There have been significant social and economic changes during the past 10 years both in Hong Kong and internationally. Some of these changes include an increased need for the skills to access new technologies and changing skill demands.

These changes have in turn created new expectations and demands on post school programmes for members with disabilities.

The Nesbitt Centre Programme seeks to respond to changing community expectations and promotes positive practices for people with disabilities in the community.

This hexagon indicates the outcomes our new "Preparation for Life" programme will aspire to provide for our members.

In recent years the emphasis has shifted for young adults in the post school years.
This programme seeks to respond to the changing expectations of the members of the Nesbitt Centre and the Community and to develop a programme which meets their changing needs.

The Nesbitt Centre Programme aims to reflect this change by assisting members to raise their competence and confidence levels whilst equipping them with the skills to function in integrated or supported employment, recreation and leisure settings, and home and community living environments, as determined by the members individual needs.

Our programme is based on the following beliefs:

• That members are entitled to have access to a programme designed to meet their individual needs.

• That the programme is inclusive, outcome oriented, based on individual needs and prioritises the skills needed for transition to adulthood.

• That the programme helps develop the members’ abilities, talents, and interests, as well as their social and interpersonal network, so that they are independent, participating members of society.

The framework for our new programme can be seen in the hexagon below.
　

The Nesbitt Centre Programme focuses on outcome oriented functional skills. It has at its core the development of the skills required and activities necessary to help individuals to live as independently as possible as adult members of the community and care and advocate for themselves.

The six areas of the programme have been selected to focus on the major areas in which a member needs to develop and improve their skills to facilitate a successful transition to adult life.

These areas are:

Life Skills,

Independent Living,

Vocational Education,

Structured Workplace Learning,

Recreation and Leisure. And

Planning for the Future.

1.  LIFE SKILLS

The Life Skills area incorporates a selection of skills and activities necessary to help individuals to live as independently as possible as adult members of the community.

The Life Skills module is organised under headings of Home Skills and Community Skills representing the environments the individual will be required to function within. The focus is on developing the skills needed to access Community facilities and care for their needs within the home.

Numeracy and Literacy skills are an integral module of the functionally based activities.

2.  INDEPENDENT LIVING

The Independent Living area incorporates a selection of skills and activities necessary to help individuals to live as independently as possible as adult members of the community and care for themselves as an individual. This module is organised under the headings of Self Care and Social Skills.

The Nesbitt Centre believes it is important to include the involvement of the member and their family and other relevant agencies in implementing this module of the programme. This should help ensure that activities and skills chosen are relevant and that they are generalised to and maintained in real life situations.

3.  RECREATION AND LEISURE

Leisure and Recreation consists of a range of activities (active or passive) whose function is to satisfy the individual and to enhance the quality of life.

No matter what level of disability, Recreation and Leisure will always constitute a major module of life. This module covers all ability ranges (i.e. mild disability to those members with moderate disabilities).

The choice of activities will range from Solo to Group, Active to Passive and will be in Home or in the Community.

This module in no way limits the selection of activity. lt is designed to include choice of any recreation or leisure type including cultural, craft and passive activities such as dance, art, photography, watching videos, listening to music and playing computer games as well as active community-based sports.

4.  VOCATIONAL EDUCATION

The Vocational Education module is designed to assist in the planning and implementation of a programme which will provide workplace experiences which are appropriate for those members for whom employment is a goal.

The purpose of this Vocational Education module is to give members the necessary skills to enable them to make realistic choices and develop the skills and behaviours required to deal with the complexities in the world of work.

It is acknowledged that vocational education may not be a realistic choice for some members who have higher support needs. Leisure and independent living skills may be the most appropriate focus areas for these members. The emphasis would then be to maximise their participation in activities which are relevant to their individual functioning at home, school and in their community.

Individual abilities will dictate the level and the extent of participation in this module.

5.  STRUCTURED WORKPLACE LEARNING

Structured Workplace Learning (SWL) aims to provide workplace opportunities to members to assist them in making a successful transition from The Nesbitt Centre to employment and active participation in the community.

