Jenny had brain injury at birth. She has learning difficulties, hearing impairment, communication problems, severe epilepsy, continence issues and sensory modulation problems. Jenny often exhibited challenging behaviours in response to frustration, over or under stimulation. Jenny is very fit, active and very sporty but had no conception of risk.

Her Case Manager met her and her family when she was 8 years old. At that time she slept with one of her parents because she sometimes had night-time seizures that were so severe she always required emergency hospital treatment. Her parents were chronically exhausted and keen for her to begin to sleep in her own bed in her own bedroom but were afraid of her having a seizure and dying. With support from the case manager a care team was recruited and a multi-disciplinary team was engaged.

Various treating psychologist-led behavioural programmes were introduced together with some rearrangement of domestic space. Within a short space of time she was happily sleeping through the night in her own bed with support team on hand if she required attention. An epilepsy mat is used in her bed so that her carer is able to respond immediately when she has a seizure. Changes in medication over time have reduced her seizure activity.

Her treating SLT sees her regularly and her support team carry out SLT prescribed home communication programmes with Jenny. The support workers have been trained in various communication techniques including Makaton and work very closely with her treating SLT.

Jenny’s sensory modulation difficulties frequently caused her to display challenging behaviours that risked her own safety and that of those around her. Her treating OT devised a ‘Sensory Diet’. This is a programme of sensory techniques that modify Jenny’s state of arousal so that behaviours do not escalate out of control. The care team and parents have been taught a whole raft of sensory techniques that they can select from and use as needed. However, Jenny needs two skilled carers available to ensure her safety at all times.

Jenny’s school placement was not working for her and with the help of the case manager her Statement of Special Educational Needs was revised and a more suitable placement was provided. Jenny has come on in leaps and bounds at her new school.

The Case Manager supported the family through the process of finding a new more suitable home. Part of the house has been adapted for Jenny and her support team. This annexe has a fully equipped sensory room and a wetroom with a specialist bath equipped with sensory features. Jenny loves relaxing in her bath with lots of bubbles, lights and sounds at the end of her day.

At present Jenny’s section of the house is part of the family home but it has been designed in such a way that when she reaches adulthood the connecting doorway can be closed off so that Jenny will have her own self-contained flat. There is a large secure garden when Jenny can play, run around with her brother and generally allow her to let off steam in a safe environment.

Jenny is now a happy active teenager who enjoys going horse riding at local stables, swims regularly and goes sailing with her dad.

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