Project:

Comprehensive Support for an Adult with Autism Spectrum Disorder

Client Overview: A 19-year-old with Autism Spectrum Disorder (ASD) faced significant challenges related to independent living, behavioral safety in the community, and stabilizing psychiatric symptoms. The legal guardians sought assistance to improve the client's quality of life and foster greater independence.

Project Objectives and Goals:

• Enhance the client's living arrangement safety.

• Address psychiatric concerns and ensure access to sustainable medical treatment.

• Foster community engagement for both the client and legal guardian.

Challenges and Issues:

• Difficulty in managing and redirecting impulsive behaviors.

• Limited opportunities for residential treatment programs due to resource availability and intensity of needed services.

• Limited understanding of available resources and support systems by the family.

Actions Taken:

• Role: Lead Care Manager

• Strategy: Conducted a comprehensive needs assessment and developed a tailored Individual Service Plan (ISP).

• Interventions: Coordinated with various service providers to offer comprehensive support.

Process and Implementation:

1. Initial Assessment: Conducted in-depth interviews to understand the family’s needs. Developed a Family Crisis Plan (FCP), conducted a Strengths & Needs Assessment (SNA), and created an Individual Service Plan (ISP).

2. Division of Developmental Disability Coordination: Connected with Division of Developmental Disabilities (DDD) providers to submit a referral for the client. Maintained ongoing tracking to ensure a seamless transition from youth services to adult services.

3. Psychiatric Assessment: Arranged psychiatric services at the University Hospital to adjust the client’s medication and psychiatric needs.

4. Therapeutic Support: Scheduled Residential Treatment Program Meet and Greets for the family to evaluate and select the most appropriate program.

5. Academic Support: Partnered with the client’s home district to coordinate vocational opportunities in alignment with the client’s Individualized Education Plan (IEP).

6. Community Partnerships: Collaborated with the local Police Department to inform of the client’s unique needs to keep the client and community members safe.

Results and Outcomes:

• Linkage to Developmental Disability Residential Program: Secured a treatment program within three months of hospitalization, resulting in a 100% decrease in hospitalizations over the following year.

• Community Connection: Linked the family/legal guardians to sustainable community resources such as PerformCare DD services, Social Security Services, and Arc of Somerset for access to adult transition information.

• Family/Guardian Education: The family/legal guardians received education on managing intense ASD needs from the residential program clinical coordinator.

• Family Home Visits: After six months, the client was able to spend time with family members in the community without incident.

• Client Feedback: "The support we received was life-changing. We now have a full understanding of how to navigate the complex world of adult Developmental Disability services.”

Reflection and Lessons Learned:

• Impact: The client's quality of life improved significantly, providing stability and hope for both the client and their caregivers.

• Lessons Learned: Individualized, holistic support is crucial for adults with special needs to achieve their full potential.

• Future Improvements: Develop a more streamlined process for accessing multiple services simultaneously and establish more community partnerships to facilitate quicker access to treatment programs for clients with special needs.