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Positive Approaches to Support People with Autism Spectrum Condition Category: Operational Dated: May 2014 Board Review: No Review Date: May 2016

Positive Approaches to Support People with Autism Spectrum Condition

1. Purpose

The purpose of this policy is to provide all staff working with individuals with autism spectrum condition (ASC), an insight of how ASC may impact on an individual’s life, whilst providing a good practice framework and guidance in which to support and engage people with ASC in all aspects of day to day living.

2. Introduction Future Directions CIC aims to work in partnership with others in promoting opportunities for individuals with ASC, whilst ensuring there is a collaborative approach to service delivery, which reflects the quality and expectations of the service as detailed within this policy. Future Directions CIC supports a diverse range of individuals with a learning disability and complex needs; this includes those with multiple disabilities, people with ASC and additional needs such as, behaviours which challenge services, health and sensory difficulties. Future Directions CIC supports people with ASC by working in person centred ways, using a variety of person centred tools and communication methods to involve/include service users and their representatives in all aspects of their lives, whilst working in partnership with others to maximise the opportunities service users have, whilst demonstrating a consistent approach and understanding of the needs of people with ASC.

As a service we understand that people with ASC will respond in different ways to situations and or experiences and that their cognitive ability may affect their behaviours and how they cope with their day to day lives and any changes which may occur.

The policy will therefore make reference to various tools and ways of working which will inform practice when supporting a person with ASC. People with Autism can have different degrees of Learning Disability which can affect all aspects of their lives. This policy sets out the values and service specification when delivering services to people with Learning Disabilities and gives guidance and an assurance that all services must be provided in line with the principles of Valuing People. Valuing People is the Governments White Paper which sets out a 3 year strategy to help authorities plan to make services and the lives of people with a Learning Disabilities better.

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2.1 The Autism Strategy/Bill

In February 2008 The National Autistic Society launched the ‘I Exist’ campaign which carried out a survey of over 1,400 adults with ASC’s and their parents/carers (The National Autistic Society, 2010c). This survey found that many individuals with ASC’s did not receive the support they need. Subsequently negotiations in Parliament led to Government support for the Autism Bill, and the Autism Act passed in October 2009.

The Adult Autism Strategy 2011 “Fulfilling rewarding lives: the strategy for adults with autism in England”, is a key part of the Autism Act 2009 and brings statutory guidance that all Local Authority or Health Body must adhere to or they could be challenged through court.

The National Institute for Clinical Excellence (NICE) also offer clinical Guidance in “Autism: recognition referral diagnosis and management of Adults on the Autistic Spectrum.”

3. What is Autism?

Autism spectrum conditions (ASC) are lifelong conditions that affect how a person communicates with, and relates to, other people. It also affects how a person makes sense of the world around them (The National Autistic Society (NAS) – ww.autism.org.uk, 28.10.2010). People with autism can often have accompanying learning disabilities but everyone with the condition shares some difficulty in making sense of the world. People with autism can vary in their disability and this is often referred to as people on the Autism Spectrum. The word spectrum is used because the characteristics of the condition vary from one person to another. There are three main areas of difficulty that people with ASC share, which are sometimes referred to as the ‘triad of impairments’ (Wing, L 1996). These are:-

3.1. Communication – differences/difficulties using and understanding verbal and non-verbal language, that is, using and understanding words and body language in order to communicate with other people and as such many will need extra time to process what has been said to them.

Common communication differences/difficulties include:-

Difficulties with or lack of spoken language;

Problems understanding the ‘gist’ of what people are saying, or spirit in which

it is said (for example recognising jokes or sarcasm).

Having a literal understanding of language and thinking people mean exactly what they say.

Difficulty in making or maintain eye contact.

Difficulty reading other people’s facial expressions and body language.

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Difficulties in regards to social communication can mean that people with ASC

misunderstand or miss interpret information, they may find it difficult to express or accurately represent their own feelings. They may struggle to understand questions or intentions unless you make them clear and unambiguous.

3.2. Social Interaction – problems in recognising and understanding other peoples’

feelings and managing or expressing their own. This can make it difficult to fit in socially and express their needs, choices etc.

Common social interaction difficulties/differences include:-

Problems building relationships or maintaining them. This can be attributed to

empathic ability.

Finding it hard to work out what other people think or feel (e.g. not understanding why you want to ask them questions).

