Case Studies

Case 5: Autism and transition

Stephen was diagnosed with autism and a severe learning disability at the age of 2 years and has required specialist support including speech and language therapy and specialist education placements. He attended a specialist boarding school from the age of 7 years and has behaviour that sometimes challenges staff, family and other students. Stephen responds well to routine and order.

He has little verbal communication but can understand simple questions from staff. Within the school, staff use picture exchange communication system (PECS) and augmented communication techniques to communicate with him. Stephen is very established at the school but now, at almost 19 years, he needs to leave. Stephen is 6-ft tall and when upset or anxious can demonstrate challenging needs and self-injurious behaviour. Stephen’s family are very clear that they want Stephen to continue to receive specialist support for his autism and behavioural needs.

• 1. What will you need to consider as the learning disability nurse when planning Stephen’s future care needs?

  Show Answer

  Correct answer:

  • Stephen will need ongoing support in a specialist service that can meet the needs of people with a severe learning disability and autism. Any setting will also need to meet his communication and behavioural needs and maintain his current communication abilities using a PECS.
  • You will need to consider resources/finances available to support this move and keep the family informed and involved in this transition planning.
  • You may find it helpful to use an advocacy service that can help represent Stephen’s needs, as these may differ from the family’s wishes. It may also help you to be clear about your role as the learning disability nurse.
  • Whist at boarding school, Stephen had the support of the speech and language therapists, so this support will need addressing in future plans.
  • Stephen will need support in adjusting to change and will need help with finding meaningful occupation/interests.
  • The Multi-Disciplinary Team (MDT) will need to consider the implementation of a behaviour support plan with the involvement of the relevant teams/professionals.