Background and setting
Winnie is nearly 12 years old. She has septo-optic dysplasia; she is totally blind with no light perception. Winnie has severe learning difficulties and a diagnosis of autism.
Winnie attends an all age special school for children with severe learning difficulties. She has additional support from a teaching assistant (TA) for about 75% of the school day.
Winnie is physically mobile and relies on a sighted guide.
Communication
It is not clear how much spoken language Winnie understands.
To support Winnie's understanding, staff use Total Communication, augmenting their spoken language in a variety of ways. They also reduce and simplify their spoken language.
Winnie's intentional expressive communication skills are very limited, consisting only of her signing "me." She uses this to convey a variety of meanings. To facilitate Winnie's expressive communication, staff provide a responsive environment and use Intensive Interaction.
In most situations, Winnie takes no active interest in her peers. However, she occasionally responds to a peer during some interactive sessions in which a resonance board is used.
Structured activity
Although Winnie is not particularly rigid with regard to routines, staff inform her of impending changes in routine.
Winnie learns most effectively when she has numerous short periods of work rather than fewer, longer sessions. She is also provided with "space" between educational activities with periods in which she either has her favourite activity (listening to music) or a walk. Walking is a sensory integration activity recommended for Winnie by the occupational therapist.
Naturally, Winnie is more likely to engage in an educational activity which is intrinsically meaningful or interesting to her, but this is not always possible. On these occasions, the TA enhances her engagement in educational activities by quietly singing to her, which Winnie finds calming.
It is essential for the TA to monitor Winnie's behaviour and moods during a work session for signs of increasing stress / anxiety. If necessary, she brings the session to a close to avoid Winnie going into crisis / overload.
Sensory needs
Winnie has a range of sensory needs. Perhaps the most difficult to manage is that she finds other people's noise aversive; it can make her very stressed / anxious. The TA therefore monitors the environment, specifically, the level of noise in the classroom.
When Winnie becomes stressed by the noise in the classroom, the TA calms her, usually by taking her for a walk. In some circumstances, the TA uses sensory integration activities to calm Winnie.
Staff working with Winnie avoid triggers and occasionally take her to a safe haven to avoid her going into crisis / overload.
Winnie has some tactile defensiveness, though she has made progress in this respect. When she first went to school, Winnie found all messy activities very aversive. Following the use of a desensitisation programme, she now tolerates brief activities in which she and the TA use Play-doh; Winnie also plays with sand for up to about two minutes.
A sensory approach to exploration is provided for Winnie.
Several years ago, Winnie was assessed by an occupational therapist who then recommended some sensory integration activities. The TA continues to use two of them.
Winnie's favourite activity is listening to music. This activity frequently follows a period of work.