911 Telecommunicators Response to Autism

Autism is becoming more prevalent every day. The Center for Disease Control and Prevention released new statistics in 2018. Nationally, 1 in 59 children have autism spectrum disorder (ASD) and boys are 4 (four) times more likely to have autism than girls.

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1 in 37 boys and 1 in 151 girls were found to have autism. These are incredibly high statistics that will affect our communities across the United States We, as Telecommunicators, need to know how to understand and help them appropriately. As of now, Adults who have autism do not have many services to aid them. Society has forced the parents to raise and support their adult children because there are not enough resources readily available in order for them to function in society. Because of how strong these children and adults are, the parents are unable to control them physically causing them to call 911. 911 centers, nationwide are having an increased amount of calls involving children and adults who have autism.

What is Autism

Autism Spectrum Disorder (ASD) is a developmental disability that can cause significant social, communication and behavioral challenges. These disorders are characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors. Every autistic person is different and may react differently. Their disabilities can range from gifted to severely mentally handicap. The cause is unknown and there is no cure for autism. Autism is a disorder that affects the brain. However, it affects much more than that. It affects emotions, maturity, common sense, judgement, eating, hearing, pain tolerance, strength, the way they move and the way they communicate. Most importantly, it affects the family too. Everyone around autism is affected. As 911 call takers, we need to remember that when you are dealing with the family members.

It is important to know that people who have ASD look the same as ‘normal’ people.

In picture one, the child looks like a typical child who is happy. In picture two, the child looks distant, tired, unfocused and irritated. He is the same child just at different times of the day. This is Austin, my son. He is diagnosed with autism, mentally retardation, oppositional defiant disorder (ODD), severe mood disorder and phonological disorder.

Autism Characteristics

When understanding autism, it is important to know the different characteristics that a person with autism may have and how to handle the situation. When a person who has autism calls 911 and needs help or is in a situation where first responders must respond, it is important to know how to handle these situations effectively without causing injury to the first responder or the person with autism. You need to know different techniques that can help deescalate the problem without adding to it. Try to remember there is always a reason for them to be acting out. Here are characteristics of autism and ways that will help you interact effectively:

  1. Having Trouble Understanding Feelings and Judgement
  2. People who have autism have a hard time understanding other people’s feelings or even their own. If they are feeling upset over something, they don’t know how to express it appropriately to let their caregivers know. When speaking to first responders, people with autism may have confused response or no response at all. Some may curse using the same phrase over and over or it will sound scripted. Because of being anxious, their behavior will escalate. They will continue this escalated behavior for a short time and then they tend to calm down.

    As the Telecommunicator, you will need to give them extra time talking. Listen to what they are not saying. Do not judge them for what they say that may come off rude. They will appear to be the bad guy because of the way they act at times. When spoken to, they may become very anxious and confused.

  3. Delayed Speech and Language Skills
  4. Autistic people may have delayed speech or problems with their language skills. For some people who are mildly affected by autism, they have slight delays in language or have large vocabularies but cannot sustain conversation. People who are severely autistic cannot speak at all or say words that are difficult to understand. If they cannot speak, they can use sign language, word processors, speech generating devices (IPAD), or pictures to communicate. Some have problems understanding jokes, phrases with more than one meaning, or sarcasm.

    As the Telecommunicator, you will need to slow down how fast you talk. Use simple words with no slang or sarcasm. Do not use jokes. If you are speaking to someone who has contact with an autistic person who cannot speak, ask them if they have the IPAD, word processor, or computer with them. Ask them to try sign language. Check for ID bracelets, anklets, shoe tags, or an autism card. Most parents or caregivers have their information written down on a card that should be with the autistic person. When speaking to them, use simple and short commands such as “Go inside.” Don’t give a list of things for the person to complete. They will not process everything that you said. When dealing with children who have autism, if you are not getting a response, you can try to use the fill in the blank method. Example: Austin say “My address is _______.” This will sometimes result in the child giving their address. Make sure when they give you the answer that you praise them.

