STEP Treatment Plan Client: Mr. C DOB: 8.23.

69 Dates of Service: Group Home: QLO Allergies: NKDA Diet: Low Fat, High protein, High calcium, Referral from: Program Manager IP Date: Tx Plan Created: 9/25/10 Relevant background r/t Leisure Functioning: Based on information from Mr. Cs referral form from 2006, his past leisure activities include eating out, movies, elevator rides, computers, going to the mall, and Elitches. According to Mr. Cs initial assessment, he currently enjoys Elitches, swimming, art projects, walking, elevator rides, bowling, super heroes, and skiing. Future leisure interests include roller skating and biking. A new assessment will be implemented shortly in order to get more accurate information. Mr. C is very creative and interested in the fantasy Referral from:_____________________ realm. He is I in toileting, eating, ambulation, and dressing. Mr. C relies on staff for transportation and receives limited income. He is frequently distracted and detached; and, needs support with decision making. At times, it is difficult to redirect Mr. C. A request has been made by Program Manager and Mr. Cs mother, that Mr. C needs to increase physical activity and one on one intervention. Program Manager: EK Admission: 7.1.06 Age: 44 Anticipated D/C: N/A

STEP TR Case Manager: Christine Devereaux, CTRS

Assessment findings: 1 Diagnoses consist of the following: Autism

Strengths: Good sense of humor, excellent memory, demonstrates care and concern for others, supportive and involved family, often spends weekends at home c parents, initiates interests I, great imagination, ed focus while working on the computer, ability to express wants and needs, and uses microwave and telephone I Motivations: motivated by paper for art projects, telephone use, snacks, eating out, and money.

Limitations: Needs prompts and limited assistance to complete household tasks/chores and daily hygiene tasks, limited safety skills, needs support and encouragement to complete tasks, needs assistance to identify and correct mistakes, needs to improve community safety skills; needs support to plan and access activities in the community

Needs assistance and support with attention to task, coping skills, physical activity, wt, to display appropriate social behavior at times, communicating when he becomes frustrated with something, self-advocacy, and decision making Needs support and encouragement to connect with social activities in the community in order to avoid boredom, isolation, and to increase social skills Triggers that increase stress and agitation include interrupted routine, in weather, overstimulating environments, high altitudes and other peoples behaviors Takes psychotropic medications as part of a management plan to assist with his interfering behaviors including fixation on objects, getting stuck, property destruction, and self-abuse (biting hand, banging head)

Cl Problem/Needs: 1. Cl needs to physical activity as a result of being overweight 2. Cl has limited access to social and community activities 3. Cl has poor concentration; needs support, encouragement, assistance, and prompts to complete tasks 4. Cl has poor community safety skills 5. Cl needs to coping and stress management skills Goals and Objectives: Goal 1.1 Cl will exercise Objective 1.1.1 When asked to participate in a physical activity by group home staff and/or STEP staff, Mr. C will agree to attend the activity. Objective 1.1.2 While attending physical activities, Mr. C will attempt to participate fully in the activities as judged by CTRS. Goal 2.1 Cl will social and community leisure involvement Client Problem/need(s): 1. Objective 2.1.1 When asked to participate in STEP program by group home staff and/or 2. STEP staff, Cl will agree to attend when he is interested 3. Goal 4. 3.1 Cl will participation in activities Objective 2.1.1 During community and social activities, Cl will attempt to engage in the purpose of the activities, as judged by CTRS. Goal 3.2 Cl will independence with completing tasks Objective 3.2.1 Prior to beginning a task, Cl will initiate effort to complete task s prompt from staff Objective 3.2.2 During participation in activities, Mr. C will attempt to complete tasks using five or less verbal prompts per task, from staff. Objective 3.2.3 During activities/tasks, Mr. C will attempt to complete the task I c minimal hand-over-hand assistance from staff as judged by CTRS.

Goal 4.1 Cl will community safety skills Objective 4.1.1 While walking in the community, Cl will look ahead to identify and verbally state at least two hazards to CTRS Objective 4.1.2 During group programs and/or while in the community, Cl will be cautious of others around him and not bump into anyone Objective 4.1.3 Before walking into the street, Cl will look both ways to identify approaching cars, then he will verbally and correctly state if it is safe to continue walking to CTRS, as judged by CTRS Goal 5.1 Cl will coping and stress management skills Objective 5.1.1 When feeling anxious, Mr. C will take three long, deep breaths as judged by CTRS Objective 5.1.2 When feeling anxious, stressed, and/or nervous, Mr. C will state all his emotions and the cause of them with minimal assistance and prompts to CTRS Objective 5.1.3 When Mr. Cs schedule changes or is interrupted, he will state at least one positive effect of the with minimal assistance and prompts as judged by CTRS

Implementation Plan Problem/Need 1: Cl needs to physical activity as a result of being overweight CTRS will meet with Cl on an average of once a month for at least 45 minutes. CTRS will also plan activities that apply to Cls need as a number one priority, and to his interest as a second pri ority. Finally, CTRS will incorporate some form of physical task during each activity. Problem/Need 2: Cl has limited access to social and community activities CTRS will meet with Cl on an average of once a month for at least 45 minutes. CTRS will plan activities that apply to Cls need as a number one priority, and to his interest as a second priority. Also, CTRS will provide transportation and the STEP program will take care of any financial necessities. Because the Cl has limited access to social and community activities, CTRS will balance opportunities for participation in both social and community activities with both 1:1 and small and large groups. While in small and large groups, CTRS will encourage the Cl to socialize with other participants. While in the community, CTRS will provide Cl with opportunities to engage in the community fully and focus on behaviors, autonomy, and choice. Problem/Need 3: Cl has poor concentration; needs support, encouragement, assistance, and prompts to complete tasks CTRS will meet with Cl on an average of once a month for at least 45 minutes. CTRS will plan activities that apply to Cls need as a number one priority, and to his interest as a second priority. CTRS will provide persistent encouragement throughout all sessions in order to keep Cl motivated and on task. PRN, CTRS will provide verbal cues, prompts, hand-over-hand assistance, and repetition. CTRS will intervene as less as possible, in order to provide more opportunities for achievement of autonomy.

Problem/Need 4: Cl has poor community safety skills CTRS will meet with Cl on an average of once a month for at least 45 minutes. CTRS will plan activities that apply to Cls need as a number one priority, and to his interest as a second priority. While in the community, CTRSs main focuses for Cl will be street crossing, looking ahead while walking, and awareness of others around him. Problem/Need 5: Cl has limited coping and stress management skills CTRS will meet with Cl on an average of once a month for at least 45 minutes. CTRS will plan activities that apply to Cls need as a number one priority, and to his interest as a second priority.

CTRS will implement stress management skills when Cl seems agitated and/or stressed. Stress management skills will consist of deep breathing exercises, recognizing emotions, verbalizing concerns, and, stating one positive comment, and creating possible solutions for the problems/stressors.

DDRC Recreation Services STEP Community Access Plan Overall Goals Consumer Name: Mr. C Date: Time: Activity: Group Home Name: Belmar

Goal 1.1 Cl will exercise Objective 1.1.1 When asked to participate in a physical activity by group home staff and/or STEP staff, Mark will agree to attend the activity.
Outcome:

Objective 1.1.2 While attending physical activities, Mark will attempt to participate fully in the activities as judged by CTRS.
Outcome: ------------------------------------------------------------------------------------------------------------------------------------------

Goal 2.1 Cl will social and community leisure involvement Objective 2.1.1 When asked to participate in STEP program by group home staff and/or STEP staff, Cl will agree to attend when he is interested
Outcome: ----------------------------------------------------------------------------------------------------------------------------------------

Goal 3.1 Cl will participation in activities Objective 2.1.1 During community and social activities, Cl will attempt to engage in the purpose of the activities, as judged by CTRS.
Outcome:

Goal 3.2 Cl will independence with completing tasks Objective 3.2.1 Prior to beginning a task, Cl will initiate effort to complete task s prompt from staff
Outcome:

Objective 3.2.2 During participation in activities, Mark will complete tasks using five or less verbal prompts per task, from staff.
Outcome:

Objective 3.2.3 During activities/tasks, Mark will attempt to complete the task I c minimal hand-over-hand assistance from staff as judged by CTRS.
Outcome:

------------------------------------------------------------------------------------------------------------------------------Goal 4.1 Cl will community safety skills Objective 4.1.1 While walking in the community, Cl will look ahead to identify and verbally state at least two hazards to CTRS
Outcome:

Objective 4.1.2 During group programs and/or while in the community, Cl will be cautious of others around him and not bump into anyone
Outcome:

Objective 4.1.3 Before walking into the street, Cl will look both ways to identify approaching cars, then he will verbally and correctly state if it is safe to continue walking to CTRS, as judged by CTRS
Outcome:

------------------------------------------------------------------------------------------------------------------------------Goal 5.1 Cl will coping and stress management skills

Objective 5.1.1 When feeling anxious, Mark will take three long, deep breaths as judged by CTRS
Outcome:

Objective 5.1.2 When feeling anxious, stressed, and/or nervous, Mark will state all his emotions and the cause of them with minimal assistance and prompts to CTRS
Outcome:

Objective 5.1.3 When Marks schedule changes or is interrupted, he will state at least one positive effect of the with minimal assistance and prompts as judged by CTRS
Outcome:

*The following goals and objectives were created on 1/14/11

Goal 6.1 Cl will listening skills Objective 6.1.1 During community and/or group programs, Mark will follow all instructions and rules given by CTRS with less than two reminders per instruction/rule Outcome: Goal 7.1 Cl will socially inappropriate behaviors Objective 7.1.1 During community and/or group programs, Mark will use his inside voice and will not make loud noises or yell c two or less verbal reminders from CTRS Outcome:

Progress Notes
Date: Activity: Details: S: O: A: P: