The Problem Once you have met one person with Autism, you have met one person with Autism

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Providing Care for the Autistic Patient Techniques to help with your interactions Tim Shea Simulation Coordinator UND School of Medicine & Health Sciences Simulation Center Medical Operations Director
Providing Care for the Autistic Patient Techniques to help with your interactions Tim Shea Simulation Coordinator UND School of Medicine & Health Sciences Simulation Center Medical Operations Director SIM-ND Father of a son with Autism Autism Spectrum Disorder Patient 1 2 This presentation will give you some ideas that might help you understand and deal with the Autistic patient and might help them adjust to you and your surroundings 4 Rate of Autism Prior to in 10, s 4 in 10, s & in 2, s 3.4 in 1, s 1 in in in 45 A ASD Autistic Spectrum Rett's Disorder B Childhood Disintegrative Disorder (CDD) People With Autism Einstein Mozart Van Gogh Beethoven Darwin Michelangelo Isaac Newton Thomas Jefferson Temple Grandin Bill Gates? Daryl Hannah Woody Allen Bob Dylan The Problem Once you have met one person with Autism, you have met one person with Autism POLITICAL CORRECTNESS: Many parents do not like the title of Autistic they feel it is a reference to a lifetime situation (IT IS) Many generally prefer ASD (Autism Spectrum Disorder) or Autism. 9 1 PARENT/PROVIDER May be as stressed out as the patient! THEY HAVE NO CONCEPT OF AUTHORITY Everybody's on the same playing field. Don t Take it personally They in general view people as things WHY DO THEY GET INJURED? They have a greater incidents of some types of injuries, Cars, Heights and Water. They may only be seeing still pictures in their mind, they actually don t perceive the cars moving. Or actually how high they are climbing. Love of water, the pressure against them feels good (like a hug to us), it is believed CHANGE???!!! To many of us this is a real stressful word 13 A main hallmark of Autistic people is UNIFORMITY of their world CHANGE to someone with AUTISM is absolutely the worse thing that can happen to them It makes everything in their mind go haywire. 14 WHAT IS GETTING SICK OR INJURED? Isn t it the ultimate change! Going to the ER or Clinic is not an every day occurrence for most people It will affect mentally everything they do 15 Understand from the get go These patients will take more time to deal with It will be quicker and better for both you and the patient if you understand a few things So if you are really rushed expect a difficult time for both you and the patient Take them on as your challenge for the day! 16 EASE THEM INTO IT - Show them the inside of the ER/Clinic Room and allow them to look around, (even open the cabinet doors) if possible hook them up to some of the devices, a heart monitor, BP Monitor and remove them The whole idea here is to allow them to adjust to the change, make them more familiar with their surroundings 17 COMMUNICATION HOW DO THEY COMMUNICATE? Verbal, PEC, Sign Language, ipad? Consider Having laminated images of the body so if cannot express what is wrong can point to the affected part of their body They may not be able to tell you what is wrong they just know that something is not right or they may be in pain but not able to understand where they are hurting 18 2 TIME LAGS It is absolutely normal for the ASD person to take 20 sec. + to maybe even a minute to respond to your question. They are not being rude they are in need of time to process what you have asked. Processing of your voice which is different, you in general are different the environment is different and this all adds to the time to figure out what you said. 19 TIME LAGS If you feel they did not hear you or did not understanding you - repeat the question in the same manner. If you change what you are saying they have start over in processing what they heard and will cause an even further delay. 20 WHAT CALMS THEM Ask the parent/provider what helps them calm down, can you provide it? For many something soft to chew on for those that are very oral for chewing will help relax them (or distract them), generally NOT GUM! 21 WHAT CAN SET THEM OFF What is hard for us as healthcare providers, things such as out-of-control behaviors and meltdowns These can occur just because of the changes. Many different things can set them off Color Red Mustaches Odd or even days They may not know what actually set them off It is difficult/impossible for them as patients to explain what causes them stress and causes them to lose control of themselves 22 DESTRESSING ENVIRONMENTS May have needs to de-stress = REMEMBER CHANGE Maybe a dark quiet space (Bathroom story) 23 PERSONAL SPACE They might have a far larger space then you are use to But they may also walk right up to you and be nose to nose when they talk with you (they don t recognize your personal space) 24 RIGHT VS LEFT SIDE HEARING Many of these patients will be able to understand what you say on one side better then the other side. Ask parent or provider if they have noticed and stand on that side when talking with the patient. 25 BALANCE Their balance may be more visual than normal patients Asking them to close their eyes and stand may be impossible for them 26 VISION They may have a very high degree of peripheral vision May try and self limit wearing hood 27 3 LOOKING AT YOU WHEN THEY TALK TO YOU They may not because they do not view people different then things. This does not mean they aren t paying attention to you. If they did not learn this at young age they may not be able to learn when older 28 COMPETING CONVERSIONS Many Autistic patients will not be able to comprehend what you are saying if there are other conversations going on close by They just will not be able to mentally process what you are saying because of the other voices 29 RESPONSE TIMES You may think a Autistic patient is acting disrespectfully or intentionally ignoring you When in fact they are just not able to process what you have said to them in a very quick manner Remember you are not the norm to them and anything outside of their absolute norm causes them to need more time to process what is happening 30 Sensory Integration Issues Especially as they become teenagers These come out Sounds Sights Smells Feels (All can be friendly or unfriendly) These can change almost weekly 31 Sensory Issues Sounds - Friendly vs. Unfriendly Lights Fluorescent / Incandescent Textures Peach feeling - eating Colors Red SOUNDS/NOISES THINGS WE DON T EVEN NOTICE Many are acutely aware of noises Fluorescent light produce sound, computer fans, etc. These may be overwhelming for them. Noise blocking headset! They may even take them to movies Even White Noise generators can cause them a lot of problems 33 LIGHTS Incandescent lights they may see the flickering (So they may be wearing sunglasses) Fluorescent lights the humming may really bother them. 34 Odors Unfamiliar or unexpected odors may cause overstimulation, even if the odor is not strong Odors perceived as strong by those with ASD may not be noticeable to most others Including perfumes and colognes, tobacco smoke (even on clothing) Sight & Visuals Neutral/solid colors are preferred They may perceive threat based on physical characteristics (skin, hair color, sex, glasses, etc.) DO NOT be offended by such sensitivities it is not the same as a racist or sexist 4 ER/Clinic KITS? In order to help relieve some of the stress of a visit to the you may want to create a sensory kit that you can have and use with Autistic patients Kits could contain a headset to block noise, weighted pads, soft things to chew on for those that are very oral and several toys The kits are meant to help distract the patient from what is upsetting them 37 Questions? 5
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