Decreasing Agitation in Neurodiverse Patients with Mental Health Concerns

Area of Science:

• Pediatric Emergency Medicine
• Neurodevelopmental Disorders
• Mental Health Interventions

Background:

• Children and adolescents face a significant mental health crisis.
• Neurodiverse individuals experience higher rates of mental health conditions and poorer outcomes.
• Existing pediatric emergency care pathways require optimization for neurodiverse patients.

Purpose of the Study:

• To implement and evaluate an Autism Spectrum Disorder Care Pathway in a pediatric emergency department (PED) and Observation Unit (OU).
• To decrease the frequency and severity of agitation in neurodiverse patients presenting to the PED/OU.
• To reduce the use of pharmacologic interventions and physical restraints for agitated neurodiverse patients.

Main Methods:

• Prospective cohort study conducted in a community-based PED and OU (June 2023 - February 2024).
• Implementation of a medical education curriculum including multidisciplinary champion training and toolkit rollout.
• Agitation measured using the Behavioral Activity Rating Scale (BARS); primary aim was to decrease agitation frequency.

Main Results:

• Data collected from 45 patients (19 baseline, 26 intervention).
• Agitation occurred in 47% of baseline patients versus 23% post-intervention (p=0.04).
• Significant reduction in agitation frequency; 3 pharmacologic interventions and 0 physical restraints used in the intervention group.

Conclusions:

• Pilot medical education curriculum effectively decreased agitation in neurodiverse pediatric patients with mental health complaints.
• The Autism Spectrum Disorder Care Pathway shows promise for improving emergency care for neurodiverse youth.
• This study provides a foundation for expanding the curriculum to general emergency departments.