Finding effective ways to communicate is fundamental to the work we do. It gives the people we support more agency in making decisions that affect their lives. Sometimes that involves coming up with innovative and unconventional forms of dialogue. Some recent work at our Ash Tree House service demonstrated the success of that approach.

JB, who lives at Ash Tree House, discovered that he loved the sound of a seatbelt unclicking. To meet this sensory need, he started undoing the belt during his regular drives out but was unaware of the danger that this posed when the vehicle was in motion.

We determined that the best solution was a seatbelt safety clip, keeping him safe without being as restrictive as a harness. When introducing this measure, it was very important that JB was involved in the process as much as possible. We looked at ways to overcome communication barriers to give JB the best possible chance of making his own decision to use the safety clip.

The PBS team worked with the Ash Tree House service team to devise a social story, with vocabulary pitched at the right level for JB so he could take in all the relevant information. The service team read the social story to JB every day for one week and then completed a Mental Capacity Assessment (MCA) with JB, using symbols and multiple-choice questions. The symbols were stuck using Velcro to allow the assessor to check for understanding. JB answered all the questions and consented to the safety aid being used.

By providing the information in an accessible way and presenting the MCA questions in a way that is meaningful and mindful of JB’s communication style, he was able to make a decision about a restriction in his life.

The exercise also highlighted the value of the service team and clinical teams working together and drawing on each other’s strengths and knowledge. Well done to everyone involved!