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.”
Tips for successful interaction with people on the spectrum:
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.