can hospital ERs be Asperger's friendlyGoing into a hospital ER is an overwhelming experience for anyone. It’s particularly difficult for someone with Aspergers, NLD or similar challenges. First, you’re there for a reason and that’s often scary. Second, there’s the sensory bombardment of noises and lights. Being around people who may be upset themselves in close contact challenges anyone. Third, ER’s have administrative procedures and staff that are unfamiliar and therefore challenging.

Some hospitals are taking steps to make ERs more sensory-friendly for children. The Nemours Children’s Hospital in Orlando, FL has the REACH program in their ER. They identify children with ASD or related disorders and accommodate their needs throughout their visit. There’s a quiet waiting area with sensory materials, toys, iPads, and headphones.

Quoted by the Orlando Sentinel, REACH co-founder Emily Bradley said, “It’s not so much about the toys, it’s about the awareness and communication.” According to the Sentinel, there’s no data on how many kid’s ERs offer similar programs. However, at this point, most ERs do not have programs for children and there are no programs for adults, who are in equal need of consideration.

What can parents, spouses or others do to make the ER situation work as smoothly as possible?  It’s important to realize that ER staff members want an evaluation to go well, and want to minimize problems for patients and themselves.

  1. If a professional therapist, psychiatrist or primary care doctor is involved, have the doctor call ahead to give the staff a “heads up” about the patient’s challenges and needs.
  1. Individuals of any age with Aspergers or related challenges ideally should go to the ER with a parent, spouse, friend or family member with whom they’re comfortable.
  1. If you’re the accompanying adult, go immediately to the Registration or Intake desk and identify the patient as being on the autism spectrum, and make it clear that special accommodations may be necessary for the patient to be cooperative and calm.
  1. Ask to speak to a professional or the nurse in charge, and take the time to clearly and specifically explain the challenges and what’s needed. Don’t assume if someone says, “I understand” that they do. Each person with Aspergers, NLD or related challenges is unique.
  1. Make clear that the situation of being alone in a new setting and questioned by a stranger could be agitating. Explain that the patient would do best if you accompanied him or her. If necessary, suggest questions be relayed through you.
  1. Ask the nurse or APRN to explain the ER process to you, so you can tell the patient exactly what to expect. (For example, she or he will probably be on a bed surrounded by curtains in a large area.) Find out who will come in and what procedures will be done. If it’s possible, have the nurse stop by to be introduced.
  1. Try to get the patient to a relatively quiet place as soon as possible.
  1. Be sure that symptoms such as a lack of facial expressiveness are understood to be part of the syndrome, so the patient is not thought to be mentally disturbed.
  1. Create strategies for procedures you anticipate might be upsetting. Explain to the patient exactly what will be done, step-by-step, and talk about what the patient can do to stay calm.
  1. Even if the process is difficult, remain calm yourself. Your feelings will have a strong impact on the person you’re helping.

If you have a child or are an adult with Aspergers, NLD or similar challenges, you might help a lot of people if you are proactive and check with your local ER to see if they are sensitive to people with differences. Suggest that someone qualified provide training, or if necessary, talk about it yourself. Share this article.

Educating the staff would be a service to your community. As Ms. Bradley said, making the ER process more divergent-friendly is mostly about awareness and understanding.

Child playing photo available from Shutterstock