>> GOOD MORNING. I'M DEBRA CHEW FROM THE OFFICE OF DIVERSITY AND INCLUSION, WE'RE A NEW OFFICE FORMERLY OF THE OFFICE OF EMPLOYMENT AND DIVERSITY MANAGEMENT. I WANT TO WELCOME YOU TO THE FIRST DISAABILITY EMPLOYMENT AWARENESS SERIES. WE'RE DOING THINGS DIFFERENTLY, WE DO THIS 365 DAYS OUT OF THE YEAR NOT JUST DURING OCTOBER, NOT JUST FOR ONE MONTH SO THIS IS A NEW SERIES HERE, THE NEW SERIES IS PART OF OUR DISABILITY PORTFOLIO AND DESIGNED TO BRING YOU INFORMATION AND EMPLOYMENT INFORMATION FOR PEOPLE WITH DISABILITIES AS WELL AS RETENTION. TODAY FOCUSES ON EMPLOYMENT OF INDIVIDUALS AT INTELLECTUAL DISABILITIES AN OVERARCHING PIECE OF OUR PORTFOLIO. IRONICALLY EARLY THERAPY AND MONTH IT WAS ANNOUNCE THAD THE EMPLOYMENT AWARENESS THEME IS EXPECT, EMPLOY AND EMPOWER. NORMALLY WE WOULDN'T HAVE A CONVERSATION ABOUT THE SAME UNTIL THE OFFICIAL MONTH OF OCTOBER BUT I WANT TO TALK TO YOU TODAY FOR A FEW MINUTEWHAT THAT MEANS AND WHAT THESE WORDS MEAN, EXPECT, EMPLOY, EMPOWER AND HOW IT TIES TO TODAY'S PROGRAM. THESE THREE POWERFUL WORDS SUM UP THE NEED TO ADVANCE THE PEOPLE WITH DISABILITIES THAT EVEN MORE WORDS SEND A MESSAGE THAT IT'S MORE THAN JUST HIRING, IT'S ABOUT THE NEED FOR CONTINUOUS CONTINUOUS EFFORTS IN BEING INCLUSIVE. ALL OF US DURING OUR YOUTH WERE TAUGHT TO EXPECT EMPLOYMENT, ALL WONDER WAG OUR CAREERS WILL BE, WHERE WE WOULD BE EMPLOYED AS ADULTS. MOST OF US IF NOT EVERYONE WAS TAUGHT TO STRIVE FOR A CAREER. WE WERE TAUGHT IF YOU STUDY HARD AND YOU WORK SMART AND DRIVE YOUR OWN SUCCESS THAT YOU HAVE A WONDERFUL CAREER. HISTORICALLY PEOPLE WITH INTELLECTUAL DISABILITIES WERE ISOLATE FRIDAY SOCIETY RATHER THAN INTERNATIONAL CLASSIFICATION GREATED, INTEGRATION AND INCLUSION INTO SOCIETY IS WHAT WE EXPECT AND A LARGE PARLIAMENT OF THAT INTEGRATION TIES TO EMPLOYMENT AND INDEPENDENT AND FEWER THAN ONE OF EVERY FIVE PEOPLE WITH INTELLECTUAL DISABILITY SYSTEM ENGABLINGED WITH SUPPORTIVE EMPLOYMENT. THAT'S WHY WE'RE HERE TODAY TO SHARE AND DISCUSS ONE WAY THE NIH IS ADVANCING THE EXPECTATION OF INCLUSION AND EMPLOYMENT EMPOWERMENT TO PEOPLE WITH DISABILITIES. WE HAVE A LOT TO COVER ON OUR PROGRAM TODAY. I'M DELIGHTED TO SEE SO MANY PEOPLE IN THE AUDIENCE, IT WARMS MY HEART AND I WANT TO INTRODUCE MAUREEN GORLE Y WHO WILL PROSIGHT OPENING REMARKS AND SET THE STAGE FOR THIS WONDERFUL DISCUSSION. [ APPLAUSE ] >> THANK YOU DEB, AND THANK YOU EVERYBODY FOR BEING HERE TODAY. I WORK IN THE CLINICAL CENTER AS CHIEF OPERATING OFFICER AND HAPPY OVER THE PAST SEVERAL YEARS TO HAVE BEEN AND CONTINUE TO BE EXECUTIVE LEADER OF AN INITIATIVE THAT WE CALL PROJECT SEARCH WHICH IS TO TRAIN AND HIGHER TRANSITIONING YOUTH WITH INTELLECTUAL DISABILITY WITHIN OUR FULLY IMMERSED WORKFORCE. AND YOU WILL HEAR MORE ABOUT THAT FROM OUR PANEL TODAY AND BEFORE I INTRODUCE THEM, JUST A COUPLE OF BRIEF COMMENTS ABOUT WHAT WE'VE LEARNED IN THE CLINICAL CENTER FROM A LEADERSHIP PERSPECTIVE OVER THE PAST SEVERAL YEARS ABOUT WHAT IT MEANS TO HAVE PEOPLE WITH INTELLECTUAL DISABILITIES JOIN OUR WORKFORCE. SO WE WERE CONTACTED ON KIND OF A COLD CALL IN FEBRUARY OF 2010 BY THE IVY MOUNTAIN SCHOOL IN ROCKVILLE. AND THAT'S A SCHOOL FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES, AND WE INVITED LOU MERRIC AND JAN WINTRALL OUT WITH US TO TALK IN THE CLINICAL CENTER ABOUT THEIR PROPOSAL TO LAUNCH THE PROJECT SEARCH INITIATIVE AT THE CLINICAL CENTER. AND SUFFICE IT TO SAY WHEN THEY CAME AND MADE OR PRESENTATION, WE WERE SO INCREDIBLY IMPRESSED ABOUT WHAT A WELL DESIGNED COLLABORATION PROJECT SEARCH REPRESENT THAD WE IMMEDIATELY SIGNED ON AND I THINK THAT OUR RELATIONSHIP AND THE EFFORTS THAT WE'VE MADE OVER THE PAST FOUR YEARS HAVE BEEN AMONG THE MOST REWARDING WORK IN MY CAREER AND CERTAINLY HAVE BEGUN TO HAVE A BIG IMPACT ON THE CULTURE OF THE CLINICAL CENTER AND HAVE SPREAD BEYOND THE NIH. A COUPLE OF THINGS I REALIZE ABOUT LEADING THIS INITIATIVE IS THAT IT'S A BIG CHANGE INITIATIVE FOR AN ORGANIZATION AND THE REASON I SAY THAT IS BECAUSE WE LEARN THAT PEOPLE WITH INTELLECTUAL DISABILITIES TRYING TO GET JOBS IN THE FULLY IMMERSED WORKFORCE PHASED SIGNIFICANT CHALLENGES. IF YOU THINK ABOUT ANY TRANSITION, AGE YOUTH THAT YOU KNOW, AGES SAY 18-21 WHO ARE GRADUATE FREE RADICALS GENERATED HIGH SCHOOL AND FROM COLLEAGUE--GRADUATING FROM COLLEGE AND MAKING THE NEXT STEP TO INDEPENDENT LIVING, FINANCIAL, SELF-RESPONSIBILITY AND BASICALLY MOVING OUT OF THEIR PARENT'S HOUSES AND RUNNING THEIR OWN LIVES IS CHALLENGING ENOUGH. BUT IF YOU HAVE AN INLECTUAL DISABILITY ON TOP OF THAT, IT'S MORE CHALLENGING. BEYOND THAT WE'VE LEARNED BY BEING HONEST ABOUT THE PHENOMENON OF HIRING THESE INDIVIDUALS IN THE WORKFORCE IS THAT THEY FACE SIGMA. PEOPLE THINK THAT THEY KNOW WHAT IT'S GOING TO BE LIKE TO WORK WITH SOMEBODY WITH AN INTELLECTUAL DISABILITY AND THEY'RE GIVEN REALLY A VIRTUAL IDENTITY IF YOU ASK PEOPLE AND I JUST COMPLETED A SMALL QUALITATIVE STUDY, IF YOU ASK PEOPLE WHAT DID YOU THINK IT WOULD BE LIKE, PEOPLE HOLD GENERALLY LOW EXPECTATIONS AND THEY'RE VERY CONCERNED ABOUT THE BURDEN OF TIME, NOT ONLY THAT AS A MENTOR OR SUPERVISOR, THEY'RE CONCERNED ABOUT THEIR INABILITY TO MENTALLOR EFFECTIVELY BECAUSE--MENTOR EFFECTIVELY BECAUSE PERHAPS THEY NEVER DEALT WITH AN INTELLECTUAL DISABILITY BEFORE. BUT THEN WE FOND OVER TIME WITH INCREASING SOCIAL CONTACT THAT THESE INDIVIDUALS ARE HIGHLY PRODUCTIVE, THEY GAIN SKILLS QUICKLY, THEY QUICKLY GAIN CO-WORKER ACCEPTANCE AND THEY CAN BECOME AN EQUALLY HIGH MEMBER OF THE WORKFORCE THAT WE EMPLOY HERE AT NIH OR IN ANY ORGANIZATION. AND SO WE NEED TO GIVE THEM AN OPPORTUNITY TO SHOW THEM, TO SHOW US, SORRY WHAT THEY CAN DO AND WE NEED TO BE OPEN MINDED, NOT TO TAG THEM WITH THE STEREOTYPE BEFORE EVEN MEETING THEM. SO, THE REASON I SAY IT'S AN ORGANIZATIONAL CHANGE EFFORT IS BECAUSE TO OVERCOME THAT STIGMA REQUIRES NOT ONLY THE EFFORT OF LEADERS IN THE ORGANIZATION TO PAVE THE WAY, BUT IT REQUIRES LIKE ANY EFFORT WHERE YOU'RE CREATING CHANGE, THE COOPERATION OF FRONT LINE EMPLOYEES AND WE'VE HAD THAT ACROSS THE NIH. MANY, MANY PEOPLE WHO HAVE BEEN WILLING TO TAKE ON AS A MENTEE, AN INTERN WITH INTELLECTUAL DISABILITY AND WE'VE SEEN OVER AND OVER AGAIN THIS GROWING RELATIONSHIP AND ACCEPTANCE IN THE ORGANIZATION. SO YOU'RE GOING TO HEAR ALL ABOUT THAT TODAY AND I'M VERY PLEASED TO BE ABLE TO INTRODUCE OUR PANEL. FIRST, WE'LL HEAR FROM DR. MELISSA P A TRISI, AND SHE IS CHIEF OF THE DEVELOPMENTAL INTELLECTUALS BRANCH OF THE MARIA SHRIVER CHILD INSTITUTE OF EXPHELGT HUMAN DEVELOPMENT. HE WILL BE TALKING ON TRANSATION RESEARCH IN THE LIVES OF DEVELOPMENT BUSINESS PROGRAMSABILITYS. SHE EARNED HEAR MB, Ph.D. FROM THE STANFORD UNIVERSITY SCHOOL OF MEDICINE, AND COMPLETED HER RESIDENCY AT THE UNIVERSITY OF WASHINGTON. SHE SERVED AS CHAIR OF THE SCIENTIFIC ADVISORY BOARD OF THE JUBEAR'S SYNDROME AND RELATED DISORDS FOUNDATION. AND FOLLOWING DR. P A RISI WILL BE JOINED BY DENISE FORD AND DENISE IS GUEST AND PATIENT RELATIONS AT THE CLINICAL CENTER. SHE MANAGES EIGHT DIFFERENT PROGRAM AREAS IN THE CLINICAL CENTER INCLUDING HOSPITALITY SERVICES, MESSENGER, AND ESCORT SERVICE AND OFFICE OF PATIENT RECRUITMENT. DENISE SERVED AS THE NIH TEAM LEAD OF PROJECT SEARCH SINCE ITS LAUNCH IN 2010 AND SHE RECEIVED HER BACHELOR'S IN DIETICS FROM THE UNIVERSITY OF CALIFORNIA DAVIS AT MS FROM VIRGINIA TECH. STEVE BLANK SYSTEM OUR COLLEAGUE FROM PROJECT SEARCH, HE COMES TO US AS THE DIRECTOR OF EMPLOYMENT SERVICES FROM SEEK, AND THAT'S A LOCAL VOLUNTARY ORGANIZATION, HELPING PEOPLE WITH INTELLECTUAL DISABILITIES, SEEK STAND FORS SEEKING EQUALITY EMPOWERMENT AND COMMUNITY FOR PEOPLE WITH DEVELOPMENT AT DISABILITIES. STEVE OVERSEES HIGHLY SUCCESSFUL PROJECT SEARCH INTERNSHIP PROGRAMS IN COLLABORATION WITH THE NIH. SMITHSONIAN INSTITUTION AND THE MONTGOMERY COUNTY GOVERNMENT. HE HOLDS MASTERS OF ENGINEERING, ECONOMICS AND MANAGEMENT FROM THE UNIVERSITY OF OXFORD IN ENGLAND AND MEMBER OF THE NATIONAL ASSOCIATION OF PEOPLE SUPPORTING EMPLOYMENT FIRST. SO WITH THAT I WELCOME OUR PANELISTS AND PROMISE WHAT WILL BE AN INFORMATIVE PRESENTATION TODAY. THANK YOU. [ APPLAUSE ] >> THANK YOU VERY MUCH FOR THAT KIND INTRODUCTION, IT'S A PLEASURE TO BE HERE TO KICKOFF THE SERIES AND WHOA, WHOA, WHOA. SOMETHING HAPPENED. OKAY, VERY SENSITIVE. SEE IF I CAN GO BACK HERE. I APOLOGIZE, I THINK I PUSHED THE WRONG BUTTON. OKAY. I THINK THE TOUCHED SOMETHING OVER THERE. IT WON'T GO THERE. AND YOU KNOW WHAT I WAS ASKED TO DO THIS MORNING IS TO REALLY SET THE STAGE FOR THE DISCUSSION THAT WILL FOLLOW AND SOME OF THE REALLY WONDERFUL EXAMPLES AND PERSONAL STORIES FROM PROJECT SEARCH AT THE NIH. SO WHAT I'D LIKE TO TALK ABOUT IS MEDICAL AND EDUCATIONAL NEEDS OF ADOLESCENCE WITH INTELLECTUAL DISABILITIES. SOME OF YOU MAY BE WONDERING, YOU KNOW, REALLY WHAT IS AN INTELLECTUAL DISABILITY AND HOW IS IT DEFINED AND EVEN A DEFINITION SUCH AS THIS IS SOMEWHAT CONTROVERSIAL. WE HAVE A TERM WE USE CALLED GLOBAL DEVELOPMENT AT DELAY AND IN MY EXPERIENCE AS A PEDIATRICIAN, WE USE THIS TERM FOR YOUNG CHILDREN WHO ARE AT RISK FOR INTELLECTUAL DISABILITY AND A CHILD HOSEN'T MET--HASN'T MET HISSER HER DEVELOPMENTAL MILESTONE. SO THE DELAY IS A WARN TAG WE NEILD TO FOLLOW--WARN TAG WE NEED TO FOLLOW THIS CHILD'S ABILITY AND HOW THAT PROGRESS. THIS HAS REPLACED THE MORE NEGATIVE AND P A JORAATIVE, AND NOT THE LEGALLY APPROPRIATE TERM MENTAL RETARDATION AS PER ROSA'S LAW PASSED IN 2010 WHICH CODIFIED THE CHANGE IN TERMINOLOGY AND ALL OUR FEDERAL PARTNERS I WOULD LIKE TO SAY HAVE BEEN USING THE TERM INTELLECTUAL DISABILITY BECAUSE I THINK IT'S MUCH MORE APPROPRIATE AND NEUTRAL. NOW HOW IT'S DEFINED AT LEAST IN LEDGES SLAGS IS AS FOLLOWING AND THAT'S A LOT OF VERBIAGE SO BEAR WITH ME. SIGNIFICANTLY SUBAVERAGE GENERAL INTELLECTUAL FUNCTIONING, EXISTING CONCURRENTLY WITH DEFICITS AND ADAPTIVE BEHAVIOR DURING THE DEVELOPMENTAL PERIOD THAT ADVERSELY AFFECTS A CHILD'S EDUCATIONAL PERFORMANCE. SO IT'S A LOT OF WORDS AND IT'S AN ATTEMPT TO GET AT THIS RELATIVELY COMPLICATED TERM WE USE, INTELLECTUAL DISABILITY. SO WHEN YOU USE THESE DEFINITIONS AND TRY TO UNDERSTAND WHAT THE EXTENT OF INTELLECTUAL DISABILITY IS IN THE U.S., IT'S ESTIMATE THAD THE PREVALENCE IS AROUND SEVEN-EIGHT MILLION AMERICANS OF ALL AGES. SO THIS IS NOT JUST A SMALL SUBSET OF OUR POPULATION, IN FACT IT COMPRISES ABOUT 3 PERCENT OF THE GOODBYE THE GENERAL POPULATION, PEOPLE WE WORK WITH AND SEE ON A DAILY BASIS. AND IN THIS COUNTRY WE HAVE A MUCH MORE INCLUSIVE ENVIRONMENT THAN IN SOME COUNTRIES IN THE WORLD WHERE INDIVIDUALS WITH INTELLECTUAL DISABILITIES ARE NOT EMBRACED AS PART OF SOCIETY AND ENJOY REGULAR OPPORTUNITIES. UNFORTUNATELY, WE CAN'T TALK ABOUT INTELLECTUAL DISABILITY WITHOUT TALKING ABOUT THE TERM I. Q. OR INTELLIGENCE QUOTIENT AND I'M SURE MANY OF YOU ARE FAMILIAR WITH THE USE OF THIS TERM TO TRY TO DEFINE SOMEONE'S INTELLECTUAL FUNCTIONING. HOWEVER THE USE OF I. Q. SCORE SYSTEM PROBLEMATIC FOR A NUMBER OF REASONS FIRST OF ALL IT'S PREDICATED ON THE NOTION THAT--I THINK THAT'S WORKING--THAT THERE'S NORMAL INTRUSION OF IN--DISTRIBUTION OF INTELLIGENCE SCORES WITH AVERAGE AT 202 STANDARD DEVIATIONSIATIONS COMPRISING 95% OF THE POPULATION. SO BY DEFINITION, THOSE THAT ARE LESS THAN TWO STABBED ARD DEVIATIONS BELOW THE MEAN WOULD BE I. Q. OF 70 OR LESS. NOW THERE ARE A LOT OF STANDARDIZED TESTS THAT ARE USED TO MEASURE I. Q. BUT HAVE TO REMEMBER THERE'S A CERTAIN AMOUNT OF VARIABILITY THAT GOES ALONG WITH THESE TESTS AND IF YOU TEST A GIVEN CHILD OR INDIVIDUAL OR ADULT. YOU MAY FIND THAT THEY VARY BY PLUS OR MINUS 5 PERCENTAGE POINTS. THERE'S ALSO UPON THE AGE OF INDIVIDUAL, UPON THE STAGE, LEVEL OF FUNCTION, MAYBE WHAT THEY HAD FOR BREAKFAST THIS MORNING AND ALSO A VERY CONCERNING ASPECT KNOWN AS CULTURAL BIASES THAT MANY PEOPLE FEEL CLOUD THE INTERPRETABILITY OF MANY STANDARDIZED I. Q. TESTS PARTICULARLY FOR THOSE WHO REPRESENT ETHNIC OR CULTURAL MINORITIES. SO THIS IS REALLY ONE PIECE OF THE PUZZLE WHEN YOU TALK ABOUT INTELLECTUAL DISABILITIES. I REALLY PREFER THE DEFINITION THAT THE AMERICAN ASSOCIATION ON DEVELOPMENT INTERNATIONAL CLASSIFICATION ETC. DISABILITIES WHICH IS AAIDD, WHICH IS THREE COMPONENTS: SIGNIFICANT LIMITATIONS IN INTELLECTUAL FUNCTIONING, REASONING, LEARNING, PROBLEM SOLVING, SIGNIFICANT LIMITATIONS IN ADAPTIST BEHAVIOR, EVERY DAY SOCIAL AND PRACTICAL SKILLS AND THIRDLY THE ONSET HAS TO BE BEFORE THE AGE OF 18 AND I THINK MANY GROUP VS INCORPORATED THIS DEFINITION AND FIND IT TO BE A MORE USEFUL TERM THAN JUST BASING I.D. ON I. Q. SCORES. SO RELATIVE TO THIS, I WANTED TO SHOW YOU AN EXAMPLE OF WHY IT'S MORE THAN I. Q. SCORES AND TALK ABOUT WHY AN INTELLECTUAL DISABILITIES WE HAVE TO TALK ABOUT RELATIVE STRENGTHS AND WEAKNESSES. SO WHAT YOU SEEOT RIGHT HERE ARE TWO DRAWINGS BY TWO DIFFERENT INDIVIDUALS WITH AN INTELLECTUAL DISABILITY. THIS PERSON HAS WILLIAMS SYNDROME, MISSING SMALL AMOUNT OF CHROMOSOME SEVEN, DETAILS NOT THAT IMPORTANT AND THEY HAVE STRONG LANGUAGE SKILLS BUT POOR VISUAL PERCEPTUAL ABILITIES SO WHEN ASKED TO DRAW A PERSON WITH A BICYCLE THIS IS WHAT THE PERSON WITH WILLIAMS SYNDROME DREW. IF YOU LOOK CAREFULLY CAN YOU SEE THERE MAY BE A PERSON HERE, WHEELS, BIKE, CHAIN, PEDALS OVER HERE, BUT IN TERMS OF THE VISUAL PERCEPTION, IT'S VERY DIFFICULT TO DISCERN THIS IS A PERSON ON A BICYCLE. AND IN FACT CORRELATES SHOW THAT THERE IS IMPROVED DEVELOPMENT OF THE LANGUAGE CORTEX IN THE BRAIN BUT NOT SO MUCH IN THE AREAS OF THE BRAIN WHERE YOU VISUAL PERCEPTUAL SKILLS. SO THIS PERSON HAS AN I. Q. OF 50. IN CONTRAST A PERSON WITH DOWN'S SYNDROME WHEN ASKED TO DRAW A PICTURE OF A BICYCLE WITH A COMPARABLE I. Q. DREW SOMETHING THAT MOST OF US WOULD AGREE LOOKS LIKE A BICYCLE RIGHT? TWO PEDALS, SEAT, HANDLE BARS AND DOWNS SYNDROME IS A GENETIC SYNDROME DUE TO EXTRA COPY OF CHROMOSOME 21, THEY HAVE POOR LANGUAGE SKILLS BUT STRONG VISUAL PERCEPTUAL ABILITIES AND THEY HAVE BETTER DEVELOPMENT IN THEIR BRAIN OF THE BASAL GANGLIA WHICH IS IMPORTANT IN THESE AREAS OF DOPEMENT. SO THE POINT HERE IS THAT EACH THOUGH THESE TWO INDIVIDUAL VS A VERY SIMILAR I. Q., THEY'RE VERY DIFFERENT IN TERMS OF THEIR ABILITIES AND IN TERMS OF RELATIVE STRENGTHS AND RELATIVE WEAKNESSES. SO WE HAVE TO TAKE EACH PERSON AS AN INDIVIDUAL. THERE ARE MANY DIFFERENT WAYS ONE CAN CLASSIFY INTELLECTUAL DISABILITY. CAN YOU TALK ABOUT THE DEGREE OF IMPAIRMENT. AGAIN, SOMETIMES WE RESORT TO TALKING ABOUT AN I. Q. BASED DEGREE OF INTELLECTUAL IMPAIRMENT, TALKING ABOUT MILD, MODERATE, SEVERE PROFOUND. WE TALK ABOUT DOMAINS OF DISABILITY BASED ON THE UNDERLYING ETIOLOGYS AND DEGREES OF IMPAIRMENT, FUNCTIONAL LIMITATIONS AND SOCIETAL LIMITATIONS OR WE CAN TALK ABOUT THEM BASED ON THE PATTERN AND INTENSITY OF THE SUPPORTS THAT ARE NEEDED FOR THAT INDIVIDUAL TO HELP THEM FUNCTION IN SOCIETY. AND THEN YOU MIGHT JUST SAY, WELL, WHY ARE WE BOTHERING CLASSIFYING ANYWAY, DOESN'T THAT REALLY LABEL PEOPLE? IN FACT THAT THERE ARE SOME PRACTICAL CONSIDERATIONS FOR WHY CLASSIFICATION IS IMPORTANT AND AGAIN THE AIDD SAYS TO ALLOW US TO STAY LORA RODRIGUEZ SUPPORTS FOR INDIVIDUAL IN THE FORM OF THE SET OF STRATEGIC PLAN ELECTEDIES AND SERVICES PROVIDED--STRATEGIES PROVIDED OVER A SPIN. AND THAT PUTS A POSITIVE SPIN ON CLASSIFICATION. IT'S BASED ON THE ASSUMPTION THAT INLECTUAL DISABILITY IS A CONDITION THAT CAN BE ENHANCED, THAT CAN BE IMPROVED UPON BY SUPPORTS RATTLER THAN A STATIC LIFE LONG--RATHER THAN A STATIC LIFE LONG DISABILITY. SO IN OTHER WORDS A PERSON IS NOT DEFINE BIDE THEIR DISABILITY BUT ALLOW THEM TO CONTINUE TO GROW AND DEVELOP JUST LIKE INDIVIDUALS WITHOUT INTELLECTUAL DISABILITIES. THERE ARE MANY DIFFERENT CAUSES OF INTELLECTUAL DISABILITIES AND WE DON'T HAVE TIME TO GO INTO THAT AND IT'S NOT REALLY RELL VABT FOR THE PURPOSES--RELEVANT FOR THE PURPOSE OF THIS TALK BUT TO GIVE YOU A FLAVOR AND SPECTRUM AND DIVERSITY IN INTELLECTUAL DISABILITY. THERE CAN BE GENETIC OR