Bushey Hall Road

AC lives with 4 other people. He is a gentleman in his late 50’s who has a severe learning disability, Autism Spectrum Disorder (ASD), Depression and PICA.  He does not communicate verbally, nor does he recognise photographs, pictures or videos. AC was aggressive, physically pushing staff and other people being supported. He was very manic and couldn’t settle for more than a minute, not even to eat.

These behaviours included running when the front door was opened into the busy roads outside his house seeking cigarette butts to eat.  At times he would grab staff and push/pull them into the road leading to multiple near-miss traffic incidents.  AC once went into a nearby house manically pacing nearly causing a physical altercation with the owners of the house.  When near shops AC would take food/drinks and then refuse to leave for hours at a time.

After discussion with his psychiatrist, we referred AC to our in house clinical team so that we could write a new Positive Behaviour Support (PBS) Plan. Our PBS mentor and key-worker met to discuss concerns and complete a detailed BBAT assessment and observe behaviours.  Our assessment showed that AC was looking for tangible reinforcement and his destruction of property was a need for constant interaction.

We discussed very regular bursts of interaction in the house and getting outside more as well as using support holds in the community in particular high risk areas and the staff training required to give them confidence in these skills. A new PBS plan was developed for AC and the team was given the opportunity to process this and give feedback on it. WE then provided in-house team training designed specifically around AC’s needs and team concerns. We began to record each 15 minutes engagement and the outcome of it.

We met his social worker and family and psychiatrist at his annual review to discuss AC’s eating cigarette butts. AC would be asked to spit them out and exchange them for apples and mints as soon as he is willing each time.

Results observed :

  • Incidents have reduced from 15 in November to 3 in December, 3 in January and nil in February and March.
  • AC now calmly walks out of the house closing the front door behind him and hasn’t once attempted to run into the road.
  • All signs of physically aggressive behaviour has ceased.
  • AC now laughs more regularly and shows signs of happiness such as rubbing his ears and banging his feet and slapping his head and smiling.
  • AC is calmer in the house and has not destroyed any items since January.
  • Staff are able to give more time again to other people they support in the house as they are not needing to be reactive to AC the whole shift.

Next Cast Study