During an emergency, knowing how to approach and communicate with someone with autism spectrum disorder (ASD) is crucial to the safety of both the firefighter and the individual.
Individuals with ASD experience high levels of stress during an emergency, which can increase the severity of the situation. Sensory overload, disruption of routine and unfamiliar social interactions can be very overwhelming. Individuals with ASD have four specific categories of characteristics: social interaction, social communication, routines and repetitive behaviors, and sensory processing.
Below are five tips that first responders should use in an emergency that involves someone with ASD.
1. Look for water, then ask LIFE questions
Individuals with ASD commonly are attracted to water. When responding to an eloping call, start by looking for nearby pools, lakes, creeks, etc. Once these are identified, ask family members the 4 LIFE questions to navigate your search and save time finding the individual.
- L: What does the individual loath? Finding out what an individual with ASD doesn’t like or fears could eliminate where the individual wouldn’t go.
- I: What are the individual’s interests? These might lead the person in a specific direction.
- F: What fueled elopement? A change in routine or a new
- stimulation can trigger eloping. Knowing the trigger might permit deciphering when and why the individual eloped.
- E: What was the individual’s expectation? What is the individual’s normal routine at that particular time or what did that person expect to do that day? This helps if the individual was trying to get back on schedule or fulfill an expectation. This gives a first responder possible destinations to search.
2. Adapt how you assess injuries
Individuals with ASD can be hypersensitive (overreaction to light, sound, touch and pain) or hyposensitive (lower tolerance or attraction to the same stimulations). This is vital when considering injuries and treatment. First responders should consider that the individual might not communicate properly any pain or injury. Different assessment techniques might be required—for example, a full physical examination, rather than relying on pain reactions or the patient’s communication.
3. Reduce sensory overload
Firefighters must be aware of sensory overload triggers. Minimize lights and sirens. Reduce body contact without permission. When possible, explain where, how and what you’ll use to touch the individual. For some, even the softest touch can be excruciating.
When stress is heightened, individuals with ASD need to deescalate. Some tend to flap their arms, spin or rock. This stimming can be mistaken for spastic movements that are associated with other conditions or for being under the influence of drugs or alcohol.
Expand personal space and avoid restraints. Calming techniques could reduce the need for stimming.
4. Consider your communication style
Figurative language and indirect questions can be difficult for individuals with ASD to interpret. “Give me your attention” is more ambiguous than “Focus on what I am saying.”
Nonverbal forms of communication also are difficult. Direct, simple, step-by-step descriptions of what’s happening is best. For those who are nonverbal, consider having a symbol board on hand.
5. Connect to the ASD community
Knowing the individuals with ASD who live in your community could change how calls come in and how firefighters might respond.
Images of puzzle pieces and rainbow infinity symbols and butterflies are common icons of neurodiversity. Seeing these symbols on automobiles and shirts can open a dialogue between fire companies and the community.
Provide opportunities to educate people with ASD on fire safety. Allow for them to touch, hear and see firefighter equipment. Children’s books display firefighters in the red hat and coat. The realistic image of a firefighter’s gear (masks, breathing apparatus) can seem scary. Invitations to be part of drills allows for practice and familiarity before a real emergency occurs.
Be prepared
Approaching an emergency with the thought “Could this be someone with ASD?” would allow time to rethink the approach. Understanding the uniqueness of ASD and training on adaptive procedures can improve the immediate safety of all who are involved.
