Age: 25

Richard is twenty-five years old and non-verbal. He is diagnosed with autism, learning disability and obsessive compulsive disorder. He attends surgery with his support worker, who explains that Richard suffers from eczema triggered by stress. He is suffering from a flare-up at the moment and is scratching his arms continuously so that they are now bleeding and infected.


  • Discuss with Richard’s support worker exactly when the scratching is at its worst, in order to explore whether a distraction activity could be used at this time.
  • Discuss the treatment options to be used and whether Richard can be encouraged to administer these himself. For instance, having a cream that he applies whenever he wishes may be an alternative activity to scratching.
  • Involve Richard in all explanations of diagnosis and treatment. Even if he does not seem to respond, he may well be listening and understanding what is said.
  • Explore the underlying cause of the flare-up so that a longer-term treatment plan can be put in place for Richard’s stress.
  • Agree a clear monitoring and follow-up plan with the support worker.
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