Solving the Autism Puzzle Creating a Broad Spectrum Tool to Improve Care Delivery in the Clinical Setting



Autism spectrum disorder (ASD) is a developmental condition that affects how people communicate and interact with others. People with ASD may have different sensory and behavioral needs, which can make it challenging for them to cope with unfamiliar or stressful situations, such as undergoing surgery or a medical procedure.

To address this issue, a team of researchers from Seattle Children’s Hospital developed and implemented a quality improvement (QI) project to create a broad-spectrum tool that can help identify and meet the specific needs of patients with ASD in the perioperative setting.


The Project


The project involved three main steps:

  • Developing an assessment tool that can capture the sensory and behavioral preferences of patients with ASD, such as their preferred sounds, lights, smells, touch, and activities.
  • Providing education to perioperative staff members on how to use the tool and how to care for patients with ASD, such as using visual aids, social stories, and positive reinforcement.
  • Providing sensory aids to patients with ASD, such as headphones, weighted blankets, fidget toys, and aromatherapy.

The project aimed to evaluate the outcomes of the intervention on three metrics:

  • The satisfaction of perioperative staff members with the tool and the education they received.
  • The number of behavior response team calls made for patients with ASD, which indicate a crisis situation.
  • The experience of families of patients with ASD with the perioperative care they received.


The Results


The project involved 250 staff members and 50 patients with ASD who underwent surgery or a procedure at the hospital. The results showed that:

  • The staff members reported a significant improvement in their ability to meet the needs of patients with ASD after the intervention (P < .001).
  • The staff members rated the sensory aids and the assessment tool as very useful and stated that they would continue to use them in the future.
  • The number of behavior response team calls for patients with ASD decreased from 12 in the pre-intervention period to 4 in the post-intervention period.
  • The families of patients with ASD reported a high level of satisfaction with their perioperative experience and appreciated the individualized care they received.


The Implications


The project demonstrated that using a broad-spectrum tool to assess and address the sensory and behavioral needs of patients with ASD can lead to better outcomes for both patients and staff members in the perioperative setting. The tool can help reduce stress, anxiety, and agitation for patients with ASD, and increase confidence, competence, and satisfaction for staff members.

The project also highlighted the importance of collaboration among different disciplines and departments, such as nursing, anesthesia, surgery, and psychology, to provide optimal care for patients with ASD. The project team plans to share their findings and tools with other hospitals and health care settings that care for patients with ASD.



What is the name of the assessment tool?


The assessment tool is called the Autism Spectrum Disorder Perioperative Assessment Tool (ASDPAT). It is a 10-item questionnaire that can be completed by the parents or caregivers of patients with ASD before their surgery or procedure.


What are the benefits of using the ASDPAT for patients with ASD and their families?


The ASDPAT can help improve the quality of care and the safety of patients with ASD by:

  • Reducing the risk of adverse events, such as agitation, aggression, self-injury, or elopement, that may occur due to sensory overload or misunderstanding.
  • Enhancing the communication and collaboration between the perioperative staff and the families of patients with ASD, and ensuring that their preferences and needs are respected and met.
  • Increasing the comfort and satisfaction of patients with ASD and their families, and decreasing their stress and anxiety levels.


How can I prepare my child with ASD for their surgery or procedure?


There are several ways you can help your child with ASD feel more comfortable and less anxious about their surgery or procedure, such as:

  • Visit the hospital or clinic before the day of the surgery or procedure and familiarize your child with the environment, staff, and equipment.
  • Use visual aids, such as pictures, videos, or social stories, to explain what will happen during the surgery or procedure and what to expect afterwards.
  • Bring your child’s favorite sensory aids, such as headphones, weighted blankets, fidget toys, or aromatherapy, to the hospital or clinic and use them during the surgery or procedure.
  • Communicate with the perioperative staff about your child’s sensory and behavioral preferences and needs, and ask them to use the ASDPAT to guide their care.
  • Provide positive reinforcement and praise to your child for their cooperation and bravery.


How can I support my child with ASD after their surgery or procedure?


After the surgery or procedure, you can support your child with ASD by:

  • Monitoring their pain and discomfort and providing appropriate medication and comfort measures as prescribed by the doctor.
  • Following the discharge instructions and providing adequate rest, hydration, and nutrition for your child.
  • Resuming your child’s normal routine and activities as soon as possible and providing structure and consistency for them.
  • Seeking professional help if you notice any signs of regression, trauma, or distress in your child.



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