Management of critical care emergencies in children with autism spectrum disorder

Table 5 Protocol that includes guidelines for the initial assessment of children with autism spectrum disorder in the emergency setting¹

Protocol component	Guidelines
Recognizing ASD	Identify children with a known diagnosis of ASD from medical records or caregiver reports
	Observe for signs of ASD if no diagnosis is provided (e.g., communication difficulties, repetitive behaviors)
Baseline behaviors	Gather caregiver information about the child’s baseline behaviors and typical responses
	Note any deviations from the child’s usual behavior that may indicate distress or pain
Communication preferences	Determine the child’s preferred method of communication (e.g., verbal, visual aids, sign language)
	Use simplified language, clear and concise instructions, and visual aids to enhance understanding
Involving caregivers	Involve caregivers in the assessment process to provide comfort and familiar support
	Ask caregivers to interpret the child’s behaviors and preferences
Sensory sensitivities	Assess for sensory sensitivities (e.g., to noise, lights, touch) based on caregiver input and observation
	Minimize sensory overload by reducing noise, dimming lights, and avoiding unnecessary physical contact
Behavioral triggers	Identify potential triggers for behavioral challenges from caregivers (e.g., certain noises, activities)
	Avoid known triggers and implement strategies to maintain a calm environment
Pain assessment	Use tailored pain assessment tools suitable for children with ASD, such as the Non-Communicating Children’s Pain Checklist or the face, legs, activity, cry, consolability scale
	Observe for non-verbal indicators of pain (e.g., changes in facial expression, body movements)
Medical history	Obtain a detailed medical history, including any comorbid conditions, medications, and allergies
	Consider the child’s history of reactions to medications and previous medical procedures
Individualized care plan	Develop an individualized care plan based on the initial assessment findings and caregiver input
	Ensure the care plan addresses communication needs, sensory sensitivities, and behavioral management
Documentation	Document all findings from the initial assessment, including baseline behaviors, communication preferences, and any identified triggers
	Update the care plan and share relevant information with all team members involved in the child’s care

¹This table format helps systematically organize the guidelines for the initial assessment of children with autism spectrum disorder in an emergency setting, ensuring that each crucial aspect is covered comprehensively.

ASD: Autism spectrum disorder.