Wendy Goldband, author, and Bill Davis, a father of an autistic child co-authored the book Dangerous Encounters: avoiding perilous situations with autism (Amazon link) contributed this post to Everyday EMS Tips. This post is an excerpt from the book. Wendy Goldbland and Bill Davis write:
About one in every 150 children in the U.S. is now diagnosed with autism – a complex neurological condition with a variety of symptoms that affect individuals in different ways. It is four times more prevalent in males than females, and increased almost 200% in the last ten years. People with autism can have many or just a few of the disorder’s common characteristics. No two people exhibit the exact same symptoms, making autism a spectrum disorder. Some people can be very high functioning and others very low functioning. Some individuals may be highly verbal while others are nonverbal, some have above-average intelligence while others may have mental retardation, and some may respond atypically to different sensory stimuli.
Workers in the emergency service field should be very aware of the fact that people with autism can be violent and aggressive. Teenagers, in particular, have been known to be very aggressive and have some very peculiar behaviors relating to hormones and sexuality. But understand that autism is not a psychological disorder. The peculiar behaviors you might encounter are not from a person who is out of control or has a psychological problem. It is not a result of poor parenting. His actions cannot be physically helped. If you encounter a person with autism, you might as well forget everything you know about communicating with a typical human being because it’s not going to work with autism.
If called to an accident, how do you determine if a person has autism or if a person with autism is hurt? I always stress to evaluate, evaluate, and reevaluate. If a person with autism is sitting in a car wreck he may not have even understood he was in a wreck! He may just defer the whole incident so that it’s gone from his reality. Perhaps he has a very high threshold of pain. He might not know he’s hurt, might not tell you, or might not think it’s important. He may not recognize danger, pain, or that the person he’s with is hurt. In fact, he might be absorbed in watching a tree right now. All these are very protective autistic responses to shield from over-stimulation.
A serious problem can be very minor to a person with autism. But a minor scrape can be traumatic. When my son scraped his leg he had to be in sweat pants for three days because he couldn’t deal with seeing it. He paced the floor and looked at it constantly. It was very serious to him.
Here are 10 Everyday EMS Tips when responding to a situation involving a person with autism:
1. Assess for injury! Assess for injury! Assess for injury!
2. Interpretation of pain may be abnormal – Serious injury may be ignored; Minor scrapes may be interpreted as traumatic.
3. If parent is unable to respond, look for ID card on parent or keys explaining child’s disorder.
4. Approach slowly. Be calm, direct, quiet, and repetitive.
5. Explain everything in simple words and gestures before making any physical contact.
6. Do not interrupt fixating or repetitive motions unless necessary.
7. Ambulance or emergency room settings may be highly over-stimulating, agitating, or even painful – Take the child to a quiet place as quickly as possible.
8. May have severe allergies to food and drugs – Kids with autism are often on many different medications and are prone to allergic reactions or dangerous drug interactions. That is why it is probably a better choice not to administer any medications to a patient with autism unless the guardian is there to inform you or it is an absolute necessity.
9. Try to demonstrate on yourself or colleague when explaining procedures – Use drawings or pictures.
10. Remember that people with autism may act over-excited or agitated when faced with the unknown or when they don’t know what’s expected of them.
Bill Davis is the father of Chris, who has autism. Breaking Autism’s Barriers: A Father’s Story chronicles Bill’s fight to overcome the physical, emotional, public, educational, and therapeutic obstacles to his son’s disorder.
Co-author of Breaking Autism’s Barriers and Dangerous Encounters:Avoiding Perilous Situations with Autism, Wendy Goldband, MSW, is a Registered Representative and Insurance Producer with an expertise in long term care and special needs planning. She is the former Senior Marketing Manager for Crump Insurance Services, and helps families with special needs plan their financial futures. Wendy enjoys giving talks that help groups understand the unique issues seniors and special needs families face. She is a trained hospice volunteer, been part of a medical mission to Jamaica, and is a Best Friends Animal Society Ambassador. Email Wendy Email Wendy.