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Behavioral Management of Children With Autism in the Emergency Department
Katherine H Wolpert1, Ian Kodish2, Soo-Jeong Kim
1From the Assistant Professor (Wolpert) and Associate Professor (Uspal), Division of Emergency Medicine, Department of Pediatrics, University of Washington.
Pediatric Emergency Care
|December 29, 2022
Summary
Autism spectrum disorder (ASD) youth often visit emergency departments for behavioral issues. This guide helps practitioners manage their complex needs, including agitation and comorbidities, for effective care.
Area of Science:
- Neurodevelopmental Disorders
- Pediatric Emergency Medicine
- Child and Adolescent Psychiatry
Background:
- Autism spectrum disorder (ASD) involves social communication deficits and repetitive behaviors.
- ASD youth frequently experience emotional dysregulation, aggression, depression, and suicidality.
- These symptoms lead to frequent emergency department (ED) visits for behavioral and mental health evaluations.
Purpose of the Study:
- To provide guidance for emergency department practitioners evaluating youth with ASD.
- To address the common psychiatric comorbidities, agitation, and depression seen in this population.
- To outline considerations for managing organic etiologies, agitation risk, and disposition planning for ASD patients in the ED.
Main Methods:
- Review of clinical presentations of ASD youth in emergency settings.
- Analysis of common psychiatric comorbidities and behavioral challenges.
- Discussion of diagnostic and management strategies relevant to the emergency department.
Main Results:
- Emergency department visits for ASD youth are often driven by behavioral and mental health crises.
- Psychiatric comorbidities such as agitation and depression are prevalent.
- Careful consideration of organic causes, agitation management, and disposition is crucial.
Conclusions:
- Emergency department practitioners require specific knowledge to effectively manage ASD youth.
- A systematic approach is needed to address behavioral symptoms, comorbidities, and disposition in this population.
- Optimizing care for ASD youth in the ED improves patient outcomes and resource utilization.
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