Evie and Princes Street
Evie is 10 years old and has a diagnosis of autism and she attends a special needs school. She really likes girly stuff, enjoys fashion games and make up games on the iPad, likes to play with dolls and particularly enjoys watching videos of Disney characters. Problems came up when Evie suddenly started to refuse to walk down a certain section of Princes Street. After 3 sessions over one month with our senior project worker Kate, Evie was able to walk down Princes Street again without any problems.
Evie and her family had a Friday afternoon routine which included a trip down Princes Street which they all enjoyed. But all of a sudden this wasn’t possible anymore. Evie would happily walk to a certain point on Princes Street but then she would become extremely upset and would bolt away if the family tried to get her to walk there. Evie was starting to become upset about going to Princes Street at all. The family had had similar experiences on holiday and, as they often returned to the same holiday place, this would continue to cause problems too.
It seemed that Evie was scared for some reason to go down this area of the street and she would do anything possible to avoid this. The family felt that there was one shop in particular that she had once reacted to when passing it but couldn’t be sure if this was the problem.
Although Evie has some spoken language and is able to ask for things she wants, she finds it difficult to explain her views on things. And whilst she understands day-to-day instructions she struggles to understand explanations. This meant that talking about what the problem was wasn’t an option. In fact, communicating with Evie at all in that moment in the street was impossible as she so quickly became so upset that communication which may have worked at less stressful times to explain or reason with her could not be used in this instance.
How we helped
We were unable to know what the root of the problem was. It may have been linked to some sensory sensitivity, however, as she was able to go to other noisy, busy places and follow instructions without a problem, it wasn’t something obvious.
Because we had used a token system with Evie for other work we had done with her, this was a system she trusted and was very confident with. We therefore decided to use this system to clearly communicate with her in this stressful situation and to support her gradual desensitization to the problem area.
We introduced the token system on an area of Princes Street Evie happily walked down. We asked her to follow the direction to walk in and she received tokens for doing so. Every time she filled the token board she was given a favourite sweet. The board was filled very quickly over periods of 10-30 seconds to start with.
When we reached the problem area of the street, Evie was obviously nervous and, initially, tried to bolt away. We therefore started with her just having to stand near the beginning of the area and, when she filled her token board, she would both get a sweet and we would move further away from the location. We repeated this going back only to this initial start point until Evie was happy and relaxed standing there and we no longer needed to retreat at the completion of a token board. We then moved our target spot further and further into the area very gradually to allow Evie to remain calm and co-operative. Evie’s mum would walk a couple of steps closer then ask Evie to come to her. Kate, the Project Worker would prompt Evie to do so whilst giving her tokens to communicate to her she was doing well and that she wasn’t going to be asked to go further at that moment. By this means we could gradually move further into the area. After 10 or so token boards we no longer needed to retreat out of the area and so were just moving forward. Evie became increasingly relaxed. We stopped for a lunch break which included some of her favourite things to eat just on the edge of the area. After this, we made quick progress all the way along Princes Street, using the token board. Evie remained calm throughout.
During the next trip, Evie’s mum did the delivery of the tokens and we walked up and down the street from both directions. Evie still paid close attention to the token feedback but she required no breaks or the gradual build up we had used in our previous trip.
Evie’s mum then practised this again without the project worker present and over subsequent trips, as Evie remained calm and relaxed they used the token board less and less. The family can now access Princes Street without needing to use any support and they successfully used the strategy on holiday in the area which had previously been a problem.