Why Better Rehabbers love what they do!

With the help of one of Better Rehab’s Behaviour Support clinicians, things are looking better for Cortez and his family

Cortez is one of Better Rehab’s child participants. He has been diagnosed with a range of complex issues, including level 3 autism spectrum disorder (ASD), post-traumatic stress disorder (PTSD), sensory processing disorder (SPD), reactive attachment disorder (RAD), attention deficit hyperactivity disorder (ADHD), mild intellectual impairment and anxiety.

His behaviours of concern have made it difficult for Cortez to develop connections with others, process change, engage with daily tasks, express emotions and manage his attention. He has also experienced auditory and visual hallucinations, which have been linked to his PTSD.

There were also times when Cortez would have intense and dangerous outbursts that required emergency respite accommodation placement and the implementation of restrictive practices. As a result of his behaviour, Cortez had a high turnover of support staff, with five different agencies ending their support services.

But that didn’t stop Cortez’s family and Support Coordinator from advocating for his needs. In 2021, they connected with Better Rehab Behaviour Support Practitioner, Jarrod Stokes-Marshall. The results have been incredibly positive.

“Initially, Cortez was an extremely challenging participant to work with, having experienced so much trauma in his young life,” says Jarrod. “But that doesn’t change the fact that he’s an amazing kid with so much potential – if provided with the right support and guidance.

“I was very willing to give my all, even if I was still an early practising clinician at the time.”

Securing the right NDIS funding

Following the completion of the Functional Behavioural Assessment (FBA) and Positive Behaviour Support Plan (PBSP) in early 2022, Jarrod initially focused on upskilling Cortez’s support network through comprehensive staff training and in-home observations to analyse their engagements with him.

When Jarrod first received the referral for Cortez, he was provided with less than Level 1 Improved Relationships (IR) funding. Because of the high intensity and frequency of the child’s behavioural outbursts, Jarrod used the funding within 6 months of a 2-year NDIS plan and advocated for an early plan review. This resulted in Cortez being provided with Level 3 IR funding, equal to 120 hours of interventions and support.

“Navigating the NDIS and advocating for the funding Cortez desperately needed was also a professional win for me. This has become a blueprint for me to use in advocating for other vulnerable and young people who need IR funding,” Jarrod adds.

With this new funding, Jarrod has been able to move to weekly appointments with Cortez, focusing on a 1:1 intervention approach with the core objective of direct intervention and skill development. Jarrod prioritised addressing the main underlying triggers with Cortez, such as waiting, technology access, and changes to routine.

Due to Cortez’s diagnoses, these concepts had to be broken down into smaller learning outcomes, such as engaging with a social story or a joint activity with Jarrod before moving to the teaching skills (Function-Based Replacement Strategies) contained within the PBSP.

The success of a tailored plan of action

“I took a client-centred approach to therapeutic engagement with Cortez, adapting the content and medium in which skills were introduced as required,” shares Jarrod. “I then gradually reduced the frequency of 1:1 engagement as the support network increased their confidence with implementing both the PBSP and teaching skills with Cortez in between my visits.”

Seeing this progress with the support network, Jarrod developed short- and long-term goals for Cortez, both of which have been achieved by the end of 2022!

After two months of sessions, Cortez was able to complete one or more social stories, learning activities or games without interruption. He also achieved the long-term goal of identifying and articulating his emotions, as well as solving a strategy problem to better regulate himself — this was a massive clinical win!

Before each session, Jarrod conducts a “feelings check-in” and regulatory “body scan” to understand if Cortez is feeling heightened before proceeding with the learning activities. Through this approach, Cortez is able to verbalise which zone he was feeling in. If he feels like he’s in his self-identified ‘Charizard’ or red zone, they will first conduct regulatory activities until Cortez returns to his green zone for the session to begin.

“He’s very sensitive to sensory stimuli and was initially very hesitant to allow me inside the house during the first month of working with him,” says Jarrod. “But since then, I’ve had many wins with Cortez. The biggest of which is his self-initiated implementation of the teaching skills, as well as running to hug me and being excited for our sessions to commence each week.”

Light at the end of the tunnel

Cortez reported to his mother and Support Coordinator that he enjoys spending time with Jarrod. He’s always excited to work on expressing his emotions, discussing challenges that he finds upsetting, and working on solutions that he can implement himself. Cortez always mentions that he wants to make Jarrod proud by practicing his regulation and problem-solving skills when he’s feeling upset so he can avoid becoming his ‘Charizard’ zone.

Cortez is now doing well and adapting to changes. He’s started a mental health day program with Queensland Children’s Hospital to focus on repairing the relationship with his loved ones, stabilising the home environment, and reintegrating him back into school. He’s also looking forward to continuing his clinical progress with Jarrod this year. Although there’s still frequent engagement with behaviours of concern, the recorded intensity and duration of Cortez’s outbursts have significantly decreased in the 2021 to 2022 monitoring period.

“Seeing him really grasp and correctly implement the teaching skills have been extremely rewarding. It also made me constantly re-evaluate the SMART goals set due to him reaching these milestones ahead of expectations,” shares Jarrod. “I’ve seen so much growth with Cortez since working with him and I am excited for his ongoing clinical growth in the coming years.”

Want to connect with Better Rehab’s superstar Behaviour Support Practitioners?

Send an email to our friendly admin team at admin@betterrehab.com.au or call 1300 073 422.

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