Autism and wellbeing


Sarah Butcher outlines an approach designed to improve the physical, intellectual and emotional wellbeing of young people with autism

A combination of educational, learning and social support can help young people with autism and complex learning and behavioural needs to make sense of the world around them. There are a number of elements which can support this approach and help in overcoming barriers to learning; this is really important because young people with autism think and learn differently to their peers in mainstream settings. The goal is that they are able to communicate effectively and achieve the highest level of independence and fulfilment possible.

Perhaps as important as the specialist approach itself, is for the approach to be transferable across settings, and designed to support parents and carers, the home, respite and future placements as the individual grows towards greater independence. 

Waking day curriculum

In 1993, I spent six months in Japan as a development specialist in a special needs school. I undertook a research project which informed the development of an approach called the “waking day curriculum”, now widely used in the autism sector.  

This allows young people to learn throughout their whole day including before school, evenings, weekends and during school holidays. It provides a structured programme of learning, both in group and individual activities. These activities focus on communication, academic and vocational learning, daily living skills and physical activities and ensure that each young person has access to learning throughout their waking day. 

A waking day curriculum offers each young person the opportunity to live within a structured routine which enables them to develop appropriate sleeping, eating and toileting routines. 

I find that learning occurs most effectively when the teaching is meaningful and relevant, and the young person is motivated to learn. This approach supports continuation of the young person’s social, emotional and self-care development.

Challenging behaviour and communication

While autism awareness is growing, greater understanding is still needed in mainstream schools and amongst the wider public. I see many cases of young people with autism being excluded from school for exhibiting challenging behaviour when, in fact, their behaviour is just a means of communication. If a young person with autism is being aggressive, it is usually because they cannot find a way to tell us something is wrong in their world. 

When working with young people with autism it is very important to understand what is driving the physical aggression; we have to look beyond what they are doing and ask why they are doing it. It may be driven by difficulties in communication, high levels of anxiety, sensory overload or not understanding what is expected of them, so punitive measures are not appropriate here.


For young people with autism, sensory differences can further challenge their ability to understand their environment. Getting the environment right can support these young people by increasing their understanding and reducing their anxieties. 

The use of physical structures such as furniture and materials can help make it clear what the young person is being asked to do or what the area is for, and can also help reduce distractions. Physical structures can be employed across all environments – in learning settings, the home and the wider world, including in the local community.

Visual schedules

Visual schedules can be used to tell young people where they are going. They can also addresses and promote independence by allowing an individual to function without ongoing verbal support from a staff member. A schedule organises and sequences events, thereby reducing anxiety and adding more predictability to the day. It works with the strengths of autism by being visual, adding routine and clarifying information.  

Schedules link very closely to work/activity systems. When a young person arrives at the place that was on their schedule, a work activity system supports what they are then expected to do.

Work systems

A visual work/activity system is something that can answer the questions: what do I need to do? How much do I need to do? How will I know when I am finished and what happens next?

Work/activity systems can be implemented everywhere, from a bathroom/bedroom everyday activity to a community based shopping trip.  

Work systems are unique to each young person, depending on their understanding; they can vary in length and can be presented in a variety of different ways. “Finished” can be represented in line with the level of the individual young person, and what happens next always needs to be recognised as a key ending to the task, to help the young person re-engage with their next activity.

Physical activity

Physical exercise provides the opportunity to develop a young person’s physical wellbeing and channel excess energy, re-establishing focus and attention to help with sleep patterns and readiness to learn. It can help with reluctance to play and difficulties with adjusting to groups. Regularly scheduled physical activity within a structured day can also promote participation in activities with others and social interaction. 

Exercise carried out within physical vocational and leisure activities also plays a role in decreasing stress and behaviour difficulties. 

Working in partnership

There will always be a number of key people in a young person’s life, including parents, staff and external practitioners. When they all work collaboratively together, it’s easier to ensure learning objectives are identified and young people are supported to fulfil their potential. A collaborative approach also delivers consistency for both the young person and for their family. 


Every young person will have needs and requirements which are unique to them. Often, the support of a multi-disciplinary team is central to improving the functional communication, independence skills, behaviour and mental health of young people with severe autism. 


For young people with autism, the arts can be a really powerful medium. They offer an alternative means of communicating their needs, expressions and feelings. Creativity is not dependent on language or social convention but can be expressed in many alternative sensory and communicative forms.

Autism is fascinating, enlightening, demanding and challenging; you can learn something new every day. It is a puzzle which we can help young people to solve so they can learn to thrive, achieve and be part of society. It’s all about development and understanding rather than containment and just being “OK”.

Further information

Sarah Butcher MBE is the Director of Residential Care at Prior’s Court. Sarah has worked in the care sector for many years, and her focus has been on young people with severe autism since joining Prior’s Court almost 20 years ago:

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