Article One:
The changing mission of adult day programs.

Programs attended by adults with developmental disabilities are changing. Now more adults who have disabilities and are in good health have options that extend beyond staying home or attending custodial day programs. No longer must people spend day after day doing nothing of any significance to anyone. Cottage industries are springing up; adults with disabilities are living, working and participating in their communities. These adults expect to be paid for what they do and appreciated for who they are– just like you and me.

The philosophy and quality of these programs are profoundly affecting the lives of people who attend them. Being "a member of" and having a sense of "belonging to" are important human needs. While some adults may have little desire to move beyond a familiar safe-haven, others feel an intense need to be more independent. Thus, an adult day program can be both a means to an end and an end in itself. Either way, programs should provide individuals with emotional support and opportunities to grow and learn.

Money management, conflict resolution and communication groups often practice components of skills rather than engaging in real life. Unfortunately, some adults have been asked to show me/point to pictures since they were children and still don't seem to "get it." Actually, they do "get it." The point is . . . there isn't one!

Life is not a dress rehearsal.

When the focus of a program shifts from, "We are here to take care of you, instruct you and make sure you do what we think is best for you . . ." to "We are here to support you so you can take care of yourself or direct your own care, learn more about what you are interested in and take control of your life," a very important transition occurs. And so, this story begins.

One year ago, the Skills Center, Inc., an agency with several adult day programs located in the Monterey Bay Area changed its Mission Statement to read: "The vision of the Skills Center is to become a leader by following the ambitions and aspirations of the people it serves."

Andy Pereira,¹ the program director, wondered aloud to me, "Does AAC have something to offer us?" He said, "Given our mission statement–to which the Board of Directors and administration are committed–we face a major problem. Many people who attend our programs have never been asked what they want to do–not in school, not by their families and not by us. Few of our clients understand what a personal goal is, and those who do may not be able to tell us because of their communication problems." They have articulation and language problems, limited knowledge of English and social interaction styles others find very difficult.

What does AAC have to offer? I observed each of the programs and then met with Andy and other top administrators. I said, "In my opinion, no AAC in-service training, device, communication technique, individual client assessment or treatment plan would begin to address your mission. It is our AAC philosophy that can help you the most." I explained that inherent to the field of AAC is a belief and a knowledge that everyone communicates somehow, everyone can participate somehow and that special communication techniques and strategies can help. "To achieve the outcomes you want," I said, "You must change what you do in your programs."

They didn't kick me out. Instead we really began to talk. What if clients became more responsible for what happened to them each day? What if they designed projects, assigned roles, found materials? What if they were treated like adults and sometimes allowed to fail and learn from their mistakes? What if the role of staff changed? What if staff became coaches and supporters, rather than trainers, instructors or bosses? What if communication opportunities happened all day long?

The rest of the story flows from a shared vision that all individuals at the programs would: