…It’s a New Paradigm!

By Dr. Janice Ryan, OT, HSDP

Healthcare historians now say, “the world as we knew it shut down” in March 2020. Less than one and a half years later in October 2021, my company and I signed a program development contract with the CEO of a large organization that serves individuals with intellectual and developmental disabilities (IDD) over the lifespan. That was when I began learning firsthand… why so many people believed it would be impossible for me to deliver on my contract.

It’s now three years later and I’m proud to say that I have designed a program that will make a positive difference for a lot of people with IDD. Since I’m an occupational therapist (OT) who could provide direct services, I suppose my contract didn’t feel like a frivolous expenditure. However, it was the fact that I was also a Certified Human Systems Dynamics Professional (HSDP) that allowed me to see the program design phase to its completion. Now, I’ll focus on the current program we have in place and tell you why I say that it’s a new paradigm in service delivery for people with IDD.

A Historical Perspective of Reductionistic Science

Reductionistic science has served us well through the use of research that breaks complex biological and medical conditions down into their smallest parts. This has brought us to a 21st century in which the World Health Organization (WHO) lists twenty-five vaccinations for preventing infections. During the last century smallpox was eradicated and measles, polio, and tetanus were heavily restricted.

New paradigm scientists don’t question the benefits of reductionistic science but have rediscovered our need to simultaneously consider and research holistic relationships between small parts and the whole. There were many reasons for this reawakening, with one of the most pivotal being our rediscovery that we as humans are connected to an ever-changing environment. COVID-19 was a final blow to our over-confidence that we will one day eradicate infectious diseases that have the capacity to continually mutate.

“New paradigm scientists don’t question the benefits of reductionistic science but have rediscovered our need to simultaneously consider and research holistic relationships between small parts and the whole. ”

Our rediscovery that humans are connected to ever-changing environments during COVID-19 might be considered the “dark side” of this scientific paradigm shift. People with intellectual and developmental differences will benefit from the “light or bright side”. One bright light that came from this reawakening is our new ability to speed up slow-moving change processes.

Nurturing the Patterns of Change in Today’s IDD Service Organizations

We often hear people say, “the world is changing too fast!” Yet sometimes it seems as if needed service changes for people with IDD are changing way too slowly! In the 21st Century, we even understand how and why both statements can be true at the same time. In fact, researchers prove every day using statistics that change-over-time leads to an outcome paradox. Happily, this is the New Paradigm for people with IDD because we now know how to speed up slow-moving change processes.

The dynamic systems approach can be used to help parents, teachers, and therapists know what is true and useful to address in service to people with IDD. The dynamic systems approach is supported by new paradigm science. This means we can think of new paradigm science as a rebirth of pre-reductionistic science but, with benefit of all the knowledge reductionistic science has already provided. Now, let’s explore three ways the dynamic systems approach can be used to speed up slow-moving change processes in IDD service organizations.

Learning Ecosystems are a Dynamic Systems Approach. The first way to speed up slow-moving change processes for improving IDD services is sometimes called a learning ecosystem. As an HSDP, I have consistently used the dynamic systems approach for program design and development. My first program design project was in a new Intensive Outpatient Program (IOP) that includes a psychosocial rehabilitation classroom serving adults with IDD and a mental health diagnosis.

Learning ecosystems are a program design solution for complex organization environments. Success depends on creation of open and honest communication among team members. In this way, conflicting motivations are reduced, and unifying program development solutions are more easily recognized and achieved.

I learned quickly that the Psychosocial Rehabilitation (PSR) classroom program operates much like a learning ecosystem. In this IDD service context, learning ecosystems are a dynamic systems approach that can be used to promote mental, physical, and cognitive flexibility in adults with IDD. Like values observed in other program development projects using the dynamic systems approach, the PSR classroom program operates by placing high value on social-emotional learning through open, honest, and developmentally appropriate communication.

Like all dynamic systems approaches, the PSR classroom teacher observes to understand individual and group behavior and to positively influence rather than be “in control” of what happens. Many individuals with IDD served in this program have emotional triggers and some are diagnosed with Post-Traumatic Stress (PTS). That is why the program needed to add day-to-day flexibility to the lives of individuals the program served by using an additional learning ecosystem approach.

By working together with IOP and PSR Program Managers, I turned a small staff meeting room into a well-equipped sensory room for especially anxious or upset students. It became part of a student empowerment value system that fit well with the teacher’s classroom philosophy. IOP and PSR Program Managers and staff took a vote and decided the space would be called The Zen Den. A photo of the Zen Den in shown below.

Both pieces of multisensory environment equipment were manufactured by Southpaw, LLC. The vibrating stuffed dog was manufactured by HealthMeter.

The Zen Den above contains the Interactive Marble Panel attached to one wall, a comfortable glider with padding, and an Interactive Super Switch that allows visitors to turn the marble panel to their favorite color on the light spectrum. A small projector can be used to produce the relaxing effect of slowly moving clouds and stars in a night sky. Too-bright overhead lighting is subdued using light covers and felt fabric is used throughout the room to absorb potentially annoying sounds.

