Nestled between the tourist hub of Bournemouth, the coastal harbour of Lymington, with the ancient priory town of Christchurch on our doorstep, the range of things to do here is diverse.  Horse riding, flying a light aircraft, cycling in the New Forest, water skiing, and horticulture–just some of the activities that people we support have experienced.

And that’s the most incredible aspect of living where we live.  There is something for everyone, activities both active and passive.  Oceanarium, tree canopy walks and zip lining, fun fairs, picnics at music festivals such as the annual jazzy Stompin’ on the Quomps, the Air Festival with planes old and new cutting through the skies above us.  Gentle strolls through deer-filled forest or along the beach.  From achieving dreams to simply enjoying time to be, to breathe sea air and sit a while looking out over the ocean to Old Harry’s Rocks and beyond.

Perhaps nothing reveals so much about individuals as how they choose to play – how they invest their time and energy for leisure time.  Leisure is that time free from demands or activities of daily living.  Everyone needs regular recreation that develops skills, promotes good health, relieves stress, facilitates social interactions, and provides a general joy for living. ––Regina Cicci, Ph.D. [Developing Recreational Skills in Persons with Learning Disabilities]

At Apple House care homes we strive to support residents to lead a healthy lifestyle and to be as independent as possible. We provide access to a programme promoting healthy living and wellbeing, with home cooked fresh food, regular exercise, and creative activities. This article outlines why it is important to give people with autism the opportunity to take part in creative activities and regular exercise.

Challenges for people with Autism

For people with autism, you may notice that they can have challenges in interacting in social situations as it can be overwhelming at times with direct verbal communication. We may not get a direct response or eye contact and we can wonder if we have been understood. So it may also be a struggle to build a relationship with them through words alone.

At times people with autism can have rigid mindsets as this may be their way of making sense of the world around them. So, therefore, change can be difficult as they feel reassured by a routine that gives them a sense of control. They may not always understand that a change in routine may be something beyond their carer’s or parents’ control. Such as the illness of a friend or a change in who supports them due to outside factors.  They may need help in regulating their emotions in response to these situations.

Sensory experiences

Jackie Edwards (2017) describes how people with autism may have difficulty making connections between their tactile, vestibular and proprioceptive sensory systems where they may be overactive or not active enough with how they interact with their environment.  For example, they may have a hypersensitivity to loud noise or bright light, may also be de-sensitised to tactile experiences. So, therefore, they would benefit from a sensory diet to improve sensory integration.

She advocates giving people with autism access to different sensory experiences to help improve concentration and attention. This in turn may help them to be able to regulate awareness of their surroundings more effectively as well as to help them relax and not feel overwhelmed, leading to increased socialisation and interaction, promoting less rigid thinking, creativity, and motor skills.

Benefits of exercise

At Summerwood we recognise the importance of exercise by helping our residents access their community, take part in physical exercises such as the gym and swimming, and helping with gardening, tending the vegetable patch etc.

According to Healy S, et al. (2018) research shows that for people with autism exercise can have a number of benefits:

• Reducing stereotypical behaviours or self-stimulating behaviours
• Improving social skills with sports that promote teamwork
• Helps to reduce weight gain or obesity
• Can increase a person’s attention as repetitive behaviours can decrease
• Exercise can reduce anxiety and improve the ability to regulate emotions, build resilience to anxiety-triggering situations
• Exercise can improve motor skills and coordination for people with autism

Benefits of creative activities

The creative arts is another important activity and we support individuals to participate in regular arts and music classes in the community and within Summerwood, their home.

Art can give a person a sense of control as they learn to adapt to the task in their own way. Drawing and painting can also help to improve and maintain fine motor skills. Creative arts can be an effective way to engage with the person in a non-pressurised way. Tactile art forms such as paint and clay also provide a sensory experience to fulfill the needs of the person to be able to balance their sensory experiences more effectively. Music can elicit interactive emotional responses and melodic rhythms can help them engage.

Arts and wellbeing

People with disabilities can be more vulnerable to mental health issues so we are aware that it is important to provide a way for people to communicate their emotions appropriately. Behaviours on the surface may arise due to an inability to verbally communicate how they feel. Behaviours thus can have a function so this highlights the importance of non-verbal communication and communication aids to help people communicate their needs.

For further assistance, creative arts therapy with a trained art therapist can be a way for a person to be able to express and/or regulate their emotions when words are difficult. It can also help to improve cognition and emotional regulation where the aim is to use the art materials or creative activity to access emotional wellbeing and to help a person learn to regulate their emotions and understand themselves within a safe and facilitating environment.

— By Andrew Wright, Support Worker, Summerwood Care Home, Hants (Previously Rated ‘Outstanding’ by CQC).

References and further reading

Draycot, C. (2013) Educating Autism – Art and Creativity to Engage an Autistic Child in the Classroom. The Art of Autism: Connecting through the Arts. https://the-art-of-autism.com/educating-autism-art-and-creativity-to-engage-an-autistic-child-in-the-classroom/

Edwards, J. (2017) The benefits of multi-sensory environments. Autism Journey Blog.

Healy S (2018) The effect of physical activity interventions on youth with autism spectrum disorder: A meta-analysis. Review article. Autism Research. 11(2) · April 2018.

Rudy, L.J (2017) How Does Art Therapy Help People With Autism? Very Well Health. https://www.verywellhealth.com/art-therapy-for-autism-260054

The Apple House Ltd Approach:

The world of management and strategic planning can be full of jargon-based terms and phrases, which can take the core meaning away from readers who want to see the direction and aims a company wants to work towards.

While it is crucial that our company has a clear strategic plan from directorship level, the methods which enable this plan to work through an operational route are key to achieving the common goal. This planning stage will assist the company forward through an ever-increasing demanding economy and climate.

For our Company, the aim is to protect the homes of the people we support and the jobs of the people whom we employ throughout our services.

An infographic is used to give an overview of our Operational Goal Planning.

–Romaine Lawson, Director of Operations, Apple House.

What is Autism?

Autism is a lifelong developmental disability that affects an individual’s behaviour and communication. People with autism may lack social awareness, emotional reciprocity and the ability to sustain conversations. Autism Spectrum Disorder (ASD) is characterized by severe and persistent deficits in social communication and interaction (American Psychiatric Association 2013). In the UK the Autism Act (2009) led to the government producing statutory guidelines for autism. With a clear pathway of diagnosis, where everyone has a right to an assessment. 

Most parents notice some symptoms of autism when their child is two or three years old but these symptoms can change as the person gets older. The characteristics may be different in girls than in boys so diagnosis can be difficult. There is also a lack of a genetic or medical testing and the impairment may also be accompanied by other conditions such as epilepsy, ADHD and learning disabilities. People with autism may also have a co-morbid mental health condition such as anxiety or depression.

Features of Autism

Wing and Gould (1979) identified a Triad of Impairments with difficulties with social communication, difficulty with social interaction and difficulty with social imagination. People with autism may find it hard to keep eye contact due to an overload of speech, facial expression and body language data to process. They may also be unaware of personal space and may be unaware of non-verbal cues in communication.

They may also exhibit restricted or stereotypical patterns of behaviour and can be hyper (over) or hypo (under) stimulated by their environment. This can result in obsession with a particular topic, self-stimulating behaviours such as finger clicking, hand flapping, and an overload of emotional and sensory information, resulting in ‘stimming’.

According to Martin (2009) Baron-Cohen’s theory of mind can be considered as the fourth impairment for people with autism. As they will find it hard to imagine a world from someone else’s perspective and understand that other people have different thoughts and feelings independent from their own. This can be misinterpreted as a sign of rudeness as they may not be able to see things from another person’s perspective.

Working with autism

These difficulties can have the effect of preventing someone with autism feel the close bonds of relationships, and over compensatory rituals and routine can provide them with a feeling of safety and reassurance. So it makes sense that people with autism find routine very reassuring, although it is important to note that people with autism can adapt to change they just need support with time and preparation given to them so it is not just a sudden change that can make them feel overwhelmed.

Practitioners have advocated the importance of early intervention with environmental stimulation appropriate to a child’s needs is necessary for developing creative thinking in children. As many people with autism may need help with sensory processing to help them balance and regulate environmental stimuli. For instance some people may be sensitive to light or noise while they may need extra tactile stimulation. So in some cases it can be about thinking of the senses as a ‘graphic equaliser’ where people need help to balance their sensory input.

Strategies to encourage social interaction and communication can include the use of visual aids to help promote understanding and reduce anxiety. Carol Gray developed the use of ‘Social Stories’, while pictorial story boards can be useful. TEACCH promotes structured learning environments that encourage visual based engagement and communication. Also helpful is the use of a temperature gauge so they can communicate their feelings.

Creative strategies to help to attune and develop interaction and communication with people with autism. As often for two way verbal conversation can be too overwhelming due to the fact that they struggle to cope with verbal, nonverbal and body language, all at the same time. Arts Therapists encourage use creative mediums such as art, drama and music to engage and aid communication and interaction. Working together on an art object or creating a performance can be a less intrusive way of building a relationship for a person with autism. It may also meet their sensory needs and be a way of discharging emotion with directed movement and action.

