if you discovered that you were being underpayed
because you were handicapped?
xx. what agencies or programs are available to assist you in finding
a job?
yy. How much money can you earn without losing your social security
benefits?
zz. what is the maximum amount of SSI (supplemental security income)
you can receive?
aaa. What information would you put on emergency medical cards?
bbb. what plans would you make for receiving emergency medical care
in your community?
ccc. Suppose you notice that one of your ankles is extremely swollen,
what would you do?
ddd. what would you do if you. discovered at 10:00 at night that your
temperature was 100 degrees?
-18-
saw
eee. What would you do if you say blood in your urine?
666. How long does it take to get a bed sore?
999. What would you tell someone who you wanted to date about your
disability?
hhh. How can you find out if you are sexually sterile?
-19-
iii. which birth control method helps protect against VD?
?
jjj. How is sex important to you?
appect
kkk. How does your disability effect your ability to function
sexually?
lll. How much income per month do you need to have in order to live
independently?
mmm. What major expenses do persons who live independently have?
nnn. what possible sources of income are available to you?
000. If you needed personal or psychological counseling, what places
might you go for help?
ppp. How can you find out what your social security bene benefits are?
-21-
999. what would you do if your vocational rehabilitation counselor
planned to stop providing services to you?
rrr. what would you do if your social security check was two weeks past
due and you needed the money?
sss. If your attendant stole some of your medication, what would you say
or do?
ttt. what can you do to help get laws passed to make life more normal
for handicapped individuals?
-22-
иии. What reasons might you have for living in a nursing home?
VVV. How can handicapped citizens assure that public facilities,
goods, and services are made accessible to them in the future?
www. why are organizations or coalitions of handicapped people
important?
xxx. Why is location an important variable to consider when choosing
a living arrangement?
LF/asm
10/4/77
/ What would you do of you were at a
center and storted eeper
leacing symptoms of depreflexia
do of a surger unsested Da Relyeag
you to something you preferred to do
How would you choose
CA
LA.
fin
when would be a good place for you
asa person Cu a w/ to meet
f.
4.4
poneone of the offosite per?
leisure SP
a.m.
Deperating on the puporeq this of
would Insider some questions
med
a others, much higher priority than
self Mochty
NEW OPTIONS INDEPENDENT LIVING SKILLS EVALUATION
1. Suppose you are a severely physically disabled person who required the
assistance of an attendant in dressing, undressing, and other personal care
activities.
a. If you were going to hire an attendant where would you look or
advertise for one?
b. If someone applied to be your attendant, how would you describe
his/her job duties?
C. When interviewing a prospective attendant, what questions would
you ask?
d. If your prospective attendant gave you the name of someone who would
recommend him/her, what questions would you ask this reference person?
e. How much and how often would you pay your attendant?
6. What would you do if your attendant was always late for work?
-2-
g. would you expect your attendant to know how to assist you or would
you prefer to train him/her yourself? (explain why)
h. Do you have any legal responsibilities such as social security taxes
or insurance to pay when hiring an attendant?
i. For what reasons would you fire your attendant?
j. How would you explain to your attendant that he or she was being
fired?
k. What would you do if your attendant had a car accident on his/her way
to work and was unable to get there?
-3-
l. what agencies or programs might help you pay for an attendant?
m. What are the advantages and disadvantages of sharing your attendant
with other disabled people.
2. Suppose you are a severely physically disabled person to who must depend upon
a wheelchair for basic mobility and finds it difficult to transfer without assistance.
a. If you needed to go to the grocery store which was two blocks
away from your home, how would you get there and back?
b. If you could afford to buy a van or a car, which would you get and why?
-4-
C. If you bought a van, how would you fix it up?
d. If you needed to go to school which was ten miles away from your
home, how would you get there?
e. If you needed to go 2000 miles away from home on a business trip,
how would you get there?
6. What special arrangements would you need to make in order to travel
by (a) bus, (b) train, or (c) airplane?
