One of D's daily focuses is to complete tasks with increasing independence. D starts her day by getting dressed independently and comes upstairs to do her morning bathroom routine. D's morning routine is posted beside her bathroom mirror and includes small pictures to clarify each task. D was ready to transition from using a commode in her room during the night, to only using the toilet. We removed the commode from D's room and put it away. D is working hard to keep her bed dry and only use the toilet when needed. This means that she needs to climb up and down two flights of stairs to use the bathroom. Deanna's ease of access to the stairs has increased noticeably since the removal of the commode. D still wears briefs to bed at night in case she has an accident. After D completes her morning ablutions, she makes her breakfast with minimal prompts and only the occasional reminder. She prepares a homemade bran muffin from the freezer by thawing it in the microwave. D has learned to press one button that thaws her muffin adequately. D also peels her own banana, and gets her single portion of yogurt from the fridge and opens it herself. D also pours herself a glass of milk, which she uses to swallow her morning medication. D's medication is always administered by staff.

D is able to manage more household chores and is a great help in the day to day cleanliness of her own space.  She does her daily chores with only verbal prompts/reminders. She has learned to complete tasks without physical support and pays great attention to detail when cleaning her own bathroom sink, etc.

Focusing on having a safe body throughout Deanna's day is essential for her to be successful in her community inclusion program. She is out in the community everyday and enjoys being outside, and interacting with others. Deanna starts her day with a conversation about what a safe body looks like. D is able to give us examples of this. ie. calm and kind, quiet voices, eating slowly and safely, and no banging on herself, others or objects. Also, D will tell us about having 1's all day. D is rewarded when she has a safe body with fun things like seeing the "action" (planes, boats, sealife, etc) and going to the beach, and library. These are activities that reinforce her in being successful with keeping her body safe. There has been a lot of growth in this area this last year. We monitor Deanna's "Happiness Factors" on a scale of 1- Calm and 4- unable to self-regulate (reports are provided). We are seeing more consistency with D being able to have full days of 1's. Deanna is able to self-regulate in situations that she may not have been able to regulate in before, like loud places, and when she is around children who have raised voices (with support). We continue working towards Deanna needing less direct support in these circumstances. We want to note that using similar language across supports makes a difference in supporting her understanding and growth with this goal.

This goal is in progress.

Last year, D's daily walk during her Day Program was usually no longer than one hour. This year, D walks at least an hour per day during Day Program time. She usually walks the length of a beach twice per week. This walk includes searching for "calm stones", which means that D is constantly bending over to examine and/or pick up her newly found treasures. These walks often take 1.5 hours (or longer, depending on how she is feeling), from start to finish. Two other days per week, D walks the length of the Breakwater, or along Dallas Rd. She also delivers the free Times Colonist paper each Thursday and Friday, which is another hour's walk each of these two days.

D has lost approximately 40 lbs over the past 4 years. D's physically healthier behaviours continue to expand. She can now bend over easily, which translates into her ability to do many more activities. She can tie her own shoes, wash her own body in the shower, put on her own clothes independently, etc. When D began the delivery of her Times Colonist paper route, it took her longer to walk the route, and go up and down the stairs of people's homes. Today not only has she fully memorized the details of each home delivery, but she is moving her feet/body much more quickly. She often has a noticeable pep in her step and walks with purpose.

D has developed more ability to be able to respond to her own needs and manage them independently. D now shows reactions to hot and cold. She will put on a sweater when she is cool, or states "I'm hot" when feeling that way. D now reacts outwardly she feels pain, when she accidentally bumps herself. She says, "Ouch!" She also responds to other body needs such as asking for a band-aid if she needs one.

D shows more ability to understand conversation, what it looks like in practical application and how it impacts others. She is stringing many more words together now. For example, yesterday D said, "I'm going to tell Mom when I see her that I saw a Blue Whale". This is huge progress from using only two words together about a year ago. She shows more awareness of others and often regulates her actions and thoughts accordingly. Some of D's actions show that she is thinking outside of herself. For example, D will open a door and hold it, to allow another to go through. We now observe Deanna often showing care for others.

About a year ago, D began asking what the makes of vehicles are. With regular chats about the vehicle makes while we are out in the community, D has almost memorized all makes of vehicles. She is now beginning to learn the models. She shows great interest in learning this, and asks about them every time we drive in the car.

We have discussed the importance for D to have another support person. This person needs to be consistent in D's life, as it takes time for D to build and maintain relationships. At the moment there are two people who are trained and have a strong relationship with D. Unfortunately, neither of them are easily able to have time off as there is no one else able to provide support. A third support person is essential in the big picture, in order for D receive the support that she needs to be successful.