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

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.

Intergenerational learning and friendship has been proven to bring lasting and positive outcomes for all and, in these exceptional times of reduced community access, Apple House care homes greatly value a diverse means of retaining each home’s position in the heart of their communities.

Sharing art, stories and fun videos is enabling both the children of the nursery school and the team and residents of Summerwood to reach out and bring fun and joy to each other.

Here are some of the fabulous paintings sent to Summerwood recently [shared with the kind permission of the nursery school manager; school identity protected].

— Jane Montrose, Managing Director.

Everyone had a great time in a socially distanced manner!” — John Caslake, Registered Manager, Summerwood.

Our panel of judges, comprising residents and directors, had a very tough job choosing just one winner from the three beautiful cakes crafted by our staff teams as each home pitched against the other in a super-friendly competition.

Apple House care home’s cake won the taste test! The sponge was moist and utterly scrummy. Decorated with delicate sugar daisies and cute bees, it was as pretty as it was delicious. Summerwood care home’s cake wowed us all. In the design of our logo –a plump green apple– and with little sugar people circling the cake, it was so creative we were all speechless!

However, it was an Easter cake contest and Redcroft care home’s fabulous two-tiered masterpiece really was unsurpassed. With sugar bunnies having fun in chocolate ‘dirt’ and a carrot cake and chocolate/caramel centre, it simply had to win. As the bake-off was a friendly inter-team event it was fitting that the prize should be a night out for the winning team. In addition Redcroft wins a donation to be made in the home’s name to the Dorset Cancer Care Foundation, helping local families in their fight against cancer.

Thanks go to Redcroft for hosting the party which followed the cake judging, and to Apple House and Summerwood for their contributions to food and fun. With a number of games, many of which were hand-made by individuals living at Redcroft, all enjoyed an afternoon of great fun in the garden and patio.

Joined by CQC and leading representatives of the sector, presentations and discussion will centre on what is already being achieved and what work can be done to take John’s Campaign’s ethos even further forward.

John’s Campaign was founded in 2014. Since then, overwhelming support has been shown from across the UK. Over 1000 wards, hospitals and other institutions have pledged their support. 58 MPs from across political parties signed an Early Day Motion in December 2014. Following this, the then PM, David Cameron, voiced support on the Andrew Marr show. A year later, NHS England officially endorsed the campaign, including it in their 2016/17 Commissioning for Quality and Innovation payment framework.

Apple House proudly adopted the core principles of John’s Campaign in 2017 and were commended for this by CQC as part of their inspection which led to a rating of our Hampshire care home, Summerwood, as ‘Outstanding,’ achieved by only 1% of care and nursing homes in the UK.

On Thursday we will be discussing how we greatly value the excellent inclusive relationships we work hard to establish and maintain with family and friends of people we support.  

Our team extends beyond ourselves in reaching out to the people outside our organization for their ideas, input and involvement.  We do this by whatever means are appropriate to the individual and can include social media, Skype, our Open-Door policy and regular face-to-face meetings.

— Jane Montrose, Managing Director, Apple House Care Homes.

Carly’s nomination was supported by family members of the individuals she supports and you can see from the newspaper article above just how highly valued Carly’s contribution is to their loved one’s care.

Jane Montrose, Managing Director of Apple House care homes, said, ‘Do we seem just a little bit proud of Carly? WE ARE BEYOND PROUD! For Carly, this is so deserved. She always goes above and beyond and so I am not surprised to learn of yet another occasion when Carly has prioritised the needs of those she supports and their families above her own personal obligations.  Carly is one hundred percent focused on each individual and her pro-active approach has been rightfully highlighted. Good luck Carly!’

Carly will be attending the awards ceremony and lunch this Thursday, 15th November, cheered on by Romaine Lawson, Director of Operations.

