What is the Capability Approach (CA)?
The Capability Approach focuses on the student’s interests, strengths, and skills with broad creative supports that enable adaptation or increase capability.
The Capability Scale:
I use the Capability and Independence Scale © (CAIS) as my guide and structure during the interview. The items and domains come from my own research on what is essential for quality of life. An article Dr. Tom Reio and I have written will be submitted soon for peer review in The American Journal of Occupational Therapy.
I use structured interview questions with the individual (when helpful), his parents, teachers or other advocates. The process using the CAIS will help indicate the individual’s capability in ‘independent levels’ and ‘with supports’ all placed on a score sheet. The findings can 1) reveal areas of the person’s life that are full and those that are void. It can also indicate 2) specific life skills that are strong and those that need strengthening. 3) and show the type of support needed and the intensity of support required.
Six Assumptions Regarding the Capability Approach
1) A transition-planning tool should provide more than a student or person’s current functioning status. Rather, it should offer a process for planning that includes individualized supports with interests and strengths that foster participation in diverse settings. After implementation of a plan, it is then necessary to track a student’s progression and adaptation.
2) Measuring what a person can do ‘with supports’ is more important to the direction of planning than measuring what a person can do independently or ‘without supports’. A student’s self-determination can be enhanced through the exploration, exposure, and the engagement through interests and strengths.
3) To aid the individual in reaching successful post school outcomes, there must be an examination beyond the typical quantitative measurements of supports that yield frequency, time, and prompting.
4) There must be an examination to the quality of supports within the framework of people, visual and other supports using tools to communicate or interpret and understand their world, environments, and structure (Wolman’s 1973 factors). 5)
5) The quality of support must meet the individual where he or she is in development and must resonate with personal interests and preferences. Without this link, a separation exists between the support and the student, producing a strong disconnect.
6) Assumptions 1 – 5 should be considered for each student in school transition or individual in person-centered-planning regardless of intellectual ability, ranging from severe to high functioning.
What are Broad Creative Supports and how are they part of the Capability Approach?
Broad Creative Supports include natural supports and more. The Capability Approach uses four of Wolman’s (1973) factors that impact a person’s behavior; 1) physiology, 2) structural, 3) environment, 4) people supports (organismic). Physiology in the Capability Approach is not applied to the study of functioning living organisms. Rather, physiology is viewed as a support that enables the individual to better interpret and respond using the sense through which outside stimuli are perceived.
There are numerous strategies for this type of assistance, some examples: visual pictures, drawings, photographs, sound therapy. The four broad creative supports environment, physiology, structural, and people supports are examined within 35 life skill content items in the CAIS ©. Each of the 35 items represents critical life skills in self-determination that reflect an overall extent of quality of life.
Four Categories of Broad Creative Supports (BCS):
1) physiological—is typically viewed as functions of living organisms and their parts, including all physical and chemical processes. The focus here in this approach however are the person’s senses through which outside stimuli are perceived. Supports within this category aid a person in processing information. There are numerous strategies for this type of assistance. Some examples are: visual pictures, drawings, photographs, sound therapy or devices to improve functioning (i.e., glasses for vision); technical assistance to self regulate behavior in order to manage the stimuli within a setting (i.e., checklists); or communication (i.e., an Apple I’Touch, or I’pad);
(2) structural—routine set, arrangement of the order of daily activities, or list of events that have purpose, meaning, or enjoyment;
(3) environment—exposure to different settings to increase the individual’s participation in daily living, developing interests, community adaptation, skill maintenance, personal contribution to community or others; and
(4) organismic (people supports)—peer mentor, peer student, coworker support, and outside positive feedback reflecting acceptance of the individual with a disability to participate in a setting.
These four factors influence a student’s adaptations, enabling his or her interaction and exposure to everyday inclusive environments and quality of life (Wolman, 1973).
How is the Capability Approach different from other transition assessments on quality of life and life skills?
