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How SIS training enhances staff knowledge, confidence, and more

You heard about the Supports Intensity Scale, examined it, and have finally bought it so that you can start administering the tool with persons with intellectual disabilities. Your staff has enough experience with assessment tools, and, after all, how hard can it be to administer a planning tool, right? Jonathon Crumley, Regional Supervisor with Georgia’s Middle Behavioral Services is not likely to agree. “The difference in my understanding of SIS before and after the AAIDD (formerly AAMR) training workshop was like night and day,” he explains. Like Crumley, Steve Mason of HARC in Florida, Pastor Merle Ihrman of Good Shepherd Communities in California, Ruth Pellman of York Regional Services in Canada, and other professionals across the United States have discovered the benefits of attending a SIS training workshop before administering the Scale.

Over the past year, the American Association on Intellectual and Developmental Disabilities (formerly AAMR) has worked with states and private providers to provide one-day introductions to SIS, train-the-trainer programs, as well as training interviewers on administering the Scale. So, what makes SIS training essential? Here's what training attendees and AAIDD senior trainers had to say about the major benefits of attending a SIS training workshop.

Understanding the supports focus of SIS
“The heart and soul of SIS is in its person-centered philosophy; with SIS, you are not gauging deficits, but are measuring supports needed to allow a person perform just like a person without a disability,” explains Jonathon Crumley about his biggest takeaway from an AAIDD SIS training workshop. Crumley, along with 13 other trainers, went through extensive SIS training in Georgia, after the state announced adoption of SIS in 2005. “The idea of measuring supports is simple enough, but unless you really understand that concept with proper training and practice, it is very likely that you will revert to a typical functional assessment. If this happens, your scores will be skewed, and ultimately the person with a disability will not receive proper supports and services.”

It is this drive toward providing  the best possible care and services to people with intellectual disabilities that prompted Ruth Pellman, a consultant and trainer to York Regional Services (York), to choose SIS over other instruments for the York region of Canada. While discovering the instrument, Pellman realized early on that “SIS training was essential in ensuring that the instrument is administered in a fair, reliable, and professional manner." Pellman, along with 6 other staff persons at YRC, went through SIS training this May with two AAIDD senior trainers. Reiterating what Crumley says about understanding the SIS mindset, Pellman explains, “We had to make sure we learn how to ask questions and hear the answers from the people we serve so that services are based on actual support needs as opposed to our perception of their needs, disabilities, and abilities.” Understanding the transition to a needs-based assessment constitutes a major portion of an AAIDD SIS training workshop.

The face of an AAIDD SIS training workshop
AAIDD senior trainer Michael Chapman says, “With SIS, it is no longer about what is wrong with the person and fixing it. It is about getting a profile of supports needed by the individual, and the training helps you get there.” To reinforce this message, a typical SIS training workshop begins with a one-day, in-depth overview of the Scale, including why SIS was created and best practices in administering it. The introductory session also includes guided interviews and role playing by AAIDD trainers. Both in the train-the-trainer workshops and in training SIS interviewers, attendees work in pairs and independently on conducting interviews with persons with intellectual disabilities. Typically, depending on the length of the training, trainees convene at the end to discuss challenges in interview techniques, style, and the understanding of SIS. In train-the-trainer workshops, AAIDD trainers offer individualized critiques based on observations, and at the end, individual trainers are evaluated to ascertain if they have a sound understanding of SIS and hence are reliable trainers or administrators. In general, SIS training workshops are customized to fit the needs of the organization or state, although the outcome is the same--to train trainers or administrators to be reliable interviewers of SIS.

Ensuring inter-rater reliability and data integrity
The essence of SIS training efforts, like with the York group and Georgia, is establishing inter-rater reliability. That is, SIS training ensures that all the administrators of the Scale have a sound understanding of the Scale and score it consistently. This is essential for the assessment data to be valid and reliable. Michael Chapman explains, “For SIS to be effective, data must be solid, which means, interviews must be conducted in a way that data obtained is accurate and consistent across all personnel who administer the Scale. The implications of being reliable are obvious—once staff is trained and protocols are established, it does not matter who administers the tool, the results will be the same.” Establishing reliable trainers and SIS interviewers is essential to ensure that the person's needs and support services are identified accurately. Chapman reminds us that, “With SIS, all said and done, you are talking about the very lives of people. The supports and services received by the state or service provider are essential for the person to live in society.”

