Justin Lambert

OUTCOMES REPORT & CASE STUDY

Justin Joseph (J.J.) Lambert
Long Island (SILO) Participant
Evaluator: Tony Gentry
Date: August 23, 2024

Brief Summary:

J.J. Lambert is a 21-year old autistic white male, who graduated high school this spring and is hoping to pursue home-based post-secondary schooling. He also has severe Crohn’s Disease and other medical conditions (see his mother’s outcomes report for equipment she needs to help supervise his behaviors). He credits a shower hose provided by the grant with helping him tolerate bathing, and a bidet with helping him manage hygiene and risk of wounds re toileting (see below). The grant provided a Lenovo Chromebook and Penreader like the ones he used at school, but he hasn’t been using them, hoping instead for a desktop gaming computer (see below). He has recently begun using a reminder pillbox provided by the grant, but the Nest Protect smoke alarm has not been set up yet. The bidet was left behind when the family moved in June; it is hoped that the grant can provide one for the new apartment, too, as this is a health concern.

Key Phrases from Outcomes Interview:

Mr. Lambert is preferentially non-verbal. He did speak briefly during the interview, but most of the applicable testimony was provided by his mom (see her report).

Outcomes Report Narrative:

[This is a complicated case, because two study participants are in the same family, and the family switched homes in the midst of SILO’s provision of equipment.]

Mr. Lambert is a 21-year old (bd 9/11/2003) unemployed white man, who graduated high school in the past year. He is a behaviorally unstable autistic individual, preferentially non-verbal, who also has Crohn’s Disease, asthma and sleep apnea. He lives with his mother, Melonie Basabie, also a study participant (see her outcomes report, as some items for her help him, too) and his younger sister. When initially enrolled in the study (6/27/23), they lived in an apartment in Patchogue. SILO provided recommended equipment for that apartment, installing some items (see below) there. In May 2024, after a family member’s altercation with a neighbor, Mr. Lambert and family moved to a new first-floor, 3-bedroom apartment in Bellport, where they now reside. They took some of the grant-provided equipment with them, but left some behind. Tony conducted the outcomes evaluation at the new apartment, interviewing Mr. Lambert and his mother side by side.

Mr. Lambert’s initial Supports Intensity Scale was conducted on 7/17/2023 (see Lambert_Justin_Summary Report 7.17.23.docx), finding that he needed close supervision, encouragement and task sequencing guidance to complete some ADLs (dressing, hygiene, bathing, medications) and schoolwork. He was not doing any home chores and was always accompanied on community outings. Police had been called to his home, per his mother, when Mr. Lambert had become aggressive on more than one occasion. She also feared that he may be at risk of self-harm. He had wandered away from home on occasion and gotten lost. He was proficient in the use of his iPhone, school laptop computer, iPad, and PS5 and Switch gaming consoles and was considered safe to prepare food in a microwave.

Tony’s initial home visit, on 7/17/2023, was at their second floor, two-bedroom Patchogue apartment. On this visit, case manager Laura Conrad attended. Mr. Lambert did not participate, gaming in his bedroom. His mother Melonie Basabie identified his needs (and hers – see her outcome report), and the following equipment was recommended (see Lambert-AT-Recommendations.docx).

Tony visited for an outcomes assessment on 4/29/24, but did not conduct the interview, because some recommended items had not yet been delivered. The shower hose, bidet, pillbox and penreader were in place (see below), but some of the items recommended for Ms. Basabie were not, so a final outcomes evaluation was postponed, and SILO was notified of additional needs (see Basabie outcomes report).

The family moved from Patchogue to a 3-bedroom, first floor apartment in Bellport on 6/22/24. On 8/23/24, Tony visited and completed an outcomes assessment on participant’s satisfaction with the following provisions:

Aquadance 2-head Shower Hose: Per mother, Mr. Lambert was an incomplete bather, fearing showers and only soaking in tub, refusing to use soap (perhaps because of allergies). Tony recommended a shower hose, so he could control the direction and flow of water, and suggested that mother teach him to start at his feet and only gradually work up to his face and head, in order to overcome his concern about the shower.

This solution worked well for Mr. Lambert. He and his mother agreed that he was now showering completely on his own without need of supervision, using the shower hose. They brought this shower hose with them to the new apartment and it was installed.

Adjustable temperature/dual-wash bidet: Per mother, Mr. Lambert resisted using toilet paper and had developed skin abrasions from poor toilet hygiene. Because of digestive issues related to his severe Crohn’s Disease, she considered this a medical emergency.

The bidet worked well for Mr. Lambert. He readily used the bidet installed in the Patchogue apartment and his skin condition healed. Unfortunately, when the family had to move out of the apartment rather suddenly, they left the bidet behind. Tony has requested another from SILO.

Lenovo IdeaPad Gaming Chromebook: This is the computer version Mr. Lambert used in high school, per his mother. It was ordered and delivered by SILO, but in the interim, he instead requested a gaming desktop computer, saying he needed it in order to pursue post-secondary training in coding. He brought the chromebook to the new apartment, but no one has used it. His mother says she does not know how to use it and Mr. Lambert so far refuses to use it.

Mobi Smart Pillbox with Phone App Reminder: Initially, Mr. Lambert had difficulty using this pillbox, disliking its reminder alarm sound. His mother said he had knocked the pillbox off the table in anger when it alarmed. In Patchogue, she unplugged it. Tony suggested using app-based reminders on Mr. Lambert’s iPhone instead. On the outcomes visit, however, Mr. Lambert said that he had begun using the pillbox again, and that it was working well for him. He especially liked that the compartments held exactly the right pill to take at the right time, so he didn’t have to fumble with pill containers and did not miss his doses.

Nest Protect Smoke Alarm: Mr. Lambert’s mother said that he panics in emergencies. This talking smoke alarm (with phone app alert) was recommended to provide guidance in case of home fire. SILO delivered this device, but did not set it up. On the outcomes visit, Ms. Basabie said it was still in its box and that they didn’t know what to do with it. Tony contacted SILO for a follow-up visit to install the Nest.

Pen Reader: Per Ms. Basabie, this device helped Mr. Lambert with his schoolwork. It was delivered, but Mr. Lambert hasn’t used it much, though he may do so when he pursues post-secondary schooling.

Subjective Responses:

SHUSS-NY Assessment:

[A single SHUSS-NY report was completed by Basabie and Lambert together, in discussion for agreement on ratings]

Mr. Lambert’s satisfaction with the AT intervention was rated using the SHUSS-NY instrument. Considering the equipment and training provided by the grant altogether, he rated the following items (1-5 scale) as a 5 (very satisfied): (2) I am satisfied with the smart home assessment process; and (2) I was actively involved in selecting appropriate smart home devices to meet my needs.

He rated the following items as a 3 (more or less satisfied): (1) I am satisfied with the information and training provided about how to use my smart home devices; (2) I know who to contact if I have a problem with my smart home devices; and (3) the devices work effectively.

He rated the following items as a 2 (not very satisfied): (1) I am satisfied with the timeliness of providing the smart home devices; (2) I receive timely assistance when I request help with my smart home devices; (3) the devices meet my needs; and (4) I use the devices without difficulty.

The total score on Mr. Lambert’s SHUSS-NY survey (range from 9-45) was a 27, average score = 3.0.

Note: They said that completing the SHUSS-NY may be misleading, because they really like some of the equipment provided (the rhoomba, the bidet, the shower hose), but that they are disappointed in others (computers and some others). They have had good experiences with SILOs provision of equipment, and sometimes not so good experiences.

Video Transcripts:

See Basabie outcomes report for transcripts of videos, all conducted side-by-side

Photographs: