Understanding Autism Spectrum Disorder: For Emergency Personnel
This resource was developed for emergency medical personnel to better understand individuals with autism and the additional supports they may need in emergency medical situations.
- Can be on a spectrum from barely noticeable to profoundly disabling.
- Can have significant social, communication, and behavioral challenges.
- Can have intelligence that ranges from intellectual disability to gifted.
- Frequently have comorbid conditions (genetic, behavioral, or medical/mental health).
Autism Spectrum Disorder (ASD)
- In the DSM-V, Autistic Disorder, PDD-NOS, and Asperger Syndrome were combined into a broader category called autism spectrum disorder. This spectrum is further distinguished by the levels of severity.
- The core features of ASD are persistent deficits in social communication and social interaction and restricted, repetitive patterns of behavior, interests, or activities.
- These core symptoms can present as: repetitive routines or rituals, peculiarities in speech and language, socially and emotionally inappropriate behavior, inability to interact successfully with peers, problems with non-verbal communication, and clumsy and uncoordinated motor movements.
Signs and Symptoms that Autism May be Evident
- Delayed speech and language skills.
- Talks in a flat, robot-like, or sing-song voice.
- Uses reverse pronouns (“you” instead of “I”).
- Repeats or echoes words/phrases or repeat words/phrases in place of normal language.
- Trouble expressing their needs using typical words or motions.
- Does not use or has difficulty understanding gestures/ body language.
- Unusually talkative (verbose) with little conversational turn-taking. Appears unaware when people talk to them but respond to other sounds.
- Avoids eye contact and prefers to be alone.
- Difficulty relating to others or little or no interest in other people.
- Trouble understanding other people’s feelings or talking about their own feelings.
- Does not understand jokes, sarcasm, or teasing.
- Interested in people, but does not know how to talk, play, or relate to them.
- Deficits in attention (doesn’t point at objects to show interest or look at objects when another person points at them).
- Seeks (rather than resists)particular sensory input (ex: weighted blanket).
- Avoids or resists physical contact.
- Unusual reactions to the way things smell, taste, look, feel, or sound.
- Does not understand personal space boundaries.
- Engage in stimming (self-stimulatory)behavior; repeating actions over and over again (i.e., rocking, swaying, jumping, finger flicking).
- Trouble adapting when a routine changes.
- Meltdowns; increase when stressed, fatigued, or feeling unwell.
ACT for Autism: For EMS and First Responders
ACT (Assessment and Communication Tactics) provides a framework for response from EMS and other first responders. ACT takes a two-pronged approach.
Assess and Control the Situation
- Gain as much information as possible about what led to or surrounds a situation.
- Determine the best way to approach or communicate with the individual.
- Minimize sensory stimuli, such as flashing lights, sirens, high-volume walkie-talkie devices, loud yelling among responders, and eliminate non-essential persons.
Communicate to Gain Understanding and Compliance or to De-escalate the Situation
- Approach slowly and calmly keeping, some distance between you.
- Use the person’s first name (if you know it) and assure you are there to help.
- Talk in a quiet and calm voice and try to establish a rapport, no matter how urgent the situation.
- Give simple, clear directions paired with a visual or demonstration.
- Don’t attempt to touch, grab, or restrain the individual without preparing him/her, first.
- Explain what you’re going to do or want him/her to do.
- Ask yes/no questions and avoid sentences or questions that require more complex responses.
- Allow the person time to calm down.
ACT for Autism: For Emergency Department Staff
ACT (Assess, Communicate and Treat) provides a framework for response from healthcare providers. ACT takes a triangulated approach.
Assess the environment and best approach or communication mode to gain information.
- Prepare a quiet exam room.
- Minimize sensory stimuli (clutter, loud equipment, bright lights).
- Eliminate non-essential staff.
- Determine the best way to approach or communicate.
- Gain as much info as possible from both the patient and the caregiver.
Communicate to gain history, examine, and evaluate.
- Approach slowly and calmly, keeping some distance.
- Use their first name and assure you’re there to help.
- Talk in a quiet/calm voice.
- Try to establish a rapport, no matter how urgent.
- Don’t attempt to touch, grab, or restrain without preparing the individual, first.
- Before examining, explain what you are going to do or want him/her to do.
- Ask simple yes/no questions.
- Avoid questions that require complex responses.
- Allow the person time to calm down and added time to process and respond.
Treat using care and consideration.
- Consider sensory issues (taste/smell of medication, textures or temperature of materials).
- Show materials beforehand and let the patient touch them (if possible).
- Model intervention on the caregiver.
- Cover splint or bandages with non-threatening images for young patients.
This information was developed by the Autism Services, Education, Resources, and Training Collaborative (ASERT). For more information, please contact ASERT at 877-231-4244 or info@PAautism.org. ASERT is funded by the Bureau of Supports for Autism and Special Populations, PA Department of Human Services.