Autism: Special Considerations for Responders

By Vincent J. Vitiello, L.S.W.

Autism is a disorder of the brain that results in a variety of developmental problems in young children. It is usually characterized by impairments in social interaction, impairments in nonverbal as well as verbal communication and imaginative activity, and a noticeably restricted display of activities and interests as well as a pattern of repetitive behavior. The signs of autism usually appear before age three, and the disorder affects four times as many boys than girls. The New Jersey Center for Outreach and Services for the Autism Community estimates autism affects 1 in every 500 people.

As a result of the severe social, communicative, and behavioral problems associated with autism, firefighters and emergency medical technicians should be aware of the following when encountering an autistic child or adult.

Behavior of the Autistic Person

  1. May be unaware of danger as well as incapable of realizing a danger.
  2. Reactions and responses to events may vary and be unpredictable.
  3. Up to forty percent of the autistic population may have seizure disorders.
  4. May exhibit a high tolerance for pain.
  5. 5. Skill development may be uneven as evidenced by behavior that is not age-appropriate.
  6. Atypical reactions to sensory input. May fixate on lights, sounds, and objects such as flashing lights, sirens, and glimmering objects.
  7. May be attracted to water.
  8. Inability to communicate verbally and, as a result, may appear argumentative, stubborn, or belligerent and resistant to changes in routine. However, 50 percent of the autistic population is nonverbal and may utilize sign language, picture boards, or other communication devices to communicate.
  9. May run away if left unattended.
  10. Appear as socially distant and as if other people are objects.
  11. Marked physical overactivity, may rock front to back and side to side.
  12. May engage in aggressive or self-injurious behavior.
  13. Repetition of the same word(s) or phrase(s).
  14. Lack of eye contact, may be poor listeners and act as though deaf.

Considerations for First Responders

  1. Speak calmly, allow time for a response to questions or directions, repeat the request or words, talk in short and direct phrases, and make one request at a time.
  2. Use calm body language, avoid abrupt moves or actions.
  3. Do not crowd, allow as much room as possible.
  4. Avoid waving arms or using a lot of hand gestures.
  5. Do not pat shoulders or touch face unless necessary for examination.
  6. Do not attempt to stop repetitive motions unless they are potentially harmful to themselves or others.
  7. Do not leave unattended or unsupervised.
  8. Be alert to sudden attempts to re-enter a dwelling or occupancy./ol>

    Additional Considerations

    1. 1. The local fire department should be informed of residences where an autistic person(s) resides so they can be included in preplanning, special needs/alert lists, etc.
    2. Family members/caregivers should be encouraged to consult with their local fire department to determine a fire emergency action plan suitable to their particular needs.
    3. The installation of additional smoke detectors in specific bedroom(s) and other rooms as well as on every floor level to enhance early detection capability.
    4. Upon exiting a residence in an emergency, a particular family member/caregiver should stay with the autistic person. The autistic person should never be left unattended.

    Thanks to Dennis Debbaudt, author of “Avoiding Unfortunate Situations” (1994) and a 25-year veteran of law enforcement, for his contribution to the information presented here.

    Vincent J. Vitiello is a captain/executive officer with the Maplewood (NJ) Fire Department. He is a state-certified fire official and level 2 fire instructor. He has one bachelor’s degree in health and physical education from William Paterson University and another in fire safety administration from Jersey City State University, He is a licensed social worker with one master’s degree in public administration from Kean University and another in social work from Fordham University.

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