Crisis, First Responders and Autism
Are first responders encountering more autism?
As of March 2022, the CDC says 1 in 44 children is on the autism spectrum.
That means for every 44 calls you take you will probably see at least 1 individual on the autism spectrum.
My guess is that you will see a much higher percentage than that because autism is known to be significantly under-diagnosed and under-reported. In addition to that, individuals with autism are prone to finding themselves in bad situations – everything from being at the wrong place because they didn’t understand the consequences, or perhaps even escalating a situation with their neurologically-induced anxiety, need to control, and reaction to environmental stimuli.
On top of that, sometimes their behavior is perceived by onlookers as just odd. And the emergency phone number gets dialed.
Gratitude For First Responders
Our first responders are some of the most compassionate, brave, well trained and needed individuals on the planet.
Most of us – especially those of us with kids on the spectrum – have a huge appreciation for the job they are doing! Gratefully, they show in up in our lives when we are often at our worst!
It’s stressful for all of us when something happens and we need the help of emergency services like an ambulance, the police, or the fire department. That stress is ramped up tenfold when one of the individuals involved or witnessing the crisis has autism.
Regardless of the amount and depth of the training first responders receive, most simply can’t be immersed in the in’s and out’s of autism. So, to help them help us, here is a cheat sheet to inspire increased awareness.
Autism is a social disability. First responders will certainly encounter individuals with ASD that they can immediately recognize as different. But they will ever-increasingly encounter high functioning individuals with autism who are more difficult to identify. (Click here to read What Does It Mean When You Say “High Functioning Autism”?)
“If you encounter someone having difficulty communicating, it’s ok to ask if they are on the autism spectrum.”
That means very often the individual on the spectrum doesn’t respond in situations or interpersonal interactions in the ways that would normally be expected.
Complicating Their Job
Exacerbate the everyday difficulties of someone with autism, (like with a crisis situation which includes tension-filled, frightening, or painful experiences), and you have a recipe for a big blow up!
One example happened when a young man with autism was stopped by the police for a traffic violation. He pulled over as expected, but was very stressed and couldn’t communicate that he had autism.
When he began to become agitated, the police officer reached into his car to turn it off, and accidentally touched the young man. This set off a confrontation between the two that wound up with the young man strapped to a gurney and hauled off to the hospital psych ward!
That escalation might have been avoided if the individual who was stopped could have communicated he had autism, or if the officer had suspected autism and approached the young man differently.
If you encounter someone having difficulty communicating, it’s ok to ask if they are on the autism spectrum. Difficulty with language in carrying degrees is part of autism, so the individual may be more able to indicate a positive response without the need for forming words. (Click here to read Autism As A Social Disability.)
C.R.I.S.I.S.
Here is an acronym to give first responders some basic information and help set their expectations when they are dealing with someone on the spectrum:
C – Remain Calm
Individuals with ASD often emotionally que off of their parent or those around them, so maintain a calm perspective is helpful.
The National Autism Academy developed the C.A.L.M Method to assist in increasing compliance:
- C = Check the emotional environment and calm yourself, parents, or others who might influence the person on the spectrum.
- A = Assess the neurological regulation needs of the individual (stimming behaviors such as flapping, chewing, pacing or talking incessantly indicate the need for neurological regulation). Provide regulation as needed.
- L = Linear language is the best way to communicate so you are most likely to be understood. Concrete, straightforward, non-abstract, linear language will improve the understanding of the individual on the spectrum. Always ask if they understood, and have them repeat what you said to confirm. Quick agreement or saying they understand is the fastest way to get you to leave them alone and often does not indicate real understanding).
- M = Motivate extrinsically by offering something that appeals to the individual as a reason to do something.
R – Remember Processing Time
Individuals with ASD process the world differently, and frequently need more time to respond.
This may not be possible in certain situations, but recognize that a lack of response or a non sequitur maybe because the individual needs time to process.
I – Illustrations
Use pictures to help communicate with less words.
Illustrations are often easier for those with ASD to insure they get the full meaning of what you are saying.
S – Sensory Hypersensitivity
Individuals with ASD struggle to a varying degree with sensory hypersensitivity. That means lights, sirens, commotion, shouting, smells, heat or cold, or any other type of sensory stimulation may create sensory overload that results in the individual being unable to process and respond appropriately.
I – Incongruent behavior/words (anxiety and non-sequiturs)
Individuals with ASD are prone to react in extreme or emotional ways that may not seem be in keeping with the severity of the issue at hand.
This means they can overreact, or underreact. They may respond with “I hate you” when what they are really experiencing is a great deal of discomfort in a situation.
Autism is a social disability so expect behavior to be different, realize that the individual may not recognize or understand authority or common social expectations, and may react very differently than expected.
S – Stimming
Stimming is a signal that the individual’s brain neurology is not in a state of calm.
When an individual displays stimming behavior, intervention would be appropriate to avoid a meltdown.
Once the person with ASD goes into a meltdown, there is no magic bullet to stop it, rather all you can do is keep the individual safe until they can calm themselves.
Physical stimulation such as jumping, rolling on the ground, swinging, rocking, chewing, etc. are all calming activities.
The most effective and preferential activity may change from situation to situation and person to person.
Increasing Need
Newest statistics show nearly 2% of all school aged children are on the autism spectrum, and that number is expected to continue to increase!
As the growing population of individuals with autism begins to mature, there will be an ever-increasing need for first responders and all public servants to recognize, understand and support more effective interactions with individuals on the autism spectrum.
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