Difficulties in picking up the unwritten rules of social behaviour (e.g. how close

to stand to other people when talking to them).

Fewer social skills.

Special interests.

Due to these interaction difficulties some people may prefer to spend time alone rather than seek out the company of other people; whilst others maybe keen to talk to other people and make friends but do not have the skills or are unsure how to do this.

Difficulties with social interaction can make it harder for a person to explain what they want or need or they may not want to engage with others or understand how to take part in the interaction.

3.3. Social Imagination, Flexibility of Thought & Behaviour – problems understanding

and predicting other peoples’ intentions and behaviours and imagining situations outside of their routine. People with ASC find the unpredictability, confusing and daunting.

Common social imagination and flexibility of thought difficulties include:-

Problems with predicting what will happen next, or what could happen next.

Finding it hard to self organise and plan (for example, cannot structure their

day without support).

Difficulties in adjusting to a new/different pace demanded by a situation.

Difficulties with changes to planned events or routines and the different occurrences that can fill such a gap.

Less ability to transfer new skills learnt in one situation to another.

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Not understanding the concept of danger (for example, that running on to a busy road poses a threat or danger).

Fear of change and planning for the future (for example, a person might

initially reject all discussions about going somewhere new or unfamiliar).

Specialist interests: fixation on a particular topic of interest that can dominate all aspects of imagination.

Due to the difficulties described it is hard for people With ASC to understand their own needs and wants or imagine alternatives there may be to their current situation.

3.4. Other Related Characteristics:

3.4.1. Sensory Issues

Many people with ASC experience some form of sensory over sensitivity (hyper- sensitive) or under sensitivity (hypo-sensitive). A person’s sensitivity level can vary over time and between different senses the sensory sensitivities or under sensitivities can relate to:-

Sounds Touch Taste Smells Light Colours Body awareness Balance

These sensitivities may cause the person anxiety or even physical pain. It is important that a record of an individual’s sensory differences is documented via the assessment process or planning process to plan the appropriate support and environmental requirements (see Section 5.4).

All Service Users with a diagnosis of Autism should be supported to complete a sensory profile that helps identify areas of difference and sensitivity. This can feed into understanding and planning to meet the needs of the Service User (See Appendix A). 3.4.2. Stress and Anxiety

Because the world and the people in it can seem so unpredictable, many people with ASC experience stress and anxiety. This can have a great impact on the three main areas of difficulty and their sensory tolerances. Anxiety can be a real difficulty for many adults with autism and Asperger syndrome. It can affect people psychologically and physically. Anxiety can happen for many reasons and people with ASC can vary in their ability to cope with it.

For people with ASC staff must remember that they often have difficulties with their emotions as they need an imagination. People with ASC often have difficulties in this area as they are unable to imagine things and so understanding emotions can be difficult as it is abstract.

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By staff helping service users to understand anxiety, they will help or support the service user to manage their anxiety better. Staff need to support service users to ask for a referral to local service professionals to support both the service user and staff team to understand the service user’s anxiety and how to manage it effectively.

3.4.3. Other difficulties

People with ASC can have additional difficulties, such as Learning disabilities (all the people we currently support); or specific learning difficulties like dyslexia or

dyspraxia; or related conditions such as Attention Deficit Hyperactivity Disorder

(ADHD).

Asperger syndrome is a condition on the autism spectrum and normally affects people with average or above average intelligence, but they may still have complex support needs.

Some people with an ASC are able to live relatively independent lives, whilst others (the people we support) require varied levels of support throughout their lives to meet their individual needs.

4. Mental Capacity Act 2005 Considerations

Where individuals need support to help them make decisions this will be clearly documented within their support plan, person centred plan/review and decision making agreements accordingly.

5. Good Practice Principles for Supporting People with ASC

5.1 Personalisation

As a service we embrace person centred ways of working and each person unless they choose otherwise will be supported to develop a Person Centred Plan/Review (See Personalisation Policy, Health Action Planning Policy and Service User Health and Wellbeing Policy). Person Centred Support Planning means putting the person at the centre of everything we do and ensuring that they are central in planning for their lives. This is a way of helping people to work out what they want and the support that they need to help them to get it. Person Centred approaches are the methods used to help a person achieve what they want and these approaches will be determined by the person as to what works well for them.

Person centred Planning approaches such as Essential Life Style Planning also identify the pace in which an individual prefers to be supported. It also accepts that positive risk taking as necessary for individuals to grow and develop in their own way.

