6.4. Typical Story Content

Personal information. All TiME transcripts contained some content (i.e., two or more sentences) providing personal information. Nearly all of this content was strengths-based, not deficit-based, emphasizing interests, hobbies, skills, and other details that presented students/patients as unique, multi-faceted, and likable. The two school sites, where TiME tools were created in preparation for post-school transition, also frequently included information about students’ resumes/job experiences (e.g., names of employers, and key responsibilities such as shelving books, bagging groceries, delivering mail, and wiping down tables). In terms of TiME format, both school sites and the inpatient unit tended to begin TiME transcripts with personal information about students/patients.

Communication. All TiME transcripts contained at least some content about communication, and information about students’/patients’ communication styles and strategies was the most consistent across sites. For example, most TiME transcripts contained information about student/patient’s communication modalities (e.g., speaking versus non-speaking communication, low- and high-tech AAC options). Most TiME transcripts contained content about how to support receptive communication, including getting the student/patient’s attention (e.g., say my name), the maximum number of words to use when addressing the student/patient, and the importance of breaking instructions into manageable chunks. Most TiME transcripts also included content about how best to support the student/patient’s expressive communication (e.g., the need for wait/processing time, the benefit of written and visual choices, and the importance of letting the student/patient know if you do not understand what they said so they can repair the breakdown). Many of the TiME transcripts created by the three sites divided the communication section into separate sub-sections (e.g., “How to Talk to Me”, “How I Talk to You”, and How I Interact”).

Learning tools and preferences. All TiME transcripts contained at least some content about learning tools and preferences, although emphases varied across site types. Transcripts commonly included information about the student/patient’s learning strengths (e.g., understanding math concepts, tech literacy), learning-related challenges (e.g., distractibility, motivation issues), ideal learning environment (e.g., quiet, uncluttered spaces), and other learning preferences (e.g., hands-on learning, predictable routines). Most commonly, TiME transcripts contained information about preferred tools and strategies for learning (e.g., setting alarms, following schedules, modeling new tasks, and enthusiastic praise). There were no apparent differences in story content across sites or site types.

Behavior/emotion regulation. Information addressing this content domain varied more dramatically across site types than any other domains. TiME transcripts created at the inpatient unit always included content (i.e., between three and 40 sentences) about behavior/emotion regulation. This was not true for the school sites, both of which only sometimes included information about students’ behavioral challenges/support needs, and when they did, included minimal information addressing this content area (i.e., no more than 2–3 sentences). When provided, behavioral content across sites commonly included information about challenging situations for students/patients (e.g., loud noises, changes to schedule, non-preferred tasks), their most challenging behaviors (e.g., grabbing and hitting others, self-injurious behavior, property destruction, yelling, and escape/avoidance), and strategies for supporting students/patients through difficult situations (e.g., talking/moving calmly around the student/patient, encouraging them to take breaks, offering hand squeezes). TiME transcripts developed for the inpatient unit also frequently provided detailed information about patients’ behavior plans and instructions on keeping patients and others safe during behaviorally difficult moments.

Asking for help. Although there was only a minor amount of content across TiME transcripts dedicated to addressing how students/patients asked for help or were working on self-advocacy goals, almost all TiME transcripts contained at least some content (i.e., one to two sentences) about this. Primarily, transcripts provided information on students/patients’ goals related to self-advocacy, and strategies for supporting goal mastery in this area. School sites were more likely than the inpatient unit to include information about self-advocacy goals.

Diagnostic/medical. This was not a major content domain. Information typically included names of students/patients’ diagnoses and medical conditions (e.g., autism, intellectual disability, ADHD, Prader–Willi Syndrome, mood disorder, seizure disorder, allergies, and pica), as well as strategies for supporting these conditions (e.g., reading glasses, gastronomy tube, medical bracelet). As with behavior/emotional regulation, TiME transcripts created by the inpatient unit usually contained more extensive information about patients’ diagnoses and medical support needs.

Mobility/motor issues. Only a few TiME transcripts from the three sites included information on mobility/motor issues since only a few students/patients required special support in this area. One of the two schools never included information on mobility. Types of information included in this section primarily addressed motor challenges (e.g., walking down stairs, sitting down in a chair, fine motor tasks, and gross motor stamina), as well as strategies for support (e.g., providing physical supports, offering adaptive tools, using orthotics or a wheelchair).

Safety. Although only a few TiME transcripts created by schools included safety information, most TiME transcripts created by the inpatient unit included at least minimal content (e.g., one or two sentences) about keeping the patient safe. Typically, transcripts identified key safety issues (e.g., being around water, interacting with animals, running across streets), as well as strategies for supporting students/patients (e.g., providing careful supervision in these contexts and, in some cases, holding hands).

Summary. Overall, each site developed idiosyncratic ways of creating TiME tools that used similar content across students/patients, as well as recurring transcript structures, while still retaining enough variation to reflect individual student/patient profiles.