Crisis Services with People Who Have Autism

TEAM AUTISM

Committee for

Seamless Services After Age 21

Crisis Prevention Plan

•Proactive planning is essential for individuals who have autism

•May require thinking outside the box

•Flexible & individualized practice approaches

•Focus on prioritizing risks most likely to occur

How to Prepare

1) Review historical patterns in terms of crisis response, prevention, intervention, stabilization & recovery

2) Evaluate potential areas of risk using caregiver interview and risk assessment tools

3) Select situation most likely to occur

4) Provide ample opportunity for team members to consider ramifications of such event regarding phases of prevention, intervention and recovery

- designate roles- assign duties- give team members permission to skip

perfection

Crisis Planning Meeting

•Share ideas regarding prevention•Share ideas regarding intervention•Share ideas regarding recovery•Gain consensus to measure how “crisis” is

defined for the individual•Develop behavioral support plans to help

the person cope•Teach coping strategies on an ongoing

basis

Crisis Planning Meeting Exercise• Envision the crisis event happening• Imagine how the person is reacting as

strategies are implemented• Imagine what staff are doing• What potential problems do you encounter?• What if anything can you see that you need

that you can not access quickly?• What can you accomplish easily?• What requires considerable effort?• What stands out as something that you need

help with during intervention?

Crisis Prevention Planning

•What needs does this person have for routine?

•What needs exist for provider relief?•When is stress most likely to lead to a

crisis situation?•What actions during intervention may

increase stress?•What changes would be necessary in a

crisis situation?

Crisis Prevention Planning• Using likert scale rating, how stressful are the

following factors for this individual? Change in identity of caregiver Change in daily schedule Change in location of belongings Change in weather Change in noise or activity levels Change in lighting Requests/Demands for activity Other _______________________

Crisis Prevention Planning• List a potential resolution for identified concern.

i.e. Change in caregiver = High Stress

How to Resolve a change in caregiver? - Practice specific social script for coping with change - Introduce service participants to new caregivers during socialization

rather than immediate immersion in caregiver role- Pair new caregiver with old caregiver for shadow work so new caregiver

can learn to mimic preferred supports - Have favorite or most trusted caregiver provide initial

introductions and tips for successful interaction

- Collaborate with first responders.

For example, schedule a tour of crisis respite sites, recruit a local police officer to join the team, offer training for paramedics……

Young Adults in Transitional Crisis

CONCERNS• Self identity• Functional

milestones • Total lifestyle

change• New social demands• Coping with anxiety

and fear• Looking back at

achievements• Looking forward at

new goals

POTENTIAL AIDS• Receptive &

expressive language skills

• Communication methods for life review

• Opportunity to maintain historical social bonds

• Support for gradual transitions using desensitization

• Lots of praise & reinforcement

Making Change Easier to Cope With•May vary from person to person•Planning, discussion, practice & relief•Verbally recognize change when it happens•Use photographs to increase understanding,

comprehension and clarity•Practice making changes in small increments•Verbally acknowledge losses, gains &

differences•Gradually fade out old stimuli as it is

replaced more with new stimuli•Role model client-specific coping techniques

School-to-Work Transition Planning•Beginning at Age 14

▫Meet with School Personnel ▫Develop initial relationships with

community resource providers by requesting information, tours, and comparing service options

▫Complete community resource eligibility applications

▫Determine education tracking path▫Communicate changes to providers

Young Adult Residential Changes• Community based services may empower your

young adult to remain at home or move into an individualized support setting with daily staff

• Explore all behavioral health care, home health care, personal care, and independent living options within your region

• Apply for Housing and Urban Development assistance

• Residential options require annual approval & renewal of eligibility to determine the level of service

• Familiarize yourself with Behavioral Health Services policies such as Policy 8114- Change in Residence Policy