Individuals with chronic conditions and difficulty expressing their own health care needs may struggle to regulate themselves during or after injuries or accidents e.g. falls from moving objects. Being able to cope with being hospitalised for short or extended periods, wearing casts or taking additional medication on top of their normal routines can be extremely challenging and may change sleep patterns, food intake and contribute to greater self harm or repetitive behaviours. Visuals at a certain level can be of support, however, the real issues related to pain management and self care for comfort in managing the injury on a day to day basis as the eg. wounds heal require detailed conversations about what is happening, what is needed and what is within ‘our’ ability to control versus supporting knowledge that wounds may take different levels of time to heal. Visual supports do not provide hands on physical comfort for the emotional distress that may be being experienced. Working with families to enable parents to support their loved ones with second to second non verbal conversations that involve regulated directional touch and visual attention are extremely important to assist with managing the distress of the injury. Understanding how to use and how to grade the direction of physical touch being expressed by the individual but also by the adult or adults caring for that individual is important. Simple changes in where someone is being touched to provide cues may be less distressing versus it may need to be the timing that is being controlled.