  5. Repetitive Behaviors
  6. A common symptom of autism is repetitive behaviors. They may flap their hands, rock back and forth, jump and twirl, arrange and rearrange objects, repeat sounds, or spin in circles. Sometimes the behavior can be self-stimulating. They will do the repetitive behaviors to calm them in a hectic environment and to block out the over stimulating situation. Sometimes they will show self-injurious behaviors. They don’t realize the consequences of hurting themselves. They sometimes will beat their head against a wall because they are mad and do not feel the pain. Some will bite themselves until they bleed or they will hit walls with their feet or hands.

    As the Telecommunicator, you will need to give them time to get through their repetitive behavior. Do not interrupt the behavior unless it is dangerous. Be understanding and calm. If you sound irritated, you are more than likely going to get an elevated response from the caller. Ask the caller about injuries. Sometimes the child will not be able to tell you they are hurt.

  7. Lack of Awareness to Danger or Elopement
  8. People who have autism sometimes don’t think about what may happen if they do run into the road or do something that has a consequence. Most elope and wander away from their safe places. They could be wandering because they want to get to something that interests them (train tracks, water, park, or their safe place) or scared due to sensory issues. According to Autism Speaks, 50% of people with autism, of all ages, run or wander from their safe environment. In the United States, accidental drowning was the cause for 91% of deaths amongst autistic children. They have a tendency to go to places that have water. Other dangers that could occur are; getting struck by a vehicle, dehydration, falling from a high place, hypothermia, abduction, victimization, and assault.

    As the Telecommunicator, use google maps or any other resources you may have, to see where bodies of water are and instruct first responders to those locations to check for the missing autistic person. Ask the caller where the person likes to go and if there are any friends or therapists in the neighborhood.

  9. Inappropriate Responses
  10. People who have autism have difficulty expressing themselves correctly. Sometimes they will laugh about something that is not funny, or they will tell a joke that makes no sense at all. They may curse at you but it makes no sense or seems scripted. They lack appropriate social skills.

    As the Telecommunicator, ensure that you are unfazed by what they say. They could use profanity, but not really understand what that means. Be calm.

  11. Sensory Processing Problems
  12. Many people who have autism have an unusual response to sensory input. They have difficulty processing sensory information and cannot handle loud sounds or bright flashing lights. They will not respond to you when these things are going on. Some have problems with eating certain foods because of the texture of the food. Some are adversity to touch and don’t like to be touched at all.

    As the Telecommunicator, ask the caller what the autistic person does or does not like. If you have the ability at you center, add a note on their address about sensory problems. It is not recommended to have an officer respond to the autistic person with lights and sirens on due to frightening and overstimulating them. They may become violent.

  13. Temper Tantrums
  14. Children who have autism typically have temper tantrums because they cannot regulate their emotions. They can display very immature behavior such as having outbursts or crying in inappropriate situations. They like schedules and if you get off course, they tend to get very upset. While having a temper tantrum they will scream, possibly run, kick, hit, curse, bang their head or pull their hair. These situations happen a great deal in stores because they are overstimulated.

    As the Telecommunicator, you will get these calls from citizens and they will not understand what is going on. Get the best information you can on the people who are involved. See if you can find out if they believe the child may have a mental disorder. If so, notify your units, so they can ensure the safety of the child.

  15. Contact Parents or Caregivers

Whenever you are dealing with people who have autism, it is best to have their parents or caregivers there when First Responders are speaking with them. They will help the person calm down and be able to tell you what the person is adverse to instead of you having to learn that on your own. If you have contact with the parent or caregiver, find out where they may go, if they have sensory problems, and what their likes and dislikes are. This is all very helpful information for you to have when first responders are out with them. If you are speaking to them on the phone, try finding out what their favorite toy or game is. Talking about their favorite game or toy will calm them down and distract them from the problem.

It is very important that you remember, everyone who has autism is unique. No two autistic people are the same. Every year, the numbers for autism gets higher and that means you will encounter them more frequently. Try to remember that the caregivers have a tough job and they need support and encouragement too. Autism is not curable. You cannot go to a store and get medicine to fix it. You may be able to get medicine that will reduce the behavior, but it does not cure it. However, if you believe an autistic person is being abused, notify an officer and let them evaluate.    

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