-5-
g. If you were in another city 2000 miles away from your home and your
wheelchair got a flat tire, what would you do?
h. If you went to an airline ticket counter to purchase a ticket and
the agent said it was against the rules for you to fly, what would
you do?
i. What agencies or programs might help you find and pay for transportation
to get back and forth from your work or school to home?
j. What agencies and programs might help you find and pay for transportation
to get back and forth from your hospital or rehabilitation center to
your home?
-6-
k. What would you do if the welded joints on your wheelchair frame
broke?
l. If you were stuck inside a van by yourself and the automatic lift
would not work, what would you do?
m. If s omeone invited you to a restaurant which you knew had steps,
what would you say or do?
n. If s omeone invited you to a movie and you: did not know if it was
accessible, what would youndo?
-7-
0. If youufound it necessary to use the bathroom while dining at
a friend's house and discovered the bathroom door was too narrow,
what would you do?
p. What companies rent cars with hand controls, where are they
available, and how much do they cost?
q. How does a person who uses hand controls get a driver's license and
what special restrictions will they have?
-8-
r. How would younget from your wheelchair to your seat when boarding
a train, plain, or bus?
So. How often do you need to check the bearings on your wheelchair?
t. Are there reasons why you should or should not oil the wheels on
your chair?
u. Where all would you expect to find information about various kinds
of drivingeaids such as hand controls, lifts, raised roofs, etc.?
-9-
v. What rules does the vocational rehabilitation agency go by when
deciding whether or not to help you buy equipment?
W. What steps should you take when planning to visit a shopping center
where you have never been before?
X. What would you do if you went to a sporting event at a large arena
and they told you you would have to buy the most expensive seat in
the house because you were disabled?
-10-
y. If you were treating someone to dinner at a fine restaurant, and
the waiter brought the bill to your guest, what would you say or do?
z. If you needed a tape recorder to help you takeenotes in a class at
school and your instructor asked you not to record his lectures,
what would you say or do?
aa. If your bowels began to move unexpectedly. during the middle of a class
e period at school, what would you do?
-11-
bb. If you were trying to transfer from your car to your wheelchair
by yourself and your chair rolled back out of reach, what would
you do?
cc. What active sport like basketball do people in wheelchairs parti-
cipate in?
dd. What passive competitive activities like playing cards do people in
wheelchairs participate in?
ee. What special accommodations exist in some parks and recreational
areas for persons in wheelchairs?
-12-
66. By what methods might younget from your wheelchair into a swimming
pool and back out?
gg. What musical instruments do persons in wheelchairs play?
hh. What great historical figures were handicapped?
ii! What are the advantages and disadvantages of living with a
group of persons who are also disabled?
-13-
jj. What questions would you ask when shopping for an apartment?
kk. How many inches wide must a door be in order to accomodate your
wheelchair?
ll. What is the approximate turning radiússof your wheelchair?
mm. What agencies or programs might assist you in paying rent?
nn. How does one apply for Section 8 Grant Subsidy Payments?
-14-
00. What program or programs pay more money for you to live in a nursing
home then they do for you to live by yourself?
pp. What special accommodations would you like to have in your bathroom?
99. What special accommodations would you like to have in your kitchen?
rr. How many inches high must a table or cabinet be for your knees
to fit under?
-15-
ss. Why or why not would you want your attendant to be your friend
as well as your helper?
tt. How can you protect your lap from being burned when cooking?
ши. What questions should you be prepared to answer on a job interview?
VV. What questions should you ask your prospective employer?
-16-
ww. What would you do if you discovered that you were being underpayed
because you were handicapped?
xx. What agencies or programs are available to assist you in finding
a job?
yy. How much money can you earn without losing your social security
benefits?
zz. What is the maximum amount of SSI (supplemental security income)
you can receive?
-17-
aaa. What information would you put on emergency medical cards?
bbb. What plans would you make for receiving emergency medical care
in your community?
