A person-centred approach can make a huge difference when helping people with autism to develop their personal skills.
Celebrating success is one of the many rewards of being a parent, carer or educator of a young person with an autism spectrum condition (ASC). However small or insignificant their accomplishments may appear, people with ASC often need to overcome many additional challenges to achieve the things that are important to them. These may include being in environments that challenge their communication, sensory or learning needs.
When supporting young people with ASC at school, it is important to start with a holistic assessment of a person’s cognitive, sensory, motor and communication needs as a first step to promoting positive outcomes. It’s crucial that everyone knows what is important to the person, their identified needs, and what’s working or not working from their perspective. This information should be gathered from the individual, who is at the centre of the process, as well as from the people involved in their lives. This is what’s known as a person-centred approach.
Once the individual’s goals have been identified, each target should be broken down into achievable steps. Quality of life measures serve as a reminder, as well as an overarching framework, for focussing interventions on factors such as improving emotional wellbeing, self-determination, personal development, and social inclusion.
Personal development is broader than academic achievements and includes activities such as meal preparation, getting dressed and leisure pursuits, such as going to a group dance class, all of which are just as important as formal education targets.
At our school for young people with ASC we talk about the “four zones” of emotional states. These are often represented by colours, to make abstract ideas more concrete and give young people a point of reference that they can remember:
- Blue Zone – sad, tired, bored
- Green Zone – calm, focused, happy
- Yellow Zone – frustrated, worried, excited
- Red Zone – terrified, angry, elated, out of control.
To help a young person relate to these zones they can be presented in a number of different ways. For example, for a young information communications technology (ICT) enthusiast, you might translate the zones into computer behaviour: blue means the battery is low, green is running well, yellow is a warning screen requiring action and red is a system crash.
It is important to present information in a way which is meaningful and appropriate to each student. Davie, a young man with pathological demand avoidance, was unlikely to engage in a task requiring recognition of facial expressions when the materials were in symbol form because he found this too babyish. When the activity was modified and symbols were substituted for photos of familiar staff, he got involved and had a great time doing it.
Tina presents with tactile sensitivities, which increase her anxiety and greatly limit her participation in everyday tasks if she has to touch and handle objects that are unfamiliar to her. She shied away from wiping the table or changing bed linen. The use of routine and repetition with Tina created a sense of predictability which helped her a great deal. Activities were graded each time she took another small step. She now attends agricultural college on a weekly basis and is able to wear Wellington boots, handle animal feed and go into the animal enclosures.
Regulation, predictability, persistence and repetition help to develop a quality of life which reflects skill development and independence.
Developing personal skills
Here are a few useful tips for helping individuals with ASC to develop their personal skills:
- incorporate their interests; people can be encouraged to take part in an activity that is new or unfamiliar if it links to their interests, for example, a favourite computer game or character or leisure activity; ensure the learning is enjoyable
- plan and be organised; if the activity is set up, it will help stimulate the person’s interest; provide cues about what is expected using pictures or checklists to structure the learning activity and help them to move through the stages
- be flexible about how and when the learning occurs; choose a time when the individual is calm, alert, focussed and ready to engage
- match the task demands to the person’s level of skill and ability
- make allowances for the person’s ability to cope and adapt to the demands of the task
- break down the task or activity into steps and decide which parts can be done independently, which parts require support, and which parts are too difficult
- instruct, prompt, demonstrate and guide; provide a level of help that matches the individual’s ability
- give praise to reinforce their efforts; this may take the form of natural reinforcers, such as going out to play once they have fastened up their clothing, or rewards such as extra time on their preferred game
- repetition and routine are essential, make the activity a normal a part of the daily routine so it becomes more familiar; repeat the experience regularly so the person masters each stage of the task before transferring the skill to other areas of development
- limit distractions, avoid interruptions, and incorporate sensory preferences so they are working in a comfortable physical space and feel calm and focused.
It can be challenging to strike a balance between providing support and encouraging independence. People with ASC may avoid new experiences because they prefer to engage in familiar, predictable activities. They may feel as if too much is being asked of them and there is a risk that they will disengage or become distressed.
However, when an individual is unoccupied or under-occupied or only takes part in a narrow range of activities, there is a risk that their skills will deteriorate and they will lose their confidence and self-esteem.
Providing active support promotes independence and encourages people to have a greater involvement in decisions about their own lives. This kind of “working with”, rather than “doing for”, approach enables young people with autism to develop new skills through everyday activities. These skills give them more control over their lives and help to ensure a good balance is found between providing too much or too little assistance.
Emma Gosling is Senior Specialist Occupational Therapist at Options Barton, one of six independent schools run by Outcomes First Group for young people with autistic spectrum conditions, associated complex needs and behaviours that challenge: