Breaking Through the Silence

A PUCK Success Story

Jack*, is a 16 year old nonverbal autistic youth who was referred to Psychiatric Urgent Care for Kids (PUCK) due to a recent escalation in aggressive and high risk behaviors. These included disrobing and eloping from his therapeutic school setting, as well as physically striking his guardian with increasing intensity. These behaviors began intensifying shortly after the unexpected loss of his father, a loss he had not been able to process due to communication challenges and limited access to specialized grief support.  

Upon arrival at PUCK, he presented with acute distress. Our multidisciplinary team worked with him using trauma-informed, neurodiversity-affirming approaches tailored to his developmental and sensory needs. Over the course of his visit, he participated in activities designed to help him externalize and process his grief. He created a “memory bottle”—a therapeutic art project filled with symbolic objects representing memories of his father—and was guided through a somatic exercise to identify where in his body he holds his grief. This allowed him to begin recognizing and naming emotions through nonverbal cues. 

To support regulation and safety post-discharge, he was equipped with personalized sensory tools and a home communication board structured around a “first this, then that” visual schedule. These tools were carefully selected to reduce frustration, enhance predictability, and give him a greater sense of control—key elements in reducing aggressive incidents. 

During the discharge process, his guardian—his grandmother—was visibly emotional. With tears in her eyes, she shared that she had never seen professionals take such thoughtful time with her grandson. “No one ever gives him the time of day,” she said. “I thought no one would ever see him the way I do.” 

His story is a testament to PUCK’s mission: to provide compassionate, immediate, and developmentally appropriate psychiatric care to youth in crisis—especially those often overlooked by traditional systems. His progress during this brief, intensive intervention underscores the power of responsive, human-centered care to transform not just behaviors, but lives. 

*All names have been changed