Patient Assessment Autism

Weekly Autism Tips for Emergency Responders – Patient Assessment

Patient Assessment AutismDuring a standard assessment in a conscious patient, we rely heavily on the patient’s communication – why EMS was called, what hurts, what happened, etc. This can become complicated when assessing a patient with Autism. Even a high-functioning, verbal Autistic patient may or may not physically feel pain. Sensory processing issues often include difficulty interpreting temperature and pain, and it’s hard to assess someone who can’t tell you what hurts!

Abnormal pain interpretation can sometimes mean a minor scrape or ache is perceived as a trauma or a major injury completely ignored. Traditional OPQRST surveys are not particularly reliable when someone has little sense of where their body ends and space begins and, most likely, what they ARE experiencing is not consistent with what you are observing on scene. Throw in communication deficits and sensory overwhelm of lights and sirens and being surrounded by strangers… patient assessment can be a sticky-wicket indeed.

The first thing you can do is try to remove sensory triggers if possible – remember that an ambulance setting can be extremely overwhelming for someone with Autism but so can the scene itself. Keep the scene as quiet and calm as you can.

Use the parent or caregiver and all the information they have to offer. Believe me when I tell you that most Autism parents have done their homework and know a great deal about their child’s challenges and medical issues. Establish a baseline behavior status to help in your assessment. I purposely did not say “baseline mental status” here because Autism is NOT a mental illness. While it is also not a behavioral issue, unfortunately we must rely on behaviors to help us identify Autism on a scene.

Remember that being touched may be perceived as pain, so do your best to engage the patient while triaging from distal to proximal. A Dollar Store slinky has done wonders for me – it distracts my patient while I get 85-90% of my assessment done before they realize what’s happening. (Don’t ever give a patient your cell phone or keys for this purpose, FYI!) Communicate what you are doing, whether they are verbal or not. A nonverbal patient can still hear and understand you. Bandages and adhesives may cause aggression due to sensory processing issues.

Assess thoroughly – look for less obvious injuries and DO expect the unexpected. Not long after I finished my first responder training, my son came running out of his room one evening screaming and raking his tongue. I quickly tried to figure out what was happening – did he bite it? Get stung or bitten by a bug he ate? Was there a toy in his mouth? In his other hand, I saw the glow-in-the-dark necklace from our earlier outing at Stone Mountain… bitten in half. The glowing liquid was all over his tongue and it was burning him. There was nothing about that in my first aid and responder manuals :) It was fine, by the way, Poison Control cleared him, but I never would have imagined looking for that kind of injury. Or the backward tumble out of the shopping cart at the grocery store, or the many times he’s wandered from school settings… but I digress.

Finally, during your assessment be aware of severe food and drug allergies as well as Pica Syndrome. Parents and caregivers are the best fountain of information, but in absence of that resource, there may be alternative IDs or apps that can provide you this valuable information in a snap.

Share your assessment tips and experiences – parents or responders – below. I love hearing from you!

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Help Me Illuminate the Future for Those with Autism

logo_waad-227x300As you know, I am extremely involved in the Autism community, both to support my son and in the Emergency Preparedness/Emergency Responder arena. I am blessed and honored to be training some of Georgia’s finest men and women in uniform – Law Enforcement, EMS, Fire Rescue and Disaster Responders – on how to recognize and safely interact with Autistic persons on the scene of a crime, fire, medical call or disaster. My goal is to have all of Georgia’s responders trained within the next 18 months. The Autism Society of Georgia is helping me do that by fully endorsing my training programs!

April 2 is World Autism Awareness Day. 

Please join the Autism Society of Georgia and me by helping us illuminate the future and create awareness for Autism.

For as little as $5.00 you can help us light a luminary for 1 child or adult.

There are over 150,000 children and adults in Georgia identified with Autism and we are making a difference. And, because my training programs are critical to the safety of the Autism community, the Autism Society of Georgia is giving 20% back to Spirit of Autism when you donate through my unique link so that I can continue to provide this training.

If you feel inspired to, you can click here to go to mydonation page or head over to Autism Society of Georgia’s The Future is Bright website to learn more about the campaign. From there you can choose Spirit of Autism on the right hand side by clicking my logo.

Thank you for being a part of MY community. I know you haven’t heard from me regularly in a while… I apologize! I’m almost done with Advanced EMT school and can come up for air soon : ) Now back to my IV drip conversions and drug calculations!

xoxo

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Special Needs Mothers Need Not Apply

My neighborhood has a special Women’s Club that meets regularly and hosts family-oriented social events. I’m going to be direct and get right to the point: I have been asked by several women not to attend any of these meetings because I have an Autistic child.

