Understanding Common Medical Concerns Like GI Distress, Seizure Disorders, Mitochondrial Disease and Psychiatric Comorbidities is Key for ED Providers
Children on the spectrum are four times more likely than neurotypical children to visit the emergency department (ED.) Due to sensory challenges and shortened attention spans; long waits, exposure to multiple providers, and unpredictable environments can cause stress for both the child with autism and the caregiver when visiting the emergency room. Previous research shows that nearly 30% of autism families who visit the ED experience a negative or unwanted outcome. Often this is due to the provider’s lack of knowledge of autism spectrum disorder (ASD), communication challenges with patients, and disregard for caregiver concerns. These challenges are why a new continuing medical education (CME) article published in Pediatric Emergency Care, is particularly needed and welcomed. The report begins by featuring three learning objectives for healthcare providers:
- Identify the primary features of ASD and describe communication and intervention techniques used to improve care in the emergency department for children with ASD.
- Understand the medical and psychiatric conditions that children with ASD are at increased risk for and identify strategies for their evaluation and management.
- Develop strategies to identify behavior changes caused by underlying medical issues.
To make ED visits less stressful for kids with ASD, the article suggests providing alternative waiting rooms and treatment rooms that are quiet and private. Also proposed is clear communication with the caregiver since communication through the caregiver is an effective way to communicate with the child. Perhaps most important is the review article’s list and assessment of comorbid medical conditions for patients with ASD that could cause a trip to the emergency room. These conditions include gastrointestinal issues, abdominal pain, constipation, diarrhea, encopresis, seizure disorders, as well as metabolic and mitochondrial disorders. The review article ends with a reminder that behavioral manifestations could be a sign of medical distress and recommends looking for other conditions such as dental infections, otitis media, urinary tract infections, or unspecified injuries.
