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“Parenting a Child with Autism: What Should I Do In a Crisis?” Six Tips to Prepare for a Mental Health Crisis in Children on the Autism Spectrum
For some children with autism spectrum disorder (ASD), the core symptoms of impaired communication, social skills and repetitive behaviors are just the beginning of the challenges that they face. An ASD diagnosis also brings an increased likelihood of receiving a secondary mental health diagnosis, such as depression, anxiety and psychotic disorders, many of which manifest in severe behaviors that can quickly escalate to a crisis situation for a child and their family.
Researchers at Baltimore’s Kennedy Krieger Institute recently conducted the first study to compare mental health-related emergency department visits between children with and without ASD. They found that mental health-related emergency visits are nine times more likely if the child has an ASD diagnosis compared to typically developing peers. The study found that externalizing symptoms, such as aggression, self-injury or impulsivity, were the leading cause of emergency room visits among children with ASD.
Dr. Roma Vasa, senior study author and a child psychiatrist in Kennedy Krieger Institute’s Center for Autism & Related Disorders, encourages parents to plan ahead for a mental health crisis, even though the circumstances may be difficult to predict. She offers the following advice:
- Schedule a visit with a psychiatrist before an outburst occurs. If your child is having behavior problems, a psychiatrist can recommend treatments that can reduce these behaviors before they reach the level of a crisis. Schedule more frequent visits with the psychiatrist if the behaviors are getting worse. Identify risk factors and seek input on what do in an emergency situation.
- Prepare a crisis emergency plan. Before a child’s behaviors put him and others in a dangerous situation, have an emergency plan in place that clearly outlines what steps caregivers and professionals should take if a situation escalates. This plan may consist of specific behavioral interventions/medications, calling 911 or taking the child to the nearest emergency room.
- Have routine discussions about the emergency plan. Talk with everyone involved in the life of a child with autism about what to do in the case of an emergency and share the crisis emergency plan. These individuals might include relatives, school professionals, clinicians, friends, local law enforcement, community members and others.
- Locate and visit your local emergency department. Call ahead to see if it is possible to meet with an emergency department manager in order to plan for an unexpected trip. While some will not grant this request, you can drop-in to get a sense of the environment and what may occur upon arrival during a crisis.
- Identify inpatient psychiatric units that your child may go to if he needs to be hospitalized. Plan ahead for possibly transporting your child there, make arrangements for the care of siblings, talk with your employer about taking time off to visit your child and talk with the treatment team.
- If you have private insurance, find out more about the psychiatric care that is covered under your policy. Know your options for outpatient, inpatient and emergency department mental health treatment and ask your child’s care providers to help you advocate for the services that you need.