CHROMOSOMAL CAUSES, DOWN SYNDROME, RELATIVELY COMMON CONDITION IS FRAGILE X SYNDROME DUE TO A CHANGE ON THE X CHROMOSOME. THERE ARE COMMON GENETIC CONDITIONS LIKE FACIAL CARDIO SITUATIONS AND KLINEFELTER SYNDROME THAT CAN PLAY A PART IN INTELLECTUAL DISABILITY. THERE ARE OTHER ENVIRONMENTAL FACTORS THAT CAN CONTRIBUTE LIKE PREMATURITY, PREDISPOSE OR INCREASE RISK THAT THE PERSON WILL HAVE AN INTELLECTUAL DISABILITY. PRENATAL EXPOSURE CAN AFFECT INTELLECTUAL DEVELOPMENT AND WE KNOW THAT ALCOHOL AND OTHER DRUGS CAN IMPACT THE COGNITIVE GROWTHS OF THE DEVELOPING BABY. PERINATAL COMPLICATION CANS ALSO AFFECT DEVELOPMENT AND POSTNATAL DEVELOPMENT INJURIES AND ACCIDENTS, TRAUMATIC BRAIN INJURY FOR EXAMPLE CAN LEAD TO INTELLECTUAL DISABILITY AND EXPOSURES IN THE ENVIRONMENT SUCH AS LEAD, WE ALSO KNOW CAN CONTRIBUTE TO INTELLECTUAL DISABILITY. IN GENERAL AND AGAIN THIS IS VERY GROSS OVERSIMPLIFICATION BUT INDIVIDUALS WITH MORE MILD I.D. IN NOSE SITUATIONS IT IS MORE LIKELY TO BE ASSOCIATE WIDE RACIAL, SOCIAL AND FAMILIESIAL FACTORS THAN INDIVIDUALS OF MODERATE OR SEVERE INTELLECTUAL DISABILITY WHICH IS MORE LIKELY TO HAVE A BIOLOGICAL OR GENETIC CAUSE. THERE'S GREAT DEAL OF VARIABILITY AND A VERY ROUGH CONSIDERATION. I WAS ASKED TO TALK ABOUT SOME OF THE MEDICAL NEEDS FOR THOSE WITH INTELLECTUAL DISABILITIES AND AGAIN THIS COULD BE THE TOPIC OF A COMPLETE TALK IN AND OF ITSELF BUT I WANTED TO GIVE YOU A SENSE OF SOME OF THE RELATED CONDITIONS THAT CAN AFFECT THOSE WITH INLECTUAL DISABILITY AND I BORROWED LIBERALLY FROM THIS TABLE IN A TEXTBOOK ON CHILDREN WITH DISABILITIES EDITED BY MARK BATTSHAW AND THIS IS REALLY BASED ON A SURVEY AND IT'S BY NO MEANS COMPREHENSIVE BUT WHEN YOU LOOK AT INDIVIDUALS WITH INTELLECTUAL DISABILITY AND GET A POPULATION BASED SAMPLING, YOU WILL SEE THAT SEIZURES OR EPILEMESY ARE RELATIVELY MOB IN ABOUT 22% OF INDIVIDUALS WITH I.D. HAVE SEIZURES AS A CONDITION THAT ACCOMPANY INTELLECTUAL DISACT. CEREBRAL PALSY 20%. HEARING PROBLEMS ARE COMMON IN AND VISION PROBLEMS ARE VARIABLE DEPENDING ON THE UNDERLYING CONDITION, RANGING FROM TWO-27%. DOWNS SYNDROME IS LISTED HERE, FRAGILE X IS AUTISM IS A RELATIVELY COMMON FEATURE IN THOSE WITH I.D. AND THEN ADHD AND SOME OTHER BEHAVIORIAL MAN TESTACEANS ARE RELATIVELY COMMON. SO THE BOTTOM LINE IS THAT THERE ARE SOME THINGS WE KNOW TEND TO TRAVEL WITH INTELLECTUAL DISABILITY BUT AGAIN IT DEPENDS ON THE UNDERLYING CONDITION AND THE INDIVIDUAL HIM OR HERSELF IN TERMS OF WHAT THEIR MEDICAL NEEDS ARE GOING TO ENTILE AND YOU CAN--ENTAIL AND YOU CAN IMAGINE THAT SOMEONE WHO HAS THESE ISSUES, THE MEDICAL CARE WILL BE IMPORTANT TO PROVIDE THAT CARE IN A COMPREHENSIVE WAY THAT WILL INVOLVE A MULTIDISCIPLINARY TEAM. THIS SLIDE IS ONE TO REMIND ME THAT THE MEDICAL NEEDS NOT ONLY VARY ON ORBED LYING CONDITION BUT ALSO ACROSS THE LIFE SPAN AND THESE ARE ALL INDIVIDUALS WITH DOWNS SYNDROME AT VARIOUS AGES AND STAGES OF GROWTH AND DEVELOPMENT AND BECAUSE DOWNS SYNDROME IS ONE OF THE MOST COMMON FORMS OF INTELLECTUAL DISABILITY, I WANTED TO GIVE YOU IDEAS OF MEDICAL ISSUES FOR THOSE WITH DOWNS SYNDROME. SO CHILDHOOD SOME ARE RELATED TO BEING BORN WITH A HEART DEFECT. HALF OF BABIES HAVE A HEART DEFECT. HEARING LOSS IN 2/3RDS TO 3-QUARTERS. EYE INFECTIONS, EAR INFECTIONS, SLEEP APPLICATIONSNIA AND NECK SPINE INSTABILITY AND THESE ALL CAN BE TREATED BUT IF YOU DON'T KNOW TO LOOK AT THEM, YOU MAY NOT KNOW THEY'RE SIGNIFICANT FOR INDIVIDUALS WITH DOWNS SYNDROME. IN CONTRAST WITH INDIVIDUALS WITH DOWNS SYNDROME REACH ADULTHOOD, THYROID DISEASE CAN INCREASE AS WELL BUT THERE'S INCREASED PREVALENCE IN, DOLT AS WELL AS TYPE ONE DIABETES AND SILLIAC DISEASE. FINALLY MANY INDIVIDUALS WITH DOWNS DIN CHROME BY THE AGE OF 40 WILL HAVE SOME DEGREE OF ALZHEIMERS DISEASE, AND IT'S BEEN ESTABLISHED BUT IT'S IMPORTANT TO KNOW IF YOU ARE PROVIDING CARE FOR SOME PEOPLE WITH DOWNS SYNDROME. NOW WHAT PEOPLE DON'T KNOW IS THAT THERE ARE ADVANTAGES TO HAVING THESE SYNDROMES, SO A PERSON WITH DOWN SYSTEM LESS LIKELY TO HAVE A CORONARY ARTERY DISEASE OR LESS CAUSER CAUSING TUMORS TUMORS AND THERE'S POSITIVE ASPECTS TO EACH OF THESE CONDITIONS. THERE ARE--THERE'S A HIGHER RATE THAN IN THE GENERAL POPULATION FOR AN INDIVIDUAL WITH AN INTELLECTUAL DISABILITY TO HAVE A PSYCHIATRIC DISORDER OR MENTAL HEALTH CONDITION AND IT'S ESTIMATE THAD APPROXIMATELY 40% OF THOSE WITH I.D. WILL ALSO HAVE ONE OF THESE CONDITIONS IN COMPARISON TO THE GENERAL POPULATION WHERE THE PERCENTAGES ARE ABOUT EIGHT%. THE SPECIFIC MENTAL HEALTH CONDITIONS DEPENDS ON THE PERSON AND THEIR GENDER AS WELL AS THEIR INDIVIDUAL FACTORS, ADHD AND AUTISM AS WELL AS ANXIOUS AND DEPRESSION ARE RELATIVELY COMMON AND YOU CAN ALSO SEE PSYCHOSIS BI-POLAR DISORDER AND CONDUCT DISORDERS AND OBSESSIVE COMPULSIVE DISORDS, AS WELL. I WANT TO TAKE THIS TIME TO HIGHLIGHT A WORKSHOP THAT WE'RE SPONSORING IN ONE WEEK, AT FISHER'S LANE HERE IN MARYLAND ON MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES RESEARCH CHALLENGES AND OPPORTUNITIES AND WE'RE REALLY INVITED EXPERTS IN THE FIELD TO HELP US IDENTIFY WHERE WE CAN POTENTIALLY MAKE PROGRESS IN THIS CHALLENGING ISSUE OF THE CO-OCCURRENCE OF MENTAL HEALTH CONDITIONS AS WELL AS DEVELOPMENTAL DISABILITIES, NICHD AND NIMH ARE COSPONSORING AND WORKING WITH SPECIAL OLYMPICS AND NATIONAL ASSOCIATION FOR THE DUAL DIAGNOSE INDEED TERMS OF ORGANIZING THIS WORKSHOP. LET'S TURN AND TALK BRIEFLY ABOUT THE INTELLECTUAL NIGHEDS FOR THOSE WITH INTELLECT-UAL DISABILITIES. WE MOVE FRIDAY PERSPECTIVE OF ISOLATION 30-40 YEARS AGO TO ONE OF INTEGRATION AND I LIKE THIS SLIDE BECAUSE SEE THE ABILITY, HERE'S A BOY WITH DOWNS SYNDROME WITH HIS TYPICALLY DEVELOPING PEERS AND THEY'RE ALL JOINING TOGETHER. THERE'S LEGAL REQUIREMENTS. THE HISTORY OF EDUCATION LEGISLATION IN THIS FIELD AGAIN COULD BE ANOTHER TALK UNTO ITSELF AND I WANTED TO HIGHLIGHT A FEW OF THE IMPORTANT TIME POINTS. IF YOU LOOK AT PRIOR TO 1965, THERE REALLY WASN'T A LOT IN TERMS OF INCLUSION AND SPECIAL EDUCATION SERVICES FOR INDIVIDUALS WITH DEVELOPMENTAL DISABILITIES AND IN 1975, ONE OF THE IMPORTANT LEGISLATION WAS PASSED, THE EDUCATION FOR ALL HANDICAPPED CHILDREN ACT AND THIS STARTED TO GUARANTEE A FREE APPROPRIATE PUBLIC EDUCATION FOR SCHOOL AGED CHILDREN AND IT'S PROVIDED SOME FUNDING TO SUPPORT THAT EDUCATION, SO THAT'S WHY THIS--THIS DATE WAS SO IMPORTANT. IN 1990 THE INDIVIDUALS WITH DISABILITIES EDUCATION ACT OR IDEA WAS PASSED AND THIS FIRST ACKNOWLEDGE THE USE OF PERSON FIRST LANGUAGE AS WELL AS CHANGING THE TERMINOLOGY FROM HANDICAP TO DISABILITY. IT ALSO INTRODUCED THE IDEAS AND FORMULATED THE IDEAS OF AN INDIVIDUALIZED EDUCATION PROGRAM AS WELL AS TRANSITION PLANNING. THIS IS ALSO THE SAME YEAR THAT THE AMERICANS WITH DISABILITIES OR ADA ACT WAS PASSED. SO THERE WAS A LOT GOING ON IN 1990. AND THEN IN 2004, THE INDIVIDUALS WITH DISABILITIES EDUCATION IMPROVEMENT ACT OR IDEA 2004 ACT WAS PASSED AND THIS HAS GUIDED INDIVIDUALS FOR EDUCATION SINCE THAT TIME AND IT MANDATES SPECIAL EDUCATION SERVICES TO MEET THE NEEDS OF A CHILD WITH DISABILITY AND THAT'S TO FIND A PHYSICAL, COGNITIVE OR BEHAVIORIAL. IT GUARANTEES THE ACRONYM. WHERE PEOPLE COME UP WITH THIS, I DON'T KNOW BUT FREE APPROPRIATE PUBLIC EDUCATION, FOR ALL CHILDREN AGE 21 IN THE LEAST RESTRICTIVE ENVIRONMENT. SO THAT'S REALLY KEY. IT MEANS THAT YOU REALLY TRY TO BE INCLUSIONARY AND BRING CHILDREN INTO THE ENVIRONMENT WITH THEIR PEERS AND IT ALSO ESTABLISHES THAT THERE SHOULD BE ANNUAL UPDATES TO THE INDIVIDUALIZED EDUCATIONAL PROGRAM FOR EACH CHILD WHO RECEIVED SUCH SERVICES. SO THERE WE GO. SO PUBLIC SCHOOLS ARE REQUIRED TO PROVIDE A NONDISCRIMINATORY EVILLUATION FOR ANY CHILD WITH A DISABILITY AND THE EVALUATION OCCURS BY A MULTIDISCIPLINARY TEAM INVOLVES A SYICOLOGYST AND PLUS OR MINUS THESE PARTICULAR EXPERTS AS NEEDED. OCCUPATIONAL THERAPY. PHYSICAL THERAPY. SOCIAL WORKER INVOLVED AND VERY IMPORTANT ARE PARENTAL INPUT AND I WOULD ADD THE