CCC. Suppose you notice that one of your ankles is extremely swollen,
what would you do?
ddd. What would you do if you discovered at 10:00 at night that your
temperature was 100 degrees?
-18-
eee. What would you do if you say blood in your urine?
666. How long does it take to get a bed sore?
ggg. What would you tell someone who you wanted to date about your
disability?
hhh. How can you find out if you are sexually sterile?
-19-
iii. Which birth control method helps protect against VD?
jjj. How is sex important to you?
kkk. How does your disability effect your ability to function
sexually?
lll. How much income per month do you need to have in order to live
independently?
-20-
mmm. What major expenses do persons who live independently have?
nnn. What possible sources of income are available to you?
000. If you needed personal or psychological counseling, what places
might you go for help?
ppp. How can you find out what your social security benefits are?
-21-
999. What would you do if your vocational rehabilitation counselor
planned to stop providing services to you?
rrr. What would you do if your social security check was two weeks past
due and you needed the money?
sss. If your attendant stole some of your medication, what would you say
or do?
ttt. What can you do to help get laws passed to make life more normal
for handicapped individuals?
-22-
иии. What reasons might you have for living in a nursing home?
VVV. How can handicapped citizens assure that public facilities,
goods, and services are made accessible to them in the future?
www. Why are organizations or coalitions of handicapped people
important?
xxx. Why is location an important variable to consider when choosing
a living arrangement?
LF/asm
10/4/77
PROPOSAL FOR DEVELOPMENT OF
MODULE ASSESSMENT PACKAGE
New Options Program
D.G. Stuart, Ph.D.
8/4/77
BACKGROUND AND PROBLEM
The New Options Transitional Project provides participants
with a variety of learning experiences directed towards
increased independence in living. Information and skills
are transmitted through a series of modules which use lectures,
group discussions, field trips, guided exploration and
modelling by staff and members of the community. It is
necessary to begin some detailed assessment of the module
experiences for the following reasons: (a) First, it is neses-
sary to find out what the participants are retaining as well
as what they are being taught - this is a basic tenet of
education; (b) the module leaders need feedback on the ef-
fectiveness of their procedures; (c) program planners need
information on the usfulness of the modules and on the degree
of overlapor gaps between them. Each module leader may be
making their own judgments about the performance of the
participants, but a standardized assessment is needed which
can be carried across modules, leaders and participants.
OBJECTIVES
This evaluation project will develop a series of methods and
tools for use in the teaching modules. The techniques will
vary with the goals and procedures of the various modules but
will have in common the goal of integrating the assessment
procedures with the teaching process so that the testing is
not deen as disruptive or unnecessarily burdensome. Feedback
on performance is, in fact, one of the most important parts
of the educational process.
It will not be an objective of this study to evaluate teacher
effectiveness, but rather to develop ways for staff and module
leaders to assess the effectivness of the modules in meeting
program and module goals. Without such information the teachers
lack feedback about their efforts.
PROCEDURES
The development of the evaluation procedures and materials
will take place in close consultation with the module leaders
and the staff of the program. The form of the evaluation is
expected to vary considerably from module to module, but it
is hoped that some continuity across modules can be developed.
Performance Guidelines:
Three approaches to the establishment of performance guidelines
may be taken:
1. Criterion Achievement: This assumes that there is a basic
core of information or skolls that the person must master;
his performance is compared to these criteria, and if he
fails bo meet them he may either repeat the necessary
material or be judged unsuitable for that part of the
program. If many individuals fail to meet the criteria
then the instructional mathods or the criteria must be
changed.
2. Goal Achievement: This approach assumes that each person
will enter the module with a different set of goals.
The person's achievement - and module effectiveness -
will be assessed on the basis of how well the individuals
do in reaching their goals. This differs from the Criterion
Achievement model only in that the goals doffer for each
person.