5.2 Total Communication

Total Communication is an approach that aims to make use of a number of modes of

communication – such as sign, oral, auditory, written, visual and objects of reference. To create a successful and equal communication between individual with different language perception and/or production and needs. To use Total Communication

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methods staff must support service users in a variety of ways and be willing to use all available means to communicate in order to understand and be understood.

5.3 Promoting Independence

The ethos of the service is to work with individuals in a person centred way, this means using the person’s preferred method of communication and individual approaches. Person Centred plans/reviews/One page profiles are used to help identify what’s important to the person to remain in control of their lives. These plans help the service to determine with the person what they want to do with their life, planning for the future and their independence. Staff will support people to do this by: -

Supporting them to do things for themselves using the appropriate tools in the

planning stages to encourage decision making and ownership of choices.

Supporting the person to interact with other people in a variety of settings and situations to encourage learning to take place and in the development of social understanding.

Working with agreed support plans in determining and evaluating outcomes and agreeing with the individual the next stages of their development, so that they are able to move forward in their plans for the future.

Supporting person centred risk taking through a multi disciplinary approach

and consultation, being mindful of the links to other relevant policies and procedures e.g. Personalisation, Health Action Planning, Risk Management.

5.4 Micro/Macro Transition

As a specialist Learning Disability service the staff are aware of the need to support people effectively through transitions and this is embedded within practice. To ensure that individuals are supported effectively in relation to both macro and micro transition guidance has been developed to assist staff in the supporting of people with autism spectrum condition through micro and macro transitions.

Micro transitions are the movements/changes/rhythms that occur on a daily basis, for example, the beginning of one activity and the end of another. Such micro transitions may include the movement of an individual from one area to another, moving from one room to another. Micro may include supporting an individual with anticipating what will be happening next, to make predictions and allow time/space for those micro transitions to occur.

Macro transitions are the significantly larger changes/events that naturally occur in people’s lives; such as moving school/college, moving house, going to Hospital or for dental treatment, starting a new job. Macro transitions may also include the changes that occur between adolescence into adulthood, understanding changing relationships and bereavement.

Staff will be expected to follow any behavioural/management/support guidelines a service user has in place to help prepare them for any micro/macro transition.

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5.5 Behaviours which challenge

Behaviours which challenge or challenging behaviours are often caused by problems of communication, social understanding, social imagination and sensory problems. It is important that support staff recognise that challenging behaviour is not inherent to a person with autism, but rather the result of barriers to effective communication, environment and social inclusion.

Therefore staff need to try to understand autism from within. Staff need to try to share the mind of someone who is different (W. Lawson & T. Peters). By trying to understand the behaviours from within (the underlying causes), staff will see that the exhibited behaviours have important functions for people with autism spectrum condition and often have a protective function.

Staff should not try to stop the behaviours but through understanding the function of behaviours staff can support service users to replace the behaviour with experiences that serve the same function.

“Learning how the senses of each individual with autism function is a crucial key towards understanding the person”. O’Neill 1999.

6. Diagnosis

Where an individual is referred to the service with a diagnosis of ASC it is important that the managers who are involved in assessment process request certain information. This should include and form part of the assessment report:

The date of the diagnosis.

The name and profession of the person who made the diagnosis.

Information or copies of any completed sensory assessments or profiles.

Any other specific information in regards to the individual and how their autism

spectrum condition effects or impacts on their day to day lives.

Where an individual is referred to the service and it suspected that they have ASC it is important that the managers involved in the assessment process gather as much information as possible, including reasons why ASC is suspected and how it impacts and affects the individuals’ day to day life. The assessment team may want to use the sensory assessment and the environmental assessment to help with the assessment process.

7. Staff Responsibilities This policy is relevant and applies to all staff working within the service and to those who work within the environment e.g. students on placement .

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7.1 Operational Network Managers and Team Manager responsibilities: Operational Network Managers and Team Managers are accountable for ensuring this policy is implemented so that all staff are aware of the contents of the policy.

Operational Network Managers and Team Managers must ensure staff are appropriately trained and have access to relevant information that will assist learning in supporting someone with ASC. Information and links in relation to ASC are available on the Service Intranet site.

Managers from Future Directions CIC will regularly review practice in relation to policies and procedures in line with research and government strategies/ directives to ensure it is still relevant and updated.

