Safely Sedating Children and Adolescents Who Are Neurodivergent

Children who are neurodivergent have higher rates of injury, number of health care visits, and perceived need for sedation compared with their peers who are not neurodivergent, resulting in unique medical care challenges for this patient population. Sedation of children who are neurodivergent is challenging due to increased risk of adverse events, medication interactions, and behavioral complexities. Safe and effective sedation requires individualized planning, careful agent selection, and incorporation of nonpharmacologic strategies. Significant variability exists in sedation practices for children who are neurodivergent, highlighting the need for greater education and clinical guidelines. Sedation clinicians should consider the potential sensory sensitivity and communication limitations of a child who is neurodivergent. Environmental modifications, tailored communication strategies, sensory tools, caregiver involvement, and individualized coping plans may be beneficial. Future research should prioritize patient- and family-centered care goals, evidence-based design of neurodivergent-friendly settings, standardized sedation protocols, customized sedative dosing for the neurodiverse population, and expansion of home desensitization programs to improve safety, comfort, and equity in care for patients who are neurodivergent.