Harvey is 25 and has Autism. He lives at home with his family, where he is supported by care staff as well as ABA-trained tutors. His parents approached Open Avenues as they were concerned about his progress, particularly around his communication, challenging behaviour, and engagement in activities. Harvey’s speech was mumbled - often inaudible - and unclear. As a result Harvey could only be understood by those who knew him very well. He would become anxious and agitated by changes in routine, and rarely initiated activities, instead choosing to be sit alone throughout most of his day.
A number of targets were put in place to increase Harvey’s clarity of speech, for example encouraging him to order and describe picture sequences on flashcards (“first the man opens the fridge, then he gets a drink, last he drinks it”). Tutors encouraged Harvey to speak clearly and loudly, by modelling phrases for him to echo. Now, Harvey is more confident to raise his voice and make himself heard, and he can now be understood not only by those close to him but by the wider community. On a recent trip to Subway, he was able to order the salad for his sandwich without support, even making himself heard and understood over the counter to the server!
To help Harvey’s anxieties around transitions, visual schedules were introduced. Tutors and care staff began to use these consistently before and during activities and trips, referring to the schedule often to reassure him of what was happening. Any changes in routine were updated on the schedule and discussed with him so he felt prepared and supported. Harvey is less anxious now in the community and he has been supported to assert himself by expressing his anxiety to staff, and asking for a break if he is feeling nervous.
The visual schedule was also used to encourage Harvey to engage more in activities. As individuals with Autism are often better able to process visual images than written text, small picture symbols were made of all the leisure activities available to him at home and in the community. By offering Harvey limited choices of 3-4 activities, it was easier for him to weigh up his options and decide what he might like to do. Recently Harvey has begun to initiate engagement in activities such as swing ball and darts, which is a big step forward.
Visual prompt cards were also made for his daily chores such as cleaning his bedroom and doing the laundry. Staff taught Harvey to follow these independently using a consistent approach, and strategies like least-to-most prompting and prompt fading. Now Harvey is able to follow the schedule, be more independent and less passive, and take on a share of household responsibilities.
Harvey’s quality of life continues to improve due to his increased engagement in a range of leisure activities and chores, improved access to the community, and strategies in place to help him cope with anxiety and distress.