William wants structure

William wants structure

William has autism and has not spoken for many years. He uses his own form of Makaton which he has become reliant on because he feels it gets his message across. However, as he has got older he has been having difficulty communicating his needs.

William likes structure in his life; knowing what he doing, when and with whom is vital for him. He lives his life by his daily and weekly calendars. He has a daily pictoral chart which he sets up each morning with his daily routines for food, medication and anything else for the day; he also has a normal calendar on which his key worker draws whatever activity he will be doing that day. This is usually done one or two weeks in advance so that he knows what is happening. Staff run through his pictoral charts each day to reassure him about what is going to happen that day and to remind him about future planned events and special occasions such as holidays, concerts football matches and visits to family.

If things do not go as William expects he self-harms by slapping and punching his face, lowering his trousers and slapping his thighs, and head butting door frames or he causes damage to his home.

Staff have been using his pictoral chart and calendar to help William to understand what is happening in his life. They have found that he does not like to hear the word ‘no’ and that this was one of the major triggers for his self-harming or causing damage. It was decided that staff should always reply to William’s questions in a positive way. So, when he asks “Will I be going to see my Dad” the reply is “Yes, you are going to see your Dad” at the same time showing him on the calendar when this is due to happen.

Simply reassuring him about events in his life has decreased William’s self-harming and helped him to feel much less anxious.