Boy, aged 12, Severe learning difficulties, Autistic, non-verbal and PICCA

M is a 12 year old boy, with a diagnosis of autism, ADHD and Picca. He became ill as a toddler and following that his interest in his surroundings, toys and those around him decreased dramatically. His parents reported that although his health improved his speech, which was developing typically for a boy of his age, stopped and he was not speaking at all.

M came to Pegasus School in 2005, a frustrated, anxious and frightened little boy, who would show this by displaying a range of severe challenging behaviours towards the environment, staff and peers. He was incontinent and found it extremely difficult to tolerate anything in his bedroom, as he would need to rip his bedding, mattresses, wallpaper, clothes, nappies and toys, as well as smear, all of which had a dramatic effect on his sleep pattern. He was used to having catalogues placed on his bed for him to shred, as a distraction from the environment, shredding over a book a night into tiny uniformly shaped pieces, often settling past 1-2 o’clock in the morning- it was only when he was asleep could we put a blanket over him to keep him comfortable. M also found meal times stressful, having to eat alone as to see anyone else with food would result in extreme anxiety and physically challenging behaviours.

Since joining us we have used consistent approaches developed with the occupational therapist, the speech and language therapy team, the medical team, our consultant clinical psychologist, his teacher and the dedicated group of student support assistants who were either involved in his key care team or who helped support and implement the range of programmes that were put in place for him. The programmes included assessing his sensory needs and adapting and minimising his bedroom so it could become a relaxation zone, developing his use of PECS and schedules to aid communication, reassessing his medication, looking at his diet as well as setting a zero tolerance on ripping items.

Two years on M now settles to bed at a reasonable time for a boy his age, his mattress remains permanently intact and he gets into bed under a full set of bedding! He has been out of nappies for over a year now, and he has recently had an enclosed fish tank in his room, with plans to increase the decoration and set up a sensory relaxation/cushioned corner in his room to further meet his sensory needs.

He calmly communicates using a variety of methods including gestures and limited signing, photos and symbols, working towards PECS phase 3b, and he can request what he wants without all the frustration and anxiety that he had before. We have also been successfully in significantly reducing the amount of medication he is on, with the benefits of this visible in his appearance as well as his behaviour. He attends a class of four, with often three or four staff offering a high level of support. His teaching and learning is based around the TEACCH approach, and a range of strategies for meal times have resulted in his full participation with his peers in the dining room or in his house unit, calmly choosing what he wants to eat using our symbol menus, scraping his plate in the bin when he’s finished and then helping to wash up the dishes if on his house unit.

He has made friends since joining us, often going to sit next to peers if they are upset. He has also formed lots of strong relationships with adults. He accesses the local community on average five days a week, going shopping in town, to café’s and community parks for example.

During the holidays trips further afield are planned for M. He has remained non verbal since his illness but he communicates with us in his own way, as well as learning new systems, and he is so much more relaxed and happy.

Pegasus School, Caldwell Hall, Main Street, Caldwell, Derbyshire DE12 6RS. Tel 01283 761312