Gavin, aged 43 years has a diagnosis of Asperger syndrome and lived with his father all his life until his father’s death. Although very independent, Gavin had difficulty adjusting to life without the support and guidance his father had provided. He was referred to an Occupational Therapist, Annabel, who worked regularly with Gavin to teach him some practical aspects of daily life. As they got to know one another, Gavin felt gradually able to share his anxieties, which enabled Annabel to identify some unexpected areas of vulnerability. For instance, she discovered one day that Gavin had fallen down the stairs in the night and cut his head very badly. He did not seek medical help because he knew his local surgery would be closed and could not judge whether his injury constituted an emergency. From the blood loss and concussion symptoms he described, it clearly had. Gavin needed guidance in this area to keep him safe.

Strategies

• Discuss with Gavin the relative roles of different sources of medical help (e.g. out of hours G.P.; NHS Direct; Emergency Services).
• Discuss with Gavin common domestic accidents and emergencies, recommended first aid treatment, and when/what medical help should be sought.
• With Gavin, develop a list of personalised questions and answers, based on Gavin’s concerns and aspects that he finds difficult to judge.
• Using all of the above, develop with Gavin a personal reference file (either visual, written or both, depending on his preferred learning style) that he can use when alone to help him decide whether he should seek help and if so, what kind.
• Practise role-playing different scenarios using the personal reference file, in order Gavin to experience how it is used practice.