Healthy Kids - Winter 2023

SERVICES Autism in the ER Rady Children’s offers specialty help in emergency health S

ome 21,500 children with autism visit Rady Children’s each year, often visiting the emergency department (ED) for a range of medical and behavioral concerns. Some of those children get to meet Abbey Hye, a behavioral specialist with Rady Children’s Autism

AT RADY CHILDREN’S, A MYCHART ACCOUNT IS REQUIRED FOR VIDEO VISITS. Ensure that your username and password are up to date before your visit. You may receive a call from clinic staff ahead of the appointment with further instructions, though this may not be necessary. Before your child’s appointment: „ Write down any questions you may have for your provider „ Have a list of your child’s symptoms and how long they have occurred „ Prepare a list of your child’s current medications and dosage (you will enter them in the pre-visit check-in section, EZ Arrival) „ Gather any test results pertaining to the appointment that were completed in a non-Rady Children’s facility „ If requested by your clinical team before your visit, obtain vital signs, such as height, weight, temperature or heart rate „ If requested by your clinical team, send photos via a MyChart message How to Prepare for Your Video Visit

Discovery Institute. Two days a week, she’s stationed in the Sam S. and Rose Stein Emergency Care Center at Rady Children’s to help pediatric patients with autism, their families and health care staff work together for a successful ED experience. Hye is there to help wherever she’s needed, from the waiting lounge to the exam room to patient discharge. “We can go anywhere they need to go,” she says. Autism is a complex neurodevelopmental condition that affects people differently but often includes difficulty with communication and social interaction and restricted or repetitive patterns of behavior, thoughts, interests and activities. Children with autism can become especially anxious or agitated in situations where their senses are overloaded—like a visit to a noisy, brightly lit, bustling ED. Even a relatively routine procedure, like placing an IV, can create a stressful situation for the patient, parent and physician alike, Hye says. “We have to determine what strategies will help make the experience less scary and avoid challenging behaviors,” Hye says. “We have to keep the patient and the staff safe.” Since late 2019, Hye and her colleagues have used a three- pronged approach to improve care for kids with autism. The Autism Friendly Health Safety Initiative includes a parent questionnaire, an autism-tailored toolkit and training for hospital staff. The questionnaire helps the health care team identify if a child with autism has any specific sensory or communication needs. Parents are asked what makes their child uncomfortable—for instance, too many people in a room or certain smells or sounds— and how they might express that distress. “The rationale behind this questionnaire is that we know that parents know their child best,” Hye says. “So parents should not have reservations about sharing and advocating for your child.” The questionnaire also asks parents what typically calms their child in stressful situations. Music? Fidget toys or bubbles? A written schedule? That’s where the toolkit comes in. It’s stocked with sensory items designed to soothe and motivate the child during their visit. Autism experts are in the ED 20 hours a week. Outside of those hours, the emergency staff can lean on what they’ve learned during their previous collaborations with the autism team. “We’re teaching staff in a busy environment, but it allows us to be proactive,” Hye says. Rady Children’s began offering greater support for patients on the autism spectrum in response to data showing that children with autism can have trouble accessing health care. A difficult doctor’s visit can mean escalating negative behaviors and canceled appointments. Doctors and nurses also need the confidence to care for children with autism. “This was inspired by the needs of patients and physicians,” Hye says. “I am so proud of what we’ve been able to provide for our families to better meet the needs of kids with autism.”

TIPS FOR A SUCCESSFUL VIDEO VISIT Block off time for the appointment. A parent or guardian is required if the patient is under 18 years old. Conduct the video visit in a well-lit room. Bright lighting should be in front of you, not behind you. Check your tech. Enable camera, microphone and speaker. Ensure they are working properly. Beware of background distractions. Keep your video visit space as quiet and private as possible.


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