INDIVIDUAL OR CHILD'S INPUT AS WELL, PARTICULARLY AS THEY GET OLD ENOUGH TO HAVE A SAY IN THEIR EDUCATION. AND THIS IS A REMINDER, THIS IS THE I IN IEP SO WE CAN'T FOR GET HOW IMPORTANT THIS IS WITH THE SERVICES. THE PURPOSE OF IEP IS TO DETERMINE IF THERE ARE ACCOMMODATIONS, MODIFICATIONS OR SPECIAL INSTRUCTION ARE NEEDED AND THEY'RE DESIGNING THE EDUCATIONAL SERVICES AS WELL AS ACHIEVABLE GOAL FOR THAT INDIVIDUAL FOR THE SCHOOL YEAR, WITH THE UNDERLYING THEME BEING AN INCLUSIVE ENVIRONMENT WHENEVER POSSIBLE. SO IN THE LAST FEW SLIDES, I JUST WANT TO TALK A LITTLE BIT ABOUT TRANSITION FROM ADOLESCENCE TO ADULTHOOD. IT'S A CHALLENGING TRANSITION, I THINK IT'S CHALLENGING WHETHER YOU HAVE AN INTELLECTUAL DISABILITY OR YOU DON'T AS MENTIONED BY MISS GORMLEY EARLIER AND THERE ARE SEVERAL TRANSITIONS, YOU HAVE TO GO FROM SCHOOL TO FROM HOME TO A COMMUNITY SET NOTHING MANY CASES AND FROM A CHILD BASE TO AN ADULT ORIENTED HEALTHCARE. SO THESE ARE A FEW OF THE CHALLENGES THAT EXIST FOR ADOLESCENTS IN INTELLECTUAL DISABILITY IN MOVING TO ADULTHOOD AND IT'S IMPORTANT TO REMEMBER THAT IT'S A PROCESS, NOT A ONE TIME EVENT. YOU DON'T SAY, OH I'VE TURNED 18, I'M TRANSITIONING NOW, NO, YOU NEED TO HAVE BEEN PLANNING FOR YEARS, ACTUALLY IN ADVANCE AND THEN BE READY AND HAVE THE SUPPORT SYSTEM SET UP TO REALLY MAKE THAT TRANSITION A SUCCESSFUL ONE. IT DOES REQUIRE COORDINATION INVOLVING HEALTH CARE, EDUCATIONAL VOCATIONAL SOCIAL SERVICES, ALL OF THESEAZ SPECTS NEED TO WORK TOGETHER AND I THINK IT'S IMPORTANT ALSO TO REMEMBER AGAIN THAT SELF-DETERMINATION SKILL HEAT SHOCK SYSTEM BE FOSTERED. I THINK THERE'S A TENDENCY FOR SOME INDIVIDUALS WHO HAVE INTELLECTUAL DISABILITIES TO BE SORT OF PROTECTED BY THEIR CAREGIVERS OR FAMILY MEMBERS, AND NOT TO BE ALLOWED TO MAKE MISTAKES AND NOT BE ALLOWED TO LEARN FROM THEIR EXPERIENCES. SO SELF-DETERMINATION IS ACTUALLY VERY IMPORTANT. AND PART OF THE I.D. E. A. LEGISLATION OF 2004 WAS TO START THE PLANNING AT 16 YEARS OF AGE SO THAT YOU HAD SEVERAL YEARS TO GET IT IN PLACE. THERE'S A WONDERFUL WEB SITE WWW.GOTTRANSITION.ORG. WHICH HAS RESOURCES STOOLS AND FAMILY, HEALTH CARE PROVIDERS AND STATES TO HELP TRANSITION INTO AN ADULT MEDICAL MEMORY CLONE MODEL AND THIS IS PUT TOGETHER BY THE NATIONAL HEALTHCARE TRANSITION CENTER AND I DON'T EXPECT YOU TO READ THIS, THE POINT IS IF YOU GO TO THE WEB SITE THIS, IS ENTICEMENT FOR YOU TO GO, THERE'S WONDERFUL PDF, TWO PAGES THAT SHOWS SIDE BY SIDE COMPARISON FIST YOU ARE TRANSITIONING YOUTH TO HEALTH CARE PROVIDERS, ADULT HEALTHCARE PROVIDERS, IF YOU ARE TRANSITIONING TO ADULT WITHOUT HEALTHCARE PROVIDERS OR INTEGRATING ADULT INTO'S ADULT HEALTHCARE AND THERE ARE SIX ASPECTS OF--SIX CORE ELEMENTS OF HEALTHCARE TRANSITION THAT ARE LISTED BOTH HERE AND ON THE NEXT SLIDE. SO I THINK THIS IS A USEFUL TOOL FOR INDIVIDUALS AND THEIR FAMILY MEMBERS AND THEIR HEALTHCARE PROVIDERS TO MAKE SURE YOU THINK ABOUT ALL THE ELEMENTS THAT NEED TO BE IN PLACE FOR SUCCESSFUL TRANSITION. SO MY LAST SLIDE IS ABOUT ONE FLUE PIECE OF PROPOSED LEGISLATION THAT HAS NOT YET BEEN PASSED AND THIS IS CALLED THE ABLE ACT, ACRONYMS ARE ALWAYS GREAT, ACHIEVING A BETTER LIFE EXPERIENCE ACT. IT WAS REINTRODUCED IN 2013, INTRODUCED IN CONGRESS IN THE PAST AND THIS WOULD ALLOW INDIVIDUALS WITH DISABILITIES WITH THEIR FAMILIES TO OPEN A TAX SHELTERED SAVINGS ACCOUNT TO PAY FOR CERTAIN LONG-TERM EXPENSES. SO IT'S SIMILAR TO THE 529 PROGRAMS THAT YOU MAY BE FAMILIAR WITH THAT ALLOW FAMILIES TO SAVE FOR COLLEGE EDUCATION IN GENERAL. BUT CURRENTLY IN ORDER TO CALLIFY FOR SERVICES, INDIVIDUALS WITH DISABILITY CANS ONLY SAVE A TOTAL OF $2000 IN ASSETS AND EARN $700 A MONTH OR LESS. SO THERE'S A REAL DISINCENTIVE FOR THEM TO SAVE MONEY FOR THE LONG-TERM OR TO HAVE A DESCENT PAYING JOB. SO BECAUSE OF THIS, THIS SORT OF LEGISLATION WOULD HELP ENCOURAGE PARENTS TO SAVE MONEY FOR THEIR CHILDREN WITH DISABILITIES, AND ALLOW THEM TO REALLY PLAN FOR THE LONG-TERM FOR EXPENSES THAT MEDICATE AND SSI DON'T COVER SUCH AS EDUCATION, HOUSING CAREER COACHING AND TRANSPORTATION. SO, I THINK--I TRIED TO GIVE YOU AN OVERVIEW ABOUT INTELLECTUAL DISABILITIES. TELL YOU ABOUT WHAT IT TAKES TO INSURE A SUCCESSFUL TRANSITION AND EMPLOYMENT ADOLESCENTS FOR INTELLECTUAL DISABILITIES, THE REWARDS ARE ENORMOUS FOR ALL OF US AND OUR COMMUNITIES AND I THINK WE WILL NOW HEAR ABOUT AN EXAMPLE OF A SUCCESSFUL PROGRAM IN THAT DOMAIN. SO THANK YOU VERY MUCH. [ APPLAUSE ] >> GOOD MORRING, EVERYBODY I'M DENISE FORD AND TO GIVE YOU A LITTLE BIT OF BACKGROUND BEFORE I GET INTO SHARING THIS PROGRAM WITH YOU THAT WE'RE SO EXCITED ABOUT. I'VE BEEN HERE AT NIH A LITTLE OVER 30 YEARS AND SO THAT'S QUITE A LONG TIME AND OF THAT TIME ABOUT 25 YEARS OF IT HAS BEEN SPENT IN MANAGEMENT, VARIOUS LEVELS OF MANAGEMENT THROUGHOUT THE CLINICAL CENTER. AS MY HOME ORGANIZATION, BUT FIVE YEARS AGO, IF YOU WOULD HAVE TOLD ME, THAT I WOULD BE SITTING HERE TODAY, SHARING WITH YOU ANY LEVEL OF EXPERTISE ABOUT INDIVIDUALS WITH INTELLECTUAL DISABILITIES, I WOULD HAVE TOLD YOU, YOU WERE CRAZY BECAUSE I HAD REALLY NO FIRST HAND EXPERIENCE OR CONNECTION WITH THIS WONDERFUL GROUP OF POTENTIAL IN THE GOVERNMENT WORKFORCE. AND SO, THIS PASSED FOUR YEARS THAT WE'VE BEEN INVOLVED IN IN PROGRAM CALLED PROJECT SEARCH HAS BEEN AN INCREDIBLE LEARNING EXPERIENCE, LEARNING CURVE FOR ME, I DO NOT COME TO THIS WITH A BACKGROUND IN TECHNICAL BACKGROUND IN EITHER MEDICAL OR REHAB OR SUPPORTIVE TRAINING. I'M A DIETITIAN BY BACKGROUND. SO MY LEARNING CURVE WAS PRETTY STEEP. BUT TO HAVE EXPERIENCED WHAT WE'VE SEEN OVER THE LAST FOUR YEARS WITH THIS INCREDIBLE GROUP OF YOUNG PEOPLE AND UNDERSTANDING THE REMARKABLE POTENTIAL THAT THEY HAVE AND FINDING A WAY TO UNLEASH THAT POTENTIAL IN THE WORK ARENA AND TO BE ABLE TO HARNESS THEIR SKILLS AND REALLY PROMOTE OPPORTUNITIES FOR THEM TO BECOME EMPLOYEE THAT WORK SIDE BY SIDE WITH US IN THE FEDERAL WORKFORCE HAS BEEN JUST NOTHING SHORT OF THE MOST AMAIDSING PART OF MY 30 YEAR CAREER. THAT'S WHY WE'RE SO EXCITED TO BE HERE WITH US TODAY TO SHARE WITH YOU THIS PROGRAM THAT THE NIH HAS TAKEN ON OVER THE PAST FOUR YEARS TO HIRE INDIVIDUALS WITH INTELLECTUAL DISABILITIES. SO THIS PROGRAM IS CALLED PROJECT SEARCH AND THIS IS A VERY UNIQUE BUSINESS-LED PROGRAM THAT TAKES PLACE ENTIRELY IN THE WORKPLACE. AND HAVING A PROGRAM LIKE THIS THAT IS TOTAL WORKPLACE IMMERSION HAS A LOT OF BENEFITS TO OUR YOUNG PEOPLE WE BRING IN AS INTERNS. THE BENEFITS ARE THAT WORKPLACE IMMERSE FACILITATES A VERY SEAMLESS COMBINATION OF CLASSROOM INSTRUCTION, CAREER EXPLORATION, AND HANDS-ON TRAINING IN THE WORKPLACE AND WE BRING IT ALTOGETHER TO SUPPORT EACH COMPONENT. OUR PRIMARY OBJECTIVE FOR THESE YOUNG PEOPLE IS REALLY TO GET THEM--WHAT WE CALL EMPLOYMENT READY BY THE END OF THE PROGRAM AND THAT MEANS THAT THEY HAVE DEVELOPED AND IDENTIFIED AND DEVELOPMENT CORE SKILLS AND AND APPROPRIATENESS IN THE WORKPLACE IN TERMS OF BEHAVIORS THAT THEY ARE ELIGIBLE FOR ENTRY LEVEL GOVERNMENT POSITIONS. AND THIS PROGRAM PROJECT SEARCH WAS FOUNDED IN 1996 AT THE CINCINNATI CHILDREN'S HOSPITAL AND MEDICAL CENTER BY TWO-CONFOUNDERS AARON REILLY AND SUSIE RITOUSKI AND IT'S IN NOW OVER 200 SITES ACROSS THE UNITED STATES, ENGLAND, SCOTLAND, AUST AUSTRALIA AND CANADA. IT'S WIDE SPREAD. IT'S IN HOSPITALS. IT'S IN BUSINESSES. IT'S IN BANKS. IT'S IN MONTGOMERY COUNTY GOVERNMENT SYSTEM AROUND HERE AS WELL AS THE SMITHSONIAN AND US. WE'RE KIND OF THE THREE CORE PROJECT SEARCHES HERE IN THE METROD. C. AREA. --METRO D. C. AREA. SO HOW DOES THIS PROGRAM? THE FIRST COMPONENT IS THE NIH AND THE NIH IS THE BUSINESS SITE. WE PROVIDE THE WORK SITE FOR TRAINING. WE ALSO PROVIDE THE EMPLOYEES AS MANAGERS, SUPERVISORS AND MENTORS FOR THIS PROGRAM. IVY MOUNT SCHOOL THAT MAUREEN MENTIONED IS IN ROCKVILLE AND THEIR POST-HIGH SCHOOL PROGRAM PROVIDES PROVIDES APPLICANTS--WE RECRUIT FROM THEM TO FILL OUR SLOTS. THEY ALSO PROVIDE A FULL-TIME ONSITE EDUCATIONAL INSTRUCTOR