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UNDERSTANDING AUTISM

Tips for successful interaction with people on the spectrum:

Consult caregivers.

Keep the situation as calm as possible.

Limit sensory stimulation.

Avoid physical contact.

Keep questions direct, specific, literal, narrow.

Find a favorite topic to make the subject comfortable.

Ask permission and tell patients what comes next.

Do not interrupt repetitive “stimming” except to avoid injury.

Be cautious when using restraint. Autistic individuals are vulnerable to positional asphyxia.


Emergency vehicles, screaming sirens or a crisis at home, school or work can overwhelm anyone.

Now imagine a person who already struggles with basic human interaction and verbal communication confronting such an accident or exigency.

That was the challenge presented March 31 to a group of more than 40 local public safety personnel — to learn how to better anticipate and respond to the needs of the burgeoning number of Americans with autism spectrum disorder.

Though each case is unique, the defining traits of the diagnosis involve difficulties with social interactions, communication and hypersensitivity to their surroundings — everyday trials exacerbated by the sights, sounds and stress inherent in an emergency.

Even a gentle touch that is unexpected, commands or questions that come too fast, bright lights, loud noise or the mere presence of uniformed personnel can quickly escalate a situation for someone with autism or related disorders, experts say.

And yet, the subject of autism spectrum disorder and related safety risks are seldom included in standard training for firefighters, paramedics and law enforcement officers, even though studies show that those on the spectrum are seven times more likely than others to come into contact with first responders.

The three-hour-long session two weeks ago in Santa Rosa was part of a growing movement to address that lack of training.

“If you haven’t dealt with these folks — and I’m sure you have — you’re going to with increasing frequency,” autism safety trainer Matt Brown told those present at the Finley Community Center.

The incidence of Autism Spectrum Disorder has grown 10-fold over the past four decades and is now estimated to affect one in 68 children nationally, according to the Centers for Disease Control. Many share common traits that include sensitivities to touch, sound and other stimuli that can overwhelm them — sometimes prompting repetitive “stimming” behaviors, like rocking or hand-flapping, which help people with autism regulate their sensory experience, Brown and others said. They often have a high threshold for pain and may not reflect that they have a serious injury.

But these activities also can invite unwanted attention and wariness, in addition to interfering with a first responder.

Frustration, fear and just being pushed beyond their own threshold of sensory input can take them to “a point where they’re going to blow-up,” said Brown, a retired federal probation officer in Portland, Maine and father of an autistic teen. “That’s the last place we want to be.”

People on the autism spectrum also may be impulsive, with nearly 50 percent prone to wandering or “bolting” from a place of safety without a clear understanding of danger — running directly into traffic, for example, or being drawn to a swimming pool, creek, pond or lake.

Drowning is the leading cause of unnatural death among those with autism.

More than half the attendees stayed for a “train the trainer” session designed to help them share what they’d learned with others. Many said they were interested in pursuing additional training on the topic.

“This is exactly what we hope will happen in every community around the country,” said Lindsay Naeder, director of the autism response team for New York-based Autism Speaks, one of the world’s leading research and advocacy agencies. “First responder training has been really important. Basically, we’re working in as many places as possible to develop a network of resources.”

UNDERSTANDING AUTISM

Tips for successful interaction with people on the spectrum:

Consult caregivers.

Keep the situation as calm as possible.

Limit sensory stimulation.

Avoid physical contact.

Keep questions direct, specific, literal, narrow.

Find a favorite topic to make the subject comfortable.

Ask permission and tell patients what comes next.

Do not interrupt repetitive “stimming” except to avoid injury.

Be cautious when using restraint. Autistic individuals are vulnerable to positional asphyxia.

The Sonoma County training was a grassroots effort inspired by Sonoma County Regional Parks Ranger Beth Wyatt, whose work has put her on the front lines of several urgent situations involving kids on the spectrum.

One involved a 10-year-old girl who needed help coming ashore in the park swimming lagoon and was unable to provide her name or interact fully with a lifeguard who was trying to determine if she had taken in water, Wyatt said.

In another case, a boy unable to swim had been kayaking with his mother when the boat overturned in the lake. Firefighters trying to assess his condition on shore were not able to learn anything from him that might help.

Wyatt realized, she said, that “no one really has experience with these folks.”

Her own emergency medical training included no such content.

She has two young children of her own on the autism spectrum, so the need for first-responder education was especially personal.

“Just as a parent,” Wyatt said, “I wanted to do this training so my kids are safer in the community, so that if they have to go in an ambulance, if they have to see a fire truck, if they have police contact later …”

She started two years ago by sharing what she knew with fellow rangers, then did some research that resulted in last week’s session with Brown, whose work in the area is nationally known.

At least a half dozen of those attending the training acknowledged having family members on the spectrum, including sheriff’s Lt. David House, an administrator at the county jail.

House said jail personnel occasionally call when he’s off-duty, seeking advice on handling someone with autism disorder who comes into custody.

“I would certainly like to see more training like this,” he said. “I certainly would like to see for all deputies, for fire personnel.”

Sharen Bertrando, a program specialist with the Sonoma County Special Education Local Plan Area in the county Office of Education, also attended Brown’s training.

“I think it could be something that could really blossom within the county, and could really go wider,” she said.

That’s music to Naeder’s ears, as Autism Speaks includes partners like Brown and The National Center for Missing & Exploited Children to develop local and national approaches to increase safety for those on the spectrum.

“Every single person who is in contact with an individual with autism needs to be aware of their needs for safety and support,” Naeder said, “because when an emergency occurs, quick action makes all the difference.”

You can reach Staff Writer Mary Callahan at 521-5249 or mary.callahan@pressdemocrat.com. On Twitter @MaryCallahanB.