Autism and Social Camouflaging

Hull, et al (2017) discusses social camouflaging, which is how people of all genders manage the way others perceive them in social situations. They suggest that people with ASD struggle with this have and it takes a lot of mental effort minimise their social soothing behaviours in public and this can cause stress and anxiety. A person who may seem to be functioning well in society may actually struggle to maintain this.

They also point out that this may account for less girls being under diagnosed with autism as boys will more likely to exhibit externalizing behaviours such as hyperactivity and conduct problems. While girls are more likely to internalise these difficulties leading to difficulties in emotional wellbeing.

This explains why often people with autism can struggle with mental wellbeing and emotional regulation, compared to the ‘neurotypical’ population. So it is useful to help them with coping strategies and when they do feel distress. Ccording to Connoer et al (2018) adaptive cognitive strategies can be successful with anxiety, but they are less successful at helping someone deal with destructive feeling and aggression. As over thinking and rumination can be a maladaptive response.

References

Conner, C. White, S. Beck, K. Goltx, J. Smith, I. Mazefsky, C.(2018)  Improving emotion regulation ability in autism: The Emotional Awareness and Skills Enhancement (EASE) program. Autism, 1–15. Sage Journals.

Hull, L. Petrides K.V. Allison, C. Smith, S. Baron-Cohen, S. Lai, Meng-Chuan Mandy, W. (2017) “Putting on My Best Normal”: Social Camouflaging in Adults with Autism Spectrum Conditions.  Journal of Autism and Developmental Disorders. DOI 10.1007/s10803-017-3166-5

Martin, N. (2009) Art as an Early Intervention Tool for Children with Autism. Jesssica Kinsgley Publishers

Wing L. and Gould J. (1979) Severe Impairments of Social Interaction and Associated Abnormalities in Children: Epidemiology and Classification. Journal of Autism and Developmental Disorders 9 (1) 11-29

A postscript from Apple House HQ:

Huge thanks go to Andrew Wright, qualified art psychotherapist and valued member of the Summerwood staff team, for kindly sharing this detailed and interesting article he has written for our blog. We are incredibly fortunate to have such a talented and creative team member. We have Andrew’s full permission to share the above article but Andrew remains the copyright holder of the work and no sharing or use of his work is permitted without authorisation from the copyright holder: Copyright: Andrew Wright 2020.

Importance of creative activities and exercise for people with autism

Introduction

At Apple House care homes we strive to advocate a healthy lifestyle and to be as independent as possible. We provide access to a programme promoting healthy living and wellbeing, with home cooked fresh food, regular exercise, and creative activities. This article outlines why it is important to give people with autism the opportunity to take part in creative activities and regular exercise.

Challenges for people with Autism

For people with autism, you may notice that they can have challenges in interacting in social situations as it can be overwhelming at times with direct verbal communication. We may not get a direct response or eye contact and we can wonder if we have been understood. So it may also be a struggle to build a relationship through words alone.

Often people with autism can have rigid mindsets at times as this can be their way of making sense of the world around them. So, therefore, they can find change difficult as they feel reassured by a routine that gives them a sense of control. They might not always understand that a change in routine may be something beyond their carer’s or parents’ control such as an illness of a friend, or a change in who supports them due to outside factors; Covid restrictions have been an exceptional challenge for many. Help and support may be needed in regulating  emotions in response to these situations.

Sensory experiences

Jackie Edwards (2017) describes how people with autism may have difficulty making connections between their tactile, vestibular and proprioceptive sensory systems where they may be overactive or not active enough with how they interact with their environment.  For example, they may have a hypersensitivity to loud noise or bright light, may also be de-sensitised to tactile experiences. So, therefore, they would benefit from a sensory diet to improve sensory integration.

She advocates giving people with autism access to different sensory experiences to help improve concentration and attention. In order to help them to be able to regulate awareness to the surroundings more effectively as well as helping them to relax and not feel overwhelmed, leading to increased socialisation and interaction. Promoting less rigid thinking, creativity, and motor skills.

Benefits of exercise

At Apple House care homes we recognise this importance by supporting and encouraging residents to access their community, taking part in physical exercises such as the gym (when safe to return) and swimming, and to help with gardening, tending the vegetable patch, and cycling.

According to Healy S, et al. (2018) research people with autism exercise can have a number of benefits:

• Reducing stereotypical behaviours or self-stimulating behaviours
• Improving social skills with sports that promote teamwork
• Helps to reduce weight gain or obesity
• Can increase a person’s attention as repetitive behaviours can decrease.
• Exercise can reduce anxiety and improve the ability to regulate emotions, build resilience to anxiety-triggering situations
• Exercise can improve motor skills and coordination for people with autism

Benefits of creative activities

The creative arts is another important activity and we support residents to actively participate in regular arts and music classes in the community and in the home.