AND THAT SUPPORTS CLASSROOM ACTIVITY. SEEK AND STEVE IS OUR LEADER FROM SEEK IS THEY PROVIDE APPLICATIONS MRI KAIB CANTS AS WELL SO WHEN HE HAS CLIENTS THAT ARE YOUNG ADULTS THEY ARE APPROPRIATELY SCREENED AND REFERRED TO US FOR OUR PROGRAM AS WELL AND THEY PROVIDE OUR JOB DEVELOPMENT AND ONSITE JOB COACHES. AND THEN WE HAVE PROJECT SEARCH, SO THESE THREE PIECES, NIH, IVY MOUNT AND SEEK, ARE REALLY THE LEADER COMPONENTS TO SUPPORT THE PROJECT SEARCH MODER MODEL HERE AT NIH. AND IT PROVIDES AN AMAZING INFRASTRUCTURE OF CURRICULUM AND GUIDANCE AND TERMS OF HOW TO SET UP AND RUN AND SUSTAIN A PROGRAM. THEY ALSO BRING IN OUTSIDE SUPPORT FOR EDUCATIONAL AND JOB DEVELOPMENT. SO IF YOU LOOK AT THE PROGRAM IN WHAT IT IS AND HOW IT LOOKS ON A DAY-TO-DAY BASIS. IT IS 30 WEEKS AND IT'S AN UNPAID PROGRAM SO BASICALLY OUR INTERNS ARE VOLUNTEERS DURING THAT 30 WEEK PERIOD. IT'S BROKEN UP INTO 10 WEEK PRORATIONS. THAT MEANS ONE INTERN HAS THE OPPORTUNITY TO WORK IN THREE DIFFERENT PLACES ACROSS THE NIH AND GET A FEEL FOR DIFFERENT JOB TASKS, DIFFERENT WORK ENVIRONMENTS, EVERY OFFICE OR SITE IS DIFFERENT IN TERMS OF THE TYPE OF PEOPLE, HOW MUCH ACTIVITY, HOW MUCH CUSTOMER CONTACT, FACTORS LIKE THAT. THE INTERNS ARE MATCHED TO THESE WORK SITES. BASED UPON THEIR SKILL AND EMPLOYMENT TOLERANCE AND THOSE--THOSE TWO THINGS WE DO A REALLY GOOD JOB OF REALLY INDIVIDUALIZING AND UNDERSTANDING FOR EACH OF OUR INTERNS. SO THAT THEY HAVE THE BEST OPPORTUNITY FOR SUCCESS IN EACH OF THESE ROTATIONS. IT IS MONDAY THROUGH FRIDAY. IT'S PRETTY MUCH A NORMAL TYPE WORK DAY SITUATION. THEY COME IN AT 8:30. THEY ARE HERE UNTIL 2:30. THERE'S ONE HOUR OF SUPPORTIVE CLASSROOM ACTIVITY AND THE REST IS IMMERSION INTO THE WORKPLACE AND WORK TAG ENTIRE TIME. SO OUR GOAL REALLY GOES BEYOND JUST GETTING THESE PEOPLE JOBS. IT'S REALLY SETTING THEM UP FOR THE START OF A CAREER. SO THAT THEY CAN ACHIEVE A LIFETIME OF SELF-SUFFICIENCY, SO IT'S NOT--WE DON'T JUST HOLD THE CARROT OUT, YOU KNOW YOU DO THIS 30 WEEK PROGRAM AND WE GET YOU A JOB, BOOM, THAT'S IT. THIS IS REALLY SELECTIVELY PLACING THESE YOUNG PEOPLE TO MAXIMIZE THEIR POETIC POTENTIAL FOR SUCCESS. AND THEN POST-HIRE, ONCE THEY ARE HIRED PROJECT SEARCH OFFERS A WHOLE SECOND LAYER PROGRAM TO SUPPORT THE NEW HIRE ASK THAT GOES ON FOR THE FIRST TWO YEARS AND IT'S SCHEDULE, YOU HAVE A TWO YEAR PROBATIONARY SO OUR PROJECT TEAM SUPPORTS THOSE YOUNG PEOPLE IN THAT TWO YEARS. JUST TO GIVE YOU AN EXAMPLE OF THE TYPES OF ASSIGNMENTS THAT OUR INTERNS HAVE AND I WILL TELL YOU THAT WE STARTED FIRST YEAR, JUST IN THE CLINICAL CENTER, AND AFTER THE FIRST YEAR, WE EXPANDED ACROSS THE NIH AND WE NOW HAVE 12 I. C.s THAT ARE PARTICIPATING TO SUPPORT OUR WORK SITES AND OBVIOUSLY A HIGHER IN OUR INTERNS AS WELL. SO WHAT HAVE WE ACHIEVED OVER THE PERIOD OF TIME AND THE DATE I HAVE UP HERE IS REFLECTING OUR FIRST THREE YEARS, OUR FOURTH YEAR CONCLUDES A WOKE FROM THURSDAY. AND--WEEK FROM THURSDAY AND OUT OF OUR CLASS OF 12 THAT WILL BE GRADUATING AT THAT TIME, EIGHT HAVE ALREADY RECEIVED JOB OFFERS HERE AT NIH BUT I HAVE NOT INCLUDED THAT IN THIS DATA SO GIVEN OUR FIRST THREE YEARS, WE GRADUATED 33 INTERNS AND HIRED--25 RECEIVED PAID EMPLOYMENT POST HIRE. SO THAT IS A HIGHER RATE OF A LITTLE OVER 75% AND THEN WE ALSO TRACK THE SUSTAINABILITY OF OUR HIRES, AND SO ONCE THEY'RE HIRED, HOW MANY ARE STILL IN THAT JOB AT THE END OF YEAR ONE, YEAR TWO AND SO FORTH. SO FAR 84% OF OUR HIRES HAVE BEEN SUSTAINED. SO WE'RE PRETTY PROUD OF THIS. BUT MORE THAN JUST THE NUMBERS, WE'RE JUST PROUD OF THE ACHIEVEMENTS THAT THESE YOUNG PEOPLE HAVE MADE AND WE'RE PROUD OF THIS ORGANIZATION. WE HAVE SEEN SO MUCH IN THE WAY OF CULTURE CHANGE, ACCEPTANCE, INCLUSION, REALLY APPRECIATING WHAT THESE YOUNG PEOPLE BRING TO THE WORK SETTING. AND ONCE YOU'VE EXPERIENCED IT, THERE'S A BIT OF MAGIC INVOLVED IN IT AND IT'S HARD FOR ME TO EXPLAIN BUT I'M LOOKING AT SOME OF OUR WORK SITE SPONSORS IN THE AUDIENCE AND I SEE THE SMILE ON THEIR FACE, KNOWING AND UNDERSTANDING WHAT I'M SAYING. SO NOW I WILL TURN IT OVER TO STEVE WHO WILL TALK ABOUT THE CHALLENGES THAT THEY FACE IN THE WORKPLACE AND HOW PROJECT SEARCH ADDRESSES THAT. >> THANK YOU DENISE. LET ME SEE IF I CAN WORK THE CLICKER. SO JUST A BIT MORE ABOUT MYSELF. I'VE BEEN IN THE FIELD DISABILITY WORKFORCE DEVELOPMENT FOR 15 YEARS. AND FOR MOST OF THAT TIME IT'S BEEN NOT WORKING WITH A SUCCESSFUL PROJECT SEARCH PARTNERSHIP, THAT'S REALLY ONLY HAPPEN INDEED THE LAST FEW YEARS. SO FOR THE FIRST 10 YEARS OF MY CAREER, WE WERE OUT THERE WORKING WITH MOM AND POP STORES, WITH WORKING WITH DIFFERENT TYPES OF ORGANIZATIONS TO TRY AND FIND EMPLOYMENT. IT'S HARD. IT'S VERY HARD AND THE CHALLENGES ARE OBVIOUS AND THEY TALKED ABOUT THE CHALLENGES AROUND INTELLECTUAL FUNCTIONING AND SOCIAL ADAPTATION AND THE SWEET SPORT FOR MAKING SURE THAT WE GET TO--SWEET SPOT FOR GETTING TO COMPETENCIES AND EMPLOYMENT FOR THESE YOUNG PEOPLE THERE. 'S A STUDY OUT THERE THAT SAYS, INDIVIDUALS WITH INTELLECTUAL DISABILITIES 10 YEARS OUT AFTER SCHOOL IF THEY DON'T HAVE A JOB COMING RIGHT OUT OF SCHOOL, 90% OF THEM WILL STILL NOT HAVE A JOB 10 YEARS LATER. SO THIS PROGRAM IS CRITICAL TIMING, IT'S CRITICAL SUPPORT AND INFRASTRUCTURE, THE CHALLENGES IS MORE OF AN EXPERT DISABILITY OF THE CHALLENGES BUT THE INTELLECTUAL FUNCTIONING IS AROUND THE BASIC DECISION MAKING. JUDGMENT, PROBLEM SOLVING AND JUDGMENT FOR WORK RELATED ACTIVITIES AS WELL AS LIFE RELATED ACTIVITIES. CROSSING STREETS AND VARIOUS OTHER ACTIVITIES OF DAILY LIVING. SOCIAL ADAPTATION, COMES IN MANY DIFFERENT FLAVORS OF COMMUNICATION, SOCIALLY APPROPRIATE BEHAVIORS, BOUNDARIES, AND I BE A LOT OF PEOPLE LOOKING AROUND SAYING, WELL I BE I HAVE A LOT OF NEW YOUNG EMPLOYEES WHO HAVE THESE CHALLENGES AND THEY'RE QUITE SIMILAR TOW SOME OF THE YOUNG PEOPLE HOWEVER THEY'RE OFTEN MORE PRONOUNCED. SO THESE ARE THE TYPICAL CHALLENGES, THIS POPULATION IS FACING, WHAT--WHAT MAUREEN HAS TALKED A LOT ABOUT IS SIGNATURES STIGMA. THE SIGMA HAS COME ABOUT OFTEN BOTS OF THE INDUSTRY THAT I'VE--I WORK IN. WE STARTED WORK PREGNANT INDIVIDUALS MANY MOONS AGO IN SEGGREGATED SITTINGS. THEY OFTEN WERE IN INSTITUTIONS AND THE ONLY OPTION FAMILIES HAD FOR THEIR SON OR DAUGHTERS COMING OUT OF SCHOOL OR BEFORE SCHOOL. BEYOND SEGGREGATION WHEN THE MOVE TOWARDS KIND OF MORE INCLUSION CAME ABOUT, WHAT HAPPENED WAS, THE INDUSTRY MOVED TO SMALLER SEGGREGATION SO THERE'S SHELTERED WORKSHOPS WHICH MANY OF YOU MAY BE FAMILIAR WITH, THROUGHOUT THE COUNTRY, AND STILL 60% OF INDIVIDUALS WITH INTELLECTUAL DISABILITIES THROUGHOUT THIS NATION ARE IN SEGGREGATED SHELTERED WORKSHOPS AND NOT GIVEN THE OPPORTUNITY FOR COMPETITIVE EMPLOYMENT LIKE THIS PROGRAM OFFERS. SO THERE'S AN ISSUE AROUND JUST EMPLOYEE AWARENESS. EMPLOYEES AWIVE DON'T KNOW THE INDIVIDUALS WITH INTELLECTUAL DISABILITIES WHO ARE LOOKING FOR OR COMMITTED TO WORK OR INTERESTED IN WORK. THERE'S OFTEN A LACK OF NOTION OF PRESUMPIVE EMPLOYMENT, COMPETENCY THAT SOMEONE WITH AN INLECTUAL DISABILITY CAN WORK AND HOW CAN THEY WORK AND WHERE CAN THEY WORK. AND OFTEN NEGATIVE COWORKER PERCEPTIONS. I'M SURE ALL OF US IN THE AUDIENCE HAVE MET AN INDIVIDUAL WITH DOWNS SYNDROME WHO'S A BAGGER AT SOME OTHER GROABRY STORE, THAT IS OFTEN THE CONNOTATION THAT EVERYONE COMES WITH IS THAT WHERE AN INDIVIDUAL WITH INLECTUAL DISABILITY BELONGS OR MAY BE COMPETENT. AND WITH PROJECT SEARCH WE'RE TRYING TO SMASH THAT NOTION BECAUSE THAT IS INCORRECT. THERE ARE INDIVIDUAL WHO IS'VE BEEN BAGGER WHO IS HAVE GONE THROUGH THE PROGRAM ARE SUCCESSFUL AND LAUNCHING CAREERS IN THE FEDERAL GOVERNMENT SO WE'RE HOPING TO BREAK THAT COMPLETELY. SO ALL OF THESE CHALLENGES, ALL OF THE STIGMA, PERCEPTIONS CLEARLY GETS IN THE WAY. THE--THE EMPLOYMENT RATE FOR INDIVIDUALS WITH INTELLECTUAL DISABILITIES IS AROUND 23% SO IN FACT, ON THE SLIDE HERE, IT SAYS 30% BELOW THE NATIONAL RATE, THAT'S FOR ALL PEOPLE WITH ALL DISABILITIES, INDIVIDUALS INTELLECTUAL DISABILITY