3. Improvement Level: In this model, the evaluation focuses
on the improvement made from the entering level of skills
or knowledge rather than on the attainment of some
specified goal. This assumes that people differ in their
entry level skills and that only a certain amount of
improvement can be expected during a specified instructional
period.
Assessment Techniques:
The following assessment techniques may be used.
1. Information retention and recognition - These are the
familiar paper-and pencil tests using multiple choice,
true-false, or free response formats to assess what
information the person has acquired. They are useful in
those modules which supply new information to the
participants, such as medical or legal knowledge.
2. Work Samples (paper and pencil) - Work samples are simply
examples of how well the participant can perform a task
such as making out a budget, applying for a job and so
forth They apply to those modules where specific skills
such as these are being taught.
3. Work Samples (behavior) - Work samples may include acti-
ties such as going for a job interview, shopping for clothes
and so forth. Actual performance is the criteria.
4. Role Playing - This is similar to work samples except that
the situation is an artificial one asing project staff
or peers to simulate the desired sonditions. Both staff
and peers may then provide ratings of the person's per-
formance. Ratings of performance in group process terms,
i.e., how well the person interacts with others while in
the module may also fall under this heading.
A series of instruments, procedures or tasks will be developed
through consultation with staff and associates and through
a search of the literature. Module leaders will be asked to
try out these techniques and report or their usefulness and
efficiency. Reccommandations for a "final" form of the package
can then be made. It is expected that the assessment package
will continue to evolve with the program, but hopefully
a useful core of techniques can be developed that will change
slowly, or not at all. It is also possible that the availability
of a standard set of assessment items will help stabilize
hhe pøogram by providing some continuity across changes of
module leaders, participants and staff.
MEMO
9/15/77
TO:
New Options Program Staff
FROM:
Jean Cole
SUBJECT: Module Assessment Plans
Jane, Mary Ann, and Jean met on 9/15 to clarify our efforts at module
assessment and specifically to consider the usefulness of an associates'
retreat on 9/24 to address this issue. We agreed on several points.
(1) Instead of seeking to develop a set of 'tests' geared to the content
and structure of program modules, we might better seek to develop a compe-
tancy-based individual assessment tool. Presumably this would address broad
areas of competance important in independent living and community partici-
pation. Materials from the Sioux Vocational School and other programs
might be useful models. Our thinking about this assessment of individual
competance should not be bound by the currently-existing module system.'
(2) We perhaps need to rethink our documentation of the content of each
module. In the past we have tried to formulate an outline of six sessions
for each module and have been frustrated by the fact that our outlines are
continually changing. It might be preferable to develop a whole repertoire
for each module of 10, 12, or whatever number of sessions, any 6 of which
may be used in a given cycle. (We actually have done this in practice I
think, but have not recorded the module content in this fashion.)
(3) We need to schedule a staff retreat during the week of 9/26 to hammer
out these concepts and develop a coordinated 'plan of attack'. Any retreat
with Dennis Stuart or the associates should be scheduled after this meeting
of the staff to clarify what we are trying to accomplish. A date and time
for this retreat will be set on 9/19.
*This individual assessment tool would presumably help us plan module content
for each cycle as well as document what each individual learns in the program.
JC
9/15/77
STUDY OF CRITICAL INCIDENTS
Background information
research number
disability
age
sex
marital status
living arrangement
activities
level of education
sources of financial support
Status at onset of disability
age
marital status
living arrangement
activities
level of education
employment experience
financial status (independent, dependent on
parents, etc.)
