Karen was born deaf and blind with mild intellectual disabilities and brittle diabetes. Now 41, Karen has spent the last 25 years with LIFEDesigns, which has given her opportunities that wouldn’t have been available to her otherwise. Karen works at Domino’s two hours a day building pizza boxes—a task she has mastered and finds enjoyable. She has built trusting relationships with many staff members, recognizing them by smell and touch and communicating using tactile sign language. With the help of the staff, Karen goes hiking, skating, and swimming (her favorite activity). Karen often squeals in joy during these activities and is often found with a big smile on her face in community settings.