We had the framework but needed the details. Here are the first things we learned:
1. IF YOU BUILD IT, THEY WILL COME … SO DON’T BUILD IT. Day programs without walls can only be truly accomplished if there are no walls. Small meeting hubs with limited space and little to no entertainment are necessary for grouping and staffing changes. However, larger spaces with entertainment options (TV, arts and crafts, work out equipment etc.) will become the path of least resistance and humans gravitates to the path of least resistance. We rent a corporate apartment in a few complexes that are friendly to individuals with disabilities. This allows for a small hub space, in addition to allowing all the individuals we serve access to the amenities when they are with a staff person. Instead of the path of least resistance being a warehouse with a movie room, arts and crafts, segregated work out equipment, etc.; our path of least resistance is an apartment complex where all of the tenants (the vast majority of whom do not have disabilities) share an indoor pool, outdoor pool, tennis courts, dog park, work out facility, etc. We also use our main office as a hub. No one is tempted to stay in a location where their CEO, billers, HR and compliance officers work all day. This also gives the office workers, who spend more time dealing with bureaucracy than changing lives, a chance to see the individuals we serve and remember why they are dedicated to doing what is often a thankless job.
2. DON’T BUY A VAN. If you see a non-professional sports team of a dozen or so people walk into a fast-food restaurant, what are the chances you will talk to them? If you see a couple people walk into a fast food restaurant, what are your chances of talking to them? Research shows that you are much more likely to talk to a small group than approach a large group in a community setting. The goal is not to be isolated in a group, but to be an active part of your community. This cannot happen in big groups that travel in a van with a label on it.
3. STAFF IT. Traveling in cars, not vans, also ensures that your ratios will not exceed 1 staff to 4 individuals. Even with our least involved individuals on the autism spectrum, we find it impossible to maintain safety and integration in the community at a ratio higher than 1:4. While you may all be going to the same place, the smaller ratio is a key to success. For example, we have a waterpark connected to the zoo in Columbus. We have a designated day for this activity when it is in season and many of the individuals we serve may be there at the same time. However, they are in small groups throughout the water park just like all of the other families and groups of friends who are at the waterpark. Because of our low staff to individuals served ratio they do not need to stay together, all arrive or leave at the same time, all choose the same activity at the same time, etc. This increases social interaction opportunities with typically developing peers and decreases behavior because choice and control over one’s life decrease behavior for everyone. When I have had to wait in a line at the Bureau of Motor Vehicles for two hours to renew my driver’s license, I am not in a very good mood and may have more behavior (snapping at someone, honking while driving, etc.) than I would if I had not spent so much of my time waiting around for others and had more control over the time it took for that particular activity. Choice will not eliminate all behavior, but it will eliminate some – this is true for everyone.