Autism: How to Cope Amongst the Chaos

Presenters:Emily Onderick, BS, CCLS

Kari Kletter, BS, CCLS

Autism Speaks

Quick Facts• Affects the entire family• More common in boys than girls • Every child with Autism is unique• Schedules/routines are important• Difficulty regulating emotions• There is no cure• Cause is unknown

Common Misconceptions• “My child does not feel pain.”• “We have to hold them down.”• “Nothing helps. They are just going to scream.”• “They can’t follow directions.”• “Education isn’t beneficial and is unnecessary.”

Specialized Techniques: Assessment• Parents are your best source of information• Sit down • Minimize amount of new people at one time• Questions for Caregivers:– Past experiences– Daily routines – Tolerance/reaction to pain– Comfort items– If nonverbal, best way to communicate – Sensory-seeking– Sensitive to touch

Specialized Techniques: Assessment

• PLAY– Positioning– Social– Toy selection– Types of activities

“Autism does not define the child, it’s a piece of who they are.”

Specialized Techniques: Planning• Allow time for the child to explore new area• SLOW DOWN• Collaborate with interdisciplinary team• Limit the amount of people involved• Frequent, nonthreatening visits• Introduce new items slowly• Consistent staff members• Collect toys that are familiar to the child

Specialized Techniques: Intervention“A child with Autism is not ignoring you, they are simply waiting for you to enter their world.”

• Utilize weighted mats and lead aprons• Use positive reinforcement• Speak slowly and use simple, short steps• Use pictures or act out steps• If/then statements• Be direct with requests• Familiar toys or objects, topics of interest, singing

and counting can help with distraction• Examples:__________________________________

______________________________________

Specialized Techniques: Intervention• One Voice• Parental involvement/support is HUGE • No one injured rule• Utilize visual schedules• Attention: Buzzy, Pain-Ease, EMLA, etc. may

be over stimulating• Utilize modified comfort holds

Specialized Techniques: Demonstration

Utilize for children who are teenagers, sensory-seeking and may/may not be cooperative

Utilize for children who are

younger/school-age, and sensory seeking

Utilize for children who are school-age/teenagers,

may/may not be sensory seeking and

are active

Utilize for children who are school-age/teenagers, may/may not be sensory

seeking, and are higher functioning

Collaboration: Nursing/ Physicians

• Discuss plan of care– “My Poke and Procedure Plan” cards– Inform team of child’s escalation items– Discuss options for sedation, if necessary/available

Collaboration: Child Life• Brainstorming (CCLS coping) • Hand-off and transition– Forward thinking– S.T.A.R program

Hospital-Wide Resources: S.T.A.R. Program

• Sensory Tactile Auditory Rockstars– Program information cards– Guideline & protocol forms– Intake form

• Parent/Nurse/Child Life

– Information form on chart• Board in patient’s room• Star on door

– S.T.A.R cabinet• Location • Toys• Resource list

– S.T.A.R binders

References• Davit, Caroline J., Rachel J. Hundley, Janine D. Bacic, and Ellen M. Hanson. "A Pilot

Study to Improve Venipuncture Compliance in Children and Adolescents with Autism Spectrum Disorders." Journal of Developmental and Behavioral Pediatrics 32.7 (2011): 521-24.Www.jdbp.org. Web.

• Vaz, Irene. "Improving the Management of Children with Learning Disability and Autism Spectrum Disorder When They Attend Hospital." Editorial. Child: Care, Health and Development 7 June 2010: 753-55. Print.

• Nelson, Diane, and Kristi Amplo. "Care of the Autistic Patient in the Perioperative Area." Association of Perioperative Registered Nurses89.2 (2009): 391-97. Web.

• www.autismspeaks.org