Karen is a woman in her fifties with profound multiple learning difficulties and a diagnosis of autism. She is a very energetic lady, often bouncing around and flicking her fingers rhythmically on her clothing; tapping against her stomach, leg, shoes, and the arm of the chair on which she is sitting. She has a set of stock phrases she often repeats, but recently we have noticed the increasing number of phrases she echoes and picks up and uses at a later date.
We have seen Karen almost every week for twelve years and she used to dip in and out of the interactive opportunities, briefly exploring a resource from our trolley or linking her feet with ours as she sat on the swing seat in her garden. The level of engagement was intense, but fleeting, although it was repeated frequently throughout the time we spent at her home, with her returning many times to re-engage with us. She would often vote with her feet, seemingly withdrawing from the interactive space and retreating to her safe places, perhaps to process the communicative interactions that had taken place.
Our consistent approach, coupled with a regular team of practitioners, supported Karen to gradually extend the time she would spend in our presence engaging with us. It began slowly. First exploring one resource, then two, eventually sitting on the periphery of the group. Over the space of eighteen months, the time she stayed with us lengthened, until she chose to sit as a part of the group for the whole session, catching our attention from across the room. The characteristics we responded to were, how she flicked rhythms on her clothes, or how she tapped, and she began to sing along to the songs we used with others in the group or repeat the phrases other people she lived with used. Sometimes she would come to dance with us or request a hug. The change in how she chose to interact and spend time with us was immense, and had taken so long, and yet, by the time she was spending an hour in our company, completely engaged, it felt effortless!
This is a true testament to how long it can take to build up a trusting relationship with someone and how important it is to respect their boundaries yet remain constantly available and ready to engage. It may have taken ten years to get to that stage, but it was well worth the wait!
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