1. Autism: How to Cope Amongst the Chaos Presenters: Emily Onderick, BS, CCLS Kari Kletter, BS, CCLS

2. Autism Speaks

3. Quick Facts Affects the entire family More common in boys than girls Every child with Autism is unique Schedules/routines are important Difficulty regulating emotions There is no cure Cause is unknown

4. Common Misconceptions “My child does not feel pain.” “We have to hold them down.” “Nothing helps. They are just going to scream.” “They can’t follow directions.” “Education isn’t beneficial and is unnecessary.”

5. Specialized Techniques: Assessment Parents are your best source of information Sit down Minimize amount of new people at one time Questions for Caregivers: – Past experiences – Daily routines – Tolerance/reaction to pain – Comfort items – If nonverbal, best way to communicate – Sensory-seeking – Sensitive to touch

6. Specialized Techniques: Assessment PLAY – Positioning – Social – Toy selection – Types of activities “Autism does not define the child, it’s a piece of who they are.”

7. Specialized Techniques: Planning Allow time for the child to explore new area SLOW DOWN Collaborate with interdisciplinary team Limit the amount of people involved Frequent, nonthreatening visits Introduce new items slowly Consistent staff members Collect toys that are familiar to the child

8. Specialized Techniques: Intervention “A child with Autism is not ignoring you, they are simply waiting for you to enter their world.” Utilize weighted mats and lead aprons Use positive reinforcement Speak slowly and use simple, short steps Use pictures or act out steps If/then statements Be direct with requests Familiar toys or objects, topics of interest, singing and counting can help with distraction Examples:________________________________ ________________________________________

9. Specialized Techniques: Intervention One Voice Parental involvement/support is HUGE No one injured rule Utilize visual schedules Attention: Buzzy, Pain-Ease, EMLA, etc. may be over stimulating Utilize modified comfort holds

10. Specialized Techniques: Demonstration Utilize for children who are teenagers, sensory- seeking and may/may not be cooperative Utilize for children who are younger/school-age, and sensory seeking Utilize for children who are school- age/teenagers, may/may not be sensory seeking and are active Utilize for children who are school- age/teenagers, may/may not be sensory seeking, and are higher functioning

11. Collaboration: Nursing/ Physicians Discuss plan of care – “My Poke and Procedure Plan” cards – Inform team of child’s escalation items – Discuss options for sedation, if necessary/available

12. Collaboration: Child Life Brainstorming (CCLS coping) Hand-off and transition – Forward thinking – S.T.A.R program

13. Hospital-Wide Resources: S.T.A.R. Program Sensory Tactile Auditory Rockstars – Program information cards – Guideline & protocol forms – Intake form Parent/Nurse/Child Life – Information form on chart Board in patient’s room Star on door – S.T.A.R cabinet Location Toys Resource list – S.T.A.R binders

14. References Davit, Caroline J., Rachel J. Hundley, Janine D. Bacic, and Ellen M. Hanson. "A Pilot Study to Improve Venipuncture Compliance in Children and Adolescents with Autism Spectrum Disorders." Journal of Developmental and Behavioral Pediatrics 32.7 (2011): 521-24.Www.jdbp.org. Web. Vaz, Irene. "Improving the Management of Children with Learning Disability and Autism Spectrum Disorder When They Attend Hospital." Editorial. Child: Care, Health and Development 7 June 2010: 753-55. Print. Nelson, Diane, and Kristi Amplo. "Care of the Autistic Patient in the Perioperative Area." Association of Perioperative Registered Nurses89.2 (2009): 391-97. Web. www.autismspeaks.org