A whiteboard is available and has become a favorite for artists who naturally use drawing to calm themselves when feeling anxious. Music, a white noise machine, and a basket of hand fidgets are available for individuals who relax in this way. Journaling and adult coloring activities are available for individuals who are calmed by this type of self-expression.

Some individuals served in the IOP/PSR program have OT sessions in the Zen Den and others can visit it as needed. Stress-level self-rating scales have been completed by individuals receiving OT since January 2023. As with all learning ecosystem projects, data is used for continuous improvements, to make successes replicable, and to prevent habitual continuation of poorly performing interventions.

Therapeutic Multisensory Environments are a Dynamic Systems Approach. The second way to speed up slow-moving change processes for improving IDD service delivery is a variation or enhancement of the learning ecosystem approach. This variation of a learning ecosystem is called a therapeutic multisensory environment. An example of innovative treatment tools that can be used for this job are shown in the photo below.

Both pieces of multisensory environment equipment were manufactured by Southpaw, LLC.

Since many individuals with IDD are also diagnosed with sensory processing disorders, multisensory environments are being used to enhance multisensory integration for optimal learning. Individuals receiving OT in this room can enjoy an enhanced learning experience by simply rolling the Interactive Power Cube to another side. In this way, a simple movement can be used to change the color of water in the Bubble Tube shown behind it.

The pleasurable and calming experience that comes from watching rising bubbles in water is combined with the feeling of empowerment the individual with IDD experiences from positively changing the conditions of their environment. New paradigm science researchers have used statistical methods to study what happens in the brain during the pleasurable visual experience of watching bubbles rise in water, clouds or stars moving slowly in the sky, or the joyful body-sense experience of planning and executing successful movements. This multisensory integration process typically occurs when young children are playing in their physical environment during moments of active movement and exploratory learning.

Now by using this single innovative pair of multisensory environment tools, multisensory integration can be stimulated in individuals with reduced mobility or visual acuity. These are individuals with IDD who had challenges that limited their early childhood exploratory learning or movement. What a fabulous approach for the typically very slow-moving change process of reducing developmental gaps later in life!

This experience also engages social-emotional learning which is a common challenge for individuals with IDD. Cause and effect, color recognition, and new communication skills can be developed more quickly in an enhanced learning ecosystem like shown in the last photo. This same approach can be seen in the photo below.

The use of these multisensory environment tools and methods are examples of ways the dynamic systems approach can multiply and speed up positive therapy outcomes. The Interactive Super Switch is being used to change the color of water in the Large Bubble Tubes with Platforms shown in the photo background. This type of switch motivates a higher level of arm-hand control and color recognition. As for cause and effect, the Interactive Super Switch is ideal for preparing students for using communication boards and devices.

RoboKind Robots for Individuals with Autism are a Dynamic Systems Approach. The third way to speed up slow-moving change processes for improving IDD service delivery is also an enhancement of the learning ecosystem approach. This variation of a learning ecosystem is called a RoboKind robot. Since many individuals with IDD are diagnosed with autism, multisensory integration for social-emotional learning and development of communication skills is a common challenge. An example of this innovative treatment tool is illustrated in the photo below.

This robot’s name is Milo. He and other RoboKind robots are considered by many to be the most sensory-friendly facially expressive robots for teaching children with autism about emotion and emotional regulation. By slowing down the speed of facial expressions and communication pattern changes-over-time, students with poorly integrated visual and auditory processing can learn faster and better. By reducing speed of change-over-time, negative learning effects of processing challenges associated with poor multisensory integration are reduced and social skills can be developed more easily.

The dynamic systems approach takes advantage of the benefits of positive repetition and practice consistency. Milo helps individuals on the autism spectrum develop physical, mental, and social skills through this winning combination. Another way to think of this is that Milo’s slow pace gives confused minds extra time to decide what is true and useful to consider during social or physical exchanges with environment. That is why we say, Milo’s slow-moving facial expressions and clearly predictable communication patterns are another learning ecosystem enhancement for innovative IDD service organizations to consider.

Conclusion

I have to admit that I agree when I hear people say, “the world is changing too fast!” Yet, I am happy this is the New Paradigm for people with IDD. I have provided a brief introduction to three of the ways new paradigm science has given IDD service organizations the capacity to speed up slow-moving change processes. I’ve also touched on a way new paradigm scientific researchers use statistics to prove the increased service, treatment or learning change-over-time outcomes of using this dynamic systems approach.

Enhanced learning ecosystems give individuals with IDD a brighter future by helping them better connect with their ever-changing physical, social, and service organization environments. Stay tuned! I feel confident more applications of new paradigm science are on the way for helping parents, teachers, therapists, and service administrators speed up positive changes in innovative organizations serving people with IDD everywhere.

References

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