SYSTEM EVEN MORE CRITICAL, UNEMPLOYMENT RATE, THE GAPS OF COURSE ARE MORE FOCUSED WITH INDIVIDUALS BETWEEN 18 AND 21. THE YOUTH, THE TRANSITIONING YOUTH THAT WE'RE TALKING ABOUT AND AS MAUREEN WILL TELL YOU VERY MUCH SO, ONCE SHE GETS HER Ph.D. DONE, THE STIGMA AROUND THESE INDIVIDUALS, THE PERCEPTIONS THAT THESE INDIVIDUALS PACE FROM EMPLOYERS, COMMUNITY MEMBERS, FROM NEIGHBOR SYSTEM CONSTANTLY GETTING IN THE WAY OF THE EMPLOYMENT, THE POSSIBILITIES FOR THESE INDIVIDUALS. SO HOW DOES--HOW DOES THIS ALL FIT IN. WELL, PROJECT SEARCH ALLOWS BUSINESSES, ALLOWS EMPLOYERS, COWORKER TO GET A CHANCE TO MEET AN INDIVIDUAL, TO UNDERSTAND WHO THEY ARE. TO LEARN THE COMPETENCIES TO REALLY PUT THEIR SKILLS IN THE RIGHT PLACE AND THE SUPPORT OF THIS SPRM ALLOWING THESE CONNOTATIONS, THESE RESULTS TO GET SMASHED AS DENISE SAID, THE RESULTS ARE 75-80% UNEMPLOYMENT RATE VERSES A NATIONAL RATE OF AROUND 25%. --I'VE GOT FLYING BRIDGES IN HERE I'M SURE. OKAY, SO, THIS IS MAUREEN'S SLIDE HERE THAT I'M GOING TO WORK OUR WAY THROUGH, BUT THIS TALKS TO THE PROJECT SEARCH CONTRIBUTION. AS WE TALKED ABOUT THE FIRST ENTRY POINT ARE THE INTERNS, THE YOUNG PEOPLE WITH INTELLECTUAL DISABILITIES AND THE KEY DIFFERENCE HERE IS THE HOST BUSINESS IS PART OF THE SELECTION COMMITTEE, SO SEEK AND THE HOST BUSINESSES COME TOGETHER TO LOOK FOR INDIVIDUALS AND RECRUIT INDIVIDUALS AND WE'RE NOT JUST LOOKING FOR ANYONE WITH INTELLECTUAL DISABILITY BUT IT'S ALL ABOUT EMPLOYMENT, IT'S ALL ABOUT A COMPETENCY, COMMITMENT AND WILLING WILLINGNESS TO WORK, THIS IS A VERY INTENSIVE PROGRAM. WHAT ELSE DO WE NEED? WELL, WE NEED WILLING AND PARTICIPATORY INTERNSHIP SITES. WE NEED THE ORGANIZATIONAL MENTORS TO COME INTO PLACE AND THAT'S INDIVIDUALS WHO MAY BE SUPERVISORS RIGHT NOW OR INDIVIDUALS OR COWORKERS AND THOSE ARE THE INDIVIDUALS THAT THE HOST BUSINESS PROVIDES, TO PROVIDE THESE OPPORTUNITYITOSE ALLOW THESE INDIVIDUALS AND COMPETENCIES TO GROW AND DEVELOP, BUT WHAT IS THE KEY IS THE PROJECT SEARCH TEAM AND THEY'RE HERE TODAY SO WE WANT--I WILL LET THEM. SORT OF RECOGNIZE THEMSELVES A LITTLE BIT. THE PROJECTS SEARCH TEAM. >> YEAH. >> IT'S AS DENISE--AS DENISE MENTIONED, IT'S MADE UP OF FULL-TIME INSTRUCTOR AND TWO JOB COACHES WITH THOSE INTERNS AND OUR POST-HIRE SUPPORT TO MAKE SURE THOSE INDIVIDUAL WHO IS ARE EMPLOYED REMAIN SUSTAINABLE EMPLOYEES GROWING AND DEVELOPING AND IT'S THE TRIFECTA OF SUPPORT AND ENVIRONMENTS AND COMMITMENT TO INCLUSION THAT ALLOWS THESE GUYS TO GROW AND DEVELOP AND THROUGH 10 MONTHS, THESE INDIVIDUALS INDIVIDUALS GET A CHANCE TO TRY VERY MANY DIFFERENT ACTIVITIES SOME OF THEM ARE SUCCESSFUL, SOME OF THEM FAIL AND THAT'S PART OF THE EXPLORATION THAT THEY'RE LEARNING TOWARDS GROWTH AND DEVELOPMENT BUT AGAIN, WE'RE HAVING THESE INDIVIDUALS COME AWAY WITH 10 MONTHS OF SKILL DEVELOPMENT AND ALLOW THEMSELVES TO PROVE THEMSELVES TO SHOW THEIR COMPETENCIES TO THE EMPLOYERS AND I'M GOING TO TURN IT OVER RIGHT NOW TO ONE OF OUR ALL-STAR WHO IS IS A FARMER INTERN AND NOW A SUCCESSFUL EMPLOYEE WITH THE CLINICAL CENTER AND ANOTHER ALL-STAR HER MENTOR AND SUPERVISOR, I WILL HAVE DENISE FACILITATE THESE GUYS TO TELL US MORE ABOUT THE PRODUCT SEARCH AND SUCCESSES GOING FORWARD. [ APPLAUSE ] >> I'D LIKE TO INTRODUCE TO YOU AMETHYST THORTON. SHE WAS I GRADUATE IN OUR PROJECT SEARCH CLASS IN 2011. AND SHE IS NOW--SHE IS A CLERK IN OUR ADMISSIONS AND VOUCHER OFFICE AT THE CLINICAL CENTER AND SHE WORKS IN THE PATIENT SUPPORT SERVICES DEPARTMENT. MONIQUE, MONIQUE HARRISON IS HER SUPERVISOR, SHE'S THE SUPERVISOR IN ADMISSIONS AND VOUCHER. AND THAT'S PATIENT SUPPORT SERVICES DEPARTMENT. MONIQUE'S BEEN A PART OF THE CLINICAL CENTER STAFF FOR HOW MANY YEARS? >> ALMOST SIX. >> ALL RIGHT, SO, WHAT I WOULD LIKE IS IF MISS AMETHYST, IF YOU COULD TELL US A LITTLE BIT ABOUT WHAT YOU DO? TELL US A LITTLE BIT ABOUT WHAT YOU STARTED, YOUR JOB LOOKED LIKE WHEN YOU WERE WERE FIRST START INDEED 2011 AND NOW THAT IT'S ALMOST THREE YEARS, TELL BE THREE YEARS IN JUNE THAT SHE'S BEEN IN HER POSITION AND WHAT IT LOOKS LIKE NOW. START WITH BACK IN 2011. >> OKAY, I COULD TELL YOU THAT. WELL, TO BE HONEST WHEN I FIRST GOT HIRED FROM--AFTER I WAS WITH PROJECT SEARCH I STARTED OUT FILING AND THAT TIME I WAS USING PAPER. AND THEN THAT CHANGED WHEN I'D BEEN TOLD FROM DENISE AND A FEW OTHERS THAT WE WERE GOING PAPERLESS. AND SINCE THEN I'VE BEEN SCANNING VOUCHERS. >> SO HOW IMPORTANT IS WHAT YOU DO? >> VERY GOOD QUESTION. ALL RIGHT. OKAY. [LAUGHTER] ALL RIGHT. I WOULD SAY IT'S SO IMPORTANT THAT EVEN ALL OF MY COLLEAGUES AND YOURS TRULY AND MY SUPERVISOR, NEVER FELT SO PROUD. I WOULD SAY THAT WOULD BE EXTREMELY IMPORTANT IN MY BOOK. >> HOW DO YOU FEEL ABOUT PROJECT SEARCH PREPARED YOU TO BE SUCCESSFUL IN THIS JOB? WHAT DO YOU THINK PROJECT SEARCH DID FOR YOU, THE PROJECT SEARCH PROGRAM IN TERMS OF HELPING YOU BE SUCCESSFUL AND THE JOB YOU HAVE NOW? >> ALL RIGHT. WELL, I'VE LEARNED SOME LIFE LESSONS ABOUT ADULTHOOD, KNOWING HOW IMPORTANT IT IS AS FAR AS WORKING AT A JOB. I'VE LEARNED A LOT OF STUFF FROM PROJECT SEARCH BECAUSE THEY'RE ONE OF THE MAIN FACETS THAT HELPED ME OUT WHEN I'M HAVING TROUBLE AS FAR AS WORKING AND BECOMING AN EMPLOYEE. >> TELL US ABOUT YOUR SUPERVISOR, MONIQUE? >> I CAN HONESTLY TELL YOU THAT SHE IS A GREAT RESOURCE, SUPER EFFICIENT, I LIKE THAT IN A SUPER VISOR AND SHE MADE ME SO PROUD AND I'M PROUD, IT MAKES ME FEEL GOOD. SHE'S NICE, SHE'S AWESOME SHE KNOWS WHAT PRODUCTIVITY IS ALL ABOUT AS FAR AS WORKING AT A FEDERAL GOVERNMENT SHOP. SHE'S ONE OF THE MAIN PEOPLE TO GO TO AS FAR AS JOB WISE AND I LIKE THAT. >> YOU SAID THAT VERY WELL. YOU DID SO MONIQUE SHARE WITH US A LITTLE BIT ABOUT HOW--WHAT IMPACT HAS AMETHYST HAD TO YOUR WORK TEAM? >> SO, I THINK AMETHYST'S IMPACT HAS BEEN TREMENDOUS. WHEN WE HAVE A STAFF OF MAYBE 20 EMPLOYEES, TWO DIFFERENT SERVICE AREAS ADMISSIONS AND VOUCHER SO AMETHYST WAS HIGH HIRED TO WORK IN BOTH AREAS SO THERE IS A VARIETY OF TEAM MEMBERS THAT COME IN AT DIFFERENT TIMES OF THE DAY. SO WHEN AMETHYST FIRST STARTED WITH US, THEY WERE NERVOUS BECAUSE WHAT WE TALKED ABOUT EARLIER, THE STIGMAATISM OR JUST NOT KNOWING SO WE HAD A JOB COACH TO COME IN. WE DID A LOT OF TALKING AND COMMUNICATING SO AS TIME WENT ON, AMETHYST IS JUST ONE OF THE STAFF MEMBERS, TEAM MEMBERS. SHE WORKS WELL WITH OUR COLLEAGUES. SHE'S MADE A LASTING IMPACT ON US ALL. WE'VE LEARNED FROM HER. SHE'S LEARNED FROM US; WE DON'T HAVE TO DO ANYTHING DIFFERENTLY OR I DON'T TRAIN HER ANY DIFFERENTLY THAN I WOULD ANOTHER EMPLOYEE. WE MAY SIT DOWN WITH EACH OTHER AND GO THROUGH THE INFORMATION BUT AS FAR AS HER BEING ABLE TO COMPLETE A TASK WHENEVER I ASSIGNED ONE TO HER, SHE'S ABLE TO DO IT. SHE STARTED FILING IN THE VOUCHER OFFICE, BUT NOW WE DO DO SCANNING AND IN ADMISSIONS SHE PULLS CHARTS, PREPARES THE PAPERWORK FOR THE NEXT DAY. SHE KNOWS ABOUT PATIENT CONFIDENTIALITY, RIGHT? SHE HELPS US TRANSMIT DOCUMENTS TO DIFFERENT PEOPLE IN DIFFERENT PLACES AND SHE'S JUST BEEN A VALUABLE OR INVALUABLE EMPLOYEE TO US. THERE'S BEEN SUPPORT FOR AMETHYST AND MYSELF THE WHOLE TIME SHE'S BEEN HERE. WE DON'T REALLY RELY ON OTHER SUPPORT OR WHOLE LOT, AS I'M BEING HONEST RIGHT NOW. WE HAVE A REALLY, REALLY GOOD WORKING RELATIONSHIP SO IF THERE'S A QUESTION, I'M ABLE TO ANSWER IT, THE TEAM'S COMFORTABLE SPEAKING WITH AMETHYST, SHE'S COMFORTABLE ASKING QUESTIONS SO WE DO VERY WELL AS A GROUP WHEN IT COMES TO MAKING DECISIONS. >> RIGHT. >> THANK YOU. >> SO YOU GUY CANS SEE WHY THEY'RE ALL-STARS, RIGHT? >> THANKS FOR SHARING WITH THE GROUP AND I THINK ASTERISKS THIS POINT WE WOULD LIKE TO OPEN IT FOR QUESTIONS. COMMENTS? >> IF YOU HAVE A QUESTION, CAN YOU PLEASE COME TO THE MIC IN THE MIDDLE OF THE AISLE? >> GREAT PRESENTATION, THANK YOU SO MUCH. IS THE PROJECT SEARCH AVAILABLE TO EMPLOYERS THAT HAVE BEEN HERE A LONG TIME? AND MAYBE THEIR CURRENT JOB REALLY DOESN'T MEET THEIR SKILL LEVEL? IS THAT A POSSIBILITY TO HAVE AN EMPLOYEE CONTACT YOU? >> SO THE