* All names and identifying details have been changed to protect the privacy of individuals
Summary of Young person
Danielle is a 13 year old girl. Danielle has been diagnosed with autism and an oppositional defiance disorder. Danielle is under the care of a dietician due to concerns regarding a possible eating disorder. Danielle is under weight and is known to be reluctant to eat in the presence of others.
Danielle is prescribed medication to assist her to manage her behaviour.
Circumstances leading to placement
Danielle was initially referred to Barnardo’s due to her parent’s inability to manage her challenging and aggressive behaviour in the family home.
Danielle was admitted to a Barnardo’s residential home following a serious incident in the family home.
Immediate concerns at the start of the placement were as follows:
- Danielle’s refusal to take her prescribed medication for several months prior to the placement
- Danielle’s refusal to attend school
- Danielle’s reluctance to leave her bedroom
- Danielle’s reluctance to go out on social activities or attend appointments
- Danielle’s refusal to have any contact with her mother and siblings
- Danielle’s refusal to tend to her personal hygiene for months at a time
- Danielle’s reluctance to eat in the presence of others
Danielle’s key workers have used a range of tools and strategies to work with her since her admission. These include; person centred planning, behaviour management plans, rewards systems, visual aids and school day plans, negotiation and consultation.
Since her admission to a Barnardo’s children’s home, Danielle has made significant progress and attained the following outcomes;
Short term outcomes
Danielle has now resumed attending school and is attending on a daily basis.
Staff members have negotiated a modified timetable with Danielle’s school (including a revised start time) in order to promote her school attendance.
Staff members use sand timers to help Danielle understand the concept of time. For example, Danielle uses a 10 minute sand timer in the mornings in order to help her to achieve key steps (such as getting up, getting dressed, applying her make up etc.) within the agreed timescales.
- Danielle has resumed taking her prescribed medication following the encouragement of staff members.
- Danielle is eating her meals with staff members and other young people.
- Danielle is attending activities with staff members and other young people.
- Danielle is tending to her personal hygiene on a weekly basis.
- Danielle is now able to attend medical appointments. She therefore now has the opportunity to receive support from health professionals.
- Danielle has been supported to re-establish contact with her father and paternal relatives.
- Danielle is being supported to rebuild her relationship with her mother and siblings.
Long term outcomes
- Due to Danielle’s present stability in the placement, the Children and Adolescent Mental Health team is now in a position to carry out a re-assessment of her needs. This re-assessment may result in a review of Danielle’s current care plan.
- The current care plan stipulates that a long term therapeutic placement with onsite education and mental health support is to be identified for Danielle. This could result in Danielle being placed further away from the family home and extended family members. However, a re-assessment of Danielle’s emotional and mental health needs could result in a change of the care plan. This could lead to the possibility of Barnardo’s becoming Danielle’s long term placement.
- A potential long term outcome is the attainment of educational qualifications. Danielle is attending a mainstream school. Danielle’s placement at Barnardo’s has meant that she is able to continue to attend her school. Danielle’s improved school attendance has meant that her school is now in a position to carry out a Personal Education Plan and ensure that Danielle receives the support that she requires.
Contribution of Social Pedagogy
The staff team’s social pedagogy training has provided them with the skills, resilience and confidence to work with a young person who was extremely emotionally and physically withdrawn at the start of the placement. For example, Danielle would frequently lock herself away in her bedroom and opt to relieve herself in her room to avoid having to come out of her room to use the bathroom.
Staff members first began to make a break through with Danielle by opting to engage in meaningful conversation with her at night. Danielle tends to actively seek staff attention at night as she has difficulty sleeping. Staff members used this opportunity to discuss Danielle’s feelings and wishes.
One of the night workers was allocated to co-key work Danielle. As a result, was able to contribute to the developing of her Person Centred plan, rewards programme, a daily routine schedule and a behaviour management plan.
As Danielle is now settled into an established routine she is now better able to sleep at night. Additionally, she is now able to able to engage with all staff members throughout the day.