Managers from Future Directions CIC will review this policy annually to ensure it remains relevant and informs practice.

8. Individual Staff Responsibilities Staff need to familiarise themselves with the policy and other relevant policies and procedures identified within this policy.

Staff must attend relevant training as agreed with line manager and participate fully in the delivery of practice that is consistent with the policy’s intentions. Staff are responsible for the implementation of individual care plans and the documentation of any changes noted. Staff to keep up to date records (including service user records and their own personal development records/files including individual training matrices), consistent with the delivery of individual plans and progress.

9. Training “Training should be viewed as a starting point not a solution”. Autism Strategy 2010. therefore All new staff employed by Future Directions CIC will receive autism awareness training via their induction. This will be in line with the government recommendations highlighted in the autism strategy 2010 which states ‘all staff working in health and social care need to receive autism training which focus’s less on theory of autism, but more on insight into how autism directly affects individuals and families’, whilst giving practical advice and support to staff when engaging, meeting or communicating with individuals with ASC. Existing staff will access the autism awareness training via identification at appraisal and then application to attend via induction.

10. References/Further Reading

Attwood.T (1998) – Asperger Syndrome: a guide for parents and professionals. London. Jessica Kingsley publishers.

Bogdashina. O- (2003) - Sensory Perceptual Issues in Autism: Different Sensory Experiences - Different Perceptual Worlds, London. Jessica Kingsley Publishers. Clements, J. and Zarkowska, E. (2000) Behavioural concerns and autistic spectrum disorders: explanations and strategies for change. London Jessica Kingsley Publishers

http://www.amazon.co.uk/exec/obidos/search-handle-url/203-4018435-2971137?%5Fencoding=UTF8&search-type=ss&index=books-uk&field-author=Olga%20Bogdashina

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Autism strategy..... Gillberg.C (2002) - A guide to Asperger syndrome. Cambridge. Cambridge University Press. Godwin Emmons, P. and McKendry Anderson, L. (2005) Understanding sensory dysfunction: Learning, Development and Sensory Dysfunction in Autism Spectrum Disorders, ADHD, Learning Disabilities and Bipolar Disorder. London. Jessica Kingsley Publishers. Howlin.P (1998) – Children with Autism and Asperger syndrome: A guide for practitioners and carers. Chichester.

Wiley

Jordan .R (2001) –Autism with Severe Learning Difficulties: A guide for parents and professionals. London. David Fulton Humphreys, S (2005) ‘Autism & architecture’www.autismlondon.org.uk/pdf-files/bulletin_feb-mar_2005 accessed 16 March 2006 Morgan.H (1996) –Adults with Autism; A guide to theory and practice. Cambridge, Cambridge University Press Morton-Cooper (2004)-Health Care and the Autism Spectrum –A Guide for Health Professionals, Parents and Carers, London, Jessica Kingsley Publishers. National Autistic Society (2006 a)-Information sheet: What is autism? London. National Autistic Society. National Autistic Society (2006 b) - Information sheet: What is Asperger syndrome? London. National Autistic Society. Nguyen.A (2006), Creating an autism-friendly environment, London. The National Autistic Society. Plimley.L (2004) Analysis of a student task to create an autism-friendly living environment. BILD.Good Autism Practice Journal 5.2 Pp35-41 Schopler.E (1995) –Parent Survival Manual; A guide to crisis resolution in Autism and related Developmental disorders. New York and London, Plenum Press Whitaker.P (2001) –Challenging Behaviour and Autism-Making sense, making progress; A guide to preventing and managing challenging behaviour for parents and teachers. London. National Autistic Society. Whitehurst .T (2006)-The impact of building design on children with autistic spectrum disorders. BILD Good Autism Practice Journal 7.1 pp31-9 Wing.L (1996)-The Autistic Spectrum; a guide for parents and professionals. London. Constable and Robinson.

Planning Support Health Action Planning Risk Management (Service User) Personal Relationships and Sexuality Personal Care Positive Behavioural Support Fair Recruitment and Retention Learning and Development Course and Conference Application Supervision Appraisal Requests for Services Friendship and Support End of Life (Including Death of a Service User and Notification of Death)

http://www.autismlondon.org.uk/pdf-files/bulletin

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Positive Approaches to Support People with Autism Spectrum Condition Appendix A

Sensory Profile Checklist Revised (SPCR)

Please write clearly, in black ink, initial amendment and do not use tippex

Name Date of Birth

Date Diagnosed

By whom Where?