PROGRAM ITSELF IS REALLY CONCENTRATED ON YOUTH 18-24. >> THAT'S RIGHT. >> SO SOMEBODY WHO MAY BE A LITTLE OLDER MAY NOT FIT INTO THE GROUP DYNAMIC AND THAT'S A PIECE OF THE PROGRAM ITSELF. SOMEONE WHOSE OLDER WHO MAY NOT BE MATCHED WELL, POSITION WISE, THAT'S SOMETHING YOU CAN APPROACH US AFTERWARDS AND WE CAN TALK. >> GOOD, THANK YOU. >> AMETHYST, I HAVE A QUESTION FOR YOU. I WONDER HOW PEOPLE HAVE MADE YOU FEEL WELCOME AND INCLUDED IN YOUR WORKPLACE. >> WHOA. [LAUGHTER] >> WOW,--OH--GOOD QUESTION. WELL, FOR ONE THING ABOUT THE HUDDLE, THE HUDDLE TO ME IS EXTREMELY IMPORTANT AND THERE'S A REASON FOR THAT. MONIQUE SHE TELLS US SOME GOOD INFORMATION LIKE MAINLY THE INFORMATION OF WHAT'S HAPPENING AS FAR AS PSS, THAT'S PATIENT SUPPORT SERVICES AND FOR EXAMPLE, THERE'S LIKE THE RENOVATION THAT MY DEPARTMENT WE--WE END UP DOING DIFFERENT AREA AREAS MONIQUE TOLD ME THAT I'LL BE GETTING MY OWN AREA. >> SHE WILL HAVE HER OWN DESK, OWN COMPUTER. BUT WHY DON'T YOU TALK A LITTLE BIT HOW YOU'RE INCLUDED WHEN YOU INITIALLY STARTED WE WOULD HAVE CELEBRATE BIRTHDAYS AND AROUND CHRISTMAS AND WE HAD TO SHOW THAT WE WOULD ALL EITHER CHIP IN MONEY TOGETHER-- >> OH YEAH, OR ICE CREAM SOCIALS. >> THAT'S RIGHT. BECAUSE I COULD GIVE YOU AN EXAMPLE. THE CHRISTMAS PARTY, I ENJOYED IT BECAUSE THERE'S A SECRET SANTA. AND ANOTHER THING AT ONE POINT WE HAD A POT LUCK AND THE POT LUCK WE BRING OUR OWN FOODS AND DRINKS. REALLY FUN, LOVE, REALLY FUN ACTIVITY AND EVENT. --I, TO ME, I LOVE BEING INCLUDED BECAUSE IT'S SUCH AN HONOR THAT'S ONE REASON. AND ANOTHER REASON KNOWING HOW IMPORTANT IT IS TO WORK AT ONE OF THE BIGGEST RESOURCES AS FAR AS HOSPITAL RESEARCH AND I NEVER FELT THIS PROUD SO THANKS FOR THE QUESTION, I APPRECIATE IT. >> THANK YOU. >> YOU KNOW MY QUESTION IS FOR SITES OUT THERE, THAT MIGHT BE THINKING ABOUT EXPLORE THANKSGIVING OPTION, COULD YOU SHARE WITH US, WHAT WOULD YOU LIKE TO SEE OR WHAT'S THE IDEAL SORT OF APPROACH. YOU KNOW IS IT--A SITE HAS TO HAVE A JOB IDENTIFIED, IS IT THE RIGHT ATTITUDE, COMMITMENT FROM MANAGEMENT OR WHAT IS THAT SPECIAL SAUCE THAT'S NEEDED? >> SO, GOOD QUESTION. SO IF ANYONE IS INTERESTED IN JUST EXPLORING WHAT PROJECT SEARCH COULD OFFER YOUR AREA, JUST SEND ME AN E-MAIL AND WE WILL--OUR TEAM BETWEEN STEVE AND LOU AND MYSELF, WE WILL SIT DOWN AND MEET WITH YOU. YOU DO NOT HAVE TO HAVE ANYTHING GELLED IN YOUR HEAD AS FAR AS EXACTLY WHAT AN INTERN WOULD DO IN YOUR SITE--THAT'S REALLY OUR JOB. IS TO TALK TO YOU AND SEE WHAT GOES ON IN YOUR WORK AREA AND WE CAN SUGGEST THE TYPES OF JOBS THAT--OR JOB SKILLS AND TASKS THAT DO IMPORTANT THINGS IN YOUR AREA. IT'S A 10 WEEK COMMITMENT AND THEN, YOU KNOW IF YOU--YOU DON'T HAVE TO SIGN ON EVERY 10 WEEKS, CAN YOU TRY IT OUT AND SEE HOW IT IMPACTS YOUR AREA. STEVE DO YOU WANT TO-- >> YEAH, I THINK--THAT'S EXACTLY RIGHT. YOU DON'T NEED TO HAVE EACH THE FAINTEST IDEA OF WHAT AN INTERN MAY DO, YOU JUST NEED TO HAVE US IN FOR HALF AN HOUR, 45 MINUTES. WHAT GENERALLY WORKS WELL IS A CONVERSATION WITH THE MANAGEMENT, CONVERSATION WITH TEAM MEMBERS, AND CONVERSATION ABOUT WHAT ARE THE NATURAL WORK FLOWS AND PROCESSES AND WHAT YOU DO. THROUGH THAT WE CAN START UNBUCKLING AND UNRAVELING SOME OF THE TASKS THAT MAY WORK AND IT MAY START WITH AGAIN VERY STRAIGHT FORWARD ROUTINE ENTRY LEVEL TASK BUT HOPEFULLY BUILD AND THAT'S WHAT WE'RE LOOKING FOR IS THE SLOW BUILD AND LAYERING OF THE TASKS. >> HI, I'M INTERESTED IN ASPECTS OF INCLUSION AND HOW BASED UPON YOUR INTERACTIONS WITH SUPERVISORS HOW INCLUDING THIS POPULATION HAS OPENED OTHER SPACES TO DISCUSS ISSUES OF DIFFERENCE IN THE WORKPLACE AND WHAT'S YOUR TAKE--TAKE AWAY FROM THOSE CONVERSATIONS WITH MANAGEMENT AND SUPERVISORS BASED ON THE PROGRAM HERE AROUND INCLUSION? LIKE HOW DO WE--HOW DO WE UTILIZE OR LEVERAGE THE WORK THAT YOU'VE DONE TO KIND OF CREATE INCLUSIVE SPACES AROUND OTHER ISSUES OF DIFFERENCE IN KD--SALLY--AND THROUGHOUT THE NIH. >> THAT'S AN IMPORTANT QUESTION AND I THINK ONE OF THE BIGGEST THING SYSTEMS IS THAT ACTUALLY BRINGING PROJECT SEARCH INTO A DEPARTMENT OR OFFICE OR A SECTION DIVISION OPENS THE DOOR. AND LEVERAGE IS THE RIGHT WORD BECAUSE IF WE GET AN INTERN IN A GENERAL OFFICE AREA OR WORK SPACE, IT SPREADS. PEOPLE ARE--AMETHYST IS VERY TYPICAL OF THE OUTGOING NATURE OF OUR INTERNS AND THE GENUINENESS AND THERE'S A BIT OF A MAGIC. I CAN'T--I CAN'T DESCRIBE IT IN CONCRETE WORDS BUT IT'S JUST AN IMPACT ON THE WORK SETTING. IT MAKES IT REAL. IT SOMETIMES, WHEN THERE'S REALLY BUSY AREAS, I KNOW AROUND OUR HOSPITAL, IT CAUSES PEOPLE TO HAVE TO SLOW DOWN A LITTLE BIT. AND REALLY BE COGNIZANT ABOUT AN INTERACTION, A VERY MEANINGFUL INTERACTION TO HEAR AMETHYST SHARE ABOUT THE IMPORTANCE OF PRODUCTIVITY IN A WORK AREA. IT HAS AN AMAZING IMPACT ON PEOPLE IN OTHER AREAS. PEOPLE WHO HAVE WORKED THERE FOR SEVERAL YEARS WORK LOOK AT THEIR TEAM AND WORK DIFFERENTLY. THIS IS A FULLY INTERNATIONAL FULL--FULLY INTEGRATED WORK PROGRAM. WE DON'T MAKE ANY CONCESSIONS. SO WHEN SHE WAS TALKING ABOUT THE POT LUCK, AMETHYST HAS TO BRING SOMETHING, SO MAYBE AS AN INTERN, AND SHE WAS TREATED A BIT, BUT WHEN YOU'RE AN EMPLOYEE, YOU CONTRIBUTE LIKE EVERYBODY ELSE DOES. PERFORMANCE STANDARDS, PMAPS ARE HELD FOR EVERYBODY ELSE AT THAT GRADE IN OUR JOB AND SO OUR GOAL PARTICULARLY IN THE PROBATIONARY PERIOD IS TO MAKE SURE THAT EVERY HIRE AND PERFORMING AT THAT LEVEL OR ABOVE FOR EVERY CRITICAL ELEMENT IN THE P-MAP. SO THERE'S NO CONCEPTIONS LIKE OH IT'S OKAY, IT'S NOT OKAY, THIS IS THE SAME PLATFORM THAT WE HIRE ALL OF OUR GOVERNMENT EMPLOYEES ON AND THEY'RE HELD TO THAT. THAT I BELIEVE REALLY DEVELOPS THE RESPECT FOR THESE YOUNG PEOPLE BECAUSE IT'S NOT LIKE CONCEPTIONS ARE BEING MADE, THEY'RE TREATED LIKE EVERYBODY ELSE AND THAT'S THE REAL INCLUSION AND INTEGRATION AND IN SOME WAYS, LIKE I REMEMBER WHEN AMETHYST WAS FIRST HIRED SOME OF IT'S A LITTLE BIT TOUGH FOR THEM TO HAVE TO TAKE. YOU KNOW, SO WHAT DO YOU MEAN. SO I DIDN'T COME TO WORK ON TIME TWORKS TIMES IN A ROW, I HAVE TO GO MEET WITH MY SUPERVISOR AND TALK ABOUT THAT. YES. AND I MEAN THESE ARE THE STANDARDS EVERYBODY'S HELD TO. SO I THINK THAT HELPS TO CREATE THAT FULLY INTERNATIONAL CLASSIFICATION GRECTED WORK SETTING. >> --INTEGRATED SETTING. >> JUST TO ADD TOXIC EFFECTS WHAT DENISE SAID BECAUSE THAT'S WHAT I DO. WE ALWAYS STRUGGLED ABOUT A TOP DOWN MANDATE LIKE YOU HAVE TO DO IT AND I THINK WE BALANCED SOME OF THAT BUT THIS IS AN ORGANIC PROCESS AND I THINK THAT'S WHAT'S MADE IT KIND OF COOL AND PEOPLE KIND OF BOUGHT INTO IT AND NOT EVERYONE HAS. YOU KNOW WE HAVEN'T HAD PEOPLE OVER HERE SAYING THIS ISN'T THE RIGHT THING TO DO, YOU NEED TO DO IT SO I THINK THAT'S IMPORTANT IS THAT PEOPLE HAVE KIND OF SIGNED UP AND BEEN THE PIONEERS, THE FRONT PEOPLE AND AS THAT ORGANIC THING GROWS LIKE A VIRUS IRONICALLY IN A HOSPITAL, WE BRING ON MORE LIKE PEOPLE DOING LIKE THING WHO IS WANT TO SORT OF LET PEOPLE WITH DIFFERENCES SHOW THEIR COMPETENCIES. WE DO KIND OF LOOK FOR FOLKS THAT KIND OF GET IT, TO HELP US GET INTO THOSE AREAS. NEW AREAS LIKE IF WE'RE TRYING TO KIND OF BREAK INTO A NEW INSTITUTE OR AREA, WE'LL LOOK FOR THAT PERSON THAT CAN HELP US KIND OF TRANSLATE WHAT'S GOING ON IN THAT PARTICULAR OFFICE OR DIVISION. SO IT DEVELOPS. >> I WAS HOPING TERESA WOULD STAND UP. >> WELL THIS GENTLEMAN ASKED THE QUESTION I WAS GOING TO ASK, BUT THIS TEAM MADE A WONDERFUL VIDEO TAKEN--THEY'S STILL UP ON THE WEB SITE THAT GIVES YOU INTERVIEWS WITH OTHER FOLKS WHO PARTICIPATED AND IT'S--IT'S WONDERFUL TO HEAR FROM THEM BUT IT'S RIGHT IN THE SETTING AND IT'S ANOTHER PIECE AND IF YOU ARE INTERESTED AND WANT TO EXPLORE FURTHER. >> TERESA IS ONE OF OUR CHAMPIONS THAT GETS IT IN AT NCI. SO THESE HELPING US. >> I WONDWAS WONDERING COULD YOU EXPANDOT PEOPLE FIRST LANGUAGE, YOU MENTION TODAY IN YOUR PRESENTATION, MAYBE DENISE COULD FOLLOW ON SOMETHING WITH FIRST LANGUAGE WORKS WITH PROJECT SEARCH AS WELL. >> SO THE I THINK THE PEOPLE FIRST LANGUAGE IS