Trevelyan is a 65-year-old man from Detroit, MI. He has a bright smile and loves physical activity. Trevelyan has autism and lives in a residential center for people with developmental disabilities and has since he was 13 years old when his mother felt that she could no longer care for him at home due to his size and aggressive behaviors. Trevelyan does not use verbal communication. He knows a few words in sign language (“please,” “thank you,” and “sorry”). After bringing him to the residential center as a child, his mother and other family members have rarely visited him, stating that they couldn’t afford to take time off work
or travel the 1.5 hours to the center to visit him. His case file indicates that he grew up in an impoverished area and that he likely had limited access to appropriate interventions, such as applied behavior analysis, speech and language therapy, or occupational therapy. Not much is known about his home life prior to coming to the center. Because he frequently exhibits aggressive behaviors towards staff and peers, he is often on one-to-one supervision. When he was younger, restraints and basket holds were frequently used in response to his aggressive behaviors. A behavioral analysis indicated that Trevelyan is more likely to act aggressively when he isn’t allowed to have a preferred snack (either it is unavailable or belongs to another resident), when another resident is doing something that he wants to do, or to escape demanding tasks at his day program. His behavior plan has focused on redirecting him to other tasks and minimizing task demands with limited success. However, there are other times when he will push staff, run out of the building, or start slamming into doors and walls with no apparent antecedent. It is assumed that he becomes “overstimulated” because of his autism. Staff are frequently injured and turnover has been high, and many staff report that the stress and injuries from working with Trevelyan is a major reason they quit.