Case Study - Sebastian

Sebastian is 8 years 8 months. He has Leber"s amaurosis, with light perception only. He has moderate learning difficulties and a diagnosis of autism.

Sebastian attends a special school for young people with visual impairment where he is taught in a class of six pupils who have little or no sight and additional needs. He has additional support provided by two Teaching Assistants (TAs) who are permanently attached to the class.

He is learning to use a long cane and echo location. In fact, during his lessons with the mobility teacher, the cane can be seen as part of the task structure, a component of the TEACCH approach. It may help him to stay on task.

Sebastian appears to understand the verbal language used in class well enough to function effectively. However, he does not always respond to instructions, despite apparently understanding what he has been told to do. To support his receptive communication, staff reduce the amount of spoken language and simplify it. They also give explicit instructions.

Although Sebastian communicates verbally, he tends not to engage spontaneously with other people. He usually responds to questions. Sebastian sometimes participates briefly in a conversation with a group consisting of his teacher and 2 or 3 peers; he makes relevant comments which indicate a better than expected level of social awareness. However, he rarely engages with his peers when the teacher is not involved.

Sebastian presents as rather aloof and detached. This cannot be easily explained, but is probably related to a certain quality in the intonation of his speech.

He is learning uncontracted braille.

Sebastian has a deep interest in cassette recorders. They are used to provide him with tangible rewards.

Sebastian is reluctant to repeat tasks, so he is provided with a wide variety of tasks to practise any given skill.

Because he is single channelled, Sebastian cannot attend to another person whilst he is engaged with a task. He blocks out all attempts by another person to attract his attention and to provide assistance. Thus staff need to understand when it is not appropriate to initiate communication with him.

There is some zoning in the classroom, where the layout remains constant. Sebastian has a designated seat at the work-tables, so he can find it independently. When a change is made, it is explained and demonstrated to Sebastian.

To help Sebastian to navigate around the classroom, clutter is minimised.

In the past, Sebastian quite frequently kicked people and objects; bit, scratched and head butted others; banged his head against objects; screamed; swore; and threatened others verbally. The triggers for this behaviour were not always known, though it is likely that being confronted with a change in routine and being thwarted were sometimes factors. Staff now endeavour to avoid these triggers.

Sebastian has an excellent memory for events, knows his routine and does not cope well with change. Staff now try to keep to his usual routine, and ensure that all events he is informed of do actually happen. With the aim of supporting him to cope with changes, staff now inform him of impending changes in the usual routine. On most occasions now, he copes when there is a change in the usual routine if he has been informed of it.

Sebastian also found being thwarted very difficult. A clear boundary was put in place for dealing with this.

Sebastian's behaviour now challenges much less often.

Sebastian is tactile defensive: he dislikes messy activities, such as modelling with Play-doh, and handling ingredients when preparing food. He is therefore supported to engage in messy tactile activities.

Sebastian is very musical. His interest and skills are being developed: he is learning to play the drums and piano, and often performs at school functions; he also has an excellent singing voice.