For children with autism and other forms of disability navigating daily life can be a challenge. Compound that with having been hurt by someone or being in the midst of a crisis. This is the experience of many individuals living with disability. First responders are trained to evaluate, deescalate, and support. In addition to these important skills, first responders must take special consideration when encountering a person with autism. Interacting with people with autism will require additional layers of support as highlighted in this blog.
It is important to recognize that if you meet one person with autism, you have met one person with autism. Stephen M. Shore, who made this statement, was doing so with the intention that society recognize one individual with autism is not the same as every individual with autism. Autism is conceptualized as existing on a spectrum, with numerous experiences of what this may look like. Autism, usually appears by age two, affecting 1 in 42 boys and 1 in 189 girls. More children are diagnosed with autism than AIDS, diabetes, and cancer combined and is the fastest growing developmental disability (1 in 68 cases). In addition to autism, an individual may experience: seizure disorder, poor nutrition, high rates of accidents and injuries, gastrointestinal disorders, mental health diagnosis, and intellectual disabilities. All of these potential experiences can impact how the first responder needs to support the individual in a crisis.
Autism affects three areas; communication, social interaction, and restrictive or repetitive behaviors/interests. An individual may be non-verbal or use echolalia (meaningless repetition of another person’s words) to communicate. They also may not feel comfortable with eye contact or touch. An increase of sensory input is also a strong experience for an individual with autism, as their senses are heightened. Sirens on the police car, the lights on the ambulance, the smell of one’s cologne, or being touched can cause an individual to shut down in a crisis, not allowing the first responder to get the information that is needed.
First responders are trained to collect minimal facts; who, what, when and how. There is never a time to ask “why”, because often a child does not know “why” and this question can also be associated with blame. To best support a person with autism through a crisis first responders should engage the caregiver in a discussion about communication or sensory needs that may impact the interaction. First responders should also minimize external stimuli, including: lights, sirens, and number of professionals interacting with the child. Give the child personal space; do not assume they want high fives or a hand shake. Do not initiate touch, but allow the child to explore you (ie touching a badge). Utilize slow and purposeful movements while explaining your role. Speak calmly and use developmentally appropriate language; do not assume the child cannot understand you or needs to be spoken to with “baby talk”. Utilize 3-5 word sentences with direct phrases and avoid slang terms or idioms. Remember to allow time to process a question, this may take a few moments.
It is important to remember that sexual development occurs at the same rate for someone with autism as someone without autism. An individual with autism experiences feelings of love, lust, and loneliness, but there is a lack of sexuality education with this population of individuals. This may be evident in a lack of understanding of appropriate boundaries or anatomical names for body parts. When it comes to issues of sexual development, support the child just as you would someone without autism.
Responding to an individual with autism in a crisis may require additional time and consideration, which is often a delicate dance. Just remember that this experience will be enhanced by following the examples listed above. The most important part is that the individual feels in control, safe, and supported. Treating individuals with autism with respect and taking time to understand their special needs will go a long way in a crisis situation.