Purpose This checklist was originally designed by Olga Bogdashina for completion by parents of children who have been diagnosed as having Autism Spectrum Disorder (ASD). The SPCR is intended to clarify the sensory experiences of individuals and to draw a sensory profile (‘Rainbow’) in order to identify possible sensory strengths and weaknesses that would be helpful in selecting appropriate methods of support and working with individuals on a day to day basis. Instructions Please tick the appropriate answer to indicate the statement described as: WT – Was True in any time in the past: in brackets, specify the age of the child when

the statement was true, e.g. (two-five years). T – True now (if it was true and is true now, tick both answers). F – False (if the statement is not true). NS – Not Sure or do not know.

Additional information is welcome: write it near the question, or copy the question number on a blank sheet of paper and add the information there. Please try to answer all questions.

No. Behaviours WT T F NS

1 Resists any change

2 Notices every tiny change in the environment

3 Does not recognise a familiar environment if approaches it from a different direction

4 Does not recognise people in unfamiliar clothes

5 Is not fooled by optical illusions

6 Constantly looks at minute particles, picks up smallest pieces of fluff

7 Dislikes dark and bright lights

8 Is frightened by sharp flashes of light, lightning, etc.

9 Looks down most of the time

10 Covers, closes or squints eyes at bright light


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11 Is attracted to lights

12 Looks intensely at objects and people

13 Moves fingers or objects in front of eyes

14 Is fascinated with reflections, bright coloured objects

15 Runs a hand around the edge of the object

16 Perimeter hugging

17 Gets easily frustrated/tired under fluorescent lights

18 Gets frustrated with certain colours (specify: )

19 Is fascinated with coloured and shining objects (specify: )

20 May respond differently (pleasure – indifference – distress) to the same visual stimuli (lights, colours, visual patterns, etc.)

21 Selects for attention minor aspects of objects in the environment instead of the whole thing (e.g. a wheel rather than a whole toy car, etc.)

22 Gets lost easily

23 Fears heights, stairs and escalators

24 Has difficulty catching balls

25 Appears startled when being approached suddenly

26 Makes compulsive repetitive hand, head, or body movements that fluctuate between near and far

27 Hits/rubs eyes when distressed

28 Feels/acts blind

29 Ritualistic behaviour

30 Response to visual stimuli is delayed (e.g. fails to close eyes when the light is being switched on, etc.)

31 Any experiences are perceived as new and unfamiliar, regardless of the number of times the child has experienced the same thing

32 Sudden outbursts of self-abuse/tantrums or withdrawal is response to visual stimuli

33 Does not seem to see if listening to something

34 Avoids direct eye contact

35 Appears to be a mindless follower

36 Surprises with knowing ‘unknown’ information

37 Smells, licks, touches or taps objects

38 Seems to be absorbed (merged) with lights, colours, patterns

39 Seems to know what other people (who are not present) are doing

40 Covers/rubs/blinks, etc, eyes in response to a sound/touch/smell/taste/movement

41 Complains about (is frustrated with) the ‘wrong’ colours of letters/numbers, etc on coloured blocks, etc.

42 Displays a good visual memory

43 Reactions are triggered by lights, colours, patterns

44 Easily solves jigsaw puzzles

45 Remembers routes and places

46 Memorises enormous amounts of information at a glance

47 Poor at mathematics.

48 Learns nouns first


49 Has difficulties with adverbs and prepositions

50 Idiosyncratic patterns in language development (e.g. names one

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thing to denote the other, etc.)

51 Gets easily frustrated when trying to do something in a noisy, crowded room

52 Does not seem to understand instructions if more than one person is talking

53 Covers ears at many sounds

54 Is a very light sleeper

55 Is frightened by animals

56 Dislikes thunderstorm, sea, crowds

57 Dislikes haircut

58 Avoids sounds and noises

59 Makes repetitive noises to block out other sounds

60 Bangs objects, doors

61 Likes vibrations

62 Likes kitchen and bathroom

63 Likes traffic, crowds

64 Is attracted by sounds, noises

65 Tears paper, crumples paper in the hand

66 Makes loud rhythmic noises

67 Gets frustrated with certain sounds (specify: )

68 Tries to destroy/break objects producing sounds (clocks, telephone, musical toy, etc.)

69 Is fascinated with certain sounds (specify: )

70 May respond differently (pleasure – indifference – distress) to the same auditory stimuli (sounds, noise)

71 Hears a few words instead of the whole sentence

72 Pronunciation problems

73 Unable to distinguish between some sounds

74 Hits ears when distressed

75 Feels/acts deaf

76 Response to sounds, questions, instructions is delayed

77 Echolalia in monotonous, high-pitched, parrot-like voice

78 Sudden outbursts of self-abuse/tantrums or withdrawal in response to auditory stimuli

79 Does not seem to hear if looking at something.

80 Reacts to instructions better when they are ‘addressed to the wall’

81 Looks for the source of the sound

82 Seems to be absorbed (merged) with sounds

83 Seems to be able to ‘read’ thoughts, feeling etc of others

84 Complains about ‘non-existent’ conversations, sounds

85 Covers/hits ears in response to light, colours/touch, texture/smell/taste/movement

86 Complains about (is frustrated with) a sound in response to colours/textures/touch/scent/flavour/movement

87 Displays a good auditory memory (for nursery rhymes, songs, etc.)

88 Reactions are triggered by sounds/words

89 Uses idiosyncratic routinised responses


90 Uses songs, commercials, etc to respond

91 Cannot keep track of conversation

92 Composes musical pieces, songs

93 Unable to distinguish between tactile stimuli of different intensity

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(e.g. light and rough touch)

94 Resists being touched

95 Cannot tolerate new clothes, avoids wearing shoes

96 Overreacts to heat/cold/pain

97 Avoids getting messy

98 Dislikes food of certain texture (specify: )

99 Moves away from people

100 Insists on wearing the same clothing

101 Likes pressure, tight clothing

102 Seeks pressure by crawling under heavy objects, etc.

103 Hugs tightly

104 Enjoys rough and tumble play

105 Prone to self-injuries

106 Low reaction to pain, temperature

107 Cannot tolerate certain textures (specify: )

108 Is fascinated with certain textures (specify: )

109 May respond differently (pleasure – indifference – distress) to the same tactile stimuli (Clothes, touch, heat, pain, etc.)

