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Case study: Hugh

Hugh is diagnosed with Autism, Sensory Processing Disorder (SPD), Global Development Delay, Severe Learning Difficulties and Epilepsy.

Hugh was previously placed within a residential setting specialising in supporting individuals with epilepsy. However, due to difficulties supporting and managing Hugh’s wider needs, they were forced to serve notice on his placement.

Hugh engaged in a variety of behaviours that challenged the staff team at the time, in particular physical aggression and environmental damage. The level of challenge that Hugh presented with meant that he was not attending formal education sessions and spent a majority of his time in a low-demand and spacious residential area.

What support did the College provide to Hugh?

Prior to Hugh’s arrival the College worked closely with his existing support team to develop a well planned and executed transition appropriate to his needs. This included periods of staff shadowing and supporting to build a working rapport; concrete visual information with photographs and social stories explaining what was happening and overnight stays prior to him moving into the College. This allowed Hugh to understand what was happening as much as possible and prepared him for the change, reducing any anxiety that he might experience as much as possible. When Hugh arrived he seemed to settle into college life well but understandably still demonstrated signs of anxiety and behaviour that challenged similar to his presentation in his previous placement.

Key to a successful placement for Hugh was identifying his sensory and communicative needs and developing systems, strategies and activities that supported his development, understanding and self-management where possible.

A variety of sensory assessments were completed in order to create a sensory profile  and a subsequent sensory diet that would enable Hugh to better manage his arousal levels throughout the day, avoid sensory situations that Hugh may find distressing and give him better access to activities with sensory experiences that he seeks. Weekly sessions exploring Hugh’s likes and dislikes as well as offering him the chance to develop self-regulation skills were provided by the Occupational Therapist.

A comprehensive assessment of Hugh’s communication skills was completed which highlighted a variety of possibilities for developing Hugh’s communication skills but also noted his enjoyment of Intensive Interaction and the positive effect that this could have on Hugh’s engagement and need for interaction. Consequently, weekly sessions with Speech and Language Therapists were scheduled to explore Intensive Interaction and ways to develop a consistent communication.

Many of these sensory and communication development strategies were also incorporated into Hugh’s educational day and embedded into a curriculum designed to build Hugh’s skills for future life which included vocation, independence, social, essential and leisure skills.

What have been the Outcomes for Hugh?

Generally Hugh appears to be happier and more relaxed. His ability to tolerate sitting with his peers has increased throughout the year he has been with the College, and he has been demonstrating good working relationships with his supporting staff.

Hugh’s GoTalk9 is now embedded into his daily routine and is offered throughout the day to encourage Hugh to communicate if he would like to remain in the classroom, or engage in another activity. This has increased Hugh’s ability to communicate with his staff and has been a positive way of Hugh communicating his wishes as an alternative to engaging in behaviours that challenge.

Hugh actively engages in shopping at local supermarkets; choosing his snacks when prompted and independently placing items into the trolley. Hugh is also actively engaging in using equipment appropriately e.g. knives to cut vegetables.

Hugh is currently entering his second year in Beechwood College and is progressing well in many areas of his life, and there has been a 20% reduction in incidences of behaviour that challenge in comparison to Hugh’s initial period at Beechwood College.

It is too early to start formally planning Hugh’s transition out of the College and the emphasis is helping Hugh to develop the life skills he will need in the future. It is therefore important that Hugh continues to receive the specialist input from the residential, educational and clinical disciplines that foster his growth.  A primary focus of this at present is to develop Hugh’s communication skills so that he is able to clearly and consistently make his wants and needs known.  Although there has been considerable improvement in his communication skills improvements, Hugh continues to struggle to fully utilise more traditional means of Alternative and Augmentative Communication (AAC); however improvements within the classroom environment using ICT offer the promise of further development.

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