2. A BEGINNER’S PERSPECTIVE:
Mount Vernon Developmental Center Ohio Department of Developmental Disabilities
A BEGINNER’S PERSPECTIVE:
“FIRST STEPS”

3. Everyone walks around with trauma in their history. Every one of us
Everyone walks around with trauma in their history. Every one of us! Including the people you serve. They have things in their experience that you cannot even imagine or know about. Understanding this, and asking the right questions, can help us to transform the human services system – not just at DODD – but at whatever agency a person may go to for help and guidance.” Raul Almazar, NCTIC December 3, 2014

4. Individuals with a Developmental Disability are:
Mount Vernon Developmental Center Ohio Department of Developmental Disabilities
Individuals with a Developmental Disability are:
Are at a much higher risk of PHYSICAL ABUSE compared to the general population
Are 4 times more likely to be VICTIMS of CRIME
Are up to 10 times more likely to be SEXUALLY ABUSED than the general population
The CHALLENGE for us is to uncover these traumatic events and to move forward with this knowledge.
The challenge: ….in our individuals’ histories and learning how to address their current needs with this knowledge.

5. Self Injurious Behaviors
The impact of trauma in DD is “hidden in plain sight” and manifested through:
Behavior Disorders
Aggression
Manipulation
Self Injurious Behaviors
Criminal Behavior
At-Risk Behavior
With trauma, the behaviors that people display are coping mechanisms which can include:
Not communicating due to fear and
Acting out due to anticipating a specific bad experience
The NON-VERBAL way of speaking to us… ACTIONS, GESTURES, RISKY BEHAVIORS/ATTENTION GETTING

6. OMHAS trainings-Fall 2013-Select DC staff attended one session
At MVDC, our first step into TIC was EDUCATING “from the inside out” starting w/Management:
DODD/Director Martin made expectations clear on TIC trainings and strategic planning in DCs
OMHAS trainings-Fall 2013-Select DC staff attended one session
Participated in TIC Regional Collaboratives
By the end of 2014, all 10 DCs across the state were trained by Raul Almazar (SAMHSA/NCTIC)
At MVDC (86% of staff)-All Departments/No Exceptions completed the 2-day training

7. AFTER RAUL’S TRAINING:
Mount Vernon Developmental Center Ohio Department of Developmental Disabilities
AFTER RAUL’S TRAINING:
Feedback*-informal “Walk-Arounds” and discussions
Work Groups-for individuals and staff during moves and for any personal needs and/or acknowledgements
Resource materials- “Staff Room Reading” and Online access to MVDC Internal websites-(6 Principles, articles, PowerPoints, links to resources of interest)
Follow up-Sending staff to TIC seminars, training HRC on new DODD Behavior Strategy rule….
Updating Policies & Procedures referencing TIC
-FEEDBACK SENT TO RAUL- the feedback was extraordinary. Lots of personal input and appreciation
-Educating our Human Rights Committee members on the new Statewide DD Behavior Rule that specifically references Trauma is to be taken into consideration….. --First DODD rule that references “Trauma”

8. New DODD Rule 5123:2-2-06 Effective 1-1-2015
(D) Development of a behavioral support strategy that includes restrictive measures (7) A behavioral support strategy that includes restrictive measures shall: (a) Be designed in a manner that promotes healing, recovery, and emotional well-being based on understanding and consideration of the individual's history of traumatic experiences as a means to gain insight into origins and patterns of the individual's actions;

9. TIC is now a part of our new employee orientation
Mount Vernon Developmental Center Ohio Department of Developmental Disabilities
MVDC- IN PROCESS:
We are creating a “buy-in” from Management and staff at all levels- keeping interest in the subject of TIC active and part of our dialogue.
TIC is now a part of our new employee orientation
Our commitment to TIC is being embedded into MVDC’s on-going “Strategic Planning Process” and will become part of the DC’s culture

10. MVDC is currently reviewing:
Mount Vernon Developmental Center Ohio Department of Developmental Disabilities
MVDC is currently reviewing:
How to apply the 6 Principles of TIC into what we do for our individuals, staff and families
How to incorporate TIC into our policies and into our work within the community
How to use this information to effect organizational and cultural change

11. We are also acknowledging Champions in our Center
Mount Vernon Developmental Center Ohio Department of Developmental Disabilities
We are also acknowledging Champions in our Center
New TIC workgroups- activities, education and recommendations to management. *
We will be involving everyone since many of our individuals will transition out of the DCs and into the community-which affects both individuals and staff, coming and going.
NO MANAGEMENT ON WORKGROUPS UNLESS REQUESTED BY THE GROUP

12. Lesson Learned: Awareness
MVDC is at “Square One”, as are other Developmental Centers around the state:*
Lesson Learned: Awareness
Empowerment, Voice & Choice, Cultural, Historical & Gender
We need to start identifying trauma in histories, and apply in principles in our Care Planning & Crisis Management -Involve all- [Bio-timelines]
Lesson Learned: Staff Well-Being-our starting point
Collaboration, Peer support and Self-Help
Education of TIC, support for personal self-awareness, “transitioning emotions” and job insecurities
-Past methods have failed to recognize & address trauma in DD, but now……..
DODD is driving the process through the 6 Principles of TIC.
-Validating feelings- comforting & involving staff with moves – eliminating MOT-disruptive to families

13. Lesson Learned: Dependency on others
Trustworthiness-Collaboration & Mutuality
Severity and scope of disabilities many times limits our ability to “ask”*… 82% at MVDC are severe to profound-medically fragile and most are total care.
Multiple system involvement- throughout life
We are “listening” to those who are non-verbal
Some have difficulty in building trust and feeling safe with staff who must physically “handle” them on a day to day basis.
-So, we depend on others familiar with the person and with their histories
-“reading” the individuals well known to us
-DECADES IN THE SYSTEM- SINCE SMALL CHILDREN- NO ROOTS-
-MULTIPLE SYSTEMS – SPECIAL ED, FOSTER CARE, CHILDREN’S RESIDENTIAL -INSTITUTIONALIZED
-MULTIPLE PROVIDERS- COME AND GO/BACK AND FORTH- HISTORIES FOLLOW THEM
-HISTORIES GET CUT AND PASTED OVER AND OVER
-OLDER INDIVIDUALS-
FAMILIES DECEASED OR
SCATTERED OR
DON’T CARE

14. Lesson Learned: Individuality-in persons with DD
Safety-Empowerment, Voice & Choice, Histories
-DODD’s Positive Culture*
-Comforting-What best comforts or redirects?
-Staff learning triggers and how to manage
-Autism –Presents some specific challenges
-Crisis Admissions- “learning on the fly”
-Transition Protocols – Individuals & Staff
DISCUSS POSITIVE CULTURE INITIATIVE BY DODD-
-TRAINING ON RECOGNIZING PERSONAL NEEDS
-PERSONAL SPACE
-AUTISM TRAINING STATEWIDE
-CRISIS ADMISSIONS
-DISCHARGES – PLANNING FOR….

15. Our “first steps approach” offers new tools and techniques to help our staff and individuals feel more prepared and empowered for changes and transitions.
Understanding the impact of trauma and developing trauma-sensitive approaches within our DCs is critical as we search for ways to better support people with complex needs in DCs now and in the future.”

16. QUESTIONS? Dana.Mattison@dodd.ohio.gov (740) 393-6226
Ohio Department of Developmental Disabilities
Dana Mattison, Superintendent
Mount Vernon Developmental Center
1250 Vernonview Drive
Mt. Vernon, Ohio 43050