CASE: Pull It Together

RESULTS: Support and Trust

Overview: Barbara is a 38-year old woman with a diagnosis of Moderate Intellectual Disability; Bipolar Disorder; Intermittent Explosive Disorder and Pervasive Developmental Disorder.  Barbara exhibits several serious challenging behaviors including Property Destruction; Aggression; Self-Injurious Behaviors and has a history Pica. In 2003, she was a psychiatrically hospitalized for verbal and physical aggression to her family and strangers and it was no longer safe for her to reside with her family, as she needed 24/7 supervision and care.

Although Barbara was getting support, she frequently called 911 when feeling anxious or bored

Challenge: She is friendly and outgoing but may need reminders to maintain appropriate social boundaries. Barbara can be very sensitive to how others feel and their perception of her. When she becomes anxious, Barbara can often be overheard telling herself to “calm down” or “pull it together.” Barbara may go through periods of severe deterioration of emotional stability and adaptive function. Although Barbara was getting support, she frequently called 911 when feeling anxious or bored; or if she perceives that others are not responding to her requests in a timely manner.

Solution: Our SYC Behaviorist spent a lot of time getting to know Barbara and gaining trust. Previously, Barbara would physically attack people she did not trust and use loud and derogatory language. Over time, she began to trust her behaviorist and would take her proactive suggestions. The two developed a plan, which included getting Barbara connected to a therapist to manage her untreated anxiety, replacement activities instead of calling 911,  and coping skills to help manage stressful situations.

Results: Barbara is no longer calling 911. She has developed friendships outside of the home and has a circle of friends that she is able to call each day. Barbara is better able to structure her leisure time and has a variety of activities that she enjoys participating in. She now calls her SYC Behaviorist to share when she is having a good day, instead of calling when she is in crisis.

CASE: Out Of Control

RESULTS: Developed Skill Set

Overview: “Carol” is 39-year-old women with Moderate Intellectual Disability and Down Syndrome, and has been working with Stephanie Young Consultants for the past 3 years. Due to these diagnoses, Carol is often inflexible, has difficulty controlling her emotions, causing her to become easily upset, and often out of control.

Challenge: When Carol is out of control. She can be verbally and physically aggressive and has destroyed property. Due to these behaviors, she resides in a residential home with 24/7 staff and requires an extensive amount of attention to keep her calm when she is upset.Carol has learned that if she becomes upset enough, staff will provide her with the attention she enjoys. Although Carol can communicate verbally, she often has limited understanding of the context and language in everyday conversation, and when she misinterprets this, it often leads to her aggressive outburst. She can be independent for some of her daily living tasks but does need assistance on awareness and abilities. Carol has a supportive family. Carol has an infectious smile, she enjoys Disney movies, ice cream, and loves any activity involving art. She looks forward to outings with her family.

Carol learned how to safely express her frustrations without yelling, hitting or throwing things

Solution: Our SYC behaviorist has provided direct care service providers with the training and intervention strategies necessary to manage and modify difficult behaviors, while teaching functionally related replacement skills to Carol. SYC engages Carol in behavioral art activities, creating social stories that help Carol learn how to safely express her frustrations without yelling, hitting or throwing things. Her SYC Behaviorists trains staff at Carol’s residence to help give them the tools they need to better manage Carol’s outburst. She has also worked closely with staff on repeating verbal communication to ensure Carol understood what was being asked, as well as not engaging in carol’s attention-seeking behaviors. SYC has also worked with Carol and staff to create structure and positive reinforcement in the home that help carol lower her overall frustration to everyday events.  Carol has been currently working on flexibility by defining what situations are a big deal versus little deal along with coping strategies that could be helpful in little deal situations.

Results: Since working with SYC Behavior, Carol has had a decrease in her overall serious incidents, utilizes alternative means of expressing her frustration and communicate to others her needs.