For states especially, stakes are high, since obtaining reliable scores is necessary to ensure that financial support and services are allocated fairly to people with intellectual disabilities. Crumley explains, “There is no way for a state to judge the accuracy with SIS without a standard. There should be accountability between everyone administering SIS and it is essential that bundled at the state or regional levels, the scores be consistent in order to best serve our citizens with intellectual disabilities.” Within Crumley’s own organization, all the SIS trainers meet every six months to ascertain that everyone is following the same administration protocols and that the Scale is being administered reliably and consistently. Apart from encouraging such internal inter-rater reliability checks, AAIDD also works with states and private organizations to conduct an annual Inter-rater reliability check with internal staff training on or administering the Scale to individuals with disabilities.

Tackling interviews with competence and confidence
For Michael Chapman, a major goal of the SIS training workshop is to develop competent and confident interviewers. This is with due recognition that the effectiveness of SIS as an assessment tool depends on how well a SIS interview is conducted. “The AAIDD SIS training is designed to help the participant have faith in oneself while conducting interviews, and it ensures that the individual has the knowledge and the ability to either administer the instrument or train other people to use the instrument,” explains Chapman. A SIS training workshop explores interview techniques in addition to training participants on the core content of the Scale. Says Willie Ingram, Mental Health/ Developmental Disabilities Services Director at the Georgia Regional Hospital, “The SIS training enhanced my skills by providing insights on how to connect with respondents, help them relax, and work toward asking the right questions. This ensures the most appropriate rating while completing the Scale.” Steve Mason of HARC in Florida supports Ingram’s position. “The most valuable part of the SIS training was trying out the interviews and getting feedback from the instructor on the scoring and understanding which questions worked,” Mason says. AAIDD senior trainers Natalie Ihli and Chapman explain that a fair part of the SIS training focuses on coaching interviewers for independence, and touches upon everything from strategies to conduct good interviews, use appropriate language, and asking tough questions on intimacy and personal needs. While guided interviews throughout reinforce knowledge acquired by the attendees, independent practice interviews with people with disabilities during and after the training help attendees explore an interview style that is unique to them. Ihli explains, “A good SIS interviewer has to be very sensitive to the respondent and has to have the ability to explain the instrument and show him or her the overall picture as to why it is necessary and helpful.”

Adding meaning to a job
Apart from these obvious benefits, Ihli points out that during a SIS training workshop, participants often experience an epiphany on the use of SIS. “Often times, a state employee has to administer SIS because the state has mandated it and s/he does not necessarily understand how it benefits the person with a disability. Attending a SIS training changes that.” Ihli explains that the SIS training provides staff with a clear idea as to how it helps individuals achieve their goals and aspirations. “They see that SIS is different, a tool with real, tangible benefits for the people they serve and that makes a difference.” For Willie Ingram, “After SIS training, I know how the items on the Scale directly correlate to resource allocation” (a major goal of the state).” Another well-documented result of using SIS is developing a good Individualized Service Plan for a person based on true and not imagined needs of the individual. Crumley points out, “The SIS is tremendously helpful for the ISP process. It tells you exactly what areas a person needs support in and how the goal should be written. Hopefully, if you provide the right supports, then a year later, the same area of support would have gone down.” However to reap these benefits, you require a clear understanding of the instrument, including its three-part rating scale and understanding the positive, supports orientation of the Scale.

So, whether you are a service provider or a state agency, SIS will benefit and empower the individuals with intellectual disabilities, and the practical knowledge contained in a SIS training workshop will maximize your understanding of the people you serve and help align supports and services delivered to them.

Click here to read more feedback from attendees of past SIS training workshops.

If you are interested in scheduling a SIS training workshop, click here to send an email to AAIDD. Please include the number of people you’d like trained and whether you are interested in training interviewers or trainers within your organization.

To read guidelines on how to select the right SIS trainers for your organization, click here.