110 Complains about parts of the clothes

111 Hits/bites themselves when distressed

112 Feels/acts numb

113 Sudden outbursts of self-abuse/tantrums or withdrawal in response to tactile stimuli

114 Does not seem to feel being touched if looking at/listening to something

115 Fails to define either texture or location of touch

116 Can tolerate only ‘instrumental’ (not ‘social’) touch

117 Sometimes does not react to any tactile stimuli

118 Seems to be absorbed (merged) with certain textures

119 Seems to feel pain of others

120 Complains about being touched/hot/cold, etc. In the absence of the stimuli

121 Complains about (is frustrated with) feeling colours, sound, etc. When being touched

122 Complains about (is frustrated with) feeling being touched when being looked at.

123 Complains about (is frustrated with) backache, etc./heat/cold in colourful/noisy/crowded places.

124 Displays a good tactile memory.

125 Reactions are triggered by textures/touch/temperature.

126 Unable to distinguish between strong and weak odours.

127 Toileting problems.

128 Runs from smells.

129 Smells self, please, objects, etc.

130 Smears/plays with faeces.

131 Seeks strong odours.


132 Bedwetting

133 Cannot tolerate certain smells (specify: )

134 Is fascinated with some smells (specify: ).

135 May respond differently (pleasure – indifference – distress) to the same smells

136 Complains about smells of some pieces of food while ignoring the

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rest

137 Hits nose when distressed

138 Has difficulty in interpreting smells

139 Response to smells is delayed

140 Sudden outbursts of self-abuse/tantrums or withdrawal in response to smells

141 Does not seem to feel smell when looking/listening, etc.

142 Avoids direct smells

143 Sometimes does not react to any smell

144 Inspects food before eating

145 Seems to be absorbed (merged) with smells

146 Complains/talks about ‘non-existent’ smells

147 Covers/rubs/hits nose in response to a visual/auditory stimulus/touch/taste/movement

148 Complains about (is frustrated with) the smell in response to a visual/auditory stimulus/touch/taste/movement

149 Displays a good memory for smells

150 Reactions are triggered by smells

151 Unable to distinguish between strong and weak tastes

152 Poor eater

153 Uses the tip of the tongue for tasting

154 Gags/vomits easily

155 Craves certain (plain) foods.

156 Eats anything (pica)

157 Mouths and licks objects

158 Eats mixed food (e.g. sweet and sour)

159 Regurgitates

160 Cannot tolerate certain food (specify: )

161 Is fascinated with certain tastes (specify: )

162 May respond differently (pleasure – indifference – distress) to the same food

163 Is confused with (complains about) the food he used to like

164 Has difficulty in interpreting tastes

165 Response to tastes is delayed

166 Sudden outbursts of self-abuse/tantrums or withdrawal in response to taste

167 Does not feel any taste while eating something and looking at/listening to something

168 A very careful eater

169 Sometimes does not react to any taste

170 Seems to be absorbed (merged) with certain food

171 Complains/talks about ‘non-existent’ taste in mouth

172 Makes swallowing movements in response to a visual/auditory stimulus/touch/smell/movement


173 Complains about (is frustrated with) some tastes in response to a visual/auditory stimulus/touch/smell/movement

174 Displays a good memory for tastes

175 Reactions are triggered by certain food

176 Clumsy, moves stiffly

177 Odd body posturing (places the body in strange positions)

178 Difficulty manipulating small objects (e.g. buttons)

179 Turns the whole body to look at something

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180 Low muscle tone

181 Has a weak grasp, drops things

182 A lack of awareness of body position in space

183 Unaware of their own body sensations (e.g. does not feel hunger)

184 Bumps into objects, people

185 Appears floppy, often leans against people, furniture, walls

186 Stumbles frequently, has tendency to fall

187 Rocks back and forth

188 Cannot tolerate certain movements/body positions.

189 Is often engaged in complex body movements, esp. when frustrated or bored

190 May have different muscle tone (low-high)

191 Pencil lines, letters, words, etc. Are uneven (e.g. sometimes too tight, sometimes too faint)

192 Complains about limbs, parts of the body

193 Difficulty with hopping, jumping, skipping, riding a tricycle/bicycle

194 Does not seem to know what their body is doing

195 Very poor at sports

196 Tires very easily, esp. when in noisy/bright places, or when standing

197 Does not seem to know the position of the body in space/what the body is doing, when looking at/listening to/talking

198 Has difficulty imitating/copying movements

199 Does not seem to know how to move their body (unable to change body position to accommodate task)

200 Watches their feet while walking

201 Watches their hands while doing something

202 Seems to be absorbed with body movements

203 Complains about ‘non-existent’ physical experiences (e.g. ‘I am flying’, etc.)

204 Involuntary postures of the body in response to a visual/auditory stimulus/smell/taste/touch

205 Displays a very good proprioceptive memory e.g. understands directions better if produces exact movements they have to do in order to follow these directions

206 Reactions are triggered by body positions/movements

207 Mimics the actions when instructions are being given

208 Resists change to head position/movement

209 Fearful reactions to ordinary movement activities (e.g. swings, slides, merry-go-round, etc.)

210 Has difficulty with walking or crawling on uneven or unstable surfaces

211 Dislikes head upside down

212 Becomes anxious or distressed when feet leave the ground

213 Enjoys swings, merry-go-round

214 Spins, runs round and round

215 Fears falling or height

216 Spins, jumps, rocks, etc. Esp. when frustrated or bored

217 May respond differently (pleasure – indifference – distress) to the same movement activities (swings, slides, spinning, etc.)

218 Resists new motor activities

219 Tiptoeing

220 Becomes disoriented after a change in head position

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221 Seems oblivious to risks of heights, etc

222 Holds head upright, even when leaning or bending over

223 Gets nauseated or vomits from excessive movement (swings, merry-go-round, cars, etc.)

224 Does not seem to mind any movements when looking at/listening to something/talking

225 Avoids balancing activities

226 Becomes disoriented in noisy/bright places, or after physical activities

227 Rocks unconsciously during other activities (e.g. watching a video)

228 Inspects the surface before walking on it

229 Appears to be in constant motion

230 Involuntary movements of the body in response to a visual/auditory stimulus/smell/taste/touch.

231 Experiences movement while being still (e.g. ‘I am flying’ while being in bed)

232 Reactions are triggered by motor activities

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KEY FOR DECODING THE CHECKLIST


