EMERGENCIES AND INDIVIDUALS WITH SPECIAL NEEDS: TEN TIPS FOR FIRST RESPONDERS cont.

limited to, repetitive flapping of the hands, swinging a piece of string, tapping, rocking, or any other rhythmic movement that the individual finds calming. Individuals who stim often carry a self-soothing device (string, stick, toy car, rubber band) that could be mistaken for a weapon in a tense situation.

Sometimes stimming is interpreted as an effort to distract and manipulate the situation. Other times it is misinterpreted as being intoxicated or impaired by a mood-altering substance. Both interpretations are incorrect.

FIRST RESPONDER TIP

Become familiar with "stimming" behaviors and know that stimming usually keeps the person calm while interacting with you. Unless stimming behaviors become aggressive and harmful, stimming should not be stopped.

8. LOOK FOR 'WANDERERS' NEAR PLACES WITH RHYTHMIC MOVEMENT OR SOUND (THESE ENVIRONMENTS OFTEN MIMIC STIMMING)

Many frantic 911 calls occur because an individual is wandering or missing. Places that attract individuals on the Autistic Spectrum or with other sensory disorders, provide rhythmic stimulation. The rhythmic sight and sound of pools, streams, lakes, ponds, trains, or traffic are attractive to individuals on the Autistic Spectrum, because it is very similar to the rhythmic movement of ‘stimming’. They do not always recognize the dangers of water, traffic or trains.

Unfortunately, children with Autism are 160 times more likely to die from drowning compared with the general pediatric population. They are often unaware of the danger that exists in these situations. Special needs

therapists work with parents to develop emergency plans in the event a child is missing.

FIRST RESPONDER TIP

When police are called because an individual is wandering or missing. Ask for a copy of the emergency plan (if available). This often includes identifying information.

Look first at nearby bodies of water, traffic, trains or even a swing in a neighbor's yard. Wanderers often go back to places with rhythmic sights and sounds to feel calm. They may also return to familiar places (a McDonalds or neighbor's home) or to the last place they visited.

9. NOT KNOWING WHAT TO EXPECT CAN CAUSE A TOTAL LOSS OF CONTROL AND PANIC

Many individuals with chronic conditions have already experienced many hospital stays, blood draws and multiple surgeries. Being poked with a needle or squeezed with a blood pressure cuff is not new. They need a sense of control. Knowing what is going to happen next can help them feel control. Telling them what to expect before it happens can decrease panic and anxiety and prevent them from resisting or trying to run away.

You can eliminate a panic response by remaining calm. Many times, a parent or caregiver can inform you of best ways to calm the individual.

FIRST RESPONDER TIP

When possible, EMTs and paramedics should explain step by step exactly what is going to happen next, before you do it. Explanations such as, "You are going to feel a small poke of this butterfly needle" or "You are going to feel a squeeze on your arm to

check your blood pressure and you will be ok," can give the person a sense of control. Often, the individual will ask you to put the cuff over their sleeve or take pressure on their lower arm so their skin feels less of a squeeze. Their requests are often based on their sensory triggers and past experiences.

10. PARENTS AND CAREGIVERS KNOW THE INDIVIDUAL BEST

Parents and caregivers are often available and willing to share important information with police, paramedics and EMTs during a crisis or emergency situation. This gets difficult when an adult with special needs, who does not have a legal guardian, refuses treatment. In some cases, the patient's right to refuse treatment trumps the parent or caregivers’ opinion about treatment needs. In any event, parents and caregivers are an excellent resource for police officers, paramedics and EMTs, because they know what calms and what triggers the individual, especially during an emergency.

FIRST RESPONDER TIP

Ask parents, caregivers and those who know the individual about how best to communicate. EMT’s and paramedics can inquire with parents and caregivers about an updated emergency medical sheet that lists medications, doctors, treatment facilities, triggers, calming techniques and best ways to communicate. In some cases, the fire department has already been alerted. This is because, prior to an emergency, some families alert the fire department about an individual in the household who has a care plan regarding a chronic condition. This helps first responders know what to expect if they should encounter this individual. 

Nothing can take the place of a first responder who is knowledgeable about this special population. Police officers, paramedics and EMTs often save the lives of children and adults with chronic health challenges. Understanding the 10 First Responder Tips allows everyone to be prepared and achieve the best outcome during an emergency. •

ABOUT THE AUTHOR:

Nancy Musarra Ph.D. is a licensed clinical psychologist who provides forensic services regarding psychological and competency evaluations. In her private practice, she consults with parents regarding developmental, neurological and mental health challenges at home, school and in the courts. She authored The New Normal; 7 Things to Know as You Care for and Love a Child with Special Needs. She also facilitates First Responder Training Workshops for law enforcement, fire and EMS: Dealing with Autism and Neuro-Developmental Challenges in Public Safety and How Do Professionals Who Deal with Stress and Trauma Everyday Maintain Resilience? Contact her at nancy@drnancymusarra.com.