As EMS professionals, we encounter all kinds of situations + patients. Every shift brings about unique challenges, but we must always be ready to act and to advocate for all of those who seek and need our care. We are public servants first. With that being said, we must continue to sharpen and refine our skills, which includes gaining a deeper understanding about populations with special needs. This blog will focus on one such group who experiences the world around them a little differently than most. EMBRACE THEM!!
Autism Spectrum Disorder (ASD) represents a broad range of conditions characterized by challenges with social skills, repetitive behaviors or stimming, speech, and sometimes nonverbal communication. The spectrum is so much wider than you think. Einstein would have likely been on it, because he didn't speak until age 3. ASD is not a mental illness and it's not a psychological disorder.
A friend and fellow first responder, Brandon Fromeyer, has a son who has formally been diagnosed with autism. Brandon graciously gave me some pointers that are extremely relevant to EMS, particularly, he wanted me to share some these tips/tricks around caring for these special individuals.
#1 - When you meet one person with autism, you've only met one person with autism. There are many subtypes, and they are all different, therefore, our approach to care should not be "one size fits all". However, in general, it's advisable to speak slowly, in a calm fashion, and be explicit in your communication. Let them know what is going to happen next.
#2 - Having encounters with non-verbal patients can be very challenging, it's important to locate or contact a caregiver or guardian. Approach them 1 on 1, if possible, as groups of responders, will make them anxious and certainly won't help your situation. While non-verbal, they may still be able to fully understand you. Lastly, consider turning off the lights & sirens.
#3 - First responders are 7x more likely to encounter someone on the spectrum than neurotypical individuals. 1/100 people are somewhere on the spectrum. Additionally, be aware they don't necessarily have an awareness of danger - something that is innate in other populations.
#4 - In cases of wandering, it is imperative to check nearby bodies of water immediately. Some may see it as an overgeneralized claim, but many with ASD are fascinated by and even obsessed with water.
Source: Autism Treatment News
Some will argue that autism, is a difference and not a disorder. Others say that individuals with autism simply have atypical minds in a stereotypical world. Few will argue that autism is most definitely a lifelong condition, but I'll add that maybe we have been misunderstanding the nature of the condition. Perhaps we should rethink how we see autism. Maybe it's not a condition of incapacity or disability, but a condition of profound sensitivity and potential.
The environment in which children with autism grow up in means so much. The environment that we create when caring for an autistic child also carries a lot of weight and will likely determine the trajectory of the entire call. Individuals with autism can flourish and provide our society with great value. The key is early intervention (as parents and EMS personnel).
Children/Adults with Aspergers Syndrome (the mildest form of ASD) can be extremely brilliant, and many can do some complicated tasks way better than you or I. Still skeptical as to whether or not the ASD population can provide great benefits for humanity -- please look up Temple Grandin and her accomplishments as just one such example. Temple states, "the world needs ALL kinds of minds" - as an EMS professional -- never lose sight of this.
Maybe our first error is seeing the autistic child as being separated from their surroundings, but the reality may be that they are deeply connected to their surroundings. They essentially can't detach from their environment. - hence why they get easily overwhelmed and over stimulated.
In closing depending on the environment that we create around an autistic child, they have the potential on the one hand to thrive, to become a source of joy and inspiration to us. On the other hand, they have the potential to be overwhelmed, beyond the point of what they can bear. So, as a result, they simply shut down almost completely. When the autistic patient shuts down, they may require a level of practical care that would be completely unnecessary if we were just a little mindful of how they experience the world.