Specifically, the SWL programme provides members with structured learning opportunities in a real or simulated workplace. This module of the programme is only undertaken by members for whom employment is a realistic goal.

Each placement provides on the job training and mentoring that develops the member’s technical and generic employability skills.

The skills are assessed, usually following the work placement, and this assessment is used to provide feedback to the member and their parents and to inform the member’s Negotiated Transition Plan (NTP).

The SWL module of the program will be administered by the Nesbitt Centre Staff, who will also develop a network of Local Community Partnerships with the community, schools, business and industry to maximise the member’s training and employment opportunities.

6.  PLANNING FOR THE FUTURE

As members develop into young adults they establish friendships, interests and job preferences. This development is the same for young adults with intellectual disabilities as for their non-disabled peers, the only difference being that they may require more help to access such opportunities. The member will have support from the Nesbitt Centre staff. They may, however, also need help from their family and/or service providers who provide specialised support in facilitating access to community programmes in adult life

The transition process involves the gradual and planned transfer of responsibility from the Nesbitt Centre to the young person, his or her family and service providers within the wider community.

The individualised Negotiated Transition Plan (NTP) is the formalised written plan to facilitate successful movement of the member from the Nesbitt Centre to adult life. Nesbitt Centre staff will develop this plan after consultation with members, parents/caregivers and other community agencies, where appropriate.

The Negotiated Transition Plan (NTP) is an essential process for selecting the modules of the programme that each member will access. The NTP will determine the functional, social and interpersonal skills a member needs to acquire or improve on and the support needed to achieve the stated goals.

The focus is on preparing the member for as independent a life as possible in the wider community. The emphasis is on allowing the member to achieve their potential and to participate in activities with the least amount of support.

Where possible, integration into mainstream community activities is to be encouraged but it is acknowledged that for some this may not be the most appropriate way to meet the member’s needs.

Through communication we build relationships with other people, we let others know how we feel and what we think. Being able to communicate and knowing you are being listened to is important.

Speech is not the only way to communicate; therefore the member’s at the Nesbitt Centre who do not have speech are still valued 'communication partners'. TNC speech and language therapy provision is based on the same person centred planning principles as the TNC programme. Speech and language therapy is ideal for facilitating and preparing the groundwork for effective person centred planning. The Multi Disciplinary Team share their therapy outcomes and knowledge of the members’ abilities and communicate effectively to ensure that the programme fulfils their needs.

The criterion for therapy considers the following factors:

• Poor knowledge or use of language relevant for their environment at home, in the community and at the Centre.

• Inability to interact successfully with their peer group

• Ineffective communication skills, whether non verbal or verbal

• Poor nonverbal skills and understanding such as proxemics, perception or expression of emotions, turn talking, rate, tone and volume of voice etc.

• Poor oral motor control. Oral motor therapy is a tactile teaching technique which supplements 'traditional' auditory and visual speech therapy. This component of therapy is used to improve muscle awareness, placement and strength/motor memory – all prerequisites for the development of speech clarity.

The speech and language therapy provision at TNC aims to support and provide the members' with successful communication, whatever the mode of communication may be.
　

According to one's uniqueness and potentials, an individual develops interests, skills and life roles. Occupational therapy at the Nesbitt Centre aims to maximize individuals' independence in performing daily tasks of our life roles through group activities and individual programs. In collaboration with other disciplines, occupational therapy focuses on planning, evaluation and implementation of person-centered programs on independent living, vocational development and leisure activities: independent living - individuals' functional abilities in activities of daily living which include fine motor skills and functional abilities of upper extremities in personal hygiene and grooming, dressing, bathing, feeding, meal preparations, household work and safety, grocery shopping and social events.

Besides, simulated and on-site vocational training on work skills, environmental adaptations, ergonomics and work safety are important towards one's vocational development. Through task-oriented and purposeful activities, individuals will have equal opportunities to experience and overcome challenges with guidance. Occupational Therapy at the Nesbtitt Centre also promotes individuals' quality of life with exploration of multi-sensory experience and leisure activities in community.
　

