Occupational Therapy News OTnews November 2019 | Page 28

FEATURE LEARNING DISABILITIES 2016 PHASE 1 Piloting the SHEA 2018 INTERIM • Collating emergent themes • Evaluating 2019 PHASE 2 Developing person-centred use THE FUTURE • Share nationally with wider OT community • Provide training • Research Figure two: The SHEA progression Mostafa (2008) suggests that interior spaces can be modified (using colour, texture, spatial closure, orientation, acoustics and ventilation) to positively influence the behaviour of individuals with autism. We will be sharing the SHEA with local service-user groups to gain their perspectives and facilitate individual choices and preferences to further promote safe and homely environments. Challenges We are strongly reliant on care staff and families to complete the SHEA on behalf of service users. As a result, we sometimes receive inconsistent responses from care staff teams who may not to know their service users well and are unable to identify service user preferences for what makes a homely environment. In these circumstances, we have found that it is better to complete the tool in partnership with staff, the wider care-staff and family members. We are aware that the environment is not just the physical space that a person occupies, but also the people, culture, social factors and opportunities that influence the person. There is therefore a need to turn our attention to these other factors to be considered as a whole when thinking about the right individualised environment (NICE 2015). And beyond… Research is needed to determine the effectiveness of interventions from the use of the SHEA with service users so that we ensure a more person centred tool. We recognise the need for ongoing evaluation of the SHEA and further research into its validity. Following interest shown at the AHP conference, we hope to disseminate the SHEA to other occupational therapists in learning disability services with the development of a training package. This provides opportunities for research into its reliability and effectiveness. We think it may also have wider clinical 28 OTnews November 2019 applications to areas such as mental health (for example, dementia) and paediatric settings. All these are potential areas of future research for us. References Mostafa M (2008) An architecture for autism: concepts of design intervention for the autistic user. ArchNet International Journal of Architectural Research 2(1): 189-211 NHS England (2017) Transforming Care. Model Specifications: Supporting implementation of the service model. Available at: www.england.nhs.uk/wp-content/uploads/2017/02/model- service-spec-2017.pdf [accessed 17 June 2019] Nagib W and Williams A (2017) Toward an autism-friendly home environment. Housing Studies 32 (2): 140-167 National Institute for Health and Care Excellence (2015) Challenging behaviour and learning disabilities: prevention and interventions for people with learning disabilities whose behaviour challenges. NICE guideline [NG11]. London: NICE Royal College of Occupational Therapists (2017) Professional Standards for Occupational Therapy Practice. London: RCOT Sánchez PA, Vázquez FS and Serrano LA (2011) Autism and the built environment. In: Williams T (ed) Autism Spectrum Disorders – From genes to environment. Rijeka: InTech. Available at: www.intechopen.com/books/autism-spectrum- disordersfrom-genes-to-environment/autism-and-the-built- environment [accessed 17 June 2019] Audrey Yong was a clinical specialist at the Eastbourne Downs and Weald CLDT, Sussex Partnership NHS Foundation Trust at the time the SHEA was conceived. She is now a senior lecturer at the University of Brighton; Stuart Heaton is a clinical specialist at the Eastbourne Downs and Weald CLDT, Sussex Partnership NHS Foundation Trust; Diane Chandler is the lead occupational therapist for East Sussex, Brighton and Hove CLDT, Sussex Partnership NHS Foundation Trust. For more information on the SHEA please email: Diane. [email protected] or Stuart.Heaton@ sussexpartnership.nhs.uk