AUTISM SPECTRUM DISORDER
Ken is a 7 year old boy with severe autistic spectrum disorder. He lives with long term foster carers and attends a special needs school. At the time of referral, Ken was living in a respite centre for children with disabilities. Ken is able to communicate verbally but he often struggles to communicate his emotions and needs to others.
Reason For Referral
Ken was referred for occupational therapy by his school as he was demonstrating severe challenging behaviour both at school and the respite centre. His behaviour involved physical aggression to property and other people, absconding, shouting and screaming. Ken was clearly distressed in these situations and often required physical support to remain safe. The occupational therapist was asked for support in the assessment and management of these behaviours.
Occupational Therapy Assessment
Ken underwent a period of intense occupational therapy input over several months. An initial assessment was carried out to identify the causes of Ken’s behaviour. The assessment was completed in close collaboration with the behaviour specialist who was also working with Ken at the time. Assessment included formal tools such as sensory integration assessments as well as informal observations and interviews with family and the staff who supported him.
The assessment identified that the key causes of Ken’s behaviour were:-
- An extreme sensitivity to visual and auditory (noise) stimuli;
- A need for regular movement;
- An inability to cope with change;
- A need to fully explore environments and support workers before being able to settle;
- A need for clear structure and routine in his day.
Occupational Therapy Treatment Plan
The occupational therapist worked closely with Ken’s family, teachers, social workers, behaviour specialist and the staff at his home to develop a comprehensive program which included:-
- two hourly sensory strategies to provide necessary movement stimuli;
- regular calming strategies based on a sensory integration approach;
- adaptation of the environment to create a low stimulus environment;
- implementation of visual timetables and aids to support his understanding of what is happening;
- Implementation of a photographic staff rota to enable him to understand which staff would be working when.
It was also identified that the constantly changing environment of the respite centre could not provide long term support for Ken. At the request of Ken’s parents, the occupational therapist worked closely with social services to identify appropriate long term foster care. Ken was found a place where the environment and people were more consistent and stable.
Following the input of occupational therapy and other agencies:-
- Ken is now settled in his new home;
- He continues to attend the special needs school where the approaches and strategies are used consistently with all staff;
- Ken’s carers were also supported to implement the same strategies at home to ensure consistency for Ken;
- Ken‘s incidence of challenging behaviour has reduced significantly - he is calmer at school and at home;
- Ken is beginning to be able to accept small changes in his routine and he has developed a therapeutic and trusting relationship with those who support him;
- He is requiring fewer services and support from social services and appears to be a much happier young man;
- He is engaging well in class and showing great improvements in his academic learning.