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Autism: planning for transition into community living

Dr Mitzi Waltz, disability consultant, trainer and writer gives hers tips and advice on supporting autistic people to transition into community living. Dr Waltz discusses working in a person-centred approach and gives some practical advice on how best to support autistic people during this life transition.   

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Author: Dr Mitzi Waltz

Autism: planning for transition into community living

If you are an autism service provider, one of your most important tasks is likely to be supporting transitions into community-based living. Personalisation and attention to detail are key to making the process a success. This article provides useful tips to help you provide the best possible support, and achieve good results for clients.

If you are a parent or carer, you may also find this article helpful in working cooperatively with professionals.

Personalisation

Whether the adult you are working with is a young person stepping into adult life for the first time, or an older person transitioning from residential care to community living or in need of assistance—perhaps due to aging or other life transitions—that adult should be at the centre of the planning process. 

Begin by building up a picture of the person’s needs, preferences and occupations, the important people in their lives, and the facilities and services that they use. Things to ask about include, but should not be limited to:

•    names and locations of family and friends who are important to them—any who provide occasional or regular care should be prioritised
•    name and location of GP and of any specialists or therapists they see 
•    location of work, voluntary work or courses they do
•    location of other important places—day centres, clubs, any places where they have a sense of belonging
•    favoured activities, such as hobbies, and their usual daily routine.

Ask anyone what makes a place feel like “home,” and it’s the presence of familiar people and things. That’s one of the main reasons out-of-area placements are frequently a failure. People with autism may struggle to maintain their interpersonal connections, but these are nonetheless essential to their wellbeing. It is counterproductive when decisions made by others disrupt relationships. It’s also a hallmark of autism that transferring skills between locations can be extremely difficult.

So, when making plans for housing, always try to keep the person in, or very close, to the community they know. The one exception to this rule is if the person themselves requests a different location: for example, an adult planning to live independently whilst attending university may well need to move to a new city.

Attention to detail

Adults who are verbal or who are skilled at using communication devices can usually tell you which skills they have, and which they need to develop, before they will be able to manage on their own. Areas you may need to ask about include:

•    budgeting and paying bills
•    meal-planning and shopping
•    basic cooking
•    personal care
•    basic household chores
•    independent communication with GP and other professionals
•    managing paperwork e.g. benefits forms
•    handling problems with neighbours effectively
•    safety at home and in the community
•    using public transport.

That’s not to say that adults living in the community need to have personal mastery of all these skills: many adults on the autism spectrum are capable in some areas but need temporary, occasional or lifelong support in others. However, you need to be certain that either the adult has shown (not just said) that they can manage in each of these areas, or that where support is required, it is provided. 

For those who are moving into group homes, skills for independence are equally important—and so are staff attitudes. There can be a danger of staff jumping in to do things for residents, resulting in loss of skills, unless they have proof that the person is capable and have been instructed to give them time and space to manage their own lives to the greatest extent possible.

How to help

Preparation can be difficult with local social services operating on austerity budgets, so parents and carers can often play a helpful role. If you learn that an adult has not had a chance to learn how to do laundry, for example, you could set up a home-based training programme with the parent. You can use written or pictorial checklists to provide support that the person can then take to their new home. Skills learned in one location may need to be relearned when the type of washing machine and location changes, but the feeling of competence gained from learning once will make the process easier the second time. Make a visual record of competence that the person can refer to, in written form, or using photos of skills being successfully employed.

Skills practice should be in real-world conditions whenever possible. For example, rather than having a discussion about communicating with your GP, it makes much more sense to actually communicate with the GP, with support, then have a chance to discuss what could be done differently or more effectively before trying again.

Meal-planning, shopping and cooking are roadblocks for many young adults, including typically developing university students. Creating a personal cookbook on paper (perhaps laminated), as a computer file, or using a cooking Web site or mobile app is a great way to begin, and gives the person ownership of the end product for life. Hands-on practical experience of preparing healthy food, preferably repeated enough times to gain real confidence in the kitchen, is a must. It’s usually better for this to happen in a home kitchen than on a course.

Realistic budgets based on likely benefits levels or actual wages can be created, and used as the basis for discussing how to save money on food, utility bills, transport costs and so on. 

Date added: 29 April 2016