NB joined Cascade in crisis. With a severe autistic spectrum disorder, he didn’t speak or eat. Previous to his placement at Cascade, his behaviour had often been aggressive and frequently distressed.
At seventeen years old, NB weighed just under seven stone, with the very real prospect of having to be drip-fed in hospital. Understandably, his family were desperate for help. They were well-meaning, caring people that had simply run out of ideas.
We adopted the Picture Exchange Communication System (PECS) to develop some engagement, and consulted with a number of specialists, including a dietitian and speech and language therapist, to begin to build a workable eating pattern. This was supported by a quiet and calm environment, and a team that used every bit of time, energy and imagination to reduce any sources of anxiety and improve NB’s life. We personalised his environment, including things such as monkey bedding - and realised quite quickly that he was a fan of all things simian!
In terms of NB’s eating, progress was gradual. Using PECS, we would offer him a choice of four solid foods to accompany his shakes. Initially, he wouldn’t eat in front of anyone. Then he’d eat at home. Then he’d eat with other residents. Next, we’d take him to the pub, where he wouldn’t eat at first, but would have a few chips on the way home. Ultimately, he had food in the pub with his friends - including us!
There were setbacks. NB had begun to see his parents again. This was initially accompanied, first for a couple of hours at a time, then a day, and finally over Christmas and a holiday. It was on the holiday that NB stopped eating. This time, however, we had a plan which was quickly put into place and NB continued on his upward curve.
Three and a half years on, NB is doing great. He eats well, he is happy and his behaviour reflects this. His communication extends to 100 words - with the occasional nursery rhyme thrown in!