Bear in mind, I have never brought my son to a meeting, he has never been to a social event, he has never caused a neighborhood “ruckus.” He has Autism. It’s not contagious, scary or dangerous. There’s nothing unusual to stare at when you meet him. Why, then, am I blatantly cast out?

I have been a single mom for nine years. My children and I have lived on this block, renting my home, since our return from Knoxville two years ago. I have never brought a date home (what’s dating, ha ha!), had a loud party, had any questionable visitors, or been in trouble with the law. In fact, having disaster response training under my belt and being a volunteer with the Fire Department, I would be an amazing resource for the community if someone would dare get to know me.

I walk my two giant Malamutes at least twice a day and always wave and exchange small talk with everyone I meet. Everyone waves and smiles back, yet we’re still not allowed into “the club” (first rule of Fight Club is…). Worse yet, I continually get asked why I’m not seen at the club meetings, and am also labeled the “crazy homeschooling neighbor that doesn’t participate.”

This just compounds our history of being kicked out of restaurants, book stores, flights (!), and why no one in my family will visit us. I’ve also been told he’s not Autistic, it’s my parenting that’s the problem. That’s a good one!

With all the awareness work and training I do, why are we still experiencing this kind of response from people?

What should I do?

Well, I have some options about my neighborhood. I don’t have the energy to tackle public places at the moment (I will move one mountain at a time!), but here are my choices:

  • I can whine about how unfair it is and feel like a victim
  • I can say, “Oh well,” and let it roll off my back, like water off a duck
  • I can organize a neighborhood gathering of my own, or request to be a special “guest speaker” at the next one

If I can train law enforcement, EMTs, and firefighters about Autism, why can’t I put something unique together to present to my neighbors? It would be so beneficial for everyone to learn a little more about Autism and my son in particular. This way, when we have a wandering situation (which recently happened!), I can feel like my neighbors have my back rather than feeling like they are sitting in judgement. Sure, they may continue to judge me after they learn more, but that’s none of my business.

Now I’d like to hear from you

Have you ever felt persecuted by a group due to your (or your child’s) Autism? How did you respond? Would you like to learn more about giving a small presentation to your neighborhood? Share your comments below, drop me an email, or say something on the SOA Facebook page – I always love sharing thoughts and ideas with you.

Why Emergency Responder Education – Part I

My son was 18 months old. He was standing next to my bed, humming, as I was folding laundry and separating the piles. Then he walked out. In the time it took me to fold a pair of jeans, this child had walked to the other end of the house, found my keys, figured out which one was the car key (!), went outside, opened the trunk, and climbed in. NO EXAGGERATION.

Around that same time period, I remember driving to an errand, both kids in the back seat, and glanced in my rear view mirror with horror to see my son “surfing” on the arms of his car seat, yet the restraints were still fastened. Holy Houdini! (I went through about three of four different models of car seats that year trying to find a straitjacket-level security device!)

In First Grade, I dropped him off at school, walked halfway with him to his class (the IEP requested we start to assert some independence in the mornings… ha!) and went on my merry way after kisses and high fives like usual. It just so happened that I forgot something from the house. Coincidentally, I also needed gas that morning and went left instead of right, passing the school again. About four blocks from the school, in a direction I normally never would have traveled, was my son, walking with his backpack and singing, without a care in the world. He apparently walked right out of the building after we parted in the hallway, and the teacher assumed he was absent that day… AHHHHHH!!!! No one knew! Imagine what could have happened if I turned right that day!!!!

So these are some crises that sprouted unexpectedly within the structure of a normal day. What if there was a fire in your home, or you were in an auto accident? What if you were hit with severe weather or a natural disaster? What if your child with Autism creates a public disturbance? How would a police officer deal with him or her?

Would an emergency responder recognize the signs of Autism in your child, or would they treat them as if they were mentally ill, on drugs, or non-compliant?

Why Emergency Responder Training is Needed

Many children on the Spectrum have no visible signs of a disorder. An average child in appearance with socially unacceptable behavior that no one understands can lead to a nightmare if public safety is involved. Your child may get pushed around, put in jail, injured, or worse.

It’s vital for emergency responders to identify the signs and behaviors of Autism and learn how to make your child feel as safe and non-threatened as possible to avoid a perilous outcome. Police Officers, Firefighters, and EMTs learn about alcoholics, diabetics, cerebral palsy, and mental retardation. With as many as 1 in 70 children being diagnosed on the Autism Spectrum today, the time has come for everyone to understand! This should be part of standard training. That’s why I am called to begin such training in my own county and work my way out.

Do you think a Firefighter, EMT, or Police Officer would know how to communicate with or understand your child in an emergency? Feel free to comment below!

Stay tuned for Part II of this post… behaviors, tips, and what you can do in YOUR community to help emergency responders learn more!