Daily Echo Editor Andy Martin said, ‘We are delighted to be hosting these very special awards for the second year. The dedication of all those involved in caring for others, whether they be professionally trained or informal or family carers is amazing and these awards are a tribute to them and all they do. Where on earth would we be without them? We heard some wonderful and inspiring stories in last year’s awards. I know it will be the same this year.’

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I was thinking about what to talk about on our company blog. I could have written something funny or about an interest that I have.  But instead I thought I would share something.

I have a brother who is four years older than me who has a learning disability.  Since I was a little girl I have always been very protective towards him.

I have worked in care for over 30 years now, and so I have seen almost all there is to see from the care provider’s perspective.

Recently I have found myself having to stand up for my brother once again.  It has helped that I have the knowledge of how things are done from a care provider’s side.

This has made me stop and think!

We provide care for residents to the best of our ability and I think we all do an excellent job.  But, there is something very special about the support of family, especially a parent.

Sometimes we [carers] need to remember even more how precious those we support are to their families.

Sit back and reflect on how difficult it is to hand over the care of that person to complete strangers.

Families often find it difficult and feel guilty that they are unable to provide the care themselves. So, when you have contact with a family member that seems overly anxious or seems to be asking for the impossible, bear in mind:

How would you cope with handing over the life of a family member to people you don’t know?

How do we help promote confidence in us and what we do as a provider?

— Pam, Support Worker, Summerwood care home, Hants.

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Huge thanks to Pam for sharing such a heartfelt and insightful post with thoughts which are deeply personal to her and so valid. In fact, what Pam eludes to is that we, as a provider of care, are in a hugely privileged and responsible position of trust.  Trust between the family, the individual and us. We consider that trust to be a circle which must never be broken.

Trust underpins the essence of care.

Families are our partners, and we theirs.  We joined John’s Campaign (click HERE to read a Guardian newspaper article on their success) to deepen our commitment to the loved ones of those we support, and were delighted to be featured in their blog.  Please take a moment with a cuppa to read our post: Family Friendly, What Does it Mean? where we share ways in which we encourage and nurture close partnerships with families.

‘No-one knows an individual as well as those closest to them.’

— Jane Montrose, Managing Director, Apple House care homes.

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A career with Apple House Ltd is rewarding, challenging, interesting and fun. Our team members are valued, appreciated and supported. With opportunities to further your training and experience, you will be encouraged and mentored to participate in the latest professional qualifications that will enhance your career pathway with us.  With a generous hourly rate and £100 Golden Ticket when you join our team, there has never been a better time to make the move to Apple House care homes.

Apple House is an experienced provider of residential care and support for adults with learning disabilities including those with complex needs.  As a provider, our core aim is to guide each person in our care, to achieve their personal best – as defined by them, and with them. We achieve this by implementing our ethos on a daily basis, which is to actively empower each individual to set and accomplish their personal goals and to live as independently as they are able. We achieve this through promoting skills training, education and work-based activities while providing a home, which is non-institutionalised, accessible and safe.

We currently require a Senior Support Worker and Support Worker at Redcroft care home in Southbourne and at Summerwood care home in Hampshire.  We help with travel costs to Summerwood to staff living beyond a six-mile radius from the home.

Contact us today for an informal chat:

Telephone: Summerwood, New Milton on  01425 839687 and ask for John, or Redcroft, Southbourne on 01202 428158 and ask for Sharron, or complete the form on the ‘Contact Us’ page.

We look forward to welcoming you!

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Apple House care homes are proud to have joined John’s Campaign as part of our ethos of inclusion, of recognising the important role of family and friends to care residents’ wellbeing and personal identity.

“I quite like the title ‘Honoured Guests.  It reminds people, whether we are family or friends, that we are there as guests of the resident. This title also reinforces that staff and relatives should have one purpose, which is to support the person who is resident in the care home, and that their contribution is well-regarded.” — Professor Martin Green.

Within the publication, ‘Honoured Guests,’ Apple House care homes are referenced:

Care England is a registered charity and the leading representative body for independent care services in England.

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