Management of critical care emergencies in children with autism spectrum disorder

Table 6 An example of communication protocol for children with autism spectrum disorder in the critical care and emergency setting¹

Protocol component	Guidelines
Simplified language	Use clear, concise, and simple language to explain instructions
	Avoid medical jargon and complex phrases
Visual aids	Utilize visual aids, such as pictures, symbols, and written instructions, to support communication
	Prepare visual schedules to outline steps of procedures or routines
Non-verbal cues	Pay attention to non-verbal cues from the child, such as body language, facial expressions, and gestures
	Respond to these cues with appropriate actions or adjustments to care
Caregiver involvement	Involve caregivers in the communication process as they understand the child’s needs and preferences best
	Allow caregivers to interpret and explain the child’s behavior and needs
Repetition and patience	Repeat instructions and information as necessary to ensure understanding
	Be patient and give the child extra time to process information and respond
Clear instructions	Give step-by-step instructions for procedures, breaking down tasks into smaller, manageable parts
	Use positive language to explain what will happen, avoiding negative or fear-inducing terms
Calm and soothing tone	Maintain a calm, soothing, and reassuring tone of voice
	Avoid sudden changes in tone or volume that might startle the child
Consistency	Ensure consistency in communication methods among all staff members interacting with the child
	Use the same phrases and visual aids to prevent confusion and build trust
Personal space	Respect the child’s personal space and avoid unnecessary physical contact
	Approach the child slowly and from the front, avoiding sudden movements
Preparation and explanation	Prepare the child for procedures by explaining what will happen in advance
	Use visual aids and simple language to describe each step of the process
Feedback and reassurance	Provide positive feedback and reassurance throughout interactions to build confidence and cooperation
	Acknowledge the child’s efforts and successes in following instructions or coping with procedures
Crisis communication	Develop and follow specific communication strategies for managing behavioral crises or meltdowns
	Use calming techniques and de-escalation strategies as needed

¹This table organizes the guidelines for effective communication with children with autism spectrum disorder in an emergency setting.

ASD: Autism spectrum disorder.