Caring for a Child With Autism in the Emergency Department

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Recommended: Challenges for parents of autistic children

Introduction
1 out of 88 people are diagnosed with autism. 1 Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by impairments in socialization, communication, and repetitive behaviors. 1,2 There is a wide range of symptoms as well as variations in levels of developmental delay and cognition. 1, 3 As the prevalence of autism continues to rise, more children with ASD are being seen in the emergency department. Healthcare staff often struggle to communicate effectively with this population of children and have difficulty finding appropriate interventions when challenging behaviors occur. 1 A 2011 study conducted in Pennsylvania surveyed 3500 parents of individuals with autism who had required an emergency department or hospital evaluation. 28(%) of the respondents reported having negative experiences and unwanted outcomes. (original: The results were attributed to lack of communication, education and experience of ED personnel who were evaluating and treating individuals with autism. 2 )(better: The authors of this study attributed these less than desirable outcomes to the several factors. First, the ED personnel lacked training about the characteristics of autism. Second, they had little experience treating individuals with autism. The purpose of this article is to explore barriers to caring for pediatric patients with autism throughout various stages of the ED course and provide recommendations to improve patient comfort and safety, quality of care, and family satisfaction.
Arrival and waiting
Children with autism often find comfort in strict adherence to routine. An unplanned visit to the emergency department interrupts their schedule, which may build upon the anxiety that is already present from...

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...10. Kopecky K, Broder-Fingert S, Iannuzzi D, Connors S. The needs of hospitalized patients with autism spetrum disorders: A parent survey. Clinical Pediatrics. 2013;52(7):652-660.
11. Tucker S, Derscheid D, Odegarden S, Olson ME. Evidence-based training for enhancing psychiatric nurses' child behavior management skills. J Nurses Staff Dev. 2008;24(2):75-85.
12. Shellenbarger T. Overview and helpful hints for caring for the ED patient with asperger's syndrome. J Emerg Nurs. 2004;30(3):278-280.
13. Tagon T, Bryan Y, Kurth C. Pediatric radiology sedation and anesthesia. international anesthesiology clinics. Frontiers in Pediatric Anesthesiology. 2006;44(1):65-79.
14. Bass K. Specialty: Autism approaches need to be tailored to each person. The Pennsylvania Nurse. 2006;6(1):14-16.
15. Thorne A. Are you ready to give care to a child with autism? Nursing. 2007;37(5):59-61.

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