This key will aid you in completing the chart and rainbow. If you have ticked the ‘True’ box for a question in the Sensory Profile Checklist then you will need to colour in the corresponding box in the chart. For example, if you have answered Question 15 as ‘True’ then you colour in Box 2 in the V column. Some questions in the profile relate to the same box in the chart. For example, if you have answered ‘True’ to either Question 76 or 77, colour in the Box 9 in the H column. Once you have completed the chart, count the number of coloured boxes in the corresponding section. Colour in the same number of boxes in the corresponding section of the rainbow. For example, if you have coloured in ten boxes in the V column, then colour in ten boxes of the V section of the rainbow. V – Vision T – Taste H – Hearing P – Proprioception Tc – Tactility Vs – Vestibular S - Smell

1 V1, V6

2 V1

3 V1, V6

4 V1, V6

5 V1

6-9 (hyper-) V2

10 V2, V3

11-16 (hypo-) V2

17-18 V3

19 V4

20 V5

21-22 V6

23 V7, Vs7

24 V7, P7

25-27 V7

28 V8

29 V8, HV, Tc8

30 V9

31 V9, H9, Tc9

32 V10

33 V11

34 V12

35-36 V13, H13

37 V14, Tc14

38 V15

39 V16

40-41 V17

42 V18

43 V19

44-50 V20

51-52 H1

53-59 (hyper-) H2

60-66 (hypo-) H2

67-68 H3

69 H4

70 H5

71 H6

72-74 H7

75 H8

76-77 H9

78 H10

79 H11

80 H12

81 H14

82-83 H15

84 H16

85-86 H17

87 H18

88-91 H19

92 H20

93 Tc1

94-98 (hyper-) Tc2

99-100 (hyper-) Tc2, S2

101-106 (hypo-) Tc2

107 Tc3

108 Tc4

109 Tc5

110 Tc6

111 Tc7

112 Tc8

18


113 Tc10

114-115 Tc11

116 Tc12

117 Tc13

118-119 Tc15

120 Tc16, Tc20

121-123 Tc17

124 Tc18

125 Tc19

126 S1

127-128 (hyper-) S2

129-132 (hypo-) S2

133 S3

134 S4

135 S5

136 S6

137 S7

138 S8

139 S9

140 S10

141 S11

142 S12

143 S13

144 S14, T14

145 S15

146 S16, S20

147-148 S17

149 S18

150 S19

151 T1

152-155 (hyper-) T2

156-159 (hypo-) T2

160 T3

161 T4

162 T5

163 T6, T7

164 T8

165 T9

166 T10

167 T11

168 T12

169 T13

170 T15

171 T16, T20

172-173 T17

174 T18

175 T19

176 P1

177-179 (hyper-) P2

180-183 (hypo-) P2

184 (hypo-) P2, Vs2

185-186 (hypo-) P2

187 (hypo-) P2, Vs2

188 P3, Vs3

189 P4

190-191 P5

192 P6

193 P7

194 P8

195 P9

196 P10

197 P11

198 P12

199 P13

200-201 P14

202 P15

203 P16, Vs16, Vs20

204 P17

205 P18

206 P19

207 P20

208 Vs1

209-212 (hyper-) Vs2

213-214 (hypo-) Vs2

215 Vs3

216 Vs4

217 Vs5

218 Vs6

219 Vs7

220 Vs8

221 Vs9

222 Vs9, Vs13

223 Vs10

224 Vs11

225 Vs12

226-227 Vs13

228 Vs14

229 Vs15

230 Vs17

231 Vs18, Vs20

232 Vs19

19 Positive Approaches to Support People with Autism Spectrum Condition Category: Operational Dated: May 2014 Board Review: No Review Date: May 2016

RAINBOW AND TABLE


V H Tc S T P Vs

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

20 Positive Approaches to Support People with Autism Spectrum Condition Category: Operational Dated: May 2014 Board Review: No Review Date: May 2016

RAINBOW AND TABLE


This document is available to use and can be accessed via G drive, Future Directions Forms, Service Users, Health, Autism revised which meets the Copyright requirements of appendix 1,2,3 of ‘Sensory Perceptual Issues in Autism and Asperger’s Syndrome’ by Olga Bogdashina. NB: The copyright allows photocopying of appendix 3 Rainbow and Table and the use of the Sensory Profile Checklist Revised and Key for decoding the checklist but does not allow photocopying of these two appendices. None of the appendices can be published to any website or other publication.

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