Toward Practice Advancement in Emergency Care for Children With Autism Spectrum Disorder

Area of Science:

• Pediatric Emergency Medicine
• Neurodevelopmental Disorders
• Healthcare Quality Improvement

Background:

• Children with autism spectrum disorder (ASD) often struggle in busy clinical settings like emergency departments (EDs) due to sensory sensitivities and difficulties with transitions.
• The unpredictable nature, wait times, and care demands of the ED can exacerbate these challenges for children with ASD.
• Limited literature exists on the specific needs of children with ASD in the ED, hindering the development of clinical guidelines.

Purpose of the Study:

• To identify stakeholder perspectives on clinical priorities and recommendations for improving emergency department (ED) service delivery for children with autism spectrum disorder (ASD).

Main Methods:

• Qualitative data were collected through focus groups with parents of children with ASD, ED clinicians, and ED administrators (n=60).
• This phase followed initial qualitative interviews with children, parents, and healthcare providers.
• Data analysis employed an interpretive description approach.

Main Results:

• Stakeholders found current ED care insufficient for meeting the needs of children with ASD.
• Key clinical priorities identified include: ASD-specific preparedness for ED processes, wait time management, sedation/restraint strategies, child-focused support, healthcare provider training, post-ED resources, and transition planning.
• Enhanced child- and family-centered care was strongly recommended.

Conclusions:

• Emergency departments require significant improvements to effectively serve children with autism spectrum disorder.
• Implementing stakeholder-recommended priorities can enhance the ED experience and outcomes for children with ASD and their families.
• Future clinical guidelines should incorporate these findings to promote more inclusive and effective ED care.