"It's Not Rocket Science": Considering and meeting the sensory needs of autistic children and young people in CAMHS inpatient services

This report makes numerous recommendations to suggest how inpatient
CAMHS sensory environments can be improved. We encourage everyone to
read the full report and to apply as many as possible. Some are significant
changes, but many are small things that will make a big difference. They are all
listed at the back of the report. The ten recommendations identified on this
page are at the top of the wish list.
These recommendations have been ‘picked up’ and ‘built on’ by the National
Autism team at NHSEI. They are now the foundation of Sensory Friendly
Wards.
1. Create a predictable environment. Let people know what to expect, who to
expect and when. Offer accurate and timely information to create more
certainty and a feeling of safety.
2. Involve autistic people with relevant expertise in reviewing the sensory
environment, in a meaningful way. Every location is different and will have
different things that need to be prioritised. Autistic people have different
sensory perceptions, so it’s critical to involve people. Listen and take action.
Continue to review. It is beneficial to bring in external expertise, but it’s also
important to involve people using the space. Ask them what’s working and
what needs to change.
3. Ensure all staff have training from autistic experts and allies that understand
autism and sensory needs. All staff includes the multi-disciplinary team (MDT),
healthcare staff, the ward team, facilities staff, educators, cooks, cleaners, and
agency staff.
4. Assess everyone’s sensory need on admission and consider how sensory
need will be accommodated and supported in care plans. Support people to
reduce problematic sensory inputs and manage these to support restraint
reduction. As part of care planning, support people to do the things that help
them to self-regulate, including repeated movement (“stimming”), access to
hobbies and favourite possessions, quiet spaces, outdoor space, and access
items such as noise cancelling headphones, caps, blankets etc.
5. Personalise risk management and decision making. Support people to have
choice and control. Make decisions in relation to individuals, involving the
person (and their family, as appropriate) wherever possible. Avoid blanket bans
(decisions or bans that affect everyone, rather than being decided on an
individual basis).
6. Swap alarms for ‘silent’ alarms. This will significantly reduce noise and
escalation on the ward and reduce the frequency of distress caused by alarms
“It’s Not Rocket Science” Page 11
for those with auditory sensitivity. Staff need to be alerted rather than alarmed;
silent alarms will ensure alerts happen without causing distress to other
people.
7. Reduce noise and echo. Ensure there is quiet space and outdoor space that
people can access at any time. Soft furnishings, gently closing doors, carpet,
sound absorbing panels and acoustic vinyl can all help. Consider background
noise too (including roads, heating and cooling systems, extractor fans, voices,
TVs/radio, chatting etc). Ensure there is an actually quiet space and outdoor
spaces people can access at any time. Support time out from noisy or
otherwise overloading environments during the day, and as needed.
8. Change all fluorescent lighting for alternatives. Ideally halogen, but highquality LED bulbs, with diffused lights are better than fluorescent. Lights should be quiet – not buzzing or flickering.
9. Consider the impact of smells. This includes smells from people, food,
cleaning products, and laundry products. Neutralise smells wherever possible
(closing doors, using unscented products, supporting people to ‘mask’ smells
with preferred scents, or to use preferred products).
10. Consider the impact of touch and texture. Hypo and hyper sensitivities
might mean that people may be more or less sensitive to physical contact.
Need to add guidance information in relation to food (texture, control), shower
/ bath / personal care, drinking, eating, bumping into things and use of
restraint.