Who?
An autistic individual currently supported 2:1 in a supported living setting. This individual is non-vocal and can show behaviours of concern that can cause harm to themselves and others.
Why?
To teach this person to express their key needs in a safe way, efficiently and in a way that is clear for those around them. Previous methods of teaching communication have not been successful.
How
The individual was provided with a communication board space in their flat with favourite items, activities and food items. The individual has been shown the pictures whilst using the items/activity to ‘pair’ picture with the word spoken and activity. As activities occurred they were shown the picture in a now/next format. Whenever they stood up to move towards something or showed early warning signs of distress, the staff would ask them to ‘show me what you want’ indicating the choices. They would then model how to choose for the individual to copy. Over time, the individual was able to choose for themselves when asked. The pictures were increased to include more complex options and separate choice cards were developed for more items such as activities out of the house, foods, drinks, music/games in the home. This means that not only can they indicate they need to go out, but the location.
Progress
Initially is was difficult to know what this individual wanted/needed. They would go to cupboards and search or point to their shoes to go out/get their coat. When teaching began, they were not able to accurately choose a card, sometimes grabbing or throwing the cards. With extensive modelling and staff training, they are now able to use between 20-30 different cards and can select options. PRN use was reduced from 7-2-0 over three months and incident intensity remains low and less frequent.
Next Steps
To increase the variety of choices available and to consider moving to a tablet that can be easily taken from the home.
To move towards feelings and emotion cards to support with regulating and communicating these needs also.