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"His bad days now are what the good days used to be"

Donnie Fisher has a charming personality that rarely is matched. He quickly endears himself to others with his contagious smile, playful nature and sense of humor. Donnie is 28 years old, blind, nonverbal, and has autism. His enjoys interacting with people in a playful manner, eating, and lounging in the pool. During the past year Donnie has been attending the Hillsborough Association for Retarded Citizens, Riverview Campus (HARC) and receiving support services from CARD. During this time his quality of life has improved tremendously. This, however, did not occur without incredible efforts on the part of his support team.

CARD was asked to support Donnie when his day program closed and he transitioned to the HARC adult training program. Once Donnie began attending HARC his self-injurious behaviors increased dramatically. At one point he was not able to attend HARC due to the severity of the behavior and HARC's concern about their ability to support him. Mary Reed, of CARD, pulled together a support team to develop a plan for Donnie. The team included Suzanne Ather (a new CARD support specialist) who knew Donnie from his previous adult day training program; Donnie's parents Keith and Ilene Fisher; Barbara Lazarus (Donnie's support coordinator); HARC management Stephanie Heller, Robin Spencer, Bob Wold; and direct care staff that worked with Donnie.

The team developed a plan over time that addressed the many needs Donnie had due to his personal challenges. The plan included addressing health issues, social needs, needs for predictability, activity needs, communication, and the skills to be learned. Good communication between home and HARC was a critical factor in fitting the pieces together.

Health needs were largely handled by Donnie's psychiatrist Dr. Villalba. Donnie's parents are grateful to Dr. Villalba for the special effort he made to understand Donnie's health concerns. Dr. Villalba listened to the numerous concerns communicated by Donnie's parents and the team and identified numerous health issues. Once the health issues were identified, Dr. Villalba provided the medical input and necessary referrals to other specialists. Slowly, but surely, health issues were addressed or resolved.

Donnie's parents were anxious that he begin attending HARC again. It was clear to the team that Donnie's return to HARC needed to be set up for success. Barbara Lazarus was able to get assistance from Developmental Services to fund a one to one support provider and a consultant to develop a crisis management plan.

Donnie returned to HARC with the intensive support of Bob Wold. With Donnie's health stable and the support plan to guide him, Bob made the programmatic changes necessary to provide Donnie with the supports he needed to be successful and happy. These supports included a highly structured schedule with numerous social opportunities interspersed throughout his day within and between vocational, recreational, and daily living activities. Pamela Jenkins, a speech and language therapist experienced with augmentative communication systems, has started working with Donnie and training the HARC staff in use of the voice output device. Fading the one to one aide will be considered as Donnie learns how to use the communication device to express his wants and needs and staff are completely trained in responding to Donnie's communication.

Since Donnie's return to HARC nearly a year ago he has not engaged in the behaviors of concern. The team was happy that it was never necessary to use the crisis management plan. He spends most of his time very busy and very happy. Donnie's mom once expressed her feelings of relief and happiness by saying, "His bad days now are what the good days used to be."

The team brought together and facilitated by Mary Reed, of CARD, was instrumental in the positive changes in Donnie's life. It was not always easy, but these people committed to Donnie, worked hard as individuals and as a team to support Donnie. The reduction in challenging behavior and increased quality of life probably exceeded any team members' expectations. To see Donnie now, happy, reminds the team that the hard times were a means to an end. Team members have a true appreciation for one another, the individual efforts, and group effort it took to get Donnie to this place.

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