Evaluating Intervention Use in In-Home Support Service (IHSS)

Individuals with complex developmental issues and behavioral needs must have comprehensive support for them to have the safety and stability needed during their care. In this evaluation, an intervention targeting a 10-year-old child with autism was implemented through IHSS to secure protective supervision for 24 hrs. The ten-year-old boy was also diagnosed with anxiety and intellectual disability. The intervention is aimed at eliminating high-risk behaviors like self-harm and elopement but at the same time provides financial support for the primary caregiver: Evaluating Intervention Use in In-Home Support Service (IHSS).

In this assessment paper, the effectiveness of this intervention is assessed through observational reports, caregiver feedback and service coordination. The paper also explores the strengths, issues and recommendations for future improvement of services for vulnerable groups.

Identifying Information

The name of the client who received the social work service is C. The client lives in a shared home with his mother and siblings. In their home, he has his own bathroom and bedroom.

The client also has limited comprehension, finds challenges in following prompts and is incapable of self-advocacy. C communicates mostly in English, but in most instances, his communication is non-verbal, and at times, he whispers to his mother.

Target of Intervention

The targeted issues that call for intervention in the case of C is protective supervision because the client has high-risk behavior like self-harm, running away, and difficulty expressing their needs. The specific concern in this client’s case include:

1. Running away, where the patient has a history of wandering away, and the very recent incident took place in August. Even though there were security measures in place, the risks were still high because there was a nearby canal.
2. Self-harm is another issue because the patient harms himself, mostly by scratching himself till he bleeds and breaking objects with the intention of injuring himself.

• The client cannot express himself and so he finds difficulty in verbalizing his emotions. Therefore, he is always anxious and frustrated.

1. The client stays out of school; for example, he has been away from school since November 2024 due to a dramatic event that involved him and his aide.

Assessing these issues will involve direct observation, needs assessment, and caregiver interviews that are conducted through the In-Home Support Services (IHSS) framework (Rahadian Syah et al., 2024). Other assessment approaches include the use of safety risks and observation checklists that help determine that the client needs 24-hour protective supervision through the IHSS funding.

Intervention

Family support is the first and most important intervention this client needs. There should be financial compensation to the primary caregiver (mother) to reduce stress and allow her to have enough time to take care of C (Chistol et al., 2023). The second intervention is safety, where this client requires constant monitoring to prevent him from self-harm and elopement.

The third most important intervention is service coordination. The intervention should facilitate service connections in the future like education solutions and therapies for C.

Evaluation of Intervention

The interventions were evaluated using ongoing caregiver reports and agency assessment tools. In the assessment, no clinical feedback tools like CSRS, SRS and ORS were used but the interventions followed the monitored progress below.

1. Caregiver interviews were used, and in this case, the mother assessed her ability to manage C’s needs and track behavior changes if they improved or not.
2. Incident reports were also used, and, in this case, running away and self-harm were the issues of interest. The assessment examined the decrease in elopement post-intervention.

• Another intervention was service engagement which involves tracking efforts to introduce therapy and reintroduce school attendance.

Summary of Findings and Client Response

Some of the key outcomes included improved safety because there were no elopements reported post-intervention. A reduction in self-harm was also recorded, and it was noted that self-injury was reduced, but the client still struggled with anxiety. Further, there was family stability because the compensation C’s mother received for caregiving helped her remain present and more involved in the care of the client. However, there were some barriers recorded, like school re-engagement, that remained a challenge, and there was still a need for more educational interventions.

Evaluation Challenges/Strengths

The challenge that was recorded was a lack of standard evaluation tools within IHSS, thus making it harder to quantify behavior improvement. Moreover, the client’s communication challenges made it harder to collect proper feedback. The strengths that were recorded in the entire evaluation were the caregiver’s insight, which offered valuable qualitative data, and further addressed the safety concerns.

Theoretical Perspective

The Applied Behavior Analysis (ABA) principles and Ecological Systems Theory informed the entire intervention (Rahadian Syah et al., 2024). The ABA principles guided behavior management and safety planning. The Ecological System Theory, on the other hand, presented the need to have a multilevel system that promoted the client’s well-being.

Recommendations and Conclusion

The recommended intervention for the future is the formalized behavioral assessment. There is a need to implement standardized tools to track progress. A school reintegration plan is also a recommendation for future intervention. In this case, partnering with special education professionals to create a safe transition back to school will be helpful for C and other clients like him.

Another intervention is enhanced therapeutic support, where in-home and virtual therapy for C should be explored. The intervention was successful in providing the client’s family with financial support, which showed why it is important to have ongoing evaluation and service coordination.

References

Chistol, M., Turcu, C., & Danubianu, M. (2023). Autism Assistant: a platform for autism Home- Based therapeutic intervention. IEEE Access, 11, 94188–94204.             https://doi.org/10.1109/access.2023.3310397

Rahadian Syah, D. Z., Yetti, K., Novieastari, E., Gayatri, D., & Nining, S. (2024). Factors influencing patient satisfaction in home care services: A systematic review. F1000Research, 13, 969. https://doi.org/10.12688/f1000research.154937.1

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Evaluating Intervention Use in In-Home Support Service (IHSS)