Children with autism who must go to a hospital emergency room (ER) may find the environment difficult. The bright lights, noise, and sometimes chaotic activity present special sensory challenges. ER doctors and other staff may be unfamiliar with autism, but hospitals in Pennsylvania have adopted a manual to help them better understand and deal with autistic patients.
“So often practitioners misconstrue behavior of patients with autism and do not realize the behaviors they exhibit are not maladaptive but rather those that characterize the condition, and this leads to poor outcomes,” said Dr. Arvind Venkat, vice chair of the department of emergency medicine at Allegheny General Hospital in Pittsburgh, in a press release from the advocacy group Autism Speaks. He is also a co-author of a training manual called “Assess Communicate Treat for Autism (ACT)” for ER physicians and other practitioners.
"It's time for those of us in the general health care system to get prepared," he added.
Why the focus on the hospital ER? Its frantic pace can feel threatening to people with autism.
“The environment is very anxiety-producing for a person trying to make sense of the world and having a difficult time with anything new or or novel," said Joann Migyanka, associate professor of special education at Indiana University and an autism consultant. “Things usually go from bad to worse from the misunderstanding of sensory or communication cues.”
Other states have developed similar manuals. For example, the University of South Florida in Tampa has developed a guide for Florida hospitals, "Autism & the Emergency Room," which is similar to the Pennsylvania ACT manual.
The ACT and the Florida manuals include the following recommendations:
- Place patients in a quiet, dimly-lit room with less equipment.
- Avoid multi-step questions and ask questions that require only a “yes” or “no” response.
- Talk to the patient's caregiver or family member whenever possible to get an effective medical history.
- Keep your voice calm and minimize words and touch.
- Let patients see and touch the instruments and materials that will be placed on their bodies.
- Place a warm blanket on a patient to help calm him or her down or to administer medications.
The ACT training is funded through the Bureau of Autism Services of the Pennsylvania Department of Public Welfare and Autism Services, Education, Resources and Training. Pennsylvania emergency nurses and other personnel are being trained in the methods. Surveys indicate that providers felt more comfortable and better equipped to help patients with autism after being trained.
To order a copy of ACT, please contact Jeffrey Fratangeli at email@example.com or call him at (724)357-4719.