EXTREMELY IMPORTANT AND PRIOR TO HAVING THIS SORT OF EXECATION AND I THINK IT'S AN EVOLVING PROCESS TO BE HONEST WITH YOU, I THINK WE TEND TO--WE TEND TO DEFINE PEOPLE BY THEIR DISABILITY OR AT LEAST HAVE DONE SO IN THE PAST SAYING, YOU KNOW, THAT DOWN SYNDROME PERSON AS OPPOSE TO INDIVIDUAL, REFERRING TO THEM AS AN INDIVIDUAL OR A PERSON FIRST WHO HAPPENS TO HAVE DOWN SYNDROME, THEY'RE NOT DEFINED BY THEIR CONDITION JUST LIKE, YOU KNOW WE'RE NOT DEFINED BY THE FACT THAT, YOU KNOW I HAVE FLAT FEET OR I HAVE, YOU KNOW THIS SORT OF ISSUE, SO IT'S REALLY AN EFFORT TO TRY TO RECOGNIZE THE UNIQUENESS OF EACH INDIVIDUAL TO REFER TO AN INDIVIDUAL AS A PERSON EVER MERIT REGARDLESS OF THEIR PARTICULAR SITUATION WITH THE 1975 LEGISLATION, THAT WAS ACTUALLY, THE FIRST--I THINK THE FIRST PUBLIC RECOGNITION OF THE IMPORTANCE OF USING THAT TYPE OF LANGUAGE TO RETO INDIVIDUALS WITH INTELLECTUAL DISABILITIES. >> THERE'S A LOT OF EDUCATION THAT OUR TEAM DOES FOR WORK SITES AND WORK TEAMS AND THAT'S ONE OF THE FIRST THINGS THAT WE INTRODUCE IS HOW TO--YOU KNOW THAT THE LANGUAGE HOW TO REFER TO INDIVIDUALS OR YOUNG PEOPLE WITH AN INTELLECTUAL DISABILITY AS PEOPLE FIRST. ALSO WE USE A LOT OF TOOLS THAT WE HAD A YOUNG MAN WHO WAS HIRED INTO OUR OFFICE OF MEDICAL EDUCATION AND CLINICAL RESEARCH AND YOU KNOW PRETTY HIGHLY STRUCTURED OFFICE. AND THIS YOUNG MAN FOR HIS FIRST STAFF MEETING, WHERE HE WAS INTRODUCED TO THE BIGGER OFFICE STAFF, HE HAD A POWER POINT PRESENTATION, HE USED FOR HIS INTRODUCTION AND THE FIRST SLIDE WAS, YOU KNOW A PICTURE OF HIM AND HIS NAME, THE SECOND SLIDE SAID, I HAVE AUTISM BUT AUTISM DOES NOT DEFINE ME. SO LET ME TELL YOU WHO I AM. AND THEN HE WENT ON WITH THE SUBSEQUENT SLIDES AND TOLD ABOUT HIS INTEREST AND WHAT HE LOVES AND WHAT HE FEELS HES GOOD AT AND HOW BEST TO TEACH HIM HOW TO DO SOMETHING NEW. THAT KIND OF THING. AND THAT'S WHAT IT'S REALLY ABOUT. I MEAN ALL OF THESE YOUNG PEOPLE IN THIS PROGRAM ARE INCREDIBLE PEOPLE, INTERESTS, AMAZING SKILLS AND INTELLECT AND BEING ABLE TO UNDERSTAND THAT AND THEN TO BE ABLE TO ALSO UNDERSTAND THEN WHAT ARE THEIR CHALLENGES AND HOW DO WE BEST NEAT MEET THEIR NEEDS WHETHER IT BE TRAINING COMMUNICATION OF NEW PROCEDURES, WHATEVER IT MIGHT BE AND THAT'S WHERE OUR TEAM COMING IN AND OUR TEAM IS ONSITE ALL THE TIME TO HELP WORK SITES WHO ARE SPONSORING OUR INTERNS AND WITH THE HIRES ONCE THEY'RE HIRED. >> I WAS ALSO WONDERING STEVE COULD YOU TALK A LITTLE BIT ABOUT THE RESOURCES BECAUSE I HEARD MENTION OF JOB COACH A COUPLE OF TIMES AND I KNOW I HAD EXPERIENCES WHERE MANAGERS ARE SOMETIMES A LITTLE HESITANT WHEN I HEAR JOB COACH AND OTHER TYPES OF DIFFERENT TECHNOLOGY AND RESOURCES THAT ARE USED TO MAKE THE EMPLOYMENT SUCCESSFUL. CAN YOU EXPAND ON THAT. >> SO SEEK IS AN ADULT PROVIDER OF LONG-TERM INDIVIDUALS WITH DISABILITIES WE GET FUNDED THROUGH THE STATE OF MARYLAND THROUGH THE DEVELOPMENT DISABILITIES ADMINISTRATION AND SHORT-TERM THROUGH THE DEPARTMENT OF REHABILITATIVE SERVICES SO THAT'S THE FUNDING STREAM. ONE OF THE THINGS WE'VE NOT MENTIONED HERE IS THE ANSWER COST TO NIH. THIS IS USING 55ING PUBLIC RESOURCES TO PROVIDE STRUCTURE AND SUPPORT, THERE'S TWO JOB COACHES THAT ARE ASSIGNED TO THE 12 INTERNS PER YEAR AND YOU KNOW ONE-SIX AND SO THOSE COACHES ARE ON INDIVIDUALS THAT ARE ONE TO ONE WITH THE INDIVIDUALS, THAT IS PART OF THE RECRUITMENT, WE ARE LOOKING FOR INDIVIDUALS THAT HAVE A LEVEL OF INDEPENDENT AND COACH TAG ISN'T GOING TO REQUIRE THAT CONSTANT SUPERVISION AND SUPPORT. SO THE JOB COACHES ARE PART OF THE SEEK ORGANIZATION THAT ARE PROVIDED BY SEEK AND THEY ARE THERE TO AUGMENT THE NATURAL TRAINING, NOT THERE TO TAKE OVER THE TRAINING, WE'RE NOT EXPERTS IN PATIENT SUPPORT SERVICES OR VOUCHERS OR ADMISSIONS ALTHOUGH BY NOW WE MIGHT BE. BUT WE ARE THERE TO AUGMENT WHAT MONIQUE NATURALLY DOES AND THAT MAY MEAN TRANSLATING THE TRAINING INTO SOME FORM OF TASK ANALYSIS, A PICTURE CHECK LIST, IT MIGHT BE USING iTOUCH TECHNOLOGY WHICH WE'RE USING A LOT TO HELP THESE GUYS, REMINDERS AND SCHEDULES, TASK ROUTINES THAT MAY CHANGE AND GET UPDATED. ONE OF OUR COACHES IS AN EXPERT IN HAND SANITIZER AND MANAGEMENT, THE 560 HAND SANITIZER UNITS THROUGHOUT THE CLERICAL CENTER OF BEING ORGANIZED AND ROUTED AND SCHEDULED FOR TWO FULL-TIME, PART-TIME JOBS FOR INDIVIDUALS, SO, YOU KNOW THAT'S WHERE WE WORK WITH THE DEPARTMENT AND WORK WITH THE SUPERVISORS THE NATURAL FLOWS, THE NATURAL WORK AND PUT A TWIST ON IT SO IT WORKS AND IS TAYLORED FOR THE INDIVIDUALS. >> AND I ALSO HAD A QUESTION FOR MONIQUE. IF I WAS A MANAGER AND I SERS SITTING ON THE--SITTING ON THE FENCE OF WHETHER IRB--I WANT TO GET INVOLVE INDEED PROJECT SEARCH, WHAT ADVICE WOULD YOU GIVE TO ME, WOULD YOU SAY TO ME? >> I WOULD SAY GO FOR IT, DEPENDING UPON THE U.S., MANAGERS, THE AMOUNT OF SUPPORT THAT THE TEAM WOULD PROVIDE TO YOU, YOU WON'T OR WOULDN'T FEEL ALONE. THEY'RE THERE EVERY STEP OF THE WAY, BUT THEY DO ALLOW YOU TO TAKE CONTROL AND DECIDE OR SET THE TONE FOR HOW THE TRAINING WILL GO, COME IN, WORK WITH YOU TO SET UP WHATEVER YOUR ACTIVITIES OR JOB DESCRIPTION FOR YOUR EMPLOYEE AND THEN WHENEVER YOU MAY IS A QUESTION, SOMEBODY'S ALWAYS THERE, BUT IT'S ACTUALLY FOR ME OR HAS BEEN A NURTURING EXPERIENCE JUST TO SEE AMETHYST GROW FROM COMING IN AND JUST TELLING US SHE KNOWS HOW TO WORK ON TIME AND LEAVE ON TIME W. HER LUNCH BREAK IT IS NOW ACTUALLY SAYING, OH WHAT ELSE CAN I HELP YOU WITH? HOW CAN I DO THIS? OR MONIQUE WHAT ABOUT THIS? SO WE'VE GROWN. THE SUPPORT IS THERE. IT'S BEEN EASY, FOR ME, IT'S BEEN RELATIVELY EASY AND JUST--IT JUST FEELS GOOD AS A PERSON, IT MAKES YOU FEEL GOOD TO KNOW THAT YOU'VE HELPED SOMEONE AND IT DOESN'T COST ANYTHING. IT'S JUST GOOD. >> AND WHAT IMPACT HAS IT ACTUALLY HAD ON YOUR SURROUNDING STAFF? HOW HAVE THEY CHANGED DURING THIS PROCESS? >> ACTUALLY I THINK INITIALLY WHEN AMETHYST CAME, THEY WERE KIND OF NERVOUS, THEY DIDN'T KNOW WHAT TO EXPECT OR THEY ONLY HAD ONE PERCEPTION OF AUTISM, BUT AMETHYST DOES VERY WELL WITH WORK, SHE UNDERSTANDS. SO ACTUALLY AT THIS POINT, THERE IS NO DIFFERENCE. IF I'M BEING HONEST, SHE COMES IN EVERY MORNING SHE HAS EXPECTATIONS THAT SHE'S SUPPOSED TO DO, SHE KNOW WHAT IS THEY ARE AND ALL OF THEM ACTUALLY, WE WORK AS ONE COHESIVE GROUP AND IF SHE MAY HAVE FORGOTTEN SOMETHING AND SOMEONE MAY REMINDER BUT FOR THE MOST PART SHE'S BYE-BYE BEEN IN THE JOB FOR ABOUT THREE YEARS SO SHE'S JUST ONE OF OUR COLLEAGUES AND WE'RE JUST NOW AT THIS POINT JUST LOOKING TO GIVE HER OTHER RESPONSIBILITIES BECAUSE SHE'S MASTERED THE TASK AT HAND SO FAR FAR. WOULD YOU AGREE? >> OH, YEAH. BUT NOT TOO MANY. [LAUGHTER] WELL, FOR ONE THING I AGREE A HUNDRED AND MORE FOR MONIQUE. IT'S ALWAYS GOOD TO WORK YOUR HARDEST AND IT IS GOOD ESPECIALLY IF YOU'RE AN EMPLOYEE BECAUSE I ALWAYS--I ALWAYS SAY THAT EVERY MORNING THAT I WORK MY HARDEST SO BASICALLY--YOU GOTTA KNOW THE IMPORTANCE OF HAVING A JOB AND KNOWING HOW TO DO IT AS FAR AS BEING AN EMPLOYEE AND I SHOULD KNOW BECAUSE I'VE LEARNED BITS OF WHAT HAPPENED FROM DAY ONE TO EVEN MORE DAYS AS I GO ALONG. I DO LEARN GOOD LESSONS. SO TO BE HONEST IF IT WASN'T FOR MONIQUE WHO WAS A GREAT RESOURCE, I WOULD STILL HAVE TROUBLE AND I KNOW I SHOULD KEEP THAT IN MIND AS LONG AS I THINK POSITIVE AND CONTINUE TO WORK MY HARDEST AND THAT'S GREAT. >> YES, THANK YOU. >> GOOD JOB. >> SO IF THERE'S NO MORE QUESTIONS WE'RE GOING TO WRAP THIS UP. I WANT TO THANK MELISSA, STEVE, DENISE FORD, AMETHYST THORNTON, MONIQUE, AND DEB, CHEW AND COMING AND SHARING WITH US. SO THIS IS THE FIRST OF A SERIES. SO WE'LL WILL ANOTHER PROGRAM ON VETERAN'S HIRING FLEXIBILITIES AND TELL BE HELD ON JUNE 24th IN WILSON HALL FROM 11 TIME-12:00--11:00-12:30. AND THEN WE WILL HAVE ANOTHER WOB ON OBESITY IN THE WORKPLACE ON SEPTEMBER 2nd. IF THERE ARE NO MORE QUESTIONS, WE WILL ADJOURN AND THERE WERE EVALUATION AND QUESTIONS AIRES SO PLEASE FILL THEM OUT AND LEAVE THEM FOR US AT THE BACK OF THE TABLE. THANK YOU. [ APPLAUSE ]