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Decreasing Agitation in Neurodiverse Patients with Mental Health Concerns

Diana Hou Yan1, Avery Jeon2, Yunfai Ng3

  • 1Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA. diana.yan@mountsinai.org.

Journal of Autism and Developmental Disorders
|December 19, 2024
PubMed

Insights

A new medical education curriculum successfully reduced agitation in neurodiverse pediatric patients within emergency departments. This intervention also decreased the need for medication and physical restraints, improving care for this vulnerable population.

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.
Abstract

Keywords:
AgitationAutism spectrum disorder clinical pathwayNeurodiverse patientsPediatric emergency department

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