Worldwide best practice dictates that any educational programme should be underpinned by the skills prioritised and considered as essential to the person’s learning and those which will maximise the educational outcomes for that person.

A list of the Key Competencies recognised as implicit in worldwide best practice has been used to underpin the conceptualisation of this framework. Lists of similar skills considered essential to successful participation in society may be found in a range of educational programmes and educational curriculum worldwide. These key competencies have been validated as essential skills by educational research worldwide including the findings of the OECD (Organisation for Economic for Co-operation and development).
For further information please refer to http://www.oecd.org/dataoecd/47/61/35070367.pdf

These competencies are considered essential for effective participation in the emerging patterns of work and independent living. They focus on the capability to apply knowledge and skills in an integrated way in work and community situations.

These Key Competencies are generic in that they apply to work and community living generally rather than skills specific to work in particular occupations or situations. This means that the Key Competencies are not only essential for effective participation in work but are also essential for effective participation in adult life generally.

The characteristics of these Key Competencies:

• It is essential for preparation for employment and or Living in the Community.

• It is generic to emerging patterns of work and community living.

• It equips individuals to participate effectively in a wide range of social settings and adult life generally.

• It involves integration and application of knowledge and skills in a range of situations.

• It enables one to learn and to treasure lifelong learning process.

• It is amenable to credible assessment.

The Key Competencies have been summarised as follows for the purpose of the Nesbitt Centre Programme:

• Collecting, Analysing and Organising Information
  The capacity to locate and categorise information in order to select the required information, represent it in a useful way, and evaluate both the information itself and the sources and methods used to obtain it.

• Communicating Ideas and Information
  The capacity to communicate effectively with others using a range of spoken, written, graphic and other non-verbal means of expression.

• Problem Solving
  The capacity to apply problem-solving strategies in purposeful ways, both in situations where the problem and the desired solution are clearly evident and in situations requiring critical thinking and a creative approach to achieve an appropriate outcome.

• Planning and Organising Activities
  The capacity to plan and organise one's own work activities, including making good use of time and resources, sorting out priorities and monitoring one's own performance.

• Using Mathematical Concepts and Processes
  The capacity to use concepts such as number, space and measurement and techniques such as estimation for practical purposes.

• Working with Others and in Teams
  The capacity to interact effectively with other people both on a one to one basis and in groups, including understanding and responding to the needs of a client and working effectively as a member of a team to achieve a shared goal.

• Using Technology
  The capacity to apply technology, combining the physical and sensory skills needed to operate equipment with the understanding of scientific and technological principles needed to explore and adapt systems.

NOTE: These key competencies will be used to report to members and their parents on the member’s progress and skill development within each of the modules.

• Why have these particular modules been selected for inclusion in the programme?

This programme has emphasis on functional skills. These may be described in terms of skills that are frequently demanded in natural, domestic, vocational and community environments. Those skills that have an extremely low probability of being required in daily activities can be described as being non-functional. These skills are given a low priority.

• How will skills be selected for my son/daughter's individual Negotiated Transition Plan?

A critical factor is how often the skill is actually required in natural environments and the relative extent to which performance of the skill enhances independent functioning. It is also important to recognise the different levels of independence and acknowledge that some members will never be without some degree of support. We need to look at the natural environments in which our members are being prepared to function.

Members needs, level of disability, access to resources and local environments, and cultural and economic diversity, are some factors which need to be considered when developing an appropriate individualised programme.

• Why aren't Numeracy and Literacy modules in the program hexagon? Will my son/daughter be taught these skills?

The Nesbitt Centre Programme focuses on outcome oriented functional skills. Members will continue to develop numeral and literacy skills. Therefore it is important that developing a member's numeral and literacy skills is approached in a different and more functional way.

Numeral and literacy skills are an integral part of many areas of the programme and must be addressed within the context of each module; Life Skills, Vocational Education, Independent Living, Structured Workplace Learning, Planning for the Future and Recreation and Leisure. As this is an individualised outcome based programme, each member's needs and priorities will determine the extent to which numeral and literacy skills are developed.