08 June 2022

Dear Planner,

Positive Rhythm has been supporting and family over the last several weeks. With the intention of developing a comprehensive behaviour support plan & then supporting formal and informal supports to implement the plan.

has a significant disability that impacts on his independence on a daily basis.

These include:  Autism Spectrum Disorder  Global Intellectual Disability  Attention Deficit Hyperactivity Disorder  Hyperacusis  Generalised Anxiety Disorder Symptoms can include:  Panic attacks, &  Auditory hallucinations associated with Schizophrenia.

The impact on Executive functioning must not be underestimated.

experiences many difficulties in    day-to-day functioning as a result of

diagnosis, which affects his capabilities significantly on all levels. Of note is difficulties in the community and at home that can be correlated back to executive functioning deficits, of which impact the way is able to interact with the world around him.

Executive Functioning has three main areas that include:

1. Working memory

2. Cognitive flexibility (also called flexible thinking)

3. Inhibitory control (which includes self-control)

   struggle’s with many of these executive skills:

• Has trouble starting and/or completing tasks
• Has difficulty prioritising tasks
• Forgets what just heard or read
• Has trouble following directions or a sequence of steps
• Panics when rules or routines change
• Has trouble switching focus from one task to another
• Gets overly emotional and fixate on things
• Has trouble organising thoughts
• Has trouble keeping track of belongings
• Has trouble managing his time
• Has trouble using inner speech to assist with thinking, dealing with emotions and controlling of own behaviour (difficulties with expressive language)

Trouble with executive functioning also influences the following:

• Transitions: struggles with transitioning from one activity to another and from environment to another (particularly difficult when transitioning from iPad/phone). Transitioning can often lead to being overwhelmed and becoming dysregulated.
• Emotional control: struggles to emotionally regulate during times where does not get the outcome was expecting or unpredictable environments. This presents with yelling, swearing (often directed at others), and threats of self-harm.
• Focus: struggles to remain focused on set tasks, particularly when the task is not of interest to and is distracted.
• Organisation: requires ongoing prompting to complete most tasks and stay focused on what is meant to be doing, both at home & work (Single minded focus).
• Frustration: displays low frustration tolerance when needs are not being met or is unable to make sense of the world around When starts yelling and begins to disengage or avoids people or situations, becomes overwhelmed.
• Social engagement/communication: has limited social skills & limited ability/desire to engage in social situations/environments including to interpret social situations effectively. When is overwhelmed in social settings, or not able to communicate/engage effectively, will become verbally aggressive towards others in an attempt to have needs met & be understood.

A PBS focused transition to decrease formal support hours are necessary to ensure & supports have had a period of adjustment. This will assist in a smooth transition.

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PBS focuses on providing person-centred, strength-based plans that includes the definition of | behaviours of concern & strategies to improve = quality of life and decreasing and/or delimitating these behaviours of concern.

currently requires 24/7 support in his home in Belconnen, which _ is funded for. This is a successful lifestyle for & — family. A reduction in this funding, at this time would be detrimental would also be unsafe for

Positive Rhythm expects this transition period to include: e The completion of PBS Plan to include a transition to decreased staffing e Support & training to implement to PBS plan & especially the transition (Initially 16 x 2.5 hours & then 12 x 2.5 hours to maintain the PBS focus throughout the plan year).

If you have any further questions regarding the above information, please feel free to contact , our client service manager on

Regards,

Behaviour Support Practitioner