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Kupietz emphasized that even if it appears that an autistic child is not paying attention (many do not make eye contact) or if they do not seem to understand, first responders should continue communicating by speaking clearly and slowly and using literal, direct language. It is also important to remain calm, be patient and use soft, calming tones.
In general, first responders should minimize physical contact with an autistic individual and be aware that many have sensory issues. If a physical exam is necessary, Kupietz recommends responders start at extremities and work toward the trunk and head to gain the trust of an individual. Using a favorite toy or item can also provide comfort during such interactions. It is also important to note that many autistic individuals have higher-than-normal thresholds for pain, which can mask serious medical issues, Kupietz found.
One of the most enlightening aspects of Kupietz’s research resulted from interviews with parents of autistic children. None knew that they could bring children to a firehouse and introduce them to firefighters. It is important to familiarize autistic children with first responders. Showing them response equipment, letting them see firefighters in full gear and talking to them about what firefighters do, can help familiarize them with an emergency response. Taking the time to do this could potentially alleviate the newness and fear during an emergency situation and help an autistic child feel more comfortable with responders.
One of the biggest issues is getting autistic individuals to respond appropriately to an emergency situation. For example, many autistic children are frightened by traditional fire alarms and rather than exit a building, will choose to hide. During his research, Kupietz interviewed several parents who had installed alarm systems capable of recording the parent’s voice. This recording not only alerted the child to a situation, but also instructed them how to respond and react.
To address the wandering issue, many parents equipped autistic children with GPS devices to help locate them. Parents also used jewelry, temporary tattoos, cards or tags stitched in clothing to alert others that the child is autistic.
The bottom line: do not ignore autism
The recent CDC report demonstrates that autism is a disorder that is not diminishing. Department leadership must take appropriate action to educate first responders about how to best respond to an emergency situation involving an autistic individual. Using best practice guidelines and the information found in Kupietz’s research paper can help departments be proactive about their response to situations involving autistic individuals before the situation arises.
The report by the National Center for Health Statistics, “Changes in Prevalence of Parent-Reported Autism Spectrum Disorder in School-aged U.S. Children: 2007 to 2011-2012,” is available at http://www.cdc.gov/nchs/data/nhsr/nhsr065.pdf.