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On March 20, 2013, the U.S. Centers for Disease Control and Prevention (CDC) released a report stating that one in 50 (more than 1 million) U.S. schoolchildren are diagnosed with autism spectrum disorder (ASD).
This is up substantially from a previous report, which found one in 88 U.S. children having ASD. While there remains some debate whether this higher occurrence rate is the result of more children having autism or is caused by changes in reporting methods, it is clear that autism is an increasingly common disorder throughout the country.
And first responders must take note.
Emergency responders must educate themselves about this disorder and learn how to adjust their response to situations that involve an autistic individual, said Dr. Kevin Kupietz, adjunct professor of Emergency and Disaster Management at American Military University in Manassas, VA, and a volunteer firefighter with the Roanoke Rapids Fire Department in North Carolina.
As part of his enrollment in the U.S. Fire Administration (USFA) Executive Fire Officer (EFO) program, Kupietz researched best practices for emergency response to incidents involving autistic individuals. He found that statistically, an autistic individual is seven times more likely to need the service of emergency responders than a non-autistic individual. Therefore, as the number of autistic children and adults increases in the U.S., the greater the likelihood is that first responders will encounter an autistic individual during an emergency situation.
Kupietz’s goal with this research paper was to answer two primary questions:
1. What is being done in fire departments to prepare responders?
2. What are the best practices?
Kupietz found almost no existing research focused on autism and emergency response. He began his research by surveying three groups: fire department personnel, healthcare professionals who treated autistic children and parents and caregivers of autistic children. Kupietz included the survey results and recommended best practices for first responders in a paper titled, “Best Practices for Autism During Emergencies.” (You can read the paper at http://www.usfa.fema.gov/pdf/efop/efo46708.pdf; for a list of recommended best practices, see Appendix H.)
What is ASD?
According to the CDC, ASD is a set of complex neurodevelopment disorders. Children who have ASD display mild to severe impairments in social interaction and communication along with restricted, repetitive and stereotyped patterns of behaviors, interests and activities. During his research, Kupietz found that the majority of first responders had not received specific training about autism.
“There’s not enough information about specific disorders,” Kupietz said. “We put it all in a nutshell and treat them all the same and that could cause more issues in the long run than if we can learn about the different aspects of disorders...There are different techniques for each one of them.”
Autism is an especially difficult disorder to train first responders about because the spectrum of ability differs greatly from individual to individual. For example, one autistic child may run away at the sound of a loud siren, but another may be attracted to the loud noise, he said.
Common tendencies of autistic individuals
While it is difficult to generalize autistic behavior, there are a few commonly cited tendencies. One is an affinity for water, even when children cannot swim. Studies have found that autistic children are at a higher risk of drowning than non-autistic children. Many children are fearless when it comes to water and have little regard for the temperature or the depth. Also, many autistic children wander. Efforts to locate them may be impeded by the fact that many will hide or not respond verbally when they hear calls from searchers.
Communicating directly with an autistic child can be difficult and frustrating for first responders. Many autistic children communicate visually rather than verbally. Many understand what a person is saying, but cannot answer.