Art can give a person a sense of control as they learn to adapt to the task in their own way. Drawing and painting can also help to improve and maintain fine motor skills. Creative arts can be an effective way to engage with the person in a non-pressurised way. Tactile art forms such as paint and clay also provide a sensory experience to fulfill the needs of the person to be able to balance their sensory experiences more effectively. Music can elicit interactive emotional responses and melodic rhythms can help individuals to engage.

Arts and wellbeing

People with disabilities can be more vulnerable to mental health issues so we are aware that it is important to provide a way for people to communicate their emotions appropriately. Behaviours on the surface may arise due to an inability to verbally communicate how they feel. Behaviours thus can have a function so this highlights the importance of non-verbal communication and communication aids to help people communicate their needs.

For further assistance, creative arts therapy with a trained art therapist can be a way for a person to be able to express or regulate their emotions when words are difficult, helping to improve cognition and emotional regulation. Where the aim is to use the art materials or creative activity to access emotional wellbeing and to help a person learn to regulate their emotions and understand themselves within a safe and facilitating environment.

— Andrew Wright, Senior Support Worker and Trained Art Therapist, Little Amberwood care home.

🔊 Listen to this

References and further reading:

Draycot, C. (2013) Educating Autism – Art and Creativity to Engage an Autistic Child in the Classroom. The Art of Autism: Connecting through the Arts. https://the-art-of-autism.com/educating-autism-art-and-creativity-to-engage-an-autistic-child-in-the-classroom/

Edwards, J. (2017) The benefits of multi-sensory environments. Autism Journey Blog.

Healy S (2018) The effect of physical activity interventions on youth with autism spectrum disorder: A meta-analysis. Review article. Autism Research. 11(2) · April 2018.

Rudy, L.J (2017) How Does Art Therapy Help People With Autism? Very Well Health. https://www.verywellhealth.com/art-therapy-for-autism-260054

Most of us, though, can manage to regulate our temperatures–ice cold Pimms in a shady spot of the garden or nestled away in an air-conditioned office.  We might be a little sticky, a little flushed, but we know how to make ourselves cooler, how to feel when our core temperature is rocketing, and to act swiftly to keep ourselves safe and prevent overheating.  The most risk we face is to pong or to have a restless night’s sleep.

For many, the heatwave poses an actual and very significant risk to their health and wellbeing.  The NHS define those at risk from heatwaves as: Older people, babies and young children, people with serious chronic conditions such as breathing or mobility problems.  People with serious mental health needs, those on certain medications and people who are physically active and sporty, and those with drugs and alcohol dependency.

What are the risks of overheating?

The body normally cools itself in a very clever way, (see HERE for the clinical bit).  The body is such a clever machine in that it will make our skin sweat if the temperature is higher than skin temperature.  In some people this mechanism is impaired because of chronic conditions, illness or medication.  If they cannot sweat effectively, their bodies cannot regulate temperature as efficiently.  Also, if the person is dehydrated or even wearing tight fitting clothes, their bodies cannot sweat as easily and therefore will overheat.  Sweating and dehydration can cause illness such as electrolyte imbalance and reduce the functioning of the respiratory and cardiovascular systems.

So, overheating can cause: heat cramps, heat rash, swelling of the ankles and fingers, dizziness and fainting, nausea and even death.

Who is at risk in social care?

As discussed above, we are mostly able to take steps to control our body temperatures by putting in place measures to mitigate the risks.  We do it automatically, without thought.  Some individuals do not necessarily have the capacity to adapt behaviours to keep cool.

Autism Uk discuss sensory differences in people with autism who may be over-sensitive or under-sensitive to sensory stimuli such as touch and sound and overload.  Imagine then, a hot day such as we are experiencing today – the brightness of the unclouded sky, the whirring of fans, the crowds of people drawn to public spaces.  Imagine then, the change in routine that may be essential to keeping safe: staying out of the hot sun, being offered more drinks and hats to wear and sunscreen applied.  All of these challenges can be profound for people with autism, with wider learning disabilities, with anyone for whom they rely on others to keep them safe and well but may not understand why things are different.  Routines and structure are very important for autistic people and change can be distressing, worsened still if the person is hot and uncomfortable.  Uses of picture symbols can be very helpful to explain and reinforce the change and reasons behind it.  Activities that are known to be calming to the individual can be offered in a cool and shady place where the person feels safe.