ACTIVITY
TIME ELAPSED
IMPORTANCE
SINCE ONSET
OF ACTIVITY
OF DISABILITY
1. admission to rehabilitation hospital
2. first awareness of others whose injuries
are long-term or permanent .and their
reactions
3. first discussion acknowledging
possibility of less-than-complete
return of function
4. prognosis conference
5. acceptance of prognosis
6. first attempt to communicate
emotional reaction to injury
7. first time to sit up in wheelchair
8. first attempts at ADL activities
9. first assessment of appropriateness
of old goals and establishment of
first new goal
10. first pass to go into the community
with friends or family
11. first time to feed self
12. first time got dressed up
ACTIVITY
TIME ELAPSED
IMPORTANCE
SINCE ONSET
OF ACTIVITY
OF DISABILITY
13. first return home after discharge
14. first social acknowledgment of per-
manent handicap
15. first meal in public
16. first encounter with old friends and
associates
17. first rejection by an old friend or
significant other person
18. first rejection by peer group
19. first withdrawal from close relation-
ship (breaking engagement, decision to
divorce, etc.)
20. first new social relationship after
discharge
21. first time family has responsibility
for personal care (catheter and bowel
program)
22. rearranging room to accomodate new
equipment (hospital bed, wheelchair,
etc.)
23. ramping own home or making other modifications
24. first clinic appointment after discharge
25. first architectural barrier
ACTIVITY
TIME ELAPSED
IMPORTANCE
SINCE ONSET
OF ACTIVITY
OF DISABILITY
26. first ballgame
27. first dance
28. first time to attend church
29. first shopping trip
30. first movie
31. first visit to club
32. first party
33. first physical participation in
sports activity (swimming, fishing,
etc.)
34. first card game or other activity
involving fine finger activity
35. first trip
36. first use of public restroom
37. first return to school or job
38. first job interview or first application
to attend school
39. first accident (bowel, urinary) outside
of living situation
40. educating old and new acquaintances about
bladder and bowel incontinence
ACTIVITY
TIME ELAPSED
IMPORTANCE
SINCE ONSET
OF ACTIVITY
OF DISABILITY
41. first response to child's question
regarding disability or wheelchair
42. first explanation of needs, either to
ask for help or to keep from receiving
unneeded help
43. first time asked stranger for help
push
up curb
door
pick up something
emptying leg bag
up steps
eating
44. first time asked friend for help
male
female
45. first discussion of sexuality
46. first flirtations outside of hospital
47. first date
48. first sexual experience
ACTIVITY
TIME ELAPSED
IMPORTANCE
SINCE ONSET
OF ACTIVITY
OF DISABILITY
49. first planning to move out of parents'
home
50. first independent living situation
51. hiring first attendant
52. losing first attendant
53. first admission to nursing home
54. first time to stay alone
55. first time to stay with attendant
56. first time out overnight with friends
57. first time drove car
58. first "set back"
59. first pressure sore
60. first infection
61. first episode of dysreflexia
62. first emergency
63. first time upset chair
ACTIVITY
TIME ELAPSED
IMPORTANCE
SINCE ONSET
OF ACTIVITY
OF DISABILITY
64. first mechanical problem with wheelchair
65. first time to get dirty hands from
wheelchair
66. first difficulty with personal grooming
67. first handshake
68. first attembts to maneuver on carpet
or other new surfaces (grass, etc.)
69. 'first attempt to switch on TV, radio, any
appliance
70. first use of telephone
71. first attempt to prepare food
72. first look into full length mirror
73. first photograph
74. first time associated socially with
other disabled persons
75. first joking about disability-related
situations (wheelchair out of control,
"crip jokes", etc.)
76. first realization that shoes do not wear
out; first purchase of new shoes
ACTIVITY
TIME ELAPSED
IMPORTANCE
SINCE ONSET
OF ACTIVITY
OF DISABILITY
77. first responsibility for personal
finances
78. first negotiations with agency for
financial support (TRC, DPW, etc.)
79. first paycheck
30. first attempt at new activity not learned
at hospital (transferring
into bed,
etc.)
81. first time skipped suppository
82. first time skipped corset
83. first time skipped medications
84. first time requested a different
orthotic device or piece of new
equipment
85. first time excluded from activity by
family or friends because of physical
limitations
86. first decision to marry
87. first decision to have a child