April is National Autism Awareness Month

April 2nd is International Autism Awareness Day

What do you know about Autism & Emergency Response?

Firefighters may encounter or be asked to provide services to a person with Autism Spectrum Disorder. Recognizing the signs of autism and knowing effective ways to approach a person on the autism spectrum can minimize situations of risk or victimization of the individual, as well as the risk to those intervening.

People on the Autism Spectrum may:

• Not
understand what you say
• Appear
deaf
• Be
unable to speak or speak with difficulty
• Engage
in repetitive behaviors
• Act
upset for no apparent reason
• Appear
insensitive to pain
• Appear
anxious or nervous
• Dart
away from you unexpectedly
• Engage
in self-stimulating behaviors (i.e., hand flapping or rocking)

Helpful hints for interacting with someone who has Autism:

• Speak
slowly and use simple language
• Use
concrete terms
• Repeat
simple questions 
• Allow
time for responses
• Give
lots of praise
• Do not
attempt to physically block self-stimulating behavior
• Remember
that each individual with autism is unique and may act differently than others
• This
individual may not understand the law, know right from wrong or know the consequences of his or her actions

 CONSIDERATIONS FOR FIRST RESPONDERS

There will be many situations in which a person on the autism spectrum may encounter first responders. A survey of individuals with 
ASD and their families indicated that 35% of individuals with autism had been 
the victim of a crime and that 23% have had interactions with first responders due to wandering or eloping.

When responding to situations involving individuals with ASD, first responders
should take into consideration that individuals with
disabilities are often
taught compliance – values and beliefs that affect
behavior and social
etiquette that may make them more vulnerable to
Individuals on the autism
spectrum may:

• Not question “rules” or those in charge
• Not be assertive
• Agree with adults or authority figures out of necessity
• Always honor other people’s opinions or their personal choices may not be honored b others
• Be taught to be obedient and dependent
• Due to the nature of autism and the social environments in which individuals with ASD may live, the risk for victimization and abuse are
 heightened by:
• The individual’s reduced privacy
• Lack of teaching regarding healthy sexuality and decision-making
• Reduced expectations by caregivers and others
• Rewards provided for obedience and passivity
• Limited friendships and increased social isolation
• Negative attitudes toward those with disabilities

First responders should also be aware that autism is a spectrum disorder that affects every individual to a differing degree. 
Individuals may be highly verbal or nonverbal, have above-average intelligence 
or cognitive limitations (mental retardation), and may respond differently to 
sensory stimuli. 

During instances of heightened anxiety or when they do not 
know what is expected of them, individuals with ASD may also lose some of their
 abilities more readily. Providing reassurance will assist in alleviating the
individual’s anxiety and
discomfort.

APPROPRIATE RESPONSE/DELIVERY OF SERVICE

A lack of personal familiarity with individuals who have a disability may cause first responders to feel professionally awkward and
 uncertain when providing emergency care and assistance. Common reactions to
 individuals with disabilities include fear, embarrassment, or pity and, 
unfortunately, too often disbelief, disregard, or discounting of information 
supplied by the individual. Awareness and education of first responders about
 disabilities increases their ability to provide appropriate response.

Recognizing behaviors associated with autism will allow you to best respond to the situation. A person on the autism spectrum may:

Not respond to a uniform, badge, or other emergency response symbols. Autism may limit a
person’s ability to recognize and differentiate uniforms and other common 
symbols. Pointing out these items to allow the person to focus is helpful.

Avoid eye contact. People with ASD often have difficulty making eye contact. Do not 
insist on eye contact or misinterpret lack of eye contact as disrespect or 
guilt.

Make repetitive motions or sounds. Repeated movements or sounds may be a signal of
distress but may also be the person’s means of securing comfort. Unless the person is causing injury or damaging property, do not stop these behaviors.

Become upset when touched. Avoid touching if possible. If you have to have physical contact 
with the individual, explain in simple terms what you are going to do and why.
 Try saying, “I want to help you, but I (explain what you intend to do).”

Not provide I.D. when asked. Be patient and speak slowly and calmly. Keep questions simple
and allow time for answers. Repeat or rephrase. The person may not be able to 
speak. Check for ID jewelry, an ID card, or ID sewn into the individual’s clothing.

Lack awareness of danger. Gently persuade or remove the person from the dangerous
situation. Offer an alternative to the dangerous action. Be aware that if the 
person is anxious there is a risk they could bolt without warning.

Continues to do something after being told to stop. Demonstrative, non-threatening gestures
may communicate more effectively than a verbal command. Demonstrate what you
want the person to do.  Repeat the behaviors and instructions. Experts dealing with autism use a communication board if possible and allow 
time for processing of information before responses are given. Do you have a communications board for communicating?

Appear to be under the influence of alcohol or drugs. The actions of people with ASD can
 appear to be odd or inappropriate. When asked about drug use, the person may
 admit to having taken drugs if they take prescribed medications. Avoid making
 assumptions about alcohol or drug use.

Become self-injurious. Under stress an individual may become self-injurious. Use the
 least invasive technique possible to ensure the individual’s safety.

Become aggressive. Restraints should only be used if the individual’s or other’s safety is at risk. Individuals with ASD may have a poorly developed upper trunk
 area. Positional asphyxia could occur so it is critical to ensure that a prone
position is not used and the person is moved to a secure and quiet place away
from distractions. De-escalation techniques to calm or distract the individual
are safer and more effective.

Note: My wife, who works as a school nurse specializing with special needs children recently attended a conference focusing on autism (UCSF March 2010). This information is shared to help us all do the job just a little bit better. It usually starts with awareness and then an understanding. Now you are more aware, and hopefully learned a little bit.

For those out there that don't think this is going to be a concern, think again... here's documented diagnosed cases of autism and the yearly increases expressed in a graph... a picture says a thousands words...

Questions or Comments: Feel free to always to drop me a line via FFN.   TCSS, CBz

 For more information, please contact: www.autism-society.org