Autism Awareness

While today may be Autism Awareness Day on the calendar, for many they need no reminder, and they are aware every day, all day, however for the rescuers there are a number of ways to be more aware.

Each call a 911 Dispatcher takes is different; just as every run a Firefighter or Emergency Medical Technician (EMT) takes is different.

911 is typically the first point of contact for most emergencies, and the vast majority of callers to 911 can speak and comprehend functionally, however many with autism cannot. The speech and cognitive deficits impacting many on the autism spectrum pose some unique challenges in dispatching aid to those calling.

For Firefighters and EMTs, encountering some of the autism spectrum becomes even more of a challenge, whether the call before a routine medical situation or pulling a person with autism from a burning building.

So, for today, Autism Awareness Day, there are some tips for first responders to keep in mind, so they can be more aware of encountering those with autism

• Listen to how a caller may be speaking. They may seem impaired, as many with autism speak differently. A person with autism may seem impaired or incoherent.
• Those with autism may focus on one word and repeat that one word, or repeat a phrase, unable to stop themselves.
• Getting the basics from a caller, who, what, when, where and how can be very challenging, and requires extra patience. Consider breaking the questioning down to asking what they are afraid of, and use short instructions, with no room for interpretation. Many with autism are very ‘black-and-white’ in their thought process.
• First and foremost people on the autism spectrum cannot be identified by their appearance. People with autism look like everyone else. People autism, children and adult alike, are identified by their behavior.
• Expect the unexpected. Yes, this can be said for any run, but those with autism are likely to be injured and unable to accurately describe even where the pain is. Those with autism may ingest something totally unaware of what they have ingested, with no ability to recall where it was they even got into something to ingest.
• If a parent, caregiver or guardian is on the scene with a patient with autism, ask them what level of support your patient needs. Find out how verbal they are, what triggers they may have, and any tips they may have for working with the patient.
• When encountering a patient with autism be aware that it is common for them to have sensory issues. The feel of tape, or certain sounds, could increase anxiety or aggression
• It is common for those with autism to move slowly and have trouble following instructions. As you examine a person with autism, explain everything you are doing, slowly, with short phrases, avoid being vague. As you perform your exams go from distal to proximal. Working with your patient in this manner may help reduce aggression, anxiety and avoid involuntary outbursts.
• It is not uncommon for adults with autism to act in a childlike manner or have childlike tendencies. If you carry stuffed animals on your rigs, consider one for an adult with autism to calm them and give them something to focus on.
• When possible, remove a patient with autism from a scene, to a quiet area. Removing the patient to a quiet room, or the back of an ambulance with the doors closed may help with not only patient safety but in reducing their level of distraction. If possible show your autistic patient what you will be doing step by step on another person or possibly a stuffed animal, if kept on your rig.
• Be aware that many people on the autism spectrum do not have what would be considered a normal range of sensations. Your patient may not feel pain, cold or heat in the manner in which you’d expect. It is not uncommon for those with autism to fail to acknowledge that they are in pain, despite what you can clearly see evident from an injury. Some patients with autism may respond to pain in a manner such as stripping off their clothing, humming or laughing.
• People with autism often cannot control their own body movements. It is common for those with autism to flap their arms, or beat their own chest, among other involuntary body movements. Be aware of not only your own safety but that this typical physical movement may be the baseline for your patient.
• In a fire situation be aware that an adult with autism is just as likely to hide as a child. Even if there are no known children in a home, an autistic adult is likely to hide in a closet, behind furniture or under a bed.
• Those with autism often have significant comprehension deficits, making them unaware of the extreme danger of a situation. With the comprehension deficits of autism, a victim might become aggressive and resist being restrained as they are rescued.
• When it is necessary to restrain an autistic victim during a fire-rescue, be aware that many with autism have a poorly developed torso, and are likely to lower their head and neck. If steps are not taken to account for this, they can suffer positional asphyxiation.
• When encountering a person with autism, use clear and succinct phrases, such as “Sit Down”, “Wait Here” or “Get In.” Do not give your victim any room to misinterpret what you are stating to them. Those with autism often take longer to respond to directions, this can be because they cannot comprehend what is being asked of them, and their language processing skills are slower. This, coupled with fear, makes the reaction times even slower.
• Those with autism, children, and adults, are an extreme flight risk after being rescued. It is imperative that a victim with autism must never be left alone. If you must leave them, you must leave them in the care of someone else.

While people with autism present indications across a wide spectrum of verbal and body language cues, following these basic awareness tips not only makes situations easier for your patents and their caregivers but for you as their rescuer as well.

Autism Awareness is not something we should be aware of one day out of the year, but rather something we must be aware of each and every day.

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