Assessing Ease of Delivering Emergency Care for Patients with Autism Spectrum Disorders.
Theodore Kouo, Neha Bharadwaj, Jennifer Kouo and 2 others
PMID 34016829WHAT IT FOUND
Children with autism had significantly more difficulty completing routine emergency care tasks than matched peers.
They faced more interruptions in their plan of care and required more staff assistance for blood draws. This suggests specific gaps in how emergency departments handle this population.
Key findings
01Patients with ASD had statistically significant higher median task completion index scores (0.25) compared to neurotypical controls (0), indicating more difficulties in care delivery.
02Children with ASD had higher odds of difficulty with triage vitals, requiring additional staff for peripheral IV placement, and experiencing delays in their overall plan of care.
03Higher task completion index scores and an ASD diagnosis were both associated with increased odds of receiving some form of restraint.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study relied on retrospective nursing documentation, which may be incomplete or influenced by implicit bias against patients with ASD. It only included patients who were admitted to the hospital, representing just 10% of all ED visits by children with ASD, so it may not reflect the experience of those treated and released. The scoring system did not account for whether patients were taking psychotropic medications at baseline, which could have affected their behavior. The study excluded children with other neurodevelopmental disabilities, so findings may not apply to that broader group.
Declared interests
The study was supported by the National Institutes of Health and the Centers for Disease Control and Prevention. No specific financial conflicts of interest for the authors are listed in the provided text.
The easy way to misread this
Do not interpret the need for extra staff during IV placement as evidence that the staff were ineffective or that the procedure failed. The study found no difference in the number of IV attempts between groups, suggesting that preemptively assigning more staff may actually help prevent multiple attempts and reduce stress, rather than indicating a problem with the procedure itself.