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Perspectives of Health Care Providers Regarding Emergency Department Care of Children and Youth with Autism Spectrum Disorder

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Abstract

This study aimed to characterize the perspectives of health professionals who care for children with autism spectrum disorder (ASD) in the emergency department (ED) and to determine what strategies could optimize care. Ten physicians and twelve nurses were interviewed individually. Questions related to experiences, processes, clinical decision-making and outcomes of children with ASD recently seen in the ED. Interviews were audio recorded, transcribed, and analyzed using a qualitative framework. Participants identified factors that facilitated effective care, including communication strategies, parental involvement and teamwork. Barriers identified included child characteristics, the ED environment, and competing demands. Recommendations included additional staff training and stakeholder engagement. However, making accommodations was often described as being at odds with how the ED functioned, with implications for future service planning.

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Acknowledgments

Funding is gratefully acknowledged from Autism Intervention Research Network-Physical Health (AIR-P) and Autism Speaks-Autism Treatment Network (AS-ATN). Dr. Zwaigenbaum is supported by the Stollery Children’s Hospital Foundation Chair in Autism Research. We are grateful to Matthew Milen and Neelam Mabood for their assistance with this study. We also thank the health care providers who participated in this research, as well as the children with ASD and their families whose experiences guided the overall research program.

Author Contributions

L.Z., D.B.N., B.M., A.S.N, R.S., W.R., S.R., J.C.-S and W.R.C. designed the larger study from which this data was taken. L.Z., D.B.N, C.K. and B.M. developed the concept for the current paper. C.K. and A.G. collected the data. D.N., B.M., C.K. and A.G. analysed the data. L.Z, D.N. and C.K. wrote sections of the paper. All authors discussed the results and implications and edited the manuscript at all stages.

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Authors and Affiliations

  1. Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada

    Lonnie Zwaigenbaum, Amanda S. Newton, William R. Craig & Raphael Sharon

  2. Faculty of Social Work, University of Calgary (Edmonton Division), Edmonton, AB, Canada

    David B. Nicholas & Christopher Kilmer

  3. Department of Social Work, Factor-Inwentash Faculty of Social Work, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada

    Barbara Muskat

  4. Department of Paediatrics and Dalla Lana School of Public Health, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada

    Savithiri Ratnapalan

  5. Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada

    Justine Cohen-Silver & Wendy Roberts

  6. Department of Social Work, Hospital for Sick Children, Toronto, ON, Canada

    Andrea Greenblatt

  7. Autism Research Centre, Glenrose Rehabilitation Hospital, 209 GE, 10230 - 111 Avenue, Edmonton, AB, T5G 0B7, Canada

    Lonnie Zwaigenbaum

Authors
  1. Lonnie Zwaigenbaum
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  2. David B. Nicholas
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  3. Barbara Muskat
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  4. Christopher Kilmer
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  5. Amanda S. Newton
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  6. William R. Craig
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  7. Savithiri Ratnapalan
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  8. Justine Cohen-Silver
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  9. Andrea Greenblatt
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  10. Wendy Roberts
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  11. Raphael Sharon
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Correspondence to Lonnie Zwaigenbaum.

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Zwaigenbaum, L., Nicholas, D.B., Muskat, B. et al. Perspectives of Health Care Providers Regarding Emergency Department Care of Children and Youth with Autism Spectrum Disorder. J Autism Dev Disord 46, 1725–1736 (2016). https://doi.org/10.1007/s10803-016-2703-y

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  • DOI: https://doi.org/10.1007/s10803-016-2703-y

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