Understanding a “typical person” to be a better SIS interviewer: Notes from AAIDD Senior Trainer, Jonathon Crumley

Jonathan Crumley, AAIDD Senior SIS Trainer recently provided this explanation on the role of understanding “a typical person” while administering a Supports Intensity Scale assessment. We thought this speech from Jonathan has some great and essential tips for interviewers rating the Supports Intensity Scale.

“I have been working with many of you in your SIS meetings, coaching and assisting you in preparing for Inter-interviewer reliability checks. I have noticed a common theme among most of the Service Coordinators that I have co-interviewed. It seems that the reason many are having problems with the Supports Intensity Scale is a lack of understanding when it comes to 'typical person'. As typically functioning adults, we do most of the items that make up SIS with little to no thought. They are routine for us.

For example, when was the last time you considered everything you do when you shop or clean your house? If you are like me, you do these things with such ease and routine that you are probably thinking of something else while you are cleaning or walking down the aisles of the store. My point is that we have mastered these items so well as "normal" adults that we don't even have to give thought to even the smallest of components.

It is for this reason that I think a lot of SIS interviewers have such a hard time rating the Supports Intensity Scale. Without a clear understanding of how a typical person does the activity, and everything that goes into doing the activity, it is impossible to have a comparison whereby to compare the consumer.

I recently explained it like this to Service Coordinator: Remember in high school when you had to do science experiments? The experiment always has a control factor--a factor that remained the same whereby all other variables could be compared. If SIS were a science experiment, then Typical Person would be the constant and everything else, including the person, is the variable. The person (variable) is compared to how a typical person (constant) performs the activity. By this you are able to capture in a rating the difference. What is the support to bring the variable (person) to the constant (typical person)? As you can see, without a clear understanding yourself of typical person it would be extremely difficult to know what the person needs to bring them to performing the activity like a typical person.

One solution is to start paying attention to all the things you do in your personal life when you are doing the items ranked by SIS. Over the next few days, pay attention to what you do when you go out with friends, operate your home appliances, cook, socialize outside your household, take your medications, etc. This will be time well spent I assure you. What you are doing is building a clear understanding of how typical people do the activity and everything that goes into it.

Let me end with an example:Think of the last time you were in the community and "interacted with community members" (Part B of SIS). Maybe it was a person you know that you ran into in the cereal aisle, or a waiter that you struck up a conversation with. Let's look at what you did.You and other typical people: spoke verbally to the person, you spoke clearly so that you could be understood, your words made sense and therefore the other person could respond, thereby having a conversation. You were appropriate in what you said and how you acted toward the person and you were polite. Maybe if appropriate you hugged or shook hands, and so on.That is the standard. This is how typically functioning adults interact and have conversation with community members. Knowing the standard (which is the expanded item definitions) think of a person on your caseload. Ask yourself, for s/he to do the above like you would what support would someone else have to provide?

Let's briefly look at the rating key in regards to type of support for this item:0 = obviously this score would represent no extra support. They interact just like any other typical adult would or just like you.1= reminders/monitoring would have to be given (maybe it is because they have to reminded not to hug everyone, or not to say certain things, or to not stand too close to the person, etc.). For whatever reason, if the reminders and monitoring is there, they could do it like you 2= verbal/gestural prompting would be needed to explain why they do or do not need to do certain things, or they may need to be prompted to speak louder, slower, more clearly, etc. 3=partial physical would be needed if the support person would ultimately have to step in and translate or speak for the person in some respects. Ultimately, for a conversation to be had, someone else is going to have to have part of the conversation for them.4=Full physical would be needed for a person that is perhaps non-verbal or at best verbal but makes no sense in their speaking or words they say.. .in effect, someone would have to speak for them to be understood.”

We asked Jonathon why he felt it was important to understand the notion of a “typical person” and he explains:

First, if an interviewer has a clear understanding of how most people perform the activity, it allows them to verbally present the item in a way that respondents and the person served can often relate to. When the interviewer uses first person language (as opposed to reading out an item) and presents the item in ways that most people perform the activity, respondents usually make the connection that, "Hey that is the way I do it" or "That is the way anyone would do it."

Secondly, by skillfully presenting an item in the light of how most people (including respondents perhaps) perform the item, the interviewer has verbally and visually described the standard of performance for the activity. This visualization is important because often times many
respondents have never thought of the person engaged at this level of performance.

Finally, this personable style and conversation around how other people involve themselves in these activities allows for the person to be a part of a conversation where they are seen as everyone else, not just in relation to another person with disabilities. Often times the person with disabilities are only talked about in the context of other people with disabilities. In this approach, the person is talked with and about just like anyone else.