The CAIS can help identify the individual’s strengths with acknowledging challenges, and with broad creative supports that are designed to meet needs. When each of these are identified separately and also applied in combination, possibilities on employment, hobby, or other community living options for the student are revealed.
The Capability Approach involves these in which I describe in a formula.
Interests/Strengths (IS) + Acknowledging Challenges (AC) + Broad Creative Supports (BCS) = Adaptive Capacity Levels (ADC) and Emotional Stability.
The individual’s adaptive capacity levels are determined in both ‘on his own’ (independently) and ‘with supports’. Often the individual’s adaptive capacity levels are shown to be higher in ‘with supports’ than ‘independent’ levels. This can show us how capable the individual can become ‘with supports’. This is a selling point for employers.
How Can the Capability Approach Show An Individual’s Progress?
The process of this evaluation repeated at a later date can determine the student’s progress in specific areas and overall as well. This process can indicate the extent that matching of strengths/interests, with acknowledging challenges, and with broad creative supports has worked for the student. (An Added Value)
Why use ‘acknowledging challenges’ instead of a ‘disability label’ when setting community living goals and making future plans.
Use ‘acknowledging challenges’, not label or disability characteristic. Let me give an example.
The characteristic written in Marcus’ report about his disability states — ‘he does not understand and respond to verbal and non-verbal communication of others. If this characteristic is the emphasis in planning, it will be difficult to discuss options for his participation and growth beyond his label.
What is ‘acknowledging challenges’?
Acknowledging challenges is when the family/advocates or a person-centered-planning team sees through the lens of an individual’s challenges (not disability) in order to recognize external barriers that stand between the person and his ability to achieve a desired objective. For example, to participate in a setting of a church social, Marcus uses a peer support to participate among others and to negotiate meeting others.
What is the added value of examining the student’s areas of living?
The Capability Approach examines 7 areas of living: General functioning, Cognitive Capability, Social Life Capability, Domestic Household, Occupational, Emotional Stability, and Communication.
A person’s capability levels across the 7 areas of living can provide insightful information that can be part of determining the community options (employment, community integration or living), and the kind of individualized supports needed.
For example, look at problem solving in Cognitive Capability; look at self-care in personal hygiene in Domestic/Household Capability; examine adjusts or adapts to unfamiliar people in Community Life/Social. It is a value to examine all of these life content items. Providing supports can impact a person’s success in employment and should be addressed and measured.
The individual’s 7 areas of living –merge and relate to one another closely. When the person’s areas of living are examined individually and in combination with each other, this process can reveal valuable insights about strengths, challenges, and broad creative supports that meet personal needs and may go unnoticed in a structured interview.
How does this service, the Capability Approach (CA) help the individual with a developmental disability?
What you have tried that worked or didn’t work.
What you have not you tried.
What will likely get your son or daughter and you the parents/family the result you want.
Strategies to develop a plan.
Strategies to create the broad creative supports and how to use them on your son or daughter’s behalf.
How you know you have made progress and when you have succeeded.
Reveal skills that are missing from his or her daily life.
Strategies to further develop skills.
Strategies to further develop and use strengths.
Possible clues to increasing motivation.
Asking the right question.
Solving the right problem.
Honoring Personal Family Values
Strategies for developing new behaviors or habits, the individual and his or her family too.
In using the Capability Approach my clients are the individual and the parents or advocates. They become part of the assessment process. My service is providing an interview. Next, I combine all the data and analyze the findings. Lastly I provide written recommendations that can increase the individual’s daily, desired life goals, and overall quality of life. The individual or family can share the recommendations with schools, agencies, or other professionals who will benefit in understanding the individual. This may help in providing an individualized program ‘with supports’ to meet his or her interests, strengths, and needs for supports.
In my recommendations, I draw upon what has worked for many young adults with autism and developmental disabilities in my professional experiences (22 years), others’ research, my own research (10 years), experiential knowledge with my son Trent, 34 years. I see my experiences as one of my greatest assets in using the Capability Approach with these individuals and their families and advocates.