published 22 Nov 2014 by houghp in category with 0 comments

Terry has a complex physical disability, a learning disability and a visual impairment. He has very limited movement and appears to take very little notice of what’s happening around him.

We noticed that he put a lot of effort into raising his arm to his nose. His arm and most of his hand are encased in a splint, which is lined with a furry fabric. We saw that a little of this fabric touched his nose each time he raised his hand. We thought that he might be putting all this effort into this action to experience the feel of the fur on his nose. We wanted him to know that we had noticed his interest and would respond to him through it. In our box of equipment we have a few pencil cases, each made of different textures and each filled with a different ‘stuffing’ (survival blanket, bells, bubble wrap etc.). We chose one with a similar texture to Terry’s splint lining. Next time he touched his nose, we put a hand on his shoulder (our signal to let him know something was going to happen) and then gently stroked the pencil case across his nose, once. His facial expression changed. We tried it again and he said ‘Oooh’ in a soft tone which was unusual for him. The next time we altered the action by stroking his chin instead; he vocalised again and smiled. This was the first time we had seen him smile, so we knew we had made a connection with him.

Over the next few months we built on this connection, always trying to match our action to one of his, no matter how small, so that Terry was getting the message that we were responding to him – he was in charge. Terry showed us that he was getting braver about physical contact and we built on this by introducing anticipation games involving shoulder rubs and handshakes. Over time this has led to Terry confidently joining in a game with his housemates, involving a large body-ball being rolled from one person to another. As long as we still stick to the anticipation signals he has established with us, Terry trusts us enough to join in on his terms.

Some names have been changed to protect confidentiality but otherwise these are all real life example of our work.