With diagnoses of autism-spectrum disorder continuing to rise, many institutions, from schools to entertainment venues to retail outlets, are making themselves more accessible to patients on the spectrum and their families. A local hospital emergency department is among the very first in the country to do the same thing.
The Emergency Department at HealthAlliance of the Hudson Valley’s Broadway Campus in Kingston, and its Parsippany, New Jersey-based practice, Emergency Medical Associates (EMA), worked together to develop a program that would help patients on the spectrum feel safe and supported and allow practitioners an easier way to provide healthcare.
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“The experience of being in the emergency department is traumatic for anyone, but it is especially so for patients on the spectrum,” says Fareed N. Fareed, MD, FACEP, director of the emergency department at HealthAlliance of the Hudson Valley. “There are a lot of people coming in and out of rooms, loud sounds, bright lights, all noxious stimuli, and these patients are especially sensitive to that. We see these patients fairly routinely, and we thought that maybe there was a better approach.”
HealthAlliance and EMA met with the Autism Society of the Hudson Valley to create a 30-minute training program for everyone involved in emergency medicine at the hospital, including paramedics, nurses, physicians, technicians, and administration. The training covered such issues as how to talk to a patient on the spectrum — “You can’t just fire questions at them, because they may not process language the same way,” Dr. Fareed says — and how to touch them to conduct an exam or start a procedure. Clinicians learned, among other things, to be aware that patients on the spectrum have a higher risk of suffering seizures.
Communication is often the biggest challenge, so the program uses iPads with autism-specific apps that help staff communicate with patients and learn why they need care, what their pain and discomfort level is, and how they prefer to communicate. “They can point to faces with grimaces that indicate pain scale, or click on a body part to show us what hurts,” he said. The iPads also help staff explain things to patients.
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“We also learned that certain stimuli can be very comforting to these patients,” he says. So the department now has a “sensory box” filled with objects made of a variety of textures to enable patients with autism to calm themselves and deal with stress better. “There is a squishy ball and a pin wheel, for instance, and as soon as they play with it, magically, they are much calmer and more amenable to exams or procedures like blood-draw,” he says.
Dr. Fareed says that, since initiating the program last year, many patients on the spectrum have been successfully treated more easily. And though, “by now, everyone knows someone on the spectrum,” he says, “parents and family members are surprised to see that we do this, and thank us for taking them into consideration.”