It is also essential that staff stay hydrated and well and so the measures below apply to everyone.  Apple House Care Homes have today contacted our team to remind them of steps they can take to stay cool and well.  Romaine Lawson, Operations Director, told the team to ‘Drink plenty of fluids and to listen to their bodies.  To wear lighter clothing.  If they are struggling, speak up and reach out for support where needed.  To be safe and look after themselves.’

How can we keep people well during a heatwave?

• Check that fridges and freezers are running at the right temperature.
• Check that the person has light, loose-fitting cotton clothing to wear.
• If you plan to move an autistic person somewhere cooler, think about the impact that will have and take sensible measures to minimise distress.
• Cover windows that let in most sunlight and open the windows at night, when it is cooler,  if it is safe to do so.
• Make sure that people at risk stay out of the sun between 11am and 3pm.
• Advice the use of sun hats and apply a high UV factor sun block cream regularly.
• Reduce the level of physical exertion like going up stairs or for long walks, especially during 11am and 3pm when the sun is at its hottest.
• Offer regular tepid baths or showers or washes.
• Cold food such as salads and fruit have a higher water content.
• Offer drinks regularly but avoid tea, coffee and coke which contain caffeine as caffeine can add to dehydration.
• Monitor daily fluid intake, particularly for the most vulnerable.  Record daily intake.

The above guidance can be found on the Government’s website or by clicking HERE

We want everyone to have fun in the sun, to enjoy the opportunity to make the most of this wonderful place in which we live.  Apple House care homes are by the sea, the forest, parks, and have a wide variety of exciting things to do and see — but we want to do it safely which is why WE ARE HEAT-WISE. — Jane Montrose, Managing Director, Apple House Care Homes.

🔊 Listen to this
        
    

“We are fortunate to be located a stone’s throw from the wonderful beaches and shops and nightlife of Bournemouth.  Not just for holiday makers, Bournemouth offers all year round entertainment and we took advantage of this recently as we often do.  Cameo Nightclub was the venue for a ‘Big Night Out’ event providing a fantastic opportunity to socialise with others at a night of music and dancing.”

“Before Cameo, of course, was our Halloween party to rival all others!  Everyone at Redcroft seemed to greatly enjoy decorating the house in spooktacular fashion, carving pumpkins which were put on display, and preparing the buffet.  The party was a great social occasion where all came together for an evening of dressing up and eating delicious food.”

“And, as if that wasn’t enough fun, two residents left Redcroft bound for a fabulous holiday on the Isle of Wight where they settled in to a cosy cottage that boasted its own hot tub! Time was spent exploring the island and visiting a variety of pubs and restaurants.  We enjoyed making use of the swimming facilities available, and visiting the unique and varied shops and even a model village.” –– Tom, Senior Support Worker, Redcroft.

If you need an emergency LD placement, let us throw you a lifeline…

We will work with you to ensure that a first class and personalised package of support is in place with as little as three hours notice!

People with complex and challenging needs are welcomed as warmly as those who are more independent.

LET US PROVIDE A STEPPING STONE FROM RESIDENTIAL CARE TO SUPPORTED LIVING.

Consider us to provide a comprehensive transition including life skills and community access safety.

CALL US IF YOU NEED A SHORT-NOTICE PLACEMENT OR A LONG TERM ALTERNATIVE. We are here to meet your needs, to be flexible, to be the best but to offer value.

Please telephone John Caslake on 01425 839687 or Sharron Eyears on 01202 428158 and let us be your lifeline.

The State of Health Care and Adult Social Care in England 2015/16 looks at the trends, highlights examples of good and outstanding care, and identifies factors that maintain high-quality care. It was written by the Care Quality Commission (CQC) through their findings between Spring 2015 and Summer 2016.

The report summarises that most services they inspect give ‘good’ care to the people they support even though they may now been doing this with less money to pay for it.

It also states that adult care services have been able to maintain quality but that there is concern over the sustainability of adult services. Adult services have less money coming in and need to pay more money to staff members.

Some services are changing the way they provide the care to people to try and balance how they can do more with less.

Quality care provision is at the forefront of Apple House Ltd and we are working creatively and flexibly to adapt to the social care market. Our main principles of being committed to provide compassionate, professional care which enhances the quality of life for our residents and enables them to feel supported and valued within the community in which they live, remain our priority.

You can find more information on the report through the links provided below.

This information is also discussed through our residents, team and management team meetings so that we are kept abreast of national developments.

Link to – The State of Health Care and Adult Social Care in England 2015/16 – Summary:

Link to – The State of Health Care and Adult Social Care in England 2015/16 – Easy Read:

–– Romaine Lawson, Director of Operations