John is fourteen years old. He has autism and severe learning difficulties. When he came to the school he also presented with challenging, complex and aggressive behaviours. Previous school placements had broken down and he had not left his home for two years. On coming to Bladon School, John was stuck in repetitive and habitual behaviour which he did for hours on end. He was highly anxious, unable to manage transitions and found it difficult to remain on tasks he didn’t like. He also had difficulty ending motivating activities. His anxiety would increase when other young people returned to the house and he would display his anxiety by taking his clothes off, urinating, smearing and becoming vocally loud.

Bladon House School has significant previous experience of working with young people with high anxiety, autism and challenging behaviours.

The agreed outcomes to be achieved by the school were to;

• Improve John’s and his families quality of life
• Build his independence skills

Thorough assessments’ are provided for all young people referred to the school . These form the basis for planning, review and a step by step solution based approach. On arriving at the School John was allowed plenty of time to settle in to the home without there being too many demands on him. He was given a symbolised schedule with two symbols to represent ‘now’ and ‘next’.

After John’s morning routine was completed he was presented with familiar activity interests; to improve personal care, increase independence skills, reduce anxiety and the behaviours presented as a result of his anxiety.

Motivators and preferred activities were readily available throughout the day and transitions between activities and around the school site were introduced slowly.

A waking hours curriculum and dedicated team was provided in order to; build relationships with John and his family, to extend his skills in using visual prompts, with a structured predictable routine, using a TEACH approach and allowing time to process demands/requests. Specialist input was provided from the Speech and Language Therapist, Occupational Therapist, Physiotherapist, Psychologist, with regular inter disciplinary meetings. A close working relationship was developed with the family and school staff and the Psychologist engaged in direct work with them. Visual support was also provided at home as well as at school.

After four months at Bladon John was able to start the morning with minimal prompts and complete everyday routines quickly and independently. He could use six visual symbols and was attending school. He was also able to access a range of activities. These included attending worship at his mosque, visits to the park, swimming, McDonalds and buying items in a local shop. His anxiety significantly reduced and he showed no anxious behaviour with peers. John was no longer incontinent and was not smearing or destroying things.

John’s family were overjoyed with his progress in such a short period of time and were able to enjoy spending each weekend with him at their home and going out as a family.