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March 2017

“There is no need for temples, no need for complicated philosophies. My brain and my heart are my temples; my philosophy is my kindness.” - Dalai Lama

 
On a regular basis, someone will turn to me and proudly say, “I haven’t used Ukeru in months!” What they mean by this is: they haven’t had to use our blocking techniques and materials to de-escalate behaviors with clients. What they don’t realize is: they haven’t had to rely on these approaches because they are using Ukeru all the time.

In This Issue


Recent Highlights

Upcoming Events

Shining a Spotlight

Certainly, the physical techniques that minimize the need for restraints and seclusion — and, in particular, the use of protective equipment and soft blocking materials to keep both the caregiver and client safe — are an important part of Ukeru. But they are only a component of the system.
 
There is a far easier way to define what using Ukeru really means: adhering to the golden rule. At its heart, Ukeru is treating those depending on you in a way that you would want to be treated. It is shifting from a paradigm of placing demands, saying “no,” and exerting physical control to providing limits and structure in a safe, comforting, and secure environment.
 
While it might seem obvious, those of us who work in behavioral healthcare know that this philosophy can easily get distorted. No doubt we all have some familiarity with the following cycle:
 

 
The cycle is likely to be repeated because this approach can cause, reinforce or maintain aggression. In addition, it establishes a negative relationship with those providing care.
 
Creating a culture of comfort versus control — or “using Ukeru”— requires us, as professionals, to put ourselves in the position of someone experiencing distress; to let go of any perceived “upper hand;” and, most importantly, to be at our best when those we support are at their worst. Ultimately, it requires professionals to ensure that the individual entrusted to their care is safe, valued, and respected.
 
Defined in this way, who wouldn’t want to “use Ukeru”? If you want to imagine what it might that look like in your organization, the next time a client is experiencing behavioral difficulties, ask yourself:

  • If I was the one experiencing this distress, how would I want someone to respond?
  • What choices and alternatives can I offer to this client?
  • Is there another employee who has a special connection with this client who can help alleviate the crisis?
  • Have I asked the client what he/she needs right now? 

By simply asking yourself these questions, you will be “using Ukeru.” And you will be surprised at how the paradigm begins to shift.
 
Traditionally, the mechanisms professionals in our industry have been taught to make us feel less vulnerable have been coercive interventions. But, we can be comforting, increase the functional autonomy of those we serve, and maintain safety for all involved. We can create a sustainable treatment model focused on giving those we serve choices about their own lives and the control they want and deserve. It can be done. We can all “use Ukeru” all the time.

 

To stay informed in between issues of this newsletter, please be sure to follow us on Twitter @UkeruSystems or on Facebook. Current information is also available on our our website

Sincerely,

Kim Sanders, President, Ukeru Systems

RECENT HIGHLIGHTS



The recent Endrew vs. Jefferson County Supreme Court case represents a win for students with developmental disabilities. Prior to the Court’s favorable decision, which came out just last week, Ukeru President, Kim Sanders spoke to The Hill about the case, regarding a child with autism whose parents sued the school district, believing his right to a meaningful public education was denied. Kim explained to the publication that, even before we ensure we are educating children, we must first stop hurting them. Read more here.
With 277,000 children estimated to be secluded or restrained in classrooms each year, Ukeru wanted to visualize that data over one, five-month period of time. The following infographic clearly illustrates just how often these and other high risk techniques are inflicted on students.

On March 22, Ukeru hosted a panel discussion on the idea of “Comfort Vs. Control” and what that means in practice.



This discussion, moderated by Ukeru President, Kim Sanders, featured two expert panelists:
  • Jennifer Burns, LeMoyne School Day Coordinator at Altapointe Health Systems
  • Veronica Federiconi, Chief Executive Officer, Autism Services
Panelists shared details on their organizations’ journey to reduce restraint and seclusion.
 
A recording of the conversation can be found here.
 

UPCOMING EVENTS

Ukeru will be presenting at the following conferences: In addition, we will be exhibiting at The Council for Exceptional Children Special Education Convention and Expo on April 19-22 in Boston.

 We hope to see you in person soon!
 

Throughout 2017, Ukeru will be hosting a series of training events  including one day User Certifications and a two day Train-the-Trainer certification courses  at its Winchester, VA campus. Upcoming dates include:

  • April 4-5, 2017
  • May 9-10, 2017
  • June 6-7, 2017
During the sessions:
  • Conceptual training will be provided on:
    • Verbal and nonverbal communication;
    • Managing and de-escalating conflict by converting/diverting aggressive behavior;
    • Building an environment focused on comfort rather than on control;
    • Taking into account the high prevalence of traumatic experiences in individuals who receive services for developmental, behavioral and mental health needs.
  • Physical techniques will also be taught by including the effective use of protective equipment to keep both the caregiver and client safe.
For more information or to register, please contact info@ukerusystems.com.

SHINING A SPOTLIGHT


Autism Services CEO, Veronica Federiconi spending time with one of the many students her organization serves.
 
SHINING A SPOTLIGHT
 
Interview with Veronica Federiconi
 
As part of our efforts to share information and help support the elimination of restraints and seclusions, we want to shine a spotlight on individuals and organizations driving change. In this issue, we are speaking with Veronica Federiconi, CEO of Autism Services, the only agency in Western New York that solely serves people with Autism. Veronica was also a featured speaker on our recent webinar, “On the Front Lines: How Comfort vs. Control Works in Practice.”
 
When did you start working in the Autism field?
I have always been interested in analyzing the underlying causes of behavior in children and adults with autism. I began working with children and adults with all abilities in the 1970s. I first encountered autism in children affected by the rubella epidemic, who also faced other challenges, in an institutional setting. They were non-sighted, non-hearing, were diagnosed at the severe end of the spectrum and exhibited extreme self-injurious behaviors and aggression. That was the start of my career in Autism and I have never left.
 
How has training changed over the years?
In my early years working in institutions, because it was run by psychiatrists and with a medical model, I received training in the administration of medication and use of camisoles. As time went on, the state required us to learn other, less restrictive approaches, and we were introduced to crisis management curriculums.
 
In addition to the proactive part of the curriculum, which helped us to identify the early signs of extreme behaviors, there was also a physical part of intervention. That was extremely difficult for me. It never felt right to put my hands on anyone. But, at the time, that was all that we were taught and certified to use.
 
Can you describe your personal experience, as a caregiver, in using restraint and seclusion?
The first time I had to physically intervene with someone, it was a very emotional experience. Afterward, I contacted the instructor, explaining that I did not feel okay with it. He said, “That is exactly how you should feel. You should never want to put your hands on anyone. You should always try to recognize early signs and be proactive.”
 
Since that time, I have been working to understand the impact the environment has on the behavior, learning, and comfort of individuals with Autism. My focus for the last 26 years has been building an environment that is engaging, supportive and comfortable. My mission and vision is serving this population without having to physically intervene. 
 
What was your introduction to Ukeru?
I heard Kim Sanders speak at an Autism Society of America workshop several years ago. She was not speaking about Ukeru at that time, but rather how her organization was moving toward a culture of hands off, no restraints, no seclusion. My immediate reaction was: This is exactly what I want to happen. I want people to understand that it is never okay to put your hands on someone else. I want people with Autism to be more supported, comfortable and learn to be more in control of their own behavior.
 
I immediately talked with my team about what I had heard. We consulted with Kim and developed our own blocking curriculum called API, Alternatives to Personal Interventions, a term used for holds and restraints in managing behaviors.
 
Over time, I saw staff injuries, turnover and workers compensation steadily increasing. I decided to reach out once again to Kim and Grafton to see if she was experiencing the same challenges. She confirmed that they were and the result was the development of Ukeru.
 
How did you implement this program?
In July 2016, we invited Ukeru to present its “Train-the-Trainer” program in so that our staff could become certified. We then embarked on a complete Ukeru training program for every person and program in the agency. When we informed the state that we were embarking on this effort, they were very supportive. Now, everybody has been trained on and is using Ukeru.
 
Can you share an example of success?
We started the program with one of our most challenging adult gentleman; someone who was in a four person, supine hold for four out of a six hour day. We knew that if Ukeru could work for this person, we would be able to make it work for anyone.
 
We began by determining the environments and activities that were of most interest to him and the staff whom he preferred. We had to be very patient and very consistent. There were intermittent bursts, but over time he realized that, not only could he get attention and physical sensory input in other ways, he could also have control over his life. Now, restraints are no longer necessary for him.
 
How has the staff responded to the implementation of Ukeru?
The feedback is very positive. At every training, we solicit feedback and, in response, hear how easy staff find the Ukeru blocking materials to use. Additionally, they appreciate that we are introducing the materials to our children and adults in a respectful, non-threatening manner.
 
How do you respond to those who say that eliminating restraints entirely puts caregivers and others at increased risk?
I would let the data speak for itself. Since we introduced this initiative, staff injuries are down considerably as are our workers compensation claims. We are using more Ukeru techniques and less physical restraints.
 
I would also point to the achievements of those served by our agency: People who, in the past, could not move from one room to the next without challenges are now out in the community, working and engaging in meaningful activities of interest. People who used to require several staff for assistance at all times are now walking around with little to no risk of harm to themselves or others, with minimal staff supports.
 
At Autism Services, we are so grateful for Ukeru’s trauma-informed care training. It fits perfectly with where we are progressing as an organization. We hope to someday create an environment where our children and adults move about freely.

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