ASD & Hospitals: Getting the Most Out Of Eval

Our friends with autism experience a unique suite of experiences in the medical health odyssey. Not every provider is trained on ASD, and those that are aren’t necessarily in every environment. No one sees an emergency coming, so when a person with autism needs help at the hospital, it behooves providers to at least have a foundational knowledge of how to help these individuals get the support they need.

The ASD & Hospitals blog post series is aimed at healthcare providers in hospital, inpatient, or outpatient settings. It details ways that individuals with ASD can be supported.

The medical evaluation process is a critical step in the process.To make sure you are getting the most productive evaluation you can, consider these steps:

• Always ask about the person’s primary form of communication, and make sure they have access to it at all times.

  • If their caregiver has to leave, make sure they leave the communication system with the patient

• Ask caregivers what has worked in the past.

• Use a private room where possible

• Ask about sensory sensitivities, including light, smell, touch, and common phobias (such as needles).

  • Meet those sensitivities where possible; for example, a room with low light can go a long way toward maintaining calm

  • Be aware that paper gowns may be intolerable for some autistic people; if possible, let them keep and wear their preferred clothing

• Assess response to pain; individuals with ASD can have hypo- or hypersensitive experiences of pain and temperature

• Get a history of previous emergencies, especially behavioral and what worked to de-escalate.

• Ask about special interests; use them to build rapport

• Be aware: some individuals are really into shiny or novel objects, and may grab medical instruments without regard for safety

• Anticipate resistance. You’re there to help, but they might not understand. And that’s okay. Notify the treatment team to be prepared. Some challenging behavior can include:

  • aggression (biting, scratching, pushing)

  • dropping to the floor

  • running

  • self-injury (self-biting, hitting their own head, bashing against walls)

  • attempting to swallow things

  • disrobing

• Be aware: many people with autism spectrum disorder are an elopement risk. Arrange the environment so they are motivated to stay in the room.

• Make sure the individual knows what’s happening and what’s going to happen

  • Use clear language on their level

  • Pictures can help

• Provide rewards for cooperative behavior

As always, go out there and do good.