S is an 18 year old man with Learning Difficulties, Autistic Spectrum Disorder traits, and Behaviours that challenge. He came to Ashdown Care from a long time spent living in a hospital environment. He demands a lot of positive social interaction and will force others to interact with him. S’s challenging behaviour has included running away from support workers, destroying his own flat and the communal areas, and lashing out at support workers and strangers when out in the community. S finds it difficult to negotiate day to day demands and his capacity to monitor and control his impulses are limited.
S’s behaviours were recorded on a daily basis and certain patterns were observed. Based on detailed records a Positive Behaviour Support Plan and corresponding risk assessments were developed.
As a result S was offered a structured day time activity programme which was developed based on his preferred activities:
- Going for walks/runs in the countryside
- Playing video games
- Going out in the car
- Watching films
- Using a sensory room in an Activity Centre
S was given lots of positive attention and feedback throughout the day/evening. Staff continued to offer this regardless of any disruptive behaviour he may have shown. Initially the risks to the public and staff were minimised by only taking S to wide open spaces with very little community integration where he could walk and run. Over a period of several months the triggers for his behaviours were monitored as more community integration was introduced into his weekly activities. Eventually staff were able to support S to use public transport and attend a cinema.
By providing consistent support and positive approaches in a phased way by all members of staff the frequency of S’s challenging behaviour in an internal and community setting was dramatically reduced and his quality of life improved. This experience changed our working practice because initially the professionals involved in S’s care could not envisage this amount of progress being made with this individual and did not really encourage us to take positive risks. However the support staff involved in S’s care believed that they could achieve these outcomes for S, we decided to support their development plans under close supervision from both the Manager and Social Workers. This case study demonstrates that with sustained effort of a highly experienced staff team, the life of what may seem like a very difficult individual can be enhanced to a level which could not have been imagined in a hospital environment.